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022-1008-30-040
O N 0 CO) 0 3-0 0 d � O y j O b'i � 7 O fD 1 C .• O C .► V �D A rr z Z o w< cn Z P. T 0• O m O = 91 O1 N O O 7 O N O. (D m Q CD N r N O" n _ CD o N o co C: m fJ cn CD x ° r* m o x o ! x c O m CD l o a coi o 0 o O v o 3 A C O fC O ... (O O. ' N j 7 N G O CA N N N a w m cn z D a w D N C 0) CD D cn N o. 0 0 0 03 co N D a 0 V O :3 ` O CA w C 0 CD m CD Z O N O O N O O .Z1 w CD N N z t/1 w C 3 6 CD 000 m Z 00 —' N 3 ����I a3y� o w D a4 Q vov - �I� �vo ,Ny N O =r O A N fl! O. ' d 9 N = C ' 9 N CL A _ - N O eD _ CD N c0 3 o 3 m C N r n o °' z o O D D o 0 D D O o °: O ° o CD ° N• A I (D I (D c c m w m CD Z CD —I N N to C A z O a Q R 0. z N OD I CL � c 3 A z I � 3 M 3 M Z m N! Z N r CD CD o' ? n a v o 0 _ m O ID C C 0 o CL o a o . cn I � 3 CL fi A I i I I O r0 I � � N ' A 0 0 b CD fD o c v+ O to O p (D a I o (D o CD n- ,�, � Parcel #: 022 - 1008 -30 -040 09/15/2005 07:43 AM PAGE 1 OF 1 Alt. Parcel #: 4.28.18.50A -40 022 - 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): 0 = Current Owner, C = Current Co -Owner LEROY R & BARBARA M DULL O - DULL, LEROY R & BARBARA M 1163 60TH AVE ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description " 1163 60TH AVE SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 2.000 Plat: 1332 -CSM 15/4150 SEC 4 T28N R18W NW NE BEING LOT 3 CSM Block/Condo Bldg: LOT 3 15/4150 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 04- 28N -18W NW NE Notes: Parcel History: Date Doc # Vol /Page Type 07/11/2002 683915 1925/555 WD 07/23/1997 686/01 i 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/10/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 40,000 261,000 301,000 NO Totals for 2005: General Property 2.000 40,000 261,000 301,000 Woodland 0.000 0 0 Totals for 2004: General Property 2.000 16,000 187,500 203,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 115 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division t J INSPECTION REPORT Sanitary Permit No: 420365 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: Vanbeek, Ro er Kinnickinnic Township 022 - 1008 -30 -040 CST BM Elev: Insp. BM Elev: BM Descri lion: vo' TANK INFORMATION V ELEVATIO9 DA A TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark /Y/-/ 0 d Dosing Alt. BM � 3 b U Aeration Bid . Se er p Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet EAS I T Septic f t Dt Bottom 9� s Dosing , Heade /Man. 2' S/ , Aeration Dist. Pipe r �a 2. Holding Bot. S tem / &f� 0 PUMP /SIPHON INFORMATION Final Grade S� 1 Manufacturer Demand St Cover - GPM �• /UD. Model Number TDH Lift Friction�Los�s System H ad T DH� �Ft Forcemaln Len t _Dia. Dist. to Well ar j ,-J SOIL ABSORPTION SYSTEM 44 4—D BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L 6 JBLDG WELL Di LAKE /STREAM bEACOM Manufacturer: INFORMATION CHA ER OR Type Of S stem: I gA el 0 O � / Model Number: DISTRIBUTION SYSTEM G , ey,C Header /Manif Id Distribution x Hole Size x Hole Spacing Vent Air Inta / / Pipe(s) ( h Length Dia Length a Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center >� edlrrench Edges Topsoil �1A Yes [� No L Yes P No COMME ' (Include de discrepencies, persons present, etc.) Inspection #1: / / ` Inspection #2: / a VU Location : 60th Avenue Unknown (NW 1/4 NE 1/4 4 T28N R1 8W) NA Lot 3 '` Parcel No: 04.28.18.40A 40 1.) Alt BM Description = / oJ �a S 2.) Bldg sewer length= -3J 1 - amount of cover =>,q / 3.) Contour = Plan revision Required? Yes Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor•s Signature Cert. No. r 201 W. Washington Ave., P.O. Box 7162 0 `�SCO�SI Mme, WI 53707 -7162 Site Address De artment of commerce q- -v z-- 4/ 9/ S // to 3 Sanitary Permit Application ' Number In accord with Comm 83.21, Wis. Adm Code, personal information you provide 0 Check if Revision T ` may be used for secondary purposes Privacy Law, s15. 1 m L App ht�on Information - Pkase Print An Information , `�` state S N umbor - 7 7 & j Z R' WED Property Owner's Nam Parcel Number Q Z - 2.0 property Owwr's Property Location ST. CF CiIX w0i� ! _i i Al � H. S T� N, E .571 may. State Zip Cow Lot Number r Block Number Subdivision Name CSM Numbe 60 1 IL Type of Building (check all that apply) (]City 2 Family Dwelling - Number of Bedrooms DVitiage ❑ PublidCommerciSI - Describe Use wnship i i ❑ State Owned / ' nd wl X 7-5' Nearest Road (,t/ 00 b /. 7' 5 "d A l jML Type of (Che& only one box online A (numbering scheme for idteriW use). Complete line B if applic2ble) A- 2 Replacement System 3 ❑ Replacement of 1 60fitiont , Ad For Co®ty use stem Tank B. if Sanitary Ferric Previously Issued Permit Number Date Issued k IV. Tape of Permit: (Check all that apply (numbering scheme is for internal use) 44 ❑ Non Pressurized In -Grand and 47 0 Sand Filter 50 0 Constructed W 22 ❑ Pressurized In- Ground 410 Holding Tank 48 0 Single Pass 510 Drip 45 ❑ At -Glade 46 ❑ Aerobic Treatment Unit 49 ❑ Recinvlating 30 ❑ V. tment Area Information: Design Flow (MM Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Re Proposed Rate(GalsJDays1Sq-FL) ) evader Ke� G �G �� 0 z " Is Y3 4 VL Tank Info CaPAeity in Total Number curer Prefab Site Steel Fiber Plastic Gallons Gall= of Tanks Concrete Conte Glass New Existing Tanks TXdM Septic of Holding Talc x - 1255— ,,X, i 0 VII. Responsibility Statement- 16 the undersigned, responsu ty for bow"tion of the POW" shown on the attached plans. Plumber's ame {Print) Plumber's ?"ft "RS Number Business Phone Number Plumber's Address (street, City, state, ' 7 a ( / k) S 7 VM, /De t use oni roved Disapproved Y Permit Fee�(inoludes Groundwater D Issued eat Signature o Stamps) snreharge Fee) / ❑Owner Given Initial Adverse �S � Q Determi natiou Conditions of Approval/Reasons for disapproval t d XW 8 3 �rl,S' � �!'�'��:tin�i�tiv�'li� -- �`°'�G��►,w�o:�y GtN IS tv- Qfox071aQ ' 3 /� Attack ormpide plans 00 the Cannel ad►) f the sptem an papr not less rim 8112 z ll his ffi she SBD -6398 (R. 05/01) PROJECT rRooer Vanbeek PLOT LAN D ESS 578 Hwv 65 Roberts Wi 54023 NW 1/4 NE 114S 4 /T 28 N 1 w wN Kinnickinnic COUNTY ST. CROIX MPRS Shaun Bird 226900 8/2/02 CONVENTIONAL DATE BEDROOM 4 AT -GRA CONVENTIONAL LIFT HOLDING TANK MOUND )00( CONVENTIONAL TANK SIZE 1255 gallons LIFT TANK SIZE HOLDING TANK SIZE DOSE TANK SIZE 765 LOAD RATE 1.0 ABSORPTION AREA 600 �-- BENCHMARK V.R.P. TOP Of St Fence Post # Of chambers none ❑ BOREHOLE O ASSUME ELEVATION 100' Filter Zabel A -100 WELL . H, R, p, Same as Benchmark SYSTEM ELEVATION 101.7 60th Ave Alt. B.M. B. Scale = 1 /4 11 = 10 , Area 15' Below 1 50 System is to remain undisturbed Well is to meet all 98' setbacks found in 101 1 00' 99' Comm. 83, Grading is to be done to divert run -off away from system B -1 O B -3 6% Slope Huffcutt Combo Tank Pro 4 Bedroom House w B -2 N Tank is to be properly "' bedded and provided with -° lockdown covers with ° approved warning labels r �D Pro ert Line Safety and Buildings 10541N RANCH ROAD r HAYWARD WI 54843 i TDD #: (608) 264 -8777 �scon- www.w sin w ww. cornrnerce.state. wi. us/sb isconin.gov � Department of Commerce Scott McCallum, Governor Philip Edw. Albert, Secretary August 23, 2002 CUST ID No.226900 ATTN: POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING, INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 08/23/2004 Transaction ID No. 776942 Site ID No. 638997 SITE: Please refer to both identification numbers, Roger Vanbeek above, in all correspondence with the agency. 