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018-1090-56-000
o a ~ o~ M ac M .. 0 0 N O C i ~L 0! Y •~ 4 N `r'iJ •~ r~ V •~ O r~I~i r C"i O W 7r G~ .~'.r Cd a A g ~: I W I ~ Z ~ r- ~~`~ I ~~ o zv' r .°'Z~ ~ H r .0 C 7 LL 3 3 ~ m Z .+ O '~O a m a> v m a ZZ j N .. E R z ~ L c _ ~ a '~v ro w +~ y ' cca t ~ Q ~ r ~ 3 a ~~~aaa ~ a :.. ~ ,~ C N ~ ~ N N ° ° N J U o o o I N N E M N m = 0 0 ~a m ~ - N O C ~ N y C O 0 o I S ~ N ~ ~ C N ~ ~ O OD N ~ ~ N ~ f6 O ~ Z T j Z M 0 d .~ w € a ~ ~ a .~ ~ m ~a~, ~ v '~ ~ 3 vat c :: ~ Ot~nci ~°o 3 0 O ~ 0 N c 3 co ~~. fi C N N O)fp ~ N 3 mt-- N O Cn to ~ w. __ N ~~mt A N C ~ f6 y N C ~ p C f0 C L p, ~ ~ V O N ~? X00 ~ . Z ~ N Na ~ ~ O-p O ~ c ~ c U ~ O ~ ~ C ~ O Q rn~O C N w E ._ a~ a~ t 0 3 a~ m ~ E E ~ ~ L ~ ~ N } .. O m c a z ~n a f`0 O ~ N ~ C y .'> Z ~ Y 0 U ~o Z r~ 0 m .o z N c 0 .~ w 0 N N E a ro ~ ~ c°ii a °o C ~ N 16 ~ ~ N d ~ C N '~ L ~ ~ '; ~?, _.. ~ Z ~ 9~f~• ~--3 a `~~ ,s-: "-fit . r :? ,:e' u is -- x- r.^. cv a v.?,^~t,,r- '~~.. ..~ -.i-~ :~ ss:_ _s.. ~, :.4 ~~ ~~ ' VV ~ ~ l~ ° Q~ -y a~ s~~ ;~~.d ~r( .3i ~ - ~ it .+. ~ t,'~ .~ ry~ - - %s+ ~~. x. I I i :u~ rr s ;~, ~r .~.r~a,', ~ ., - .. -X Wisconsin Departrfleni of Commei~e PRIVATE SEWAGE SYSTEM Safety and Building Division , , INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Parsnnal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township N seth, Hal Hammond Townshi CST BM Elev: Insp. BM Elev: BM Description: Y ~1 car ~u'~ r/Or V~ tA.p~ 0 1 renlK IIU~nRMOTI(~N ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic 5~.. '?~ I~ ! Dosing ~ 1 ~}~p . (1 Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ?~ / 'S.o- ~ ...-~ Dosing ~ ~ ~ ~ 4 ,~ 3 0 f a Aeration Holding PUMP/SIPHON INFORMATION Manufacturer ~„ _ /~ tJ~"' GPM odel Number ~~( B~ H Lift ~ Friction Loss Sys rvr~.curaur ILC~,~ !o I~~•^~ 11 SOIL ABSORP 10N SYSTEMSYSTEM BED/TRENCH Width 1 Length ~ DIMENSIONS ~ ~~ SETBACK SYSTEM TO INFORMATION Type Of System: nIG~TI")I~I ITI/11J QVCTC1111 c~r0 i Head TDH F S'p 20.51 st. to Well 1 7 ~~ c~ N . Of Twxert~CflA29nn Z~ C~.~ P/L BLDG WELL S r 1~Zo ~ I Sb+ _-.b.. s. county: St. Croix Sanitary Permit No: 399690 0 State Plan ID Nom~,:~/ ~+tO Parcel Tax No: 018-1090-56-000 !~, a9r ~~ ?zI STATION BS HI FS ELEV. Benchmark // ~ Alt. BM Bldg. Sewer SUHt Inlet I,~,~ 3•`ES-~ «" }S ,~ 9~• 1 St/Ht Outlet Dt Inlet Dt Bottom 'Z"~~ ~, C4.~ 1 lf.• Ofi,~D 6 ~ Header/Man. s:3 fl 1 Dist. Pipe .. . 3~6 •,~ / Bot System~CC('-~CjC~•~~ ~t C6Y~faz~ rot Fin I Grade ~-- SH2.~ 5-- St Cover r' ~wr .o r ~J (ol,l ~- J~~~ t ~lT~. a ~~ >;.lS ~~ti,~ ~u~. OT I;~.,tl lS ~O ~- 0 I _r to~~ )IMENSIONS No. its Inside Dia. E/STREAM LEACHI ufacturer: CHAMBER _~ rslDl o Header/Manifold • t ~ Distribution ~~ Pies !~ f -- x Hole ize ~ (~ 1 x Hole Spacing !1 Vent to Air Intake ~~ Di y q y th ~ l• Dia ~ i I~ Spacing L ~ Z ~~ a Length eng e.~u r~r~~rro .. .___.___ ~___._.v_ ~_... .,., ern...... rir nr_r~r~nn NVCiPTC UrIIV Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ;. Yes °n', No '~= Yes No ,max i° COMMENTS: (Include code discrepencies, persons present, etc.) Insp c\tio/n #1: MAr'(/ •GS/~~ Inspection #2: / / 1 ~`~ ~ ~~ ~ Parcel No: 16.29.17.721 Location: 1774 96th Ave Hammond, WI 54015 (SE 1/4 NE 1/4 16 T29N R17W) P easant H.irll~s Lot 56 ~I 1.) Alt BM Description = .~~~ .rrw•~o~e ~~~• ~ ~~ ~ru ~ ~ `~ +~~;~~ Q~ a~j; 2.) Bldg sewer length = ~.3p1 ~ ~~~' - ~ ~ ~' , ~~'!` -amount of cover = ~ ~, / ` ~ ~- I (~~" S -r -~ - v •~ an vision Required? ~. Yes ~ No ~' ~ I ~ i , ~3 ~Z Use other side for additional information. i -- --- -- Da a Insepctor's Signature Cert. No. SBD-6710 (R.3/97) ,~ ~ ~ ~ av ` y ' Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 County ~ .S ~~ ~ ~- ~ ~ ~se~ns~n Madison, WI 53707 - 716 2 Site Address _ '~ // q~ `` ` De artment of Commerce Sanitary Permit Application' . ~ _ ~`~ P`rn"39 ~~q o In accord with Comm 83.21, Wis. Adm. Code, personal informati wyou prov rnfF~ .`'Ct ) '' i ' ^ C}~k if Revision t . J L 3 tna be used for seco ses 1'rivac Law, s15. ~k tfi ~ I. Application Information -Please Print All Information ,~,~, State -~ I.D. Number i ~~/oG~ ~ .-, , - ' 'i - ~~ ~,~ ~,, Property Owner's Name „ Parcel ber ~, 2~j', 2~ Property Owner's Address _~ "' z Property Location I ~~ ~~ /~`t ~ . ~ ~ y ~ 14 ~.4,S T N,R C~ State Zip Code Phone Num ty' Lot Number Block Number s~ Subdivision Name CSM Number ~ YD S ~~ ,~~ /l d'.,~1 , II. Type of Building (check all that apply) .tt Fye~~ow .