HomeMy WebLinkAbout022-1050-70-200 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
574398 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:
Bartos, Ken &Sue Kinnickinnic, Town of 022-1050-70-200
CST BM Elev: Ins .BM Elev: BM DescrJ' o�'M , f Section/Town/Range/Map No:
16b , d /V o. 0 e�J/ '� ` N 0 hC+� 1� (r 18.28.18.276A20
TANK INFORMATION ELEVATION DATA , 2 164,ZIP /66
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
S= ry s7` /Dr> d
Septic fir, y �d b Benchmark d`I'7' /66 Dosing ' Alt. BM ,t Goy
Aeration k-j)bk. Bldg.Sewer wk � x(05
d .
Holding St/Ht Inlet 4-3 � 19,&--7
TANK SETBACK INFORMATION St/Ht Outlet
TANK TO P/L WTI LI BLS Vent to Air Intake ROAD Dt Inlet
'- /
Septic r —7 Dt Bottom �->� ��2 )' 17a
Dosing r / / ,7 Header/Man.
l0 7•?O /� ,fib
Aeration d D Dist. Pipe 2 7,D /6/115(o
Holding Bot.System 3. yZ /DO g�
Final Grade / .� 16 •SlP
PUMP/SIPHON INFORMATION l [ 2-O M
Manufacturer I I Demand St Cover V2,
GPM 1"Y 6� Z.s� It,3,
Model Number Z9,�� f 3 �• C&- C
TDH Lift' y.' Fricti n Los System Head TDH Z Ft o Z.M �.
Forcemain Length Dial/, Dist.to Well
0
SOIL ABSORPTION SYSTEM
BED/TRENCH Width I Length No.O ran che PIT DI EM NSIONS No.Of Pits Inside Dia. Liquid Depth
DIMENSIONS /" �D -� �-
SETBACK SYSTEM/ TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
Type f System: Z3 1 1 T A UNI7 Model Number:DISTRIBUTION SYSTEM
Header/Manifo)d it Distribution / i x Hole Size �! Ix Hole Spacing Kto Air take
Length (19 Dia Z Pipe(s)Length �. Dia ' ZS Spacing � � 3 L • In e
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over I Depth Over xx Depth of xx Seeded/Sodded WOo- xx Mulched
Bed/Trench Center ' Bed/Trench Edges \ Topsoil ' No s E] No
AA 9-j�
COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: /U /17 /b7p
Inspection#2: / 2�/ ( 'r
Location: 370 Vorwald Street RIVER FALLS,WI 54022(SE 1/4 NE 1/4 18 T28N R18W) A Lot•1 a cel No: 18.28.18.276A20
1.)Alt BM Description= T� � �✓�l�n GL �' �e�j ���w `
p W&
2.)Bldg sewer length= 1 , �L qD ��;w�- � Yr►0 J_ 11 V��j'o� �,,t(ow
-amount of cover=1 f q' �n.
Plan revision Required? E] Yes " No (� 3
Use other side for additional information.
Date Insepc rs Sign a Cert.No. r
SBD-6710(R.3/97)
Plot Plan. -Page9 qq
Pro Owner SuS B „ _
P 1 . 40 ft
_ (except where notes
Legal Descriptwn +�* c$"" 1 - -- BackhoepU
o�"�N'���4 s�� �S -t"zSN. �t8 w Toys� — •- •
7����
I�lN/J)C-AlAJN S'T C- cCo.�
O1X N!T-, bV(sCbNSyJ• 1�orth
s
��� O-ln� (J,J1� C.T.�F. SS �- .. • '•
p �M
I SRC=iH,4 DZbb NE-W W Is SEP,
,IDS � e ' � °� 36 ' *.ty
� T
a 3
3
.J
site Locatio
5 n
z 'd SLLT-9Z�-STL 2ui,4sal ITOS d},0 =L0 t1T BT daS
County r7
Safety and Buildings Division
201 W.Washington Ave., P.O.Box 7162 Sanitary Permit Number(to be filled in by Co.)
Madison,WI 53707-7162
See 2 ,,N� V� 5�� 3� 8
O pM State Transaction Number
N A ary Permit App tion X95
In accordance with si.V3.21(2),Wis.Adm.Code,submission of this form to the appropriate governmental unit
is required prior tdobtam,ng a sanitary permit. Note:Application forms for state-owned POWTS are submitted to Project Address(if different th Cm ling address)
the Department of Safety and Professional Servies. Personal information you provide may be used for secondary 7 0 \ 'J f AI,�t Id 3T
purposes in accordance with the Privacy Law,s. 15.04(1)(m),Stats. 'v�K. 6
�L� S
I. Application Information-Please Print rrmation parcel# `Property Owner's Name
Property Owner's Mailing Address Property Location / 2-7�
v V W I t s Govt.Lot 1 C
City,State Zip Code Phone Number �j�y,,� '/4, Section�_
r circle one
t Gr � S �Qi Z Z T N; R E or
II.Type of Building(check all that apply) Lot#
A Subdivision Name
I or 2 Family Dwelling-Number of Bedrooms "i
Block
❑Public/Commercial-Describe Use ❑City of
CSMNumber
❑Villageof,}
❑State Owned-Describe Use / Town of p Li M/*2 u
9 k 7a o
(/fin' ) ZC� 14 �j ,.,�h.�t.
