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040-1265-80-025
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 488075 0 GENERAL INFORMATION (ATTACH TO PERMIT) Sta Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. ?i,? O T :TL1'N5 Permit Holder's Name: City Village X Township Rarcel Tax No: Brushy M ound Partnership I Troy, Town of 040 - 1265 -80 -025 CST BM Elev: ( Insp. BM Elev: r BM Description: Section/Town /Range /Map No: Go .,D C70 . 0 f3, # Z U_,d_a 16.28.19.1440A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark �ul'ese�� --• l i zoo 41 Z /6q•z4 Dosing , � Alt. BM D Awa4iem Bldg. ewer `) .°► 7 Q Z F`� -` �a fah SZS 'y Holding t t Inlet `f . 37 S t/Ht Outle TANK SETBACK INFORMATION TANK TO PIL WELL BLDG. V ent o Air Intake ROAD Dt Inle ep is / / ' Dt Bottom osmg ea er an. r 750 yg 16 I: — Z oZ S A eration uist. Pip � e�- ` 2.'fl 2. `f I 2 • 'fV 1 . S}' o ing o . byStOM 3.1 o ma r G rare PUMP /SIPHON INFORMATION 1---) : anu ac urer k / GPM n o v rr er , ` G J 5, t q a o e um er � S ZZ /tfa ay. ou i :c nc ion oss ys em ea /$b / I lLfla . Z $ / or-1011mr-MIn Mull jLt:IIyLII I U. VI I I t:[ IU Iub F-11 DIMENSIONS ITT 01 1-11b 11151uu Uld. ILIquju Depill DIMENSIONS I INFORMATION CHAMBER OR �. • r ll- > r � � � � � UNIT "f0.6 ,S -PdL;Illy 11111L LU -11 / Pipe(s) // / Length 3' A Dia (� Length ZJ Dia 2- Spacing ressure Systems Only xx Mound Or At - Grade Systems Only Bed /Trench Center Bed/Trench Edges Topsoil Yes 1 1 No Yes 1 1 No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: S / Zz / �� Inspection # : - /V� 23 / Location: 325 Gandy Dancer Circle Hudson, WI 54016 (SE 1/4 SW 1/4 16 T28N R19W) NA Lot 79 .Parcel No: 16. 1.) Alt BM Description = GoJ•QJ`- G —� �C 2.) Bldg sewer length= ZI ', ��. /0- - amount of cover = '/ Plan revision Required? F P No � � 'I 2q Use other side for additi tion. — -Date - In ct t ature a SBD 6710 (R.3/97) w�� � (4- /�/Jo Z5 2-cep _ l I " ^' v , r I EZFIow Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) r Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 83 -44-3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of - 36 inches. 600.00 Design Flow (gpd) 12.00 Site Slope ( %) 101.00 Installation Contour Line Elevation (ft) 125.00 Contour Length Available (ft) 32.00 Depth to Limiting Factor (in) 0.40 In -situ Soil Application Rate (gpd/ft) Distribution Cell Information 6.00 Cell Width (ft) 3, 4, 6, 7. 9, or 10 Only 1 100.00 = Dispersal Cell Length (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /ft 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution F Y Pressure Disribution Information network? Enter Y or N (c or e) c Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation (ft) 4 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 2.00 Estimated Orifice Spacing (ft) = 6.00 ft /orifice tcemain Diameter (in) 180 cemain Length (ft) Does the forcemain drain back? Y 90.00 Inside Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 29.36 Forcemain Drainback (gal) 1 rtical Lift (ft) 90.37 5x Void Volume (gal) 6.27 ction Loss (ft) 119.73 Minimum Dose Volume (gal) 94 Total Dynamic Head (ft) 41.19 System Demand (gpm) (� Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice E2.00 00 dia. options choice \ 0.75 25 x \ 1.00 50 x X 1.25 x x 1.50 x x 2.00 x �1 3.00 x Gallons /inch Calculator (optional) Treatment Tank Information 800.001 Total Tank Capacity (gal) 1200.001 Septic Tank Capacity (gal) 38.80 Total Working Liquid Depth (in) WIESER IManufacturer 20.62 gal /in (enter result in cell 1349) Dose Tank Information Effluent Filter Information 800.00 Dose Tank Capacity (gal) JPOLYLOK Filter Manufacturer 20.60 Dose Tank Volume (gal /in) IPL525 Filter Model Number WIESER I Manufacturer Project: C ' Page 2 of 8 C' Sao S-3 Center Connection Lateral Layout Diagram Place Appropriate Lateral Diagram From Right Below Force main connection via tee or cross to manifold at any point. Laterals are identical ri Orifices point up, except every 5th one P points down for drainage. S •= Turn -up W ball valve or x IEx12 xr2 -)l Laterals & force main of PVC Sch 40 oleanoutplug per COMM Table 84.30 -5 Number of Laterals 4 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.01 ft Lateral Length (P) 49.25 ft Orifices per Lateral 25 Lateral End (Z) NA ft Orifice Density 6.00 fe /orifice Lateral Spacing (S) 3.00 ft Manifold Length 3.00 ft Lateral Flow Rate 10.30 gpm Manifold Diameter 1.50 in System Flow Rate 41.19 gpm