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004-1035-40-100
Parcel #: 004-1035-40-100 06/12/2008 01:56 PM PAGE 1 OF 1 Alt. Parcel #: 15.28.15.236A-10 004 -TOWN OF CADY 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 -JOHNSON, JAMES G JR & BONNIE K JAMES G JR & BONNIE K JOHNSON 329 HWY 128 WILSON WI 54027 Districts: SC =School SP =Special Property Address(es): " =Primary Type Dist # Description " 329 HWY 128 SC 5586 SPRING VALLEY SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 7.200 Plat: 4574-CSM 17-4574 004-03 SEC 15 T28N R15W PT NW SW LOT 1 BEING Block/Condo Bldg: LOT 1 CSM 17-4574 (7.200AC) EZ-U-2433/365 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 15-28N-15W NW SW Notes: Parcel History: Date Doc # Vol/Page Type 10/10/2003 743329 2433/365 EZ 08/11/2003 734929 2357/223 WD 07/25/2003 732131 17/4574 CSM 07/23/1997 1064/252 WD more... 2008 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 04/09/2007 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 28,000 150,500 178,500 NO UNDEVELOPED G5 5.200 3,300 0 3,300 NO Totals for 2008: General Property 7.200 31,300 150,500 181,800 Woodland 0.000 0 0 Totals for 2007: General Property 7.200 31,300 150,500 181,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ,nsin Department of Commerce ,PRIVATE SEWAGE SYSTEM ,ety 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: ~ h ~ ~ ~ City Village X Township Johnson, James r • Cad Tqwnshi CST BM Efev: Insp. BM Elev: BM Description: ~yt, ~~ , © ~ uo, ~ m y ~ ~ ~ ~~~G~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ',n~~ ~; h(J~' ~- t'I Dosing 'l V V Aeration Holding TANK SETBACK INFORMATION TANK TO P /L WELL BLDG. Vent to Air Intake ROAD Septic Dosing rn ~1~1 ~ ~ ~®Of ~ ~ ` ~'~ f Aeration Holding PUMP/SIPHON INFORMATION Manufacturer ~ n Demand ~ - V f/1.~. t~- GPM Model Number ~~~ ~ / /~ 31~I1~ 1~` TDH Lift Friction Loss - System Head ~ G ~ TDH Ft t5 ~. , (o.o Forcemain Len -11- ~ Dia. ~ri Dist. to Well ~ ~+~ r ~b ~ ~O•I,~ ABSORPTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No: 430303 0 State Plan ID No: Parcel Tax No: Section/Town/Range/Map No: 15.28.15. STATION BS HI FS ELEV. Benchmark ~ / dd ~ ` C , Alt. BM Bldg. Sewer 9. o R~,uO St/Ht Inlet ~l,ol 93,E SUHt Outlet , ~ ,Z~ ,s Dt Inlet Dt Bottom ~y~S ~'o.ay Header/Man. ~t /f Tti r ~l d 5••5p ~ .2.Z.~ Dist. Pipe ~ 5 !I > Jr•~o2 (q ~ / -/ Bot. System b,27 ~, ~~5~ Final Grade / "a hove 1a~Qe.+~a.Q ~ Od ' over y.a -g~ rt~h k j C %D,! ~ 3~ (~ C~-u,r ~ .2~ 9 7.5~ Z 7 27 ~ ~. ~/~' BGB/TkEM~Ii DIMENSIONS Width /_ ~ u° Length ~ 5 7 No. Of TeeAeties {. Il S ~ , .l PIT DIMENSIONS --~'-~ No. Of Pits Inside Dia. Liquid Depth SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System:. (,~ •~ UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold ~ ~~ Length ~ Dia oZ Distribution ~ / Pipe(s) is o u 1 ~ Length ~ °~ 1 Dia 12 Spacing x Hole Size i+ 1~ V x Hole Spacing ~ r ,~-~3/z Vent to Air Intake nf7~ L'h SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Svstems Onlv Depth Over i Depth Over xx Depth of xx Seeded/Sodded xx Mulched BedlTrench Center \ I / Bed/Trench Edges Topsoil - Yes ~_.~ No Yes No CQMM~ENTS: p ~ ~~ de ~scr~pt~ cie~~s~s present, etc.) Inspection #1:~/ oZl / ~J nspection #2: ~ / ?.~/ / 03 ((pp i M~ ((77 Location: 3~J State Highw,,ay,y8 Wilson, WI 54027 (NW 1/4 SW 1/4 15 T28N R15W) NA Lot 1 10~ Parcel No: 15.28.15. 1.) Alt BM Description = 5~Y'~~ ~~~` G7~'~ 2.) Bldg sewer length = ti7 -amount of cover = ~ ~ G@+~Qr Plan revision Required? . , Yes (-j~No ov\ i --`~ ~ - - ~ - - `_- --- __ ____ -_.___ - __I I~~_ ~5 -I~ _i - _ _\-~_~ r. - - - _ -1 1 Use other side for additional Information. ____ i ~ ~~_ ~ _ ~___ j SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. ,Safety and Buildings Division County ~ 201 W. Wasbjngton ?ave., P.O. Box 7162 ST CROIX ~ I SC~~SI ~ Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) . De artment of Commerce (608) 266-3151 30 Sanitary Permit Application State Plan I.D. Number / / In accord with Comm 83.21, Wis. Adm. Code, personal information you provide TRANS ID# 889667 r may be used for secondary purposes Privacy Law, I.)l>ul_.. , _., _ _ .._.u._ Project Address (if different than mailing address) ~ I. Application Information -Please Print All Information ~ ~~ " 3 Z ~ S . I ~ ~. ~ Properry• Owner's Na me I ,~, E ~ ` L Q U . j ' JAMES & BONNIE JOHNSON ~ ' Aa~~ A' 6 t Y Block i' 4 1035 4 ~ - - ?4(~ 00 Property Owner's M ailing Address „- ... ~ e_ ~ 1.~.__.._ { .~9 Property Location 3003 WILSON STREET, LOT 69 N[~T 'k .