Loading...
HomeMy WebLinkAbout008-1027-90-100NVsconsirlDepartmentofCommerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: ^ City ^ Village ^ TQwn of: LaBecki Wade Eau Cralle Township CST BM EI v.: ~ 31 ~~ Insp. BM Elev.: BM Description: ~~~ 2 ' "~ ~ 0 .3 I r = ~5t ~ N TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic (~ ~" ~~ ~,~ Dosing ~ ~~ Aeration Holding TANK SETBACK INFORMATION TANK TO P/ L WELL BLDG. vent to Air Intake ROAD Septic ,r 2 / p r NA Dosing ~~ ~( ~` ~ ~ NA Aeration NA Holding PUMP /SIPHON INFORMATION ~ ~~ Manufacturer ~ Demand Model Number ~`-(3~- a~'` G TDH Lift \to•IO Lriction 1 ~$ Systema TDH'~ ~' t Forcemain Length nr Dia. F2 " Dist. To Well SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No.: 353397 St to Plan ID No.: ru4~us. /~~: zg9s-~y arcel Tax No.: STATION BS HI FS ELEV. Benchmark ~ fl~ I a$. 3 I ~ p Y 3 - 30 ~p~..ol Bldg. Sewer ~2-~ gSrs- St/ Ht Inlet 13.52 ~ g~ ~9 St/Ht Outlet Dt I n I et ------" Dt Bottom ~b , }~~ 9 (. S }- / Header / Mard!~ 5- ° G pB .8 ~-( Dist. Pipe ~ ~ 9 (08.40 Bot. System 5 ` ~0 8-~ Final Grade ~ .ee_ S t~.s ~ CA (3•q~ 1t3.4o )cSa.a TR NCH Width ~ Len th_ ~ No. f T nches PIT No. Of Pits Inside Dia. Liquid Depth DIM N I S l DIMEN I N SYSTEM TO P/ L BLDG WELL LAKE /STREAM LEACHING Ma cturer: SETBACK CHAMBER M INFORMATION Type O - . n M0~^^~ 5 ~ + ~Z ~ ~ 1 I -'~' OR UNIT oe r System: DISTRIBUTION SYSTEM ~.~~' Gefrs""`'~~ l Header / Mani of Distribution Pipe(s) > ~ « x Hole Size x Hole Spacing Vent To Air Intake Length ~e~ Dia_ '- ~,~ Length 35L~'" Dia. ~ ~ Spacing ~ ~~c( ~p ~~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ^ Yes N ^ Yes ^ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: D(o/ o~j oolnspection #2: --~ f-' Location: 2441 50th Avenue, Woodville, WI 028 (N 1 4 NW 1/4 10 T28N R16W) - Lot~- ~ 1.) Alt BM Description = d~ 3 ~ `~~ f r `/ `~ _ ~ (. 3 3) = /! o~ . ~ 8 C,- 2.) Bldg sewer length = I$ r -amount of cover = > Zo ~- ~ ; 3 ') 3.) contour = 10L.9 8 L H'= ~ IOC' 3 I S~ ~,,. ~.~ ~ u~ t8 `" S e, ~ U C1ut~ alp(" ~ec~- - S) ~,,.,~Q q1.~. Plan revlslon r'equire~ ^ Yes {~(No 5- , Use other side for additional information. ~ ° ~- c~D ~~ i X SBD-6710 (R.3/97) Date Inspector's Signature Cert. r' ADDITIONAL COMMENTS AND SKETCH ` SANITARY PERMIT NUMBER: r '~ Safety and Buildings Division ~~ISCO/1S%/1 SANITARY PERMIT APPLICATION PoBoW302ngtonAvenue Department of Commerce In accord with tLHR 83.05, Wis. Adm. Code Madison, WI 53707-7302 ~r~~ • Attach complete plans (to the county copy only) for the s ~~-~9t s county than 8 v2 x 11 inches in size. n,~ ~ ~` ~`~„ - • See reverse side for instructions for completing this a tior~E~E'`~0 ,~v' y State Sanitary Permit Number ~ _.~' . ^ 353 `l ~ r Personal information you provide may be used for secondary purpose N A ~ ~ Zuu® ~ ~] Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. ~{„, F ~ -. z`ryr' SO ~u`o ~(,t/ O t'r/~"cy ~ „_ .,State Plan LD. Number 1. APPLICATION INFORMATION -PLEA E PRIN ~kL IN ON ! ~ ` Z~qS Prop rty Owner ame / ~ ~'- ~ ~ ~~ 6 ~ ~~ ~` U / N E (or x~a '~!1f R l ~ S f T Z~ . ~ . i / ~ , , r j , Property Owner's Mailing Address r Block Number City, State 1 v!L!L/i0 YJ Zip Code '.Z Phone Number (~~~ 68 -373 Su Ivision ame or CSM Number ~. ~U©G ~~-I y° ~8i II. F B IL ING: (check one) ^ State Owned ~ '/ a Ity ~ ~ ' ~ ~ n Nearest tRoad ~ T~ ~ Public 1 or 2 Famil Dwellin - No. of bedrooms s~ L. U Tow OF ~- 'C V ' vZ {II. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) ~~_. bog„ ~p~1~~i--lob ~ ,:2g,~(..1~16 0 n , • 1 ^ Apartment / ondo - 2 ^ Assembly Hall 6 ^ Medical Facility/ Nursing Home 10 ^ Outdoor Recr 3 ^ Campground 7 ^ Merchandise: Sales/Repairs 1 i ^ 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 online B, if applicable) A) 1. ,New 2. ^ Replacement 3. ^ Replacement of 4. ^ Reconnection of 5_ ^ Repair of an -_____System ____-___System _____________ Tank Only___________.