Loading...
HomeMy WebLinkAbout040-1081-60-050 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County St. Croix ' Safety and Building Divis?A n INSPECTION REPORT Sanitary Permit No. 463412 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. S Ila, Brian T roy, Town of o �d _&J 40 CST BM Elev: Insp. BM Elev: BM Description: n Section/Town/ ange /Map No: /Z. a /Qtj aw\, 1 �. 21.28.19. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. 3 . o3 IUD V Septic 12oo BenVo /6 � , 4 /6�1 Dosing Co U.0 �� v Alt. BM4� � 3 ' X76 / ?b . Aeration Bldq. Sgwer , / (, rK; 2476 ) l -fib Holding St/Ht Inlet 3g 9s o TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROA Dt Inlet Septic , d Y` Dt Bottom > voo Dog,5jw Heade (. S �y 7�• p Aeration Dis Pipe_ / G 6� / A/ . Holding Bot System PUMP /SIPHON INFORMATION rZ, a 4 Manufacturer Demand SttCC GPM 1 T Model Number /1 0 L,/ (. 1 TDH 1 1 ,q q Fricti n less System Hea Forcemain L D' I I - _&Ic Disstt. to Well SOIL ABSORPTION SYSTEM �" , ; j c . 2d . ti Zsj BED /TRENCH Width L No. Of Trenches PIT DIME SIONS o. Pits �nsi Liquid DIMENSIONS & `� i SETBACK SYSTEM TO JBLDG WELL LAKE /STREAM LV ACHINiK cturer: INFORMATION CHA B OR _ Type em: / > 2 I IT ` Model Number DISTRI ON SYSTEM � &-"U. Header/ 'fold Distribution � C� Hole Size x Hole Spacing Vent to Air Int�ke <n Pipe(s) I i t v P g Length Dia Len th Dia S acin T I SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only 0 Depth Over _ , p_/( Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center �Y" — Bed/Trench Edges Topsoil Yes No Yes No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: -/ S / 5 Inspection #2:_?/ Location: 555 Chinnock Lane Hudson WI 54016 (SW 1/4 NE 114 21 T28N R19W) NA Lot 3 /�IIt' dl / IF No: 21.28.1914 1.) Alt BM Description = I or o+ 2.) Bldg sewer length 2b j 5�< 2 0 7 (S C`t k✓`� T 70' G�} I v-4 (J u; t(k7 7 � - amount of cover = l y Plan revision Required? Yes /No O 10 ,1� Use other side for additional information. - Date Insepctor's Signature Cerl. No. SBD -6710 (R.3/97) 04/1 22:09 Fax 0004 Brian & Angie Sylla 502 Rolling, Meadows Drive River Falls, WI 54022 SE Y4, NE %, S 21, T28 N R 19 W N Troy Township St. Croix County Scale 1 " - 40' u Weiser 12001800 tank , BM #1= 100.00' Top of spike in tree 0.30' above ground v BA'i #2 = 97.53' Top of spike in ground 35' of 2 "force main ( h L o f�,3 U NV ; Ql � o g,3 �o I' ' p y "4e),sfi A t Pqg��. Safe ty B6 and B ' �4n County 201 W x 716 St. Croix �s adis , - - 7162 Sanitary Permit Number (to be filled in by Co.) eons�in Department of Commerce C (608) 26b -3151 Sanitary Per>niit App 'ea �Y State Plan I.D. Number r Z - 5 - In accord with Comm 83.21, Wis. Adm. Code, personal 'nformati n1S�CE (� maybe used for secondary purposes Privacy La �$15.919��NG OFFI Proje A ddress (if different than mailing address) I. Application Information - Please Print All Information SS Chinnock Lane Property Owner's Name © Parcel # Lot # Block # Brian &Angie Sylla Property Owner's Mailing Address Property Location • 502 Rolling Meadows Drive SW NE City, State Zip Code Phone Number <' 1 /4, Section 21 River Falls, WI 54022 715- 425 -0113 circle one) l T N; R r II. Type of Building (check all that apply) II I ✓ Ot CA.5 Dt ( 1�O�7�lt_ Qt4.� ubdivision Name A-71 M Number Q 1 or 2 Family Dwelling - Number of Bedrooms \ / f I Public /Commercial - Describe Use ❑ State Owned - Describe Use e� 9 k L-7 ❑City ❑Village i�ownship of Troy III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. 