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010-1021-40-000 (2)
Cn T. T. m Z ~ az < < ~ i ~p O. ~ . > > N ~ N c ~ ~ ~ ~ ~ 3 ~ ~ N ~ N Q N ~~ O O~ n C ~ N N (D C C n (D V O ~ A N ~ ', (D ~ ~ ~ ~ ~ i ~ N - o t; i O ~ -« - W O ~ ... N ~ C W a ~ N C y N N O ~7 ro fD ~m ~ o ~ ~ a O ~ N y C < y' Q ~ ~ fD N Q. '° o ~ ~ = v fD C n G7 C Z 3 aao m o r:N o a3 ~ 0 ~p 00 X. fD O. O A fD N 7 O O 7 O a ~ a I OZN ~N a m m o ~ ~ ~ ~ w aay o Qam o ~ ~ 3 co G7 a I ~ m a ~ O CD ~ ~ O ~- n cn O ' 3 ~ ~ d o ~ ~ ° ~ ° ~ v1 ~ ~ '6 • 1 # ~~ ^• '° 3 d - ~ m A ~ \ 3 _ - i, ~ .. 1 ~ 7 3 • W O ~ O w Ir ~ W ~ m y d a _ o _ O O N ~ r-r; C1 O ~ ~ ~ i O W O N ~ O ~' ~ N N O O ~ ~ CI N C fD G W W ', '~ O. ~ O i c°o ~ D S '' i~ '; !~ N O N O C ~p ' N O C ? A m ~ a ~ (D ~ O O .~. ~~ O a i; ! ~l w ~ ~ I O ~ _ f A N ~ I D ~ ~ ~ A ~ ? i O ' ' f D N O ' (Jt ., m m _ a ~ w ~ ~ ' ~ N 3 N ~ ~ .. v ~ N D D ~ o o ! i a ~~ N A O i~ 0 m y i ~ -{ N ~ ~ Z n N ~ ~ ^ Q A Z O (p • • ! ~ .. N O ~. -. ~ ~ O ao v m W 0 0 3 ~ ~ o 3 r: z °' 'I ~ N (D i p ~P pj A (D 3 m T I ~ I II 7 a ,~ j A b ~ ~ 3 a 0 w ti 0 a A N ~ N w ~ N 'r V ~~0 .~ ~- - Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INriQRMATION (ATTACH TO PERMIT) 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 Hennessy, Mike Emerald Township BM / •~ I I ~ Qo.c~' TANK I FORMATION TYPE MANUFACTURER CAPACITY Septic ~ ~t.SC--t2 12 sa ~5a Dosing 1' v) t t Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic r ~ (UO ~ (A~ I ~ / ~--• Dosing ~t ~ i •~ I r ~ Aeration Holding W PUMP/SIPHON INFORMATION ~1, Manufacturer ~~ D mand •--~-~ ' t~TCL(~°- ~J ( t) GPM Model Number / L G t!1 Lift + Friction Loss System Head TDH Ft °I•"~~ .~~ ~•S~' 2(•13 Forcemain Length Dia. ,, Dist. to Well , (~ I(u 2 ~ SOIL ABSORPTION SYSTEM Q..^ ~ $ I~,,,~( ELEVATION DATA County: St. CroiX Sanitary Permit No: 463073 0 tate Plan ID No: '~ 0 oD s . /e arcel Tax No: 010-1021-40-000 SectionlTown/Range/Map No: 09.30.16.131 B STATION BS HI FS ELEV. Benchmark ,33 ~~6.3 ~ao•c~` Alt. BM Bldg. Sewer f SUHt Inlet 13.33 •ZI, SUHt Outlet Dt Inlet• Dt Bottom t~•t,8 ~S 3 D q p ' In'ol0 Header/Man. Y~4° I o/. S~3' Dist. Pipe , °j O 0 •9o I 0 I' ~[~~ T Bot. System 5, ~ 00.~ Final Grade St Cove r /~ 6 ,~ D ~.~-Z~ • ~' ~,.~/~..•./ • 3 •L . 3 ~ 3L . ~ ~ I BED/TRENCH DIMENSIONS Width /'_ f Length ~~ No. Of Trenches ~ PIT DIMENSIONS No. Of Pits Inside Dia. Liquid De-p-tf-i~~ \ SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LEA ING CHAMB OR Manufacturer: i Type ~ ystem: ~ ~ ~ ~ ~~~ i ~ ~ ~ ~ UNITT~ del Number: DISTRIBUTION SYSTEM Header/Manifold r~ Distribution , ~ x Hole Size a x Hole Spacing Vent to Air intake th 3 •O ~ Pies t // O + '~ 3 ~ ~ ` 2 ~ Ir ~ Leng Dia Qf Length :- is I /7 Spacing / • SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center BedlTrench Edges Topsoil Yes ~] No , `] Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1I y/~,,,~G O~,/~ Location: 2336 160th Avenue Emerald, WI 554013 (SE 1/4 NW 1/4 9 T30N R16W) NA Lot tl'1" " ' ~~ 1.) Alt BM Description = S T~D.I. 1~0,~/n~+~+-C.w~S 2.) Bldg sewer length = .. ~ ® ~ -amount of cover = > ~2`~ ( - lv~ ~x~.r ~^' 1~'°~ Inspection #2: ~ 7'~ Mew,.~~'t(" Parcel No: 09. 0.1 131 B Plan revision Required . '; Yes No Ilea-, 0 S' ~,c./ ~ ~~~V- - - ~ r ~ 1 ~ ""7 II Use other side for additional informati n. ~ ~__ SBD-6710 (R.3/97) ~ Date _ _ ~ _t~ Insepctor's Signature Cert. No. ~~ Safety and Buildings Division County ~~ ~ j ` ~ ~ 201 W. Washington Avc., P.O. Box 7162 f - I iseons~n Madison, WI 53707 - 7162 Sanitary Perms Number (to be filled in by Co i ~ De artment of Commerce (~8) 266-3151 ~ } 3 w, Sanitary Permit ~ ~ ~~~~~'~~ State Plan 1 D Number In accord with Cornm 83.21. Wis. Adm. C e, rmatitin``you provide O(p 00~`L ~' "7~~,/bt.K. D may be used for secondary purposes ttt~y La 15.04(1)(m) (( Project Address (if different than mailing address) ~ I i I. Application Information -Please Print All Information `J ~~ „ ~ w ne r Property O 's Na me ~ ' ~ ~ltvi (~~..,.