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HomeMy WebLinkAbout040-1188-90-014 r>t / ST. CROIX COUNTY ZONING DEPARTM AS BUILT SANITARY REPORT Owner 04 - 4 z L /5 . - 0 , tn~8 Address IDA 7=' r st CROIX City/State r<,t /~G L 2C INOGo FCE Legal Description: ~G Lot 741 Block Subdivision/CSM # '/4 A/ '/a , Sec. , T?LN-RaW, Town of o e PI # u~/ 199 -:06 -014 SEPTIC TANK DOSE CHAMBER HOLDING TANK INFORMATION: Tank manufacturer Size ST/PC /69 kaoSetback from: House /0 WeIL.o P/L>- S-- Pump manufacturer 24U,-,e,< Model 4:3 -7 Alarm location r46 - - „ , L r " mm m (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM: -c. Type of system: / 10 O,,G! Width .3 Length Number of Trenches S y 7 Setback from: House ! 1/. 2 Well ,S'e P/L S~ Vent to fresh air intake ELEVATIONS: -F- Description of benchmark 69/1 f' -ee P n c- Elevation - -2 41 Description of alternate benchmark [7 Elevation Building Sewer / i ST/HT Inlet SST Outlet « 'FC Inlet PC Bottom Header/Manifold Top of ST/PC Manhole Cover b Distribution Lines ( ) D 7 Bottom of System ( ) ( ) ( ) cf g+ LS Final Grade ( ) p ( ) ( ) Date of installation/ermit nu ber 2 ~~13 State plan number 7~ ~y 6 Plumber's signature ~se number j ~Z } Date /Q!~ Inspector Aoc. Complete plot plan r NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW PLOT PLAN Scale 1"= 40 ' 1~Dtq- N"r13 P1P h~L 4$•~~ ~8?]- 1' owe PoF ~q, e1.g~ ~ lv prpr X. I n $ Y 4 ~ of Q GF Qvtu~ k"Pv t v.Q~ a~~ P, t/► ~'C9L` v1 ~ w~ l x Ito v S F by ~L V B 0 o 0 v' S 9 6 Y x Zoo' LS `S Mir UO r~oT CAM ~h c oCZ Dl S ~U~i_(~ 1s f1R• INDICATE NORTH ARROW Wisconsiri Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division County ST. CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary~14911O o Personal information you provice may be used for secondary purposes [Privacy La s.15.04 (1)(m)]. y y wb Br RANmit , ANIEL ❑+koy village Town of: - State Plan ID No.: D CST BM Elev.: Insp. BM Elev.: 711 escription: Parcel TUft-1188-90-000 (oo O~ r. " y, TANK INFORMATION ELEVATION DATA A9700505 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. eptic Benchmarlk OSIn f,5 ,A Aeration y- Bldg. Sewer I L! C(~ _ Q Holding Inlet I ! `1 [ .~5 TANK SETBACK INFORMATION ~ Outlet Vent TANK TO P / L WELL BLDG. A ir Ito ntake ROAD Dt Inlet ep Icy )D,5 NA Dt Bottom ~.o m 2 mss' NA Header/ Man. c1 j q8- -7 Aeration NA Dist. Pipe 0 l~ ,7 Holding Bot. System 5 .13 o PUMP/ SIPHON INFORMATION Final Grade Manufacturer ~~GI ! Demand f] rr J,r ' , Model Number 1-2,-7 ?1.d ! GPM TDH LiftlO.S,) Friction) System ? 5 TDH.!q,(,Ft Loss CA Head Forcemain Length ' Dia. 2" Dist. To Well SOIL ABSORPTION SYSTEM B D TRENCH Width ~ ' Length No. Of Trenches PIT No. Of Pits Inside Dia. Licjuid Depth DIMENSIONS DIMENSIONS SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING( Manufactu INFORMATION Type Of CHAMBER', Model. Number: System:lnn,ov1.11 OR UNIT DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake , Length ~ Dia. 2u Length-]2--5- Dia. ~-l acing LI' I ~f v SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over x Depth Of xx Seeded/ Sodded xx Mulched Bed/ Trench Center Bed /Trench Edges toil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, e s k! LOCATION: T$OY 36.28.19.813,NE,NW 74 EAST AiDRIDGE DRIVEr I Si h! l o ? . liJ Ili re c. Cl l T11frd /0 V r. 4ao U n / f? Q hlpC- t/Old C /x/11 1 we l\ ,o r (feel 1 <~7c. Plan revisionrlequlred? ❑ Yes 0 No Use other side for additional information. ~7j 9~ j SBD-6710 (R.3/97) p1 d .Q( B ?t6W 'V j EI.7106 Date Inspect)r's Signature No. r ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ~ 4 SANITARY PERMIT APPLICATION 201eE. W and shingt nAve sion *Lconsin In accord with ILHR 83 05Wis. Adm. Code P.O. Box 7969 Department of Commerce , Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County Gl than 81n x 11 inches in