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018-1086-16-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION ~ (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Schmidt, Tim Hammond, Town of CST BM Elev: Insp. BM EI BM Description: ~ ~~ ' ~~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing ~ ~ ~~ Holding TANK SETBACK INFORMATION TANK TO P!L V'dELL BLDG. Vent to Air Intake ROAD Septic I S/ ~ // 1 ' ( ! 1 p l~ l „~ Dosing ' ~ / A l~ (O - ~~ 1 -^ Aeration Holding PUMP/SIPHON INFORMATION '/\. ~~ Manufacturer errand GPM Model Number ~ ~ ~ ~ 5 . 1 TDH Lift g, Frictio~Loss System Head TDHZ~ Ft / Forcemain Leng~S,~ ~ Dia. / Dis . to well ,~ county: St. Croix Sanitary Permit No: 479377 0 State Plan ID No: Parcel Tax No: 018-1086-16-000 Sectionlrown/Range/Map No: 20.29.17.636 ELEVATION DATA STATION BS . +~ L HI ~ FS ELEV. Benchmark 2~yZ /oz, icra Alt. BM Bldg. Se r ' 7~ $ ~. S SUHt Inlet / ~-~ St/Ht Outlet _ Dt Inlet .~ ~ Dt Bottom z ~ ~ ~' ~g Header/Man. Dist. Pipe ~ ~ Bot. System ~$~ ~. Final Grade .z.rJ Q ~• 1 St Cover .,.~ of / f ~ Z 3.3Z S[)II ~RSORPTInN SYSTEM ~_ \ BED/TRENCH DIMENSIONS Width / Length J(O ~~` w / o. renc PIT DIMENSIONS ~~ No. Of Pits -~ Inside Dia. ~~ Liquid Depth SETBACK SYSTEM TO /L P BLDG WELL LAKE/STREAM LEACHING Manufacturer. ~` INFORMATION CHAMBER OR Type O ystem: ~~! ~ r ~ J _ /~ N ~~ UNIT Model Number. '1 r11STRIRIITIC~N SYSTEM Header/Manifold ~ rr I~ Distribution / CL~ Pipe(s) / /~ / r / x Hole Size J ' x Hole Spa~ing Ve to Air Intake Len th ~ 9 ' Z Dia Length J!~ Dia 1 ~Z,.Spacing / b 3 CO ~ ~ Cnll f'_f1\/FR ., n.,.«.s c.,~-e..,~ n.,r.. .... Mnnnrl nr ef.rrarlo Svcfr±ms Only G~"" ' - Depth Over t Bed/Trench Center / Depth Over Bed/Trench Edges ~ xx Depth of Topsoil ` ~ xx Seeded/Sodded ~ ~_i No xx Mulche es ~] No + ~ 1 ~ ~• ~~ ~~. ;,,~ COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ / 3~/ 0~ ~ Inspection #2: / / Location: 865 162nd Str Hammond, 154015 (SW 1/4 SW 1/4(2"~T2_9N R17W) Halmmond Oaks Lot 16 Parcel No: 20.29 7.636 1.)AItBMDescription= ~lJ~ ~G7v2~~ ~-""P`'"^''S ~ ~^a~~~~~ ~//~, _~O~ ~~ 2.) Bldg sewer length = ~ ~ Qty,,, V ~~ -amount of cover = rJ / ~JN.~.. ~ ~.~~~ i i ~ b ~ - - ~ ~- ~ -- - - -- - ~ ~--_~~~ , r Plan revision Required? ]Yes to ~ ~~'4['J ~ ~ Use other side for additional information. ~ _~ i ~~_ - -~ - Date ~,,,. Insepctor' Signat Cert. No. SBD-6710 (R.3/97) Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 ~' ~S~QQSI Q .Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce ~ (608) 266-3151 7~ T Sanitary Permit A ati n !~!~ - - F S e Plan LD. Num er In accord with Comm 83.21, Wis. Adm. Code, perso fo ti ' you provide b ' _~~ ` r'~l~s . /~. , `-) may e used for secondary purposes Privacy w, 5. 1)(m) ~y f ~( C j (~ ( I ~ 7 i' .. fE1~1 r act dress (if different than mailing address) , ~ S~ ~ ~ I A lication Information Pl P i Al ee ~ a . pp - ease r nt l Information ~ST. CROIX COUNTY Property Owner's Name ~ -~ ~ f ~ 6~ i ~ ce] # Lot # Block # . I ~ ^~ Proper ty Owner's Mailing A ddress ~ Prop cation ( ~ i ( ' f ~ /~ `~ ~~ t ~ ~ " "" ~ ) L 1 1 t .V t:./ 1~ ~, ~' ~ City, State Zi Code Ph l~ /,, %,, Section acs p one Number Q crrcl ~- ~ II T e of B din (check all th t l T 1 N; R E o W . yp g a app y) ~ S ~ ~ Subdivision Nam CSM N b s ~ `7L. or 2 Family Dwelling -Number of Bedrooms e um er ^ Yublic/Commercial -Describe Use ~ ~ S' ^ State Owned -Describe Use ~~// ^City_^Village tdaownship of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) -, , ~~ , ' ~ ~~ `~~ ew S stem y ^ Replacement System ^ TreatmenUHolding Tank Replacement Only ~ ^ Other Modification.to Existing System B • ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner 1V. T e of POWTS S s tem: Check all that a 1 ^ Non -Pressurized In-Ground Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip L' ^ avel-less Pipe ^ Other (explain) V. Dis ersaUTreatment Area Information: ~ Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersa Area Required (sf) Dispers Area Propo (sf) System ElevaHo , ~S~ . a ~.o ~ a~5d.