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018-1086-26-000
Wisconsin Department of Comm~.rce Safety and Building Division ~ PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes IPrivacv Law, s.15.04 (1)(m)l. Permit Holder's Name: City Village X Township Lalle ,Patrick Hammond, Town of CST BM Elev: Insp. BM Elev: BM Description: J~ ~ n~ ~ i TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ' 1 ~ S fir- /~O Dosing G o.~.-~0 5d ~-. C"~ L ~p~ c.~ ~ ~ ~J Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic IZ; J~ ~ ^ ~ - /~ ~ Dosing ~ 2,./ ~ ~ ~ 5 / ~ 5' Aeration Holding PUMP/SIPHON INFORMATION Manufacturer f Demand ~ ` .,Q~ GPM Model Number ~ ` ' TDH Lii~ ~ Friction Loss System Head TDZH2 ,~~qt `"''~~ Forcemain Length ~ Dia . !~ Dist. to well j Z SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No: 463499 0 State Plan {D No: Parcel Tax No: 018-1086-26-000 Section/Town/Range/Map No: 20.29.17.646 STATION * BS r d HI lJl . FS ELEV. Benchmark Alt. ~- p ~A~~w~C.rl~i ~ ~ ~ $ ~ 3 Bldg. S wer ~ 3 ~ ~ ~~ ~ Z SUHt Inlet ~3,rJ5 $ 7 . ~~ SUHt Outlet .~ Dt Inlet .~, ,~ Dt Bottom I' . ZS ~ ? J Header/Man. y ~ ,~ Dist. Pipe ~ ~ ,~1~~ Bot. System ~ ! ,7~ J / Final Grade * ~ ~ (~ ~ St Cover Z$bS ~ 3~ ~©1.30 ~.d BEDITRENCH Width « Length ~ No. renc P17 DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ Ci~ // `' ` ~\ \ SETBACK SYSTEM TO P/L BLDG WELL LA!:E/STREAM LEACHING Manufacturer: ~~ INFORMATION CHAMBER OR T e tem: YP ~ ~, ~ ,eS ^ [ ,/ ~ ~ UNIT Model Number: 1` I~ISTRIBl1TION SYSTEM ~ _.cL- Header/Manifolds ~~~ Z ~ Distribution ~Z I ~~ ~ p() 7 ~ ~ , ~ x Hole Size ~~ x Hole Spacing ~ ~ Ve t to Air Intake J ~O ~ ~ Dia Length Spacing ' Length (1 0 r Dia ~ `~ ~ R[lII OnVFR v Drncm~rn Rv~4nm~ rlnhi vv Mn~tnrl CIr O}-r1'AfIP SVStPIl1S Or1IV Depth Over ~ Depth Over I xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ~~ Bed/Trench Edges Topsoil ` ~ i Yes ~ ; '~ No es ~ :JI No I COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ' / ~ / ~Q5- ~~i Inspection #2: / /. Location: 1603 86th Avenue Hammo d, WI 54015 W /~ NW 1/4 20 T29N R17W) Hammond Oaks Lots; 26 Parcel No: 20.29.17.64E 1.) Alt BM Description = -~ ~~ ~J ~~' ~' ~ 2.) Bldg sewer length = ~ ~ ~ ~ ` "c'"O ~ ~ ~~~~' ~ _ ` -amount of cover = ~ ~ J t ~ ~Q~ c C ~_ ~ ~- - f - Plan revision Required? I ~, Yes 13YNo f n I I ~ ~ /~ ~ , Use other side for additional information. ~ l__.__ ~ ___ _ Date Insepctor's gnature Cert. No. SBD-6710 (R.3/97) ~~ Safety and Buildings ' 's Counry ,.• ~ , 201 W. Washington Ave., P.O. Box ` 7162 ~ ~ Co ) mber (to be filled in b it N P i , ~ Madison, Wl 53707 - ~S O . y u erm tary San a I I ~~ (608` 266-3151 ~ 3 [/! Department of Commerce Sanitary Permit Applicatio ~ ~{~~, rovtd Adm Code ersonal information ou Wi 21 83 an I.D. Number ~ ~ p . , p , s. . In accord with Comm maybe used for secondary purposes Privacy Law, s15.04(1 m) Project ddrrxs (if different than mailing address) ~~ ~~a 8~ ~~ A/~ L Application Information -Please Print All Information t .~ ,. , ,, , Pr rty Owner's Name ~ '- ` ~ ~ FG ~ ~r~~rui, ~; i~ arcel Lot # Block # ~~ ,.., roperty Owner's Mailing Address Property Location ~~ Y., ~Y., Section ~_ City, State Zip Code Phone Number (NS r~'Y`'D ~~ cucle T ~ N; R~E W B ~f eo~t~.~ p~y~. e [I. Type of Building (check all that apply) Z Subdivision Name CSM Number 51-u ~ ~ ! ~ (~I or 2 Family Dwelling -Number of Bedrooms / ~ ~ r ~ ^ PublidCommeroial -Describe Use ,`'~ Q4 ^Ciry ^Village (Township of ^ State Owned -Describe Use III. Type of Permit: (Check only one box on line A. Complete line B itapplicable) ~ ~$ - ~O S!!o " LCo - 6a O A' New System ^ Replacement System ^ TreatmenUHolding Tank Replacement Only ^ Other Modification to Existing System List Previous Permit Number and Date Issued B• ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New Before Expiration Plumber Owner ~ IV. T e of POWTS S stem: Check all that a 1 J~ X ^ Non -Pressurized In-Ground Mound >_ 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ ~ Constntcted Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter /' p ~ J Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain) (...Q ~. V. Dis etsal/Treatment Area Information: n Flow (gpd) Design Soil Application Rate(gpdsf) Disrpersal Area RequireRRd (sf) Dispersal Area Proposed (st) System levation g Desi ~ g~r ~ lla~ pP3D 4~U ~~ // 1~Y 7~® ~ ~J VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel fiber Plastic A ~ ~~ Concrete Constructed Glass Gallons Gallons of Units ~~ J i~ New Existing Tanks Tanks ldin Tank ti H S / g c or o ep r ~ Aerobic Treatment Unit - Losing Chamber ~~Q e j5 / ~ VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) P bet's Sign a MP/MPRS Number Business Phone Number w ~ D a Plwmber's Address (Street, City, State, Zip ) !~1 !'III. Count ~/De art ent Use Onl Sanitary Permit Fee (includes Groundwater Date Issued Issuing nt Signature o ps) Approved ^ Disap Surcharge Fee) 6 5 Z S ~ ~~S ` Op 5 ^ Owner ~ easo vial ~ 'l ' _ IX. Conditions of Approval/Reasons for Disapproval 3, ~~ ~ ~' oJ~S ~ /\ s~2. O / ~ YSTEM OWNER: f ~ r /~ ~~-' ~ Gfnti: "~' C ~~ J~ ~ . t, ., ~ . Septic Mink, effluent filter Arid dispersal ceH must all be services ! ritt~ritairisd as per management plan provided by pklrnber. 2. AA seQiach ~ must be rtieirtWned ss per appllceble t;ode / ordirnfices. Attach eompkte plans (to the County only) for the system on paper not less than 812 x 11 inches in size v D 50. SBD-6398 (R. 01/03) ^ sa;l e JaruQf;o„ ,~;~ ~ EXlS t~i'n~ ~ ~acle e lev: • /ocu.te.d /crop. Sfr..t'e ,q~p~oX. Joca~{i~n o~ ne; borl„~ !'es;dce r- ~~~s~''~ htou..~d Ser-/~~ ~ , ~1.6ori~y r~S, d'Cn~e. ~ropo~,-noc.~,.~,da.~ t7~3aX~o~! ~ s'k 9D'd:S~OerSa/ ~e !/. 7`c~JO C-z.J y~' o~, ~ cis ~YJac<.~l a~ ~.~' ro ~rojaose~ ~reserCo.,cr•e~e a~L~/ tP~?/~5a Com 6.'r+a~E;o~ 4 F'.'l ~CLL` S. T au.Z` /c~ 1 Proposed 1,.)e. ll ~ ac.o~+or. ppPaop; 3 ~s R a [~~.~7. 89.70' ~`s~.~loP./.e: bu;t~l,~nq.S~u~ ~o~dc,. ~ 9~ os~ ` '" Fero h. b~ (33 ,,. 97.o'Co~rtou~ /s9. /6' f3pp~aX ~ /0lCc~+~ of ~e~51,[~-~ wc,l1 O ICSi since ao 0 0 Mound Ssrvi~+1 ht. bor'~~ ° rc3~; d~.nc~ Ali. B.,rt.: Top o~/at S~i.Ye. ~. Benc.~, -~ta',t'~ Tom o~/of St~e.~ Elev: = 97 Sl2, flssumerJ ~,-e~= /w.Gb py goF9 o.~ ne ~~bo,-T.+S resrd ce r- e~~s~'''~ ~,.Loc...~d Sep/~' /'le,~/~6or,%,y r~ S; ~rc-e. rJ I~ropos-~.el vnound a~ t7.3D;r ~o~ 4-Y s X 9D'd,'s~ersa/ Ce !/. 7'u~o (z~ l" ~ ~ Or, ~ GeS ~GGt.~(G~ 2. Sd ~ ~So;l eda(liaf;o~ ~o;~E • Ekr S t~r'ng _4 ~ac~P F. (e-~: • /o C.~ite.d ~D ro~O. S fz.t'e PropoSe~ c~res~Co„cr~e~c %~ F, / t~.cr-at s. T c<..~ pct P ~.d P P~ ' ~ (oc.a~+o>. PRaP. 3 g ~ a RES. 89.70' o. v ~`s~.~oP.de. h du;l~l,-.~.5~~ ~„~ sue. ~/D ~dC. ~~~~ • y~ ot~ 9 ~ ~' Wabd ~ -96 W _ _ _ / ~~,. 99.o'Co~tou~ ~sy. /~' ~pprox•%~'£'f, rOf ~frJGk~o~-•/ -f WCl( Or E,f'i7 fj'n q ~CSi~cjirrc'e 0 Moand Ssr/i^0 nee bar-~^ ° raS; d~nc~ Ali. tg.rvt. ~ Tp aE/ot Sta.f~e. ~ 8~nc,~, m~~~ Tp of/otStufe. ~\ E(ev: = 97 ~.2~ /(SSGcme.d ~kr~ - icv.~o' py, 8 0~'9 ~~~ t • ~ .. ~ Wisconsin Department of Industry, SOIL AND SITS,-€1fAl.llATION ~' Page / of Labor and Human Relations ' " Division of Safety and Buildings in accordance Ltd ~..fI:HR 83.09, WIS. ~ .- ~` '~ ~ ,. ~ ~~ ~' Coun ~+ ~~ Attach complete site plan on paper not less than 81/2 x 11 inches in ze: ,Plan mupf : - '~ ``~ 5/ • G~ include, but not limited to: vertical and horizontal reference point (B ,-dissection and ', percent slope, scale or dimensions, north arrow, and location and di$tahde to rest ~oad. Parcel I. . # O • APPLICANT INFORMATION -Please print all informatioHt. r "t~>`r.`, M Rwi®w by Date Personal information you provide may be used for secondary purposes (Privacy La~i,~sf'15.04 ~i) `i{{,)),; G c=f(;~ ~ ~ ~ Z Property Owner ~ V M a ~ eo LAN D ~ d ,Prpperty_L r" n, (~ ~ ~~ N"fl~ ~7/~ 1 ~ ~D /J . Ld. ' 114 1u~1 i4,S ~-~ T ~ 7 ,NCR ~ to(or) W Property Owner's Mailing Address Lot # Block# Subd. Name or CSMf1 332.. M i v,~~SoTA sr• E~15 T I yo ~ ~ L ~4M.~to~vD oi9-ks' City i1 State Zip Code Phone Number ,-,,~ Nearest Road w ~ Z OJT PnVL ~ ~~. ~ SS~O ~ (wS~ )222',S5S5 ^ City ^ Village CJ sown qti,~ (~1d ['New Construction Use: ~rsesidential /Number of bedrooms ^ Public or commercial -Describe: 3 Addition to existing building ^ Replacement ~ Recommended design loading rate bed, gpd/tt2 ~ trench, gpd/tt2 Code derived daily flow ~~ gPd ~ 5 .