Loading...
HomeMy WebLinkAbout014-1028-20-200 St. Croix County Planning and Zoning Afondav, January 12, 2009 at 4:00:17P.41 Detail Sanitary Information Page 1 oft Computer #: 014 - 1028 -20 -200 Sub /Plat: NA Section: 13 Parcel #: 13.31.15.1948 Lot: 2 TN /RNG: T31N R15W Municipality: Forest, Town of CSM: Vol. 23 Pg. 5525 1/4 1/4: NW 1/4 NE 1/4 Owner: Witthoft, Robert & Joanne 3173 County Road 0 Clear Lake, WI 54005 State Permit: 514916 Issued: 07/03/2008 POWTS Dispersal: Mound less than 24" suitable s Permit: New County Permit: 0 Installed: 07/21/2008 POWTS Detail: NA Bedrooms: 3 WI Fund: POWTS Pretreatment: NA Notes Issuer /Inspector As Built Pl umber Other Requirements Additional Notes Money Owed Ryan Yarrington >4/1/00 - Not Required Gille, Dennis need parcel number! Mound installed 7/14/08 $0.00 Ryan Yarrington i ;e a Oft: Yes Scheduled Pump Date Pumped 7/21/2011 * 8 2 4 1 875018 KATHLEEN N. WALSH REGISTER OF DEEDS CERTIFIED SURVEY MAP RECEIVED RECORD 05/19/2008 11;30AM THE NORTHWEST QUARTER OF THE CERTIFIED SMVEY MAP NORTHEAST QUARTER, OF SECTION 13, VOL 23 PAGE: 5525 TOWNSHIP 31 NORTH, RANGE 15 WEST CO FEE 13, COPY FEE: 3.00 0 TOWN OF FOREST, ST.CROIX COUNT Y,WISCONSIN PAGES; 2 North 114 UNPLAMD LANDS Section 13 -31 -15 S86'40'26 "E 2672.66' Fd Survey Mark Nail 0! ( ses•4o•z"e _ 1336.33_ 41.2 a 3 — centertine 13 08 8, _ t 1688 44' w 4S:o9T . 3 3 ' � _ %i1c — ' a'd _ .� �.I -�}o _ buildP�n s e t b ac k line" "1C'g4'+' 1 �•� � Earn LQr 316,021 sq.ft. - 263,534 sq. ft. NE Corner N -o 45 .09' 316,021 7.25 acres bids ► ' 6.05 acres n 4: Section 13 -31 -15 L. �. inct. r -o -w noF incl. r -o -w � - Fd Aluminum Cap ,n 360.28" .... Ad N88'o2'43`E 806.14' O od rn of o 1 N � V1 a LO LOT 2 3 0 '3 4 Ln a 1,450,842 sq.ft. 509 te5t5 cn U_ 33.31 u acres N LANDS E- e Incl. r -o -w ,.-0 v - -- al rn N 1 , 1 .43,192 sq. ft. till Ile) Z1 t "' a 33.1 acres ca nct. r -o -w o n i o � Z a PREPARED FOR: Jerry Cress 3155 CoRdQ Clear Lake, WJ : >w saner Ntv/n;r� B J SE comer 'rb + N86 53'26 "W N 1339.16' NW E /N ish 1 01 , to O South 114 uNLANDDS Section 13 -31 -15 Fd Aluminum Cap Note: Each parcel on this map subject to State and County laws, rules and regulations (i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office for advice. A possible violation of the St. Croix County Zoning Ordinance DRAFTED BY: will be created if the existing structure, located 200' from the JQel A. Brandt property line; OR 150' from the publiS road right -of -way, ever A SURVEYING LLC houses livestock or animal units. + LEGEND Moo 0._ ..... Government Corner (as noted) '••; 1M' t� �1' ' it o.- ..._Set 3/4 "x18" Iron rebar weighing r St1 1.502 lbs. /lineal ft. � existing barbed wire fence North .s referenced to the "-•••• North tine of the Northeast Quarter of Section 13 -31 -15 SCALE= 1" = 300' s• which beari S86 0 40'26 "E (St. Croix County Grid System) 0 300' 600' Sheet 1 of 2 Vol. 23 Page 5525 coo/zoom gaesa do 9a1i 00 ui0U0 g L 99 98£ S1L xtra LS =S1 NON 900Z/61/60 1 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix ` Safety and Building Division INSPECTION REPORT Sanitary Permit No: 514916 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: 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 Parcel Tax No: Wilthoft, Robert & Joanne Forest, Town of CST BM Elev: Insp. BM Elev: Description: Section/Town /Range /Map No: I BM �f1. q e3T 13.31.15. TANK INFORMATION ELEVATION DATA Z. RB, J 4 TYPE MANUFACTURER CAPACITY STATION BS I FS ELEV. L •g 9�f. Septic Benchmark I , 1 J G.� Dosing AI 1 / L� n (1 � %i,c ; Bldg. Sewer 0 $ r, ; Holding St/Ht Inlet • �+�• 2,9 TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/ WELL BLDG. Vent to Air Intake ROAD Dt Inlet \ Septic A)4 v Dt Bottom 154 $ -5 L [ Dosing 7-S i Z15 j Header /Man. 1. All 3. Az . (-5 Aeration Dist. Pipe • �� �� r f! Holding Bot. C 7 i � Final Grade / PUMP /SIPHON INFORMATION 3. /ai - S b� Manufacturer 1 Demand St Cover ZOCAl GPM Model Number 5 . TDH Lift Friction Loss System H ad 611 Z.34 •S J TDH 7Z ��r1 Forcemain Ler Dia. Dist. to Wei z f� SOIL ABSORPTION SYSTEM (p• �� BED /TRENCH Width / Length / No. O Tren es PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 7 S C __­1 `— \ SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type ystem: �� J � i /L A I UNIT Model Number: 1 00 4 1 %_ 1 $ DISTRIBUTION SYSTEM 15 Header /Manifold Distribution/ C � 0-1 / x Hole Size `` // x Hole Spacing Ve Air Int 9 / Lenth 3b • P g v � 2 t! Len th Dia • Length • Dia J S acin i I i SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over / Depth Over xx Depth of xx Seeded /Sodded I xx Mulched Bed/Trench Center Z Bed/Trench Edges ITopsoil I A.,. et j No No t, G [_� COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: 7 / 7 / O nspection #2: / e s / Location: 3173 County Rod Q Clear Lake, WI 54005 (NW 1/4 NE 1/4 13 T31 N R15W) NA Lot 2 P16 4-J arcel No: 13.31.15. 