Loading...
HomeMy WebLinkAbout008-1028-80-050 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 399404 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information yuu provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village x Township Parcel Tax No: Olson, Molly I Eau Galle Township 008 - 1028 -80 -050 CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 2—.1 D oz•la ao 0 Dosing Alt. BM Aeration Bldg. Sewer , S, bb qb - �o Holding St/Ht Inlet � D qb fo TANK SETBACK INFORMATION SvHtOutlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 25' , e Dt Bottom Dosing Header /Man. Aeration Dist. Pip (& h , `I / 1 , L / Holding 113ot. System (5- "T �S R2.96 � PUMP /SIPHON INFORMATION Final Grade S b R6 •So Manufacturer Demand St Cover / GPM �•(D ' b Model Numbe TDH Lift riction Loss System Head TDH Ft F main Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM (�b MD RENCH Width Length jNo. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIME ONS (o2 163) 11 1 SETBACK SYSTEM TO c e P/L JBLDG IWELL LAKE/STREAM LEACHING Me of cturer. INFORMATION CHAMBER OR S Type Of System: t UNIT Mod I Number: ✓- > Sa / > q o DISTRIBUTION SYSTEM Header /Manifold p Distribution x Hole Size x Hole Spacing Vent to Air Intake .� Pipes ' Length Dia L LSpac ing (p OIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of eded /Sodded xx Mulched xx Se Bed/Trench Center Bed/Trench Edges Topsoil Yes ❑ No [W Yes ®No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:1L/��/ O�_ Inspection Location: 417 County Road BB WI 54028 (SW 1/4 NW 1/410 T28N R16W) NA Lot NA Parcel No: 10.28.16.147A 1.) Alt BM Description 2.) Bldg sewer length = Z 3 ( (S amount of cover - 6 revision Plan Use others de for additional i No information. Dat Insepctors Signature $BD -6710 (R.3/97) Cert. No. - /175 Sanitary Permit A plication Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code ZO1 W. Washington Ave. PO Box 7302 See reverse side for instructions for completing this application Madison, WI 53707 -7302 VISCO)nSin Personal information you provide may XQr secondary purposes Submit completed form to county if not Department of Commerce [Privacy Law . 15s04(1)(rn)] r state owned.) Attach complete plans (to the county copy o y rthe sy tem, on pa g& #Rt, less than 8 -1/2 x 11 inches in size. County State Sanitary Permit Number J 0 Ch i yild to pre ions plication State Plan 1. D. Number 9 V1 Location: App ication Information - Please Print all Informs ' Property Location Property Owner Name ! All y i /ll�� Property Owners ail' g Address Lot umber Block NUM er 70o City, State Zip Code one rqr r Subdivision Name or CSM Number II. Type of Build' g: (check one) ❑ City ❑ 1 or 2 Family Dwelling - No. of Bedrooms : e� var �`0"" 5 Scv6w il�i� ❑ Village Town of ❑ Public /Commercial (describe use): _ , ❑ State - Owned S .S I Nearest Road A Rff Parcel T ax umbe s) I III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑Addition System System Tank Only Existing System B) Permit Number Date [ssued ❑ A Sanitary Permit was previously issued IV. Type of POWT System (Check all that apply) Non- pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland- • Pressurized In- ground ❑ Holding Tank ❑ Single Pass , ❑ Drip Line • At -grade - ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. DispersaVTreatment Area Information ✓ e f 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate L 6. System Elevation 7. Final Grade Required Proposed Rate (Gals. /day /sq. ft.) '(Min. /inch) Elevation VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks 7- — ❑ ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the P TS shown on the attached plans. Plumber's Name (print) Plumber's Signature (no star MP /MPRS No. Business Phone Number rJ. P 9. TCd r i V Plumber's Address (Street, City, State, Zip Code C�-L /4 2 ,fi C IX. County/Department Use Only �Y r Date Issued Issuing Agent Signature (No stai.ips) D D iSa aNi pry er ek. ApgTOVed IIOw&,er 6iv[ti Z; }iat WJ ii we ree q vlrge Deb r i i t4 1 7 �> _ l M p o e s for Disapproval: 1. Effluent filter tope installed and maintained per manufacturer's recommendations. 