~..r- '' Parcel k Lot X Block N / ,,~ /~ /~ Property Owner's M ailing Address Prope Location I / 1 ~` ^ ( f~ City, State ~ r Zip Code Phone Number ( Orlf) C I ~~ ~ ~ d ~ 7~l L CJ CIr C ',J\ Z /r Y R l~ E ( C~ N T BtLldut~check all that apply) I ype of W _ / ; ` I or 2 Family Dwelling -Number of Bedrooms siet+tFe CS Number ~ v s ^ Public/Commercial -Describe Use O 3Sq ~~- P l3 ~S ^ State Owned -Describe Use ^Ciry ^village Township of ; /~/7 ~[- III. Type of Permit: (Check o x on line A. Complete line B if applicable) ©~p- p2(~ -CTOt7 . ~3~ A ^ New System I ~ R placemcm Sy tem g p y ^ TreatmendHoldin Tani Re lacement Onl ^ Other Modification to Exisnn S stem g y j B. I _' Permtt Renewal ^ Permit Revision i ^ Change of ^ Permit Trarufer to New List Previous Permit Number and Date Issued ~ I Before Expiration Plumber ~ Owner i I ~ I .y t f I IV. Type of POWTS System: (Check all ,that apply) ( (o' k ~QD 1M9~1 CQlik~ U ~ ~1 •o l 1 • n J~~/ r '~' Non -Pressurized [mGround ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At•Grade ^ Single Pass Sand Filter Coru[rucred Wetland _ Pressurized In•Ground iu Holding Tank ^ Peat Filter ^ Aerobic Treatment (Jnit =' Recirculating S,2nd Filter Rearculaung Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ ther (ex lain) ~ V. Disoersal/Treatment Area Information: ~. t/ = D/ Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) i System Elevation O"D ~, o ~ t~ r UD ~ D ~ • ~"~o j VI. Tank Info i Capacity in Total Number Manufacturer Prefab Site Steel Fiber ! Plastic I Galloru Galloru i of Units Concrete Constructed I ~ Glass i New Existing, I Tanks Tanks --_---- --~ ~- Septic or Holding Tank / ( L't,',> ~ ' ~I t. L7.Z ~ Aerobic Treatment Unit ~~ ~~~ Dosing Chamber ,~.. VII. Responsibility Statement- I, the undersigned, assume responsibility for ~ tallation of the POWTS shown on the attached plans. Plumber's Na me iPrmt) Plumber's Si Mature ~'/MPRS Number Business Phone Number i ~- / ~ r Plu is Addre ss (Street, C ,State, Z' C e . ~ %rs ! V[II. County/De artment Use Onl ", Approved .~ Disapproved i Sanitary Permit Fee (includes Groundwater Date Issued ~ Issut gent Signature (No Stam ~ Surcharge Fce) 35~ _ ~/' J ^ Owner Given Reason for Denial V ~~ G V ~~/ IX. Conditions of Approval/Reasons for Disapproval 3 \~~ r ~- ~N ems. ~'_ _ ,Q Q ~j ~, / , SYSTEM OWNER: / de f+~ `t'' 1 Septic tank, effluent filter and dispersal cell must all 4e serviced /maintained ~~ ~t S ~ °~~ ~ as per management plan provided by plumber. ~- 2. All setback requirements must be maintained as per applicable code/ordinances. Attach complete piton (to the Count? on17) for the s7ttem oo paper not less than 81/2 z 11 inches in size SBD-6398 (R. 01/03) C {~.~ Q(..~'~= ~"~~ ~> ~. ~ N ~ N ~ ~~ .. m ~, m ~ ~ ~ ~ 0 ~ ~ ~ ~ ~ ~ z ~ ~ Z -° ~ ~ ~ o ~ ~ x __ . _ _ ~_ ~°~d F~ m `. . ~ \ veo i 1 ~~ ~ N~ A Z i V E ~ .p~ :I f. p,,~ ~~ -~ a t ~ S ~ m 0 o~ ~. commerce.wi.gov .' ^ ^ ~scons~n Department of Commerce Safety and Buildings PO BOX 7162 MADISON WI 53707-7162 TDD #: (608) 264-8777 www. com merce.wi. gov/sb/ www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary September 21, 2004 CUST ID No.224617 LYLE J MYERS NORTHLAND PLUMBING INC E1556 STATE ROAD 64 BOYCEVILLE WI 54725 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/21/2006 SITE: Mike Hennessey 2336 160TH Ave Town of Emerald, 54012 St Croix County SE1/4, SW1/4, S9, T30N, R16W Identification Numbers Transaction ID No. 1060082 Site ID No. 689621 Please refer to both identification numbers, '' above, in all comes ondence with the a enc FOR: Object Type: POWTS Component Manual Regulated Object ID No.: 980897 Maintenance required; 600 GPD Flow rate; System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.Ol/Ol), Pressure Distribution Component Manual -Version 2.0, SBD-10706-P (N.Ol/Ol) 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. 