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022-1015-30-100
Wisconsin Department ofCommerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 515039 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: Ruka, William & An Kinnickinnic, Town of 022- 1015 -30 -100 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: -3 c.ST 06.28.18.8713110 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER . CAPACITY STATION BS HI FS ELEV. Septic y,.. Benchmark Dosing j Alt. BM Aeration �a ` f Bldg. Se r .7 b c7 Holding St /Ht Inlet G $ , Q . , nk St /Ht Outlet 7 O TANK SETBACK INFORMATION TANK TO P/L WELL 9BLDG.. Vent to Air Intake rROAD Dt Inlet Septic >/66 , Z / g Dt Bottom 2a Dosing 7Z f Header /Man. 1 3- 6 L 16 5 ' 9 Aeration Dist. Pipe Holding Bot. System 3 el 3. , PUMP /SIPHON INFORMATION Final Grade ? • as J C 7 • S Manufacturer GP and St Cover / O . 13, (A Model Number '"7 3 L O *'j 4-- TDH Lift • z % Friction /osss� System Head Q TDH Ft Forcemain Len 19 Dia. Z ! Dist. f Well 7Z / SOIL ABSORPT SYSTEM BEDITRENCH Width Length No. O re PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS /Q / O g "\ \ SETBACK SYSTEM TO 1 � P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer INFORMATION CHAMBER OR Type Of System Z-7 'Lli�f Z ZV A 4_ UNIT Model Number: M J Ai DISTRIBUTION SYSTEM ° Header/Manifold �� Distribution �� �� x Hole Size ,r x Hole Spacing Ve Air Intake Pipe(s) o i 3D ' Z 5 `� C Lengt Dia Length 3 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 Mulched Bed/Trench Center S 7 Bedlfrench Edges \, Topsoil may. es 0 xx No '$ Yes Lj, No �v r COMMENTS (Include code discrepancies, persons present, etc.) Inspection #1: 1� / &/ dg In / / Location: 918 Tower Roa 'dson, WI 54016 (SW 1/4 NW 1/4 6 T28N R18W) NA Lot 1 '5N., I LA4 Parcel Inspection #2: : 06.28.18.87D10 1.) Alt BM Description 2.) Bldg sewer length = r - amount of cover Plan revision Required? Yes ><No Zb' 7 Use other side for additional information. L Date Insep is Sig re Cert No SBD -6710 (R.3/97) commerce.wi.gov Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 St. Croix i sco n s i n Madison, WI 53 7 Sanitary Permit Number Nu++mbeaber (to be filled in by Co.) [)apartm of Commeroe J 1 5 63 1 Sanitary Permit Application State Transaction Nu In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental / /P 3 3 5 / 3 unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POWTS are roject Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for second " 918 Tower Road purp oses in accordance with the Privacy Law, s. 15.04 1 m , Slats. I. Application Information — Please PrOA All Information Property Owner's Name Parcel # 022 - 1015 -30 -100 William C. & Angela Marie Ruka Property Owner's Mailing Address FEg 2009 Property Location 6525 23' Street North 1J Govt. Lot r City, State Zip Code TPlGa hi SW -/,,NW Y, Section 6 Oakdale, MN 55128 L ZONING OFFICE 0E.4 (circle one) lI. Type of Building (check all that apply) 61� L # T b N; R 18 W ®1 or 2 Family Dwelling — Number of Bedroo Subdivision Name (' 1 CSM ❑Public /Commercial — Describe Use •� .'N ` r' [[[XXX Na City of ❑State Owned — Describe Use ❑ Vill CSM Number age of J. O 6,U d.-j Vol. 15, Pg. 4166 ® Town of Kinnickinnic III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A* ® New System Replacement ❑ Treatment/Holding Tank Replacement Only Other Modification to Existing System (explain) �•�" ^ System B. ❑ Permit ❑ Permit Revision ❑ Change of ❑ Permit Transfer to List Previous Permit Number and Date Issued Renewal Before Plumber New Owner Expiration IV. Type of POWTS System/Component/Device: Check all that appl ❑ Non - Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil 2 Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treatment Area Information: k, V747 Design Flow ign Soil Application Rate(gpdsf) gpd) es Dispersal Area Requi d (sf) Dispersal Area Propo d (sf) System Elevation 600 600 sq. ft. / .:.� 600 sq. ft. 3 101.92'@ 20" above C� 100.25' contour VI. Tank Info Capacity in Total # of Manufacturer a Gallons Gallons Units o H New Tanks Existing Tanks z0 H uWFa a Septic or Holding Tank 1250 0 1250 1 Wieser Concrete ® ❑ ❑ Dosing Chamber 750 0 750 1 Combination VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Si ature MP/MPRS Number Business Phone Number Bill Schumaker 27990 (715) 386 -3121 Plumber's Address (Street, City, State, Zip Code) 1070 Scott Road, Hudson, WI 54016 VIIIL Coun /De artment Use Onl proved _ Di . o Permit Fee Date I sued Issui n re gent Sig t� wn i�Vaon for Denial $ j_ 2C' CCU 2 7 6 IX. Condit' easons for Disapproval J 1. Sept[ tart[(; ettluent diner and dispersal cell must all be services / maintained as per management plan provided by plumber. 