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HomeMy WebLinkAbout008-1072-70-075Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safetiy and B?i";~ing Divis+m - INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. ermit Holder's Name: City Village X Township ~Cne endorf, Brent Eau Galle, Town of ST BM Elev: Insp. BM Elev; BM Descrip 'on:~ ~~ is ~ v ~a 6. 1j TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic l ~ ~"f ~ Dosing Aeration ~' Holding -rnNK SETBACK INFORMATION TANK TO ~ P/~ WELL BLDG. Vent to Air Intake ROAD Septic ~ ~~ ~~ .~ /5~ ~{' Dosin / ~ ...1 ~ Aeration Holding PUMP/SIPHON INFORMATION Manufacturer ~ ~ U ~~ Demand GPM Model Number G y~ TDH Lift„ 6Z Friction Loss System Head TD,Fj ~~Ft 7 ~/5 ~(p Forcemain Len~~ ~ Dla. Z I ~ Dist. to well OIL ABSORPTION SYSTEM County; St. CroIX Sanitary Permit No: 506104 0 State Plan ID No: ' Parcel Tax No: 008-1072-70-075 Section/Town/Range/Map No: 25.28.16.379E CLtVAIwrv uHIH STATION BS HI FS ELEV. Benchmark ~ ~ ~- ~ /~ / ~ 1' /oo • ,I Y Alt. B~ Go S. b'S !tm . 35 Bldg. Sewe ~N ~~ Q ~~ ~ ~~ J / nS ~ Z St/Ht Inlet 9. 6 yG . StIHt Outlet / ~- Dt Inlet ~ Dt Bottom ~ «~u / ~ an. .IZ, dt9.'$$ Dist. Pipe + { 9 ~ , ~' Bot. System c~C~ 2 3 (p.'77 ~{ .~7 ~p ~et . Z3 Final Grade t ~, 7 ~~ St Cover r Z C ~3 ~S-et~ lbq. s, LSD / 00. ]~ 7. r~ 9~,y ~ . Y~ ~ Jw~vl.h~ 3 ~- ~ BED/TRENCH Width / Length No. f Tren hes P T DIME IONS No. Of Pits Inside Dia. Liquid Depth pIMENSIONS ~b ~ ~D l~C SETBACK SYSTEM TO P!L BLDG 1Po'ELL LAKE/STREAM CHING Manufacturer: CHA R INFORMATION Type ~f/~ystem: ~ e , r~ I Model Nurriber: , / / 1 D v ~ (~~ /lJ vla I I~lou i wrv a i o r r/Manifol d H ~ivr i ~~ f ~ Dlstributlon ~~ x Hole Size x Hoie Spacing/ Ve~ Air ake e ea d 1 w ~ Ey ~ ~~ Pipe(s) 7 I 9 (~Z ~~ l ~ ~ I Dia ~ y Length a Length Dia Spacing JVIL VV V Cll ~ JC r'IC,SUIC Jya.c~~~a v.~~y Depth Over ............._ _. __ __-_. xx Depth of _ _, _ xx Seeded/Sodded ~~~~ xx Mulched Depth Over ` ~ BedlTrench Center y ( Bed/Trench Edges Topsoil ~ ~ ~ Yes Na \ Yes No y p ~ ..-v r-~~ ~. E3 CIC. COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Y/ / """// " ~ iins~pec4ti~o'n ~~: ~__~ ~"t ~ Y' Parcel No: 25.28.16.379E Location: 2625 12th Avenue Woodville, WI 54028 (SW /4 SW 1/4 25 T28N R16W()~ NA Lot 3 1.) Alt BM Description = ~' ~"'~J~' s~~'~e~ Wj~.~.~1~~'("'-" "~~ ~ ~~ ~u~~ 2.) Bldg sewer length = ~ 5 ~ ~ „ _ _ _ L ,~ '~~'~,j 3 ~ / ~ /~ 6~,f~~a,/ J .' ~ Q~~ - amount of cover = W~~ 9~ 2 " ~ ~ ~~-~ ~' of ~ . C.~., ......- s ~-- ~,-~ ~ S o,.~... -~ ~- ~ Plan revision Required? Yes '~'No r„ ~V ~ I ~ ~ ~ ~~ Use other side for additional information. Y ~ Cert. Nu_ Date {nsepctor' Signatur SBD-6710 (R.3/97) Cq#1'll'rIC'.1'G@.WI.~gV Safety and Buildings Division County ~ 201 W. Washington Ave., P.O. Box 7162 ST. CROU( ~~~ ~ ~ ~ Madison, WI 53707-7162 Sanitary Permit Number (to be filled in by Co.) l~~p~~»t,Q~t ~~ ~~~~ 5 ~ a Sanitary Permit Application State Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appro riate governmental 1376154 unit is required prior to obtaining a sanitary permit. Note: Application forms for slat ed P WTS are project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may sed f eco oses in accordance with the Privac Law s 15 Slats 04(1)(m) /~ ~ Z ~ z S ~ 2 ~ ~x . . , , . . I. A lication Information ase Print All Property Owner's Name / Parcel # BRENT KNEGENDORF 8-1072-70-075 Property Owner's Mailing Address 1 g 2007 MAR Property Location r ~J ~ PO BOX 112 , ~ L vt G L t l ~ ~/ . o o City, State ip Cosdt CROIX ~ umb SW ''/e, SW '/., Section 25 WOODVILLE WI 4028 715/7 - (Check One) N T R