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002-1086-95-000
Parcel #: 008-1066-10-000 03/30/2007 05:12 PM PAGE 1 OF 1 Alt. Parcel #: 23.28.16.337 008 -TOWN OF EAU GALLE 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 -NELSON, BRENT T & LYNN M BRENT T & LYNN M NELSON 286 CTY RD B WOODVILLE WI 54028 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 23 T28N R16W 40A NE NE Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 23-28N-16W Notes: Parcel History: Date Doc # Vol/Page Type 06/24/1999 605608 1436/607 QC 06/24/1999 605607 1436/605 QC 07/23/1997 1157/145 WD 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 05/12/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.000 29,200 346,900 376,100 NO PRODUCTIVE FORST LANDS G6 36.000 40,600 0 40,600 NO Totals for 2007: General Property 40.000 69,800 346,900 416,700 Woodland 0.000 0 0 Totals for 2006: General Property 40.000 69,800 346,900 416,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/1712001 Batch #: 513 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 St. Crot~x County Planning and Zoning Mor:da~,, Apri[ 02, 2007 at 10: 50:39 AM Detait Sanitary Information Page 1 °f 1 Computer #: 002-1086-95-000 Sub/Plat: metes & bounds Section: 34 Parcel #: 34.29.16.5026 Lot: TN/RNG: T29N R16W Municipality: Baldwin, Town of CSM: 1/4 1/4: NE 1/4 SW 1/4 Owner: Etzler, Brad 2418 County Road BB Baldwin, WI 54002 State Permit: 463443 Issued: 05/03/2005 POWTS Dispersal: Mound less than 24" suitable s Permit: New County Permit: 0 Installed: POWTS Detail: NA Bedrooms: 4 WI Fund: POWTS Pretreatment: NA Issueriinspector As Built Pam Quinn NA Not determined ~iur3ed C~'f~: No Plumber Other Reouirements Helgeson, Bennie Additional Notes Money Owed no installation scheduled as of 3/27/07 - ?? 1.9 $0.00 acre parcel as of WD 585-407 U e~~~ h Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division + 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: Etzler, Brad City Village X Township Baldwin, Town of CST BM Elev: Insp. BM Elev: BM Description: TANK IN FORMATION TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to well SClli ~RSnRPTInN SYSTEM ELEVATION DATA county: St. Croix Sanitary Permit No: 463443 State Plan ID No: Parcel Tax No: 002-1086-95-000 Section/Town/Range/Map No: 34.29.16.5026 STATION BS HI FS ELEV. Benchmark Alt. BM Bldg. Sewer SUHt Inlet St/Ht Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bot. System Final Grade St Cover BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: CHAMBER OR INFORMATION Type Of System: UNIT Model Number: nICTRIR11TIntJ CVCTFM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing Srlll CnVFR ., o.e~~~~re c..~•oma n.,t.. YY Mnnnrl nr obCrade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ~! Yes No I +! Yes I ' No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 2418 County Road BB Baldwin, WI 54002 (NE 1/4 SW 1/4 34 T29N R16W) NA Lot Parcel No: 34.29.16.5026 1.) Alt BM Description = 2.) Bldg sewer length = -amount of cover = Plan revision Required? i !j Yes I' ! No I ~ j ~- -~ Use other side for additional information. ~ ~~ ~ ~ -- Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) Cq#T111'iBt'G@.tfYI,~OV Safety and Buildings Division County ~ 201 W. Washington Ave., P.O. ox 7 T CROIX ~/°~('~ ~ ~ j„ Madison, WI 5 -71 Sanitary Permit Number (to be filled in by Co.) oeperttneat of cammeres 3 Sanitary Permit Application State Transaction umber In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate govetntnental 1131280 unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are oject Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide ma be u osea in accordance with the Privac Law, s. 15.04 1)(m), Stars. 2418 CTY RD BB I. A lication Information -Please Print All Information Property Owner's Name Parcel # BRAD ETZLER 002-1086-95A00 Property Owner's Mailing Address Property Location / 5o Z b 441 270TH STREET ST. CROIX COUNTY C , Govt. Lot City, State Zip Code Phone Number NE ''/y SW '/y Section 34 WOODVILLE, WI 54027 651-283.5236 (check one) T N R ^ IL Type of Building (check all that apply) / Lot # 2g ; 16 ^ E / W /^I ~ / il D lli b f B 2 F N d NIA Subdivision Name or am y we um er o rooms ng - e ~~ NIA ^ ^~., ~` L ~,/ ' M Block # Public/Commeroial -Describe Use (/ NIA ~ City of ^ State Owned -Describe Use CSM Number ^ Village of / /~ ~ ~) n /v ~ ~ fit' / ~ N/A ^/ Town of BALDWIN / O t ~t, t__QSL_1L III. T ype of Permit: (Check only one box on line A. Complete line B if applicable) A' /^ New System ^ Replacement ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System (explain) S t ys em ~ v f'- S ~ 0 B. /^ Permit ^ Permit Revision ^ Change of ^ Permit Transfer to List loos Permit Number and Date Issued Renewal Before ~ Plumber New Owner 463443 05/03/2005 Ex iration IV. T e of POWTS S stem/Com onent/Device: Check all that a 1 ^ Non-Pressurized In-Ground ^ Pressurized In-Ground ^ At-Grade ^ Mound >_ 24 in. of suitable soil ^/ Mound < 24 in. of suitable soil ^ Holding Tank ^ Other Dispersal Component (explain) ^Pretreatment Device (explain) V. Dis ersallTreatment Area Information: . ~ Design Floyd(gpd) / Design Sorl tcation Rate(gpdsfJ ~ Dispersal Required (sf) ~ Dispersal Proposed (sf) 600 ~ q~ System Elevatio 100 34 ~ 600 ~ 1 l,. 