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014-1010-90-000
SITE PLAN AS C3ucc.r-~ ~,p~,J ~R,GIaDAw~. ~/ Vd r.~ S~~~R.. ~~.35' .v ~~~ TA-~~. ZN~ TA.y1t i~~1.G'1' 9 v . 2c7 i ~ .~i 5 Q~~--1 rrwK.~xr.-r ~t.~f` Bmz J(~'N ~ ~ 2003 sr ~o G ~X CoUni7 r ~JI,ti~(, oFF~~~E A~c~a.AC~.~ 5c~w~rt. ~f a~ Dr~pTH 5 ~ .r I!,~ Ft~p.v+1 Z~svua~ borV A-l.oi.1C~ ~VLL ~.~iIJGT~ r~ Bm ~ BM Bench D~Iazk EL 100.00 A o ~.. ~ ~'l.d~~ ~ rJ 10"O A lL BMZ ~tj'fTom OF 5 i~L Sipahlc, Q1.® n ) *ZZ1o564 l~t ;~- (oI4~U3 R~C~i~~D Department of Commerce .d Building Division r PRIVATE SEWAGE SYSTEM INSPECTION REPORT GEN'cRAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)j. Permit Holder's Name: City Village X Township Reindahl, Lorne & Nicole Forest Townshi CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Hol i ~ / 2 ' T NA K SETBACK INFORMATION TANK TO ~~pp~P~/L~~ 7..OCc~o WEL n LDG/.~ ~ O't Vent to Air Intake ROAD Septic Dosing Aeration Ho ~ t' ~~ ~ t ~ ~ ' ~~ PUMP/SIPHON INFORMATION 0 Gt.. 0 6~~i .~ Manufacturer Deman GPM Model Number TDH Lift Friction System Head TDH Ft Forcema'i~ gth Dia. Dist. to SOIL ABSORPTION SYSTEM hl/ //-\ ELEVATION DATA County: $t. Cr01X Sanitary Permit No: 420786 0 State Plan ID No: ~ ~} ZZv3 Parcel Tax No: 014-1010-90-000 Section/Town/Range/Map No: 05.31.15.806 STATION BS HI FS ELEV. Benchmark ~~ Alt. BM S'~j 5, ~ ~ ` ~ Bldg. Sewer y / -~ fa ~~ ~ u ~, SUHt Inlet t/ ~ ~~ .~ St/ Outlet v~ Dt Inlet Dt Bottom Header/Ma . Dist. Pi e Bo System Final Grade S er ~~~~ ` 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: INFORMATION CHAMBER OR Type Of System: UNIT Model Number. DISTRIBUTION SYSTEM A I/ /`C Header/Manifold Distributi x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER (~ /J~Q/1/ x Pressure Systems Onlv xx Mound Or At-Grade Svstems Onlv Depth Over ~ Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ~~ Yes G No ~ ~J Yes ~ No COMMENTS: (Include code'tliscrepencies, persons present, etc.) Inspection #1:~/_ ~/ 0/ Inspection #2: / / Location: 2310 280th St Clear Lake, WI 54005 (SE 114 SE 1/4 5 T31N R15W) NA Lot ! Parcel No: 05.31.15/.806 1.) Alt BM Description = '~ ~ /~ 5~.~,,r~,e d- ~a~~ J- l/I~~~~ P/. Tr 6t~ 2.) Bldg sewer length = ~~ t (2 0 '~ ~ + ~ ~ J (,~,~ S ,~- ~/-UXx ~./~ ~ (/t 1 `` ~~~ ~, S' f ~'"- - amount of cover = ~ / ~ ~/~ ~ SI~ . , ... I ~ I A~ .,_G i~ _upti ~~jh,~ _, ,___ 3 r _ ------ ----- __ --- - - r - - I~ -- ---, Plan revision Required? Yes I ' No ~ ~~, i Use other side for additional information. ~___ ___~ ~ __.__ ~ ~_~-~~_.~____ L_ SBD-6710 (R.3/97) ~ Date ~~ ~~ ,,y InsVJ`-``-~N s Signat re F Cert. No. ~pf'7~C1fU[l~'~ ~iilzr%1~t~-° ~f '~UYyi ~Sy~z.~~'iv~. Safety 9nd Buildings Division County 57 LfZpl ~ 201 W, Washington Ave., P.O. Box 7162 ~~~~~S~n Madison, WI 53707 - 7162 Site Address ~~ 23 ~ ~ Z~d ~~ e ~rtment of Commerce • • Salutary Permit Apphc Sanitary Permit Number ~ ~~VED ~d (~ ~-~~ , In accord with Comm $3.21, Wis. Adm. Code, personal inf do ^ Check if Revision ma be used for seco ses Priva Law S. 1 m I. Application Information -Please Print All Information APR 1 1 2003 state P1~5 Z2 v 3 Property Owner's Name ~ ~ fZ' ~iN~ (~1( pt ~E ~ ~ ~ N~ST.CRO!X000NTY ZONING OFF Pstcei Number Q14,- l~~Q-_~~-bC70 ~ . j .-C~- i ICE Property Owner's Mailing Address ~ Property Locadon ~...31 t:7 Z~O~ ST s ~ ~ $'G ~ • SrJ T 3 i N. R• l5 City. State Zip Code Phone Number Lot,~NZtimber Block Ntmtber / U t L C~iAiZ ~A K~ W1 ~ 5~,~' "1 Ir'j~'~•(p~j - 3(n®O ame CSM Number Subdi visi o n /~ `~~ II. Type of Buuding (check all that apply) ~ ~ ~~ ~ ^City " ~ 1 or 2 Family Dwelling -Number of Bedrooms ^Village ^ Public/Commercial - Describe Use ~I'owtuhip ~O f~~ ^ State Owned Nearest Road Z~o~ sT III. Type of Permit: (Check only one box on line A (ntnnbering scheme for internal use). Complete line B if applicable) A' 1 ^ Ne 2 ,~ Replacement System ^ RepiacemenE of 6 ^ Addition to For County use S stem ank Oni Bxis m B. ^ Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) 47 ^ Sand Filter SO ^ ConsWcted Wedand 44 ^ Non -Pressurized In-Ground 21^ Mound. _ 22 ^ Pressutized Itt-13touud 1 ~Q Holding Tank 48 ^ Single Pass 31 ^ Ddp Line 45 ^ At-Glade 46 ero tc reatment Unit 49 ^ Recirculating 30 ^ Other V. Dis ersaUTreatment Area Informati on: Design Flow (gpd) Dispersal Ares Dispersal Area Soil Applicadon Percoladon Rate System Elevadon Fiaat Grade Required Proposed ays/Sq.Ft.) RaEe(O a ls./ D (Min.Mch) Elevadon ~~//''''~~ /~ ~~ / w l VI. Tank Info Capacity in .Total Number Manufacturer Prefab Site Steel Fiber plastic t3alions Galloat of Tanks Concrete Consttttcted Gnus New F.xlada= Tanks Taab Sepclc or Holdi~ rank 2 -- ~, ~ " 2. s ~~ ~( Dosing Chamber VII. Responsibility Statement- I, the rmderst~ned, assume responsibtlity for htstallation of We POWTS shown on the attached plans. Plumber's Name (Print) Pl is Si tore MP RS Number Business Phone dumber Rai ~R~~iDE~VL ~ ~2!