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HomeMy WebLinkAbout004-1003-50-200Wisconsin 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: City Village X Township Briese, Dan Cad Townshi CST BM Elev: Insp. BM Elev:~C l M Description: '~:~ c_ST r'3 ~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic t l~~ 2 i ~ ~. ! J e c~ e:~ Dosing Aeration ti -~--°°-~~ - ~e~ Holding `°~,.~, _. - __._ TANK SET CK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic .~~~ ~"r' ,~~ „_ Dosing ~~ ZJG ~. t t 2 .mss- Aeration Holding PUMP/SIPHON INFORMATION ''`t ~ ~ Manufacturer Demand ` G +L r,t ~~ GPM Mode! Number ~~ ~~ TDH Lift FrictjQn Loss System Head TDH Ft 5 rL G.~ ~3.~~ Forcemain Length „ Dia. ~~ Dist. to weu SOIL ABSORPTION SYSTEM ELEVATION DATA County: $t. CrDIX Sanitary Permit No: 430289 0 State Plan ID No: Parcel Tax No: 004-1003-50-200 Section/Town/Range/Map No: 02.28.15.21 A10 STATION BS HI FS ELEV. Benchmark ~. (.y ~ ilJ~2 ,~ ~ rj -l Alt. BM Bldg. Sewer ),~ ~ ~ ~ ~ ~ , St/Ht Inlet /~t) ,~- ~~. 5 SUHt Outlet Dt Inlet Dt Bottom 17.3 ~~~ ~ Header/Man. ~ L---r 9~ ~~, Dist. Pipe r Sv~- i. Cam,,,+~ w r • -~`~ g - ~-i 9 ~- ~€.~ Bot. System S y. 3 9 a. 2 S Final Grade I~ ~ - ~. ~~ St Cover tvn~ci:~-P' S:7 ~~ ~'~ ~ ~' ~''- w 3 . t."~ ~ . BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Li uid Depth DIMENSIONS -- ,. ,.1 SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHI Manufacturer: INFORMATION BER O CHA Type Of System: .L ~ 7 r ~ r I I ,-.l ~ o ~ i MI odel Number: ~ C ~. t~ b~ DISTRIBUTION SYSTEM Header/Manifold Length ~ Dia ~ Distribution Pipe(s) ~ ` Length `~ Dia ( Spacing 3. ~ , x Hole Size/ p f( Cj x Hole Spacin/g J l;- r / • ~ r! Vent to Air Intake rte. 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 BedlTrench Center ~ ~ ~ Bed/Trench Edges ~, ~ ~ Topsoil J Yes i~~ No Yes l No COMMENTS: (Include code discrepencies, persons present, efc.) Inspection #1: /U / ~ ~ / ~ Inspection #2:~ ~ / i7 / -~ s~ltx~.J ter` ~ Location: 580 315th Street Wilson, WI 54027 (NE 1/4 NW 1/4 2 T28N R15W) NA Lot 4 Parcel No: 02.28.15.21A10 1.) Alt BM Description = Ta t' ~,' _ .~o:.-r c(c,.~ , c ,~ 2.) Bldg sewer length = .3 j l: u ~[~+'L r U - amount of cover = "~ - - - -- ----- - - Plan revision Re uired? Yes :' No ~ f~'/ d ~ a Use other side for additional informati n. L~ 3 II '~ _ _ Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) \ /~ Safety and Buildings Division County ~ 201 W. Washington Ave., P.O. Box 7162 ST. CROIX ~ SCOII SIO. Madison, WI 53707 - 7162 t~8) 266-3151 Sanitary Permit Number ( be filled in by Co.) ~3 ~ ~ De artment of Commerce 0 .- Sanitary Permit Application State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, pe TRANS ID # 894028 may be used for secondary purposes Priva y Law dress (if different than mailing address) Project A d ( ~ ~ Print All Informs Pleas ti I f i on Sd ~ ~ ~ 5 5 e on - n orma on I. Applicat l;, 1 ? OQ3 f _ Property Owner's Na the Parcel X Lot Block Y DAN BRIESE ~ ~ ,,_ _- 004-1003-50 Property Owner's M ailing Address ~. t~ ~ ~~ O Property },ovation , 1097 110TH STREET ~~ ~k ~JY"~ section 2 City, State Zip Code Phone Number , , / ROBERTS WI 54023 715/235-4203 (circl ) T 28 N; R 15 E oW ly) / (check all that a e of Buildin II Ty pp g . p // CSM N b -~" 1 or 2 Family Dwelling -Number of Bedrooms um er Subdivision Name ~ ^ PubliGCornmercial -Describe Use 700978 ^ State Owned -Describe Use ~~ x 7 ~o ~ ~' ~~' ~~~f S ^Ciry_^Village ®'fownship ofk~#~i-~11F~G III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A' (~ New System ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System B. ^ Pe trtnt R ne ewai ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. of POWTS S stem: (Check all that a 1 ) ^ Non -Pressurized [n-Ground ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sattd Filter ^ Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain) V. Dis rsal/Treatment Area Information: Design Flow (gpd) te(gpdit) Design Soil App icatio5 S 11 Dispersal Are Required (sf) Dispersal A rea Pro sed (sf) System Elevation v 450 , po ~-'~~ ' 1. 0~ 4~0 boo ~lS. ~ VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units ~ ~ ~ Q ~ _`~ ~ ~ Concrete Constructed Glass New Tanks Existing Tanks / t.