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Home My WebLink About002-1078-80-050St. Croix County Planning and Zoning Detail Sanitary Information Tuesday, March 27, 2007 at 10:18:27AM Page 1 of 1 Computer #: 002-1078-80-050 Sub/Plat: NA Section: 31 Parcel #: 31.29.16.463610 Lot: 1 TN/RNG: T29N R16W Municipality: Baldwin, Town of CSM: Vol. 18 Pg. 4665 114 1/4: SW 1/4 SE 1/4 Owner: VandeBerg, Mona 613 Va ndeberg Drive Baldwin, WI 54002 State Permit: 399417 Issued: 09/25/2001 POWTS Dispersal: Mound Permit: Replacement County Permit: 0 Installed: 10/10!2001 POWTS Detail: NA Bedrooms: 3 WI Fund: POWTS Pretreatment: NA dotes Issuer/Inspector As Buili Plumber Other Requirements Additional Notes Money Owed Not determined >4/1/00 -Not Required Wang, Tom this was formerly lot 1 of CSM 3/881 $0.00 Kevin Grabau Sic€,e<; `w:Eft~: Yes ~nance Scheduled Pump Date Pumped 1st Notification 2nd Notification 3rd Notification 10/10/2004 4/11/2005 04/01/2005 4/11 /2008 a l . '' ~~~~~~ • 9 ~~ FItED oCT ~~ 1979 des a coNHEu ~,~I~e at D..a>, >bq Ceo6x Coaohr, ~lliwc~~ ~^ CERTIFIED SURVEY MAP l surcvtrUR's RECORD ROY V~YNDEBERG Part of the Southwest 1/4 of the Southeast 1/4 of Section 31, Township 29 North, Range 16 West, Town of Baldwin, St. Croix County, Wisconsin. APPROVAL OF THIS MINOR SUBDIVISION APPROVED o Indicates 1" x 24" iron pipe stake set. DOES NOT MEAN APPROVAL FOR BUILDING SITE OR SEPTIC SYSTEM. OCT 16 1919 REFER TO H62.20. ST. CROIX COUNTY " l~ COMPREHENSIVE PARKS PLANNING A 6 S ~ AND ZONING COMMITTEE o W~ ~.o G. (1 ~ ~ ~1 J ~ ~ 4- N e ~~ ~ ~ ~ wo~~ ~ e o ~ $ ~ ~ ,w N ~ ~ ~~ ~''o ~ ~~ ~ ~ , ~ ,~~ ~v~~o ~ .N I,' ~ ~~(~~C ~ LOT / 2.39 ACRES W ~ \m ~ ~ v ~ W ~ ~ p ~ ~,~ Z V ~ ~ ~ N Z ~ ~ 6A,QA 6E ~ , VII, I: ~ v W J ~~ ~ z ~-oR y m (D `~ ~ ~ ~ 0 ~ ,c- A M E N . ~~ L ~ ---- -- ____. E / 3.52 ' y.~ / g /. ¢ 5 ' ~ \ hi , I S87°~S 00 E' S 8Y° ~G'SO' ~/~(pD~/ O ~. I O A .d IiVA Y SE/Y1,E /~,i T ~ ~I ~ 'fin h' O F2 /Z ~ C ~,' A R ' V S.G/. C0,4, SEC'. A roJ~34'/4" ~MONVME/VT,J C /~z°O~'00" v ~¢ ° o~ ~ O~ •' DESCRIPTION •~~SG o,Ns .• .~ =~;'' JAMES L. ,.~= MURPHY - _~?, S-1042 4 ~,:, RIVER FALLS, ; O $ ~~. '~F 111111111 That certain parcel of land located in the Southwest 1/4 of the Southeast 1/4 of Section 31, Township 29 North, Range 16 West, Town of Baldwin, St. Croix County, Wisconsin, more fully described as follows; Commencing at the Southwest corner of said Section 31, thence N 00° 00' 00" E 668.75' along the West line of the Southwest fractional 1/4 of said Section 31; thence S 87° 45' 00" E 873.85'; thence S 87° 16' 50" E 1323.93'; thence N 53° 26' 51" E 75.09'; thence N 88° 38' 39" E 191.45' to the PUINT OF BEGINNIIVU of the parcel to be herein described; thence N 02° 39' 40" E 100.28'; thence N 15° 11' 20" W 200.55'; thence N 65° 39' S6" W 273.09'; thence S 03° 54' 18" w 425.11'; thence N 88° 38' 39" E 324.97' to the FOINT OF BEGINNING, containing 2.39 acres, more or less, including a 66' wide easement for ingress and egress described along centerline as follows; EASEMENT DESCRIPTIUN: Commencing at the Southwest corner of said Section 31, thence N 00° 00' 00" E 668.75' alon the West line of the Southwest fractional 1/4 of said Section 31, to the POINT OF BEGINNII\(~ of the following described easement; thence S 87° 45' 00" E 973.85'; thence S 87° 16' S0" Ear, 1323.93'; thence N 53° 26' S1" E 75.09' to the termination point of said easement. Vol. 3 Page 88~ ,`~CG,~ • ~~i~/~~ Certified Survey Maps James L. Murphy t St. Croix County, Wisconsin ~ Registered Land Surveyor ~.~. Volume 3 Page 881 r . ~~~~~G~ .~ J~ l7~ ~^ ~,/,., , / ~~ / / .. ~ /~~ Q / ~ °~Y , 1 ,P') ~ .. "a~~-^..sw~„•' .- `' -` '~'' _::~,.,...~. ~au€~.,~ ;,,~za~~ia~;ur ~~,~•~i~r~v~evaai~kn,~,,z, . ~. , 'LAT [SCONSIN EMERALD PAGE54 N b 'A z' 0 b a T iA N C': SAL' GALLS PAGE 22 T-29-N ~ R-16-W O Farts $ Hoxm 1'uLHsh~s, Ltd. See Page 112 For Additional Names. Tour Complete Hardware Stor---e -- Plumbing • Tools • Housewares • Appliances • Ns Sporting Goods Headquarters for Western Wisconsin Over 800 Guns in Stock Andy Rudesill G R E G E R S O N 1962 Cty. YY ~ Baldwin, WI 54002 ~ Hardware Phone: 715-684-3881 (715) 684-3246 Fax: 715-684-2834 880 Cedar Street • Baldwin, Wisconsin Full Line of: Muzzleloading Supplies & Guns • Fishing Tackle • Reloading Supplies for Rifle & Shoteun S ew ~~, ~: Parcel #: 002-1078-80-050 ~onsi2oos 11:07 AM PAGE 1 OF 1 Alt. Parcel #: 31.29.16.4636-10 002 -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 