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HomeMy WebLinkAbout008-1041-10-000Wisconsin Department of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT ~ ~ (ATTACH TO PERMIT) GENERAL INFORMATION 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 Peave ,Bill Eau Galle Townshi CST BM Elev: Insp. BM Elev BM Descdption: ~1 ~ D i v o • quo-~ ! . ~~g 7 a ~- ,,~.U~-- o ~-- ~ c~s-~= TANK INF RMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic -~v / d ~~ Dosing ~~~ ~~~ Aeration - vo- Holding --'' TANK SETBACK INFORMATION TANK TO , P/L, ~y i ` WELL BLDG. Vent to Air Intake ROAD Septic a.~ ~ ~ ~ ~ d / Dosing ~~~ Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Frictio oss System. Held TDH Ft f3. . o aa•'ts Forcemain Length ~ Dia.2,~ Dist. to Well a, ~ a SOIL ABSORPTION SYSTEM county: St. Croix Sanitary Permit No: 420527 0 State Plan ID No: Parcel Tax No: 008-1041-10-000 STATION BS HI FS ELEV. Ben hmark ~OP~Q o I74 . ~ / iav . r O.~ m Alt. BM / Bldg. Sewer ~z. S~, a~ St/Ht Inlet a.~ fig, o St/Ht Outlet ~~ ~-. Dt Inlet ~/ Dt Bottom 2 ~6 . o g ~ G Header/Ma . Dist. Pipe ~`,,~ Z ~ ~ 7 aS~ o Bot. Syste :~ ~.35ti~ ~ W ~ ~ ~ ~ ~ 3 Final Grad -~ 895 St Cover 1 ,o~- ~s'~ ~~~ r!~ ~D BED/TRENCH DIMENSIONS Width Len~th~ I ~ No. Of Trenches / n „ PIT DIMEN S No. Of Pits Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO P/Ls BLDG WELL LAKE/STREAM ACHI CHA OR Manufacturer: T f S t ype ys ~ ~ ( S ~~ / ~ ~D , Model Number: DISTRIBUTIUN SYSTEM l~t~ati a~~ U,~'~ns~,o~T.? Header/Manifold Distribution ) x Hole ize ~ x H a Spacing V Z r ~ Pip s)~ ~ ~ y /~ (t ~ / // V~ Len th Dia g 9 Len th Dia ~ S acin p 9 / SOIL GUVER x Pressure Systems Only xx Mound Or At-Grade Systems Onlv Depth Over ~f Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ~~" ` `~ , ~~ Bed/Trench Edges Topsoil ,-~ Yes I ~ No ~, Yes '; No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/ ~~ /Q !/ Inspection #2:~/ ~~ Location: 2530 County Rd N Baldwin, WI 54002 (SE 1/4 NW /4 14 T28N R16W) NA Lot ~~ ~/Parcel No: 14.28.16. 8 ~5' ~lruse Sip~i'r~ r; 6offD~ ~ /P~~u„v~ ~ ~t~gJOv 1.) Alt BM Description - T s~f,~, /~-r°C /~ 2.) Bldg sewer length = ~ ~ ' -f-~/ / K! ~(//,LCQi~.~~ -amount of cover = ~ 5 ~ 3.) Contour = Plan revision Required? ~; Yes ~iC' No Use other side for additional information. SBD-6710 (R.3/97) T--7 Date - - ,, ~ ~-- ~~~'~---~ I ___' --- -- - -- - - I (~( Insepctor's Sign ture Cert. o. Q2~ ~~~~ entto Airlntake >f (~~ ~, -~7M Parcel #: 008-1041-60-~5U 11/02/2004 11:37 AM PAGE 1 OF 1 Alt. Parcel #: 14.28.16.211A 008 - TOWN OF EAU GALLE Current 0 ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): * =Current Owner * PEAVEY, WILLIAM E & JEAN L W_~.L1AM.€~J€~N L PEAVEY 2530 CTY R\D\ N WOODVILLE WI 5 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 36.987 lat: N/A-NOT AVAILABLE SEC 14 T28N R16W 40A SW SW FItA Block/Condo Bldg: 008-1041-60 (211) & EXC PT TO CSM 'T Z~ --~ Tract(s): (Sec-Twn-Rng 401/4 1601/4) ~~~ ~ 14-28N-16W SW SW Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 837/408 07/23/1997 715/581 2004 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/19/2004 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 36.987 2,000 0 2,000 NO Totals for 2004: General Property 36.987 2,000 0 2,000 Woodland 0.000 0 0 Totals for 2003: General Property 36.987 2,100 0 2,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 04/17/2001 Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 N ~ ~ ~ V N ~ ~ a 2422 2433 2428 N N 2447 ~, 2460 24~ 2464 2475 8 ~ 2474 L 2484 / N V ~ N 2512 N 2548 2549 ~"~ 2555 ~`r~i 2581 ~ ~ A N M N ~ W r ~ V VN V ~ ~ 65 2509 2531 • 2530 2533 ~ ~ C 2559 ~` ~ ~~ ~, Z 2581 •. 258z ~ ~ pi a ~ ~ f ~ / V 1 ~ ~W.1 N v r W r • t w S e„g~ 637 th 266, j~ .~S J ^ O `~, ..a v..a~ -•~ -~•- .