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002-1086-70-100
/ 0 2 7 % j 2 « & (D . / k 0 f � . 2 � § � ® � � k ) } U. ] E ; . «_ L co / E § & 2 { 2 7 § z a © / A z 7 \ ) E % � ) / q 0 k k \ � .. 7 � E § § ] . N . E i a. 040. ' aC) § 2 \ CD 8 k k \ \ k k \ \ EI t- � 2 a a ;2 ƒ »§\ \ ) co @ 3 = § 2 G @ IL 2 2 f 2 / » m m . / co & _ E / k k k ca \ \ \ § = E : ) r 4) @ @ g G / 40. 2 / \ k /\ 2 C f k\$ - / k \ k / o ) / } }) \ �. ■ � « : E k 2 $ ( IL � CL EL k 7 / 0 a 2 0 3 v Parcel #: 002 - 1086 -70 -100 02/27/2006 03:28 PM PAGE 1 OF 1 Alt. Parcel #: 34.29.16.500B 002 - TOWN OF BALDWIN Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner JOANN M MUELLER O - MUELLER, JOANN M 2427 HWY 12 WOODVILLE WI 54028 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 2427 HWY 12 SC 0231 BALDWIN- WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 4.375 Plat: N/A -NOT AVAILABLE SEC 34 T29N R16W PT E1/2 NW 1/4 BEING Block/Condo Bldg: LOT 1 OF CSM 10/2790 (NE NW 2.543A) (SE NW 1.832A) Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 34- 29N -16W Notes: Parcel History: Date Doc # Vol /Page Type 10/21/2002 694898 2017/377 WD 10/24/2001 660024 1745/316 SD 07/16/1999 606900 1442/216 WD 07/16/1999 606899 1442/215 WD more 2005 SUMMARY Bill M Fair Market Value: Assessed with: 87328 127,700 Changed: 10/25/2002 Last Chan Valuations: g Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.375 11,800 70,200 82,000 NO Totals for 2005: General Property 4.375 11,800 70,200 82,000 Woodland 0.000 0 0 Totals for 2004: General Property 4.375 11,800 70,200 82,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch M 555 Specials: User Special Code Category Amount 010- GARBAGE SPECIAL ASSESSMENT 45.00 Special Assessments Special Charges Delinquent Charges Total 45.00 0.00 0.00 III • J ,�� �:D.Z • /D�P6 — 7D m � t ooa - /086 - 2 !ov s' aoB ° FIL 2 35/. 2- 9. t G, s—oo 6 J U L 1 JAMES O'CONNELL • r U 3 r S e.L e o 1 Register of Deeds 5 19.3 J c(, .375 Ac St. Crolx Co., WI ti s C ER T I F .I ED SURVEY MAP Located in the E1 /2 of the NW 1 /4 of Section 34, T29N, R 16W, Town of Baldwin, St, Croix County, Wisconsin. Surveyed under the direction and a, ned by: Joseph Paron of 2427 U.S, HWY "12" S 86 °35'51 "E, Woodville, i. 54028 1312.74' U.S. HWY. 6' :1?" 1312.74' NW corner _ N1/4 Cor. Section 34 Sec. 34 T29N,R16W Joint driveway o (from ties) (Berntsen Cap) easement recorded ie N in Vol. ioe� Pg, ,06 ° UNPLATTED j-AZID3 -- -- o 0 S 87. 47'21 "E 260.21' POINT OF BEGINNING LEGEND <\ 'y -- Section corner monument a * A (as noted) W z oWELL w 0 1" X 24" iron pipe weighing Shed 1,68 lbs. / lin, ft, set, o� Hou e ❑ 'A --- +� --,c- Fence line w 3 zz _, w Shed r���lIN ►0/��� SEPTIC ,�o /��' al m w LL VENT HARVEY GNP`! S JOHNSON �� °� ®�' n zI S -1899 3 J S HUDS� �I _ w I WIS �f� ' ^ a1 .1 190586 SQUARE FEET of .....••''.�0�" Z O (4.375 AC.! p wl 4 SUR` D O AP PROX IM ATE " 40" LI NE ~ �hol��ras�� O East line of the S W 1/4 p a SCALE IN FEET I" --100' of the NW 1 /4 O z � Z DI 0' 25 50' 100' 200' 300' Bearings referenced to the North line of the: NW—r/4, assumed N8e 35'51 "W A 18 )`941 SY. CROIX COUNTY C:; ve Plannit 5 3.5' zoning ersd _ _ k , z 2 _ J- Commlttea If not recorded 72' CHICAGO NORTHWESTERN 72' %vithin 30 days Of RAILROAD approval date -41 #— znproval shall be • n ++!!S, vpld Ot OF TRACKS DRAFTED BY: J64/(r 4942300 VOLUME 10 PAGE 2790 � ST. CROIX COUNTY ZONING DEPART BUILT SANITARY REPORT AS B T SANTT , Owner ,� ' /�� ,, � ) u � S .' Property Address T City /State Legal Description: Lot -�T_ Block Subdivision/CSM 1/a , t /4, Sec._V, T,2�LN -R4,,,_W, Town of PIN # SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer Size ST/PC /off/ Setback from: House 9 M Well (� PAL, � Pump manufacturer Model D3 Alarm location p (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: ✓'i Width Length � Number of Trenches ® � Setback from: House $& ) Well �— P/L _6_ Vent to fresh air intake _ ELEVATIONS Description of benchmark _ ,G �i - ��5�� Elevation 451 Description of alternate benchmark Elevation Building Sewer 7� STMT Inlet 97 ST Outlet PC Inlet PC Bottom -� Header/Manifold 1,9.17V Top of ST/PC Manhole Cover 3 -2 f �_ Distribution Lines Bottom of System ( Final Grade ( ) () ( ) Date of installation //3159 Permit numbe �� r � State plan number / Plumber's signature icense number -22F�Q,�'-=� Date J 6 1131 S Inspector 4 41, Complete plot plan w' x NOTICE Please provide the following: • A plan view sketch showing everything within 100 feet of the system. o center of se Two horizontal reference p tic tank manhole cover. t p • Show alternate benchmark, if applicable. PLAN VIEW !o°' 6� o 10 0 � P Y i iND ICATE NORTH ARROW t Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count y INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary 3445 Permit 9 X 98 Personal information you provice may be used for secondary purposes [Privacy La I s.15.04 (1)(m)]. Per *ft ftW me i4ICHAEL J & KRISTI ❑ACityBCLV•i(ALL I Town of: State Plan ID No.: o CST BM Elev. 1 Insp. BM Elev.- BM Description: Parcel T UaL 10$6 -70 -100 .O O 9 L TANK INFORMATION ELEV ON DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic !k i A Benchmar�C Dosing 4 ht p( 9 . Z 2 Aeration Bldg. Sewer (� y q,?, .7 Holding St/Ht Inlet j,QNK SETBACK INFORMATION St/ Ht Outlet T A P/ L WELL BLDG. Vent to ROAD Dt Inlet Air Intake Septic �r > /do !SO t NA Dt Bottom Dosing g > , r S"o ' v NA Header / Man. A �- g e �a?• `I T z ' Aeration NA Dist. Pipe A 9a • 9l Holding Bot. System PUMP / SIPHON INFORMATION Final Grade 14, � . Manufacturer G lix 5 L emand �` oZ ?3.ZG Model Number 3K ' ( � C /•S� 9 ZZ TDH Lift(�•� Lriction .d Setema TDH �,& Ft _tf� 9S, } 13.2G Forcemain Length -3o Dia. � Dist. To Well /u p' SOIL ABSORPTION SYSTEM / TiRCw4i Width Len th t P . PIT s PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 2 - la. DIMENSION SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK CHAMBER INFORMATION Type Of ! 3 Z OR UNIT Model Number: System: t) DISTRIBUTION SYSTEM Header / Manifold a Distribut ipe(s) j t x Hole Sizg x Hole Spacing Vent To Air Intake Length 1L.5 Dia. Length S�• Dia. �� — Spacing �' 5 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.) /Oiy /011 - W LOCATION: *ALDWIN 34.29.16.500B,NE,NW 2427 HIGHWAY 42 A- � �g �J� �r 4.t �' y r, � Cb Plan reKision required? E ] Y PA No Use other side for additional information. 1 13 ( z SBD -6710 (R.3/87) Date Inspector's Signature Cert. No. t ADDITIONAL COMMENTS AND SKETCH ' SANITARY PERMIT NUMBER: ° t A. w F , # ' ° a r # a�. s ° _ a F { i F x x i . E g #- t I k t 3 E m P.� s s s i t q ° i a ' � # E e °�._.., .. E t m t 7 z x x � 2 3 e SANITARY PERMIT APPLICATION s afety and Washington Division Wisconsin In 201 W. Washin ton Avenue P O Box 7302 Department of Commerce accord with ILHR 83. g Is A ITT'/ a Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) fort m, on 9p per n lef�s county than 81/2 x 11 inches in size. RAC I • See reverse side for instructions for completing thi lication c 1;= ` State Sanitary Permit Number JUI Personal information you provide may be used for secondary purpo 199� `° ❑ Check if revision to previous application (Privacy Law, s. 15.04 (1) (m)]. ST C � ROUX State Plan I.D. Number Site Id 176808 I. APPLICATION INFORMATION - PLEASE PRIN I Trans Id 236207 Property Owner Name �t�ic tion rli.chael Wellens S ,11 1/4, S 3 4 T , N, R 16 Y940 Property Owner's Mailing Address Lot Nub Block Number 2427 US hiwy 12 City, State Zip Code Phone Number Subdivision Name or CSM Number Woodville WI 54028 ( ) CSM 519137 II. TYPE OFT ILDING: (check one) ❑ State Owned ❑ !t� Nearest Road Lj ❑VII age Baldwin US Hwy 12 Public M 1 or 2 Family Dwelling - No. of bedrooms Town OF III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 002- 1086 -70 -100 3 �. 29. I (a , Agoo $ 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. ❑ New 2. ® Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an ______System ________System _________ Only______________ Existing System ________ Existin�5ystem 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 © Mound 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 6&t Fd.0- 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 600 Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation 500 500 1.2 N/A 92.17 Feet 4.47 Feet VII. TANK Cap acit in g allons Total # of Prefab. Site Fiber- Exper. INFORMATION New Existin Gallons Tanks Manufacturers Name Concrete