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HomeMy WebLinkAbout002-1079-30-100Wisconsin Department of Commerce Safety and Buru~ing Di;i ion PRIVATE SEWAGE SYSTEM 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 Ro ,Ton Baldwin Townshi CST BM Elev: Insp. BM Elev: BM Description: ~ • fl ~ t7p • ~ ~ Q~G CS i ~. rk. ( 1/117 r~ u~rvltlrlril Ivry TYPE MANUFACTURER CAPACITY Septic ` Dosing ~ S L~ ~' s~ Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic , t $ r `~ Dosing , ~ Aeration Holding PUMP/SIPHON INFORMATION ~~,,` i Manufacturer ~ Demand GPM Model Number (~~ H Lift t 5 Friction loss System Head , fl TDH Ft S tlo ~ ~ . ~ `• s • 3 Forcemain Lengt h I 'a. f~ Dist. to Well Q D Z ~ SOIL ABSORPTION SYSTEM CLGVNIIVI7 LI/11h county: St. Croix Sanitary Permit No: 430226 0 ~~atpe P~la2n I~DpNo: ~.. Parcel Tax No: 002-1079-30-100 Section/Town/Range/Map No: 32.29.16.466A10 STATION BS HI FS ELEV. Benchmark i I Alt. BM D./ b ~ •'S r Bldg. Sewer 9.Lo ~.lS~ SbHt Inlet 9,QZ ~ D.~ SUHt Outlet ~ O o~ o.bg Dt Inlet fie, rZ, ~ o.~ Dt Bottom /3. C ~• 301 Header/Man. 2 ~ 3 D $• S ~ Dist. Pipe .2 , 2~ Z, 3a d O 2• o / ~~(~ Bot. System Z,r6~ 2 `~Z ~ 9S / Final rad ~ w ~~~ ~,¢ 1Z+ C8t1~ - eo St over '~,m ~, it 93.9 ~( i y, yg ~ ~ Gtrvz /'~Z ~-9s' qS- /TRRl~OCH Width Length o. Of'frcacucc PIT DIM SIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS .~ I ~ V SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Ma ct INFORMATION CHAMBER OR Type Of System: G~ t -.. $ ~„~ ~ UNIT _ el Numb DISTRIBUTION SYSTEM / h-4v ~cf- PILI Header/Manifold ~f • f Distribution , (l , P x Hole Size of x Hole Spacing ~ Vent to Air Intake '_ ~ f~ Length 2 ~ Dia ' ',v 'pe(S)~-/.t~`\ l ~Q Z • J~ Length ZgC 7Dia `' Spacing I/g / n • s3 L 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 Bedlrrench Center Bed/Trench Edges Topsoil ~ Yes ~ No r] Yes f ~ No QM~F~ITS: (Includ discr p per ons resent, etc. Ins ection #1: ~ / / Inspection #2: I ~ /~ t° ocation: 2273 70th Avenue Baldwin, WI 5400 (NW 1/4 NE 1/4 32 T29N R16W) NA Lo 1 ~ (mJ`Q~~~ ~. Parcel No. 32.29.16.466A1 1.) Alt BM Description = (t7~ di',t?tJ~~Q,~tB""1. ~ E ~ 3~ 2.) Bldg sewer length = ~ a` ~ ~ '~,` -amount of cover = ?~ I/~ ~. t ~) r -- , Use otheriside foruadd tional in Yes ~No Q~ ~ I~ ~ ~ ~/~ 4 ~I -- - formation. ~'~ --- L- ~ ~ - _ _ - I~'- - _.' SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. ~ 201 W. Wsslliageon Ave_, P.4. Cott 7082 ~C~~~,n Madison. WI 33707 - 7082 ~rlent of ComtnefCe (608) 2616546 Sanitary permit Appli(~o~ ~ ~~ ~~~r to aaeotd with Comer 93.21, Wk. Ad>R Coda pelaooal io yor provide array be rued !or seooadsey putpoeoa pelvrc5' Law,~rl S.Of(Ixtet) to Cnforwadoa -please 1!rint AD Iafocmagoa (~ u ~ ~' ~© f9~ g_iq,~ City, Sate I~l~w~~ ~ [,c~; , II.'Cypa atBulldta` ( k a!1 [bat apply) y 07 1 Ot ~)Frfiit?' ~M+C1~~ -A1tt~bq' Of 8 syo~ ~ ~~~ ~ ~ ~ ~-'~ (~tLU i ~ l.. Y'O 1 ~~3~ ~ r- 2z~-3-- ~0~~1^~ , yYCC1 k / lo[ p \ RMrY ~~+(/ Ya / d~ Yti Sartion ~L =.~ g ~ ~9 ~; R~~~, ~- fSM Nutob 0 Pa61iea0etnataKial- ~««+b. ue = 9S. (~ ~- Do ~. ~ ~g 3~ ~ ~ v. i P ~F39~ ^ Strtc Ou~aad- Dam'bs Uae 0 D '= 23 l.qz' Oaty_dvina~e o~t,>r,;p ~- iit. Type of Peranlt: (Chock only otte box osi 1Wa A, Cotmpkte line H if applicable) Oo2 - (0~'9 ~~ - l~ e~-!a (,t11 ~ Nnv syatatt D Jtepiaaetsteat 37atcat ^ ?ramtaWkwlaiog lank Replaestnalc Only d Omer Modiryeation to Eteisting System R. ~ Pamir R~aaowal ^ Psrmit Yevisioo 0 patffe of ^ Pamir Ilaemfer to New ~ Previous Permit Numbrt ^ttd Dart: Issttrd ~~ ~~ Plumbs Oarner (~ Nolt -PtmsYtirsd LrCiround ~Ntound ~ 21 in of suitable Boil [] Mowtd t lAa~, of svisabk mitt ^ At-Grade (~ Single Prey Seed FFltcr [] Cooatrtteaed Wetland ^ Ptmtuiaed Inllrouod O Heldiny Teak d Pea[ FS~on ^ Aatobic Trerrment Unit O Recircalatir$ Seed FiLot ^ Reciroubiana S7athrtie Madir Filar ^ I.sachiog Chamber Q Drip Line ^ Gnvd•ltas Pipe ^ Othee (esplain) r rearmt:nc ettsa satormanasr. °1 S'.6 } ~~) .~ 1 S Ia Dit~persal Ara Requ'wed (sn Dispersal Area Ptoposeai {sq system Ekvadon ~' I . 2 ~° o ~o ~~.59 9~~, k lafo t.ap.ciry io Texrl Maanfxmeor Prefab Sire Steel e4a Ptssdc tiailons -- Gslloru of Units Coaaste Coasmrcud Glary a '4-'IlI-~Res asm ~Sftate-m//estt- 4 the nudataitned, amlote t+esp~oea~tb~ti,[ty ter tacnllrtion of tre POWTS rltowa or dtr.tnc~M/ed pl^as. _://.ti~C~~ ~up1s P 'rSigot-tu~ L~G!