~c~-~ '~ Septic or Holding Tank 1000 1000 1 WIESER CONCRETE X Aerobic Treatment Uttit Dosmy Chamber 600 600 1 WIESEK CONCRETE VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plate. Plumber's Na me (Print) Plu is Si gna MP/MPRS Number Busitteas Phone Number BENNIE HELGESON 20292 715/772-3278 Plumber's Addre ss (Stmt, City, State, Zip Cade) W1229 770TH AVENUE, SPRING VALLEY, WI 54767 VIII. Count /De artment Use Onl Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Surcharge Fee) t7 ~ ~ Dat Issued 8 ssuing Ag nt Signature o tamps) ^ Owrter Given Reason for Denial ~ ~ ' °Zq 0 F7C. Conditions of A pprovaUReasons for Disapproval C ~• s.~c_ p $ (p 03 ~ M OWN~ R: n ~, SYSTE 1 Septic tank, effluent filter and I"fir $ 3fJ"`7i ~~ ~' GUK~i ~-~ , t d i i n nt~ a dispersal cell must all be serviced ! ma Z'~ YI.P~C.¢iJ% ~ ~ rovided by plumber lan nt ~n (~'C-~ . p p as per manageme 2. All setback requirements must be maintained ~' '~° ~ ~~- ~y " / --~'~l`~i~-.•~~r- • U ~~r ~3,eF3- / t~s.~l G~~y?.~ua.oL as per applicable code/ordinances. ( Attacd complete plans (to the County only) for the system on paper not less than 81/2 x 11 iocbet in sift ~C - SBD-6398 (R. 01/03) ~ /" . ` -- RECEI QED f'~c ~ d~ -~ r ', ~~ ~, Q r- -~ s~ AUG - 5 20 ~) C..~._ WL ~2 r 1~ v~ ~~ ~ ~ ~~ a e S a ~ ~a oa, ~AFErr 13 \ `~ D~DGS DIV. ~~ ~ a.M. goo. ao T~~ o f t ~'~ Luc ~p ~ ~r9. R~ 66a., r e~. ~ y~ q1-~ i / i 8/ ~ _~ / i / /i / ~ ~ ~r ~~ r ~: N~ qY. Y P,p ~ ''/orb . R, bbo ., ~~~~& --~ C-le~, ~>. U ~~r~J~ 3BQ~{~ ~ Urn ~ e~c~v iv •c~~ s ~, 8 ~~~ ~ _l ~y.~S/ 3 ~~ ~ i S I .~ A' ~ 3..a~r....}-F-(`~~4 ,, ~ '~ J ~ ~ 1 ~ "~uc ~~~ ,~a, :, i 3 ~s ~h r~~~ y~ ~ -. ~ ~ c y UL F~roPGs ~~ a 1 6 O "- . S~ ~L/~~ T~hk ~><c~ ~ S oc,,c~rl s ~ ~scons~n Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. com merce.sta te.wi. us/sb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary August 06, 2003 CUST ID No.220292 BENNIE W HELGESON HELGESON EXCAVATING W1229 770TH AVE SPRING VALLEY WI 54767 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/06/2005 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Dan Briese ~(~ 315TH Street Town of Cady St Croix County NE1/4, NW1/4, S2, T28N, R15W Lot: 4, FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 913867 -~ ~3c m Numbers Transaction ID No. 894028 Site ID No. 662705 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 Code 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: General Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.O1/O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD-10706-P (N.O1/O1). • 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. • 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 s Cane APPI ~RTMH i'O~Lt~ON OF~~11 SEE CORF • 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. BENNIE W HELGESON Owner Responsibilities: Page 2 8/6/03 Comm 83.52 Responsibilities. Tlie 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. Sincerely, ~~~~Y~G~ 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 .~ PROPERTY OWNER: PROJECT NAME: INDEX SHEET DAN BRIESE (Q 97 110TH STREET ROBERTS WI 54023 DANA BRIESE PROJECT LOCATION: NE 1/4, NW 1/4 , S 2, T 28 N, R 15 W MUNICIPALITY: TOWN OF CADY COUNTY: ST. CROIX DESIGN: PRESSURE DISTRIBUTION MANUAL SBD-10573-P(R/99) MOUND COMPONENT MANUAL SBD-10572-P (R 6/99) CONTENTS: Page 1 Page 2: Page 3: Page 4: RECEIVED Page 5: J U L 1 8 2003 Page 6: SAFETY & BLDGS DIV~Page 7: Page 8: Page 9: Plot Plan Cross Section and Plan View of Mound Mound Deflection r1~pn~ Distribution Pipe Layout ~0~~ ,T~~~~ Septic Tank & Pump Chamber Cross Section & Specifications WLP1000/600-MR Zable Tank Specifications ESPpNpE E •~+.r. Pump Specifications POWTS Owner's Manual & Management Plan - Pg. 1 POWTS Owner's Manual & Management Plan - Pg. 2 Name: Bennie Helgeson Address: W 1229 770th Avenue Spring Valley, WI 54767 Credential Number: 220292 Signed Date: July 11, 2003 RECEI VEp ~~ 1 ~ e s a ~ ~a o~ ~ ~'A f' _ ~ 2003 ,~~ ~ 11V. a.~. Boa. oo 41LL QF q~>~y i ~1 ~ r / /G / ~ I ,~ I ~~ .~, G 83 ~ ~1 ~~. ~r P,P~ ~/e~r~ _ R,bbo ~, C7~1~~ lei, ~ 7. o -_'~~~ ~~~ r~~~ s ~,'d ~ _ J3~ / ~ ~y,~S/ 3 ry~ ~ i 5/ ~ ~~y ~ 1 a "~~ Ma.r R r.LG - -_ --_ ~ y~ f-~--~'z~ P~a`'oSe y'v~- ~ \~ I 3BQ~Q f ~oP~sec~ ~~~~ i bao ~4~! . s~~/fl~~ Task 1 ~~~! e i ~~= 4v ~x~~~ S ~~''~ Ltv ~ fir. , `1AU_ r~ ~.SC Synthetic Covering Medium Sand Topsoil "~ _-1 ~ E 3 slope Cc (l 0 f Z~- 2 %2 Aggregate _ ID Page ~ Of 9 istribution Pipe G ~ teu. y~. ~~ Forc ain Plowed From Pump Layer Cross Section Of A Mound System Using A Bed For The Absorption Area Signed: License Number: Date: Force Main - L A /D Ft. B ~/6 Ft. K /()° j Ft . L ~'~ Ft . ~ '7, S" Ft . t 9~ Ft. w a. ~ Ft. D ~~ Ft . E ~_ Ft . F ,BO Ft. G ,S Ft. H / Ft. ~~~ ~~ 9~'.