st noted Steel glass Plastic App Tank Tanks Septic Tank or Holding Tank 1200 1200 1 Iidwestern Precast ® ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber 800 1 800 1 Iidwestern PRECASfl ® I ❑ I ❑ I ❑ I ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plum is Signature: t p MP /MPRSW No.: Business Phone Number: Bennie Helgeson 0292 715/772 -3278 Plumber's Address (Street, City, State, Zip Code): W1229 770th Avenue, Spring Valley WI 54767 IX. COUNTY/ DEPARTMENT USE ONLY {/ ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Ag ent ignature (No Stamps) pp roved Owner Given Initial H �' Surcharge Fee) a� . � Adverse Determination 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. A sanitary 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 Wiscansin Administrative CQde 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 S. Onsite sewage systems must be properly maintained., The septic tank(s) must be pumped by a licensed pumper whenever necessary, usual ly,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: (. 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 mains/water 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 2226 ROSE ST LACROSSE WI 54603 -1905 Nvisconsin TDD #: (608) 264 -8777 www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary July 22, 1999 CUST ID No.268093 ATTIC POWTS INSPECTOR ZONING OFFICE HELGESON EXCAVATION INC ST CROIX COUNTY SPIA W1229 770TH AVE 1101 CARMICHAEL RD SPRING VALLEY WI 54767 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 07 /22/2001 Identi£i ers Transaction ID . 236207 Site ID No. 176808 SITE: Please refer to both identification numbers, Site ID: 176808 above, ,;in all correspondence with the agency. St. Croix County, Town of Baldwin NE1/4, NW1/4, 534, T29N, R16W Facility: Michael Wellens Residence FOR: Description: Four Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 480366 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installationloperation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerel , DATE RECEIVED 07/10/1999 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 Gerard M. Swim BALANCE DUE $ 0.00 POWTS Plan Reviewer - Integrated Services (608)785-9349, Mon - Fri, 7:15 AM - 4:00 PM jswim @commerce.state.wi.us Wi MA T c±?t1e: 7033 MOUND SYSTEM DESIGN Residential Application INDEX AND TITLE SHEET Project M ICHAEL WELLENS 4 bedroom residential mound Owner MICHAEL WELLENS Address 2427 U.S. Hwy 12 Woodville, WI 54028 Legal Description NE1 /4NW1/4, Sec.34, T.29N., R.16W. $. p ally Township Baldwin County St. Croix itto Subdivision Name CSM Vo. 10 P . 2790 Lot No. 1 9 ENj coMM� 1NGS Parcel ID Number 002 - 1086 -70 -100 oEVaRZMSO y p p1V1 ENCE Plan Transaction Number GoRRES SEE Index and title sheet Page 1 Mound calculations Page 2 Mound drawings Page 3 Pres. dist. calcs. and laterals Page 4 TDH and pump tank drawing Page 5 Pump performance curve Page 6 Site plan Page 7 Attached soil evaluation report Page 8 Designer Bennie Hel eson License Number 220292 Signatur Phone No. 715- 772 -3278 Date 6/28/99 Notice: Tampering with this file by unauthorized persons is prohibited. Deliberate modification will result In disciplinary action under s. 145.10, Wis. Stats. Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). SBD- 10462 -E (R.05M) Page 1 of 8 MOUND SYSTEM DESIGN Complete red boxes as necessary. 1000 gpd maximum design flow. Inch- pounds Metric Residential or commercial? r (r or c) (y or n) u Replacement system? Creviced bedrock site? n (y or n) Slope 7 % Wastewater flow rate 600 gpd 2271 Lpd Depth to limiting factor 10 in 25.4 cm In situ soil infiltration rate 0.6 gpd /W 24.4 Lpd /m` Contour line elevation 90.0 ft 27.43 m Use standard fill depths? x OR esign depth? in F____Jcm Place X in box to use standard depths (24 and A +4 inclusive) OR specify design fill depth. Center or end manifold c (c or e) Hole diameter 0.25 in 0.12 0.156, 0.188, 0. 