~ ^City 1 or 2 Family Dwelling -Number of Bedrooms ~ .- ^Village PubiiciCommerc' ri Use ^'I'ownship ~ ~t-/y~ e~ GC ^ State Owned ~ n~ ~ i ~~n Nearest Roa Pmt" -G.r a~ ~C2 (o XI ~ Cis III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A 1 New 2 ^ Replacement System 3 ^ Replacement of 6 ^ Addition to For County use stem Tank Onl Eris ' S stem Permit Number Date Issued B. ^ Check if Sanitary Permit Previously Issued IV. Type of Permit: (Check all that apply)(ntunbering scheme is for internal use) ~ ~ `-~~ 44 ^ Non -Pressurized In-Ground 21^ Mound 47 ^ Sz.*~cl Filter 50 ^ Constructed Wetlaid 22 ^ Pre In-Ground 41 ^ Holding Tank 48 ^ Single Pass 51 ^ Drip Line 4 At-Grade 46 ^ Aerobic Treatment Unit 49 ^ Recirculating 30 ^ Other ' eatment Area Informati on: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade v ti fl Required Proposed Rate(Gals./Days/Sq.Ft.) (Min./Inch) e a on ADD l~ 04 r~dd , ~ tea-- y~ ° ~~~ .~ - VI. Tank Info Capacity in .Total Number Manufacturer Prefab Concrete Site Constructed Steel Fiber Glass Plastic Gallons Gallons of Tanks New Existing Tanks Tams ~dc or Holding Tank _ la ~L} ~ Y Dosing Chamber l ~~T VII. Responsibility Statement- I, the undersigned, assume responsibBity for lion of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature RS Number Business Phone Number aa~ y~o ~ ~- 3~6-~/~ 1 Plumber's Address (Street, City, State, Zip Code) X67 ~ ~ '~ ~ _ VIII. Coun /De artment se Onl roved d ^ Disa Sanitary Permit Fee (includes Groundwater Date Lssued Issuing Agent Signature (No Stamps) pp ~pprove Surcharge Feej ^ Owner Given Initial Adverse ~ ~ .~ ~ Determination . J . C ~ ditio _ as of ASprovaUReaso . for Disappr~ 1_ _ , a~ IX. n D- n A _ n c i .a~~ ~.O~.Q~o ~ tCJ~D . , ~ ~~ j,,, ~ ~ ~ - ( ~---~ `~ ' ~ .L.... Q1 M . 11 {wnl... {...L.~ AU9CII COmp1C[e p{aa~ tw [[{C a,oun~y vo{yJ nor {uc s~sccau w rp....... SBD-6398 (R. 45/01) rLU•1• rL~ty Scale 1"=y~' ` Bi°1 •b~-(_-_tTL.: IOU- 0 ~ o ri 1o c~' o f ~ I Z,`~ ~.cY~~ DV LT ~w1 I.}Z _ ~. ~~~ • ~~ I K K K h ~ _ W`~L:L. ~ \3~ > sp r t.'1~-C1j'`l. S'~ 5~Y''[ 1~fRL~ : _ ._._ _J_ ""_`C I ~~ . <~ ~ ~~ _ l y„1 N N 0 A r Go~J~v'''Z '~L .°1.~ -b \ST' ~~ LW `lq_g ` S3i ~_ q~~ ~~. ~~ ZS ~s o ~ y I'w~c • ~°lo Page 3 of -7 1.1~~b (~ J ~0 ~~0~ Q b I~ ~ L~ - - ; a ~ za -- _~~ ~~~ 0 ~1 ~~ `~ ~ O 1 ~t0~ ~S ~ '/ 8, ~ ~ -+ ~ _ ~a~ T 1lS ' ~- - ou 7.~oT '-~ P ~ a~ o`z Dis~zs3 ~'1'u q~vzkA ~• ~S _ ~ -~ S 'ra «7, NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation ipes with approved caps. ( Z required). 3. Septic tank to be 1'Z.`~p ~BUp gallon capacity manufactured by 1tit~~s ~Z. ~LJ c.12.~~ W ~ (~ l8 tX~ ZP~B ~Z ~t L`r~'2 . - 4. $ench markc~ •, S~ P~UU 5. Divert surface water around system to prevent ponding at the uphill side. •+ . isconsin Department of Commerce CUST ID No.267341 Scott McCallum, hoKernor Philip, Edw. Albert, Secretary January 15, 2002 ~ D ARTHUR L WEGERER WEGERER SOIL TESTING & DESIGN SERVICE PO BOX 74 RIVER FALLS WI 54022 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 01/15/2004 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA ~~" 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Bonte, Ron Residence 96TH Ave Town of Hammond St Croix County SE1/4, NE1/4, 516, T29N, R17W FOR: Description: Four Bedroom At-Grade System Object Type: POWT System Regulated Object ID Ne.: 826541 Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi. us/sb www.wisconsin.gov n ~~~ ~F~ ;?~ ST CROiX _. %fstN'tG(>F~ ,. ~~. .....~ Identification rs Transaction ID . 7 106 Site ID No. 64027 Please refer to both identification numbers, above, in all cones ondence with the a enc . 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. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "At- grade Component Manual Using a Pressure Distribution System for Private Onsite Wastewater Systems" SBD- 10570-P (R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10573-P (8.6/99). 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 at- grade manual, and section VI of the pressure distribution component manual are complied with. A copy of this letter including instructions and information relating to proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. 