®5~4- `l t5)l,31_3O2v Plumber's Address (Street. City, State. Zip Code) _ ~~, ~q 13TH A~ BA~r.I ~1 ~gIZ Conn /De artment Use Onl Approved ^ Disapproved Sanitary Perndt Fee (includes Groundwater Surcharge Fee) c Date Issued Signature Stamps) ^ Owner Given Initial Adverse o ~" j,pp '- ~ ~ (° (0v !/~O3 Determinadon IX. Conditions of ApprovaUReasons for Disapproval , ~ SoL2 ~~~ C'd- rid A± a ^ ~d~~ ~ ~~ /~ i~'~~ Z /<~'~~d- Rio JII `~ , . ~T a=e~r,(,wa~,,. Gone-ems ~ d /{ J 7'~ ~ Attach c ~mpt t (to th ~ oanty~ als) r em oa papd' Aa tep~hhaa„a~ x u m SBD-6398 (R. OS/Ol)~T~-a a-v-.~2~.o"u"~ ~'r`~f""""`" a~-.'e° d. xZ~'~~~-~°` '~ HOLDING TANK SERVICING CONTRACT 3" ~ I ' O ~ This contract is made between the Holding Tank Owner(s) Name(s) and Pumper's Name L p /Z,v ~ ~ rT~v ~ A l~ L ^ lJ; ~ ~ ,~ ~ r Sa nJ We acknowledge the installation of (a) holding tank(s) on the following priop¢per~ty: (Provide legal descript`ons:) ~ f <= ~ ; C' ~ ~ ~ ~4Yl w `i- ~~ .i .~ ;1 .i <j F Cy'tir~+b~+T ~S/+` (~ 1 ~,t ,E ,f . t, : V .. 5~_C~!#,~..' 'z` -'til - i.S -- 1. The owner agrees to file a copy of this contract with the local governmental unit that has signed the rltl*T1TS7 P TOr"f?P711Pr'rt ~'Plrl~~ •P.fI :., !`.. ,,.«. 47 Gar/~~/.,~~ •~:. > > __ ... ~. - U~ ~u- _ . _~___ .1..3....... ~ ..:..............:\.~\~~.. yr ia. c-wu. ~.vuc a11u UiG a~prUVea riOlQing lanK Component Manual. This agreement will also be filed with the St. Croix County Zoning Department. 2. The owner agrees to have the holding tank(s) serviced by the pumper and guarantees to permit the pumper to have access and to enter upon the property for the purpose of servicing the holding tank(s). The owner agrees to maintain the access road or drive so that the pumper can service the holding tank(s) with the pumping equipment. The owner further agrees to pay the pumper for all charges incurred in servicing the holding tank(s) as mutually agreed upon by the owner and pumper. 3. The pumper agrees to submit to the local governmental unit that has signed the pumping agreement and to the County, a report for the servicing of the holding tank(s) on a semiannual basis. The pumper further agrees to include the following in the semiannual report: a. The name and address of the person responsible for servicing the holding tank; b. The name of the owner of the holding tank; c. The location of the property on which the holding tank is installed; d. The sanitary permit number issued for the holding tank; e. The dates on which the holding tank was serviced; f. The volume in gallons of the contents pumped from the holding tank for each servicing; g. The disposal sites to which the contents from the holding tank were delivered. 4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event of a change in this contract, the owner agrees to file a copy of any changes to this service contract or a copy of a new service contract with local governmental unit and the County named above within ten (10) business uays front tue date of cuarg~ to this sc:~:c; contact. Name(s) (Print) Subscribed and sworn to me on this date: ,~-//-03 Todays Date Pumper's Namrle (Print) P er's Siclr;~t~ ~ Notary'Public Signature 1'~t,. ~ /n~c~YzSG 3~ r ~:~~ __,. ~' a 7 • BOO Pumper's Registration Number _ - Commission Expiration ~'14~3 isconsin Department of Commerce Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264-8777 www. commerce.state.wi. us/sb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary Apri103, 2003 CUST ID No.226564 RONALD E FRIEDELL FRIEDELL PLUMBING 1419 13TH AVE BARRON WI 54812 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/03/2005 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Lorne & Nicole Reindahl 2310 280TH St Town of Forest, 54005 St Croix County SE1/4, SE1/4, S5, T31N, R15W FOR: Replacement holding tank, 3 bed room residence Object Type: POWT System Regulated Object ID No.: 896626 Identification Numbers Transaction ID No. 852203 Site ID No. 657068 Please refer to both identification numbers, above, in all correspondence with the agency.' P.