~ ~#`~ ~ ~ VI. Tank Info Capacity in Gallon Total G ll Number Manufacturer Prefab Site Steel Fiber plastic s a ons of Units Concrete Constructed Glass New Existing Ta Tanks Septic or Holding Tank (~ Q J Aerobic Treatment Unit Dosing Chamber I VII. Responsibility StatemeAt- I, the undersigned, assume respo installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumb gna MP/MPRS Number Business Phone Number e ~ P `~ a~ x°14 ~ ~~ a35- ~ 3 ' Plumber s Address (Stree ity, State, Zip Code) VIII. Coun /De artment a Onl Approved ^ Di ed Sanitary Permit F (includes Groundwater Date Issued Issuin Agent Signature o Stamps) ^ ~ n Reason for 'al Surcharge Fee) ~~~' A IX. Conditions Approv UR al - ~e' ~n ~ SYSTEM O 3~~~ J~~s ~~ a"'~ WNER: 1 Septic tank, effluent filter and ~S y~ ~ G ~,~,;,,,~, es . dispersal cell must all be serviced /maintained ~~ -"'"-- J as per management plan provided by plumber. ~~ /~ ` Q ,, ~ ,. 2. All setback requirements must be maintained 1. s ~"`-J ~_ 1 ~ as per applicable code/ordinances. ~ S ~ ~ °---° ----r--•~ r•--~ ~•~ •+~~ ~~~y.,r ~~q~ wr wn sysrem un paper noc less roan sric x 11 inches in size SBD-6398 (R. 01/03) ~) ~ti 0 ~I ~~ ~-,_---" s ~-+ ~ ~ ~' ~ .~ 3 U a ,v ~c L -~' n ~ Q U .. 0 d c-( o O y ~ ~ ~~ ~~ !n ~ ~ '~' x ,--t o ~+ 'd" ~~ ~.. ~~~ '~ r" i~ S ~- J ~~ a J (~ J V :- J ~--d ~_~~ d J S ~ ~ 'a ~~ ~ ~ ~ ~ o ~ ~ ---~ `;~ s ~ ~~ 3 ~~ ~f -J I' ~ ~ I I 5 Y ~ J ~ _1 ~ ~~ 99 ,j ~ ~ i i ~ ~ Js ~i ..~ d _~ ~ -. ~ ~ `~ F D ~ O N ~/' ~~J V O Y ~7~ r-1 r 7~ ~ O } d J n -~ ~~ '- s 6 ~d ~~.~/ v~ f y d"'~ s d ~ ~ ~. y 1~ r r 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.wi.gov/sb/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary July 29, 2005 CUST ID No.225094 MICHAEL P ROGERS ROGERS PLUMBING E4457 HWY I2 MENOMONIE WI 54751 ATTN. POWTS inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/29/2007 Identification Numbers Transaction ID No. 1160329 SITE: Site ID No. 702211 Tim Schmidt Please refer to both identification numbers, 162"d Street above, in all comes ondence with the a enc . Town of Hammond St Croix County SW1/4, SW1/4, 520, T29N, R17W Lot: 16, Subdivision: Hammond Oaks FOR: Description: Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1030991 Maintenance required; 450 GPD Flow rate; 25 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/01), Pressure Distribution Component Manual -Version 2.0, SBD-10706-P (N.O1/Ol); 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: DER RTI OF Approval Requirements: ~, SEE CO • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.01/Ol) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD-10706-P (N.O1/01). • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. MICHAEL P ROGERS Page 2 7/29/2005 • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat • Comm 83.22(71 A copy of the approved plans specifications and this letter shall be on-site during construction and oven to inspection by authorized representatives of the DeQartment which may include local inspectors Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence 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, ~~~~ ~~o ~ ~C_J~T~ ~~ Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@commerce.state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 Henry F Grote ,Certified Soil Testing i i L Tim Schmidt -Mound Construction Materials and Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: RECEIVED 2 2 2005 Mound, SBD-10691-P (O1/O1) JUL Pressure Distribution, SBD-10706-P (O1/O1) SAFETY & BUILDINGS Location: Lot 16, Hammond Oaks SW '/a, NW '/a, Sec. 20, T 29 N, R 17 W Town: Hammond County: St. Croix Date: July 28, 2005 Owner: Tim Schmidt Address: 6695 Wildflower Drive, South Cottage Grove, MN 55016 Plumber: Mike Rogers Signature: ..