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018-2003-07-000
Wisconsin Department of Comrr.~rce Safety and Zuildi-ig Di• ~ ion PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal informatir'~ you provide maybe used for secondary purposes (Privacy Law, s.15.04 (1)(m)]. SS 3r Permit Holder's Name: City Village X Township P.C. Collova Builders, Inc. Hammond Townshi CST BM Elev: Insp. BM Elev: BM Description: I~-rvr~ Ilvrul<mr~lwrv ~ ~<.. Go TYPE MANUFACTURER CAPACITY Septic Dosing ~V ~ ` ~ l.J r„~ Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~~/ iv/~ ~, j r ~~ j Dosing ~~ N> ~ ( l Aeration Holding PUMP/SIPHON INFORMATION Manufacturer ~ ~ Demand GPM Model Number ~~ ~~ ® ,3~ TDH Lift Friction Los ~ System Head TDH Ft ~ ZI.C)~ ~.~ `-E.~ 3I•~ Forcemain Len th l~ Dia. ` Dist. to well !~~ ~ ~ c~ ~ SOIL ABSORPTION SYSTEM tLtVAlIU1V UAIA county: St. Croix Sanitary Permit No: 453315 0 State Plan ID No: l0/ 7!oZ ~ Parcel Tax No: 018-2003-07-000 Section/Town/Range/Map No: 18.29.17.901 STATION BS HI FS ELEV. Benchmark n f r'c o~ ~o~~n~bic~~o. 3 > I 92.7 / U3. i ~q .(Q 1 Alt. M Bldg. Sewer ~ ~! ~, ~ 3 j SUHt Inlet °~ . 3~ £~ 3 . 3 ~ SUHt Outlet Dt Inlet Dt Bottom Header/Man. Z 3 ` Gov ~ ~ Dist. Pipe '2.•3S /~ V Z5'~ Bot. System ~ t~ - ~~.~.~: . ~~ 94.E r Final Grade ~ _ ~ t U2.a~ St Cover ~ n ~ i} t ~'~ S• ~+ .7 Z w..-~ c a Y. -~ 4 ..r Ea.~ 3 -~ 9 ~ 10 S t3 ."i --~qi.,.+ c.x. BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Insid Depth DIMENSIONS , ~ ~ / S 'T / SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHI anufacturer: INFORMATION CHAMB OR Type O/yyy~r~~vstem: / I I O J ~ I ~Z~ Z ~ ~`'"" T ~• ~ ,~ ~ UN Model Num r N DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake // f Length ts~ Dia ~ ( Pipe(s) i t Length yam, Dia I / Z Spacing ~ ~ ~~- Z ~ r~ ~~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems On!v Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ~ ~ Bed/Trench Edges ) ~ Topsoil S- ;__ l Yes No ~ 'Yes ~ ~] No I~1-' 8• > .. COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~1 O / U Inspection #2: ? /,•ZFi / ~'`l K "'`~- r Pr~> Location: 992 156th Street Hammond, WIn(54015 (NE 1/4 NW 1/4 18 T29N R17W) Crick Bottom Overl Lot 7 Parcel No: 18.29.17.901 'ro G~ CEJ~I~tq~ytJ~ `j,1 ~~ Q\v w Utf r 1.) Alt BM Description = ~' ~~~ h 1 0 ~~ o 2.) Bldg sewer length = ay ~ ~/~~.,__ ~ _ ,! V,~2~_ _ ,/ -amount of cover = } ~~/ t,../v'~`ar~ Go,rr.~ ova Plan revision Required? Yes L? No I '7 ~~~ ~ c~~ ' G ' Use other side for addition in rmaUon. '~_~ __ 1-_ ~__ _ __- _ __ ____~ BD-6710 (R.3/97) Date Insepctor's Signature Cert. No. PLOT PLAN PROJECT P.C. Collova Bldrs. Inc. ADDRESS P.O. Box 489 Somerset Wi 54025 NE 1/4 NW 1/4S 18 /T 29 N/R 17 W TOWN Hammond COUNTY ST.CROIX 6/30/04 BEDROOM 3 MPRS Shaun Bird 226900 DATE CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 450 # of chambers none BENCHMARK V.R.P. Top of Steei Fence Post ASSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE O WELL * H. R. P. Same aS Benchmark SYSTEM ELEVATION 99.2' Alt. B.M. is top of Survey Iron B.M. * aC~ 97.0' ~ Property Line ' 'B-3 r 29% lope __ 6- 97.5' Property Line ^ B- It71~~~5 Scale = 1 /4" = 10' ~~ ~~~ ~`~ ~ ~~ ~ ; Grading is to be done ``S r to divert run-off away from system SQ is '`e.,,~ '1 ,~ + S a fi, ~7 Well is to meet all ' setbacks found in Comm. 83 98' 98 Area 15' below system is to remain undisturbed G -~..~? ~~~ ~ Huffcutt p.O.W.T.S. Combo Tank Conditionally - ~P P RAVE Q Pro 3 . Bedroo DEPARTMENT OF COMMERCE House _ 81ON OF BAFETYAIID 81111,pING8 SEE CORRESPONDENCE 400' Property Line Tank is to be properly bedded and provided with lockdown covers with approved warning labels 156th St. t ~ Safety and $uildings Division County ~ ~ ' ~ ` ~ ' 201 W. Washington Ave., P.O. Box 7162 ~ ,~ ) ~~~~~~~~ .Madison, WI 53707 - 7162 ber (to be filled in by Co.) Sanitary Permit Nu m (608) 266-3151 ~ / ~~~ ~ ~3 3 / ~ De artment of Commerce Sanitary Permit Application State Plan I.D. Ntr ~~~ `O ` ~ ~~ rovide l informati ou n d C 83 21 W Ad d i h p y e, persona o o w t , m to accor Comm . u. maybe used for secondary purposes Privacy Law, s15.04(lxm) Project Address (if diffeteret than mailing address) ~ ~ ~ rs~ L Apph'cation Information -Please Print All Information l3l - ll0 3 -0~ -0llu y /~-p / q '~'~ ~- r ~_R\ ~ ~^ Parcel # # Block # PropeRy Owners Mailing Address ~, ~ property Location ~-~ ~;ty, See Tip Code one Number ~ ,., t ll W l h c app e y) ~ ~; e k a II. Type of Building (c '~ ° ~~- Sul vision N CSM Number or 2 i+amay Dwelling - Ntunber of Bedrootac ~lj < S-~ ~ ~: ~ _-~r~.~ •,, PnblidComtoea'ial-DesccibeUse is •~~ state l?wned - Describe use . 9 ~~ 2 ~~_ ~u>age ownsbip Id T ype of Permit: {Check oily one boz on line A. Complete line B if applicable) A' ew System Replacemutt System Treatmeret/Holding Tack Replacement Only Other ModiScatioo to Existmg System Lrst Previous Permit Number and Date Issued B. Permit R omit Revision Change of Permit Transfer to New o -- ~' Before Expiration Plumber wner s ~ 3 3 ~ S IY. a of POWTS S s tem: (Check all that a t Non -Pressurized In-Ground ound> 24 in. of suitable soil Mound <24 in. of suitable soil At-Grade Single Pass Sand Filter Coe-sttueted Weiland Pressurized In-Ground IioIding Tank Prat Felten Aerobic Treatment Unit Recirculating Sand Flier Recirculating Synthetic Media Fitter Leacbiag Clearnber Dri Line Gravel-kss t7flter (explain) < Y. Di etsal/rreatmentAnea Information: Design Flow (gpa) Design Soil Apps - Rate(gpdsf) Drs Area Requited esfl Dispersal Area Propo (af) Sysoe~ Elevation "`~ ~' -2~ i- ~~ ~ 1~ ~n S ~ ' ~ ~ ~ _.,, ~ ~~ ~ ,,~ p,(~ ~ YI. Tack Info Capaci m To Number afacturer Site Steel Fbt6r Plastic Gallons Gallons of Units Concrete Cooslruded Glass New FiisBog Tasks Tacks Sepcaa ltoldog Tank ~ ~ ~ ~ Aerobic 7mtment Unit ' I?osing CLaenba , ~ VII. Res onslblli Staten I, Ure and ed, asibllity for tasfallation of the i'OWTS e;bown on the attached tas. Business Phone Number PI Naatet) Plumber's S' MP/MPRS Nyfnber d r J n ~~ ~ Plumber's Address (Stmt, City. State, ti . ) , /~ YIIL Coua /De rtmeat Use Onl ate Issued sigttature (No s D ('u-clades Gmunawater Sanitary Permit Fee r ~ J Approv ~PPro~ Sutrharge Fee) T/ S~ -~ / ,Z b Owner Gives Reason for Denial IX. Conditions of Approval/Reasoas far Disapproval ~ ^ 0 0 ~1~ ~G~~` ~' ~~ ~ ~STS~[lGl/rn ~c/Ld ~` ~ ~~~ y ~_ Attach complete pleas (to the County only) for the system oa paper act less than 81lL x 11 inches is size commerce.wi.gov i ^ ~scons~n Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LACROSSE WI 54601-1831 TDD #: (608) 264-8777 www. commerce.state.wi. us/sb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary July 14, 2004 CUST ID No.226900 SHAUN R BIRD BIRD PLUMBING, INC 100$ 192 ND AVE NEW RICHMOND WI 54017 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/14/2006 Identification Numbers Transaction ID No. 1017625 Site ID No 684757 PR-VgTE S 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. p~~ No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06 , stats. '' Drv~seow o~ SAfF SITE: ' P C Collova Builders Please refer to both identification numbers, 992 156TH St above,. in all comes ondence with the a enc . Town of Hammond St Croix County NE1/4, NW1/4, S18, T29N, R17W Lot: 7, Subdivision: Crick Bottom Overlook FOR: Description: New 3BR Mound Object Type: POWTS Component Manual Regulated Object ID No.: 962582 Revision; Maintenance required; 26 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/O1), Pressure Distribution Component Manual -Version 2.0, SBD-10706-P (N.O1/01); Zabel A100 Biofilter The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders SEE CpRR • This system is to be constructed and located in accordance with the approved plans and with the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0" SBD-10706-P (N.01 /01). • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual foc Private Onsite Wastewater Systems Version 2.0" SBD-10691-P(N.01/O1). A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of 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 shal] relieve the designer of the responsibility for designing a safe building, structure, or component. SHAUN R BIRD Page 2 07/l4/2004 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, ennis R Sorenson Wastewater Specialist ,Integrated Services (608)785-9336, dsorenson@commerce.state.wi.us Fee Required $ 60.00 Fee Received $ 60.00 Balance Due $ 0.00 WiSMART code: 7633 Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 1 ~~~Z ~~~ Date: 06/30/04 Owner: P.C. Collova Bldrs. Location:NE1/4NW1/4 S18 T29 N,R17W 992 156th St. Hammond System type: Mound System (Revision) Manuals Used: Mound Component Manual Version 2.0 (01 /31) Pressure Distribution Manual Version 2.0 (01 /31) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Conti ency plan 9-11. Soil test Shaun Bird Signature, License nury~er 226900 DACE $VST~M ~~ ~~ ,; ~, "~~y~~y µµy{- ..A I}~~1LFO~Lf~~ ~ `-~.~~, _ . PLOT PLAN PROJECT P.C. Collova Bldrs. Inc. ADDRESS P.O. Box 489 Somerset Wi 54025 NE 1 /4 NW 1/45 1 8 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROlX 6/30/04 BEDROOM 3 MPRS Shaun Bird 226900 DATE CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 450 # of chambers none BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 99.2' Alt. B.M. is top of Survey Iron B.M. * @ 97.0' ~ Property Line B-2 Grading is to be done to divert run-off away from system Property Line 97.5' ^ B-1 Scale = 1 /4" = 10' Well is to meet al! setbacks found in Comm. 83 98' 98. Area 15' below system is to remain undisturbed Huffcutt Combo Tank P.O.W.T.S. Conditionally Pro 3 ~~~~~~~~ Bedroo CEPARTMENT OF COMMERCE House _ 81~ OF SAFETY AND BUILDtNtis J SEE CORRESPONDENCE 400' Property Line Tank is to be properly bedded and provided with lockdown covers with approved warning labels 156th St. B-3 .. 5ynt~tietic Covering /4S f.~, `C' 3 3 Sand _~----.. r/ ~j Top soi I ----~ 3 ~E Signed: Sfope Bed Of 2y- 2 %2 Force Moin Aggregate From Pump Cross Section Of A Mound System Using A Bed For The Absorption Area i_icense Number: Date: r--- a Plowed Layer D ~ Ft. E _L Ft. F ~S'~t . ~ ~_ Ft. N E ,'- Ft , - Observation Pipe--.~ ~ ,~ f3 x it - - -- _ _ _....-------- --- --- - A ~~---------------------_ __------=_--~_.----------- j Farce Main i ~_ ,~ I Distribution ~ 8ed Of 2 - 2 %2 ( ~ ~ ~, i i pipe Aggregate I u,~~ 1 ~~ Observation Pipe Permanent Markers ~' ~~b jh' Sfcn C¢ f ~~fi t~~tr,., a,fl A ~ ~ Ft. B ~-~-~Ft. K ~-f Ft . L ' ~'.~ Ft. J ~_.!_- 1= t . ;~~ Ft. ~~ ~~ Ft . ~ ~ page - Of - istribution , Pipe C e!~ Pfan View Of Mound Jsing A .For The Absorption Area C/~ex ~oeoltd On iotlNn, Cq~snY •Ne~a IHIT M~{.s HI>tix'C t• CanAK}roe ~C. Sf fined License Number Date -- _...~.. F~. x ~ Inel~ei S ~.. Y _.,...~,_ i nchas~,~~j ~ Hatm Diameter ~f-~~ Inc!- latsra~ ~"~ Inch{as) Manifatd ,~`,,,,,z inches. Fprca Msin " ~ inches ~ of hcYeslPiPa Z ~ Invert Elevation of Laterals ~, Ft. PsrforestM4 R~P• Detaii ,. , £ Pt3MP_; ~~D S CRASS 5£cT%,.~---'- .. .r~ZK,QgBgvE G~DE ~ ~„ G~ SENT pZPE ~~dlNDai~ y ~~` ~RpH D4flR, 4~R ;~iTAKE ~~ ~~'~~ E ~' PI~~~:`~P~~~ ~ INLET LS i~iA'F£R TZG HT 5 E~°r a FtLTEF* '~ ~'"_ . B AAPi~~ ~ C p0liT0 SOLIt! ~yFF ELEu ~ ~,_.,._=~-FT - D SOIL p~HP ----- FCpTIOt~~ ~E&tNfRFR~F JJ ~CTCflhDU ICT W;Tip • Z• ~- S ~ ~ '. C,RS- ~ TIGHT j SEAL ~ '' i , 1 f ~ APFRQV ~D pL4AfNOLE C0~1Eit W/ F'AD1.~K ~ r wpRt~ING tABE.. ;Su MIM• ,,...~_ ~p ~~ IP FE 3~,IC SOII ~- R ~ a pppRO~~ BE~~~N~ tTi+TD~ TAN NCgETE pAfl 3 _ ~ ~"" c ~ c,,~ SpECZFIC~TZONS r.- f DER ;3P-Y = l ~p+SB~ COSES ,., ~~ Ci~~11+16 ~ CAL- SEP'rIC ! DQSE ~~£ v~~ME F~~gp=K: ~---•-"' i A1+iK I"1AI+IUFAC~REK : GAS . - A .., ~~ = ~ ~C'AL SEPTIC t. CAL- ;HCitES T -R 5~~. D~~ APACITI£5 ~ ~ GAL. 8 = ,,...~-- INCHES "---,,---"' ~~,NFAC~R~:' ~ Y-- j ~j~t,AL ALARn MODEL ~3~SER = '~'- C ~ ~„.. INCHES ~XTCB TYPE - FACTiJRF.R = ~ ~ P'ER I LHR 15.23 sd~ pDtiP ~~ L ~l4BER : - T K NZR Z t~ ~ Ssa1ZTCH TYPE= ~ pCl~fP ~ ~ ~''~ c ~ s FEET ,~I pN ,~P~ • FEE? RETIRED D2SCRARGE ~T'E DgSTgIB~ '~ EE1' CI: $E'~£Pg p~T~p fli F ANI3 • g'ACTOR • _ • ~ FEET v £R'FYCA L~ 3iET~ ~ + M NIMU w CR'K ~~~I# X ~~PT/ ~~ ~ ~pTAL ~ D~p-MET'£R 4 j'/ PuM~ L~~~~~ ' 11~'f£g~IAL DIMENSSOi~~ {~F _ 4A'~ E LICERS~ ~~$~~ •. 2188 3/- w w T07AL DYNAMIC F~tEAD/CAPACITY HEAD CAPACITY CURVE PER MaNUTE - ~ ~ MODELS "140/4941}° EFFLUENT AND DEwATER1NG Ft. Meters Gal. Ltrs. 5 1S2 91 344 14 45 10 3.05 8a 378 45 aS7 7fi 288 f2 ~ 14 ,4140 20 fi.1o ss 257 zs zsz s9 223 • 35 10 3p 9_ta a9 785 ~ - 35 10.67 38 t•a 40 12.79 21 79 S a5 13.72 5 79 2 p 7ACk vows 48' = 8 0 v 15 0 4 r OY 10 2 5 0 U.S. GALLONS 10 30 40 50 60 70 tr0 90 100 t t0 LITERS gp 160 240 320 a~ 0 ~fF10W PER MHUIJfE 070904 ~{ 1 CONSULT FACTORY FOR SPECIAL APPLICATIO S~ • Electrical alternators, for duplex systems, are avaiable and supper with an alarm. • Mechanical aitt3mabrs, for duplex systems, are avaiable with orwffhout aharn~. • Control alarm systems are available for 1 phase pumps used in simplex system. See FM0732. • Variable lave! control switr~tes are available f+~' controlling sfigle phase ~~• • Datb~ piggyback variable level float switches are atr~able for variable levet tong cycle controls. • Sealed Qwik Box avallab~ for outdoor irtstagations. See FM1420. • Over 130°F. (54°C.) special quotation required. • Refer to FM0806 for 200° F. applications. ?40 Series - 53 (bs. 4140 Series - 73 lbs. t40/4140•'• tiIODB.S Co-d<oi ~~" Alodel Model VoI~Ph Mods Amps D N140 N4140 115 1 Mort 15.0 1~1&5 2or3&4 E740 E414Q 230 1 Non 7S 1 or 1 & 5 2or3 84 eN140 BN4140 115 1 Non 15S tort&5 2or3&4 BE140 gE¢1g0 pD 1 Non 7S 1 or 1 & 5 2 1x3 & 4 b~i SEE.ECTlON GUIDE 1/2 CSR SK1524A 1/z rwr sKt~e t. Sirgfe piggyback var4abie level float swddt or douse piggyback variable levc float slNiodt. Reterilo FM04n. - ~._. 