size. i • See reverse side for instructions for completing this application State Sanitary Permit Number 29glgg The information you provide may be used by other government agency programs E] Check if revision to previous application (Privacy Law, s. 15.04 (1) (11 State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION 417& 1 q el- 6 Prope,rty-pwner Name P open ocation /1 l r G ~,tyt,~j J iy 1 i4 /1e) 1/4, S j T , N, R A E (or) W l Property Owner's Mailing Addre s r Lot Number Block Number City, aVe Zip Code Phone Number Subdivision Name r CS MINI u er II. TYPE F BUILDING: (check one) ❑ State Owned ❑ City Nearest Road 1-1 Public 1 or 2 Family Dwelling- No. of bedrooms To age own OF III. BUILDING USE: (If building type is'public, check all that apply) Parcel Tax Number(s)) 1 ❑ Apartment/ Condo 1e5 l J 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. ,~Q New 2. ❑ Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair 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 J.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) Elevation 5 1 _3 7 3 7 cJ 9,-~4eet J, Feet VII. TANK Capacity gallons Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New Existin structed Tanks Tanks Septic Tank or Holding Tank ©L°~ / ~°S L°.''~ ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber O ❑ ❑ ❑ ❑ ❑ 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 ignature: o Stamp - MP/MPRSW No.: Business Phone Number: L, G e , 7, _ _3 ?acs Plumber' ddress (Street, St e, Zip de): IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing Agent Signature (No Stamps) ~ Approved ❑ Owner Given Initial 20 " j~ Surcharge Fee) Adverse Determination llIZ-4-971 X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: I+ 44VUO*- -4 1, Co hop iv" Wv'r4 w+e. l~,e,• l""" -i 4e At.- iks Awl4t -1h v-f- ' 4^'R N` / "uj4M -j Ir ~1 ~Z ~ Fyw~ to M.'(Q~MArt 4-i t~.. 44 7 S / llw ! ✓ SBD-6398 (R.11/96) DISTBIBU N: Original to County. One co o: Safety & Buildings Division, Owner, Vlu r -~4 t+vse•~' 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, 608-266-3151. 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 or 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 1 through 7 VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County / Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contaminatior;. investigations and establishment of standards. 4 SAFETY & BUILDINGS DIVISION 401 Pilot Court, Suite C isconsin Waukesha, WI 53188 Department of Commerce Tommy G. Thompson, Governor William J. McCoshen, Secretary November 25, 1997 WEGERER SOIL TESTING & DESIGN SERVICES GARY SHURTLEFF P.O. BOX 74 P.O. BOX 476 421 N. MAIN ST. RIVER FALLS, WI 54022 RIVER FALLS WI 540225 Plan ID 9761946 NE,NW,36, 28, 19W Municipality of TROY Inspector: County County of ST. CROIX Private Sewage plans including the following element(s): MOUND 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. 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. Inquiries should be directed to me at the telephone number listed below. Please refer to Plan ID number listed at the top of this page when making an inquiry or submitting additional information. Sincerely, )6~74__ JULIA A. LEWIS POWTS Plan Reviewer (414) 548-8638 SBD-5524-WAK (R.12196) i Page of 6 MOUND SYSTEM FOR A I BEDROOM RESIDENCE LOCATED IN THE NF 1/4 OF THE Nw 1/4 OF SECTION 36 T 2$ N, R 1q W, TOWN OF c UL)( 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 P.O.W.T.S. .PAGE 5 of 6 PUMPING CHAMBER PAGE 6 of 6 PUMP PEUORMANCE CURVE Conditionally Av4Ac4Jn sx /~rrlJ SraF ~asMJ✓ ri ..+lv rr ~..y~ .+i✓c r- 5 b -p r% VEAL AENT OF G0N4 ERCE PREPARED FOR SAFETY A~ BUILDINGS ONDE~iCE lp. o. Box y.-) 6 = R[ uE1Z FlkL, S, W ) 5 C1 Z 1 RECEIVED N O V 19 1997 PREPARED BY SAFETY & b,,.:. L..'