HomeMy WebLinkAbout038-1200-50-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Cr oix
Safety and Building Division
1 % INSPECTION REPORT Sanitary Permit No: 420661 0
ATTACH TO PERMIT)
GENERAL INFORMATION ( ate Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)J. Btg�r = T -014$ � /✓D,
Permit Holder's Name: City Village X Township Parcel Tax No:
Stout, Richard Star Prairie Township 038 - 1200 -50 -000
CST BM Elev: Insp. BM Elev: BM Description:
t.,Ak V** 0 /1 - 20 L)e� ( 0 0 z/.
TANK INFORMATION 11 ELEVATION DAT / 1)-,31 , 06, 1 US
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
Dosing � t < < Alt. BM
Aeration Bldg. Sewer 1
Sb
Holding SUHt Inlet 1
3 •� SS• 15
St/Ht Outlet
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic SO ' , 1 1 Dt Bottom g• + _ f
5-0 13 � ST)
Dosing 1. > 5b , Header /Man. 2. Z- /
.. 23 g6.o3
Aeration Dist. Pipe
2.q r qS -90
Holding Bot. System 3, Ivry
gs .2s
PUMP /SIPHON INFORMATION Final Grade y
Manufacturer / /� Demand St Cover
Model Number GPM
�. TDH Lift Friction Loss System Head TDH Ft
Forcemain Length Dia.,, 11 Dist. to Well -> ��
SOIL ABSORPTION SYSTEM ,toy — C. -
B D Width Q r Length f No. Of Iraacgx PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Dept
'MRO ENSIONS /
SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM LEACHING anufacturer:
INFORMATION CHAMB
Type Of System: 5 �+ 1 SO -� IT odel Number.
DISTRIBUTION SYSTEM
Header /Manifop Distribution Lr x Hole Size x Hole Spacing Vent to Air Intake
�j.f) 2 /1 Pipe(s) 2� 0„ 3. O t
Length Dia Length Q.a" "'Dia Spacing f r Z- 3
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched
Bed/Trench Center Bed/Trench Edges Topsoil
�A Yes No
0 No � Yes []
OMM YTS: (Include code discrepencies, persons present, etc.) Inspection #1: / O a�3 / Inspection #2: "y- --
Location: 0th Ave Star Prairie, WI 54026 (SW 1/4 SW 1/4 18 T31 RI 8W) Rolling TXs Lot 8 Parcel No: 18.31.18.1059
1.) Alt BM Description = �� 1 '
2.) Bldg sewer length =
20
- amount of cover = 2r{ 5fl,� dpve
3) C -t zo ' .
Plan revision Required? [ifl Yes XNo 3 �(
Use other side for additional information. 3D f L_ \ ��
SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No.
i
k
+ O
T
Safety and Buildings Division County
ff 201 W. Washington Ave., P.O. Box 7162
N visconsin Madison. WI 53707 - 7162 Site Address
De artmtnti Com merce
Sanitary Permit Application sadwy Permit Number
In accord with Comm 83.21, Wis. Adm. Code, personal information you provida �Qo&
ran be used for sec as Privac Law s15. 1 ml
❑Check if Revision
I. Application Information - Please Print All Information State Plsn I.D. Number
Property Owner's Name Parcel Number
Property Owner's Mailing Address Property Location
G?a- O, u B e � • 5 ,10 -A, S V T N R /
City, State Zip Code Phone Number Lot Number �✓ Block Number
_ .iix� = +i,1PJl
ZO;'.i,i 0! =FIEF= Subdivision Name CSM Number
&L led �oll
H. Type of Building (check all that apply) ✓ ❑City
V 1 or 2 Family Dwelling - Number of Bedrooms 3 ❑Village
❑ PubdiciCommercial - Describe Use t [RTownship 57 2 J l
❑ State w f nl / d 1/ I k S S `� ' 05 O N rest Road
/, o ' o� '
M. Type of Permit: (Check only one box on 1lne A (numbering scheme for internal use), Complete line B if applicable)
A ' I J kNew 2 ❑ Replacement System 3 ❑ Replacement of 6 ❑ Addition to For County use
S stem Tank Only I Existing System
B. ❑ Check if Sanitary Permit Previously Issued Permit Number ed Issued
IV. Type of Permit: (Check all that apply) (n ering� the is for internal use) ... .
err
44 ❑ Non - Pressurized In- Ground 2� I unc ' 47 ❑ Sand Filter 50 ❑ Constructed Wetland
22 ❑ Pressurized 1n- Ground 41 ❑ Hol 48 ❑ Single Pass 510 !! Drip Line
45 At - Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other
V. Dis ersaMeatment Area Information:
Design Flow (gpd) Dispersal Area Dispersal Area Soil Applicadon Percolation Rate System Elevation Final Grade
/ Required Proposed Rate(Ga ./Days/Sq.Ft.) (Mindlnch) Elevation
VI. Tank Info Capacity in Total Number Manufac r ( Prefab Site Steel Fiber Plastic
Gallons Gallons of Tanks f��� ��� ( Concrete Constructed GIass
New Existing 1� Ie
Tanks Tanks J� 7
Septic or Holding Tank
Dosing Chambor
VII. R es onsibllit St t- I, the undersigned, assume responsibility for px4ilatlon of the POWTS shown on the attached plans.