2_ Mechanical alterr-ator M•Pak 10-0072 or 10-0075. 3. See FM0712 for correct model of L3ectrical Afternabor E-Pak. 4. Variable level control switch 10-0225 used as a control activator, spet~fy duplex (3) or (4) float system. O CAU7iON Ai! instat}ation of controls, pro~ction 4revices and w"v1n9 sttov}d be dpne by a qualified licensed electritaan. Ai} e}ectricat and sttt~y codes should be 9otbtived including the most recent National Electric code {NECy a4ta the occupational s°-tety and Health Act {OSHAI. ~ESE~VE P~1~ERED QEStGN For unusual cronditions a reserve safety factor is engineered into the design of every ZoeNe~ ptxnp. MAK Trk P.O. BOX 16347 ;~;~ tot;~nAe, KY 402560347 Nrrersof.. SN~TO: 3849 Cane Rtln ROed ~ o Louist~e, KY 4029)-198f yP ~,q~ ,~~ ~O . ® ° (502) 778.2739.1(8 928-FUME ® Copyright 2001 Zo~ler Co. Ail rights reserved. ~"Single~Seal Desigrt~' ght 53 lbs. ~ (=/l O N ~ ~ ~ N e~i o ~' cn O ~ Z N in D o. c ~ .+ Z O 0o I'0 a Ic ~ ~ 1 C 7 O s m m c m 3 7 Ul N d .N ~ O. ~~ O d ~ N O j N V p~_ N N fD O1 m N O 7 N O o° ~a n y 0.'' °c ~ F 3 ~ ~ i ~ ~' ~ ~ i 3 ~* o ~ -o j n ~ O O m W', ~ N ~• a', 5_ o. ~ i~ a ~ N Ut ~ N U1 rn O O O ~ 2 v N ~ y ~ o G ~, ~ aC y < 3 °-' A ~ o cn ~ ~ ~ ~ o- c a a 0 3 0 m N C O' fD O ~ ~ a C •'•' 3 !~ Z f W G T C 7 a 3 ~ o 3 n 3 ~ ~ m _ -~ o N ~ tNO N O '' O V a ~ w a o b s o 3 0 y o -o' y O C 3 :'• Q .. ~ v n A W O O g x j A Z O .a 'A ,~ ' `A Z O .. ~ O m ~ ~ z A .Z1 Z ~~ A ~_. ~I O O L7 ~• 0 !O N v ~' O C fi ~~ ~v N O O A A K ti d0 O to '"~ O ti ., Wisconsin Department of Commerce Division of Safety and Buildings w SOIL EVALUATION REPORT Page 1 of in accoraance wnn ~,omm a~, vvis. ram. t,cwe County ~ Plan must er not less th n 8 1/2 x 11 inches in size h o l t sit l o Att ~ . c an n pap a ac mp e e e p indude, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 1 _ _ ~ ~ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ~~ o~-~ ~ 3 ~ ~~~ Please print all information. Revi a Date Personal iMormaUon you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~ 7 °~ 4 Property Owne ^ ` ~ ~ Property Location c' l j ~ (7 ~~ Govt. Lot ~ N R E (or W T ~ 1 /4 /4 S Property ~ptner's Maili Address y ° ~' °_ ~ ~ Lot # Block # . Naj~ or M# `' City State Zip ode I?~1on m~0!f. ^ City ^ Village Town Nearest Road New Construction Us Resi tial I Plliitib~edlYe~~bms Code derived design flow rate GPD ^ Replacement ^ Public or Comm aal -Describe: __._~___ -- Parent material S Flood Plain elevation if applicable/ ~ ~ ^ ft. General wrrxner>ts ~ ~ (~ n ~ i and recommendations: l l/ ~ Ss.,.S~ ~.,. Boring # ^ Bonng ~r~AG r j .Pit Ground surface elev. 'C/ ~ T ft. Depth to limiting factor ~ in. Soil licatron Rate Horizon Depth Dominant Cdor Redox Description Texture Structure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Cdor Gr. Sz. Sh. 1 'E~2 Z- - ~ ,~ ~ r~ ~~ ~- ~ 3 C~ 0 ~ ~-- vo~-~- ~i1 ~ I ) ! B~~ # ^ Boring (,~ ~ ~ ~ ~ 1 _ l ~"'1 ,Pit ~rouno Surface eiev~~- tr. uepm to ummng racror v ~ m• Soil lication Rate Horizon Oepth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#2 { 1 ~'~ ~ ~~ 3~ L -°-~ ~ r t 3 b CJ l'dl C ~ 0 r - vw.- ~,/ 1 lA- Nl.>¢ • Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 'Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Sig re CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address ` Date Evaluation Conducte Telephone Number 1008 192nd Ave, New Richmond, WI 54017 ~ ~ ~ ~ ,,_~ /~ 715-246-4516 ~, Property Owner Parcel ID # Page of Boring # Boring it Ground surface elev. ~.~! ~ ft. Depth to limiting factor ~_ in. Soil liption Rate Horizon Depth Dominant Color Redox D~3scription Texture Structure Consistence Boundary Roots GRDIft; in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Efl#2 -z~ ~-- S n Boring # ^ Boring l_J U Pit vrouna sunac:a Cmv. i r. ~oNu ~ w un uw ~ ieuv~ ~~ ~. Soil ication Rate Horizon Depfh Dominant Color Redox Dexcription Texture Structure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 ^ Boring # ~ Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate Horizon Depth Dominant G31or Redox Description. Texture Structure Consistence. Boundary Roots GP D/fF in. Munsell Ctu. Sz. G3nt G31or Gr. Sz. Sh. 'Eff#1 'Eff#2 'Effluent #1 = BODE > 30 < 720 mglL and TSS >30 < 150 mglL 'Effluent #2 =GODS < 30 mglL and TSS < 30 mglL The Department of Commerce is an equal opportunity service providec 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. 580.8330(8.6/00) Soil Test Plot -Prd'Ject Name P.C. Collova Bldrs. Inc. dddress P.O. Box 489 Somerset Wi 54025 Lot ~ Subdivision Crick Bottom ~ ird >TM #226900 6130104 NE 1/4 N W 1/4S 18 T 29 N/R1 ~ W Township Hammond Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post System Elevation 99.2' *HRPSameasBenchmark Alternate Benchmark Top of Survey Iron @ 97.0' Alt. B.M. is top of Survey Iron , , ENT Pl.l~N . QoWTS oYYNER~S MANUAI.B~ MANAGENt SYSTEM SPECIFtCAT10NS SePt+c Tank t;aPa~Y F[LE lNEORMAT[ON 0 ~ ~. optic Tank ~u{acxuter ref p~,it ~. L-/ ~3 3 ! `~ Effluent F1ter Manufacttirrer Ntarnber of g~r+ooms Numbef of Oo~~l Units Estit floes (aveca9e) Des19n tfotiv (P~~~ (Espmaot son PwP~On Rate ._•---_ - ~~ Efl9uent Filter-Model `~ ti ldA . Na Pump-Tank CapadtY aVd pump Tank Manufad:ut`er .Pump Manu~~r x 1.5) ~ .>~ .a1/d I - j.~ aUd ~ PumP Model < a pfetreatment Unit Inftuet[t/E~~ Quality Fats..0il ~ Grease Biochemlcel Oxygen Demand Total Suspended Solids Pretreabad went Quality ' Biochemical Oxygen Demand Total Suspended Said Fermi Coliform (geometri Maximum Effluent Particle Site MonthtY average ~pG) 530 m9n• (80Ds) 420 mglL ~Sg) 5150 n- Monthy average" (SODS) S30 mgt 530 m9 (rSS) mean) 510' cfull QOmi s c ya inchdiameter a sandlGm~ t=rlter O Mechanical Aeration O Disinfection Pags~~ 7! ai [7 ~ tHA D AIA ,,.- ~-•~~ O NA 6.3 ~ ,9at o ~ H1A ~,,/p NA i~ ~~~ O Peat Fllfsr O Wetland p Other. Dispersal Celt(a) ^ In.ground (pressurized) O In-ground (gravity) ound O At-grade ^ Other. Values typlcar for domestic (non~oomrt+erc~n wastewater end ynk eRiuent~~a~ std ical for v wastewater. .