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HomeMy WebLinkAbout010-1013-30-000Wisconsin Department of Commerce PRIVATE 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: Howell, Patrick M. City Village X Township Emerald, Town of CST BM Elev: Insp. BM Elev: BM Description: TANK IN FORMATION TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. CrDiX Sanitary Permit No: 515100 0 State Plan ID No: Parcel Tax No: 010-1013-30-000 Section/Town/Range/Map No: 05.30.16.82 STATION BS HI FS ELEV. Benchmark Alt. BM Bldg. Sewer SUHt Inlet St/Ht Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bot. System Final Grade St Cover BED/TRENCH DIMENSIONS Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER OR Manufacturer: Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia 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 Bed/Trench Edges Topsoil ~ Yes ~ No ~ Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / /. Location: 2286 170th Ave. New Richmond, WI 54017 (SE 1/4 SE 1/4 5 T30N R16W) 40 acres Lot Parcel No: 05.30.16.82 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? ^ Yes ^ No '~ ~ ~ ~, I I j i Use other side for additional information. I_- J Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) a.[[~, 4l{IILG` .___ 7.ip {,Alfp ~ V\~ [ • .w~L FAR NNING & ZON-N S~' /,y ~~,~ t3eation ' A,Vpc n!'BaiititiieR deck sll that a~-ly) y ~ R- ~ # T~® M' R ~~i Q ~ 1 ar 2 Pemil 1h 11i ' y ve sB -. Number of ~adr ~.. ~d ~Q y\ ~ Sabdiviaion Narrx Pubiic/(=onanerniet - Dnacrit~e Uaq ~M' HMdc ~ C~.r'i~Y' G day a 9Mle Owned M ~rNfe Use ca,, r- ~f ' Numtr+r ViNa~e of CS1Vf Town of C y' lii. 'i"~)t Af i'~~ (ChtMk Only etas lbatt as line A.. Ctrinplata one B #~tip~taWo) ~`' ldew 9yatem lteldammanl 'f+~/nwM/teMdia Tsnk B Replacemoat OMy odor Modification w Batbliag (explain) system B. Permit Poliltit it~.wiafon Change of 7'etmit TraaiFer to List Pmviors Peratit irientber and Data Issued Retrevwil tletbre 13x ration Plumber Naw Owner rv orrow[rs >vnav l~e: er6eek.:l chat Non-Prarruriaed tn-c3mund lh~urized 1n~Cironnd AtrCliiade Mound _>_ AA in. of wila6le roil Mound ~ 7A ia. of atNreble soil FitdQing 'l'ank ~ Uthq' D aai ( ~) ^ -f - Y' I ajy) Za Y. ~ V![ratt~rerrt elsat >Gaf'nnint«tMn Ct < C ,e I)asign Flaw (gpd) 1)raign SaU Application Rmo(g~det? Dtsperaal Area iteggimQ I~ tN>tpmeai Atre Proposed ~~ 8~stepl Elttnetion V!. Tsutk info Capacity in TMeI f of MpwlLaWrer Maiterial t3alipsls Cialions I3idts Nair Taaka Bacieling Tmka SgNicar 1#alding'fank /-Z `eser c ~~ Vii. Reitpia~lblNty ~tatetrtenh I, the , asweae Ibs'tinb nice POAiVTBt N tl~aatbtehee P6nnUer's Name lk'ritttl Pltaatrgr'a iBnapae Nnmber Bnainesa Phase Nwaher !Jy c"!s`a yn S'Cs~iG-,i+s a~la s- ~ ~2 Q ? ~~''~` t2 Pinmher's Addl'ess (atlt'.81, Croy, State, T,ip Ct-de3) l d 7~ cZf'-i'e~ .sue d~/ ~' ~~L a l 4' VIII. Crpl /De fit U~ -~ Ayptiwed --- D'~pQrm'at l/ ._, t)wnar (}iven ltoaaon ffnr Denial Parinit~ $ / L /' ~ l~tetasued s~ABa~t i /r ~ 7 ! /p a G~ ~ i~.~~YSTE 1~l O~I~uReasmaa li-~r Abappirovel 1 Septic tank, effluent filter and dispersal cell must all be serviced /maintained as per management plan provided by plumber. _ 2. All setb as per applicabl °1 ~ 2cV0~ ~t 1, ~ cf.~. - avg. ~ ~L°1b S! ,;a4e o~~11~y,\~~ ~ i~~~~J 6001 ~'i 1~~/~Lst~~ ~ ~.,Qa~.~-~~~ ~~~ STS. ~~,v~~ >~ M Ili. ip.~1y~ paler~t lw. Aron 4usx 1A tndrs ri rise ^ ~ Gtr°/®..,1l/' - (>/•(~;~~GL~/2 ~ /p/~ 3' !,X/~/~, l~~ - ~/~ `~c~ ~ '- U . n- r•R. ~~ ~ >iro~ ~ - llwc d u,~ ~~e2 S S '~ .moo ~~''" ~l~~ 3 C~n2 four ~ S ~~~~.. ~.. ~ r ~, ~~ ,, ,r ~;~ . y. / ~~-'~ /tie ` - `` E `, . ~-- ~~ ,~1. ~ ~~ ,, ~ ~ _ ~"~, F ~y , ~~, ! °~'3 ~ da't' 1j4~ ~~~ ~° IN a 4 ~~ a ~~.,~ _ ~~ -~ ~ c ~ ~- !"~< i ,. ~: -. y < `~ ~ ~~ ~~~ ~~ n ~ ~ ~ ~~~ ~ 1~, w ~ ~ ~~ ~~ ~~~ ~~ ~~ , ~. ~ i~ q. ~~ ~ ~ ~ n c ~ . ~ ~ ~1 i~ A .y z ~ . `.~. ~- s50ooom E 551 Doom E om E ~ JOINS PANEL 0115 55200 e r y. , & i~. -u- ~ 4 y ~W7. .. ia~ .