Loading...
HomeMy WebLinkAbout042-1045-20-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 574388 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:-7 Korbel, Wayne&Carolyn Warren, Town of 042-1045-20-000 CST BM Elev: Insp.BM Elev: BM Description: �/ Section/Town/Range/Map No: G�j( r, $4 143.l✓'j 17.29.18.2570 Im I a TANK INFORMATION ELEVATION DATA p,-7 Lb.7 /406 TYPE MANUFACTURE CAPACITY STATION BS 1DHI'L FS ELEV. Septic �✓� (p Benchmark /, 15 77 / Dosing ( / Alt. M r6 cl g rna (v 5( (. 'l 7 Bldg.Sew 5, 19 gy-3 7 St/Ht Inlet Holding , � °14/. St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. ent t it Intake ROAD Dt Inlet _ �O d S Septic //� Dt Bottom y ?/� Dosing / Header/Man. Z 9 7 jrT //(o S� Aeration Dist. Pipe 3. '7.4dT Bot. System Holding I,D cf(j . L Final Grade 1 .ZZ C y.7l PUMP/SIPHON INFORMATION Manufacturer Demand St Cover, Z zo l:r GPM 7 C.O _ J .� Model Number 15 / s �f 7 t� r TDH Li Friction Loss System Head TDH t ,.5� !Z I e-------4=== Forcemain Length , Dia.Z, I Dist.to Well / SOIL ABSORPTIONS STEM / BED/TRENCH Width Length No.Of Troche PIT DIM S; IONS No.Of Pits Inside Di=_ Liqui Depth DIMENSIONS \� SETBACK SYSTEM TO P/L JBLDG WELL LAKE/STREAM CHAMBER OR Manufacturer: INFORMATION Type tem: 34 a6 w � UNIT Model Number: DISTRIBUTION SYSTEM HeaderlManifold // Distribution / x Hole Size3 I x Hole Spacing / Vent i Intake Length_Dia Z L ngth _ Dia t5 Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only ` Depth Over � Depth Over xx Depth of xx Seeded/ a 1xx Mull ed Bed/Trench Center ' , D Bed/Trench Edges Topsoil \ � es No Yes LEI No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / Z`J/ Inspection#2: /�/ A 427C Location: 1075 100th Ave. Roberts,WI 54023(NE 1/4 NE 1/4 17 T29N R18W) metes&bounds Loau+ Parcel No: 7. 9.18 1.)Alt BM Description= Jam- P'U W Q i 2.)Bldg sewer length= �� je"l s O" ��' W -amount of cover= )I 1�Z Plan revision Required? E] Yes No Use other side for additional information. I — Date Insepctor's Signat a Cert.No. SBD-6710(R.3/97) • l�S -u a) " � m � � D Q � � o> g. - � Z m ao z ii z -nmH BOO � m o v� W WOZO Z O n �. ?' �v W '0 -n O LA A ^� -4 -NIm N mid s� c —1 �, r- ZZ o vZ y m rn O N 61 � y oc4 C b �o � Qoo n � VV on ril to pq Ch IjA G > c -J © tti 70 .n p " VN E y CP- ln V . G -At G M 713 o _ c it n y p p r o m g S G-Z 'L o Z L G � 3 y A VA 0 � � � y t v, C It c o - - Q County Safety and Buildings Division $ T• Q,Q0.Z 7C 201 W.Washin t Box 7162 Sanitary Permit Number(to be filled in by Co.) ` x(37'7162 3 AL ra pe11111t A I1 10 State Transaction Number pp COUNTY ental unit 2y S 3G�.a. In accordance with SPS 21(2),Wis.Adm.Code,submission of thi�rC-•1,3.�./� r(�Qn is required prior to obtaining a sanitary permit Note:Applicationo� WTS are submitted to Project Address(if different than mailing address) the Department of Safety and Professional Servies. Personal inf, n you provide may be used for secondary purposes in accordance with the Privacy Law,s. 15.04(l)(m),Stars. L Application Information-Please Print All Information Property Owner's Name Parcel# CSR #e aqa ./oq5'— � •o coo Property Owner's Mailing Address Property Location 1 O 7 Y loo fare. Govt.Lot 2.5—'7c— City, ) State Zip Code Phone Number N E 1/` ME 1/., Section /7 gog ek rs W • S Sf a 23 1/5. 7 4 4 - .q4 /a. (circle one) H.Type of Building(check all that apply) Lot# Lill or 2 Family Dwelling-Number of Bedrooms �5� Subdivision Name ' Block#��� ❑Public/Commercial-Describe Use ❑ City of ❑State Owned-Describe Use CSM Number ❑Village of ,Town of A R R III.Type of Permit: (Check only one bog on line A. Complete tine B if applicable) A. ❑New System Replacement System ❑Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System(explain) B. ❑Permit Renewal ❑Permit Revision ❑Change of Plumber ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV.Type of POWTS System/Component/Device: Check all that ❑Non-Pressurized In-Ground ❑Pressurized In-Ground ❑At-Grad ®Mound>24 in.of suitable so' ❑Mound<24 in.of suitable soil ❑Holding Tank ❑Other Dispersal Component(explain) - retreatment Device(explain) i n V.Dis ersal/Treatment Area Information: Design Flow(gpd) Design Soil Application (gilds Dispersal Area Re -ed(sf) Dispersal Area Proposed(sf) Sy r��Elevation y5a /•D 0•ln - ilS� 7Sa K5a /S75' , ? 