60TH Ave Town of Kinnickinnic St Croix County NW1 /4, NEI /4, S4, T28N, R18W Lot: 3 FOR: New mound, 600 GPD Object Type: POWT System Regulated Object ID No.: 866104 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes P and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in /' iC() DF �c d chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use:' ARTMEN General Approval Conditions: D D F • This system is to be constructed and located in accordance with the enclosed approved plans and with the �� "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10691 -P "�'"._�___ �--- ( N.01 /01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment SEE CORF Systems" SBD- 10706 -P (N.01 101). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • 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. • Inspection of the private sewage system 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. Stats. • The maintenance plan for this system must be given to the owner of the POWTS. Key Item s • The ro osed ump settings have bee is greater t an rimes the void volume and less than 20% of the design wastewater flow plus drain back. Note • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner SHAUN R BIRD Page 2 8/23/02 of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. • The bottom of the distribution cell shall be level per the Mound Component Manual. • The maximum finished slope of the mound surface shall be equal to or less than 3:1 per the Mound Component Manual. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15 beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • Maintain well and waterline set backs per COMM 83.43(8)(1). • Provide frost protection per COMM 83.43(8)(c). • Holes must be drilled with a sharp bit and all burrs and foreign matter removed before installation. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addresse shall provide a copy of this letter to the owner and any others who are responsible for the installatZReviewer, maint nance of the POWTS. Sincerel Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Patricia POWTS In grated Services WiSMART code: 7633 (715) 634 -7810, Fax: (715) 634-5150, M -F 7:45 am - 4:30 pm pshandorf@commerce.state.wi.us cc: Leroy G Jansky , Wastewater Specialist, (715) 726 -2544 Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 8/2/ 2 to 0 Owner: Roger Vanbeek Location: Lot 3 60th Ave System type: Mound System Manuals Used: Mound Component Manual version 2.0 (01/31) Pressure Distribution Manual version 2.0 (01/31) Page# e`.Rf .S. 1. Cover Page r 2. Mound Plot Plan OF CO 3. Mound Cross Section uo acs 4. Pipe Cross Section /Pipe Layout i_SPONDENC 5. Pump Chamber Cross Section 6. Pump Curve 7 -9. Maintance and Contigency plan 10 -12 Soil test Signature License number 226900 8/02/02 PLOT LAN PROJECT Roaer Vanbeek D ES 578 Hwv 65 Roberts Wi 54023 NW' 1/4 NE 1/4s 4 /T 28 N ` 1 W wN Kinnickinnic COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 8/2/02 BEDROOM 4 CONVENTIONAL AT -GRA CONVENTIONAL LIFT HOLDING TANK MOUND )= SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 600 # of chambers none BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE (D WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 1 bL)VV , of CW Alt. B.M. 60th Ave B. M. Scale = 1/4 = 1 Area 15' Below 150 System is to remain undisturbed 98' Well is to meet all 101' 100' 99' setbacks found in � Comm. 83, u 3 —( Grading is to be done to divert run -off away from system B -1 B -3 6% Slope Huffcutt Combo Tank Pro 4 Bedroom House =f w B -2 u Tank is to be properly - bedded and provided with -°a lockdown covers with m approved warning labels r CD Property Line Dat _ z �1 Non -Woven Filter Fabric 4" Observation Pipe Perforated Below Filter Fabric Distribution Pipe_ 102. Z AM C -33 Sand N .6 Topsoil - - - =_: G j 7. Slope X00 Bed Of 2 %= Force Ma Fiav►ed Drain Rock From Pump Layer 'D !i Cress Section Of A Mound 'System Using A Bed For The Absor do Areo -F G L` A � Ft. li 3 Ft. I Ft.- J Ft. K� Ft. . L � • j ! ,�Ft. r r n u-Ps W3,2, 0 Ft. L 44bservotion Pipe -� -- --- --- a — J' — K m A vi � i Force Moin W = _ - _,.�.�------- -�_..._�_.._._ From Pump © Distribution Bed Of y— 2 %Z Pipe Drain Rock 4 Observation Pipe Permanent Morker Pipe or Rods P1on View Of Mound Using A Bed For The Absorption Area PAGE OF Perforated Pipe oetoit �0 i End View ) Ptrtorotta y PVC, P.Pe How Located On Bottom. are Equally Spaced lean v A-AXP fa x + t ^ S a PVC Force Mail► �t. AXIT tiom USXT Ira cdmw +;On PVC Matpfold Pipe Pros l Lt. r2-- ['� - Distribution Pipe Layout P �� Ft. R R. X Inches Y Inches Signed: Hole Diameter Inch License Number: Z� 7, Z, � 9 � �' Lateral a Inches) ---~- Man ifold " �� Inches_ Date: Force Mai " Inches # of holes /pip Invert Elevation of Laterals /a�. ;Ft. rage Ut SEPTIC TANK - f-PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS 4" Cl VENT PIPE 12" MIN. ABOVE GRADE 6 WEATHERPROOF 2:25 FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT MANHOLE COVER W / PAD LOC X 6 FINISHED GRADE WARNING LABEL , sy" 18" IN y C.Z. i105�0.woa s .D. INLET WATER TIGHT SEALS GAS- + 1 ' TIGHT + QED FILTER ----� A SEAL APPiI0VE0 PIP —�--- ALM JOINTS E 3 B ' ONTO StR.IO "i"' ' ON SOLID SOIL `� C 1 PUMP OFF ELEV . �d`FT. ' OFF D 3 APPROVED BEDDING UNDER TANK CONCR SPECIFICATIONS SEPTIC / DOSE 5 TANK MANUFACTURER: NUMBER DOSES PER DAY: TANK SIZES: SEPTIC /� 5 GAL. DOSE VOLUME INCLUDING DOSE _ GAL • F LOWBAC : GAL. '......... s / . - 3S ALARM MANUFACTURER: S,u CAPACITIES: A = NCHES = = L: � S � G � .. GAL. MODEL NUMBER : B = 2 INCHES a ue GAL. SWITCH TYPE: i iu - f 7• C = INCHES z L. PUMP MANUFACTURER: I MODEL NUMBER : - z ? D INCHES SWITCH TYPE: v UMP REQUIRED DISCHARGE RATE GPM • PUMP E ALARM WIRING AS PER ILHR 16.23 WAC VERTICAL DIFFERENCE BET OFF AND DISTRIBUTION PIPE Al: FEET � - MINIMUM NETWORK SUPPLY PRESSURE . . . . • . . . . . 