O -VANDEBERG, THOMAS A & IATHLEEN THOMAS A & KATHLEEN VANDEBERG 613 VANDEBERG DR BALDWIN WI 54002 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description * 613 VANDEBERG DR SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 6.550 Plat: 4665-CSM 18-4665 002-03 SEC 31 T29N R16W IN SW SE LOT 1 CSM VOL Block/Condo Bldg: LOT 1 3/881 ORD NKA LOT 1 CSM 18-4665 (6.55AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 31-29N-16W Notes: Parcel History: Date Doc # Vol/Page Type 12/18/2003 749457 2476/467 TD 12/02/2003 748021 18/4665 CSM 07/20/2001 651678 1684/126 QC 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/28/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 6.550 13,700 122,100 135,800 NO Totals for 2006: General Property 6.550 13,700 122,100 135,800 Woodland 0.000 0 0 Totals for 2005: General Property 6.550 13,700 122,100 135,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch #: 510 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building,pivision * INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. permit Holder's Name: City Village X Township Vandeber ,Mona Baldwin Townshi ST BM Elev: Insp. BM Elev: BM Description: C~ ~V v~ U 'ANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic wr`CS~-' G d Dosing ~d Aeration __ Holding TANK SETBACK 1NFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic y ~ ~ i ~- I~ s Dosing ~ ~ / / J , .~ Z , / ~ ~ / Aeration Holding _= ~ PUMP/SIPHON INFORMATION Manufacturer o~.~-~ ~ Demand GPM Model Number 2~•~ ~ ° ~" DH Lift Friction Loss System Head DH i Ft Forcemain Length ~ Dia. ~ Dist. to Well f o Z~ ~'loG SOIL ABSORP ON SYSTEM County: St. Cf OIX Sanitary Permit No: • 399417 State Plan ID No: ~o fl Parcel Tax No: 002-1078-80-000 STATION BS HI FS ELEV. Benchmark 3. ~ 3,G Alt. BM ~/-/IF Bldg. Sewer e.X.c Ht Inlet 9. ~ 3 ~ . ~"z SUHt Outlet Dt Inlet Dt Bottom 2, , L Header/Man. 3 , 1 ~ I 0 . S9 I Dist. Pipe ~ ~ Sv `p~ , L~ I 'T Bot. System . 10 ~ ~t Final Grade stt- ~~ St Cover 4.~q,C rx tM.~ ~/ T• ~ `l o~ 9 \ ~ ap , ~ ~ BEDITRENCH Width ~ Length ~ No. Of T~asq~s PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 0 C ~ 1I SETBACK SYSTEM TO J P/L BLDG ELL LAKE/STREAM LEA Man er: INFORMATION T e Of System: r CHAMBER Yp ~ Z~ ~~ f ~0 `~ Model Num r~k DISTRIBUTION_SYSTEM l~~ affix -~ re.~lr_'l~.,A Header/Manifol Distribution x Hole Size x Hole Spacing Vent to Air Intake tf ~~ ~ Pipe(s) t \ rr t Di ~ A S i 3' ~ 3 h t [I /S II 2 Length ~ 0 Dia pac ng Lengt ) a SOIL COVER x Pressure Systems Onty xx Mound Or At-Grade SYStems OnIY 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 discrepencies, persons present, etc.) InQspection #1~:~~~~_/~/ O ~ Inspection #2: 0 ~ Location: 613 Vandeberg Street Baldwin, WI 54002 (SW 1/4 SE 1/4 31 T29N R 6W~ f A Lbt'IT~C' r, Parcel No: 31. 16 4 1.) Alt BM Description =C~/A')~ 2J Bldg sewer length = ~- I ~ ! dO ~- ~~ -amount of ver = ~ ~~ '7 ~ 3.) Contour = _ ~ z ~ ~ Z Ta 3, 8s-= q Pd Plan revision Required? [~ Yes No ~ ~/ Use other side for additional information. nk Z-~ 1 ' Date Insepcto s Signature Cert. No. SBD-6710 (R.3197) 3 ' „ ~ Safety and Buildings Division 201 w. washittgton Aye., P.O. $ox 7162 County Q i ~ . ~~B ~ I ~C~II SI~ Madison, wI 53707 - 7162 She A ' ~ S Qe artment of Commerce !~ l 3 (, i~CbC Sanitary Permit Application sanitary Permu Number In accord with Comm 83.21, Wis. Adm. Code. persoml information you provide 2~j (~/ ^ Check if Revision J Y q 7 r ma be used for I.aw si5. i L Appltaati~ Information -Please Prhtt All Itdormatlon ''\.~ ran I.D. Numbe~?Q~,.~ ~ Property 's Nary Ot ~ % l g 3 g G ~ ~C, - en e ~~U ~ " '~ ~ T ~ ~ ~ o ~ ' `-- ~ a ~ ~ ~~~~ . Property Owner's a __, ~ : ~ nr~ ~ t / F .j OIE d' ~_ ~ sr`'~ Ymperty (~ ~~ u•s~ ~ T~I N R 16 ~ City, State Zip Code Phone r I~k~G Lot 8 Number ~ t ~ ~~ ~~ ~ ~ ~~~aa ~~ .~ Name CSM Numbet , ~ . r ~ y ; ~~-Z ~ II. Type of Building (check ail first apply) ~ ~ ^Ciry 1 or 2 Family Dwelling -Number of Bedrooms 'QYillage Q LJ i y~ ^ public//Commercial -Describe Use Q1•ownsivp ^ State owned Nearest Road ~~N~~~r III. Type of Permits (Check only one box on line A (numbering scheme for internal usej. Complete line B if applicable) A' 1 ^ New ?