- ~ _~G1, v~. s w ,e;~5 ~ ~ 33, a zoNE A~ ~ ,~s ~ ~ ~.. t ~ ` .. ~ ~. Y ~ ~ t,~~, ~ s ZONE i4 .. , <, l~~ µ`% Y n r t~! ~j ' ~t F yt~ ~ ~r tr., ~~ s~l;; _ r7 ~~ [u .I v ~1 - .; ~. JJ ti ~~ '~~ i •t 6.Y~ ~ :'k i~ 5 ~ 1 i r i H ~ - r F fi - ,, ~'"-. i ~ - ~ ~1, ~-~='. r ~~I ~ ~'~ . -~L-. ZI ~ fl '~ ~ ~ ' / ~ }' ly s~ ~ ~ ~ 1 ~ t ~~ 1Xr ~ 1 r ~~ •t<. -~' '~ '' V ~ ! _'D } ~F _aY N'K~'~ 'TT ~ ~ t~~f,' .. SST _.~ ~!~, UNIl\T~ l Q0~~59 ~i ~ +Y- i~a ~ ~ ~~, , 1 ~ ,yr, ~ tali ~~ y ~ ~:sk~~~. ~., e' ~ '•t ..11 i ~`' 3 4 .. ^ u-b 5'%.:i ~: ~ t~ p.. _ ~ _, s . .~ ~ ~' .~ , , r*s ~. ~i k. ~4, ~ '~ ~ ~~~ m • ~~ ~ ,, ~~s _ _~ti ~ ; ~ r C ~s 4%t ~;~`.~ K yr ~I(, 1 xf ' ~ ` T ~~`~~ t ~ v~ ~ ~ r'~gpQ c a ~ }~F, - -:y.w ~ Y' Jon Sonnetag From: Rod Eslinger Sent: Tuesday, December 12, 2000 8:15 AM To: Kevin Grabau; Jon Sonnetag; Mary Jenkins Subject: FW: Floodplain Requirements -----Original Message----- Erom: Jansky, Leroy fmailtoajansky@commerceatatewi,usj Sent: Tuesday, December 12, 2000 8:09 AM To: Barron County; Brettner, Jackie; Eslinger, Rod; Farmer, Darryll; Helgeson, Mike; Herrick, Cleo; Jain, Kenneth; Koehler, Jim; Peterson, Dan; Peterson, Larry; Shambeau, Jay; Spanel, Gary; Tesky, CeCe Cc: Kaminski, Roman Subject: Floodplain Requirements A question has recently been asked with reference to county plan reviews of systems that are located in the floodplain. The following message addresses the sanitary permit issuing agent's (SPIA) role in such reviews. Reviews by the department are outlined in Tables 83.22-1 and 83.22-2. Systems located in the floodplain are not included in the tables. An "Application for Development of a Flood Plain" (SBD-6698) form (formally known as a Plb. 89 form) is no longer required by the department for development within the floodplain. When a system is to be located in a floodplain area the following code sections need to be considered: 1. Comm 83.32(3, Wis. Adm. Code states that no part of a POWTS may be installed in a floodway except as provided in NR 116, Wis. Adm. Code. 2. Comm 83.45(6)(a), Wis. Adm. Code requires POWTS treatment and holding tanks to be watertight. And (6)(b) requires vent and observation pipes to terminate 2 feet above the regional flood elevation. 3. Comm 83.43(8)(g), Wis. Adm. Code requires POWTS treatment and holding components installed in areas subject to soil saturation to be anchored to prevent flotation. \ ~ Comm 85.4 3 a e Wis. Adm. Code requires the site r_egort to include the floodplain elevation (RFE or regional flood e evation), and the surface elevation of any adjacent navigable waters or reservoir. n,,,,,~,~~, SyS.~i{~,1,~ ~p 1"~Q' In addition, it is recommended that designers/installers check with the DNR for any requirements or permits required by them for disturbances such as excavation and/or filling in a floodplain area prior to plan submittal to the SPIA. It is my opinion that the county SPIA may review and approve POWTS plans within its' scope of authority that are located in floodplain areas as long as the review considers/addresses the above referenced requirements. ~~• ~©~3Xa~ S. e. 7 ~/~ /a ~ ~~~ ~~ ~,~ ~ z ,,,~ ~,~, ~2 , -, ~~- /9 ~~ y ~ - .~ ~z~ ~z s- ~ is ~~ ~',~ 3 ~ ~s ~ ` 109 z . 3z o, 3 ~ ~~`~ ~ ~ S. ~~~3. .~'_ a fp B2, 1 `~~ ~~' 3~ ~a~z 'p-~ ' ~t ' /v~ ' ~/ ~l /5. z /p7 ~~~ ~`~- s ~ ' s<,~ ~. ~~ °~_ j~~ f ` ~~ ~_~ ~~ ~ ~~ ~ ~ c~j _ ~~ ~ ~ ~ ~'Z ~ ~ ~3 ~~, ~ ~o~ j, ~~ -9 `,''~ ~ ,~`~- . ~~ ~~ ~~~ ~~ -~ ~t i ~~ M ~~ r y r ~~ .w ~~ ~i Q r A !°1 T ll"'i ~ • i a< •_~_~~ ~~~ ~1• • Q M ~'~a° s ,~ ~~~ ~'-v 's ~O ~ y ~ ~G T f n r e -~ x e ^^ .,. srsw ~", r rs ~y - ~t ~s x p L1r ~°° a a r .. ~~ "" +~so r ~ ,,; ~ 4 ~ s 3 ~ ~j ~` ~' "~ z-- ee~~ Q ..;' ~t ~~ Q~ L Rio '~ .~-.`~ tee, -~~- SEPTIC TANK ~ PUMP CHAMB .~~ IQN AND SPECTFICATIO:~S~ -~. ____. 4" Cx VENT PIPE x2" MIN, ABgV~ ~,D~ ~ W~ATH~RPRQOF ? 25' FRAM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR. INTAKE WITH CONDUIT MANHOLE COV FINISHED GRADE ~ :,, :: W/ PADLOCK 4" CT RIS~~R WARNING LAB ----.__.__ ~-- ~ ,r MIN . 18" IN ~ _ 6" MAX. .. INLET ...:.., .-~, ~s .. ~ ~~ WATER TIGHT SEALS SAS, ; ' xIGHT ~ `~ ~I PPR4VED .