219, 0.25, .50 s 0.281, or 0.313 inch only. Lateral spacing ft Use 0 lateral s acin for trenches. Estimated hole space 3.50 ft Not a final calculation. Number of laterals 4 Pump tank elevation 84 ft Outside bottom of tank. Forcemain length 30.0 ft Forcemain diameter 2.0 in 1.5, 2 3 or 4 inch only. 2.067 in Actual I.D. HOLE DIAMETER CONVERSIONS 1/8 =0.125 1/4=0.250 SYSTEM SOLUTIONS Inch-pounds Metric 5/32=0.156 9/32=0.281 Estimated daily flow 600 gpd 2271 Lpd 3116 = 0.188 5116 = 0.313 7/32 = 0.219 Absorption cell Design load rate & area 1.2 gpcw 500.0 ft 46.45 m` Linear loading rate (LLR) 8.33 gpd /ft 103.3 Lpd /m Design width (A) _ 7 7 3 0r ft 2.13 m Cell length (B) 72.0 ft 21.95 m Depth of cell (F) 9.5 in 24.1 cm Sand filter Upslope fill depth (D) 26.0 in 66.0 cm Downslope fill depth (E) 31.9 in 81.0 cm Basal area required (gpdrnfiltration rate) 1000.0 ft 92.90 m Supporting components Topsoil depth 6.0 in 15.2 cm Subsoil depth at center 12.0 in 30.5 cm Subsoil depth at cell wall 6.0 in 15.2 cm End slope toe length (K) 14.11 ft 4.30 m Up slope toe length (J) 9.80 ft 2.99 m Down slope toe length (1) 16.90 ft 5.15 m Total mound length (L) 100.22 ft 30.55 m Total mound width (W) 33.70 ft 10.27 m m 1rJ,4 , e1 CvQ_H�P s Project: Gatherlwft Pal ow 14 bedroom residential mound Transaction Number: Page 2 of 8 MOUND PLAN VIEW observation pipes (types) J 33.7ft A A= 7.00 ft 2.13m 10.27 m B = 72.0 ft 21.95 m W B J= 9.80 ft 2.99 m I K I = 16.90 ft 5.15m K = 14.11 ft 4.301 m 100 22 ft 30.55 m typ. obs. pipe (anchored securely) I = down slope dimension [^ = absorption cell (AxB) J = up slope dimension = plowed area (LxW) K = end slope dimension 1W 6- (152 mm) T MOUND CROSS SECTION D = 26.0 in 66.0 cm lateral topsoil G H subsoil cap E = 7179 in 81.0 cm invert 92.67 ft F = 9.5 in 24.1 cm elev. 28.25 m F G = 12.0 in 30.5 cm ASTM c33 H = 18.0 in 45.7 cm D Sand Fill E Sys. 9 1 - 71 ft y elev. 28.09 m 90.00 ft contour 27.43 m elev. 7%----,, slope D = upslope fill depth plowed layer E = downslope fill depth Note: Absorption cell media will consist F = absorption cell depth of aggregate and pipe with laterals G = subsoil + topsoil depth at cell wall centered across AxB media. The cell H = subsoil + topsoil depth at cell center media is covered with geotextile fabric. Designer notes: Final gr ading plan should include placement of fill on upper side of mound and grading of area now carrying overflow to divert surface water away from the mound site. dhicl�ke.l Wealens Project: 4 bedroom residential mound Transaction Number: Page 3 of 8 PRESSURE DISTRIBUTION CALCULATIONS Absorption cell Inch-pounds Metric Width (A) 7 ft 2.13 m Length (B) 72.0 ft 21.95 I rn Lateral specifications Number laterals 4 Holes/lateral 10 holes Lateral length (P) 34.83 ft 10.62 m Hole diameter 0.250 in 6.35 mm Lat. dis. rate 1 gpm 0.73 Us Sys. dis. rate 46. gpm 2.94 Us Hole spacing (X) 44 in 111.8 cm Lateral diameter Pipe diameter Design options Design choice Designer must 1 in (25 mm) Place X in red 'Xn one choice 1 114 in (32 mm) x box of chosen from the options 1 112 in (40 mm) x x diameter.. provided. 2 in (50 mm) x 3 in (75 mm) X Manifold diameter Pipe diameter Design options Design choice Designer must 1 in (25 mm) X' one choice 1 114 in (32 mm) x Place X in red from the options 1 112 in (40 mm) x x box of chosen provided. 2 in (50 mm) x diameter 3 in (75 mm) x 4 in (100 mm) x Distribution system contains: 4 Lateral(s) LATERAL DIAGRAM - CENTER CONNECTION Place correct lateral diagram by clicking in one of the drawings at right and dragging the diagram into this area. Force main connection via tee or cross to mardFold at any point. • O T Laterals are identical typic � P end cap ti S • ,E X If x12 ` x12 +1 Laterals & force main of PVC Soh 40 Last hole drilled next to end cap (per CONINI Table 84.30.5) Holes drilled on the bottom of the lateral, • =permanent end marker equally spaced Inch-pounds Metric Lateral length (P) 34.83 ft 10.62 m Lateral spacing (S) 3.50 ft 1.07 m Hole spacing (X) 44 in 111.8 cm Manifold length 3.50 ft 1.07 m Hole diameter 0.250 in 6.4 mm Lateral diameter 1.50 lin 40 I mm Forcemain diameter 2.00 lin 50 mm MIC -Lk-p-1 W0JteWs Project: 4 bedroom residential mound Transaction Number: Page 4 of 8 i TDH and Pump Tank Drawing Total Dynamic Head Operational head 2.50 ft MM m Vertical lift 7.57 ft m Are laterals the highest pant in the Friction loss 1.05 ft m system? Yes Where. �x Total dynamic head F= 1.12 ft If no, what is the highest elevation Dose Volume downstream of pump? Dose is > . 