7 � FEET FEET FORCEMAIN X FT /100 FT. FRICTION FACTOR . . FEET TOTAL DYNAMIC HEAD j FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH : WIDTH DIAMETER LIQUID DEPTH 3�'J SIGNED: LICENSE NUMBER: Z4 DATE: �rs8 r r ' - TOTAL DYNAMIC HEAD /CAPACITY HEAD CAPACITY CURVE PER MINUTE EFFLUENT AND DEWATITING it MODEL 152/153 W Lj MODEL 152 153 Feet Meters Gal. Liters Gal. Liters 153 5 1.5 69 261- 77 291 12 'w - 10 3.1 61 231 70 265 152 c� 15 4.6 53 201 61 231 _ 20 6.1 44 167 52 197 25 7.6 34 129 42 159 r 8 30 9.1 23 87 33 125 0 20 35 10.7 -- -- 22 85 0 ( XN 1 40 12.2 -- -- 11 42 4 Lock Valve: 38.0 R. (11.6m) 44.0 R. (13.4m) 10 a14M 0 20 60 80 100 GALLONS LITERS 0 320 s 1/4 80 160 240 3 27/32 a 5/8 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS 3 27/32 4 _ • Ted dosing panels a vailable. `' ® 3 27/32 • Eiachical altemajors, for duplex systems, are avaiilable and supplied with an alarm. • Va&&e level GmW swiUm are available for c ontrolikV single phase SYSUM • Double pggybm* varlaWe level flo at switches are available for vw&e • Semi Qwik-Box available for installatION. See FM7420. • Over 130°F. (54 °C.) special Quotation requked. r Ft9- 152f153 Series' 12 1/8 15211 codroll Model Volts -Pd MMode 5 1/8 N152 115 1 Non 8.5 1 2or3 (�f152 115 1 A++b 8.5 Ydudad 2or3 maea E152 230 1 Non 4.3 f 2or3 eE152 230 1 Aida 4.3 Isduded 2or3 153 115 _ 1 Nan 10.5 1 2or3 81153 115 1 Aida 10.5 Herded 2or3 SELECTION GUIDE E153 230 1 Non 5.3 1 2or3 1 ski* pw)ack wadable level duetswOCh ordo" piggyback variable level float BE153 238 1 Aub 53 kwiuded 2or 3 swktL Refer b FM0477. ® 2 See FM0712 Tor conut model of EIe h;W Aflem for E -Pak Ali jeewledon of wab* s. woiecdan devlees and wbtnfl sboakl be done by a w 3 Variable lew cardrd wAi ch 100225 used as a cooUd aerator, spedly duplex (3) cased de*1010• Afl duhiai and wily codes drodd be Mowed H draft the most or (4) W system. rewktMadond EdadtFcCode piEClaud IbaOcenpaflakd Safetyand Nea4h Att{OStIA). RESERVE POWERED DESIGN For unusual conditions a reserve safety %ft is engineered into the design of every Zoeller Pump. MAE T& P.O. ter 16347 l arevvft KY 40256.03 Miwl 6tsrsaf. . jD 3649CmRt La&wl a, KY 40211 - -1961 O (f ' 104 778 2 731 .1fang s �unrPr SKY 1,9 9 1�: so�re<:r� Pl/it f. FAX (504 774-W4 a Copyright 2000 Zoeller Co. Ad rights reserved. P a ge POWTS OWNER'S MANUAL & MANAGEMENT PLAN FS.E it3PORMATION SYSTEM SPECIFICATIONS Owner 2 V Septic Tank Capacity D NA Permit Septic Tank MwWfti WW 0 NA anuent FUN Manufacturer ❑ NA DESIGN PARAMET Eflluetut F Model NA Hof Bedrooms 4YfN Number of tbnnrrnec'cial Unfls �P-Tm* Capacit/ e�.S� at NA Esdmalaed tbw (av!era9e) c PcunP Tank M ucer O NA Design ftw (peato. ( x 1 -5) fs c3 0 NA SoA Rate /. aV _ pump p Model DNA Application kdtuentl Auent t may Monthly �U Filter 0 Peat Filter Fats. Oil & Grease (FOG) S30 mg1L p Medhardcal Aeration 0 Wetland Bkxhrnkad OMW Demand (800, &220 mgiL O 131sk Ci Other: Total Solids (1 SS) 5150 Manufacturer Pry Effluent Wanly _NA Mond* average` Dispersal Cell( Demand (BODs) &30 mgJ!- 0 In- ground (gravity) n -ground (pressurized) TOW Suspended Solids (TSS) 530 mg1L 0 At-grade p ' o � Fecal CoGfoum (geometric mean) 510' cluf100m1 D Maudmturrn Effluent Particle Size K inch diameter Values 4V" for d=eSbc t�"•ODRY Q" and seplictW*eM0W1t- !� Valdes bpk* for pretreated write rater_ MAINTENANCE SCHEDULE Service Event Service Frequency At least ore every p �� r(s) (Maximum 3 yrs.) inspect condition of tanks) tan s When combined sludge and scum equals one -third (V of tank volume p ump out c ontents of �) 0 tr>ort s) (Ma)imum 3 yrs.) Inspect dispersal ce (s) At feast once every Clean eftuent filter At least once every D months s) Inspect pump. ptunp controls & alarm At least once every 0 months s) O NA At least once every O s) O NA Flush Iatiemis and test At least once every p months 0 years) O NA a�her; Other: At least once every 0 months 0 year(s) 0 NA MAI NTENANCE INSTRUCTIONS be made an Individual canyin9 one of the licenses or and dispersal t lrtspf3Gfiot� tuft Sewer; POWTS Irt: i Mash Piutnber; Master Plumber S pperator. Tank insps must include a visual inspection of the tarnk(s) to �► any m�r9 or broken measure the volume of combined sludge and scum and to check for any back up hard�v M identify any txadCs , , The dispersal call(s) shall be visually Inspected to check the effluent levels or portding of effluent on the 9 of efttue<nt on the ground surface. The ping of effluent on the for potd'�g and ► authority grou in tine pipes to check a �-� and requires the Immediate rtctificatiot of the local regulatory tion of sludge and scum In any tank equals one-third (19 or nrore of the tank volume. the When the combs accumulation entire contents of the tank shatl be removed by a Septage Servicing Opp and disposed of in accordance with ch. NR 113. VVisoonsin Administrative Code. iued - POWTS c�omponenls, pretr+eatuFmertt components: and any The serAcbtg of effluent filters. mechanical or pressu • a certified POyyTS Maintainer . other maintenance or nxx*o ft at intervals of 12 rrwnths or lass shell be perform by of any service event A shall be provided to the k=l regulatory authority within 10 days of canpktion START UP AND OPERATION ucts or other am For new c. p to use the POWTS q�edc treatment tank(s) for the high are chemicals that may impede the treatment process and/or damage the cusp cell(s). Iug detected have the contents of the tank(s) removed by a septage servk*V oparabor Prior to use. Page G— of Z / System start up shall not occur when 'conditions are frozen at the hnfdtrallve surface. o tuft may 0 above l�r levels. When power is restored the excess wastewaterYA be dbd=gW to the dspw3al cell(s) In one large dose. overioa&V the call(s) and My result in the b To avoid this slradon have the contents of the primp truck removed by a prior &restortng power b the effluent pub or canted a Plumber or POWTS MaIntalner to 1 assist in nvmtwtly opera the Pump controls to restore nomad levels within the pump tatdL Lb not drive or park vehicles over tanks and dispersal cells. Do not drive or park over. or otherwise disttab or compact the area war 18 feet down slope of any rrourtd or at-grade sod absbrption area Reduction of ebrAvition of the fdovt from the wasWmder street may improve the perforrnmtoe and prdatg the We of the POW M antililodw - cotton w&v bs; degreaseta; doodad SOS; gapers; dish fadai ; fat fo kWW116n u (sump pump) wader; finA and vegetable peeliugs; gasoline; herbicides. meat s at pnodtrds; pas sanitary naptdns; tampons; surd water softener txkte. ABANDONOMENT Maw the PoWrS falls and/or is permanantly.tdcen out of service the fob steps std tke taken to inste that the system is properly and safety abandoned in compliance with ch. Comm 83.33. Wisconsin Code: • All piping to tanks and phis shad be disconnected and the abandoned pipe op~ seated. • The its of ag huft and pits shall be removed and properly disposed of by a Serge Servkurtg Operator. • Alter p all tanks and pits shall be excavated and removed or their covers remand and the void space Bled with sat grave! or another ineit sold material. CONTINGENCY PLAN if the POWTS faits and cannot be repaired the Mowing measures have beem or must betaken, to provide a code compliant replacement system: O A suitable repwarnerd: area has