~~/ 2 trench, ft2 Maximum design loading rate ' 1 bed, gpd/ft~ trench, gpd/ft2 Absorption area required y l `1 bed, ft 31 Recommended infiltration~~~su~rfa~ceTllelevation(s) Su • ~ ft (as referred to site plan benchmark) Additional design/site considerations N~ ,I n Parent material ~~ E'Ss D Ur~ Q~NSL~ T/ ~~f Flood plain elevation, if applicable TT-- Conventional Mou In-Ground Pressu AT-Grade System in Fill ~ Holding T~ S = Suitable for system ~ ,-,~ ^ U ^ S ^ g U ^ S ~L-~,'t1! ^ S C U = Unsuitable for system ^ S U IJd 5 ~re•/•n•nT1ArJ o~oneT Boring # i Ground elev. ~'/ • 1 /f ft. Depth to limiting factor 3 min. Boring # ~.. Ground ,~j elegy. f ~ • ~ft. Depth to limiting factor ~in. Remarks: CST Name (Please Print) Rpt3ER~' Address .w•~ v.-......... - 2 Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont. Color Structure Texture Gr. 5z. Sh. Consistence Boundary Roots GPD/ft Bed ,Trench s 9• soy io y vE'!~ - S~ /fs tt. 1~fS ~ c~ ,. - .K;. , s ; . ~ 3 ~o ~ f ~o+ s . ~ ~ --- . Z~ • r, _ _~. 2 ~o SL of s h ~f v ~ crv C -- - . s ; • ~, •K .5 o ioYR ~!Z v G- . , ~S ~n y~ ..~~.r.~,~ d scaeclate8 I C.hT' Signature D~f • z3 . Telephone fvo. ~~s• 38G • ~- ~ s CST Number ~z.4375 ~~ VH $ ~ ~~ L ~'~~ SOIL DESCRIPTION REPORT PROPERTY OWNER ~~ ~ ~ S ~ ~ h • PARCEL I.D.# LOT ~~ _ ff AH~1 o~vt7 ~f BOring # Horizon Depth in. 3 •io •~- ._ Ground elev. ft. Depth to limiting RamarkS: Remarks: i ~ Page ~ of Structure 2 Dominant Color Munsell Mottles Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Bourdary Roots Bed ,Trench ~0 3 ~o yR 1 / ~o - fif Mots goy ~ ~. ~L 5 SCG l shy 2fSh ~f S~6 d s ti c S c - - ! f - - . ~{ :. S .5 ~ . ~ • Z ~ ~ , 2 Horizon bepth in. Dominant Color Munsell Mottles Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ft Bed ,Trench factor --'n' Remarks: Boring # Ground elev. ft. Depth to limiting factor '"~ Remarks: SBDW-ti330 (R. OB/95) ~~ r G -(~- ~ ~ ~ C "17- .,..~ •*.) G ~' ~ c ~ Z ~ ~~ _ _ ,, W W ,, Za ."O ~' - . .... _ __.__, 6. - ~, N O ~ ~~_ ~~ .--~ ti 0 -t N ~ 3,,610 ~ P~ -~ ~.. N ~-. ~ 9~ oo ,P w ~J r- G o 7- ~ , ~ c _ ~c ~ ~ ~ ~ ~ ~ ~ ~h ~ 1 "'~ ~ C. v ~ ~ ~ ~. o .--- ~ o. _ ~ vW ~ ~~ d oS"~ 6' -~C r 0 1 Iv 'O .w r I commerce.wi.gov isconsin 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 Doy4e, Governor Mary P. Burke, Secretary May 13, 2005 CUST ID No.222904 JAME5 W BOUMEESTER BOUMEESTER & SONS EXCAVATING INC 1070 HWY 35 N HUDSON WI 54016 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/13/2007 SITE: Patrick Lalley 1603 86~' Avenue Town of Hammond St Croix County SWI/4, NW1/4, S20, T29N, R17W Lot: 26, Subdivision: Hammond Oaks Identification Numbers Transaction ID No. 1135085 Site ID No. 698227 Please refer to both identification numbers, above, in all comes , ondence with the a enc . FOR: Description: Proposed Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1017479 Maintenance required; 450 GPD Flow rate; 30 in Soil minimum depth to limiting factor from original grade System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/01), Pressure Distribution Component Manual -Version 2.0, SBD-10706-P (N.O1/O1); Biofilter The submitta( 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: • 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). • The pressure network is to be constructed in accordance with publications SBD-10706-P(NOl/O1) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems -Version 2.0" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01 /81)". • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. P.0.169i.T. Cvyidtiallald __ y JAMES W BOUMEESTER Page 2 5/13/2005 • Comm 83.22(7) - A copy of the approvedplans specifications and this letter shall be on-site durine construction and open to inspection by authorized representatives of the Department which may include local inspectors. Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) -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. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. 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. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee. shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Gerard M. Swim POWTS Ptan Reviewer -Integrated Services (608)-789-7892, Mon. -Fri. 7:30 am to 4:15 pm j swim@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 INDEX AND TITLE PAGE Project Name: Patrick Lalley 3-bedroom residential mound Owner's Name: Patrick J. Lalley _ Owner's Address: 585 Broadway St. Hammond, WI 54015 Parcel Address: 1603 86th Ave. Legal-Description: SW1/4 NW1/4, Sec. 20, T.29N., R. 17 W. Township:. Hammond County: St.Croix Subdivision Name: Hammond Oaks Lot Number: 26 Block Number: Parcel I.D. Number: 018-1086-26-000 '~ Plan Transaction No.: ~ M`'1- OOM'~`"a ptpGS ~ ~- ~ MENS OF ANp gUl~~ R ~`I p~PP SAfE Page 1 Index and title pN~s~p EtiGE Page 2 p Data entry ON ORR s i d d M RECEIVED Page 3 SEE C raw ng oun Page 4 Lateral and dose tank MAY - 6 2~U5 Page 5 System maintenance specifications Page 6 Management and contingency plan FETY & BUILDINGS Page 7 Pump curve and specifications SA Page 8 Site Plan Page 9 Soil Evaluation Report Designer: Jim B umeester License Number: 222904 Date: 05 2/0 Phone Number: (715) 386-9020 Signature: Designed Pursuant to the Mound Component Manua! for POWTS Version 2.0 SDB-10691-P (N. 01!01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 4.01 (R. 09/04) Page 1 of 9 MAY-12-2005 03:16 PM A.C.E. Soil & Site Eval 715 248 7764 Mound and Pressure Dfstrlbudon Component Dm<ign Design Worksheet _$ J ~~ Sb Inronnatlon (r or c) R ReaidentiAi or Comrrrerciat Dssign ~ en+d ~ (~ rune ~ ~OOAO F.atlmated Wactswater Flow (tom 7~ es-aa h..w soil ldt~ltlNtt tdr 1~1 l.60 Peakirp Fac54r (s.g.1.3 ~ 15096) C0a0""a"~~'~` .00 Design Flow (~ 4.00 Bite Slope (96) 91.84 Contour une tlevatlon (it) 30A0 to Limltinp Factor (in) 0.40 to-situ Sod Applic~ion Rate (9pdfR~) Dhlbrlbution Cell IfNonmatloe 80.00 Dispersal Cell Length Akxrg Contour (ft) = 5.~ Cell Width (R) 1.00 Dispersal Ce(l Design Loading Rate (gpolfC~ 1 irrt)uent Wastewater Quality (1 or 2) Ate the lakerals the highes t in the ~lbutiort Y Pine Disrihution tnfonrtatlon network? Enter Y or N (c or e) a Center or End ManlYold 2.50 Lateral Sparing (ftj It N above, enter the elevation (ft~ 4 Number of L.aterala of the highest point. 0.126 Orifice Diameter {in) (e-9.0.2 2.60 Estimated Qriftce Sparing (ft) = 8.25 ft~lorMlce 2.00 f=onaemsin Diameter (In) 160.00 For~emain Length (fn Does the forcemaM drain back? (~ Y~ 76 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.S 18.84 Vertlca! lift (ft) 2.85 Friction Low (ft) l 27.99 Total Dynamk: Head (ft) l.~er~d Diante~er ltekc!>:on in. die. choice 0. 1.00 1.Z5 1.50 x x 2.00 x 3.00 x Traah»ent Tank InfomratiOA 1000.00 Se is Tank Cspec~ty (gaq Wieser Concxete Manufacturer 24.47 For+csmain Drainbeck (gad 81.25 Sx Void Volume (gal) 105.72 Minimum Dose Volume (gal) 29.88 System Demand (gpm) M+snif4ld Diarneesr Setectiwt in. rile. choice 1.25 x 1.50 x x 2.00 . 3.~ Oailone/lnch Calcu~tbor (optional) 848.00 Total Tank Caper (9an 38.04 Total Woiitring Liquid Depth pn) 17.00 ggUin (enter result in cell 849) Qose-Tank intotmation Efirsent Fliter inromeaeion 846.00 Dose TaNc Capacity (gan ~! Filter' Manufacturer 17.00 noes Tank Volume (gaUin) At 4Q Filter Model Number Wieser Concrete Manufacturer PnDjecc_ Patrtdc !alley 3-t~droom nesiderrtial mound Page 2 of 9 P. 02 MAY-12-2005 03:16 PM A.C.E. Soil & Site E~al. 715 248 7764 Mound Plan View 1/108 ........... ... .... t • r~} } r r'•"'{ : :•'r~?!.~-.]r'~r• ;•r•~ r.r.r.}.J'"r r}~}.r r f•r•r s.r•r.r•r.r•~•S•r•r 17}:: .r. •~• s•r•1•Jtl.r••r•r•r•f•3' ~'r7 • .~ .'. . ~ . _ `~~ Moand Component Dirteensions Clown sio toe extension made. A S.OE? ft E 8.40 in H 1.00 ft K 7.10 n B 90.00 ft F 9.30 in ~ 7.50 R L 104.35 ft D 6.00 in G 0.50 ft J 4.80 ft W 17.30 ft 450.00 (ft~ Dispeesel Cell Area 1125.00 (tt~ i5asal Ares Availab~ 5.00 (gpd/ftj Linear Loadietg Rate 9.00 (11)1110 B Dbs. Pipe Placement -Mound Gr+oes Section View Agpe~gate Dispersal Area Finished Cacade 88.93 (ft) 97.14 (tt)---~ F ~~ Dispee~saf Cell =[~ Elevation . . . . .