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HomeMy WebLinkAbout006-1003-10-040St. Croix County Zoning Detail Sanitary Information Monday, January 03, 2005 at 3:15:34 PM Page I of 1 Computer #: 006-1003-10-040 Sub/Plat: NA Section: 2 Parcel #: 02.31.16.17A30 Lot: 2 TN/RNG: T31N R16W Municipality: Cylon, Town of CSM: Vol. 17 Pg. 4606 1/4 1/4: NE 1/4 NE 1/4 Owner: Ninke, Mike 2390 250th Street Deer Park, WI 54007 State Permit: 430419 Issued: 10/07/2003 POWTS Dispersal: Non-Pressurized In-ground Permit: New County Permit: 0 Installed: 10/23/2003 POWTS Detail: Bio Diffuser (11") (PSA) Bedrooms: 4 WI Fund: POWTS Pretreatment: Unknown Notes Insaector As Built Plumber Other Requirements \ Additional Notes Money Owed Emily Lund (contra NA Bird, Byron Jr. check to see if this is part of a civil suit being This is part of a 4-lot CSM in the NE/NE 1/4 of $0.00 Signed Off: Yes brought against Mike Ninke by DNR for Sec. 2 that has not yet been assigned parcel violation of a hunting access easement umbers. System was conventional, but must esignate area below primary for replacement due ~ -..., t adjacent wetland to west of system/house. ~e<.,. Maintenance Scheduled Pump Date Pumaed 1st Notification 2nd Notification ~ 'fication 10/23/2006 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division ' INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 'ermit Holder's Name: City Village X Township Ninke, Mike C Ion Townshi SST BM Elev: Insp. BM Elev: BM Description: 1bU < I~' IeU > ~ ~ a-tl t wh.1~l~ r. _ v' frv TANK INFORMATION ELEVATION DATA r)rV~ TYPE MANUFACTURER CAPACITY Septic .~ i Dosing Aeration / l , j~- U HoldingHolding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Se tic p 0 ~ ~ ~b j ~ / I I •-~ ~ Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Numb ~~ I' TDH Lift Fr 'on Loss System He TDH Ft Force in Le i~ / Dia. y~ . to Well SOIL ABSORPTION SYSTEM County: St. CrDIX Sanitary Permit No: 430419 0 State Plan ID No: ParcelTax N _ 00 -1003- SectionlTown/Range 02.31.16. ,f~ (e'.E~k~' STATION BS HI FS ELEV. Benchmark ~ ~~ D c' 7c D U • b Alt. BM /~ tv IGI F d i L S.-7 C7 ~J 7, D Bldg: ewer StlHt Inlet SbHt Outlet ~~~ Dt Inlet / Dt Bottom Header/Man. • 5~ ~1 3 Dist. Pipe u~r 3•SL~ Bot. System wed- eves ~~ ° i •(o(o ,~~ Final Grade S,3D ~/7.yC) St Cover _ 4.50 , a-L~ 8ED/TRENCH DIMENSIONS Width ~ y Lengt~ ~ ~ No. Of Trenches - C~ I PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth f y c h~ i~l-tom SETBACK {NFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER OR Manufacturer: a ~ I b <~: Type Of System: p ,, 144.~~ ~~5nver~ ~~~ ~ ~ ? / / ..7 K' ~=U i / UNIT Model Number: DISTRIBUTION SYSTEM ~ Header/Manifold Distribution x Hole Size x Hole Spacing r Intake Vent to Ai Length ~ / Dia ~ „ ~e Length ~t! ~ Dia_ Spacing ! / ~1~ /~ ~ ( ~ '7 ~ / SOIL COVER x Pressure Svstems Only xx Mound Or At-Grade Svstems Onlv Depth Over Bed/Trench Center Depth Over Bedffrench Edges xx Depth of T xx Seeded/Sodded No xx Mulched f ~ ~.-^, o 3~ ~c- r COMMENTS: (Include code discrepencies, persons present,~~.) Inspection #1: j O /23 / ~~~ Z- Location: 2390 250th Street Deer Park, WI 54007 (NE 1/4]5' 1/4 2 T31 N R16W 40 acres Lot 2 Parcel No: 02.31.16. 1.) Alt BM Description = ~ ~~ ~ ~"'`~ u~~ ~ w v~~ ~ ~,~a~_ f~~`'~~ ~ ~' I~ ~~"G`~ !,/ 2J Bldg sewer length = ~jy ~ Cb~~ ~~~oNCI ~~ ~(,~.~~ (/1't s~ {'~fa1~~ ~.~C ~~~/VG -amount of cover = ~/ a ~~ ~ ~~Q~{idri o2 ~ ~ (f `~ / ~ ut,,, I.lek,r t ~ ~~ Plan r ision Required? j ]Yes jo ~ I I '7 ~ ` L ~J I ~j~ Use other side for additional information. 1. ~ ~ _~ l1__ _ __ ! ' ~~_ ..________~_. _ _______ i ~ 1 ~~ SBD-6710 (R.3/97) Date Insepctor's Signature ert. No. PLOT PLAN PROJECT Mike Nike ADDRESS 2374 250th st DeerPark W. 54007 NE 1 /q SE 1 /4S 2 /T 31 N/R~~ W TOWN CylOn co[1NTY ST. CROIX 9-30-03 BEDROOM 4 MFRS Byron Bird Jr. 2205 DATE CONVENTIONAL XXX -Grade ONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gal LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE fJ LOAD RATE •7 ABSORPTION AREA 842 # of chambers 28 ,, BENCHMARK V,R.P. Nail in white oak ASSUME ELEVATION 100° ^ BOREHOLE O WELL «g,R,p, Same as BM l L-aT Z., Z •-'Wiscoa9inDepartmentoflndustry, SOIL AND SITE EVALUATION REPORT Labor and Human Relations Division of Safety 8. Buildings ..,:_ . ~.