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HomeMy WebLinkAbout018-1086-13-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT ' GENERAL INFORMATION (ATTACH ~O 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 Ruhl, Pierce & Laura Hammond Townsh CST BM Elev: Insp. BM Elev: BM Description: _ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic J ~~ Dosing ~~~ S(~~ Aeration ~~~ J ~ (~~ Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~~ ~ / ~ j / 5 Dosing ~V i C~ t f A j ICJ `~ ~ J Aeration Holding PUMP/SIPHON IN No: ELEVATION DATA , q~ ,,,~' ~„_ St. Croix 453287 0 ~ 018-1086-13-000 iAap No: 20.29.17.633 STATION BS HI FS ELEV. Benchmark ~ I /02 ,' / Alt. BM ~~~ a z.~~ /~ 3 . o Bldg. Sewer ~et 1 ~,~ St/Ht Inlet ~ .~ ` ~ Z~ St/Ht Outlet U 7 , ~ ~ t7 . x / Dt Inlet d ~ D ~`7~ 3S Dt Bottom ~+ 7~0 ~~ Z~ Header/Man. /~ r /bI ~~ Dist. Pipe / , I / ~ / < <( Bo oSystZem ~~ 7to /d~, Z Fi I Grade ' ~ ~~. ~~ ver ~ c~ f~~ Z ~ ~ ~~3 . a ~ ~~.~,~ ~ I' ~5 ~aa ~ ~ ED ENCH ENSIGNS Width ~ ~ Lengtt}~ t l-r(j~~ No. Of T enche ~. PIT ENSIGNS No. Pits Insi ia. Liqu th SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER OR Manufactures - Type y~stt~em: L~ ~ ~~ / UNIT Model Numb DISTRIBUTION SYSTEM Header/Manifold )t ) l~ /Z' i JL Distribution j ~ ~ / Pipe(s) ~ 1 ~ Z 5 x Hole Size ~j x Hole Spacing f / Vent to Air Intake ~, ' Length Dia I .. Length Dia Spacing `' ~~i ~~ • S O5~ SOIL COVER x Pressure Svstems Onlv xx Mound Or At-Grade Svstems Onfy Depth Over ~ Bed/Trench Center ' ) / Depth Over Bed/Trench Edges ~ xx Depth of Topsoil \ ~ xx Seeded/So ded `Yes ~ No xx Mul ed - es `.. ~ No (p~j ~ J COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ / ~b//~~~~-l Location: 875 162nd Ave Un own (NW 1/4 NW(_1/4 20 T29N R 7W~, Ham~umond Qak of 13 '- ' 1.) Alt BM Description = ~~yy,~ZC~'y~''4~ ""`tom' ~ ~r 1 ~~ ~ ~~0~ ~~ 2.) Bldg sewer length = '~°~ I b ~• ~g3 ~~ ~~{, y1 -amount of cover = •+1/, 5 ' ~J 3.) Contour = /lea , Z. Plan revision Required? ' ~ Yes No I ~ ~~ Use other side for additional information. ~ ~ i ~~ ___ ~ Date SBD-6710 (R.3/97) Inspection #2: l / Parcel No: 20.29.17.633 1 Cert. No. ~Qll_ ABSORPTION SYSTEM „ Safely and Buiidit~ Division, Co®ty ~ ~ 201 W. Washington Ave., P.O. Ba,>E 71~~ _ ~scons~n . ~ ~~ - 7162 ~ Sarmary P~ Ntmtber (to be filled in by Co.) Department of Commerce (6t11~266~3151 2~- Sanitarp Permit Application s~ Phm I.D. Number to accord with Catttma 83.21, Wis. Adm. Cade, persoml n yon provide 99~ ~ 3 / =~~ us ~ n ~ may be used f~ sewadary PmP~ ~Y Isw s15~p4(1)(m) -..~..- ...,.ss _ Address (if ditieYw[ than m~ailiog address) I. Application Information - Pleam Print AII Information 3 .. ~ ,- ~ 7 ST. ~N~ts~nrv1~ ~7s / 2 Property owner's Na ~ J U t~! 0 2 20 04 GPalree~t # ~d ~~ j ~~ o slow ~ Property Ow,>er's M atlnrg Address ~ .. `, • r, ;: ~, ;~ ~ ~ Property ioc~on R~ zOr~~NG~~FFIC~--_ (~~~ City, State Zip Cade Phone Nnrnber ccrZ- _ yin - -G.~ _ - ~~- t«rde E~ T~N R~ ~ ~ ; _ II. Type of Building (t3reck all that apply) a~ al S ~rwi a ~ p KS ~ ~ ^ 1 or 2 Family Dwelling -Number of ,3 ~~~ Name CSM Number ^PablidConunercial-DescribeUse 0 lNI fl IZ" f~ ,f/ ^ State Owued -Describe Use = ~ , " - - ~-• - ^C'ity ^Vellage 81owt~ship of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) - `~' It~New System ^ Replaoemeot System ^ TteaamendHolding Tank ReplaCemeot Oily ^ Other trladification a Existing System B. ^ Permit Renewal ^ Permit Rev-sion ^ Change of ^ Permit Transfer to New List Pceviom Ferrell Number and Date Issued Before Expiratiion Plumber Owner ;rv. ofPOwrs ~: au that > - ^ Non Presauizod In-Gmand ~Maond > 7A in. of suinbh so ^ Mamd < 24 ia. of snirsble sor7 ^ At-Grade ^ Sit>gte Pass Sand Fdrer ^ Constructed Weiland ^ Pressurized LtGround ^ Holding Tank ^ Peat Filter ^ Aerobic Treatrcent Unit ^ Recirwlating Sand Filter ^ Recirtatlating syntbdic Media Filter ^ Leadtiog Chamber D Drip I.me ^ enavd-less Pipe ^ other (explain) V. etrt Area Infornu~ion: Design Flow (gpd) Design Sort Application Rate(gpdst) Dispasd Area Requirod (sf) Dispersal Area Proposed (sf) Systrsn Elevation ysa y .S'd f'd /, 7 VI. Tank Info Capacity ut Total Number MarwFawtrer Prefab Si6e Stud Fr'ber Plastic Gallons Galk-ns of Units ~~-~g _ ~ /; i,~, Concrete Cwtstructod Glass ~ Taotrs TaoL~s Z~ ~L %¢ - sePt;c ~ !/,~ S V Aerobic Treaanaa Unit ~ Qwober ~ ~' 1 v YII. Responsibility Statement- I, the malasgned, assmmt: respa~ity for of the POWYS shows on the aitxhed phms. Pbttttber's Na me (PrirN) s Si g~e~-~- MP/MPRS Number Business Phone Ntmaber Phmnber's Afire ss (Street, fit),, z~r Code), ~~u G f1- yO2 - ~2/0 Fogel Plumbing & P~II Tie:l~ ~ s - - 37 ~ VIII. Co ~ Sanimry Permit Foe (includes Csroondsraeer Dine hauod - Agent S' (No Stamps) ^ Reason for Denier ~) ~ 3~ -'`- ~ a~ it7i:. Conditions Appro 3~ D ~~ - ~ 1 _ _ 1e ~ J ~„ -~ „ j~ 1 l ~ W' SYSTEM O ~ ~ ,~_ 1 Septic tank, effluent filter and ,-.~ 5~-~-~ ~~~~~~K ~~ ~ ~~~ ~~ ll must all qe serviced /maintained l di ce spersa as per management plan provided by plumber. ~~~ a ~ 'I,e~'~- ~ o~`~,,.Q -~dt~a--~ ~ 2. All se#back requirements must be maintained 1 as per applicable code/ordinances. ~,/ ~ ~~~~~~ _ ~~ ~ y~~~ ~-17i. nuaep wmptste Pleas tq the ~ oal» tl~r the systt~ mt t tin~yy SllZ:11,ia~ i$ size ~_-=J-~S f -~~- . .r' ~: O ~ ,• ~ o o ~ "~ _ ~ Q N !~- tp P6 Iw G ~V~ A ~ ~ ~ ~ , ~ N ~ o II II ~ `~ o 0 b ~ ~ c fD tZ, o 'd W %O ti~ ~ g ~ bC !O ~ C ~ ~ ~~ ~ H ~ ;% o _ ° ''' o ~o \x. a., ~ ~ o ~ ~ c~ cfl co~ ~a ~7 d~o~'rb .,. ~ ti k I a• a ,~ ~ ~ ~ °_ v~°Ox p n ~ ~' y ° w~0 ~' ~~ ~ Off; ~•z ~ C ~ w ~. p ~ ~ c0 ~ O ('~ ~ p ~l A• ~ C o °po b b ~,~ ~ ' ~ ~ ~ b ~ o,b ~ 0 ~`" ~ c•~o o ~ o ~. 'Zs A ~ y ~ ~, co I ~ ~ ~ ~ a, ~ b b ~ ~ ~' ~' ~ ~ ~ N o ~ p ~. ~ p Or O A ~' `T1 p ~ , J', ~' ~ o b / ~s o ~ ~ / ~ ~ co ~ x ~ ~ ~ on co p ti ' ~ p ~ ,~' ~. ~ o ~ ~ /, ro ~ ~~ / ~ ~ ice,, % ~ ~ ~ oc ti ti commerce.wi.gov i ^ ~sconsin Department of Commerce Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264-8777 www.commerce.state.wi. us/sb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary May 10, 2004 CUST ID No.224059 KEITH E STONER 23220 WOOD CREEK RD SIREN WI 54872 ATTN.' POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/10/2006 Identification Numbers Transaction ID No. 996931 SITE: Site ID No. 683250 Oevering Homes Please refer to both identification numbers, 162ND St .above, in all correspondence with the agency. Town of Hammond St Croix County NW1/4, NW1/4, S20, T29N, R17W Lot: 13, Subdivision: Hammond Oaks Subdiv FOR: New 3 bedroom home Object Type: POWTS Component Manual Regulated Object ID No.; 957245 Maintenance required; 450 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.OllO1), Pressure Distribution Component Manual -Version 2.0, 5BD-10706-P (N.O1/O1) 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.O1/O1). • This system is to be constructed and located in accordance with the approved plans, the "Mound Component Manual for Private Onsite Wastewater Systems Version 2" SBD-10691-P(N.O1/O1). • The pressure network is to be constructed in accordance with publications SBD-10706-P(NO1/O1) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems -Version 2.0" and/or the sizing methods of publication "S5WMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81)". 