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012-1072-80-000
`YYisconsin Department of Commerce PRIVATE SEWAGE SYSTEM 'Sad ty~nd Bu'"ding Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes IPrivacv Law. s 15.04 !~ vm~t Permit Holder's Name: City Village X Township Brown, Rick & Roxanne Erin Prairie, 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 SUIL At3SURPTION SYSTEM LEVATION DATA County: St. Croix ~ Sanitary Permit No: State Plan ID No: Parcel Tax No: 012-1072-80-000 Sectionlrown/Range/Map No: 34.30.17.527A HI FS (Bench Bldg. Sewer St/Ht Inlet SVHt Outlet Dt Bottom Header/Man. Dist. Pipe Bot. System ISt 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 Manufacturer: Type Of System: CHAMBER OR UNIT Model Number: vla I ItIOV I IVIY J T.71 CIVI Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing JVIL VVVCR x pYACC1IYP Cvc4nm~ flnl.. .... 11e......d n. n• r_...,~,, c....a....... r._~.. 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: / /. Location: 1842 120th Avenue New Richmond, WI 54017 (SW 1/4 SE 1/4 34 T30N R17W) NA Lot 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Inspection #2: / / Parcel No: 34.30.17.527A Plan revision Required? 'Yes No Use other side for additional information. __ ___,_ __ Date Insepctor's Signature SBD-6710 (R.3/97) Cert. No. Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Bui)ding Division r 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 Brown, Rick & Roxanne Erin Prairie Townshi CST BM Elev: Insp. BM Elev: BM Description: ELEVATION DATA 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 C(111 ARSnRPTI(~N SYSTEM county: St. Croix Sanitary Permit No: 4 61 t 0 State Plan ID No: 1 ~ d (/\ Parcel Tax No: 012-1072-80-050 Section/Town/Range/Map No: 34.30.17.527A STATION BS HI FS ELEV. Benchmark Alt. BM Bldg. Sewer St/Ht Inlet SUHt Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bot. System Final Grade St Cover BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: CHAMBER OR INFORMATION Type Of System: UNIT Model Number: r11STRIR11TInN SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing C(111 Cf1VFR ., o.e~~~~.e c.,~•e.,,~ n.,i.. ..v Mn~~nrl (lr Of_[~rada SvatPms ~nlv Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center BedlTrench Edges Topsoil ~ Yes ~~ No ~ Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / /_ Location: 1842 120th Avenue New Richmond, WI 54017 (SW 1/4 SE 1/4 34 T30N R17W) NA Lot Parcel No: 34.30.17.527A 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = ~-- -, -~ Plan revision Required? [ Yes ~ No I ~ j Use other side for additional information. ~L -_ - --J Date Insepctors Signature Cert. No. SBD-6710 (R.3/97) COmmerce.Wi.gOV Safety and Buildings Division county + 201 W. Washington Av P.O. Box 7162 $t, CrO1X ' ~ ~O ~ ~' ~ Madison, WI -7162 Sanitary Permit Number (to be filled in by Co.) DepartmerK of Commerce s ~ 5 oa ~ Sanitary Permit Application State Transaction Number In accordance with m C 83 21 2 Wi Ad C d i i b f hi f h ~ Trans, ID# 799440 s. o m. . ( ), s. m. o e, su m ss on o orm to t e approp gove t s project Address (if different than mailing address) unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owne WTS are submitted to the Department of Commerce. Personal information you provide may be used fors ndazy u ses in accordance with the Privac Law, s. 15.44 1 m , Stats. -" 3 1842 120th Ave I. A lication Information - Ple Print All Information - . Property Owner's Name Pazcel # Rick & Roxanne Brown ' ~~) ~r ~ BOOS 012-1072-80-050 Property Owner's Mailing Address r ~ -, ;;~nOiX COUNTY Property Location • th 654 215 Ave ' ~ ?CANING OFFICE --_--- . Govt. Lot . ..,,~ _....~..- _ City, State Zip Code Phone Number S W ''/., SE '/<, Section 34 (circle one) Somerset, WI 54025 (715) 247-5305 T 30 N; R 17 w II. Type of Building (check all that apply) Lot # ^ 1 or 2 Family Dwelling -Number of Bedroom 3 Na Subdivision Name p ~; 1 ,~Q_ ,M,` Bl°ck # Na- 3 8 acre pcl 5 ^ . Public/Commercial -Describe Use Na ^ city of ^ State Owned -Describe Use CSM Number ^ Vie of ~ ~ ~,,/JJ n ~ ~ c `)d r ~ O'T°wn of Erin Prairie l0/~.rX ~ / . J Na III. Type of ermit: (Check only one box on line A. Complete line B if applicable) `~' New S stem Y ^ Re lacement S stem P Y ^ Treatment/Holdin Tank Re lacement Onl g P Y ^ Other Modification to Existin S stem ex lain g Y ( P ) B• Permit Renewal ^ Permit Revision ^ Change of Plumber ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration ~~ Owner #499206 issued 10/ 13/06 ~ 1V. T e of POWTS S stem/Com onent/Device: Check all that a 1 ^ Non-Pressurized In-Ground ^ Pressurized In-Ground ^ At-Grade Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ Holding Tank ^ Other Dispersal Component (explain) ^ Pretreatment Device (explain)_PolyLok PL-525 effluent filter V. Dis ersaUTreat ent Area Information: 5' X 90" dis ersal cell Design Flow (gpd) 450 d Design Soil Application Rate(gpdsf) 1 0 ASTM C-33 sand ~ Dispersal Area Required (sf) 450 s ft Dispersal Area Proposed (s 450 s ft System Elevation 100 62' t 11" abo e gp . q. ~~ q. . ~ ~ . v a ' 0.5 in-situ soil ~ 99.70 contour VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units a o b v New Tanks Existin Tanks B ~ c d ~ Y ` y ~ Y cs~ U ~ ti vz C7 f~. Septic or Holding Tank 1 ~~~~ _ 1,000 1 Wieser Concrete X nosing Chamber 600 _ 600 1 Combination ST/PC X VII. Responsibility Statement- I, the and signed, assu a responsibility for ' tion of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' Signa MP/MPRS Number Business Phone Number James K. Thompson 5___-- 30021 (715) 248-7767 Plumber's Address (Street, City, State, Zip Code 340 Paulson Lake Lane, Osceola, WI 54020-5413 VIII. Coun /De artment Use Onl roved ^ Permit Fee Date Is ued Issuing t Signature p ove $ G~ 1 ~ o /Q /Q b Own iven Re for Denial IX. Conditions of A~p~r~ Reasons for Disapproval p /~ /D L7 Dot SYSTEM PwY~~R: 3~ TZO ; ~- tcr +-C ~ T ~° ~~°~ ~'e . ~- , f . Septic tank, effluent-lifter and t~ dispersal cetl must all be servk:es / maintained /01~.3/D(D ~..a~c+~ ~ as per management plan provided by plumber. 1 2. AN setbacktequirements must be maintained I1 i ~ ' i ~ `~ ti dtJ ax. Q.G.. o+~ ~ +~ O w t - Attach to complete plans for the system and Submit to the oun only on p per of less than 8 r!2 z 11 i~es in size SBD-6398 (R. 01!07) Valid thru 01109 ~~ ~t/ ~ ~ ~GC~n+~ ~' Safety and Buildings Division County •, ~ ~ 201 W. Washington Ave., P.O. Box 7162 St. CroiX ~scons~n Madison, WI 53707 - 716 _ Sanitary Permit Number (to be filled in by Co.) De artment of Commerce (608) 266-3151 ~ ZO Sanitary Permit Application ~ ~ LD. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide o'ect Address (if different than mailing address} may be used for secondary purposes Privacy Law I. Application Information -Please Print All Information ~~8 /fZ / ~ Z D ' Stxeet Property Owner's Name Parcel # 1 of # aA, Block # Na Rick & Roxanne Brown T. CROIX COUNTY p/Z,. /07 - -GYX~ Property Owner's Mailing Address PropeRy Location 654 215` Ave. Gov't lot . . S~ _'/•, _ SE _'/., Section _ 3 `>` City, State Zip Code Phone Number 30 N; R_ ' ~_W Somerset, WI 54025 (715) 247-5305 II. Type of Building (check all that apply) ^XI or 2 Family Dwelling -Number of Bed 3 Subdivision Name CSM Number ^ Public/Commercial -Describe Use ,J~ 3fS F}c.re, Par~,Q_, ^ State Owned -Describe Use ^City_^Village ^XTownship of _E,--; ~, ~'r4; -;~ III. Type of Permit: (Check only one box on line A. mplete line B if applicabl A' ^ New System ^ Replacement System ^ Tr ent/Holding Tank R acement Only ^ Other Modification to Existing System H. Permit ^ Permit Revision Change it Transfer to New List Previous Permit Number and Date Issued Renewal Before Plumber er Ex iration _ #420581, Oct. 27, 2004 IV. T e of POWTS S stem: Check all that a 1 ^ Non -Pressurized 1n-Ground ^XMound > 24 in. of suitable soil ound in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Presswized In-Ground Holding Tank Peat Filter erobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter ^ Leaching Chamber ^ D ' Line ^ Gravel-less ^ Other (explain) V. Dis ersal/Treatment Area Information Design Flow (gpd) Design Soil Application Rate(gpdsf) Di al Area Require (sf) Dis al Area Proposed (sf) System Elevation 450pd / 1.0 gpd sq. ft. - ASTM -33 fill 450.00 sq ft 9 DU 0.00 sq ft EISA 100.62' @ 11"above O ~ 50 5! 99.70' contour VI. Tank Info Capacity in Num Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Un Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank 1,000 _ 1,000 1 Wieser Concrete Combination X Aerobic Treatment Unit Dosing chamber 600 600. 1 Wieser Concrete Combination X VIL Responsibility Statement I, the and reigned, assume respo or installation of the POWTS shown on the attached pleas. Plumber's Name (Print) lumber's ignature MPlMPRS Number Business Phone Number James K. Thompson ~-- MPRS #3002I (715) 248-7767 Plumber's Address (Street, City, S ip Code) 340 Paulson Lake Lane, Osceola, WI 54020 VIII. Coun /De artment Use Onl Approved tsapprere Sanitary Permit Fee (includes Issu Issuin ant Sign o Groundwater Surcharge Fee) ~ ~~ ~ / ~~ ~`3 a~ rven Reason fo Trial )X. Conditions of ApprovaUReasans for Disapproval _ n n SYSTEM OWNER: 3~ 1~`~ o•pp(~o.7aQ, ~J" K~.-tt~..~C, O (~lel`.+~..~- G ;c4.~~ 1. Septic tank, effluent finer and 1 P 1/~ dispersal cell must all be servit;es / mainta6fsd ~o~ tMo ~~ ~ ~~G~ , 143 Qcnc~.~cJG /o/Z7 O~ ber l . um as per management plan provided by p All setback requirements must tle maintainsd'~ D ~.5~~~~. ~~/ZSIO Z 2 . ai per applkable GOd! / Ordkgtloes. /~ n `~ o ~ C ~' ~ e,~l. .~o , ail ~ r.. i ( Attach complete plans (to the County only) for the system on paper net less than 81/2 x I1 inches in sru~ /(,.prG ~~ ~~~ Jr ja „~_ Go,ww~Gic~L... /Va ~e~. SBD-6398 (R. 01/03) G s~`~e ~~ ~nts~4Q.. . - - ----- - Safety and Buildings Division County 1 ~ 201 W. Washington Ave., P.O. Box 7162 ~ S-~, CiY`0~ i1~~I~ Madison, Wl 53707 - 7162 Sanitary Pemtit Number (to be filled in by Co.) De artm erce (608) 266-3151 2 ~~ / I J I r][Illt Application State Plan 1.D. Number ~~cc~brd with Comm $'x.21, Wi Code, personal information you provide 9 yyo ~ ~s , p ~ ~a be used for sewn s Privacy Law, s 15.04(1)(m) ~ Project Address (if different than mailing address) .' t%,;„ ~/~~ 1. 'r 'on -Please Print Qb - C~ i ~ ~ ~h m~ N V 1~~~ D~~~ / Property Owner's N (,'~ Parcel tt Lot N Block ti ~~- ~D a. `'~ ...'~~/'dGc~ 7Z-~O-DSO Property Owner's ailing Address Property ation J~7 ~l ~ ~ • s s~' 3~ City, State Zip Cude P hone Number h, Section y<, 5omt~-'St~ s[j~Z~ / (~ JS ,~C~7~ ~~Q~ circle one) T 3O N R~P W 11. 'I'y of Building (check a hat apply) ; ~ L7l or 2 Family Dwelling -Number edrooms ~ Subdi vision Name C SM Number _ ^ }'ublic/Commercial -Describe Use ___ - ---- v _ / ~ /T " 3 ~ L~'e Gf _ _ _ _ _ ^ State Owned-Describe Use ^City_^Village ©'Iownship of _ ~i''Pn ra'~r 111. "I"ype of Permit: (Check only one box Ilne A. Complete line B if applic e) A. New System ^ Replacement Syste ^ Treatment/Holding'fank placetnent Only ^ Other Modification to Existing System B• ~~..,, LKPermit Renewal ^ Permit Revision Change of ermit Transfer to New List Previous Permit Number and Date issued Before Expiration Plu er w[ter ~f 2O ._-G•( T ~o ~u.2S 2~2. 1V. T of POWTS S stem: Check all that a 1 ~] Non -Pressurized ln-Ground l+~'"Mound > 24 in. of suitable soil otrnd < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ ConstrucKed Wetland ^ Pressurized !n-Ground ^ Holdin Tank t Filter ^ I g ^ Aerobic'freatment Unit ^ Recirculating Sand Filter i I Recirculating Synthetic Media Filter ^ Leaching tuber ^ p Line Grav 1 less Pie Other (explai I V.llis rsal/TreatmentArealnformatIon: K .0 D. Design Flow (gpd) Design Soil Application Rate dsf) ispetsal Area R ui (sf) Dispersal Area Proposed (st) yste Elevati~ _ _O~ i ySO o S ~ ' ~:~ ,d._ ..o. :/Cd•_6Z C~)~~J_~~. 5.~: _!.o _~~1~ S! y~~ d ersa t ~-- 1 Vl. Tank Info CapaEitym Total tuber ~ Manufactu Prefab Site Steel Fiber i Plastic I Gallons Gallons f Units Concrete Constructed Glass '. i Ncw Existing Taiilcs T:vilcs i Septic or Holding Txnk ~J ~ ~ ~~~ ~~~ // C~ ~.-~19 /~ Aerobic Tsa[mcn[ Uni[ Dosing Chamber )~~ ~ ! n /7_~~ ~ln ~ Sr (• /'L ~ ~ ss ~- ~r ~ ~'~ VII. Responsibility Statement- 1, the un rsigned, assume respon si b i ti ty for installation of the POWTS wn on the attached plans. Plumber's Name (Print) Pl ber~Signatttre /MYRS Number Business Phone Number e~r~e/ z2.5~3~ ~~z ~l S-/9z7 lumber's Address ( treet, City, State,L.i .,ode) /D ?a ~~ ,~.er ~i' Da. ~ 17'~c ~tGr- u~ /. Syo '' V111. Coon /De artment Use O Approved ^ Disa Sanitary Pentrit Fee includes Groundwater Date issued ssui gent Si~tatur (No Stamps) ^ Owner Given eason r Denial Surcharge Fee) ~ ~ _ O , 27 T IX. Condition of Approv ~ ~~ SYSTEM OW NE 3 ~`~S l 1 Septic tank, uent filter and t n dispersal ce must all be serviced /maintained rrtc~~-r.~-~C. r,e ~~_ ,,.~. ~ ~ n i as per ma~gement plan provided by plumber 2. All setbac requirements must be maintained as per applicable code/ordinances. !!~/Z~o Z ~-~ Attach complete plans (to the County only) for the SBD-6398 (R. 01/03) i on paper not Icss than 8112 a 11 inches in size '-~~ ~~Q ~ ~. ~~,~~ ago ~~~ ,~ ~ C'~~ti.1 ~ ~O ~~ ,Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division J INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes IPrivacv Law. s.15.04 f11(m11. ermit Holder's Name: City Village X Township 3rown, Rick & Roxanne Erin Prairie Townshi ST BM Elev: Insp. BM Elev: BM Description: ~-rvr\ IrvrVKMA1IVN ng R I CAPACITY TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION /r Manufacturer Demand GPM Model Number TDH Lift Friction Loss System H TDH Ft Forcemain Length Dia. Dis o Well aVt~ ~-rsavrcr 1 wlv ,Y51 CM ,/ ELEVATION DATA county: St. Croix Sanitary Permit No: 420581 0 State Plan ID No: Parcel Tax No: 012-1072-80-050 STATION S HI FS ELEV. Benchmark Alt. BM Bldg. Sewe SUHt I t S t Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bot. System Final Grade t Cover BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. f Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEA G Manufacturer: INFORMATION Type Of System: CHAMBE R UNIT Model Number: r11@T~1~1 IT If'1u n\~nTP^•• ~.~........v~• ~ v.v. ten, ^ Header/Manifold Distributio x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia .+.... Length Dia Spacing vv~a_ vvv~R x hr'P_SCllr'P Svs4amc nniv ..., Mi...n.l n. na_r_..,.a.. c...a......, n_~.. Depth Over Bed/Trench Center Depth Over Bed/Trench Edges xx Depth of Topsoil xx Seeded/Sodded xx Mulched ^ Yes ^ No ^ Yes ^ No I:VMMtN 15: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 1842120th Avenue New Richmond, WI 54017 (SW 1/4 SE 1/4 34 T30N R17W) NA Lot Parcel No: 34.30.17.527A 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = 3.) Contour = Plan revision Required? ~, Yes ^ No Use other side for additional information. ___ SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. 1 Sanitary Permit Application Safety & Buildings Division ' [n accord with Comm 83.21, Wis. Adm. Code See reverse side for instructions for completing this application 201 W. Washington Ave. PO Box 7302 M di ~y rsCpnS~n urposys d for seconda id b f i a son, WI 53707-7302 Oepertment of Commerce ry p e use ormat on you prov e may Personal in ' ~ ~ ~D Zi privacy Law, s. 15.04(l)(m)] ~( l 3 ~ 5 X (Submit completed form to county if not state owned. Attach com fete fans to the coon co onl for the stem, on a er not less than 8-I/2 x I 1 inches in size. Coon ty 5E . ego; State Sanitary Permit N ber ^ Check if revision to previous application ~...~ $ .,... . _~. ~. ~ State Plan 1. D ONumbe ~ S - , y !~ / / N" I. A lication Information -Please riot all Information ~ ~ ' ~ ~ ~' Location: >~~ Pro Owner Name ~j~ , c t, a~ . LP~rop~erty Location 3 ~ L 7 ~ O Q~ 17~ /°" OLc17'l / ~" . W Jw 1/4 , S T. .N, R Propcrtty Owners Mailing Address Lot Number Block Number City, State Zip Code Nucnh~ .,. •.„.-.~,-..u... Su ion Name or CSM Number ~>~s~ ~i. .syo mss- ,~ s ~y - s~ _' II. T pe of Building: (check one) d ~3' of Bedrooms :~ - No lli D ' Crty ,~ ~~~~ ^ Vill e . we ng 1 or 2 F Ird ^ PubliclComme ~ l (describe use):_ own of r~.~ ^ ~~ ~-~^,e C: ^ State-Owned d W/ ?D ~~ /i ~ - estRpad ,~,,o PW /.ZD~~N'~ ~ ~~( 9~ ~ ~Sa~n.d~'/~ ~~ ~ = ~~ o r v 92 ( vno(~ ar 1 Tax N mber{s)O/ - ~f77.Z _~-oslo T o mil: Check one box on line A. Check box on line B if a li le 3 - 3D •. l rj. 'f III . A) ew 2. ^ R cement 3. ^ Replacement of 4. 5. 6. ^ Addition to Existin Svstem S stem S stem Tank Onl Permit Number Date Issued B) ^ A Sanita Permit was reviousl ~ sued ly. Type of POWT System: (Check all th appl ^ Non-pressurized In-ground ound filter Cons cted Wetland ~ fine ^ Pressurized In-ground ^ o rng ank ^ ogle Pass Dr ^ At- de ^ Aerobic Treatme nit ecirculatin er: V. Dis ersal/Treatment Area Information: I .Design Flow (gpd) 2. Dispersal Area 3. Dispersal 4. Soi pplica[ion 5. ercolation Rate . S ~ m Elevation nal Grade 0 Cor'~+' do ~ ~te alsJday/sq. ft. (MinJinch) Required Proposed SGv++• s// ~soi• ~~ DAD, 62~or / ~ . .S Sa off. DSO .,~ 5O Tank VII Capaci in Tota # of turer Prefab Steel Fib astir n uf a a . Information Gallons Gallons Tan ~ ~ Con- n- g s ~ ! ~ /~ ~ Q i ~"" c structed epM 6~itd'~i a71 New Tanks Existing Tanks ~ ^ s ~,~~ ~ ~ - i ~v ~~ VIII. Responsibility Statement I, the undersi .ed, assume res rsihili for inst lion of the POWTS shown on the ched fans. Business .vne 1:umber Plumber's Name (pent) Plumbe 's Si lure s MP/MPRS ~ne // So~(~ 38l - d~9a Plumbers Address (Street, City, State, Zip Code) /070 G~/11~ ~ ~-, ~ moo/ IX. County/Department Use On y natur stamps) e t Si i A II1/Approved ^ Disapproved ^ Owner Given [nit Adverse Sanitary Perrnit Fee (Includes Groundwater Surcharge Fce) . ~} ~~ ~ ~ ~/-0 g n g Dat% Issued ssu l i/ Z~ O ~ ~ L(.l~I/Yr._ Determination X. Conditions of Approval / ions for Disappro~lC~ ~2~~~`/ Q~~~~~/may. 7 ro 1~~~i~o%z) ~ ~' ~ ~ u ~ ~~~ .sy~~ ~ Qd nlLe ~O/°~~,2u~.~'f 2 L~ ~~ _ C~ ~ ~ a'Y" ~/~ ~ 'l o'er Old / _ ~ i ~. C i V/ 1~~~ ~iTGGL~j~GV n0G~j~(,{~C/Z,2(/t- ~d Cif rvr~r,. p ,~ - . L~ ~3 ,~ 97. a4 1 _~ ~ ~ J ~ ~ S D 6~ Z r~ 3~ ~~. 4 ~ /"v) L ~ I •'C.. Q, ~~Qoxartne a/~Q+Jn s~rYs~-~~~. 3~ TjU ~I. /~ / 7C.v., % n . c ,, Ei'~~ r0izii ~: ~, 5~ . C,z Cc~ /, Acs. b. /1 `,P d IYI. 4i~ r n S/ e ~ r~ ^ - ""' ~ ~M a ~ '' ' ~ .. ' ~ ~ - ~ w~~ eb~. ~ ~ssu Y~ .r,¢d 9.x,8 ~Zy~i~ a~• Id, Sc..~e,~- ~ Pro~o05e-eJ /8. SS %~ i06. 70 ~rp~ooSe-d ~ ~y'e'Ce ivtairl. /lloandW/ SX 90'OI;S~crSa~ 3 6~d~cn~, dj eel. Two ~,~ !~-t«aCS Er fe5~~enGL, ' (jjs~ pcopos ed ~, cep /bco ~. ~ 6, :.a~~ ~ S,oa c c.~/ a..~' ..~ e. u. amble r4-/07e e ~'~'/ucnt ~/t~c.~ at owt lei, B7 ~ Sou. /o~-C,;,e - 3c~'r ~. ~oF 9 r ~ ~ iscons~n Department of Commerce Scott McCallum, Governor Philip Edw. Albert, Secretary November Ol, 2002 CUST ID No.225036 MICHAEL P MC DONELL ACE SOIL & SITE EVALUATIONS 340 PAULSON LAKE LANE OSCEOLA WI 54020 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/01/2004 SITE: Rick & Roxanne Brown 120TH Ave ~ f yLZ Town of Erin Prairie St Croix County SWI/4, SEl/4, S34, T30N, Rl7W FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 877658 Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. comme rce. state.wi. us/sb www.wisconsin.gov Transaction ID No. 799440 Site ID No. 652496 Please refer to both identification numbers, above, in all correspondence with the aeencv. 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 Cplldlh chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. ~~~~ The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Requirements: DE F2TMENTC N t)E E • This system is to be constructed and located in accordance with the enclosed approved plans and with the '~ "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.01/O1) SEE CORRE: and the SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST_SAS (01/81) • Per manual cited above, limited activities are allowed in the area I S feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat • Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. • The changes made to this plan on 11/1/02 by this reviewer were acknowledged and approved by the system de igner. ~- ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 I Identification Numbers I MICHAEL P MC DONELL Page 2 11/1/02 Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/instal lation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence 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, ~~~~~. Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@commerce.state.wi.us cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544 Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 .~ MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE 9j~ ~~ OCJ ~~ ~ G~` Project Name: Rick & Roxanne Brown 3 bedroom residential mound ~ ~_ f~~~ Owner's Name: Rick & Roxanne Brown ~Q ~t~ Owner's Address: 654 215th Ave. O ~4 Somerset, WI 54025 • Legal Description: Township: County: Subdivision Name: Lot Number: na Block Number: na Parcel I.D. Number: 012-1072-80-050 Plan Transaction No.: SW1/4SE1/4, Sec. 34, T.30N., R.17W. Erin Prairie St. Croix na Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Site Plan Page 9 Soil Evaluation Report Designer: Mike McDonell License Number: Date: 10/05/02 Phone Number: Signature: i~~ ,~~ 'wally ~~~~ 'COMMERCE r~ 1LDfNG$ f'ONDENCE 225036 715-386-8692 Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SD&10691-P (N. 01101), 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 Site Inform ation (r or c) R Residential or Commercial Design 300.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 450.00 Design Flow (gpd) 3.00 Site Slope (%) 99.70 Contour Line Elevation (ft) 25.00 Depth to Limiting Factor (in) 0.50 In-situ Soil Application Rate (gpd/ft2) Nate: Sand fill (D) calculations assume a Table 83-44-3 in-situ sal treatment for fecal Cdiform of <= 36 inches. Distribution Cell Information 90.00 Dispersal Cell Length Along Contour (ft) = 5.