1.) Alt BM Description = , / 0, C L I 10 2.) Bldg sewer length = Z S C - amount of cover = / n n G ewyt•Q, �a t, 7 Plan revision Required? )f Yes Use other side for additional informati Date Insepc or's Si y ure Cert. No. SBD -6710 (R.3/97) commerce.wi.gov Safety and B ildingsM`PP /E D o ty S T /� � 201 W. Washingto Ave., 2 l/LO''7' I t l epartment s c o n s i n Madison, I 53707-7162 S tary Permit Num (to be filled in by Co.) of Commerce JUL 0 2 2 00 �� / Sanitar y_ Ply Permit A licati n ST. CFt01X COUNTY aeTransactionNumber T' �55 3Z In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form the =g a unit is required prior to obtaining a sanitary permit. Note: Application form ect Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary u oses in accordance with the Privacy Law, s. 15.04 (1)(m), Stats. I. Application Information — Please Print All Infor n t CL A � t •! l� Property er's Na P A Parcel # D ur. Pro a Location i Property wner's ailing Address mow'""' p riT r A 19 /Q w G vt. Lot J Ci tate Zip Code Phone Number 4/447 y4, Section ('circle one 4 ljC/.f� 7 J - � 7 T .(/ N; R /t� E orb Type of Building (check all that apply) Lot # V--- ❑ 1 or 2 Family Dwelling — Number of Bedroo Subdivision Name +�.. Block # El m Public /Comercia] — Describe Use ❑City of irOOM,�} M Number ❑ 'Village of ❑ State Owned Describe Use �/ 2 � 7V O✓�►�! � 552. own of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) FB. A New System El Replacement System g p Y g System ( p ❑ Treatment/Holding Tank Replacement Only El Modification to Existing (explain) El Permit Renewal El Permit Revision List Previous Permit Number and Date Issued ❑ Change of Plumber ❑Permit Transfer to New � Before Expiration Owner IV. T ype of POWTS System onent/Device: Check all that appl ❑ Non - Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil T Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treatnrnt Area Information: Design Flow (gpd) Design Soil Application e(gpdsf) Dispersal Area Require f) Dispersal Area Propose System Elq,v tion VI. Tank Info Capacity in Total # of Manufactur r Gallons Gallons Units U y New Tanks Existing Tanks (w p 2 2 y . {✓ �Ot) ` I a U yr tA rn ii C7 a Se ' or Holding Tank DQ Dosing Chamber / o o VII. Responsibility Statement - I, the undersigned, assume responsibility for installation of the POWTS show the attached plans. Plumber's Name (Print) P( r s ature E' umber Business Phone Number Zz 141 7Q= .2G p' 4 6 37 Plumber's Address (Street, Ci[y State, Zip Code) 3s'z V o s i AO%A l &, i S'yo 0 VIII. Coun /De artment Use Onl Approved ❑ Permit Fee Date I ued Is nt Signature teas. Denial �� 7 b$ IX. Condit6*STE11V�easons for Disapproval n 1. Septic tank, effluent filter and 3 �. 1�8tJt dispersal cell must all be servk•,es'/ maintained as per management plan provided by plumber. 1 '' ; L✓` 2. All setback requirements must be maintained as W applicable code / ordimmm. Attach to complete plans for the system and submit to fe County only on paper not less than 8 112 x 11 inches in size SBD -6398 (R. 01/07) Valid thm 01/09 N z.z iv7� PART of MOO Ac. /Or. caoix Co. 04205rrEP� - � l 1 I � t r i 5 O �oSeY1 i,ovs� M -1 rn.r NVF tow/b00 �8 W�1771,� `rq�llk Eco 14 alo7 Nia /Vrs 13 1WKls&r Zz 1v7� PART of 34.09 AC-. /$r. CROI Eie /coo, y Z A � d r d � 1 i I � I ' J t t i � \ 1 1 � � 1 � 1 5 v �aSe1� 3SR H oFFcqrr t cw /boo 64 c4 '" 8W47yo^3 'r-44K tam �i aM �lz 1 T Safety and Buildings 3824 N CREEKSIDE LA commercemi.gov HOLMEN WI 54636 TDD #: (608) 264 -8777 isconsin www.commerisco govs6t Department of Commerce www.wisconsin.gov Jim Doyle, Governor Jack L. Fischer, A.I.A., Secretary June 19, 2008 CUST ID No. 221471 ATTN: POWTS Inspector DENNIS J GILLE ZONING OFFICE GILLE TRUCKING & EXCAVATING, INC. ST CROIX COUNTY SPIA 352 140TH ST 1101 CARMICHAEL RD AMERY WI 54001 -2840 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/19/2010 Identification Numbers