0 VL Tank Info C acity in Total #of Manufacturer Gallons Gallons Units 2 New Tanks Existing Tanks o " 2 -1 22 c9 n U cn w U C Septic or Holding Tank W t c F n/O LO , Ic Dosing Chamber 0-re- W/ jr ✓— D k- J Z J VII.Responsibility Statement-I,the undersigned,assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name(Print) I Plumber's Signature MP/MPRS Number Business Phone Number 0 04f AJrQ NuuL ;-2_7 z� a 7�s`- 7q4 -b3 U Plumber's Address(Street,City,State,Zip Code) 9�6-7 l b s ga- S Yo -13 VDY Coun /De artment Use Only Approved ❑Disapproved Permit Fee Date Issued (� ing Agent Si ature ❑Owner Given Reason for Denial V2 • 60— 23 / IX.Conditions of Approval/Reasons for Disapproval SYSTEM OWNER: 1.Septic tank,effluent filter and Otlf. •a �Q� f'r�(i"t �s� dispersal cell must be serviced/maintained �SQl 3�3. 33 as per management plan provided by plumber. 2.All setback requirements 't h. per app ica lotg" &s f&W—gollm and submit to the Couqty only on paper not less than 812 z 11 inches in size SBD-6398(R. I1/11) ROBERT W ULBRICHT Page 2 0 9/12/2014 • The system was designed to meet the influent quality defined in SPS 383.44(2)(a) The quality of influent discharged into a POWTS treatment or dispersal component consisting in part of in situ soil shall be equal to or less than all of the following: 1.A monthly average of 30 mg/L fats,oil and grease. 2.A monthly average of 220 mg/L BOD5. 3.A monthly average of 150 mg/L TSS. • SPS 383.54(3)(b) (b)The servicing frequency of an anaerobic treatment tank for a POWTS shall occur at least when the combined sludge and scum volume equals 1/3 of the tank volume. • The inspection,maintenance and servicing reports shall be submitted to the governmental unit within 30 calendar days from the date of inspection,maintenance and servicing. • The owner is responsible for the operation and maintenance of the private onsite wastewater treatment system (POWTS)in accordance with SPS 383 and the approved management plan • The owner of a POWTS shall be responsible for ensuring that access opening covers remain locked or secured except for inspection,evaluation,maintenance or servicing purposes. • Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Provide a copy of the approved POWTS plans and this letter to the owner. • Prohibit vehicle traffic and soil disturbance within 15 feet of the downslope edge of the mound pursuant to "Mound Component Manual Version 2.0" SBD-10691-P(N.01/01;R. 10/12). • Insulate 4"0 conveyance pipe pursuant to SPS 382.30(11)(c),W.A.C. 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. 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 Edwin A Taylor Wastewater Specialist,Integrated Services WISMART code:7633 (715)634-3484,Monday-Friday 8:00 am To 4:30 pm edwin.taylor @wisconsin.gov I oEY�xrup�T DIVISION OF INDUSTRY SERVICES 10541N RANCH ROAD m HAYWARD WI 54843 Contact Through Relay Y www.dsps.wi.gov/sb/ www.wisconsin.gov A�01 'SSI°N�� Scott Walker,Governor Dave Ross,Secretary September 12,2014 CUST ID No. 226375 ATTN.-POWTS Inspector ROBERT W ULBRICHT ZONING OFFICE ULBRICHT&ASSOCIATES CO ST CROIX COUNTY SPIA 2812 10TH AVE 1101 CARMICHAEL RD SPRING VALLEY WI 54767 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/12/2016 Identification Numbers Transaction ID No.2453022 SITE: Site ID No. 805604 Wayne Korbel Please refer to both identification numbers, 1075 100TH Ave above,in all correspondence with the agency. Town of Warren St Croix County NE 1/4,NE 1/4, S17,T29N,RI 8W FOR: Object Type:POWTS Component Manual Regulated Object ID No.: 1500733 Maintenance required; Replacement system; 450 GPD Flow rate; System(s): Mound Component Manual-Ver.2.0, SBD-10691-P(N.01/01,R. 10/12); 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. The owner,as defined in chapter 101.01(10),Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • A copy of this approval letter and index sheet shall be attached to plans that correspond with the copy on file with the Department. Changes to the approved plan must be submitted for review and approval. Failure to properly attach the approval and index page to plans that match the copy on file with the Department may result in enforcement action under s. 145.10, Stats. • This system is to be constructed and located in accordance with the approved plans,and the"Mound 1P,0" �•s� Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD-10691-P(N.01/01). o,iditlo1l • This system is to be constructed and located in accordance with the approved plans and with the"Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0" SBD-10706- r,0 (N.01/01). DIP- Prior to construction of the dispersal area,check the moisture content of the soil to a depth of 8 inches. U� Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil.Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4-inch wire, 00RR�SP the site is too wet to prepare.If it crumbles,site preparation can proceed.If the site is too wet to prepare,do not proceed until it dries. • Abandon the existing system components per SPS 383.33 28121 Oth Ave. Spring Valley, WI 54767 715-772-8**2 y ff2 PROJECT INDEX Plan I .D. # Date jq - 20, 11 Owner -WA XM F_ k/O R BEL - Phone 7(5- MI 34 1 Z_ _w___-.-y��.T.__ Address 10 75 / 00 * AVE. Ro5i5g-r_5 to 5L10 Z5 Legal Description pl,4 oq2.. /Oq5 . 2000p_._..-.....g AcGPeS. MegcTs 41. soo"Os. tJ F,Yq WEYq -Sec. 171 Tal 0) P, lbw I Town of WARREN County ST. C,(Z 0 1 C.S,T. R- _UW3 R I Gti T Z-->- U .3 75 Installer 14E"')RY % WALTER ST-CROIA C00mry Z Local Au h rity/ ijoervision '01, IM6 :PBf>T-, PROJECT DESCRIP-UON -715. 3606 • Y690 A MvvtJP SSMC .5YSTeM FOR A 3 t3evizm. Hot-te - `l,O Ird . PeS46.&3 W"l-a'F1060 - Sot l. 5 APOE -Svi*rABle FOR A MOV)JP .5y5rem 1t51t,xr- 1 ,1" 5AUD Fill * sr--?rlc / pump Cvm(3o T-APK 5HAII f3r= WftTER PPLOOFE"P — 5"(Ep ArT. F Ac_rot�_y WITH B1'r0AW'F0i).5 ALL NON-CONFORMING ?'IsErp- TREATMENT TANKS SHALL, P-1065 3 olx3T5 5EAW12 ft( SO, BE ABANDONED PROPERLY PER G9Mk449Ar__1 SPS. 3£33. 33 to 1. 1Q P14. C 0 PIE Top I gAtlxrl C 0 WV j 5 lkql ........- % FtOBMW. ULBRICHT 0 01150 HUDISON,W1 I G Pg- 1 PLOT PLAN VIEWS Pg. 2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWS (REVERSE SIDE DETAILS INSPECTION PIPES & FABRIC/TOP FILL DETAILS) Pg.3 PIPE LATERAL LAYOUT (REVERSE SIDE SHOWS DETAILS OF LATERAL CLEAN OUTS) Pg-4 DOSING CHAMBER CROSS SECTION &- SPECS. Pg.5 PUMP PERFORMANCE SPECS (REVERSE SIDE SHOWS PUMP DETAILS) Pg.6.OPERATION, MAINTENANCE REQUIREMENTS (REVERSE SIDE SHOWS SITE & SPECIFIC PROJECT DETAILED INFORMATION,UNIQUE TO LOCALE AND GOVERNMENTAL UNIT AREA) The attached plans and specifications are based on the following approved manuals., "Mound Component Manual For Private Onsite Wastewater Treatment Systems 'I (Version 2 . 0 SBD-10691-p(N.OlZ01) and ""Pressure Distribution Component Manual For Private Onsite Wastewater Treatment Systems" (version2.0) SBD-10706-P(NOl/01 ) . • 11S -a ao -�_a mm � r m Q ° m O D g o comz \ Z z m —1 0 > z o° � �. ° -7a W ° Z Z o A �1 \ � � �_ o m = 9 � d 7 kA z ° c mm r � M c M10 -4 � m El CO- 1 a. • G C r; �S - G C m , _ e G kA �o wt � too VA o N Q ` y o _ Apr rr .D I k�j Adr cV1 L Vc�-'RL -7,VVJ- 2 o � jaw o 2 he sodid UOII13Axzsqo—8 oing!j JQIIO:)106013 JOWAA �6 --\aoejjnsOADeINDUl "UI "lilt" -ulw.9 MIS 84ujeq3 sfiuildno3 ite Id tpeal e VF)u i —-elp-ulw v jo do_L des ItIffi)joleM te -lilt" eq""q3 a:)4iledo)j )U1113eal F 0 j,Ad L luaisXs punoW L,jo uO'130s-SSOIa -9 Qjni?!j ulat" a390:1 adolS ease p.811!1 lepa)CI JaAO:) 11a3 uoi nq!jlsia adid uoi eAjasqo .0 oe m D U•U D — w i T tf 'w E D 1_ - Di 5i Rif3uT�o� Z� A jj3eL- ATE Gr , TkCcka E'S s PI P w OF T°P so(L V/' 1 E,Qi4i.U�L.. s ysrEM U)J` FORM TOE' 0 70 Rfalo M6J7• 1 E . :D ; SAW> , Jf/f Plewwo To p Sd J-- u 9S 7 /0 % StoPE {D� F'aRcE' u� Fo R� D 7 MAW E t W/lroa vJ3 PER Rep "748 ' Fr. — F-LEVAT-lot-) s 17- 2-01 i p E• �' �° Fr. IMVERr OF q IATGRA ( S F FT• - G 5 � Top © F Rock � 97•Soi Fr. ' H I• U FT• T"'P °F N IATERA (S PLAN VIEW OF Mou.)jD wi rti 'B r� Q CEMTP):}L FORM MAW A (7 FT• 50 TorRC. (3 -73r 0 Fr K• /0 Fr T i c O 1 -�� T 15 w � F 00 t- °0 w 3 o y fT- F BE V OF Pvc cAppEp To Ii.N Agti d SSE R VATI o 0 Pfpes loC4T%a.v6 : C -fv 10 FROM MNO oF' Calls PEQ MAO PwT MARKERS (TopS o C/t=,,4A20o s`vE` � RE(QU RED BASAL AQeh � `pAi�y wRSt"EF'low � ySD JJJ 750 Soo L _ C APACi Ty PROPOSED BAsM APeN ( A -75 J ,� C�' + l 5, l 5-7 5 C � � M v, 1 sAZ.. rT. OF. ,C-A 6t6� Al FLvs H To R�De- ��9w,v lab ,*, ROX SIMILAR APPROVED PEVI CE, r� �,y.. a qq elf1p &) 1A /00�,p /BUG /34// P4 DI5TRI15UTIO P Pt?E LA�a u'T' 3 of G P9 CENTR,NL- FORGE MAIw P Is r 15T tio(F = �- I x x � r w TOTAL V010 VOIUME of NF-TwoRK FT. Imckes gals . lr `f OTAL VOID VOI OtAC o C-' FORCE MA N y 0 � 3 5-1 s. a INVERT EI EVNTIOQ /01- 30 OF LAT'eRA15 Hole Vi NMET o � r� s CAREFully •Ramove /III EIZ, iN E PRitl tD ORfICE "(30RR5 "' 1.