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030-2114-60-000
0 C) C c o o o C 0 CD G q H I z II M 7 I � z yj rn £ z °o z £ ro _ o d m M w a m M F- fn C N C C9 N U o z v Z m Z d c o 0) f- N (D Z N E U `o Cl) "v CK • N c N O WAWA ro r _ 4 O Q Q p U �l z z o z C (D c N N E N w C. N CNO N d m 5 O O G a a O D. .� N w L °� v) v) to a o N > 0 � co Z o •� R a a a N C FL o o N � 7 p N LO Z v > O O O C � L-.. o r ' LL w Q v O O M N C 0 4) 7 j M Lo `- � y li ', r r- � C9 5 N 410. • C"i N O O N - C M '', >. Lo 17 y O 0 � U • y' O M U) U M O z Y (n N J2 w m a *k d CL `N ; w A v a O U) v i - Wisconslh Department of Commerce PRIVATE SEWAGE SYSTEM y: Safety and Buildings Division Count INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 353207 Permit Holder's Name: ❑ City []Village lR Town of: State Plan ID No.: Dynan, Daniel Town of St. Joseph CST BM Elev.:. Insp. BM Elev.: BM Description: Parcel Tax No.: L 1 ` P vc- 030 - 2114 -60 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic W2ek f tr� Benchmark Dosing Alt. BM �.GZ I W •$z` Aeration Bldg. Sewer /!• 8 Z q(, -I1' Holding St/ Ht Inlet 21. If TANK SETBACK INFORMATION St/ Ht Outlet 9 (Z,p�f 0.95 r Veo TANKTO P/L WELL BLDG. AiirIntake ROAD Dt Inlet ,� 05 20 , SY ' Septic 36 'yqU , !s - — NA Dt Bottom � 6,$ �• �S Dosing tit /gyp' Z,T a NA Header /Man. �arFf- 3 17 ,0160 /z.4� gs.sY Aeration NA Dist. Pipe , ?sp Holding Bot. System IV, Zr PUMP/ SIPHON INFORMATION Final Grade Manufacturer G'S Demand St cover A03 1 • O Model Number w,60 3 I L `C" GPM Friction S stem r . 1`� � TDH Lift F .10� L oss �,S H y TDH �5, Ft Forcemain Length Dia. Dist. To well SOIL ABSORPTION SYSTEM MM RENCH Width length r No. t Tr riches PIT No. Of Pits Inside Dia. Liquid Depth IM N 1 N 3 DIMENSION SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Man fact rer SETBACK INFORMATION Type of CHAMBER r o el Number: System: � • Z "`° OR UNIT DISTRIBUTION SYSTEM Header/Manifold u Distribution Pipe(s) x Hole Size I x Hole Spacing Vent To Air Intake Lengtl'i�P� Dia. Le th Spaci 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 I ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (include code discrepancies, persons present, etc.) Inspection #1:05' an Inspection #2: ''t""f -- Location: 340 127th Avenue, St. Joseph, WI (SE1 /4, NW1 /4, Section 31 T30N -R19V) - 31.30.19.943 1.) Alt BM Description = t -&U 2.) Bldg sewer length = 1$.0 f 1 p+ � I r ' , O 3' S'`/ lid - amount of cover –? t8 Plan revision required? ❑ Yes JX No Use other side for additional information. ID 5 2S aU ` SBD -6710 (R.3/97) Date Inspector's Signature Cert. No ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: m t = � 33 _ i _.1 . E i _ = i q I s E I E gat �+ PERMIT COUNTY D1LHR SF R UNIFORM PERMIT # (PLB 67.7) PERMIT RENEWAL DATE: PERMIT TRANSFER DATE: ORIGINAL PERMIT ISSUANCE DATE: STATE PLAN I.D. NUMBER: PROPERTY LOCATION: CITY: VILLAGE: t ea yq/ t ea, ,T N,R (ot TOWN OF: LOT NUMBER BLOCK NUMBER: SUBDI ISION NAME: — NEAREST ROAD, LAKE 0 LANDMARK: PREVIOUS SANITARY PERMIT HOLDER (IF CHANGED): SANITARY PERMIT TRANSFERRED TO: NAME SIGNATURE: NAME: PHONE NUMBER: ADDRESS: PHONE NUMBER: ADDRESS: I, the uncle rsi ed, hereby assume responsibility for installation of the private sewage system that has previously been approved for this property, PLUMB R' 1 A UR PREVIOUS P MBER'S NAME (IF CHANGED): PLUMBS 'S ADDRE PREVIOUS PL S A SS: MP7rAPRSW NUMBER: PHONE NUMBER: MP /MPRSW NUMBER: PHONE UMBER: SIGNA RE F S NG AGENT: DATE API ROVED: DISTRIBUTION: Original - County Copy - Bureau of Plumbing Copy - Owner DILHR -SBD -6399 (R. 5J82) 0 Copy - Plumber r � ' 3�o � � V� Safety and Buildings Division SANITARY PERMIT APPLICATION 201 W. Washington Avenue N VLconsin P O Box 7162 Department of Commerce In accord with Comm 83.05, Wis. Adm. Code Madison, WI 53707 -7162 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8112 x 11 inches in size. • See reverse side for instructionsfor completing this application State Sanitary Permit Number 3 53 - r Personal information you provide may be used