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HomeMy WebLinkAbout002-1060-50-200 Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count y INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary 3445 68 Permi IX Personal information you provice may be used for secondary purposes [Privacy La k s.15.04 (1)( Per r�t I � :f PAXTON & TAMMY ❑City CL�(i[IauP Town of: Pte Plan ID No.: tSA1,UWl ' ,bst = .Io(, } CST BM Elev.: Insp. BM Elev.: BM Description: arcel Tax No.: 1 0 ltro (Bot A9909312 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Q ( "C> Benchmark L 1. 3 to (.34 r UO a Dosing �►✓ o� , p i Aeration Bldg. Sewer Holding St/ Ht Inlet S TANK SETBACK INFORMATION St/ Ht Outlet 12. Z(. TANK TO P/ L WELL BLDG. Air Intake ROAD Dt Inlet j� ,o Septic >�5 1E NA Dt Bottom Z p, 8, Dosing >q-5 « - f-:5' NA Header/ Man. 3, q`, z-t- Aeration A Dist. Pipe 3 ' }Z_ q4, z3 Holding Bot. System q!• 3 �s PUMP/ SIPHON INFORMATION 166' lar Final Grade Manufacturer DeRand AN—, Model Number j5pa,5 -%+ GPM ( , 0,%f �O,d TDH Lift , fit Lrictio , ,ot a System TDH Nq,\ Ft kead Forcemain Length 3u Dia. 2 u Dist. To Well > tap T I SOIL ABSORPTION SYSTEM t2, ,G (a ��f o , 02.13 1(•a�f ( - 8ED_# Tfl@NEH Width , Length ! N( 4 0f PIT No. Of Pits Inside Dia. Liquid Depth EN 1 N $ 7 DIMENSION SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHI Manuf r: SETBACK — INFORMATION Type O �2>>a �-- ° OR UNIT del Number: System: DISTRIBUTION SYSTEM L eader / Manifold N Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake CA 94 y y ength -+ Dia. 2, Length 2A t Dia. _ Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) a-^�°� •� _ (�� LOCATION: BALDWIN 25.29.16,NE,NW 2631 COUNTY OA D - S OA qqsq P A*__ A wR Plan revisioHrequired? ❑ Yes No S Use other side for additional information. l oci 1 3 • 1 k M xr SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. I r ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: § a t 3 3 , I . , s a � e Y f f e i ., z .am n_..— m ve- e ...P...._ ... .....,..... ... ,...... ., a ..... €..... ...... ... _ ._. ��_ , 1 I y s 3 3 F E � 9 e 0 d � _ z S m.� 3 F , a � S� s F i 9 T L t E 1 § i 3 ems _ 7: y� W., s � i § ! s a L I Safety and Buildings Division ` SANITARY PERMIT APPLICATION 21B W Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County than 81/2 x 11 inches in size. • See reverse side for instructions for completing this application State Sanita Permit Number Personal information Nu y ou p rovide may be used for seconds `vi ��— y p y second purposes ❑Check if revlsl n to p vlous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Numb r I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION 6 Pro Owner E; 4e oc 1-", o� f *E4 S 2 T 2 �, N, R/Z E (or Property Owner's Mailing 0dd ress� Lot Number w Block Number JJ y� City, State , Zip Code Phone Number Subdivision Name or CSM Number SA II. TYPE OF BUILDING: (check one) ❑ State Owned 0 Cit Nearest Road �/ El Public 1 or 2 Family Dwelling - No. of bedrooms r T own of �i�c �� �� K/, 111 BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) P{ ' �jlZC., 1 ❑ Apartment/ Condo © bl ® 0 —2.00 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel /Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. Ig New 2. ❑ Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an - _____System ________ System____ _________TankOnly______________ Existing System ________ Ex(stingSystem B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 