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HomeMy WebLinkAbout028-1006-90-000 ~ o a"ai I y d a' ~ I ~ I b o I N h ~ I a o~ w I odi ~ I ~ y I ' } aNi I Z c 1i c 0 ) Q N v a ~ I U) o w E z € m N F- U) j I O I O Z ~ U V w d Z a c E Z N ~ -o I ~ M N i c = O C Q 2 z z O N zl N C c co 0 M III N E C L d d r U co N a vi co c O d N 0 O° ° °GOa a 4) Z j f N N N v N UL a -j oil z a.aa N CL v Co J V~ rn rn } a>rnrn III L O O _ co r.- 0 N O `L N a LO O m aNi m 'o m Q in m o rn' ° c , ° O N O'a C E m O Q RO ~ J N C w rdj d r ` a C N d co to I~ N I N M Y 4) 'a F- C_ N N N 7 E CO O W O U ~l O O U) N O Z Z g fn C/1 Y a € n V ~ L: IL 44 CL `Iv r... E .2 c W A 0CL '!OaiCi R ~n / ,y r• ~C> BENCHMARK: ALTERNATE BM: /`~f}I~ / ~4^~ SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: -L Liquid Capacity: Setback from: Well House Other Pump: Manufacturer Model#~ Size Float seperation Gallons/cycle: Alarm Location SOIL ~ABSORPTION SYSTEM Width: 333 Length ( Number of trenches Distance & Direction to nearest prop. line: r Setback from: well: House Other ELEVATIONS Building Sewer ST Inlet:, / J/ ST outlet: PC inlet C a C~ PC bottom`? Pump Off Header/Manifold ~E°'~ "Bottom of system Existing Grade ',e941 Final grade DATE OF INSTALLATION: C PLUMBER ON JOB: LICENSE NUMBER: RECEIVED 111_ INSPECTOR: ST Cr~oI,1997 ~,.i. COUNTY 3/ 9 3: j t (>,ZONINGOFIRICE J Page of ' Scale 1"=LAO Ch r IA l~ 1~~vL~P~t' Z o t ~ L n b z N p rIj ~v Loa o L t .4.-- z s o o O.J ti 0 r ,o ~ Lr~wrv .4 r"s r ~ V) ' ~y 0 fi 0 07 O P Z t N4 o a' 1 i .Wisconsiry Department of Commerce SEWAGE SYSTEM Safety and43uildings Division PRIVATE Count . CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanita2§,§3i Personal information you provice may be used for secondary purposes [Privacy , s.15.04 (1)(m)). SMEESTER,NaLOREN 'R fr~Rf v" Town o : State Plan ID No.: t BM Elev.: Insp. BM Elev.: BM Description: Parcel ~4.:1006-90-000 0 6 146 7/g 71-_2 TANK INFORMATION ELEVATION DATA A9700213 6 TYPE MANUFACTURER CAPACITY STATION HI FS ELEV. Septic Benchmark ~13' /,/,j Dosing Sd f L. o' 3 Aerati n Bldg. Sewer . 5!9 ~G . r I Hol St l W Inlet 9 Qom? l TANK SETBACK INFORMATION St/~ft Outlet Zz' Ventto TANK TO P / L WELL BLDG. Air Intake ROAD Dt Inlet 9, Sz Jn~, Septic NA Dt Bottom Dosing NA r/man. i_ . Aeration NA Dist. Pipe n. . Holding Bot. System PUMP / N INFORMATION Final Grade 777 Manufacturer Q o Demand Model Number # (P - TDH Li ft q~ ' Friction,, 56' System J*~~ TDH y,/ Ft I f- `c Forcemain Length] Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT NO.Of Pits Inside Dia. Liquid Depth DIMENSIONS ' DIMEN I N SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACH Manuact SETBACK CHAMBER INFORMATION TypeO 1~. Model Number: System: OR UNIT DISTRIBUTION SYSTEM LLManifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake S6/mod ti/h Length "D Dia. oz Length Dia. Spacing X/ T 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 Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ N ❑ Yes ❑ No rf COMMENTS: (Include code discrepancies, persons present, etc.) 4-As 4~ej34 3 ','LOCATION: RUSH RIVER 2.28.17.31B,SW,SE 1954 50TH AVENUE s C0 `V. 6, C Plan revision required? ❑ Yes No Use other side for additional information. -144Z If7 l SBD-6710 (R.3/97) Date Inspector's Signature Cert No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: vSANITARY PERMIT APPLICATION Safety oand B fBuii ngWater Bureau of uildiin Water System! 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less Counrty N than 8 112 x 11 inches in size. UVQ l • See reverse side for instructions for completing this application State s4nitta y Permit Number The information you provide maybe used by other government agency programs ❑ Check it rev sion to previous application [Privacy Law, s. 15.04 (1) (m)). S+a an/24e, State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION Property Owner Name Property Location r- /I J In t rr S'0/4 sr-r14, S 2 T N, R/ (o W Property Owner's MailingrAddress Lot Number / Block Number p Th *&I c City, State , Zip Code Phone Number Subdivision Name or CSM Numbe .s C,drv.,1 w~ ~o®~ c7~S)6 ~o L /b l3 6~ L II. TYPE F BUILDING: (check one) ❑ State Owned ❑ City NSA Village ~ u f! /1 /l/CA 4l-✓'t• Public 1 or 2 Family Dwelling - No. of bedrooms Town of III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo i . a 9.17. 