pk ~ I. Tempe of Building (check all that apply) I # ; 2g 16 ^ E ^/ W ~ _ or 2 F il Dwelli - Numb o f B d 3 Subdivision Name y oms ~ am ng er o e r N/A S JIp„v~: ^ Block # Public/Commercial -Describe Use }~p JgR_ K N/A City of ^ State Owned -Describe Use CSM Number ^ Village of /0 ~~ ~~ r 7g5gg2 ~ Town of EAU GALLE J III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A' /^ New System ^ Replacement ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System (explain) '~- System B. ^ Permit ^ Permit Revision ^ Change of ^ Permit Transfer to List Previous Permit Number and Date Issued Renewal Before Plumber New Owner Ex iration IV. T e of POWTS S stem/Com onent/Device: Check all that a 1 Ors.. O ~ ^ Non-Presswized 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) ~~ /6 V. Dis ersal/Treatment Area Information: Design Flo`~pd) Design Soil lication Rate(gpds s~~ i ~ Dispersal Are equired (sf) ~ Dispersal Area Pr sed (sf) System Elevatio/n 23 / 99 600 ~/ h 1 ~ , j 800 2OQ 600 (~~ . VI. Tank Info Capa 'ty in Total # of Manufacturer Material Gallons Gallons Units New Tanks Existing Tanks wlP~ la,~ ~r Septic or Holding Tank 1250 1250 1 WIESER CONCRETE Prefab Concrete Dosing Chamber 750 750 1 WIESER CONCRETE Prefab Concrete VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumb Signatwe MP/MFRS Number Business Phone Number BENNIE HELGESON 220292 715/772-3278 Plumber's Address (Street, City, State, Zip Code) W1229 770TH AVENUE, SPRING VALLEY WI 54767 VIII. oun /De artment Use Onl proved _ D' Permit Fee Date Issued Issuing t Signature Owner en Rea or Denial $ / ~ , ~ ~ ~ 9 a -~ IX. Conditions of Approval/Reasons for Disapproval / ~ - 3~ SYSTEM OW -~ E ~~d A "~ ``'' ((~~ ('aJ~ sG ei~ Jd" r ar. C~O N R: ~ . t. 1. Septic tank, effluent finer and ~~ ~ ~ ~ ' ~e~. r~ / e,('~,,,~` dispersal cell must all be servibes ! maintained ~ l as per management plan provided ~ plumber. 2. All setback requirements must bs maintained ae per app11f~0ot~ileOflaMTttSelte system and submit to the County only on paper not less than 812 x 11 inches in size SBD-6398 (R. 01/07) Valid thru 01/09 ~ ~-~~ L~L~: Ulm' _~-~. - Fe+1~ ---1~1'1C' ev~CQ~~ ~ ~ -- ---- -- ~' r~JG l1`!d 1 ,, ~~ ~1 i j c7~~-a-~ J -- __ --- ~~~ ~ ~~Q ~ `~ _P_ .St,~ y- S~ y -s.~sr~8 R ~6~ Emu, X4.1 l~ rt~~w~ ~, ~'p S7; C~'U/X Cou~~tL 03 ~ r4rs ~+ 3 t----~- v-: "- `1~ ~ ca1~ - ~ ~7 -... _- -r----------- + ~S S h Ow c~ E-x ~ r ~ 'r-o P o-~ I ~'~ f~tK ~~~ W ~'~ "~'- ~'~"C6L~l-d -Fo de (~'' -F~-as~ s~~ /v~ ~._.~~ C Ie~KOc~,S ~y ~,7 a f 7s~ `~~c 0 ~~ .,, ~Yc~~:S~~ -. i ~RSC~75r~ C0.. ~Se.p-~ ~ c~ p o s e Tam ~ ~,v ~ f~ ~a I.~ ~ O k 8~ Sa S ~~ 1-~-~-- e ~o~ o T- ~ ~ u ~UL P,~~ ~ ~3 ~c~ i ~ / ~~ o~~ ~. ~3~~/~ Q. i b .Q. / \ ~D ~ i ~ ~ ~ ~ a~~C~~y°l ~• ----- --- ~i ~ ~vs«:Q ,-- ~a c U-r+-~ ,~ ; ,~ j G~ ~-~-~.- ~ --__ ____ ~ _r_. _.____-_.- __. ~~~~~~ '~~ y ~ ~-~ f-E~w. I~ c~~1 -X~ ~ ~, ~ I "= y ~s S h o~ ~ _4 I Sc,~ y~ Sc,J ~ -S~ST'~8 R~6~ ~~~.,,, ~~.I l~ ~tov~c~s ~, ~ ~ ~~; CCU/X ~ou.~~l~" o ~~ ,4c r~s ~f 3 s--; 3~~~ ~-op o~ I~''~PUL ~f~ ~ h V ` ~__- C I e0.Ka~.,.~-s j ~~ a f 7S'~ `' c ~i n ~~, O~ ~ ~rc~~S~~C IR5o~7~U C~~. .- Se.~?-~ ~ c ~ ~ o s ~ Tam` ~C ~.lJ t f~ Pb I~ ~ a Sa S ~ l~-e-- .D.~'l, ' " ~~ ~ IOC. ©a ~-~ u d~UL / P~~~ ~ o~ a ~ C~ \~ ~~ ~` ~~ .