MMound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade �.J Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Ele�vation `� D 7 2 &xr �Ke Feet ' 7 0 - 4 , 7 Feet Capacit VII TANK in Ca allo s g Total # of r Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con Steel glass Plastic App New Existing strutted Tanks Tanks eptic Tank orhFe 1 aaL, / m 2F ❑ ❑ ❑ ❑ ❑ , Lift Pump Tank r / ❑ ❑ ❑ ❑ ❑ II. — R — EMNSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. PI u ber'ANa (Print) Plum is r�tu e: tamps) MP /MPRSW No.: Business Ph one Number: Plumb 's Addre(Strty�St� , Zip�de): n 77 3 �/ 4,/ � 7 y o0 IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate I ssued Issuing e t gn ture (No Stamps) [R ❑ Owner Given Initial ��e- a07 Surcharge Adverse Determination f X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11/97) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. Asanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608 -266 -3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mainstwater service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which. can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. • Safety and Buildings • N v isc 2226 ROSE ST LA CROSSE WI 54603 -1905 o nsin Tommy G. Thompson, Governor Department of Commerce William J. McCoshen, Secretary April 06, 1998 CUST ID No.267341 ATIN: POWTS INSPECTOR WEGERER SOIL TESTING & DESIGN 421 N MAIN ST PO BOX 74 RIVER FALLS WI 54022 RE: CONDITIONAL APPROVAL Transaction ID APPROVAL EXPIRES: 04/06/2000 SITE: Site ID: 4254�`� ip ST CROIX County, Town of BALDWIN t� = NE1/4, NWl /4, S25, T29N, R16W PAX RASMUSSEN FOR: FiC� Description: MOUND Object Type: POWT System Regulated Object ID No.: 9820 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes listed in the regarding line above. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • 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(d), Wis. Stats. • 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. Adm. Code. A copy of the approved plans, specifications and this letter shall be or. -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation /operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. When making an inquiry or submitting additional information, please refer to Transaction ID No. in the regarding line. Sincerely, r ° DATE RECEIVED 04/04/1998 FEE REQUIRED $ 180.00 &RA M SWIM , POWTS PLAN REVIEWER FEE RECEIVED $ 180.00 Integrated Services BALANCE DUE $ 0.00 (608)785-9348, MON - FRI, 7:15 AM - 4:00 PM JSWIM @COMMERCE. STATE. WI.US A Page of 6 MOUND SYSTEM FOR A 3 BEDROOM RESIDENCE LOCATED IN THE NE 1/4 OF THE Nw 1/4 OF SECTION ZS ,T Zg N, R W, TOWN OF laFsfl, l-b InJI N COUNTY, WISCONSIN. RECEIVED INDEX APR - 4 19 PAGE 1 'of 6 TITLE SHEET SAFEI Y & bLJ61'-' DIV. PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW -CROSS SECTION: PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUMPING CHAMBER ' PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR 70 G C PREPARED BY WEGEFREFZ SOIL TESTING AMID . I3E13 I C- M E3IEF;Z`! I CE ��,Ntoe P.O. BOX 74 421 B. KAIK ST. � C O.Ns/ P'.O.W.T.S. RI FALLS. YI 54022 Conditionally 715 - 42 5 9 - 0149 • r AMUW`. APPROVED usw0fp S D -9i5 P � �LLSWORTII, i WIS. DEPARTMENT OF COMMERCE DIVISIO AF TY AND INGS I G' � , 8 SEE CORRES a!t iNM� DENCE g$-59 JOB NO. `. PLOT PLAN Page 'Z- of �o Scale 1"= SO' a.3 �ew1 a+-J 0. EEL q q SB�1 $ 'Z LL F39 b0 ►voT eta} - vp oR �nyIS Q. LL r ` JJ zZo o� C 2 Page 3 Of Approved Synthetic Covering C.33 Distribution Pipe Medium Sand Topsoil ___— —____ F Elev. S• S —� E p_ 3 b q % Slope Bed Of 1 %2 Force Main Plowed Aggregate From Pump Layer D � - o Ft. Cross Section Of A Mound System Using E \. Ft. A Bed For The Absorption Area F o-g Ft. G 1 -O Ft. A Ft. H 1 -5 Ft. Linear Loading Rate = o� -b GPD /LN FT B Ft. Design Loading Rate= o.L(.GPD /SQ FT j Ft. J — 1 Ft. K 1 Ft. - A! tellidte n L 6`l Ft. e� W - 21 Ft. - TOTCCTICT'TT'� — L j Observation Pipe g K A -- -- - - - - -- -- - - - - -- - - - -�f W ° - ------- - - - - -- - Force Main ' « Distribution 7 :—B ed Of 2 — 2 2 Pipe Aggregate I Observation Pipe Permanent Markers (Anchor securely) Plan View Of Mound Using A Bed For The Absorption Area pa _�:Of Perforated Pipe Detoll 0 End View )Perforated End Cap �+ PVC Pipe Install permanent marker at end of each lateral Holes Located On Bottom, Are Equally Spaced Q S PVC Force Main P PVC Manifold Pipe Distri ution Pi e Lost Hole Should Be_) I Next To End Cap 1 End Cap / P Z 2 . Ft. Distribution Pipe Layout S L/ Ft. X V $ Inches Y � Inches Hole Diameter 1 !y Inch Lateral 1 Inches Manifold Inches Force Main Inches # of holes /pipe Invert Elevation of Laterals `1 Ft. Place 1st hole Z y rr from center of manifold with succeeding holes at VW intervals. Last hole to be next to the end cap. PUMP CHAMBER CROSS SECTION AND SPECIFICATIOuS ' PAGE S OF VCUT CAP -J" C.1- VENT PIPE WEATHER PROOF APP 10 f ROM ODOR, ROVED LOCKING MANHOLE JUIJCTIOW BOX COVER WITH WARNING LABEL - IZ'MIU. wiMDOw OR FRESH ( _ AIR 1WTAKE GRADE `I" MIN. W AIN. COWDUIT �-- 18.IKII►I. __________ PROVIDE I - - - -- IAILET _T AIRTIGHT SEAL it v APPROVED JOI A Tank construction shall comply I APPROVED JOINTS with ILHR 83.15 and ILHR 83.20 i II ( ALARM e i II I I I I ON C I -- - - 76•ot, I CLEV. FT. PUMP � � OFF O 1S pp CONCRETE BLOCK 3" APPRWFL - RISER EXIT PERMITTED OIJLy IF TAWK MANUFACTURE HAS SUCH APPROVAL S & W I NQ SPECIFICATIOMS D05E Mtpw�-R'R►J PST IJUMBER OF DOSES: PER DAy TANK$ MMJUFACTURCR: TANK 51ZE: - 7 so GALLONS DOSE VOLUME t �Sb -0 ALARM MANUFACTURf�R: S.T � `1� .2LQ SS INCLUDING BACKIFLOW: G AL%.O?JS MODEL IJUMBCR: tiZ� HW CAPACITIES: A= �' 11Z INCHES OR 32 1. GALLONS SwiTCH TYPE: - m � ` ' Z r _ u " 5 = 2 INCHES OR 19. 4LLOL15 PUMP MANUFACTURER: GO C= INCHES OR 1Sb GALLOMS MODEL NUMBER*. - 8 b EPO D= \Z INCHES OR 2314. GALLONS Tom 1 Sn S SWITCH TYPE' S MOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RArE Zg-o8 GPM INSTALLED ON 5EP CIRCUITS VERTICAL DIFFERENCE BETWELLI PUMP OFF AWD_DISTRIBUTIOM PIPE.. Z0.021 FEET + MIAIIMUM NETWORK SUPPLY PRESSURE .. . . . .. .. . . 2.50 FEET + \ FEET OF FORCE MAIN X �` 61 F IN fLFRICTIOU FACTOR. FEET TOTAL MAJAMIC. HEAD = 2 �' S � FEET DIAMETER IUTERUAL. DIMEMSIOWt OF TANK: LEMGTH ;WIDTH - ;LIQUID DEPTH . a BOTTOM AREA - 231= GAL /INCH AS PER MANUFACTURER = 1°l•S GAL /INCH Goulds Cn of Submersible - Effluent Pump r EPO4 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- • Homes components. Available for automatic and tic cover with Integra( handle • Farms Motor: manual operation. Automatic and float switch attachment • Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical points. • Water transfer 115 or 230 V, 60 Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty • Dewaterin RPM, built in overload with rated oil and water resistant g automatic reset. preset at the factory. Single phase: 0.5 HP, ■Bearings: Upper