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HomeMy WebLinkAbout040-1205-30-000 ry, o -°°' ° N ° 03 °� I M Oa of O O � I I p � O N v d V 0 O rd c p a� c ti e € CL F a - o o y E y c c P3 CD a o c Z ° c Z E c LL c LL O L O T C 3 (D x o Q w E Q O air I Cl) CU v w z 0) E E Z = O :' o Z € 0 0 v m H Z a m a m 0 O Z c c o o LL Y 0 N Z a) Cl) N 0) N m a) C a CL N 0) N �' m Q z m z z z w N z l d d c �) N V O O > d m LL U w « " c G a ti G C a -0 g 1 U) d7 Ur) :3 o 3 N N Nr �I 0 1 C7 M ! O O O n C7 O O O 0 d z CL c 7 O N 'a O CO M m o O N w N N � o u� O I E rn o O E I L — O m C O O m C C D a � � N CD fA a) � LO � N �1 E 'O °—� Q } v1 �p 'O °' Q Z (A co O Lo N C ` 'O W C 0 N O O O p 0 E O Q {.7 p O C C N C t> n. p F O € p c O N O O 00 C m N O C O 7 N M O N �- H v Z co O) a .2:1 c c c d O M d • O H O N N z N= H m 0 z Z w In CL IL Q 2 L: CL Lam 0 co t Y�l a c c :: c +• o t A c0 ° ao ',0U)i 0 y00 I - AS BUILT SANITARY SYSTEM REPORT OWNE V jpt�(T)tk-SEeCj,& , j r>NSHIP [ roy SEC. j'�iv -n w ADDRESS $ ST. CROIX COUNTY, WISCONSIN. � . t �'Q _ a SUBDIVISION ,�,ay`��� %� .OT - 'S LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 VERY THING WITHIN 100 FEET OF SYSTEM aw 0 r „ VI �+ I,c � 9 I dii6-a e flo thj Arrow �)A L SC BENCHMARK: (Permanent reference Point) Describe:' S / .4J- Elevation of vertical reference point: ��,.� Slope at site: SEPTIC TANK: Manufacturer: �p� ,� Liquid Capacity: /e (2-4L Number of rings on cover Tang manhole cover elevation: Tank Inlet Elevation: e Tank Outlet Elevation: 4nfflm5g t PUMP CHAMBER Manufacturer: Number of gallons Number of gal. pump set for a cycle gallons; total capacity o distribution lines gallon: size of pump head; gallon per minute horsepower brand name of pump .'and model number ; Type of warning device HOLDING TANK: Manufacturer �� Number of gallons Elevation of manhole cover Type of warning device SEEPAGE PIT SIZE: �J!Q,,, um er ot pits feet diameter ,.feet liquid depth seepage pit in e -t pipe- elevation bottom of seepage pit elevation feet .3 3�',EM p�p`('A SEEPAGE BED SIZE: number of lines w id t h /�% length 55 tile depth Zo SEEPAGE TRENCH: width or, length PERCOLATION RATE 10 -3p AREA REQUIRED 9y5'b REA AS BUILT 957 [3 .INSPECTOR .DATED PLUMBER O JOB LICENSE NUMBER M.!r, I ..r ` s .� �,., ., `�.� r j _,M 1.. I �. t , i ...r- .�...._ ..�.. ... _.. >.... ', - ., ..� a , �' :- i .� �� 'B � it AS BUILT SANITARY SYSTEM REPORT .:TER , TOWNSHIP `�/� ®� SEC. _ T .zg N, R __t W ,0. ADDRESS , ST. CROIX COUNTY, WISCONSIN. '13DIVISION , LOT - LOT SIZE .3 + PLAN VIEW -Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM �.. » ' S•S t m0 bo ' c-7 1e �r. 7-r I M a Rr 15e p /o 4,-!r1_ WE4 LT, s•.T • wk�.��io aen a�' - L TIC TANK(S) 6? dD MFGR. (,�J� 1 Er CONCRETE `' STEEL NO. of rings on cover Depth DRY WELL '.INCHES NO. of width length area s no. of lines 3 width lengt area 9XS depth to top of pipe 3REGATE 2 _ :K RATE /p_ : a a _ AREA REQUIRED Q.gl� b' AREA BUILT :claimer: The inspection of this system by St. Croix County does not imply complete -pliance.with State Administrative Codes. There are other areas that it is not possible inspect at this point of construction. St. Croix County assumes no liability for Item operation. However, if failure is noted the County will make every effort to _ermine cause of failure. BASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. ~ INSPECTOR DATED PLUMBER ON JOB ��p11i LICENSE NUMBER 9 4/ REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM Sanitary Pe.nmi t CP 7 State Septic ,2 'DAME �� ,�� Townbhip St. Croix County f ocati on i�tj AlF, ec�tion_„pLot # Sub ivi,6ion 'EPT T ANK Size – – gaXxonb Numbeh o6 campantment�s� 64om: we1.E f Building / � 12% stope�__� Highwaten - flUM PING CHAMBER Size gat.2on4 - Pump Manu6aetune4 Modet Numb' a H OLDING TANK Size_ gat ton. Number o6 Compahtments Pumpers Atan.m Sy.a tem )�. ,6tanee 64om: Glett Bui.Eding 12% 6tope_ Highwate4 ABSOR PTION SITE Bed Trench 4 6nom: Wett Buit,ding__ T2% .6tope 0 Highwaten ,BSORPTION SITE DIMENSION Width o trench r 6t Req uiAed area � � � - - ^ 6t Length o6 each tine � 6t Depth o6 hock below tite in Numbers o6 tinee Depth o6 tock oven tile._ _4-n To.tat Length o6 tines 413 !2 6t Depth o6 tit-e below grade_ 2 - 0 1n D.i.etance: between tine.6 At St o6 tne.nch in. pen 100 At Y 7uLA1 absUlLpt-i. opt area — 6t Type o6 Coven: Papers o4 trcaw 'IT DIMENS ": Numb eh o6 pit.e et around pi t�s yee no Out,6ide diameter D pth below inlet At Total abbonption area i At Ar ea kequi4ed � 6t INSPECTS