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Wisconsin Department of Conkmerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division ,. n INSPECTION REPORT Sanitary Permit No: 430441 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: Smith, Charles & An f I Kinnickinnic Townshi CST BM Elev: Insp. BM Elev: BM D scription:, / Section/Town /Range /Map No: D • ��� C7 y1`1 1 05.28.18. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark a (3rn ►�� l60=6 Dosing w b Alt. BM Aeration _ _ Bldg. Sewer 5 � Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P L WELL BLDG. Vent to Air Intake ROAD Dt Inlet jt 0 .3/ Septic / G Dt Bottom a /60• Z1 Dosing S S _ 3 / ► h _ eader/ /D k2 r / Aeration t0 Dist. Pipe 6 tam & / Holding Bot. System �� Y - r �- P PUMP /SIPHON INFORMATION Final Grade f to '7 Manufacturer Demand St Cover (, GPM Model Number `4 TDH Lif 3 ( 1 Friction Los System Head TDH Ft jS 1� �`� : Forcemain Length Dia. / Dist. to W II Z ' xloT l A& SOIL ABSORPTION SYSTEM Z BEDITRENCH Width Length No. Of Trenches PIT DIME IONS No. Of its Insid 'a. Liquid Depth OD DIMENSIONS / SETBACK SYSTEM TO P/L BLDG WEL LAKE /STREAM LManufacturer: INFORMATION Type f System: �, f C T � / Model Number: DISTRIBUTION SYSTEM i Header /Manifold IlDistribution x Hole Size �J �Q x Hale Spacing Vent ttoo1Airi[- Intake If l_engthia _j_ Length 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 Bed/Trench Edges Topsoil ( Yes Ej No J Ye7r- COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / ZI / 03 Inspection #2: Location: 1094 Co. Hwy N Hudson, WI 54016 (SE 1/4 N 1/4 5 T28N RI 8W) NA Lot 3 g yl — ox p �er l 4e'FA8� ;, ra 1.) Alt BM Description = ST/ D A— /V6'7— C1+u&_H7— -A✓ 2.) Bldg sewer length = Z� �+'t'2o r b 5 ' n� - amount of cover = , 3/ �_ l DO S y h ��� Plan revision Required? [ _I Yes V No 1 / � O�� CC- #t.o , Use other side for additional information. / l_• SBD -6710 (R.3197) /( f �� Insepctor's i nat e tL T Sat�ty and buildings Division COW" m 201 W. Washington Ave., RO.13ox 7082 ST. CROIX COU I �O ��� MadisAm, W i 53707 - 7082 3ariitary Permit Number to be filw in by Co.) Department t)I Commerce (608)261 -6546 14 D Sanitary Permit Appl Plans I.D. Number In ac ication q 11 g7 C/ ��14 -zf cord with Omen 83.21. Wis. Adut Code„ peteimal information you provide _ may be used fix seamlary ptuposes Pnvacy Law, st .)_U4(1 F"oet Address (if different than mailing g) L Application Information — Please Print All Information .T, AP 1. 1't PropeAy Owner's Natter "J ?� (� qtr ^ i a , `� Parccl # Lot 3 PA O& CHARLES AND AN $ T I'ntpcsty Owner's Mailing Address' � a L 4 J 2226 BEECH STREET _ SE NE sei2Kiii 5 City, state: lip (a3e e 4 + 7 " ST. PAU MN 55 19 1- 53 -1333 T 28 N; R W — -..^ IL Type of Building (check all that apply) �� S _ , L CS Number 1 or 2 Family Dwelling Number ol'F3edrootr►s 4 d �Q M S _ _..__. _ _ -. _ _ V t.-1 c � v �q -1 _T —3 Publu%Cananizaual — lk=ibc Ulu '[ 1 ❑city_Livatage INTownship of KINNICKINN IC 111. Type oFPermit: (Check A n1j , one Ixpx on line A. Complete lin B i appl icabice — A. New System Replauenwm Systan U TTeatnwmt/lluldiag Tank Replacement Only (klietr Aloclif+estion to Existing System $• Permit xenewal ❑ Permit Fevmon ❑ change of I - I -ennit Transrer to New Lim Permit Number and Date Issued I3etbrc Expiration Phunbet tinier IV_ Type of POWTS S tern: i ZABEL A -100 FILTER - 26ELLER PUMP MODEL152 + U Noce - Pfcssuriaed 144 r *,N1.i '> 24 in. r ofsuitable soil _ Mound < 24 in. of suitable soil ❑ At -crack U Single Pecs Said Filter { Constructed wetland ❑ Presa►nval in-Grou holding Tuck C Petri Fatter Aerdiic Trcxifrnpit ti.A it Rec;re urlat;ng sand Filter n Rrrirnitating Synthetic Media Filter n I,mching C hamber 1 Drip line n Cr►avel -less Pix: ❑ tad►« (emA=) V. DispersalItent. Area Information: DesignII ow(gpd) Design jlA�on Disl>erxaIAr� Regiaired(s� �hspcts� Pmpoed(St)„ System El ✓ (0 7 T� t� 600 .5' J 1200 C 6 � 1495 Abu 101.17 VL Tank Into in Tout Number Mamdactttmr Prefab Site Steel Fiber .Plastic: Gm km (:akwm oflimts Caricxete Constructed Glass New Ex ►stt� Talcs Tanks septir or UoWmg lank. X 125 1 WIESER X Am*ic Treatment I Init ITnc'rq,c'.}e�.nhcr X 1000 1 WIESER X VII. Responsibility Staterment- 1, the andpwipwapsume rvgm= ibif y for lostallatka ordw POWTS shown an the attached plans. Number's Nanw (Print) ' MPIMPRS Number Bu%inr ce ire Number TODD FEATHERSTONE 242514 715 - 381 -1704 Plumber's Address (Smelt, (Yy, State, C rxic) P.O. OX 467 HUDSON, WI 5 4016 VI Code /1!e artmeet Use Only "W- U Disapproved Sanamy Pemnt Fee (indudes GToundwatear Flare Issued uitig ) Surcharge Fee) l ❑ Owner Given Reason for Decrial � 3 IX. Conditions of ApprovallReasons for Disapproval 3 YSTEM OWNER: /' � SL *a Septic tank, effluent fitter and (�fiNf/YY dispersal cell must all be serviced 1 maintained n as m must b lumber. (,{iyt / All setback requirements ust be maintained 7 �� t,, � � �-� as per applicable code /ordinances C� . 3 • q3-( ,- -74 f ,%Uacb cen*tece pt= (ta the Carroty 6*) for the sysuw an paW nalexkUan stn z 11 is i I N N a o � -� r r, Safety and Buildings PO BOX 7162 MADISON WI 53707 -7162 TDD #: (608) 264 -8777 �sconsin w ww.comm www.wisconsin.gov sb www.wis .wisconsonsin.gov Department of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary September 22, 2003 CUST ID No.242514 ATTN.• POWTS Inspector TODD C FEATHERSTONE ZONING OFFICE FEATHERSTONE EXCAVATING INC ST CROIX COUNTY SPIA 368 TOWER RD 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/22/2005 Identification Numbers Transaction ID No. 919874 SITE: Site ID No. 665309 Charles Smith Please refer to both identification numbers, Country Rd N above, in all correspondence with the agency. Town of Kinnickinnic St Croix County SE1 /4, NEIA, S5, T28N, R18W Lot: 3, FOR: Object Type: POWT System Regulated Object ID No.: 921582 MOUND/ DWELLING 600 GPD The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes K 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 quirements. A copy of the cifica approved plans, sperions and this letter shall be on -site during construction and open o V, a 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 p `" r u A-FE 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 10 1. 