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HomeMy WebLinkAbout034-1031-20-000 Wisconsin Department o Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division County: St. Croix INSPECTION REPORT sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) 563864 0 Personal information you provide may be used for seconds State Plan ID No: secondary purposes[Privacy Law,s.15.04(1)(m)]. Permit Holder's Name: City Village X Township Mahoney, Brian C �(per Parcel Tax No: CST BM Elev: S rin field, Town of 034-1031-20-000 Insp.BM Elev: BM Description: Section/Town/Range/Map No:II TANK INFORMATION /Q 14.29.15.218B TYPE ELEVATION DATA MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Gw �• 5 � 'e��G>� �) �� Alt.BM Aeri+tien ` bmt T. Bldg. Sewer Holding SUHt Inlet TANK SETBACK INFORMATION St/Ht outlet /44(to W--LL B�DG. Vent Air Intake 1j f �,� ROAD Dt Inlet 7 L 0�Y Dt Bottom r �,� ( _ Header/Man. 41 Dist. Pipe ` 3•$Z /QZ , '3$ i Bot.System PUMP/SIPHON INFORMATION Final Grade Manufacturer 2-:5 16 3. 3 Z6�(e Demand St Cover Model Number �N �L� GPM� } ��. � 1,/ /��' S TDH Lift/! Friction Los System He d Tp L6 `�r 5 •7 /Q�•Z Forcemain Length Dia. f Dist.to Well SOIL ABSORPTION SYSTEM BED/TRENCH lWidth '' Length No.ODIMENSIO NS 5 PIT DIMENSIONS No.Of Pits . Liquid Depth SETBACK 45 e ` _�P/L BLDG WELL LAKE/STREAM LEACHING INFORMATION CHAMBER OR ` >5a -3 UNIT Model Number: DISTRIBUTION SYSTEM 4� HeadedManifold � Distribution � Pipe(s) x Hole Spacing Vent t r Intake Length 3 Dia Length , pia Spacing==,3 to �• u SOIL COVER x Pressure Systems Only Depth Over y y xx Mound Or At-Grade Systems Only Bed/Trench Center Q Depth Over xx Depth of xx Seeded/Sodded U Bed/Trench Edges \ Topsoil t�-,�11� xx Mulc ed No es 0 No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: g/ ls/ �3 Inspection#2: Location: 946 Rustic Rd 3 Glenwood City,WI 54013(SW 1/4 SW 1/4 14 T29N R1 5W) NA Lot 1 �O�J / Parcel No: 14.29.15.218B 1.)Alt BM Description= V 0 S C v� c S 4L ,• 2.)Bldg sewer length= 9� 3W h �'( � y�,Q,� e✓ -amount of cover= Plan revision Required? �W Yes C7 o , 4-:5 Use other side for additional informatlio`nn. LT_ji5�/ 3 SBD-6710(R.3/97) Date Insep is Signal Cert.No. U-, + F (( rl A --9 L M IL rA LO I tr N 1 _ 1-? - O h County Safety and Buildings Division St . Croix t' 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) ~ Sa' Madison, WI 53707-7162 5~,3 9 Cozl A~ State Transaction Number tary Permit Application Z 7 8 In accordance 3 . ip2 Wis. Adm. Code, submission of this form to the appropriate go is r e q u i r e d prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitt the Department of Safety and Professional Services. Personal information you provide may be used for secondary edifferem than mailin ) purposes in accordance with the Privacy Law, s. 15. 1 m Stats. L Application Informations axe Print All Information T FF Property Owner's Name Sr C P # Brian Mahoney RO.',v d 34 - 163 l - 2-6 - OC~C Property Owner's Mailing Address Pi;grq- Location 844 County Road W Govt. I.ot Cm, Stat Zip Code Phone Number SW_ SW ys, Section _14_ Glenwood City, WI 54013 715-222-3502 - - (circle one) Lot T 29_N; R-15- west IL Type of Building (check all that apply) This XI or 2 Family Dwelling - Number of Bedrooms 3 NA J- proposed system will serve on Three Lw bedroom residential Home. /vo ~S~-+~- -r Block NA ❑ City of CSb1 Number ❑ Village of 75=. / Ai ✓ J C-,,~ X Town of Spring Field III. Type of Permit: (Check only one bog on line A. Complete line B if applicable) -A- New System Replacement System Treatment Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) Y List Previous Permit Number and Date Issued B. [I Permit Renewal El Permit Revision ❑ Change of Plumber 11 Permit Transfer to New Before Expiration Owner IV. -Type of POWTS system/component/Device: Check all that 1 A o t) ' Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Oradz X Mound?: 24 in. of suitable soil Mound < 24 in. of suitable soil Holding Tank ❑ Other Dispersal Component (explau►) ❑ Pretreatment Device (explain) A. 7 V. Dix rsal/Trea ent Area Information: f Design Flow (gpd) Design Soil Application Rate(gpds Dispersal Area Re (sf) Dispersal Area ( System Elevation 450 .6 900 6D 900 101.62 VL Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units a d o New Tanks Existing Tanks Qp °.1 A ,UCc~.