8113 0-2P / 0 e 6 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. ❑ New 2. X Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repai r of an System System_____ Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ;@Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 42 ❑pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ~cSQ 7 g, Elevation Feet l~10, Feet VII. TANK Cap ac t in gallons Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel Plastic New Exlstin strutted glass App. Tanks Tanks Septic Tank or Holding Tank 'e,,$ C/Q ~ ❑ ❑ ❑ El ❑ Lift Pump Tank /Siphon Chamber r eS ~~2 El El ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature- (No Stam ) MP/MPRSW No.: Business Phone Number: X117' -1-=6Fy-3>30 Plumber's Address (Street, I!i t Mate, pCode): IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issue Issuing A ent Signature (No Sta pproved ❑ Owner Given Initial ?e Surcharge Fee) Adverse Determination afJ AGO/~' X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: SBD-6398 (R. 05/94) DISTRIBUTION: Original to county. One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS " 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable:- 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD-6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 ar 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information Provide all information requested for numbers ` through VIL Tank information. Fill in the capacity of every new/or existing tank, list the tota, gallons, nLA-nh?1 of tanks and manufacturer's narne, indicate prefab or s; to constructeJ and tank material. C c-plete fc- a/! ;,ptic, purnp/siphon and holding tanks fcr this system. Check experimental approval only if tanks received experiiment:~ ?roduct approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriai! I-, refix (e.g. MP, etc:.), address and phone number. Plumber must sign application form. IX. County! Depa -L nent Use Only X. County / Depart rent Use Only. t ; I'CatIC!15 no 8 1'2 x i.; ;t,e'd fc 1'ie -Jnty. T??P. pans n"IiJst i`t' t3~t)t el<;r1 C ...'Orw licn'J'dL.'fj r?g taflk~~},ser-ili- .'UH-P Or St ..i3 aC_ IV_ lFU <.Ii r'ig ;rV'r'C.; "0 Ei, O tt"Ie '0. 1 b501 UG!1 a 1: 7u `_Jz nu ' fGl'i'iidUOl. GROUNDWATER SURCHARGE 1983VL1 10) .,_`Ude_fiht-Cr'eauonSU'charges(gees)for 4 I~ft? 11=i,_ :^lhic"l:dn effect groundw^J and estabiis;;menLof staindards- SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Commerce June 12, 1997 2226 Rose Street La Crosse WI 54603 WEGERER SOIL TESTING 421 N MAIN STREET PO BOX 74 RIVER FALLS WI 54022 RE: PLAN 597-40696 REVISION TO PLAN 596-41150 FEE RECEIVED: 150.00 SMEESTER, LOREN REFUND DUE: 30.00 SW,SE,2,28,17W TOWN OF RUSH RIVER COUNTY OF ST CROIX MOUND SYSTEM The Department has reviewed the above-referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval. of the system is based on chapter 145, Wisconsin Statutes, and chapters Comm 83 and 84, Wisconsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter Comm 82 or in chapters ILHR 50-64, Wisconsin Administrative Code. - The approved changes will become an addendum to the plans previously approved. All other portions of the installation shall. conform to the original approval. This plan submittal. approval will expire two years from the approval date, or if a sanitary permit is obtained, plan approval will expire on the day the initial sanitary permit expires. The licensed plumber responsible for this installation shall keep one set of plans with the Department's stamp of approval at the construction site. The installer shall notify the appropriate inspector when inspections can be made. All. permits required by the city, village, township or county shall be obtained prior to installation. An overpayment was made in the required fees and you will. receive the refund noted above in six to eight weeks. SOD-7997 (8.11/96) SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Commerce WEGERER SOIL TESTING Page 2 June 12, 1997 PLAN S97-40696 Inquiries should be directed to me at the number listed below. Please refer to the plan number shown above. Sincerely, erard M. wim Plan Reviewer Section of Private Sewage (608) 785-9348 SBD-7997 (R.11/96) Page of 6 MOUND SYSTEM 6 FOR A Z BEDROOM RESIDENCE C SYS'TC-l sly FOR p"Dl•Llt>-= - LOCATED IN THE SW 1/4 OF THE S E 1/4 OF SECTION Z , T Z% N, R k1 W, TOWN OF R US!