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022-1011-60-125
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 563899 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: Delander, William Kinnickinnic, Town of 022-1011-60-125 CST BM Elev: Insp..B Elev: BM Description: 6 �� Section/Town/Range/Map No: 05.28.18.70E TANK INFORMATION ELEVATION DATA TYPE MANUFACTURFj.�s ' CAPACITY STATION BS HI FS ELEV. Septic /, / fit ���//.n- 3 M Benchmark 97 g� W t vJti�-- gel 1..a,■ !1 e /.046 ( ,Z, /a Dosing r, �'S / Alt. BM oF1 / d /o k ✓2� Bldg.Sewer `i, I s �� �� ,` (,y Holding u St/Ht Inlet 9, aS 9' 4 M.'15 s. 55 TANK SETBACK INFORMATION St/Ht Outlet TANK TO /L. WELL BLDG. Vent t it Intake ROAD Dt Inlet `, -- Septic / / 1 Dt Bottom W%, g) 30 — — Jt ( 2.tic)S • /. 7!) Dosing / / / / Header/Man. 90 Fs► 3o 171Z 5.. 67 "If • 93 Aeration Dist. Pipe Holding Bot.System Final Grade ,,as PUMP/SIPHON INFORMATION 4, b? 77 .`l 3 d/k-. Manufacturer / GPM St Cover �+v GPM '/ i , (gypµ.c,`� ^ 5.S 7/. / Model Number P Q S 5( C f TDH rift,/ Friction Loss Head TDH 2 t ,i System 3,b7 3•Z-5 23, J Forcemain Length / Dia. ,1 Dist.to Well 1// / /4'5. z (:::----- SOIL ABSORPTION SYSTEM BED/TRENCH Width 1 / Length / No.O Trenc PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS Lc 75 ■►..__ �_ --........., SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Typcc��OO��44ystem: / / / A CHAMBER OR 7 V 5 3/ /66 /�`� UNIT Model Number: i� d�� 10 ,v DISTRIBUTION SYSTEM lea v Header/Manifold/ �L e/Distribution // x Hole Sing{ /1 x Hole Spacing Vegrt Tp Air Intake 1' ` Pipe(s) 3-1. F /r L/�II Length 3 Dia Length Dia Spacing 3 / o 3 . Z_ l/ SOIL COVER / x Pressure Systems Only xx Mound Or At-Grade Systems Only a, K,, Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center /e V Q.! Bed/Trench Edges Topsoil i 1 r J a—c Yes NoSYes A No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: (1 / /3 /3 Inspection#2: / / Location: 587 100th Street Roberts,WI 55023(NW 1/4 NW 1/4 5 T2 IN R18W) NA Lot 4 g. 460 Parcel No: 05.28.18.70E 1.)Alt BM Description= 671 � '� G�Jr c'-''^'S �iced 6(..� 0�'Z 2.)Bldg sewer length= 5 -amount of cover= / n n 5 a sC�G_ i / 0.317C Plan revision Required? t Yes No / / i / j Use other side for additional information. L SBD-6710(R.3/97) Date Insepcto/.Signa e Cert.No. 3 iS - - 1 h 0 1.}..Ledi /1"). 6 - f = D6 ' r / 'lf uc_ / '" 7d a 13p, - = i u - / f ( f A .01K4 gr(-)' imisimeme ye`-7---1-' ,Er- 77 - .- ° _ , M 6-3 - -0 _ %" ?,-----5--'..-7: A. 'k P: for A"( 0 I County yC. Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 San itary Permit Number (to be filled in by Co.) D K Madison, WI 53707-7162 'moo P S 1Q1''s~ State Transaction Number Sanitary Permit Application z 2a Z. q3 rN in accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are su itted to Project Address if different than mailing addre the Department of Safety and Professional Servies. Personal information you provide may be used for / purposes in accordance with the Privacy Law, s. 15.04(1 (m , Stats. V#?- I. A lication Information - Please Print All Informatn Parma Property Owner's Name 04 <13paa-16 -j90-~ 3 r Property Owner's Mailing Address ,D/,1- ~,oU Property Location / -76 Govt. Lot ~r- 9 8 °v -7---/Y1 . Phone Number /V iAL '/4, Section J City, State ip Code )qj~ ta* 7/S- 7lv U T N; R 6c-i le ore) H. Type of Building (check all that apply) Lot # 1 or 2 Family Dwelling - Number of Bedrooms CTS Subdivision Name 6r cud Block # 11 Public/Commercial - Describe Use O I 6 El city of CSM Number p El Village of 11 State Owned -Describe Use X 75 AO-LO-J. s c 7 / (0 11 Town of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) List Previous Permit Number and Date Issued/ B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New Before Expiration Owner IV. Type of POWTS S stem/Com onent/Device: Check all that apply) /1 OtJ ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade $ Imound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersal/Treat t Area Information: Design Flow (gpd) Design Soil Application Rate(gp Dispersal e Require sfZ Dispersal Area Propos' r (s System Elevation S''o G(1 JVy~/) lf' ✓2 VL tank Info Capacity in Total # of Manufacturer Gallons Gallons Units o "0 L) n I New Tanks Existing Tanks 7 ~ y d !llC~~~ [Z a. U 'vs H v5 is. 5 a, Septic or Holding Tank /00(=> O00 ~jp0 Dosing Chamber 600 VII. Responsibility Statement- I, the