Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
008-1012-10-300
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety an'd Building fsivis;on ;~ ~ INSPECTION REPORT GENERAtyINFORMATION (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 Preble, Ro er Eau Galle Townshi :ST BM Elev: Insp. BM Elev: BM Description: l a~ ' ~ 0~ ` ~ ~r~.. ~~. SANK INFORMATION TYPE MANUFACTURER CAPACITY Septic r , I~~~ ( f / a Dosing r~ ,^- _ / l~fJ ""'er • _ ~U Aeration ' I / ~ -~~ [~V Holding G TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. vent to Air Intake ROAD Septic ~a~- 33 ~ 33+ Dosing /! ~~ 7 , _ „_ 1 t V' Aeration V Holding PUMP/SIPHON INFORMATION Manufacturer f(b/vl Demand ~ ~j GPM Model Number we S ~~• TDH L`f~ ~ Fricti~ Loa ' System Heasi j TDH ~ ~~Ft Forcemain Len qty,,, `` ((~J Dia.. Dist. to weu 0 T _ / //`~ ABSORPTION SYSTEM BED/rRENCH Width ~ ~ Lengt NSIONS SETBACK SYSTEM TO INFORMATION Type f ystem: ~~~~ r)1_CTRIRIITI(~N SYSTEM i,~ No. ~ r i rencnes I Ln~_ xJ~{ P/L BLDG WELL 0~ a~~ `Na ELEVATION DATA county: St. Croix Sanitary Permit No: 404966 0 State Plan ID No: Parcel Tax No: 008-1012-10-300 STATION BS HI FS ELEV. Benchmark ~/ ~ ov Alt. BM rx ' ~. ~ 3' 3S' ~I ?- 3 Bldg. S wer ~ ~Dp Q / /. , SUHt Inlet //•G 7.2 SUHt Outlet / ~` Dt Inlet / /' Dt Bottom S3- ~ 3 Header/Man~/~ e ~ 9s f~Q/.~ Dist. Pipe .~ , ~/~ ~ ~ Bot. System Final Grade f'~~ St over ~~1 - 3 6 ~l3 • S /' ~ ~ l.~ 1~1, P~ I Of Pits // G o(..,..L Bic Header/Manifold /i / ~I h G Distribution ~ Pi e s q (~ ~ ~ / / S i g ' Di / x Hole Size ! i ~~ x Hole Spacing ~ l r, ~ Vent to Air ntake ~ ~~ ~S Dia Lengt pac n Length a . O Snll_ CnVER v Drnc~nrn C~.~4crnc Only YY Mnund Or At-Grade Systems Only Depth Over ~. ~ ~ ~,/ Bedfrrench Center ~" oLi"'~ - Depth Over - Bed/Trench Edges xx Depth of Topsoil xx Seeded/Sodded l N Yes No o f~ Yes COMMENTS: (Include~de discrepencies, persons present, etc.) Inspection #1:~/ ~ ~l U~~~~ Inspection #2: 1 7 / 0 `-~ Location: 2366 50th A~v-e'+Woodville, WI 54028 (NW 1/4 SE 1/4 4 T28N R16W) NA Lot 3 ~~ '~ ~/ Parcel No: 04. 8. .63A30 1.) Alt BM Description = ! '~~ ~~ ~~ ~~~`~ 2.) Bldg sewer length = 3~~}' - amount of cover = ~, g / 3.) Contour = 3 ~ / ~ _- Plan revision Required? ~ I Yes `. No III ~ ~~ ~ '~ i~ D Y -__. _~~ j~jy~y~-- - - - - ~ L _ _---~ _I Use other side for additional information. `__--~__-- , -~~~~~-- ---- Date Insepctor Signature Cert. No. SBD-6710 (R.3/97) OR i /6 `''" xx Mulched r Safety and Buildings Division CO1~' ~~`, ~ 201 W. Washington Ave., P.O. Bax 7162 •S~~Yd ~ X ~` ~~~~~~ Madison, WI 537{}7 - 7162 Siu Addmss - ~~ ,~ ~k 3 `~ tom, < - •De artment of Commeroe permit Number Sanitary permit Application ~qG~~ tnformation you provide ^ Check ~' F~vision In accord with Comm 83.21. Brie. Adm. Code, persoml • ma ~ usmd ~ ~ ses Privac Lsw s15. 1 m p)~ l.D. Number t. Appt~caaon Itttoro -Please Prhtt All Information ~ ~q l b . T~•-S 1 D 1 Number . Z$ • 1 b . 6 - 30 P~~ pr's N~°e RECEIVED ooe- lot2- o- d Y' I' ~ property Location props Owner's ~~ MAR 2 2 700 ~GJ y, ~',~1L• S T I' N, xrG a a i3 ~ ~a-1y'' °`-~a- o~ s~ Lot Number Block Number ~~{{ r City, State ~ Code U~~O CE Y Subdivision Nano CSM Number Syol~ cs~1 ~ ~' i~ a II. Type or suitdhtg (check au tttt+t ~+Plyl as ~ z ~ ~ °"K• Ckity ^ 1 or 2 Pattdiy Dwelling -Number of t3edrooms ^Viilage Q pttbiic/Ctuaanercial - rite Use ~ ownsbip Gz ~ -~ Nearest Itaad Cb,. ^ Stau Owned ~~"` 7~' ~ ` x r~ ~ ~nnst••..~ "^ a3~~~1•`i2 )sue SQ ~ v~ III. Type ~ permit; (Check only one box on line A (numbet~ scheme for internal use). Complete line B if applicable} For Couat~ use A. 1eyi, 2 [~ R~ttacement Systeun 3 ^ Replacemetu of 6 ^ Addition w Teak Oal Exis ' aaem Fermis Number Dau Fssued B. ^ Check if Satunuy Pormit. Pnvlously Issued N. Type of Permit: (Check all that applyy(aumbering scheme is for internal use) -lE A--roe ~ • 21~~ 47 Q Saad Fi1ur 50 ^ Constructed Wetland 44 Q Non -Ftessvrixed Ia-Grautd 51 ^ Drip Line 22 ^ Pressuri~d ~~~ 41 Holding Tank 48 ^ Single Pass 46 ^ Aerobic Tnataneat Unit 49 ^ Recireulatitt8 30 ^ Other 45 ~ At-Grade V, eatment Ares Inforntatbn: percoiadon Rau System Elevation Piaai Grade Design Plow (gpd) Dispersal Ares Dispersal Area Soil Applicadon Elevation ~~ propoSed Rau(Gals./I3ays/Sq.Ft.} (Min.llnch} /6l~ ~ 9~ ~Q.~ . 7 ~ ~~d ~ 60 ~o~ , s ~~- t m .Total Number Maaufactunr Prefab Site Steel Fiber Plastic ~. T~ ~p CaI~•ty ~ Conente Constructed Glass ~~ Clarions of Teaks New Esisdat Taub Tsaln Sepcie or xowine Task - ~ ~p j ~ es e v l~osieg ~~ ~ ~dr3 1 ~/ ~` ~S'-G v ~ , astassue tesponslbWtY for a of the FOVVTS shown oa We attached VII. onsibili Statement- I, the utidersigaed Number Business Phone Number Plumber's Ntutte (Print) Plu,mbe:'s Stg W,l - ~ wy.,- ey Plumber's Address tStreet. CttS'. State. Zip Code) cc j'c a ~ ~~ VIII. Cotmt JDe artment ZTse t?til ens Si tun (No Stamps) Sanitary Permit Pee (irbcludes Groundwater Date Issued Issuing Ag 8m '~, Approved ^ Diaappmved Surcharge Fee) ^ Owner Given Ir>itial Adverse ~ ~~. ~ ZS ~ DeurnLination IX. Cottdititxas of Approv~~~Reastnts for lsstppro~ -~ a- ~ l !