~. fr ( v to m A w C7 P. Septic Tank X 700 2 Le is Bjork X Lift Tank X 700 1 Lewis Bork X VIL Responsibility Statement- I, the undersigned, assume MSPOMlhility for hq4tHation of the PORTS shown on the attached plans. Plumber's Name (Prim) bet's S1 a MPiMPRS Number Business Phone Number Lewis Bjork I 253976 715-231-7375 Plumber's Address (Street, City, State, Zip Code) ` E7818 Count Road E, Menomonie, W154751 VQL ountv/De artment Use Only Permit Fee Date Issued Issuing. e Signature Approved sapproved year Reason for Denial $ ✓ 1 IX. Conditions of ApppprovaMReasons for Disapproval S~-a fb J G-t(~ alG SY$TEM VWNER: 3~ Ge d! .`a ow 1 1 $epiiG tank, effluent fi ter and e~ Pkv t.J 1 rT.~ i p G`^"•~~ . dispersal cell =must aft be services / maintained / as per management plan provided by plumber. 2 M s+ 40clUOMMS must be Malntilmd as per gVICtibte tlode / ordinafii es: ti ATtg•~ DIVISION OF INDUSTRY SERVICES 10541 N RANCH ROAD HAYWARD WI 54843 w Contact Through Relay 3 I a S www.dsps.wi.gov/sb/ p $ w~ www.wisconsin.gov Scott Walker, Governor \°F~'ssro~~~ 'w Dave Ross, Secretary July 30, 2013 CUST ID No. 253976 ATTN: POWTS Inspector LEWIS C BJORK ZONING OFFICE LEWIS BJORK LLC ST CROIX COUNTY SPIA E7818 CTY RD E 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 07/30/2015 Transaction ID No. 2274381 Site ID No. 793240 SITE: Please refer to both identification numbers, Brian Mahoney above, in all correspondence with the agency. Rustic Road 3 Town of Springfield St Croix County SWIA, NW1/4, S14, T29N, R15W FOR: Description: Mound, 3 bedroom residence Object Type: POWTS Component Manual Regulated Object ID No.: 1439060 Maintenance required; 450 GPD Flow rate; 19 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01101, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01101, R. 10/12), SSWMP Pub. 9.6; Effluent Filter CQNpITI The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes p►OF and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed DEpT and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. S The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code PRO 'SSIQ requirements. t)IVIS10 No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, The / stats. The following conditions shall be met during construction or installation and prior to occupancy or use: JC / ~E Key Item(s) • 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. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per SPS 383.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of SPS 384.10. No fixture, appliance, appurtenance, material, device or product may be sold for use in a plumbing system or may be installed in a plumbing system, unless it LEWIS C WORK Page 2 7/30/2013 t 1 i s of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. • The existing POWTS must be properly abandoned per s. SPS 383.33 Wis. Adm. Code. • Maintain well and waterline set backs per SPS 383.43(8)(i). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. 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 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 Industry Services 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 and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Patricia L Shandorf( POWTS Plan Reviewer, Integrated Services WiSMART code: 7633 (715) 634-7810, Fax: (715) 634-5150, M - F 8:00 a.m. - 4:45 p.m. pat. shandorf@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm Lewis Bjork LLC Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services (formerly Safety & Buildings) will be modified. Code references with prefixes starting with "Comm" have been replaced with "SPS" to recognize the relocation of the Division of Industry Services from the former Department of Commerce to the Department of Safety & Professional Services. Additionally, all IS (formerly S&B) codes have been renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. LEWIS C BJORK Pagge 2 7/30/2013 is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. • The existing POWTS must be properly abandoned per s. SPS 383.33 Wis. Adm. Code. • Maintain well and waterline set backs per SPS 383.43(8)(i). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. 