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HomeMy WebLinkAbout008-1077-10-020 cousin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix afety and Building Division Sanitary Permit No: INSPECTION REPORT 574322 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Erdahl, Julie I Eau Galle, Town of 008-1077-10-020 CST BM Elev: Insp.BM Elev: IBM Description: Section/Town/Range/Map No: '� "ro 1� p,E' 27.28.16.401A-20 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER ���y 5 L CAPACITY STATION N64 MA 5-05 S ( HI FS t tE�LEEV. Septic G , Q 100 Benchmark 1, Z �D3 106 `"� Dosing �� AIt.BM jbg6' YVtkj .� 2-15 jag. Co �o Bldg.Sewer �TSe Li�Ct'4-irk J Holding St/Ht Inlet q.7 75 SHtft-6attet-- �- TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dtfrftl=t-- �- 1 O Q Septic t Dt Bottom Dosing " Header/M an. �2 b.1.r,D5 O t'Ll, , L _ Dist. Pipe 2.0(3 (6Z.12- Bot. System `t ?j, lot,cly Final Grade PUMP/SIPHON INFORMATION I 10 3 Manufacturer -zoh� D mand St Cover GPM Model Number J7 q 9 , TDH Lift` f Friction 6os System Head , TDIH ' Ft OI Forcemain Length t Dia. �y Dist.to well SOIL ABSORPTION SYSTEM BEDITRENCH Width 1 wr Length No.Of Trenches PI I�MENSIONS Pits a Dia. L th DIMENSIONS �-1� �15 r _+� SETBACK SYSTEM TO P/L BLDG IWELL LAKE/STREAM LEACHING Manerfaetwflp� INFORMATION CHAMBER OR Type Of System: t `1 �1 s t� 1► n UNIT Mode'Plwm DISTRIBUTION SYSTEM N x Hole Spacing Vent to Air I�t e Header/Manifold Distribution x Hole Si c M� 9 l _ Pipe(s) Lj►�(�a 1 t �r� /,�r y ' I �Q I Ip�t1AV Length Dia Len th Dia t J Spacing J SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only (p!#," 1� Depth Over D Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center I I BedlTre dges Topso ( �es No Yes No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: �7 / nn! Inspection#2: Location: 198 250TH ST Woodville,WI 54028(NE 1/4 E 1/4 27 T28N R16W) NA Lot 2 �,���.�L.. p'p arcel N 7.28.16.401A-20 dv,p r,k r�►e�l a s 4cv-1- � p cl �� 6lc_ 1.)Alt BM Description= �- ^6., Jd,-z 2.)Bldg sewer length= 2tp M�nl -amount of cover= � bature 7) Ck Plan revision Required? Yes No Use other side for additional Information. Date Insepctor's Cert.No. SBD-6710(R.3/97) r ti V � � � rte v cn �1 j � ,( � CPA County Industry Services Division � �' , t,,l $ •, 1400 E Washington Ave Sanitary Permit Number(to be filled in by Co.) ' P.O. Box 7162 f COUNTY Madison,WI 53707-7162 i/��� " T.CROIX T SJNITY DEVELOP NT Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(2),Wis,Adm.Code,submission of this form to the appropriate governmental unit Z4 2,T 3 9 is required prior to obtaining a sanitary permit. Note:Application forms for state-owned POWTS are submitted to Project Address(if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary �J. / u ses in accordance with the Privacy .zF Law,s. 15.04 1 (m,Stats. 0 I. Application Information-Please Print All Informs ' .S d'�� Property Owner' in ! Parcel# rn a- JJ Llik ErA,V,\ 0 08 — 10-1 — 10 — 020 Prope Own is Mailing Address Property Location R I 25'O ~ S} Govt.Lot ( City,State Zip Code Phone Number OW y, W VJ /4, Section Z.1 no�vi��.� (!.1 Sy 0Z$ -its -L9C ^Z-911 (circle one,. T ZH N; R _Eo II.Type of Building(check all that apply) Lot# R I or 2 Family Dwelling-Number of Bedrooms Subdivision Name I Block# El Public/Commercial-Describe Use IGC�. ❑City of ❑ CSM Number O El Village of State Owned-Describe Use I To.of 9&0 Gall,_ Ill.Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System ReplacemHSystem Treatment>Hol ding Tank Replacement Only ❑Other Modification to Existing System(explain) B. ❑ Permit Renewal ❑ Permit ReChange of Plumber ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV.Type of POWTS S stem/Com onent/Device: Check all that apply) A O ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑At-Grade ❑ Mound>24 in.of suitable soil ®Mound<24 in.of suitable soil ❑ Holding Tank ❑Other Dispersal Component(explain) ❑Pretreatment Device(explain) V.Dis ersal/Trea ent Area Information: ,C Design Flow(gpd) Design Soil Application Rate(gpds Dispersal Area Required(so Dispersal Area Proposed(sf) System Elevation (1000 , 10 boo U 1300 1 107- 0 V VI.Tank Info Capacity in Total #of Manufacturer Gallons Gallons Units c =' New Tanks Existing Tanks a. U c � a in j N N w Lr� w ° H ii (7 ii. Septic or Holding Tank 1466 Dosing Dosing Chamber X OAt� (,�c X VIII.Responsibility Statement- 1,the undersign re si i l instal ti n of the POWTS shown on the attached plans. Plumber's Name(Print) Plumber's Sin MP/MPRS Number Business Phone Number Le,w�s R .<->- 'LS'SON1 b 'j 1s-231 —15-15 Plumber's Address(Street,City,State,Zip Code) E-1 v8 c QA C o"IQ nILA_ W 1 fS7LAISml Vlll. oun /De artment Use Only Approved tsappro L Permit Fee DatZued/ Iss uing ent Signature $ L❑ r Given Reason for Denial / IX.Condit0Y93MWPMlffRtasons for Disapproval 3 1. Septic tank,effluent filter and �! dispersal cell must all be seryIRe1 I maintained n e- t.✓1 �6^'I riper management plan provided by plurriblf. Z. 