12 2 nothing in this rc3dc3m shall relieve the designer of the responsibility for designing a s:I a wilding, structure, or co Inquiries concerning this correspon ence maybe 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 Robert Kanter POWTS Plan Reviewer, Integrated Services WSMART.code: 7633 (608)261-7735, Monday -friday 8:OOAM - 4:45PM rkanter@commerce.state.wi.us r n Wastewater Specialist, 71 726-2544 cc: Le Leroy G Ja sky, astewate Spec a st, ( 5) MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: CHARLES AND ANGIE SMITH Owner's Name: CHARLES AND ANGIE SMITH Owner's Address: 2226 BEECH STREET ST. PAUL, MN 55119 Legal Description: SE1 /4 NE1 /4 S5 T28N R18W °- Township: KINICKINNIC County: ST. CROIX Subdivision Name: Lot Number: 3 Block Number: ---- ---- -- Parcel I.D. Number: 022 1011 0,1* 1' d Plan Transaction No.: Page 1 Index and title Page 2 Data entry rs Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Y Aida BUILDINGS Page 6 Management and contingency plan Page 7 Pump curve and specifications ;;pONDENCE Page 8 Concave Mound Configuration Page 9y}/p Test Page 1$ Plot Plan Page 1::�A POWTS OWNER MANUEL Page 1qjj; POWTS APPLICATION Designer: TODD FE License Number: 242514 Date: 09/18 3 Phone Number: 715- 381 -1704 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 3.11 (05/01) Pagel of 12 i x" J Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a Estimated Wastewater Flow (gpd) Table 83 -44-3 in -situ soil treatment for fecal 400.00 600.0 ! Peaking Factor (e.g. 1.5 = 150 %) � I coliform of <= 36 inches. Design Flow (gpd) / (] 7 00 Site Slope ( %) ! 100.5 ` Contour Line Elevation (ft) _ epth to Limiting Factor (in) 0.50' In -situ Soil Application Rate (gpd /ft Distribution Cell Information 100 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.001 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 (c or e) Ci Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation (ft) 4� Number of Laterals of the highest point. (_ 01881 Orifice Diameter (in) (e.g. 0.25) 3.00; Esti Orifice Spacing (ft) = 9.38 ft /orifice 2.00; Forcemain Diameter (in) 40.00! Forcemain Length (ft) Does the forcemain drain back? Y`� 89.00' Pump Tank Elevation (ft) Enter Y or N 3.25 System Head (ft) x 1.3 6.52 Forcemain Drainback (gal) 11.67 Vertical Lift (ft) 62.81 5x Void Volume (gal) 1.44 Friction Loss (ft) 69.34 Minimum Dose Volume (gal) 16.36 Total Dynamic Head (ft) 41.94 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 1.00 1.50 x 1.25 x x 2.00 x x 1.50 x 3.00 2.00 x 3.00 x Gallons_ /Inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1250.00 1 Septic Tank Capacity (gal) Total Working Liquid Depth (in) WIESER Manufacturer gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 1000.001 Dose Tank Capacity (gal) Zabel !Filter Manufacturer 27.31 Dose_ Tank Volume (gal /in) `A100 Filter Model Number ' WIESER Manufacturer Project: CHARLES AND ANGIE SMITH Page 2 of 12 lr 3 Mound Plan View T :::1/1 B � J Observation Pipe LF : -: — l K: T A .. . W ... :l _ .:..:..:. _ :.B ❑ 3 . •. •. •.•. . L Mound Component Dimensions A 6.00 ft E 13.04 in H Aft ft K Efift B 10 Oft F 9.25 in z ft L ft D 8.00 in G 0.50 ft J ft W 600.00 (ft Dispersal Cell Area 1 1495.25 (ft Basal Area 6.00 (gpd /ft) Linear Loading Rate 1 10.00 (ft' /10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 102.94 (ft) —� G I H "" " "" "' 101.67 ft Lateral �a (� F Dispersal Cell ( ) 101.17 ft --► — Invert () Dispersal Cell D Elevation ::.:. :.❑ r 100.50 (ft) Contour Elevation /6's 7.0 %Site Slope Geotextile Fabric Cover Shading Key a Dispersal Cell See lateral details on ❑1 _ Topsoil Cap .a 1.5 ft Page 4 for number, size, — o ' S : and s pacing of laterals. Subs a o : ❑;:: s`r'::._' P g © o Ca . a Laterals are equally ASTM C33 Sand © .. F x m 0.5 ft Typical Lateral i .. ... spaced from the ® Tilled Layer c f ? 5 distribution cell's r A e .r 5 Aggreg 0 ❑ 99 9 t centerli 'ne in the - i - — A IF distribution cell (AxB). Project: CHARLES AND ANGIE SMITH Page 3 of 12 Center Connection Lateral Layout Daigram Force main connection via tee or cross to manifold at any point. Laterals are identical � P 5 •= Turn -up va'ball valve or IE If xl2 I xl2�l Laterals & force main of PVC Sch 40 of ea n out pl u g per COMM Table 84.30 -5 Holes drilled on the bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.188 in Lateral Diameter 1.25 in Orifice Spacing (X) 3.18 ft Lateral Length (P) 49.29 ft Orifices per Lateral 16 Lateral Spacing (S) 3.00 ft Orifice Density 9.38 ft /orifice Lateral Flow Rate 10.49 gpm Manifold Length 3.00 ft System Flow Rate 41.94 gpm Manifold Diameter 2.00 in Total Dynamic Head 16.36 ft Forcemain Velocity 4.28 ft/sec Dose Tank Information Locking cover with waming label and locking device and sealed watertight Electrical as per NEC 300 and -► Comm 16.28 WAC min. Disconnect --- 444 --- Tank component is properly vented LForcemain Alternate ouNet location diameter WIESER Manufactufer 2 in. Capacityl 1000.00 Gallons. — T Volume 27.31 gal/inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 20.08 548.32 C B 2.00 54.62 � P ump off e levation (ft) C 2.54 69.34 90.00 D 12.W 327.72 D Total 36.62 1000.00 Dose tank elevation (ft) 3" Bedding under tank. 89.00 Alarm Man uafacturer ;LEVEL Alarm Model Number LVL -1 Pump Manufacturer ZOELLER Pump Model Number 152 Pump Must Deliver 41.94 gpm at 16.36 ft TDH Project: CHARLES AND ANGIE SMITH Page 4 of 12 Y t Mound System Maintenance and Operation Specifications Service Provider's Name ,FEATHERSTONE EXCAVATING, INC. Phone 715-381-1704 POWTS Regulator's Name ST. CROIX COUNTY Phone 1 715 - 386 -4680 1 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1250 gal Maximum TSS 150 mg /L Soil Absorption Component Size 600 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 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepage once every 3 years _� Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table 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)(i), 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 Turn -up Detail Finished .•...........•• ............... Grade 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: CHARLES AND ANGIE SMITH Page 5 of 12 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD- 10691 -P (N.01 /01) and SSWMP Publication 9.6 (01/81)] 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 shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subj to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tan shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet fitter shall be assesse least once every 3 years by inspection. The outlet fitter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions a made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the finer is equipped with an alarm, the fiftei shall be serviced if the alarm is activated continuously. Intermittent fitter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tan the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the ne) service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution Svstem No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seed 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 sr compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the mound be heavily mulct as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BO,p150 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 1d ctu /100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specifiE 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 flus 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 I& above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continaency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in pro operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repair 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 its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and re 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. Project: CHARLES AND ANGIE SMITH Page 6 of 12 4 f 'N"' ; IC r- EAU /C1`ACI v HEAD CAPACITY CURVE W PJ 0 D E L 152/153 W w 1 r: Lj 50 153 1. E:.9 26' I , 12 40 - — 1 t 2,� /U 2Li_ 152 I i0 61 23' j c, 30 - - -- � ? 