TITLE 21 1 PP VED _ ��" � DATE 19 V REJECTED DATE 198 �ZEASON FOR REJECTION REPORT ON INSPECTION OF SANITARY PERMIT # 99� (1 ) Name and Address of Permit Holder Person /Persons at Site (2 )Date of Inspection Name, ess, o. o ns a ing Plumber Time of Inspection 3 INSTALLATION CONSISTS OF: ❑ Septic Tank ❑ Seepage Trench []Dosing Chamber ❑ Seepa a Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System N ermanen reference in escri e: Elevation of vertical reference point: Slope at site: (5)MATERIAL AND DEPTH OF SEWER: (6)SEPTIC TANK: Manufacturer: Liquid Capacity: Tank Inlet Elevation: Tank Outlet Elev: # ft to lot or property line: # ft to well: M DOSING TANK: Manufacturer: # of gallons: # of gallon pump set for a cycle gallons; total capactiy of distribution lines gallon; size of pump head; gallon per minute ; horsepower ; brand name of pump and model number Is the warning device installed? ❑ YES ❑ NO Wired? ❑ YES ❑ NO 8 HOLDING TANK: Manufacturer of gallons ; construction ; depth to the cover ft; If septic tank is being used are baffles removed? YES [ ft from residence; ft from well; ft from property line. Type of warning device Is the warning device installed? ❑ YES ❑ N0; Wired? ❑ YES ❑ NO; Locking device on cover? []YES ❑ NO; Diameter of vent and material Distance from building to vent (9) SEEPAGE PIT SIZE: # of pits; ft diameter; ft liquid depth; ft to residence; ft to well; ft to property line; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than seepage pit inlet pipe - elevation ft; bottom of seepage pit elevation ft. (10) SEEPAGE BED SIZE: ft width; ft length; tile depth.; li.neal feet tile; ft to residence; _ ft to well; ft to lot or property line; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than 20% falling away toward lakes, water courses or drainage ditches Elevation of tank discharge line entering bed ft. 11 SEEPAGE TRENCH: Total length of seepage trench ft; width ft; tile depth ft; ft to well; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than 20% falling away toward lakes, water courses or drainage ditches; elevation of tank discharge line entering seepage trench ft. (12) Has system been installed in area indicated on EH 115? [] YES ❑ NO (13) Has system been installed in floodway? ❑ YES ❑ NO Floodplain? ❑ YES ❑ NO DILHR -SBD -609 N.0 /80 Signature of Inspector i 1 "'753 REPORT ON INSPECTION OF SANITARY PERMIT # (1 ) Name and Address of Permit Holder Person /Persons at Site (2 )Date of Inspection Name, Address, Icense NO. ot i ns a ing P umber Time of Inspection (3 )INSTALLATION CONSISTS OF: [ Tank ❑ Seepage Trench ❑ Dosing Chamber ❑ Seepage Pit ❑ Seepa a Bed ❑ Holding Tank ❑ Fill System B N ermanen reference Point) Describe: Elevation of vertical reference point: Slope at site: (5)MATERIAL AND DEPTH OF SEWER: (6)SEPTIC TANK: Manufacturer: Liquid Capacity: Tank Inlet Elevation: Tank Outlet Elev: # ft to lot or property line: # ft to well: (7)DOSING TANK: Manufacturer: # of gallons: # of gallon pump set for a cycle gallons; total capactiy of distribution lines gallon; size of pump head; gallon per minute ; horsepower ; brand name of pump and model number . Is the warning device installed? []YES ❑ NO Wired? [:]YES ❑ N0 8 HOLDING TANK: Manufacturer # of gallons ; construction depth to the cover ft; If septic tank is being used are baffles removed? YES ❑ N0; ft from residence; ft from well; ft from property line. Type of warning device Is the warning device installed? ❑ YES []NO; Wired? [ ❑ NO; Locking device on cover? ❑ YES ❑ NO; Diameter of vent and material ; Distance from building to vent (9) SEEPAGE PIT SIZE: # of pits; ft diameter; ft liquid depth; ft to residence; ft to well; ft to property line; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than seepage pit inlet pipe - elevation ft; bottom of seepage pit elevation ft. (10) SEEPAGE BED SIZE: ft width; ft length; tile depth.; lineal feet tile; ft to residence; ft to well; ft to lot or property line; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than 20% falling away toward lakes, water courses or drainage ditches Elevation of tank discharge line entering bed ft. 11 SEEPAGE TRENCH: Total length of seepage trench ft; width ft; tile depth ft; ft to well; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than 20% falling away toward lakes, water courses or drainage ditches; elevation of tank discharge line entering seepage trench ft. (12) Has system been installed in area indicated on EH 115? ❑ YES ❑ NO (13) Has system been installed