undersigned, assu a responsibility for installation of the POWTS shown on the attached plans. Plumber,' Name t Plumbe i /MPRS Number Business Phone Number rf /TP(V o? 037 7is -76a 07 Y Plum 's Address (S t, City, State, Zip Code) o 7o 2//,-3 Coun epartment Use Only Permit Fee Date sued Issuing nt Signatur 2 Approved rave $ /J even Reason for Denial IX. Conditzo„a.af~~easons for Disapproval 1!0 'o n n S e ~i ' geptits'tank,efflubntfdtm►SM dispersal calf must all be servkeis t Ir t l el as per management plan provided by plug. l as per appNc" code rotdii>artces• Attach to complete plans for the system and submit to the County only on paper not less than 81e z 11 incbes in size SBD-6398 (R. 11/11) . s o~ynxxlT DIVISION OF INDUSTRY SERVICES 10541 N RANCH ROAD m HAYWARD WI 54843 3 aS Contact Through Relay P www.dsps.wi.gov/sb/ $ www.wisconsin.gov .Pp 0~ 5 ION Scott Walker' Governor Dave Ross, Secretary August 09, 2013 CUST ID No. 220357 ATTIC- POWTS Inspector BRADY J UTGARD ZONING OFFICE UTGARD PLUMBING & HEATING ST CROIX COUNTY SPIA PO BOX 413 1101 CARMICHAEL RD AMERY WI 54001 - - HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/09/2015 Identification Numbers Transaction ID No. 2290285 SITE: Site ID No. 793718 William Delander Please refer to both identification numbers, 988 Co Rd N above, in all correspondence with the agency. Town of Kinnickinnic N St Croix County CON~~1~0 NW1/4, NWI/4, S5, T28N, R18W pppPRO FOR: EP T OF sxv Description: Mound, 3 bedroom residence D c~JO%A Object Type: POWTS Component Manual Regulated Object ID No.: 1441437 p Q :eS 8t Maintenance required; 450 GPD Flow rate; 26 in Soil minimum depth to limiting factor from original grad C Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01101, R. 10/12), Pressure Distribution Comp I 1fiual Ver. 2.0, SBD-10706-P (N.01101, R. 10/12), SSWMP Pub. 9.6; Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Cod CORR and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be co SEE and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. 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: 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 BRADY J UTGARD Page 2 8/9/2013 is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. • 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 Reviewed r , Integrated Services WiSMART code: 7633 (715) 634-7810, Fax: QJ'5) 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 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. BRADY J UTGARD Page 2 8/9/2013 is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. • 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 _-.7- Patricia L Shandorf POWTS Plan Reviewer, Integrated Services WiSMART code: 7633 (715) 634-7810, Fax:~(7,15) 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 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. MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN INDEX AND TITLE PAGE Project Name: WILLIAM DELANDER Owner's Name: WILLIAM DELANDER Owner's Address: 988 CTY RD. N ROBERTS WI. 54023 Legal Description: NW/NW/S5/T281R18W Township: KINNICKINNIC %LLY County: ST.CROIX :j) ND Subdivision Name: CSM 710988 VOL17 PAGE4467 USER ICES ;TRY SERVICES Lot Number. 4 Block Number. Parcel I.D. Number. 022-1011-60-125 Plan Transaction No.: spONU ^ CE Page 1 Index and title Page 2 Data entry C Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 PLOT PLAN Page 9 SOIL EVALUATION Designer. BRADY UTGARD License Number: 220357 Date: 07/2211 Phone Number: 175-760-0946 Signature: i Designed Pursuant to the Mound Component nual for POWTS Version 2.0 SDB-10691-P (N. 01101), and SSWMP Publication .6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 3.11 (R. 06/01) Page 1 of 9 Mound and Pressure Distribution Component Design Site Information 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 96.50 Contour Line Elevation (ft) 26.00 Depth to Limiting Factor (in) 0.50 In-situ Soil Application Rate (gpd/fe) Distribution Cell Information 75.00 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpolfe) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? 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. 