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpolftz) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest int Pressure Disribution Information (c ore) a Center or End Manifold 2.50 Lateral Spacing (ft) 2 Number of Laterals 0.125 Orifice Diameter (in) (e.g. 0.25) 2.50 Estimated Orifice Spacing (ft) _ 2.00 Forcemain Diameter (in) 100.00 Forcemain Length (ft) 93.50 Pump Tank Elevation (ft) 6.50 System Head (ft) x 1.3 6.62 Vertical Lift (ft) 1.90 Friction Loss (ft) 15.01 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. o tions choice 0.75 1.00 1.25 1.50 x x 2.00 x 3.00 x Project: Treatment Tank Information 1000.00 Se is Tank Capacity (gal) Wieser Conc. combo. Manufacturer in the distribution Y network? Enter Y or N If N above, enter the elevation ft of the highest point. 6.25 ftz/orifice Does the forcemain drain back? Y Enter Y or N 16.31 Forcemain Drainback (gal) 81.25 5x Void Volume (gal) 97.56 Minimum Dose Volume (gal) 29.66 System Demand (gpm) Manifold Diameter Selection in. dia. ions choice 1.25 x 1.50 x x 2.00 3.00 ~~ C~„" Gallons/Inch Calculator (optional} /~ 602.82 Total Tank Capacity (gal) ~""/ 51.00 Total Working Liquid Depth (in) / 11.82 gal~n (enter result in cell 649) Dose Tank Information Effluent Filter Information 600.00 Dose Tank Capacity (gal) Zabel Filter Manufacturer 11.82 Dose Tank Volume (gal/in} A100 Filter Model Number ~ Wieser Concrete Manufacturer Rick 8~ Roxanne Brown 3 bedroom residential mound Page 2 of 9 Mound Plan View y _~ _~ -I Mound Component Dimensions H 1.00 ft K 8.35 ft I 7.77 ft L 106.70 ft J 6.08 ft W 18.85 ft 1149.73 (ft2) Basal Area Available 9.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area -I H I F • ~ ~ ~ ~ ~ ~ ~ ~ ~ = ~ oispersai ceii :::::::::::: . 101.12 (ft) Lateral 100.62 (ft)-~ ~ : ~ : : : : : Invert Dispersal Cell '~ ~ ~ =' ~ ~ ~ Elevation E • ' D ~ ; ~; • ------------------------------------- 1/10 B • •Observation Pipe '~' . ~~~' K r: 's}: tr 'ti•ti•.'S' Q• L A 5.00 ft B 90.00 ft D 11.00 in E 12.80 in F 9.50 in G 0.50 ft 450.00 (ftz) Dispersal Cell Area 5.00 (gpd/ft) Linear Loading Rate Finished Grade 102.41 (ft) -' -•~ -' ~~ -' ` ~ -• ~ ~ - " - ~ 99.70 (ft) Contour Elevation 3.0 % Site Slope Geotextile Fabric Cover Shading Key m ~, ~- Dispersal Cell See lateral details on 0 _ Topsoil Cap •"~' Subsoil Ca c ii a o 1.5 ft • ..".;;; ": ;: ;~ ; ~ ;; ;.: s ~ "" ~ ." " es. ::'"" ~ ~' ~ . Page 4 for number, i i f d p ©g ASTM C33 S d ~, r :: . "' ~''~ ' "' '~ " ~ ~' '~ ~'~ ze, an ng o s spac an ~ ~ - ~ ": ..: ~ F laterals. Laterals are ®~ Tilled Layer ^5 : ••rLr: Aggregate = ~ a o 0.5 ft ~ Typical ~ ::. > '' ' : ~ ~"~r~r°~•~~~'~ ~~ ~ equally spaced from the distribution cell's . * A -~ centerline in the distribution cell (AxB). Project: Rick & Roxanne Brown 3 bedroom residential mound Page 3 of 9 End Connection Lateral Layout Diagram Later scepter avert a imension •=Turn-upwlt~sllvahe®or¢leanout plug P All laterals are identical ~f X-}~ Holes drilled on the bottom of the lateral 9 equallg spaced ~ Force main eannection via tee or cross to marufokt a[ ang point. Laterals & force main of PVC Sch #0 [per CONIM Table 84.30-5) Number of Laterals 2 Lateral Diameter 1.50 in Lateral Length (P) 88.55 ft Lateral Spacing (S) 2.50 ft Lateral Flow Rate 14.83 gpm System Flow Rate 29.66 gpm Total Dynamic Head 15.01 ft Orifice Diameter 0.125 in Orifice Spacing (X) 2.53 ft Orifices per Lateral 36 Orifice Density 6.25 ft' Manifold Length 2.50 ft Manifold Diameter 1.50 in Forcemain Velocity 3.03 ftl Dose Tank information Locking comer with warning label and kxking device and sealed watertight Electrical as per NEC 300 and -~ Comm 16.28 WAC DiSCOnneCt ~ 4 in. min. W /(100~~ ~ 11'~ 2 Tank component is properly vented Wieser Conc. combo. Ca aci 600.00 Volume 11.82 Manufacturer Gallons gal/inch/ A Dimension Inches Gallons A ~ ~:5 2&$7 34x-26 B 2.00 23.64 C .SI'. 'i 7-~9 Oil '~~ 936 D 12.00 141.84 Total .76 600. B 3.~G. ii C D ;y~ f ' Bedding un er tank. Alarm Manuafacturer LevelArm Alarm Model Number DLV Pump Manufacturer Zoeller Pump Model Number #98 Pump Must Deliver 29.66 gpm at 15.01 ft TDH E-- Alternate otrtlet location Forc~nain diameter ~ 2 in. Weep hole oranti- siphon device P• ump ofif elevation (ft) 94.50 ~elevatron (ft) 93.50 Project: Rick 8~ Roxanne Brown 3 bedroom residential mound Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name J. Thom , POWTS INSP.#4819 Phone 715-248-7767 POWTS Regulator's Name St. Croix Coun Zonin Phone 715-386-4680 System Flow and Load Parameters Design Flow -Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other In and/or service once eve 3 ears Should ins and clean at least once eve 3 ears Test once eve 3 ears Should test month) Laterals should be flushed and ressure tested eve 1.5 ears In for ndin and see a once eve 3 eats Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted 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 84, 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 Valve Box ' ' ' Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Rick 8~ Roxanne Brown 3 bedroom residential mound Page 5 of 9 • 1 ~ N - W W t ^1 _~:5 ,~ '_- O GALLONS HEAD/CAPACITY CURVE ' HEAD CAPACITY CURVE ' EFFLUENT MODELS - ~-. TOTAL DYNAMIC MEAD/CAPACITY PER MINUTE -' '- EFFLUENT AND DEWATERING - J asr>a ~. SERIES 6749 97 W 137139 sal 16J 166 116 Ipp sW ,~ 1 _ ___ FT N: Gal Ltr1 Gal Lti GaL Lt1 Grr. Ltr4 Gal. Ltr1 Gal. Ltrs Gal. Lts. Gal Ltrs. Oal Un. Gal Us. Ga LYa. _ _ s 1.6z u 16J sa 21z n 27a Ia JW 10a b1 al a71 at tat 66 223 ,sa b17 156 sal --?. - - 1o a06 a1 129 u n~ 61 z;i 79 )00 too J7/ /1 z3a el pf ba 220 lu 6a0 1st an t s a.67 19 n ~ t ~ u ~ m a 2a2 91 a+4 ao 2z7 ao 717 Sa 220 lag .sal 1 u sag _ ~ zo aloe. la s~ 2s sa as laa u aw as 2z~ ao 2z7 as 2zo tx ala t.o ~ - _.- . ? - 26 7,02 1 JO 74 %2a0 a7 211' sa 2sa. 6a 220 121 u1 1)J 60) t . I 30 A14 66 .'241 66 206 W ?I~ 90 -. ~/O a1 27D t21 {aa 127 NI T._ W 12.19 - b :174 b 172 66 200 76 '26a ~ 61 220 106 a97 111 UI - 186 60 Id2~ ~ . 21 '- W 3J 126 at -.I91 W .219 61 ?20 90 u1 100 )79 ~ 60 1129 . t6 -67 u 181. >d 1 a0 da 220 )1 2a9 0.5 322' - )0 21.x1 a0 Lla 10 ' ~ 62 197 N 19a 70 2661 - -__t. _ 1 * 165 BO .24,x/ 11 6J IS 170 b 106 Sa 20+ 90 27.aJ ' >? 121 2 1 )7 1 W j - -t- 18] 100 a0. a9 11 'ab 21 N _ _- I _r-- I IO 3200 7 2D s y) I Lxk VWS: 19.26' 2a 76' 23' 2a' 6a' 8a' 97' )a' I15' 91' ss7' EFFLUENT &DEWATERING - _ 185 Warning: Model 185 should not be subjected to less than 30 feet TDH. 169 - Note: For Head Capacity on Model 112, industrial l co umn-explosion proof pump, see FM 219. t6t y7 188 __~ --- 98 ; 5 .5 5, 7 ,59 1d 139 SEWAGE &DEWATERING ~_~=~ci G +o~ so 6o i 7o eo i 90 loo i„ o 1 20 lu o I. o 1,50 16 0 ~ WARNING: Model 293 should not ha cllhiarforl LITER$ eC 160 210 320 W -2 9. .R.rr y, 24 8 7 22 7 20 - 6 18 ~ 6 5 16 r 50 I1 IS 12 r 40 35 10 ~- 30 6 --- 25 6 --- 20 15 / ~-- 10 2 -- 5 0 GALLONS 100 180 560 610 ,_ - to less than 15 feet TDH. 1 Kos: / 4L// ~O 0 _-____ 5 - TOTAL DYNAM{JC HEAD/CAPACITY PER MINUTE SEWAGE AND DEWATERING -- SERIES 782 768 287 286 - 482 2H 297 ~ 793 291- ---~ 795 FT. M Gal. LIr3 Gal LIr3. Gal. Llla. Gal, Llli. Gal. Lirf. _ Gil. Llr3. Gal. Lllf. G11. LIr7. Gal Lirs _ Gal LIr3 ' S t52 90 311 t28 1B1 l2B 481 128 181 130 192 1B0 BBt 110 530 198 N2 725 852 ~ ~-r t0 7.05 60 227 - 89 337 89 737 B9 377 95 J80 t58 598 121 189 tB1 6B5 ?OS ))6 t5 1.57 ~ 22.5 85 50 tB9 SO 189 SO 1B9 83 238 ~ 135 511 t08 101 130 192 ' 165 625 185 700 ?0 6 10 t0 38 10 3B 10 3B 33 175 106 401 B8 333 1t9~150 t50 568 16B 636 I 25 7.82 78 788 68 257 106 IOt 136 515 _ t5] 52~ 39 9 t1 1J 183 _ 17 t78 90 710 171 158 _ _ u0 530 I /0 t2.t9 - S t9 SO 189 -- . 