-......,,.so ,... J 1 • ~ d 7~ ., ~ i ~0l W. Washington Ave.. P.O. Box 7162 c~ 1 ~' s~~~5~>~"" ~ y(adison, WI 53707 - 7162 ~ Site Address Department of Commerce I ~ S ~' '' Sanitary Permit Application S~~y Pecmic Number i 83 C ~~~~ In accord w th omm .21, Wis. Adm. Coda, personal inionnation you provide ^ Check if Revision may be used for secondary tratooses Pnvacv 13w, s15.04l1 (m) I. Application Information -Please Print all Informatio ,::t ; • a ~' ;; Scatr Plaa I.D. t~u~bar Property Owner's Name Parcel Number - ~ ~ ~;^ ~ 8 2002 ~ _ _ _~ V Property Owner's Mailing Address ~ ;; c. h ~~ Properly Location ~ Q ~~ ~ _ ,~ , ~ 'A ,i• S T N, R City, Stau Zip erode Phone Number Lot Number ~ eck Number •--- Subdivision Name CSM Number t.~ a ~1 ~. ~~ ~ a is - 98 a3 - ____ II. Type of Building c eck that apply) ' ^Ciry ~1 or Z Family Dwelling -Number of Bedroot»s ^vi11a B- ^ PubliGCommercial} scri Use -' Township I~A,N C. C ^ Stott Owned r - ~ ,'~ - ~~ Nearest Road ~t ~~ III. Type of it: (Check only one box on line a (ntlmberirtg scheme for interaaI use). Complete line B ie a plicable) A' 1 ^ New 2 Replacement System 3 ^ Replacement of 6 ^ Addition co For County use S sum Tank ONv Existin System B• ^ Check if Saniary Permit Previously Issued Permit Number Dace Issued IV. Type of Permit: (Check aU that appiy)(ntlmdering scheme is for internal use) ~E. -lam 44_^-Noa-Pressurized In-Ground 21~ Mound 47.-^ Sand Filter SO ^ Gonswcud ~Vetlartd ~---- ~-~•---- 22 ^ Pressurized Ia-Ground 41 ^ Holding Tank 48 ^ Single Pass S1 ^ Drip Line 45 ^ At-Grade 46 ^ Aerobic Treannem Unit 49 ^ Recirculatin 30 ^ Other V. Dis ersa!/Treatment Area Informati on: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate(Gais . Days/Sq.Ft.) (Min./Ineh) Elevation ~~(^~ ~~ ~~ C"~~ Q ~ ~~ • o I Yr VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Galloat Gallons of Tanks Coocreu Constructed Glus Near I Exatin~ TaNn Tanks Sepde o tlvtnttt~'Tank o I ~~ ` ~ ~ « VII. Responsibility Statement- I. the de 'tpled . e sponsib' y for installation of the POW TS shown on the attached plsuit. P tier's Name (Print) lu r s Signam ivt~P/MPRS N r Business Phone Number ~ ~ ~~ " - -J~3 ~ Plumber's Address (Stree4 Ciry, Sn Zt e) VIlI. Countv/De artment U Iv Approved ^ Disapprov ~aturary Permit Fee (includes Groundwaut Date Issued Issuing gent Sigmturo (No Stamps) ^ Owner Given Initial Adverse Surcharge Fee) Deurmimtion 2 ~ J2~'~- . p~ `Z!A IX. Conditions of Ap rovallReas or Disapproval p nn "f ~~"^' v WS b ~e" ~ • t,9~A~•uL Ga~ e~C.. a~( t~.r ~~ l'~'~ICrt.~ °'''~ .S1•K~ Attach eomplae presto (to t5e Counq ooJr) f the system on paper not lea than $I/: s 11 lochs In sae s~S-~~... t,o ~ cam- ~" - _., ~ ~, 5 u-.~u~ SBD-5398 (R. OS/O1} ~C~~~I~~'~t'(.~vw~.A.~-- , I`~.- C Saiery ang Buildings Divtston _o~nry ~~ ~ M - . ~ ~Ol W. Washin ton Ave.. P.O. Box 7162 o ~ ~5~~~~~~"" i Madison, WI 53707 - %162 ~ S~ce address Department of Commerce ! I rj " '' Sanitary Permit Application Sasuary Permit Number ~~~ Ia accord with Cotttm 83.21, Wis. Adm. Code. penotut iniottnaoon you provide ^ C.hak ~ Revision may be used for ueondarv aurooses Pnvacv Law. s15.04(1 ml I. Application Information -Please Print all Informatio ~~C ~~~ ~ Sate Plan I.D. ~r ~ ~9'y`~ ~ ro+~5 lQ Property Owner's Name Parcel Number ~ 0 ~ ~ 2 8 2002 ~ _ _ _ property Owner's Mailing Address GIX CUUfJTY C'~ a h ST Property L.ocadoa . . LC~ilivG OFFICE ~~~ ~~~ .f, S T N, R City. Sate Zip Code Photle Numtxr Lot Number ~ Welt Number ~- Subdivision None CSM Number '1 ~ ~• ~ a is- 98 a3 ~ - - II. Type o[ Building ecit that apply) L 3 " ^Ciry ~l or 2 Family Dwelling -Number of Bedrooms ^villa - 8- ^ Public/Commercial ~~escripe Use ~ _ Township ~A,td C. ^ Sate Owned r r, ~ ~ ~'~ - ~ ~r o ~~- Nearest Road << ~~ e N o = .Z-Zo s.~ III. Type o[ 't: {Check only one box on line a (numbering scheme for internal use). Complete line B it a pliable) A' 1 ^ New 2 Replacement System 3 ^ Replacetnetlt of 6 ^ Addition to Ftu County use S stem Tank ONv Existin Svstem B. ^ Cheek if Satsiary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check aU lilac apply)(numbering scheme is for internal use) atE. -l 44 ^ Non-Pressurized Lt-Ground 21~ Mound 47. ^ Sand Filter SO ^ Conswcted Wetland --•---~---- 22 ^ Pressurized In-Ground 41 ^ Holding Tank 48 ^ Single Pau S1 ^ Drip Line 45 ^ At-Grade 46 a Aerobic Tratment Unic a9 ^ Recirculatin 30 ^ Other V. Dis ersaUTreatt neat Area Informati on: Desiatt Ftow (tpd) Dlapecsal Area Dispersal Area Soil Appliudoa Pereoladon Rate System Elevation Final Grade Requited Proposed Rate(Gals./Days/Sq.Ft.