HomeMy WebLinkAbout010-1083-20-070Wisconsin Depurtmentofj-ommerce ~ PPIVATE SEWAGE SYSTEM
Safety and Building Division
INSPECTION REPORT
GENERAL INFORMATION (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
Mueller, Fred & Christine Emerald, Town of
CST BM Elev: Insp. BM Elev: BM Description: (~
/C~ I~YV~ G' cST
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY
Septic ~ (a,
~ul, i..~ : rf
~LX~~
Dosing (
~Z'. ;~...,bC~
~;` C•C (~i~~
Holding
TANK SETBACK INFORMATION
TANK TO P/L
~ WELL BLDG. Vent to Air Intake ROAD
Se tic
p
~~ i
~ /~ ~
I` ~
N 1
~~
~,
Dosing ~ ~fj °
J ~.C~ ~
O ..
Aeration
Holding
~~ ,~ _ ,~
PUMP/SIPHON INFORMATION ~-"""
Manufacturer
Model Number ~, n 1
Length r Dia. _,~ Dist. to
`~ ~'" LW~
Demand
`~ GPM
5 ~~~
SOIL ABSORPTION SYSTEM
~. r
BED/TRENCH
DIMENSIONS Width j
g Length i
~ No. Of Tre es
~ PI'r DIMENSIONS
~~ No. Of Pits
~ Inside Di\a.
` Liquid Depth
~
SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING
CHAMBER OR Manufacturer.
INFORMATION Type Of ys`'t~: ~~ ~~ ~ , /~
~V UNIT Model Number.
~.
e~~nrn~st ITIA-1 @VCTCIIA
Header/Manif Id i~
9 i Distribution ~ ~ j ~
Pipe(s)
~ x Hole Size ~ ~
~ x Hole Spacing r
(
Z Ve to Air Intake
~ j+
~
Spacing~
th Dia `
L
~ p
O ,
Dia
Length _
eng
vv~~ ..... ~..
Depth Over , .. ~ ~~~~....-...~~..,...~ .....~
Depth Over
es
h Ed
d/T
B .......----- -- - -- -
xx Depth of
Topsoil
~ - -
xx Seeded/ odded
xx Mul ed
~] No
es ~
i
BedlTrench Center ~ ` ~~ ~
g
renc
e , es L ~ No .
_ ~
3.15
~7,~
-BZ
~~ E
~k
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~G / ~ ~ /U~ Inspection #2: / /
Location: 2438 County Road D Emerald, WI 54013 (SE 1/4 SW 114 34 T30N R16W) IJA Lot 2 G~tuQ P el No: 34.30.16.5080
~ ~ ~CJ ate.. ~ OvJ <~
1.) Alt BM Description = ~~~~ ~l
P (, J
2.) Bldg sewer length = ~~
-amount of cover = +i thn~- "`~ Cu ~ `)~
~ J ~~IZ~laS
_ ---
1 - -- -- -,-~'-3~
Plan revision Required? n II nformatidn. No i ~ ~ T.+ ~ ~ ~ ~I' I -- _- - -- -- -- -------- - --- - ~ ~ ~1 -~
Use other slde for additto a
Date Insepct s Signa Cert. No.
SBD-6710 (R.3/97)
county: St. Croix
Sanitary Permit No:
479472 0
State Plan ID No:
Parcel Tax No:
010-1083-20-070
Section/Town/Range/Map No:
34.30.16.5080
STATION BS
3. HI
!b3• FS ELEV.
/
Benchmark
~, ~,(~
~~,~
l~3b
Alt. BM
G; ~~. Cam .Z ~ ! ! + $.
!.
Bldg. Sewer .7+~ a ~ ~ ~ +~ IS • I
SUHt Inlet o ~. t~
SUHt Outlet
'\
i.
Dt Inlet
~~
Dt Bottom
O
~~,
Header/Man. ~ ~ ~C
7 ~~®, i5
Dist. Pipe ~' 2 ,L}~ eaa , ~ 3
Bot. System ~ T ~~ '
t Final Grade
St Cover `
t~°.`~~ ~ Z 7g
a~J~ ~,C~ 9~ ~ 1
a+
zz
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is W
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to to
w
12 J
ti
to
a
6
d
z
a
zo 4o so y- o
0o too t2o
GAPpGrrY GaLLON3 PEq MINUTE
'All EC6/EC>/EH7 Seriee pumps have 3/4" Solids handling
bil
" ~~ ~~`
~ ~~
capa
ity and 2
NPT discharge. Y
~~ ~ ~o t' -
Cuctpmer Sefvicr.:18881782.7~~83 ^ Far Ordcra: (80p1176.9d46 ^ Www..+rertteD^mps.mm ^ Sra•Rite Indystrks, Inc . ^ DetdVOn, WI 331 IS USA
5395355E (A/pll
10/27!2005 13:46 17156581344
TOM GUSTUM
P~„,;+ ~ ti~99r2
s-ra- ra~~r~°
i^m
...L - u:
7^ war I ' ° O .., .
~600~
Dimensions (In Inches) are for estimating purposes only.