in floodway? []YES ❑ NO Floodplain? []YES ❑ NO DILHR -SBD -6095 N.0 8 Signature of Inspector f State and County State Permit # Permit Application CountyPermit # as for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address:'S�F� �. B. LOCATION: 1YC '/4, Section Z,6, T y t N, R 14 E (or) a Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village Ckavok -- STArmov Township Y C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family Duplex No. of Bedrooms 1 No. of Persons D. SEPTIC TANK CAPACITY &OC2 Total gallons No. of tanks f HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete Poured -in -Place Steel Fiberglass Other (specify) New Installation Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured -in -Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate — Total Absorb Area sq. ft. New 0 ( Replacement Alternate (Specify) Seepage Trench: --- No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed: �_Length ZV Width_ L� * Depth Tile depth (top) ' �� No. of Line Seepage Pit: Inside diamet$�r�� Liquid Depth No. of Seepage Pits Percent slope of land jYv Distance from critical slope-7 WATER SUPPLY: Private EF Joint ❑ Community ❑ Municipal ❑ Owners name as listed on EH 1 15 if other than p owner: I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH -115 prepared by the Certifie Soil Tester, NAME r C.S.T. # - :!5;?l and other information obtained from "<' (owner„ ui . Plumber's Signature MPfPdFP'149w# ,°;' -'i Phone # - 4 /7J Plumber's Address L3 4Vg6m3 L4 - IrL PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca- tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors property. If well has not been drilled please indicate. ZI 4- Ir E a F 7 i t t t 7 � E I � t 1 F ..« .., e € E E , a Do Not Write in Space Below FOR COUNTY AND STATE DEPARTMENT USE ONLY Date of Application �f3 'a 7'�b Fees Paid: State �y, '¢y Cou ty ?�• `'�� Date ' ,, Permit Issued /Rejected (date) /6 -,9 7 Issuing Agent Name Inspection Yes No State Valid# Date Recd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 7 /1/78 L "If You Like Our Service, Tell Your Friends" / BIRCHWOOD PLUMBING AND HEATIN E. F. GROVE OWNER '� PHONE 425 -8824 ' ROUTE THFj IVER FALLS, WISCON 022 / C L ivz R Ra Z f � �b teeo CAL, O $•FN��! M�RIC 1 Ax L3 -2 o Qb r5 ,La 7 J. R \ GoT3 ��S•M EH 1-15 : WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES .DIVISION OF HEALTf-I, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS $ LOCATION: NW %, ME %, Section lW , TVN, R E-►) W, Township or alit+ Y = Lot No. 73 , Block No. 7t..r,>\iCtt2- STA'I['1 a County Subdivision Name Owner's Name: 17+yk- L.cwlSTttuc..Tt�� b'7> Mailing Address: GNU �T. �1 a,L � 1- �►- <... °yl�( T S '. TYPE OF OCCUPANCY: Residence 'X No. of Bedrooms Other' EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT S 4 DATES OBSERVATIONS MADE: SOIL BORINGS PERCOLATION TESTS 4— I SOIL MAP SHEET t' Z SOIL TYPE 7b4 il�` Z' l3vR -w- L1p►fyDT PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN /IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P_ I 7 5 ; 7, -q" s 2U N d P- Z Ala „ !. rs Z � IZ "Zc> ►.lam 30a Z II4- Z �lfd - Z ' /g 1 Vir P— iu� tc- 10 1 --r. ti t4w I 0 vc . SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) B D A.TEO l — 1 O -- $t0. = Z 17� rl n► `� � Zii4 r� �.i � ► 1 S B- B— PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indica number of squa a feet of absorption area needed for building type and occupancy. 6 - rl 11J 11UA lKQA -i 7;. Z< � 15 ?__ Indicate scale or distances. Give horizontal and vertical reference points. Indicate sl xv A ' o F _41 121 limit a • s tN %u o • b ? GY IOU ai q av C P = q 4,41 LA;r- I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. Name (print) . _ aAwtA s L , M v12Pv1-! Certification No. 5 �-✓' L'� Address 31 Y`► , ZNa -C_ 'r S 22 Name of installer if known ` C-, e 0 CST Signatur ` COPY A —LOCAL AUTHORITY , EH 115 1`16. 9/78 J R REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES (3\ 11 01 P.O. BOX 309, MADISON, WISCONSIN 53701 � N � LOCATION:' /4,.�'/4, Section !� ,T' N,R r9E� W, Township �nieipatity "%- C. ® ✓�i2. �TAT� OA.r �! u Lot No. � ,Block No. County � f/s �ST b I N ame Owner's /Buyers Name: Mailing Address: 3f / ~ - TYPE OF OCCUPANCY: Residence _ e — No. of Bedrooms 3 COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW t REPLACEMENT ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS lam" l70 PERCOLATION TESTS SOIL MAP SHEET g Z NAME OF SOIL MAP UNIT Qyu P RCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTE INTERVAL MIN /IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- N O ��- I►IA"C\ o W ��i S t,A N O V - C q. S o l- 0 2 P N G \Q b M SOIL Go J 0N.. P- 7 '� R 'K -rta W S rt %A s P_1__ - rL >r nr \ L. t v 6 . O T ZO I P 1 o .O I M G Mo v P ; T G JQL t � \. to #-A P- N wo ut-0 %Lr `6 b0'N 1 VVLW -r% IC M 1"V`t S I N 11 Ir ..._ IrK►st � P- rZ�T� 2� o A - 3 Zos C-IS s•ca.