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 KEITH E STONER Page 2 5/10/04 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. Asper 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 maybe 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, Carl J Lippe Wastewater Specialist ,Integrated Services (715)634-3484, clippert@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 ` _~ MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Oevering Homes Mound Lot 13 Owner's Name: Oevering Homes Owner's Address: 838 Summer Pines Circle Hudson WI 54016 715-760-0001 Legal Description: NW1/4-NW1/4 Sec. 20 T29N-R17W Township: Hammond County: St. Croix Subdivision Name: Hammond Oaks Lot Number: 13 Block Number: NA Parcel I.D. Number: 018-1087-70-000 Plan Transaction No.: Page 1 Page 2 Page 3 Page 4 Page 5 Index and title Data entry Mound drawings Lateral and dose tank System maintenance specifications Page 6 Management and contingency plan P.D,W,T,$. Page 7 Pump curve and specifications 7 Page 8 Plot Plan C~,azditiona~ Designer: Keith E. Date: 05/02/0 Signature: Mound Component M. SSWMP Publication 9.6 Version 3.11 (R. 06/01) .;. *'~,G License Number: ~• ¢ Phone Number: 5 Wis• ~. ' DEPARTMENT Of COMME` p~ ON Of SAFETY ND BU1~~ ,___. esi $PONDEidGi 715 653-2324 I~nt to the ~sion 2.0 SDB-10691-P (N. 01/01), and Distribution Networks for ST-SAS (01/81) Page 1 of 8 Mound and Pressure Distribution Component Design Design Worksheet Site Inform ation (r or c) R Residential or Commercial Design 300.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 450.00 Design Flow (gpd) 11.00 Site Slope (%) 100.20 Contour Line Elevation (ft) 24.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 90.00 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Pressure Disribution Information (c ore) c Center or End Manifold 2.50 Lateral Spacing (ft) 4 Number of Laterals 0.156 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimated Orifice Spacing (ft) _ 2.00 Forcemain Diameter (in) 20.00 Forcemain Length (ft) 93.50 Pump Tank Elevation (ft) 4.55 System Head (ft) x 1.3 7.20 Vertical Lift (ft) 0.44 Friction Loss (ft) 12.19 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. o tions choice 0.75 1.00 1.25 x x 1.50 x 2.00 x 3.00 x Note: Sand fill (D) calculations assume a Table 83-44-3 in-situ soil treatment for fecal coliform of <= 36 inches. 5.00 Cell Width (ft) Are the laterals the highest point in the distribution ~~ network? Enter Y or N If N above, enter the elevation ft) of the highest point. 7.50 ft2/orifice Does the forcemain drain back? Y Enter Y or N 3.26 Forcemain Drainback (gal) 56.36 5x Void Volume (gal) 59.62 Minimum Dose Volume (gal) 32.31 System Demand (gpm) Manifold Diameter Selection in. dia. o tions choice 1.25 x x 1.50 x 2.00 3.00 Gallons/Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1000.00 Se tic Tank Capacity (gal) Total Working Liquid Depth (in) Weeks Concrete Manufacturer gal/in (enter result in cell 849) Dose Tank Information Effluent Filter Information 805.12 Dose Tank Capacity (gal) Zabel Filter Manufacturer 21.76 Dose Tank Volume (gal/in) A100 Filter Model Number Weeks Concrete Manufacturer Project: Oevering Homes Mound Lot 13 Page 2 of 8 Mound Plan View i- 1_ ..................................... 1/10 B . . • Observation Pipe '0' .. K „~. s . ~~ ~' ~. _t Jj - T A -~ I - L Mound Component Dimensions A 5.00 ft E 18.60 in H 1.00 ft K 9.14 ft B 90.00 ft F 9.25 in z 12.63 ft L 108.28 ft D 12.00 in G 0.50 ft J 5.12 ft W 22.75 ft 450.00 (ftZ) Dispersal Cell Area 1586.75 (ftZ) Basal Area Available 5.00 (gpd/ft) Linear Loading Rate 9.