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HomeMy WebLinkAbout018-1087-70-000 o °~' ° I ~ ° ~ 3° ° a M ~., ~ 0 I ~ ~ M ~ ~ ! N N ~ A. ~ ~ ~ I ~ c I ~, o o ~ N I a I ° I ~ y o I ~ ~ a y co I O ~ ~ c ~~ ~ ~ I ~ 'Q -O c~ c i O ~ I I o. w ~ E N I a~ a~ ~ a N i a i a 3 o ~ o ~ c ? °_ I c Z °' c ~ m o ~ m o 0 LL ~0 0 LL CO O C ~ 3 C fd ~p Q U I Q ~~ »~ M C M ~ ~ Z E I ~ E Z O O ~ ~ ~~ d d a m ~ d I a m N ° y ` z v , I o a a I a ~ N/ Y 1.1. t ~ N m I N N Z~ 7 C O C f!) 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Please select a credential holder's name to review status and continuing education information. Rlack=Annr~ved Vellc~w~tn I2enevvai Process Red=Expired or Not Valid Credential ID Name City,State,Zip Type Expiration 223971 STANGL, JOSEPH A SPRING VALLEY WI 54767 Master Plumber 03/31/06 http://apps.commerce.state.wi.us/SB_CredentiaUSB_CredentialApp?cred_id=223971 &for... 11/8/2004 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and wilding Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Tobiassen, Michael Hammond Townshi CST BM Elev: ~ Insp. BM Elev: lard BM Description: ~ ~ ' G _7, TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~ riCisi~/~.- ~ w ~Q~~ Dosing Aeration ~~ ~ ~ ~~~ Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Z `'r T ~ ~~ ~ ~ ' ,~ Dosing Z~~ Z`~" ~, r / ~ ~ .~ Aeration Holding PUMP/SIPHON INFORMATION r`V Manufacturer ..'c~ ~~ Demand GPM M ~ ~ N tuber ~ ~ ~ ~ ~~ Z~ , ~7Z TDH Lift Friction Los System He d ` TDH~~~~Y~1 Forcemain Leng t r Dia. % Dist. to well Z5 , ctZ SOIL ABSORPTION SYSTEM County: $t. CrDIX Sanitary Permit No: 463177 0 State Plan ID No: Parcel Tax No: 018-1087-70-000 Section(Town/Range/Map No: 20.29.17.690 ELEVATION DATA STATION BS HI FS ELEV. Benchmark ~d Bldg. Sewer ~ ~ ~ .7 SUHt Inlet ') ` ~~J SUHt Outlet \ `r Dt Inlet \ ~ Dt Bottom I ~ g Header/Man. ~ `y r 1 G C~ I Y Dist. Pipe Z9 ( -~ L ~~- Bot. System ,~ ~ ~ 3, ~ ~ 7 ~ ~ Final Grade ~~ 99.3Z St Cover •~ /~. BEDlTRENCH DIMENSIONS Width i ~ Length / No. Of Trenff~~es ' PIT DIMENSIONS No. Of Pits Inside Dia. ~ Liqu' Depth ~~ Y.c Cs ~ ~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION ~ CHAMBER OR \ Type Of S tem: ~~ / ~ ~ .~ / = r./\ V UNIT Model Number: 61i /~ _ l l {~ ~ DISTRIBUTION SYSTEM Header/Manifold ~ r' ~ ~ ~ I /~ Distribution ~ ~ i r i Pi e s ~J ~ • ~ , / ~ - ~~ ~ ~ x Hole Size ~ j i ~/ ~ x Hole Spacing f ~ Ve to Air Intake ~/ Length ' Dia Dia Spacing Length I d ~/ ~`' `' SOIL COVER v Procsura RvcTams Clnly rY Mnund Or At-Grade Systems Only Depth Over i Bed/Trench Center / ~ ~ Depth Over Bed/Trench Edges xx Depth of Topsoil ' (' j xx Seeded/Sodded \~. Yes No xx Mulched Yes ~' No ~ ~ +"S- ~~ j,l i ~+- COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #L•-~~~ -/ F ~ Q/ ~ Inspection #2: / / 29 17 690 l N 20 ~ P a s~ s ~ Location: 1636 87th Ave Hammond, WI 540 15 (SE 1/4 NW 1/4 20 T29N arce t Add R17W) Hammond O . . . o: 1.) Alt BM Description = ~ G~,~,,~; ,,~ ~ ~ ~~; c~G~ G~~ ~ ~ 0 W \~1 • `I ~ 2.) Bldg sewer length = ' 3 ~~ ~ ~~ - amount of cover = ` / r Oo . Zt - Plan revision Required? ~ Yes~No i \ ' , ' nth, ~ Use other side for additional information \ ~ . Date Insepctor's natur Cert. No. SBD-6710 (R.3/97) ~ Safety and Buildings Division County I 201 W. Washington Ave.. P.O. Box 716 ..,-, 7 {- ~~ ~ ® iseansin Madison. WI ~~ anitary Permit Numbs (to be fi led in by Co.) De artment of Commerce to an Number Sanitary Permit Ap hOn (~vid~ R °Lt74 ~ • ®Oo2 S o In aceord with Comm 83.21, Wis. Adm. Code, t l X~ p ~~ Address (if diffex'ertt than mailing address) may be used for secondary purpose Privacy , ,~U ~ iU \ i ,} 1. Application Information -Please Print All Iaformtttion ZpNING ~F ~~3~ ~ ~~ ~~ O Parcel K a7 Block N Property Owner's Name _~ . / ~ ~' ` '~~ ~~^ Property Locution © ~~ (~ 7 , '7v Owner's Mailing Address ~/'~ ~ //,( (,Lr ~~ ~ V~ ~'~~. /V JC/ti Section ~/ ~ ~' C' ,State Zip Code Phone Numbu p / ~ ~ , ~ ~~ , ~ ~, 0 ~ T~N~ R.