'M Mf ippliCibl�COdr/OIdI1MyIOIN �� to 1� �-,A Attach to complete plans for the system and subm t to the County only per not le's than 8 112 x 11 inches in size G.a 4P SBD-6398(R0313) " 9"PART DIVISION OF INDUSTRY SERVICES 5�' ron 2331 SAN LUIS PL STE 150 < ' GREEN BAY WI 54304 Contact Through Relay www.dsps.wi.gov/sb/ y� Ga ` www.wisconsin.gov A Q;, �O 'ssroNAtiS� Scott Walker,Governor Dave Ross,Secretary I July 16,2014 CUST ID No. 253976 ATTN POWTS Inspector LEWIS C BJORK ZONING OFFICE LEWIS BJORK LLC ST CROIX COUNTY SPIA E7818 CTY RD E 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/16/2016 Identification Numbers Transaction ID No.2425397 SITE: Site ID No. 804005 Tom&Julie Erdahl Please refer to both identification numbers, 198 250TH St above,in all correspondence with the agency. Town of Eau Galle St Croix County NW1/4,NW1/4, S27,T28N,R16W FOR: Object Type:POWTS Component Manual Regulated Object ID No.: 1493432 Maintenance required; Replacement system; 600 GPD Flow rate; System(s):EZflow Mound Component Manual,(R. 7/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s)referenced above. CON owner,as defined in chapter 101.01(10),Wisconsin Statutes,is responsible for compliance with all code requirements. DEPT OF No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145:06, �!R(�FEg$I stats. DI'NlSHM OF IN The following conditions shall be met during construction or installation and prior to occupancy or use: Reminder(s): • This system is to be constructed and located in accordance with the approved plans and with the EZflow Mo Component Manual,(R 7/12) $EE CO • The changes made to this plan were discussed with and approved by the system designer and reviewer. • All manhole covers terminating above grade must have effective locking devices. • The approved Tuf-Tite Septic Tank Riser and Lid approved by the state is 24 inch.The product review letter has been attached to the stamped plans. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department,which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance.As per state stats 101.12(2),nothing in this review shall relieve the designer of the responsibility for designing a safe building,structure,or component. LEWIS C BJORK Page 2 7/16/2014 Inquiries concerning this correspondence may be made to me at the telephone number listed below,or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation,operation or maintenance of the POWTS. Sincerely, Fee Required$ 250.00 Fee Received$ 250.00 Balance Due $ 0.00 Rachael E Huempfner POWTS Plan Reviewer,Integrated Services WiSMART code:7633 (920)492-7728,M-f 7:45 am To 4:30 pm rachael.huempfner@wisconsin.gov cc: Lewis Bjork LLC Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services(formerly Safety&Buildings)will be modified. Code references with prefixes starting with"Comm"have been replaced with "SPS"to recognize the relocation of the Division of Industry Services from the former Department of Commerce to the Department of Safety&Professional Services.Additionally,all IS(formerly S&B)codes have been renumbered and addressed in a"300" series. For future reference,the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) r Residential or Commercial Design 400.00 Estimated Wastewater Flow(gpd) 1.50 Peaking Factor(a-g. 1.5=150%) 600.00 Design Flow(gpd) 4,40 Site Slope(%) 100.00 Installation Contour Line Elevation(ft) 125.00 Contour Length Available(ft) 12.00 Depth to Limiting Factor(in) 0.60 In-situ Soil Applicafion Rate(gpd/ft ) i Distribution Cell Information 8.00 Cell Width(ft)3.4. 5, 6.7, 8, 9 or11 0 Only F I 00.001 Dispersal Cell Length(ft) 1.00 Dispersal Cell Design Loading Rate(9polfe) 1 Influent Wastewater Quality(1 or 2) Are the laterals the highest point In the distribution =Yy Pressure Oisribution Information network? Enter Y or N (c or e) a Center or End Manifold 3 Lateral Spacing(ft) If N above,enter the elevation ft l 2 Number of Laterals of the highest point. i 0.156 Orifice Diameter(in)(e_g_0.25) 6 4.00 Estimated Orifice Spacing(ft)= 12.00 ff/otiftce 2.00 Forcemain Diameter(in) 30.00 Forcemain Length(ft) Does the fbrcemain drain back? Y <12 91.00 Inside Pump Tank Elevation(ft) Enter Y or N 0.00 Forcemain l=itter Loss(ft) 4.55 System Head(ft)x 1.3 4.89 Forcemain Drainback(gal) 10.83 Vertical Lift(ft) 90.29 5x Void Volume(gal) 0.48 FrictlQn Loss(ft) 95.18 Minimum Dose Volume(gal) 15.86 Total Dynamic Head(ft) 26.93 System Demand(gpm) Lateral Diameter Selection E2.00 Diameter Selection In.dia_ options choice in options choice 0.75 x 1.00 x x 125 1.50 x x 2.00 x 3.00 x 2 Gallonatinch Calculator(optional) Treatment Tank Information 700.001 Total Tank Capacity(gal) 1"�� 1400.00 Septic Tank Capacity(gal)' 37.141 Total Working Liquid Depth(in) Lewis Bork IManufacturer 18.85 gaUn(enter result in cell 1349) Dose Tank Information Effluent Filter Information 7011-001 Dose Tank Capacity(gal) Life Time t=iller Manufacturer 18.851 Dose Tank Volume(gaUn) ILT9 lFiller Model Number Lewis Bjork Manufacturer } 12 13 Project: Tom&Julie Erdahl-Replacment ound