!1 WEC EEZER SO I L TEST I NG AND. I>EE3 I CPi SERW ICE ®~~qt NS ® ~~SC O P.O. BOt 74 421 K. KAIK ST. •ti ~i~j RIVET FALLS. VI 54022 7I5-42`,-0165 2 WECE ER = 4915 P • ELLSWORTN, L Wis. Id f•••.n.• ^t~ Ao'°~e fNU ~ 1 1-ll.q~ JOB NO. g _ 3 y PLOT PLAN - . Page Z, of 6 Scale 1"= t4p ' t S"S- ao"r~Uv~1 eut'1~~ of @~ t3,•,~,-~L lclll.p' o~v t Dtq, fit. °~8. Ss ~n.oN pt~e %n - t •2' ON ~D1 OF 'tC't-'~PaORl~ Pl1A . Ql A PP~41c • U~ eLot-1 0 ,Q a S.Y `o~ 3ti Ol'l ~L~,rt kyP~e v~vG vc\c t emu. ~ 3 ~ pr !9 0 0,u°- ~ o \ ~R °l S - O _ x.96 Y ~ 3ti ~ ~ a,` nq.~i bJ Zoo, tiS ' S M ~w. DO UOT r~►-t aR-cr nCz DiS~'(ZQ S ft R~9 tUSJIOC,l_. ►veL l. w 0Z !V1oUSt_ _pp\_~ pf r_Lt"T sc~ --(3 F 'tom rvoVp_~ tZT UA1F 'tv TaU[IUIt1e, V1 1cv• -Z Z' - ~ c S q-7, I -7 NOTES: •1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. ( V required) 3. Install 4" observation pipes with approved caps. ( Z required) 4. -Septic tank to be tibpu /60o gallon capacity manufactured by ~Av l N 5 eS C.t~Xl C RUZM C~1Z n~ V ~1`~ - t-vL P CT- l6OD 5. Bench Marks S "Out 6. Divert surface water around system to. prevent.ponding at the uphill side. Page Of l~ Approved Synthetic Covering rrs-r" c.33 Distribution Pipe Medium Sand H _ G Topsoil F Elev. 48.55 3 E u b 3 % Slope Bed Of 2- 2 Force Mbin Plowed Aggregate From Pump Layer D 1.0 Ft. E Ft. Cross Section Of A Mound System Using F o.`d Ft. A Bed For The Absorption Area G I- o Ft. A 8 Ft. H 1.5 Ft. Linear Loading Rate=00- GPD/LN FT B Ft. Design Loading Rate= •y GPD/SQ FT j l~ Ft. J 8 Ft. K ~O Ft. L 61 Ft. W 3 Z. Ft. L Observation Pipe 8 K A I - - - I•----- Force Main Distribution Bed Of 2M- 2 2 Pipe Aggregate I Observation Pipe Permanent Markers (Anchor securely) Plan View Of Mound Using A Bed For The Absorption Area Page Of 6 Perforated Pipe Detoil End View ~ )Perforated End CoD] PVC Pipe Install permanent marker at end of each lateral rn Holes Located On Bottom, Are Equally Spaced Q S PVC Force Main i P PVC Manifold Pipe Distri ution Pipe Lost Hole Should Be I Next To End Cop End Cop i P z..Z.. S Ft. Distribution Pipe Layout S 4 Ft. X 3 4 Inches Y _-a6 Inches Hole Diameter y Inch Lateral Inch(es) Manifold Z- Inches Force Main " Z Inches # of holes/pipe $ Invert Elevation of Laterals 91.658. Place 1st hole l8rfrom center of manifold with succeeding holes at 3(," intervals. Last hole to be next to the end cap. Combination Sept;ic;Tank and PUMP CHAMBER CROSS SECTION. ARID SPECIFICATIOKIS ' PAGE S OF C~ VEIJT CAP WEATHER PROOF JUiJCTIOU box 4'c.Z. VENT PIPC APPROVED LOCKING lO' FROM ODOR. MAWHOLE COYER avCM •"iINDOW OR FRESH ~ wARN1WG t.P.6EL.. A~IWTAKE cosap~tr 6~IMPOQ . N .i I 'i' 1.111J. 6 S f r'w' I I6'MIAI. 16"Mltil. y~11~3~~llon~ PIPt PROVIDE I II.1L ET 'AIRTIGHT SEAL I I11 I (I APPROVED JOIAIT: APPROVED JOIAI7 I III W/C.I. PIPE" Kpvc W/C.I. PIPEaR Tank construction I it ALARM shall comply with - I 11 ILHIR ('13.15 and 33.20 !s I I ow C I I 86-6~ I CLEY F'C PUMP OFF D COAICRETE BLOCK fit, 86.00' 3" APPRove. RISER EXIT PERMITTED OWLy IF TAWK MAIJUFACTURE R HAS SUCH APPROVAL BEDDIN4 SPECIFICATIOUS SEPTIC f w`~•T- ~b~n DOSE MAIJUFACTURCR:~" ~uC n os WIJMbER OF DOSES: 3'65 PER DAy TA KI K5 TAWK 51ZC \DdD 60d GALLOWS DOSE VOLUME z S_5'. EtF~RO S`1SfTE}'IS )MCI-UDIIJG OACKFLOW: t'Ys GALLOWS ALARM MANUFACTURER: MODEL WLJtABCR: O W CAPACITIES: A= I $ INCHES OR 30~' O GALLOU5 SWITCH TUPE: CU B= Z IUCHES`OR 33 7 G( LLOUS PUMP MAiIUFACT LIKE R: Z~~ CV>v1 C= O INCHES OR t33•~ GALLOWS MODEL WUMBER: 48 D- S INCHES OR X33 GALLOWS OZ_p SWITCH TYPE: eU1ZY IJOTE: PUMP AMD ALARM AARE TO 6E MIKIIMUM DISCHARGE RATE GPM IAI5TALLED OW 5EPARAT1 CIRCUITS 3~- 1/ERTICAL DIFFERENCE DETWELLI PUMP OFF A1JO.D15TRIBUTIOW PIPE.. \Z-• 3Y' FEET + mimIMUM METWORK SUPPLY PRESSURE , , . . . . . . - 2•SO FEET + 65 FEET OF FORCE MAIM X Z'-)Y FYofr.FKICTIOU FACTOR. FEET TOTAL DtIIJAM1C, HEAD = I e66 FEET DIAMETER Pump chamber ILITERLIAL