~ BEAL ~ ~ ~PROVEq ~ ~ ~ JOINT'S WITH PIPE 3, ~ ~ , ALM APPROVED PIPE lNT4 SQL I D ~ ~ ~ ON SOi.I pTSOI L ~OI~. PUMP OFF ELEV . ~''~ , . ' - + ~ OFF 'TM's RISER EX 7 PERMITTED OT IF TANK ,; M.9NUFACTUR£F 3" APPROVED BE~A~~dQ (~~~ ~,~,~ HAS APPRdVAI CONCRETE PAD SEPTIC / DOSE SP.~t.. TANK MANUFACTURER: ~ t•~?,S~i~~ TANK S~I~ES,; SEPTIC I~j p (;AL. ~. DOSE ~~~~ GAL, A LAR~M MANUFACTURER ; ~R+~~T MODEL NUMBER. SW T TC H TYPE : '~*ne_A,s,~,_ PUMP MANUFACTURER ; ~~ MODEL NUMBER : ~p d SWITCH TYPE: ~.~~~ ~~ REQUIRED DISCHARGE RATE ~ ~ GPM ~~~~ AQ~~S PER DAY : ~'` DpB~ VAi~E INCLUD''NG ` F LOWBAC K : IJr ~ GAL . C.~I'~1G,~T~~,~,; A = ~,o~ INCHES = ~I,~^GAL E ~ ~ INCHES ~a GAI C = ~ INCHES = ~$ ~GAj D = ~ INCHES = ~ a~, GA' PUMA' ~ AI„~#RM WIRING AS P£R Z LHR 16.23' W, VERTICAL DIFFERENCE BETWEEN PUMP Q~'~' ,~,~~ I~I~TR~BUTION PIPE la~ FEET + MINIMUM NETWORK SUPPLY PRESSURE • + - ~.Q FEET FO~tCEMAIN X ~~0 ~'^~/~,qp ~~, ~ 2.5 FEET ~•.,_. F~~Q~'TON FACTf1R ;~'+ FEET '~?~'+~~ ~~NAMIC HEAD = -~,~~~~FEET INTERNAL DIMENS?'ONS QF PUMP TANKi LI~~~'H WIDTH; DIAMETER ---- ~ ~ G-,~L pee ~ ° SIGNED: ,..„ l') DATE: ~GOULDS PUMPS APPLICATIONS Spedfically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS • Solids handling capability: 3/a"maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size: 1'/~" NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F {40°~ continuous 140°F {60°C) intermittent. • Fasteners: 300 series stainless steel, • Capable of running dry without damage to components. Motor. • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. •EP05 Single phase: 0.5 HP, 115 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: l0 foot standard length, 16/3 S1TOW with three prong grounding plug. Optional 20 toot length,16/3 SiTW with three prong grounding plug (standard on EP05}, • Fully submerged in high grade turbine oil far lubrication and efficient heat transfer. Available for automatic and manual operation. Auto- matic models include Mechanical Float Switch assembled and preset at the factory. FEATURES ^ EP04 Impeller: Thermoplas- tic Semi-open design with pump out vanes for mechanical seal protection. METERS FEET 10 g 30 s 251 ~ 2 x ~ b Zp ~ s 0 1s '~ 4 ta- 0 3 10` z 5 1 0 oa Submersible Effluent Pump ~~ 3 V ~ 1 EP05 ^ EP051mpeller. Thermoplas- tic enclosed design for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ^ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ~ Motor Cover. Thermoplastic cover with integral handle and float switch attachment poirlts. ^ Power Cable: Severe duty rated oit and water resistant. CAPACITY ^ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTING ~~ Canadian stanciaids Assodation (tSA listed model numbers end in "F" or "C".} Goulds Pumps is 1509001 Registered. 10 12 m~/h Goulds Pumps ~ 2000 Goulds Pumps tiJ' ITT Industries Effective February, 2000 83871 to zo 30 40 50 GPM / / f -----_ Q ~~ Y m ... w a rn N N O O W O .A ..0 Wisconsin Department of Commerce Division of Safety and Buildings Plan must ches in safe er of less 8 1X2 x 11 a Att h l t it l in . an on pap Ha ac comp e e s e p n indude, but not limited to: vertical an ~t (BM), iredion and percent slope, scale or dimensions, north arrow, and location an i ce to nearest road. Parcel LD. ~~~"i -"' n '"" ,~ - Please print all information. Revs d ~ Dat Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). .. l,(,(/~ ~ ~ ~ 6 Property Owner ~ Property Location ~ ~ ~ Govt. Lot L_ 1 /451 /4 S ~ T N R GT E (or Property Owner's M 'li Address Lot # Blod< # Subd. Name or CSM# City State 'p Code Phone Number ^ City ^ Village To N r t Road )/ J/ ~-77 ° n ~~ 3 Zl~b~b ~ 7~ , ~ ~ 1./~~ /. L i ( ~ f New Construction Us ~ Residential / Number of bedrooms Code derived design flow rate ~U Q GPD ^ Replacement ^ Public or commerdal - escribe: _______. __~_-_- ___ _ t' ~' Parent material s S~Y~ ~ Gz~--~ 7-ci ,rf `' ., Flood Plain elevation if applicable/, _ ' / ~ ft. General corrurser>ts J ~ I ~. J~l/Ci'~~'" "" ' <°~ , ---~'i~~ f~l~~fJU1 ~ i/ ~'^ ' ~j4f ~ . and recommendations: S c ~1~.