0 times lateral volume Forcemain drain Lateral void volume 14.7 gal 55.6 L back to tank? ("x" one) Minimum dose 150.0 gal 567.8 L x Yes Drain back 5.2 gal 19.7 L No Dose volume 155.2 gal 587.5 L Typical Pump Chamber Layout In combination with state approved treatment tank. Tank construction as per Comm 83.20(3) WAC. approved manhole cover with 7IC weather proof warning label and locking device grade levels Junction box aT disconnect gT levels altemate 4" vent pipe electric as per NEC 300 and E-- outlet Comm 16.28 WAC location 18" (46 cm) min. wall of pump k approved I chamber or outlet joint � combination tank A Provide 1/4" weep hole or anti- alarm on siphon device as necessary pump on B Grade levels pump 85.1 ft C - pump tank manhole = 4" (10 cm) off elev. 25.9 m minimum above finished grade D - vent =1 2" (30.5 cm) minimum above finished grade 8476 ft Pump tank elevation 3 " (75 mm) of bedding under tank 25.6 m bottom of tank Tank manufacturer Midwestern Precast 1,2001800 gal. Z Pump tank capacity 21 gal /in Pump tank volume 8191gal Pump manufacturer 113 oulds Inches Gallons Pump model number 13385 WE03 o A 19.1 401.3 27 B 2 42.0 Alarm manufacturer 1S. Elect system C 7.4 155.2 Alarm model number 1101 HW D 10.5 220.5 n1I6w-id WelletiS Project. athedne Ad Pam 4 bedroom residential mound Transaction Number: Page 5 of 8 MODEL 3885 M • Su bmersible Effluent Pump Submersible Sewag I i ` 1r to MN! EIII°enl I s 1 ME IE 115 IEE I MUMS FEEL l .... - ,I<, 6 '- I MODEL: 3872 s i 8 MODEL: 3 85 6 tP0 5 h I I 1 , _ 1 - I I I = 15 I _ Q 90 Ir rp i I i _ i I I i O is 1 10 I O 2 O In 5 1EP, 0. 0I -. .: J0 50 60 70 US 6ET.1 0 10 20 - 10 0 50 F0 10 AO :0_00 It IJO 110 U.S I01'M U AIL i 0 ZO J0 J 6 B t0 17 IJ 16 mYM1. ° 1° CAPACITY ° y6bD �,o� cnrnclTY '° Pump Specifications Features and Benefits Cq Pump Specifications Features and Benefits 1/= HP *Glass filled thermoplastic vortex ' /:1 through 1 12 HP •AII models feature silicon carbide Up to 75 GPM impeller with stainless steel Up to 130 GPM mechanical seal faces for superior Maximum head to 18' insert and pump out vanes for Maxillllllll head to 123' abrasive resistance and extra Discharge size 2" NPT mechanical seal protection. Discharge size 2" NPT long life. Solids: 2" maximum -Rugged glass - filled thermoplastic Solids:' /�" maximum •Cast iron semi open non cloy Motor casing and base design provides superior strength and corrosion Motor impeller with pump -out vanes All motors feature ball All motors feature ball for mechanical seal protection. resistance. bearing construction. *Cast iron motor housing for bearing construction. • Rugged cast iron volute type casing Single phase: 115V efficient heat transfer, strength Available in Single and adaptable for slide rail systems. Materials of Construction and durability. Three Phase 115, 200, • Corrosion resistant threaded Cast iron 230, 460, and 575V. stainless steel shaft. Thermoplastic •Corrosion resistant threaded All single phase models . Motor is full high stainless steel shaft. y submerged have capacitor start motors. y ed in g Stainless steel quality oil for lubrication • Available in automatic, and manual Materials of Construction and efficient heat transfer. models. C,lsl Trull • Optional silicon bronze impeller *GSA listed models available. Sl;tinless >Icel available. • CSA listed models available. <U) Underwriters Laboratories All Modefs are designed for continuous operation and feature stainless steel hardware. U O.4 W8 L 44, zl ■ So; ! 04WI/0. ; ors �Cte/ir�� �cvdvi Cie, w /. 51/0 28 N �a f✓ c�' csr►7 � �. X790, SE. C.roik w e. LC.� o 46edroom ok{6o f bLt; Cd oFS :� �ssu.ned �eS'venc Scwe o . cw ". ' el'W - = yod.c+D' 71&.97 739a8' ASTM -[� 3a3Stp�e f�be insabfed QspGr'82. f`—�Xisf;nq Propo /,2 /8c� �s�P, s sf� n As , st" Y uA"P 83 ,Z'scf,. Uo Pd,e, 5 k ed IN- V) B -� pro4„6,ked d�s-E�rbanee Q Ca . 7oM wisoonsin Department of.Commeme SOIL AND SITE EVALUATION Page 1 of 3 Qivision of Safety and Buildings in accord with Comm 83.05, W is. Adm. Code A.C.E. Soil & Site Evaluations Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County Include, but not limited to. vertical and horizontal reference point (BM), direction and St. Croix percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D.