\ Z.1U~2 , S'I'• CR~`X COUNTY, WISCONSIN. INDEX PAGE l 'of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW-CROSS SECTION; PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT .PAGE 5 of 6 PUMPING CHAMBER PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR EGI Vpp \u t2..~J QtN~ M Pflt.ll.~t N S1"1 ~!S`'T~"R °i sy so Z ter t6-)Z jo s Bpc-bvj)", w1 sq n-L - SAFETY a ~g~S'~ 1l>N ot= PLKir 1~p. S°i'b - ~L 11 S0 fig, ~ PREPARED BY ` F, ws oxi ti~+lS fNM 01 1 QF q,~ r`C, 1+ E r s0 z L TEST I NG IN ,t •S/,,y AND. ARTHUR LL i~fl.~S'F .S''45✓r • WDGER R c~~ C ` V J P-0. 301 74 421 K. KAIK ST. E+L weRn~. RIVET FALLS. VI 54022 ( 715-42`5 -0165 ~ N~ 1 '1 L S o'xZ.s s:u u _ _S 4 • FT - - - t S I G 1"~ x suu 30 Z SUM S 1 L~ PwKC~ C uwt.,~~ = zo 6 n Q - Z4'F ZVO•~" V-, S @C 'DlS►Gn/E~ i~iZ 3 13pItm = LISA G lv1` w Rs`TE~n'i~1Z L4 lb 8 p r.- JOB NO. 6 - 2~ $ PLOT PLAN Page Z- of (o Scale 1"= gQ ' ~i `h cd ~ l a C ~ Sri v L~ ~Y Z a O L n 1 C / J N I N 0 S sCp x CA 10 C ~ c O 0 I C, no rit W f Lht.►N .4 r i 10 ~ r V) N~e~r i u ~ Qc47 ~J / / O 0 ~r r Page of Approved Synthetic Covering t*rs-r" c 33 Distribution Pipe Medium Sand Topsoil -l - H= G RS- F EleV 3 - E b % Slope Bed Of 2~ 2 Force Main Plowed Aggregate From Pump Layer D ~•y Ft. E \.-I ZFt. Cross Section Of A Mound System Using A Bed For The'Absorption Area F o•$ Ft. G ~•b Ft. A 8 Ft. H l-S Ft. Linear Loading Rate= a•S,7 GPD/LN FT B S Ft. Design Loading Rate= o.•14 GPD/SQ FT j 1•,o Ft. J Ft. K \Z Ft. Ai*eea*te Position L -15 Ft. of W 3 3 Ft. Force Main L Observation Pipe A I - - W I° -----------------------I Distribution Bed Of 12 2.2 Pipe Aggregate Observation Pipe Permanent Markers (Anchor securelY) Plan View Of Mound Using A Bed For The Absorption Area Page Of Perforated Pipe Detail 0 End View , )Perforated End Cop.) b\t~i PVC Pipe Install permanent 'marker at end of each lateral Holes located On Bottom, Are Equally Spaced S PVC Force Main P PVC Manifold Pipe Distn ution Pipe Last Hole Should Be I Next To End Cap End Cap P Z 3 Ft. Distribution Pipe Layout S L] Ft. X Sp Inches Y SO Inches Hole Diameter try Inch Lateral Inch(es Manifold Z Inches Force Main " Z Inches # of holes/pipe Invert Elevation of Laterals `9,cl Ft. 6y-l UL X y = X2.06 GP►-J a Place lst hole ZS from center of manifold with succeeding holes at SOS intervals. Last hole to be next to the end cap. ' PUMP CHAMBER CROSS SECTION ARID SPECIFICATIOUS ' PAGE S OF (O CUT CAP •i"c.i. VENT PIPC f r-T WEATHER PROOF APPROVED LOCKING MANHOLE 10'f ROM ODOR, JUNCTION BOX COVER WITH WARNING LABEL ? It'MIU. WIIJDOW OR FRESH I AIR ItJTAKE I GRADE I y' MIN. cu 9 } I COIJDUIT \ • PROVIDE I • INLET r AIRTIGHT SEAL I III ~ I III v APPROVED JOINT/ A Tank construction shall comply I Iil APPROVED JOINTS with ILHR 83.15 and ILHR 83.20 I II I i I ALARM e i it i I I ON c •I I _ I CLEV. PUMP-~ -_J OFF 0 L tZ _ OO CONCRETE DLOCK 3" APPRW9I> - KISEK EXIT PERMITTED ONLY IF TANK MAWUFACTURER HAS SUCH APPROVAL gEDpI 5PECIFICAT10KJS .....CELL DOSE TA AIK MANUFACTURER: W1ESM L`p1ICR~"S'~.T IJUMBER OF DOSES: 3'~5 PER D" • TANK SIZE: GALLONS DOSE VOLUME z FL„'--' 2.p S~1S S INCLUDING DACKFLOW: GALLONS ALARM MANUFACTURER: MODEL NUMBER: I'll "w CAPACITIES: A= WCHES OR '3Sd• °I GALLONS SWITCH TUPE: Mey-eCJRY .5= Z INCHESOR 4b-I GALLONS PUMP MAWUFACTURER: Z'O Q-ujF\Z C i 8 INCHES OR "0'4 GALLOMS MODEL WUMBER: Q6 D- 10 INCHESOR 2"O-S GALLONS SWITCH TYPE' msmC'&•`r LIOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATE z S AA 2) GPM INSTALLED OW 5EPARATE CIRCUITS VERTICAL DIFFERENCE OETWCEU PUMP OFF AUD.OISTRIBUTION PIPE.. 12 L FEET + MINIMUM NETWORK SUPPLY 1PRES5uRE . . 2.so FEET + `\S FEET OF FORCE MAIN X Fo Y pLFRICTio11 FACTOR. 