®.!N t'~»`aclrti The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes I 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. e~ h1ENT The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: :~~ E CORRE~ • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Holding Tank Component Manual, SBD-10571-P (R.6/99)" • In the event this holding tank malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described the Holding Tank Component Manual are complied with. A copy of this information must be given to the owner upon completion of the project. Review Nntes • Each manhole cover or service port to be no more than 25' from service road or drive per Holding Tank Manual, Table 1. Reminders • A meter shall be installed by a pro erl licensed lumber on the waters stem that ade uatel measures the -amour o water used by the structure, excluding hose bibs and wall hydrants, which do not discharge into e sanitary system. • Anchor tank as necessary to negate buoyant forces per COMM 83.43(8)(g). • Materials shall conform to the requirements of COMM 84. • The existing POWTS must be properly abandoned per Comm 83.33 Wis. Adm. Code. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits ~ RONALD E FRIEDELL Page 2 4/3/03 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 ~eview shall relieve the designer of the responsibility for designing a safe building, structure, or component. • Note: County regulations concerning the prohibition of holding tanks may vary. Check with the local permit issuing agency. '~ • Note: The servicing of POWTS holding and treatment components, including septic tanks and holding tanks, is required to be performedby licensed pumpers under chs. NR 113 and NR 114. Inquiries concerning this correspondence maybe 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, oper~atrO' ii~r~naintenance of the POWTS. Sincerely, _~ Patrici POWTS Plan Reviewer , Yntegrated Services (715) 634-7810, Fax: (715) 634-5150 , M-f 7:45 am - 4:30 pm pshandorf@commerce.state.wi.us Fee Required $ 60.00 Fee Received $ 60.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544 " . ~ CONCRETE HOLDING TANK DESIGN Two Concrete Tank Option INDEX AND TITLE SHEET Project Lorne and Nicole Reindahl Owner Lorne and Nicole Reindahl Address 2310 280th St Clear Lake WI 54005 (715) 263-3600 Legal Description SE SE S5 T31 N R15W Township Forest County St Croix Subdivision Name Lot No. Parcel ID Number 014-1010-90-000 Plan Transaction Number Index and title sheet Page 1 Holding tank specifications Page 2 Site plan Page 3 Management & Continency Plan Page 4 Designer Ron Friedell Signature _~~`~-~.~Qau) Phone No License Number 226564 Date Designed pursuant to: Holding Tank Component Manual For POWTS SBD-10571-P (R.6/99) T.S. ~nulry ,PONDEN ~s~~ (715) 637-3020 03/24/03 version 2.0 (o3RO1) Page 1 of 4 HOLDING TANK SPECIFICATIONS Two Concrete Tanks In Series 3 If one- or two-family, number of bedrooms And/Or....Non-residential estimated flow per day 2000.0 Minimum holding tank volume required 4286.0 Total holding tank capacity proposed (gal) 2077.0 Tank 1 capacity (gal) ~~...JX for round tanks 2209.0 Tank 2 capacity (gal) Ska P e ast Co. _ ]Tank manufacturer S J Ele__ctro ~"".- Alarm manufacturer 101W ~~ ! Alarm model number HOLDING TANK CROSS SECTION 12" min. 4" min. ~~ Cy ~~E--Vent pipe 131ind plug to seal outlet opening _ _ ~~ T 12.0 in Service alarm on ~' ~ box Manhole cover with locking device and warning label Note: Manhole and vent locations may be reversed. Finisheld grade W 18" 35.0 Tank 2 Tank 1 3 in. min. bedding under tanks. Anchor tanks as necessary to negate buoyant forces. Electrical as per NEC 300 and Comm 16. Note: All tank joints, and joints between tank openings and piping are sealed watertight. Inlet Project: Lorne and Nicole Reindahl Transaction Number:' Page 2 of 4 J HOLDING TANK SITE PLAN Project: Lorne and Nicole Reindahl N Legal Description: SE SE S5 T31N R15W Subdivision Name: Scale: 1: 60 Transaction Number: Lot No.: 1 .. ~"fir ~ 3d~ w~ 3f3D tih3U.~ uoos~ ~ ~ p Rt~~ Nf~ ~~ e*wsT. ~ N~~~ 4 o Bra ¢ C7 ~ O ti ~'' 94~ ~~ n Pam, E~ ~ ov. v N A• ~. ~ ~tA ~, ~ ~ Io oAi~ © BmL ire `1`l.u~ Safi ow, oF~ ~r/~ L /`- -oiac, o,~ ~~~s~ac, GA~-~ N"~- HI©~piac, "C`paK o-Jcy 2~c~ 5'PL SK~~ HT2, No~o~~c.