Loading...
HomeMy WebLinkAbout040-1240-30-000 ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT ,- ON finer Property Address City/State Legal Description: : Lot Block -- Subdivision/CSM #��� , '/a ,0 '/4, Sec. �, T f( - Rj7_W, Town of IN -- ` = SEPTIC TANK -- DOSE CHAMBER -- HOLDI G TANK INFORMATION: Tank manufacturer L[)U ot� _ Size ST/P& / bCD Setback from: House oZ 7 Wel N P/L _ Pump manufacturer Model Alarm location (HOLDING TANKS O�Ib� Setbacks: Service road Vent to fresh air-intake` Water Line Meter location _ Alarm location SOIL ABSORP I3' ON SYSTEM Type of system: Width �_ Length 93 ' Number of Trenches Setback from: House �J,5_ Well P/L ),C)_ Vent to fresh air intake 6,2` ELEVATIONS Description of benchmark _ `Ta �� S�`�� ��- Elevation Sao Description of alternate benchmark Elevation Buildin g Sewer 3� ST/HT Inlet %07� ST Outlet PC Inlet 162 3 PC Bottom S 9t Header/Manifold /o ;z •) 6 Top of ST/PC Manhole Cover 1601 Distribution Lines () /4L 1 () ( ) Bottom of System () 1 6 1 , 1 7 () ( ) Final Grade () `d �, y () ( ) - I Date of installation Permit number 3 S" 31 SO State plan number a s C-) - T L S , Plumber's signature License number 2a Q 7 Date 1 / / Inspector TILI Complete plot plan i NOTICE Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to `center of septic tank manhole cover. t7 • Show alternate benchmark, if applicable. PLAN VIEW Q �. 0 ') INDICATE NORTH ARROW 1 r Wiscoil'sin Department of Commerce PRIVATE SEWAGE SYSTEM Count y Safety and Buildings Division INSPECTION REPORT St. C GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Persona+ information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). 353180 Permit Holder's Name: ❑ City ❑ Village [R Town of: State Plan ID No.: Town of Troy M Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: (� (' b Q Z 11 / 5 �/ 040 - 1240 -30 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic P 16 Benchmark Dosing 6 Alt. BM 1, Bldg. Sewe 0 eZ 13, Hold i �ii Ht Inlet 12. (z Z , ANK SETBACK INFORMATION TANK TO P/ L WELL BLDG. Ven to ROAD Air Intake Septic ± ZU Z ,' �' NA Dt Bottom y G Dosing Z-3 A,14 3 � / NA Header/ Man. A Dist. Pipe ItXe,� �� I 82. r0 I ng _ Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer LD emand St cover Model Number U � � � GPM DH Lift \J,� Lriction Q. System 2. TD 1 , t / 1 , orcemain Lengtheo Dia 3 r� Dist. To Well , SOIL A RPTION SYSTEM BED(/ TREN Width r Leng a No.O T nches PIT No. Of Pits Inside Dia. Liquid Depth DIM I _ DIMENSION S SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING manufa . INFORMATION Type Of CHAMBER OR UNIT Moe Number: System: Aq DISTRIBUTION SYSTEM Header / M 'fold Distribution Pipe(s)l x Hole Size x Hole Spacing Vent To Air Intake Lengt Dia. Length Lx_: Dia. I 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/Tr nch Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS (Include code discrepancies, persons present, etc.) Inspection #1:jL //y /? Inspection #2: 1Z./K79 Location: 5n 1, Country k Oaks Lane, /1 River Falls, WI (SE 1 /4, S 4 a n 21 T Q N- 19W) - 21.28.19.1221 /f (f 9 ,-f c�cSCr; > _ `/ rJ (,`� `� . J / Novi! , Gx�e✓ wc�d - os- -6�dQ� w••o. , a�J fur - 35" Wrjj V- (6w`� Plan revlslo U Yes No Use other side for additional information. W M �[, SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. r � Safety and Buildings Division N*Isconsi SANITARY PERMIT CATION - -, 201 W. Washington Avenue In accord with ILHR 83- 0,5i1,Wis,,Adm Code \ P O Box 7302 Department of Commerce j Madison, WI 53707 -7302 II r ,. -r • Attach complete plans (to the county copy only) for the system, on paper` r4bitles couR 112 x 11 inches r . than 8 ches in size. • See reverse side for instructions for completing this a ll ati.Qn state anitary PPermitI� El er 1 ENO /k ° •,l Personal information you provide may be used for secondary purposes t . �p OUNty G eck if revision to previous application (Privacy Law, s. 15.04 (1) (m)]. N/NG OF�ICE St a Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL I TI a-S O '71 Property Ow er Na et, P10 � j L on p n v4, S T a g, N, R 1 g E (or)© Property Owner's Mailing Address Lot Numb Block Nuglber 5 { o�U City, St at Zip Cod Phone Number SuVisi n Name or CSM N be II. TYPI DING: (check one) ❑ State Owned it � ea rest Road ❑ Vil age El Public 1 or 2 Family Dwelling - No. of bedrooms own of tb III. BUILDIN SE: (if building type is public, check all that apply) Parcel Tax Number(s) 1 Apartment/ Condo 1 0 4 4 O — i 0_ 3 000 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 ________ 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 KMound ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure ❑ Pit Privy 13 ❑ Seepage Pit � x Q3 ` ❑ Vault Privy 14 S S ystem-In-Fill ❑ Yste 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 (s ft.) (Gals/da /sq. ft.) (Min. /inch) Elevati n s 1 -.V Feet �� .