• •. .•.•.- ._ ................ Srt:iAinq 1vh- Topsoil Csp ~~~~~ $ubscrR t:ap A8TNA C33 Sand ® Tilled Layer ~r~r• rr -~`~ ~ H .,.,,,,, 2 ,,,,,,, ~ .~.~ p~~j ~ 87.64 (R~ Lateral Invert 4 4 . , . .84 (1t~ (`rontOUr EleYatlOn 4.0 % Site Slope ~ ~w Dispes~t Dell ~ 0.5 ft r,L•yr,'; Y.tr?~eral r:'7 .• r•r•: •.••:•r•:•r•r ~-~-- A /"'` Geote>QIIe Fabric Cover t See lateral details on Page 4 Ibr number, site, and apadng of Faterais. F Laterals ~ equaly spaced team the I aisaibviron ~eir$ # cantee6ne In the ~ dlsMbutbn Dell (AxB). P. 03 Project: Patrick t_adey 3bedroom residential mound Page 3 of 9 MAY-12-2005 03:17 PM A.C.E. Soil & Site E~al 715 248 7764 End Conneetlon Latenll Layout Diagram O1'~p •~Tunl.uplA~fb/IIwWIOlaalen011tpluo ~ N uearair are Idmrbal ~ x-•~~ F1ol~s ddMad on 1M bole4m ai do laearai a~twMr spaoad Fame mire oonrodort sAa qv or araax to m>twolQ ac ~ paw. Laenars ~ tame main d lw,c aati to (par L:ONNA Ta6M 950- Ntlml7Cf of Laterela 2 Lateral Dlarneter 1.50 In Cetera{ Length (P) 88.55 R Lateral Spacng (S) 250 n Lateral Ftow Rate 14.>xi gpm System Flow Rate 29.66 gpm Total Dynamic Head 27.99 tt Orifice t31arr1eter Orifice Sparing (7() Orifikxs per Lateral Orlflce Density Manifold Cerrgtfl Manifold Diameter i~oroemaln Velodty Dose Yank Infarm~ttion Elachical aa< par' NEC 900 arxi --^--- Comm 18.E WAC J.. TaMc oanpararR is propedlt ~enled Corlanste Manufacturer Ca acit B~B.OtI Gallons ohrrrle 17.00 gaUinch Inches Gallons A 17.78 ZS B 2.tm 54.00 C 8.22 105.72 12.00 204.00 Totat 38.tm ti46.00 tank. Alarm Marnlafadtmer ievelArm Alamt Model Number QLV Pump iYtanufactur+er ZoeNer Pump Model Number iJPi 140 _ -- ~- Pump Must Deliver 29.88 gpm at 27.98 it TOH A B --~C}- D ft /Orifice 1.501in ~+v~~++o te~bq and lxldr~ deMlce ena ...Ma WaIN'lgl~ i 4 tn. min. E-- AiEe~reela auNst bcallon Faoemeln dlameler ~I 2 in. Wasp hole a ~ aiplton devbe deurdon 79.00 4t~e. h~Nc ainaetl°" 78.00 P. 04 Project: Patrick Laney 3-bedroom r+estdential mound Pape 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name Jim Boumeester Phone (715) 386-9020 _. -- _; POWTS Regulator's Name St. Croix County Zoning Phone 715 386-4680 ~', stem Flow and Load Parameters Design Flow -Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 300 gpd Maximum BODS 220 mglL Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frectuencv Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Ins ect and/or service once eve 3 ears Should ins ed 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 Inspect for ponding and seepage once .every 3 years __ 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 cetf 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: Patrick Lalley 3-bedroom residential mound Page 5 of 9 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, w 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 w unauthorized entry into a tank w component. Septic lank 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 fitter shall be assessed at least once every 3 years by inspection. The outlet fitter shah be ckyaned as necessary to ensure proper operation. The fitter cartridge should not be removed unless provisions are made to retain soids in the tank that may slough off the fitter when removed from its enclosure. If the fitter is equipped with an alarm, the filter shah 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 Tess than ma>amum scum and sludge accumulation in the tank. The addition of biological w chemical additives to enhance septic tank pertormance is generaNy not required. However, if such products are used they shaA be approved for septic tank use by the Department of Commerce. Pumo Tank The pump (dosing) tank shall be inspected at Least once every 3 years. AN switches, alarms, and pumps shall be tested to verify proper operation. If an effluent fitter is installed wthin the tank tt shall be inspected and serviced as necessary. Mound and Pressure Distribution SY~ No trees w shrubs shoWd