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HomeMy WebLinkAbout018-1064-00-100Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH j~ PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 'ermit Holder's Name: City Village X Township Aune, Dave Hammond Townshi SST BM Elev: Insp. BM Elev: BM Description• l ~, b I0 0• ~ a,c,,Q ~. TANK INFORMATION TYPE 3 ~ MANUFA T~.1RCE~ ~ ti(~ CAP~1CrITY (iT~J-j Septic ~ Dosing ~~ ~~ ` .~(~ Aeration Holding TANK SETBACK INFORMATION TANK TO -P~/L^ 5 ri'~1' h WELL ~ BLDG. Vent to Air Intake ROAD Septic ~~,/ I \ N Z Dosing Aeration Holding PUMP/SIPHON INFORMATION (~1~T/~l,C.i!it~-~ Manufacturer (~~ Demand GPM Model Number TDH . Lift Friction Loss TDH Ft Forcemain Length la. Dist. to Well ELEVATION DATA county: St. Croix Sanitary Permit No: 453295 0 State Plan ID No: Parcel Tax No: 018-1064-00-100 Sectionffown/Range/Map No: 28.29.17.431 A70 STATION BS HI FS ELEV. Benchmark ----- ~ 2- ~' ~ . ~ ~ ~ ~ . Alt. BM ~. Bldg. Sew ~~ , !] l ~0 ` St/ t Inlet 2 , U y ~. ~ SUHt O ~ 1e L~ ~ r GG~i'' I _ - w /to 14.Cte- a ~ - S, 1 Dt Inlet ~- ~- Dt Bottom ~ ~--- Header/Man. ~( (s ~f,' ~ ~S- ~ Dist. Pipe / Botj sy§~m Z ~ ~ Final Grade ~ ` // 2 ~. ,~ Ct st Cover 3 , ~-~ --. t7 SOIL ABSORPTION SYSTEM ~ ~ .)L.S~A- -" 2(~ -{~Z.P~ -t-- I `? BED/TRENCH DIMENSIONS Width ~ Length,,'/'~"~ " ~ No. Of Trenchgs ` ~ PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth f ` 1 _ ~ SETBACK INFORMATION SYSTEM TO P/L BLDG WE L LAKE/STREAM LEACHING R HA ur ~. , ~~ ~ ~~ Type f System: ~,, ,, ~j ~~o ~(~tJi .~- ~ ] ~ UNIT Model Number. DISTRIBUTION SYSTEM Header! anifolid Distribution (/~ ,~.~ x Hole Size x Hole Spacing ~ ,{~ p~Pets) g ~ l i ~ '~ ~` 0 Length Dia Length Dia Spacing_ / f J SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over / ~ Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center /-~ ~ ~ ~ Bed/Trench Edges Topsoil ~~] Yes ~~ No j ~ Yes ~ No U.. V`'`" COMMENTS: (Include c~~o a discrepencies, persons present, etc.) Inspection #1: /~/ Inspection #2: / / Location: 749* 170th Stl~+ikno~ (N 1/4 SW 1/4 28 T29N R17W) NA Lot 1 Parcel No: 28.29.17.431A70 1.) Alt BM Description = 2.) Bldg sewer length = Z ~ 11~0~~ Q'~6-'U-lµ--~ 7~ ~ a~"~~`~~ ~ , -amount of cover = ~ ~/ .,-„ ~~_'.r..f/ w I'~TR~n~Y~~v~ Plan revision Required? j Yes ~ ~~+ No i ~ Use other side for additional information. ~_~ ~ ~ _ 1 ~.~ SBD-6710 (R.3/97) Date Insepctor's Signatur Cert. No. 6 r Vent to Air Intake i~ ~ ~ ~- Jafety and Buildings Csivisian ~ County ~ ~~~ -_~----~~~ 2t3f W. w+ashington Ave„ P.O. Box ? ib2 S~Gr/cJ ` X ~~~~n~"'~~ ~ Maciisrn, WI 537Q7 - 7162 Sanitary Permit Numtaer (co be filled in by Ca.) De artment of Commerce s (50i3} 2t5b-3151 z gs ~~ Sanitary Permit Application state Plan I.D. Number to accord wtth Comm 63.21, Wis. Adm. Coda, persona! information. you provide may be used for secondary purposes Privacy Law, x15.04(!}(m} Praject Address (if different than mailing addresa> I. Application Ittfortasation - iPlease Print Ali tirtformation ~~ ~ ~{- ~~ ~ ~~( • Property Owner'a Na rtte 3aFCai•#•, Lei M T HEock ~ ~~~ ~.~~ P~d~ ~A~ ~~ 5 200 ~ i Property Ownw's M ailing Address ~ i . CROix:;UUIvI `, Property Location ~/~' ~dt'o S(~ O' / 0 /a `~d ~ ~er~~s ~ ~ _ ZONING OFFICE ~< ~ ~l.J yl, S~ k,Secaon .~~ City, State I / n ,Zip Code Phone Number ~1 i ,~f/~4l ~G- ~e!/>5~ ~ ~'~ I ,~' `G/~l T ~ ~ ~G~~ y ~.~2 (circle o i '~3~~r T oZ ~ N; R /7 E o~ iI. Type of Building (check all that aPPiY) ~ ~^ge t1 _ Q M,, _~~ ~; ri i or 2 Family Dwel;irtg - Number of $edrootns d~-~~_^~_e_.1_..._.J Subdivision Name CSM Number ^ PubliclCommarcis! -Describe Use Qx>+~' ~`Q. `~ CMG ~~~7,~ ~ /~'~IR~ ^ S:ate Owned - Describe Use qt/ t`~" 'f'O SGN City I~Villag Township of •~`t~s,. ~i III. Type of Pernxlt: (Check anly one bvx on 11 a A, Ca late B i app s) A' j New System ^ Replacement System ^ TroatmentlHolding Tank. Replacement Only ^ Other Modification w Existing System List Previous Permit Number and Date issued B. ^ Permit RCncwal ^ Permit Revision ^ Change of ^ Permit Transfer co New before ExpUatren , ~ Piumber Owner ~ i i Iv Type of POWTS System: (Check aU that appt~} _~~ Non -Proasurized In-Ground ^ Maund > 24 in. of suitable soil ^ Mound [ 'L4 in. of stitable soil ^ At-0rade ^ 5ittgle Pass Sand Piltcr `I ~ ^ Ctuaspucted Wetland ^ Pressurized In-Ground d Holding Tank C Peat Filter ^ Aerobic Treatment Un[r ^ Recirculatin@ Sand Pi!ter~ ^ Rtcirculatin S thetic Media Fitter Leachin Chamber G D ~ Line ^ Gravel-;eta Pie ^ Other (ex lain) ~~ V, )p reallTreattnent Area Information: ~'9' - Y ~` IJssign Fiow (gpd) Design Soli Appliradon Rate(gpdsf) Disperse ea wired (s~ Dispersal Area Proposed (sf} 5ystWn Elevation ~~ ~ ° '~~ ° Esc - lr~z s ~ s1~S ~ k cO,~ts VI. Tank Info Cap city in Total Number Manufacturer j Prefab Sita Steel Fiber Plastic Galiotu Gallons of tIn! ~ ~ ~ ~~ Concreu Constructed Glass New Ewisdas , !