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 approvaTthe 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 mainte ce of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Robert Kanter POWTS Plan Reviewer ,Integrated Services WiSMART code: 7633 (608)261-7735 ,Monday-friday 8:OOAM - 4:45PM rkanter@commerce. state. wi.us ~.n ~;~°. ~~1~' .~E=~~ ~~ 6^ .a~^. € ~.~,. DlUS51J~ OF FF SEA CO cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 Mound System Cover Page pg, of 6 r"~ Project Name: Hennessy-Mound Owner's Name Mike Hennessy Owners Address 2336 160th Ave Emerald, WI 54012 Legal Description rSE ~ /<, i sw ~ %4 Sec T 30 N, R 16 w ~ ~ Township Emerald ___ _ _ County f Saint Croix ~ t -- - _ Subdivision N/A Lot# Parcel ID# Table of Contents pg• 1 Cover page 2 Mound Sizing Calculations 3 Pressure Distribution Layout and Dynamics 4 Dose Tank 5 Management and Contingency Plan 6 Plot Map total # of pages: 6 Designer Name: MP/License #: Date: Ph. #: Signature: ;~ l' , a' A 4' ./ .:iU ..J~yJ'~1l...~J Lyle J. Myers ~;tvUE=P~CE 9/9/04 7156432520 Mound System Design Methods Used per "Mound Component Manual For Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD-10691-P (N.01/01) per" Pressure Distribution Component manual for Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD-10706-P (N 01/01) 3bAdvisement N12486 220th St, Boyceville, lNl 54725 Ph: 715-643-6068 email: Mound System Page 2 of 6 Mound Sizing Calculations Project Name: Hennessy-Mound Site Conditions _ Project Type: 1 or 2 Family Dwelling Slope: 4 # of Bedrooms: 4 Depth to limiting factor: 15 in. Absorbtion rate of fill material: 1 gal/ftZ/day Absorbtion rate of in-situ soil: 0.4 gal/ft2/day Effluent quality , Eff#i ' • Max BOD effluent value: 220 mg/I Max TSS effluent value: 150 mg/I Design of Entire Fill Cell depth at upslope edge (D): Cell depth at downslope edge (E): Distribution cell depth (F): Cover thickness over edge (G): Cover thickness over center (H): End slope width (K): Fill length (L): Upslope width (J): Downslope width (Toe) (I): Fill Width (W): 21.0 in. 23.9 in. 9.5 in. 6 in. 12 in. 11.0 ft. 122.0 ft. 8.2 ft. 11.2 ft. 25.4 ft. Design of the Distribution Cell Basal Area System Design Flow: 600.0 gal/day Basal area required: 1500 ft2 Distribution cell width {A): 6.00 ft Basal area available: 1720 ft2 Distribution cell length (B): 100.0 ft Area of Distribution Cell: 600.0 ft2 Observation Pipes Contour Elevation of Mound: 99.01 ft location from end of cell (Z): 16.67 ft System Elevation of Mound: 100.76 ft Final Grade of Mound: 102.55 ft Mound Plan View J ~Dbservation Pipes ~ ~ 7-~-I / \~~ ~ ~ K= o~ Qistribution ;ell ~~ B k-K t I Tilled Area/Fill Material L Mound Cross Section Final Grade--_ _ Observation Pipe Synthetic Fabric--~~-~, f~ ( -- _G Distribution Cell _-~-_~,. _ ~ ~'-~.`, S stem Elevation, ~ ~¢,", F'' ~ ~ ~` F ~~ `~_ Cover Materiel ~ ~-`~ f~'~ ~ lateral O r E InverC Fill Materiel;'- ; ~~ -=~ Tilled Area J ~r~ f.