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 Per manual sited 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. Comm 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. ARTHUR L WEGERER Page 2 1/15/02 • 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). In addition, 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. • 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. A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat 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 [he Division of Safety & Buildings reserves the right to require changes or additions should conditions azise 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 tr-e 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 aze responsible for the installation, operation or maintenance of the POWTS. Sincerely, 7 ~ r ~ ~~,/r ,~ Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@commerce.state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 • ~ ~ TITLE SHEET Page l of ~ AT-GRADE SYSTEP-i FOR A ~ BEDROOM RESIDENCE This ,.plan has been prepared in accordance with the At-Grade ComDOnent Manual SBD-10570-P,'and the Pressure Distribution Manual.SBD-10573-P ~ CZ. ~/aa~ C2. 6iq~~ .-J LOCATED IN THE S ~ 1 /4 OF THE N~ 1 /4 OF SECTION l 6 , T Z-°l N, R 11 ` W, TOWi1 OF ~W~1M f~-y~, ~ g'C-. ~.~ ~,X COUNTY, WISCOPtSIN. INDEX PAGE l of 7 PAGE 2 Of 7 PAGE 3 of 7 PAGE 4 of 7 PAGE 5 of 7 PAGE 6 of 7 PAGE 7 of 7 R.Llt~l _ L3 01vT~, _ - -____ __ 1x11 _ 1'7 p Tt~ ST ~ _:"- TITLE SHEET SYSTEM r1ANAGEMEN~= PLAN PLOT PLAN PLAN VIEW-CROSS SECTION DISTRIBUTION PIPE LAYOUT PUMPING CHA2IBER CROSS SECTION PUriP PERFORtiANCE CURVE PREPARED FOR PREPARED BY ~~ ~~F ~~~ ~~ ~ ~ GFA ~~ ~©~~ V ~~~ t~O ~~ • L.IEGEI~SR SC3 2 L .TEST 2 NG AND . • - DES 2 Get SSRV 2 CE P.O. Box 74 421 Pd.~lain St. River Falls, WI 54022 Phone 715 - 4 2 5 - 016 5 ~,,y~oe®®eseeo ~' Fax 715-425-6864 ®~ ,~~~~a~,®~sy +.~f s . ~1PPR~ ., _~s~ ~~.,~~ E.LSY1GHT ti ~ y / i ~~ ®®e ` S ~ L~~ '' ~ ~®~ BEE. C4RRESPI • ~0ji~s~awa~ ~.. ~ ~-0 Z JOB NO . O ~ - 3 2 6 At-grade System~Hanagement Plan Pursuant to Comm 83.54, lJis.Adm. Code Page Z. of `septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. Tne contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic ink and . outlet fiiter shall be assessed at least once even 3 years by inspec5on. Tn out et i e. ..all be c:eaned as necessari to ensure pro er o eraticn. The fiiter cartridge should not be removed unless provisions are made to retain solids in the tank that may s pug o e r ter when removed from its enc:csure. If the filter is equipped with an alarm, the filter shall be serviced if . the alarm is activated continuously. Intemiirent filter ale „ s may indicate surge flows or an impending continuous alarm. Tne septic tank shall have its contents removed when the volume of sludge and scum in the ink exceeds 1/3 the liquid volume of the tank If the contents of the tank ere 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 ma~amum scam and sludge accumulation in the tank The addition of biologi~l or chemical additives to enhance septic tank performance is generfly not required. However, if such products are used they shall be approved for septic tank use by the Depar`Jnent of Commerce, Safety and Building's Division. Pum--° Ta^k _ . The pump (dosing} tank shall be inspected at least once every 3 years. All switches, alams, and pumps shall be tested to verify proper opertion. If an effluent fiiter is installed within the tank it shall be inspected and serviced as necessary. At-grade Component and Pressure Distribution System No trees .or shrubs should be plantea or allowed to grow on the component. Plantings may be made around the perimeter and the component shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the component is not allowed. Cold weather install- ations require the component to be heavily mulched for frost protection. Influent quality into the at-grade system may not exceed 220mg/L BODS, 150 mg/L TSS and 30 mg/L FOG. Influent flow may not exceed the maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each later!, and it is regmmended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure testis performed it should be compared to the initial test when the system was installed to determine if prince c:ogging has oquned and ifi orifice cleaning is required to maintain equal distnbution within the dispersal cell. Observation pipes within the dispersal