-ATl~ RI.\L `� I l IN�I�ES . MAN � I`nLl] �� � 1-�01 * 5 IOC14TE17 ou iNCI�>` s 6 orroM, eueWc.y FORCE MAW 2„ SPAcr-a . # RO 1E 5 I IA-MMA L P ER IZ vR) PiSM50TI ftREN o(E, • qg t{o(e-5 _r0 rA-L i ,.3 �o C T wa l< 50. FT. — q• 3 SEE RED)ERSE 510E FOR 'TERMINAL C/p D -rhiL tit PER OTIS , Fos, !f G "0 ES 915CG PA E RATE To QE yN1 ; PeR MINUTE PER t4ole • t)15T'R.� i3L'C ION Di 5 ch ARSE RRTL FOR I^Ack IATERA l Him • TOTA L I STP-1 Bt,MW DlScI�A�CLgE (ZRTE rbR 1-je-- womv, ' 9 AI 5 /Mlw @ a. �5 M► Ni MU M HeNp D z N 541" AS 84" REQD rrl 43' z z Fi c m w D ' 0 rnO I rn O UP 42" � 4" CAS a 1 3" 461" e 5" r D D (n X — n 38" m°� \ v 1 D N n N UP 40" V 4" CAS , g � o m , m z c 3; D c z D 41" -H 0 v m N I D I N m D r n Z Z a c_ Fn rm ; D '`A " z Z -Ni n Z v ^ D 4��D Ajpm*aFmy<0<0DN zm xx �-0 z 0 2n0 v)o8 =p0�85fAAFz m OQ m� m N y mOp xDp xr�_ X,r0�; N rn Nv cN-iUm-' �v��1 C z f7 N(n �� �<nz�--?-•�r''`:wG' r�i-� Q OZ ZZ \m0 M ch D. � DD-4 to(-mlp��a s (7`O C7C aw N� a OD N N N . .. t v ms's i vrn Mmo, D!9 00 =A N p Ow NmD IDD rmow' �n'v ?1 C) z ��'-` O oh) N G r W n v En 5dO Z Z 6)O m� m� N 0� D c o v D 0 n0 A D �� =rZ r� v n —{ r °< .n :E Z z O Z Z os. m °n 0 0 H n y" C y '�-N v o -� Z v m < Z -I r _0 r'I* C m o m (7 m C') � v �� pc 2 OJ v N m v p " rn m AD O Do n X < 3 z N DH 0 z r � M m v \ N V&P1000/650-MR m DRAWN BY: WCP SCALE: 1 4"=1'-0" PRE-POUR: 0- m SEPTIC MANUAL �o������ DATE: 00/00/00 DATE:. OST-POUR: Z W3716 US HWY 10 MAIDEN ROCK, NA 54750 0 800-325-8456 FILE: 1M000 e - SEPTIC TANK h PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS " CI VENT PIPE 12" MIN. ABOVE GRADE & !►WEATHER PROOF aI _ LO FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR_ INTAKE IpGK612 - WITH CONDUIT MANHOLE COVER! c O R ! W/ PADLOCK 6 f----WARNING LABEL i ���� ._._..�.....�.— .. .._-�. , V'"'.x------- .- I��.a�____ _�•--4" MIN. 1.0 �l INLET I . GAS 411 �D'D� �'AC TIGHT A I I APPROVED 4D. 40 l.Tm —f— I , ALM JOINTS W/ nuc pi pL, Mp�C`� � pOLY(pGx �j25 B ON PIPE 3 ' ONTO � I � j,p SOLID �.O yC3.3) i SOLID SOIL SOIL C PUMP OFF ELEV . F2'. -- OFF Ah RISER EXIT PERMITTED ONLS 50.1TV)A — g(Q�0 i IF TANK MANUFACTURER 7V.00 (p�0 MR 3" APPROVED BEDDING UNDER TANK HAS APPROVAL ' 1�C) I CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE e TANK MANUFACTURER : GutES�R. CCN!/l� NUMBER DOSES PER DAY f 40 j TANK SIZES : SEPTIC /DOd GAL. DOSE VOLUME INCLUDING I i DOSE GAL. /oFLOWBACK: Ibo GAL. ALARM MANUFACTURER: Leust RlArRM CO CAPACITIES: A = 17 INCHES = 30o GAL. MODEL NUMBER : --V.V.L- — 3WITCH TYPE: F 0 B = 2ry INCHES = 3q GAL. PUMP 'MANUFACTURER: ZOE�-L-ER C = • b INCHES = /b0 GAL. . MODEL NUMBER : � , — /. 31'24 D = � �j•7. INCHES = �• GAL. J4tIlVU'tUlw SWITCH 'TYPE:Pt"Y t32gG(c v 16 REQUIRED DISCHARGE RATE 3X GPM PUMP & ALARM WIRING AS PER .ILHR 16 . 23 WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE q.. FEET + MINIMUM NETWORK SUPPLY PRESSURE . 3_._ FEET + 50 FEET FORCEMAIN " -3-3FT/100 •FT. •FRICTION FACTOR . . . - Fi 5 FEET TOTAL DYNAMIC HEAD FEET INTERNAL DIMENSIONS OF PUMP 'TANK: LENGTH WIDTH DIAMETER LIQUID DEPTH <�. i� FL.o w I3A►GK), A" FORCES MAci N ) ,50T'oT1tL) h E}S V011> P/C .Specs — !: �GWEEP HDIE 105s Fo R A %(a hole /� (3ou� 7 f s PUM P = 11.79 A . 19 x 3. 5 = '7-4 GPM •'• REQu11 0 Ac-fv }L, Pi ScRAR6E R 4rL Musr r3E ->3 QN0 GPM ., - Q SEPTIC TANK, per Comm. 83 .44 ( 2) (c) shall be equipped with an outlet attached approved filter device (Zabel I PF R, FOR-MUL R fliter) .' Tank shall have an approved above ov��' ..t,�a�E '�• ground locking manhole cover for regular (every 12 months or less) inspection & servicing by a SIDD - 1070(p"p (N OV) licensdd service pumper. 'MI r P♦ • � of � _ d ZOLLER EFFLUENT PUMP MODEL 98 HEAD CAPACITY CURVE s ? { MODEL"9tr / ! !