- r._~_ 1 3 Page _ of _ COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size Plan must include but St . Croix , . not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION 1lichael TTinke GOVT. LOT T',TF 1/4 ~?F 1/4,S 2 T 31 ,N,R 1 ~, ~or) W PROPERTY OWNER':S MAILING ADDRESS 2374 250th. St. LOTT # n/a BLOCK # n/a SUBD. NA R CSM # n/ ~.~y-2 (~ (o rp CITY, STATE ZIP CODE PHONE NUMBER ^CITY ^VILLAGE MOWN NEAREST ROAD Clear Lake G7I. 54005 ( ) n/a. Cy]_on ?.50th. St. (~lew Construction Use ~} Residential / Number of bedrooms /_ . [ ]Addition to existing building [ ]Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate . 5 bed, gpd/ft2 .6 trench, gpd/ft2 Absorption area required 1200 bed, ft2 1000 trench, ft2 Maximum design loading rate . 5 bed, gpd/ft2 . h trench, gpd/ft2 Recommended infiltration surface elevation(s) 100.00 ft (as referred to site plan benchmark) Additional design /site considerations n/a Parent material pitted. oiztwasr. Flood plain elevation, if applicable n/a ft S =Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK u =Unsuitable for s stem ~S ^ u ~S ^ u fr~s ^ U ~S ^ U ^ S C~1 ^ S fa3dJ SOIL DESCRIPTION REPORT Boring # .................. ................. .................. ................. 1 Ground elev. 7.03 . S£t? Depth to limiting factor >5~3,. Boring # _ ?. €.. Ground elev. 103 . loft. Depth to limiting factor >84" Depth Dominant Color Mottles Texture Structure Consistence Boundar Roots GPD/ft Horizon in. Munsell Du. Sz. Cont. Color Gr. Sz. Sh. y Bed Trencft 1 0-8 10yr?_./2 none L. 2./m/sbl: mfr c/w 2/m .5 .h 2 P,-20 10yr4/4 none sl. 2/m/shk mfr g/w 1/m .5 .6 3 ?..0-32 7.5yr4/4 none stone 0/s~ mfr g/w n/a .5 .6 4 32-52 10yr4/6 none IaS. 0/sg mvfr f;/w n/a .7s .8 52-64 7.5yr1+/4 none Jo~ a /stone O s ml c s n a .7 .8 6 64-74 7.5yr5/4 none f_ S. 0/sg mvfr g/w na/ .5 .6 7 74-f'3 10yr5/4 none ,o. S. 0/s~; ml na/ n/a .7 .8 Remarks: 1 0-~ 10yr2/?. none L. 2./in/pr mfr c/s 2/m . 5 ' .6 ?, 6-36 7.5yr4/4 none Co.s. 0/sg rtl_ g/w 1/m .7 8 3 36-52 10yr5/6 none F S. 0/sg mvfr_ g/w n/a .5 ~.6 4 57,-54 10yr5/4 none o. S 9 ~ n/a n/a .7 ~.8 .~ `f~ c"~G o~ ~o ~., y r Remarks: ~'`~~ ~ ~~' CST Name:-Please Print ~~~~. one: Oar L. sTeel - Address: ~ ' 1 200 - T , ,tT Signature., ,~='~ ~~ 6-!}-~~ Date: ?29T~Number: PROPERTY OWNER rtichael TTintce SOIL DESCRIPTION REPORT Page? •of` 3 PARCEL I.D. # Boring # .....;.; :y ``'~ 3 >,...:~_ Ground elev. 102 5~ ft. Depth to limiting factor g ,~ Boring # `<::.... `~~~~ L+ >w: Ground elev. 1oIlfnS Depth to limiting factor ~~ Boring # ;:4.;:::;::>;;;;: 5 Ground elev. 101.4 ft. Depth to limiting factor Boring # .................. Ground elev. ft. Depth to limiting factor Depth Dominant Color Mottles Text r Structure Consistence Bax~fa Roots GPD/ft Horizon in, Munsell Qu. Sz. Cunt Color u e Gr. Sz. Sh. ry Bed Trench 1. 0-7 10 r4 4 none scl ?. m shk mfi c w ?. m .L- .5 7-17 7./SyrL+/4 none co.s. 0/s~; mvf_r c/s 7./m .7 .f~ 3 17-26 10yr5/L~ none fS 0/sg, mvfr g/w 1/f .5 .6 4 26-L+fi 7.5yrLf/4 none ~ ~o~ 0/sg mfr b/w na/ .5 .E 5 La£t-5~ 7.5yr4/~ none FS. 0/sp mfr g/w n/a .5 .6 6 58-hid 7. SyrL+/L+ hone S. O, sp r~fr g/w na/ . 5 .6 7 h8-R8 lOyrL+/L+ none Co. S 0/sg ml na/ n/a .7 ~.F Ramarks~ 1 0-10 10yr7,/?. none L. 2/r~/shk mfr c/w 2./m .5 .h 2 10-29 l OyrL+/3 none sJ.. ?./m/shk mfr g/w 1/m .5 ~ .6 3 2.9-80 ( 7 5 r4L44 none ~_~1~ sp-shk r-vf_r n/a na/ .5 .6 stratified hroughout the +3-hori_ on Remarks: 1 0-10 10yr2./2 none L. ?,/m/pr mfr c/w ?../m .5 `:..6 2 10-21 10yrL+/4 none SL. ?./m/sbk mfr P/w 1/m .5 .6 3 .1-33 7.5yrL}/4 none o. . /stone 0/s, mfr /w /a .5 .h L+ 3-SL+ lOyrL+/h none ls. 0/.sp., mvfr n/a na/ .5 .6 Remarks: Remarks: SBD-8330(8.05/92) STEEL'S SOIL SEKVICE Gary L. Steel ~ . C.S.T. 2298 rtichael PTinke New Richmond, WI 54017 ~'` MPRSW-3254 PTE--',~ATF;';; S?.