~ u ,Section ~~ City, State Zip Code Phone Humber _ ~kll0 1`1ENOI~IONIE tivI 547~~ 715/232-8236 (circle one) `a~ T 28 N; R 15 E or~ (check all that apply) „_ ) e of Buildin II Ty ~ g . p -/ ~/ Subdivision Name ~~ Number s~ 1 or 2 Family Dwelling -Number of Bedrooms 3 ^ Public/Commercial - Descri Use 73213 i ^ State Owned -Describe Use C4'ln ~(,v~ '~3 ~0 x~ -- ~- ^CitYr^Village ']Township of LADY III. Type o! Permit: (Check only one box on Gne A. Complete line B if applicable) A' ~ New System ~ ~ -~~. ^ Replacement System ^ Treatment/Holding Tank Replacement Otily ^ Other Modification to Existing System B. ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. T of POWTS S stem: (Check all that a 1 ) ^ Non -Pressurized In-Ground Mound > 24 in. of suitable soil ~ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized ln-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Rectrculatin Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain) V. Dis rsal/Treatment Area Inforntatio»: Design Flow (gpd) Design Soil Applicatio te(gpdsf), Dispersal Area equired (sf) Dispersal Area roposed (sf) System Elevation 450 ~~ ~ 1. o, s 1" ~~~ 450 QD 450 /Q(oS' 98.53 VI. Tank Info Capa ' in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units /' / ~ ~} - ~ Concrete Conswcted Glass New Existing ~ i ~~ / t'lj~ / Tanks Tanl:s ( Septic or Holding Tank Aerobic Treatment Unit ~'"E c~"'~r 600 600 1 WIESER CONCRETE X VII. ResponsibiUty Statement- I, the undersigned, asstune responsibility for irtstallatlort of the POW'I'S shown on the attached plans. Plumber's Na me (Print) Plu is Si gnature MP/MPRS Number Busittess Phone Number BENNIE HELGESON 220292 715/772-3278 Plumber's Addre ss (Street, City, State, Zip Code) W1229 770TH AVENUE, SPRING VALLEY WI 54767 VIII ount /De artment Use Onl Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing A ens S' Stamps) wner Given Reason for Denial ^ O Surcharge Fee) ~ ~ ~. d b ~ 6 6 ~ ~ / / _~.__ w Yo~ EM OWNS vaUReasons for Dis~ 3 er,~, ' ~ S7~u~~Z~ t ~ n p~ w ~S (~ 1 c, effluent filter and { ,-P/L ~ S'Z [/ ~ ~Ze2m~ G~~ dispersal cell must all be serviced /maintained ~ ~'~` i~ ~ _ ~~ ` as per management plan provided by plumber. f~ceeay ~- Gt<~Lf~r°G~~ - ivt,u~ ~.% 2. All setback requirements must be maintained v ~~ . ~ ~~ S4LC ~~ li ~ as per a cable code/ordinances. - / ~ C' -Prt, arn~,~-~ ~3~ ~3, SBD-6398 (R. 01/03) Attach wmplete plans (to We Couaty only) for the system on paper not less lhan SIrz x 11 Inches in size 0 .~) ~~G~ ~~Iu Y~ , of j~r-o~ r~ 1 i ~ ~ ` q~. s3 Pl~w..~e ~ ~ Q evlr\ ~~e ~}ele. es~vi ~aoa o - ~~ f i, . \ `to ~~,~ at ".~ I~~ ~ Q 3y. ~, s%°P ~ Q3 _ _..._ ~ \ ;'~'~, fOD,UD ' ~©~, of ~ ~'' Svc. ~, p.~. ~~~ ~ ~~ ~ ~ f~ n ~ ~ ~ _~ a" Pu \ To,~ o ~ I ~ '~ ~ ~ QUL ~~~ ~~ ~ ' C ~ ~ ,~„ PuL n ~ropaSe~ j~o~(~oo G~.~. t- ~ e TQ'~ ~, 3 ~3ecl ~~~}~~/Das~ ~, ,Uo ~t~ ~ ~~o m~ ~ ~ ~ ~ 0~ ~ ~~=~ ~ ~ ~~ ~ ~ ~~ ~kc,e f 5 .~ou~~ ;~ ~(2(UC-Zv /-~~ __ _ --- -- ,. ~ ~ ~scons~n Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. commerce.state.wi. us/sb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary July 28, 2003 CUST ID No.220292 BENNIE W HELGESON HELGESON EXCAVATING W 1229 770TH AVE SPRING VALLEY WI 54767 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 ~>v~~ X3030 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/28!2005 SITE: James Johnson State Hwy 128 Town of Cady, 54027 St Croix County NW1/4, SW1/4, S15, T28N, R15W FOR: Identification Numbers Transaction ID No. 889667 Site ID No. 189810 Please refer to both identification numbers, above, in all correspondence with the agency. Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 913405 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. 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 COttd~ "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD-10572-P ~~~~ R. ure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" -10573-P (R.6/99). D RTMENI N OF • 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 CORRE 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 • 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 Page 2 7/28/03 Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, ~ ~'~~~ 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 f PROPERTY OWNER: PROJECT NAME INDEX SHEET JAMES JOHNSON 3003 WILSON STREET, LOT 69 MENOMONIE, WI 54751 JEAN LISTER PROJECT LOCATION: NW 1/4, SW 1/4 , S 15, 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 RECEIVED page 4 JUL 16 2003 page 5 SAFETY & BLDGS DIV. Page 6 Page 7 Page 8 Plot Plan Cross Section and Plan View of Mound Mound Deflection Septic Tank & Pump Chamber Cross Section & Specifications WLP1000/600-MR Zable Tank Specifications 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 .~ion~lly ~~~® OMMERCE i nr :SPONDEN Signe Date: July 15, 2003 ~i,e~V1~(I~"~ ~.l ~iw.