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030-1035-95-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 552400 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: Tro oStudio LLC, Christopher Krumm St. Joseph, Town of 030-1035-95-000 CST BMElev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: / l Qb, a f . - / PVT) + :inn 10.29.19.1201 TANK INFORMATION ELEVA ON DAT TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic IJV~ l.-i' Benchmark 2-V / p 2 , a - O Dosing tI I, -o Alt. BM Po . SZ~1~ Aeration _ Bldg. Sewer l6 D r ~ ~ s Holding St/Ht Inlet 6 ~6 9S t~ TANK SETBACK INFORMATION St/Ht Outlet ~0 303 7 SIB 3 9S, TANK TO W_~L L BLDG. Vent to Air Intake ROAD D et Septic 0 Dt B Dosing Header/ n. q y- Aeration Dist. Pipe, X jf~ 4C qz d Holding Sot. System ~J C 3` 23 PUMP/SIPHON INFORMATION Final Gra B >3 3 7 7 Manufacturer 1 GP nand St Cover Model Number Vh (/YI TDH Lift Friction Loss System Head TDH Ft (T-k t6 4111 Forcemain Le-ngW- ia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width 1 Length / No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 3 -ls- '2,-- / SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM ACHI Ma to / INFORMATION ,CHAMBER OAt V T e Of System1 UNIT Model Number: tki /Z 50 Ifa.(y~C 1Z l y b l/tl 1O rT~ D IBUTION SYSTEM by"I Bader anifold Distribution / It I V\V / x Hole Size x Hole Spacing Vent t Air Intake Pipe(s) -V 11 Length Dia Length Dia Spacing ZL~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only 10 / Depth Over Depth Over xx Depth of 1xx Seeded/Sodded xx Mulched Bed/Trench Center Bedlrrench Edges Topsoil 0 Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:-7 / 01 y Inspection #2: Location: 1097 County Road A Hudson, WI 54016 (W 1/2 NE 1/4nn10,,T2911N R1/9,,W) metes & bound Lo Parcel No: 10.29.9..1199.112201 1.) Alt BM Description 2.) Bldg sewer length = L Z - amount of cover n o I~DUQny„VI ~ Plan revision Required? ❑ Yes ;401 _ S Use other side for additional information. v v SBD-6710 (R.3/97) Date Insepctor's S nature Cert. No. ~tT County orb( Safety and Buildings Division St. Croix v Ft) 201 W. Washington Ave. O. Box 7162 Sanitary Permit Number (to be filled in by Co.) T ~ ~`~VED Madison,' 53 7, 00 ww-VIA q1) State Transaction Number knit Application 2017 7 In accordance with SPS ~ ~ O6&4ibmission of this form to the appropriate governmental unit is required prior to obtain lazy permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04 1) m), Stats. 1097 Co. Rd, A 1. Application Information - Please Pr' All Information Property Owner's Name Parcel # TropoStudio LLC - Chris Krumm 030- Property Owner's Mailing Address Property Location Z ® `T' 683 Delaware Ave. • .1-. Govt. Lot City, State Zip Code Phone Number NW _NE _'/e, Section 0_ St. Paul, MN 55107 (651) 260-9670 (circle one) T 29 N; R 19 E or W II. Type of Building (check all that apply) Lot # ❑ 1 or 2 Family Dwelling - Number of Bedrooms Na Subdivision Name Block # Na ❑ Public/Commercial - Describ Cse0ffice Space Na ❑ City of ❑ State Owned - Describe Use CSM Number 6 Z ❑ Villaae of Na 5<-6 Z own of St. Joseph -2 c III. Type of Permit: (Check on y o he box on line A. Complete line B if appl'c ble) A. ❑ New System Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner A IV. a of POWTS System/Component/Device: Check all that apply) " 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 ex lain) El Pretreatment Device (explain) V:ispersaUTre went Area Informatio : 22 I filtrator "Q-4 Plus" standard chambers, 4 endca s, Pol Lok PL-525 effluent filter Design Flow (gpd) Design Soil Application RMZTpdsf) Dispersal Area Required ( Dispersal Area Proposed sf) System Elevation 96.OOGpd 0,70 Gpd/Sq. Ft. 137.15 sq. ft. 460.40 Sq. Ft. 93.00 VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units o $ New Tanks Existing Tanks a' y p P[1 a U v~ w c7 A. Septic or Holding Tank 750 Na 750 1 eeks C ncrete X 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 Signature MP/MPRS Number Business Phone Number Jim Boumeester MPRS 222904 (715) 386-9020 Plumber's Address (Street, City, State, Zip Code) 1070 Hwy. 35, Hudson, W154016 