} (Hlin./Ine6) Elevation L r Ll~ ~ ~ • O 1 ~ / T r t VL Tank Iltfo Capuiry in Tool Number Marrtrfuturer Pniab Site Steel Fiber Plastic Gallons Gallons o! Tanks Concrete Consweted Glass New Ezistttta Tanlta Tanka S~ o ~ ~ ~ ~ 1 t ~ ~l VII. Res onsibility Statement- I. the de 'geed, potuib' y for instaUatioa of the POw'i'S shown on the attached plant. P is Name (Pritu) !u r s Sign i'vtP/MPRS N r Business Phone Number ; Gl - - -s~3 l ~ Plumber's Address (Street, City, Sa Zl e) ~ 1 ' ~ c i l ~E yCd .!~ ,(~ J VIII. Countv/De artment U Iv Approved ^ Disapprov Saniary Pemtit : ee (includes Grtwndwamr Dan Issued Issuing gent Signature (No Stamps) Surcharge Fee) ^ Owner Given Initial Adverse ~/ ~ 32~'-- Detenninadon . b j IX. Conditions of ap_~r(oval/Reas or Duapprovai r, ~``" ~,~~- vw~7t~. uti `a ~it.. ~ • °~ ~6,.uL.. Cr aK- a~a(t~t,o't.x~Q Th ~, ,r'p _ .l- ~ wit., wt.~,...~' v~ ~+~' U ~I -~.~~ ~ ~~~ ~ V Attxa complete puns ito the wuotT y) f tae rystem on paper not 1w than SI/: a 11 laenea to size sue.. t>o ~ cam, SBD-5398 (R. 05101) ~C ~(.~ ~ b~.. S` SQ~u~`~- C n 0 ~~_ ~~ ~6 ~,.}r ~ °~ j ,~ 0 Qr ~~ ~O > ~ U e o `~ 3 a» ~~ 0 ~~ ~. ~~ ~ ~~ ~~ ~ ` ~ ,, ~ _, , ~ ~~ ~~~ ~ ~, . •_--~ (~ Y~ o~_-,. ... ~~ ~. ~=, ' _T ~ ~ ~ i ~ ~ x ~ ~ ,. `, , ' ~ ~ '~ __ _ ~ , ~-- . ~~ i, -d ~ ' ,. t ~ ~ ~ 1.. ,I i _, - ~- ~'. ~~-~ ~c ~~ fir- U i 1 - _~ ~~ ~- , ~_ ~~ _~ '~ ~ ~~ ~~ o' ~~ .~ ~~ ~~9 ~ Y isconsin Department of Commerce Safety and Buildings 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304 TDD #: (608) 264-8777 www.commerce.state.wi.us/sb www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Secretary October 21, 2002 CUST ID No.220728 CLARENCE L GLOTFELTY ENVIRO-TECH SYSTEMS & SERVICE N4955 SUNNY HILL RD WEYERHAEUSER WI 54895 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/21/2004 ATTN.• POWYS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Bill Peavey 2530 County N Town of Eau Galle St Croix County SE1/4, NW1/4, 514, T28N, R16W FOR: Object Type: POWT System Regulated Object ID No.: 873968 Identification Numbers Transaction ID No. 794570 Site ID No. 651487 Please refer to both identification numbers, above, in all cones .ondence with the a enc . Cond. The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. DEPARTMENT The following conditions shall be met during construction or installation and prior to occupancy or use: , OF ~ i ~' ~~, This plan action is subject to designer and reviewer comments on the plan. SEE Provide the homeowners with a user's manual on the operation and maintenance of this POWYS system. #1. Include each component manual name, number and date on the title page of the plan. (POWYS application) . #2. Abandon failing system per Comm 83.33. #3. Provide Frost protection per Comm 83.43 (8)(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. 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 to the owner and any others who are responsible for the installation, operation or maintenance of the POWYS. a. CLARENCE L GLOTFELTY Page 2 10/21/02 Sincerely, W C. Wesley C be Plumbing Plan Reviewer ,Integrated Services (920)492-5613 , M-R 7:00 - 16:30, F 7:00 - 11:00 wgrube@commerce.state.wi.us cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544 C/O Clarence Glotfelty Enviro Tech Systems & Services Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 RECEIVED S E P 2 4 2002 SAFETY & BLDGS.-Dl1f Project MOUND SYSTEM DESIGN Residential Application INDEX AND TITLE SHEET Owner ~ i Address ~~ ~G ~, v .. Do~V ~ ~~e '7~~'- ~~9~ -~.~c Legal Description ~j~,~L/ f ~/~ ~y S~ /~ ~a~ ~~~ !