III.Type, of Permit: (Check only one box on line A. Complete line B if appli able) n
A, Il New System ❑Replacement System ❑Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System(explain)
-----�
List Previous Permit Number and Date Issued
B. ❑Permit Renewal El Permit Revision ❑Change of Plumber El Permit Transfer to New /
Before Expiration Owner
IV.Type of POWTS S stem/Com onent/Device: Check all that apply)
❑Non-Pressurized In-Ground ❑Pressurized In-Ground ❑At-Grade X Mound>24 in.of suitable soil ❑Mound<24 in.of suitable soil
El Holding Tank ❑ ther Dispersal Component(explain)
❑Pretreatment Device(explain) 4 —v FX
V.Dis ersal/Trea ment Area Information: /
Design Flow(gpd) Design Soil Applicatio ate(g sf) Dispersal Area Required y Dispersal Area Propo (sf) System Elevation ✓/
p ( . ", , (" 4 00 `fi/ 63 _4 8
VI.Tank Info Capa ity in Total #of Manufacturer o
Gallons Gallons Units U 2 N
New Tanks Existing Tanks / o °� 4 n `^�
/,- �Z a U inn v� C7 a.
Septic or Holding Tank l SG/
Dosing Chamber g D d 4 `
VII.Responsibility Statement- I,the undersigned,assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name(Print) Plu er's ig ture MP/MPRS Number Business Phone Number
e15V 47 OS l-9� - Ss94
Plumber's Address(Street,City,State,Zip Code)
6 Q
Gi d 0 y 10 L " Q S
VII ount /De artment Use Only
Permit Fee Date I;el Issuing nt Signature
Approved isapproved $ /- /
,ven Reason for Denial �7 ' ! /
IX.Conditions of Approval/Reasons for Disapproval
SYSTEM OWNER: 3� Go� •�'t
1.Septic tank,effluent filter and 1 e C re, i/.. P�� t"�
dispersal cell must b rviced/maintained Y` I
as per management plan provided by plumber.
2.All setback requirements must be maintained
as per app ica *tom @ii WW%s for the system and submit to the County only on paper not less than 8 1/2 x 11 inches in size
SBD-6398(R. 11/11)
MARY JO HUPPERT Page 2 9/19/2014
• Inspection of the POWTS installation is required.Arrangements for inspection shall be made with the designated
county official in accordance with the provisions of See. 145.20(2)(d),Wis.Stat
• SPS 383.22(7)A copy of the approved plans specifications and this letter shall be on-site durine construction
and open to inspection by authorized representatives of the Department which may include local inspectors.
Owner Responsibilities:
• SPS 383.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and
maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s.
SPS 383.54(1).
• SPS 383.52(2) A POWTS that is not maintained in accordance with the approved management plan or as
required under s. SPS 383.54(4)shall be considered a human health hazard.
• SPS 383.55 The owner is responsible for submitting a maintenance verification report acceptable to the county
for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s)
utilized in the POWTS.
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
a This Amount Will Be Invoiced.
z When You Receive That Invoice,
Charles L Bratz Please Include a Copy With Your
POWTS Reviewer 2,Integrated Services Payment Submittal.
QQ8)789-7893 ,7:45 am-4:30 pm Monday-Friday WiSMART code:7633
charles.bratz @wisconsin.gov
Edwin A Taylor,Wastewater Specialist,(715)634-3484,Monday-Friday 8:00 am To 4:30 pm
y1�9�YAxr�ta�r DIVISION OF INDUSTRY SERVICES
�0 f o1P 3824 N CREEKSIDE LA
HOLMEN WI 54636
�•R K ���UTy S ��I� Contact Through Relay
---- http://dsps.wi.gov/programs/industry-services
www.wisconsin.gov
Scott Walker,Governor
Dave Ross,Secretary
September 19,2014
CUST ID No. 224832 ATTN.•POWTS Inspector
MARY JO HUPPERT ZONING OFFICE
HOLLISTERS SOIL TESTING&DESIGN ST CROIX COUNTY SPIA
W9875 690TH AVE 1101 CARMICHAEL RD
RIVER FALLS WI 54022 HUDSON WI 54016
.CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 09/19/2016 Identification Numbers
Transaction ID No.2456975
SITE: Site ED No. 806071
Ken& Sue Bartos Please refer to both identification numbers,
370 Vorwald St above,in all correspondence with the agency.
Town of Kinnickinnic
St Croix County
SE1/4,NE1/4, S18,T28N,R18W
Lot: 1, Subdivision: CSM 16/4423
FOR:
Description:Mound/Four Bedroom/Sloping Site
Object Type:POWTS Component Manual Regulated Object ID No.: 1502921
Maintenance required; 600 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade;
System:EZ-Flow Mound Component Manual,(R. 7/12),
Pressure Distribution Component Manual-Ver.2.0, SBD-10706-P(N.01/O1,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. The owner, as defined in
chapter 101.01(10),Wisconsin Statutes, is responsible for compliance with all code requirements. CONQ
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, APP
stats. pEPT OF
The following conditions shall be met during construction or installation and prior to occupancy or use: PROFFSS1
Reminders DIVIS10%OF
• This system is to be constructed and located in accordance with the enclosed approved plans and with the
component manuals listed above.
