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018-1069-00-100
I I I ~ ~ N O O N ~ 7,l' ~p ~ O y C ~ ~ ! ~ N N ~ N O C ~ ~ rn I ~ I ~ ~ A vD I ~ a o I , W ~ o ~ O m - Z ~° ~ C fD a a c z ~ ~ I ~; ~ a ~ I v o~ ~ ~ ~ ~ o' I N I Q, I Z O_ I o W N W °' C (D ~ Z ~ ~ N ~ !i N O 3 I N fl. _ ~ ~ ~ . ~ ~ N I m o' m' °? c;3 a ~ z I o ° ~ ~.~ n i ~ n ~ 1 ~ .~ ~ ~ ~ O ~. ~ ~ N A ~ 7 ,< ~, fND fD a y N p y p ~ c < 0 ~ ~ O CD C O ~'° ~ o ~' ~ . c°a'o as~ < f nro mm~a~~ ~`~ ~N QN 7 W -~',N I ~ ~ ~ a m ~ ~ Q ~ O 7 ~ ° ~ ~ o c ~ ~ ~ ~ ~ ~ ~ ~ ~ 3 r: '~ ~ w o o ~ W 4/ 7 O H y ~1 ~ O a ~ a cn s ~~~' 00 ~ o o °o °- W W < O O O Go ~~~~ ~ N ~ ~ o v ~ v A ~ m ~ ~ ~ m ~ .. 7 w C 00 Z ~ O ~ '0 y N ~ C ~+ N ~ ~ ..: a ~ ~ D 7 Q W ~ a 3 O •'~ 3 !~! Z W C a 3 d o 3 ~ 3 ci ~ a d _ ~ o d 3 ~ j° o -' °rn O 7Q ~ ~O Q p O D y O O S i 'p ~ :'.' 6 3 ~ °: o D <n .P 0 O O A ? ~ i ~ M A ~ ~ (A -1 W ~ ~ z A ~ Z V ~ g A d :: A'+ -~ R A~ O .~"S. 0 ~• O N ~ y a ba N b N O A A N OrQ N ~ A ~°,, b ti ~ - - - ~~RiG@~A~ SOIL EVALUATION REPORT ,,n Department of Commerce ,s(on of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code our Attach complete site plan on paper not less than 8'/: x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and part percent slope, scale or dimemsions, north arrow, and locatbn and distance nearest road. Please print all info Ep ev' Persons information you provide may lre ed for s~l~r~ ec (Privacy l.aw, s. 1 .04 (1) (m)). caner ope y oca ion 1179 page t of 4 Certified Soil Testing St. Croix .D. CSM Pending ad By Date N' _ ~ ~ _ ~ f~2o rope y C ~, ~ Z~~ G Lot SW 1/4 NW 1/4 S 31 29 N R - r vv Moll, Bruce Property cane s ai tng ress CGUNTY Lo # Block # Subd. Name or CSM 1840 80th Ave. S1 • ~R~tX FFICE 3 CSM Pending City fate Zip o e P ~ Cit ~ Village ~ Town Nearest Road Hammond ~ WI 54 15 715-796-5491 Hammond 150Th St. Use: ~ Residential / Number of bedrooms 3 Code derived design flow rate GPD -/_~ New Construction Replacement ~ Public or commercial -Describe: Parent material till Flood plain elevation, if applicable NA General comments and recommendations: no residence staked; 3 br assumed; shallow conventional system OK B-5-6-7 area; mound OK B-1- - -4 area i 'I ~ J Boring # o"""y ' Pit Ground Surface elev. 91.9 ft. Depth to limiting factor ,~_in• Soil Appligtan Rate nsistence C Boundary Roots GP D/ft= Horizon Depth in. 1 ~ 0-5 Dominant Color Munseii 10YR 3/2 Redox Description Qu. Sz, Cont Coior - Texture sil Structure Gr. Sz. Sh. 2 m gr o ds cs 1f/m .5 .8 2 5-20 7.5YR 4/4 - sl 1 m sbk ds cw 1 m .4 .6 3 20-26 5YR 4/4 - fs 0 sg dl cs 1 m .5 •9 4 i 26-48 10YR 4/6 - fs 0 sg dl cs 1 m _ .5 .9 5 48-60 BR ome gr co to onzon y rests ante o p ene ra ion , very ig weakly cemented Borin g - Boring # ' Pit Ground Surtace elev. 92.3 ft. Depth to limiting factor 46 in. Soil Appligtion Rate Consistence Boundary Roots Horizon Depth Dominant Color Redox Description Texture GPDIfN G Sz. Sh. Munsell Du. Sz. Cont. Color in . 1 i 0-9 10YR 3/1 - sil 2 f sbk mvfr cs Zf1 m .5 .8 2 ~ 9-17 7.5YR 4/4 - sl 1 m sbk ds cw 1 m .4 .6 3 '~ 17-29 7.5YR 4/4 - sl 0 m ~~ mfr cw 1 m .3 .5 4 , 29-46 10YR 5/6 - fs 0 sg dl cs 1 m .5 .9 5 146- 5 _B~ ~ ---- ___- ~ y rests ante o pene ra ton, very ig -wea y semen a ;some i stratified 10YR 7/6 fs in horizon 4 _ _ „ , ~.,~ ..,...n .,..a Tcc ~zn c 1 Fn mn/1. 'Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L - um er ame ease nn tgna 222774 Henry F. Grote ---- Address Certified Soil Testing Date Evaluation nducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 51 8/28/2000 715-233-0398 ' m *~' ~ ~ G ` ' Property Owner Moll Bruce c 4 ~ ~' ° , Parcel 1D # t;SM Pending ~ v P~9 3 Boring # Borin ~ 9 e ~ N Pit Ground Surface elev. ' 89,g ft, - Depth to limiting factor 21 in. s Horizon Depth in Dominant Cobr Muns ll Redox Descri twn p - Texture Structure Consistence --ms's Boundary Roots Soil Applkxt~„ . e Qu. Sz Cont. Cobr Gr. Sz. Sh. 1 0-3 10YR 3/1 - sil 2 f sbk mvfr cs 2f1 m .5 .8 2 3-21 7.5YR 4/4 - sl 1 m sbk ds cw 1 m .4 .6 3 21-36 2.5Y 5/3 c2P 7•SYR 4/6 ~- lOYR 6/2 scl 0 m mfi cs 1m NP NP 4 36-53 7.5YR 3/4 - sl 0 m mvfr cw 1 f .3 .5 5 53-80 10YR 5/6 - fs 0 sg dl - _ .5 .9 ---6 i 80+ 50% g poc ets s rn onzon ; gr co m onzo n Boring # Boring Pit Horizon Depth Dominant Cob in. Munsell 1 ~ 0-7 10YR 3/1 2 7-21 7.5YR 4/4 3 ~-27 7.5YR 4/4 4 ~ 27-64 2.5Y 5/3 Ground Surface elev. 94.5 R ft. Depth to li miting factor 21~ in edox Description Texture Qu. Sz Cont Cobr Structure Gr. Sz. Sh. Consistence Boundary - sil - sl 2 f sbk 1 m sbk mvfr cs ds cs - scl _ 0 m mfi cs - scl 0 m mfi - r ^ Boring # Boring Pit Horizon Depth Dominant Col in. Munsell 1 0-8 10YR 3/1 2 ~ 8-23 10YR 4/4 3 ~ 23-33 7.5YR 4/4 4 33-45 7.5YR 4/4 5 45-46 5YR 4/4 6 46-76 4/4 ~- ~s.~s' Ground Surface elev. R d 98,g ft. Depth to limiting factor ~ 76 in. e ox Description Qu. Sz. Cont. Color Texture Structure Consistence Gr. Sz Sh. Boundary - sil 2 f sbk mvfr cs - sil 2 m sbk mfr cs - sl 1 m sbk mfr cs - Is 1 m sbk mvfr cw - sl 0 m mfr cw - sl 0 m mfr - onzon is an irreau ar an -^ ~Q~,,.,~.....,,.._ .., .. ____ Appliption Rate 2f1 m 1f .5 .4 .8 .6 1m NP NP 1f NP NP Application 1f/m .5 - I .g -~ 1f .5 --- .8 1 m .4 ~ .6 - .7 2 - .3 .5 - .3 ~ .5 'Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L The Department of Commerce is an equal opportunity service provider and a ploye#r.21f BouDneed assn tanc eto ascesso ervices or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R 07/Op) Certified Soil Testing o a a g' - 9S• ~~~ . ~ - a~ ~ ~ ~`°,,.' Moll, Bruce Parcel ID # CSM Pending 1~ Rnrinn Page 3 of 4 ~ ~ ~ Boring # ®""""~ ft. De th to limitin tactor in. ~ Pit Ground Surface elev. 97.5 P 9 > 70 Soil Appliption Rate Horizon Depth in. Dominant Color Munsell RedoxDesaiptan Du. Sz Cont Cobr Texture Structure Gr. Sz Sh. Consistences Boundary Roots 1 0-4 10YR 3/1 _ sil 2 f sbk mvfr cs 1f/m •5 .8 2 4-12 10YR 3/2 - sil 2 f sbk mvfr cs 1f .5 .8 3 12-25 10YR 4/4 - sil 2 m sbk mfr cs 1f .5 .8 4 25-30 7.5YR 4/4 _ sl 1 m sbk mfr cs 1f .4 .6 5 30-70 7.5YR 4/4 - Is 1 m sbk mvfr - - .7 i 1.2 r ~ I onzon as occasrona s me usrons strati re gr co -_--.~ Boring Boring # Pit Ground Surface elev. 96.7 ft. Depth to limiting factor 5=~ in. Soil AppiigGon Rate Horizon Depth in. Dominant Cobr Munsell Redox Description Qu. Sz Cont Color Texture Structure Gr. Sz Sh. Consistence Boundary Roots 1 0-4 10YR 3/1 - sil 2 f sbk mvfr cs 1f/m .5 .8 2 I 4-12 10YR 3/2 _ sil 2 f sbk mvfr cs 1f .5 ~ 8 3 12-25 10YR 4/4 - sil 2 m sbk mfr cs 1f .5 ! .8 4 125-43 1 7.5YR 4/4 _ sl 1 m sbk mfr cs 1f .4 j .6 5 43-50 10YR 5/6 - Is 1 m sbk mvfr cs - .7 ~~ 1.2 6 50+ BR ~ ~ onzon as some gr co ; y resistance o penetra ion, wea y semen e Boring Boring # pit Ground Surface elev. ft. Depth to limiting factor in• Soil Application Rate Horizon Depth in. Dominant Cobr Munsell Redox Description Du. Sz. Cont Cobr Texture SWcture Gr. Sz. Sh. Consistence Boundary Roots --- I I ' Effluent #1 = BODS> 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 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) certified Soil Testing • -`S~ / `~ ~ M ~ 3 ~ ~ ~a ~~ ~ ~~~ f ~~ ~ ~~ # ~~ a ~ 3 s ~ L ~ 3 _. ;_ .. ~ s ~~~ a D N ~ ~ o ~ y ~ d / l..n N S d ~ ~ ~...,,, r ' _~ v ~ (.~ ~v \~ j ~ ~- S ~( ~ 1~= ~ ~ 0 N 0 N `9 --/~ N 1 ~ ~~ .- .. `v f~~ -+ __o ~- ~ ~ _~ t 3 .~ ~ ~ y ! fl l a ~ ~~ w _/ ~ e.~ i' i d ~ ~ --r --~ 4 -~ ~ .~ ; _; '~ o ../ C ~ ~ f ~~ ~ o 0 ~~n~~ ~ I d o~ i \ u .n ... a" ~ ~ r' rt ~ L/ ~~ ~ ~ +. •, i \ cl' \ f `~ ~ ~~ L J ~ ~ .~ 3 ~ ~ ~ a P `~~ a .~ 0 ~-~ ~) ~~ J _! u ., ~ a~ -~ ~ ~ d ., 4 0 ~~ 8 ~ z M ~ z 9 z, "GRIGINAL 1181 SOIL EVAk:~AT1C?1J.REPORT Wisconsin Department of Commerce Page 1 of 3 Division of Safety and Buildings in accordance wit G`o ~, Ws. Adm: Cgde ;;v, Certified Soil Testing Attach complete site plan on paper not less than 8'/: x 11 inch s h- ' e. PI~t) fr~ta~.,r ~t~ ' ~; , : ~ St. Croix include, but not limited to: vertical and horizontal reference n~direcb'bn3~rld' ' percent slope, sale or dimemsions, north arrow, and locetio ~pdfdistance to nearest road ~ ' ..~~ cel LD. Please print all infor o . - ~ ~ ~. ~ ~~ ? ~' ~~~~~` °' CSM Ing _,~ ff@~riewe By 2 Date Personal information you provide may be used for "~~',PurPos~ (FtiS~cy Law, s.19~((fY, (r~i`jc~l } ~ ~..~~ 3 i rope caner \ , ~ .., io r_, Moll, Bruce ,~`'~ ~FC`ri.~~l~ ,, d~ ~.