~(~'.zv~' ~~~~~~ ~/.J P~Numba'~~7 Plumber's Addreas (Shyer, City. Suuq Zip Code) / 'V>iCI. Coua !D rtment Use pal ~ ~. ~Apptoved ^ Ditspprovod Sanitary Pamir Fee {intludd Grottadwattx Doe 8eued lasu ~ ti ant Signrture: (No a) Suncbage Fa) 0 Ownst (}iven Kansan roe l~tial 3 s0--- . ! `~ 2(~ IX. Conditions of Approval/Reasons !or Disapproval ANoea complete pNtu (lo tLe Gr^ty oelr)!or tbo ywem a. papa tgtlpe fleas art2 x 11 iwi~a Ir the SBD-6398 (Yt. 08/02) 70~Ave. ~ %t ~ Elcda-ion - jE-EX~SEi f'~nct/.iz( ~^ Proposed irtocc~d of z~:~?x //.~ ~'~ ~Ys:r90'~.'sP~sa/ cei/w/~ / z.s3: - a ~../ i / ~ .~~' d / ,v~ ~ ~.~ ~~ . Pro pouf ,,coo/6ce 9av. eo~nb,~a~•or, ta.~K.s/ ~abel A-icbeFF/ua~L`- Second U~a...bu: ~~,~, mgr.- -r / ~",o. ~~, ,p,~o~. c/G'U•Cv,' q~50 nto~..r 9s so' , Pr'o posed ~A-75amR' ~u,,.,~0 Cfw.« 4tr ^ a~ C y`A.~T. r<. 3o3y ¢~'/4w+t /~ht. y "sa~•VO P.rc; b4: /d,•~, se~acr --~ Proposed 3 bcdrea~ ('tS~dtnCc proposed i.k.~1--~ I ( P~. B aF 9 0 a ~ ~scons~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 Jim Doyle, Governor Cory L. Nettles, Secretary July 14, 2003 CUST ID No.220853 DALE E HUDSON BOLDT'S PLUMBING & HEATING, INC. PO BOX 78 BALDWIN WI 54002 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/14/2005 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Tony Roy 70TH Ave Town of Baldwin St Croix County NW1/4, NEl/4, S32, T29N, R16W FOR: Object Type: POWT System Regulated Object ID No.: 909710 Identification'Nambers Transaction ID No. 883308 Site ID No. 661172 Please refer to both identification numbers, above,' in all correspondence with the agency.: The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes COlZl~lt and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in ~~~~ chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: DEFARTMENTI General Approval Requirements: SEE CORRE4 • 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 SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST SAS (01/81) • Per manual cited above, 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. • 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 • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • 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. Stat • Comm 83.22(7) 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. DALE E HUDSON Page 2 7114103 Owner Responsibilities: • 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). • 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 83.55 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. 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. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, ~.~~~2~e ~~~~~ Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@commerce.state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Tony Roy 3 bedroom residential mound Owner's Name: Tony Roy Owner's Address: 1928 4th Ave. Baldwin, MN 545002 Site Address: X)CXX 70th Avenue Legal Description: NW1/4NE1/4, Sec. 32, T.29N., R.16W. Township: Baldwin County: St. Croix Subdivision Name: CSM Vol. 16, Pg. 4397 Lot Number: 1 Block Number: NA Parcel I.D. Number: 002-1079-30-100 Plan Transaction No.: RE~EtV'~D JUN 2 p 2003 I.DGS OIV.a SAFETY & B Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Site Ptan Page 9 Soil Evaluation Report Designer: Dale Hudson License Number: Date: 06/02/03 Phone Number: Sign ure;~y ~ ~ ~,N~-?--~ o-~,r n =1X' ~,. ~ ~ ,~ r~GGh~-ti9ERCE ~~C., ~tQ1NGS ;PONpE 220853 715-684-3378 Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 3.0 (03/01/01) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 300 00 Estimated Wastewater Flow (gpd) Table 83-44-3 in-situ soil treatment for fecal . 50 1 5 = 150%) g 1 Factor (e Peakin coliform of <= 36 inches. . . . . g 450.00 Design Flow (gpd) 7.00 Site Slope (%) 95.67 Contour Line Elevation (ft) 13.00 Depth to Limiting Factor (in) 0.50 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 90.00 Dispersal Cell Length Along Contour (ft) = 5.