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HomeMy WebLinkAbout018-1067-70-100~~~ o• ./ 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 IPIIVBCV Law, s.15.04 (1)(m)l. Permit Holder's Name: City Village X Township to-ZG Hawkins, Core Hammond, Town of 'T~+ CST BM Elev: Insp. BM Elev: BM Description: rc~ Q~1 ~ cs~' TANK INFORMATION TYPE ~/ II MANUFACTUR~T'~ CAPACITY Septic wl~S~ 106 Dosing ~ C~'~ {~ Aeration Holding TANK TRACK INFORMATION TANK TO P/L WELL .RI I~G. Vent to Air Intake ROAD Septic r~ + l ~ 3 ~ , ~. ' ~-- Dosing 11 L~ s~ ~ sz Aeration Holding PUMP/SIPHON INFORMATION ,. Manufacturer Et-1-~•Q. Demand GPM ~f. Model Number ~ .1-l 'IDH 7~ Lift ~ ~K Fricti L ss ~ ~3 System Head 6 • S~ TDH F 2 S. Forcemain Length r r Dia. Z ~~ Dist. to Well SOIL ABSORPTION SYSTEM ELEVATION DATA county: St. Croix Sanitary Permit No: 488047 0 State P n_ ID No_ ^ ~S• Parcel Tax No: otg-/obi- ~~~ Section/Town/Range/Map No: 30.29.17. STATION BS HI FS ELEV. Benchmar (.~lo`f Iplv,io /d0 Alt. BM S. i S' / 9~.e Bldg. Sewer ~, ~, O `• 28, / O 7 SUHt Inlet ~ yy-- I y w%/P• St/Ht Outlet .~v~ / ~•6/ Dt Inlet Dt Bottom ~~ ~ ~ 2 6 i 3• Header/Man. (o ~ 9S:Ob i Dist. Pip f 11-. let .LO .L L/ •L2 9s• O y i 7 Bot. System •• 2 n . ~ ~ 1 7 'nal Grade w ~ ~ rr 'iF C•0~9"' °~ Co~ve~r~ a Co ~,r i'3.93 9z.~1 B /T~REN@FI• Width ~ Length 1 No. Of T~enehes PIT DIMENSIONS No. Of Pit Inside Dia. Liquid Depth DIMENSIONS ~2.~ ~-~s SETBACK SYSTEM TO P/L BLDG WELL ~. LAKE/STREAM LEACH G anufacturer. INFORMATION CHAMBE Type Of Systerp: ~O ~ ~~ 1 ~ ~Y ~ ~ Model Number: I'11STRIRIITInN SYSTEM / t~ i'f~ rocL_ e•OOU i Header/Manifold it Length 2 • o Dia ' Distribution Pipe(s) Ct- t ' , i~ ~ Length ~ ~ • is / Spacing 2• o Hole Si e ~ ~ 1 ~ x Hole Spacing ~ ~/ 2 • ~ Vent to Air Intake ~^ Still CnVFR v D ncm~rn Svc4omc Only YY Mnnnd Ar At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched BedlTrench Center Bed/Trench Edges Topsoil ~ Yes No 'i ', Yes i `~ No .~ COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: `l / ~ ~ / U~' Inspection # /ro /l~ Location: 723 150th Street Ha on 54 5 (SW 1/4 W 1/4 T29N R17W) NA Lot 1 ~~• p¢le~ Parcel N ~ 0~~ 7~~ ^s ~ 1.) Alt BM Description = ~ ~ ~` p~ O ~"•-. _ ~ 1ng1 S e_ 2.) Bldg sewer length = ~z _ `'h_a.~~c (;6~4~5 -amount of cover = 3w "~(-, ~ ~ ~~' ~.IotXt,~, 0~__ _ ---- --- J --~Tj- - Plan revlslon Required? is ~ Yes ~ No . /~ Z~~~ Use other side for additional information. L__ _- ~ I ~ ~J- / z Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) . /~~~~~~ 201 W. Washittgton Ave., P.O. Box 7 Madison. WI 53707 - 7162 ~ I - ''I"T Permit Number (to be filled in by Co.) (608)266-3151 a Oe artment of Commerce grate p LD. Number Sanitary Permit Applicatio ` ,y ~~g ~ -~, /Q•# ~ In accord with Comm 8321, Wis. Adm. Code, personal information provide may be used for secondary purposes Privacy Law. x15.04(1 X ) '.-'~'_~ ~-, ~~~ ,~ roja:t A ress (if different than mailing address) ~ 1. Application Information -Please Print All Information ST CR~IX CD ,~, _ / ~j d ~ ~~ arcel q Lot M 131eek-U-- Owna's Name r Q ` ~ / J~ d ~ ~ r ~`i ~l ~" l~ ~ • - ~ ~ yr s a. Io~-7 -76 - n o0 property Location property Owtra's ailing Address i`~(ia' ~ R ©~~ vv R y S~ ~ d2 d -~ s~ ~.., S~ ~.~ Section ~o iC,' /nState ~e ~ i Cf/'C~/1r`~~Y ~ I'`'~ t Zip Code ~~)(~ l .C Phone Number 7Q(o ~?~ oZ /~!~ T~N: R 1~ Eo°~J 4 Type of Building (check all that apply) ~ v dj S i d~on~~- SM Number y @~ 1 or 2 Family Dwelling - Number of Bedrooms ~t <~' /Q P ~9~ ~9s~ 9S ^ PubliclComtneaial- D««ibe Use (~ -'°-~` i ~ ity ^Village ~i'ownship of~L,~ - ^ State Owned -Describe Use ~ur~ .~ Iii. T ype of Permit: (Check Daly one boz on line A. Comp ere line B if applicable) A' ew System ^ Replacement Systan ^ Tteaunptt/Holding Tank Replacement Only ^ Ocher Modification to Existing System List Previous Permit Number and Date Issued B. ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New Before Expiration Plumbs Owner ~ t t ~ ~ -- = 20 , ~O 1[V. T lla• of POW'TS S em: Check all that a ^ d Fil of suitable soil < 24 in ~ M ter ^ At-Grade ^ Single Pass San . o ^ Non -Pressttri~ed In-Ground ^ Mound >_ 24 in. of suitable soil ssurizod In~iround ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirwlating Sand Filter ^ d ^ P l re an CansuuUed Wet Line ^ Gravel-less Pipe ^ Other (explain) ~ Reeirwtating Synthetic Media Filter ^ i,eactting Chamber ^ Drip 2 • / V. Dis rsal/Treatmeat Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Roquired (sf) O ~ Dis 1 Men pro ed (sf) l~ ® ~ ~~ Systan Elevation ~ y , 3 j~ ~' p ~ rrC9 / ~ Prefab S ite Steel Fiber Plastic YI. Tank Info Capacity in Gallons Total Gallons Number of Units Manufacturer Concrote Constricted Glass New Existing Tanks Tanks / Septic a tbldiiig Tank ~ f GOO ~ ~'^' ~~"~ ~ Aerobic Trdtment Unit - Dosing Clurd>cr ~ (y O V(I. Responsibility Statement- i, the anderslgned, assume resPoas[biGq• far fastallatioa of the POWTS shown on the attached plans. MP/MPRS Number Business Phone Number Plumber's Si lure Plumber's Name (Print) ~ g~ c~ z Plumber's Address (Street, City, State, Zip Code) VIII. Count •/De artment Use Onl Sanitary permit F includes Groundwater Date Issued Issuin Agent Signatur (No Stamps Approved ^ Di~SappaaY~,-~~~ - Surcharge Fce) ive Reason for paiial lX. Conditions p SYSTEM OWNER; 1 Septic tank, effluent Tilt®r and dispersal cell must all ~@ serviced /maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances. Attach eompkte plain (to the County aaly) for the system °° paper ant fns tlrau i12 x I l loches la siu SBD-6398 (2 01/03) .,~. - _ . _- . y~8.os' ,Sa,'/ eda/ua.~'o.~,0, f • E/e/Q~o~ lnc.a~d pry stQ.re f p r e: / = y~0 .~ ~,~ ~ ~~~ Q~ P~op~sed Pro posed u9ie5a/'Co»ere{~cJLp/ue~/6s~ we,U ~oca{:o~ ~'.onsbrna,6'ua Syo6~t 6w,K/Pu.np @Jia.•~bei' ~ '~e~ be / ~}-iao e ~F/u a.,b ,Crier a 6 S. r, ou,~'/e~• a ~ 8R0;,,____ _ eQ bu:/dinJc Sewn; ` ` " .~ 8 °b Slo~ae ~~_ o a3 PropoSCd 3 becllt~rn CorrtDur _ ~ -~ ` ' - - - - _ _ _ _ 4 _ ~rc s r'd cnGG Ali. (S.~r1.~ Too o~'roa~ ~~pos(,d ir+O~ncla.t 13. y7;r /3s~ 09" w/ ¢ ;r ii.2. sv'd,'J~oersa/ Ce.l/. Four (y~- d,'sf,-i'~a.{yb7 la~ei'a/,r ~.f /iy'x Ss, ss' cJ/ %/ Ol'i~''c!S ,SyNoceda.L~' ?.0.2. y 56e~1 ~e~,e Posh. Eleu~ - q y ors;' -----, vr.~K-n i n csrr : i Q~v of fe t ,gssu.n~d elegy . /OD.A?' ___--- a 3~~ commerce.wi.gov ^ ^ ~scons~n Department of Commerce Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264-8777 www.commerce.wi.gov/sb/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary June 16, 2005 CUST ID No.222781 HENRY J NECHVILLE 967 HIGHWAY 65 ROBERTS WI 54023-8510 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/16/2007 Identification Numbers Transaction ID No. 1143968 SITE: Site ID No. 699808 Corey Hawkins Please refer to both identification numbers, 150TH St above, in all comes ondence with the a enc . Town of Hammond St Croix County SW1/4, SW1/4, S30, T29N, R17W FOR: Description: New mound, 3 bedroom residence Object Type: POWTS Component Manual .Regulated Object ID No.: 1022526 Maintenance required; 450 GPD Flow rate; 16 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/O1) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, '~~ stats. ~ The following conditions shall be met during construction or installation and prior to occupancy or use: ~ ~~ 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 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 finished grade with a watertight cover. Note • The proposed pump is near its limit with the proposed total dynamic head. If upon installation, the total dynamic head increases, the proposed pump must be reevaluated and may be inadequate. 