0 New System ys ❑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 IV. Type of POWTS System: Check-all that apply) v ❑ Non - Pressurized In- Ground © Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ 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 0 Drip Line ❑ Gravel -less Pipe ❑ Other (explain) GG / V. Dispersal/Treat ent Area Information: a , J Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required Dispersal Area Proposed System Elevation 600 0.5 � 600 � 600 y 98.5' 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 or Holding Tank 1200 1200 1 Weiser x Aerobic Treatment Unit A_ ' ; k 1 -- Dosing Chamber ;800 1 1800 1 1 1 Weiser x VII. Responsibility Statement- I, the undersigned, assume res , ponsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number Roger Nelson 1 1 ,4�1_4 MP 226497 715 - 273 -4444 Plumber's Address (Street, City, State, Zip C __ ;4V 122 East Summit Avenue EII worth, WI 54011 VIII /De artment Use Onl pproved Sanitary Permit Fee (includes Groundwater D Issued Issuing t Signa�� Surcharge Fee) -y ` / bs rve�Rcs�. nial IX. Conditions of Approval/Reasons for Disapproval (� �✓..d.ti: � -�o,>� � ✓.. Sd -fie._ le SYSTEM OWNER: r a nd Saptir: dis a ell must all be serviced / m intained as per management plan provided by plumber. 2. I se ac requirements must be maintained as per applicable code /ordinances. Attach complete plans (to the County only) for the system on paper not less than 8U2 x 11 inches in size SBD -6398 (R. 01/03) Safety and Buildings 4003 N KINNEY COULEE RD commerce.Wl.gov LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 i sco n s i n www.w www.coe.wi.gov/s sin.go / Department of Commerce iscosin.gov Jim Doyle, Governor Mary P. Burke, Secretary April 15, 2005 CUST ID No.226497 ATTN: POWTS Inspector ROGER D NELSON ZONING OFFICE NELSON PLUMBING ST CROIX COUNTY SPIA 122 E SUMMIT AVE 1101 CARMICHAEL RD ELLSWORTH WI 54011 HUDSON WI 54016 CONDITIONAL APPROVAL . PLAN APPROVAL EXPIRES: 04/15/2007 Identifi Numbers Transaction ID Noo. . 112 1125874 SITE: Site ID No. 696911 Brian & Angie Sylla Please refer to both identification numbers, Chinnock Lane above, in all correspondence with the agency. Town of Troy St Croix County SW 1/4, NE 1/4, S21, T3 8N, R19W FOR: Description: Four Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1013134 Maintenance required; 600 GPD Flow rate; 34 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual -Version 2.0, SBD- 10706 -P (N.01/01); Biofilter 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. C,onflll No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, x > stats. The following onditions shall be met during construction or installation and prior to occupancy or use: DErARTmENT g RCN S'VTI Approval Requirements: SEE COR.< • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /O1) and the SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST (01/81) • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • 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. Stat ROGER D NELSON Page 2 4/15/2005 • Comm 83.22(7) A co of the approved e e h e n- i ti O copy plans, specifications and this letter r s all b o s to during construction o and open to inspection by authorized representatives of the Department, which may include local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. 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. • Comm 83.55 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation /operation. 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 l �- Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday cbratz @commerce. state. wi. us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 i 9 FC MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIG -lLf Residential Application .� INDEX AND TITLE PAGE Project Name: Sylla 4 bedroom Mound System Owner's Name: Brian & Angie Sylla Owner's Address: 502 Rolling Meadows Drive River Falls, WI 54022 Job address: Chinnock Lane .5 w' Legal Description: ,S8 1/4, NE 1/4, S 21, T 28, N R 19 W Township: Troy County: St. Croix Subdivision Name: Lot Number: 3 Block Number: Parcel I.D. Number: Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications. Page 6 Management and contingency plan, Page 7 Pump curve and specifications F- cc ,""r.,,, Page 8 Plot Plan Designer: Roger Nelson License Number: MP 226497 Date: 04/06/05 Phone Number: 715 - 273 -4444 Signature: h, k, 7 - Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 4.0 (R. 04/03) Page 1 of 8 i 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 o 1.50 Peaking Factor (e.g. 1.5 = 150%) coliform of <= 36 inches. 