�r SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO BEDROCK Q6SERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES B - 7 z. N aK>r 7 - 7 7. - 7 i3 L T u s\ k Z4 S ' O" S B Z No m > -1 �` 1 L. I'S ' 3 0" I � �.� B„ � Z s C]r • ' S B- 3 74 - fA > - 74 - " 131 L Z 5" i, 1 R " is J 4s • " 546 B- Z, - 78 r4lb NL - 76 " 81 L 'Ts • Z9" 5 :1 " 31 %, s QI " S B- S 7Z N KIS '7 ? c t" b% I.. TS • 3 L" Si� 311" 4 B- co 7 - L rJ0Vdk z- 4" %1 L T • '�sO 30" PLAN VIEW (Loc&4p�rcolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy !b) 5 SQ \� t• Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. t s - F E e •�� r / r °�° S ,� � $DK 1323_ _ 1- � . �. � E (--� '' !off v 0 _ 13A�c�a lP► - i $ s ; 9 § � �.,.. „� - i ., F fry � Y ' IO �Q S -� - G'I • $ � I, the undersigend, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. Name (print) 1V` VtZ Certitication No. 55 - 5V 7 Address 3 1 4 - y A R1. Lee_ 5 , l Sd, O ZZ .Name of installer if known A 0,00r CST Signatur Copy A Local Authority -- 117 /000- IINW— REI fq1 ON OWL BORINGS AND F ► 1COI, WISCONSIN DEPARTi1gENTOt° HEALTH AND SOCIAL SERVICES "` P.O. BOX 3 9 MADISON, WISCONSIN 53701 LOCATION;�,..,._ 1►, ,T „, N, L W, Township ity . +, R1rr r♦ 4r.iiwr Lot No. , Blook No. ter++° °'” :" ar Coun IvistionName tY Owner'x/Buyers Mailing Address- 1 - YPE OF QCGt1PANC*4 Residence No. of Bedroomi COMMERCiA EFFLUENT DISPO64CISYSTEM: NEW A REPLACEMENT ALTERNATE SYSTEM OT"ER....�....._. DATES 08SERVATIONS MADE: SOIL BORINGS +f j f ... ..,. PERCOLATION.TE SOIL. MAP SHEET ; _ Ze W _..,,_., NAME OF SOIL MAP UNIT PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- SINCE HOLE HOLE AFTE INTERVAL BER INCHES THICKNESS 1N INCHES IST WETTED SWELLING IN MINUTES PERIOD t PERIOD 2 PeRIOD 3 MIN /IN P P- P" •.wo.� .w+,.=. —" ,, t r.., ai a', .. ,' ..r b',..-A b 1 P— P— P SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS.OLOA, NUMBER INCHES TEXTURE, MOTTLING AND DEPTH TO`8110R CK I, OBSERVED ESTIMATED HIGHEST IF O8$ERVED IN INCHES B-'^ ,'? a ,, r • .4. g x B"^ w,RS4w. 1" W�" jx... PLAN VIEW (Locate p6teolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the Iota Ion cF'slg. feet °tff suitable arm. Indicate number of square feet of absorption area needed for building type and occupancy ; � �� "� �; inoft tla scate or distances. " Give horizontal .and vertical - reference points. Indicate slope. a . , 1 r 3 �+ S } „ i J i ' .,.. b _+ ' 41 F �� 1 { I , �51 . !� —.. - r I. the undersigend, hsreby certify that the soil tests reported on this form were made by me In accord with the prnredura4 end awthods specified in the Wisconsin Administrative Code, and that the data recorded and locatiomof text holes are correct to the befit of my knowledge and belief. a' Name I;wint! ti, Certification No. Address + .:,. •�.� ;� �.... it 37 Name of insulter if known CST Signature CoPy' D — slo C*py for Soil Tester I � ��., 3 r _" � �. ,• � .. s � � � a " '_. __ y ' : _s . - _z. ._. ,. ..,� .� _ ... ,. ,. .,. - .. �. M- -- _ � .. i I� Wisconsin Di )artment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and F' iilding Division / INSPECTION REPORT Sanitary Permit No: 430367 0 GENERAL INFORMATION (ATTACH TO PERMIT) 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 X Township Parcel Tax No: Brim, Robert and Lisa I Troy Township 040- 1205 -30 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: © 1 OD T b p j " PV G (Y) I� 16.28.19.957 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM cM hate Aeration Bldg. Sewer . T� /D D 1`�. Holding St/Ht Inlet y g� /61 C% TANK SETBACK INFORMATION St/Ht Outlet S 106 0 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic > 1 Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System n,id i�. vi- 2 11. o cfs ,03 t U.( vast I t. 0 5 3 ) ! , v `S � ar , We A CC 4s PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Cover 111R� Model Number TDH Lift Fricti Loss System Head TDH t _T_ Forcem ' Length Dia. ist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width r Length No. Of Trenches 3 PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth ONS DIMENSI J b/ 1' �D�'l -S SETBACK SYSTEM TO P/L JBLDG IWELL LAKE /STREAM LEACHING Manufacturer: /- INFORMATION CHA UNIT e +- Type Of System: re to " / d ber: �" V�� �� S -> / V b DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole �Size x Hole Spacing Vent to Air In tak Length / / Length Dia q Pipe !