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016-1017-40-050
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 552391 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you 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: Jensen, Greg D. & Jean Glenwood, Town of 016-1017-40-050 CST SM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: /00 a I GS l 08.30.15.138A05 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic o Benchmark Zaap 3.5 l03. /od Dosing 3 / Z 00 . BM (o? /d 83 Bldg. Sewer F ) ~F / b 3 Z5 /~D- z5 Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet 45, q9, 05 TANK TO P/5L~ WELL BLDG. Vent to Air Intake ROAD Dt Inlet 79 ` Z5 .ZS Septic Dt' ottom 194 C d% dZ Dosing /A^ / C~ / Header/Man. i 2•0b Q W J d Aeration Dist. Pipe 2.O Z. !V 1061_ Holding Bot. System , t -7 0.2 ~/i i7., ,e ~ PUMP/SIPHON INFORMATION Final Grade Z f Manufacturer 1 Demand Stover G a ~.O Z6 ej L-1- GPM J 3, a~ /.a a 4} Model Number s ou ' J TDH Lift Fro ~ss System Head TD Ft i 11Z Forcemain Lenc t Dia~ly Dist. to Well 3(p /oo. SOIL ABSORPTION SYSTEM BED/TRENCH Width i Length No. f Tren es PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 'I to a SETBACK SYSTEM TO JP/LW BLD W LAKE/STREAM JAER ING Manufacturer: INFORMATION OR Type Of stem: M del Number /l o .,j 1 3y > 2-66 SS kv DISTRIBUTION SYSTEM d 0 j~ Head anifold Distribution x Cole Size x Hole Spacing Vent to Air I~take i' Pipe(s) / / ~1 f ? / ✓ Z I Len th Dia Length ~ Dia ' • ~ Spacing ) / . (47 9 ' 0 SOIL COVER x Pressure Systems Only x nd Or At-Grade Systems Only y cc, Depth Over Depth Over xx 94th of xx Seeded/Sodded xx ulched Bed/Trench Center Bed/Trench Edges psoil ~I3 Gt ~ Yes 0 No I l es No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:7/ Zlo/ 12- Inspection #2:7/ 1 2 a Location: 2866 160th Av. Glenwood City, 4 54013 W 1/4 SE 1/4 8 T30N R15W & bo d Lot G / Z'- rcell No: 08A0.15.13 05 1. Alt BM Descri tion ~1~ "i 5,A9 2.) Bldg sewer length = JC , C~~ If~~ J - amount of cover = A"5 Plan revision Required? Yes No / „ j1 v Cc l/r/l/c (n 6 Use other side for additional information. SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. County Safety and Buildings Division r` p; 201 W. Washington Av P_Ceox 7162 Sanitary Permit Number (to be filled in by Co.) Madison, WI 5 -t s It J1119 23`3 p pr>itW ermit Application I-- State Transaction Number In accordance with SPS 3$3 21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit Ti (.2 L is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to of t Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secon a (b0~ W A UC purposes in accordance with the Privacy Law, s. 15.04(l m , Slats. 1. Application Information - Please Pri II Information W tv Property Owner's Name f Parcel 01I.- - also J EAJ 0 11, - 10 1-7 - 50 4&6 Property Owner's Mailing Address Property Location Govt. Lot 15, City, State MZip Phone Number jA f U,) y,, ~ y,, motion ucle one NEW T,30 N, R E or IL Type of Building (check all that apply) Lot # ® 1 or 2 Family Dwelling - Number of Bedrooms Block # Subdivision Name ACGG~D { / , ❑ Public/Commercial -Describe Use D(d~ 11 ❑ City of w * ^ ❑ State Owned - Describe Use CSM Number [I Village of ✓lL ~I own of III. Type of Permit: (Check only one boa on line A. Complete line B if applicable) 1Yjoa.&61 ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) A. 0"New System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued/ Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all that apply) O V ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) g;;, 01rd V. Dis rsal/Treatme Area Information: Design Flow (gpd) esign Soil Application Rate( sf) Dispersal Area RequireX/seol Dispersal Area Proposed (sf) System Elevation 900Y 7 9 9 :'75 evr.ToL6- VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units U New Tanks Existing Tanks 361 ^ 2 o v Septic or Holding Tank cguov Dosing Chamber / VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Si tar MP/MPRS Number Business Phon beumr Plumber's Address (Street, City, State, Zip Code) 4/77 / 7d' `A v -rLXK_% c L-AKIL U-)( -5492rl /I VIII. Coon /De artment Use Only )<proved ❑ Perrm_itJFeee~ Date )ssue(V Issuing A #t Signature 44.- ❑ O ven Reason for ial $ v4 ✓ 715 1 Z IX. Conditi.9lMtessons for Disapproval 3 Gs 1. $eptic tank, effluent finer and 4~,~ dispersal cell must all be services / maintained 410 per management plan provided by plumber. 2. All seack ray must. be maintained .T iKGGM1~Lf~ e ~P.r~ jc' V ► ('e Attach to complete plans for the system and submit to the County only on paper not leas than 8112 x 11 inches in size /,.