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 102.97 (ft) ~I H teral F , .:::::: Dispersal~Cell 101.70 (ft) La 101.20 (ft)~ - Invert Dispersal Cell ~ ~ ~ ~ ~ ~ t Elevation E ~ : D ~ : ~: J , J•J •J ;•-;•-;•-]•'l `;•;'-5.'S~-l~-;~•;,`7.•';-'; ';~•j~~'j~'-;:.-]`-;~-~~-;~-; ; ;';';;~`5 ~ ;~ ;~ ; ;. `;~ ; li `; i •J i4 ;. 1.';.''S • ~ . . • ~ : :t• •~J ~~l•-~J~-~J,--.~__J~__J~__J~-_, ~~J ~~J•'•!~•-J~•.J~~.1.-.J~-_,~-:l~_-{_-J ~_-J •_-J ~'-J •-~l •-~J -~J -~S ~~l •_~~•,,~J .=l•-~l~•~l•~J~'-J~_~J __ _-S _-J _-J -_J _~J, { J. •J. ~. J. J. J J J .__ -~ ~ ~ ~ ~ _ 100.20 (ft) Contour Elevation 11.0 % Site Slope Geotextile Fabric Cover Shading Key ~ c. ~- Dispersa{ Cel{ See lateral details on 10 _ Topsoil Cap }}~~~ _ c Q• ~ c 1.5 ft ~~•,.••.•,;.;•.y.;.,.;s ~a., • y- Page 4 for number, size, and spacing of laterals Q Subsoil Cap ~ 1° ~ •!r-~ ~.- ~ I . Laterals are equally © ASTM C33 Sand ~ •:„, _ F Tilled Layer ~ d ~ v o 0.5 ft ~ ~' Typical Lateral :• .:• ° _ °. ~re spaced from the distribution cell's ^5 0 Aggregate "•° "•~ "~° "~'~''~_ `° centerline in the A '* distribution cell (Ax6). Project: Oevering Homes Mound Lot 13 Page 3 of 8 Center Connection Lateral Layout Daigram Force mai n connection via tee or cross to manifold at any point. ~~ P •=Turn-upwf balluaiueor I~X-.~IExl2 I xl2~I claanoutplug Holes drilled on the bottom of the lateral. s Number of Laterals 4 Orifice Diameter Lateral Diameter 1.25 in Orifice Spacing (X) Lateral Length (P) 44.23 ft Orifices per Lateral Lateral Spacing (S) 2.50 ft Orifice Density Lateral Flow Rate 8.08 gpm Manifold Length System Flow Rate 32.31 gpm Manifold Diameter Total Dynamic Head 12.19 ft Forcemain Velocity Dose Tank Information Electrical as per NEC 300 and --- Comm 16.28 WAC ~ Disconnect ~- Laterals are identical Laterals & Force main of PVG Sch 40 per COMM Table 84.30.5 Tank component is properly vented Weeks Concrete Ca aci 805.12 Volume 21.76 Manufacturer Gallons gal/inch A B C D Dimension Inches Gallons A 20.26 440.86 B 2.00 43.52 C 2.74 59.62 D 12.00 261.12 Total 37.00 805.12 3" tank. Alarm Manuafacturer S. J. Electro Alarm Model Number 101-01H Pump Manufacturer Goulds Pump Model Number #3871 EP04 Pump Must Deliver 32.31 gpm at 12.19 ft TDH 0.156 in 3.05 ft 7.50 ft` 2.50 ft 1.25 in 3.30 ft/ Locking cover with warning label and locking device and sealed watertight i 4 in. min. F- Alternate outlet location Forcemain diameter ~ 2 in. Weep hole or anti- siphon device P~elevation (ft) 94.50 D~ elevation (ft) 93.50 Project: Oevering Homes Mound Lot 13 Page 4 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name Tri-Coun Sanitation Phone (715) 386-0114 POWTS Regulator's Name St. Croix Coun Zonin Office Phone (715) 386-4680 System Flow and Load Parameters Design Flow -Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Ins ect and/or service once eve 3 ears Should ins ect and clean at least once eve 3 ears Test once eve 3 ears Should test month) Laterals should be flushed and ressure tested eve 1.5 ears Ins ect for ondin and see a e once eve 3 ears Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished • ............. ............... Grade 6-8" Diameter Lawn ~ Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Oevering Homes Mound Lot 13 Page 5 of 8 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution Svstem No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 30 mg/L TSS, 10 mg/L FOG, and 10° cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. ContinAencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating cendition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Oevering Homes Mound Lot 13 Page 6 of 8 GOULDS PUMPS ._~_,: ~. >~ ~~ 7 6 s 4 3 z 1 0 ~''~ ~' APPLICATIONS SpecificaNy designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS • Solids handling capability: '/4" maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size: 1'/z" NPT. • Mechanical seal: carbon- rotary/cera m ic-stationary, BUNA-N elastomers. • Temperature: 104°F (40~C) continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 HP, 115 U or 230V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: 10 foot standard length, 16/3 S1TOW with three prong grounding plug. Optional 20 foot length, 16/3 S11W with three prong grounding plug (standard on EP05). © 2001 Goulds Pumps Effective May, 2001 83871 • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Auto- matic models include Mechanical Float Switch assembled and preset at the factory. FEATURES ^ EP04 Impeller: Thermoplas- tic Semi-open design with pump out vanes for mechanical seal protection. METERS FEET 10 9 30 8 zs 0 w x v_ z 0 J Q 0 20 1s 10 s Page 7 of 8 Submersible Effluent Pump 3871 EP05 `~ ^ EP(?5 Impeller: Thermoplas- tic enclosed design for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ^ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ^ Motor Cover: Thermoplastic cover with integral handle and float switch attachment points. ^ Power Cable: Severe duty rated oil and water resistant. 00 10 ZO 30 0 2 4 6 8 CAPACITY ^ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTING (~° Canadian standards Association (CSA listed model numbers end in "C" or "F".) coWds Purps is ISO 9001 RegisUered. 5 GPM z.s rr 40 50 GPM 10 12 m3/h Goulds Pumps 4~" ITT Industries t `1 O ~ ~ n o tZ r~ O , e. A ~ h. ~p r7 8 A O ~ ~ ~ ~ ~ ~ ~ o II o II ~ v c~ ~ co O a of b ~ , ri C II b p o ~ pC ~ ~ ~ o ~ o ~ , ~ ~ ~ o ~ _ ~ b ~~ '~ ' ~o ~ ~ x~~' ~ ~ ~ ~ ~. ~ ~ ~xo ~ ~ ,Q to i o ~ ~ c~ ~ ~D ~ ~ ~ ~ b ; a. N a vo ~ ''d ~ ~ 0 ~,, ~ ~ ~ ~ i ~ ~ I M lD ~ z ~ C/~ . CN ~ ~~O ~ ~ ~ ~ ~ ~ ~ ti ~ p' ~ ~ ~~ ~ -. ~ A~ ~.~ c ~ o ~ b b b n ~~ o ~ o ~ ~. ~~ ~ ~ ~ ~ o ~ ~ ~ 'b o ~ i ti ~ ~ o ~ coo o n ~ i c`~o ~ coo ~ A O ~ p ~ ~ / ( 'I i ~ ~ n ~. ~ ~ ~ ~ ~ ~ ~ O A . ? i Q ~ ~ o p ~ n ~ ~ ~ b o ~ ~~ ~ ~ ~ 00 ti Wisconsin Department of Commerce SUIL tVHLUH I IUIV KCt'vR I Page ~_ of .~ Divisias of Safety and Buildings in accordance wilts Comm 85. Wis. Adm. Code qty Attach canplete site plan on paper not less than 8 1/2 z 11 inches in size. Plan must ' iru~trde, but not limited to: vertical and horizontal reference point (BM), direction and Parcel LD. percent Slope, scale ~ dimensions. north arrow. and bcation and distance to nearest road. p - R by Date Please print all information. Pasoral irdarrrratiorr you Provide mey be used for secondary t> (Pm~Y t.aw. s. 15.04 (1) (m}). F'~tY Ortrner Property I.ocatson ~~. Govt tot ~~ 1/4~~ 1/4 8 „~ T jS ~ N R / E (o,~ ,~-v,~' Property Owners Mailing Address lot # Block # Subd. Name ar CSMfI P3~ /3 '- 1i~59YAt'O.!/~j ~/l~ s City State Zrp Code Phone Number ^ City ^ V'Na9e (r]'T~ Nearest Road ocJ v ~ (7/J ) D --o~ 1 .d 3 Cade derived design tbw rate 5/~'O _ tir-u [v)'f<lew Constnuxiors Use: [g Residential l blsunber of bedrooms ^ Replacement ^ Public or commeraal -Describe: Parent material LdES3 ~yaR ~~5~` - J2LG s' Flood Plain elevation if applicable _ H/~ -- ft Genera! oorrarsersts and reoorrsrnendations: Gw.e FAT s~B!/ii/D su~sr~p - ~~R~ nr~udp iys r=te .~•¢s'T ~ ~ L.~. C - ~ Boring / a Boring # Ground surface elev. ~~ ~ ft. Pit Depth to limiting factor ~ in- Sq~ Application RatE C i t Boundary Roots GPDIft' Horizo n Depth Dominant Color Redox Description Textiue Stnrdufe ence ons s ' # ' in Munsell Qu. Sz. Cont Cokx Gr. Sz. Sh. Eff#1 Etf 2 . /' -g /~ - 3 .