Pagexof TI, SO/Z0 30Vd O-M60fESZM3-1 9L8LZ8Z91L 8Z:80 VIOZ/91/LO End Connection Lateral Layout Diagram •=TUM-UprlKOag valve 43Frtean.outptu8 tar Ces pokt up Bpi every M s aria pok is rt wo for drainW- Forcvmain connM011 via t09 M aosstl)MW M at 4W-POW- taceratsrk tace�main af> sci� o Ail laterals idatcal With oriftCs egw9y Vey- per SIM Table M.30- Number of Laterals 2 Orifice Diameter 0-156 in Lateral Diameter 1.50 in office Spacing(X) 4.10 ft Lateral Length(P) 99.20 ft Orifices per Lateral 25 Lateral End(Z) 0.80 ft Orifice Density 12.00 fe/orifice Lateral Spacing(S) 3.00 ft Manifold Length 3.00 ft Lateral Flow Rate 13.46 gpnr Manifold Diameter 1.50 in System Flow Rate 26.93 9pm Forcemain Velocity, 2-75 ft/sec Dose Tank Information Lodsengcuvar with warning label and looking device and seated waterfght Electrical as per NEC 3 00 and ^--► SPS 316.300 WAG Disco 4 in-min. nnect Tank component is property vented E Alternate outlet location Foteemain diameter Lewis Bork Manufacturer �T ; 2 in. Capacity 700-00 Gallons Volume 18.85 galfinch A Weep hole or anti- Dimension Inches Gallons B siphon device A 22.09 416.32 B 2-00 37.70 C Pump off elevation(ft) C 5.05 95.18 91.67 D 1 8-00 150-80 D Total 37.14 700-00 Dose nk elevation(ft) Bedding And Ba"I As Per Manufacturer 91.00 Alarm Manufacturer SJE-Rombus Alarm Model Number TAAB-01 Pump Manufacturer jZDhler Pump Model Number 1152 Pump Must Deliver I 26.93 gpm " at 15.86 ft TRH Note-Switches containing mercury may not be used in this system. Project: Tam&Julie Erdahl-Replacment Mound Page)Lof'401. E0/E0 39bd 0--1AdJUsSIM3-1 ScELTEZSic eZ:80 VTOZ/K/LO M ' vFyp RTb{E1' DIVISION OF INDUSTRY SERVICES ys' Toy Plumbing Product Review U�2 P.O.Box 2658 3 ;r Madison,Wisconsin 53701-2658 TTY:Contact Through Relay q w Scott Walker,Governor A�OSSIONAti' Dave Ross,Secretary May 21, 2013 TUF-TITE TED MEYERS 1200 FLEX CT LAKE ZURICH IL 60047 Re: Description: SEWAGE TANK COVERS, LIDS, RISERS Manufacturer: TUF-TITE Product Name: SEPTIC TANK RISER AND LID Model Number(s): 24" RISER AND LID Product File No: 20130080 The specifications and/or plans for this plumbing product have been reviewed and determined to be in compliance with chapters SPS 382 through 384,Wisconsin Administrative Code, and Chapters 145 and 160, Wisconsin Statutes. The Department hereby issues an approval based on the Wisconsin Statutes and the Wisconsin Administrative Code. This approval is valid until the end of May 2018. This approval supersedes the approval issued on 3/17/08 under product file number 20080159. This approval letter shall be incorporated with your previously approved plans and/or specifications approved under product file number 20080159. This approval is contingent upon compliance with the following stipulation(s): • The manhole cover must be secured to the riser using screws which are not standard or phillips head to be considered an effective locking device. • Joints between riser sections shall be seal with butyl mastic sealant and secured with a minimum of four screws. The department is in no way endorsing this product or any advertising, and is not responsible for any situation which may result from its use. Sincerely, Glen Jones Public Swimming Pool Plan/Plumbing Product Reviewer phone: (608) 267-5265 fax: (608) 266-2602 email:glen.jones@wi.gov SBD-10564-E N.10/97 File Ref:13008001.DOC � r i EZftaw® MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Tom &Julie Erdahl- Replacment Mound Owner's Name: Tom &Julie Erdahl Owner's Address: 198 250th street Woodville WI 547028 715-698-2979 Legal Description: NW NW 27 28 16W Township: Eau Galle County: St.Croix Subdivision Name: NA Lot Number: - Block Number: - 'TIONALLY Parcel I.D. Number: 'ROVED --SAFETY AND Plan Transaction No.: NAL SERVICES Page 1 Index and title JUSTRY SERVICES Page 2 Data entry Page 3 EZflow mound drawings Page 4 Lateral and dose tank cSPONDENCE Page 5 Distribution media Page 6 System maintenance specifications Page 7 Management and contingency plan Page 8 Pump curve and specifications Page 9 Plot pan , Plot plan Legend Page 10 Attchments, Septic/Dose tanks , Manhole Risers , Soil n Page 11 Effluent filter, Designer: Lewis Bjork _ License Number: 253976 Date: 06/27/14 Phone Number: 715-231-7375 Signature: Designed Pursuant to the EZflow Mound Component Manual Ver.August 20,2007, SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS(01/81)and Pressure Distribution Component Manual Ver.2.0 SBD-10706-P(N.01/01) EZflow Mound Version 3.0(R. 3/1/12) Page 1 of Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) r Residential or Commercial Design 400.00 Estimated Wastewater Flow(gpd) 1.50 Peaking Factor(e.g. 1.5= 150%) 600.00 Design Flow(gpd) 4.40 Site Slope(%) 100.00 Installation Contour Line Elevation (ft) 125.00 Contour Length Available(ft) 12.00 Depth to Limiting Factor(in) 0.60 In-situ Soil Application Rate(gpd/ft) Distribution Cell Information 6.00 Cell Width(ft) 3, 4, 5, 6, 7, 8, 9 or 10 Only 100.00 =Dispersal Cell Length (ft) 1.00 Dispersal Cell Design Loading Rate(gpd/ft2) 1 Influent Wastewater Quality(1 or 2) Are the laterals the highest point in the distribution F Y Pressure Disribution Information network? Enter Y or N (c or e) a Center or End Manifold 3 Lateral Spacing(ft) If N above,enter the elevation ft 2 Number of Laterals of the highest point. 