Pltun PIumber': signature RS Nuunber Business Phone Number
!' ' r -2 ?-y�Qd
Plumber's Address (Street, City, State, Zip Code)
VIII., Co !De artrnent Use Oal
pptnved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Data Ltaued nt Signaturo ( o Stamps)
Surcharge Fee)
11 Owner Given Initial Adverse . 3J 5 _ , j 7/ , W WI�
Deter�minarioa
TX. Conditions of ApprovaVRemons for Disapproval
ycorCe tt�ndAh ar <.at - P dAA
da ma-
Tam anurr � d u� S� �b ��c'� —
Ag�nv,(Jb
complete plan to the Couaty e ) or tlu on papa not las than 812 a It tw%oa In du
�6li �t � • - iki� dZ aj, r l-
S D- 6398(R.05101)
Scale 1 "= y0 -P age of
W �Q L
i L K_; TEZ.
t3`ry`t - Z — tiL IW - O r
7
SuG6�,T�-•p �o � i
trL hoc N
4S
91 tOpkic
0. �. , � � � , o � S`n�.e `cat s Pcrc�p i
r
_- p- ' r
6 8 r,
- yf/
1 O
.. cwt x •-�
l0
i
46 4
i
,
NOTES:
1. Elevations shown are existing ground elevations unless otherwise noted.
2 Install 4" observation pipes with approved caps. ( Z required).
3. Septic tank to belti gallon capacity manufactured by
I L Q� e;z- d-0?J L 2 L �_J/ 6_ 1800
4. Bench mark
- Divert surface water around system to prevent ponding at the uphill side.
•
Safety and Buildings
• 4003 N KINNEY COULEE RD
LA CROSSE WI 54601 -1831
TDD #: (608) 264 -8777
N viscons i n www.commerce.state.wi.us /sb
Department of Commerce www.wisconsin.gov
Scott McCallum, Governor
Philip Edw. Albert, Secretary
November 20, 2002
CUST ID No.267341 ATTN: POWTS Inspector
ARTHUR L WEGERER ZONING OFFICE
WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA
PO BOX 74 1101 CARMICHAEL RD
RIVER FALLS WI 54022 HUDSON WI 54016
CONDITIONAL APPROVAL L�
PLAN APPROVAL EXPIRES: 11/20/2004 Identification Numbers
Transaction ID No. 808536
SITE• Site ID No. 653361
Richard Stout Please refer to both identification numbers,
210th Avenue above, in all correspondence with the agency.
Town of Star Prairie
St Croix County
Part of SW 1/4, SW 1/4, S18, T31N, R18W
Subdivision: Rolling Oaks - lot 8
FOR:
Description: Proposed hre Bedroom Mound System
Object Type: POWT System Regulated Object ID No.: 881385
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.
The following conditions shall be met during construction or installation and prior to occupancy or use:
General Approval Conditions:
• This system is d and I i„ �ordance with the enclosed app plans.
• 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.
• Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner
of the POWTS explaining that periodic cleaning of the septic tank outlet filter is required. The access
opening used to service the filter shall terminate at or above finished grade with a watertight cover.
• 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.
Owner Responsibilities:
• 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).
P.OWT.S.
Conditionally
APP R 0 V Ef".)
ARTHUR L WEGERER Page 2 11(20(02
Owner Responsibilities Continued:
• Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as
required under s. Comm 83.54(4) shall be considered a human health hazard.
• The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is 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
Fee Received $ 175.00
Balance Due $ 0.00
Gerard M. Swim
POWTS Plan Reviewer - Integrated Services
(608)- 789 -7892, Mon. - Fri. 7:30 am to 4 :15 pm WiSMART code: 7633
jswim@commerce.state.wi.us
cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544
r
TITLE SHEET Page 1 of
BOUND SYSTEM
FOR
A 3 BEDROOM RESIDENCE
This plan has been prepared in accordance with the Mound Component
Manual SBD -1057 P and the Pressure Distribution Manual SBD- 10573 -P
C tz , b/ ctcl CT-. 6 19 9
LOCATED IN THE ' 1/4 OF THE SW 1/4 OF SECTION )3 , T 3) N, R )101 W,
TOW14 OF +2�E �--• ��� COUNTY, WISCONSIN.
INDEX
PAGE 1 of 7 TITLE SHEET
PAGE 2 Of 7 SYSTEM MANAGEMENT PLAN
PAGE 3 of 7 PLOT PLAN CP O
VIEW-CROSS PAGE 4 of 7 PLAN SECTION
PAGE 5 of 7 DISTRIBUTION PIPELAYOUT
PAGE 6 of 7 PUMPING CHAMBER CROSS SECTION vw
PAGE 7 of 7 PUMP PERFORMANCE CURVE Ilk
PREPARED FOR
-
13 S 3 pwq i v lz� 1l*r, CL
�vbSOfJ , y J 1 Sib) a
PREPARED BY
WEGE:f =ZE1=Z !0 C3 = L .TEST 3[ NG
AND.
DES I Gfii S�RV I CE
P.O. Box 74 421 N.Main St.
River Falls, WI 54022
Phone 715 -425 -0165 \ .`
Fax 715- 425 -6864 r ..
EtLSWCIHTN, d
was.
