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HomeMy WebLinkAbout004-1027-70-000Parcel #: 004-1027-70-050 04/22/2008 08:47 AM PAGE 1 OF 1 Alt. Parcel #: 12.28.15.1856 004 -TOWN OF CADY Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 06/02/2006 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O -BENJAMIN, RICHARD H & KATHERINE L RICHARD H & KATHERINE L BENJAMIN 463 320TH ST KNAPP WI 54749 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description * 463 320TH ST SC 5586 SPRING VALLEY SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 3.770 Plat: 5216-CSM 21-5216 004-06 SEC 12 T28N R15W PT SW NW CSM 21-5216 Block/Condo Bldg: LOT 01 LOT 1 (3.77 AC) Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 12-28N-15W SW NW Notes: Parcel History: Date Doc # Vol/Page Type 06/23/2006 828116 WD 06/02/2006 826651 21/5216 CSM 04/07/2006 822378 WD 07/23/1997 704/146 2008 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 03/31/2008 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 28,000 167,400 195,400 NO UNDEVELOPED G5 1.770 1,100 0 1,100 NO Totals for 2008: General Property 3.770 29,100 167,400 196,500 Woodland 0.000 0 0 Totals for 2007: General Property 3.770 29,100 159,800 188,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 8 2 6 6 5 1 VOL 27 PAGE 5276 1{ATALEEA H. REGISTER OF DEEDS ST. CROIX CO.. MI RECEIVED FOR RECORD A6/02/Z~ 12:~BPM CERTIFIED SURVEY 11AP REC FEE : 13. CIA Pl1PY FEF - C R TIFIED SURVEY MAC' L LOCAT2=/D RNA 15 ST TOE ~ C~ADYwST CROIX CANTS; TNOgSCON~N 8 NORTH, THE NW CORNER OF SEC. 1 , T. 28 N, R. 15 W (FOUND 3/4" REBAR). RECEIVED N ~ PREPARED FOR: v, DAN RHY =' A~G I $ UNPLATTED- LANDS. 2 3 206 ~ ..... . . ~ 3 BEARINGS ARE REFERENCED ~ ~ N89~5T00"E 334.65 TD THE VEST LINE DF THE ~' CR~~X COU 2 ~ 301.65 NORTHVEST QUARTER NTY ~ASSUM£D). SiJRbEYOR'S RECORD I ~ i I 0 N ~ w~ ; I z_ -+ N ~ I SHED Iti ~~ (~~ ' ~- Z • 33 .~3 I HOUSE ~ ~ (~ ~ Z ~- ~I Q • ~' '`~ I ~`~ 3.70ACRES ~ 3 Q . ~ • ~ eW h I :~ 164,079 SQ. FT. ' ~ . Z . cV ~ v • 3 3.17 AC. EXC. R/W ~ Z . ~ I !n ~ ;~_ 138,200 SQ. FT. ~, ~ I g I ;~ I ~ 50~ 2 I I - I - • • , • HIGHWAY SETBACK UN£ THEE 1/4 CORNER OF ( ~ SEC. 12, T. 28 N, R. 15 W 33 3 ~ (FOUND ALUM/NUM CAP ~ ~ 589 5700"W 301.65_ ~ / ~ -'- - N89 40'14 E / ~ ~ ~ ~` 4 5TH A V E, 31.32 ~ 5000.50 ~ ~ "~ S89 40'f 7"W 334.67 ^~ ~souTH u~ivE o>=~E NW 1 4 ~ N ~ I M - 5335.17 ~ ~ SEC. 12, T. 28 N, R. I S W Q `~J i ~ ~ ~- 3 N 2 I I PENDING C. S. M. ~W~ (I ~t ... ~ ~~sc o~rs~•s, LEGEND JAME811A. • = FOUND 3/4' RE R ~ WEBER ~' o= SET 1' D.D. X 18~IRON PIPE ~~~ WEIGHING 1.13E BS IIPER LINEAR FOOT. ~ ~ Q• ~= GOVERNMENT CDR~NER AS NOTED 9yQ SUFt~!~~O I~ :. 1' = 100' JAMES M. WEBER, S-1804 - PASSE ENGINEERING, INC. 0 50 100 200 SHEET 1 ~F 2 HUDSON,~,E~WI 5016 806-06 THIS INSTRUMENT pIPAFTED BY JIM WEBER DATED ! '1V~+~ 13 ZC~L t oft Vat 21 P~~e 5276 N oNo Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division t ' INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT? Personal Information you prowoe may be uses ror seconaary purposes Irnvacy yaw, s. i o.uw C~ /I~TVI Permit Holder's Name: City Village X Township Rhy, Dan Cady, Town of CST BM Elev: 1 Insp. BM Elev: ~ BM Description: ~ ~ q~• ya 9 ~? ~fo o~ `7-- os fi ~ csr ,kr: e •y SANK INFORMATION TYPE ~ MANUFACTURER /~ APACITY Septic w r ~5~2 6 Dosing ' + - II ~~ Aeration Holding TANK SETBACK INFORMATION ~J . en o Ir n a e ep Ic > ~,.5... ~ ~rG01 3 r osing a ~~ y ~ ~t era Ion o Ing PUMP/SIPHON INFORMATION anu ac urer ~,~s eman GPM o e um er • ~• f)~ ~~ r ~p I O ~- Ic lon oss ys em ea ' ~'' 2.©~ .SO S. orc n eng L~ Ia. Z ~- L A6a7VRr' 1 IVIY J i l l Girl ENSIGNS ~ 8~' :~6. Zs C3~ i County: St. CI.OIX Sanitary Permit No : 488132 0 to Plan ID No: Parcel Tax No: 004-1027-70-000 Section/Town/Range/Map No: 12.28.15.185 ELtVA 1 IUN UA 1 A STATION BS HI FS ELEV. Benchmark p,~, q~~ 9~- o Alt. BM BI g. Sewer ~. Q _I ~s. ~/ - t/ t In et ~•.