0.156 Orifice Diameter(in)(e.g. 0.25) 4.00 Estimated Orifice Spacing(ft)= F 12.00 fe/orifice 2.00 Forcemain Diameter(in) 30.00 Forcemain Length (ft) Does the forcemain drain back? Y 91.00 Inside Pump Tank Elevation (ft) Enter Y or N 0.00 Forcemain Filter Loss (ft) 4.55 System Head (ft)x 1.3 4.89 Forcemain Drainback(gal) 10.67 Vertical Lift(ft) 90.29 5x Void Volume(gal) 0.48 Friction Loss(ft) 95.1 Minimum Dose Volume(gal) 15.69 Total Dynamic Head (ft) 26.93 S em Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 1.50 x x 1.25 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator(optional) Treatment Tank Information 700.00 Total Tank Capacity(gal) 1400. 0 I Septic Tank Capacity(gal) 38.00 Total Working Liquid Depth (in) Lew' k Manufacturer 18.42 gain (enter result in cell B49) Information Effluent Filter Information 1 0.00 Dose Tank Capacity(gal) Life Time Filter Manufacturer GD C� 16.76 Dose Tank Volume(gal/in) ILT9 I Filter Model Number St`s, Lewis Bork I Manufacturer Project: Tom &Julie Erdahl- Replacment Mound Page 2 of 11 Mound Plan View 1/10 6 :::.::: : : : : : : : : : : : : : : . . : : : : s : ::: J :Observation Pipe : : : : : :..Q. . ': : : : : : : : : . : : : : . . . . . . . . . . . . . . . . . . . . . K . tir r r tir yr;•fir r 1r1 f1r f1�r1 1r r f�r1r11r r r r r r f y1 1 r r j •r•r•r•:. r•:•r•r•;•r• •r•r•:•;•;.;•;•:•r•:•r; r;r.r.;.r.r.r.r.r.r.r.;•:•r. r.:.r.r.. A . . . . . . . . •ti.ti.ti....ti.ti.ti....y....1. ti.•..ti.•..•..•..ti.•..1.•.. .5.ti.ti.y.1..•.ti..•..,..... ..1.ti L..•. •'r:r.r..•.1'.J'.r.r1r •:r.r.r.::r:r.r.r:r�:::.:.::;1r:1.::;~r.'•:�r1r• r•;•:•;•r•• W f, 1.. . . . . . . . . . . . . . . . . . . . . . . . . . B �. -.3-:..•: : .:-: :-:•:-:-:-:•:•:•:•:•:•:•:• • • •:•:•: .:•:•:•:•:•:•:•:•:-:•:• :•:•:•:•:•:•:•:• I L Mound Component Dimensions A 6.00 ft E 27.17 in H 1.00 ft K 12.40 ft B 100.00 ft F 12.00 in 1 13.01 ft L 124.79 ft D 24.00 in G 0.50 ft J 9.28 ft W 28.28 ft 600.00 (ft2)Dispersal Cell Area 1 1900.92 (ft2)Basal Area Available 6.00 (gpd/ft)Linear Loading Rate 1 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View EZflow Dispersal Area Finished Grade 104.00 (ft) 11 .111,;,/„111M�Y,111,1,,,,.. G F Dispersal Cell 102.50 (ft)Lateral I _ ” 102.00 ft —� ==6 Invert Elevation ( ) ;:;: 3 ::::;:::::: . .. . .i.i.i.i c : i'c i i.i'i=: Dispersal Cell •.•.[ •.•.•.•.•.•. . 1 Elevation .E.. ; D ; ; s . .•.-.•. .•.-. . _ :• `: _;; :: ] ] >; �� .k 1. �l ,'• ✓�,.� � AAA. � .- 100.00 (ft)Contour Elevation 4.4 %Site Slope Typical Dispersal Cell Shading Key See Page 5 Q_ Topsoil Cap >o a a.2 !1111!/ Subsoil Cap v a c 2.0 ft Approved Geotextile Fabric Cover ASTM C33 Sand -r is 4 Tilled Layer •r•r•ti . . f•.r r i •r• W r:•• r }r••r r• r F EZflow Media r.r•r.r• •r•r•r•r•r•r• r•r•r•r•r•r• .r.r.r•r• r.r•r. .r.r.r.r.r w 0 0.5 ft See details on page 4 for number,size,and spacing of laterals. Laterals are located in the 4"gravity distribution pipes as shown on page 5. Project: Tom &Julie Erdahl- Replacment Mound Page 3 of 11 End Connection Lateral Layout Diagram 0x Tarn-upv4ball V21VOOf ClssnOUlplug P I Orifices�up a every�' S 1.3t orifice kacaNed ed Z 1{-X--4 am pis for drainage• Force mails eormetion via tea of cross to mean om a<ang Pte• Laterals&face main of PVC Sch 30 AN is ads identical with orifices e cd par SPS Table�&4.304 126.93 Orifice Diameter 0.156 in Number of Laterals in orifice Spacing (X) 4.10 ft Lateral Diameter 25 Lateral Length(P) ft Orifices per Lateral ft Orifice Density 12.00 W/orifice Lateral End (Z) Manifold Length 3.00 ft Lateral Spacing (S) ft Manifold Diameter 1.50 in Lateral Flow Rate Forcemain Velocity 2.75 ft/sec System Flow Rate gpm Dose Tank Information Ling cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and -- 4 in.min. SPS 316.300 WAC Disconnect E-- Alternate outlet Tank component is properly vented location Forcemain diameter 2 in. Lewis Bork Manufacturer Ca aci 700.00 Gallons DVolum e 16.76 g al/inch A Weep hole or anti _ im sion Inches Gallons B siphon device 22.00 433 52 C Pump off elevation(ft) O� 91.83 5.68 95.18 167.60 D Total 41.77 700.00 Dose tank elevation(ft) Bedding And Backfill As Per Manufacturer 91.00 Alarm Manufacturer SJE-Rombus Alarm Model Number TAAB-01 Pump Manufacturer JZohler Pump Model Number 152 Pump Must Deliver 26.93 gpm at 15.69 ft TDH Note: Switches containing mercury may not be used in this system. Project: Tom &Julie Erdahl- Replacment Mound Rage 4 of 11 L6 Uf/owo Distribution Cell Media Layout 6.00 Cell Width (ft) 1.50 Sidewall to Lateral (ft) Distribution Cell Cross-section Arrangements (@(SQxD1n 6 ft W ide pode Component Legend SR1-7A Bundle-5 ft or 10 ft lengths SRI-12A or EZ 1201A in 5 ft or 10 ft lengths SR3-12H or EZ 1201 P or n^ , in 