•' ~
Catalog'
Nurtlber
P ~ ~
Max.
load
Am s •
Volts
Phase/
C les
Cord
Lt:rt th
Mechanical
5witth
EC650120T 1 2 t2.0 115 1/60 20' Tethered
~EC650120M 1/z 1Z.0 115 1/60 ZD' Manual
EC650220T 1/2 5.6 230 160 20' Tethered
EC6502ZOM 1 2 5,6 130 1/60 2D' Manual
EC650320M 1 2 5,5 208-290 3 60 20' Manual
EC650420M 1 2 2.7 460 3 60 ZO' Manual
EC750120T 1/2 13.0 115 1 6D 20' Teth red
EC750120M 1/2 13.0 115 160 20' Manual
EC75022pT 12 6.4 230 1/60 2D' Tethered
EC7SOZZOM 1 2 6.4 230 1/60 20' Manual
EC750320M 1/2 6.0 208-Z30 3 60 20' Manual
F.C750420M 1/2 3.0 460 3/60 20' Manual
EC7100ZZOT 1 6.6 230 160 _
20' Tethered
EC7100220M 1 6,6 Z30 1 60 20' Manual
EC7100320M 1 5.$ 230 3/60 20' Manual
EC7100a20M 1 3.0 460 3/fi0 ZO' Manual
HIGH HBA, D MODELS
EH7501ZOT 12 12.0 115 1 60 20' Tethered
EH750120M
EH75022pT 1 2
12 12,0
6.5 115
230 1/60
160 20'
20' Manual
Tethered
EH750220M 1 Z 6.5 Z30 1 60 2D' Manual
l:H750320M 1 /2 5.Z 230 3/60 20' Manual
EH750420M 1/2 2.7 460 3 60 20' Manual
EH71002ZOT 1 8,7 230 160 20' Tethered
EH7100Z20M 1 8.7 230 1 /60 2D' Manual
1:H7100320M 1 6.0 230 3 60 20' Manual
EH7100420M 1 3.1 460 3 60 20' Manual
~ r PAGE 01
N ~ ~ ~U VYl
a h~ CurU~
r ~ r ~
GAPgGnY LITEPi3 PRR MINUTE
o so too ,sa zoo s5o soo aao aoo aso
Safety and Buildings sio County St. CI'D1X
~ ~ 201 V';. Washington Ave., 16
~scons~n Madison, WI 53 - 7162 itary Permit Number (to be filled in by Co.)
(608) 266-315? ~"l ~ ~ -1
Department of Commerce I /
Sanitary Permit Applicati n ~~'~~
~ tategP082LD. Number
~® 7~~'S ~~
In accord with Comm 83.21, Wis. Adm. Code, personal informat n you provide
may be used for secondary purposes Privacy Law, s I5. (1)(m)` i_ ,.,
~~ -
~ p ject Address If different than mailing address)
2y 3~
I. Application Information -Please Print All Information ,Sr CFA
~1X ty Rd DD
~
~
COU Q
-
Property Owner's Name FFICE
eller
F
d M arcel # of # Block #
010-1083-20-O~Q~ 2
re
u
Property Owner's Mailing Addres - Property Location
'
1415 Broadwa At. A t 5 S 1)~ '/<, SW'/4, Section
City, State Zip Code Phone Number ,(~
T ~ N; R~W ~ s S~O
Hammond, WI 54015 715-796-5362
II. Type of Building (check all that apply)
~ ~~
~
M Number
Subdivision Name C
S
~' '`~~~
X 1 or 2 Family Dwelling -Number of Bedrooms 4 ~
7
~
^ Public/Commerctal -Describe Use ~ Un . ~!/J~®.h. ~lQ&4~ Vol 17 Page 4595
/ 3 ~ ~~
^ State Owned -Describe Use ^City_^ Village X Township of Emerald
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
`~~ X New System
~- ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System
B• ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New
List Previous Permit Number and Date Issued
Before Expiration Plumber Owner
IV. T e of POWTS S stem: (Check all that a I 0~'t
^ Non -Pressurized [n-Ground X Mound > 24 in. of suitable soil ound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ /
Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^
Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain)
V. Dis ersal/Treatment Area Information:
Design Flow (gpd) Design Soil Application ate(gpdsf) q Disperse Area Required (sf) Dispersal Area Pro osed (sf) System Elevation
600 6e9` Sl 1 z~ O . ~ ' - v .~j ( 600 f ~U-{t _ ~^i+4R ~ I~~-~ 99.43 `/
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
New Existing
Tanks Tanks
Septic or Holding Tank X 1200 1 Skald Pre-cast X ,S//'J~^jt ~/ a
Aerobic Treatment Unit
Dosing Chamber X 750 1 Skald Pre-cast X
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
Tom Gustum ;~~ 0~ 227618 715-658-1344
Plumber's Address (Street, City, State, Zip Code)
N13450 937"' Street, New Auburn, WI 54757
VIII. ount /De artment Use Onl
pproved ^ Disapproved Sanitary Permit Fee (~ncludes Groundwa r
Surcharge Fee) ~L.!'1 ~ Date Issued
~~ Issuin A t Sim t o Stamps)
!
~
^ Owner Given Reason for Denial 77 ~~11 ` 3 ~ ~~
r
IX. Conditions of Approval//R~e/a,~sons for Disapproval 3 ~` S~~
~-~"~~~
E~~
n.