Forcemain Velocity 4.21 ft/sec Dose Tank Information Locking cover with warning label and locking device, and sealed watertight Electrical as per NEC 300 and --► Comm 16.28 WAC 4 in. min. Disconnect --- -!ll --- Tank component is properly vented E— Alternate outlet location Forcemain diameter WIESER Manufacturer _ 2 in. Capacity 800.00 Gallons Volume 20.60 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 21.02 433.07 B 2.00 41.20 C P ump off elevation (ft) C 5.81 119.73 90.83 D 10.00 206.00 D ir I Total 1 38.831 800.00 1[ _± Dose se tank elevation (ft) Min. 3" Bedding under tank. F 90.00 Alarm Manufacturer S VT- Alarm Model Number g t 0, Pump Manufacturer s- rt £rfrs Pump Model Number Hf A'10 s Pump Must Deliver I 41.19 gpm at - 23 - 9 - 394 ft TDH Project: Page 4 of 8 4 79 r� ism fety and Build' . Washington A e., P. `' - C m t ` I Madison, WI 5 707 9 � v Sanitary rmit Number (to be filled in by Co.) Scons (608) 26 3151 �Y�� �� Department of Commerce Sanitary Permit Application ate Plat I.D. Number l In accord with Comm 83.21, Wis. Adm. Code, personal information y prov&. CROIX CO C) q may be used for secondary purposes Privacy Law, s15.04(l)( ) ZONING OFFI C Soject A I ress (if different than mailing address) I. Application Information - Please Print All Information �5 d n Csw Property Owner's Name Parcel # of # 'r Block # /V r h 4a r c�S`1 nt tC, t Co . 0 — _p (. /4 A) Pro rty Own is Mailing Address Property Location City, State RO Zip Code Phone Number SE 1,4, ` V4= Section W iN S j (cE ok) nsa T � N; R�E o IL Type of Building (check all that apply) s I/ SubdivisicLnNa e CSMNumber �` or 2 Family Dwelling - Number of Bedrooms j+,�t �r ❑ Public /Commercial - Describe Use S) 3 ❑ State Owned - Describe Use ❑City_ ❑Village IrTownship of r 0 . � III. Type of Permit: (Check only one box on line A. Complete line B if applicable) J A. )(New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner `� 11 if / IV. Type of POWTS System: Check all that appl ❑ Non - Pressurized In- Ground P > 24 in. of suitable s \ o iT ❑ Mound < 24 in. of suitable s6i ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line Gr el -less Pipe ❑ Other (e in) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Re ed (sf) Dispersal Area Proposed (sf) System Elevation b'�) .J (0c O I n pO /vl,s VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic Holding Tank 1( 0 , 00 ( t 1 S Y 5 C in O Aerobic Treatment Unit �n, __ •• �/ Dosing Chamber X o I 'E. r--r VII. Responsibility Statement- I, the undersigned, a onsibility for inst0attoskof the POWTS shown on the attached plans. Pllnber's Name (Pri M"PRSIlumber Business Phone Number Plumber's Address (Street, City, State, Zip Code) r llasl 19 Soh N-; Q�c�mon� D f VIII. County /De artment Use Onl K Approved ❑ Di sa r ed Sanitary Permit Fee includes Groundwater Date Issued Issuing Agent Signature o Stamps) Surcharge Fee) O v ❑ Owner Given Reason for De 'al 1 1,55V IX. Conditions Approv /R SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. 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) r r � �r H r. 1 . i �/ 1 ♦�� ►tx �. ■ / � y r r � IL Safety and Buildings 4003 N KINNEY COULEE RD commerce LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 s co n s i n www.commerce.wi.gov /sb/ www.wisconsin.gov Department of Commerce Jim Doyle, Governor Mary P. B urke, Secretary February 2006 r1' , CUST ID No. 220537 ATTN. POWTSInspector CALVIN W POWERS ZONING OFFICE POWERS EXCAVATING, INC ST CROIX COUNTY SPIA 1969 185TH AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 02/08/2008 Identification Numbers Transaction ID No. 1236094 SITE: Site ID No. 709155 Derrick Construction Co Inc Please refer to both identification numbers, Gandy Dancer Circle above, in all corres ondence with the a enc . Town of Troy St Croix County SE1 /4, SWIA, S16, T28N, R19W Subdivision: Glover's Station 5 Addition, lot: 79 FOR: Description: Proposed Four Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1060043 Maintenance required; 600 GPD Flow rate; 32 in Soil minimum depth to limiting factor from original grade System(s): Ezflow Mound Component Manual, (N.6/03), Pressure Distribution Component Manual - Version 2.0, SBD -1070 - . 