` ~ ~ Tatakx Tanks '4't Septic or Holdi[~ Tank lBd~ ,~ S ~ Y i Aerobia Treatment flail i, Aosu~ Chamber ~~ ~~ ~ ~ e lr , VII. Res n.lbWty Statement- I. the tyndersl ed, assume roapoastbility Par allation of the P0WT8 shown on the attached plans. Plumber's t3a the (Point) Piumber'c Si gnature !vfPi 1PI2S Number ~ Business Phone Number i ~<` L~.wa ..s~h~n•-e~ey c tea. ~~~jd' { ~l3'-.~~'G ~l~ T --~ Plumber°s Addro to (Street, City, Stan, Zip Code} / VIII, Catnnt /De artmetst Use Onl __ ~ApprovQd ^ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Feo} ^ 0 en Reason for Denial ~ z~'"_. ~~ ; 1LX. Canditiont; Approv -~ '~'~ SYSTEM 0 ER: ~'~ ~ gZ ~ S ~- °'"'` ~®~• ~ 1 Septlc tank, effluent filter and //~~ ~ dispersal cell must all 4~ serviced / maint~insd c~l ~ ~.~~- ~ d"~"" Sev.~ ~ s ~ Ire as per management plan provided by plumber. J ~n ~ ~ ~_.--- S~ 2, All setback requirements must be maintained r~ `''~ P~'~ ~ ~--~~~ as per applicable code/ordinances. ~~~ ~ ~--Q~Q,,,,, , ~-- Astaeh eoalptete plaatt (ta the Cotmty Daly) for the systopa~oa paper ant o: i112 ac~ehea a xis S. -~'----' S~D••6398 (R. O1/a3) `~'~Q-'~. eiu~ "'~"~ J~_ ~~ ~~ ~ z ~. ~ _• ~~ ~~ `~ ~" ° `z-- ~ ~ `~ p~ ~ ~ ~ ..--- v ~ ~ ~ ~ .~ ~~ ~~ ~~ ~~ ~J d~ ~~ p ~~ ~~ _~ N o ci v °~ r ~3~' -~ ' • ~ `~ ~~ ~~- .~ ,~ ~~ ~ ~ ~ ~ ~ ~ 3 a .~ a. l oQ~ G ~- s ~~ ~9 a l~ ~- ~~ ~~ ~ a h~~~ ti ~ ~ ~~ o ~ ~° .U~' ~. / ~~~ ~ ~a 0 ~1 a ~~ ~~ .~ - ~~`~ . (~. \` ~. ~~ ~~ 0 cz-- 3~ ~ a~ ~ -~~ ~ ~ \ ~ ~ ~~ ~~ ~ ~ b ~ ~~~~o ~ ~ ~~~ ~ ~~ ~ o ~ ~° ,U~ ~. Utz` ~ ~ o ~. ~ Q ~ ~- ~~ ` ~ ~3 J .~ l ~~ \~ p ~r ~~ _~ N w o tl v °~ n • ~~ ;~ `~- ~i ~ ~~ 1 ~ ~a ~ ~1 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page _ ~ of __3 Division of Safety and Buildinos in accordance wrtn t;omm ua, vvts. nom. ~ooe t Pl - County ~ T an mus Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. parcel (.D: Please print all fnfiormation. Personal information you provide mey be used for secondary purposes (Privacy Law, s. 15.DA (1) (m)). Re ' ed by Date Property Owner c~ U, ~ ~ Property Location Govt Lot ~{/~J 114 ,SW 1 f4 S ~~ T~ f N R E ( W Property Owner's Mailing Address lay ~ S~ ~l Lot # Bock # Subd. Name or CSM# City State Zip Code Phone Number [] Crty ^ ~Ilage (~ Town Nearest Road ~ New Construction Use: I~ ResidenC~ai / Numbe{ of bedrooms~__ Code. derived design flow rata _~~~~ ~-~ _-__ GPD ^ Replacement , ^ Public or commercial -Describe: _ -_- -_---__- ---------- Parent material _-_'i'~~ - _ ------_- Fbod Plain elevation if applicable _-!UJ~ __,,`--_-___ ft. and recommendations: s~5"I 'e i/h ~~{'J` 'ITS P ~t^C''~ ~) "b~ ~Ut~J._,1r q (~ U U Boring ~-s°0~~~ r t Boring # ~/ /_~,l ' ® Pit Ground surface elev. _LL~ fvv ft. Depth to Iimtting factor _~~?~.in. Soli A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots. GPD/fiz ~-- in. Munsell Qu. Sz. Cont. Cobr Gr. Sz. 5h. 'Eff#1 'Efftt2 ~ _v 3/ -- ~~ ( z ~,I es ~ i~ ~c~ ~- - 1... ~ V~Srj~ ~ GV-J r ~ ., f.~ ~- (p l d ~ - 5u L z t~5~ ~ t~ ~ S - • z ~ ~' Boring # ~ Boring .pit Ground surface elev. ~~~ ft. Depth to limiting factor ,~~ in. Soil A ication Rate Horizon Depth Dominant Colar Redox Descr~tion Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Cobr Gr. Sz. Sh. 'Eff#1 'Eff#2 1 v'/~ t 3 Z ~ sf'I ~s6 ~, r ~ s ~ ,~~ ~J , ~ (~ Z „zy ~~ s~ ~ ~~ - r ,,~ .~ 3 Z q- ~ ~ ~ S~ l ~ ,~, ~ Lw y ~o~ ,~ ~- L~ ,~ ~ _ - r Sy- .S~ •S SQL, r Efliueni ~1 = BODs > 30 < 220 mg/l and TSS >30 < 150 mg/L ' ~tttuent #'1 = t3V u5 < 3u mgJL arw t s~ < .iu mg/t_ CST Name (Please P ' t)/ ignature CST Number ~~/~ Ad ress Date Evaluation Conducted Telephone Number z//3 ~u~~~w~,_~~j P,,i~ S y°z~ ~ ~~S-c'is 7is'7~o- a?--~ ~ ~. Property Owner ______-_-_------- Parcel ID # Page _~- oF__ `-- U Boring Bo ring # [ ~ pit Grou nd surface elev. ~[. l~/ v ft • D epth to limrttng fiactor Sea A icadon Rate t T Structure Consistence Boundary Roots GPDIft= Horizon C Depth in. a- z Dominant Goior Munselt l~ z Redox Descrtption Qu. Sz. Cent Cobr r--- ure ex S~ / Gr. Sz. Sh. ' S U~ .E~ '~ Eff#2 3 -z z r ~ ~~ l - ~~ - ~S L ~ ,,.... -~'f ~ ~~- 'S `, ~----- ~. q-, _ off' 41 ~ 3~ - X3.2 `f3• Z . 2 .~ .Y .~ (J Boring Boring # ^ Pit Ground,surface elev. ~_:____ ft• Depth to limning factor ___.__ in. Soii Ap lication Rate Texture atrUCturB Consistence Bour~eiary Roots GPD/ft2 Horizon Depth in. Dominant Cobr Munselt Redox Description Ou. Sz. Coni Cobr I Gr. Sz. Sh. 'Eff#1 'Eff#2 - I ~ I _ U Boring Boring # Ground surface elev. _________ ft. Depth to limiting factor _-___ in. ^ Pit Soil A I•tcatton Rate i Texture Structure Consistence Boundary Roots GPDHt2 Horizon Depth in. Dominant Color Munselt on Redox Descript Qu. Sz. Cont. Cobr Gr. Sz. Sh. `Eff#1 'Eff#2 I -- L_ ' Effluent #1 =GODS > 30 < 220 mglL and T5S >30 < 150 mg/L ` Effluent #2 = BODS < SO mcyL and TSS < 30 mglL The Department of Commerce is an equal opportunity service prvvic7er and etnploy+;r. If you nc::z; assistance to access services or need material in an alt,:r^ate format, phase contact the department at 608-266-3151 or TTY 608-264-8777. s¢n-alio i a.u~ron~ PAGE ~ OF~ LOT# LEGAL DESCRIPTION:~J,,[I~4~~14,5 ~1 T~~ N,R~E(or~ NAME: SCALE: I"= ~ c ~Nn(ELEVATION: t~~ ~ BM 1 DESCRIPTION: na,~I ~~- Jr rr ~~~C•e~,~..Qi~/'< t BM 2 ELEVATION: ___(~! ~ Z ~ BM 2 DESCRIPTION:~{~D ~~- Sl--~~ ~ _ ~ `~`' SYSTEM ELEVATION: ~vP ~ I, ~ ~a~ ~ ~~yd SYSTEM TYPE: ~ a~ ~ ~~ ri ~~ ~d~~ ~~ ~ ,- \ ~`~ b' ~ ~ :~ ~~~ 4~~ DATE: ~ ~~ - d n ~ l ~:iv~..