600.00 Design Flow (gpd) 9.00 Site Slope ( %) 98.00 Contour Line Elevation (ft) 34.00 Depth to Limiting Factor (in) 0.50 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 67.001 Dispersal Cell Length Along Contour (ft) = 8.96 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /ft 1 I 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) a Center or End Manifold 2.99 Lateral Spacing (ft) If N above, enter the elevation ft 3 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 4.00 Estimated Orifice Spacing (ft) = 11,77 ft /orifice j 2.00 Forcemain Diameter (in) 35.00 Forcemain Length (ft) Does the forcemain drain back? Y 90.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 5.71 Forcemain Drainback (gal) 8.17 Vertical Lift (ft) 40.03 5x Void Volume (gal) 0.35 Friction Loss (ft) 45.74 Minimum Dose Volume (gal) 15.02 Total Dynamic Head (ft) 21.01 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in, dia. options choice 0.75 1.25 x 1.00 x x 1.50 x x 1.25 x 2.00 1.50 x 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1200.001 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Weiser 800 - 325 -8456 1 Manufacturer gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.001 Dose Tank Capacity (gal) JZabel 1- 800 - 221 -5742 1 Filter Manufacturer 22.241 Dose Tank Volume (gal /in) IA100 Filter Model Number Weiser =Manufacturer Project: Sylla 4 bedroom Mound System Page 2 of 8 Mound Plan View T 1 1/10 B_• Observation Pipe -' '3 J '�•�'ti �''•:'•• 5 '•'• ti••••�•••�•• •' A j ti j ti' j � , s', • : .tir. •: �•, : f :' }: :r: f • B . . . . . . . . . . . ... *.,. * .......................... * , * * , * ... — t ....... ...... I ........... ............................... L Mound Component Dimensions A 8.96 ft E 15.68 in H 1.00 ft K i1ft ft B 67.00 ft F 9.00 in z 10.51 ft L ft D 6.00 in G 0.50 ft J 4.13 ft W 600.32 1 (ft Dispersal Cell Area 1 1304.21 (ft) Basal Area Available 8.96 (gpd /ft) Linear Loading Rate 1 6.70 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 100.25 (ft) — —� rrrrrrff.. G H rrrrrrrrrrrrrrr {,. rrrrrrrrrrrrrrr rr rrr rrrrrrrf.- F : : : Dispersal Cell 99.00 (ft) La teral 98.50 (ft) —11110- — Invert Dispersal Cell :� i Elevation E . . •.. •..•...... . • . - ti 4 4 s , - 98.00 (ft) Contour Elevation 9.0 %Site Slope Geotextile Fabric Cover Shading Key c. T Dispersal Cell See lateral details on 10 _ Topsoil Cap c ° 1.5 ft ti• ; ti• ;•.;.;•. ti••.. °•.; Page 4 for number, size, rrrrrf Tn o 5 ti •�r:• • ti•:• and spacing of laterals. ©0 Subsoil Cap _� P 9 © ASTM C33 Sand ` Z �•' •• j '' _' •r F Laterals are equally �, 0.5 ft :ti Typical Lateral ' • r' spaced from the E ® Tilled Layer ° - :' ❑ : r ?r r I distribution cell's 5 rrr A o r•:•:;r•:; •::::.•• •.r • centerline in the A distribution cell (AxB). Project: Sylla 4 bedroom Mound System Page 3 of 8 l End Connection Lateral Layout Diagram Center the laterals over the A & B dimension •= Turn-up we ba 11 va Iva or ales n out pl u g P .I All laterals are identical IE X — � 1 Holes drilled on the bottom of the Iateral equally spaced S Laterals & force main of PVC Sch 40 3 (per COMM Table 84.30 -5) Force main connection via tee or cross to manifold at any point. Number of Laterals 3 Orifice Diameter 0.125 in Lateral Diameter 1.00 in Orifice Spacing (X) 4.09 ft Lateral Length (P) 65.44 ft Orifices per Lateral 17 Lateral Spacing (S) 2.99 ft Orifice Density 11.77 ft /orifice Lateral Flow Rate 7.00 gpm Manifold Length 5.97 ft System Flow Rate 21.01 gpm Manifold Diameter I 1.50 in Total Dynamic Head r 15.02 ft Forcemain Velocity 1 2.15 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 Disconnect 4 in. min. Tank component is properly vented - E— Alternate outlet location Forcemain diameter Weiser 800 - 325 -8456 Manufacturer 77 7 2 in. Capacityl 800.00 Gallons Volume 