cell shall be'checked for effluent ponding. Ponding levels should be reported to the owner and any levels above 4 inches considered as an iapending hydraulic failure requiring additional, more frequent monitoring in accordance with•Comm 33.52 (2). General • This system shall be operated inaccordance.with Comm '82-84 Wis.Adm.Code and shall be maintained in accordance with it!s component manual SBD 10570-P•(B,6/99)~and local and state rules pertaining to system maintenance and maintenance reporting.. No one should ever enter a septic or pump tank since dangerous cases msy be present that quid qus2 death. Septic and pump tank abandonment shall be in accardance with Comm 83.33, Wis. Adm. Code when the tanks ace no longer used as POWTS components. Septic or pump tank manhele risers, ac-~ss risers and covers should be inspected far water tiehtness and soundness. Access openings used for service and assessment shall be sealed watertight upon the campleacn of service. •Any opening deemed unsound, defective, or subject to failure muss be replaced. Exposed ac: ess openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component Contir~cencv Plen If the septic tank or any of its gmponents became defe^sve the tank or gmponent shall be repaired or replaced to keep the system.in proper opening gndi6on. - If the dosing tank pump, pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a gmponent of the same or equal performance. If the at-grade component•fails to accept wastewater'or~"eRiiis to discharge vasteva'ter to the giound surface, it map be necessary to install an aerobic pre-treatment unit or .replace the component. Additional site and soil'enaluations may need to be done and additional plans may'need to be prepared and approved by the Department of Commerce, Safety and Buildings~Division. . Questions .about the•operatiori or maintenance of this_system should be directed to «• The County Zoning Office at 1 ~,S -- 3 ~'b•- ~~ b~ 0 Sr, °~-R~tX. The system installer at _ "11S_3~b_ 3121 gL' ~h1N1,R12..LsR The tank manufacturer at ~p~ _ 3 ZS _ g Sb 1ti ~ ss L~ The effluent filter manufacturer at app-ZZ,[. 571~'z. ~-'PC13~1 77`Q `~ ~r1 ~ - K C~ 3 O - 92.0 - ~l8 ~~ Gov ~~ ~ PLOT PLAN Scale 1 "= ~~ ' /~ . - - ` Bv'1~1=[ = L~-:._10~: ~_` o-.i 'r~~ of ! /2,k ~-cYv17U~~- e ~~ ? Z $ ' Ply b"t `T'YChJVt_$ ~ .... -- <~ ~p~~ 1`ftj y„1 N O 1 1 ~,,~vr2 ~1..q,G -~ q,q.s ' S3 ~ ~~~ ~~ ~s `o~ y''pt,c llp' or-Z'` Pty. F.wt, BMt~ ~~, ~'ldrj • t 3° 10 _~ ~v J ~~b `~ i / ~~. 1 `- ~~ -- ~~~ _~- _~ .~ ~~' i._ -~ `~ Page 3 of -7 $• Za ~; /~~ g,~_~ ~- a ~ c`z. D ~s'r~z-~3 ~.~;~.~~ Tyr S'MIN. -_._ - NOTES : -"---~_ . ._ . 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z .required). 3. Septic tank to be lzap 8Up gallon capacity manufactured by 1-y1.~`~ Z eUIU C.tz~'TE W / I~ l8 c)c~ ZP~ ~z. ~ ~~ 4. $ench markcs ; S~ P~UUF` 5. Divert surface water around system to prevent ponding at the uphill side. ~~.P~N ~\~ - CUSS S' ~`f~ 0 N ~~G~ ~.1 p ~ 7 - ~' ~5, B ~ >5 f' oa.r.~- ri~'ti 5~ r " 2 ~ ~ ------------ ------------fix- o ~ ~ ' r~~~ ~ ~ ~~ 'A ~ _ ~ o ~ W C C'1~-Jl FD ~-D ~- ~1 ~------------ -----------~~~b o a ~ `~ o aSL~zc, ^'11uw wez-~.s - ~ 1z~ b . ?5 y I/6 B I/6 B i I /2 B ~ ' r A = (~ - FEAT _ . o = .- 10 0 Fir C _ 3 FAT Linear Loading Rate= 3 ~ ~ GPD/LN FT L _ ~ l ~ ~~ Design Loading Rate= o. SGPD/SQ FT Observation Well ~S~ZS~r ~- ~=r~eY~-off, .Sa~vZ~'t,,~! Fa b r i e ~.~, tea, s_-~.r.~,~~---,~~---~~" ~G ~ ~~ ?5~ ~ A ~r2~~ C . ~ I~~~ 'S -~{ 9~o S~oPt A =2~ Distribution La t e ra 1 ~-~v. °l~ • s .Soil Cover ~% Y/ 6'i w, tiN. I~~:, ~Whl~7 ~Z'~ A . ?5~ i Fig. 8c. Plan View and Gross Section of a Wis.:,onsin At~rade Unit with 'I~o Absorption Areas With in a Single Unit on a Sloping Site Distribution Pipe Layout Pace S of 7 Place the holes at the bottom of the distribution pipes . at'equal spacing. ?remove all burrs from the pipe and holes. Extend the end of each laic-aI up with the use of Iong tt:rn or 4f ° $tdng to a point with six ~~ inches of the final gt'ade. Te.'minate the ends of the Iate.-ais with a valve,: thre2ded c~ or • treaded plug. Provide aces firom final grade for the valve; thresded can or threaded plus. " ~"' =.