and lower • EP05 S SPECIFICATIONS 115 V, in le phas RPM, FEATURES heavy duty ball bearing construction. Pump: EPO4 built in overload with ■ EPO4 Impeller. Thermo- • Solids handling capability: automatic reset. plastic Semi -open design AGENCY LISTING 3 /4 ' maximum. • Power cord: 10 foot with pump out vanes for • Capacities: up to 55 GPM, standard length, 16/3 SJTO mechanical seal protection. $p• Canadian Standards Association �� • Total heads: up to 24 feet. with three prong grounding ■ EP05 Impeller: Thermo - • Discharge size: 1 1 /2' NPT. plug. Optional 20 foot plastic enclosed design for (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with improved performance. end in F or AC ".) rotary/ceramic - stationary, three prong grounding plug BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion. resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 • Capable of running dry without damage to s 30 components. ' Pump: EP05 8 I • Solids handling capability: 25 i4. S 9 3 /a' maximum. • Capacities: up to 60 GPM. A � s 2 ! • Total heads: up to 31 feet. - • Discharge size: 1IN NPT. z 5 • Mechanical seal: carbon- 0 15 rotary/ceramic - stationary, 4 is. 6 BUNA -N elastomers. • Temperature: 3 10 104 °F (40 °C) continuous 140oF (60 °C) intermittent 2 5 0 0 0 10 20 30 40 50 GPM 0 2 4 6 8 10 12 M CAPACITY ®1995 Goulds Pumps, kro. Effective May. 1995 83871 7W Department of Industry SM AND SITE EVALUATION Llibor and Human Relations _ -P_age / _ of Y_ Division'ot Safety and Buildings in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and 57 e y ` g percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # 9 � APPLICANT INFORMATION - Please Pr' ` Reviewed by Date Personal information you provide may be used for seco ses rivar aw, s. t$:04.0 (m)). Property Owner Property Location r , Govt: of 1/4W� � 1/4,S T ,N,R �� E (or&/ 'e r Property Owner's Mailing Address co 191 Loll" Block# Subd. Name or CSM# � sr GHax 9 o � o City State Zip Code 7,�k e FOC,,� City El village (Z Town Nearest Road '14 j y AAL /I R New Construction Use: ® Residential / Number of bedrooms •3 Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow gpd Recommended design loading rate _,_bed, gpd/ft trench, gpd/ft Absoiation area required bed, ft trench, ft Maximum design loading rate ,_ bed, gpd/ft f trench, gpd/ft Recommended infiltration surface elevation(s) g� > _ft (as referred to site plan benchmark) Additional design/site considerations �2.A✓�"�u v 9� i Parent material G,t.� c . `�. / '(1 &r Ao a S,6 Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure I AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ S 5O U ®S 1 : 1 U 1:1 S ® U [- [a U [Is Ud U ❑ S ® U SOIL DESCRIPTION REPORT Boris # Horizon Depth Dominant Color Mottles Structure GPD/ft Boring in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed , Trenchj l r 3 S/ JOY el v c s Ground ALMR 1 6 C I E 7, 4 D S I ap ft. Depth to limiting factor aQ in. Remarks: Boring # -i E y 5 l 1r�a b 0 r ►r S' S lm -2 I - 3c Zo r 1 or Ground - -- - --- - - - - -- - - -- R ft. I Depth to - - -- — - - - -- - - - - -- - -- - — j limiting factor 174 Remarks: CST Name (Please Print) Signature Telephone No. Address Date CST Number /d T a tl "'e -re -4/ L✓ , _4"'i�4 /i SOIL DESCRIPTION REPORT ^ ?ROPERTY OWNER Page .2 of — PARCEL I.D.