~J Township _L_(,t.U ~~~~ County _~ ~r'Of X Subdivision Name ~ Lot No. . Parcel ID Number _ Plan Transaction Number Designer Signature Date =~ l Page 1 of 9 . ~~ ~. ., M, .. ~~ ~ Index and title sheet Mound calculations Mound drawings Pres. dist. calcs: and laterals TDH and pump tank drawing Pump specifications Site plan Turn-up detail Management plan License Number ~ionally :OVE D Page 1 Page 2 Page 3 .fv ~ ~ UILDlN ~ ~/ Page 4 - Page 5 SPONDENCE Page 6 Page 7 Page 8 Page 9 220728 Phone No. (715) 868-5831 MOUND SYSTEM DESIGN Complete red boxes as necessary. 750 gpd maximum design flow. Residential or commercial? ~(r or c) Slope a-.. Design flow rate gpd Depth to limiting factor in In situ soil infiltration rate o. gpd/ft~ Contour line elevation ft Use standard fill depths? ~~ OR Design depth? ~~in Place X in box to use standard depths (24 and A+4 inclusive) OR specify design fill depth. Orifice density Orifices per ft` Center or end manifold ~(c or ei Orifice diameter in o ,ze, o.,ss, o.,sa. 0.2,0, o.ls. Lateral spacing ~ ft Use 0 lateral spacing for trenches. o.za,, or o.3,s inrn oniy. Estimated orifice space , Q ft Not a renal calculation. Number of laterals Pump tank elevation ft Outside bottom of tank. Forcemairi length ft Forcemain diameter . p in 1.5.2, 3 or a inch only. ~ ..n Actual I.D. u'' S1f~STLM SOLUTIONS D~.$ig'n fipyf rate Absorption cell Appfic8t~at~t ratb & area 1.0 gpd/ft~ Linear loading rate (LLR) D~stgn width (A) Cell length (B) Depth of cell (F) Sand filter Upslope fill depth (D) Downslope fill depth (E) Basal area required (gpd/infiltration rate) Supporting components Topsoil depth Subsoil depth at center Subsoil depth at cell wall ~ End slope toe length (K) pfh Up slope toe length (J) Down slope toe length (I) Total mound length (L) Total mound width (W) Project: Transaction Number: DIAMETER CONVERSIONS 1/8 = 0.125 1/4 = 0.250 5/32 = 0.156 9/32 = 0.281 ~~gpd 3/16 = 0.188 5/16 = 0.313 7/32 = 0.219 y SO ft` gpd/ft ,~ ft o' ~ t~~ ~~ /~.D in moo.©" --- _. In ~po ftz r~, 9 / a ~'p ~,Po~! 3.0 9.0 in in Wes-' " d 3.0 , in ~ ft o ft 1----s I ,5 ft ._~ 5 ft o ft Basal adjustment made. Page'~of 7 MOUND PLAN VIEW ~~~~T i._d~°~f t W . ~~~ ~ observation pipes (typica~ ~~ ~w~ A=' . 1't B = ft ~'°~ J = ft ~ . 8 a_v~.. I = ft = y',z,j a,11S• K- ~; - 1 /68 ~ ~ {t = .?~ IM _I- ~'1~= L'/ ~ S t. obs. i e YP P P (anchored securely) I =down slope dimension =absorption cell (AxB) J = up slope dimension O =plowed area ri • ~n~ , K =end slope dimension M ~ S + A • t g- MOUND CROSS SECTION e~cl '~d. e ' D=~~in- D' ~ s lateral topsoil ~ ~ H .. invert 7a.~ .ft elev. ____- ~_-_ \ sys. ~ y ~, elev. %M _ .o ASTM C33 ~__ \~ Sand Fill IMC G subsoil cap . ~3 ~ E ~, ~~ `„`~ ~ ~ ~. F = ~. in = e. F G 6.0 in S pnM ~\ H = 12.0 in y \\ ft contour ~' D = upslope fill depth plowed layer E = downslope fill depth F =absorption cell depth G =subsoil + topsoil depth at cell wall H =subsoil + topsoil depth at cell center J`~1 = W 1 ~~ 01 Sa,v.d ~ i l ~ ~,..J~o -...~. slope Note: Absorption cell media will consist of aggregate and pipe with laterals centered across Ax8 media. The cell media is covered with geotexUle fabric. Project: Transaction Number: Fanejof~ PRESSURE DISTRIBUTION CALCULATIONS Lateral specifications Number laterals Hole spacing (X) Holes/lateral Lateral length (P) Hole diameter Lat. dis. rate Sys. dis. rate Lateral diameter Designer must "X" one choice from the options provided. .: ~. .i .. Bch- ounds Metric in Cm holes " 'ft m t , in mm ,l~ gpm Us ~r(J~; gpm ' Us Pipe diameter Design options Design choice 1 in (25 mm) 1.25 in 32 mm) X 1.5 in (40 mm) X 2 in (50 mm) X 3 in (75 mm) X Place X in red box of chosen diameter. LATERAL DIAGRAM -CENTER CONNECTION Place correct lateral diagram by clicking in one of the drawings at right and dragging the diagram into this area. Do not press delete when lateral diagrams are in use. I P 'I • IF X -~ IE x!2 Last hole drilled neNt to end cap Holes drilled on t he bottom of the lateral, equally spaced xf2 ~I Laterals & force main of PVC Sch +0 (per COMM Table 8+.30-5) • =Turn-upva'ball valve oroleanoutplug Inch- ounds Lateral connection point center Lateral length (P) Hole spacing (X) in Hole diameter in Lateral diameter ~,~ in Forcemain diameter 2.00 in Project: Transaction Number: Metric m ~~_ cm 401mm 501mm Page of ` ~~ v.