~E I W [L Type of uildiag (check all that apply) ~ Q~ ~~~ ~ ~~rn . 1 Subdivision Name CSM Number ^ 1 or 2 Family Dwelling - Numbs of Bedrooms .I~ .(~1 ^ public/Comrrtercial -Describe Use q /, ^CitY ^Village (Township of ^ stater Owned - Deseribe Use S ~ 1 a INld~~t/Y!~ C1~ ~ to ~ ~'`rn ' ~t/L "l (o. (p I ,,~.t -vt ,.t III. Type o ertait: (Check only oae boz on lint A. t,,omplde line B if applicable) A' New System ^ Replaeanertt System ^ TreaunendHolding Tank Replacemertt Only ^ Oder Modification to Existing System List Prcvious Permit Ntrmber and Date Issued B. ^ Permit Renewal ^ Permit Revision Change of ^ Permit Transfer to New ~ r"~ ~ ~ p Before Expitat~on ` lumber ~ O er v N. T of POW'CS S cm: Check all that a ^ Nott-Prr~surined In-Ground Mound>_24 in. ofsuitable soil ^ Mound <24 in. ofsuitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Cwnstttcted Wetland ^ Pressu • and ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unk ^ Recirwlating Sand Fi -~e..,w Other (explain) ' Recirculuting Synthe6e Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less ipe V. Dis rsal/Treatment Area Information: ~ S EI lion ~ ~~ Design `F-l-o~w~(gpd) Design Soil Application Rate(gpdsf) Disposal Area Required (s Dispersal Area Pro / ~~~ Y~ `~' ~ ~ ~ ~ refab Site St Fiber PI/antic 1 YI. ank Info Capacity in otal umber Manufacturer Gallons Gallons of Units Concrete Constnrcted Glass New Existing ~ ~ / ' Tanks Tanks ~ `~ Septic or Holding Tank f , '- ~ ~ ~ ~ ' Aerobic Tn.atment Unit rb?+~ Dosing Chamber ~ Ga (~ VII. Responsibility Statement- I, the aadersigned, assame resporrslbllity for iastallatioa of the POWTS shower on the attacked plans. bet's Si lure MP/MPRS Number Business Phone Number Plumber's Name (Print) !~ Plumber's Address (Street, City, State, Zi e) \'I[l. ount ~/De artment Use Onl mPs) Sanitary Permit Fee (includes Groundwater Date I sued 1 rng Age Signal ~ Approved ^ Disapproved Surcharge Fce) df~ ~ l / 7i ^ Owner Given Reason for Drnial {~ ~ `'`r I~. onditions of ApprovaUReasons for Disapprotml ~S /_ ~-~- Athch a k plans (to the Ceuary )for the system paper wet less than E12 s ll inches In size SBD-6398 (R. Ol/03) _ _ . ~- ... _- .. .... 0 15 30 Graphic Benle (Feet) 1 Inch ~ 30 ft Page 8 of 8 Site Plan For: Michael R Tobiassen Lot #70 Hammond Oaks 1st Add. SE1/4-NW1/4 Sec.20 T29N-R17W Hammond Tnsp. - St. Croix Co. BM#. P Proposed S x 90' Mound Cell w/System Elev. = 97.60' 11 Proposed Wieser Concrete 1000/600 combo tank w/label A-100Filter Bm#2 97.30' 1.060 Acre Parcel Building Setback Line Cep I Pr posed Sch. 40 2" Fo ce Main 60' 94.10' proposed 3 Bedroom ....r ~ Home BM#1 ~ =Top of Green Stake Elev. =100.00' m#2 ~ = Ground Elevation at Yellow Stake Elev. = 97.30' '~ FN# 1636 87th Ave. Note: Maintain well and waterline setbacks per Comm 83.43(8)(1) .- commerce.wi.gov ^ ^ isconsin Department of Commerce Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264-8777 www.commeice.state.wi. us/sb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary May 25, 2004 CUST ID No.224059 KEITH E STONER 23220 WOOD CREEK RD SIREN WI 54872 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/25/2006 SITE: Pressure Distnbuhon Networks for ST-SAS (01/81)" ~(~n c 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. RTN N Of 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: ~ SEE G~ ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 Identification Numbers Transaction ID No. 1002956 Site lD No. 683896 Michael R Tobiassen Please refer to both identification numbers, 1636 87TH Ave above, in all correspondence with the agency. Town of Hammond St Croix County SE1/4, NW1/4, 520, T29N, R17W FOR: Description: New mound, 3 bedroom residence Object Type: POWTS Component Manual Regulated Object ID No.: 959346 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.O1/O1) and SSWMP Publication 9.6 Design of 'p.d General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the design manuals noted above. • 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. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. Key Item(s) • The tank access openings shall be per Comm 84.25(7). • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above fmished grade with a watertight cover. KEITH E STONER Page 2 5/25/04 _, Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • Maintain well and waterline set backs per COMM 83.43(8)(1). Consult the Department of Natural Resources for well setbacks and exceptions to the setbacks. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construetion/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 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 o~,aintenance of the POWTS. ' ~-~j f/~~vl Patricia L andorf `j POWTS Plan Reviewer , Inte rat d Services (715) 634-7810, Fax: (715) 63 -5150 , M-f 7:45 am - 4:30 pm pshandorf@commercestate.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: Michael R. Tobiassen Mound Owner's Name: Michael R. Tobiassen Owner's Address: 2349 Driftwood Lane Stillwater, MN 55082 (651) 439-8260 Cell# 651-270-3591 Legal Description: SE1/4-NW1/4 Sec. 20 T29N R17W Township: Hammond County: St. Croix Subdivision Name: Hammond Oaks 1st Addition Lot Number: 70 Block Number: NA Parcel I.D. Number: ~,'r.s• ~pl~(z~~y Plan Transaction No.: Page 1 Index and title .~ OM Rc Page 2 Data entry TY AN ~ Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications ~~SPnN~ N Page 6 Management and contingency plan " Page 7 Pump curve and specifications ~~ a ~ Page 8 Plot Plan a```rua ~ ~~~~~ s~ ''~'d4 Designer: Keith E. Stone KENT E '? Dense Number: Desi gner# 1575-007 Date: 05/13/04 _ STONER '. 1~ine Number: (715 ) 653-2324 D .1575 Signature: ~~ ~p~p /;en. ~~~~~~ua~b the Mound Component Manual for Fyt`~!'YNrlfi®~W@Y~ion 2.0 SDB-10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 3.11 (R. 06/01) Page 1 of 8 6 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 (%) 96.60 Contour Line Elevation (ft) 24.00 Depth to Limiting Factor (in) 0.60 In-situ Soil Application Rate (gpd/ftZ) Distribution Cell Information 90.00 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/ftz) 1 Influent Wastewater Quality (1 or 2) Pressure Disribution Information (c or e) c Center or End Manifold 2.50 Lateral Spacing (ft) 4 Number of Laterals 0.125 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimated Orifice Spacing (ft) _ 2.00 Forcemain Diameter (in) 145.00 Forcemain Length (ft) 80.00 Pump Tank Elevation (ft) 6.50 System Head (ft) x 1.3 17.27 Vertical Lift (ft) 1.96 Friction Loss (ft) 25.73 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. o tions choice 0.75 1.00 x 1.25 x 1.50 x 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 Y network? Enter Y or N If N above, enter the elevation (ft) of the highest point. 7.50 ftz/orifice Does the forcemain drain back? Y Enter Y or N 23.65 c Forcemain Drainback (gal) ~, ~~ 81.16 5x Void Volume (gal) ~~ ~ 104.81 Minimum Dose Volume (gal) hS (d~ 24.72 System Demand (gpm) Manifold Diameter Selection in. dia. o tions choice 1.25 x 1.50 x 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) Wieser Concrete Manufacturer gal/in (enter result in cell 649) Dose Tank Information Effluent Filter Information 602.82 Dose Tank Capacity (gal) Zabel Filter Manufacturer 11.82 Dose Tank Volume (gal/in) A100 Filter Model Number Wieser Concrete Manufacturer Project: Michael R. Tobiassen Mound Page 2 of 8 Mound Plan View ..................................... ' 1/1.0 ,B-.'