been evaluated and may be utd?ced for the location of a replacement sod absorpbon sysl, The replacement area should be protected from disdrrbance and compaction and should not be infinged upon by required semis from existing and proposed strrxktrre, lot lines and were. Failure to protect the replacement arm will result in the need for a new sod and site evaluation to establish a suitable replacement area, Replapemed systems must comply with the rules in effect at that tire. 0 A suitable replacement area Is not available due to setback and/or sod limitations. Batwing advances in POWTS echnalogq a holding tank may be Installed as a last resort to replace the faded POWTS. /� e sibs has not been to identify a suitable replacement area. Upon failure of the POWTS a sod and site evaluation mud be perlbr med to locate a suitable replacement area U no replacement area is available a ng tank may be instalied as a last resort to replace the faded POWTS. and atVrade sod atsorp systems may be neco m*ucted in place k"vi rg removal of the biormat at go atldlidive surface. Reconabuctions of such systems mum comply with the rules in effect at that thine. «WARNING» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANLNOR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMME S POWTS INSTALLEIR POWTS MAINTAfNM Name GG f`/ Name -,5` `/ Phone /,X SEPTAGE SERVICUM OPERATOR UMP LOCAL REGULATORY AUTHORITY Name � J Agenc ` Phone Ptrone / — L TMs doaaneot vim dmftd t!y the sraRs Of Vw Qrwn War. Moquette and wa nhwa � Zoning +� SanTtalion agencies- This document meets of cln. Comm 83.22M(bK1)� and s3 Stt1)..M & (3) w�+� A Code- Ilse of I* down" does not the mininnrn GMW (vat) guarantee the pe rums ace of the POWTS. Maintenance and Contingency Plan for a Mound System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Dose Chamber is to be pumped at the same time as the septic tank. 3. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 4. Once every 3 years the mound is to be inspected via the inspections pipes in the at- grade. The laterals are to be inspected via the cleanouts. 5. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 6. Pump and electrical components are to be checked at the time of the pumping. 7. Owner agrees to leave the area 15' below mound undisturbed. 8. The owner agrees to save this plan. 9. Trees, shrubs, and other similiar vegitation are not be planted on system. The system is not be driven over. 10. Effluent Quality is not to excede the requirements found in Comm. 83 Contingency Plan 1. Pump alarm goes off, call pumper and pump out dose chamber and septic tank if needed, then bypass pump float and try pump without float. If this works, float is bad, replace float. If pump still does not work, check power at the pump with a electrical device such as a hair dryer. If no power, check breaker inside house and call a electrician. If there is power, then pump is bad and needs to be replaced by a plumber. 2. If mound fails, determine cause of failure, test another area or remove pipe and sewer rock, retill soil, install new mound system. 3. Replace any other failing components as needed. Important Phone Numbers Plumber: Shaun Bird 715- 246 -4516 Pumper: Tom Mondor 715 - 246 -5148 St. Croix County Zoning 715 - 386 -4680 Shaun Bird #226900 8/2/02 f Wisoonsin Department of commence �d F a SOIL EVALUATE J `' � 7 P ?T Page of Division of Be" and Buildings a with Comm 85, Wis. Adm. Code Attach complete site plan on paper not teas than 8112 x 11 inches in size. Plan must include. but not limited to: vertical and horizontal reference point (BM), di redion Parcel I.D. percent slope. scale or dimensions. north arrow. and location and diet we arest d. p 2Z – (J6 3U' O �` U Please print all Info y Date Persona brrormation you provide may be used for seca,da pu (Privacy Law. a. 15.04 ( 0 Propertyownar ® g Iz– U CL Govt Lot 1/4 Iv 1/4 S T � N R E ( W Property Owner's Maili ss �, , � # I Subd. Name or CSMiI City State Y Phone N ❑ City ❑ Village Town Nearest S q0 2 - 5 ( ) Canshuc ion esidential / Number of bedrooms Code derived design flow rate 6 GPD ❑ Reptaoement ❑ ublic tx Describe: Patent material -9 Flood Plain elevation if applicable General oartrrrerMs _ and neoorrsnen 0 5` re- l�,v t mil, I 6 Boling a # Boli Ground surface elev. ft. Depth to i nbV factor in. Sal Appliceition Rate Mortw Depth Dominant Color Redox Description Texture Stuclum Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'E01 - Eff#2 2, O� Z # 0 BwkV © ® Pit Ground surface elev. rg1ft. Depth to limiting fa in. Appl ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell } Qu. Sz. Cont. Color Gr. Sz. Sh. y 'E##1 *Eff#2 6 Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 1 ' Effluent #2 = BOD < 30 nV& and TSS < 30 n CST (Please P — — re _ CST Number Address Evaluation Conducted Telephone Number . r Property Owner Parcel ID # Page of Boring 0 Boring Pit Ground surface elev. 0 3 ft. oeptf, to Ikrvting factor in. Sod Application Race Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPM in. Munsed Ou. Sz. Cont. Color Gr. Sz. Sh. 'Eif#1 I 'Eff#2 3 b -3L b S w . 3 a Boring # ❑ Boring C] pit Ground surface elev. ft. Depth to limiting factor in. Sod Appimbon Rate Horizon Depth Dominant Color Redox Description Texture Sfnrdure Consistence Boundary Roots GPDM in. Murrell Ou. Sz Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Bc," # ❑ Boring Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil jGPD/W tion Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots in. Munseil Ou. Sz. Cont. Color Gr. Sz- Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 < 220 rrxyL and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mgA- 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. se"w(PL6 ) f s, Soil Test Plot Plan Project Name Roger Vanbeek Shaun Bir Address 578 Hwy 65 Roberts Wi 54023 CS 226900 Lot 3 Subdivision ------- Date 8/ 2/02 NW 1/4 NE 1/4S 4 T 28 N /13 W Township Kinnicldnnic Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post System Elevation 101.7' *HRPSame as Benchmark Alt. BM Top of Survey Iron @ 97.0' Alt. B.M. 60th Ave B.M. Scale = 1/4' = 10' 50AL 98' 101' 100' 99' B -1 B -3 6% Slope Pro 4 Bedroom House CA) B -2 u N i 0 CD r 5 CD Property Line ot y , RECEIVED Safety and Buildings 10541N RANCH ROAD �� 3 2002 HAYWARDWI 54843 TDD #: (608) 264 -8777 www.commerce.state.wi.us/sb ST. CROIX COUNTY www.wisconsin.gov ZONING OFFICE Scott McCallum, Governor Philip Edw. Albert, Secretary s AW isconstn Department of Commerce August 23, 2002 L CIIS o. I nspector -- – F SH -BI PLUMBINU INC -- — NE Identi cation um ers r ion o. ite o. 97 Please refer to both identification num ers, a ve, in all correspondence with the agency. CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/23/2004 SITE: Roger Vanbeek 60TH Ave Town of Kinnickinnic St Croix County NW1 /4, NE1 /4, S4, T28N, R18W Lot: 3 FOR: New mound, 600 GPD Object Type: POWT System Regulated Object ID No.: 866104 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10691 -P ( N.01 /01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10706 -P (N.01 101). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • 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. • Inspection of the private sewage system 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. Stats. • The maintenance plan for this system must be given to the owner of the POWTS. Key Item(s) • The proposed pump settings have been adjusted provide a dose volume that is greater than 5 times the void volume and less than 20% of the design wastewater flow plus drain back. Note • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. • The bottom of the distribution cell shall be level per the Mound Component Manual. • The maximum finished slope of the mound surface shall be equal to or less than 3:1 per the Mound Component Manual. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • Maintain well and waterline set backs per COMM 83.43(8)(i). • Provide frost protection per COMM 83.43(8)(c). • Holes must be drilled with a sharp bit and all burrs and foreign matter removed before installation. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence 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 to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, atricia an or an eviewer , ntegrate ervic s - ax: (7135 - - am - pm ps an or commerce.state.wi.us ee equire Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky , Wastewater Specialist, (715) 726 -2544 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County. St. Croix Safety and Building Division ' INSPECTION REPORT Sanitary Permit No: 399631 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: Vanbeek, Ro er I Kinnickinnic Township 022 - 1008 -30 -040 CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution T ole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over lxx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ❑ Yes [M No ❑Yes ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 2263 60th Avenue Unknown (NW 1/4 NE 1/4 4 T28N R18W) NA Lot 3 Parcel No: 04.28.18.40A 40 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? ❑ Yes ® No Use other side for additional information. Date Insepctor's Signature Cart. No. SBD -8710 (R.3197) I _ oaa - ' Safety and Buildings Division Carty an 201 W. Washington Ave., P.O. Box 7162 57 irsconsin Madison, W 1 N Site Department of Commerce % t, %•� Sanitary Permit A ,pe p rs O � Sanitary Permit Number !n accord with Comm 83.2 1, Wis. Adm. Cod on rr a be used far ses Priv p 15. 1 m Check if Revision f 1. Application Information — Please Print All Informado NO 1 0 2001 tate� I.D. umber✓ Property 's Name S Gu arce Number . t$• / A — I NGO F j .. oai oo Property o 's Mailing Address / Property Location 0 l0 � ( 8 �t o !14 K; 7' T GO N, R City, State [Zip Code Ph Lot Block Number Subdivision Name CSM Number ,1!� ft II. Type of Building (Check all that apply.) D City or 2 Family Dwelling - Number of Bedrooms �' 0 1 Village _ 0 Public/Commercial -Describe Use dha ownshi A 141 L C] State Owned Nearest Road / III. Type of Perm y. (Check only one box on line A. Numbering is for internal use.) (Complete line B, if applicable.) A. 1 New 3 0 Replacement of 1 6 0 Addition to stem 2 0 Rep System Tank Only System For County use B ' OCheck if Sanitary Permit Previously Issued Permit Number T Dt, Issued IV. Type of POWT System: (Check all that app, y. mbering is for Internal use.) 440 Non - Pressurized In -Ground 2I� Mound 47 0 Sand Filter 50 O Constructed Wetland 22 O Pressurized In -Ground 410 Holding Tank 48 0 Single Pass 510 Drip Line 45 0 At -Grade 46 OAerobic Treatment Unit 49 0 Recirculating 30 E)Odw 2 V. Dis rsal/Treatment Area Information: _ *A a 1 6CN .60 Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate system mevation Final Grade Required &,m Proposed Rate(Gals./Days/S Ft.) (Min. /Inch) Elevation — sat, od VI. Tank Info Capacity in Total Number ufacGUer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New CxisCng n Septic oouowiff 4tllt DoaingCbamber 1 ' %Z r . ' C VII. Responsibility Statement 1, the unde responsibiUty for installation of the POWTS shown on the attached plans. Plum 's Name (Print) PlWws i MP MPRS Number Business Phone Number loan �- SeN z..- L Z- (S� 22L 2f- Plumber's Address (Street, City, State, D D VIII. C /Department Use LJ Disapproved A Date Issued s (No Stamps) oved 0 Owner Given Initial Adverse' Sanitary Permit Fee (in odes Groundwater PPr Surcharge Fee) 2 C X4 /Z'�?✓'C Determination Conditions of Approv for S , o �air�'C ^� 5rt �/ CVr/K -�7 , Fal'L GN�t lv�rVV�LC/t -tiJ • err ayu44 61 — t S rtSr p cwt+ 1ti@a X'a r ji.A t«cuso. c �' �ts vJ t�s. V tLtti. YWa vr� 3 wta-VO%m Mir- t6tAA LS1t4' �$Xt,� Attach complete plans (to the County only) for the system on paper not less than 3112:11 inches in size CRT) -6199 (R - 05/011 v' a r. O .wA4 - J , o Lgo v 4 . e11i Lt'L'��q s�.tY S �� �� _ alit -� !L o,�w o� , •o `e j vt. � « 2 ~� ►eo.o) v. ( t4.14 J L.7 � Ne�•e.; elt•°6 aMlow bs� \�`iAl� w ..,r4tr 71 S�•..:.� 1. i a cs. � two • �r� t t s . z a' �.•' C P%Jc S J� 4'O UU � �.,.,1- v o•a -4� � i r 1 . Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 *isconsin www.commerce.state.wi.us /sb Department of Commerce www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Acting Secretary November 19, 2001 CUST ID No. 139462 ATTN. POWTS Inspector TODD L SINZ ZONING OFFICE T L SINZ PLUMBING INC ST CROIX COUNTY SPIA E5609 708TH AVE 1101 CARMICHAEL RD MENOMONIE WI 54751 -5520 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/19/2003 Identification Numbers Transaction ID No. 690766 SITE: Site ID No. 638997 Roger Vanbeek Please refer to both identification numbers, 60TH Ave above, in all correspondence with the agency. Town of Kinnickinnic St Croix County NW1 /4, NEIA, S4, T28N, R18W Lot: 3, FOR: Description: Four Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 821177 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD - 10706 -P (N.01 /01). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the Mound manual, and section VI of the pressure distribution component manual are complied with. A copy of this letter including instructions and information relating to proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. • 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. • Comm 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. ' . TODD L SINZ Page 2 11/19/01 + 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). In addition, 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. • 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. • 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. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the coup designated official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. g county A copy PP P P of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence 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 to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer 11, Integrated Services WiSMART' code: 7633'' (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday cbratz@commerce.state.wi.us a V • . s Roger Vanbeek - Mound Transaction # Construction Materials and Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: Mound, SBD - 10691 -P (01 /01) Pressure Distribution, SBD - 10706 -P (01 /01) Location: Lot 3, Vanbeek CSM NW 1/4, NE 1/4, Sec. 4, T 28 N, R 18 W Town: Kinnikinnic County: St. Croix Date: November 9, 2001 Owner: Roger Vanbeek !O 42°� Address: 578 H 65 Robe , WI 54023 Plumber: To inz O G Signature: r License # MP 1 462 Attachments: 6748 -Plan Approval Application SBD -8330 page 1: cover ConA onally 2: design criteria &calculations APPROVED 3: plot plan 4: system cross section WAM EIff OFCOMMERM 5: plan view, lateral detail � 6: pump tank exit detail SEE CORRESPONDENCE 7: pump curve 8: system management page 1 of 8 ., • � � • Y ryo A e"'� 5 �� a« ^^ s s # � W w�yP�n......wr.. . »w ....v.ei.rarb... Design Criteria Residential Wastewater Contaminant Load: 30 mg /L < BOD < 220 mg /L Anticipated septic tank effluent 30 mg/L < TSS < 150mg /L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/L Bedrooms x 100 gal/bedroom/day x 1.5 �' " gallons /day hydraulic load Design Calculations In situ designed loading rate d' 3 �� gallons /sq. ft. per day Depth to estimated high ground water in. Depth to bedrock ? � in. Cross slope at system % Force main length Z Z ft. of Z in. Manifold /header length 3 ft. of in. Drain -back gallons Lateral length 4 @ 5'b ° ft. of ��� z in. Lateral elevation °Z ° ft. @ bottom of lateral Lateral hole size ��� b in. @ in. ( `6'' o ft.) Spacing k 3 holes /lateral S Z holes total Lateral volume $,4 gallons Total lateral discharge rate gallons /minute @ z ft. head Network pressure,compensation losses Elevation difference 9 •Z�� ft. Friction loss ft. @ 3� gallons /minute Total dynamic head 13 ° ft. Pump /sil*on 4 VO gpm @ Z Z e'` ft. of head Manufacturer ° � a "' Model # �- Dose volume C gallons Lift /siphon tank `a w �w �z-� wix, C-0 gallons Septic tank Y Z�'o gallons Effluent filter �~ Measurement pump on and off in. Height alarm from tank bottom in. Reserve capacity S ` gallons specs.calcs res Page Z of 1`��- sw- 4•zg - \`8 w I o wo , �O...M; 1LiMw'i`�.iYM C v �va. S c a.1 � , �� 4v a girl :L o,`.w o � lo,. ) °v't, 2" � ► ea.o ) z J t.7 6 j'O Ka�a; K'�•°L cr..�•+� \os� ��"�° w ,.rt+o 3 h, 90' 6 1" Sw...e � ` Coe L1 to o,�.. toll,, � ��ru.Q t.a•, i-oW, � r ejC. %J, 40 Yo w. ( Slo 1l 9 .�.u;� bra�c 1 �. �ro •�•e.. �- U w .Q � t tJ� .�'' `'•��r I�rA 6 C ` L•� � t w �..s �taa(j � �.v X A��Mt tit (�'� gslow / '. \ Cf9•tZ �a.o�, �� Q..v l tsr JI..��wTV.' r*%r.y 6' -10 I \ h 1 3 Ar L� l OO . O ` Pf a i i 9 r � r I i I V z. to' S o� {v•O' Z6AI 6 1 O . 4 \ � u L t. � O b 1 a.r v ..'ti o .,. .... t I l\ '�'a b e �- o Y., " ` o > � . c ^ .k.. � •� O \ 0. QN Q/v w • H.w Z .� 1 ?'ho �+-� v/`^-Gri�1 l3 Yl V't. K O 1 6 �1 ` I 11 N ` A( _ ( n 1 �I f�V C. �t� `i'V i.�..< wa��h t Z z .� r / / IoN 4. I 4 y,,n Sl- I ` I 4 o\ ... S o h 1 •"� Q. t a..� t3..•.� 't�.r \p 0 ' 1 O �. \ ; Y+ k-S �. `R • , / u. J�j O.r T \� • ' ' �. �` I i i I 10 At L11\AMi(,' -? mirqjIt -i Hk.Al) CAPACITY CURVE r"r irNl' ANO �� rr MODEL 152/16Z W Ir iii:( ';1� IG� oc- F MIP-1cox G(11. );tort 40 1 5? 201 0, 0. 44 ........... 2 U 17 4 4 ' veil t 1U i 20 40 Go 80 100 LHLKS 0 80 160 240 320 ;7/1p FLOW PER MINUTE. CONSULT FACTORY FOR SPECIAL APPLICATIONS rirne-d dosing panels available, Electrical alternators, lot dUPIOX systems, ere available and supplied with an =trn. Variable level conttol switches are available for controlling single phase systerns. Douce Kgyback variable level Boat switches are avWlabW for variable local long and short cycle controls, Sealed Owik-Box available for outdoor Installations. See FM1420, Over 130'F. (54'C.) $pedal quootion required, .gi.s . t wo" V ohp4h mode Amm skv)&x Dupkx h • 8.6 1 �Z - 88lul 115 1 MQ Included 2o(3 1 230 1 N P62 � z BE162r I 'kulo Indk4od 200 I Non _10.6 I T 33 L 1 2 or 3 "j �2 t 5 1 Am 10.6 1 ImWod 2 (d 3 5ELECTION GUIDE E 1$3 730 1 Non I . &3 11 290 1, SNW pjqqybwk virWw luvi)l suet switch or double piggyte ok venjow love fical BE i. I ALAO Incluo0d 1 2 00 Mtch. Refer to F1611011177. 2. So FW712 for correct model of Electrical Alternator E-Pak. All muilition of cwott proj0JOn devices ind vAreig MOUld N 40m W 1 0011111114 3, variable Isv#1 control Witch 1104225 used as a conhl activelor, specify duP'Qx (3) Kens4d vqcuicim. All tlectricti and wkly mdot should be followed Including the most ricw7t Mqnal El"t cods (NEC) and the 0mvpdonel $o#my end Wub AM (03HA), or (4) Rost "tem. RESERVE POWERED DESIGN For unusual conditions a reserve aafety factor Is engineered Into the design of every Zoeller pump. "L To. To P.O. sox IOJ47 P-C To, K Xy y 402M.W47 JAV%A-dWVnl o �� arfrP cim Ruri AM 040 40211-106 f �&Urr low" shver /9,99 r ille f • I (W4 P2"%UWP PAX ( d) 774-304 0 Copyright 2000 Zoeller Co. All rights reserved. System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop adsorption with the adso tion system or any other system components, the installing plumber, T.L. Sinz Plumbing, 715- 235 -2644, or the St. Croix County Zoning Office, 715- 386 -4680, should be contacted for assistance. General Proper functioning of an on -site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a pump tank or compartment to allow a dose to be accumulated, a pump and controls, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. I . if the septic tank is installed prior to sheet -rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2 Install water - saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly. 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. Maintenance 1. The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must be back - washed into the septic tank to remove accumulated material. 4. Periodic observation pipe inspections should be made by the homeowner to examine the state of the in -situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell, 5. if this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down -slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run -off into the system area. 11. Warning: Do not enter septic, pump or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing. and /or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 WiisconsinDepartment ofCommerce SOIL EVALUATION REPORT page 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 81/2 x 11 inches in size. Plan mutt include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all in �� le d by Date Personal information you provide may be used for sec oses (Priva • aW, s 5.04 (1) (m)). Property Owner r Property Location p e a � Govt: of f 1/4,(f 1/4 S y T Z� N R /�E(or� Lo # Block # Subd. Name or CSM# Property Owner's Mail' Address t ,� ., .