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 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 Industry Services 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 and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Patricia L Shandorf , POWTS Plan RevieLr, Integrated Services WiSNL RT code: 7633 (715) 634-7810, Fax: (715) 634-5150 , M - F 8:00 a.m. - 4:45 p.m. pat.shandorf@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm Lewis Bjork LLC Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services (formerly "Safety & Buildings) will be modified. Code references with prefixes starting with "Comm" have been replaced with "SP.S" to recognize the relocation of the Division of Industry Services from the former Department of Commerce to the'Department of Safety & Professional Services. Additionally, all IS (formerly S&B) codes have been renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. T y MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Commercial Application INDEX AND TITLE PAGE Project Name: Brian Mahoney - New Mound Design Owner's Name: Brian Mahoney Owner's Address: 844 County Road W Glenwood City WI 54013 715-222-3502 Legal Description: SW NW S14 T29N R1 5W Township: Spring Field County: St. Croix Subdivision Name: CSM Lot Number: NA Block Number: NA Parcel I.D. Number: Plan Transaction No.: 3V ED A0 Page 1 Index and title ?►FE~Y~V4CCS Page 2 Data entry Im. SE ~V►GES Page 3 Mound drawings yVSTR SE Page 4 Lateral and dose tank Page 5 System maintenance specifications ; Page 6 Management and contingency plan Page 7 Pump curve and specifications 0 DE GE Page 8 Septic and Dose Tanks LRESP _ Page 9 Plot Plan Page 10 soil report Page 11 effluent filter Designer: Lewis Bork License Number: 253976 Date: 0 Phone Number: 715-231-7375 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) Version 7.0 (R. 03/2012) Page 1 of 11 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) c Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 38344-3 in-situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of - 36 inches. 450.00 Design Flow (gpd) 4.00 Site Slope 100.20 Contour Line Elevation (ft) 19.00 Depth to Limiting Factor (in) 0.60 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 75.00 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest int in the distribution Y Pressure Disribution Information network? Enter Y or N (C or E) a Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation ft 2 Number of Laterals of the highest point. 0.188 Orifice Diameter (in) 4.00 Estimated Orifice Spacing (ft) = 11.84 ft2/orifice 2.00 Forcemain Diameter (in) 80.00 Forcemain Length (ft) Does the forcemain drain back? Y 88.00 Pump Tank Elevation (ft) Enter Y or N 3.25 System Head (ft) x 1.3 13.05 Forcemain Drainback (gal) 13.28 Vertical Lift (ft) 67.38 5x Void Volume (gal) 1.10 Friction Loss (ft) 80.43 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 24.90 System Demand (gpm) 17.63 Total Dynamic Head (ft) 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 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1400.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Lewis Bork LLC Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 700.00 Dose Tank Capacity (gal) Bear Onsite Filter Manufacturer 18.85 Dose Tank Volume (gal/in) MI3-916 Filter Model Number Lewis Bork LLC Manufacturer Project: Brian Mahoney - New Mound Design Page 2 of 11 r Mound Plan and Cross Section Views ..........:................1/10 B J ~ ..................Observation Pipe . - I }?r; r;"r:}; r; r;:; r; r; r; r. r.:.•. f.r • r.. r. r.:; ;;r r~ L.•..• 1....•..1•,..•..•..1.•.. 5 L.. .L •`..L.L.......L,.,•L,.,, A. •}•P'r:r.: r.: .r r.::r.:.:.r:: ::..•..r.r.r.:.:.: .r,:.r. .:.~':t .r; r; r; r; r; r.:.r.:.:.:.:.:.:.:.r.:.:.: • .r.r.; .:.:.:.r.; .:.r.::f. ~.;.r.r. ..YV.......L. L .............L••,. L••, ,.L..........',•L•L.•,•V••,K•L,•,.L.•,.•,. L.•,.•,.•,.•,. B . I . . . . . .`1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . L Mound Component Dimensions A 6.00 ft E 19.88 in H Aft ft K 9.99 ft B 75.00 ft F 9.50 in z ft L 94.97 ft D 17.00 in G 0.50 ft J W 23.31 ft 450.00 (ft 2) Dispersal Cell Area 1203.84 (ft2) 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 103.41 (ft) 1 _ rriiirruirui 2 G l 102.12 (ft) Lateral Dispersal Cell 101.62 (ft)--► Invert . : Dispersal Cell Q Elevation D ]ij r A = A •A • A. A. 100,20 (ft) Contour Elevation 4.0 % Site Slope Geotextile Fabric Cover Shading Key o_, I _ Dispersal Cell See lateral details on F JIM Topsoil cap o C. 1.5 ft Page 4 for number, size, 0 Subsoil Cap cti? and spacing of laterals. r f ' r' r" Laterals are equally © ASTM C33 Sand F •a ~ 5 ft spaced from the ®0 Tilled Layer 0 '•r' Typical Lateral A A Y A'f•f•: '•j' distribution cell's ~ •'ry:~r:r•: •r•: r•: `r:r1r• : © •r.r.r.r Aggregate d o ti.•..L.•.••..•..L.•..L•L`L`•..•..