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest oint in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) c Center or End Manifold 2.50 Lateral Spacing (ft) If N above, enter the elevation ft 4 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 2.50 Estimated Orifice Spacing (ft) = 6.25 ft2/orifice 2.00 Forcemain Diameter (in) 35.00 Forcemain Length (ft) Does the forcemain drain back? Y 90.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 7.09 Vertical Lift (ft) 0.66 Friction Loss (ft) 14.25 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. o tions choice 0.75 1.00 x 1.25 x 1.50 x x 2.00 x 3.00 x Treatment Tank Information 1600.00 Se tic Tank Capacity (gal) Wieser Combination Manufacturer Dose Tank Information 760.50 Dose Tank Capacity (gal) 20.28 Dose Tank Volume (gal/in) Wieser WLP750-MR Manufacturer 5.71 Forcemain Drainback (gal) 81.25 5x Void Volume (gal) 86.96 Minimum Dose Volume (gal) 29.66 System Demand (gpm) Manifold Diameter Selection in. dia. o tions choice 1.25 x 1.50 x x 2.00 3.00 Gallons/Inch Calculator (optional) 760.50 Total Tank Capacity (gal) 37.50 Total Working Liquid Depth (in) 20.28 gal/in (enter result in cell 649) Effluent Filter Information Zabel Filter Manufacturer A100 Filter Modef Number Project: Tony Roy 3 bedroom residential mound Page 2 of 9 Mound Plan View 1- 1_ 1 /10 B • ' ' •Observation Pipe ' :}"~~. ti.ti.ti ', •'. ti. ti.ti.1.••.• . CJ ti• ti• ti.•..ti.ti.• •' .1.ti.•.. ••.ti. j. f•f•~~ f• f•r,r• f• j• f~ j ~• ••:: •~ •r~r•r•r•1',~ ~~ ,~ •~,•~ .r. .~ .~,.~ ~~ r•l;r; '•j' .r•r•f,,r; :f:1',: .r:rlf. .'r.r: 'jlf: :'r.'' '~' o •~. . .~7. v. . L_I • . -t Jl - T A I 1 L Mound Component Dimensions A ~ 5.00 ft E 27.20 in B 90.00 ft F 9.50 in D 23.00 in G 0.50 ft 450.00 (ftz) Dispersal Cell Area 5.00 (gpd/ft) Linear Loading Rate H 1.OOft K 11.65ft z 13.51 ft L 113.30 ft J 7.95 ft W 26.47 ft 1666.14 (ft2) Basal Area Available 9.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 99.38 (ft) +~-I H .... ~ ~ ......... 98.09 F .•:~:~ Dispersal~Cell 97.59 (ft) -- - Dispersal Cell ;~ ; ~ ~ ~' ~ ~ t Elevation E ~ ~ D ~ ; ~; • .. ...• ....• .... .~ ...... . •. ~. .. ...... ..... . .... Shading Key 10 ®Topsoil Cap ""' Subsoil Cap ASTM C33 Sand ® Tilled Layer Q .~jti: Aggregate 7.0 % Site Slope ~ 'n c ~ 1.5 ft Z _ ~ 0-~- a~ 0 (ft) Lateral Invert ~, 67 (ft) Contour Elevation Geotextile Fabric Cover See lateral details on Page 4 for number, size, and spacing of laterals. Laterals are equally spaced from the distribution cell's centerline in the distribution cell (AxB). Project: Tony Roy 3 bedroom residential mound Page 3 of 9 Center Connection Lateral Layout Daigram Farce mai n connection via tee or cross to manifold at any point. I P ~ •=Turn-uptm'ball valve or ~EX--~`Ex+2~ cleanoutplu g Holes drAled on the bottom of the lateral. Laterals are identic al Laterals & foroe main of PVC Sch 40 per COMM Table 84.30-5 S Number of Laterals Lateral Diameter Lateral Length (P) Lateral Spacing (S) Lateral Flow Rate System Flow Rate Total Dynamic Head 4 1.50 in 44.28 ft 2.50 ft 7.41 gpm 29.66 gpm 14.25 ft Orifice Diameter Orifice Spacing ()q Orifices per Lateral Orifice Density Manifold Length Manifold Diameter Forcemain Velocity Dose Tank Information Electrical as per NEC 300 and -~ Comm 16.28 WAC Disconnect ~~ Tank component is properly vented Wieser Combination Ca acit 760.50 Volume 20.28 Manufacturer Gallons gal/inch Dimension Inches Gallons A 19.01 385.44 B 2.00 40.56 C 4.49 91.14 D 12.00 243.36 Total 37.50 760.50 3 r tank. Alarm Manuafacturer LevelArm _~ Alarm Model Number DLV ~- Pump Manufacturer Goulds Pump Model Number 3885 WE03L Pump Must Deliver 29.66 gpm at 14.25 ft TDH A B C D 0.125 in 2.53 ft 18 6.25 ft2/orifice 2.50 ft 1.50 in 3.03 ft/sec Locking cover with warning label and locking device and sealed watertight i 4 in. min. ---~_... E-- Alternate outlet location Forcemain diameter ~ 2 in. Weep hole or anti- siphon device P~ ump off elevation (ft) 91.00 Dose tank elevation (ft) 90.00 Project: Tony Roy 3 bedroom residential mound Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name Boldt's Plumbing -Dale Hudson Phone 715-684-3378 POWTS Regulator's Name St. Croix County Zoning Phone 715-386-4680 System Flow and Load Parameters Design Flow- Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 300 gpd Maximum GODS 220 mg/L Septic Tank Capacity 1600 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Ins ect and/or service once eve 3 ears Should ins ect and clean at least once eve 3 ears Test once eve 3 ears Should test month) Laterals should be flushed and ressure tested eve 1.5 ears Ins ect for ondin and see a e once eve 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished ...~~......... ............... Grade \ 6-8" Diameter Lawn ~/_ Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral ~- Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Tony Roy 3 bedroom residential mound Page 5 of 9 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. 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. Septic Tank The septic tank shall 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 least 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. Pump 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 Svstem 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 soil 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 as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 30 mg/L TSS, 10 mg/L FOG, and 10" cfu/100 mL for highly treated effluent. 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 test is 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 for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. 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(s) shall be immediately repaired or replaced with a component of the same or equal pertormance. 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 absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Pagej~of this plan for the name and telephone number of your local POWTS regulator and service provider. ~~ Project: Tony Roy 3 bedroom residential mound Page 6 of 9 jY ~'~ti , pis h (~ ~^~;iC Effluent Pump CAPACITY Pump Specifica tons ~'~eatures and Be f s ~' > HP •All models feature silicon carbide GFM ~ mechanical seal faces for superior ~" ;",~ spar+, to 123' "~,: abraswe resistance and extra _= i~ size ? NPT long life. _ _ -. "{aX'~°rul>1 •• Cast iron semi-open non-clog Motor impeller with pump-out vanes ~„ ~ s feature ball for mechanical seal protection. - ~ ~~siruction • Rugged cast iron volute type casing _~~.. ? ~~ S~~ngle and adaptable for slide rail systems. ~~~ase ' ; 5. 200. • Corrosion resistant threaded 'nu any+, 575V. stainless steel shaft. phase models .Motor is fully submerged in high ~~ac~tor start motors. quality oil for lubrication Materials of Construction and efficient heat transfer. - ~ ~ • Optional silicon bronze impeller -~- ='s s~ee ' available. •CSA listed models available. u~ Underwriters Laboratories All Models are designed for continuous ope ~k~"~ ~ n ~5~ ~ ..,~; ~~,a,~. ~.., d~k r. .. ^1+ ~,y _. ,~ METERS FEFi et ~ i zo F 6,' Q W 5r 15 S U_ il. Q Z ~ 10 > ~~. O J t O ~ F ~, I- F- i ~ e~ o~ MODEL 38'2 Pump Specifications Features and Benefits '/z HP •Glass filled. thermoplastic ~:-ohe~ Up to 75 GPM impeller with stainless stee~~ Maximum head to 18' insert and pump out wanes fog Discharge size 2" NPT mechanical seal protectlo~, Solids: 2" maximum •Rugge~ glass-filled thenno;~~;s~~~~ o casing and base des qn pro =:?~ All m otors feature ball superior strength and corros~~o~~ bearing construction. resista,~ce. Single phase: 115V •Cast iron motor housing fo efficient heat transfer. strenar, Materials of Construction and durability. Cast iron • Corrosion resistant threaded Thermoplastic stainless steel shaft Stainless steel • Available in automatl~ ,~,d ~,~ ,-, models •CSA i~~sted models ai.~a~~iab!e ~ation and feature stainless steel hardware. ~ 7 0~ 9 ~~ .o zo ~o ~o ;o .. 2 a 6 B i0 12 ~- CAPACITY 70~Ave. Jo; ~ Q f~Q~G~Q p`On %t -~•E~'iSL~i ~~iJCC/iiLQ I~ I SC1t/C: i = S/O' ~SSum~ ~IZ~`• c/Gb•CY~' 9GO~Srtdo~ 1' ~ ' ~ P~a,oos~ ~o~~ of ~~~~x /~3 ~'/ 9s so w;~bC yg o~t~'cesS,oaeeda~ ~c~' a ~ z , s3: ~ ~ , pro cscd P ~~ / ,~ ~A-75UmR' ~w•.P Chow ~ ^ V O' l~ ~~ y 4A•~T ~. 3039 I a Pao pow ~,oD%cn 9d.P. ~o..bel ,¢icb r~'lu~t' Second Gra..~be~: Pro posed wc.tl --~ 0 y's~l. yo P/. c~ 64: ld;•,, sawcr proposed 3 b tclra~ res~dencc P~. 