~r / Slope ~~Forcemain System ~- Contour Notes: Fill material to consist of ASTM C33 Sand Distribution cell aggregate to comply with Comm 84.30(6)(1) Synthetic Fabric covering on cell per Comm 84.30(6)(8) Distribution Cell to have minimum 6" aggregate below lateral and 2" above. Mound System Page3of s Pressure Distribution Calculations Project Name: Hennessy-Mound Lateral Layout Lateral/Manifold Design Lateral elevation: 101.3 ft Lateral diameter: ~1'iZ ' ~ In. Rows of Laterals: z _ ! ~ Lateral spacing (S): 3 ft Manifold type: i~nter~ Lateral to cell edge: 1.5 ft Orifice diameter: o.1z5 • In. Lateral discharge rate: 11.53 gpm # of Laterals: 4 System discharge rate: 46.14 gpm Distal Pressure: 5 ft Manifold diameter: ~ z ~ In. I_._ Lateral Length: 49.5 ft Manifold length: 3 ft Orifice Spacing/Distribution Forcemain Friction Loss Orifice spacing (X): 21.60 Inches Forcemain length: 80 ft Orifices per lateral: 28 Forcemain diameter: ~ z ~ In. Avg. ft2/Orifice: 5.36 ftz Friction loss in forcemain: 3.438 ft Lateral Side View Manifold Lateral ~ Lateral x x x x x x x x x x x x 2 2 Lateral Length Lateral Length Lateral Plan View Lateral Length ~ ~ Turn-up wlball valve or cleanout plug ° ~~ S o n~ Orifices on bottom of lateral equally spaced F`VC laterals and forcemain to comply with specifications per Comm 84.30[2J[e) Forcemain conneckion via tee or cross ko manifold ak any paint Clean Out Detail Observation Pipes Clean-out plug Final Grade or ball valve Water tight cap or plug Lawn Sprinkler Box Slot Note: Closet Collar 6" Minimu~ may be used in Long Sweep 90 place of 318" bar ortwa 45's 3/$" Bar Lateral Ntound System Septic, Pump and Dose Tank Project: Hennessy-Mound Tank Information Pump tank manufacturer: Wieser Concrete Pump tank size/model: '~ wi25o/~5o-MR ',~ Pump tank gal/inch: 16.12 Actual Pump Tank Volume: 758 gal Tank bottom elevation (inside): 91 ft Septic tank size/model: wiz5o ~so/ MR _ _ ' ~ Pump and Filter Pump Manufacturer: Little Giant Pump Model: 9EH Effluent Filter: Zabel A100 Note: Access opening of sufficient size to be provided to allow removal of filter. Opening to terminate at or above grade. Pump Tank Diagram Watertight Locking Cover 4 Inch With Warning Label Finished Minimum Grade -~-,~_ Alternate Outlet Location Elect. per Comm 16.28 and F r ~ NEC 300 Weep Hole ?' or Anti- Siphon 8 Device C D Page 4 of 6 Dosage Volume Forcemain drains back to tank? QQ Yes O No Lateral void volume: 20.9 gal Dosage to absorbtion Cell: 104.6 gal Forcemain volume: 13.9 gal Total dosage: 118.6 gal Total Dynamic Head Are laterals highest point? y if not, enter highest elevation: 0 ft System head (distal x 1.3) 6.50 ft Vertical Lift ("D" to lateral) 9.59 ft Friction loss in forcemain: 3.44 ft Pressure loss from filter: ~ft Total dynamic head (TDH): 19.53 ft Dose Tank Levels In. A Reserve 29.7 B Pump off to Alarm 2.0 C Total Dosage 7.4 D Effluent depth for pump 8.0 Total Capacity: 47.0 FLOW- L[TERS/HOUR 00 2000 3000 30 10 N ~.s g W Pump must be capable of: and head pressure of: 46.1 GPM 19.6 Feet a x 0 0 20 40 60 80 Little Giant FLAW- GALLONS MINUTE 9EH PUMP PERF~RMA CE CURVE ttsv eaH s a x 2.s 0 Gal 478.2 32.2 118.6 129.0 758.0 Mound System Management Plan pursuant to comm 83.54 W. A. C. page 5 of 6 Owner's Responsibility: The component owner is responsible for the operation and maintenance of the component. The county, department or POWTS service contractor may make periodic inspections of the components, checking for surface discharge, treated effluent levels, etc. The owner or owner's agent is required to submit necessary maintenance reports to the appropriate jurisdiction and/or the department. Septic Tank: Septic tank(s) are to be inspected routinely and maintained by department approved individuals when necessary in accordance with their approvals. The