YSTEM OWNER:
1 Septic tank, effluent filter and C/et~•~ad ~l ~" ~` ~~G'"-`~~ Nit
dispersal cell must all be serviced // mad ~ i
~d~ Q~~u~n.G2 .3.~ ~~~ '~~ /ry~ld'6~'tD~->~
as per management plan provided bvnlumber. / ~! I /(
,
2. All set ac c requirements must be maintained / - /'~~~~~
> ~ ~ Y~~ -f'-"t~"'` ~ Z)
li
bl
d
/
i
as per app
ca
e co
e
ord
nances.
Attach complete plans (to the County only) for the system on paper not less than 81/2 x I t inches in size
~0
SBD-6398 (R. 01/03)
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commerce.wi.gov
^ ^
~scons~n
Department of Commerce
Safety and Buildings
1340 E GREEN BAY ST STE 300
SHAWANO WI 54166
TDD #: (608) 264-8777
www. commerce.wi. gov/sb/
www.wisconsin.gov
Jim Doyle, Governor
Mary P. Burke, Secretary
August 23, 2005
OUST ID No. 227618
THOMAS GUSTUM
GUSTUM SEPTIC SERVICE
N13450 937TH ST
NEW AUBURN WI 54757
ATTN.• POWTS Inspector
ZONING OFFICE
ST CROIX COUNTY SPIA
1101 CARMICHAEL RD
HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 08/23;2007
SITE:
Identification Numbers
Transaction ID No. 1188082
Site ID No. 703410
Mueller Please refer to both identification numbers,
County Rd DD above, in all corres ondence with the a enc .
Town of Emerald
St Croix County
SEI/4, SW1/4, 534, T30N, R16W
FOR: '
Description: Mound System for Fred Mueller
Object Type: POWTS Component Manual, Regulated Object ID No.: 1035352
Maintenance required; 600 GPD Flow rate; System(s): Mound Component Manual -Version 2.0, SBD-10691-P
(N.O1/O1)
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:
• This system is to be constructed and located in accordance with the approved plans,
and the "Mound Component Manual for Private Onsite Wastewater Systems Version
2.0" SBD-10691-P (N.O1/O1).
• The pressure network is to be constructed in accordance with publications SBD-10706-
P (NO1/O1) "Pressure Distribution Component Manual for Private Onsite Wastewater
Treatment Systems -Version 2.0" and/or the sizing methods of publication "SSWMP
Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81)".
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.
THOMAS GUSTUM
Page 2 8/23/2005
In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions
should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this
review shall relieve the designer of the responsibility for designing a safe building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the
installation, operation or maintenance of the POWTS.
Sincerely,
Keith Wilkinson
POWTS Plan Reviewer ,Integrated Services
(715) 524-3630, Fax: (715) 524-3633 , M-f 7:45 am - 4:30 pm
kwilkinson@commerce. state.wi.us
Fee Required $ 175.00
Fee Received $ 175.00
Balance Due $ 0.00
WiSMART code: 7633
cc: Leroy G Jansky, Wastewater Specialist (715) 726-2544
I ~ ~ ,
nd System
Cover Page
Project Name:
Owner's Name
Owners Address
Legal Description sE I ~ %4, Sw ~ %< Sec y4'' T 30 N, R 16 w ~
Township Emerald
County Saint Croix ~~
Subdivision Vol 17 Page 4595
P.O.W.T.S.
Lot# 2 Cn~zditionally
Parcel ID# 010-1083-20~ p')~ ~~ ~ ~~~~
OF ~~+'~~ DEPARTMENT Of COMMERCE
~ DI~JIS~ON OF SAFETY AND BUILDINGS
O
~ titi Table of Contents
N, ~ D• ~, a Cover page SEE CORRESPONDENCE
C~ q
~, 9". 1201 ~
"
~ Mound Sizing Calculations
3 Pressure Distribution Layout and Dynamics
~• r
®~
•
~~` 4 Dose Tank /Pump Curve
ency Plan
ement and Contin
5 Mana
~
~~~ g
g
e _ `~ 6 Plot Map
total # of pages: 6
Designer Name: Tom Gustum
License #: D1201
Date: 8/15/2005
Ph. #: 715-658-1344 ,,~~
Signature: C~.e~*GV~~
Mound System Design Methods Used
per "Mound Component Manual For Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD-10691-P (N.01/Ot)
per" Pressure Distribution Component manual for Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD-10706-P (N 01/01)
Mueller 600 GPD Mound
Fred Mueller
pg 1 of 6
~~~~~
AEG X 7 2005
S,qF~,~ BAGS. 0
/,
1415 Broadway St. Apt 5
Hammond, WI. 54015
715-796-5362 L
3bAdvisement N12486 220th St, Boyceville, WI 54725 Ph: 715-643-6068 email:
Mound System
Mound Sizing Calculations
Project Name: Christensen 600 GPD Mound
Site Conditions
Project Type: 1 or 2 Family Dwelling ~
Slope: 5
# of Bedrooms: 4
Depth to limiting factor: 20 in.
Absorbtion rate of fill material: 1 gal/ft2/day
Absorbtion rate of in-situ soil: 0.4 gal/ftZ/day
Effluent quality Eff#1 , ~
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):
Page 2 of 6
16.0 in.