~4 4" PyG VENT PIPE 12" MIN. ABOVL' GR~.~E: 6 >_ -O' FROhf DOOR , b1I NDOW 01: FRESH AIR INTAKE FINT.SHED GRADE ~ • ~. ~ ~ . y -- 1©" IN ; ..i .._ INLET t I ~+" Plos>'ic PIPE D . ~- ~1~:. ~r ~. t' GAS- , ''r TIGIiT ~ SEAL .~ I {~____ tt " MIN . ..G V_ ll tit it v ~ APPROVED SIC ALM JOINTS 41/hlas~'ie r.; ON PIPE 3' ONTO SOLID SOIL _ sc++ RISER EXIT OFF 1'L•'ItMI'i'TED ONLY., IF TANK MANUFACTURER HAS APPROVAL ~L~ 3 APPROVED BEDDING UNDER TANK ~I CONCRETE. PAD J~~U ~ij~ -~~ SPECIFICATIONS ~ x ~04a~ x 1 ~~ OSE TANK MANUFACTURER: I~IUMBER DOSES PER DAY: • ~ GAI.,, I)nif; Vg1,l1MJ: TNCI,UI)ING lANK SIZES : ~L'PTIC /r~0 _ ~~~, X ~/~y FLOWaACK:~ ~ 5. GAL. DOSE ~n~ GAL. ALARM MANUFACTURER: s ~ ~et.~d MODEL NUMBER : U SWITCI~ TYPE: nne~c_ /aaY PUMP MANUFACTURER : ~ e~ MODEL NUMB)rR SWITCH TYPE: CAPACITIES: A = ~ INCHES = ~~=~._-D GAL. B 2 INCITES =. -,. ~' GAL. ~(p.~(~ ~a.~ C _ j n INCHES = ~ 5 GAL. ~~ - D ~ INCHES = L~2~GAL. REQUIRED DISCHARGE• RAPE ~ Pt1 PUMP 6 nLARM WIRING AS PER ILHR 16.23 WAC ~ 3 ~ VERTICAL DIFFERENCE BETW UMP OFF AND DISTRIBUTION PIPE o FEET ~ FEET ' s•s~ + MINIMUM NETWORK SUPPLY PRESSURr + ~ FEET FORCEMAIN X ~ ~ F T/ 100 FT. FRICTION FACTOR • ~ FEET ' FEET ~•° --- _ 'TOTAL DYNAMIC HEAD ~~ ~`-~~ P TANK: ~ ~ ~ ; ~~'~'~ LENG'?'H ~~ p~R INTERNAL DI ENSIGNS OF PUM _ , __ _ . ~,. LIQUill ll1::t''TH S~ SIGNED: LICENSE NUMBER: DATE: 1/BB ~ ~ ~~D9 l•IEATHER PROOF JUPJCTIOIJ BOX APPROVED ~~~"S -b1ITFl. CONDUIT MANHOLE COVED W/ PADLtlCK E /___--WARNING LABEL ...>~_` WATER TIGH'1` ~- ~-i3~r-r-I_L Z ~~3~ ~ A E1=T=l_Ut~~IT J- L' (=1 ~.T~iZ -~- ,~ %DD c { 8 r zs = 8 4t 15 ~ t a to z s 0 U.S. GALLONS 10 0 LITERS DO 1D CAPACITY CURVE MODELS 137/139 137,139 MODELS 137!13!7 FI. 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 6 30 30 9.14 -- loc k valve: 26 ft. t0I SO 60 I 70 90 ~ 90 100 i 110 'T 160 2t0 320 t00 FLOW PER MINUTE 009921 o ~~P ~ e ~~ ~~~ 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 alternators, 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 Sorioc . d7 the 139 Rarioa . 51 Ihs SIW7a • 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. •••~{4 13/18 ~+- 7 7/t8 IL- 8 1/8 -. SELECTION GUIDE Sin le Seel Control Seleedon Listln s Model Volts•Ph Mode Am a Sim fez Du lex CSA UL M137/139 115 1 Auto 10.7 1 or 16 B -- Y Y N137/139 115 1 Non 10.7 2or287 3or586 Y Y ' BN137 115 1 Auto 10.7 Y Y D137/139 230 1 Aulo 5.8 1 or 1 3 8 - Y Y E137I139 230 1 Nan S.B 2 or 2 8 7 3 or 5 8 6 Y Y ' H137/139 20x209 1 Auto 6.2 188 Y N ' 1137/139 200.209 1 Nan 6.2 2 8 7 3 or 5 8 6 Y N ' J137/t39 200.208 3 Non 2.6 2 8 4 384 or 586 Y Y ' F137/139 230 3 Nan 2.8 2 8 4 384 or 586 Y Y ' G 137 460 3 Non 1.4 2 8 4 384 or 588 N N ' G 139 460 3 Non 1.4 2 8 4 384 or 586 N N ' No molded plug "Single piggyback switch included. Pumps mull be operated in updghl position. Three phase unlls require a contrd switch to operate an external magnetic or combination starter. For inlormalion on adcAlional Zoeller products refer to calabg on Comt>inalion slaver, FM0514; Piggyback Variable level Float Switches, FM0477: Electrical Alternator, FM04e6; Mechanical Allema• tor, FM0498; Alarm Package, FM0732; and Sump/Sewage Basins, FM0487. 1. Integral Uoal operated 2 pole mechanical switch, no exlemal control required. 2. Single piggyback variable level Iloal 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. Sse FM0712 for correct model of Electrical Allemalor E•Pak. 6. Variable level control switch 10.0225 used as a contol acUvalor, specify duplex (3) or (4) float system. 7. Four(4)holeJ-Pek,Junclionbox,forwalerllghtconnecUonforhardwiredsimplex operation, l0-0002. 8. Two (2j hole J•Pak, for Watertight hardwired PconnecUon or splice,l0.0003. CAUTION All installation of controls, protection devices and wiring should be done by a qualified ilcensed electric(an. All electrical and safety codes should be followed including the most recent National Electric 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. jf ,~ _ MAIL T0: P.O. BOX 16347 /~///~ C/ ~ Louisville, KY 40256.0347 Manulacturersol.. Zo ~ Or~~~/Y SHIP T0: 3649 Cane Run Road O o (•, ,/ ~ Louisville, KY 40211.1961 ,QU4L/77' PUMP6 SNCE ~J~t7 ~ PVMP !O. (502) 776.2731.1(800) 926•PUMP FAX(502J774.3624 -~ 4 13/18 _~ 11/Y - 11 1/2 NPi e ~ _ ~ Y~ '~ _,~ ~' ~r ~~ ~~ cr ~ o~ o>~ O ~ o~ ` ~ ~ \ o U ~ e o a 3 ~ ~ ~4 ~ . ~~ ~~ ~~ ~~ ~~ ~ ~ ~ j ~ ~' ~ a~ ;; ~ ~=, T ~~ ..._. p ~ ~ ?