DEi'ARCNtENI Oi �• ,,.••'
DIVISION U ETY AND BUILDINGS �' c► ' aL� � �i s � `'
%0 "Imms
SEE CuRRESP CE "v1C'_ �.•"� OZ
JOB NO,
ound System Management Plan Page Z- of
Pursuant to Comm 83.54, Wis. Adm. Code
Septi * ! L V ' / EL /
The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48
S
septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. Theoperating condition of the septic of
and e
outlet filter shall be assessed at leaslxmce every 3 year p�ti The ou et filter shall be cieane as necessa to
ensure proper o er a filter cartrid e s ou not be removed arri>?s3 rovisions are ma a to retain solids in the tank that
ug off the filter w -en removed from its enc osure. If the filter is equipped with an alarm, the filter s a e serviced if
the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The
septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of
the tank If the contents of the tank are not removed at the time of a triennial assessment, maintenance p
the owner of when the next service needs to be performed to maintain less than maximum ersonnel shall advise scum and sludge accumulation in
the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required.
However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and
Buildings Division.
Pump Tank
The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to
verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary.
. ry
.
Mound and Pressure Distribution S tem
No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound
shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic
(other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the
infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather
installations (October- February) dictate that the mound be heavily mulched for frost protection.
Influent quality into the mound system may not exceed 220 mgiL BODS, 150 mg/L TSS, and 30 mg1L FOG. Influent flow may
not exceed maximum design flow specified in the permit for this installation.
The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each
lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be
compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is
required to'maintain equal distribution within the dispersal cell.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner,
and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring.
General
This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code and shal maintained in accordance with '
component manual [SBD- 10572 -P (R. 6/99)] and local or state rules pertaining to system maintenance and maintenance its
reporting. -
No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and
Pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as
POWTS components.
Septic or pump tank manhole risers, access risers and covers sh ould
openings used for service and assessment shall be sealed watertight upon the completion e of t service. And 00 de. Access emed
unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall
be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component.
ki Contingency Plan
f the septic tank or an of its components Y p ents become defective the tank or component shall be repaired or replaced to keep the
system in proper operating condition.
If the dosing tank, pump, pump controls, alarm or related wiring becomes defective immediately repaired or replaced with a component of the same or equal performance e defective
component shall be
If the mound component fails
P to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired
or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption
and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper
operating condition.
Questions about the operation or maintenance of this system should be directed to:
The County Zoning-Office at 1S - 3. -6_�� Q S'(• to IZOIX
The system installer at `1 3$ 6- 3lZ) Se9IUMI���Z
The tank manufacturer at �)p0_3 - as__ Ns
The effluent filter manufacturer at � LZ S7 Za$e
The pump manufacturer of -
- -tj � 0 _ . � Zl7 - U $ VT
PLOT PLAN '
Scale 1
140 Page of 7
i
3y`'1 *4 - E= .1.000 ' oar) L IA-) 7 r U_z .
t3r�`�Z �� 100 - `' -• S" PUPP�E.
r
. �
d r
k�
JO'OF
r
m Z� 4 a7
l
r
M 1 OF dEILL-- ,
i
y ` I
NOTES:
- L L L 714 AU - ,
1. Elevations shown are existing ground elevations unless otherwise noted.
2. Install 4" observation pipes with approved caps. ( Z required).
3. Septic tank to be NW / jSO L gallon capacity manufactured by
4. Bench mark S_= S >
�. Divert surface water around system to prevent ponding at the uphill side.
Page _�_- Of -
•
Approved: sy thetic Coverine
AST - C33 - Distribution Pipe
Medium Sand
G
Topsoil
o l
" o
� b
. % Slope
Distribution Cell of Force Main Plowed
Z" to 2 Z" Aggregate From Pump Layer
t.
E 1.3fa Ft.
CROSS SECTION OF A MOUND SYSTEM s
F O -b Ft..
G 0- S Ft.
' A Ft. F. 0 Ft.
Linear Loading R ie— _� � H S�- Ft.
Rai, -e= a • 0 C_ D /LN FT
Design Loading Rate= t,gjGPD /SQ FT j 1 Ft.
J 1 Ft.
K q Ft.
_ . L 6b Ft.
Fo rce
- o� c =-- M ° -? —^ y W - Z V Ft.
- Observation Pipe
E K
A o -- --=- -- - -- --- - - - - -- ------ -- - - - - -- = - --
_ Force in
ibution
� Pipe Cell of � to 2-
a ggregate
Observation. Pipe
(Aac!%br securely)
' - PLAN VIEW OF A MOUND SYSTEX
Distribution Pipe Layout
Page s of �7
Place the holes at the bottom of the distribution pi
at equal spacing. Remove all burrs from the pipe and pes holes.
Extend the end of each lateral up with the use of long
inches of the � turn or 45 fitting to a point within six
final °ra.de. Terminate the ends of the laterals with a valvI!,:threaded cap or
threaded plug. Provide access from final grade for the valve, threaded cap or threaded plug.
I '
PVC n
Latera! PV ` P
Manifold
x x x x x!Z xt1 x x
Lateral Lenoth
Lateral Length - p
Distribution Line
P
a- _ -- r�CCRSs six
7 Pt
hYs1JlFfl�o — -o
S
i
a --
P Ft. Hole Diameter /1 6 Inch -
S 3 Ft. Lateral 1 Inches)
X ? 3 Inches Manifold " Z Inches
Force Main Inches
l of holes /pipe 1 3
Invert Elevation of -Laterals ° IS - SFt.