•.::. , centerline in the A distribution cell (AxB). Project: Brian Mahoney - New Mound Design Page 3 of 11 1 End Connection Lateral Layout Diagram Laterals c~otl over the A fr dims an 0 = Turn-up wf bsll valve or W eanoutpiuq J AN laterals are identical k- X Holes drilled on "bottom of" lateral s equally spaced Forcer m Wn oonromion via too or cross to manifold at ana point. I aterafs Morcemain Sch 40 PVC per SPS Table 384.30-6 Number of Laterals 2 Orifice Diameter 0.188 in Lateral Diameter 1.50 in Orifice Spacing (X) 4.08 ft Lateral Length (P) 73.44 ft Orifices per Lateral 19 Lateral Spacing (S) 3.00 ft Orifice Density 11.84 ft2/orifice Lateral Flow Rate 12.45 gpm Manifold Length 3.00 ft System Flow Rate 24.90 gpm Manifold Diameter 1.50 in Total Dynamic Head 17.63 ft Forcemain Velocity 2.54 ft/sec Dose Tank Information Locking cover with waming label and locking device and sealed watertight Electrical as per NEC 300 and SPS 316.300 WAC Disconnect 4 in. min. Tank component is properly vented • F-- Artemate outlet location Forcemain diameter Lewis Bork LLC Manufacturer 2 in. Ca acity 700.00 Gallons Volume 18.85 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 20.87 393.37 B 2.00 37.70 C P♦ ump off elevation (ft) C 4.27 80.43 88.83 D 10.00 188.50 D Total 37.14 700.00 ♦ Dose tank elevation (ft) Bedding under tank. 88.00 Alarm Manuafacturer SJE-RomBus Note: Switches Alarm Model Number 520-002A containing mercury may not be used in Pump Manufacturer Zohler this system. Pump Model Number 152 Pump Must Deliver 24.90 gpm at 17.63 ftTDH Project: Brian Mahoney - New Mound Design Page 4 of 11 Mound Svstem Maintenance and Operation Specifications Service Provider's Name Lewis Bork LLC Phone 715-231-7375 POWTS Regulator's Name St. Croix Count Phone 715-386-4804 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 1400 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft2 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 eve 3 ears Effluent Filter Should inspect and clean at least once eve 3 ears Pump and Controls Test once every 3 years Alarm Should test monthly Pressure System Laterals should be flushed and pressure tested eve 1.5 years Mound Inspect for ondin and seepage once eve 3 ears Other Lewis Bork for Pumping Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, 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 Tum-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: Brian Mahoney - New Mound Design Page 5 of 11 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01)] 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 SPS 383.33, 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, Stats. 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 fitter 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 BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 104 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 cleaning 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. Contingency 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. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. 6 LLJ UJ W PUMP PERFORMANCE CURVE MODEL 151/152/153 50 14 45 153 12 40- 35- lo- 152 11 U_ 30 y 8 151 0 25 J g 20 1 15- 10- 2- 5 0 10 20 30 40 50 60 70 80 90 100 GALLONS LITERS 0 40 80 120 160 200 240 280 320 360 FLOW PER MINUTE 014508 f r W v O 03 ~ O 0 CV)D 10 0 o 0 0 3 m 3 F fD v (D N m O N 0 O O 3 O N 0 x Vl N• T 1 O V O N Q. 0 (A Y d 7 x A -b t ? vi 4-A M=` 6 4 U u LM ~t 00 ` N 317 147 N -f-- La f~j ~ m M M 00 ,Ju _ ~7 "or Plot Plan Legend 1 4" PVC ASTM D 3034.42"Min. Cover where snow is not removed. 2 24" inside diameter concrete manhole brought min.4" above surrounding grade. Concrete covers chained and padlocked . 3 Precast concrete septic tank. 4 Effluent filter location. 5 4" PVC ASTM D3034. 18" Min. cover. Effluent piping or building sewer where tank is within 30'. 6 Precast concrete dose/pump/filter tank. 7 12-2 OF-B Power conductor. 14-2 OF-B alarm circuit conductor. Both wires are UL listed A-2057 8 2" PVC ASTM D-2665 -09 Schedule 40 Pipe Force main. 9 4" PVC ASTM D-2665 -09 Schedule 40 Pipe . Entering and exiting concrete tanks min 10' in length. 10 Carlon All weather pvc junction box. UL listed # A-241 11 Rock Cell treatment/dispersal cell 12 Inspection wells Project Page Bear Onsite Filters - a s9 ML3 True Effluent Filters k ;k It has been fifty years since Bob Zabel was issued a United States Patent for an effluent filter for use in septic systems. Since that time, and especially in the last twelve years, other products have been introduced that are variations of the initial Zabel filter. All of these had something in common: each incorporated a ; simple screen to keep solids larger than a certain nominal diameter, typically either 1/16-inch or 1/8-inch, from passing out of the septic tank and out to the drain field. Some specialty filters followed, designed to retain even smaller- sized solids, from 1/32-inch down to 