~ ~ ~ ~. ?' .Ir i ~ ~ ~c I ~ ~ '° i ~ I~ ~ ~ ~ , ~-- . L ~ I~ p- ~ ~ ~ ~ 0 .0 ,~ ~ ~ ~ ~ ~1% ~ ~ ~ ~ ~ ~ ~~ r ,~ ~ ' ~ ~~ ~ _. _._ .. _ .ro~...4.- ~~ ~~- -_.__ ~ __ ~ . __. __ _ i ti ~. ~ ~ / ,l O i ~- ~~ ~ ~ ~ ~i ~ ~ ~ ~ ~, ~ /~ ~~ o. ,_ .~ ~~ ~ .~ - ~ -~ ® .~ . ~ i oo~_. _. _.~~ r`1 .r ~e~~9 Typical Turn-up Cross Section Detail Finished Grade < <t<• <• <• <• <• <~ <• <• <• <• <• {• < <'<' > , , , , Y , i , ) , Y , > , Y , < < { < : ( < < { < t < < 1 < < S < <Y{Y<Yf Y{~ 3{){){Y{YI>tY{Y{YIYtY<)tY, > , , > , > • > Y > , Y > , Y > > Y , , , , , > Y , , , , > Y Y > 1<<<<<<<<{<<<<<<<° , > > Y > > > , , > > ) Y , f , , >>>>,YYYY>>,>,>>>, >>>„ >,Y,YYY>>>>> ><Y<'<,<t<,<,<,<t<t<t<,1 < < < < ` , > > > > > > < < < ~ > Y ~ < < < < < < . Soil Material ' ' ' i<< I t a t t Y Y Y > , > > > , >`>{, >•>tY`,tYt,`>`>' Threaded < < < < 1 < < < < < < < < 1 < < < > > > > > > , , , , > , > Y , , > „ >,>>,,,>>,YYYY " " " " " " " " ` Cleanout < 1 < < < < < < < < < t < t { < >,>>>>>>>„>,>>> Plug <<<<<<<<<<<<<<<< { 1 < < < < < < < { t < < 1 < <. „ >>,,,,>,>,,YY < < < < < < < < 1 < 1 < < < < > Y , > , > > , > , , Y , Y , < < < < 1 < < < < < < < 1 { > > > > Y , > > > > > , , > < < < < < < 1 < < < < < < <• < < < < t < < < < < < < 1 ~ > ) > > > ) > > , f , , , < •f < l t { t < < t < t >> Y Y Y Y Y>> Y> Y)> Y> Y> Y Y> Y < < < < < . . . • . • < < < S < y`Y`>`Y`>` 6" Diameter `.`.`.`>`>` ;~;~;~;~ Lawn Sprinkler <~I'<'<'<Y > > Y > <, :, <, < Valve Box ` ` ` ` ` < < t < < > ) > Y Y Y ) > ) ) > > Y ) > > > ) Y < < < < < < ( < < 1 < < < < < < < < Y ) ) > > ) ) ) > > ) ) > > Y ) 1 Y Y ) > Y > . > ) > ) ) ) , > > > > , < < < < < < 1 < < < 1 < < < 1 < 1 < YY,)>,>,>>))>>>>) < < < < < < t 1 < < < < < < < < > > Y Y > > Y f > > > > > > ) > Y 3 Y Y > Y ) > Y > Y > > > > > > > Y Y Y > ) , Y<Y<Y`Y`,` Soil Material Y;Y > Y ) ) > Y ) > ) > ) > ) ) ) > ) f Y > < < < < < < < < < < < < t < < < < < < < < < < < < < < < < < < < Y ) > > ) > ) ) ) ) Y > f ) t < < 1 /• .............•.......:i ) ) ) > Long Sweep 90 ` `>`)`>`)`)`~ • or Two 45 Bends to Vertical Distribution Lateral Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. 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 lank 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 approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. Ail 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 Svstem 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 conpaction may hinder aeration of he 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 for frost protection. 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 testis peformed 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 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manual [SBD-10572-P (R. 6/99)j and local or state rules pertaining to system maintence 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 the tank. Continsrency 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 shall be repaired or replaced immediately 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 removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions on the operation or maintence of this system should be directed to your county zoning or health inspector. ~~ q.d9 ~: ` r~RIG9NlAt, Wisconsin Department of Commerce SOIL EVALUATION RE Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8'/: x 11 inches in sae. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimemsions, north arrow, and location and distance to nearest road, Please print a!i information. Personal information you provide may be used for secondary purposes (Privacy l.aw, s. 15.04 (1) (m)). 