2. AN setback requirements must be maintained es per applicOW code / otdirmw es. Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 x 11 inches in site SBD -6398 (R. 01/07) Valid thru 01/09 - R�� 35!30' 31y ^ LY Pro/oo5ed 6 3' , r 8/. s0' 21' 6/ eg o ,' Twe/dc��z� or;f ceu�parycc�rzy at�B° 1 "se�. s! P. ✓.C. Torre �.'„ .5 / <a�cd pro�s< -c/ u�i eSe i Cv»cre�e tarok �f y "s�C. ✓a w /2sz 7S - MQ C11 dV. S.T /lac . � / /aK/4c•S1S � O G " �rc�E s /eq dG . 5� "ScJi• d0 , Qd, c. b u /a; Sct �cf P ro a d r•� Proposzd C/ 6 t X/, - ooln 4�e ade Q - • I J � �,r, s ta� �r�le elegy Cale: C5 /r/ ✓oQ /S 4U6G ° .S�.Croit U T 64t; 3.3294 ores U - Tcv� �Cna' Safety and Buildings 3824 N CREEKSIDE LA commerce.wi.gov HOLMEN WI 54636 Contact Through Relay www.commerce.wi.gov /sb/ i scons i n www.vvisconsin.gov Department of Commerce Jim Doyle, Governor R ichard J. L e in e nk ugel, Secretary February 05, 2009 CUST ID No. 227990 ATTN.- POWTS Inspector WILLIAM C SCHUMAKER ZONING OFFICE SCHUMAKER PLUMBING ST CROIX COUNTY SPIA 1070 SCOTT RD 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 02/05/2011 Identification Numbers Transaction ID No. 1633573 SITE: Site ID No. 745648 William C & Angela Marie Ruka Please refer to both identification numbers, 918 Tower Road above, in all correspondence with the agency. Town of Kinnickinnic St Croix County SW1 /4, NEIA, S6, T28N, R18W Lot: 1, Subdivision: CSM Vol 15, Pg 4166 FOR: Description: Mound / Four Bedroom / Sloping Site Object Type: POWTS Component Manual Regulated Object ID No.: 1215676 Maintenance required; 600 GPD Flow rate; 16 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual - Version 2. 0, SBD- 10691 -P (N.01 /O1), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01 101); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, coltifit stats. The following conditions shall be met during construction or installation and prior to occupancy or use: OF Reminders This system CORA • T h stem is to be constructed and located in accordance with enclosed approved plans and with the y anc the e c osed appro component manuals listed above. • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. i WILLIAM C SCHUMAKER Page 2 2/5/2009 • Inspection of the POWTS installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat • Comm 83.22(7) A cony of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department which may include local inspectors Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 7 /7 Fee Received $, 250.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday charles.bratz@wisconsin.gov cc: James K Thompson, A.C.E. Soil and Site Evaluations Leroy G Jansky, POWTS Wastewater Specialist, (715) 726 -2544 , Friday, 7:00 A.M. To 3:30 P.M. i FEB Q 4 1�&'N D AND PRESSURE DISTRIBUTION COMPONENT DESIGN e Residential Application !�` INDEX AND TITLE PAGE Project Name: William C. & Angela Marie Ruka 3 bedroom residential m ound Owners Name: William C. & Angela Marie Ruka Owner's Address: 6525 23rd Street North Oakdale, MN 55128 Site Address: 918 Tower Road Legal Description: SW1 /4 NW1 /4, Sec.6 , T.28N., R.18W. Township: Kinnickinnic County: St.Croix Subdivision Name: CSM Vol. 15, Pg. 4166 Lot Number: 1 Block Number: Na Parcel I.D. Number: 022 - 1015 -30 -100 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan ,on Page 7 Pump curve and specifications Page 8 Site Plan owl) WF`. Page 9 Attached soil evaluation report BEY SPONDENCE Designer: Bill Schumaker License Number: 227990 Date: 01/30/09 Phone Number: (715) 386 -3121 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD- 10706 -P (N. 01/01) Version 5.1 (R. 06/06) Page 1 of 9 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 400.00 Estimated Wastewater Flow (gpd) Table 83 -44 -3 in -situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150 %) fecal coliform of - 36 inches. 600.00 Design Flow (gpd) 3.00 Site Slope ( %) 100.25 Contour Line Elevation (ft) 16.00 Depth to Limiting Factor (in) 0.50 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 60.001 Dispersal Cell Length Along Contour (ft) = 10.00 Cell Width (ft) 1.001 Dispersal Cell Design Loading Rate (gpd /ft 11 Influent Wastewater Quality (1 or 2) Are the laterals the highest oint in the distribution Y Pressure Disribution Information network? Enter Y or N (C or E) C Center or End Manifold 2.50 Lateral Spacing (ft) If N above, enter the elevation ft 8 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) 2.50 Estimated Orifice Spacing (ft) = 6.25 ft /orifice 2.00 Forcemain Diameter (in) 175.00 Forcemain Length (ft) Does the forcemain drain back? Y 87.