DIMLW510W~ OF TAUK: LEkI&TH ;WIDTH ;LIQUID DEPTH BOTTOM AREA - 231= - GAL/INCH AS PER MANUFACTURER = 16.72 GAL/INCH pf~G'F- 6 0~ 6 3 7/8 6 1/4 W' HEAD CAPACITY CURVE La MODEL "98" 4 5/8 o 8 g 25 3 5/8 v 6 ® - - ~ ~6 66 O 4 15 4 3/16 0 10 2 3~-yy 5 1 112-11 1/2 NPT 0 . U.S. GALLONS 10 20 30 40 50 60 70 80 LITERS 80 160 240 0 FLOW PER MINUTE ; TOTAL DYNAMIC HEADIFLOW PER MINUTE EFFLUENT AND DE WATERING CAPACITY 12 HEAD UNITSfMIN FEET METERS GALS LTRS 5 1.52 72 273 10 3.05 61 .231 15 4.57 45 170 4 3/16 20 6.10 25 95 Lock Valve 23' SK1102 CONSULT FACTORY FOR SPV= AL APPLICATIONS • Electrical alternators, for duplex systems, are available and a//riable level float switches are available for controlling single supplied with an alarm. /and three phase systems. • Mechanical alternators, for duplex systems, are available with ; Double piggyback variable level float switches are available or without alarm switches. for variable level long cycle controls. SELECTION GUIDE 1. Integral float operated 2 pole mechanical switch, no external control required. Standard all models - Weight 39 lbs. - P. 2. Single picgyback variable leve' float switch or dcuble piggyback variable level, 98 Series Control Selec ' n float switch. Refer to FM0477. Model Volts-Ph Mode Amps Simplex qU x 3. Mechanical alternator 10-0072 or 10-0075. M98 115 1 Auto 9.4 1 or 1 & 7 - 4. See FM0712, for correct model of Electrical Alternator, E-Pak. N98 115 1 Non 9.4 2 or 2 & 6 3 or 4 & 5 5. Control switch 10-0225 used as a control activator, specify duplex (3) or (4) float system. D98 230 1 Auto 4.7 1 or 1 & 7 - 6. Four (4) hole J-Pak, junction box, for watertight connection or wired in E98 230 1 Non 4.7 2 or 2 & 6 , 3 or 4 & 5 ' §imptex or duplex operation, 10-0002. 7. T%4o,(2) hole J-Pak, for watertight connection or splice. CAUTION ForinfomotiononaddibonalZoellerpmductsrefer tocatalog onCombination Starter,FM0514;Piggyback All installation of controls. protection devices and wiring should be done by a qualified VanableLevel Switches, FMO477;Electrical Altemalor,FM0486;Mechanical Alternator, FM0495;Sump/ licensed electrician. All electrical and safety codes should be followed including the most Sewage Basins, 1`11010487; and Single Phase Simplex Pump Control/Alarm Systems, FM0732. 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. MAIL TO: P.O. BOX 16347 Louisville, KY 40256-0347 Manufacturersof. . O SHIP TO 3649 Cane Run Road Louisville, KY 40211-1961 Quaurr Puwas fA',CF 19,79 PUMP ZY (502) 778.2731.1(800) 928-PUMP FAX(502)774-624 NOV-25-97 TUE 11:12 AM NELSEN WEBER SURVEYING.M 1 715 425 6864 P.02 Combination Sept c;Tank and PUMP CLj&fA }ER CROSS SECTION A.UD SPECIFICATIOMS ' PAGE S OF ~a • -VET CAP WfATHEK PROOF JuwcTloU 150n y`Cj, VENT PIPE APPROVED LOCKIFJG 10' rROM QOO1t,. tooWHOLC COVER P01V 4 tvJK4Lf.>tWG L..E+~9E.1. -,ilu00W OR FRE:5H S CO~sDut i AJAItJTAK£ 6 M~.>L - I y' MrW. i!-C c. b S r°M'"' "raw' f 16 AIR. 16'nlm. y~~I1JSVtdlon7 PI{ PROVIDE I►JLE T ~ A!RTt6NT SEAL. I I C I ~ ~34~~L~S A I I ~ ~ APPRDYEO JOINTS APPROVED JotrJT I I I I W/C•I. PIPC,~ftp'c W/C.T• PIPEoR Tank construction ~ II ALARM shall comply with 'I II ILHR 6)3.15 and 83.20 o I + _ I { vu C ! 8b 6~ LLLV. FT. PUMP- -`J ~ OFF 0 GOuCRErf 86.00 ' 6LOCK w~~3" ADP►Za►F; RISEK EXIT PE,RMITKD QIJLy IF TAIJK MAMUFACTURE~R HAS SUCH APPROVAL gEQgIN4 SEPTIC, E 5PECIFICATI0QS w`T- 1b~c► D05E 1y~1`S CptUCjZI T~Rp`yac7 S WUMBER OF DOSES: 3' 65 _P~K DAy YhNK MA►1UFACTURER; TAIJK tZ C: V Obi b 0 U CALLOW S DOSE VOLUME r b Sv ALARM MAIJUFACTUFLERn IIJC.LUDING 6At:xsL0W: 0%-LONS MODEL. IJUMDER: CAPACITIES; A= IUC14E5014. 