# APPLICANT INFORMATION - Please print all Information. 002 - 1086 - 70 - 100 Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Reviewed By Date Property Owner Property Location n (Y� l ��� �l li e v, 5 Govt. Lot NE 1/4 N W 1/4 S 34 T 29 N,R 16 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2427 U.S. Hwy 12 1 ' CSM Vol. 10, Pg. 2790 City State Zip Code PhoneNumber City Village ®Town Nearest Road Woodville WI 54028 715- 684 -5961 Baldwin I U.S. Hwy 12 ❑ New Construction Use: Residential / Number of bedrooms 4 ❑Addition to existing building Replacement Public or commercial describe Code Derived daily flow 600 gpd Recommended design loading rate .5 bed, gpd/ft2 .6 trench, gpd /ft' Basal area required 1200 bed, ft' 1000 trench, ft' Maximum design loading rate .5 bed, gpd/fF .6 trench, gpd/ft' Recommended infiltration surface elevation(s) 92.17' at 26° above 90.00 contour. ft (as referred to site plan benchmark) Additional design / site consideration Existing system eligable as cat. I WI. Fund failure - current owner wishes to apply prior to sale of property. Parent material Glacial till. Flood plai n elevation, if applica ble NA ft S for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U= Unsultabie for system EIS N U N S[A U L] S ®u ❑ S❑ U ❑ S® U EIS ❑ U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft' Boring# Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. C Boundary Roots Bed h k 1 0 -5 10yr3/2 None A 2fcr mvfr as 2f,lm 0.5 0.6 71 2 5 -14 10yr4/4 Non A 2m mvfr cs 2f &m 0.5 0.6 Ground 3 14 -21 10yr5 /4 Non Ifs 1 csbk mvfr cs 1 f &m 0.5 0.6 elev -- - -- -- -- - -- - - -- — 88,50 ft 4 21 -47 10yr5/6 f2d7.5yr5/8 — Ifs 0 m mfr - - 0.4 0.5 Depth to limiting factor 21" - -- Remarks: Li 1 0 -5 10yr3 /2 None sil 2fcr mvfr as 2f,lm 0.5 i 0.6 2 5 -14 10yr None sil 2fsbk mvfr as 2f &m 0.5 0.6 Ground elev 3 14 -26 10yr4 /4 fl d7.5yr5/8 sl 2msbk mfr cs 1 f &m 0.5 0.6 89.24' ft 4 26 -43 I Oyr5 /4 m2p5 /6 sl I csbk mfi - - 0.4 0.5 Depth to limiting factor 14" Remarks: Many silt coats observed on v rticle faces f soil peds in horizon #3. CST Name (Please Print) Signature: Telephone No. James K. Thompson 715- 248 -7767 Address A.C.E. Soil & Site Evaluations Date CST Number Ref It 340 Paulson Lake Lane, Osceola, W1 54020 6/28/99 3602 1055 PROPERTY OWNER. Cathaine M. Paron SOIL DESCRIPTION REPORT 1055 page - 2 - of - 3 PARCEL I. () 002-1084-70-100 A.C.F. Soil & §We E Depth Dominant Color Mottles Structure GPDfft Horizon Texture Gr. Consistence, Boundary Roots Bed Trench in. Munsell Qu. Sz. Cont. Color Sz. Sh 0-5 10yr3/2 None sil 2fcr mvfr as 2flm 0.5 0.6 2 5-10 1 Oyr6/3 None sil 2fsbk mvfr as 2Mm 0.5 0.6 Ground elev 3 10-19 1 Oyr4/4 fl d7.5yr5/8 sl 2msbk mfr cs IMM 0.5 0.6 90.57' ft 4 19-42 10yr5/4 m2p5yr5/6 A 0 M Mfi 03 0.4 -- --------- Depth to limiting factor 10" Remarks: Ground elev Depth to limiting factor =arks! Ground elev Depth to limiting factor Remarks:� Ground elev Depth to limiting factor Remarks: �. 343 ■ �; ! Obserra , � . �G�vi CCe, tJ / • syo 28 4/0' .2 790, SE. o" w e.LC.7 o �,t n Mar EXisd' � 6t drum ak � of it ki t.d ne oFS;d. /�ssce.neal r c5. o 21td-= d.dD' - -► stwe 9/00 -.'� 7.26.97 7 a8 " �gbendon ey,�t n Sysb�.n As,ou' �e . 83 90.00'x„ _ _ _ ` ■ _ _ _ _ _ _ 5 k ed Dt h ■ zoo c� R . Wisconsin, Department of Commerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Safety and Buildings in accord with Comm 83.05, W is. Adm. Code A.C.E. Soil & Site Evaluations Attach complete site plan on paper not less than 8'/2 x 11 inches in size. Plan must FReviewed Include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix percent slope, scale or dimernsions, north arrow, and location and distance to nearest road. APPLICANT INFORMATION - please print alllnfonnatton. 