600 ~ . , VI. Tank Info Capacity in Total # of Manufacturer Material Gallons Gallons Units New Tanks Existing Tanks Septic or Holding Tank 1250 1250 1 WIESER CONCRETE Prefab Concrete Dosing Chamber 750 750 1 WIESER CONCRETE Prefab Concrete VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' afore MP/MPRS Number Business Phone Number BENNIE HELGESON ~ ~- 0292 715-7723278 Plumber's Address (Street, City, State, Zip Code) W1229 770TH AVENUE, SPRING VALLEY, WI 54767 VII oun /De artment Use Onl Approved _ Di a roved Permit Fee Date/issue Issuing ntSignature _ ner r Denial $ ~ ~ ~ ~ 11 / Z ~ ~ "1 ~ { i ! ~ ~ ~ G IX. Conditions of Approval/Reasons for Disapproval 3` ~ ) , r ~ SYSTEM OWNER: / 1. Septic tank, effluent fitter and dispersal cetl must all be services / mailttsined as per management plan provided by plumber. 2. All setback re uirements must be a3 pef appti0il~fdtdeAlrgldr(~i',the system and submit to the County oNy on paper not less thane 7rz a t1 mcnes m size SBD-6398 (R. 01/07) Valid thru 01/09 -f~lol ~(~ ~ -~ty, 1 o r n ~~~ ~ro~~s a~-:~- ~~~ ~ ~ to so/ ~s~ ~~_ ~. ~~ 3.. ~I ~ a~~ _. ,~ ~G~raaR/ y,. puC- ~ ~rC pD.s~{ 6-rp-° l Qe~ .Zh S w~4.~L' /-~-o •n -~ S~ ~ ~ s s fh ~ o" ,~ ej° ~V. ~~• ~ I Po~~ a~ _~ _~ ~.`T, H `'38~, ~. „ ~c. ~__~ -- ~y \. o~3i ~ 3~ ze,~f ~~~ Tc, ~ ~~ ~ ~ " ~ ovt c4 ue~ ~; ,v u C~,tC` I~ \ 99. s ~a.~t.-~ l ~= ioo. ao ea~ ~____,~ yy. s ~~~ commerce.wi.gov isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. commerce.wi. gov/sb/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary Apri126, 2005 CUST ID No.220292 BENNIE W HELGESON HELGESON EXCAVATING W1229 770TH AVE SPRING VALLEY WI 54767 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/26/2007 SITE: Brad Etzler County Road BB Town of Baldwin St Croix County NE1/4, SW1/4, 534, T29N, R16W ATTN. POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 Identification Numbers Transaction ID No. 1131280 Site ID No. 697394 Please refer to both, identification numbers, above, in all corres ondence with the a enc . FOR: Description: Four Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1014788 Maintenance required; 600 GPD Flow rate; 14 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual, SBD-10572-P (R.6/99), Pressure Distribution Component Manual, SBD-10573-P (R.6/99); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes 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. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD-10572-P (R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10573-P (R.6/99). • The pump chosen for the design is at the limits of its capacity. If the total dynamic head is calculated to be higher, at the time of construction, a pump that meets or exceeds the system flow will need to be installed. Coed ~~~~~ DEFARTMEN' ~~.C13N OF F • 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 SEE CORRI are prohibited. ' • 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. $ENNIE W HELGESON Page 2 4/26!2005 • 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 duringconstruction and open to inspection by authorized reRresentatives of the Department, which may include local inspectors. 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 maybe 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. Sincere-ly, ~~'~Gt2~~ ~- ~~~ ~~ 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 INDEX SHEET PROPERTY OWNER: BRAD ETZLER 1101 4TH STREET ST PAUL PARK, MN 55071 PROJECT NAME: BRAD ETZLER PROJECT LOCATION: NE 1/4, SW 1/4, S 34, T 29 N, R 16 W MUNICIPALITY: TOWN OF BALDWIN COUNTY: ST CROIX ~E~~,~~® APR 2 p 2005 ~S DESIGN: PRESSURE DISTRIBUTION MANUAL SBD-10573-P(R/99) MOUND COMPONENT MANUAL SBD-10572-P (R 6/99) CONTENTS: Page 1: Plot Plan Page 2: Cross Section and Plan View of Mound Page 3: Distribution Pipe Layout Page 4: Septic Tank & Pump Chamber Cross Section and Specifications Page 5: W1250/750-MR Tank Specifications Page 6: Pump Specifications Page 7: POWTS Owner's Manual & Management Plan - Pg. 1 Page 8: POWTS Owner's Manual & Management Plan - Pg. 2 Name: Bennie Helgeson Address: W 1229 770th Avenue Spring Valley, WI 54767 Credential Number: 220292 Signed i 4 ~ ~~~ Date: April 19, 2005 o~;o~MERCE ~~~Q1NGS ~~! SPONDFNC~ ' s ~Io1' ~(« r. PAY I of ~ 9~s .~ ~~~ ~~ ~ ~rp ~~+Fj ~ C=~''- ~ B ra ro`. -,sue c.~~. r. ~ ~ \ 3. ~I7 a~~ __ . 7C~raaR/ _. ~„ pvL. n~c ~1pS~ CrM-° t ~+ 6d ~ ~ S ~, j4-~~ ~a ~ -e S~ ~. ~ s s 7h G~o~~ ,~- ~i° ~,V. lbo • ~ I ,~ vc- o!__~--~~,,~~ d pl3i ~ 3!, _ ._.._.r.---~---- ~, M -~- .~ .