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 28.55 Forcemain Drainback (gal) 14.42 Vertical Lift (ft) 47.65 5x Void Volume (gal) 5 5.65 Friction Loss (ft) 76.19 Minimum Dose Volume (gal) 1 L 0.00 In -line Filter Loss (ft) 39.54 System Demand (gpm) 26.57 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 x 1.25 1.00 x x 1.50 x x 1.25 x 2.00 x 1.50 x 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information 757.64 Total Tank Capacity (gal) 1250.001 Septic Tank Capacity (gal) 47.00 Total Working Liquid Depth (in) Wieser Concrete I Manufacturer 16.12 gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 757.641 Dose Tank Capacity (gal) Pol Lok Filter Manufacturer 16.121 Dose Tank Volume (gal /in) PL -525_ _ Filter Model Number Wieser Concrete Manufacturer Project: William C. & Angela Marie Ruka 3 bedroom residential mound Page 2 of 9 Mound Plan and Cross Section Views T 1/106 - - -_ J Observation Pipe ©' K .. .. • 5 A ti ti _ W .... .. ........................ .. :.:.:.:. '' I L Mound Component Dimensions AF 10.00 ft E 23.60 in H A8.03 ft K 10.70 ft B 60.00 ft F 9.00 in z ft L 81.40 ft D 20.00 in G 0.50 ft J ft W 28.63 ft 600.00 (ft Dispersal Cell Area 1 1236.26 (ft Area Available 10.00 (gpd /ft) Linear Loading Rate 1 6.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area FinishegGrade 103.67 (ft) —r ,,..,,,,... ♦ H G l ,,,,,,,., ,,,, F Dispersal Cell 102.42 (ft) Lateral 101.92 (ft) -� — Invert Dispersal Cell •:•:• Elevation D • k.. -lti - - "]'- `'. : "=-`." -'<i." < { '<�c �?. ?• <] -:<<' - '� _.tY.- . _.:�- ?':'�:'�'._.- - "'s`= •�,.�... 1'. : A, . ` 11. ,�. 4 ,. .�. -: • • • .t �' { - 1 { <- AA ,?.° } 7 dl� 10 .25 (ft) Contour Elevation 3.0 % Site Slope Geotextile Fabric Cover Shading Key o Dispersal Cell See lateral details on 10 _ Topsoil Cap c a 1.5 ft Page 4 for number, size, 20 , 111 Subsoil Cap w o r. and spacing of laterals. ASTM C33 Sand Laterals are equally `a L ." F spaced from the <'. < Tilled Layer 0.5 ft 'Typical lateral r : r distribution cell's © ;•;•;••ti Aggregate o centerline in the A distribution cell (AxB). Project: William C. & Angela Marie Ruka 3 bedroom residential mound Page 3 of 9 Center Connection Lateral Layout Diagram Force main connection wa tar or cross to man*old at any point. Lawals am identical dr- R P • g TtNtaup aNdn ckanotat plop or ball valve g Holes drilled on the bottom of the lateral. Laterals $ tome main of PVC sch 40 as per Corffwn Table 84305. W4, Adm. Code Number of Laterals 8 Orifice Diameter 0.125 in Lateral Diameter 1.00 in Orifice Spacing (X) 2.54 ft Lateral Length (P) 29.21 ft Orifices per Lateral 12 Lateral Spacing (S) 2.50 ft Orifice Density 6.25 ft /orifice Lateral Flow Rate 4.94 gpm Manifold Length 7.50 ft System Flow Rate 39.54 gpm Manifold Diameter 1.50 in Total Dynamic Head 26.57 ft Forcemain Velocity 4.04 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and Comm 16.28 WAC 4 in. min. Disconnect Tank component is properly vented Alternate outlet location Forcemain diameter Wieser Concrete Manufacturer 2 in. Capacityl 757.64 Gallons T Volume 16.12 gal /inch A 06 q Weep hole or anti - Dimension Inches Gallons B siphon device A 28.27 455.77 B 2.00 32.24 C Pump off elevation (ft) C 4.73 76.19 ♦ 88.00 D 12.00 193.44 D Total 1 47.001 757.64 il Dose tank elevation (ft) " Bedding un er tank. ~— 87.00 Alarm Manuafacturer LevelArm Alarm Model Number JD Pump Manufacturer Gould Pump Model Number 38 WE05H Pump Must Deliver pm at 26.57 ft TDH Project: William C. & Angela Marie Ruka 3 bedroom residential mound Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name Bill Schumaker Phone 715 386 -3121 POWTS Regulator's Name St. Croix County Zoning Dept. Phone 715 386 -4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 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 years Alarm Should test month) Pressure Systeml Laterals should be flushed and pressure tested every 1.5 years Moundl Ins ect for ponding and seepage once every 3 ears Other 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. 7 All 'L.. .J i..: ..1.. i... -w. 4-- 4-L — 1.. P`.. -- OA \AI ;— AA— 1 —A— .J. I% yi icy iailu JJ1VOQ Ii - Nipiil IIIQLGI IQIO Nu1111VI III Lu Id IG I G-4UII G1 111ci ILO 111 Vul 11111 V V 10.!lul l 1. VV4G. 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 ............. Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: William C. & Angela Marie Ruka 3 bedroom residential mound Page 5 of 9 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), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD - 10706 -P (N. 01/01)] 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 subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the 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 System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg /L BOD 150 mg /L TSS, and 30 mg /L FOG for septic tank effluent or 30 mg /L BOD 30 mg /L TSS, 10 mg /L FOG, and 10 cfu /100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic 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 proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: Page 6 of 9 - GOULDS PUMPS Submersible Effluent Pump 3885 , rrw,xr rwro } PROSURANCE AVAILABLE FOR RESIDENTIAL APPLICATIONS. APPLICATIONS ■ Shaft: Corrosion - resistant Single phase: ■ Bearings: Upper and stainless steel. Threaded • Built -in overload with lower heavy duty ball bearing Specifically designed for the design. Locknut on three phase automatic reset. construction. following uses: models to guard against • All single phase models ■ Power Cable: Severe duty • Homes component damage on feature capacitor start rated oil and water resistant. • Farms accidental reverse rotation. motors for maximum Epoxy seal on motor end • Trailer courts p y • Motels ■Fasteners: 300 series starting torque. provides secondary moisture • Schools stainless steel. •'/3 and V2 HP —16/3 SJTOW barrier in case of outer jacket • Hospitals ■ Capable of running dry with 115, 208 and 230 Volt damage and to prevent oil • Industry without damage to three prong plug. wicking. Standard cord is 20'. • Effluent systems components. • 3 /4 -2 HP —14/3 STOW with Optional lengths are available. bare leads. ■ O-ring: sspositive ■ Designed for continuous Three phase: g' ures p sealing against contaminants SPECIFICATIONS operation when fully • Overload protection must submerged. be provided in starter unit. and oil leakage. Pump •Solids handling capabilities: •'/2 -2 HP —14/4 STOW with bare leads. 3 /4" maximum. MOTORS AGENCY LISTINGS • Discharge size: 2" NPT. ■ Fully submerged in high- ■ Designed for Continuous • Capacities: up to 140 GPM. grade turbine oil for lubrication Operation: Pump ratings are Tested to UL 778 and • Total heads: u p to 128 feet and efficient heat transfer. within the motor manufacturers CSA 22.2 108 Standards TDH. recommended working limits, ® By Canadian Standards ■ Class B insulation. Association be operated continuously c us File #LR38549 104 °F (40°C) continuous without damage when fully 140 °F (60 °C) intermittent. submerged. Goulds Pumps is ISO 9001 Registered. • See order numbers on METERS FEET reverse side for specific HP, 40 130 - SERIES: 3885 volts e, phase and RPM's E15 { - - - - - g 120 — — -�— SIZE:' / <' SOLIDS _ - -- j -_ - _ -_ _ RPM: 3500 & available. 35 1750 110 - ' � WE2 N FEATURES 30 100 - - - - -- 5 F1 — f + ■Impeller: Cast iron, semi ° a 90 �' W 25 _._. _ —,._.. t ... -__ .___ -------- open, non -clog with pump -out 80 vanes for mechanical seal —+— 20 0 _ _. _ r _ T __ __ { -- __ _ protection. Balanced for ; 60 smooth operation. Silicon ° - - — - bronze impeller available as a 15 - h } an option. 40 .I - - -+ + --- ■ Casing: Cast iron volute type -�°• 3 1 for maximum efficiency. . . 20 5 2 "NPT discharge. 10 ■ Mechanical Seal: SILICON o o {- CARBIDE VS. SILICON 0 10 20 30 E SQ 6 ins 80�� 100 110 20 130 140 150 160 GPM CARBIDE sealing faces. 0 5 10 15 20 25 30 35 m /hr Stainless steel metal parts, CAPACITY BONA -N elastomers. 3 9 5 y � �°'"�' /�7iA7/1tu/Yl s�Ply`af�rcfd• Goulds Pumps © 2002 Goulds Pumps ITT Industries Effective October, 2002 www.goulds.com /� q 83885 Off" / M/27/09 TUE 09:00 FAX 715 386 4686 Z001 .r q*A.iiu/ .,nsi6 Department OfCommerce SOIL EVALUATION REPORT Divlsion of Safety and Buildings Page of !n accordance with Comm 85, SMs. Adm. Code Attach complete site plan on paper not less than 8 112 x 11 Inches in size. Plan must County Include, but not limited to: vertlgl and horizontal reference point (13M), direction and lW Percent slope, scale or dimensions, north arrow, and Iocatlon and distance to nearest road. Parcel I.D. Z — 30- 106 Pease print alllnfonnation. Re ' d by Date hh Personal Information you provide may be used for secondary purposes (Privacy Law, s. 13.04 (1) (m)). U Pro perty Owner Property Location A Gout_Lot_ 'S 114 NW 1 /4 S� T �.