~eS ~ff,,~((~hc~v~ _ Ptc~..~,~Der~ ~ehh ~ e ~#7~1~ es~vi aa0a~~ .~ - 7c~ o' ~---- ~t o ~R o f ~H~y ~a~ ~8 3 t3 i p t3.M. ~dc~.ao' ~ro,~ of ~ ~ ~~ i~r`' ~ a~ a \ .B.1~t, ioo. ~.~ Topo~ly'~ ~~ ~'~ ~'~ropoSecX. ~ooo~~To~o Gad. 1- ~ep~"~c/[J0.Su Tati~ IV /~/~ ~~~ ~° /1 C Q -P ~~ ~kc~ f s SG~o~~ ~f2 RUC-Zv /-~~_ __- - ~9 in~Q it a ~ . ~ _ Synthetic Covering ASTM C 33 Medium Sand 7opsoll --~ ~ E 3 ~ % Slope C~L~.Of 2M- 2'2 Aggregate -" Page ~„ Of$ istribution Pipe f_/~~~. /P~, G F D ~, ick~. q 7. s3 Force Main Plowed From Pump Layer D /_ O Ft . E ~~ Ft. Cross Section Of A Mound - F ~U Ft. y~y,.e~, / C.OaA~1~ ~ f Signed : ~ g 7 ~_ F t . ,~~~a~ axle ~ License Number: _ K ~ Ft. w,/p, ~b~~~~ Zse~ L ~~ Ft. Date: ~ ~_ Ft, ~o~~//Olv.~~ Ye~i ~~-tlp6~~ T ~_ Ft. W gyp, (O Ft. L_ ------ Observation Pipe ~ ~ ----- _._,_.. K r---------------------------------------a --- I ~~ A ~ - ~ -------------- ---------------------- I W - _ _l------ ---- r ' N , ~~ Distribution ~~~~ Of i - 2'2 Pipe Aggregate I Observation Pipe ~Q~~ ~ ~s~.~ ~re~.-- Plan View Of Mound r>.1 n~: ~ •. ~Iavr1~S doh ~ so v- ~~~t-s~ C. IEttNO~~~ Perforoled ripe Deioll ~ ,~ End VIEW Perloralad / . ~8 Holes Located_ on Bottom are Equally Spaced e ~t NQxT -~e r(d~~ +ol o•Y e ~f'~ P~o• Distribution Pipe Layout ~-- Signed: License Number: Daee: R ----. S ~ / X a Y l Hole Diameter ~ Inch Lateral " ~ ~ Inch (es) Manifold ~ Inches force Main " -~ Inches ~.,~~vE~t ~~i~~. 99 03 N o~~s ~e r ,~Tera ~ = ~ ~ k ~7w~ ~a-~-~,,-~.Is = 7,6 To~-~. ! Page~Of S ~wn~e~'. ~r0ryl~5 1o~nSoh SEPTIC TANK E PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS ~," ~UC...VENT PIPE 12" MIN. ABOVE GRADE E WEATHERPROOF JUNCTION BOX APPROVED > 25' FROM DOOR, WINDOW OR WITH CONDUIT L WgNPO V~R ' FRESH AIR INTAKE ~ LOCK (j-roue oJ ~ -- WARNING LABEL - . FINISHED GRADE ~~,, r ~~ ._4" MIN. ~ b Kin. ~~ ~ 2y ,~ N ~U~ Q86ERW-[~onl S. D. u 18" IN. PIPE ~ ~~ I$ nn~N. INLET ~~ ~ GAS- ~ WATER TIGHT SEALS 1~ T VAPPROVEO A ~ ~ SEAL ~ JOINTS WITH FILTER ~A $~~ ~ , i ~ ALM APPROVED PIPE ' ~b APPROVED ~a„X ~~„ ~, l PIPE 3' B ~ ~ ' pN ONTO 3 SOLID SOIL ONTO SOLID SOIL PUMP OFF ELEV . ~~'T _~___ ~ i ~ OFF ~ ~~• i~7 D 3 APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS ~ l t CCs.~C T.. dl`4'Y~1u ~ -- ~~- SEPTIC / DOSE '1 i33y X ~ .. ;;~ ~!-- ~~~, TANK MANUFACTURER: iwi~SErS TANK SIZES: SEPTIC ~____o~ _- /HFLO BACKG a3 6 DOIa `~ g•I3 GAL. DOSE _ GAL. /.,00 • ~ ' MANUFACTURER: ~ ~• E~~~ro ~S~-~'^S CAPACITIES: A = ~ ~ INCHES = OL ~Q GAL. ALARM MODEL NUMBER: ~(~i Hu3 2 INCHES = :33 • s-?GAL. SWITCH TYPE: ~ ~ ~ ~~~ g = _ ,~ C = ~ INCHES = /tX~ S~ GAL. PUMP MANUFACTURER: Z6e e~ ' MODEL NUMBER : 9g = ~- D = IO INCHES = 167. GAL. SWITCH TYPE: 1a~ ~1~r~~-~., i REQUIRED DISCHARGE RATE ~~ GPM PUMP E ALARM WIRING AS PER ILHR 16.23 WAC `g. /~ ~3 FEET VERTICA L DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE ~ FEET + MINIMUM NETWORK SUPPLY PRESSURE ~~_ FEET i~ + ~ FEET FORCEMAIN X 2.(~ FT/100 FTOTALIDYNAMICAHEAD •_ / ;o FEET ~~,~ WIDTH DIAMETER INTERNAL DIMENSIONS OF PUMP TANK: LIQUID b~T1T-_~'' _. SIGNED: LICENSE NUMBER: DATE: 1/88 -~ a 150' ; . . ; , . i i ~ i i ~ ' ~ i i ~ i i TOP VIEW T OUTLET T- o> M SIDE VIEW SCALE: 1 /4' = 1' ,_ ~~ ~ ~ ~~ { WLP1000/600-MR' ZABLE TANK SPECIFlCAl10NS DIMENSIONS: WALL: 3' BOTTOM: 3' COVER: 5" MANHOLE: ~4" LD. HEIGHT: 56 O.D. LENGTH: 150" O.D. WIDTH: 84' O.D. ~, BELOW INLET: 42' O.D. UQUID LEVEL: 36' WEIGHT: 14,795 LBS INLET AND OUTLET: 4° BORE WITH STOP FOR QUIK-T1TE, FERNCO GASKET, CAST-A-SEAL BOOT OP, EQUAL INLET AND OUTLET BAFFLES: WISCONSIN, SEE DETAfL #10 (OTHER STATES SEE CHART) LIQU{D CAPACITY: 27.88 GAL/IN (SEPTIC) I-" VENTS 16.76 GAL/IN (PUMP) LOADING DESIGN: 7' 0" UNSATURATED SOIL JLET iv ~~~~~ ~©~~D~~C~ W3716 US HwY 10. MaDEN Rock, 1M s+~so 800-325-8456 MODEL WLP1000/600-MR ZABLE SEPTIC/SEPTIC. SEPTIC/PUMP OR SEPTIC/SIPHON JANUARY, 2000 FlLE: wtPlOOO 6o0-Mf 6 1/4 i/8 +{ ~8 4 3/16 FLOW PER MINUTE (x79971 16 SK7102 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and Variable level float switches are available for controlling single supplied with an alarm. and three phase systems. • Mechanical alternators, for duplex systems, are available Double piggyback variable level float switches are available with or without alarm switches. for variable level long cycle controls. Stanriarri all madels - Weiaht 39 Ibs_ -'/z H.P. 98 Series Control Selection Model Volts•Ph Mode Am s Sim lex Duplex M98 115 1 Auto 9.4 1 - N98 115 1 Non 9.4 2 3 or 4 8 5 098 230 1 Auto 4.7 1 - E98 230 1 Non 4.7 2 3 or 4& 5 For information on additbnal Zoeller products refer to catalog on Piggyback Variable Level Svdtktles, FM0477; Electrical Alternator, FMfki88; Medranical Altemalor, FM0495; Sump/Sewage Basins, FM0487; Single Phase Simplex Pump Control, FM1598; Alarm Systems, FM0732. SELECTION GUIDE 1. Integral float operated 2-pole mechanical switch, no external control required. 