be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shat! lie seeded and mubhed as necessary to prevent erosion and to provide some protection frwn 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 w 30 mg/L BODS, 30 mglt 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 permd for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and tt is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is pertormed it st>nt~d be compared to the initial test when the system was installed to determine if orifice clogging has occured and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observvation pipes witttin the dispersal cell shall be checked for effluent pondmg. Porxling levels shah be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monttwing. Continoencv Plan If the septic tank or any of ds 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 w related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a cornponer>< of the same w equal pertomiance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, d will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologicalty clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Patrick Lalley 3-bedroom residential mound Page 6 of 9 MAY-12-2005 03:18 PM A.C.E. Soil & Site E~al 715 248 7764 tr 0 N Y u '° x g to I~ ~ T,17.~{ a ~, e m, ro. to s~ PUMP PERFOWAANCE CURVC MODEL t40/4140 X40, maea TOTAL DYNAMIC HEAD/FLOW PER MINUTE EFFLUENTAND DEWAT'ERINa ...~.. MOl]EL 140/ 4140 Feel e t.d M 770 To e,0 10 ~6 Te e,d ri tre 7o a, ad eao 7a r,d ao 77J ~ e.1 49 {ds 30 T0J 70 ill ~ Tl.2 2b 106 46 T3.7 T7 W 9hutdflleed: QON.t a.3e ~,arT ettte~u aAUae ~ A4 ~ b(. a ~n ~ie~: n~ m wr, S~se~f~ f'tPgl 1116eo u iu ao ep . RCWne1lt WlyJt! CONSULT FACTORY FOR SPECIAL APPLICATIONS • Eledrkal akeme~ors, for duplex systems, are available and supplied with an atamt • AAechankal aitemalors, for duplex systems, are available with or without 818fr116, • Control alarm systems are avaNable for 1 phase pumps used in simplex system. See FM0732. • Variable level carstrol switches are available for controlling single phase sys- tems. • Double piggyback variable level float switches are available for variable level bn8 cycle controls. • Sealed Qwtk43nx avaflabta for a,tdoor instatlatans. See FM1420. • Refer to FM0808 for epplicatlons above 130°F (54°C). 14 W4140 i10DELS Control Selection Mold t4lodet Voles-Ph MoOe Ampa Sknplex 17upk N140 N4140 115 1 Non 12,0 1 or2 3 E140 E4140 130 1 Non 6.0 1 or 2 3 8N140 8N4140 115 1 Auto 12.0 -- BE140 8E4140 230 1 Auto 6.0 -- ~aam eNteaa SELECTION GUIDE 1. Far automatic use single piggyback variable level float svditd~ or double piggyback viariade level float switch. Refer t0 FM0477. 2. See FM122B for correct model of simplex conlrtat panel. 3.3ee FM0712 for correct model of duplex contrd panel, • cnu~noN All inrWllation oT contr°ha, pr°taction davicew end wiring sheUld bB done pY a qualdNd lieenead akeVitlan. All ekclrical and eafctr codaf aMuld N bllowed plCludinq SM rttaal rettnt NatiortU Eketric Cade (NEC) and the Occupatbnai Sahry and Neagh ACt IOSNAi. ' Pi94Y~ switch Included. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered Into this design of every Zoeller pump. Abli f0: P,0.1~;7r 169{7 Laubwde, KY td}d6.OJq ~ lnlrP n7; 3616 t'ane Alm Reed Mrxdactue-s or.. Lcu4>;de, NY 402ff-1861 PUMP !D_ rSO4 r7&~3T . r rdog~ sas,w~ ~'' S~ /939' aTrTaapetfhrcom x~x (502} 7N.96Z~ ..~_._____~_._._-.----------- _._-.._..~_._...___,_,_.__...___.___.~..-.._..__.~__. M_......... _ _....,.- --_.-.-.._....___.____-..._..,_.. _,._..-. 0~ CepyrlgM 20051oeMttr Ce. Atl rfghte reserved. P. 05 P~. ~ ~'9 Wisconsin Department of Industry, SOIL AND SI7 p- I ~~~ Page ~ of tabor and Human Relations 'i i ` Divisibn'of Satety and Buildirigs in accordance tt~ L~I(~' 83.b9, is. ~' Coun ~~ Attach tom lets site Ian on a er not less than t3 1/2 x 11 Inches in I~~IE ~(j - Q include, but not limit d to: verti al and horizontal reference point (B~ction and ~~` I~ ~.l s~ ~/~ ~~ I e scale or dimensions, north arrow, and location and di tame to st road. ParceC.l. . # O percent s op , ~~ ~ ~ ~ ~ ~ ~ _ ~? ~ ' ~d S~ ' _._I ~..,~9 i-_.... sr coax `~ APPLICANT INFORMATION -Please print all inform tr COUNTY R 'ew by Date p~N~ i~ Personal inforrnatan you provide maybe used for secondary purposes (Privacy L `~ . ~Z4 (T) (m)~F~iCE V ~ L Property Owner ~ (~/.