-f'' // S acin JV � ,� AJ A /V W/ J / Dia p SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over De th Over xx Depth of xx Seeded /Sodded xx Mulched Bedlrr enter Bed/Trenc es No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection Location: 560 Omaha Road Hudson, WI 54016 (NW 1/4 NE 1/4 16 T28N R19W) Glover Station Lot 3 Parcel No: 16.28.19.957 1.) Alt BM Description =p, l(() ii j om b Y4vt� t� y �� fait k ny y "4e5' JO 2.) Bldg sewer length = lo b l [,yJ�t7 {{__ t (t -. b y �r�t � L' � L�' � 4 "C if N°t - amount of cover = a4 C t an oe �� 1 / Mot h61..f" r 0 514 ` -- - -- L U Plan revision Required? � Yes �o U ^ Use other side for additional information. �7� ` - - - - - - -� [ 5�! VV SBD -6710 (R.3/97) Date I Insepctors Signature Cert. No. a nx vo - a4 rA. 1 14 Jt{a wits ST GR$ CO ZONING IQ1001 Sally ad a 0 N 1Dieisiea Cower 600� a 2011 W. wt o k w l Avg, ?.a 7� �K 1Yt S97a7' - z (es illei is Co: ne Va"t of Comtm (6W261-45" REC 3D 36 Sanitary Permit A"li+cation 1* 03 ts.e k a "e.aea caw�e to ��. a w�. C•+� �wds Vas S E P owes east eier.eeneeeey P.1. s try tee., d s.w=x+y ► a A"Mo L Ap Bleat. laftn at es - flare i'.!a An 6eR+r.eetiew c o u 4SU-- zoNiN arsrr�e rase teeat a 3 ' siort *� C. i Sa. r' D 0 h"" 0 -laws moms Ad*M #01110101,09willas Ewa n T"t of saillding (do* as *M ap ly,1 CSU Newaer trDtiMl - Deacal�r iIlrs ❑Stiwte+rwt- Deree#sUse 11L 7yr of PwvAh (Chalk w1y awe box as line & Cewykle lass X if " Now 9j a- xx op l ownw S ysaas OTVAIWOWAI&Offift er oeir 0 odw Noddembas m80004 Sigman Ramew ❑ twak RwMa n amw of CI tawit Twooft a Ns i it teenasf *« ► rMe►sr ar* Dac t>swd 111116 -NO Lawler oe�eer IV. of rovers i4esw d D Uw.f; a4 W sf r *Ab U0 0 era..e c H aF .9 nisak 1W 0 wea.ae 0 tnss.ehee er Ommd O ftM Teek O iws rem O +Veeolic Tearnseee lam O Reairtuieia* Sad Fi W 0 e serer tnaee ❑ CLwiv ❑ c Las 0 a 0 - 7 t Design SON ]t+roww Arm Rsgs&W ( Ann > i F o q 95 , Vt. TkA tots Ci wiv is Taus N Na 3*9 3wd Fha PGisas 001111006 erlatae of LMiits E'eseaere Coeseneeed (Ads MOWS h�lu x4165 7tirewfs.e ids 000ea ML - t at M* r*" ter .t wK tfiWU e%&M w ge aetseW t 'r Now B aimess Mow INesba S3 `7S Phobos Addlama Ckal.C+4. t.io v,rz. N c vm. c (" ©oiee .d saniaey t iw Not W" (N• ) Q o. c».�n. te. wee., �) 250 2 3 ix C"Oftas.r AptorduRa..aa Rey t ra, i „ o� 3) � �r SYSTEM OWNER; p,� .� 1 Septic tank, effluent filter and �� °`�_ LI ,�j cT dispersal cell must all be serviced / maintained '� �_ 6- u. ' cw- t as per management plan provided by plumber. cob- `J1D" __ _ p; �' 2. All setback requirements must be maintained "�"'' as per applicable code/ordina - -- F pubto+t*►de SBD -6398 (R. 08/02) i 1 lot ok 3 i i ok t VL t I l - • , nn ,4 E Y S to 7 ay to .IQ 1 -q G-..) IN o4j o -1 aos 3Q, 00c� - _ 2 4 4 ` R6ft\ y o n .� y��� ►�V �..P � Q ! l � '. �'„ i �. '. I i i �_ i i � � -- i � I i i j i _ _ i > � _ _. __ ___ i _.. I � 1 i .. j ' ;� i i r. + , . � ..Lhr I • � - -- „ � � _ .. R , � '. i I '� ', i - i . _ :- - . i i ', li --- ', '. 1 ' '. j ' I j 1341 Wisconsin Department of Commerce SOIL EVALUATION REPORT P age 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel Soil Service Attach complete site plan 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 dimemsions, north arrow, and location and distance to nearest roa Parcel I.D. 040- 1205 -30 -000 Please print all information. viewed By Date Personal infonnalion you provide may be used for secondary purposes (POwrtm (.15.04 (1) (m)). , Z3 Property Owner Property Location Nelson, Bill & Linda Govt. Lot na NW 1/4 NE 114 S 16 T 28 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 560 Omaha Rd 3 na Glover Station City Statq Zip Code Phone Number J City I Village a Town Nearest Road Hudson WI "j 54016 715- 425. 6518 - -` Troy Omaha Rd New Construction Use: 0 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement J Public or commercial - Describe Parent material Pitted outwash plains Flood plain elevation, if applicable na General comments and recommendations: Conventional ,system elevation 95.00ft,trenches spaced and depth to code 5.00ft below grade. M jim Boring # Boring Pit Ground Surface elev. 100.00 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fN in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 1 0 -15 10yr3/4 none sil 2msbk mfr gw 2f/1c .5 .8 2 15-43 10yr4/4 none scl 2msbk mfr gw 1f 3 43�- $ 7.5yr4/4 none sl 2msbk mfr gw �4f � 4 68 -120 7.5yr4/4 none sl/Is 2msbk mfr na 5 .9 �. 