~~ Observation Pipe J ~-B -----1------- ~K ~ ---------------------t---------- / l.c~-9h --- °----------------~----------------------•~ o~ Cell w i - -j----------------_`----~I Distribution C~tl Of Zp- 2 %Z Pipe Aggregate I Observation Pipe C/ca., o~sfs ~asu re~~ - /S• y .~ Plan View Of Mound Using A Gell For The Absorption Area - _ -mil ~ ~ v~ ~ 1J ~e ~ I ~2 c, ~ l o v~ ~ b l.u.:ner" > • 0.h __ t--1_~.~s----_.. 1~rv~ o5ec~ 45' 'X t v' ~ r L1.._. 3'.~y3`~ 0697 X loo - 6-y7 p5 3 o F q ~~.97 ~G 7~~'1~~~-~oh x .oc~6S~ ~-,~ x 4S= ys,83 _~ C ) ~ o ~. o---T ~(G~~.SC C. ~Eccv~~x-~~ Perlorol~d rip. .ion End Vl~w P~rforalad ~ ~ ~ P~c~o~.9 Holes Located_ on Bottom are Equally Spaced ~~ ~ r_ {~ ,..~ 'o~ e ii ns Q xT -~' a ~a rn ~ i QL~_ ~ If•~ r~0• Distribution Pine Layout_ Signed: License Number: Dare: P y~~ ,, ..~~((s) x3a ~ ~, s ' ~"` ~ ~~ _Z___ ~r x as ,, Y ~a Inch Hole Diameter - Lateral " ~ Incn (es) , Manifold " a Inches 8'orce Main " o? Inches ~.,V VE fi`t' ~ 0`213. ~ ~ , 7 ~ '~D ~ e S ~r~r(' 4-0.t.Qf2Lf Tp~'a~ `IO~eS = 7 W ~ Gr : `/Au i..,ln GS ; _ Page 5 Of y ' SEPTIC TANK E PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS v" ~UC. VENT PIPE 12" MIN. ABOVE GRADE f; WEATHERPROOF JUNCTION BOX APPROVED > 25' FROM DOOR, WINDOW OR WITH CONDUIT MANHOLE COVER FRESH AIR INTAKE W/ PADLOCK E ~ WARNING LABEL FINISHED GRADE „ ~ ~4" MIN. , K+q. " ~~ ty y'~Pv~ UP~SERw-Tioa! S. D• u 18" IN. PIPE ~;~ 18 rn~N: ~~ INLET ~ ~ • GAS- i ~ WATER TIGHT SEALS T TIGHT ~ ~~ \ , VAPPROVED A SEAL JOINTS WITH F~~TER ~ ALM APPROVED PIPE APPROVED Z~ $~~ ~ - B ' ON 3' ONTO PIPE 3' ~~'~~"~~' ~ ~- ~ SOLIO SOIL ONTO SOLID SOIL PUMP OFF ELEV . ~FT. C --~-- ~ ' OFF D 3" APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE ~, S X S._.. ~~ _~~,~ ~~I. TANK MANUFACTURER : ~~~ ~ Se ~' - TANK SIZES: SEPTIC ~ 'v GAL. DOS~~ S3M~aFLO BACKG ~~. ~ GAL. DOSE __ I~--~"'~-' ~~ 0 4 SAPACITIES: A = I $ INCHES =,~,~.GAL• ALARM MANUFACTURER: < S rI ~ S S~"ew~ .. MODEL NUMBER: 101 N1~`~ f g = 2 INCHES = ~~ ~ ~L• SWITCH TYPE: /y) ~- ~~ - ~o0.r C = ~ INCHES = ~s~ GAL• PUMP MANUFACTURER : ~ n~c• L I c~ MODEL NUMBER : 1 S3 ~~~~ D = ~- INCHES = ~~cAL• SWITCH TYPE: M~~~u~H REQUIRED DISCHARGE RATE ~~ GPM PUMP E ALARM WIRING AS PER ILHR 16.23..WAC FEET VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE ~y--r~--~ FEET + MINIMUM NETWORK SUPPLY PRESSURE -~_ FEET + ~ 7S- FEET FORCEMAIN X oZ.O FT/100 FTOTALIDYNAMICAHEAD••=• 7y~ FEET WIDTH DIAMETER _____.__ INTERNAL DIMENSIONS OF PUMP TANK: LIQUID D-F°p~A- ~~ (lCo• 7~ ~7~-~• Per ~w[~. ~~PuSc Sec Ta~t/~C ~~• LICENSE NUMBER: _ DATE: SIGNED: 1/88 ~w~ne~.2 4w~ I-JA ILL ~~~~P.~ .~ - : i' '~ i i i s OUT ET ~n i Tf1P VIEW SIDE VIEW SCALE: 1 /4" t' . WLP1000/600-MR ` ZABLE TANK SPECIFlCATIONS DIMENSIONS'` WALL: 3' BOTTOM: 3' COVER: 5' MANHOLE: ~4' I.D. HOGHT 56 O.D. LENGTH: 150' O.D. WIDTH: 84" O.D. BELOW INLET: 42' O.D. UflU10 LEVEL: 36' WEIGHT: 14.795 UPS. INLET AND OUTLET: 4° BORE WITH STOP FOR QUIK-TITS, FERNCO GASKET, CAST-A-SEAL BOOT OR EQUAL INLET AND OUTLET BAFFLES: WISCONSIN, SEE DETAIL X10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 27.88 GAL/IN (SEPTIC) ~" VENTS 16.76 GAL/IN (PUMP) LOADING DESIGN: 7' 0° UNSATURATED SOIL JLET 9 N <t ~~~~Q ~oa~D~~C~ ware us Hwr ~o, MaoEN Roar. ~ s4~so 800-325-8456 MODEL WLP1000/600-MR ZABLE SEPTIC/SEPTIC. SEPTIC/PUMP OR SEPTIC/SIPHON JANUARY, 2000 FILE: WLP1000 600-MR ~n P_r : 1/A t~S f~~rl ~se_ HEAD CAPACITY CURVE MODEL 152/153 ~IW 153 12 40 152 x _~ 30 8 0 ~ 20 0 4 10 - 0 20 40 60 80 100 GALLONS LITERS 0 80 160 240 320 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS • Timed dosing panels available. • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik-Box available for outdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. 1521153 Series 152/153 MOOELS Control Selection Model VoKe-Ph Mode Am Sim lex Du lex N152 115 1 Non 8.5 1 2 a 3 BN152 115 1 Auk 8.5 Included 2 a 3 E152 230 1 Non 4.3 1 2 a 3 BE1S2 230 1 Aub 4.3 Included 2 a 3 N153 115 1 Non 10.5 1 2 a 3 BN153 115 1 Auto 10.5 Included 2 a 3 E153 230 1 Non 5.3 1 2 a 3 BE153 230 1 Auto 5.3 Included 2 a 3 O CAUTION Ali installation of controls, protection devices and wiring should be done by a qualified licensed electrician. All electrical and safety codes should be followed including the most rttent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). TOTAL DYNAMIC HEAD/CAPACITY i~E:R MINUTE iFLU[~:! AND DEWAlEI21NG aF _-.__ __ MODEL ~ -------- 152 r . 153 Feet Meters (;al. 