~ TP N rr; 'rho 2~ gay- ~ KpW ~ Wow l.,vc,AT- oti1 Se~u~. P-p-a4 1 me:~f C~xr,M fl2.5v'R~vi~nn~NtS F~rz 5~3~ ~- Prtc.N AND Ca~-m 84. l0 FD R T~ ~g 6~ rY1A7~'R,-Al. l~t~ Page 3 of 4 Ir N z 0 S ~ w ~ a- P- ~ ~.~c, Fiw m N o u s e ~'v ~.A a k `To Pt1.e~'~' CorY• M ~2.3a(, f t~ ~o tZ. TNSu-.p-i ivrJ ~~Gtut/2lumSiJrs WaT~e... Mt~'T~t'-- T~ ~c$ ~STAt..~..r~p PAR (~mm 82. ~S3 HOLDING TANK MANAGEMENT PLAN This Private Onsite Wastewater Treatment System (POWYS) has been designed, and is to be installed and maintained according to Comm 83, Wis. Admin. Code, the Holding Tank Component Manual (SBD-10571-P 611111999), and the St Croix County Sanitary Ordinance. 1. This POWYS is designed to accommodate an estimated domestic wastewater flow of 857.2 gpd. 2. The owner of this POWYS is responsible for system operation and maintenance, including all provisions in the attached Holding Tank Servicing Contract and Maintenance Agreements. 3. Each time the wastewater in the second tank reaches a level of 12" below the inlet invert (at which time the alarm will activate), the pumper listed in the current Servicing Contract must be called to empty the tank's contents and dispose of them in accordance with NR 113, Wis. Adm. Code. 4. At each service event, the service provider should visually inspect the condition of the tank, risers and manhole cover(s) and verify that the alarm system functions and manhole locking devices are present. Discrepancies are reported to the owner in a timely manner for corrective action. All corrective actions shall comply with the county sanitary ordinance and Comm 83 and 84 Wis. Adm. Code. 5. All service events or inspections of this POWYS shall be reported to the county within 10 business days. 6. The owner may not remove any of the wastes from the holding tank(s), or cause such wastes to be removed by any person not authorized to do so under Ch. 281, Wis. Statutes. The discharge of wastes from this holding tank to the ground surface, including intentional discharges and discharges caused by neglect, constitutes a failing POWYS and may result in issuance of correction orders or a citation by the county or state. 7. No one should enter a holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within these tanks may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. 8. In the event that this POWYS fails and cannot be repaired, a code compliant replacement holding tank may be installed in the same location (a new sanitary permit is required for such a replacement). Connection to municipal services would also be considered at this time if they are deemed available to the property. 9. If this POWYS is replaced, or its use discontinued, components no longer in use it shall be abandoned in accordance with Comm 83.33 Wis. Adm. Code. 10. if there is a problem with, or question about this installation, the following persons should be contacted: a. Installer :.......................... Friedell Plumbing Phone: (715) 637-3020 b. Service Provider ................ Drew Anderson Phone: (715) 455-1404 c. County Zoning or Health Dept. St Croix County Zoning Phone: X715) 386-4680 11. Project: Transaction Number: Page 4 of 4 Wisconsin Department of Commerce Division ofi Safety and Buildings SOIL EVALUATION REPORT Page ~ of..~ ~ m accoraance wrm wrnrn oa, vvrs. rum. wuc County ~'1' . GQ~7l X t~ 5~ 3~ ~ S ~ Plan must t less than 8 1/2 x 11 inches in size i l • ` ' a . an on paper no te p Attach complete s include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. ©f 4' I v ~ ~ "' ~ ~ "' ~~ If,z~ -v ~- Please print all Informat/on. ~ ~~'J 5~~ eviewed y Date Personal information you provide may be used for secondary purposes (Privacy Law 15.04 (1) (m)). C,(~ a2 ~j Property Owner "~ `' 4O LvR;C,i~'S~ 1Jtcc~i~,,E. r~~t~ ~v Pr erty Location Gov Lot`~JF, 1/4`j~, 1/4 S J T ~ I N R (, l~or) W Property Owner's Mailing Address 231 ~ Z~C~~'~ Si 5 ~~~ Lot Block # Subd. Name or CSM# 5'~ere~ City State Zip Code Ph ne N OV (',~AR.