002- 1086 -70-100 Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Date Property Owner Property Location Catherine M. Paron Govt. Lot NE 114 NW 114 S 34 T 29 N,R 16 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSW 2427 U.S. Hmy 12 1 CSM Vol. 10, Pg. 2790 City State Zip Code PhoneNumber City E] Village ZTown Nearest Road Woodville WI 54028 715- 684 -5961 Baldwin U.S. Hwy 12 ❑ New Construction Use: Residential / Number of bedrooms 4 ❑Addition to existing building Replacement Public or commercial describe Code Derived daily flow 600 gpd Recommended design loading rate .5 bed, gpd/ft .6 trench, gpd/ft Basal area required 1200 bed, ft 1000 trench, ft Maximum design loading rate -5 bed, gpdr .6 trench, gpd/ft Recommended infiltration surface elevation(s) 92.17' at 26" above 90.00' contour. ft (as referred to site plan benchmark) Additional design / site consideration Existing system eli as cat. I WI. Fund failure - current owner wishes to apply prior to sale of property. Parent material Glacial till. Flood plain elevation, if a I`icable NA ft S= Suitable for system Conventional Mound In -Ground Pressure AT -Grade System in Fill Holding Tank U= Unsuitable for system ❑ S N U ® S❑ u ❑ S MU I ❑ S® U ❑ S ®u M S❑ u SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPDr Borin Horizon Texture Consistence Boundary Roots 9# in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 1 0 -5 10yr3 /2 None A 2fcr mvfr as 2f,lm 0.5 0.6 2 5 -14 1Oyr4 /4 None sl 2msbk mvfr cs 2f &m 0.5 i 0.6 Ground 3 14 -21 1Oyr5/4 None Ifs lcsbk mvfr cs if &m 0.5 0.6 elev 88.50' ft 4 21 -47 10yr5/6 f2d7.5yr5/8 Ifs 0 m mfr - - 0.4 0.5 Depth to limiting factor 21" Remarks: 2 1 0 -5 1Oyr3/2 None sil 2fcr mvfr as 2f,lm 0.5 0.6 2 5 -14 10yr6 /3 None sil 2fsbk mvfr as 2f &m 0.5 0.6 Ground 3 14 -26 10yr4 /4 f1d7.5yr5 /8 sl 2msbk mfr cs if &m 0.5 0.6 slev 89.24'ft 4 26 -43 10yr5 /4 m2p5yr5 /6 sl lcsbk mfi - - 0.4 0.5 Depth to limiting factor 14" Renigifg: Many silt coats observed on v le faces f soil peds in horizon #3. CST Name (Please Print) Signature: Telephone No. James K. Thompson 715- 248 -7767 Address A.C.E. Soil & Site Evahiations Date CST Number Ref # 340 Paulson Lake Lane, Osceola, WI 54020 6/28/99 3602 1055 PROtpB2TY OWIMR: Catherine M. Paron SOIL DESCRIPTION REPORT 1055 Page 2 of 3 PARCEL LDS 002- 1086 -70 -100 A.C.E. Soil & Site Evaluations Depth Dominant Color Mottles Structure GPD/ft Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. �o nsistence Boundary Roots Bed Trench 3 1 0 -5 10yr3 /2 None sil 2fcr mvfr a s 2f,lm 0.5 0.6 2 5 -10 10yr6 /3 None sil 2fsbk mvfr as 2f &m 0.5 0.6 Ground elev 3 10 -19 10yr4 /4 fl d7.5yr5 /8 sl 2msbk mfr cs H &m 0.5 j 0.6 90.57' ft 4 19 -42 10yr5 /4 m2p5yr5 /6 sl 0 m mfi - - 0.3 0.4 Depth to limiting factor 10" Remarks: Ground elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: r ■ -o; ! Obser ; en U wn P r: p ' e,QL�te/' ; nom n� P CZr ®n ��' e- Xi5'E;nq �en e �ihe/ a s!� 7 � • S. may. iz (-dap. l:�e o r <4. Croix w e. LC.7 o Z1 E"Xisd' bx nC4 Af A t s ilmx�<d Blew. 46tdroorn ok C -o or ba;C4 re5:c+�ene Sewer =9 /.W ' 7 3? a8 f}sTM - 3c3yP.d.e +�be ;a3L4Ated Qsper82.3o(Ir)(CX — ZXi'St;nq Scp�C. P,•op0 240 /YCV s see . e- y ,�,r e . C.omb, -n 5 :� /Pu"P 83 Z'sck. VO /. IE s k e.d h t fv !'o...�d 7�.��4�e • i Q c Q.0. i JUL -26 -99 07:36 AM P.02 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer M 'p-. I ,� L e 1t" s l�,e 1 tC'N X. 6 )o / eti Mailing Addrross d L Zl S Property Address o? 227 W1v ly (Verification required from Planning Department for new construction) �.� Parcel Identification Number d '4 -'7a /Go City /State ...,� � y �� �'.� _ 0 U — ..,.___r LEG AL D 5!QRIPTI Property Location __ALE_ %, _d1A6Z. A, Sec. 4 , T_ ^ ,N-R W w W, Town of �-+Ad � I AJ Subdivision Lot # . Certliled Survey Map # 61 _. Volume Page # d 79 Warranty Deed # Volume /`{`��. Page # 02/ Spec house O yes (a no Lot lines identifiable iK yes O no SYSTEM MAINTENANCE Improper we 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 it licensed pumper. Wbat you put into the aysteza can affect the function of the septic tank as a tresttuent stage to the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a chaster plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site waatewaterdisposal system is in proper operating condition and/or (Z) after inspection and pumping (if necessary), the septic tame is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sews$$ disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural, Resources, State of Wisconsin. C4racation statics that your septic system bas been maintained must be completed and returned