~'~~W 1/4 NW1/4 g 31 29 N R 17 W rope ne s ai ing ress ~ ~ ~ o # Subd. Name or CSM 1840 80th Ave. + ~ ~ P ~? ~ ~ CSM P g VT ity tate i one rinl~aCiik ~ Village Town Nearest Road Hammond ~ WI 54 T •~~ ~/ Hammond 150Th St. ~~ . New Construction Use: Residen I / yirt~~r.pf~bedr8orns ~` 3 Code derived design flow rate GPD Replacement Public or co c aI~ ~cr• Parent material till Flood plain elevation, if applicable NA General comments and recommendations: no residence staked; 3 br assumed; shallow conventional or at-grade system OK B-3-4-5 area; mound system OK whole area surveyed ^ Boring # Boring Pit Ground Surface elev. 100.4 ft. Depth to limiting factor 31 in• Soil Appligtion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIfN in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-4 10YR 3/1 - sil 2 m gr ds cs 2f1m .5 .8 2 4-11 10YR 3/2 - sil 2 f sbk dsh cs 1 m .5 .8 3 1 i-31 10YR 4/4 - sl 1 m sbk dh gs 1 m .4 .6 4 31-55 7.5YR 4/4 - scl 0 m mfi cs - 0 0 5 55-82 10YR 7/3 c2d 7.5YR 4/6 Is 0 sg ml - - .7 1.2 onz occa i na s ra r re an s ^ Boring # r Boring Pit Ground Surface elev. 101.5 ft. Depth to limiting factor 32 in• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-6 10YR 3/1 - sil 2 m gr ds cs 2f1 m .5 .8 2 6-17 10YR 3/2 - sil 2 f sbk dsh cs 1 m .5 .8 3 17-29 10YR 4/4 - sl 1 m sbk dvh cs 1 m .4 .6 4 29-32 10YR 7/3 - fs 0 sg dl cs - .5 .9 5 32-44 10YR 8/2 f2d 7.5YR 4/6 fs 0 m dvh cs - 0 0 6 44-58 10YR 6/4 c2d 7.5YR 4/6 sl 0 m mfr cs - .3 .5 7 58-70 7.5YR 3/4 - scl 0 m mfr - - 0 0 Effluent #1 = BOD_> 30 < 220 ma/L and TSS >3n < 1Fn mn/I • Ffflunnr ~~ = ann ~ an .,,..n ~.,.r rcc ~ ~n ....,n ame ease rrnt igna ur _ um er Henry F. Grote 222774 Ad ress Certified Soil Testing a e va uat on on uct elephone Number E. 4366 353rd Ave., Menomonie, WI 54 8/28/2000 715-233-0398 Property Owner Moll, Bruce Parcel ID # CSM Pending Page 2 of 3 ^ g Boring 3 Borin # ~ Pit Ground Surface elev. 102.8 ft• Depth to limiting factor 50 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-4 10YR 3/1 - sil 2 m gr ds cs 2f1 m .5 .8 2 4-12 10YR 3i2 - sil 2 f sbk dsh cs 1 m .5 .8 3 12-31 10YR 4/4 - sl 1 m sbk dh cs 1 m .4 .6 4 31-50 7.5YR 4/4 - s 0 sg dl cs 1 m .7 1.2 5 50-52 7.5YR 4/3 f2d 7.5YR 4/6,5/3 sl 0 rp mfr cs - .3 .5 6 52-72 5YR 4/4 - scl 0 m mfi cs - 0 0 7 72-76 10YR 7/3 c2d 7.5YR 4/6 fs 0 sg ml - - .5 .9 ^ g Boring 4 Borin # ,pit Ground Surface elev. 103.6 ft. Depth to limiting factor 54 in. Soil Appligtion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 1 0-4 10YR 3/1 - sil 2 m gr ds cs 2f1m .5 .8 2 4-13 10YR 3/2 - sil 2 f sbk dsh cs 1 m .5 .8 3 13-34 10YR 4/4 - sl 1 m sbk dvh cs 1 m .4 .6 4 34-39 7.5YR 4/6 - s 0 sg dl cs - .7 1.2 5 39-54 7.5YR 4/4 - sl 0 m mfi cs - .3 .5 6 54-76 7.5YR 4/4 c1d 10YR 6/2 scl 0 m mfi - - 0 0 g Boring 5 Borin # pit Ground Surface elev. 103.5 ff• Depth to limiting factor 42 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Du. Sz. Cont Color Gr. Sz. Sh. 1 0-5 10YR 3/1 _ sil 2 m gr ds cs 2f1 m .5 .8 2 5-14 10YR 3/2 - sil 2 f sbk dsh cs 1 m .5 .8 3 14-31 10YR 4/4 - sl 1 m sbk dvh gs 1 m .4 .6 4 31-42 5YR 4/4 - sl 0 m mfr cs 1m .3 .5 5 42-48 2.5Y 6/4 f2d 7.5YR 4/6 scl 0 m mfr cs - 0 0 6 48-60 7.5YR 4/3 - scl 0 m mvfr - - 0 0 Effluent #1 = BODS> 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 materia3 in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. R- SBD-8330 (R.07/00) Certified SOII Testing .~ 4 ~~-~ ~~ ~~ ~~ ~ ar 4 u $ v. ;~ ~ ~ o ~ ~ ; J 3 ~ ~~ ~c't ~ s 3 .~ ~ ~ 9 9 S <-.t' n,. .~^ 7 /~/~ \j. YI J ~' a .~ ~ ~ ~ ~~ _~ ~ ~ r o ~ ~ C~fl ~ t ~ ~ ~ ~ ~~ ~ `,~ ~ o Q ~~ ~ ~ ~f ~ ~~ 9 4 N d ei r s 2 ;~ ~~~ ,~ ~- =" "! ^' ..-1- i (~ 9 Z r -~ ~ ° p~" .~ r ~ ^~ y--~ O ~' + ~P ~ t ..~ I • 4 J f ...d .i i a ~ ~,. ~~ ~ ~ dj ~ "~ ~ ,) d ; ,, ~ ~~ f ~~ o . ~ ~, ~ J ,..~ .- ~ ~ ~ o ~ r" ,JZ~ Q~~~a ~ ~~ 1~ L c6 9 ~r 3 s .J MJ ~.i m ~-i ~J O M Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safer'y~ and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes IPrivacv Law, s.15.04 (1)(m)l. Permit Holder's Name: Kofal, Brian City Village X Township Hammond Townshi CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER ) GEC CG rC(~ ^ o ~~h-~ CAPACITY Septic ~ah~l A-toc~ ~c.C~ Lw~ /c>c~U Dosing h/~Cti.~ ~ `3 ~ Aeratio ~~ ~ `~~ G)- (6 Q 3 Sbr'~ls Holding ~' TANK ~ETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~, (UU ~ ~~ ~; ,~ ~C~ y ~ ~~ Dosing ., ~~ Aeration Holding PUMP/SIPHON INFORMATION ~E. ~. SOIL DIMENSIONS V 3 f ~ / SETBACK SYSTEM TO INFORMATION Type Of System: ~aVa..n:~•Lrlo~' DISTRIBUTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No: 430195 0 State Plan ID No: Parcel Tax No: 018-1069-00-100 Section/Town/Range/Map No: 31.29.19.474A10 11 l`~ STATION BS HI FS ELEV. Benchmark Alt. BM Cu• cry *c t~,,t Nom*-. s~~ fy', 3Z_ Q, /o$, ,.., ~~ /ab, C.e, Bldg. Sewer A - t t t ,7 St/Ht Inlet I-l ,45 9 ~. 3'~ St/Ht Outlet ~ Dt Inlet /' Dt Bottom *+-~' Zl.ri~ c g(,.7~, Header/Man. Dist. Pipe N Tv~0.°~.6..-~ ~ 8. I s. ~~ (~ G'Z2 ot. System s o~ g. 3s 9 • Z$ q q Final Grade 7 ~' --- St Cover at~~ uu ~ /S~d~,l;~ furs ~'~ca.~r.~ No. Of Trenches ~ PIT DIMENSION No. Of~ Inside Dia. ~ ~ CHAMBER OR \r1°MF ~ ~ ri o ~ UNIT ~/~J l l'~ "- ~fv~ Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake r . Length~_ Dia ~"'1 , Pipe(s) Length Dia Spacing -_ ~ ~ L.~ ~ SOIL COQ x Pressure Systems Onlv xx Mound Or At-Grade Svstems Only Depth Over Depth ver xx Dept of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Tren dges Topsoil - L-, Yes i ~~j No i,, ,Yes 1 No A~ 5e. roc COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: l /~/ a3 Inspection #2: / / Location: 655 150th St Hammond, WI 54015 (SW 1/4 NW 1/4 31 T29N R17W) NA Lot 1 Parcel No: 31.29.19.474A10 (7i'~ (Ci~itl~ ~ l L Rye ~" irt//e~2~2 "_ Lh'i i~~ /~ G~tT~J 1.) Alt BM Description = LpT3 b CST ~h~ of ~Y~3'~ Gt,~_s~~.~{R_.~ 2J Bldg sewer length = I Q` y ~ ~ a _ -amount of cover= ~ Sf( u.~r•r~ Pfw~-. J~k ®(!~ hd ~~r~•-~ `~`~~~ ~d ~ 6hsP.-rv~ S E a'~ CoYrJtji 2 a c oa-. n. ,r_ p T Plan revision Required . Yes No I ,~- ~~,-_- ` j/ -_ I ` l~~ ~ t7 ~~ I, ~ ~ I/ '" 1 ` Use other side for additional informati ____ __, __ ~ _ _-- __ _ _ ,._ _._,___________ ___ , _ Date Insepctor's Signature Cert. No. x-6710 (R.3/97) Manufacturer -~ (~ ~ Demand o ee. GPr1 Model Number ~ N I S~ o'L Zy 3 TDH Lift Friction Loss System Head TDH Ft orcemain Length ~ Yv Dia. Dist. to well 1 , 13CU+~an r ~Ur t^ Sanitary Permit Application Safety & Buildings Division ~~ ~ `~ In accord with Comm 83.21, Wis. Adm. Code See reverse side for instructions for completing this application 201 W. Washington Ave. PO Box 7302 seonsin Personal information you provide may be used for second u oses `~ p ~ Madison, WI 53707-7302 Department of Commerce [Privacy Law, s. 15.04 (m)] (Submtt completed form to county if not state owned.) Attach complete plans (to the county copy only) fort system, on paper not less than 8 -1/2 x 1 I inches in size. County w ~ , ~ ~ ~ State Sanitary Permit Number eck if revision to previous application State Plan I. D. Number /V I. Application Information -Please Print all Information Location: rpss Property Owner Name Property Location Sal Gt ~°'1 ~ /4~~, S , R~~E (o Property Owner's Mailing Ad res s Lot Number Block Number ~ ry City, State Zip Code Phone Number S b division Nam or CSM Number / ~/ // v . Type of Building: (check one) 1 or 2 Famil D elli - N f B d ~ ^ City ^ Village y w ng o. o e rooms : ~~ ~ P bli /C i l d ib I~'I'own of u c ommerc a ( escr e use):_ ~ ^ State-Owned ~ j~d :~?fi '~O a~'~ ~! Q / ~ ~~~ ~~ ~~ /~P ~,/ ~ ~G ~- /' ~ Nearest Road ~ ~ ® O _ ~~ - Pazcel T Num er(s) ' III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) A) 1. ~Iew 2. ^ Replacement 3. ^ Replacement of 4. 5. 6. ^ Addition to Sy System Tank Only Existing System B) Sanitary Permit was previously issued Permit Number ~1 ~ 1 _` S Date Issued ~J - ~" / Q IV. Type of POWT System: (Check all that apply) Non-pressurized Ln-Qrn»r~ ^ Mound ^ Sand Filter ^ Constructed Wetland O-Pfessunzed I g d ^ Holding Tank ^ Single Pass ^ Drip Line ^ At-grade ^ Aerobic Treatment Unit ^ Recirculating ^ Other: V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil App ' lion 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (G day q. ft.) (Min./inch) Ty, „~ ~ ~ ~° Elevation ~f 5 0 ~~ ~~-- . S ~-- T - ~ ~~~ VII. Tank Capacity in Total # of acturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks , ~~ ~ Con- Con- glass ~0 New T k Existing T k ~ 9,~~D d-] Crete structed ~ ~ an s an s ~ J~` ^ ^ ^ ^ VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (print) Plumber's 'nature (no slam s~ MP/MPRS No. Business Phone Number c 6~tir i ~ f ~'' 3 ~ /'_' /,a ~~ ~6 Plum er' ddress (Street, City, State, Zip Code) r .