31~~'O GALLOw5 SWITCH TyPC: III k~R.CuR~ B= INCMES"OR GpLLOM5 PUMP MAWUFAC-fUKCR: ^Z04j~LL*y cttJCMES OR 33.X? GALLOWS MODEL MUMMER: ti3'l - ON INCHES OR GALLOIJL T`D"t~1'ti i ro0 Z.. O 5W17C-H TYPE: ~ CUI~-Y MOTE: PUMP AMD ALARM ARE TO DC MIIJIMUM DISCHARGE RATE 3, yY GPM INSTALLED OW SEPARATE CIRCUITS YCKTICAEr DIFFERENCE DETWCEU PUMP OFf A1J0-015T1Z{$UTIOIJ PtPE.. \z. 3,& FELT + MIMIMUM NETWORK SUPPLY PRESSUR~E/. , . . . . . -1 _So FEET + 65 FEET OF FORCE MAIN Y, Z'2Y F/oarYFKICTION FACTOR.. 1. -1$ PECT ..r TOTAL DBWAMIC HEAD = 1 e.66 FEET Pump chamber DIAMETER 3btl 11JT>F.R1JAt. 0{MEW51pAl~i OF TA►JK: I`1~A1Cr7H-.WIDTH ._._~.;LIQU10 DEPTH BOTTOM AREA r 231= _ GAL/SNCEI AS PER MANUFACTURER - GAIL/INCU ,NOV-25-97 TUE 11:12 AM NELSEN WEBER SURVEYING,M 1 715 425 6864 P.03 0 T-- --4 13/10 7 7/16 . I J N HFAD CAPACITY CURVE MODELS 1371139 a +/e MODELS 137/139 Ft. Meters Gal. Ltrs. 5 1-52 93 352 • ~/1 S ° z 10 3.05 79 299 0 15 4.57 54 242 e~ 0 20 8.10 36 136 1 11f 11 1/7 NPT 8 30 f16 bb . - gck 137,139 10 26 ft . 144 s 1 t} U.s- GALLONS to Z 30 •o so e0 70 00 90 100 110 T~ URRS I go ISO Z~q 320 400 14 o FLow PER MINUTE 40ri _J_~u H7077, 008827 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Three phase pumps are available in 200/208V, 230V or 460V. • Va6able level control switches are available for controlling single and three • iteclrical alternators, for duplex systems, are available and supplied with phase systems. an alarm. • Double piggyback variable level float switches are available for variable * Mechanical atemators, for duplex systems, are available with or without level long cycle controls. alarm switches. • Over 130•F. (54°C.) special quotation required. • Combination slavers are available for 3 phase pumps- • Refer to FMO806 for 200° F. applications- • Control alarm systems are available for 1 phase pumps. 137 Series • 47 ft. 139 Series, 51 lbs. SELECTION GUIDE Single seal Control Sdecdon Listings 1. Integral float operated 2 pole mechanical switch, no externs) control required. Model volts-Ph Mode Am Simplex D es CSA UL 2 Single variable level 8001 switch or double piggyback piggyback variable level 11371139 ? 15 1 Non 10.7 2 or 2 & 7 3 or $ & 6 Y Y float switch. Refer to FM0447. BN137 115 I Auto 10,7 Y v 3. Mechanical alternator M-Pak 10-0072 or 10.0075. Refer to FMD495 01371139 230 1 Auto 5.9 1 or t & 9 Y v 4 Combination Starter, fiefer to FM0514, 2 E137r139 270 1 Nutt 5.8 012 & 7 3015&6 V Y • H1371139 200-208 1 Auto 6.2 1&0 rN N 5- See FM0712 for correct model of Electrical Alterrtalor E-Pak, 1137/139 200.208 1 Non 62 247 3 or 5 & 6 N 6. Variable level control switch 10-0225 used as a control aellvalor, Specify duplex ' J1371139 200208 3 Non 2.6 2&4 3&d or 5&6 Y (3) or (4} Moat system. F13/1139 230 3 Non 2.8 2& a 344 015&6 Y G137 400 3 Non to 2$4 3&4 or 5&8 N 7, Four (4,1 holeJ•Pa':,jun0onbox,forwatertight connection forhardwired simplex G139 4113 3 Non t.4 2& 4 3&4 or 5&8 N operation, 10-0002_ • No molded plug •'Sirlgle 099Mck switch lncluded_ 8. Two (2) hole J-Pak, for Watertight hardwired PGonneetipn or splice, 10-DD03. Pumps must be operated In upright position. CAUTION Throe phase units require a oonlyd switch to operate an ememal magnetic or combination starer- All installation of controls, protection devices and wiring should be done by For information on addoonat Zoeller products refer to catalog on Combination alarter, FMO514; a qualified licensed electrician- All electrical and safety codes should be Po o ckVariabfeWeiFloatSwad,os,FMo4n_HealicalAAemator.FM04W,MechaMoarAllema- followed including the most recent National Electric Code (NEC) and the for. FM0495: Alarm Padwge, FMO732: and Sump/Sewage Basins, FM0487. 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. JIWL TO. R0, BOX 10347 lgrls 4fle, KY 40256.0347 14ranufacturelso/, . SHIP TC: 36d9 Cane pun Road pq~7 Louisn7la,KYdOZrt-ig51 gl ~(q(/YYPWO9~NCE ~i/iJJ e • f'!