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HomeMy WebLinkAbout018-1090-58-000 ~ N C ~ ~ ~ ~ ~ ~ ~ W .. ~ ~ T~ ~ Z y h ~ N ~ 7 01 y, t < y ~ 7 fD C ~ ~ ~ ~ N a ~ d ~ O ~ ~ a °, ~ ~ ~ 3 ~ fR N ~ ~ ~ v I °' ~ ~ _ D y ~ W ~ c ° I 3 ~ O ~ rn c n ~ I ~ ~ -• o m ~ ~ ~ ~ ° ° 3 w w f c ~. ~ '~ '9 n ~ i o ~ ~ ~ ~ ~ N 3 N N V~ O ~ 3 ' a .. ~ I N 3 I °. I Z .. O I -' ~' ~ cb cc a, ~ 0~ ~ ~ S ~ ~ ' g m i c o c ~ D I A ~ o m a ~ c ~ wcZ 1 ~ ~ x z ~ O_ ~ N d [/r 7 ~ ~°~ W ~ a ~ o - d ' • 3 ; a a Z I I f w ~ a _. o I ~ 'm c ~o a I ~ N I g I x I =, I I I I ti I I o ' I m I c °o ~. 3 m o n' ~ v ~_ ~ ~ ?~ J Q ~ ~ ~ 3 ~ 4° O ~ ~ n ~ Q w °o y O '~ N o c $ ~ m .. ~ ~ d d 7 y N d Q d ~ N g z ~ -~ .~ C! ~ 7 m ~ ~ z a ~ Z m d 0 ... A~ C O A~ O Q ~• t~ C 0 ~• ~l y ~~ A fi C Z ti 0 0 A ,b ~'" o°o ,c~N A c~, ~ ~ ~°,, b Wiswnsin Depattment of Commerce PRIVATE SEWAGE SYSTEM Safety and Building DiviSlon INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) 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 Bonte, Ron Hammond Townshi CST BM Elev: Insp. BM Elev: BM Description: (SO. ~ l'~•a~ Sw ~e'~ttn-aQr ~ c uT~ ~3w~'~'`~ IAIVr~ IIVPVKIVIAIIVN TYPE MANUFACTURER CAPACITY Septic ~cr~-t~ ~~ 6c~ Dosing .s Aeration Holding TANK SET~ACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic , ~ ~ 1 J ~, 7 Dosing t~ i~ X1 6 ~, r Aeration Holding PUMP/SIPHON INFORMATION Manufacturer , `- Demand •+,~-- GPM Model Number ~ JL _D ~0.1j~ TDH L Friction Los System Head TDH Ft •lo .i~ 3•ZS ~• Forcemain Length 7 r, Dia. ~ 11 Dist. to Wel JVIL A KF' 1 IVN 5YJ 1 tM RENC idth ~ Lengl DIM S 1 b G SETBACK SYSTEM TO INFORMATION Type Of System: ~4T - G,2~ DISTRIBUTION SYSTEM I No. Of Trenches 2 ~ P/L BLDG r- Ion ~S~ 1 CLCVAIIVIV UHIH County: $t. C('OIX Sanitary Permit No: 429938 0 ate Plan ID No: ` Parcel Tax No: 018-1090-58-000 Section/Town/Range/Map No: 16.29.17.723 STATION BS HI FS ELEV. Benchmark t o~.~ o Alt. BM Bldg. Sewer ~'~ 1 OZ • ~ St/Htlnlet ~, O',3o1 SUHt Outlet Dt Inlet Dt Bottom ~ ~~•3~ Header/Man. Dist. Pipe 3.30 ~ 0`~• 0 Bot. System ~/ G "'~'- ~ 03 • ~'O Final Grade St Cover k ~ cam. J~ D bloom D ._ OfQits nside Dia LAKE/STREAM UNIT :~ - ~03•~ HeaderlManifold Distribution ( ~~ Pipe(s) ~ ~ x Hole Size ~ 1 3 x Hole Spacing ' Vent to Air Intake `.. ~.~ Length Dia D ~ Length/ Dia ~' Spacing ~"' ~6 Z •~ ~-' SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Svstems Onlv Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ~ Yes j ~ No i Yes !~ No ~~(GGS: (Include cod~repe ies ersons resent, etc.) Inspection # • Inspection #2: - cation: 1782 96TH Avenue Hammond, Wf 54015 (~ 1/4 NE 1/4 16 T29N R17W)'PM{ an't Hill§`I~ a n. Lot 58 Parcel No: 16.29.17.723 1.) Alt BM Description = 1 2.) Bldg sewer length = ~b V - amo n;of coy r = > ~{2 ~ ~~ ~'~" d .,~,~w Plan revision Required? ','' Yes ,, o ;-- -~~ } ~~,~_ _ _ __ __ --`---_----- -- -- 'l ~ I - --- Use other side for additional information. ~~ ~ 1 i - t~ ~ ~~ sepctor's Signature Cert. No. SBD-6710 (R.3/97) e _r~ ' Safety and Buildings Division C~h' /'/~~/J ~/' / ~~ ~ 201 W. Washington Ave., P.O. Box 7162 f /R/V Madison, WL 53707 - 7162 i Sanitary Permit Nuutber (to be filled in by CoJ n iscans (608) 266-3151 ~~ ~ 93g Department of Commerce ' State Plan LD. Number ~ OCf~Z. ~z ~ ~ANa~t Sanitary Permit App infornl~t~j;ygyt~ivSd~~ ~ Adm Code Wi 83 21 C ~ ~ - ~ fQ' , p s. . , omm In accord with tray be used for secondary proposes Privacy w, s15.04(1xm) Project Address (if diH"erent tban ing address) ~7$z 9!v'"'~r/E 1. Appllcation Information -Please Print All Information ; ~ 1, ~ ~ A K Property Owner's Name Parcel # Lot # Ir$ Block # dY! rye" L ; ~~' d S-! o + - o .