0.188 Orifice Diameter (in) (e.g. 0.25) 3.00 Orifice Spacing (ft) = 9.38 fe/orifice 2.00 Forcemain Diameter (in) 145.00 Forcemain Length (ft) Does the forcemain drain back? Y 87.00 Pump Tank Elevation (ft) 3.25 System Head (ft) x 1.3 23.65 Forcemain Drainback (gal) 10.33 Vertical Lift (ft) 46.90 5x Void Volume (gal) 3.07 Friction Loss (ft) 70.55 Minimum Dose Volume (gal) 16.65 Total Dynamic Head (ft) 31.46 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 - 1.25 x x 1.00 1.50 x 1.25 x x 2.00 1.50 x 3.00 2.00 x 3.00 x Gallonsiinch Calculator Treatment Tank Information 600.00 Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) 36.00 Total Working Liquid Depth (in) weiser Manufacturer 16.67 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 600.00 Dose Tank Capacity (gal) POLYLOK Filter Manufacturer 16.76 Dose Tank Volume (gal/in) PL-525 Filter Model Number weiser Manufacturer Project: WILLIAM DELANDER Page 2 of 9 Mound Plan View 1/10 B s J • _ Observation Pipe Q ' K J O A Yi/ B. . I L Mound Component Dimensions A 6.00 ft E 15.04 in H A5.22 ft K 8.44 ft B 75.00 ft F 9.25 in z ft L 91.89 ft D 10.00 in G 0.50 ft J ft W 20.80 ft 450.00 (fe) Dispersal Cell Area 1168.91 (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 99.10 (ft) ..rrf * H rrrrrrrrr rrriirit,~ •j 2,11,11 G . f/fJrff r{r~r\ 97.83 (ft) Lateral Dispersal Cell 97.33 (ft)--► - Invert Dispersal Cell t Elevation E D ..1... 1 96.50 (ft) Contour Elevation 7.0 % Site Slope Geotextile Fabric Cover Shading Key -T Dispersal Cell See lateral details on i~ Topsoil Cap ° 1.5 ft Page 4 for number, size, © rfr" Subsoil Cap w O and spacing of laterals. ASTM C33 Sand ~ t / F T Laterals are equally Tilled Layer d 0.5 ft Typical Lateral spaced from the F5 Aggregate a c 5[] t distribution cell's enterline in the 40 A * disctribution cell (AxB). Project: WILLIAM DELANDER Page 3 of 9 Center Connection Lateral Layout Daigram Force main cormeotim uia tee or cross to manifold at arty point. Laterals are identic al 1 P sk Turn-up ref bail vshro or 1 X~IEsl2 a12~ Laterals & force main of PVC Sch 40 ciesnoutplug per COMM Table 84.30-5 Holes drilled on the bottom of the lateral Number of Laterals 4 Orifice Diameter 0.188 in Lateral Diameter 1.25 in Orifice Spacing (X) 3.20 ft Lateral Length (P) 36.80 ft Orifices per Lateral 12 Lateral Spacing (S) 3.00 ft Orifice Density 9.38 fe/orifice Lateral Flow Rate Laft gpm Manifold Length 3.00 ft System Flow Rate gpm Manifold Diameter 1.25 in Total Dynamic Head Forcemain Velocity 3.21 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 RForcemain 4 in. min. Tank component is property vented Altemate outlet Nation diameter weiser Manufacturer 2 in. Capacityl 600.00 Gallons Volume 16.76 gal/inch A _ Weep hole or anti- Dimension Inches Gallons B siphon device A 23.59 395.37 B 2.00 33.52 C Pump off elevation (ft) C 4.21 70.55 87.50 D 6.00 100.56 D Total 35.80F-600.00 ink elevation (ft) 3" Bedding un er tank. 87.00 Alarm Manuafacturer LEVEL Alarm Model Number DLV Pump Manufacturer GOULDS Pump Model Number EP05 Pump Must Deliver 31.46 gpm at 16.65 ft TDH Project: WILLIAM DELANDER Page 4 of 9 I Mound System Maintenance and Operation Specifications Service Provider's Name UTGARD Phone 715-760-0946 POWTS Regulator's Name ST. CROIX Phone 715-386-4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 fe Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Freauencv Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Should inspect and dean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Inspect for ponding and seepage once every 3 years INSPECT FILTER ONCE A YEAR Misc illaneous Constru, gftn and Materials Standards 1. Observation pipes are sk*ed 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 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: WILLIAM DELANDER Page 5 of 9 Mound System Management Plan Pursuant to Comm 83.54, Wfs. Adm. Code 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 tardc abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POVVTS 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 conpletior► of service. Any opening deemed unsound, defective, or subject to bilt a must be replaced. Exposed access openings greater than 8-inches in diameter shag to secured by an effective kxdung device to prevent accidental or unauthorized entry iota a tank or component. $sof Tank The septic tank shag be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contorts 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 filler shag be assessed at least once every 3 years by inspection. The outlet filter shag