20.8 in.
9.5 in.
6 in.
12 in.
10.0 ft.
95.0 ft.
6.9 ft.
12.0 ft.
26.9 ft.
Design of the Distribution Cell Basal Area
System Design Flow: 600.0 gal/day Basal area required: 1500 ft2
Distribution cell width (A): 8.00 ft Basal area available: 1500 ftZ
Distribution cell length (B): 75.0 ft
Area of Distribution Cell: 600.0 ft2 Observation Pipes
Contour Elevation of Mound: 98.10 ft Location from end of cell (Z): 12.5 ft
System Elevation of Mound: 99.43 ft
Final Grade of Mound: 101.23 ft
Mound Plan View
~ /Observation Pipes z~
W K ~~~" distribution Cell `b ~ A
1~
--
B K-
Tilled Area/Fill Material
L -
Mound Cross Section
Final Grade
Synthetic Fabric-~
Distrik~ution Cell~•,
System Elevation-,L=F-
Cciver Material
Fill Material
`~(]bservation Pipe
~ ~- ,~~G
4 ~ d d
6~ ~ b~7 ~ ~„~,~ F
7
Lateral a 3
1 n~~e rt ~
~ Slope u Forcemain
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.
Iled Area
~~szem
Cra nto u r
Mound System
Page 3 of 6
Pressure Distribution Calculations
Project Name: Christensen 600 GPD Mound
Lateral Layout Lateral/Manifold Design
-
Lateral elevation: 99.9 ft Lateral diameter: ivz i ~ In.
Rows of Laterals: ~ ~ Lateral spacing (S): ~ft
Manifold type: center ~ Lateral to cell edge: 1 ft
Orifice diameter: 0.155 ~ In. Lateral discharge rate: 8.59 gpm
# of Laterals: 6 System discharge rate: 51.53 gpm
Distal Pressure: 3.5 ft Manifold diameter: ~ Z ! ~ In.
Lateral Length: 37 ft Manifold length: 6 ft
Orifice Spacing/Distribution Forcemain Friction Los
Orifice spacing (X): 28. ~ Inches Forcemain length:
Orifices per lateral: 16 Forcemain diameter: 2 ~ In.
Avg. ft2/Orifice: ~,2'v~ft2 Friction loss in forcemain: 4.219 f~.--~~
Lateral Side View
Forcemain
Lateral Lateral ~ . ~~~
~ ~ ~
~aterai ~engm f~><eral ~engtn
Lateral Plan View
a I I PVC laterals and forcen~in to comply with
~ lul speaf a6ons per Canm 84.30(2)
Forcemain connection via tee a aoss to manifold at any point
Clean Out Detail
dean-aut plug
Grade r-ar ball valve
Observation Pipes
v'Vater tight cap
ar plug
Lawn
Sprinkler
Box
Long S+n+eep 9l7
^riwo 45's-~_
6" Minimum
-Slot
Mate: Closet Collar
may 6e used in
place of 3f8" har
--3f8" Bar
r~ ~-'`~
~~__._
Lateral Length
Mound System
Weep Hole
or Anti- B
Siphon
Device C
D
Dose Tank Levels
In. Gal
A Reserve 3t), g -ae.$- 490.3
B Pump off to Alarm 2.0 32.1
C Total Dosage 8.2 131.3
D Effluent depth for pump CO 96.3
Total Capacity: •>!e'l~ 750.0
~7
Pump Curve: 9EH
FLAW- LITERS/HOUR
10
Pump must be capable of:
and head pressure of:
51.5 GPM
16.3 Feet
w
w
a
N
7.5 W
W
f
s
A
z.s
0
Pump tank manufacturer:
Pump tank size/model:
Pump tank gal/inch:
Tank bottom elevation (inside):
Septic tank manufacturer:
Septic tank size/model:
Septic, Pump and Dose Tank
Project: Christensen 600 GPD Mound
Tank Information
Skaw Precast
750
16.05
92
Skaw Precast
1200
Page 4 of 6
Dosage Volume
Does forcemain drain
back to tank?
Lateral void volume: 23.5 gal
ft Dosage to absorbtion Cell: 117.3 gal
Forcemain volume: 13.9 gal
Total dosage: 131.3 gal
Pump and Filter Total Dynamic Head
Pump Manufacturer: Little Giant Are laterals highest point?
Pump Model: 9EH if not, enter highest elevation: 0 ft
Effluent Filter: simtec STF 110 System head (distal x 1.3) 4.55 ft
Vertical Lift ("D" to lateral) 7.43 ft
Note: Access opening of sufficient size to be provided to allow
removal of filter. Opening to terminate at or above grade.. Friction loss in forcemain: 4.22 ft
Pressure loss from filter: ~p ft
Total dynamic head (TDH): 16.20 ft
Pump Tank Diagram
Nktertight Locking Cover
4 inch ~V~fth blaming Label Fnished
Minimum , Grade
Alternate J
Outlet ~
Location
Elect. per Comm
16.28 and
Forcemain NEC 300
0 20 40 60 80
Little Giant FLOW- GALLONS/MINUTE
9EH PUMP PERFORMANCE CURVE
115V 60HZ
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 andlor 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 fltPrc ara t~ hP rornnve.+ st. rlaanprl ac Harps ary with provisions to keen -
soids~coxn_r~sin4 the septic during removal. Igo more-thara_1.L3 of the usabl .tank vol ~m _ may h^or.~,~,n~iPd
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.