6 34 12S? , ;2 I `a � z o 9.' 2- 81 33 125 ll o I - >. % -- 42 4— Valvc: k'7 IF il' =.6•m` 4��0 Fl "3,.1rn) 10 - . 014508 I 20 40 60 80 100 GALLONS LITERS 0 80 160 240 320 FLOW PER MINUTE I} CONSULT FACTORY FOR SPECIAL APPLICATIONS F `,% ' `' • Timed dosing panels available. o , • Electrical alternators, for duplex systems, are available and supplied with _ ' an alarm.. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. j • Sealed Qwik -Box available for outdoor installations. See FM1420. • Over 130 °F. (54 ° C.) special quotation required. " - -- 1521153 Series a (_ 1521153 MODELS _ _ Co Sel f, Model Volts-Ph Mode Amps Simplex Duplex I k N15 BN152 2 115 1 Non 8.5 1 _ 2or3_ — — - -- 115 1 Auto 8.5 Include 2 or 3 t sKZOSa _ E152 230 1 Non 4,3 2 or 3 1 141 I BE152 230 1 Auto 4.3 Included 2or3 N 153 115 1 _ Non i 10.5 1 __2or3___ BN153 115 1 Auto 1 0.5 Included 2 or 3 - +— —- - -- -- E 153 230 SELECTION GUIDE 1 Non 5.3 L_ _i 2 or 3 ' - -- - or 3 -- 1. Single piggy ck variable level float switch or double piggyback variable level float BE153 230 1 Auto 5.3 Included 2 switch. Refer to FM0477. O CAUTION 2. See FM0712 or correct model of Electrical Alternator E•Pak. All Installation of controls, protection devices and wiring should be done by a qualified ?. Variable level ontrol switch 10 -0225 used as a control activator, specify duplex (3) 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). or (4) float syE t em . RESERVE POWERED DES113N For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL T0: P.O. 80X 1634 is Z 7 Louisville, KY 40256 -0347 o ( SHIP T0: 3649 Cane Run R d Manufacturers of �7p At Louille, KY 40211 Ur1L /TY PUMPS S NCE I�tIJ N . 011 /P �O (502) isv 778- 2731 .1(800) 928 P MP Q http://www.zoetier.com L/�Y� FAX (502) 774 -3624 D Copyright 2000 Zoeller Co. All rights res r ed. CONCAVE MOUND CONFIGUREATION CHARLES AND ANGIE SMITH CO. RD. N TOWN OF KINNICKINNIC ST. CROIX COUNTY SETA, NE1 /4, S5, T28N, R18W LOT 3 3- 98x100 =3.061 ( (3.061 x .00265) + 1) x 98 = 98.79 I I w p+r0tr awtar . 1T A �i6i' Pmertatt,�_Q Papa 2 d ' pit Orouedelar �� i L � h- O�pw b IMNfUnO hder _ In, � IaCaf ttatten Qepih Donwunt Corr tiedml Oftor"m TeaMM SM Mtw% C&Wdina BvindoN ROM G a i In. Mum" Qu. al. cons, Omer Gr, St- 8h. •t=flMt ' as - Os t 'hi -� a - " Crew ! a pit Ground s uce Nay. _ R. Depth to Illnlftrtg r.dor - - -- �-•— — En, ' Hodeon Doo Dominant 1 0etatpllon T"wm �rut>ft2e COrtsblOttea sou et. t3atM�d2y Raor3 GPNM In. Muneell Ou. $x a". C04 a D � a °ortr„° a Pit Ortwad su tece 21ev. d. Depd, b lY►tltlnp a9tor in. iM t tfolhon A. t)emrrt C96 +tedolt a.wiptlgn T.xtW. arm" Condtnence nou wwy Rows 309 AMMOOM n. AdttnaaA tau. Sz. Cont. Color ar. &, 9h. •EAN7 Gma `EtAUx HfiNNM Nt ■ 80D, r 303 ,UD mprl W4 T!8 3,30 150 ffjG& ' IMUSM Ir9.900 x .-. 10 mpll. and Y'$3 : >Q mg4 r. The Deperumant of Commerce 13 an equal opportunity a9rvioe pMVidu and amptoyeC. It you Hoed 40413tanee to 109223 3ervigel or need matm{al in w att2nae11e Amnit. Plea2e eomect die depusment at 60&266.3 t S 1 or TTY 40 &204.4777. aaaai3tr.� f a ______ �___� ������. Lod �&. -S- Al, c. o ON I 'NA /� �_fs 1A 6 0 - 3 C: b C.., 4 � � V V � J' �T'1Z cK n • s 30- All MW r 'f N s P AAajvt NO COW M %twa PI M5 i 7 7 : , Lox STAKUD f . iiause aaG, c^ 8 2 4 • 51Cp.CSf 2ZwY�Z Df►iE; Q'l -D 3- 0 �j �,, 1 4 Wisconsin Department of Commerce SOIL EVALUATION REPORT page f of 3 Division of Safety and Buildings in accordanc with Comm 85, Wls, Adm. Code C��X County Attach complete site Plan on paper not less than 8112 x 11 inches In size. Plan must . induce, 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. Re wed by l7 G Date Please print all Information._ °h�/03 Personas informellon you provide may be sfEOtMfMry purpoeAttf�rl oY Uw s. 15.04 (1) (m)). proper(y(Jwner roperty Location _ ,,ccyy ,9E 114 h1E 1 1A S T J Z% N R If �or) W G{i41RLE5 f1Nf�ii SM I M '' of # Block # Subd. Name or CSM# i property Owners Malting Address $? 222( E�ESC44 ST• city U Vlnage Town Nearest Road city State P ry one Code derived design flow rate — S GPD New Construction User Residential / Number of bedrooms , ! - -_ ❑ Replacement ❑ Public or commercial - Describe: -'- — Parent material I / /ir,7 W Alg&i Fkod Plain e•.evatlon it a,^plicabie _. nj,/}. it, General comment and recommendations: AAOVfi(J ZA S[e k 0.5 LOADING RATE ❑ Boring a Boring # 02, g'y ry, Depth to limiting factor _ in Soil A Iicatlon Rate RT Pit Ground surface elev. - 1,. -- Roots GPDIff Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary •EfT#1 'Etft12 in. MunseB Qu. Sz. Cont. Color Gr. Sz. Sh. ( .q tO i -- 511 - r 3 g42 7, `Ik 7 15 '44 1 J cz Is m -�s 0.7 .Z to ZSl $ 7.5 K i 2 Boring # ❑ Boring '7 h. Depth to Umiting f _�.� In. Soli llcatlon Rate 1W Pit Ground surface elev. fob, 0 Roots GPD1tf Horizon Depth Dominant Color Redox Description Texture Grt IcIlle Consistence Boundary •Etf#1 •ER#2 in. Munseli Qu. Sz. Cont. Color 8 1 .5 g i l k t l - I , _m 7- ,t 1 -7 5 var 31t4 14o N A 63 K- F tuJ N • Effluent #2 BOO _< 30 mg& and TSS _< 30 mgrl. Effluent #1 HOD > 30 220 mglt and TSS >30 1160 mg/L CST Number CST Name (Please Print) Signature 2Z 3Z H t- LA &M F_ Telephone Number Date Evaluation Conducted Address Wej% bge'AVE, vE "FA' k WI 5`lOz2 07-05-03 fit r�+y, Page ? or Property Owner . gAbl� Parcel ID # __ _ —� ---- i� Boring # Baring i Pit Ground surface elev. _[Q 3� ft. Depth to limiting factor _ I^ Soil lication Rate h� Horizon Depth Dom Caton Redox Description Texture Structure Consistence Boundary Roots GPDJK •Eff#1 'Eff#2 in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. i 2 ►2 -23 3 St1 ,M S ' � , �: S r . -- •alt — Boring # Boring pit Ground surface elev. __ R Depth to limtling factor _ , in. Sat — Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff .. •Eff#1 'Ent #2 In. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Boring a Borin # Ground surface elev. ft. Depth to limiting factor In. ❑ pit Solt Aoolication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP /ff In. Munsell Ou. Sz. Cont. Color Gr. Sz, Sh. 'Eff#1 'Eff#2 • Effluent #1 = BOD > 30 220 mglL and TSS >30 1150 mgA- ' Effluent 02 ■ BOD <_ 30 m91L and TSS < 30 mglL The Department of Commerce is an equal opportunity %erviee provider and employer, if you need assistance to access services or r ', need material in an altcmate format, please contact the department at 608 - 266.3151 or TTY 608 -264 -8777. S110 (RAM) ._. �_ ... ._.. —__. ..__- ..,r' -�- +ate!