# 3oring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots G e ptf t2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench around 3 /1 s C C 67 . : Aev. 9ft. )epth to miting actor in Remarks: ?oring # 'round lev. ft. !:apth to r. .iiting actor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench ::oring # :round ev. _ft. epth to Wiling actor _in. Remarks: ioring # round RV. ft. epth to ailing rtor in. Remarks: BDW -8330 (R. 08/95) r �t Z w rk -� v � s , a s• Gi V 4 t �V ,Ofx COUNTY b _- �__...._..�.....�,_.__._..__ - ,! (veri ficatiou rrruirrd fivi y P zan! t I)epaxtmc ut for n Rwaf ..aon t at <r .ttarx y/ Leraton M . %� fig, . `f� Fit - �P._ �� `FQ rar r +✓Z...,,� W&ITXIMPY Deed 11 volume = . p 2 � W r � q o B� a j�� ca Z M ry } �E � r � e +xr�Ixl y� t / a at Pali - M a u ih=tiL tU&.- t µyp y q� Hi1 tJ y1�.5F.4 •il- N e fe;. y ' is 17bjk' ?• 'C r- ` )1�au 4 a `ksfi 9t'.:ri j —;, W iW M a lk ; , aret:,ft NL tr iftft, Ya O YS in PCOM op=pg condition m&OC (x) aRer Lasp4d oa and pampit3g Cj Y)r septi%e twk.is k t %n ft& of tdudge. Mr-Ce Ik �dbMwead the abew heats and agxoe to � f +rte saws r yas sd b' y d o Dgwtwe �t of i�==c= and the Dcpa Wwd of Nabors[ Sixbe of* abaliag that y= septic system has bocce maia mined oast be compiicted and ncb=cd to the SL C .()ormty within 30 days. of *c &= yea CTim6oa date- 9IGMnMt OF APPLICANT DATE owr W, c»iTrCAWON I (woo) ccr"Y that all shag on this fonu ane tme to the best of my (oar) knowledge. I (we am (arc)',dw ow ners) of &a pmpedy describod abov% by virtue of a wamaty► dead .worded is Register of Dodds Office. Z 99 APPLICANT DATE ssssss AW information that is utis � 'rte may rcarlt is We sanitary permit being revoked by the Dom• ssss*s s� Inctadc Mth this appikatloa: a stamped warranty dood fiom the Register of Deeds o Qaoe a copy Of the axtifrod survey map if te(brenoe is Laude in the warranty deed VOL 1441 PAGE 298 606688 - KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS S7. CROIX CO,, WI RECEIVED FOR RECORD Craig E. Rasmussen and Gloria J. Rasmussen, husband 07 -12 -1999 10:30 AN and wife, conveys and warrants to Paxton M. Rasmussen and Tammy K. Rasmussen, husband and wife, the following EXEMPT #DEED e described real estate in St. Croix County, State of CERT COPY FEE: Wisconsin: COPY FEE: TRANSFER FEE: RECORDING FEE: 10.00 PAGES: 1 P�� d �--' Recording Area Name and Return Address rn be fo ? ku5 mt-t.s.se K FIRST UTIONAL BANK OF BALDWIN 990 Main Street Baldwin, Wl 549n2 002 - 1060 -50 (Parcel Identification Number) Part of the Northeast Quarter of the Northwest Quarter (NE % of NW %) of Section Twenty - five (25), Township Twenty -nine (29) North, Range Sixteen (16) West, more particularly described as Lot One (1) of Certified Survey Map filed June 10, 1999, in Volume 13 of Certified Survey Maps, at Page 3662, as Document No. 604772, office of the Register of Deeds for St. Croix County, Wisconsin. Exception to warranties: all easements and restrictions of record. This is not homestead property. Dated this _1Q' day of 71�1- 1999. Craig E. Ra ussen crA i * *Gloria asmussen AUTHENTICATION ACKNOWLEDGM61%,�0 " " 1 '� ST Signature(s) i7° n (� -A UJIC.t� STATE OF WISCONSIN ',, �� ~n ��� r �� A � ,,,`,• ST. CROIX COUNTY Personally came before me this 1-fek day of f _ L 1999, the above name oria J. authenticated this [;� day of T✓ - � Rasmussen to me known to be the person(s) who executed the foregoing instrument and acknowledge the same. signature T �1/��� .1 1 Cc� !J v &/,J_ 4 / �fl�l� /(i signature type or print name type or print name TITLE: MEMBER STATE