13X kA s. 33X 6 _ 31.q -e 6P)kl
Combination Sept4c; and
PUMP CHAMBER CROSS SECTIOM AID SPECIFICATIONS ' PAGE OF 7.
VEIJT CAP � WEATHER. PROOF
JUL►CTIDU sax .
'1 C.Z. VE PIPC y APPROVED LOCKING
110' FROM DOOR, MA1JHOLE COVER t-JI k{
:iIA1DOW OR FRESH wP'StNrA1G LA6EL.
u�'gp�Glou PIPE ALP wTAKE S co,.,putr
GCE
- -
I L" PROVIDE
(}�J
-�- AIRTIGHT SEA I I
L 3.1
Appro z�-�- A 1 Approved
9 _Zc60 I IC I joint w/
ALARM PVC pipe
I r
C I
S 1.00 I I
CLEY. fT.
7 PUMP —�
OFF
D COUCKETE
>Z�_ O b O 1 - pLocx
5
RISER EXIT PERMITTED OAJLy IF TALJK MAL:UFACTURI`R HAS SUCH APPROVAL 1 3- APPR�t>: �DD t N4
SEPTIC F SPECIFICATIONS
DOSE
TA WKS MAQUF 1JUMBER OF DOSES: S' S
PER D;A ..
TALIK SIZC : 1 00 L 6 SCE GALLOQS DOSE VOLUME z
ALARM P _ S � ZT) qnl� S ItJCLUDIIJ 6ACKFLOW: L C.ALl_ONr,
MODEL WUMBE 101 HLAJ CAPACITIES: A= 18 WC14E5 OR 3 0
GALL03JS
SWITCH TtIPE: __ " C Ljl B= _2- OJCHES'OR G{LLOU5
PUMP MAIJUFACTURCR: _ GOUL__=
C = WCHE5 OR 1OZ GALLOLJS
MODEL I.IUMHER: �1�OS 1
D= INCHES OR 2 GALLOIJS
SWITCH TYPE: Y"LL�`R1°U�Z -C/ UDTE: PUnP AUO ALARM A To BE
MIMIMUM DISCKARUE •RATE 3- -- _gL_ GPM INSTALLED ON SEPARATE CIRCUITS
VEKTICAL DIFF.EFLEMCE DETWEELl PUMP OFF AUO- .DISTRIBUTIOQ PIPE.. Iq FEET
+ MINIMUM INJETWORK SUPPLY PRESSURE , ; b �� FLET i. �. 0 7_ 1 . 3�
+ I00 FEET OF FORCE MAIN X Z'1 -I F/ o Fr. �' FRICTIOLJ FACTOR_. 1q FEET
lo
TOTAL 0tI JAMIC HEAD = Z _ 3 _:_ , R FEET
As per manufacturer 1_l gal /in. Liquid depth 38a
• Goulds _°i
"• Submersible
w Effluent Pump
3871 EPO4
EP05
APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Rousing: Cast iron
Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer,
following uses: • Capable of running lubrication and efficient strength, and durability.
• Effluent systems dry without damage to 'heat transfer. ■ Motor Cover Thermoplas-
• Homes components. tic cover with integral handle
Available for automatic and
•Farms Motor: manual operat and float switch attachment
• Heavy duty sump ion. Automatic
EPO4 Single phase: 0.4 HP, models include Automatic
Dewatering RPM, , points.
• Water transfer 115 230 V, Hz, Float Switch assembled and ■ Power Cable: Severe duty
• built in overload with
automatic reset preset at the factory. rated oil and water resistant.
• EP05 Single phase: 0.5 HP, ■ Bearings: Upper and lower
SPECIFICATIONS 115 V, 60 Hz, 1550 RPM, FEATURES heavy duty ball bearing
Pump: EPO4 built in overload with ■ EPO4 Impeller. Thermo- construction.
• Solids handling capability: automatic reset.
1 /a° maximum. • Power cord: 10 foot plastic Semi -open design AGENCY LISTING
•Capacities: up to 55 GPM. standard length, 16/3 SJTO with pump out vanes for
mechanical seal protection. 0 Canadian Standards Association
j • Total heads: up to 24 feet. with three prong grounding
• Discharge size: 1 NPT. plug. Optional 20 foot ■ EP05 Impeller: Thermo- end numbers
(CSA listed model
• Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for d i " to " del
rotary/ceramic - stationary, three prong grounding plug improved performance. or )
BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged
• Temperature: thermoplastic design provides
104 °F (40 0 C) continuous superior strength and
140°F (60 °C) intermittent. corrosion resistance.
• Fasteners: 300 series METERS FEET
stainless steel.
• Capable of running 10 (;
dry without damage to s 30 I
components. j is
Pump: EP05 8 —
• Solids handling capability: c 25
% maximum. w 7 j z 3, tq i i
• _ — i -- -- - ' - - - -- i
Capacities: up to 60 GPM. 6 20
• Total heads: up to 31 feet.
t
• Discharge size: 1 NPT. z 5 ! 3�•°t _ Imo)
• Mechanical seal: carbon- c 15
rotary/ceramic - stationary, a 4
BUNA -N elastomers. - epos'
• Temperature: 3 10 I i PO
104 °F (40 °C) continuous _
140 °F (60 °C) intermittent. 2 i
5 �.--
• 1 i
OL 00 10 2 j
0 30 40 50 GPM
0 2 4 6 8 10 12 m'/h
CAPACITY
m 1995 Goulds Pumps, Inc.