~.,, G ~n ~ ~ nI ~~ ~ r, /~~ 1 2~,f~/~ J~L; C7 ~ ' v l y~~G'r/yU ~- ~~/ ~ ~ nng ~`~~" ~ X.11k '; y,,''~?ar;I/L~r.~~ Z -~7~}v~+~Vl~l/U ~~wt/ ~ri`~ ~~ # pit Ground surface elev. ~!`~~pth to limiting factor ~~~.~ in. ` ~ ~ Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~Z -~, mss" - ~ ~~ ~ ~ ~ ' ~~ ~~ . ~. , ~" ^ Boring l Gt;a/,i.~.~--~ .•~r~.~,-,- -- ~n /~/lr~~ 0`~ pit Ground surface elev Depth to smiting factor m• Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~ •~l ~ ~~ 3~ '~~ S~ ~ ~ s~' ~ ~ • ~ / ~ ~~ r _._.. S J^ ~ ~~' r/~ ~ .. / t J 7 v Gf~ ~~ Effluent #1 = BOD > 30 < 220 mg/L and TS5 >30 < 1 ' tmuent iF1 = ~sw < su rrxyi_ ana i a~ ~ su mcy~ CST Name {Please Print) ~ ' ~e CST Number Bird Plumbing, Inc. Shaun Bird ~°='"~~ 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 ~_~-~ ---~~~ 715-246-4516 S SOIL EVALUATION REPORT ~ pa of ~ ~t'!G??~~ E oat/~~ ~~ ,? in accordance with Comm 85, Nis. Adm. Code <r-~ , ~C~/ a County J •~.. C T~ j ~' CJ { ~ Property Owner Parce~ ID # Page of Boring # ^ Boring 3 Pit Ground surface elev. ~__ ~. Depth to limiting factor --~ in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 7 a Boring # ^ Boring ^ pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIfC- in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 ^ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil icaflon 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 'Effluent #1 = BODE > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-6330 (8.6/00) r Soil Test Plot Plan Project Name Pat Howell Sha rd Address 1784 215th St. New Richmond Wi 54017 C #226900 Lot ----- Subdivision ------- Date 4/10/04 SE 1/4 SE 1/4S 5 T 30 N/R16 W Township Emerald Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 1 /2" pipe System Elevation 103.3/102.0/100.5 *HRpSameasBenchmark Alternate Benchmark Top of 1/2" pip 98.3' ~ ~ Q T--~ f_ ~ 7D S~ ~ ~+ Z~~~~ -_ fO1.54 -t~30 - Z.G M s = /urn. ~ s50ooom E s51 of om E JOINS PANEL 0115 552°I Im E ~' ~ ~ I ~~ ~ ~ I, :' e °~ ~'~ ~' Fr.] F~ Y . , ~ ~;- 33 ,~ zorvE a.j j ,, - ZONE A '< '~ r Y u_M - - - e ~ ~~a'.M~ ar ,. ~ _. __ "' .. i. Ir yr~? art .V•' ~~yk, - ~ t • ~C ft ~ ~r - .. y.. fl ,{ fit - 4. "i5~ ~. 5 , > - yy }y~~~ ~, rtS ~ 4:~. , y~,: `~ ZON - ~. ~ hFf ~,Ta '~ ,.~i ~~' r i~ ZONE X ,_., ~,, J 3~~~ ~ ?: ~~. I L ~' _ Y ~ y~,~_ ti': ~~ A ~a ~~., . . y . •. _~ w~'~ - ~. i ~.. ~ ~ . ~ e. ,. - u ~ z.: UNINCOR ti ~t ~' .~ ~ ~ Q' g .~•- . ~ ~K.~ ~ ~ ~i ~~~ ~ ~~~ ~ ~,, '+'~ {~ d .,' II r ,i.'. Y y t r .a,j u,. ,1~4. e+~~ ~ Sri •. r. G .1 I. ~ - i r ~.--- -- -- -- - - ' ` ~ .~ ZONE A `Fr~a,Y, - -- - ~ 13zo' ,~ ~ T~ ~ ~ 1 - may. ~ ~;,, 13zv ~-y Q-= ~, ~ _ ~ ~-~ ~ ~~~~~ L ~ ~ ~, ~___.-, 7° ~ ,. ~~ ~ qtr 's~~YU. U~trtned .tilrrrri~ ~~_. ~"~~ ~ ~r ;_ ~;. ;~ ,, ~ ~ ~. ~t. , u. y - ~ ~, ~ ~-- v ~ ~" ~. ~ ~ ~n .~, - r Jon Sonnetag From: Rod Esiinger Sent: Tuesday, December 12, 2000 8:15 AM To: Kevin Grabau; Jon Sonnetag; Mary Jenkins Subject: FW: Floodplain Requirements -----Original Message----- From: Jansky, Leroy [mailto:Ijansky@commerce.state.wi.us] Sent: Tuesday, December 12, 2000 8:09 AM To: Barron County; Brettner, Jackie; Eslinger, Rod; Farmer, Darryll; Helgeson, Mike; Herrick, Cleo; Jain, Kenneth; Koehler, Jim; Peterson, Dan; Peterson, Larry; Shambeau, Jay; Spanel, Gary; Tesky, CeCe Cc: Kaminski, Roman Subject: Floodplain Requirements A question has recently been asked with reference to county plan reviews of systems that are located in the floodplain. The following message addresses the sanitary permit issuing agent's (SPIA) role in such reviews. Reviews by the department are outlined in Tables 83.22-1 and 83.22-2. Systems located in the floodplain are not included in the tables. An "Application for Development of a Flood Plain" (SBD-6698) form (formally known as a Plb. 89 form) is no longer required by the department for development within the floodplain. When a system is to be located in a floodplain area the following code sections need to be considered: 1. Comm 83.32(3)©, Wis. Adm. Code states that no part of a POWTS may be installed in a floodway except as provided in NR 116, Wis. Adm. Code. 2. Comm 83.45(6)(a), Wis. Adm. Code requires POWTS treatment and holding tanks to be watertight. And (6)(b) requires vent and observation pipes to terminate 2 feet above the regional flood elevation. 