~ 1 4 ~• 1. , L l ~ / ~' n l / ~ ~ ,~ ~v L~ ~a/o / o~~ /a ~ I B3 ~~ ~~ commerce.wi.gov ^ ^ isconsin Department of Commerce March 13, 2007 CUST ID No. 220292 BENNIE W HELGESON HELGES.ON EXCAVATING W1229 770TH AVE SPRING VALLEY WI 54767 ATTN. POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. commerce.wi.gov/sb/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/13/2009 Identification Numbers Transaction ID No. 1376154 SITE• Site ID No. 723132 Brent Knegendorf Please refer to both identification numbers, 12TH Avenue ~ above, in all_corres andence with the aaenc . Town of Eau Galle - St Croix County SW1/4, SW1/4, S25, T28N, R16W Lot: 3, Subdivision: CSM 785882 FOR: Description: Mound /Four Bedroom /Sloping Site Object Type: POWTS Component Manual Regulated Object ID No.: 1121465 Maintenance required; 600 GPD Flow rate; 26 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual, SBD-10572-P (R.6/99), Pressure Distribution ComponentManual, SBD-10573-P (R.6/99); Biofilter 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. 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: Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manuals listed above. • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and ~ dispersal are prohibited. COQ • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption ~~~ area. chs. NR 811 & 812c OE~~ • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. gEE • Inspection of the POWTS 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. 5tat BENNIE W HELGESON Page 2 3/13/2007 • Comm 83.22(7) 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 mawinclude local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. 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. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 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. All pemuts 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 maybe 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 POWTS. Sincerely, Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday charles.bratz@wisconsin. gov Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.0.0 WiSMART code: 7633 cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544 ,Friday, 7:00 A.M. To 3:30 P.M { ~ RECEIVED MAR 1 2 2007 SAFETY & BUILDINGS PROPERTY OWNER: INDEX SHEET BRENT KNEGENDORF PO BOX 102 WOODVII.,LE, WI 54028 PROJECT NAME: BRENT KNEGENDORF PROJECT LOCATION: SW 1/4, SW 1/4, S 25, T 28 N, 16 W MUNICIPALITY: TOWNSHIP OF EAU GALLE COUNTY: ST CROIX DESIGN: PRESSURE DISTRIBUTION MANUAL SBD-10573-P(R/99) MOUND COMPONENT MANUAL SBD-10572-P (R 6/99) CONTENTS: Page 1: Plot Plan Page 2: Cross Section and Plan View of Mound Page 3: Distribution Pipe Layout Page 4: Septic Tank & Pump Chamber Cross Section and Specifications Page 5: WLP1250/750-MR Tank Specifications Page 6: Pump Specifications Page 7: POWTS Owner's Manual & Management Plan - Pg. 1 Page 8: POWTS Owner's Manual & Management Plan - Pg. 2 Name: Bennie Helgeson Address: W1229 770th Avenue Spring Valley, WI 54767 Credential Number: 220292 ~._ Signed Date: March 9, 2007 ~nArty _~~'~D ~o~~~ :ESPONDENCE ~~ (.~ ~- ~ r ~- n ct art ~ r $yntnt:tic ~:overing STS"l ~ 3 Medium Sand -1 Topsoil _ J i ~ E 3 ' ~~ % Slope i" ~-d-D t i. 2 ~Z g99regate Cross Secti~~n Of A Mound Signed. License Number: Date: P a e 0~ I Distribution Pipe ~ '0/. ps -- _ ~G , ~ F ~~ D i ~ ~' Or1~ V.' Plowed Force Main From Pump Lcyer A /p Ft. - p ~ Ft. is ~~ Ft . L 7~ Ft. --- J S', Ft. 1 1~ Ft. W .3d~ Ft. p e S3 F t E/,3~Ft. F ~a Ft. ~ ,~ Ft. H ---~-- F t - - -~I Observation Pipe ~K ,~ g ----- ~ _ _.... _ --- - ~ ~.._. - --- --_--~_ --------- o A ~ ------------------------ ~!_ J ~„ -r . ~~t_l- Of 2 - 2'2 ~Distribulion A regale Pipe 99 / ~c~o I I p, Observotion Pipe (3a.5a1 ~r~o~- = Plan View Of Mound ~6..~11 ~y ~6"I ~~~ ' '~ -C t ~a,~,y.~~ r l c~ '\ \~ y, l~le~r1`b`~~~ ~ ) V ~~iIIrlD~llon. vlo, ~_~r.ed ~_cense Number: ;..~~ porturui ~~I lrll_i!