91 356 -- n5 175 - - y l -?'- I 50 15.71 __ -- _ _ _ 58 2?0 _ __ l .I 89 177 60 18.29 t] 19 _ 59 223 70 2t Ir 75 95 Lock V1Ire t8' 21.5' 2t.5' 27.5' 26' 75' /?' S0' 6T 17' ~ I -~-- 1 293 1 I I 282 -- _r- j i 292 i i 282 288, 287, 268 281 Y91 2951 1 10 20 30 40 f _--.-_~ _- 50 60 70 80 t h_-~ W LL 0 5 0 5 90 100 110 120 130 140 150 160 170 180 190 200 210 220 270 -------~- I 1 I I I I U T E F S 0 80 160 240 1T---~-r-----~-~-- ~-' 320 400 48u 580 640 720 800 880 7°~~ L~ 8 3 ~~ 97. a¢ vim' ,~.1~~ ~'S~ ~ ~µ~ ~~ ~ S~°PQ D 8~ Z r'~( 3~ ~~. 1 Jo, / E"v~~~c cam, ; y~ t ~•~/~ / E(iC /~L~ ~/~ K~ ~~Q XCZi'Jr1Q ~/'~-'n S~YySEY~% See. 3 ~ T3o~r,, ~ /7c,.~., %,~. of E/'//~ ~irii /'i ~~ 5~ • CT, ~~ ~ , c.J ~. Alt•6ry-.: ~Qi/ r~ S~ ~,Ped Y• Q~ '30'''x' ^ // ,.. {~s~ ''~eb~. ~ssu,.-,mod ~ Zy ~~~ d, Se.,.~e,r: Qra~oOS~-e~ /8. SS ~ iO6. 70 P~0(o052d ° f'n~'ce maul. /iloa~d W/ S~X 90'al;s~t~.SaC ('e5~~enGC' ~ ~ L~J~,~ ~~ Proposes! I, ~o/6c.0y~P. C~6, i~a~~ cM SPa ccz/ at- ~ropo;ea 5eptrc.~+„~' (~~rn ~ha,n,b.e/w/ ,,~ e u. owt lit, 3~'r_ ~. ~oF 9 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owners K: ~/~ ~ h-b~~nne ~'~'~r~ Mailing Address ~`~ Property Address City/State /, SAO 2S- d om Plannin Department for new construction) Parcel Identification Number O /~ -/072 - 80 -OSy 3~c. 30~ ~~. ~ ~~ ~ LEGAL DESCRIPTION :':,Y:,rt~' Lv: 3ti~n J~ i~.i, s ~ lea, CPS. 3~ T 3~ ~T_?? 1'' W, Tntivn Of ~/''Jn ~ra%r/G . Subdivision /l~ ,Lot # Certified Survey Map # 11s~- .Volume ,Page # Warranty Deed # ~~~ ~~~/ ,Volume I~~ 2 ,Page # (vZv Spec house ^ yes Lot lines identifiable 0 y s ^ no SYSTEM MAINTENANCE 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. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeymanplumber, restrictedplumber or a licensedpumperverifying that (1) the on-site wastewaterdisposal 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 Zuuitlg Of ice Fvi.hiT. 3~ da f the three y ar exp' 'on date. X ~ r X l l e o©~ 1 SI NATURE O PLICANT DATE OWNER CERTIFICATION 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 roperty described ab ve, by virtue of a warranty deed recorded in Register of Deeds Office. ~ ~ /~ /~ ~~ S GNATURE APPLICANT DATE ****** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ****** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed Mound System Management Plan ~~ao~~ Pursuant to Comm 83.54, Wis. Adm. Code /- General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No ors should suer enter a septic ar pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no kxrger 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 complyion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. E~osed access openings greater than 8-inches in diameter shall be secured by an effer~ive kxking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall 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 condtion 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 sdids in the tank that rrray slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alam~.s may indicate surge flows or an impending cor-tinuous alarm. The septic tank shall have its contents removed when the vdume of sludge and scum in the tank exceeds 1/3 the liquid vdume of the tank. ff the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the need service needs to be perforated to maintain less than rrra>amum scum and sludge accumulation in the tank. The addition of biological or chemical addltives to enhance septic tank performance is generally not required. However, ff such producxs are used they shall be approved for septic tank use by the DeparUnerrt of Commerce. Pump Tank The pump (dosing) tank shall be inspected at leant once every 3 years. All switches, alarms, and pur-ps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the round. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mum as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snore compaction in the vuinter will promde frost penetration. Colo weather installations (October-February) dictate that the around be h~vily mutctred as protection from freezing. Influent quality into the mound system may oat exceed 220 mglL BODS, 150 mg/L TSS, and 30 mglL FOG for septic tank effluent or 30 mg/L BODE, 30 mg/L TSS,10 mglL FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not a maodmum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and lt is recommended that each lateral be flushed of accumulated sdids at least once every 18 months. When a pressure test is perforated it should be compared to the initial test when the system was installed to determine ff orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effk~errt ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or corrrporrent shall be repaired ar replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls. alarm or related wiring becomes defective the defective components}shall be immediatey repaured or replaced with a component of the same or equal perfomtance. If the mound compor>ertt fails to accept vvastewater or begins to discharge wastewater to the ground surface, lt will be reparired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing bidogically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Rick & Roxanne Brown 3 bedroom residential mound Page 6 of 9 ,~-* Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT in accordance with Comm 85. Wis. Adm. Code 1572 page t of 4 A.C.E. Sal & Site Evaluations County Attach complete site plan on paper not less than S'/: x 11 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal reference parri (BM), direction and cation and distance to nearest road nd l i th l l di t Parcel I.D. . mems ons, nor arrow, a o percen ope, sca e or s 012-107 -80-050 c~ ~a _ T ~ Z ~ ~ ~ ~! Please print all infonna ' / @ ~ _ ~ 'ewed B Date ,~~~~ Personal informatron you provide may be u for sec~yr q~eg~i~e~L w, s. 15. (1) (m)). ~~ ZS Q" Property Owner Pr Location Richard & Roxann Brown 20Q2 Go .Lot SW 1/4 SE 1/4 S 34 T 30 N R 17 W Property Owner's Mailing Address ~ Lot Block # Subd. Name or CSM# 654 215th Ave. T, ~;±~~ ~~~x ~-~~~!