___ Existing System __~_____ Existin~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 1 1 ^ Seepage Bed 21 Mound 30 ^ Specify Type 41 ^ Holding Tank 12 ^ Seepage Trench 22 ^ In-Ground Pressure ~ ~ 42 ^ Pit Privy 13 ^ Seepage Pit ~ S 43 ^ Vault Privy 14 ^ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: C o Y ~~ L, S~ ~, 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Pert. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation VI1. TANK INFORMATION Ca aclt in alto s g Total # of Manufacturer s Name Prefab. Slte con- l s Flber- Plastic Ex er. . p N i E i Gallons Tanks concrete tee glass A p ew n x st strutted Ta Tanks tic ot:-l~s1r#+ag~ank /oA0 j L.C.J ! `t~S '~ ~ ~ ^ ^ ^ ^ ^ Pum Tan © ^ ^ ^ ^ ^ ^ SPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation. of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) ~ Plumber's Si natur • (No S mps) MP/MPRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zi e): I .COUNTY/ DEPARTMENT USE ONLY. ^ Disapproved Sanitary Permit Fee (Includes Groundwater ate slue Issuing ent Sign ture (No Stamps) Approved ^ Owner Given Initial ~ Surcharge Fee) 3 b Adverse betermination 2~cw 0 G~ x rnNn~Ti nNC nt` eaaRnvei / RFecntic FnR niceaalanvei • ~...~_ a ~,_ - 1) ~6k.~,.,~P 5 y5{u~ hti~,~ >ti•.~/t.t a s~ Sc~'zick ~~ caf~wt~r..~_ Z~ "1~ier~ WaS a oftg~r.G~ocy~Cy 5tfcuc~~ >~r C DTs ~ ~PScy'rtirr5 Gb.-~,-~ ~P cN<t~i , ~ ~ // SBD- 6398 (R.11/97) ~ (rva.~; ot.~ . Sy S~c.u DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber v - -- _ INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be 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: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. 11. 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 81/2 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 contamination investigations and establishment of standards. ' ~• ~ ~ ~scons~n Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce. state.wi. us Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary March 08, 2000 CUST ID No.267341 WEGERER SOIL TESTING & DESIGN 421 N MAIN ST PO BOX 74 RIVER FALLS WI 54022 ATTN: POWTS INSPECTOR ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD ----~-~_ HUDSON WI 54016 } k, RE: CONDITIONAL APPROVAL ~~-~`e..- ' ~~ Identific bers PLAN APPROVAL EXPIRES: 03/0 /,21ld"2r ~` /'" ; ." r~ Transaction ID .2995 4 ~ ., r Site ID No. 18763 ~ ~'' '"` ~ ~ F ;,,.., Please refer to both identification numbers, SITE: Site ID: 187636 :-; ~ '"~ ~ above, in all corres ondence with the a enc . St. Croix County, Town of Eau Galle ~, ,`, ~~ a ~ ~' ~ ~ NE1/4, NW1/4, 510, T28N, R16W ,~ , ti~t~,~~,.r;=tit; Facility: Wade Labecki/c.o. Lindus Cb~stxtzGtion.Pro~ eEi'~ idence FOR: ``~~... ~' t I Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 650456 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • 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. Stats. 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/instal lation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, Gerard M. Swim POWTS Plan Reviewer -Integrated Services (608)-785-9348, Mon. -Fri. 7:15 AM to 4:00 PM j swim@commerce. state. wi.us DATE RECEIVED 02/29/2000 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 BALANCE DUE $ 0.00 WSMART code: 7633 ~~ T'lTLE. S ~ ~,L T Page ~ of 6 MOUND SYSTEM FOR A 3 BEDROOM RESIDENCE LOCATED IN THE ~yEl/4 OF THE NW 1/4 OF SECTION ZO ,T ZS N, R ~6 W, TOWN OF ~-Lj 6~ - , ST. ctLC)LJ( COUNTY, WISCONSIN. INDEX PAGE 1 'of 6 PAGE 2 of 6 PAGE 3 of 6 PAGE ~ of 6 PAGE 5 of 6 PAGE 6 of 6 TITLE SHEET PLOT PLAN PLAN VIEW-ROSS SECTION : ~ ~ S• DISTRIBUTION PIPE LAYOUT P O'iti0n,dtly PUMPING CHAMBER Cpjtia' ~~~ PUMP PERFORMANCE CURVE ~~Q aMM~RC ~~ -~ :~MENt ~F N DLO - OEp p. cR~~p~ A ~ ~~ PREPARED FOR tiv ~ D~, L R-t3 22.1-~I c to L t ~.,Ol~ S Co~.t S'~-~ ~'101v _ Bi~~-OWttiv ~ -,v 1 S~ioOZ _ -- PREPARED BY ~;-~ ~~~ s~ ~ 2 8 ~~~n ~~ B [D~s~~ Y. WEC-,Ef~E~ St7 2 L . TEST S NG AND . - I3E~ I Gl~i SEt~~1 I CE F.O. B11Y 74 421 N. }UtIM ST. RIVER FitLS. YI 54022 715-4c,r0}65 ~;~- A, ~~P -w~, ARTNt!R L N'[[cRcR PuiSP o EIL;;wUATH, a /~ W5. ~~ ~~ire-'6.. ~~dG~~' Z- L1--00 JOB NO . ~ O - Z3 ~ . ,' PLOT PLAN Scale 1 "= 40 ' v ~•l S m 1 To ~- a 2~ Page Z~ of (~ ~., ~o ~t 3vE _ - F~ ~-~~ 1~ 2~ ~z ~o~ ~e o~~~ s ~~% ,~ a~ , ~ o~ ~~ ~~ \ v~ ~v~ \\\~S ms`s / / ~ , ~ ~~ Ca~v~-nv~ . lo6,s ' Bo~-~p ~„~ ~ ~ cN X2.105,5 Fr~~' 130 o~ 2k pVC F.1"~, ~b`UF~I.'