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HomeMy WebLinkAbout014-1015-60-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 567227 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: Federal Home Loan Mortgage, foreclosure Forest, Town of 014-1015-60-000 CST BM Elev: Insp. M lev:~ BM Description: Section/Town/Range/Map No: 9 07.31.15.101 B TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. 5 , S• /D / 9 19 Septic r Z /QvU Benchmark 3 1621 57 .7 -.CA D ~ D J / DQ Alt. BM ~j 7 $ y3- Aerrti6rr ~ f ~.~L p Ir [o Bldg. Sewer `e r yr Holding St/Ht Inlet St/Ht Outlet ' TANK SETBACK INFORMATION \ TANK TO P/L WELL BLDG. Vent to r Intake ROAD Dt Inlet \ Septic I Dt Bottom 17-7 75 Dosing C 33 / Header/Man. 5.(""5 97, l z- Aeration Dist. Pipe 5.0 97 `7 Holding Bot. System r 7c'/ -'7 PUMP/SIPHON INFORMATION Final Grade 9 g Manufacturer /I I IULL Demand St Cover GPM r,- C/ • X 9Z - t G. ~ O ~J U Model Number y loel r TDH Li/ Z qd Friction Loss System Hea TDH IF ~T7 , r Forcemain Length / D/ Dist. to well SOIL ABSORPTION SYSTEM /46 Y A ay = /eb -7. BED/TRENCH Width ( Length No. Of Trenches PIT DI ENSIGNS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS „ SETBACK SYSTEM TO P/L BLDG 1 WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR t 6 UNIT Model Number: Type Of System: _7W Ge~~ '+tDv~c ~5 Z I 75 ~ DISTRIBUTION SYSTEM No(1(.~ -=z- To Header/Manifold Distribution x Hole Sizx Hole Spacing Vent to Air take Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/S ded xx Mul hed Bed/Trench Center / q Bed/Trench Edges Topsoil es No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: / / Location: 2631 CTY RDClear Lake, WI 54005 (NE 1/4 NW 1/4 7 T31 N R1 5W) metes & bounds Lot Parcel No: 07.31.15.101 B 1.) Alt BM Description JG O P 2.) Bldg sewer length = 3 v ~bf l " 5 1✓ a .0 S c,r r a - amount of cover 7 4 Z.r d~ QD D 1~~-~ c.~ + r / _ 'mil / G v~ -4b_ p r✓- -C` YUUca w Plan revision Required? Yes No Use other side for additional information. SBD-6710 (R.3/97) Date Insepct s Signatur Cert. No. s d ~ 444 3 e a CF 4 ~ G ti 9EH SERIES SUMP/EFFLUENT PUMP 11.65 8.95 4 O 0 Specifications MODEL OE USTING NP VOLTS SOUOS SIIf RUNNING PERFORMANCE (GPM @ HERO) NO. NO. SHUTOFF PSI PWR. CAD. WEIGHT DIMENSIONS NO. (Dula) AMPSIWATIS y 10' Is, 20' (FL) IFtI IusJ IxxtxW) 9EH-CIM 509330 U= 4110 115 3/4 13.0 1000 70 64 55 41 32 116 20' 24 711 z 11.64 x 8. 94 9E4101 509340 UUCSA 4110 230 3/4 6.5 1000 70 64 55 41 32 13.8 20' 24 9.11 z 11.64 x 6.94 9EI CIA-RFS 509350 UUCSA 4110 115 3/4 13.0 1000 70 64 55 41 32 13.8 20' 27 9.11 x 11.64 x 8.94 9EH-CIA-RFS 509360 Ut= 4/10 230 3/4 6.5 1000 70 54 55 41 32 13.8 20' 27 9.11 x 11.64 x 8.94 Continuous Duty Rated-'Little Giantwastewaterpumps are rated continuous duty as long as they are run within the published ratings forthese pumps.' FLOW- LITERS/HOUR Construction o 1000 2000 3000 Motor Housing Epoxy Coated Cast Iron Impeller Material Poly Carbonate 30 10 Irn eller Type Closed Vane Volute ABS Li 7.5 Q~ Power Cord SJTW-A 20W Mechanical Shaft Seal Nitrile with carbon and f CM 7: 5 ceramic faces O Fasteners Stainless Steel 10 w 2 s = Shaft Stainless Steel Bearings Upper Sleeve and Lower 0 0 Ball Bearings 0 20 40 60 8o FLOW- GALLONS/MINUTE PUMP PERFORMANCE CURVE 115V 60HZ ply 3 Little Chant Pump Co. o PO Box 12010. Oklahoma City, OK 73157 s Phone: 405.947.2511 ' Fax: 405.228.1550 www.LittleGiantPump.com . E-mail: customerservice@littlegiant.com Form 995235 - 07/03 County Safety and Buildings Division St. Croix 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) e $P Madison, WI 53707-7162 ermit State Transaction Number Application In accordance with SPS Ae - Adm Code, submission of this farm to the appropriate governmental unit is required prior to obtai permit. Note: Application forms for state-owned POWTS are submitted to Project the Department of Safety Professional Services. Personal information you provide Ag be used for secondary Address (if different than mailing address) ores in accordance with the Privacy Law, s. 15.0 1 m Stats. Q L Application Information - Please Print All Information o Parcel 0Y) - Property Owner's Name i-- © 000 annie Mae Peel.