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018-1092-05-000
Z ;0 N Z o ~ ~ ~ a ~ m ~ m ~ ., tra N N ~ ~ ~ N 7 (Q ~ fD n d 7 O ~' A N cc; o W ~I O ,--, =w Z 0 O ~ c m a Z '0 m ~ y 3 o ~ ~n m ~ s O m ~m m O ~ '~ c ~ ~ N N C (D C (p d ~ O ~p fN ~ 3 ~ 0 c m N 7 O 0 a m O N m n [R D 7 fl. W ~ _. O, _. ~: o• v a" > > m v ~ N n Z O ~ N ~. (D a ,.., ~ N ~ m -o w v, m N.fl.~ ~ ~ O N N• Q ~< ~ N. O v a ~ m o ~ ~ o. m o o. ' ~ ~ N 7 O _ ~ O Fn O O ~ O ~ n to p c °.: ~ ~ m ~ ~ ~ ~ ~ ~ 3 3 r: o cn po w m '',~ 0 0- ', rn O O 7 N .N. C N d O. O it a ~ N O ~ ', ~ ~ ~ '' N N 00 ~ '~ V ~ ~ ~ ~~~p', N N N ~ ', v v o m d A w y 3 °' D D o ', a N O O (D Vi C d a m N O W ~ a ~ °o 3 N Z fD A ~ G T c 7 Q ~ d o A v .a ~ c m •• m ~ ~. ~ o o 3 iv m 3 •`° 0 ~ v N ~ ~ O O v ~ ~ O 7 O O y O ff 3• .. ~ m cn ~ m d m p Z ~ J A ~ ~ C~ ~ ~ < ~ a ~ z m ~ A ,A A fi a o~ N O O Oo A A to ~ ~ A r ~ y ... y Parcel #: 018-1092-05-000 01/18/2008 03:40 PM PAGE 1 OF 1 Alt. Parcel #: 01.29.17.737 018 -TOWN OF HAMMOND Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O -BEARD, JOHN W & DEBRA A TRUST JOHN W & DEBRA A TRUST BEARD 24413 S RIBBONWOOD DR SUN LAKES AZ 85248 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description '` 1191 207TH ST SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 1.451 Plat: 08-098-PINE LAKE SUB LOTS 2/6 018-02 SEC 1 T29N R17W PT PT NE 1/4 PT GOV LOT Block/Condo Bldg: LOT 05 3 & PT GOV LOT 4 PINE LAKE SUBDIVISION LOT 5 1.451 AC Tracts}: (Sec-Twn-Rng 40 1 /4 160 1 /4} 01-29N-17W NE Notes: Parcel History: Date Doc # Vol/Page Type 12/11 /2002 701761 2076/157 QC 07/08/2002 683557 1923/154 WD 03/19/2002 673841 8/98 PLAT 2008 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/30/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.451 45,400 0 45,400 NO Totals for 2008: General Property 1.451 45,400 0 45,400 Woodland 0.000 0 0 Totals for 2007: General Property 1.451 45,400 0 45,400 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 Code Adminis 715-386-4680 Land Information Planning 715-386-4674 ,fix Real 715, Towrz TRC Letter Dear Ms. Hawkins: On December 3, 2007, the County received the above Concept CSJbI. The formal submittal has not been made yet, however, here are some initial comments: Iu addition to the required submittal items: 5 1. Does the Town of Hammond have ordinance standards addressinglot frontage on a public road? The County can only require these public improvements if they are required by the Town. If you have any questions or concerns. please feel free to contact our ofiicc. Sincerely, r~f~~.,, Alex Blackburn Zoning Specialist ABhnl cc: Ed Forliti, 201 Packer Dr, Roberts, W 15402 Surveyor -Doug Zahler File LD0238 _._.._._:.,x~...,,,,,..x~;. ST.CROIX COUNTY GOVERNMENT CENTER 1 1 O 1 CARMICHAEL ROAD, HUDSON, W/ 54016 7153864686 FAX PZC~CO.SA/NT-CROIX. WI. US ~NW4V.CO.SAINT-CRCIX 19/l US Wisconsin~DepartmentofComn~erce PRIVATE SEWAGE SYSTEM Safety and Building Div~i~n' • INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Beard, John Hammond, Town of CST BM EI ~ ~ Insp. ~ Fnlev:~ BM Description: _~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic '~ ~,Zcsv Dosing ~d ~ ~~ l,~a~ ~~,r~ a l/ Aeration ~~/ Holding TANK SETBACK INFORMATION TANK TO P W~l..ll BLDG. Vent to Air Intake r ROAD S tic Z ~ ~ , ~ ~ s '- Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer ~~O ~ ~UG~ Demand GPM Model Number TDH Lift ~g .a3 Friction Loss ~ . rv Syste Head ~. ~ TDH Ft Zia. l03 Forcemain Leng t i Dia. y Dist. to Well ELEVATION DATA County: St. Cro[X Sanitary Permit No: 506306 0 State Plan ID No: Parcel Tax No: 018-1092-05-000 Section/Town/Range/Map No: 01.29.17.737 STATION BS HI FS ELEV. Benchmark ~ .,.... ~ • ~O` U Alt. ~ V~ O t ~'~ ~ Q ` ~0 B g. Sewer ~ C J ~ ~ ,. ~ (, ` p~ , Q 0 .1 SUHt Inlet ~ O ~ 3 SUHt utle /' ~ Dt Inlet -~ ~,~/ ~~ ,. ~~ Dt Bottom ~'~. }- ~. 3 / ~9. ~U Header an. Dist. Pipe) (. / ,~ N ~~~a7 y~ ~~ 3 Bat• System . 2~ y r 95 Final Grade St Cover ~" (~ ~ 2• S'-/.f 3.0 3.3 3.~ / ~ ~ ~~ SOIL ABSORPTION SYSTEM %'"~?~~ ` / l ~-i .e-,~ ~ f , s u~ BEDITRENCH DIMENSIONS Width Length 1~ No. Of Trenches ~ PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth / ~ / (/ 3 y~.Q~ SETBACK SYSTEM TO P/L B G WELL AKE T AM L ACHIN Manufacturer: INFORMATION OR CHA Type Of System: ,^,, u ~'lk~ ~ ~/ ~ I ~ , ~ T Model Number: DISTRIBUTION SYSTEM "~'1'~lVilnp.~ "~3 l~lt>..-I~o / Header/ /Ma nifclld~ Distributi on~~ ~ ~J ~ 2~ ~'~ x Hole Size ] 1~ x Hole Spacing / ~ Vent to Air Intake - Length Dia ~ Spacing Length ~ Dia j• Styli CnVFR „ a.o~~~~~o S.,afnmc n.,i.~ ir~at~ld fns Ot.[~rada fiV3tP_m5 Only COMMENTS: (Include code discrepencies, persons present, etc.) nspection #1: / In pection #2: /,~/~~ ~~ Location: 1191 207th Street Baldwin, WI 54002 (SW 1/4 NE 1/4 1 T29N R17W) Pine Lake Lot 5 ~ C~ ar o: .2.17.73,7 1.) Alt BM Description = ~",~L ~~~~~p¢~*~~''~ ~~" 5-j.