BAR OF WISCONSIN Notary Public St. Croix County, Wisconsin (If not, My commission is permanent. (If not, state expiration date: authorized by §706.06, Wis. Stats.) DULY 30, 2000 THIS INSTRUMENT WAS DRAFTED BY *Names of persons signing in any capacity should be typed or Thomas A. McCormack printed below their signatures. Baldwin, WI 54002 Information Professionals company Fond du Lac, Wisconsin 800 -655 -2021 w 9 �0 5 F' �9q9 w N C ER T I E I ED S UR V E Y MAR st quarter of Section 25 , h Northwe Located in the Northeast quarter oft e q Township 29 North, Range 16 West, Town of Baldwin, St. Croix County, Wisconsin. Owned by: Craig & Gloria Rasmussen North line of the NW 1/4, Section 25 IV LANDS S87 °01'39 "E M - j S 87' 01 ' 39 "E 417.42' a A/8700 /',39"w 1339.79 h NW Corner _ C. T. H. "D" Section 25 - -_ O 922.37 6 , 1 a3' N 87 '01'39 "W 417.42 - — — — -- `� - - - - N 1 /4 Cor. . Section 25 ..... . ......... ........... SETBACK LINE .................. ............................... (10 m Q' C� � v � 204,732 Sq,ft'. (4.700 acres) m Q� W including right -of=way: t� 0 190,957 sq, ft.. (4... 384 acres) 3 C6 excluding right -of -way. 0 O • .i O t i • O , ELI I O LL ® T I O � 1 �..�.... Q to Q i JI _I 0_I Z� Z w q3 N 87'01'39 "W 417,42' UNPLATTED- LANDS Legend , 0S , St.Croix Co. section corner monument. QN % N • 1"X24" Iron pipe g i e wei hin 1. 16 lbs I w o X 0.51 G. HAR \j e'Y per lin. foot set. tA$0N Bearings referenced to the North line of �1� N = the Northwest quarter of Section 25, assumed S87 "01 °39 "E. �, < »......� `1 ND U SCALE IN FEET l "= 100' ,111 111 O 100 200 300 This instrument drafted by 4992631 Vol. 13 Page 3662 1459PAGE 258 6 1 1 099 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 09 -28 -1999 10:00 AM EASEMENT EXEMPT # CERT COPY FEE: COPY FEE: TRANSFER FEE: RECORDING FEE: 14.00 PAGES: 3 ------------------------------------------------------------ Return to: Thomas A. McCormack 740 Main Street Baldwin, WI 54002 Nud --- ODD - --fib aoo ----------------------------------------------------------- 100 - 5rj - ao 0 DRAINFIELD EASEMENT dh ' Easement made this day of July, 1999, between Craig E. Rasmussen and Gloria J. Rasmussen, husband and wife, Baldwin, Wisconsin (hereinafter referred to as GRANTORS), and Paxton M. Rasmussen and Tammy K. Rasmussen, husband and wife, Baldwin, Wisconsin (hereinafter referred to as GRANTEES). 1. GRANTORS are the owners and occupants of a tract of land described as: North East Quartcr of North West Quarter (NF '-4 of NW 1 -4) of Section Twenty-five (25), Township Twenty -nine 29 North Range Sixteen 16 West EXCEPT Lot 1 of Certified Survey Map filed June 10, 1999, in Volume 13 of Certified Survey Maps, at Page 3662, as Document No. 604772, office of the Register of Deeds for St. Croix County, Wisconsin. 2. GRANTEES are the owners and occupants of a tract of land described as: Part of the Northeast Quarter of the Northwest Quarter (NE '-4 of NW 1 -4) of Section Twenty -five (25), Township Twenty -nine (29) North, Range Sixteen (16) West, more particularly described as Lot one (1) of Certified Y 1459n 259 Survey Map filed June 10, 1999, in Volume 13 of Certified Survey Maps, at Page 3662, as Document No. 604772, office of the Register of Deeds for St. Croix County, Wisconsin. 3. GRANTORS desire to convey, and GRANTEES desire to obtain, the right to establish a sewerage absorption unit (mound system) and sewerage pumping pipe across the above described tract of land of GRANTORS. 