-cra'( IvG~~if OG• " lal S- 00- operty Owner's Mailing Address Property Location (101-6 14221 Dallas Park Way c°° cove. Lot City. Stat Zip Code Phone Number SW 1/,, SE 1/, section 7_ Dallas TX 75254 - - - (circle one) -7- Dallas IL Type of Building (check all that apply) Lot # T _31 _ N; R -15_ West XI or 2 Family Dwelling - Number of Bedrooms 3 This proposed system will serve one 3 bedroom residential Home. (5-'~ ST1 I~K,7 Block# 11 City of Na CSM Number ❑ Village of X Townof Forest III. Type of Permit: (Check o ' one s o line A. Complete line B if applicable) A. New System placement System Treatmetw'Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) X Number and ~ Date Issued B El . Permit Renewal El Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Before Expiration Owner NV ' w IV. Type of POW TS stem/Com onenW)evice: Check all that a 1 I X Non-Pressurized in-Ground ❑ Pressurized In-Ground ❑ At-Grade Mound > 24 in. of suitable soil Mound < 24 in. of suitable soil Holding Tank ❑ Other Dispersal Component (explain) 1 ❑ Pre nt a e_ lai) T V. Dispersal/Treatment Area Information: Design Flow (gpd)/ Design Soil Application Rate(gpdsfl Dispersal Area Required (sf)~ iT Are Proposed (S System El vation f 450 .7 V/ 643 Dy/ 96 VL Tank Info Capacity in Total # of Manufac Gallons Gallons Units g .0 2! m o U b - d. New Tanks Existing Tanks o a U u~ v~ c: C7 Q Sep ) tic Tank X 1000 1 Weiser x Lift Tank X 600 1 Wieser x VIL Responsibility Statement- i, the undersigned, assume responsibility for inst tion o the POWTS shown on the attached plans. Plu nber's Name (Print) Plumber's Si ture bfPiMPRS Number Business Phone Number Kent Hoke 224199 715-962-4155 G Plumber's Address (Street, City, State, Zip Code) 200 Bremner Ave Suite D Colfax W154 30 Court /De artment Use Only Permit Fee Date slued g e Signature Approved ❑ Disapproved $ W-' Q~ (Q 1 ❑ Owner Given Reason for Denial / IX. Conditions of Approval/Reasons for Disapproval 3 ~iG~L ~CCb4Z< e- SYSTEM OWNER:J l L 1. Septic tank, effluent filter and =yT - 7 22 S ~D dispersal cell must be serviced /maintained as per management plan provided by plumber. 2. All setback requirements must maintained as per applicable code/ordinance ces. In-ground soil absorption Index and Title Page Project Name: Fannie Mae - Replacement System Owners Name: Fannie Mae Owner's address: 14221 Dallas Parkway, Dallas TX,75254 Daytime Phone: Project Address: 2631 county Q, Pare s# WI C,leA,r L.a.Ke-, Legal description: SW SE 7 31 15 West Township and County: Forest ST.Croix County DSPS Site ID No.: Parcel ID No. Plan Transaction No.: Page 1 Index and Title Page 2 Data entry, Design Criteria and Sizing Designed Pursuant to Page 3 Plan View Cells Following manuals Page 4 Cross View Cells In-ground Absorption Page 5 Over view cells SBD-10705-P (N.01/01) Page 6 Tank Configuration/ dose info Page 7 A B Filter Specs Page 8 Chamber Sizing Page 9 a,b System maintenance specifications Page 10 Contingency Plan All materials must comply with Page 11 Plot Plan DSPS 384 and installed with the Page 12 Plot Plan Legend Manufactures specifications So. ~eOd' Attachments: Chambers, Lift pump esigner d instong pI er: Sid Hoke License # 224199 Signature Page 1-10 Data entry, Design Criteria and Sizing Residential strength waste water <30mi FOG <220MG/L <150MGfL TSS Anticipated effluent for In-ground treatment and dispersal after pretreatment unit will be 3 Bedroom Home Estimated flow = 300 300 x 1.5 = 450 (Floor drains will serve finished floor in mechanical room. Design Calculations In situ design loading rate Depth to estimated high water Depth to Bed Rock Cross slope at system Trench sizing ' 31c~e r l,~emr w-fir _ A I0 450 gPd /.7 gPd per sq ft = 43 sq ft minimum effective area for medium sands. rrY7 f Se .a . Install Quick 4 chambers 3' wide cells. 450/5= 130 linier feet g. cetI min._ Propose 2 cells Win len h. 130 linear feet Total proposed sq ft area 450 sq ft d Page 2-10 In-ground cell plan view vent Final and original grade 99' 12" Sch 40 pvc pipe Bottom of System 96' 65' Page 3-10 i r Cell Cross Section View Final and original grade 99' TT ent or watertight cap 4 4" Sch 40 PVC Bottom of System 96' 3' 3'min ' I Page 4-10 Over View cells 0 0 3' >3P 3' 65' i i O O 4" 30/34 PVC pipe Page 5-10 D z N 56" AS 84" D REQD m 42 3 Z z m c ~ D W n ;o - m \ 0 UP 41" ` n \ n J- I m 4" CAS D m 3" 48° I 5" 1 O 1 W- DA m x V) m v 36 0 m r m m 1 01 _ < < c m m 0 I N UP 38" J A 4" CAS c m L m z 41 N c 41 O m D 39" v o m cn D I mm D r 0 _10 D ~ r r Z Z v ~ Uci z0< z z D m m D -n0 7C m;, 0 D Z -1 raor=roco*zz Z OK OU)D D9z (7) n O9D > z -p~~ vZmDOODO nm xs ;o0z 0r-(1,) v DU ~nv ~nv 2p0~0==~Orcz() -J, vci~ °xv mc-)m = U) n ~z0 m>0 ~~~..~.r- mW MZ W r z O N ca m U) r ITI Z u Z F' o O I<rI m~ Cn C01 ; N N s s m O z0 m = D D r i O D DN Z N C O D z O,N m mI I O• p s0~ I U) m ~4N Op- TI v D o z 01 2~ D r~m O VJ U)mD I < o m O c l.J 0 (n N .v. z m s ~w mm D~- A vv n m z w v+ n 0 O Z z D y m D rrl m p W co o ~ D 0 r m z o W O C D rm 0> ~0 JO m -=-I 0 D w °m m n W \ R1 <O ~ = z --I m< o m z Z 0 0~ c -H m c Zz ;a O0 W ~ z~ -1 ;0l U) y ~ O 1 O ; V) O z OC m~ OA 0 O m r ;o m D a A o_ m m n ~ r c m H z 0 r- ;u O m A Z m m V \ m WLP1000/600-MR MIERER COIICAETE DRAWN BY: SME SCALE: 1 1'-0" JPRE-POUR: ~ml SEPTIC MANUAL W3716 US HWY 10 MAIDEN ROCK, WI 54750 DATE: JANUARY 2010 POST-POUR : \ ° REVISED JAN. 2010 800-325-8456 FILE:XP1000/600-MR Dose Tank Information Tank Manufacture