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. HENRY J NECHVILLE Page 2 6/t6/2005 ' • 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 wall 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 construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should- conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence maybe made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or m~ nan of the POWTS. Sincer y, Patricia L Shandorf POWTS Plan Reviewer , Inte Services (715) 634-7810, Fax: (715) 634-5150 , M-f 7:45 am - 4:30 pm pshandorf@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 ~ ~ • t MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE _~'~"' Project Name: Corey Hawkins 4`6edroom residential mound Owner's Name: Brad 8~ Sharon Patnoe Owner's Address: 719 150th St. Legal Description: Township: County: Subdivision Name: Lot Number. Parcel I.D. Number. Plan Transaction No.: Roberts, WI. 54023 Parcel Address: Pending SW1/4 SW1/4, Sec. 30, T.29N., R. 17 W. Hammond St.Croix Proposed CSM (~ ~~ -~ ~. 1 Block Number: f~iC~~-~FOt9 °' ~ µ pending from 018-1067-70-000 ~'" _ ~.~ Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Site Plan Page 9 Soil Evaluation Report Designer: Henry Nechville License Number: 222781 Date: 05/11/05 Phone Number: (715) 749-3322 Signature: ~9-,vt.y %~,~e~, Designed Pursuant to the Mound Component Manual 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) V ~~ Version 4.01 (R. 09/04) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet Site Infor mation (r or c) R Residential or Commercial Design T 300.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 450.00 Design Flow (gpd) ___ 8.00 _ 92.71 Site Slope (%) Contour Line Elevation (ft) ~ 16.00 Depth to Limiting Factor (in) _ 0.60 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information ~_ 112.50 Dispersal Cell Length Along Contour (ft) _ __ 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) ~_ Pressure Disribution Information (c or e) ~ cl 2.00 4~, i- -- 0.125 2.00 j _ 2.00 r 300.00 r 83.00 Center or End Manifold ~, Lateral Spacing (ft) Number of Laterals Orifice Diameter (in) (e.g. 0.25) Estimated Orifice Spacing (ft) _ Forcemain Diameter (in) Forcemain Length (ft) Pump Tank Elevation (ft) 6.50 System Head (ft) x 1.3 10.96 Vertical Lift (ft) 12.89 Friction Loss (ft) 30.35 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. o ions choice -______- 0.75 -- 1.00 1.25 1.50 2.00 x x x __ x ___~ _r_~.__ 3.00 x I ~ t,Sd ~h-- . Treatment T~"k~lnformation 1000~~Septic Tank Capacity (gal) Wieser Conc. Combo Manufacturer Dose Tank Information ~ 646.00 Dose Tank Capacity (gal) 00 Dose Tank Volume (galrn) CWieser Conc. Combo Manufacturer Note: Sand fill (D) calculations assume a Table 83-44-3 in-situ sal treatmerrt for fecal coliform of <= 36 inches. 4.00 Cell Width (ft) Are the laterals the highest point in the distribution ~__ network? Enter Y or N If N above, enter the elevation (ft) of the highest point. L 4.02 ft2/orifice Does the forcemain drain back? ~ Y _j Enter Y or N 48.94 Forcemain Drainback (gal) 70.79 5x Void Volume (gad 119.73 Minimum Dose Volume (gal) 46.14 System Demand (gpm) Manifold Diameter Selection in. dia. o tions ___ choice 1.25 x x ~_T 1.50 x ~ 2.00 3.00 x _ ~,__~~ Gallons/Inch Calculator (optional) 646.00 Total Tank Capacity (gal) _ _ 38.00 Total Working Liquid Depth (in) y 17.00 gal/in (enter result in cell B49) Effluent Filter Information (Zabel ~ _ ')Filter Manufacturer ~A100 __ _ _ _~~ Filter Model Number Project: Corey Hawkins bedroom residential mound Page 2 of 9 ~ ~'~' Mound Plan View 1_ .. 1/10 B . .. 'observation Pipe ~ '~' K ~' :Q .:~: 'F. . .... ...............B ................~... • L~J i L Mound Component Dimensions A 4.00 ft E 23.84 in B 112.50 ft F 9.25 in D 20.00 in G 0.50 ft 450.00 (ftz) Dispersal Cell Area 4.00 (gpd/ft) Linear Loading Rate 1896.59 (ft2) Basal Area Available 11.25 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 96.15 (ft) 2 H ,.. pi ~ ateral F .. • ::: spersal Cell 94.88 (ft) L 94.38 (ft)-- - ;.u Invert Dispersal Cell :~ ' ~ ~ " ~ ~ ~ t h., Elevation E ~ ~ D ~ ~ ~; ... .. _~ 1 ~ ~~ , a~ --j-. , , - ", ', 4 ,.,~„ - - ~ ~ ~ ~ 92.71 (ft) Contour Elevation 8.0 °~ Site Slope Shading Key 1^ Topsoil Cap © ~~"~ Subsoil Cap ©g ASTM C33 Sand ®~ Tilled Layer 0 Aggregate ~ a c 1.5 ft a o 0 ~ ~ 0.5 ft H 1.00 ft K 10.79 ft z 12.86 ft L 134.09 ft J 7.11 ft W 23.97 ft Dispersal Cell ~ Q i ..