~C`.sS ao~ T`-tF.1cr L ~,ZOSS s, i1y1~7 FVC, ~ F`J~ PVC Lateri ~ ~ Maniiofd r-- L.aterl x x x x!Z xfZ x l x ) x x L3terat Length -~ ~ ~ Lateral Length - P PLAN V\~,~.J ~ ~~ a _ ~- -- ~ ~cc~s soy -~ ---0 P ~ Ft. ~ ~ Hole Diameter ~ 1$ Inch~~ ~-~-~ S ~_ Ft. ~ Lateral ~) l~Y InchEes) X ~-~ Inches Manifold ~- Inches -- ~ Force Main " ~ Inches ' ~: . p of holes/pipe Z S ~ . Invert Elevation of.LateraTs 1~1-5 Ft. _ .. 2. S ~.X ~ - y l = ~o .zs,~ ~r ~ ~! l • 0 G pay . ' _. Combination Sept,3c~•Tank and PUMP CHAMBER CROSS SECTION AAJO SPECI ., - u.~ sp ~orJ P IpE w/r1rlRrsttT'r.~p ' Ft N tSHfl • G~DE I " 18'MIAI. IAJLET APProved joint w/ PVC pipe sL, ~V • ~ ~ . 00 ~r' xlu, `__ ~ 19'Ml~l. . ~,: VE1JT CAP 1 Z cor..,Du~T IOIUS ' PAGE ~ OF WEATHER PKOOF - JUIJCTIOIJ 90X . APPROVED LOCKING M~IIJHOLE COYER cv!'i11 wASiN1UG LP.gE~,. i~ ! ~ I _ I - I \\`` ll ' PROVIDE 1 ~'j'AIRTIGH7 SEAL I III I III _. /, I III I III I I I AIItiRM 6 I II I r I I ou c •i I I PUMP -~ --~ OFF D C0IJCRETE " • ~ BlOCK Approved joint w/ PVC pipe RISER EXIT PERM1TfED OIJLy 1F TA1JK MA]rUFACTURER HAS SUGH APPROVAL~3~AP~~`~B 6FD0 c rv4 SEPrIc F ~ SPECIFICATI~f~1S DOSE TAA1K MAt`lUFACTURCR: w~~~ ~C-~L''' DUMBER OF DOSES: 4-~ w P TAAlK SIZ C : Z ZOO ~ A DO GALLp-JS - ER ps,~ DOSE VOLUME r ' ALJtRM MAUUFACTUR.CR: S•5'• ~L~zp S~ sTL'h~S IF.ICLUDIUG 6ACKFLDW: " Z S~-S GALIOhIS MODEL f`ILIMBER: ~~~ ~w CAPACITIES: A. 1~ I~Z L IUCHCS OR l~~•7 GALLOt SWITCH T~PL: _ r`"'1 ~rIZC(,/~Z ~ JS 8= Z IucHES'aR ~~l• Z Gpuous PUMP MA3JUFACTURCR: - GOV ~.-a Q C = ~ l ~~1JCHE5 OR `s4- S GAUous MODEL ~lUMBER: ~~'' ~'S - 0=__ ~~ I~HES OR 1~S' SWITCH TYPE: ~ L'~~Cu/ __ GALLOAJS IJOTE: PUMP AUO ALARM ARE~T 6~C~ M113lMUM DISCHARGE "RATE~1- O_CpM INSTALLED OAJ SEPARATC CIRCUITS VERTICAL DIFFERENCE DETWCEU PUMP OFF AIJD..Di57R18UT10iJ PIPE., ~G_-15 FEET ~- KlLtil~tUM 1~IETWORK SUPPLY PRESSURE . .. ~ • SO FEET ~.p~C L• 3~ ~ ~- ~l~ FEET OF FORCE f,UIIJ X 3_u~ F~pFZFjZIC710W FACTOR., 3•$I FEET TOTAL OyAIAMIC HEAD = Z.(~'0~ FEET • As per rlanufacturer Z~, 60 gal /in. Liquid depth 3 ~, ~' `'•~w. ti G.I. VElJT PIPt ~ 1Q' FROM OODR. ~iIfJDOW OR FRESH ALK ruT~,KE -i ~:; ~~ .K~ 8 gFFIC zna~ ~~~ 1~ -~8ao LLEY$ q•~SfT. Goulds i~E 7 °`' Submersible Effluent Pump ~ ~ r~ u 3871 EP05 APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS Pump: EP04 • Solids handling capability: 3/a' maximum. • Capacities: up to 55 GPM. • Total heads: up to 24 feet. • Discharge size: l'/z°NPT. • Mechanical seal: carbon- .. rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C)intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Pump: EP05 ~ • Solids handling capability: 3~4' maximum. • Capacities: up to 60 GPM. • Tota{ heads: up to 31 feet. • Discharge size:l'/2' NPT. • Mechanical seat: carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 HP, 115 V, 60 Hz,1550 RPM, built in overload with automatic reset. • Power cord: l0 foot standard length,16/3 SJTO with three prong grounding plug. Optional 20 foot length,16/3 SJTW with three prong grounding plug (standard on EP05). r rQ 0 ~ FFFT 0~ • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available far automatic and manual operation. Automatic models include Mechanical Float Switch assembled and preset at the factory. FEATURES ^ EP04 Impeller: Thermo- plastic Semi-open design with pump out vanes for mechanical seal protection. ^ EP05 Impeller: Thermo- plasticenclosed design for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ^ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ^ Motor Cover. Thermoplas- tic cover with integral handle 'and float switch attachment points. ^ Power Cable: Severe duty rated oil and water resistant. ^ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTING SA• Canadian Standards Association (CSA listed model numbers end in "F" or "AC".) ~ I ~ ~ .~0 i j ~ I ~ i ~ r~ ~~ .» to , ~~ ~ ~ ~ ~TJG y I :. , - '- - ~~ 1 25 ! _-_~ rji; , -- -- ._ ~. -~ . I I I ~ ~ 2 I ~ I --_ - I 20 - c - 15 ~ I i - 0 i I I ! I I I I ---- -- I - EP05'-- i 5 j ~ I EP04 _. ~' I 00 1 n ~ n ~ n a n 5 0 GPM 0 2 4 6 8 10 12 m'/h CAPACITY ©1995 Goulds Pumps, Inc. Effective May, 1995 83871 'tlfar~in Dd~rbtentbf.Cammerce - SOIL EVALUATION REPORT Page I of_„~., f1Fi~iainn r'~f 3n~v ~ Ruildinas -- l .. • ~' ht acoomdaru:e YYNh Cornet ff5, VYIB. norm. voce ~~ T + =~ ~~, ,. .. S . Cir i Attach complete site plan on paper not bas titan 8112 x 11 irtc>ftes in size. Plan must but not HrNbed to: vr'rtlcai and hortzortfel referertoe point (BM), direction and include Paroei LD. . w. and location and dtstence 1o nearest road. north a rr o e ns bns acme ordim eroent slope , p , pp ~~ ~~ t ~ p .