Transaction ID No. 1553248 SITE: Site ID No. 738974 Rob Wittho05 Please refer to both identification numbers, CTH Q above, in all correspondence with the agency. Town of Forest St Croix County NW1 /4, NE1/4, S13, T31N, R15W FOR: Description: Three Bedroom Mound System / New construction / 7% slope Object Type: POWTS Component Manual Regulated Object ID No.: 1187862 Maintenance required; 450 GPD Flow rate; 25 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual- Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual- Version 2.0, SBD - 10706 -P (N.01/01) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. • 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 ofSec. 145.20(2)(d), Wis. Stats. • The area within 15 feet horizontally down slope of the dispersal cell shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • Maintenance information must be given to the owner of the tank explaining that periodic cleaaing of the effluent filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • 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 P.4.w.T,S. Conditionally APP ROVE D"h DEWS J GILLE Page 2 6/19/2008 Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • 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). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptabb to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 atthe 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, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Gerard M Swim POWTS Plan Reviewer, Integrated Services (608)789 -7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swim@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN 9 j N(W Residential Application INDEX AND TITLE PAGE G3AI30 Project Name: ROB WITTHOFT Owner's Name: ROB WITTHOFT Owner's Address: 2719 210 AVE DEER PARK WI Legal Description: NW NE S 13 T 31 N R 15 W Township: FOREST County: ST.CROIX Subdivision Name: Lot Number: Block Number: Parcel I.D. Number: 014 - 1028 -20 -000 Plan Transaction No.: 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 Pu�� rvep�d S - /o -// SOZA - ; Designer: DENNIS GILLE License Number: 221471 Date: 06/13 Phone Number: 715 - 268 -6637 Signat r�� Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 4.0 (R. 04/03) Pagel of 7 DEPARTMENT OF COMN DIVISION OF SA FETY AND BUILDINGS ` - SEE COR - SPONDL"N4 ;�_ Mound and Pressure Distribution Component Design Desion Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 83 -44 -3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of - 36 inches. 450.00 Design Flow (gpd) 7.00 Site Slope ( %) 99.50 Contour Line Elevation (ft) 25.00 Depth to Limiting Factor (in) 0.60 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 75.00 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /fe) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution F Y Pressure Disribution Information network? Fntar Y nr N (c or e) c Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation (ft) 4 Number of Laterals of the highest point. 0.156 Orifice Diameter (in) (e.g. 0.25) 2.00 Estimated Orifice Spacing (ft) = 6.25 ft /orifice 2.00 Forcemain Diameter (in) 75.00 Forcemain Length (ft) Does the forcemain drain back? Y 88.00 Pump Tank Elevation (ft) Enter Y or N 4.55 System Head (ft) x 1.3 12.23 Forcemain Drainback (gal) 12.17 Vertical Lift (ft) 67.44 5x Void Volume (gal) 2.34 Friction Loss (ft) 79.67 Minimum Dose Volume (gal) 19.05 Total Dynamic Head (ft) 38.77 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 1.50 x x 1.25 x 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information 627.00 Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) 42.00 Total Working Liquid Depth (in) HUFFCUTT CONCR Manufacturer 14.93 gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 627.001 Dose Tank Capacity (gal) JZabel Filter Manufacturer 14.931 Dose Tank Volume (gal /in) IA100 Filter Model Number HUFFCUTT CONCR Manufacturer Project: ROB WITTHOFT Page 2 of 7 Mound Plan View T .........' .............. ....... J 1/10 B := : :::.......:.......:.: 3 ... . Observation Pipe F K r.r.fy.,•.r..•yy.r.l.l.f.f.f . f.r . l.t.r.r.:.r.ry. r. r•l. r. r. r.: .f.f.J.r.f.:.:.r.l.l.:.l.:.r.r- L• t• L• L. 4• •.•S•L.L•S•S•4•L.L•L•S•4•S•L.L• • L Lit•t•t•4•L•L•L•'.•S • t•S•S•S.S•S•S•S•L•S•1 �.••. :;t.✓; r•J•J; ;.l; l.:.l.f•f.J : t.r.r..., f J,.•.J.l.r.r.J:J;:: �: l:l::::•••: r:.•:::1;..'