~~-Li 2.) Bldg sewer length = 22 f JC~~! (~(~ ~Uli(,p~2 //.7 ~f // ~/1~,~(~(~/~'~-- J f ~~/ ~"~~~ -amount of cover = (17 ' S~ ~d ~Q j 0 -~ -~4)M ~~~;~~~1'~~~" C.~,~/~2~ G~L1~L~ Pla uire~ ~ Yes No [ ~_ l D p - - ~ ~; ~ ~ ' I_ ~ ___ '~ -- _ ~'~-~%~'- _ _ ~~ _ -1 ~ -- - -1 se other side for additional information. ~~`~" Date Insepctor's Signature rt. No. SBD-6710 (R.3/97) Depth Over Depth Over Depth o xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ~ Yes ~ No ~ Yes ~ No cpmmerce,yyi,gpy Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 St. Croix i se o n s i n Madison, WI 53707-7162 Sanitary Permit Number (to be filled in try Co.) .epartmertt of Camnert:e 50{0 Sanitary Permit Application State Transaction Number `' ' O ~ ~ Q In accordance with s. Comm. 83.21(2), Wis. Adm Code, submission of this form to the a go unit is required prior to obtaining a sanitary permit. Note: Application forms for state-o PO p~~ Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used fo W ~ ~ in accordance with the Priv Law s. 15. 1 m Stats. ' ' ~ ~~ ~ O I. A lication Informs -Please Print All Information Property Owner's Name I pal g l $ - /OSL- ~ - o Bohn & Debra Beard 7 O Properyy Owner's Mailing Address Property Location ,191 407th street (, 737 Govt. Lot City, State Zip o t-m r ' SW %., NE %., Section 10'lir~ Hammond, WI 54015 ~` o"e1 i OUN7Y T N R II. Type of Building (check all that apply) ~~ Lo # ^E ~/ W ; 17 29 ~ ®1 or 2 Family Dwellin - Number of Bedrootrtc ~ ~u ) Subdivision Name ~ g ~ ~ Block # P(nl ~ L /gd ~ ~ ~ Public/Commercial -Describe Use 1 City of ^ State Owned -Describe Use ~ ~ CSM Number ^ Village of ~ ^/ Town of Hammond III. T ype of Permit: (Check only one boa on line A. Complete line B if applicable) A. / New System Replacement Treatment/Holding Tank Replacement Only Other Modification to Existing System (explain) ~"""'-'"" System B. Pennit Permit Revision Change of Permit Transfer to List Previous Permit Number and Date Issued ~ Renewal Before Plumber New Owner E itation IV. T of POWTS S stem/Com nent/Device: Check all that a 1 Non-Pressurized In-('mound Pressurized 1n-Ground At-Cnade / Mound >_ 24 in. of suitable soil Mound < 24 in. of suitable soil ^ Holding Tank ^ Other Dispersal Component (explain) ~Pretreatmem Device (explain) -~ ~~ ~ fy ~ M i~'~F V. Dis rsaV1'restmeet Area Information: Design Fiow (gpd) Design Soli Application Rate(gpdsf) Dispersal Area Requited Dispersal Area Pro sf) System Elevation VI. Taak Info Capacity in Total # of Manufach-rer Material Gallons Gallons Units New Tacks Existing Tanks ~ Z d 'J-~ t /200 a T /C.CJ ~ Septic or Holding Tank ~. f 2FJQ ~ 1 WI@SBr Pre6tb Concrete DosmB Chamber 1016 ffQ~} MO btu 1 Wieser Prefab Concrete VII. Res nsibili Statement- T+ the undersigned, sesame rtxponsibi ' for ins llatioa of the POWTS shown on the attached plans. Plumber's Name (PrinH Plumber's Signatur MP/MPRS Number Business Phone Number Roger Nelson MP 226497 715-273-4~d4 Plumber's Address (Street, City, State, Zip Code) 142 East Summit Avenue Eilsworfh, WI 54011 Coun / De aliment Use On Approved Di pro Perrrtit Fee Date Lssued lssuin ent Signs Own even for Denial $ M ~ (~ l/V g Zd O D 1X. ConditQWN~;easons for Disapproval ~\ /' /t `~ ~ . ~t~ ~. ~S ~ 1. Septic tank, effluent filter and ) (..~w~3,c~ ~ ' dispersal ceA must all be services /maintained ~:i.t.CG~- w~ +l'~. i ~ dl'~+~+~+~~ as per management plan provided by plumber. / 2. Aq se4beck requirements must be maintained '~ ~ C P 9- ~ .p>>~a.t~de~~. a trK a i-et~ , ~, r ~. Attach to complete plans for the system and submit to the County ody en paper not less tha~ In a 11 inches in siu ~O SBD-6398 (R. 01/07) Valid thin 01/09 >Z John & Debra Beard 1191 Z®~ Street Hammonds WI .~WY,NEy, S1,TZ9N,R1T~ Harmmond Township St Croix County Scale 1 " = 4U' Weiser %2~%~ T„ ,{r BM #1= e~ 1(lO.QQ' nail in 8" elm trce ~ ,~ of Z"force main i n,0 ~ -~ is ~ ~ ;~ ~~ ~~ ~ ~ ~' ~~ ~~ ~ ~ 1 n 1 1 ~~~ _ ~ _ <~ r ~n k /2~p/~~ 0 i ~,yJ ~. ~_ n , ` 1 ii _Y v u~ 1 ~~r~ ta,~, S G y" ~ ~°uc 1 ..r ~ ~ -H r ~ ~ 00 ~ ~ D ~n S~1 ~` ~ U' ` (,(,~ ~!~ " t ~ ~_ J _ .~~ S ~~ ..~ ~~`, 4 ~l b) c a A -C ioti1EL 6~ -~ ~ N Q- I' ,r v~ L page 8 of 8 I~' ~a~,~sitr~' ,~ ~ ~ 'John & Debra Beard 1191 Z47"" Street Hammont~ WI .~ .