SEE G
• The observation pipes must be located at a junction point between two polystyrene aggregate bundles so as not
to create separation of the bundles within a product.
• Per manual cited above,limited activities are allowed in the area 15 feet down slope of the component area.
Soil compaction,excavation,vehicular traffic and other similar activities that impact the treatment and
dispersal are prohibited.
• The well must be a minimum of 25 feet from any POWTS tank,and a minimum of 50 feet from the absorption
area.chs.NR 811 8,1112c
• A Sanitary Permit must be obtained from the county where this project is located in accordance with the
requirements of Sec. 145.135 and 145.19,Wis. Stats.
MARY JO HUPPERT Page 2 9/19/2014
• Inspection of the POWTS installation is required.Arrangements for inspection shall be made with the designated
county official in accordance with the provisions of Sec. 145.20(2)(d),Wis. Stat
• SPS 383.22(7)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 wkich may include local inspectors.
Owner Responsibilities:
• SPS 383.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and
maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s.
SPS 383.54(1).
• SPS 383.52(2) A POWTS that is not maintained in accordance with the approved management plan or as
required under s.SPS 383.54(4)shall be considered a human health hazard.
• SPS 383.55 The owner is responsible for submitting a maintenance verification report acceptable to the county
for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s)
utilized in the POWTS.
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
This Amount Will Be Invoiced.
s` When You Receive That Invoice,
Charles L Bratz Please Include a Copy With Your
POWTS Reviewer 2,Integrated Services Payment Submittal.
° +k=: )789-7893 , 7:45 am-4:30 pm Monday-Friday WiSMART code: 7633
charles.bratz @wisconsin.gov
rY Vic: Edwin A Taylor,Wastewater Specialist,(715)634-3484,Monday-Friday 8:00 am To 4:30 pm
Jam M
EZflow"MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name: KEN&SUE BARTOS
Owner's Name: same)
Owner's Address: P.O. Box 772
Hudson, WI 54016
Legal Description: SE 1/4 of the NE 1/4, Sec. 18, T28N, R18W
Township: Kinnickinnic
County: St. Croix
Subdivision Name: NA
Lot Number. 1 Block Number: NA
Parcel I.D. Number. 022-1050-70-200
Plan Transaction No.:
Page 1 Index and title
� ua��a�a►a;araf�j Page 2 Data entry
�+��°'s°'er,,� Page 3 EZflow mound drawings ZONALLY
�+"•.�......•• °� %i Page 4 Lateral and dose tank
Page 5 Distribution media ROVED
MARS"JO Page 6 System maintenance specifications SAFETY AND
a HtIPPERT Page 7 Management and contingency plan JNAL SERVICES
D 1889 Page 8 Pump curve and specifications jDUSTRY SERVICES'
-RIVER FALI S � PAeg q _pUat-_._.r-LAIJ
W1
r�anatntna►�1�� RRESPONDEN
Designer. /tiAr-J CD WkppEKr License Number: t fS5_zi-OD 7
Date: 09/03/14 Phone Number. 7/5--4z.+--ITTS-
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)
1.501 Peaking Factor(e.g. 1.5= 150%)
600.00 Design Flow(gpd)
4.00 i Site Slope (%)
98.80 Installation Contour Line Elevation (ft) 120.00aContour Length Available(ft)
24700; Depth to Limiting Factor(in)
0.40 In-situ Soil Application Rate(gpd/ft2)
Distribution Cell Information
9.00: Cell Width (ft)3, 4, 5, 6, 7 81 9 or 10 Only 70.00 = 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 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�
Number of Laterals of the highest point. i
0.156: Orifice Diameter(in) (e.g. 0.25)
4.00, Estimated Orifice Spacing (ft) = 11.67 ft2/orifice
2.00 Forcemain Diameter(in)
120.00= Forcemain Length (ft) Does the forcemain drain back? Y
95.00; Inside Pump Tank Elevation (ft) Enter Y or N
0.00 Forcemain Filter Loss (ft)
4.55 System Head (ft)x 1.3 19.57 Forcemain Drainback(gal)
4.47 Vertical Lift(ft) 65.48 5x Void Volume(gal)
2.20 Friction Loss(ft) 85.05 Minimum Dose Volume(gal)
11.21 Total Dynamic Head (ft) 29.08 System Demand (gpm)
Lateral Diameter Selection Manifold Diameter Selection
in. dia. options choice in. dia. options choice
0.75 1.25 x x
1.00 1.50 x
1.25 x x 2.00
1.50 x 3.00
2.00 x
3.00 x
Gallons/inch Calculator(optional)
Treatment Tank Information Total Tank Capacity(gal)
1200.00 Septic Tank Capacity(gal) Total Working Liquid Depth (in)
Weiser Concrete Manufacturer f 1 gal/in (enter result in cell B49)
Dose Tank Information Effluent filter Information
800.00 Dose Tank Capacity(gal) Polylok ,Filter Manufacturer
22_.24, Tank Volume(gal/in) 525 Filter Model Number
Weiser Concrete Manufacturer
Project: KEN&SUE BARTOS Page 2 of 61
Mound Plan View
1/10 B : J
Observation Pipe 3
K. J. .r.:." ".r:r er:•r:r: : J.d.r l:'•:.d.::::1°!. . . . . ^ . . . . . . . e
J.r•J.f.d'.:.J:r:J::" :.:.f.r
'J1•."J:'•::. r J J • :L:yJ:.ti,`.�1,:•:0::��.�d,•'.""a1fa•."•''�f111�1�L :L••.• ..'L:°'{.,.