~ ~ ,,,`ate- ~- :~h~,~- ~q 9 `~' ~ ~ l~- ~""~.~`~""" "":,- _ G Spa ` (-~ ~ ~ s~pe ~U~c..s Attaeh coasptete plans (to the Cam4 aaly} ter the sntem on net than 8112 t 11 laehd bt siu SBD-b398 (R. osrol) / ~ EledQEion ,(I~..B.iK.~Top~y~" ~ ~ (~~ a/e:/~=5/O i ~! B ° ~o6zr~ d` Q•c..~iQ~d b2 °~ 7o~e/sor, /o~°7°e-rbY ^ ~o~ 3 o~FP~9oaud cs"c. SESc~.;, Sec. 5t T.~. of --. Eak~oaGE.e SE,•CrDlkeoy~l. i i I~ I I~ ~ Pro pos~cl Moen d at 2lo.7SX /13./S' ~ I al I ~I ly11~~a{ero.Cs SPace.d ~ 3.0' wt I~ rl x°83 yd ~'oii{,'cc.5 Spac.Cdo~ 37~ ~S °la ~ f5/oPl .f i II ~ II II a~ I, ~ ' I a~ ~I ///''''~~~Z"~.Vo P.v.c. ~ /~~/~~ ~~ L29 ~ ~ c..o~ b;.,ob~n s.r./P.C. zs •F--~,.,/ Abel ~4-icy eFFlacnE F"lt4/~~ S.T. ou-tl~~. ~. ~.h vKoT~: ~ o ~" y "sc~F . ~/o P v c . bu%ldnci Se.~~a6 Proposed aPf'~X. P. o ' 6 ~ /aw ~1 bcdrovn, ~~ "~S'Ccc181'ao/Q. Z qs' ~'eSi dencG C/ o p~opo~ ~u ~~.. z„- t ~z~8/ ' ~ ~i. B aF 9 Safety and Buildings `' ~~ ~ 4003 N KINNEY COULEE RD LACROSSE WI 54601-1831 ~ ~ _ TDD #: (608) 264-8777 iseons~n -CE~VED www•commercestate.wi.us/sb www.wisconsin.gov Department of Commerce . ,.c 2 g 2~~ Scott McCallum, Governor Philip Edw. Albert, Secretary IX COUn 'nNfNG nF~i~, February 20, 2002 CUST ID No.227990 A7TN.• POWTS Inspector WILLIAM C SCHUMAKER 1070 SCOTT RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 02/20/2004 ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Rodger Preble 50TH Ave Town of Eau Galle St Croix County SW1/4, SE1/4, S4, T28N, R16W Lot: 3, FOR: Description: Four Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 830066 Identification Numbers Transaction ID No. 709161 Site ID No. 641301 Please refer to both identification numbers, above, in all cones ondence with the a enc . The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.O1/O1) and the SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST SAS (01/81) • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the Mound manual, and the pressure distribution component manual aze complied with. A copy of this letter including instructions and information relating to proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. It is recommended that the mound azea be deep chisel plowed to help break up the platy soil structure that was reported at the site. The county may, at their discretion, request verification of the plowing prior to continuation ~~~j of system construction. ~~~rr""'""- Access to the filter for cleaning must be provided per Comm 84.25 (7) acid (8),Wis. Adm. Code product ~pRf a approval conditions. ~ ~~ Per manual sited above, Limited activities are allowed in the azea 15 feet down slope of the component area. ~ ~ L Soil compaction, excavation, vehiculaz traffic and other similaz activities that impact the treatment and dispe aze prohibited. WILLIAM C SCHUMAKER Page 2 2/20/02 • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). In addition, the owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazazd. • Comm 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions azise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who aze responsible for the installation, operation or maintenance of the POWTS. Sincerely, Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@commerce.state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 FEB--H31 -20k52 12 :26 F'M A. G . E. So i I $; 5 i t. ~ Eva 1 T 15 24r~ ^r 7£4 MOUND AND PRL88URE DISTRIBUTION COMPONEhIT DESIaN RasldeMial AppNcetit7n t INDEX AND TITLE PAiiE Project Name: Rodger Pntilble 4 bedroom residential mound Owner's Name; Rodpar Pablo Owner's Address: 231 Nsrr~ekaaon ~~ N~udvOn~W! 54016 ~!, __ Legal Description: SW1f4SE1/4, Sec.4, T.28N., R.18W. Townattlp: Eau Geitle County: St. Croix Subdivision Name: CSM Vol. 15, Pg. X180 lot Numt~er: 3 Block Number: na Parcel I.D- Number. 008-101 Plan Transaction No.: Pago 1 Pape 2 Psye 3 Page 4 Page 5 Page 8 Page 7 Pape $ Page 8 F . 0: '2.10.000 • A ~~ .