~- S~- F s L P-t 'S - --' S L. ~ 3 _4/T 7•S-s F sGL D G B~9 ~~ # ©~ Giund surface elev. 4 ~i F' R Depth tp 9 far~or z 7 in- Horiza't Depth Dominant Color Redox Desaiption Texture StrucWre Consistence Boundary Roots as. Munsell Ctr. Sz. Cont Color Gr_ Sz Sh. I B- -1. 3 z~ ~ z - L - a • Effluent #1 = BODS > 30 < 220 mpA. and TSS >30 < 150 rrsgll ~:ST me (Ple'ase Prstt) ~,..~ - t Date ~ Address Fogerty Plumbing & Perft T sting ~s~ gyps < 3p myl ~sd TSS < 30 mgA=~ CST Number .2 ZltcY~ ducted Telephone Number ate' _~i~=,G3s-9~f, 6Z si ~ ~ Z' _ _ Fogerty Plumbing _ _ #221180 28288 McKenzie R~ - Sp~cner, WI 54~ , - (``7??i5? 635-9 .d~~~ _ _ /2~'~ -- Lt~T ~/~ ~ lfpw„v~or/> Q~~Cs .. u - ~,=,r~~ .. i = f~urJl~ lm~~ ADS d ~/ = 7~-~ ~ T BrsT ~roD ~D~ /OS:3i-~ 7 ~ .$~ i~ . g-3 ~~•- ._. ~ .~ 8-z ~' x /, .~, 3 ~~~' X Y /o/ o • • a ~ ,l ` ~.~~ C i 1 a _---~-____.~_~,__~_. __---~_-.~ Wisconsin Department of Industry, SOIL AND SITE EVALUATION Labor and Human Relations Division of Safety and Buildings in accordance with s. ;83:ps, Wis. Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. ,Plen trust Y ~ Coun X. s~. C~d~'~ include, but not limited to: vertical and horizontal reference point (BM), difeCtion and t`~ -,,., ;. t„~,, Page / of ? percent slope, scale or dimensions, north arrow, and location and distartEs to nearest~road. ; ; t; Parcel l:D.,# Q ' ~, .::..~ .Y , :~:~ 1 ' a~ • ~a • so • as APPLICANT INFORMATION -Please print all informatlion eviev~gd y Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)lk , , ~ ; , :~` Property C!vvner ~ (>H is l e~ lr~A.'1 ~ ~ b r~: PrOpolt~r~ '- ' E : ~° V ~ ~d t'I'll~ ~7~ 1 ~ !~ /v ~.. Govt. l.at ~/ ~ ~T4 M/4,S.i ~ T 2 y ,N,R ~, •!~(or) W Property C+wner's Mailing Address L . ~,; ,~ I~ck# ubd. Name or CSM# 332. M i ~N~S oT~4 sT >~~s T I yo ~ ~ ~FMMD~vD G/4'~f' City State Zip Code Phone Number ~~~' Nearest Road k~ ~ Z.. ST• V ~- ~`'~ ~ . 5S/ o ~ (~OS/ )Z 22 ' S5S,5 ^ city ^ village L"1 Town e1µ ! (/ d [+~"~lew Construction Use: L~rsesidential /Number of bedrooms ~ Addition to existing building ^ Replacement ^ Public or commercial -Describe: Code derived daily flow y~o gpd 2 Recommended design loading rate` bed, gpd/ft2 trench, gpd/fl2 Absorption area required bed, ft2 J 1 ~ trench, ft2 Maximum design loading rate • ( bed, gpd/ft~ trench, gpd/it2 Recommended infiltration surface elevation(s) SI.L 3 ft (as referred to site plan benchmark) Additional design/site considerations Parent material /DE't;S D~JF~2 D~NSL~' T/~~f Flood plain elevation, if applicable N~~" ft S = Suitable for system Conventi~on~al rM~oun~ In-Ground ~P-res~s a AT-Grade System in Fill Holding Tgank~ U = Unsuitable for system ^ S LI'J U L_T5 ^ U ^ S LI!f ~ ^ S ~ ^ S u V ^ S u Boring # Ground elev Depth to limiting factor 2 t.Lin. Boring # 2 Ground lev. i ~. ~ft. Depth to limiting factor 3 Z,-,_in. Remarks: 9' CST Name (Please Print) R~B~RT NL~RIIC~T Signature Address 0111 r1GC~_RIPTIr11~1 RFP~RT l D i t C Mottles Structure R t GPD/ft2 Horizon Depth in. o or om nan Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary s oo Bed ,Trench ~ o • f io yR 3 - L tfsbe ~l s cs /f • y ~ • s • 3 v .--.-- G•S /f s ~ s - r •`s` • • d Cl Hoff G ~- ~~" C w - ~~ S y /o ~o ~G / S ~e~ ~ - -- ; N sy~ ~/~ Remarks: ~ ' . o ~ o - - Sc. / ,rb ~ c c.s - 5 •s ,, '- ~ G2 KD~j G cwt ~ G ._.. ; ICJ 4 ('2. S io S/LL ~ S vii' , S • 3 Date / Telephone No. ~~s• 3gG • ~~ ~ s CST Number ~~4375 Private Sewage Consultants ~~ l' ~1 V~'1 8 I ~f~ L ~a~ '' SOIL DESCRIPTION REPORT Z .3 PROPERTY OWNER {~ Page of _ PARCELI.D.ff ~•oT 13 "~MM!'~~~ ~~ ~-S S ~" '~ • Boring # 3 Ground e~lev~t -+'~~ . '. Depth to limiting factor ~in. Horizon Depth Dominant Color Mottles Structure B d R t 2 in. Munsell QW• Sz. Cont. Color Texture Gr. Sz. Sh. Consistence oun ary oo s Bed ,Trench Z •~~ ~~Y~ 3i --- SiL 2fsh ~s~ cs - . s~.