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/isconsin,Department of Commerce PRIVATE SEWAGE SYSTEM County St. Croix Safe - wilding Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) I ?3 ?"/"7 o GENERAL INFORMATION T) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. / g'STOg 9 Permit Holder's Name: A City Village X Township Parcel Tax No: CST BM Elev: Insp. BM El BM Description: 1 Section/Town /Range/Map No: / 66 . z �3 r . "t 1- G5r z�', 2 , /5, A.vo TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER ki CAPACITY STATION BS HI FS ELEV. l Septic s-- // c+(�� "T.I J MOO Benchmark Dosing (�O n �1�,"` s J Alt. BM �g /6 3 /dG' Z ° ..,... 6 LA ,j.e... 4,1.— Ty, yy V O( v. 4.-0. 2 f'd4-- Bldg. Sewer y Q Holding i 2 5 y 3 St/Ht Inlet - 16,r1 5 3.37 TANK SETBACK INFORMATION St/Ht outlet TANK TO A P /Li WELL BLDG. V t to Air Intake ROAD Dt Inlet Septic S� / J Dt Bottom \ 3 !a3 -- 825 13,-.3"/ Dosing / / 1 Header /Man. 56 ` 3b (0 3 (03 ig . z . oct Aeration Dist, Pipe I . c 5 /61-11 Holding Bot. System 2.31 /0/ PUMP /SIPHON INFORMATION Final Grade Manufacturer d , /03 .O / Demand St Cover / / r ( J � Zo eil GPM Z /lf"" 6.: y L 1 9. T Model Number 6 , w , `5 I 2 4 . 7 7 TDH Lift Friction Loss D ia. System Head / T DH '] Ft 6 "4 "4 2.9 12.7 6. , i.,„ 55 17, Forcemain Length ' 1 / Dist. to Well -" 21? a 3 4t i SOIL ABSORPTION SYSTEM DIMENSIONS BED/TRENCH Width / Length No. Of Trend PIT DIMENSIONS No. Of Pits Inside Dim Liquid DIMENSIOIONS S ib e SETBACK SYSTEM TO V P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION T ype Of System: CHAMBER OR `_ /� DO f 50 le 56 5 , /64 U NIT Model Number: DISTRIBUTION SYSTEM 564-- Header/Manifold 1 / Distributi ' ( / x Hole Size I f x Hole Spacing Ven to Air Intake Length Dia /' Length 53151, on Z Dia / 6 Spacing 5 Q ✓ SOIL COVER �/ ` ' `? / x Pressure Systems Only xx Mound Or At -Grade Systems Only G ,'„ Depth Over �, Depth Over xx Depth of xx Seeded S.. ded it �,�/pqulched Bed/Trench Center Bed/Trench Edges \ Topsoil a • n Yes 0 No Yes In No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: // / q / /d ---„, p Inspection #2: / / Location: 4 1,�, 4- c(,�,° 13/40-4-) '1.�► � Cawe� Parcel No: 1.) Alt BM Description = / D ✓` (Ail fLi jam,. 2.) Bldg sewer length = 74 ' Q`OSCtr ✓� -,a�S V� � - amount of cover = _ i WO' MI Plan revision Required? Yes No !' /6 6 � g � 7 Use other side for additional informa ion. S SBD -6710 (R.3/97) Date Insepc s Signet Cert. No - Pa'id mo,, no . ti. commerce.wi.gov Safety and Buildings Division County 201 W. Washington Ave_, P.O. Box 7162 s r �e/ )C f Madison, WI 53707-7162 Sa itasy Permit Number (to be filled in by Co.) Department of Commerce Sanitary Permit Applicati P �. Stat T A/ 3 Number 9 In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to 1 !J 5 a 0 O 1 unit is required prior to obtaining a sanitary permit Note: Appli••.. .. • ' are cot Address (if different than mailing address) submitted to the Department of Commerce. • Personal information you p e '.. . • sec , • /�� purposes in accordance with the Privacy Law, a.15.04(1xm) Stats. / 71/ ill I. Application Information - Print MI Inform Property 's Name / S E L P r� 9 +7 L O 1 O Parcel # C ry Li-gt2v� 04 - /OCai•SD - /DO TY Property Owner's Mailidg Address 5 I . l.reQ1X CQUtdOF Property Location �+f `` ` �j p NNING 8 ZONING OFFI (. y37 A' moo) �i OT� / ,( )A / Govt Lot /� City, SSttaat Zip Cade . Phone Number 56 v., we Y., Section a Q J t7 !/- /f5�7 f 16--41e- I N 4Q c+ f( / C� 22 T e; O N; R / in E IL Type of Building (check all that apply) ___(1.1.c)27 Lot # 4 1 or 2 Family Dwelling - Number of Bedrooms ' a Subdivision Name al. 4 Q lqv�, Block # ❑ Public /Commercial - Describe Use / 0 City of ❑ State Owned - Desedbe use ` CSM Number 9b201 0 Village of /� 5 X % // lor�It6O CX�CJIL vol Z {.� / �{' / „ c/ so g Town of C.�y IIL Type of Permit: (Check only one box on line A. Complete line 13 if appllca A. Idew System ❑ Replacement System 0 Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. 0 Permit Renewal ©Permit Revision ❑ change of Plumber a Permit Transfer to N ever List Previous Permit Number and Date Issued / Before Expiration Owner / Q � IV. Type of POWTS System/Component/Device: (Check all that apply) 6 de. C I O ❑ Non - Pressurized In- Ground ❑ Pressurized In -Ground 0 At -Grade ound > 24 in_ of suitable soil ❑Mound < 24 in. of su' ble soil 1/ ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) i % I V. DispersaVf' Area Information• Design now (gpd) / Design Soil Application Dispersal Area R iced (sf) Dispersal Area Proposed ( System Elevation ' f5 - o a 4/ f( ZS C J Y6 ✓ /D /. 3 b VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units { 0 7 New Tasks Existing Tanks I/ l i eAzi, r ' / o B p yu , g a r [/ �y�' / � � � in Sot �i 'ts. C7 fs. - Septic crf fDDo �` ` - 0 - // / Q. Dosing Chamber ! POD — / 400 1 it.45 Se- VII. Responsibility Statement I, ibe undersigned, ass . responai , 1 1 . oftbe POWTS shown on the attached plans. Plumber' e . t) Plumber' ' , , MP/MPRS Number Business Phone Number /e1)0 1 , , a*(P/PV6 z 7(C-23r-044/ye Plumber's Address (Street, City, State, Zip £ e o ? 76 g ' cy` yli ( 4.f W .C ? 1.7 VIII. County/Department Use Only / J p ved 1 :. spina ' Permit Fee L. Date neat Issuing Si,. / q ■ L. ,. en Reason • Denial s CPL../ . °° : / 346 /ib , 1X. Condit q A easonsfor l approval 37 Gc q��� ` S ;A 4. ; •. i aa • 0 . 1. Septic tank, effluent filter and � dispersal cell must all be servlb / maintained a Reek wr ke. 144;6 6 tet.4.- 1- as per management plan provided by plumber. 