/MP CO_ (502)77d-Z731 17 (®00/ 828,PUMP FAX(S02)774.3624 Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page --I of 3 Labor and Human Relations Divisior', of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY c,ZUU( '5r. Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but PARCEL I.D. # not limited to vertical and horizontal reference pant (13M), direction and % of slope, scale or dimensioned, north arrow, and location and distance to nearest road. o 4(3 - \l88 -.9 0 - 01%j APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REV DBY DATE PROPERTYOWNER: ~ZtC* 1tR-D 1=oX PROPERTY LOCATION Gr~Z~( SttvvLTt_ f= GevF-Lff t`'E 1/4~w 1/4,S36 T Z% N,R 1q E(oil PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # p _ o. 3ux y,7 t, -t y - ot~1n` ~ D 6E AcP.~'s CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE MOWN NEAREST ROAD ~clulslZl S,WI S~Cri (its) P_o woovWD6E 1>9- 097' New Construction Use [ Residential / Number of bedrooms 3 [ I Addikn to existing building j ] Replacement [ I Public or commercial describe Code derived daily flow SD gpd Recommended design loading rate ~_bed, gpolft2 , trench, gpdAl Absorption area required 3Z S bed, ft2 3Z5 trench, 1112 Maximum design loading rate 5 bed, gpd$ • b _trench, gVW Recommended infiltration surface elevation(s) Q `a • 55 It (as referred to site plan benchmark) Additional design / site considerations t ~tov~.~p w / 8'x 4Y Z lD , -I". I ' Or- Sfr b 90- Parent material Flood plain elevation, if applicable ti' • ft S = Suitable for system CONVENTIONAL MOUND IN GROUND PRESSURE AT GRADE SYSTEM IN FILL HOLDING TANK U=Unsutable fors stem ❑S ®U ®S ❑U [IS IOU EIS IMU ❑S ®U [IS OU SOIL DESCRIPTION REPORT 14. " G►ZfY~~ \,#WSUtttt•8t_jr tut ?o 1 t r1 IT%ft ftl^ , Depth Dominant Color Mottles Texture Structure Consistence Bardary Roots GPD/ft Boring # Horizon in Munsell Qu. Sz. Cont. Cola' Gr. Sz. Sh. Bed ranch 1 0-9 ~o`-t2 zlZ - si\ ZMS a~Sl) c5 - - S `12 2 2 - S 1 Z `FS b12 m `Fv' C_ N 1 ~s~k wt cg - .z . 3 Ground 3 3b-So l0`~1Z j! 6 - si elev. ELITI72t 4 Su-68 10`118 y13 eZ-S~rR S~8 sL t:,) oln yrt'~ N.P• • Z Depth to limiting factor 50" Remarks: Boring # _ o_Zq to3 12 zIZ si Zms~k vq-' ' ek-) . S 3 z Zq-sl. to ~ li 313 - s l 1 Z'Fs~tz - 3 SI-63 110`114 31L cZ-S`t2.S1fi S~C-1 OV-.) 4vt'~{. - '2 Ground ' 0 elev. LLI16`-fL c~ 3-" Depth t0 limiting factor Remarks: CST Name:-Please Print Phone: 715 -4 2 5 -0 Z 15Z Arthur L. We erer egerer S0'1 Testing & Design Service-P.O. Box 74 River Fa11s,WI 5- y Signature: / Date: CST Number: ~[_i-e z_ 97-1~7 - M00576 g~.r-.tom ~ • PROPERTY OWNER Sl-tyRTQE~F SOIL DESCRIPTION REPORT Page of PARCEL I.D.# 0 ~LO-l~88- `1(0-01y Boring # Horizon Depth Dominant Color Mottles Texture Structure GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Consistence Boundary Roots Bed Trerxh 3 0-16 10`-[2 zlz - si ZM S~1t MP' , acv - -S . 6 Ground 3 ZS-1-1 Lo Ii y!y - s; s bh rn'PI- cg - z. . Z elev C.. 9 5 ft. 4 -q9 10X12 31 Y • S `i 2 SIB S t O h1 ~1- - x, • P.: . -t Depth to limiting factor Remarks: Boring # Sly 2-h1 abk Cw 4 2 z6 36 ~`tR- 31y - sl 1 z~~~~ m'FI- z° S _ .g ~ Ground 3 3l -14 1 1 It 12- 31` - S~ SbYt Vw'F~- cs - • 2 1.3 eele ft Lf It8-6I, Lo1-1 cz- Y/ ct~.s~c~t sl,6 sl'Q- J ob,.N Z Depth to I limiting factory Remarks: Boring # I o-9 2 z lz - st l -Lyn Shh o,Q.sl~ ~S - s .6 IS Z 01 y l o`~ ~i z (2- 2 wt C 3 -Z'44 b L v 12- 31 ` - s i I 1 s~lz tin'~r S . Z 3 Ground ~l el ft. -sy lo`tR y13 -,.sti sL sJ$ Depth to limiting factor j tl 6" I Remarks: Boring # i 13, Ground ` elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) PLOT PLAN Page 3 of 3 SCALE 1"= Ll0' C4N1vvr1 L1.,an-ss Rti~` -pt. lcl~.p' av -2 1'Diq. evYTprq of @~SD ` ttu)•J P1Pe . '~hPq'OW~ PttA . Zoo' ~ F- LkwN ~ A'Pt'ROX • luutPi K,~„p s 8.Y DO (xz 31 Vk%,j3t.4;m t4 0 Z. f 0 x-96 4 \ -v I 3 ~ C3.1 tTt-9.'1 Z Zoo' ~ ~ vS ' S `M iN. Do UOT CA~"L1~h~-T oR DtSR►R.t3 '~t'1 s KR~I w ~VSk, Z'0 Q~ \ I L~3T 