� Feet acit VII. TANK in Cap acity PI Total # of Prefab. Site Fiber- Plastic Ex per INFORMATION Gallons Tanks Manufacturer's Name Concrete con- steel glass a ` P App. New Exist in strutted Tanks Tanks Septic Tan r� Qi!T rQSQ /S ❑ ❑ ❑ ❑ 11 i PumpTa /Smp,e+rEh> im O ❑ 1 ❑ 1 ❑ ❑ ❑ SPONSIBILITY STATEMENT I, the undersigned, assume responsibility for i alla on of the onsite sewage system shown on the attached plans. Plumber's Name: (P ) I Plu�ker's Sig ature: St mps) MP /MPRSW No.: Bu�s Phone Number: I rs 5 L Plumber's Address (Street, City State, Zip Code): IqL0 - Lo W -5 al IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater P e Isu n Agent Signat e ( o Stamps) �IApproved ❑ surcharge Fee) j � �� / ° Owner Given Initial ,I k Adverse Determination X.'CONDIT�O S NS OF APP OVAL /_REAS FOR DISAPPROVAL: �..- = n v -- i+ , - 0_&_ll, p, t 46 dt4t4 A mod[ glen T SBD- 6398 (R.11197) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber Safety and Buildings 2226 ROSE ST LA CROSSE WI 54603 -1905 TDD #: (608) 264 -8777 hsconsin www.commerce.stateml.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary October 08, 1999 CUST ID No.273085 ATTN.• POWTS INSPECTOR CALVIN POWERS ZONING OFFICE POWERS EXCAVATING INC ST CROIX COUNTY SPIA 1969 185TH AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 10/08/2001 Identificati S Transaction ED o. 250718 Site ID No. 510 SITE• Please refer to both identification numbers,` Site ID: 5107 above, in all correspondence with the agency. St. Croix County, Town of Troy SETA, SE1 /4, S21, T28N, R19W Subdivision: 1" Addition to Country Oaks - lot 20 Facility: Derrick Construction, Inc. FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 494443 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 /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, DATE RECEIVED 09/30/1999 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 erard M. Swim BALANCE DUE $ 0.00 POWTS Plan Reviewer - Integrated Services (608)- 785 -9348, Mon. - Fri. 7:15 AM to 4:00 PM jswim @commerce.state.wi.us Wi8NT2�," N viiAPPLICATION FOR REVIEW -Com all a es- P cons�n -Co p ages- Department of Commerce Safety & Buildings Division This page may be utilized for fax appointment requests Bureau of Integrated Services Complete and indicate date plans will be In our office NOTE: Personal information you provide may be used for secondary Complete for confirmed appointments *• purposes (Privacy Law s. 15.04(1)(m)]. Not available for POWTS at this time. . 1. Private Sewage Submittal 2. Type of Submittal: System Type Transaction ID: Groundwater Monitoring ew ( ) 9 ( ) Replacement Previous Related Trans. ID: ( Site Evaluation ( POWTS System ( ) Petition (attach form SBD -9890) Appointment Date *: ( ) At Grade ( ) Experimental Review ( ) E Assigned Reviewer: Holding Tank ( ) Engineered System ( ) Nonpressureized In- Assigned Office: Ground- conventional *Plans must be received in the office of the appointment no later than ( ) Pressurized In- 2 working days before the confirmed appointment. Ground Mound 3. Project Site Information - Fill in all known information. ( ( Aerobic System Site Number ( ) Sand Filter Number & Street: d ( -) Constructed Wetland Legal Description �_ �_) county r� ( ) Other: ` ( City ) Village ( ) Town of Gallons per Day: Facility Name: (individual and /or business name of project) Building Type (check one): �; ��; eo Dwelling, 1 or 2 family ( ) Public Building Facility Add ss: ( proiect a ressl fl Zip Code ( ) State -owned Building f ScZS u'Y ((oo�� O f3o)C N� � n\on( 11 S d I 4. After plans are reviewed, please: (check all that apply) _ Call when completed. Mail plans to custome , 3, 4 Requesting party will pick up Circle customer number from below. Other: 5. Complete the following designer /owner /requesting information. Utilize the check boxes when designer, owner or requesting party is the same to avoid repeating information. e.':d e�gci�slpngPartj�if,dlffer`dr`tt thairi:aesi rre`r$(Cast�r'r�er*3 First Name Last Name Customer Number First Name Last Name Customer Number L Company Name Company Name A dress Address �S S`th v City State Zip +4 (9digits) City State Zip +4 (9digits) Phone Number (area code) Fax or Internet Phone Number (area code) Fax or Internet `I l5- Check others if applicable Check others if applicable ( Owner ( ) Payer ( )6 Requesting party ( ) Owner ( ) Payer O.; _ ,.w hfo µ First Name Last Name Customer Number First Name Last Name Customer Number Company Name Company Name RECEIVES Address Address SEP 2 9 1999 City State Zip +4 (9digits) City State Zip +4 (9digits) Phone Number (area code) Fax or Internet Phone Number (area code) Fax or Intemet Check others if applicable Check others if applicable ( ) Payer ( ) Payer ( ) Other MAKE CHECKS PAYABLE TO DEPT OF COMMERCE TOTAL AMOUNT DUE $ Attach check here Review Code 7633 SBD -10577 (R.10/98) L I 6. Calculation of Fees Required (circle all that apply.) System Type (Include new and existing tanks) Up to 5,000 gallon holding tank ............................ .........................$60.00 ................................ ............................... 5,001 10,000 gallon holding tank .............:............ ........................$100.00 ................................ ............................... Over 10,000 gallon holding tank .................... ..............................$ 150. 00................................. ............................... Upto 1,500 gallon septic tank ..................... ............................... $110.00 ................................. ............................... ho' 1,501- 2,500 gallon septic tank ..................... ............................... $120.00 ................................ ............................... 2,501- 5,000 gallon septic tank ..................... ............................... $ 160. 00................................ ............................... 5,001- 9,000 gallon septic tank ..................... ............................... $200.00 ................................ ............................... 9,001- 15,000 gallon septic tank ..................... ............................... $300.00 ................................ ............................... Over 15,000 gallon septic tank ...................... ............................... $500.00 ................................ ............................... Up to 1,000 gallon dose chamber ....................... .....................:...$70.00 ................................ ............................... 1,000- 2.000 gallon dose chamber ....................... .........................$80.00 ................................ ............................... 2,001- 4,000 gallon dose chamber ...................... ........................$100.00 ................................ ............................... 4,001- 8,000 gallon dose chamber ...................... ........................$120.00 ................................ ............................... 8,001- 12,000 gallon dose chamber ...................... ........................$140.00 ................................ ............................... Over 12,000 gallon dose chamber ...................... ........................$160.00 ................................ ............................... Experimental System (additional one time fee) ........... ........................$300.00 ................................ ............................... Revisions Approved Plan .......... ........................:...... .........................$60.00 ................................ ............................... Petitions for Variance Setback ............................ ........................$100.00 ................................ ............................... (Include Form Site Evaluation ................. ........................$225.00 ................................ ............................... SBD -9890) Plumbing .................... ..............................$ 225. 00................................ ............................... Revision...................... ............................... $75.00 ................................ ............................... Groundwater Monitoring - Per Site ......................................................... .... .................... ............................... (other than a proposed subdivision) Site Evaluation in Lieu of Groundwater Monitoring ........ .........................$60.00 ................................ ............................... Subtotal ..... ............................... Priority Review: Enter same amount as subtotal ..... ............................... Prior approval from a section chief is required for a priority review. If approval is granted, the priority will be reviewed within 5 days of receipt. Enter TOTAL here and on bottom of FRONT PAGE $ lo-� Note: Fees for aerobic or prepackaged treatment systems that may include trash tanks shall be calculated based on the rated capacity of the aerobic unit or prepackaged treatment system as compared to an equivalent septic tank size. Note: Fees are pursuant to ch. Comm 2 and are subject to change annually; please contact any of the offices listed below for the most recent copy of this form. Note: Comm 2 provides for a partial fee refund if a plan action has not been taken within the 15 days of receipt of all required information. 7. Appointment, Scheduling Information, and Plan Submittal Checklists. At this point in time appointment options for POWTS scheduling is not available. If you wish to schedule a review appointment in advance, call any of the full service offices. At the time of making an appointment, you may request review fqr a specific office or desired (beginning) date for review. You may also FAX the front page of this application and receive a FAX back'with an Appointment Date, Transaction ID No. and Assigned Reviewer. Plans must be received in the office of the appointment no later than 2 working days before the confirmed appointment Non - scheduled submittals or submittals received without a confirmed appointment date and transaction number on the form may be assigned to offices other than the receiving office depending on reviewer availability. To obtain a submittal checklict call