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038-1239-22-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) 579011 State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, S.15.04 (1)(m)]. Permit Holder's Name: City village Township Parcel Tax No: Francis J. & Paula Nauss TOWN OF STAR PRAIRIE 038-1239-22-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: ~n1 G'S ( 17.31.18.1283 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURE CAPACITY STATION BS HI FS ELEV. :5.75 s5. Septic Z'n Y Benchmark W"e6er g. 6 16b6 -T 3.13, 166 Dosing v f Alt. BM 4 7.7Z- g5. y5 P Bldg. Sewer a /a it ;57Z-5 I )t 11• to S6.57 Holding St/Ht Inlet * l#4 79.x3 TANK SETBACK INFORMATION St/Ht Outlet A 1#-'671 -7 Irv TANK TO P/L WELL BLDG. Vent Air Intake ROAD Dt Inlet A-<< /s 7 7, Septic ~ 6 ~ 27 ~ Dt Bottom Dosing /`/•Z 73 93 7 56, (Afd ~ !0 3 1 _ Header/Man. ?944 Aeration Dist. Pipe I '(Pt aQ • /,q Holding Bot. System 10 ( ! 7.Z2, 98.53 PUMP/SIPHON INFORMATION Final Grade Manufacturer ((r 5.5 ~G~ • Z~ d C, I C ~ GPMand St Cover Model Number /40 7_9 •0, / 1 Tr L. 491-17- 3 DH Lift Friction Loss System Head 7DH Ft z5.z1 2.75 3.Z5 r31•L1 / . 1 •Z3 93.! N-9 F6.9`/ Forcemain Length Dia. Dist. to well / b Z A)A SOIL ABSORPTION SYSTEM BED/TRENCH Width Length / No. Of Tre PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS / L[-3 C :Is SETBACK SYSTEM TO f0 T P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type O System: Mo /J 56 ~#4 /v111114- UNIT Model Number: DISTRIBUTION SYSTEM -re. Header/ManJrfold Distribution / x Hole Size Ix Hole Spacing lVeto Air Intake 'ri 1, 5 Pipe(s) S J g L / Length Dia Length ~I•, Dia v Spacin 3 3 , G~ e4-. SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over _TT Depth of Seeded/Sodded xx Mulched Bed/Trench Center 7/ Bed/Trench Edges psoil T Fv] Yes Fit] No ❑ Yes Q No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 9IZ$ f Inspe 'on #2: Location: 956 218TH AVE 1.) Alt BM Description= SGP+'~- `F;.k 17.1JA_ 01 2.) Bldg sewer length = + 27 I ! W - amount of cover = I /1 n ~i Ina?^ S 1.pC, O I~ Plan revision Required? ❑ Yes N'No 9 36 ~3~7$ Use other side for additional information. SBD-6710 (R.3/97) Date Insepc s Sign ~1 re Cert. No. PUMP PERFORMANCE CURVE w PUMP PERFORMANCE CURVE PUMP PERFORMANCE CURVE SUMP / EFFLUENT MODELS LL 3~8',1rr~ 3Ea EFFLUENT A°ssw CAPACITY 318",112" & 3/4" SOLIDS PASSING CAPACITY ' 5N55 1 MODEL 48 57159 72 76 98 . 137639 14014140 151 152 153 1st Feet Meters Ga. Liters Gal. Liters Gal. Liters Gal. Liters Gel Lifers Gel. Liters GaL Liters Gal. Liters Liters Gat. Liters 1 5 1.5 29 110 43 163 38 144 50 189 72 273 93 352 86 326 50 189 69 261 77 291 10 3.1 22 83 34 129 30 114 40 151 61 231 M 299 80 303 46 170 61 231 70 285 38- 7 15 4.6 10 38 19 72 14 53 30 114 45 170 64 242 73 276 38 144 53 201 61 231 20 6.1 - - 17 64 25 95 36 136 66 250 29 110 44 167 52 197 1 25 7.6 - - - - - - - - - - 8 30 59 223 16 61 34 129 42 159 36- N4186 30 9.1 - - - - - - - - - - - - 49 185 - _ 23 87 33 125 40 122 - - 28 12 - - - 11 42 34- tt 5D 152 - 60 18.3 - - - - - - - - - - - - - 32 i 70 21.3 - - - - - - - - - - - - - - - - - - - 24.4 - - - - - - - - - - - - - - - - - 80 - - 30- 95 K\ - - - - - - - - - - - - - - - - - - I 27 90 .4 - 100 VA - - - - - - - - - - - - - - - - - - 30.5 - - - - - - - - - - - - - - - - - - - 110 33.5 - 5 - - - - - - - - - - - - - - - - - - 28- 120 36.6 - - - - - - - - - - - - - - - - - - - 130 39.6 - 26- gl- Shu9oft Head: 1 18 fL5.5m 1925 R 5.9m 18115.5m 25 It. 6m 23 fl .Om 26 R (7.9m) I 5D fl.15.2m 30 R 9.tm 38 8 11.6m 44 iL113.4m °a 804 2 165 4165 z 7 Y 15114161 163/4163 16514165 185/4185 18614186 18814188 18914189 191 0 4153 G.L U1- GaL _Lem GaL Uh- Gel. Liles CaL Liters Get Utm Gal. Ulna Gel. Laws 20- 65_ 100 379 61 231 61 231 s8 220 145 549 145 549 45 170 93 352 61 231 61 231 58 22 140 s30 140 530 45 170 1 161 189 85 322 60 227 61 231 - - 58 220 134 507 135 511 45 170 4161 4189 79 299 59 213 60 227 58 22 128 484 131 496 45 170 70 265 57 216 59 223 58 220 122 462 125 473 45 170 e 62 235 55 206 58 22D 85 322 58 220 116 439 120 454 45 170 ' 45 170 46 172 55 206 70 285 58 22D 104 394 109 413 45 170 18B 14- 41 4188 20 76 33 125 s0 189 51 193 58 220 90 341 97 367 45170 15 57 39 148 32 721 58 220 71 269 86 322 45 170 23 67 9 34 52 197 51 193 M21,1 45 170 12 10 38 45 170 26 106 45 170 753 - 31 117 2 8 45 170 16 80 40 151 a is 30 114 4885 - - - - - - - - - 20 76 - - 10 38 56 R(17.1 m 66 R(2.tm) B9 R(26.4m 73 KkT.) 114 fL(34.7m) 91 R(27.7m) 810 M33.5m) 137 R(41.8m) 6- 2D- ' 009922 1 2 ® CAUTION Model 185/4185 should not be subjected to 4 7" 53,55 76 ±131 less than 30 feet TDH. 57.59 NOTE: For Pump Performance on Model 112, industrial column 0 10 2D 40 50 50 70 60 90 100 110 120 130 140 150 explosion proof pump, see FM0219. GnLLONs LftERS 0 80 160 240 320 40D 48D 56 FLOW PER MINUM SEWAGE AND MODEL 211 264 266 267 268 2704270 282/4282 264M284 292/4292 29314293 294424 295142% w w w r.. ~ cn ~ 4 ca ~ µ ac ura as m ue sa a,~ ~ ae DEWATERING . .w _ 4y . " al III ID 5) 22- s s +a a e w a a+ zn e m w we 24- ua sw w - - - - - - - - - - o 70 uz - - - - a Iw xs 20- 65 +asana.u easan asuae., asuare aaau.n aurs.i unrw szMi wansa, wueri aama.i 0 4 a 11360 009904 = 55 2 16- < SD < p 14 45 293 r 12 40 PUMP PERFORMANCE CURVE 35 30SEWAGE MODELS 25 2" SOLIDS PASSING CAPACITY 266, 282 270 6 20 267, 15- 4- to- 2- 5 211 264 232 284 294 295 A CAUTION Model 293/4293 should not be 0 GALLON 10 20 3D 40 SD 60 70 80 90 100 110 120 130 140 t50 162 170 180 190 200 210 subjected to less than 15 feet TDH. 220 23 LfTERS p 80 160 240 320 400 480 560 640 720 800 ROW PER MINUTE © Copyright 2003 Zoeller Co. All rights reserved. 6 SQuAw LAKE ts~~T~ s Zo- ZZ d g)til EL. = /cc.oo Toe Or L'' PVC DIPS . A r. g ►'n 6L, = 97,oZ S Top o N ®Bo,et C©N CLJ.Q L, AJJ t t, = 97.35 Z'' f=otcc m ai+u /00 ~o a Z tow GAL. IT. PROM61,0 t TOOL f< u P~SIO boo GA-L. R v~P od' L" ~=oece N - sJe. OR'- ~-Q tl~1a 4 30-Ox 86'J' g3\ m Ou ti CON rou~ L/ nl/c Q' I (b~ y PAT ~ x}W~ub LOS; PRAWW& 9V Cu RT ~~Co $s,o n1 - 7<~Z,4 /)4" i 2-~)UA&n s% r' /oo ~e,~iE~sET W-T svoa25 W 'lY ~ t' ~o t Ens E 7 1,t1 I Lsy~' 2 S ~Y -5 /7 /_3% JR !8 ►J U376 D ry Coun Safety and Buildings Division% , C 1 C i 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) i ` P Madison, WI 53707-7162 -5-6 3 Y .6-Co ermit Application ~ State Transaction Number WAG:rr In accordance with SP 1(2 s. Adm. Code, submission of this form to the appropriate government ~7 S/ v is required prior to obt a itary permit. Note: Application forms for state-owned POWTS are submitted t Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be usee~jsecondary O purposes in accordance with the Privacy Law, s. 15.04 1 m , Stats. CC S-~ Z1,9 7 VC I. Application Information - Please Print All Information Property Owner's Name azcel # U 5 `°u o 1 2 3 1 Z Z- 000 Property Owner's Mailing Address ,L ~~t.! y~ Property Location d~( 13 3ie[ 86 E 7- Govt. Lot City, State Zip Code Q Phone Number Q v. /V F Section, 1 7 //LL LO / F~ CO U~8 T 3 N R / irclEo / H. Type of Building (check all t tat apply) Lot # I or 2 Family Dwelling - Number of Bedrooms Z Subdivision Name Block # S U L0 L ~4 K" 6 i xT ❑ Public/Commercial -Describe Use ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of iaTo.of S7,4 A-4 )o e/4 /4JI /L III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A ® New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. Permit Renewal Permit Revision ❑ Change of Plumber Permit Transfer to New List Previous Permit Number and Date Issued ❑ ~-0/ Z9 ~ 2 dv -7 Before Expiration Owner Fi IV. T stem/Com nenUDevice: Check all that apply) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At- Mound > m. uitable soil C. --)d < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) Pre treatment Device (explain) V. Dis rsaVlYeatment Area Information: Design Flow (gpd) Design Soil Applicaton RaWgpdsfk Dispersal Area Requi (s ispersal Area Pro (sf) System Elevation 'tj~v 0 0.G'//. o 411 750 4) /5-91 S s~ 910. S' Z VI. Tank Info C ity in Total # of Manufacturer Gallows Gallons Units c v ° New Tanks Existing Tanks ~e e U a U yr rn w C7 P. r Septic or Holding Tank /000 /000 WVV Dosing Chamber 75-0 75-0 1 S rC VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum a MP/MPRS Number Business Phone Number N ro Sc 14 m Z Z 3 7(0 71S-760-&L18,6 Plumber's Address (Street, City, State, Zip Code) / /150 ' A v E flYG mat' S!