1612 Certified Soil Testing ~ounty , ~ `" ^a w ~ rOIX Parc~t~1.D;,_ i~ ~~rn,~~41-10 000 ur FiCE_ ~ 6N Property Owner Peavey, Bill Property Location Govt. Lot SE 1/4 NW 1/4 S 14 T 28 N R 16 W Property Owner's Mailing Addre$ Lot # Block # Subd. Name or CSM# 2530 CTHW N City State Zip Code Phone Number 'City _ j Village t/I, Town Nearest Road Woodville ~ WI 54028 715-698-2361 Eau Galle CTHW N __j New Construction Use: v Residential /Number of bedrooms 3 Code derived design flow rate 450 GPD /'; Replacement _ Public or commercial -Describe: Parent material till Flood plain elevation, if applicable NA General comments and recommendations: install 4' x 112.5' rock bed mound on 94.4-95.3 design line as upslope edge of rock w/ 1.9-1.0' sand fill Boring # ~.,1 Boring 4 6 i 2 J/f Pit Ground Surface elev. 9 . ft n• . Depth to limiting factor - -~~ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10YR 3/2 - sl 2 f sbk mvfr cs 1flm .5 .9 --- F- 2 ~ 10-13 10YR 4/3 - sl 1 m abk mvfr gs 1m .4 .6 -----~- 3 ! 13-24 10YR 4/4 - sl 1 m sbk mvfr cs 1f .4 .6 -- 4 I, 24-28 10YR 4/4 f2d 7.5YR 5/3 sl 1 m sbk mvfr cs - .4 .6 5 ~ 28-33 10YR 4/6 - s 0 sg ml as - .7 1.2 6 ~~ 33-54 10YR 5/4 c2p 7.5YR 5/8,5/3 scl 0 m mfr - - 0 0 occasional gy si coats on peds in horizon 3 Boring # -_~ Boring dl Pit Ground Surface elev. 93.8 ft. Depth to limiting factor 27 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 ', 0-10 10YR 3/2 - sl 2 f sbk mvfr cs 1f/m .5 .9 2 ~ 10-15 10YR 4/3 - sl 1 m abk mvfr cw 1f .4 .6 3 15-27 10YR 4/4 - sl 1 m sbk mvfr cs 1f .4 .6 4 27-32 10YR 4/4 f2d 7.5YR 4/6,5/3 sl 0 m mfr gs - .3 .5 5 ! 32-40 ~ 10YR 5/4 f2p 7.5YR 5/8,5/3 scl 0 m mfr - - 0 0 _._._ I II common gy si coats on peds in horizon 3 Effluent #1 = BODS> 30 _< 220 mg/Land TSS >30 < 150 mg/L "Effluent #2 = BOD < 30 mg/Land TSS < 30 mgC SST Name (Please Print) Si na ure: CST Number henry F. Grote 222774 4ddress Certified Soil Testing Date Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 54751 8/19/2002 715-233-0398 l .., Property Owner Peavey, Bill Parcel ID # 008-1041-10-000 .Page 2 of 3 Boring # '=-~ Boring /; Pit Ground Surface elev. 95.3 ft. Depth to limiting factor 2$ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots z in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-3 1 OYR 3/2 - sl 2 f sbk mvfr cs 1f/m .5 .9 2 3-9 10YR 3/2 - sl 2 m sbk mvfr cs 1f .5 .9 3 9-28 10YR 4/4 - sl 1 m sbk mvfr cs 1 f .4 .6 4 28-36 10YR 5/4 f2p 7.5YR 4/6,5/3 scl 0 m mfr - - 0 0 ~~ i occasional gy si coats on peds in horizon 3 w/ a few inclusions 10YR 4/6 s Boring # _ Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 I _-_ i ~ ---- Boring # --' Boring 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 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 -- I I I i i _~ i i ' Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 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 608-264-8777. SBD-8330 (R.07/00) Certified Soil Testing r e M P d' ~y' s 9 fl 9 d 9 i D 0 J 1 2 3 d ~~ s ((9 I! 4 r ' ~i z F-- a ~ a J c,/~ O `~-~- a .~ ~~ ~ ~ J .~ ~t T ~ ~ r ' ~~ ~ ~ I Q ~ ~ 'd / ~ 0' d ~ ti~ ^ l d ~ d ~v ~f i C ~ !~ ~ \ 8 P ~ d; ..~i * ~ T J ~~ 0 ~~ 1 a a~ d 1 ~ ~° ~' yo ~ d ~ a ~ r o~ao = u A '~ ~ s d t p~ s ~ ~ ~ ~ o 3 ~, ~ . , ~ ~ ) ~ ~Y ~ fl ~ ~ .J e .-. s ip ~..~ _ ,~ ,~ ; a a 3 d ~d ~ ~i ~ e~ ? " ~ ~s • ~e 80 l *d a p. c~ ~~ `3 '~ ~~ ~o fi ~ ~ cad '~J ~ d ~~ ~~ V f, ~~ ~ ~ ! ~ e~ ~~ s M ~ ~` ~ O CJ 3 -~~ J ~~ .x F"r'" ~d t a~ ~ 1 <-_.. d ~ ~ ~s~v N ® Y g ~ r~ J ~ J+ J _ . i 3 3~ -f s ,~ ~3 ~ ~ ~J ~~ y~ ~r u sn1 , ~_, a OwnerBuyer Mailing Address ST CROIX COUNTY SEPTIC TANK MAIIVTENANCE AGREEMENT AND OWN/E~RSIiIP CERTIFICATION FORM ?m ~/ C~lii~x 5~~~~~ l ~~ i~ Property Address ~ S~ ~ ~ C~ ~ ~y > (Verifi/ration required from Planning Department for new constructi/oin) - CitylState w a d l/ V r ~I p , ~ ~ Parcel Identification Number (/ ~ /Y ~ ~ 0 ~~ a ~~ ^ ~~ LEGAL DESCRIPTION V' properly Location ~ 1/4,'/4, Sec. ~ ~ . T a ~N-R~W, Town of ~~/ a ~a ~ Subdivision .Lot # Certified Survey Map # _, Volume .Page # warranty Deed # ~ l ~ ~ 7 3 ,Volume /D ~7 ~ ,Page # S~ 6 Spec house ^ yes ~no Lot lines