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012-1055-20-000
,consin Department of Commerce PRIVATE SEWAGE SYSTEM oafei~y8nd Ba"~~ding 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)J. 'ermit Holder's Name: City Village X Township Hoverson, Brian & Wend Erin Prairie, Town of .ST BM Elev: Insp. BM EI v: BM Description: TANK INFORMATION- TYPE MANUFACTURER CAPACITY Septic ~Z Dosing ~ p~ U Aeration Holding TANK SETBACK INFORMATION TANK TO ~ P/L ,~ _ WELL ._-- BLDG. Vent to Air Intake ROAD Septic ! > 5~ /V 6T ~ ti / to ~ •IF'~r "I Dosing > ~~ / 3 Aeration Holding PUMP/SIPHON INFORMATION /'1X-~! ~ ~ ~'t~V-~ Manufacturer Demand GPM Model Number ~ S~ 3~~' TDH Lift ~J Friction Loss System Head TDH Ft Forcemain Leng th , Dia. ti Dist. to w; u ~ 2 ~ O ( t~tvP-i i~rv v~+-i ~- county: St. Croix Sanitary Permit No: 506273 0 State Plan ID No: Parcel Tax No: 012-1055-20-000 Section/Town/Range/Map No: 25.30.17.386 STATION BS HI FS ELEV. Benchmark . z4 r~~•, c~ . ~ ~; ~ . r~ ~ r Bldg.'Sewer ~ ,b o S~ ,0`71 g~, ~~ SUHt Inlet 3DJ ~2 S ~~.~'~~ SUHt Outlet r-- Dt Inlet r o ~~. ~ ~ ~. Yo 8Z. Dt Bot~tom__ 0 2 7 Header/Man. .y~r- Z 3.06 `~ • ~ `~ ist. Pipe / ,s ti ~ 3 ~ ~~~~! 7 Bot. System ~ Finalnal G~ Q ./~ ~ O ~ , 101 St Cove ,~ ~' 3(~ ~• 7S y ~ ~ r enn n12Cl1DDT1(lAl CVCTFM ~ A c'-~f! 1 J~ ~, n . _ /~. __ ~ BEDITRENCH Width ~ No. Of Trenche_ ~ Length ~ PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ O ~( SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM L C Manufacturer: CH ER OR fNFCRMATION Type,QJ.~ystem: Y{~ / ~! ~ l,~ ~~~ ,~S ~ UN Model Numher l I~~ I~ ., ~ , ~ ~ , n Ate. ~ r11 [~T l1~~1 ~TIA\I G`VCTCIIA /~ //A ~ - - -- v v ~ - - Heade . `anifpld • I ~ ~! Length Dia ~. 5 Distribution v pipe(s) I ~ tr ~ / Length Dia Spacing_ x Hole Size r~C N I Z~ la / x Hole Spacing ~ ~,~-2 ~ l Vent to Air Intake e~~u nn~ieG _ ^____-_ e.___._.v_ ~_~.. .,., ee,...^a rlr A4_f_r~/In SvcTnmeSlnly OLf!'hLYi/-I - ~~ ...........~ ~ ~.. Depth Over -a- Depth Over __ xx Depth of - xx Seeded/Sodded xx ulched Bed/Trench Center Bed/Trench Edges Topsoil ~'~_ ~ ~ '=J Yes i~t, No i al Yes 'i No / . . -, ,, s COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:__ t! / ~' / ~° ' ~spection #2: t t ! ~ ~ /~ Location: 1385 200th Street Baldwin, WI 54002 (NW 1/4 NW 1/4 25 T30N R17W) 40 acres Lot C~' ~ rcel No: 25.30.17.386 1.) Alt BM Description = P 2.) Bldg sewer length =~~ r - ~ ~~~1,E~~~e~;u-~~Cc - amount of cover = /.I ~ --, Plan revision Required? Yes ! ` ~ No / / / 3 „~ I ~ ~ 6 G s Use other side for additional information. U 7 ~ - `-- __' Date Insepctor's Sign ure Cert. No. SBD-6710 (R.3/97) C0111ft1@f Cd.N-LgOY Safety and Buildings Division County 201 W. Washington Ave., P.Q. Box 7162 St. CTO1X non Madison, WI 53707-7162 Sanitary permit Number (to be filled in by Co.) 5 b tp 2~3 Sanitary Permit Appliea n Number state T io''n ~ f z / In accordance with s. Comm 83.21(2) Wis. Adm. Code submission of this f ro overnmental ` , , p g unit is required prior to obtaining a sanitary pennik Note: Application forms o e5 are Project Address (if different than mailing address) submitted to the Departmem of commerce. Personal information you p may be ndary see in accordance with the Privac Law, s. 15. 1 m Stats. ~. / 3 ~ Z.~ ~- 5d- L A lication Information - P int All Information . Property Owner's Name ~ Parcel # Brian & Wend Hoversan RECEIVED 012-1055-20-000 Property Owner's Mailing Address Propeerty Location 3g J U L 2 3 2 U U 1 ~ L~ 477 Sterlin Street South ~~ ~ City, State ~~ ilx counlr Phon Number NW '/,, NW ~/., Section (circle one) M l d MN a ewoo , 739-7032 T 30 N; R 17 w II. Type of Bailding (check all that apply) ok, u.d Lot ~ ^ 1 or 2 Family Dwelling -Number of Bedrooms ~~ +~~ Na Subdivision Name f p 14~ Block # G ^ Public/Commercial -Describe Use Na Na ^ city of ^ State Owned -Describe Use CSM Number ^ Viit~ of ,~y~ p X ~0~ /~o ~ n di Na Down of Erin Prairie III. Type of Permit: (Check only one box on line A. Complete line B if appikable) A. ew System '-~-~. ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System (explain) B• ^ Permit Renewal ^ Permit Revision ^ Change of Plumber ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. T of PUWTS S s tem/Com ent/Device: Check all that a ^ Non-Pressurized In-Ground ^ Pressurized In-Ground ^ At-Grade nand > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ Holding Tank ^ Other Dispersal Component (explain) ^ Pretreatment Device (explain) V. Dis ersai/1'reatment Area Information: Design Flow ( Design Soil Application Rate(gpdsf) Dispersal Area Requ' (sf) Dispersal Area (s System Elevation G 600 gpd 1.0 ASTM C-33 sand 600 sq. ft. ~p6 ~ 600 sq. ft. ~~ 99.00' at 6" above 0.6 in-situ soil Z~ 98.50' contour S$. ~/ VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units ° ~ New Tanks Ex;sting Tanks ~ I 5 5 ~ ~ ~ ~ `^ y ~ ~ ~. z +n h ~ w ~ a °~ aO~ T~ 1,200 _ 1,200 i Wi ser Concrete X Dosing ~"'~ 800 _ 800 1 Combination ST/PC X VIL Responsibility Statement- I, the u reigned, ass a res nsib ity for' of the POWTS shown on the attached plans. Plumber's Name (Print) Plum s Sign MP/MPRS Number Business Phone Number James K. Thom son 30021 715 248-7767 Plumber's Address (Street, City, State, Zip Code) 340 Paulson Lake Lane, Osceo a, WI 54020-5413 VIIL Coan /De riment Use llnl proved ^ sapprov Permit Fee Date I ed Issuing t Signature ^ R $ ~~ , Ob 7 ~ Z ~ ~~ ven ea Denial ~_ on ~~~ _ easons for Disapproval / t_ I o r - 1 ` 1. <..,-~!iCtalllt..e}IMi~>~r~ 3? Levt,[~M~" p'uv~+~4~c. GL Oul- Cq,:~ww~~.lFj °l~-~ 0. (w ^~persal cell r1w~tM lla~tlalvir<es !maintained ~,~, f s / ~; ~ E~.[.Ad~; ~,Cw• .,`/~, 712.x{ 1 a7 ~c (' s per managettl~elt piali provided by plumber. I I 2. •,~isetback~-rwstbemaintained S~.Ofe,~. zo,n'.~.~j. aeolicalile taldaJ'orndNr~cea. ~j to complete pines for the system and sabmit b t`e Coanty only o8 poper m-t less ttun S tR: Ii SBD-6398 (R, 01/07) Valid thru 01/09 ' ~ ~~oPosfd ~ Qy ~~iJ~i`~q ~/YicIF ~/P.!/.' -~ Ejc,'s,d, Fond / h G l/ Qrop o~se'~ ,. we71 1 oca~;o7 Ki 1 Sfie c,~ +. 7 .~ ,~ .~ h .~ Briv~d'Q.1a~dy ~odvdvr) pp~o~oi ~w~yhwyy, sec.zS,T.3oh,,Pi7c~y T, 0{~Ei'ih/~iY4'rr'C, So~~e-r'Cil~~.,cc~/ D ~OAc,reb PcJ, ~C7/$-/oSS-ao-an ~~oposeo( cvtesci'~onar~~c g5 wl~ ; ZGfl~Bcb earl~:na-~'Gn ~ ~~ Pik/u a~{,-~~va ts, rowt~ ~, ~, ; i `, o .Z "sc.(.flD~/.G ~ ' 1 ~ ~ ~ •/ / b~.l0/' ~~ i ~ /. ~ ~ l~.o _ ~ ., i' --* i /, L 45.2 .no ~b~~~ , 9G.Q- _ - --- ---- - - ' ~ ~ 97.0_'_ ------_- _____. •- _. ~ ~{ •. _-==-~- ~7- --- ,~ m ,.- ~,~ Co"~a~ ~ Syy~,~a,rGa ~o~ o __ _ ----~ ~cc . ffssu.~,c ~a; /;~ 8.,E/.r~ ~- P~opost~l ~{ bcdrxyn ~ES, d Li-Ge Con~iol/:~q 5~.c.J6~c, 3 ,. 75=._~ ~_.Propo3ed~dundc~E~~/.,39,'r %/G,S~S' d;s~',6a~ioH /ax5c.-a/.rat1%s~c98.~7' _ yY y~ or', f`ces~P.rccda~.2.s.3.' "• _ -~ _ ., < ., `o ~•~. `tee • a. c~Jcod ed "\ wc~de d ¢ b~LLy~y -.~ ° ~1 z ~~ ., ay ~Xi~fi`ng ~ra.de ~/e~I.' ~F-EX,s~.x~ F•nce/nG Pro os.trJ ._ weJf locaf;o-~ ~~ ~~ ~ SAC L~ ~l •~ .~ h BriQ.~ Z' A.k~n dy ~overdvr1 pprpo.~ nwYyhwyy, sec.zS,Taoh,,pi7c~y T, oFE~-~hP~a•~re, .5~•enc~x4u,,~i O S~OAv~6 P~ ~Oi2-/oSS-XJ-CCYJ P~opose.af ~1'ESC!'~'onc.r~~ 8s ~ ~ , ,, ~ ~ ~ ', lo~ fcncarna;n i~ ~ ~.,;sr ~ , 1~ ~ ~ n+!3o~yr' ___..., ~ °~ ~' y~.a' , , ~ ~ ,•~ bal. ~ ,, .' ,' ~ ~ ~ 9.10_' -------- -----_ •' ---- f__ ~~ 98.0-- - _--_- =-_ -_- •~-- ~{ ,g~ _ __ ____ ° ~ s ~ opc ~ t~ "''1' c'o.,~pa dot p~ l SYyf,~a~Ga/ fi'CC . i`tSSuAnGc/Z/td,' ~/GY~Cd.~ - r Proposcd µ bcdra~n ~dJl dLn~ Cpn'~/0(linG 5 /t.1~e L~ bwk~,;~ s,~e~ 9G. T3. .. ~? ~ ~ w c ''~ Q° r .Pro~oo3ed~oundaE,Z~jl.,39X %/G.yS' ~i sE/'i~iu`~idr /q~a/.1 ~t/j~ }C 98.7' _y1'~d'°or.~`ces,~Paccda~.2•S.j' - - _ ~°01 .~ ,~ .o -. \ ~~U. .`/Q \ •~O. o~ ~'~/d Wooded /~ 3.20 ~1 Sow. Z`~ o'~ ~` 'ti_.. woade d $ . btLLy~y ~~. ~a{9 COR11'1'1@f ~.lAt~.gOY . 'n Saf~y and Buld~gs PO SOX 7162 MADISON WI 5370-7162 TDD e: Leos) 26a-sm www.oorrur~eroe.wigoWsW www.wisoonsin.gonr .pm ooy~s, c3o~arrar Mil P. Bwite, Secratsly Iuly 17, 2007 CUST ID No. 30021 TAMES K THOMPSON A.C.E. SOIL AND SITE EVALUATIONS 340 PAULSON LAKE LN OSCEOLA WI 54020 CONDITIONAL APPROVAL PLAN APPROVAL EXi'IRES:'07/17/2009 SITE: Brian Hoverson Town of Erin Prairie, 54002 St Croix County NWl/4, NWl/4, 525, T30N, R17W FOR: A7TN.• POWTSLispector 20NING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 Identification Numbers Transaction ID No.14172{f8 Site III No. ?27931 Please refer m both identification numbers, above, in all ndeuce with the Object Type: POWTS Component Manual Regulated Abject ID No.:1142213 Maintenance required; 600 GPD Flow rate; System(s): Mound Component Manual -Version 2.4, SBD-10691-P. (N.O1101), Pressure Distn'bution Component Manual -Version 2.0, SBD-10'7116-P (N.OI/Ol) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin S~rtes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all cock requiremems. No person may engage in or work at phnnbing in the state unless licensed to ~ so by the Drpartme~t per s.14S.06, slats. The following conditions shall be met during construction or uostallafiion and prior to occupancy or use: Renuindens This system is to be constructed and located in accordance with the approved plans and with the "Pressure Disfriixdian Component Manual fear Private Onsite Wastewater Treatment Systems Version 2.0" SBD-10706-P (N.Ol/Ol). • This system is to be constinicted 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.pl/Ol). • The