~ IX. Coun /Department Use On y pproved ^ Disapproved ^ Owner Given Initial Adverse Sanit ermit Fee (Includes Groundwater Surche F ~e,) ,(~ n ~f~ ~ Date sued ~ suing Age Signatur stamps) D t i ti ~ ~~ rWt ~ '~' 4 " " ~ ~ U 1 e erm na on / (! roval /Reasons for Disapproval: ~~~ ~ ` p`yt R. SYSTEM O~"N~~ Z 1 nt filter and ( ~ p GL ~ ~ Q~ w ~ ~ dispersal cell must all be serviced /maintained ` ~~ ! ```'~' ~ ~ ~G as per management plan provided by plumber. ~~~ „! .~ C~G~L1;~~~~~ S~/S~1'~ ~~° 2. All setback requirements must be maintained '~J`" ~ L ~ ~~ Q3_~;~~ ~ ~ /~/J~ ~ as er a licable codelordinances S~ ~ GV1 ~ / ~257~-~=-1:~-°" pp p . ~li5 l~U~/ ~'4-~ ~~z~~~ ~ ~~ ~ ~~~ 2003 - ~ ~- ~ ~~ c~ ~~ ` PLUT PLAN PROJECT Brian Kotal ADDRESS 2007 280th ave Emeral Wi. 54012 SW 1!4 NW 1/aS 31 /T 29 N/it 17 W TOWN Hammond COUNTY ST. CROIX 9-15-03 BEDROOM 3 MPRS Byron Bird Jr. 2205 DATE CONVENTIONAL A -Grade CONVENTIONAL LIFT XX HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gai combo LIFT TANK SIZE600 gal combo DOSE TANK SIZE HOLDING TANK SIZE ~ LOAD RATE ABSORPTION AREA # of chambers BENCHMARK V,R.P. top of foundation ASSUME ELEVATION 100' ^ BOREH `1e1~ R'ELL *H.R.P. Sarr12 aS BM Of 12„ Stand2~~~1>~1~ NATION T-1=99.4 T-2-99.4 y/Z ~1~0 Cov Chamber with 31.1 ` ft^2 per chamber ~ ~'~ C L~.~~-~d' ~J Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT Page ~ of ... .-..~....-...vv ....., vv.....• vv, •..v. • .v.... vvv.. Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County ~ ~ ~~ G ~e include, but not limited to: vertical and horizontal reference point (BM), direction and l l i i Parcel LD. ,S Q_ /Q / ~ Uv ~ /~~r 6 ~ ' percent s e or d mens ope, sca ons, north arrow, and location and distance to nearest road. ~O f Please print all information. R awed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~ t 2~ u Property Owner Property Location Govt. Lot 1/4 /4 S N ~~ R / E Property Own fling Address // ~7J ~6t~ Lot # ~ lock # Subd. Name or CSM# ~ _' ~~l5 ~~.J Flo Ci State Zip Code Phone Number ^ City ^ Village own Nearest Road ~/ ` ,,[ New Construction Use:,~Residential /Number of bedrooms ~_ Code derived design flow rate L~ S'~ GPD ^ Replacement ^ Public or Comm vial -Describe: Parent material r-~ / Flood Plain elevation if applipble ft. General comments /n~ ~f- and recommendations: Tr - ~ = ~' ~' ~ f~G"T-L,//°tz, S'/.S !~^}~'~ ,,) G s~ ~fJ ~ I. 3 `I ~ / Boring # ~ Boring ~ ^ Pit Ground surface elev. ~~~ft. Depth to limitingi5ctor®~ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence .Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. S h. 'Eff#1 'Eff#2 / ~ ~ B ~!'Z~ /L / /t' 1 /^ / GS 1~ ~~ Boring Boring # ^ pit Ground surface ele~~~~J ~ ft. Depth to limiting factor~1d$ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu . S z . Cont. Color Gr. Sz. Sh. 'Eff#1 'E ff# 2 l 1 // , / ~ i/ ~/ ~s ~ ~ /~' ~ Q ~ G ~ ~_ `~ . S ~.-. - tmuent ~~ _ ~w5 > su < Llu mgrs ana i s5 >su _< i 5u mgi~ - t=muen~ ~~ = tsw5 < su mg~~ and i 55 < su mgi~ CST Name (P se Print) ~ Signature ~` CST Number Address at Evaluation Conducted Telephone Number SBD-8330 (R07/00) /~ 1 Property Owner r/U I^ t u ice! ,~/~ Parcel ID # Page of Boring # ~- Boring . ^ Pit Ground surface elev.~8 ~ ft. Depth to limiting factor ~/~~ in. Soil Appligtion Rate Horizon .Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 6!. ~- c / ~ .~ G v ~~ r .,~ ^ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Appliption Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ^ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 'Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 =GODS < 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 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) + Soil Test Plot Plan Project Name Brian Kofal Byron Bird 3r. Address 2007 280th ave. Emerald Wi. 54012 CSTM #220527 Lott Subdivision V15 P4088 DateB/15/2003 CountyST. CROIX SW 1 /4 NW 1 /4S 31 T 29 N/R17 W Township Hammond Boring (~ Well PL Property Line# AIt. BM ~,T o_f-~~,~~ f o ~ ,BM or VRP Assume Elevation 100 ft top of foundation ~ ~ Y..~ s~~ ~ System Elv. T-1=99.4 T-2=99.2 H.R.P. Same as BM Safety and Buildings Division County ~ ~ ' 201 W. Washington Ave., P.O. Box 7162. 1 - ( /`+/~-0~~~~ Madison, WI 53707 - 7162 (~8) 266-3151 Sanitary PerTnit Number (to be filled in by Co.) ~3v !~s Department. of Commerce Sanitary Permit Application 141 /~, State Plan I.D. Number ~ ~ s ~~ ~~ ~ ~ Wis. Adm. Code, personal information you pro e In accord with Comm 83.21 ! , - ~ , may be used for secondary purposes Privacy Law, s E;~(ull,,,,__ >af Project Address (if differe-n7t~than mailing address) ~ S S ~~V'~ Sl ~ I. Application Information -Please Print All Information i O ~ / Property Owner's Na me / r ~ ~ f~i~~ $' ~~~ ~~ ~` ~©,~' ~ ~ ~ Parcel # Lot # Block # l 1 Property Owner's M ailing Address .~„~,; : `' ~ Property Location ~ / ~ ~` / "°-~... City, State e ~^ Zip Code ~J !s Phone Number /~~~ ~ i- `~5/z /-~' ~ (ctrcl n N; I~~E r W ply) g -~w*, (check all that a II T e of Buildin ~ 3 ~ p g yp M Number I or 2 Family Dwelling - Numbec of Bedrooms l~.isP~~$ 86 6 ^ Public/Commercial -Describe Use . __ ^ State Owned -Describe Use ~ (n'L- ~03 •~ - ~ ^City_^Village Township of III. Type of Permit: {Check ly ne x on line A. Complete line B if applic e) ~'' ew System ^ Replacement S m ^ TreatmenUHoldin Tank Re acement Onl g Y Other Modification to Existing System B. ^ Permit Renewal Before Expiration ^ Permit Revision ^ Change of Plumber ^ P mit Transfer to New O er t P vious Permit Num Dale Issued IV. Type of POWTS System: (Check all that appl ^ Non -Pressurized In-Ground ^ Mound > 24 in. of sui le soil ound < 24 in. of suitable soil ~AC-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Hol g Tank ^ Peat Filter ^ Aerobic Treatment Unit Recirculating Sand Filter ^ Recirculating Synthetic Media Filter ^ Leaching Chamber rip Line ^ Gravel-less Pipe ^ Other (explain) V. Dis ersal/Treatment Area Information: De si gn Flow (gpd) Design Soil Applicatio RaLejgpds~tN J ~5 Dis rs Area Required (sf) Proposed (sfl A r e a Dispersal System Eleva tio~ !L 7 ~ l `~~ n ,~ ~ ~ / - ~ r/V z ~~J VI. Tank Info Capacity in otal Num r Manufacturer Prefab Site Seel Fiber P1ast1C Gallons Gallons of U is ~ Concrete Constructed Glass New Existing ~~~~~~/~J `/ 'tanks Tanks Septic or Holding Tank M~ ~'~'CJ Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the under geed, ume responsibility for installati of the POWTS shown on the attached plans. Plumber's Na me (Print) ~ ~~ Plumb 's Si azure MP/MPRS tuber Z ~ Business Phone Number r/ ~ ~ ~ ~ ~ti , , ov . ~.~/z 6 Plumber's Addre ss (Street, City, State, Zi ode) ~ VI Count /De artment Use Onl Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Surcharge Fee) ~ ~ D to Issued ~ uing gent Signa o Stamps ^ Owner Given Reason for Denial ~ ~ ~ ~~ ~~-/t~r-..~ IX. onditions of Approval/Reasons for Disapproval ` ~'3 5~- . 1 ~ ~~/,~ y.~~/Atta/(c~h7 complet/e~Sl7oans (to the County only) >fo,{r t/h/e systems onn (pa/per not less tlfan 8~1/~2 x 11 inches in size ~ 9r ^~ n ~ ,n„' n t~., , ,,,,tta t' l ~/ (J ~ dd'?,~/!; ~ Gv't~.< {LXi!/ ~o~ ~~"""`~ ~ ,PLOT` PLAN PROJECT Bruce Moll ADDRESS 1840 80th Ave Hammond Wi 54015 SW 1 / 4 NW 114 S 31 /T 29 N/R 17 w TOWN Hammond COUNTY ST. CROIX 6/18/03 BEDROOM 3 MPRS Shaun Bird 226900 DATE CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none ,BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100' Fitter Zabel A-100 ^ BOREHOLE O WELL .H,R,p, Same as Benchmark SYSTEM ELEVATION 103.3' Scale = 1 /4" = 10' ,~~~ B.M. • 330' Property Line the contours and % slope was 103' field verified by designer, B-1 104' 103.3' and B-2 are not to used for installation purposes B-4 Area 15' below system is to remain undisturbed Well is to meet all setbacks found in Comm. 83 ~ B- v, 0 Pro 3 Bedroom House Grading is to be done to divert run- off away from system 1 0~2' B - 1 ~ 4% Slope ~6 ~ B- Huffcutt Combo Tank B-2 Tank is to be properly bedded and provided with lockdown covers with .