• —;� 3 , t _ PLOT PLAN r: am iPE h > f >� M5M W'f 2 , cA71 SO 1 22m, K 'I o /01 78 �- 50L "W R vAma NO COMM B3 %TACK PROLUM5 � �7 1 p1�5 E1 ►4Z_4 L.J 7 efo St LoT 3 sx- i }{ ARC SLOP. 83 � O S v Q: _ Q o r' f' � fit.. 5 51GNErn C5t �, Zzy832 PAZ 07-03 -03 r wiscor rtm ent of commerce SOIL EVALUATION REPORT Page of 3 Divisg a ty and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must J l� include, but not limited to: vertical and horizontal reference point (BM), direction and P VE I V E D R percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Tic Cr A Please print all information Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). S C r p 2 4 ? O O Z 0 Property Owner Property Locati t n ST. CROIX COUt\1TY {cQr �'G G Z - Govt. Lot C.� 1/ N414JSFS7 T N R f E (or) f9 Property Owner's Mailing Address Lot # Block # Sub . Name or CSM# 22 0 . G. -P � ' c �,� 3� �� I"l P�4 city State State Zip Code P ne Number E] City ❑ Village [aTown Nearest Road [ New Construction Use: Residential / Number of bedrooms 5! Code derived design flow rate IV .5 O GPD [3 Replacement E] Public or commercial - Describe: Parent material _ Tl + Flood Plain elevation if applicable �// ft• General comments 5 �STCrh - e //t v 9 �; U 0 and recommendations: „ L (6A4-ou Q/1 3 03 Boring # Boring ® Pit Ground surface elev. 1 1 / 0 fL Depth to limiting factor / 4• in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 "Eff#2 [ 0 -/0 10 r 3 /Z S r ' / rn�cb r c S I ✓� .S Boring # Boring pit Ground surface elev. ft. Depth to limiting factor Z W in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I 'Eff#1 'Eff#2 d r Z S- ;Mgbk IVl r GS j V-( "5 . /' Z(o d S� r Gl ' p en ( e vn C 4 L4 61 1 k- 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) lure CST Number S3 0 Address /,, � ��./ GJ� cS�L DZS� Date Evaluation - o - nZbctdd Telephone Number Property Owner L - eA crfz Parcel ID # Page 3 F - 31 oring # Pi Ground surface elev. ft. Depth to limiting factor � in. Soil Application Rate, Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ilz _. . In. Munsell Qu. Sz. ConL Color — Gr. Sz. Sh. 'Eff #1 'Eff #2 o — /Z Z rA r cS 6 Z�l 3 'Z 7•S - Y, , 1 7'16 o 9 —�t'L y-(r' — • .6 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rale. Horizon Depth Dominant Color Redox Description.,_ . Texture - Structure Consistence Boundary Roots GPD /fl= In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'Ef102 E Boring # ❑ Boring ❑ pit- Ground surface elev. ft. Depth to limiting factor In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture . Structure Consistence Boundary Roots GPD /ft: In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'Eff #2 ' Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/t and TSS < 30 mg /L The Department of Commerce is an erpral 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. seanso (r<o-rM) . PAGE OF NAME L Gh c r 7— LOT# 3 L EGAL DESCRIPTIONS T Y ,U X ,,s 5 T 7- 8 ,N,R, / r E(or� I SCALE: I"= yO BM I ELEVATION /ov . o BM I DESCRIPTION -h 0- I' "puc- D; Rc BM 2 ELEVATION 99, Sb I BM 2 DESCRIPTION g o �- I " p v c - - "P C SYSTEM ELEVATION `I q, (� d SYSTEM TYPE /'120 u ✓tA CONTOUR ELEVATION y g ,2 '� So 1�1 a -3 6 I � SIGNATURE DATE � y KATHLEEN H. MALSH ' REGISTER OF DEEDS ST. CROIX CO. 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L2 N I m Z U I v bIUI xrn O ;� I�t I j - 4 368.97'... z O i � S S01� 09'48 C "W 395.61' o i �J 1 l:J IN� N U) Im N ` -- Z O I�,I N rn rn� I-I rn 0 I K� cn F,° -n No in N �� zv SODS rn > � . w - j S0 3 '4 ; `� z N m F1 m n 0 O �`�IC�Ii Im w 1 368.98' I `l°) yW� ° c'' O - — �-` - -- z I D �- D Z Q o \ Z rn p� I = J z M r m Z - `. n ^ \ m N I 1 'A' 0 i� rn n m =I a cn Z OD �\����\O�� N 6 92 n 0 ---1 O to Z O 33' EF' 368.98' 2249.96' � Ee m z m m N01 °09'48 "E 394.31 EAST LINE OF �' z m = n A [1 ,Osr ( THE NE1 /4 O 0 m0 rn n 1 _ _ _ _ _ _ _ N01 °09'48 "E 2644.27' r POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page 1 of 2 FILE INFORMATION SYSTEM SPECIFICATIONS Owner CHARLES AND ANGIE SMITH Septic Tank Capacity 1250 a l ❑ NA Permit # q3D L Septic Tank Manufacturer ❑ NA WIESER DESIGN PARAMETERS ` Effluent Filter Manufacturei5, ❑ NA Number of Bedrooms 4 ❑ NA Effluent Filter Model -1 ❑ NA Number of Public Facility Units NA Pump Tank Capacity a l ❑ NA Estimated flow (average) 600 g al/day Pump Tank Manufacturer ❑ NA WIESER Design flow (peak), (Estimated x 1.5) gal /d Pump Manufacturer ZOELLER ❑ NA Soil Application Rate .. 7 al /da /ft2 Pump Model ❑ NA Stan4*4 Influent /Effluent Quality Monthly average' Pretreatment Unit J"A Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD _ <30 mg /L ❑ In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L NA ❑ At -Grade )i Mo Fecal Coliform (geometric mean) 510 cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other:lq Other: �rNq Other. O "Values typical for domestic wastewater and septic tank effluent. Other: A�'NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(sl At least once every: ❑ month(s) (Maximum 3 years) 13 NA 6 year(s) Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ Yeah 1(s) (Maximum 3 years) ❑ NA Clean effluent filter At least once every: ❑ month(s) ❑ NA Lrear(s) Inspect pump, um controls & alarm At least once every: ❑ mo ye ar(s) ❑ NA Ins P P. P P p years) Flush laterals and pressure test At least once every: ❑ month(s) ❑ NA ❑ year(s) Other: At least once every: ❑ month(s) KNA ❑ yearls) Other: c4N A MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surf ace. The ponding of effluent on the ground surf ace may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4/01) /� Page 2 of 2 START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tanks) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cells) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. f T sit s not b evaluated identify a ble replac t area. U on f ' ure of the �WTS sit an ' e �v ev lua on st pe rmed t loca a suit le re lacem t area. I o rep ment ava e a ho ing tan m installs as a last to repla failed PO ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name __ �( Name FEATHERST Phone 7l _ ��� Phone 715 381 - 1704 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name PINKI('S Name ST. CROIX COUNTY Phone 651 -436 -5788 Phone 715-386- This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. 