pressure network is to be consttiu~ed in accordance with publications SBD-10706-P(Ndi/Ol) "Pressure Distn'bution C,ompaemnt Heinle! for Privatee Onsite Wastewater Treatm~t Systems -Version 2.0" and/or the si~ang methods of publication "SSWMP Publication 9.b Design of Pressure DisGdbution Networks for ST-SA3 (01!81)". A copy of the approval plains, specifications aml this letter shall be on-site during won and open to won by authorized reproves of the Deparmn~, which moy include local inspecEo~s. All permits t+equired by the state or the local municipality shall be obtained prior to of ~srntefioduu,~allation/operation. JAMES K THOMt'StRi tie 2 vt~noo7 In granting this approval the Division of Safety ~ Buildings reserves the right to require changes ~ additions should conditions arise making them necessary f3or cede compliance. Asper state state 101.12(2 nothing in-this review shall relieve the designer of the re~onsibi'ht' y for designing a safe building, shucixue, or campone~t. Inquiries concerning this correspondence may be made tome at the telephone number listed below, or at the address cm this letterhead. The above left addressee shall provide a cePy ofthis lets to the owner and any~others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, ~~~ Allen C wendorf wastewater specialist ,Integrated services (608)235-0595 , awendorf@commerce.state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, POWTS wastewater Specialist, (715) 726-2544 ,Friday, 7:00 A.M. To 330 P.M. MOUND AND PRESSURE DISTRtBUTtON CQMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Brian 8 Wendy Hoverson 4-bedroom residential mound ______ Owner's Name: Brian & Wendy Hoverson .._..._ Owner's Address: 477 Serling Street South Maplewood, MN 55119 Legal Description: NW1/4NW1J4, Sec. 25, T.30N., R.17W. Township: Erin Prairie County: St. Croix Subdivision Name: Na - 40 acre parcel Lot Number: Na Block Number: Na Parcel I.D. Number: 012-1055-20-000 Plan Transaction No.: Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Index and title Data entry Mound drawings Lateral and dose tank System maintenance specifications Management and contingency plan Pump curve and specifications Site Plan oil Evaluation Report Designe . Jim Tho on License Number. Date: 07109/0 Phone Number: Signature: _ ~ g0 s ~~c~~~F SqF J~C 12 20p~ ~~~ B~/`D p,p.W.T.S. ~N~S Conditionally ,~ppROVE DEPARTMENT Of COM~AER ' G;~ Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SD&10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 3.0 (03!01!01) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet (r or c) Site inform R ation Residential or Commercial Design 400.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 =150%) 600.00 Design Flow (gpd) 15.00 Site Slope (%) 88.50 Contour Line Elevation (ft) 36.00 Depth to Limiting Factor (in) 0.50 In situ Soil Application Rate (gpd/ft2) Distribution Cell information 100.00 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/ftz) 1 Influent Wastewater Quality (1 or 2) (c or e) Pressure a Dit;ribution Information Center or End Manifold 3.00 Lateral Spacing (ft) Z Number of Laterals 0.125 Orifice Diameter (in) (e.g. 0.25) 2.50 Estimated Orifice Spacing (ft) _ 2.00 Forcemain Diameter (in) ~ ~ 90.00 Forcemain Length (ft) 84.00 Pump Tank Elevation (ft) 6.50 System Head (ft) x 1.3 ~'G. 14.65 Vertical Lift (ft) 2.08 Friction Loss (ft) 23.22 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. _ options ~^ choice 0.75 1.00 1.25 1.50 x x 2.00 x 3.00 x Treatment Tank Information 1200.00 Se tic Tank Capacity (gal) Wieser Concrete Manufacturer Dose Tank Information 800.64 Dose Tank Capacity (gal) 22.24 Dose Tank Volume (galJin) Wieser Concrete Manufacturer Note: Sand tiA (l1) calculations assume a Table 83.44-3 in-situ soil tn3iatment for fecal coliform of <= 36 inches. 6.00 Cell Width (ft) Are the laterals the highest int in the distribution Y network? Enter Y or N If N above, enter the elevation ft of the highest point. 7.50 ftzlorifice Does the forcemain drain back? Y Enter Y or N 14.&8 Forcemain Drainback (gal) 90.53 5x Void Volume (gat) 105.21 Minimum Dose Volume (gaq 32.95 System Demand (gpm) Manifold Diameter Selection in. dia. options ~r ~ choice 1.25 x 1.50 x 2.00 3.00 Gallons/lnch Calculator (optional) 800.64 Total Tank Capacity (gal) 36.00 Total Working liquid Depth (in) 22.24 gaUin (enter result in cell 649) Effluent Fester Information Pol Lok Filer Manufacturer PL-525 Filter Model Number Project: 6rian ~ Wendy Hoversan 4-bedroom residentia} mound Page 2 of 9 Mound Pian View 1- 1_ . 