~ Q l Lip LAN O ~ d cPr ~ ~ '1 Q ,N;R / ~(or W V ~ S d N'~ ~>'~ 1 I ~~ ~J . Lod 1 /4 /VW 4/4,S' 2 T .c• l ) Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 332. hrUN~SoTA ST: E~15T lyo~ 2G ~HMOND ~~',~t' ~~~ Nearest Road W ~ Z City State Zip Code Phone Number 5 ^ City ^ Village LJ r o`er ~ ~ d ST'• Pnu~ I l~l ~. i SS~o I (~Sl )zzZ •SSS ~ (~iesidential /Number of bedrooms ~ Addition to existing building ['Flew Construction Use: ^ Replacement ^ Public or commercial -Describe: yso Recommended design loading rate • • bed, gpd/ft2 ' S trench, gpd/ft2 Code derived daily flow gpd ~ 7 Absorption area required bed, tt 2 ~ ~ ~ trench, ft 2 Maximum design loading rate bed, gpd/ft2 trench, gpd/f12 Recommended infiltration surface elevation(s) su ~ ft (as referred to site plan benchmark) Additional design/site considerations N~~ tt Parent material ~~ E'sS ~ ~~ Q~NSF T1 f~f _ Flood plain elevation, if applicable Conventional Mou In-Ground Pressu AT-Grade System in Fiil i Holding T S = Suitable for system ,.,// LK» ^ U ^ S ^ g U ^ S ~L-j,'U/ ^ S U = Unsuitable for system ^ S L~ U L{G 5 SOIL DESCRIPTION REPORT Boring # Ground elev. ~G • eft. Depth to limiting factor 3 ~in Boring # Z; Ground elev. ~ ! 7 ' ~tt. Depth to limiting factor Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont. Color T ~ o • ~o y~e 3l 3 -- 9 • ~o y vEl~ Ioy - ~~ tf ~io+s.. Remarks: ~in. Remarks: 9, CST Name (Please Print) Rpl3~RT NL~R~C,~T Signature Address Strut exture Gr. S. L I S S~ If; ~~ l~~ D~-f • z3 . Telephone No. ~~s•3S~•~~~s CST Number ~~.4375 Prlvata Sewage Cons 655 O'Nell Rd. ,~ V H 8) ~D ~ ~'~v SOIL DESCRIPTION REPORT Page ~" of PROPERTY OWNER ~~ ~ ~ ~ ~ ~ ~~ ~AHf10~~ ~ PARCEL I.D.M GO Horizon Boring # De th Dominant Color Mottles Texture Structure p Gr. Sz. Sh. Munsell Qu. Sz. Cont. Color i Consistence Bouridary 2 Roots Bed ,Trench n. ~/ sh,~ d s ~ S ' ~ ' 3 i .io io 3 - sic. afsh ~ ~ _ .s;.~ _. ~ /f Ground elev. .~ ~D .--L-- /' / L ~ 1 Mots S`~ ! ~SN i y ~~ vr~ y~ ~ .,_ ~ L ' ? j 9~~ Depth to limiting ~ factor in. Boring # Ground elev. ft. Depth to limiting factor in. Boring # Ground elev. ft Depth to limiting factor in. Boring # Ground elev. ft. Remarks: to G ~ ~ C i ~ ~ ~, N -~ J e ~' _~ ~ ~ Z ~ ~ ~ ,, r ., "~ n ~, __ ~i -• ~ ~6 t~ Z 3 . ,~ ~To .--~ 0 -t N ~~ ~ s- = ~ ~ ~, 1 W ~J r- G o 7- ~ . ~ ~ c (~ N ~ ~ nl ~ ~ -~-~ ~( G ~" ~ ~l ~ ~ ° L ~ ~ ~ N ~. 05(18/2005 03:02 7153865583 HOKE ST. CROD+f: COUNTY SBP~'YC 'Y'ANK MAYNTf~TANCE AGRF.~NT AP~ID QWNIIRSHIP CBR'1.TFICA'Y'ION FORM Owner/Bttycar Mailing Addt~ess Property Address CitylStabe i ~ ~~~ t PAGE 01 Parccl Identification Number d /f~- /'D~l - ~ (o - c~x`~ Property Location ~ y~ , ~ ~/. , Seo. d~Q . T ~~N R~_W, Town of A~lcc /YI Mf~/'~ Subdivision ~~ ~ ~ c~, ~ ~ !~. ,Lot # ~~- CerKlied Sntvry Mxp # ~ , Voh»ne . Petge # Wttrrtwtp Dead # "7~ 8 ~~ y . Votttme Psge #. oS spec house ~ Lot lance identifiable ~ m ANCE tm~nper use sad tnaitlbenance of your septic systeot could .result ~in its prntnatmao ~iltn+e W handle vyaatts. Proper naanees~.nce oosuris~ of out the st~tic'tadc every three yw s or sooner. if needed by s licensod p~mfpEr. Whrt yon pnt into the ayrtom csa affect fhe function of the septic tank as a u+mgoatt se ige in die waste disposal sygtea~. Owner tuaiabeotnoe nespoaa«'b0itiee ase apecafiod in ~ Comm 83.52(1) and is 12 - St, (~ County Sattitory Otdimace. . The property owner agrees to submit to St Qrouc Coaaty Zrtnuitg Deparhuatt a ceetificatian 1bxm, etga~ed by the owner acct by a nsaeeer phanber, jotuaeyaoon pWmober, restricted pWmber or a Ii cued ptnper verifying that (1) the on~iea waatearaltar dispoaai ~r ~ ~ ~ P~ ~-~S ~t+~ and/or (2) alkx it~pocliert u+d ptutf~-ing (if necessary). 