~~,1 t^.iV~ .~i~rr~I~l~./ti'T+v:V'J . S H P T ~. C TAN X~ pit M r ~ F A}? B A R CR vS S _ ,______,_,___~~___ k,. , ~-" CI VENT ~P?PE ~~.2~""`~`~I+fi: `ABfl'4''E ..GRADE' ~ WEATFiERPR00 3 25' FROM DggR, WINDOW OR JUNCTION BOX FRESH AIR INTAKE r---WITH CONDUIT FINISHED GRADE 4" CI RxS::R Z~" 'MIN ~w,.....~61.. NLET ~--- WATER TIGHT SEA~.S PPROVED IPE 3' 1iT0 SQL ID OIL PUMP OFF ELE~I . FT . 1 A B "~.'_ C ~D ,. i ~+ I' GAS- ~ ', T?GHT~ SEAL ~ s-; ~ ~ t ~ ON OFF AppgQYEL MANHOLE COVER w/ PADLOCK ~ WARNING LABEL -~" MIIv . ,~ ~e /APPROVED JOINTS WITH APPROVED PIPE 3' ONTO SOLYO 5QIL ~~ RISER EXST PERMITTED ONLY IF TANK MANUFACTURER HAS APPROVAL 3" APPROVED. $EDDYNG UNDER TANK CONCRE'T'E PAD SPECIFICATIONS SEFTIC / DOSE fiANlt MANUFACTURER : ~„ e~~„ NUMBER LOSES PiR DAY : _,,,~._,,,,_, TANK SI~£S : SEPTIC 1d~' GAL. DOSE G ~G GAL . ALARM MANUY'AC'TURER: ,,,,,L ~ U+:la.v,~ MODEL NUMBER: ~ s. v SWITCH TYPE. ~e,,,,t-c. .~._. ~, PUMP MANUFACTUR£.R : [EAU; /g~ MODEL NUMBER : ~-~~' o ~v' SWITCH TYFE: nr,r,r~ _ REQUIRED DISC~iARGE RATE _~ GPM DOSE V OLUMS INC LL'DING F LOW$AC K : /~_ GAL . CAPACITIES: A = ~, INCHES = ~.~5'~ GAL. S ~ INCHES = ~~„GAL C = ,~ INCHES =CAL. D = ,~,~„ INCHES = _ ~~ GAL . PUMP ~ ALARM WIRI hG AS PER I LHR I6.23 WAC ;J:EItTICAL DIFFERENCE BETWEEN PUMP GFF ANn DISTRIBL'TI(?N PIPE ~,~„__,,, F£Es ~+ MINIMUM NETW®RK SUPPLY PRESSURE _~'FEET + G~ FEET FQRCEMAIN X ,~l.,~FT11Q0 FT. FRICTION FACTOR 1; 3'T ~'E£T TOTAL DYNAMIC HEAD = ~.5 7 FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH ; wZDTH ; DIAMETER LIQUID ~~ ~~ ~ M SIGNED: f~'~.F.~c.--~~~" LICEN'SE NUMBER: .2~77~~Gf DA'I`S: -,~~~~- ~ ~ ~.~ ^ r w wo.~w rw+ d/8~ (~ GOULDS PUMPS Submersible Effluent Pump ,~ EP04 ~~ ~ EP05 ~€ APPiLICATI®NS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPEtIFICATIQNS • Solids handling capability: '!+" maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size: 1'/~" NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastamers. • Temperature: 104°F {40°C) continuous 140°F {I;0°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, 50 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 HP, 115 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power card:l0 foot standard length,16/3 51TOW with three prong grounding plug. Optional 20 foot length, 15/3 S1TW with three prong grounding plug (standard an EP05}. ~ 2400 Goulds Pumps FNedive February. 2006 63877 • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Auto- matic modeisinclude 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. ^ 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 Gable: Severe duty rated oil and water resistant. ^ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY 415TING ~,' Canadian standards Assodarioa {CSA listed model numbers end in "F" or "C".} Goulds Pumps is ISO 901?1 Registered. METERS FEET _.._.,, _ ~_ _ _ ,,._. . _ .._ ,.,..,...,.. _... ....,..,.__ ..._. 10 ._ 9 30`-^---~--„ _.. ._.. _. _ , ._..~ SCPnn _.. s-. .-, s ~ zs Fr x 5t 0 25 ,- _ , e 20 ~ _ .._ _ . _. ,._ 5 15t ~ - _.. _ . __ ~_.~. , ar s r 10~---~-._ ;_ _ '_ . _. _ 0 oa 1o zo ao 4a 5o GPM o z a s a cAPaclTv 10 12 m~/h Goulds Pumps ITT industries FFiOfvT VlE4V 't: i _ __ ____..---~......____._ ~°---- -- (cFFECTIVE !"ENG'TH} (-I 1 I ;~ 1 ~ ~ ~ t ~ „e -i I f 1! 1~ ~ ~ f f .,i' ~i ~ 1 ~ t. - ~ SiQE VIEW I.~ t \ - 910E VIEW _~- --._ ..._ ., ,.. .. . r•c.it.e.u7Ytllial ~pr~clEBGa~t£?RS" ;< ----,...~.~_ 3~" x 52:1 X 12. Effective t.engt7 ~~ 4i3" Invert Height--- ~'""-'""-" ~" TIP VIEW Invert heigttt _~ B" or 1.25" MultiPort Errd Cap N~!LTN~gTUR~.~TI~S~E~IAt~,L?B:>~-4~11tT~.. /M1~ARR/~~jy:y 4n1 s. - tu.a It+y q b is ar J i.uate, wu tye a(M ~.,u,nr aun ry ' ... 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Uy- uulrarfilY ib (tl,once G w,l¢nU tl. r„vp'Narr:),.iv Tli nnl .,L,.ti V~!Pktu 10 alp i.ifry r)Irgr Klan thu nry. 'h4" )b J ¢F PSU ! Sl9', Lr 7. ~!,NMi Ndf8r11Y OYOrb7 L' , , nes Is Ar.r rwra 1 a (x,rnac: mr ,f¢tras c., ~ b,Jlluafn A , ~ nr r rata: a w w Nlac r ~a~ a rCi nw~ w ~'-~FY ul tw appic.1U8 war ~rlty, anJ WIOWO C~.N•hul' F re r Ya 4+. erg -, ()u f ~ +~,n, :::4 rYn.t~,l.t ~ n"; r'. rfl9cJ 6he1 N8f MIt prM O f.0 Uwr'.r.Xr Vr ~rNtS. ~ l'n; tJ S~t:n nUr> 1 !K1..n c.18ir i a r ~ ~ • SYSTEMS I I~IC ~ t:flV/lDlIANI?!1~/ I ~ILIItB W98fi!w~Pt~l' SOQJtYCVls'" 6 ~usir~~ss Park Road • RrJ. E~x ?68 Olt SayGr~ok, r:T 064 ~ 5 860-577-7000 • FAX 860-577-700 c 800.221-4436 S FafOtil'". a 7gg 1161; 5.17 CA 5, Erifi,>i$tl; 5,33$,0; 7. $.401,t IG; S,aC t 4 3. p„ Jt c ;,'; a : t5.t~ r~,58H.77t}~ 5,£139,N4e llandv+-. r Fe!en1'J: f .i2y.