1/64-inch. However, most of these filters were maintenance intensive due to their single- screen design. With the introduction of the new MI-3 filter series, Bear Onsite, LLC, brings the first true filter to the industry. The MI-3 filter provides multiple levels of filtration within the cartridge to allow for progressive removal of smaller and smaller solids from septic tank effluent. By spreading the removal of solids over several levels, MI-3 fifters feature a longer service life, while still ensuring that the drain field is protected from excessive solids. In addition, MI-3 improvements aren't restricted to the cartridge itself, but extend to the fitter case, with a design that includes a built-in baffling system to keep solids out of the case, and a settling chamber to slow the velocity of effluent entering the fitter cartridge. This patent- applied-for design allows solids to drop out of the effluent before ever coming into contact with the filter cartridge-therefore, increasing the service life of the filter. Finally: today's new, true filter design, competitively priced with the screens of the past! aee the System in Action Find a local distributor Learn more: Filter Function Brochure Filter Applications Brochure Product warranty information Product Installation & Maintenance Instructions State Approvals: MN VA ; . r . Tuf-Tite Riser System Tuf-Tite makes a full line of Risers and accessories for Pre-Cast applications. I 4 Riser Lid - with Molded-in gasket. Available in 12",16", 20" and 24" diameters. Green Only. Concrete Lid - with handle. Use the Safety Pan to cast your own concrete lids. Safety Lid - May be used in place of concrete lid. Fits 24" Riser Pan only. Black Only. Safety Pan - Safety PanTM available for 16", 20" and 24" Risers. Green Only. 6" Tall Riser - For septic tanks. Stackable in 6" increments. Available in 12", 16", 20" and 24" diameters. 12" Tall Riser - For septic tanks. Stackable in 12" increments. Available in 20" and 24" diameters. Black Only. Tank Adapter Ring - For mounting riser or lid to tank when casting-in is not an option. T TIsconsin OIL EVALUATION REPORT. #82 Department of Commerce ECEIVEI n accordance with Comm 85, Wis. Adm. Cc Page 1 of 3 Division of Safety and Buildings Northland Plumbing, Inc. n ~ Attach complete site plan on p s?=/2 x 11 inches in size. Plan must County t Croix include, but not limited to: verticgl and;~~p(iz.,QntaJ reference point (BM), direction and percent slope, scale or dirrp'~f fNdW"[A y,i l cation and distance to nearest road. Parcel I.D.' 03 2o- Please ad <-1 print all information. viewed Date , Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). I 1 Property Owner Property Location f U J Mahoney,jm Govt. Lot SW1/4, NW1/4, S14, T29N, R15W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 844 County Rd W v i 3/-P . 3 7 City State Zip Code Phone Number City Village Town N rest Road q Glenwood City WI 1 54013 Rustic Road 3 New Constructio Use: Residential / Number of bedrooms _ 3 Code derived design flow rate 450 GPD Rep acemen - Public or commercial - Describe: Parent material Glacial Outwash/ / Flood plain elevation, if applicable ft. General comments +Xwn-~ 4h / / UD , c2 /~J~U / G>✓Cl and recommendations: Boring Boring # 1 Pit Ground surface elev. 100.20 ft. Depth to limiting factor 24 in. Soil Application 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 1 0-9 10YR3/2 sil 3sbk mvfr Cs 2m .6 .8 2 9-14 10YR5/3 sil 3sbk mvfr Cs 1m .6 .8 3 14-24 10YR5/4 sc 2sbk mfr Cs if .2 .3 4 24-30 10YR4/6 10YR6/8flf spots sc 2sbk mfr cs .2 .3 I i Boring 2 Boring # Pit Ground surface elev. 99.68 ft. Depth to limiting factor 25 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure ; Consisten Boundary Roots GPD/ft= in. Munsell Qu. Sz.`Cont. Color Gr. Sz. Sh. `Eft#1 'Eff#2 1 0-6 10YR3/2 A 3sbk mvfr cs 2m .6 .8 2 6-14 10YR5/3 sil 3sbk mvfr Cs 2m .6 .8 3 14-25 10YR5/4 sc 2sbk mfr a 1f .2 .3 4 25-32 10YR4/6 10YR6/8flf spots sc 2sbk mfr Cs .2 .3 I I Effluent #1 = BOD 5> 30 < 220 m ?/L and TSS >30 < 150 mg/L " Effluent #2 = BOD5 s30 mg/L and TSS <_30 mg/L CST Name (Please Print) ignat CST Number Michael J. Myers _ 267985 Address Northland Plumbing, Inc. Date Evaluation Conducted Telephone Number 2943130th Ave Glenwood City, WI 54013 7/22/2012 715-265-4115 SBD-8330 (R.07100) Property Owner Mahoney,Tm Parcel ID # Page 2 of 3 R IT] Boring Boring # Pit Ground surface elev. 96.96 ft. Depth to limiting factor. 