_0_tuil ., ~' `~ \~ /~ ;nu VI~>r C U i~ i b u [_ i ~'? l' i p e____~ ° u c ~. Holes Locates acedottom rare Equally P r ~ le •~ /~ ~ I, iQ~QX ~rSt..-N ~'f g„ y .. .. ~/ R ------ T ~ '/ X 7~ ~, ~r~ Y e 1- ~ Ynch ter Hole Diam .. _ /~ ~' Inch (es) Lateral ~~ d ~ Inches hlaniEol • force Main ` .. Inches `1 ~~ ~3 • .~,,t,~ ~~ER ~ ~ I~e~. Na~eS -Per ~`eir•a.~ - 3 ,~,~w, ~j~r o ~r ~-~~v~s = X 3 ~~ ~ ~ /D~. (~,.;,,, ~ . ~ c,~ c~,r S= Page ~} Of 8 SEPTIC TANK Ec PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS WEATHERPROOF ~~ Qtx• VENT PIPE 12" MIN. ABOVE GRADE E JUNCTION BOX APPROVED >_ 25' FROM DOOR, WINDOW OR WITH CONDUIT MANHOLE COVER tRESH AIR INTAKE W/ PADLOCK E "~(2~ /~.~ WARNING LABEL C~r~~ - f-1 l -u" MIN. -- ,~" MIN `WATER TIGHT SEALS --1- ~ F1~7ER 1, i P E 3 ' ~j ~ ~ -f-- ~,~;r~~ soy ~o ~ ~') C l PUMP OFF ELEV . 9,3,C~FT . D iy° s, o. ~:. ~~ ~~ I ', GAS- ~ ~, TIGHTS , SEAL ; ALM ' ON i ' OFF ~„ 18 MlN• APPROYEO JOINTS KITH APPROVED PIPS 3' ONTO SOLID SOIL 3" APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS ,:.;~~w; MANUFACTURER: ((%ilc-'~SPr --- - ------ ,_;_,r.~ SIZES: SEPTIC ~_ GAL. D ~, S~oGo-~ E FLOWBACKG ~o~ GAL. DOSE ~L CAPACITIES: A = cis INCHES = S!~_GAL. ;;~,qRM MANUFACTURER: S- jr~ ~~ . -~ MODEL NUMBER: g 2 INCHES = . 2•~~/ -GAL•. SWITCH TYPE: C ~ INCHES = ~I~~GAL. :>~ rt? ?~(ANUFACTURER : _ ~~, ~-~ _--___--_. ;.tUDEL NUMBER : S/L D 13 INCHES = ~~~-=~~L. SWITCH TYPE: ~~-I ~_,!~; ?RED DISCHARGE RATE ~~~~ GPM ~ PUMP E ALARM WIRING AS PER I LHR 16.23 wnc ~• 73 FEET :F'1'ICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE• ~ FEET • MINIMUM NETWORK SUPPLY PRESSURE y~_ FEET FORCEMAIN X ~_FT/100 FTOTALIDYNAMICAHEAD •=• 1~FEET WIDTH DIAMETER _______ ';dTCRNAL DIMENSIONS OF PUMP TANK: LENGTH ,~ ' LIQUID D~fiF~~_. LICENSE NUMBER: DATE: ,i~f.~: - 0 ~I O U Z J W ~Q Z ~ ~' ~' O H ~ O Y j ~-. F U. N ~ F c ~ ~ .. a~ w0 o Q p p p m o F- ~ cn a vv Q ~ U Q O W ~ Q J= U Z Z \~ ~ Q ~ ~ Q WWW Z U o ~ ° ° o~ ~W //~~ ~ o o ~i~ - O I1') d' O c~i~Q ~ ~wcn W N tD~ ~ ~~ p ~/~ ~ ~/ d. : p ~ N 0 1n F- J !~ ~ ~fn 1-= ~ Q 1- m H H N~ ~ Y J = o~=xtF..3 = omY o~ ¢ w Z Q o (NJF-~ZC~O 00C_~ ~iJ pQOOawwOw~ ~ ~~~ ~ Vl z~~ n- Q p ei n7U~2J~mJ3 Q Q V ~ N Z ~ Z ~ J J O Q O o Z z J „yti 3 ~~ w- S a ,:~ J N G E E a LttJ o n ~ ~ a ~J '~ U ~~~ a ~ N ( ~ mot' L~ p K ~ ~ _ ~ ~~o~ I ~~ \ ~~ ~ o ~wc ~ cn - O I o ~ U W 0 ~~ ~, ~ ~, ~ n,ft(1 N ~ 3cwno LL~_JJ L~ ~O J (yJ O 3 3 ~~ w_ S~ Q I J N a U i n 0 3 J O 0 0 N Q Z Q ~I wyy METERS FEET 10 i ~ . _ ~ -_ , _ ,____+ MODEL: 3871 9 30 r ~'-T { I 6 t i . _ . i _.... I _ _t-__. _ _ ..~ 25. .~_ ._-_ } -- 1_- ~ I ~---r w 6 - ~ - .. __ ., _ ~ . _ U 5 20f I ;. a = a _ EP05 ___. _ C 3 10 ~- _I __~ ~ .__. O 2 t'" --f s r- +-----r--- __+.-~_ r~___ -~--- EP04 - . ___ I - _. _. _. 0 o C.- `I I t---- 0 10 20 30 ~ 40 50 US GFM 0 2 4 6 8 10 12 m°itu CAPACITY Pump Specifications Features and Benefits °/lU and'/2 HP •EP04 impeller- semi-open design Up to 60 GPM with pump out vanes to protect Maximum head to 32' mechanical seal. Discharge size 1'/2" NPT • EP05 impeller -enclosed design Solids:'/4" maximum for improved performance. Motor • Rugged glass-filled thermoplastic All motors feature ball casing and base design provides bearing construction. superior strength and corrosion jingle phase: 115V resistance. Materials of Construction • Cast iron motor housing for ;ast iron efficient heat transfer, strength, Thermoplastic and durability. stainless steel •Corrosion resistant threaded stainless steel shaft. •Available for automatic and manual operation. • CSA listed models available. ~~eration and feature stainless steel hardware. ' POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page _,Z of ~_ rI'1 n,1A ATtAAI Owner gent kneRendorf Permit i1 ., ~..,..., n n n n 11ACT000 -rrr,~nwinC C(`LJFfllll F nir.u. , Service Event rlnspect condition of tank(s) At least once every Pump out contents of tank(s) When combined sit Inspect dispersal cell(s) At least once every Clean effluent filter At least once every Inspect pump, pump controls & alarm At least once every Flush laterals and pressure test At least once every Olner: At least once every Other: Service Frequency ^ month(s) (Maximum 3 years) ^ NA 2 f~ ear(s- dge and scu m equals one-third 1Y31 of tank volume O NA O month(s) (Maximum 3 years) ^ NA 2 ®year(s) (s) O NA 13 p ear( - Y I~ month(s) ^ NA 13 O year(si ^ month(s) ^ NA 3 ®year(s) O month(s) ^ NA ^ year(s) ^ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effiuent on the ground sond ng The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any p of affluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. when the combined accumulation of sludge and scum in any tank equals one-third (Y,1 or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance. with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event• GMW (4/01) ,..,nr~^^ cocr+ICIr~ATtANS "Values typical for domestic wastewater and septic tank effluent. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page_Zof_~ FILE INFORMATION Owner gent kne~Tendorf Permit t! _ __.., .. ...... urrcoC r onucnr u G Service Event Inspect condition of tank(s) At least once every Purrp out contents of tank(s) When combined slt Inspect dispersal cell(s) At least once every Clean effluent filter Inspect pump, pump controls & alarm At least once even At least once even Flush laterals and pressure test At least once even Other: At least once even -Ot118r: __~-_ Service Frequency ^ montn(s1 (Maximum 3 years) ^ NA 2 ® ear(s) dge and scu m equals one-third (Y,- of tank volume ^ NA ^ month(s) (Maximum 3 years) ^ NA 2 ®yearlsl (s- ^ NA 13 O earl 1 Y ® month(s) ^ NA 13 ^ year(s) ^ month(s) ^ NA 3 ®year(s) ^ month(s) ^ NA ^ year(s) ^ NA rJIAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tanklsl to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground sond ng The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any p of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y3- or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance. with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4,011 ,..,..-..-.. ~o~r~crre~rtnlUs 'values typical for domestic wastewater and septic tank effluent. Owner: Brent Knegendorf Page~_of_~_ S"PART UP AND OPEKA"PION I~or new construction, prior to use of the POWTS check treatment tattle(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(sj removed by a Septage servicing operator prior to use. System startup shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks tnay fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one lazge 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 I S 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. ~13ANDONMEN"f \\'hen the POW'fS fails and/or is permanently taken out of service the following steps shall betaken to insure that the S~'slem is properly and safely abandoned in compliance with ch. Comm 83.33, Wisconsin Administrative Code: All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. 1']te contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. fUler 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 I'OWTS 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. ^ .4 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 azea. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement azea. If no replacement azea is available a ltolding tank maybe installed as a last resort to replace the failed POWTS t~ 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. «W ARN ING» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT O?:YGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH ~fAY RESUL'T'. RESCUE OF A PERSON FROM THE INTERIOR OP A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ~llDi"I'IONAL COM144ENTS aOYYTS INSTALLER Name n Phone 715 772-3278 SEPTAGE SERVICING OPERATOR PUMPER ~ Name Johnson Sanitation ' ~ Phone 715/273-5811 ' 7nis document was drafted by th• staffs of the Glean Lake, Marquette and Waushara County 2;onlnp and sSutUaUon apenclge; . one minimum requiremsnls o! ch. Comm 83.21(Z)(b)(t)(d)6(f) and 83.5<(7), (Z) d (3), tMsconsln AdminlitraUw Ctidr. Vii Of lbli dOWIfMAt d0ai t;10~ POVYTS MA1NTAlNER Nama ' Phone 71 7 - LOCAL REGULAtORYAUTHORI'PY . Agency St . Croix Count Zotlin Phone 715/386-4680 Thli doatatrnt atats 9uarantes th• perlormanu olthe POWTS. G~WRpU Wisconsin Department of Commerce .LapI~~EPORT Page ~ of Division of Safety and Buildings ~~F[~ m accoraance wi wmm a~, vvis. rum. wuC -- County s. f- ~ ~® ~ ~C t h 1 11 i ~ s nc (ze~~ e ~i $n ~c}}}yy Attach complete site plan on paper not less than 8 1/2 x ~ 4 inGude, but not limited to: vertical and horizontal reference int (BM), dirLctibn~akt percent slope, scale or dimensions, north arrow, and locat n an~~i a to nearest road Parcel LD. 008 /07 Z ' '70 '" a 7 s ~KUIX COUNTY '~' Please prinf all informat ZONING OFFICE Revi d by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. t5. 3 /°f Q7 Property Owner Property Location ~Q 5 Govt. Lot X1:1.) 1/4 51/4 .25 Tag N R l~ E (or W ~ 0 ~ 1, Property O w ner's M~~appiling Adddress Q Q Lot # Block # Subd. Name or CSM# ct ~~ ~ crr vo1`G7 rl7Q~ i bv~ ~`~" City State Zip Code Phone Number t~ ~ ~ll ~ ^ City ^ Village Town Nearest Road Ia~ti ~}u ~- , ~, ,( ~f (~ rsi 698-~ ~r U 3 ~e 1_ ~L Sv~.~ a ~ a l ~ New Construction Use: L:.I rcesidential / Number of bedrooms ~ Code derived design flow rate r GPD ', ^ Replacement ^ Public or commercial /- Describe: Parent material ~ ['J e5S !~ U ~6' / i 1 / Flood Plain elevation if applicable ~ General comments u,sC r /~~, ~~ ~ ~K~~r ~~ p,~Y ~c~s ~ o~ G•z l I and recommendations: o n C v,2 ~t-a~~ 9$. ~ a(~crh t~ S7 5 -~-~,~ E l e~ . ~l `~ r ~ 3 Boring _ ,/ Boring # Pit Ground surface elev. ~~ - ~- ft. Depth to limiting factor ~? in. Soil lication Rate ti i D Texture Structure Consistence Boundary Roots GP D/f~ Horizon Depth in Dominant Color Munsell on escr p Redox Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Eff#2 . gay ~ s ~ ~.~ -~t- ~ s `v"'u . ~ - ~ ~7-3 IbyK ~ .~ ~ 11 ~~sb~C '~ 1J~ ~ ~ Boring # ~ Boring p Pit Ground surface elev. 0~ ` ~ ft. Depth to limiting factor ~ in. Soil A lication Rate D h lor t C D i Redox Description Texture Structure Consistence Boundary Roots GPD/Hz Horizon ept in nan o om Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 . ` C~ /f~ I / ( I U 3 - ~. o / o yiZ ~ -- ~~s ~ l ~ ~l s ~ ~sbk '' it ~ i ~ Ivy , to ~ S1 - ~ * Effluent #1 = GODS > 30 < 220 mg/L and TSS >30 < 150 mcyt_ - trnuent sz = aws ~ ov ~~ ~yr~ a. ~, ~ ~~ . ~~ ~ ~~r~ CST N e (Please Print)t Signature ~j ~ CST Number P vti ~ , ~ T'I 2 ~~ P s o ~ ~.~-~-,,.---f~G'~ ~ c3~ a n a 9~ Address ~ Date Evaluation Conducted Telephone Number ~,y~a~~ ~~o-~~. ~9~~ . .5~pr~~~ 1/~~1~~ Cvt q_~~_o y 77~-.3~~ 1 s y~67 Property Owner ~0.t,~.