~W Ys,1VE iG, S I, T Z9 N, R 17 W Hand Township S~ Croix County Scale 1 " = 44' Weiser %2a% T„,{r BM #1= e~ 100.44' nail ~E tepe iie 8» elm bee ~ ,~ of Z"force main ~ SispG , ~, ti t: i• i °~ w- ~ o ~'"'S~rrr/' commerce.wi.gov iscansin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. co m m e rce. wi. g ov/s b/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary August 17, 2007 CUST ID No. 226497 ROGER D NELSON NELSON PLUMBING 122 E SUMMIT AVE ELLSWORTH WI 54011 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/17/2009 SITE: John & Debra Beard 117TH Avenue Town of Hammond St Croix County SW1/4, NE1/4, S1, T29N, R17W Lot: 5, Subdivision: Lot # 1, CSM Vol 8, Pg 2235 Identification Numbars Transaction ID No. 1402701 Site ID No. 726111 Please refer to both identification numbers, above, in all corres ondence with the a enc . FOR: Description: Mound /Four Bedroom (Two Structures) /Sloping Site Object Type: POWTS Component Manual Regulated Object ID No.: 1134612 Maintenance required; 600 GPD Flow rate; 38 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/O1), Pressure Distribution Component Manual -Version 2.0, SBD-10706-P (N.O1/O1); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, Cohn stats. !i°= The following conditions shall be met during construction or installation and prior to occupancy or use: QEH~Ri.A'FN Reminders i' ~~ • This system is to be constructed and located in accordance with the enclosed approved plans and with the SEE CGIif~ component manuals listed above. • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the POWTS installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat ROGER D NELSON Page 2 8/17/2007 • Comm 83.22(7) A co~y of the approved plans specifications and this letter shall be on-site during construction and open to insvection by authorized reyresentatives of the Deparhnent, which may include local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). ' • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. ' Inquiries concerning "this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday Charles. bratz@wiscons in. gov Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 763'3 cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544 ,Friday, 7:00 A.M. To 3:30 P.M. '~b r;~~,Y ~ ~ 2~~r MOUND AND PRESSURE DIST~tIBUTION,C4Al~PQ~NT DESIGN / .,, '.Y{ Residential AppliC2tion ' -' ~ - ~-~ • ~ • ~~ ~~ INDEX AND TITLE PAGE Project Name: Beard 4 bedroom Mound Owner's Name: John & Debra Beard Owner's Address: 1191 207th Street Hammond, WI 54015 Job address: Legal Description: SW 1/4, NE 1/4, S 1, T 29 N, R 17 W Township: Hammond County: St. Croix Subdivision Name: Lot 1 CSM vol.8 page 2235 Lot Number: 5 Block Number: Parcel I.D. Number: 018-1092-05-000 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications v,- `~`~ v Page 6 Management and contingency plan - ~ Page 7 Pump curve and specifications ~ Page 8 Plot Plan `~oM~ERCe ~~~1LDING,,,,SSSS .~lVl7E/~N C Designer: Roger Nelson License Number: Date: 05/23/07 Phone Number: Signature: MP 226497 715-273-4444 Designed Pun3uant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 4.0 (R. 04103) Page 1 of 8 Mound and Pressure Distribution Component Design Design Worksheet Site Inform ation (r or c) r Residential or Commercial Design 400.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 600.00 Design Flow (gpd) 6.00 Site Slope (%) 93.50 Contour Line Elevation (ft) 38.00 Depth to Limiting Factor (in) 0.50 In-situ Soil Application Rate (gpd/ftz) Distribution Celf Information 60.00 Dispersal Cell Length Along Contour (ft) 1.00 Dispersa{ Cell Design Loading Rate (gpd/fly) 1 Influent Wastewater Quality (1 or 2) Pressure Disribution Information (c ore) a Center or End Manifold 3.33 Lateral Spacing (ft) 3 Number of Laterals 0.125 Orifice Diameter (in) (e.g. 0.25) 2.75 Estimated Orifice Spacing (ft) = 2.00 Forcemain Diameter (in) 13 ~ '' 180.00 Forcemain Length (ft) 78.00 Pump Tank Elevation (ft) ~It:~u~ 6.50 System Head (ft) x 1.3 1 $ - ° 3 15.67 Vertical Lift (ft) 2, I 2.91 Friction Loss (ft) 25.07 Zto, to Total Dynamic Head (ft) Lateral Diameter Selection in. dia. o tions choice 0.75 1.00 1.25 x x 1.50 x 2.00 x 3.00 x Treatment Tank Information 1200.00 Se tic Tank Capacity (gal) Weiser 800-325-8456 Manufacturer Dose Tank information 800.00 Dose Tank Capacity (gal) 22.24 Dose Tank Volume (gal/in) Weiser Manufacturer Note: Sand fill (D) calculations assume a Table 83-44-3 in-situ soil treatment for fecal coliform of <= 38 inches. 10.00 Cell Width (ft) Are the laterals the highest int in the distribution Y network? Enter Y or N If N above, enter the elevation ft of the highest point. 