Effective May, 1995
83871
c' PAGE� OF ,)
NAME S l,) � LOT# 1� LEGAL DESCRIPTION f>l -V /SST 31 .N.R I R"E (orw
SCALE: 1 "= ( CSC
ABM I ELEVATION I C} C) ' O
BM 1 DESCRIPTION u : ( ' ^ �t�""R- P� l,C /
,/'BM 2 ELEVATION 1 - 0
BM 2 DESCRIPTION
SYSTEM ELEVATION O O /
ALTERNATE ELEVATION
CONTOUR ELEVATION C/ y d C)
I
� Pte � o' t
� v
�h c dv i v 2 [r✓ll �` �-
to 4n'#
Id I
zlo
SIGNATURE DATE
,visc ,)ns n uepartment of Commerce SOIL AND SITE EVALUATION
Divisi v of Safety and Buildings Page of
:sureaL of Integrated Services in accordance with Comm-8&99, Wis. Adm. Code
Attach complete site plan on paper not less than 8 1/2 x 11 inches ip,size; Plan must County
include, but not limited to: • vertical and horizontal reference point (BM), direction and r I S4 .
percent slope, scale or dimensions, north arrow, and location and distance to nearest road: Parpel I.D. #
APPLICANT INFORMATION - Please print all information. t iewed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). `
Property Owner Prop4rty-Lodation
\. Govt. Lot Sl. 1/4 SUJI/4,S T 31 • N,R jq� E (or)
Property Owner's Mailing Address Lo! # Btock# Subd. Name or CSM#
353 u u Tr. _ _ -.. p<<ln Oaks
City State Zip Code Phone Number City ❑Village Town Nearest Road
t4ucl n i L.JI ,moor I (fits )Sy9 (x`731 2.' – - Zicr = 4-"
® New Construction Use: ® Residential/ Number of bedrooms 3 —J / Addition to existing building
❑ Replacement ❑ Public or commercial - Describe:
Code derived daily flow Oo gpd Recommended design loading rate S bed, gpd /f12 6 trench, gpd/ft
Absorption area required / 2 00 bed, ft lQ 6 0 trench, ft 2 Maximum design loading rate -5 bed, gpd/ft trench, gpd /ft
Recommended infiltration surface elevation(s) 9.S o 0 ft (as referred to site plan benchmark)
' Additional design /site considerations 0 0 , 4a o f 9 r Q d
Parent material Flood plain elevation, if applicable i1/ ft
S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank
U = Unsuitable for system EIS U [�?S ❑ U ❑ S @U I ❑ S Eru ❑ S UU EIS 9 �� U ""
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft
in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed ,Trench
a -tz lb v r5l — 5, I 2 mA- C-5 I v 5 c
t z- 30 1L) / L i � S'. 2 r�bk rY I C 5 ,• w
Ground �d r yl�n F1F� r�l S�C� rrlabk mi CS
elev.
Depth to
limiting -
factor ,
Remarks:
Boring #
k
L a - - SI m cook rnZr C s lV
Z 2 9 -2°f l0 q r ' 1(9 5 - t I 2r`rtc�bd, �, LS — s �O
Ground
elev.
ft
Depth Depth to
limiting
factor
_ 4y z iln. Remarks - ,' 1 6 /� a fad _ d c! 5l L
CST Name (Please Print) nature Telephone No.
A,Ja SchumcLke
Address Date CST Number
Z)13 ''L" 3+. Sornec5 lit 5 y- i -no 2s 33o�
- *V iscanstn Department of Commerce SOIL AND SITE EVALUATION 3
Division of Safety and Buildings Page of
Bureau of Integrated Services in accordance with _CAw rrJ3 , 9, Wis. Adm. Code
Attach complete site plan on paper not less than 8 1/2 x 11 inches ip size Plan muss I County
include, but not limited to: vertical and horizontal reference point (BM), directicin and . , S4 . C.r o
percent slope, scale or dimensions, north arrow, and location and distance to riearest road, pamei I.D. #
APPLICANT INFORMATION - Please print all information. R iewed by 111� Date j
Personal information you provide may be used for secondary purposes (P4acy Law, s. 15.04 (1) (m))..
Property Owner "brty u ation
Ck r + Govt. Lot 5L ' 1/4 GLOM,S T 31 ,N,R tg• E (or)
Property Owner's Mailing Address Lot # -, Btock# Subd. Name or CSM#
53 u e e Tr • 6..� R oth
LJl l I\5
City State Zip Code Phone Number ❑ City ❑ Village 0 Town Nearest Road
f f� i (.J1 ' f2. = Kam,
New Construction Use: ® Residential/ Number of bedrooms 3 ' Addition to existing building
❑ Replacement ❑ Public or commercial - Describe:
Code derived daily flow 00 gpd Recommended design loading rate bed, gpd/fIF !� trench, gpd/ft
Absorption area required /2 C30 bed, ft 2 0 C3 trench, It Maximum design loading rate bed, gpd/1`12 � trench, gpd/ft
Recommended infiltration surface elevation(s) �- O 0 It (as referred to site plan benchmark)
�n v � -
Additional design /site considerations (' � � (-e J 9
Parent material I l Flood plain elevation, if applicable ;: ft
S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank
U = Unsuitable for system ❑ S U US ❑ U ❑ S [4 U ❑ S ISPLI I ❑ S R EIS Wi l
SOIL DESCRIPTION REPORT
Boring Horizon Depth Dominant Color Mottles Structure GPD /ft
Bed
9 Texture Consistence Boundary Roots 2
z in. Munseli Du. Sz. Cont. Color Gr. Sz. Sh. ,Trench
_.. 2 12.30 ID r `I 1 r 5;1 2►-,^abk c
Ground _ �b `�� F �•� �`�! 5 1W mGbk "A CS 5 �
elev.