~ Rep>uxmem 3ystern 3 ^ Raplacement of 6 ^ Addition to For County use F stem Tank Oal Exis stem B. ^ Ctualt if Sanitary Pemntt Pnviousiy Issued Permit Nnmber Date Issued IV. ~ of P~cmit: (t~clc su that appiy>tmm>~~r i~Chaaae is for hz4eraal tme) d~s~ ~~ ~qo / 44 ^ Non -Press<uiu:d In-Ormtad 2~ Mound ,~ 47 ^ Sand Fiilter 50 ^ Coustsvcoed Wetland 22 ^ Presattriud In-Groin 41 ^ Hoidiog Tank 48 ^ Sigle Pass Sl ^ Drip Liao 45 ^ At-Graff 46 ^ Aerobic Umt 49 ^ 30 ^ Other ~ ~ / V. Area Informati on: Design Flow (~ - Diapcrsat Atat Dispersal Ama Sal AppliCadoa Percotatioa Rate System Bievatioa F'iaal (trade Fatei~•~'~~1 (Min./Indt) Fdcvation ~~ ~ v ~~d ~ 1, D , ,~. ,~, 3S' ,~1, 3 ~ VI. Tank Info Capacity in .Twat Nnmber lkamdacturer Prefab Site Steel Fiber plastic Cations Galloffi of Tenks Concrete C:o (;lass ~1,,,~~b iVew Tados. raal~ l S a< Hok4iaa rank _ ~ ~ ~ X Iw~oa r'`r iK nv VII. Statement- I, ehe naderai~ed, assume [or the POW15 shawu on the attached phaet. Phmiber'a Name (Print) ~ MP ~ nNnnm Bnaimsa Phone NwmQber ~? ~~~ ~ ~ ~ OYJ / ! (t Phtmber'a Address tSttert. City, Cah:) f~ ~ - 1l~ ~e ~'`~~r r~' : sJ~va~ VIQ. Use . [~ (] ~ ~~ Fee (iacindea tirongdwater Datd'Tsnud ~oature (No Staff owaar tiivat !aids! Adverse . 3 a ~ 6 1 4~1 Determination ~~ l /~'J'v~~, I8. CwtdiNo~ of ApprovatllReasotaa for Disapproval U 1. The existing system shall be abandoned per code requirements. ~ 2. Effluent filter to be installed and maintained per manufacturer's recommendations. 3. Well setbacks to be maintained er NR 811 & 812. ~""- i,~p.~}u~- .~, G~~ ~ m papv sot len tiwo ti11E z it ~aU SBD-6398 (Yt. 05!01) ~ ~ iscons~n Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi.us/sb www.wisconsin.gov Scott McCallum, Governor Brenda J. Blanchard, Secretary August 30, 2001 CUST ID No.691727 ARTHUR L WEGERER WEGERER SOIL TESTING & DESIGN SERVICE PO BOX 74 RIVER FALLS WI 54022 / a1.2~ , CONDITIONAL APPROVAL ~/ ~~i' `" A7TN.• POW7S Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HiJDSON WI 54016 i, PLAN APPROVAL EXPIRES: 08/30/2 ~ R ~,t {~ w~-/ tiECr{YEJ SITE: MONA VANDEBERG r:~ ?? C c n Q tt ~~~~ VANDEBERG ST ~ SAY TOWN OF BALDWIN ,%~ ST CROIX COUNTY `~' ZON~tGa~~ SW1/4, SE1/4, S31, T29N, R16W FOR: ~ j ~ DESCRIPTION: THREE BEDROOM MO Transaction ID N .670510 -• .Site ID No. 63498 Please refer to both i eetification numbers, ~.. -- ~abave, in all correspondence with the agency. OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 808907 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: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.OI/Ol) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD-10706-P (N.OI/O1). in the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section ViIt of the Mound manual, and section VI of the pressure distribution component manual aze complied with. A copy of this letter including instructions and information relating to proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • Access to the filter for cleaning must be provided per Comm 84 product approval conditions. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required • Limited activities are allowed in the area 15 feet down slope of the component azea. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The concrete pad is the toe area of the component is to be removed. The mound azea must be deep chisel plowed to help break up compaction of the soil structure that may result from the removal of the concrete pad. The county may, at their discretion, request verification of the plowing prior to continuation of system construction. ~ ARTHUR L WEGERER Page 2 .8/30/01 4 • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). In addition, the owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 14S.I3S 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. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at-the address on this letterhead. Sincere! , ~~ Charles L Bratz POWTS Plan reviewer II- Integrated Services (608) 789-7893, Mon.-Fri. 7:45 AM to 4:30 PM cbratz@commerce.state.wi.us FEE REQUIRED $ ! 75.00 FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 WiSMART code: 7633 cc: MONA VANDEBERG • ~. TITLE SHEET This plan has been Manual SBD-10691-P (N.O1/O1) LOCATED IN THE SW TOWi1 OF $•Pi-t~ptti; I~OUIdD SYSTEi~1 FOR A 3 BEDROOr1 RESIDENCE Page 1 of -7 prepared in accordance with the Mound Component and the Pressure Distribution P•Ianual SBD-10706-P (N.O1/O1) 1 /4 OF THE 5 ~. 1 /4 OF SECTION 3l , T Zq N, R 1 6 [d, 1~ S'C-- C.1Z,.