~ 9'~F ~F C~/ irtCWX sad tilde ~ ~~~ ~F Data entry ~~ ~pa~ Mound drawings "®n Lateral and dra<oe tank y~n System maintenance apecifkations V Management and contingency plan ®~i Rump curve and apedflcations (/ Site Plan Soil Evaluation Report Designer: BIR Schumaker i.lcense Number. Date: 02!01!02 ~ (~ ~ ~ Phone Number Signature: ~1~~~~j~~.,s~~ 227680 715-388-3121 Dasipned Purs+iant 0o ebe Mound Component Manual for POWTS Version 2A SD8-tOQ91-P (N. fl1l01). and SSWMP Publication 9.8 Design of Pre&st,ir~1 Distribution Networks ibr ST•SAS {01!94) Version 3.0 {03101/01 } Page 101 9 ~~~`J )VED = t:oMla>~cE ,~( t Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) ___~ R Residential or Commercial Design 400.00 Estimated Wastewater Flow (gpd) -- 1.50 Peaking Factor (e.g. 1.5 = 150%) 600.00 Design Flow (gpd) _ __ 5.00 Site Slope (%) `_ ___ 99.00 Contour Line Elevation (ft) 13.00 Depth to Limiting Factor (in) - _ - ---, 0.50; In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 100.00 ~ Dispersal Cell Length Along Contour (ft) _ ___ _ 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) r ~ 1 I Influent Wastewater Quality (1 or 2) Pressure Disribution Information (c ore) I el Center or End Manifold 3.00 Lateral Spacing (ft) j 2 Number of Laterals __ ~ _ 0.125 Orifice Diameter (in) (e.g. 0.25) ___ ~ 3.00 Estimated Orifice Spacing (ft) _ __ ~ 2.00 Forcemain Diameter (in) _ _ 'i _ 170. _ Forcemain Length (ft) . _ 8.50 Pump Tank Elevation (ft) 6.50 System Head (ft) x 1.3 ~. 1. Vertical Lift (ft) 2.75 Friction Loss (ft) 31.20 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. o tions choice -- ----- -- 0.75 1.00 ~ __ _^_j 1.25 I ~ 1.50 x x 2.00 _ x __ 3.00 x i Treatment Tank Information 1250.OOLSe tic Tank Capacity (gal) .__.. 'Wieser Concrete Manufacturer Dose_Tank Information _ 75_0.0_0; Dose Tank Capacity (gal) 16.121 Dose Tank Volume (gal/in) ! Wieser Concretre ~ Manufacturer ...._ ..-__.._"___.____._.__~_.-___._......J Note: Sand fill (D) calculations assume a Table 83-44-3 in-situ soil treatment for fecal coliform of <= 36 inches. 6.00 Ce11 Width (ft) Are the laterals the highest int in the distribution ~Y __ '. network? Enter Y or N If N above, enter the elevation ft of the highest point. 9.09 ft2/orifice Does the forcemain drain back? ~ j Enter Y or N 27.73 Forcemain Drainback (gal) 90.43 5x Void Volume (gal) 118.16 Minimum Dose Volume (gal) 27.19 System Demand (gpm) Manifold Diameter Selection in. dia. o tions ___ choice -- 1.25 x ~ ____ ~ 1.50 x i x 2.00 3.00 Gallons/Inch Calculator (optional) 757.64 Total Tank Capacity (gal) 47.00 Total Working Liquid Depth (in) 16.12 gal/in (enter result in cell 649) Effluent Filter Information ;Zabel _ __ __ Filter Manufacturer A100 _ ~ Filter Model Number Project: Rodger Preble 4 bedroom residential mound Page 2 of 9 i Mound Plan View i Observation Pipe . K .5: .~~:. ... ..~~. ..•.•.•. . . .~.g.~_ . . . _ • M. ~t Jj - I A I 1 _ - ' L Mound Component Dimensions A 6.00 ft E 26.60 i n H 1.00 ft K 11.58 ft B 100.00 ft F 9.50 in z 12.38 ft L 123.15 ft D 23.00 in G 0.50 ft J 8.37 ft W 26.75 ft 600.00 (ft2) Dispersal Cell Area 1838.24 (ft2) Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Gross Section View Aggregate Dispersal Area Finished Grade 102.71 (ft) ...~~.. G I" .:.:.:.;.::: teral F ..:::: ~ : ~ Dispersai~Cell 101.42 (ft) La 100.92 (ft)--• - ~~~~~:~:~:~:~:~:•. Invert Dispersal Cell :~~~:~:~:~:~~' '•~~~ ::::::::::::: •:::;:;.:.•.•••.•.•.•. t . D ~:~:~:~:~:; 3 :.:.:.;. Elevation ~: E ~:~:~:~:~:~:~:~: •. ~•. .~:~:•. ~. . .. ,~ :~. _~.. -~- - ~ ~- - - -- -- - - ~ - - - - 99.00 (ft) Contour Elevation 5.0 % Site Slope /~ Geotextile Fabric Cover Shading Key 10 ®Topsoil Cap © ~~~" Subsoil Cap ©~ ASTM C33 Sand Tilled Layer 05 ~~ Aggregate ~ a . ~ Dispersal Cell a c 1.5 ft . ,.•...• ........•..•.• ~o ~ ,~~~ : ~° m ~ t l i l l .T ~ o ~ ~ 0.5 ft era yp ca a ~~ ~-- A Project: Rodger Preble 4 bedroom residential mound See lateral details on -#- Page 4 for number, size, and spacing of F laterals. Laterals are equally spaced from the distribution cell's centerline in the distribution cell (Ax6). Page 3 of 9 End Connection Lateral Layout Diagram Laterals centere overt i P • =Turn-u p vN' ba I I va Ive or cl eanout pl u g All laterals are identical IF ~{-~I Holes drilled on the bottom of the lateral S equally spaced ~ Force main connection via tee or cross to manifold at any point. laterals & force main of PVC Sch 40 [per COMM Table 84.30-5) Number of Laterals Orifice Diameter 0.125 in Lateral Diameter 1.50 ' Orifice Spacing (X) 3.08 ft Lateral Length (P) 9 ft Orifices per Lateral 33 Lateral Spacing (S) 3.00 ft Orifice Density 9.09 ft2/ori Lateral Flow Rate 13.59 gpm Manifold Length 3.00 ft System Flow Rate 27.19 gpm Manifold Diameter 1.50 in Total Dynamic Head 31.20 ft Forcemain Velocity 2.78 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and -~ Comm 16.28 WAC ~ 4 in. min. Disc~ect ---1- .________ Tank component is properly vented Wieser Concrete Ca aci 750.00 Volume 16.12 Manufacturer Gallons gal/inch -r A B C D Dimension Inches Gallons A 25.24 406.83 B 2.00 32.24 C 7.79 125.55 D _ __ 11.501 185.38 Total 46.53 750.00 3" Bedding tank. Alarm Manuafacturer '`` LevelArm _ Alarm Model Number I DLV _v `__ _ _ Pump Manufacturer I Goulds - i --- -- Pump Model Number WE05H ~. Pump Must Deliver 27.19 gpm at 31.20 ft TDH F-- Aftemate outlet location Forcemain diameter ~ 2 in. Weep hole or anti- siphon device Pump off elevation (ft) 79.46 D, ose tank elevation (ft) 78.50 Project: Rodger Preble 4 bedroom residential mound Page 4 of 9 Mound S stem Maintenance and O eration S ecifications Service Provider's Name J. T_ hom~n POWTS INSP.