• Partonal intormatlan you provide may Ise urad for secondary Pu~P~+ (P~oy ~. r. 98.04 (1) (m)). ~N • 3O ~r . ~ ~ } Properly Location ~ ~-- •• ~ .. .. V 114 f /4 S T N R E (o Govt.. Lot ' l~mperty (,)caner a~Maifing Address _ o . ... Lot # Bloolc # . ' 8ubd. Name or CSAItlY' = 1 ~..., " ~,.' ~ ~ r T t ....._ Zip ` ^ City ^ Village Town . ~ Nea>~eat,RgtaKi . Z r ~ [~+New Cons6ucfion ~ Use: I~Residentiai ! Number of bedrooms _~_ Coda derived design flow race l.. Q' d GPD [~ Replacement ^ Public or oomrtten9af -Describe: Parerrtrreibriel : Flood Plain ebvatieort if ~ ~• Geneial comrrrerrta S' YS t /'y't ~'~ d • ~p; ~ e~ and reaornrrtendaiiorra• .,,w. ,. ~.f, b~~ .., -~; ' ~~~c - .'v ~~ ~ ~' n C~ G7~- ~ ~ Wlc-t -~ yV1 o r-C -2 r c; r ~ ~ # o~ Q~., in. Z • ~n R Depth to IMBrrg facxor ~ ~ ~ Pit Ground aur<aca elev. 1 R ~ ~ .. a e • Halxat G Depth Dominant ,_ _ Redox Desaiptbn Teodure SWc~ur+e Conabtertoe Boundary Raois ' in. Munsall (1u. Sz. Gont. Cobr Gr. Sz Sh. '~ ~ - r ~ ....~. 3 _.....,.,_ ... _ . S ~ 1 - -- Z ,,;.e..~..,.. .... . k ~ Pit Ground surface elev. ~. ~ iJepth to tkrdt>rtg factor ~ Q„~in. ~ Rates ~....... ,~{oon, ;,..Depth Ootni+nnrtt Radox Desaipgr~+n Texture Stnrcluns Consistence Boundary Rootis GPOJfP ~ in. ~ Munaell Qu. Sz. Cont. Cairn. r Or. Sz. Sh. 'Etf#1 'EtiiiF2 .~~..w.... .._,_.. . . . " Effluent #'I a BOD > 30 _< 220 mg1L and ~:a ~ ~~0 < 1St) mgA.. ' Etiluent rFl = tx.ru < su rrrgrr. ana ~ a~ r xr n~grr. CST Name (Phase, ~Prktt).. - .. - Hato. ~ Le ~ Address date Evaluation Conducbd Tabpharte Number d-Il rJJ~ rt'vCrSe-~ 1~.;''i_w.~. ~S ( -a ?-- Z __ - - _ ~.^... ~.....,. ~ ~ Page ~~~ ProPeRY Owner ~~~~~,~ Parcel iD ~ ~~ ~ ^ Bonng Pit Ground surface elev. g9 •~ an. ft. Depth ro limiting facbor'._,.~.p,___. ~ Shc Ibatlon Rate. PHofixon. . Depth DonMnant Cobr Redox Des~xipfjon Texuere Stnwture Consistence 8oundery Sz. 3h Gr Roots O ~,}~ *E~2 ` in. Mansell Du. Sz. Cont. Coke . . . _ ~ 5 s w; ,, - ~ ,..,.. S ~ ~ . -(~i c , ~~:~..~ ~... 5 , - ,... k . . . 2 ' ~ ~. ~ ,~ ,. ~~+'~:~ . "1 ~~ # ^ ~~ Ground sur#aoa elev. ~ U ft. Depth th limiting factor-_,~~ in• it ~ gory Rate Wotizon Depth Dominant Colas Redox Descxtption Texture Structure Consistence Baindarl- Rooms OPD/l~ 'Eff~'! "Ef~2 in. Mansell (1u. 3z. Cons Color Gr. 3z Sh. ~ S c , ~ zm m _ ;„, .if... . i . .. .. ,, 4 .., ~ . , ' ~, " ,.. # ... U ~~ Ground surface elev. ft. Depth to limiting factor in. .......,.. ^ Sok Rate Plt ~~ ~.. pepth _ Domin~t Cobr Redox Desrxiption TexWre Sbudure Consi~erwe 13ourxlary Roofs 'Et'f~f ~~ in. Mansell Giu. Sz. Cont. Color ~'• ~ Sh• ! J~J~~ti 7.ISi~. ~• ww r (( ~; ~ ` - ..... ti d .. x r w r . y VM3 I .~ 1; .. }{ 1....m .......... .. .. _. _~ .. _ °,.~,°°.~' ~ , ' EHiuent #'l = 80Da > 30 < 220 mg/L and TSS >3U < t a0 mg1L ' Effluent #R2 = t30D8 _< 30 rnglL and TSS _' 30 tngll. ~M ..._.......__ .. _ ~'"~"""'"'t'lte'Department of Commerce is an equal opportunity service provider and employer. If you need assistance to acxiess services or need material in an alternate format, please contact the department at 608-266-3351 or TTY 608-26A-8777. { se~•t33ocr<.mrool f ^~ PAGE 3 OF NAME QoP\ -~-e I OTI#~i ~ LEGAL DESCRIPTIONS ~'/,NF'/4 S IIoTZq N Rl ~ E (or)11'~ SCALE: 3"=~tJ ~ Y_ BM 1 ELEVATION r~ • O BM 1 DESCRIPTION -{-cam-~ ~ ,Gvn~u ~ f- "~' r BM 2 ELEVATION l (~O . d ~_` j ~j , BM 2 DESCRIPTION ~o~ o ~ ~" Co n~ v ~ ~- SYSTEM ELEVATION q ~ • D O ALTERNATE ELEVATION-. ~J/~~A 9' 8.3~ CONTOUR ELEVATION . 4 ~~c~ ~~ ~ pj~<~~ (~.-- v ~ ~ BM 1 ET.EVATIUN • U L /. BM I DFJSCRTPTION_ ~P d ~ /Z ~ o~ CQ c ~ ~` BM 2 BLBVA.TION jD0 , C~ i~ l BM 2 DHS(;RII'TION~~ ~-~ 2 ~ (~o -'~ ~ tl `-~ ~" SYST~,M BL~VATION ~ D ALTERNA'X'I: FcLEVATION /~// ~ CO1~T'IOIT1~ EI.HVATION O ~.. S. .~, PAGE 3 OP~ { '-_ ~p2 ~~~,~ ,~ ,9900 ',G ~ Id Wd6I:~0 Z00Z 80 woa~ `Idlfleoonsin D'epartrrrent of Commerce SOIL EVALUATION REPORT Page I of ~ Dnrisiort of Safely and Buildings ~~ m aoooroanoe wmr ~:ornm era. v,ns..,am. were Plan must ee 8112 11 i u ~ l h s ~Y J ~- • ~,r' t . x n s an res ite plan on paper not ess t Attach cxNrrplete include, but not limited fo: ver'ticad and horeorrtal reference pant (BM), direction and p~ I.D. percent slope, scale or dimensions, north arrow, and oe to nearest road. ~ '..r / y ti PIHrA$@ (>t!'