Weiser Electrical as per NEC300&SPS316.300WAC Gallons 600 Locking cover with Warning Label and sealed water tight. Gallons per Inch 17 Tank is properly vented. Force main length 30' of _2 sch 40 pvc. Void volume (2"is.163 per foot) Friction loss is relative to amount of gallons per minute of pump / no orifices or min head. Maximum dose size is <19% of the of the DWF plus drain back. Dimension Inches Gallons A= 28.54" 506 Ground surface B= 2" 35.46 C= 4.46" 79 D= 6" 106.38 weep h Totals 41 727 Alarm Manufacture SJE-Rombus Alarm model Number 520-002A A Pump Manufacture -Zoeller i B Pump Model N152 C Pump must deliver_N/A gpm Pump Off At >30_ ft of TDH p 3" Bedding under tank Project Page 6b 211- ~:7c!5~4 r~*.. )Uer 'f LL~)IV3S1 Vh TE4-f.UM ZF' 95tt:1i. P. 2 - JU21u V2 i SAFETY AND BUILD*46a DM8tQN - Plumbing Product Renew Box 7162 Y - r W Madapq~. 4wkcensn 5J707 Visconimn Department of Commerce S&N Mccallwa, Governer Phillp W. Albert, Secretary March ze, 2002 ORENCO SYSTEMS INC BUSINESS DEVELOPMENT BILL CAGLE 814 AIRWAY AVE SUTHERLIN OR 97479 Re' Deseripliom SEWAGE TREATMENT APPARATUS Manufacturer ORENCO SYSTEMS INC Product Name: 8" BIOTUBE EFFLUENT FILTER Model Number(s): FT0822-146, FTP0822-148 Product rile No: 20020129 The specifications and/or plans for this plumbing Product have been reviewed and determined to be in compliance with chapters Comm 82 through 84, Wisconsin Administrative Code, and Chapters 145 and 160, Wisconsin Statutes. The Department hereby issues an approval based on the Wisconsin Statutes and the Wisconsin Administrative Code. This approval is valid until the and of March 2007. This approval is contlrxient upon compliance with the following stipulation(s)' • An access opening of sufficient size to allow removal of the filter must be provided over the outlet tee baffe of which this product is installed. This access opening must terminate at ar above grade. • Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter will be necessary. • When this product is installed in an Interior compartment, the discharge connection must be solvent cemented to a single four inch diameter schedule 40 PVC, plastic pipe (ASTM D-2665 or ASTM D-1785) which is solvent cemented to a four inch diameter schedule 40 PVC coupling encased in the interior wall. • The influent holes on the effluent filter shall be approplately configured by the manufacturer so that the influent holes are positioned between 65% and 75% of the tank's minimum liquid level- This shall be coordinated with the manufacturer or manufacturer's representatives by submittal of appropriate tank drawings and/or dimensions. • The discharge rate of the filter must agovr sufficient flow to prevent the tank's inlet from becoming submerged. • When this product is installed in an exterior compartment, the discharge connection must be solvent cemented to a single four inch diameter Schedule 40 (ASTM D-2665 or ASTM D-1785) or SDR 26 (ASTM "o34) PVC plastic pipe which extends through the outlet opening of the tank to a point at least three feet beyond the undisturbed ground surrounding the excavabori made for the tank. When the boss stop is required to be removed, afn:ten permission must be obtained from the tank manufacturer prior to installation of the product. The department is in no way endorsing this product or any advertising, and is not responsible for any situation which may result from its use. Sincerely Michael J. Beckwith, CIPE Plumbing Product Reviewer phone. 608-26"742 fax: 608-267-9566 e-mail- mbeckwith@oommerce.state.wi.us 580 105i6A-E (N 1 WB7) Flo tier, 02042901 FAH NO. 541 4S9 2884 DI ~ TkS.. yS ~ o .O°es'eA .'AYYP.ie2'~'d'.LS S• _aT ~d CC -A t ~k y 23 A 5 1! ~ Y i rAn;% e m PaFt-W Fmc Noce 7RT om p+9w► To Ft01~ Fnone i Pion. F" - b inn • Soil Absorption System Cross Section Final Grade 4' Schedule 40 PVC Vent Pipe t f .~----L= C / VVthVent Cap Leaching l'L 1 _ft Chamber System Elevation Soil Absorption SYStem Plan View ft Trench 1 Leaching ft Vent Or Observation Pipe Chambers R 4° Dia. Trench 2 Header Leaching Chamber Specifications Q*utC Manufacturer And Model EISA Rating Qd sq ft per chamber Soil Application Rate_ g ft ~ 32 tubers gp¢l Design Flow _ . Soil Appli n ate - ~ EISA = ~ 2 rows of 0V ambers each. t 5 *Pa""r O~ End cc.Ps ~v~-ptis e ,moo? _Ch~►~6e~S L4 encr( ems Page of r~ Y) POWTS OWNER'S MANUAL AND MANAGEMENT PLAN FILE INFORMATION Owner Fannie Mae SYSTEM SPECIFICATIONS Permit # Septic tank capacity 1000 N/A Design Parameters Septic tank manufacturer Wieser N/A Number of Bedrooms 3 Effluent Filter manufacturer Orenco Biotube N/A (100gpd/bedroom) Effluent Filter model FT0822-14BA N/A Pump Tank Capacity 600 Gal N/A Number of Commercial Units N/A Estimated flow (average) 300 Gal/day Pump Tank manufacturer Weiser N/A Design flow (DWF) estimated x 1.5 450 Gal/day Pump model Zoeller N152 N/A Soil Application Rate .7 Gal/day Pretreatment Unit X N/A Influent/Effluent Quality (NA E3 Monthly average Sand/ Gravel Filter N Peat Filter Fats, Oil and Grease (FOG) 30 mg/L Mechanical Aeration Wetland Biochemical Oxygen Demand (BODS) x220 mg/L X-1 Disinfection Other <_150 mg/L Manufacturer: Model: Total Suspended Solids (TSS) Pretreated Effluent Quality Monthly Average Soil Absorption Component Biochemical Oxygen Deman BODS) s30 mg/L 10rip-Line In-Ground (dosed) In-Ground (pressure) Total Suspended Solids (TSS) <_30 mg/L At-Grade Mound Fecal Coliform (Geometric mean) du/iooml Other Maximum Effluent Particle Size 1/8" diameter Dispersal Units - Manufacturer: EZ FLOW Aggregate cell(s) Model: 1203H Calculations: Soil Dispersal (EISA) or DWF _ Application Rate = Area Required _ (Aggregate Trench Width) _ #Units or Total Length of Aggregate Trench(s) 7 643 128.6 Linear ft req. F45o7l.l _ = - 130 linear ft Deisgned 2 - 65' trenches Design Criteria "Design of Pressure Distribution Networks for Septic Tank-Soil Absorption Systems" Publication 9.6 (SSWMP manual) "ICC Flowtech Mound Component Manual" Version 1.2 "EZ Flow Mound Component Manual" Version 8/20/2007 SBD -10854-P (R.1/12) "At-Grade Component Manual Using Pressure Distribution" Version 2.0 rX1 SBD -10705-P (N.01/01)"IN-Ground Soil Absorption Component Manual" Version 2.0 SBD - 10691-P(N.01/01) "Mound Component Manual" Version 2.0 SBD -10657-P (R.6/99) "Drip-Line Effluent Disposal Component Manual" SBD -10706-P N.01/01) "Pressure Distribution Component Manual" Version 2.0 Other- Maintenance Monitoring Schedule -Maintenance and Management Service Event Service Frequency Pump/Inspect tank(s), inspect dispersal cell(s), clean filter At least once eve 13 months X 3 years other Inspect pump and pump controls, alarm, pretreatment unit At least once eve 13 months X 3 years other Flush and pressure test laterals At least once eve 13 months X 3 years other I Start Up and Operation: For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a Septage service operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of the water-saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwashers, ect. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable/fruit peels and seeds, bones and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non-biodegradable items such as baby wipes, tampons, sanitary napkins and others of this kind shall not be introduced to the system for they may cause premature failure to the POWTS. INPSPECTIONS AND MAINTENANCE: Inspection shall be made by an individual carrying one of the following license or certifications: master plumber, master plumber restricted sewer, POWTS maintainer or Septage service operator (per attached maintenance schedule). Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and check for any backup or ponding of effluent to the ground surface and test all electrical equipment such as pumps and alarms. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with effective locking devices to prevent accidental or unauthorized entry to the tanks. When the combination of sludge and scum in the tank exceeds one-third or more of the tank volume, the entire contents of the tank shall be removed by a Septage service operator and disposed of in accordance with chapter NR113, Wisconsin administrative code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufactures specifications. Solids washed from the filter shall be retained in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back-up of sewage into the dwelling or surfacing. ABANDONMENT. When a POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. SPPS 383.33 Wisconsin administrative code. - All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed - The contents of all tanks and pits shall be removed and properly disposed of by a Septage service operator - After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or other inert solid material. Page 9 b CONTINGENCY PLAN: If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system. 0 A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area, render it unusable. Replacement systems must comply with the rules in effect at the time of replacement 0 A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. P-1 The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. 0 Mound and at-grade soil absorption systems may be reconstructed in place following removal of the bio-mat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at the time. WARNING: SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TRATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MY BE DIFFICULT OR IMPOSSIBLE. COMMENTS: Page 10 i 9 i 3 J ~gg V t 4 Or S 3 Q oo h & 3 t" v 1 Olt e t v c- o- 0 O O y M } id 'j \ Plot Plan Legend 1 4" PVC ASTM D 3034.42"Min. Cover where snow is not removed. 