8 aF 9 ~- ~ -~~ yyi~natrt pepartment of t:,ommart:e SOIL EVALUAT{ON REPORT Page ~ of ~. Olvlabn of Safety and Bundings In ecoordanco with Comm B5, Wis. Adm. Code County Attach complete site plan on pepst nol less than 8 112 x 1 t Inches In size. Ptah must / Include, but not Amried to: veAlcel end horizontal rofer+anca point (BM)• dlrodbn and ~ ~ 0 O percent elope, scale w dimensions, rwrih arrow, end location end dlatance to nearest road. ~ O Q _ I ~~ ~ ~ Date Avlewed.,byr,".. ,~ .^ Plsaae print ell frttormat/on. ;~,(_~,;_,~. _ - , P~~ond 4doemrrtto~ you provla~ meY b~ wed fa ueonOsry purpwst (PrHacy l.hv, ~. 1S.Ol (1) (m)). ~ _ Property Qwner Property Locatfoii ~ ,; , . IvW--~1/41~6.1 '';~ 'T 1q N R llo W AKS NFL`{ ipLSBY{~Clt'T property Ovmers Melting Addreu Lot # BI # SubO• N~ipor~~'jSMa zZ..SS 70'''r'` ~kUE • -- -- ~ .•~_. p ulna a ~`fown Nearest Road U.3~D~J 1 L.t,~, 1 W~ 15y 024' ~ { ~ l ~) ia~ U' 4190 1 1`~~-Ol!» New CortStruWon Uae:~ Rettdentlal i Number of bedrooms ~_ Code derived design now rate _ ~ ^ Replacement ^ Public a oommerdel - Desaibe: N- Paren! rrsterla) ~[~ Tl ~- Flood Plain elevalton it appUCabb aenaraloommenta pPlt_t.- l.A,bo and rocornmendations: ~V10UW0 sVS'~TcN~ t2ti/t~u.~R~o 1~ sft~ ,~~ ~E 5~-JT~ ~,Qr1~tD~R 4.5, fez r rn ~~ # ~ Boris ~ Pit Ground surface etev. _~L 5q ri• gepth to limiting tador ___1,~L_~ In. Horizon Depth fn. Dominant Color Hansel Redox Description Du. Sz. Goat. Color Texture l 0-14 o Y ~/ t '~ ~' z -1y v 3 s~ I 2 3 4-19 0 3 '~ - ~ H .2S ~ b c.z ~~ e~. ize~ T 2Z" D Bong # ^ Boring 2 Jirn•' PII Ground suciece elev. QS oq R. ~ Horizon Depth in. Dominant Cola Munsetl Radox Dosaiptlon t]u. Sz, Cont. Cotes Texture 1 p I L L _ 13 ~~~ Si l 3 20 3/ v p 4 C N /~ - t:3P0 ~1\ ~'~ 1~1 ~ \~ REcE ._ ~ 201 "- p~~s~ ~ -- sZ t:~x zvt~~~ / ~ %;, e ~~, Structure Conelatence Boundary Roots Gr. Sz. Sh. ~Effgt ~ Or f mob K rri~r C z-~t~-~n 0.5 pth to Iimiltng fedw _ ) 3 _ In. Structure Consistence Bound Gr. Sew Sh. g ~ l -70 ~K }~v&. d.8 ' 2 of ~ J' a- OO O ~~pp~~(~ Z Q79 Parcel IO li .QQ-.~_ GS ' R EC+~ _ Paga ~ ~ . _- property Owner ~ ~ a Boring N ~ PII Gnxmd surface elev. q5~ ~ h. Depth to llmuing tailor ~. ~I fcatbn Ra t` Horizon Depth Daminant Color Redox DeacrlpUon Texhxe Structure Conalatance Boundary Roob GP •EifKt Dff 'Efh><2 In. MunaeG Qu. Sz. Cont. Color Gr. SL Sh. Y L~~-m 0 •S O , l p- it 1 --- t, cs -f o S o.8 z -~ u~ -- st l ~ Z~t~- O.Z- 03 '2 ,-, -,~ ,,..,.3/u r~~o~ r: tAVr~4~e 5l~ ~ Tf _ Boring ^ 0oruig p. In. Sell cation Ra ^ PIt Ground °~~ eiev' - h• Oeplh to IImIHng Fedor GPD/tt' Horizon Depm Dornlnant Color Redox Desaiplion Texture SWcture Conslatence Boundary Roots •E(fp~ 'Eff1H2 In. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. ^ Boring q ^ Boring a Ground ~urlaca e{ev. _ h. Depth to Umitlng lector ~• ^ PK Sill A icatlort Ra criptlon Texture SWdure Conalstence Boundary Roots GPDIIY Horizon Depth Dominant Color Radox Dea •Eff#1 'EiTri2 in. Mansell QU. Sz. Cont. Color Gr. Sz. Sh. ' EKluent pt = BODr > 30 < 220 mg/L and TSS >30 _< 150 mgA. ' EtAuent tit • BODr < 30 mgA. and TSS ~ 30 mg/l The Depanmcnt of Commerce is an equal opportunity service provider and employer. !f you need assistance to access tcrvices or need material in an aliertute format, please contact the department at 608-266-3151 or 'I-1-Y 608.264-8777. laDJ730 I11.MC0) p~Of pI.AN „~_ Wtaoonetn Department of t,.orr,merae 1 6..VJ1__~ ~~ ~_3-°I SOIL EVALUATION REPORT Page ~ of N1~~aw,r~ w w.vj a.... ~~.......~_ _^ In ac/wrdence with Comm 85, Wis. Adm. ode County C Altsch oomp(e(e site pion on paper not less than 8 tl2 x 11 inches in slze. Plan must Ux:tuda, but not grnlted to: verilcel and horizontal roferance point (BM), dlrodlon rnd ~ ~ 0 0 O percent slope, scale or dlmanslons, tlorth arrow, and locetbn end dlatance to neerost road. O O " i D e Please prlnf atJ Jnt*ormetJon. t1 ~'~~"` ~' ' "~ P~nond NdonnaSa~ you provl0~ may bs utad fa sseonaary purpwef tPrk~cy t.nv, ~. 15.04 (1) (m)).; ~, Property Qwnar Property lost ~ ~ ; ,~ ~ ~, `: AST /V~L~ Cc•LS$1(~~Gi"T lv~A1-' ~ 1/4 JVE r ~ T 29 N R ~ b ProO~riY Owner's Matpnp Address Lot # Bl # ~ 'Sutx1. Ptam~Z1rJ~M# ~. ,•, ~7vI~sGC~'c1~~~` u'`g5 ~~~ ~~~ ~ ~. Nearest Road to p a r ^ C(ty Villapa ~ ~`'fown t,~c~nv~u.