2. Single piggyback variable level float switch or double_piggybadc variable level, float switch. Refer to FM0477. 3. Mechanical alternator 10-0072 or 10-0075. 4. See FM0712, for correct model of Electrical Altemator. 5. Control switch 10-0225 used as a control activator, specify duplex (3) or (4) float system. CAUTION All installation of controls, protection devices and wiring should be done by a qualified licensed electrician. All electrical and safety codes should be tollowed including the moat recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. T__ __ Mai ro: P.o.13ox 1x347 - Z Louisville, KY 40256-0347 Manu/acturersol.. SHIP TO: 3649 Cane Run Road • e Louisville, KY 40211-19x1 ,QLGd[/T-'~UMP9 SNCE ~a9sJr7 ~ http://www.zoellei corn Pl1MP CO. (~2J 7 FAX (502J 77o ss2 ~UMP © Copyright 2001 Zoeller Co. All rights reserved. 1 1/2-11 1/2 NPT U~CR~ 0 BO 160 240 Wisconsin Department of Commerce nl~a~~~„ ~f ~afarv and 6uildinas SOIL EVALUATION REPORT Page_ ~ of -~ h r i.... u,~ accordance with Gomm ttb, wls. Horn. ~.oue Co my / Attach complete site plan on paper not less than 8 1/2 x 1 t inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and p I.D ~ P R 2 g and location and distance to nearest road. north arrow cale or dimensions l e t , , , s s op percen Please print all information. 1 ) lew by T. CR ~ Dat TY ~3 ) (m ). Personal information you provide may be used for secondary purposes (Privacy Law, c. 15.04 ( NI Property Owner -+~ Property Location onto Govt. Lot ~ ll~ t/4-S (~1/4 S ~.~ ~ L -~ Tag N R ~~ E ( W ~ dLvvteS •- Property Owner's Mailing Address. Lot # Block # Subd. Name or CSM# 3`f~" ~W i~8 `- City State Zip ode Phone Number ^ City ^ Village awn ' Nearest Road ~w (~ 8' c<<~~ ~ LS ~ va c ~-S i ~ - 6 t Q-~w Construction Use: Residential (Number of bedrooms ~ Code derived design flow rate ~~ GPD ^ Replacement ~ ^ Public or commercial -Describe: ` ~~ ~ :'/f _.__ Flood Plain elevation if applicable Parent material ~ ~~ DL~tt- 7 General comments S ~ ~ ~~ ~/ ~~ /~ SaKl~' !~-~~~r -elr ~cQ ~ ~ ~ k 7 S ~'`~~ ~~ r~ ' ns: and recommenda ©~ C~ ~ ~ cry Cc~ ~t©~t,- ~P7, S3 • 57 s ~-~~~. rev, 9 ~- s3 ~ ~l cx.tu , ~~ l / Boring / Boring # IJ Pit Ground surface elev. _/ ~ ~ ft. Depth to limiting factor ~ In• Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP 'Etf#1 D 'EtT#Z in. Munsell Qu. Sz. Cont. Color ~ Gr. Sz. Sh. j /J S ©-~( Ioy~C 3 f a r aw - _ 3 _~, 5.~ i r ~ // / r ~-) n Rnrinn tionng rr !~ pit Ground surface elev. ~~ ft. Depth to limiting factor In• So)I ication Rate Horizon Depth in. Dominant Color Munsell (u Y ~ 3 Redox Description Qu. Sz. Cont. Color Texture ~ ` Structure Gr. Sz. Sh. ~ -~ ~ k Consistence t~v. t- Boundary ~ w Roots t~ { GP 'Eff#1 S D/ft= 'Effk2 ~ _ ~ S. ~ .~ ~ ~ a .,.. S 6k D ~r t,r } ~ r ~_n __a •ree ~ Zn .....n • Effluent #1 = BOD > 30 < 220 mg/L and 155 >su ~ eau mgrs ~~~~~~~~~ ~~ - ~~~ _ -- •••~- -• - - -- - - CST N me (Please Print) Signature CST Nuntt>er ~~c~a9.~ vL t -2~ S Address Date Evaluation Conducted Telephone Number Lam! ~ a 9 7~0,~~ ~{v~< <S~~rhs ~~~~ ~/- ~S-off ~7~ :.3~~~ Property Owner d(-hies _~Jol/lk S©~ Parcel ID # Page a Of -~ . Boring Boring # ~J Pit Ground surface elev. 7 ~ ' ~~ ft• Depth to IimiGng factor ~ in• Soil ication Rat d B Roots GP D/ft= Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz Cont. Color Texture Structure Gr. Sz Sh. Consistence oun ary •E~ E ' ~ ` ~~ --- ~ sbk ~ ~~ c u ~ S ~-5~ v ^ Boring ^,,,,~ ~ ~~'~lN/ ~~'cCj"~ L{ Boring # ~ (1 vV'~- ~~ ( pit Ground su ace . ~s1~' -~-~ ft. Depth to IimiGng fact r in. Soil ication Rate on Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots •E~GPD/ff3E~ J in. Munsell Qu. Sz. Cont. Color Gr. Sz. S~h).~ a t o R~ ys R~ cQ o b ~~- c~ ~~ a 3 ``nn Xv O y k /~ C L c ~- `-- Boring a Boring # Ground surface elev. ft. Depth to limiting factor ln. ^ Pit Soii ication Batt Horizon Depth Dominant Color Redox Description Texture SWcture Consistttrtce Boundary Roots 'E~GPD • in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ' Effluent #1 = BODS > 30 _< 220 mglL and TSS >30 < 150 mg/L 'Effluent #2 = BODb _< 30 mglL 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. 500.8))0 (R.NW 1 ~C~b1~Eh. Jc#-v~neS ~©~\r~Sc~ln °,,~-~ r ~---~ ~.l~l. Ion. coca '`l'"e~p ~ ~ L ~'' ~~ ~~ ~~ -ho ~'/~ df F-k.rs~ l~ g /~7ip~ r a k . louse ~ ion ~, 1 ~~.~ 3 m ~ 3 ~ ~ 83 1 \ ~" /~ rc.~ $ /o~.~ ~j ~ ~ s/oP e ~~ \ ~ ~ ~ \ ~ \~ ~ ~\ \ $~ ` ~ ~ ~ ~ i `, \~; ~, \ ~~ 13.1, ~OC~, a.