the material order unit at 608- 266 -1818 or one of the full service offices listed below Madison S &BD Hayward S & BD LaCrosse S &BD. Shawano S &BD Green Bay S &BD Waukesha S &BD 201 W Washington Ave 15837 USH 63 2226 Rose St 1340 E Green Bay 2331 San Luis Place 401 Pilot Court PO Box 7162 Hayward W154843 LaCrosse W154603 Shawano WI 54166 Green Bay, WI 54304 Waukesha WI 53188 Madison Wl 53707 -7162 608 - 266 -3151 715 - 634 -4870 608 - 785 -9334 715 - 524 -3626 920 -492 -5601 414 - 548 -8600 Fax: 261-6699 Fax: 715-634-5150 Fax: 608-785-9330 Fax: 715 -524 -3633 FAX: 920 -492 -5604 Fax: 414-548-8614 TDD 608- 264 -8777 Email: haywardsch@ Email: lacrossesch@ Email: shawanosch@ Email: greenbaysch@ Email: waukeshasch@ Email: madisonsch@ commerce.state.wi.us commerce.state.wi.us commerce.state.wi.us commerce.state.wi.us commerce.state.wi.us commerce.state.wi.us PAGE /kOF� MOUND SYSTEM FOR A 3 BEDROOM RESIDENCE LOCATED IN THE 1 /40F THE 1 /40F SECTION�l ,T,,l N,R LW, TOWN OF ro COUNTY, WISCONSIN. Ldr ad t INDEX PAGE 1A OF 9 TITLE SHEET PAGE 1 OF 9 WORK SHEET PAGE 2 OF 9 WORK SHEET PAGE 3 OF 9 WORKSHEET PAGE 4 OF 9 WORK SHEET PAGE 5 OF 9 PLOT PLAN PAGE 6 OF 9 PLANVIEW CROSS SECTION PAGE 7 OF 9 DISTRIBUTION PIPE LAYOUT PAGE 8 OF 9 PUMP CHAMBER PAGE 9 OF 9 PUMP PERFORMANCE CURVE PREPARED FOR SOS P b & O x A N j_� A o ,j 6lx s `f o' 7 PREPARED BY P WE SEX A TIN C pr , dittos ally a aD s3 7 $ � ► �9,N yl! E N� SA j A 1969 185th AVE N pENC4= NEW RICHMOND, WISC. 54017 SEE CORRE 715- 246 -5135 WORKSHEET - MOUND SYSTEM DESIGN Des mound system for a ,1)c s:;i,e characteristics are. ucpth to groundwater or bedrock in. Landslope % �d Percolation rate �r��L� Distance from dose chamber to distribution system 6 ft. Elevation difference between pump and distribution system ft. Stcp 1. WASTEWATER LOAD co Y"` gal.' Stcp 2, SIZE THE ABSORPTION AREA A) Area required �J �' a X 7-5 sq. ft. B) Bed or trench length (B) = 3 70 C) Bed or trench width (A) a ft. f -D) Trench spicing Wastewat load .24 coal /ft /day B ft. Step 3. MOUND HEIGHT A) Fill depth (D) Q f ft, B) Fill depth (E) = D + slope (AJf�� i �. ft. 1 C) Bed or trench depth (F) _ 0 23 ft. D) Cap and topsoil depth (G):-, ft. E) Cap and topsoil depth'(H) _ ft. Step 4. MOUND LENGTH I A) End slope (K) _ (D + E l + F + H x 3 = � �. 05 ft. \fir/ J B) Total mound le c( {L = B + 2(K) _ 1 J 3 • ft. - 75- �io� /l3, 8s Step 5. MOUND WIDTH Al) Upslope correction factor M A2) Upslope width (J) n (D + F + G)(3)(factor) _ ft. DA3X s B1) Downslope correction factor B2) Downslope width (1) _ (E + F # G)(3)(factor) = ftl� Cl) Total mound width (W) for bed = J + A + I _ ft. C2) Total mound width (W) for trenches <<, J + + (no. trenches -1)(c) + A + I _ ft. S3+ a Step 6. BASAL AREA A) Infiltrative capacity of natural soil = 3 gal. /ft /day .,w i B) Basal area re q uired = wastewater f natural soil infiltrative. cdpacity�R sq. ft. Cl) Basal area available for.bed for sloping sites = B x (A + I) _ sq.. ft. P C2) Bas are avail le for trench' " for' sloping sites = C. 15 C3) Basal area available for "trench or bed for level sites = B x W = sq, ft. Sign: _ Lironse Vu: �?b��7_ Data: � i Step - DISTRIBUTION SYSTEM 7A) SIZE DISTRIBUTION SYSTEM 1) Hole size = in. I's 2) Hole spacing . 3 & . in. 3) Distribution pipe length in. 4) Distribution pipe diameter =_ in. I , 5) Spacing between distribution.pipes ■ in. 6) Distance from sidewall to 'distribution pipe = in. 7B) DISTRIBUTION PIPE DISCHARGE RATE ft. 1) Number of holes per pipe 1G' 2) Flow per pipe __L GPM. 7C) SIZE MANIFOLD 1) Manifold is central/ .�._.. end 2) Manifold length a'O 3,� _ ft. • 3) Number of distribution Ines a a 4) Manifold diameter 3 in. 7D) SIZE FORCE MAIN 1) Minimum dosing rate A _ 8 GPM 2) Force main diameter �00 .y� ,3 in. �� 3 3) Friction loss = 3 - & � o o, +• ft. I 7E) TOTAL DYNAMIC HEAD 1) Vertical liffR' N ft. 2) Friction loss = ft. 3) System head 2.5 ft. ,= a, ft. 4) Total dynamic head s �a� ft. { .i,i.cerse. ,ZaO53 2 of NP4 7F) PUMP SELECTION b Cam^ , /9 1) Pump selected will discharge GPM at ,� ft. total dynamic head. 2) Pump model and manufacturer �2-5 Q 3)1 L P 7G) DOSE VOLUME g5 / -r 1 0 T 0. ^ - 1) 10 times void volume of distributidn lines R . gal. /cycle 2) Daily wastewater volume 4 4 doses /24 hrs. // gal. /cycle 3) Minimum dose volume _ gal. /cycle �r0 ,349 7H) DOSE CHAMBER 1) Minimum capacity required Ucvn s c ..u:_ � - Z o S g 3L Date: i v i f i pec�l� c- .. }__�v.�����;�,.�.� �_Z, _ _ �_ S � �� _� � _�q� S 1a(I T �N �'�4 Clro�,yc I _ � s , ` . _�, c�utT' _- I - - -- — -- - j'_ � _! . � . gar' `� 1 � `iOCt� rte/ i a C . S .a.b cc og - I 1 a I I I I _ I 1 I I - - -- - - _ — - - -- - - -- - - - t 1 I 1 � I I � I ! d - ! i � f 1 I ' I I I ! i I t 4 I 1 f_ i 1 - I -- . . 1 ��5� i � � 4� Page Straw, Morsh Hay, Or ' Synthotic Covering r Distribution Pipe Medium Sand N R , c . Topoll- %Slope • Bed Of ? 2 %? Force Main Plowed . Aggregate Layer D��_ Ft. Cross Soction Of A Mound System Using • E /, 01 Ft. ' �A Bed For The Absorption Area F .