$ N R�$ E (or w Property Owner's Mailing Address Lot # Block # Subd. Name or CSNW P - - 'a'(:3 x z at z 1 _ �s� I G OtY state Zip Code Phone Number F_] City [j Vibge Town 9 r PPrU L H N S`SoZ S ( 61 Z) - 2 z.3 -10 8 7 'r—,t ml,3 1 � r - IU C ZOt�y - CZ.C? I New Construction Use: ® Residential / Number of bedrooms 3 ❑ Replacement Code derived design flow - L� GPD ❑ Public or commensal - Describe: Parent Gene �m �� Flood Plain elevation if a 1*le _� and recommendations: MOUE k1 � C) I X S 0 r p n �•„ —� - - - - i �' - t M UKI Z0' OF s +°�D Ft Lrl_ . x .. .. C' 0►..1`TDU2 �Z -ts1J . l gyp. Z S - � � `'��,� ,; ❑ Boring # Boring ® Pit Ground surface elev. fL Depth to limiting factor -,� In. Horizon De Soil Application Rate Pth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W In. Munsell s Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Etf#2 0-9 10trz- -312 Z q - 1.O L 3 Lb - S i 1 z`Psbk wig C - . •0 16_35 S11LV4 Boring # - ❑ Boring ® Pit Ground surface elev. 10 1. 1 0 fL Depth to limiting factor �1 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/R' In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •EM - •>=ff#2 ail Z`�5�12 Wl 3 ��,. > o�r� 3l6 e1 •s �rz s!� s ' 1 e_sbk v>? - . Z , 3 Effluent #1 = $OD > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD, c 30 mg/L and TSS < 30 mg/L CSI Name (Please Prtnt) : S re �� CST Number Arthur L ° Wegerer .. ;OI.;Sq, 220254``' Address W e g e n e r S O i l Testing. &. Desig S e rvi c P_ Date E valuation Cond Telephone Number 421..11. Bain St. River Falls, WT 54022 . -Yip'-,_,_:�• y. (, = o1 1715- 425 -0165 0.1/27/09 TUE 09:01 FAX 715 386 4686 fj003 'roperty Owner Parcel I D # Page Z- of 3 E Boring # ❑ Boring ® pit Ground surface elev. Q4 --7 ft. Depth to f milling factor ! in. Horizon Depth Domi Soil Application Rate nant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in, Munseli Ou. Sz. Cont. Color car. Sz. Sh. "Eff#1 •Eff#2 1 0 -9 t n fL 31 - t- - si l zl_P3�>k 2. 9 - !p`t 3!b rn`�`h CS - •S - 1 b- � •2 VFz y! Ci�{' � .sy>Z S/� s i cl tcsbk m �c . Z _3 I boring # ❑ Boring J ❑ Pit Ground surface elev, ft. Depth to limitin fa P 8 clot In. Soil Application Rate iorizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP0/ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 • • Boring # ❑ Boring ❑ Pit Ground surface elev. fL Depth to timltln • fa ctor in. Soti 0cation Rate uizon Depth Dominant Color Redox Description Texture Slrur bX8 Consistence I Boundary I Roots GPD/►t In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eft#1 - •Eff#2 Effluent #1 a BOD > 3D < 220 rng/L and TSS >30 < 1 do mgtL ' Effluent #2 = BOD 30 _ � < _ mgfl. and 7SS < 30 mg/l- ' be 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 depattrnent at 608-266 or TTY 608 264 - 8777. ��o tx.erool • 01/27/09 TUE 09:01 FAX 715 386 4686 U 002 - PLOT PLAIT Page 3 of 3 Scale 1'= Sp' t - = i - tl __ - -.:�Z; _100= 0'..o►v '2 - 3111." -� Won oP�- CkrLL CjL, iot.gZ ' v Ati �ti .� `� tRfSrJ n° fir- eOMQ,Re� arz 3"� � QIS�rL•� � �� ' a r L — LoT' SAS f i` } K„ 5 -1210 715 -425 -0165 220254 of - - A .. 9 1 CST Signature Date Telephone No. CST No. Job X10. 6 JA110/ ir. Department of Commerce r SOIL EVALUATION REPORT Pa of 3 * Divlsl .; of Safety and Buildings •/ in accordance with Comm 85, Wis. Adm. Code S l • C,1 _i Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County � !X 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. Q2 _ -�O— 106 Please print all information RD ate Personal information you provide may be used for secondary purposes (Privacy law, s. 15.04 (1) (m)). Property Owner ^ Property Location A l/ K Gou,L_l aL c, W 1/4 NW1 /4 S 6 T N R E (or W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# S !( P•� SC�X 2C1 2 — c_ g City State Zip Code Phone Number ❑ City ❑ Village) Town Nearest Road . gT• Pf vlj L > 4 NJ I S S ( 6 t Z) � Z3 -10 8 - 7 1—, �1 1 C Yr- -j Q )V L C -- OINQ - \z (Z C?Pe'D ®, New Construction Use: ® Residential / Number of bedrooms - Code derived design flow e - . L4 Sa GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material _ L 1""l l.l. Flood Plain elevation if a ib'able A ft, t f _ General comments and recommendations: h� q r X S O r l s'[�Z ( BUTl 111v r; ? ►^-) �v t w), ult ZO k 0 F S 1`1 l FL L.l.. x CO��CO LM.Z£U . L 00. Z S FFI Boring # . Boring Td ® pit Ground surface elev. O l • 3 ft. Depth to limiting factor i b 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 y 1. o 9 S' 1 Z '�s b { WI CS - , S $ ,_ Z 4 -16 Lo v 2 , 3 L si1 Z4 ML` 3 16_35 �,S�fZ�l6 e.l Z.S�25�8 l��sl �.esbk w1� - .4 ,b a Boring # ❑ Boring ® pit Ground surface elev. l O 1 - 1 0 fL Depth to limiting factor 1 �7 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/1`1 In. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. •Eff#1 •Eff#2 sil Z-�sbk m'F►- 2. -L 1 2316 - s ip - ZIP sblz 3 11r Limp- 3l6 - 1.S `12 S! S i J esbk ►� - • Z -3 • 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) SST CST Number — 01.59 -, e Arthur L Wegerer' A 1 22025 Date Evaluation Conducted Telephone Number Address Wegerer Soil Testing. & Design Service 421 ITT. Bain St. River Falls, WI 54022 L/ -'z _ pl 715 -425 -0165 Property Owner L �DQ AZT' Z Parcel ID # fU G Page Z of 3 a Boring # ❑ Boring ® Pit Ground surface elev. Q 4 • ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft= In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 0-9 l SZ 3 l Z - S i) Z sb1 c rn T - Ti �sVFL y/ e. .3 y2 /p, S icl 1c Sbk »��t- • z _3 F-1 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 is GPD /ft' In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 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 /f 2 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 TTY 608 -264 -8777. SBD -6330 (R6100) PLOT PLAN Pae 3 of 3 Scale 1 = S Sc O �i-1 - 27 - . 100:0' ON -1 `�L61�; 3 /y DlA• �V� l�l{�E fti►7`�iTl , Lo T `f o\ �c�IJI- L et X00 zs' ate,►► -z �ol'T�n or-- ceu EL, ioi.q -Z • 9.� - t3.3 y\ o� aA . 2 r .A L o Z — — DoT S - IS � E 7 -p 5 -Q -01715-425-0165 220254 CST Signature Date Telephone No. CST No. Job NO. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM o Owner /Buyer Mailing Address (,PS as k& `�'� , � , bc�kd o.,� �- Mw ~ ] a.t Property Address (Verification required from Planning & Zoning Depart ent for new construction.) City /State Parcel Identification Number 0 a,a - a 1 LEGAL DESCRIPTION Property I Locatiotl S W /� , '/� Sec. _ _ __, T �_ N R W, Town of Kt N N c\� (N N t C Subdivision Plat: Lot # Certified Survey Map # C_SrTN , Volume \ 5 , Page # \ b Warranty Deed # (before 2007)Volume , Page # Spec house I yes no Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and /or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 frill of sludge. I /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my /our knowledge. I /we am /are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms _ A /- /a 7 il SIGNATURE OF APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) r . I f�l�i'IC�INNIC r W E �.�01.. - X%* A" ... �.., .. S 991( „ 4 •.,, pli.e. rnr 1r h.,,., ,NN SM1• See Page 30 Q L &P rm= Uean &Glenda 69.64 Simonson ry Lawrence Jr c&F. 40 Dan &Jacque c 21'• Hansen 38.97 Farm Inc ".E v12 42.5 &Frederick Frederick GIOLid ❑ 65 Nelson m 72'52 n o A Qa IF 5 Harold ,> Le nez & Lawrence Vorwald �' m r„ 71.8 Artmld &. ❑2 N 193.34 eta r &M Va ogM 1 Lenert2 ° Abdul Ma"�•ua Hunter a a0 40 116.71 152.48 Shams r °n* 197.5 SS 156.36 196.6 = 3 MHZtar Fre oNR & derick 94 - fl 1 G Kl v_ Le , - „ nertz ❑ erald Galen J 179 " 2 0 110.08 659 O Joseph & ' Thompson 2p � += Robert & ° , -r $ s Robert ,g Kathleen Benson 73.22 Josep o 120 au &Dale - Barbara Mark & c "'' 3 ' I &Doris Ro I,e,k M &s Net. 169.77 Garbe hine d -1 etal Bazde11 v 232.5 Ickler Laurie Iv.ae t a Robert o Harry Paul, Alvin &Holly Lisa Delander I &A ec< rk Garbe 80 l y U 160 7 117.5 Van Beek Sollom xnma: nl Fam'r 53 J,hnson 40 Sandra, & James 60 50 118 19.9 .� N 40.27 ` Lubich James N °o O Knnk� a• Susan & Gordon & Fisk 1" Arnold & 115 Van caalayes,. ro n.mmm " , Vn Beek M sperm Maener J 35 Marcella Lueck oanna &Mary E Pinski R Sumner 80 160 James Jr & 110 A Monk °;, • B - 2 40 9.5 - 56.31 Fd.;n ; • K v1. 20 Elaine Ray »a a m E &513 9 Ross& 160 -r $ 'Thomas &Lisa E&C Daniel MN '- 127.36 D&N Mever Marvin Mary Pau K &BALI. + 9 180 45 20.P 157 73s Olr &M Q Hill �� m 136 R&G "Ad J ohnson '1 lodge Z2.. 41 20 m� Fm Tr L.M.d Viola sen Liddle D A h.,tc ao 5 �. y ? 2f " `� ,,:, C* 9 = 160 158 JRO enheimer 3 John & Lene o 27 Y „E 5 rtz Fnaedrk e , m z z , Carol &wane B - = stee W &P 20 R Ma.-" a_v (},36 Far smdn " g c E B &r g5 C &R Frederick Phoebe Marvin & 305.7 ]•fir] Liddle Edwin & �• Feyereisen = NE ill & ]829 'V ° H18 Kathryn H6 Kalh fr3' z 113.4 Nelson thany m P &R x 'h` a Lamothe s &e &Ku „ley Paulson Ca ry" 'h fj D 56 k etal inehan laneur E k2 J1 U 2 N �N 38 40 142.6 40 2 r` 40 2 •,,, �� 20 100 Dorothy Phillip m J Michael . P &I c ac Gerald O Harold & T .� us9 John Agronomics a0 e &" Inc Emholtz ,w Joanne 117.37 „ Schmid, D&1 me Mickelson t DNR 3 37 40 c^de1n z z 2 •N Morrow 113.21 173.5 122.23 138 lv . 3 C� Gudreaull 221.06 167.82 14 J 4 5 '192.2 & K Gri 2 er I I I Reer A & Kl J 40.61 J laua ei A 2 26 •z= v $ David 4 a= R.rmr,nw 73.68 sreven 154 Jeffrey & Nancy < rr = 197.68 75'13 139 &Vicky David Mookittrick& 3 w Waltert `< gu CR Quiggle Christensen Dorothy c;e,ald T Bl «,m R &J e d Sh 20 t v y croeder &Ross _ _ +. to A a! F William & Gerald Howard &D.. 20 Bars«ss {� Orlande N L N i V Scceaton o , n No "nan ze.4z ; 2 _ E sther Fuller 190.19 �'�'� 39 & Robin Tr o17 A &s D &c Phil' ' Ps o L = Q' $1 K &K KmneJy R &L 11 a0 Osca"°5 Petex'^ a Fdm �NSt br1 A & Jnmth 40 `.Donald Gloria = s R;am1, & �R w R W 5 LL Rick a cd N Kirchner =` 9' &A u 80 (U Mueller � < e.ner^" 2 Geretd & Anthony Maiden 0 etl . y 0 ed^ & 2 6 SR l 7homa ,�,• F^ JJ Robin Rick & Lora Inc Glenn & ab m 20 140 y Q•I Phyllis TE 2 LOWe John E lames 4U Donna Badje VI v John 158.7 g0 _" v A16 n 103.4 43 40 s u Bettendorf v" 31.6 Fuller ° D.k & 49 Kart & Te an a Raymon d & -' 4 a Leif & B y L & .E n 250 GR s. F 49 r`Kr, lh Gau40 ° "` Olive Jacobson David & �i 140 Juliann Luse Erickson 4795 Nuhh - .. 