•: -''• . ,L� a 5.......... f: A: L " ' :: :: ::: f.f.J•r;r•nJ; l.r.nl. 5 ':• t.:: i.:. r. r. ::�: ::r:::i:i:i:r'r ::i:i:i:i:r; •.r 1. L.......L.S..•t•t•.•L..•.S•.. t.S.t.. 4.......... 5..�.5.. l ;:t:t:.�. . L :� :::�1.1 TP• :•J•t•!•!•f•f•t•J•f•f•r•t• J • :•fti :•J•r•!•!�J~J•:•f•J•t•:ir; :�r•t; J•:: ::: ':•�•�•J • 1.4•LK•L•L•L•L•L•L•4.4•S•1 �S•4•S•L•L•S•41•L•S• S•t•t•••�t•L.S•S••.•t•• S•L•1•L• .•?y:t 1 J•! V• t•l.: . :.:.1M•Nt•h,.:.!•hhf•J•f•Nh!•h •r• . !•t•!•:•firtiA::J•::f ::Y•:.: .:.:' •:• :::Y '.'- ' -' -'.' 4.L.LL•4•L. Lit• L. S• S• L. 4 •S•4M1 :5•L.t••.••..t•�..L.4.4:t. :.1:4:1 :t.S.•. �5.... t•S�•. :5....5 ��.•� �L.L.L �ti t... �t•S� . W 1. B 1. I -- Mound Component Dimensions A 6.00 ft E 16.04 in H 1.00 ft K 8.76 ft B 75.00 ft F 9.50 in 1 9.98 ft L 92.51 ft D 11.00 in G 0.50 ft J 5.48 ft W 21.46 ft 450.00( ft Dispersal Cell Area 1198.58 (ft) Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 7.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 102.21 (ft) ► � .... 111. .1.....1...2.1111111,11,.111,.. T ..:.:. :.:.:.:.:. G ...................... . . F Dispersal Celt 100.92 (ft) Lateral 100.42 (ft) — Invert :.. Dispersal Cell :::: E D = s Elevation � ........ ....:.:.:.:.. 4 99.50 (ft) Contour Elevation 7.0 % Site Slope Geotextile Fabric Cover Shading Key c_. T Dispersal Cell See lateral details on 1❑ Topsoil Cap °' 1.5 ft L Page 4 for number, size, Subsoil Cap a o 5 ' ` `• and spacing of laterals. ..... 11111,,,11 .. © ASTM C33 Sand y 1° r "'- - L F Laterals are equally Tilled Layer m 0.5 ft `; ' Typical Lateral ~ %c; spaced from the c :f _�:` -: distribution cell's ❑5 Aggregate c :�: °:r.�: ''' "'� �� "�'''"• centerline in the A distribution cell (AxB). Project: ROB WITTHOFT Page 3 of 7 Center Connection Lateral Layout Daigram Force main connection via tee or cross to manfokl at any point. Laterals are identical I P •= Turn -up wf ball valve or I<- X--- id2 I 02 +1 Laterals & force main of PVC Sch 40 cleanoutplug per COMM Table 84.30 -5 Holes drilled on the bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.156 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.10 ft Lateral Length (P) 36.75 ft Orifices per Lateral 18 Lateral Spacing (S) 3.00 It Orifice Density 6.25 If /orifice Lateral Flow Rate 9.69 gpm Manifold Length 3.00 ft System Flow Rate 38.77 gpm Manifold Diameter 1.50 in Total Dynamic Head 19.05 ft Forcemain Velocity 3.96 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and -► Comm 16.28 WAC 4'n. min. Disconnect Tank component is properly vented E Altemate outlet location Forcemain diameter HUFFCUTT CONCR Manufacturer _� 2 in. Ca aci 627.00 Gallons Volume 14.93 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 25.66 383.10 B 2.00 29.86 C P ump off elevation (ft) C 5.34 79.67 88.75 D 9.00 134.37 D Total 1 42.001 627.00 D� ose tank elevation (ft) 3" Bedding uncler tank. 88.00 Alarm Manuafacturer I LEVEL ALARM Alarm Model Number I DVL Pump Manufacturer IZOELLER Pump Model Number IN140 Pump Must Deliver I 38.77 gpm at 1 - 9 - 0 - 5 - 1 ft TDH Project: ROB WITTHOFT Page 4 of 7 Mound System Maintenance and Operation Specifications Service Provider's Name DENNIS GILLE Phone 268 -6637 POWTS Regulator's Name ST. CROIX CTY. ZONING Phone 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 ft Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 :]cfu/100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 ears Mound Inspect for ponding and seepage once eve 3 ears Other 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 Z75 Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral g Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: ROB WITTHOFT Page 5 of 7 Mound System Management Plan 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 one should ever enter a septic or 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 longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking 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, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps 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 mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched 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 snow compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg /L BOD 150 mg /L TSS, and 30 mg /L FOG for septic tank effluent or 30 mg /L BOD 30 mg /L TSS, 10 mg /L FOG, and 10 cfu /100 mL for highly treated effluent. Influent flow may not exceed maximum 