~i3 Property Owner's Mailing Address Property L,ocauon D/ ~sT' S~ ~~., NE ~~., section ~~ City, State Zi p C ode Ntnn ber Phone Q ,./ c ~ [ a77 f~a/i ,,'l ~ a ~ .l ' 7 ~ ~^l b qq T /~ / N; R~E or~ ) l 1 t y) ap ~ Su, j.ir. app Il. T of Building (check all tha ~ Subdivision Name CSM Number 1 or 2 Fautily Dwelling - Number of Bedrooms - - ~` ~ . / /~S , S y~~~ /t~/r ~j/ /f r+~ ^ PubGc/Commereial -Describe Use - r 1 A'F' "~ / ^Village~ownship of IK/~ ^City 1 ^ State Owned -Describe Use O _ 111. Type of Permit: (Check o one box on line A. Co ple line B if applicable) A' ew System ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System B. ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New list Previous Permit Number a~ Date Issued Before Expiration Pltmrber Owner 1V. T e of POWTS S stem: Check all that a 1 ~ ~fCVIGo ~ - b - / ^ Non -Presstuized ln-Ground ^ Motmd > 24 in. of suitable soil Mound < 24 in. of suitable soil At-Cnade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Presstuized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Fiher ^ Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip line ^ Gravel-less Pipe ^ Other (explain) V. Dis ersal/Treattnent Area Information: Design low (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (s0 Dispersal Area Proposed (sfj yttem Elevation o . ~F9 900 9/8 ion ~ Vl. Tank Info Capacity in Total Number Manufacttuer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass Ncw Existing Tanks Tanks Scptic o u,.i~~- ..~.- /~/) /~W / ~ / Aerobic Ttcatmcnt Unit Doming Chamber ~~ Vll. Responsibili Statement- 1, the undersigne ssume res sibility for instailadon of the POWTS shown on the attached plans. Plumber's Natne (Print) Plumber' rgtiat MP/MP1LS Number Business Phone Number ~~v G ~,vz ~~/39i~(z ~~S=Z~~ ZG~f ty, S to Zap C Plumber's Address (Street, Ci / 1 ' ! M/ ~/1 ,/ p Vlll. Count /De artment Use Onl roved A roved ^ Disa Sanitary Permit Fee (includes Grotmdwater Date Issued is g Agent Signature (No Stamps) pp pp Surcharge Fee) ~ ~~~ OI ^ Owner Given Reason for Denial 1X. Conditions of ApprovaURea~sons for Disapproval ~ ~ r I Q' /~ `' I - U`+~""~ t ' l T~ O~~C _a-~ V~n.la4.T ~'.X ~CJJ-+^~ t1~Q~ ~ to ~'~. { b~ ` ~ ~~ _ -----~ - r ~'D '~'~. Vlv[q W ~ ~ n( ~ar~c- .rZq,LUU ~~- ~ Mdsvtit°`~xd/ . AttY[~ COmpleie Maus tin uiC l.OYn[y UsayJ cur aw: ayaacm uu NaW, uva aaa ...... o,. r ......w... .r -...~ SBD-6398 (R. 01/03) ~, r I ~ ~' 9 f I ~_r ~' ~ ~~ ~ ~S ~~oo iy _ f/~ ~' ~ o r ~^- ~3 J /~ • dc11 0 3 ,~ ~ f~ ~- J n I 0 ~ ~ ~ ~ ~ ~; 3 ,, ~ -~ 3 ? " 3 d ~~_ ~ ~ ~ 3 ~ o ~ ~ ti ~ D ~ ~r ~ 7 `~' i ~ U .%+ ~- ~- s ,.~ ~' ~~ 3 ~ _ - ~ ~ ~ ,~.~ ~'' J d `, S •VY J ~• i ~ s "~ d 9 o r ~ ~ ~ s -~ ~ N fq/ ~ ~ { ~ ,) ~ ~ ~ ~ 0 r' ~ .1 ~~ (C~ `G~ ~ '~'r N ~t.l a J, M 1 r c~. ~/ y ~. ~~ /: i \ .. ~ \\\ 7 y d r'- 9 / ~ e~ ~ ~ -~ .J N ~ N ~ ;9 ~ .~ ~ 1 _- .1 S `J . ~ ~ ~scons~n Department of Commerce 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 Jim Doyle, Governor Cory L. Nettles, Secretary April 17, 2003 CUST ID No.139462 TODD L SINZ T L SINZ PLUMBING INC E5609 708TH AVE MENOMONIE WI 54751-5520 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04!17!2005 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Ron Bonte Residence County Hwy T Town of Hammond, 54002 St Croix County SW 1/4, NE1/4, S16, T29N, R17W Lot: 58, FOR: Description: Three Bedroom At-Grade System Object Type: POWT System Regulated Object ID No.: 899696 Identification Numbers Transaction ID No. 860942 Site ID No. 657941 Please refer to both identification numbers, .above, in all correspondence with the agency. 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: General Approval Requirements: • 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 (R.6/99). • 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 off setting (D) is proposed to be at six inches from the bottom of the tank. The pump pad, along with the legs of the pump, may leave the impellers out of the liquid effluent before the pump off setting is reached. This Con,G should be checked at time of construction to insure this condition is not encountered. This setting maybe ~~~~ adjusted, with the inches coming from the reserve capacity area. DER RTMEI • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption~> .