5 ft or 10 ft lengths O 4"Perforated Distribution Pipe With Pressure Lateral Inside Turnup Enclosure — — — — — Pressure Lateral Bundles are covered with approved geotextile fabric as per the their product approval. Distribution Cell Plan View Layout -Typical 6.00 Cell Width -A(ft) 100.00 Cell Length -B(ft) Center Connection Lateral Layn,it n;anrnm Force Main 6ftWide - - - - - - - - — — — — — — — — — End Manifold — — — — — -— — — — — — Project: Tom &Julie Erdahl-Replacment Mound Page 5 of 11 Mound System Maintenance and Operation Specifications Service Provider's Name ILewis Bork LLC Phone 715-231-7375 POWTS Regulator's Name ISt. Croix County I Phone 715-386-4680 System Flow and Load Parameters Design Flow-Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow-Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1400 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Inspect and clean as necessary at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test periodical) Pressure System Laterals should be flushed and pressure tested every 3 years Mound Inspect for ponding and seepage once every 3 years Other Lewis Bork Pumping 715-231-7375 Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap and are secured in as shown in the EZflow Mound Component Manual Ver. August 20, 2007. 2. Dispersal cell media conforms to EZflow products approved for use with the EZflow Mound Component Manual Ver. August 20, 2007. Media is covered with an approved geotextile fabric. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, 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\ L/ 6-8"Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Lateral Ends at Last Orifice Where Variable Length Cleanout Begins Long Sweep 90 or Two 45 Degree Bends Same EZflow S thetic Media Diameter as Lateral 2.10 Feet Distribution Lateral Lateral Cleanout Project: Tom &Julie Erdahl- Replacment Mound Page 6 of 11 Mound System Management Plan Pursuant to SPS 383.54,Wis.Adm.Code General This system shall be operated in accordance with SPS 382-84 Wis.Adm.Code,and shall maintained in accordance with its'component manuals[EZflow Mound Component Manual 8/20/07,Pressure Distribution Component Manual Ver.2.0 SBD-10706-P(N.01/01)and SSWMP Publication 9.6(01/81)]and local or state rules pertaining to system maintenance and maintenance reporting. Septic and pump tank abandonment shall be in accordance with SPS 383.33,Wis.Adm.Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers,access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound,defective,or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s.281.48,Stats. The contents of the septic tank shall be disposed of in accordance with NR 113,Wis.Adm.Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm,the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment,maintenance personnel shall advise the owner as to 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 Wisconsin Department of Commerce. Pump Tank The dosing(pump)tank shall be inspected at least once every 3 years. All switches,alarms,and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. If the force main has a weep hole,it should be noted if it is functional during pump operation,and if not,it should be cleaned. *****No one should ever enter a septic or dose tank since dangerous gases may be present that could cause death.'"*" Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter,and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic(other than for vegetative maintenance)on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations(October-February)dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS,and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5,30 mg/L TSS,10 mg/L FOG,and 104 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 3 years. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner,and any levels above 4 inches considered as an impending hydraulic failure requiring additional,more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank,pump,pump controls,alarm or related wiring becomes defective the defective component(s)shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface,it will be repaired or replaced in its'present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media,and related piping,and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Tom &Julie Erdahl- Replacment Mound Page 7 of 11 w �. E- w PUMP PERFORMANCE EC CURVE MODEL 1511152/153 50 14 45 153 i 12 40 OrL, w 35 152 s 10 30 o $ 25 351 0 f- 6 20 15 4 10 2 5 0 10 20 30 40 50 60 70 80 90 1"00 GALLONS LITERS 0 40 80 120 160 200 240 280 320 360 FLOW PER MINUTE 014908 b� �7 61 CN C o � 8 W c•. �D • n O O .i r Q5 � r O � T 1 Plot Plan Legend 1 4" PVC ASTM D 3034. 42"Min. Cover where snow is not removed. 2 24 inside diameter plastic manhole brought min.4" above surrounding grade. Concrete/plastic covers screwed down. 3 Precast concrete septic tank. 4 Effluent filter location. 5 4" PVC ASTM D3034. 18" Min . cover . Effluent piping or building sewer where tank is within 30'. 