--. License: MP 225094 Attachments: SBD-10577 -Plan Approval Application SBD-8330 Page 1: cover 2: design criteria & calculations 3: plot plan 4: system cross section 5: plan view, lateral detail 6: pump tank exit detail 7: pump curve 8: system management ~~~%>~1~11y ~ w a`~~ TEY CG'~'AfERC ~qk.. U cs SPpry~ENCE page 1 of 8 v• Design Criteria ~`'~ Residential Wastewater Contaminant Load: 30 mg/L < BODS < 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/L 3 Bedrooms x 100 gal/bedroom/day x 1.5 ~ gallons/day hydraulic load In situ designed loading rate Depth to estimated high ground water Depth to bedrock Cross slope at system Force main length Manifold/header length Drain-back Lateral length ~. @ Lateral elevation Lateral hole size ~~b in. @ ~ ~ holes/lateral Design Calculations n ~ Z gallons/sq. ft. per day ? ~ ~ in. ~ 8 in. • O % ~.,. r,,,,~ ~ `~ ~ ft. of 2 in. 2.q, ~ ¢ z~ ft f ~`IZ 3~ ,~ g S ~, ~ ~~, l 3 b.o ~g ~,g~~ 2~, og ~ ~ s~ Lateral volume Total lateral discharge rate Network pressure compensation losses Elevation difference Friction loss Total dynamic head Pump/si~[on ~"~ gpm @ I Manufacturer ~ ° e-1,1a~v Dose volume Lift/si~ion tank ~ ~ ~t n~ l cxrn - b~ ~, ~~ Septic tank ~, .o m. i,~4 gallons ft. of ``~ z in. ft. @ bottom of lateral in. ( 3,d ft.) Spacing holes total gallons i gallons/minute @ z ~ S ft. head ft. ft. ft. @ z5 gallons/minute ft. ft. of head Model # ~ ~ Z gallons ~ `rO gallons ~ `~ gallons Effluent filter ~r0''~~ ~ ~ ogz..Z- l4'~A y"~~•.~•~'C-~-~~ Measurement pump on and off S ~ ~ in. Height alarm from tank bottom ~ ~ ~ o in. Reserve capacity ~~~'~ gallons specs.calcs.res ~~. g C,o ~o ~ 3, b 2 . S~ \ 9.3 S' 2d Page Z of ~ 4 w~ ~ ~'~~ _: ~ 0 ~~ ~' ~ , .:~ v ~ ~ ~ ~~ ~ ,i, ~ti ~Y s ~ ~ c~S o ~ ~ , S C~ ~ ~V 3 ~c nL -Y _{ s 0 ~_ n ~., .~ J C./~ r ~~ rt t7' U C ~ ~~ a y ~ ~ ~n ~ ~ 1^ d ~~° ~ V/ ' x ,~ o ~ `~' ~' ~~ ~ ~~~ ~o d c-( (~`~ r~ ~ M i~ I ~-- J 3 J ~ ~ L-'~J ~ s ~ .~ ~ ~ o j I s 0 .%~ d J 0 ~r ~~ ~ `~~ - D ~- ~ r~ _J .s :~i d 0 ~I ~~ - D s "r ! O N ~- r 6 ~~ j i J ~ 1 Y O ~~ ~ ~t- ~ ~ ~ r N /" ~ ~ } d ~ -~ ~ ~ os '~ /d ~}} v~ b y ~~ 1 a ~ }?y ~_ y ~ ~ ~ .~ ~~ ~ ~9~ i ~ i. ~ ~~s I d -~r e~1 ~ ~ ! J ~i;5 V ` ~ ~'1-~vr- `Jr~SS J~-~'Ftoy ~ w I H ~ ~, w /~ '- ~~ j '~f ~ 1 i i'~ ~ C ~ ~ ~ ~ f /.\ -~ • k YV~~ ~- -{~ ~ \ l=I w. J \ \ 9~e 4~ ~ I r ----- ~° •~ ~ ~ ~ ~ ... , , ~ ,, 1 _... ....._ .... ~ ..__j.._. _ y,o7o ~ I ~~,os ~. ~:bi _.~. ~ v' 4-, ~' ~~.o, ` l ~ \ !\ ~ ~ ~ w 0~ r9 ! ~c- u cr \G N 1` -__ rn~. ~t2.' ~ 0.TQXa i 2.ru-i Nti ~ • ~ ~, ~ t 11~ 2 \~ v ~ S c.~ ~ v» oc r. ; C of d~ ~ 1. q,F~ra~G jr 2 c.~ : ----_ t Q.1r < <~ t 1 ~'L PVC Sc ~ 20,p i ~~ I 3, o' I ~,~~ I I 3,~' I 3,~' l s 4-, ~" I wvh~.~1 '("~`/ '~~~wwa[,aO< ~1~1.,~y ~-o Ci~w.,~ ej~'•~.b~sjG` ~ ~ ~ Q t } ~c `"'~/ V w` v t y •U X t ~ o ~r ~.~,(v, w. ~ OwT i ~ ..JJ 2 QU L S L~ ~ O~<< r. w. ~~r• ~~ ~ \ C ` v u ~ ~~ ~ o\ ~ o .~ 1 .~ c~• JL en...~ ~. ~a o-~ o r.. \ ; ., c.~ ~` 3 l~ o A e~ ~ ~ > a~ ~ ~w s ~~ ~ \~ i ~;,, ;;. , ` ~ (', 1 (~ ~. 1 i'Y 1JQ ii ~; . . X . on`~ ~ ' Mn~~ ' WEATNERpao~~ ' LOCKING CO`/fiR ~BE~ .J'u~cT,c~ &sx ,, lt/A/t~N /NG . ,( / I Q~iCK Di~CAU~ICT-~ Grade elev. y`~Z (," ~ ..~ ~ .4. 4, `~~~ --~ J. i .} 4" PVC soh ~ ' ~~T~% ~ 40, 3' onto _ 1, solid ground 4" PVC ~\ 24u I.D. Bch 40 ~i ' Mt~xUOLE i I vent 4 , i,K,~ r ~-_ i _ _ _ ~ • ~ _ . Lr--- ' / i ~ ~ n ~ ~ wE:G"P ~ GPI' R-OV i.D A ~ ~ o , p ~~ N OCF 4" PVC '~ ~QSICET ,SbNT'J ~ ~ ~4F F L E `sch 40, (ALL D i /S p Al 3' onto c~K-+Ec.T~o++S 1 ~- `'^/ ~ b .~ ~ - \ V'.O ~ ON solid C , ~ ~ ~ Q ' ' ~~ ground I „ l.e.~, a. /v h O w T Yom \ S~ O ~ b ~ ~~~~ c~ ~ C7 ~ ~ v. c. ,o C'~ f' ~ = c~ S~ZZ-1 ¢ r3A PwyP o q ~, C G FL~v~ - ~ bc~K ~d4,~ 1~~~c~ ScPr~c ~i _SPEC.IFI•CATIOFJS ~~' oos~ T~uK: MgUUFgCTU0.CR; ~ `~~ IJLIM6ER OF DO~CS: ~ ~ ~ _ per day T^~.1K SIZC ; ~ ~' ~~~ GALCO-JS • .DOSC VOLUME A~ARr1 hW~UFAtTURCR; S `~ ~~` tit~~ IAICLUOIW(, OACKFI.OW ~ ~~ ~ gallons nOD[L uuYbER: ' \ ° ~ ~~ ``' CAPACITIES: A- 2o'O IuCHeS CR 3~~'2 ~...q,y.,,`, ,~~~ gallons ~wiTCM TyP[; g ~ Z' i~;C-+ES oa ~3 S Z gallons PIMP /'1LUUFgCTURCR: ~OQ' ~ '~'" C a SAO iucaES CR ~~'g_ gallons MOOCL rJUMDCR; \'~ ~ 1S0 ~~ D^ ~ iNtMES oa gallons ~wiTCN TbPf: ~MQ.4~v ... IJOTE: PUMP A1.10 ALAR11 ARE TO Bc r1i-JIMUI'~ DISCHARGE RgTe 25~~ INSTALLED Ou SEPnR~TE circuits G - h1 vcRr~c~L o~FFE~f-JCf ~CTWCCU Puhr ocr ~+UO OIJTRI~UTIDAJ PIPC.. ~3,1~, FECT t .M'uir1UM uETWORK SUPPIy PilEtiURE 2'Sr FCCT +o~~"~ + ~ ~ ~ FEET OF PORCC MAItJ X `-~F~o ItFK1CTI0u fgCTOR. z«S FEET ~ zS ~~ - TOTAL DyUAMIC HEAP ~•~ fF.ET ~' ~~~, IUTERAIA~. DIME-,1510AJL •Of TAIJK~ LE-.IGTH ,~~, ;WiOTH ~g ,LIQUID pC p T H J ~j • _ ~.i ,.' W W ~~ 12 ~ 40 0 W x ~, 30 z 8 r 0 20 o 4 t0 HEAD C,APACIfiY CURVE MODEL 152/153 53 TOTAL DYNAMIC HEAd/CAPACITY PER MINUTE EFFLUENT AND DEWATERING MODEL 152 153 I` Feet Meters Gol. Liters Gol. Liters I 5 1.5 69 26t 77 29t 10 3.1 61 231 j 70 265 ' 15 4.6 53 201 61 23 t 20 6.1 44 167 52 ' 97 25 7.6 34 ~ t 29 ; 42 ', ' S9 30 35 9.1 10.7 23 -- 87 33 ' ~~ ' ' -- 22 E 40 t2.2 -- -- ~ =' Lock Valve: 38.0 Ft (t'.6m;jaap F; ;'?