~OF area. chs. NR 811 & 812c SEE CORE • 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. TODD L SINZ Page 2 4/17/03 • 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 • Comm 83.22(7) 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. • The changes made to this plan on 4/17/03 by this reviewer were acknowledged and approved by the system designer. 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 instal lation/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, C~ 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 cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544 Henry F Grote ,Certified Soil Testing •. Ron Bonte - At-grade System Transaction # Construction Materials and Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: At-grade, SBD-10570-P (6/99) Pressure Distribution, SBD-10573-P (6/99) Location: Lot 58 (former lot 4, CSM) SW1/4, NE 1/4, Sec. 16, T 29 N, R 17 W Town: Hammond County: St. Croix Date: April 16, 2003 Owner: Ron Bonte Address: 1011 170th St. Hammond, WI 54015 Plumber: Todd inz Signature: License # 139462 Attachments: 6748-Plan Approval Application SBD-8330 page 1: cover ~~~ GI Y G~ 2: design criteria & calculations G 1 Y G 3: plot plan ~1,~ ~ ~ "[l;t:; 4: plan view, system cross section 5: lateral detail 5~~~ ~ ~L~~~ ~~~„ ~~ally 6: pump tank exit detail ~~~ 7: pump curve coM~EacE 8: system management ~ILQINGS _ PONDS ,~ page 1 of 8 ~' ~ ~ Design Criteria Y~ Residential Wastewater Contaminant Load: 30 mg/L < BODS < 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 1 SOmg/L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/L 3 Bedrooms x 100 gal/bedroom/day x 1.5 4'~~ gallons/day hydraulic load In situ designed loading rate Depth to estimated high ground water Depth to bedrock Cross slope at system Force main length Manifold/header length Drain-back Lateral length Z @ Lateral elevation Lateral hole size 3ftV in. @ Z 3 holes/lateral Design Calculations o, ~ ~ gallons/sq. ft. per day ~, 4t in. ~8~ S.g 15' N~ 2.~ 4.5 , C~ ~ ~4.Z z4. o 4b ~+ Lateral volume 1 b ~' Total lateral discharge rate 3 °'3 b Network pressure compensation losses ~'~'S~ Elevation difference 1'•~ Friction loss ~ ~'i ~ Total dynamic head `~ ~~ b Pump/si'phon 3Z•~ gpm @ -~ Manufacturer ~~ ~~ r- ~- ~ ~~ Dose volume ~~• o Lift/si~ion tank ~ ~-L-~' ~~ ~ ~ - Lvo ~ -~ ~~ Septic tank .. Effluent filter ~ f ~~ F ~ ok22- -4 ~f'- Measurement pump on and off ~' t Height alarm from tank bottom ~ 3 • t Reserve capacity ~'~°. ~ ~pecs.calcs.res in. ft. of ~ in. ft. of in. gallons ft. of Z in. ft. @ bottom of lateral in. ( ?• ° ft.) Spacing holes total gallons gallons/minute @ ~~ 5~ ft. ft. head ft. ft. @ 3 ~ gallons/minute ft. ft. of head Model # S N ~ ~ ~ gallons ~~ gallons t ~o gallons m. m. gallons Page 2- of g i r f f d' 9 -~' ? ~ ~ ~ 6 ~ ~ ~ s ~ ~ S ~y o ~i J ~3 J /~ ~~ -r 9 V 3 fl ~... d M Z ~~ 1- v 3 I .~ ~ ~~ n ~~ Z ~- ~ ° 0 ~ o .~•v r .%+ d ~ i ~" I ..s~ `~ r^ ~ ~ ~ \ ~~ 1 O ~~- 5 '~' /~~ Q ~~ O ~~ 0 b ~. ai ', fi ~ ~ ~; 3 ~ ! ~ v ~~ 6 ,~ rr o ~ ~' '' 3 0 ~ ~ a~ ~ ~~ 9 ~~ ~ , ~ `'~ 9 0 l~ ~ ~-- ~ i ~ ~- ~ __,. r N ~ ,~ /' {./ n ~ d ~ ,~ f / ~~ ~~ ,~ ~ ~/ Q d' ~ ;~ _ ~ ~ N _~ 1 3 ~a . ~ --~ N ~. ~ ~, n 9 r c~~ a~ sy .°J 1 4 :J ~ ~_ ~ j t i 5~ s- ,, ~ ~ ~, \ ~2.0~ 5~ .~ ~Z , -_----------1-------------1 .~ 1 ~~~ ~ ~ ~ ~ ~ ~~~ r 2' tZ. o ~ 1 l .c~' ,o-I o b s Q,,, ., ~.~: ~ -. O livt~~ ~.J2~~~I ~ --t `~ ~ ` ~N 1 4 " '~~ ~' Fabric - Observation Well ~ s' ,s~. t1- I ~ 0 K~L QIrU 0. TiOy ~-ti. Q.,l G 1.s~~- ~o ``a.~. Distribution Lafieral ~--Soil Cover 12 ~~ ~ ~~ o ~o~,Z ,, . ,. <, ~ L 1 n.v / ~~V . ~ o ~~ I ~~ ~--- \ ~' ~ ~ `Si r 2z. ~ '~ U ~;;~ t i"~ v c s aS. 4-0 ~ P ``~ "'~ ,.'\., ~.o ~a.t ~•-.i~.. ~a..aj/ ~... Tom' 1 ..~1..