~ Values typ Service Fregve Service Event inspect cond'Non of tank(s) Pump out contents of tank(s) Inspect d~pef~ Oett(s) Clean effluent filter inspect Pump' pump O°ntrots 8~ alarm Flush laterals and Pressure test ^ moms At Least once every _. oats When combined sludge and scum e4 At feast once every At least once every At Least once every At least onus every At least once every At least once every D months ^ months ~~ D months ' p monfhsL O ;) (Maximum 3 ym•1 (y~) of tank volume ~ear(g1 O NA ear(s) ~ NA a year(s) DNA p months fl year(s) O tVA `~"°`' Licenses or tgtAil'[1•ENAi~~ INSTRUCTIONS an individual cat'rYing one of the fotlowiMngaintainer, Septa9e t setts shall be made by r ppWTS lnsp'e~o[': P01N~any missing or brotcen Of tanks and dispe~ r Plumber Restricted Sews g to iden8ty Inspections plumber Masts on of the tank(? for any back uP motions: Master ns must include a visual inspedi and ten, and to sheds tor. Tank insped~ to check the effluen S ~ , ~ ~y mocks or leaks, measu, ~e Qispersai oelt(~s) sh~l~~t~ ualty inspected wing of effluent o ~ s h round surface- round surface- '>~ P° authorit~~ ~ ~~ng pf effluent on the 9 for any ponding of effluent or[ the 9 Lion of the local regulatory in the observation P~ and to ctredc wires the immediate nott~ cord""Rion and ~ uals one-third (K) or mofe of ~ rank volume NR ground surface may indcate a fa7ng e and scorn in any tank eq Sed of in axordance'~' When the combined aa7umulation of sludgy by a Septa9e Serviang Operator and dispo entire contents of the tank shall be remov retreatfr»ent components, and any 113, Wist~nsln Administrable Code• ~ onents, P a certified PODS Maintainer. e servicing of effluent filters, mechanical or Pressurized POWTS comp ~rtned aY . Th is of 12 months or less shall ~ ~ of oompienon of arty service event. other maintenance or monitoring at intetva - within 10 days k ~ repent sha~l'be provided to the local regulatory authority roduds or other s for the presence ~f painting p STARTUP ANO OPERA7'lON g sheds treatment tank() ersal cell(s). tf high concentrations are For new construction, Poor ~ use °f the POr~ess and/or damage tfie tliSP nor to use_ ~' a the treatment emoved by a septage servicing operator p chemicals that may Ped detected hate the contents of ffie tank(s) - Pa4e-~-.°f--~- ~^`` r ~~ ~l~conditions are frozen at the infittrative surface- ~ ~~ ~ ~~ ~ysbem start up shaft not oxu 9bove nom higttnratec tevQis. When P~eC • sand may result in the es Pump trartks rrtiay ~ e dose, overloading the ~( ) During vower °~g teat oell(1s) in one lar9 cin't -tank removed by a w,-u be d'~changed to the d'ssPe '^~~~ dace d~eharge of efA~sas!t: Te ~O~ this situation have me ~n~~d $ Plttmt~er or POINTS Maintainer to backup ,mooring Power ~ the effluent pu P um tams Sef~9e Ser~n9 pperatoc prtor m..pontr~ fo reStorB norma- revels within the p . P assist (n martualiY aP~'ting the R P feel Dells. Oo not dnve or park over, or ot~erwtse disturb or compact; Do not drive or pant vehicles ~~ ~~ 8nd dispe vvithln ~5 feet down slope of any mound or at~grade soil absorption area. a rfcrmance and prolong the life the area ern the wastewater stream may impr~e th Pe rte butts: condoms: cotton swabs: de9~ denial Hass; diapers: Reduction or-etuntnatton of the tolfowtr-S efin s asotin~e; grease:~ herbiddes; meat of the POVYT'S: antibiotics: ~babY ~!'dPeS~ water iruft and vegetable pe g = ~ r saftenef brine. dlsinfec~attts: ~ fourrdatbn drain (sutnR P pes)fici, des: s~ar+itary napkins: tampons,'and ware ~~- medi~ons; olk painting products; - anently.taken out of service the for[awln9 steps shalt 4e taken to insure that the ~~ ~ pOWTS faits and/or is perm yysconsin ActminisCaWe Code: ~~ ~ Pro~dy-and safety abandoned in compliance vvfth ch- Comm 83.33, nin s sealed. to tanks and p'1ts shat! be disconnected and the abandoned Pipe ot~e • ~ PIP~g d its shall~be removed and properly disposed of by a Septage Servicing Operator. .. The contents of a[[ tanks an P after umping, at[ tanks and pits she![ be excavated and removed or their ~,rers removed and d'B void space P ~ rave! or another inert solid material. filled with soil, $ CONTiNGENGY PLAN ~~ the following measures have been, or must tie fairer. to Provide a code if the POWTS fails and cannot be rep compliant replacement s~~m- coon and should not A suitable reptaoen~ent'area has been evalshould be prof tedbfrom disturbance and ~mpalaoement soi ~ tacement area. absorption system- The rep from .existing and proposed structure, lot tines and wells_ Far ure o be infringed upon by required setbacks rotect the replacement area wiA result in must comply with theiru es nteffect at that time~b~ a suitab e P replacement area_ Replacement systems suitable replacement area is not available d a last resort o r place i~ failed POWTSn9 advances in PO ~ be installed as ethnology a hording tank may n failure of the POWTS a sod.an e site has not been evatuabed to ktentlfy a suitable replacement area. Upo ' evaluation must be Per{ormed to rotate a' suitable replacement area_ if no reptaCernent area is available a. o(ddng tank maY be installed Ss a last resort to replace the failed POVYTS_ removal of the biomat at Mound and at-grade soil absorpt7on systems may be reconstructed in place following • fittiratNe surfaoB< Reoonstrudtons of such systems must wmpty with the mien rn effect at that time. <cWARNING}~ TANKS MAY COfVTAJN LETHAL GAggEg AN~lOR INSUFFtC[ENT OXYGEN. SEPTIC, PUMP AND OTHER TRFATME~ CIRCUMSTANCES. DEATH MAY 00 NOT EN'T'ER A SEPTIC, PUMP 4R OTHER TRFA'TMENT'fANK UNDER ANY RESULT. , RESCUE OF A PERSON FROM THE iNT'ERIOR OF A TANK MAY BE DtFFlCULT OR IMPOSSIBLE. ADOCTIONAL COMMENTS . POVYTS MAlNTAiNER POYYTS INSTALLER Name ,uti- ~~I Name r''' Phone ~~ '~ Phone f „T"-- ~ -" .~ V(CING OPERATOR PUMPER LOCAL t~EGULAT'ORY AllTH4RCiY SEPtAGE SER Agency ~ ~ < Name ~ ~~~-- Phone ~/.J`. Phone i ~ Th>s dpcament meets n t~tce. Marquette and Waushara County Zoning and S_ttr-itatioa;agendes. TTtis oowmoM was dialled try. the stafrts of the Gree ~ Ccde_ Use of this Oocoment does not the minimum rbqu'uemantS of t!t Comm 83.2?