for secondary purposes p Check it revision to previo applicatlo n� [Privacy Law, s. 15.04 (1) (m)]. State Plan Review Transaction Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATI N —' Proper, Owner Na h Q Property Location �5� Z"1l-y OZ8 W 1/4 va, S T , N, R or Property O ner s Marling Add ss / Lot Number Block Number City, e 7 � Zip Code Phone Number S ision N m or SM Number / ( ) AW I IL TYPE OF BUILDING: (check one) ❑ State -Owned ❑ Cit r Nearest Road ❑ Vil age Public 1 or 2 Famil Dwelling - No. of bedrooms Town of III BUILDING USE (if building type is public, check all that apply) Parcel Tax Number(s) 3 , 3O, i9. 9 1 ❑ Apartment/ Condo I 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, 1' New 2. ❑ Replacement 3_ ❑ Replacement of 4. ❑ Reconnection of 5, ❑ Repair of an ------ System ........ System------------- Tank Only --------------- Existing System _____,__ Existing System 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 120Seepage Trench 22 ❑ In- Ground Pressure 42 E] Pit Privy 13 [] Seepage Pit �,1 X S� 43 ❑ Vault Privy 14 ❑ System-In-Fi I I Vfi . 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 Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /' ch) Elevation / Feet Feet Capacity VII TANK in gallons Total # of Prefab. Site Fiber- Expel. INFORMATION New Existin Gallons Tanks Manufacturer's Name Concrete st C on - Steel glass Plastic App Tank - Tan k eptic Tank o ing Tan —^ ❑ ❑ ❑ 1 ❑ ❑ Lift Pump Tank r ❑ ❑ El ❑ 1 : 1 - 960 + 1 &n I h VII . SIBILITY STATEMENT I, the ndersigned, assume responsibility for instal tion of the onsite sewage system shown on the attached plans. Plumber' ame• (Pri ) r Piumber' ign ure: m Business Phone Number: I MP/MPRSWNo.: Plumber's A dress s treet City, Stat ip Code): IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater Signature (No Stamps) Approved E] Owner Given initial Surcharge Fee) Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: pp �• �S . �Av1 , SBD -6398 (R.12/99) - 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 V1/(sconsin 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 systern, 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 oe installed. 11. 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, re:onnection, 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 / Depart ment Use Only. X. County % Department Use Only. . Complete plans and specifications not smaller than 8 112 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. t CA aa5 a. ®o f A � a y A� APB a �,�� dry/ Curves P umps MM A& n T 60 -�4 I MOD E L 3 SIZE 3 A" Solids wEt;N ' 10 t ?U W E 10x1 OJ -- O wE07H ZZ r IOi WCOJM I ' w E 40l D 10 i 0 � 0 10 70 4 w 60 70 Oc SYi I 1 t0 I:y Go #4 , p 10 :� — :rJ m'm C r ,. >,,...;�. ; , r , -T., F; ,, ,,N. �, ,• �.. " , :�u�C� PUM it C MITE96 fEEt 1: ► —1 7 WE ] 4- 7--T 0 10 70 � 0 CAPACCI v IYrO OVr1Y� IVmp�. 1�4. t 14GV.t wry. ! � C)1+1' PAGE OF �i9.J �r94iBrJ� PUMP CHA CROSS SECTIO ANO VENT CAP VENT PIPE WEATHERPRooF APPROVED LOCKING -- ri � - JU UCTIOA) DOX MA WHOLE COVER WITH 25' FROM DOOR, WAA►IING LI►6r`l WMIU. WINDOW OK FRESH I AIR IAITAKE GRADE i I y" MIN. IB'MIW. COIJDUIT �- ---- - - - - -- . \\�� PROVIDE I - - - -- IAILET - AIRTIGHT SCAL I III APPROVED JOIIJT A I I APPROVED JOI►1' II W/ ' PIPE PE EXTENDIWC. 3' fXTENDII 3' I I I ALARM OWTO SOLID SOIL 11 OIJTO SOLID SOI D � I ON LLEV 91 6 FT. � PUMP -� b OFF 0 COIJCKETC BLOCK - - RISER EXIT PERMITTED OWLy IF TANK MAIUUFACTURER HAS SUCH APPROVAL 3" �}pPfioVEa $EDDIniG "ncicr Tr'.► -IK SEPTIC IF SPECIFICATIQfJS DOSE TAWAS MAWUFACTURCR: pry 'O'x I1W"`•HCR OF DOSES: Pi:R DAB TAWK SIZE: &ALLOWS DOSC VOLUME S � s LNG INLLUDIWG DACKFLOW: _ GALLOW ALARM MAUUFACTUR MODEL )JUMBEK: � � � CAPACITIES: A= ,Z::L IUCNES OR ;g.2l GALLOWS SWITCH TYPE' r 5= :2 - INCHES OR .f1f GALLO PUMP MANUFACTURER: G - INCHES OR GALLOIJS MODEL ).!UMBER: D - INCHES OR 412 - GALLOUS SWITCH TYPE: MOTE' PUMP AND ALARM ARE TO DC INSTALLED ON SEPA0.ATC CIKCUITS MI►JIMUM DISCHARGE RATE �-- G PM VERTICAL DIFFEIL BETWEEM PUMP OFF AUD OISTRIBUTIOU PIPC.. FEET + MIUIMUM NETWORK SUPPLY PRESSURE // . . . . . . . . . FEET } _ FEET OF FORCE MAIN X ,v.