7'S'- F1ZOM~l y"J~U~D - 1.J~tl~ } SIN' 04 l-I 7 (715 ) 425-01 A5 - 1400576 CST CST Signature Date Signed Telephone No. # Attach complete site plan on RREVI paper not less than S 1/2 x 11 inches in size. Plan must include, but 7"• G2 q V( not limited to vertical and horizontal reference Point (B", direction and % of slope, scale or .D. # dimenAione d, north arrow, and location and distance to nearest road. ,APPLICANT DATE INFORMATION-PLEASE PRINT ALL INFORMATION DBY040-N138,90- E PROPERTY OWNER: lZ tCt{-}~2D x _LeT t/4 ~t 1/4,S 3 b T 3U~.t,~, ; [~p,~Z EELLAGE N PROPERTY OWNER'S MAILIN A DDRESS GeVT- N,R 1 `1 E o• aIIx ~SUBD.SM# PCODE HONE NUMBER ~jfOWN NEAREST ROAD w New Construction Use ()9 . Residential / Number of bedrooms 3 oop ~ p~ DR t't~3T ~ l ] Replacement f 1 Public or commercial describe (1 Ate" to e*ting building Code derived daily Bow `l. Sp gpd . Recommended design loading rate-~--t>ed Absorption area required 3Z S bed, ft2 31. $ trench, g •9P~ trench, gpolft2 Recommended infiltration surface elevation(s) Q ti3 , SS Ma>arrlum design loading rate • 5 bed, gp~2 .6 trench, 9P~ Additional design / site considerations ~IOV It (as referred to site plan benchmark) 8 k u M) AI , J' Q>= S'frt%.t ►=a LL, , Parent material Flood plain elevation, if applicable ti- 1, It S = Suitable for system coNVENTIONAI STEM U = Unsuitable for stem C) S ®U ® MOUND ❑ U ❑ SOUND PRESSURE ATGRADE SyI S IN ~ U S ®U S U a tNG TANK rl-T G R. SOIL DESCRIPTION REPORT I-~~" I tT b~ vtTrt-Bt~ Eu ~U De th Dominant Color Boring # Horizon in Mottles Texture Structure Munsell Qu. Sz. Cont Color Consistence, GPD/ft Gr. Sz. Sh. BwxbY Roots 1 ) o- 9 o 2 z I z - s i l Z+n s e Ck S c Bed ret>ct' Lt2 Ztz - si Z`Fs~k w, ~ Ground -1 36-so 1pylZ 3!6 _ st 1 (22-3 - •S elev. I ~k fit- cg _ , z 'P-tt 4 so-66 1o`iR y13 e-~,.SvQ sfa SI c, ° Depth to - N . P. ; • L limiting factor Spy - Remarks: Boring # Z ~ ~9-SI- to IZ 313 sl I Z'Fs>~ cs .S `I 31L c 1 round 3 SI-63 10 -skip-sits J o h, ev. 116`-ft th 10 ng S1" Remarks: T Name:-Please Print Arthur L. We erer Phone: ress: 715-425-0165 e$erer Soil Testing & Design Service-P•0• Box 74 River Falls,WI 54022 mature q-)- t-1 Date, _c) CST Number: 7 M00576 B~t~`tt ~ - • , PROPERTYOV4KR S RT-`r-F SOIL DESCRIPTION REPORT Page? of PARCEL I.D.#r 0'4 0-~kb8- 010-014 Boring # Horizon Depth Dominant Color Mottles Texture Structure GPD/ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Consistence Boundary Roots Bed Tnerdi 3 0-1b lp 2 7-11 - si Z.n~ S~1t m`~h ~v - • S IL 3 13 - g ' Z. ~S ~1r h1 GS • S , 1. Ground nd 3 ZS-1-1 1(31111R y!y s i J s bh 'f'1- cs - Z. . 3 `l5i ft. IOI1IZ 31Y C`1•S`t2S~8 Slc~ O h1~►- ~•P. . Z Depth to limiting factor , Remarks: Boring # 2-M Avt m'~►. t w ' y 2 Z6 3b lo`t~Z aty - st) Z..~~b>< w►'~I- ~s - -5 Ground 3 31-~ g lo`s IZ 3 f ` - Sri f ~-Sbh ~'F►- cs - - 2 .3 Ile It. ~g-66 Lo~tcz; yl Cl,. 11Q Sit ale. OV, yrr `F- - N•~. _ Z Depth to limiting factory [7T j F Remarks: Boring # 1 0-9 to~2 z lz - 5t: I ZM Shh o,Q.sh cg . s ~ , 6 El Z a-Zy Vts4%LZIZ - si 1 Z`-Stih S I .6 3 Zy-SF b v'10- 3) L s l C~ s~1z b'1'~Ir c S .-.2- Ground ~!6-sy l~~i (z Yl3 Sti R S lg si c.1 c~ y►1~t. - N•~. , 2 ell ft. Depth to limiting ' factor y6~ Remarks: Boring # \ i 13 I Ground i elev, ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) _ Page 3 of 3 . PLOT PLAN SCALE 1"= x-10' ccYVTrvr1 Lr1.,°L-).SS ZL Lc10.p' a~ erll~prt o~ %,fD'- tR007-5 t?l- SS r aJr _ rte. \o~-Z' 0" loP of 1 '~4~W~ PEA . • . -ioo' 6d F- - ~a1 A'PPQ.oK- l.nurTi ~„p z 8.y pp ~ ID'S Z g.3 ~ P 1-96V \ 3ti I V, L Do T.>oT C1r* L Phi T" n'R DtSR>RR 'ni'1 s KR.