8 s FEET TOTAL 09IJAMIC. HEAD - 1- •.41 FEET DIAMETER INTERNAL. DIMEWSIONt OF TANK: LENGTH ,WIDTH -LIQUID DEPTH 3..? BOTTOM AREA _ 231= GAL/INCH AS PER MANUFACTURER = 20 OS GAL/INCH _ - E rW. -HEAD CAPACITY CURVE 3 7/8 6 1/4 MODEL "98" 30 4 5/8 -1 8 25 t3 3 5/8 6 20 -I- U p F a 15 ® 4 3/16 4 0 10 28. 08 ~ 1 1/2-11 1/2 NPT 2 5 0- _T7 U.S. GAIIONS 10 20 30 40 50 60 70 80 IJTERS 80 160 240 0 FLOW PER MINUTE TOTAL DYNAMIC HEADIFLOW PER MINUTE EFFLUENT AND DEWATERING CAPACITY 12 HEAD UNITS/MUI FEET METERS GALS LTRS 5 1.52 72 273 10 3.05 61 231 15 4.57 45 170 3 5/16 \ - 20 6.10 25 95 f Lock Valve 23, , CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and • Mercury float switches are available for controlling single and supplied with an alarm. three phase systems. • Mechanical alternators, for duplex systems, are available with or • Double piggyback mercury float switches are available for without alarm switches. variable level long cycle controls. SELECTION GUIDE Standard all models - Weiht 39 lbs. - '/sH.P. 1. Integral float operated 2 pole mechanical switch. no external control required. 2 Single piggyback mercury float switch or double piggyback mercury. float 98 Series Control Selection switch. Refer to FMO477. Model Volts-Ph Mode Amps Simplex Duplex 3. Mechanical akemator 10-0072 or 10-0075. M96 115 1 Auto 9.0 1 or 1 & 7 - 4. See FM071Z for correct model of Electrical Altemator, "E-Pak". N98 115 1 Non 9.0 2 or 2 & 6 3 or 4 & 5 5. Mercury sensor that switch 10-0225 used as a control activator, specify D98 230 1 Auto 4.5 1 or l &7 - duplex (3) or (4) float system. 6. Four (4) hole "J-Pak", junction box, for watertight connection or wired4n sim- E98 230 1 Non 4.5 2 or 2 & 6 3 or 4 & 5 plex or duplex operation, 10-0002- - 7. Two (2) hole "J-Pak", for watertight connection or splice. CAUTION For information on additional Zoeller products refer to catalog on Combination Starter, FMO514; All installation of controls, protection devices and wiring should be done by a quali- Pggyback Mercury Switches. FM0477; Electrical Altemator, FM0486; Mechanical ARemator, fied licensed electrician. All electrical and safety codes should be followed indud- FMO495; Alarm Package, FM0513; Sump/Sewage Basins, FMD487; and Simplex Cormol Box, ing the most recent National Electric Code (NEC) and the Occupational Safety and FIN0732. Health Act (OSHA). RESERVE POWERED DESIGN f For unusual conditions a reserve safety factor is engirt. eered into the design of every Zoeller pump. UNL TO. P.Q BOIX 16347 L, touiswft KY 40258-0W Manufacturers of.. . &W T&. 3M Lwh0e, KY OELLEf' O. °4M of~o ~fvw rrPuwvs Savcr la/a/✓ „ © (5oz) narr3l . 1('eoo) f1'2a-~uMP FAX T74-W4 SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations September 19, 1996 2226 Rose Street ~j La Crosse WI 5460 SEA 2 3 1936 WEGERER SOIL TESTING STCROI.X 421 N MAIN STREET ~CO(JNTy PO BOX 74 v^ OBE ti RIVER FALLS WI 54022 ; RE: PLAN S96-41150 FEE RECEIVED: 180.00 SMEESTER, LOREN SW,SE,2,28,17W TOWN OF RUSH RIVER COUNTY OF ST CROIX MOUND SYSTEM The Department has reviewed the above-referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval of the system is based on chapter 145, Wisconsin Statutes, and chapters ILHR. 83 and 84, Wisconsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter ILHR 82 or in chapters ILHR 50-64, Wisconsin Administrative Code. This plan submittal approval will expire two years from the approval date, or if a sanitary permit.-, is obtained, plan approval will expire on the day the initial sanitary permit expires. The licensed plumber responsible for this installation shall keep one set of plans with the Department's stamp of approval at the construction site. The installer shall notify the appropriate inspector when inspections can be made. All permits required by the city, village, township or county shall be obtained prior to installation. Inquiries should be directed to me at the number listed below. Please refer to the plan number shown above. Sincerely, i rd M. S m Plan Reviewer Section of Private Sewage (608) 785-9348 SBDA-798718. 