2. All setbacks to system and residential structure must meet applicable code requirements. 3. a Property is zoned Ag- residential - only one principal dwelling is allowed on this property. 4. Floodplain mapping = Zone "C" (ok) SBD -6399 (R. 07/00) Dave Fogerty 28288 McKenzie Rd. Spooner, WI 54801 m GL QCs �-ss /fCR�s (715) 635 -9609 Y . ?Vc Paps ,tail/ y Pi ` Z.EwAr j -X a ys 0 = /� �,� mac• � •T «,� rgeti. ,� ,� F.zr r.�,�. � /lan,,� B o e o 9 / n 7 71 I ' 3 necx��s .t+�7 3XG2•.�' �.. cd s �4rn�� I i I /37 02 °v I J u V . -vin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of 3 Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but 1 C&4Z-X not limited to vertical and horizontal reference point (EIM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. y01 •— Q APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION RE WE Y DATE PROPERTY OWNER: PROPERTY LOCATION "' ©G GOVT. LOT W 1/4 , 1/4,S/� T 2 ,R / E (odp PROPERTY OWIjER':S MAILING ADDRESS LO T # BLOCK # SUBD. NAME OR CSM # CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE ZTOWN NEAREST ROAD New Construction Use �[/J Residential / Number of bedrooms y [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow D gpd Recommended design loading rate . gy bed, gpd /ft .j— trench, gpd/ft Absorption area required J�;ff bed, ft 7" trench, ft Maximum design loading rate bed, gpd 1ft trench, gpd/ft Recommended infiltration surface elevation(s) 9j.0 PArm,'FA7 i Z, 3 ft (as referred to site plan benchmark) Additional design / site considerations Parent material — , �OWrz ACT 2. 47 Flood plain elevation, if applicable ft S = Suitable for system C NVENTIONAL I MOUND IN- ROUND PRESSURE I AT -GRADE SYSTEM IN FILL I HOLDING TANK U= Unsuitable fors stem VD S❑ U PS ❑ U LAS ❑ U S❑ U 1 ❑ S V1 U 1 ❑ S U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft hew Boring # Horizon Texture Consistence Boundary Roots � in. Munsell Clu. Sz. Cont. Color Gr. Sz. Sh. Bed Tw& 7 8 Ground elev. 9 L ft. Depth to yp limiting z y factor Remarks: Boring # 9s,..7..... z _ -- OS — '-4 Ground elev. PZ'Z- ft. Depth to Q • o r� limiting .� factor 7/O Remarks: T Name: — Please Print F X,F-- ?- Phone: Address: Signature Dat � CST Number: Od ��/ PO PROPERTY OWNER 74101 SOIL DESCRIPTION REPORT Page? PARCEL I.D. # Depth Dominant Color Mottles Structure GPD /ft htv Boring # Horizon Texture Consistence Bortcary� Roots in. Munsell Du. Sz. Cont Color Gr. Sz. Sh. Bed Trench Ca(r Ground elev. Depth to limiting o factor `� Remarks: AP4 62. Boring # - /o- LS o F � `/.. 2- _ 6 ::s > _ to - r os L Ground elev. Y _ q 10 -41 L ft. d Depth to r -� /0--S ©sG Oft A5' - limiting factor ' Remarks: Boring # Ground elev. 97a. ft. Depth to limiting factor Remarks: t,� - ?S'�;_ ��lo Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) r FOGERTY PLUMBING & PERK TESTING, INC. P.O. Box 130 ROBERTS, WI 540 f{3E Q Q / = dam► / roA if l Ir? rc l't pc �5�7�.wE A�•O � /� " �,gpvE �� T p�T /oz, z. 3 � �l sl J'' r a/o �6 T G �Q J� .1VAe7fk FSE-Gv , Frf zs FOX - v;PW/,/ P.�£Ll> 1�RE' ss Fv/t Nts y�►c�Tff�' .� saw lip y �► uh�y . AWE - FSBc0 /lvT�E sfi�y9,t���A,) � /70� IT-A14 �"�',vCF .r Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). .. Table 1: System Design Specifications Sanitary Permit Number Number of Bedrooms Design Flow - Peak (gpd) rs Estimated Flow - Average (gpd) IN p Septic Tank Capacity (gal) Soil Absorption Component Size (ft S/ Type of Wastewater Domestic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil-Absorption Component Design Flow =Peak (god) Maximum Influent Particle Size (in) 1/8 r Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified 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 (Servicing Septic or Holding Tanks, Pumping Chambers, Grease' Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic tank and outlet filter shall be assessed at least 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 filter when removed from its enclosure. If the ` Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of scum and sludge 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 an assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. Manhole 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 the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with.Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption - Component ' The soil absorption component serving this structure is designed to accept domestic f wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over thi's component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. Plantings of deep- rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion into the component may obstruct wastewater flow. CONTINGENCY PLAN If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: �f 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 strucwre, 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 soli Umitatlom 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 soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area b available a holding tank may be installed as a last resort w replace the failed POWTS. • 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> > S EPT IC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TRJEATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT", RESCUE OF A PERSON FROM TUS INTERIOR OF A TANK MAY BE DIFFICULT OR IMPASUR1 F. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name Phone Phone SEPTAGE SERVICING OPERATOR (PUMPERI LOCAL REGULATORY AUTHORITY Name l Zo.t ` n Phone / S — 9 eo Fogerty Plumbing �A� - V-.00) A #221180 28288 McKenzie Rd Maintenance Spooner, WI 54801 (715) 635 -9609 J The interval for servicing septic tanks is set by state and local c a ulato g agent es uggest two to fi years. wide difference of opinion on what this interval should be, but most 9 ry should be cleaned when the The Zabel'" filter, which does not increase the frequency of servicing for the tank, septic tank is normally inspected and pumped. However, our filter is virtually self - cleaning. The continued action and fall to the of the anaerobic organisms on the Zabel filter causes I d9b p artic l es l by an alarm when the filter needs ervic ng. the tank. If your filter contains a SmartFllter alarm, y o u To service the filter: 'Servicing any zabet filter should only be done by a certified septic tank pumper or installer. Locate the outlet of the S3 septic tank. Firmly pull the filter handle and slide the cartridge out Remove the tank cover of the case. m 2 and pump the tank if ' Note: A tee handle may have necessary to prevent to be used if the filter is too tai. any solids from ! below level to reach Contact Zabel for info on tee. escaping to the field �: ' handles a when the filter is removed:' - AM W While holding the cartridge over j the access opening rinse off the Insert the filter cartridge cartridge with fresh water, being back in the case making careful to rinse all septage material sure the filter.car[ridge Is:; perl back Into the tank_, proy�alignec�.an s ae dd t neces fu clean Ute Ater:(_ completely i . rt .In' e� r 'Note: It is no sary B 'spotless'. The biomass brow jrfg. Otte q aides in the pretreatmen(�pn?oesS be left on the fitter. (if .J _ . Replace t may be disasse i The product(s) shown are covered by one or more of the following patents: U.S. 5,762,793, 5.580,453, 5,591,331, 5,759,393, 5,683.577, 5,582,716, 5,779,896, 5,593,584,5,795,472,5,736,035, 4,710,295, 5,382,357, 5,482.621 U.S. Des. 386,241, 349067, x605501,50985 Des. 309007, Australia: 134440; Canada: 2,135,937; Israel: 111574; New Zealand:-26482 ++ Other Patents Pending Call for a free ZABEL ZONE An Onsite Wastewater Magazine 1- 800 -221 - 5742 • Website httpllwww..z�abel 6om e INSTALLER'S NOTES: RECYCLE GREASE! Do not pour grease down the drain. Your septic tank and filter will not handle it. NO BLEACHES! Do not introduce bleaches into your system. The bacteria in.your septic tank is what makes your system work. Bleach kills the bacteria. When that happens, your septic tank will no longer function correctly. This will cause premature failure of your system. WATER SOFTENER! Do not run the brine solution into your septic tank. This solution has a high