4. Therefore, GRANTORS, in consideration of the sum of One and No /100s ($1.00) Dollar, receipt of which is hereby acknowledged, do hereby grant, sell and convey to GRANTEES the right to lay, construct, operate and maintain said unit and pipe in, on, and about the property of GRANTORS, more particularly described as: (put in legal description). Commencing at the northeast corner of the above - described Certified Survey Map; thence S00 °00'17 "W along the east line of said Lot One (1) a distance of 125 feet; thence S87 °01 "E parallel to the north line of said Lot One (1) a distance of 50 feet; thence N00 °00'17 "E parallel to the east line of said Lot One (1) a distance of 125 feet; thence N87 0 01 1 39 "W a distance of 50 feet more or less to the northeast corner of said Lot One (1) and the point of beginning. SUBJECT to the right of way of County Highway D. The rights herein granted may be assigned by the GRANTEES in whole or in part. The grant likewise includes the right of ingress and egress on the lands of the GRANTORS for the purpose of exercising the rights herein granted, the right to install a gate or to make a temporary opening in any fence on said lands at the point where such fence crosses the route of said sewerage pumping pipe or lines. The GRANTORS, for themselves, their heirs, successors and assigns, covenant not to erect any structure or other barriers or to take or allow to be taken any action on said lands that would interfere with the installation, replacement, maintenance or removal of said unit and pipe. To have and to hold such right and easement to GRANTEES, their heirs, successors and assigns, forever, provided, however, that said right and easement shall VOL 1459nGE 260 expire in the event said sewerage absorption unit (mound system) shall fail. For clarification purposes, "failure" of said system shall be construed to mean the necessity of replacing, rather than making ordinary and necessary maintenance and repairs to said system. IN WITNESS WHEREOF, GRANTORS have hereunto set their hands on the date first above written. r Craig E 7R mussen Paxton M. Rasmussen J Gloria . Rasmussen TadrRffiy K. Rasmussen Subscribed and sworn to before me-��� S,c�ra -�w�S °� Cra aid �� '�a�USAhis aT day of 9 Dawn Kegley Nntaly Public tar atdDdv St. Croix County, W' My commission: THIS INSTRUMENT DRAFTED BY: AUTHENTICATION Thomas A. McCormack Signatures of Tammy K. Rasmussen Attorney at Law and Gloria J. Rasmussen 740 Main Street authenticated this 28t y of Baldwin, WI 54002 Septembe , 1999. State Bar No. 01011884 Thomas A. McCormack TITLE: Member State Bar of Wisconsin t - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- Return to: Thomas A. McCormack 740 Main Street Baldwin, WI 54002 ----------------------------------------------------------- DRAINFIELD EASEMENT Easement made this day of July, 1999, between Craig E. Rasmussen and Gloria J. Rasmussen, husband and wife, Baldwin, Wisconsin (hereinafter referred to as GRANTORS), and Paxton M. Rasmussen and Tammy K. Rasmussen, husband and wife, Baldwin, Wisconsin (hereinafter referred to as GRANTEES). 1. GRANTORS are the owners and occupants of a tract of land described as: North East Quarter of North West Quarter (NE 1 4 of NW 1 -4) of Section Twenty -five (25), Township Twenty -nine (29) North, Range Sixteen (16) West, EXCEPT Lot 1 of Certified Survey Map filed June 10, 1999, in Volume 13 of Certified Survey Maps, at Page 3662, as Document No. 604772, office of the Register of Deeds for St. Croix County, Wisconsin. 