~ approved warning labels --~ a~ a 0 ~,b~ I ~~y ~- ' . ~scons~n Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi. us/sb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary July 08, 2003 CUST ID No. 226900 SHAUN R BIRD BIRD PLUMBING, INC 1008 192 ND AVE NEW RICHMOND WI 54017 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL ~- IdzntiftCaftt#rt ~Ttznbers PLAN APPROVAL EXPIItES: 07/08/2005 Transaction ID No. 883750 Site ID No. ti61266 SITE: Bruce Moll Please refer to both identificationnumbers; Town of Hammond, St Croix County above, in ail correspondence with the SW 1/4, NW 1/4, 531, T29N, R17W a en FOR: Object Type: At-grade POWTS 450 gpd Regulated Object ID No.: 909962 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. The following conditions shall be met during construction or installation and prior to occupancy or use: Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner c the POWTS a lxp aining~llaLneriodic cleaning of the seU c ou et lter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. The long dimension of the at-grade distribution cell shall follow the countour. 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 maintenance of the POWTS. Sincerely, Leroy G. ansky, Wastewater Sp 'alist (715) 726-2544 Voice (715) 726-2549 Fax ljansky@commerce. state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Wi51v1AR'1' code: 7b33 . ~ ~ R~~~ J~ ~V~D ~,qli; ~ 2 3 ZOp3 Cover Pa~'~ ~~~~s o~~, Shaun Bird ~'~ $ ~ 3 °'~' ~ Q Bird Plumbing Inc. 1008 192nd Ave P.O.W.T.S. New Richmond Wi 54017 C"of~~dittOna~'ly 715-246-4516 ~~ DEPARTMENT OF COMMERCE DIVIS N 4F SAFETY AND BUILDINGS Date: 6/18/03 Owner: Bruce Moll ~~ ~o ~s~o ONCE Location: SW1/4 NW 1/4 S31 T29 N,R17 W L^gMIF~ Lot 1 150th St. Hammond System type: At-Grade Manuals Used: At-Grade Component Manual version 1.0 SBD 10570-P (R.6/99) SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST- SAS (01 /81) Page# 1. Cover Page 2. At-Grade Plot Plan 3. At-Grade Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-9. Maintance and Contigency plan 1(l-1 ~ Snil tPSt Shaun Birc Signature License ni PLOT PLAN PROJECT Bruce Moll ADDRESS 1840 80th Ave Hammond Wi 54015 SW 1/4 NW i/4S 31 /T 29 N!R 17 W TOWN Hammond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE6/18/03 BEDROOM 3 CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none ,BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 103.3' 330' Property Line Sca I e = 1 /4 ~~ = 1 O ~ i,oT'~ B.M. the contours and % slope was field verified by designer, B-1 and B-2 are not to used for installation purposes Pro 3 Bedroom House Area 15' below system is to remain undisturbed ~ B- 0 Grading is to be done to divert run- off away from system 103' 10\ 104' 103.3% B-4 Well is to meet B - all setbacks found in Comm. 83 Huffcutt Combo Tank Tank is to be properly bedded and provided with lockdown covers with approved warning labels ~'l B-1 ~ 4% Slope D 6-2 a~ .B ~6~ L ~ ~r ~ ~~ ~~ 'PVC FpRE.~,.MAtll „ ~~ -- --" _ T ~-- DESTPS~~:~>1Tlont LAT£..RAt -f SrABk~~~~D o8~~.vR~~ars '+~tELt t 5` lf68 ~ 1/6B ~ A = ~ ~'t- G S = V F~. = f~ L_ { v~ = ~ ~ ~t . r------, ~ ~_____~,~ „ i» GE t_ t_ o ~ lz, " Z f2 AGG~t~G.~FE }}QPRd~ED S~'A1Ti~ETIt. i`Q~~sC -" ST~rBti.'l~~D Qbseruat€on---~ Wei f !~ ~~ ~~~ \ 1 +i[ ! 2 ~ ~` p'sstribu;ion ~a~eral ,.~~ . Soil Cover B ..~ ~~ ~--' ~ .- 2 ~~ --;-~- 6.. ~ , ,., ,~. ~~ ~~ A ~~ 1 f SLOP Q r 2 L~WL© ~A~Li~ 5j Plan View and Cross Sects°n °£ Wisconsin At-grade Unit with a Single Absorption Area on a Sloping Site L1c~.~tsE.~~ Stv~a-tu ~~ Page flf pistri5utinn Pipe Detail 1 or ~ LatQral ~°tworlc * Last dale Should $e Next To ~uR~i-uP •~TtaRi~t •uP~~ ~~L~strout~ P~'C Force Mai n PYC Qistribntion Pipe ~ ~ P --~ ~Cce~~- ~D~t ` t ~r=~N lsh-ati!' Hole Diameter _~ Inch ~~ ~ ~ R ___.__.--- F t . ~- - X ~ inches La*_Qral Diameter Inch(es~ Y~ Inches Force Main Diameter ________ Inches ~." Uf Hol esl'Pipe -7 Invert E'ievation Of Laterals /~->. Fy. Signed: License Number: t3ate: --_ SEPTIC 'rA_..N`--t ~EATti£RPRDOf y'= GI ~tE13T PIPE iZ" MIN • A$OU£ GR.gDE ~ ,jUI+iCTI~7t~ 80X APPROVED MANHOLE CQv ER > Z S + ~`RaH D4fl~ , WINDOW 4R ~ ITH C~JNi3U I : W! PADLOCK ~ FRESH AIR iirITAKE ~ ~ W/~iII3~G LABEL FINISHED CSRADE _,_ ~~„~,___~:' MSN. ,~ ~ tr+n• ZY`~ ~- D` u I8" ZN • 1'it£ s ,s ~ I I~ LET i ~, WATER TIGHT SEALS ~ GAS- ~ , TIGIiT ~ _ ~ / VgQPRilYEfl ~ ~£At, _ ~ dait+i~S uITH ~~ LT ~R. } t ~ RLM AppRpYEO PIPE __ ___ $ `- '- QN 3' O~TI3 SOtIQ SOIL APPRaYED ; z PIPE 3' O~iTO SQlID V ~3 ~' FT ' C : 4FF SDI! . ' F EL£ pt32§P 4F D ~ ~! APPROVED BE#~DIN'G UI~IDER TA3+i~C SPr~'IFICATZONS COi~3CRETE PAD ~ !/ ~ ~. ~ ~~: SEPTIC / DOSE iANK MAt+t~)FACT4lRER: OAL . TA?~fK gI2£S = Dt?SEiC `~ ~ GAL- ALARM MOD L NLtMBER' ~iZTCH TYPE= p~~g MAidt7FAC'T[tR£R MODEL NtIK$ER SSdITCH TYPE= DI SCI~fARGE RATE I+R.3MB£Ft DOSES PER DAY = DOSE V t~;.~7~'tE GAL - F L0 SAC~~ S ~~,~`~INCHES A , = .../~~ ~r,s CaAL. : ~ CAPACITIE AL. g 2 INCHES = _____-_ ~ C ~~INCHES ` J GAL, = ~ i~tCIiES = G=-~'AL L D R Z NG AS PER _ _ I LHR 1+6.23 WAc ~ SGPM - PU24P ~ ALARM idI - ~~ F £ET R EQU I R £D ___-r I3ISTRIBU'iZON AMD Or F ~ FEET VERTICAL i~IFFEREIdC£ $EpRESUR£ + MIN Uti N£T~,?ORK S~3pPLY "GF x ~ . _ ~ • - CTQR TJIQO FT. £R;CTIOI3 FA HEAD .. ~' FEET _ • -~~ FEET ~ ~ + ~ c ,~ f £.£T FOR~£MAZN T£3TAL DYNAMIC `, , = -- , __------ ~,- . H , DIAMETER ~~_ I~J?£ttMAL DIMENSIDAIS ~I~' FUM? TANK: ~~ ~ ~ LIi~i3ZD ~--.---------' ~ ClT S ZG~IEI3, PUMP C€#AMBIwR Cr',OSS SEGT;ON AND Sp£CSz ICATIaNS i~$8 0 Q i U Q 0 J Q 1- GALLONS LITERS I p 80 160 240 320 HEAD CAPACITY CURVE MODES 152/ 153 w I~ I`` 50 153 2 4D 15~ 30 - 8 i 20 4 - 10 I ~ ~ ~ 0 20 40 60 80 10 W w FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS • Timed dosing panels available. "" • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Seated Qwik-Box available for outdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. 1521153 Series 1521153 MODELS Control Selection I Model VoItsTPh Mode Am~S ~ Simplex ~ Du lex ~1 N152 T115 1 Non 8.5 1 2 or 3 BN152 115 1 Auto 8.5 Included 2 or 3 E152 230 1 Non 4.3 t 2 or 3 BE152 230 1 Auto 4.3 Included 2 or 3 N153 115 1 Non 10.5 1 2 or 3 BN153 115 1 Auto I 10.5 Included 2 or 3 E153 230 1 Non 5.3 1 2 or 3 ~ BE153 230 1 Auto 5.3 Included 2 or 3 D CAUTION All installation of controls, protection devices and wiring should be done by a qualified licensed electrician. Ali electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Nealth Act (OSHA). TOTAL DYNAfd:tG HEAD~CAPACITY PER MI~UT~ EFFLUEfvT AND DEWATERING OMI DEL ~ 152 153 I Feel 'I Meters ~ Gel. I L:iers I poi. I r ~r°15 -- --- J -- ~~ j 1.5~ ~ 09 r ~ 2_u i 77 2.91 , ~-- (- p~T t ~ 6' ~-i 70 ~ 205 ~ i 15 4.6~ 53 i 201 '~ of 1231 ---r- ~O--~-1 ~ 44 ~ I- ~ 167 ~ 52 ^2 I-'.97-II ~ 15a 25 ~ 7.6 I 34 I 129 I ~ .JO ~J.1 L.J ~? 'i ~3 li ~ ~~i I I 35 i 10.7 -- _~ 2~ I _8 ---r---,--~-- I 40 ~ 1Z2 ~ -- ~ -- ~ 11 ~ 42 ~ L-- - - Look vole: ~a_°__.= - (''s,,-_~)~~4~~ Fi (?~.ar„)~ 3 27/ I l~ I'~R i I -~._-- SELECTION GUIDE I ~ >7/~2 i - ~I -~ ~;is_ _-L _~_ I 5 ~/3 _-.1- srczosa 1. Single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0477. 2. See FM0712 for correct model of Electrical Alternator E-Pak. 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) or (4) float system. 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 _~ /7 ~./~~~'~-.- Louisville, KY 40256-0347 Manuiacturersot. . ~ ~ ~ / J ~. ShLoui~ it e~KY 4021R1 1961 ad , Z ~ ,~ ~~1 Ri.~l \I ~ ~ ,QLLQL.TY ~Uh1PS ,/iNCE ~r/~~/ ~~ ~ /y~~w ,gyp ~O (502) 77 ~ X502) 7403624 SUMP htip://www.zoeller.com / ,Y,! © Copyright 2000 Zoeller Co. All rights reserved. Wisconsin Department of Commerce SOIL EVAL ATI~~I~ Division of Safety and Buildings in accordance with Comm 85, is. Adfrl,,~od~ AA fP~' j~( y Attach complete site plan on paper not less than 8'/= x 11 inches in size. Plan m st include, but not limited to; vertical and horizontal reference point (BM), direction nd ~ CI~01 X 1` percent slope, scale or dimemsions, north arrow, and location and distance ton rest ri>'a~ONING FFICE Please print all information. R vi Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 1181 . Page 1 of 3 Certified Soil Testing St. Croix CSM Pending ~ < _ Date Moll, Bruce Govt. Lot SW 1/4 NW 1/4 S 31 29 ~ Property caner s ai Ing ress Lot- Block # Subd. Name or CSM 1840 80th Ave. 1 CSM Pending City State Zip ode Phone Number Cit Village Town Nearest Road Hammond ~ WI 54015 715-796-5491 Hammond 150Th St. / 17 W ~j New Construction Use: Residential /Number of bedrooms 3 Code derived design flow rate 5 J Replacement ( Public or commercial -Describe: Parent material till Flood plain elevation, if applicable General comments and recommendations: no residence staked; 3 br assumed; shallow conventional or at-grade system OK B-3-4-5 area; system OK whole area surveyed GPD NA mound Boring # Boring Pit Ground Surface elev. 100.4 ft. De