-'"C I I 2 °~ I I 2.0' (l.o~ I.o~ 2.0 ~ ~ Z.a ~.0~ ~'~ ~ Qo~c ~ w KrNti ! ~` d'O 4 ~ O n -Z w ~ l • ~, b ~^~..o, "-'S O -. 1 h ~ A'~. CSl-..T W. ~'30~ v `.`. ...a.1 ~`1 •O s+. ~~ ~~ ~ ..._.. -~ ~_~ S oS LOCKING COVfiR ---~ lt/A/t~N /NG .f /~BE~ , QtItCK Dt~C,O~1VtC7-~ ~~~ ~ __.__j J. 4M Pyc ~`~ 4m PIP6 3' ~U NDISTuRB~D SOIL. ZQu I.D. Malun~ .... I i~ r ~aW-~wiD A i SICFT ~NT-J ~_ BllFFLE L PtPG ~ ~rWEC.TtO~ ~ Qr~~p F~" cs 'eti1.- t((411~3 A C 1, t' v . Q/v :.~ O w n. ~ ~~ ~ }l ~ ~.s D ~~~ Co~vt.RFT"c bcoCK 1 T .~ I SEPTIC f SPECIFI~CA TIO~ 1$ ~4 ~ ~~'"5`` 00 5 E TAt 1 S ~ ~~ ` ~ . , ~. MA-JUFACTURCR. ~ w uLIMBER Oi ~~' TAlJK SIZE ; ~ t}~O - (~~ DOSES: PER DAB ALAR1'1 Nl'UlUFACTUiZfAQ; GALl.01JS `` S ~ ~}~ ~i-v DOSE VOLUME ~ ~ IAJ " e CLUDING 6ACKiLOW: vA'.'.ON$ / ~OOCL 1.1U{hfbCR: . 1 e 1 1,}.~ CAPACITIES: A . ~'~'~ 4~'b SWITCH TyP[: ~ '~"`~'` `~~~o IUCHCS OK OA~Lv~: G'UMP MAtJUFACTURCR: ~ ~~Ow cti, 8 Z I-JCNES OR ~ 1 Z4•g 'vw.~0.:$ _~+ MODEL -JUMDCR: S~~ ~ 3p C ° ~uC~ES OH • '~~.'v ,. ~~~_.,~. SWITCH TaPC: ~/"~~~v ,,,, 0' ~ INCHES GR ~°~~". .,~..~~.;- M11JIh1UN1 DISCHARGE ~ RArc ~'y "'~ "~M IJOTE' PUMP A-,JD ALARM ARC TJ bC VERTICAL DIFfERCIJCf DfTWCCU G PUMP OF/ /~y0 p13TRiDUT INSTALLED Ou SE PARATC ~~ ~ ~ 7 CIkC,. ~„ + MI-,~IMUM NETWO RK SUPPIy PREtSURE ~ ~ ~ ~ ~ ~ + ~~ ipf`I PIPE.. FEET Z.,~ •r~.~,S -~ FECT ~. Io o ~ ~ ' FCET OF FORCC MAIN X 2•o~_iT,~ ~too-[FRICTIOU FACTOR. O'"~1 - FEET ~ 3 ~ _ TOTAL. OyUAMIC HEAD ~'~ -~1 U ~~ IIJTEKA1Al, OIMEIJbt0A1C •oi TA 1JK: LEAIC.7H 1 ~~1, ._ FEET ~ -ZL ;w~o " ~"2 2 4 -- TH ;Llqulo oePYH FoR~~ z ~~ p..~ n ~ rv WEATNERPRCtJF ("~ .TUNC7tON )t &~c f T I', ~~ /7/iTT%ii~7 .w Pv4 ~ j vt r,T _4~4oI -~ K 3 c~vrc~ "-' _ _ _ ~~wL.c s..~. 4c at. { 3' ono ~-- ON - I l++~LL'vcc~ t I G-,~uuO s, ~ " 4~,. ar~ i Pw1P ~ ~~ ~ ,~r x ~ ~ Purnn Characteristics MotK UrJt StrbnoriRV1+ A~toaot{c 1lwdals SNE130~{ µonaptwK .SSI MI food A~ t.0 R~OIa Slaiod -ef~ (4 ) R.~,~, 1 ssc E~ e { v~ ns H wt: 60 o {40'F Atti~ionf MENU a,;y. ~ Ma„~. 4s..: ~ Deuiar Sh• 1-I/2' M/7 (J~uitw} SoXds Na~isq 3/4' 114rtui) u,~ ~v.~rt sa ~. hwrar Cord l i/>, SJTW, 20' std. Performance Data ,j 6 -~ ~ I~ tfi ~ o' WKhlIS• ill e t ' 30.3 total Nth hot 1 i 12 i ZO 2~1 OIrN ~Il.l.1 44 "~ S4~ I! S= 12 0 Dimensional Data i. AE~wo~ i+:sf~s z. cwt ~., ~y : I~ ~~ 3. Ma la i«eauaw+ t~ ~~ t two„ a~ ~ .. roc rppn,a~. s. oND-i w~ o~~ b, '1k rwr~ ti ~ a ~nt~ nrrio^ a ar prihci ~d rhw ~pdkowo at1aA r»ricf ~ ~•~, ~ 1{. ~. ~ „~ „~ i,o„ ~~~~~~ s,~~ s~~~•~vpa (94) hA~ ry/ i ~:" 1999 H drancaic' Purnpl, Ashlgrna, (Jh~o N' R h RoeweO. ~~ NYDRQMATIC w - Yom. Aurhonz-d to:d Cauriburor- ~~~ ~ 840 BarKp Rwd AsNan(, Ohb 44101 (el: 419•I69.9041 hx• 419.911 J017 W~h Site: wrr.ptpldrpump.ronl ~' ShcES C>ffKtS IN Ail tiWOR CRIES ANC COUNTRIES ~ ,' . • ~, o,,, ~ ) ~ O ntrm u: W.U~•8350 t2G4 5M ~""' ~ Materials of Construction System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the homeowner, and the homeowner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, T.L. Sinz Plumbing, 71~-23~- 2644, or the St. Croix County Zoning Office, 715-386-4680, should be contacted for assistance. General Proper functioning of an on-site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a pump tank or compartment to allow a dose to be accumulated, a pump and controls, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. { . If the septic tank is installed prior to sheet-rock andlor painting, pump the septic tank before normal residential use begins to ensure adherence to contaminant load design criteria. Install water-saving appliances whenever and wherever possible. >. Repair even small water leaks as soon as possible. 1. Never pour grease or oil down any drain or stool. ~. Garbage disposals are not recommended; if you must have one, use it sparingly. ~. No paper products other than tissue should go into the system. -. 7. No chemicals should go into the system. 