be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solft in the tank that may slough off the filfler when removed from its enclosure. If the filler is equipped with an alarm, the filter shall be serviced 9 the alarm is activated continuously. Intermittent filter alarm 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 shag advise the owner of when the next service needs to be performed to maintain less than maximum scum and skidge accumulation in the tank- The addition of biological or chemical addithies to enhance septic tank pertonnnance its generally not required. However, if such products are used they shag be approved for septic tank use by the Department of Commerce. Prgno TffiNc The pump (dosing) tank shag be inspected at least once every 3 years. AN switches, afarins, and purmpe shall be toasted to verify proper operation. If an effluent rifler is installed within the tank it shag be inspected and serviced as necessary. Mound and Pressure Distribution Svstsm No trees or shrubs should be planted on the mound. Plantings may be., ade around the mourhd's perimeter, and the mound shag 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 a not recortxnended since soh cornpaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter w M promote frost penetration. Cold weather installations (October-February) diddee that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L mss, 150 rrg/L TSS, and 30 mglL FOG for septic tank effluent or 30 rm SOD,, 30 1 g/L 5, rrhglL TSS, 0 rglL FOG, and 104 du/100 rrd. for highly treaded effluent. Influent flow may not exceed maximum design flow specified in the perndt for this installation. The pressure distribution system is provided with a ftushig point at the end of each lateral, aid 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 wataled to determine if orifice Dogging has occurred and if orrice leaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for of lord pondig. Ponding levels shag be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent montoring. Contingency Plash If the septic tank or any of its components become defective the tank or component shag be repaired or replaced to beep the system in proper operating condition- If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shag be immediately repaired or replaced with a component of ft sane or equal performance. If the mound component Wis 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 dogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to brig 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 WILLIAM DELANDER Page 6 of 9 Lq GOULDS PUMPS Submersible Effluent Pump R EP04 & EP05 Series APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas ■ Bearings: Upper and lower Specifically designed for the grade turbine oil for 6c enclosed design for heavy duty ball bearinq following uses: lubrication and efficient improved performance, construction. • Effluent systems heat transfer. ■ Casing and Base: Rugged • Homes Available for automatic and thermoplastic design provides AGENCY LISTING • superior strength and c mama{ operation, Auto- corrosion Canadian farms standards AssmkAion Heavy duty sump matk nxxkb include resistance. IR` File # LR38549 Water transfer Nledunitai ■ Moto P" Switch Motor Housing: Cast iron 9 Goulds is 150 f 900 Dewaterin preset at the t heat transfer, assembled and or efficient Puy erect factory. strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic • Solids handling capability: FEATURES cover with integral handle and Solids maximum. float switch attachment points. EP04 Impeller Thermoplas_ a Power Cable: Severe duty • Capacities: up to 60 GPM. tic semi-open design with • Total heads: up to 31 feet. pump out vanes for mechanical rated oil and water resistant • Discharge size: Vlz" NPT, seal protection. • Mechanical seal: carbon- rotary/ceramic-stationary, BONA-N elastomers. • Temperature: 104 F (40')Q continuous 140"F (60'0 intermittent. METERS FEET _...T • Fasteners: 300 series to stainless steel. _ • Capable of running 9 3,01, - dry without damage to 5 c'am' l components. - 25 - Motor: • EP04 Single phase: 0.4 HP, v b 201 1 or 230 V, 60 Hz, 1550 RPM, built in overload with } 5 automatic reset. • EP05 Single phase: 0.5 HP, a 4 115 V or 230V, 60 Hz, 1550 a lo. i EPOS r RPM, built in overload with automatic reset. z EP04 • Power card: 10 foot 5~- standard length, 16/3 } S1TW with three