~jl,)C COUNTY, WISCOPISIN. INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEI IIAiIAGEi~IEN T PLAiv PAGE 3 of 7 PLOT PLA~d PAGE 4 of 7 PLAN VIE~7-CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIP E LAYOUT PAGE 6 of 7 PUr•1PING CHAtiBER CROSS SECTION PAGE 7 of 7 PUMP PERFORI.IANCE CURVE PREPARED FOR :oN~ _ ~~-~~E g~z~ _:_ __ :: 6~3 v~rv~EQ~z~ sr. _:.::::.::-8 ~'rL,pLV1 ICJ ~ lw L 5 ~{,U O Z RECEIVED AUG 1 7 2001 SAFETY & BLDGS DIV. PREPARED BY WEGEF~ER SLR S L . TEST S NG AND . . ~3ES ~ G~i SERV = CE P.O. Box 74 421 i~d.ifain St. River Falls, G1I 54022 Phone 715-425-0165 Fax 715-425-6864 COlt~ltlOl'1QIZJ~ APPRt~VED ~~~~ 8EE C~RREgp E JOB N0. ~~'~'07 ~ - ~b-o~ Mound System Management Plan page Z, of ~ f • Pursuant to Comm 83.54, Wis. Adm. Code - Seotic Tank The septic tank shalt be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of.the septic tank and outlet filter shall be assessed at {east once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain.solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The - septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank; If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Pum° Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution S tem No trees or shrubs should.be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since scil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg/L GODS, 150 mg/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure testis performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked far effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manual rid local or state rules pertaining to system maintenance and maintenance reporting. Sgt _10 b~l_P (~i01 /p 1~ No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Continaencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump,. pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions about the operation or maintenance of this system should be directed to: The County Zoning Office at 1.~S-38b ~_u68O ST-C~2.OLX " The system installer at ~ LS- ~LZ"S- QQS$ w~~G The tank manufacturer at $~~p.32$_$l(.S6 -,ulErg~, The effluent filter manufacturer at ~W- Z.Z/, S7y.Z Zl~tg~, The pump manufacturer at ~ b 30 - $' Z0. ~8~ ~ "GOUTS 0€~! 30/2001 14:11 ,. 17154256864 ~'tn bE RS~~u~) s~•~c ~k x '~ Cjp 1Z. ^'1 ~N'L~ V4`1`~p ~6itt.(a ST. ~-----// ~~-3 ~~ ~ ro BT>~ Rv~ . •~ 30° ` ~ WEGERER SOIL TESTING Scale 1 "= 30 ' ~s` ~ u° p~c ~~ r~J/ •v G F1'CZ R-G ~. ~~~~i L.~~,lilz PAGE 02 Page ~ of ~7 x ~• 9.S °- Z~~ or z" Qvc F,r~ . ~we~~ o ~\ a . 3 'O • '~ ~ Do iv 1'31- CoN-GAe~- / OQ b1~'rUR.B ~~ -~~ \~S ~o \ \ ~ COnTcUvCt. ';.. r'lq.gc ~ \ \ \g'~ ~ ~ ~. ~ ~ \ \ ~ Lam. too3S -,~ 1° \\ \ ~ ~ \ ~o ~ \ ,.~ \~ ~o s .1 ~.~ z Cvrac• P~ .. \ y EE CORRESPONDENCE ,~o - s~~ 8-h tt-Z- aL. 1d3.~•Oty ~.1~~CU'CY`~C~Fr..~duiZ..~c7U60, C~ ~ 3 V Pnv D~l3~szG s~-. ~y o >~ t-~ ' NOTES: 1. Elevations shown are existing ground elevation$ unless otherwise noted. 2. Install. 4" observation pipes with approved caps. ( ~ required). 3. Septic tank to be 10 0~ ~bSO gallon capacity manufactured by W ~ ```~.~Z ~p ~1 ~-1Z~1~' w / ~- - L ~ Q o Z >~ fit. 1~ ~'i`~'t 4. $ench mark , • S~ ~AuVC 5. Divert surface water around system to prevent ponding at the uphill side. 08/30/2001 14:11 17154256864 WEGERER SOIL TESTING Approved Synthetic Coverzng~ c1S T`i C 3 3 Medium Sand Topsoil "~~ . .._1 + ~ - 3 .. . 3 % Scope - Distribution Cell of , ~" to 2~" Aggregate PAGE 03 ' Page ~ Of 7 stribution Fipe G F~`~Ele~r . 1,Op . 3 5 Force Main From Pump CROSS SECTION QF A MOUVA SYSTSi~i Linear Loading Rate=~0-v GPD/LN FT Design Lvadinc Rate= u y~pD/SQ FT n ~ ---1 ~ - ~ ~ r.. `_` - _ a--f~-------- ------•- Q o--~------ ~6 B ---- -_ W ~-~-L~--~~ --- _ ~Distributio Pipe 1 -Qbservotion Pipe K • ---- - -----~~__---- Force Main ---' = ------- .~. - - - --~ ) PrcG~-mss pox n Ceil of '~" to 2~" aggregate Observotion Pipe U-aChar iecvreiy) • •• PLAN VIEW OF A MOUND SYSTE:4 A 10 Ft. 6 U 5 .-_..- 1=t. - I ~Z Ft. ~ S Ft. K ~- S Ft. L ~O Ft. w Z~ Ft. Flowed Layer i) Cs- ~ F't. E a•~ Ft. F a.a Ft. G o.SFt. N ~- u Ft. t 08/'0/2001 14:11 17154256864 WEGERER SOIL TESTING PAGE 04 ~. Distribution Pipe Layout Page S of ~'7 Place the holes at the bottom of the distribution pipes at equal spacing. Remove all burrs from the pipe and holes. Extend the end of each Iaieral up with the use of Iong turn or 45° fitting to a point within six inches ofthe $naI grade. Terminate ttte ends of the Iatezais with a valve,-threaded cap or threaded plug. Provide access from fxaaal grade for the valve, threaded cap or threaded plug. -~;cc~ss Box_. T`~t P 1 Cluj L . ~,Zt~S S S~-~11~ t~~ PVC, PVC ~VG Enfant-1 ~ Manifold ~ Lateral x x xit xrt x x x x '. ateril Lan h .. latarat Length . P Distribution 'ne P L'PrN V ~ cw . ~' ~ Rcr~s ~aox a - -o >1 rru ~ r~ ~ a- - - ' • ---0 PVC ~-oe~' n Asnl i °~- - - --\- - - _ ~q `~~~~~ P Zl.b Ft_ ~ Nole Diameter ~I~ Inch - S ~. ~~ Ft. ~ Lateral 1 Inches} X Z y Inches Manifold Z - Inches - ~ force Main " Z Inches J. ~ of holes/pipe fl - Invert Elevation of Laterals~oD.