r.r.r.:.J..•..•• 5. •:.r•j•• . . • 7 .,::rd:.;.:i" .::: r A
W L.L.L. .b.•,. .b:S:?{: •:: :•:.:.J•r•:•r•J.:•r•J•r•:•r•J.r.--M —
•L•L•L•L•L•L••,.b L•L•L•L•°.•L•L•b•L•L•L•L•L•L•Lj'a• •ti�'.••'1:•:'•+.•.�. . . . . . .
B . . . . . . . ..
� .
L
Mound Component Dimensions
Down slope toe extension made.
A 9.00 ft E 16.32 in H 1.00 ft K [Aft ft
B 70.00 ft F 12.00 in z 12.43 ft L ft
D 12.00 in G 0.50 ft J 6.70 ft W
630.00 (ft2) Dispersal Cell Area 1 1500.00 1 (ft2) Basal Area Available
8.57 (gpd/ft) Linear Loading Rate 1 7.00 (ft) 1/10 B Obs. Pipe Placement
Mound Cross Section View
EZflow Dispersal Area
Finished Grade 101.80 (ft) ---►
F Dispersal Cell 100.30 (ft) Lateral
99.80 (ft)--► — 6;::,,,
:: :::�:: Invert Elevation
Dispersal Cell s ::: :::: ; f
Elevation D 3
4
98.80 (ft) Contour Elevation
4.0 % Site Slope
Shading Key
Typical Dispersal Cell
C See Page 5
Q® Topsoil Cap > d
2 """' Subsoil Cap o o Approved Geotextile Fabric Cover
ASTM C33 Sand �' 0 2.0 ft
d r
4 ® Tilled Layer 5 10 WW. L;•J. .J.
b.tij• 5•L•
l 5 ',•111: 1:• •'•L rJ 'L:1J1
5 {f1:1:1 EZflow Media t �� 1f .j.j{fL ?1� Lf1• ?b�11{• F
L.L L•L.1. f"r•J.1•J.J. r.. . ..:•r•J
JY•r :l Y:L•L•L L L•L•L•L
N O 0.5 ft brLf{ L b.{•J.r ..r.J.r.r.
r•J•J
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: KEN &SUE BARTOS Page 3 of
End Connection Lateral Layout Diagram
Place Appropriate Lateral Diagram From Ri ht Below
i =Turn-up Yd aalI valve or cl son outpl u a
1 E P
�""Z -- I t oririCB locslted at z 14-X All laterals iderritel,■.an orftes egpe spaced: s
Farce rnaln cannenian vim,tee or crass to maroMld at any point. Laxerala a.Forte main of ESC Sth O S
per SPS"rabrc 384.30-6
Orifices point UP except every Stn one points down for dranage.
Number of Laterals 3 Orifice Diameter 0.156 in
Lateral Diameter 1.25 in Orifice Spacing (X) 4.03 ft
Lateral Length (P) 69.26 ft Orifices per Lateral 18
Lateral End (Z) 0.74 ft Orifice Density 11.67 ft2/orifice
Lateral Spacing(S) 3.00 ft Manifold Length 6.00 ft
Lateral Flow Rate 9.69 gpm Manifold Diameter 1.25 in
System Flow Rate 29.08 gpm Forcemain Velocity 2.97 ft/sec
Dose Tank Information Locking cover with warning
label and locking device and
sealed watertight
Electrical as per NEC 300 and --►
SPS 316.300 WAC Disconnect 4 in.min.
Tank component is properly vented F— Alternate outlet
location
Forcemain diameter
Weiser Concrete Manufacturer �_ 2 in.
Capacity 800.00 Gallons
Volume 22.24 gal/inch A
_ Weep hole or anti-
Dimension Inches Gallons B siphon device
A 20.15 448.07 C
B 2.00 44.48 P� ump off elevation(ft)
C 3.82 85.05 t 1 95.83
D -10.00 222.40 D
Total 35.97 800.00
Dom se tank elevation(ft)
Bedding And Backfill As Per Manufacturer 95.00
Alarm Manufacturer SJE Rhombus
Alarm Model Number 'Tank Alert AB
Pump Manufacturer Zoeller
Pump Model Number '98
Pump Must Deliver 29.08 gpm at 11.21 ft TDH
Note: Switches containing mercury may not be used in this system.