�. Ft. & 1_ -- Ft . A � Ft. N 1'-5 Ft. 9ned: !3 'SFt. cense Number: © -s3 K !a- °S Ft. - i s - 99 . L rr3 Ft te: 9 Ft. ;.: Position I . Ft. of W L, 3 Ft. Force Main _ — — ._:.•. Observation Pipe—, Distribution. e Of z 2 %2 Pipe Aggregate Observation Pipe Permanent Markers Plan View.Of Mound Using A tip For The Absorption Area i E page' C Perforated Pipe 041011 n End Vhw End Cap ) P PVC i PV � C -,Pi • P Notes Lowed On Bottom, yott . Ate f Y SpaCed EP�C� A,S 604-1,61) I Lail Hofi Shou1'd Be Hatt To End Cap Dittribuliora Pipo Layout P 5 Ft. �. X Inches Y Inches Signed: _ Flolc Diameter _,V-e Inch License Number: Lateral= lZ" G L IA t 11( s) Date: 'Manifold " _••3 • Inches, R -- � 5 - 9 I / Force Main ._3 Inclt�js N of holes /pipe Invert Elevation of Laterals,Le�Ft. ' SEPTIC TANK &• CHAMBE CROSS SECTION AND SPECIFICATIONS (� � . . P 4" CI VENT PIPE 12" MIN. ABOVE GRADE S WEATHER PROOF' 25,' FROM. DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT MANHOLE COVER W/ PADLOCK >; FINISHED GRADE 4 Cl RISER' WARNING LABEL 6 MIN. ABOVE G AD E -4 MIN 18. IN. 6 MAX. INLET • I ; WATER TIGHT SEALS GAS - L F GHT ' 4" BAFFLE AL APPROVED PIPE ALM JOINTS W/ CI 3I ONTO I ON PIPE 3' ONTO SOLID I . SOLID SOIL SOIL �c�b RISER EXIT PUMP OFF ELEV . 9I,� FT. OA PERMITTED ONLY IF.TANK . MANUFACTURER HAS APPROVAL 3 APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE TANK MANUFACTURER: W QLs NUMBER 'DOSES PER DAY: TAN SIZES SEPTIC lavO GAL. DOSE .VOLUME INCLUDING DOSE Ipw;� GAL. FLOWBACK:. �3� GAL. ALARM MANUFACTURER: C� t �L�e�a•r , CAPACITIES: A = A INCHES = GAL. . MODEL NUMBER: lol Ff SWITCH TYPE: B = 2 INCHES = - Z GAL. PUMP MANUFACTURER: C = t.3 INCHES = GAL. MODEL NUMBER: V3 �P D %'_ INCHES = fot�1'� GAL. SWITCH TYPE: -f- _ REQUIRED DISCHARGE RATE .SD GPM PUMP 6 ALARM WIRING AS PER ILHR 16. 23 WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE �� FEET + MINIMUM NETWORK SUPPLY PRES RE �. FEET + &C) FEET FORCEMAIN X �FT /100 FT. FACTOR' — 3 FEET u• T.OTAL DYNAMIC' HEAD = !jj - FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH- ; WIDTH ; DIAMETER.,_= LIQUID 1D==' SIGNED: LICENSE, NUMBER: aa0537 DATE: � �/ o �erC , :ck 0. ( %1k t\ ,,. T V*_> Goulds Submersible Effluent Pump 3885 APPLICATIONS • Overload protection must smooth operation Silicon can be operated continuously S ecificail desi ned for the be provided in starter unit: bronze impeller available as without damage. p y g • Shaft: threaded, 400 series an option. following uses: stainless steel. .aye R m Bearings: Upper and Homes ■ Casing: Cast iron volute lower heavy duty ball bearing Farms •Bearings: ball bearings type for maximum efficiency. construction. upper and lower. 2" NPT discharge adaptable ■ Power Cable: Severe du • Trailer courts � � • Motels • Power cord: 20 foot for slide rail systems. rated, oil and water resistant. • Schools standard length (optional m Mechanical Seal: SILICON Epoxy seal on motor end lengths available). • Hospitals Single phase: CARBIDE VS. SILICON provides secondary moisture Industry CARBIDE sealing faces. barrier in case of outer jacket •'/3 and % HP —16/3 SJTO • Effluent systems Stainless steel metal parts,. damage and to prevent oil with 115 V or 230 V three BUNA -N elastomers. wicking. prong plug. SPECIFICATIONS • % -1'Y2 HP —14/3 STO with ! Shaft: Corrosion - resistant ■ 0 -ring: Assures positive Pump bare leads. stainless steel. Threaded sealing against contaminants • Solids handling capabilities: Three phase: design. Locknut on three and oil leakage. W maximum. •'/2 -1'/2 HP —14/4 STO phase models to guard • Discharge size: 2" NPT. with bare leads. On CSA against component damage AGENCY LISTINGS • Capacities: up to 128 GPM. listed models — 20 foot on accidental reverse rotation. p len length SJTW and STW ■ Motor. Full submerged In SP Canadian Standards Association • Total heads: up to 123 feet g y g TDH. are standard. high -grade turbine oil for • Mechanical seal: silicon lubrication and efficient heat U� Underwriters Laboratories carbide -rotary seat/silicon FEATURES transfer. carbide- stationary seat, 300 ■ Designed for Continuous series stainless steel metal •impeller: Cast iron, semi- Operation: Pump ratings are open, non -clog with pump - parts, BUNA -N elastomers. within the motor manufacturers • Temperature: out vanes for mechanical seal recommended working limits, 104 °F (40 °C) continuous protection. Balanced for 140 °F (60 °C) intermittent. METERS FEET , • Fasteners: 300 series 90 stainless steel — SERIES: SOLI • Capable of running dry., 25 eo 1 R 1 � . RPM: AR IOUS without damage to - 5�"" — components. 70 Ei 6FT 20- — — Motor so — Single phase: _ Eo • % HP, 115 V, 200 V, 230 V, '15 50 60 Hz, 1750 RPM; Y HP,. z 115 V, 60 Hz, 3500 RPM; 0 40 E0 H '/ HP — 1'/2 HP, 230 V, 60 Hz, 3500 RPM. ° 10 30 i — • Built -in overload with. 2 0 w EO3L " automatic reset. 5 • Class B insulation. :10 Three phase: • '/2 HP — 1'/2 HP 200/230/ OL o 460 V, 60 Hz, 3500 RPM. 0 10 20 30 40 50 70 so 90 too 110 120 130GPM • Class B insulation. 