// / 6/e 2a- � o -+ + e eo— 1/2-11 1/2 NPt a— tl.tl, NILLONS 10 () 30 /0 50 60 70 aC 11tfA! e0 160 210 0 FLOW PEn MINUTE Torsi 0-10 playtIAlpnutt Httutut tare t*WAttwne . MtN tA►Atlly 12 UrMteMrN e , Fell, Nt/tne tlullE,r lint v , 1 1 It 913 10 3.00 el 231 1 11 1.4t 41 170 20 t t0 24 OS t«kValva h3, a 5/}{ CONSULT FACTORY FOR SPECIAL APPLICATIONS e Electrical Ah anlars,for duplex systems,ere available end a Mercury Iloat switches are available for controlling single end suppled wMh an alarm. Mecherl�al 1119maloto,tt3r Ehtpiex syslema,are available with of a Double phase systems. *khoul Mom exrfichq. piggyback mercury float switches are available for variable level tang cycle controls. Standard en models-Weight 39 lbs t/1 11,p, 1, ►+eerdno.roperusd2 SELECTION GUIDE !N tabu !. single 1 P�trwhenkal switch,no external control rprdad. Control Selection`-- P 09yheck mercury Uoy switch or double PiCYback mercury," Mode f ypbg-ph Mode Am 1 aim hr twitch.Refer b fl017T. M9{ f talc P Du 1.1 3. Mechankai ahernslw 100012 at 1000M 9.6 1. &o FMO1r?,for correct model at Ebcirtcat Aiarulor,'•EPak^, Dge 230 —e' 2 ot3�1L_ _ a or 4 s. Mercwy son"00d switch io-0220}Writ p •wnlyd weWyor ,peelrl• 1 �c 1 or t t 1 duptex(3)a(it)Ibu system, fSS 230 I lion 1 S - 3 a F f11 r+4M"J Pak".funedari boa,rot ples'a&plot oWredon Io00m. Mfelt/dpM eonrredlon or caked N stm• t. Two(t)ho4`Jrra",for tanell" Spite•. rse t�rsy�pl M aeeerW ANp pftd sb rsrw it tat" YY i C q,,W (/Mt;EbckkY Allsrnu« U ►011; MA.l e iobneeb st CAUTION ;V thsnhsl Aurnsbr. prdsdke 4@46@9 and nd wi sAead w dae 1 1WPe1 13; stake,ri"T;taw mCaved O.K. asnssd stwrletsn AS*"I.d and ssh s &e stud► IsSo.►,N y a k wrsluallrsesd Nsllensl EMdrs C�(NEC)nsit M( slaty tit Nsr1EA Ad fOt"A), l• - RESERVE POWEPED dESIGN For unusual conditions a reserve!safely(actor 10 drigineered Into the design of o,iery Zoeller pump. nIre IRr.u.e0X 16111 / � IOtRSVir4 XY I0?58-0311 Manufacturers of... rC L L SNIP 10;3 J80 04,Moors I ant q ter 0 Xy Inert{ Quwrirr�itries„f'.vcr/9.x.9 a. (SOT/7%d•?73 f:e FACj507►f74-3624 Property Owner WA r N 9 /<-DJR BE L Parcel ID# C)7 Z . /o 7 5j . z O o o o Page Z of 3 ❑ Boring y2 /, S S S a Boring# �0 / 7.1. ce' �' pit Ground surface elev. _ \ ft. Depth to limiting factor Z in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure acinsistence Boundary Roots GPD/ft 2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. * ff#1 ff#2 0.7 /0YR 3f2 L z.f 56K X5 15 Z • 12, io YR 3 L If s6/1 ds 3 2' 1 /o Yes 511-- Z f 5k 4R-F R -7.5 YR s 51, -Fi c w — • y 5 � y 7•SYZs f(-C- gars sL /fsbk tm f1' . 7 5 Y R Ce/e ❑ Boring# ❑ Boring AT .5W P R o p. C o R N e R r)Q 135AN PA rch �+ © pit Ground surface elev. ' ft. Depth to limiting factor 17 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft z in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. =ff#1 * ff#2 1 0. 6 1bYR .Yz L ifsbr- [f . 6 . 8 2 G,• 17 7 5YR /, 5L 2f Sbk f-%V-PR C5 If • 6 /- 0 3 17- 75 YR s f(-F Mors SG /fSb,K /m R c5 — . 41 . 7 s Y R !� •y 7.5 Yk, c j c MOTS SGG 1-fsbk 3-_ F-1 ❑ Boring Pit Boring# Ground surface elev. ft. Depth to limiting factor in. ❑ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell, Qu.Sz. Cont.Color Gr.Sz.Sh. :ff#1 * ff#2 *Effluent#1 =BOD 5>30<220 mg/L and TSS>30 <150 mg/L *Effluent#2=BOD 5<30 mg/L and TSS'<30 mg/L The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need.material in an alternate format, contact the department at 6.08-266-3151 or TTY through Relay. SBD-8330(R11/11) OR All s �-�1��z _ Wis. Dept.of Safety and IL EV P1AA j RT W / of 3 Division of Safety and rdance with SPS 385, Ad m. Code ty G i cc�� —county SY• C R X Attach complete site plan or} eLn�fess 8 1/ x 11 inches in size.Plan must include,but not limited to:v 1 an nce point(BM),direction and Parcel I.D. percent slope,scale or dimenSi \O w, and location and distance to nearest road.' l 7 �print all information. a by Date Personal information you,�wde may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). r/L�� Property Owner q Property Location t (� WAIN E J<O R B EL Govt Lot N9 1/4�"�1/4 S i7 T Z� 'N RIO E(or W) Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# 1 75 It o+-k NJE• 8 R65— -kEET'5 3 City State Zip Code Phone Number ❑City []village gTown Nearest Road P-013EQ"1'2 WI 4611 ( 715 ) 7�f4' 3(��2 WAKR�� /Oo th Ave , . ❑ New Construction Use:4 Residential/Number of bedrooms 3 Code derived design flow rate ��� GPD Replacement // ❑ Public or commercial-Describe: /� Parent material /O ES ovER ,VENSE TJ//S Flood Plain elevation if applicable N/A ft• General comments AtA��Wt Tested suitable t0��a and � recommendations: �pund(P.O.W.T.S.)system using 'Gt►Ji Voitm Cop• ,001Z ,. ly5'r. ElEv. = goo. 5,9 ' y5p. 20 Boring S•5•S Boring# n l� Pit Ground surface elev. ft. Depth to limiting factor 1 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. ff#a ff#2 o•/o IoYK 311Z L- 2-" sbK JQ s 95 / • S Z /o•/8 /o YR 316 5IL L-f sb k J5 . C5 , / 3 Zy /o Y2 (#& 51L Z-� 5b9 �PR C W — • G • 7.5 YR •F 1•F M o+s /;sb K !SIR i? r Z F Boring �q 5 55 Boring# Pit Ground surface elev. ft. Depth to limiting factor in Soil Applicati2n Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft z in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. ff#1 'Cff#2 / 0. 