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1322
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel Soil Service
County
Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must St. Croix
include, but not limited to: vertical and horizontal reference point (BM), direction and _
percent slope, scale ar dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. l 0 ?-~
010-'t~98~-28-9~A
Please print all information. viewed Dat
Personal information you provide maybe used for ,r~~cy ylsur, 15.04( (m)). ~ t~ 7 6
Property Owner i Prop Location
Christensen, Kurt x ,,,. ,. Govt. i° na SE 1/4 SW 1/4 S 34 T 30 N R 16 W
Property Owners Mailing Address 1 _ _i '? s - u '~ 'Lot # z Block # Subd. Name or CSM#~ I SGt p~¢d/t~O
877 Benoy Dr ~ ~ pen na 35Acres
City State Zip Co Phd~n~ Numtier ity ~ Village [~ Town Nearest Road
Hudson ~ WI 5401 ~386~3~~~~ ~~~ Emerald Cty Rd DD
New Construction Use: y~i Residential / Number of bedrooms 4 Code derived design flow rate 600
J Replacement J Public or commercial - Describe:na
Parent material Ridges of ground moraines Flood plain elevation, if applicable na
General comments ~22. ~~
and recommendations: Mound design, system elevation 99.40ft based on contour line elevation 98.10ft. GPD
Boring # ~ Boring
~ Pit Ground Surface elev. 98.70 fl. Depth to limiting factor 20
in.
Soil Application Rate
Horizon Depth
in. Dominant Color
Munsell Redox Description
Qu. Sz. Cont. Color Texture Structure
Gr. Sz. Sh. Consistence Boundary Roots GP
*Eff#1 DIft2
*Eff#2
1 0-8 10yr3/2 none sil 2msbk mfr cs 1f .5 .8
2 8-16 10yr4/4 none sicl 2msbk mfr cs 1f .4 .6
3 16-20 7.5yr4/4 none scl 2msbk mft gw na .4 .6
4 20-48 7.5yr4/4 c2d 7.5yr5/6 scl om mfr na na .0 .0
Water seepage at 20"
Boring # Boring
Pit Ground Surface elev. 98.70 fl. Depth to limiting factor 36 in. Soil Application Rate
Horizon Depth
in. Dominant Color
Munsell Redox Description
Qu. Sz. Cont. Color Texture Structure
Gr. Sz. Sh. Consistence Boundary Roots GP
*Eff#1 D/ft'
*Eff#2
1 0-11 10yr3/2 none sil 2msbk mfr cs 1f .5 .8
2 11-17 10yr4/4 none sicl 2msbk mfr gw 1f .4 .6
3 17-36 7.5yr4/4 none scl 2msbk mfr gw na .4 .6
4 36-43 7.5yr4/4 none scl om mfr gw na .0 .0
5 43-50 7.5yr4/4 c2d7.5yr5/6 scl om mfr na na .0 .0
Water seepage at 36"
* Effluent #1 = BODS> 30 <_ 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mglL and TSS < 30 mg/L
CST Name (Please Print) .-- Signatury:~ i"' CST Number
David J. Steel ~" 248956
Address Steel Soil Service Date Evaluation Conducted Telephone Number
1564 CR GG, New Richmond, WI 54017 5/21/2003 715-246-5085
.0~
Property Owner Christensen, Kurt Parcel ID # 010-1087-20-050 Page 2 of 3
Boring # Boring
If Pit Ground Surface elev. 95.80 ft. Depth to limiting factor 45 in. Soil Application Rate
Horizon Depth
in. Dominant Color
Munsell Redox Description
Qu. Sz. Cont. Color Texture Stnx;ture
Gr. Sz. Sh. Consistence Boundary Roots D
*Eff#1 *Eff#2
1 0-9 10yr3/2 none sil 2msbk mfr cs 2f .5 .8
2 9-12 10yr4/4 none sicl 2msbk mfr cs 1f .4 .ti
3 12-45 7.5yr4/4 none scl 2msbk mfr w na .4 .ti
4 45-52 7.5yr4/4 none scl om mfr gw na .0 .0
5 52-60 7.5yr4/6 c2d7.5yr5/6 sl om mfr na na .3 .5
Water seepage at 52"
^ Boring # J Boring
_J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Stnucture Consistence Boundary Raots P
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
^ Boring # --1 Boring
_J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P
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/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 deparhnent at 608-266-3151 or TTY 608-264-8777.
I `
Page 3 of 3
STEEL'S SOIL SERVICE INC.