concentration of lime (that's what makes your water hard). The lime tends not to settle out in the septic tank but goes directly to the drain field. Lime is an excellent sealing agent, and yes, it does the same thing in your drain field. Think of your sewer system as you would your car. Treat the attached information as you would your car manual. Remember, also, that your car requires regular maintenance. Care must be exercised as to what you put into it. And like your car, your system eventually will wear out. The question is - how quickly. If you have any questions, please call: Dave Fogerty 715- 749 -3656 -Roberts _ 715- 635 -9609 - Spooner If you have an emergency, and you only get voice mail at these two numbers, call Keith Knutson at 715- 796 -5436 - Hammond I have read the attached information regarding the construction and maintenance of my sewer system. Owner's Name Date w d - biol li ` t r w �-J , -K 2 t rr 9 All y ► l I L z �- @7 Sk ir 3 ~- wF s ' Y — X x -- NI l r n V 00 x .......... lit �\ = 1 � •� ^" �� "n Ink Z0'd SSOb S26 6TF ? S3WOH AOOd4HS 6£:9S TOW -60- ../ ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerA4uM 0 165tte' dLSt�ji/ — Mailing Address ?� ' Property Address (Verification required from Planning Department for new construction) City /State G/4W 144t' Parcel Identification Number ,gwp— LEGAL DESCRIPTION Property Location AIX) '/4, 5& Y,, Sec. 0 , T2_N -R /` W, Town of X3& e.424—o= Subdivision "'--' ,Lot # + 2 Certified Survey Map # , Volume , Page # Warranty Deed # - AvD(B 7 , Volume fir/ , Page # �'� Spec house O yes no Lot lines identifiable it yes O no SYSTEM MAI - r 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 master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal 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. I/we, 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 Resowcet, 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 ve.ar PYn; —"-- A7 " SIG14ATLP9 OF APPLICANT 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. ' SIG�ATLWt OF APPLICANT DATE • * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Depa�ent. x , *• 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 iI I DOCUMENT NO. WARRANTY NEED STA'rE OF WISCONSIN —FORNI 9 3 0 0 6 0 .` THIS SPACE RESUVED FOR RECORDING DATA TI118 INDEN`rURL;, Made by Olc Solstnd I /k /,I 01e 1 Sol stad and L SoIst' Id husbind 1 wife, grantor S of SL. CCOIN County Wiv.onsin, hereby conveys and warrants to 'Molly 13our. n i r i 'grantee RETURN TO of C Y U L:' euntc, Wi: f,x the rn:r. (if One 1 No/100 (C,;l.00) consideration the fullowint; tract of laird in l' 1 "t wuly, St.'tc t IOII N.I11, �)� �� °;t' �,l'_', " c Our)rt".�r of t. h: l,,tt. n , ,t ('' �,) �, �•.. I'?) all in '1' <n,n:,}Iir, nt Cur d1 CI In - ,� C1 tilt VI:IC VAI> A11�;1 I ::t �I STA'I'F, OF tV1scO'N51 ., n �Yt;��q ���1�E3 �i���..c, n =� �,tt� t! t.�r .iirn� im:'ninr•nt :nnl l.nowlodged the smil, , i p L NOTARY i t't i (t •� I :�tli i �V M SEAL � TfAh ihetrument draftco t3 Notary Public :i L Cr oix County, Wis. D0 i,Aftlklb'�' NORMAN t�� -, My Commission (Sttpirea) ([s) O(.'�'ft1�1IIC.1 L p (S�}bf the Wltpt Drorld n ��t al m mp oq W ra rhpL Garr Plainly Drtatsd or typewritten thereon the aam i� r Of W ors, prpatser. witnes 3 pad nd notary) J ```222 I WARRANTY DEED —STATE OF WISCONSIN, FORM N . X. C. riu1111 co., nusrari i 1541PAGE274 6 29574 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI I I RECEIVED FOR RECORD I I Document No. 09 -08 -2000 9:00 AM I I I I I JOINT DRIVEWAY AGREEME EXEMPT N CERT COPY C OPY FEE: JOINT DRIVEWAY I TRANSFER FEE: EASEMENT AGREEMENT I RE FEE: 16.00 I I I I I Return to: Thomas A. McCormack I 1020 10"' Ave. I PO Box 2120 Baldwin, WI 54002 I 008 - 1028 -80 Parcel Numbers THIS JOINT DRIVEWAY AGREEMENT (the Agreement) is between Thomas George Bourn (Parcel A Owner) and Molly Olson, f /k /a Molly Bourn (Parcel B Owner), and Richard Wayne Bourn (Parcel C. Owner). R E C I T A L S: A. Parcel A Owner is the owner of certain real property located in St. Croix County, Wisconsin, as described on the attached Exhibit A and referred to