`17vC 3 (~ ~~ ~{UV`~1~, ~a ~ ~' .~ ~ N ~ {°` ease ~~~ w- ~ 21 ~~ ze ~~.~us3` 15~ ,,~ ~~ L~ 1."~ '~ 1vw ~Cz.N~t. p~ 02~ ~ , Nrr1 cur ~ I Nw~ To B` E~ ArT LET SO' ~RU-^~ _ _ __y' ~- IU vS~ ~~ ~ ZS' ~~. i `~~vr~-J ~ NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. ( Z required) 3. Install 4" observation pipes with approved caps: (~ required) 4. Septic tank to be lppp~6o~ gallon capacity manufactured by ~~L'S~1Z CO-v CIZ~TL= ~R-c~oU c~-S w~.PcT -l l~ ~O 5 . Bench Mark ~_ . ~ uo p' oN'cu~~ o~ l.r~T Si~A-ke ~YT l~ ~W ~~~ ~ wT• ~ 1~L~- t31" 1 ~Tl. /o ~! 31 ' C~1 ALL ) N l~c~apW l-••~c-:. 1sT ITT f.~W °~`R~1 ~'(L Or= C-C'iT' 6. llivert surface water around mound to prevent ponding at the uphill side. J 2 Page 3 Of 6 Approved Synthetic Covering t~sTr-~ c ~3 Distribuf ion Pipe Medium Sand _ _ H_ ~ . Topsoil F Elev. 10`x• -J i p 3 E " S % Slope Force Main Plowed Trench of i"-2 2" From Pump Layer Aggregate Undisturbed D l.0 t. Soil E \ •2.5 Ft. Cross Section Of A Mound System Using F b.$ Ft. I Trench For The Absorption Area G ~•'~ Ft. A 5 Ft. N ~• S Ft. B ~ S Ft. I t5 Ft. Linear Loading Rate= ~,O GPD/LN FT ~ ~', Ft. Design Loading Rate= 0.3 GpD/SQ FT K 1.1 Ft . L R.~ Ft. W Z-g Ft. L J Force _B K Main ~~ A ~r - - - - -- - - - ~s qT w , - , - ~~~s~`r~ Distribution Trench Of 2 - 2 2 i:~17 Pipe A99regate I Observation Permanent 1 PiPes~ Markers • (Anchor securely) Mound Using I Trench For Absorption Area "" page ~ Of b Perforated Pipe Oetoll End Co End View 'erforoted 'VC Pipe Install permanent"marker at end of each lateral Holes Located On Bottom, ~1re Equally Spored ~p Last Hole Next To End Cop Distribution Pipe Layout p 3 5 Ft. X ~U Inches Y 4D Inches Hole Diameter ~y nch Lateral I ~y I ch(es) Force Main Inches ~ of holes/pipe 1.) Invert Elevation of Lateraislo8.p Ft. ~1X 1•l7_ lZ,g~ ~z2_ ZS~Z~ GPVti. Place lst hole ~O~from tee with succeeding holes at ~ O~~intervals. Last hole to be next to the end cap. • ~~ Combination Sept:ic~ Tank and PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS ' PAGE S OF (~ -VEAJT CAP WEATHER PROOF JUiJCTIOAJ 90X 'i~C.I. VEAIT PIPC , APPROVED LOCKING '-•10' FROM DOOR, ~ ~u-'AARNI-JG VLR~ r ~CZli '.~%IIJDOW OR FRESH A~IUTAKE ~ ~ ~,(~l P- =~ _ i 1J f6"MIA1. ' J y~~1u51~~cror.~ PIPC ~ . 1 I>J L E T ~! H-tcrFt6tt-r- e.~-p _ . 8 gFF~~S Approved .. A joint w/• Tank construction PVC pipe shall comply with ILH~ 33.15 and 33.20. !3 cjj Ca.~Du1T I I `-- .~ ~~ \\~; 1 PROVIDE I AIRTIGHT SEAL I i I I, .~ PUMP ~ ~~~ ~) ~. ~, I I ~ ^C0IJCRETE `f" NI1.1. 18'MIAI, 'lh ` I ~ ~ ALARM Il I ou I OFF Approved joint w/ PVC pipe RISER EXIT PERMITTED Oi.1Ly IF TANK MAiJUFACTURER HAS -SUCH APPROVAL~3„RP~~~~ B><DO t NG SEPTIC F SPECIFICATIDI\1S DOSE TA-.IK MA!-1UFACTURER: W1~~- L°U>\1 C..Z ~_ IJUMESER OF DOSES: ~ `aZ TA1JK :,IZC: 11100 ~60o GALLOAIS pEK p DOSE VOLUME z ,~y - ALARNI MAUUFACTURCR: ~ ~S. ~.Lfi-~T'1LD S~$`1'L1"1_g INCLUDtAJG 6AtKrLDW: ~~~ GALLONS MODEL IJUM6ER: lO ~ l`}w " CAPACITIES: A c 1~ IuCHES OR 30C~ GALLOtVs I ~~U1Z~' SWITCH TyPC: __ 1 B - _ Z IIJCHES"OR 3y G~ILLDUS PUMP MAAJUFACTURER: ZO ~'L-~ ~ 36 C = S MODEL AIUMBER: X31 IAICHES OR $ l3~ CALLOUS SWITCH TYPE: -'~'1C\Ze.u12.