~~' 014509 20 40 60 80 100 GALLONS uTERS 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 Owik•Box available foPoutdoar installations. See FM1420. • Over 130°F. (54°C.) special quotation required. 1521153 Series . __ __ t57J153 MODELS - Control Selection Model Volts•Ph ~ Mode Am s Slm lax Du lax _Nt52 t15 t Nan 8.5 1 2a3 BN t 52t 52 t t 5 t -~ Auto 8.5 Induded 2 a 3 Et52 230 1 I Non 4.3 1 2a3 BE i 52 230 1 Auto 4.3 Included 2 a 3 Nt53 t15 t Non t0.5 1 2a3 _ BN t 53 t t 5 1 ~ Auto 10.5 Induded 2 a 3 Et53 230 t Non 5.3 t 2a3 BE t 53 230 1 Auto 5.3 Induded 2 a 3 O CAUTION All insUllatfon or controls, protection devices and wiring should be done by a qualified licensed electrician. All electrical and safety codes should M followed Ineludiny the rttoet recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). 3 27 ~- ~-- ~ I j -- ,~ ~~F ~i ~__--~ i • - _ t ; _-L sKZOa. ~ ' SELECTION GUIDE 1. Single piggyback variable level float switch or double piggyback variable level float switch. Rater 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, Q O ~ .:.~ RESERVE POWERED DESIGN ~~ For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. 80X 16347 LoukviAe, KY 40256-0341 Zo Manufacturers of SHIP TO: 3649 Cane Run Road /7 ~ Louisville, KY 40211.1961 QUA1fTY PUMPS SNCF /939 PUMP !O. (5021718.2731.1(800) 928•PUMP http://www.zoeller.com FAX (502) 774.3611 © Copyright 2000 Zoeller Co. All rights reserved. t System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, Rogers Plumbing, 715-235- 1132, or the St. Croix County Zoning Office, 715-386-4680, should be contacted for assistance. General Proper functioning of an on-site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a dose tank or compartment to allow a dose to be accumulated, a pump and controls or automatic siphon, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. 1. If the septic tank is installed prior to sheet-rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2. Install water-saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. 9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. If septic or dose tanks are no longer used, they must be properly abandoned. 11. If construction timing and weather could create a frozen infiltration system, weather-proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. 12. If possible, the upslope toe of the mound system should be landscaped with additional fill to blend this area into the upslope natural grade; this will minimize the possibility of the system trapping surface run-off; final settled slope should be 2-3% over the system or 2-3% diverting surface run-off around the ends of the system. Maintenance 1. The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the dose tank must be pumped, and the filter must be back-washed into the septic tank to remove accumulated material. System use may require more frequent filter cleaning; initial inspections of the filter should be made every 6 months until a minimum time sequence is determined. 4. Periodic observation pipe inspections should be made by the owner to examine the state of the in-situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down-slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run-off into the system area. 1 1. Warning: Do not enter septic, dose or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, and/or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 s~ Wisconsin Department of Industry, SOIL AND SITE EVALUATION ~` Page / of Labor and Human Relations Division of Safety and Buildings in accordance with s. I1~~8~08yWis. F ~~ ~1 ~ r I ' : ! ~ v~ ~. ~ A _.. Shin , ~ ~~,. ~, p Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. P~aR njurkt ~ • /~ ~/ but not limited to: vertical and horizontal reference point (BM), du~ctlr5r+ and J~ ~ `"'"~ , include , percent slope, scale or dimensions, north arrow, and location and distan~e to, nearest rdad~ '; `,: i arcel I.D. # O ~, : ai • is ~: S • so • airy _ f"' eviewed _ APRLICANT INFORMATION -Please print all information.' Date ; r L `~ be used for secondary purposes (Privacy Lav~ s ;1'5.0411 (~~r ide ma ti l f Z ,~ y on you prov orma Persona in Z Property Owner ~ (> N Q l ep ~i~ll~`© t7 l ~D (3 4 ~ ' Props C ~ • ~ ' ~~) ~.