~( ryq q•~ 1 7S 1•~ J t t ut et J / t n et 0 om 'fl p, ~' ~ ea er an. ,5~~ ~.~ 3;z3 , Z Z.0$ ~•~ I a ra e ~~ ~~ ~ ~ w- . lZ ~ -- cb over ,~,~ 3~- - 9~ ob d ~' ~0 3• ~( ~ ~o , `jo..s~ ~ o . o} R }. 33 ~-~• 0 ~~ ,ro~,~ 9,sD ~~•~- r"° / INFORMATION ' "" ""' '• IS ~- b 2 ` ~'~os ~ ~1/V1~ U ~ •{,~ road ¢ , o.u~ . u [ !I Pipe(s) 1 ~ ~ f ~~ ~~, 1 ~ I ~~ Length Dia ~ ~`j Length~~~ Dia_~ Spacing~,_._. Z, ~- x Pressure Svstems Onlv xx Mound Or At-Grade Systems Only Bed/Trench Center Bed/Trench Edges Topsoil 'Yes No Yes No . ~ ., /i l l ?7 •,.. L 1 n• COMMENTS: (Include code discrepencies, persons present, etc.) s, pe-ctlon _ ~• '-~ ~p ~~~~-'~~•"""'~•~"• "-i-~~ Location: 463 320th Street Wilson, WI 5402'7 (SW 1/4 NW 1/4 12 T28N R15 ) 40 acres of Parcel No: 12.28.15.185 ~ ' 1.) Alt BM Description - S • t t D ~ ~ ~~ • ~ ,Cu ~y~ 2.) Bldg sewer length = .., (op • - amount of cover = 7 42" Se~. ~'• -- Plan revision Re uired? ~ Yes No ~ ,''-T- ~~~ ~ li ~/ ' 2 J~ Q J -- ~ -- _-- _--- Use other side for additional inform Ion. J _ _ _ o - ---~ '~ -- ~e . SBD-6710 (R.3/97) Safety and Buildin ivision County ` 201 W. Washi ve., P. x 7162 ST CROIX isconsin Madiso , 5 - 716 Sanitary Permit Number (to be filled in by CoJ Department of Commerce ~~~ Sanitary Permit App icatlon State Plan I.D. Number TRANS I D # 1258096 in accord with Comm 83.21, Wis. Adm. Code, persona inform i ou provide ma be used for seconda ur oses Privac w s 15~m~ 2 2 ~ 0 6 an mailin ad dre ss ) Project Address (if differe nt th y ry p p y , g ~ } - I. AppGcaflon Informafion-Please Print All Information ST. CROIX COUNTY - . ? 7 ~ ~t/Q3 ~J GV~ ~ '~" Property Owner's a ~ Parcel # Lot # Block # 70-000 004 1027 DAN RHY - - PropeRy Owner's Mailing Address Property Location 483 320TH STREET SW NW Section 12 '/. Yo City, State Zip Code Phone Number , , \ KNAPP WI 54749 715/772-3383 T 28 N; R ~ 5{circlC one) ~ ~ gS J • II. Type of Building (check all that apply) ak 4 ~ 5~ w~; l~r ~ ,5 a~. ^~ 1 or 2 Family Dwelling - Number of Bedrooms 3 ~O J 6~ ~ ~ cti,.~.- Subdivision Name CSM Number Public/Commercial -Describe Use N/A N/A d ^ State Owned -Describe Use lJ X ~ D ~' ^City~Village ~~ Township of CADY III. Type of Permit: (Check only one box on line A. Complete line B if applicable) G e A' 0 New System ep y ^ R lacement S stem ^ Treatment/Holdin Tank R lacement Onl g ep Y ^ Other Modification to Existin S rem g Ys B• ^ Permit Renewal ^ Permit Revision ^ Change of ^ 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 I DtJ (~ ^ Non -Pressurized in-Ground ^~ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pasa Sand Filter ^ _ --~ ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recireul ling Sand Filter g yn ^ Leaching Chamber Q Drip Line ^ Gravel-less Pipe ^ Other (explain) Q, ~r~ i Q Recireulatin S thetic Media Filter / V. Dis ersaUTreatment Area Information: Design Flow (gpd) Design Soil Appl' on Rate(gpdsf) Dispersal Area aired (sf) Dispersal Area Progoscd (sf) ~ System Elevation 450 ,~ 1 6 , 5 450 ~ 450 ~ 3 /(P . z5 91.5 ~ VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank 1000 1000 1 WIESER CONCRETE X Aerobic Treatment Unit ~' 'a ~ ~~ ~ ~ ~ lJ r(~(~l~e Cd"1I P ~-` ~-' C-, Dosing Chamber 600 600 1 WIESE CONCRETE X VII. Responsibility Statement- I, the undersigned, assume res nsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plu er's Signature MP/MPRS Number Business Phone Number BENNIE HELGESON 220292 715/772-3278 Plumber's Address (Street, City, State, Zip Code) W1229 770TH AVENUE, SPRING VALLEY, WI 54767 VIII. Coon /De artment Use Onl proved ^ reapproved Sanitary Permit Fee (includes Groundwater Date su Issu' g ent Si tore o S Surcharge Fee) ~ ~ ~ h pb V , / /~ `-7 Own ven Rees for Denial IX. Conditions of Approval/Reasons for lsapproval ~ , SYSTEM OWNER: 3~ Cov-c~: ~ a~-s , v` ~.