- toc~. ~ s Tc~ ~, ~ ~ ~ " C; ort c9u.e~" ~: ,~ ~ ~`-~tC~- i~ \ 99. t ( ~6 ~ C C`-^ ~l 'f ~_" /~G-r f` ~ lam/ ~~~ C . T, H `'~g~, \. i $~~. --t' \ ~y~. s ^'c~~e ~"" V~ C~wn~r: ~d ~fL L:~.r.: Synthetic Covering ~~, ;'~STN1 C 3 Medium Sand -~ ~.f. Topsoil 3 % Slope J i ~. -~r~ 3 -1- Aggregate Cross Section Of A Mound Page ,~ Of ~ Distribution Pipe G ~ . Caa~o .ev E/e~. S~9•s' Force Moin ~Ptowed From Pump Loyer /(~ Ft. Signed: g ~ Ft. K '1, S F t . License Number: ~ ~_3 Ft. Date: ~ ~~ Ft. /~~ ~_ F t . W ,30. ~ F t . -- L p ~ Ft. E ~,( Ft. F e ~„ Ft . ~ ~ Ft. H ~_ F t . ~~~a~ ~a~o ~ Observation Pipe- ~K J ~ ------- _ _ _ 1 if =-----~-------------_ -- - - --- - - - _ -- _ - , A t` _-~ ----- - -- -----~---------------__ - J w b '~ _ ~'~ T ____ ._._ _.. -- - - - - -- -. -' _' -- i„ ''Distribution ~`t"~' Of i - Z'a Pipe A99re9ate I Observation Pipe /3Sv`' ~ ~-~S~L~ ~~"eC~` Plan View Of Mound Q~Ur1er~t ~~ ~~'~1.~+~ C )~'o.~.o~--r C. ~ t E [tv~ Gx~-/ Perlorolnd I'Ip. Onioll J End Vlew Perloroi~a PVG Pipt ~~(~, /`'1.1111 ~u~~ __ - y Holes Located on Bottom are Equallr~y Spaced ~ r ~" l c t n t~~re ~c~ -^ ^ - ~ 'del Ylp. Distribution P~1e L` t P 5 7 : 9„ R ~~ S X ~. ~ r .. Signed: License Number: Date: Y ~( ~~ Hole Diameter ~_ Inch Lateral ~_ Incn (es) Manifold " ~, Inches n force Main ,__ ~„~~ ~~E ~* ~~1~~. ~`{d~~s ~er~~~~le~ ~ vh e r N~ b ~- 7`0 ~~ ~ ~' ~, SEPTIC TANK E PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS ~~ 4 {~(K.VENT PIPE 12" MIN. ABOVE GRADE E >_ 25' FROM DOOR, WINDOW OR FRESH AIR INTAKE GQ ~~.QJ ~-- I ~~d~w uEA7HERPROOF JUNCTION BOX WITH CONDUIT APPROVED MANHOLE COVER W / PADLOCK E WARNING LABEL 18" 'MI IN ~ ~WATER TIGHT SEALS -~•-- FI~7ER A APPROYEO (a"x ~(,,, -~- PIPE 3' ONTO SOL10 C SOIL PUMP OFF ELEV . ~•~FT . -~- D -4" MIN. • u ~$ MIN• VAPPROYEO JOINTS WITH ALM APPROYED PIPE ON 3' ONTO SOLID SOLI OFF 1y-. S.D. :; ` i~ t ~ I GAS- , ,~ TIGHTS ~~ SEAL r , ~ ' 3"APPROVED BEDDING UNDER TANK SPECIFICATIONS CONCRETE PAD SEPTIC / DOSE /(o X ~ Zf U C~~1 , TANK MANUFACTURER : L~i •e5 e -~ - --'~ TANK SIZES: SEPTIC a~ GAL. DOSE VOLUME-~F LOWBACKG ~~ 75! GAL. DOSE ~ GAL. i S• 75' G~.~, ~ • CAPACITIES: A = ~~ INCHES = S/O 3 GAL. ALARM MANUFACTURER: .S F cc +r'° .. •MODEL NUMBER: /YSI Hl ~ _ g = 2 INCHES = j'~GAL. SWITCH TYPE: ~1~~~~-~~'d~~ PUMP .MANUFACTURER : '~C>> -~ C = „~ INCHES = / (a ~ g Y GAL. MODEL NUMBER : ~~ D ~ 3 INCHES = O S C~-L SWITCH TYPE: ~~ ~~ GPM PUMP E ALARM WIRING AS PER I LHR 16.23 WAC REQUIRED DISCHARGE RATE yr, ~_ FEET VERTICA L DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE ~_ FEET + MINIMUM NETWORK SUPPLY PRESSURE FEET + /'~s FEET FORCEMAIN X ~, _FTI100 FTOTALIDYNAMICAHEAD ~=~ .•/ FEET WIDTH DIAMETER INTERNAL DIMENSIONS OF PUMP TANK: LIQUID ~,~.~~ C~•~~ (. P, t_ >~/P~st ~~ %a~ ~"e~• She SIGNED: LICENSE NUMBER: ~ DATE: _ ~ • i' 1/88 TZL~ ~G 5 ~ ~ ~ 155" W1250/750-MR TANK SPECIFlCATIONS e a A" \T~ITC TOP VIEW SCALE: 1 /4" = 1' SIDE VIEW SCALE: t /4" _ 'I DIMENSIONS: WALL: 2-1 /2" BOTTOM: 3" COVER: 6" MANHOLE: 24" I.D. HEIGHT 66' O.D. LENGTH: 155" O.D. WIDTH: 86" O.D. BELOW INLET: 53" O.D. LIQUID LEVEL: 47" WEIGHT: 14,795 LBS INLET AND OUTLET: 4" BORE WITH STOP FOR OUIK-TiTE, FERNCO GASKET, CAST-A-SEAL B00T OR EQUAL INLET AND OUTLET BAFFLES: WISCONSIN, SEE DETAIL X10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 25.96 GAL/IN SEPTIC) 16.12 GAL/IN PUMP) LOADING DESIGN: 7' 0" UNSATURATED SOIL ~~~~C~a ~oa~~~~~ W3776 US HWY 70, MAIDEN ROCK, YYI 54750 800-325-8456 MODEL W1250/750-MR SEPTIC/SEP?1C. SEPTIC/PUMP OR SEPTIC/SIPHON JANUARY, 2000 FlLE w1250 750-MR ~1 ~ ~,~°,,r°~ ' ~rc~©( ~'T Z~L~~ ~a•a.,~ t'p a F fUTnl DYNAMIC NEAD/CAPACITY PER MINUTE FFi i Ut NT nNU DEWATERING x v 0 FLOW PER MINUTE ENCE MUDEL 152 153 Feet Meters Gal. Liters Gal. Liters 5 1.5 69 261 77 291 10 3.1 61 231 70 265 15 4.6 53 201 61 231 20 6.1 44 167 52 197 25 7.6 34 129 42 159 30 9.1 23 87 33 125 _--35 10.7 -- -- 22., 85 4U 12.2 -- -- 11 42 Lock Valve: 38.0 Ft. (11.6m) 44.0 Ft. (13.4m) 3 27/32 32 CONSULT FACTORY F4R SPECIAL APPLICATIONS • Timed dosing panels available. • Electrical aitemators, for duplex systems, are available and supplied with an alarm. • Variable tenet control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and start cycle controls. • Sealed Qwik-Box available for outdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. 1521153 Series 53 MODEL Control Selection ModN YoMs•Ph Mode Am s Sim lex Du iex Nt 11 Non 8.5 1 2 or 3 aN152 115 1 flub 8.5 Induded 2 or 3 E152 230 t Non 4.3 1 2 or 3 eE152 230 1 Aldo 4.3 Included 2 or 3 Ni 115 1 Non 10.5 1 2 or 3 8N153 115 1 Aldo 10.5 Irxtuded 2 or 3 E153 230 t Nan 5.3 1 2 or 3 8E153 230 1 Aldo 5.3 Induded 2 or 3 O CAUTION All int+talletion of controls, protection devices and wiring should be done by a qualified licensed eleeuieian. All electrical and safety codes should be followed including the most recent National Electric Code INEC) and the Occupational Salety and Health Act (gSHA). S2 4 I Iz I/a - 5 t/t SELECTION GUIDE s~ 1. Single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0477. 2. See FM0712 for correct model of Electrical Alternator E•Pak. 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) or {4) float system. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL T0: P.O. 80X 16347 Louisville, KV 40256-0347 Manulacturers of.. ~ hw ~, t• SHIP T0: 3649 Cane Run Road ~ ` ~~ .® Louisville, KY 40211.1961 Quurr PUMPS SNCE /9.99 r o {502J 77&2731.1(800) 928•PUMP Atq~J/Wwwaoel/ercom A. PUMP ~0. PAX (502) 774.3624 ® Copyright 2001 Zoeller Co. Ail rights reserved. . POWTS OWNER'S MANUAL & MANAGEMENT PLAN FILE INFORMATION Owner BRAD ETZLER Permit # ~ ~~ 3 ~ (~ 3 VL.7~~an r,+w..