19 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'ErfsEi *Efr#2 1 0-9 10YR3/2 ( sil 3sbk mvfr cs im .6 .8 2 9-13 10YR5/3 sil 3sbk mvfr cs Inn 6 8 3 13-19 10YR5/4 sc 2sbk mfr cs if 2 3 4 19-30 10YR4/6 10YR6/8f2d spots C sc 2sbk mfr cs 2 3 i 4 _ Boring Boring # Pit Ground surface elev. 102.22 ft. Depth to limiting factor 19 in. J Soil Application Rate Horizon Depth I Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. .Etft •Eff#2 1 0-5 10YR3/2 sil 3sbk mvfr j CS j 2m .6 .8 2 5-11 10YR5/3 sil 3sbk mvfr cs lm 6 8 3 11-19 10YR5/4 sc 2sbk mfr cs if .2 .3 4 19-27 10YR4/6 10YR6/8f2d I sc 2sbk mfr cs .2 ,3 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. SBD-8330 (R-07!00) Northiand Plumbing, Inc. Property Owner Mahoney,Xm Parcel ID # Page 2 of 3 3 ^ Boring Boring # - Pit Ground surface elev. 96.96 ft. Depth to limiting factor 19 in. Sail Application Rate Horizon` Depth Dominant Color Redox Description Texture Structure IConsistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color I Gr. Sz. Sh. III •Eff#1 *EM2 1 0-9 10YR3/2 i ( sil 3sbk mvfr cs lm I .6 .8 2 9-13 10YR5/3 ; sil 3sbk I mvfr cs 1m .6 .8 3 13-19 10YR5/4 ! sc ! 2sbk mfr cs if .2 .3 4 19-30 10YR4/6 10YR6/8f2d spots I sc j 2sbk mfr j cs .2 I 3 I 4 h Boring F]Boring # LJ Pit Ground surface elev. 102.22 ft. Depth to limiting factor 19 in. [Soil Application Rate Horizon Depth Dominant Color I Redox Description Texture Structure IConsistence Boundary Roots GPD/ft' in. Munsell Qu. Sz.-Cont. Color Gr. Sz. Sh. *Eff#i -Eff#2 1 0-5 10YR3/2 sil 3sbk mvfr I cs j 2m .6 .8 2 5-11 10YR5/3 sil 3sbk I mvfr cs 1m .6 .8 3 11-19 10YR5/4 sc I 2sbk mfr cs 1f .2 .3 4 19-27 10YR4/6 10YR6/8f2d sc 2sbk mfr cs .2 .3 * Effluent #1 = BODS> 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 648-264-8777. SBD-8330 (8.07/00) Northland Plumbing, Inc. I Z. f I s e ~ ~ ~ ~ asp 1 I n~ 401 N 10 cal Parcel 034-1031-20-000 10/30/2012 08:46 AM PAGE 1 OF 1 Alt. Parcel 14.29.15.218B 034 - TOWN OF SPRINGFIELD Current ❑X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner 0 - MAHONEY, TIMOTHY J & CYNTHIA A TIMOTHY J & CYNTHIA A MAHONEY 844 CTY RD W GLENWOOD CITY WI 54013 Districts: SC = School SP = Special P erty Address ' = Primary Type Dist # Description ' 946 RUSTIC RD R3 SC 2198 SCH DIST GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 15.030 Plat: 3743-CSM 13-3743 034-99 SEC 14 T29N R15W PT NW SW BEING LOT 1 Block/Condo Bldg: LOT 1 CSM 13/3743 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 14-29N-15W SW NW Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1058/198 WD 07/23/1997 800/571 07/23/1997 717/540 2012 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/07/2012 Description Class Acres Land Improve Total State Reason UNDEVELOPED G5 3.000 3,300 0 3,300 NO 10 PRODUCTIVE FORST LANDS G6 12.030 29,500 0 29,500 NO 10 Totals for 2012: General Property 15.030 32,800 0 32,800 Woodland 0.000 0 0 Totals for 2011: General Property 15.030 36,400 0 36,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 w consih Department of Commerce ~ ,Division of Safety and Buildings 961LAN S TE EVALUATION Page of Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code . C_ Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and S Q percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # 0Z /D ,2D - ©00 APPLICANT INFORMATION - Please p r Itn;' Reviewed by Date Personal information you provide may be used for seco a rposes jiv law, s. 4,5.b4 ) (m)). Property Owner i prop@rty Location Lot /-j 1/45t,11/4,S T,79 ,N,R f114 o fX r 1~` 6o(iS.`;,A/ Property Owner's Mailing Address c Lot•# Block# Subd. Name SM# 9;71-5- A tlstl el Rd, 3 W3 City State Zip Code Phone Nurrl City ❑ Village Town Nea est Road ~e/ylvvetV e, lv S o {,7.F) ~s ~t1 c ~I.I1f/G' o/ New Construction Use: ❑ Residential / Number of bedrooms Addition to existing building Replacement ❑ Public or commercial - Describe: Code derived daily flow gpd Recommended design loading rate ` bed, gpd/ft2 trench, gpd/ft2 Absorption area required bed, ft2 trench, ft2 Maximum design loading rate bed, gpd/ff2 trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design/site considerations Parent material CT/_ 4 ,/'Aid 1 P6K.~ Flood plain elevation, if applicable Al 14 ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill 7Ho d ing Tank U = Unsuitable for system ❑ S co U ❑ S , U ❑ S [3 U ❑ S ❑ S ®u S (W U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 0-9 /v 514 GMs A111R 4S- M Sne- 2 C A G k P v t.S G S 3 Groundt elev a s4ft. ' Depth sf ~~~s to limiting factor Remarks: /2 r✓ k o f 5- / t Boring # i Ground elev. ft. Depth to limiting factor in. Remarks: CST Name (Please Print) Sionature Telephone No. Address Date CST Number Z 70 ~N w vo a~ G /a7`" lv D / 9 ; 2 2 SOIL DESCRIPTION REPORT PROPERTY OWNER - Page of PARCEL I.D.