~ 2 i . Seplic tank, et'fhuM lilts and G, C 2. ~ ^ e_ ~ecsls- t,J I d-~. (~~ t ~ ~-. dispersal t:eN must afl / as per nanagement plait provitiad by pkanbar. , 2. AN ssbsck requirements Hurst be rtidntaNt.d a par appliccabls tide / ordhtartces. Attach complete plans (to the County only) for the system on paper not leas than 81/l x 11 inches in size SBD-6398 (R. 01/03) ~c.~n r' l7a~ ~~~ e re 2~ e o~%~ ~~- ~~ ~~~ o~ ~, " Pc~ cr i ~ ~~~~y 3~~"~ 5~w~~- ~,r1, (Oo.O~~ ~T 1-rl c~~r~/1(/-P ~/rl~ 5 .~ )a 1 q~' ~ ~ - "~ %R ~ 1©001 no GQ1, t-~i, 11 ~\ S -- ~- ~g ~ ~, , / 8 ~e ~ s ~~o~z (3:3 s, ' ~' w n~ i ~. 3 ,E} ~---~ 1- ~-~- ~t®~ ~l~~t. ~~ ~~8 ` I ~ ~Q h ~~ .. _r ~~--~~~' c~Ui (e T~I~ saw ~~0~/`~~ ~ tv~ i i i~ ~~ ~~+~ ~r ~~~___ PJ~' ~ ; NCB G~ y" P~~~ ~ r~ ~-~ I s~~~.r ~ i ~ A, 9 ~~ ~ ~- . ~~~ -" ~ ~, ,. ~,r t,' gg,5,,- _ ,--~- 8~ ~ ~~o~~~ (3 3 ~~ ~S` \ t ~, .M. 9 7. ~O ~ m`~t` ~7I` 65~ `'J-~ ' b ~ I° ~ r~. ~ ~ ~~ ~, Vii -~.r1. coo.d~~ 5 ; k.~ w-J~ r~. R ~ ~bo,~ P ~©ool~ oo Gil, /- ~~ e ~ ~"~ ~/ /J~:S~~ ran K j~~ I7 ~ ~ k sus ~I-f-~- ysfh ff~ ~ commerce.wi.gov i ^ ~scons~n 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 April 07, 2006 CUST ID No. 220292 BENNIE W HELGESON HELGESON EXCAVATING W 1229 770TH AVE SPRING VALLEY WI 54767 CONDITIONAL APPROVAL PLAN APPROVAL EXPIItES: 04/07/2008 SITE: Dan Rhy 320' Street Town of Cady St Croix County. SW1/4, NW1/4, 512, T28N, R15W Identification Numbers Transaction ID No. 1258096 Site ID No. 711314 ' Please refer to both identification Numbers, above, in all cones ondence with the a~enc . FOR: Description: Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1069902 Maintenance required; .450 GPD Flow rate; 24 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 (8.6/99); 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: Reminders • This system is to be constructed and located in accordance with.the enclosed approved plans and with the component manuals listed above. • 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. Cond • 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 ,~~" p ARTMEN • A Sanitary Permit must be obtained from the county where this project is located in accordance with the ON OF requirements of Sec. 145.135 and 145.19, Wis. Stats. ~ ~ . SEE CORD • Inspection of the POWTS 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 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARNIICHAEL RD HUDSON WI 54016 BENNIE W HELGESON Page 2 4/7/2006 • Comm 83.22(71 A copy of the approved plans, specifications and this letter shall be on-site durine construction and open to inspection by authorized representatives 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 lOl .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, Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday charlie.bratz@wisconsin.gov Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 r INDEX SHEET PROPERTY OWNER: DAN RHY 483 320TH STREET KNAPP WI 54749 PROJECT NAME: DAY RHY PROJECT LOCATION: SW 1/4, NW 1/4, S 12, T 28 N, R 15 W MUNICIPALITY: TOWN OF CADY COUNTY: ST CRODC ~F~F~ APR , F~ Sq~~ s 2006 ~~ DESIGN: PRESSURE DISTRIBUTION MANUAL SBD-10573-P(R/99) MOUND COMPONENT MANUAL SBD-10572-P (R 6199) 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: WLP 1000/600-MR ZABLE 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 Date: Apri15, 2006 '`iQ~r~l~y ~~,~D OF COMti9ERC TEY B GS f ESPONDENCE ~t~Jn~.~r ~ ~Qv\ .~~u _ Page a,3. Df 8 Synthetic Covering ;'1 S TN1 C 3 Medium Sand -~ ~.~ TopsoU ~ 2 % Slop© !___) ~ ~ E 3 ~ ' ;' ~i_t~6.Ot 'z - 2 z Aggregate -' Distribution Pipe r_.. U ~ ~ 'r=.-~Tr o b (~(~.rcxr~ Force Main From Pump Cross Section 01 A Mound Signed: License Number: Date: A ~ Ft. a .s~-€ t . K ~ Ft. L_~~F t . ~ S"_( Ft. j ~y Ft . W ~~,5 Ft. G GU S ~ , 9v.