•.r. ~..,. ^ NA Number of Bedrooms 4 Number of Public Facility Units Q NA Estimated flow (average) 4l)U al/da Design flow (peak), (Estimated x 1.51 b0U al/day Soil Application Rate p,5 al/day/ft2 Standard Influent/Effluent Quality Monthly average ' Fats, Oil & Grease (FOG) 530 mg/L Biochemical Oxygen Demand (BODE) 5220 mg/L l~ NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent nuality Monthly average Biochemical Oxygen Demand (BODE) 530 mg/L Total Suspended Solids (TSS) 530 mg/L ®NA Fecal Coliform (geometric mean( S10° cfu/100m1 Maximum Effluent Particle Size YB in die. ^ NA Other: ^ NA 'Values typical for domestic wastewater and septic tank ettluent. MAINTENANCt SVnCUVLG Service Event Inspect condition of tanklsl At least Pump out contents of tankisl When c Inspect dispersal cell(s) At least Clean effluent filter s ~~ At least Inspect pump, pump controls & alarm At lease Flush laterals and pressure test At (east Other: At Least c~vcre~^ enCr~rCt(`eTIANR Pape ~ pf >d Septic Tank Capacity 2 ~.. of ~ ~ J:i~ Septic Tank Manufacturer WIESER CONCRETE ~;~~ ~` Effluent Filter ManufacturerZABEL ~"•'Q NA Effluent Filter Model A-l0U 12" xlU" ~~E7 NA Pump Tank Capacity 75U ~ °.O NA Pump Tank Manufacturer WIESER CUR`CRETE '; ,t7 ~ Pump Manufacturer ZOELLER PUPiP CO .y-Q NA Pump Model 152 p NA Pretreatment Unit ~:~ ~' ^ Sand/Gravel Filter ^ Peat Filter ^ Mechanical Aeration ^ Wetland ^ Disinfection ^ Other: Dispersal Celllsl ~ ,0 NA ^ In-Ground (gravity) ^ In-Ground (pressurized! ^ At-Grade ®Mound j ^ Drip-Line O Other: other: 0 NA Other: .~} NA other. ' `C} NA :~~. Service Frequency ^ month(s) (Maximum 3 years} ' .:~_p NA once every:( Q year(s) ombined sludge and scum equals one-third (Y3! of tank volume '` t1 NA ^ monthlsl {Maximum 3 yoarsl `DNA once every: 2 ® ear(s) ® month(s) '': O NA once every: 13 D year(sl ® month(s) O NA once every: 13 O earls) ^ monthlsl '?,,ID NA once every: 3 Q year(s) ^ month(s) p NA once every: D year(s) O NA Other. MAINTENANCE INSTRUCTIONS dons: Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certlfiga Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Ope(atGKi''T~k inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any ~ec~:~.~asks, measure the volume of combined sludge and scum and to check for any back up or pondin9 of effluent on the faroun~,;,> ~a g The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for arty: p of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and t4quires the immediate notification of the local regulatory authority. `' j "` When the combined accumulation of sludge and scum in any tank equals one-third lY3) or more of the tank voiumo, t_he,entiru contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ehaptsr NR -113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. ;-: oMw taro( i OWNER: BKAU ETZLEK, Pap. ~,_ of,~.. STARTUP AND OPERATION. For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may Impede the treatment process and/or damage the dispersal cell(s). if high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infittrat7ve surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispetsal cell{s) In one.large dose, overloading the cell(s) and may result !n the backup or surface discharge of effluent To avoid this situation have the contents of the ptunp tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWT8 tlltatrttatrter to assist in manually operating the pump controls to restore normal levels within the pump tank. do not drive or park vehicles over tanks and dispersal cells. Oo not drive or park over, or otherwise disturb or compact the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may Improve the performance and Qrolong the I(fe of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental tbss;'dtapera; disinfectants; fat; foundati ainU~in roducpsP pegt)icldesrsanitaryn~p nsbtampons9 a~ndesoftener~brin~e.~~ m081 scraps; medications; oil, p g p ABANDONMMENT When the POWTS falls and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with ch. Comm 83:33, tMsconstn'Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.• The contents of all tanks and pits shall' be removed and property disposed of by a Septage Servicing Operator.• • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code compltant replacement system: O A suitable replacement area has been evaluated and may be utilized for the location of a replacement soU absorption system. The replacement area should be protected from disturbance and compacUon,and should not be infringed upon by required setbacks from ex(stirig arld proposed structure, lot Imes and welts. Failure tie protect the replacement area w(II result in the need for a new soil and site evaluation t0 establish a suitable replacement area. Replacement systems must comply with the rules In effect at that time. O A suitable replacement area is not available due to setback and/or soil IlmltaBons. Barrtrtg advances Irt POWT3 technology a holding tank maybe Installed as a last resort to replace