prong j grounding plug. Optional 20 00- io foot length, 16/3 S1TW with zo 30 40 So GPM three prong grounding plug (standard on FP05)- 2 4 - 5 8 10 12 m'Ih CAPACITY Goulds Pumps E(t.efive h,ly,U~)3 ti'd" ITT Industries 106 7 -,f 4~ 131w - a~ = ~7, 7jy / , I pU f j 4A ~~so C N l f1r. CROIX COUNTY ZTPJK MAINTENANCE AGREEMENT AND OW RSHM CERTIFICATION FORM OwncrMuycr s7 Mailing Address Ptoperrf Addy+ass I- Lion. (Vtoificattou required Item Plttmiog do Dopattu~ait for eew t:oastnxc c; fst t~ -i~ Parcel Iden ' cation Number Z3 aZ a ' f b l G, a ' O o 'C~ Property [,ovation X44A . Sec.,4__ , T N _R/ R_ W Town of _ Subdivision Plat: , Lot f b 9 8 O _ _ Certified Survey Map # 7l Volume Page ot Warranty Deed fl ! 0 S 9 (before 2007)Volume ~ POW # f 0 3S7 spec house n yes hkno Lot titres idenufiabkltyes t! ao S1(STEN1 M,AjNTfNANCE AND OWNER CERTIFICATION Improper itwle ana4 nsa~ Of y~ tieptfe 3ysnbnl GOriltt result us' its premituro failwe m haAdSs wastes Proper inainienance consists of pumping out the septic antic every d free years or sooner, if needed, by a lieetrat.•d pumper What you put into the system can affect the function of the septic talk as a Maaanemt sitge in the waste disposal system. Owner mainteaanct t;S7tir's i6 i li.:r s ate specified in ¢Comm, 83.52(1) mW in Chapter 12 - St. Croix Co=W Sanitary Ordinwce, The protserty owner agrees to submit to St Croix County Planning & Zoning Departmont a cenification form, signed by the owner and by a miner ptun*er, journeyman phnnbisr, restricted plumber or a licensed pumper verifying that 11) the on-site waoewater tiicliorat system is in prupcr operating condition and/or (Z) after ;nspccVon and pumping (if ttecessaryi, the septic tank is xss fhso 10 ;wilt ,)f sludge '/we, the undersigned have read the above requirements and agree to maintain the private sew%$* disposal system witti the standards set fort!," herein. as set by the Dgmrtmeut ofComn ace and the Depatmoat of Natiiul Rosotuces, State of Wisconsin. Cettifteatior stating that your septic system has been "intained must be completed and returned to the St. Croix Counry Planning & 7Eining Depattinent within 30 days of the three year expiration date. 1/we certify that all statements oa this form are 1e to the best of my/our imowledge. I/we amhre the owner(s) of the p(optity describes above, by vine of a warranty recorded in Register of Deeds Office Number of beds' oims _ S16N AURE Of APPLICANT(S) ° A.)V ,tlformat.un that is misrepresented may result in the sanitary penin i beuig revoked by the Planntug & Zoning Depturment. Include with (his ippitcation a recorded warranty decd from the Rcgistcr of Dads Office and d copy of the cenificd 5utvcy inap it iefererice is mace sit tilt warranty ieed. (RFV . 08/05) APPROVED s r. clla?x c?+1uTy 7 1 9 8 6 tee VOL 17 PAGE 4467 E B 2 4 2003 KATHLXM H. ALSH REGISTER OF DEEDS - ST. CROIX Co., 111I a r vaCC ate ,ti-u J Qay3of RECEIVED FOR RECORD EC FE2003 10:00AK 02/24/ ppro4•:~4 date apps-.Ie1ERTI FI E D SURVEY MAP R f,i:! •r-!•~<,:1 EC FEE: 13. 00 COPY FEE• 6.00 LOCATED IN PART OF THE NW1/4 OF THE NW1/4 PAGES: 2 OF SECTION 5. T28N. R18% TOWN OF KINNICKINNIC, ST. CROIX COUNTY, WISCONSIN. - UMP- ELnA T`WMD LLAMF0~ SCALE IN FEET 1" = 200' Dwfflmf;-i-'CL)) low OO S~G~C~(~5 200 O 200 NORTH LINE PREPARED FOR: OF THE Nw1/4 FREDERICK LENERTZ NW COR. 89°4354"E 340.66' 220 LIVESTOCK SEC.5~ -32.84'1 307.82' EXCHANGE BUILDING I o ST. PAUL, MN Z I LOT 1 C> 55075 ~c u5 SURVEYOR: N bo ~ r°3, 1 m THOMAS M. HEALY co (o L------- v S do N LAND 13~ Q Oo ACCESS EASEMENT SURVEYING, INC. w RECORDED IN 2920 ENLOE STREET 33.55' 307.86' - VOL. 2149, PG. 272, HUDSON, WI 54016 DOCUMENT NO. 710648 S00°12'15"E a, S88°30'02"W 341 .41 66.02' N88°30'02"E 448-20' 1 0 I I I Q i o O -33.71' 414.49' o z -4 m . , cn y l Op l O O r2 N O N t I I N C .i_1 N o 0 rn 0 v, A w cc'o ; LOT 2 °N' I I© - I ,ou, m I~1lJ IrN, . I 34.23' 414.49' j `3 , Nnl ~ M f+l SC7 I N$8°30'02"E 448.72' I~o I D z 100' 11 ny Cn I ~ I r" I n i° u CO GJ_ N N I O I I D 3. 1~'I GJ I o o LOT 3 v ; j l <n Co m N IV _ N I G.N CT ? 