13 APPLICATION FOR REVIEW POWTS - Complete all pages - SO* & Buildings Division ( } Check if c mlim ation is Desired: (} faxed, (} mailed Bureau of integrated Services Several counties have been delegated certain authority to review plans in lieu of Commerce. For a current list of time counties and their delegation check our website at http:llwww.commerCe.state.N^.u"aiSB PowtsProgram.htmL NOTE: Personal information you provide may be used for seoandary Conf rmation of assignment to a reviewer. purposes [Prnrac Law s - 15.04(1 Stets -J ,--- ---- ---- -- _-- . Tn,naaction 1t): 1. Private 5emmge Submittal 2. Type of Submittal. ( Previous Related Trans. ID: System Type X) New ( ) Safi Saturation ( ) Revision Estirnated Completion Date: Determination ( ) Interpretive Rf�pc><i t ) Repl�errners Assigned Reviewer. Determination ( ) Addfi (� POWTS System ( } Petition (attach form SBD -9890) Assigned Office: ( ) At Grade ( } Experiment, app►ov00 Circle your choice of offices below; ( ) Holding Tank { ) Componerit Manual (Include each ( ) Nonpressurized In- Ground component manual name, s and 1. Next available appoirnimerd in any oitice, Z Green Bay, 3. Hayward, ( ) Pressurized Irr date on We page of plan) 4. LaCrosse, G. Madison, 6- Shawano, 7. Waukesha Ground ( )1uat Site Design ( X) Mound ( ) Aerobic Treatment (Mir 3. Project Information -Fill in all krnown in Sand Fiber Pr Name CHARLES AND ANGIE SMITH ( ) Gwxjle P - Location, Number & Street of project (if unknown, indicated meanest road} COUNTY RD. N _recirculating Legal NE1 /4 S5 T28N R1 8W LOT3 PARCEL I.D. #022 1011 40 111 ( ) Conistruated Wetland Legal Descrrpt,on: ( ) Drip Line county ST. CROIX C X Town of KINNICKINNIC { ) Other: Building Type (check one): 4. Miler plans are reviewed, please (check all that apply) ( ) Dwing, 1 or 2 tarnity X can customer 1, tYrt (circle number)` "Refers to customer number from below ( ) PubliclCommerdal Requestim party will pick up Buicoin9 X Mail plans to customer 1,2=3:4 (circle number)* ( ) State -owned Building — Gallons per Day S. Complete Hne mitring designertowrwrft"ues" inforr %vfionn. t%4ize the check boxes when designer, owner or requesling party is the same to avoid reptAing information. Designer Information Customer 1) Mail To Party if different than designer (Customer 3 First Name Last Name Customer Number First Name Last Name customer Number TODD FEATHERSTONE 242514 Company Name Company Name FEATHERSTONE EXCAVATING, INC. Add"m Address P.O. BOX 467 City State Zip+4 (9digds) city State Zip- (9di�ts) HUDSON, WI 54016 Phone Number (area Cade) Fax or Internet cell phone Phone Number (area code) Fax or Internet 715 - 381 -1704 715 - 386 -6885 Check Others if applicable Check others if applicable Owner owner Owner Information (Customer 2) oew Pleases m Custoer 4) First Name Last Name Customer Number First Name Lit Name Customer Number CHARLES AND ANGIE SMITH Company Name Company Name Address Address 2226 BEECH STREET city State Zip+4 (9digits) City State Zip+4 (9digits) ST. PAUL, MN 55119 Phone Number (area code) Fax or Internet Phone Number Canna code) Fax or Internet 651- 731 -9657 Check others it applicable (Mari To) Check others it applicable MAKE CHECKS PAYABLE TO DEPT OF COMMERCE TOTAL AMOUNT Our $ 175.00 Attach check hem Review Code 7833 / z ■ rnti •,■ �,v�cC;r t �.rran.4 I FU rKVrICAT1* FEE BELOW j FEE 1. A tr components are previously approved under s. Comm 84.1 o (2) or (3): Design wrxstew4ter flow ur Elie proposed system, 1,000 gpd or less ............... . .. .............................. ................. ............ .. . ...... . ..3175.00 1,001 - 2,000 gpd ............ ... .. ............................. ..... $225.00 2,001 - 5,000 gpd ........... ............................... $275A0 greater than 5,000 gpd .............................. . .. ..................... . .. . .. . ..... .. .......... ...5300.00 plus $0.05 for each gallon over 5000 gpd 2. one or more b amend components are not previously approved under e. Comm 84.10 (2) or (3): (Individual affil desigrVdeviatian from component manuals and use of components without product approvalj: Design wastewater flow of file proposed systern: 1 .000 gpd or less .. ............................... . ..1........................... ........................$300.00 1,001 - 2.000 gpd ... ........ ............................... ........5400.00 2,001 - 5,0W gpd 5.500 an greater than 5, 000 gpd ........................................................ ...........................W.00 plus $0.05 for each gallon over 5000 gpd HOLDING TANKS ONLY 3. Holding tanks previously approved under s. Comm 84.10 (2) (3 Design wastewater flow of the proposed system: 5,000 go or less ........... ............................... . ........... . ........... .. $60.00 ................... 5 ,001- 10,0DDgp4 ............................... ............................... ........................$100,00 greater than 10,000 gnd ............................ 5150.00 4. Hokk W tanks NOT lxmou* apprrntefct urxra s- Conlin 04.10 (2) ur (3) as Kf site %'vraitrUtAW tank* Design wastewater flow of the proposed system: 5,000 gpd or less . ............................... ... 5,001 - 10,000 gpd ................. ............................... .. .............. . . .. ..................$200.00 greaterthan 10,000 gpd .................. .. ........................... . .. ..... ............. ...........$300.00 Experimental System (additional one time fee). ................................. ................ ................ $300.00 Revisions to Approved Plan.. ........................................................... ............................... .360.00 Petition for Variance (Include form SOD- 9890) ...................... .......... ................ .. ... ..........$225.00 Revision to a preuiously approved Petition for Variance....... ........................ 87500 Sal Saturation Detern - li nation Report - Per Site (other than a proposed subdivision) ........... .....St 00 00 Interpretive Deterrnlnatvon Report ................................................... ... ........................... ....$100.00 Subtotal ......... ..... ........ ... 175.00 Priority Review; Enter same amount as subtoW ... .... ........................... Prior approval from a section dtief is required for a Priority review. If approval is granted, the priority will be reviewed within 6 days Of receipt. Enter TOTAL (rounded to the nearest dollar) here $ 175.00 and on bottom of FRONT PAGE Note: Fees are pursuant to Ch- Comm 2 and are subject to change annually; please contact any of the offices listed below for the most recent copy of this form. Comm 2 provides for a partial fee refund if a plan action has not been taken within the 15 days Of receipt of all required inforrrrvtion. 7. Appointment, Sch"*w"l irrf MMIJ1on, and Plan Submittal Checklists. POWTS scheduling is not available. Plarm will be assigned i after receipt of plans. K you wish to receive confirmation of the assigned reviewer and estimated coon letion date a reviewer p please check fire box in the upper right winter of the front page. Also note in the same location that you can designate a specific office for review. If you select a specific office your estimated completion date may be considerably greater than what would be possible in another office. Subrr*Ws rweived Without a spwft office Indloated on the form may be assigned to ofTlcea other than the receiving office depending on rVallwex avMlal>ility. To obtain a subrr" checklist call the Imalenal order unit at 806- 266.1818 or one of the bA 9erviee offices listed below. You may erns technical code questions to wtst om wi.us Madison S&BD Hayward S&BD LaCrosse S&BD. Shawano S&BD Green Bay S&BD Waukesha S&BD 201 W Washington Ave 10541 N Ranch Rd 4003 N Kinney 1340 E Green Bay 2331 San Luis Place 401 POO Court 53703 Hayward WI 54843 Coulee Rd Shawano WI 541136 Green Bay, WI 54304 Waukesha WI 53108 PO Box 7162 715634 -4870 LaCrosse WI 546M- 715- 5243626 920- 492 -5601 262-548 -8600 Madison Wl 53707 -7162 Fax. 715 -634 -5150 1831 Fax: 715524 -3633 FAX: 920 -492 -5604 Far 262- 548 -8614 608 -266 -3151 Email: 608- 785-9334 Email: Email_ Plat hedu� Email: PlanSc hedule@ Fax: 608 267 - 96W PianSctwduteig Fax eos - 785 - 9330 PlanScheduie@ cornmeroe.state.wi.ue commerce.state.wime TDD 688-264.8777 comnnerce state.wi.us Email: commerce.sfate.wims Email: PlenScheduleQ PlanScheduk Q Cotrrr,erce.stete_wi.us commerce.stale.wi.us d • 1 s [ ST CROIX COUNTY SEW TANK MAINTENANCE AGREE AND OWNERSHIP CERTIFICATION FORM Owner/Buyer CHARLES AND ANGIE SMITH Mailing Address 2226 BEECH STREET ST. PAUL, MN 55119 Property Address 10 , 7 1 COUNTY ROAD N (Verification required from Planning Department for new construction) City/State KINICKINNIC, WI Parcel Identification Number PENDING. 