~ ~, Qua P- ~-e aye `~-Er~~. ~ot.33 ~! ~ Y ~ ~kC~~Q't ~S S~'lOts~~ Wisconsin Department of Commerce SOIL AND SITE EVALUATION ~ ~"v u- 1 3 4ivision of Safety and Buildings Page of _ Bureau of Integrated Services in accordance,with s., ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and St . CroiX percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # 004103540 APPLICANT INFORMATION -Please print all information. Reviewed by Da Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~ ~Q/ Property owner Property Location Jim Johnson Jr. Govt. Lot NW 1/4 SW 1/4,S 15 T 28 ,N,R 15 x8~ac) W Property owner's Mailing Address Lot # Block# Subd. Name or CSM# 345 Hwy 128 -- -- n/a City State Zip Code Phone Number ^ City ^ Village ~ Town Nearest Road Wilson, I WI {54027 I( 715) 772-4696 Cady I Hwy 128 ®New Construction. Use: ~ Residential 1 Number of bedrooms 3 ^ Replacement ^ Public or commercial -Describe: Code derived daily flow 450 gpd Recommended desigr~oading rate 0.4 bed, gpd/ft2 0.5 trench, gpd/fl2 Absorption area required 1125 bed ft2 900 trench, ft2 Maximum design loading rate 0' 4 bed, gpd/fl2 0' S trench, gpd/ft2 Recommended infiltration surface elevation(s) 102.0' (Se e note) ft (as referred to site plan benchmark) Additional design/site considerations nnte'-~~P.Y Y~3~~=~ f a~ ai-i i-i nn fnr ~rari annc cacrc rn-nni-c~rl n » 1 i mi t i n ~ Parent material loess Flood plain elevation, if applicable n/a ft fa S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system ^ S ~ U ^ S ~U ^ S (~U ^ S ~U ^ S ~ U ^ S :® U SOIL DESCRIPTION REPORT Boring # 1 Ground elev. 99.6ft. Depth to limiting factor 27 in. Boring # 2 Ground elev. 96.9 ft, Depth to limiting 13_in. Remarks: ground water observed @ 46" . CST Name (Please Print) / ~Sig~ature T~~ William J. Bergh lJ`bD~'~-;,C% 715 83 -7 Address ate CST Number 615B Congress St. Eau Claire, WI 54703 5-8-97 3943 Horizon Depth Dominant Color Mottles t T Structure i C t und B R ots GPD/fi2 in. Munsell Qu. Sz. Cont. Color ure ex Gr. Sz. Sh. ons s ence o ary o Bed ,Trench 1 0-11 10YR 4/3 none sl 1 f sbk mvfr ds 2-3f 0.4 .0.5 2 11-2 10YR 5/3 none sil 2 f sbk mfr cs 1-2f 0.4 '0.5 3 27- 7.SYR 5/8 pad 7.5YR 4/6 is 1 f sbk mvfr -- -- 0.7 .0.8 Remarks: Hor. #3 is dense and resistant to penetration by knife blade. 1 2 7-1 1 YR '~ ~ ~ 3 13-2 10YR 5/3 cif 7.5YR 5/8 sil 2 f sbk mfr .`=- -- ~ .5 7.5YR 5/2 r >; ~~y ~ ~ ~~ ~ ~ ~~~„_ COX ~ is G~ . ~/T~.~~... , PROPERTY OWNER PARCEL I.D.# Boring # Ground elev. ft. Depth to limiting factor in. Boring # Ground elev. ft. Depth to limiting Johnson SOIL DESCRIPTION REPORT 2 3 Page of i Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots 2 in. Munseil Du. Sz. Cont Cobr Gr. Sz. Sh. ry Bed ,Trench 1 0-7 10YR 3/3 none sl 2 f sbk mvfr gs 2-3f .5 .0.6 2 7-18 10YR 5/3 none sil 2 f sbk mvfr gs 2f .4 '0.5 3 18-2 10YR 4/3 none sl 2 f sbk mvfr cs 1f .5 ;0.6 4 24- 10YR 4/6 cap 7.5YR 5/8 sl 1 f sbk mvfr -- -- .4 .0.5 7.5YR 5/2 Remarks: #3 with 10g gravel/cobble umerous o er pi s were g o eas an sou a ve escri ea, owever, ese s s as we were over qua i y regar ing a requiremen s or ins a ion o sep is , sys em un Curren c e. n ess a varian were an or s , si e a sep c sys em may n i g ven a ep imi ing ors oug ou a crl ea. , Remarks: Horizon Depth Dominant Color Mottles Text re Structure Consistence Bounda Roots PD/ft2 in. Munsell Qu. Sz. Cont Color u Gr. Sz. Sh. ry Bed ,Trench factor 'n' Remarks: Boring # , Ground elev. ft. Depth to limiting factor 'n' Remarks: SBD-8330 (R. 07/96) ~ '~ ._ i ~ ~ o, ~ c c t~ r ~n ~~ ~ r ..~• -t a 1 1~ ~~ d a P ~ ~ ` .~ CT. Dv ~^~l1 W 4 W l.~ l`J a c ~ ~ p ~ ~ A ~ ~ ~ _ p a ~ r ~ " ~ ~ ~ ~ _ V ~ O "` s h ym ~ ~ ~ ~ j M Z O . _~"1 ~` ~ ~~ ~ r+ ~ .y ~c++c~s' p} z C.._. ~ ~ ~ z Z d ~ ~ C Z ~, ~ ~ ~, ~ 7 ~c.., r~ ~~ PJ ~~ O O` c ~-c c V ST CROI~C COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ~ant%t ~ ~ ~o~ n s on ~` ~~ M ~ s J o ~ ,, s~ Mailing Address ~Do3 iLS~ fit, Lf~ ~ ~ ~~~°~~v~~~1~., ~~ ~~75 / Property Address a°I S ~~ ~ ~ (Verification required from Planning Department for new construction) r - ~.~ ~ o F Parcel IderitificationNumber 00~~/o35-lfu-ooo City/State LEGAL DESCRIPTION Property Location ~~ '/a, ~~ '/a, Sec. /~ , T o~$ N-R ~~ W, Town of Subdivision !