2. All setback, requirements must be maintained as per applicable cods / ordInan era. Attach to eampleete prams for the system and submit Cary only oa paper not less them Si 12 x 11 ladles is size SBD -6398 (R. 02/09) Valid t 02/11 i 4 1-- 0 I w00) '-i ttlia A: d . N. /A I,- a In ° e_, 8 . .. '° 1 \- \--_ N'' , ,.. 0. \ \ ( J } kl, '' Q .c) o iv o G-- \I\ A , d. \ 4g z 0 4 w\ \ :. ,, t) \,\, .,,, _ v) \ ,,,,... , q VD : , ti\--,1 Safety and Buildings commerce.wi.gov 3824 N CREEKSIDE LA g HOLMEN WI 54636 Contact Through Relay tisconsin www.commerce.wi.gov /sb/ Department of Commerce www.wisconsin.gov Jim Doyle, Governor Aaron Olver, Secretary September 22, 2010 CUST ID No. 139462 ATTN: POWTS Inspector TODD L SINZ ZONING OFFICE TL S1NZ PLUMBING INC ST CROIX COUNTY SPIA E5609 708TH AVE 1101 CARMICHAEL RD MENOMONIE WI 54751 -5520 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/22/2012 Identification Numbers Transaction ID No. 1858089 SITE Site ID No. 760282 Craig Hollerud Please refer to both identification numbers, Town of Cady above, in all correspondence with the agency. St Croix County SE1 /4, NE1 /4, S28, T28N, R15W FOR: Description: Mound / Three Bedroom / Sloping Site Object Type: POWTS Component Manual Regulated Object ID No.: 1281169 Maintenance required; Replacement system; 450 GPD Flow rate; 18 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.O1 /01); 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. 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: Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manuals listed above. • 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 & 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the G ' ' '", requirements of Sec. 145.135 and 145.19, Wis. Stats. CL'_ L • 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 TODD L SINZ Page 2 9/22/2010 • Comm 83.22(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, which may include local inspectors. Owner Responsibilities: • Comm 83.52 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. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 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 /instal lation /operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence 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 Charles L Bratz `J POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday charles.bratz @wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 828 -5902 , Monday, 7:00 A.M. To 3:30 P.M. Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings Division of the Wisconsin Department of Commerce. TODD L SINZ Page 2 9/22/2010 • Comm 83.22(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, which may include local inspectors. Owner Responsibilities: • Comm 83.52 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. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 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 Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence 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 ( (J F � Fee Received $ 20 0.0 .000 Balance Due Due $ 0 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday charles.bratz @wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 828 -5902 , Monday, 7:00 A.M. To 3:30 P.M. Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings Division of the Wisconsin Department of Commerce. • MOUND AND PRESSURE DISTRIBUTION COMPONENT DEpprD INDEX AND TITLE PAGE Project Name: Craig Hollerud new septic system 51k° Owner's Name: Craig Hollerud Owner's Address: 174 State Road 128 Wilson Wi 54027 715- 688 -9224 Legal Description: SE 1/4 NE 1/4 S 28 T 28N R15W Township: Cady County: St Croix County Subdivision Name: Lot Number: na Block Number: na Parcel I.D. Number: Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot Plan r-R 504.144 wtvt -p Designer: Todd Sinz / License Number: MP139462 Date: 09/01/10 Phone Number: 715 - 235 -2644 Signature: dr , Designed Pursuant to the k Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and both a; OF COMMERCE SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) and Y BOiL Cv Pressure Distribution Component Manual Ver. 2.0 SBD- 10706 -P (N. 01/01) Version 5.1 (R. 06/06) Page 1 of 21' Mound and Pressure Distribution Component Design ... -,- Site Information (R or t:; R Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 83 11 3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of <= 36 inches. 450.00 Design Flow (gpd) 6.00 Site Slope ( %) 99.80 Contour Line Elevation (ft) 18.00 Depth to Limiting Factor (in) 0.40 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 90.00 Dispersal Cell Length Along Contour (ft) = I 5.00ICeII Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /ft 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 ;; e Center or End Manifold 2.50 Lateral Spacing (ft) If N above, enter the elevation (ft) 2 Number of Laterals of the highest point. I 0.156 Orifice Diameter (in) 4.00 tJ'Ti it Orifice Spacing (ft) = I 9.701 2.00 Forcemain Diameter (in) 30.00 Forcemain Length (ft) Does the forcemain drain back? ( Y 90.00 Pump Tank Elevation (ft) Eater Y or N 4.55 System Head (ft) x 1.3 4.89 Forcemain Drainback (gal) 10.80 Vertical Lift (ft) 81.15 5x Void Volume (gal) 0.41 Friction Loss (ft) 86.04 Minimum Dose Volume (gal) In -line Filter Loss (ft) 24.77 System Demand (gpm) 15.76 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. _ options ( choice 0.75 �_ _i 1.25 x 1.00 i 1 1.50 _ x x 1.25 -4' 2.00 1.50 x x 3.00 2.00 x _____ _____H 3.00 x _ ___- Gallons /Inch Calculator (optic +rlai) Treatment Tank Information 1029.00 Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) 42.00 Total Working Liquid Depth (in) Huffcutt Concrete , Manufacturer � 24.50 gal /in (enter result in cell B49) • Dose Tank Information Effluent Filter Information 627.001 Dose Tank Capacity (gal) ' Oreruxf __ Filter Manufacturer 14.90 Dose Tank Volume (gal/in) 0822 -14ba_ _ Filter Model Number Huffcutt Concrete Manufacturer Project: Craig Hollered new septic system Page 2 of .8 " Mound Plan and Cross Section Views .............. .... . . . . 