~'~:~:~'~' ~ ~~~ObservationPipe ~. ~ '~'~ .. K Mound Component Dimensions A 5.00 ft B 90.00 ft D 12.00 in E 18.60 in F 9.50 in G 0.50 ft H 1.00 ft z 12.72 ft J 5.17 ft -t -f _f -1 K 9.20 ft L 108.40 ft W 22.89 ft 450.00 (ft2) Dispersal Cell Area 5.00 (gpd/ft) Linear Loading Rate 1595.15 (ftZ) Basal Area Available 9.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 99;39 (ft) ~I H teral F . • ; : ; : ; : Dispersal Cell 98.10 (ft) La 97.60 (ft)~- - Invert Dispersal Cell ~:~:;~.~:::~ ~' ~~~:~:~:~~~~'~~~~~~:~. t Elevation E : D : : ~: _ _ _ •~ • •_~ •_~ •"fir"~ ~"~ ~ -_~w~~~~~+ -C~~=~~~-C~`.~~-_ 96.60 (ft) Contour Elevation 11.0 % Site Slope Geotextile Fabric Cover Shading Key m c. ~ Dispersal Cell See lateral details on 1^ ®Topsoil Cap c ~ 1.5 ft ~~. Page 4 for number, size, Q }~'~~ Subsoil Cap ~ c ,~ '~` ~ and spacing of laterals. ©~ ASTM C33 Sand ~ ~ ~ ~ Laterals are equally `~`"~~`"-~` Tilled Layer = y 0.5 ft ~ • Typical Lateral .; F spaced from the ^5 ~ Aggregate ~ c ~ ~ ~~, I distribution cell's centerline in the A ~ distribution cell (AxB). Project: Michael R. Tobiassen Mound Page 3 of 8 Center Connection Lateral Layout Daigram Project: Force mai n connection +ria tee or cross to manifold at any point. I~ P •=Turn-upvWballualveor IE7{~IExt2~ cleanautplug Hales drilled on the bottom of the lateral. Laterals are identic al Laterals & force main of PVC Sch 40 per COMM Table $4.30-5 'I' s Number of Laterals Lateral Diameter Lateral Length (P) Lateral Spacing (S) Lateral Flow Rate System Flow Rate Total Dynamic Head 4 1.50 in 44.23 ft 2.50 ft 6.18 gpm 24.72 gpm 25.73 ft Orifice Diameter Orifice Spacing (X) Orifices per Lateral Orifice Density Manifold Length Manifold Diameter Forcemain Velocity Dose Tank Information Electrical as per NEC 300 and --- ~~('''ttt,,, Comm 16.28 WAC I I Disconnect II ~- Tank component is properly vented Wieser Concrete Ca aci 602.82 Volume 11.82 Manufacturer Gallons gal/inch Dimension Inches Gallons A 30.13 356.17 B 2.00 23.64 C 8.87 104.81 D 10.00 118.20 Total 51.00 602.82 3" Bedding A B C D r tank. Alarm Manuafacturer S. J. Electro Alarm Model Number 101-01 H Pump Manufacturer Goulds Pump Model Number #3871 EPO5 Pump Must Deliver 24.72 gpm at 25.7 ft TDH Michael R. Tobiassen Mound 0.125 in 3.05 ft 15 7.50 ftz/orifice 2.50 ft 1.50 in 2.52 ft/sec Locking cover with warning label and locking device and sealed watertight i ~4 in. min. ~ Alternate outlet location Forcemain diameter ~ 2 in. Weep hole or anti- siphon device P~ ump off elevation (ft) ~~ 80.83 Dose tank elevation (ft) 80.00 Page 4 of 8 Page 7 of 8 ~G~ULDS PUMPS ~ ~,. . ~~:.~ Submersible Effluent Pump 3871 EP05 ~, APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS • Solids handling capability: 'I<"maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size: 1'/z" NPT, • Mechanical seal: carbon- rotary/ceramic-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 V or 230V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: 10 foot standard length, 16/3 SJTOW with three prong grounding plug. Optional 20 foot length, 16/3 SJTW 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__~~, s zs z ° `~-~ a W ~ x u 6 20 s 0 15 a a 0 ~ 3 10 z s 1 0 00 10 o z ^ EP05 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. 20 30 40 4 6 8 CAPACITY ^ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTING Canadian Standards Auoaauon (CSA fisted model numbers end in "C" or "F".) Goilds Pimps a ISO 9001 . 