2 24" inside diameter manhole brought min.4" above surrounding grade. Concrete/ covers chained and locked down. 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 treatment/dispersal cell 12 Inspection wells Project Fannie Page The QuickC Standard Chamber INFILTRATOR• I x , r. The evolutionary patent-pending Quick4a Standard Chamber fits in a 36" wide trench and is ideal for curved or straight systems. It features the patent-pending Contour Swivel Connection'" which permits 10-degree turns, right or left. The Multiftrt" egad cap allows multiple piping options and eliminate pipe fittings. The chamber's four-foot length provides optimal installation flexibility, The Quick4 Standard The MultiPort End Cap Offers Chamber Offers You These These Unique Benefits: Unique Benefits: • Patent-pending tear-out seals on inlet • Advanced contouring connections ports provide a tight fit to the pipe swivel 10-degrees, right or left • Eight molded-in inlets/outlets allow • Latching mechanism allows for for maximum piping flexibility quick installation • Multiple ports eliminate pipe fittings • Compact nesting provides more and make looping ends easy trench length in an equivalent stack • Patent-pending MultiPort end cap height fits on either end of the Quick4 ' • Four-foot chambers are easy to Standard Chamber handle and install Infiltrator is the number-one septic • The Quick4 Standard Chamber leachtield chamber system in the supports wheel loads of 16,000 ibs/ onslte industry, with over 42 million axle with only 12" of cover units in-ground in all 50 states and A • Certified by the international 24 countries. Association of Plumbing and r*° Mechanical Officials (IAPMO) Approved in 'k.. .1.13k F; a The Quick4e Standard Chamber The Quick4 Standard Chamber B 12° mlill1ill1inill Z .37 (EFFECTIVE VE LENGTH) MuttiPort End Cap ,s• I Il 8, sa• MOW VIEW SIDE VIEW TOP VFW i Quick4 • • Chamber Specifications Size (W x L x H) :::.....34" x 53' x 12 (86 cm x 135 cm x 31 cm) Louver Height .....:....................8" (24 cm) Effective Length ...........48" (122 cm) Invert Height 8" (20 cm) INFILTRATOR SYSTEMS INC STANDARD LIMITED WARRANTY (a) The structural integrity of each clamber, end cap and cater accessory manufactured by Infiltrator ( -Units"), when Mealled and operated in - a IeadMiea of sin onsite septic system in accordance with Infirsa[or's instructions, a warranted to the ongow pureaaer (-Hokfer") against defeahe materials and workmanship for one year from the des cat aye septic permit is issued for the septic system containing the Units; pro Id. hnrivever that f a aepC p ' a fy]t reGui'0 by spplx:able Isw. the Warranty period will begs upon the data that insist ation of cute septc systanl commences. To exercee as warranty ngms. Hader muse rhoLfy Infimator n writing at its Corporate Heap luarars n Old Ssybrode, Connecticut within fifteen (15) days of she alleged detect Infimstor will sappy replacement Units for Unit determined by Infiltrator 4r to be LYIVefBd by this Limned Warranty. IMiNaldr'a liability Specifically exCludB4 die cost of removal and/or MIAllabon of the Units, (b)THE LIMITED WARRANTY AND REMEDIES IN SUBPARAGRAPH (a) ARE EXCLUSIVE. THERE ARE NO OTHER WARRANTIES WITH N F i LT R AT O R RESPECT TO THE UNITS. INCLUDING NO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS Fc''iR A PARTICULAR PURPOSE (c) This Lmted Warranty MAI be void f any pan of to Member system iS manufsenured by anyone other than Iffironata. The Limited Warranty does not extend to incident, ooysequem sf, special a adaect damages. Infiltrator shall not be liable for penalties a liquidated damages, ncNdmg 1033 of production and p=== erheed costs. a Otlher losses a 0xpenaas incurred by the Holder a any thm Party. SPSZ ~eny ewc•dled Iran e damage tic ear and teal alterat on, accident, 6 Business Park Road • P.O. Box 768 misuse, abuse o neglect of to Units; the Units being subjected to .mile traffic or cow conditions which are not permitted by ice intr all"On anstrucaorhs attune to msnain to minmum gotrw corers set form in the aaLVation instrucliats; the pacemem of improper mater" into the Old Saybrook, CT 06475 system conainirnU the tnia; fsilve d aye lkhits a the sepic system due to improper sang a improper sung, excessive water usage, "proper grease daposv, a "poorer opasnon: or o her a ant not caused by Infiltrator Th S Limited Warranty Brea be vote if she Holder fails to 860-577-7000 • FAX 860-577-7001 comply wial all Of to kVrt14 set foftn n theany Lin1Qgd Warnany, Ftrahef. in no event Shall IMiafau r W respaalb' la any bias a damage to the Holder, me Units, a any third parry resulting from insalation a shipment, or from any product liability cams of Holder a any third