22.24 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 21.91 487.38 B 2.00 44.48 C P ump off elevation (ft) C 2.06 45.74 90.83 D 10.00 222.40 D Total 35.971 800.00 iF__ Dose tank elevation (ft) 3" Bedding un er tank. 90.00 Alarm Manuafacturer IS. J. Electro Systems Alarm Model Number 1101 HW Pump Manufacturer JMyers Pump Model Number IME40 Pump Must Deliver 1 21.01 Igpm at 15.02 ft TDH Project: Sylla 4 bedroom Mound System Page 4 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name Install ed_b Nel son Plumbing Phone 715 - 273 -4444 POWTS Regulator's Name St. Croix County 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 600.32 ft 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 years Mound Ins ect for ponding and seepage once every 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 mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 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 P revent soil erosion and help educe frost penetration. P P Lateral Turn -up Detail Finished ••............ ............... Grade 6 -8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution .' ' Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Sylla 4 bedroom Mound System Page 5 of 8 i Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD- 10691 -P (N.01/01) 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, Stats. 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 filter 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 fitter 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 shall 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 BOD 150 mg /L TSS, and 30 mg /L FOG for septic tank effluent or 30 mg /L BOD 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 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 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 clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Sylla 4 bedroom Mound System Page 6 of 8 1 M E40 Series 4/10 HP Effluent and Drain Water Pumps Performance Curve MODEL ME40 EFFLUENT PUMP CAPACITY LITERS PER MINUTE 0 50 100 150 200 250 300 350 40 12 35 10 N W 30 N ti 8 H 25 Z z w 20 6 2 15 a O 4 O 10 ~ s 2 0 O 0 10 20 30 40 50 60 70 60 90 100 CAPACITY GALLONS PER MINUTE G Pv►'1 , 1101 Myers Parkway, Ashland, Ohio 44805 -1923 419/289.1144 FAX 4191289.6658 Telex 98-7443 p o K3326 7/91 Printed in U.S.A. 04'1 j,l2005 22:09 FAX 2004 Brian & Angie Sylla 50. Rolling, Meadows Drive River Falls, W1 54022 SE %,NE %,S21,T28N,R19W 11 Troy Township St. Croix County 40 Scale 1 " ° 40' u Weiser 12001800 tank Bill #1= 100.00' Top of spike in tree 0.30' above ground �! BjV #2 = 97.53' Top of spike in ground 35' of 2 "force mein ti Q� Lof3 u v d ►: � �, oo v 4l 1 O r 40 , 93 0` a D� _^ —___— f� aKse � Iea�vu7s ��Fr f 0 L. AP., 7 �S � Say( �`/i � . t / ag ST CROIX COUNTY SEPTIC TANK MAINTEI? ANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer t ( �L Mailing Address )--b Z b(-C -W 6 /� /doe -✓,S �� G� Property Address I Sj C C L �ti E (Verification required from Planning Department for new construction) City /State gee S-a'J Parcel Identification Number 4e10 /091 6 © 00 LEGAL DESCRIPTION Z T ? R W, Town of o Property Location � �`� '' /4, � '/4, Sec. — �' — A`�" Subdivision ✓ , Lot # _. Certified Survey Map # , Volume , Page # `1' � . Warranty Deed # :77 2 6s( , Volume 6 , Page # Spec house O yes Wno Lot lines identifiable yes 0 no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper rnaintenanc( consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the systerr. can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by z master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal systerr, is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standard: set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certificatior stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expirationa�e. // O .)i SIGNATURE OF UPLI r DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property_ d bed above, by- (virtue of a warranty deed recorded in Register of Deeds Office. -7/ b 5 SIGNATURE O APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department,""" ** Include with,this application: a stamped warranty deed from the Register of Deeds office i a copy of the certified survey map if reference is made in the warranty deed RE F Wisconsin Department of Commerce SOIL EVALUATIO REPOR7" Page 1 of 2 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. 