8 /0 YR t- 2f Aw- d-5 9 s If . 0 Z g• I5 10 YR 31to 51L Z4sbK rvn-FR CLU /-F • Co • B 3 15. 2Y /o yp- y 51L If sbk nM-F rz c LO . 4 7•SYl2 fI � Mo+5 5GL if56k tnf- a Z 2 . 3 5�� S Y P, f W POCKaTS o x oYR 51y SL 1f sbk nM�R a.i *Effluent#1 =BOD >30:S 220 mg/L and TSS>30 <150 mg/L "Effluent#2=BOD <30 mg/L and TSS <30 mg/L CST Name(Please Print) Si nature CST Number RoftzT 24LBP-* c;kT— Address Date Evaluation Conducted Telephone Number zs�Z /o 7' A V-e 5P?-(,\)6 W(EY IC 1 , 5g74 7 71.5. 772 - L/192- SBD-8330(RI I/I1) I � -7 v� e LP 10 ON al 0 o rn G (j rn © 7O tCi s I I UN In c °0 Cb, 7q c Q n , + O rN _I r C P • M 4131;� m ,� N c d _ fl f Page 6 of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins;tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter SPS 383.33,Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. I Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARN I NG>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC,PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER N F-"VtUE Name NE(.6\) F_ CtCAVA--noG Name 5 EVE MOL'A3 t GL1 Phone "115 . 7 q 1. 3 ;/ 'Z i Phone 115-39(o - 8 I'm SEPTAGE SERVICING OPERATOR(PUMPER) LOCAL REGULATORY AUTHORITY Name S`I'EVE MVEIVIGk Name 5T• GAO( A CTY. Zot,)W& Phone 715 - 3 8 (P - 8-LI7 Phone 7!5. 3 8'6 • yG 80 This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f)and 383.54(1), (2)&(3),Wisconsin Administrative Code. Revised 3/29/13 POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page 6 of G FILE INFORMATION SYSTEM SPECIFICATIONS Owner W h NE (<O RU E L Septic Tank Capacity /0-c'fl al ❑ NA Permit# Septic Tank Manufacturer W 1LF$E2 ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer Pot-Y 10 LK ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model 5,Z 5 ❑ NA Number of Public Facility Units l t) JU NA Pump Tank Capacity & S al ❑ NA Estimated flow(average) 500 gal/(4ay Pump Tank Manufacturer ❑ NA Design flow(peak), (Estimated x 1.5) 50 gal/day Pump Manufacturer ❑ NA Soil Application Rate • (a al/da /ft2 Pump Model ❑ NA Standard Influent/Effluent Quality Monthly average* Pretreatment Unit ❑ NA Fats, Oil&Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD5) <_220 mg/L ❑ NA ❑ Mechanical Ae ion ❑Wetland Total Suspended Solids (TSS) <_150 mg/L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Ox y Demand (BOD5) <_30 mg/L ❑ In-Ground (gravity) ❑ In-Ground (pressurized) Tot uspended Solids (TSS) <_30 /L ❑ NA ❑ At-Grade Mound Fecal Coliform (geometric mean) 04 cfu/100m1 ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size in dia. ❑ NA Other: ❑ NA Other: ❑ NA Other: ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: ❑ month(s) (Maximum 3 years) ❑ NA iM ear(s) Pump out contents of tank(s) When combined sludge and scum equals one-third (36)of tank volume ❑ NA cell Ins Inspect dispersal s At least once eve ,Xmonth(s) p p ( ) every: ❑ year(s) (Maximum 3 years) ❑ NA Clean effluent filter At least once every: ❑ month(s) ❑ NA ,'year(s) Inspect pump, pump controls&alarm At least once every: ❑ month(s) ❑ NA :9 year(s) Flush laterals and pressure test At least once every: 3 ❑ month(s) ❑ NA I&year(s) Other: At least once every: ❑ month(s) ❑ NA ❑year(s) Other: ❑ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection-of the tank(s)to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (X) or more of the tank volume,the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to,the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of<_12 months,shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. CnvcP,) AR���S�'<RCCCRRiiWl', /,a llllllllllll�l'll%%��ll�lll!i�illl!l�il�l�'�l�i/`' - � I\�ll�l���l�ill��������1���������ll��l lll�l����ll����� �rii�,' •III III� II��,. I'. r .11,11. i� ��,1�j1„I ICI III LII. i �11 l!