-T311~?-R16UI (715) 246-6200 yy7 town of Cylon ~ . ('~ ~.,. Le" /'' _5 o r ~~ m~~ ~ ~~ ,~~- ! z a ~-e~~ ~ s-}- k f0 4 1 ~~ 1 ~ h n ~ ' 2,2 ~ L ~~ 1` 13 ti '~ ~4~ ^~ h~ xl (3 ~ I~ ~~ ~~~ h~ ~ \~cw.~NCin 2715 Post Road Stevens Point, l~sconsin 54481 (715) 345-5334 ~scon Tommy G. Thompson, Governor Department of Commerce Brenda J. Blanchard, Secretary MEMORANDUM ~,.., DATE: 08/25/00 ~/`,.`,. 'A~ ~ ' ~ f ra: TO: POWTS Plan Reviewers i1~~ ~ y' ;`~~'~~~~ Wastewater Specialists :~~j ~, t ~ .; , ~~t~0 County Code Administrators ~~~ r_::..; ~- ~ -~~ Interested Parties ~ \. coy Tv ~~f pNtt~1GOFF4CE ; FROM: Roman A. Kaminski, Program n e~ ~ti 715/345-5334 -voice 715/345- ~ c~ rkaminski(a~commerce.wi.state.us - e-ma/ a~ ~, SUBJECT: Procedures for Evaluating Non-Uniform Soil Horizons s. Comm 83.44(4)(b), Wis. Adm. Code The new chapter Comm 83, Wis. Adm. Code, generally recognizes three feet of unsaturated soil as adequate for the absorptive treatment of septic tank effluent containing greater than 104 CFU/100m1 fecal coliform, and two feet as adequate for treating influents of less than 104 CFU/100m1 fecal cot'Iform. However, soil materials dominated by coarse sand and/or containing a large proportion of rock fragments larger than 2mm are recognized as having a diminished capacity to treat wastewater compared to soils composed of finer textured materials. To compensate for this lesser treatment capacity, Table 83.44-3 requires greater depths of these coarser materials to achieve the same treatment as the finer textured soils. Many coarse soils are not. uniformly compose different t xtures and (rock fragment content. horizons, strata, or layers of matenals having Table 83.44-3 cannot be directly applied to a stratified soil column, but its basic means of establishing a minimum depth of unsaturated soil required for effective treatment can be applied to each described layer. This is done by deriving a depth compensation factor from Table 83.44-3 for each described soil texture and applying it to the measured thickness of the individua4 layers in a stratified soil column. The compensation factors that are applied to the various coarse soil materials to determine the thickness for treatment equivalent to non-coarse soil are presented in a chart on page 2. Page 2 Soil Texture Multiply Layer Thickness By To Get Equivalent Non-Coarse Soil Thickness'-~ For: Very Coarse Sand or Coarser ti 0.30 0.40 Coarse Sand 0.60 & Loamy Coarse Sand 0.67 w/<35% ca. frags. Coarse Sand 0.30 & Loamy Coarse Sand 0.40 w/>35% to <60°lo ca. frags. Sand 1.00 1.00 Sand 0.30 w/>35°to to <60% ca. frags. 0.40 Influents >104 CFU/100m{ fecal coliform Influents <104 CFU/100m1 fecal coliform influents >104 CFU/100mt fecal coliform Influents <10' CFU/100m1 fecal coliform Influents >104 CFU/100m1 fecal coliform Influents <104 CFU/100m1 fecal co1'~form Influents >104 CFU/100m1 fecal coliform Influents <104 CFU/100m1 fecal coliform Influents >104 CFUl100m1 fecal coliform Influents <10"CFU/100m1 fecal coliform 1/ Determine total equivalency by adding up the equivalent thickness for the various coarse layers inn the profile. The minimum standard is 36" for influent >104 CFU/100m1 fecal coliform and 24 for influent <10 CFU/100m1 fecal coliform. 2/ Coarse sand soil texture dominated by particles between 1.0 and 2.0 mm. Exam le: 27" Very Coarse Sand X 0.30 = 8.1" of equivalent thickness for influent >104 CFUl100m1 fecal coC~form, or 27 Very Coarse Sand X 0.40 =10.8" of equivalent thickness for influent <104 CFU/100m1 fecal coliform. If you have any questions, please feel free to contact any wastewater specialist. Thanks! T ~J _ ~•~~&? e~.ssro g-2g -o 3739368 ~.•I " ' ' sr VOL » PAGE 4606 '~ ~ ~ :• • • ....... • • .-?~ ,~~ ~ RATHLfiEA H. MCA-' ._.._.__. , '>.;Up':~E'~ ` ..:•`'` REGISTER OF DEEDS ,~~~" ST CROIX CO MII CERTIFIED S U~~~I~.t,•'V E Y MAP- e9 09%2003GR04E0~0PM Loeatad in part of the Northea a Northeast Quarter Sectto . 