9.09 frz/orifice Does the forcemain drain back? Y Enter Y or N 29.36 Forcemain Drainback (gal) 56.00 5x Void Volume (gal) 85.36 Minimum Dose Volume (gal) 27.19 System Demand (gpm) Manifold Diameter Selection in. dia. o tions Choi e 1.25 x x 1.50 x 2.00 3.00 Gallons/Inch Calculator (optional) Total Tank Capacity (gal) Total Working Liquid Depth (in) gal/in (enter result in cell 849) Effluent Filter Information Zabel 1-800-221-5742 Filter Manufacturer A100 Filter Model Number Project: Beard 4 bedroom Mound Page 2 of 8 Mound Plan View i- 1_ 1110 B • ' 'Observation Pipe ' ~ ' :~~- K ~e ~: - - -f J ~l TA I L ---~ Mound Component Dimensions Down slo toe extension made. A 10.00 ft E 1320 in H 1.00 ft K 7.71 ft B 60.00 ft F 9.25 in z 10.00 ft L 75.43 ft D 6.00 in G 0.50 ft J 4.50 ft W 24.50 ft 600.00 (ft2) Dispersal Cell Area 1200.00 (ft2) Basal Area Available 10.00 (gpd/ft) Linear Loading Rate 6.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 95.77 (ft) If/ffJ 94.00 (ft) --- ~ Dispersal CeN ;(~ Elevation ~ .\ k. ,fit $w s { ,% {4 a $IA 1 a J ~. '$ ~ $ J ~ i $,Yy` ~`- I~ ~I Dispersal ceu ~ 94.50 (ft) Lateral Invert -D ~ t _ _ _ __ _ ., J~,_.:. ~•• • • ..' ~'~~'J J J J'~•3 J•l•mt•J~'J~S J J *S J~ 6.0 % Site Slope Shading Key Topsoil Cap © },~~{ Subsoil Cap ASTM C33 Sand g Tilled Layer ^5 'e ~::~ Aggregate ~ a -~ Dispersal Cell c ~ 1.5 ft W O 5 ~ 0.5 ft Typical Lateral ~ c ~ ~, ~--- q 93.50 (ft) Contour Elevation C Geotextile Fabric Cover See lateral details on Page 4 for number, size, and spacing of laterals. F Laterals are equally spaced from the distribution cell's centerline in the ~ distribution cell (Ax6). Project: Beard 4 bedroom Mound Page 3 of 8 End Connection Lateral Layout Diagram Center the laterals over the A 6 B dimension • m Turn-up wPball valy® or ml®anoutplu0 P ,l All laterals are identical lE X -~ I Holes drilled on the bottom of the lateral s equally spaded Laterals & Force main of PYC Sah 40 8 (per COMIM Table 81.30-5) Force main connection via tee or cross to maniFOld at any point. Number of Laterals Lateral Diameter Lateral Length (P) Lateral Spacing (S) Lateral Flow Rate System Flow Rate Total Dynamic Head 3 Orifice Diameter 1.25 in Orifice Spacing (X) 8.59 ft Orifices per Lateral 3.33 fti Orifice Density 9.08 gpm Manifold Length 7.19 gpmv Manifold Diameter .5.07 ft Forcemain Velocity Dose Tank Information Electrical as per NEC 300 and -- Comm 16.28 WAC tank component is properly vented Weiser 800-325-8456 Ca aci 800.00 Volume 22.24 Manufacturer Gallons gaUinch Dimension Inches Gallons A 20.13 447.76 B 2.00 44.48 C 3.84 85.36 D 10.00 222.40 Total 35.97 800.00 3" Disconnect tan Alarm Manuafacturer S. J. Electra S stems i~ Alarm Model Number 101 HW Pump Manufacturer (Goulds Pump Model Number PE 51 Pump Must Deliver 27.19 gpm at 25.07 ft TDH A B C D Locking cover with warning label and locking device and sealed watertight 4 in. min. t~ Alternate outlet location Forcemain diameter ~ 2 in. Weep hole or anta siphon device P~ ump off elevation (tt) 78.83 Dose tank elevation (ft) 78.00 Project: Beard 4 bedroom Mound Page 4 of 8 ' ~ Mound System Maintenance and Operation Specifications Service Provider's Name Installed by Nelson Plumbing Phone 715-273-4444 POWTS Regulator's Name St. Croix County Zoning Phone 715-386-4680 System Flow and load Parameters Design Flow -Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 400 gpd Maximum BODS 220 mg/L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Freauency Septic and Pump Tank EfFluent Filter Pump and Controls Alarm Pressure System Mound Other Ins ect and/or service once eve 3 ears Should ins ct and clean at least once eve 3 ears Test ante eve 3 ears Should test month) Laterals should be flushed and ressure tested eve 1.5 ears Ins ct for ondin and see a e once eve 3 ears Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. lateral Turn-up Detail Finished •~~~~~~~~~~~~• •~~~~~~~~~~~~~• 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: Beard 4 bedroom Mound Page 5 of 8 Mound System Management Plan Pursuant to Comm 83.54, ws. Adm. Code This system shah txs operated in akx;ordanoe with Comm 82-84 Wis. Adm. Code, and shalt maintained in accordance with its' component manuals [SBD-10691-P (N.01/01) and SSWMP Publication 9.6 (01/81)) and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent atxadental 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, Stets. The contents of the septic tank shall be disposed of in aa:ordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet fitter shall be assessed at least once every 3 years by inspection. The outlet fitter shall be leaned as necessary to ensure proper operation. The fitter k~rtridge 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. H the fitter is equipped with an alarm, the fitter shall be serviced if the alarm is akth-ated 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 khey 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 verity proper operation. If an effluent filter is installed wtthfn the tank tt shall be inspected and serviced as necessary. Mound and Pressure Distribution Svstem 