use of chemical/biological "treatments" is not required or recommended. If such additives are used, make sure they are approved by Department of Commerce, Safety and Buildings Div.. Effluent filters are to be removed & cleaned as necessary, with provisions to keep solids from passing the septic during removal. No more than 1 /3 of the usable tank volume may be occupied by sludge/scum. 3 year inspection: If tank has greater than 1/3 volume sludge, tank contents must be emptied and disposed of in accordance with NR 113 Wisconsin Administrative Code by an approved individual. If the inspector does not recommend pumping of the septic tank, then the owner must be notified of when pumping should be done as to not exceed 1/3 sludge volume. Septic tank should be routinely inspected to be watertight and of good repair. Pump/Dose Tank If an effluent filter has been installed in the pump/dose tank, it must be removed & cleaned as necessary, with provisions to keep solids from passing to the mound component during removal. The pump, float switches and alarms must be inspected at least every three years for proper operation. Pump/dose tank should be routinely inspected to be watertight and of good repair. Mound and Lateral System The mound system component must remain free of ponded surface water prior to pump operation. If 4 inches or more water level is detected in the observation pipes, the owner must be notified of possible problems/failure. The designed daily flow capabilities of the component should never be exceeded. Trees and any other deep rooted vegetation should never be planted, or allowed to grow anywhere on the component. Activities OTHER than mowing/maintenance (i.e. excessive walking, pets, vehicles, etc...) could compress the component and reduce it's absorbtion capabilities and/or possibly cause it to freeze in winter conditions. Lateral distribution pipes should be flushed out/tested every 18 months using the cleanout points at each end of the component to remove scum that may clog orifices. Performance Monitoring: Performance monitoring must be done at least once every three years following the installation or at the time of a problem, complaint, or failure. Contingency Plan: If the septic tank, pump tank or any of their components therein (including floats, alarms, pumps, etc) become defective, the defective tank or component must be replaced immediately to ensure that the system can operate as designed. If the mound component cannot accept wastewater or ponds wastewater to the surface, the component must be repaired or replaced in it's current location by either: extending basal toe to provide added absorbtion area; or by removing the clogged bacterial mat,aggregate cell, and distribution piping within the mound and replacing said components in order to return system to proper working order as required. I b~ N ~°~d ~~ V.p F~ ~C Z~ y C~ ~ 'vE 4I '~ m ,Z ~ ('~ O m j 4 ~ ]~~ `:•' _ °~ ~ ~ ~ ~ t ~ l~` ~ ~ ~ ~ L ~ ~ x A m i ~ 1 o ~ ~~ ~N ~ ` -~._ -~ / a de ~ G tnl ~ ~, ~ d t ~ 8 m 0 O~ s ~ ' Wisconsin Ueparlmenl of Com arcs SOIL EVALU ~6,E rt~_ Division of Salety and 8uildings~ ~~'"'~~~~. ,,, ~~r.,,~a ,~~ .:its, .. T ~~.~ m.~ 4~~de~ Attach complete site plan on paper not less than 8 t/2 x 11 inch sin size. Plan mus{, .~ `~~~~t Inryrln ~~~ not !invited te: Vef!tca! 2.^.d !?Ofi>Qn(al rolerenCe pOtnt ~ !Vt~. d'r~e.~T ~1Q~' a1'~ ~'1 percent slope, scale or dimensions, north arrow, and location and istanC~rtrhearest road. ;Jv._. Please print all information. __; -~;~~~~~~'~~~~,~- Personal intormauon you provioe may De used for secondary purposes (Priv y tsw: s ~Jl®D1~«~ Page ~_ of 3 ~^ti ST' C',e mix Paria.l i.D. i Re t~tved by }--~, ,,(~, 1 t 11A Date • LO Prnnorty nwror ' ."