�III� Illl�ll �� I I�jli, I jl III . - III Illl II'' -' Will ! �I I'lill Iilllili'I�6 I I�I�I�I�IIi%Iill� 11 tt /dlII ,�l 111 I ! : i i I I, III�IiI I I I' I I (III I�'� I'', illl IIIII i' I III, I'' I II ”' (IIIII I �� ,III I III I �� � �) I IIIII III 1, I 'illy j I Ij lj, dill�II��II► I� 'I� Jill IIIII i I I „', I,I -�. li��li IIIII(III, III I�II:�IIIIf II IIII'III � �� l��lllluni '',ilii�l�pliiumlllouln':ioru�luu��i �ruu��l�_ ..I��Iii6V61i!�I111111d�1611iIlIli III'llhlillllldld111111611d11lillllllllllilllli'IIIIIIIIiIIIIiIIIPI'llffIlllldllllVli11�61�1iPIIIIIIIIIiIIVIhI'IIIIIIIiIiPII�IVI�III'IIIIIddIiVl�ll►!I'llll�l�� I'', IIIII II�I'I I(IIIII I I:I ICI I i'I I l l i I II II II I I I VIL�Ii(IEllldllllllllllllllI''�IIIIIIIIIL+1'lift'IIIIIIIIIIIIII:IIIIIIIIIIIIIQ'f lllll�lllllllfJlPfIIIIIIIfIIIIIPIIIIIIIIIIII!I'lllfiiCll�ill�� �.I�IVljlirli!ilIli1111116111111611111111�lilllllllllilllllllillllIIiNIIII�IIli6111dIVllllllllll'IiPIIII�IIIIIdif61�lIIf�IIId�6hVl61�lllllldll!Illililli1161illlilill�lillll6161IN'IIIIVIII,lillf I�I!Illilil111111�6��j��;-- !GC�]!li1'IIIIItIIIJllllllllfl'11lllllll�lll1611111i11'IIIiIdIfIIIIIIiIV ,I. CIIIIIIIIRIfll.ll►IIIIIJIIIIdIiIPllllllllllllll'II'll''Illllll�ll ''°iIUIIIIIIII'I'I!I'I'III'II'II'II'i'I!I'II'IJ!f�II IIIII'(�IIIIII�IIIIPIIPIII'IPIII'PI'llll�l'IIIII'I!I''fPl!11�111199�I'i'IIIIIIIIIPlll9�'IIIIII'II'I!!fll!ICI!I!8111111119'IPIII'lll'UIPN69IIll'll'111'll'19'I!IIIIL�IIII'Ilhl'%�� ' I I I�111911�IIdIIIIIM1IiI!1119 1 61 1111 1 Ildlllll�llfa lulll II IIV.II U Iillli illilllilllliili i�I��IIlilil�lli Illli�i�'�'i II III��Ii il�ll rn0 U, CpyDr- ° —� C --i ;ocn Dm — mZ W (,7DON Omm C � C/) -U W T TZZ _ O C:) r- IV m Z --jr O CTI C X < O 0 C n, m Z m G) O r A 0 -I D m m n O vW zm � v m -� o C/) _{ Cn R° = m °' azz xC/, O m z = = c� Uv v0 o � ® C ". z ° O --4 cn N CD � A � A C." 3 C° N O � 4 O A N 70 1 opp W C) O � A w W Cl) O r ^W < W O r A C, w A O .p N fi=n �=n0 mCA DO DOS --av z -' z ? z � v eta 1110 Oo � O = � cnD o � oZW c7m cnN E� Ala A � C�i� om 1 N N �. Cm � � Z �7 X O O C m m ST. CROIX, COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owne uyer W_�/1'l� K Mailing Address /D s / d ° Property Address �� SL (Verification required from Planning&Zoning Department for new construction.) City/State f'l c'fj� Ir5l4arcel Identification Number O LEGAL DESCRIPTION Property Location 96 1/4 , NE 1/4 , Sec. / 7 , T 27 NR ) S W, Town of Subdivision Plat: , Lot# Certified Survey Map # /�R', , Volume , Page# Warranty Deed # S l �°`� (before 2007)Volume /a S8 , Page# Spec house❑yes Xno Lot lines identifiable Z,eS❑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. Number of bedrooms -� SI NATURE 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) 1 01-i-D(D) (Fur u:<by:ACA,FCK FLCA.FCA) y��y''qq�� SP45 1rE tJ1 ���1S��Rr 'THIS INDENTURE, made this 15th day of D�c.:vII113L ®FFICF 19 93 between AeriRank.FCt E/k/a Farr, Credic Batik of St. taut, ST CR®!X Co W1 — i r'Z•eeld for Record a iix:arally chartered corporation, with a post office address of DEC - - P.O_ Box 199 U EL' 3 0 1993 J I River Falls, Wisconsin 54022 at Wayne E. KutL�l and 1'rn 11 arb ({ 11�fa5 Pte' of the first part, and — d !`4h7 are _ ' Register Of pesdg s whose post office address is 7.075 100th Avenue Rot'erts, Wisconsin 54023 party of the second part, (hereinafter referred to as party whether singular or plural). V4TTNESSETH,that the said party of the first part, for and in consideration of the sum ril Sixty-two arid Recording rnforinatlon _ I *�ti4eYYeie'k**�c:'rie�k'h*'kYt�cieieitie,l aYinYie*sr4t'ki:it'*'.r�F�kirlrY�*etYr'kX•e'kYr*:tirhYt kit DOLLARS, ($ 62 000.Uo`*******,�y:* *) to it paid by die said party of the second part, the receipt whereof is hereby acknowledged,dees grant,bargain, sell, and convey unto the said party of the second part, his/her/their heirs,successors and assigns forever,the following described teal estate,situated the Comity of St. Croix and state of__Wiscetiisin to-wit: SEE ATTACHED FOR LEGAL. DESCRIPTION. r S t subject to all existing easements and rights of way; also subject to all taxes on said premises for the year 19 93 and following years; also subject to all unpaid parts