(~-1~ ~ WI ~ J4Cx~5_L(l- )2 L G F~ `(~ CI ^ Village [~ Town Nearest Road ~ Fo~~~r Z$v~ z3a~' ^ New Construction Use: ~ Residential / Numbe f ms ~_ Code derived design flow rate ~V GPD Replacement ,, 11 ^ Public or commercial -Describe: Parent material l~ f\.I K.Ohi ~ Flood Pldin elevation if applicable Q . ft. General comments ` i and recommendations: ~V ~it'~f~'1~1~ tld~,©~~ ~~~1~ RisGf~[r1 rn(~!J(~~ ~/ ,~` i Boring # L~ Boring n Q ~ pit Ground surface elev. Q 4 ~ f ft. Depth to Ifmiting factor ~_ in. Soil Application Rate ri H n th De Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 zo o p in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ~-5 ~•'S`(~- 1 ._' 5i Zrv-ablc M -~- 95 Zwt- .5 ,8 2 -Z~ o °i2 - ~~ e ~•- 5 B I Zrnab K t~ r•' 9S w- * 5 . S J ,°b5 2,5'iR b .5v2 z 2.c1L SGT Om m f ir- - -- o ^ 2 Boring # ^ Boring ~ Pit Ground surface elev. ~ ~.~ ft. Depth to limiting factor ~ in. Sail Application Rate i n H th De Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft~ or zo p in. Munsell , Qu. Sz. Cont. Color Gr. $z. Sh. *Eff#1 *Eff#2 ~ ~ ~.~ -- s ~ i ?~~- ~ m r 2~- - ~ 5 . S 2 r to ~cfc. 5 ~S~tz '~ ~ e zc~. Si I Z•~~.~ k r~ r >m- ~ ~ .S 2.°L - 2.5 2 ~- •r ~~,~ 4 8 .2cQ 5 i./i v -~ r -- -- ~ p `Effluent #1 =GODS > 30 < 220 mg/L and TSS >30 < 150 mgiL ' tmuenr rr~ = tsw5 ~ 3v myi~ anu r JJ ~ vv rr~y,~ CST Number CST Name (Please Print) Signature , ~~~~' Address Date Evaluation Conducted Telephone Number 4lq l3~ A'~ F~P~~~,J l~1 r 4~ ~ ~ 1 ~~ 2 i ~~Z C~t ~ 5~ ~3~ -~C~Z~ onn o»n rorn:nt 3 Property Owner T~~f~oAfi~ ParcellD # ~j Page L. of _~ ^ 3 Boring # ^ Boring (~ ~ pit Ground surface elev. l7 . Z ft. Depth to limiting factor ~_ in. Soil:Appligtion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 2 -~ Z I(~`~(L ~ • 2'~yR. Q.2t::'ll~. Sr ~ Zrn~hlC Ifr r ~5 1 .5 ~ ~ _ Z -¢ 2- ~ `(2 ~ G, G rsti24 ~ 5 bt U tr~n I'Yl ~' r "' "'--- U Q ^ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 ^ Boring # ^ Boring ^ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Uominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 Effluent #1 =BODY > 30 < 220 mg/L and TSS >30 < 150 mglL 'Effluent #2 = BODS < 30 mg/L and TSS < 30 mglL 7'l~e Department of Commerce is an equal opportttnity service provider and employer. If yott 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. SOD-8170 (R 07/00) SITE PLAN PROPERTY OWNER: L~R.Z/iJ'~ ~lC~'~.-~ ~~1~!(~ANI< PROPERTY LOCATION: `JLs Yq. 5~~4 s~G 5 "rjl ~ ~-~5~ . 1 c~ ~~~J Of ~©P..~~"~ - 51 CRS f X ~A t ® i ~ ~ ~ j ~~ ~Z ~ l ~o~s~ i ~ ~ ~ 4 sH~~ ~ ~,,awac..~: dJ N b Qm2 ~~ ~ F3 rn 1 3 ~ 1 1 if ~ ~ °~" fdf] q3` ~4 ~~ ~tv' a~ ~ O BM BEIJCH.MARK: ~l. 1C)U.O Bmz- exactor, a ~ s~ ~~~, ~~~~+~e~ aN C~aaA~,~ ~L q~.d` (~ BORE HOLES: Ron Friedell #226564 ~~ ~ ~ X14 q _ ~~Bz. q3.4` ~QI2tIU2 ~~'~3 q-t .2' ~ taf~~.. l,A~a-~~v~ J~ AGR-~ ^PA~t. STATE BAR OF WISCONSIN FORM 2 - 1998 i, WAR,,yyRANTY DEED Document Number ~ ':;• 4~ PAr t a_/ l.I l.1 This Deed, made between Bette M. Pickard fka_ Bette !' M. Johnston and Loren R_.--Pickard wife and__ husband _ .. __ __ ;. -- ----------___--- ------ ___--_, Grantor, i and.__Lorne 0. Reindahl I~ and Nicole R. Reindahl, _husband and wif~_,._as survivorship lna~ixal _propert.X.._ --- ------ - ---------- - ------ Grantee. Grantor, for a valuable consideration, conveys and warrants [o Grantee the following described real estate in St . GroiX _ County, State of Wisconsin: /O Apart of the Southeast Quarter of the South- east Quarter of Section 5, Township 31, Range 15, described as follows: Commencing at the Southeast corner of said Section 5, hereinafter known as the place of beginning; thence North in the center of the Town Road for 660 feet (40 rods); thence West for 330 feet (20 rods) to an iron pipe; thence South for 660 feet (40 rods) to the center of the Town Road running East and West; thence East to the place of beginning, said parcel contains approximately 5 acres. This parcel is also described as the South 660 feet of the East 330 feet of SE4 of SE4, Section 5-31-15, St. Croix County, Wisconsin. . e ~ ~?l,. ~.c.Gl~t-o~- (SEAL) • Bette M. Pickard .___-__. // , ~~~1/, c' ~ ~.E`~6a•4~ ____. (SEAL) • Loren R. Pickard Except[ons to warranties: MurilCipal and zoning ordinances of record and recorded easements, restrictions and reservations. Dated this 7 day of July 1999 Signature(s) AUTHENTICATION (SEAL) (SEAL) authenticated this day of il'iLE: MEMBER STATE BAR OF WISCONSIN (If not, --_. authorized by §706.06, Wis. Sta[s.) THIS INSTRUMENT WAS DRAFTED BY Bert D. Petersen, Attorney at Law 607 1 88 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED fOR REEORD 07-21-1999 9:30 AM YARRiWTY DEED EXEMPT D CERi COPY FEE: COPY FEE: TRANSFER FEE: 16~.T0 ~~SDINO fEE: '0.00 _. Name antl Return Address CITIZENS STATE BANK 101 Prentice