Project: KEN &SUE BARTOS Page 4 of q
. t
Uf/ow8 Distribution Cell Media Layout
9.00 Cell Width (ft) 1.50 Sidewali to Lateral(ft)
Distribution Cell cross-section Arrangements
G"Oe"(NO
9 ft Wide
Component Legend
®
SIR 1-7A Bundle-5 ft or 10 ft lengths
SR1-12A or EZ 1201A in 5 ft or 10 ft lengths
SR3-12H or EZ 1201 P or SR3-12H 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
9.00 Cell Width-A(ft) 70.00 Cell Length-B(ft)
Connection Lateral Force Main -
9 ft Wide
End .-,Z w: _ _ Z — - - - — — - - -:-
Manifold
Project: KEN &SUE BARTOS Page 6 of C
Mound System Maintenance and Operation Specifications
Service Provider's Name 'Darrell's Septic Service Phone,715-425-1025 7
POWTS Regulator's Name 'St. Croix County Zoning Office Phone ri 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 1200 gal Maximum TSS 150 mg/L
Soil Absorption Component Size 630 ftz 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 periodically
Pressure System Laterals should be flushed and pressure tested every 3 years
Mound Inspect for ponding and seepage once every 3 years
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 •.• •.
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 Synthetic Media 1.99 Feet Diameter as Lateral
Distribution Lateral --P'�– Lateral Cleanout —�
Project: KEN &SUE BARTOS Page 6 of q
Force Main -----��
Force Main ----��
Force Main -----♦
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[EZflowMound 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,Slats. 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 10'cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow
specified in the permit for this installation.
The pressure distribution system is provided with a flushing point at the end of each lateral,and it is recommended that each lateral be
flushed of accumulated solids at least once every 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 shalt 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: KEN &SUE BARTOS Page 7 of q
• t
W HEAD CAPACITY CURVE
MODEL "99' 4 5/8
30
3 5/8 '•�..�
0 20 +
l is O
4-
4 3/16
10
z
s
1 1/2-11 1/2 NK
° �o �o Ho eo
J.S.CALLOW
1O
inam ° 80 j 1w 240
PER kepim -
Lem w CYM
Fqt Capais blNdes.
y n 1a V3
10 d1 y,l of
1S 4S 4X 170 12
M
L!19-0 V.-
7S 6c597,
4 3/16
,
c;aNSUL `C)PY FOR SPEC:IALAFPLIGATICNK
Electrical alternators,for duplex systems.are availablO and Variable level Host switLit€s are available W W"*O&V tin&
and three phase systems.
sppp W wNh an ahM. Qouble pijgybm*variable level boat switches are available
MAedundcal ailsn ft m.for dupbx .are availab� for variable level"Cycle wwols•
vAth or without 81mm swi6ches.
SELECTION GUIDE
1.��*cp8�2��� y M"filftlr a01�1
Standard ail models-Weight 39 lbs.-Ma H.P. 2.Oka%PbWbo*VOWS bwl#wt WAMb ardwAb P%Wbo*t�Ybis bt+dl.
s°9c91sMrh i0tMlra P177.
NMirMs C°"bo1 9i1001101 a wa+.Nc.ta�I�I�orlo�oortarlo•oo7s-
MadM valh�fw no& 4.gMp110712.for eoenateiodatot6�ObbN/1NM1wbr
11108 113 1 Aab 9.4 1 ar 1.7 '— 3.Oa1Mo1.rI *joa=and m a cood act Ww,apscry dupMel(g)or H)
113 9A Aoats orwtl4"
Dli9 290 1 Auw 4.7 1 or1 d.7 "' 6.Faur(4)ho1sJ-Pst.l bO IorlasAa1a01NOOe dan
eas 280 1 Nan 4.7 2 or 2 i8 3 or4 d15 7.7 11ob J-Pa torwaMd ao ^Or spice'
CAUTION
FariakuaafoamaddMu1111�e1sr�odY�wierb ratab)1� All nsed ation of controls,protection devices and should shouts be dose by a gW►Uded
FUD10.'iC� licensed eb1t1'idasl.Ati elactrica{andsafety wades should be followed ibe most
FMgM.8m*kdJWnaW.ElYgiIIBG receot National Electric Code(NEC)and the Occupational Safety and HeaOh Act(OSHA►.