9 2y ft.
Depth to
limiting
acto '
Remarks:
Boring #
( a -9 (b w N s --- 5; Zmcok m fr C,5 Iv . (P .
Z 2 -Z-r )o r -1H 5; i Z,yn.ab � S
3 Z't- 10 p F IF r `l
L 3 �ncxbk- m I
Ground
elev.
°cI ft.
Depth to
!i
factor r Remarks: C6n� `tom T � U41 �07 - bnd
z1f Name ease Print) nature ' Telephone No.
A& SchumcLkc Cris
Address Date CST Number
Zi13 54o 2s33o�
PROPERTY OWNER 51� c 1 SOIL DESCRIPTION REPORT
Page Z of 3
PARCEL I.D.#
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
2 Bed ,Trench
•S
2 fz io
Ground 3 et 1 8 LO FIv- -T • y
elev.
Depth to
limiting
fa or
Remarks:
Boring #
I
Ground
elev.
ft. '
Depth to
limiting
factor
in.
Remarks:
Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD /ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
Boring #
Ground
elev.
ft
Depth to
limiting ,
factor
in. Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
in.
Remarks:
SBD -8330 (R.9/98)
PAGE _OF
NAME LOT# LEGAL DESCRIPTION -' '/ Wl,,S I $T 3 (,N,R - KE (or)&)
SCALE: 1 "= ( oC-
M 1 ELEVATION I U G'
BM 1 DESCRIPTION AG I , ^ ^c PG (. e
BM 2 ELEVATION 100 '
BM 2 DESCRIPTION
SYSTEM ELEVATION �� O
ALTERNATE ELEVATION
CONTOUR ELEVATION U y
� I
all
az
1
Zlo
SIGNATURE DATE �' ll�f -OC)
11 0 . � lf �y� ' .'fP '' � 1 �` � '' j l ✓ �
AIL
r. �•+` ®1 ��F q *` ♦ \ D \ �q \ '+y L � � q ® + >�s _14I r . t- , ILyLL` ♦ a `LL \` \ ♦
!,,: ♦ � �'♦ i ,� � • � `�s ♦ \ \ 4' j q �g a ♦ > 1 > + 1 1 i � � ' .� �' `1 gg ° , a � yL
I � s r .•` �, ��,� � ti �.1L, ti � .i , !, �j' /✓' a i `' , ° L i t - . �. - .. ,r
���'�'>t �y��. i� �� Ls1.ti`i +��'�qat' \y \.r't'P/` ► '�� � , ► !'�7� / '>1+���+� ��` �i'�,ie, t y1
. u /`� 5.�`•. .+.. it 01J s��,F� ♦ ae • ♦ ♦ �;" ♦ a * '� •� „/�. �F�j� • `. \ . \ �1 0
—�� - v�- C- ,�'- .,�, +, a ♦1 * ., La. , a� y L��1 q \ ��
s ,: Ali �� a ,s` ♦ iii
r* . � � �! �,a \ \ \ s i i i +. �y \�+• \'\q` i�� t L+
�'. I�. ��'" PfrPi�" fl r , Cdr;�h�' +el ���/ r �'°�!s'�� , 4.�' ` flrf�d� � s ' t \1 \?,', ►\
9 �.�1i�f.. A!'�.J�,1�'✓'Irs- prj'/C�e♦J`� for. ` �dT'` d t�'�r \ '�y'1f"l'+' a�� Ze ..,i °,'t \\
w �.✓ �� ,l�jsw�1.�\.'4i.� \ \a�Ra."L.�r, f �� ��i/ ✓ ♦` ° ✓�� /y ". q \ \��31��1
,may s �oa®\aa /,i �r I ✓' 15� ` \ \10 \\
I a�
� '����A� 1111 • � � � \ +, \" i� ♦'��s�'/.,Y�P,� \� �s�a��we♦, ;e r y.r . °. � dr ✓J , � �.