$SFt. 08!30/2001 14:11 17154256864 WEGERER SOIL TESTING - i S ~T k and VEUT CAP ~ I J 1...~ Combinat on ept,3c• an Pl1•MP CHAMBER CROSS SECTION AlVO SPEGlFICa1Tl0~l5 ' PAGE ~ OF 7. ;- w8P~1v>'J P ttsl` ~!-~tz-~1ctl~a*-P j ~~~ y'C.I. VCAIT PIPC ~ lO' f ROM ODOR. :irA100W OR Pit ESN n~tuTAKE ~~ ..~ ttJLET ~ 4~t,~ Approved ~'~~ ~`~ joint w/ (},~Lgpp PVC pipe LLEY \- Z FT -- ~ \.~~~ \./EA7HER PROOF . ~ JpUCTiOU AOX . APPROYEp LOCKING ~t•IlUJHOEE COYEK w{~ wA~tNIUG L.h~Ft.. PAGE 05 ~~~ !;I c~ ~__ v . ,,,; ~ raovlpE I ~Arttrr6N't' SEAL I I .A I I I I ~ ~1 I I I f I C 'I I I I Pur.P -~ --J ~ COUCRCTC l .- QLOCx 1~ ~. II I ~J Approved (I joint w/ ~ AI.Ntx PVC pipe ou O!` ~ __ _ -- - ~3" ADPStocfl RISCR EXIT PER/rlt'TTED O-Jt_y tv TAUK MAUUF~c7URCR NA5 SUGH APPRpvAt+ gA,pDrN4 ScPrrc f SPECiF1CATl~l•.15 DOSC TAU~~ IN1~~~ ~~ v~~,~-~ uLyydEFt OF DOSLS: ~~ ~ p~ti; p,qy MA-JUFAt;l"URCR: TAUK ~12C: ~UUd ~b~~ G4L.~OUS OQSf vOl.ldME r AI.AAM __._ MAIIUFACT(lit~R: c~'S-~~~-~-~ S`~S~-"ig INCLU01A7(, 6AGfCFLOW: , ~~ GALLOtJS /'~C3DCL 1Jt1M8ER: ~ ~ I ~~ CAPACITItS~ A=~_IAICHCS OK ~ U ~ G~lLOU3 SwITCM TyPC: ~'~ZC1~)~2'"LJ' '~ tJ $ _ ~ rULNES OR ~~ G~LIOUS I'UMF' !''lA1JUFAG7URCR: ~ O V t..1.7 S C=~_ WGHES OR ~~ WL>`OUS MODES IJUMBE>i;: 3 $ 1 4 ~~'~ s 0 ` ~..~ INCHES oR l ~~ GALLD1.tS 1'`~~LCV2-~f SWITCH TyPC: _. UOTC: l~TfrL PUKP A1JD ALA 0.1'1 AFtC TO DC t'UtJIMLfM D15GKARGE RATE ~~-~6 GPM INSTAIt_EO Q1J SEP>'.RAT£ CIACU~TS VfRrICAL OIFfC(CEIJCE CETWCEU PUMP pff AUO.OrSTRIIjUTtOU PIPC.. ~• 9~ FELT + Mru1MUM uETWORft SUPPLY PR6SSUR C , _ _ ~' SO FC:C'f (S.Oxr\.3~ + ~--,~ 'r, / • FEET OF FO0.CC MAiN X ~- ~2 PloottE~tCTiOri FACYOR.. 3_~-_.~.O FELT TOTAL OyUAMIC HEAD = `~"~~ FEET As per nanufacture~ 1~•0 gal/in. Liquid depth 3 a " ~c' Mlu. ~. ~ i8'/'tiii. ' '08/30/2001 14:11 17154256864 n ~- ~~ WEGERER SOIL TESTING ~~.FO~t~~~ cv~v ~ PAGE 06 ~5E ~ o~ 7 uouias Submersible Effluent Pump ff ~~ 3871 EP05 APPUCATl0118 SpeGflglty designed for the following uses: • Effluent systems • Nomes • Farms • Heavy duty sump • Water transfer • Dewatering ' , $PECItFICAT10N8 Pump: EP04 ': • Solids handling Cdpability: ;.:,'/; maximum:.; • Capacities: up to 55 GPM. '. ptai heads: up to 24 teat. _ ~~ discharge siZi;:1'/:' NPT. ° ' ~ • Mechanical seal: carbon- rolary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F•(60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single phase: 0.4 HP, t 15 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 MP, 115 V, 60 Hz.1550 RPM, built In overload with automatic reset. • Power cord:l0 foot standard length, 16/3 SJTO with three prong grounding plug. Optional 20 foot length,l6/3 SJTW with three prong grounding plug (standard on EP05). • Fasteners: 300 series M~'r~FtS FEET StaIn185S Steel. 10 • Capable of running dry without damage to e components.' Pump: t:PgS e • Solids handling capability: ~ 7 ~: rnaximuri~~- :. T,_ •.. • Capaeities: tip to 6d GPM. ~ 8 • Total heads: up to 31 feet. ~ - •Discharge siie:l'h` NPT. 5 • Mechanical seal: carbon- c rotary/ceramic-stationary, ~ a BUNA-N elastomers. • Temperature: ~ s ,... 104°F.(40°C) COminuous 140°F (60°C) intermittent- 2 ~ r:r-, ~~, TJ a ...~~~.;?x: ~ ~ ~- ~ ~ ~~ / O 1886 r~ollkts RvmD9. i~c- .~ • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Auromatlc madeiII include Mechanical Float Switch assembled and preset at the factory. FEATUitES ® Ep04 Impeller: Thermo- plastic Semi-open design with pump out vanes for mechanical seal protection. ®EP05 Impeller: Thermo- plast(c enclosed design for improved performance. ®t;aslnp and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ;~.o ^ Motor Housing: Cast Iron for efficient heat transfer, strength, and durability. ^ Motor Cover: Thermoplas- tic cover with integral handle and float switch attachment points. ^ Power Cable: Severe duty rated oil and water resistant. ^ Bearings: Upper and lower heavy duty ball bearing construction. AGEffCY U8TlNG ~~ Canadian 8mna0rda AsaocrrUon (CSA fisted model numbars~ , end in "F" or "AG") ;,,`'. o , o ~ zu ~, ..,, .,., _ , . :, 0 2 a 8 8 10 12 m'fi CAPACITY Etfeeitve MaY, 1885 ."' isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi.us/sb www.wisconsin.gov Scott McCallum, Governor Brenda J. Blanchard, Secretary August 30, 2001 CUST ID No.691727 ATTN.