1 ~Obsenration Pipe ~ _ :~ . B: ~: 1 L ~ Mound Component Dimensions A 6.00 ft E 16.80 in B 900.00 ft F 9.50 in D 6.00 in G 0.50 ft 600.00 (ft2) Dispersal Cell Area 6.00 (gpd/ft) linear Loading Rate H 1.00 ft z 14.68 ft J 3.71 ft -r -f _f -1 K 8.23 ft L 116.45 ft W 24.39 ft 2068.18 (ft2) Basal Area Available 10.00 (ft) 1110 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 100.79 (ft) Yf{{~ 99.00 (ft)---~ F Dispersal Cell Elevation . . .. ., .. - . _.. . , , ~ ,~ ,. ~ ,.: ,.: ~ _ ti -~-_ .. ~..~ .. • ~ H ~.~r~r~r~ 2 {fiiif.~x G n+r .~~ rI/t'i.. .. Dispersal ceu 99.50 (ft) Lateral Invert .D ~; : 1 15.0 % Site Slope Shading Key r Topsoil Cap © ftFJl Subsoil Cap • ~ • ASTM C33 Sand Tilled Layer © .~'tir. Aggregate '~ 0 ~ ~ 1.5 ft _ ~ a' o 0--l-- Dispersal C®11 ° Typical Lateral ~ tl;. ~. A Project: Brian & Wendy Hoverson 4-bedroom residential mound 98.50 (ft) Contour Elevation /'~ Geotextile Fabric Cover ` See lateral details on Page 4 for number, size, and spacing of F laterals. Lo equalry sp. the distribi centerlin distribution Page 3 c End Connection Lateral Layout Diagram Number of Laterals Lateral Diameter Lateral Length (P) Lateral Spaang (S) Lateral Flow Rate Sys#em Flow Rate Total Dynamic Head 2 Orifice Diameter 1.50 in Orifice Spacing (X) 98.67 ft Orifices per Lateral 3.00 ft Orifice Density 16.48 gpm Manifold Length 32.95 gpm Manifold Diameter 23.22 ft Forcemain Velocity Dose Tank Information Electrit~tl as per NEC 300 and ----- Comm 16.28 WAC Tank componerrt is Property vented Wieser Concrete Ca ac' 800.64 Volume 22.24 Manufacturer Gallons ga~nch Dimension Inches GaAons A 18.22 405.26 B 2.00 44.48 C 5.53 122.94 D 10.25 227.96 Total 36.00 $00.64 A B C D Disconnect ~~ Locking cover with warning label and iodcing device and sealed watertight 4 in. min. E- ARemate outlet location Forcemain diameter ~ 2 in. Weep hole or anti- siphon devit~ P~off elevation (1t> $4.85 Dose tank elevation ft 84.00 Alarm Manuafacturer Zoeller Atarm Model Number A-Pak #10-1494 Pump Manufacturer Zoeller -~ Pump Model Number 152 ~- Pump Must Denver 32.95 gpm at 23.22 ft TDH Project: Brian 8~ Wendy Hoverson 4-bedroom residential mound Page 4 of 9 Mound System Maintenance and Oaeration Specifications Service Provider's Name J. T_ hom n, POWTS INSP.#4819 Phone 715-248-7767 POWTS Regulator's Name ~ - St. Croix County Zoning Phone 715 386-4680 System Flow and Load! Paramgters Design Flow -Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 400 gpd Maximum BODS 220 mg/L Septic Tank Capacity 1200 gal Maximum TSS 150 mglL Soil Absorption Component Size 600 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frenuencv Septic and Pump Tank Effluent Fitter Pump and Con#rols Alarm Pressure System Mound Other Ins and/or service once eve 3 ears Should ins and clean at least once eve 3 ears Test once ev 3 ears Should test month) Laterals should be flushed and ressure tested ev 1.5 ears Ins ct for ndin and see a once eve 3 ears Miscellaneous Construction and Materials Standard 1. Observation pipes are skrtted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm $4, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished ...~~......... ~ •~~~~~~~~~~~~~• Grade 6-8" Diameter Lawn ._..~, Threaded Cleanout Sprinkler Vabe Box Ptug or Ball Valve Distribution Lateral ''~i-. Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Brian & Wendy Hoverson 4-bedroom residential mound Page 5 of 9 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code This system shalt be operated in accordance with Comm $2 Wis. Adm. Code, and shall maintained in acCOMance with its' component manuals [SBD-10691-P (N,OV01) and SSWMP Publication 9.6 (01/81}] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases maybe present that coukf cause death, Septic and pump tank abandonment shall be in accordance with Gomm 83,33, Wis. Adm. Gode when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective todcirtg device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shad be maintained by an individual certified to service septic tanks under s. 281.48, Stets. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclceure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuousy. Intermittent filter alarms may indicate surge flows or an impending continuous alarm, The septic tank shall have its contents removed when the volume of sludge and scum in the tank exk~fs 1/3 the liquid volume Of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shat! advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical addftives to enhance septic tank performance is generaNy not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Puma Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alam~s, and pumps shat! be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. A~~ Pr~sun4 Diatri~i y~tion System No trees or shrubs shoukf be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion arxf to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on tiie mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulctred as protection from freezing, influent quality into the mound system may not exceed 220 mg/L 8ODg, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or ~ mg/L 8OD5, 30 mg/L 7SS, 10 mgt FOG, and 104 ctW100 ml. for highly treated effluent. IMluent fbw may not exceed maximum design flow specified in the permit for this tnstaliatian. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is pertom~l it should be compared to the initial test when the system was insMlled to determine if orifice coggfng has occurred and if orifice ceaning is required to maintain equa(distrr'bution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluenrt ponding. Pondirrg levels shalt be reported to the owner, and any lelrels above 6 inches considered as an impending hydraulic failure requiring add&ional, more frequent monitoring. ~gr,~,ge cv,Plan If the septic tank or any of its components become defective the tank or cemponent shaA be repaired or r+~lak~d to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective comporrent(s} shall be immediately repaired or replaced with a component of the same or equal performance. if the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occkrrs or by removing biologicaNy cogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condttoor-. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Brian & Wendy Hoversan 4bedroom residential mound Page & of 9 I T 14 ~ 12 ~ 35 = 10 ~ 0 8 25 4 10~ 2 5• 0 cNlons PUMP PERFORMANCE CURVE MODEL 151/152/153 ROW PER MIMITE 0146eeA CONSULT FACTORY FOR SPECIAL APPLICATIONS • Tuned dosing panels available. • Electrical alternators, for duplex systems, are available and supplied 14>iffi an alarm. • Variable level control switches are avalable for controlling single phase systems. • Double piggyback variable level float switches are available far variable level long and short cycle contrds. • Sealed Qwdk-Box available far outdoor installations. See FM1420. • Over 130'F. (54'C.) speaal quotation required. 15111521153 Series 151nsa1153 YooE~s Contrd Selection YodN Vdb-Ph Yode Am 8M sx Duplsx N151 115 1 Non 6.0 1 2 a 3 [iN151 115 1 Aub 6.0 Irtduded 2 a 3 E151 230 1 Non 3.2 1 2 a 3 BE151 230 1 Auto 3.2 Included 2 a 3 N152 115 1 Non 8.5 1 2 a 3 [3N152 115 1 Aub 8.5 Included 2 a 3 E152 230 1 Non 4.3 1 2 a 3 (3E152 230 1 Auto 4.3 Included 2 a 3 N153 115 1 Nan 10.5 1 2 a 3 BN153 115 1 Aub 10.5 Included 2 a 3 E TOTAL DYNAMIC HEAD/FLOW PER MINUTE EFFLUENT AND DEWATERING MODEL 151 152 153 Feel Meters Gal. Liters Oal. Wets Gel. Liters 5 1.5 50 189 69 261 77 291 10 3.0 45 170 81 231 70 286 15 4.8 38 144 53 201 81 231 20 8.1 29 110 44 187 52 197 2 7.8 18 81 129 42 159 30 9.1 13 87 33 125 35 10.7 22 85 40 12.2 - 11 42 Shut-otT F1ead: 30 R 9.1m) 38 R (11 &n) 44 8. (13.4m) re~ S: Model 151 Ot46088 Models 1521153 327134 z z I I I I i t2 tre s tra sic2oat 153 230 1 Non 5.3 1 2a3 SELECTION GUIDE BE153 30 1 Aub 5.3 Irtduded 2 a 3 1. Single piggy~ck variable level float switch a double piggyback variable level float a cAUT1oN switch. Refer to FM0477. Aii installation of controls, protection devices and wiring should be done by a qualified 2. See FM0712 for cortect model of Electrical Aflernator E-Pak. licenses electrician. All sVectricel and salety codes should be followed including the most recent National ElecMc Code (NEC) and the Occupational Safety and Health Ad (OSHA), 3. Variable level control swttch 10-0225 U9ad aS a cot1tr01 aCtlVator, specay dUp18X (3) a (4) Hoot system. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. ///a(I ~~~ rat. ro: P o. eox 15347 ~ 0 SHIP T0: 3849 Cane Run Road Manuiecfurers of. . ~i~lii+liTWO Loukvilk, KY 40258-0341 Loulsvllk, ICY 40211-1981 n.I.,~' pr~p nrga/nvww.zoeHereom PUMP !O_ (502) FAX (b02) ~38928•PUMP /~„ PLL{/PB S,vcE ~c7JcJ , ® Copyright 2004 Zoeller Co. All rights reserved. 7~'9 t 1352 Wisconsin Department of Commerce SOIL EVALUATION REPORT p~ 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations Attach complete ste plan on paper not less than 8%: x 11 irx~es in size. Plan must County St C i include, twt not I~nted to: vertical and txxizontal reference point (8M) dmacUon and . ro x , percent slope. scale or danemsbns, north arrow, and location and distance to n~rest road. Parcel I.D. Please print aN information 012-1055-20-000, ID#25.30.17.386 . Nersonal ~ntamation ~ provide ~ ~ used ~ aY Pub f Privacy Law, s. 15.04 (1) (m)). Reviewed By Date Property Owner Property Location Don Kamm Govt. Lot NW 1/4 NW 114 S 2S T 30 N R 17 W Property Owner's Mailing Address Loi # Stock # Subd. Name or CSM# 1419 190th Street City State Zip Code Phone Number J City _f Village t~ Town Nearest Road Baldwin WI 54002 715-24ti-5571 Erin Prairie 200Th Street 4Li New Construction ~~~ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD J Replacement Public or commercial -Describe: Parent material Glacial drift Flood plain elevation, if applicable na General comments and recommendations: Recommend two trenches using 30 high capacity sidewinder infiltrator leach chambers at system elev. 93.50'. Boring # ~ Boring !