` iy l/ 1^ BYO Z J VI Coun epartment Use Only ` Approved ❑ Disapproved PermQit Fee D Issued Issuing Age! S. ❑ Owner Given Reason for Denial IX. Conditions of Approval/Reasons for Disapproval Attach to complete plans for the system and submit to the County only on paper not leas than S r/z z t t inches in size 661 SBD-6398 (R. 11/11) . SQu~w L~K~ Cs~~-T~ s Zo- ZZ PRUJOEIeTy pNC - gm EL. ioP or'L'' PvL D/PF A A LT. $ M 6L. = 97,a 5 ~ 'oo o PA N ®Bo,et H~~F CoN AJc t L = 97.35 ~o .o 1 = 6 o Nom. Z 1000GRL 5.~w/PROM640 f roOL. s° os v tt, 6 5 o g1° 800 /+L. P. c 190 gyp' /od' L" ,=aece Y;A N CIL% p R TQ t, rJ, CON roiLA~ \ \ IpA ti -Alt 97- 7! z R, .e a s% x' goo Se,~~E~sET W_T 'yoa.s 6 /SorK v . N w 'lY ~1 r 'l _ s_ i i31 NR 19 ►J e2 376 D Safety and Buildings 4003 N KINNEY COULEE RD commercemi.gov LA CROSSE WI 54601-1831 TDD (608) 264-8777 i seo n s i n www.commerce.wi.gov/sb/ ltiof Commerce www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary August 07, 2007 CUST ID No. 223760 ATTN.• POWTS Inspector JOHN F SCHMITT ZONING OFFICE SCHMITT & SONS EXCAVATING ST CROIX COUNTY SPIA 586 VALLEY VIEW TRAIL 1101 CARMICHAEL RD SOMERSET WI 54025 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/07/2009 Identification Numbers Transaction ID No. 1425906 SITE: Site ID No. 728631 Curt Jacobson Please refer to both identification numbers, 218TH Avenue above, in all correspondence with theagency. Town of Star Prairie St Croix County NW1/4, NE1/4, S17, T3 IN, RI 8W Lot: 22, Subdivision: Squaw Lake Estates FOR: Description: Three Bedroom Mound System / New construction Object Type: POWTS Component Manual Regulated Object ID No.: 1145291 Maintenance required; 450 GPD Flow rate; 22 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD-10691-P (N.01/01), Pressure Distribution Component Manual - Version 2.0, SBD-10706-P (N.01/01) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The area within 15 feet horizontally down slope of the dispersal cell shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the effluent filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • Comm 83.22(7) - A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. P.O.W.T.S. Conditionally APPROVED DEPARTMENT OF COMMERCE hwlelnan nE CACCrv nun Cum nwne JOHN F SCHMITT Page 2 8/712007 Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 T Fee Received $ 175.00 Balance Due $ 0.00 Gerard M Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swim@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. - - - - - d I ESceveo SCOTT & SONS EXCAVATING JUL 3 1 2007 586 Vaney View Trail Som715 =4 W7 si025 SAFETY & B(i1LDI CGS II AIOUND N YNTFM For. ~ jacabson Address:. 712 Rivard St. #100 Somerset, WI, 54025 Legal: NW a NE a S 17 T 31 NR 18 W Township: Star Praire County: St. Croix Conti Page 1 Plot Plan Page 2 System Cross Section Page 3 Pipe Lateral Layout Page 4 Dosing Chamber Page S Pump Curve Page 6 Management Plan Attachment 1 Soil Evaluation Report Attachment 2 Map Mound Component Manual (Version 2.0) SBD-10691 P(N. 01/01) Pressure Distribution Component Manual (Version 2.0) SBD-10706-P(N 01/01) By. AIPRSW 223760 Date: 7/25/2007 JGCCL~icf _ ~ . RR ONDENCE SEE CO 5QUAW L4KE CSTAT~ S Lo% ZZ PQopEieTV ae. AL- Bm EL. = /tom ~TOP or V' PVC- P/PE A ALT. .6 n EL. = 97,aS Top o ir Z OvC p,ac N ®Bo~E H~~F s CDIU rc4lp L ! ,0t L. = 973S" Jlxh~ Z f=o~~c" rrt /J iN /00 i _ Woo low GAL 5,",F, w1 Pkvm6LO t root 00 s0 0 ~L. p. 1 90 . o P odd Z" ~=oecE 1AJ ON . • 3o.oX ~s.~ ' jai\ c ON FO 1 atA I~'O/~±~W i u b Fob ° Cu RT._ACo gs o nJ 7! z. R,~,~.en s% /oo /6 /SorK 4vF. 50 n t ce s 6T ICI Z~ ,S YOa s I FMS E 7 1,t1 I ' 2 5 !J w'~Y /~t 5./7 T.3! NR !9 ~J ~t25 X376 D System Cross Section Page 2 Of 6 Synthetic Covering ASTMC33 Distribution Pipe Medium Sand H a Topsoil E F SYS. ELEV. 98.52Ft. D Y % Slope 2 %2 Force Main Plowed 49gregoYe Layer D 1.17 Ft. E 2.15 Ft. Cross Section Of A Mound System • F 0.79 Ft. G 0.50 Ft. A 7.0 Ft. H 1.00 Ft. Signed' B 64.3. Ft. License umber: 223760 K 10.4 Ft. Date: 7/25/2007 L 85.1 Ft. j 5.2 Ft, Alternate Position 1 17.8 Ft. of Force Main W 30. 0 Ft. L Observation Pipe 6 K d I ( _ _ ( \ Force Main ■ r Distribution z - 2 z Pipe Aggregate Observation Pipe 3 iv Permanent Markers ~ FR.~ t3~N trNDS Plan View Of Mound Tura-up With Cieanout Access BQx Plug or Batt V" PVC Force Main Distribution Lateral ,a PVC Manifold P _ X X X X/2 Distribution Lateral Layout P 31. Ft. . S 4: 0 Ft X , 36 „ Incha% Hole Diameter 3/1 6 Inch Signed: Lateral it 1k Inch(es) License h~m/ber: 223760 Manifold Inches Date: 7/25/2007 Force Main " 2 _ Inches # of holes/pipe 11 Invert Elevation of Laterals 99.02 Ft. i I J PACF 4 Or 6 PUMP CHAMLER CROSS SCCTSO+J AMD SPCC11rfCAT'/OA1S VCIJT.. CAP' &CC.i. VCUT FIN fl, WCAT14CK F&OOF APPROVED LOCKlUro T .IUycTlals eo>< 7MANNOLC COVER 'a-ml w Uu IV 6940664 Alit 1YTAKC I GRA DC ( M' MJ1J. IOr' IJJ. r.~~wrr..n r.r COUGUIT IOC/~ ' \ 1 1 PROVIDE JA1LCT AjM464T $CAL 1 ' ~ III I I I APPUpvtc ,laluil Att'ROYEO JOW? A I 11 I M►/c. NBC CJ<TClJD1Ail•F 3' I II ALARM CXTCA41wro JD1dTO &06M W6 ~ I olaro MUD BOLL 21.16 Gal./Inch I I I I om . C I I CLCK 7. 9-02t PUMP--., Off 0 COUCKETC UDCK I KISCR CXIT PCRIAME6 CAJLS IF TXWK MAJJUFACTURCR NAS Such ArPILOVAL. Was INI >6ttTIC SPCC.IFICATIOUS DO~f MuwUTACT1J1tCR:--_$~P.. I•Iw'WtR OF DOiCb: +or-5 PER TA3JK WZ9 8Q0 OALLObis DOSE YOLU14C A MAUUMGTUILU: _Septronics Tankmate 04CA-U014444 6ACKP60WI 87.04 O~~~out IKOOCL I.IL3MaClti TM-1 CAPACITICSI A- 19 WCHU CA413 44 4ALLOQ& SWITC,W TISPtf Mercury b 9 jUCxtt 0R 4. 33-520OLOUS UMP Jti11JUfACTWtCItS Zoeller .4111GNCi OR GALt0111i A40"16. NLIJK&W. I 0 _12 lA1GNF4 OR26`.1.: 1? GALLOur 152 4W1,TGi4 TYIFCt nical SuoT_ PUMP A1J0 ALARM ARE TO Ot M1IJIMIl/~ OIiCI~ARGC .4_.GFM IIJSTAtLEG Ou SEPARATE CIRCUITS VERTICAL W ELLWX B&TWMJ PU" OFF AUO.OJbTR&pUTIO+J PIPC.. •2.0 ' 0 FE C Y t P'4.Wp U^ WCTWOAA 6UPPI tj Psmtsurx . . , 3.25 FCCT + FLCT Or rOIKC OrM11J X 1.~.rJwo►LFRIC1I0W FACTOR.. 1.83 FEE t' » TOTAL DUUA41C. NEAO = 25.08 Fr,-Er WT&SLUA6 OIM Jl,o!•Ih. or T KS LEAJ(iTH _..,...,.;wJOTti♦ , LIQu10 OIiPTH 3..3-~ .'~~CO LICENSE wupkee K., 223760 7_ /25/2QQ• TOTAL DYNAMIC HEAD/CAPACITY HEAD CAPACITY CURVE PER MINUTE EFFLUENT AND DEWATERING iQ MODEL 152/153 E w MODEL 152 153 U- 50 Feet Meters Col. Liters Col. Liters 153 5 1.5 69 261 • 77 291 121- 40- 152 10 3.1 61 231 70 265 15 4.6 53 201 61 231 = 20 6.1 44 167 52 197 30 8 25 7.6 34 129. 42 159 30 9.1 23 87 33 125 20 35 10.7 22 85 ~ 40 12.2 - - - - 11 42 o 4 Lock Valve: 38.0 Ft. (11.6m) 44.0 Ft. (13.4m) 10 0145M 0 20 40 60 80 100 GALLONS LITERS s /a 0 80 160 240 320 3 27/32 4 5/8 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS 3 27/32 • Timed dosing panels available. ® 7 3 27/32 • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik-Box available for outdoor installations. See FM1420. • Over 130•F. (54°C.) special quotation required. 1511153 Series 12 1/8 15W53 MODELS control Selection Model Votis•Pln Mode_ MW SimplIn Duplex - 5 1 /8 N152 115 1 Non 1 2 or 3 BN152 115 1 Aulo 8.5 klckded 2 or 3 SK2W E152 230 1 Non 43 1 2 or 3 SE152 230 1 Aulo 4.3 knckded 2 or 3 N153 115 1 Non 10.5 1 2 or 3 SN153 115 1 Aub 10.5 bckded 2or3 SELECTION GUIDE E153 23D 1 Non 5.3 t 2 or3 1. Single piggyback variable level float switch or double piggyback variable level float BEV 230 1 Aulo 5.3 Included 2 or 3 switch. Refer to FM0477. o CAUTION 2. See FM0712 for correct model of Electrical Altemator E-Pak. AM installation of controls, protection devices and wiring should be done by a qualified 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) licensed electrician. All electrical and safety codes should be fotiowed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). or (4) float system. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16347 ` L TO- b, KY 347 Manufacturerso/.. SNIP T0: 3849 Cane ane Ru Run Road L , KY 40211.1961 hrpa corn I/& !O. (502) FAX (501) 774.362 8 -PUMP 0 Copyright 2001 Zoeller Co. All rights reserved. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page _6 of 6 FILE INFORMATION • . SYSTEM SPECIFICATIONS Owner Septic Tank Capacity 1000 al ❑ NA Permit Septic Tank Manufacturer C. P. ONA DESIGN PARAMETERS Effluent Filter Manufacturer ool ❑ NA Number of Bedrooms 3 ❑ NA Effluent Filter Model nlp _ ❑ NA Number of Public Facility Units ® NA Pump Tank Capacity 800 al O NA Estimated flow (average) 300 gal/day Pump Tank Manufacturer Week's C . ❑ NA Design flow (peak), (Estimated x 1.5) 450 al/da Pump Manufacturer Zoeller ❑ NA Soil Application Rate 0 , 6 gal/day/ft'. Pump Model 152 ❑ NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit ■ NA Fats, On & Grease (FOG) S30 mg/L ❑ Sand/Gravel Filter O Peat Filter Biochemical Oxygen Demand (BOOS) 5220 mg/L ❑ NA O Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection O Other: Pretreated Effluent Quality Monthly average Dispersal Call(s) O NA Biochemical Oxygen Demand (SOD.) S30 mg/L O In-Ground (gravity) O In-Ground (pressurized) Total Suspended Solids (TSS) S30 mg/L ❑ NA O At-Grade ■ Mound Fecal Coliform (geometric mean) S10` cfu/100m1 ❑ Drip-Line O Other: Maximum Effluent Particle Size Yo In dia. , ❑ NA Other' O NA Off; ❑ NA Other: ❑ NA , -Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: 3 O ear(s) (Maximum 3 years) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume O NA Inspect dispersal cell(s) At least once every: O month(s) (Maximum 3 years) O NA 3 ® ear(s) Clears effluent filter At least once every: 0 month(s) O NA 1 , ear(s) Inspect pump, pump controls & alarm At least once every: O month(s) O NA 1 r I ear(s) Rush laterals and pressure test At least once every: O month(s) ❑ NA 1 , l year(s) Other: At least once every O month(s) O NA O ear(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to Identify any missing or broken hardware, identify any cracks or leaks, . measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually Inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the Immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y3) or more of the tank volume, the entire contents of the tank shag be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at Intervals-of S12 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. s Page of START UP AND OPERATI N For new consvucdon, prior to use of the POWTS check treatment tank(s) for the presence of painting detected have the is that msY impede the treatment process andlot damage the dispersal cell(s). If high concentrations of the tank(s) removed by a septage servicing operator prior to use. System start up shad not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cel1W In one Large dose. overloading the cell(s) and may *result In the backup or surface discharge of . effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal calls. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. the 'Reduction or elimination of the following from the wastewater stream may improve the performance and prolong sutthe feclife of fat; POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers, foundation drain (sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; r. painting products, pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fads and/or is permanantly taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned In compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN if the POWTS fails and cannot be repaired the following measures have been, or. must be taken, to provide a code compliant replacement system: O A suitable replacemsnt area has bean evaluated and may be utilized for the location of a replacement soil absorption. system, The replacement area should be protected from disturbance and compaction and should not be infringed upon by, area will required setbacks from existing and proposed structure, toeest line a audit ble replacement t area. t he replace sy toms must result In the need for a new soli and site comply with the rules in effect at that time. O A suitable replacement area to not available due to setback and/or soil limitations. Barring advances in POWTS as s last resort to replace the failed POWTS. technology s holding tank may be installed O The site has not been evaluated to identify a suitbli replacement area. Upon failure of the POW TS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank.' may be Installed as a last resort to replace the failed POWTS. remova ® Mound and atVade soil absorption systems may be reconstructed ~ pthe laces olef following at that llimf the b)omat at the Infiltrative surface. Reconstructions of such systems must comply <<WAPJMG> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT.' . CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A ENTER A SEPTIC, PUMP OR OTHER TREATMENT TAN UNDER ANY R IMPOSSIBLE. PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name John Schmitt Name John Schmitt • Phone 760-0486 715 549-6651 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name I E Name St. Croix Ct . Zonin owners choice Phone 715 4680 3 8 6- Phone E I - - . :w This document was drafted In Compliance with chapter Comm 83.22(2)(b)(1)(d)&M and 83.64(1), (2) & (3), Wisconsin AdmWsuative Code. _ V 1278 SOIL EVALUATION REPORT Page 1 of 3 Wisconsin Department of Commerce Division of Safety 2nd Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt County Attach complete site plan on paper not less than 8'% x 11 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimemsiors, north arrow, and location and distance to nearest road. Parcel I. D. is 3 / C,~ Please print all information. Revi ed B Date Personal information you provide may be used for secondary purposes ~m!acy, Law s. 15.04 (1) (m)). Property Owner 77 Property Location Grand Properties, LP i Govt. Lot NW 1/4 NE 1/4 S 17 T 31 N R 18 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 712 Rivard Streeet, Suite 300 22 Squaw Lake Estates City State Zip Code Phone Nymper City Village 0.1 Town Nearest Road Somerset WI 54025 7T54 5900 Star Prairie 218Th Ave. tf' New Construction Use: 16 Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD J Replacement ~j Public or commercial - Describe: Parent material Glacial Till Flood plain elevation, if applicable na General comments and recommendations: Area is suitable for a mound system. System elevation is 98.52' based off of contour line established at 97.35'. Slope is 14°x. Depth to limiting factor is 22". Boring # Boring Pit Ground Surface elev. 96.90 ft. Depth to limiting factor 22 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' *Eff#1 *Eff#2 1 0-9 10yr3/3 none sl 2fsbk mvfr cs 2m,2f .6 1.0 2 9-22 10yr5/3 none sl 2msbk mfr 9w 1f .6 1.0 3 22-45 7.5yr4/4 7c1f7..Syr5/25yr5/6 sl Om mvfi 9w .2 .6 4 45-61 1 Oyr5/4 m 7.5 r /1 /8 sl 1 msbk mfi .4 .7 Boring # Boring Pit Ground Surface elev. 97.35 ft. Depth to limiting factor 26 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF *Eff#1 *Eff#2 1 0-8 1Oyr4/3 none sl 2mgr mvfr 9`N 2f .6 1.0 2 8-26 1Oyr5/3 none sl 2%bk mfr gw 1f .6 1.0 3 26-36 10yr5/4 cll 1 /2 6 sl 2msbk mfr 9w 6 1.0 4 36-56 7.5yr4/4 m2d 7.5yr6/6 sl 2msbk mfr 6 1.0 7.5 /2 * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS X30 < 150 mg/L " Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature: f / CST Number Thomas J. Schmitt +~sa yz 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 1595 72nd St., New Richmond, WI 54017 8/17/04 715-247-2941 Property Owner Grand Properties, LP Parcel ID # Page 2 of 3 3 ] F Boring # J Boring Pit Ground Surface elev. 94.45 ft. Depth to limiting factor 27 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots I *Eff#1 *Eff#2 1 0-8 10yr4/3 none sl 2fsbk mvfr 9W 2f .6 1.0 2 8-27 10yr5/3 none sl 2msbk mfr 9w if .6 1.0 3 27-42 7.5yr4/6 c1d5.55yyr6/6 sl 2msbk mfr 9W .6 1.0 4 42-76 7.5yr4/4 m3p 7.5yr6/8 sl 2msbk mfi - - 4 6 10 /2 ❑ Boring # -i Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIfF *Eff#1 *Eff#2 Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 'Eff#1 *Eff#2 ' Effluent #1 = BOD 5> 30 < 220 mg/- and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 S_30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. Page 3 of 3 rC .onducted by: Conducted For: Ref. No._ j 78 Schmitt Soil and Site Evaluations Name: Grand Properties, LP. ' Thomas J. Schmitt, CST 227429 Address: 712 Rivard St. SuitelOO 1595 72nd St. City, State, Zip: Somerset, WI. 54025 New Richmond, W1.54017 Phone: 715-247-2941 Subd.Name: Squaw Lake Estates Lot No.: 1W Legal Description: &1/4/V~l/4 S17 T31N R18W / Township of Star Prairie, St. Croix County Bench Mark EL 100.00' Top of 2" pvc pipe Alternate Bench Mark EL 97. .?S' Top of 2" pvc pipe Slope= /A/9 Contour Line EL 97 -7-5- Contour Line Length Scale 1" = 40' U C*If no ~J S7 3f~ This soil report was done to fulfill a zoning requirement. No permanent tot markers were in at the time the test was conducted. The area in which it was done may or may not be suitable for your use, or in the location shown. BUILDING PAD EXHIBIT SQUAW LAKE ESTA' Located in the Northwest 114 of the Northwest 114, the Northeast 114 of the Northwest 114, th, Northeast 114 and port of the Northeast 114 of the Northeast 114, all in Section X17, Township 3 Town of Star Prairie, St Croix County, Wiscon~ln. j ~ ONPLATTED LANDS 1 > : - - - - - ; \ r North 1/4 Garner M. Temporary Cu/• Mon 17 51 ALUM/NUM couvey Eosmeat {to be exti \ ! 