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 40 12.2 -- -- 11 42 lock Valve: 38.0 FL (11.6m) 44.0 FL (13.4m) 3 27 I Iz f/s S I/ SEL'cCTION GUIDE 32 3z 8 samosa 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 TO: P.O. BOX 16347 ~ ~ Louisvlle, KY 40256-0347 Manuladurers ol. . ~ SHIP T0: 3649 Cie Run Roed ® ® Louisville, KY 40211-1961 QvuiTrPutiPB SNCE /939. httpJANww.zoeller.com ~ PUMP ~0 (~2) FAX (502) 1248-PUMP ® Copyright 2001 Zoeller Co. All rights reserved. ,~ wsconsinDepartmentotCommerce SOIL EVALUATION REPORT Page~ot~ Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Co County ~~ ~, no ~~ Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must /C include, but not Umited to: vertical and horizonta rence point (BM), diredlon and P percent slope, state or dimensions, north arrow and 1q~ st roe . r~~~, ' aria Date Please print all 1 formation. ~ ~2~ ~ Personal information you provide may be used ror sa dary py~poses (Privacy Law, s. 15. (1) (m)). ~~ ' rope Locati Property Owner Q12 it eS~ ~~~ ~Uf;~: +u;)~ ~I,, Govt. of .,(~~ 1/4~~1/4 S ~ T ~~ N R /~ E( W property Owner's Mailing Address ; ' ` % ~'~-.=1C__ Lot Block # Subd. Name or CSM# City State Zip Code Phon Number Cc / ^ Ciry ^ village own Nearest Road ,1. ,p ~'~~ X35-vao3 ~ v^-c~l t~ob~r~ .~ SY4~3~~rs-) ~~-~vG~ C ~ ~ ~S~ S~ ,~_ GPD New Construction Use: Residential / Number of bedrooms ~_ Code derived design flow rate ^ Replacement / ^ Public orlcommercial -Describe: ~ Parent material ~i" ~ U~~' / 7~ _ Flood Plain elevation i(applicable General comments ~S ~ ~ ~ ~ X '' S ,3 ~ ~'e`/ cc>i~~ / ~ ~ sc~'~ o~ 4vO~rr- cc~dOPr ~~~ ~ and recommendations: p v~ ~ o vt~o u r 9~• ~~- ~2 ,~ q~ 25-' C ^ Boring a Boring # Ground surface elev. 9 7 ~ ft. Deplh to limiting factor ~_ in• ~ ~ RatE t~ Pit Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots •Eff#1 •Eff#Z in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ~ '/ v~ S ~~ I I w h ~~ , d ~ ~ ~ c Sd /r ~ F S 3 - o R - ` + _ ~ ~ V ` (r ~_t/i ~~VY! ~ !.••.vn Sr~n 111 ~ 1 ~ Sb ® Boring # ~ Boring ~~ , ~ , ~ ~1 G Q p)t Ground surface elev. ~,~_ tt. Depth to limiting tailor ~_ in• Consistence Boundary Roots t SOn !calk GPD/fE Horizon Depth i Dominant Color Munsell Redox Desaiption Qu. Sz. Cont. Color Texture ure Struc Gr. Sz. Sh. •Eff#1 ry I n. ~ -lv t o `112 ~ ----, 5 r ~ ~~ C t:,~-~ t r ~ ~ S -' ~ ~. mss` tf t.J I. . ~ ~ _ l0•ll2 - i 4J ~ . ~ 3 I o y!Z ~ ~ ~_ rr, ~ ~ / ~~ c ~.1 1. ._ _.,.~~ ~ ~/ • Effluent #1 =BOO > 30 _< 220 mglL and TSS >30 _< 150 mg1L 'Effluent tl2 = BOD _< 30 mgll. and TtaS _< 30 mgrL nature CS"t' ~~ CST Name lease PrinQ ©~ ~~ ~V1 v- f ~ Q E'S(~ Tale Number Address ` ~ D to E cation Conducted Pie -~.~,,-~ ,] T (~ I .~ ' Page Q~ ~ Property Owner (~ a~ L ~ !t°5 ~" Parcel ID # . "~ Boring # Bori g Grou y~ nd surface elev. ~_ Depth to limiting factor ~ in. ~ ~~ ~ J Horizon Oepth Plt Dominant Color Texture Redox Desaiption Structure Consistence Boundary Roots GPDlI! 'Eff#1 'Ett#2 tn. Munsell Qu. Sz Cont. Color Gr. Sz Sh. C " ~ ~ ' i ~ F ~ ~.~ r ~ II ® 5i( tl r~~ -I ~ ~ ~ ~ Yr3 fg- ll~ w.S~O [] Boring a Boring # ~ g, L~ Nit Ground surface elev. Depth to limiting factor in. [] Boring in. a Boring # Ground surface elev. ft. Depth to limiting fatxor it Swcture Consistence Bounds Horizon / Depth in. -II a 5 - pominant Color Redox Description Texture Gr. Sz Sh. Munsell Qu. Sz Cont. Color ~Sb~ ~ t vy ~ _ c, ty vyt2 y ~ ,, o ~~ ~ . sw` L I `" s ~k Q-~` .._ ~ t u~ 5. (c s l~l V ~ ~.~- Effluent #1 = BOD, > 30 5220 mglL and TSS >30 _< 150 mgll. ~~ r h s .~ _ l~ 'Etf#1 !~ S' t u , • Effluent #2 = BODE. 30 mglt. and TSS _< 30 rt~glL The Department of Commerce is an equal opportu eas scontactpthe departmentlat 608-266-3151 oa aT'fY 08-264-87'!7, services oc need material in an alternate format, p sari.s»o ta•~r ~~o ~_ _~~_c~v~__ --__ - fag ~ 3 0 ~ 3 ~e~; , Q ~ rres~ ~a~a9~ ~~~~ Q . M. ~ on. o~ Yo p o~ l ~~~ ~Ouc P~~Q v-/o~-~. (~~ lobo. E/c r e ~r'f- n 87.85 ~ -- 33a ` ~~- i QS / ~ klt~ 91o.8S q ~ /~ i ~ r ~` ~ Cif ~' ~. Q1 ~ °~ ~ E/eu. 4v. 8s / x ~~~ ~ ,f ' 3 ~b / ~ ~ ,~ ,! ~ ' ~ ;~ % To P d~ 1 ~'' PuL P~p-~ ~o~. ~~~bo~ Gro~~~ Eleu. 97.e M Y ~ ~ Q3 i ~ ay 3~5f~` S~ i 3 ~e~ New, .~ S~~I.