<3`q. CA I, Ssid G`ptdt palyrltb Penurrx~. In°,rtrdiur EU;1agz@r 81t1t $iCkiWlrk~6r are tB~iSterf<1 lrar~'ri+t>ark3Of IntAtratctr SysWm s"K;. mfikr8lor is a rtfylstervU t,arlemOrk in FranGltl. IFttlktafpr S)+Stef11S Inc. Is a reyr„tr+r6A v3~ymark 'rr, Me>,~co. Cprltcax, (:tlntour SwA'al COf'ne{;i10!-I, MlCrolxruLii:rg, I'olyTlJlf, tintJpl,OCk, ~hanllJAtS93datr. ~'otttLeCk, l?ulckCut, QUrckFtn>• ivld 1]u,Cka 378 tracBmerkC 61 Infilfratof $1ryt~jpl5 Ir1c. C, 2pJ43 I,~li:tr9lry Su:7terns inc. F''NVwri :n,, :. e NFG.Y1 ~n n.n~-.. ~~` --- ~. STANDARt7 CNAMBfA ;--- ---- ----_ aa° ~-; Quick4 Standard Chamber ~. ~ PowTS owNER"s MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION Owner ~ J Permit # 2, S-- DESIQN PARAMETERS Number of Bedrooms 3 ^ NA Number of Public Facility Units NA Estimated flow (average} ~j~' al/da Desig~i flow {peak), iEstimated x t .5) .Sr`~ et/da Soil Application Rate al/da /ft~ Standard Influent/Effluent Quality Monthly average` Fats, Oil & Grease {FOG) 530 mg/L Biochemical Oxygen Demand {$OD~} 5220 mg/L ^ NA Total Suspended Solids (TSS! 5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand i13ODb} 530 mg/L Total Suspended Solids (TSS) S30 mg/L ^ NA Fecal Coliform (geometric mean) 51fl` cfu/1flOml Maximum Effluent Particle Size Ye in die. ^ NA Other: DNA 'rValues typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE SYSTEM SPECIFICATIONS Septic Tank Capacity Q'~~f al ^ NA Septic Tank Manufacturer ~rC.SC~" ^ Nq Effluent Filter Manufacturer b~ ~ ^ NA Effluent Filter Model A d(J ^ NA Pump Tank Capacity ~ ai ^ NA Pump Tank Manufacturer shy ^ NA Pump Manufacturer Goa ^ Nq Pump Model ~ ~~~ ^ NA Pretreatment Unit ~VA D Sand/Gravel Filter D Peat Filter ^ Mechanical Aeration ^ Wetland ^ Disinfection ^ Other: Dispersal Ceillsi ^ NA n-Ground {gravity) ^ In-Ground (pressurized) At-Grade O Mound ^ Drip-Line ^ Other: Other. ^ NA Other: O NA Other: ^ NA Service Event Service Frequency Inspect condition of tank(s) At least once every: ~ month{sl (Maximum 3 years! earls ^ NA Pump out contents of tankls! When combined sludge and scum equals one-third (Y,! of tank volume ^ NA Inspect dispersal califs) At least once every: ^ month{s} fMeixlmurre S year8) .~ ~ earls? ^ NA Clean effluent filter At least once every: monthls! saris) ^ NA inspect pump, pump controls & alarm At least once every: ._--.- ^ month(s) ^ yearts! ^ NA Flush laterals and pressure test At least once every: ' i7 month(si ..-_ ^ year{a} ^ NA Other: At least once every: ^ month{s) _ ^ earls) DNA Other: ^ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the foltawing licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must inctude a visual inspection of the tank(s- 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 back up or ponding of effluent on the ground surface. The dispersal cell{s) shall Ise visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the lace) regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third {ys! or more of the tank volume, the entire contents of the tank shall tae removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized pomponents, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. 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J-~,9 n~ ~-~-° ..~ ,a ~ ~ ~ ~ N~ i s- , {Verificatian required from Planning Department for new construction) City/State ~'/~Fr~ ~" ;"~ ~ ~''~ ~ Parcel Identif cation Number f~~ ~ `~~o ~- O0- l d ~ LEGAL DESCRIPTION. - ~3/A- 7b Property Location N ~' '/., S ~ '/., Sec. ~ 8' . T 2`~ N-R~._W, Town of ~- rv- U n.p . Subdivision -- Lot # 6s~-~ 3 ~. /s yi ~y Certified Sarvey Map # ~ ~ _ .Volume -~ ~ .Page #~ ._ Warranty Deed # Ali /G C ~ .Volume ~ S~G"© .Page # . ~-? ~ Spx house ~ yes ®no Lot lines identifiable ~ yes O no SYSTEM MANTENANCE Improper use and nuiatenance of your septic system could result in its premature failure to beadle wastes. Proper maintenance consists of pumping out the septic tank every three yeas or sooner, if needed by a licensed pumper. What you put into the system can affect the fnnctioa of the septic tank as a treatment stage in the waste disposal system. The property owner agc+ees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeymanplumber, restrictedplumbez or a ficensedpumperverifyingthat (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, bereiq as set by the Departateat of Coaunerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the yea expiration date. ~~c~~ p~ SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) laiowledgc. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. ___.._ . ..... 1.3 ~I ~ SIGNATURE OF APPLICANT DATE s••s.a Any information that is mis-represented ms-y result in the sanitary permit being revoked by the Zoning Department. •'•••• •• Inetude with this application: a stamped wamaty decd from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed 1~ ~11% r ~7 ~ •i n rw.~ 1"t l.~ M12 ~~1,~ L~v~:~ ti'. 1 '.' IJ.