1 ; iofilter -- 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 POWTS 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 below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the 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 ap rp oved plans, specifications and this letter shall be on -site dui construction and open to inspection by authorized representatives of the Department, which may include local inspectors. P.O.W.T.S. Conditionally A DDD�t�>�n CALVIN W POWERS JR Page 2 2/8/2006 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). • 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. 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 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@cornmerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 EZFLOW MOUND AND PRESSURE DISTRIBUTION COMPONENT DESK., � Residential Application `�- INDEX AND TITLE PAGE 414P '1441 Fj z ° °6 Project Name: DERRICK CONSTRUCTION CO INC 1 10/` x/ Owner's Name: DERRICK CONSTRUCTION CO INC 1V0 Owner's Address: P O BOX 445 NEW RICHMOND, WI 54017 Legal Description: SE1 /4 SW1 /4 SEC16 T28 NR 19 W Township: TROY County: ST CROIX Subdivision Name: GLOVER STATION 5th ADDITION Lot Number: 79 Block Number: Parcel I.D. Number: PENDING Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 EZFIow mound drawings Page 4 Lateral and dose tank Page 5 Distribution media Page 6 System maintenance specifications Page 7 Management and contingency plan Page 8 Pump curve and specifications Page 9 PLOT PLAN Page 10 PERK TEST Designer: CALVIN POWERS License Number: 220537 Date: 01/24/06 Phone Number: 715 -246 -5135 Signature: Designed Pursuant to the EZFIow Mound Component Manual (N. 06/03), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) EZFIow Mound Version 1.2 (R. 02/04) &-,,. � i M ,, �, 1� � -k Pagel of 10 DEPARTMENT OF' COQ ;h "FRCE A ISION All YAND BUILDfN�S EE CO��RES NDEt'CE Feb 08 06 09 :24a 7152465135 p.3 'Y`l UFlow Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) r Residential or Commercial Design Nate: Sand fill @) calculations assumes 400.00 Estimated Wastewater Flow (gpd) Table 83 -44-3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g.. 1.5 = 150% ) colifon•n of <° 36 inches. 600.00 Design Flow (9pd) 12A0 Si Slope { %) 101.00 Installation Contour Line Elevation (ft) 125.00 Contour Length A vailable 32.00 De th to Limiti p ng Factor (in) 0.40 In -situ Soil. Application Rate (gpd/ft) Distribution Cell Information fi.00 Cell Width (ft) 3. 4. 6. 7. 9, or 10 Only 100.00 = Dispersal Cell Length (ft) 9.00 Dispersal Cell Design Loading Rate (gpd /ft) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) c Center or End Manifold andold 3.00 lateral Spacing (ft) If N above, enter the elevation (ft 4 Number of Laterals of the highest point 0.125 Orifice Diameter {in) (e.g. 0.25) 2.110 Estimated Orifice Spacing (ft) = 6.00 felorifice 1.50 Forcemain Diameter (in) 90.00 Fa Length (ft) Does the forcemain drain back? (� Y 95.00 Inside Pump Tank Elevation ft �_____ . � p O Enter Y or N `'l l 6.50 System Head (ft) x 1.3 8.26 Foremain Drainback (gal) 6.00 Vertical Lift (ft) 90.37 5x Void Volume (gal) 1'b Friction Loss (ft) 98:63 Minimum Dose Volume (gal) 25.21 Total Dynamic Head (ft) 41.19 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. o Lions choice in. dia: I options choice 0.75 1.25 x 1.00. 1.50 x x 1.25 x 2.00 x 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information 800.00 Total Tank Capacity (gal) 1200.00. Septic Tank Capacity (gal) 45.00 Total working Liquid Depth (in) WIESER Manufacturer 17:78 gain (enter result in cell B49) Dose Tank Information Effl Filter In formation 800.001 Dose Tank Capacity (gal) JPOLYLOK Filter Manufacturer 20.60 Dose Tank Volume (gain) PL525 Filter Model Number WIESER COMBO Manufacturer Project DERRICK CONSTRUCTION Co INr Mound Plan View T 1/10 B : ::: :: :: :: :: :; ......::::: :::::::::::::::: s .._ J Observation Pipe K • ..:;: . ; :. Y _ W — .;.......:a:_:_: : : :.: : : : :: : •.• ......................:::::: B ..:............................ .•3 •::• ..:.•.•.•.•.•.•.•.•.•.•.-..•.•.-.-.-.- •. .... . ..... .....•.•.-.•.- • ..•.•.•..•...... - .......... . - - ---- - ------ ---- - -- —�-- L Mound Component Dimensions A 6.00 ft E 14.64 in H 1.00 ft K A23.16 ft B 100.00 ft F 12.00 in z 12.75 ft L ft D 6.00 in G 0.50 ft J 4.41 ft W ft 600.00 (ft Dispersal Cell Area 1 1875.00 (ft) Basal Area Available 6.00 (gpd /ft) Linear Loading Rate 1 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 103.50 (ft) G ♦ H j F t := Dispersal Cell 102.00 (ft) Lateral 101.50 (ft) - -► — 61; .............................. Invert Elevation Dispersal Cell �:.:.