>r W~ ,~yoz4' ~~ (oflU-4~qD >I~ ?a-~"~-v+r. 0 W I New Construdton User Restdentlal / Number of bedrooms _ .3 Code dsiived deelpn Aow rate 43a ^ Reptacemant ^ Pub11c or oommerdal -Describe: ~~, Parent n•.stedat ~L~!'~~ _ TI 1,L F(oo0 Pleb elevalton if appUcabk General oonxnerRa and reoommendatlons: ~V101,W0 sVs't~,N~ t2EQu~tZ~o •~`~l~pFtt~ ~..a~w+'~~'~°rr~ ~S~ Cn~uR 4~ f.7' rn Pit Ground surface elev. _'~'t 54 n. Daptn to am-dnp fad« ___L~~-. ~~ # ~ ~~ ~ Horizon Depth .Dominant Color Redoz Desaiption Texture 5truclure Conalstence Boundary Roots ~r=fMf t ~~ tn. Munsel Du. Sz. Cont. Color Gr. Sz. 5h. ~ _)y ~J 3 sti I 2f [r-sb K ~r C z..~i~-m OS 0.8 3 -IQ n 3 ` t Z-~ -< rvt~r- a n ~~-r ~ -~ 3 b C.Z ~ Z-FSb VYti'i J r 'f'~-'F ~ eL l'l~-0/~ ZZ ~~ ~--~ ^ ~~~ Z I BOttnp # rn _ ~.ti _,a .. ~.e~. era„ AS. 89 R l~enth to limil(nQ tailor _ 1 ~ ~+. t ~„Y en~~ e 1 Horizon f. Depth In. ,, ~ .. - -- Dominant Coto Mansell - Rados: D3saiptlx~ Qu. Sz. Cont. Cobr T9xture StnlCtlJfr Gr. Sz. Sh. Cprnlatence Boundary Roots GPtNff ~ER#1 ~E~ I p l ~-. r O.S 0 ~~ Z.. 3 -13 2D tZ~I 3~ y o y S+ I C L-F sb)C ~ t~r~abl( a _" Jf- ~ J~ 0.5 .~ti 0.8 ©. G N _ _ _ _ ----. _ e~.. ~ ~ ~n .....n nnA TCQ a 311 maA_ EfllUent til ~ CW ~ .iV ~ LLV nRY~ miu iaa -w„ .w my... --------... - - - ;ST Name (Please Pitrtl) S turn ~~ CST Number n ~o o ~~ s ~ n 3z- Date icvaktstlon Conduaod Taiaptane Number Address ~?98?5 `9o*~Aae~,R~yEI~'~Aus,~Wl' 54022 O(o-)~01 L~~S~ y26-1'17.x, '' --~ ~,~ , RE~. ~~~,, ST C~X i'`- t~~ ~ ~ , 2a'~' e ~ ~~ ~~ ~ ~ ~ ~ s~ ~, ~ ~ ~" / ''~~ (~t ~ ~ ~ ~ '~,~ ~ J , )~ r ~ N' ~~ ~ %~ ,~ ~ `Q ~ ! (,~("1 r ~~~ ~ , t t Q"T9 '3a-000 SSS EC±~ Parcel t0 p 0 2 f C Page - 2 of 3 o Property owner ^ 9orinp 3 Boring p ~ PH t3round surface elrrv. 45~ ft. Depth to UmNing factor Soil tcattort Re horiZOn Oepth Donttnant Color Redox Descrtptfon Texture Structure Co+-aistence Boundary Roots OPD(K `Etrftl 'Eft+lf2 in. Munsetl Qu. Sz. Cont. Color ~• Sz. ~• ~~(~-tart 0.5 0 • ~ ! 0- I I ---- L as . -f aS a.s z -! N~ -- stl ~rr~-1 r-t ~~ ~ u --._.~ in. ' ^ Pit Ground aurtaCe elev. ^ h. Depth to ilmlting tacxor „~ Roots horizon Depth port>inent Color Redox Desaiptlon Texture SMrctwe Conalatence Boundary }n, Munsglf t1u. Sz. Cont. Color Gr. Sz. Sh. ~ tior- Rats GPWf! •E~t •EHN2 Boring fi ~...~ Baring _____ Ground surface elev. _ ft. Depth to pmiting factor In• ^ Plt Soil A Ication Rats ttorixon Depth Oominanl Color Redox Deat7lptbn Texture Structure Conslatence Boundary Roots PDAt' in. Murtsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Etyfi `EtiM2 • Ettluent #t = Br3D~ ~ 30 < 220 mgll and TSS a3p < 150 rrxyt. • Et»uent fit ~ $OO~ ~ 30 mgA. and TSS ~ 30 mgl! 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 608-266.31 S t or TTY 608-264-8'7'17. ya0.l)30 (R.I+DO) ,' ti ~ y pI.OT pI.AN ~G ?4 f't nJt, R~ c.trt- o F- ~h y ~~N Ey W a A L 1U J 2 ,~2 •p0 ~~~y t>t~ ac. X un~r. a~t~,. Rt,F~`~~ a F`~ SIG~17 C`1( /~%yQ' P ~~ No7F-0 - ggoUB GRObWC~ ~~' ~. C~~NCi W~ aPGK}'10~ NO CUMM 83 5~n3AGK pROBL~MS EL DAt~: J 0 ``~ M I~ ~1 ~ ` i ~ 6~y~ 00 NoT 224832 Q3.G~' l q~~~ ~ / l ~y m rA ~' AI ^~ V W ~+ y 0 n ,_ _.: ._ ~_. _ __ .__ ~: . ._ : W 7._J._. _. _ . . ~ .. t A,.R. ~ . ~ ; 1 m O ~ ~ .i - ~i ~ ~ w O ~ ~~: o _ : _ ... . _ _~ ,~ :Z. ;... _ f i -.. -- j- - ~~-_ _D ~ i ~ ~~ : m z ' N ~ ~~ ,..X j " a D ~ .., ~ c. . .. ... .. ... ..... i -~- ... . . .:... ..... i , t ... .. t .. .. ~ ~---- i ~ -- ~ V ~ ~i _._. ._. i _...---..... V ~ i i j ... ._ a..I_ ~ -' ..._ ~ _ ....o.. s,-, ._ ,. ~ = . m , • - ~ I ~ _ - ~ . O ~ : . . ~._ a ;. I Z. . _. __ -- - -. . .. D i T .. ....- _ ~- _T _ i ~ - - _i... - .._.... ..... m Z / YIYI ' j O Z Z ^ VI 1 i ~ ' 0 C W ~' 11 ~ ~ _ ~ _i.~ r _ ~ ~ Q '~' m' .. i ~ i .- ~ .~..~ _ J r 0 T o j ~~ o Q ~o ~ N. _ ~ ~ ..~ i ~ ` I - ----~- - ~ r ~_ t -} 0 1 C o y :: ~~ 1 I .~I ^^ .V .P ~: f _ W -- ~ ~ o m m ~ ~ +~ m ~ 1 ~~ 0 ~ ~ m _ ~ . N ~ ~ ~ o I - - a - ....... .. j ..~, .T I ~ ~~ I ,- ~ Q~ . ._ . ~_ ~ ~_ ~ ~' _.... .. / ` T ~~~ ... -4 TOOK SHOSV~S 2If10d 8056 5Z8 6TZ %Vd 05~OT £OOZ/8T -~ w ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer //o-,~,~~~ Tip Mailing Address Property Address ~ ~-~` 3 ~Q~' ~.