#4819 ' Phone;715-248-3271 POWTS Regu{ator's Name i _ ___ St_ Croix County Zoning ~ Phonej 715-386-4680 _~ S stem Flow and Load Parameters Design Flow -Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1250 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frepuency Septic and Pump Tank Effluent Filter Pump and Control: Alarrr Pressure Systerr Mounc i;f ICi Ins and/or service once eve 3 ears Should ins and clean at least once eve 3 ears Test once eve 3 ears Should test month) Laterals should be flushed and ressure tested eve 1.5 ears _Ins~ect for pondin ag nd see_pase once every 3 years __.___ - ~ Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have awatertight cap, and are secured in as shown in the mound component manual. ' 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished •............•. ................ Grade ~ .1 ~_. 6-8" Diameter Lawn ~ ~ Threaded Cleanout Sprinkler Valve Box ~ Plug or Ball Valve Distribution Lateral ~~y Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Rodger Preble 4 bedroom residential mound Page 5 of 9 • • . Mound System Management Plan ' Pursuant to Comm 83.54, Wis. Adm. Code ' General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with fts' corr-ponent manuals [SBD-10691-P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system mairl(enance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhde risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certrfied to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet fitter shall be assessed at I~st once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the fitter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarn is activated continuously. InternitteM fitter alarms may indicate surge flaws or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the amer of when the next service needs to be performed to maintain less than ma>amum scum and sludge accumulation in the tank. The addition of bidogical or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank tt shall be inspected and serviced as necessary. Mound and Pressure Distribution SYstem No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall lie seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L GODS, 30 mg/L TSS, 10 mg/L FOG, and 10° cfu/100 mL for highly treated effluent. Influent flow may not exceed ma>amum design flaw specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and tt is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed tt should be compared to the inttial test when the system was installed to determine if orifice clogging has occurred and tt orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump contrds, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, tt will be repaired or replaced in its' present location by increasing basal area 'rf tce leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Rodger Preble 4 bedroom residential mound Page 6 of 9 Performance Curves METERS FEET ,~( ~, ~ v~,v> ~ ti ds P'ur~n GPM m'/h (D GOULDS PUMPS. INC. 58~E{A FALLS PEW YOLK i3ia8 METERS FEET 120 35 110 ~ 100 30 90 25 80 ~ 70 Q w = 20 J Fa- ~ (] f- 15 50 40 10 30 20 5 10 0 0 MODEL 3885 SIZE 3/a" Soi~ds H 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM i , i i 0 10 20 30 m~/h CAPACITY ~p~' 9 01985 Goulds Pumps, Inc. E five July, 1985 27 /9 6. RrK. M,yiimu~ ~uaa/~~ %'az~t ~i'~~ o! . A I~E.. B. nt~~ Top o~/'~'' rc bar: E/e% = ~cb.,as,` ~ ~ e $ P~2 ^ Qro p cscd Ma k~ d at 210.7SX /13/S` w/ Cv'X /G'U'd,S~i-ibw~+'fiY~ C¢.//. ~0(1~ /I1, ~ ~a~e/o.fS s,oaced a.~ 3.0` wr yd '' o ~i j'ce.5 S~oa ced a~ 3 7 ,• 1,29 ~ -' Qe ~c.h vKa.r~+C: ~ o ~', ,2 9S' -. ~~ ~~ ~~ v~ t~ a~ °6 3 ~+~ ~~ •_I a~ o`~ i i I i ^ 50./ Edo/uQf,on P, ~ EtedQ~ion (~~ a/e./=~D ~o62r~ ~ Q~c-~ta.~d /off .3 o~'~p~'~cd CSn(. SESc•,% Sec. ~{ Tn. o F Fact ~oa.G~e~ SE,.CrOlr C'o.~ c..~/, 2."Sc.~. Vo P. v.c . F'ofCe. v-tiAi ~. ProPoSCQI '1 bcdrour., ~e5idenCG 0 ~~,. ~z78/' -~ ~ `~~~. z//~f i .z so /7sn~,.P. c.wr. b;.~o,dc.~ S.T/P.C. s.T ou~tl~~. S/ Sc,~4 • clp P, d. C . bu;ld:r~c Se.~~+-QE Q/P/°~,UP,O'be/ow t i it / s ~o/ p ~"0.o~e . Proposed will ~~.8~'9 ' WisasnsinDepartmentofCommerce SOIL EVALUATION REPORT Division of Safety and Buildings in accordance with Comm t35, Wis. Adm. Code Cou 1446 Page -~--- °f -- 3 -- A.C.E. Shc & Site Evaluations Attach complete site plan on paper not less than 8'h x 11 inches in s¢e. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel 1 D. --- ~ - --- percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. 