3. Comm 83.43(8)(g), Wis. Adm. Code requires POWTS treatment and holding components installed in areas subject to soil saturation to be anchored to prevent flotation. Comm 85_ 40(3~a^ Wis. Adm. Code requires the site report to include the floodplain elevation (RFE or regional flood ele ation), and the surface elevation of any adjacent navigable waters or reservoir. In addition, it is recommended that designers/installers check with the DNR for any requirements or permits required by them for disturbances such as excavation and/or filling in a floodplain area prior to plan submittal to the SPIA. It is my opinion that the county SPIA may review and approve POWTS plans within its' scope of authority that are located in floodplain areas as long as the review considers/addresses the above referenced requirements. Cort'ec~' C:-~..~e~n ~S. `Eo~3X4~ S. e. ~ / `,~,, i~ f ~,,~ ~~~ ate. Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 labor and HumaF~Relanons rlivimn nF C~fn!v R RI lilrlirv~c w ~_ n__I_ " - III QliVV1V ~IUI ILI II ~ VJ.V.J, •.IJ. /~VI vv~v COUNTY but Plan must include i i 8 1/2 11 i h l th l St. CroiX , n s ze. x nc es ess an an on paper not Attach complete site p not limited to vertical and horizontal reference poi 'on and % of slope, scale or PARCEL I.D. # ~~l ~ d ' ~ /~ '~ ~ ~ 3 dimensioned, north arrow, and location and d' _rtFd,tc~ r. ~t ro L. YS( ~ ' ` "'' ~' ~ ` J,~FO~RI~fA ON APPLICANT INFORMATION-PLEA \1PF~YFIT L VIEWED BY DATE fZ.~r.~~ ~ f PROPERTY OWNER: Sp ~ ~~` -' ?' PROPERTY LOCATION _ amara ~ ~~ ~~ ~` - GOVT. LOT S~ 1/4 SE 1/4,S 5 T 30 ,N,R 16 f(or) W G A R M P r pvg~ ,~ ST C LOna BLnaK # # Snap. NAME 0 M ' ~ ' ~ ...__ , Ave RoI 2580 170 th Q Ci ~ CITY, STATE ZIP BER ~~ ` ^CITY ^VILLAGE ~]fOWN NEAREST ROAD Glenwood City, WI. 54 71 1 ~ Emerald 170th. Ave. [~] New Construction Use [x] Residentia ~ m e Al 4 [ ]Addition to existing building j ]Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate • 4 bed, gpd/ft2 •5 trench, gpd/ft2 Absorption area required 500 bed, ft2 500 trench, ft2 Maximum design loading rate • 4 bed, gpd/ft2 •5 trench, gpd/ft2 Recommended infiltration surface elevation(s) 89.50 ft (as referred to site plan benchmark) Additional design /site considerations system el . based on contour line of el . 88.50' Parent material pitted glacial drift SQ ~ ._j~ct~ 2 Flood plain elevation, if applicable na ft S =Suitable for system CONVENTIONAL ^ S L~U MOUND ' ®S ^ U IN-GROUND PRESSURE ^ S [~U AT-GRADE ^ S ~] U SYSTEM IN FILL ^ S ~ U HOLDING TANK ^ S L~U U =Unsuitable fors stem SOIL DESCRIPTION REPORT Boring # .................. ................. .................. ................. 1 Ground elev. 89.8 ft. Depth to limiting factor 38" Boring # 2 Ground elev. 87.2 ft. Depth to limiting factor 32" Depth Dominant Color Mottles T t Structure Consistence Baxxiar Roots GPD/ft Horizon in. Munsell Qu. Sz. Cont. Color ex ure Gr. Sz. Sh. y Bed Trends 1 0-12 10yr3/3 none 1 2msbk mfr cs 2f .5 .6 2 12-20 10yr4/4 none sicl 2msbk mfr gw if .4 .5 3 20-38 7.5yr4/4 none sl lcsbk mfr gw na .4 .5 4 38-43 7.5yr3/4 c2d 7.5yr5/6 scl lcsbk mfr gw na .2 ; .3 5 43-70 10yr5/6 fractured 1 meston na na na na np np Remarks: __ 1 0-11 10yr3/3 none 1 2msbk mfr cs 2f .5 .6 2 11-21 10yr4/4 none sicl 2msbk mfr gw if .4 .5 3 21-32 7.5yr4/4 none sl lcsbk mfr gw na .4 ~ .5 4 32-37 7.5yr3/4 c2d 7.5yr5/6 scl lcsbk mfr gw na .2 ~ .3 5 37-55 10yr5/6 fractured 1' meston na na na na np np Remarks: PROPERTY OWNER James McNamara SOIL DESCRIPTION REPORT PARCEL I.D.