(Z)(bXtX~~(fl at+E 83.5s(f ), (2) 8. (3). Wuoonsin AOmtn)sUati+re GMw (7101) guarantee the performance of the pOVSft"S. Safety and Buildings Division 201 W W County ~ / n ~ ` / ~ - "~ . ashington Ave., P.O. Boz 7 162 ~ ~ ( ,~ ~~ i~S~ Q~S ~~ Madison, WI 53707 - 7162 Sanitary Permit Nun~er (to be filled in by Co.) Department of Commerce (~8) 266-3151 ~ Sanitar P it A li sraian I.D. Number y erm pp cation In accord with Comm 83.21. Wis. Adm. Code, personal information you provide -~ ~ / ~/~Jl~-S /. may be used for secondary purposes Priivacy Law, s l S.oa(ixm) ,~~„„ Proj Address (;f different than mailing address) I. Application Information - PI Informatio ~' "" ~~ ~ ~ ~ Property Owner's Name ~ ~ ~ 2 ~ Parcel # Lot # Block # property Mailing Addttxs ~ ~ , ~ .. ~ Property Location ©/~~ oZ-~ 3 - D "~- - ~91~1 S i City, State Zip Code Phone Nu ect on ~- C ~ ~ // ~ ~N: LL~E r W T II. a of Bui1 ' check all that a T3'P ~ ( PP . Subdivision N CSM Numbex Family Dwelling - Number of Bedmo ii f 57 OYI PublidCommet¢ial - Describe Use /~ ~ i-, G) f/ State Oarned -Describe Use ai . S-' City ti/illag+e ownship of IQ. T ype of Permit: (Check only one boz on line Complete line if applicable) A ~(ew System ~-a- Replaoranent System reatment/Hol Tank Replacement Only Other Modificstioa to ' B • Permit Renewal Permit Revision of Pernrit Transfer to New vio Befon: Expiration Plu Owner IV. a of POWTS S : ( eck all that a 1 Non -Pressurized 1n-Ground ound 2 24 in. of suitable soil ,' < 24 in. of snitable soil At-Grade Single Pass Sand Filter Cotutntcted Wetland Pressurize n-Ground Holding T Filocr Aerobic Ttcanautt Unit Recrrcrtlatiag Sand Filter Recircu Synthetic Media Filter Lsaching Chamber 'p Litre Gravel-less Pipe Other (explain) V. rsal/rteatment Area Information: Q/}P~- G S Desi ow (gpd) Design Soil Applic~ti Ra f) ~N S 1 ~ s Area (sf) ~ ~7 .Dispersal Area Pro ~ System 'on J ~~ ~ v ~ ~~ Sao ~~i VI. Tanis Info Capa« in Total Nu M Site Steel Fiber Plastic Gallons Gallons of U 'ts Cbnctete Coostrucoed Glass New Existing Tanks Tanks Seplira Holding Tack ,y~~ G~~~J Aem6icTreatmeatuait ~~ ~` Dosing t~a,trber -"' ~ ~_ VII. nsibili Statement- >y the and a bility for installation of th WTS shown on the attached Plumber's N (Print) Plumber' MPIMPRS7Number ~j ~' ~ Bu gess Phone Number /si fin r ~~ ~P/ 4., / ~V / ' / / / cJ~~ ~~ ,~ Plumber's Address (Street. City,.S/tate, Zip. ) ,~ n / J~ /~ / / 1 ~ VIII. Goan 1'De at~ment Use Otil A~l~ Sanitary Permit Fee (irrctndes Groundwater Surcharge Fee) ~-~t Ud ~ 3 , U Date ~ / S ~ Agen Signature ) ~ Owner Given Reason for Denial ` '-~ ~ ' IX. Contlitions of App ~~fiU~~ A ~ ~ ~~y~r~l~ y~'lQ:~~" ~---~/L„~ _ ~_ G~~2~~ /~~i~ SYSTEM OWNER: 'GC.~L ~'~f ~l ~0~'tT~++ _ v// (f d 3 ~~ 1 Septic tank, effluen filter and `'71?~t.~-~ ~ j• ~ ' dispersal cell must all be serviced /maintained ,3 as per management plan provided by plumber, t-~t~y,~ ~ s-~¢~~ -~d~'~~ 2. All setback requirements must be maintained ~~ ~~',/„ „r/- /~ ~-~~ as per applicable code/ordinances. ~I~-''"`~~ 2~ 1.J Attach complete plans (to the County Doty) for the system oa paper not less thus illZ z It inches is size PLOT PLAN PROJECT P.C. Collova Bldrs. Inc. ADDRESS P.O. Box 489 Somerset Wi 54025 NE 1 /4 N1N 1 /4S 18 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX 6!2/04 MPRS Shaun Bird 226900 DATE CONVENTIONAL AT-GRADE CONVENTIONAL LIFT MOUND )00C SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 454 # of chambers none BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE O WELL *g,g,p, Same as Benchmark SYSTEM ELEVATION 103.5' 1 ~Ot~ssy Property Line Tank is to be properly bedded and provided with lockdown covers with approved warning labels 1 B-1 Grading is to done to divert run-off away from system B-2 Huffcutt Combo Tank ~ ~- Ib2' '_102' 101' BEDROOM 3 HOLDING TANK B-3 7% 102.5' B.M. Alt. BM. is top of 2" pipe @ 100.0 329' Property Line Area 15' below system is to remain undisturbed 156th St. Scale = 1 /4" = 10' Pro 3 Bedroom House Well is to meet all setbacks found in Comm. 83 • commerce.wi:gov i ^ ~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 June 11, 2004 CUST ID No.226900 SHAUN R BIRD BIRD PLUMBING, INC 1008 192 ND AVE NEW RICHMOND WI 54017 .4TTN.~ POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/11/2006 Identification Numbers Transaction ID No. 1006854 SITE: Site TD No. 684757 P C Collova Builders Please refer to both identification numbers,. 992 156TH St above, in all comes ondence with the a enc . Town of Hammond St Croix County NE1/4, NW1/4, 518, T29N, R17W Lot: 7, Subdivision: Crick Bottom Overlook FOR: Description; New 3BR Mound Object Type: POWTS Component Manua] Regulated Object ID No.: 962582 Maintenance required; 24 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/O1), Pressure Distribution Component Manual -Version 2.0, SBD-10706-P pt~0 (N.O1/O1); Zabel A100 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, stats. The following conditions-shall be met during construction or installation and prior to occupancy or use: Reminders • This system is to be constructed and located in accordance with the approved plans and with the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0" SBD-10706-P (N.01/01). • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD-10691-P(N.O1/O1). 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. SHAUN R BIRD Page 2 06/11/2004 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. incerely, ~~•~9.--,--a.~, Dennis R Sorenson Wastewater Specialist ,Integrated Services (608)785-9336, dsorens on@commerce. state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WSMART code:. ?633 Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 06/2/04 ~ 0 0 ~''' ~' `~ Owner: P.C.Collova Bldrs. Location:NE1/4NW1/4 S18 T29 N,R17W 998 158th St. System type: Mound System Manuals Used: Mound Component Manual Version 2.0 (01 /31) Pressure Distribution Manual Version 2.0 (01 /31) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Contigency plan 9-11. Soil test ~, Shaun Bird Signature License number ~~ '~F ~'~ ~~ ~ ~ goo ~ ~~~ o~ °~s,/~ 4!~i f ~~~~~~~~ ... i ~~a~~~ r ~~Ir~y ~m~~ ~iJ13;~~~6~Cs~ ~ ~~-~--- CGr~i~~S~'Oha~E~VE ~. , PROJECT P.C. Collova Bldrs. Inc NE -1/4 NW 1/4S 18 /T 29 PLOT PLAN _ ADDRESS P.O. Box 489 Somerset Wi 54025 N/R 17 W TOWN Hammond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE6/2/04 BEDROOM 3 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 454 # of chambers none BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE O WELL *g,R,p, Same as Benchmark SYSTEM ELEVATION 103.5' r l~Q~? '''`-~ ~~/ Property Line B-i0~3' ~ 102' 101' Grading is to done to divert run-off away from system Tank is to be properly bedded and provided with lockdown covers with approved warning labels B-2 Huffcutt Combo Tank ] B-3 7% 102.5' B.M. Alt. BM. is top of 2" pipe @ 100.0 329' Property Line Area 1 S' below system is to remain undisturbed Pro 3 Bedroom House 156th St. Scale = 1 /4" = 10' Well is to meet all setbacks found in Comm. 83 ~°".~e ~ ~ ~` Ate'' ~w~ ;. ~$A~ ~ ~ ~ x ~. ~ ,, , Designer Date .~`.. ` No Y Non-Woven Filter Fabric 4" Observation Pipe Perforated Below Filter Fabric ASTli C-33 Sand -~ ~, " Topsoff _~ 7. S(ope Distribution. Pipe iN F4rl:t tJ.oin From Pump G Ffowed (_Cyer 'P i '~ l,~/, F ~J G f ,, K ' ~~ E 6 e d O f ~`~- 2 %Z Orain Rock Gress Section Of A Mound Systtm Usin A Bed For The Absorpt~onQ'Areo q U_ Ft. ~~/ Ft rF ~ ~ k r ~ ufo s I 13 ~ 'L Ft . ~ ~ tih~A- - ~ , ~ Ft. /ab~~ __ ~ ~ Ft. w~~~3Ft: J1~ °' A n. 0 W = - 3 0 I ___--- f_ q,"Observotion Pipe`~~~` is _.. ~ -- - - -- - - ---- ~ .