3. Avoid surge flows of water; try to spread laundry throughout the week. ~. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. If septic or pump tanks are no longer used, they must be properly abandoned. 1 1. If construction timing and weather could create a frozen infiltration system, weather-proofing with plastic sheeting and heavy mulching inay be required to maintain a functional system at start-up. Maintenance - 1. "fhe septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must be back-washed into the septic tank to remove accumulated material. 4. Periodic observation pipe inspections should be made by the homeowner to examine the state of the in-situ soil adsorption cell. Quarterly inspections are recommended, and a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. ~. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. I f the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allo~~ s reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down-slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run-off into the s~ stem area. 1 1. Warning: Do not enter septic, pump or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for residential systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.4 (2). Pumping and hauling of wastewater maybe necessarywhileanalysis and repairs are implemented. Additional testing, designing, and,~or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 « ,.Wisconsin Department of Commerce ~R~G~~~'IL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings - • in accordance with Comm 85, Wis. Adm. Code AM~rh rmm~lnfe c County c+ r,.n; ,. ' """'r"-•~ ~~•~ ,iiaii vll f/a FlCI 11V1 ICJJ IIICIII O I/G X I ~ Incnes rn s¢e. Plan must yy' Vy Vy~ include, but not limited to: vertical and horizontal reference point (BM) direction and , percent slope, scale or dimensions, north Parcel I.D. ~6W and location and distance to nearest road. CSM Pending 1 _ \'" Revie ed b Please pr' P~ -lnformation.~'~~,~ Y Date Personal information you provide may for oses (Pri'v2C~aw, s. 15.04 (1) (m)). ~ D' Property Owner - ;" Property Location Ron Bonte ~'~` ~~ '' ~ ~ Z~du ~ j° Govt. SW 1/4 NE 1/4 S 16 T 29 N R 17 ~~ W Property Owner's Maili ng Address ' _~ gT CA{,yK --- Lo BI ck # Subd. Name or CSM# 1011 170th St. ~ ~UNry tC6 ~ 4 CSM Pending ~ ~ µfLLs - ~~ Cib Hammond WI State Zip ~ r~ ~ tuber ~ ^ City ^ Village ~ Town Nearest Road 54015 ~ , ~ 11 ~j- -5 Hammond CTHW T (~~' New Construction Use: ~ Residential /Number of bedrooms 3 Code derived design flow rate 450 ^ Replacement GPD ^ Public or commercial -Describe: Parent material till Flood Plain elevation if applicable NA ft. General comments and recommendations: site is suitable for mound development or at-grade w/ highly treated effluent additional soils work in e-22 to B-3 area might lead to conventional system 22 Boring # ^ n Boring _ Pit Ground surface elev. 1n~ ~ ft na„+I, «„ I;mi~in.. ~..,.~,,. -. Horizon Depth i Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ft' n. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 1 0-4 7.SYR 3/2 - sl 2 m gr ds cs 1f/m .5 .9 2 4-22 7.5YR 3/2 - sl 2 f sbk dsh cw 1f .5 .9 3 22-41 7.5YR 4/4 - sl 2 f-m sbk mfr cs 1f .5 .9 4 41-77 7.5YR 4/6 - s 0 s ml cs - .7 1.2 5 77-87 10YR 5/4 7.5YR 4/6 scl 0 m mfr - - 0 0 ^ Boring # ^ Boring _ n Pit Ground surface elev. 102.4 ff no„~h ~., liml~i..., ~.,,.,,.. 