~L.~.. 1.t5 ci 4A-..10~,,~, SBD-6398 (R. 11/11) HARDINA SEPTIC SYSTEMS MPR.S/CST 824825 :~j 9 'q.D AC-90 .541 w . Ivi flL 1.26 - t ,,,,-ra ~aQ 1 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Jensen Owner's Name: Greg Jensen Owner's Address: 255 W. 1 st St. New Richmond, Wi 54017 I Legal Description: SW,SE,S.8,T.30N-R 15 & NW,SE,S.8,T.30N-R15W Township: GLENWOOD County: ST.CROIX Subdivision Name: Lot Number: Block Number: dittOna'lly Parcel I.D. Number: 016-1017-40-050 & 016-1017-30-000 v tl E10 1NGS Plan Transaction No.: JF _ , Page 1 Index and title ON Page 2 Data entry 30R N Page 3 Mound drawings Page 4 Lateral and dose tank ~ Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot Plan Page 9 Filter Specs. Page 10 Soil Data ( Designer: Robert Hardina License Number: 824825 Date: 03/19/12 Phone Number: 715-986-2508 Signature: L;~ZI,17,0 Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for S-T- ~~1) ct(ci~ VfiLS. a,Z~ 10,110 to r ()J Version 4.0 (R. 04/03) Page 1 of 10 - J ~s~tinxrarT Safety and Buildings 10541N RANCH ROAD ~uj s l ;r\ HAYWARD WI 54843 Contact Through Relay www.dsps.wi.gov/sb/ www.wisconsin.gov \A SSION. Scott Walker, Governor + Dave Ross, Secretary April 02, 2012 i a I CUST ID No. 824825 ATTN: POWTS Inspector BOB J HARDINA ZONING OFFICE HARDINA SEPTIC SYSTEMS ST CROIX COUNTY SPIA 477 170TH AVE 1101 CARMICHAEL RD TURTLE LAKE WI 54889-9187 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/02/2014 Identification Numbers Transaction ID No. 2067766 SITE: Site ID No. 777651 Greg Jensen Please refer to both identification numbers, 2866 160TH Ave above, in all correspondence with the agenc . Town of Glenwood St Croix County SWl/4, SETA, S8, T30N, R15W FOR: Cap Description: Mound, 6 bedroom residence Object Type: POWTS Component Manual Regulated Object ID No.: 1363908 Maintenance required; 900 GPD Flow rate; 20 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD-10691-P (N.01/01), Pressure Distribution Component Manual - Version 2.0, SBD-10706-P (N.01101); Effluent Filter 61- The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Cod SEE and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Key Item(s) • 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 component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • The revised soil test/ additional boring(s) on which this approval is based shall be recorded with the original soil test. • The bottom of the distribution cell shall be level per the Mound Component Manual. The "D" dimension shall be a minimum of 16". The maximum finished slope of the mound surface shall not have a slope ratio steeper than 3:1 per the Mound Component Manual • The float switch shall be a type that floes not contain mercury. 2009 Wisconsin Act 44 prohibits the installation of float switches or relays that contain mercury. • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner BOB J HARDINA Page 2 4/2/2012 of the POWTS explaining that periodic; cleaning of the effluent filter is required. The access opening used,to service the filter shall terminate at or above finished grade with a watertight cover. Reminder 1 F • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per SPS 383.44(6)(a)2. ` • Limit activities in the area 15' beyond the down `slope edge of the mound per Mound Component Manual. ' • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of SPS 384.10. No fixture, appliance, appurtenance, material, device or product may be sold for use in a plumbing system or may be installed in a plumbing system, unless it is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. • Maintain well and waterline set backs per SPS 383.43(8)(i). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. • Insulate building sewer per SPS 382.30(11)(c). 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. 9 4 In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise 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 and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Patricia L S na dorf POWTS Plan Reviewer, Integrated Services WiSMART code: 7633 (715) 634-7810, 1~ -(715) 634-5150 , M - F 8:00 a.m. - 4:45 p.m. pat. shandorf@wisconsin.gov cc: Charles L Bratz, POWTS Reviewer II, (608) 789-7893 , 7:45 am - 4:30 pm Monday - Friday Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Safety & Buildings will be modified. Code references with prefixes starting with "Comm" will be replaced with "SPS" to recognize the relocation of the Division of Safety & Buildings from the former Dept. of Commerce to the Dept. of Safety & Professional Services. Additionally, all S&B codes will be renumbered and addressed in a "300" series. For future f reference, the Wisconsin Commercial Building Code wvill be addressed by SPS Chapters 360-366. ' Y 1 ! k r c Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) r Residential or Commercial Design Note: Sand fill (D) calculations assume a 600.00 Estimated Wastewater Flow (gpd) Table 83-44-3 in-situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150%) coliform of - 36 inches. 