David J. Steel 1564 Cty Rd GG
CST-POWTSM Kurt Christensen New Richmond,WI 54017
L1C. #248956 SEl/4,SW1/4,S34,T30N,R16W Bus.(715) 246-6200
Town of Emerald, St. Croix Co. Fax.(715) 246-9372
35 acres Lot 1
This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your
use. The location of this test may or may not be as shown, as permanent lot lines were not established at
the time the soil test was conducted. Legend
1" = 40'
• =Benchmark Ele. 100.00Ft
Top of I /2" pvc pipe
• =Alt Benchmark Ele. 49.70Ft
Top of 1/2" pvc pipe
^ =Borings
Boring Elevations
B 1 = 98.70Ft
B2 = 98.70Ft
B3 = 95.80Ft
'rj 2 ~ 37' 13' B4 = OO.OOFt
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LEGAL ST. CROIX COUNTY, WISCONSIN NEW TXSCR02
REAL ESTATE TOWN OF EMERALD
COMPUTER NUMBER 010-1083-20-060 Parcel Number 34.30.16.5086
OWNER NAME: First KURT & ELIZABETH Last CHRISTENSEN
PROPERTY ADDRESS: Hse # 1/2 PD --Street Name-- Type SD Apartment
SECTION 34 TOWN 30N RANGE 16W '/<160 SW '/<40 SE
Line Description Line Description
TOTAL ACREAGE 10.020 PLAT CSM 17-4595 010-03 LOT01 BLK
01 SEC 34 T30N R16W PT SE SW 15
02 CSM 17-4595 LOT, 1 ~
03 (10.02 AC) 17
04 18
05 19
06 20
07 21
08 22
09 23
10 24
11 25
12 26
13 27
14 28
F1-General, F4-Prev. Parcel, F5-Next Parcel, F7-Valuations, F8-History, F10-Exit
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
OwnerBuyer ~r~ /~~~~ ~e- ~
Mailing Address /~f/5'~ ~~ ~c~c~~ ~~ -~/rro7~ ZJS ,S21~L
Property Address
(Verification required from lanning & Zoning Department for new construction.)
City/State ~~du,~..' Gt/t Parcel Identification Number ~lU- /~ ~ 3 - ~ ~- ~~ D
LEGAL DESCRIPTION /~ ~~c~
Property Location~_ 1/4 , ~'/4 , Sec.3~, T ~_N R /(~ (W, Town of ~~~m ~c~_~
Subdivision ,Lot # Z- .
Certified Survey Map # ~,3 ~~~5~ ,Volume / 7 ,Page # y~ r,~.-
Warranty Deed # X9.3 L..~ SZ/ , Volume ~ ~ ~oZ ,Page # 02 ~
Spec house yes no
Lot lines identifiable ~ 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.
Nu e f b oo s
/ /~ os-
ATURE OF APPLICANTS DATE
IGN ( )
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.
Gam' ~ G~,,w ~f.3,e-~lv0a ~-~
***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. 08/05)
`Parcel #: 010-1083-20-070 " 09/13/2005 02:54 PM
PAGE 1 OF 1
Alt. Parcel #: 34.30.16.5080 010 -TOWN OF EMERALD
Current ~X~ ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O =Current Owner, C =Current CaOwner
O -MUELLER, CHRISTINE L & ALFRED
CHRISTINE L & ALFRED MUELLER
8900 ROSEWOOD LN N
MAPLE GROVE MN 55369
Districts: SC =School SP =Special Property Address(es): * =Primary
Type Dist # Description " 2438 CTY RD DD
SC 0231 BALDWIN-WOODVILLE AREA
SP 1700 WITC
Legal Description: Acres: 8.660 Plat: 1776-CSM 17-4595 010-03
SEC 34 T30N R16W PT SE SW CSM 17-4595 Block/Condo Bldg: LOT 02
LOT 2 (8.66 AC)
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
34-30N-16W SE SW
Notes: Parcel History:
Date Doc # Vol/Page Type
04/28/2005 793454 2792/252 WD
09/04/2003 738834 2400/400 WD
08/27/2003 737588 17/4595 CSM
01 /16/2001 636895 1576/216 WD
7nf1~ cl IMMeRV Bill #: Fair Market Value: Assessed with:
Valuations:
Description Class
PRODUCTIVE FORST LANC G6
Totals for 2005:
General Property
Woodland
Totals for 2004:
General Property
Woodland
0
Last Changed: 07/29/2005
Acres Land Improve Total State Reason
8.600 55,000 0 55,000 NO
8.600 55,000 0 55,000
0.000 0 0
8.600 35,000 0 35,000
0.000 0 0
Lottery Credit: Claim Count: o Certification Date: Batch #:
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
,U 2792P 252
Document Number
State Bar of Wisconsin Form 1 - 2003
WARRANTY DEED
Document Name
THIS DEED, made between Kurt Christensen and Elizabeth
Christensen, husband and wife
("Grantor," whether one or more),
and Christine L. Mueller and Alfred Mueller, wife and
husband as survivorship marital property
_ ("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):
Lot 2 of Certified Survey Map recorded in Volume 17
on page 4595 as Document No. 737588 being a part of
the Southeast Quarter of the Southwest Quarter (SEr~
of SW's), Section 34, Township 30 North, Range 16
West, Town of Emerald
Recording Area
793454
KATHLEEN H. MALSH
REGISTER DF DEEDS
ST. CROIK CO. , MI
RECEIVED FOR RECORD
04/28/2005 12:15PK
MARRANTY DEED
EXEl~~T #
REC FEfi : l 1.00
TRANS FEE: 209.70
COPY FEE:
CC FEE:
PAGES: 1
Name and Return Address
Title One Premier Group
706 19th Street South
Hudson, Wisconsin 54016
**Grantor to retain 66' access easement along
southerly side of lot ± 632 feet for future roadway
easement. Grantee is aware that a future public
road ma be installed and dedicated to the public
y 010-1083-20-070
(town and county) and agrees to cooperate in any
such efforts including the signing of necessary Parcel Identification Number (PIN)
documents without future consideration. 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
-~
(SEAL) ~ /' (SEAL)
*Kurt Christensen *Eliz th Chri nsen
i
(SEAL) / (SEAL)
*
AUTHENTICATION
Signature(s)
authenticated on
*
TITLE: MEMBER STATE BAR OF WISCONS
(If not, p~ A- F~
authorized by Wis. Stat. § 706.06) ~
?