~I D= It1CHES OR ' D~ GALLOAIS _ IJOTE: PUMP AIJD ALARM A E TO 6E M11JlMUM DISCKARGE RATE ~-S•~~ GpM INSTALLED Ou SEPARATE CIRCUITS VERTICAL DIFFEREIJCf DETWCEAI PUMP OFF AUD..QISTRlBUT10-J PIPE., 11•'33 FEET + M11.11MUM -~ETWORK SUPPLY PRESSURE 2.5y FEET y- 13y FEET OF FORCE l'1AIN X ~'3~F~pFr.FRICTtou FACTOR. ~•~~ FEET TOTAL DyAIAMIC HEAP Z'__~61 FEET As per manufacturer ~`1.p gal/in. Liquid depth 3(, ~~ ,,. W w HEAD CAPACITY CURVE ~ ~ MODELS137li39 8 I 25 z0 ZL I 6 a o is a ° 137 139 to ZSr ~ z 5 U.S. GALLONS 70 20 30 40 50 60 70 LITERS 60 160 240 0 FLOW PER MINUTE MODELS 137/139 Ft. Meters Gal. Ltrs. 5 1.52 93 352 10 3.05 79 299 15 4.57 64 242 20 6.10 36 136 25 7.62 8 30 30 9.14 •- -- Lock Valve: 26 ft. i 90 l00 i 1t0 320 400 009921 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Three phase pumps are available in 200/208V, 230V or 460V. • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Mechanical altemators, for duplex systems, are available with or without alarm switches. • Combination starters are available for 3 phase pumps. • Control alarm systems are available for 1 phase pumps. 137 Series - 47 Ihs 13Q Soria° . S1 the Sin le Seal Control Selection Listin s Model Voles-Ph Mode Amps Simplex Duplex CSA UL M137/139 115 1 Auto 10.7 1 or 1& 8 - Y Y N137/139 115 1 Non 10.7 2or2&7 3or586 Y Y BN137 115 1 Auto 10.7 Y Y D137/139 230 1 Auto 5.8 1 or 18 8 - Y Y E137/139 230 1 Non 5.8 2 or 2& 7 3 or 5 8 6 Y Y I' H137/139 200-208 1 Auto 62 7 8 8 Y N ' 1137/139 200-208 1 Non 62 2 8 7 3 or 5 8 6 Y N ' J137/139 200.208 3 Nan 2.6 2 & 4 384 or 586 Y Y ' F137/139 230 3 Non 2.6 2 8 4 ~ 384 or 586 Y Y ' G 137 460 3 Non 1.4 2 8 4 I 384 or 586 N N ' G139 460 3 Nan 1.4 2 8 4 384 or 586 N N ' No molded plug "Single piggyback switch included. Pumps must be operated in upright position. Three phase units require a control switch to operate an external magnetic or combination starter. For information on additional Zoeller products refer to catalog an. Combination stager, FM0514; Piggyback Variable Level Float Switches, FM0477: ElectricalAltemator, FM0486;Mechanical Alterna- tor, FM0495; Alarm Package, FM0732; and Sump/Sewage Basins, FM0487. SK373 • Variable level control switches are available for controlling single and three phase systems. • Double piggyback variable level float switches are available for variable level long cycle controls. • Over 130°F. (54°C.) special quotation required. • Refer to FM0806 for 200° F. applications. 13/16 ~ i 7/16 Lt 6 1 /8 l7PrGC ~ ct= G a 13jj/16 J 1 1/2" - 11 1/2 NPT SELECTION GUIDE 1. Integral float operated 2 pole mechanical switch, no external control required. 2. Single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0447. 3. Mechanical alternator M-Pak 10-0072 or 10-0075. Refer to FM0495 4. Combination Starter. Refer to FM0514. 5. See FM0712 for correct model of Electrical Alternator E-Pak. 6. Variable level control switch 10-0225 used as a control activator, specify duplex (3) or (4) float system. 7. Four(4)hole)-Pak,junctionbox,forwatertightconnectionforhardwiredsimplex operation,10-0002. 8. Two (2) hole J-Pak, for Watertight hardwired Pconnection or splice, 10-0003. CAUTION All installation of controls, protection devices and wiring should be done by a qualified licensed electrician. All electrical and safety codes should be followed including the most recent National ElecUic 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. -,~-~ ,,.~ ,r MAIL T0: P.O. BOX 16347 ~ Louisvifle,KY 40256-0347 Manulacturersol.. ~~ Z ~~~~~ SHIPT0:3649CaneRunRoad p ~,/ Louisville,lCY 40211-1961 ,Q~cat/TYPUMPS SNCE ~~~~7 I $ ~. P~MP ~~ (502)778-2731.1(800) 928-PUMP FAX(502f 774-3624 MlisoorisinDepartrnentofCommerce SOIL AND SITE EVALUATION Page 1 of 3 division of Safety and Buildings in accord with Comm 83.05, W is. Adm. Code A.C.E. Soil & Site Evaluations Attach complete site plan on paper not less than 8%: x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and ___S_t. C____i_oix_ _____ percent slope, scale or dimensions, north arrow anct.toeation and distance to nearest road. Parcel I.D.