# ' d Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. td VV /-f7vj -~J Remarks: Horizon Depth Domii GPD/ft2 in. N 5 Bed Trench Boring # Ground elev. ft. `&o t;& J ! ( t Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD-8330 (R. 07/96) l kin 0, i : Hof s : I _ i I i I -LA I I l I I T _ _ L -T - r~ ~ - - I - - it ~ ' --1--- - - - ~ _ _ ~ - --1-- - I _ I I i j I I Y - } . i - - fi- - I I I ! t F Oct-20-2010 0e:30 AM St. Croix County PlanlZerring 715-386=46:86 911 ST. CROlX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CEMPICATION FORM Owner/Buyer c'IQt1 (~Ic,kcne~ jzc K-d~ 3 Property Addrea ` 6 (verifiaulon tt yui from Planning ding Deperunnt fbr raw c opouctIOL) Cit Atate leaw-c 6-4-4. L3- Parcel wentincation Number 0 Li - I Q'3 1- Zy -0 co L DA68CRIti ON Property i.ocatiun .a cyZ • , SCC. N RJ,r' ,-W, Tom f 0 ~SD,.r, i r~f ~"e le~ Subdivision Plat: , Lot # CertlSatSUrVeyMap # 013 = valnme 1 -3 # -3-7 . We q OC =3)vt PW # Spec hottse • yes Lot III= watiluble . C//,W S A M AND OWNER CERTIFICATION Improper use and malnUmmee 4f your ae* ayat m =dd result m lk PMMMMM f IUM to reseals W=WL Proper maintettattcc cottAn otpumping out the septic task mmy tbree yon or socaer, if seeded, by a iivenoW pumper. What you put late the aysom tats a5w the f edon of the sapdo tank ea a its unwt stage in dte waste dlspont ayoam. Ownw maintenance responaibiltdo air specified in lConmt, 83JAI) and in Chapter U -'St. Croix Cow* Seaitary Ordinate". Ill Property qPft to rn bMU to St. CMU tNInlr PhMdhl & ZW!ng D%WMWn a 0rtlfPc WWfi ibtrtt. sigma by lfte o nw end ey a nstr pinmlter. jMmt%7man ptarmbM resnioaed pttamR tar a tlocrae~ verifglttg mat l t) m~ on-sits waaatetvalet dir t ayana n is in proW operating tomMlon andA r 12) -after bspmtmn sate pntttping fif a t cssaryl, itta salads teak is len ft n W full ofsimige, k*% the wAw*WW ha" read the above mquite waa to mainak do paivata aswags diepeeal sys~ with file sndatxls asst fiwtkUmbs. =ad by Ow De c of CmwAm4wd theme ofNatal Rwoumw -g of Winnak cadf%gatjon sting daat ya=sVda aye baa bat main aked mne be oompUM and r mwom d to dw$L Ckavc C=nty & Za tag Departmw within 30 dap ofthe thrice year aggmdm date. we acetify that all statements on this &rwvm to to the but of tt ykw to mmisdga. Yw a aortae the ownerW of the property described above, by virtue of a "7 lecd recorded in Register of Dams Oflbm Numiler s€ err t Ij SIGNATURE OF ATE 0(3 ***Any information that W may mutt in the sanitary permit bent tevabd by the PiaaninS & Zoaft Dep tt. i Inohade with this spplksti m a deed how the Regiaaw ofl Offia and a copy of do osrdW w m Wrap if rehmnee is nv* In the warranty (REV. DBMS) Parcel 034-1031-20-000 08/13/2013 02:50 PM PAGE 1 OF 1 Alt. Parcel 14.29.15.218B 034 - TOWN OF SPRINGFIELD Current ❑ ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - MAHONEY, BRIAN R & DEBRA J BRIAN R & DEBRA J MAHONEY 875 325TH ST GLENWOOD CITY WI 54013 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 946 RUSTIC RD R3 SC 2198 SCH DIST GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 15.030 Plat: 3743-CSM 13-3743 034-99 SEC 14 T29N R15W PT NW SW BEING LOT 1 Block/Condo Bldg: LOT 1 CSM 13/3743 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 14-29N-15W SW NW Notes: Parcel History: Date Doc # Vol/Page Type 09/05/2012 962882 LC 07/23/1997 1058/198 WD 07/23/1997 800/571 07/23/1997 717/540 2013 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/07/2012 Description Class Acres Land Improve Total State Reason UNDEVELOPED G5 3.000 3,300 0 3,300 NO PRODUCTIVE FORST LANDS G6 12.030 29,500 0 29,500 NO Totals for 2013: General Property 15.030 32,800 0 32,800 Woodland 0.000 0 0 Totals for 2012: General Property 15.030 32,800 0 32,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 111111111111111111111101111111 8084057 Tx:4063845 State Bar of Wisconsin Form 11-2003 962882 LAND CONTRACT BETH PABST (TO BE USED FOR NON-CONSUMER ACTTRANSACrioNs) REGISTER OF DEEDS Document Number Document Name ST. CROIX CO., WI 09/05/2012 10:35 AM EXEMPT#: NA CONTRACT, by and between TIMOTHY J. MAHONEY and REC FEE: 30.00 CYNTHIA A. MAHONEY husband and wife ("Vendor," whether one or more), and BRIAN R. MAHONEY and TRANS FEE: 135.00 DEBRA J. MAHONEY, husband and wife, as survivorship marital property PAGES: 4 ("Purchaser," whether one or more). Vendor sells and agrees to convey to Purchaser, upon the prompt and full performance of this Contract by Purchaser, the following real estate, together -with the rents, profits, fixtures and other appurtenant interests ("Property"), in Recording Arm -ST CROIX County, State of Wisconsin: Name and Return Address JOHN R. PIPAL Lot 1, Certified Survey Map, filed in Volume 13,-Page 3743, recorded September PO BOX 142 30, 1999, as Document No. 611314, being part of the NW 114 of the SW 114 and the DODGEVILLE, WI 53533 SW 114 of the SW 114, Section 14, Township 29 North, Range 15 West, Town of Springfield, St Croix County, Wisconsin. 