008-1012-10-000, ID#4.28.16.63A Please print all Information. --------- -- ------~-- _ - Reviewed By Date Personal irdormatbn you provide maybe used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Robert & Richard Tor~erson___ Govt. t.ot _ _ __ ___ SW 1M SE 1/4 S 4 T 28 N R I6 W -- ------- ---- ---------- -------- -- ------- - -- p _ - - -- -- _ _ _ _ Property Owner's Mailing Address Lot # Block # Sufxl. Name or CSM# 508 Co. Hwy. BB 3 ~ ! Pro osed CSM City State Zip Code Phone Number ~ City J village / Tw~m Nearest Road Woodville I WI i 54028 715-684-3927 Eau Galle 50Th Ave. New Construction Use: ~/ Residential /Number of bedrooms ____ -- 4 _ Code derived design flow rate 6_00 _ _ _ _ _ GPD J Replacement ~ Public or commercial -Describe: Parent material Glacial Till _ Flood plain elevation, if applicable ____ _na_ ____ General comments and recommendations: Mound system elev. = 101.92' at 23" above 99.00' contour. a Boring # ~ Boring 16° Pit Ground Surface elev. _99.14 _._ ft. Depth to l _- __ __ in. imning factor .. _ Soil Application Rate Horizon De th ~ Dominant Color P ~ Redox Descri lion Texture P Structure i Consistence Boundary ! Roots _ GP0_Ift'._ _.. __ __ `Eff#2 ~ ' # , ~ 1 Eff 1 0-8 10 x313 Y - - ___ ~- _ _ `none ~ sil -- f- 2fsbk - --- - ~ ds -_ __ __-____-_ as '~ 2fm ---- 0.5 + - _ _ - i 0.8 - ---- - - i 2 8 16 ~ 10yr5/4 none i sil lthinpl ds as 2f 1m 0.2 I 0.3 - -- - - - --- --- i-- --_. - -- -- - -- l- 3 '~ 16-23 10yr5/4 m2d 7.5yr5/8 sil 1msbk i ds ~ aw 'i 1fm 0.2 ~; 0.3 -t 4 23 39 ', 10 r4/6 Y y m2d 7.5 ~/8 & ~-~ ~2 sl m2 f t 0 1 csbk ~ mfr 1 - 0.4 0.6 +- - -i-- --- ,_ - - -t-- _ _ _ 1 r __ _ ~ __ _ 1 _ *- ~ ~ -------- -~-- ~ ---- _~ __ ---- _ I _.. ._.__~ _ - i - -_ __ - __ I -+ - - -- _~ Boring # J Boring ~/I Pn Ground Surface elev. 98_97 .__ ft. pepth to limiting factor _ __~ 5"_ in. Soil Application Rate 1 I 0-9 ', 10yr3/3 2 _ ! 915 - _ 10yr5/4 _ -_ 3 I' 15 20 - 10yr5/4 t 4 20-26 10yr4/6 5 26-41 7.5yr4/6 none j sil I 2fsbk ds --~- _ _ _ _+_ _ .._.-- ---- -r -- ----- none I sil ' lthinpl ~ ds m2d 7.5yr5/8 '~ sil ' 2msbk i ds - --- -- m2d 7.Syr~/2~ m2f l00 t-- ~-- sl - --- - --r 1 csbk ~ _ _ __ mfr fad 7.5yr5/8 I scl ~.__ _ Om t mfi as ! 2fm -------t-- 0.5 ' -__ * 0.8 - ---__ as 2f,1m 'i 0.2 ! 0.3 aw 1 fm -- ----_ ~ 0..5 ~ --_ - a 0.8 _ ---- ~ , t ~ 0.4 ~ 0.6 _ ___ __ L_. , _ __ _ __ __ - ~I, - -- T-- __. ____ _ ~_... _ ~~ 0.0 ! .' - r I ~, _i _... _ _ _ ,_ 0.0 - _._ _ . _ ` Effluent #1 = BOD 5> 30 <_ 220 mg/L and 7SS > 0 < 150 mg! I nt #2 = BOD < 30 mgJL and TSS <~30 mg/L CST Name (Ple~e Print) Sig ure: CST Number James K. Thompson 5----- 3602 Address AC.E. Sal & Sne Evaluations ate Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020 8/2/01 715-248-7767 n '` property Owner' Robert & Richard Torgerson _ __ p~~ tp # 008-1012-10-000,_ID#4.28.16.63A _ Page ___2 __ of _ 3_ _ Boring # ~ ~~ " ~J/ Pit Ground Surface elev. __ 9796 _-.__ ft• Depth to limiting factor -- 13 -- -- in. Sal Application Rate Horizon Depth ~ Dominant Color Redox Description Texture Structure Consistence ~ Boundary Roots ~P DIfL~-_ "Eff#1 "Eff#2 1 i 0-8 10yr3/3 ~ none sil 2fsbk ds j as 2im ; 0.5 0.8 - rt j- -_ ------- - --- -r----- -- ------ - -- ---- - ---- -- -- -- -+- -- -- - -- _ { - - -- - 2 I 8 13 10yr5/4 j none sil ~ lthmpl ds ~ as ~ 2f 1m ~ 0.2 0.3 --_ --i-- - ---_____ ---- - r---------- --- _ _ - --- -- - -- -r- . _ _ . ._, _ __ - I ~ - _ ~ 13 22 I~ 10yr5/4 ~ m2d 7.5yr5/8 sil 2msbk ds aw j 1fm 0.5 0.8 _ ~ !- ------ ~----- ~ ---- -_ _. __. ._._ -.. 4 ' 22-30 i + 10 r4/6 ~ m2d 7.Syr5/8 & m2 f 10 6I2 ry sl 1 csbk mfr ~ ~ - ----- I - --- 0.4 ----- 0.6 ---- --- ---_ 5 -- ~ ~ ~ 30-42 ~ 7.5yr4/6 _ _ _ _ - _--- ~ tad 7.Syr5/8 & ~ Qd 10yr6/2 ~__ _ _ scl -------- Om - ___ _-- I mfi ~ -- - ~ ~ - .0 .0 - r- - ~- ------ - ___ -- -----_ ___--- - __T _ - j-- -- - I _ ___ -- - _- .._- ~ -- _ . t - - ~ . ^ Boring # J Boring Pit Ground Surtace elev. ____.__.______ ft. Depth to {uniting factor ----____ _ in. Soil Application Rate Horizon Depth Dominant Cola Redox Description Texture Stn~cture Consistence ~ Boundary Roots _ OPQItt? __._ _ "Eff#1 'Eff#2 _ --- fi-- - _ _---- r------ ------- - - -----__ ------ ----- ,-- -------- - --- - ,- -- __ _ I ~ ~, I _._._ r- - +- _------ --------- t --t " ~ - ----------- ------- ~~--- -------- 'i ~ -------. _ _ ._._._.---- --- _...- - ^ Boring # ~ Saring ~ PR Ground Surtace elev. .__-__.______ fl• Depth to limiting factor _--_~__ in. Soil Application Rate Horizon j Deplh j Dominant Caor ~ Redox Description Texture Structure Consistence ~ Boundary Roots SPQ/ft-.._ _ ff# "Eff#2 ' E 1 I T i ~~ i -_ _ - ~-- ~--------------- ~ - - --------------- T .._--- r--- ---._ 1 _ - - _, - _ ~ I r. _ r_ ,_ I ', i -- t.