1, NYC A` ; GYVUMEINT \ : upon extension of t 37r t r X49 ii4 1fc ZL 4,J1 -Alb OT ♦~~'.1~~v t/v~~~ 1 ?illy tom` t ) : / t Z\ Ollb dry,. t ~ ;'1 a~. t 1 J r ~ yy ~ Raw,^ tominerce.wl.gOV Safety and Buildings Division Coun 201 W. Washington Ave., P.O. Box 7162 X i sCL n s, n Madi 707-7162 Sanitary Permit Number (to be filled in by Co.) m Deparimerrt of comerce V40 -3 53 g 1 State Transaction ``Number CA A. Sanitary Permit Applieati y ;::Z 41F In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of s form to the app 'ate g vernmental Z 8 t~73 unit is required prior to obtaining a sanitary permit. Note: Applic tion or state-own POWTS are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information ou pr tr d for secondary purposes in accordance with the Privacy Law, s. 15.04 1 m , Stats. 7 tE7 ~T I. Application Information - Please Print All Informatiov/ 6> Property Owner's Name AUG Parcel # FRAtjCjS AUSS 03e-1Z3?,-Z7_-000 Property Owner's Mailing Address INNING &O/X CUVN Property Location o(,/TFl le JC` % /eE~ ZON/NG Govt. Lot l( City, State Zip Code Phone u NW -Iy y, Section ~Z 9'816) ~ circle one 5 T/ I I- W A T'6,0, N ~5 0 7- 657 - y0 H. Type of Building (check all that apply) T31 ~ N; R E Lot # I or 2 Family Dwelling - Number of Bedrooms .3 Z Z Subdivision Name Block # ui4 as ti4Kg t 5 7 CS S El Public/Commercial -Describe Use ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of ITTown of 57-49 AeA 1j81 r III. Type of Permit: (Check only one box online A. Complete line B if applicable) A. 19 New System ❑ g Only Replacement System ❑ Treatment/I-Ioldin Tank Replacement El Other Modification to Existing System (explain) B. Permit Renewal 11 Permit Revision El Change of Plum Permit Transfer to New List Previous Permit Number and Date Iss ed Before Expiration Owner 5 / Z 7 Z Q[5 IV. T S S System/Component/Device: Check all that a 1 ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ® Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis rsaV]rreatmcat Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation © 0. ~rD; J S_ 918. 5Z VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units 0 y New Tanks Existing Tanks 2 ❑ a U ~n rn iw C7 P. Septic or Holding Tank 0C)0 0 /000 1 , Dosing Chamber 7570 75C 1 b se k VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' gnature - MP/MPRS Number Business Phone Number Ta-l,N Jc awl lrT Z Z 7_3 -760 715- -760-0YA Plumber's Address (Street, City, State, Zip Code) ~/(n /~'OTI~ l~vc= 5 o vti~ ~ r2s~=i ~Vl/.Z~ ~ yc~ Z VI oun /De artment Use Only Permit Fee Date Issue Iss A g Agent Si atur . Approved ❑ Disapproved $ ~j ~ 0✓ ~ f ~'~tiYt/YV ❑ Owner Given Reason for Denial 0 g t I IX. Conditions of Approval/Reasons for Disapproval SYSTEM OWNER:, Ya'l~Gr~t clc- YYt~n~GGe~/~ 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumbe . I setback r ~u~r d as per applicable cc ft-Am' iOS for the system and submit to the County only on paper not less than 8 in x II inches in size SBD-6398 (R. 02/09) COUNTY SIM.PTIC" I"ANK AINFI 'NANC'E AGRIT,MENIT AND OWNERSHIP CERTIFICATION FORM f:+rnc.riliuyer -AA2~Cj~t Mailing Address ~ w - Property address (Verification iccitiit`ctl fit,rtt !'Istuiiiu^t ltrrntas !)ap.hrtnient t:,r rhea z,,+n,rructichrh.) City/state fare l I& titificatiov'NurttKr CC LEGAL 0F,$CR1ff10N Property Location MLL' 'l. , 1A, Sec. .1 7 I .._N It It' r1-.Town rai'_`~ Subdivision fiat: JtL: t Lot ~ Certified Survey Map 4 y Volume . Page Warranty Deed 3Q 4 (bet"( we -(lO7)V(%1t1m Spec house y°,--.q )(no I l lira ictt`ruiliat+l: ~ ti w nth SYSTEM MAINTENANCE ANC) OWN PX C`EIZ"l I 1"t C A T1 0 N improper tree end art,,intr~ ~n~ of your sepli,,Nm i °"c3t~J r- oft it €t,~ jvcn avure fate ire to iian:fe 4, Pioper maintenanceconsist:i rat'rurrh,.:n., i-it the,, ptic tarts, e erg ~r- ~r grxr,raur. ~i rt~~<lech i~ =t licensed ottrrtpc'. What )"uu put into the system can UNeci the titm,1 n , 11he Rcpii:' t:trhl, .75 .i It" 1 ,byte in the 41°cl tt di,posakl systenh, t,iUlle't tiiattntemincV, . rr pihta~ biiitiu are spc6faed in (oiitthh, X1 I) ,,md tit ( a _ tit, °,„ix Como "'anitaryOrdinance. ~fih~ pn,i~erty catrer a~;t'c~~ rt suhmu tc~ fit. { r",ii: t `<hutat}h3sanniihk..k Lr>iririsr. ! )etr tr7,a=ttrtt ~ et rta'icati,tn f~riith ~h~ rird ny tht' Wr and hg a fji&;tcr plumber, jouriit:;, mxI fitu b,=r, re,,trickt., f irfuwcor cx a li"r sea j)e usher vrti0, iir; ihit( I) then i-:pit, u<i,t a atcr di'llo ial s,:stcirh is it' pr,>per,~ etntirt, r-rindidort aiid or 3flcr in,pc tit-n .nisi l~t(ni(,ini' {ti th~et ssaiy)~ tlhE septic tank is less tfhar, i s hill "t"lridvt: I "v e. dir unc~lcr.iyti d Iahve read thr iihov,, r thirelr;t rlt grad agree to maintain the t,i t', at, dis of itl s~ tern With the stand.hr,f, ~,Cl (i)rtli. iierviih. as ,et Ir} the Del-irtt+ter}t r,E t't>iatihhrrret and the 1,lap<artment ofNawr.ii Ittst,,rr,es. ~i<rte,i# A i~c,±rtsitt. ( ~'riiii 'atl C, tl tittatl Tl?; lh,11 Wtir Stij?lic S >t C'r'2 1,,&? hf,_rl rmvll1;1adlf:J must be craenpicivii A rcwrlEt tl to Jiv ~i. I't,w, 1 Oil htr Planning (<nrinL I)el)3rtMCrt#.+l.iiIhni >0 d;hti,ot,tI)C three ~e r irir,ttanftrlat . [/we wtil, th;m ail stalerne iri4 on this fc.rzha are trek ttr tiar° treat of mylchur knowltdg,, . tht' ,>uahc i A of the property dt crihed albs f,} vi tihe trl'a .;a r.ant+ dvvJ re,~a.rdcd in ft"gister€r#"OLeds (Jffiec. Numbe f bedrooms inibr ation that is ntiynclsrc,;cwVd,tha% result ill thc, ,,hrtitsr ~ p rtTU t,u.rttt T. a~ akcrd h,, tllr:~ Piano ia & Zoning Depannhcnt. Inch,dtt with this application arc thrded wtwanty deed rrom thc itc 6swt ri! 17eads tll`+.ite tsiIt r,['ttc a etlifred s.rtvev inup if reference is made in the w•,arrante decd. (REV. 09107) . II IIIIIII IIII II III III II 80317 81 Tx:4022642 State Bar of Wisconsin Form 2-2003 938346 BETH PABST WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX CO., WI Document Name 07/01/2011 10:38 AM EXEMPT#: NA THIS DEED, made between -C & J Homes, LLC, a Wisconsin limited liability REC FEE: 30.00 company TRANS FEE: 90.00 ("Grantor," whether one or more), PAGES: 1 and Francis J. Nauss and Paula M. Nauss ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other interests, in St. Croix County, State of Wisconsin ("Property") (if more Recording Area space is needed, please attach addendum): Name and Return Address Lot 22, Squaw Lake Estates, Town of Star Prairie, St. Croix County, Wisconsin. 038-1239-22-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: Subject to all easements, restrictions and covenants of record. Dated ~TJ V1 Y_ a71 3e) I C & o es, LLC T r (SEAL) (SEAL) " Curt C. Jacobsen, Member 1 A, cobsen, Me r * (SEAL)* (SEAL) AUTHENTICATION ACKNOWLEDGMENT Y M. Signature(s) OL STATE OF WISCONSIN ) _049k authenticated on cep COUNTY ss. OLIC ? Personally came before me on TJ ~ `a 317 -loft TITLE: MEMBER STATE BAR OF WISCONSIN the above-named (If not, authorized by Wis. Stat. § 706.06) to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. THIS INSTRUMENT DRAFTED BY: Ronald L. Siler - Van Dyk, Williamson & Siler, S.C. 201 S. Knowles Ave., New Richmond, WI 54017 Notary Public, Stat f Wisconsin My Commission (is permanent) (expires: (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED C 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003 • Type name below signatures. 1 of 1 commerce.W1.00V Safety and Buildings Division County 201 W. Washington Ave., P.O. Box J 7 2 C o / scons i n Madison, WI 53706 D Sanitary Permit Number (to be filled in by Co.) tCleparbyont Conursearne i 5 12 Sanitary Permit Application State Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental Z & 3 unit is required prior to obtaining a sanitary permit Note: Application forms for state-owned POWTS are Project Address (if different then mailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary es in accordance with the Privacy Law, a. 15. 1 m Stats. RUE I. Application Information - Please Print All Info n REGENVED Jam' Z1,07-1-1 Property Owner's Name / Parcel # T o/35 ,6~) UG 14 009 ©z?~ z3 -ZZ - Oo Property Owner's Mailing Address t"~'+ s 64 Property Location Y ~nWXCOUNTY L , 5 PLANNING & ZONING OFFICE Govt. Lot Z Z P.O. -K Z15- City, state Ziipp~ Code Phone Number N w y,~ yti Section 17 11 sE% W LIN- (circle one IL Type of Building (check all that apply) Lot # T N; R E e ❑ 1 or 2 Family Dwelling - Number of Bedrooms . 