VI . Coun epartment Use Only Approved ❑ Permit Fee Date ssued Issuing nt Signature ❑ en Re on for Denial 7✓ . °c, / G V IX. Conditi-Mf"yWReasons for Disapproval peptic tank, effklent filter and -3) OLb ;ftpersal cell must all be services / maintained as per management plan provided by plumber, - 0 40 ctc fiagt .mer>ts MUstbe n h~airl(ad ~~r - a p*r ~ppNadli owe / is mice 4 Attach to complete plans for the system ands it to the County only on paper not less than 81/2 x 11 inches in size SBD-6398 (R 11/11) ❑ ~Lt~~ /,I ~1 a/ r%OL eoY n Lf Ca/G / Zoe 190 7 Co. Alp< Q (R~ L/ nor,! o3o-ia3.S-9s--cco t~t~7y aA ~o a ' 4r- pp~ V~ s.~r q ss4 wed O vr, _ ro " v Ptah 4Ga : 99.07' accfu ~e L.P. ccncre6c h~ropa3toiw C~ncrt~e 7 ~aP.s.T_ 1 ~ Aa~o / ~o , Po l y1.~' ILL- ~~c{~/ua~, ~ ~`lrS~crE ou~lc£ t ~ tee. ~ burr 4✓q Kew - 0 ~X~v~J' o /bon .Sl. et~-~Io 0 d D i°P -a / A-1 4.bryu~el/. Sys~m . to 6c a6a., ►~Qs,o~ e- de. c cr ~ Y4 . / -),c Ylo gAoreCJo 6 Pnspos ed d,s peisa( ee//4f 2.83: .517 51oP2-~l~ra4 31 U_/ It ''¢'{1°I~s'' $ndard T,t~/' _ ~ - S .Seri a~• - ~anderspr-,-•t~rc.,c~• sysf.~ r ettu: ~-0 6e 9~ ~ r W O t C E-'r' 1 T' o C3 eS~c~srJCi' q. ~ r R ~ d 9~rART.bfFV Safety and Buildings 5~. Toy 3824 N CREEKSIDE LA HOLMEN WI 54636 I3 i D S < Contact Through Relay P www.dsps.wi.gov/sb/ ? S Jw www.wisconsin.gov ~OssrorAl'~ Scott Walker, Governor Dave Ross, Secretary June 25, 2012 CUST ID No. 222904 ATTN: POWTS Inspector JAMES W BOUMEESTER ZONING OFFICE BOUMEESTER & SONS EXCAVATING INC ST CROIX COUNTY SPIA 1070 STATE ROAD 35 N 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/25/2014 SITE: Identification Numbers Tropostudio LLC - Chris Krumm Transaction ID No. 2099478 1097 County Hwy A Site ID No. 780925 Town of Saint Joseph, 54016 Please refer to both identification numbers, St Croix County above, in all correspondence with the agency. NW1/4, NE1/4, S10, T29N, R19W FOR: Description: Non-pressurized In-ground POWTS / Commercial facility Object Type: POWTS Component Manual Regulated Object ID No.: 1378740 Maintenance required; Replacement system; 96 GPD Flow rate; 110 in Soil minimum depth to limiting factor from original grade; System(s): In-ground POWTS Component Manual, SBD-10705-P (N.01/01); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes 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 P.~. a requirements. Condition No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.04PPRO stats. The following conditions shall be met during construction or installation and prior to occupancy or use: DIVISION of SAFETY AN Reminders • A sanitary permit must be obtained from the county where this project is located in accordance with the EE CORRESPO requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per SPS 384 product approval conditions. • All POWTS piping component material shall be SPS 383, Wis. Adm. Code. • The existing POWTS shall be properly abandoned per SPS 383.33, Wis. Adm. Code. 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. JAMES W BOUMEESTER Page 2 6/25/2012 + Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • 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. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 Gerard M Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WISNI RT code: 7633 j erry. swim@wisconsin.gov 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 reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. JAMES W BOUIV EESTER Page 2 6/25/2012 Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • 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. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 tome 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 PO WTS 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 d6~ Balance Due $ 0.00 Gerard M Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swim@wisconsin.gov 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 "reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. Conventional POWTS Index & Tilte Sheet ~p ~ 24th Project Name: TropoStudio, LLC Professional Office Space Owners Name: Chris Krumm Owner's adress: 683 Delaware Ave., St. Paul, MN 55107 Site address: 1097 Co. Hwy. A, Burkhardt, WI Project Location: Subdivision: Na Legal Description: NWt/4 NE 1/4, Sec. 10, T.29N., R. 19W., Town of St. Joseph, St. Croix Co., WI. Parcel ID 030-1035-95-000 illy fED Page 1 Index and Title Sheet J BUILDINGi4 Page 2 Site Plan / Page 3 Dispersal Cell & Septic Tank Sizing Calcualtions Page 4 System Cross Section ENCE Page 5 System Management Plan Page 6 Filter Specifications Page 7 Septic Tank Cross Section Page 8 Parcel map Page 9 Septic Tank Maintenance Agreement Page 10 Waranty Deed Attachments: Soil Evaluation Report by Shaun Bird, 05/15/2012 Mater Plumber Restricted Service: Jim Boumeester, Dept. of Comm. Credential #222904 Signature: Date: I Page 1 Of 10 Design pursuant to In-Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD-10705-P (N.01/01) So./ 1V44a.•4<m10, Ca/C= / 1 ~ ~jbPoSb,~c%o~ cl.G -Chrs f~rua 0 /9o7Co. nwb~~~`y, sec. is 7'z ~9~, Est •T~P W. S{., cro;y LAD 10;1 ©30-loss 9S ago ,oo gS4nc':" d O aotLownOT ~eec! Ptak 4tia : 9 f ors ~ccG~ re - Conc~eEt l~'o pa ~to1 W - C.herry _ W/ po ~Y~arrf~L ~S G{~~CCLn~ ~'~~LrE ~l~ Uk! 100.0 / •8.20 ~ ft7 4'p jj ~ - _ - { { EXiSFi`` ~ra(a~+ Sl e~-~'Io ~ rcloca:Elcl 0 • ~~C1~ ~"OX • ~al~on p~aXi~,7-yes ~ St~ofia~ ~ rl [~yw~11/. Sys~n ~°/D~ fro be a6a., c~o~r~ a Soar Code. a o~ ` Y1o aP~ c:a6le Prepos ed pspeeS4d e ~ ZB3 5~T re Slopc-~l~reuy~ 8~ co/ If IUS SEt«n n yS~esh a~• ~,rrbelS~o~+'~1'u-ic.~. • 5 ySC~ _ Ettu: ~ 6e 93 ~ Ejr~:3EFnT S~iarCr~ ~ l~-Wtl, v EXS~~~ , ` /Q~S:clsnce , I DISPERSAL CELL & SEPTIC TANK SIZING CALCULATIONS JOB DESCRIPTION: Proposed conversion of existing Church to office space having no more than 3 employees and 1 floor drain. Proposed system to be oversized to maximize efficiencies of installation and extend system life expectancy. DESIGN FLOW CALCULATIONS: Design Wastewater Flow: (64.00 Gpd daily flow) 1.5 conversion factor) = 96.00 Gpd (3 employees) (13gal. per employee) = 39.00 Gpd (1 floor drain)(25 gal./drain) = 25.00 Gpd Daily wastewater flow = 64.00 Gpd DISPERSAL CELL SIZING CALCULATIONS: 1. Design flow = 96.00 Gpd design flow 2. Infiltrative capacity of native soil = 0.7 gpd/sq. ft. 3. Absorption area required. 137.15 sq. ft. 4. Absorption area as proposed: 460.40 sq. ft. (22chambers total) Infiltrator "Quick 4 Plus" = 20.00 sq.ft. EISA per chamber, Infiltrator "Quick 4 Plus" end cap = 5.10 sq.ft, EISA 137.15 sq. ft. - (4 endcaps)(5.10) = 116.75 sq. ft./20.00sq.ft. EISA = 5.84 chambers required Number of trenches: 2 @ I 1 chambers per trench Trench width: 2.83' Trench length: 47.00' Trench spacing: 9.00' on center Total system area: 11.66'x 47.00' SEPTIC TANK CAPACITY CALCULATIONS: 1. Design wastewater flow = 96.00 gpd 2. Minimum required capacity: 200.45 Gallons (96.00) + (11.61 x 3* x 1.28) + (46.77 x 1.28) = 200.45 *(Requires a maximum 3 year maintenance cycle) 96 00gpd / 75 god = 1.28 gpd person equivalency 3. Proposed Septic Tank Capacity & Manufacturer: 750 gallon Wieser Concrete 4. PolyLok PL-1525 effluent filter to be installed at septic tank outlet. Pg. 3 of 10 Soil Absorption System Cross Section ft 4" Schedule 40 Final Grade PVC Vent Pipe With Vent Cap 9 o ft Leaching Chamber f7 ~3. 4- -6 ft System Elevation 2.03 ft 6.0. ft Soil Absorption System Plan View ft $3 ft { (~,.oOft Vent Or Observation Pipe Leaching Trench 1 Chambers i 4" Dia. I Trench 2 Header F Leachinq Chamber Specifications I Manufacturer And Model ~nl'/ZlsLTZJ~'~CQ-~/0/usa <6on (a2/ EISA Rating x.0.0 sq ft per chamber Soil Application Rate 0.7 gpd/sq ft 300.0 gpd Design Flow; 0•7 Soil Application Rate W,& EISA X3 Chambers 2 rows of chambers each. _ J Page of Conventional POWTS Management Plan Pursuant to Safety & Professional Services Chapter 383.54, Wis. Adm. Code General The conventional septic system shall be operated in accordance with Safety & Professional Services Chapters 382-384 Wis. Adm. Code, and shall be maintained in accordance with component manual SBD- 10705-P (N.01/01). All local and/or state rules pertaining to system maintenance and maintenance reporting shall be complied with. Septic Tank The operating condition of the septic tank and outlet filter shall be assessed at least once every two years by inspection. The septic tank contents shall be removed when the sludge and scum in the tank exceed 1/3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281.48, Stats. If the contents of the tank are not removed at the time of a biannual assessment, maintenance personnel shall advise the owner of when service will be needed to maintain less than 1/3 scum and sludge accumulation in the tank. If the septic tank is fitted with an effluent filter, it 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. Septic tank manholes 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 individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank abandonment shall be in accordance with Safety & Professional Services Chapter 383.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If such products are used they shall be approved for septic tank use by the Department of Safety & Professional Services, Safety and Buildings Division. Soil Absorption Cell Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for vegetative maintenance) over the system is not recommended. Soil compaction may hinder aeration of the infiltrative surface within the system and will promote frost penetration during cold weather months. Influent quality into the system may not exceed 220mg/L BOD5, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for the installation. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner. Levels above 4 inches indicate an impending hydraulic failure requiring additional, more frequent monitoring. Contineencv 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. Excessive ponding within the dispersal cell will be eliminated by removing biologically clogged adsorption and dispersal media and replacing said components as deemed necessary or by installing a new soil absorption cell to bring the system into proper operating condition. Questions regarding the operation or maintenance of the system should be directed to Jim Boumeester at (715) 386-9020 or your County Zoning inspector. Pg.5Of10 • • w, Filters t PL-525 EFFLUENT FILTER ( OMMERCI L) Polylok, Inc is pleased to add its new commercial filter to its existing line of quality effluent filters.The PL-525 is rated for over 10,000 GPD Alarm (gallons per day) making it one of accessibility Accepts PVC the largest commercial filters in its extension handle class. It has 525 linear feet of 1/16" filtration slots. Like the Polylok PL-122, the new Polylok PL-525 has an automatic shut off ball installed 525 linear feet with every filter. When the filter is of 1/16' removed for cleaning, the ball will filtration slots Rated for over float up and temporarily shut off 10,000 GPD the system so the effluent won't leave the tank. No other filter on rY, the market can make that claim! Accepts 4° & 6°.. SCHD. 40 Pipe' r' PL-525 Maintenance: i. The PL-525 Effluent Filter should operate efficiently for several years under normal conditions before requiring cleaning. It is recom- mended that the filter be cleaned' every time the tank is pumped or + at least every three years. If the installed filter contains an optional alarm, the owner will be notified by an alarm when the filter needs servicing. Servicing should be Gas deflector done by a certified septic tank Y Automatic shut-off pumper or installer. ball when filter is removed 1. Locate the outlet of the U.S. Patent No# 6,015,488 septic tank. 5,871,640 2. Remove tank cover and pump tank if necessary. PL-525 Installation: 1. Locate the outlet of the 3. Do not use plumbing when septic tank. filter is removed. Ideal for residential and com- 2. Remove the tank cover and 4. Pull PL-525 out of the housing. mercial waste flows up to pump tank if necessary. 5. Hose off filter over the septic 10,000 Gallons Per Day (GPD). 3. Glue the filter housing to the tank. Make sure all solids fall 4 or 6 outlet pipe. If the filter is not centered under the back into septic tank. access opening use a Polylok 6. Insert the filter cartridge back Extend & Lok or piece of pipe into the housing making sure to center filter. the filter is properly aligned and 4. Insert the PL-525 filter into completely inserted. its housing. 