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 muldied 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 exk~ed 220 mg/L BODb, 150 mglL TSS, and 30 mglL FOG for septic tank effluent or 30 mg/L BODS, 30 mg/L TSS, 10 mgll. FOG, and 10° cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum des~n 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 tt should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if or~ce cleaning is required to maintain equal distribution within the dispersal coil. Observation pipes within the dispersal cell shall be t~redced for effluent ponding. Ponding levels shalt be reported to the owner, and arry levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continaencv Pian tf the septic tank or any of its k~mponents bec»me 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 wilt be repaired or replaced in its' present location by increasing basal area 'rf toe leakage ocarrs or by removing biologically cogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Beard 4 bedroom Mound Page 6 of 8 LGOULDS PUMPS °o ~a mars Spfxladly ~ fOf 111e fdlovMirlg ue~ . ~~ Pttss~ure Pipe~Syt~Oems Basement Orsinin9 • Ht~e+"'ats ~. Mamas ~t:r ~ ao 35 2 S/f/o 7 ~v~ zu Q ~~ 70 ~~ ~_~,: • pischarge:l ~~~ NPT • Tenlperaallre:104°F (1Q~'C} nl8othltlrtl, mrlt~uous vuileri ~y~• • Solids hantNing:'h" rtlaadmum sphere. • AutorrleRic models include a float swktfl. • Manual rrwdals aval~lk. • Pumping range: s~ petforrnarloe d:aR or curve. ~I+AaKk~ tapatigr. 50 GPM • Maxinglra head: 25' TDM PE41 Pomp: • Maldrrxttn capati'-Y 6Q GPM • Mal~tnum heae~ 29' TDfI PESt Pl~alp: • Mar<imum mpsdty: 70 GPM • #Aaxinarrn head: 3r 1DFt 5ubme~ible Effluent Pump PE ~~: • ~+~ ~* ~ i~ • 115 eons • Blik~irl the~nal orerbad pro- ttxdon wihaubateticreset • Bess B ladon. . OiEfidled , • High strrngttl Arbon stecf shaft Pf31 Motot: • .33 HP, 3~0 RPM tE41 Motor:'' • .40 HP, 340 RPM • 7.5 #AaxittNxrl at!lps i ~ f~stYCU PESt Mayor:'; • .SO MP, 3Ab0 RPM • 9.S Mmdtrlltm amps • PSC design . fem... . ~:~' . ..t.. , ~-,-.:..~..,.. ::_ -: Moods: tes,. te.,. pe.+~ , , p.. .. .i ...a. , .. .r~ '~ b y... ...l... . .-. - t ~. .... w._ . .. ~.. -;..yam {.. .. ~..~.. .. y..i. ~ ~ !«.'..1_ _ ..... ..t.«-.4..... ... ..., ~ J ...}.... i .. .. ..} - . l .7.. ~ i {.l .~. _ ; ' 711 ~, C ;.. .. y ;. .. ~... ; ~, .t...t... y ~... 12.1w... ..~... _.}...~.. 3 t .I.* ~.. F .. .~. t 1 a ~ a ~ . y.. - .. ... - ~ ~ 1j.. ... ..t. ...'... _ t a ~ 2002 GouldsPV+»ps Ethetlve NoYere~ber, Zt10z ~Pe31K? Za ~ 30 4o sa so ~ ~ is c+PM so z 7. / f to C/°h'1 cRPraclTv ~. ^ last oral body. ^ Tt~enrwpfasticanpeNe- and cover. • Upper sleeve and IoMrer heavy duty t~l beating torfstructi5n. ^ Mo2or is perrtlarlertdy lubricaited far exbertded ServiO! lift. ^ teow~er+ed for aortlrllxwz ~~• • A~ ratings errs wRtrir- the rvorlorlg limits of the motor. ^ Quick disoalrlect power cad, 20' standard knglh, heavy duty tfi13 S1TW wRtt NEMA 5-1 SP, thtse prong, t 15 volt grounding phlg. • tompkae unk is heavy dtty, portable and compact. • Medlalrical seal is carbon, terarnic. 8UIW4 and stainless steel, ~ Stainless sled fasttrlers. ~~• c us Te+stad flD UL 77>i and CSA 222108 SYndMdt ~~ 6ouldt f~pr k KO 900t M~ollwd ~Q~G 700 Goulds PtMnps ITT Industries v, . - Wisoanatn Department of Commerce Division of Safety and 8uitdirtas SOIL EVALUATION REPORT Page ~_ of en accoroance vntn c:omm na, +n~s, vam. ~oae County S h 11 i l 8 2 i Plan must e t ess t an x Attach complete site plan on paper not 11 z . s inducts, but not limited to: vertical and horizontal refers in ), ~ ion and parcel l.D. percent slope, scale or dimensions, north arrow, a. Hies arest road. Please rln! •11 t t/o». ~ ~ ~ - ~ ' Re d Date ~ 6 ~ ry purpo~ aseC for ParsonN IaformeNon you pnwids Huy . R. 1 S a~ 'i i+~ti• 1 0 ~ p~hy pv~ Property ' cation .$' '~ ~D~t~ ., ~ G x~, ~ } 'C~~~;~,s ,~ ~ vt'~ '' 3 $W t141Y~ 1!4 S ~ T~ ~ N' R ~ -' ~lt'(or} NY Property ~taigrg Adrtraaa mil' r2 Lot ~~.. odr # Subd. Name or CSM# Ord, A 9 ~'! ~,- ~ `" ~ ~.of ! CSwr Vos. ,~ .3 State p e ~ 'C ^ Viitage Town Neartlsit ~ , (~} New Construction Uae: I$ Residerrtial 1 Number of bedrooms ~__ Code derived desi$r. Claw rate GPD ^ Replacement ^ Public or commercial - Describe: Parent material Lrl 1'~+ G /1~# t ~ 1 Z-L Flood Plain elevation if appflcable !! recom~mandratlona: $ U f 7"~ ca l E 1=d ~ hZ T- ~i aE'/a~oF' SYn~G~~6 Ge~2~!/~i il~h-~''~' ~ ~`'j°~ ~~ # ~ p~~ Ground surface elev. ~- ~ ft. Depth to Umitlnp factor 3 ~ ~. '-"" Soil caton Pate rizon H De th Dominant Cd Redox Description Texture Structure Consistence Houndary Roots P o p in. Mu n aep Qu. Sz. Cont Coin Gr. Sz Sh. 