# P/O-~O/ 3 ~O Boring # 3 Ground elev. 86.7 ft. Depth to limiting factor ~a ~~ 4 ~ + L age 2 ' olj 3 i H Depth Dominant Color Mottles Texture Structure Consistence Baxxiary Roots GPD/ft zon or in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trer~ 1 0-1'L 10yr3/3 none 1 2msbk mfr gw f 2 12-20 10yr4/4 none sicl 2msbk mfr gw if .4 .5 3 20-28 7.5yr4/4 none sl lcsbk mfr gw na .4 .5 4 28-36 7.5yr3/4 c2d 7.5yr5/6 scl lcsbk mfr gw na .2 .3 5 36-50 10yr5/6 fractured 1' eston na na na na np np Remarks: SBD-8330(8.05/92) .' STEEL'S SOIL. SERVICE Gary L. Steel _ 1.554 200th Ave. CSTM2298 James McNamara New Richmond, WI 54017 MPRSW 3254 s~sE4 s5-T30N-R16W (715} 246$200 town of Emerald N 1"=40' BM.= top of Co. GPS survey marker C el. 100' v~~~~ z~ ~~ ~^ ~~ C,evnan~ 66 ~6~ i Gary L. Steel 12-7-97 I `Parcel #: 010-1013-30-000 04/02/2007 11:02 AM PAGE 1 OF 1 Alt. Parcel #: 5.30.16.82 010 -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 Co-Owner O -HOWELL, PATRICK M PATRICK M HOWELL C -GRABER MICHELE L GRABER MICHELE L 1784 215TH ST NEW RICHMOND WI 54017 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description SC 2198 GLENWOOD CITY SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 5 T30N R16W 40A SE SE BlocklCondo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 05-30N-16W Notes: Parcel History: Date Doc # Vol/Page Type 05/04/2006 817992 EZ 06/30/2005 799034 2833/377 EZ-U 02/27/2003 711431 2156/486 WD 09/02/1999 609700 1453/639 WD more... ~nn~ c~ inenn n vv Bill #: Fair Market Value: Assessed with: Use Value Assessment/ Valuations: L st Changed: 05/30/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 15,000 43,700 58,700 NO AGRICULTURAL G4 8.000 900 0 900 NO UNDEVELOPED G5 30.000 45,000 ~ 0 45,000 NO Totals for 2007: ` ~ ~ s~ Totals for 2006: ` -~ ~ ~a~ ~, Lottery Credit: Specials: User Special Code I ZZZ~ ~° ZZ~ Amount ~(~ _.,.....,..~nt Charges u.uu 0.00 0.00 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer ~~~ Mailing Address ! ~ ~ ~ ~ _~~ ~h ~T ti •CtJ ~~~ `~ ~` hz ~~, ~ ~` ~'6C ~ Property Address (Verification required from Planning & ~Goning Department for new construction.) City/Statel'~~~2~ ~/VIa/1~1~, Vl/~ Parcel IdentificationNumberf.~/a~f~/~~~ OC3~1. ~'Z- LEGAL DESCRIPTION T Property Location S~ 1/a , ~~ 1/a , Sec. ~ , T .~~ N R1~W, Town of ~Y'~ e ~hJ Subdivision ~~ ~- ~f'" C S ,Lot # Certified Survey Map # ,Volume ,Page # Warranty Deed # ~ 1 ~ ~f3/ ,Volume ,Page # ~ ! S~ Spec house yes n~ Lot lines identifiable yes ry~ 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. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe 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. F` _0 1. R ~/ PLICANT(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. (REV. 08/05) POWTS t)WNLR'~ MANUAL ~ MANAGEMENT PLAN gage ~ of Z" FILE INFORMATION Owner ~cx. ~' ~a crl~ //i Permit # 5`~~S~d~ i.~..~. rr.,e.._ ~,q DESiCiN PARAMETERS Number of Bedrooms ~~ ^ NA Number of Public Facility Units Q NA Estimated flaw {average) allda Design flow tpeak}, (Estimated x 1.5) ~p O © ~i/da Soil Application Fiats S &I/da 7ftz Standard Influent/1=ffiuent Quality ~ , Monthly ave~apa* Fats, Oil & Grease (FOG! ~ 530 mg/l Biochemical Oxygen Demand (BODE) ~ 5220 mgll. i~ NA Total Suspended Solids (TSS) 5150 mg1L Pretreated Effluent Quality Monthly avar~gs Biochemical Oxygen Demand (SODg1 530 mg/L, Total Suspended Solids (TSSI 530 mg/l. f~ NA Fecal Coliform {geometric mean) 510" cfu110Qm1 Maximum Effluent Particle Size Ys in dia. ~ NA tither: ~~ C~ NR * Values typical for domestic wastewater and septic tank sff{gent. fiYlRTi311A SPECIi:ICOTi(]NS Septic 'lank Capacity ~ a.s ~7 al ^ NA Septic Tank Manufacturer ~ ` ~SZ,iZ ^ NA Effi~lppt Filter Manufacturer f~~}~,` ",6~r;~/~ ^ NA ffiuenl: Filter Mode! e .__.__ ~~'' ^ NA Pump Tenk Capacity g Q t7 al ^ NA Damp Tank Manufacturer W` ~~-Se ~ ^ NA Pump Manufacturer G O pia ~, ^ NA Pump-Model ^ NA Pretrea;ment Unit ^ NA Q SanCl{Gravel Filter ^ Peat Filter C7 Meghi3nical Aeration ^ Wetland q i~isirtfection ^ Other: t'~ispersfal Califs} ^ NA A In~Ground Igravityi ^ In-Ground (pressurized! CD At-firade D Mound Q I~rip~Lne D Other: tither"s; ^ NA Oth@r ^ NA Otharc .