2, Township 31 North, Range Weet, Town of Cyion, ro x oun y, Wlscons n. CERTIFIED SURVEY MAP REC FEE: 13g~00 A special exception use permit is required for thprFbcnEe3df dopes O~~red for and at the request of: 20R or greater not identified on the approved plot or §M. This permit Mk~hod D. NMk~ is applied for through the zoning office and is reviewed through o public 2374 250th Street hearing process by the St. Croix County Board of Adjustment. Oeer Park. wl 54007 WEST LINE OF 7NE UNPLA TTED LANDS Drof tad by. Howard H. HerrUd III N£1/4 OF IHE NE 1/4 - - - - - - - - - _,._„_,._.~~. N 00'24'21 W 663.00 .._ ~\~ 333.00' ~~~ 330.00' ,,~ ~~" ~~ ~ / x 9 ~ o -i `~ APPRC31~1E `~ ~ c s.^~. ~ C+ ~ ~ l I ST. C~OIY. COUN i I c7 p Planninn 7..~~. ,.,.t oyy~ C mate g ~.'D ~ I q NA u C ' D ~t ~rt o~c~ •• ~ SEP 0 9 2003 O • ~ cDu ~ ~ ~ 6 w ~rt N ~ ~` ~vJ ~ $ ~ g ~ ~ ~ If not reCGior~ w~:~;~n ;30 d s of~` ~ O C I~ -~ u to . K ~ approval date approval sh l be O ~ ~ ~ I I Q Os o c 4 4 ~ ~~ a~ ~ nullandvalrl ~v Z~ iCiC ~ ae o o ~ v ~ ~ ~ C~Z ~ SC ~ ~c a ~ ~~ ~ v "~' ~ ntn QRl ~ Il~iy ay o 7 3 e ~'ro ~ W ~6. v r~-1%O Z~O V I~I~ c ~ (A I 1 'C ~ ^.~ O O A, ''' ~ IV I ~ ~ l r 'M~ I o<no ~, s ~ iG ~ ie ~'c ~ ~ IC -'' I ~~ ODV ~ ~ I ~ I 0 o W ,~. rt I I~ N ~ I NN vN . O dZ I J Z Q ~ OD b D _ _ 'ma 9• ° °. 1,1 I~ .gyp 1 ~ p ~ p ~ ~ N '~ N~- a ~ •o :E IOIy ~ N~. ~~ ~ ~ o c~c O 4 3 -- o I oa~ N g ;~~0 ~ ~ +4 ~ S p0'24'S1" 330.p0 m ~ " A `~ I ~ ~ EDGE OF ~ I I /i ~ .. o I ..~ io r°i a IQ ~ 1 yyFTIANO W ~~ I , `y- • w a s l(r) N I v O - 1 N "~ Z ~ N. ---i- I N I ~,~ n ~ ~ ~O ~f~° ~ ~~ ~ 0D ' t ~m Q s a z ~ // ~ N jb ~1`-' ~~ ~~ ~*co OI h 3 w~~ Q w m> ,S00'24'07"E 267.00' ~ o as o f O n. N v ~ ~ ~ o \~ Z ~ ~ v O ~ X11 ~ ~ ~ ~ -., ~ '~ ~ 1 Oo ~ n to n cn "'~ ~ ~' I tom.. ~° 7l7 ~O ~ D \~ 1 s `~ ~ ~ u F oo ~ a' m ' m ' . 1~~ v ~ W W ~N N.+ O W ~~ fJ)~ ~. e O ~ o~ ~v ~ ° m ~ ~ o D D ~ N ~ WQ O ~Q ~D - ~„~ I ON .. -.m m ~,._ ...l ..................... ~ or ~ ~ ~ g ~i tw $o ~ / v is / `~o _ _ _ . v I _ 2_67.00'_ _ _~ .o ~ J 330.00' _ _ ~ °- i S 00'24'07" E 1908.43' iT 267.00' ` ~~~ 0 0' ~ ': ~ ~ ~~~_ ~•?511ttL~7R~ET S_0_0'24'07" E_ 663.0_0' ~soth st. 3~` EXIST 1/~ GARNER S 00'24'07" E 2901.43' ~ 3 NARTHEAST GARNER SEC. 2-31-16 (FOUND ALUM{/. A/QN. EAST ~/NE OF THE NE 1/4 ~C. ?-31-16 ~ (FOUND ALUM/. ,~faN) Q UNPLA TTED_LAIVOS BEARINGS ARE REFERENCED TO THE EAST UNE OF THE C Sheet 1 of 2 NE 1/4 OF SECTION 2. TONMSHIP 31 N., RANGE 16 W. WHICH IS ASSUMED TO BEAR 500~4'OTE. Vo1.17 Page 4606 Sanitary Permit Application Safety & Buildings Division ~~ ~ `~ In accord with Comm 83.21, Wis. Adm. Code See reverse side for instructions for completing this application 201 W. Washington Ave. PO Box 7302 seonsin WI 53707-7302 Madison Department of Commerce Personal information ou rovide ma be used for sewn u s Y p Y dary p rpo es [Privacy Law, s. 15.04(1)(m)] , (Submit Completed form to county if not state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size. County P ~ ~ O, State Sanitary Permit Number ^ Check if revision to previous application State Plan I. D. Number ~ O I. Application Information -Please Print all Informa on Location: s Property Owner Name ~ ~ Property L ~ n Z 2~ g D - Z~~~ ~ ~ ~- / ' ~ s'. .'. ~ ~ ~ 3 114 114, SpC~ 'f~ ,N, (o Property n is ailing Address Lot Nu be Block Number ./~ -~~ ~~ ~ '~ ~ C ~~ a Psi ~: Zi. ~ ~~CE ~ ~ • ~ ~ fI'GF'eS ,Sp I 1 City State ~ y Zip Code Phone Number Subdivision Name or CSM umbe ~ ~ ~ ~ C~ Gz~.'~ l ~'~~ (~/ ~~~ d l Oa6., aa.3 - D II. Type of Building: (check one) ~~ 1 or 2 Famil Dwellin - No of Bedrooms :~ ^ City ^ Village . y g . ,,~~~~ ^ Public/Commercia~l}(describe use):_ / / / d-" ~ own of y C ~ ~ ^ State-Owned 0` `Z)1"57 . ~~.S ~/ ~ 7 ~E:F.z~/w- 3 ~ ~ ~ ~ / " ~~ ~ (~. // ~ ~~ ~~ ~ /`° Nearest Roads O ~L ~I ~ < < Pazcel Tax Numbers (p66 _ ~Q~3 ~ III. Type of Permit: (Check only one box on line A. Check box on ine B if applicable) A) 1. ew 2. ^ Replacement 3. ^ Replacement of 4. 5. 