~ LS ~ ~.S- - 7;.d' 5~ ~ J~ i~. N ~ ,~ ~ /~(. is ~~ S/G Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Boring # Ground elev. n. Depth to limiting factor in. Boring # Ground elev. ft. Remarks: i H D th minant Color D Mottles Structure d R t PD/fit or zon ep in. o Munsell ~'J~u. Sz. Cont. Color Texture Gc Sz. Sh. Consistence Boun ary oo s Bed ,Trench Remarks: D=.pth to limiting factor 'n' Remarks: SBDW-6330 (R. 08/95) _ ll ~ Ulbricht & Associates ~ C~ L t I "~ 3 Q private Sewage Consultants 655 O'Neil Rd• 54018 Hudson, Wls. p ~ ~ /~~ p ~ ~"S • = /5 ` c S r 224375 f~~,vD 5 v~U ~ ~a ~ ~P~-~- ~ ~ GD ~ ~ ~ ~ lt~~ = ~ ND ~ GOT L ____ _._ _ _ . __ __-- _------ _ __ _---- _ _ _ -- - .. -- _ - --...--- -----__ -- C LoT 13 ~3 .~ ~o -----_ , 13 2 1-'--- r mil, C, ~ . 9 7. ~~ ' Mau~n syS~, cvr~, ~~~~ S~hv p fill ~ ~, ~ ~ ' So ~ L o T ~- ' 9~~ iii" ~~ z~' ~3 t -~ u ~~ ~ '3"W 290.00' I - I ~p = r c ~ ~ ~ r~ w ~ I ,~ I ~ ~ O a I S 89'36'39"W 290.00' J -' N ~ ~ I ~ ~ ~ ~ ~ O ~ ~ ~ o~ ~ O ~ ( I IO I W~ O ~ ~ ao I D N .~ •'' _ '23"W 290.00' ~ ~ O -~ o°o m I I mm Z ~. N --+ ~ ' w r ~ I ~ JOI T S 89'36'39"W 290.00' ~ ~ rn ~ I o ~ O -1 'U i (n ~ -=I I ~ TI O D O -' ~ O I ~ ' ~ 00 ~ (n ~ ~ ~'1 ' ' 01 OD N -~ ~ n _= p x'23"w 290.00' JOINT ~ I ~ D N ^ ~' ~ ~ m ~ , I m cD m W r N~ ZZ O O O`sO I I ~~ ~ ~ ~ ~, ~ ~ S 89'36'39"W 290.00' _ ~ n N~ I N I I O " '~ N~ ~ ~ mr=i a' w I _ _ ~ I °° ~ N w °°. ~~ ~W ~ ~ I ~ I ~Q ~ O O Q, p I I cn ~ cn ~ ~ D o N~ w' ' J0) T S 89'36'39"W 290.00' ~ ~ ~~ ~ ~ p ~, ~ ~ ~ ;5'23"W 290.00' ~ O N ~ Ow~ ~ I N O~ IV W cT ~ _ ~ i ~ W D ~ 0 0 Cn j a r I I N ~ m I o I ~Q ~ ~ o o ~p O o I I f'l ~ ~,,, ' -~ ~, m I N~ r~ tv Z m v 1 ~ W i ~ ~ u'_ D O S N' v ~' I S 89'36'39"W 290.00' m v m n~-1 ~ W i ~Z W N 5'23"W 290.00' ~ w I ~ ~ ~ ~''' O ~ ~ ~ _ O ~ ~ c, cD p ~ I~ W O ~ N X w , ~ o n (~ ~ o°• `~ ~ ° ~v/ ~ ~ r ~ , ~ I ~Q ~ C N ~ ~ N w I N' N ~ S 89'36'39"W 290.00' : gy p Dorn ~ ' ~ ~ z ~--~ n ~ ~- I ~ ~ J~INTI fn Irn fv nNO ~ . '45'23"W 290.00' ~ , A O ~ ~ Z I ~rn I rn r ~~ ~ O A N _ ? DN ~ ~ Z ~ ~ O ~ ~ '~ ~ ~ A ~ ~ ,,.;r p ~ I ~ m rn ~ ~ -• ~ ~ (n Tl D O~ w I 0 I I ~ ~ ~ G'1 ~ N I I .,,..~~ ~.,-~.~ won nn' FROM :OEVERING HOMES LLC Amt 30 03 08i98a FAX ND. :7155311282 FOGERTY /PLUMBING Oct. 30 2003 171GOOGG~OO ST CROIX COUNTY SEPTIC TANIG hlA[NT~iANCE AGREBMBNT ' AND OWNERSHIP (~RTlFIt,.ATION FORM p. Q own0r~auyar ~-d~ LRu.~- - /tr~hrL - - Mtuliag Address ~Z~~C.-.~-- ~~ r D~ . 3'.~~r- . .'T / Pcopcrly Ardttress .~_~g 7~ 2 ~ ~ s (Veeifieaooe errgrited iroa nep~.eneai for asw ceA.kee6ow) City/St~e ~~r=Cw . t~_.Z' ~, Ps~el ~d~ti~catioa Nw~a O/P -~0~7 " ~.- LEGAL DESCRIPTION Property Location ~~ %,.,!/.~% '/., Secs~,_, TAN-~_W, Town of L//4/11llrO.d/~ -. Std~divieial7 „/i~/~l~1ltlOrl/l) ~/l~i~.l=--•- -• ~_ ~ ~ ,Lot # ~ /-~ .'- Certitted Satway Map # .~____~ . Volame -Page # --"'-~ - Warranty Deed # ~~~ Gl ,3 Valuene ~ ~'7 Q ~ _ Page # z 7 ~ Spec honsc D yes [i~no . ~ Lot lines ida~ifiable CJ'yes Q no lqN~eprxuoewd~d~er~eplGe~gearewYs+is~~ tlepesM~~t~eta riewa~les. Paper cordt~ of prmpis art de sepia trek srery Aeee ptaes ~ aeae; ~ sailed 17 a xosewt peiep~ Nlet !~ pet ~Mo qK t~ es ^tFxt Ate t~ d Ifts aeplie ilk at a r~eaUeeat atr~ to tre arse dilW sum. 7Le popraq sweet agseee a wbaif M 3t. O~oir Taei~ pspetfineat: oe~6ioedea ~sae~, Sal t~J' de arraer and b~- a plaetiber,leere~-nrerles6e~~hied}Leberaer1•ic+eaNdpa~pa~aifyi~dat(l)16ea~sile.