th to limitin factor 31 ~in• P 9 ~ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-4 10YR 3/1 - sil 2 m gr ds cs 2f1 m .5 .8 2 4-11 10YR 3/2 - sil - 2 f sbk ,.dsh cs 1m .5 I .8 3 11-31 10YR 4/4 - sl 1 m sbk dh gs 1m .4 .6 4 ~ 5 7.5YR 4/4 - scl 0 m mfi cs - 0 0 5 55-82 10YR 7/3 c2d 7.5YR 4/6 Is 0 sg ml - - .7 ~ 1.2 ~ ortzon as occasiona s ra i ie an s o s Boring # Boring Pit Ground Surface elev. 101.5 ft. De th to limitin factor 32 in. P 9 ~c Soil Application Rate Hcrizcn ~ Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPO/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-6 10YR 3/1 - sil 2 m gr ds cs 2f1m .5 8 2 6-17 10YR 3/2 - sil 2 f sbk dsh cs 1 m .5 .8 3 17-29 10YR 4/4 - sl 1 m sbk dvh cs 1 m .4 ~ .6 4 29-32 10YR 7/3 - fs 0 sg dl cs - .5 9 5 32-44 10YR 8/2 f2d 7.5YR 4/6 fs 0 m dvh cs - 0 0 6 44-58 10YR 6/4 c2d 7.5YR 4/6 sl 0 m mfr cs - -- .3 ~ .5 7 58-70 7.5YR 3/4 - scl 0 m mfr - - 0 0 ' Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L ame ease rin igna ur um er Henry F. Grote 222774 Address Certified Soil Testing D valuatio Conduc ed Telephone Number E. 4366 353rd Ave., Menomonie, WI 54 /28/2000 715-233-0398 Property Owner MOII, Bruce Parcel 1D # CSM Pend'In ~ Page - 2 of 3 Boring # Boring Pit Ground Surface elev. 102.8 ft• Depth to limiting factor 50 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 1 0-4 10YR 3/1 - sil 2 m gr ds cs 2f1 m .5 .8 2 4-12 10YR 3/2 - sil 2 f sbk dsh cs 1 m .5 .8 3 12-31 10YR 4/4 - sl 1 m sbk dh cs 1 m .4 .6 4 31-50 7.5YR 4/4 - s 0 s dl cs 1 m .7 1.2 5 50- 2 7.5YR 4/3 f2d 7.5YR 4/6,5/3 sl 0 m mfr cs - .3 .5 6 52-72 5YR 4/4 - scl 0 m mfi cs - 0 0 7 72-76 10YR 7/3 c2d 7.5YR 4/6 fs 0 sg ml - - .5 .9 Boring # Boring Depth to limitin factor ft g • Pit Ground Surface elev. 103.6 54 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture SVucture Consistence Boundary Roots GPD/ft _ - in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ~Eff#i 1 0-4 10YR 3/1 - sil 2 m gr ds cs 2f1 m .5 .8 2 4-13 10YR 3/2 - sil 2 f sbk dsh cs 1 m .5 .8 3 13-34 10YR 4/4 - sl 1 m sbk dvh cs 1 m ~ .4 ~ .6 4 34-39 7.5YR 4/6 - s 0 dl cs - .7 1.2 5 39-54 7.5YR 4/4 - sl 0 m mfi cs - .3 .5 6 ~ 54- 6 7.5YR 4/4 c1 d 10YR 6/2 scl 0 m mfi - - 0 i 0 - ~ ^ Boring # Boring Pit Ground Surface elev. 103.5 ft. Depth to limiting factor 42 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Q(ft= - in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ~~ 1 0-5 10YR 3/1 - sil 2 m gr ds cs 2f1 m .5 .8 2 5-14 10YR 3/2 - sil 2 f sbk dsh cs ' 1 m .5 .8 3 14-31 10YR 4/4 _ sl 1 m sbk dvh gs 1 m -- .4 r-- .6 4 31-42 5YR 4/4 _ sl 0 m mfr cs 1 m .3 +~ 5 5 42 48 2.5Y 6/4 f2d 7.5Y scl 0 m mfr cs - 0 ~ 0 6 48-60 7.5YR 4/3 - scl 0 m mvfr - - 0 0 ' Effluent #1 = BODS> 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 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) Certified Soil Testirx~ Ptoperty Cf~rner M011, Bruce Parcel ID # CSM Pending Page 2 of 3 ^Boring # ®Boring Pit Ground Surface elev. 102.8 ft• Depth to limiting factor 50 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-4 10YR 3/1 - sil 2 m gr ds cs 2f1 m .5 .8 2 4-12 10YR 3/2 - sil 2 f sbk dsh cs 1 m .5 j .8 3 12-31 10YR 4/4 _ sl 1 m sbk dh cs 1 m .4 .6 4 31-50 7.5YR 4/4 - s 0 sg dl cs 1 m .7 1.2 5 50-52 7.5YR 4/3 f2d 7.5YR 4/6,5/3 sl 0 m mfr cs - .3 .5 6 52-72 5YR 4/4 - scl 0 m mfi cs - 0 0 7 72-76 10YR 7/3 c2d 7.5YR 4/6 fs 0 sg ml - - .5 .9 ^Boring # Boring Pit Ground Surface elev. 103.6 ft. Depth to limiting factor 54 in. Soil Application Rate Horizon Depth Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots.. GPD/ft' _ - in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. _ Eff#~ 1 0-4 10YR 3/1 _ sil 2 m gr ds cs 2f1 m .5 ~ .8 2 4-13 10YR 3/2 - sil 2 f sbk dsh cs 1 m .5 ~ .8 3 13-34 10YR 4/4 _ sl 1 m sbk dvh cs 1 m .4 ~ 6 4 34-39 7.5YR 4/6 - s 0 sg dl cs - .7 j 1.2 5 39-54 7.5YR 4/4 _ sl 0 m mfi cs - .3 ~ .5 6 ~ 54-76 7.5YR 4/4 c1 d 10YR 6/2 scl 0 m mfi - - 0 ~ 0 ^ Boring # Boring Pit Ground Surface elev. 103.5 ft• Depth to limiting factor 42 in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots SzPD/ft_ Ef~i 1 0-5 10YR 3/1 - sil 2 m gr ds cs 2f1 m .5 ~ .8 2 5-14 10YR 3/2 - sil 2 f sbk dsh cs 1 m .5 ~ .8 3 14-31 10YR 4/4 _ sl 1 m sbk dvh gs 1 m .4 ~ .6 ----- 4 31-42 5YR 4/4 - sl 0 m mfr cs 1 m T .3 S 5 42-48 2.5Y 6/4 f2d 7.5YR 4/6 scl 0 m mfr cs - 0 0 - 6 48-60 7.5YR 4/3 - scl 0 m mvfr - - , -- 0 i 0 ' Effluent #1 = BODS> 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 608-266-3 I51 or TTY 608-264-8777. SBD-8330 (R.o7/UO) Certified Sal Testing < ,.. . . ¢ a ~ ~ u 4 + ~ ~ o v ~ C~ ~' ~ ~ a ,~ i ~ j ~ O ~ Mt ~ ~ ~1 f ~ ~~ { ,~ ,~ ~ ~ ~ ~ ,n 6 ~ 3 -r ~~ ~ ~ : s ~- `r' 9 j_ ~ ; 0 s --~ n~ ~" 9 ~i+ 1 ~'' '.. 0 0 0 :~ c ,„ ~~ ~ o d t~ N N ~i l ^ .~ 2 f -- --~ O J N ~r .~ fl ~J ,~ ~ K CT ~! ~~yy~ ,.h i d 9 1 ~ .~/ ~ ~ '~ 2 ~ -~ ~ ° ~' .~ O ~ ~ 1 o o f ..,~ i ~ ..~ ~ ~ ~ `~ ~ d ~ ~ ~~~ ~~ a J ,...~ .- ~ ,~ ~ j J .~ • ~ ~~ ~ aZ 0 v M Maintenance and Contingency Plan for a At-grade System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Dose Chamber is to be pumped at the same time as the septic tank. 3. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 4. Once every 3 years the mound is to be inspected via the inspections pipes in the at- grade. The laterals are to be inspected via the cleanouts. 5.Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 6. Pump and electrical components are to be checked at the time of the pumping. 7.Owner agrees to leave the area 15' below at-grade undisturbed. 8. The owner agrees to save this plan. 9. Trees, shrubs, and other similiar vegitation are not be planted on system. The system is not be driven over. 10. Effluent Quality is not to excede the requirements found in Comm. 83 Contingency Plan 1. Pump alarm goes off, call pumper and pump out dose chamber and septic tank if needed, then bypass pump float and try pump with out float. If this works, float is bad, replace float. If pump still does not work, check power at the pump with a electrical device such as a hair dryer. If no power, check breaker inside house and call a electrician. If there is power, then pump is bad and needs to be replaced by a plumber. 2. If at-grade fails, determine cause of failure, test another area or remove pipe and sewer rock, retill soil, install new mound system. 3. Replace any other failing components as needed. Important Phone Numbers Plumber: Shaun Bird 715-246-4516 Pumper: Tom Mondor 715-246-5148 St. Croix County Zoning 715-386-4680 FILE iNFORN[ATtO_N _.. pwner Permit #. ~ poW-I-s,ovyNER'S MANUAL. & MANAGEMENT PLAN SYSTEM SPI=GIFICAT_iONs ~ ~~^ Septic lank Capa~tY i ~ ` Septic Tank Manufacturer ~" Effluent Filter Manufacturer DESIGN PARAMETERS `~ ~ ^ NA Number of Bedrooms ~ Number of Commercial Units j ,~~ Ud Estimated flow (average) a a ~ atld Design flow (Peak), (Estimated x ~ _5) ~ z aUda /ft Sol Application Rate Monthly average' lnfluentlEffluent Quality FOG) .Oil 8~ Grease ( Fats ~i0 mg/L , Biochemical Oxygen Demand (BODS) (TSS) lid Q20 mg/L 5150 m /L s Total Suspended So ^ NA Pretreated Effluent Quality Monthly average'` giochemigl Oxygen Demand (SODS) l Suspended Solids CrSS) t ~p mg/L 530 mg/L ` a To Fecal Coliform (georrtetric mean) cfu/1i?Oml s10 Y inch diameter Maximum Effluent Particle Size ~________._ MAINTENANCE SCNEDU~E - Service Event Inspect condition of tank(s) Pump out contents of tank(s) Inspect dispersal cell(s) Clean effluent filter Inspect pump, Pump controls 8~ alarm Flush laterals and pressure te___ st _ Effluent Flter Model Pump Tank Capacity pump Tank Manufacturer Pump Manufacturer Pump Model Pretreatment Unit , ~ Sand/Gr~vei Filer ^ Mechanical Aeration ^ Disinfection Page ~of ~J al ^ NA s..-~ _E7 ^ NA ~A~, ^ NA '.~ „mot ^ NA i i . ~, ~ ~ ~\~ .