�� F/onr>'.):RICTIOU FACTOR.. FECT TOTAL DtlWAM.IC. HEAD = FEET I►JTERKJAL DIMEWSI UC OF TAIJK' LCNGTM '\ wTii - LIQUID DEPTH 51GIJE LICENSE NU#% BLR -. DATE: Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division,of Safety and Buildings Page —/_ of 3 Bureau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must County f include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. # APPLICANT INFORMATION - Please print all information. RTw e b i D to Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Govt. Lot _ 1/4 1/4,S� Tao ,N,R E (or)o Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# City State Zip Code Phone Number ❑ City ❑ illage LM Town Nearest Road G 1 (Z�J New Construction Use: Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow 4�� gpd Recommended design loading rate ��� bed, gpd/ff —I- trench, gpd/ft Absorption area required 12� bed, tt tt Maximum design loading rate <' bed, gpd/H gpd/ft Recommended infiltration surface elevation(s) (as referred to site plan benchmark) Additional design /site considerations Parent material � Flood plain elevation, if applicable It _F S = Suitable for system Conventional Mound In Ground Pressure AT Grade System in Fill Holding Tank U = Unsuitable for system s El u ®s ❑ u W S ❑ u lZ S ❑ u ❑ s ®u ❑ s 1Z u SOIL DESCRIPTION REPORT 4 Boring Horizon Depth Dominant Color Mottles Structure GPD /ft g in. Munsell Qu. Sz. t. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench Z Z .. ..' / Ground elev. Depth to limiting L(P p� factor Tf�Z Remarks: Boring # 3 ' Ground 4 Al / _ } elev. b Depth to limiting factor -> ZZ_' in. Remar, s: CST Name (PI rint) Signature Telephone No. Address x, Da a CST Number SOIL DESCRIPTION REPORT PROPERTY OWNER . �l ,�q a�a Page of PARCEL I.D.# t) Boring Consistence Boundary # Horizon Depth Dominant Color Mottles Texture Structure Consiste B Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench S Ground elev. AIZ "C , 144& �' 7 Depth to limiting factor >, ?, in. Z Remarks: Boring # <ON Ground elev. ft. Depth to limiting factor 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 Boring # Ground elev. ft. ' Depth to limiting ; factor in ' Remarks: Boring # F Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) rA t7so.J 'JsT Q /),c ��- 9,7) ao i TtL Safety and Buildings Division SANITARY PERMIT APPLICATIO Vi sconsin N 2 01 E. Washington Ave. In accord with ILHR 83.05, Wis. 9t�ntde �. P.O. Box 7969 Department of Commerce ,.� \ Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the syst on paper wt less c my than 8 1/2 x 11 inches in size. • See reverse side for instructions for completing this appli t+on State Sanitary Permit Number 363t,2o The information you provide maybe used by other government agency pro ra - s' ^O ❑Check if revision to previous application IPrivacy Law, s. 15.04 (1) (m)]. ST c °� State filan I.D. Number OWA I. APPLICATION INFORMATION - PLEASE PRINT ALL Property Owner Name Prope y atio _ 1l4_cvjv f(4 „5, 3/ T �o . N, R 1,9 ( °`��� Property Owner's Mailing Address Block Number — V — Z City, Stat Zip Code Phone Number Subdivision Name or CSM Number (1/,2 ) . ' b - - IL TYPE BUILDING: (check one) E] State Owned 'tyy Nearest Road illage Public 1 or 2 Family Dwelling - No. of bedrooms Town OF 14 J EWAC 7's III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 2 I 2 • tq �� �� 1 ❑ Apartment/ Condo I O.?D - o2/ /Y l - GO - O v O 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 -- - --- - -- -- Tank Only______________ Existing System ---- ____ExistinqSystem 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 IN Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure � (X q / 42 ❑ Pit Privy ❑ 13 Seepage Pit / 43 ❑ Vault Privy 14❑System -In -Fill 9a' ;_.0 VI. ABSORPTION SYSTtW INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation %Std , p0 9�d O Feet p Feet Capacit VII. TANK in g allon s Total # of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturers Name concrete Con- Steel glass Plastic App New Existing structed Tanks Tanks Septic Tank or Holding Tank ® ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber V ® ❑ 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) Plumber' ignature: (N tamps) W /MPRSW Business Phone Number: Plumber' Address (Street, City, State, Zip Code): n IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved itary Permit Fee (Includes Groundwater Fate ssue Issuing Agent Signature (No Stamps) )d A roved Surcharge Fee) pp ❑Owner Given Initial Adverse Determination , - � c l X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -6399 (N 11/96) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber Safety and Buildings 2226 ROSE ST LA CROSSE WI 54603 -1905 Too #: (608) 264 -8777 Vhsconsin www.commerce.sta Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary September 16, 1999 CUST ID No.267341 ATYN: Rod Eslinger WEGERER SOIL TESTING & DESIGN ZONING OFFICE 421 N MAIN ST ST CROIX COUNTY PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 09/16/2001 Identification Numbers:.. Transaction ID No. 246030 Site ID No. 180702 SITE: Please refer to both identification numbers, Site ID: 180702 above, in all correspondence with the agency. St Croix County, Town of Saint Joseph #,r SE1 /4, NW1 /4, S31, T30N, R19W Lot: 26, White Eagle r; Facility: Dan Diamond residence FOR: Description: New 3BR Mound }t ` f `� Object Type: POWT System Regulated Object ID No:: 491020 ', r 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. Adm. Code. • 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 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 /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. incerely, DATE RECEIVED 09/09/1999 FEE REQUIRED $ 180.00 emus R. Sorenson FEE RECEIVED $ 180.00 Wastewater Specialist BALANCE DUE $ 0.00 (608) 785 -9336 dsorenson@conunerce.state.wi.us W$MART code: 7633', i Safety and Buildings 2226 ROSE ST LA CROSSE WI 54603 -1905 TDD #: (608) 264 -8777 visconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary September 16, 1999 CUST ID No.267341 ATTN. Rod Eslinger WEGERER SOIL TESTING & DESIGN ZONING OFFICE 421 N MAIN ST ST CROIX COUNTY PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 09/16/2001 Identification Numbers Transaction ID No. 246030 Site ID No. 180702 SITE: Please refer to both identification numbers, Site ID: 180702 ondence with the agency. St Croix County, Town of Saint Joseph SE1 /4, NWIA, S31, T30N, R19W �► `� Lot: 26, White Eagle �EFILIVE0 Facility: Dan Diamond residence ca FOR: P ^ ? 1999 ,* Description: New 3BR Mound GF . ppk Object Type: POWT System Regulated Object ID No.: 4910!, COUNTY t -MING The submittal described above has been reviewed for conformance with a c$ _ tsoe ` ' Administrative Codes 1II and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROV 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. Adm. Code. • 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 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/installation /operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. incerely, DATE RECEIVED 09/09/1999 �. FEE REQUIRED $ 180.00 ennis R. Sorenson FEE RECEIVED $ 180.00 Wastewater Specialist BALANCE DUE $ 0.00 (608) 785 -9336 dsorenson @commerce.state.wi.us TITLE. Page of 6 MOUND SYSTEM FOR A 3 BEDROOM RESIDENCE LOCATED IN THE SC 1/4 OF THE NLJ 1/4 OF SECTION 31 , T N, R t 9 W, TOWN OF Is �os�li , S - G� lx COUNTY, WISCONSIN. DoT It' OF w ct tTE ZNSLE INDEX PAGE 1 'of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW -CROSS SECTION: llAA 4 PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT ,� .PAGE 5 of 6 PUMPING CHAMBER 19 J 40 PA GE 6 of 6 PUMP PERFORMANCE CURVE 9 99 oil► PREPARED FOR + 1�vf- VjM0tiD PREPARED BY W E=( EF:;t SO I L TEST I NC AND. I SE= F.O. BOX 74 421 N. MIN ST. .� ,�� Nix RIVfF FALLS. NI 54022 nt?r�uA L. wE OLREA •.