~_. roperty lxation t I I V ~,/ , / •• cL ~ /~ZGss y Govt Lot SL 1 /4„S~V 1 /4 S T 3~ N R `/~ /~, / Pr/^ or:•• ~:~:nt'3r~•~c",acing Addrass I ~ Lc; # Elcck >Y Subd. Name or C~",Mt 233 l~o~~. RbE City State Zio Code Phone Number ^ City ^ ~Ilage Town Nearest Road tt~ ~~ 1 0~ ~ ~.is, -4sG Etc ~L G .E A ~j New t::onsvuction Use:~Residendal I Number of bedrooms _ Code derived desgn flow rate l ~_ _- C;PD ~Replacemenl ercial -Describe: mm ^ Public or Co Parern material ~ - ~s'~ ~//dL- ~ /L'~" Flood Plain elevation rfapplicable - h General comments ~ l ~ I I and r9~11mm9nrlaliOnc I l . 1 _ IA~ ~ ~~ 11~\ 1 ~~? ~ ~ Borny ~_ ~ ~n ~ . ~r L / J "`~~ ~~ ~y ~~ pit Ground surface elev. _ / /• ~_ ft. Dep to umiung raaor ~ ~, ~~• goil A ication Rate I-lohzon I Depth l m. Dominant Cotorl Munsell Redcx Desu ipiion l Qu. Sz. Corn. Color Texture irudure Sh. Consistence Boundary Roots GPD/fP 'Etfa1 'Effa2 / o - 9 /oYR /z 3 •Z o S/.f ~ 5~r~4 a .~1~ Zs c ~ ~c . ~ ~.~ . ~- ~~ w. ~ ' ~ pit Ground surface elev. [T. 7~_ fl. Depth to IimiGng taaor___ _..~ fin. Soil q iglion Rate I 19XtUr9 SWdur9 (;gn.Sisl9nr~ fjqundAry ft~nls (il' U/TP I I HM7.On t i UPnth t in. o ,. ~~ l Urprnnam l;plnrl fYtunsell o Y 3/Z. kertiox UgSr'riMinn Du. Sz. Cont. Color Gr. SL Sh. c.~ k rit y r c 3~' 'Eff#1 ~ t 'Effit2 ~ t ~ 3 I S- I o O ~1RS . 5Y~ s/ ~~ i ~. s c rrce. i -e. CS C - l ~u o l I Effluent at = BOD > 30 < 220 mgil and SS >30 < 150 (P, B'~s8 nt} cl~ ,.~[/ rs /,~a~~ ~~ Gi6Ju~esrf~i ~"~t , CtrlU6nl N[ - OvV, ~ .+v ~~y~ a~w ~ _ - ••a- Date Evaluation C,onduded Telephone Number 3 ~8-bf ~i~~2~s-`~/G2 ~- ; Pru~ubr~ty Owner'` • / r E~~~~ I 7 I .,--'-- ° ~ ~~~ Partx~l 10 k ~~ i 2 Page Z of pit Ground surtace elev. P o Iml tng Soil A iCalion Rate I Honzon I Depth in. Dominant Color Munsell Redox Description Qu. Sz. ConL Color Texture Structure Gr. Sz Sh. Consistence Boundarv Roots GPD/PF 'Eff#1 'Efttt2 -zo io ,es/ / a ~/ 2f.6~ /N~i ~ ~S - . G ' ~ ~ 1 1 I I I I I I I ' i 'J'-~1 Ong # ri I I l_J Pit Ground surface elev. ft. Depth to iimiling fador .'n~ Soil Aodiralion Rate Horizon I Oepth 1 in, Dominant Color Munsell Redox Oescriotion Qu. Sz ConL Cobr Texture Structure Gr. Sz. Sh. Consistence t Boundary I Roots GPD/tF 'EtNt1 'Etf#2 I I I I I I I o,..:.... « ^ Boring j___-j -- ~ [J Pil t~rounosurraceeirnr. ~~ ~,oN~~ K. ~~..~~,~~~a ~ar.~ _ .. Soil A ication Rate C tion dox Descri R Texture Stnrcture ConsistencA Boundary Roots GP O/tP Horizon Depth in. obr Dominant Munsell e p Qu. Sz. Cont. Cobr Gr. Sz. Sh. 'Etf#t 'Effi12 t I Ellpient tti = t300s > 30 < 220 nxyl ana TSS >30 < 150 mglL ' Efnuent tt2 = Br~Ds < 3U mgrL aM T SS ~ 30 ~*+g/L 111r t3rpalrtn~rt of Cunaneree is an cyuai oppcrlrtunity service provider anll tlllplbyCr. If yqU nCCI~ F15SIStanCZ tU aCl`C$$ $CIV II'CS Vr need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-$777. cgn S]!^1f_C'7Qs r *` 1 i m N u a ~ W ~, ,, ~ -a ~ ~ :~ -a ~ N ,.~ w m m~ m~ A n J L ~o ~~ a~` £ ~ n~ m ~~ ~ ~ 2 -~ o ,r ~~ ~ ~ v ~ D r m e vwp ~ \~1 ~ `_ ~" ~~ ~ ~~ -- s --;~Q ~~ `~ ~ i.~2~vF~Ky ~, ~, ~ Na ~ ~ a ~" ~ p m ~ - -,~ ,, ', _~ ~ ~- _- ~~ ~ %~ ~. ~ A m 0 O ~ r pOCUM1ENT NO. STATL' BA8 OF WISCONSIN 101R]II lii- lilq A~IONMENT O~ LANd CONTRACT s` 449496 vc: ~~o~c~ ~.. Q ASS~gIIOr. whether one or more. for a valuable consideration, assigns and conveys to ..-.Michael W. HennessY .................... ...................................................................................... ("Assignee'. whether one os more) We pVSiiBif~sxoe Purchaser's) interest is a Lsad Contract dated the.....25th,.-•,.,..