900.00 Design Flow (gpd) 5.20 Site Slope 98.75 Contour Line Elevation (ft) 20.00 Depth to Limiting Factor (in) 0.60 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 100.00 Dispersal Cell Length Along Contour (ft) = 9.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) c Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation (ft) 6 Number of Laterals of the highest point. 0.156 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimated Orifice Spacing (ft) = 9.38 ft2/orifice 2.00 Forcemain Diameter (in) 150.00 Forcemain Length (ft) Does the forcemain drain back? -Y 87.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 24.47 Forcemain Drainback (gal) 13.08 Vertical Lift (ft) 135.68 5x Void Volume (gal) 7.96 Friction Loss (ft) 160.14 Minimum Dose Volume (gal) 25.59 Total Dynamic Head (ft) 51.70 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 1.00 1.50 1.25 x 2.00 x x 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information 1290.00 Total Tank Capacity (gal) 2000.00 Se tic Tank Capacity (gal) 42.00 Total Working Liquid Depth (in) /in enter result in cell B49 huffcutt Manufacturer 30.71 gal /in ) i Dose Tank Information Effluent Filter Information Filter Manufacturer 1290.00 Dose Tank Capacity (gal) best 30.70 Dose Tank Volume (gal/in) f 10 - 8 _ Filter Model Number huffcutt Manufacturer Project: Jensen Page 2 of 10 Mound Plan View T J 1/10 B Observation Pipe : K A - - I . . B I 0::::::':::.:•: L Mound Component Dimensions A A16.00 ft E 21.62 in H 1.00 ft K 10.08 ft B ft F 9.50 in z 10.99 ft L 120.15 ft D in G 0.50 ft J 6.81 ft W 26.81 ft 900.00 (ft2) Dispersal Cell Area 1999.41 (ft2) Basal Area Available 9.00 (gpd/ft) Linear Loading Rate 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 101.88 (ft) 10 H G t - Di Tsai cell (ft) Lateral F spe 100.58 ( Invert I 100.08 (ft)-► _ 1 Dispersal Cell E D 3 ~ Elevation 4 98.75 (ft) Contour Elevation - 5.2-% Site Slope Geotextile Fabric Cover Shading Key 2- I Dispersal Cell See lateral details on 10 Topsoil Cap c = 1.5 ft Page 4 for number, size, and spacing of laterals. 0 .0 Q ® Subsoil Cap F Laterals are equally ASTM C33 Sand 0.5 ft Typical Lateral spaced from the C Tilled Layer c 5 distribution cell's 0 Aggregate o centerline in the A distribution cell (AxB). Project: Jensen Page 3 of 10 Center Connection Lateral Layout Daigram Force main connection via tee or cross to manifold at any point. Laterals are identical 'F- S y 1 P s y dhr- • = Turn-up wi ba I I vs Ive or (f X I<- 02 I 02 41 Laterals & force main of PVC Sch 40 clean out pl u g per COMM Table 84.30-5 Holes drilled on the bottom of the lateral. Number of Laterals 6 Orifice Diameter 0.156 in Lateral Diameter 1.50 in Orifice Spacing (X) 3.18 ft Lateral Length (P) 49.29 ft Orifices per Lateral 16 Lateral Spacing (S) 3.00 ft Orifice Density 9.38 ftz/orifice Lateral Flow Rate 8.62 gpm Manifold Length 6.00 ft System Flow Rate 51.70 gpm Manifold Diameter 2.00 in Total Dynamic Head 25.59 ft Forcemain Velocity 5.28 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. Disconnect Tank component is properly vented E Alternate outlet location Forcemain diameter huffcutt Manufacturer 2 in. Ca acit 1290.00 Gallons T Volume 30.70 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 28.80 884.26 C B 2.00 61.40 Pump off elevation (ft) C 5.22 160.14 _t F 87.50 D 6.00 184.20 D Total 42.02 1290.00 Dose tank elevation (ft) Bedding un er tank. 87.00 l Alarm Manuafacturer--r 3 1E Vil Alarm Model Number 101w Pump Manufacturer zoeller Pump Model Numbc,- i /ti I Pump Must Deliver 51.70 gpm at 25.59 ft TDH Project: Jensen Page 4 of 10 Mound System Maintenance and Operation Specifications Service Provider's Namebert Hardina Phone 715-986-2508 POWTS Regulator's Name F~:~R~ St.Croix Co. Phone System Flow and Load Parameters Design Flow - Peak 900 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 600 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 2000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 900 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Should inspect and clean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Ins ect for ondin and seepage once eve 3 ears Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight 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 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Jensen Page 5 of 10 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 its' component manuals (SBD-10691-P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance 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 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 a tank or component. 