`' F Typical Lateral ' 0 -- A Project: Corey Hawkinsbedroom residential mound w~b/ Geotextile Fabric Cover See lateral details on Page 4 for number, size, and spacing of laterals. Laterals are equally spaced from the distribution cell's centerline in the distribution cell (Ax6). Page 3 of 9 -T _+ -~ -1 Center Connection Lateral Layout Daigram Force main won via tee or cross to manfold at ang point. P •=Turn-up+~ball valve or IEX-~~ deanoutplug Hiles dried ort the bottom of the lateral. Laterals are identic al Laterals & force main of PYC Sch 40 per COMM Table84.30-5 s .~k Number of Laterals 4 Orifice Diameter 0.125 in Lateral Diameter 1.25 in Orifice Spacing (~ 2.02 ft Lateral Length (P) 55.55 ft Orifices per Lateral 28 Lateral Spacing (S) 2.00 ft Orifice Density 4.02 ft` Lateral Flow Rate 11.53 gpm Manifold Length 2.00 ft System Flow Rate 46.14 gpm Manifold Diameter 1.25 in Total Dynamic Head 30.35 ft Forcemain Velocity 4.71 ft/ Dose Tank Information Locang Dover „~,, warning label and locking device and sealed watertight Electrical as per NEC 300 and -~ Comm 16.28 WAC ~ 4 in. min. D' ~ --~_ Tank component is properly vented Wieser Conc. Combo Ca a ' 646.00 Volume 17.00 Manufacturer Gallons gal/inch _~ A B C D Dimension Inches Gallons A 17.96 305.27 B 2.00 34.00 C 7.04 . 119.73 D _ __._ _ . 11.001 187.00 Total 38.00 646.00 3" Bedding tank. __. _ , Alarm Manuafacturer LevelArTn Alarm Model Number' DLV Pump Manufacturer Zoeller '. Pump Model Number BN 140 Pump Must Deliver 46.14 gpm at 30.35 ft TDH F- Alternate outlet location Forcemain diameter ~l 2 in. Weep hole or anti- siphon device P, ump off elevation (ft) ~--'-- 83.92 tank elevaton (ft) 83.00 Project: Corey Hawkins ~ bedroom residential mound Page 4 of 9 ~~ • ~ Mound System Maintenance and Operation Specifications Service Providers Name Henry_ Nechville Phone ~ (715) 749-3322 i, POWTS Regulators Name ~ St. Croix County Zoning. _ ;, Phone' 715-386-4680 System Flow and Load Parameters Design Flow -Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000-600 gal i~~/~~° ~ Maximum TSS 150 mg/L Soil Absorption Component Size 450 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Freauencv Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Ins ed and/or service once eve 3 ears Should ins d 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 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 ~y Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Corey Hawkinstt`bedroom residential mound Page 5 of 9 3~ 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 fitter 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 fitter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent fitter 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 ai least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent fitter is installed within the tank tt 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 surtace 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 quallty into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 30 mg/L TSS, 10 mg/L FOG, and 10' cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is pertormed tt 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 control's, 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: Corey Hawkins;~t bedroom residential mound Page 6 of 9 3 t~'~- ~ -_ LL PUMP PERFORMANCE CURVE MODEL 140/4140 ss to so 14 a5 l2 30.35 ~ ,d T: v 0 ~e m ,s ,b 2 s TOTAL DYNAMIC HEAD/FLOW PER MINUTE EFFLUENTAND DEWATERING MODEL 140/41,40 ,; r ~ 2S•ll ~If. ~- ~~P.4y 0 to 20 ao do w w ro w to ~ cuoNS S/~. / yG.P. /rl. irl,-n: m ra..n .3rr.0~o ~v /L+.