034103120000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) This is not a purchase money mortgage. (is) (is not) Purchaser agrees to purchase the Property and to pay to Vendor at 844 County Road W, Glenwood City, WI 54013-3903 the sum.of $ 45,000.00 in the following manner. (a) $ 20,000.00 at the execution of this Contract; and (b) the balance of $ 25,000.00 , together with interest from the date hereof on the balance outstanding from time to time at the rate of 3.26 % per annum until paid in full as follows: Annual installments of princiap and interest in the amount of $8880.77 commencing on August 31, 2012 and $8880.77 on each successive August 31 until paid in full, provided the entire outstanding balance shall be paid in full on or before August 31, 2015 ("Maturity Date"). Payments shall be'appiied first to interest on the unpaid balance at the rate specified and then to principal. CHOOSE ONE OF THE FOLLOWING OPTIONS: N NO OPTION IS CHOSEN. OPTION A SHALL APPLY: ® A. Any amount may be prepaid without premium or fee upon principal at any time. O B. Any amount may be prepaid without premium or fee upon principal at any time after ❑ C. There may be no prepayment of principal without written permission of Vendor. State BarForm 11-Page 1 1 of 4 W AD V F ) D I-A ST. CRDfK C0~11'+)Y Cv SURVEYOR'S -DRD x..1.314 N PPROVED ~~~,~%\SC0,V S~ AST. COUTY CERTIFIED SURVEY MAP Planning Zon goal and Park Ns Co, LYLE L. ~ VOLUME 13 PAGE 3743 ELLIOTT ; SEP 3 Q 1999 S-1300 = PART OF THE NW 1 /4 OF THE SWI /4 AND THE HUDSON WI j SWI/4 OF THE SWI/4, SECTION 14. T29N, R15W -fOWN OF SPRINGFIELD. ST. CRO I X COUNTY. WISCONSIN if not recorded within 3U days a: approval date approval shall be I'll S,lArv;; •~%1. LYLE L. ELLIOTT. REGISTERED LAND UNPLATTED LANDS SURVEYOR S-1300. DO HEREBY CERTIFY - - THAT TO THE BEST OF MY KNOWLEDGE AND EAST - WEST 1/4 LINE BELIEF THIS PLAT IS A TRUE AND CORRECT / S 89°28'32"E 5247.81' REPRESENTATION OF PART OF THE NWI/4 OF THE SWI/4. AND THE SWI/4 OF THE N 656,04' SWI/4 SECTION 14. T29N. R15W. TOWN OF Tl~ 623.04 SPRINGFIELD ST. CROIX COUNTY. WISCONSIN. DESCRIBED AS : v 3 .00' B EGINNING AT THELWEST QUARTER CORNER d SAID SEC. 14. THENCE S89°28'32'E ALONG THE EAST-WEST QUARTER LINE 656,04 FEET: THENCE S00°24'14'E 2386.72 FEET: 3 in I'~Q v v THENCE N89°37'35'W 658.71 FEET TO THE WEST LINE SEC. 14: :cl; v THENCE N00°20'21'W ALONG THE WEST LINE LOT 1 0 w LINE OF THE SWI/4 SAID SEC. 14 ro ; ° I -w (n 2388.41 FEET TO THE POINT OF N BEGINNING. SAID PARCEL CONTAINS 36.03 N 654.529 SF. ACRES MORE OR LESS. AND SUBJECT TO A ;N 15.03 AC. 0 33.00 FEET RIGHT-OF-WAY ALONG THE N WEST LINE OF SAID PARCEL AND SUBJECT o 621.450 SF EXC. TO ANY OTHER EASEMENTS OR RESTRICTIONS :o HWY. R-O-W to OF RECORD. .z I 14.27 AC. N I CERTIFY THAT I HAVE FULLY COMPLIED WITH THE PROVISIONS OF SECTION 236.34 OF THE WISCONSIN REVISED STATUTES AND W INC •100 BUILDING SET :1J THE ORDINANCE OF ST. CROIX COUNTY IN Z ro~ BACK a SURVEYING AND DIVIDING SAME. w N THIS SURVEY WAS MADE AT THE REQUEST E~ ;li OF TIM AND CINDY MAHONEY. W 3 S89°31'03'W 657.09' 0 925 RUSTIC RD 3. GLENWOOD CITY. WIS. 3 N Co 624.09- 33.00' N. EACH PARCEL SHOWN ON THIS PLAT IS N OUSE SUBJECT TO STATE. COUNTY. AND TOWNSHIP o d LAWS. RULES AND REGULATIONS (i.e v>I WETLANDS. MINIMUM LOTS SIZE. ACCESS TO Z ° PARCEL. ETC) BEFORE PURCHASING OR (n 0. RN Q DEVELOPING ANY PARCEL CONTACT THE z I J ST. CROIX COUNTY ZONING OFFICE AND THE J of APPROPRIATE TOWN BOARD FOR ADVICE. w F- w d F- to J F- ~ d ap z J M D CL I I C Lf) N I V r°Di : N I LYL L. ELLIOTT. RLS 1300 ml DATE: AUGUST 20. 1999 A° Z LOT Ln REVISED SEPTEMBER 27. 1999 ro SCALE I* - 300' 914833 SF. 0 100 300 600 v 21.00 AC. H 869099 SF EXC. HWY R-O-W BEARINGS REFERENCED TO THE WEST 19.95 AC. LINE SWI/4 SEC. 14 a (ASSUMED NO0°20'21'W) ftw% I LEGEND SET 3/4' X 24' IRON REROD. w 33.00' WT. 1.50 LBS/FT. 625.71' 0 FOUND 3/4' IRON REROD N 89°37'35'W 658.71' N v No N90°00'00'E 692.21 R.A. ® FOUND. 3' ID IRON PIPE R.A. RECORDED AS LOT 1 CSM VOL. 9 , PG. 2523 FOUND. PK NAIL THIS INSTRUMENT DRAFTED BY L. ELLIOTT "kftft Vol. 13 Page 3743