- POWTS Inspector ARTHUR L WEGERER ZONING OFFICE WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/30/2003 Identification Numbers Transaction ID No. 6705.0 SITE: Site [D No. 634987 MONA VANDEBERG Please refer to both,identlfi~2ltion.numbers, VANDEBERG ST above, in all corres'~ondence with the a enc TOWN OF BALDWIN ~-, 'r~~ ST CROIX COUNTY ~`' ~~r•;~±~1~~ _'~ s i~...`e.;-i Y SW1/4, SE1/4, S31, T29N, R16W _ q `- ~--~ FOR: ~' ~ ~ ~ `~ ~ 4 t-QU I '~.ca DESCRIPTION: THREE BEDROOM MOUND SYSTEM i OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 808907 ` ,~, S '\`~~ ZONRVGO~PICE ,~~ The submittal described above has been reviewed for conformance with applicable Wise ~ mistrative and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. ! I '~ °~-~; ~ The following conditions shall be met during construction or installation and prior to occupancy or us • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.O1/O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD-10706-P (N.O1/O1). [n the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. to addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the Mound manual, and section VI of the pressure distribution component manual are complied with. A copy of this letter including instructions and information relating to proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • Access to the filter for cleaning must be provided per Comm 8~1 product approval conditions. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required • Limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The concrete pad is the toe area of the component is to be removed. The mound area must be deep chisel plowed to help break up compaction of the soil structure that may result from the removal of the concrete pad. The county may, at their discretion, request verification of the plowing prior to continuation of system construction. ~r , ARTHUR L WEGERER Page 2 5/30/01 • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). In addition, the owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. • 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 cequired. 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 ofthe Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/instal lation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincere! , ~~~ FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 Charles L Bratz POWTS Plan reviewer II- Integrated Services (608) 789-7893, Mon.-Fri. 7:45 AM to 4:30 PM cbratz@commerce.state.wi.us WiSMART code: 7633 cc: MONA VANDEBERG ,~ ~ Wisconsin Department of Commerce 'Division of Safety and Buildings SOIL EVALUATION REPORT ~'~P -9-~~0~ Page ~ of 3 in accordance with Comm 85, Wis. Adm. Code -- Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must ' include, but not limited to: vertical and horizontal reference point (BM), direction and t l l di i Parcel I.D. ~OZ - low P - $ u percen s ope, sca e or mens ons, north arrow, and locationand i1i§tancerto nearest road. j ~` ~ ~ Please print all inform °~~ Reviewed y Date ~ Personal infortnadon you provide may be used for seconds ~ ses (Pnva~-aw, .15.04{'O` ). ZS p ~ ~' 9 / Property Owner ~. ~ roperty' `o 'on _ ~~1~A ~/ ~~~ ~ t~ 1/4 SC1/4 S ~ J T Zq N R ~~ 6 E (or W r r-^ Property Owner's Mailing Address ~' ~° ~ , # Subd. Name or CSM# City State Zip Code Phone m er zON;tuG I City ~ ^ Village ~`J Town Nearest Road 13PtL.~w~1`J INI S4uoz (-]lS) . ~~ ~~~. ~.=_~~ P~L~W LN v~l~~~ ST, ^ New Construction Use: [~,. Residential / Number of bedrooms Code derived design flow rate Ll S l~ GPD [~ Replacement ^ Public or commercial -Describe: Parent material 5 l L.T~1 S ~ h~?®y! Ov ~ T! L L Flood Plain elevation if applicable ti ~ ft. General comments and recommendations: r'l~l~t\J~j 11J~ tp' X ~S ~ ~~~-•~Z~r~U`'i-1 U!`! C.~~.-L_ Boring # I^~ Boring ~`i pit Ground surface elev. 10 0 • ft. Depth to limiting factor ~ q8 in. t , Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~ o_S Lo~t~-3tz - sil Z`~sbk ~.sl, a.S 1~ . s .~ Z S - 3 3 l l7 `1 IZc~l~ - ~ S l eS b k Wi. V`Ft~• c- t,v - • 7 t_ 2 3 3 qs ~.s BIZ ~l(, - `s o~,, m V'F,- - . s . ~ Boring # ^ Boring 36 ®pit Ground surface elev. ~I.Q . ~{ ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 o-~ lo~.