2. GRANTEES are the owners and occupants of a tract of land described as: Part of the Northeast Quarter of the Northwest Quarter (NE 1 -4 of NW 1 -4) of Section Twenty -five (25), Township Twenty -nine (29) North, Range Sixteen (16) West, more particularly described as Lot one (1) of Certified Survey Map filed June 10, 1999, in Volume 13 of Certified Survey Maps, at Page 3662, as Document No. 604772, office of the Register of Deeds for St. Croix County, Wisconsin. 3. GRANTORS desire to convey, and GRANTEES desire to obtain, the right to establish a sewerage absorption unit (mound system) and sewerage pumping pipe across the above described tract of land of GRANTORS. 4. Therefore, GRANTORS, in consideration of the sum of One and No /100s ($1.00) Dollar, receipt of which is hereby acknowledged, do hereby grant, sell and convey to GRANTEES the right to lay, construct, operate and maintain said unit and pipe in, on, and about the property of GRANTORS, more particularly described as: (put in legal description). Commencing at the northeast corner of the above - described Certified Survey Map; thence S00 0 00 1 17 "W along the east line of said Lot One (1) a distance of 125 feet; thence S87 °01 "E parallel to the north line of said Lot One (1) a distance of 50 feet; thence N00 °00'17 "E parallel to the east line of said Lot One (1) a distance of 125 feet; thence N87 °01'39 "W a distance of 50 feet more or less to the northeast corner of said Lot One (1) and the point of beginning. SUBJECT to the right of way of County Highway D. The rights herein granted may be assigned by the GRANTEES in whole or in part. The grant likewise includes the right of ingress and egress on the lands of the GRANTORS for the purpose of exercising the rights herein granted, the right to install a gate or to make a temporary opening in any fence on said lands at the point where such fence crosses the route of said sewerage pumping pipe or lines. The GRANTORS, for themselves, their heirs, successors and assigns, covenant not to erect any structure or other barriers or to take or allow to be taken any action on said lands that would interfere with the installation, replacement, maintenance or removal of said unit and pipe. To have and to hold such right and easement to GRANTEES, their heirs, successors and assigns, forever, provided, however, that said right and easement shall expire in the event said sewerage absorption unit (mound system) shall fail. For clarification purposes, "failure" of said system shall be construed to mean the necessity of replacing, rather than making ordinary and necessary maintenance and repairs to said system. IN WITNESS WHEREOF, GRANTORS have hereunto set their hands on the date first above written. Craig E R muss en Paxton M. Rasmussen Gloria. . Rasmussen Ta iy K. Rasmussen Subscribed and sworn to before me- Vke S % S(v,4w - (S °f crai5Ra5rv►uSSen aid 4- kc Uhis ���ti day of " 199 .9 ` Dawn Kegley Public tar t®t)dfiftsconsin St. Croix County, W' My commission: I1-Y) THIS INSTRUMENT DRAFTED BY: AUTHENTICATION Thomas A. McCormack Signatures of Tammy K. Rasmussen Attorney at Law and Gloria J. Rasmussen 740 Main Street authenticated this 28t y of Baldwin, WI 54002 Se77 1999. State Bar No. 010/1194 Thomas A. McCormlack TITLE: Member State Bar of Wiscons5 i