[� ::::::::::::::: ........................ ...... . E D Elevation � :.:.:.:.:.....:.:.:.:. _ 4 _ 101.00 (ft) Contour Elevation 12.0 % Site Slope Typical Dispersal Cell Shading Key m A See Page 5 10— CL Topsoil Cap —°� c 2.0 ft Geotextile Fabric over 0 ©� Subsoil Cap 0 -t- ASTM C33 Sand v Z Tilled Layer = 0.5 ft . EZFlow Media o — �— °'::: ::::ti : '`:• `: 0 A -- T See details on page 4 for number, size, and spacing of laterals. Laterals are located in the 4" gravity distribution pipes as shown on page 5. Project: DERRICK CONSTRUCTION CO INC Page 3 of 10 Feb Q8 06 09:24a 7152465135 p.2 QW -66 Center Connection Lateral Layout Diagram Place Appropriate Lateral Diagram From Right Below Force mai n connectio via tee or crass to manifold at an olnt 9 P Laterals are identical Orifices poind up, except every! 51th one J P points down for dreirMe. 'S f= Turn-up Ydball valve or P x12 x1 oleanoutplug I4 X ---3�f 2 +I Laterals &forcpmainoF PVC Seh40 per COMM Table 84.30.5 Number of Laterals 4 Orifice Diameter 0,125 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.01 ft Lateral Length (P) 49.25 ft Orifices per Lateral 25 Lateral End (Z) NA ft Orifice Density '6.00 felorifM, Lateral Spacing (S) 3.00 ft Manifold Length 3.00 ft Lateral Flow Rate 10.30 gpm Manifold Diameter 1.50 in System Flow Rate 41.19 gpm Forcemain Velocity 7.48 ft/sec Dose Tank Information Locking cover with wamtng label and locking device, and �~ Electrical as per NEC 30Q and - --► sealed watertight Comm 16.28 WAC Disconnect 4 in. rrnin. Tank component is property vented Alternate outlet \ location Foncemain diameter WIESER Manufacturer ': 1.8 in. _ Ca aci T 800.00 Gallons ' Volume 20.60 galtineh A Weep hole or anti - Dimension Inches Gallons B siphon crevice A 20.05 ^ 412.97 C B 2. DO 41.20 p off elevation (ft) � Pum C 4, 79 98.fi3 96.00 D 1200 . 247.20 D Total 1 38.83 800.00 Dose tank elevadort (ft Mini_ 3" Bedding under tank. �— s5 Alarm Manufacturer ISPI Alarm Model Number OBSERVER 100 Pump Manufacturer IGOULDS 3885 Pump, Model Number O H Pump Must Deliver 41.19 gpm at 25:21 ft TDH Project: DERRICK CONSTRUCTION CO INC. Page 4 of 8 EZFIow Distribution Cell Media Layout 6.00 Cell Width (ft) 1.50 Sidewall to Lateral (ft) Distribution Cell Cross- section Arrangements Drag appropriate drawing to space below. 6 ft Wide Component Legend ® 6" EZFIow Bundle - EZ0601A, 5 or 10 Foot Lengths 12" EZFIow Bundle - EZ1203H, 5 or 10 Foot Lengths 12" EZFIow Bundle - EZ1203HP, 5 or 10 Ft Lengths O 4" Distribution Pipe With Pressure Lateral Inside Tumup Enclosure — — — — Lateral Distribution Cell Plan View Layout - Typical 6.00 Cell Width - A (ft) 1 100.00 Cell Length- B (ft) Center Connection Lateral Layout Diagram Drag appropriate drawing from left to space below. r� Force Main -- — — — — — — — — — — — — — — — — — — — — 6ft Wide Center Manifold Mound System Maintenance and Operation Specifications Service Provider's Name CALVIN POWERS Phone 715 -246 -5135 POWTS Regulator's Name ST CROIX CO ZONING Phone 715 - 386 -4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1200 gal Maximum TSS 150 mg /L Soil Absorption Component Size 600 fe Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu /100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 ears Mound Inspect for pondin seepage once see a once eve 3 ears Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the EZFIow mound component manual. 2. Dispersal cell media conforms to EZFIow products approved for use with the EZFIow Mound Component Manual approved 6/3/03. EZFIow media is covered with an approved geotextile fabric. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished . •• ........ 000000000000000 Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Lateral Ends at Last Orifice Where ................. Variable Length Cleanout Begins Long Sweep 90 or Two 45 Degree Bends Same EZFIow Media Feet Diameter as Lateral 1.26 4 Distribution Lateral Lateral Cleanout Project: DERRICK CONSTRUCTION CO INC Page 6 of 10 -Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code G eneral This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [EZFlow Mound Component manual 6/3/03 and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance 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 should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed 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. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet fitter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be 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 personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum 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. 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 shalt be inspected and serviced as necessary. Mound and Pressure Distribution System 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 as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODE, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 30 mg/L TSS, 10 mg/L FOG, and 10 cfu /100 ml for highly treated effluent. 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 determined orifice dogging 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 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components 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 the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails 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 cogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: DERRICK CONSTRUCTION CO INC Page 7 of 10 - [4000LDS PUMPS Submersible Effluent Pump MODEL 3885 G WE Series PROSURANCE AVAILABLE FOR RESIDENTIA APPLICATIONS. APPLICATIONS ■ Shaft: Corrosion- resistant, Single phase (60 Hz): can be operated continuously Specifically designed for the stainless steel. Threaded • Capacitor start motors for without damage when fully following uses: design. Locknut on all models maximum starting torque. submerged. • Homes to guard against component • Built -in overload with ■ Bearings: Upper and • Farms damage on accidental reverse automatic reset. lower heavy duty ball bearing rotation. • STTOW or STOW severe Trailer courts duty construction. • Motels ■ Fasteners: 300 series oil and water resistant m Power Cable: Severe d • Schools stainless steel. power cords. �y • Hospitals •'A -1 HP models have rated, oil and water resistant. Industry ■ Capable of running dry NEMA three prong Epoxy seal on motor end • y without damage to EMA th provides secondary moisture • Effluent systems components. • grounding , plugs. s g . barrier in case of outer jacket 1 1 /2 HP and larger units have SPECIFICATIONS ■Designed for continuous bare lead cord ends. damage and to prevent oil operation when fully wicking. Standard cord is 20'. e Thre phase (60 Hz): Pump submerged. Optional lengths are available. • Class 10 overload protection Solids handling capabilities: MOTORS must be provided in ■ 0 -ring: Assures positive W maximum. sealing against contaminants separately ordered starter • Dischar a size: 2" NPT. ■ Fully submerged in g high-grade to unit• and oil leakage. • Capacities: up to 140 GPM. turbine oil for re • Total heads: up to 128 feet lubrication and efficient heat power cords all have AGENCY LISTINGS bare • STOW po po cord ends. TDH. transfer. Tested to UL 778 and *Temperature: ■ Class B insulation on • Designed for Continuous C�� CSA 22.2108 standards Operation: Pump ratings a As Canadian standards 104 °F (40 °C) continuous IA-1 /z HP models. Assoaatlon 140°F (60 °C) intermittent ■ Class F insulation on 2 HP within the motor manufacture r's S Rle #LR3 8s49 • See order numbers on models. recommended working limits, Goulds PUS is 150 9001 Registered. reverse side for specific HP voltage, phase and RPM`s METERS FEET available. 40 130 LT S� — SERIES: WE 120 SIZ M: 3500 &DS FEATURES 35 110 — � r T __ —i J _ 1750 - -!• S GPM i ■Impeller: Cast iron, semi- 30 100 � �j -� � 5 F _ open, non -dog with pump- p 90 out vanes for mechanical W 25 80 seal protection. Balanced for — - —— ` - - - - ? - smooth operation. Silicon a 20- 7° _ + bronze impeller available as o 60 an option. a 15 50 - ■ Casing: Cast iron volute ° ao type for maximum efficiency. 10 30 2" NPT discharge. - ' -- - 20 5 ■Mechanical Seal: SILICON lI 10 -{ - �- -- CARBIDE VS. SILICON _ CARBIDE sealing faces. e ° 0 Stainless Steel metal es 23 "' 0 10 20 30 4 so 60 70 80 90 ' 100 110 120 130 140 150 160 GPM BUNA -N elastomers. �� o s 10 1s z° z5 30 35 m I CAPACITY 1 ` �(. i � Goulds Pumps ® 2004 nT Water Technology, Inc. �/ �/ ITT Industries Effective December, 2004 www.goulds.com b� j 83885 - ts_8 G� to i . ` C 4 i - ! I 1 " k - - -, ,YNA i lob -JA l ► T I { QQ L C 1 t € \? 