6. D Addition to System System Tank Only Existing System B) Permit Number Date Issued ^ A Sanitary Permit was previously issued IV Type of POWT System: (Check all that apply) on-pressurized In-ground ^ Mound D Sand Filter ^ Constructed Wetland Pressurized In-ground ^ Holding Tank ^ Single Pass D Drip Line ^ At-grade ^ Aerobic Treatment Unit ~ Recirculating Other: ~ L~ ~l -: f ~~ ~~ ' ~%r~ ~ -> - user /~t ib ~~ V. DispersaUTreatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area Required 3. Dispersal Area Proposed p ~j 7~ ~ 4. Soil Application Rate (Gals./d s ft.) 5. Percolation Rate (Min./inch) 6. System Elevation ~ ~ r. ~ = ~,~ ~ 7. Final Grade Elev at ion ~j~ t~ b q /' / /!r ` f~ VII. Tank Capacity in Total # of Man turer Prefab Site 'Steel_ Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing Crete structed Tanks Tanks ~~. ~ c_ / t-t~L~ ~5 ^ ^ O ^ ^ ^ ^ ^ ^ VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumb is Name (print) ps): Plumb 'nature (no s ;~ MP/MPRS No. Business Phone Number _ is Address (Street, CityyyS.t~ate, Zip Code IX. Co nty/Department Use Only ' pproved ^ Disapproved ^ Owner Given Initial Adverse Sanitary Permit Fee (Includes Groundwater Surcharge Fee) ~d ~ ~~ ' Date Issued -7 ` ~ Iss ing gent Signature (No stamps) ~ ~~ Determination . a J 1' ~ v ~~ >i royal /Reasons for Disa royal: SiK~ ~ G~~ ~~ ~j~~PP /' PP 1 Septic tank, effluent filter and C~~YYI ' ~~ • SZ- ~ ~ ~~ ,~2 ~ dispersal cell must all be serviced /maintained ~~ as per management plan provided by plumber. ~ ~ GC S~~Yy-. 2. All setback requirements must be maintained ~ ,,, ry ~ ~ as per applicable code/ordinance e / s. SBD-6398 (R 07/00) w~--•-~~ ~• ~ I m NbT ,Gt-oo D t'~g-i.J fls.~A-,ems . d"h 6 ` PLOT PLAN PROJECT Mike Nimke ADDRESS 2374 250th st DeerPark ~. 54007 NE i/4 SE i/4S 2 /T 31 N/R 1 /(~ W TOWN CylOn COUNTY $T. CROIX r 9-30-03 BEDROOM 4 MPRS Byron Bird Jr. 2205 DATE CONVENTIONAL XXX A Grade ONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1260 gal LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE ~ LOAD RATE .7 ABSORPTION AREA 842 # of chambers 28 ,BENCHMARK V.R.P. Nail in white oak ASSUME ELEVATION 100° ^ BOREHOLE O WELL *g,g,p, Same aS BM .. Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT P,~~; , . Page ~ of m acavraanae wiur wmm aa, vns. rwm. was minty ,[ ~ Gro Attach complete site plan on paper not less than 81/2 x 11 inches in size Plan must / / ~ . include, twt not limited to: vertical and horizontal reference point (BM), direction and t l l di i p~ I,p, ~~ _ „r `~~ ~t ~lnvr. percen s ope, sca e or mens ons, north arrow, and location and distance to nearest road. Please print all information. eviewed Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~ Q Property Owner ~ ~ a ~~- . ~,-~ ... ~_ + ~ropertyLocation / ~ ~ H Govt. Lot 114 14 S T N R~ E( W Property Owner's Mailing Address ~ ;~ ~~~~~~ a yot # Bock # CSM# s ~ ~ 3~ 3 ~' , y. ~ ~ City State ~ Zip Code Phone Number City ^ Village Town Nearest Road ew Construction Use~Residential / Number of bedrooms Code derived design flow rate ~B---a GPD ^ Replacement ^ Public or commeraal - escribe: Parent material ~i!>'~c /Flood Plain elevation if applicable ft. General comments T- / y, ~~ ~ , /~ and recommendations: ! t'` -- IN ~ ~~-~~ ~ Boring # ~ Boring ~ ~~~ pit Ground surface elev. ft. Depth to limiting factor _ ~? ~ in. _ . Soil 'cation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/iP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 D" ~ `ji .s'" ' `~" ~' 3 ~.~ s a.,..c~ , ~-. G - ~ !/ ~f ®Boring # ~ Boring ^~,~ ~ / G . pit Ground surface elev. ~~ ft. Depth to limiting factor ~ in. Sal Gcation Rate Horizon Depth Dominant Color Redox Description Texture Stnxxure Consistence Boundary Roots GP D/fC~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 ~ D .~ ~, ~ r=muenr ~i = esw > ;iu < c~u mgit_ ana i a> >3u < iau mgi~ - tmuen[ ~r1= taw <'su mgi~ arw i ~.~ ~ 3u mg-~ CST Nam~se Print) ~ t /~~ Signatur ^~ ~~~.~ ~/ h ..