'Eff# 1 'Eff112 ~ p h [~ y~ r 3 x 3 ~ '''/ - - s -~ , . , 7 ~ ~~ lP0 ~i ~~ ~ ~ G ~°`~ ~ ~ Pit Ground aurtace etev. ,~ ~ • f tt. Depm to ilmoung Tacwr yLv in. th Dominant C Redox Dssaipfion Texture Structure Consistence Boundary Roata D ~ licatlon Rate GPD1f! Florizon ep in. Munse~ Qu. Sz. Cont. Color Gr. Sz. Sh, 'E~'l ~~ a ~,,~ -~i ~, ~ L. ms a s,~ w ~ • Efliusnt #1 =130D > 30 =228 mglL and TSS >38 S 158 mglL ' EfAuartt #2 = BQD = 3a myL and TSS <_ 30 n+glL CST Name (Please P Signature CST !Number y.Lq-rv ,~0 h~ IYSd n~ ~ ~~ Date Evaluation Conducted Telepixyne Number r~, -s , ~ ~.; .~ a ~ .d tt c-r ~c-.L ~„ii . S' 1-~7aQ' ~ ~'' ~'1 d - 0~ '7 /~ ~-5'q -cs~ 5 `7 ,v r -r v s .- ~ - -_ -v .. ~. .., Property Qwner s~~~-V ~~p 1"~ N ~ C d' Parcel ID # Pegs ~` of Boris # ~ p~~ Ground surface elev. ~ ~ ~ tt. Depth to Uniting factor _,.~_ In. Sal Icatlon Rate Horizon Depth Dominant C Redox Descrlptlon Texture Structure Consistence Boundary Roots GPi 71ff ln. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. 'EtI#1 •Eifli2 . a ~~ ~ r ~ c,~ r~ dsN ~>~ l ~ G 3 ~-3g s' ' ~~ ,~: 1:v OBE m~,~ '' _ 1,~. i { spring ~ 0 Boring L._J V Plt L+rG4Rla aurraee esv. ,,. VoN43 v HIIIIYI I~ {61dV1 ^,. Sal Ilcatlon Rate Horlmn Depth Dominant Col Redox Destxtptton Texture Structure Crmsiatence Boundary Roots GP DIH' In. MunaeU t]u. Sz. Ctxd. Caor Gr. Sz. Sh. •Eff#1 •Eff#2 ^ Pit Ground ~Ce °1e'~' R Depth fo Nmittng factor in. l.~J Ong ~ ^ ~~ SoU icadon Rate Horizon Depth Dorr>inant Redax Deaalptbn • Texture Structure Consistence Boundary Roofs In. Munastl C+.u. Sz. Corn Color Gr. Sz Sh. •Eff#1 "EAM2 ,: • ERluant #1 = BODs > 30 < 220 mgiL and TSS X30 ~ 150 mgff. ' EtAuent #2 = BC+D, _< 30 mSIL and TSS = 30 mgtL 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 608-26b-3151 or TTY 608.264.8777. sao•esso ts•~t Property Qwner s~~j-V ~~~? 1-l~} N rJ C d • Parcel tD ~ Page _ ~ of l ~ 1j:! YlI wwnv avnaw vwv. - n. uv}.u~ w gngw~y wvw - ~. So;l Iication Rate Horizon Depth Dominant Color Redax Description Texture Structure Consistence Boundary Roots GPi 7/ff tn. Munsell Qu. Sz. Cont. Color Gr. Sz Sh. 'Et6#1 'EfKR2 ~ ~"~ ,S 3~3 ~ sal, M~K 1b5/-~ ~-S ~ 1'~i S' ~ ~ a ~N ~ 5/ ~ ~~.. r~s dsN cY~ l yl !v ('~ ~ Q Boring ~ J r~ PIt VINYIIY.lY110W07Qr. IM VOrJNi wfi11gY1~ 10..w~ ql• ~ (~pn Rate Horizon Depth Dominant Redox Description Texture Structure Consistence Boundary Roots GP D/t! ln. Munseq Ru. Sz. Cont. Color Gr. Sz. Sh. 'Et11~t 'Etflr!'2 n eo~a ~ ~ ~~ _ut-~ f~~-- L V Pit v. wsna vr..aw v~v ~~T"• •~ •••••-'a • •• Soil Rata Horizon Depth Dominant Redox Deacxiptbn . Texture Struchae Consister~e 8ourxiary Rants ~. Munaefl f]u. Sz. Corn. Color Gr. Sz Sh. 'ER#t 'Eitri2 1_ • Effluent ty1 = BOD, > 30 _220 mglt. and TSS >30 :150 mgA. ' EtAueni ~ > BOD, _< 30 mgA. and TSS = 30 mgll. The Department of Commerce is ail 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 608-266-31 S 1 or TTY 608-264-8777. sao.e3w trzdooi =1~ ~~ •. ~ ,~ ~ . _~ N ,,: ~,,~ J~D~'O.S ~~ p~~13~)C' d~Dl4-cb yic3 ~ o 0 ~ o T ~~ ._ w v~ s S d "~ ~ ~ Q~/mE ~~~~ S I TLr D~~ tl-N ~'0~ }- d T ~S scx~~~ 1s ~~. = ~1a'un~~-Fs.~ a~~m~rs~on~~a ~3, f~i. 1 s nr~: ~~. ~ Tf9 ~ F ) ~ ~ ~~ ~ z. m To~~F 1 /'~ Tt/. ®g Yom, 1gYl N y ~ }~ ~ ~ ~~ q~~~ a~.s, ~- _. q,~~, GS ~~~a oo~~ - ocwnoN LKLTCII _ -- mYr or lUlIfOAT PINE LAKE SUBDIVISION A t:OUNTY PLAT LOCA7LD IN PART OP OOVL/1NMlNi LOT ~, PART OP OOVlRNMCNT LOT ~ MID PAIR OP TN! LWt.V OF 71st NLtµ, ALL IN !LOTION 1. T=ON. 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CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIl' CERTIFICATION FORM Owner/Buyer ~~n til/~jg/ ~ ,~,~Q, / f ~~~ Mailing Address 5,~~~orr ~/Lei ~Z ~S 2~ Property Address ~~ /~ ~ia~C ~/LC .5~1c~~'f~~ ~ Tin ~~~~.~.~ ~ ~ L'~a~,~- ~ ~~// (Verification required from Planning & Zoning Department for new construction.) City/State f9y/~1r~?~~~ Gl%~ Parcel Identification Number ~i~ D/~--~oot~- ~o /!(J LEGAL DESCRIPTION Property Location jL1/ 1/a , /~~ '/a ,Sec. 1 , T ~~ N R ~ ~ W, Town of ~~~1mo~Q~ Subdivision ~~~ ~/~C Certified Survey Map # Warranty Deed # ~~l ~~f Spec house yes no Lot # .~~ Volume ,Page # Volume ~~(~ P ,Page # Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION !/~` 7 Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms ~_ SIGNATURE OF PLICANT( ~ /Z3/ 6 Z DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. *** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) Document Number St. Croix County Occupancy Affidavit for Common POWYS serving Multiple Dwellings ~~% Name - (Owner} Typed or printed being duly sworn ,states, under oath, that: 1. He/she is th own part owner of the following parcel of land located in St. Cro1x County, Wisconsin, recorded in Volume 1923 Page ~_ Document Number ~~~~7 St. Croix County Register of Deeds Office: A parcel of land located in the '/a of thg ~'/~ of ection ~, T ZQ N - R 7 W, Town of ~/,e~1/yld , St. Croix County, Wisconsin, being duly described as follows (include Tot no. and subdivision/CSM or detailed legal description): `a~' S ,~~t! ~(i1;C f~f ~vr5 rsAr1 ~ ~~~ ~fi~~~ ~~ ~/y/X ~!r'I~ ~~ll~~y~"! Illtit lllit itttt Illll iltlt itllt lttt llllit till flit * 8 5 7 GG 5 5 5 1 ~iJ7~~~ KATHLEEN H. WALSH REGISTER OF DEEDS 5T, CROIX CD., WI RECEIVED FOR RECORO 08/14/2007 04:05PM AFFIDAVIT EXEMPT A REC FEE: 11.00 COPY FEE: 2.00 PAGES: 1 Area Name and Re~uru.Add ess t~ ~yi~f S• ~ b~ Q~~ ~'~ .