the felled POVY~3. O The site has not been evaluated to identify a suitable replacement; area Upon faqure of the POVYTS a soq and site evaluation must be performed to locate a suitable replacement area. If no replacement area (s avaUable 8 holding tank may be installed as a last resort to replace the failed POWTS. ~ he infiitratlvetsurface. oReco sWctionstof ssuch systemsmust comply with theltvles9n effe at filet time~t ~ «WARNING» SEPTtC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANDlOR INSUFFICIENT OXYGEN. RESUOL7 ERESC E OF AI PERSON FROM THE INTERIORNOFTA TTANK MAY BE D1F~ICULT OR IMPOSE. BIE IUTAY AOD1710NAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name HELGESON EXCAVATION INC Name r Phone 715/772-3278 •Phone 715/273-5811 SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORYAUTHORI'1RY Name JOHNSON SANITATION ~ Agency ST CRUIX COUNTY ZONING Phone 715/273-5811 Phone 715/386-4680 This document was drafted uy the stalls o/the Green Lake, -darquette and Waushara County Zonlnp and SanNatbn apendge. This doctment rttsets me minimum requirements of eh. Comm 89.22(2)(b)(1)(d)b(Q end 83.54(1), (2) b (3), Wisconsin AdminlstraWe Code. tits of tttlt docuntettttroes itOt 9uarantes the periortnsnce of the POWTS. G1AVtl(7JGt) ~_~ wisoonsin Department of commerce SOIL EVALUATION REPORT ~ Division of Safety and Buildings e~ in acco da ith C 85 Wi Ad Cod "t '~ F°~ ~~ 3~ Page 1 of 3 r nce w omm s. m. e County St Croix Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limfted to: vertical and horizontal reference point (BM), direction and parcel I.D. ~.vt w ~ ~ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ~Q ~- - 6"~Gt~ Please print all information. Reviewed Date_ Personal information you provide maybe used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). s 3 Property Owner, Property Location ^ Steve Hanks t SW 1/4 NW 1/4 S 34 T 29 N R 16 Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 440 Frontage Road $tev s City State Ztp Code -Phone Number ~ Village ^ Town Nearest Hudson WI 54016 ( 7~5-386-1176 Cty Rd BB 0 New Construction Wse~ Residential / Number of bedrooms 3 Code derived design i' t .450 GPD Replacement ®Pubik: or commerdal -Describe: t`x' = "`~-- ~-- ::'" ~` ~r ~ r Parent material __ ('rlacial Till Flood Plain elevation ,~pllCable ft. '"'~ a~-,*~,, ,~. ~'~I ~'~'~ Site is suitable for a mound only at a "'t2ftion.a6~^14 incliec~%f,~. and recommendations: r; _ ~ _ r :;, ; ,..,~ . Boring \~ {~;,~; 1 Boring # t ~' _~ pit Ground surface elev. 100.13 ft. Depth to flmidng factor ~ 15 )n• Soil tcation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence GP D/iP In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 `Eff#2 1 0-9 10yr3/3 - sil 2msbk mfr cs 2f .5 .8 2 9-15 1 5/3 - sil 2msbk mfr cs - .5 •8 3 15-27 10yr5/4 d2dsyrsia sicl lmsbk mfi - - .2 .3 I - I Boring # ~,,,,~ Boring 98.36 20 V ru •,•••••~••• ~....owo~a ,a. vaNu~ w nnnwiy ~avu.n nr. Soil lotion Rate Horizon Depth Dominant Color Redox Description Texture Struc~tre Consistence Boundary Roots GP DRF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-7 10yr3/3 - sil 2msbk mfr cs 2f .5 .8 2 7"20 - sil 2msbk mfr cs - .5 .8 3 20-36 7.Syr5/6 c2dsyrsis sicl imsbk mfi _ _ .2 .3 - tmuern $i = nvu > 3v < ~u mgll. and T55 >30 < 150 mg/L 'Effluent = BOD < 30 mglL anti TSS < 30 mglL CST Name (Please Print) gn CST Number Thomas C Nelson 227387 Address n Condtx#ed Telephone Number 1432 120th Street, New Richmond, WI 08/15/01 715-246-2454 s~,~ i ~ ~~, Hanks Parcel ID # Page 2 ~ 3 3 Bonin # ~ Boring g ~ Pit Ground surface elev. 98.57 ft. Depth to Rmiting factor 1 S in. Soil icatlon Rate !"loriZOn Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Cobr Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-7 10yr3/3 - sil 2msbk mfr cs 2f .S .8 2 7-ls 1 /3 _ sil 2msbk mfr cs - .S .8 3 1s-30 7.Syrs/6 c2d5yr5l8 sicl lmsbk mfi - - .2 .3 4 ^ Boring ~~ # Pit Ground surface elev. 97.98 ft. Depth to limiting factor 14 in. Sal n Rate -fioAmn Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fi? (n. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 p_7 10yr3/3 - sil Zmsbk mfr cs 2f .S .8 2 7-14 siI Zmsbk ~' cs .S .8 ~: 14-26 10yr5/4 c2d5 r5/8 sicl lmsbk mfi - - ,2 .3 # ~ Boring ~~ Pit Ground surface elev. ft. Depth to flmffing factor in. Soil Rate kforizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D in. Munself Qu. Sz. Cont. Color Gr. Sz. Sh. *Etf#1 *Eff#2 * Effluent #1 = BODS > 30 < 220 mgl~ anti TSS >30 < 150 mglL * Effluent #2 =GODS < 30 mglL and TSS < 30 mgfL 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 1 or TTY 608-264-8777. sen.e3wr~ pe.ouoo> ... r ~` S ~ ~,.~ e 4-1~. n ks ~~ ~ o~ 3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OwnerBuyer Mailing Address ~ ~ ~ l Property Address OWNERSHIP CERTIFICATION FO r (o,~ ~1,ro ~-~'1 C?1~'n ~~ ~~ 5 ~~~ ~ ~- ~~~ a ~ (Verification required from Pl ~ming Department for new -~- J ,.. \\--~~---- 1 Identification Number ~ ~%I~C~C~x-~ ~ J~'~ City/State f I~l~~-- Parce D~a--~0 ~ ,~d._~ ~~ 1 LEGAL DESCRIPTION Boa- ~0 6- ~-~ ~ ~• ~ '/~, Sec. 2 ~, T~,N-R~W, Town of - ti ~• Property Location ~ /,~~~~~ ~L..