� �Q � ..._, City State Zip Code ne Num y ❑Village [•Town Nearest Ropo (�] New Construction Use: [)I Residential I Numbe'' ttle"j4 ski " Code derived design flow rate l � d d GPD ❑ Replacement Public or commercial - Desc 5 ` .: J Flood Plain elevation if applicable Parent material �// ft• General comments and recommendations: O gg*, -e-1 �P— v r9 ? L, Boring # Boring I ® 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 /fi? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 - ID f 3 siI r>r IVY 2 - 3t� 10-4 I� sic+ Z rn-Fr -� IL, 3 c2p - 7.5v c 4 ) Z k rr ; _ - 5 •9 a Boring # n Boring ® pit Ground surface elev. 9 q-!96 ft. Depth to limiting factor 2 0 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 2 $- 20 y -- S i c l 2-vns6k r of 3 2L� - 5 UP 1.5 (P 5L 2ro sbik r4 • - s 9 * Effluent #1 = BOD > 30 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L CST Name (Please Print) S' nature o CST Number � ,�-K IZ - � = 0s330 Address Date Evaluation Conducted Telephone Number a s Property Owner Parcel ID # Page of a Boring # F1 Boring I [A pit Ground surface elev. Im.00 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 - 3 Sil 2-mob c-5 I 5 C2 - 1.5 4 SL n4i F Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil ApElication 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 F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil ADDlication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 - Eff#2 - Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg /L • Effluent #2 = BOD < 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 TITY 608 -264 -8777. SBD -8330 (8.07/00) : PAGE_- OF .13_ _ NAME Uuvx h e ek LOT# LEGAL DESCRIPTIONAU '/4_W/<, TZ4,N,R ISE (or) ►r SCALE: I "= Z / 1 6 , BM I ELEVATION �Oa • 6 x BM 1 DESCRIPTION OP 0 t Z �rJJL P� (fie + BM 2 ELEVATION q R 3 Sec- BM 2 DESCRIPTION 4op a Z Ale- D De SYSTEM ELEVATION /O /• y U ALTERNATE ELEVATION /y CONTOUR ELEVATION �9 9 La 5 he PC 0 9 oQ,o L ■ �D ■ B'� Bmi SIGNATURE DATE �ZS-til ST CROIX COUNTY SEPTIC TANK MAWrMANCB AGREEMENT . -ANA OWNERSHIP CERTIFICATION FORM +wnex/B er c e- ly O `er Tailing ddress ddress � 63 (Verification required from Planning Department for new coustcucti.0 lStat - � t� � , Parcel Identification Number 22 — l0 Y — 30 ' 0 ,EG F SCRIP T`ION I�t, -R �G i D� O N �w, Town of - Ln.� 'n `n 1 C "on /4, I,, Sec. T Lot* ;ubdi n C"11rux I Survey Map # , Volume __, . Page. # tWarraa Deed # I � S-e�� Volume --�z `� o . Page # -�- �� Spec hous ❑yes no Lot lines identifiable ,yes ❑ no use and m its premature failure to Dandle wastes. P aintenanexof your septic system could result in roper maintenance can pumping � out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can the function of the septic tank as a treatment stage m the waste disposal system- I be anmeat a crab "tion form, signed by ft owner and by a �r owner agues to submit to St- C Zoning Dep the on -site wastewaterdisposal system y plambe4 restnctedplumber eu a hcensodpump� venf3►►ng (1) c tank is less than 1/3 full of sludge. is mr g condition andJor (2) after inspection and pumping (if necessary'), system w sewage disposal w ith the standards U " co maintain the private 'geed have read the above rgpirements and agree cation set forth. in, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification t c system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 stating y days of three year expiration date. J DATE 4ihd A OF APPLIt AN'r p R R CATION the o wners) of k I (we) certify that all statements on this form arc true to the best of my (our) knowledge. I (we) am ( are) the pM erty dcscn abo , by virtue of a warranty deed recorded in Register of Deeds Office. DATE QF APPLICANT Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. �! Incl ade with this application: a stamped warranty deed from the Register of Deeds Office a copy of the certified survey map if ref"== is made in the warranty deed I _ ,— D OCUMENT NO. STATE BAR OF WISCONSIN FORM 1 -1982r THIS SPACE RESERVED FOR RECORDING DATA WARRANTY DEED 492523 PAGE Q� a OFFICE This Deed made between - __--- � l�d © 1 ph- PYc�L1Se, - -a - Sir1e - -• f°�, w - __man -_ -------------------- - - - - -- -------------------- - - - - -- ------------------------------- ...___ a V '�as 16th ------ - - - - -- ----------------------- - - Z ------------------------ --- ----------- ------ - - - - -- Grantor, y Apr1 D. 1 9 84 and --- R _oger_.Van_aeek__and.,Sandy..Van __Beek - ,__husban d__ and, wife -- o f 8: 30 A as jQin t__ tenan?_t's->--------------------------------------------------------------- - - - - -- - - - - - -- ------------- - - - --- ------------ -- ------------ -- - - - --- ----------------- --- ------------ --- ---, Grantee, BoabF� wf Dili Witnesseth, That the said Grantor, for a valuable consideration_QnC .Dollar -- ($1. OD)_..alad__ o_ther___good_iud_ -val uabl.e..c_ons ider_aUQn RETURN TO conveys to Grantee the following described real estate in ..,5 t.___Cro]..X_____.._.-..- County, State of Wisconsin: The West Half (W 1/2) of the Northeast Quarter (NE 1/4) of Section Four (4) Township Twenty-eight 20 North a ,Parcel No- ----------------------------------- Range Eighteen (18) West. dL . .%.,a; K l This ----------- 1S_____ ___ ______ homestead property. (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And ---------•------ g raritor-- her_ein--- ---- ---- -- - - -- --------------------------------------------•--------------------------------•------------- warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions, covenants and conveyances for highway purposes. and will warrant and defend the same. Dated this ------------- - - - - -r -T7......- -- ---...... day of ---- --- - -- -- - April --------- •---- ---- ------- -- -- ----- --- - -- 19 4 --------------------------------- ----------------------------------- (SEAL) /& (SEAL) * ---- Rudolph__Prause ---------------------------------------------------------------•- ....(SEAL) -- ----- -- ---- - -- --- ------------------------------------------------ (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) ________ ___ ____ ____ ___•_ STATE OF WISCONSIN ss. --------------- -r -------------------------------------------------------------- �> •---- ---- ---- ---- ----- ---- ---- --- --- --County. auth=44ated this 1'? _._dayof___ Y' ------------- 19__ 4 Personally came before me this ________________day of 19... C_. ------------------ ---------- --- --- -- -- - - -- the above named - - - - -- -> ------------------ -- - -- - - -- - -- - -- - - - - - - -- -------- - -- - --- Vlack----------------------------------------- -------------------------------------------------------------------------------- TITLE: MEMBER STATE BAR OF WISCONSIN -------------------------------------------------------------------------------- (If not- ---------------------------------- ---- --- --- ------- --- --- --- -------------------------------------------------------------------------------- authorized by § 706.06, Wis. Stats.) to me known to be the person ____________ who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY E dwar-.d- -E_ -.