'S , n sT j Boring # I Boring vim- ,�, 01 Pit Ground Surface elev. 100.0 Depth to limit#�g factor 130 m. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -8 10yr3/4 none sil 2msbk mfr cs 1c .5 .8 2 8 -15 10yr4/4 none sicl 2msbk mfr cs na .4 .6 3 15 -49 7.5yr4/4 none scl 2msbk mfr gw na .4 .6 4 49 7.5yr4/4 none sl 2msbk mfr gw na .5 .9 5 69 -130 7.5yr4/6 none cos osg ml na na .7 1.6 s f. * Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < mg/L and TSS S mg /L CST Name (Please Print) nature: CST Number David J. Steel 248956 Address Steel Soil Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 7/30/2003 715- 246 -5085 Property Owner Nelson, Bill & Linda Parcel ID # 040 - 1205 -30 -000 Page 2 of 3 a Boring # Boring 0 Pit Ground Surface elev. 99.00 ft. Depth to limiting factor 130 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -9 10yr3/4 none Sill 2msbk mfr cs 2f .5 .8 2 9 -15 10yr4/4 none Sicl 2msbk mfr cs 1vf .4 .6 3 15-43 7.5yr4/4 none scl 2msbk mfr gw na .4 .6 4 43 -63 7.5yr4/4 none sl 2msbk mfr gw na .5 .9 5 63-130 7.5yr4/6 none cos osg ml na na .7 1.6 F-1 Borin Boring # Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring # I Boring J Pit Ground Surface elev. ff. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD 5 > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD <.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 STEEL'S SOIL SERVICE INC. David J. Steel 1564 Cty Rd GG CST- POWTSM Bill & Linda Johnson New Richmond,WI 54017 Lic. #248956 NW1 /4,NE1/4,S16,T28N,R19W Bus.(715) 246 -6200 Town of Troy, St.Croix Co. Fax (715) 246 -9372 Glover §cation I.ot, s L°e99Sd I" = 40' Benchmark Ele. I00.00Ft op of 1/2" PVC pipe Ca� Alt Benchmark Ele. 98.85 / Top of 1/2" PVC pipe ❑ = Borings Boring Elevations BI = 100.00Ft f OD �L B2 = 100.00Ft B3 = 99.00ft B4 = 00.00ft Z � � 36 A r 1� y �6 i me� 4- TANK c��tt1 7- 3a �3 0 EZ .R,.. /T ..k •.. R!. ... RT. 7 VV c ► T 1. !! • VV wV wV 4.625 ►r !!! i!T R.► !. .i! .!► !!! sr ►t .!! ! ►► 1/2 Ctrl. Rsr r !*. !.!. ..i T.T liR. +Yt� ♦T!i RRll.r. t - • 24" 36" # 12 -112" DIA. (ryp.) i Void COOT" M of AW%uft given I 57.4X I%M U.B. afd"p .. 4.625 inches siite!+va1t (2 sid""U 7 � 1824in VOW volume per "r4U R- - 3,14 •(. 2 ' 25 '" 12M - 3.13 ilia /@ j ,18 - 117 re U.U. of seatercylindsry amkwn fit f2 ' .S mck � Tlts1 Soil V Ialerbec .1rea oid vohtmr in ag�eegate of � 3. t 4 « ¢--25 a 14 SQ. ( 12at0. - 3. 14• 3t25 i 1?inip � ��.S g221t' 7 2 U.D. afe� rY+n<ien 12 inch" Void vol ( Pr►Jected Trench Area f ome io autride cwle�dm e 2 • l.lsl .574 > 90 F ( 12in t ft w sidewall Height 13 in_ -2 aid miume at hattam a 2.00 sq.Ft. been cvt+'nders ?4iw � } ( t3ottom I t � 1, 00 Sq.Fi. r 2iwt0 {i2is; `0.2tSR' f Void wlu at Projected Trench Area outside �`� is 3 80 S@.tTt. j ( 1 !2 Tote! void vol of void .fume between cyJmdtM) 0.215 ! 2 - 0 t08 ft time =13.117 +11.422 +0.901 +&21S 0.108 4 1 763 eemK ft t fi Gallora per rt 1 .763 X 3.48. t s ( 1 36 x t S tr�� 9gregate Trench System EZ12{33N R 'nq -- industriar Group t7 65 Indus i0' P a> it �d. SCAU SW, t of t ft - 2 7 -ot i r - - WTS OWNER'S MANUAL & MANAGEMENT PLAN Page ! of + �+ •c PQ r ► .�� ❑ NA LIE 7I!A: factur rt tie 13 „al. 0 � Pertrsit # 3p 3G �- s ° NA phi- PARAMETERS fl Septic 13 Done fl Ho Vol. NA O NA fl' NA Wimber of S Effluent Manu'factura �+bw of Public FacMW Units Efflsue� t �«� m ated (average) 'flow Nh O NA _ , x 1.5) Q Pump D tPeak) flow (Estunated Model Pump A Sol Application Raba ,S - unit surf " d kdknnt/Efftmd Guaft Morl fl SW418ravell FOW © PMK Fgter Fats, Oil S Crease (FOG) 530 m91L- ❑ Mechanical Aeration 1 13 Wetland 1800,0 5220 m9& 0 NA t3 tither' gio�smical Oxygen � fl t)iait►fa Total Suspended S am 51 so mg/l. average Manufacturer 0 NA 1'"w eated Effluent Quality casts) Cents) o smemm Demand 1BODJ 530 mQ'L � f� Cl M.Gro� urizsd) Totef S SON& O-SSI 530 "V& fl NA ❑ Mound Feeg c metm} 5"10 cfuli OQrr�i 0 At- Grade CoRform tlieortnetri , C3 NA fl DriP-Le ❑ Other: Max mim�uin Effluent Partida Siza Y in die. )ONA D NA A *Values typical for dam wastewxw and septa c tw* effluent. other HANCE SCHEDULE Sew Fre4uency service Evart 161 tin 3 yews) ❑ NA ka At toast co every: pect condition of t8nkts) of tank vbiume When combined sludge and scum �') D NA of tankisf fl When the high water alarm is acd+ratad PtisrtrP out contents rrsortthtss) VAexbvWM 