5 Z Z Subdivision Name J(WO) WE C 5 T TES ~5 rk Ble>Ck Public/Commercial - Describe Use ❑ P ❑ City of CSM Stara Owned - Describe Use Number ❑ Village of ❑ Town of S % V PeNI RE IIL Type of Permit: (Check only one box on line A. Complete line B If applicable) A. ❑ New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. Permit Renews Permit Revision ❑ Change of Plumber ❑ Permit Transfer to Now List Previous Permit Number and Date Issued H ro pare on Owner I 8// S Z-O IV. VPVTONVip tens/Com enUDeviee: Check all that apply) ❑ Non-Prossurizod In-Ground ❑ Pressurized In-Ground ❑ At-Grade 12 Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treatment Area Wormation: Design Flow d) Design Soil Application Ra daf) Dispersal Area Required (so Dispersal Area Proposed (if) System Elevation Oo a5:53 2553 VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units New Tanh T~ Existing Tanks y rA ;A. 0 Septic or Holding Tank / a© Wo ~E S Dd oo i,t9r . VIL Items naibili Statement- L the undersigned, assume responsibility for installation of the POWTS shown on the attached lens. Plumber's Name (Print) Plumber' i tore MP/MPRS Number Business Phone Number ,TvHtj 5cpgi/TT ~ ~-O? ~~4 U~~ I L~?Z 76v Plumber's Addre'ss/(Street, City, State, Zip Code) C 596 I/ L Lc" S~ V/ E ~c1 d . «c lCS ~T Gl~~ 5 VII Coun evartment Use Only /1 /1 roved isapptov Permit Fee Date Is od Issu• cant Signature a~• % l~b`l en Rosa 1 DL ConditWR€~ reasons for Dhapproval 1 Septic tank; efflubnt finer and dispersal cell must all be services/ maintained as per management plan provided by plumber. 2. AN Wh ackivgWemonts must be maintained Atheh to c plek plans for the rystem and submit to the County only on paper not leas than 8 ve z 11 India In AN SBD-6398 (R. 02/09) Valid thru 02/11 Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 J, jflQ Ifisconsin Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) (608) 266-3151 Department of Commerce 11116~ (V State Plan I.D. Number Sanitary Permit Application In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ondary purposes Privacy ( is Privac Law s15.04 1 Xm) !~4 P t Address (if different than mailing address) may be used for sec 3 1. Application Information -Please Print All Inf ti RECEIVED TH Property Owner's Name Par aZ,Z Block # 0 UG 14 2007 3 _ -000 11 Property Owner's Mailing Address Property Location / Z b 2 UNTY _ QU& Y., 1[ICY., Section - 17 City, State Zip Code ~~Ph ~j (circle ~Q ~7 a T N; Rj&E a W II. Type of Building (check all that apply) Subdivision Name CSM Number 1 or 2 Family Dwelling - Number of Bedrooms ❑ Public/Commercial - Describe Use © ; 4;75% ~4 ;Icity_Elvillage prownship of C3 State Owned -Describe Use x D III. Type of Permit: (Check only one box online A. omplete line B if applicable) A. New System El Replacement System ❑ Tr endHolding Tank Replaceme my ❑ Other Modification to Existing System List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit. sfer to New Before Expirat'i'on Plumber Owner 1% , D ° IV. Type of POWTS System: Check all that apply) ❑ Non -Pressurized In-Ground ❑ Mound > 24 in. of suitable soil ® Moun 2 of suitable soil ❑ At-Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In-Ground El Holding Tank El P ilter erobic Treatment Unit ❑ Recirculating Sand((F++ill~ter ❑ / Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Li ❑ Gravel-less ❑ Other (explain) /,/7 V. Dis ersalfFreatment Area Information: Design Flow (gpd) Design Soil Application Rat sf) Dispe Area Require s9~ Dispe I Area Propos (~tY 7 J System Elevation Jr-a 4S 3 ~5 VI. Tank Info Capacity in Total Numbe anufacturer efab Site Steel Fiber Plastic Gallons Gallons ri U ' Co etc Constructed Glass New Existing Tanks Tanks Septic or Holding Tank 5 N, Aerobic Treatment Unit Dosing Chamber QU~ - C! VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's ignature PR umber Business Phone Number _0 -Z 715 Plumber's Address (Street, City, State, Zi e) Vill. County/ eartme t Use Only Approved t < prove Sanitary Permit Fee (includes Groundwater Dat Issu d Issuin gent Sig tur No Surcharge Fee / ba ~t ~C 67 ❑ r iven Reason nial t~ J IX. Conditions of Approval/Reasons for Disapproval 3\ p X- I 3 d'a 34'1 "OWm, . Septic tank, effluent filter and' dispersal cell must all he cae*m I maintauted as per management plan provided by plumber. 2. All setback requirements must be makttainbd as per appal able cosh / Cfdit 6M. . Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD-6398 (R. 01/03) SQUAW LA, KE CSiAT~ S Z0 ZZ - , PRoOeery T ove - d grn EC. =/co.co- Toe or-L'' PvL 01PE ALT- B►n EC. - 97,x5 ~ Top oC , Z Out p aj N - ®~o~t Hvc.F s. CON 7-04 IQ L I ni L t C. = 97.35 Z ~ f=O~CC N1 F{-/N ~ /OO ~ sv l . ~o Z ~a~ lD00 6AL. S. T, w/ ACOM61.0 f root .o ~P hod. L„ ,=oece na'h ID 41 ri~ • 30.0x 8s.i CON FOL4 \ J Li 1Y 1 r 8r~ a P~oju ~ PJq wu . -PPAWIw(, 6V R,v,~.en s~, boo 74z. WT ,SYOa-s n - _ - _ _ ~ I Fops E T UI I t5~/~2 5 IJW'~Y !V y s 171 T31 R ~J / N t8 y~'1 ~'~5376 0 SQlaAw L4Ke e5l-4Ti S Lo- ZZ - pQpoEaeTV -UNe. d' .Brn Et- = /mco' TOP or L'` PVC- 40/PE ~ ~}c,t. g vn EL. = 97,aS ~ T o P o ~ t ~ ~a6 N ■ ~oiet Hv~F s Coa 7-04 IQ LrAji 9235 SCDPr = /`/%a 10 Z'' f=o~cc w El1A.) /OD t Z w~ IvW 6Rt, 5,T, w~ PRomLCo t toot . p a goo GAL. o P /oo to ,=oecF IN OL TQ 'Lime 1 V • ~a 3o.ox ~s.~ ' -gym ~ ~ g3\ rvl ou tj (3 ~ c ON TO L) A~5 I 1 P~eo~E~TY ~ c 0%±~W~ub Foe p~gt~~w(, B~ AIo - 8-SP ~J (4/6 /SOrKu, ~e,~ ► E~ s ET W.T . ,5 yoa-s_ ~o n r Ens E 7 1~1 t LSy&z. 5- :5 /7 lY .fir" .T.3! NR tE ~J yVl ~t25 oU376 0 Safety and Buildings commerce.wi. OV 4003 N KINNEY COULEE RD g LA CROSSE WI 54601-1831 TDD (608) 264-8777 isconsin www.commerce.wi.gov/sb/ Department of Commerce www.wisco isconsinsin.go .gov Jim Doyle, Governor Mary P. Burke, Secretary August 07, 2007 CUST ID No. 223760 ATTN.• POWTS Inspector JOHN F SCHMITT ZONING OFFICE SCHMITT & SONS EXCAVATING ST CROIX COUNTY SPIA 586 VALLEY VIEW TRAIL 1101 CARMICHAEL RD SOMERSET WI 54025 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 08/07/2009 Transaction ID No. 1425906 SITE: Site ID No. 728631 Curt Jacobson Please refer to both identification numbers, 218TH Avenue above, in all correspondence with the agency. Town of Star Prairie St Croix County NW 1/4, NE 1/4, S17, T31N, RI 8W Lot: 22, Subdivision: Squaw Lake Estates FOR: Description: Three Bedroom Mound System / New construction Object Type: POWTS Component Manual Regulated Object ID No.: 1145291 Maintenance required; 450 GPD Flow rate; 22 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD-10691-P (N.01/01), Pressure Distribution Component Manual - Version 2.0, SBD-10706-P (N.01 /01) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The area within 15 feet horizontally down slope of the dispersal cell shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the effluent filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • Comm 83.22(7) - A copy of the approved plans specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. P.O.W.T S. Conditionally APPROVED DEPARTMENT OF COMMERCE MUMMu nc CACCTV AUn nwi mane JOHN F SCHMITT Page 2 8/7/2007 t Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 T Fee Received $ 175.00 Balance Due $ 0.00 Gerard M Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swim@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. A RECEIVED SCF 3= & SONS EXCAVATING JUL 3 1 2007 586 Valley View Trail Som=4 H7 025 SAFETY 71-1-54-9-6651 giJicoi NGS MOUND SYSTEM For: Curt Jacobson Address:. 712 Rivard St. #100 Somerset, WI, 54025 Legal: NW a NE a S 17 T 31 NR 18 W Township: Star Praire County: St. Croix Contents Page 1 Plot Plan Page 2 System Cross Section Page 3 Pipe Lateral Layout Page 4 Dosing Chamber Page S Pump Ckerve Page 6 Management Plan Attachment I Soil Evaluation Report Attachment 2 Map Mound Component Manual (Version 2.0) SBD-10691 P(N. 01/01) Pressure Distribution Component Manual (Version 2.0) SBD-10706-P(N 01/01) By. MPRSW 223760 Date: 7/25/2007 CORR ONDENCE SEE System Cross Section Page 2 Of 6 Synthetic Covering ASTMC33 Distribution Pipe Medium Sand H G Topsoil F .SYS. ELEV. 98.52Ft. 1 E D % Y % Slope 2 % Force Main Plowed 499regat"e Layer. D 1.17 Ft. E 2.15 Ft. Cross Section Of A Mound System F 0.79 Ft. G 0.50 Ft. A 7.0 Ft. H 1 00 Ft. Signed: B 64.3.Ft. License umber: 223760 K 10.4 Ft. Gate: 7/25/2007 L 85.1 Ft. j 5.2 Ft, Alternate Position 1 17, 8 Ft. of Force Main W 34.0 Ft. L Observation Pipe B K A - W ~+-------------------------•I Force Main Distribution Z- 2 z Plpe Aggregate Observation Pipe 5 io Permanent Markers ~ FRS l3dTtt >rNDS Plan View Of Mound Turn-up wtth Cleanout Access BQx Plus or Bap Vaivs PVC Force Main Disirlbution Lateral a PVC Manifold P t x -1-- X 1 X X12 Distribution Lateral Layout P 31 .5 Ft. S 4.0 Ft. X , 36 „ InchRa it 46 ~z Hula Diameter 3/1 6 Inch Signed: Lateral it 1N Inch(es) License ber: 22376Q Manifold " 1k Inches pate: 7/25/2007 Force Main 2_ Inches # of holes/pipe 1_1 Invert Elevation of Laterals 9g.02 Ft. PAGF 4 Or 6 PUMP CKXMbCR CROSS SCCTIOU A1110 S?CC1FICAr1ouS VICUT.. CAP- ` 'rGi. VGIJT P1PC WCATUCK PILOOF APPROKID LOCKIA14 I .ui&JCTIOU-sox 7MANNOL.IC COVLR ~ I /III• INff~ta. ~ tJ~•M►t►1: 1 ~fyJ1yVW V~ ► Aii-st1 1 Alit IYTAKC I GRA OC ( M, MI1J. i • ~ ler lu. COUauIY PROVIDE ( ---+~r~• .luL'!rT ~ AIRTtc;s'1T SCAL i v APIROYLO A I 1 I APIJ~pYLG 411171 w/C.Z. ►~►C I 11 1 w/C. Fitt CILTClaiwii(o S' ! (I ALARM "TI4IUG 3' ' CWTO &OLIO i0LL 21.16 Gal./Inch I 1 I ow C 1 1 .Z9. -r t - LLCK Off rump,, a COUCRETE DLOCK I RIiCII CXCT KRAITrD CWLU IF Tx.wv. / "wFACTuRL.R km SUGH XPFILOVA{. >6iPTIt 5PCCIFICAT10US ..