St. So. P O. Box 129 Clayton, WI 54004 _ ,. _ -- I 014-1010-90-000 Parcel Identiticatan Number (PIN) This 15 homestead properly (is) Eisixx2) of Bette M. Pickard ACKNOWLEDGMENT State of Wisconsin, Polk County ss Personally came before me this day of July ,the above named Bette M. Pickard and Loren R. Pickard to me known to be the person 3 _ who executed the foregoing instru~pent and acknowledge the same. i1: , . ~, Clear Lake, WI 54005 My iZtmm I~j'Es pefmanen[. (If not. state exptratlon date (Signatures may be authenticated or acknowledged. Both are not 'yam , ~i , ___ .) necessary) •~ ' Nanres of persons s+gmng m any capacay muse be ryped or prlnroa Delow rhetr signature. _ -_-- - - -- - STATE BAR OF WISCONSIN wisconsm lega+frank Co., inc WARRANTY DEED FORM No. 2 - 1998 ta~iwaukoa. ws LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF FOREST COMPUTER NUMBER 014-1010-90-000 Parcel Number 5.31.15.80B OWNER NAME: First LORNE O & NICOLE R Last REINDAHL II PROPERTY ADDRESS: Hse # 1/2 PD --Street Name-- Type SD Apartment 2310 280TH ST SECTION 5 TOWN 31N W '/ 160 %40 Line sc ption Line Description TOTAL ACREAGE 5.000 PLAT LOT BLK O1 SEC 5 T31N R15 E 15 02 COM SE COR, TH N 660', W 16 03 330', S 660', TH E TO POB 17 04 18 OS 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1-General, F4-Prev. Parcel, FS-Next Parcel, F7-Valuations, F8-History, F10-Exit ~~, d~-~ I ~~~ ~~~ ~-lu c~ ~tiJ~r- ~ ~/(~ /~ ~z~, m~l-r ,~ ;a~ 3 ' 3~~ ~~~ ~ ~ ~~ c~i~-1O(D~G~O~~c~O x.31• tS.b'ot~ Experience ~E The new online catalog from your local library www.more.lib.wi.us '~ ~ FOREST PLAT ~~ (~Ej~/~~L ~ T-31-N • R-15-W ~- !~ (LRndOw+ners) ~ See Page 112 For Addldonal Names. . _.. ?3to ~~0. s~" ~. 2800 FOLK / ST CROI% RD 2700 2800 2900 3000 9100 3200 ,1 LoN $ cwt Harold 8 °' °' Sandra C~arol$ ~ _ a • Taaemr KrfStle c. M r $ ~qcM ~ Ih~ A R°Sen Gra~da~ ba Levendoakl PaMck ~ c ~ ° COrnOiCin StreN ~ N Roe RO~r ~ ~ $ Scepu<ek I .~q,~ Rn~ M ~~ 102 7 ~, p ya '~7 ^ x6~ ReEd ~tl 2 62 , 83 ~~ 167 N ~ ~ ARE 137 CREEK V °' Trmt C'7 (Z I~ F ~ $ tl LLB 43 133 w Cormican ~ 16] ••..~ Dorotlry 1o8in m ttu R $ R Fuser ~ Iarane I.omk ~~ ~~ r ~~ 224 0 n I° $ I I~ursen Farms r $1,y $ N ~ t~~ l0ou- qos- Bn°- o c-.- r 90 70 ° a a v B~YP~ 80 r0 °Q 40 °Q 40 °~90 ~ rra° p $ Helm ~._.- n ~ ~ ! ~ I ~~ FliO"- 68 Pieh ~ g ~ t6J ~~. ° Fnnt~ t ura ~ David $ Fred Clemas .. +::- 160 °' rs 80 SO ~~b ~ °-" ~ ~6o m 260 P Blomberg80 Nitclhey 80 39 90 1~ m ~ " r t ~ Fom Ndl t37 230TH VE $ amu t s~ R Pete t :s ., ° ~ r~ ProPern« eo 40 ~ ~ ~ ~ Pn'u~ he.m$ ~~ ~~ Rose, Wa e I Shhtee ~ ~~ ~ M~~ p 5~ ~~ ~ "~ ~~~ E l~~Mo ~ v O ~~ ~pgg $ ~~ ~ e Derma shkl« $ stooks ~ t u ~ 2 40 80 ~ ~" VSx~ 120 Cron 6o Brooks 120 160 '°° ~ N ~j1 ~9 $ HelBm°n ~ Richard Leon $ Mlraaellr t WaVoa $ L G' Rhonda ~j Mlstm 1S 160 ~ ~n $I 40 ~° 7ho~mu Uhtch 160 147 atW13 M/Ollam$ m Dends Patrkk S F ~° t~nedr R~ c«- Ha~ ~ $ Kathy $ lYade gp a mod' r Gale ,10 ~FFK srbmin ~_ Fit'at 96 Stehaber8er ]60 ~ ss 80 80 3raain ~ r 220th AVE ~ ~ Ndl $ 7~~ tm~eldt O 195 7. raaN Sinfhleis I 1 Gil ~ 1s Nibs ~-. 97 a ~ S $ Krefb ~~ iwllric~h Davkl P~ ~o Sam $ 39~ 0 0 Dodd $ ~ ~ $ ~ ^ Wilma Anderson o iv 74 ~v' 140 20 160 Schmidt ~ ~ ~~~ ~ ~ `.: v :°. ,Fj r n ° °m ~ Goodrich o 0 1 ~ ~~ 4f ~ 158 = Pouter m~ o ~$ ° 0D Place °° \ I m ~ G 270 ~ Farms ~ r, p Deboer v~ o qI Inc ° ~ S,9 ° it _ W Kurt ~ ~ ~ 48 ~ ~ M $ oe. g S2 ® 160 ~ 340 ~~~ V 120 I 40 04l~ ~~^ r x a 220 t-~~ ~V ~ ~FFk Ed~ ~ ,~ a Robert at5 20 Kurtlc $ 210th AVE g ~~Q,ji Flf:er ~t ® g a Scott po F t 240 51 40 q0 David $ / $ Rita ~ sawa ul _ 40 40 Iarele~ ~ Buhr ~ p ~ ~ ~. A $$ Ludlle Esevold ~ Dennis David $ ~ SWaryR~°v ~ ~ BOLEN ~~ ,,, ~" a ~ $ I C Laude p MoR 112 lYust 80 ISS n 1601 ~Ros~ 1~°t 120 / 1~ 40 160 '- "' ~3i ~ 205th VE Erk$ W>V- •1 I N ~ ~- 00 o c7@I M~ 49 Fl ~° D~hn 198 w 9o ai 40 p ii r ~ p 168 160 160 78 ~ ~~ ~ ~ 116 SN 1-°°,~ q ~ 5 [lam Tenanoe a~°Ma.a _ ~mT F-~- 200th AVE ~radkf ~ vn r ~,. $ - ~ ~~ 1 s ~P Dabaa melt t Larrrence 76 aem $ Rhea a0 a~ 160 ~0 40 ~ Alke t~ 8 ~ 80 49 ohu Jjames$ Kesh $ rWeee AHred$ ~~~ Voeltr ~, s 3 ~$ Strom FJiawn 80 90 t" p ~'i8 200 '~ 233 irw:° ~~~ 1~ 75 ~ 160 ]II ~-.. ,~v'~ ^ e t x~m. ~t Otto aline $ '~ ro °p 1 Kuha I ~ ° ~ s.m r+rta- Gaty Hormel Robert $ ureen ~ 7ed p ~ $ ~s tl I p t'ant ~° AnnMte Itefbes ±3~7 gggg$ ~~. $ Ilea ~ tl p $ Frances Muter Rode °°-~ ~tl3 229 ~~'n~ n sman Helnbuch ~ ,^. ~ 201 120 120 160 131 w FO a p 84 Ir1 ~` p 1 n • 00 m pouf ~ ~ Dale $ $ Arline _ K F~arms~ ~ ~ b ~ ~ ~ tl I ~ 0! ~ i! ~ 34 ~ ~ i ~ 80 ~ C' ~ ~ ~- `y' M Z 155 X90' ~~ ~~~ V~ , 220 V~S ~ ~ 12e 240 80 80 D Allen$ a' Norman Forest $ ~ $ ~ o+nt p r ~. Vinson ~ ~ y ~ w~imer ~ I Sim~o~ n $ ~ 100 ~ F~ ~~~ m~ Ludewm Z1 a Ca~n~$ 8 m s C Q Schmidt ti9iN r> G iS 255 r ~ 158 t""' 160 80 S 160 s $Abbott 79 121 ~~ 40 p X120 ~^ Fitrctrtrn pAGE 54 GLENWOOD PAGE 56 _ ~gR~ ~ ~, D e ~~" GLENWOOD CITY, WI 84013 (715) 265-4429 (715) 265-4384 j '~ 15) 265-7255 FAX (715) 265-7604 ~' ~- ~J 2203P 25~ .