# ~`' ~ ° ~' rt of 008-1027-9U-0UO APPLICANT INFORMATION - Pl 4Z "print all infon»atipn. - _ - _ P --- ------- -- pat J--- -- - -- `ev~edi8 ggg Personal information you provide may be used r oridary purppttes (Privacy Law; s. 15.04 (1) (m)). ~, ~ ( ~~ /~8 ner Property Location /1 Property Ow - Michael L. & Debra A. Jo~nes~_ -Govt Lot NE 1/4 NW 1/4 S 10 T 28 N,R 16 W Property Owner's Mailing Address I '~j ` "`~'b Lot # Block # -~Sutxl. Name or CSM# ~~./ ~~(~ 2_447 50th Ave. ~~ '. s Z _ Propos CSM ____ City StateStateCode, PhbAe~fltlnlber City ~ Village ®Town NearestRoa Woodville WI 54' 8 ~'~'1'~5~-~$41~40 Eau Gape 50Th Ave. ` `" ~ ~ 3 Addition to existin buiklm New Construction ~ Rt3sidgntial ~N(urnkter,o~rooms 9 9 Replacement Use: ~ public or c0~rtrnerct~fdescribe Code Derived daily flow 450 gpd Recommended design loading rate •5 bed, gpolftz •6 ~-~. 9k~ Basal area required 900 bed, ftz 750 trench, ft~ Maximum design loading rate •5 bed, gpolft2 .6 trench, gpolft~ Recommended infiltration surface elevation(s) 108.50' at 12" above lo7.so' contour ft (as referred to site plan benchmark) Additlonal design 1 site considerations Parent material Glacial drift Fkxxi lain elevation, if a licable NA ft $=Suitable for System Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U=Unsuitable for system ^ S ®u ®S ^ u ^ S ®u ^ S ®U ^ S ~ u ^ S ® u ~~n ncc/+~~oT~nlU ~CDART Boring# 1 Ground elev 105.31 ft Depth to limiting factor 38" 2 ; Ground elev ~mnQe Depth to limiting factor 34" D th Dominant Color Mottles Structure d B Roots GPDIft' Horizon ep in Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consisten oun ary Bed Trench 1 0-9 10yr4/2 None sl 2fsbk mfr cs 2f 0.5 0.6 2 9-13 1Oyr4/4 None sil 2msbk ds cs 1f 0.5 0.6 _ 3 13-38 10yr5/4 None sl 2msbk dsh cw 1 f 0.5 _ 0.6 4 38-41 10yr5/4 m2p5yr5/8 sl lcsbk dh cw_ - 0.4 0.5 ~5 41-52 7.Syr4/6 m3p5yr5/8 sl Om dh aw - _ 0.3 0.4 6 52-82 10yr5/4 m3d7.5yr5/8 strat.gr.s Osg dl - - 0.5 _ 0.6 _ L_ ..L 1:. t _:..1... ..~f u".f Qnr~nV Remarks: Horizon #6 contains bands of stratuted s ~e ~r.s ~c gr.~ ~.~I. f,,, wx-1,1~1 „~....~ ......... ..........................e.. - -------- -- 1 I:VIlVL11U 0-9 UlN11J lVUIIV uu VV~, 10yr4/2 llV •. ...•.. •••~ None --^- -- sl ---- -- 2fsbk mfr cs 2f 0.5 0.6 2 9-15 IOyr4/4 None sil 2msbk ds cs if 0.5 0.6 3 15-34 10yr5/4 None sl 2msbk dsh cw 1 f 0.5 0.6 4 34-44 10yr5/4 m2p5yr5/8 sl 2msbk dh cw - 0.5 0.6 5 40-72 7.Syr4/6 m3p5yr5/8 scl Om dh aw = N.P. 0_2 _ Rt~rtarks: _ - CST Name (Please Print) Sign ure: Telephone No. _ James K. Thompson - S~ 715-248-7767 Address A.C.E. Soil & Site Evaluations Date CST Number Ref # 340 Paulson Lake Lane, Osceola, I 54020 11/3/99 3602 1123 PROPERT~AWNFR Michael L. & Debra A. Jones PA(tCt:L LD.# wit of008-1027-90-000 3 Ground elev 105.15 ft Depth to limiting factor 41' Ground elev Depth to limiting factor Ground elev Depth to limiting factor Ground elev SOIL DESCRIPTION REPORT ~~23 Page 2 of 3 A.C_E. Soil & Site Evaluations Horizon Depth Dominant Color Mottles T t Structure sistence Bounda Roots ~ = in. Munsell Qu. Sz. Cont. Color ex ure Gr. Sz. Sh. ry - Bed ~ Trench l 0-9 IUyr4/2 None sl 2fsbk mfr cs 2f 0.5 0.6 2 9-13 IOyr4/4 None sil 2msbk ds cs If 0.5 0.6 3 13-38 10yr5/4 None sl 2msbk dsh cw if 0.5 0.6 4 38-41 IOyrS/4 None sl 2msbk dh cw - 0.5 0.6 5 41-52 7.Syr4/6 m3p5yr5/8 sct Om dh aw - N.P. - 0.2 6 52-82 10yr5/4 m3d7.5yr5/8 strat.gr.s Osg dl - - 0.5 ~ 0.6 Remarks: Depth to limiting factor .. . i w cr~ ~yj ~eL ,C. ~ D.eb~a ,~ -To~~ ~y~7 sn~ .f ~- ec~uali/,7,~e~ e.J/. SYlO~ ~_ ~~ ~ /ot.3/'a~ ,,~`~ Pro bab le . bu, cd,'~ ~^ ./ S,~e V ~~Cd acccSS ~ ---~ B3 ~~ -E--~-~38. zs ~ ~ °e 30.2'= ~: : Teo o,~'fet ~ct,Q.~c a-,~ e,~ ~ner~ of /of ! ,(ssu,-,ed elev`.- = /Gtr. ce. ~. ~~.30~'3 Sca.Qe : / ~ ~o , ^ tic,;l ©bs~rda~or~ P-~ ~ ~/gatz~ion oCa~~° Hof 8 " o<'~rorvoslcl ~sM, ~IE~~w's; .gee. io TZBiI; 2./6cv, T,~. o~ ~aa 6'a.~¢, S~.eroir n ~ ,-n ~ca{cr, ~e.nce Pos~av~ r1.v~. Carna.r C.oE 1: Iltoepartmentafcomrrrerce SOIL AND SITE EVALUATION Page 1 of 3 Division ~ Safety and B"'~'n~ in accord with Comm 83.05, W ~. Adm. Code AC.E. Soil & Site Evaluatioag Attach corr~tete site plan on paper not less than 8'/: x 1 S inches in size. Plan must County include, but rwt lirrnted to: vertrcal and horizorrt~ reference point (BN10, direction and St. Croix percent slope, stye or dials, north arrow, and -ce to nearest road. Parcel I.D.