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 it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice leaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent 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. Continency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically 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 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: ROB WITTHOFT Page 6 of 7 TOTAL DYNAMIC HEADIFLOW PUMP PERFORMANCE CURVE PER MINUTE ME N MODEL 14014140 EFFLUENTAND DEWATERING AIN I1j. - _ n MODEL 140/4140 { Gu „ Feat Meters Gal. Ulm ,n 5 1.5 88 328 c A7u442 46 10 3.0 80 303 15 4.6 73 276 Q P 6 az 4n 20 01 08 250 14D, 414 26 7.6 % 223 nrl uvznvT 3s su 911 49 188 +u 35 107 T 38 144 14 as 40 122 28 100 { 45 19.7 17 64 ^� a a 25 ntayle Shut- r11 HMO, 601t, 15.2m _ a G 20 7117132 l 7G to 4GI�Y 2 _ J lu 20 su o Gu an m b I SALLONU LI751t; a Hn Mo 240 32U • P FLOWPERMINOTti CiVl@.3IL F FCTia7i,"L R SPECIAL APPLICATIONS sM!u • Electrical alternators, for duplex systems, are available and supplled with an alarm. S.. • Mechanical alternators, for duplex systems, are available with or without — I lie -111n NP'r alarms. • Control alarm systems are available for 1 phase pumps used In simplexsystem. See FM0732, __ J • Variable level control switches are available for controlling single phase Sys- ,- tems. l r • Double piggyback variable level float switches are available for variable level long cycle controls, • Sealed Qwik -Box available for outdoor installations, See FM1420. 1 • Refer to FMO806 for applications above 1307 (54 °C). 4 051 ._____ SE1,.IFC.:f'Itt�f!t fat3tl:llz" 14014140 MODELS Control Selection 1. For automatic use single piggyback variable level float switch or Model Model Volts-Ph Made Amps Simplex Duplex double piggyback variable level float switch. Refer to FM04rf. p p p 2. See FM1228 for correct model of simplex control panel N140 N4140 115 _ 1 Non 12,0 1 or 2 3 3. See FMO712 for correct model of duplex control panel. E 140 w.. E4140 230_ 1 _Non 6.0 1 or2 3 . BN140 i3N 115_ Auto 32.0 - -- =AC ETI0 !UI lanttllntlun at ru9t1 protectlrlt d90 as road w1rhig ullanld bo dunes by a 4putli6ad BE140 I W BE4140 230 ' 1 Auto 6.0 lice aped alacldricn. A6 elartrir,4 and N,araty I:udna should bo fl:llowe laeludlup Me rna,:t raoent N atIO Wl ElOrtdo CedaJNEC! and the Owai rdtloiul1 I hWond F10441t11 nut JOSHnI. *Single piggyback switch included. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered Into the design of every Zoeller pump. 1f mAIL ro: PO sox 16347 f "' � SHIP TO: 3 B 49 Cane Ron SH Ro (F TO: 349AOeRtua A�anulncturNrao! Lourst411a, XY 40211 -1881 , (5021 778- 2731 - 1 (M) 928 -PUMP avwwaneller.com ! L/!Y/ iI. PAX (502) 774 -3624 -- ........ _ _ ... . ... . _, _ ........ ......._.._..._..,............_ _.. .I..- .- ,.- ...._._....,.- ..._..- 0 Copyright 2005 Zoeller Co. All rights reserved. OQi- 04/2008 10 :39 FAX 715 263 2644 DORIS SCHAfIDT /EDINA rQj002 Wisconsin OSOpartrnent fety and Buil dings f rce Ol SOIL EVAL UATION REPORT viSiori oP Sa Page _ I f In aCCOrdanCe with Cmim a5 Wis Adm. Code Attach ounnpiete site plan on paper not lem than 8 412 x 41 Inch e& itY size. Plan must County ST- CftUiX include, but not limited to; vertical and horizontal refetpq P4inC I8M), direction and slaps, scaleordimen5ions, north arrow, and location and distanceto nearest road. Parcel I.D. PART 014_1038 - 20 - 000 Please print all informral(ion. Roviewed by - - -- Pcsecxnil inrametiur) you pruvido may be uSE d fnr senor da u fJat9 +YF Wsas (Privacy law, G. t9.tla (7) {m]]. ROB WMHOFT FrOpertY Location Property 0MVI's Mailing Address Govt. Lot NW 114 NE 714 S 13 T 31 N R I5 I (at "w Lot # B lock # Subd. Name or CSI1 # 21 32 CO_ fib. P City Stale Z v Code Phone Number EMERALU tVI 54013 { 7 5 -Z63 -3460 a�' ©village • Toum Neatest Road' �'- CTH „0" rondfficOlnknendafionz: onstruction Ustt ResidenbWNumbe•ofbedrooms 3 ement Code derived derJgn flow rate 4'5 Cyl7U I� Pubiit or COMmerdal - j]e9crihe tenal GLAC L DRIFT & LOBSS ____ mments Flood Plain elevatio rt applttatrje h7 {t Recommend a moulted, having a centerline located on or near the 98.5 oontour. " E -71 Baring 0 Bdru7y - - ---- Pit Ground strrtftceeleV. 95.9 ft. Depth to limiting factor 34 in, t lorizon Depth Dominant Color Redox Color Gr Sx S Soil 6 i licalion Rata DeSCriAtion 'F'BMure Shiadure Consistence Boundary Roots GPbJft= in. Munsell Qu $4. Cont. tt. - 7 0 -10 7.5 - Y'R 4n •• ail 2fabk Ira c 'FM 'EW 2 10-17 7_SYR 514 - -. ail � bk rnfr ' _ 3 17 -34 '7.5YZ 4/4 gw .b `8 _. �. 