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. 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 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 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 owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological 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 it 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 be 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 BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if 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 controls, 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, it will be repaired or replaced in its' present location by increasing basal area if toe 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 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. I Project, Jensen Page 6 of 10 Zoeller Pump Company . u5- ` vy + U- w PUMP PERFORMANCE CURVE ~ U_ MODELS 161/4161-163/4163-165/4165 9a 24 80 16514165 70 oL 20 16314163 .~..m.. _ 16- 50 0 0 12 40 30 8 20- 161/4161 4 to 0 10 20 30 40 50 60 70 80 90 100 110 GALLONS LITERS 0 $0 160 240 320 400 FLOW PER MINUTE Pump Performance Curve Models 161/4161, 163/4163, 165/43.65 Qg http://www.zoellerpumps.com/ImageDisplay.aspx?ProductlD=95&ImageName=72curve 1 2/16/2012 HARDINA SEPTIC SYSTEMS MPRS/CST 824825 "i'oP c + weu- CN5 j,✓ti - b - a 9 AcPS r Otte- lot --so v SI V L r„_ ! Sw - 3 Af- ZSd i4l P~ r+ p?w,vK . Oe uq-r i W CAL 03 .9 10 F-- LAJ 46 'A-u4CE,-- 31"X 1,2b - _ N O W o0 t F. a Y T G1 - J w V• R Z O E v,o m 'p amnn~ O OF E 0 i Z V V a o v J 0) C c v o ` a 0 IA L N R C Z a 41 14Z A tn W_ 0 ° o Y C yO O A O Y y~j O - Y■ la~ O Cl W N y a w c IT 1+~1 ° C E W >E o o E ~a V w n -C a) :E3 (vr] N N C o J L O O'f Q •'L-• j tD Go > N q ~..1 3 O- m a u v v .3c Y .n LL c rn _ d N W > o C~ " o C +4- E d L r ac c Y -6 ~y o Q Y N G W O V T E V W C aae~f E V a' r R V N C E y M v E y Z i .L c n s a a 3 R E E Z Q > c f,+ ~ a a c c r:j v © y v O N L d w 3 0 5 E R u E av > in r o v`ki m n .c Q~ R a o o o W _S'rC CL i 3; O o a a c L ~o-O OO w u 3 O v vL. 3 R c ,o - wr A C~ m o n i y 'O V O N N `y v L" 1! C 1 V O 'o O., m L C dt" Ol • .R M y c o v f 3 R v Y 1 aac-°oLO~ c voov 1 ~o z c c > a:. fA vO o 75 i C L O O q o o E 1 n~ a I i..1 o•rmN I c~ 1 o o O vv % C Z > C 9 L- N r a • V1 o a E .ra d- n c / %'O i G A O V E u N~ L E M L 1 t E 1 O " .N _a 4) -0 C IV n Q r- c; R A I W V co Y° Y" 1 Go I 006 u O v E u 1 p 3 CL C: 1 4-4 ,yy~ Y 1 «i 1 0 0 m y 1 0 i ~y o w V yJ o c a v y 1 Gi 1 O Ear RED W 1.0 ~n 1 aVi o = cd i Ado .-•q R Y c 1 1 0 pao Q ao~~N$ I O 1 N s r H RECEIVED r~K Wisconsin Department of Commerce SOIL EVALUATION RE'R Page 1 of 2 Division of Safety and Buildings Q 9 ~ in (W ance with Comm 85, Wis. Adm. Code County ~ ST. Croix ST CR01A Attach complete site plan ~iftf~fflr~/ 111 inches in size. Plan must include, but not limited to: vertical and horizonta refe nce point (BM), direction and Parcel I.D. 16-1017-30-00 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Revie d by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 7/c///Z. Property Owner Property Location Greg Jensen Govt. Lot NW 1/4 SE 1/ S 8 T 30 N R IS E (or)❑W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 255 W. 1st ST. N/A N/A City State Zip Code Phone Number ity aVllage Town Nearest Road New Richmond Wi 54017 ( 715-505-3589 160th New Construction Use[D Residential / Number of bedrooms 6 Code derived design flow rate 900 GPD Replacement Public or commercial - Describe: ft• Parent material GLACIAL TILL Flood Plain elevation if applicable N/A General comments RECOMMENDED MOUND CONTOUR ELEV. 98.75 and recommendations: ❑ Boring # ® Boring pit Ground surface elev. 98.92 ft. Depth to limiting factor 24 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 -Eff#2 1 0-12 10YR3/3 -0- SIL 2MSBK MVFR GW 2M .6 .8 2 12-24 10YR5/4 -0- SIL 2MSBK MFR CW 2F .6 .8 3 24-36 7.5YR4/6 C2D10YR6/4SL SL 2MSBK MFR N/A N/A .6 1.0 T F21 Boring # ® Boring 97.92 20 Q pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 -EN#2 I 0-11 10YR3/3 -0- SIL 2MSBK MVFR GW 2M .6 .8 2 11-20 10YR4/6 -0- SiL 2MSBK MFR CW 2F ••6 .8 3 20-31 10YR4/6 F2Dt0YR6/4SL SiL 2MSBK MFR N/A N/A .6 .8 4 31-50 5YR4/6 C2D10YR6/2SL SL 2MSBK MFR N/A N/A N/A N/A Effluent #1 = BOD > 30:< 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Numbe ROBERT J HARDINA 825 ress Date Eval ation Conducted Telephone Number Add 477 170th AVE. TURTLE LAKE W1. 