~ G~ ^ Peat Filter ^ Wetland O Other ^ NA ^ NA ^NA!. Dispersal Cel[(s) ^ !n-ground (gravity) ^ In-ground (pressurized) ~t-grade ^ Mound ^ bri ine ^ Other. Values typical for domestic (noR-commerdaQ waste~i,~ater end septic tank effluent. Values typical for pretreated wastewater- Service Frequency ^ months or(s) (Maximum 3 yrs_} At least once every ~ y of tank volume When combined sludge and scum equals one-third (') Mazimum 3 yrs.) At least once every ,~ ^ months or(s) ( At least once every At least once every At least once every At least once every At least once every ^ months ths~year{s) ^ NA ^ months ear(s) ^ NA s ^ months ^ year(s) ^ NA ^ months ^ year(s) ^ NA other- MA1NTEt+iANCE INSTRUCTIONS n one of the following licenses or inspections of tanks and dispersal cells shall be made by an individual canyi 9 clot, POWTS Maintainer, Septage missin or broken certifications: Master Plumber. Master Plumber Restnded Sewer, POWTS nspe to identi any 9 Servidng Operator- Tank inspections must include a visual inspet~ion of the tank(s) fY tea to check the effluent levels hardware, identify any cracks or leaks, measure thdtsolursmal cell)( ) shall~beivisually inscpec and to check forUen oncthep or ponding of effluent on the ground surface. The Pe ndin of effl ndin of effluent on the ground surface- The Po g authority in the observation pipes and to check for any Po g wires the Immediate notification of the local regulatory ground surface may indicate a failing condition and req uais one-third (Y=) or more of the tank volume, the When the combined accumulation of sludge and scorn in any tank eq nts of the tank shall tie removed by a Septage Servicing Operator and disposed of in accordance with ch. N enure Conte _ 113, >Nsconsin Administrative Code. retreat ment components, and any The servicing of effluent filters, mechanists oP12 mo tits orOiess steal be performed by a certified POVVTS Maintainer- other maintenance or monitoring at interva ulato authority within 10 days of completion of any sennce event. A service report shalt be provided to the local reg rY s~ for the presence of painting products or other STARTUP AND OPERATION For new construction, prior to use of the POVVi•S check treatment tank(, ersal cell(s) if high concentrations are chemicals mat may impede the treatment process and/or damage the dis o rotor prior to use_ detected have the Contents of the tank(s) removed by a septage servicing pe Page ~/ of ~~ ti ~ Syst~nl stmt uP shall not oct-ur when Sot{conditions are frozen at the infiltrativQ susfia~cef IS restored the @XCeSs er outages pump tanks may fill above normal highwater lev$1s. V1(hen po During p°'~ rsal cell(s) in one large dose, overloading the ceums) ~nkrremoved bn a e wastewater wilt be discharged to the dispe backup or surface discharge of effiuer~t To aYOw~ fo the effluent pump orncontact a Plumber or POWTS Maintainer to Septage Servicing Operator prior-tA restoring pv assist in manually operating the Pump commis to restore normal levels within the pump tank not drive or park vehides over tanks and dispersal cetlse soot abso tionr area aver, or otherwise disturb or compact, Do the area within 15 feet down slope of any mound or at-gra ~ rformance and prolong the life Reduction or elimination of ~~ hawing from the waste~ndoms~; cottonyswabs,' degreacers; dental floss; diapers; of the POVYTS: antibiotics, y pes; dgarette butts; disinfectants; fat; foundation drain (sump Pump) water, fruit and vegetable peettngs; gasoline; grease; herbiddes; meat spays; medications; oil; painting prvduk~s; pesficides; sanitary napkins, tampons: and water softener brine. ABANDONMMF_NT When the POWTS fails andJor bandoned in compeance with ch- Comm 83.33n VYisconsm Admi~nistr3tive Codethat the system is property and safety a o nin s sealed. All piping to tanks and pits shall be disconnected and the aband ~ sdpo8e~d of by a eptage Servicing Operator. The contents of alt tanks and pits shall be removed and property • After pumping, aft tanks and pits sha![ be excavated and removed or their covers removed and the void space filled with soil, grave! or another inert solid material. CONTINGENCY PLAN tf the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a e compliant replacement system: p A suitable replacemen e ~ lace ~ t areaisho~uld be protected from d stulrbance and campalcU~o and should not absorption system. Th p tie infringed upon by required setbacks from existing and proposed st,rUCture, tot lines and wells. Failure o protect the replacement area rrrill result in the need for avnth thof rule in effect at thatt6me~bHsh a suitable replacement area. Replacement systems must comply p A suitable replacement area is betinstalled as a last etsort to epoace ithe failed POWTSng advances in POWTS tech ology a holding tank. may n failure of e POWTS a soil and -D1e rte not bee valuated identify a s - le replaceme t area tlpo to en - avaiiable a site ati n mu be ed oca a suitab re men rea_ no p holdi tank a instaAed as a last resort to replace the failed PO S. Mound and at-grade soil absorption systems mayybse reconstructed in P~~ ~e ~ es9n effect atothat time. at at the infiltrative surface. Reconstructions of such s terns must comply «WARNlNG» SEPTIC, PUMP AND OTHER'(RF~1o OTHER TREATMENT TANK UNDER ANY GiRCUMSTOANCESFbEATH MAY GE . DO NOT ENTER A SEPTIC, PUM RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE ADOiTIONAL COMMENTS POWTS INSTALLER POWTS MAJNTAINER Name ~ y!'t~ 1'~-',~.~ ~ " Name ~ Erh~~ ~ ~~ ~/~/~ > a .,-`> Phone °"~ -~'"--'~'I L' .~ Phone °~? , j ~ ~' J SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORfTY' Name J , , % r >~~ Agency . ~,7'~'~~E ~ ,~^ ~~"~ Phone `-~ _..- ~; , ~ /~ ~~ Phone ~~J'~ r-% / J the staffs of the Green Lake, Marquette and Waushara County Zoning and Sarirtation agEndes. This decutrtent meets This document ryas Grafted by the minimum raquicements of ch. Comm s322(2)(b)(t}(d)&(f) and 83.54(1}, (2) 8~ (3), Wisconsin AdminisUativa Code- Use of this document does not GMw (?JOt) guarantee the performance of the POVYTS_ ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Mailing Address °~ Property Address City/State Parcel Identification Number ~~~-~y~ ~~~~~~ LEGAL DESCRIPTION o ~7 ~~ -~~ Property Location ~~~'/4, .~~`/., Sec. ~, T~N-R~W, Town of ~ /-'~ Subdivision .Lot # r Certified Survey Map # ~0'-f5~~(~ ,Volume ~~ ,Page # ~~ Warranty Deed # ~ l ~l ~ ~d .Volume z ~ ~ ~ .Page # ~ 3~ Spec house ^ yes~,no Lot lines identifiable yes ^ 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 treatmcat stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a cation form, signed by the owner and by a mastprplumber, joumeymanplumber, restrictedplumber or a licensedpumperverifying that (1) the on site wastewaterdisposalaystem is is proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/vve, 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 septi tem has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of th y expiration date. ~~~~~ SI OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property 'bed hove, by virtue of a warranty deed recorded in Register of Deeds Office. ~~~~ GNA OF APPLICANT DATE ****** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. *'`***"` '~D,~ r f /ri~ ~/ (Verification required from Planning Department for new ** Include with this application: 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 ~J 2' 2 1 1 P 1 3 8 I STATE BAR OF WISCONSIN FORM 1 - 1999 Document Number WARRANTY DEED This Deed, made between Bruce J. Moll & Thomas S. Aabv. Grantors, and Brvan J Kofal & Melanie D. Cress. Grantees. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in t. Croix County, State of Wisconsin (the "Property") (if more space is needed, please attach addendum): Lot Certified Survey Map filed May 18, 2001 in Vol. 5 of Certified urvey Maps, Pa a as Doc. No. 645866, located in part of SWt/, of NW'/s of Section 31, Township 9 Nort ~, ge 17 West, except the South 170 feet of the West 256.24 feet thereof, St. Croix County, Wisconsin. Recording Area ~ 1 794 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO.. MI RECEIVED FOR RECORD 04/21/2003 09:30AIi WARRANTY DEED EXEMpT # REC FEE: 11.00 TRANS FEE: 97.50 COPY FEE: CC FEE: PAGES: 1 Name a>rA Return Address Edina Realty Title 400 South Second Street, Suite 115 Hudson, WI 54016 Together with all appurtenant rights, title and interests. 018-1069-00-100 Parcel Identification Number (PIN) This Is Not homestead property (is ) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except liens, encumb)ra~nc~e/mss, restriMions ofnrmencord, if any. Dated this / ' '" t day of ~l 'C ~ ~ , 2003 * Bruce J. M * Thomas S. Aaby AUTHENTICATION Signature(s) authenticated this da f Dt~e ~. _._[~Lota-rv Public * State of Wisconsin TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Michael A. Jacobson, Halnmarback Murray & Jacobson, S.C. 714 N. Main St., P.O. Box 467, River Falls, WI 54022 (Signatures may be authenticated or acknowledged. Both are not necessary.) persons signing in any capacity must WARRANTY DEED ACKNOWLEDGMENT STATE OF WISCONSIN ~.., ~ 1 ~ County ss. Personalty came before me this r ! ' ' `day of the above name o ~ n.,Uss~a to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. * Notary Public, State of My Commission is permanent. (If not, state expiration date: l~ ~/ ~-ate ~ .