-z.3IZ ~ slJ Zms6k ash o~,S f~ •s _4~ Z ~_ zg ~oK`2-416 ~ is l eSbk mv`f~ e~ - "~ ~• Z 3 Z -3 b ~ •s `12 ~l6 - ~ S 1 ~ s h lz m v `F>^ cw - • ~ L • Z 6-s'7 ~~SY2~16 'PtF 'I.S~t2 SLS 1 s Ow, m`fl--vf - -S •7 'Effluent #1 = BODs > 30 < 220 mg/L and TSS >30 < 150 mgJL " Effluent art=BUDS < 30 mglL and T55 < 30 mg/L CST Name (Please Print) ign to ~) - ,Z 0 ~ CST Number Arthur L. tdegerer 220254 Address 4~ e g e r e r S o i l Testing & Design S e r v i c e Date Evaluation Conducted Telephone Number 421 N. %~iain St. diver Falls, t]I 54022 8_~`(_p I 715-425-0165 Jf . Property Owner y ~~ ~~ $ ~1ZG B # ^ Boring Parcel ID # b~ Z - ~- ~ 7 ~+ - onng 10 b - Z ^ Pit Ground surface elev. ft. DPnth fn (imitinn f~rfnr ~~~ t.. Page ~' of 3 Horizon Depth Dominant Color Redox Description . Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Efr#2 I p_-1 ~oKrZ>Iz - s11 3`~~b--c gl-, ~.~ 1~ .5 .f3 2 ~ 30 ~b~l-z yl6 - ~ s l esb~ rnv~,- c s - ~~ t. z 3 3u-bo ~•S`~R 4~~ ~l~ ~,s~c 2 s!~ 1 s ow, ~`Fi - ~S . ~ 3 S -L s- ~-E-1 G L~ Y"! U ~ 5"?U1i2~ C°-OhJ T . ^ Boring # ^ Boring . . ^ p;t Ground surface elev. _ ft. Depth to limihnn racrnr an Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 ^ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Horizon Depth i Dominant Color Redox Description Texture Structure Consistence Boundary - Roots Soil Application Rate GPD/ft2 n. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 `Eff#2 Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 = BODb < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. sao-tu3o (Rb/00) .• s~~.c ~k x 3 43~ 1ZM ~N~~ i ~~ 3°~ ~~~e~S / ~-- S Tim • 0-3 w,i' ~ C~ ~ 3 V Phv D~,B~26 S7,_ ~-ly~p) 715-425-0165 220254 S ~~ , O t -~.U 7 PLOT PLAPd Scale 1' = 3.p' G ~. ~- G ~. X-BN- a- ~~ tt Z ~ ~ 9. `~ h a.3 Ga ti~ ~ ~ ~~ Do -v ~- Cp~p~r •y ~ OZ D1Sl'L-2g 5 \\` co~~vz ~ . goo ~s' s~-Z 3 u Yru ~ o ~ ~L b~ \ Lit- lo0.bs' -~ ~~ \ ~~i aq \ ter., N.. b~ svPC~ ~° ~''~ Page 3 of 3 _~ CvJ~ ~o~ ~ ~~~ a :~ 1 \ 5 ~VO CST Signature Date Telephone Ilo. _ CST Ido. Job P10. ST CRO[X COUNT'X SBPTIC TANK MA[NTeNANCL' AGRLeeMeNT AND OVI!NBRS[i[P CG~RT[F[CAT[ON FORM Owncr/13uycc /GL~na l~~n C~ e Mtutiug Address Propcrty Address Y9 -g r ~ ~ r~ ~ r ~~uoa ~~ from rte D r~ acw coustcucxica) Ckty/StaLc ~ , /,c~/~ ~.~~_ Pamci Identification Numbs Z.F.GAL D~CIt~PTXON Pmputy Location S~ ~, ~ C ' . y~ Soc. ~ ~. T~q .N~t, ~1~~own of ~ /~~/.G~ --Y- $ubdivision ~ Lot # - ~~a stay ~ ~ ,,,`._, va~~ b a ~D - Page # w~ty n~a ~ ~ ~ ~~,i~--_~ Volumc ~ ~' # SpoG.~oasc ^ ya ®na Lot tines uk~iSab1~ ~ yes ~. no eemci~~„~=T~~da~tiai~s i ootesistsafpma~ug~.~~~ P~t~faoc~o~.rastc's.~looperm~ac~m~oe ciaeRffxt~Se,c~Q~e ~~J'~aifiroododby=per ~tyoapatimdotbceystcm '~ttst~eintbea~stete7~~, - • - . • ~T~P°•°'0P~7'~a~~g~oocsto~mttoStCyoo~acD~~~~Ygreoa~ezm~~y: isiapoopxcpa~~,dlccC~e~'ioa~ead . (~tbeon~ioceirxsocvPaberdutiosstsysbcai s C¢. ~ ~ kss $na tt3 Nadi .~ ~!b~ne,aeadmeabora,rod,~aebarm~ca~cpai~,rn6c.iit~lof~csbmd~ds ~ ~. 6atiasr~s eaet by Q,c Dew o f~a+oe and ffic Dcof Nsbm~at ~I^~'=y^.~tcminsbocn~tbe Rcsom+oes,SadeeofWisooa~sin.. days•aftire ttetrx yr.~t da~c. O0°~'~10d~rcemadodtp tho SG~~ty?~oaiagflffi+xvri~in 30 ~~~ ~ SIt1~tATf1RB OF APPI',i `-' ~p' DATE o~cea~~rc~-.~oN . I (~~ oati;y that edt oa this focmt tcc tcuo to tErc bcst of my (one ho,aarcLodgo, t (wc} am (arch the owna~(s) of ~ 1'~P~Y dodabar~ by victnc of a raanaacy flood rooocdod is Hof Doody Officc. ?~ ~ ~ a3~L ~ ,~ OFD -- DATE s~«s~ ~ ieefocmation then is tnis ~~maY t+~tlit is ~ unihry pcomit being roerokod by the Zvniag Dcnutmo~.'!"~' •~ [adadc Frith thLs s~tic~ttoa a stampod wxtixtt~r flood 6rofla ~ a of tho ~gistcx of Doody ottteoo SPY cettiCad eauvcy ~P ~ ~tcc~caoc is taadc is the wacnaty dcod Y~i.1684p~~E126 651675 STATE BAR OF WISCONSIN FORM 3 - 1999 KATHLEEN H. WAE.SH QUIT CLAIM DEED Document Number REGISTEk OF DEEDS ST. CkOIX CO, . WI This Deed, made between Mona VandeBerg, a/1:la Mona C. CEIVED RECDRD Vandel3erg 7-2D-i! 9:30 AM BUTT ClAIN DEED _ Grantor, and Moaa VsndeBerg Revocable Living Ttvst, Moaa C. CEFEcTRCOPY FEE; 16 Vandel3erg, initial rastee, Thomas Vandel3erg, successor trustee, wit CORY FEE: full power to convey ~ ~yDIN FFE REC S E: 1~.D4 Rp6ES: ~ Grantee. Grantor quit claims to Grantee the fogowing described real estate in St. Croiz County, State of Wisconsin (if more space is needed, please attach addendum); See Exhibit A attached hereto and made a part hereof. Recording Area Name and Retum Address Thomas A McCormack PO Hoz 2120 Baldw6r, WI 