and installments of special assessments on said premises which have fallen due, or will fall due hereafter. EXCLUDING therefrom and excepting and reserving to said parry of the first part all mineral and royalty rights, interests, estates and tides heretofore reserved or excepted of record by True Federal Land Bank of Saint Paul prior to January 22 1986, if any, with such easements for ingress, egress and use of surface as may incidental or necessary to use of such rights. The foregoing exclusion, exception and reservation shall include, but not be limited to, all oil, gas, hydrocarbons, coal and other minerals of whatsoever nature lying in or under the above-described lands and all royalty interests as to oil, gar and other minerals produced and saved therefrom. It is expressly understood that the said party of the fast part will make no warranty as to the extent of its ownership of minerals, or as to its title thereto. TOGETHER with all and singular the hereditaments and appurtenances thereunto belonging or in any wise appertaining;and all estate,right,title, intem-st, claim or demand whatsoever, of the said party of the first part, either in law or equity, either in possession or expectancy of, in and to the shove bargained premises, and their hereditaments and appurtenances. TC' HAVE AND TO HOLD the said premises as above described, with the hereditaments and appurtenances unto the said party of the second ..N :. ., cDnW�'cD part, shat tU iLJl list(WCIi belts, Sur..,.:vu o a muibiu ANT) THE ,AID party of the fast part• for itself and its successors, does covenant, grant, bargain and agree to ard with the said party of the second part, iii5/her/u)Bir hc-.r.-. succcssors and assigns, against all =d ever person .,., . ..,.imm"fully claiming the whole O n Part thereof. by. through or under said party of the first part, and :cone other, it will furever WAt kAN T and DEFEND. ui+G tuj �7 Page a or i ,_'!_ �nu-08PME 52 M WTI,%E'&,%WHEREOF, the said party of the first part,has caused these presents to be exectued is its corporau name the day and Year first above vir-zw.,. WTf':4LiSSESS: AGR1BAMC, FCB By, ^ -- Rodnev L. R,1mma1 Chtef Exewir ve Officer (Hame) Mile) -- of Farm Cresdll Services of NorthWeSL W1aconni.n. FLCA Acting as Attorney-in-fact for AgriBank, FCB. or: SPATE OF WISCONSI21 SS. COUNTY OF ST }t. CROI - The f o r e¢o i n r ins.rument w a s a r—k n o w a d o.d b e o r e!n t(1 P (fi r=) December l 5- 1 993 - by (hbrir) <.m L. R .nr (title) uhier i;•xe -+ iy Officer .:1,."•1'�",• of Farm CreditSerViceC of Ncrr FhwecF Wiar_gf,nr ELrA _ as Attorney—in—fact, on behalf of AgriBank, FCA Lori A. Woltman Notary Public, Piercc _ County, Wisconsin My commission expires February 26 19_25 STATE OF ss. COUNTY OF The foregoing instrument was aabimviedged beforw nie on (date) ' by (name) ,-(title) Of on behW of said corporation. Notary Public, County, MY commission expires 19 This instrument was drafted bv_ cltimaniFurm Credit Service,^. P.O- Box 199 Rl.ver Falls, Wisconsin 54022 Y CJ Jz3 Attachment "A" LEGAL DESCRIPTION: A parcel of land located in the NE'14 of the NE a and the Mw-', of tiie Nr:1. of Section 171 T29N, R18W, Town of Warren, St. Croix County, Wisconsin, •-r >re fully described as follows: Commencing at the NE cornCL of said Section 17: Thence N88 40109"W along th8 North line of the DiE4 a c67istance of 495.0(?' to the Po nt of beginning: Thence S31 36'88-B 371..381 ; Thence S3 01136"W 80.801 ; Thence N71 06100"V 435.421 (recorded as N71 0914911W 435.341 ): Thence 518 49'.53"W (recorded as S18 50111"t-4) 279.451 ; Thence N-170 46149"W 338.201 ; Thence N8�027131"W 360_001 : Thence NOo32129"E 393.141 ; Thence N89027131"W 176.271 ; Thence Ni 19151"E 494.061 to the SW corner of the parcel described wn volume 416; Page 214; Thence S88 40109"E along the South line of 'said parcel a distance of 145.001 ; Thence N1019151"E along the Fast line of. said parcel a of 106.001 to a point on the North line of the NE4 of said Section 17; Thence S88 40109"E along said line a distance of 930.89' to the point of }beginning. Contains 27.60 3rrs a c.ih j Ct to 100th J. e.. . r ig:It-of=wa f over the northerly 33' 4l.[1ece0L Alo-., vuujeuL co any and all adaizional ease"ients, right-of-ways or conveyances of record. I i i I