199& DESCRIPTION Property Location SE %4, NE 1 4, Sec, 5 . T N -R 18 W, Town of KINICKINNIC Subdivision . Lot # 3. Certified Survey Map # , . Volmne . Page # Warranty Deed # volume Z Page # Spec ho= O yes In no Lot lines i&mtifiable. Q yes 1 no : haprWameandun of ym scpdc syskm could =mh in iu fagune to handle wastm Frailer of pamping out rite septic hati every three years at soon , if needed by a hoensed puzu . What you put into the system can affect the facti a of the septic tank as a treatment stage it the wam disposal system. The property owner agrees to submit to St. 4wk ?.coring Department st certification form, 4pied by the ow= and by a p P = tricftdphmd= ora 1ke =edpumpavectfftdrat(1)&eon -site wastewsterdispoaalsystem is in proper operating condition and/or (2) alta iaspecxion and PwMiqg.(ja rY), the septic tank is less alma 113 frill of sludge. Uwe, the underdgaed have read the above requirements and ag= to maintain dre private sewage disposal system with the standards set forth. herein, as set by dw Dcpartmwt of C u mm we and the Department of Natural R�csou ams, State of Wisconsin. stn ' dmt Y� c � has boar maintained maul be letcd and returned to the St Croix County Zoning Office within 30 t� of tome expire on date. i /n - / Cx`NATURB OF APPLICANT DATE OWNER CERTMCA.TIOiti I (we) certify that all statements on this form are true to the best of m our lmo wlodge. 1 (we) am (are) the ownet(s) of *,e 717.byvirtuaafa warranty deed recorded in Register of Deeds Office. 1?,S'i o3 SiGAtk= OF APPLICANT DATE Any information that is mis- cepresentod may result in the sanitary permit being revoked by the Zoning Department- Include with this application: a stamped warranty decd &oat the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed I J 2*91 408 - 7 1 aa STATE BAR OF WISCONSIN FORM 1 —1998 KATHLEEN H WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI Document Number RECEIVED FOR RECORD This Deed, made between Frederick G. Lenertz sin I , Grantor, 04/25/2003 02:00PH and Charles R. Smith and Angie M. Smith, husband and wife WARRANTY DEED , Grantee. EXEMPT # Grantor, for a valuable consideration conveys to Grantee the following REC FEE: 11.00 described real estate in St. Croix County State of TRANS FEE: 128.70 Wisconsin (the "Property "): COPY FEE: PAGES: 1 Recording Area Name and Return Address T L� ith BLII'ne�" 11 `th - 755o F'v4 nq Ate RllrFa115.7�(L64o22�i ^ 0� m N s s �s 022 101140 000 Parcel Identification Number (PIN) 7` This is not homestead property. (is) (is not) Lo Certified Survey Map filed in Vol.1 Page 448 1, Document No. 714 11 l ocated in part of the SE % of the NE . of Section 5, T 28 N, R 18 W, Town of Kinnickinnic, St. Croix County, Wisconsin. Toge with all appurtenant rights, title and interests. none Grantor warrants that the title to the Properties good, indefeasible in simple fee and free and clear of encumbrances except Dated this 25th da of April 2003 (SEAL) (SEAL) 4T _ Fre Brick G. Ctiaf (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT i Signature(s) State of Wisconsin, ) ss. authenticated this day of St. Croix County W ENDY SW ATZMA Personally came before me this 25th day of April 2003 the above named �jt )SCONS)N Frederick G. Lene Frederick G. Len 5 t me S OF W known to be the person who executed the foregoing TITLE: MEMBER STATE BAR OF WISCONSIN instrum t and acknowled a sa e. (if not, authorized by §706.06, Wis. Stats) lLnlh 0.. THIS INSTRUMENT WAS DRAFTED BY Notary Public, Stal of Wisconsin Coldwell Banker Burnet 1301 Coulee Road My commission ij pe anent. (If not, state expiration date: Hudson, WI 54016 3 -27874 1 r D � J (Signatures may be authenticated or acknowledged. Both are not necessary.) ` Names of persons signing in any capacity must be typed or printed below their signature. STATE BAR OF WISCONSIN Wisconsin Legal Blank Co, Inc. WARRANTY DEED FORM No. 1 —1998 Milwaukee, Wis. ST. CROIX COUNTY , ~~ WISCONSIN ZONING OFFICE '.�:.. .. ���M�M X11■ .__ u.0 ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road — Hudson, WI 54016 -7710 (715) 386 -4680 • Fax (715) 386 -4686 EROSION CONTROL PLAN Parcel #5.28.18 For Lot 3, 109C.T.H. "N" (Kinnickinnic) — owner(s) Charles & Angie Smith Under St. Croix County Zoning Code 17.70(3)(b)5: "The (Zoning) Administrator may attach reasonable erosion prevention conditions to a permit approved for issuance." Comm. 21.125 also requires the building permit applicant and/or landowner to follow erosion control procedures and maintain them until the site has been stabilized. The owner is responsible for notifying all contractors performing construction on this site that an Erosion Control Plan is in effect and the following activities will be required in order to maintain compliance with the plan: 1. The primary source for construction site runoff will be the house foundation excavation, driveway, and any soil stockpiled until final grading and stabilization is complete. Septic system excavation/installation adds to temporary disturbance, but establishing cover on exposed soils will prevent erosion. Plan to apply seed and mulch as recommended in #5. Maintain existing vegetation wherever possible to minimize sediment movement. Surface drainage is to the northeast, via drainage easement between Lot 2 and Lot 3 — keep contaminated runoff away from the 20 ft. easement on the west property line existing gully (see map). 2. Route contaminated runoff into vegetated buffer areas by creating temporary diversions graded ALONG CONTOUR between excavation areas and any drainage ditches or waterways. A diversion may be used to contain runoff on owner's property. Zoning Dept provides specifications for temporary diversions. 3. If builder /excavator grades the site to create temporary diversions (see #2) to contain sediment and leaves adequate vegetative cover to protect areas of concern, installation of silt fence MAY not be necessary. Silt fence or other approved sediment control products will be required if sediment cannot be contained on owner's property with diversions and vegetative buffers. The POWTS inspector will evaluate ESC plan effectiveness and make recommendations to owner and building inspector for any action required to comply with applicable regulations. 