6 Precast concrete dose/pump/filter tank. 7 12-2 OF-B Power conductor . 14-2 OF-B alarm circuit conductor. Both wires are UL listed A-2057 8 2„ PVC ASTM D-26 65 -09 Schedule 40 Pipe Force main. 9 4” PVC ASTM D-2665 -09 Schedule 40 Pipe . Entering and exiting concrete tanks min 10' in length. 10 Carlon All weather pvc junction box. UL listed # A-241 11 treatment/dispersal cell 12 Inspection wells Project: Erdahl Page 9 24.0 DAFT LE o _ INLET --- ° OUTLET LIGUID LEVEL �. OUTLET. tj FILTER ° o ° ° q In N ° ......_._.._FILTER"... 1� � SEAM'_..; 0 tri (_ 72.0 64A r" 72.0 I SECTI❑N A--A wrYL SEALANT END VIEW 18.0 36.0 18.0 LB 700 FILTER TANK SPECIFICATIONS 4' REINFORC'D CON:. WALLS 4' REINFORC'D CONC. COVER A I I A 4' REINFORC'D CONC.BOTTOM MANHOLE, 24' PRECAST RISER t°u INLET OUTLET HIEGHT, 54. O.D. LENGTH- 72' O.D. WIDTH- 72' D.D. INLET INVERT- 41' I OUTLET INVERRT- 38' (LIQUID LEVEL) 4 I LOADING DESIGN, 8'-0' UNSATURATED SOIL. 16 M 18.85 GALLONS PER VERTICAL INCH INSIDE TANK. FOR USE AS PUMP/SEPTIC/HOLDING TANG. MORE INFORMATION AVAILABLE CONTACT, LEWIS DJORK 64.0 72.0 PLAN VIEW -- TOP SLAB LEWIS B J ❑ R K , L L C NOT TO SCALE AUGUST 20, 2012 MENOMONIE, WI DRAWN BY: JCP Tuf-Tite Riser System ET _ Sf� ITI p�� 11 Tuf-Tite makes a full line of Risers and accessories for Pre-Cast applications. Riser Lid-with Molded-in gasket. Available in 12", 16",20" and 24" diameters. Green Only. Concrete Lid -with handle. Use the Safety Pan to cast your own concrete lids. Safety Lid- May be used in place of concrete lid. Fits 24" Riser Pan only. Black Only. Safety Pan- Safety PanTM available for 16", 20" and 24" Risers. Green Only. 6" Tall Riser- For septic tanks. Stackable in 6" increments. Available in 12", 16", 20" and 24" diameters. 12" Tall Riser- For septic tanks. Stackable in 12" increments. Available in 20" and 24" diameters. Black Only. Tank Adapter Ring- For mounting riser or lid to tank when casting-in is not an option. 1 � 2014004aA \ !� LFG,9c!e:a � Ce f":1-'.'�,✓'' F%a' 1N- r'wz f Installation and Maintenance Instructions Installation Step 1 Dry fit the filter case onto the outlet pipe going to the drain field. Ensure it is centered directly under the access opening.(If outlet pipe is already in a fixed position,additional pipe may need to be added) Step 2 If utilizing the additional single side support and the two bottom supports: While the case is still dry fit to the outlet pipe, measure and cut 1"schedule 40 pvc pipe to the length needed to extend from the hubs that are pre-molded into the case to the side wall and the inside floor of tank. solvent weld pipe into the hubs that are pre-molded onto the case. Step 3 Solvent weld the case to the outlet pipe.Insert the filter cartridge into the case pressing down on the cartridge until It locks into place at the bottom of case. Step 4 if utilizing a vertical read switch:Insert switch into the hole pre-molded into the top of the filter.Press straight down until it locks into place Maintenance 1) Remove the access lid of the tank, Note:To ensure undesirable solids do not exit the tank and into the drain field,the tank should be pumped out until the level of effluent is below the outlet level of the tank. 2) To remove the filter cartridge from the filter case,pull up firmly on the handle of the cartridge dislodging it from the case.(if utilizing a vertical read switch,removal of switch is optional) 3) Using an ordinary garden hose,rinse the filter cartridge ensuring all visible septage material is removed. 4) Place the filter cartridge back into the filter case pressing down on the cartridge until it locks into place. 5) Place the access lid back onto the tank ensuring it is secure. RE-:CBVED FEES 6 2014 SAFETY Lifetime filter has a lifetime limited warranty: Lifetime filter LLC warrants the filter will be free of manufacturing and workmanship defects during normal use for the period of time the original purchaser owns the product.Lifetime filter will provide a replacement filter in the event that the original filter was j not damaged during the Installation or maintenance process.Damage to this product caused by accident,misuse or abuse will not be covered under this warranty.Improper care or malfunctions resulting from product not being installed,operated or maintained property will void this warranty.Lifetime filter assumes no responsibility for labor charges,removal charges,installation or other Incidental or consequential costs. Contact:mike@lifetimefifterlIc.com Phone:502-724-2231 � r /p,�ararC�,T DIVISION OF INDUSTRY SERVICES Plumbing Product Review P.O.Box 2658 Madison,Wisconsin 53701-2658 (t TTY:Contact Through Relay Scott walker,Governor IONA Dave Ross,Secretary March 12, 2014 LIFETIME FILTER LLC MIKE HORNBACK 146 CLIFTON HALL COURT SHEPHERDSVILLE KY 40165 Re: Description: SEWAGE TREATMENT APPARATUS, EFFLUENT FILTER Manufacturer: LIFETIME FILTER LLC Product Name: LIFETIME EFFLUENT FILTERS Model Number(s): LT 118, LT 1/16, LT 1/32 AND LT 1/64 [SEE ATTACHED