to 1130 St. Croix County Zoning Office within 30 days of the tbres year expiration date. lay a� SIGNATURE OF APPLICANT 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 owna(s) of the property, described bove, by virtue of a warranty dead recorded in Register of Deeds Office. SIGNATLR$ OF A.PPLIICANT DATE 01 M y information that is mia.representedmay result in the sanitary permit beias revoked by the Zonins Department. •oyes• " include with this appilcstton: a stamped Warranty deed from the Resistor of Dosda off l ee A copy of the certified survey map if reference is made in the wttgpily ¢q`g KATHLEEN H. WALSH STATE DAIi'0F WISCONSIN'FORM I.- 1998 REGISTER , O` `DEEDS WARRANTY DEED . CROIX CO:, WI RECEIVED FOR RECOR>a Doeument Number 0- 7 16 - 1999 9s30 AM This Deed, made between WA M" D® Catherine M . Paron, a , yingle person., f /k /a EXEMPT 0 Catherin M. CERT COPY FEE: Wolske ' COPY FEE: Grantor, TRANSFER FEE: 387.00 and Michael T. Wellens and Krist A. Wellens, RECORDING FEE: 10.00 husband and wife as survivorship marital PXES: I property w - ;Grantee. Grantor, for a valuable consideration, conveys'to Grantee the following described real estate in St. Croix County, Slate of Wisconsin (the "Property "): It ecording Area " ° "" ° " &fit VALLEY BANK, N.A. 102 North Washington Street P.O. Box 749 St. Croix Falls, Wl 54024 - 0749 002- 1086 -70 -100 Parcel Identification Number (1 .This is homestead property. (is) (is not) Lot I of CSM recorded in Volume 10 of CSM, Page 2790 as Document No. 519137, located in the NE} of the NW} and the SE} „of the NW} of Section 34, T29N, R16W, Town of Baldwin Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Properly is good, indefeasible in fee simple and free and clear bf encumbrances except easements, roadways and restrictions of record. Dated. this 7 day of .7uly 1999 * �..,: * Catherine M. Paron AUTI•IENTICATION ACKNOWLEDGMENT STATE Or WISCONSIN ) Signature(s) /� ) ss. County. Personally came before me this day of authenticated this day of July . - , 1999_ the above Warned Catherine M. Paron r III TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person who executed (Ifnot, the foregoing instrument and acknowledged the same. authorized by § 706.06, Wis. Stars.) THIS INSTRUMENT WAS DRAFTED BY - -� Michael H. Forecki, Attorney Notary Publ c, Slate of Wisconsin Eau Claire Wisconsin i:� '` My Commission is permanent. (If not; stare expiration drtic: ! (Signatures may be authenticated or ackuowlcdgCR 1%� not necessary.) ' r ` .+ x".� • 1 •Names orperaars Signing in any capacity must be typed oritM� v . g��'t�`e' • '� �$R'ANSIN WARRANTY DEED n.�998 FILED 2 JUL 18 IMO- JAMES O'CONNELL "M of Doeft 5 19137 Ca Q 1913`7 � s CEP T I F -T ED SUP VE Y MAP Located in the NE 1 /4 of the NW 1 A. and the . SE 1 /4 of the - NW I /4 'of Section 34, T29N, R16W, Town of Baldwin, St, Croix County, Wisconsin. ----- _ -- - -_, _ _ N1 /4 Corner , U.S 2625.48' Sec 3t- S 86. 35' S1 "E „ H W Y (from tie - '- 1312.74' .6d 1312.74' t0 NW Corner Section 34 0 T29N,R16W ° CD UNPLATTED, LANDS (Beratsen cap) _ o °D = JOINT DRIVEWAY*. +S`. *47'21 *E 260.21 EASEMENT. SEE R NOTE BELOW. LEGEND POINT OF BEGINNING Section corner monument. (as noted). o 1"X24" Iron pipe weighing 1.68 The per lin.- foot set. - «-- Fenceline. 1 , O NO'S'E: Joint dri way easement as iecorded in Volume j 08 ?,` _ . ... Owned by Joseple Paron stied 2427 U.S. HWY " 12 " WB"dults, Wi. � O SEPTIC VENT shed APPROVED t 0 LOT / A ZI v 1 h 190, 586 aquae feet ,j�'` 1i81 Al (4. X75 >I►eree).` n 1 I 3 - $T. CROIX COUNTY p L O.'iiQr9IiMSiVt Plsflnlc _ «v " ;� zoning: and p _ C Parks Cmn*tie w Knot recorded . y O , . North line; of tie SF.1 /4 O wHhin 30 days of o : Z : _of ,they, NW 1�4 j• N w 1 swovad data •approval t1w w E�i p,l:, C;: fC .' :� z gearing$ 4eferenc id to. the Z North line of Section 34,' assumed to be-'. N86' 35'51 "W . „ East lice 'of `the' NW I /4 of .3 (NW1 /4,::Sectioft 34) the 'WW. 1* and` of the .SW1/4 of the NW 1 /4 L) • HARVEY Q, 1.5' -JOHNSON • S -1898 9 k • • S HUDSO 1 �: CHICAGO &,NORTI•LW3TFL 72' W. WIS Q,. �� 72 _R o �� A SCA_LE� 1 = 100 — _ OF TRACKS 0' 25' 50' 100' 200' 300' This instrument drafted by: JSI • VOLUME 10 PAGE 2790 4942300 i