4. Construction equipment and vehicles must utilize a stabilized driveway access off public road for heavy equipment; this includes cement trucks, well drillers, and other contractor's vehicles that access the property during construction. This helps avoid muddy, rutted conditions that may allow contaminated runoff to reach waterways and/or drainage ditches. Property owner must repair damage to ditches resulting from multiple access points and sediment tracked on public roadways must be removed at the end of each workday. 5. Stabilize new topsoil cover over septic system with seed and mulch immediately after installation — do not wait for final stabilization and/or landscaping of entire site to cover exposed soils on the system. If weather will not permit seed germination, a heavy straw mulch cover will prevent erosion until grass /vegetation can get established. Erosion control matting can be applied any time of year and if installed properly, will provide protection even if seed germination is delayed. The owner of record during site construction will be responsible for compliance with the ESC Plan. Please feel free to contact me with questions regarding erosion & sediment control installation. Prepared by: Pamela Quinn, Soil Erosion Inspector #665054 Owner acknowledgement of ESC Plan requirements: , / /2003 4 �� cla? _ � � � � � la I it i Ira ravel a ll o s 11 054 It RD 4 \`/ / /oo»- r x �� 3 �S 714311 VOL 17 PAGE 448 REG IST ER H. M�H REGISTER OF DEEDS — - - -- -- - - - _ - . -- -- - _. —. — -- ST. CROIX CO. Wi RECEIVED FOR RECORD wF I 03/24/2003 01:00PM P N O ® CERTIFIED SURVEY MAP REC FEE: 13.00 o c I COPY FEE: 0 m 0 00 0 0) v r0 (n CD oom boa �- PAGES: 2 D Dm Via; �=Zm � � ZXZ Z -jO m - -- ° y �� Dm mz o� O NZZ �0D -- o mo m D q m m g -< c- D Z c 0 o m c r m o Z BEARINGS ARE REFERENCED TO THE m m p ;0 aD - I - n m o o Z c D �; p EAST LINE OF THE NE1 4 OF SECTION (n �' m p (^' v- 0 m D m c 4 z m 5, ASSUMED TO BEAR N01 "E W� m m OWm�m 0C� Zm� FI �r p m O rn�rw r r rrrrrrrr r r N C 0 0 Z 0 0 0 0 0 0 0 0 O o° / n i RO AJ W W N N N zzcncncncn M Z / I �I1'1!n6 7nnlnn ?h AsMka Cil1NlfRif O cW N 0 O � m fT� mm ° ° ° ° n X X m m MAR 2 X 4: Z00 r�0°N`Q .o0 N =+ Oo �O,Ox 7D 1 mm mmz m g Q -1 I N if `� pw, within 30 days of a oval shall be N) (o N o N 0) `' W 0 •��Sn 9 - 9 , W�^'Q �w�w�W �w0 m Q \ W �{ �{ D 1 1 1 (,J 1 1 O �`\ 6 V! Z N \1 N W N OW N 1 Q 0 \\ \� \Up O n ,, 0 O OD O N O O O (o N `\ o ` I m D ° I N N N N N N N N D 0 `\ 1 1 J O (� 66' J EA.0 ?0 (n O m O 1 33 ' ' 1 33' _ — c Z m I 190'L6£ 3.,85 Lo50S 0 0 -v C) LL 69£ D 50 m �T1 0 0 m N r Cn I - N '89, -4 I -- n m I N Q o 7C rn � w I - i A _ I p Z ■■ rn •w4SO1 °09'48'W I co C N m r W 1 396.26' I m II w i �� I m ) I w 1_ 368.97' I CTf Z -� y f ST. CROIX COUNTY WISCONSIN �ZONING OFFICE A,--" ST. CROIX COUNTY GOVERNMENT CENTER _ -- 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 • Fax (715) 386 -4686 EROSION CONTROL PLAN Parcel #5.28.18 For Lot 3. 109K-T.H. "N" (Kinnickinnic ) — owner(s) Charles & Angie Smith Under St. Croix County Zoning Code 17.70(3)(b)5: "The (Zoning) Administrator may attach reasonable erosion prevention conditions to a permit approved for issuance." Comm. 21.125 also requires the building permit applicant and /or landowner to follow erosion control procedures and maintain them until the site has been stabilized. The owner is responsible for notifying all contractors performing construction on this site that an Erosion Control Plan is in effect and the following activities will be required in order to maintain compliance with the plan: 1. The primary source for construction site runoff will be the house foundation excavation, driveway, and any soil stockpiled until final grading and stabilization is complete. Septic system excavation/installation adds to temporary disturbance, but establishing cover on exposed soils will prevent erosion. Plan to apply seed and mulch as recommended in #5. Maintain existing vegetation wherever possible to minimize sediment movement. Surface drainage is to the northeast, via drainage easement between Lot 2 and Lot 3 — keep contaminated runoff away from the 20 ft. easement on the west property line existing gully (see map). 2. Route contaminated runoff into vegetated buffer areas by creating temporary diversions graded ALONG CONTOUR between excavation areas and any drainage ditches or waterways. A diversion may be used to contain runoff on owner's property. Zoning Dept provides specifications for temporary diversions. 3. If builder /excavator grades the site to create temporary diversions (see #2) to contain sediment and leaves adequate vegetative cover to protect areas of concern, installation of silt fence MAY not be necessary. Silt fence or other approved sediment control products will be required if sediment cannot be contained on owner's property with diversions and vegetative buffers. The POWTS inspector will evaluate ESC plan effectiveness and make recommendations to owner and building inspector for any action required to comply with applicable regulations. 4. Construction equipment and vehicles must utilize a stabilized driveway access off public road for heavy equipment; this includes cement trucks, well drillers, and other contractor's vehicles that access the property during construction. This helps avoid muddy, rutted conditions that may allow contaminated runoff to reach waterways and/or drainage ditches. Property owner must repair damage to ditches resulting from multiple access points and sediment tracked on public roadways must be removed at the end of each workday. 5. Stabilize new topsoil cover over septic system with seed and mulch immediately after installation — do not wait for final stabilization and/or landscaping of entire site to cover exposed soils on the system. If weather will not permit seed germination, a heavy straw mulch cover will prevent erosion until grass /vegetation can get established. Erosion control matting can be applied any time of year and if installed properly, will provide protection even if seed germination is delayed. The owner of record during site construction will be responsible for compliance with the ESC Plan. Please feel free to contact me with questions regarding erosion & sediment control installation. Prepared by: Pamela Quinn, Soil Erosion Inspector #665054 Owner acknowledizement of ESC Plan requirements: _ ! • : • :f2a03 s 10/14/03 TUE 13:23 FAX 715 386 4686 ST CRX C4 ZONING X001 ......... EROSION CONTROL REGULATIONS UNIFORM DWELLING CODE (DEPT. OF COMMERCE) PROJECTS AFFECTED a Straw bales, filter fabric fences or other barriers to • All new 1 and 2 family dwellings in Wisconsin started protect on -site sewer inlets on or after December 1, 1992. • Additional controls if needed for steW slo • Additions to dwellings