~3.... 0069 f MArtiUiACTLIRCR: $ C • P uur+brA Of +or-5 PER TA" OLZIC 800 CPALt ows 0041 VOLUMC ~A j4AUUpAGTWC>CR; Sept ronics Tankmate uJCLUOi+JC. &ACK1r60W1 87.04 C~ttoNt KOOCL IJiiJ+10CRi TM-1 CAPACITIES= A a 19 WCHCs CA41_ 3 44 WLLOU3 SWITG1' orarti - _Mercury D 2_.lucKt6 OR 43-5 2 LIMP A"IFACTURCCt Zoeller C •._4._.11411Li OR 87.0 (ALLoij$ A40" r IJU)4& . - 152 ow 12 +fJGNF.s 01t261 . 12 GALLOUc 6WI.,rC14 TUPC:.--- Me2tignical u0T[: PUMP ^No ALAILM AR[ TO OC wulm 1M 014C► AKGS RATC 2`* GIM INSTALLED Ou SEPARATE CIRCUITS YCRTICAL 01/fiR A&M G&TWCCV PUMP OFF AUD.OiSTRIDUTIO+J PiPC..2-0 • 0 FECr t P4N}L U^ IJCTWDILIt SUPPI.-S PRCLSURC . . 3.25 FL.CT ♦ 1~^ ►LCT or iORCC 1'W>•I Y. r g#tFAICr1064 FACTOA....1._83 FEET s~ TOTAL. 01dWAM1C. NtAD c 25.08 FEEr WTCKuAl. OIM S~OU~. 0/ T AI LEWCPTH _,;WIOTH i LIQU10 Or`PTH 3._ RIGUCO LICCUSE NuKeCK- 223760 oA•rc.. 7~/25./2Q0' TOTAL DYNAMIC HEAD/CAPACITY HEAD CAPACITY CURVE PER MINUTE EFFLUENT AND DEWATERING MODEL 152/153 w MODEL 152 153 50 Feet Meters Col. Liters Gal. Liters 153 5 1.5 69 261 77 291 120- 40 152 10 3.1 61 231 70 265 15 4.6 53 201 61 231 Ilk, = 20 6.1 44 167 52 197 30 25 7.6 34 129. 42 159 8 c 30 9.1 23 87 33 125 a 20 35 10.7 22 85 40 12.2 11 42 4 Lock Valve: 38.0 Ft. (11.6m) 44.0 Ft. (13.4m) 10 ou5M 0 20 40 60 80 100 GALLONS LITERS 0 80 160 240 320 s 1/4 3 27/32 4 5/8 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS 3 27/32 4 • Tuned dosing panels available. ® 3 2 • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik-Box available for outdoor installations. See FM1420. • Over 1307. (54°C.) special quotation required. 1511153 Series 12 1/8 i 15211 MODELS Yodel volts-Ph mode Duoiu_ 5 1 /8 115 1 Non 5 1 2 3 BN1 BN752 115 1 Aub t1.5 Included 2a3 SK2064 E152 230 1 Non 43 1 2 a 3 BE152 230 1 Auto 4.3 Included 2 a 3 N153 115 1 Non 10.5 1 2 a 3 BN153 115 1 Aub 105 Inidded 2a3 SELECTION GUIDE E153 230 1 Non 5.3 1 2 a 3 1. Single piggyback variable level float switch or double piggyback variable level float BE 153 230 1 Aub 5 3 kldlded 2 a 3 switch. Refer to FM0477. o CA TION 2. See FM0712 for correct model of Electrical Altemator E-Pak. All installation of controls, protaafon devices and wiring should be dons by a qualified 3. Variable level control switch 10.0225 used as a control activator, specify duplex (3) kowed electrician. AN siacirical and safety codas should be followed Including the most recent National Electric Coda (NEC) and me Occupational Safety and Health Act (OSHA). or (4) float system. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. UAU. TO: P.O. BOX 16347 LwrisvfVe, KY 40258-0347 Manufacturers of. . SW TO. 3649 Cane Run Road Louisville, KY 40211.1961 Q~Ty OWAF flVff /9,99 778-2731 - 1 (800) htpor.com P(502) FAX (502) 774-M2 928 -PUMP 0 Copyright 2001 Zoeller Co. All rights reserved. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page , 6 of 6 FIVE INFORMATION . SYSTEM SPECIFICATIONS Owner Curt Jacobson Septic Tank Capacity 1000 al ❑ NA Permit 0 Septic Tank Manufacturer Week's C. P. ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer 001 ❑ NA Number of Bedrooms 3 ❑ NA Effluent Filter Model O NA Number of Public Facility Units M NA Pump Tank Capacity 800 al ❑ NA Estimated flow (average) 300 al/da Pump Tank Manufacturer Week's C. O NA Design flow (peak), (Estimated x 1.5) 450 gal/day Pump Manufacturer Zoeller ❑ NA Soli Application Rate 0 , ( al/da /ft= Pump Model 152 ❑ NA Standard Influent/Effluent Quality Monthly average• Pretreatment Unit 0 NA Fats, Oil & Grease (FOG) S30 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODJ 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg/L ❑ Disinfection ❑ Other: Pretrestod Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (SOD.) 530 mg/L ❑ In-Ground (gravity) O In-Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ NA ❑ At-Grade 0 Mound Focal Coliform (geometric mean) 510• cfu/100ml ❑ Drip-Line ❑ Other: Maxknurn Effluent Particle Size Ys In die. , ❑ NA Other: ❑ NA Otter: ❑ NA Other: 13 NA ^ •Vakus typical for domestic wastewater and septic tank effluent. Other: 13 NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) 0 NA 3 O ear(s) Pump out contents of tank(s) When combined sludge and scum equals one-third of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA 3 ® ear(s) Clow effluent filter At least once every: ❑ month(s) ❑ NA 1 0 ear(s) inspect pump, pump controls & alarm At least once every: ❑ month(s) ❑ NA 1 0 ear(s) Flush laterals and pressure test At least once every: ❑ month(s) ❑ NA 1 0 ear(s) Other: ❑month(s) ❑ NA At )east once every: ❑ ear(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual Inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, . measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the irm ixilete notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing operator and disposed of in accordance with chapter NR 113, Wisconsin Adminlstrative Code. All other services. Including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals•of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page of START UP AND OPERATION the presence of painting products or other chemicals For now constdedon. prior to use of the POWTS check treatment for f high concentrations are detected have the contents that may impede the treatment process and/or damage the dispersal con(s). of the tank(:) removed by a septage servicing operator prior to use. System start up shall not occur when sot conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power Is restored the excess wastewater will be discharged to the dispersal c4W In one large dose, overloading the call(s) and removed by ay 'result In the backup or Servicing Operator discharge of effluent. To avoid this situation have the contents of the pump tank power to the effluent pump or contact a Plumber or POWTS Malntalner to assist In manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal calls. Do not drive or park over, or otherwise disturb or compact, the area within IS feet down slope of any mound or at-grade soil absorption area. 'Reduction or elirmination of the following from the wastewater stream may Improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;. foundation drain (sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; x Painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS falls and/or Is permanently taken out of service the following steps shall be taken to insure that the system Is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • Aft piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or. must be taken, to provide a code compliant replacement system: O A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be ink~j upon area by required setback: from •xisting and proposed structure, lot linos and wells. Failure to protect the rep result in the need for a new sot and site evaluation to establish a suitable replacement area. Replacement systems must comply with the vilss in effect at that time. O A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. O The site has not been evaluated to identify a witabli replacement area. Upon failure of the POW TS a soil and site evaluatlon must be performed to locate a suitable replacement area. If no replacement area is available a holding tank. may be installed as a last resort to replace the failed POWTS. ® Mound and at-grade sot absorption systems may be reconstructed in place following removal of the blomat at the ` infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC. PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT MAY RESULTYGEN. D N T.., ~ ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER John Schmitt ENam Name EE(E7715) John Schmitt PhPhone 760-0486 549-6651 SEPTAGE SERVICINO CfPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY nwners choice Nam. Name St. Croix Ct Zoning Phone Phone 715 386-4680 •'wr Comm 83.22(21(bl(1l(dl&(f) and 83.640). (2) & (3), Wisconsin AdmWstratiw Code. Thy docucnaru was dratted In oonspliance with chsptst 1278 Wisconsin DepartmenlofCon Wrlerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt Attach complete sde pan on paper not less than 8%: x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. Please print all information. Reviewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Grand