2005 St. Croix Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan m ST, include, but not limited to: vertical and horizontal reference point (BM), direction an Z QDUNT (Pending) percent slope, scale or dimensions, north arrow, and location and distance to neares G p Please print all information. 12evi Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 1 Property Owner Property Location E( ■ BRIAN & ANGIE SYLLA Govt. Lot - - -- SW 1/4 NE 1/4 S 21 T 38 N R 19 Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 502 Rolling Meadows Drive 3 -- City State Zap Code Phone Number ity E]vllage ■ Town earest Road River Falls, WI 54022 ( 715 425-0113 Chinnock Lane Troy a New Construction Use Residential / Number of bedrooms 4 Code derived design flow rate PD Replacement Public or commercial - Describe: Parent material Loess over till Flood Plain elevation if applicable N A ft. General comments Mound System -- 0.5 ft. sand fill -- 0.6 loading rate and recommendations: Revised report submitted to relocate system from previous test dated 12 - 21 - 03. County on -site by Kevin Grabau, Zoning Specialist 07- 07 -04. 1� Boring # 0 Boring a Pit Ground surface elev. 92.50 ft. Depth to limiting factor 34 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. *Eff#1 *Efr#2 1 0 -5 10YR2 /2 A - h,.r, � 1 2f -labk mvfr cb 2vf-co 0.6 0.8 2 5 -12 _ _.._� 1 f- bk mfr cb lvf-co 0.6 0.8 12 -30 l OYR2 /2 SC't/vrtrZ. -' 1 2f -mabk mfr ai 1 vf-co 0.6 0.8 .� 4 30- 39OYR sil 2f -mabk mfr cb -- 0.6 0.8 5 34-46 10YR3 /4 c2d 10YR4/6&10YR6/1 sil 0m mfi aw -- 0.0 0.2 6 46 -60 7.5YR3/4 f2f IORY4 /6 s Osg ml -- -- 0.7 1.6 (Horizon 6 is banded w/Is & sl wc) F 3 1 Boring # ❑ Boring 99.00 36 0 Pit Ground surface elev. ft. Depth to limiting factor in. Soil licetion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -6 10YR2 /1 -- 1 3f -mgr mvfr cs 3vf-co 0.6 0.8 2 6 -14 IOYR2 /2 - 1 2f -msbk mfr cb 3vf-co 0.6 0.8 3 14 -29 1OyR3 /2 - 1 2f -msbk mfr cs 2vf -co 0.6 0.8 4 29 -36 10yR3 /4 - sil 2f -mabk mfr as 2vf-m 0.6 0.8 5 36-40 IOYR3 /4 f2f IOYR4 /6 Is 0m mvfr as 2vf-m 0.7 1.6 * Effluent #1 = BOD > 30 220 mg/LL and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 ngA- and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Mary Jo Hollister 224832 Address Date Evaluation Co ctRid Telephone Number W9875 690th Avenue, River Falls, WI 54022 07-07- (revised 03 - 25 - 05 ) (715) 426 - 1775 PLar PLM 00% 6Y u.A t ,!�nw46 le Lgmp 07 73 aOw IN TWE D S iKLL JAI7REE .30 714, 40 u Ia A TI, i 22!U rT#jO or ZPIX& IN ' v,l SI vamw MUM A7 J � t ( Z � .to' i CH�,uNOac y low 4 49 UBl FRO - �z -2�.o7 Wisoonsin Department of Commerce SOIL EVALUATION REPORTt ? s Page l of 2 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code I Courxx! ; i_ `) k ?0 0 9t. Croix Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. (bending) percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. 'Reviewed by- Date Personal information you provide may be used for secondary purposes (Privacy Law, a. 15.04 (1) (m)). Property Owner Property `motion a BRIAN & ANGIE SYLLA Govt. Lot -- SW 1/4 NE 1/4 S 21 T 38 N R 19 E (o0 W Property ownees Mailing Address Lot # Block # Subd. Name or CSM# 502 Rolling Meadows Drive 2&3 — (Pending) City a Zip Code Phone Number E]vllage ■ Town Nearest Road River Falls, WI 1 54022 ( 715 425-0113 Chinnock Lane New Construction UseEj Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe: Parent material Loess over till Flood Plain elevation if applicable blA ft. General conwrients 3 holes dug to investigate