~,.,. St. Croix County Holding Tank Agreement tate Pnlan Transaction Number - LD(~NE Q~~~~~~ Name - (Owner) Typed or printed being duly sworn ,states, under oath, that: 1. He/she is the owner/part owner of the following parcel of land located in St. Croix CoTUrcy, ~iv isconsin, recorded in Volume t yk.3 Page C"3 " Document Number 1D071 St. Croix County Register of Deeds Office: A parcel of land located in the'/. of the ~'h of Section ~_, T~ N - R ~_ W, Town of i=~ ~.s r , St. Croix County, Wisconsin, being duly described as follows (include lot no. and subdivision/CSM or detailed legal description): Agreement Date: 3` ~~- o j 7 1 6300 KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CO., MI RECEIVED FOR RECORD 04/11/2003 09:30A?I HOLDING TAAK AGREEMENT EXEl~T It REC FEE: 13.00 TRANS FEE: COPY FEE: 3.00 CC FEE: ~rr~_~- RECEIVED app f 1 2003 ST. CROiX CUUN i '.' ZONING OFFICE Name and Return Address Lbi1NE 1'Z~~vDAifL ~;rv ,~YO'= S~} ~~i«, !_Gks ~~ sztao~ O 1 ~ -Ib l~~ - -- v . Parcel Identification Number (PIN) We acknowledge that application is being made for the installation of (a) holding tank(s) on the above described property or that continued use of the existing premises requires that a holding tank be installed on the property for the purpose of proper containment of sewage. Also, the property cannot now be served by a municipal sewer, or any other type of private onsite wastewater treatment system as permitted under Ch. Comm 83, Wis. Adm. Code, or Ch. 145, Wis. Stats. As an inducement to the county to issue a sanitary permit for the above-described property, we agree to do the following: 1 . Owner agrees to conform to all applicable requirements of Ch. Comm 83, Wis. Adm. Code relating to holding tanks. If the owner fails to have the holding tank properly serviced In response to orders issued by the govemmental unit or the Department of Commerce to prevent or abate a human health hazard as described in s. 254.59, Stats., the govemmental unit (Town) may enter upon the property and service the tank or cause to have the tank to be serviced and charge the owner by placing the charges on the tax bill as a special assessment for current services rendered. The charges will be assessed as prescribed by s. 66.0703, Stats. 2. The owner agrees, pursuant to s. Comm 83.54 (2), and Comm 82.40(3)(e), Wis. Adm. Code, to have a water meter installed in the structure. The water meter shall be installed by a plumber authorized by the Department of Commerce to make such installations, with said installation complying with State regulations and manufacturers specifications. The owner agrees to be financially responsible for the purchase, „ - t - -d _ t. , _ Et _ .~. ~•• ~ , ra•~.., c` ::.....•~rco :~ enter "$:auatiOP maintciiui,:~ci, Diu ...,.a. r u''ia. 'NGt' " "•-''- .: [i.^::G 3Y:... .., .,...., . .., ,. the above-described property on a regular basis to read and/or inspect the wafer- ' 3. Owner agrees to pay all charges and costs incurred h•• " servicing and maintaining the holding tank in sup The govemmental unit shall notify the owner of ai the event the owner does not pay the costs within on the tax roll as a special assessment for the abat 4. The owner, agrees to contract with a person who is file a copy of the contract with the govemmental un copy of a new service contract, with the govemmenta~ ity for inspection, pumping, hauling, or otherwise human health hazard caused by the holding tank. • within thirty (30) days from the date of notice. In ees that all the costs and charges may be placed tax shall be collected as provided by law. Code, to have the holding tank serviced and to Ty of any changes to the seMce contract, or a ~e date of change to the service contract. 5. The owner agrees to contract with a person licensed ~ .