0 10 20 30 W/h CAPACITY ®1995 Goulds Pumps Effective May, 1995 83885 0(;T. -20' 97(M0N) 09:41 EDINA REALTY RIVER F TEL:7 425 0331 P. 010 wlsFarss ume, Industry Labor an SOIL AND SITE EVALUATION d Hume.. I�eietlons Pegs , of Dlvlslon of Safety and Buildings In accordance with s. ILHA 83.09, Wis. Alinch complete mile plan on paper not toss hrnn 8 1/2 x I 1 Inches in size. Pion must County Include, but not finlled to: vertical and horizontal reference point (am), direction and ST. GP-0 1 k percent elope. scale or dimensions, north arrow, and locallon and distance to nearest coed. Parcel I.D. M APPLICA14T INFORMATION - Please print elf information. nevlewed by Date Personal Information you provide mnyr be•uaed for secer purimses (Privacy Low. m. iS.ee (1) (m)). property prosier Property location _l IrWREAV GE _ W- /M f/RP/q y CP.t�r.��/e Govt. Lot S'E 1/4 sF 114,S t! T W ,N,R E (or)o Property Owner's Metling Address lot Blockm Subd. Name or CSMm w 93oZ 600 '�1 Auk'- 2 p it A - rte - !c�4.r,Py oA.f -s city Slate Zip Code Phone Number P_ F A 1( W t. $ a a Nearest Rasa Ri ve �..,/ Addition to exlsUng building ('7/S ) {��$ - 9a32 'Q Cit Q vina 0 c vrr oy o.�,rs t v . 0 New Construction Use: nestdentlal / Number of bedrooms 3 +� 4 0111P - X0.0 T P��jyi T $ AO 0 nepiacemenl Q Public or commercial • Describe: 6 fW ` .VO r (ems fGUI.tiF�t�DX yso - Code derived dolly flow - fie - god Recommended design loading rate ±/J bed. gpd/11 t 3 trench. gpd/it Absorption area required bad, fl 7 Iraneh, f1 Maximum design loading rate bed, gpd/it _ 1_3 (carton, gpdAt Recommended In fil tration surface ele va tlon(s) - _=L,EA' e q m -3 It (as referred to site plan benchark) Addition /cite atfons T/PL- .t -IeZ 7 — /f�ou r✓v S`STE•t -( Parent material !.L.�� BZ �rxu` ifS "� cif - �.ar- StoivE ✓7 N _cyW- JVC.AL,V_ t /-- __ t, Flood Plain elevation, if applicable rt S - Suitable for system I Conventional Mound In- around Pressur AT System M R Holding Tank U Unsuitable for system �} S Q�U Q S Q U Q g � Q g Q g 1 6 CC SOIL DESCRIPT R EPORT Bating N Horizon Depth Dominnnl Color Mottles Texture Structure Consistence boundary Roots O D In. Munsell Ou, Sz. Cant. Color Or. Sz. Sh. Bad Tench utev. Ground 3 _ �o Y e e 3 f / 141st' S�1.t .t•,,f�p c4! / 7` — elev. G - J --f-- � . y 7 SY lr_1�c �:xB y�� ScL p, 4111 �,•��- � �. �, . ,� Depth to timilGtg , lactor y S.S. Remarks: /�E,P/`Ji;rni' /, y/ �i Es7 GT /vim S AT 3C;I- •• ' Boting R [ 0 - S Qtound - -F I F err /Sn� �' N 1 5 N x. --ma ys5 Depth to limiting 3_ _ : fac tor , P�P.y r �L t _ r►. Remarks: , il'/,S /'L / T� �'L % ".o A.) S /f-T CST Name (Please Print) ' Slgnalurs ROf3t =R T Z1 LQR 1'C �-/ 7-, Telephone No / Address 7i5716 386 - 8 f35 Date CST Number 7Co CST�N 2 S/e Z Private 8ewege Consultants - e56 O'Nall Rd, lludson, Wis. 64018 Perm /ta Bet o ro !Deal z /ng 77-!13 pan be granted . RBOUi ROJECT WILL PLAN ESTg7'E LEVEL w P ill need ROYAL Plana Dy c oed be submitted qualified designer Pcr 1.L.1-l.R. 93.00 (a) � : • it OCT. j UN) 09:41 EDINA REALTY RIVER F TEL:715 425 0331 P. 011 PROP[RTY OWNER SOIL DESCRIPTION REPORT Page Z of � PARCEL- 1.0.0 L D f' Z p- cov .►.T.er U Boring A • Horizon Depth Dominant Color Mollies Structure 2 Texture Consistence iftunddary Root s Bed . Trench In. Munsell Ou. Sz. Cont. Color Or. St. Sh. • S- -� 2 � o YIP - S. / z S Clround 3 f:�1 i O yIe J/ � S. • 2 , " ,b,r W • S else. — Depth to z- IIm11Mg Inctor 1n. Remarks: _!Sr S.S'• t. ��i�i`fii173i/ Y� �EST�% e?'io u s �T sjo Boring A � - _ L9round elev. Depth to ,! limiting Inctor Remarks: Fiorizon Depth Oominnnl Color Mottles Texture Structure Consistence Boundary Roots t in. Munsell Ou. St. Cont. Color Or• St. Sh. Bed , Trench B oring A i Ground ele - - -- Orptll to - Ilmiling factor Irk• Remarks: Boring M Ground else. t1. Depth to limiting factor In. , Remarks: SBOW -9330 (q 0g/g5) I • t. ti OCT. z20 I 97 (MO,N) 09:42 ED I NA REALTY RI F TEL: 7' 4 . 425 0331 P. 012 '/3M. Fo�.w p 7 of SvpvEyoip s a rP .tT t 17,3 N -o 4 c� H m cn i R t � b -� ILA tai Z C � I -lo OCT.- 20'97(MON) 09:42 EDINA REALTY RIVER F TEL:7 425 0331 P. 013 .. j' �]I..BRICHZ' & ASSOCIATES CQ. - - 655 O'Neil Road •Hudson. W1 5416 R•g. beslgnerse/EnglnssAngSya/ems 715- 386 -8185 Prlvafs Sewage Cansulfan/s SPECIAL NOTES TO T13E BUYERS/ BUILDERS, REGARDING SEPTIC SYSTEMS AND SOIL TESTING ON LOTS *8 THROUGH 20 IN COUNTRY OAKS. All of the lots evaluated will require mound type septic systems. With only a few exceptions, the soils across the 1st Addition to Country Oaks had very fine weak textured silt loam in the upper 12" of topsoil (a soil loading rate o£ .3 GPD /ft2). These low soil loading rates will require larger trench type mound systems by design codes. Trenches can be no wider than 48 ". It is suggested, to the installer, if a 4 bedrm. home is proposed, some test areas provided may not be long enough for a single 4`x125' trench, in which case a wider mound utilizing two tenches 4'x 63• may be more suitable. CAUTION: since all of the soil test sites are very heavily wooded, extra careful planning and site preparation is required. Great cars will need to be taken in removing