~'~' City State Zip ode P _f City ~ Village ~ Town Nearest Road Somerset ~ WI 54025 715-247-5305 Erin Prairie 120Th Ave. ~;,r ~ C~~ Use: ~I! Residential / Number of bedrooms 3 Code derived design flow rate Replacement J Public or commercial -Describe: Parent material Glacial Till Flood plain elevation, if applicable General comments /_ and recommendations: Install mound system at 11"above 99.70' contour. -~ ~S `' 7° ryra ~}~ao a~" J~~ 450 GPD na a Boring # J ~~ Pit Ground Surface elev. 101.44 ft. Depth to limiting factor <11" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft2 *Eff#1 *Eff#2 1 0-10 10yr3/2 none sil 2fcr mvfr as 2f, 1 m 0.5 0.8 2 10-15 10yr5/4 m2d 7.5yr5/8 sil 2fsbk mvfr cw 1 f 0.5 0.8 3 15-20 10yr5/4 m2d 7.5yr5/8 sil 1 fsbk mvfr cw - 0.2 0.3 4 20-32 10yrti/4 m2d 7.5yr5/8 scl Om mfi - - 0.0 0.0. Boring # Boring W" Pit Ground Surface elev. 96.15 ft. Depth to limiting factor 17" in• Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP Dlftz *Eff#1 *E 1 0-11 10yr3/2 none sil 2fcr mvfr as 2f, 1 m 0.5 0.8 2 11-17 10yr5/4 none sil 2msbk mvfr cw 1f 0.5 0.8 3 17- 1 10yr5/4 f2f 7.5yr5/8 sil 2msbk mvfr cw - 0.2 0.3 4 21-27 10yrfi/4 m2d 7.5yr5/8 scl 2msbk mfi - - 0.0 0.0. S ins observable on scl ped faces in H#4. * Effluent #1 = BOD ~ 30 <_ 220 mg/L and TSS 30 < 150 mg/ t #2 = BODS < 30 mg/L and TSS <30 mg/L CST Name (Please Print) Sig ure: CST Number James K. Thompson s,--- 3602 Address A.C.E. Sal & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceaa, WI 7/31/02 715-248-7767 ~ prcperty pW;,er Richard & Roxann Brown Parcel ID # 012-1072-80-050 Page 2 of 4 Bonng # -j B0"ng >~ Pit Ground Surface elev. 97.12 ft. Depth to limiting factor 24" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' *Eff#1 *Eff#2 1 0-8 10yr3/2 none sil 2fcr mvfr as 2f, 1 m 0.5 0.8 2 8-14 10yr514 none sil 2msbk mvfr cw 1fm 0.5 0.8 3 14-24 7.5yr5/4 none sl 2msbk mfr cw 1fm 0.5 0.9 4 24 2 7.5yr5/4 f2f 7.5yr5/8 sl 2msbk mfr cw - 0.5 0.9 5 32-36 10yr6/4 m2d 7.5yr5l8 scl 2msbk mfi - - 0.4 0.6 Sand grains observable on scl ped faces in H#4 & 5. n . Boring # _J Boring ~~~E.~~^' v J (/ cT7 ~ G~~/ `f6"v .r~ v~c'~Wri..L~ II Pit Ground SurP/ace elev. 98.95 ft. Depth to limiting factbf~ll 2$" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' *Eff#1 *Eff#2 1 0-8 10yr3/2 none sil 2fcr mvfr as 2f, 1 m 0.5 0.8 2 8-14 10yr5/4 none sil 2msbk mvfr cw 1fm 0.5 0.8 3 14-28 7.5yr4/6 none sl 2msbk mfr cw 1 fm 0.5 0.9 28 0 7.5yr4/6 f2f 7.5yr5/8 sl 2msbk mfr cHr - 0.5 0.9 H#4 consists of an unsorted mi~dure of 2msbk 7.5yr4/6 sl & 1 msbk 7.5yr4/6 Is. Redox. concentrtions spear within Is pockets at interface with sl. Sand grains observable on sl ped faces. Boring # j Boring ~' Pit Ground Surface elev. 100.41 ft. Depth to limiting factor 14" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots : _ *Eff#1 *Eff#2 1 0-18 10yr3/2 none sil 2fcr mvfr as 2f,1mc 0.5 0.8 2 8-14 10yr5/4 none sil 1 msbk mvfr cw 1 fm 0.2 0.3 3 14- 0 10yr5/4 f2f7.5yr5/8 sil 2msbk mvfr cw 1f 0.5 0.8 4 200-27 7.5yr4/6 none sl 2msbk mfr cw - 0.5 0.9 5 27-36 7.5yr4/6 f2f 7.5yr5/8 scl 2msbk mfi - - 0.4 0.6 Sand grains observable on scl ped faces in H#5. * Effluent #1 = BOD ~ 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 department at 608-266-3151 or TTY 608-264-8777. _.~ pr~ypwher Richard & Roxann Brown Parcel ID # 012-1072-80-050 Page 3 of 4 a Boring # J Boring S~S-~/1"'~ Qh~~- Pft G ound Surface elev. 99.70 ft. Depth to limiting factor 30" in. Soil Application Rate Horizon Depth Dominant Cola Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 1 0-11 10yr3/2 none sil 2fcr mvfr as 2f, 1 m 0.5 0.8 2 11-22 10yr5/4 none sil 2msbk mvfr cw 1fm 0.5 0.8 3 22-30 7.5yr4/6 none sl 2msbk mfr cw 1 fm 0.5 0.9 4 30 7.5yr4/6 f2f 7.5yr5/8 sl 2msbk mfr cw - 0.5 0.9 Sand grains observable on sl peel faces in H#4. ~,~ # ~ Bonng 5y~~- ~ ", c~~ ti Pit Grdund Surface elev. 99.82 ft. Depth to limiting factor 25" in• Sal Application Rate Horizon Depth Dominant Caa Redox Description Texture Structure Consistence Boundary Raots *Eff#1 *Eff#2 1 0-10 10yr3/2 none sil 2fcr mvfr as 2f, 1 m 0.5 0.8 2 10-18 10yr5/4 none sil 2msbk mvfr cw 1fm 0.5 0.8 3 1 -25 7.5yr4/ti none sl 2msbk mfr cw 1fm 0.5 0.9 4 25 1 7.5yr4/6 f2f 7.5yr5/8 sl 2msbk mfr cw - 0.5 0.9 Sand grains observable on sl peel faces in Fi#4. ^ Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mgJL 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. ` ~, a v T •~,a~-arv B. ter.: T ----~ r~ `'/'e6~. ilssu.~~~zd el e~ = loo. cry,' , / ^ Bi Red ~ is ~z ~~ ~~ ~ "~ Eleva-~."~~ 82 ~ Sca/e:/`=S~o, ^ S~rySEr~%~~. 3~ 83 ~ ~T3o~; iP ~7cJ., ~n, c~ 97.04' Erin,~itzi~'~e, ~•Crp~~ .~ cJ /, Aef.b. : v(q,/ ;~ ~ ",Pea/ P ne . E/Qµ = ioi sv , ~~ 8~f 3 ~ 51 oP ~ A ~e~ c 44 ~~ ~ ~~ Q6 ~ - c.~^b01` 9970 99.L6 `'~~ 99.&9 ~on ash . ~o~ ~ '~ isconsin Department of Commerce November 01, 2002 CUST ID No.225036 MICHAEL P MC DONELL ACE SOIL & SITE EVALUATIONS 340 PAULSON LAKE LANE OSCEOLA WI 54020 RECEIVED ~'`-}~ ~ 1 2~~2 ST. Crl01X COUNTY ZONING OFFICE CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/01/2004 SITE: Ri oxanne Brown 120TH A /~~ Z Town of Erin Prairie St Croix County SW1/4, SE1/4, S34, T30N, R17W Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. commerce.state.wi. us/sb www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Secretary ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 Identification Numbers Transaction ID No. 799440 Site ID No. 652496 Please. refer to both identification numbers, above, in all -correspondence with the agency. FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 877658 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. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.01/01) and the SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST SAS (01/81) • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c MICHAEL P MC DONELL Page 2 11/1/02 • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat • Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors.. __-- - -- • The changes made to this plan on 11/1/02 by this reviewer were acknowledged and _ approved by the system designer. , / ~ C~~~J ~ ~_ _~~-~/~~ Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence 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, MICHAEL P MC DONELL Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@commerce.state.wi.us Page 3 11!1/02 Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544 ~~~,~ Document Number H3~~~ bra-- ~o~a-- ~~ ~a~ r~st2C ~ Gla - -o~a-~a -~So 5a~~ n.Q-~-.~-a~,.~,.~ ~~ y i 1532Pa~~ ~22 STATE BAR OF WISCONSIN FORM 2 - 1999 WARRANTY DEED This Deed, made between Mark L. Lux and Melinda S. Lux, husband and wife Grantee. Grantor, for a valu onst era ton, s o rantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): ~,~~ ~ ~~~ SW '/. SE'/., Sec. 34-T30N-R17W except the West 66 feet thereof. Together with an easement described as the South 33 feet of the West 66 feet of SW'/. SE'/. Sec. 34-T30N-R17W. St. Croix County, Wiscons~" Iq'3-ZOOo ~+' -('o M~~ S e~K tN s Ola- 1v?a-~v- lid w ~ ~~r C ~~ ~~1 a ~,9-~a 6~77Lc34 KATHLEEN H. WALSH kEGISTEk OF DEEDS ST. CkOIX CO., WI RECEIVED FOR RECORD 08-OB-2000 9:15 AM WARRANTY DEED EXEMPT N CERT COPY FEE: COPY FEE: TRANSFER FEE: 282.00 RECORDING FEE: 10.00 PAGES: 1 Recording Area Name and Return Address RETURN TO: TITLE ONE 70619TH STREET SOUTH HUDSON, WI 54016 012-1072-80 - ~>Q~V'tQe~ ,,wee. '`~~- Parcel Identification Number (PIN) This is homestead property. (is) i~~4 Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. Dated this a~ ~ day of July ~ 2000 s ^ AUTHENTICATION Signature(s) authenticated this day of , TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stets.