~ /~e~Jr06~ Parcel ID # Page ~ of -3 Boring # ^ Boring f ~t Ground surface elev. g~ ft. Depth to limiting factor ~ i in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 -II D R 3 5 ~' S~~ 4-n~~ C S ~~ « . ~ ~ 8 3 i p y - i' ,b r ~ 1 ~~ 3t'-so l© t2 ~ ~< ~ it ~, lv~ a Boring # ^ Boring ~s ~/ ~'it Ground surface elev. 7 7. ~ S ft. Depth to limiting factor l / in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 -I! ~ ~ --, s t ~ ~ .~ b v,~~~ C S U .~ ~ ~ , g a -/ ~6~ , ~ t ~, , ,, 1 ~F . Y ~ ~/6'S`0 foy ~ /r JCL uL ~ GM~ ~ Iv'r ~ ~ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ^ Pit Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fg 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 =BODE < 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 for;nat, please contact the department at 608-266-3151 or TTY 608-264-8777. SBU-8330 (R.07/00) Property Owner ~(At,.~ ( ~2 ~ $O!>~ Parcel ID # Page ~ of -3 Boring # ~ Boring ~/ ~t Ground surface elev. ~ 7 ~ ~ ft. Depth to limiting factor ~ ( in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 / --~i a IZ ~ ~ ~'s~~k ~~~ c S ~v « .~ E 8 ~ I l- (~ --- r r y c< l v ~~ ~~ 3i-so i© ~ ~ y~s ~ ~ ~ 6` f' lv~ Boring # ~ Boring ~! L~jt Ground surface elev. 7 ~, lra ~ ft. Depth to limiting factor ~ ~ in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlfg in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 J` ~ t^~ /` /' IU / D ,~ id ~( ~,~,, I ~, t~F . Y , ~ yb-sa toy ~ ~~ ~c~ uL b c~-~ ~ fv'~ a . Boring Boring # pit Ground surface elev. ft. Depth to limiting factor in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 `Eff#2 I 'Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 =BODE < 30 mg/L aril 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. S 13 U-8330 (R.07/00) :. ~I ~~- Pl a.,,. 1~ ~cc~~Q ~ ~~~ ~U1 .~XCe.~IJ `~ /q 5 ~~ b ~~ ~~ b 0+ 0 L a.., ~- ~, 'B. I~ ~a «©• y ~®P 0„~ ~ y „ ~u~ ~?~~t ~to ~~ti ~~ r5 , R. bbo ' B~ ~ge ~ o~ 3 ~~~ ~ ~o f ~ ~ ~.r~ io / / S ~~ ~ ` ~~~ ~~v o /~'~v / Q ~ R3 / ~` 1Q a ~.1'l . #~ ( 1 O O. O v ~~ / ~ Ta Lei c-~ ~~ PAP ~. ~~~ R,bbDn y D ~ `} 36y~ ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address PU -~-~c.. t t ~.~ ~~ ~~rd v r LLe L' c~ / ~ ~~~ ~' Property Address City/State LEGAL DESCRIPTION Parcel Identification Number ~0~5 `~ ~~~~ V°~~ ~ ~~`'~ Property Location 51.y '/ , SW '/a ,Sec. aj`a , T a~~ N RAW, Town of Ecru ~~ 1) e. Subdivision ,Lot # ~. Certified Survey Map # ~g~ ~ ~~ ,Volume ~ / ,Page # ' / l~ Warranty Deed # ~. ~ ~/~ 9 ,Volume ,Page # Spec house ^ yes' no Lot lines identifiable' yes ^ 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 l2 - 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 ofNatural 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. Uwe 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 .~ / ~ /_ SIGNATU 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. z~ z5 ~ 2 ~~. !~~ (Verification required from Planning & Zoning Department for new construction.) (REV. 08/05) is State Bar of Wisconsin Form 1-2003 WARRANTY DEED Document Number ~ Document Name THIS DEED, made between Larry Albrightson ("Grantor,' whether one or more}, and Brent L. Knegendorf ("Grantee,' whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): See Exhibit A E3424c~`~ KATHLEEN H. MALSH REGISTER OF DEEDS ST. CRQIX CO. , WI RECEIVED FOR REGORD 01/11/2007 02:30Pl1 NARRAIiTY DEED EXERG~ # REC FEE: 13.00 TRAtIS FEE : 156.00 COPY FEE: CC FEE: PAGES: 2 Recording Area Name and Return Address Title One 70619'" street south Hudson, WI 54016 008-1072-70-075 Parcel Ident~cation Number AIM This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Roadways, Easements and Restrictions of Record. Dated January 2, 2007 (SEAL) (SEAL) (SEAL) AUTHENTICATION Signatures} ACKNOWLEDGMENT STATE OF WISCONSIN ) authenticated on St. Croix ) ss. COUNTY ) ~: . •: TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Star. § 706.06) ~,~..