/I Pit Ground Surface elev. 98.59 ft. Depth to limiting factor ~90~~ in. Sot n Rate AppNcatio Horzon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Rocts GP D/ft= in. Mansell Qu. Sz. Cont. Cobr Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-12 10yr3/2 none sl 2fsbk mvfr as 2fm 0.5 0.9 2 12-18 10yr4/4 none st 2fsbk mvfr cs 2f,1 m 0.5 0.9 3 1$~2 7.5yr4/4 none gr. sl 2msbk mfr cw 1f 0.5 0.9 4 32-52 7.5yr4/6 none Ifs & s tmsbk mvfr cw 1f 0,4 0.6 5 52-90 7.5yr5/6 none Ifs & s lcsbk mvfr - 1f 0.4 0.6 Horizons #4 consist o an unsorted mbdure Osg s ~ lsbk .Loading rates esta lished to reflex most restrictive soil conditions encountered. goring # _I Boring >~ Pfl Ground Surface elev. 98.51 tt. pepth to limiting factor '97„ in. ~ Application Rate Horizon Depffi Dominant Color Redox Description Texture Stnx~ire Consistence Bourxlary Roots in. Munsntl Qu. St. Copt Color Gr. Sz. Sh. lEff#1 'E 1 0-12 10yr3/2 none sl 2fsbk mvfr as 2fm 0.5 0.9 2 12-24 10yr4/4 none SI 2fsbk mvfr cs 2f,1 m 0.5 0.9 3 2450 7.5yr4/4 none gr. sl 2msbk mfr cw 1f 0.5 0.9 4 50-62 7.5yr4/6 none Is 1 msbk mvfr cw - 0.4 0.8 5 62-97 7.5yr5/6 none Ifs & s 1 csbk mvfr - - 0.4 0,6 Horizon #5 consists of an unsorted mixture s sbk ifs. oading rates established to reflect most restrictive soil condflions encountered. "Effluent #1 = BODS> 30 <_ 220 mg/L and SS >30 < 1 mg/L ~~ Effluent #2 = 80D5 < 30 mg/L and TSS < 30 mg/L CST Name (Please Printl S~naf~ma . _ ~'"~^~'~~' .,~.•r ... __. _ _ ~ James K. Thompson ~ ~ ~~_ X02 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, Wt 54020 12/21/2000 715-24&7767 w. Property Owner Don Kamm Parcel ID # 012-1055-20-000 ID# Page ~_of 3 r r Boring # ~ Soring ! t ~ Pit Gnwnd Surface elev. 96.10 ft. Depth to limiting factor >g3" in. Soil Apptlcation Rate Horizon Depth Dominant Cobr Redox Descrfptbn Texture Structure Consistence Boundary Roots in. Mansel{ Qu. Sz. Cunt Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-13 10yr3/2 none sl 2fsbk mvfr as 2fm 0.5 0.9 2 13-32 10yr4/4 none sl 2fsbk mvfr cs 2f,1 m 0.5 0.9 3 32-50 10yr5/4 none sl 2msbk mfr cw 1f 0.5 0.9 4 50-82 7.5yr416 none Ifs ~ s 1 msbk m~Fi' cw - 0.4 0.8 5 82-93 7.5yr5/8 none tfs & s 1 csbk mvfr - - 0.4 0.6 Horizons #4 8~ 5 t~nsist Of an unsorted mixture of Osg s 81sbk Ms. Loading rates established to ref~cf most restrictive soil conditions encountered. Boring # _.,] Boring Pit Ground Surface elev. 96.33 ft. Depth to limiting factor >gg° in, ~ ~ Rate Horton Depth Dorninard Cc~or Redox Description Texture Stnkture Consistence Boundary Roots in. Mur~sell Qu. Sz. Cont. Color Gc Sz. Sh. *Eff#1 'Eif#2 1 0-12 10yr3/2 none sl 2fsbk mvfr as 2fm 0.5 0.9 2 12-19 10yr4/4 none sl 2fsbk mvfr cs 2f,1 m 0.5 0.9 3 19-40 7.5yr4/4 none gr. sl 2msbk mfr cw 1f 0.5 0.9 4 40-56 7.5yr4/8 none Ifs & s lmsbk mvfr cw 1f 0.4 0.6 5 56-89 7.5yr5/8 none Ifs & s 1 csbk mvfr - - 0.4 0.8 Horizons #4 8 5 consist of an unsorted mixture of Osg s & lsbk Ifs. Loading rates established to reflect moat restraive soil conditions encountered. Boring # -~ Boring Pit Ground Surface elev. 97.26 ft. Depth to limiting factor >90" in. ~ q,r Rate Horizon Depth Dominard Color Redox Description Texture Stnx:ture Cor~eistence Boundary Roots in. Mansell Qu. Sz. Cunt Color Gr. Sz. Sh. *Eff#1 "Eff#2 1 0-12 10yr3/2 none sl 2fsbk mvfr as 2fm 0.5 0.9 2 12-32 10yr4/4 none sl 2fsbk mvfr cs 2f,1m 0.5 0.9 3 32-48 10yr5/4 npnp sl 2msbk mfr Cw 1f 0.5 0.9 4 48-78 7.5yr4/8 none ifs & s 1 msbk mvfr cw - 0.4 0.8 5 78-90 7.5yr5/8 none Ifs & s 1 csbk mvfr - - 0.4 0.8 Horizons #4 & 5 consist of an unsorted mixture of Osg s 8 1 sbk Ifs. Loading rates established to reflect most restrictive soil conditions encountered. * Efntrent #1 = BODS> 30 < 220 mg/L. and TSS >30 < 150 mglL * EfFluent #2 = BODS < 30 mg/L and TSS <_30 mgll. 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 deparlrnent at 408-266-3151 or TTY b08-264-8777. SBD-8330 (R0~l00) A.C.E. SON $ SiEe EwM~tlot~s v ~~ 303 n w . 1 . ` ~, , ` ~ ~ ~ . ~ ~ ~ , - ~ . ~ p,•t ~ E/e da~~ o~-~ :~ ~~ Ju 2 Gti ,. ~ -. ,~ '// -, ~ 1 ^ ~ / `, ' ` 1 i / ~ ~ r ~ ~ ~~ 1 ~ , ~ ~ ~ ~ N ~ ~ ~ 9,t.o eo~ ~ , i T ~ / ~ ~ ~ ~ ~ ~ ~ ~' i i ~~ f i I ' ~ 1 ~ 9yo' '~---- ~ , , . 