~/~ Z / ~`~+ G(/~14,S.KJ T ovt i•,Qt. ~ '' ,N,R ~ 7 ~'(or) W ~ ~ ~ O N•~ S v Property Owners Mailing Address 332_ h i IvN~5oT~ sT: E~1 ST ~ yo ~ _ ~ L k .Name or CSM# ~ .4~M.HOwD o~4•~s' City State Zip Code Phone Number ST• PAVE- I ~ N • ~ 5Sl p ~ ~ (SOS/ )222.555,5 ~~' Nearest Road w / Z ^ city ^ village L"J Tom e1,µ ((,O b [Y1'New Construction Use: LKfiesidential / Number of bedrooms 3 Addition to existing building ^ Replacement ^ Public or commercial -Describe: •~ Code derived daily flow ~_ gpd Recommended design loading rate ~ Z bed, gpd/ft2~trench, gpd/ft2 Absorption area required ~~bed, ft2 3 7 trench, ft 2 Maximum design loading rate bed, gpd/fl~ trench, gpd/ft` Recommended infiltration surface elevation(es) SrC~. •~.~~/'/~ ,r~ ft (as referred to site plan benchmark) Additional design/site considerations T I~ ~ ~~" / z z'" ~ ~ ~ ~~y ~~~y'~~~ Parent material ~D Et;s ~ ~~ D~NSF T/ ~~f Flood plain elevation, if applicable N ~-ft S = Suitable for system Conventional Mou In-Ground rP-reassure AT-Grard-ems System in Fill Holding Tank U = Unsuitable for system ^ S ~U ~^ U ^ S ~ v ^ S ~ u ^ S Ir..`S, U/ ^ S ...... r~~e•~nlrlTln\I nCOnQT Boring # 1 Ground ~j elev. ''. ~ft. Depth to limiting factor ~in. vv.r ... ... l . _ . _ - - - Structure GPD/ft2 Horizon De th P in. Dominant Color Munsell es Mott Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed ,Trench z °~ •~ ~• a ~° ~• s _ s ~ s /~ c ... ~ . s •ollli~. s/lr ; (56/80 'b) 0££8-Ma9S ;~ C1 UH $) ~~ L ~'~~ SOIL DESCRIPTION REPORT PROPERTY OWNER /~ //~~ ~^ PARCELI.D.M ~/T ~(~ /~/~Mlr'jr9~~ ~i4 ~"~ S ~~~ • Page ~' of ri H th D Dominant Color Mottles Structure d R t 2 o zon ep in. MunseN Cu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boun ary s oo Bed ,Trench y •~ ~o _._.. -- S/C.. if ,~ ~ ~i ' G' S - . 2 ; • 3 3 •1 ~ ~ ~ - .s:. /'~~/2 S/~i ' Remarks: Boring # , Ground elev. - ' n. ; Depth to limiting factor In. --- Remarks: Baring # Ground elev. ft. Depth to limiting l i C Mottles Structure R t GPD/tie Horizon ' Depth in. or nant o Dom Munsell ' rlu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary s oo Bed ,Trench factor , In'' Remarks: " Boring °# Ground elev. ft. Depth to limiting factor ~,~ ~ ~S') ,ti ~a ~vvf~ . T'oP a~ ;. - Ya2 . IS ~~11 r~(~. ~'~~v, _ Sao. 37 ' ti a ~ GG T ~.. ----1 .... _.._.._.~.....~._ ._._._...._~..~...._ O Ha LG% / to S~A~E: /'' _ ~O • = ,C3~I~,~G~O-e P ~ T s M oUti1~ S~/ST'' ~~~U. w '~ ~~~fl ~~ 58 ~ 1~ pj2 • . So w ~~, ~3 ~- y °7a 3~ -~ ~~ C, L-. Na ~I1 POWTS OWNER'S MANUAL MANAGEMENT PLAN I+'ILE INFORMATION Owner '.-~.-; Permit # bESIGN PARAMETEIl2S Number. of Bedrooms 100gpd/bedroom ^ NA I+lumber of Commercial Units NA Estimated flow (average)* ~p gaUday Design. flow (peak), estimated x 1.5* DgaUday Soil Application Rate . ~ gaUday InfluentlEffluent Quality (NA^) Monthly Average** Fats. Oil & Grease (FOG) 5 30 mg/L Biochemical Oxygen Demand (BODs) Total Suspended Solids (TSS) S 220 mg/L S 25(Img/I. Pretreated Effluent Quality ^ Montlily Average*** 'Biochemical Oxygen Demand (BODs) 5 30 mg/L Total Suspended Solids (TSS) - 5 30 mg/L Fecal Colifonn (geometric mean) <10+cfu/100m1 Maximum Effluent Particle Size 1/8 inch diameter * Wastewater Flow Verification on and calculations: (Other than bedroom based) * * Values typical for domestic (non-commercial wastewater and septic tank effluent. ***Values typical. for pretreated wastewater. SYSTEM SPECIFICATIONS Septic Tank Capacity ~ gal ^ NA Septic Tank Manufacturer ^ NA Effluent Filter Manufacturer ^ NA Effluent Filter Model - ~ ^ NA Pump Tank Capacity ~ gal ^ NA Pump Tank Manufacturer , P e,r' ^ NA Pump Manufacturer 'ZaClL2 ^ NA Pump Model ^ NA Pretreatment Unit A ^ Sand/Gravel