~~fl ,Lot # ~ Certified Survey Map # ~ 3 a ~ 3 I ,Volume f'7 ,Page # '~ 57y Warranty Deed # ~~ ~ a Cl ,Volume x35'7 ,Page # ~~ 3 Spec house O yes ~J no Lot lines identifiable f~ yes ~ 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 form, signed by the owner and by a master plumber, journeyman plumber, restrictedplumber or alicensed pumper verifying that (1) the oa-site wastewaterdispossl 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. Uwc, 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. Celtif CttaoII stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 ~s of the three year piration date. 1,--, PLICANT DATE NA O,, 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 property descri d ve, by virtue of a warranty deed recorded in Register of Deeds Office. ~/ DATE S N 0 I:I ANT 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 ~~~~ a tuanRMaT1~N r~~„~,...... - - - Owner JA,,IE Permit # ...-c.~n_~~ eevetUFTFRS v~~wn ter....-....... _ - Number of Bedrooms 3 ~ ^ NA Number of Commercial Units ~ NA Estimated flow (average) 300 aVda Design flow (peak), (Estimated x 1.5) 450 aVda Soil Application Rate aVda /ftz Influent/Effluent Quality Monthly average' Fats, Oil 8 Grease (FOG) 530 mg/L Biochemical Oxygen Demand (BODE) 5220 mg/L Total Suspended Solids (TSS) 5150 m /L Pretreated Effluent Quality .~ ®NA Monthly average" Biochemical Oxygen Demand (HODS) 530 mg/L Total Suspended Solids (TSS) 530 mg/L Fecal Coliform (geometric mean) 510• cfu/100m1 Maximum Effluent Particle Size Y, inch diameter M 1 SYSTEM SPECIFICATIONS Pafle 7 of 8 Septic Tank Capacity al ^ NA Septic Tank Manufacturer IESER CONCRETE ^ NA Effluent Filter Manufacturer ABEL ^ NA Effluent Filter Model -100 12" x 20" ^ NA Pump Tank Capacity 600 al ~ NA Pump Tank Manufacturer IESER CONCRETE ^ NA .Pump Manufacturer ZOELLER PUMP C0~ NA Pump Model 98 ^ NA Pretreatment Unit ~ NA ^ Sand/Caravel Filter O Peat Filter ^ Mechanical Aeration O Wetland ^ Disinfection ^ Other. Manufacturer Dispersal Cell(s) ^ In-ground (gravity) ^ In-ground (pressurized) ^ At-grade ®Mound ^ Dri -line O Other • Values ryplcal for domestic (non-corrunerdaQ wastewater and seppc tank effluent. •• Values typ(cat for pretreated wastewater. AINTENANCe 5cncuut_c Serv nt Service Frequency Inspect condition of tank(s) Pump out contents of tank(s) At least once every 2 ^ months year(s) (Maximum 3 yrs.) ~ When combined sludge and scum equals one-third (Y) of tank volume Inspect dispersal cell(s) At least once every 2 ^ months ~Xyear(s) (Maximum 3 yrs.) Clean effluent filter At least once every 1 ^ months . ~Kyear(s) Inspect~pump, pump controls & alarm At least once every 1 ^ months year(s) ^ NA Flush laterals and pressure test At least once every 3 ^ months year(s) ^ NA other. At least once every ^ months ^ year(s) ^ NA other: At least once every ^ months ^ year(s) ^ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer, Septage Servtdng Operator. Tank inspections must indude a visual inspection of the tank(s) to identify any missing or broken hardware, Identify 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 Servicing Operator and disposed of in accordance with ch. NR 113, Wisconsin Administrative Code. The servicing of effluent filters, mechanical or pressurized POWTS components, pretreat+finent components; and any other maintenance or monitoring at intervals of 12 months or less 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. 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. ORNER,: JAMES JOHNSON • System start up shall not occur when soil conditions ere frozen at the infiltrative surface. Pale 8- of $~ 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 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 Matntatner 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 Ufa 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; herbkides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMMENT 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 Adm(nlstrattve Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shalt be removed and properly disposed of by a Septage Servicing Operator • After pumping, afl tanks and pits shall be excavated and removed or theft covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS faits 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. O A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS tec ology a holding tank may be installed as a last resort to replace the failed POWTS. n f h s' a as not be valuated t e 'fy a sui le eplaceme -tea. Upo a re of the POWTS a soiled !' `~ it alu 'on t be rfo d to loca a !table epla ant tea. no rep ment a aJs_avaiiSble a holding tank y be instal as a last reso to replace fled PO S. ~ 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 ADDITIONAL COMMENTS POWTS INSTALLER Name HELGESON EXCAVATION I - Phone 715/772-3278 POWTS MAINTAINER Name -' -Phone 715/273-5811 SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY ' ' - Name JOHNSON SANITATION - Agency ST. CROIX ZONING OFFICE - Phone Phone ` ~ This document was draRed