1/10 B::::::::::::::::H:;:;:;:;:E:;:Et •-. - Pi - ::::::::::::::::::::::::E::::::::: t J k ::: :::::: : •:: : :::::: : .:::::::::::::::::::: : :::::::::::: • ....••• • . - .` , .r. ..::::::::::- :•:- ..•:-:•: 0 El 0 - - - - - - .... .. A . ... . W ••• :. -...;.: . „ .. ......„............„ ......... .. : ................. ,..... „.• •••••••• — : ..:. .......: ::,:.: :, g ::,:...... ... .: ..:,::.::.::.:..:.:. : • • _ • • .. • ............ • .. . ...... ... „ ... .-.•.••• • •••• -,- •• .-..- - .•••.••• .-.•••• ••••..-.... ' ........ ................... ..................,....,. ,, ,.. ...... .. ... ••• .-.•..•...•••••••. .•.• -.-.-,-.......• •••-. - - - - - - - ,-- - - - - - - - • - - - - - - - - - - - - - - - - - -•-•• - - --- - -- -- ---- --- ---- - - -- -- --- -- --- --- -- .•-• • 1 :.:::.: ..... . .. . • .. , .... .. ..... .. . .. „ .. „ .. „ . .. .„ .. . .. .... . .. ..... „ ...... ...... .... .. .. . „ . .. „ . .... . .... . . . „ . . .. ... . „ .. . ...... . . .. . .. ... . . . .. ... . . . .... ..... ... ..... ... .. .. . . . . „ .. ..... .... . . „ . • . .. ...... . „ ... .... „ . ........ . . „ . „ .. .. ... „ .. . . .. .. • • -. •... ..• • •.•.•.•.•..... ........•..• •.• •.•.• .•....• •.•..... • • ...,..,.... .. • • •• .•.• •.•.• •...••••• . • .• -. ----• •-•-•-• -- — - -- '-' -- ' — - -• ---- • - ' ' •. -- - ' ' — •-• -- - " • —I— - 1 • L • Mound Component Dimensions A 5.00 ft E' 21.60in H' 1.00 ft K 10.33 ft B 90.00 ft F 9.50 in 1 11.31 ft L 110.65 ft D 18.00 in G 0.50 ft J 7.10 ft W 23.41 ft 450.00 (ft 2 ) Dispersal Cell Area 1467.99 (ft 2 ) Basal Area Available 5.00 (gpd/ft) Linear Loading Rate 9.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 103.09 (ft) ,_ „.„?...exilat . G I I H 10t,S, ;;; , F 101.80 (ft) Lateral ... „ . „ --• ••-••••••••••••••-•.- c le p erei ll c . .,-, i „„ : ,. i „.,„:,..,„7, 2 i NI. ,40 .:,,:,:::,:::,,::: 101.30 (ft)-10. --4 . .. „ . .. . • :::: Invert Dispersal Cell -1,..,::::::.:,•:•::::::::::::::::::::-::: :'::.: 4,-!,,:.::::::::: 0:::::::::::::::::::: :::::::::::::::::::::::,::::::::: ::: ::::::::::::::::::::: :::;:::::::::: . - • -: • ' ': eu Elevation ,, . :..,:i,71•'-',i:-•:::::::::::::*.:::::'*.::::::::::::•::;:,•:::::::•,:,,,::::- -:::::::::::::::::::-;,:•:::::::••••:: •,,,-.:•:„.,.,.:,•••• . ...•..-.........•• • .. El la • 99.80 (ft) Contour Elevation 6.0 % Site Slope Geotextile Fabric Cover ShatJing Key - 9 8.1 — , Dispersal Cell See lateral details on 1-ap . 5 t . 1 ft 1 Page 4 for number, size, , . 1 I.,. -,:,-----.1 c. g- .i 2--, 0 I i i i i .7. _ _...-. 7 ! --mew- -- i ---' t__) i r .,; : ! ; -z.: ; • . , ; AsTro -c33 - --.---_. -'es ii. ; i : ', ,. i F til t I - -rp,,, ,, --•- - _ z I t i ti.t, it i ' YPGai LatE`rai ! 1 spacen From Inc? t-iti.'diiiiW ILI 1.1W A - 411 - 11 - distribution cell (Axil). Project: Craig Hoilerud new septic system Page 3 of 41 End Connection Lateral Layout Diagram �<aterals centered over the & 8 Qimension • Turn --U d ba l l valve or of oa n out pl u g • All laterals are identical k- x -+1 Holes d the bottom of the lateral S equal spaced ,j, • Force main correction via tee a cross to manifold at ang point. Laterals b force main of PVC sch 40 (per CONWI Table 04.30-5) Number of Laterals 2 Orifice Diameter 0.156 in Lateral Diameter 1.50 in Orifice Spacing (X) 4.02 ft Lateral Length (P) 88.44 ft Orifices per Lateral 23 Lateral Spacing (S) 2.50 ft Orifice Density 9.78 ft /orifice Lateral Flow Rate 12.39 gpm Manifold Length 2.50 ft System Flow Rate 24.77 gpm Manifold Diameter 1.50 in Total Dynamic Head 15.76 ft Forcemain Velocity 2.53 ft/sec Dose Tank Information waft cover with warn label and locking device and �_ sealed watertight Electrical as per NEC 300 and —♦ 1 Comm 16.28 WAC /� 114 in. min. Disconnect ill Tank component is properly vented l E F— Alternate outlet bcation 1 1— Forcemain diameter Huffcutt Concrete Manufacturer : — .G 2 in. Capacity 627.00 Gallons Volume 14.90 gal/inch A Weep hole or anti - Dimension Inches Gallons i B siphon device A 22.31 332.36 B 2.00 29.80 C Pump off elevation (ft) f ( 91.001 C 5.77 86.04 D 12.00 178.80 f D ji Total 42.08 627.00 , Dose tank elevation (R) r 3" Bedding u er tank. 90.001 Alarm Manuafacturer SJE Rhombus __.._.._ Alarm Model Number Tank Alert 1 Pump Manufacturer Zoeller _____ 7 Pump Model Number L 9151 _ Pump Must Deliver 1 24.771gpm at 1 15.761ft TDH Project: Craig Hollerud new septic system Page 4 of £'l Mound System Maintenance and Operation Specifications Service Provider's Name T L Sinz Plumbing Inc. I Phone 715 - 235 -2644 POWTS Regulators Name St Croix County Zoning Phone, 715 - 386 -4680 System Flow and Load Parameters Design Flow- Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft 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 Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test monthly Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepage once every 3 years Other We recommend pumping tank every 2 or 3 yrs. Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(1), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Tum-up Detail Finished .. Grade \if 6 -8" Diameter Lawn . • Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Craig Hollerud new septic system Page 5 of Z'? Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shaft be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals (SB0- 10691 -P (N.01/01), SSWMP Publication 9.6 (01181), and Pressure Distribution Component Manual Ver. 2.0 SBD - 10706 -P (N. 01/01)1 and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shag be in accordance with Comm 83.33, W. 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 kt diameter shah be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shaft be maintained by an individual certified to service septic tanks under s. 281.48, Stilts. 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 (east once every 3 years by inspection. The outlet filter shah 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 lank 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 rernoved at the tine of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical addltives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump ( dosing) tank shaft be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent fitter is installed within the tank it shaft be inspected and serviced as necessary. Mound and Pressure Distxthution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perkneter, and the mound shy 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& BOD 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD 30 mg/L TSS, 10 mg/L FOG, and 10 cfu /100 ml for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is 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 6 inches considered as an impending hydraulic faikre requiring additional, more frequent moritortig. Contingency Plan If the septic tank or any of Is components become defective the tank or component shall be repaired or replaced to keep the system in proper operating conron. If the dosing tank, pump, pump controls, clam or related wiring becomes defective the defective cornpone:tt(s) shaft be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreabnent devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. boP PUMPPERFORMANCCURVE ... TOTAL DYNAMIC HEAD/FLOW MODEL 151/1 so PER MINUTE - - - , 14 EFFLUENT AND DEWATERING - 153 45 , 12- 4° 1111116,. MODEL 151 152 153 ' s '-- 1 35 10 ighlk, Feet Meters - Gal. Liters Gal. Liters Gal. Lfters - 5 1.5 50 189 69 261 77 291 5- killinbliall. 10 3.0 45 170 61 231 70 265 15 4.6 38 144 53 201 61 231 i 25 111111101111E1111 = - - 20 8.1 . . , 29 110 ; 44 . 167 • 52? 197 1- 6- 28 mo ' 25 7.6 16- '61 - 34 129 42 , 159 m''' li 14. MI 1 ___„.1. 16 ' lik - 30 91 ''' - - - 23 la . - 125 ........■AA 4 - 1111111111k - I riA 40 122 - - - -- ' - 11 42 10 2- 11111111111111111\11111111 , Shut-off Head: 30 It. (9.1m) 38 ft. (11.6m) 44 IL (13.4m) I 5 - 01450813 0 10 2030 I 40 50 .. 70 80 90 1.. GALLONS trrERs 0 41, a alo iio 2bo 240 2i0 310 sio FLOW PER MINUTE 014508A Model 151 Models 152 /153 CONSULT FACTORY FOR SPECIAL APPLICATIONS r 67132 — 8 114 3715 4 5/8 327132 4 518 • Timed dosing panels available. 0% f , • Electrical alternators, for duplex systems, are available and 327132 supplied with an alarm. ,4 :.,44 . 3 7/8 • Variable level control switches are available for controlling 3 v/32 single phase systems. 4,--i------- i i ,...- • Double piggyback variable level float switches are available 1 1 for variable level long and short cycle controls. • Sealed Qwik-Box available for outdoor installations. See FM1420. . ......... .1414 Mila 1 • Over 130 °F. (54°C.) special quotation required. ' =1 zi n n 1511152/153 Series 1111/18 121/8 ■ 151/152/15.3‘ fAOSELS Control Selection 111111111111 1 ---F I 1 11111:1 Model Volts-Ph Mode ..2 _ Amps Simplex Duplex ... — — — „..,,, , iftIKA1111111NIIIIIM 11 4315 .filEMEIMMItii. 5 1/8 N151 115 1 Non , , 6,0 1 2 or 3 ler—w., minsmo•-■ ,1 BN151 115 1 Auto 6.0 Included 2 or 3 717.191. if 1. urfra- II , _1 E151 230 1 . , Nan 32 1 2 or 3 8E151 230 1 Auto . .3.2 Included 2 or 3 SK2444 s,08 N152 115 1 Non 8.5 1 2 or 3 BN152 115 1' - Auto 8.5 . Included 2 or 3 E152 230 1 Non 4.3 , . I 2 or 3 , 8E152 230 . 1- . Auto' 4.3 Included 2 or 3 N153 115 1 Non 10.5 1 2 or 3 BN153 115 1 Auto 10.5 - Included 2 or 3 E153 230 1 Non 53 i 2 or 3 SELECTION GUIDE 8E153 30 1 . Auto 5.3 Included 2 or 3 1. Single piggyback variable level float switch or double piggyback variable level float 1 CAUTION 1 switch. Refer to FM0477. Ail Installation of controls, protection devices and wiring should be done by a qualified 2. See FM0712 for correct model of Electrical Alternator E licensed electrician. All electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) or (4) float system. - , " - ....- RESERVE POWERED DESIGN For unusual conditions a reserve.safety factoris engineered into the design of every Zoeller pump. „ MAI TO: , / P i ?. 40 1 3 2 0 5 X 6.0 163 34 4 7 7 „ I SHIP TO: 3849 Cane Run Road Manufacturers o(.. • ' , Loulevtle, KY 40211-1961 • 'ratan Asipe SAT 15 ' • ay MI /ff Plf (502) 778-2731 • 1 (800) 928-PUMP http:/Avww.zooller.com • /--- , • FL/1W, FAX (502) 774-3624 • 0 Copyright 2004 Zoeller Co. All rights reserved. /1P rk;:m ' : v\ .., g 1 . -z.- ,. v‘ --1 \o.>) )\ .. ? .;,\ c , I -k 8 F -1. -.:,-\ 11.■ ... - 7% ,_ x' c -f.' 'N. -. .. . .4) o t ‘‘ i is \ 4). , , , i .. \ , -., r 0 1 \ \ i Z ,, _ __ -- -4 r k a ,....F (7‘ , 1, t) �' ~� - � b _ i _ . , \I\ r , ‘ _, - (-...-, 0 n...._g --1 G N* - Zof II o Z. t k _. r ft, o r-. n 01 I ill C 0 c o z "'..- 17 Z 7 Sow 9 1U: l 111 i ll 1 ; , ,4 .. 111111111 I111 I . . 