--.,day of_.._MiIrG~ ................. 19.~~.., executed by .Marx-- Sclili.~ ................•-•---••-•---------...---•----..._....---............................ --•----• ................•-------..._......------.......--°-._...--•--•----••---.............. s• Vendor to .payy.~?~..-And~c~a__~~_dare..~i.lles~li~~--aka..Dayna,.A... B...._ . Gi 1le s-pie•~-,-now --known.. a S.. ~~y.Ilal._A.....Ai.d.ClI3......-•----....---- on lands b ~ .• .. ~.. S t . ~r0 ~X .~»...__.- -~-°~--County, Stab oY Wiseonsin, together with (the indabtednaq therein referred to and) all the iatarest of the Assignor in the Land Contract and the lands described therein. which Land Coo- tract was recorded is the OSice o! the RegLter of Deeds of said Connt~. on •. March 3 0 .. 1la..8 7 - sa Document Number.. 4 2 3 7 61 _ in .» .........................«. y • f ~~ (~x-------773........--•--•---. of Ql~'Y)con (....82 ......................• The Assignor oovenanta that then is now owing and an aid on said Lead Co Thousand Seven Hundred Forty One and 94/100 (S18 TNie NAC[ a[[[aYW IOa aeCORO1Ne O[T~ REGiSTBR'S OFFICE sr. cao~x aa, Hn Reid fa Record d JUL 071989 ~~ Leo A. Beskar ""O"" TO P . O. Box 13 8 River Falls, WI 54 2 11v~+~SriM~ ~_-~ itract~ the sum of -...-._ Elgt}teen 7d Od1 ~ ..___ end aLo interest at ..---10.5 $ per cent per annum inm ......------ June Z 5 ~ -- 19 8 9--._---- ~ that Assignor i• the owner of the above described interest in the Land Contract and has good right to assign the same, and that the condition of the title of Assignor's interest is the same as at the time of recording the Laced Contract. FARAGRAPHS APPLYING IF THIS I9 AN ASSIGNMENT OF PURCHASER'S INTEREST: (f4trll[e either L ert =.) By accepting and recording tF.L assignment, the Assignee agree: 1. That Aaignee ar[ames and agrees to pay the obligation secured by the Land Contract, to comply with aU terms and conditions of the Land Contract, and b hold harmless and indemnity Assignor as to the performance o! all obligations. terms and conditions of the Land Contract. (OA) HXllfiFlEMitX~XitliikilL iH1i~KiIdt16~LK/fi7CY0fiT$MsliitK~IHENiW~iI7NiYic 7~J~7Ct0~efm[Xitp[ited~n~eC~LttOl]001diCf¢fC700didi[x 7i1.lOd[OD][di0b70fCl~t[CC4QX~lK~dOf.10lC~ig1lN1p00~EC YD~x![7L7d~aa8oa14y ]ax fDd1[ itetdc X Xf ptpgjiC PARAGRAPHS APPLYING IF THIS I3 AN ASSIGNMENT OF VENDOR'S INTEREST: (Striloe either L or L) Xx~'Mitlf l4~Ui7i(iIYIXYiil~iXiiKiiKQaC~F~e~GIG86i~liitYlfix~iclibtii~sd6MliYel[)[7[ifac~ol[i! ~x~~a~cRoe~e~ot~citnmooefe~txaaobaMdl~mt6ex~t0oo>MegclOat~twi~aew~ptwcyaaaNtxdsx~xat~id~[~do~7tx Mifi1RX7(t~~C ZXZBtitYslR~YoliiiK7id3iit iKM+li~fiiiR~f[]I~Th1idC$~NLX]111t1~~CXi[7[8tD[tifilt)C1l~t~iX=1MC i6i~INCiSleft~m[~~tlr~]watmta<~Wr,~tarfe~„>w~cts~otcxl~cimo~t~Sl~ocEC~alcatx~mcalmc fYlwfc}p~atmet~e~mt7uc~~[}Nmtxecx>rI~[atmmt3iuKQrorsc Sr~x»tcfe~Idti[~c~islooaoxSbe~cldfi~;x x>,mc>t9oxemm~c fostxDmarglh><loooatoeirsxltx>q>~eodicaacidte~sotdc~o~a~C>mtdtoeiimx fh~c hP er will be responsible for all of the 1988 taxes as they ~ecome ue .il~ i~g"~' -- Thin .._...13......----•--._.. homestead property. (i+) ~I1~N gated thin ............................................... day of ......__.. s ._..-•--• ......................•--•-•-•--..._._......__.._.._........ (SEAL) ADTSSNTICATION 9 (SEAL) aka Ycnown --as ..AaXma-. A...-Bi don-------------•----------- (sEAL- ACSNOWLSDaII[BNT g~„t1le(a) of.Michael-•W,•-Hgn;)~~~y,..at}ti 3TATL OF WISCONSIN na ~nc~ ea $' -on Gi.llespig, aka ,a, _ A~,....:.._~.,..~~~~e.~ga,.~.:.._n .. lJt~iA.. as a na A. B .....-•-•----------------•-•------•---Coanty. a thin ....d ot__....711 e___.._....., 19. s 9 Personally came before me this . day of ....................................