by the staffs of the Green Lake, Marquette and Waushara County Zoning and Sanitation agendas. This d0aunartt meets the minimum requirements of ch. Comm 83.22{2){b){1)(d)8(f) and 83.54{1), {2) & {3), Wisconsin Administrative Coda. Use of this doCUmont doss not guarantee the performance or the POWTS. ~~~~ 1 2 3 5 7 Z~ 3 SPATE BAR OF WISCONSIN FORM l - 2000 ~ WARRANTY DEED Document Number 7'4929 /1 RA7HL6fi11 H. NA1.SH ~ i RfiGISTfiR OF DEEDS ST. CROIx Co. t YlI R1+GSIVBp FDR RECORD This Deed, made between dames G. Johnsop and Diann C. Johnson. ' Bs/ii/2AA3 18t30A11 s n and ea h h Grantor, and James G. Johnson. Jr. and Bonnie K. Johnson, husband sad wife as survivorshia MARRAIlTY DHED maritgj,property Grantee, I:IIElPT i 8 Grantor, for a valuable consideration; conveys to Grantee the fallowing g~ gam; 11.00 described real estate in S~ Croix County, Stat¢ of Wisconsin (the "Proporty") TRAiIS FEE: (if mare space is needed, please attach addendum`,; ~ E: 2.00 CCPF A parcel of land located in the Northwest Quarter of the Southwest `B PAGES: 1 ~ Quarter (NW I!4 of SW 1/4} of Section Fifteen (1S), Tow~nshlp Twenty eight (28) North, Range Fifteen (15) West, Town of Cadr, St. Croix County, Wisconsin, more fully described as: Lot One (I} of Certifed Survey Map recorded on July ZS, 2003 in Yol. 17 CSM Page 4574 as ~ Document number 732131. ~ Recording Area f Name and Retum Addross 'Rgbert J. Rk><ardso ~ t`G rt rt Jp~+nSOrl ~~ Bait Ot7n ~~ 5233 ve., P.O. Boz 394 ~~~ ~'k- ~ ~ rang Valley, 767 t, (~; ~5ort, I.t31 Sr/gl` I Together with all appurtenant rigtlts, title and interests. P8 nrt f QUd"1035-4Q-0Q0 Parcel Identification Number (PIN) This is not hanestead pcopecty (is) (is not) Grantor warrants that the title to the Property is good, lndefeasib'se in fee simple and tree and clear or' encumbrances except easements, restrictions, eights of way of record. Dated this ~ day of August. 20-.Q3. "' Jarges G. Johnson * piano C, Joh n AUTHENTICATION 5ignature(sl authenticated this day of TITLE: MEMBER STATE BAR OF WISCONSIN {tf not. authorized by 670b.06. Wis. Stats,l THIS INSTRUMENT WAS l]RAFTED BY Jennifer A O'Neill Bakke i~orman, SC Sprln>: Valley. WI Sg7b7 (Signatures may be atuhenticated or aclmowladged. Both ate nol nacasaary.) Names efpersotls signing in any capacity must wARa.ANTY DEED FORM No. 1-2000 ACKNOWLEDGMENT STATE OF W SI_~NSIiY 1 1 ss, PIERCE County Persanaily came before me this i August 2~i to me ianovattl to be the acrson(s) +~~' ~ ca` ~....... • t.~ t~' g`b NNtpYM•',,''• Notary Public. State of Wiseo in My Commission is petsnanent. (If not, ciao expiration date: .l •e. iNFO.FRO (SOO~SS•2011 www,infoproform, car6TATE BAR QF WI9C0 E ' d OOZE 13C213Sb~ dH Wdl+b ~ 0 i EOOZ ~ I Jfld RUG 14 2003 10:45RM HP LRSERJET 3200 p,7 _•, • - ~- (~ ~ ,. •.- a b m r i ~~~ -~. 500 ~i2LLKt70~ t~GNO.L '' 3AiI1A1[S @LT~CZL809 XYd 8S ~ bT COOZrdT: 90 6LIG£2L809 '' 73i~ ].31 V~L r7 PAGE 4574 KhrtiGEEN N. +eALSH -" RF.gI5TER OF CEEPS 1H':u INSTRCIME"JT ~]RAFTEp 8Y FI)4'Ak FIANJM J4B NO.0334 GATT. S-2a43 ST. Cfl0[X CO. , NI RECEIV£f? FqR REwgRG ~.~.. ~ 07125/2003 e2a15PK ~'~""" ~ CERTIFIED 5ilRVEY MAP 6[AR1NG54REAEFEAFNCEAtOTi-ZEST. RE; L' FEE: IS. 06! cROa cc~~n~ caaRO~ruTesVsTer,n COFY FEE 4. ae ~~ ~nrst~~T"..'f'Is:1 ~':~i',nu`~ 'p;ti1`~w~~.~ J~ ~Jl~~~C~ AGES: 3 ~~w1 ~...1.~ r S 0 .~-- R T ~~~ H. e~ 2B" r~ G ~~,~' D(tS?IN:~ CEIVTF_:iUNE _ _ _ __ - ~ s 'vU~185G~'W t -v. ~. `~~(:' !A/}320. 7~'u _~ ~ Z5 '~ 132u.1C F~j' N'bST, LI!~iF vF'YE SuvfJ1 ~\ ~` ~~~ \Mi R $ .._ '~r SOO°33'34"'W 387.06' _ __..._ n R -- --~ ~' ~ ~ - ACCESS RFSTR:CTFD SF~ ACCE95 RES-raICTpN NCTE --~ G' . CNSHEET2 i ~ 5~:' HIS3:}WA~' ScT3ACJ! FHCAA f~i311't.~F=K~v `S ~ ~ ~ r z _ •1Lti'T "ETBAGK FFit?M R~•3~fi .'1k 1~lAV • ~ ~ ~ ~ ~ ~rnrn'I •~ ~ l~PPI~~aVEQ ~ 1 T ,. i ~ tR ~ ~. cr~o~x ~ Iir 2 ~ Z ~' gill, '~ ;i '~1(l"v ~~y~ g 1- s~g 'p ~ y~,' o~ D `a ~ ~ f 114 E ~ fNnv.f f.~~d~y;}I i ~ ~~~ ~ ~ 0~ ii h iI98Pl U li)C V-, ~~, .C. no •n ~.,p avid void ~ ~~,, ~ ~ ~ .~ m ~ yw w~ p~ Z I ~ ~ ~v IQ ~ ~ ~~ "'1 ~o ~ i ao ~~~~~ ~~ ~°c ~ "~ -fin ~ IN;. ~ ~~ ~~~r ~.~~ ~~ ~ ~~ iL,j 0 ~` ~ ~~ ~~ ~' ~ ~~ N i~ ~~ N ~~ ~ 1 G W I O 0~ CS ~ X ~ ~ 2 O ~ 7 ~ ~ c~ ,u~i 5 ~ OI ~ ~ ~+ ~ m ~ z ` ~~ ~ ~ $~ a ~ ~ `" a ~ICC1°3d'34"E 387.6" ... ~_~~?G~1~'~t,,,:,;"~; CSC C~,<";~~IG'~ CJL~~!~^nl~~J Ci`_'' ~~~~ p ---------------~- S SHEET t OF 3 SIiEET9 b'~;,t? Page 4574 s-d oozs l~raasd~ ~H wesf~ot soon rt snd ~ERTI~'1ED S~IRVEY MAP t_OCATED IN PART OF THE N1M1/4 OP T!-!E SW7!4 OP SECT40N 18, T281+1, R13W. TOWN OP CAGY, ST. CR171K COUNTY, VYISCONSiN. OWNER PRi:PAi~ED FOR: SUFiVE1fOR ,AME3 & OtANE JOHASON .IA+Ml:£ d NSNNIr: J~hiNflCN 3i5 STATL• R~eIG 72S ?OC3'NR30N STP~ET bV'~I_,~iON, W! 59rY17 ~_~799 ~sE~1Ctr;;MiE, YN 53T5t 233.08 - !