# ~ ~ ~ prt of 008-1027-90-000 APPl~ANT INFORAAATlON - P .,~i-rf all information. Re g pate Personal information you provide maybe used for ry pu r ~~ Law, s.45.oa (i) (m)}. ~ ~ ~Z7/Le ao Property Owner ~::;:::;' ~'°' / ~ Property Location Michael L. & Debra A. 3anes ~~'~l.~ Gov¢ Lot NE 1I4 NW 1/4 S 10 T 28 N,R 16 W Property Owner's Mailing Address ~ Lot Block # Subd. Name or GSM# 2447 50th Ave. ~ '' ~~, ~ ~ ~'~qr '~gt~,' • . ~ Q Proposed CSM City Site W-G ~` rl. ~ City [~ ~Itage Town Nearest Road Woodville WI 5 `';.715- ~54p.~'~` Eau Gape 50Th Ave. New Construction ~ Res' `-.'I N~rr s 3 ^Additiat to existing building Replacement Use: ~ PubtiC or commeraa describe Code Derived daily flow 450 gpd Recommended design being rate •5 bed, gpd/ft~ .6 trenf~l, gpdtftZ Basal area required 900 bed, ftz ?50 trench, ftz Maximum design boding rafie .5 bed, gpdHtz .6 trench, gpolft~ Rectxnmended infdtratbn surface eievatiorl(s) 108.50' at 12" above 107.50' contow ft (as referred t0 site plan benchmark) Additional design /site considerations Parent material Glacial drift Food in elevation, if icable NA ft S=Suitable for System Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U=Unsuitable for system I ^ S ®U ®S ^ U _ _ ^ S ®u ^ S ®u ^ S ®U ^ s ® D Boring# 1 Ground slay ,ru zt a Depth to limiting facto 38" 2 Ground clay 107.88 ft Depth to frmiting 34" th De Dominant Color Mottles--- - Sere i d B Roots ~~ Horizon p in. Munsell Qu. Sz. Cont. Cobr Texture Gr. Sz. Sh. sten Cons oun ary Bed '; Trend 1 0-9 10yr4/2 None sl 2fsbk mfr cs 2f 0.5 ', 0.6 2 9-13 10yr4/4 None sil 2msbk ds cs if 0.5 ~~ 0.6 3 13-38 10yr5/4 None sl 2msbk dsb cw If 0.5 0.6 4 38-41 IOyrS/4 m2p5yr5/8 st lcsbk dh cvv - 0.4 0.5 5 41-52 7.Syr4/6 m3p5yr5/8 sl Om db aw - 0.3 ~ 0.4 6 52-82 10yr5/4 m3d7.5yr5/8 strat.gr.s Osg dl - - 0.5 ~ 0.6 L'L~ L__i Du.1.... Renlatlcs: Horizorr #6 cotttairts bands of Sh'atttied sac gt s ac gr rs .~ gr si fu- texuu-a va„u, ~, ~,~ ,,.,,.~..., ,,,,,,..,.....s.. _-- _., ...:.z..e.,..,..,i ....tee 1 0-9 10yr4/2 None sl 2fsbk mfr cs 2f 0.5 i 0.6 2 9-15 10yr4/4 None sil 2msbk ds cs if 0.5 0.6 i3 15-34 IOyrS/4 None sl 2msbk dsb cw If 0.5 0.6 4 34 4 10yr5/4 m2p5yr5/8 sl 2msbk dh cw - 0.5 0.6 5 4 72 7.Syr4/6 m3p5yr5/8 scl Om db aw - N.P. ~ 0.2 -T--- Remarks: CST Name (Please Printj Signatu ~ Te~phone No. James K. Thompson a-- 715 248-7767 gddress A.C.E. Sot? & Site Evaluations Date CST Number Ref # 340 Paulson Lake Lane, Oscrmla, 54020 11/3/99 3602 1123 pROPBtTY OiWNER: Mic~l L. & Debra A. Imes SOIL DESCRIPTION REPORT ~ ~~ Page 2 Of 3 • n c e_a n ewe II..el.,a~;...,c .p 'ARCEL LD. ~F ort of00 &1027-90- Depth 000 Dominant Color ~~ Structure i B d R ots - ~"- GPD/ft~ Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. stence s oun ary o Bed ~ Trench 3 1 0-9 10yr4/2 None sl 2fsbk mfr cs 2f 0.5 0.6 2 9-13 10yr4/4 None sil 2msbk ds cs if 0.5 0.6 Ground elev 3 13-38 10yr5/4 None sl 2msbk dsh cw if 0.5 ~ 0.6 105.15 ft 4 38-41 10yr5/4 None sl 2msbk dh ew - 0.5 ~ 0.6 Depth to 5 41-52 7.Syr4/6 rn3p5yr5/8 scl Om dh aw - N.P. 0.2 limiting factor 41' _ 6 -_ 52-82 - 10yr5/4 -- m3d7.5yr5/8 strat.grs --- Osg dl - - 0.5 ~ 0.6 Remarks: Horizon #6 contains bands o concentrattans o~ undthr~u f stratified s & gr.s & gr.ls & gr.sl out anion an .are associated-w . All textural bands in this horizon exhibit high c content. Redox. it~i to mte aces• Ground etev Depth to limiting factor _ Remarks: -- - - - Ground efev - - - --- Depth to limiting - - - fac~or -- -- __-- _ --- Remarks : Ground elev Depth to limiting factor _ Remarks: w cry mil; claeC c. ~ Debra ,~ -T~~ ~yy7 S'0~ ~¢ ~l'~- Cc~ct~(~/i'LCe~ ~.J/. SS~O~ n. P~.3o~'3 ^ So;l pbs~rda~or~ p,-~ ~ ~/er~z~ion oCa~~° .Lod ~$ " o('~~oPoSlo( esn~~ /lEf4ri7w~; .fee. io TZSiI; Q./6u1., ?",c. off' Caa 6'a,~¢, SE.~'io6r ~., ~a~, .,~Q(.~ou7 ,d CJ . .