~VL 1- ~h~nnvn ~kr~x J l,, ~ ~l -c ,~ . ~L 2589P 366 St. Croix County Occupancy Affidavit 1 Q ~U JV ~= Name - (Ovmer) Typed or printed being duty sworn ,states, under oath, that: !. He/~e is the owaer/pact owner of the fotlowing parcel of lead located in St. (koi:c County, Wiscaa~n, :a:ordod in Voluox ~ Sbr~ Page 3 Z 9 DoGUacnt NumbefZ 1 .0~5t. (~oix County Register of Deeds Offix: A partxl of land tocatod is the 1L Y. of t1b5W Y. of Soctioa _ a T~ N-R_ /7 W, Town of ~Y, St Croix Cotmty, Wiacoasia, being ~- tieaat as follows (include lot no. and snbdivisioat~CSM or deniicd legal descxiptian): 7649t~13 KATH4EEtl [l. YAi.Stt REGISTER OF DEEDS ST. CROIX CO. , wI RECEIVED FOR RECORD 86/®4/2A®4 12:3®Plt AE'FIE AE?Pt # REC FEE: 11.1118 TRANS FEE: car >:ES: CC FEE: PAGES: 1 Name and Return Address ~c ~4u.~ 7DO Bns~.~w~-H 51+r. ~i~- /0 6 y-6o - ~o o ~, 5r3ir~~o) As ovmer of the above desq~ed .1 acknowledge that the septic system serving this nesiderloe is sized for a bedroom home, a a design flow of O .The design flow is calaAated by assuming t Ko gpd for 2 individuals per bedroom. There ttre cxxt+entiy~acrxpartts in ttus residence: ,(~ oaxipartts erne pemdtted based tm the design flow. Thet+sfor+e the septic system serving this residence is code oorrtp~rrt. However, I understand that if theme are interttiorts to exceed the number of permitted occupants, ltte system wfq need m be nlod'tfled to acoomodate any increased wastewater flaws and/or oontaniula:r-t bads. 1 also adknawiedge that 1 wdl make this information available to any future parties interested in purchasing this property. Dated this _~ day of ~. ~.c .?~t3 . Tftt~: tER sraTS enR of wtscoNSIN (N not. auttwrtzed by § meos, wis. Stats_~ _ THl8 RtSTRIR.IENr WAS ORAFIEO BY (Signat~es may be ~ a acknowk+dged, l3clh are not nsoessarY.) * ~ c9 wr+A. ENT STATE OF WISCONSIN ~- 8~b_c county I came before me this ~ day n'e-" 4~~above named b me known b tro the person(sl who eooecuted the toregoirg and acknowledge the same. Notary PubYc. Stale of My Convnt a: s permanerx. H rat, state data: Ogle: ''rWS P/IRiE I.S PART OF 11i1S tFGAt. OOglYENT'- DO NOT REINOVE" TJYsf:tOfttlellonAlaafbeeonpbledbysu6~M: ard~llSreQt~MJ- OaisrluuRo~nnedonaudtasfUe a+r~1v o ~. •fb. ~apicadan tlhlristpags dla.dooumen! oriaaybpfroadoa addirJorrslpapssdtf~s dboarrwrrt. ~; the d Wt oaNSrpge adds oas Sips b yvar dbarwsnt and NRsoonaln SM~ taRlif7. U 2 5 6 0 P 3 2 9 DocuMeiv-s rlo. ~{ I STATE BAR OF WISCONSIN FORM 16-1982 TRUSTEE'S DEED Gene E. Aune and Audrey J. Aune as Trustee of Gene and Audrey Aune Revocable Trust for a valuable consideration conveys without warranty to David G. Aune and Shannon T. Aune Grantee, the following described real estate in ST. CROIX County, State of Wisconsin: • ~~-~ (SEAL) * Audrey J. Aune Trustee REC FEE: 11.00 TRANS FEE: COPY FEE: CC FEE: PAGES: 1 Independence State Bank E401 Menomonie St.. QO 8ox 325 a~ Elk Mound, WI 54739 1 ~~ II 'l'ax Parcel No: 18-1OG4-00-100 Lot 1 of Certified Survey Ma #418 ecorded in Volume 5 of Certified Survey Maps, Page 4184 as Document #657734. Being a part of the NW 114 oft a 1/4 of Section 28, Township 29 North, Range 17 West, Town of Hammond, St. Croix County, Wisconsin. Also any part of Outlot 2 of Certified Survey Map #3621 recorded in Volume 13 of Certified Survey Maps, Page 3621 as Document #600341 which may lie between the Westerly 66.01 feet of said Lot 1 Certified Survey Map #4184 and 170th Street. Dated this day of , 2004. `'~-^-~., (SEAL) * Gene E. Aune Trustee Signature(s) AUTHENTICATION authenticated this day of ,2004 * TITLE: MEMBER STATE BAR OF WISCONSIN (If not. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Rick L. Pendereast Attorney At Law (signatures may be authenticated or acknowledged. Both are not necessary.) •Natnes of persons signing in any capacity should be typed or printed below their TRUSTEE'S DEED 3Ni Vision Form SDDO7 WI Rev. 07/09/96 ACKNOWLEDGMENT STATE OF WISCONSIN ST. CRO1X County 76 1 GU67 KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CO., NI RECEIVEI! FOR RECORD 04/29/2004 10:15AM TRUSTEES DEED EXEMPT # 8 1 ss. Personally came before me this o2lrL} day of u.pn.~.Q , 2004 the above named Gene E. Aune and Audrey J. Aune to me known to be the persons who executed the foregoing instrument and acknowledge the same.~~,,~~// My is s ~a~36 = Z • ')K a[urei*• n ~ i ~% G i~~~Sj~~,OFttt~ `~~` County, Wis. Rent.- (lf not, state expiration date: 3 / 1 1 / 0 7 File # 00456064 ` . , .~ Submit original form to Register of Deeds with document(s) to be recorded. Completely fill in all appropriate areas. TYPE or PRINT clearly in BLACK INK, and use ALL UPPERCASE LETTERS. If typing form, type through verticaFcharacter lines. L GRANTOR (Seller) ff more than ONE (1} glantOr, dteck box at left and list on attached'addteldttm. Nirte: lines 67-72 must be tpmpleted with grantor's address. 1. Your Last Name or Company Name Note: For this purpose a married couple is orm grantor N same last narrui (see line 2). ALINE . 2. Your First Naswts) cad Mld~e britlaf(s)- 8 a married couple, show boot tkst names ad middle kdtEls. 