1 p ~ O I 1 0 C) 33 33' _-3 4' ca Co I ~R rn I m m 1 414.49' N4t ci o wm ~ N88°30'02"E 449.23' i OD r Z ao Z Z) N 100'-~-1 I A I A o N g N LOT 4 4 cD co c N~°3rO~4p52 $w % LEGEND ~M21 O, FOUND ALUMINUM ST. ° ,all (9 CROIX COUNTY SECTION n _ O"lv4` CORNER MONUMENT 1 I o 4.6 N7r 4 z n SET 1" OUTSIDE 1 I~ A 3.3g, 829 DIAMETER BY 18" I ~ i ut I° r ~MM~ O LONG IRON PIPE, m WEIGHING 1.13 LBS. PER LINEAR FOOT I tl~ w ( n~D PROPOSED DRIVEWAY LOCATION ull N 66' WIDE JOINT DRIVEWAY EASEMENT w1/4 CORD BUILDING SEC. 5 LOT AREA TABLE SETBACK LINE Lot # Description SQ. FT. ACRES LOT 1 INC RW 96,691 2.22 ~~~G0 LOT 1 EXC RW 87,122 2.00 LOT 2 INC RW 94,263 2.1620 LOT 2 EXC RW 87,123 2.00 Y J_I LOT 3 INC RW 94,372 2.17 x LOT 3 EXC RW 87,123 2.00 LOT 4 INC RW 138,449 3.18 UOSON, Q LOT 4 EXC RW 115,889 2.66 wi ~O THIS INSTRUMENT DRAFTED BY: WILLIAM KANE JOB NO. 6000-16 DATE: 09/06/2002 REVISED: y 02/24/2003 SHEET 1 OF 2 SHEETS Vol .17 Page 4467 APPROVED ST. CROiX co.tIP4TY e F E B 2 4 2003 ays of If nct recce approval - - null .=nA n!d CERTIFIED SURVEY MAP LOCATED IN PART OF THE NW1/4 OF THE NW1/4 OF SECTION 5. T28N. R18W. TOWN OF KINNICKINNIC, ST. CROIX COUNTY, WISCONSIN. PREPARED FOR: SURVEYOR: FREDERICK LENERTZ THOMAS M. HEALY 220 LIVESTOCK S do N LAND EXCHANGE BUILDING SURVEYING, INC. ST. PAUL, MN 2920 ENLOE STREET 55075 HUDSON, WI 54016 SURVEYORS CERTIFICATE I, Thomas M. Healy, Registered Wisconsin Land Surveyor, hereby certify: That I have surveyed, divided and mapped that part of the Northwest Quarter of the Northwest Quarter, Section 5, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin, described as follows: Beginning at the Northwest corner of said Section 5; thence South 89 degrees 43 minutes 54 seconds East, assumed bearing, along the north line of said Northwest Quarter of the Northwest Quarter, a distance of 340.66 feet; thence South 00 degrees 20 minutes 39 seconds East, a distance of 278.30 feet; thence South 88 degrees 30 minutes 02 seconds West, a distance of 341.41 feet to the west line of the Northwest Quarter of the Northwest Quarter of said Section 5; thence South 00 degrees 12 minutes 15 seconds East, along said west line, a distance of 66.02 feet; thence North 88 degrees 30 minutes 02 seconds East, a distance of 448.20 feet; thence South 00 degrees 20 minutes 39 seconds East, a distance of 814.09 feet to the centerline of County Trunk Highway "N"; thence North 70 degrees 31 minutes 00 seconds West, along said centerline, a distance of 474.65 feet to on angle point in said centerline; thence North 71 degrees 48 minutes 29 seconds West, along said centerline, a distance of 3.35 feet to sold west line of the Northwest Quarter of the Northwest Quarter of said Section 5; thence North 00 degrees 12 minutes 15 seconds West, along said west line, a distance of 997.83 feet to the point of beginning. Containing 9.73 acres, more or less. Subject to road easements over that part token by County Trunk Highway "N" and 100th Street and all other easements and restrictions of record, if any. That I have made such survey by the direction of Mr. Fred Lenertz, owner of said land. That such is a correct representation of all of the exterior boundaries of the land surveyed and the subdivision thereof made. That I have fully complied with the provisions of Chapter 236.34 of the Wisconsin Statutes and the subdivision regulations of the Town of Kinnickinnic and St. Croix County, in surveying, dividing and mapping the same. ~►`sGO~B~~M Thomas M. Healy, -7 -4 THQMAS M. Date: February 24, 2003 14EALY S"25" HuoSON. COQ S U Each parcel shown on this map is subject to State, County and Township 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 and the Town of Kinnickinnic for advice. THIS INSTRUMENT DRAFTED BY: WILLIAM KANE JOB NO. 6000-16 DATE: 09/06/2002 REVISED: 02/24/2003 SHEET 2 OF 2 SHEETS Vol.17 Page 4467 U 27?2P 10 .5 , 790596 KATHLEEN H. WALSH REGISTER OF DEEDS STATE BAR OF WISCONSIN FORM 1 - 2000 ST. CROIX Co.,- WI Document Number WARRANTY DEED RECEIVED FOR RECORD 03/28/2005 10:30AN THIS DEED made between Ta Yang, a single person Grantor, and WILLIAM L DELAIDER WARRANTY DEED EXElPT # Grantee. Grantor, for a valuable consideration, conveys to Grantee the following REC FEE: 13.00 described real estate in St. Croix County, State of Wisconsin (the TRANS FEE: 150.00 COPY "Property': CC FEE : PAGES: 2 SEE ATTACHED EXHIBIT A ~i Recording Area Name and Return Address: Land Title Inc. 19M Silver Lake Road Suite 200 N% B t Z 01016,q . Together with all appurtenant rights, title and interests. 