5 GPM \ zs rT 50 GPM t o 12 m3/h Goulds Pumps ITT Industries Mound Svstem 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 Svstem 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 ft2 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: Michael R. Tobiassen Mound 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 mglL BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mglL 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. Contingency 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 condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Michael R. Tobiassen Mound Page 6 of 8 .. Page 8 of 8 0 15 30 Graphic Scale (Feet) 1 inah - 90 ft Site Plan BM#1 For: Michael R. Tobiassen Lot #70 Hammond Oaks 1st Add. SE1/4-NW1/4 Sec.20 T29N-R17W Hammond Tnsp. - St. Croix Co. Proposed S'x 90' Mound Cell w/System Elev. = 97.60' I1 Proposed Wieser Concrete 1000/600 combo tank w/label A-100Filter Bm#2 F. 97.30'9 ~(j 94.10' 1.060 Acre Parcel Building Setback LinE sed Sch. 40 2" Main Proposed 3 Bedroom Home BM#1 ~ =Top of Green Stake Elev. =100.00' #2 ~ = Ground Elevation at Yellow Stake Elev. = 97.30' FN# 1636 87th Ave. Note: Maintain well and waterline setbacks per Comm 83.43(8)(1) '4V15consinD'epartmentofCommerce SOIL AND SITE EVALUATION Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code Attach complete site plan on paper net less than 8'/ x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (f3M), direction and percent slope, scale or dimensions, north arrow, and location"aid dfstetce to nearest road. ,, APPLICANT INFORMATION - Pleas print all informatitm. Personal information you provide may tie used for s~rtdary purpose,>~8rivacy Law, s. 95:04 (1) (m)). ~`'~ Page 1 of 3 Gustum Septic Service County St. CrO1X Parcel I.D.# iewed - /~~~Date Property Owner / w ~ Property Location Humbird Land Co oration " Gaut. Lbt n/a SE 1/4 NW 1/4 S 20 T 29 N,R 17 W _ Properly Owner's Mailing Address ; r. r ' ^ Lot # Block # ~ ~ Subd. Name or CSM# f5T 332 Minnesota Street, East 1404 '~ ~ ` . ; ~ n/a Hammond Oaks 2MB Addition __ City State Zip~ode PhoneNuMbt~,~ ,,,L __ ~ ityVillage ®Town Nearest Road Saint Paul MN 551,1 651 '2~~~ ~~5 Hammond ~ 160Th Street New Construction ~ Resideri ' ` Nt1r~b~r t)~ ms 3 ^Addition to existing building Use: ^ Replacement ~ Public or commercla ascribe Code Derived daily flow 450 gpd Recommended design loading rate .5 bed, gpd~ .6 trench, gpdfft~ Absorption area required 900 bed, ft~ 750 trenc 2 areu~n ' n loading rate .5 bed, gpd/ft2 .6 trench, gpd/ft2 Recommended infiltration surface elevation(s) along 96.6' contour it (as referred to site plan benchmark) Additional design I site considerations Blvl 2 = 97.3' Parent material sand stone /ground moraines Flood lain elevation, if a livable n~a ft S=Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U=Unsui#able for system ^ S ®U ®S ^ u ^ S ^ u ^ S ®u ^ S ®U ^ S ® U SVIL DESGRIPTIVN REPURT Boring# 1 Ground elev 97.3' ft Depth to limiting factor ~o• 2 Ground elev 94.1' ft Depth to limiting factor 2a• H ri Depth Dominant Color Mottles T t Structure Consisten Bounda Roots GPD/ftZ zon o in Munsell Qu. Sz. Cont. Color ex ure Gr. Sz. Sh. ry ~ ;Trench 1 0-10 10yr3/2 none sit 2msbk mvfr as 2f,lm 0.5 0.6 2 10-14 10yr4/4 none sit 2msbk mvfr cw if 0.5 0.6 3 14-18 7.Syr4/4 none sit 2msbk mvfr cw - 0.5 0.6 4 18-25 7.Syr4/6 none sit 2msbk mfr cw - 0.5 0.6 5 25-29 7.Syr4/6 none gr. sl 2msbk mvfr cw - 0.5 0.6 6 29-35 7.Syr4/6 ~ 7 510yr7/1 ~ m mvfi - - n.p. ~ n.p. Remarks: 1 0-11 10yr3/2 none sit 2msbk mvfr as 2flm 0.5 0.6 2 11-15 10yr4/4 none sit 2msbk mvfr cw if 0.5 0.6 3 15-21 10yr4/6 none sit 2msbk mfr cw - 0.5 0.6 4 21-28 7.Syr4/6 none sit 2msbk mfr cw - 0.5 0.6 5 28-35 7.5 4/6 yr c2-3d 1 7/2 7.gy~g sit 2msbk mfi - - 0.5 0.6 Remarks: CST Name (Please Print) Signature: Telephone No. Tom Gustum - A~r7Tl~('~r1!GQ~IGVYr- 715-658-1344 Address Gustum Septic Service Date CST Number Ref# N13450 937th St., New Auburn, WI 54757 3/1/00 227618 1191 PROPERTY OWNER: x~mbvd Land Corporation- ____.... SOIL DESCRIPTION REPORT PARCEL LD.