perry. For this Limited warranty in apply, the Units must be installed A accordance with all site oo ditiora required by state and local codes; all other 1 .,8~a~1-4436 applicable la s; and Infltrator§ ifnawler- anatrlrCtlOna. (d) No repesentatwe of Infiltraor has me awnaiy tic change m extend this Llmaed warranty. No warranty applies w any party othertan the www.inflitratorsystems.com original Hader. The above represents the standard Limited waramy ofared by InfiEaror A limited number of sates and counties have different warranty requrements. Any Purchaser of Units should contact Icltrata's Corporate Headquatters n Old Saybrook. Connecticut. par to such purchase, to obtain s Copy of the applicable warranty. and should carefully read that warrsnty prior to the purchase of Units. For technical assistance, installation instructions or customer service, call Infiltrator System at 1-800-221-4436. U.S. Patents: 4,759,661, 5,017,041; 5,156,488; 5,336,017; 5,401,116, 5,401,459; 5,511,903 5,716,163, 5,588,778, 5,839,844 Canadian Patents: 1,329,959; 2,004,564 Other patents pending. Infiltrator, Equalizer, Quick4 and Side Winder are registered trademarks of Infiltrator Systems Inc. Infiltrator is a registered trademark in France. Infiltrator Systems Inc. is a registered trademark in Mexico. ChamberSpacer, Contour, Contour Swivel Connection, Microt.eaching, MurtPort, PoIyTUff, PoslOck, OIHCkCLd, QujckPlay, SnapLock and StraightLock are trademarks of Infiltrator Systems Inc. Q 2006 Infiltrator Systems Inc. Printed in U.S.A. 0250808WA-1 Sep 06 13 07:09p Will Heidt Soil Testing 7158327525 a.2 Wisconsin Deparanent of Corrmrett e SOIL EVALUATION REPORT Page Division of Safety and Buildings in accordance with Gomm 85, Wis. Adm. Code j~ Courtly r Attach MrqkW We Alan on paper n~ less than 8112 x 11 inch ' in Sine. Plel1 must inchtde, but not tim ltxl to: vett artrt hati2otttaI retrence pctirtt (SM), duedron and Parcel ID_ percerd slope, scale or dimensions, north anew, and location and distance to nearest road- Revrarved by Date please print all irdcrMadon. Persoawwano0ic"yo„Pr~vidameyce~ttar$er=dwYPUf"3*3( tWw-yLaw,5.i5.os(1)tn+f)- Property Omer RropertyLocation {1 h G04 Lot 114 W S T N R E (or) W Subs. Marne or Pr `tkvrter')s Mailing (rAddressi 4t Lot# Btoctc# cSMlk I l.r`t s JOA /A n vats Town Nearest Road State Z4, Code F'h umber [i G+ty, ity Code derived design Raw rate S~ GPD Q New Construction Use• eafa11 Number of bedrooms ~ ~ Retmalaria) PW,&fwrd ~ ' F'ubtt or carnrr Ciat - Descri6ea ~71~- Plood plain elevation ifapplicable J2`~ rq ~ Paren I Iemi Comments yt~,, l/ y V " r aft 1Ti~411~. 'f'y j' „ V r t. iD~V Ger ar,d reconMer+d0160M. r e- ca Po Boring i Bating # p~ Pit Gramdsclrfaaele++. fl. Depth to tirriting factor in. Snit tton Rate L• t I Horizon Depth Cbrts'viartt Colo Red= pespipTart Texture structure Consistani a emMary Roots 'EfFfG1 "Eifi2 in Munsell Qu. sL Cont. Color Gar., sz. Sh. 6,7 sir J`t cc. n,,J4 a. aF~ t %a t d .50ftng # 0 Boring Grouund tattoos elev. ~ tt Depm to fClttttng factor _ in. ,,~ry Iicatian Rate Pit Redox Description TexOute Struckrre Gor>gisfjence Boundary Roots GP101 Hortzan Depth pantryant ~fliF'1 "EfNF2 in. Munsett Qu_ Sz. Cont. Color Gr. Sz. Sh, + 'M(~ 4, fZ' /Jr I'~i a7.3 D- Z . A&-z' CL Z IS'6 3 636 ,7 Y 15 0. f*~C -71 110; ~ . EMuent #1= BOD > 3D c 220 m L. and TSS X30 ~ 150 mg1L " E~luerAt 02 = Boo 130 ixgtL and TSS _<r 30 mg CST Nacre (PI Signs t~t~Ht~ic~t 5011 f ~ it C 17 i Dale Evalualion Conducted fetept,orte Nunbez of of, Address Wndoyf W1 54 -99 5 VIA a , I Z~ -gip R r a l 3 i` L y -10 0 ca } v Maw c' b'd 8Z5L~£881L 6u!ls9i POS 1P!8H 11!M d60:L0 £ l 90 des ► Sep 06 13O7:09p Will Heidt Soil Testing 7158327525 p-3 Property Owner Parcel ID # Page Z of -T-- Boring # Soong / pit Ground surface dev~oe I 6. Depth tv limiting factor / ©5 In. Sol on Rate Horizon Depth fbmir>ardCokxr Redox t3escriptbn Texture Structure Consistence Boundary Roots GPDAF in. Munsetl Liu. Sz= Cont Colof Gr. Sz. SK -Eff#i 'Ef1#2 1 d- - R3 1~ .,.,rLt 4c. .9 -L~ 1' 7.5 s etc -1 /65 A 12 rl 0~1 f ~ Boring # Boring F-1 Ppit Ground surface alev:- --..~--ft. Depth to lirniting factor in. Sol PIN tion Rate Horizon Depth Uornin-W Color Redox Description Texture StnxWm Consistence Boundary Roots GPi')R in. Mansell Qu. Sz. Cant, Color Gr. Sz- Sh. 'Eff01 •EfW2 L p Boring Boring Pit Ground surface elev. R. Depth irrrt ng actor in. Sol Appileation Rate Horizon Depth DamirrantOofa Redox Description ? Texture Structure Consistence BourlUry Roots GP.DAF rM Munsett C},.. Oz. Cent. Color; Cr. Sz, Sh. -ErrM1 -EfW2 Efluerf #1 = BODS ? 30:!S220 rVIL and TSS >30.,< 150 mgtL ' Effluent 02 = BOD,~S 30 rWL and TSS 130 myL The Department of Commerce is an equal opportunity service provider and employer. I f you need assistanct to access services or need material at an alternate format, pleasg contact the departntent at 609-266-3151 or TTY 608-264-8777. 