°-•._. 19........ the above named . Leo A. Beskar ....-•----•--•---••-•--•----•---•----• ...................•------•--........_._.. TITLE:- MEMBER-STATE BAR OF WISCONSIN •_-.-• ..............•.•,.._-._ (Ii not- --------------------•--•---...._....__....-----......_.._... ~ authorized by 4 ?08.06. Wis. Stets.) to me known b be the rson ....._...... who executed the -...~ ~ ~~.~©~ F DEC ~ 1983 a. ~ a.•M~ .~ CERT) FiED SURVEY MA~'~-~°~ Located in the SE 1 /4 of the SW 1 /4 of Section 9 , T 30N, R 16W , Town of Emerald, St. Croix County, Wisconsin Surveyed for: Mary Schmit DESCRIPTION A parcel of land located in the SE 1 /4 of the SW 1 /4 of Section 9, T30N, R 16W , Town of Emerald, St. Croix County, Wisconsin, described as follows: Commencing at the S1/4 corner of said Section 9; thence WEST (assumed bearing referenced to the monumented South line of SW 1 /4, bearing assumed due WEST) 555.83' along said South line to the point of beginning; thence continuing WEST 496.38' along said line; thence NORTH 375.03'; thence EAST 496.38'; thence SOUTH 375.03' to the point of beginning; containing 186, 157 sq. ft. (4.274 acres), and being subject to all easements, restrictions and covenants of record. N D rn c m 0 ao ~ IC O z ~ I~ ~ ~ ~a = 1 ~m w I° ro w O 1r w ~a z I~ IN _UNPLATTED 900 Op. EAST APPROV~~ DEC 81983 O w sr. CROIX COU`:SY ~~AND ZONIN(3PCOMMITTEENIN6 _LANDS_ 496.38' O~ 90c IC G ~~ ~ Ir = a ~~ rn ,o N + O HOUSE ~'- POINT OF BEGINNING 90o Oo 9O 00 WEST 496.38 w w _ WEST _ _ 496.38' _ a EXISTING TOWN ROAD w S.W. CORNER SECTION 9 T30N, R 16yy r~~ ~-~~ ~ .1AMES E .. UNPLATTED LANDS SCALE IN FEET I°= 100 w 0 W I Ir a v Iz ~y 555.83 S I~4 CORNER ST CROIX COUt~I'l'Y SEPTIC TANK MAINTENANc:.E AGREEMENT AND OWNERSHIP CER'I'IFICA'T'i~~N FORM OwnerBuyer ht~c~tEC. ~E•t/~cJCSs~ Mailing Address 2334 llsd-f~- ~1 v~ Property Address Z 3 ~ 4 /GO f~- ~¢r/E ..~ (Verification required from Planning Department for nsw construction) City/State E/ ,~ ~ / Parcel Identification Number LEGAL DESCRIPTION Property Location s~ '/<, ~ '/., Sec. 9 . T 3U N-I~1~W, Town of ~~~C6r?~L~ Subdivision _ ,Lot # Certified Survey Map # _, Volume ~_~ Page # Warranty Deed # . Vohunc _ .Page # Spec house ^ yes ~no Lot lines identifiable Dyes O no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result ix~ it:~ premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or soocur, if needed by a licensed pumper. What You put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber,,}ourneymanpluasber, restricted plumber or a liceuscd pumper verifying that (1) the oa-site ~stewater 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. the undersigned have read the above requirements and agree to waiutain the private sewage disposal system with the standards Uwe, set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certificatton stating that your septic system has been maintained must be completed acid returned to the St. Croix County Zoning Office within 30 days of the year expiration da . ~~ ~Z9/e~ SIG TURF OF APPI,IC DATE OWNER C)Exrtr'ic;A~,r ~~lv I (we) certify that ail statements on this force arc true to the best of my (out) knowledge. I (we) am (are) the owner(s) of the prop descn'bed above, by v' a of a warranty deed recorded is Etc~.ister of Deeds Office. 'G~-~ '"v ' 1 / L5/ Q S ATURE OF APPLIC DATE An information that is mis-represented may result in the sanitisry >>ecmit being revoked by the Zoning Department. ""«"* s«sa•s Y •• Include w[th this appllcatton: a stamped warranty deed from the Register of Daeds office a copy of the certifced survey map if refarenco is mado in the warranty deed