10/841 Page 1 of 6 MOUND SYSTEM FOR S96-41150 A 3 BEDROOM RESIDENCE LOCATED IN THE SkJ 1/4 OF THE S~ 1/4 OF SECTION Z ,TZ N, R 17 W, TOWN OF R,V Slt\ \~`V\ %T-• C\w1.X COUNTY, WISCONSIN. INDEX PAGE l 'of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN -PAGE 3 of 6 PLAN VIEW-CROSS SECTION; PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUMPING CHAMBER PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR LuIZ~ Atio w11`~~L~N sw~~'sT~ °l S 4 SO 1'N Rv F. , Z3AL,DW11v , k1l S~002 PREPARED BY WEGEFZER St7 S L TEST I htG ~ AMID . s Z3ES Z cam SE:RV I GE Q~w Cg~k-5-101 74 421 K. MIK ST. ® w c' cF p ALffS : K.L.SN"[iRT1i, 15 e F'~ . VI 54022 2? i Wi F • _ SIGN ~'f00Kl~ Dom' p1i s1 jig JOB NO. ~7 6 -24 8 PLOT PLAN - _ Page Z of Scale 1"=- 4D' YN1. q"t ~~,p~ ~ ~ - ~ cam- c3 _ e-x-tsT. i/ I ~ %r,5 u~ b~lvR13 S t*?`n t I T1.1-LS Fl'►'t~q~1 PI Ar,. o•\ ~}uvs~ to of y"pvC C t"LOCI k UJO-L Z O"\ g>o , o.ggm' To z, 1313 ar ' 9~ NOS = Z 1' ~tN~ o}= i p P ~ 1S Zooa ~~`n-I o►= w,ou~. ~y - L1 . lu U. O~ oti CR L G~t,~t6~ FWuIZ 1`~T OQC . ~Kls'~►~ G S~T1e 1~~tiC to ~ ~B~Ot~~ t~S P~ ~nD~, NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted., 2. install permanent markers at end of each lateral. (q required) 3,. Install 4" observation pipes with approved caps. ( Z required) 4. Septic tank to be%lwn bob gallon capacity manufactured by ZS LM Co►J C~Z I:'~ R-OZucTS i v L-\::~CT- l 6130 5. Bench Mark s Pf130 UC 6-Divert surface water around mound to-prevent ponding at the uphill side. _ Page Approved Synthetic Covering Rs-rm C 33 Distribution Pipe Medium Sand Topsoil . H G F Elev. Q -J E D 3 . u b % Slope Bed Of Z- 2 %2 Force Main Plowed Aggregate From Pump Layer D Ft. 1,~Z Cross Section Of A Mound System Using E Ft. A Bed For The Absorption Area F 0.9 Ft. G k•b Ft. A 8 Ft. H k -S Ft. Linear Loading Rate=q•S"GPD/LN FT B 4-1 Ft. Design Loading Rate= b .14 .GPD/SQ FT I 1 Ft. J Ft. K \Z Ft. Ai*eeftate Position L -1 Ft. of Force Main W 3 Ft. L J Observation Pipe 13 K A Distribution Bed Of Pipe Aggregate I Observation Pipe Permanent Markers (Anchor securely) Plan View Of Mound Using A Bed For The Absorption Area i Page Of (o Perforated Pipe Detail 0 End View Perforated End CoD] PVC Pipe Install permanent marker ~o<`OSat end of each lateral Holes Located On Bottom, Are Equally Spaced Q S PVC Force Main Q PVC Manifold Pipe Distn ution Pipe Lost Hole Should Be I Next To End Cap End Cap P 2'Z Ft. Distribution Pipe Layout S L) Ft. X 4 8 Inches Y u 13 Inches Hole Diameter 1!y Inch Lateral I Inches Manifold Z Inches Force Main " Z` Inches # of holes/pipe b Invert Elevation of Laterals9S-9 Ft. 6y- V.V) ~.UZ x y_ -La.ob GP►~j Place 1st hole 2(1N from center of manifold with succeeding holes at q8' intervals. Last hole to be next to the end cap. Combination Sep•tc. Tank-and ~o PUMP CHAMBER CROSS SECTION AMD SPECIFICATIOMS ' . PAGE 2 ),OF - - WEATHER PROOF -VELDT CAP JuLICTIOL! 150X H"C.I. VENT PIPC APPROVED LOCKING 101 FROM DOOR, MANHOLE COYER PQ111i -AhmDOW OR FRESH wARNILlG Ll48EL ALP, IIJTAKE S cor lpu~T c r tj • ~ cl9 * ~ K~R11 I - Y~ MILT. 1 ~ ~ 18' Irl11J. 18'MIAI. \ IkILET PROVIDE I _ -T.AIRTI6HT SEAL II v APPROVED JOIIJT ~A~~`~S A I I APPROVED JOINTS I I I W/C.I. PIPE,tPv( W/C.I. PIPEOR Tank construction I I I I shall comply with I I ALARM ILHD (83.15 and 83.20 rs I II I I ow C I E.LCV. FT PUMP-OFF gE D CONCREeL Z-6. SOI QLOLK 134- APP'Rove: RISER EXIT PERMITTED OQLy IF TAWK MAIJUFACTURER HAS SUCH APPROVAL BEDDING SEPTIC E SPEC.IFICATIOAIS DOSE TANK MALUFACTURCK' lyl C.(a),JCZ 1JUM9ER OF DOSES: 3~y PER OAy TANK SIZC : l~V~ bOb GALLONS DOSE VOLUME ALARM M"UFACTURE.R: S14SR-YI11 S INCLUDING 6ACKPLOW: GALLONS MODEL DUMBER: I t Nw CAPACITIES: A= l$ INCHES OR 3b~' GALLONS SWITCH TAPE: L~Cc '~f B= INCHES°OR 3~'4 G( LLOM5 PUMP MAk1UFACTURCR: ZO.t✓TZ.L~'1Z Cam' C= a INCHES OR 133.E GALLOLl5 MODEL k1UMBER: D- S INCHES OR GALLOMS SWITCH TYPE: IJOTE: PUMP AMD ALARM ARE TO bE MILIIMUM DISCHARGE RATE ~8' Ug GPM INSTALLED OW SEPARATE CIRCUITS VERTICAL DIFFERENCE DETWEEU PUMP OFF AUD..DISTRIBUTION PIPE.. FEET MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . 2.5 2 FEET + ~Zfl FEET OF FORCE MAIN X 1' 61 FYp FT.FKICTI01.1 FACTOR.. FEET TOTAL Dyk1AMIC HEAD = FEET Pump chamber DIAMETER INTERLIAL DIMEWSIOW~ OF TALIK: LEkI&TH ;WIDTH ;LIQLIID DEPTH BOTTOM AREA - x,231= GAL/INCH AS PER MANUFACTURER ~7 GAL/INCH pE 6 of 6 HEAD CAPACITY CURVE 3 7/86 1/4 _ MODEL "98" 30 4 5/8 8 25 e 3 5/8 6_20- m + + U_ O a / .lb 15 4 3/16 o 4 10 28. 08 0 1 1/2-11 1/2 NPT 2 5 0 U.S. GALLONS 10 20 30 40 50 60 70 80 LITERS 80 160 240 0 FLOW PER MINUTE i TOTAL DYNAMIC HEAD/FLOW PER MINUTE l EFFLUENT AND DEWATERING CAPACITY 12 HEAD UNITS/MIN FEET METERS GALS LTRS 5 1.52 72 273 10 3.05 61 237 15 4.57 45 170 - /16 20 6.10 25 95 3 5 Lock Valve 23' CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical altemators, for duplex systems, are available and • Mercury float switches are available for controlling single and supplied with an alarm. three phase systems. • Mechanical alternators, for duplex systems, are available with or • Double piggyback mercury float switches are available for without alarm switches. variable level long cycle controls. SELECTION GUIDE Standard all models - Weiht 39 lbs. - Yz H.P. 1. Integral float operated 2 pole mechanical switch, no extemal control required. 2 Single piggyback mercury float switch or double piggyback mercury, float 98 Series Control Selection switch Refer to FM0477. Model Volts-Ph Mode Am Simplex Duplex 3. Mechanical Altemator 10-0072 or 10-0075. M98 115 1 Auto 9.0 1 or 1 & 7 - 4. See FM0712, for correct model of Electrical Aftemator, "E-Pak" N98 115 1 Non 9.0 2 or 2 & 6 3 or 4 & 5 5. Mercury sensor float switch 10-0225 used as a control activator, specify D98 230 1 Auto 4.5 1 or 1 & 7 - duplex (3) or (4) float system. E98 230 1 Non 4.5 2 or 2 & 6 3 or 4 & 5 6. Four (4) hole "J-Pak", junction box, for watertight connection or wired4n sim- plex or duplex operation, 10-0002. 7. Two (2) hole "J-P . for watertight connection or splice: For irdonnation an addltianal Zoeller product refer to catalog an Combination Starter, FM0514; CAUTION vdud- Piggyback Mercury Swddan, FM0477- Ekdrical Alternator, FMO486; Mechanical Alternator, All iicensed leekicimLls, All l electrical protection devices d and evices and safety wiring codes should should be b followed a - FMO495; Ak- Packa FMO513- Sum tied licensed a ty and pl5ewage Basins, FM0487; and Simplex Control Bot, irg the most recent National National Electric Code (NEC) and the Occupational Safety and FM0732 Health Act (OSHA). RESERVE POWERED DESIGN { For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. Z ASM TO. P.O. I= 16W L. t. oflfst&, KY 4025644 Manufacturers of... SW TO. 3200 Old o OELLE/4' O_ 4MB l ,r/~YLZr /939" j m (W4 776-2731 0 1(800) 920-PUMP FAX 5W) 7744=4 _-WiscoosinDepartmentof-Industry,- -SOIL AND-SITE-EVALUXTtOX-REPORT --p 1-of -3 Labor and Human Relations - D%rs~onufsatezy in accord with ILKR 8105,1Nis. Adm. Code-- ' COUNTY s r~ 1:T• C."VX Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan i , not limited to vertical and horizontal reference point (BM), direction and % of ale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. ~,e & ~ D Z.8 - t 00 6 q O rl tr REV• D BY DATE APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATIO ,y . PROPERTY OWNER: K~ER7 LOC Ti ,9 % t.bQ~ V0,& "t'C -A 1 `fty S`f'1 ~ Sb SE T Z@ N,R I7 E(orD PROPERTY OWNER':S MAILING ADDRESS SUBD. CSM # lot S S `11t Y~ - o%- S 13 67?_ CITY, STATE ZIP CODE PHONE NUMBER NEAREST ROAD a ~0►.,I►~ w 1 s Lb)" (-)1S) 68q- -Z,5~1 SOT* [ j New Construction Use ~J Residential / Number of bedrooms Z _ [ ] Addition to existing building K Replacement [ J Public or commercial describe 16rJ FOB 3 Code derived daily flow 4STO gpd Recommended design ding rate o bed, gpd/ft2 = trench, gpd/ft2 Absorption area required a-1S bed, ft2 'a-S trench, ft2 Maximum design loading rate o 5 bed, gpd/ft2 0 - 6 trench, gp(w Recommended infiltration surface elevation(s) Q IR'• LI ft (as referred to site plan benchmark) Additional design/ site considerations N1ourJj w l 8 1«!