� 715'4LJ -016J = ELLSrvOHTH, m JOB NO. PLOT PLAN Page Z of Scale 1"= SD ' CVt S, o, 3 Vy S � l r 8o M OF e�p �t °lZ -6,oj IOS' 25��'�"v a• -1 S - qz( o � C` P s 10 or-4 PvC vA _ woua�D G� gYS Ix • O ly N LOT ZO r � 5 _LZT1t 1 ZJ Fizo� Sw11# I - aZ�.S a., `NP of ST" Fe) P a ST - -- 1�t Oav WtSZ of Bvlztep � LtZt, BOX — NOTES -1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. (Y required) 3. Install 4" observation pipes with approved caps. ( Z required) 4. Septic tank to be V Doo /666 gallon capacity manufactured by ?'1 ) A. c . 5. Bench Marks S p�3GU� 6. Divert surface water around system to prevent.ponding at the uphill side. Page 3 Of Approved Synthetic Covering Rs-'w) C.3; Distribution Pipe Medium Sand G Topsoil = _-- �, -_ -- F Elev. E D 3 S�A� 5"f % Slope P \N 'Ve �� � Bed Of 2 2 %2 Force Main Plowed OIld tjo Aggregate From Pump Layer D W) Ft. �+�a\ ep� Cross Section Of A Mound System Using E \ Ft. A Bed For The Absorption Area F 0• Ft. S ��r�t���� � �r�..�� G 1 • � Ft . 4; co A `u Ft. N �•5 Ft. Linear Loading Rate =q.s GPD /LN FT B q1 Ft. Design Loading Rate= c) -� .GPD /SQ FT j Ft. J `] Ft. K 1)l Ft. Alternate Position � L Ft. b9 W 31 Ft. L J Observation Pipe 0 i3 K A - W L----- 7 --------- - - - - -- ------------- - - - - -- Force Main Distribution Bed Of 2 "— 2 2 Pipe Aggregate Observation Pipe Permanent Markers (Anchbr securely) Plan View Of Mound Using A Bed For The Absorption Area I Page Of (� Perforated Pipe Detail 0 End View Perforated End Cap PVC Pipe j � Install permanent•marker �o<o� at end of each lateral Holes Located On Bottom, Are Equally Spaced S PVC Force Main Q PVC Manifold Pipe Distri ution PiQe Last Hole Should Be Next To End Cap End Cap P c ' Ft. Distribution Pipe Layout S Y Ft. S� ' w X 3 6 Inches yVA�� Y 3 6 ®VNV g� ,�' Inches 1 P itto Hole Diameter y Inch Cott �` m Lateral Inches) s <•_� Manifold Z Inches Pik Force Main Z Inches 1giVO #of holes /pipe ~ ~ t om •,r Invert Elevation of Laterals Ft. SSE F x V \71 = 9.16 X �4 z - 3- kt G p ty Place 1st hole 18 � { from center of manifold with succeeding holes at 26 "intervals. Last hole to be next to the end cap. Combination Septic;Tank and PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS ' PAGE OF b VEIJT CAP WEATHER PROOF JUIJCTIO►J box , j'C.I. VENT PIPE APPROVED LOCKING ' -•10' FROM DOOR. MAWHOLE COVER P '.iIN00W OR FRESH wA(tIV11J6 l.PvgEL . A R IAITAKE co; - )DOIT fj i 5' I V y " II�Sr�c�7oIJ PIS PROVIDE I IAlLE T 'AIRTIGHT SEAL I I I I I v � RFFL�S I I APPROVED JOIAIT P A I APPROVED JOIUT: W /C.z PIPPEO construction I II ALARM W/ � I �IPE�p�c all comply with w I 133.15 and 83.20 a I I c ol , I oN �u c - 15 FT PUMP � OFF C O UC RET E a�w 5LOCK t,� 1 3" APPFco�F�, RISER EXIT PERMITKO CULtI IF TAWV MANUFACTURER HAS SUCH APPROVAL BEDDING, SEPTIC E SPECIFICATIOKIS DOSE I PRA 3.31 TAIJK MAIJUFACTURCR: ` IJUMI3ER OF DOSES: PER DAy TA SIZE: - 100 ` C� SO GALLOMS DOSE VOLUME 2 ALARM MANUFACTURER: S-S �-�-M-0 SkSTLYI g MICLUDING BACKfLOW: 1S 3 GALLONS MODEL IUUMBER: W t,. CAPACITIES: A= �$ IUCHESOR 30E CALLOUS SWITCH TYPE: r B= INCHES OR 31 G�LLOLJ5 PUMP dKAIJUFACTURER: GOV L C IUCHES OR 1 GALLONS MODEL NUMBER: 38�I D 5 D= 9 INCHES OR lS3 GALLONS SWITCH TYPE: h'1�'lZrU1� -I( MOTE: PUMP AMD ALARM ARE 0 DL MINIMUM DISCKARGE RATE 3�'�ly GPM I INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE DETWEEU PUMP OFF AI,10..DI5TRIBUTIOW PIPE.. X3'15 FEET + miultAUM METWORK SUPPLY PRESSURE .. 2 FEET .F lO S FEET OF FORCE MAIN X 2 ' F YoFT.FRICTI0A1 FACTOR.. FEET TOTAL OtIIJAMIC HEAD = 1q FEET Pump chamber DIAMETER IIJTERAIAL DIMEIJSIOWJ OF TANK: LENGTH 1 ;WIDTH ;LIQUID DEPTH BOTTOM AREA — - 231 GAL /INCH AS PER MANUFACTURER -- GAL /INCH i `t"ti� �Fp2 Y'�hJCt= CUR V ?E 6 c 6 Goulds Submersibl Effluent Pump 1 38 71 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 t d tic cover with integral handle e or automatic an • Farms Motor: manual operation. Automatic : 0.4 and float switch attachment • • EPO4 Single hose HP, p oints. Heavy duty sump 115 or 230 V, 60 e: 0.4 H0 models include Mechanical p • Water transfer RPM, built in overload with Float Switch assembled and ■ Power Cable: Severe duty • Dewatering automatic reset. preset at the factory. rated oil and water resistant. • EP05 Single phase: 0.5 HP, ■Bearings: Upper and lower in SPECIFICATIONS 115 V, in le phase:-0.5 0 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 9 /4" maximum. • Power cord: 10 foot with pump out vanes for • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. 