1 2fablk m& 4 34 TSY'R ftd 7 518, fxd 75YR sa lfab dw _.w .8 1Jc mfr - .f, .8 S 45 -59 7..55 4/6 - .__._ sI Out mtr cs .2 .6 o 59 -69 MY 7/6 „_ --- s on M1 _ . __.. ,7 14 .__ StOundMter aeermgc at 63" . :0 1 Borinya� Bodiv — t�,6 Pit C�rundsurfiswelev. 9S'4 25 - - -- Depth to 6 faW'_ In Horizon Depth Doiinant Color RWox Desafption Texture Struct4fe Consists Bounds Roots S oil �lication kale in. Munsell Qu. S7 - Coot Gr. Sz_ _Color ry GPDlffr 5n, vol I 1 0 -10 7.5YR 4/2 °..- siI 2fablw mfr C5 z I0 " 2s '7 -5YR 514 -.... 2f _6 ,8 all 2fsbk y. M 9W -_^ 5 8 3 y 25-47 7.SYIt 414 ltd 7. sYR sig, Ud 7.SYF S/3 sit 2fabk mfr dW •b - - 47 -58 - 4 7.Ssm /4 f1d"YR5 18,dd7.5YR513 81 Om — — _ Mfr gW .2 -6 5 58 -72 1 0Y 518 _ (CCmeatcd) t3 Osg _ - t>afi 0.0 ^ 0.0 - Mew 01 W SOD > 30 c 220 nt IL and TSS , -3C} w 151) CAiuent 42 BOD a 30 � � - C51' ►Fame: (ply print) "" Slgna mg/L and T5S Z5 30 mg /L Ci�2I5 FRI r % CST Number Artdi ss — -- 71618 - trr Evatual3on rntciucted e 499 - 4 1/2 AVE, CLAYTON, W1 54004 Telephone Nuinber 2/9108 715- 419-•0127 • 06/04/2008 10:39 FAX 715 263 2644 DORISS SCH9fIDT /EDINA ia003 Property Ownr3r W _ Parcel ID # Page 2 of 3 Boring # 0 Boring 99 t + Pit Ground surface ele+r- ' fL Depth to limiting favor 3S in. Boil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Bowdaty Roots GPDIfr In. Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. *EH #1 'EM2 1 0 -9 7.5U 412 - -- sit 2fabk mfr cs 2f .6 .$ 2 9 - 7.5YR 4/4 - - - - -- 1 2fabk mfr 9w --° .6 .8 3 35-44 7-5YR 4/4 fld 7.5YR 5 /8, f2d 1 2fabk mfr dw _. .6 .8 4 44 -55 7.5YR 4/6 — — sl 0M Mfr - -_ .6 Boring # Haring Pit Ground surface elev.—ft. 0@0 to limiting factor in h gal Applicotion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence 130undwy Roots GPD /fC� _ in. Munselt Qu. Sz. Cont. Color Gr. Sz. Sh. *Etffil 'Efw Boring Bo'yng # i►�ll GrOUnd surface elev. R- Depth to limiting faCtOr„ irr. Pit _ _ Soil Applir�GOn ftale Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots QPDff in. Munseil Qu_ Sz. Cant: Color Car. Sr. Sh. "Eff#1 "Effti2 Effluent #1 = 90% 30 c 220 mg1L and TSS >30 �5 150 mgt! * Effluent = 50D, 30 m91L and TSS a 30 rnglL, The Department of Commcroe is an equal opportunity service provider and employer_ If you need assistunce to access services or need material irY au idiernate format, ploa a contact the department; at 608 - 266 - 3151 or TTY 608 264.8777. SUL ell— ,M- 811UO1 .0,004/2008 10:40 FAX 715 263 2644 DORIS SCHMIDT/HDINA 0004 Y '� C�- i���M��F �� iL I` _ � � 1 1� � i ` 1 uJ' � ej � r Vim 45 1 Wisconsin Department of Commerce S EVALUATION REPORT Division of Safety and Buildings Page 1 of 3 in accordance with Com Is. m. Code Attach complete site plan on paper not less than 81/2 x 11 in size. P County ST. CROIX include, but not limited to: vertical and horizontal reference point (B coon an percent slope, scaleor dimensions, north arrow, and location and distance rest road. Parcel I.D. P T 0 - 1028 -20 -000 Please prin Revie d by Date Personal information you provide may be use for sec n ! ^, e ( �7Scy Law, .75.04 Property Owner roperty Location ROB WITTH FT JUL 0 2 2008 ovt. Lot NW 1l NE v4 S 13 T 31 N R 15 • Property Owner's Mailing Address E or)® 2132 T, CROIX COUNTY of # Block # Subd. Name or CSM# Co. . RD P ZONIN City State Zip Code 111ulic VAUI Village EMERALD WI 54013 ( 715-263-3460 ��' Town Nearest Road y CT 14 "Q" New Construction Useg Residential / Number of bedrooms 3 Code derived design flow rate 450 Replacement GPD P Public or - Describe: Parent material GLACIAL DRIFT A: LOESS Flood Plain eievadon if applicable ern ft General comments and recommendations: Recommend a mound, having a centerline located on or near the 98.5' contour. " �1 Boring # Q Boring Pit Ground surface elev. 95.9 ft. Depth to limiting factor 34 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff*1 *Eff#2 1 0 -10 7.5YR 4/2 - -- sil 2fabk mfr cs 2f 2 10 -17 7 2fsbk mfr .5YR 5/4 - -- sil 6 8 gw .6 .8 3 17 -34 7.5YR 4/4 - -- I 2fabk mfr .8 gw -- .6 4 34-45 7.5YR 4/4 fld 7.5YR 5 /8, t2d 7.5YR 5/3 1 2fabk mfr dw -- .6 .8 5 45 -59 7.SYR 4/6 - - -- s( Om mfr cs -- .2 .6 6 59 -69 2.5Y 7/6 s Osg ml - -- - -- .7 1.6 groundwater seepage at 63" a Boring # Boring 98.4 25 Pit Ground