S'ilpis Pflass 8tlapirc PasipCais[RI199BC Alsms Syillna.8111732
RESERVE POWERED DESIGN
For unusual coriditions a reserve safety facfior is eMlneered MdD the design of every Zoeller Pump-
OAO T&RD.em 16317
• ,,Lattip�e41(Y.d»7 ^-ilenaleab>wad-• _
� 81>fpli0r 34taf�.eRrelload _
PI/M/' lD:' t� 714
rAQE,.' ,. crp. _._._
' Plot Plan _ -
Property Owner -
Description ut i &-A I + (except where nok
Legal _
n =Backhoe
of-'4-L—AS.V4. sZc. %g, TzBN, Tr,,l9 VJ 'T-VVJ AJ QPF
KlNN1�xlNN1t. sr c�olx Ct►u
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_ North
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Site Locado •
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Wisconsin Department of Safety aryl,Professional Services
3 A
Division of Industry Serve r�®
V SOIL EVALUATION REPORT Page I of 3
in accordance with SPS 383,Wis. Adm. Code
County ST.CROIX
Attach complet plan on rit less han 8 1/2 x 11 inches in size.Plan must
include,but not limit on
reference point(BM),direction and Parcel I.D. 022- 1050-70-200
percent slop- north arrow,and location and distance to nearest road.
;pM�'1`�N` Please print all information. Reviewed by Date
Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). ` ?.f u4 1 L2tLa
Property Owner Property Location
KEN&SUE BARTOS Govt.Lot ----SE 1/4 NE 1/4 S 18 T 28 N R 18 11 El
Property Owner's Mailing Address Lot# Block# Subd.Name or CSM#
P.O.BOX 772 1 -- CSM 16/4423
City State Zip Code Phone Number []City ❑Village ■ Town Nearest Road
Hudson, WI 1 54016 1 ( 330) 524-5196 Vorwald Street
E] New Construction Usee Residential/Number of bedrooms 4 Code derived design flow rate 600 GPD
Replacement Public or commercial-Describe:
Parent material loess over till Flood Plain elevation if applicable ft.
General comments Mound System-- 1.0 ft.sand fill--0.40 loading rate
and recommendations:
Property Address 370 Vorwald Street
a
,,
i G;;f ii^�✓` c ii- 'Y1. %yy�,,. ly !` {..y1 4 F,i
/
C'
Boring
FTI Boring# �
Q Pit Ground surface elev. 101.92 ft. Depth to limiting factor 20 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 0-10 10YR2/2 - 1 2f-ma&sbk mvfr as 2vf-m 0.6 0.8
2 10-20 10YR3/4 - sicl 2fabk mfr as 2vf-f 0.4 0.6
3 20-26 10YR3/6 c2f 10YR6/2&IOYR6/2 sl Om mfi -- lvf-f 0.2 0.6
❑2 Boring# Boring 96.82 32
Q 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 I *Eff#2
1 0-18 10YR2/2 sil 2fabk mvfr gw 2vf-co 0.6 0.8
2 18-24 10YR4/4 sil 2f-mabk mfr cw 2vf-co 0.6 0.8
3 24-32 10YR4/4 sicl 2fabk dsh gi 2vf-f 0.4 0.6
32-till/ rk/clay
*Effluent#1=BOD >30<220 mg/L and TSS>30<150 mg/L *Effluent =BODS a 30 mg/L and TSS<30 mg/L
CST Name(Please Print) Sign CST Number
MARY JO HUPPERT/Hollister's Soil Testing& esign 224832
Address Date Evaluation forfducted Telephone Number
W9875 690th Avenue,River Falls,WI 54022 09-01 - 14 715-426-1775
SBD-8330(R07/13)
Property Owner BARTOS,Ken&Sue Parcel ID# 022- 1050-70-200 Page 2 of 3
Boring Boring
g El Pit Ground surface elev. 101.17 ft. Depth to limiting factor 30
F-;1 0 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 0-8 10YR2/2 -- I 2f-mabk mvfr as 3vf-m 0.6 0.8
2 8-16 10YR4/4 -- A 2fabk mfr cs 2vf-m 0.6 0.8
3 16-30 10YR3/4 -- sil 2fabk dsh ci 2vf-f 0.6 0.8
30-till
F41 Boring# Boring 99.80
• 24
Pit Ground surface elev. ft. Depth to limiting factor in.
--go—ilApplication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlfF
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2
1 0-8 10YR2/2 -- 1 2f-ma&sbk mvfr cs 3vf-m 0.6 0.8
2 8-18 1 1 YR3/3 sil 2fabk mfr cs 2vf-m 0.6 0.8
3 18-24 10YR3/4 -- A 2fabk dsh ci 2vf-f 0.6 0.8
24-till rk/clay
F—I 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/fF
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=BODS<30 mg/L and TSS<30 mg/L
SBD-8330(807/13)
,- --4F ..,--.F
KlNni(.Xn!Al+.!.. sr,C.xr—oix QuN'Y. IvV1s4`bAlStn! Z•by'fi
____ _____ North
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Site Locado is
50ti-rt+ p/L y..._ 517.31'
1 h
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Oct-19-2010 01:59 PM St. Crcix County Plan/ton ng 715-386-4686 t{1
ST.CROIX.COUNTY
SEPTIC TANK MAINTENANC9 AGREEMENT
AND
OWNERSHIP CERTIFICATION FO M
Owner•/Buyer -----
Mailing Address
Property Address t f—c, l 46
(Verificationn required if in Planning&Zoning Department ror now construction,)
City/State c� l S ��
Parcel Identification Number — l ds' t) - �6�
SAL DESCRIPTION
Property Location„5 �/,. ►1/ r/.Sec. Q ,T N R_10 W,Town of ,/,N,,,t c
Subdivision Plat: Lot# /
Certified Survey Map#_ Volume / —,Page# jV112 3,
Warranty Deed# '3 / (before 2007)Volume page#
Spec homes -yes Lot lines identi.Aeblo y no
SYSTEM MAINTENANCE AND OWNIER CER P ATI N
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 lank every three years or toorter,ifneeded,by a licensed pumper. What you put into
the system can affect the flinction of the septic tank as a treatment stage in the waste disposal system. Owner maintenance
responsibilities arc specified in§conms.83.52(1)and in Chapter 12-St.Croix County Sanitary Ordinance.