- K r-.~. - ^ ------------------------------- ~ - . j 1 j Force Mo(n ~° _. _..{.~__..~~_.~.,_ --_ .__..___.... From Pump Distribution Bed Of i2~- 2'2 pipe ~ Drain RocK ~„ 4 Obcervetion Pipe=-:~~;~.~' permonent Morker ~5~~..~'' ~ ~ ~ ~rv,~sv ,bv~-.~,.~.~- ~ p e o r Rod s Plon Yiew Of Mound U>r(nq A Bed for The Absorption Area PAC e_..,~.oF /~'rz Located On 8otton+. Egya~ty SPOCea tti9T 130l.L AItiXT T6 Cd111tC}~Df1 ~t. ~~. Signed: i.icense Number: Oate: X Inc~es Y Z~ Inches Hole Diameter ~ Inch Lateral ~" 2 'Inch{es) Manifold 2 Inches Force Main Z Inches # of holes/pipe_~~ Invert- tiev~tior~ of Laterals ~Y~Ft.-. Q~~,~~ Pes4oroled ogee Detoil t ~ ~' • ~ ~~MP fl ccFTIG •f~K £ .._..- ~ AND SP£s. ~f TcaT~oKS C~ t?S S ~ E~ ~' ~' „ iSZK "4~SOyE .GRADS ~ ~„ C~ VENT PIPE ~'i~INi}D~l y ~II~ FR4H D40R • ' ALA ;MTAiC~ ~l'~'~ pY~~ : , - 8~ ~#_' o ~~.... I YNLET 1 - -- ~ . 'T`IGH'T 51.5 FiLT~R ""~...-~- ~C~~ P~ 3~QLi0 ~` " v FT- SOIL pUI4P ~}E'F £L~ • r.-- B ~~ D yIEATH£~tPR~}OF AFFRQV ED JU NCTI ~~ $flX ~~{pLE CDY EA ia~TH C4~~LiIT W~ PpDI.~K {{~ r ~AR~iNG ~~Lr ~ - -~c" Hhi - - i. a. , ' ~~u MSN- : = s T ~ • 3 . s GA5- r ~qp{~f£~ TIGHT r t )OIiiTS Mi7H sF.AL '• A~„s . ~ppROYm PIPE ' 3 ~ ' t?N ~ y IL { r • S Y ..w BEBBT3~tG UI+~D~ TANR~~ j~_ „ ~„11tCiIETE PAfl ~~ 1+,pPRO~~ l SPrCTFICA?IONS ~ . DO'S ES P'~ 'pA-Y = ...---------' 3+Ni'l5yR ~~ ~s S£pTSC J DOSE ggB: DOSE Y~d~ME ~N~ggCK~. J~--'~'~GAL-~i ?A3+iK 34AI+RlI'ACZ7l CAT, =~6AL- SEPTTC O~ .--- 6Ay- ~!~ `~Z3~ICi~3E5 T111t1C ST2£S = DQSE CAPAC~TZ£S= A = `~ t~ GAL- 2 INCHES ~~----- AY+ARN ~~i~~$ER~= U ~~ ~ _~--.~ INCHES ~..-•-~ -- H r~x1'CR q'YPE • ~'L t/ C s ~~ 5 C~-1'. ~FAO.1'~JRF.R = ~ L ~ - D = ~~ 15.23 WAC PU. Kg N~£L ~i"[gEg • q5 PER ~;fig TYPE= ~ PCti~iP ~' RLARM i,,ITRI~G FEET OPt~i 4ZPE DTSCHARGS ~''?E DTSTRIBU'Ei~ RE4ti+IRF~ £EK ptt24P fl~'F AAtB - gp,CTOR ' = •/,~~rFEET C£ $£T~ pREgsUR~ -FN;CTTQN vERTTGL a;FFER'~ >3 .Tl1G~.F?• 7'fN~;C Hr~ '~ + MIH11"lUli FE£ ~FORCEli1~i;H X ~-,-- TflTAL ,„ ?iAMET£R .~--•-- FUG' T~K' ~~~i3ID ~~r• ~-=-"'-` . INT£R~AL OIMENSIDI~~ ~3F STGPtED- _ L.ICEI~Sz. ~M$~ -. 4 AT E = -.--""-------~ '18$ ~ • HEAD CAPACITY CURVE MODEL 152/153 w 4i ~~ 50 153 12 40 152 °a W _ . ~, 30 z 8 r 0 20 0 4 10 0 20 40 60 80 100 GALLONS LITERS 0 80 160. 240 320 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS • Timed dosing panels available. ~` " • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik-Box available for outdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. 152!153 Series 1521153 MODELS Control Selection Model Voits•Ph Mode Am s Sim lex Du lex N152 115 1 Non 8.5 1 2 or 3 BN152 115 1 Auto 8.5 Included 2or3 E152 230 1 Non 4.3 1 2 or 3 BE152 230 1 Auto 4.3 Included 2 or 3 N153 115 1 Non 10.5 1 2 or 3 BN153 115 1 Auto 10.5 Included 2 or 3 E153 230 1 Non 5.3 1 2 or 3 BE153 230 1 Auto 5.3 Included 2 or 3 O CAUTION All installation of controls, protection devices and wiring should be done by a qualified licensed electrician. All electrical and safety codes should be followed including the most recent National ElecVic Code (NEC) and the Occupational Safety and Health Ad (OSHA). - TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE EFFLUENT AND OEWATERING I MODEL 152 1S3 Feel Meters Gol. Liters Gol. Liters 5 1.5 69 261 77 291 10 3.1 61 231 70 265 15 4.6 53 20 t 61 231 20 6.1 44 167 52 197 25 7.6 34 129 42 159 30 ~ 9.1 23 I 87 33 125 35 10.7 -- - - 22 85 40 12.2 ~ -- -- 11 42 Lock Valvz~ 3fl.0 Fi. (11.Em) 44.0 Ft. (13.4m)i ,. 3 ~ 7/3 iz ,/s i _L__ SELECTION GUIDE 32 32 3 sKZOea 1. Single piggyback variable level float switch or double piggyback variable Level float switch. Refer to FM0477. 2. See FM0712 for correct model of Electrical Alternator E-Pak. 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) or (4) float system. RESERVE POWERED DESIGN For unusual conditions a reserve safety #actor is engineered into the design of every Zoeller pump. MAIL 70: P.O. BOX 16347 Louisville, KY 40256-0347 Manufacturersof. . Z - ' SHIP T0: 3649 Cane Run Road ~ ~ >:' ~~` ~ ® Louisville, KY 40211-1961 (502)77B-273f • 7 f800J 928-PUMP Q~~/rrPuMas Sacf /939 hitp;//www.zoeller.com ~ ~ `~MP !O. FAX (502) 774-3624 © Copyright 2000 Zoeller Co. All rights reserved. ,~ a l f ~ , ~Vlrisooruin D~artrnent of Commerce Division of SafeH and ermldrms SOIL EVALUATtON REPORT Page, of in accordance wlm c;omm ts5, wis. Aam. woe ~ ~ j ~ Attach complete site plan on paper not less than 81/2 x 11 inches s¢e I V E ` irxau~. tart not limited to: vertical and n«izontal refererK:e poirrt ( percent slope, scale ~ dimensions. nortii arrow. and location and >, fence to nearest road. I.D. Q Ig' - 2()t) ~ - O ~' - Ctfl'O . q o I • Please print alt tnformatfon. M qY 0 1 2 0 0 Rem ~ Date Personal irdonnafion you Proride may be used fa secondary Pu<P~ ~ t.aw, s. 15.04 (1) (ml). ~ • L~ Ptoperiy ONmer ~ j ~ ~ FAT Y ~ 1/4 S ~ T N R E ( W • t7 / © ~ ply pwn~ ty~ug /~dr~ n ~ .u( t.ot # Block # "" Name or CSA~ iG qty State 2~ Code Phone Number Oily ^ Ytiage Town Nearest Road New Construction Use: / Number of bechcoms Code derived design flow rate •~ ~ GPD Parent material f ~Jgod.~~d a~~~~Ucanble^ ~~d _ R _7 ~ ~TiPn,l.. 'f"L./Y iIIJG! ~ lei ~.A/U I '~ 4.9~ ~ ~ '•O1 ~'~`f/ 7~YJ~ Boring # I Pit Ground surface elev. ' ~ ~' ~ tt. Depth to tirr tacror~ Rate - Soti Fbrlaon Depth Domirtmrt Redox Description Texture Strtx~txe Consistence Boundary Roots GPDAP in. Munsep (~u. Sz Corrt. Color Gr. Sz Sh. 'EtT#1 'EB#2 Pit Ground surge elev. R Depth to timrting factor ~;~~. Soti Rate Ftorizon Depth Dominant Cobr Redox Desaip4an Texture Strtx~ure Consistence Bourxiaryi Roots GP D11F in. Mansell Au. Sz Cont Color Gr. Sz Sh. 'Etf#1 'EffsR2 1 i 0 r 3/z •--~'~ S c a~ Y M Fie c 5 a m • S ~ ~- ' .~- f b r shy S C ~ ~ / w / ~ , ~ ~ Ettkient fkt = BOD > 30 < 220 mgA_ and TSS >30 < 1 ' tfltuerx iu = tiw _ su mgrt. ana ~ ~ _ ~, «egr~ C~~~~(please p~ CST Number i• q Date Evakration Conducted Telephone J < ~ OWner 1 l i ~~ # ~~j ~~ ~ °+-7 Parcel lD # / ~ Page v of,~ R ......u.........aw v.a - .a. vvFru. w w~uwy ~auu~ - SOd Rate Horizon Dominant Redauc Oescxiption Texture Stnx~txe Boundary Roots Gt' OIfF in. Munseq Qu. Sz Conk Color Gr. Sz Sh. 'Efl'#1 'Eft#2 Z :~, ~~ ~- r ~ F' ~ I F ~ S ~~ # ^ i3arin9 ^ Pit Ground surface elev. tt. Depth to 9 factor ~. Sod Rabe Horimn Depth Dominant Redox Destxiption Texture Sb'cxxu<e Ca~sistence 8oundan+ Roots GPD/iP fn. Munsed Qu. Sz. Coat Color Gr. Sz Sh. 