~! auv~..,. aw,.... ---- ~ ~ fU'~ ' ~ Certified Su ey ap~ , Vo wne '~~~,VVarranty Deed # ~ ~ a Syy ,Volume Spec house O yesno Lot lines identifiable yes O no SYSTEM MAINTENANCE Improper use and maintenanceof your septic system could result in its premature failure to handle wastes. Propermaiatenaace 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, journeyman plumber, restricted plumber or n 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 stsadards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. CertilScatiou stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office~withia 30 day e e year expiration te. ~. ~ ~ / / !~ S NATURE OF PLICAN 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 owaer(s) of the roperty described above, by virtue of a warrant deed recorded in Register of Deeds Office. ,2~ / ~/ ~~ S NATURE OF PLICANT DATE Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ****** ~t~k +I~W,U Lot # ~ ~~ G :~~'J`~y ~~/>~f ~~ ~ V 1 Page # o Page # 1 D 8 •" 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 ' I1 i J..26'i3P 106 STATE BAR OF WISCONSIN FORM 2- 2000 Document Number WARRANTY DEED THIS DEED, made between Steven Hanks, a married person and Craig S. Ericson, a single person, as tenants in common, Grantor, and Susan M. Langenfeld, a single person, and Bradley W. Etzler, a single person, as joint tenants, Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin: SEE ATTACHED EXHIBIT A Recording Area '772dJ' ~4 KATHLEEN H. NALSH S"I~. ICROIX CO. EE~ RECEIVED FOR RECORD 08/24/2084 82:48Pit NARRANTY DEED EXEfQT # RBC FEEL 13.00 TRANS FEfi : 459. ~ CSC FEE: PAGES : 2 Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. Dated this 16th day of August, 2004. ~~~~ • Steven Hanks AUTHENTICATION Signature(s) „V.,r~~r.LL~, authenticated this 16th day of August, 2004~Otary plabllt'+ nsin * TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Peterson, Fram & Bergman -Steven H. Bruns i 50 East Fifth Street, St. Paul, MN 55101 (Signatures may be authenticated or acknowledged. Both are not hecess .) 'Names o[ persons signing in any capacity must be typed or printed below theid signature Name and Return Address: Edina Realty Title, Inc. 400 S. 2°d St. -Suite 11 S Hudson, Wl 34016 441468 ~..~ a..~ .. ............ ...... ~.,~.. .,.,., 002-1087-10-OOq OQ 2-108 7-40-000 , Parcel Identification Number (P>M002-1087-95-000 This is not,hwo`mestead property. VV ~ ~~ ~ ~~- ~ ~ l~~ ~ ~~'~..~ * Craig S. ricson ACKNOWLEDGMENT STATE OF WISCONSIN ) ST. CROIX COUNTY. ) ss. Personally came before me this August 16, 2004 the above named Steven Hanks, a married person and Craig S. Ericson, a single person, as tenants in common to me known to be the person(s) who executed the foregoing instrument and acknow ed the same. 1 ~ A ~ . ,,~... *Cheri Brown Notary Public, State of Wisconsin My commission is permanent. (If not, state expiration date: 3/t 1/2007 ) 1? WARRANTY DEED STATE BAR OF WISCONSIN FORM No.2-2000 ~- U_.26'f3P 109 EXHIBIT A Parcel A: The East '/ ofthe Northwest '/, of Section 34, Township 29 North, Range ] 6 West, Town of Bald except that part ofthe East %ofthe Northwest '/. of Section 34, Township 29, Range 16, lying Northerly ofthe and Southerly of State Trunk Hi wtn, St. Croix County, P,ltway "12" as now laid out, St. Croix County, Wisconsin. Railroad Right of Way Parcel B: The North 8 Rods ofthe Northeast ;ofthe South_~~ west ~~,, Section 34~sh• ---° •~ --$aldwin, St. Croix County, Wisconsin. ~p 29 North Range 16 West, Town of j Parcel C: The North 30 Rods ofthe Northwest'/< ofthe Southeast'/. ~ ~` Baldwin, St. Croix County, Wisconsin. ,Section 34, Township 29 North, Range 16 West, Town of Parcel D: Part of the Northwest'/. ofthe Southwest'/, and part ofthe Southwest %. ofthe Northweyrt y, o North, Range 16 West, Town of Baldwin, St. Croix Coun Centerline of Coun ~, ty, Wisconsin, described as follows: Commencing at~the 3intersect on,of the n' T~ 1-lighway BB with the East line of said Northwest'/, ofthe Southwest'/.• line 531.61 feet; thence West at a right angle 178.92 feet; thence South at right angles 442.23 feet to Highway "BB"; thence Southeasterly along said Centerline 200.0 feet to the place of beginnin St. ~ thence North along said East the Centerline of County Trunk g, Croix County, Wisconsin. ' ~ Parcel #: 002-10 7-40-000 05/03/2005 10:11 AM PAGE 1 OF 1 Alt. Parcel #: 34.2 .16.5048 002 -TOWN OF BALDWIN Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historic ate Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * =Current Owner * LANGENFELD, SUSAN M SUSAN M LANGENFELD ETZLER,BRADLEY W BRADLEY W ETZLER 1101 4TH ST ST PAUL PARK MN 55071 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description SC 0231 BALDWIN-WOODVILLE AREA ry~n~ SP 1700 WITC ~ ~ GC Legal Description: Acres: 3.000 Plat: N/A-NOT AVAILABL E SEC 34 T29N R16W N 8 RDS OF NE SW ,, A Block/Condo Bldg: ~j ~ Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 34-29N-16W Notes: Parcel History: Date Doc # Vol/Page Type 08/24/2004 772504 2643/108 WD 11/08/1999 613424 1469/046 WD ~nn~ ci ineineeQV