built after June 1, 1980. special conditions P� or other APPLICATION PROCESS MAINTENANCE AND WASTE DISPOSAL • Erosion Control Measures trust be included on the plot sstab un�e d co b y ulcchi be d n �rn tin a site is Plan submitted with the building permit application to landscaping g' or the local building inspector in communities where the . All building waste must be properly opfsrly disposed to pre dwelling code is enforced • Plot plant must show: vent pollutants and debris from being carried off -site — Location of the dwelling, other buildings, wells, sur- ENFORCEMENT face waters and disposal systems on the site with • Er osion control inspections will be made during other respect to property lines regular inspections (footing and foundation, rough con- - Direction of all slopes on the site struction, final, etc.) — Location and type of erosion control measures • violations must be corrected within 72 hours • Stop work orders may be issued for noncompliance CONTROLS REQUIRED FOR MORE INFORMATION, CONTACT • Silt fences, straw bales, or other approved perimeter - Local building inspector measures along downslope sides and side slopes - Department of Commerce, Safety and Buildings Divi- • Access drive sion, P.O. Box 7969, Madison, Wisconsin 53707, (608) 266 -2128. STORMWATER PERMIT (DNR) PROJECT'S AF'F'ECTED — Proposed erosion and storm water pollution control • Any grading or construction project that disturbs 5 practices during and after construction acres or more and is not covered by a building permit — Documentation that an erosion control and storm + Smaller sites that are part of a planned development water management plan which meets DNR standards involving 5 acres or more of land disturbance has been prepared (plan does not need to be submit- Effective October 1, 1992 for any new or continuing ted with the application) project — Other information related to site location and per- Exceptions: Indian tribal lands and work done by local mit holder government staff CONTROLS REQUIRED APPLICATION PROCESS • Erosion control measures specified in the Wisconsin • File a "notice of intent" application (Form #3400 -161) Constr iction Site Best Management Practice Handbook with the Department of Natural Resources (DNR) 14 • Measures to control storm water after construction days before construction begins FOR MORE INFORMATION, CONTACT • Application must include: + Department of Natural Resources, Storm Water Pet- - Timetable for land disturbing activities and installa mils, P.O. 7921, Madison, W1 53707 -7921, (608) tion of erosion control measures including project 266 -7078 start and completion dates LOCAL ORDINANCES Cheek with your county, and city, village or town for any local erosion control ordinances including shorelalnd zoning requirements. Except for new 1 & 2 family dwellings, local ordinances may be more strict than state regulations. They may also require erosion control on construction projects not affected by state or federal regulations. A publication of the University of Wisconsin - Extension in cooperation with the Wisconsin Department of Natural Resources and Department of Commerce, Ron struss, Water Quality Educator, UWEX Western Area and Carolyn D. Johnson, Urban Water Quality Educator, UWEX Southeast Area. UW- Extension Provfd" equal opportunities in employment and programming, This publicaton is available from county UWEX offices or from Extension Pubffcations, 630 W_ Mifflin St., Mattison. WI 53706, (6019) 262 -3346. Copyright 1997 by the Board of Regents of the University of wiscomin System doing businessss as Cooperailve Extension, University at wsoonsin Fadension. Send inquiries about copyrlgtlt permission to Director, Cooperative Extension PutAications, 201 Hiram Smith Hall, 1545 Observatory Drive, Madison, WI 53706. GW0001A Standard Erosion control Plan for 1 6 2 Family Dwelling construction Sites DNR: wT- 158-as R -02-97 -2101 -14-5 10/14/03 TUE 13:24 FAX 715 386 4686 ST CRX CO ZONING 002 r 4 g Indicate management strategy by checking ( ✓) the appropriate box; -La Management Strategies 11 Temporary stabilization of disturbed areas. Note: It is recommended that disturbed areas and soil piles left inactive for extended periods of time be stabilized by seeding (between April rst and September 15th), or by other cover, such as tarping or mulching. 0 Permanent stabilization of site by re- vegetation or other means as soon as possible (lawn establishment). Indicate re- vegetation method- Seed ❑ Sod F7 Other ❑ Expected date of permanent re- vegetation: Re vegetation responsibility of. Builder C Owner/Buyer L l Is temporary seeding or mulching planned if site is not seeded by Sept. 15 or sodded by Nov. 15? Yes C W ❑ C* Use of downspout and /or sump pump outlet extensions. Note, • ft is recommended that flow from downspouts and sump pump outlets be routed through plastic drainage pipe to stable areas such as established sod or pavement Trapping sediment during dewateiing operations. Note: Sediment - laden discharge water from pumping operations should be ponded behind a sediment barrier until most of the sediment settles out. Proper disposal of building material waste so that pollutants and debris are riot carried off -site by wind or water. Maintenance of erosion control practices_ ' Sediment will be removed from behind sediment fences and barriers before it reaches a depth that is equal to half the barrier's height. • Breaks and gaps in sediment fences and barriers will be repaired immediately. Decomposing straw bales will be replaced (typical bale life is three months), • All sediment that moves off -site due to construction activity will be cleaned up before the end of the same workday. • All sediment that moves off -site due to storm events will be cleaned up before the end of the next workday. • Access drives will be maintained throughout construction_ • All installed erosion control practices will to maintained until the disturbed areas they protect are stabilized. For more assistance on plan preparation, refer to Chapters iLHR 20 & 21 of the Wisconsin Uniform Dwelling Code, the DNR Wsconsin Construction Site Best Management Handbook, and UW– Extension publication Erosion Control for Home Builders. The Wisconsin Uniform Dwelling Code and the Wisconsin Construction Site Best Management Handbook are available through State of Wisconsin Document Sales, 608/266 -3558. Erosion Control for Home Builders (GyWO001) can be ordered through Cooperative Extension Publications, 608/262 -3346 or the Department of Commerce, 608!267 - 4406 ■ AF •� ■ 1 1 i is 1 • 11 e• ANN ■r ■r�■�i ■r ■■ ■■■■ ■■ ■Rol ■m■■ i■ ■ ■ /I�1 ■!� ■ ■■ ■fir ■ ■I ■ ■■ I■ ■ ■■ �I1i ■ ■ ■ ■fi�1 ■E ■ ■ ■ ■ ■I�'i. ■ ■I■ i ,lam i ■ ■II■ ■�i!■ ■ ■ ■!��■■■�•!. ■ ■11■ ■ ■►/f.rl ■i� ■ ■ ■�A ■■ ■■ �� ■111■ ■ �� ■ ■ ■ ■�� ■ ■ ■•.��A\ ■ ■� i31 ■III■ �, � - ■ ■ ■ ►rJ�r■�� /t �■■►� ■ ■ ■II■■ 111 .. . ■ ■ ■ ■ ■■ ■ ■ ■ ■ ■ ■■■ ■■■ ■ ■I� ■'■ ■ ■ ■ ■ ■■ i ■■ ■ ■■ iii■ ■ / ■�■ NONE ■ ■ ■■ ■■ ■■ i■ ■ //■ ■1