~ &tM~ Ml t J, W4' 017 S ~ Y -t L~_. Parent material C T t Rood plain elevation, if applicable N - I~ - It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for system ❑ S RJ U ®S ❑ U ❑ S El U ❑ S ®U ❑ S ®U ❑ S LO U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Botrtdary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed rertdl 0-9 vz-I 3tz - sib Z~sbk w►~~ LS - o.S o.6 Z R-3o lo~(z 31~ S Z gbtT tin`~1- C s o. S o. ~ Ground' 3 3o S$ 7.5~l CL 31 S1g Sc elev. -14~ fC. Depth to limiting factor 3 0~ Remarks: Boring # Z. tZ3 [z StI `Fs Mbk -V O-S - O.s~ o. Z _ - i•~>ti..,~::H;<>r Z q -Z-7 LOO-t2 3j L s l ~ 3~ sb~ tin `~t~ CS o,s o. L , 3 Z~-3S ~.SK2 3lY IS 8S~ \ v+tiSbh vn~'Fh C - €r'•S Ground elev. S-~1a-S~Q 31y [ °)9- o ft S11 2 sfa ~S tS~ C7 n~1-tip` Cw Depth to S Y$- 51 loy k 31 L -),S 4% SIP. I% Ow\ YVI- - - limiting fags q Remarks: CST Name:-Please Print Phone: Arthur L. [degerer 715-425-0165 V`eegserer Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022 Signature: Date- CST Number: M0057-6 PROPERTY OWNER S`N1 q-EFSIM SOIL DESCRIPTION REPORT Page of. 3 PARCEL I.D. # D LO b 6 - °1 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft In. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3 0_9 ~o~t~z ~lZ sib Z`FSbFc m H CS. - o.s o.b Z 9 ZS 1 o`iR 31 G _ S11 Z~S~~ tin`FI.- CS ` 4.5 0• Ground 3 Z -S Z `)-s 4 R 3)y 15 51 O S 9 - `V ~I _ _ ~ ~ S'°! lZ- S a s~ I O w~ elev. °1°1 •o ft. Depth to limiting factor Remarks: Boring # ~ o- 8 tiO`1 Z 3 l .Z S 1~ Z S bIT Y"L`f1-• ~S - • S i ~Z S- ZO l l7 y IZ 316 S 1^ Z'F S dk YYi `FI- C°_. 5 . 3 7-0 .3 ~k3-tRL 31b C tz 5/8 Ground elev. oil; -o ft. s Depth to III'mitin9 factor Remarks: Boring # cca No \ Z 3 ~V~Tt L~ U G . Z3 r-') vtL 1 Inj Ground elev. U - lJ ft. Depth to V t 1 limiting s~ 1 G ~1 - 3 g U S , factor Remarks: !boring # I u t'om`-?-•.'v} Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) PLOT PLAN Page 3 of 3 SCALE 1"= alp ' LL9.`t L ~ c~ a c3 _ ~t Rq T\\ \ UAL DlsTc,R~3 9+"1 sure Z 8D - ! Z I NIX0 \ U. o~ 9 ~o ~•46mi Tb Zoo $ T-• -P 98 o T4 . L[NN OH 1 p oM P h-5tc~ lS ZJJO'# wiou-b, D~^'l - ~L. ~,u U . p~ oN Lo►~) C..R~ G~'h~~ Fl,tw12 1~T OoOR . (715 ) 425-0165 M00576 CST Signature Date Signed - Telephone No. CST # FORM NO. 985-A • NY Nl~l.rCprpYry~ 3 8 8 9 6 7 Stock No. 26273 -CERTIFIED SURVEY MAP NO. 3.362 Part of the SE 1/4 of the SW 1/4 and part of the SW 1/4 of the-SE 1/4 of Section 2, Town 28 North, Range 17 West, Town Rush River, County of St. Croix, State of Wisconsin as described in Volume 5 of Certified Survey Maps, Page X62 as Certified Survey - Pl~r~lee r WEST LINE,SE 1/4, +Z SEC. 2, Tr28N .R.17W. UNPLATTED. LANDS. P I L E N89051'16"E NOV 2 1983 COMM C ~ 4 f 758.70 JA" of Z FENCE : n Iii Orok fib, 1Nbaovi *-SEPTIC O 6 8 ~I Z o SYSTEM O I o EXISTING g cn ; r a F BUILDINGS 0 -4 PPROVED LOT i NOV 1 M3 SOUTH LINE,SWV4 435,612 SQ.FT # SEC.2, T.28N-R1TW. 10.0 ACRES f ST. CROIX COUNTY LW W/O R.O.W. w CWO►► S .FARO Tt Q ZW°AN Cpl MMU SW COR, SEC-2' b 410,575 SQ. t wo AND d T. 24N- .17 W. 9.4 ACRES ! o _ r' --758.70L- S89°51'16"W 89°5I I618661' 5 I' 6"E -242749--~ -758.70-- S89051'16 "W O?--2052.21-- ~i SOUTH 1/4 COR. ---5238.40'-- SEC.2, T. 28 N7R.17W. SOUTH I INE,SEI/4 SE OR. SEC.2, OAK DRIVE SEC.2,T.2BWR17W T.28ty-RI7W SCALE: I"= 200' UNF ATTED LANDS 0 100 200 300 400 BEARINGS REFERENCED TO THE SOUTH LINE OF-SECTION 2 28 N7 LEGEND R.17W. ASSUMED AS N8906116"E. 0 W IE GHING 21.502 4" ROUBNSD/ IRON ROD 0 FOUND 3/4" ROUND IRON ROD t9 SET BERNTSEN AWMINUM CAP MONUMENT SURVEYOR'S CERTIFICATE 1, I-eon R. Herrick, Registered Land Surveyor, hereby certify that I have surveyed, divided and mapped a part of the SE 1/4 of the SW 1/4 and part of the SW 1/4 of the SE 1/4 of Section 2, town 28 North, Range 17 West, Town of Rush River, County of St. Croix, State of Wisconsin more particularly described as follows: Commencing at the South 1/4 corner of said Section 2, the point of beginning; Thence S 89° 51' 16" W, 186.61 feet; Thence N 00° 17' 17" W, 574.16 feet; Thence N 89' 51' 16" E, 758.70 feet; Thence S 00°17'17" E, 574.16 feet; Thence S 89° 51' 16" W, 572.09 feet to the point of beginning. Said. parcel contains 435,612 square feet more or less 10.0 acres+± Excluding rnadwav rioht-of-wav 410.575 square feet more or less; 9.4-acres - That I have STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County