1 I 1 - -.... r... ~...~- ~ // ^ ~ ~ 1 / ~~ ~ 8 3 od ^ ~, . ~ ~ 48.0 ~ ~ _ 12.% slope. ,~ys-hem/s9'o, -' ^ i imo B,Z______ ^-----------, ------- ~ ~~ d Asskmesj ~le~- _ /o4.c6. • s 3 v .,. lJ ot~s /90 ~~ /, 32D ~'- Sou•~ p%qa. /; rte '' ,. , ( ,P '~ ,C3S',2 t Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT in arrnrctanrp with Cnmm RS Wic ArJm Code 1352 Page 1 of 3 A.C.E. Sal & Site Evaluations County Attach complete site plan ai paper not less than Sy: x 11 inches in size. Plan must Crooc include, but not limited to: vertical and horizontal reference point (BM), direction and P cel I D percent slope, scale or dimemsions, north anow, and location and distance to nearest road. . . 012-1055-20 00 D#25.30.17.386 Please print all information. Revi y Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). / ii _ _ ..~ S' D 1~(~Y/~ Property Owner Property Location ~~~,G~/K. Govt. Lot NW 1/4 NW 1/4 S 25 T 30 N R 17 W Properly Owner's Mailing Address Lot # Block # Subd. Name or CSM# ~ State Zip Code Phone Number City ~ City ~ Vllage ( Town Nearest Road ~ ~ WI 540 Erin Prairie 200Th Street /~ New Construction Use: ~ Residential / Number ~ bedrooms 3 _ Code derived design flow rate ~ ~; , , 4~0~GPD Replacement ~ Public or commercial -Describe: Parent material Glacial drift _ ti .'•yi' Flood plain elev~t(on;•~applicable na General comments and recommendations: Recommend two trenches using 30 high ca ~' pacity sidewinder infiltrator learf~?c,~lambers at system elev. _ 93.50'. _ ..ti _ 1^ Boring # ~ Boring n:~. " ~ >'84 in. ~I Pit Ground Surface elev. 98.59 ft. Depth to limiting factor Application Rate Sal Horizon Depth Dominant Caor Redox Description Texture Structure Consistence Boundary Roots GP DIfP *Eff#1 *Eff#2 1 0-12 10yr3/2 none sl 2fsbk mvfr as 2fm 0.5 0.9 2 123-18 10yr4/4 none sl 2fsbk mvfr cs 2f,1m 0.5 0.9 3 18-32 7.5yr4/4 none gr. sl 2msbk mfr cw 1f 0.5 0.9 4 32-52 7.5yr4/6 none Ifs & s 1msbk mvfr cw 1f 0.4 0.6 5 52-90 7.5yr5/6 none Ifs & s 1 csbk mvfr - 1 f 0.4 0.6 Horizons #4 & 5 consist of an unsorted mixture of Osg s & 1sbk Ifs. Loading rates established to reflect most restrictive soil conditions encountered. Boring # ~ Boring Pit Ground Surface elev. 98.5) ft. ~~ !'~ Depth to limiting factor >97 in• Sal Application Rate Horizon Depth Dominant Caor Redox Description Texture Structure Consistence Boundary Roots GP DIft~ *Eff#1 'Eff#2 1 0-12 10yr3l2 none sl 2fsbk mvfr as 2fm 0.5 0.9 2 12-24 10yr4/4 none sl 2fsbk mvfr cs 2f,1m 0.5 0.9 3 24-50 7.5yr4/4 none gr. sl 2msbk mfr cw 1f 0.5 0.9 4 50-62 7.5yr4/6 none Is 1 msbk mvfr cw - 0.4 0.6 5 62-97 7.5yr5/6 none Ifs & s 1 csbk mvfr - - 0.4 0.6 Horizon #5 consists of an unsorted mixture of Osg s sbk Ifs. Loading rates established to reflect most restrictive sal conditions encountered. * EfFluent #1 = BOD ~ 30 <_ 220 mg/L and TSS 0 < 150 ffluent #1= BODS < 30 mg/L and TSS <30 mg/L CST Name (Please Print) S' ature: CST Number James K. Thompson 5.~-- 3602 Address A.C.E. Sal & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 12/21 /00 715-248-7767 property Owner Don Kamm Parcel ID # 012-1055-20-000, ID#25.30.17.386 Page 2 of 3 Boring # Boring Pit Ground Surface elev. 96.10 ft. Depth to limning factor >93" in. Soil Application Rate Horizon Depth Dominant Color Redox Descriptiai Texture Structure Consistence Boundary Roots *Eff#1 *EtT#2 1 0-13 10yr3l2 none sl 2fsbk mvfr as 2fm 0.5 0.9 2 13-32 10yr4/4 none sl 2fsbk mvfr cs 2f,1 m 0.5 0.9 3 32-50 10yr5/4 none sl 2msbk mfr cw 1 f 0.5 0.9 4 50-82 7.5yr4/6 none Ifs & s 1 msbk mvfr cw - 0.4 0.6 5 82-93 7.5yr5/6 none Ifs & s 1 csbk mvir - - 0.4 0.6 Horizons #4 & 5 caisist of an unsorted mixture of Osg s & 1 sbk ffs. Loading rates established to reflect mast restrictive soil conditions encountered. Boring # ~ Baring Pit Ground Surface elev. 96.33 ft. Depth to limiting factor >89" in. Soil Applic~ion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots : *Eff#1 *Eff#2 1 0-12 10yr3/2 none sl 2fsbk mvfr as 2fm 0.5 0.9 2 12-19 10yr4/4 none sl 2fsbk mvfr cs 2f,1m 0.5 0.9 3 19-40 7.5yr4/4 none gr. sl 2msbk mfr cw 1f 0.5 0.9 4 40-56 7.5yr4/6 none Ifs & s lmsbk mvfr cw 1f 0.4 0.6 5 56-89 7.5yr5/6 none Ifs & s 1 csbk mvfr - - 0.4 0.6 Horizons #4 & 5 consist of an unsorted mixture of Osg s & 1sbk ffs. Loading rates established to reflect most restrictive soil conditions encountered. Boring 5 Boring # Pit Ground Surface elev. 97.26 ft. Depth to limiting factor >90" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' *Eff#1 *Eff#2 1 0-12 10yr3/2 none sl 2fsbk mvfr as 2fm 0.5 0.9 2 12-32 10yr4/4 none sl 2fsbk mvfr cs 2f,1m 0.5 0.9 3 32-46 10yr5/4 none sl 2msbk mfr cw 1f 0.5 0.9 4 46-78 7.5yr4/6 none Ifs & s 1 msbk mvfr cw - 0.4 0.6 5 78-90 7.5yr5/6 none Ifs & s 1 csbk mvfr - - 0.4 0.6 Horizons #4 & 5 consist of an unsorted mixture of Osg s & 1sbk ffs. Loading rates established to reflect most restrictive soil conditions encountered. * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS <30 mg/L and TSS < 30 mglL 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. fa,r. 3 0~3 :~ -tt \ ~ - ~'2 G~ ,. ~ -. ,~ y/ " ~ poi/ ©(xSe/Y~Q~i or- pig .. • Ele dad; a~-> ,- -, -~-. ~-~isf~~zi ~nce%ne ~ ~ ~"~' ~ ~occ.rd ~6o be unSu+~alale ~`~ \~ I $S i .