54002 1.06-2033-20,002-10780,002-1078-70, I 002-1078-90 Parcel Identification Number (PIN) This is homestead property. i19i ~) Together with all appurtenant rights, title and interests. Dated this ~ ~~_ day of SJ ~_ 2001 s _ a AUTHENTICATION Signalwe(s) authenticated this day of ~~~rv~~ • Mona C. VandeBerg ACKNOWLEDGMENT STATE OF WISCONSIN _) ss. St Cron County ) Personally came before the this /~ ~: a .day of "~~ 2001 -~.titq,~tiieve t~med Mow V Berg, a/k/a Mona C. Vawd (~ y TITLE: MEMBER STATE BAR OF WISCONSIN '" `~ - tn me 7-mown to e e persons ore~img (II'not. inatnunent er)dpcknowledged t eut Q V~ 1 authorized by § 706.06, Wis. Stats.) z fSC THIS INSTRUMENT WAS DRAFTED BY ^ _ -~'-j,,~u >< ~ ~( ..-cG4 G _ Thomas A McCormack Notary Public, State of Wisconsin y~~i_ ;-'=' Idwin, W _ M Commission is y pertnanent. not, s rtet:xpriata- n et~e• (Signatures may be autbenticated or ackwwledged. Both are not necessary) __, . _T.--') Names of persons signing in any capacity must he typed or printed below their signature. intarroria, a,a^^^o,,.a c,,,o.^v, Fo„a,~,.,~, w, STATE BAR OF wISCONSIN eaaesszoz' QUIT CLAIM DEED FORM No. 3 -1999 V01. 1684 PA<< 127 EXHIBIT A NW'/. of NE '/. and N '/ of NW %+ of Section 6-28-16 EXCEPTS 779.6 feet of W 513.7 feet of N '/~ of NW '/+; S 'r4 of SW '/+ and S '/z of SE '/. of Section 31-29-16 and EXCEPT Lots 1, 2 and 3 of Certified Survey Map in Vol. 5, page 1395 and EXCEPT part to Village of Baldwin in Vol. 685, page 429 and in Vol. 698, page 342 and EXCEPT Certified Survey Map in Vol. 10, page 2844 and EXCEPT Certified Survey Map in Vol. 10, page 2852 and EXCEPT Certified Survey Map in Vol. 10, page 2919 and EXCEPT Certified Survey Map in Vol. 11, page 2988 and EXCEPT Lot 10 of Certified Survey Map in Vol. 11, page 2998 and EXCEPT Certified Survey Map in Vol. 9, page 2537. „i. i515o1-~E 419 PERSONAL Mona VandeBerg, as Personal Representative of the estate of Roy A. VandeBerg ("Decedent"), for a valuable consideration conveys without warranty to Mona VandeBerg, Grantee, the following described real estate in St. Croix County, State of Wisconsin (hereinafter called the "Property"): Es+.'2'4072 KATHLEEH H, iIALSH REGISTER OF DEEDS SF. CROIX CO., WI RECEIVED FOR RECORD OG-02-2000 9:30 AM EOtTtApl REPRESEiiRTIV CERT COPY FEE: COPY FEE: TRAN5FER FEE: RECORDING FEES 10.00 PAOES: 1 Thomas A. McCormack 102010th Ave, PO Box 2120 Baldwin, WI 54002 108-2033-20, 002-1078-8D, 002-1078-90, 002-1078-70 (Parcel Identification Number) NW'/. of NE'/. and N'r4 of NW %. of Section 6-28-16 EXCEPTS 779.6 feet of W 513.7 feet of N'/ of NW '/+; S 'h of SW '/. and S %z of SE '/. of Section 31-29-16 and EXCEPT Lots 1, 2 and 3 of Certified Survey Map in Vol. 5, page 1395 and EXCEPT part to Village of Baldwin in Vol. 685, page 429 and in Vol. 698, page 342 and EXCEPT Certified Survey Map in Vol. 10, page 2844 and EXCEPT Certified Survey Map in Vol. 10, page 2852 and EXCEPT Certified Survey Map in Vol. 10, page 2919 and EXCEPT Certified Survey Map in Vol. 11, page 2988 and EXCEPT Lot 10 of Certified Survey Map in Vol. 11, page 2998 and EXCEPT Certified Survey Map in Vol. 9, page 2537. This deed is exempt from transfer fee and transfer return per Sec. 77.25(11), Stats. Personal Representative by this deed does convey to Grantee all of the estate and interest in the Property which the Decedent had immediately prior to Decedent's death, and all of the estate and interest in the Property which,fh/,e Personal Representative has since acquired. Dated this ~~" day of ~/~-C. , 2000. AUTHENTICATION Signature(s) authenticated this _ day of x ~~~ ~~ ~ 'Mona VandeBerg Personal R esentative • Personal Representative ACKNOWLEDGMENT STATE OF WISCONSIN ST. CROIX COUNTY ~ -,- Personaly came before me this day of .5~~~- 2DD0, the above named Mona Vandet3erg, as Personal Representative of the Estate of Roy A. VandeBerg, to me known to be the person(s) who ex e e foregoing instrument and acknowledge the sa signature type or print name TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authored tn' § 708.08, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY signature •~ P type or print name ~ ..~'r7rua E ~ ~ Notary Public, St. Croix County, WiV~in:'T .~ '~ My commission is permanent. (If no~, ss ajatte expSiatlon' date: 1~e~~°l~b1A~~' 'Names of persons signing in any capat:lty'ahould be typed or printed below their signatures. ~ ., Information Prdaaaionak Compuy faraf ~ ~~. Wiacwuin 69n-06S~2027