54889 9-20-11 715-986-2508 Property Owner JENSEN Parcel ID # 016-1017-30-000 Page 2 of 2 3 Boring # 11 Boring E] Pit Ground surface elev. 98.75 ft. Depth to limiting factor 22 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Etf#2 1 0-10 10YR3/3 -0- SIL 2MSBK MVFR GW 2M .6 .8 2 10-22 10YR4/6 -0- SIL 2MSBK MFR CW 2F .6 .8 3 22-40 10YR4/6 C2D10YR6/2SL SL 2MSBK MFR CW IF .6 1.0 Boring # Boring 98.67 21 !.J Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-11 10YR3/3 -0- SIL 2MSBK MVFR GW 2M .6 .8 2 11-21 1 YR4/6 SIL 2MSBK MFR CW 2F .6 .8 3 2140 10YR4/6 C2D10YR6/2SL SL 2MSBK MFR CW IF .6 1.0 Boring ❑ Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 "Eff#2 * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-2648777. SBD-8330Te t (R07/00) HARDINA SEPTIC SYSTEMS MFRS/CST 824825 pp w eLL C AS r ~ ~ _ _5o t_ rr r, 5 L 0 w 410 AG~f > 4PA4CEt: ot~- 101*1 yd~ y o =1° e l E E 3 Jfi y.? I-!moo? A i re V 4L _ _ l Q'L taw{e:~ea~ ,4 e6c,!;c 17?::;,L" Z:t) 106 r~~C '-TO 4G A 1 LT /D _r ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer jE 0 Mailing Address 21 S5 0,7- cJ te_arva u W 1 5 O I' l Property Address a7fUt l t © 'M Q, rr (Verification required from Planning & Zoning Department for new construction.) 014- (oil- q0- 6s;0 City/State c IT Parcel Identification Number Q i te 10J_) - 30 - w LEGAL DESCRIPTION Property Location A/W 1/4 , S E 1/4 , Sec. , T30 N R_L.5-W, Town of ~,(,c,~ caaC;G`J CFT Subdivision Plat: , Lot # Certified Survey Map # q q , Volume , Page # uty"Dee# g~ I 1~ 2 (before 2007)Volume , Page # Spec house ❑ yes [B-rluo Lot lines identifiable +<es ❑ no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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 Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on thi orm 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 w anty deed recorded in Register of Deeds Office. Nu r of bedrooms Ce- NA "7\~ A,*,-- 2 A/ l Z S OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 09/07) ECEIVED ! 1 1 1 1 1 I1 1 1 ~ m it 0 9 7Q1z State Bar o sons 0 2003 * 8 7 9 9 2 4 Lli TRACT (0) 9, ~~L 61 Lnv.n ..UU1y1-( PLANNING & ZONING OF CE (TO BE USED FOR NON-CONSUMER ACT TRANSACTIONS) KATHLFEN H. WALSH REGISTER OF DEEDS Document Number Document Name ST. CROIX CO. ; WI RECEIVED FOR RECt1R.D CONTRACT, by and between Lawrence Meyer Jr 08/13/700$ 10:40AM ("Vendor," whether one or more), LAND CONTRACT EXEMPT I and Greg D Jensen and Jean M Jensen, husband and wife survivorship REC FEE: 17.00 marital property ("Purchaser," whether one or more). TRANS FEF: 405M PAGES: 4 Vendor sells and agrees to convey to Purchaser, upon the prompt and full performance of this Contract by Purchaser, the following real estate, together with the rents, profits, fixtures and other appurtenant interests ("Property"), in Recording Area ; St Croix County, State of Wisconsin: Name and Return Address Timothy T Sempf The West of the Southeast '/4, Section 8, Township 30 North, Range 15 West, 1 AT EXCEPT the South 600 feet of the West 800 feet of the Southwest 1/4 of the Southeast ATTORNEY LAW 314 Keller Ave e N #200 '/4 of Section 8, Township 30 North, Range 15 West and EXCEPT Lot I, of CSM Amery WI 54001 recorded on January 13, 2003 in Vol. 17, Pg 4442 of CSM as Document 9 705669 located in part of the Southwest Quarter of the Southeast Quarter of Section 8, Township 30 North, Range 15 West, Town of Glenwood all in St Croix Co., WI 016-1017-30-0000; 016-101740-050 Parcel Identification Number (PIN) This is not homestead property. Purchaser agrees to purchase the Property and to pay to Vendor at his (iis (is -not) residence This is a purchase money mortgage. the. sum of S 135,000.00 in the following manner: (is)(isnot) (a) $ 60.000 at the execution of this Contract; and (b) the balance of $ 75.000 , together with interest from the date hereof on the balance outstanding from time to time at the rate of 4 % per annum until paid in full as follows: Yearly payments of $16,847.03 beginning September 1, 2009 and each year thereafter until paid in full. provided the entire outstanding balance shall be paid in full on or before September 1, 2013 ("Maturity Date"). Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. CHOOSE ONE OF THE FOLLOWING OPTIONS; IF NO OPTION IS CHOSEN, OPTION A SHALL APPLY: ® A. Any amount maybe prepaid without premium or fee upon principal at any time. ❑ B. Any amount may be prepaid without premium or fee upon principal at any time after ❑ C. There may be no prepayment of principal without written permission of Vendor. State Bar Form 11-Page I © 2003 STATE BAR OF WISCONSIN 1 of 4 CHOOSE ONE OF THE FOLLOWING OPTIONS; IF NEITHER IS CHOSEN, OPTION A SHALL APPLY: ® A. Any prepayment shall be applied to principal in the inverse order of maturity and shall not delay the due dates or change the amount of the remaining payments until the unpaid balance of principal and interest is paid in full. ❑ B. In the event of any prepayment, this Contract shall not be treated as in default with respect to payment so long as the unpaid balance of principal and interest (and in such case accruing interest from month to month shall be treated as unpaid principal) is less than the amount that said indebtedness would have been had the monthly payments been made as specified above; provided that monthly payments shall continue in the event of credit of any proceeds of insurance or condemnation, the condemned premises being thereafter excluded from this Contract. Purchaser shall pay prior to delinquency all taxes and assessments levied on the Property at the time of the execution of this Contract and thereafter, and deliver to Vendor on demand receipts showing such payment. Purchaser shall keep the improvements on the Property insured against loss or damage occasioned by fire, extended coverage perils and such other hazards as Vendor may require, without co-insurance, through insurers approved by Vendor, in the amount of the full replacement value of the improvements on the Property. Purchaser shall pay the insurance premiums when due. The policies shall contain the standard clause in favor of Vendor's interest, and evidence of such policies covering the Property shall be provided to Vendor. Purchaser shall promptly give notice of loss to insurance companies and Vendor. Unless Purchaser and Vendor otherwise agree in writing, insurance proceeds shall be applied to restoration or repair of the Property damaged, provided Vendor deems the restoration or repair to be economically feasible. ❑ Purchaser is required to pay Vendor amounts sufficient to pay reasonably anticipated taxes, assessments, and insurance premiums as part of Purchaser's regular payments [CHECK BOX AT LEFT IF APPLICABLE]. Purchaser shall not commit waste nor allow waste to be committed on the Property, keep the Property in good tenantable condition and repair, and free from liens superior to the lien of this Contract, and comply with all laws, ordinances and regulations affecting the Property. If a repair required of Purchaser relates to an insured casualty, Purchaser shall not be responsible for performing such repair if Vendor does not make available to Purchaser the insurance proceeds therefor. Vendor agrees that if the purchase price with interest is fully paid and all conditions fully performed as specified herein, Vendor will execute and deliver to Purchaser a Warranty Deed in fee simple of the Property, free and clear of all liens and encumbrances, except those created by the act or default of Purchaser, and: CHOOSE ONE OF THE FOLLOWING OPTIONS; IF NO OPTION IS CHOSEN, OPTION A SHALL APPLY: M A. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination, at the time of execution of this Contract. ❑ B. Purchaser states that the following exceptions set forth in the title evidence submitted to Purchaser for examination, at the time of execution of this Contract, are unsatisfactory to Purchaser: ❑ C. No title evidence was provided prior to execution of this Contract. State Bar Form 11-Page 2 ® 2003 STATE BAR OF WISCONSIN 2 of 4 CHOOSE ONE OF THE FOLLOWING OPTIONS; IF NEITHER IS CHOSEN, OPTION A SHALL APPLY: ® A. Purchaser agrees to pay the cost of future title evidence. 