7. Replace septic tank cover. 5. Replace the septic tank cover. 42" 61 I Z I 84,. r- 46" O m m 4 I > r ev. I < < Fri m > in O D ,0 Ao i mZ ' A D D n 40" m r y~ A ° D I- O -i O < C m D r 07, O f m O A < m n A n 6I z c D r- = r p -0 O 1 Z O Z Z p rrl Z Ir Z D D Q D D- Z c CO O Z O O D C m r-~ 0 ° Im m mC D A = C, O l70 2 p O N S 2 m -I r Z z = cA ADZ D m00 mD0 ~O a0~~ cn D m D r n AZ C ~(AC r m r tv O Z~ S (~A r m NZ~ 1 0 o <~O mOmi- O7N O Q) D O mD N DN >D - o-, Dm~ m m O < Z r"D m m AC) O mmCO ~ m W A~ (7 n z N O i j cn m D D W N m O n- m y 0 m D Op m cn c r n -A cn A z m mmr mm A 0 O Z _ G~ v G7 m --i m (f) O7 0 -10 A A '>7 O -Tj O c m 0 D mc.~ D n> D O c.n~A 71 CA -0 x ° < °0 N v z o c, r( z < n z m c_- C7 z DA p m 0 O ' N T~ ° 0 D A D D vpm A a°~ /lJ n m D O N Z C m O F O O A n ~ ° N A O C O Z O n 0 m p AD ° A z m C m v m < r- A (A m (A m A m A A A n Z 0 r z m A m m m z m \ O = WLP750-MR SCALE:1/4" = 1' REV NO. DATE MIERER coUGHETE DRAWN 6Y SWT V Z SEPTIC MANUAL W3716 US HWY10. MAIDEN ROCK, WI 54750 DATE: JANUARY 2008 REV, JAN. 2008 800-325-8456 FILE:WLP750-MR . 7 of/v NORTH SCALE: I"= 40 40 20 p 40 r~ t nl r RECORDED AS 80 RODS r 553' (i 873) WEST OF SECTION CORNER - 3 SB9°0251"E 133.63'- - MEASURED IMI.23' fFts`f SECTION LINE ESTABLISHED BY CURXE SECTION LINE 6A8ED ON SECTION C>rORN..~MONUfN0ftS OF RECORD 1888,10' SEO110N 10 b6 Val. NE CORNER, SECKIN 10 i r ! Iv Ali, HOUSE CHURCH BUILDING ~r ~ t1f SEPTIC VENTS LEGEND FOUND ALLIMINUtit iX JNT' SECTION CC4INER LIAO"JUMI FOUND OUrSlDE mo,t7 IRON PIPE Sul WITH / o- ~ADJOININGPROPERTY O FOUNDI-1J4'CUTSICE f DIAMETER IRON PIPE FOUND 3iS' 01.0,1 fER IPCP m FOIJ04D 318" DINAETER IROJ~ SET I" OUTSIDE DIANETER a 0 LONG IRON PIPE, WEIGF?INC f LBS. PER LINEAR FC07 FENCE PREVIOUSLY RECOKED DIMENSION WISC e<' IV ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/ Mailing Address G83 ,2 Alw_ /~a~~ r✓!/l 01 Property Address /047 (2o. Ayl 14 Loo, (Verification required from Planning & Zoning Department for new construction.) City/State Parcel Identification Number O 30 -1-436-- 9S-eZY~ LEGAL DESCRIPTION Property Location )Z.J '/4 , 1,!5- '/4 , Sec. /V , T _g:2__N R /9 W, Town of .5-6. J3st,94 Subdivision Plat: ✓(cc , Lot # C,-. Certified Survey Map # Ylc, Volume , Page # Warranty Deed # (before 2007)Volume /0z5__ , Page # /o6 Spec house ❑ yes no Lot lines identifiable Vyes ❑ 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 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. Number of bedrooms - 9~~Pd SIGNATU OF APPLICANTS 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) . 9 0 pia ,•r u iu iu:/+n APl St. Croix County Plan/toning 715-386-4686 1/2 POWTS O11UNER'$ MANUAL & M,ANAGT PLAN Page of FILE INFORMATION pwna3 Septic Tank Capacity O al 0 NA Permit # Septic Tank Manufacturer RK, C7 NA t1EStQ#V PARAME1'6R8 Effluent Filter Manufacturer pv aK M NA Number of Aadroams A Effluent Filter Model S,t J 3 NA Number of Public Facility Units G n, Jd Ct NA Pump Tank Capacity - al NA - 75 EstfmaWl flow (average) sl da Pump Tank Manufacturer PIA Design flaw (peak), (Estimated x 1.5) al da Pump Manufacturer lb NA Soil Application Rata si/day/1t2 Pump Model NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit NA Fats, Oil & Grease (17001 2930 mg/L. R Sand/Gravel Filter CI Peat Filter Machemioal OXygen Demand (SODA) X220 mg/L R NA fO Meohanldat Aeration 0 Watlond Total Suspended Solids ITSw) 41601 mg/L, R Disinfection a Other; Pretreated Effluent Quality Monthly average Dispersal Cell(s) R NA Stochernioal Oxygen Demand 11300,1 430 mg/i In-Ground (gravity) 0 In-Ground (pressurized) Total Suspended Solids (TES) 430 mg/I, 0 NA R At Grade IO Mound Facet Coliform (goomstric mean) 291 O¢ cfu/100ml Q Drip-Line Q Other: Maximum Effluent Particle Size ya In dla, q NA Other: 0 NA Other: DNA Other,, RNA *Values typloal for domestic wastewater and septic tank effluent, Other; R NA IVIAINTENANOE SCKgDUL.E setviae Event service Frequency inspect condition of tank(s) ±At least once eve R mnnth(a) -~:7 . ry° l3wear(s) (IllialSimwrn 3 years) q NA Pump out contents of tank(s) When combined sludge and scum equals one-third (Y) of tank volume Cl NA Inspect dispersal call(s) At least once every; marxth(a) (MOXfnt gears) Q NA L5t- ear s 13 Clean effluent filter At least once every; i mon v (s) 0 NA Inspect pump, pump controls & alarm At leant once every: ©meoon't (a) ANA Flush laterals and pressure teat At least once every: ©n (s) CkNA Othen At ieest once every, mast (s) iNA other; q ear ,s I& NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal 03113 Mall be made by an individual aerrylng one of the fallowing liconses or cordflcations; Master Plumber; Master Plumber Raetrioted S+swer; POWTS Inspeotori POWTS Mslntainsr 810209 Servicing Operator, Tank inspeoticna must include a visual inspection of the tank(s) to Identify any mfesing or broken hs~rdwaro, Identify any pe r, leaks, measure the volume of combined sludge and scum and to check for any back up or pondlmg of off( Ide if the ground or leaks, The disperse( Dolt(s) shat) be visually inspected t4 check the effluent [ovals In the observation pipes end to check for any pandinq of affluent an the ground surface. The ponding of effluent on the ground surface MAY (ndImAte at failing condition and requires the Immediate notification of the local regulatory authority, When the combined eaeumutaticn of sludge and scum In any tank equals ons-third or more of the tank volume, the entire contents of the tank shall be removed by a Sap;age Servicing Operator and disposed of In accordance with chapter NR 113, Wisconsin .Adminlatrativa Cade. All other services, Including but not llmited to the servicing of affluent filters, mechanical or Pressurized components, Pretreatment units, and any servicing At intervals of 2912 months, shall bs Performed by a certified POWTS Maintainer, A servloa report shall be provided to the local ragu[atory authorlty within 10 days of Completion of any service event, OMW (4/01) START UP AND OPERATION Page of For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process andlor damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POINTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: M 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 structure, 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 soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. 11 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 is available a holding tank may be installed as a last resort to replace the failed POWTS. 0 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 > > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAI ER Name Name Phone Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL RECUI.ATORY AUTHORITY Name Name S' C-a O " C'Phone y`I-~ N Phone G' `Y lp U This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. START UP AND OPERATION Page of For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cellls). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the purnp controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or coiipact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall lie taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails : and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: 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 structure, 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 soil limitations. 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 is available a holding tank may be installed as a last resort to replace the failed POINTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biemat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < < WARNING > > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR Of A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWT°S INSTALLER POINTS M, IINTAIN ER Name ,J Name Phone Phone S£PTAGE SERVICING OPERATOR (PUMPER.) LOCAL REGULATORY AUTHORITY Name Name St C:lZ6t .6N1 i N c Phone Li 4,c- Phone ,hy_ 744 WA~ I E This document was drafted in compliance with chapter Comm 83.22(2)(b).,(1)`(d)&(f) and 83.54(1), (2) &'(3l, 'Wisconsin Administrative Code. i lot- VN / Wisconsin