3. Social Severity Nanbar o- FEBI GENE E. AND AUDRSY J. 389449085 -_ 11."GRANTEE (Buyer} If more than ONE (1) grantee, Chedt box at left and list on attached addendum. 4. Your Lest Nattre a Company Nana Nom: For [his purpose a manied carpb is one ~amee N same last name (see fire Sj. ALINE 5. Your Firot Name(s) and Middle Initlatts) - U a married coupe, slaw bath first names and middle initials. 8. Social Security Narr~ar or FEIN DAVID G. AND SHANNON T. 389926376 7. Sheet or Flre Number. N any Ta. StreR Name, PO Box, or Otlter Address {slier `PO Box' ad Box Number) ~ 2 4~ (~ tr TJ 4 ~ w ~ ~ S ~l- r . 8., }CRy 9. SbEa 1a. up coda t'1 fat M M a n i>. wI .r t f ~ / ~ TO RECEIVE TAX BILL AT ANOTHER ADDRESS, check bare and compkie Seetfat X, page 2 ' ~: III. PROPERTY TRANSFERRED it. htmc~a: tiny X Town ~ Chad{ HadtOUonal parOMs sea Ibtaa amchea sddandum. 12. Name of the CrtylYHlagNTown 13. County Name HAMMOND ST. CROIX 74. Fhyakd Preparly Ada<ass or Road Address (desaip0otrj VACANT LAND ON 170TH STREET 15. Tax Parcel Number as N appeare oa Property Tact bN lane btstructlons) 18-1064-00-100 18. Property DasulpUox: IW -ttb0t- plat, CaAiBad Sareay 1{tEr (CSYj, or other dasigeatiar N descdptlon wi0 not flt hero, add altesMae+d teas lastructlom) SEE LEGAL ADDENDUM 17a. Section (primary) 17b. TownaMp (prkrmry) 170. Rarpe {primary) Chedt hero H amore {ban aw lot sari block, ~ H legal description is mats ahd bands w cwtlRsd survey map: attach legsl descrlpHon as an ndum (see instructlorre). IV. COMPUTA'CION OF FEE OR STATEMENT OF EXEMPTION oa~ARS t~Nrs 18. Total value of REAL ESTATE traruferred {round up to gre S 3 () 0 t) 0 IN WHOLE 19. Transfer tee due (Ilne 18 X .803) 0 ~ (? nsaroat 5100) DOLLARS 20. Transfer Exemption $ 20a. N you sMar °003` or'017,° N H 28b. D~ of Orlglnal Number, SEC 17.28 esaadeiay b prorMe your Lead Costraet prevloas dowarart number. MONTH WtY YEAR 21. Yelue Of perSOnei propsriy trensferred but EXCLUDED ~ ~ iN~~ 22 Yelue Of property exempt fr~ Ioeai propafi tat ; ~ from Hoe 10. O NICLUDED on rro t0. DOLLARS V. TO BE COMPLETED BY 23. Doverrartt Number 28. Comsyanee Waaerdy/ Code Cando Dead ~. Couay (,) 30. Murridpa0ty {+) 1RIZED COUNTY/LOCAL OFFICIAL 24. VohrmetJackst 25. PageRmage 28. ~ Recorded Lard tkut Clakn Otlar Contract Deed (expakr) -) 3,. comity ~ 3:. Manl~p.lny tz) 34. Enter rambar of sores for each 1(Residen8al) 2 (Comrrertsaq parcel elessifka0on sad check t 2 a preceding box to show predominaat ctassHication. 35. Assessment Yea ~. L.ud a PE-500 (R. 1-2000) Yes No 7 (Otlar} 7 i Cnnfinund ~ MONTH OItY YEAR 27. Data ~ Conveyart0e t~lTH oAr YEAR Check H more tltan two {2) municlpaU- ,~ 33. Is this s splN parcelT ties: H so. refer to lasWcBaas (see krsata0onsj 3 (klamdadurtng) • (Agrlctaheat) 8 iSl+mmp6weste) 8 (Foreeq 3 4 5 8 37. tmgowatads 30. ToW Assassatmt S ~ ., ~t~hip1eL FATHER/SON Finandal ~P~d Outer ~ Subsidiary Sale mdudas Deed'n Otlter ~~ 40. Type fe mange satisFaGicrt of (explain) -) r ~ lard oa+frad X d1. Ownership interest }( Fu0 Partial OMer transferred (explain) (oxplain)'i- Ownership interest Uansfarred may be a foil interest of a fD5 ownership; a hdl interest of a partlal ownership; or other (explain). 42. Does grantor retain any oflhetdiowing X None ~ Easement ~ x~).~ rights? d3. Granta k: X hxOvidual Corporation Trusl Parinershpt nY~dy OOter {spedty) ~ VII. GRANTEE'S FINANCING X Finandalinstihdion- Fnartcialinstitutioo- Obtained from Assumedexlating Olher3Mperry wflnartcing 44. Chsck boxes for all financing types that aPVIY Conventional Government seller financing financing htvolved VIE. PHYSICAL DESCRIPTION AND GRANTEE'S PRIMARY USE OF PROPERTY 45. Type of X Lard artty Cgdgnkxum Property Laml and OOter ~ bu8ding(s) (spedfy) d8a. Predominant Agdcuktad• if 5O• did ~ Yes X d8b. Cheek iF Grantee's use % Skgle ta,rtay Yuki-iamiy ~ tone Share urtit grantor Quin property for less than 5 yeeara? ~ No Primary Residence Canxnerdal tduce0arr N any hox~ at leN are checked, explain use Mre y lthkty Tekepiwrte corrq~erty 47a. Lot Size (ROUND TO NEAREST WHOLE FOOTi 47b. Toth Acres 48. YFUPFCAMTL Acres ~. Feet of Water Frontage 4T. Estimated ff eondoanininm, land area check here and ~( OR Z 3 proceed to Bne S0. FEET FEET ROtaA TO TENTH OF AN ACRE ROtxtD TO lFItT iwiOlE Arx2E IX. ENERGY Yes 51. Exclusion Code ~ N W1 f, 52 ff W-12 provide document number where recorded attach 50. la this pproperty aub)ect to the Residential '] explanation ~ W° it N i X N vid cl d o, pro on co e) o ( e ex us Rental Weatherization Standards, COMY87? X. CERTIFICATION-We declare under penalty of law, this return has been examined by us and to the best of our knowledge and belief it is true, correct and complete. 