0 Canadian Standards Association • Total heads: up to 24 feet. with three prong grounding • Discharge size: 1 1 /2" NPT. plug. Optional 20 foot ■ EP05 Impeller: Thermo- (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for end in " F" or "AC ".) rotary/ceramic- stationary, three prang grounding plug improved performance. 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 ' -►-f- 5GPM components. Pump: EP05 e LzSFT i • Solids handling capability: c 25 3 /4 " maximum. a • I Uj • Capacities: up to 60 GPM. 6 20 • Total heads: up to 31 feet. _ �3 • Discharge size: 1 NPT. Z 5 • Mechanical seal: carbon- > I 3�•y rotary/ceramic- stationary, 4 15 BUNA -N elastomers. o I ` EP05 • Temperature: 3 i o 104 °F (40 °C) continuous ( EPO4 140 °F (60 °C) intermittent. 2 5 0 00 10 20 30 40 50 GPM L _L L 0 2 4 6 8 10 12 m /h CAPACITY ©1995 Goulds Pumos. Inc. Wi. nDepartrnentofIndustry, SOIL AND SITE EVALUATION REPORT Page 3 La , id Human Relations 9 _ Of Div n of Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but Ste'• C not limited to vertical and horizontal reference point JE , c>"'gjct�, on And,% of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and dist ; �o'Poarasf'►dad. ' 03 O - Z.) X\[. fpD APPLICANT INFORMATION PLEASE NFdRMATION R IEWBY DATE PROPERTY OWNER: ;' PROPERTY LOCATION (� I� - \ - 2) ` Pr 1 1U fJ� ,, GOVF. - WT StZ 1/03 W 1/4 a 1 T 30 ,N,R 11 E ( W PROPERTY OWNER':S MAILING ADDRESS "? LOT'# I BLOCK # SUBD. NAME OR CSM # ST CITY, STATE ZIP COD PHOfif9 []CITY ❑VILLAGE MOWN NEAREST ROAD ST - V4�vt_ Mr') SSI09 `(.6 1) �`t7= '��8 D4 New Construction Use [JQ Residential / N, , df ` ' 3 [ j AdditiQn to existing building Replacement [ j Public or commercial describe Code derived daily flow 4 SO gpd Recommended design loading rate • 4 bed, gpd$ trench, gpd/ft Absorption area required , 1 S bed, 11 trench, ft Maximum design loading rate ' S bed, gpd /ft trench, gpd1ft Recommended infiltration surface elevation(s) 0 t ft (as referred to site plan benchmark) Additional design/ site considerations Y`'1 OyK� W�$ >C `11 r L3� . Y•'11 w L -w1 U 1 z' pp Sf\� H u- . Parent material wry. Tt L-L- Flood plain elevation, if applicable Q A It S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem El U ®S ❑ U ❑ S O U ❑ S U ❑ S O U ❑ S ®'U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed ITrench U D `1, 2 3 L Z S) 2. h'I. 3 b k WL z Zo - �- 311 - S i 1 z `�s b k w> �h �S _ • 5 Ground a -31(c, �lS`t\ZSla s .2 a2�ft. S1-6S •S `11-) 1 y Depth to limiting factor , 3 Remarks: Boring # 0 -4 10HR 3LZ — s1� Z'f'sbIz rY1'F1r eS 5 .� Z Z a -zr, �tcz �!L — si s Z s�231y k muri� a-w .S Ground elev. 4 y 6 -6I, �•S Y 2 4��6 s� o S 1�� , S', b ° l - L!-� ft ` Depth to limiting factor 6 Remarks: CST Name: — Please Print Arthur L. We erer Phone: 715_ 425 -0165 V egerer Soil Testing & Design Service -P.O. Box 74 River.Falls,WI 54022 Signature: Date: to CST Number:. C-4 C19 - Z13 -� i� 220254 PROPERTY OWNER ' Z� 1 P`t'1k3 l SOIL DESCRIPTION REPORT PARCEL I.D. # O SO— Page Z- of 3 Boring # Horizon Depth Dominant Color Mottles Structure Texture Consistence Bour>d�y Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trer>ch k) Lt 31(� — si 1 Z (�sb Vj Ground elev. 9 2.0.0 ft. Depth to limiting factor ` E 1 1 1 Remarks: 7 Boring # ;.���: »:•.