2 140 u z ao 5 4° rr 1 9. .. SS 80.47 74.33 2 Robert Jr 2 cc Mid = PShaw Gibson 31 o Timothy M 30 Howard ed 91.37 40 & W y n ona Daniel & Ann N eemral Fa'^ilr Hem s 7ronan Ley d Masen =` Feeas s &Ian x MA o zo 76 Gordon 80 Keatle� Krumwiede $� oA 43.x6 ;� 9. °" smro M _ Griffey y o o John &N John & y 9 Oscar 31.87 35 M s m c M john & _ - 77.7 Candace H - &Doris R. Gary J lames& °, u'sJ3 +^a`Idvgmi" Kimberly JH Jr &N Marlin 30 160 �a T" 168.8 Bettendorf &Sh ya Lee aron Donna T� &M So1um = m Thom nTuust Krear _ . 0 3 3.z t 39 9 Curtis HiII _ Anderson " q4.5 O P Daniel & ° Linda 1.5 Keith & .. Allen & Linda W Perkins v 3 -To"' Jeanne sm 1 &o Han I &1 lei re, T &5 T Haas v Clark b , River Falls t Nvhagen pylW = & Kelh' Florer 40 y < Sale11 40 F- •c 26 $ Trs 24.14 H to D d., Leota Andrea - R >- 20.73' ° Its 1. K 5.1 11 4.9 RBluhm& 4 Andrea 70 x Land Trust 40 77.87 In u, Amm 29X m • br r 1Prina Sm WIS v 5H 40 4891 29.5 Trs G St Croix 5&G Cudd = 66 Daniel Gerald sm S i _ O G Y 7 -A 6 -.2 65 11 G 66.36 Lin &Betty rs o T & S 314.58 v COLLnty J.J 34 Cemohous m z 3? lxe Prvchmhki 3'yr K L &I 315.5 Z u', 8f1 &Lgl P7 P&UI& 4279 'elson 810 59.2 °L in RLS Chnsio h 60.86 27 m d Per y Suzanne S" Q -- Wayne 312 &Sherry ,r R 112,8 Soderbeck is Kruym '� C 200 Kramer R CIYti Il a Vernon " 3 1 rxw laa 138.86 40 & D Peskar ar S c 1 MuPnn< 2' ¢ �, ° eborah 7 J 5 Faller H Kw Vernon & 91.16 , v � H.- 3 GO Eugene & 94 R"be &Kaye" Daniel& 7 4s Vemon& Stanley pmold Adeline Peskar , Judith c Peskar o tN 1 5tanle Hansen Fm Tr d' o Betty Swenson M'� "r o David Janet Bauer 103 P-k., Peskar & Rose R 114.32 Mn 23.2 4o Y 40 __ n FL 378 yunker .9 '` C Glenn Darlym• o &cB'<niP Michael IA F gE Judith e C &Ter. B-c Gary & n Paul & 219 & Peggy CK `" N ^ ^ -r Hansen = c Wachtler crab Janet Cudd Sara Larson ,. Gerald 373 40 Lohman G M = 101.63 59 0 0 40 39.93 Judith Grimm 140 61.87 80 al _� < [- o Paul & L,,,,„ l &M - Stanlcr Peskar °a avid &Debra 65 & Carol 3s Do othy a, a ; ao J &E S 3 t u Ovsak 177.$5 Kohn John & ,g C : Williams Margaret Walker LL "- FF zii = Ray a I, an �•a -_ Alice Hanson s c z9 cm zz v D 2 M 30.93 . Z x 'r &T 1a $ '55 I Stewart Grace Gary & Vernon & 3, 132.56 s- met,. s - nddh 213.82 RIVER 130 Ral h o0 4o LA•nn Nelson G mm s" Lucille Kelly s- = 256.3 Tucpci 39 40 39 Todd & V L 2 z v RM to Robert & Tluvd 1•d1. Patri FALLS Gerard Kenne h Norman & Dean Bergseng S ` o Karen Miller & ca of 1 & Dade "e 199.99 ROb`y m &Ruth Lee ° Grace Nelson p Williams c Nicholwm 120 4ll RF L,.II Club 212 57.3 3 40 102.4 1300 1400 1500 M 1000 900 1100 Pierce County ° • as a • Furniture • Appliances • Accessories - Sleep Shop RNISHINGS FURNISHINGS Carpet • Linoleum • Ceramic • Hardwood Floors Custom Design Work • Professional Installation E Where You Will Find Name Brand Merchandise At Mill- Direct Prices! HOM "The Friendly Place" M 155 State Rd 35N •River FaIIs,WI 0 FURNISHINGS (7 5) 425 -2782 Your One Stop Home Decorating Specialist Host Cleaner... Yes, we have Host Dry Carpet Cleaner in stock. • FURNISHINGS 0 [44"1 1 4 1 FURNISHINGS Parcel #: 022 - 1015 -30 -100 04/12/2007 10:15 AM PAGE 1 OF 1 Alt. Parcel #: 06.28.18.87D -10 022 - TOWN OF KINNICKINNIC Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - RUKA, WILLIAM C & ANGELA MARIE WILLIAM C & ANGELA MARIE RUKA 6525 23RD ST N OAKDALE MN 55128 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 3.329 Plat: 4166 -CSM 15/4166 FKA 15/4105 SEC 6 T28N R18W SW NW FORMERLY LOT 1 CSM Block/Condo Bldg: LOT 1 15/4105 NKA LOT 1 CSM 15/4166 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 06- 28N -18W SW NW Notes: Parcel History: Date Doc # Vol /Page Type 01/31/2007 843646 WD 08/17/2006 832415 WD 10/04/2001 658314 1732/242 QC 10/04/2001 658313 1732/241 W D more... 