53. Agent for 5d. Agent's Naam (ff agent involved 5r sale} 55. Telephone Number Cxantor Grantee 56. Street or Flre Number, if any SBa. Street name, PO Box, a other address (enter °PO Box" and box number) AREA LADE 87. City 58. Stye 50. Zlp Code 60. Preparers Name or Firm Name 81. Teephone Nmnber RICK L. PENDERGAST 7158348871 AREA CODE SEND TAX BILL T0: 5s. wine (~ ~` V ~ ~ l ~" n '~ 83. Street or Fira Number, if any 83a. Street wine, PO Box, a (Nher Address (enter'PO eox° and Box Number) tu. clty 5s. stxe 55. ZP~ 67. Grantor's Street or Fira Number, ff any 67a. Grantor (where grantor can be reached in the tulles) Street wine, PO Box, or Older Address {enter °PO Box° and Box Number) 68. City 69. Shte T0. Zip Code A rA r.t ~~ .D i~ I S y s) ~ 71. Dated 72 Telephone Number 74. Dated 75. Telephoto Number nY/~z~a~ 7ij~4~237L ~ oy `~tS~IS~(,~-'vim MONTH DAY YEAR AREA CODE YEAR AREA CODE T3. Signaturo of Grenlor or Grantors Agent (PLEASE ATTEMPT TO KEEP SIGNATURE WITHIN BOX) tee or Grantee's (PLEASE ATTEMPT TO KEEP SIGNATURE WRHIN BOX) 1 File # 00456064 Legal Description Addendum Lot 1 of Certified Survey Map #4184 recorded in Volume 5 of Certified Survey Maps, Page 4184 as Document #657734. Being a part of the NW 1/4 of the SW 1/4 of Section 28, Township 29 North, Range 17 West, Town of Hammond, St. Croix County, Wisconsin. Also any part of Outlot 2 of Certified Survey Map #3621 recorded in Volume 13 of Certified Survey Maps, Page 3621 as Document #600341 which may lie between the Westerly 66.01 feet of said Lot 1 Certified Survey Map #4184 and 170th Street. AMERICAN TITLE & ABSTRACT COMPANY, INC. Agent for First American Title Insurance Company Affidavit by Owner Commitment No. 00456064 Gene E. Aune Audrey J. Aune STATE OF WISCONSIN COUNTY OF ST. CROIX The undersigned owner(s), in consideration of selling or refinancing the real estate described herein and in consideration of First American Title Insurance Company issuing it Policy(s) of title insurance insuring an interest in or title to the real estate described herein, and being first duly sworn on oath deposes, states and warrants, except as stated in Paragraph 7 below: 1. That the undersigned is an owner of the real estate which is described in the above referenced commitment (herein called "the Property"): 2. That there are no encroachments of fences, buildings or other improvements to the property onto any easement or onto adjoining property, and no encroachments of any fences, buildings or other improvements of adjoining premises onto the property; 3. That there are not any unrecorded easements, party walls, agreements, or rights- of-way which affect the property; 4. *That during the last six months, no work has been done and no materials have been furnished in connection with the improvement of said property. That there are no uncompleted buildings, structures or other improvements situated thereon; (STRIKE INAPPLICABLE PARAGRAPI~ OR *That during the last six months, work has been done and materials furnished in order to make improvements to the property, but that except as stated in Paragraph 7, all of said work and materials have been fully paid for and there are no claims or disputes in existence with reference thereto, that no notice of intent to lien has been given, and that waivers of lien from all appropriate parties are attached hereto. 5. That owner is in sole possession of the property and that no other party has possession or has right of possession under any lease or other agreement, written or oral; 6. That since the effective date of the commitment referenced above, owner has not filed bankruptcy, received notice of any pending cause of action, conveyed or encumbered the property or is currently a party to any action that could result in the filing of any judgment or lien against the property. 7. Exceptions to the above statements: OWNERS Gn ~-- Gene E. Aune /~`~ l,Jr.~-~,v~.,c.~ Audrey J. Aune The foregoing instrument was acknowledged before me this 21st day of DOCUMENT NO. STATE BAR OF WISCONSIN FORM 16-1982 TRUSTEE'S DEED Gene E. Aune and Audrey J. Aune as Trustee of Gene and Audrey Aune Revocable Trust for a valuable consideration conveys without warranty to David G. Aune and Shannon T. Aune Grantee, the following described real estate in ST. CROIX County, State of Wisconsin: s~~'3`~ , ~ ~ Independence Sate Bank E401 Menomonie St.. P~ Box 325 Elk Mound, WI 54739 Tax Pazcel No: 18-1064-00-100 ~, of of Certified Surve Map #4184 ecorded in Volume 5 of Certified Survey Maps, Page 4184 as Document #657734. eing a part of the NW oft 1/4 of Section 28, Township 29 North, Range 17 West, Town of Hammond, St. Croix County, Wisconsin. Also any part of 0utlot 2 of Certified Survey Map #3621 recorded in Volume 13 of Certified Survey Maps, Page 3621 as Document #600341 which may lie between the Westerly 66.01 feet of said Lot 1 Certified Survey Map #4184 and 170th Street. Dated this day of , 2004. ,~ ~ `'~~~ (SEA * Gene E. Aune Trustee AUTHENTICATION Signature(s) authenticated this day of ,2004 TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stars.) ACKNOWLEDGMENT STATE OF WISCONSIN 1 I ss. ST. CROIX County (SEAL) Personally came before me this o21 `<t day of Q.W'~'~ , 2004 the above named Gene E. Aune and Audrey J. Aune to me known to be the persons who executed the foregoing instrument and acknowledge the same. ~d~,~,, ~ * Audrev J. Aune Trustee 65734 I!r'1~rHLi=EN H. WALSH r~EGIS'rER 01= DEEDS ~~'I. CIiOIX CO. WI RECEIVED FOk kECdRD 09-28-2001 9:30 AM CQF~Y fEE: 3.00 hECURDING FEE: 13.00 CER T I ~I ED SURVEY M,4 P Located in the Northwest quarter of the Southwest quarter East 1/4 Corner of Section 28, Township 29 North, Range 17 West, Town of Section 28-29-17 ~ Hammond, St. Croix County, Wisconsin. (County surveyor's monument) . w N ~ N ~ b ~ ° r. ro v ~ , Owned by: UNPLATTED_ LANDS_ S 02'S0~40"E 209.41' ~~ iW ~i ? J lOr~d~ ~ Sq. ft. ~ (2.'