Properties, LP Govt. Lot NW 1/4 NE 1/4 S 17 T 31 N R 18 W Property Owners Mailing Address Lot # Block # Subd. Name or CSM# 712 Rivard Streeet, Suite 300 22 Squaw Lake Estates City State Zip Code Phone Number i'''r City Village i/ Town Nearest Road Somerset i WI 54025 715-247-5900 Star Prairie 218Th Ave. 0 New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD IM Replacement Public or commercial - Describe: Parent material Glacial TIII Flood plain elevation, if applicable na General comments and recommendations: Area is suitable for a mound system. System elevation is 98.52' based off of contour line established at 97.35'. Slope is 14%. Depth to limiting factor is 22". a Boring # Boring t,/ Pit Ground Surface elev. 96.90 ft. Depth to limiting factor 22 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary I Roots GPD/fiz 'Eff#1 'Eff#2 1 0-9 1Oyr3/3 none sl 2fsbk mvfr cs 2m,2f .6 1.0 2 9-22 1Oyr5/3 none sl 2msbk mfr gw 1f 6 1.0 3 22-45 7.5yr4/4 c 7 S.Y5 /6 sl Om my i gvv .2 .6 4 45-61 1 Oyr5/4 n 7.5 S /1 /8 sl 1 msbk mfi - .4 .7 F-1 F2 ] Boring # Boring Pit Ground Surface elev. 97.35 ft. Depth to limiting factor 26 in. Soil Application Rate Horizon I Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= 'Eff#1 'Eff#2 1 0-8 10yr4/3 none sl 2mgr mvfr 9w 2f .6 1.0 2 8-26 1Oyr5/3 none sl 2fsbk mfr gw if .6 1.0 3 26-36 1 Oyr5/4 cIf 10vr6/6 sl 2msbk mfr gvv 6 1.0 4 36-56 7.5yr4/4 m 2d5 .5yr6/6 sl 2msbk mfr - .6 1.0 • Effluent #1 = BOD 30-< 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD <_30 mg/L and TSS <_30 mg/L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt , 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 1595 72nd St. New Richmond, WI 54017 8/17/04 715-247-2941 Property Owner Grand Properties, LP Parcel ID # Page 2 of 3 F3 -]Boring # Boring Pit Ground Surface elev. 44.45 ft. Depth to limiting factor 27 in. Soil Application Rate Horizon I I Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 2 'Eff#1 'Eff#2 1 0-8 10yr4/3 none sl 2fsbk mvfr 9W 2f .6 1.0 2 8-27 10yr5/3 none sl 2msbk mfr 9W 1f .6 1.0 3 27-42 7.5 r4/6 c I d 7.5yr6/6 Y 7.5yr6/2 SI 2msbk mfr 9W .6 1.0 4 42-76 7.5yr4/4 m 3p 5 /8 sl 2msbk mf - 4 g ❑ Boring # Ij Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizor I Depth Dominant Color Redox Description Texture I Structure Consistence Boundary Roots Gpn/ft, 'Eff#1 'Eff#2 ❑ Boring # Boring 10 Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 'Eff#1 'Eff#2 i Effluent #1.= BOD > 30<220m 9/1- andTSS >30 < 150 _ mg/L 'Effluent #2 = BODS -j.30 mg/L and TSS < 30 mg/l 'I he Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. Page.Io Re£ No. Cooducted.by: ConductedFor..__.~. ra? 'Schmitt-S-oll_ d ,~1te $valuattons Grand Properties, LP. Thorpas. J.. Sc bxri4 CST 227429 -Address_ 712 Rivard St. Surte100 _ 1595 72nd St: - City, State, Zip. Somerset, WI 54025 New Richmond, WI. 54017 Phone: 715-247-2941 Subd.Name: Squaw Lake Estates Lot No 7 7.0 _ Legal Description: IAA ~1l4 S17 T31N R1SW - Township of Star Prairie, St. Croix -County Bench Mark E1:-100.00' Top of 2" -pvc pipe - --Alternate BenchMark-E07.RrTop of2"--pvc pipe , Slope : l ~ _.Contour_Line El. ?7,,r Contour Line Length 7S Scale 1" = 40' C - - - _ _ _ - - - a` A~ _ /o - I , i S I I . 3 r- -This -soU report wastone-to fulMI-a-zonmg requirement-`No permanent lot-~arkers were in at-the-time the-test~n as i i,. 11, 1 _conducted._Ttle 4 m wh it was done a or may not be suitable fo_ r~rour use, or in the location shoi vn. ' i BUILDING PAD EXHIBIT SQUAW LAKE ESTA' Located in the Northwest 114 of the Northwest 114, the Northeast 114 of the Northwest 114, th, Northeast 114 and part of the Northeast 114 of the Northeast 114, all in Section X17, Township 3 Town of Star Prairie, St Croix County, Wisconn. j % OOLLATTEDLANDS ~y `I~ ► North 114 Cornar~ " ~ r T "Section 17-31-18 Temporary Cul- ALUM/NUM COUNTY Eosment (to be exti i ~ Y ` o A QNUMDNT upon extension of t r ' 16! rA, 7 t ar i a w ?C i ^ A i t• " 110 1 rmway r •i 6 : ~ 0 'Oor lei 1.1. I 1278 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 or 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt Attach complete site plan on paper not less than 8'% x 11 inches in sae. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and c, percent slope, scale or dimemsiora, north arrow, and location and distance to nearest road. Parcel L D. 0,3 is 3 Please print all information. Rev' B Date Personal information you provide may be used for secondiMMU- (_'rivacy l s. 15.04 (1) (m)). Property Owner • 77 r. " Property Location Grand Properties, LP S Govt. Lot NW 1/4 NE 1/4 S 17 T 31 N R 18 W Property Owner's Mailing Address ,I Lot # Block # Subd. Name or CSM# 712 Rivard Streeet, Suite 300 22 Squaw Lake Estates City Stat Zip Code Phope,Numper J City I Village 0,1 Town Nearest Road Somerset ( WI 54025 -71S4`- 5900 1 Star Prairie 218Th Ave. A New Construction Use: 0 Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD J Replacement J Public or commercial - Describe: Parent material Glacial Till Flood plain elevation, if applicable na General comments and recommendations: Area is suitable for a mound system. System elevation is 98.52' based off of contour line established at 97.35'. Slope is 14%. Depth to limiting factor is 22". Boring # J Boring NI' Pit Ground Surface elev. 96.90 ft. Depth to limiting factor 22 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 'Eff#1 'Eff#2 1 0-9 1Oyr3/3 none sl 2fsbk mvfr cs 2m,2f .6 1.0 2 9-22 10yr513 none sl 2msbk mfr gw 1f .6 1.0 c1f 5 2/6 sl Om mvfi gw - .2 .6 3 22-45 7.5yr4/4 4 45-61 1 Oyr5/4 m ~d5 '5 r /8 sl 1 msbk mf - .4 .7 7 2] Boring # j Boring Id Pit Ground Surface elev. 97.35 ft. Depth to limiting factor 26 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz 'Eff#1 'Eff#2 1 0-8 10yr4/3 none sl 2mgr mvfr 9`N 2f .6 1.0 2 8-26 1Oyr5/3 none sl 2fsbk mfr 9w 1f .6 1.0 3 26-36 1 Oyr5/4 c1f 10yr6/6 sl 2msbk mfr gw .6 1.0 10 /2 4 36-56 7.5yr4/4 m 7d5 'S /2 /6 sl 2msbk mfr .6 1.0 ' Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD <30 mg/L and TSS a 30 mg/L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 15% 72nd St., New Richmond, WI 54017 8/17/04 715-247-2941 Property Owner Grand Properties, LP Parcel ID # Page 2 of 3 3 ] F Boring Boring it Pit Ground Surface elev. 94.45 ft. Depth to limiting factor 27 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 1 0-8 10yr4/3 none sl 2fsbk mvfr 9w 2f .6 1.0 2 8-27 10yr5/3 none sl 2msbk mfr 9W if .6 1.0 3 27-42 7.5yr4/6 cld 7.5yr6/6 SI 2msbk mfr 9W 6 1.0 7.5yr6/2 4 42-76 7.5yr4/4 m3p 7.5yr6/8 sl 2msbk mfl - .4 .6 10 /2 ❑ Boring # Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 'Eff#1 *Eff#2 ❑ Boring # Boring _ J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 'Eff#1 *Eff#2 * Effluent #1 = BOD 5 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODr- 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. Page 3 of 3 ~~onducted by: Conducted For: Ref No. ra ? 8 Schmitt Soil and Site Evaluations Name: Grand Properties, LP. ' Thomas I Schmitt, CST 227429 Address: 712 Rivard St. SuitelOO 1595 72nd St. City, State, Zip: Somerset, WI. 54025 New Richmond, W1.54017 Phone: 715-247-2941 Subd.Name: Squaw Lake Estates O S/ Lot No.: 1W Legal Description: &114/J/I/4 S17 T3 IN RI 8W / Township of Star Prairie, St. Croix County Bench Mark EL 100.00' Top of 2" pvc pipe Alternate Bench Mark EL 97,?S'Top of 2" pvc pipe slope= /5/9 Contour Line EL 97.35` Contour Line Length 7-S - Scale 1" = 40' U G ~ L Ito, kA 0\ V ~ 3 y6 ~ ~n5 I S7 This soil report was done to fulfill a zoning requirement No permanent tot markers were in at the time the test was conducted. The area in which it was done may or may not be suitable for your use, or in the location shown. N N O v l ~ a (SEE SHEET 1 CF 2) 129. v gym'-=.,1 a : / ~ r ~ ts` ~M i Cy t ICA_ _ 010 ` i \ f~r d ~ F Q lb' r F c T D z 7s;E.~,,,~o rn o,, 0-. co I w SQUAW LAKE ESTATES LEGEND: (p COUNTY %J4n Section Comer Monument of Rerotd he Northeast 1~4 of the Northweost ~~Secticn 11, O set _1p' x 18' an AeSar Locoted in the Northwest 114 of the Northwest i/4, (weighing 4:JOJ IDs. per Imem foot) theost $t CrO~. COOOfy, W!SeonSln. Set i' x 18' O.D. Iron'Oe Northwest 114 w of the 3 or th, Ri9e o 8 West, oT ow, Of slor o Prm~e, S the Northeast 1 4, w (weighing 1.13 Ibs. per fieor lool) Nor ML Delineofed Wetland Areas Budd,; Setback Line -a^e' [or (100' from A-O-W - Call" Street, +iarnec's~ s 50' from R-O-W - Lacol Streetx Serdion V-!!