~aarelerd~isla~ is a peapiai i biied~fias ait~ifor(11~iksiragaeK•s sd peepias (desoeary~, dte aeptk troll is Wi thew 1/3 fuN o[siedse. tIM-s. ~ aedeeotpeiTan~eadia sltoeeeetpiealesrlaaeedtr~ts aieef~iaitpawtea'"etle' ~ s7~a wiege tfw sfeedsede s~tta~.one:i.ss.ectgieD~ee~cfarCle.aoad~aDepeeewuRo[I~iMewl~aeree+~SwsatRi~oealA. t~wioe ~t~Ir~ a~icsfete+ttiasbesarfewiee/~tieo~laededz+aNwitstis St t`~CAewq-?~~ ~w.'d~dw 30• ~ si "r~ru'" cs+rtl~eva+rn- - a-~- ~ OWNER t^SR1'i~~ATIO~j i (trcj ~!- stir sit lteieeweefe ~ its tats aee foie b tits bat a[ 4 (wwI Iosoailae~e. I (~) aw (~ ~ e~e~s~ °.r the pro~+;~ et~aisd ~ !ry ritee tali wees~tp iesl.eaiisd is ><espinar al Deode ODioa - - -~ ~SIGIiA'itfttfi UP?~PLICJtM • ~~ DA't`E• -- te.rw ~ iafaenediep 9Nt is tti.eepeyopMedsssy rasrkse rlo peteeit bed > br drc lraeiag D ""~~ •• IaeWde w9t4 tMIR applisadsw; ~ s~mped aetranty, dart Flan the lksislar of Deeds office a eepy at ple oadified siwsY tttep if tefesencs is ni~4e is the we..rnhr Ieeal U ...2579 P 278 STATE BAR OF WISCONSIN FORM 2 - 1998 WARRANTY~DEED Document Number This Deed, made between Hammond Land, LLC, a Minnesota Limited Liability Company Grantor, and Price B. Ruhl and Laura R Ruhl, husband and wife r------ Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croiz County, State of Wisconsin: Lot 1 Hammond Oaks Subdivision., Town of Hammond, St. Croix County, sconsin, subject to notes, easements, restrictions, covenants and rights of way of record, if any, including but not limited to those for drainage, water retention, ponding and or utilities as may be shown on the plat of Hammond Oaks Subdivision recorded in Vol. 8 of Plats, page 2, St. Croix County, Wisconsin. Name and Return 3- 018-1086-13-000 Parcel Ideritifcation Number (PIN) This ~ not homestead property. (is) (is not) The warranties of this deed, either express or implied are limited by the Grantor to the Grantee, or anyone i n the chain of title, to an amount not to exceed the consideration expressed herein, that being the stun of 533,900.00. Exceptions to warranties: This Deed conveys after-acquired title. Grantor warrants only that Grantor has not done or suffered anything to enctunber the property, except: 2003 and 2004 real estate taxes remain unpaid, Plat of Hammond Oaks Subdivision recorded in Vol. 8 of Plats, page 2, Doc. No. 627995, Declaration Establishing Protective Covenants recorded in Vol 1533, page 610, Doc.No. 628035, First Amendment to Declaration Establishing Protective Covenants recorded in Vol. 1544, page 412, Doc. No. 630311, all >n St. Croix County, Wisconsin. Dated this 18th day of May 2004 Hammond Land, LLC AUTHENTICATION Signature(s) authenticated this day of , TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stets.) THIS INSTRUMENT WAS DRAFTED BY Paul A_ Baillon, Attorney at Law (Signatures may be authenticated or acknowledged. Both are not necessary.) ., by ~'~~-'~ President . Austin J. Baillon ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. Ramsey Colmty. ) Personally came before me this 18th day of May , 2004 the above named Austin J. Baillon to me known to be the person(s) who executed the foregoing instrument and acknowle ge the same. w...~A. * Paul A. Baillon NOtAP~ °ueuc-~ESOrA Notary Public, State of iscons My Commission is pernialten , no , sta expira~`YYr~~~ January 31 2005 .) 763663 KATHLEEN H. NALSH REGISTER OF DEEDS ST. CROZX CO. , NI RECEIVED FOR RECORD 05/24!2004 11:30Al1 NARRANTY DEED E%FJPT # REC FEE: 11.00 TRA11S FEE: 101..70 COPY FEE: CC FEE: PAGES: 1 "Names of persons signing in any capacity should be typed or printed below their signatures WARRANTY DEED 87ATE I4AR OF W ISC ONSiN FORM No. 2 - 1998 INFORMATION PROFESSIONALS CObIPANY FOND DU LAC, W[ 800-655-2021 PAR7 OF THE N~1t1 /4 {~F THE NW1 J4 AINp THE TOWi~iSHIP 29 N[#F?TN, RANGE 17 1+VEST, TOWN U~" 5E C. 20 ~w