902014 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI CERTIFIED T T D �+ �J 08/13/2009 RECEIVED FOR RECORD SURVEY V E i A P CERTIFIED D SURVEY : MAP M VOL: 24 PAGE: 5646 PART OF THE SE 1 \4 OF THE NE 1 \4 OF REC FEE: 13.00 SECTION 28, TOWNSHIP 28 NORTH, RANGE 15 WEST, COPY FEE: 3.00 TOWN OF CADY, ST. CROIX COUNTY, WISCONSIN. PAGES: 2 _N_�rthe.ast C -)rnec PREPARED FOR: Section 28-28-15 1" Survey Mark Nail Robert & Joy Holerud 154 HWY 128 UNPLATTED (Ar--- Wilson, WI 54027 - LANDS o 1 - -- 69.39' u, (1) • N89'52'41 "W r\i I Ln : ni ! north line SE /NE S89'52'41 °E 792:00' POB I 0 a- E � • 1 I o Z n. ° W I � . o LOT �� I. `� 80' 218,039 sq.ft. �. m 75 I m 5.00 acres g 1 50' • i o � �1 o i . N - o I� se SHEDS `° ° i N oil OV 0 �� 1 587'57 34_W_ .a? .. - - ---- - w O ,— fJ� _ _0 .._ -1 l - rat O ! W ..--fence o . o - ..-- Iy S88'00'48 'W 403.62' Ac.� $87'57' .34"W �. z1r z9' r Ch 061 1 33.07' ti LO 111\ I centerline of 66' wide 1 rri I ingress- egress easement 1 60' 1 65' 1 over existing driveway 1 UNPLATTED (shored occess serving unplotted lands) ,; LANDS access to State Highway by East 1/4 Corner DOT permit # 55 094 - 09 Section 28-28-15 and permit # 55- 095 -09 1" Survey Mark Naii NOTES: This lot may be subject to ; a farmland preservation agreement Each parcel on this map is subject to State and County laws, rules and regulations (i.e. wetlands, minimum lot size, access to parcel, etc ). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office and Town Board for advice. DRAFTED BY: 5 C O /4/ JOEL A. BRANDT ` �. +'G+"ei.A . .. JB SURVEYING LLC ■ * .; DRAKDT * ; X 5-2003 . tip '■ ` — '�'1:.. LEGEND ?^7 • � ! ► " e Found Government Corner (as noted) �, �� o Set 3 \4' x 18" Iron Rebar weighing a % a d' minimum of 1.50 lbs per lineal foot North is referenced to the East Line of the Northeast SCALE. 1" — 150' Quarter of Section 28 -28 -15 n (7) (44) rift) CERTIFIED SURVEY MAP PART OF THE SE 1 \4 OF THE NE 1 \4 OF SECTION 28, TOWNSHIP 28 NORTH, RANGE 15 WEST, TOWN OF CADY, ST. CROIX COUNTY,WISCONSIN. DESCRIPTION A parcel of and located in part of the Southeast quarter of the Northeast quarter, of Section 28, Township 28 North, Range 15 West, Town of Cady, St. Croix County, Wisconsin, more particularly described as follows. Commencing at the Northeast corner of said Section 28, Thence S00 ° 15'29 "E, along the east line of the Northeast quarter of said Section 28, a distance of 1315 52 feet, to the north line of the Southeast quarter of said Northeast quarter, thence N89 °52'41 "W, along said north line, a distance of 69.39 feet, to the west right - of - way of State Highway 128, and point of beginning of the parcel herein described thence S00 °04'37 "E, along said right -of -way, a distance of 138 52 feet, thence S05 °30'23 "E, a distance of 135.87 feet, thence S87 °57'34 "W, a distance of 315 39 feet, thence N74 °51'43 "W, a distance of 90 38 feet; thence S88 °00•48 "W, a distance of 403 62 feet, thence N00 °07'19 "E, a distance of 277.07 feet, to the north line of said Southeast quarter of the Northeast quarter thence S89 °52'41 "E, along said north line, a distance of 792.00 feet, to the point of beginning. The described parcel contains 218,039 square feet (5.00 acres), and is subject to easements of record. SURVEYOR'S CERTIFICATE I, Joel A Brandt, Registered Land Surveyor, hereby certify. Thar I have surveyed, divided, and mapped the above described parcel of land in full compliance with the provisions of Chapter 236.34 of the Wisconsin State Statutes, along with the provisions of St Croix County in surveying, dividing and mapping the same. That such map is a correct representation of the exterior boundaries of the land surveyed and the subdivision thereof made. Said survey was done under the direction of Robert and Joy Holerud Dated this q day of Avc.vs , 2009 , ,.• %••••- � o k. �\ �,�.�► �� 1 JOEL A � Joel A. Br .i dt, R.L.S. S -2603 * • BNANDT : * JB SURVEYING LLC 5 .,o systOCO CtiY, �;'•. do ' ;,. • CERTIFICATE OF COUNTY TREASURER . II STATE OF WISCONSIN ) COUNTY OF ST. CROIX) SS 11111111111ii 11 '-'1't 111110 1111# 9 0 0 4 902014 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD SURVEY D T 08/13/2009 03:15PM CERTIFIED S U R V E Y M A i� y� CERTIFIED SURVEY MAP VOL: 24 PAGE: 5646 PART OF THE SE 1 \4 OF THE NE 1 \4 OF REC FEE: 13.00 SECTION 28, TOWNSHIP 28 NORTH, RANGE 15 WEST, COPY FEE: 3.00 TOWN OF CADY, ST. CROIX COUNTY,WISCONSIN. PAGES: 2 N ,rtlieast C - )rner Section 28-28-15 PREPARED FOR: 1" Survey Mark Nail i Robert & Joy Holerud 154 HWY 128 U Wilson, WI 54027 LANDS ° W 69.39' v1 CD • N89'52'41 "W 1 N I u1 I \ C n 'IN xl north line SE /NE S89'52'41 "E 792.00' POB ' l I I o • —I 17\D CT C N m IW' z a o c-,., 3" LOT 1 so N N : ■ 218,039 sq.ft. a_ ; m 75 ' j I r i 5.00 acres g 50' •0 , o.�CI o i • . <� N �. ' ul ( J O cr w SHEDS " ° I O r J N Q'_ v I S87'S7'34 "W —Cr) _ -4 ..... - - m 392.87' : O W - - - -fe nce S88'00'48 "W 403.62' C'1.-915------, _ z 1 c. z i CPI"' � i jj'43 „w + \Ji�i / .._ 11Nj 33.07 t iN centerline of 66' wide I pi I ingress– egress easement 1 60' 65' over existing driveway UNPLATTED (shored access serving unplotted lands) ii r LANDS _ . . . ,. , , 9 92 E'd '7Z ToA 7 10 Z aaaUS aniaeluaseJdad 6uiuoZ (1unoJ xioJJ 1s Pfon d ue llnu U� v' }j l 7<� eQ He Ienadde e�ep lenoxlde /I Jo step ( u tyl{M pRD1(YJ9J 20U m i 6007 --1- 5 C ) 1 - siy4 panoJddb 6002 E t and G 1 _ JaJnseaJl /C1 / JaJnseaJI • A.i.ra PM XIC440 '..I..* 4,(.)c- wou j ' dew AanJns pay .kiej siy4 40 spuel ayl 6ur4Jal4e S�cti -f- eQOV 'J- bple)7o /g Jo se sluawssesse leiJeds J0 sexe4 piedun ou pue sales xe4 pawaapaJun ou MoyS aD!J40 !w ui sp.ro)a.i eq. 1ey4 (J 4Ja.) /geJay op 'xio..1. Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings In accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 x 11 inches in size. Plan mu� - S Cr01x Include but not limited to: vertical and horizontal reference point (BM), di °sr n Parcel I.D. 06 -� 0 P e r c e n t slope, scale or dimensions, north a r r o w , and BM r e f e r e n c e d t o m *u• ' •' 004- 1066 -50 -000 R y Date Please print all information J Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)) G� 77 Property Owner Property Location Robert & Joy Holerud RECEIVED Govt. Lot SE v. NE v, s 28 T 28 N R 15 w • Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 154 Hwy 128 JU1 0 6 7009 Lot > 3 C — % • td ik City State Zip Code Phone 0 City 0 Village ® Town Nearest Road Wilson WI 5402'T2 ';}. Cady Hwy 128 0 New Construction Use: El Residential / Number of Bedrooms 3 or H Code derived design flow rate 1 150 a r (oar GPD El Replacement 0 Public or Commercial — Describe: 1 J- cI 40 ve - G' 1 2,0k / f a i T #1 5 Parent Material Loess over Till Flood Plain elevation if applicable / N/A ft.� General comments and recommendations: 0k_ 7 1 Boring # ❑Boring Q Pit Ground Surface Elevation 99.8 ft. Depth to Limiting factor 23 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -8 10YR3/2 - SIL 2 -f -gr mfr cs 3f 0.6 0.8 2 8 -11 10YR4/4 - L 2 -m -bk mfr gs If 0.6 0.8 3 11 -18 10YR4/4 - SCL 2 -m -bk mfr gs - 0.4 0.6 4 18 -23 10YR6/3 - S 0 -sg ml gw - 0.7 1.6 � 10 YR5 /4 7.5YR 4/6 &5/6 c-2-d LS 0 -m mfr - - 0.7 1.6 2 0 Boring J Boring # O i Pit Ground Surface Elevation 100.1 ft. Depth to Limiting factor 32 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -9 10YR3/2 - SIL 2 -f-gr mfr cs 3f 0.6 0.8 2 9 -15 10YR4/4 - SIL 2 -m -bk mfr gs If 0.6 0.8 3 15 -23 10YR4/4 - CL 2 -m -bk mfi gs - 0.4 0.6 4 3 -3 10YR4/4 - SCL 2 -m -bk mfi cw - 0.4 0.6 5 (I)10YR6/4YR4/6 Bands S 0 -sg ml - - 0.7 1.6 * Effluent #1 = BOD, > 30 < 220 mg/L and TSS > 30 <_ 150 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS <_ 30 mg/L CST Name (Please Print) Sign c2 G YV� CST Number Mark Iverson 46672 Address Date Evaluation Conducted Telephone Number P.O. Box 155 Hammond, WI 54015 July 2, 2009 715- 796 -5664 Property Owner Robert & Jo Holerud Parcel ID# 004 - 1066 -50 -000 age 2 of 3 o Boring 3 Boring # P Limiting Pit Ground Surface Elevation 98.7 ft. Depth to Limitin factor 18 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -10 10YR3/2 - SIL 2 -m -bk mfr gs 3f 0.6 0.8 2 10- 10YR4/4 - SICL 2 -m -bk mfr gs 1f 0.4 0.6 3 8 -38 1 0YR4/6 7.5YR4/6 c-2-d SCL 2 -co -bk mfr cs - 0.4 0.6 4 -47+ 10YR7/3 &6/4 - S 0 -sg ml - - 0.7 1.6 o Boring 4 Boring # EIPit Ground Surface Elevation ft. Depth to Limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 0 Boring 5 Baring # wit Ground Surface Elevation ft. Depth to Limiting factor in. soli Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/tt 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 = BOD5 < 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. • 72- 0 Pro et r 41 L i N G N 0 i1 i i f s D -1 : D d'e › Z "mg\ I ' I Z : _ b \ \ \ \ Z 4" ' -.0 \ .1 \-\ .1) Nt y Z1 U `0 ,s z N 0 PA '11 H s' 0 -40 j L 4 ' U ' U 4 N s Q a IA 93 o Z 'A 7 .0- i � T i -C 0 6) t� 6- 1 g)) 0 J J oi5 ,( P 0 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer. c ��I tt Ho l (e r Mailing Address LS ' H y / 2y L; - fr (SG, L -I Property Address / 7 H L»' / z' L/f f sot/1 L. -L S 9 02.7 (Verification required from Planning & Zoning Department for new construction.) City /State L.,-1 LSU,, / t✓I Parcel Identification Number LEGAL DESCRIPTION Property LocationSE `/4 , A E 1/4 , Sec. , T 1 N R /-S W, Town of Ga d Subdi.vi.sion �.r _ __ , Lot # - Certified Survey Map # Volume 2- Page Warranty Deed # ,_.__..7 Volume _ _ , Page # ..._ ...............___.... Spec house yes Lot lines identifiable 4111 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 §Comm. 83.52(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 (2) after inspection and pumping (if necessary), the septic tank is o operating condition and/or ) p P wastewater disposal system is in proper p g ( 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 Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. 1 /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 above, by virtue of a warranty deed recorded in Register of Deeds Office. property described abo y Y Number of bedrooms Cl/i /Q / �" - 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. 08/05) • 11111111111 11111 11111 11111 11111 11111111111111 II11 State Bar of Wisconsin Form 3 -2003 * 9 0 3 2 3 5 1 QUIT CLAIM DEED 903235 BETH PABST Document Number Document Name REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD THIS DEED, made between Robert Holerud aka Robert A. Holerud and Joy M. 09/03/2009 01 :20PM Holerud, husband and wife QUIT CLAIM DEED EXEMPT I 8 ( "Grantor," whether one or more), and Craig A. Hollerud REC FEE: 11.00 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 Recording Area County, State of Wisconsin ( "Property") (if more space is needed, please attach addendum): Name and Return Address Part of the Southeast Quarter of the Northeast Quarter (SE 1/4 of the NE 1/4), of Section Twenty -eight Thomas A. McCormack (28), Township Twenty -eight North (T28N), Range Fifteen West (R15W), Town of Cady, St. Croix .1020 JOth Avenue County, Wisconsin, more particularly described as follows: PO Box 2120 Lot 1 of Certified Survey Map recorded August 13, 2009 in Volume 24, of Certified Survey Maps, Baldwin WI 54002 page 5646, as Document No. 902014. RESERVING, HOWEVER, to Grantors, their heirs, successors, and