3 ytsan:) 0 NA kopect dispersal tsMW At least once everY `� rrsnntttts) O NA At least once evWr 83 Clean effluent OW fl morrth(s) A At least once every. E3 ) Inspect + P►p A alarm At ) s) NA At least WOO ev�erl : s Flush laterals and prreSK" test lEI monthlsl l"" At kwa once oval, D A c og one of the following New"" or certifications: MAtNTENAf� py CTis IS shag meals by operator (pVmpe r l• Inspections of tanks aid dispersal , POWTS' cracks or POWTS inspe Inspe t Plumber, Haslet Restricted Se �of the tanktankts) d OW m i s sing or broken hardware, identify n the ground Tank inspections moat kids av ual itrsd and sc�>zrr and check for any tack or WP for an'V p ection leaks, measure the Volume of combined � to k the affluent levala in a fa" condition anC surface. The C811(s) ts) -s be v di effluent on the ground p of e ffluent on the > surfac l regulatory authodw. requires the immediate notif ration lo one -third (Y9) Or more chapter the tank volume. tM When the combined of sludge an d scum in an treatment tank of in accordance with chapter HR 113 auxin S+ e9e Servicing entire contents of the tank shall be rerm►ved by a it�9 Operator 14drrir� Code• m� a nts AM other services. including but , pretreatrrHer Wisconsin pressurrted compose not to the servirittg of e ffluent fitters. certified t'OWTS Maintainer. units, and any servicing at, of 51.2 rnordhs. shall be pafiorwit by a cxartifr completion of any service event: A service report shad be pro to the local re�a ory au> ► w it h in 10 date GMW !2102 START UP AND OPERATION For new Page , oR cherolcele prior to of the POWTS check treatment tankts) for the presence of Painting products. s0lVUnts I have the contents of the a aer the sou Vis s its). br t concmdrations are d ter.W dwt May lmpeda the trea went tankis) removed by as � the prior to use. System start up shall not occur when 3W conditiong we from at the infiltrative surface. wastewater win + Se o d es the tanks may 0 end water levels When power s restored the excess ca ft) in one large discharge to flastonril; Power effluent. To avoid this situation haveY ovemrload them restating m the controls to restore t o tact the con tents Of ft a P ar POW �� to assist Servicing Operator Wvsft within the prior pump tank. opearstirhg the Dump Do not drive or park vehicles aver tanks and within 15 feet down slope of any mound or at-g� • Do not drive or park over, or otherwise disturb or C the am Reduction ru area. elimination of the following from the w POWTS: antibiotics; baby woes; cigarette Tatar co tton n abs; de r O 0 th e and prolong the life o€ the painting Products P Pernpl sa ,frost and vegetable p g herbs �infectants; tat, ca rhitary napkins; : and water softener brirse. t pd�' meat �% oil; bons ABANDOA1MEN When the POWTS talk and/or w pemhanendy taken out of service the followi be p and safely abandoned in cornphance with ch8Ptw Comm 83.33, shag Adm taken e tttstsoe that the system is � Cade: AD piping to tanks and pits shall be disconnected and the abandoned Pipe openings sealed. a The contents of all tanks. and Oita shah be mmoved and Property disposed of by a SePtage • Servicing Operat so n'gra� Or another irhert and pits shall be excavated and remover! or their covers removed and the void $pace filled with solid material. CONTINGENCY PLAN If the POWTS fags and cannot be repaired the fallowing measures have been, or must be taken, to provide a code replacement system: compliant A suitable replacement area has been evaluated and m system. The replacement area should be protected from mi dis' disturbance and the location of a sit soil absorptio and should not ba irtfrirugad upon by result to e> and site evaluation atructum. lot fines and wells. Failure to Protect the r ernent area win luation to establish a Suitable �t anus. comply with the nines in effect at that time. Replacement systems rneust A suitable nioacemant area is not available due to setback and/or soil limitations. technology a hag tank may be iintelted as a last resort to ice the failed pOWTS. Barring advances in POWTS O The site has not been evaluated to identify a suitable area. evaluation must be Performed to locate a suitable �Dn fail re of the POWTS a sad and site may be as a last resort to replace the faq`led POWTh. nk �E aura. I€ no replacement area is available a holding tar* 0 Mound and at-grade soil abwMdo system may be recons tructed infiltrative surface. ReconStrtuctions of such system Piave following removal of the biornat at the < <WARNING> > ierrs must with the rules m effect at that time. �C. PUMP AND OTHER TREATNUIT TANKS MAY CONTAIN LET}itAL pq ENTER A SEPTIC, PUMP OR OTHER TRF.ATMT TAME UNDER ANY AND CIENT OXYGEN. DO NOT SON THE �OR OF A TANK MAY BE DWFICMT OR NVOSSIBLE. ' DEATH MAY RESULT. RESCUE OF A AMTIONAL CONMN M °OWTS INFT Nam POWTS MAN?Ai r Pfnone Name i5 S Phone ;EPT'AGE SERVICING OPERATOR (PUMPERl Name LOCAL REMATORY AUTHORITY Pf>o Name Phone S O � t w� draf0ed by tFta staffs of the Greets Lake. Marquette and 7 Waueara County tarter Comm 83 . 