0 B. Vendor agrees to pay the cost of future title evidence. Purchaser shall be entitled to take possession of the Property on August 12, 2008 Time is of the essence as to all provisions hereunder. Purchaser agrees that in the event of a default in the payment of principal or interest which continues for a period of 30 days following the due date or a default in performance of any other obligation of Purchaser which continues for a period of 30 days following written notice thereof by Vendor (delivered personally or mailed by certified mail), the entire outstanding balance under this contract shall become immediately due and payable at Vendor`s option and without notice (which Purchaser hereby waives), and Vendor may singly, alternatively or in combination: (i) terminate this Contract and either recover the Property through strict foreclosure or have the Property sold by foreclosure sale; in either event, with a period of redemption, in the court's discretion, to be conditioned on full payment of the entire outstanding balance, with interest thereon from the date of default and other amounts due hereunder (failing which all amounts previously paid by Purchaser shall be forfeited as liquidated damages for failure to fulfill this Contract and as rental for the Property); (ii) sue for specific performance of this Contract; (iii) sue for the unpaid purchase price or any portion thereof, (iv) declare this Contract at an end and remove this Contract as a cloud on title in a quiet-title action if the equitable interest of Purchaser is insignificant; (v) have Purchaser ejected from possession of the Property and have a receiver appointed to collect any rents, issues or profits; or (vi) pursue any other remedy available in law or equity. An election of any of the foregoing remedies shall only be binding on Vendor if and when pursued in litigation. All costs and expenses including reasonable attorney fees of Vendor incurred to pursue any remedy hereunder to the extent not prohibited by law and expenses of title evidence shall be paid by Purchaser and included in any judgment. The parties agree that Vendor shall have the options set forth in this paragraph available to exercise in Vendor's sole discretion. Following any default in payment, interest shall accrue at the rate of 8 % per annum on the entire amount in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance). Vendor may waive any default without waiving any other subsequent or prior default of Purchaser. Purchaser may not transfer, sell or convey any legal or equitable interest in the Property, including but not limited to a lease for a term greater than one year, without the prior written consent of Vendor unless the outstanding balance payable under this Contract is paid in full. In the event of any such transfer, sale or conveyance without Vendor's written consent, the entire outstanding balance payable under this Contract shall become immediately due and payable in full at Vendor's option without notice. Vendor may mortgage the Property, including the continuation of any mortgage in force on the date of this Contract, provided Vendor shall make timely payment of all amounts due under any mortgage, and the total due under such mortgages shall not at any time exceed the then remaining principal balance under this Contract. If Vendor defaults under such mortgages and Purchaser is not in default hereunder, Purchaser may make payments directly to Vendor's mortgagee and such payments will be credited as payments hereunder. All terms of this Contract shall be binding upon and inure to the benefit of the heirs, legal representatives, successors and assigns of Vendor and Purchaser. State Bar Form 11-Page 3 O 2003 STATE BAR OF WISCONSIN 3 of 4 Dated j /1Z Z /OR VENDOR: PURCHASER: (SEAL) (SEAL) * Lawrence Meyer, Jr * Greg D Jen (SEAL) IfAA (SEAL) * * Jean ensen AUTHENTICATION ACKNOWLEDGMENT Signature(s) Lawrence Meyer, Jr, Greg D Jensen STATE OF WISCONSIN ) and Jean M Jensen } ss. authenticated on POLK COUNTY ) Personally came before me on 1,00 * Timothy T Sempf the above-named Lawrence Meyer, Jry GieJ nsenand TITLE: MEMBER STATE BAR OF WISCONSIN Jean M Jensen - (If not, to me known to be the persLdt ) w g4tAM4C foregoing dg he am e - Z c authorized by Wis. Stat. § 706.06) instru nt and ackno ~Q . . A C_/ UBL1G. THIS INSTRUMENT DRAFTED BY: Sally M ickard •O' Timothy T Sempf #1019141 Notary Public, State of Wisconsin Amery WI 54001 My Commission (is permanent) (expires: '11•=08-09 ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. LAND CONTRACT STATE BAR OF WISCONSIN FORM NO. 11-2003 * Type name below signatures. State Bar Form I I-Page 4 © 2003 STATE BAR OF WISCONSIN 4of4 L~Se Y`~ +'n 8 0Tx54043038 $ Document Number Document Title 957095 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 05/25/2012 11:31 AM EXEMPT REC FEE: 30.00 PAGES: 3 Recording Area Name and Return Address &A 25j pC~J lst, Parcel Identification Number (PIN) Ole,-10)`7-30-000 0/1~ -101?