022-1011-60-000 Parcel Identification Number (PK 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 Dated this 17th day of March 2005. . * Ta Yan Jl~ AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF MINNESOTA ) WASHINGTON COUNTY. ) ss. authenticated this 17th day of March, 2005 . Personally came before me this 17th day of March 2005 the above named Ta Yang, a single person to me known to be the * person(s) who executed the foregoing instrument and TITLE: MEMBER STATE BAR OF WISCONSIN acknowledged e' (If not, MAJA,~A N 14r authorized by § 706.06, Wis. Stats.) *Nan J. Lentz THIS INSTRUMENT WAS DRAFTED BY Notary Public, State of Minncso My commi ion is permanent. (If not, state expiration date: ~3 i I ao to ) Larry Mountain, Attorney, 1900 Silver Lake Rd #200, New i _Brighton, MN 55112 (Signatures may k e authenticated or acknowledged. Both are not necessary.) ~ *Names of persons signing in any capacity must be typed or printed below their signature NANCY J. LENTZ Notary Public-Minnesota My ~ Jan 31 2010 WARRANTY DEED STATE BAR OF WISCONSI 0.1-2000 U 2 7 7 2 P 106 EXHIBIT A Lot 4 of Certified Survey Map recorded in Volume 17, Page 4467, as Document Number 710988, being located in part of the NW 1/4 of th NW 1/4 of Section 5, T28N, RI 8W, Town of Kinnickinnic, St. Croix County, Wisconsin. a a+axaa r.m+ nss m b I 8 A-,Bb A-,B nn A-Ab Z-G&A 090%A p O o _ z - z 6 l w -~ytiP/ O_ c°5 O o : T x ~O W s 6 x W ry J v LL a z I °9i p m Q w o O< x g w 6 09SQ~9 Z m um .b-91 (fiX~ t J I r.9 I O IE a w 1~ r • I I ~ ry ~ ~ ww ~ tm~ f I Im + K X i Q I~ 92 O~ m x~ I ry z~ > w = ! a4iZ g r i - r 3 N m F m 1 C16' ~~9-Z HSA .9-.er b-.bZ R 0 -rte a~uau-ag 9µmn8 ~rU 8uay/atay ~ LTA O E"' L ~I 1d3GNV IHQ SHI/VOH NOZI2IOH N r . socuo ` /7+~5/f~' Q R cn cn sDA oxd NO IDV"LNOD , I lir------------- - - - - - - - - - - - - - - - - ml 1 ~ I I I I r :I r ~ I i I I I I -r I i i I I I 1 h I 1 n I I I I I I'~ ~ Y,~ 1 ~ I I I I' ~ I II I i t ~ ~ f;. I I I. I I l I 11 :I F I' t' I I i l sl I I_ I u,l I r _ - I I I I I I I I = I I, I i i I I I I i I: I I I I I I 1 L,rJ i-J 1 _ 1 •rt I I r-- I° I 1 ' ~ ft~• I I LT j I eo Y I I L~ .n I 1 I 1 1 - II L____________________________________ - ----fin J ~ ~ V N 4~ t w JI ~ r Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3 Division ot,yafety and Buildings in accordance with Comm 85, Wis. Adm. Code ' County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include,. but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.6Z--2-- percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 101t- Please print all information. Reviewed Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). lo , Property Owner A Property Location -7 /r,~ __re(Ir-kcy' Lamer-+Z r"" Govt. Lot IjW 114 kV1/4"`Sr',_5 _5 T Z!R- N R E (or)@ Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# ZZO La ve5foc.k Exch(af )Ge AU ~~j y v A' f 7 L/ 1 &"-7 City State Zip Code Phone tuber ❑ City ❑ Village [RTown Nea est Road S~ 31- 1 Ku- M N 556-15 ( ) el loci *V % New Construction Use: Residential / Number of bedrooms ` 4 Code derived design flow rate JD GPD ❑ Replacement Public or commercial - Describe: Parent material Flood Plain elevation if applicable ft. General comments f e f~ S T n~ and recommendations: C --I-a~ -e 1 e J. I Boring # ❑ Boring 7 Qr ® Pit Ground surface elev. q 4, ft. Depth to limiting factor L C3 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 O-i 3 SI ! 2 r cS I v . 5 11- 2$ I I Si J sb m C5 3 2$- I p y I F 5 ADD 5,--1 7 -nSbL U .6 ❑ Boring Boring # 8. pit Ground surface elev. 9 7 ft. Depth to limiting factor_ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/flz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 1 6-13 i -13 i v Z 13- 4 mfr c 5 ( Ca 3 4 -L4( 0 l `F ~ZF 1 4/ l0 SO ( SJ foi ~ ( o Effluent #1 = GODS > 30 < 220 mg/L and TSS >30 150 mg/L ' Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L CST Name (Please Pri nt Sig ture CST Number S33( Address Date Evaluation Conducted Telephone Number ~ 1l s~ - I S p L /o Z 71S--Z 7 -W a8 SBD-831n 11'07100) Property Owner L 2A-~'e Z. Parcel ID # Page of Boring Boring # Pit Ground surface elev. qS Q ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 o tb sit rn ~5 1v ,5 $ I -~Z J cs _ Z iz- !S cI r L4 3 vc-N FZ( y 5LI i _ ( (o Boring # E] Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ❑ ❑ Boring # Boring Ground surface elev. ft. Depth to limiting factor in. ❑ pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 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 