Filter ^ Peat Filter ^ Mechanical Aeration ^ Wetland ^ Disinfection ^ Other: Manufacturer: Model: Dispersal Cell(s) ^ In-ground (gravity) ^ ground (pressurized) ^ At-grade ound ^ Drip-line ^ Other: ^ Leaching Chamber Manufacturer Model Approval Stipulation Soil Application Rate_gpd/ftz Area Req. Absorption Area Credit per unit ft Minimum Number of Chambers ^ Aggregate Design Flow/Loading Rate= min Materials: all materials must comply with WI Adm. Code COMM84 and be installed per manufacturers specifications and approval letters. DESIGN CRITERIA ^ "Wisconsin At-grade Soil Absorption System, Siting, Design & Construction Manual" (Converse et.a1.1990) ^ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. Publication 15.22 ^ ."Design of Pressure Distribution Networks for Septic Tank-Soil Absorption Systems" Publicarions 9.6 ^ '"Design. of Conventional Soil Absorption Trenches and Beds". RJ. Otis - ASAE Publications 5-77 and "Design Manual - Onsite Wastewater Treatment and Disposal Systems". EPA 625/1-80-012 October 1980 ^ SBD -10570-P (8.6/99) "At-Grade Component Manual Using Pressure Distribution" ^SBD --10567 P (8.6/99) "In Ground Absorption Component Manual" ^SBD -10703.=P (N.O1/Ol) "In Ground Soil Absorption Component Manual" Version 2.0 p-SBD -10628-P (N.6/99) "Recirculating Sand Filter System Component Manual" ^ SBD -.10656-P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual" SBD ~ 10572-P (8.6/99) "Mound Component Manual" ~BD -10691 P (N.O1/O1) "Mound Component Manual" Version 2.0 L`1 SBD -10595-P (86/99) "Single Pass Saud Filter Component 1Vlanual" ^ SBD - 10657-P (86/99) "Drip-line Effluent Disposal Component Manual" SBD -10573 P (R 6/99) "Pressure Distribution Component Manual" SBD -10706-P (N.O1/Ol) "Pressure Distribution Component Manual" Version 2.0 ^ Drip-line Effluent Dispersal Component. Manual for Multi-flo Onsite Wastewater Treatment Units MAINTENANCE MONITORING SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every ^ months ear(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one-third (1/3) of tank volume Inspect dispersal cell(s) At least once every ^ months .year(s) (Maximum 3 yrs.) Clean effluent filter At least once every ^ months year(s) Ix-spect pump,pump controls & alarm At least once every ^ months ear(s) ^ NA 'Flush laterals and pressure test At least once every ^ months ear(s) ^ NA -Naives At least once every ^ months ear(s) ^ NA Other: At least once every ^ months _ _ ~ ^ year(s) `~ NA -Page of START UP For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the. treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions aze frozen at the infiltrative surface. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation ofwater-saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Nate: this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable/fruit peels and seeds, bones, and food solids such as those produced by a gazbage disposal should be minimized. Toilet tissue is the only :paper that should be discharged into the system.. Other non-biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts,. dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum. products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS .and. contaminate your drinking water supply. Maintain a reguL3r steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction. of snow over the dispersal unit may cause it to freeze up. valves ~ aeves shall be operated in the followvag manner: Alarms Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back-up of sewage into the dwelling or surfacing. INFECTIONS .Inspection shall be made by an individual cazrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). egtic Tanks Component Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks or leaks, measure the.volume of combined sludge and scum and to check for any backup or ponding of effluent to the ground surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one-third (II3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR113, Wisconsin Administrative Code. The outlet filter(sj shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Fitter cleaning maybe