cc OWNER/BUYER I OkCA, (yt A ~l &YA) t~ liK ~_r~s i MAILING ADDRESS PROPERTY ADDRESS S O T~ /~y f (location of septic system) Please obtain from the Planning Dept. CITY/STATE c 2-41 Z PROPERTY LOCATION _y 1/4, .S 06~ 1/4, Section T~N-RL-7_W TOWN OF 0.5 U if /e ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAP 3, PAGE 43661OT NUMBER-~ 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 licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating conditioq and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. VWe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expi ation date SIGNED: DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 y B T C - 100 This application form is to be completed in full and slgh6d by the owner(s) of the property being developed. Any inadequacies gill only result in delays of the permit issuance. Should 'his development be intended for resale by owner/contractor, (:pec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - Owner of property r C) (1AW 1LYN vWlEC-57M Location of property St'j 1/4 S~ 1/4, Section ,T-2~N-R f `W Township '2i_.54 ~kVeK Mailingaddress ~?J`Y ~ ~~~~J1~1, W~ Samoa- • Address of site MAIL Subdivision name 0,514 Lot no. Other homes on property? Yes _ X No Previous owner of property L e Oar Total size of property Total size of parcel Date parcel was created Are all corners and lot lines identifiable? Yes _No Is this property being developed for (spec house)?• Yes ___&_No Volume and Page Number`A_ as recorded with the Register of Deeds. - - - - - - - - - - - - - - - - - - INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PISE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Yap shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property, described in this information form, by virtue of a warranty deed recorded i the office of the County Register of Deeds as Document No. _,e_3 © g0 3 , and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of the County Register of Deeds as Document No. dinoalu~rLee of Applicant Co-Applicant Date of Signature Date of Signature - DOCUMENT NO. WARRANTY DEED _ ! TNTS s►ACS eeseevso row RecoRoTwa DATA STATE BAR OF WISCONSIN FORT[ 2-MM 530803 .O.O ),.It%...JaLtln-and-Aaren-.D....Jnha.---husband ..and__- , . F ..vila - JUL 3 1995 conveys and warrants to Loren. Smeenter...and---------------- c.. 9:30 AN., ......X"13,=......... Slaeemtsr..-.husband-.and... wile ~ra y! 501" TO F _ . - - - the foltowin` deserHW red Vdate In •St.:-- CT017e ...............cmeq. - Stat* of Wisems1a: Ta: Pareel No:...--............ All that part of the Northeast Quarter of Southwest Quarter (NE% of SW%) and All that part of Northwest Quarter of Southeast Qaurter (NWk of SE's) of Section Two (2). Township Twenty-Bight North (,e28N), Range Seventeen West (217N) lying Southerly of interstate Highway 0940. Part of Northeast Quarter of Southwest Quarter Mt of SW%) described as follows: Ccmisnce One (1) rod North of Southwest corner thereof; thence South One (1) rod; thence last One (1) rods thence Nally to Point of Beginning. Rant-Ralf of Northwest- Quarter of Southwest Quarter (B'h of NW% of SW's), lying Southerly of Interstate Highway 0940; Southeast Quarter of Southwest Quarter ( of SNP)- and Southwest Quarter of Southeast Quarter (Sft~ of Sltt)f Alt In 3ectiou Two (2), Township Twenty-Bight North (T28N), Range Seventeem West,(R17W) EXCEPT PART to State of Wisconsin in Vol. ~3680'j, pagi 559. is This homestead property. I Exception to wavrantles: Easements and restrictions of record. 21st. June . is...95! but _ day of dellrered June 26r. 1995 pursuant to SEC. 706. (1qr--4A- t.......... (SEA r.._.......... (SEAL) i L) Le_ on W. _ Ja . (SEAL) ! _ - ..............(SEAL) Nam -It----,7_a?W1-_.... _AUTUXUTICATION ACKNOW LEDQUNNT U1 Leon W. Jahn and Karen D. STATE Op wMMUSIN 2 th - une ip..95 . PeesasrsOr eve before ms 9 ........._..._-day of namsed Leos Rif. Jahn and Karen t.O aY►aa a_ Thomas McCOrlaCt TITL>es N sTTATX MR OF WUICONSIN^ ( iz i 78i.9iR, Wis. to no loww tie be the person ...e who ezeeated the forellobss asstevs~R aad acirnowledp the same. THIS INaTRMMpR WAS DRA/Tm BY W - ~ 1