� O _� 10`1 31 Z — l � Ground 3 ZZ�7 `► S`�1Z Sly — S� `trt S �� �'F►- - - ` elev. • y ' • 5 cl 4 S ft. Depth to limiting t factor i Remarks: Boring # w ` O1 Ground C�- I�ti G elev. f t, Depth to limiting I factor I. Remarks: 3oring # > around ! alev. ft. )epth to imiting actor Remarks: _ P LOT P LAN Pa 3 of 3 SCALE 1 "= S6 v , o• 3 QTIY y h��• � ,�o� _. >lS NR$ Tml P�Lf�a1q O� v _ � �QD L.uT 21 � w o ua� A LuT Z� 0►., 'Trip dF 5'►e:EL F P o 3'T Qr1t�Z - NFL.. R,ZY $' OiU B+tS�-- OF 8U\21eQ krtt!:t. Sax 9LI -Z l3 c 715 ) 425 -0169 CST Signature Date Signed Telephone No. CST # r k d 'Fbmian�Fl06tio Ind try, VgLI AT.10N REP . (�- Page of 3 labbrand slaloms ,40 of saretyla Bulllnp t a rd MY ST". Qlv_o C 'Attach complete site pl n o pape r no a an 81/2 x 11 i hes`in size. Plan. must include, but . not limitedlo vertical a Horizontal refe, once point (BM), direction and % of slope, scale PARCEL I.D. # dimensioned, north arro location and distance to nearest road. `�) C. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE 7AA - I l O fj PROPERTY OWNER: C / p ppcty S cttPff-f— PROPERTY LOCATION 6A1 T..tOf S 1/4 NW 1 /4,S 31 T 3D ,N,R \ Q E ( W PROPERTY OWNER' MAILING ADDRESS -- LOT # BLOCK # SUBD. NAME OR CSM # P1FA1 0 SSA X69 e, G - %'LVD. VJlt[1Z TGIF CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE ®GOWN NEAREST ROAD ST, p,PCvL, MN S 5 1o1 (6S1) q 10 - GoI_F s;" - Zm -3 t;'Q rte( N__X ° 2D. New Construction Use N Residential / Number of bedrooms 3 [ J Addition to e xisting building () Replacement [ J Public or commercial describe Code derived daily flow q SO gpd Recommended design loading rate y bed, gpd/ft - trench, gpd/ft Absorption area required bed, P . 31 S trench, P Maximum design loading rate S bed, gpd /ft trench, gpdtO Recommended infiltration surface elevation(s) °1. Zq• 5 It (as referred to site plan benchmark) Additional design/ site considerations SEE-- p N Z 1 N1 U i Y' % w� $ ' X t'l - r © Q � Parent material G LP'c _ttt _ Flood plain elevation, if applicable N A It rUUns Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE I AT-GRADE SYSTEM W FILL HOLDING TANK uita ble fors stem ❑ S ® U X S ❑ U ❑ S ®U 11, (� U ❑ S MU ❑ S O U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourx1ay Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed rends 2'31 - Z Ground 3 it 3 y �•S`tR s 7 L� yy 0 h v�t.� • y , 5 elev. ot Z ay--6y We s �rZ3r ss _ s! ,s 1vJU'T)- - •3 —. -__ Depth to limiting f� T Remarks: Boring # 0 -9 t t�- R.- 312 S 4 Z ° 1 9 Z.(o. IZ`tl2 3I (, S b) w,fi •;raWcS 3 z6 - S`1R -3Iy s� �es�h mv�; �� •q •S Ground . r Depth to ©© " limiting f faC or > Remarks: CROIx ; E CST Name : — Please Print Phone: ` LNG Arthur L. We erer 715 -42 -Q 5 egerer Soil Testing & Design Service -P.O. Box 74 River Falls, Sgnature: Date: _ qS- Q3- 1 ?- '- M00576 r *ROPERTYOWNER YTMQ - b. C 4 T-PSOIL DESCRIPTION REPORT Page of �ll,#ICEL I.D. # V>E�ht ) Kj r. Depth Dominant Color Mottles Structure GPD /ft 'Boring # Horizon Texture Consistence Bound3y Roots In. Munseli Qu. Sz. Cont Color Gr. Sx. Sh. Bed Trench s Z,m 3bk ti► Uft-- 0-S . S Z z.o -3y 1�'� 2 3l � � s � I Z `F-s�k �`�' c.S � • S Ground 3 , 3y S3 1 p11 Q 31 L � ,S �f l S f S � � C�w� 1^ Cg M � • Z e y� Y S3 -6S 1 -1r23 - S LIR. 5 L 0 t)epth to `limiting fa �� Remarks: Borin g # 13 I _ Stvund,: j elev. D ' e th to P Ifiniting factor Remarks: B rin E )a ' Qtoun& px)L Y t�� elev. Depth to limiting factor 1 Q JV S f Remarks: Boring # U>J Q Minnzj'j 0 Ca►J 6 S Gfod c�1= S g L(S ft: Depth to limiting fa_c_tgf, F Remarks: S86 030(R.05/92) ' P LOT P LAIN r. Page 3 of 'i SCALE .V'= CEO [J g :coj`vo �Z . °t7 S , 5 3 \�.EL'qZ -89 l3uT.UFB�p �Tl. �IZ�.S' o i �- . @r� 1A i i i / NJ7�S 1. `c ` lo `t L � SE - M BE ffT LETr T ZS PtZa M ! 1Uv►vb . _ 7.. ✓V `t,L N K S. t SC3 k At %` 3- by Nut cUM. Pfl - tT oz O�S'N `C'� r'1 t`�R�A OR `R'1 p ep� 7 bOMU S\UpE o� `T?i� ►'� u un.p - C44AL - '5 -iZ3- 1`7 y ( 715 42.5 65 M O0576 CST Signature Date Signed Telephone No. CST # l 10/24/99 10:48 HEDBERG HOMES 4 6517773892 901 . 10/21/99 THU 08:10 FAX 713 389 4e88 ST CR.X CO ZONING X1003 ST CROIX COUNTY SEPTIC TANK MAINTENANCB AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer l ayk i'J 4 Mailing Address Zmi I u t ST I M / 11 171 Property Address K ` (Veriflaetfon required from Planning Depa ant for new construction) , City/State Jo Parcel Identification Number LEGAL DESCRIPTION I Property Location n /,, '/., Sec. - . T .Lo -. N -R ZLW, Town of 'S l,A�g ._ Subdivision U)I + P aa�Ak Lot # . Certified Survey Map # . Volume • Page # .