- Mack_ .r.- Davis-on_&._ V1ack------------- R - _Falls,__ Wisconsin__- 54022----- ---- ------ - - - - -- Notar Public __-_---__- ___- _•__-- _- ___________-- -_ - -_- -Count Wis. ( Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) date: 19 --------- *Names of persons signing in any capacity should be typed or printed below their signatures. WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Co. Inc. FORM No. 1 -1982 Milwaukee, Wis. I - - 653876 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO. WI RECEIVED FOR RECaRD C/ 08- 15-2001 9:00 AN DOT NUMBER 55 -65- 3298 -2001 COPY FEE: 3.00 RECORDING FEE: 12.00 W � O PAGES: 2 m I m or z 11 Z BEARINGS ARE REFERENCED TO THE 0) D m NORTH LINE OF THE NE1 /4 OF SECTION z N Ln cu 4, ASSUMED TO BEAR N89 57 - 37 - W O O A m m ca 0 O �M co 00 0 o z C S01 °09'33 "W 5318.05' - - 1 Z ;� D Z r Z zz o 09 ' 11 171 r m 0 m �°�0 325.39' 00 �oz a cn 49 O c c ��cQ A � 92.66 � m70M C m �mm <� i m i m ADZ �0 N � m CO l� (O N t Z Z 0 i o n� 0 I � co N.i N r 1 �w oz Z O j p 1a m 0 I p ^ (� Z cf) N z Z = i Oo o r� n i Zo o °z 0 0 m i �7Di 1 mm t I� O� In Q 33 O �� v � cf) 1 ° io O D A —I iGud C,J 0 ice° v 09'33 "W 325.39' i i�o o z Z S01 ° m (0 N j@ j� TO Z C I � t� (O K) t r lO -41 � Oi m Z �l� �C Z Z m iQ w v cnD � w p� �� v O I /� N Poo 10 c) m N vpi m I� Z 1 ° m 0 = N C NO1 °09' J �: ; - - - -- -1 CA) 0 _ 1 O 1 �r r () ,�o m _ IQ o z K o SO1 °09'33 "W 1 0 �] O Z j5 o a7 z cz 0) co W w R m p D cn � m C m 0) m10 O N im i Z ° m z m z c -_` 4 n p v D a) 37 0 ,, mn 0 �n(n � -0O OD z z CD o o � _cn °�� i - � s Z !A _4 ° c) m o * n p v S01 °09'33 "W 325.39' — — — —' — — . m z °= o m R : Rj ooN 1 I ; m z �� W r 1 v I i I z o - m U ,o �� I� N O z O p - °Z ° ' N vLn 0 1 0 '� I@ '� n Z w I -' ���i0 ' Z 193.46 o S.T.1"i. "S N01 °07'14 "E co cn cn N W - ----- *S MGIG?_t5�4__CDl[`ni]D� w APPROVED ST. CROIX COUNTY C N C 01 m m Pt Zoning and Parks Cornmi9ee M 00 -1 50 8;: �o AUG 1 200 i � cj zZ 0 * N O A m If not recorded within days o approval date approval al shall be . null and void N THIS INSTRUMENT DRAFTED BY KEVIN REED JOB NO. 6011 -02 DATE: 0/01 ISED 8/14/01 Vol. 15 Page 4150 f CERTIFIED SURVEY MAP LOCATED IN PART OF THE NW1 /4 OF THE NE1 /4 OF SECTION 4 T28N,R18W TOWN OF KINNICKINNIC, ST. CROIX COUNTY, WISCONSIN. OWNER SURVEYOR ROGER VANBEEK S & N LAND SURVEYING HW Y 65 DOUGLAS J. ZAHLER 578 578 HW` ROBERTS, 5 54023 2920 ENLOE STREET HUDSON, WI 54016 D.O.T. NOTES PER TRANS 233 ACCESS RESTRICTION NOTE: ALL LOTS AND BLOCKS ARE HEREBY RESTRICTED SO THAT NO OWNER, POSSESSOR, USER, LICENSEE, OR OTHER PERSON MAY HAVE ANY RIGHT OF DIRECT VEHICULAR INGRESS FROM OR EGRESS TO ANY HIGHWAY LYING WITHIN THE RIGHT -OF -WAY OF S.T.H. 65; IT IS EXPRESSLY INTENDED THAT THIS RESTRICTION CONSTITUTE A RESTRICTION FOR THE BENEFIT OF THE PUBLIC AS PROVIDED IN S.236.293, STATS., AND SHALL BE ENFORCEABLE BY THE DEPARTMENT OF ITS ASSIGNS. ANY ACCESS SHALL BE ALLOWED ONLY BY SPECIAL EXCEPTION. ANY ACCESS ALLOWED BY SPECIAL EXCEPTION SHALL BE CONFIRMED AND GRANTED ONLY THROUGH THE DRIVEWAY PERMITTING PROCESS AND ALL PERMITS ARE REVOCABLE. HIGHWAY SETBACK LINE NOTE: THE HIGHWAY SETBACK LINE (PER TRANS 233) SHALL BE 50 FEET FROM THE HIGHWAY RIGHT -OF -WAY, OR 110 FEET FROM THE HIGHWAY CENTER LINE, WHICHEVER IS THE GREATER DISTANCE. NO IMPROVEMENTS OR STRUCTURES ARE ALLOWED BETWEEN THE RIGHT -OF -WAY AND THE HIGHWAY SETBACK LINE. IMPROVEMENTS INCLUDE, BUT ARE NOT LIMITED TO SIGNS, PARKING LOTS, PARALLEL DRIVEWAYS, WELLS, SEPTIC SYSTEMS, DRAINAGE FACILITIES, ETC., IT BEING EXPRESSLY INTENDED THAT THIS RESTRICTION SHALL CONSTITUTE A RESTRICTION FOR THE BENEFIT OF THE PUBLIC ACCORDING TO SECTION 236.293, WISCONSIN STATUTES AND SHALL BE ENFORCEABLE BY THE DEPARTMENT OF TRANSPORTATION. CONTACT THE WISCONSIN DEPARTMENT OF TRANSPORTATION DISTRICT OFFICE FOR MORE INFORMATION. THE PHONE NUMBER MAY BE OBTAINED BY CONTACTING YOUR COUNTY HIGHWAY DEPARTMENT. NOISE NOTE: THE LOTS OF THIS LAND DIVISION MAY EXPERIENCE NOISE AT LEVELS EXCEEDING LEVELS IN S. TRANS 405.04, TABLE 1. THESE LEVELS ARE BASED ON FEDERAL STANDARDS. THE DEPARTMENT OF TRANSPORTATION IS NOT RESPONSIBLE FOR ABATING NOISE FROM EXISTING STATE TRUNK HIGHWAYS OR CONNECTING HIGHWAYS, IN THE ABSENCE OF ANY INCREASE BY THE DEPARTMENT TO THE HIGHWAY'S THROUGH -LANE CAPACITY. VISION CORNER NOTE: NO STRUCTURE OR IMPROVEMENT OF ANY KIND IS PERMITTED WITHIN THE VISION CORNER. NO VEGETATION WITHIN THE VISION CORNER MAY EXCEED 30 INCHES IN HEIGHT. SURVEYOR'S CERTIFICATE I, Douglas J. Zahler, Registered Wisconsin Land Surveyor, hereby certify that by the direction of Roger VanBeek, I have surveyed, divided and mapped apart of the NW1 /4 of the NEi /4 of Section 4, T28N, R1 8W, Town of Kinnickinnic, St. Croix County, Wisconsin; described as follows: Beginning at the N1 /4 comer of said Section 4; thence S01 0 09'33 "W, along the north -south quarter line, 325.39 feet; thence S89 0 57 1 37 "E 610.12 feet; thence N01 0 09 1 33 1 E 325.39 feet to the north line of the NE1 /4 of said Section 4; thence S89 0 57'37 "E, along said north line, 66.01 feet; thence S01 "09'33"W 325.39 feet; thence S89 °57'37 "E 553.18 feet to the westerly right -of -way of S.T.H. "65 "; thence N01 °07'14 "E, along said westerly right -of -way, 193.46 feet; thence N44 °25 "W, along said westerly right -of -way, 184.87 feet to said north line of the NE1 /4 of Section 4, also being the southerly right -of -way of 60th Avenue; thence N89 "57'37"W, along said north line and along said southerly right -of -way, 1107.13 feet to the point of beginning. Above described parcel contains 8.562 Acres (372,964 Sq. Ft.) Parcel is subject all easements, restrictions, and covenents of record I also certify that this Certified Survey Map is a correct representation to scale of the exterior boundary surveyed and described; that I have fully compiled with the provisions of Chapter 236.34 of the Wisconsin Statutes and the Land Subdivision Ordinance of St. Croix County and the Town of Kinnickinnic in surveying and mapping same. Pets ()V: W,SC0 Douglas J. Zahler RLS 2145 r j DOUGLAS J. 2 S & N land Surveying ZAHLER 2920 Enloe St. S -2145 Hudson, WI 54016 HUDSON, WI Each Parcel shown on this map is subject to State, County and Township 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 the Town of Kinnickinnic for advice. THIS INSTRUMENT DRAFTED BY KEVIN REED JOB NO. 6011 -02 DATE: 6/20/01 SHEET 2 OF 2 Vol. 15 Page 4150