_ s�j► L, i -, f ♦f'/iv'l�t.�d,; +y.G'�.�ry� ♦.� ;, �'1��P: °.!4; ti`L • + j _ .
i e is �a'idr �,5� �., .�y, �'. r��t,�` \ ,, �5 f�
v �'
/ o
01 r-' \> �'4 c% :. .1 �?t c,r' ! a� �3 �! .....�rk:i - '" 'r , •.� 1, •':. f'
w . �r ♦,� r�� � �. �� . l � � ,, y � } . IV
, � _ a . .,•,
♦« � +� ,,/ :\ ; ". ` i �, r ♦ .'' �J J ,� � f a { , � r. ^. � e . + :`s f 4 y .
r
1 ,�� � \+R. , ,� �+ ♦�. s`` I+ < fry.i"�;+� . � .Tr ar ^t � ' r '. y .,. . ,+ _ f y . '
•+'. �J` �j 1�A � ! J, J� '♦ �I � Jd / ms s `'�' t ' r t �� 1'Y _ "� k�
'PAtd`�►'I.�1 r . /� % r '� f w s J' r'
+� � r , a,• , of , �I � � s p,/•f ++" _ � r # �w r/I' /.+i /./y' - y
r �4rdi� '�'',a < �• "�"s '.+:; a•J'+i
I { o ff ♦r \� y'� w /� :v�✓at e♦ > >a°..ayi�r� ♦ :aa. >:a�d�+r +j,
Ii1� fi � � Ir � �,! \ �� 11 n , r �J� /.,j� �t �1'�� ,4.:•�'A'w�.� ��� .t - �4 R ; ti'.4`s, °� �r� �, � I�
f: 1.I �a.`' � 1 � J i . r �• ?;� 'A/'�.'M"��: iyT / + �e1 r �t ����I
d' � � '� � � i '/�'`.. '�' /'� � ♦' �9.7m„� � �� LIB �✓ j ' s •
' \ ����� = .: �'`�� ���aa ' � ��..wa�.r Raa�>a♦. O \0��ga�aatiaa..a>
FF 11
Lei I
i
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page / of '�-
ME INFORMATION SYSTEM SPECIFICATIONS
Owner /U /D _ Septic Tank Capacity dd U al O NA
Permit #r � Septic Tank Manufacturer (� /e3� ❑ NA
DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA
Number of Bedrooms ❑ NA Effluent Filter Model — g v ❑ NA
Number of Public Facility Units Pump Tank Capacity !30 ()ll/ /T al ❑ NA
Estimated flow (average) gal/day Pump Tank Manufacturer ❑ NA
Design flow (peak), (Estimated x 1.5) v gal /da Pump Manufacturer ❑ NA
Sod Application Rate , p �i `j ' 3 �� s/ da I Pump Model �� d S ❑ NA
Standard Influent /Effluent Quality Monthly average` Pretreatment Unit
Fats, Oil & Grease OG) 530 mg/L [3 Sand /Gravel Filter ❑ Peat Flter
Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA
Biochemical Oxygen Demand (BODJ 530 mg/L ❑ In- Ground (gravity) ❑ In- and (pressurized)
Total Suspended Solids (TSS) 530 mg /L A ❑ At -Grade - ound
Fecal Coliform (geometric mean) 51 • /100ml ❑ Drip -Line ❑ Other:
Maximum Effluent Particle Size Y in dia. ❑ NA Other ❑ NA
Other: ❑ NA fir: ❑ NA
"values typical for domestic wastewater and septic tank effluent. Other. ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
O nth(s) (Maximum 3 years) NA
Inspect condition of tank(s) At least once every: 1 2 —�j ear(s)
Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA
❑ month(s) (Maximum 3 years) ❑ NA
Inspect dispersal cell(s) At least once every: Z — 3 13-fe
❑ month(s) ❑ NA
Clean effluent filter As At least once every: Z 3 (s)
onth(s) ❑ NA
Inspect pump, pump controls & alarm At least once every: ye (s)
M-fnonthW ❑ NA
Flush laterals and pressure test At least once every: ❑ year(s)
Other: 13 month(s) ❑ NA
At least once every: ❑ year(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 (Y 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 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 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.
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals
that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents
of the tank(s) removed by a septage servicing operator prior to use.
System start up shall 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 cell(s) 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 cells. 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.
Reduction or elimination 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;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails 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:
• 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:
❑ 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 infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
❑ 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.
Th site has not valuat o ide tify a suitable replacement area. Upon re of the P WTS a soil and site
eve ion u e perfomn to locate a itable lac ent ar no re eme r avails tank
y e installed as a last resort to replace the ai ed POWTS.
Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat 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 OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name SC`jv/.yl Name
Phone 1 M6 31 Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Name
Phone Phone / �� , ,
This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1). (2) & (3), Wisconsin Administrative Code.
rt h hapt
r ST CROIX C01UNTN'
` SEPTIC TANK MAAINTENA =SCE AGREEMEN I
AND p�FINERSI:-iTP CERTIFICATIQN FGA
Owner /Bugger -
' E
3 :.�
Mailing Address ---� --
Property Address � � De artn'tut for new GonsTructiatl)
(Varificrrtiorl required from P.anninB P
Marcel Cdentification Number g 3! Lg 10-579 City/State ..� �
F- fir, Town Of
S cJ ' /,, Sec. / 7 �_..-
Property Location �,6 /,, _.• ---. , Lot # �.
Subdivision =�-� ^, rage #
volume
Certified Survey Map # ' Y �, p
� 2
Volume ..L -----
eed #
`l
�V�tr _ es G n
Lot lines identifiable y
( Spec,'hcuse yes u
ears or s e fail�ua to krandle vrastes, Proper znaintararce
N reznatur er. at you put iuito t h e sysrcrr�
r use and � tenaxlec of your optic systerza could result in its What p a Licensed P='
Per every three years sposal system.