Bill #: Fair Market Value: Assessed with: -- - - - - ------- -- - - 42701 2,800 Valuations: Last Changed: 04/26/2000 Description Class Acres Land Improve Total State Reason PRODUCTIVE FORST LANC G6 3.000 1,900 0 1,900 NO Totals for 2004: General Property 3.000 1,900 0 1,900 Woodland 0.000 0 0 Totals for 2003: General Property 3.000 1,900 0 1,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 04/17/2001 Batch #: PRGRM Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 t Parcel #: 002-1086-95=000 05/03/2005 10:24 AM PAGE 1 OF 1 Alt. Parcel #: 34.29.16.5026 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): " =Current Owner * LANGENFELD, SUSAN M SUSAN M LANGENFELD ETZLER, BRADLEY W BRADLEY W ETZLER 1101 4TH ST ST PAUL PARK MN 55071 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description oZ ~ ~ ~ .~d _ ~ SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC ~ ~~ ~ ~ ~ ~ P/ ~~ -~~r Legal Description: Acres: 2.000 lat: N/A-NOT AVAILABLE SEC 34 T29N R16W IN SW NW & IN NW SW Block/Condo Bldg: BEGIN INT E LN NW SW WITH HWY BB; TH N 531.61 FT W 178.92 FT; S 442.23 FT TO CL ~ Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) HWY BB, TH SELY ON CL 200 FT TO POB INCLUDES PARCEL 505E Notes: Parcel History: Date Doc # VollPage Type 08/24/2004 772504 2643/108 WD 11/08/1999 613424 1469/046 WD 07/23/1997 585/407 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 42697 1,200 Valuations: Description Class UNDEVELOPED G5 Totals for 2004: General Property Woodland Totals for 2003: General Property Woodland Last Changed: 06/28/2004 Acres Land Improve Total State Reason 2.000 800 0 800 NO 2.000 800 0 800 0.000 0 0 2.000 1,600 0 1,600 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 04/17/2001 Batch #: PRGRM Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 • ~ Parcel #: 002-1088-60=000 05/03/2005 10:20 AM PAGE 1 OF 1 Alt. Parcel #: 34.29.16.509A 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): * =Current Owner * LANGENFELD, SUSAN M SUSAN M LANGENFELD ETZLER, BRADLEY W BRADLEY W ETZLER 1101 4TH ST ST PAUL PARK MN 55071 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description `} SC 0231 BALDWIN-WOODVILLE AREA G~~~ ~/1/ SP 1700 WITC Legal Description: Acres: 19.000 Plat: NiA-NOT AVAILABLE SEC 34 T29N R16W N 19/40 NW SE Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 34-29N-16W Notes: Parcel History: Date Doc # Vol/Page Type 08/24/2004 772504 2643/108 WD 11/08/1999 613424 1469/049 WD Anne CI 111A11A A DV Bill #: Fair Market Value: Assessed with: ---~ --~-~~-~--~-- 42712 17,800 Valuations: Last Changed: 04/26/2000 Description Class Acres Land Improve Total State Reason PRODUCTIVE FORST LANC G6 19.000 12,000 0 12,000 NO Totals for 2004: General Property 19.000 12,000 0 12,000 Woodland 0.000 0 0 Totals for 2003: General Property 19.000 12,000 0 12,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 04/17/2001 Batch #: PRGRM Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 . ~ 'Parcel #: 002-108 05/03/2005 10:10 AM PAGE 1 OF 7 Alt. Parcel #: 34.29.16 03A 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): * =Current Owner * LANGENFELD, SUSAN M SUSAN M LANGENFELD ETZLER,BRADLEY W BRADLEY W ETZLER 1101 4TH ST ST PAUL PARK MN 55071 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC /- -P~~l'~ Legal Description: Acres: 29.000 Plat: N/A-NOT AVAILABLE SEC 34 T29N R16W SE NW LYING S OF RR R/W Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 34-29N-16W Notes: Parcel History: Date Doc # Vol/Page Type 08/24/2004 772504 2643/108 WD 11/08/1999 613424 1469/046 WD 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 42698 27,200 Valuations: Last Changed: 04/26/2000 Description Class Acres Land Improve Total State Reason PRODUCTIVE FORST LANC G6 29.000 18,300 0 18,300 NO Totals for 2004: General Property 29.000 18,300 0 18,300 Woodland 0.000 0 0 Totals for 2003: General Property 29.000 18,300 0 18,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 04/17/2001 Batch #: PRGRM Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 r ~ ~ v ~ D i® 1~ '~ --I-- ----- / / I ~_~ ~ / o V I ~~c~ \ / o I ~ ~ -I'' _ / D 1 / (.~ I ~ ~ ,~ C~ tv ~. / " -~ rr~ ~ W / ~ `~ a ~` ~~ ~ cn ~ ~o i ~~ - / ~ ___ -___ __ _1_ -- ~ -- I.. I I I cn I 0 -P m I ~a I I s Roos ~~ i .. / T /~ ~./ .~ ~ i~~ ! z ~ , ~ ,~ i ~ ~ / ~~f~ ~ ~ ~: ~Nlo A~ 1~ ~ II I I ~J ~ I I I .. 9 I I I I I I ~` ~ I ~ ~ _t~ y N C11 I ~ ~ °o I ~ '' ~ I ~n 1s (.. ti 00 Murphy Land Surveying W9302 800th Ave. River Falls, WI 54022 June 23, 1999 Description for rezoning for Robert Sell:. ,.. :- ~ REcivEp ', n~ '~ ..-~µ~.;1 Phone: (715) 425-9032 Fax: (715) 426-9711 Home: (715) 425-8510 The East 112 of the Southwest 1/4 of Section 34, Township 29 North, Range 16 West, Town of Baldwin; St. Croix County; Wisconsin; lying North of the centerline of the county trunk highway, EXCEPTING THEREFROM, the Northerly4 acres thereof. Also, all that part of the-Noah 1/2 of the Southeast 1/4-lying.Northerlyofpresentraiir~ R.O.W. in said Section 34, EXCEPTING THEREFROM, the North 30 rods thereof. ~~~ a ~~~ I, Laurence W. Murphy, Registered Land Surveyor, have not complied with the minimum standards for property surveys in Chapter A-E-S of the Wisconsin Administrative Code. The owner of the property ltas agreed to- exclude the following work Only a description of the property has been provided, the boundaries of the property have not bee umente and..a rna of said-property has notebeen produced. Any encro ents that ay exis am not aware of. No acreage figure is given. (~ ~7 R ert Se 1 Dated: W. Murphy l Land Surveyor ~~`~y.1~sC' NS/~~'*~ . 