identifiable yes ^ no SYSTEM MAINTENANCE Improper use and maintenanceof your septic system could result in its premature failure to Handle wastes. Proper mainteaa:,cc consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mastorplumber, journeymanplumber, restrictedplumber or a licensedpumperverifyingthat (1) the on site wastewaterdisposal system is is proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year ex ' 'on date. ~ ~ ,~~a2 SIGNATURE 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. h ~~~~ G~ SIGNATURE OF APPLIC DATE *~**** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ****** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed }- TNI• 3/4CL 11tltNVtO 1011 11tC01101N0 OAT• DOCUMENT NO. ,, WARRANTY DEED ~' 'STATE BAR OF gI,~ONSIN FORM 3-1~;I; ;~ ,, ~4 .. .. ~ ~ _ ~ .J J ~i 5164'73 `L__-~- ~'~~5fi4 -__ -- -._ _ . ~.;~-~ ~:-i=;c~ I I~ __._._-__--- - __-___-.__.._ _ - ._ ~7 C;~:f CO.. f,1 ~ ~ •- -•-•-.....-Betty Helgeson•---a-.-single person ....................... ~i Re~s'41bRoou4 3 .._...--• ....... ..............-------------....... ~ MAY 14 1994 ~I II -------- ----------------------------...-------...............-...----------------• ~--------................. ~ ~ i i : s A. M I - ~. convrys and warrants to .... W~llidm g. •Peave~, and dean L=: '~ ~~ ~~ PPave ~•-- -•---•- Ib~plardAati l Ij ................ -....... X.i.. husl~and..and wife.-_..... i ~; ... - I 1 _________ - - ~ --__~ 11 .-.........•• ............. ..... .... .. ..•. ...... _--......... .. ... .-- - .-.....-.........-.......... -..... I. RRURN TO V . ..............................................~___-__...- ~ .I~ ... .......... .......... 1 _~~.-._~~ St:--CFQ~.R ...............County - -------- ;' i! the following described real estate in ............ ~" ~ State of Wisconsin: ~~ Tat Parcel No:.......--°-----°------------ i I !~ South One-Half of Southwest Quarter of Northeast Quarter ~` ~~ (S~ of SW~ of NEB), P.LSO East One-Half of the Northwest Quarter '! (E~ of NW's): ALSO, A);&~that;part_b€ the: Northeast One-Quarter of the r~ " Southwest One-Quarter (NEB of SN'~) lying Northerly of the hlghxay 'I (County Trunk "N")f ALSO, North One-Half of the Southwest fey '.~ One-Quarter of the Northeast One-Quarter (N~ of SW~ of NEB), '~ ALL in Section Fourteen (14), ?ownship Twenty-bight North {T28N), Range Sixteen West (R16W). ,~ This deed is giver_ in fulfillment of a certain land contract between '~,' the above parties, dated March 11, 1982, and recorded in the office of L'-~ the Register of Deeds for St. Croix County, ir, Volume 646 of Records, at page 282, as Volume No. 377509. i1. The interest of Clifford Helgeson was terminate3 by the ten;tination of dent's '' Property interest dated February 1?, 1994, and recorded a~1N~-ch 16, 1994, in a.~ yi Volume 1069 of Records on Page 315 as p~ctunert No. 514215. ~~'R::i~s.~~ ~~ ~% FEE i s nOt homestead property. Thin .............•------• -- (is) (ia not) Exception to warranties: Easements and restrictions of record, and except any liens or encumbrances created or suffered to be created by the acts and defaults of the grantees, their heirs, successors or assigns. 94. y ........ ............... ......... 19-.. Dated this 6t:h.-------• ................ day of ...-•---•-----•. --- - -----•--•------•-------(SEAL) AIITSBNTILATION Signature(s) --•-------•----------------- anthenticated this -.--._.-day oi.__°----------•----------+ ~-----• TITLE: MEMBER STATE BAH OF WISCONSI1ti (I! not..---------•----- - -- ---------------------.._. authorised by ;f 708.08. Wis. Stata.) . ............(SEAL) ' ------$etty. Helgeson-•---•------ --........-.. - --•----------------.----...(SEAL) ACSNOWLgDQMBNT STATE OF WISCONSIN St . Croix _•-••-_County. i ~" ---•-- •Peraonallp came before me this ..6th-----•--da.y o! ...............•---------1~-p---•----•--• 1994--. the above named t3etty_ Helgeson _.-_ - ..... to me known to be the Person .._...-----• who executed the foregoing w~~and acknowledge th v ~ uA.~ ----~"'"d- !R 4 ~ `, r ~~ - w a ~ '! ti }#' . ~~.:~. ~° s• F_