trees and brush without disturbing the fine delicate silt loam topsoil. If the site is carelessly disturbed, the Zoning Dept. will reject the site and require costly new testing and designing! Do not allow anyone to drive across or compact or distuyb the topsoil. Consult with the Zoning Dept. Inspectors, a qualified plumber, or designer for advice on how to properly prepare the site for mound system construction. The Owners /developers have provided a complete approved soil test area, registered with the zoning office as required by subdivision ordinances. It is difficult to imagine today where a future buyer prefers to build upon a lot. Common sense is used to select a site at this point. If the buyer intends to utilize the test area, careful planning between the owner and septic plumber (or designer) is very important. Careful planning with qualified designers/ installers is critical. THe final actual size and shape and location of the septic system is dependent on the size and type of home proposed. Test areas large enough for a 3 -4 bedroom home has been provided, but a larger home may require new of additional soil testing. The septic system can not be shifted outside of the recorded teat area. i pg. 4 of 4. J I Wisconsin Department of Industry SOIL AND SITE EVALUATION �-.. Labor and Human Relations �~- t of Division of safety and Buildings in accordance with s. ILHR 83.09, Wis. Attach complete site plan on paper not less than 8 1/2 x 11 Inches in size. Plan must County 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 1. 7 , APPLICANT INFORMATION - Please print all information. R wed C ;_) ;U aTY Personal Information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ' � G OF�WCE Property Owner Property Location L , f wRE C� IV M ANI ) (AfRrti ,-,e) Govt. Lot SE 114 1/4,S � Z ,R 1 9 E (orXP Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 6v 9302- 6o0 7 4m 20 /s: �9oo�T.r - �ovur,Py 04X'5 City State Zip Code Phone Number ,�,� Nearest Road R 1( � �h115 W 1, 54 o , 2Z ('�/5 9032- El city ❑ village U ►own Z N T y l53N ew Construction 3 to N = �✓ N � NO T Use: Residential !Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Nlk r. VOT Code derived daily now (Poo gpd Recommended design loading rate bed, gpd/it 2 3 trench, gpd/ft Absorption area required bed, tt trench, tt2 Maximum design loading rate 2bed, gpd/fi ' 3 trench, gpd/ft Recommended infiltration surface elevations 5E� ,3 () � tt (as referred to site plan benchmark) Additional design /site co ations SITE ,t°� .0 /,f T/ T---f-( B2 '1ioru � 4s �vTiit t'r�- S�'c�- seo�,_.e q l Parent material � N /f�r1aiLS�. -f _ Flood plain elevation, if applicable (t S = Suitable for system Conventional Mound In- Ground Pre AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ S [] I�S ❑ U ❑ S ❑ S M 1 ❑ S 0-15' ❑ S ["U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 In. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench D - 7 /oy 3 /a- - - si/ / VCS i Ground 3 elev. 99.7 k _tt. 7,s y s c� Depth to limiting factor SSS. Remarks: /�fkl / >f13i' /i /� .� / l�>Es7� S AT' 3 Boring # 1 L` 0- S lo y�P 3 /� S� / ! s//.\ /irr �� Is y L -10 313 S / / r` s6,c` �►if' s �'� ; , 3 -3 D 3/ Ground elev. 2 5 ft. 55.5 Depth to limiting factor P P��fi� �� �'rr/ tfeSTe1?'r o,� S + 3 �. min. Remarks: CST Name (Please Print) ROBERT . 0 (- Signature 17 Telephone No. aRlc��- 715=386 -e? 1635 Address Date CST Number Y& 0S7 "LI 2 1� Z Private Sewage Consultants 855 O'Neil Rd. Hudson, Wis. 64016 PROPERTY OWNER SOIL DESCRIPTION REPORT _ Page � of PARCEL I.D.11 �OO w7 - Xr Boring Horizon Depth Dominant Color Mottles Texture Consistence Boundary Roots 9 Structure 2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench Al 3' ► � /oy 3 /a Si/ 1 2 2 - /0 3 / 7 3 S. /. Zf s Ground elev. 3 ft. 7, S y f I f $CL 0, ti,•t irre ti N Depth to �Dy �. limiting factor In. ; Remarks: S s.,s. ��ifi //� EST %G /'lo -v,� �T ,3f •� Boring # Ground elev. , tt. 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 # F, Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SODW -8330 (R. 08195) I I I J �3M j1�'ou�c• o : Tod o� Sv�pvFr�,p s a .rP ,fT S X07 �oF� /OD• a� 0 X73 �O r o � ?6 •C Z m � q w � m i rt y � y y `" 0 �♦ ♦ O y � ULBRICHT & ASSOCIATES CO. 655 O'Neil Road - Hudson, WI 54016 Reg. Designers of Engineering Systems 715- 386 -8185 Private Sewage Consultants SPECIAL NOTES TO THE BUYERS/ BUILDERS, REGARDING SEPTIC SYSTEMS AND SOIL TESTING ON LOTS #8 THROUGH 20 IN COUNTRY OAKS. All of the lots evaluated will require mound type septic systems. With only a few exceptions, the soils across the 1st Addition to Country Oaks had very fine weak textured silt loam in the upper 12" of topsoil (a soil loading rate of .3 GPD /ft2). These low soil loadin g 9 g rates will require larger trench type mound systems b design codes. Trenches can be n Y Y g o wider than 48 ". It is suggested, to the installer, if a 4 bedrm. home is proposed, some test areas provided may not be lonb enough for a single 4 trench, in which case a wider mound utilizing two