~ , (Verification required from Planning Dcpartmcnt for new construction) City/State _~Z ~ Parcel Identification Number ao~ - /0~9-~0-/DD LEGAL DESCRIPTION , ° (~~° ~ _ ~ ~~ Property Location ~ %,, /~~ %., Sec. .~~ , T ~ 9 N-R /~ W, Town of Z~G ~ ~u'I Y-- Subdivision Lot # Certified Sarvey Map # _ ~o CI ~ ~ 4 ~ Volume Page # ~ '7 . Warranty Deed # ~ 0 ~ Z Volume _ 206 ~ .Page # Z~ Spec ~O°~ ~ Y~ IIO Lot lines identi5.able C~7'yes O no SYSTEM~~yIAINT~NANCE -~ Ia~t+operuseaadmamteaaaoeofyonrt~tic:ystuaooaldresaltmixspc+emadmefailunetohaadlewastes.PmpermainLcaan~oe ooasists of pamping oat flee septic tank curry Smoe ~ ~ ~ by s 4oeased P~ ~t ~ Pm i~o ~ ~~ eaa affect.ttre SmC6ion of the septic tank-as_ a treatment stage is Sae aaste drspos. al.. . T~ I~P~Y~ °~°~' tO to Sc Ck+oix Zcamg Departmco~t a .ctrtification form signed by the owo~ec and ~y a p~I~Y~P restrictodplvmrberor a Iioeasodrr~ifyiag Brat (1) $be on~ite wasOcavatrrdisposal system is is proper operating ooaditioa and/or (2) aster as and pampiag.(rf necessary), $~ septic-tank is kss .than I!3 Full of sledge. . ~ tine narl~igaed have read the above regairrm~ and ~ to maintain tibe private sewage disposal syst~cm with the standards set fords, herein, ~ss set by the Depar(mem of Comayeroe and the Dgrartimeat of NatoraI Resources; State of Wisooosin.. C,exti~cation ~~g that ~ septic system has here maintained mast be oomplctod and rebaned to the St Q,oix.Couaty Zoning Office within 30 days of th,e Sure year expiration date. ~~ h SIGMA OF AP NT OWNER CERTII~'ICATION I (we) certify that all statements oa this form anc true to the best of my (our) knowledge. the property dcscrr'bed above, by virtue of a warranty dood recorded is register of Deeds Office. SIGNATURE OF APPT;It.,,ANT ~l ~ /~3 DATE I (we) am (are) the owner(s) of 8~i~~.3 DATE «««««« «««««« ~y information that is mis-rcpreseatod may result in the sanitary permit being rcvokod by the Zoning Department. •• Include with this application: a stampod warranty docd From the Register of Dodds ollice a copy of the certified survey map if reference is made in the warranty deed , 1 2069 P 250 ~~~~3~ STATE BAR OF WISCONSIN FORM 2 - 2000 Document Number WARRANTY DEED This Deed, made between David R. Johnson Grantor d Anthony M. Roy, a si !e person Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach adde KATHLEEN H. li1ALSH REGISTER OF DEEDS ST. CROIX CO., NI RECEIVED FOR RECORD 12/05/2002 09:30A1f EXE?PT tl REC FEE: 1i. 00 TRANS FEE: 105.00 COPY FEE: CERT COPY FEE: PAGES: 1 Recording Area Name and Ret»rn Address Thomas A. McCormack PO Box 2120 Baldwin, WI 54002 .~ ' S oo2-IO79-3 C~ _ ~~ _, ~ p~ Yazcel ldentific 'on Nttmber (PIN) ~O Z _ I l7 This is homestead property. / '/ b/ ~ _ I~~ (is not) (• T ~O Part of the Northwest Quarter of the Northeast Quarter (NW 1/4 of NE 1/4) of Section Thirty-two (32), Township Twenty-nine (29) North, Range Sixteen (1~ West, St. Croix County, Wisconsin, more particularly described as follows: Lot One (1 f Certified Survey Map filed October 10, 2002, in Volume 1 of Certified Survey Maps, at Page 4397, as ocument No. ti93688, office of the Register otDeeds for St. Croix County, Wisconsin. This deed is given from grantor as trustee to the assigns of Arthur M. Gisbrecht and Nellie S. Gisbrecht, pursuant to the terms and conditions of paragraph 4 of that certain agreement recorded July 26, 2002, in Volume 1940, Page 46, Doc. No. 685813. Exceptions to warranties: Easements and restrictions of record. Dated this ~~~ day of ~jJy~(M ~1°li2- , 2002 * - ?/Yti'~ • David 12. Johnson ~; -- THENTICATION A U ACKNOWLEDGMENT ~,/( -rte ) t ~ Signature(s) U~ I J ,~ U )'~ ~Z-. J l1 tl,Vt3b1J STATE OF WISCONSIN ) ss. _~ St. Croix Cotmty ) authenticated this ~ ~ ay o M~~ a+1rc'/Z.. personally carne before me this tray of 2002 the above named t ~~l~ ~ R , /1tiGCD~t~tA ~ - -~--- David R. Johnson TITLE: MEMBER STATE BAR OF WISCONSIN to me known fo be the person(s) who executed the foregoing (If not, _ authorized by § 706.06, Wis. Stats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY ~ _ Thomas A. McCormack _ Notary Public, State of WISCONSIN Baldwin, WI 54002 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both