3.~ ~ '••.• ~ • ~LAURENCE ~; '* rn W MURPHY Q =~= S 1713 >s' N -~. RIVER FALLS,,:. J~ "' w 9 J ~ Parcel #: UU2-~ 08 -30-~ ~ 05/03/2005 10:12 AM PAGE 1 OF 1 Alt. Parcel #: 34.29. 6.504A 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): * =Current Owner * SELL, ROBERT K & MARY K ROBERT K & MARY K SELL 243 9 CT~(B11B$ . OODVILLE WI 54028 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description SC 0231 BALDWIN-WOODVILLE AREA ~ ~~~ SP 1700 WITC ~ ~/ ~ ~l~"` Legal Description: Acres: 15.000 Plat: N/A-NOT AVAILABLE SEC 34 T29N R16W NE SW EXC RR RNV N 8 l~'~ BlocklCondo Bldg: RDS &EXC PT LYING S OF CO HWY BB ~ ~ Tract(s): (Sec-Twn-Rng 401/4 1601/4) 34-29N-16W Notes: Parcel History: Date Doc # Vol/Page Type 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 42700 Use Value Assessment Valuations: Last Changed: 06/28/2004 Description Class Acres Land I prove Total State Reason RESIDENTIAL G1 3.000 10,500 151,600 162,100 NO AGRICULTURAL G4 11.000 1,000 0 1,000 NO UNDEVELOPED G5 1.000 100 0 100 NO Totals for 2004: General Property 15.000 11,600 151,600 163,200 Woodland 0.000 0 0 Totals for 2003: General Property 15.000 11,800 151,600 163,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 04/17/2001 Batch #: PRGRM Specials: User Special Code 010-GARBAGE Category SPECIAL ASSESSMENT Amount 45.00 Special Assessments Special Charges Delinquent Charges Total 45.00 0.00 0.00 Safety and Buildings Division County ` 201 W. Washington Ave., P.O. Box 7162 ST. CROIX ,SC0~~1~ Madison, WI 53707 - 7162 Sanitary Pemtit Number (to be filled in by Co.) (60 8) 266-3151 Department of Commerce * Sanitary is 1,)( n State lan LD. Number ,~, TR NS. I D # 1131280 In accord with Comm 83.21, Wis. Adm. e, ati you provide cc~~ may be used for secondary purposes Pnvac 5.04( Xm) MAY ~ G 20 ~ ifferent than mailing address) , Projec Address (if d p ~ I A lication Information -Please Print All Information ~ 2 ~~ 0 ~ . pp ST.CROIX000N Property Owner's Name BRAD ETZLER ~ ~ ~ arc Lot # Block # - ~--- -- --- -~" '"'"~ ~~ "" _ Property Owner's Mailing Address on 1101 4TH STREET (~ NE '/ SW y Section 34 1 City, State Zip Code Phone Number ~ ti ST PAUL PARK, MN 5 071 651 /283-5236 ~O `Z9 N R ~ G(circli one) 'r~~ l~ II. Type of Building (check all tha pply) ' K~ 4 Subdivision Name CSM Number [~ 1 or 2 Family Dwelling -Number of Be m N/A N/A Public/Commercial -DescribeU s e 1J / ~ ~,~, _ ~ / ^ State Owned -Describe Use / ~ ~a I'V/!Q ~0 ~ ~ (',~7'(, QCity QVillage "^I'ownship of BALD W I N . S' III. T ype of Permit: (Check only one box on line Complete line B if ap able) A' ~ New S stem y `-----~ ^ Replacement System ^ atment/Holding Replacement Only ^ Other Modification to Existing System B• ^ Permit Renewal ^ Permit Revision ^ Change ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. T e of POWTS S stem: Check all that a 1 ^ Non -Pressurized In-Ground ^ Mound > 24 in. of suitable ~ Moun 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ~ Hold' ank ^ Peat Filte ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter ^ Leaching Chamb ^ Drip Line ^ Grave s Pipe ^ Other (explain) V. Dis ersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate( f) Dispersal a Requir (sf) •spersa Area Proposed (sf) System Elevation 600 1, ~ S i-~'w' © 600 /~9d 100.34 , ~2 ~ v VI. Tank Info apacity in To Number Manufacturer Prefab Site Steel Fiber p]astic Gallons G ns of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank 1250 50 1 WIESER CONCRETE X Aerobic Treatment Unit \ _ /~ Dosing Chamber 750 750 1 W ER CONCRETE X VII. Responsibility Statement- I, the undersigned, assume responsi 'lity for installation of the POWTS shown on the a ed plans. Plumber's Name (Print) Plunlb~,r's Signature MP/MPRS Number Busin Phone Number BENNIE HELGESON P 2 715177 278 Plumber's Address (Street, City, State, r de) W1229 770TH AVENUE, SPRING VALLEY, WI 54767 VIII oun /De artment Use Onl Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Date sued suing Age t Signature ps) < SurehargeFee) L~~] ~ ~ r 3 ^ Owner Given Reason for Denial / ~T . !/ Q IX. Conditions of ApprovaUReasons for Disapproval 3 ~ S~ i'JC_ C~y~'~ ~ YSTEM OWNER:. ~ ~3.SZ ~ ~pA/A 1 Septic tank, effluent filter and ~/ ~~%r"' "" ~~ ~ dispersal cell must all be serviced /maintained 0 "n ~ "" ~~ `~~/ -~Z.d'73 on 9~ ~ C1~ ~ [A !1~ i~'~i7 , ~ as per management plan provided by plumber. 2. All setback requlremen s mus ~~~~ % b~ ~~ ~[~~~~~~1/~- ~ as per applicable code/ordinances. ~ - ~.~J (X~Y ~t S y L ~ ~~ ~~ Attach complete plans (to the County onl~for the system on palfslr not less than 81/2 x 11 jnche in size SBD-6398 (R. 01/03) %~u./+