2 30 Horizon Depth Dominant Color Redox Description Texture Structure ~ Consistence - Boundary Roots -Soil Application Rate GPD/ft~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 1 0-7 7.5YR 3/1 - sl 2 f k mvfr cs 1f m .5 .9 2 7-30 7.5YR 4/4 - sl 2 f-m sbk mvfr cs 1m .5 .9 3 30-41 10YR 4/3 - scl 0 m mfi cs - 0 0 4 41-55 10YR 4/3 f2p 7.SYR 5/8 scl 0 m mfi - - 0 0 S~ 5~ ~ ~ a, •r / ' Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 /L ' Effluen #2 = BO a < 30 mg/L and TSS < 30 mglL CST Name (Please Print) Signa ure ST Number Henry F. Grote 222774 AdEre 4366 353rd Ave. , Menomonie, WI 54751 1E/2000 n Conducted 715e12e~ho~~ Number .. ! -.. . Property Owner Ron Bonte Parcel ID # ~ . Page 2 of 3 3 ^ Boring Boring # ® Pit Ground surface elev. 102.0 ft. Depth to limiting factor 74+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlfti in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-12 7.5YR 3/2 - sl 2 f sbk mvfr cs 1f/m .5 .9 2 12-42 7.5YR 4/4 - sl 2 f-m sbk mvfr cs 1m .5 .9 3 42-74 7.5YR 4/6 - lmcos 1 c sbk mvfr - - .7 1.2 horizo 3 has pockets of loos sand os + some nclusions 1 ^ Boring Boring # ^ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Oepth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ^ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ^ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 • Effluent #1 = BODS > 30 < 220 mg/L and TS6 >30 < 150 mg/L • Effluent #2 = BODs < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-E330 (RN00) r~ ~. } V ~ ~ d ~~ ~. Q' ~- ~ ~ ~ s ~w 7 f - r o ~ ~ ~ ~~ 0 S f 9 1e (~ ~ - \ * ~~ N 3 (- F- 3 I ~.ln Z F-- ~ ° " u l.~ O ~/+'`. (r' /_~ .~" ..3 3 ~i N 9 S J ~- ~'J ~ N ~~ cab 0 ~~ n 0 I r. ~ '~ ~3 r ~ 3 fi ~ /~ " s ! o ~ v ~~~ _ ~, -~ ~ o_,j ~ ..~ Ni ~~ J ..i ~ '~ ~, (~ M 1 a s ~~ .. o .. ~ / ~ c r v eo 9 - s~ M ~ ~ ~ M ~ ~ ^ ~ ~ ~ ~ i ~ 9 ~ ~ ~G l~ ";~' c_UL ~' d `_ti'is+:trrrsin Czepariment of Commerce SOIL EVALUATION REPORT Page, 1 ,f iJf~t~ipn of Safety and Buildings .--... ~-~., f-,•°~~ ~-.~,'~ ~ ------ m accofdarice ti~riih'Cotptn $S,`vVts. Adm. Code .___ ` ! 3 county =t,arn cornplete site plan on paper not fess than 8 172Lx~Yincties in slzs. Plan must St. Croix u~dude, but not limited lo: vertical and horizontal reference point (BM}, direction and ____. ~~~^^ ~ ~ Parcel L0. Ferc:e'nt slope, sale or dimensions, north arrow, and location and distance to nearest road. CSM wPriding Please print all infarmation, Reviewed by -~" ..~-~~te --_..____._., i t'ersonai uttannatiorr you provide may be used br secondary purposes (Privacy law, s. 15.04 (t) (m}} F'fi)Qr.rty C)wner f Property LocaGOn ~ Rttrt Monte ~ Govt. Lat SW Ili NE if4 S tb T `g N R t , i 4~.• Prope Owner's Maif +1Y in Address 9 Lot # Block # --~ - Subd. Name or CSM# "--"~-~ ' tr)77 770th St. ^~ - CSM Pending C~hJ State Zip Code Phone Number ---__.._ ~ City ~ Village ~ Town Nearest Road .._.._ _. _. _.___._i ;' ~ °~ ~Inmand, WT 54075 I i 715 I 796-524f1 tiatmnond CTHW T ,~~ view Construction ~ tJse: t_J Residential /Number of bedrooms 3 Code derived design flow rate 450 _ _ _ _ ~ ~ y- __ ;;~ ,~ I ~,eplacement ` `-° [] Public ar commercial -Describe: _ _ ~ Parent matenai tit]. Ftocxl Plain elevation if applicable NA ~_ _.~ rt I ____ isen~ral comments { ancrecommendatians : site is suitable for mound development or at-grade wJ highly treated effluent ~ additiot7al sails work in @ 22 to B-3 area might lead to conventional syst.t.}m i f Bonny # ~ goring Q Pit Ground surface elev. __ 1t)3~ ft. Depth (o limiting factor 77+ in. _~ _ !~ar?iar~ OepU; Dominant Color Redox Description Texture Structure Consistence Boundary Roots CPCl `r~~ +n. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Effr,„~ - _ 'Etf»: 0_4 7.5YR 312 - sl 2 m gr ds cs 7fJm .5 .~ ~ 4-22 7.SYR 3J2 - sl 2 f sbk dsh cw 7f .5 .9 3 22-47 7.5YR 4!4 - 51 2 f-m sbl< mfr cs tf .S • lr 47-77 7.SYR 4/6 - s U s ml Cs - ~. 5 77-E77 7UYR 5!4 7.SYR 4I5 scl U m mfr - - U % i goring # LJ Boring I (:,1 r_rn ..,~r ce~~r-,ra Mtn„ 7U2.4 H n.....~ .,. ~,...:.:..,. r_...... 3t)tt - ray .. - - _ - - - - - -.. -_r... ,_ ._... _..y ......-. Si)it .AppliCat7otr Rdtr_ Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPOlftr in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. 