TABLE OUTLINING: FILTRATION SIZE AND RATINGS IN GPD] Product File No: 20140048 The specifications and/or plans for this plumbing product have been reviewed and determined to be in compliance with chapters SPS 382 through 384,Wisconsin Administrative Code, and Chapters 145 and 160,Wisconsin Statutes. The Department hereby issues an approval based on the Wisconsin Statutes and the Wisconsin Administrative Code. This approval is valid until the end of March 2019. This approval is contingent upon compliance with the following stipulation(s): • Installation and servicing of this product must be in accordance with the manufacturer's instructions. A copy of the manufacturer's installation and servicing instructions must be given to the owner of the system. • Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter will be necessary, • A manhole extending to grade must be provided over the filter, • MAINTENANCE: Clean filter at inspection/pumping interval. • Additional information is included as attachment(s)to this letter; see attachment A. The department is in no way endorsing this product or any advertising, and is not responsible for any situation which may result from its use. Sincerely, Glen Jo®roc� POWTS Reviewe r phone: (608)267-5265 fax: (608)267-9723 email: glen.jones @wi.gov I SBD-10564-E(N.10/97) File Ref:14004801.00C i ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer TO m k Cr dd a%.\ Mailing Address 1°l 8 2 SO '' S W o o J'j I 11 W S y 0-L T Property Address l q t Z SO S W o o " 'AL'_ W 1 5''1 d 1-1 (Verification required from Planning&Zoning Department for new construction.) City/State W o a dv i Ik W \ Parcel Identification Number d 0 g - 10 7-1 - 10 - OIS) LEGAL DESCRIPTION Property Location W4 '/4 , NW 1/4 , Sec. V1 , T 7-0, N R \b W, Town of Fa,) (a a lk Subdivision Plat: ,Lot Certified Survey Map # b 2- , Volume 3 , Page# �s Warranty Deed# -! l (before 2007)Volume , Page# Spec house❑yes❑no Lot lines identifiable❑yes❑no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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§SPS. 383.52(1)and in Chapter 12-St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning&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. I/we,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 Safety And Professional Services 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 Planning&Zoning Department within 30 days of the three year expiration date. 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 described above,by virtue of a warranty deed recorded in Register of Deeds Office. N b of bedrooms S C 1 0 D/ (4 A7 flpe�t�_ SIGNATURE OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning&Zoning Department. *** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV.04/12) r G� fvL t 3492 Wisconsin Departm�ommercg rLoN SOIL EVALUATION REPORT Page 1 of 3 Division of Safety an Buildin `� �� 0,% 90 with Comm 85,Wis. Adm. Code GO 0p County St.Croix Attach complete site plan o N�than 8 1/2 x 11 inches in size.Plan must include,but not limited tgSre iffhorizontal reference point(BM),direction and Parcel I.D. percent slope,scale or ' Ions,north arrow,and location and distance to nearest road. $ /b 77 " /Z5 ^ d Z '� Please print all information. Revi ed by Date Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). 7 2� Property Owner Property Location Ej Tom&Julie Erdahl Govt.Lot NW 1/4 NW 1/4 27 T 28 N R 16 E(or)® Property Owner's Mailing Address Lot# Block# Subd. Name or CSM# 198 250th street 2 - 884312 City State Zip Code Phone Number DCity rj Village ■ Town Nearest Road Woodville WI 1 54028 ( 7)15-698-2979 250th street Eau. cial.1-ju- ® New Construction UseEj Residential/Number of bedrooms 4 Code derived design flow rate 600 GPD E)Replacement Public or commercial-Describe: NA Parent material Loess cap over till Flood Plain elevation if applicable ft. General comments Install 24"mound on the 997 contour,.6 basil Soil pit range from A+5-7" ,I think the sandy clay loam in the and recommendations:front yard has enough course sand in it to not be massive,has some structure to peds and provide enough drainage of horizon 1 and 2 F T] Boring# 0 Boring Pit Ground surface elev. 997 ft. Depth to limiting factor 12 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-5 7.5yr3/3 sil 2fsbk mvfr cs 2f .6 .8 2 5-12 7.5 r5/4 sil 2msbk mvfr as if .6 .8 3 12-15 5yr5/3 c2f1oyr6/2 scl Ifsbk mfr - - - 4 15+ free water 2 Boring# El Boring 13 99.7 0 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/fg in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-6 7.5yr3/3 sil 2fsbk mvfr cs 2f .6 .8 2 6-13 7.5 4/4 sil 2msbk mvfr gs if •6 •8 3 13-16 5yr5/6 c2f10yr6/2 scl lmsbk - - - - 4 16+ _ Free Water *Effluent#1 =BOD,>30<220 mg/L and TSS>30<150 ffluen 2=BOD <30 mg/L and TSS<30 mg/L CST Name (Please Print) CST Number Lewis Bork 253976 Address Date Evaluation onducted Telephone Number E7818 County E Menomonie WI 54751 6-17-2014 715-231-7375 r Tom&Julie Erdahl 2 3 Property Owner Parcel ID# Page of 3 ] Boring# 11 Boring 99.6 15 E] 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/ff in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-5 10yr3/3 - sil 2fsbk mvfr cs 2f .6 .8 2 5-15 7,5 4/4 - A 2msbk mvfr as if .6 .8 3 15- 5yr5/4 c2flOyr6/2 scl lmsbk mvfr - - - - 4] Boring# Boring 98.5 I S 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/fF in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-9 10yr3/3 - sil 2fsbk mvfr cs 2f .6 .8 - 2 9-15 7.5 4/4 sil 2m mvfr as if .6 .8 3 15- 5yr5/4 c2fl0 6/2 scl Imsbk - - - - - Boring F-1 Boring# Ground surface elev. ft. Depth to limiting factor in. Pit [Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2- *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 608-266-3151 or TTY 608-264-8777. SBD-8330Test(R.07/00) QU Li O o `� rl r r 0 r o� �$ uv 0 r � W 1 illl11111!'""'!1111►''""'li IIII 1111111111111{ * d b 4 3 t 2 2 884312 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI CERTIFIED SURVEY MAP 11/14/2008 FOR RECORD O OPM CERTIFIED SURVEY MAP PART OF THE NORTHEAST'-1\4 OF THE NORTHEAST 1/4, VOL: 23 PAGE: 5583 BEING LOT 2 OF CERTIFIED SURVEY MAP, VOLUME 11, PAGE 3117, REC FEE: 13.00 LOCATED IN SECTION 27• TOWNSHIP 28 NORTH, RANGE 16 WEST, COPY FEE: 3.00 TOWN OF EAU GALLS, ST. CROIX COUNTY,WISCONSIN. PAGES: 2 UNPLATTED LANDS 20th AVE 2679.92' _ _ _ {sa7 14'54"Q (2680.02') — S87'21'-"06"E 670.00' centerline -- 2009.92' S8721'06'E dj 276:.04' S87.21'0 6"E Northeast Corner S87'21'06"E— 33.04 - O7 393.96' POB _ _ 33.04' _ Section 27-28-16 North 1/4 Corner S87 21'06'E y 275:98' _ — — — — -? Fd Aluminum Cap Section 27-28-16 S87'21'06"E 360.92' Fd Aluminum Cap 636.90' L OT 2 building setback line o 174,661 sq.ft. No I - - - rn 4.01 acres _ N O Ln N rn incl. r-o—w ° I 9 I°° o 0i M O house °rndwY.� cr (rn °o_ sheds Ln m I m 8 _ LOT > ° so, tests P rri I I LO"i' 1 ' 270,310 sq.ft. well septic! e° I UNPLATTED 4' O area I - -——— —— 6.21 acres w I S LANDS '`t incl. r-o-w 148,090 s ft. � q• r--100'—I w U! 3.40 acres i _ ° excl. r—o—w I `Z3° I ry I rn z z 253,877 sq.ft. 360.96' 33.04 66 iP °o 00 5.83 acres N87'13.30"W 394.00' rn Ln I rn_°r'- rn N excl. r-o-w co I� _ ° Q1 I N driovewoy tests N i I ' I j - - 635.76' 33.04 o N87'1 3'30"w 668.80' I PREP.'-.RED FOR: (N87o7'1s"w} o ° I to Julie Pfendler LOT 3 °rn V 198 250th St --- - M Woodville, Wi 54028 CSV1 #:3117 v Icc r*i Note Eac,I) p;,rr el. an this map is subject to State and County laws, Q� ruie_. and regulations ii e. wet?ands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact East 1/4 Corner St. Crcix County Zoning Office and Town Board for advice. Section 27-28-16 Fd Aluminum Cap ���n LEGEND DRAFTED B JOEL BRAND T ...__Government Corner (as noted) JB SURVEYING LLC o_ Se` :3\4" x 18" Iron Rebar weighing a minimum of 1 50 lbs per lineal foot ��BC0N, iN _ _ _ Found 1" Iron Pipe JOELq• � c ) __Recorded Data * ' � 5-3003 ;011.11111111111111000 CJTY, North is referenced to the East tine of the Northeast �A Quarter of Section 27-28-16 SCALE 1"' = 150' wnich bears S00°06"1S"E Sheet 1 of 2 'T f Croix County Grid System) 0' 150' 300' %/-I �� o- 5 83 8206855 State Bar of Wisconsin Fonn 3-2003 Tx:4170681 QUIT CLAIM DEED 991651 Document Number Document Name BETH PAB$T REGISTER OF DEEDS ST. CROIX CO., WI THIS DEED,evade between Julie A.Pfendler 01/17/2014 2.51 PM ("Grantor,"whether one or more), EXEMPT#: 1 and Julie A.Erdahl REC FEE: 30.00 PAGES: 1 ("Grantee,"whether one or more). Grantor quit claims to Grantee the following described real estate,together with the rents, profits, fixtures and other appurtenant interests, in St.Croix County, State of Wisconsin ("Property") (if more space is needed, please attach Recording Area addendum): Name and Return Address Julie A.Erdahl 27-28N-16W NE NE 198 250th St. 198 250th St. Woodville,WI 54028-7222 PLATT:5583-CSM 23-5583 008-200 BK/CONDO: Lot 02 SEC 27 T28N R16W PT NE NE 008-1077-10-020 27.28.16.401A-20 FKA LOT 2 CSM 11/3117 Parcel Identification Number(PIN) (10.215 AC) BEING CSM 23-5583 Lot 2 (4.01 AC) This is homestead property. t 0'.w o� L 0.ul �«C . Ct�a.� Lo..�i-1 4t)� (is)(is not) \ 1 Name Change ONLY,NO Real Estate Transfer per Statute 77.21 (1) ll Dated (SEAL) (SEAL) �— (SEAL) (SEAL) UTHENTICATION ACKNOWLEDGMENT Signature(s) `9' STATE OF WISCONSIN ) s$. authenticated on 0 V-1 ya l �1 . ��`I X COUNTY ) Personally came before me on the above-named )t i 2 T✓d_a4,1. _ TITLE:MEMBER STATE BAR OF WISCONSIN (If not to me known to be the person(s) who executed the foregoing authorized by Wis. Stat.§706.06) instrument and acknowledged rthe nsa�mme. THIS INSTRUMENT DRAFTED BY: „",Q 6, Notary Public,State of Wisconsin My Commission(is penuan`npp�,,ti��l (Signatures may be authenticated or acknowledged. Ilnlh are not t fyi). • - • - NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHO FE C 1"YDL�f r[F•IED. QUIT CLAIM DEED CL 2003 STATE BAR OF WISCONSIN �� � N� /��4/'• Nr�j14 NO.3-2003 'Type name below signatures. _ PUBLIC • ,� St.Croix County 991651 Page 1 of 1 :,r`f�9 •, • • .•�C��`` 4,,�OF��SG��•