1 I C ► � 4 � I i ! � � 1 { , k , f � i f i i P d nsin Department ofIndustry. SOIL AND SITE EVALUATION REPORT Page I of 3 r and Human Relations I of Safery b t3uik5ngs in accord with ILHR 83.05, W Adm. Code COUNTY _ 5 � G� •lX ...ach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (6M), direction and % of slope, scale or PARCEL I.D. # V>Q Uv G dimensioned, north arrow, and location and distance to nearest road. ' APPLICANT INFORMATION— PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION —3 W friW e' tMk, z E � �S S Cl L, j Z Sc 1/4 SW 1 /4,S I'T � ,N,R 1.q E (a W PROPERTY OWNER' MAILING ADDRESS. P BLOCK$ SUBD. NAME OR CSM # Z �tV - !D Z�2tUE CITY, STATE ZIP CODE PHONE NUMBER ❑VILLAGE Qc TOWN ' NEAREST ROAD i ,_IQ E Z 1=�,w1 54oZZ.hLS) �1Z5 $tbl `ri��f Gt�NoY t' 1d`1z.e J}(1 New Construction Use Residential! Number of bedrooms 3 [ 1 Addiki to e )ds& g builldirtg [ 1 Replacement [ 1 Public or commercial desixibe Code derived daily flow `1 So gpd Recommended design loading rate - 37 bed, gpd/tt - trench, gP d/ft2 Absorption area required 3 bed, ft 3 - ) S trench, R Maximum design biding rate • S bed, gpA : wx:h, gpoltt ecommendedi ftadw stufiace elevadon(s) - s $ It (as referred to - site" plan benchmark) Additional design /site considerations LZ" o F Srtxb Fi�� Parent material L% 3 Qv C,\_ �f -L - nLL Flood ainelevation, IT cable � l"St pi appli cable A U S a Suitable for - U for tem ❑ SS ELI 0S ❑ U ❑ ®PRESSURE [Is NU ❑ SS ®'U , ❑ SS M SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color ( Mottles (Texture I Structure IC or�s�nce I I Roots GPDIft in. Munsell Ou. Sz. Cant Color Gr. Sz. Sh Bed rendh E 0 —LS lw-Ii Z_312 3t� - Z93\" t ti►'L - � L�' •S •� Z \S vw-t V -2 L2 911 ZS-rt Sbk yh — . S , Grotmd 3 3) - (1 11 _ al 12.r, -,sbk Yvt'(!� Llu :— =S , lam elev. . km.o t 414 t0tia-3 /6 •s �z'.5 /8 %11 : 3 r Depth to I I factor i Remarks: Boring # r � Z lo-� ti�� 2 3l6 _ s i I Z� � u`fs ew — • S � . 6 3 2.L -3ZI l 0 `t R" 4z S t J Z rn S bk h2'Fl� �J — • S Ground etev 3z-S� I O 3!6 - S�e S �� s i �.J w uo It Depth b limiting F Remarks: CST Name - Please Print Arthui L. We erer 715 - 425 -0165 ' eg rer.Soil esting & Design Service -P.O. Box 74 River•Falls,WI. 54022 S�natwe: - - 4� • . ' .. Go > f o3 - oats: S � � CST Ntattrb 220254 DA0PE9rhWNER R Sclkj LTZ SOIL DESCRIPTION REPORT Page I of 3 PARCEL IA bring # Horizon Depth Dominant Color Mottles Texture Structure GPD /ft In. Munseli Qu. Sz. Cont Color Gr. Sz. Sh. Consistence Bourx* Roots Bed TmrIch sit cW • 5 6 Z lz_3 z 16 Lf cz ,roun 3Z - 6 un 3 6 1 `i {Z 5/A _ rev. l ��'' m U `�L • y . S g �•o )epth to millng 10 4 ' Remarks: oring # 31 Tound !pth to Hting :lor Remarks: ring # 31 Fund iL 4h to- - - - -- - - - — - - - ing x Remarks: ng # nd _ tt. Ito Ig Remarks: ..,. PLOT PLAN Pa 3 of 3 SCALE 1 SD ' ci v W-. luc�•o crow b ° cYl6, >��" t ►I A EtIGH PuC 1F'tit�s2'4NIL l >>�- a r � V tn.a�_ 3pp}`t o 13 1s, . to z - d' '} _ r OCR D 1s 213 • -tt y , � - ZS' -mo ,ay.1 - • ��0•D CtJ bye H , � 1i! a D� R - Pv °L piPE w t s .1 ` thsH P e VW ' km pipe, 00.103 —�9 _( 715 ) 4 ?.,� n1Fi5 CST Signature Date Signed Telephone No. CST # Laa and Human Rela Department Industry labor and SOIL AND SITE E V A L U AT I R T Pag of 3 / Division of Safety 8 Buildings in accord with ILHR 83.0 �Ad�o4@ n'1.` - ,`' UNTY Attach complete site plan on paper not less than 81/2 x 11 inches in si . Plan mus not limited to vertical and horizontal reference point (BM), direction an j% of slope, scale or P EL I.D. # dimensioned, north arrow, and location and distance to nearest road.: x A APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION DBY DATE PROPERTY OWNER: 'PROPERTY LW t W . f� f wp kj) �U� \S S Ct U L. j Z 681 L$T SC 1/4` 14,S 1-6T � ,N,R Lq E ( �W . PROPERTY OWNERS MAILING ADDRESS. LOT# QlbCx# NAME OR CSM # ZS8 �lv ?S lDE �2lUE GL S` 5 T -A CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE ®TOWN ' NEAREST ROAD p(J New Construction Use Residential / Number of bedrooms 3 [ 1 AdditiQn to existing building (] Replacement (] Public or commercial describe Code derived daily flow q SD gpd Recommended design loading rate - 37 bed, gpd/ft - _ trench, gpd/ft Absorption area required 3 15 bed, ft 31 S trench, 11: Maximum design loading rate • S bed, gpd /ft • trench, gpd/ft Recommended infiltration surface elevation(s) 101 _ p ft (as referred to site plan benchmark) Additional design / site considerations buY-A�, w/8 ')e- u ' a tL'z) , r-1 c jj . 