surface elev. ft. Depth to limiting factor in. _ Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots soil ~ GPD/fi? n rate in. Munsell Qu. Sz Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -10 7.5YR 4/2 - - -- sil 2fabk mfr cs 2f .6 • 8 2 10 -25 7.5YR 5/4 - - -- sil 2fsbk mfr gw __ .6 .g 3 2547 7.5YR 4/4 fld 7.5YR 5!8, fld 7.5YR 513 siI 2fabk mfr dw _ .6 .8 4 47-58 7.5YR 4/4 fld TWR 5/8,12d 7.5YR 513 sl Om ___ mfr � 2 .6 5 58 -72 10YR 5/8 - - - -- (cemented) s Osg m g - -- __ 0.0 0.0 Effluent #1 = BOD > 30 220 mg /L and TS >30 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signat CST Number CHRIS FREDERICKS 71618 Address Date Evaluation Conducted Telephone Number 499 - 4 1/2 AVE, CLAYTON, WI 54004 2/9/08 715 -419 -0127 Property Owner WIT Parcel ID # Page 2 of 3 3 Boring 35 # Boring 1 E] pit Ground surface elev. 99.9 ft. Depth to limiting factor (n• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -9 7.5YR 4/2 --- - - - - -- sil 2fabk mfr cs 2f .6 .8 2 9 -35 7.5YR 4/4 -- - - - - -- 1 2fabk mfr 9W --- .6 .8 3 35 7.5YR 4/4 fl d 7.5YR 5/8, f2d 1 2fabk mfr dw - -- .6 .8 4 44-55 7.5YR 4/6 sl Om mfr ❑ Boring # Boring n 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/f? 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. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mgA- * Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608- 264 -8777. SBD- 833ffca (R.07 100) t er., el Ao s k v jAe VXLj,, fl jl�k' t-- I in rot .4 ir. f - 2 joe ',Lt p th e r "Ae 0f-' ? CERTIFIED SURVEY MAP THE NORTHWEST QUARTER OF THE NORTHEAST QUARTER, OF SECTION 13, TOWNSHIP 31 NORTH, RANGE 15 WEST, TOWN OF FOREST, ST_CROIX COUNTY,WISCONSIN DESCRIPTION A parcel of land being the Northwest quarter of the Northeast quarter, of Section 13, Township 31 North, Range 15 West, Town of Forest, St. Croix County, Wisconsin, more particularly described as follows: Commencing at the North quarter corner of said Section 13, as point of beginning of the parcel herein described; Thence S86 °40'26 "E, along the north line of the the Northeast quarter of said Section 13, a distance of 1336.33 feet, to the Northeast corner of the Northwest quarter of said Northeast quarter Thence S00 ° 12'45 "E, a distance of 1320.61 feet, to the Southeast corner of the Northwest quarter of said Northeast quarter; Thence N86 0 53'26 "W, a distance of 1339.16 feet, to the Southwest corner of the Northwest quarter of said Northeast quarter Thence N00 0 04'39 "W, a distance of 1325.50 feet, to the point of beginning. The described parcel contains 1,766,863 square feet (40.56 acres), and is subject to easements of record. SURVEYOR'S CERTIFICATE I, Joel A. Brandt, Registered Land Surveyor, hereby certify. That I have Surveyed, Divided, and Mapped the above described parcel of land in full compliance with the provisions of Chapter 236.34 of the Wisconsin State Statutes, along with the provisions of St. Croix County in surveying, dividing and mapping the same. That such map is a correct representation of the exterior boundaries of the land surveyed and the subdivision thereof made. Said survey was done under the direction of Jerry Cress. Dated this 7 day of /"ic3 , 2008. �S 0 a A. �_ rte......... ,�� •. * 8RMR1T ilr Joet A. randt R.L.S. S -2603 APPROVED 18 SURVEYING LLC i7.C111MCdxn'Y '• ODtx11�: Film kv&zenb9 CERTIFICATE OF COUNTY TREASURER MAY 1 q 2M STATE OF WISCONSIN) If not nwo odwwiin30 dap Ot COUN OF ST. CROIX) SS �>�� OW bo 1, Cherc'1 I S 1 8 hC� the duty elected, qualified and acting treasurer of the county of St. Croix, do hereby certify that the records in my office show no unredeemed tax sales and no unpaid taxes or special assessments as of Dw ;;)I b, D-T affecting the lands of this Certified Survey Map. g S -1 —OS Date Tre surer F'r6 -`-& -�y lire -2 Approved thts day of /"1 c, .2008. tt�`` '�X 1rcK}�wn St. Croix County Zoning Representative Sheet 2 of 2 Vol. 23 Page 5525 coo /cooln _ -- Sousa ao 92ti 00 xxOUD as L899 99C SZL XVJ LSIST KOM 800z /6 l 111111 11111 full lflll 1111111111 111111111111111111 * 8 7 6 3 9 8 1 876388 STATE BAR OF WISCONSIN FORM 1 - 2000 KATHLEEN H. WALSH REGISTER OF DEEDS Document Number WARRANTY DEED ST. CROIX CO., WI RECEIVED FOR RECORD THIS DEED, made between Jerome F. Cress, Grantor, and Robert W. 06/09/2008 12 :15PM Witthoft and Joanne R. Witthot husband and wife, as survivorship marital WARRANTY DEED