~C -'Gq d Lrt13tS 0 !b 1B0 240 ~ a ftOW PER MINUfE CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Mechanical alternators, for duplex systems, are available with or without alarms. • Control alarm systems are available for 1 phase pumps used in simplex system. See FM0732. • Variable level control switches are available for controlling single phase sys- tems. • Double piggyback variable level float switches are available for variable level bng cycle controls. • Sealed Qwik-box available for outdoor installations. See FM 1420. • Refer to FM0806 for applications above 130°F (54°C). ,R NPr src,suA .n wr sx,sz.~ 14 0/4140 MODELS Control Selection Model Model Volts-Ph Mode Amps Simplex Duple N140 N4140 115 1 Non 12.0 1 or2 3 E140 E4140 230 1 Non ~ 6.0 1 or2 3 BN140 BN4140 115 1 Aulo 12.0 - BE140 BE4140 230 1 Auto 6.0 -- SELECTION GUIDE 1. For automatic use single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0477. 2. See FM1228 for correct model of simplex control panel. 3. See FM0712 for correct model of duplex control panel. O CAUTON All installation of controls. protection devices and wiring should be done by a qualdied licensed electrician. All electrical and safety codes should be followed including the moss recent National Electric Code (NEC) and the Occupational Safety and Health Act iOSHAj. 'Single piggyback switch included. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. ---- ` MAIL T0: P.O. BOX 16347 `. Louisville, KY 40256-0347 Manufacturers o(.. 0 SHIP T0: 3649 Cane Run Road ® ~~ Louisville, KY 40211-1961 Queurr PUMPB SNCF /999 - www.zoeller.com PUMP !O. (502J 778.2731.1 (BOOJ 928-PUMP FAX (502) 774-3624 © Copyright 2005 Zoeller Co. All rights reserved 4140 P- ~0~9 y~8.os' Q~ P~op~Sed{:o~ Propo~e.d u.9ie5ar C.o»e.re{~ e~JL~/a~7~6S'o ~'e-u (~~'C'o''..sb:na,67.n SyoE~t ~..K/Pw»p ~.!-a.nber ~7 ~be~ {f-/40 e~/[4~wt~ ~G'Yf'cr¢~ 3. T, Q(.t.t'/Ct~ e -~ E/edQ ~i'on ' ~ oc.a~e,d prc~ s~ /J.~ e~ i4M2 _ O 8~~ 'Z'b - ~ I N~o --~ ---._... bui /dinJc Sewn: 8 °b Slo _ '~ --_ _~-_ PiopaStd 3 bea~,~ Cori't1x4r ~ .•. _ ' ~ ~ __ _ ~ - ~ . _ ~~e s r d e-nGG A1~• ('S.irf.: Top o~'~aand SE.a~I ~e~ PoS~. '°/~OSC~/noanc/a.t.23.97~'~9t~a9' ~IZW = 97. ~;~ w/ f! X //.2. ,s~'d.:laersc/ CGl/. ~ u!" ~<l) ~--- d.'s~Ei-i'Lu.6b~ la~ei'a/J a~ /yy'X Ss, ss' dent-~ o ~. _~- /~ 3~~: 4Wsconsin Department of Commerce Division d Safety and Buildings SOIL EVALUATION REPORT in ~rrfvri~rv~n with (`.nmm Rri Wic Gr1m C'ncia 1902 Page 1 of 3 A.C.E. Sal 8 Site Evaluations County -. Attach complete site plan on paper not less than 8'h x 11 inches in size. Plan must St Croix oclude, but not limited to: vertical and horizontal reference pant (BM), direction and Parcel I D percent sope, scale or dimemsior>s, north arrow, and location and distance to nearest road. . . Prt of 018-1os7-70-000 Please print all information. Reviewed gy Date Personal ~rfonnae5on You Provide may be used for secondary Pr+P~ (Privacy Law, s. 15.04 (1) (m)) Property Owner Property Location Bradley R. 8 Sharon M. Patnoe Govt. Lot SW 1/4 SW 1b g 30 T 29 N R 17 W Property Owr>ers Mailing Address Lot # Block # Subd. Name or CSM# 719 150th Street 1 Proposed CSM City State Zip Code Phone Number ~ City _J Vliage i/ Town Nearest Road Roberts ~ WI 54023 (715) 796-2730 Hammond 150Th Street 1/i New Cor~,struction Use: ~ Residential /Number of bedrooms 3 Code derived design Bow rate 450 GPD Replacement ~ Public or commercial -Describe: Parent material Glacial till Fkxxi plain elevation, if applicable na General rxxnmerrts and recommendations: Install mound system with 4' x 112.50' dispersal cell. System elevation to be 94.38' at 20" above 92.71' contour. of ~~ Pit Ground Surface elev. 92.76 ft. Depth to limiting factor 16" in. Soil Application Rate horizon Depth Dominant Coon Redox Description Texture Stnicture Consistence Boundary Roots GP D/ft2 in. Murrsell Qu. Sz. Cont. Coor Gr. Sz. Sh. 'Eff#1 `Eff#2 1 0-10 10yt32 none sil 2fsbk mvfr cs 2f,1 m 0.6 0.8 2 10-16 10yr4/4 none ~ 2fsbk mvfr aw 1fm 0.6 1.0 3 16-28 10yr6/4 none LSBR Na Na - 1vf 0.0 0.0 I Limestone bedrock observed in Horzon #3 consists of kx~se, fractured limestone fragements of approx. 