%Ilt il/i 1 . -' ' ' ,~ ~ . , o ~ Date ~ 04 (7) (m)). n You Pie ~Y be used for ~ivaty Law: a..1 Perswiai arformati .Q~}.lM. ~ CJ'''~ " "^~ Property Owner ~ ,: i< (~ _- location C~vt.,, of ~ 114 114 S T N R J E (or O~~l' Property Owt-er's Mating Addr+t~s 1 .~. ~ t ~' ,. .ST ~~~Ix Lpi ~ Block # Subd. Name or CSMIf ///~ ~ ~ t ~Y State ZP ~ OFF-CE ' ^ Village Town :Nearest Road ~, 'y d w~ ~ ( , (~ New Construdiorr Use: C~Residential / Number of Cade derived design flow rate ~.. Q d GPD ^ Replacement ^ Pub6c or commercial - Describe: Patent material : Flood Plain elevation if applicable ft Ger>eral comments s ys a nit ~-~ v . ypQ;2o~,,o and reoommenda6ons~t~d~c> r 'C~'Cv • ~O • ~.J a # n° ~~ w Pit Ground surface elev. 7 Z • ~n tt, pe~h to limiting factor in. ~ ~ Hereon Depth Dominant Redox Description Texture Stnrc~ure Consistienoe Boundary Roots in. Murrsdl Qu. Sz. Cont Color Gr. Sz. Sh. *EfF/f1 •Eff#2 ' 1 •~r L ~ Z r ~ .err ~ •~~ 3 ! ~ .5 I I -- -' 2 2 Bor~# ° Bann ® Pit Ground surface elev. 9g, ~ ft. Depth to Itmit~g factor ~~G m. Sod Rate Horizon Depth Dominant Cobr Redox Texture Struduie Consister~e Boundary Roots GP DRF in. MunseU Qu. Sz. Coat Cobr Gr. Sz. Sh. *Efflf'I 'Eff#2 Z L -" if ~ z ~ C I V • 3 • ~ c! • r • * Effluent #1 = BOD_ > 30 < 220 ma/L and TSS >30 < 1 50 mall * Effluent #2 = 80D . < 30 mglL and TSS < ~ mg/t. CST Name (P~ Print) CSTNumber_ __ I~C~'l~ ~C ~t c Y~G~~Ler' ' ~ aS3_~9 Address -~ Date EvaNiation Conducted Telephone Number a~~3 go~5f. ~mrerSe--~, ~~ ,~-It~35 1y-~~~-oo ~t5-a~~-ycx~g r 4 Property Owner ~~3d ~1 T ~ Paroel ID # - Page 2 of ~_ Bonng # Horizon Depth in. ~ 3 .. U ~~ Pit Ground surface also ~R Dominant Color Redo~c Description Texture Mansell Qu. Sz Cont Color z ,-~ S.1 ~ .. ~ .5 ~ Sic.l ~P~ to l~~g Structure Gr. Sz Sh. 2 b K Consistence Boundary i1Yl~ ~ r+ Soil Rate Roots GPD!([~ '~~ I v!C .5 . ~ ~- •~ r ~~ # ~ Bonng ^ Pit Ground surface elev. ft Depth to limiting factor in. Soil j~jpn Raf3e Horizon Depth Dominant Color Redox Description Textun: Structure Consistence Boundary Roots GPD/fft in. Mansell t2u. Sz. Cont Color Gr. Sz Sh. 'Eff#1 "Efl#2 ^ Pit Ground surface elev. ft. Depth to limitarg factor in. ~9 # U ~~ Sal ~ Rate Horizon Depth Dominant Redox Oesaiption Texture Structure Consiatienae Boundary Roots GPD/fF in. Mansell Du. Sz. Cont Cobr Gr. Sz. Sh. 'Eff#1 'Eff#2 'Effluent #1 = BODE > 30 _< 220 mglt. and TSS >30 < 150 mglL ` Effluent #2 =GODS <_ 30 mglL and TSS _< 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an atternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. ssasa3o (x.mroo~ PAGE 3 OF NAME ~o n ~-~ LOT# ~ ~o LEGAL DESCRIPTIONS ~'/4N F'/o S /(o T2 Q N R ~ '~ E (or)1~d- ~~••~~ ~ SCALE: I"= ~VC~ BM I ELEVATION ~~ • ~ ~ BM I DESCRIPTION ~d D-~ ~ ,Co,1c4u ~ f- '~'^ -" BM 2 ELEVATION /(JO . d ~ ~ b BM 2 DESCRIPTION -~oQ o ~ z 1~ QCo ncQ u ~ ~-- SYSTEM ELEVATION -/ -(• ~~ ALTERNATE ELEVATION ~J~~+ ('f1NT(IiTR FT FVATT(1N ~ 0 • ~~ a 1 l.t~V1A ~.v u. ~ a ~ SEPTIC TANK Ivi~~IIJTBNANCB AGRBBMEN'T .AND OWNERSHIP CBRTIFICATION FORM ~wnerB roPorty 'ropcrty --T - - (Verification required from Planning Department for new constnictioa) a~ ~c~'('t~y'v~L ~ ~~~ Parcel Identification Number ~ ~ ~ ~ ~~~ ~~° -~~ PTI/ON / Sc ~ C '/~ Sec. ~~ T ~ N-R ~~ W, Towa of ~0.Y1'~Y~ . /4, ~ s -' ~ibdivis~on e~ Survey Map # C~ ~ ~ ~ ~`~ • Volume Page Lot# ~~. # ~~ FVarran}y Deed # 6 ~ ~ ~~ ~ . Voltune _, Page # Spec hose ^ yes ~ no Lot lines identifiable ~, yes ^ ao roper use and mainteaancc of your acptic system could result in its premature failure to handlo~~ ~u Pro ~~ ~~ coasis~ o dumping out rho septic tank every three years or sooner, if needed by a hcxnssod Pumper can aff the function of the septic tarilc as a treatment stage is the vvasta disposal sysiem- ~ b the owner and by a property ownu agr~ocs to submit to St. Croix Zoning Dcpartmeut a ~~On fon~, signed y mastzr , journeyman plumbed trsiricted plumber or a licensed pumper verifying that (1) flue on-site wastowaterdisposal system is is operating condition and/or (2) after inspection and pumping (if necessary). the Sepdc tank ~ less than 1/3 full of sludge. nts and agree to maintain the private sewage disposal system with the standards ~, ~ 'gncd have read rho abova requircmc of Natural Resources, State of Wisconsin- Cettlfication set forth. in. as set by the Departtnant of Commerca and the Depatlm~t to rho St. Croix County Zalung Office within 30 crating t your septic system has been maintained must be completed and returned drys f three year expiration date. ~_ DATE O R R CA~O j o~ {caowl e I we am arc the ownec{s) of I (wc) certify that all statements on this form aro true to the best of my ( ) e~ ~ ( ) ( ) ~ p described above, by virtue of a warranty deed recorded in Register of Deeds Office. lz ~ ~~ Gi DATE ~(}IyA OF PLIt,,,AIJT • ••• • i ~ Any information that is mis-represented may result in the sanitary permit bcinS revoked by tha Zoning Deparmient. • i i i. i _; E.'