~ I = yc~ ~kc~p ~- ,~s S~ow~ SOIL EVALUATION REPORT * Page ~ of vvsconsin Department of Commerce Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code minty ~ ~ J no /C Attach complete site plan on paper not less than 8 1/2 x 11 Inches in size. Plan must but not Umited to: vertical and horizontal reference point (BM), d(redion and d i G d Parcel f.0. u e, n . percent slope, scale or dimensions, north arrow, and location and distance to nearest roa Reviewed by Date Please print all Information. Personal Information you provide may ba used for secondary purpoaea (Privacy Law, a.15.04 (~) (~^))• Property Owner ~~ , ~ ~ ~,-~ ».~- 6 ~ ~ property Locatlon , , ) (~ ~ 1/4 /~ 1U 1 /4 S ~ t Lot G T ~~ N R ! ~ E ( ~N ~ >r e ov Lot , Block # Subd. Name a t~M# props Owner's Mailing Address %97 /~ofh S t~~~~`! ~ s zoos t Road e own ^ Villa Neares Ci State Zip C e hon Number Ce ~ 3 g ^ City C~~ ~ ~s ~ Sf ~.~ sv 3~ Code derived design flow rata New Construction Use: Residential /Number of bedrooms ~~ C3PD ^ Replacement / ^ Public or commercial -Describe: evation if applicable d Plain el ~ Floo ~ ~ r Parent material S Vii` ~- y~~' / l ~ ~ x ~ S .3 / ~~e!/ I,t>~r~ / ~o I ' saH a~ ~c..,pr er- c.r~0`OPr ~i0~ e, neral comments G e ~S ~ and recommendations: c' o,~-f o u t- 9~• ~~ 0,,, CM ~~ ~~ S 7 s ~{ ,,,,,. ~,.~ ~, ~ g ~3 Boring Boring # Nit Ground surface elev. 7 / ft. Depth to limiting factor ~ ~• L`~ So>I qqt Ratf Horizon Depth Dominant Color Radox Description Texture Sh. Gr Sz Consistence Boundary Roots •Etf#1 'fcf~2 In, Munrgsell Qu. Sz. Cont. Color r~ . /' l S- . ~ ~ II ii~ w•5b~c I r W Il ~ ~ ~ ~ , F s 8 b ` s / ~, 3 - --. . r. 0 2 , _ ~, a .~ ~-- ~ .. ~ , n (r'~r /~` 1/ i' 1 ~ t (M 510 ~ - ~ . . ~ _. a Boring # Boring ~~ ft ~ C7 Depth to limiting factor ~__._ ~• $pu ication Ra it Ground surface elev. , SWct~re Consistence Boundary Roots (3POJ(E Horizon Depth Dominant Color Redox Description Texture Sz. Sh. Gr •F~f#1 •~ in. Munsell Qu. Sz. Cont. Color 5 r ~ . ,F't_ C W it ~ , S' , l b -lv to y t2 l t.J i r , S- . 3 I o ti /Z ~ t,v. ~ • Effluent #1 = BOD > 30 _< 220 mglL and TSS >30 _< 150 mglL CST ~~ ease Pr(nt) i nature ~Inlnr~ 2 e Address ~ ~ ~ J- J r ~ 7 /~ / • Effluent #2 = BOD _< 30 mgll. and TSS < 30 mAIL O ~ E nation Conducted Telephone Number Page ~_ ~ Property Owner v~ ~ ~~ ! ~ S e' Parcel ID # Pil Ground surface elev. ~~~L ~ Depth to limltinp factor ~ ~• ~ Texture Swdure Consistence Boundary Roote GI Horizon Depth Dominant Color Redox Des xcxipUon Gr. Sz. Sh. 'Ei<#~ In. Mansell Qu. Sz. Cont. Color t~F ~- ` x;_ r I I ~ t I a.u~ I t ~ _ ~, s~ I ' Boring Boring # rface elev~ n• d Depth to limiting factor ln. ~ Grou 0 Pit inant Color D su n Redox Description Texture (;,onsistenca `u G Boundary Roots ~ ~~~ om Horizon Oepth in. Mansell Qu. Sz. Cont. Color Sh, r Sz ~ II s ~ vy --, ~ ~ (..~ I J ~- Boring # ~ Boring Ground surface elev. _ _ h• Depth to limiting factor ~. _ it Texture Structure Consistence Boundb Horizon Depth Dominant Color Redox Description Sh. Sz Gr in. Mansell Qu. Sz. Cont. Color . . ~ ~ ~ '~ ~ / --II 1C~`1 ~ Sb ' cr ~ a - vyi2 ~ "~ f k ,, ~(.~ L ~ l G s ~ - o`- . s 5 t1 ~ w i i ~ 5, c 4 ~u-3 f ~ `I _ _ _ r. Roots •Eff#1 (U t u S- > < 150 m 'Effluent #2 ~ BODE _ 30 mgll-and TSS ~ 30 mglL • Effluent #1 = BOD, > 30 _< 220 mglL and TSS 30 _ 9~- 7'hc Department of Commerce is an equal op ai ~ lease contactpthe depaartmentlat 608.266-3151eoa a'1'T'Y 08-Zf~8777. ervIces or need material in an alternate form , p SdD.i))0 (R.6I00) Q(~?~~f-; ~ ~ r t esc.._ /~ -~-~ ~a9~ 3d~~3 ~ r~ n lt v . y7.8s Q . M. ~ od. oa Yo P o~ ~ ~~~ Luc D,~~ ~'/o rep • ~~ ~bo~ ~ - 33a' J~~~. !3$ / ~ Flt J . 9(o.8s` + Q ~ i ~ ~ = " i n Q~ ~ ~ dl i ~ ~ / ~ / Flu. 9V. $S / 14 X ' G / ~ ~ 3 ~e ~~~ / ~ ` ~'0 ~ , ~ 3~5~~ ~ I ~ ~I ~ Y S ~.M, i q a. qo ./ / ~ G , a.~ ~ ~ ~y `C'®p o~ I ~'' Puy P~p-~ ~or~.2•bboL. ~ Grou.r.c~ ~- '~('o t .~ Eleu . 9 7.6 p 1'ropost Q ./~ 3 t3Q~Q Nen7 Z ri ~ ~kc ~e p ~- rat s S~oc.c~~ ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ~G1.1~ `e- Mai ling Address / l~ q ~ ~ ~ D~ ~' a ~ ~~-5 ~ ~' ~ ~ U Property Address - ~~ ~ ~~. ~~___~_~~--- (Verification required from Pla-uiing Department for new constructic City/State ~~~ ~ S 0 /~ (,a~~ Parcel Identif cation Number Day-~f~~-~~~'' LEGAL DESCRIPTION " " o ~ ~~_. ~~ Property Location ~ ` '/4, ~I~~'/4, Sec. ~, T a~f N-R ~~ W, Town of ._.~._.-• Subdivision ,Lot # ~• Certified Survey Map # ~ ~'~7~ ,Volume ,Page # .~-~~~ Warranty Deed # S ~'`)~ ,Volume ?