• ~ ~~ `~ Property Owner _,~/ ~~- ~~ Parcel ID # Page of goring #Boring ^ Pit Ground surface elev. _~~~ ft. Depth to limiting factor ---,~-~- in. Soil ication Rate Horizon Depth Dominant-Color Redox Description Texture Structure Consistence Boundary Roots GP D/if in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Efi#1 •Eff#2 off. r ~ R- G~` i~~ . - ~ Boring # ^ Boring ^ Pit Ground surtace elev. ft. Depth to limiting factor in. Soil 'cation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/If in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Etf#2 Boring Boring # Ground surface elev. ft. Depth to limiting Factor in. ^ Pit Soil ication Rate Horizon Oepth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP Dfli? in. Munsell Qu. Sz. Cont. Cobr Gr. Sz. Sh. •Eff#1 •Eff#2 • Effluent #1 = BODS > 30 _< 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BODs <_ 30 rtxlll. and TSS <_ 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R07/00) Soil Test Plat Plan Project Name Mike Ninke Byr Bird Jr. Address 2374 250th st DeerPark Wi. 54007 TM #22052'7 Lott Subdivision Date?/25/2003 CountyST. CROIX NE 1 /4 SE 1 /4S 2 T 31 N/A ~ W Township Cy1on [~ Boring (~ Well PL Property Line# Alt. BM (White 1" pipe 96.'7 ,BM or VRP Assume Elevation 100 ft.Nail in white Oak SystemEly. T-2=93.iT-2=92.6 H.R.P. Same as BM ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwaerBuyer q n ~.5 0~ ~~ er ~~ Mailing Address Property Address (Verification required from Planning Department for new City/State Parcel Identification Number ddb ~ 1 a b `~ _ ~ ~ v -~ LEGAL DESCRIPTION ~ ~ ~ ~/ ~~ Properly Location ~~ '/., '/4, Sec. ~, T~N-R W, Town of ~ Subdivision Lot # _~. 5-~- // Certified Survey Map # _ % .3 y ~~ ~ ,Volume ~ ~ ..Page # X60 ~r,~ , , ~ ~ 0 Warranty Deed # ~~ ~ ,~~5~~ ,Volume GIQ 7 .Page # ~ ~ Spec house ~ yes ^ no Lot lines identifiable ~" yes ^ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result is 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 mastorplumber, journeyman plumber, restrictedplumber or a licensedpumperverifying that (1) the on site wastewaterdisposal system is is proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the year a iratipn te. .f ~ ~~ `~ SI A O PLICANT DATE OWNER CERTIFICATION 1(we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property descn'bed a , by v' a of a warranty deed recorded in Register of Deeds Office. ~ ~~ SIG T OF APPLICANT DATE «**s*s 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 is the warranty deed POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page ~ of 7i FILE INFORMATION SYSTEM SPECIFICATIONS ~,~.v o Il Owner / ~. Permit # Ja DESIGN PARAMETERS Number of Bedrooms ^ NA Number of Public Facility Units ^ NA Estimated flow (average) al/day Design flow (peakl, (Estimated x 1.5) ~-D gal/day Soil Application Rate al/da /ft2 Standard Influent/Effluent Quality Monthly average" Fats, Oil & Grease (FOG) 530 mg/L Biochemical Oxygen Demand (BODS) 5220 mg/L ^ NA Total Suspended Solids (TSS) 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand IBODS) 530 mg/L Total Suspended Solids (TSS) 530 mg/L ~ NA Fecal Coliform (geometric mean) 510° cfu/100m1 Maximum Effluent Particle Size Ye in dia. ^ NA Other: ^ NA *Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE Septic Tank Capacity a1 ^ NA Septic Tank Manufacturer ^ NA Effluent Filter Manufacturer ~ rj ~ ^ NA Effluent Filter Model ~-tj ^ NA Pump Tank Capacity al NA Pump Tank Manufacturer NA Pump Manufacturer NA Pump Model A Pretreatment Unit ^ Sand/Gravel Filter ^ Mechanical Aeration ^ Disinfection ^ Peat Filter ^ Wetland ^ Other: A Dispersal Cell(s) In-Ground ( ra ' ^ At-Grade ^ Drip-Line ^ NA ^ In-Ground (pressurized) ^ Mound ^ Other: Other: ^ NA Other: ^ NA Other: ^ NA Service Event Service Frequency Inspect condition of tankts) At least once every: ^ ea~lsj(s) (Maximum 3 years) ^ NA Pump out contents of tank(s) When combined sludge and scum equals one-third (Y31 of tank volume ^ NA Inspect dispersal cell(s) At least once every: ^ ea~isj(s) (Maximum 3 years) ^ NA Clean effluent filter At least once every: ^monthls) yearlsl ^ NA Inspect pump, pump controls & alarm At least once every: ^ year( 1(s) ^ NA Flush laterals and pressure test At least once every: ^monthls) ^ year(s) ^ NA Other: At least once every: ^monthls) ^ year(s) ^ NA Other. ^ 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 Servicing Operator. Tank inspections must include a visual inspection of the tankts) 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 ce111s1 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 (Y31 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 chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shalt 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. GMW (4/01) Page Zof,?