on the exhibit and in this Agreement as Parcel A. B. Parcel B Owner is the owner of certain real property located in St. Croix County, Wisconsin, as described on the attached Exhibit B and referred to on the exhibit and in this Agreement as Parcel B. C. Parcel C Owner is the owner of certain real property located in St. Croix County, Wisconsin, as described on the attached Exhibit C and referred to on the exhibit and in this Agreement as Parcel C. Parcel C Owner is the holder of easement rights in that certain Access Easement recorded November 27, 1991 in Volume 924 of Records, Page 420, as Document No. 476253, and desires to join in this agreement to provide for the sharing of responsibilities and costs of the Easement Property referred to in Paragraph D. below. D. Parcel A Owner, Parcel B Owner, and Parcel C owner wish that a driveway (the Driveway) be constructed on that portion of Parcel B more particularly described on the attached Exhibit D and referred to on the exhibit and in this Agreement as the Easement Property. E. Parcel B Owner is willing to create an easement over the Easement Property to enable Parcel A Owner to use the Driveway, under the terms of this Agreement. AGREEMENT For good and valuable consideration, the receipt and sufficiency of which are acknowledged, the parties agree as follows: 1. Grant. Parcel B Owner grants a nonexclusive easement and right -of -way to Parcel A Owner and Parcel A Owner's successors and assigns as the owner of Parcel A to use the Driveway and the Easement Property as a joint driveway for ingress and egress to County Highway BB from Parcel A, and Parcel C Owner consents to said grant. 2. Permitted Users. The easement granted in Section 1, above, may be used by the Parcel A Owner and its tenants, employees, customers, and invitees in common with Parcel B Owner and Parcel C Owner and its tenants, employees, customers, and invitees. 3. Initial Construction Costs. Parcel A Owner, Parcel B Owner and Parcel C Owner will construct the Driveway and shall maintain the driveway at their expense, to be shared equally among the parties. LOT 1 ` C.S.M. _9/ 2425 146A NW 114- W 114 639.59 y 146B LOT 2 a 2A2-6 10 ----= __� - - - -- w — w I 147C 644.33' o� 60109 572. 70.83 _ ti la0 d_ 0 147A Jam ' �a , 2�- iIF, 147A OS LOT 3 J I 14/3903 SW 1/4- -SW 114 f 147B SW COR. crr , n H -::514=6 00e -- /o,-IR - cry D4� — /v Z8-- 6~. -- o s o , � 3�\- 2 5 2�� - /D 2s- -49,0 /D � t � ENH zx? aso / 11-'Ieg 627014 w CERTIF SURVEY MAP MOLLY OL SON Located in part of the Southwest' /4 of the Southwest' /4 of Secti 10, T 28 N, R 16 W, Town of Eau Galle, St. Croix County, Wisconsin: LEGEND N OWNER'S ADDRESS COUNTY SECTION CORNER 474 C. T. H. "BB 0 MONUMENT (AS NOTED) SNOB ARE REFERENCED TO WOOD V/L L E, W/ 54028 SET 1' x24• IRON PIPE (MIN. THE WEST LINE OF THE SW 114 WT. 1.13 LBJ LINEAR FOOT) OF SECTION 10. T 28 N. R 18 W. • FOUND 1' IRON PIPE ASSUMED AS N 00' 00' 00' E. o SOIL BORINGS WEST 114 CORNER SECTION IO, T PB N, R 16 w /FOUND BERNTSEN ALUMINUM NON. I i SCALE IN FEET:1 kich 150 fed ' 0 50 100 150 300 ml I S. L /N NW 114 N. L INE SW 1/4 .7 SW // - 4 - - f33 33I � /) tu m J QI $ W "� / ne,n•• q[j �� I I �• L /N E PR / VA TE RO A D W A Y_EA_SEMENT J � �� 66 PR /VATS ROADWAY EASEM — _ ENT �VOL. 924, P. 420 J S. L /NE PR /VATE S 8 6 ° 38 + 44 1 + E• , �O EA T LIE RE • 670.83 R"OWAY r4SEAIENT �s ROADWq N P y EASEME . T 33.06 63777 p I W SE CORNER �� r =�v �A /00' = i EASEMENT O L 1 I I o ti W h '� p W o W m LOT 3 0 0 , •35.� 6 _. o d o a O S 8� f 07 44 -E , g I ° O $I ° p CONTAINS 231,45B SO. FT. OR 5.3/4 AC. /O 5 .70 /I t/ (221,55B SO. FT. OR 5.086 AC. EXCLUDING RIGHT OF WAY) �` /29 g p ��t Fyi j 3' 3 1 3304$ q -G \ O 872. 02 FENCEL INE rry O Ri I / N B7° 2'4B rc 66 T. H. " II A W 905.06 p Go �I a ' APPROVED 0 \ z 3 T OIX COUNTY W URE 5OUrNw�� REVISED THIS //M DAY SECTION 7d ^ qjW parks Committee + OF JULY, 200D I FOUND 314 IRON BAR) 1�Y JUL 2 5 2000 wv�rt�us. If net recorded within 30 days of LAND approval date approval shall be null and void THIS INSTRUMENT DRAFTED BY JERALD L. LARSON SHEET / OF 2 Vol. 14 Page 3903