~s Plowe d Layer p /,O Ft. E /. 96 Ft . F , g0 Ft . G . ~ Ft . H /, O Ft. L. Observation Pipe ~ K - '~ _! a -~-~--_---'_ 1 r ---------------------- ---- __ _ . ~ ~ _ _._ _ _ ~ `~~ A 14 _ ~ _ - - - - - ----------------------------- w 6 ~ - \ ,„ ~Lt-Of Z~-2% Distribution Pipe A99re9ote I ~ Observation Pipe - ~ ~ ~~' ~ ~ «s~~l ~~-~~ - Plan View Of Mound C )ea~.o~ 1" C ~. n °~8- Porlorolnn t~lp. Onioll ~~ / End Vlav {~.r tU(UIf u ~` Pvc P~Dr Cowl r~~v,~_E~1~ =-1-.. _. --- Holes Located on Bottom ere Equally Spaced ~a "'~ ., ~~ o ~ "i ~ I~~I Plp. Discribucion Pipe Layout Y 5y ~ .. .. x ~,~,~ s ~~ ~~ Signed: License Number: Dace: ~.~ L ~ x ,- Y .~ 7 `L Inch Hole Diameter _~_ Lateral ~~.. Inch (es) Manifold " ~ Inches force Mt~in " ~~ Inches x~ LSE ~~ ~ I~e_L~. 9~2• ~ ~ Leer o-~ ~~- e~'-~-~5 - x 3 Tote ~o%s = 7s ~~ Y~-P~Y" ; ~Gi.h ~ ~ U Page ~ Of~ .--, ' -a SEPTIC TANK 6 PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS 4" .PV~VENT PIPE 12" MIN. ABOVE GRADE E WEATHERPROOF O T D 25' FROM DOOR, WINDOW OR T CONDUI WITH COVER MANHOLE FRESH AIR INTAKE W/ PADLOCK E ~~~,,,,~~ ,~~, ~~ • S- WARNING LABEL / ~r_~4" MIN. _ 18" IN. • - s. D. ~' \ ~I 1 ~~ 8 MIM. INLET ~ ~, I . WATER TIGHT SEALS GAS- ~ 1~ T vAPPROYED R A ~ ~ SEAL , JOINTS KITH r ~ --t- ~ ALM APPROYED PIPE APPROVED ~~ ' {~6i t 3' ONTO ~ ~ ~ ON PIPE 3' SOLID SOIL ONTO SOLID C I ' SOIL PUMP OFF ELEV . ~~ : C7FT . -~- OFF D 3" APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS rotes t r~i~ Ts ~~t~s SEPTIC / DOSE ~ 1~~7 , X $, = ~ , ~~ tJc3I . TANK MANUFACTURER: (,{.,(Fsf=~ ---~ TANK SIZES: SEPTIC J0.~'~ GAL. DOSE ~_ GAL. ALARM MANUFACTURER: ~• ~T, ~1~~`~.-a MODEL NUMBER : ~ rr, ~f-~_ r SWITCH TYPE: ~~ ~~ F(~ua/- PUMP MANUFACTURER : ~-c0 u.-t ~ I _ MODEL NUMBER : (= SWITCH TYPE: REQUIRED DISCHARGE RATE ~ ~.7~`~PM DOSE VOLUME INCLUDING ~: , S~ C~1. -~ F LOWBAC K : S~', .37 GAL . CAPACITIES : A = l ~ INCHES = O~ 1.6 Q GAL. B = 2 INCHES = 33•~ GAL. C = ~ INCHES = JO .S GAL. D = ~D INCHES = I67• ~ GAL. PUMP E ALARM WIRING AS PER ILHR 16.23 WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE ~~ ~ FEET + MINIMUM NETWORK SUPPLY PRESSURE ~ ~ FEET + ~- FEET FORCEMAIN X O FT/100 FT. FRICTION FACTOR ._ iZ__ 3 TOTAL DYNAMIC HEAD FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH WIDTH DIAMETER LIQUID 6E~`AI - 3 ~ `~ ,~ I (~ • `1(~ ~~~. ~'~'~- ~v~c~ ~Ic2s~- Ss<-- Task 5~,< <_ Sh-~~ SIGNED: LICENSE NUMBER: DATE: 1/88 ~~ ~v~~ 1so' TOP ~~IEtiY SCALE: 1 /a' = 1 `t VtIV I J ,~~~ ~( -~ ------ ------ INLET OUTLET '~ n ~ d. . ~ N ~ ~ 3" ~inr~ vl~w SCALE: 1/4' = I w~~ ooo/soy-R zAS~ ~'A~lK SPEClF1+CAT14NS DIMENSIONS: WAIL• 3" 90TTOM: 3" COVER: 5" MANHOLE: 24" I.D. HflGHT: 56" O.D. LENGTH: 150" O.D. WIDTH: 84' O.D. BELOW INLET: 42' O.D. LI4UI0 LEVEL: 36" l4EIGHT: 14,795 LBS. iNLET AND OUTLET: 4" 80RE WITH STOP FOR QUIK-TITS, FERNCO GASKET, CAST-A-SEAL BOOT OR EQUAL INLET AND OUTLET BAFFLES: WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 27.88 GAL/1N (SEPTIC) 16.76 GAL/IN (PUMP) LOADING DESIGN: 7' 0' UNSATURATED SOIL ~C~~C~a ~oa~~~~c~ W3716 US HWY 10, MAIDEN ROp(, WI 54750 800-325-8456 MOOEL WLP1000/600-MR ZABLE SEPTIC/SEPTIC, SEPTIC/PUMP OR SEPTIC/SIPHON JANUARY, 2000 FILE: wlplooo 600-MR „ i Pttmp Specifications ;~~ H P ~. Up to 40 GPM ~ Discharge size 1'/<"NPT Solids:'/s" maximum Motor Single phase: 115V Materials of Construction Brass/thermoplastic Features and Benefits •Top suction eliminates '~ impeller clogging. • Corrosion resistant r construction. •Float actuated svJitch. Mtr[rts rtEt ~ .s MDDEL DVP03 1 a 6 20 ~ ~ ~~ i =5 ~ 75 ~ ~ ., a Z ~, ~2 ~ S ,~ I _ ' ~~ 0 S ~0 ~5 20 25 JO JS °U LLS.f,PM n _L 0 2 4 6 B 10 m~pir cAeAarv r U MfICHS fECi to ' 9 ~ ]0 ~~ 25 ......'._ .. _... e ._. 0 6 20 '-- _._. _ U_ 5 f 15 ___ ____ _. ~ 1 _.i 1 _ _. i . I--_ ~ .. ~-_~ L. ~~ ~ -, MODEL: 3871 ' ~s . ~~ ; ., . .. ._..., a ° :.. `: _ • ~- ~ y -~- _ _ r_ ....._.