3" x 3° - 6' x 5' plates 2"- 4° thick. Voids between plates filled with t 0yr 4/4 mfr sd. ^ gang # _ BOrtrlg 1/ P~ Ground Surtace elev. 89.95 ft. pepth to limiting factor 22" in. Sal Applicaton Rate 1-br¢on Depth Dominant Coon Redox Descrption Texture Stricture Consisterxx Boundary Roots GP D/FP in. Mur>sell Qu. Sz. Coat. Cobr Gr. Sz. Sh. `Eff#1 `Eff#2 1 0-10 10yr32 none sl ~ 2fsbk mvfr cs 2f,1 m 0.6 1.0 2 10-17 10yr4/4 none ~ 2fsbk mvfr cw 1fm 0.6 1.0 3 17-22 10yr4/6 none sG 2fsbk mfr aw 1vf 0.4 0.6 4 22-35 10yr6/4 none LSBR Na Na - - 0.0 0.0 Limestone bedrock observed in Horizon #4 of k>ase, fractured l ~ween plates filled imestone fragerrtents of approx. 3"x3" -6'x6" plates 2°- 4" thick. Voids with 10yr 4/6 mfr sd. ` Effluent #1 = BOD ~ 30 < 22p r~/L ar>~ TSS >30 < 1~0 mg/L ~~' Effluent #2 = GODS< 30 mglL and TSS <~0 mglL CST Name (Please Print) \ Sgnatu c:s l rvumoer James K Thompson \ e 3602 Addre~ A.C.E. Soil 8 Site Evaluations Date Evaluation Conducted Telepiwne Number 340 Paulson Lake Lane. . WI 54020 4212005 715-248-7767 _ Paoperty Owner Bradley R. & Sharon M. Pafnce Parcel ID # _Prt of 018-1067-70-000 Page ___ 2 of _ 3 a Boring # ,' Boring Depth to limiting factor 48" in 69 ft 92 R t li i -- -- . . on a e . Sal App cat / Pit Ground Surface elev. _ th Dominant Color Horizon De Redox Descri tion Texture Structure Consistence Boundary Roots ' _ p in. Munsell p Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 _ _ '~ T 10yr32 1 0-9 none sl j Zfsbk mvfr cs - --- 2f,1m 0.6 1.0 2 9-17 ~'i 10yr4/4 ~ ~ none --~ scl ~ -- 2fsbk ~ mfr cw ~ 1fm ~ --- 1.0 0.6 3 ~ 17-26 i 7.5yr4/6 ~ none T sl 2fsbk mvfr gw 1fm 0 6 1.0 + - 7.5 r4/6 4 ~ 26-48 y ~- ---- - - -- - -~- ----- _ ___none _ __ Ifs/sl__ _ lmsbk - _mvfr ~ aw t------ - 1f ~ -- 0.4 0.7 ~ _-- - -- - - --- 5 ~i 48-54 10yr6/4 ~ - - - - none ~ - --- LSBR - -- Na ---------~ ~ - Na - -f----- --- f-- 0.0 ' _0.0 }__ r ~ j i -- H#4 consists of a mature of 7.5yr4/6 1 msbk Ifs & 7.Syr4/6 1 mst~k sl. Limestone bedrock observed in Horizon #5 consists of loose, fractured limestone fragements similar to other profiles. Voids between plates filled with 10yr M4 mfr sG. Pit Ground Surface elev. __ Na ft. Depth to limiting factor 12" in. Sal Application Rate Horizon i De th Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots GPD/ft' _ p in. ~ Munsell Qu. Sz. Cont. Cobr Gr Sz. Sh , ~ 'Eff#1 'Eff#2 1 % 0-10 10yt3/2 ---- none --------- sil ----- 2fsbk -- ----- mvfr cs 2f,1m 0.6 I 0.8 , ~ T 10-12 10yr4/4 i 2 none ~ srl ~ 2fsbk mvfr ~ aw 1fm 0.6 0.8 T _ rt fi ~ _ * _..- ----- f i 0 0 0 0 3 12-19 10yr6/4 none LSBR ! Na Na ~ - 1v . . _ -- I'; - --~--- -- ~ I -- ---- -- I ~__ ~~~ ---- t_ , , ~ --1---- ' ~ !, i I - - ~ - - - - --- ------- - --- ~- ~ ---- -- ' -- ^ Ong # Boring PR Ground Surface ekv. _ ft. Depth to limiting factor _ - in. Soil Application Rate Horizon I Depth Dominant Cobr Redox Description Texture Structure Consistence ~ Bour>dary i Roots ~P~/~ ___.___ in Munsell Qu Sz. Cont. Color Gr. Sz Sh. 'Eff#1 `Eff#2 i - - - _- - - - -- - --- - ---_-- ---- - I - ~ ------ --- - _ _ . _ _ -- --~ - _ _ I - - -- -- - -{ - -- _- - --- - ----. _ - t----- - ~ t -- - ---- ~ t------t ~- -- ~' i - i _ I ~ -- ~- - -- - r --- - ~ _ ..---- _ --+ i -- --- - _ _ - -{ 4- _ -- ------ ~ -- -- - - -- - - _-- _ . -- _ ' _ 'Effluent #1 = BOD ~ 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 60A-266-31 ~ 1 or TTY 608-2Fi4-8777. r ' ~ ^ ~./ eda/ua~'a~,p,f • E~ed4fon --~F-- ~.rsti~ Fence%•.ie p~ e:/=~~ ~~8.os' 2~ ~ i9oz Q~ ^ a 880 , -' -az- -- - - -- - -- ~'~O~ ----_ ^ __ 8~ Sloae ' ` - -___ . Q 1 ~ • ~,sfer, co„ feu,. _e_l e~ . 9,2. ~~ _- .(3. ~To o~'roK~d S~~l ~Q~ce Posh. Eleu~ - 97. hrs.' ,Qss u.n cd e lecJ,` . / pD. Lb,' /~ 3~: Wisconsin Depar6rtent of Gomrrrerce SOI 1LA~_ Division of Safe1Y and Buildings „! .'