- ~- --------- ----- I I - ---+- -,------- ------ i ~ I -- -- ------ - - -_ ------ ~ -- - --- ---__ ___ _ ---- ~ _ - --- _ -- ----- ------------- ~ ------- ~ - --- _ __ ---- I-----_---- i - - _ _ --- - - _ _ __ - - ...__ _ _ - ---~_ _ i----- -- I 'Effluent #1 = BOD 5> 30 < 220 rrtg/L and TSS >30 < 150 mg/L 'Effluent #2 = BODS <30 mg/L and TSS <~0 mg/L The Department of Commerce is an equal opportunity service provider and empbyer. If you need assistance to access servicxrs or need material in an alternate formal please contact the denartrneni at 608-266-3151 or TTY 608-264-8777. :~~ ~ -~ 8 rt ~ T p oF~'~ ~, rc bay: E7e% = iG+o. zS,' O ? ,~ g $ ~i2 ^ I 100, I g~ a~ ,~ ~ u~ Wl~ 9$' `; s~ ~i s~o~oe r~ c~~ ul X19900' i e( ~z9 - de huh v~t~~. ~ o i '` /-e b ar. Ass u m.e d e 1. = / ~O.1.7~' ,2 9S' a3 ~z~ai' So ~,4 ~e ~ _ _ ~ 50/~ Eda/uaf,on P~'E ~(ed¢Eion ~c ~ I ca /e : / '= ~fD ~od~r~ ~` Q•cliQ.~d 7'o~sor~ ~o~;~joer6y /off. ~ o ~~o~o~oQsc d CS~'~, SESc,.; SQe. ~{ Tn. o F Eak(oQG(,e~ SE..C~O~k~'o.~c~l, ~~. 3 ~' 3 s Wisconsin Deparbnent of Commerce Division of Safety and Buildir>gs SOIL EVALUATION REPORT in ~rrlw~isnrn with ~!nrw, RK Wic nrlm (^.rviw 1448 paps 1 of 3 A.C.E. Sal & Site Evaluations ~~ Attach complete sde plan on paper not less than 8~4 x 11 inches in size. Plan must St. Cron include, but not limbed to: verticail and horizontal reference pant (BNq, direction and ' Para~l I D on and distance to nearrot road. percent slope, scale or dimemsions, north ar . . 008-1012-10-000, ID#4.28.18.63A Please prl r i~ f n 7 R~ Date Personal adormatbn YW Provide ~ or second purpos Sri , s. 15.04 (1) (m)). ZS ~ ONrt>er >£EE1i/E '~ ~. Properly Location Robert & Richard To erso _ ~„--- ~ ~• Lot SW 1/4 SE 114 S 4 T 28 N R 16 W Property CMmer's Maili Add ~ ' 20~' - "~ AUG 2 9 "' Lot # Block # Subd. Name or CSM# 508 Co. Hwy. BB ~ 3 Proposed CSM City Zip umber J City ~ vilage ~- Town Nearest Road Woodville ~ t• 4 44 Eau Gape 50Th Ave. ~C / \ /1 ', ~, Construction Use: roorrrs 4 Code deriaad design fkrwrate - _ 600 GPD :.~ Repiaoement ~ Public -Describe: Parent material Glacial T81 Flood plain elevation, ff applicable na General comments and re~orrurrendations: Mound system elev. = 101.92' at 23" above 99.00' contour. o~~# ~~~ ~] Pit Ground Surface elev. 99.14 ft. Depth to limiting favor 18" in. ~ ~ ~ horizon Depth Dominant Color Redox Description Texture Structure Consistence ~Y Roots Dlft~ •Eff#1 1 0$ 10yr3/3 none sit 2fsbk ds as 2fm 0.5 0.8 2 8-18 10yr5/4 none sit lthinpl ds as 2f,1m 0.2 0.3 3 18-23 10yr5/4 m2d 7.5yr5J8 sit 1 msbk ds aw 1 fm 0.2 0.3 4 23-39 i Oyr4l8 ri2„~ f j ~/ ~~` si 1 csbk mfr - - 0.4 0.8 Barirg # ....yl Boring Pti Ground Surface elev. 98.97 ft. pepth to limiting factor - 15~~in• Sal Application Rate Horizon Oepth Dominant Color Redox Description Texture Stnichire Consistenos Boundary Roots GP DJfI= 'E 'E 1 0-9 10yr3J3 none sit 2fsbk ds as 2fm 0.5 0.8 2 9-15 10yr5J4 none sit 1thinpl ds as 2f,1m 0.2 0.3 3 15-20 10yr5J4 m2d 7.5yr5J8 sit 2msbk ds aw 1 im O.,S 0.8 4 20-28 10yr4J8 ii2~f1~`~ sl lcsbk mfr - - 0.4 0.8 5 28-41 7.5yr4/6 fad 7.5yr5/8 scl Om mfi - - 0.0 0.0 * Effluent #1 = BOD ~ 30 <_ 220 mgJL and TSS > < 150 #2 = BOD <_30 mglL and TSS <-,30 mglL CST Name (Pl~se Prints Sg ro: CST Number James K. Thompson ~~ 3602 Address AC.E. Soil & SiUe Evaluations Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceaa, Wt 54020 8!2/01 715-248-7767 pgrop~ty Owner , Robert ~ Richard Torgerson Parcel ID # 00&1012-10-000, ID#4.28.16.63A Page 2 d 3 ~~ # ~ Borirg Pit Ground Surfaoe elev. 97.96 ft. Depth to limiting factor~,~in. ~I ~ Horizon Depth Domin~t Cola Redox Description Texture Structure Consistence Boundary Roofs "'Eff#1 *Eft#2 1 0-8 10yr3/3 none sil 2fsbk ds as 2im 0.5 0.8 2 8-13 10yr5/4 none sil 1 thinpi ds as 2f,1 m 0.2 0.3 3 13-22 10yr5/4 m2d 7.5yr5/8 sii 2msbk ds aw 1fm 0.5 0.8 4 22-30 10yr4lti m2d 7.Syr5/8 & m2f l /2 sl 1 csbk mfr - - 0.4 0.6 5 30-42 7.5yr4/6 Qd l(y 6/ ~ sci Om mfi - - 0.0 0.0 ^ ~~ # ~i Boring _) Pit Ground Surface elev. ft. Deptt- to limiting factor in. ~ q Rate Horizon Depth Dominant Cola Redox Descriptior- Texture Shucture Ca~sistence Boundary Roots *Eff#1 *Eff#2 ^ ~~ # _, Boring ~ Pit Ground Surface elev. ft. Depth to limiting factor in. Sod Application Rye Horizon Depth Domin~t Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 'Eff#2 ' Effluent #1 = BOD 5> 30 < 220 rrtglL and TSS >30 < 150 rrglL • Effluent #2 =BODE <_30 mgll. and TSS <~30 mgfL The Department of Commerce is an equal opportunity service provider and empbyer. If you need assistance to access services or need material in an ahemaLe format, please cxmtaet tt-e deoattment at G08-26Cr31S 1 or TTY 608-264-8'777.. ~~.. ~ ~2 ^ ~ i~. B.nt. ~ Top oFj"~~' rt bar: Ele% = /Gb. zS,' e o 4 °~ 1990°, I i I s' 1,29 ~~ ~~ Wl~ 99' ~ s-` o'} 8 3 ~~ S/oPa ~I C~i I h199.o0' I 8/- g¢ hc.h Vtilar,~': ~ o ~', re b a.r~, Assu m.ed e!, = l DU. C~' Z9S' ~z~e/' J~ ~ `~c~{~e. ^ So~Y E'd4/uc.fo~ P%~ C!e de ~ o~ ca/e./"=5~0 7o~eiscr~ ~G~o7oe.r6y /off 3 oP~o~-9oaud C5n(, ~ESt~:, Sec. ~ Tn. o ~' EQcc Ga.GLe, SE..C~Dik eo,, c,.