~ NOTARY
THIS INSTRUMENT DRAFTED BY:
* -'-
Michael H. Forecki Attorn
Eau Claire, Wisconsin ..
ACKNOWLEDGMENT
STATE OF WISCONSIN
ss.
St. Croix COUNTY) y-~ ~. -OS
Personally came before me on ,
the above-named Kurt Christensen
Elizabeth Christensen
to me known to be the person(s) who executed the
foregoing instrument and acknowledged the same.
' ~ Qaaiail QL A. CK{.~4J Vla
otary Public, State of Wisconsin
y` • My Commission (is permanent) (expires: 03/23/2008 )
(Signatures m A gg r knowledged. Both arc not neceuary.)
NOTE: THIS IS A STANDARD FORM. CII~ NS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED.
WARRANTY DEED OF WISCONSIN FORM No.1-2003
•Type name below signatures.
Attorney Michael H Forecki 3452 Oakwood.Hills Pkwy Ste 1, Eau Claire Wl 54701-7928 Phone: (715) 835-3029 Faz: (715) 8354112 T52J0965.7,FX
Tide One Premier Group Produced with ZipFonn TM by RE FarmsNtri. LLC 12025 Filleen Mib Road, C11MOn Township, Michigan 48035, (800) 383-9905 www.zidam. can
~~~bBS . ~i<<
Wisconsin Dc~}'artment of Commerce ~ SOIL AND SI'
Divis,on of Safety and Buildings
/1 in aeordance with
Attach complete site plan on paper not less than 8 '/~ x 11 inc .Plan must
not limited to: vertical and horizontal reference point (BM), direction an percent sl
dimensions, north arrow, and location and distance to the nearest road.
APPLICANT INFORMATION -Please print all information
Personal information you provide may be used for secondary proposes (Privacy Law, s. 15.04(1)(m))
Property owner:
Kurt and Elizabeth Christensen ~
Property owner's mailing address: L~.~-
877 Benoy Road ~~
City /State /Zip Code Phone number:
Hudson /Wisconsin /54016 715-386-6340
® New Construction Use ^ Residential/Number of bedrooms Unknown -Design for 3BR Addition to existing building: i~IA
^ Replacement ^ Public or commercial -describe
Code Design Flow Rate: Unknown -must be appropriate size for the contour and soil restrictions
Parent Material: Glacial Till -ground moraine
General Comments and Recommendations: Soils are somewhat well drained glossoboralfs underlain by clay loam. Redox features are the result of
perching above the dense clay loam layer. Along narrow mound SAS is recommended for this site. Pits 4 & 5 are located in a concave slop ee pl
plan. Pits were hand dug. ZA Pam Quinn visited this site with CST on 3 October 2005 to onfirm de th of limitations in pits 1, 2, 3, 4. .
e-..-. ~i .ter. rV ~vr~rrmr~wi TiTTATT
Borin #
g HOrizOn Depth Dominant Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate .
Z
n
g\
J in. Munsell Color Qu. Sz. Cont. Color Gr. Sz. Sh. GPD/FT
ff#2
Eff# 1 F
Pit 1 ~
H' ,
Ap 0 - 8 l OYR 3/2 NA sil 2fsbk mfr as 2f 0.5 0.8
Ground Btl 8 -16 lOYR 4/3 NA sil 2msbk mfr aw if 0.5 0.8
Elev (ft
)
.
96.34' Bt2 16-25 7.SYR 4/4 fld 7.SYR 5/8 gr sicl lmsbk mfr aw lvf 0.2 0.3
r- -
Depth to C 25-30 7.SYR 4/6 map 7.SYR 5/8 grcl massive NA NA NA
limiting
factor- in.
16
l
~..w..,,-t,::. ,.t..., i...:,a,.:.,,, :,, rzrt
Boring # Ap 0 -11 lOYR 3/2 NA sil 2fsbk mfr as 2f 0.5 0.8
Pitt Btl 11-15 IOYR4/4 NA sil 2msbk mfr aw if 0.5 0.8
Bt2 IS-23 7.SYR 4/4 mld 7.SYR 5/6 gr sicl lmsbk mfr gw NA 0.2 0.3
Ground
Elev (ft.)
C
23-27
7.SYR 4/4
map 7.SYR 5/8
gr sicl
massive
96.34' r ^ ~`
lFt'',)
Depth to
limiting
factor- in.