assigns, an easement for ingress 004- 1066 -50- 000; 004- 1066 -60 -000; and egress to and from State Highway 128 in favor of the balance of the Southeast Quarter of the 004- 1066 -30- 000; 004 -1067- 70-000 Northeast Quarter (SE 1/4 of NE 1/4), the East Half of the Southwest Quarter of the Northeast Pal Identification Number (PIN) Quarter (E 1R of SW 1/4 of NE 1/4), and the Northwest Quarter of the Southeast Quarter (NW 1/4 of SE 1/4), of said Section Twenty-eight (28), Township Twenty-eight North (T28N), Range Fifteen West This is homestead property. (R15W). (is) O Dated eil, / ( G / • (SEAL) t • _ ` (SEAL) * ' obert A. Holern " (SEAL) �� �� /� � (SEAL) of rud AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF Wisconsin ) ) ss. authenticated on . St. Croix COUNTY ) Personally came before me on Q-1--01 * the above -named Robert Holerud aka Robert A. Holerud and TITLE: MEMBER STATE BAR OF WISCONSIN Joy M. Holernd (If not, to m own to be on(s) who 4 / i ''foregoing a u t h o r i z e d b y Wis. Stat. § 706.06) in m t • - / .W e,,5 4 i } 1 z� •�: THIS INSTRUMENT DRAFTED BY * : *.�. ) ' 4 .4 r Thomas A. McCormack Notary Public, State of Wisconsin , 7 '; Baldwin, WI 54002 )age M y commis & ) (expires:..'• ) • (Signatures may be authenticated or acknowledged. Both are not necessary.) :' • '�� NOTE: THIS IS A STANDARD FORM. ANY MODIFICATION TO THIS FORM SHOULD BE CLEARLY IDENCIFIE/D‘. QUIT CLAIM DEED C2003 STATE BAR OF WISCONSIN FORM NO. 3-2003 *Type name below signatures. INFO-PRO" Legal Foram • (800)655 -2021 • irtoprofoims.com llII 111111 Mul 11111 IWI IM 1II * 903236 5* 903236 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD Document No. 09/03/2009 01: 20PM JOINT DRIVEWAY AGREEME EXEMPT t REC FEE: 19.00 JOINT DRIVEWAY - PAGES: 5 EASEMENT AGREEMENT Return to: Thomas A. McCormack 1020 10 Avenue, PO Box 2120 Baldwin, WI 54002 004-1066 -50- 000; 004-1066-60 - 000; 004-1066-30-000; 004-1067-70-000 Parcel Numbers THIS JOINT DRIVEWAY AGREEMENT (the Agreement) is between Robert A. Holerud and Joy M. Holerud (Parcel A Owner) and Craig A. Hollerud (Parcel B Owner). RECITALS: A. Parcel A Owner is the owner of certain real property located in St. Croix County, Wisconsin, as described on the attached Exhibit A and referred to on the exhibit and in this Agreement as Parcel A. B. Parcel B Owner has acquired by gift from Parcel A Owner certain real property located in St. Croix County, Wisconsin, as described on the attached Exhibit B and referred to on the exhibit and in this Agreement as Parcel B. C. Parcel A Owner and Parcel B Owner wish that a driveway (the Driveway) currently located on that portion of Parcel B shown on the Certified Survey Map of Parcel 13 and referred to in this Agreement as the Easement Property, shall by used by both Owners and their successors and assigns. AGREEMENT For good and valuable consideration, the receipt and sufficiency of which are acknowledged, the parties agree as follows: 1. Grant. Parcel A Owner retains a nonexclusive easement and right -of -way to Parcel A Owner and Parcel A Owners successors and assigns as the owner of Parcel A to use the Driveway and the Easement Property as a joint driveway for ingress and egress to State Highway 128 from Parcel A. 2. Permitted Users. The easement granted in Section 1, above, may be used by the Parcel A Owner and its tenants, employees, customers, and invitees in common with Parcel B Owner and its tenants, employees, customers, and invitees. 3. Maintenance Costs. Until any building is constructed on Parcel A Owner's property, Parcel B Owner shall bear all expense of maintaining, repairing, and removing snow and debris from the Driveway. Following issuance of an occupancy permit for any building constructed on Parcel A Owner's property (or, if no occupancy permit is issued, then following occupancy of any such building), Parcel A Owner and Parcel B Owner shall bear all maintenance expenses equally. Unless Parcel A Owner and Parcel B Owner agree otherwise, all maintenance, repair, and removal shall be performed by Parcel B Owner, and Parcel A Owner agrees to promptly pay its share of the expenses of maintenance, repair, and removal incurred by Parcel B Owner within 30 days of billing for the expenses. If Parcel A Owner does not promptly pay its share, Parcel B Owner may pay the full cost and then have an immediate right to reimbursement from Parcel A Owner, together with interest at the rate of 12% per year on the unpaid amount and all reasonable attorney fees and other collection costs incurred by Parcel B Owner. Repairs and maintenance shall be performed at such times and in such a manner as are mutually agreeable to the parties. If the parties are unable to agree within 10 days of a written request by one or the other on the need for the repair or maintenance, then the matter shall be referred, upon either party's request, to arbitration. 