necessary ai more frequent intervals than stated in the maintenance schedule to keep the system operating. ~(t'ump Chamber/Treatment Tanks Component // ~~' The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be `made for leaks, backups, surfacing, missing or broken security devices and other hazdwaze and the condition of the filter. Any service needs or repairs shall be promptly taken Gaze of. Q In-isround t,,ravity Component Dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or dischazge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. Page of ~{~Ivlound, At-Grade, In-Ground Pressure //~~" The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage, or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that :equal distribution of effluent is occurring to promote the longevity of the system. REPORTS .Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Code. - All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. - The contents. of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. - After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or other inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ^ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil from existing and proposed structure, lot lines and wells. Failure to protect the replacement azea will result in the need for a new soil and site evaluation to establish a suitable replacement azea. Replacement systems must comply with the rules in effect at that time. A suitable replacement area is not available due to setback and/or soil limitations. Baring advances in POWTS technology a holding tank may. be installed as a last resort to replace the failed POWTS. ^ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement azea is available a holding tank maybe installed as a last resort to replace the failed POWTS. [~ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative I surface. Reconstructions of such systems must comply with the rules in effect at that time. «W;ARNING» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIItCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Hilt Name Phone S". 2 $`~ L Phone 'SEPTAGE SERVICING OPERATOR (Pumper) LOCAL REGULATORY AUTHORITY Name:: Agency ~ W, IU/IV Phone. Phone Kc1WPDATAIEH~POWTS OWNER'S MANUAL.doc Page ~ of SEI"TIC-TANK MAINTENANCE AGREEMENT A:ND OWI~iERSH1P CERTIFICATION FORM tli~i"iGl/i.~Li~i:i ~~~~~_..._ya Y f y~~~ ' __ • 1. 1 ~ 4ai~drdS5 ~ n ~ n `.'1 ~ ~ A ) 1 1 ~'T I~.~ J~C.f( 1/ I~l V L - l~J.xil It ~, z ~~ ~~r~xlsorry Aciciress (verification required from Planning Department for new ~it?~/State arcel Identification Number ~~- ~~~.~o " < <o - ~i15~ S~a~~ C.c.s.) ~~ropercy Locatc~n.~~ i/{, ~?.idl'/~, Sec. ~, T~_N-R~2W, Town of ~~Y f1Yi4t~a'tir~e~ IYia~ # Voltune I,ot # __.L_(~___. Page # '~~i'~,~'iC~iuty l~eec~ # ,_~ ~~ ~ ,Volume ,~3 s ,Page # 3~~. S~~:c house Q yes ~° Lot lines identifiable ^ yes ^ no u ~'S`l~~l~~ N~TI~`r`ENANC3E Tnaprt~peruse and maintenanceof your septic system could result in its premature failure to handle wastes. Propermaintenanc~ Wo~ists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the syscezu c;,•:o, aftcci fire fuuctiorl of the septic tanl~ as a treatment stage in the waste disposal system. `l he proparty owner agrees to submit to St. GYoix Zoning Department a certification form, signed by the owner and by ~sc~rpiuwl~er, journeyuianplumber, restrictedplumber or a licensed pumper verifying that (1) the on-site wastewater disposal systen: i5 iu proper operating condition audlor (2) after inspection and pumping (if necessary), the septic. tank is less than 1/3 full of sludge. iwc, the. uudras,gued leave read the above requirements and agree to maintain the private sewage disposal system with the stan3:ards Nei fc~nlt, herein, as set by the Deparunent of Commerce and the Department of TIatural Resources, State of Wisconsin. Certitic:~tior stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office witL ~ 3 ~ days of the three yaar expiration date. ~~~N~~ ~~~.7'Y~3lCAT~C~N ~ (~'c7 certify that all statements on this form are uue to the best of my (our) knowledge. 