~. Ham. Code, who shall submit to the county on a semiannual basis a report detailing the servicing of the holding tai ..arrtmental unit or county may enter upon the property to investigate the condition of the holding tank when pumping reports and .,racer readings may indicate that the holding tank is not being properly maintained. 6. This agreement will remain in effect only until the county office responsible for the regulation of private onsite wastewater treatment systems certifies that the property is served by either a municipal sewer or a private onsite wastewater treatment system that complies with Ch. Comm 83, Wis. Adm. Code. In addition, this agreement may be cancelled by executing and recording said certification with reference to this agreement in such manner which will permit the existence of the certification to be determined by reference to the property. 7. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner shall submit this agreement to the register of deeds, and the agreement shill be recorded by the register of deeds in a manner which will permit the existence of the agreement to be determined by reference to the property where the holding tank is installed. Owner(s) Name(s) =Please Print . Subscribed and sworn to before me on this date: L06~u~E 2C.T NOA ~ L 3- l J- o Notarized Owner's Si~n~a]ture(s) Notary Public / , ^~ GuW _ - ~Gf G3 Gu/ Govemmental Unit Official Nam~~Tf. Il+wuf~ Print . ~` / My Commission Expires ~ S Govemmental Unit Offlct~ ~~ f0 `" Drafted by: ° ~a C • ~' Document nay De uses Tor secondary purposes trnvacy maw s. ~ o.vy~ ~ pn ~~~ ' f$ p-Al;~ IS~~ART OF THIS LEGAL DOCUMENT - DO NOT REMOVE" .,...,.. This information must be completed by submitter.• document title. name 6 return address. and P/(V (if required). Other information such as the granting clauses, leagal description, etc. maybe placed on this first page of the document or may be placed on additional pages of the document. Note: Use of this cover page adds one page to your document and $2.00 to the recording fee. l~sconsin Statutes, 59.517. "Document Number STATE BAR OF WISCONSIN FORM 2- 1998 II U 2 2 0 3 P 2 5 2 WARRANTY DEED This Deed, made between Bette M. Pickard fka Bette M. Johns ton and Loren R. Pickard,,_wif e_and husband _ _ Grantor. and Lorne 0. Reindahl II and Nicole R. Reind 1, husband and wife, as survivorship marital -Pro.-- ertY Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate In St . CrolX County. State of Wisconsin: A part of the Southeast Quarter of the South- east Quarter of Section 5, Township 31, Range 15, described as follows: Commencing at the Southeast corner of said Section 5, hereinafter known as the place of beginning; thence North in the center of the Town Road for 660 feet (40 rods); thence West for 330 feet (20 rods) to an iron pipe; thence South for 660 feet (40 rods) to the center of the Town Road running East and West; thence East to the place of beginning, said parcel contains approximately 5 acres. This parcel is also described as the South 660 feet of the East 330 feet of SEA of SEA, Section 5-31-15, St. Croix County, Wisconsin. I~erording luea Name aril Return Address CITIZENS STATE BANK 101 Prentice St. So. P.~O. Box 129 Clayton, WI 54004 014-1010-90-000 Parcel Identification Number (PIN) This ~' S homestead pmpcrty. (+5) f~x~t+) of Bette M. Pickard Exceptions to warranties: Municipal and zoning ordinances of record and recorded easements, restrictions and reservations. Dated this day of Jtl y 1~-• (SEAL) ~~ ~ ~~'~'-''' ~ (SEAL) * Bette M. Pickard (SEAL) (SEAL) vt._,,_~s Lor n R. Pickard _ AUTHENTICATION ACKNOWLEDGMENT Signature(s) authenticated this day of , TITLE: MEMBER STATE BAR OF WISCONSIN (lf not, authorized by §706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED 8Y Bert D. Petersen, Attorney at Law State of Wisconsin, ss. Polk County. Personally came before me this day of July ~~ , t~ he above named Bette M. Pickard and Loren R. Pickard to me known to be the persons who executed tFre foregoing Instrument and acknownledge the same. Larry J. Demers Notary Public. State of Wisconsin Clear Lake , WI 54005 My commission Is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not 7-07-02 _, _.) necessary.) ' Names of persona algning In sny capacity must be typed a printed below their signature. STATE BAR OF WISCONSIN WISCEN1'tMl t.!{tar Po.•rnlc CO., k1C. WARRANTY DEED FORM No. 2 - 199a r"ta1N°r~t°°• wls.