'EtT#1 'Eff#2 Boring # ^ ~~ ^ Pit Ground surface elev. ft. Depth to g factor in. Sod Rate Horizort Depth Dominant Redox Description. Texture Struc4xe Consistence Bourtd~y Roots GP DIfP ~. Munsed Qu. Sz. Carrt. Cobr Gr. Sz Sh. 'Eff#1 'Etf#2 ' F-ftlt~t #1 = BODs > 30 < 220 mg/L and TSS >30 < 150 nIgIL ' EtflueM #2 = BODs < 30 mgA.. 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 alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. sou-s~wcseao~ ~ r .:. Project Name Soil Test Plot Plan P.C. Collova Bldrs. Inc. Shaun Bi Address P.O. Box 487 Somerset Wi 54025 ~ Lot 7 Subdivision Crick Bolton Date 12/4/02 900 1 /4 NE 1 /4S 18 T 29 N/R17 W Township Hammond Boring 0 Well PL Property Line County ST. CROIX ~or VRP Assume Elevation 100 ft. ~ Top of Survey Iron System Elevation 103.5' *HRpSame as Benchmark / ` '' ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer P. C. Collova Builders, Inc. P O Box 489 Somerset, WI 54025 Mailing Address Property Address ~ ~~ (Verification required from Planning Department for new City/State ~~~ (~~ Pazcel Identification Number ~~ ~ - ZUO 3 - ~ 7- ~~ LEGAL DESCRIPTION e 9~ ~ i Property Location %,, ~ %,, Sec. ~~ , TC~ N-R~W, Town of ~-lA.-'V~-/1'ib~"~C'.Q Subdivision _ ~/~~I(~)K ~C~~(1 ~ Lot # Certified Survey Map # Volume ,Page # Warranty Deed # __ G2 ~~ ~~~. Volume _~~ ~ .Page # -`)~4 Spec house l~'yes ^ no Lot lines identifiable Q yes ^ no SYSTEM 1<'IAINTENANCE Improper use and maintenance of your septic system could result in its prematurafailure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if receded 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. The properly owner agrees to submit to St. Cmix Zoning Department a certification form, signed by the owner. and by a masterplumber, journeymanplumber, restrictedplumber or alicensed pumper verifying that (1) the oa-site wastewaterdisposal 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 Zoning Office within 30 of the three year expiration date. P. C. COLLOVA BUILDERS, INC. ~~~~ ~ ~ SIGNATURE OF APPLICANT (715) 247-2742 DATE P.O. Box 489 SOMERSET, WISCONSIN 54025 OWNER CERTIFICATION 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 e rope described above, by virtue of a warranty deed recorded in Register of Deeds Office. '~ ~ /~~/~ SIGNATURE OF APPLICANT DATE ****** Any information that is mis-represented may result in the sanitary pernut being revoked by the Zoning Department. ****** r~ ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed "' ,~ ENT PUN oWTS o1NNER'S MANUAL ~ ~ T~ sPE tFiCATIQ1dS P SYS --nON Septic Tank Capaaty _ L !J l ~`- ~ Septic Tank M~ufacturer Effluent F1ter Manufadurar -u~-rF~tS . ~ •. ~ .~e Effluent Ftter~MOdel Numb« of Bedr+~s 1 Un'tts Number Of Commetda Estimated flow fav~ta9e) (EstimaOed x 1.5) oes~n tbw (Pea~~ Sou App~adO^ (Rabe IMtuent~Effluent Quality Fats..0if ~ Onrase (FOG) Biochemical Oxygen pefnand (1300s? Totes[ Suspended Solids {TSS) Prstneated Effluent Qual•Ry - ~ en Osrnand (SODS) B,octlemicat OxY9 nded Solids {TSS) Total SC ~ (geometric mean) Fecal Co Maximum Effluent Particle Size - - - Service Event tnsped apnd~on of tank(s) Pump out contents of tank(s) tnsped dispe~t cell(s) Clean effluent filter lnaped pimp, Pip controls 8 alarm Flush layarals and pressure test ...~ r,.... . --"~- Pump~Tank CaPadtY atfda PurnP Tank Mar-ufadurer Manufadu~ atld --' .Pump J .. Model _~~~aVda /!°c~ Pump Pretr~tment Unit Monthly average' 0 Sandl~3r'BYeI Filter . ~p rng/L ^ M~hanical Aeration:- S?20 mg/L ^ Disinfection Page f ~} D PIA ~~ NA ^ WA o NA ,~~ ^ NA ^ Peat Fitter ^ Wetland ^ Other. Monthly average" Dtspacsad Cell(s) ^ {n-ground (p~assurQed) ^ In.~round (gravity) ..~lfound ~i0 mg1L 0 gt.$rade ^ Other ~~ mg/l. ^ Ori ine 5'f 0' d`u/'{ QOmt non-oom~*+erda~ ~~~ter end Values nrplcal for domestic Y, inchdiameter ~ctankofRuent ~,~,nster. « Values Zypical for D~~ Service FrequancY Maximum 3 yrs.) cc~~ ^ months ar(s) ( At least once every J third (yes) of tank volume When combined sludge and scum equals o Ks) (Maximum 3 yrs•) At least once every At least once every At (east once every At least once every At least once every At least once every ^ months _ ^ months ar{s) p nmomo the t~ year(s) O NA n months ^ Yea O (tiiA ^ months CJ year(s) ^ ~ ^ months _CI year(s) ^ NA Mpi~NpNCE INSTRUCTIONS n one of file fo€towing fioenses or cbor, POW'fS Maintainer, Septage Inspectlons of tanks and dispersal cells shall be mNad~e ~ n ISewer: POWTS f nape ~ Menltfy any rri~ssing or broken ttons: Master Plumber. Master PWmber on of the tank{s) m end to check for any back uP tor, Tank inspections must indude a visual inspecti a and scu harid~, ~ any cr~adcs or teaks, measufe the volume of combined sludg to ~~ tl~e effluent Ierrels round surface• The dispersal cell{s) shall be visually inspede~ ponding of effluent on the or pondin9 of effluent on the g nding of effluent on the ground surface. uta autt,ority. in the obseNatan pipes and to check for any Do ulres the Immediate notification of the lost rag tory ma ind'~cate a failing condition and req uals one-~i~ ~~ or mare of the tank volume NR ground surface y e and scum fn any tank eq s~ of to acconiance fit' yy}tgn the vombined aaumulation of sludg b a SePta9e Servicing Operator and dispo entire contents of the tank shat) be mmoved y vents: and any - onents, pfe~t~ment cameo 113, Wisconsin Administrative Code- ressurized POVYTS comp rfoRned by a certified POWTS Maintanner• The servicing of effluent filters. mechanipl or P ~ Semi event ermaintenance or monitoring at intervals of 72 monthas rho ~ ~ n Q ~ of completion of any ~ UtatorY A servk~e report shall'be provided to the local reg roduds or other s for the presence cif pairtting P START UP ANO OPERATION ersal cell(s1. if high cancentratbns are or to use of the POY~'fS check treattinent tank( For new construction, pn rocess and/or damage the dlsp rator prior to use_ chemka~ that ~, impede the treatment moved by a septage servicing ope detecttd have the contents of the tanks? -° Page v of ~ re frozen at the infittcau ~ ~~ ~;•conditions a fed " ~adt not occur ~rtten~ above normal ti~ghwatef tenets. yyhen p°~ is recto m result in the gystem start urges Pump ~~' may a dose. overloading the ce4t(s) ~ ~ . cam pBii(s) in one ~ um tar-k removed by a Outing P~"fer ed tp the d~Pe this sitfration have the contents of PletlPtr~ber or pOWTS Maintainer to ,r,np be dls~h~9 To avoxi or contacx a vrastie+~ra~r f efli t cent mP e o ~! the effl Pu bada+P or surface disch~ .