••~ THIS INSTRUMENT DRAFTED BY: c~~E:Y atY P~ Personally came before me en January 2, 2007 , the above-named Larry Albrightson known to be the person(s) who executed the foregoing rent and acknowledEed the s,~Yie. Eau Claire, Wisconsin ~ Notary Public, State of Wisconsin My Commission expires: 10/12/08 ) (Signatures nosy be aut6enttcated or admowledged. Both sre not.uecessary.) NOTE: THLS IS A STANDARD FORM.. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED A 2003 STATE BAR OF WLSCONSIIV FORM NO.1.2003 • ~'~name below signatures. 11108 02/01/'10F95 13:.te lt~rv74 r17 ....,...._...._ _ . ' ~) ~~ , Ck t IT CERTIFIED SURVEY MAP LOCATED IN PART OF THE SW1/4 OF THE SW1/4 OF 8ECTION 23, T28N, R18W~ TOWN OF FAU GALLE, ST. CROlX COUNTY, WISCONSIN. W1/4 CORNER SECTION 25 PREPARED FOR gURVEYOR KURT AND ELIZABETH EDWIN C FLANUM CNRISTENSEN NORTHLAND SURVEYING. INC. 677 BENDY DRIVE P.O. BOX tl ~ HUDSON. WI 56016 R08ERTS, WI 56023 °' ~ ~ (~ 6 U 1P DD % G~D~ `. ' 125.99' ~ ~ ~ ~ $ SergB'n'E Iz03,3t' ..~-12V.....,. ~ N I ,e ~• 765682 VOL 19 PAGE 4917 KATACEEK H. M7(L3R-- ~G I ROI KOCO. EE~ RECEIVED FOR kECORO 01/26/2085 02:45PH CERTIFIED SURVEY HAP REC FEE: 13.00 COPY FEE: 3.00 PAGES: 2 SCALE IN FEET 1" = 200' I 206 O 200 12TH AVENUE --~ ~ NORTH LINE OF THE SWt/4 OF THE SWt/a-~y pG ~ 370.20' 1 ~ $ ~ ~'~ . N I o .... .........~ o; Z Z z~ ; X y W ~ : LOT 3 w ~ 5.22 ACRES INC. R/Y'/ iMO, 227251 S0. FT, o, v~ N p 50' . ,~ • 5.03 ACRES EXC. R/W . 219.209 SO. FT. ~. 1 ~ ~ ~ I w : ~ QI a • ~ b•. ~~~ in S8r35.22'E.366.84' I BENCHMARK []ol TOP OF 3/d' REBAR tl ~ ELEV. n 1085.85 N N (}I r , ~ ~I ~ al $ ~ • ~ • vii y ~1 ser 6'22"F~ 6a OB' = .. ........... E E N .I. ...... 00 ... ~ ~' N : ~STN~ FEET SOUTH LINE OF THE ~ . i r . OF THE SW1/4 OF NORTH t ROD OF THE A vaf `r $ THESWIN SWt/40FTHESWt/4 ~ r$ .- ( 55 I SS . ~' ~~ ~~ ~I ~' h C~tl it ~ N 01 ~I ~ I ~~I w v' Q I ~I C01 O I Z I =' al~ ~~ ~I ~~ I 91I I,a 55' a ~sa ~- SOUTH LINE OF THE ' • NORTH 219 FEET OF THE : SW1/a OF THE $Wt/a ~. •. rn 65 LOT 1 ~ OUTLOT 1 ~. ~, _ 12.01 ACRES INC. R(W v t 2.5Q ACP.ES INC. WW I Op~ 522,961 S0. FT. ~ ~ 566,513 S0. FT. • 11.81 ACRES EXC. R/W o ~P t2.36ACRES EXC. RM/ 514.455 SO. FT. ~ 538.678 S0. FT. . ALL LOTS ARE RESTRICTED TO A • ' LOWEST BVIl01NG OPENING ~ ELEV...t07a.50 M t• N ' N BENCHMARK TOP OF 3/6• REBAA t~15 ~ LOT 2 41 $ 8At ACRES INC. R/W rh 348.774 SO. FT. . 7.97 ACRES EXC. R/W 347,282 S0. FT. O ~ N O w ~ °C 3 g= ~/ ELEV.. 1078.21 1 5, j SOUTH LINE OF THE SWl/4 13' . 7.3' s TH 626.85' 427.60' 431.65' ~.~..:' ~T se7•ds~srE 87°48'57"W 1289.1 O' 33.03' LEGEND N87.48'S7"W 2644.28' ~' , L~ ALUMINUM COUNTY SEC710N ~t ~ ~ ~ N87 6'STW ~. / V ..............:........\/ CORNER MONUMENT FOUND d~~ ~ 6o~oUNo 1322.13' 5W CORNER b~lSn 9 YJ~ ~o ~~~ ~ /Sl/1 CORNER SECTION 25 m MASONRY NAIL FOUND , ~ SECTION 25 i _ i ~ ~ ~ t• 0.0. IRON PIPE FOUND `~ ~ ~ 0 y/• x t8' IRON REBAR SET WEIGHING ~S ~ 1.SO IBS. PER LINEAR FOOT ~~~ ~ z~ 604 ~ 6oB°G;~" ..... BUILDING SETBACK LINE off' ~ ~ ~C saL TEST / --- --~ PROPOSED DRIVE / X----X FENCELINE ' ~ ~ 9 THiSINSTRDMENTDRAFTEDBYSAMROAMS SHEET 1 OF 2 SHEET'S y3 JOB NO.Oa•t30 OATEt2.8.O1 Vol 19 Page 4917 f ~.y u. File No.: 11108 EXHIBIT A Lot 3 of Certified Survey Map recorded in Vol. 19 on Page 4917 as Document No. 785882 being a part of the SW `/+ of the SW '/., Section 25, Township 28 North, Range 16 West, Town of Eau Galle. Tax ID #:008-1072-70-075 2of2