> or printed below their signature. STATE BAR OF WISCONSIN FORM No. 1-1999 Information Professionals Co., Fond du Lac, Wl 80!1655-2021 -. ;,,,. ...~ __ ,~IINMM~~^ - nn^ EROSION CONTROL PLAN ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 • Fax (715) 386-4686 For Lot 1, (CSM#6458661655 150`h St. (Hammond Twp.)_- Owner(s) Brvan Kofal Under St. Croix County Zoning Code 17.70(3)(b) 5: "The (Zoning) Administrator may attach reasonable erosion prevention conditions to a permit approved for issuance." Wisconsin Admin. Code Comm. 21.125 requires the building permit applicant and/or landowner to follow erosion control procedures and maintain them until the site has been stabilized. The Owner is responsible for notifying all contractors performing construction on this site that an Erosion Control Plan is in effect and the following activities will be required in order to maintain compliance with the plan: 1. The primary source for construction site runoff will be the house foundation excavation, driveway, and any soil stockpiled until final grading and stabilization is complete. Septic system excavation/installation adds to temporary disturbance, but establishing cover on exposed soils will prevent erosion. Plan to apply seed and mulch as recommended in #5 below. Maintain existing vegetation wherever possible to minimize sediment movement. The proposed septic system is >100 ft. west of a tributary to the South Branch of the Kinnickinnic River. 2. Route contaminated runoff into stabilized vegetated buffer areas by creating temporary diversions graded ALONG CONTOUR between excavation areas and any drainage ditches or waterways (see attached detail for construction of diversions). Make sure no concentrated drainages or ditches can pick up runoff and/or create erosion problems or transport sediment onto Lot 4 and/or into the above-mentioned tributary. 3. If builder/excavator grades the site to create temporary diversions (see #2) to contain sediment and leaves adequate vegetative cover to protect areas of concern, installation of silt fence may not be necessary. However, silt fence or other approved sediment control products will be required if sediment cannot be contained on owner's property with the diversions and vegetative buffers. The Building Inspector or POWTS Inspector will evaluate ESC plan effectiveness and make recommendations to owner and building inspector for any action required to comply with applicable regulations. 4. Construction equipment and vehicles must utilize a stabilized driveway access off public road for heavy equipment; this includes cement trucks, well drillers, and other contractor's vehicles that access the property during construction. This helps avoid muddy, rutted conditions that may allow contaminated runoff to reach waterways and/or drainage ditches. Property owner is responsible for repair of damage to ditches resulting from multiple access points and sediment tracked on public roadways must be removed at the end of each workday. 5. Stabilize all disturbed areas with topsoil cover, seed and mulch immediately after final grading. If weather does not permit seed germination, a heavy straw mulch cover will prevent erosion until grass/vegetation can get established. On steep slopes or areas with little topsoil cover, erosion control matting can be applied any time of year and if installed properly, will provide protection even if seed germination is delayed. The owner of record during site construction will be responsible for compliance with the ESC Plan. Please feel free to contact me with questions or ask for assistance with erosion & sediment control installation. Prepared by: Pam Quinn Soil Erosion Inspector #665054 Owner acknowledgement of ESC Plan requirements: /_/2003 EROSION CONTROL REGULATIONS Erosion control and stormwater regulations can be complex. Local, state and, in some cases, federal regulations may apply. Before construction make sure you have the appropriate permits. LOCAL ORDINANCES Check with your county, city, village, or town for any local erosion control ordinances including shoreland zoning require- ments. Except for new 1- SZ 2-family dwellings, local ordinances may be more strict than state regulations. They may also require erosion control on construction projects not affected by state or federal regulations. UNIFORM DWELLING CODE (DEPT. OF COMMERCE) CONTROLS REQUIRED • Silt fences, straw bales, or other approved perimeter measures along downslope sides and side slopes. • Access drive. • Straw bales, filter fabric fences or other barriers to protect on-site sewer inlets. • Additional controls if needed for steep slopes or other special conditions. FOR MORE INFORMATION, CONTACT: Local building inspector • Department of Commerce, Safety and Buildings Division, P.O. Box 7162, Madison, Wis. 53707, (608) 267-5113. STORMWATER PERMIT (DEPT. OF NATURAL RESOURCES) CONTROLS REQUIRED FOR MORE INFORMATION, CONTACT • Erosion control measures specified in the Wisconsin Department of Natural Resources, Storm Water Permits, Construction Site Best Management Practice Handbook. P.O. 7921, Madison, WI 53707-7921, (608) 266-7078. • Measures to control storm water after construction. For more assistance on plan preparation, refer to the Wisconsin Uniform Dwelling Code, the DNR Wisconsin Construction Site Best Management Handbook, and UW-Extension publication Erosion Control for Home Builders. The Wisconsin Uniform Dwelling Code and the Wisconsin Construction Site Best Management Handbook are available through the State of Wisconsin Document Sales, (608) 266-3558. Erosion Control for Home Builders (GWQ001) can be ordered through Extension Publications, (608) 262-3346 or the Department of Commerce, (608) 267-4405. A PDF version of Erosion Control for Home Builders (GWQ001) and Standard Erosion Control Plan are also available at http://clean-water.uwex.edu/pubs/sheets This publication is available from county UW-Extension offices or from Extension Publications, 45 N. Charter St., Madison, WI 53715. (608) 262-3346 or toll-free (877) 947-7827. A publication of the University of uw Wisconsin-Extension in cooperation with the Wisconsin Department of Natural Resources and the Wisconsin ~xrEnsion Department of Commerce. ©1999 by the Board of Regents of the University of Wisconsin System. Send inquiries about copyright permission to: Director, Cooperative Extension Publications, 201 Hiram Smith Hall, 1545 Observatory Dr., Madison, WI 53706. University of Wisconsin-Extension is an EEOJAffirmative Action employer and provides equal opportunities in employment and programming, including Title IX and ADA requirements. GWQOOIA Standard Erosion Control Plan for 1 bt 2 Family Dwelling Construction Sites DNR WT-458-96 R-02-02-2M-10-S Editing and design by the Environmental Resources Center, University of Wisconsin-Extension. h' Printed on ~~ reryded paper W ~ , J' m V a Indicate management strategy by checking (/) the appropriate box. Q a` o Management Strategies v z ^ ~ Temporary stabilization of disturbed areas. Note: It is recommended that disturbed areas and soil piles left inactive for extended periods of time be stabilized by seeding (between April 1 and September 15), or by other cover, such as tarping or mulching. Permanent stabilization of site by re-vegetation or other means as soon as possible (lawn establishment). • Indicate re-vegetation method:Seed ^ Sod ^ Other • Expected date of permanent re-vegetation: ~ -ent 3C ~ Z tro 3 • Re-vegetation responsibility of: ^ Builder ~ Owner/Buyer • Is temporary seeding or mulching planne ' if site is not seeded by Sept. 15 or sodded by Nov. 15? ^ Yes No 'Q Use of downspout and/or sump pump outlet extensions. Note: It is recommended that flow from downspouts and sump pump outlets be routed through plastic drainage pipe to stable areas such as established sod or pavement. ;0' Trapping sediment during de-watering operations. Note: Sediment-laden discharge water from pumping operations should be ponded behind a sediment barrier until most of the sediment settles out. Proper disposal of building material waste so that pollutants and debris are not carried off-site by wind or water. Maintenance of erosion control practices. • Sediment will be removed from behind sediment fences and barriers before it reaches a depth that is equal to half the height o f the barrier. • Breaks and gaps in sediment fences and barriers will be repaired imme- diately. Decomposing straw bales will be replaced (typical bale life is three months). • All sediment that moves off-site due to construction activity will be cleaned up before the end of the same workday. • All sediment that moves off-site due to storm events will be cleaned up before the end of the next workday. • Access drives will be maintained throughout construction. • All installed erosion control practices will be maintained until the disturbed areas they protect are stabilized. _n w ...E ~. W m ~' EROSION CONTROL PLAN CHECKLIST Check (/) appropriate boxes below, and complete the site diagram Q` with necessary information. H z Site Characteristics North arrow, scale, and site boundary. Indicate and name adjacent streets or roadways. Location of existing drainageways, streams, rivers, lakes, wetlands or wells. Location of storm sewer inlets. 