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kristine Ogland Hudson, WI 54016 (Signatures may be authenticated or acknowledged. Both are not necessary.) ~~' ~' ~{ + Mark L. Lux ~ w~~ • Melinda S. Lux ACKNOWLEDGMENT ,C~`TATF (1F i1d~?A~:RI /VC. 1 ss. County ) Per: ovally came before me this _~~~~ day of July , 2000 the above named Mark L. Lux and Melinda S. Lux, husband and wife to me known to be the person(s) who exccut~J the foregoing instrument and acknowledged the same. • _ Notary Pu ic, S t o~F~1lt+scefrsirr My Commissio i ermanent. (If not, s*_ate expirati~r~ date: 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 Intormalion Profsuiorwb c~Y, Fond du Lac, wi 800~655•Z021 nn ~ . Grantor, and Richard J. Brown and Roxann Brown, husband and wife K e W ~-L l• IYI ~ 11 J e d 6 'd&JudithOLson •- ~~'' ~ )amen k Carol RichaM & Yamcw 138 C • a w 00 o .. `1 ; WBr] ~' asey z a Larry Dittman 76 k 53 ~ and ~ a F, Trailer `' 107.3 Hesselin ~s loM 4< • t 143.5 ~ 97.5 y k= George ~~Y Heath .~ ~ kie • Michael & Carla • V P E . akl a~.,a l Rpn,la D. rr tP.z Carolyn 225.9 Kathleen Dal S ~ IP y k r k WR ~Bflfl efdl ~ 5phnat Tt Aldernun ~Mllb . 68 Kelly RF J2 • • 59 . Rkl F°neat ~ gpp Mar ie a Boho Monty 1 Wi a Monteith oaa "' L l bb rk Otartes ~ ~ ` etal •k ~ H:Lbann _ Vemell • N 63 punn Farms Q rrie ~ • C ~'f ' 'a Lyle T & Donna 120.7 a ~ 240 Inc ~.? ~,~ ; 146.1 ,sr Nippoldt Skogtlmd 1~ Quam ~ Bruce ~ All-Rick Np 9 Gillen ~ ~ 'tr I ~r ;fir` . Properties 239 160 3 t • Smith • 90 120 etal • 3 Q ,~,~;, , ~ „ z f !~: ~ LLC <ko "°'""' • ., ~, $ • ckm s to x s ullian ~d,am • Lamm i~ ` 1~ i M ^ r •rU p INJ ~ 3 39 • ak< • l • "a`°" Gregory k D1aM y Tk Adelaide $ ~ IM k Lyk S app ]DSeph k R+ve RM~j Gill k K.rl p ppp Naugen 40 Henry rn ~~~ ~ i0 •Z ~; c GG s e ~ ~i ~{~ ~.:' ^'r~ z oemwhng •~ .~q Nippoldt M&R710 a ~~ &Lorraine 147.7 -B lames puns Thomas 'il 2 E ~ 2$ aY e ~ _ ._ • ld g ms a : E M ~ ~ t~ m ~~ M,une,.• R - M ~ o j ~ :a Z ~ illen & Jerry Farms losePh • Harer PkR Emmert tnc er etal ~_ ~ s. $' ~ ~ Gerrit & r Dona `Theresa Mahoney e a Culver k Barbara on d A z Schmi 78.1 t • ao U 0 1 '~ Lortaine 5 onnaw Gillen • dp 106 -'a ~' Jason 9 ers n 49.47 's 280 . ,; w,e„ ~ ~k Ter-Rae Van Dyk •Dwayne 59.7 & ~ 238.5 °be"'"'" FryAmtwd Farms Inc " 6 ~ 163.6 Peggy Milton Jr L Peterson Te r-Rae Farms 1(~ „S ci0~en as 36.9 FO Z .a 69.6 & Jason Raymond 74,9 Eleanore 160 • Inc 158 29 8 • • ~~ • ayrre & Linda 151.5 lR a • Bergstrom = ~ ~ gren• s.+trau 4 Dwayne, Peggy ~ ~` Ter-Rae 116.9 40 u a.r~ w• n e = Kathleen ROaymon 40 & Jason Farms IILC • 145 ~ n Br ` !r Mary 110.6 40 zo as ~. Monty "' B • 632.6 Dennis Stoddard Terri ~;ubu<n EBen X i lronh °n 2~ p` JdIileS & • ' ~ ~ 4 • 73 Albert ~ J Donahue .~ 6 Ian) Rai '1 F °6 Wesley Emmert 558.4 Donahue ,"", ~ ~e ~° Hp'°e„ Geurkink Tr • 160 200 • Dairy InC 'a°°en ul g ~ roan. Rebhan GG Haffner ~B yb,n ~ Nk 'ton & Dennis & Grace Jeff ~ l~ktey Erin Getukin 40 g Corners } 2so fi 80 • ' ' lR Dorothy Emmert ~ • t ;. . Geurkink -r~t • • T G lag ,~ • 107.2 ~ Peterso~ 80• s,ra • s ~` • . • • C' • Ja.a ~ • , • • John k S e ~ wdaeen •a ' ~ Ka T M 9 99 ~ ~ • . 320 Cr O . . s ~ y < . 40 rn .. ~ 7s.a Breckpahler Dennis & Grace 78 Gerard dr Helen John & C eOr$111e Donald & Mar erire 8u ~ ` ~ „' 'S 40 , I(athle&en ~y 237.8 Johnson K Emmert Clemas • 80 i Sehottler Maloney 159 ~ l j ay Mc rr J e Q ~ 320 ~ 8 Dew°an v 69 e y ~ . Donavan & ~~ ' E°1Q1ert Kukuska K~ Vernon & Rebecca & Karen Kamm ~ Richard 320 ,a ~~~ Nagel w k Iola' "~ Kamm e 160 so 7 ~ ~ Stafsholt 142 critfiths Harold Mlk 160 Umlyn • l6p • , ~ . 156.2 71.6 . & Robert 240 • e • • Deleon BO : pribnow t0 'a u • • • • • ~ 3 taus aaa~k '' l ~ E ° a'~ ~ c • ;o ~ e 170 rrie JQ am me M q0 ~ Pa ~ ~ h e ~ • • Marvin John & 40 ti JDJm Q' 437.7 240 John & 7s ~"`~ ° o .z Dona u Dp~~ra,Vne a . "s ''3 oe°ns ar Jane Heinbuch Georgina Mickelson Georgina '° e"'m Kruiz rlga w ~ w~ ~ m soaerberg 70 240 Schottler 200 • 170 Schottler CJ ovarck G C 6 • • 40 Jeffrey 320 m .ti ~ m G~' ~ ~ k 187.9 40 • Fem ~ i 160 Cihlar Richard Dennis ~ ~ v ° ,hti `~ ~ (` ' ~amae themes '~~ Fn'uw ar Tamara L k • Partnership Stafshoit { & Grace go ~ ~ kCmu,ie klwn ~~ ooanank 120 •c & Carol ~~! s ~ LLP 155.5 70 Allen a Emmert ~ ~ ~ : Thomas • KB,nLm w w ~ ,r ~ y. 144.9 a5 • W593 ~rg • MM S DS • Ry zt ~K Mp Carl • •~lm 139 t~ ]. ` ~ o Q • 0o James Dennis Leiana ne na •~E LW Bliss & Kuhlman Howard 63 WmPotts 230 ~ ~ e Stoddard ar ~ Emmert 160 stodaara ~ Mta„ptm 120 & Edna :WIC IFE. k~' $taf bolt v ~ 74.6 p 120 Walker • !~ 155 Dercm C O •~ • r-'(J 143.5 Vi 120 ~" 0 d r ~ 1 2 12 Vemonk ~ $ $ ark dr .. r Peterson & pavi DtvR BBill~o 1'arrie Savadge Lyrm Franey ~ ° Debra ~ ]osep 77.7 qp 120 & h elinda ~ tson e Lux .208.8 sprat Quam ; x ~ - ~ ^g A Ken Ga[ e ~ i ~ n,pm,s & hUry Jo n Cdretyn ~ :~ ~ y/ ~ .g E o N N 16 T 91.7 ' k'" ('g5¢tf 55 ~ p;,a, ~.~ ~ Man : = Gelderlws rtC B q a ~ 3 U lanary 152.8 W Dalton • T ~ ~ ~`,' ~ CoC~b s James r ~ g -~ 1 ~r Lake • 100 °`M ~ ~ ~ '10 150 ~ ~ ~ ~ w 80 • • & Robert sr levy ~ u eo Emmert Derrick 119.5 E • z ~ = ~ must 7z • 2t 00 2000 ~ ~ E 1800 ~ ppE 1700 1900 1500 1600 cswaRr~r ca-ap cR~~M~y ~c CHEESE CURD CAPITAL OF WISCONSIN PO BOX 610 ELLSWORTH, WI 5401 1 <715) 273-431 1 FAX <715) 273-5318 O ~L _~ Z Z m Z O O va ~ C ~ d Q N to ~~_ N fD 7 3 3 `~ > ~ n a i rr. 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A N W O ', O S ~ O C ~ D '' N ~ a ~ ~ Z: ¢ Z N N N ~ D ~ o v m ~ °_'~ m o ~''~~ °.: m a (~ ~ ~ C• CT Z Z ~ ~ 'b D D ~ ~ a N A ~ O 3 0 m' -~ -~ to c p 2 ~ N ~I ~ ~ y O ~~~'~WA 0 a z ~ Z 3 a ~ °o ', cn ~ m ~ m ~ ~ fD A G W t/1 li 7 ~~ . v ~ ~ c f° 7 ~ a o c 3 (~ d r. ~, • ~v \ ~ ~ ~ i Q ee .'T • o~ "ti ~ 0 o •`.~~y~ V ~y,~ • v ~' ~• fi H C Q' `t '~ `C ti 0 lV V A ti N d0 ?? ~ N L .A w+ J% S (~ parcel #: 0~ 2-~ 072-80-050 04/05/2007 11:02 AM PAGE 1 OF 1 Alt. Parcel #: 34.30.17.527A 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 RICHARD J & ROXANN BROWN O -BROWN, RICHARD J & ROXANN 654 215TH AVE SOMERSET WI 54025 Districts: SC =School SP =Special ` -Primary Property dresses • Type Dist # Description Q 1842 120TH AVE ~, ~ ,,. SC 2422 ST CROIX CENTRAL C/-'~ ~ ~ ~ q~^~~? SP 1700 WITC '~ Legal Description: Acres: 38.000 lat: N/A-NOT AVAILABLE SEC 34 T30N R17W SW SE FKA 012-1072-80 Block/Condo Bldg: (527) & XC W 66F `- Tract(s): (Sec-Twn-Rng 401/4 1601/4) 34-30N-17W SW SE Notes: Parcel History: Date Doc # Vol/Page Type 07/27/2004 769903 2624/480 QC 08/08/2000 627784 1532/622 WD 07/23/1997 1064/265 WD 07/23/1997 930/277 more... 2007 SUMMARY Bill #: Fair Market Value: Assessed with• 0 Valuations: Last Changed: 11/07/2005 Description Class Acres Land Improve Total State Reason PRODUCTIVE FORST LANDS G6 3.000 9,600 0 9,600 NO MFL BEFORE '05 CLOSED W8 35.000 112,000 0 112,000 NO Totals for 2007: General Property 3.000 9,600 0 9,600 Woodland 35.000 112,000 112,000 Totals for 2006: General Property 3.000 9,600 0 9,600 Woodland 35.000 112,000 112,000 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 aF Wisconsin Department of Industry, = Labor aGd Human Relations 'Division of Safety & Buildings SOIL AND SITE EVALUATION REPORT Page,~of~ in accord with ILHR 83.05, Wis. Adm. Code COUN ~'O Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but 1 not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or .D. #~ dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE P~IN~T ALL INFOR~IIATION IE n~ _ ~// PR PERTY OVER: uye+- PROPERTY LOCATION J / C~ . .. GO . T ,5 i•.I 1/4 ,S T XN,R l or~ PROPERTY OW ':S MAILING DD ESS .