1 1 OF Sri Frc Parent material L w� 8 Q y ZIR y , 'n LL Rood plain elevation, if applicable N A ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem 11 S ®U 2S [] U [] S ®U I[] S 2 U 0S o U I O S OU SOIL DESCRIPTION REPORT CC& � t M l Depth Dominant Color I Mottles I Structure �Dih_4_ Boring # Horizon Texture Str FC(ns'�stence I I Roots in. Munsell Qu. Sz Cont Color Gr. Sz. Sh. B-- u I 0 -LS LO�t�3L2 — zo - 195 - Mv1 Z �s 31 Vzs -t � 2-�z . s1 tat s Ground 3 3141 tQ 4p_ 316 - si I 2-wrSb k Wt`s. ?-q ►.v � S . (o c elev. 1 W.13 ft. 4 ul_ W` .S1-1RL5J8 sit ��bk h��l- _ •zl Depth to limiting factor Remarks: Boring # O -10 Vo'-L tZ 3 I z - S11 zizb . S le lbw lU`l rZ 31( 1M \J-f1' eLa - • S - 6 3 ZL 3 l TZ _ _ Z u ZC Z S i l Z w1 S 6 h2'Fln S b h G ud elev. u1-IIZ316 7 l ut.0 fL � S he S/ s i C_J 1 �Sblz �'►'1'�r' - .Z . y Depth to limiting factor Remarks: CST Name: — Please Print Phone: Arthur L. We erer 715 - 425 -0165 ' egerer Soil esting & Design Service -P.O. Box 74 River •Fa11s,WI.54022 ' Signature: Date: CST Number.. '� Go- fo3 -�9 S!� -� 220254 PROPERTY OWNER E f SCt- iUt_ Z SOIL DESCRIPTION REPORT Page of 3! PARCEL I.D. s! IP ► ) 6U G Boring Horizon Depth Dominant Color Mottles Structure g Texture Consistence Bourclary Roots GPD /ft lk :. >:.,,,,,� in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. : > 3 :: > `� O —LZ �O`-l2 �! Z _ Z`� b Bed Trends S ! z tz -� z l b � t 3/ 6 • � s "''-�' ew � • s � 6 , � 5 � Z,h,S m fg ecv — , S Ground 0 CL y/6 0y►•, elev. g r;.o Depth to limiting fa � 4 f Remarks: Boring # Ground elev. ft. Depth to — limiting factor Remarks: Boring # Ground elev. It. Depth to I limiting factor Remarks: 3oring # around 'lev. It. )epth to imiting actor Remarks: _ '�l rrr •�n�n •'.r .. u PLOT PLAN Pa 3 of 3 SCALE 1 "= SZ ' U U Q / 1Z . luo.o' cev 6 "�ris1� �. - loin v -t' gp�(lO1 t or is kt,-, CC) :'Liu � ° -• O 3' I - �1 . Lu0•D cj -) elt G H PvC PIPE. e 00.103 -�9 1 zZ.oZSy . . ( 715 ) 425 -0169 3 r CST Signature Date Signed Telephone No. CST # ST. CROIX COUNTY I SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer _ 1i+' 5 b+�/ n u ti.L Q PO4W t4 e't S Mailing Address Pa �0 4 D4 "A wka Property Address "71C -y (e t c . C4 V?-Cxz (Verificat required from Planning & Zoning Department for new construction.) City /State u `rY t Parcel Identification Number LV4 S 0 Z S LEGAL DESCRIPTION Property Location 5 �E 1 /4 , 5 %4 , Sec. V , T - Z- ( Z N R 1 W, Town of Subdivision �B t1 , Lot # t . Certified Survey Map # "��� 1 1 - 7 - , Volume S Page # Warranty Deed ;4 t'o C- �' ! , Volume 24 g , Page # Z Spec house e no Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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 Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, joumeyman 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. Uwe, 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 Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my /our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Numbe bedr r - / 0 ( .o SIGN TURE OF APPLICANTS) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08105) 7j 6 /3U /lUUS 16:36 5t. c r oix county Snaron ruiier-)-llerrICK CO -Amy t/t U 2488P 128 -7si42), s3L • • STATE BAR OF WISCONSIN FORM t - 1999 KATHLEEN H. WALSH REGISTER OF DEEDS Do t Number WARRANTY DEED ST. CROIX CO. MI RECEIVED FOR RECORD TLis Deed, made between C. 14L Bye, tadividaally, and Dennis R. amd Sandra G Schultz Revocable Trost, Dennis R_ Schultz and Sandra C: 01/09/2004 09:45AB Sdanitz, trmsteee WARRANTY DEED EXEWr 1 17 Grantor, and Brasby Mound Partners, L.L.P., a Wisconsin limited RM FEE s 11.00 partnership TRAMS FEE: COPY FEE PA6ESe 1 (Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (The "Pr%M%3r j: Nam and Return Address Lots 77, 7 �79 80 and 81, Glover Station Sth Addition, C. M. Byas tion, Town of Troy, St. 238 Riverside Drive Croix isconsn P.O. Box 167 River Falls, WI 54022 040- 1266-00 -000 Pared IdeutlIIca w Naruber 0'�l This is A homestead property. This deed is given in satisfaction of that certain Land Contract between the parties dated Julyt a4d recorded in the Office of tae St. Croix County Register of Deeds on July 25, 2000 in Volume 1529 of Records. page 216 as Document Number 627002 sad later a9w4med as recorded in the offices of the St. Croix County Register of Deeds on June S. 2002 in Volume 1929 of Records, pages 1o7 and 108 as Document Number 684421. Additional PIN numbers. 040 - 1265 -60 -000, 040-12654(1-000,040-126S-70-W% 040 - 1265-90 -000. Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Property is good, indefeasible In fee simple and free and clear of encumbrances except easements and restrictions of record and will warrant and defend the same.. Dated this day of T G ✓ iy� * D e nnis � � R. Sch y G M, Bye �'� AUTHENTICATION Amp STATE OF WISCONSIN Slgoatwc(s) ) am Sur (,*ra IX County. ) Personally came before me this f_ dry of authenticated this day of • �a_ - 11 ff = tea above named Dennis R Sehn1t24wJ mdra C. Sehultz and C. 11L Bye TITLE: MEMBER STATE BAR OF wISCoNSiri �•• • Of not. t6 me known to be the person( ong acimowbdga tba a uthorized by 4 706.06, Win. Stets.) cod THIS INSTItuba 'P wAs DRAFTED ov C. M. Bye * Attoraay at Law Notary Pubuc, State of Wisconsip y = s aeeessaryj may be mttheatteattd or acknowledged. Both are not My Coanmisalon is permanau Oup �ekplga'�aLe: ) .. `Nemm of Persons Sigal-& In any eapacigy should be typed or printed below their algoawr s wwsawnrr DOM BrATZ awn O! WRICOMM rossat x� r - csss ir •dry UIM 1:._ :.241id Qe , 6 --s3 -O4 7 L E P CLEAR T: wl .•Y 3 VOL 18 PAGE 4766 ��!� •.. ». Oi+ 1SATALE H. MAT.SH -- '' REGISTER OF DEEDS •�4v,nro rnv -• RECEIVEDD FOR . CERTIFIED SURVEY MAP 06/03/2004 03:4 Located in part of the Northeast Quarter of the Southwest Quarter and part of CERTIFIED SURVEY MAP the Southeast Quarter of the Southwest Quarter, all in Section 16. Township 28 REC FEE: 13.00 North, Range 19 West, Town of Troy, St. Croix County, Wisconsin; being Lots COPY FEE: 3.00 77 -80 of the Plot of Glover Station Fifth Addition as recorded in the St. Croix PAGES: 2 County Register of Deeds Office. Prepared for and at the request of: BEARINGS ARE REFERENCED TO THE NORIM —SOUTH Brushy Mound Partners, L.LP QUARTER LINE OF SECTION 16. TOWNSHIP 2a N., RANGE 1505 Hwy 65 19 W. WHICH IS ASSUMED TO BEAR N01 49'24 "E. New Richmond. WI 54017 Drafted by. Howard H. Hwrlld III CURVE TABLE CURVE RADIUS DELTA ARC CHORD CHORD BEARING TANGENT BEARING C1 80.00 62 4' " 8 82.89 N • 39" S71 tf467A!31'E C2 883.00 13'54'31" 1 214.35' 213.82' N3927'15 -5 "E N4624'31"E N32^30 C3 1 600.00 33 7' " 346.83' 342.02' 4 V S5 '00" no ° 2D0 STA TION N TH GRAPHIC FOURTH ADD %T/O/V SCALE IN FEET: 1 inch = 200 feet 66 NCRlhl IX4 CCAWER 72 A CR I OVER j/ 6� \ 64 Planning Zoil" Parks CommiiliW -�_ 7 ,• }\ \ JUN d 2004 Qom" N �� - �'s �'� IX4 unrE \ 74 If not recorded with of 7.3 ��!- ` '•�� g approval dale a all be QO ?0. P nuN a w Cp a73� N 200.732 SQ. FT. : m LOT T9 4.61 ACRES d — t 158.040 so. o 5 LOT80 3 � 63 A 1 CP �z oa 6� pl EASEMENT / J l6 s 3' AS SK101HV �T' =�E . -/ _ . N or DOVER T " 'LYyl3 v 5�1'93 ZFj W .. - •_ ` e�-�o iii iSTA noti �► ` o .>? v` 2 ` +. > Q I Ll i F7F7H c t^ O dr1 W Fir 8 4 ADDV776W - -- ^�D CIS- 1 I � LOT77 ^': LOT 78 o" w _ a - a �I 141.873 SQ. FT. � 203 685 SQ. FT- - - v - 3 rte, 3.26 ACRES_ - 4.67 ACRES N 81 I 83 = z _ 300.22• 2:: 450.00 N8 9' 1 8'0 9"W N89 * W 750.00 357.34' LLNoLA TTED- LANDS ° 82 NO 7E. THIS IS A RECANFIGURA7IAN A� LOT LwE LOCA7IAN BrmEEN `d 4075 77-8a ALL CONWAN75; RES7MC770WSs EA5r"EN7S, E7r.. SHOWY ON THE PLAT or 'ALOMW STAT7CW f7FTH A00ffl V' APPLY 70 L075 HEREON. ? w JOB / V8057SU155 LEGEND: 1 Prepared by v �� N Section Corner Monument of Record 2 • sf Set 1' x 18" Iron Pipe weighing Phone No. (715) 246 -4319 1.13 pounds per linear foof Z I Fax No. (715) 246 -3830 O Found 1" Iron Pipe P.O. Box 325 ® Found 1 -1/4" Iron Pipe New Richmond, WI 54017 Sheet 1 of 2 O Found 2" Iron Pipe .. • Building Setback Line (As Dimensioned) Vol.18 Page 4766 i t R Trial And Road Map For Glover Station N N . .. .... �r 9 8 7 6 5 4 10 3 I n ,n S OIIAt1A ROAD 2 11 a ` 19 20 21 22 23 h'p� 1 12 n 24 25 13 18 17 3U 31 26 16 b 27 28 29 14 15 35 40 41 39 38 37 36 33 43 34 42 P 44 c 47 Row 48 50 59 52 53 c 54 55 45 b 46 68 49 6U 56 92 ......... 0-67 57 ° ,...... 69 58 70 62 61 91 I 66 90 j 71 63 64 89 72 <� 65 88 87 74 73 86 9 3 SCALE IN FEET o 79 80 75 85 94 95 0 200 400 800 84 76 7 78 81 LEGEND 3 N 83 96 97 98 '• N MOTORIZED I NE ' .. ...................•........... . ............................... i F 1 ,TOgE NA A ONNERS ................... ASSOCIATION ( WIDE WITH 50' RADIUS CURVES 20' 82 CHATTANOOGA DRIVE ATt11ERwIIDTF OLDEN ENG ER�IG CO. 2w--i NO1t4bTORIZED I ►na+ Civil Engineers do and Surve ors 1U1 TRAI m� AINE° 113 W. Wdmt St, River Fole, NA 540 2 100 99 � A590CIATION_(40' WIDE. (715) 425 -7631 103 102 SS � EI LOTELINE). ...........t .. ............. .�... CL IEMS C.M. DYE AND DIANE L. ONE DENNIS R. SCHULTZ AND SANDRA C. SOIA TZ DATE W P.O. BOX 107 711 25 1/2 AVENUE 9 9 — 2380 RIVER FAILS, WISCONSIN 54022 CUMBERLAND WISCONSIN 54629