soils at different location then previously tested. This report to be added to report and recommendations: dated 12 -21 -03. County on -site by Kevin Grabau, Zoning Specialist. a Boring # ❑ Boring -- a Pit Ground surface elev. ft. Depth to limiting factor 34 in. Soil ieation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Court. Color Gr. Sz. Sh. *Efr#1 "EfF#2 1 0 -5 10YR2/2 — 1 2f -labk mvfr cb 2vf-co 0.6 0.8 2 5 -12 10YR2/2 — 1 2f -mabk mfr cb lvf-co 0.6 0.8 3 12 -30 10YR2/2 -- 1 2f -mabk mfr ai lvf-co 0.6 0.8 4 30 -39 10YR3/4 sil 2f-mabk mfr cb — 0.6 0.8 5 34-46 10YR3/4 c2d 10YR4 /6&1 0 YR6/1 sil Om mfi aw — 0.0 0.2 6 46 -60 7.5YR3/4 f2f IORY4 /6 s Osg ml -- — 0.7 1.6 (Horizon 6 is banded wAs & sl wc) Boring # ❑ Boring F Pit Ground surface elev. ft. Depth to timiting factor in. Sofl iaation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff: in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Efr#1 •Eff#2 2 other its similar w/banded weswds.) • Effluent #1 = BOD > 30 220 nV& and TSS >30 < 150 mg& ' E vent #2 = BOD 1 30 mg& and TSS < 30 mgA- CST Name (Please Print) Signature CST Number Mary Jo Hollister 224832 Address Date Evaluation Conducted Telephone Number W9875 690th Avenue, River Falls, WI 54022 07-07-04 (715) 426 - 1775 I.r� f,..If TMYV� PWf PLAN per? SY uA %kN Lmp /!: is CO MM OFSr e ATE CD SQL BA3Jr W/ BAS + 44 NO GOMM 8S SEt?�ICK �ODLE 5 M 8� a� T X Rr '�,�.: P"Ak R ECD VE'j x VWsconsini Department of OIL �'/ALUATION REPORT Page 1 of 3 Division of Safety and Buildings S inh8a Comrr85' Wts. Adm. Code County St. Croix Attach complete site pluri on not ii�ic4 I pidiu3s size. Plan must hctude, but not irnfled to: reference Point (BM), direction and Parcel I.D. (Pending) percent slope, sole a dimersions, north arrow, and location and distance to nearest road. Date Please print an fidbrmadm. Personal iMainstion you provide may be used for secondary Purposes (racy Low, s. 1 5.04 (1) (m)). / 7 D Ply pviner Property location a CHARLES WEBSTER (Buyer. Brian Syna) Govt. Lot — SW 1µ NE V4 S 21 T 28 N R 19 E (or) W Propert Ownees Mailing Address Lot* Block # Subd. Name or CSW 102 Nesbitt Drive 3 -, (Pending) State Zip Code Phone Nuntw V lage own Nearest Road Mina, SDI 57462 ( ) NK Uoy 1 Chinnock Lane Q New Construction UseEj Residential / Number of bedrooms 4 Code derived design flow rate 600 GPO ❑ Replacement ❑ Pubic or camiercial - Describe: It Parent material /� L "" oess over till Flood Plain elevation if appicable 14 4 Generalcomments 7 n �v 4, - Mound System - 0.5 Loading Rate - 0.5 R sand fAl and reconirriendations: �� nodes. 1 Boring # ® Pit Ground surface elev. 96.65 ft. Depth to kWnft& g #actor 30 Soft Rate Horizon Depth Dominart Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsei Qu. Sz. Cont. Color - EMI -002 1 0-6 10YR2/2 - 1 3f -lgr mvfr I cb 3vf-co 0.5 0.8 12 - 1 2f- k mfr aw 3vf-co 0.5 0.8 2 6- 10YR22 3 12 -21 1 10YR3/2 1 2f -mabk dh aw 2vf-co 0.5 0.8 4 21 -26 10YR3 /4 - sl 2f -mabk dh cur 2vf-co 0.5 0.9 5 26-30 10YR3 /4 - sl 1 fabk dh cur 2vf-m 0.4 0.6 6 3040 10YR3/4 - deh ci 1 vf-f 0.0 0.0 7 40- - - LSBR 2 0 �9 . 35 # son" ❑ Pit Grou surfaeeelev. R. Depth to 1rrNUi9 factor c• soft Application Rate Horizon Depth Dominant Redox Description Texture Strucbxe Consistence Bwndary Roots GPDM in. Munsei Qu. Sz. Cont. Color - Ef #1 - Eff#2 1 0-5 10YR2/2 - 1 3f -lgr mvfr cb 3vf-co 0.5 0.8 2 5-9 10YR2/2 - 1 2f- mfr cb 2vf-co 0.5 0.8 3 9-12 10YR3/2 - 1 2f -mabk dh cb 2vf m 0.5 0.8 4 12 -24 10YR3 /4 - sil 2f -mabk dh cur 2vf-co 0.5 0.8 - lmabk dh cW lvf-m 0.4 0.6 5 24-35 7.5YR3/4 sl 6 35-43 7.5YR3/4 - scl m deh cf - 0.0 0.0 LSBR - * Effluent #1 = BOD > 30 < 220 mglL and TSS >30 1150 mgIL ' Gent #2 = BOD <- 30 mg& and TSS <_ 30 mg& CST Name (Please Print) Signature ,��fII�� /._. CST Number M Jo Hollister #a'S &' 224832 Address �-j Date Evakration Conducted Telephone Number W9875 690th Avenue, River Falls, WI 54022 12-21-03 (715) 426 - 1775 1 CERTIFIED SURVEY MAP LOCATED IN THE SW 