arc not ncassary.) ') + Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN tNFO•PRO (800)655.2021 www.intoprotorms.com FORM Na. 2 - 2000 /^~ ~~~a~i.,.Jk ~~ v...8.. t" ( t ~. .. Planr,;nr 7~•. , , _ . , i7(;T 1. d ZOOC -°°t~•~°°,~t,-4 CERTIFIED SURVEY MAP RUI9 ~In'" '" ~' , LOCATED IN PART OF THE NW1/4 OF THE NE1/4 OF SECTION 32, T29N, R16W, TOWN OF BALDWIN, ST. CROIX COUNTY, WISCONSIN. PREPARED FOR: DAVID R. JOHNSON 2255 70TH AVENUE WOODVILLE, WI 54028 SURVEYOR: DOUGLAS J. ZAHLER S & N LAND SURVEYING, INC. 2920 ENLOE STREET HUDSON, WI 54016 SURVEYOR'S CERTIFICATE I, Douglas J. Zahler, Registered Wisconsin Land Surveyor, hereby certify that by the direction of Nellie Gisbrecht, I have surveyed, divided and mapped part of the NW1/4 of the NE1/4 of Section 32 in T29N, R16W, Town of Baldwin, St. Croix County, Wisconsin; described as follows: Commencing at the North Quarter Corner of said Section 32; thence S87'07'34"E 970.33 feet along the North line of the Northeast Quarter of said Section 32 to the point of beginning; thence continuing along said north line S87'07'34"E 330.00 feet to the east line of the Northwest Quarter of the Northeast Quarter of said Section 32; thence S00'38'07"W 660.00 feet along said east line; thence N87'07'34"W 330.00 feet; thence N00'38'07"E 660.00 feet to the point of beginning. Above described parcel contains 5.00 Acres (217,634 Sq. Ft.). Above described parcel is subject to right-of-way of 70th Avenue and subject to all easements, restrictions and covenants of record. I also certify that this Certified Survey Map is a correct representation to scale of the exterior boundary surveyed and described; that I have fully compiled with the provisions of Chapter 236.34 of the Wisconsin Statutes and the Land Subdivision Ordinance of St. Croix County and the Town of Baldwin in surveying and mapping same. _ _ ~ -S- 0 2 Douglas Za I r •i~ 2145 ~ Date ~~ Mr S & N Land urve ng OF WfSC 2920 Enloe St. ,~~ oy Hudson, WI 54016 ~ DOUGLAS J. SZ ZAHLER S-2145 HUDSON, S IS. Each Parcel shown on this map is subject to State, County and Township laws, rules and regulations (i.e., wetlands, minimum lot size, access to parcel, etc.) Before purchasing or developing any parcel contact the St. Croix County Zoning Office and the Town of Baldwin for advice. Vol. 16 Page 4397 THIS INSTRUMENT DRAFTED BY: WILLIAM KANE JOB N0. 6085-01 DATE: 07/30/2002 SHEET 2 OF 2 SHEETS Vol . ~ 6 Page 4397 1 , LOT 1 5.00 ACRES (217,634 SO. FT.) INC. R/W 4.75 ACRES (206,744 SO. FT.) EXC. RM/ VOL_ 1~_PAGE__ 4~9.7~ KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CO. , WI CERTIFIED SURVEY MAP RECEIVED FOR RECORD 10-10-2002 1:40 Ph ~~~-~,.~~ ~= -~~ t.` LOCATED IN PART OF THE NW1/4 OF THE CERTIFIED SURVEY IiAP sT.c~~o~> NE1/4 OF SECTION 32, T29N, R16W, TOWN REC FEE: 13.00 Plannin^7nr°~ OF BALDWIN, ST. CROIX COUNTY, WISCONSIN. COPY FEE: 3.00 ocY z o 2002 .....__. _ M[~pL~,CQ'~C~D dLQG~D~ If ~~t rNca~;a~: O~[n~l~D o ~ 04[~GG3~ approval date, :,:• ~ ------------------- ~~~ ` ~ N,/4 COR.- 70th Aven SEC. 32 ~~_____---~_-__-- tl@ S87°07'34"E io `'~ .587°07'34°E 330.00' NE coR. SEC. 32 970.33' ~ CO S87°07'34"E NORTH LINE OF THE NE1/4 CO ~ 1300.33' w ~ S87°0734"E 3sn nn~ PREPARED FOR: DAVID R. JOHNSON 2255 70TH AVENUE WOODVILLE, WI 54028 SURVEYOR: DOUGLAS J. ZAHLER S & N LAND SURVEYING, INC. 2920 ENLOE STREET HUDSON, WI 54016 I~ ~~ ~ i~ I~ ~ i~ I ~~ I I~ I~ j11~I~ I~ I~ I~ I~ I~ I~ I ~o ICJ Z O w a~ 0 y a 1'11 O NN~~ D N Z Z Nfn~ 3 ~ N T~ D °~m p m ~ 20'± mmm ~~z n v 0 d ~ N-'1 ~r^O w~ ~o~a m z r+i Z O ~~ pF W/S~,o ti yP DOUGLAS J. ~Z ~, ZAHLER ., _ S-2145 ~~'~Q Z- SCALE IN FEET 1" = 100' 100 0 100 0 7'± N87°07'34°W 330.00' 6'33688 25'± z ~n N ~~ ~m I~ ~ = o I I~ I~ ~ m z m m I Ul I ~ a I ` I ~ I ~ I oo I ~J rn ~ I~ I~ ~ C i~ iQ I~ Q Q I~ I~ ~ j~ 22'± I I~ t~ Mf~JG°?dQ`~t~4C~D dLQ[vJD~ O~[~JGD _ 1~ pdQ44C~[~ I LEGEND THIS INSTRUMENT DRAFTED BY: WILLIAM KANE JOB N0. 6085-01 DATE: 07/30/2002 (~ FOUND MASONRY NAIL O SET 1" OUTSIDE DIAMETER BY 18" LONG IRON PIPE, WEIGHING 1.13 LBS. PER LINEAR F00T ROAD SETBACK LINE ~~~~~~~~~~~~~~"~~~~~~~~~~~~ (100' FROM RIGHT-OF-WAY) ' m FOUND 5/8" DIAMETER IRON REBAR SHEET 1 OF 2 SHEETS Vol . 7 6 Page 4397