-!B 75' from O.H.W.M. of SSuow Labe) (ESIA811.S'!EO /ROId on ED LAND' hY Cama of 1kS Gs RECOAO) Proposed Driveway Locati UNPLA _ _ - _ _ the NW- 1~1 o! NatA 114 Caner No, Ine of the NE-114 12' Uldlly Easement N,W,1,_, 1 Bp'Ra as - the Nf-1/4 958.1' , I Section I7-31-18 Eosme'l nl (la oe ex(mgished upar _58936'011E 2565.60'- \ --z- Existing Fence L'me (AIONiNUII OWNIY 9819 ` -S8n6'02"E 1569.13'- NI) edehsia of the rod) 588'3fi'01"E 1282,80' - DMineoted Wetland Bmndmy 3 we936'01'f Calculoted 100 -yea High Water Level Lee 2 7 32 a es _asle.ay caroaae _ n' R \\~02.80' Ordinary 40 Water Marc of Squaw Loke -146848- -7" g•• "Ttor;15 (.aTaa'T ' on •1 Nwz' p 1" 1 S88'J6'01' 72282' o d II h r yz4',1 4 ' 1 " i -1 1 11 LEG. Minimum Elevation of Lowest Budding Opening LOTO 171.66' ; I 1151.16' i H.W.L. Calculated 100-yeo High Water Level Elevator •`~1 I \ \ 122,613 sq. It. \ I ~B /'"m/ . I I b 2, Ury n . 261005 ® Benchmok - iW of Iran LOT6 a,.,.,...:'' . I j ~7 V g.Q=981.4' LOTH l ~ monument as noted 154 aces t °o Area to O.HW.N: :!m II 315 acres S m III Z Ln s Jj,', r o m, 146608 sa it, 9625 c c 5. f ' pp N 66 a'es v- a x NI dewllaas o xwr. 996 ~9 p5 _ o Aeo 0HW O~em o,w M Nero I%B 6wea a av m mN°.a4. w D 6,➢ h CO vy0 LO126 ° 05 o,'e. 3 aG m GWer ham Ne led PrM'.vmnay %at py - C ( ` ye6 IOJ,001 s0. i. am pam t d!h a / T '11, 246 acres NS orna a mVat who, ds M)•pn9 dA raJd hlerhre wU a ad z Y wl x559 rFt) 6a d me omms~ nagrepnme ro a 9 amge me apaa p I w nd Wed is Wiad9 W Area fo OHWM ai ardor vla he m'e clot m,e Hdvaee ° aIM w ar 6am°9' LOTI71 1.15 cues t deelractep a{1aiq, RUM ertawln9 a N rota aaM14470 788 sq. ~y8 a f /6 voaz ester rvnsye. a ft 56 , SS) ' it : i e een 4 pla arnsge dldaz s, J69 acres 41 / a gave eneb5e M*, 006 pe`Z 1BS 70' tsraep'q LB.0:=960.2' . s, r e l sole. C.,Iy ad Lo16 9 IDe we, W. a Ie6 mw" 'j,inhm mt nre, a ~ ~ ~ ~ /35 \ )f 944.4 • x-_ \ ~ o cam is I w.w rAn and rraAm2ra G.e. ae8aax N4 am Darta mama men adnae LOIY parnH, ek). Bvive P.-.g y Toro Bard la ' 95.1.1 ,9dr'oy / i4 > ~I r / o o ii Canty iafq othob and Ue WP'Wro I wap- 0 Casnnmr; kea la he d'aAepanve s 87,65! s9. N. ?Sts /q o i0 111 y' r r o e A WaN ettNlbn ux Dtanil ie aW he permd a.1 w ter 2.01 ones a 9~a nN iam4M1a m 1pe apD!w`~ 9'N- plw eamVq P~f1 I ~M ! 6 Area fo O.HW.M:: t o uu mnin4 alBn ad'" erect dwaBh s w 1019-39. Rip, BoQa al 4dye'JnmL v 1.61 aces t I: mravn + 7 Ill I o t R ? Woo by ue SL aon Camtr ~8.2>, • o `lo a s76•58'0f.E 4 ~ \ 19.33 I : if 1. I ~ ~ f rl "N / I Ww y^p LOT28 I m m ~m 6 ~a° Z U I po1led6dw dN.trekeY n , 124770" (1 . V-- 235.00 •"-jOU I" a N ~0 0 c Y1 1.86 ones I N ~ n I ti Prw !o Oh.wM Y o/ u: CURVE TABLE n r awe TANGENT BEARINGS I0711 y, ;8:6=9aaJ 916.7 4405 PRC CHORD CHORD BEARiNO CURVE RADIUS DELTA NIm0T15'E N72'0921'E f~'~'09,E ? 67687 s4 fl " o awi' F 07:23"E pIO.YG 171:12' N6T02'U'E \4 i m 1.97 ones i w ':1 yvi l / 6 N93' 103 % ' '.adz 00 I I a C22 161W 61'0312' 18670 dl tOS 26 W7.W 10'13'20' 29:90' 29.76' N35,0t'OS'E \+Nh ! ^~l az°w lr N08'06"19'E N53'36'03'E I. ~D ~i o o 'h\ Ayyw' _ As6Yi 23055 LO T29 L01 21 167.00 St49'SY 156%' 18020' N30'S1'%'E b h 1 M1 bf sl 99, I sq. If. C23 237.00 45'29'54' 185,03' NII.23'IS'E U j 11 \ Ls`~'P. bad/ 115 ones W. \ 7 ww3z L01 21 233A0 671'12' 26.72' N34'pg92'E : ry \ \ 0 1 J z00 o , / of Aeo ra aHwu.:. LOi 22 23300 3855'hY 15245' N69f lNT30'01'E N5376'0YE IQT23'S9'E LOT21 ~i z /t. a~ay yC n,e1.71 aaest ' 11 a a w vA\ ~ 0 I~;umW ' C24 167.00 52'12'M' S2T30'O1 V 10143'S9'W 553'%'03'V C,. 0l~ • 1.8.0.=959.1' i. II 1111 945 Xhfe' Mak \V A V A~ N m o a w 23390 52'12W' 21229''x' S09'3T7B'y ` 66 tM1 µ \ \ \ i ism C25 2118' 66.92' 66,69' ~b°~ - (QNW ll it L01 24 233:07 lb' S35'43'40'V E 5~'~ 1BO.dp 9/Q69' ll 1 L0126 233m 35'44'46' 145:36' 14a0Y 53051'%'v S53'36'03'V SOB'06'09"V r t,m1 I NB}74~r~ t ' dtfdmi7 I "l 1 167.00 45'2951' 132.61' 12946' S43'ST23'V - 11 I. - L,9su m / i' by O.N) 11 n oa C26 55%' ( " \ kw ~i L01 E7 167:00 19'11'20' 1679' 75.73' S21'IY26'V S25'0153'V i t~J y19.66' { Ile lr 1( w °r L01 28 I67.W 26'12'31' S2B'2259'E 58153'S1'E s o' r~y\\ oy n n ]az! !a e waaWy \ 7~ N C27 xa9B I0T0P44' 77L49' 66411' S69'21'04'E / r(hJ' no \ 6-m1 J LOT31 /f. 58F lfli 2B 1131W 2S'OS'34' I90:B8' 179Aa S UJ' \ ',:Ire n 112 60 e ~A~x I ww ry9 'm.. 6 x:wL lai!ij - 260 Dues ~ti9 o n' : ~29 A~r~I l0i 29 41x00 18'S7'l0' 13662' 135.99' 47 19421 'eq U ) ,95x6' 0 Area to O.H.iVM.: \ ~77$S9, ~`n•1 o~r?N L0133 41x00 53MT18' 39111' 370AT S20'IT11'V v,l 'aEws ll 09'41'12' 6992' 6971' N30'W'3B4 N81'S3'S1'V 6q¢Pt3M1/ r ~OTB4', ~ 219 ones LOi 32 413h0 N25'5b'365'V /oStE9o~ 71186 s9R AO~o [8:0:=959!' "9p meow*~ 1 a t z C28 311x0 111'51'29' 677.75' 57594 N02.2T95'E ~i I 6 y 1 'ti-q 7 < 321:ON (;Of, ~ I 156 ones 951 L0137 747.E 55'0651 333: N5370OY ~ Iyl' .B0 965.2 I ~ i L0131 317:80 567777 313.95' 73404' S4010715'V S09'06'09'V S72'09'21'V r~ 27790 64'03'12' 260A8 2/743' S3S7T03.5'V n"C n.- uY 9497 m,.;, LOi 31 273:00 54'5749' ?2321 214.80' S4CI7p'V i'' ia- ESNi 233A0 373929' 15314 15010' S677f39.5'V SORB P6z A106, I 1 pI LOTBI o 9'09'23' 37.24' 3720' 5 W' Sgryz6A / 88)17 50 z = o LOT 35 233:00 0 96553 ~h 104 acres W , °A LOTS3} l'' Armloo.HWM.: ry," o z0a 1,76 all-5 o h ~ r Wr7yW 75,743 s9. ll. n ' / Y 1.8.0.-9520 ; " L01ffi . I 1.11 aces 135,162 sa !f.' I '~cwaw 2 LOT35 B.0.=950.8' I 110 acres maxf3l Area to O.N WaI:: 345-E 419.63' s 1.18 ones t t r {'L 'm~da,A1•, RwL~ : IV S88'3 rl `V✓Dtdb' 66' 0"..oy Eosnwrt Arlo to' Lo! 31 "j Mt %bnf Access) -795.97'- -4 o SJBY 7 ;4 19.96'- 214.86, 73.44 . e /N68'33'45 W-1269.3T~>. SE homer of 114 of fhe NWNE-0 prepared for and at LOl 12 ,1 f the revest of: BEARINGS ARE REFERENCED III py1+'~ Saufh 1me of . - owl 10 THE NIXi1N LINE Of THE wv ly br the NW-113 of j 8d flues Temoma;y Cui-Ce-su` Mke Germoln NW 1(4 WHICH IS ASSUMED ( 3!ed uoa / /y 1\ 712 q'rrord Sl.CS the NE-fI4 ~-Eosmnl la ae e y't ' / , of i0 BEAR S89136'02'E. Somerset, W 54025 t apILY eoer e / Il; B7AI 1 C J ~eI y uNPLATTF] ,6,"_ ae1Wm ;~9 +sn1a~N ry, -=-Rep-hp by ~CBig Iw 9 rm 'pane Na (715) 6-,U 216-1319 J ,`,'tt m Na (715) 216-78]0 IY~rL~~~ IPD' P.O. Box 525 Nn Forhk W 610!7 N FM. I I'd' ~ • fa0lest SHEET 3 Of 4 SHEETS I V 2740 2 5 0 7$ts 244 State Bar of Wisconsin Form 2-2003 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS ST. CROIX GO., WI Document Number Document Name RECEIVED FOR RECORD 01/31/2005 03:301PH THIS DEED, made between Grand Properties. LP WARRANTY DEED ("Grantor," whether one or more), EXEMPT # and C & J Homes LLC REC FEE: 11.00 (Grantee," whether one or more). TRANS FEE: 179.70 COPY FEE: CC FEE: Grantor, for a valuable consideration, conveys and warrants to Grantee the following PAGES: 1 described real estate, together with the rents, profits, fixtures and other appurtenant Recording Area interests, in St. Croix County, State of Wisconsin ("Property") (if more space is Ai~TO o..i R.Inm A!tllfP.Ci needed, please attach addendum): Lot 22, Squaw Lake Estates. St. Croix County, Wisconsin. va,($a-n-e 9T6 S,'x 4R .5 S* e ey iVo Part Of. 038-1070-70-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: Easements, restrictions and rights-of-way of record, if any. Dated n _ Grand Proper LP (SEAL) _(SEAL) * *By: Michael J. Ge ain (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) Grand Properties. LP B : Michael J. Germain STATE OF ) authenticated on ) ss. COUNTY ) *Kristina O gland Personally came before me on TITLE: MEMBER STATE BAR OF WISCONSIN the above-named (If not, to me known to be the person(s) who executed the foregoing authorized by Wis. Stat. § 706.06) instrument and acknowledged the same. f THIS INSTRUMENT DRAFTED BY: * Attorney Kristina Ogland Notary Public, State of Hudson, WI 54016 My Commission (is permanent) (expires: ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ® 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003 • Type name below signatures. INFO-PROT' Legal Forms 800-655-2021 www.infoproforms.com ST CROIX COUNTY ' SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/ Buyer A L-1- G Mailing Address i3 a Z) S J R-~"" Property Address ?D- 2-) (Verification required from Planning Department for new co ction} City/State ST x-o- W1: Parcel Identification Number LEGAL DESCRIPTION Properly Location _&2) „Q[(L Sec. N-R W, Town of S`T Subdivision Lot # Z Z Certified Survey Map # , Volume , Page # Warranty Deed # 7~~c 9 914-' , Volume 4-7 VQ , Page # 7. Sn y_ Spec ho a ye 7~no Lot lines identifiable g yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. / C~7 SIC#N MUOF APPLICANT bAft OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the prope described above, by virtue of a warranty deed recorded in Register of Deeds Office. 7 ~~II~A OF APPLICANT t)ATE Any information that is mis-represented may result in the sanitary permit being revoked by thaZoning Department. i Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed i i I s