5DD$l3Crr~t (RU7ADj ~ F - Page 14 EFFLUENT mE.. reRs PUMPS sN = w/ Float IRl M =Auto Float Attached (vertica N = Non-Auto (manuaq PUMP E = 230V Non-Auto (manual) ~araes Snzr "FLOW-MATE"98 !O- -t M' H MON", > Litt:P ZBN90 BN98 12 HP 11511 Automatic Cast Iron 12" Solids, 1-12' Mae. Tethered Float (16) 358.95 ZN98 N98 12 HP 11511 Manual Cast Iron 12" Solids, 1-12' Disc. 319.45 FEATURES: The "Flow-Mate" is constnxXed HEAD CAPACfTY CURVE BMB of durable cast iron, carbon so UWEL'W 112 HP cerffiRlc seals and a non- 2s dogging vortex impeller. 15' Cord m APPLICATIONS: rs The "Flow-Mate" is ideal for seWic tanks, dosing, low to Pressure Pipes, large mounds and step systems s 0 0 10 20 so 40 50 so 70 eo "DOSE-MATE" 151,152,153 Lut Price ZBN161 SN151 113 HP 115/1 Automatic Cast Iron 12" Solids, 1-12' Disc. Tethered Float (201 =08 ZN151 N151 V3 HP 11511 Manual Cast Iron Me Solids, 1-12" Disc. 281.16 ZBN152 BN152 4110 HP 115/1 Auk Cast Iron 314" Solids, t-12' Disc. Tethered Flat (201 355.06 ZN152 N152 4110 HP 115/1 Manual Cast Iron 314" Solids, 1-12" Disc. 314.16 ZBN153 BN163 1/2 HP 115/1 Automatic Cast Iron 3!4" Solids, 1-t2- Disc. Tethered Float (201 498.95 ZN153 N153 12 HP 115/1 Manuel Cast Iron 3/4" Solids, 1-12' Disc. 452.00 ZE153 E153 12 HP 23011 Manual Cast Imn 3/4" Solids. 1-12" Disc. 462.00 FEATURES: v PUMP PSOMIAKE cURVE The' Dose-Mate° is Cwwmcted of wa6~ tstns+tlss BN152 durable cast iron, carbon ceramic seats and a ran-dogging vortex imMiler. 20' Cons p ° m APPLICATIONS: The ")ose.Mete° is ideal for septic E tanks, doealg, low pressure pees, mounds and step systems ls' IN avm a a e w w w w o w aanetriwr a~w y /1.9 r ' Wisconsin Department of Commer SOIL EVALUATION REPORT Page / of Division of Safety and Buildi in accordance with Comm 85, Wis. Add nty Ou Attach complete site plan on pa i4\han 81/2 x 11 inches in size. Plan :st" Cou include, but not limited to 1 rizonta ference point (BM), direction and 1 D percent slope, scale or di ons, no h 8a~1nd location and distance to nearest r d. P/ea4p *niyalt informallon. _w Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~~2wvw--- , J- I bp Q Property Owner g' Property Location Govt. Lot !ul 1/4-66 1/4 S T3( NR JWW Property Owner i iling Ad Tess Lot # Block # Subd. N or Nql City State Zip Code PhoAe NUfter ❑ City ❑ Village Town Nearest Road ( ) Far 0-s 3 t C ❑ nstruction Use: Residential /Number of bedrooms 3 Code derived design flow rate S~ GPD commen Replacement jPulbbifiorcomrin Pre `Flood Plain elevation if applicable ft. General and commendations: r Q co roft Boring Boring # M 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/ff in. Mimsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 6--1 95* 3 010E S ~5 S 3'Ftc o.y a-7 z ~z Y(3 15 q~ -Ffc- o./I 75V V/1 ;Zfic 00 K 91f 5-/ 1s 6cc- r,4 - 49-r n-a 16 c o t go l Boring # Boring d Pit Ground surface elev. 7 ~ t. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Colo Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munseil Qu. Sz. Cont. Color Gr. Sz. Stu. *Eff#1 *Eff#2 z /5}~6 3/-z rvafs~ 51 ~f'~ a~ a-z o.~ 3 6M ,z y V Is U o. (-c 70 r s S o • ~6 leg 410-A 9,44f Effluent #1 = BOD > 30.5 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 - _ _ mglL and TS S:5 < 3Num~ CST Name (Pie V~IHeitit Soil Signal I~l~~l►~ ~ Address Date Evaluation Conducted Telephone Number Mondoyi, WI 54755 ~ , < 02 /T5 026 3< C ~ C~ Z z Property Owner Parcel ID # Page of Boring # Boring _ Ground surface elev d pit ft. Depth to limiting factor / /6 5 in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 7- Y 5 l a ~~~R y s 1CL 5 /6 F-1 Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 H Boring F-1 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/Fe 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 = BOD5 < 30 mg/L and TSS < 30 mg& 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. M-8330Tw (R07M) r o~ A O W NZ M a v O a o w - tin Q ro f7a , 10 r, ~_~r zz~ IV Wa,ov jkl-e Wit. a Eulx i7vn rtanftk ►YfiJ 7t3`St3t3~i1'i30 111 5`EP I IV TANK AMMANCE AOMWENT ANT. OWNRIFI i ON `RM OwnffMuyer Y-) Y-) I Proms Addrm 46 3 l i { liffi=iimt 4m • ROM P W ~ fWaaw conlouedot3,j. City/Sttstc 1 t'A~ 1 Pagel Fd0 if odor mba f" ~C) I - "C)CC) Um-" =99gyPTION y Locaim Lo, 4/-, , stx. , T 2.N R W. To" of SubdivWon Plat: , Lot 0 Certified Sttxtrey Map # Vohitma Warn" iw-- q 3 Oxfm 3v Pw# lWase Ya Lm &=Wmn f'W* , yes _'iM%M ii MNTWAJ C= AND QWM QM =G--JTON InVroper nse and maktammam of your septic spatmawW resait in its fat'fum w haadie Pmper ttmakammm agasim vF'punwing om the Septic to* rwary *MW yaars Os MW-. WAM&CL by s UVWAW6 1 YM Pm fnta the system m amw dialmatlon of ft se}* testk as s t irc d aystt= OWMWMOMMN responalbirWes an specified in lCorm 83.Mi) ad in C p* U -St. C mixC ► WY Ordicmnce. 