~Otln9 ppwer to ig vYittfin the Bump tdrilc e ~Mdng DP~tiDf pcior~ ~ ppl~trOls to restore normal Seve fn manualh' oPe*~`fing the PumF .. po not drnre or park over, or offiet~srise disttub or oompa-ct, over tanks and dispel ~• absa lion area- Do not drive or paw vehldes mound ar at-grade soil ~ e the performance and prolong the life the area wls'in t5 feet dawn sbpe of any from the wastewater stream may impn~decreaser~; dental floss; diaper Reduction or~el'unination of the toliowing ~ butts; condoms; cotton sHrab ~ maSe;. herbiades; meat antibiotics: ~Y ~P~~ d~ fruit and vegetable peelings; ~asotine; 9 of the POVYTS: n drain (sump p~mP} water, ~; •and wafer softener brine. dsinfec#~~~ ~ ~ ~nfing products: t~~des; san>tstY napkins, Campo ~~ shad t~ taken to incurs that the ANOOI~~T n .taken out of service the fottowtn~ steps sin Administrative Code: ~ falls andJor is pem~ane ~ VYtten the pOVYTSand safety abandoned In oompt'carfoe with ch. Comm 83.33, IA/isconnings seated. system is prot~Y disconnecxed and the abandoned pipe ope a Servicing Operator. its shaA 1,7e d;sposed of by a SePta9 All plptng to tanks and p ~ steal! tie removed and property The oontients of aft tanks and P Shall be eXCavated and femoSled or their covers rer--oved anti the void space . after pumping. all tanks and P~ fined with sal, S~ or another inert solid material. measures have been, ar must tie taken, to Provide a code CONT'iNGENCY PLAN ~~ the following fails and cannot be rep cement soil if the POWTS compliant ~eplaoement system' be utilized for the location' of a reP~W'on and should not nt'atea has been evatuateci and may p A suitable reP~~ meet area. should be protected sretmstructure. lot tines and wells. Failure to absorption system. The replac8 d~cs from existing and propo be infringed upon by required setba re Iaosment area v+rill result in the needm t awith the rules n effect at that time~b~h a suitaPle~S protect the P ems must co P Y ~ r - cm tions_ awing advances 1n O r placement area- Replacement cyst PO ~ replacement area is not ava~ll leg ue to~r~ort to replace me ~~ n facture of the POVYTS a so8.and n tan aY t area. U men 1 q~K" v enti{y a su'rtabie rePia ~fab a: not evalua n a - ~ es ire e u "on st ed as a last resort to replace the failed 011Y'r ~ following removal of the biomai at nstntcted in pia ms may be repo witf'- ~e rules in effect at that ttme. .p,~ Mound and at-grade soII~absorPb°n ~of such systems must comply ~/ `'the infiltrative surface. Recansfsuctio -~ ~ p!O(z lNSUFFICIFNf' EK• <cyyARN1N DEJ~TH MAY SEPTIC, PUMP AND OTHER 1'RF~1` GtRCUMSTAN UO NOT ENTER ~- SEPTiC, PUMP OR 07HER TREATMENT TANK UNDt:R ANY RESULT.. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAYBE DIFFICULT OR IMPOSSfBLE. ADOCTIOIYAt.. COMMENTS . Pov+rrs MAtnrr'aINER POYYTS 1NSTALL.ER Name ~ Hr1~i Name / ~~ Phone 7/„ ~°"%~ ~r~JJ LOCaL. FzEGULATORY AUrFHOR1N SEPTAGE SERYiCIP[G CIPERATOR PUMPER agency u~ /'~ ~~ 8 ? Name ~- ~ ,b • Phons r Phone =-~ ~ ~~ This dowrr>eN meea This aowment was drafted b'Y ~ stafFs of the Green Leke, and 83.5481, C1I & (3j W consi~~m ain3sVatire Ccde:~U~se~of th)s document does not me min;n+um requ',remants of dt_ Comm 83.22(Z)(f-H1l(~~(fl ( - Ctyryy(1J0f) guarantee the perfomtarsoe of the ppV',ITS_ U 1950P 528• ~---. . * ~' " STATE BAR OF W ISCONSIN FORM 1-1998 WARRANTY DEED I iusband and wife .Grantor, and P C t;ollova Builders. Inc. .Grantee. Grantor, for a valuable consideration corneys to Grantee the fdlowing described real estate in St. Croix County State of Wisconsin (the "Property'): 687242 KAi'HLEfiB N. MALSN REGISTER OF DEEDS ST. CROIX CO.. MI RECEIVfiD FOR RECORD 08-16-2002 9:00 AK ~ t DEED REC FEE: 13.00 TRANS FEfi: 1155.08 COPY FEE: CERT COPY FEE: PAGES: 2 t~ P' C/Colbva BWklers, Ina x/~~notl- Avenue mood , WI 54010 %'~~~~ 909 078-1039-20-•000 / 018-1039- 018 1039 80 000 Parcet{dentlOcatlon Number(PiN) Thla la not homestead property. (19) (IS not) Sao Exhibit A attached hereto Together with all appurtenant rights, title and Interests. none Grantor warrants that the tide to the Properties good, indefeasible in simple fee and free and clear of encumbrances except Dated this 15th day of August. 2002. hn J. Iton (SEAL) (SEAL) A.t pY C -, ~~TE OF wtSCO~ Signature(s) ^r~?~Y ~"' _ItVd authenticated this NO 3L1C ~A-~N~~ f TITLE: MEMBER STATE BAR OF W ISCONSiN (If not, authorized by §708.08, Wis. Stets) (SEAL) ~i. ~ _D i ~~~~i arolyn G. alton (SEAL) ACKNOWLEDGMENT State of Wisconsin, } ss. St. Cro& Counly Personalty came before me this 1~ day of August ?502 the above med . a and I Ito a nd Wif w -.~ ~kz ~ Notary Public. State of Wisconsin THIS INSTRUMENT WAS DRAFTED BY My commfsabn Is pe anent. (If not, state explratbn date: Cddwell Banker Bumet V~ } 1301 Coulee Road Hudson, W 154018 a~aa~o (Signatures may be authenticated or acknowledged. Both are not net:esaary.) • Names of el n in en ca must be or rioted below their s nature. STATE BAR OF WISCONSIN Wisconsin Legal Btenk Co, Ina WARRANTY DEED FORM Na 1-1998 Milwaukee, Wis. C~ (Cr,C ~ ~~''1 ~U E ~(..b OK t' o F 2 . ~~ ~ ~ . ....r:...v.~'.~f::.l.!"`...-xd•L•:s3d,.m.,.,.trIIy„uf„;;n~uW,.~ ~~ :'. _ ~- - ; ,::., :.~ '~#~fiWbarirhLseii~d~vso0r5t,-;eci~ ;~;t~rbrr.n, A part of the NE ~/. of the NE '/. and In part of the NW y. of the NE '/, and In part of the SVd: Y, of the NE Y. of Section 18, Township 29 North, Range 17 Weat, Town of Hammond, St, Croix County, Wisconsin and mare partlcularfy described as: Beglrlning at the Northeast comer of said Section 18; thence S89.33'31 "W 372:01 feet along the North line of the NE Y. of said Section 18; thence S89'33'31°W along the North line of the NE '/. of said Section 18 775.94 test; thence S00°52'23"E 250.00 feet; thence S89.33'31'W 968.24 thence S89'33'31'W 528.00 feet: thence S00°52'23'E alor~ a North~outh Qua a Sec~oMf Ilne of said Section 18 1311.77 feet• thence Nti9'33'39'E 626,33 fast; thence N00°31'25"W 30.23 feet; thence N89'33'24"E 692.78~feet; thence N00.52'23`W atgng the East line of the SW % q+f t}1O NE '/. 330.31 feet; thence N89°33'24'E along the South line of the NE Y. of the NE '/. 949.Og~f~t; thence N00'52'24'W 1321.19 feet to the Point of 8eginntng. ...Ji/i . ;~,~~, 6 V F~2.L.~v ~ 2 or- ~ i .. 'z^ w s yM I~/ / ~~ ~ J I~ M „Zt~, L0. LO N ~ ~ ~ ~~ N ~ r Nom cr rn ~~ Z ~ N ,00'OZ~ D D ~ < ~ - ,0~' ~ oOV° ~ ~ `~z° Z Ul W r / A ~ O c~0 ~ / ~ _ -_-~ ~ D y ~ ~ ~ w ~ cn ~~ I ~ W -rl ~ / ~~,• N TI m ~ti ~ v C"'' `' I 0 ~, -~ ~' O N N ~ N N / ,p ~ , ~ -P y IN C r -~ ~ ~ off, o ~ ~~ti D~ ~ < Cn ~ y N _... /,Q n fTl ~ ~, I -~ ~ ~ / \ / ~ I~ , Fo ~ goy ~ D-~IN ~, ~ \ d O ~, Z Iw I -o ~ ~ w w O `° oo Z c~ ~, ~ w rn co I r~ _ ~ N c,,, w ~ \ ~_ ~v v g 6 :'' N X69 ~ ` \ rno ~ ~ ~ ~~S y \ \~• ~\ \ ~ r ~ 1 ~ -~ ~- --~ to O ~ ~ . „55' s I -~ y \ ~ -~5g~zo~ ~ z ~ v o0 ~ ~ O N ~ S ~ I 1 D W y ~° w ~ O ~_ I ~~