~ ~ Page # O Spec house O yes ~no Lot lines identifiable yes O no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification fonm, signed by the owner and by a master plumber, journeyman plumber, restrictedplumber or a licensed pumper verifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full o~f sludge. Uwe, the undersigned have read the above requirements and agree to mastain the private sewage disposal system with the StaAdaids set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIG~TURE OF APP DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. rl ~ / +~~ DATE SIGNATURE OF APPI;ICANT Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. *****• *.**** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed POWTS OWNER'S MANUAL & MANAGEMENT PLAN FILE INFORMATION ' ovmer DA Perrnit # MAINTENANCE SCHEDULE Service Event Inspect condition of tank(s) Pump out contents of tank(s) Inspect dispersal cell(s) Clean effluent filter pump controls & alarm Flush laterals and pressure test ~vsrFM SPECIFICATIONS Pape _$_ old Septic Tank Capacity al . O NA Septic Tank Manufacturer IESER CONCRETE ~ NA Effluent Filter Manufacturer ABEL O NA Effluent Filter Model A-100 12" x 20'O ~ Pump Tank Capadty al O ~ Pump Tank Manufacturer WIESER CONCRETE ^ ~ .Pump Manufacturer ZOELLER PiJMt?i'C0~ ~ Pump Model 153 O ~ Pretreatment Unit ^ SandlC~ravel Filter O Mechanical Aeration ^ Disinfection O Peat Filter O Wetland O Other. Q NA Dispersal Cell(s) O In-ground (gravity) ^ In-ground (pressurized) O At-grade I~ Mound O Drip-line ^ Other: • Values typical for domestk (non-cortvnsn~aQ wsatfwatet and septk tank effluent. ' •+ Values typical for pretreated wastewater. Service Frequency At least once every 2 O months ~ year(s) (Maximum 3 When combined sludge and scum equals one-third (y~ of tank volume At least once every 2 O months ~ year(s) (Maximum 3 yrs.) At least once every 1 O months . C~year(s) At least once every 1 ^ months C~year(s) O NA At least once every 3 ^ months Q~year(s) O NA At least once every O months O year(s) O NA Other. At least once every O months O year(s) ^ NA MAINTENANCE INSTRUCTIONS . Inspec~lons of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certtflcations: Master Plumber; Master Plumber Restricted Sewer, POWTS Inspector; POWTS Maintainer, Septage Servldng Operator. Tank Inspections must include a visual Inspection of the tank(s) to identify any missing or broken hardware kfentify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y,) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servidng Operator and disposed of In aa:ordance with ch. NR 113, Wisconsin Administrative Code. The servidng of effluent filters, mechanical or pressurized POWTS components, pretreatment components, and any other maintenance or monitoring at intervals of 12 months or less shall be perfomned by a certified POWTS Maintainer. A servk{e report shall be provided to the local regulatory authority within i 0 days of completion of any service event START UP AND OPERATION. For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemlcats that may impede the treatment process and/or damage the dispersal ceti(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. OWNER: DAN BRIESE System start up shall not occur when•soil conditions are frozen at the infiltrative surface. Pape 9 of,,,~9 During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one.large dose, overloading the Dell(s) and may result in the backup or surface discharge of effluent To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore riormai levels within the pump tank. __ •• Do not drive or park vehicles over tanks and dispersal cells. Do 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 prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss;'diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbtddes; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDON«IUIENT When the POWTS fails 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, Wisconsin•Administrative Code: • Ali piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shali'be removed and properly 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 fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: O A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compactton.and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ^ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS ' technology a holding tank may be installed as a last resort to replace the failed POWTS. ^ The site has not been evaluated to identify a suitable replacemen# area. Upon failure of the POWTS a soil and . site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. CX Mound and at-grade soli absorption systems may be reconstructed in place following removal of the btomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. «WARNING» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANDIOR iNSUFFICiENT OXYGEN. DO NOT ENTER A SEPTIC PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER 1 ~ r Name HELGESON EXCAVAT Name •' Phone 715/772-3278 •Phone _ . •. • • • . SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY ' ' ~ ~ ' Name JOHNSON SANITATION Phone Agency ST CROIX COUNTY ZO NG • Phone 715/386-4680 ~~, This document waa dratted by the staffs of the Green Lake, pAsrquette and Waushara County Zoning and Sanitation apendea. This doaiment meets the minimum requirements of ch. Comm 83.22(2)(b)(1)(d)b(f) and 83.54(1), (2) ~ (3), Wisconsin Administratlve Code. Use of this dodtment does trot guarantee the performance of the POWTS. C,Myy(Zp~) ' 'J 225'i P y00 STATE BAR OF WISCONSIN FORM 2 - 1999 Document Number WAlt2RANTY DEED This Deed, made between Bruce A. French and Ruth A. French, husband and wife Grantor, and Daniel J. Briese and Melissa John, Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Crone County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area -73055 KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CO. , liI RECEIVED FOR REGORD 05!28/2003 09:30AM IiARRANTY DEED EXEl1~T Ii REC FEE: 11.00 TRANS FEE: 89.70 COPY FEE: CC FEE: PAGES: 1 Name and Return Part of Fractional NE '/. of theNW '/. of Section 2, Township 28 No ATTN: B ~ETCE VAN HEUKELO Range I S West, St. Croix Cotmty, Wisconsin described as follows: Lot 4 of FtISt Na110(la1 Batlk Certified Survey Map filed December 5, 2002 in Vol. I b, page 442 , PO BOX 166 No. 700978. River Fags, WI 54022 _ ooa-I bD~f- lOO3 -5~ Parcel Idenftfication Number (PiN) This is not homestead propeRy. Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. Dated this ~~`~' day of May ~ 2003 s AUTHENTICATION Signature(s) authenticated this day of s -t~• Personally came before me this ~b - day of 2003 the above named A. French add Ruth A. French, husband and wife TITLE: MEMBER STATE BAR OF WISCO `~?,' to a own to be the person(s) who executed the foregoing (If not, t t and acknowledged the same. authorized by § 706.06, Wis. StatsJ ~ ~}~ _.. ~ i" i ~ ~ ~~ THIS INSTRUMENT WAS DRAFTED B "P[~ 0( ~~''" ~~ ~ ~ a Attorney Kristine Ogland otary Public, State of Wisconsin u son, I Olb My Commiss on is perm~ent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ~`- • s" . ~"~~ ') Names of persons signing in any capacity must be typed or printed below their signature. xramaion Prot~«~ts C«na•~+x ~ ~ ~. ~ STATE BAR OF W ISCONSIN ~t WARRANTY DEED FORM1t Na 2 -1999 ~) (is not) # Bruce A. French ~ ~ ~~~ + Ruth A. French ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. p~~G~tc. County ) c~:~~ ~ oritu ~uK V t Y nrirr- MtOCATED IN THE FRACCAOYA ST~CROIXOFCOL)NTY WWISCa IN CTICNV 2. 72$N, R 15W, TOWN OF 3026 60TH AVENUE WILS~V, WI. 54027 BEARINGS I~FERENCEO TO THE NORTH-SOUTH 1/4 SECTION LINE OF SECTION 2. ASSUMED TO _~ BEAR S00 00'00"E. N1/4 CORNER, FRACTIONAL SECTION 2 ( ALUMINUM CAP FOUND ) GENERAL. NOTICE STATEMENT THE PARCEL. SHOWN HEREON IS 5tJ8JECT TO 57ATE, COUNTY AID TOWNSHIP LOWSSI~ZE,EETC~. BEFORE PURCHASIN OR DEVEL~INGSSAN~ PARCEL CONTACT THE ST. CROIX COUNTY ZONING AND THE APPROPRIATE TOWN BOARD FOR ADVICE. LEGEND -~ -INDICATES SECTION CORNER MONUMENT ( AS NOTED ) • - It~iICATES i" (OUTSIDE DIAMETER) IRON PIPE FOUND. IRON PIPE WEIGHING 1.~tL8~/DLINEARR ) FOOT SET. U_NPIATtED LANDS OWNEO BY PLATTERS N88°58'36 "E 630.00 ' 0~~ ~ ~w F- ~- °~ ~ a ~a ~ ~ y m o 0 a~~ 0 ~ ~._ =~o SCALE IN FEET 1~ 50 ' O' 75~ 150' 300 l~®~ 214.185INCLUDINGERIGHT--pF-WAYS ) 202,94 EXSOU~I~ FRIGHT--OF5WAY (DES ) 596.99' S88° 58'36 "W 6~ .00 ' UN_ PlA1TED tAND6 OWNED BY OTHERS ~~ • •~~ * r r_ EP ;~.* l,~N~~~! ~~ SUNV. PREPARED BY: _ ..._ ...y..r~ _ ~ ~ ~.........~~. ~ . N rn w °o 0 ~~ ~ 33.01' ~~ H ~ J ~ O } ~ Q3 Q Q m~ m m vwi F! uw w zQ°o of ~o 0 0 '~~ ° ~ ~~ ~~ ~ f .o ~° i 33.01' m ~i m S t y ~ ~ ~~+ ~\ 1 ' ~ v `;~1 ~~ ~~ .. st ~ J O U ~IQWW N ~ S f- ~r ~ O m 0 ~ ~I ~~ z 4 ~~ ~~+ ~'. ~ _ ...-_. ti ~, ~', ' _ .~ ~~-''- ~, ' ~. .