Department f Commerce OIL EVALUAf 10P1 Page / of Division of Safety and B ildings N1 i`; - in 8 *ce wit Comm 85, Wis. Adm. Code Attach complete site plan on p s I tfi+'dk' 1 inches in size. Plan must County C 0,-, ~ ~ x include, but not limited jo: ve l~l reference point (BM), direction and Parcel I.D. 7f percent slope, scale or (lirwl orth arrow, and location and distance to nearest road. 6 330 273, 57' ' `erV Please print all information. Rowed ~y/ Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location / f r, f Govt. Lot AIL, 1/4~C114 S/0 T N R E (or W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 8 3 0C 1,f e.va - /Oc3 -x /oo -/o D 2 &4 City State Zip Code Phone Number ❑ City ❑ Village Town Nearest Roa ,v if S /D c ~h o -&7a Jo s ❑ New Construction Use:WResidential ! Number of bedrooms Code derived design flow rate 9 GPD Replacement 0 Public or mmera - Describe: e ✓ _ "4CtJ- Parent material y~~~v f ft ~2 a Z) G: Flood Plain elevation if applicable A/ ft. "9' 1 General comments and rei;omi lendations: System Type J f System Elevation., Boring rn " v „ Boring # Q ttF' pit Ground surface elev. 1 U l ft. Depth to limiting factor in. R Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 1 0-/ p a t MY, J'4' Z / Ill Day C / 6^ ri 1 941- r ~ ) r Boring # ❑ Boring ® pit Ground surface elev. q7,2--ft. Depth to limiting factor- in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 -Eff#2 1 0' Z r s 3 - a tf Z22 t Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 ' Effluent #2 = BOD < 30 ffxA and TSS < 30 mg1L CST Name (please print) CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 `J 715-246-4516 Property Owner _ Parcel ID # Page of F3-1 Boring # 41 ❑ Boring Y- 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 e9o' k 1.11 4 2 U s L/ C 3 - iz S ,,1~4 hiA - r1 ~a v I F-1 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 GPD/ff in. Munsell_ Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring # ❑ Boring F-1 ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon ')epth 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 = BODS < 30 mg/- 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.6100) Property Owner _ Parcel ID # Page of Ong # ❑ Boring ~i 13-1 Ground surface elev. l ft. Depth to limiting factor P Pit ' I in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF II Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 in. Munse fo- Z v s c a k fJ n/J W l S ~ 3 l iZ U CrI it f ❑ Boring Boring # limiting factor in. E] ft. Depth to Pit Ground surface elev. 9 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 Boring ❑ Boring # E3 Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil liication Rate Horizon ')epth 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 = BODE > 30 < 220 mg/L and TSS >30 < 150 mg/_ ' 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 (IL&W) Soil Test Plot Plan Project Name Chris Krumm Shau d Address 683 Deleware Ave St. Paul Mn 55107 CS 4226900 Lot Subdivision Date 115112 NW 1/4 NE 1/4S 10 T 29 N/R19 W Township St. Joseph ❑ Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Bottom of siding System Elevation TBD *HRpSameasBenchmark County Road A Property Line Scale = 1/4" = 5' Property Line Private water service I Existing office 3 employees and 1 ❑ B-2 floor drain Nell 0% Slope B.M.* ST B-3 ❑ DW B-1 Property Line o . -11{~1{~~~~N~III~I 4 7 J j Tx:4035064 949474 BETH PABST REGISTER OF DEEDS CERTIFIED SURVEY MAP ST" CROIX Co., wI RECEIVED FOR RECORD LOCATED IN PART OF THE NW 1/4 OF THE NE 1/4 OF SECTION 10, T29N, R19W, 01/24/2012 2:30 PM TOWN OF ST. JOSEPH, ST. CROIX COUNTY, WISCONSIN; BEING THAT PARCEL OF EXEMPT LAND DESCRIBED ON THAT DEED RECORDED IN VOLUME 105, PAGE 106, AS REC FEE: 30.00 DOCUMENT NO. 95874, ST. CROIX COUNTY REGISTER OF DEEDS. COPY FEE: 3.00 PAGES: 2 SCALE: 1 50' ii-na 50 25 0 50 FE ORDED AS BO RODS + 553' NI/4 CORNER 3') WEST OF SECTION CORNER SECTION 10 - - ' I°1EASORED7879-92- - - • - -I - S89°43'15"W 2639.59' OF NCI/4 °°-NORTH LINE _ • - 49' / qV ~ ~GARAGE SB9°43'IS'N! 1888.10' ♦ - ~ S89°43'15"W 751. _ . v' i 66 • / L --~N®Qa I N5 CORNER - / 640 a' -V! G~ HOUSE SECTION 10 o 9. 