~i'G~ LL~C~ o~S ~ /oz. 3/ ~a~ Pao bab fe . ba-~; ~Iy S-~e V ~%'c[d ~sS -~--~ ~ ,..: -E---~E-- ~t38. ~.s -~ U o ~ ~' ~o ~3~~ goo ~1. io7.3 9' i G% ~ ^ a2 ~O"1.88 1 ,o,so - i 1 io7. si' ~os,~~ 1 1 3 ~ ,,, I~..,u„ ~..o ,~ ? Slope, 81 E~ciS,~'nct ~a wn 3oZ -~ ~¢ : To~O o~'~:i'~~C 2'~ ALf;~s' .M. ~ -1ow.P ~n ~fcr, ~¢,rice d ~ Corner off` /oz` ~ i{SSuin2d Pos~evE r1..r•~. Corns-o LoE !. e lei.`' = /Gtr. ce: Elr d: = ~os!3/.. ST CROIX COUNTY SCPTiC TANK MAINTENANCE AGRBL~ML~NT AND OWNL'RSHIP CBRTIFICATION FORM Owner/IIuyec Mailing Address `~ 7 ~ ~ 3 0? ~ b ~ ~,~ L G,, ~,, ;~ Property Address ~'4 T~ ~v (Vuificstioa trquirrd from Piaaaiag Dcpartiacat for acw cotuttuctioa) ~ ?" Ci /State _`Cc1 ©~ ~ U ~ L / tY Patrei Identification Number I/F,GAL AF;~SCRZk'7`rON Propctty Location ~/~ %, 6`'~~J'/< Scc. !b • T ?~_N-R l~ W, Town of _ G° .6t ~, ~~-Z~ z Sttbdivision Lot # ~- Cetfified Scuvey Map # _ ~ /~~ ~?' ,~ Volume l Vii' .Page # 3~3/.S- warranty n~a ~ ~ 2 ~ 5~~ Volume _. ~ .ICJ / Page # - `~,_ Spot ~onsc D yrs ono Lot lines identifiable [~ yes D no SVI~~INANC~ ~~~~ ~'aooofpuarrc~icsYsbcmooc:IdnsaItiai~~ `ah~*+r~;tt.n.toLandlewastcs.Pmpa P ~e t~ dray tta+oc Y~ or soao~ if zdooded a licensed c~a: a~oct ~e .fimc6i~oa of the tank-as.a p~ .m Su ~raste disposai.~tystcm, '~t ~ ~ into tie system T~ ProP~Y ~ +~es to ~rt~to St (kvii~ Z~oa~g D ~ oa~i5catioa form, signori by ffie oaracc and ~y a 'P',>~ym~mpl~mbe~t~ci~ebedpl~era~cati~aeasedP~fY~~t(Ij ~e oa~site~~sposatsy~soeriz. is is penpex opexatiag ooaditz'on sndlo~r (2) aRer iaspoetioa and pua~,ing.(~f Y). g~ septctank~is less tBan It3 ~fu1l of iiadge. . ~ ~ amdasrgnodbaFe rad HLe abome tnquic~ sad agcue to nszintaia Que puvatc scwag~c disposal ~ wins bye standards _~ ~. Laeri4as set Ey't5e Depac~meat of (bamaem and the Department of Nataal R,esoanocs; State of Wisooasia.. Cczi%~cxfion ~ Y~ ~ ~ bxa avast be ooaiplcted sad ~d to tEnc St. t~oix-County Zoning Office within 30 dayd,x~ of t'he three yet 'on date. U~ SIGMA OF APPLiC~ANT / / d DATE OWNER• CERTII2'ICA.~'ION I (~j Y that all stated oa this foam an tYUe to the best of my (oc:r)lcnowiedgc. ~ Y ~'~ by vict<ee of a rvarcanty dood c~oeorded is ~tegister of Dads Officc_ ~~` SIGNATURE ,AppT:iCA,NT I (wc) aaa (are) the owaei(s) of / / DATE s«ssss ~ information ~ is mis '~~Y Mutt is the raaitary Permit being rLwokcd 6y the Zoning Dcpar6meat. ssssss s• Include Frith this appiicattoa: a rtsanpod wancaaty doed &nm the Register of Dads oflicc a copy of the certified eutvcy map if rrfcoeace is made in the warranty dcod s FILED ~o FEB 2 5 2000 ~ ~m~ lf.wetstt l f Rt9lslerol Darks SLCfoiltCo.,wl ~ ~ ~ ~ ~~ ~ ~' NW LOANER ' SEC. !° CERTIFIED SURVEY M,4 R ALUMINUM cAP FouNO Located in the NEl/4 of the NW 1/4 of Section 10, T28N, R16W , Town T of Eau Ca11ey St.Croix County, Wisconsin, including Lot 1 + soo°oo'oo"E Owners: Mike & Debbie Jonea of that CSM recorded in !3??.a' 2447 50th Avenue VoL.8, .2209. A ~ Woodville, WI 54028 Bearings referenced to the ' -- - North line of the NW 1 /4 of DETA/L ry Nor ro scaL Containing (and being a replat) Section I0, assumed to be i of that Certified Survey Map S 0°00'00"E. recorded in Vol. 8, page 2209. _ UNPLATTEO LANDS _ \ ~ - _50TH "~-~•pb`'06"E 132'48' A_VEN'UE_ t - 33.OS'- ~ / S 90'00'00"E 1322.44' ~^ ,"+, 33.03' ~ -I EI~DeT - - - - '~'..~\a aa~:se~ - - ~-oo. -~.-3~~-7e. - J, - - NORTH L /NE OF THE NW v4 6 6o rQ !0/0.66' ©~ ~ NOO°00 'E ~'\ ~^\ ' lJ~ 33.00 I ~ N!/1 CORNER °s ~^ y ~ N!e°00'0"E ~..~t't j i SEC. +0-?B-/B ..... ......... 100 S£TBA[X... _4lNE ........... ..... q'\'~' m\ ~ .... ... .........67l T' _..I ~~.~~ COUNTY O .g ...... ..... .._. ........ .... _... ............~..... Note: this private road ease- ~~ „`~, ~~§y~,~;' N3e°oo+o•E ~•.~ suRVer ment will sexvice Lots 2 and 4~y`~ o~ s ~j/ 67!'~ n N Foun'a. ~ 1~.~ I ~~ N90°00'00" ! ~' ®~ 3 I ~ p~~ ~.., :218.89' 3 ~~ i ~ ~ '30.77' !68.31' ,, ~' '/s.°o , .,~ a. ` 6 c~ ss.~7' ono •B~j- zes.7s'...,. . \ m' S 0'00'0 "E 96.7!' ~ • 20 IS''' Y{ I n! ? 1,256, 178 Sq.ft.(28;84 Ac.) _q I ~ ~®~r z! ' N w including right-of -way. w N I /3a,sB/ so Fr. I ~ e .+ N a ~ 1,222,799 S ft.