~~~~ ,~ t S1/4 (OALU~MIMJMCCAPFOUNOC)iON 2 Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8%: x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. Please print a Personal information you provide may be used Property Owner French, Bruce Property Owner's Mailing Addre~ 3026 60th Ave. City Wilson State Zip WI ~ 54027 ~ 715-772-3334 /! New Construction Use: y' Residential /Number of bedrooms 3 Code derived design flow rate 450 __ GPO i»., Replacement ~_ Public or commercial -Describe: Parent material loess over till Flood plain elevation, if applicable NA General comments and recommendations : install 4' x 112.5' rock cell mound on 99.1 contour as upslope edge of rock w/ 1.0' sand fill for 3 br (assumed-not staked) a Boring # _,,, Boring /I Pit Ground Surface elev. 99.4 ft. Depth to limiting factor 24 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz __ in. Munsell Qu. Sz. Cont. Color Gr. St. Sh. 'Eff#1 'Eff#2 1 0-4 10YR 3/2 - sil 2 m gr mvfr ~ cs ! 1f/m ' _5 8 - - -----f -- ---~ -- - ~ - ! ~ .- -- _ - 2 ' 4-10 ! 10YR 3/3 - sil 2 f sbk mvfr cs i I 1 m .5 I 8 ~ 3 10-16 10YR 4/4 - sl 1 m sbk mvfr gs ~ 1 m 4 6 - I-- 4 ~ 16-24 10YR 5/4 - Ifs 0 sg ml cs 1 m .5 9 5 ', 24-40 I - _ --- - - - 10YR 5/4 f2d 7.5YR 4/6 Ifs 0 sg ml - - ~' .5 9 , ~ - i ^ Boring # ::" Boring ~/', Pit Ground Surface elev. 99.1 ft. Depth to limiting factor - 32 In. Soil Application Rate Horizon ', Depth ~ Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fN in. ~ Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 ,,I 0-5 ~ 10YR 3/2 - sil 2 m gr mvfr gs 1f/m ~ .5 ' 8 2 5-11 --_ 3 11-23 10YR 3/3 10YR 4/4 - - sil sl 2 f sbk 1 m sbk mvfr mvfr I cs ~- cw 1m _', .5 .8 1m ~ .4 ' 6 4 ~23-32 10YR 5/4 - Ifs 0 sg ml cs 1 m ~ 5 I - .9 - - 5 ', 32-49 10YR 5/4 f2d 7.5YR 4/6 Ifs 0 sg ml - - .5 9 i ! -~ i i - - I 'Effluent #1 = BODS> 30 < 220 mglL and TSS >30 < 150 mg/L 'Effluent #2 = BODS < 30 mg/L and TSS < 30 mgr CST Name (Please Print) Signature. CST Number Henry F. Grote L - `=~~ 222774 Address Certified Soil Testing Date Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 54751 10/14/2002 715-233-0398 or secor~~c~purp ses(P~Jaey'1~, s. 15.0 Pro ~ ,..1 ~_ ~ 200'. ~'~~ r~ Gov Lot s, . c;i~~ ~> ~,~~.. ~ . - . ,r 1662 Page 1 of 3 Certified Soil Testing St. Croix ~- 5 a CSM Pen Reviewed By --Date (1) (m))• erfy Location Lot NE 1/4 NW1/4 S 2 T 28 NR IS_W Block Subd. Name or CSM# 3 . -- ~ to ~yZ6 __ ~~ City ;~ 'age / Town Nearest Road Cady ! 315Th St. a. Property Owner French, Bruce Parcel ID # 5 a CSM Pending Page 2 of 3 _ ' a Boring # Boring /' Pit Ground Surface elev. 96.7 ft. Depth to {imiting factor 24 in. Soil Application Rate th Horizon Oe Dominant Color Redox Description Texture Structure Consistence Boundary Roots P ' p in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 1 D-6 10YR 3/2 - sil 2 m gr mvfr gs 1f/m .5 ~~ .8 2 II, 6-12 10YR 3/3 - sil 2 f sbk j mvfr ~ cs 1 m .5 .8 3 12-19 10YR 4/4 - sl 1 m sbk mvfr cw ~ 1 m .4 .6 4 ~ 19-24 10YR 5/4 - Ifs 0 sg ml cs 1 m ~ .5 - _ _9 5 ~I 24-44 ~ 10YR 5/4 f2d 7.5YR 4/6 Ifs 0 sg ml - - 11 .5 ~'~ 9 - ~-- If ^ Boring # Boring - Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color in. ~ Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ft' ', `Eff#1 `Eff#2 i --- ---- --- ---T -- - __- ~- - f i -t ----j -- --- - --- - i i -- -~- ___.: ---- -- - j ----i- _ r Boring # -~ Boring I Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence i Boundary Roots C~PD/ft= __ __. 'Eff#1 `Eff#2 _ I ~ ~~ j ~ II ~, - - ---fi- i ~ T - --- ~ --- - ~ ~ ~ ~ ..-- -- I i ~~' -- -- _ I .. ' Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 =GODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department ai 608-266-3 i 5 i or TTY 608-264-8777. 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CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF CADY COMPUTER NUMBER 004-1003-50-100 Parcel Number 02.28.15.21A OWNER NAME: First BRUCE A & RUTH A Last FRENCH PROPERTY ADDRESS: Hse # 1/2 PD --Street Name-- Type SD Apartment SECTION 2 TOWN 28N RANGE 15W'/4160 NW'/440 NE Line Description Line Description TOTAL ACREAGE 35.083 PLAT LOT BLK 01 SEC 2 T28N R15W NE NW 15 02 EXC PT TO CSM 16/4420 16 03 17 04 18 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1-General, F4-Prev. Parcel, F5-Next Parcel, F7-Valuations, F8-History, F10-Exit .. LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF CADY COMPUTER NUMBER 004-1003-50-200 Parcel Number 02.28.15.21A-10 OWNER NAME: First DANIEL J & MELISSA A Last BRIESE PROPERTY ADDRESS: Hse # 1/2 PD --Street Name-- Type SD Apartment SECTION 2 TOWN 28N RANGE 15W'/<160 NW'/440 NE Line Description Line Description TOTAL ACREAGE 4.917 PLAT CSM 16/4420 LOT4 BLK 01 SEC 2 T28N R15W NE NW 15 02 LOT 4 CSM 16/4420 16 03 17 04 18 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1-General, F4-Prev. Parcel, F5-Next Parcel, F7-Valuations, F8-History, F10-Exit