1 (we) am (are) the owner= iii pxuptaty cieSCribed above, by virtue of a warranty deed recorded in Register of Deeds Office. 7 ,/~„~~ ~ _. ~~tp ~ +hai: ail s~arss en chjs fQrrp axe xCua sc nc~ best of usy (cur) y~rtl~dge. 1(~ro~. axxt (are) Y.it4 a:,.~~~,~-. . ` °~ ~'~~~. ~- aec~rdc8 ix~ ~ L~~ off' D~ Qf#~ice. ~~,~ pm d~ssurataca3. ~r UY +rirt+w of n r~varca,~.ty flood F S ~ ~ ~ ~,~~ ~; ~~~~ ~:,.;..: u:ti:exx~w~t ;wry },~ormannr~ shAt i~ ~sRxs~prea9craccd tray result 8n tY:a sar~i'®zy Peru ~~.~ ravoi~d by r3acZ~~zing ncpartxcla;~.t. raw ,ltt~l3d~ ~E~. ti~iv u~All~~; a sramged ~va~a~Ey Gaed fr©tn tl~o ~egfates of AeGd~ 4f~cc ~, ~,~~+ of iii ees-ti$ad at>."vey map if ~ecl;'aretw,s is ~d~ in-s3zo ~~1~ dsibet ~~ Z ~~,' ~,, s ~ ~ ~r r cr ° N ~ , c `j ~V n ~ ~. ~-- "'T~~ li %1 J _ _ ._ \-~. J ,~ r ~r ~{.1 ~\ _a d ~ Cn - _ n C3' V ~~ .,--- ='' ~' ~ ~ a ~ } d _n ~ ~ ~ a j~ c-' ~ ",. ~ O" x ~--I 0 ~ ~~ ~~~ ~ ''~ ~; Q M ~- J d J r ~ V ~ ~l .~ Q J ~I ' ~ ~ ~ ~ ~ s r di p ~-t f C N CI-S ~ ° S.o~ Y J O ~~ n ~ ~ ~y~ sYo •3 ~ _'~" j J N~ ~ ~ ~--~~ n I z 0 .r:~ 0~ J 0 .f as j ~ •3 ~~ ~ ~ ~ --'--j O ~nn~ 3'~~ j t i '~" ~~ ~~ ;,, ~ ~ .~ ~ , ..~ ~~ ~~s a ~~ ~' ~ ~ ~ `~ ~ N i- ~ d ~ --' ~~ G ,J J "~ l../° va ~i p1 /, y s 3 ~ o ~~`~. O Y 4 ~ff ~ o f ~°," • ~_ n n ~ fl II ~ i d If ~ w II O ~. II II II } II ~ s II r' ~. ®: ................... e m J_ II ~ „ ~ 4. II ~k ~ I ~~ c0•P _ = ~-t I • II I I ~ ,I .I i ~~ II it I ~I '1 I II b ~~ ~, ~ ~~ ~ 88 !ZG~ ~~?HH S~Wt1H N4y~I'~3VJ~' lt/3?~J ?b8b96Z~tL ~,8 ~trT. 5AR" ~~ ~ ~~ + --- ~ x ~ ~ I ~ ~ $ a ~ ~ ~.~.. ~ o ~ @ E ~ f ~~~ ~~ £8: £6 3~t7d S3WOH N'~~I~J3WH lti3?~£i T.bSbS£Z9T.L Z£ :bT SDA' `1 1 S 3 S i' 3 7 tf STATE BAR OF WISCONSIN FORM 2 - 1998 WARRANTY DEED Number This Deed, made between Hammond Land, LLC, a Minnesota Limited Liability Company Grantor, arld Timothy D. Schmidt Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croiz County, State of Wisconsin: Lot Town of Hanunond, St. Croix County, 68527'6 KATHLEEN H. YALSH REGISTER OF DEEDS ST. CROIX CO. , 1tI RECEIVED FOR RECORD 07-29-2002 10s00 AH EXEi DEED REC FEE : 11.00 TRANS FEEz 74.70 CORY FEEz CERT COPY FEES PAGESs i and Return Address 018-1086-16-000 Parcel Identification Number (PIN) This ~ not homestead property. (is) (is not) Exceptions to warcanties: Subject to notes, easements,nstrictions,covenants and rights of way of record, if arty, including but not limited to those for drainage,water retention,ponding,and or utilities as cnay be shown on the plat of Hammond Oaks Subdivision recorded in Vol. 8 of Plats, page 2, St Croix County, Wisconsin. The warranties of this deed, either expressed or implied are limited by the grantor to the grantee, or anyone in the chain of title, to the consideration expressed herein, that being the sum of 524,900.00. Datcd this 19th day of July 2002 AUTIiENTICATION Signature(s) authenticated this day of , TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stars.) THIS INSTRUMENT WAS DRAFTED BY Paul A. Bailion, Attorney at Law (Sigttattlres may be authenticated or acknowledged. Both are not necessary.) Hammond Land, LLC ., by ~~~_ President . Austin J. Baillon ACKNOWLEDGMENT STATE OF WISCONSIN ss. Ramsey County.) Personally came before me this 19th day of July , 2002 the above named Austin J. Baillon __ ~_ to me known to be the person(s) who executed the foregoing inst ent and acknowledge the same. PAUL A. BAILLON • Paul A- Baillo ~-~: NOTApY PUc'.~.Ic-MINNE90TA Notary Public, Sta o tsconsin My Commission i te: January 31 ~ 2005 rj 'Names of persons signing in any capacity should be typed or printed below their signatures 8TAT8 aAR OFw18CONSIIi WARRANTY D88D I'OriM No- 2 - 1998 INFORMATION PROFESSIONALS COMPANY FOND DU LAC, WI 800-bSS-2021 `,~- ~/ ~ ~ p ~a ,~RF , L ,~ •'\ ~/ ~{ ~ ~ 7 ° _ ~ ys~,Ts~x arl~ ~' ~~r~,y+rx i ~a ~.~: ti~~ .1 #,~ ~ ~~ Y ~/ 7~I ~4 n~':~ ~A ~ ~ e Z f ~ • C 5 `„b~.r //AA ~e~ k '~. ` 1 .. ~ . ~ + i . f. ~ Y~~F¢ .q t A : e t ~ ~-~'*~c ri ~r (( ~\ rJ~ NIrI~ _R ~yl.~ ~ ~3 ~ ~ ~ vQ G ~ F ." ~ s ~6a. ~'! ^Ny j ~1'V r"1'~~~.Y't.rVir»~~`~~.~.i`1~yu+.-~-.r~.'.F plf ,IJ, t ;~~ ~'I/ ~, ~d4. ~, el ~ ~ l~.g~. 'Ali'd'I!'" 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