, if needed by
ant the septic taza�. a is the wa5tt di
consists of pumping tic tank as a treatment stag
can affect the fuzlction of the soP De a nment a ccrtlficatian form, signed by the owner and b }' a
roe owner a , roes to submit to St. Croix Zoning p pu mp er verif g that (1) the O n - is lesr Of sludge
Thep p rtY ber or a lietnsedpturl4 the sep
nSasterplumbers�ourueymanplumber, restr%otadpium f neccsaary), darcl
oadition andlor (2) aft disposal er inspecrian and pumping ( stem with the
star
it in proper opera 8 o taro the private sownBe' st sy
Wee to crawl State of Wisconsin. Certu�ioatior�
31we, the undersigned hove read �a� n
leut of Cors>nteCe and the Departni
tnt of Natural Resources, Office within 30
r ' as set b the Dcp cam letad and retained to the St, Croix County Zon>n$
hc.eut, y p
s et forth, t� tairaad must 3 t our iptic syettm has [7Gen ri1alIR
- the yo r C
days
of three soar expuat�on date.
DATE
I(5NATURE OF APPLICAANT
ai
o w e, I (we) an7 (are) the owncc�a%
QA NL � CEurr^t�'�iC'� �`� are true to the best of my (our) kn g
I (we) certify that an atat, ,OrLts oa this form
the property
dascnL
dd about, by virtue oY a wslrt'anty dead recorded in l�cgister of Deeds Of 4e (
a, 2ii�T DATE
SIGN QF APPLICANT revoked by the T
�� *� ** Any Departrn
lien that
is rnis- represented May result in the sanitary permit being
in,forrrla office
y D r SatdT a
A tieatian: a stamped warranty doad from th Reg warranty de ed
*w Include with this app 3 copy of th cartifted juntey M if referMo 1S made In tll�
15 -'2
STATIC B" OF WISCONSIN FORM 2 • - LM
Datumad Numbor WARRANTY DEED 7' T
I T
This Dead. MMIC between -- Gavle -"UU and ROOMY K. RECCVP FOR RECORD
Callahan, husband and Hft !0:45 AM
Grantor,
l
conveys and Warrants t husband and W AQ"V, I rey
wife
Grantee. F--..
Grantor, for a valuable consideration, conveys and warrants to GnIM99 the TzAHSFP FEF.-. 125-00
f described real estate in- St. Croix — County. State of Wisconsin (The PEt-ORD14i FEE: 10-04
ReurdL Name std /y ea Addr..
038-1077-70
p identilkstion Number (PIN)
This Is homeg"dPrOPOM
SW 'A of SW 14 of Section 18, Township 31 North, Range 18 West, Town of Star Prairie, St. Croix County, Wisconsin which
includes Lot 1 of Certified Survey Map in Vol. 13, Page 3750, Doc. No. 612266.
Exceptions to warranties: Easerarnis, restrictions and rights-of-way of record, if any.
Dated this - Zqj!2_day of February, 2000.
0 t ,� {'d of �d�.�e�
ah
Calls"
(My 4
se.mry K Ce ttt
ACKNOWLEDGMENT
STATE OF WISCONSIN
AUTHEIMCATION
Coualy
Signature(s) Gavic X. call" AW &SOMME;. Callahan,
Personally cam before rw this — day of February,
'nushWW wife 2000, the above namil to me known to be the
— authenticated this 1LO of F ebruary, parson(s) who executed ft f=80 instrument and acknowledge
2M. the wins.
++ Kristine gland •
Stat of W
Notary PubliE. isitl
TITLE: MENMER ST OJE BAIL OF WISCONSIN my Comission. is permanent. (If not, stag expiration date;
(If not, — I —')
authorized by 1706.06, Wis. Stats)
rNiS INSTRUMENT WAS DRAFrED BY
Asuirrity Krktina 0slarid
Hudwal W1 5016
nay b Both are flatrwCOMY-)
'N o j persons signing in any capstity Omid be rmd or OlUld below their signw'"
WASIAWW can SrA711 DAR orwiscoNsill
r0" IM
jkFoKMATjQNPR0FE3S10NALSCOMPANY FOND QULAC.W
v �ry o f ,uvo av r i •.� \ \���
. � ' \\ o re•. \ '
a�' 8 PN V
8 89 E 375.44'x. /
.44' t7 `
�a
33.00 1
to
I 1.808 ACRES
1.577 ACRES 78,786 80 FT ®�
66,706 80 FT '' / O
• r � 83°06,41 E 333.3, 8 81 °24'42 E 388.82,
1 2.18•
i
946.6 bf a9
�P o
1.508 ACRES
65,694 80 FT
2.111 ACRES ' ` ; 0
213,8, 8 76°5 ?Ze. I
91,96E 80 FT ` N e _ I .
I� I
\ 401. 90.
O \ � ® 1 � W
Z �. 7 I
�� oFT ;
l `�' 1 >> $�• Z
8 89°33'16' E 312.27' 1 �` ,. la
. 4 Y 1.511 ACRES
s 65,824 SO FT I
1.403 ACRES
�l 61,117 80 FT
\ _ l
42
N 89'WI w 709.75' DEDICATED TO THE F
`c$
M
rOP O F MONUMENT
SOUTH LINE OF THE SW1l4 N 89 0 33'16" W 145 2.49'
tOP
O
_CEViITT�970.00'
J.S.a.S. DATUM OF 1929 210TH AVENUE
TED BY MICHAEL ERICKSON JOB NO. W179 DATE: 6-14-00 U N P L A T T E D LANDS O W N E L