.,~-aa~~»~a ..,;f,,,,. a~w~~ Q~,,, ~~P 1902 Page 1 of 3 A.C.E. Soil & Site Evaluations -- (-`1 C ~ Attach complete site plan on paper not less than 8~~c 11 inches irv e. rr~~m~sl • j S ~Qi I(~I~ ' St. Croix anr! include, but not limited to: vertical and horizontal reference pointj8 ibh percent slope, scale or dimemsions, north arrow, and location and di rice io nearest road. Pa I I.D. 1067-70-000 f 018 rt C3~Ut~ ~CIJMTY o - ti l/i f i t orma on. a n n Please pr ~01`iJ('aG O~PI~E e Personal information you provide may be used for seoaidary tx ~ ' ~ ~ ~ 0~4 ~, Property Owner Property Location Bradley R. & Sharon M. Patnoe Govt. Lot SW 114 SW 1~ S 30 T 29 N R 17 W Property Owner's Mailing Address L Block # Subd. Name or CSM# 719 150th Street 1 Proposed CSM City State Zip Code Phone Number City Village / Town Roberts ~ WI ~ 54023 (715j 796-2730 Hammond 150Th Street / New Construction tJse: / Residential / Number of bedrooms 3 Code derived design fkmr rate 450 GPD ~i Replacement Public or commercial -Describe: ~ Parent material Glacial till Flood plain elevation, if applicable nor General comments and recommendations: Install mound system with 4' x 112.50' dispersal cell. System elevation. to be 94.38' 20" bove 92.71' contour. ~~ a Boring # / Pi~~ Ground Surtace elev. 92.76 ft. Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture 1 0-10 10yr32 none sil 2 10-16 10yr4/4 none sl 3 16-28 10yt6l4 none LSBR Depth to limiting factor 16" m• Soil Application Rate Structure Gr. Sz. Sh, Consistence Boundary Roots GP *Eff#1 D/ft2 *Eff#2 2fsbk mvfr cs 2f,1 m 0.6 0.8 2fsbk mvfr aw 1fm 0.6 1.0 Na Na - 1vf 0.0 0.0 of loose, fractured limestone fragements of approx. 3' x 3" - n- x ci- places r~- between plates filled with 10yr 4/4 mfr sl. ^ Boring # Boring / Pit Ground Surface elev. 89.95 ft. Depth to limiting factor 22" in. Soil Application Rate H i th D Dominant Color tion Redox Descri Texture Structure Consistence Boundary Roots GP D/ft' or zon ep in. Munsell p Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10yr32 none sl 2fsbk mvfr cs 2f,1m 0.6 1.0 2 10-17 10yr4/4 none sl 2fsbk mvfr cw 1fm 0.6 1.0 3 17-22 10yr4/6 none scl 2fsbk mfr aw 1vf 0.4 0.6 4 22-35 10yr6/4 none LSBR Na Na - - 0.0 0.0 Limestone bedrock observed in H ff4 consists of ,fractured l n plates filled imestone fragements of approx. 3" x 3" - 5' x 5' plates 7'- 4' thick. Voids wfth 10yr 416 mfr scl. * Effluent #1 = BOD ~ 30 <_ 220 mg/ and TSS >30 < 1 mg/ uent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name {Please Print} Signatur . CST Number James K. Thompson ~--- 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceo 154020 4212005 715-248-7767 i ^ ~o:/ ¢da~uc~la~ ~0, • E/ed4 ~i'on ' ~.oc.a~ed prcp s~ _ KGB. os' ~~ ~ ~9oz _ a 8Ro ;_ --az-------__ 9~d'-_____ ~ __ 8~ Slo~ae ` ` -- ____ -~_ ^ . SY~~ Cor~'fasu,,~ 9.2.71 41.70' SF~~I ~e~ Pos6. Elea: - 9 7. Srs. ~- Assu.acd elegy . /OD.Gb,' ~.-- d ~~~ ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ~ ~~-~. Mailing Address Property Address • ~ A~w ~ ~ira~.! r-~ o ~^ ~ ~ ~ i Sy O 11 (Verification required from Planning Department for new construction.) City/State ~ w i Parcel Identificatiro~n Number v! 8- 0 6~ -? d ~- o 0 0 LEGAL DESCRIPTION ~ Y~M~ ~ ~ ~ ~ _------ Property Location S~ '/4 , S W '/a , Sec. ~ o , T dZ g N R/ 7 W, Town of Subdivision ,Lot # ~. Certified Survey Map # ~ `~ ~$ ~ g ,Volume 1 Q ,Page # y 4 8 ~ Warranty Deed # 8 ~ o `~ ~ ~ ,Volume a8 `I 8 ,Page # b 3 ~ Spec house yes ~ Lot lines identifiable ye no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in § Comm 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal 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, herein, as set by the Department of Commerce 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 Department within 30 days of the three year expiration date. ~-.., . ~ SIGNA OF APPLICANT l2 /iS/ Q~ DATE OWNER CERTIFICATION Uwe certify that all statements on this form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the prope scribed above, by v' e f a warranty deed recorded in Register of Deeds Office SIGNAT OF APPLICANT DATE ****** Any information that is misrepresented may result in the sanitary permit being revoked by the Zoning Department. ****** Include with this application a stamped warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. U; 28y8P 036 I STATE BAR OF WISCONSIN FORM 2 - 2000 Document Number WARRANTY DEED This Deed, made between Bradlev R Patnoe and Sharon Mc Kenzie Patnoe, husband and wife Grantor, and Corey M. Hawkins and Korina S. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croiz County, State of Wisconsin (if ' eeded, please attach addendum): LOT ONE F CERTIFIED SURVEY MAP IN VOLUME NINETEEN CERTIFIED SURVEY MAPS, PAGE 4986, AS DOCUME~iT NUM~ER,95898 FILED IN ST. CROIX COUNTY REGISTER OF ~DIEDS OFF CI EON MAY 25, 2005, BEING LOCATED IN THE SOUTHWEST QUARTER OF THE SOUTHWEST QUARTER (SW 1/4 OF SW 1/4) OF SECTION THIRTY (30), TOWNSHIP TWENTY NINE (29) NORTH, RANGE SEVENTEEN (17) WEST, TOWN OF HAMMOND. Subject to 150`" Street right of way. Recording Area 8 ~i 0 '3 5 6 KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CO.. liI RECEIVED FOR REGARD 07/21/2005 08:45AM NARRAHTY DEED EXEMPT # REC FEE: 11.00 TRANS FEE: 98.00 COPY FEE: CC FEE: PAGES: 1 Name and I2eWm Address Grey (~. ~a~'f~~hS ~~b9 ~'~('-~ctitlF, ~~e ~(,u (~' r~, (,U ~ s~~o3 Partot018-1067-70-000 ~5^~ ~7~ Parcel Identification Number (P>M This is not homestead property. (is) (is not) Exceptions to warranties: easements, restrictions and rights of way of record, if any. Dated this ~ day of July, 2005. Si¢nature(s) AUTHENTICATION '~utl~arttic~fe~t~is day of ~~end . ~ cttaat.~ ~. ~a~son • ~, .. , •~ ~ - __ ._ , A~'s,, ~ ~ . State of Wisconsin .TE BAR OF WISCONSIN * Bradley R P no * Sharon Mc Kenzie Patnoe ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. PIERCE County. ) Personally came before me this ~ ~ day of July .2005 the above named Bradlev R Patnoe and Sharon Mc Kenzie Patnoe /it~d by X706.06, Wis. Stats.) ~:'~IS INSTRUMENT WAS DRAFTED BY River Falls. WI 54022 (Signatures may be authenticated or aciatowledged. Both are not necessary.) • Names of persons signing in any capacity must be typed or WARRANTY DEED to me Irnown to be the person(s) who executed the fore¢oint; instrument an~ lrnowledee~the s e. s Notary Public, State of ! My Commission is periiian~t. (f not, state expiration date: A_ .) STATE BAR OR WISCONSIN NORM Na 2 - 2000 tNFO•PRO (SOOKi55-2021 www.infoproforms.com i! 1?' .~ 79589$ VOL 19 PAGE 4986 KATIICEEIf H. REGISTER OF DEEDS ST. CROI K CO. 11I RECEIVED FOR ~tECORD 05/25/2005 01:30PH CERTIFIED SURVEY HAP REC FEE: 13.00 COPY FEE: 3.00 PAGES: 2 CERTIFIED SURVEY MAP Bradley R. Patnoe and Sharon McKenzie Patnoe Located in the Southwest '/. of the Southwest '/, of Section 30, T 29 N, R 17 W, Town of Hammond, St. Croix County, Wisconsin WEST QUARTER CORNER SECTION 30, T 29 N. R !7 W (FOUND !'I~NP/PE) ~' ~ EL-'1 35 A L Q ~ AC~~S .. ~, ~' ~' N 8 'o ^ S os.o ' M i I 868.05' SW I/4 H LDVE SW I/f N ``: ~I I - ORT ~ I ~ I L0~ 1 i I ~ $.686A SQ. FI: I ~ I ~ I 3.45! ACR~~ ~.~13 SQ• Fl: ~~ I 1 I I • Z ~ ~~ o •. ~ 468x1' `~oi• I LOT 2 ~ I ~ 1857gACRFS OR g 3 SQ. FT. `~ 17599A 0 oto 51Q. FT. -SEPTIC (EXCL- R~~ e ~ I ~ N I \ pp~ ~ I ^S, 3 LL fl4RN NORTH cmE SOUTH 672.6' ~ p „ 1 ~„ay rr __ I SW //~ - SW I/~ ~ W z ~ ~ IS .O' ~ _ aa~~ Gl~ ~ ° ~ I ~' I ~~ $ ~ $ ~ I I R ,'T.., I ~ y ~ QI ~~ I ^ Q~ I ( ~ ~t~`33~ ~ ~~ ~~ ~ ~I I~a ~ ~ ~ 11 p ~ ( I~ 77 ~ ~ I L_ _~. _._ 1 SOUTHW6T CORNER SECTION 30, T79 N, R !7 W (FOUND BERN7SENSURdEYNAlL~ ~~~I~Q ~~ I_ ~~ owNERS'AnnRESS ~,~,~ 719;5oth Street Roberts, WI.54o23 hi ~I ~19 C O1~T3~ i 'u.vW ~; MUHY a ~ i777777//////yg ~ ~ y DI ~ ~ LD82dV1LLE ~i Ri F~ r I 41 .•. wi. . e'er'" ~ ~~ •~ LAT7 9~ 8 a ~~ n ~-" ~ ~ ai DATED -February 8 =~" ~LEGEND~~~~ 1~*- ~ Indicates i"O.D. x i8" Iron Pipe Set ~ Weighing i.i316s. per lineal foot • Found i^ Icr~on Pipe Indicates Soil Boring Section Comer Monument 0 (as noted) - x - Indicates Fence N SOUTHQUARTERCORNER SECTION 30, T I9 N. R !7 W C (Fi7UND 'PK' NA!!.~ c Scale in Fed ~ " soo 100 o soo 30+ ~ m tl~e6ear&~o ~N o~o~ ~ ~E~. Vol 19 Page 4986 This Instrument Drafted by Mark W. 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