15~ clay bridging in Btl.
CST Name: Eli M. Gottfried, Gottfried Environmental Signature: ~, Tel. No. 715-833-1400
81
CST # 2219
2005
be
r
te: 3O
c
to
Address: 124-1/2 Graham Ave. Eau Claire, WI. 54701 D
a
)
~r{/- y~A y~~//~
~,(~///',
/
/
/
/
/
V IiV~/K !l/ U ~~/ i / r~- f1 ~~ i /!/ ~+li~~
n 85, ~i~~d~~~~
NE:I ~` ~ ~ ~dG5
ide, but
scal~r CROIX C
OUNTY
_ ZON~OFFICE
I
Nearest Road uT~`- ~D f- ,
CTH DD ~C
age '
""`' St. Croix
Parcel ID # rp~, h _ ~/~ ~~ _ 1 /, -_ _~
Property location
Gov't lot: SE 1/4 SW 1/4 S34 T 30 N, R16 E (or) W^
o # lock # Subd. Name r CSM# / "7 / /"~~
A~ A NA , , _ (/ 7
C,, ~ ~. U
Property owner Christensen
SOIL DESCRIPTION REPORT
Parcel 1D#
Boring #
Horizon
Depth
Dominant
Redox Description
Texture
Structure
Consisten,{~,,..,
-Boundary
Roots 4
Soil Application Rate
Pit 3
lA't 5 ~ in. Munsell Color Qu. Sz. Cont. Color Gr. Sz. Sly, "'""~
~,~;.., :. GPD/FTZ
n; .,,.,-~ Eff# 1 Eff#2
Ap 0 -10 lOYR 3/2 NA sil 2msbk' ~ mfr as 2f 0.5 0.8
Ground Btl 10-15 lOYR 4/4 NA sil w c 2msbk mfr gw if 0
5 0
8
Elev (ft.) . .
95.90 ~ 15-20 7.SYR 4/4 fld 7.SYR 5/8 sicl lmsbk mfr as NA 0.2 0.3
Depth to Cl 20-26 5 YR 4/4 map 7.5YR 5/8 cl lmsbk mfr NA NA 0.2 0.3
limiting
factor-in.
15
Remarks: 2f worm channels in Btl.
Boring #
Pit 4 Horizon
~ k3) Depth
m. Dominant
Munsell Color Redox description
Qu. Sz. Cont Color Texture Structure
Gr. Sz. Sh. Consistence Boundary Roots Soil Application Rate
GPD/FTZ
Eff# 1 Eff#2
A 0
10 IOYR 3/2
p - NA sil 2fsbk mfr as 2f 0.5 0.8
Ground E 10-13 l OYR 4/3 NA sil 1 mpl mfr aw 1 f 0.4 0.6
Elev (ft.)
96.34
Btl
13-17
7.SYR 4/4
mld 7.SYR 5/8
sil w c
lmsbk
mfr
gw
NA
0.2
0.3
Depth to
limitin Bt2 17-19 7.SYR 4/4 m2d 7.5YR 5/8 sicl ]msbk mfr NA NA 0.2 0.3
g
factor- in.
Remarks: ~ ~ , ~~
Boring # Ap 0 -1 1 l OYR 3/2 NA sil 2fsbk mfr as 2f 0.5 0.8
Pit 5
E
11-14
lOYR 4/3
fld 7
SYR 5/8
sil
lm
l
mfr
]f
0
4
0
6
. p aw . .
Ground
Elev (ft.) Btl 14-19 7.SYR 4/4 mld 7.SYR 5/8 sil w c lmsbk mfr gw NA 0.2 0.3
96.34 Bt2 19-22 7.SYR 4/4 m2d 7.SYR 5/8 sicl lmsbk mfr NA NA 0.2 0.3
Depth to
limiting
factor-in.
0
Remarks:
Boring # Horizon Depth Dominant Redox description Texture Structure Consistence Boundary Roots Soil Application Rate
B 1
R~~~ in. Munsell Color Qu. Sz. Cont. Color Gr. Sz. Sh. GPD/FTZ
Eff#I Eff#2
Ap 0 -I 1 lOYR 3/2 NA sil
Ground Btl 10-15 lOYR 4/4 NA sil
F.,lev (ft.)
96.34' gt2 x,19 7.SYR 4/4 fld 7.5YR 5/8 gr sicl
Depth to Cl 19-22 7.5 YR 4/4 map 7.SYR 5/8 cl
limiting
factor- in.
15
l
Remarks: hand boring; small amt of clay in Btl
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ST. CROIX COUNTY
Planning Zoninn a„~ p~-~~ r^+~+mittee
AUG 2 7 2003
If not recorded wirnin 3v gays of
approvai date approval sAall tae
CERTIFIED ~'~~VEY MAP
LOCATED IN THE SE1/4 OF THE SW1/4
OF SECTION 34, T30N, R16W, TOWN OF
EMERALD, ST. CROIX COUNTY,
WISCONSIN.
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~ -------------- ----------------- -------------- SECTION 34
~ THIS INSTRUMENT DRAFTED BY EDWIN FLANUM JOB N0.03-41 DATE: 7-21-03 SHEET 1 OF 2 SHEETS