~ START UP AND OPERATION ~ ' For new construction, prior to use of the POWTS check treatment tankls- for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal celllsl. If high concentrations are detected have the contents of the tankls) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal 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 Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within i 5 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall tie taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ^ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ^ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a evaluation must be performed to locate a suitable replacement area. I n ~ ea is available a all as a th f{- Q(~1J / ~ ( ^ 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 ~, ~ Phone - ~ POWTS MAINTAINER Name x/12 I Phone / ~--'~ _.~ 3 '~ SEPTAGE SERVICING OPERATOR (PLMPER) LOCAL REGULATORY AUTHORITY Name Ct hG Phone ~ ~ Name _ li'r'e r ~ , Phone ~ ~~ This document was drafted in compliance with chapter Comm 83.221211b1111(dl&lfl and 83.54111, (2) & (3-, Wisconsin Administrative Code. -- ~~/, / DEPARTMENT OF ~~~"`'~ ~~ FETY & BUILDINGS INDUSTRY, PORT ON SOIL BORINGS AND DIVISION LABOR AND cc P.O. BOX 7969 HUMAN RELATIONS PERCOLATION TESTS (11J MADISON, WI 53707 (H63.0911) & Chapter 145.045) LOCATI ' SECTIO TOWI~HIP/MU ICIPALITY: OT NO.: BLK. NO.: SUBDIVISION NAME: /~~ N % ~ (0 1 ~ ,,((// (,,/'• L/ • /7 !`~/j/~7J ~7n` CO'U''NT~Y: ER' BUYER'S NAME• OWN AILING ADDRESS: M I ICF Residence NO. BEDRMS.: ~ COMMERCIAL DESCRIPTION: New ^Replace RATING: S= Site suitable for system U= Site unsuitable for system DATES OBSERVATIONS MADE (PROFILE DESC IPTIONS: A I N TESTS: l ~~ ~ - ~O 7 ~- 9a CO NVEcNTIONAL: ~~+ ~~ MOUNcD: ~ ~+ ~ IN-GROUNccD~PRESSUR_E: ~J ~ ~ SYSTEcM-IN-F-F~ILL ~ V L_J V HOLDING(T~AN~K: ~ S LJ V RECOMMENDEDSYSTEM:(optional) If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(51(b), indicate: I Floodplain, indicate Floodplain elevation: ,~jl/~' PROFILE DESCRIPTIONS BORING TOTAL D PTH TO GROUN DWATER-INCHES TEXTURE CHARACTER OF SOiL WITH THICKNESS COLOR AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED ES .HIGHEST , , , TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- ~ 9~. o~ ~ - ~- ,~ ~ - o~.~~~s, o- B- ~ r~- { ~ E 7~ o - s~ - a ~` B- ~ ~ `~9. ~ ~ ~ 75 ~ ~ s-,~ 9: ~ ' ~ 7 ~s y ~- E3- ~ ~ /~ `~` tS D /~/ ,vim' T DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCH RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. P RIOD t PE I D 2 P I PER INCH P- P- 3 n/ ~ P- P-_ P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe zontal and vertical elevation reference poin~tsyand show th~,e,1'r location on the p t plan. how try. urface levation at all borin and the Ir of land slope. ~+ r~D1P~*RJ ~' ~taE f~i' 1''bLf~'' ~0~1A~ /~L/A~~~• ~. ~OL~_~ SYSTEM ELEVATION ,I 270' S~c~~t ~. i- ~~ --',~. io~?e'~~,dt.~s ~ f ~ ~ E '~ i ~ ' ~~Ld1~ 3 ~ 3 ~~~ __ _ - - P" s~A ~. ~' oB9 I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAM int): TESTS WERE COMPLETED ON: ~ L o AD A~ f„©~ ~ (//'s K/ C~~~CATIOf'NUUMBER: E •,? 7 6 PHO% ~NUM~~R(Optional): c1S vIJ 7 o~IC T GN A TURE r 30 PERCOLATION TESTS~_,~+v ~ ~ ~~. ~ _ `" ~ "" at DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DI LHR-SBD-6395 IR. 02/82) -OVER - 114'~"TF~l1CTl®NS FC3~ C®MPL~TII~ ~71~M 115 - SI3C7 - X395 To hc: a ~ i ~~ acc.ura~te:, soil test, your sport mast irtclt~c~e: 1. Coi ~ rz; The use s'e iy Indic her this is a == ~ or c;ommerri .' ~XIMUM =:iraonts or r~rnmercia9 use plar f; ~, Es t!