I
The pmparty av
eer agrees w submit to 5t.C"'reoix County Planning&Zoning DO P81111-101118 a ceniF '
� 8 pa ct►tton form,signed by the
owner and by a master plumber.journr an lutmbor.rest,' e it
'Ym P restricted phtmbcrora licensed pumper verifying that(i.)the on-site i
wastewater disposal system is in peoper operating condition endlor 2 after in
less than I!3 nBl of sludge.
( ) inspection and pumping i if necessary},the septic oink is
I/we,the undersigned have head the above requirements and agree to maintain the Private sewage disposal system with the
standards sot fortis,herein,as set by the Department of Commerce and the Department of Natural Resouroes,State of Wisconsin.
Certification stating that your septic system has been maintained must be completed and retumed to the St.Croix County Planning&
Zoning Department within 30 days of the three year expli aticn daps,
i/we certify that all statements on thietydead are true.to the best of tnylotn•knowledge. I/we am/are the owaer(s)of
properly described above,by virtue (a wa recorded in Register of Deeds Office,
Numb of bedrooms
SIGIVATl1ItE OF I.IGANT(S) DATE
***Any information that is misrepresented may result In the Sanitary permit being revoked by the Planning&Zoning Departrrmt***
Include with this application a recorded warranty deed from the Register ofDeeda Office and a copy ofthe oertifred survey map if
reference is made in the warranty deed.
(REV.08/0,S)
r.
Gof - l
EWERT2— t R
Properly Owner o7 Z - /OS • 70 " - Z 3
-— Parcel 10 p
Page of
3I �°'Irrg a tlorinq 9�
.6& YSS
I'll `Ground surface elev.— if. Depth to limiting factor 240 In.
1 kaimn Depth Dornigant Color Redox DescriptionTexture Structure Consistence Boundary Roots Shc Applicagon Itate
1"• Munsell Qu.Sz. Cont.Color ry GPD/Hl
Gr.Sz.Sh• •EIIN2
y= cs 3 f
L 6 10 /P M 3
D Lo 1 /0 1 ------
D-,2,51
/aye .yo 51G ��'Sh Am Al' �/ — . Z.
. 3
oe
ftorinp{/ Ll so-ring
U pit Ground surface e1Qv.-` - i II. beplh to lirnlling factor In
Florizon Ueplh DOminnni Color Redox Uescrl lion Soil Ap Ilcaflon(tale
D Texture Slnrclure Consistence Boundary Roots GPD/fl=
In. Munsell Qu.Sz. Cont.Color
G►.Sz.Sh. •Efl!/t 'Eff#2
r porin
UBoring p U g
I'll Ground surface elev. fl. Depth to limiting fact In.
I lortton DePlh Dominanl Color Redox Desrrlpllon Texture SIM a Soil Application hale
In. Munsetl Consistence Boundary Roots GPD/Ih
Qu.Sz. Cont.Color r.Sz.Sh.
•ENArI •Elfi/2
'Effluent fl1 -BOU,>30<220 mg/L and tSS>30< 150 mg/L
Effluent#2-BODE<30 mg4.and TSS<30 mglL
1 he beparinrent of Commerce is an c ual n r
q pp0rhmity service provider and employer. If you need assistance 10 access services or
need material in an alternate format,please contact lire department at 608-266-3151 or 7TY 608-264-8777.
Sno vim(R min)
I '
M
R PST eF 3 6 4 s A310 2
'Msconsh►Deparhnenl of Commerce SOIL EVALUATION REPORT
►Ivislon of Safely and Buildings page / of
In accordance with Comm 85,Wls. Adm. Code
/1ltach complete slle plan oil i er riot less than 8 U2 x 11 Inches M size.Pian mull County .57- G,pd/•x
b►clude,but not limited to:ve f cal and 10TIZonlal reference point(BM),direction and
percent slope,scale or dimensions,north arrow,and location and distance to nearest road. parcel I.D. p 2 Z • /Q,s'Q '7,0-
Please pNrff all Inforrnaflorr. R ewed b Dale
Personal Information yott provide may be used for secondary proposes(Privacy Lew,s. Mo,f(1)(m)).