9~o septic teak is less thm 113 ~ of T/aie. the undersigned have nand thm above retp~tttsota ear: agrex to roaitMain the private sewage dispoal system with ties sfiuodards net forth, hett;ia, as sat bS+ the Deparfimcat of Conutterce at:d the Deparhacrtt of Natuncl kesouroes, Stsoo of Wisconsin. OestiScati~vn stating that your septic aysecm pas been mointained tnu.~ be oornpieted and tdnrned to ~e St Ckoia County Zonft-g Dapatltttmct within 30 days of rise three year expiratfon date. ~~ ' SYGNA~'C1RB F AFPLiCANT cam/ ~ s/ 0.`5 AATB RT C lUec~e oettify that ap statements on this foam are true to the brit of roy/our laaowledge. Uwc antare tLe owners) of the 'hod `by virdte of a warronty died teCOr+ded in 1?.egister of Deeds aflice ~i t s~ a~"" SIONAT[JRB F APPLICANT DATE •"••~ My iofottmatien flat u mistgpt+esented may resort in the sa::nary peemit being eevolced by the Zoning Departanont. "•~~• Include with this application a etteaped watrangr doed trap the Regis ter of Deeds Offico told t Dopy of the cettitiad su[vey mop if Yefe~co as made its the wtttre~r ~, . U 2614P 265 I STATE BAR OF WISCONSIN FORM 2 - 1999 Document Number WARRA1rTTY DEED This Deed, made between Mark T. Inouye and Katie L. Inouye. husband and wife Grantor, and Patrick J. Laliev. a sinEle person Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Lot 26, Plat of Hammond Oaks Subdivision in the Town of Hammond, St. Croix County, Wisconsin. 76f348'9 KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROI X CO.. li I RECEIVED FOR RECORD 07/1212004 10:00AI1 IARRANTY DEED i:Xt:M~T # REC F'EE: 11.00 TRANS FEE: 98.70 COPY FEE: CC FEE;: PAGES: 1 Recording Area Name and Return Address/ ~ F,iJ ~3 0 ~ IYs~eaGs ~~... P~ ~a>R ~ ~.+ f }~a rn wt o +r`.1, ~ ~ cS yo !s- 018-108ti-26-000 Parcel Identification Number (PITY) This is not homestead property (is) (is not) Exceptions to warranties: Easements, restrictions and rights-of-way of record, if any. Dated this ___ ~~~ ' 1 day of July , 2004 * -~-- - - - -- * Mark T. Inouye _# _, -._~ .--- ~ tie L. uye -- - AUTHENTICATION nnACKNOWLEDGMENT Signature(s) STATE OF ~Q~~~ ) - ----- -) SS. ---~------- - ~, i~~ county ) authenticated this day of r TITLE: MEMBER STATE BAR OF WISCONSIN (If not, _ _ `~~tttun authorized by § 706.06, Wis. Stats.) - _ -~~`~~ ~ .~~ .` ~vs.~• THIS INSTRUMENT WAS DRAFTED BY ; A Attorney Krishna Ogland __ _ ~; } Hudson, WI 54016_ _ -_-" ~~lC (Signatures may be authenticated or acknowledged. Both are not neces9y`riQ~~~,_ ' Names of persons WARRANTY DEED Personally came before me this _ ~1~ ' ~'ay of July ,2004 the above named Mark T. Inouye and Katie L. Inouye, husband and wife Nota 1 My Cen *. any capacity must be typed or printed below their sigtiliitre. SPATE BAR OF WLSCONSIN F'OLiM No. Z -1999 rn to be the person(s) who executed the foregoing and acknowledged the same. nT L R.4nrid State of ~__~__~ O % y L(~,i o~ s permanent. (If not, state exptra ion date: Information Professionals Co., FoM du Lac, WI 500.655-2021 Parcel #: 018-1b86-26-000 05/25/2005 01:x5 PM PAGE 1 OF 1 Alt. Parcel #: 20.29.17.646 018 -TOWN OF HAMMOND Current ~X'i ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): " =Current Owner PATRICK J LALLEY " LALLEY, PATRICK J 585 BROADWAY HAMMOND WI 54015 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description " 1603 86TH AVE SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 1.000 Plat: 2039-HAMMOND OAKS LOTS 1/59 '00 SEC 20 T29N R17W PT SW NW HAMMOND OAKS Block/Condo Bldg: LOT 026 LOT 26 1.000AC Tract(s): (Sec-Twn-Rng 401/4 1601/4) 20-29N-17W NW SW Notes: Parcel History: Date Doc # Vol/Page Type 07/12/2004 768489 2614/265 WD 08/15/2002 686960 1948/59 WD 12/26/2001 666352 1799/613 QC 08/10/2000 627995 8/3 PLAT 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/22/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.000 20,000 0 20,000 NO Totals for 2005: General Property 1.000 20,000 0 20,000 Woodland 0.000 0 0 Totals for 2004: General Property 1.000 20,000 0 20,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Jessie Subject: Lalley/boumeester 463499 plowing Location: lot 26, hammond oaks, Hammond Start: Thu 7/28/2005 9:30 AM End: Thu 7/28/2005 10:00 AM Recurrence: (none)