+ Warranty Deed # e<1 6 y , Volume /yS� Page # Spec house © yes ® no Lot lines identifiable 8 yes 0 no SYSTEM MAiNTENANCF Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the unction 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 a matter plumber, joumeymanmplumber, restricted plumber or a Ucensedpumper verifying that (1) the oa site wastowaterdisposal system is in proper operating condition. andlor (2) after saspocdon and pumping (if necessary), the septic tank is less than 1i3 fall of sludge. 'we the undersigned have read the above re ulrements and agree to maintain the � � 4 g* private sewage disposal system with the standards P set forth, herein, as set by the Department of Commnerce and the Department of Natural Resources, State of Wisconsin. CeTdfncatian stating that your #optic system has bees maintained must be completed and returned to the St. Croix County Zoning Offke within 30 of the three year a /noon date. SIGNATURE OF pl.VC AVT DATE OWNER IC, alON 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 e property described a e, by virtue of a warranty deed recorded in Register of Deeds Office. ' Sit3NATIIRE OF AITLICA 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 warmnty deed from the Register of Deeds office a copy of the certified survey map if reference is nmadc in the warranty deed /O Vol_ 1457PA;E 472 614647 y STATE BAR OF WISCONSIN Foit -U 1- 1998 KATHLEEN H. WALSH REGISTER OF DEEDS Dwument Ntimher WARRANTY DEED ST. CROIX CO., WI This Deed, made between—Pr Develogment. LLC RECEIVED FOR RECORD 09 -20 -1999 1:00 DM WARRANTY DEED EXEMPT t Grantor, conveys and warrants CERT COPY FEE: to Daniel J. Dynan and Pamela A. Dynan, husband and wife COPY FEE: 2.00 TRANSFER FEE: 360.00 RECORDING FEE: 10.00 PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (The "Property "): Recording Area Name and Retu Addre. s t3►E , (.� tt 5N o 030-1091 - 20-000 Parcel Identification Number (PIN) This is not homestead property. Lot 26, White Eagle, St. Croix County, Wisconsin. Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this ' 77 C" ? day of August, 1999. Preservation Development, LLC By AliTHENTICATION ACKNOWLEDGMENT Signa(ure(s) Preservation Development. LLC, by STATE OF WISCONSIN ) ) 55. County ) authenticated this _La_!� day of August, 1999. Personally came before me this day of Jute , 1999, the above named Wt to me known to be the Kristin Ogland person(s) who executed the foregoing iaurument and acknowledge the same. TITLE: MEMBER STATE BAR OF WISCONSIN (If not, _— authorized by § 706.06, Wis. Slats.) Notary Public, State of Wisconsin THIS INSTRUMENT WAS DRAFTED BY My Commission is permanent. (If not, state expiration date: Attorney Kristin Ogland ) Hudson, W154016 (Signatures may be authenticated or acknowledged. Both are rt. necessary.) *Names of persons signing in any capacity shouid be typed or printed below their signatures WARRANTY DEED STATE 3AA OF wtSCONSIY F(VLV No. 2 - nM{ INFORMATION PROFESSIONALS COMPANY FOND DU LAC, VA 600.6;5.2021 Y --_ . CERTIFICATE OF SURVEY LOT 26 , WHITE EAGLE GOLF CLUB TOWN OF ST. JOSEPH, ST. CROIX C WISCONSIN //�, OT jy T 0 0 ( 32 , : - c�1�,�c QO HSE GAR �o ca N83 '26' ;7 "W 70 � ti 112. L 26 < 198326 S.F_ p II m � 4.55 ACRES X a 20.0(1' .p W =83 °54'40" 4' L= 161.10' m N R- 110.00' �/� : Tt @ S87 °36'32 "W ` / rn Z rn 9 3 .19' 29 N14 "08'41 "W `.N 84 °0 '25" 9.00' CENTER LINE 12' -{ ' GOLF MART EASEMENT NORT LINE OF THE NE 1/4 OF THE SW 1/4 OF SECTION 31 a7 } N87'06'20"W 312 -20' 371, EAST LINE OF THE NW 1/4 OF THE SW 1/4 OF SECTION 31 LB3Em Q SET 1'' X 24" IRON PIPE (1.68 LBS /LIN. FT,) 0 SET 2" X 30" IRON PIPE (3.65 LgS /LIN. FT.) I HEREBY CERTIFY THAT THIS SURVEY WAS PREPARED 13Y ME OR UNDER MY DIRECT SUPERVISION AND THAT I AM A DULY REGISTERED LAND SURVEYOR UNDER THE LAWS OF THE STA OF WISCONSIN. < -�;;' "6y�� -- - /°~ = l CLARENCE E. SCHULTZ EG. NO. S-2031 DATE MLLCHEM WPA JMT landsoope architwturw sos s. aW n e ° -774091 Land adrrs� �+r�e 716 0 Ire"