608-264-8777. SBD-8330 (R.07/00) 4 'roPertY Owner LE 1l E C3 Parcel ID # Page of ❑ Boring # Boring 9S Q ft. Depth to limiting factor _Zj in. pit Ground surface elev. ~ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 'Eff#1 PD/ft'Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. r 1 Z' Z- i2-2" - -l C 5 c i 1. A -t ❑ Boring Soil Application Rate F-1 Boring # El Pit Ground surface elev. ft. Depth to limiting factor in. Roots •EGPD/ft:E Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ❑ Boring ❑ Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 'Eff#~ PD/ft~Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Effluent #1 = 130D5 > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = GODS < 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-6730 (R.07/00) PAGE_ OF NAME C 6 cr~-Z LOT# 7 ""LEGAL DESCRIPTION VW Y .yW to ,S G- T L8-,N R, /,E(or)V~ SCALE: 1"= BM 1 ELEVATION /00. d BM 1 DESCRIPTION 2j2 r1-f e BM 2 ELEVATION I~ / y BM 2 DESCRIPTION jp SYSTEM ELEVATION SYSTEM TYPE IK O O n CONTOUR ELEVATION qCo . S- I • " O o B'3 SIGNATURE - DAT Parcel 022-1011-60-125 07/22/2013 09:38 AM PAGE 1 OF 1 Alt. Parcel M 05.28.18.70E 022 - TOWN OF KINNICKINNIC 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 - DELANDER, WILLIAM L WILLIAM L DELANDER 988 CTY RD N ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 587 CTY RD SS SC 2422 SCH D ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 3.180 Plat: 4467-CSM 17-4467 022-2003 SEC 5 T28N R18W PT NW NW CSM 17-4467 LOT Block/Condo Bldg: LOT 04 4 (3.18 AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 05-28N-18W NW NW Notes: Parcel History: Date Doc # Vol/Page Type 03/28/2005 790598 2772/105 WD 03/18/2003 713595 2174/486 WD 02/24/2003 710988 17/4467 CSM 2013 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/10/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.180 50,000 0 50,000 NO Totals for 2013: General Property 3.180 50,000 0 50,000 Woodland 0.000 0 0 Totals for 2012: General Property 3.180 50,000 0 50,000 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 APPROVED sr.Feo r. c c,uurY 7 1. 0i 9 8 6 VOL 17 PAGE 4467 F B 2 4 2003 KATHLTM H. WALSH REGISTER OF DEEDS If nut recc?:uou w.,c,+• • su Cays of ST. CROIX Co., wi RECEIVED FOR RECORD approval date appro. sldiffRTI FI ED SURVEY MAP REC FEE: . 0:00AK null i 02/ FEE: 13.00 COPY FEE: 6.00 LOCATED IN PART OF THE NW1 /4 OF THE N W1 /4 PAGES: 2 OF SECTION 5, T28N, R18W, TOWN OF KINNICKINNIC, ST. CROIX COUNTY, WISCONSIN. Mmp- LL/~ u IUD GrJD~ SCALE IN FEET 1" = 200' OWHMLD) M,, W O WC [anpI !3~3 200 O 200 NORTH LINE PREPARED FOR: OF THE NW1/4 FREDERICK LENERTZ NW C 189'43'54"E 340.66' 220 LIVESTOCK SEC. . 5 5 32.84' 307.82' EXCHANGE BUILDING j ST. PAUL, MN z LOT 1 N 55075 o l N 1 °w SURVEYOR: N (D I l o l ~ v° 1 - I 1 bo C,; 1 fll THOMAS M. HEALY P N Q15 L______ N S do N LAND r I33' 33' ~ o PO ACCESS EASEMENT SURVEYING. INC. c2 W RECORDED IN 2920 ENLOE STREET 33.55' 307.86' O VOL. 2149. PG. 272, HUDSON, WI 54016 S00°1 2'15"E - a, S88°30'02"W 341.41 r- DOCUMENT NO. 710648 66.02' `r-. N88°30'02"E 448.20' I O 1 ice' 0 33.71' 14.49' i~i~ V)m C> y ~21~I- N ~z; ~ N 2 ° IIMI l N m G~ N N o ° ° r------___ I~ I fn O V1 a w LOT 2 W oo o A o~r1 O 34.23' 414.49' 1 I n~ m I 1 0 I ' NF8°30'02"E 448.72' 1~v I Q° O Z rn 31 Kv F5 1001y1 N (n 1 1 rn g w N N LOT 3 ° Z o o ° , o I I ° IV fV N I I rn C' -n N O C') I OI~_' N Q, p I A -4 O j lUl cn 33 33' --34 4 4' W I o in 0 V) I m m 1 414.49' o I ' N n 0 m CnI ~8°30'02"E 449.23' z m 1 ~ b0 z 2 -100,-" A N 1 LOT 4 L (0 ° Q o, , w wpo w Cr baI ~ ~ N7p 3 rOp"~v44 $ C I LEGEND 1 j 1mg N7 ` 44 p S2 , i FOUND ALUMINUM ST. I O 3 CROIX COUNTY SECTION i~ c~ 00 (1/4 CORNER MONUMENT 101 I m ~ ~op/tn` I I Z N~ o °uZ/ S SET 1" OUTSIDE I 3 3g 482g DIAMETER BY 18" I t o I= r 0 LONG IRON PIPE, 0 1 z l v o WEIGHING 1.13 LBS. I PER LINEAR FOOT gyp] m ~~•j C PROPOSED DRIVEWAY 1 ~1 co iLOCATION I FQ 66' WIDE JOINT I ~ 11 /4 CORD DRIVEWAY EASEMENT W sec. 5 I LOT AREA TABLE BUILDING • . SETBACK LINE Lot # Description SO. FT. ACRES LOT 1 INC RW 96,691 2.22 0N LOT 1 EXC RW 87,122 2.00 7 LOT 2 INC RW 94,263 2.16 LOT 2 EXC RW 87,123 2.00 Y LOT 3 INC RW 94,372 2.17 LOT 3 EXC RW 87,123 2.00 Z LOT 4 INC RW 138,449 3.18 UDSON, LOT 4 EXC RW 115.889 2.66 NNI Q~ THIS INSTRUMENT DRAFTED BY.- WILLIAM KANE I v~ v JOB NO. 5000-16 DATE: 09/06/2002 REVISED: 02/24/2003 SHEET 1 OF 2 SHEETS Vol. 17 Page 4467