--. ^ ' / ~~ ' ` 1 i ~ ~ r ~ ~ , ~ f r ~ ~ ~ a ~ ~ ~ ~ ~ N ~ ~ %1.0 ~'o~ , I T r ~ ~ r ~ + 1 i ~ ~ f ' ~ / ,.~ r ~ i I 9yo' ~' - - -' ~ r r r ~ `. ~ 8~ I ~ d~ I - E/ec~ ~ 9G."yo T ~r B 3 a/ ^ 7\°~. ~ i 98.o T _ _ _ l2.% slops ,~ s,~cmr~.9'o~,' ^ i iaoo -` B.Z _ ____-----------~~ io2A' --------- .--. ~nc~ rv1 ~ Ylw,1 ir. S~~EIw+ ~^ce • ~ d Ass~.cmer.~ e.-I ev- ~ /00. ~. t • s 3 h v .r o per ~: ec~cf W otkls X90" ,, P~'9°~ ~Pe~~,c3.s,2 ' ~ Parcel #: 012-1055-20-000 04/05/2007 10:40 AM PAGE10F1 Alt. Parcel #: 25.30.17.386 012 -TOWN OF ERIN PRAIRIE 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 - HOVERSON, BRIAN L &WENDY J BRIAN L & WENDY J HOVERSON 477 STERLING ST S MAPLEWOOD MN 55119 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 25 T30N R17W NW NW 40 AC Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 25-30N-17W NW NW Notes: Parcel History: Date Doc # Vol/Page Type 03/15/2007 846486 WD 01 /19/2001 637090 1577/235 W D 2007 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessme nt Valuations: Last Changed: 05/31/2006 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 19.000 3,400 0 3,400 NO UNDEVELOPED G5 10.000 3,700 0 3,700 NO AGRICULTURAL FOREST G5M 11.000 17,600 0 17,600 NO Totals for 2007: General Property 40.000 24,700 0 24,700 Woodland 0.000 0 0 Totals for 2006: General Property 40.000 24,700 0 24,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT . AND OWNERSHIP CERTIFICATION FORM .~ Owner/= Mailing Address Property Address /ice-.-~ ~` Lc~r~ ~~g5 ~ ago ~. (Verification required from Planning & Zoning Department for new construction.) City/State Parcel Identification Number ~/~ - /~ ".~~°~ LEGAL DESCRIPTION Property Location ~ 1/a , ~ i/a ,Sec. ~, T 3C~ N R/Z._W, Town of ~i'^~ l~~ir'i 2 Subdivision t~a - ~D~d~ ~ t ,Lot # Certified Survey Map # r ,Volume '- ,Page # Warranty Deed # ,Volume ,Page # Spec house y~ no Lat lines identifiable es SYSTEM MAINTENANCF,~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 andlor (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 amlare the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms ^~ SIGNATURE OF PLIC ) 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,~DS) State Bar of Wisconsin Form 1-2003 WARRANTY DEED Document Number U Document Name THIS DEED, made between Angela M. Kissinger, formerly latown as Angela M. Paulson Married _ _ ("Grantor," whether one or more), and Brian L. Hoverson and Wendy J. Hoverson, husband and wife, 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): Northwest Quarter of Northwest Quarter (NW 1/4 of NW 1/4) of Section Twenty- five (25), TownshipThirty (30) North, Range Seventeen (17) West, St.Croix County, Wisconsin. f34648C KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CO., wI RECEIVED FOR RECORD 03/15/2007 09:35AM NARRANTY DEED EXEMPT ~ REC FEE: 11.80 TRAMS FEE: 505.50 caPY FEE. PAGfiS~ ~ 1 Recording Area File # ~' 15 $ (~ Edina Realty Title 440 South Second Street, #115 Hudson, WI 54016-1974 012-1055-20-000 Parcel Identification Number (PIN) This is not homestead property. (x) (is aot) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Easements, restrictions, and rights-of--way of record, if any. Dated February 23, 2007 /1 c (SEAL) (SEAL) (SF A i .) s AUTHENTICATION Signature(s) authenticated on TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. La Crosse COUNTY ) Personally came before me on February 23, 2407 , the above-named Angela M. Kissinger "formerly known as Angela M. Paulson, Married to me. ],grown to be the person(s) who executed the foregoing ent and aclcno ledg d the same. ' :,ci1 :4 Public, State of Wisconsin ' My Commission (is permanent) (expires: ;/O~o2'a'~p"Z~# (Signatures may be authenticated or aclwowledged. Both are not necessary.) '' Q ~~ ~ ~ NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHO(JI.D BE CLEARL~3D~ + ~ ~ ' WARRANTY DEED ®2003 STATE BAR OF WISCONSIN .-' ~GI~LYJQ';.~~ * Type name below signatures. ~ ,~ j M ~ ~ , .• .. THIS INSTRUMENT DRAFTED BY: Attorney Scott Kissinger, 205 Fifth Avenue South, Suite 600 La Crosse Wisconsin 54601 //