- ^ NA FViHlnl r CIVFlFY4L a7N1'ICIJ~JLC Service Event Service Frequency Inspect condition of tank{s} At least once every: ~ ~ yea~~$?{s) tWlaximum 3 years} ©NA Pump out contents of tanktsD _____ When combined sludge and scum equals one-third (Y3) of tank volume~+ ^ NA Inspect dispersal cell{sl At !asst ones ever Y~ ^ month{si (Maximum 3 years} ~ year(s) ^^-~ ^ NA Clean effluent filter At least once every: ^ monfhts) ~ ff ~ ~3[ year{s) _ C] NA ^ monthdsi ^ NA Inspect pump, pump controls & alarm At least once every: ^-• ^ yaarts) ^ month(si ^ NA Flush laterals and pressure test At least ante every; ^-- ^ year{s? Other: ^~ At least once every: ,~ ^ month(s) ^yaarts} ^ NA Other: DNA MAINTENANCE INSTRUCTIONS Inspections of tanks and disperse! cells shall be made iaY i1r! ipd~vidual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer, POVHta Inspeatpr; Pp1NTS Maintainer; Septage Servicing Operator.. Tank inspections must include a visual inspection of the tanks) tc~ id®nti~y any musing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and tq check for any beck up or ponding of effluent on the ground surface. The dispersal ceN{si shall be visually inspected to check the efflu®rtit levels in the observation pipes and to check for any ponding of effluent an the ground surface. The ponding of effluent on the grraund surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of siudgs and scaurtt in any tank equals Qne-third (Y31 or more of the tank volume, the entire contents of the tank shall be remavsd by a Septag+a' ~ervioipp I~perator i,nd -disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicsing of effluent filters, mechanical or pressurized components, pretrdatment units, and any servicing at intervals of s12 months, ahltll be pQrfarmed by a certified POWTS Maintainer. A service report shaft be provided to the local regulatory authority wl~Chin 10 days of completion of any service event. Page ,_~!__ or 'v &TART UP AND OPERATION For new construction, prior to use of the POWTS eh~isk #r1-~~r~iriit t+~kl•1 ~Pr tfie presence of painting 'products or ether chemicals that may impede the treatment process and/or darlf~d,~~~, ~i^tt~jl b~~~{~1:: ~{ high concentrations .are detected have the contents of the tanklsl removed by a saptage servicing opera#~tr '~tl+~ ~- u~ System start up shall not occur when soil conditions dry ,ff~lt+ i!t ~~ iRf{Y#'i4'~Me surface. During power autagas pump tanks may fill above hflrrtt~E h~t~h~~i~r 1+~~1Mrr power' is restored tfio excess waeteanrater witl be discharged to the dispersal celNa) in ono large dower ~~~ril~~dih~ t~ {~{r}~ ~i'td may result in the bar:kup or surface discharge of effluent. To avoid this situation have the contents rf$ ~ ~ .~', rItd ~bY a 8eptage Servicing Operator prior to restoring c ntact a Plumbdl' ~~ 'N~~'~~~ ~M.~, tl~p~ '~~ ®~ist in manually operating the pump controls to power to the effluent pump or o ., . restore normal levels within the pump tank. Do not drive or park vehicles over tanks and disper~ppjl;.~3~I}i~~ {~~} r!!~t ~i`1tfM pi`;klark over, or otherwise disturb or compact, the area within 16 feet down slope of any mound or at-grade ~~ I~~at{l~r'l ~i'bh, Fleductian or elirhination of the #ollowing from the >ilt~r~tM-~#}~I~t #ki'trrllii~l Rtil`i~ ii~nprove the performance and prolong the life of the POWTS: antibiotics; haby wipes; cigarette butts; ~ ~~q~iii'~t~q +~ ~-~~; degreasers; dental floss; diapers; disinfectants; fat; ~~ ,Qf grease; fierbicides; meat scraps, medications; ail; foundation drain isump pump) water; fruit and vtt~bl~ ~~!#ilh ~; painting products; pesticides; sanitary napkins; tarri~i4~li; Il>riif ~~l~.