~'v17L~i,~G i ~ ~S ~~ ~iP,-- /a~9z o5-ao o I Pamel Identification Number (PIN) 2. As owner of the above described property, I acknowledge that the common private onsite wastewater treatment system (POWYS) serving this residence is sized for ~ bedrooms, or a design wastewater flow of OU GPDldwelling. The design flow is calculated by assuming I50 GPD with 2 persons per bedroom. There are currently ____ occupants living in this residence; the maximum permitted occupants/dwelling is based on the design wastewater flow. Therefore the POWYS serving multiple dwellings is currently code compliant. However, I understand that if the number of occupants/dwelling exceeds the design flow, the POWYS wilt need to be modified to accommodate increased wastewater flows and/or contaminant Ioads. 1 also acknowledge that 1 will make this information available to any future pa igs interested in~urchasingnthins-p7roperty. Dated this ~ ay of ~~~ , ~Z .~ ~~ ~ ~~~ ~,//mil * GY!/1 ~ Lt't ~i~° '~ Signature(s) AIITHENTICATION authenticated this day of TiTLE_ MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Slats.) TH[ iNSl'RUMENT W AS DRAFTED BY ~ir~ /~?~'lm~s~~rr (Signatures may be authenticated or acknowiedged. Both are not necessary) ACKNOWLEDGMENT STATE OF WISCONSIN ) )ss. St, Croix County. ) ~ ,P~ers~on7ally came before me this ~~ day of ..~1. [he above named < to the known to be the persons} who executed the foregoing instrument and acknowledge the same. ~ ti+iofay-Aublic, State of Wisconsin f~ ~~ ~r // ~ ~~c My Commission is pe nanent. If not, expvahon date:. Date: /~ ~t 4-~ ' . . ~/ . "THIS PAGE IS PART OF THIS LEGAL DOCUMENT - DO NOT REMOVE" ~ "'i.I ' '. .., G ~~... , This information must be completed by submitter: document title. name & return address and PIN (rjrequired) Other inJbrmanort ,ruc$ die gr~ipg ~ ' .'~ a clauses, legal description, etc. may be placed on this first page ojthe document or may be placed on additional pages ojlhe document. N ie: ~ Cho p_((~t~soO+rer` ,~` page adds one page to your document and 52.00 to the recordine fee. Wisconsin Statutes, 59.517. ~ - f U ~ ~ ... .,~, > ~~ a 1 of 1 '~ 2076P 157 STATE BAR OF WISCONSTN FORM 3 - 2000 Document Number QUIT CLAIM DEED This Deed, made between John W. Beard and Debra A. Beard, husband and wife 701761 KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CO. , NI RECEIYED FOR RECORD 12/11/2002 09:30A1i EXERT ~ ib Grantor, and John W. Beard and Debra A. Beard Joint Revocable Trust, John W. Beard and Debra A. Beard as Co-Trustees Grantee. Grantor quit claims to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Lot 5 of Plat of Pine Lake recorded at the Office of the St. Croix County Register of Deeds on March 19, 2002, in Volume 8 of Plats, on Page 98 as Doc. #673841, located ie Part of Government Lot 2, Part of Government Lot 3 and part of the Southwest Quarter (SW `/.) of the Northeast Quarter (NE `/.) all in Section 1, Township 29 North, Range 17 East. Subject to protective covenants. REG FEE: 11.00 TRANS FEE: COPY FEE: CERT COPY FEE: PAGES: 1 Recording Area Name and Return Address L Maureen L. Kinney Z/ JOHNS & FLAHERTY, S.C. 205 5th Ave. S., Ste. 600, PO Box 1626 La Crosse, WI 54602-1626 Part 018-1000-80-110 Parcel Identification Number (PIN) This is not homestead property. (~ (is not) Together with al! appurtenant rights, title and interests. Dated this ~~ day of December 2002 * AUTHENTICATION Signature(s) authenticated this day of * TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.} TH[S INSTRUMENT WAS DRAFTED BY Maureen L. Kinney, JOHNS & FLAHERTY, S.C. 205 5th Ave. S, Ste 600, PO Box 1626, La Crosse, WI 54601-1626 (Signatures may be authenticated or acknowledged. Both are not necessary.) J hn .Bear s Debra A. Beard ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. La Crosse Countv ) Personally came before me this ~• day of December ,.:2~.-' the~$ove named John W. Beard and Debra A. BesYd ~ ~i'.. •' ~ • ~:; • • • ' . = ~~--r' !f- ~ ~~ - to me known to be the person(s) who execuded ~F fo egoirlg~ , instrumen}t~and acknowledged the sart~.