- q0-0,-0 Ka-~-,~~ O i so n THIS PAGE IS PART OF THIS LEGAL DOCUMENT - DO NOT REMOVE. This information must be completed by submitter: document title name & return address, and PIN (if required). Other information such as the granting clause, legal description, etc., may be placed on this first page of the document or may be placed on additional pages of the document. WRDA Rev. 12/22/2010' I 1 of 3 SEVER EASEMENT AGREEMENT STATE OF WISCONSIN ) ) SS. COUNTY OF ST. CROIX ) THIS AGREEMENT is made by and between Greg Jensen, as both the "Grantor" and "Grantee" of 2866 160"' Avenue, Glenwood City, Wisconsin. Recitals A. The Grantor/Grantee is the owner of certain real property commonly known as 2866 160th Avenue, Glenwood City, Wisconsin, and more fully described as parcel #016-1017-30-000, SEC 8, T30N, R15W, NW SE (Servient Estate) and parcel #016-1017-40-050 described as SEC 8, T30N, R15W, PT SW SE EXC S 600' OF W 800' & EXC CSM 174442. (Dominant Estate) B. The Grantee desires to acquire certain rights in the Servient Estate. 1. Grant of Easement For valuable consideration, Grantor- hereby grants to Grantee an easement on and across the following-described portion of the Servient Estate: parcel #016-1017-30-000, SEC 8, T30N, RI 5W, NW- SE. Easement starting point at SW comer-of-parcel #016-1017-30- 000. From southwest corner of parcel, 190 feet east, then 140 feet north, then 190 feet west, then 140 feet south to starting point. 2. Character of Easement It is the intention of the parties that the easement granted appurtenant to the Dominant Estate, in that the easement benefits the use and enjoyment of the Dominant Estate by Easement provides a minimum of 50' work area beyond and around sewer mound' system. It is understood and agreed that the easement conveyed hereby shall give and convey to the Grantee herein the right of ingress and egress upon the lands above described for the purpose of the location, construction, maintenance, use, installation, removal and repair of sewer improvements. 3. Duration and Binding Effect It is further understood and agreed that the consideration above mentioned shall be extended to the Grantors heirs, assigns or successors in interest. 4. Purpose of Easement The easement will benefit the Grantee by Easement provides a minimum of 50' work area beyond and around sewer mound system. It is understood and agreed that the easement conveyed hereby shall give and convey to the Grantee herein the right of ingress and egress upon the lands above described for the.purpose of the location, construction, maintenance, use, installation, removal and repair of sewer improvements.. 2of3 5. Limitations Grantor herein reserves all oil, gas, and minerals now owned by him on, in and under said land Grantor warrants that the subject property does not constitute any part of the homestead of the Grantor. Grantor crops the land around the sewer system and will use property for crops within the granted easement bordering sewer system. 6. Grantor's Rights Grantor also retains, reserves, and shall continue to enjoy the use of the -surface of the land subject-to this. easement for any and all. purposes that do not interfere with or prevent the use by Grantee of the easement. Grantor's retained rights include, but are not limited to, the right to build and use the surface of the easement for driveways, alleys, walks, gardens, lawns, planting or parking areas, and other like uses. If the Grantor or any of the Grantor's successors or assigns dedicates all or any part of the property affected by this easement, the Grantee and its successors and assigns shall execute all instruments that may be necessary or appropriate to effectuate the dedications. 7. Termination This easement may be terminated by written agreement signed by all owners of record and other successors to the respective interests of Grantor and Grantee in the Dominant and Servient Estates. Grariiee, his/her heirs, successors, and assigns may execute and record a release of this easement at any time. This easement shall also terminate if the purposes of the easement cease to exist, are abounded by Grantee, or become impossible to perform. S. Entire Agreement This instrument contains the entire agreement between the parties relating to the rights granted and the obligations assumed. Any modifications of this Agreement must be in writing and must be signed by both parties. This agreement is entered into on Z day of 12012. Greg Jense - r r/Grantee Subscribed and sworn to before me this day ,aOT4 Notary Public /_~~_l5 y r Op WISG~ 3of3 i