~r iA ~i~liif`~lrine. ABAND011lMF.NT When the POWTS fails and/Or is permanently takeli dtlt tl$ serkld~ ~lei~l ~4~EbWr!pg steps shall be taken to insure that the system is properly and safely abandoned in compliance with ol~~ptdr t~bilht'r1 ~i~'~~~~ iy~~Pnsin Administrative Code: • Ali piping to tanks and pits shall be disconlt`il~{~~ ~IhCI ~hP ablW{wf~tld~i~ plpe+ openings sealed. .. ~. `' di' bead of b a Septage Servtcing Operator. • 'the contents of all tanks end pits shall be r~lttr~.V~ ~rrrsl ~rt#~{[~ly ~~- , . Y • After pumping, all tanks and pits shah be II~1>Iltrariil'l4tf ~ftd t~ri~~-v{td`~t their covers removed and the void space fined with soil, gravel or another inert solid material. GONTINQ~NCY PLAN tf tt-e PO fails and cannot be repaired the fdlliai+lrl{{;p l~~di~~l~+~ hh~~i Ij!i~en. or must be taken, to provide a code compliant replacem t system: A suitable replacement area has been evlil~r~t~l rri;~-, .~ 11~~I~k+l~} for the location of a replacement soil absorption system. The replacement area should be prap~ili~rp~i#d ~4grh ~lsdWi'~iip+itE;#nd compaction end should not be infringed upon by required setbacks from axisting end propoS~+ilr~l~it~lii Ilaki;~ll~~~ flfi~t` 7Yeiis. Failure to protect the replacement area wilt result in the need fqr a new snit and site eY~l~~idh i~ ~I~~~i~l~h ~ ~t~lteble replacement area. Replacement systems must comply with the rules in affect at that time C] A suitable replacement area is not avails ,{p qua fd ~~~~~~k ~lS?r soil limitations. Qarring advances in POWTS technology a holding tank may be installed l'I~:~ ~ r~prf ~i~`riptli}+~~1 the fatted PDWTS. ,` QO The site- as not en evaluated to identt~ir.,~i r?u~~bl~l I'spl+Il#I~~#~l~ area. Upon failure of the POWTS a soil and site avaluatton be performed tq locate a k1iic~(~~R rp~lillfit ~~ If no replacement area is availak~te a holding tonic may b tafle s a last resort to replace t`Fi+~ ;~ttf111.~1i ~~~~:~ ^ Mound and at-grade soil absorption cyst®M$ }11Ny ''~~ riN~i+~P#I'~~p~~ ~ Ptace following removal of the biomat at the infiltrative surface. Reconstructions of such py~ipr~s ir~,iet qd~ kith the rules in effect at that Lime. < <wA~-N~NO> > SEPTIC, PUMP AND OTHER TREATMENT TANKS liil~ ~ , ~, ~6SES AND/OR iN8UFFICIENT OXYQEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT ~'~~~ i~lt ,;, ~ : , STANCES. DEATH MAY RESULT. RESCUE OF A hERSON FROM THE 1NTERiOR OF A TANK MAY t3E ~I ...` ADpIT10NAL COMMENTS POWTS INSTALLER TAINEfI Name `1A .~ L ~I+~r!'!i~ _ Phone ? / ~' _ 3 8 --.~ 1 ~, / ~~ SEPTADE SERVICiMQ OPERATOR {PUMPER} ~ ~ ~ fATORY AUTHORITY Name Phone i~ri~ l S`3 ~~ ' (o v Wisconsin Administrative Code. This documsnt was drafted in compii~+nce with ctiaQter Comrn~il~i~{lill~'~ibiili~~li~stfi rand ~~~64i1}, i2i & i31, J 2156r `i86 I STATE BAR OF WISCONSIN FORM 2 - 1999 Document Number WARRANTY DEED This Deed, made between Jason A. Langer and Jo A. Langer, husband and wife, Grantor, and Patrick M. Howell and Michele L. Graber Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): SE1/4 of SE1/4 of Section 5, Township 30 North, Range 16 West, St. Croix County, Wisconsin. Recording Arca 7 1 1 4 3 1 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO. , MI RECEIVED FOR RECORD 02/27/2003 10:00AN EREgF+i ~ REC FEE: 11.00 TRANS FEE: 282.00 COPY FEE: CERT CDPY FEE: PAGES: 1 Name and Return Address WESTconsin Credit Union P.O. Box 269 New Richmond, Wi. 54017 010-1013-30-000 Parcel Identification Number (PIN) This is not homestead property. Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. Dated this ~~~ day of February , 2()03 t AUTHENTICATION Signature(s) Jason A. Langer and Jo A. Langer, husband and wife, authenticated this ~ d y of February 2003 + Kristina Ogland TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina Ogland Hudson, WI 54016 (Signatures may be authenticated or acknowledged. Both are not necessary.) ~ Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2 - 1999 ~) (is not) '~ ` • Jason A. Langer , --Q~ * Jo A. Langer ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. County ) Personally came before me this day of the above named to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. Notary Public, State of Wisconsin My Commission is permanent. (If not, state expiration date: __ •) Information Professionals Company, Fand du Lac, WI 900b55-2021