~I MOVE w V 'M Q ~ \ 1 . LZtvXY Z'S FId M M 4U)JD. . - C' -c. -7 (715 ) 4 9.5 - (17 5 14005 7 6 CST signature Date Signed Telephone No. CST # STC-105 ;EI TIC TANK MAINTENANCE AGREEMENT St Croix County OWNERBUYER/c~ fr',u- u _ MAILING ADDRESS 5 7- PROPERTY ADDRESS (location of septic system) Please obtain fro the Planning Dept. . CITY/STATE Z/ / z Z`r PROPERTY LOCATION ~r 1/4, _ 1/4, Section J N-R2 2-W TOWN OF V ST. CROIX COUNTY, WI rs LOT NUMBER SUBDIVISION o~o _ie e CERTIFIEDSURVEY MAP , VOLUME PAGE, LOT 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. r 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 condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, 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 ye p`ir tion date. SIGNED: v G DATE: :Z St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 8 T C - 100 This application form is to be completed in full~'and"8igned by the owner(s) of Llie prnnerty being developed. Any inadeguacirs will only re,;,,lt in :.Mays of the permit issuance. Should this devel ronmp -it be ix, L.ended for resale ",by . owner/contractor, (spec house), t_.nen a second form should be retained and completed when the propor*y is sold and submitted•1`to this office with the appropriate deed recording. ---w----------------------------------.ryF4.w--..ww-i r--_ n In Owner of property D4- A Location of property ~ 1/4le~ 1/4, Section Township Mailing address 717 7% Address of site subdivision name 14 Lot no. L~ Other homes on property? Yes No - 7- Previous owner of property a 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 /;Z 70 and Page Number _2--!5 as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWINGS A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE 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 Certified Survey description Map references to a Certified Survey Map, the shall also be required. PROPERTY OWNER CERTIFICATION e to the I (we) certify that all statementWeo amthis form are tru the best of my (our) knowledge that I (we) (are) the owner(s) virtue of f the of a property described in this information form, by warranty deed recorded t,:1,e, ce of the County Register of Deeds as Document No. ppl ' 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 V- construction of said system, and the same has been duly recorded i the office of the County Register of Deeds as Document Nr 17J- Sl ture of-Applic4jCft Co-Applicant /.,2 2 A-? Date of S gna ure Date of Signature WARRANIY M F P A DOCUMENT NO. pArr VOL li QE± IS rF-R'S OFFICE - RQ~ di g-Eiill~Dev~].Q~ -I_n~o p~ a_i<€ 1. aJ _ ~g CR 01 X C 0.. W I ► II _ - Recd for Record I~ - OCT 13 1997 II conce)'s anr.1 ~canams n, Daniel T Branigan and jcAnne t. 11' ---ranigans- ht-stad_ wife - - - - ' 4 ~ A - - ..o_~.... R trr.. of O.ed. _ . n+tS SPACE nFSFnvED cOn nECOnDING DATA NAME AND nFRMN ADnnEss - - - ;;t. 'e, Inc. the h~llo.ein descnled real estate in _ St. (YO1X County, j _ i'_3 • State of Wisconsin: 206 2nd St. 111 54014 i~ ii 040-1188-90 i' PARCFI iUENItr ICMI(,N NUMBEn---- 1 I Ii Lot 74, C)ak Ridge Acres in the Town of Troy, St. Croix County, Wisconsin. I' i !I 1 1-his is Pot homestead prol,erty I; (tc not) II Exception to warranties: Easements, restrictions and rights-of-way of record, if any. t ~i Datnf this 10th day of - OCtCber ^ D., I9-~?._. n ii n Hil Develo ` I rated (SEAL) ~ht (SEAL) r 14 e, rd Al, ii (SEAL) - - - (SEAL) AUTHENTICATION ACKNOW LEMMENT l State of Wisconsin, Signature(s) ~ ss j St. Croix County authenticated this day of - 19 rerv,nally came before me this day of oCtober IQ gZ-. the above named - b0Uinc-Hills.-Developuieat,-IncQrpora_ted_ I I IlE: MEMBER STATE [)AR OP W'ISCJNSIN (If no, amlimized by §KW06, Wis. Stats.) ft- .t.~ *ar. kno,cn to he the hclst^n ssho esecua•d the (ores' fig jl s ~ t4OTAqY r .>t n MIS nt and ackno~.,iedKr the ne • 1S RJStRUMFTtI WAS pfiAF1ED BY 14 `c 1'Y• 1 L PVLA 1.-t -Attorney .lSristina-Q~land 71 r - Virginia R. Gartman - __Hudson._1r1L_54Qt6---------- ~'~:~,rti• rllhh.. St,_ Croix _ - r„Irl~t~•. was