-~r ~ decd from the Register of Deeds office •• Incl~de vrith thts application: a stamped war:aaty a copy of the certified curvcy map if reference is made in the warranty deed ' STATE 8AR OF WISCONSIN FORM 1 - 1998 WARRANTY DEED rEsrEs4409 r,r't7FILcE1~l H. LIALSfI ibcuneerH FMneber p ~ 7Q,1 Yn! P 6 REGISTER OF DEEDS : AGE ~ :~, . cROix CO., WI This Deed, made beiween Ronald C. Bonte i(ECEdVED FOR kECORD Glenn A Knudtson 1;-07-2001 9:30 AN i1RRRflNTY DEED Grantor, E:(c"9PT M and Hal P N~ seth a nd Mi chat 1 e r. Nyseth, f,ERT COPY FEE: us an and Wif _ e as survi vorsh; Ci~FY FEE: , p T TRANSFER FEE: 105.00 marital ro art - p p y • ="C.",'LiNG FEE: 11.00 ~ Grantee. PRGESt 1 Grantor, for a valuable consideration, conveys to Grantee the following described real estate In SY _ ('roi x County, State of Wisconsin (the "Property"}: necexcfiny Nea . Name and AeNum Address Part of the E ~ of the NE ~ of Section 16, Township 29 North, Range 17 West, St. Croix County, Wisconsin, described as follows: KRIST!NAOGLAND ATTORNEY AT LAW of Pheasant Hills First Addition P.C ('^X 359 q May 8th, 2001 in Volume 8, Page 48, HUDSO~J, W1540i8 Document #644952 Tosether with all appurtenant rights, title and Interests. 018-1090-56-000 Parcel ldentincauon Ntnlbar lpM This i c not homestead property. (is) (IS not) Grantor warrants that the [Itle to the Property Is food, Indefeasible :r. fee simple and free and char of encumbrances except Easements, licenses, zoning ordinances, and restricitons of record. Datedth~ls,~,,~,,,6(t~h~ day of DP~E+,mhPr 7.001 ~~~:1 ' vc"~-~ - ~51' (SEALI (SEAL) Ronald C. Bonte r Glenn A. Knudtson (SEAL) AUTHENTICATION Signature(s) authenticated this day of , (SEAL) ACKNOWLEDGMENT State of Wisconsin, aa. St. Croix County. Personally came before me thts 6th day of _ _DeeemheY 2 0 O 1 ,the above ruined TITLE: MEMBER STATE BAR OF WISCONSIN (If not. authorized by §706.06, Wis. Scats.) THIS INSTRUMENT WAS DRAFTED BY Ronald C. Bonte 1011 170th St Rnnald C_ Rnri Tenn A_ Knudtson to me known to be the person ~ c. ,executed itf?e Foregoing Instrument and acknowl~ga a eiM.-' +~ ,/ r8 ,,., Hammond, WI 5901 5 (71 5) -796-5240 Notary Publlt, Slate of Wisconsin ~ " . ,: !11e My cornmisslon Is permanent, (It not, state exptraUon date: (Signatures may be authenticated or acknowledged. Both are not ) necessary) ~ ' • Names er pesom npelna In ury uprclty emu( br typed w printed blow Ihrb slannun. WARRANTY DECD STATE BAR Op WISCONSIN FORM No. I - 1981 W4cwy6, opalWWt CO.. N,;. Miwaeiaa. wte. / n v -\ I PHEASANT HILLS FIR. LOCATED 1 N THE NW 1 i4 OF THE NE 1 i4 AND I AND 1 N THE SE 1 i4 OF THE NE 1 i4, ALL ! N TOWN OF HAA~IONDJ ST. CRO I X CC I -------------------- , ---I--_- ~ ------------------------------- ~ UNPLATTED LANDS ~ ; \ I ~ ~ S89'P8' OP'E @8P, O,q' (TO NW COR. LOT 54) r-----•~--~------•--- re Ir.o I I I 3Tt.0Y' (TNIi i/EET) O SEE I C -- I I I I I I a ~ ~ ~ ( ~ ~ ~ ,UA~I TIED.,, I ~ gg ~ S LOT 58 ~ I LOT 54 I I LOT 55 n '" 3. T3 ACREi ~ S88.05' I i I = y~ /6f, 4!4 i0. FT. w l~ 04 E I SHEET I a I ~ I I LOT ST s L I ~ ~ It8.~7 5~0. FT. « 87 ~I I ! Y I I - - ...x ........................ I I I ~~~ rte.... -PUB _ - _ ~ - -~'.----~~i°'°a.,o•` ~~..~._~~ ....... .®....... =®~ ~,~~ ROAD .w I SEE ....._......... :: I I ~,~;~,;_......~._..__ . - - - .........-••' y r I I I ......... at. I I e I I I I I i i i ~ ~ a I LOT 64 I LOT 63 I LOT 62 ~ e LOT B1 .~ LOT 80 ; St. I I I m ; t.ao ~Ea . s.3a AcaFa • I I SHEET ~ 113,033 i0. FT. ~ /iT,6TJ i0. FT Qy I Y. I I I ~ 8 ;j ~ :~W8 I _1_ i ~ •$ I ~ I •/~ $~;~~ I I I a>a, se' (TN/i i/EEt) ~ m ..... -----~-------~--•~------L--- ua.a~ --- ~. EAfl-rErf q/MTER ll1E Nae•~i' m w PP77, of (To sw coR. PLAT) 530E. Oq' (TO HEST WARTER CORNER ) UNPLATTED LANDS soooorta nllf 11/tAtlAEllf DrtAFtEO ~Y JIN rE1ER SHEET ! OF 3