'ivfs#t 'E~f# 0-' 7.5YR 3l"1 - sl 2 f sbk mvfr c 1f1m =. ~~ 7-30 7.5YR 4/4 - si 2 f-m sbk mvfr cs 7m .5 .:~ ~~ 3U-47 7UYR 413 - scl fl m mfi cs - 0 ;; 4 41-55 70YR 4/3 f2p 7.5YR 5/8 scl 0 m mfi -- - 0 0 i a ' Effluent #1 =BOOS > 30 < 220 mglL and TSS >30 _< 150 mg/L 'Effluent #2 =BOOS < 30 mg/t and TSS < 30 mg/L CST Name {Please Print) Signature CST Number t+enry E-. Grote '22774 Address a Evaluation Conducted Tele ho fr umber ~ E. ta36b 353rd Ave., Menorttonie, Wl 54751 17/2000 775-2~3-fi~98 Property Owner Ron Bonte Parcel id # Page 2 of 3_v a Bonng # ^ Baring ^ Pit Ground surface elev. ln7•B ft. Depth to limiting (actor 7[i+ in. Soil Applicadcn I?ale Harizan Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDrft' in. MunselE Qu. Sz. Cont. Color Gr. Sz. 5h. 'Eff#1 •Ettx? 1 0-12 7.5YR 3!2 - sl 2 f sbk mvfr cs if/m .5 .9 2 12-42 7.5YR 4/4 - sl 2 f--m sbk mvfr cs 1m .5 .9 3 42-74 7.5YR 4/6 - lmcos t c sbk mvfr - - .7 1.2 horiz 3 has pockets of 1005 sand os + some nclusions 1 Baring # ^ Boring [] P;t Ground surface elev. ft. Depth to limiting (actor in. Soil AppliCabnn ±ia;e Horizon Dopth Dominant Cotar Redox Description Texture Structure Consistence Boundary Roots GPDrti~ in. Munseli Ou. Sz. Cont. Color Gr. 5z. Sh. 'Eff#i 'E`tx2 Baring # ^ Boring - © Pit Ground surtace elev. h. Depth to flmiting factor in. Soil Applicatian Rate Haman Depth Dominant Cofor Redax Description Texture Structure Consistence Boundary Roots GPDift~ in. Mnnself Qu. Sz. Conf. Color Gr. Sz. Sh. 'Effiti 'E!tx? ' Effluent #1 = BODE > 30 < 220 mglL and TSS >30 < 150 rrip/L 'Effluent #2 =GODS < 30 m TSS < 0 mglt. The Department of Comrntree 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 Tl"Y 608-264-8777. S0t7-1U)0 (RNOOj r r''( l1~ i `~ 9 v~ ~'' s c. ~, ~ ~~ `~ ~ 1 t ~ ~~ ~ ~ .... ...-~ ~~ 3 ~ ~~ X Q ~~ ~-- ~~ J ~i a ~---~ ~ (- ~- J 3 f 1 ~ ~~ ,~ N V Q J ~ t* ~ .+~ N ~~ ~~ } Q s ~~ n ~^~ a M_ `.-~" i \\~ ~ 1 ~ 9 y '7f f`~ ^ +~ 0' e . t ~ ~\ ~ ~ \\ - N ~ Q ~ ,,,, y V~ N .a `~ ~ 9 ~ N a ~ ~. ..:, ~- ~3 N ~ ~ ~ 0 v "~~ ! ~ _ ..~^~ ~ ~ J ~ ,~ ~ o ~ } y~ r ~ ~ ~ ~~~ ~ ~ ~ ~ ST CROIX COUNTY SEPTIC TANK ~,ti~;[iVTENANCE AGRBBNIBNT AND OWNggSHIP CERTIFICATION FORM QwnerBuyer Mailing Address Q ~ Properly Address ,`~ th S-t ~ 1 ~~ ~ ~ L ~~S ~ (Verification required from Planning Depattm~t for new City/State ~O'"~M mdr`~? ~ \ry~ Parcel Identification Number ~w,GAi. DEESr'R~PTION L /' ~q _ ~ W Tovva of 1 ~C3..Irn 1'Y~O - ~C '/~, ~~ y4, Sec. ~ ~ . T O' 1 N R~ ProPcrtY Location ---- ~'Q ~-c.'`` ~ ~~ ~ Lot # `J ~ S ~ Subdivision ~ ~.. ~ ~_ ~_-. -_ .Volume ..Page # Certified Survey Map # _ , r ~j ~ y ~ ~ ~ ,Volume ~ _~ Page # ~f Warranty Deed # spot house ^ yes ~^ no Lot lines identifiable yes ^ no QVC'I`C+ M t ~n its pctimaturo failure W handle wastes. Proper maim use and marnteaaiueof your septic syst or soon~sr, nAed~ed by a licensed pumper. What You gut into the system o of pumping out the septic tank Query throe years can affect the ftwction of the septic tank as a treatment stage is the waste disposal systesn- a ~fipdian form. signed by the owner and by a .fie Pr'oP~Y agrees to submit to St. Ck+oix Zoning fat (1) the on-sifle wastewutc~disP°sal sin' plumber, r+estirictedplumber or a licrnsedpumPer ~ tic tank is less than 1/3 full of sludge. mastCrplumVe~+] 'lion and/or (2) after inspection and pwmping (if nexssary~ ~P is is proper operating and agree to maintain the private sewage disposa-1 system with the standards Ilwe, ~ mod have head the above roquir'emeats of Natural Resources. Stag of Wisconsin. Certification of Commerce acrd rho Department to the St. Croix County Office within 30 set forth, herein, as set by the Departaa,ent Zoning that your septic system has been maintained must be completed and returned da of the Year cxp date. - ~] /~.