'TtaZ pmplfty wm-r qm io 3'[i lm-1 tit St. Mu tmmTy Pho" & T.W"D*Nftm a tiPa"dPkt M Wit, m by tt o vm MW by l naadrrp . jOmweYnan ptamber, mfr ttra tt v~ityhtg tract i t f fist a snc wu*wAtet diwat'= a m is in prgw gmwi g coxtdttka. wrdit f2} ati a inspection and pu.j phrg tff nr tier •s ptk tank is i+ess than f :t3 fuifi ~3ttut~,e. Ywa,dw undmignod havereactdoeEtam aasd,sgrae#+ atMt aesragadispaaa!ty tlm ~ sac ss ,alst by #be of ~ ~ ~ of t+im~1 ~ e~ ~V: cardfladw SWANS tw1'W hrb"a mdmhmd .mmba, C=aWAw=km 8c Zoaiag Depa mvw v4d& 30 daPaftM flues year as11 ta0 date. Use carder 69 A stabxtmnts an this fam am ttta to the best of bwwMdaL 'Oma dw acne of the protx* described abom by virtne of e awattty dead moaxkd in Rczbw of Deede Qty ~it}thet• e€ts 10 {1 j 13 DATE A=6t M gets Prat ***Arty BiiFM=dOR ON-10 A 1 - may Twat fa the waft y pam* b*g tr3 by FWdd* & Zaft D"M& ~ raohWe wtdt doe apptioatiaa a remw*d warraity deed i`i+n tits RsgUbw a!• Desch: Offift snd a COW O MO oaili&d sutvay taa W rehmme k node lh the wwmty deed. t1i~1'•ii8Rt33 3E zcirr V-U-U UN 983939 FORECLOSURE BETH PABST 12 CV 909 REGISTER OF DEEDS Document Number 'rnLEOF.OCKXf1~1ENT ST. CR4DIXGO WI RECEIVED FOR RECORD WH REAS, pursuant to a judgment cif foreclosure and sale rendered in the 08/ 20],,3 08:01 AM Circuit Co urt of St, Croix, Wisconsin, in an action between, Federal National ~ / Mortgage. Associatio n, plaintiff and Pamela J. Rogers a ~ EXEMi~,#t* :14 iik/s Pamela J. Ramirez, REC PE..?.00 defendant(s), and after due advertiseinent, the mortgaged ES x -`T described was sold on ,Tone 11, 2013 to ect premises hereinafter the plaa ~ ,intiff, Ft dent[ National Mort gage Association, for thestirt; of 111,395-86. **Th8 above recording nfot•makion A14DW''HERY~AS, the said purchaser. plaintiff, federal National Mortgage bee~ n~tectco"jeaHy,f*&rd ds v Association, is now entitled to a conveyance accord :in~g to law. NOW & returned to.tlte,sut3mitter THEREXORE, the undersigned. conveys to Federal National Mortgage Association, the tract of land in St. Croix County, Wisconsin as described below. IPROPERTY ADDRESS: Rccrnd this docaiment with the Register ot',Ihitxis 2631 County Road: Q, Clear Lake, WI 54()()a \aa:ir-and Return Mdress I I GAL D:1=SC RIPTIOIV Blommer Petermatr S.C.°, 1.65 Bishops Wry; Suite 100 The West: 9 chains 13 links of the North 3 chains IS links of the Northeast Brookfield. NVI53001 Quarter of the Northwest Quarter (NE 1/1 of NW 1/4) of Section Seven (7), Township Thirty-One (31) North of Range Fifteen ('15) West, TOCTFTI-IER WITH a permanent and perpetual easement over and across part of the North .Half of the Northeast Quarter of the Northwest Quarter (N I/2 of IA of NW (1(4-l() ,~-f(~ijoh 1/41) of said Section '7-31-I5 for the purpose of maintaining l'~el tijc~uircaiiai ~3mher (PIN) a drain pipe and drain field as recorded in Volume 444, page 368, as Document No, 293180, Said land Ic=ing in the Town of Forest, St. Croix County., Wisconsin. Sherif ohn : Shilts Sher k of St: Croix, County Date: .Y.,` STATE OF WISCONSIN St. Croix COLNI TY I~ N 4 t fi Ott before nie carne Sheri:tf John A Shiltc known to be the individual and officer described in saK'. ocurrtt tt and who exeGttted the above conveyance and ac.knowled e for the uses and pttrpses therein set forth. 17 d that he executed the same for such sherii'f, 'r/, .s V Print Name.- - Notary Public,, State of Wisconsin ^ ~ ~ a•ta ° i ~ ~ ~ ~~rv fa~~ a•~~r~•.ii 3 My commission expires: d c ak 'i \ t S This instrument was drafted by Dustin a.~Tca yahoo ;;~K 165 Bishops Way, Suite 100 Brookfield, )VI 53005 I 1 of 1 Parcel 014-1015-60-000 10/08/2013 10:36 AM PAGE 1 OF 1 Alt. Parcel 07.31.15.1016 014 - TOWN OF FOREST Current 0 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 PAMELA J RAMIREZ 0 - RAMIREZ, PAMELA J 2631 CTY RD Q CLEAR LAKE WI 54005 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 2631 CTY RD Q SC 1127 SCH DIST OF CLEAR LAKE SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC SP 0038 CLEAR LAKE FIRE DIST Legal Description: Acres: 3.000 Plat: N/A-NOT AVAILABLE SEC 7 T31 N R15W 3A W 9 CHAIN 13 LINKS OF Block/Condo Bldg: N 3 CHAINS 18 LINKS OF NE NW Tract(s): (Sec-Twn-Rng 401/4 1601/4) 07-31N-15W Notes: Parcel History: Date Doc # Vol/Page Type 06/02/2003 724038 2260/142 QC 991/198 WD 797/577 422/541 2013 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/17/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 17,500 118,400 135,900 NO Totals for 2013: General Property 3.000 17,500 118,400 135,900 Woodland 0.000 0 0 Totals for 2012: General Property 3.000 17,500 118,400 135,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 108 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00