4. Equal Rights of Use. Parcel A Owner and Parcel B Owner shall have equal rights of ingress and egress over the Driveway and shall take no action to prevent the other party's enjoyment of such rights. Parcel A Owner may subdivide Parcel A at any time in the future and convey rights to use this easement to any third party who may acquire an interest in any portion of Parcel A. 5. Covenants Run with Land. All of the terms and conditions in this Agreement, including the benefits and burdens, shall run with the land and shall be binding upon, inure to the benefit of, and be enforceable by Parcel A Owner and Parcel B Owner and their respective successors and assigns. The easement retained under Section 1 of this Agreement is an easement appurtenant to Parcel A and may not be transferred separately from, or severed from, title to Parcel A. Furthermore, the benefits ofthe easements retained under this Agreement shall not be extended to any properties other than Parcel A or portions thereof without the consent of Parcel B Owner. The specific parties named as Parcel A Owner and Parcel B Owner in this Agreement, and each of their respective successors and assigns as fee simple owners of Parcel A and Parcel B, respectively, or any portion of Parcel A or Parcel B, shall cease to have further liability under this Agreement with respect to facts or circumstances first arising after the party has transferred its fee simple interest in Parcel A or Parcel B, respectively, except, however, for obligations that accrued during the party's period of ownership of title. 6. Non -Use. Non -use or limited use of the easement rights granted in this Agreement shall not prevent Parcel A Owner from later use of the easement rights to the fullest extent authorized in this Agreement. 7. Governing Law. This Agreement shall be construed and enforced in accordance with the internal laws of the State of Wisconsin. 8. Entire Agreement. This Agreement sets forth the entire understanding ofthe parties and may not be changed except by a written document executed and acknowledged by all parties to this Agreement and duly recorded in the office of the Register of Deeds of St. Croix County, Wisconsin. 9. Notices. All notices to either party to this Agreement shall be delivered in person or sent by certified mail, postage prepaid, return receipt requested, to the other party at that party's last known address. If the other party's address is not known to the party desiring to send a notice, the party sending the notice may use the address to which the other party's property tax bills are sent. Either party may change its address for notice by providing written notice to the other party. 10. Invalidity. If any term or condition ofthis Agreement, or the application ofthis Agreement to any person or circumstance, shall be deemed invalid or unenforceable, the remainder ofthis Agreement, or the application of the term or condition to persons or circumstances other than those to which it is held invalid or unenforceable, shall not be affected thereby, and each term and condition shall be valid and enforceable to the fullest extent permitted by law. 11. Waiver. No delay or omission by any party in exercising any right or power arising out of any default under any of terms or conditions of this Agreement shall be construed to be a waiver of the right or power. A waiver by a party of any of the obligations of the other party shall not be construed to be a waiver of any breach of any other terms or conditions of this Agreement. 12. Enforcement. Enforcement of this Agreement may be by proceedings at law or in equity against any person or persons violating or attempting or threatening to violate any term or condition in this Agreement, either to restrain or prevent the violation or to obtain any other relief. Ifa suit is brought to enforce this Agreement, the prevailing party shall be entitled to recover its costs, including reasonable attorney fees, from the nonprevailing party. 13. No Public Dedication. Nothing in this Agreement shall be deemed to be a gift or dedication of any portion of the easement granted under this Agreement to the general public or for any public purpose whatsoever. Parcel A Owner and Parcel B Owner agree to cooperate with each other and to take such measures as may be necessary to prevent the dedication to the public of the Driveway, whether by express grant, implication, or prescription, including, without limitation, the posting of APrivate Drive@ or ANo Trespassing@ signs. Such measures shall not, however, unreasonably interfere with the easement rights granted under this Agreement. Dated: Seek,ki&C_I___, 2009 (Parcel A Owner) 62 ,Q)--,,t 2,6e_._ Robert A. Holerud in Jilt �/ ,/ • J/ . ,,tee . _ d (Parcel B Owner) r 4‘,,,/ Cra 1 A. Hollerud / ACKNOWLEDGMENT STATE OF WISCONSIN COUNTY OF ST_ CROIX • (? This instrument was acknowledged before me on `a.p 1 , 2009 by Robert A. Holerud and Joy A. Holerud. i 4 g. '' .� n r Notary Public, State of Wisconsin 7 . , ' My commission expires 3 - 4 - f gy '; t . ‘'''.." r d QN .' , } ACKNOWLEDGMENT STATE OF WISCONSIN COUNTY OF ST. CROIX This instrument was acknowledged before me on SA-(5t , t , 2009 by Craig A.got, d, a - '.... , N- .a. - )5. - w.r } . ' i. x" a r . y Notary Public, State of Wisconsin = 't --'''' ' ,: lk. :: '' ' ' ■ '74:7 ' 4"' .." My commission expires 1- t -i o 7 y .), :,, taP+€A, • EXHIBIT A Southeast Quarter of the Northeast Quarter (SE 1/4 of NE 1/4), the East Half of the Southwest Quarter of the Northeast Quarter (E 112 of SW 1/4 of NE 1/4), and the Northwest Quarter of the Southeast Quarter (NW 1/4 of SE 1/4), of said Section Twenty -eight (28), Township Twenty -eight North (T28N), Range Fifteen West (R15W), EXCEPT Lot 1 of Certified Survey Map recorded August 13, 2009, in Volume 24 of Certified survey Maps, page 5646, as Document No. 902014. EXHIBIT B Part of the Southeast Quarter of the Northeast Quarter (SE 1/4 of the NE 1/4), of Section Twenty -eight (28), Township Twenty -eight North (T28N), Range Fifteen West (R15W), Town of Cady, St. Croix County, Wisconsin, more particularly described as follows: Lot 1 of Certified Survey Map recorded August 13, 2009 in Volume 24, of Certified Survey Maps, page 5646, as Document No. 902014.