1/4 OF THE NE 1/4 OF SECTION 21 T28N, R 19W, TOWN OF TROY, ST. CROIX COUNTY, WISCONSIN. - /a "a 'F NE CORNER N 1/4 CORNER SECTION 21 SECTION 21 NORTH LINE OF T28N, R 19W T28N. R 19W THE NE 114 _ N 89 0 2 2' 2 E 263 7.86' �- 1318.93' -�— 1318.93' � I OWNERS & SUBDIVIDERS 3 I CHARLES C. & JANET E. WEBSTER , LOT 1 I 102 NESBITT DRIVE I C S M + MINA, SOUTH DAKOTA 57462 I I m UNPLA T TED LAND I VO GE 51296 ( POINT OF o CH /NNOCK -- -- BEGINNING LANE �' N0� HH LOV OF TW SW 1/4� DO_C. X3853— 8 ThE _ 1 N 69 0 21' 15 1328.78 — � — "� — F8-z — UN_PL A T TE Toozi �' — 750.82' 11 11122. EASEMENT AREA " N 09 N N^ CONSERVAT "I N M I LAND co S 89 °39' 07 W 13 p . ' � " 4 62 LO T 4 • �"� o � � _ - "� %� � "' ' ' 284.00' I�'INI 286.00 ^� M 3 0 - Z p �S 89 °21' 15" W 570.00 Icy o _ U I B3 i 1 66 W /DE ACCESS M N� ' 1 �`A EM�NrREdDIMED AV Inn_ I-I�lO�QI�I I I I` VOLUM 1363 �'AGI_ �'7 N M y g �IQI , IQCIOI Lo ®B2 I w I LOT 2 N EAST LINE OF b "CONSERVATION ! Thf' SW 1!4 _ q LOT 3 a � � O � EASEMENT ARE,4 "66.01' �OF THE NE 114 ���� C4 o rn 183.991 - VI �' J� 2 C �z O 1 I ®B� _ I N 5 4 • �. � 3 Z I O$ �F �! U w ( I I co 0 I �� o�o�o� o � ► P� ' CON � i I I I I I 1�p I l - 686. I _ L� _ - _ 540 145.9T 402.50' - S 89 °20 W 1088.50' MONUMENTED EAST -WEST 114 SECTION LINE -� LOT LDT 2,_C._S.M_, VOL. 4LP_G._1157 C. S. VOL. 13 DOC.�377181 W PAGE 353_5 LEGEND - DO C. j`5$8 W N COUNTY SECTION CORNER MONUMENT; \ rn N ALUMINUM CAP, FOUND. O ° 1 1 /4" x 18" IRON PIPE WEIGHING o z z m 1.68! /LINEAR FOOT, SET SCALE IN FEET m zz�w • IRON PIPE. FOUND (1" UNLESS w w OTHERWISE NOTED). w w o " ® 1 SOIL BORINGS PERFORMED BY w z p O_ 0 150 300 600 MARY JO HOLUSTER ON DECEMBER ►= o 21, 2003. z = W PROPOSED DRIVEWAY LOCATION. wow in mzoa — _ . BUILDING SETBACK LINE 150' AREA INCLUDING TOWN AREA EXCLUDING TOWN FROM R.O.W. LINE, 50' FROM LOT SIDE AND REAR LOT LINES). ROAD RIGHT - - WAY ROAD RIGHT -OF-WAY 2 13.532 AC., 589,451 S.F. 13.414 AC., 584,349 S.F. NOTE: ALL IRON PIPE ( FOUND 3 18.588 AC., 809,702 S.F. 18.361 AC., 799,802 S.F. OR SI SET) ARE DIMENONED AS OUT I DE D I AME I . 4 5.071 AC., 220,899 S.F. 4.587 AC., 199,803 S.F. THIS INSTRUMENT DRAFTED BY JEROD A. FINK PAGE 1 OF 2 i prop" Owner Webster, Charles (Buyer. Sylla) Parcel ID # (Pending) page 2 of 3 r 3 Bwft Boring (LOT -5) # pd Ground surface elev. 99.65 ft Depth iKratirng factor 37 in. Rate Horizon Depth Dominant Color Redox Description Texture Skuckn Ca ce Boundary Roots GPDM in Qu. Sz. Cart Color Gr. Sz. Sh. - Ef*1 I "Eff#2 1 0-5 10YR2/2 — 1 3f -mabk mvfr ab 3vf-co 0.5 0.8 2 5 -10 _ 1 2f -mabk mfr ab 2vf-o 0.5 0.8 3 10-21 IOYR3 /4 — sil 2f-mabk mfr ob lvf In 0.5 0 g 4 21 -37 7.5YR3/4 — sl If- -msbk mfr cb lvf-f OA 1 0.6 5 37-42 7.5YR3/4 — scl In mfi ci Ivf-f 0.0 0.0 6 42-44 — — LSBR — _ — — — -- F - 1 g Boring Pit Ground surface elev. ft. Depth to g factor n. Soi Rate Horizon Depth Dominant Color Redox Description Texture skuc m Consistence Boundary Roots GPD/fP inn. Murnsell Qu. Sz. Cont. Color Gr. Sz. Sh. -EM1 Boft # Bodrs Pit Ground surface elev. ft. Depth to *a" factor in. EW App Rate Horizon Depth Dorr kwt Color Redox Description Texture Consistence Boundary Roofs GPM in. Munseti Qu. Sz. Coat. Color Gr. SL Sh. - Hf#1 - Etf#2 * Effluent #1 _ BAD > 30 < 220 nV& and TSS >30 <_ 150 mgfL ' Effluent #2 = BOD < 30 mgA- and TSS <_ 30 mglL 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. senru3arrar cRmrom PLOD' PLAN p 3 O 04MC WE65T LES / E XC� T r O-m lz s � ��. " --. E - SS E E SEr . Z! J TZ 9 A�l Ia. TOW G Z = SoV� (_t�T 3� s � w000SED 21. Z ACRES Z R W a a 1 0 Lam c� F14 Cp ,b vC u� V . 6 A b eke J 1 !� L OT 3 Fr Quo ` r AE ti r EL 103.3 _ CA ,wM� �E x �a E p;tsBR @Ziop OLi E 4797 RMYSTER OF DEEDS ST. CROI% CO. YI RECEIVED FOR RECORD 07/29/29MM 12:25PH LOCATED IN THE SW 1/4 OF THE NE 1/4 OF SECTION 21, T28N. R 19 FEE i TOWN OF TROY. ST. CROIX COUNTY, WISCONSIN. PALMS: 2 N 1/4 CORNER NE CORNER SECTION 21 NORTH LAC OF SECTION 12 T28N. R19W ThIE' A1E 1/4 N 89'2 E 263 7.86' �T?8N• R19W 1318.93' +' �+ - _ 131&93 Qyy� de SlJEDlV�ERS 3 j WEBSTER , LOT 1 ! _ 102 NESBITT DRIVE MINA. SOUTH DAKOTA 87462 I C S 4 I PLA TTEQ �ANlD VOL. UN ( POINT OF r n PAGE 1296 I BEGINNING S mwrH L^ a- T sw Y ow DO X385385 H ' ME 1 N 89 °21_15" E 1328.78 _� 99.8' o ! .. MC p� P " $ 39 O 7 , � s A~ Q`' ss.00' i ell N ^ , r - _ l 8256. - 4 30. 