# 3 Ground elev 97.3' ft Depth to limiting factor 24' ttat Page 2 " ~~ 3 ~' Horizon ~~ Dominant Color Mottles Texture Structure nsistence Boundary Roots -r-- ~~ in. Munsell Qu. Sz. Cont. Color GF. Sz. Sh. Bed ~ Trench 1 0-8 10yr3/2 none sil 2msbk mvfr as 2f,lm 0.5 ~ 0.6 2 8-11 7.Syr4/4 none sil 2msbk mvfr cw if 0.5 0.6 3 11-17 7.Syr4/6 none gr. sil 2msbk mfr cw - 0.5 ~ 0.6 4 17-24 7.Syr4/6 none gr. sl 2msbk mfr cw - 0.5 ~ 0.6 5 24-35 7.Syr4l6 Q-3d 10yr7/2 7.Syr5/8 gr. sl 2msbk mvfi - - n.p. n.p. ^-- - f\GI I IQI IW. Ground elev Depth to limiting factor Ground elev Depth to limiting factor Ground elev Depth to limiting factor T Remarks: r, .. I i p c Property Line ~i T I-r, CJ~ I ~ ~~ ~w ~ W Contour g7 3~ ~" ~ ~ Contour 96.6' Contour ~W 94.1' 0 0 m ~ 0 oq r Ic (.~ ~ ~ ~ ~~ N ~ mltAwc ~"ON3 C ~ C ~Q -=a x' ~~zon 3 S'+ N n ~ ~ 0 A ~ N"~ N O m "'~ f~/! ~ oo A Property Line ~ ~ ~ ~ cn N -' r m ~ Z II ~ II fTi II m II Cn ~ D r ~ 0 O ~ -P rTl rn r- ~ ~ O C < m rn O Q ~ G7 (JJ z c0 -~ ~ fTl ~ J O ~ z D C.J O '~ ~ ~ ~ O ~ O Z ~ ~ Cn l I ~ v~ ~ ~ ~ ~ ~ ° o ~ C ~ z O CO D ~ _Tl D ~ n O m r ~ ,L7 ~ z m m r+-i = O z r~ ~ ~ ~ ~ r m O fTl '~ m n ~ 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.t 5.04(1)(m)]. Permit Holder's Name: Tobiassen, Michael City Village X Township Hammond Townshi CST BM Elev: Insp. BM Elev: BM Description: TANK IN FORMATION TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to well SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. Cr ~X Sanitary Permit 453290 0 State Plan ID N . Parcel Tax No: 018-1087-70-000 Section/Town/Range/Map No: 20.29.17.690 STATION BS HI FS ELEV. Benchmark Alt. BM Bldg. Sewer St/Ht Inlet St/Ht Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bot. System Final Grade St Cover BEDlTRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Ontv xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center BedlTrench Edges Topsoil ~] Yes No n Yes [ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 1636 87th Ave Unknown (SE 1/4 NW 1/4 20 T29N R17W) Hammond Oaks 1st Add Lot 70 Parcel No: 20.29.17.690 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = 3J Contour = Plan revision Required? I~ Yes ~ No _,'. Use other side for additional information. ~_________._________. SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. i I I i I I ~ O V=i O N N n O ~ ~ ~. (~ Z D I ~ D ~, I a W I O I I o I I ~ o v_ ~ , I ~ ~ I ~ ~ I D I m I~ f I m I ~ I ~ c I I ~ I ~ ~ I y I I I I I i ~ ~O ~ n ~-°cm n I ~~~ _. cfl cu o' I o; 3 v I ~ ~ OZ ~ ~ p~j y ~1 N O Q y ~ fD ~ i - a. a m ~ I ~ ~ ~ ~ m N I ~v fA (D I ~ ~. ,~ o I ~ ~ v I ~ _~ I ~ ~ I ~ o ~ ~ O ~- c °' f ~ ~ 3 ~ gy `~° 'm ' ~~ m 3 9 -: - -~ O A ~ W Q ',~ = ' ~ N O O OD ~ ~ , N O II ~ O N I j ~,, O VO 7 d V m ~ I p O O N ~ N I -- N O O „' (D I _7' d _ '6 ~ G O a ~ l i O ~ ''I rn ~ ', a°~o D ', N N c ° ' 'c7 ', rcn o ~ ~ , ', 3 ° a o I .. ~ ~ a a °v i i i v ~ o o ~ ~ ~^ o ~ ~ ~ a O 3 m A D o ~ n ~ ~ N N n a 0 0 m c Q (D N O W ~ N N a 3 °o ~` 3 ~! z 0 '" Z n A .~ m N O I O Z ~ ~ li~~ I ~ i~ C 3 Q 0 ~• O ~• A 0 A 1 0 ti 0 0 A A W Vq ~ f0 ti N ti Safety and Buildings Division qty 201 W. Washington Ave., P.O. Box ?162 C llC' ~~~~~~~~ Madison, WI 53707 - 7162 Sanitary Permit Number (m be filled in by CoJ Department of Commerce (~8) 266-3151 ~ ~ Sanitary Permit Application A ' D s~ ~` LD. Number ~i In accord with Comm 83.21, Wis. Adm. Cade, ptasottal information you pro ! 00 ~v tt~y be used for stxottdary purposes Privacy Law, sI5.U4(lxm) Project Address (if different than mailing address) I. Application Inforimation -Please Print All Wo ~ ~ ~ ~ ~~ _ I'n ~ Property~Owner's Na me ~ Pamel tl ~. ~ qol t ~ Btock f ~ JIJN ~ 2 ~GO~ _ ~ b_~ C7o) ---- Property Owner's M ailing A Property Location ~ I ~l" 00 UNIN(~ OFFiCF s~ 54 /Yls1 Sf Section City, State Zip Cade Phone Number , , STsLL~d S'S"O~' ~P.