22 t21(bl(11(d) &M and 83.54(1), (2) & (3). Wisconsin native Code. Zom agencies in cOnVIance with ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owncr/Buyer f. l I' s Mailing Address Property Address (Verification required from Planning Department for new construction) City /State Parcel Identification Number Q 4J p I a dS –'in -,6 �• �S } � LEGAL DESCRIPTION Property Location w %,, Sec. IL , T DJ4 Town of rc) Subdivision ior\. Lot # Certified Survey Map # , Volume Page # Warranty Deed # --I -% t f Volume _ a. Page # 3 --- Spec low 0 yes /P( no Lot lutes identifiable yes O no YSTE Improper Use and rrtaintananceof your septic systerrr could resn m its premature faihrre to handle wrastes. proper consists of pumping out the septic tark ,Gyny bract Yew or soccer, if needed by a lieensed primger_ What you put into the system can affect the ftmctioaa of the septic tank as a treatment stage in the waste disposal system - T ProP�Y owner agrees to submit to St Crom Zoraing Department a courwatian f master P) ` 1 �, signed by the owner and by s � is tt Pte• tamed phriabex ar a fireased p `Ping that (t) the on-stet � � dipt� pt operating condition and/or (2) after inspection and pub (if necessary). the septic tank is less than 113 flail of sledge. b*c, the undersigned have read the above set f �u and egret; b r>tiinrain the private sewage dispOSal sysepa triEh the standards forth, hat* as set by the Dep o f Conijilarce and the Departnxnt of NavxW Resources, State of Wiaconsia• Cugfiastilm stating that your stoic system has been n aiataimed nsna1 be completed and returned to the St Croix C., orrnty Zoning Office win 30 Of expiration date GNA Q F APPLICANT O DATE UWNER ERTIFIt^s�rrON I that all statrts era this form are true to the best of m our know ledge- IS e descri above, by virtue of a warranty deed recorded in Register of Deeds Office. I (we} am (are) the owntx( of A PPLICANT A s, DATE " "'• Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. 00 " Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified surve ma if reference P is made in the warranty decd FROM :THE GEHRKE FAX N0. :715 -381 -2904 Aug. 22 2003 11:02AM P2 08/22/03 FRI 09:27 FAX 716 986 4047 MISTRR OF DERps 2 001 73&Cm. e 4 �l P H. vmsH or ums -M CD.. MI ITATR MAR OF WOMM F011 M 34M UM V0 MOR UCQRD WAIWASTY OM 4MAl2M 11 e5AN THM MD. Mob beawrti » 1� lilroa art Lial. Na.ab 1ilRR� DRRD hw0aaa =4 wr& Oran W acid xdmt L ftiw aed Low D. Seise bided sad w V6, ,a Swvtvm** MOW pm WW- 0 =1m REC FSE a 11.00 Gmnw. Dar a �aebW casddwV*M, CM�rt end tll MUM = G=Me �� Glow Y E ms , t 809.7A dw f+a11awft cM wA ed seal aauta a !� C c Cemfs►, 9erlt d W1ac +�dn: elan aFbMOI . PAC 1 Glow �1► �a me Tom 4f I�'aa►. CoaeMq►. 1heeNDt wea+ Isnss aad � t.1 tiaral�a>4►'t� � ,ppR.�ae. - � itS I& wwwoodw 1ielatR Wt SO t6 Rpen►aate. raeMoo and rte► Of 010.1105 �� ibieh��Pr Datad thin 31 It dAY of W 2003 AUTMMMATION A SI anuaE�? $TATEOF Wt9CON M 15a St. CROIX COUNTY. ) es eu ►cored d� tauoor cow baioee aaa dqr &�► 31. 2003 the "vr, p1ANE M, 81►FiR� avow Br N* Nebo and Lim Ii tlrOn. h7aebbd and vi* b tine hlloMa so bs to pop �e MSC. the OMokg "Ct'17.E: t1fi 1rY 4 70b.86, vllis. Stet+•) t�+aa 1yR It 7ttr1®Nr wrws t1IY ir t am of Wb omft � ep�q,s, }s pesm�ooient. (i£mR. eteee acph3ldon Qne: Ran T8b - Uol1E 13etg _, 1 408 & rMb Sand eiltl #� ' W15<016 I t1 �S;�n�ns 11M�Y bs a . Aae►ere a+t �ewNr11•) 4 madpwnsmemos sm"dw mobs 4ipad�c�cM�Wr� a� dllines 01 10�IIt .OVER ST W I/4 1 AND THE NEIMOF SECTION 16,T28N 1 R19W, TROY, ST. CROIX COUNTY,WISCONS I N NI/4 CORNER SECTION 16 T28N, R19W DINT OF \� EGINNING UNPLATTED LANQS � S89°00'33 "E 841.90 — 250.00 -- 405.90 -- -- o016 N 0 5 a 4 2.13 ACRES 2.87 ACRES \ LU �O 3 � 3. 3 ACR o no OV h o Z h 163.58, � ro ..<v / _ SAN % i3 5 3.10 ACRES 169.89 14 O h �0 0 M 0 , i' 2s0 O . tilg o q Af A ? 23 � , 2s .0 Sss° tis 0 A) � ti 2.17 ACRES a S \ 6 9 IN S2 / . 00 , 24 2.65 ACRES � r9p° 00 4 - - -- O� �O **,% 25 q 2.16 ACRES �p c �s�• --�00 / lw ce .O