84.00 �� n �, �• I 28 3t ® 83 S 8 o �r57o, W N X11 i 1�i 0 0 1 i7 B1 t ►�S Yv�L OiV1O1�1�1 '21 ®82 S v- b r-�. ) LO 2 , EAST LOC O#r LOT 3 i "CONSERVATION rHE• SW 1/4 ;N ,00 , EASEMENT AR 6• OF Tom£ J 114 ,. 6.Oti i I; C.4 '' APPROVED I ! 1 s 3. s i IL _ ._ rawr «B 1 1st o, \ _ 0j ,� \ ! JUL 2 9 2004 i9' _ a d8 1 T OQF N '�?1 ► Mootnroordodvwwmn34 day* ot 1 w� I ° � °J ° /\� + P,- Lr]GA F E 1 1 f apMvat dan *opW; l shaN tW $ �s y i nua and voW 5 1 I z gn I • 145.97' .50' _ S 89.20' 46" W 1088.50' i "AAEW EAST -WEST 1/4 SECT /ON LOVE LOT 1 LOT 2, C.S. P� VOL.�4 77,57 _C S. M VOL. 13 LEGEND 1?OC.377181 PAGE�.335 = DO_c. �588s84 COUNTY SECTION CORNER MONUMENT, N ALUMINUM CAP. FOUND. 0 1 1/4 x 18" IRON PIPE WEIGHING r co NOTE- ALL IRON PIPE ( FOUND 1.68# /LINEAR FOOT. SET. OR SET ARE DIMENSIONED igz AS OUT IDE DIAMETER. IRON PIPE. FOUND 1 UNLESS SOL OTHERWISE NOTED). B1 MARY JO B O DECEMBER ° SCALE IN FEET r 21, 2003. av w - -�► PROPOSED DRIVEWAY LOCATION. O 150 300 600 M R.O O _ SUE DING SET13ACK LWE FF((R11pO50• SIDEANDREAR LOTLues). LOT AREA INCLUDING TOWN AREA EXCLUDING TOWN ROAD RIGHT -OF -WAY ROAD RIGHT -OF -WAY EXISTING FENCE. 2 13.532 AC.. 589,451 S.F. 13.415 AC.. 544,349 S.F. SLOPES GREATER THAN 2OX 3 18.588 AC., 809.702 S.F. 18.381 AC„ 799,802 S.F. AS SHOWN IN THE USDA SON. SURVEY. . 4 5.071 AC, 220.899 S.F. 4.587 AC, 199.803 S.F. THIS INSTRUMENT DRAFTED BY JEROD A. FINK PAGE 1 OF 2 Vol 18 Page 4797 7722E,4 U._ 264 1P 4 62 � KATHLEEN H. WALSH STATE BAR OF WISCONSIN FORM 1 - 2000 REGISTER OF DEEDS Document Number WARRANTY DEED ST. CROIX Co., WI This Deed, made between CHARLES C. WEBSTER AKA RECEIVED FOR RECORD CHARLES WEBSTER, A SINGLE MAN, _ 88/23/2084 08:88AN WARRANTY DEED EXDPT # Grantor, and BRIAN P. SYLLA AND ANGELA M. SYLLA, HUSBAND REC FEE: 11.00 AND WIFE HOLDING AS SURVIVORSHIP MARITAL PROPERTY, TRANS FEE: 234.88 COPY FEE: CC FEE: PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in ST. CROIX County, State of Wisconsin (the "Property") (if more space is needed, please attach addendum): LOT THREE (3) OF CERTIFIED SURVEY MAP IN VOLUME EIGHTEEN (18) OF CERTIFIED SURVEY MAPS, PAGE 4797, AS DOCUMENT Recording Area NUMBER 770179, FILED IN ST. CROIX COUNTY REGISTER OF DEEDS Name and Return Address OFFICE ON JULY 29, 2004, BEING LOCATED IN THE SOUTHWEST LEO A. BESKAR QUARTER OF THE NORTHEAST QUARTER (SWI /4 OF NEI /4) OF RODLI, BESKAR, BOLES, & KRUEGER, S.C. SECTION TWENTY ONE (21), TOWNSHIP TWENTY EIGHT (28) NORTH, RANGE NINETEEN (19) WEST, TOWN OF TROY. 219 NORTH MAIN STREET, PO BOX 138 RIVER FALLS, WI 54022 Subject to Chinnock Lane right of way. 07 - /0 6 ly St. Croix County, Wisconsin. PART OF 040 -1081- 60-000 Parcel Identification Number (PIN) This is not homestead property. Together with all appurtenant rights, title and interests. 09) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Dated this 19th day of August 2004 * * CHARLES C. WEBSTER AKA CHARLES WEBSTER * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF VV 1 ) ) ss. I Q,y�t County ) _ day of Pers rally came before me this + �r ►1 day of CHA -- RLENE EARSON CfA ke the above named d •� --tef Pu blic tma Wi sc onsin � • ��T BAR OF WISCONSIN > • 4 ;: to me known to be the person(s) who executed the foregoing 6.06, Wis. Stats.) instrument and acknowledged the s 4Vj •.....• I3IviENT WAS DRAFTED BY LEO A. BESKAR Notary Public, State of RODLI, BESKAR, BOLES & KRUEGER, SC My Commission is pe a t. If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) B f ) * Natnes of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN INFO-PRO (800)655-2021 www.infopmforrns.com FORM No. i - 2090