(28.07 Ac.) w ?l7,eoo so.fs• irl 3.0o Acaes• o ('r) El • VI 'O 3.00 ACRES I l71 • I N m m .~+ N excluding right-of-way. N m I m a a' °p r- ~ ~ n Om I 10~~Q I IO ~N pl %IFNote: Easement recorded m -+ ~ v ~ c m ' ;~ 2 ~ M m? on CSM in Volume 8, page ° ~ ~ ~ I ° h Q I M a <° 2209. This will be a w I ~' IL®7T 1 ~ N ~ 'I ~ .. In joint driveway easement for j n ? ~ o I ~ ~ ~ i Lota 1 and 3. ~ o ........ 3oo.ooll......,.. 2. . o ~ APPROVED ~--Z , N 90.00'0 "w °c~ o o l ti ST. CROIX COUNTY W I Z. ko Planning ~ -~",4e r W ~ N ~ I i h C~ 2 4 200 313.94' Y ' Q '' S 90'00'00"E = z I h' *• lfnotrecordedwithin30daysof LOT 3 ACREAGE ~ ~ t ~ i w approval date approval shall be 140 , 0 9 7 Sq . ft . (3.2 2 A u°, m ~ 3 null aril vold including right -of -way' ~; I29,835 Sq.Et (2.98 A)~ _I Note: Rock pile at SW excluding right-of-wayb jl corner, witness corner 2 I found 502°55'33"W 8.55' ~I from corner. vi' ul SOUTH L/NE OF THE NE-NW so?°ss'33"W S 89' 58' 39"W 1320.74' B'73~ UNPLATTEO LANDS LEGEND - '~ 3 ; . A C m 4r ST. CROIX COUNTY SECTION [ORNER (AS NOTED!. O ~ m O I"X24" IRON P/PE WEIGHING L6B LBS. /LIN. Fr SET. N ~ • l"IRON PIPE FOUND. O M 2 (R/ PREVIOUSLY' RECORDED INFORMAT/ON. S!/~ CORNER Q CURVE NUMBER. sECrlON !o•zB_!s " !! IRON PIPE FOUNOI. -•-.- OLO LOT / LO1-L•INE (C.S. M. /.B, P. 22091. This instrument drafted by Vol. 14 Page 3815 SCALE /N FEET !"= 200' O 200 400 600 4992656 vol. ~5n1Pac1:449 ~ ~~ Michael Jones, a/k/a Michael L. Jones and Debra Jones, a/k/a Debra A. Jones, husband and wife, conveys and warrants to Wade E. Labecki, a single person, the following described real estate in St. Croix County, State of Wisconsin: 62095 KATHLEEN H. WALSH kEGISTEk OF DEEDS ST. CkOIX CO., WI RECEIVED FOR RECORD 04-10-2000 1:30 PM WARRANTY DEED EXEMPT M CERT COPY FEE: COPY FEE: TRANSFER FEE: 30.00 RECORDING FEE: 14.00 PAGES: 1 Name and Retum Address Thomas A. McCormack 102010'" Ave. Baldwin, WI 54002 008-1027-90; 008-1027-90-100 (Parcel Identification Number) Part of the Northeast Quarter of the Northwest Quarter (NE '/4 of NW '/.) of Section Ten (10), Township Twenty-eight (28) North, Range Sixteen (16) West, Town of Eau Galle, St. Croix County, Wisconsin, including Lot One (1), more particularly described as Lot Two (2) of Certified Survey Map filed February 25, 2000, in Volume 14 of Certified Survey Maps, Page 3815, as Document No. 618846, office of the Register of Deeds for St. Croix County, Wisconsin, TOGETHER WITH AND SUBJECT TO anon-exclusive 66' wide private road easement over and across the above-described property as shown on said Certified Survey Map, in common with the owner of Lot Four (4) of said Certified Survey Map, which easement is shown on said Map as 66' Private Road Easement, as described in that certain Joint Driveway Easement Agreement between the parties of even date. AND FURTHER SUBJECT TO the Terms and Conditions of the Protective Covenants for said Certified Survey Map of even date. Exception to warranties: all easements and restrictions of record. This is not homestead property AUTHENTICATION Signature(s) authenticated this day of , signature type or print name TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by §706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Thomas A. McCormack Baldwin, WI 54002 Dated this ~Q_ day of , 2000. .~ " el L. J es .Debra A. Jones ACKNOWLEDGMENT STATE OF WISCONSIN ST. CROIX COUNTY ~~ day Personally came before me this 2000, the above named Michael Jones, a/k/ Michael L. Jones and Debra Jones, a/k/a Debra A. Jones, to me known to be the erson(s) who execute the feregoincJ instrument and ac wle a the same. >, ' "~ • ~~^'s s ature j v " pe or print name ~" ;;; .c . p I La Notary Public St. Croix County, N is~pa,S'IQ• ~ ~ My mmi ion is permanent. (If nei>r<y'~te ~$cpirall~hdA}e: ..... " ames of persons slgning In any capacity should lie' I;yped or printed below their signatures. ~. Information Professionals Company Fond du Lac, Wisconsin 8066552021