~ .. '... . ~ J .... I __ _r _. _ - ......1 , I ~ ~ ~ , ;_ 5, .r. . ~_ .~ ~ ~ ...__ a o .. °o._ .. _ ~o to ao 00 ~ uxwd 0 2 a Pump Specifications °/,o and'/: HP Up to 60 GPM Maximum head to 32' Discharge size 1'/:" NPT Solids:'/°" maximum Motor A!I motors feature ball bearing construction. Single phase: 115V Materials of Construction Cast iron Thermoplastic Stainless steel .6 y w ~. ...-.. .Ca ACrL~ 30 .~-~ T .P~ '. Features and Benefits • EP04 impeller- semi•open design with pump out vanes to protect mechanical seal. • EP05 impeller -enclosed design for improved performance. • Rugged glass-filled thermoplastic casing and base design provides superior strength and corrosion resistance. • Cast iron motor housing for efficient heat transfer, strength, and durability. • Corrosion resistant threaded stainless steel shaft. •Available for automatic and manual operation. • CSA listed models available. All Models a;~e desrrned for contirurous operatron and lecture stainless steel hardware. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page _Z of ~_ ----- ,,..~....-...wr.nwrc FILE INFORMATION Owner ,,.r~ liA~ r.~iY Permit # MAINTENANCE SCHEDULE Service Frequency Service Event ^ month(s) (Maximum 3 years) ^ NA Inspect condition of tank(s) At least once every: Z [~ ear(s) 1 of tank volume e-third (Y l ^ NA When combined sludge and sc 3 s on um equa Pump out contents of tanklsl ^ month(s) (Maximum 3 years) ^ NA Inspect dispersal cetllsl At least once every: 2 l3 year(s) ~ month(s) ^ NA At least once every: 13 ^ yearls) Clean effluent filter Gt month(s) ^ NA ump controls & alarm Inspect pump, p At least once every: 13 ^ year(s) ^ monthlsl ^ NA Flush laterals and pressure test At least once every: 3 f~year(s) ^ month(s) ^ NA Other: At least once every: ^ year(s) ^ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the Sepo gegServ cSng OpeeatorcatTank Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer, inspections must include a visual inspectioanodf scumaand )toocheckr fo a any backgupr or pondingdof aeffluentton the ground surface. measure the volume of combined sludge onding The dispersal celllsl shall be vaceallThespondingtofceffluent onfthe ground surface ay indicate a failing condition and requires the of effluent on the ground surf P immediate notification of the local regulatory authority. When the combined accumulation of sludge and scumServic n ta0peratorlsandedisposediofrin a co dance wth chaptertNRe113 contents of the tank shall be removed by a Septage 9 Wisconsin Administrative Code. retreatment All other services, including but rot ~im<; ~ months,eshallnbeoperfol medfby a cert f ednPOWTS Ma tainereomponents, p units, and any servicing at inter A service report shall be providQd to the local regulatory authority within 10 days of completion of any Service event. *Values typical for domestic wastewater and septic tanK ernueui. ~ ~ Page ~ of _~ 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 chemicals that may impede the treatment process and/or damage the dispersal celllsi. 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 infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal celllsi in one large dose, overloading the cell(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 normal 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; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT 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 chapter Comm 83.33, Wisconsin 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 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: ^ 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 compaction 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 replacement 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. ~ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat 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 AND/OR 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. ~r,r.,r,n~~n~ nnnnnn~ntTc ?'OWTS INSTALLER 's, Name ~,~ ,~ Phone 715/77L-3278 SEPTAGE SERVICING OPERATOR (PUMPER} Name ~i(~liilSUti ANITA7.'IOi~ Phone 715/273-5811 i POWTS MAINTAINER Name ,^; Phone 715/273-5811 LOCAL REGULATORY AUTHORITY Name ST. CRUIX COUNTY ZUIIING Phone 715/ 386-4b8U This document was drafted in compliance with chapter Comm 83.22(211b1(llldl&If1 and 83.5411), l2) & (3i, Wisconsin Administrative Code. RECEIVED Wisconsin Department of Com rce APR ~ 3 ~00~3 SOS - A N REPORT Page f of~ Division of Safety and Buildings ST. ~ C 5, Wis. A County ~ ~ ~ /~ Attach complete site plan on sin size. P a include, but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Re ed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). '~ 7 Property Owner Property Location ~ ~ 1 1!4 ~~/4 ( Govt Lot S( 1~ T oS ~ N R ~~ E ~ , , . Property Owners Maili g Address ~ -t - S Lot # Block # Subd. Narr~ or CSM# ~,f~,~t ~tz ~ y83 3ao 1 City State 'p Code Phone Number ^ Gity ^ Village own Nearest Road n ~~ (7rs) 77a - 3383 ~A p Y ~~~ fti S - (a'New Construction Use: [~'f~esidential / Number of bedrooms _~ Code derived design flow rate ~l/.TO GPD ^ PuWic or commercial -Describe: ^ Replacement / Parent material _ ~C OPSS 0 l~c'r /s ~~ Flood Plain elevati~ if applicable ~ General comments $ ~ k ~6. aS~ ~~cl/ Gvs~Li /.~ ~r Scc cQ GS~ C ///1 Cc.~c dreg- l~jd~ F- o ~ . and recommendations: Corn ~ 90, S C/~ Oc-C~t cQ ~ y S f-cr,,,~ ~lev . 9 /, s ^ Boring # o ~~ Q / L~' pit Ground surface elev. 7~ 9 ft. Depth to limiting factor ~ g in. Soil lication Rate H i th D Dominant Color tion Redox Descri Texture Structure Consistence Boundary Roots GP D/fP zon or ep in. Munsell p Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~ ~ --~ L ~ ~i- c w ; ., ~ ~ ~ -- ,.,,, b r r t t ~ 8 O ~ C .~P / ~ 1 [ 1 i ) N a A (o li tip S Uc 5 - Vt-.~'f -- a °~ Boring # t~~BOring p~~ I~ pit Ground surface elev. a i• S ft. Depth to limiting factor 3~ ~. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 b-f (gib ---~ a ~ s~b on-~~ ~ w (~ , 8 ~ - o -- S L ~ , ~ t ( ~ ~ r -3 L~ b y ~ 3 D~ S ~ 5 V-'LU~1- W .-~ C / 7 o C C fc. ___- p, v o~ o ` Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 = BOD < ~ mg/L and r ~ < su mgru CST N (Please Print) ignatureG ~ CST Number n e ~ saw. .~2oa~~ Ad1dress~p ,/ ~ ) f ! /, 1 ate Evaluation Condu/cted Telephone Number [l,(J~~r~'/ ~~D~~ fTt~t~ /s1 Uee(~~ (.Ur ~_~ ~- ~!o ~~07'~~7g C, 7 / nr*~ n+wn mnn~nm ~T /f~ Property Owner ~CLIn- ~ u l ~1 Parcel I D # Page ~ of ~_ ^ Bonng I Boring # ~--~~ IL~t Pit Ground surface elev. ~~ ft. Depth to limiting factor ~~ in. Sal ication Rata Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DlfF in. Munsell Qu. Sz. Cone Color Gr. Sz Sh. `Eff#1 'Eff#2 'a ~ ~ ~ -~ Lw iu ~ g -1 tc~ !~ ~t ~ ^ Boring # ^ Boring ^ pit Ground surface elev. ft. Depth to limiting factor in. Sal A ication Rate Horizon Depth Dominant Cdor Redox Description Texture Structure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Cdor Gr. Sz. Sh. 'E(f#1 'Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ^ Pit Sal fication Rata Horizon Depth Dominant Cdor Redox Description Texture Structure Consistence Boundary Roots GP in. Munsell Qu. Sz. Cont. Cdor Gr. Sz Sh. `Eff#1 "Eff#2 'Effluent #1 =BODE > 30 < 220 mglL and TSS >30 < 150 mg/L 'Effluent #2 =BODE < 30 mg/L and TSS _< 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) Properly Owner dLlti R^ . ~P~cel ID # Page a of ^ Boring I / Boring # ~t Ground surface elev. ,.~~ ft. Depth to limiting factor -~-- in. Soil A ication Rata Horizon Depth Dominant Colo Redox Description Texture Structure Consistence Boundary Roots GP DIfP in. Munsell Qu. Sz. Cont. Cdor Gr. Sz Sh. 