~~ DATE SIt3NATURE OF APPLICANT OWNER CERTIF~CA'1'fO~i our knowledge. I (we) am (arc) the ownei{S) of I (wc) certify that all statements on this form are t ~e t~ , °g~f ~ of D~ Office. propC1h+ d •~ a by a of a wam~nty deed ~ J~ I n 2 DATE VJ SI(3NATtJRB OF APPLICANT r s «s s ~ «s«sss pny information that is mis-represented may result in the sanitary Permit bou'8 invoked by the Zoning Department. warranty dud from the Register of Deeds office ss Indade with thls app(lcatioa: ~ the certified survey map ff refereaoe is made in the warranty decd r~~--r t~°~ K~ ire ~~ ~~~ Rpr 08 03 08:46p Honte Excavatin~s (7151796-2519 p.2 • ••• •.... n,wrr ru JGKVC JV A~ttA. SHEET` EGEND '~ - - fib - FOUND t" IRON i'!PE EV. • i ~2T. 73 • FOUND P' IRON PIPE ~ O SET 2' X 30" IRON PIPE WEIGHING ~ ~~ 3. 85 LBS, PER L 1 NEAR F007 ~2' ~` ~- N07E: SE7 I` X 24" 1R01ti1 PJPE WEIGHING ~ 1. 13 LBS, PER t !NEAR FOOT AT ALL ~~ . ~ ._._L_._. OTHER L 07 CORNERS 2' 4~~ ~- ~, UTILITY EASEArt'NT f TYP. _1___ ~O ..~.....~.. SET®ACKS ® - DR l VE+VAY L OCA T ! ONS f ) - REGORD DATA '; HWF - HIGH WATER EL£VAr1oN 10t0r-YR 140-YEAR FL ODD ELEVATION !~ O G ~ ~a mot' ``~ "! •~ 02, Rt.4~~~r~5 CI~'K~. DT 61 sr.,t~tdx ~p R~+~t #~.xs,r ,~ da t e~1.s~hsr.:o~..~s BEARINGS REFERENCED TO 7HE EAST-WEST GUAR TER L 1 NE OF SECT ION 16. MEASURED AS S88°2T' IT'E. fST. CROIX COUNTY COORD 1 NA TE SYSTEM J 100 o roo 200 300 i c~aPH i c scat. F - ~eE r F1pr 08.03 OE):4EIp Hente Excavatin6 ' ~ ~o~ i520~6~ 93 s7a [L~ t§Ali UL W'SCONSIN FORM 7 - 7999 1)OCttaICA[ }1UAbCr TRUSTEE'S DEED Rabrri J. RtcOardson ix Tru~teo ~F Kusilek CiAritYble Rcmaiodcr L'nitru-t crcLtod Mrr l8, 1000 Por n valuaulc eonsJdcratiau eouvcye witlxritt warranty tv Ra~l® C. Bontt and (:1lbe Knrdtaon Grantcc. tae following described coal cstsm in St C~oia C'nunfy, S1LIe pl't.Viycunyin (if mprc +pan: is needed, plonx;~ttut~ adtlendum;• hG /. Cxceat ma tollow~ny paroltc: (I) Essr 38 rods o; tlxc Nertb 3 ] rods of SE!/. N>r% (Z) SPuth t 9 r,yti: uflha E~+: t 38 reds of NE'!• NE% l3)'~'onri 461 fait nt tht f:4~t 13?4.3'I r'aat n. hl'/, ri'r'/, (4) Lot 1, Vol. "2", C'e;Zi}icd tiwvey ]tap, paFc x17, bcing part ot'thc SE'6 Tvh'/. All in Sccriat i 6-29.17. W Kcturn hdota55' ~ t _ .,• . "_'HOMJ15 A . McGGR.'dACK Attorney at Law 7.020 10T" Ave. PO Sox 2120 Baldwin. WI 54G02 __ UIK-1033-8fl~ 018-103400-l00, M3-fl13d-IO,M,30 Pnnrl itknttfKalion liurabcr {P1N) Daltd trin: ~ fi/ _ day ril' June _. , 2000 'Haber chardron uAfdC AUTHEITICATIUM1 Signature(.} RebertJ.ltiehordton u~thenticatcd thin fir Uay of luuC ~` 200tl r~~AS ~ . S ci~c~,cah,tsz,~-~L TITLE: MEMBER STaTF RAR OP WTSCONSlN {If not, outh~+rircd by ti 706.Q6. VVis. Slats,) "f}iiti MS'i`RUMEN'! WAS DRAFTED UY Thomax R Sc~omacltrr Bakke Ivor may. 5C (S'~itnaiwta may he vutl,a:+ltauteJ ur ucknuwleJ~ J. Ruth bra r.ol neccsiary.j ' NamM u! persmts si8etiug i:t arty cnpnetty moat be typed of 1'RI1tiTEF'ti irR.F.r) ACKItiUWLEDGMJrNT S1'ATt3 Q! Wbeonsin } ss, St Croix _^ County y 1'ersnnally came Itefnt.: me tit ix day of Jun! 2000 tha above uarn¢d Robert J. Riehard-on tib me knovm .a be the I7crson(s) who exrcutcd Ute foregoing inatrutnont and acknu,viadgrJ the Same. Notary' ; ublic. 5tna of W iseonsot ..... _... . My Can:mission 15 pUYltallr'flt. (IT IlOt, Mare expii~tion date: rinsed below choir sigt:nsurc, - _- mtonnonon rnNaarmnw Crnopany, Fero ac ass vn tit'A'ra tb•,R t7k' Vvtt>CblvSiN aoc~ss-aoz, FOAM va. ? - t ~'Jp Trus'.uc (7151796-2519 p•6 ~,~''' ~- ~~ r~~s~~ KATHLEEN H. WALSH REGISTER OF !?EEDS bT', CkOIX CQ„ u: RECEIVED FQR AECORD Qi-19-2000 4x30 AM TRtSiEES DEE'0 E]tEHP? W CdtT t'31aY FEe coax FEES TRANSFER FEE: 900.99 RECORDSM, r•EE: 10.00 PAGES: t Fleeording .4rcn 4mi~~ 2033Q ~2 ~V~ Q-r J ~j2 ~ Q rc~ y > ~a°i 040 -~ a U ~oo ioo Vf W+ • ~ ~r'~„ c d' W V ~ ~~; ~~V ~O ~ ~~ a4~`~ .~~ h~Nj~ ~40~42 ~ J ~y~2~` cI~2Q2~ 4+2~v~Q ~Q ~x °~ vi 4 ~~~~~~ ~ Wv~m ;° 2 m 42 2 o ~a ~ a c ~ ~ U ~oz Zia Q _' - _ _ _ EAST COUNTY TjgUN _ _ _ ~ e3s. z ~~' _......._ _._ ....... ; SU.O° 35 :~._= - ~: g-------2~. __~ SETBACK L I NEB ~~ Q Z: Q: J~ ~= W' ti: ~~ Q J: 0.~ Z: J~ _ .._ I N ~ ..... n, m ~O "~ N ~ ~ N ~ co W O O 0 QD QD F= ~W~. ~Q vy F- ~ ~pN J N , :_. 1~ QD . SOO°35'45"E