0 ~. o o ~+, o ~r o o ~, 0 Location of existing and proposed buildings and paved areas. The disturbed area on the lot. Approximate gradient and direction of slopes before grading operations. Approximate gradient and direction of slopes after grading operations. Overland runoff (sheet flow) coming onto the site from adjacent areas. Erosion Control Practices Location of temporary soil storage piles. Note: Soil storage piles should be placed behind a sediment fence, a 10 foot wide vegetative strip, or should be covered with a tarp or more than 25 feet from any downslope road or drainageway. Location of access drive(s). Note: Access drive should have 2 to 3 inch aggregate stone laid at least 7 feet wide and 6 inches thick. Drives should extend from the roadway 50 feet or to the house foundation (whichever is less). Location of sediment controls (filter fabric fence, straw bale fence or 10-foot-wide vegetative strip) that will prevent eroded soil from leaving the site. Location of sediment barriers around on-site storm sewer inlets. Location of diversions. Note: Although not specifically required by code, it is recommended that concen- trated flow (drainageways) be diverted (re-directed) around disturbed areas. Overland runoff (sheet flow)from adjacent areas greater than 10,000 sq. ft. should also be diverted around disturbed areas. Location of practices that will be applied to control erosion on steep slopes (greater than 12% grade). Note: Such practices include maintaining existing vegetation, placement of additional sediment fences, diversions, and re-vegetation by sodding or seeding with use of erosion control mats. Location of practices that will control erosion on areas of concentrated runoff flow. Note: Unstabilized drainageways, ditches, diversions, and inlets should be protected from erosion through use of such practices as in-channel fabric or straw bale barriers, erosion control mats, staked sod, and rock rip-rap. When used, a given in-channel barrier should not receive drainage from more than two acres of unpaved area, or one acre of paved area. In-channel practices should not be installed in perennial streams (streams with year round flow). Location of other planned practices not already noted. Standard Erosion Control plan for 1- & 2-Family Dwelling Construction Sites According to Chapters Comm 20 St 21 of the Wisconsin Uniform Dwelling Code, soil erosion control information needs to be included on the plot plan which is submitted and approved prior to the issuance of building permits for 1- & 2-family dwelling units in those jurisdictions where the soil erosion control provisions of the Uniform Dwelling Code are enforced. This Standard Erosion Control Plan is provided to assist in meeting this requirement. Instructions: 1. Complete this plan by filling in requested information, completing the site diagram and marking appropriate boxes on the inside of this form. 2. In completing the site diagram, give consideration to potential erosion that may occur before, during, and after grading. Water runoff patterns can change significantly as a site is reshaped. 3. Submit this plan at the time of buildin permit application. PROJECT LOCATION BUILDER kw~r.. WORKSHEET COMPLETED BY OWNER ~~,r`~ DATE ~-31v"'"~ Please indicate north by completinng the arrow. „J -N- CITL AIA~"AAAA _ _ (i11_ 4982000m.N. 12 ..~~ i I ~ ~c p ~o' o ~~ 7F -/ p I Ip6 i i I i ~~~ i, io i ~ , I ° I I I I I 24 ~ I - 1 -L-~--I~- -- //oo- ~ ~ ~----~---- i -! I ~ I /ozo ~~~. I I - I oI I 4981_... ~ I: I I //pp I ~' ~/ ~ ~~ ~ ~ 'oso I I I a I ~ I ~ A ~~....~ I _...~,- ~ ~ ~ ~ I BM I o i /050 i /058 /07 TT I ° o I I ^• / 060 I I ~ ~,/ " L I .~ ~ ~ I ~~ I ~- ~ `, -- -- -- - - --- 4980 I I ~. I I ~~~ I I 25 I ozo I ~ - --- - -- - -- -- --- ~- - --I-- ~ - /090 ~. I I ~~ I I I Ip401 ~ I I //00 D I I ~I o I r I ~ 000 .. ~ ~ i 4979 ~ / I ° 0 o i /049 i / - ~ I /04~J ~ .o /030 i~atholic Cem ~ ~ .~ ° / ~ -~ ~~ i o j. / ~ ~ . //~~~~ o ' 9s , ~ a-n~ -- - - - ~~ ~ °~ t- _~ ~•.~..~ Y,, ~. L 57'30" ; ~q'o~ ~ ~'~ ~ ~ ~ Ktinn~~ innaso~. I ~~ ~ ~ ~~ ~~ ~~ I ~~.~_..~ /054 132 _ _ _ __ _ 0 ° 3 i i -- 4978 / 44 ~ --- ~ - - - - - - ~ ;0 I _ I O,, ' I I °1 o I -- '( ~~ / /oo I - ---- - --~--- --- ° ° - --- - - i -~ -. - I ~ T 29 N /NE ,/045 -- i / /07 '' ~e 1 . v~.a ~,~ - l 29 T28N~ --. .... ~~. I - o.~ Q 'n __ _ _ u ~ ~\ In II ~ r,~J/ `•~ ~~ ~~ .. . ~.,, I ~---- ~SO_ ~ V 1 ~ ~ ~.,~n .. / II -~ ,rte r{/ 1 ~~,,. 6~a866 ~"°'"' ERTIFIED SURVEY MAP frATED IN PART OF THE SW1/4 OF THE NW1/4 OF SECTION 31, `_ ..* 9N, R17V1/. TOWN OF HAMMOND, ST. CROIX COUNTY, WISCONSIN. NW CORNER BENCHMARK© LEGEND SECTION 31 SE CORNER BRIDGE CONCRETE CURB ~ ALUMINUM COUNTY SECTION CORNER OWNER ELEVATION =989.32 MONUMENT FOUND W O BRUCE MOLL U.S.G.S. DATUM 0 ~ ~i 1' X 24° IRON PIPE SET WEIGHING o u~ 1840 BOTH AVENUE - 1.13 LBS. PER LINEAR FOOT HAMMOND, WI 54015 100' ROADWAY SETBACK UNE (OR AS SHOWN) z w '. g ~ BENCHMARK A '~ Z u~] M m MASONRY NAIL FOUND ~ ~ C DOUBLE SP IN POWERPOLE OO 1' STEEL SURVEY MARKER FOUND ~ ELEVATION =989.33 ~ ~ ~w U.S.G.S. DATUM ~ z ~ NJ~n]p1~Q44C~D dLn1G~lD~ OO ~7f~C~© D~'l 04G7C~G3~ ~ Lu ~ NORTH LINE OFTHE SW1/4 OF THE NW1/4 m $ ~' ' ~ S89°24'28'W 1373.16' ~ w I ~` __ _/ X 0 33,0p' ; HIGH WATER UNE ELEVATION (DETERMINED FORA 100 YEAH `~ \ FLOOD PER NOTES ON THE HYDRAULIC REPORT) WAS DEANED 28'+/- Z \ PROM A HYDRAULIC REPORT DONE FOR THE 150TH STREET ; F/~y STATEPROJECTI.D.1000.76-22 ~ BRIDGE ` ` wq~ ` ` 80UTH BRANCH ~ ~~ ~ ~ ``\ ~ ~ ~ -_, KINNICKINNIC RIVER - ~ e $ ~~2 ~ ---- POEED F o P ` ~ `~ CENTERLINE OF ID ` ~ • ` \ ~ LOCATED SWALE -~ w 33' 33' S8Y39'3B1N363.01' s, ~ U ~- ------'----' • z ~` ~' ~ ~ ~i 00'; 330•or 33 -~ LOT AREAS ~ ~ . \ ~l(~ 7" i P POSED • ., ~i - DRIVE LOTS • '~ M a~ ~ O• g ~ ~~ ~ • ~ N ~ 8~ _ ~~ . r .di'' a 3A Z ° ° i ~ 93.O 30 01' ®i - -200.Od ~$_JOINT DR E EASEMENT i ~ ~~~O.Oa ~ FORL TS2ANBO ~ ~~ I 33~~~ 39'9'1"!,. ,ot: ~ ' RING LOCATION ~ (TYPICAL) Oi : u $ 8 i ° ~ ~ ~ LOT 2 ` ~ ~i 33: ~ ~ I L S89°39'38"W 383.01' ~' ~u ~ 330.01' • !~~ o ~ P POSED ~ ., ., • • ~~ DRNE 'SEE NOTE B ~ $ ~ I LOT , $ ~i ~ ~ ~ 1 ;SHED f SILO g , ~ jn 33.00' ~ 0 BARN ai - N89°39'38'E 363.01'. T08 78' RUINS ~~ ' ~i 3.25 LOT1 2.00 ACRES INC. RIW 87,122 SO. FT. 7.82 ACRES EXC. RAN 79,202 SO. Fi. LOT 2 2.00 ACRES INC. RAN 87,122 SO. FT. 1.82 ACRES EXC. RAN 7s,zoz sQ. FT. LOT 3 2.00 ACRES INC. RM/ 87,122 SO. Fi. 1.82 ACRES EXC. RAN 79202 SO. FT. LOT4 34.56 ACRES INC. RNV 1.506,530 SO. FT. 34.24 ACRES EXC. R/W 1,491,428 SO. FT. 5-3 ~ LOT 4 p ~- ~1~~ l ~~ ~ a~ ~- w _U- Owm U~~. ww rn w ((//~~ ~~W F- ~~a0 H BOO x LL O WN~ '~O Q 2 J oo ~Q~aw sv~ ~? O '~~ M ~ \ ~ u~a7d ~- zZ N89°39'38'E uw. LL 256.25' ~~ S00°01'S6"W ~ oo EXISTING ~ 0170.00 $ ~ DRNE FOUNDAflONS EAST -WEST 1/4 UNE N N89°39'3B'E ~ 1111.14' • 256.25' SEE DETAIL N89°39'38"E 1113.14' SECT ON 31~ ~ e D e D 0 ~] [~© [3~ Q 1~~~~n ~ N89°39'38"E / MG~]PdQ44C~D dQMn D~ OMIn --------------------------------- 3957.83' ------------ ~~yOTTOg7~ SCALE IN FEET 7' = 200' $ ~ E1/a CORNER ti~ ~ NOTE B (LOT 1): 200 0 200 400 SECTION 31 LOT 1 IS SUBJECT TO A EASEMENT DESCRIBED IN VOL 1111.14' 700, PG. 187 AT THE ST. CROIX COUNTY REGISTER OF NORTHLAND SURVEYING 1113.14' DEEDS OFFICE FOR A SEPTIC SYSTEM SERVICING A p.0. BOX 290 \ 4 TREE OCCUPIES POSITION HOUSE ON THE PARCEL OF LAND LYING SOUTH OF SAID HUDSON, WI 54016 \ ~ CORNER LOT 1. JpB 00-03 DATE 10-24-00 \\ THIS INSTRUMENT DRAFTED BY MICHAEL ERICKSON 70l 3 Vol. ] 5 Page 4088