'Eff#1 'Eff#2 0 ~ '~" ~ ~ -~ L w i ~ r 1 r.c~ /r rl ^ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Sal icalion RaOa Horizon Depth Dominant Odor Redox Description Texture Structure Consistence Boundary Roots GP DJfF in. Munsell Qu. Sz. Cont. Cdor Gr. Sz Sh. 'Eff#1 •Eff#2 Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Sal 6cation Rata Horizon Depth Dominant Cdor Redox Description Texture Structure Consistence Boundary Roots GP in. Munsell Qu. Sz. Cont Cdor Gr. Sz Sh. 'Eff#1 'Eff#2 • Effluent #1 =BODE > 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 =BODE < 30 mg/L and TSS < 30 mgiL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) riot ~~~~ ~,-. ~ e r' ~~ ~1~ `~11^^~C[S~ff1~~ %p°s` 3 B~ . ~~ ~o~-~ ~~ ~ckrcac~ e, ~ r 32~~~ S ~ ~nf3 ~.-~~L /~...~- t,t~ oocQ.ec~ ~ ~, M, l Oa. «> ~+' ~, ~~~~ i ~, i i i B~ ~~,S.i 1~7 , / ,- ~~ ~- ~p.5i ~ ~ a 6~- ./ ~; .. r ~~~ ~~~ s I o,R.-~ ~ ~~ ~ 13,M. 47•~l , N S`0. ~'1 ~©, I P~o,Pos~~Q 3. ~ ~4~~-~ ~.©fi f ,C i~ =c ~ T -~ o~ y~f~ .~~~ _ ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Mailing Address ~ ~ ~ ~ ~f3~` ~'~Yp~ Property Address (Verification required from Planning Department for new City/State ~~ ~^-h ~ ~ I Parcel Identification Number oU ~{ - Jo Z7 - 7O a U ~ LEGAL DESCRIPTION ~~ 5 ~1/ 12- Property Location ~ `/e, 3~''/4, Sec. ~_, T~_N-R 1 `7 W, Town of Subdivision ,Lot # Certified Survey Map # ,Volume ,Page # Warranty Deed # ~ ~~ ~ `~ ~ ,Volume ,Page # Spec house O yes C~ no Lot lines identifiable m yes D no SYSTEM MAINTENANCE Improper use and maintenanceof your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIG ATU OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the pe described above, by virtue of a warranty deed recorded in Register of Deeds Office. ~ l /d l o ~i SIGNA OF APPLICANT DATE ****** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. *""#*' " Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed State Bar of Wisconsin Form 1-2003 WARRANTY DEED Document Number Document Name THIS DEED, made between MARJORIE WHEELER, MARY J. MEYER, THOMAS C. WHEELER, LISA M. WHEELER, MARYA E. MEYER, and PAUL C. MEYER ("Grantor," whether one or more), and DANNY RHY and MARYJO RHY, husband and wife as survivorship marital property ("Grantee," whether one or more). Grantor for a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in ST. CROIX County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): The SW '/. of the NW '/. of Section 12, Township 28 North, Range 15 West, Town of Cady, St. Croix County, Wisconsin. 822378 KATHLEEY H. MALSH REGISTER OF DEEDS ST. CRUIX CU.. MI RECEIYED FUR REGARD 84/0?/2086 18:38AM MARRAHTY DEED EXEMDT i REC FEE: 21.88 TRAYS FEE: 516.8® GUPY FEE: CC FEE: PAGES: 6 Recording Area Name and Retum Address SKINNER LAW FIRM 406 Technology Drive East Menomonie, W [ 54751 1.~u.N 189~t ~' 004-1027-70-000 Parcel Identification Number (PIN) This is not homestead property. ~~ (is not) Grantor warrants that the title to the Property is good, indefeasible, in fee simple and free and clear of encumbrances except: NO EXCEPTIONS. Dated ~`~'f I ( S~ Z06.(~ (SEAL) ~ ~1 ~~~.- ..h.,..~-- ~......~ (SEAL) * * MARJORI WHEELER (SEAL) * AUTHENTICATION Signature(s) authenticated on * TITLE: MEMBER STATE BAR OF WISCONSIN (If not, ~~t.N*`~~~ly authorized by Wis. Stat. § 706.06 P •,......,,~ P ~• •.., ~ 0 f• TH]S INSTRUMENT DRAFTED BYE _ • Brent D. Skinner KRISTAM. SKINNER LAW FIRM d! NOTE: THIS IS A STANDARD WARRANTY DEED 'Type name below signatures. 1 of 6 ~A (SEAL) ACKNOWLEDGMENT STATE OF WISCONSIN ) I ss. L~ ~,rU~S~. COUNTY) Personally came before me on ~~,YZ^ h ~ ~ ~ a~~..