Properly Owner / V w Properly L lion IV�
4L6,10 �7L a�G zo
Govt.Lot 15 114 114 S 18 T2 lb N l E(or)W
Properly r s Mailing Address Lot 0 Block M Su d.Name or CS
City Stale Zip Code Phone Num er
577! nA vL �N s� ( �b (,City []Village Town t� ��cZ
f 75 71 s) 3 8 6'-T-2/4 K Ni li e—&iitl c ? 4j
New Construction Use:M ftesidenllal 1 Number of bedrooms 3 Code derived design flow rate_yT o
ReMaremenl [] Public or commercial-Describe: GPD
Paren)rnalerial � '� Qy�' yews- �j�/s flood Plain elevation if applicable
It.
General cornrrrents PER 00-AM4 953 O (2)(Q•)CA) SiTE-,S 7�7�D Per llit�e
and recommendations: .
A -/ yA ROlE /�.�s o� 4 /Vou eo
,,f 4o0 Tj o.v.}L �� ,t�/r7/e�t'OVt�D .S/ft-fp
U] Boring M [j Boring t Ssy
PII Ground surface elev. fl. Depth to limiting factor �� In.
/ a
--
G L z s S hK K 5 s cCf S 3 a S.o,i l Application
r8 R
a
te Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Application
Munsell Q .Sz. Cont.Color Gr.Sz.Sh. 'Efoll 'E2 o• S /0YR i/3
2 S•/b /oYie 3/3 Y yl�
51L �.fshK s es i u
S'2,& /d l✓
y� �/
•s
• 3 S
o R cz Rio r••.s GG /�S6 �,1vf� z, • 3
[2flPoring ff Boring ' /„
Pit Ground surface elev. 8 fl. Depth to flmitin factor 2 •7
P g In.
1 lo►izon Depth Dominant Color ftedox Description Texture Structure Consistence Bounda Roots rSoll Appncatlon Rale
In. Mansell ry GPD/11r
Qu.Sz. Cont.Color Gr.Sz.Sh. (Ntt •Effl12
ioy�P 3/3 AOlfhX s �s .3 s
L Z S � � GS �• f • 5 • �
3 !7•LS !o R y S!c z f� �r,.1�i �`S f . s
5 50 /o R . <2,a2 h o lS L'L. /e 1w,t Z
EEF-- 3
'Effluent Of -BODs>30<220 mg1L and TSS>30< 150 mg/L •Effluent 112=BOD
CS1 Name(please Print) �<_3 0 mg/L and TSS<30 mV/-
Signature
CST
Number
2243, 75
Address
• bale Evaluation Conducted Telephone Number
1Ui✓ fit l' -4 2,3^1 715. 30&-0185
Ulbricht&Associates Zpd Z
Private Sewage Consultants
655 O'Neil Rd.
Hudson,Wis. 54018
For ksua nse of permit and designing
COMM:UbfiCht&Associates
Registered prolate wastewater consultant and plumbers
655 O'NG4 Road
Hudson,WI 54016
715-38&8185 or 715-772.3442
ORIGINAL : ��
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Parcel #°. 022-1050-70-200 02/29/2008 02:51 PM
PAGE 1 OF 1
Alt. Parcel#: 18.28.18.276A-20 022-TOWN OF KINNICKINNIC
Current X ST. CROIX COUNTY,WISCONSIN
Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type
00 0
Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner
TERESA& DUANE H HEGNA O- HEGNA, TERESA& DUANE H
N8471 597TH ST
RIVER FALLS WI 54022
Districts: SC=School SP=Special Property Address(es): '=Primary
Type Dist# Description 370 VORWALD ST
SC 4893 RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 2.684 Plat: 4423-CSM 16-4423
SEC 18 T28N R1 8W SE NE LOT 1 CSM 16/4423 Block/Condo Bldg: LOT 01
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
18-28N-18W SE NE
Notes: Parcel History:
Date Doc# Vol/Page Type
10/26/2004 778153 2683/473 WD
05/27/2003 722886 2253/135 EZ-U
12/23/2002 703256 2088/361 WD
12/03/2002 700628 2066/185 WD
2008 SUMMARY Bill#: Fair Market Value: Assessed with:
0
Valuations: Last Changed: 08/10/2005
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.684 60,000 0 60,000 NO
Totals for 2008:
General Property 2.684 60,000 0 60,000
Woodland 0.000 0 0
Totals for 2007:
General Property 2.684 60,000 0 60,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch#:
Specials:
User Special Code Category Amount
�I
I
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
710 1 Es�3
I f FEB Z Q M VOL-16 PAGE 4423
KATHLEEN H. WALSH
W THIS INSTRUMENT,DRAFTED BY: WILLIAM KANE REGISTER OF DEEDS
p I JOB N0: 600-08 DATE: 08/27/2002
ST. CROIX Co., WI
u REMSED: 09/19/2002 RECEIVED FOR RECORD
12/10/2002 11:00AN
m O O L 0 0 0 X r -----------------------
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Vol.16 Page 4423