-iI~HWA" vET[iP.CK. _iA; (Vo trr!provBme~t Ncte COW!N ~ FiANUkd ;YDR'hiLd:'VD SUR'~ErtN3,, rNC 355 A HtIY.~" FOBEA7~.:1'! 54023 lao Imprarernents or structtres ara at,owed be;watt~l tha right-oi-way line and the highway setbaca: line. Impr~vemen;s and structures include, tw? ae no[ limped to, signs, parking areas, driveways, wails, septic systems, drainage facilities. buildings and retBlning w51s. It is expressly interded tttet 'I this restriction is far the treneft of the public as prov"sd4c in section 236.233, Vi~tsconsin Statute;, and shall be en`orceable by the D°partme^t of?rti"!spoRatloz ar I?s assigns. Contact the Wisconsin Daparment of T,~ansponaGon far mare intcrmation Tcs phnnE ..^,umber may be octained oy contacting the County Higl'~ vay Cepartment 233.05 - A.~~C~SS RESTPIC1lON .All lots and blocks are hereby res#icted 9o Ihet no owner, possessor, user, licensee, cr other perspn may have ary right of direct vehict:lar i~rgrsss !corn or egress to any ? Highway lying rr"+thir the right-oF•way ct S.T.ti "24: ft is exoressiylnierd~ that this :estrJction constitute a restriction !or the benefit ~t tha public as pr~vlded in x.238.293, 51ats., and shat! be enforceable by the depatlrrrenl or its assigns. Any aooess shat tae aBoned only by special excepttart. Any access silrswed by special exception s~sii be Cpntirmed and grantad anly tnrougn the drivebvay permi-lir,r; process and ei! permlfs ara ~e++ocatrisr. The Wisconsin peparment ai7rarsoortat~.n has ranted c~ ID'i3 10 trans 2331C the axis rig rNBhvayar~Cesszs ass owr on iris map, Additional land divisions. changes fn lard use, or f ( ~ ~ ~ ~ re ocatton a e rlveway to an altarrs?iva public road at t^s ~!scretion of the departmerrt. 283.i0S-PJ015t NOTc~ The lots or this larc division rr+ay expert®rea noise at levels exc~dirtg levels;n s. ' raps 406.t}a, Table t. These levels are based on iaaeral standar~s. T~ department of transporatAlon is rGi responsible for abating na!se trcm existing state trunk highways or conneetirtg highways.. ira tt'e absen^r. of any increasz by the department to thg ^ighways through-lane cepacit~. $I~E>=~ 2 of ~ sHEeTs ., ~, ~(,,..r ,t,~ri rJT'd r10ZE 13Cri3SH~ dH WH9irOT EOr1Z iT OftH CERTIFIED SURVEY MAP LOCATED IIV Pr4R'T OF THE NW114 OF TFIL 8Wi/4 OF SECTION 1S, T28N, fR1 SiW, TOWN OF CMY, ST. CROiX COUNTY, WISCONSIN. OWNER PREPARED FOR: SURVEYOR JAcAES 5 l7lAN6 JONr•!SCN ,it,MES t4 Bt?NN~E JOHN~(JN cDWIN ~ FLANUM 84E SrATE RDAD 128 30'J31YIL51rv STREeT NGATHt.ldJD S:;RV,-'`rtNG: NvC. WI ~50N. 4N 54021 r.QT 89 858 A. M WY "85" Mc:NDrn40~~lIE,~ld'S~751 RCBERTS.W154023 SIJgVfYOa'S CEr'i1'IFtCP,TF i, Edam ~~, Plenum,'3egis'.erad;fJsronsfn'~and 8tmeyot, herebycertiiythat byitedirection of Bonnie Johnson, i ha`~e surJeved, mat?~:d and described the parcel of land wh'ch is represented by th s Cert'fied Survey t~tap that tre exte~or t~cundery of the parce'. of land surveyed and mapped is describes as fo;lows: A Ce~:ei of ianc;'ocated in pert of 1ha N'uYtr4 cf the 5Vd1/4 of SscCon 15, T28N, P.tSW, ?crxr of (;ady, St. %roix Ccunty, b~Jisaonsir; descr'bed as ioifows: rornmancin;~ at the SVJ Corner of said sect!c~~; thence NOtJ°1e ~0°w, slang the west fire of the SVlrt/a, l32G t0 teef to the south line of t7e Nlh'ti4 of !hF SN'1r4; thence S89°59'57"E, e~eng sold so;.Cn fine, 58.69 fee; t:, tie east i;ne rf S't€te ~"runk tii;,fiway "12&' being the point of beginning; theme oor'Itinuing 539°5g'S?'~, atom said south lire, Bt~.S2 feet; them N00'35'34'E 387.08 feet; t"~1ce tvt33°54'S"'4l' 910.32 feet to said east lira; tt~nce SCn;'35°34'Vb', along said asst !ine, 3B7 Dti foe! to the point c' beglrn','~:7. Desaibed parcel c~~ntairs ?.2Q acres (313,fa26 Sr, rt.;. Parcel s subjear to all erasesr;ents, restri:~~nns aid ~rvenants of record. i, ~~ISa coniry trot !h:s CanifiExi 5i:rvey Map is a c:^rs~ct represertatfon to scale of the ~terior bcunde~y suveyed anC Cascribeci; that I t,ave ru:ly comp':ed w~?tr the currant provisions of C~ at:~ter 236:34 of *,he '~.ISOOns r Strtutes cind i s^~d St!>3ib4son Urttt^,anea of the t:our`5r of St. Croix to surveying ar.c! mapping same. ,~ ~ 4t. ~~ a'~ ~'C :' EOVdIN C. -, ~' F~ANUM _ S-24H7 •~ x • HMER" • 4Vi5 q •o. ~~J ~+ r~ •" i ,~ Each itaresl sho•~+.+ ~a this mvp (plat) is subject to State and Coant'; laves, rules and re~3latfons ('.s , wettan as, rrlirlrr~ur~, 'ot size, access to oarcef, eic ; Be~cre pure7asing ar dEVeic+pir, any parcel contact the 5i.: rc ix runty ~~!ing Offic. ancr;he Trnm ci Cady for adafce. SHEET 3 OF S SHEETS ..- ,_ 'v'o1.17 Qage 4574 II'~ 007E 13C213SH"1 dH WliC.i~Ot E007 4T Jnd