~l, ~~~ 3 ~ 3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer '`^.~ ~~,~~ & ~S ~~,o ~ ~, ~ `c,~~,^c ~/~ ~ Mailing Address ~~ ~ 3 .~ ~!/G~ ~.~ ~c ~~ v ~, ~'~ ~u ~.r® •, T l :i ~o / G Property Address 3 ~D ~-~ i„J l (Verification required from Plannin Department for new Ci~~/State ~~~. ~~ ~(e w .~ Parcel Identification Number o o k - /o ! .2 - ~ o oa ~-? o f ~~ p,~ LEGAL DESCRIPTION Property Location ~ '/a, .S L '/a, Sec. ~, T ~-8~ N-R f (.~ W, Town of ~ ~- k C~z «^c Subdivision _ _ _ ,Lot # ~_. Certified Survey Map # ~.S"~~~ ,Volume /~ ,Page # ~~1~~ Warranty Deed # / ?O ~ 72 ,Volume 1 ~.~ .Page # .2~ Spec house ~ yes ~ no Lot lines identifiable ,I~ yes D no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeymanplumber, restrictedplumber or a licensedpumperverifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGMA OF APPLICANT t~ / ~ f / D.Z DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. ,~~ ~.~,~ SIGNA OF APPLICANT DATE * * * * * * Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. * * * * * * ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed 26 1833P ~~~ ~~~ STATE BAR OF WISCONSIN FORM 2 - 1998 670672 DEEDS ~ ~ ' WARRANTY DEED i'EGISTEk Or F Document Number `~~• CkOIX CiJ.! WT This Deed, made between Robert Torgeraon and Richard kECEIVED FOP. RECORD Torgerson,a/k/a Richard Louise Torgerson 02-09-2002 11:30 AM YARRAHTY DEED Grantor, and Rod r Preble and Stephanie Preble, husband and wife 8e EXEMDT A 17 CERT COPY FEE: --- COPY FEE: TkRHSFEk FEE• kECORDIHti FEE: 11.00 PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin: Recordin Area Name and Retum Addross Part of the Northwest Qttarter of the Southeast Quarter (NW 1/4 of SEU4) and ~~ •tS •~ C P,~ 6 the Southwest Quarter of the Southeast Quarter (SW 1/4 of SE 1/4) of Section ,2 ~ r 3 L ~v n.+•- ~~• y .~ ~ s ~ Four (4), Township Twenty-eight (28) North, Range Sixteen (16) West, Town w 1 S•..~o / G ~d ~ ~r1 c ~t of Eau Galle, St. Croix County, Wisconsin, more patticulazly described as t follows: of Three of Certified Survey Maps filed September 26, 2001, ]n VOhun 008-1012-10;008-1011-95 Parcel Identification Number (PIN) o tad Survey Maps, at Page 4180, as Document No. 657491, office of the This is not homestead property. Register of Deeds for St. Croix County, Wisconsin Fm9 (is not) This deed is given in full satisfaction of that certain Land Contract between the parties dated October 31, 2001, and recorded November 12, 2001, in Volume 1760 of Records, at Page 307, as Document No. 661780, office of the Register of Deeds for St. Croix County, Wisconsin. Exceptions to warranties: Easements and restrictions of record, and except any lieat or encumbrartces created or suffered to be created by the acts and defaults of the grantees, their heirs, successors or assigns. Dated this ~~ day of /~.(.d~ , 2002 AUTHENTICATION Signature(s) authenticated this _ day of, . Ro art To rson .Richard Torgersoh ~/ ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. St. Croiz County. ) ,~~~ Personally came before me this Z_ day of /7~ ~ ~ ~ ~ ~~ 2002 the above named rt.,ro..a~t,e and Richard Toreerson. a/k/a s TITLE: MEMBER STATE BAR OF WISCONSIN (If rat, authorized by § 706.06, Wis. StatsJ THIS INSTRUMENT WAS DRAFTED BY Tbomas A. McCormack Baldwin, WI 54002 (Signatures may be authenticated or acknowledged. Both are not taxessary.) to me known to be the person(s). iMtrumalt and BikngwledSe thti sa ,' ;"'r -, ~, Notary Public, State of Wisconsin My Commission is permanen . no , s Ve exptra on _e: 'Nwnes of persons aigniDg in any capacity' should be typed or printed lxlow their signatures STATE BAR OF W IaCONa1N WARRANTY DEED FORM No. 2 - 1998 INFORMATION PROFESSIONALS COMPANY FUND DU LAC, WI a00-655.2021 _ ~ n If not recorded vfi:~+o 3u as>'s yr SHEET 1 OF 2 approval date approval sh~u Le null and vrid 6s~49i Y.A~iHLEEN N. WALSN REGISTER OF DEEDS ST„ CROIY, CO. WI Ei:~1JED FOR kECdR.6 ii9-2o-e00i 11:15 AM %OFY F'EE: 3.UO kECOkDI4G FEE: 13.00 CERTIFIED SURVEY MAP` ~' Richard L. and Robert O. Torgerson Located to part of the Nor[hwest % of the Southeast %r and the Southwest % of the Southeast of Section 4, Township 28 North, Range /6 Wert, Town of Eau Galle, St Croix County, Wisconsin. Wisconsin D.O.T. Approval No. 55-94-3304-2001 owivarsannRESS B~sa~ N LEGEND 508 C.T.H. 'BB' TO TitE MDRTH~90UT111N secTtoNUNEOFSecT-DN~, uuacAresrx24•u~onalpESEr WOODVILLE, W154028 T z~ µ R u w, nssuMED As ° (MW. wT. -1.131B.A.uu. f r.) NO?'t{'OYW. • WDICATESI'~20NPiPEFDUND NoRnf fu coR~R sc~I_e w ~T r =300' n sou. eoRwucs (PROPOSED s~rrc srsTEM) SECTpN 4, 728 N, R 18 W RNERMONUMENT ASNOTED) (FOUN02 biONP1Pq 0 SECTION CO .