~~ acres) ti a IL in rn ~~ NN I M v O ~ ' ~ IL ®7T- ~ C~ l ~~ W ~ _ (V ~ ~l l (U ~ ~ J~ • I OI ~ m 143.02' ~i ~ N 00'10'0 cn i 3 U~ _ i IA fU ~ ~~ N ~ cv fl! ~O W ~- i ~ I ~ i ~ ~ ~ ~ ~ I QI O ~, ~ m z~ z ~~ S89°/6 ~22~~E 33.00 ^~~ ~ . 01 ' ~ ~~. " _ _ • N 00 i u 10 05 W „ _I 70 7 H ,}~,, - ~ S T ~ VOL. 13, PG. 3621 . _ ~ _ ~ - UNPLATTED LANDS at 1 /4 C.nrnar I m n (V 3 (U lU (0 si m Z W Gene & Audrey Aune 1708 Cty Rd "J" Hammond, w~PPRC~~/ED ST. CROIX COUNTY Planning 7_nning and Perks Cg~mittee sEP 2 s zoos ,.~ If not recorded witntn 3U days of approval date approval shall be L EC~.r~~~void • 1 "X24" Iron pipe weighing 1.68 pounds per lin. foot set. ~ 1" Iron pipe found. -~--~- fenceline U, i ~ County surveyor's mon. of Z I (aluminum cap. ) QI J, SCALE lIV FEET l ~=100 O l00 200 Bearings referenced to the East-West 1/4 section line, assumed 589°16'22"E. .,`~~~~~,0 Ns~ti ~~~' . _ ~NARVEY ~,,, ~ ~ ~OMNgON • 189 S' 9 ! uo50N r H W~~ f'o • ~~Ih.. ~ Nrl _ ~ f "~ ~ ~, s • Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings Page of ............~ ................. ....,.., ,..., , .w. r•aan ~. ervue Attach complete site plan on paper not less titan 8112 x 11 inches in size. Ptan must County //~C V include, but not limited to: vertical and horizontal reference po'snt (BM), direction and Parcel I Q ° percent slope, scale or dimensions, north arrow, and location and distance to nearest road. . ~-+'~ Please prlnf aJl information. Reviewed by , Data Pereonal information you provide may be uaed for aecor~dary purposea (Privacy Law, s. '15.OA (t) (m)}. Property Ow Property Location '"~,7 'L ~ ~ ~V ~ Govt. ot ~(/t,J 1/4~i..c 114 SL ~S T N E ( r) W Property Owner's Mailing Address ~ Lot # Biock # Subd. Name or CSM# 2 `ECG ~`~ ~~. ." City State Zip Code Phone Number ~ City ~ Village Town Nearest Road New Construction Use. Residentlal i Number of bedrooms ~~ Code derived design flow rate Replacement ~ Pubiic or rcial -Describe: Parent mater[al __ ~~Gi-/tJi;~: ~ ~ Flood Plain elevation if applicabl Genera! comments and recommendations: ~ f ~ ~ ra~ c '3 i '~ j GPD ~ ~ ~ ft. ,j(i! 3 Q ?..E~~1 '~ ST CAq(X MIG QFFICE Borln ~ % ~`~ _ ~`r~ Boring # g T`r..~.__.....-,, , ~ f Pit Ground surface elev.~~, ~ ft. Depth to limiting factor ~ in. ~~..~a ' '~ oil A licabon Rate Horizon Depth Dominant Cotor Redox Description Texture Structure Consistence Boundary Roots GPD/ttz fn. Munsell Qu. 5z. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 t 2 ~ 3lZ ~,-, ~ s- ~ ~ S - 2 z ~ ~" ~~ 3 i° .s Vii" s-,~ t - 0`2 3 ~ ~ - 114 ~~~ - ~ 3 Boring # t^~ Boring ~ ~ 2 1~1. Plt Ground surface etev.~4 ft, Depth to limiting factor fn. Sdi A pliptlon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlft' in. Munsell 4u. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 *Eff#2 " ernuent rF1 = GODS > 30 < 220 mg/L and TSS >30 _< 150 mg1L • Effluent #2 = BODS < 30 mg1L and TSS < 31S mg1L CSC a e (Please~(i~ ~ /~ S' atu ~~ C,ST~Nu~t~ r • UplO GVOIUL1UV11 VV°~t34[.IQV ICIQ(.i1lVllp IV 411141GI ~ 5131)-83;30 (RU7!UU) ~. Property Owner Parcel ID # Page of Boring # Boring i ~ 1 Pit Ground surface elev.~~ ft. Depth to limiting factor ~ in. Soil A tication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft~ in. Munsetl Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 "Eff#2 ~ S'3~ ~ ~ - ~~ ~ ~ ~~ 8-70 ,~ ~'~ ,~ ~/9 Z ^ Boring # ^ Boring ^ pit Ground surface elev. ft. Depth to 11m1ting factor In. Soil Ap icatlon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/!t= in. Munsetl Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 "Eff#2 Boring # ~ Baring ^ Pit Ground sunsets elev. ft. Depth to limiting factor in. Soil Ap licadon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft~ in. Munsetl Qu. Sz. Cont. Color Gr. Sz. Sh. "EtT#f 'E~ "Effluent #1 = 8005 > 30 < 220 mg/Land TSS >30 < 150 mg/l. 'Effluent #2 =BODE < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportttnity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (8.07100) Soil Test Plot P1 Project Name Dave Aune Address 1240 N. 4th St. #1 New Richmond Wi 54017 ird Lot Subdivision ------- N W 1 /4 S W 1 /4S 28 T 29 N/R 17 W Boring 0 Well PL Property Line BM or VRP Assume Elevation 100 ft. /ATM #226900 Date 7/28/01 Township Hammond County ST. CROIX Top of 2" Pipe System Elevation At-Grade *HRp Same as Benchmark Al~ RM Tnn of Neil in Tray rnl 1!1!1 7' N .~ N A O N