~ the above-named MARJORIE WHEELER to me known to be the person(s) who executed the foregoing instru~ent attjl-acl~nowledged the same. ~Z otary Public, State of WISCONSIN Z~ y commission (~carrea$) (expires: ) ~ acknowledged. Both am not necessary.) .ATION TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. BAR OF WISCONSIN FORM NO.1-2003 INFO-PRO^' Legal Forms • (600)655-2021 • inioproforms.com ~I MAR J YER by MAR A E. ME R u/p/a dated 8/ 1 /2005 ACKNOWLEDGEMENT STATE OFC~~~~ )ss. County of 1,) 0..Q~Q ) Personally came before me this 2 ~ day of ~ 1G(11(;k~ ,2006, the above named Marya E. Meyer to me known to be the person who executed the foregoing instrument and acknowledged the same. ~`"~'~ Yuunw~assau * ~ * YY COf,MIISSION 1 DD 361621 y ~ EXPIRES: f~ 10, 2009 '~~~~ ep,abt~e~gob,-Swrion Notary Public, ~tafe of _ My commission expires ATTACHMENT CJ 2of6 ~. ~ HOMAS C. WHEELER ACKNOWL DGMENT STATE OF % 1Gti-! ) )ss. County o ~ - 1 ) Personall came before me this ~~ day of ~~'`/[1~.C~c.. , 2006, the Y above named THOMAS C. WHEELER to me known to be he person who executed the foregoing instrument and acknowledged the same. w ~ • Notary laic, State of _ BRENDA lUGO My commission expires Nobry R'bNC - Arizona PNnp County • My Comm. Exokss Jul 6.2008 ATTACHMENT 3of6 LISA M. WHEELER ACKNOWLEDGMENT STATE OF ~C~Sh~nq~~n ) )ss. County of ~np~12YY1-~ ) Personally came before me this `~. day of ~(J,11(i~ , 2006, the above named LISA M. WHEELER to me known to be the person who executed the foregoing instrument and acknowledged the s p 1 Note P blic, State of 1 n My co fission expires /q b Notsry PuDtic Stets of Washington AMY D. ALBER730N My Appointment Expiros Jun i9, 2t106 ATTACHMENT 4 of 6 YA E. MEYER ACKNOWLEDGMENT STATE OF t ) r )ss. County of \~~~ ) ~. Personally came before me this ~ day of ~ ~~~ ~ , 2006, the above named MARYA E. MEYER to me known to be the p son who executed the foregoing instrument and acknowledged the same. ~ V ~~ /,~ .~Y ^~ ~ Notary Public, State of µyrpp~21 My commission expires '~ * EXPIRES: March 10, 2008 '',,E~e,~' t~MdlknrBd~MNadry ATTACHMENT 5of6 PAUL C. ACKNOWLEDGMENT STATE OF ~ LP ) )ss. County of ~G~ ) Personally came before me this ~ day of fit, , 2006, the above named PAUL C. MEYER to me known to be the person w~o executed the foregoing instrument and acknowledged the same. ~'~~ ~~~ Notary Public(, Sate of _ `ppY P Yl101TH FIASSAN My commission expires k 1r IIII ~``~ •~~/yy~~ IX~~ ~f~ ~Q~ LN/J ~+grap,~r 9ondedTlru6Yd~etNdMySlniuS ATTACHMENT 6of6 ~n in v ~_- (V t0 ~__v 1 ap (V N ~-- M fh .~- ------ __ _ _ __._ ___ _ -- - ___ __ 50' _ <------- _ ....._.. 12'7 --- __ __ ~_ _ _..._ .._ _ 25'5 _ ___ _ - __... - - - _ _ _ _ 12' _ _ __.._ 8'7. _ - _ _ 5'g -_ _ 6'3 __ __.._~_ - -16'g --_-_~.----._~_.~ so, LIVING AREA __ 1400 sq ft r N ____-_~ ____i_ 6'4 ---- f-- ---- - 4' ~ lJ ~ __._----- 10'2 LAUNDRY O ~ 8'4x6'11 iA ~--- °' STUDY c 12'8 x 9' V .r_i_ __ . _ - --____ za~1o _. - _ __ _- -- 24'7 ------ T4 --~-- 5'10 13'4 ~ 3'2 -~- 8'11 ~ B'11 ~ 10'1 ~F 13'2 ~ 78 ~ 16'8 4 15'10 LIVING AREA 1355 sq ft GARAGE 28' x 27'4 4,3 .__ ~o i~ -~ I ~"> N i -- N _t -11' T9 -° 26'10 --- Parcel #: 004-1027-7~0-00~ 04/13/2006 09:52 AM PAGE10F1 Alt. Parcel #: 12.28.15.185 004 -TOWN OF CADY Current i,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 -WHEELER, MAJORIE ET AL MAJORIE ET AL WHEELER 128 N 9TH LACROSSE WI 54601 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description SC 5586 SPRING VALLEY SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 12 T28N R15W 40A SW NW EZ-U-1351/037 Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 12-28N-15W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 704/146 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 09/07/2005 Description Class Acres Land Improve Total State Reason UNDEVELOPED G5 40.000 25,600 0 25,600 NO Totals for 2006: General Property 40.000 25,600 0 25,600 Woodland 0.000 0 0 Totals for 2005: General Property 40.000 25,600 0 25,600 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