tenches 4 63 may be more suitable. CAUTION: since all of the soil test sites are very heavily wooded, extra careful planning and site preparation is required. Great care will need to be taken in removing trees and brush without disturbing the fine delicate silt loam topsoil. If the site is carelessly disturbed, the Zoning Dept. will reject the site and require costly new testing and designing! Do not allow anyone to drive across or compact or distuyb the topsoil. Consult with the Zoning Dept. Inspectors, a qualified plumber, or designer for advice on how to properly prepare the site for mound system construction. The owners /developers have provided a complete approved soil test area, registered with the zoning office as required by subdivision ordinances. It is difficult to imagine today where a future buyer prefers to build upon a lot. Common sense is used to select a site at this point. If the buyer intends to utilize the test area, careful planning between the owner and septic plumber (or designer) is very important. Careful planning with qualified designers/ installers is critical. THe final actual size and shape and location of the septic system is dependent on the size and type of home proposed. Test areas large enough for a 3 -4 bedroom home has been provided, but a larger home may require new or additional soil testing. The septic system can not be shifted outside of the recorded test area. pg. 4 of 4. I I ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer -DO 14 N LD �f N E IS e ►, e r �k Mailing Address �� Kok 'L9 4- Property Address (Verification required from Planning Department for new construction) - ���v - City /State I�yc7L-' mss, Parcel Identification Number 0 4a ° 1x-40 LEGAL DESCRIPTION Property Location iii %4, sic '/4, Sec. 2 1 , T " N -R 14 A W, Town of . Subdivision O a ws Lot # Certified Survey Map # Volume , Page # Warranty Deed # (° `� � `� , Volume Page # Spec house ❑ yes 9no Lot lines identifiableX yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and' by a master plumber, journeymanpl*ber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification . stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 da of the three year expiration date. I �h� o-)- /M clvi,/ 60 ;za , 99 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 owner(s) of thS property descri bed above, by virtue of a warranty deed recorded in Register of Deeds Office. Aod��u (!�v- /0 / , 7 1 SIGNATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.****** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed I _ VOL 1? 78 pAul'S7 i STATE BAR OF WISCONSIN FORM 2 — 1982 ji !i ' J1�8�� �� WARRANTY DEED ! DOCUMENT NO !+ ,_ ......... . REGISTER'S OFFICE if Christopher Manderfeld, a /k /a Christopher P. ��� RC�f! �+ o W1 I� Manderfeld, and Am s Monderfeld /a >+'_ {� Manderfeld, husband and wife, I� NOV 2 4 1997 i I I conveys and warrants to Donald W Nelson and Lois M_ Nelson, ; 10:00 A r� + ! husband and wife, Re later of pvsds f (I ! THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS ' the following described real estate in qt- Croix County, j i :Ki"i`I►vr► GOLAND �j State of Wisconsin: UZ, Estreen & Ogland ;i I I; P.O. Brix 359 !} ' lludson, WI 54016 I �1 II �I PARCEL IDENTIFICATION NUMBER li f i j� Lot Twenty,(20), First Addition to Country Oaks in the Town of Troy, I St. Croix County, Wisconsin. j !j TRANSFER FE I �I ii If This is not homestead property. ! f' Xjb�X (is not) I a! Exception to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of November A.D., 19 97 !i j (SEAL) '+ ( E. M ande r a L l . X St Lwh r MantiPrfPl d, al ]s l a hri e tpphpx ! I. a /k /a Amy Manderfeld (SEAL) P. Mar�derfeld (S EAL) i f * r AEEIW �gEtA�P�'x�--a3s �s�r-i$ir' rz , "a ,,, .9eld� ! Ii AUTHENTICATION ACKNOWLEDGMENT II i it Signature(s) Christopher Manderfeld, a /k /a State of Wisconsin, i II Christopher P. Manderfeld, and Amy Manderfeld, ss. i! !� County. + j authenticated this day of November 19 97 Personally came before me this day of (� 19 , the above named j! i� I IuF i� Kristina OgLaad I` !I TITLE: MEMBER STATE BAR OF WISCONSIN (� (If not, authorized by §706.06, Wis. Stats.) to me known to be the person who executed the foregoing i instrument and acknowledge the same. ! Ii THIS INSTRUMENT WAS DRAFTED BY ii Attorney Kristina Ogland * I; �i Hur7Gnn, WT S4016 Notary Public, County, Wis. j! !j II (Signatures may be authenticated or acknowledged. Both are not My commission is permanent. (If not, state expiration date: necessary.) , 19 . Names of persons signing in any capacity should by typed or printed below their signatures. j� STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc, l j WARRANTY DEED Form No. 2 - 1982 Milwaukee, Wis. I f y +_ -1 ` -ter WCL G4:t04 t�19 i'lUKt°MY LF4NiJ SUKVtY1N1. Flt) 426 9 711 P.01 v, J l OP N c c M O � N _� Z� i co o y u c N O N CO o ",n Q \ 0 ° Lq v7 _ at 6 a N '~ O 0h 4 t 4 0 t+1 t N O O to V ni p O m W t0 t• � �j Q Q ti � O Z 1 - 4 0 - o Q. _ - .. q wa - ►- �� r � �``� U? Lu v Z) LID 05 O CO j N N t Z V Q V �ri 141 V