~i''-' y 9 -Fi6~ R ~~ c~ _- N T ~ e of Building check all that apply ~ ~ T II ~ , _ . yp . . a~ ~"'S ('4's `"'~'^"` I"`""' bdivision Name CSM Number S ®1 or 2 Family Dwelling -Number of u . f F ,x ^ PubliGCommercial -Describe Use ~ f - ^ State Owned -Describe Use ~ ~ ~ _ ~Z.O t ~ - ~ a ~ - ^City ^village 8T ownship of _. .(pp O III. T ype of Permit: { only oue boat on ' A. C line B if applicable) ',' I~'Nt;w System ^ Replacement Sys ^ Trea okling Tank Replacement ONy ^ O Modification to rem ,r B. ^ Permit Renewal ^ Permit Revision ^ Change of Permit Transfer to New L and Date Before Expiration Plumber r - 1V. T of POWTS S stem: (Check that a 1 ) ^ Non -Pressurized In-Ground ~M > 24 in. of suitable soi! ^ Mound < . of suitable soil ^ At-G ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized round ^ Holding Tank ^ Peat Filter Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter Leaching Chamber ^ Drip Line ^ Gravel-1 'pe ^ Other (explain) V. tsal/Treatment Area Info 'on: Design Flow (gpd) Design Soil tption Rate(gpdsf) Disposal Area Required (sf) D Proposed (sf) Syscem Elevation ~ ~~~ S ~ ' ~ ~~' ~O~ / ~n v ~ r~, ~/ VI. Tank Info Capacity Total Number Manufacturer b Site Steet Fiber Plastic Gall Galbm of Utnes / Comtrttaed Glass Tanks anks Z/~ L /~ " ~ ~/ • _ , septic or ilea d / ~diEY,7~ nosing Chamber _ r ~„~ / __ VII. Responsibility Statement- I, ttm'imdasigped, assume responsibility for installation of the POWYS shown on the attached plans. Plumller's Na me (Print) Plu 's Si gna -tblls/MPRS Number Business Phone Number _ Fogerty Plumbing 1 - ~ ~x ~ 7/~ - .~s- 9`0 Plumb ~~Je~ ~it~~tate. Zip Code) 7/S-~3S = s :2 ~G ~X Spooner, WI 548Q~. 6av- vl- v6 VIII. Co se Oni -4x70 - L Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Date Lsstted t Signs (No Stamps) Surcharge Fee) ~ ^ O Reason for Denial 3So ~' IX. Conditions Apprn 3 1 .~ _ n ~, ,~ ~ ~_ I SYSTEM OWNER: --'o-t~- ~"^e~ V~ 1 Septic tank, effluent filter-and S~ t e~ dispersal cell must all be serviced /maintained ` as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances. Attach complete phms (to the County only) for the system on paper not Less roan au~ x ii inches m arcs ST CROIX COUNTY .SEPTIC TANK MAINTENANCE AGREEMENT _-- AND OWNERSHIP CERTIFICATION FORM Owner~aye~ lyrrr~.~~' ~ ?P ~3s~- ~r~.ci .Mailing Address Property Address (Verification required from City/State Parcel Identification Number ~/ P -/~~7 ~~ -~D ~~ 6q °~ - LEGAL DESCRIPTION - Property Location ,~E %, ,,~_ %, Sec. ~ , T,~? ~N-R/` 7 V~, Town of ~i!i~~or~l> r Subdivision _~~,~i~roir/i~ . ®,~s' /~ f ~ _, Lot # .Z~. _ Certified Survey Map # ,Volume ,Page # - Warranty Deed # l~/7Z 9 .Volume /~,~D ,Page # -~G~ - Spec house O yes C-~'no Lot lines identifiable Oyes O no SYSTEM MAINTENANCE Impropernse andmaiuteoaaxof ~ ~ticSy~cm~iemitinitspmaoatnsefa~etu l~ndkwastc~. Pmpermaintenance consists of pan out the septic teak every three years ar sooner, if noeded by a J~caased Wlmt you pat into the system can aQ'ect the function of the septic tack as a tneataneat stage in the waste disposrd system. . The pr+opaty arwner agrees io submit to St Croix Zmiag Department a boa foam, aigaed by the owner and by a masterplnmber, jomnoymanphm~restnctedpraraffioe~edpamperveafyingtlnt(I) ton sitie~vas~vatexdi~osal system rs m proper apera48g ooathtron anrl/ar {~ atb~ sad pumgmg (if necrossry), the septic tank is kss ~n 1/3 full of sludge. Uwe, the aa~sigaod have read the abo~ne reams and agree to maintain the pmatie sewage disposal system with the standards set faath, herein, as set 6y the Dot of Co~nenx and the Deparmaent of Natn3al Re9o~orces, State of Wisconsin. Crrtification stating that your septic system has 6eea mod must be