property, Grantee. E%EKPT II REC FEE: 11.00 Grantor, for a valuable consideration, conveys to Grantee the following TRANS FEE: 204.00 PAGES: 1 described real estate in St. Croix County, State of Wisconsin (the "Property "): Lot 2 of Certified Survey Map recorded May 19, 2008 in Vol. 23, Page /4 5525, as Document No. 875018 being part of the NW ' of the NE `/. of Section 13, Township 31 North, Range 15 West, Town of Forest, St. Croix County, Wisconsin Recording Area Natne and Return Address: Title One PO Box 16 Amery, WI 54001 File #12810 Together with all appurtenant rights, title and interests. Part of 014 - 1028 -20 -000 Parcel identification Number (PIN) This is not homestead property. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except reservations, restrictions and easements of record, if any, and public highways, zoning and building regulations. Dated this 2 " day of June, 2008. * erome F. Cress * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) POLK COUNTY. ) ss. authenticated this Personally came before me this 2nd day of June, 2008 the above named Jerome F. Cre a known to be the person(s) who executed the fore it1ls O and acknowledged the TITLE: MEMBER STATE BAR OF WISCONSIN same. (If not, O authorized by § 706.06, Wis. Slats.) *Sidne P. Jones 9.A A THIS INSTRUMENT WAS DRAFTED BY Notary Public, Stat isctir�i§in My commission is p If expiration date: Jul 31, 2011 `SAN * ) Michael H. Forecki, Attorney (Signatures may be authenticated or acknowledged. Both are not necessary.) *Names of persons signing in any capacity must be typed or printed below their signature 1 of 1 WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1-2000 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer d 49 Ar Mailing Address 1 6 Property Address 31 (Verification required from Planning & Zoning Department for new construction.) Cit y /State �� �-� Parcel Identification Number LEGAL DESCRIPTION Property Location W 1 /a , , f 1 /4 , Sec. A L , T 2 _ /N R�W, Town of Subdivision ` , Lot # Certified Survey Map # '6 75 0 1 , Volume Z 3 , Page # ' ' .e2 Z � . Warranty Deed # , Volume ,Page Spec house yes no Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. 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 Deportment of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my /our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms 3 - *� Ala - �13 SIGNATURE OF APPLICA ) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) • • do • 1 • IIiuI�IIIIIIIIIIIIIII' 1 ■ �- g: _- IIIIIIIIIIIIIIIII R i m - .C• I�III�I 'i�C�ii - . B p !•O ��. eE� i �- � ��■ II'IIIIIIIII�III C-,. — ■_ ■_- ,CJ - __ == Il�i���llllllllllll '� - -: _�= -�: IIIIIIIIIIIIIIIIIIIIIIIIIIIIII �' 11111111111111111 �� - a�� C� ■ 1 �� Ci -�_�` nmuu■nun O ■ �_� - !11111111111111111111111111111 -:�9 •ice - =i p ��� •ice �i _ m i s s - - - _ ■ -� �� Cam: Marshfield Production No. 42512 by Wick Building Systems, Inc. PAGE: 1 OF 1 PO Box' ' 0 2301 E FOURTH STREET MARSHFILD WI 54449 (715) 387 -2551 w 0 1�b � x ° x o ° „z,z ° J! LIN eou UZ __ W iml it 1 1:1:1:1 : 1 (~ _i :1: HALF W ATT. W1 CAP Ca 00 1:14 1: 1:1: 1: t: I V f 6 C4 :1; 1: 1: 1;I z 1:1:1;11 0 ° III I HL d8 :1:1 1 1:1:1 1 0 0 2 _ Q D x- z 0 M N W n z A W d o� a., q 0 0 � p 0 , RETAIL CUSTOMER and BUILDER This is a CUSTOM DESIGN PRINT with nominal dimensions. This plan is subject to additional engineering review and may require changes as a result. Local building codes may require some alterations to this plan. The addition of options may also require alterations. This plan cannot be confirmed or built until this copy is returned with the signature of both the customer and the builder. Signature confirms acceptance of this plan as presented. Changes to this plan may require additional changes. o � ra O O m N� ^� we WYZWiFINLIN� aJ 0 <Z a Z 31E Q N q 3 O z Jwa�W3CEN WW p ___________ O W S Z New Uan. doors Q So o xw.. o 3 f av3a a F— N w z � W LJ m w I ww �w w ao W N t /s s ZSH o J' "> „tea — po azz JN o w NwGI ,-�NQ a J❑ W~ D a W - O W a F 0 1 r - -- ---------- °----- ---- ---------; ------ - ----- ------ ----- -� f w A w~ o a = O J g7 � JNL7 H Z gF' H Z JN SWFI w aa� ° 0 oa - ------ - w ---------------- d Q J_ OJ I z z 3 a p Z Z r o - o N do o ---- -------- ---- -- - ---- III - a p - U Z _o N011tllliSNl . [ ..IIVM NOI1tlQNNOl 3O H1QIM IVn13tl ,E -.L2 NOI1tllf1SNI .I NOIIVINSNI I❑ 3QIS1f1O Ol ,9-1L2 _w> °S°-