€is a n~ ~°,ent systean; 5. ~ rnt%iete ng boxes. A S(T (S SUITI~E3LE Ft~R A H~ ~"!-INK 04~1LY 4~ A~t~ :YST~ '1 _ :_E~'~ t '1 r3ASE[7 ON S`}~i_ ~C~ND[TIC3NS; ~. _ esc the a, _ ~r ~;vriting profile tlescriptior7s at~~~ cc~rr~pleting the plot plan; A i°EGI€3LE ~ ~7g yc est i«cations. l~rauvinc~ to scale is prof€~rred. A =,~,~st ir+ey ka~, ,. y +tr be.~chn~ _:' k . _ ,~ ~ of ~~ poir' ~ early shown, i are perrnanr~nt; `~. ~i n~~riate hoxE> , '78s, a~" ire ~ _ ~ ,~ test exe~~p- t l! ~~' ~ ~ .ch z~s fJoor~l plain, i~'n) does not apply, ~>;a~e C~1=A. in the a~;propriate taox; 7 ~, I {,~ .;e your cx.~r~er~t ao<° r~l your certification nun~l:~er, 1 ~ " c~ .ies artd c#istribr~te gas ~, ~ ~ ~ ~~,LL 5C3'_ TESTS MUST t3E FILED L'UlTH THE ~~~~§~lT'f t°.IITHIN 30 C)AYS C?'= 'l [~, , • ~ i , . ~ ~ N 1 ~,~~::.~.111ATIC)NSFCBC~t CEF?TIFIEQ SUIL . _oi1 .. ,; > s Other =+nbois cr~1~ ... ~ ' ; ~ ~ ,e ~~. _ _ ~~~ 3"} t ~ ,e (5 .. ~ ~'n t~ _. __~ +-ci i3t£aCjS ~ ~ r~ i5 .-- , ,;ld - .. .Si - ~ 'i} i ='1 - _ ~ I' _ ? ~- .., ,~. s~ - Silt C3y _ s<,I - ` L: ,,~ ~t sic! -- C~!- . L ~.. n~rot sic - Si` ~t iay fif ~ , nitre, fai ,. ~c; - ~ t;c ~~~r}, r~r - d -distinct textures - , h~,~ ,e c9isK>osal p -- pry=:ninerrt rt _ v~satet SM - ?~ Mark U`RP - V^°`aai Reference F'vir,t ,, t '_ TC~ T1-1 C. ~: ter,€~ ~ tF, _: ste ~ i~~r ~,;, 'The ct:>irnt ~~r Tr'~ C Y '~}anent may ~ equest r ~~~ [t ~ _ ~ ,: ,:.r::~rtce. A {;c r,. I ~.s for the priv~~rtE> appli~ ~ _ t~ ~/ in ar~'er to - of ,iru~ DOCUMENT "!O. 49330 .~~i~ 987PACiE ~~~ t,«gSPACERESEHVEOFOgRECORWN4DATA ~YARAANTY DEED STATE-BAR OF WISCONSIN FORM 2 -1982 RE+GISTER'•~ OFFICE. RoDar~ tt;rq~ardl - ~;. ,~,a 4.Yx ~ i ~~ Desetnber • is 9Z (SEAL) (SEAL) This id moo; homestead property. ~ (is not) exception to warranties: '1E1M - x ,,t D, ~tly~ySe s sieale Derso>t conveys and warrants to is dDtlNdti raErurw To the following described real estate in St Crot= ~'"~• G06 1003 ~ State of Wisconsin: ....c , nnl~ i~ 1 ~. , Tax Parce{ No:..~u ~~ A3 0! Ss atad ~ of 1tE nt- Section t. Toxesbip 3 Ra-tnge 16 W•. St. Croix Cotot~. ~ ~ ~ ~~ day Signature(s) AUTHENTICATION (SEAL) authenticated this day of • t 9 • TITLE: MEMBER STATE BAR OF WISCONSIN ({f not, authorized by § 706.08, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY P!iehael J, Schattots e r ve • Amer. !~ _51+001 (Signatures may be authenticated or acknowledged. 9oth are not necessary.} .ACKNOWLEDGEMENT STATE OF yytSCpNSIN ss. POL'S County personally came before me this 28t1 day of D *.~r _ . t 9 9s~--the above named M to me xno foregoing .. My sr, cROOCCO.,w~ _ Recd for Record DEC 2 9 1992 ~ ' X0:20 11A _ who executed the the same. County, Wis. (If riot, state xpiration • Names of parsons sI1F+ln9 M any capacity s1+ould ba Iyped a Dr~~ glow tl~ar WARpANTY DEED STA OR~ ~pF2W/ISC~2NSIN WISCONSIN REAI TORSI ASSOCIATION .eon Hayaa ~. ataa~aon• w' ss~at ,_ ~{{ I L.. ~ _ Parcel #: 006-1003-10-040 01/03/2005 03:37 PM PAGE 1 OF 1 Alt. Parcel #: 2.31.16.17A-30 006 -TOWN OF CYLON Current ^X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * =Current Owner 'SCHWERDTFEGER, DANIEL & KAREN DANIEL & KAREN SCHWERDTFEGER 2390 250TH ST DEER PARK WI 54007 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description " 2390 250TH ST SC 1127 CLEAR LAKE SP 1700 WITC Legal Description: 4.810 Plat: 1787-CSM 17-4606 SEC 2 T31 N R16W 47A NE LOT 2 CSM Block/Condo Bldg: LOT 2 17-4606 (4.81 AC) Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 02-31 N-16W NE NE Notes: Parcel History: Date Doc # Vol/Page Type 05/10/2004 762083 2568/179 WD 04/14/2004 739368 17/4606 CSM 1008/59 W D 2004 SUMMARY Biil #: Fair Market Vatue: Assessed with: 52398 39,300 Valuations: Description Class RESIDENTIAL G1 Totals for 2004: General Property Woodland Last Changed: 09/08/2004 Acres Land Improve Total State Reason 4.810 40,000 0 40,000 NO 4.810 40,000 0 40,000 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 04/17/2001 Batch #: PRGRM Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 ~ 0.00