ooaaplet~ar and zefnrnod m the St Croix County Zoning Offcx within 30 days of the three ~ e#piratioa date. ~ - SI ATURE OF APJ'LICANT DATE OWNER CERTIFICATION I (we) certiify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the d v , b of a warranty deed ru:orded in Register of Duds Office. - - / / SIGNA ~ OJ I'LICANT DATE- ***'`" Any information that is mis-represented may result in the sanitary permit being revo)Ced by the Zoning Department. *•'`#" ~~ ** Include with this appiication:_ a stamped warranty, deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed i! 1 91 0 ~' 2a 8 STATE BAR OF WISCONSIN FORM 2 - 1998 WARRANTY PEED This Deed, made between Merlin Land, LLC, a Minnesota Limited Liability Company Grantor, and Michael R Tohiassen Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croiz County, State of Wisconsin: 6 8 2 7 2 9 KATHLEEN H. NALSH REGISTER OF DEEDS ST. CROIX CO. , YI RECEIVED FOR RECORD 06-14-2002 11:30 AI! WARRRNTY DEED ExEEI'wr • REC FEfi: 11.00 TRANS FEE: 79.7@ COPY FEE CERT COPY FEES PAGES: 1 Name and Return Address L~alntnond Oaks 1st Addition Subdivision,Town of Hammond, St. Croix qty, Wisconsin 018-1087-70-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is clot) Exceptions to warranties: Subject to motes, easements,restrictions,covenants and rights of way of record, if any, including but clot limited to tlmse for drainage,water retention,portding,and or utilities as may be shown on the plat of Hammond Oaks Ist Addition Subdivision recorded in Vol. 8 of Plats, page 25, St. Croix Coltnty, 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 $24,900.00. Dated this 11th day of June , 2002 Merlin Land,LLC AUTHENTICATION Signature(s) authenticated this day of TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stets.) THIS INSTRUMENT WAS DRAFTED BY Paul A. Baillon, Attorney at Law _ (Signatures may be authenticated or acknowledged. Both are not necessary.) * by ~ ~ - ~-~ President s Austin J. Baillon ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. Ramsey County. ) Personally came before me this 11th day of June , 2002 the above named Austin J. Baillon to me known to be the person(s) who executed the foregoing instrument and acknowledge the same. ~) • ~ /if ~' a~, ~ N0T 4R~ PUS:.IC•MINNB$OTA Notary Public, State of W My Commission is permanent. (If not, state expiration te: a January 31 , 2005 .) -r 'Names of pennons signing in any capacity should be typed or printed below their signatures STATE BAR OF W ISCONBIN WARRANTY PEED FORM No. 2 - 1998 INFORMATION PROFESSIONALS COMPANY FOND DU LAC. WI BOO-655-2021 OAKS .SUBDIVISION I ----~ ~ ---- I I /4 ~OF SE 20 I ^~~~ _ ~ n ~ ,8L'Ol£ ~ ~ ~' v ,p8'1r t£ 9 / z 'o °' b y c~ .A~r w, r0 ~ c.~ c0 rn v -~ N v ~ N '~~o°DOmi a u. ,.• ~ sic" ~, D ~ • N ~ ~• r / ~• W -' D y O~ v NO O \ ~°~ ~ ( A> ~N ---1 ~p "' ~ .. to n ~ - y D ~ ~ ~ ~ a; R ~ y ~ ~\ ~ N ~ N y u ~-- N I ~ I ~ ~ ~ ~ ~~ 0 fn .Z 3.ll,S£.IOS' ', ' .L8•s£Z 3.1Z,£Z.os . I / ~ ~ ~ ~ W -~ ® © ~ . coo r \ --~--- ~' r ~~ O ~ ~ ~ O a N D ~ / ~ ~ a ~~ ~ ~ ® ~ O ~ ~, Ni 9 ~~ ~, I ~w ~8'LLZ 3.1Z,£Z,OOS I ~ ~ ,S6'98Z 3„IZ.~Z.OS s' ~° I ~ z r o i C ~ i t~ O ~"~ O I rn ~ a' o I ~~ O o ~ D ~ NI ~ to a D o = ~~ II °o S I N o ~ ~~ ~ o r OD N - -i~r OT- '~-- 1 -J I ~ I ~ fTl ~ w OD I C - - ,68'LLZ _ _ ~ ~ _ - - - - - - ~ r~ ~ ~ I - J ~N ~„ ,ZO'L8Z 3.tZ,£Z.OS ~, W ~ I r 164TH ST. _ w _ _ ~ N i I D _ ~- - ~- w o co Z I ~ 4S ~''- ,90'LSZ 3. ~Z,£Z.OS ~ I 0 - -- -- ~ ~ I - -• - - -~ ~ sr•sc / ~ ~ I r °6 ~ D N w o -~ ~ m= ~ I m~ D ' ~ Io °DD V ° t~0 O~ I D= ~ = I I a~ N ~ I ~ '-'~ ~ ~ N I ~ ~, vi f*l N O~ ~' ~~ D ~ I .. n . z I ~"°. Z tT1 D ~'' ~ I ~ ~ °D ~' ,£l~LBZ 3.1Z.£Z.os o ~I J ~ A r o ~ I I' 29.2=~~ o -Zi I I I I p~ ~ N I U 121.72' ~ ,££ .££ o I ~ n W o0 l v; I + , ~ o co I u ~ ~ .., I in I ''