~- ~ ' ~ ~ ~ ' / ~ OT# BLOCK# ~ SUED. R ~k}f„ ~ ~ c . 0 ~Q 1 / .. CITY, TAE ZIP CODE PHONE NUMBER TY ^VILLAGE N :~ T ew Construction Use [~ Residential / Number of bedrooms ~ [ j Addition to existing building. j Replacement [ J Public or commeraal desaibe Code derived daily flow y~o gpd Recommended design loading rate ° S bed, gpd/ft2 ` ~ trench, gpd/ft2 Absorption area required Do bed, ft2 ~~~ trench, ft2 Maximum design loading rate . -S bed, gpd/ft2 . ~ trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan nchmark) /Q Additional design /site siderations .~Q Gt Parent material a S SI~b I sK- ,yam b ~k Flood plai evation, if applicable ft S =Suitable for system U =Unsuitable fors stem CONV IONAL ^ S ~J U rn~~OU~ND LAS ^ U IN-GROUr~ PRESSURE ^ S ,ICU AT•GRADF~ ^ S J~tJ S^YSS ,~,,ULL I~ ^ S NG~UK ESCRIPTION REPORT Boring # .:<_;.;; 4 . : ,. ::.:>. :' :: Ground elev. ~ ~3ft. Depth to limiting fa3 ~„ Boring # :: ::::: t~ ~~~:: :: ? ~~:: r« ::::: 4: Ground elev. , ~~ ft. Depth to limiting fa~tprl ~' Horizon Depth i Dominant Color Mottles Texture Structure Consistence Bo~.ndsry Roots GPD/ft n. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trertth ?/ 9 -17 ~ a r~- S d /lla~~ `Z ,"'/q'6~' w~ ~~ G~ j ~ , ' '7 ~/ ' Z4 ~ ~ 8 ~ / O C_ ~ /TY G L~ .~ ~ . ~ ~" 3 n ~ s ,c r Q' ~ S ~ ,~ ~~ C ~,.~ -- . ~ '.-S' S o-60 ID tt Y 6 5" ,f: s cz ~ $' ~ s ,lam- /~ - ~ _ 3 oy Remarks: ~ ~ lZg 4 ~n 3 vr~- Z vh /'>fB/l ~i-, f ~ . ~ ~ z ~- ~s y~ ~1 ~~-~- s~ ~ 5.~~~ v ~ ~., ~ ~ ~,S Remarks: _ Name:-Please Prin~A , Phone: a-- wwj CST Number: s 03 yy 7 PROPERTY OWNER PARCEL I.D. Boring # :~ y:: 3 Ground elev. ~~~ Depth to limiting fac~r~o~ Boring # '~ :~ :. t~ 4 Ground elev. ft. Depth to limiting factor Boring # .:~¢.w:::«. ...:; ;:~ k'>i SOIL DESCRIPTION REPORT Page ?< of 3T~ th D Dominant Color Mottles Structure nce i t C Boundar Roots GPD/ft Horizon ep in. Munsell Du. Sz. Cont Color Texture Gr. Sz. Sh. ons s e y Bed Trends v l0 ,. ~ -~9 ~~ ~ ,~ ~ K'" J~- ~ I ~'''' l ~'~ ~~-s~~ ~~-- ~ c~ c~ 3 9'~ ` ,~ ,e 5 S f ,~. sly . ~'- c ~ .-- y 3 : ~ ~,~ ~ ~ ~ z.s s ~ a s~.,~ Y -- Remarks: Ground elev. ft. Depth to limiting factor Boring # <~~r<:4<:::.:,:::: <' ,: >:>.> :;. .. :~: •<:<s:.:,<4::,: Ground elev. ft. Depth to limiting factor Remarks: n.........i.... Remarks: SBD-8330(8.05/92) .~ , . P G 3 `,~ s 63 ~ Nr ~~~r (~ = Naf;~IG ~0~ ~' ~ 5 ~~~ ~V ~~ ~~ ~° I,Z o fi~ bra ENO ~~,,~ C~ x~,,.<<..,.. `~ po 0 ~~ I I i !, I i i I ~~ ~ fI sa' Parcel #: 012-1072-20-000 02/13/2008 08:41 AM PAGE10F1 Alt. Parcel #: 34.30.17.522 012 -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 -GROVE, KEVIN T & JULIA L KEVIN T & JULIA L GROVE 1842 120TH AVE HAMMOND WI 54015 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description * 1842 120TH AVE SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 40.116 Plat: 3614-CSM 13-3614 SEC 34 T30N R17W PT E1/2 OF E 1/2 OF THE Block/Condo Bldg: LOT 1 SW 1/4 NKA LOT 1 CSM 13/3614 40.116AC Tract(s): (Sec-Twn-Rng 401/4 1601/4) 34-30N-17W Notes: Parcel History: Date Doc # Vol/Page Type 04/30/1999 602311 1423/074 WD 07/23/1997 1064/265 WD 07/23/1997 930/277 07/23/1997 771 /96 more... nnno ~~ ~nene n nv Bill #: Fair Market Value: Assessed with: ~.........,......r... . 0 Valuations: Description Class RESIDENTIAL G1 PRODUCTIVE FORST LANDS G6 MFL BEFORE '05 CLOSED W8 Totals for 2008: General Property Woodland Totals for 2007: General Property Woodland Last Changed: 11/07/2005 Acres Land Improve Total State Reason 2.116 31,700 390,400 422,100 NO 3.000 9,600 0 9,600 NO 35.000 112,000 0 112,000 NO 5.116 41,300 390,400 431,700 35.000 112,000 112,000 5.116 41,300 390,400 431,700 35.000 112,000 112,000 Lottery Credit: Claim Count: 1 Certification Date: 12/04/1998 Batch #: 519 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel #: 012-1072-80-050 02/13/2008 08:36 AM PAGE 1 OF 1 Alt. Parcel #: 34.30.17.527A 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 -BROWN, RICHARD J & ROXANN RICHARD J & ROXANN BROWN 654 215TH AVE SOMERSET WI 54025 Districts: SC =School SP =Special Property Address(es): ~ * =Primary Type Dist # Description ' 1842 120TH AVE ~ ~ ~ ^ (1 SC 2422 ST CROIX CENTRAL ,~~ ~ SP 1700 WITC ,~ '`~ r L' _ ~II/-"> Legal Description: Acres: 38.000 Plat: N/A-NOT AVAILABLE SEC 34 T30N R17W SW SE FKA 012-1072-80 527 & EXC W 66FT Block/Condo Bldg: ( ) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 34-30N-17W SW SE Notes: Parcel History: Date Doc # Vol/Page Type 07/27/2004 769903 2624/480 QC 08/08/2000 627784 1532/622 WD 07/23/1997 1064/265 WD 07/23/1997 930/277 more... 2008 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 11/07/2005 Description Class Acres Land Improve Total State Reason PRODUCTIVEFORSTLANDS G6 3.000 9,600 0 9,600 NO MFL BEFORE '05 CLOSED W8 35.000 112,000 0 112,000 NO Totals for 2008: General Property Woodland Totals for 2007: General Property Woodland 3.000 35.000 3.000 35.000 9, 600 112,000 9,600 112,000 0 9,600 112, 000 0 9,600 112,000 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 ~~63'7 M ~lL~~ , AR ~ 9 1999 ~TMIEENH Rgplstero~ p ~ ~ 2 ~ CroGc Co, ~ ,~ CERTIFIED SURVEYMAP Located in the NE'/e of the SW'/4 and the SE 1/< of the SW '/a of Section 34, T30N, R17W, Town of Erin Prairie, St. Croix County, Wisconsin. _----- LANDS OWNED BY: MARK & MINDYLUX 1842 120` s•., Hammond, WI. 54015 1239 C.T.H."E" New Richmond, WI.54017 Job No. 99-008 L~-~ Scale 1" = 300' Bearings referenced to the South line of the SW'/4 of Section 34, assumed S89p43'O1"W SCALE IN FEET I" = 300' 0~ 150' 300' 600' 900' NOTE: because the pazcel shown hereon is over 35 acres it is not subject to those provisions set forth under Chapter 18 of the St. Croix County Subdivision Ordinance. Also, no approvals aze necessary from the Town Board of Erin Prairie or the St. Croix County Zoning Office for the creation or sale of this pazcel. NOTE: The parcel shown hereon is subject to State, County and Township laws, rules and regulations (i.e., wetlands, access to parcel, etc. ). Before purchasing or developing any parcel contact the St. Croix County Zoning Office and the appropriate Town Board for advice. LEGEND ~- Indicates Section Corner Monument ( as noted ) o Indicates 1" X 24" iron pipe weighing 1.13 lbs. / lin. ft. set. *---~- Indicates fence 16~ ~~ zl I ~I WI ICI ~i g' z~ ~~ rl~ F , :o,; t.y E ~ - ~~ „ 1 G~I:f'~~ 3TM '~ ~ .,.~ N1/4 Comer of Section 34 (County nail found ) N 00° 02' 33" E 2,633.51 UNPLATTED LANDS N 89° 57' 18" E 661.13 a' EAST- WEST I /4 SECTION LINE s' ~~D~ ~~~ ~~ ~~ 5~ `~p~~~~G ~~ o~ ~ N ~ N ~ ~ v ^ :shed ~A~A,`[ ~i` V ': `dwelling l~. .1 ~~-? N ~~ y~~ ~~ ~~\ O~~ IZ I~ I~ ~1 'm ~O I~ Iz ID I W ~~~~ 0 m ~o 0 100' ROADWAY SETBACK LINE., , ., w ................. w M_... C -qi- 120TH AVENUE `° ; ~ s s9°_43: SW Comer of Section 34, ( Alum. Mon.) South line of the SW 1/4 N 89° 43' 01" E 1,983.42 UNPLATTED LANDS Vo1.13 Page 3614 LOT1 c ~ 1,747,452 square feet (40.116 acres ) ~ including R.-O.-W. `~' 1,725,635 square feet w _ _( 39.615 acres )- ~ excluding R.-O.-W. „~ M o septic area Z ~ a- N 89° 43' 01" E_ 661.14_ ~ )1 "_W_ _661.14 - ~ urn/ y ti'~~/ S a S1/4 Comer of Section 34 ~ T30N, R17W (Alum. Mon.) SHEET 1 OF 2 z 0 ~n 0 c m n. O r 0 N w w N rn ~~ (D --+s