~'•. - * 'J i': / Notary Public, State of WISCONSIN ~'""""" .,•-°j My Commission is permanent. (If not, state exp date: * Names of persons signing in any capacity must be typed or printed below their signature. STATE BAR OF WISCONSIN QUIT CLAIM DEED FORM No. 3 - 2000 INFO-PRO (800)655-2021 www.infoproforms.oom Page 1 of 1 r s S From: Steven Fisher Sent: Tuesday, February 04, 2003 2:42 PM To: @Zoning Department Subject: Hold Permits on Pine Lake Subdivision Please withhold the issuance of septic permits related to Pine Lake subdivision until the followin items are resolved: • A Chapter 30 permit is issued from the DNR. • The dedicated public roadway is constructed. I will be requesting that the Town of Hammond withhold any building permits until these items a completed as well. Jane/Shar would you please flag appropriate files. 2!4/2003 n ,~ - . ~ ___ ~ ST. CROIX COUNTY ~,~'~_ =- ~- ~ - WISCONSIN ,~;M;.~.~ __ `'~~~~~ ZONING OFFICE ~ - ST. CROIX COUNTY GOVERNMENT CENTER _ - __Y____ ~. -_~._ - 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 • Fax (715) 386-4686 June 12, 2002 Mike Sliva Secluded Land Company, Inc P. O. Box 99 Barron, WI 54812 Re: Pine Lake Subdivision Dear Mr. Sliva: The Zoning Office has been informed that road construction and house construction have taken place on the above subdivision prior to the installation of erosion control measures on the site. This is in violation of the Erosion Control Plan approved by the Land and Water Conservation Committee on September 4, 2001, which states that storm water ponds and overflow drainage ditches are to be constructed first along with appropriate erosion control measures, prior to any roadway construction. St. Croix County Subdivision Ordinance provides that financial guarantees be submitted to ensure the proper construction, installation and maintenance of required roads, utilities, erosion control measures, and other improvements. The County has the authority to utilize these guarantees to see that improvements are properly constructed and completed. It is imperative that you, as the developer, take immediate action to correct the violation noted. By Friday, June 21, 2002, you are to have installed the appropriate erosion control practices, and have them inspected by the Land and Water Conservation Department. On .Tune 11, 2002, yourself and Peter Kling of the Land and Water Conservation Department, agreed upon the following actions: 1. Install two rows of silt fence in the ditch upstream and two rows of silt fence in the ditch downstream of the culvert along 117`h. Straw bales will also be added as extra protection. 2. Install silt fence around the east side of the dirt pile along, east of the temporary driveway. 3. Install silt fence between the west side of the temporary drive and the south side of the abandoned driveway. This will catch runoff from the west side of the temporary driveway. Page 2 June 12, 2002 Secluded Land/ Pine Lake Subdivision 4. Install two rows of silt fence in the south ditch of the existing driveway, just east of the intersection with the temporary driveway. Straw bales will be added for extra protection. This will catch runoff from the east side of the temporary driveway. You and your engineer must work cooperatively with the Department of Natural Resources during the Chapter 30 permit process to ensure compliance with their requirements. If these items are not completed by June 21, 2002, citations may be issued in accordance with St. Croix County Subdivision Ordinance 18.23 Violations and Penalties. Additionally, financial guarantees may be utilized to obtain compliance. Until compliance with the approved erosion control plan has been obtained, and the appropriate DNR permits issued, sanitary permits will not be issued for additional residences proposed within the subdivision. Should you have questions or concerns, please feel free to contact this office. Si erely, Mary J Jenkins Assistant Zoning Administrator C: Peter Kling, St. Croix County Land & Water Conservation Department Ken Peterson, Chairman, Town of Hammond Eunice Post, Department of Natural Resources Steve Wlodyga, Pine Lake Association File LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF HAMMOND COMPUTER NUMBER 018-1092-05-000 Parcel Number 1.29.17.737 OWNER NAME: First.JOHN W & DEBRA A TRUST Last BEARD PROPERTY ADDRESS: Hse # 1/2 PD --Street Name-- Type SD Apartment 1191 207TH ST SECTION 1 TOWN 29N RANGE 17W'/4160 NE'/<40 Line Description Line Description TOTAL ACREAGE T PINE LAKE SUB LOTS 2/6 018/02 LOT05 BLK 01 S 9N R17W PT PT NE 1 0 PT GOV LOT 3 & PT GOV LOT 4 16 3 NE LAKE SUBDIVISION LOT 5 17 0 45 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1-General, F4-Prev. Parcel, F5-Next Parcel, F7-Valuations, F8-History, F10-Exit