~~ t 1 0 -x- NDICATESPENCELINE o `'~-- ~_ ~_ '' -d(!VP~q 7TE~ L4N~S (R=) RECORDED as L 3 3 ---- lO ~ ~ --- --~_ _~ ----- LQh!NEp BY ~ 4~ (Z ' w ~ - __ -~-~_ -~ __~NrERSTATE G -~-,. -~ AYIy „E ~ ,~ ~"• ` .H_I ywA Y X94. m ~ -- LOT i, xx •roTt'_l-~. ._~_,_.__-~_. __ C S. M, ~ STAIEA~ .36' ~•E m ~21Z~~' r~~„_~~`~ y ~-.~,_ ~ _- VOL 14, ~ COUMYHAfiMyRY ...~~ ~~ ~'`M'AY'~~~~ -~ _ ~•--. PG. 3920 ~' "_~ ----------; - SOUTNL~IENWINSEI,4 -~91• -- _ e'x -twESwrA1,sE1H - -- - ~a'rii~ ''~--.`_. z I ~.._ ~ I ~. , ss wt:sTl~lE y SW1NSEiM ~-r-- UNPLA7TED .L_A~QS (OWNED i BY PLATTE I I N(17TN RA4 LINE :3aTNAYE. SOUiN1M~~ _NBB°~8'S5'W T.a'- ~Otl1 AVENUE SOt1THEASTCORNERSECTIGW4, CORNER c~ T 28 N. R 16 W (FOUND BERNTSEN --. ,~ SEC7fON1, ~`~S ALUMINUM MONUMENT) 'O T 72SAtRf6W ~;p (p.IC NAIL SETFROM TIES) LOT 1, _~~~,jlFlED oo~,~mnx~xa<aesem. ~~ '~ ~~ l S RVEYMAP ____ l1NPLATTED `SGONg~~ „_~V- ~-~' i UNPLA7TED !1 .r' ;~ .~;n LANDS VQLUME_ 8, PAGE 22 _ LANDS ~ 'to~ i~~ (QWNED - --- A~1~R0llCt~ OTHERS) RPHY i'i ,~~ eT, ronlr r.2iv TY ~ 1773 ee> .m ~N I Planning Zoninn and Pa~9e .^.~~~•_,:'!", FALLS. . ~ a 'fn~.w rrn A n non. DATFD:_ .. ..., ~~@~~° WI. ,^J0 & I 7H1S INSTRUMENT a7AFTED BV JERALD L IARSON ~,~,~e. ~3~~3~' Vo1.15 Page 4180 f 1,,:/ j e ,IqN 1 ~ I ~~r . ~' 654'91 I:A'1'HLEEN H. WALSH i~'tEUT~'l•ER OF' DEED5 f~T. CFtOTX CO. WI RECEIVED FOR kECdRD 09-26-2001 11:15 AM COPY FEE: 3.00 RECORDING FEE: 13.00 CERTIFIED SURVEY Richard L, and Robert O. Torgerson Located in part of the Northwest % of the Southeast %: and the Southwest % of the Southeast f/4 of Section 4, Township 28 North, Range 16 West, Town of Eau Calle, St. Croix County, Wisconsin. Wisconsin D.O.T. Approval No. 55-94-3304-2001 owNER~sAnnl~ss eEA~NGSARE N LEGEND 508 C.T.H. "88" TO THE NW?TH-SOUTH 1~4 SECTION LINE OF SECTION 4, INDICATES 1 " x 24"IRON PIPE SET O WI 54028 WOODVILLE (MIN. WT. -1.i3 L6.AJN. FT.) T 28 N, R 16 W,~ S QED A~ , • INDICATES 1 IRON PIPE FOUND NORTH 1/4 CORNER SCALE IN FEET f " =300' A SOIL BORINGS (PROPOSED SEPTIC SYSTEM) SECTION 4, T 28 N, R 16 W (FOUND 2"IRON PIFE7 - SECTION CORNER MONUMENT (AS NOTED) -s_._ 1 1 0 x INDICATES FENCELINE ` "~- -....,_` "" `~- _~NP[q n-E~ SA (R=) RECORDED AS ND $ --_.._,_ l_~WNEp BY I ~ ~ _ -._.._ .`~ OTHERS _ . ~ . - ~ _ -/NT,EygSTq TE 1 ` -- ____ , ~ y --_. _ / .-- -- ... C_ S_ M, 14 VOL - ~ - S !~ 567.38' 1212.30' ""--~._ ;~ • ._ ..,,, - TA>E'A/yDC~N1Y ~FRSTAt~E` H~A -~ _., ,~'_~ • 'S " , . ~ . Hl(, --- - Y gq -x~ NWAY -- °~~~ PG. 3920 " - _ - _~a.s4' o _ _ _ _ _ - SOUTHUNENWf/4SE1/4 - ~- - --_ - ._ -----___• 6.x _ _ r ~ NORTHUNESWI/4•SE1/4 "'~-~ t N CAUTION- ~,~ N WEST UNE HIGHWAYSETBAGK ~ y z o swvasEl/4 ~- RESTRICTIONS PROHIBIT ~ I ~ ~ IMPROVEMENTS (SEE SHEET 2) m m ~ ~ o p ~ N LOT 3 ~ ~~ ~ ~ ~ `' ~ ~ N CONTAINS 871,200 SQ. FT. ~' Z ° Y; t / ~- , a OR 20.000 AC. (850,486 SQ. cn I m O -• ~ ~ ~~yy,,~ -' 4,~ FT. OR 19.524 AC. EXCLUDING N 'J ~ m m TOWN ROAD RIGHT OF WAYJ ~ _.,,._ UNPLATTED ~ --- 1 00 ;-+ ~ • I ------------- J ~ ~ ~ ~ ~ IW -• ~ m LAND$ LOT ~ ~ O ~.."' _ - CONTAINS 70 ,254 SQ. FT. A N OTT 2 CONTAINS 117,161 SQ. F'T~ I FT OR ~ C ~n rn o ~ . OR 16.1 a4 A .(695,005 SQ. OR 2.690 AC. (107,031 sQ. OWNED FT. OR 15. AC. EXCLUDING 2.457 AC. EXCLUDING TOWN ROAD ~ I ~ --------' --~- ,~ , I y ; m ~~ _ ~.. ~ ROAD R T OF WAY) RIGHT OF WAY) , ~ ~~ BY PLATTERS) ~ .m ~~ ;~, ~ ---- -------- o ~ ,~ ;~ ;- ~' ;o Ia ~ I N as°a sss" w ^ ~~ iY, iC y A o sao ~N ~ SHOD 8~~ ~ e m ~ $LOT "~LL2 ~ ~ ww ~ ~ .~ m e SED m ASERP7IC[~ .~ .°o W DRIVEWAY I 1 A ~ D " AGAR. DWELL i _____ _____ _ _____ 100'000MYBUI ING -SETBACK UNE - `----- -"-°--- ------ ~ Z1 100' ', NORTH RNY UNE • $~ ~ g - N 89° 55" W 1184.81' - ~ o ~~~ 50TH AVE. :50.009 .- ~ OcY •~ 1- 310' _ - ;;627.81' ~- /I - -- ~- SDUTH RNV UNE: -1 ~~ Qi~"' I ~ Z :~~-i 'm ;-~; o ~ ~~ i~~ ;~M ;o ,. ;cn .y i~~ m ~w tZI SOUTH 1k - -~ CORNER `~ - ~~ oa °ev vv rr •' - N 89°46'55" W 2647.04' - R= WEST) SECTION 4, ( T28N.R16W (P.K. NAIL SET FROM 71ES) LOT ~ ~~RTIFIED .___ UNPf~ITTED __ SURVEY MAP _____ _ LANDS VOLUME_ 8, PAGE 22__ (OWNED _. ., ,. ,>~,~~`~~:~:''.~ ~ ~,' :. I .~,r ~ ' , .. , ~~ 'II ~i: ~) t ~ -i~ I THIS INSTRUMENT DRAFTED BYJERALD L. CARSON 5Ef' ' 6 ZOll1 ~.03'~Y''~o N89°4G55'1N 1462.3T _ .~ - ~ _SDU7 UN 1/4 ~Qth AVENUE SOUTHEAST CORNER SECTION 4, - - ---- - T 28 N, R 16 W (FOUND BERNTSEN ALUMINUM MONUMENT) 'i n: ~ I •r c ... aF,, l,.t~~~ I,~ ., , ~ , .:.~ ..., rn.,~i . ,, ..' Vo1.15 Page 4180 o~`c~O~~n^OOpp oopOO DONS GGGGGf UNPLATTED o~0~°~~5° ° ° ° ti °oo~ LANDS ~ °oo o° ° ° LAU E °E ° ~~G ' OTHERS) o FHY 1713 ° * ~ ~ RIVER ~ ~ FALLS, ° O ~ DATED: ~^o~~'s°°°. wl. °,° JG, g A/~ AUGUST ]0, 2001 ~' °°°°„°°°°gJoda$ w QpGGGG O~DO~~o ooo~~ SHEET 7 OF 2