1+ M 71 n Cn °M 2/ ..0 p • _ -L- -i v Vv 191/1 C? w m V 0V' CHURCH 2\ A U p V~ BUILDING N M LOT 1 M mm / 10,000 SO. FT. SEPTIC A,> N o -0 r S VENTS o PREPARED FOR: O 640/ ® ov REDEEMER LUTHERAN CHURCH NORTH 3 -n rn 9 1097 COUNTY ROAD A N / F~QQ pp Z HUDSON, WI 54016 Z p WELL FOR CHURCH SURVEYOR: BUILDING SHARED WITH h ADJOINING PROPERTY DOUG ZAHLER 2920 ENLOE STREET SUITE 101 HUDSON, WI 54016 - OF VVI$ \ \ / \ \ / -'DouCiLAS J. `ry 2146 ZAHLER S--21 / Ds ti Por 2 I ~ FENCE CORNER \ \ LEGEND / FOUND ALUMINUM COUNTY SECTION CORNER MONUMENT / • FOUND 2-3/8" OUTSIDE DIAMETER IRON PIPE / FOUND 1-1/4" OUTSIDE DIAMETER IRON PIPE FOUND I" OUTSIDE DIAMETER k\ IRON PIPE NOTE: SET 1" OUTSIDE DIAMETER BY 18" This survey was performed to monument the corners of that property O LONG IRON PIPE, WEIGHING 1.13 described on the deed recorded in Volume 105, page 106, Document LBS. PER LINEAR FOOT No. 95874, St. Croix County Register of Deeds. This Certified Survey PREVIOUSLY RECORDED Map is being recorded to memorialize said monuments and to t ) DIMENSION reference the property to the accepted section line of record. X FENCE THIS INSTRUMENT WAS DRAFTED BY: DOUG ZAHLER JOB NO. 6814-004 DATE: 1/12/2012 SHEET 1 OF 2 1 of 2 Vol 25 Page 5829 8 0 4 9 1;0 2 State Bar of Wisconsin Form 2-2003 Tx :4036192 WARRANTY DEED 950659 BETH PABST Document Number Document Name REGISTER OF DEEDS ST. CROIX CO,, WI THIS DEED, made between The Evangelical Lutheran Church of the 02/10/2012 4:18 PM Redeemer, a Religious corporation EXEMPT#: NA REC FEE: 30.00 ("Grantor," whether one or more), TRANS FEE: 330.30 and Tro~oStudio, LLC PAGES: 2 ("Grantee," whether one or more). . Grantor, for a valuable consideration, conveys and warrants to Grantee the following Recording Area described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St Croix County, State of Wisconsin ("Property") (if more Name and Return Address space is needed, please attach addendum): River Valley Abstract & Title 1200 Hosford Street, Suite 201 SEE ATTACHED LEGAL DESCRIPTION Hudson, WI 54016 File No. 2808068 030-1035-95-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: Easements, restrictions and rights-of-way of record, if any. k Dated February 3, 2012 The Evangelical Lutheran Church of the Redeemer. ik 9,-- VD (SEAL) (SEAL) * David Brown, President * Iris Bierbrauer, Vice President _16t, (SEAL) (SEAL) * Kim Lon ecker, Secreta AUTHENTICATION ACKNOWLEDGMENT Signature(s) j%%%111111111 STATE OF WISCONSIN ) 441' authenticated on ) ss. St. Croix COUNTY ) Personally came before me on February 3, 2012 TITLE: MEMBER STA l~~Z~ .O ehs C<?~ ~ the above-named David Brown, President, Iris Bierbrauer, Vice President and Kim Longnecker, Secretary i Iit, a1 thorized by Wis. Stat~ 71 0 to me known to be the person(s) w o exe ed the foregoing tltt+'~ instrument and acknowledged t t THIS INSTRUMENT DRAFTED BY: * Doug Berg Lorr' L. De s No Public f Wiscon ' Eden Prairie MN 55344 Commissi is permanent) (expires: April I, 2012 ) (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. WARRANTY DEED ® 2003 STATE BAR OF WISCONSIN FORM NO. 2-2003 1TAname below signatures. k i ATTACHED LEGAL DESCRIPTION l Part of the NW1/4 of the NE1/4 of Section 10, Township 29 North, Range 19W, Town of St. Joseph, St. Croix County, Wisconsin .described as follows: Lot 1 of Certified Survey Map filed January 24, 2012 in Vol. 25, Page 5829, Doc. No. 949474. Formerly Known As: Part of the NW 1/4 of the NE 1/4 of Section 10, Township 29 North, Range 19 West, Town of Saint Joseph, St. Croix County, Wisconsin, described as follows: Commencing at the Section corner of Section 2, 3, 10 and 11, Township 29 North, Range 19 West, Town of Saint Joseph, St. Croix County, Wisconsin, thence West 80 rods to fence on West side of road leading from Burkhards Mill to R.R. Station, thence West 553 feet, thence S24°50'W 33 1 /6 feet to a stake, thence S24°50'W 100 feet, thence Easterly at right angles 100 feet, thence Northerly at right angles 100 feet, thence Westerly at right angles 100 feet to afore mentioned stake. Parcel ID Number: 030-1035-95-000 f 4 2 of 2