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/10/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.329 50,000 0 50,000 NO Totals for 2007: General Property 3.329 50,000 0 50,000 Woodland 0.000 0 0 Totals for 2006: General Property 3.329 50,000 0 50,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 843E+L+E+ XATHLEEH H. WALSH State Bar of Wisconsin Form 2 -2003 REGISTER OF DEEDS WARRANTY DEED ST. CROIX CO., WI RECEIVED FOR RECORD Document Number Document Name ' 01/31/2007 11:00AW WARRANTY DEED EXEMPT # THIS DEED, made between Antonio J Choinowski and Hesper L. Choinowsid, husband and wife TRA FEE: 11.00 ( "Grantor," whether one or more), COPY FEE: 252.00 and William C Ruka and Aneela Marie Ruka, husband and wife CC FEE: ( "Grantee," whether one or more). PAGES: 1 Grantor, for a valuable consideration, conveys and warrants to Grantee the following Recording Area described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ( "Property ") (if more space is RETUNT TO: needed, please attach addendum): Assured Title, LLC That part of SW IANWIA Sec. 6- T28N -R18W described as follows: Lot 1 of Certified Survey Map recorded in Vol. 15 of Certified Survey Maps, page 4166 as Doc. No. 1810 Crest View Drive #1 B 656071 Hudson, WI 540165 ��al 022- 1015 -30 -100 Parcel Identification Number (PIN) This Is not homestead property. (is) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated January 30, 2007 (SEAL) (SEAL) * *Antonio J. Chojnowsld (SEAL) (SEAL) * *Hesper L. Chojnowski AUTHENTICATION ACKNOWLEDGMENT Signature(s) authenticated on STATE OF WISCONSIN ) ) ss. ST. CROIX COUNTY ) * TITLE: MEMBER STATE BAR OF WISCONSIN Personally came before me on January 30, 2007 , (If not, the above -named Antonio J. Choinowski and Hesper L. authorized by Wis. Stat. § 706.06) Cholnowski. husband and wife to me known to be the person(s) who executed the foregoing THIS INSTRUMENT DRAFTED BY: instrument and acknowledged ame. Attorne y David J. Estreen E �J_� 304 Locust Street Notary Public, State of Wisconsin NOTARY My Commission (is permanent) (expires: (SI naVrrislAy be a hen ted or acknowledged. Both are not necessary.) NOTE: THIS I D AN ICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ATE BAR OF WISCONSIN FORM NO. 2-2003 Type name below signatures. Q� ,� INFO -PROTM Legal Forms 800- 655.2021 www.intoproforms.com OF gG 656071 KAFHLEEN H. WALSH REGISTER O DEEDS s . CROIX CO. WI RECEIVED FOR RECdRD of SHEET 1 OF 2 SHEETS 09- 06-2001 11:5 A n z o w COPY FEE,: RECORDING FEE: 13.00 v PAGES: 2 T G3 _ w N gv Ds �mo � gc„mz 7C0 o *o0 < oN° ����y O h v rl r by�''� O Z xm m �N r no�coC., z ch g zx n mo "� z� — Z �n yp� y $ m S m� �--� ITT O mr r m �m �O C $ z � �a ro m c M o v = �� N o C, _ o 0 � m z O BEARINGS ARE REFERENCED TO THE o o M EAST -WEST 1/4 LINE OF SEC 6, G�1G°�dQ�'C D � S e L a m,% TO BEAR S88WI4 "E P o V o4a�a� - - - -- ----------- --- -- - 90TH m m - 0 S00 °04'27 ' W 26 ------- - - - -- -` a°o n v _ S0 930. N 8.7�0 a 418.26' 512.44` J O o iv S00°07'52"W 930.70' I I Q 1 03 i� i�OQ y !� N 1 co v I I p I �i �o� io . . . . . m. . . . . . . ►12 I�IO 0 6 6 k1d `� V co n 3 D WEST LINE OF THE = i n i o� m 00 m cg m O w w SW1 /4 OF THE NWI /4 m 3.02' 175.76 Q P w "1 � ni j l°R� 0 I ' 208.78' ti Q° z W .I w A i -� :m 33. 33 S00°04'27'W7���' n w .° .._ - -- w w w � g0'6L1 O a s E�,,3os (o � „t NIo I `a m Q < NI CI o 1 I g °Q' z rev w �id'� i A co po Ico m v �g� S '27 3 — S01 *55'46"W 460.64' (9 -1 '� 33,00' ' 427.64' f4 ty CD m r � : w ��. w w� C 0 r g bi d z I� N - �m m v p >A r d� ��� -� a � � O nn Q A U1 Q 2 j vi m Q I n 33.02' 434.03' NOWVY'51 IN 467.05' U) H Sr Q � °7 � q �F 'J �1 � O M m OLN - V L5o NJ - U'�o CI e � i _n m w 7� z o : co C. �2 c cn 00 ~ a ~ A OD N o? �, m - - -- - ------ - - - --- - I+ EAST LINE OF THE SW1 /4 OF THE NWi /4 20'+ w -- m ^ � C O7'51 "W 872.43' w P o l�J[n�pdQ44C DD dLaG�D OO � ]C D �`I Qo vm[RpR@) I+ a Po V01.15 Page 4166 CERTIFIED SURVEYORI SURVEY MAP DOUGLAS J. ZAHLER S & N LAND SURVEYING INC. LOCATED IN PART OF THE 2920 UDSON, WI 54016 SF1 14 OF THE NW OF PREPARED FORS SECTION 6, T28N, R18W TONN OF KINNICKINNIC, ST. CROIX 220 LIVESTO 0 FREDERICK XCZ COUNTY, WISCONSIN. EXC HANGE BUILDING ST. PAUL, MN 55075 SURVEYOR'S CERTIFICATE I, Douglas J. Zahler, Registered Wisconsin Land Surveyor, hereby certify that by the direction of Frederick Lenertz, I have surveyed, divided and mapped a part of the SW1 /4 of the NW1 /4 of Section 6, T28N, R18W, Town of Kinnickinnic, St. Croix County, Wisconsin; Described as follows: Commencing at the W1/4 corner of said Section 6, thence S88'04'14 "E 208.78 feet along the East —West Quarter line of said Section 6 to the point of beginning; thence continuing along said East — West Quarter line, S88'04'14 "E 685.98 feet to the southwest corner of Lot 1 of a Certified Survey Mop recorded in Volume 3, Page 735 at the St. Croix County Register of Deeds Office; thence N00 "W 467.05 feet along the west line of said Lot 1; thence S88 "E 467.05 feet along the north line of said Lot 1 to the east line of said SW1 /4 of the NW1 /4; thence NOO'07'51 "W 872.43 feet along lost said east line to the north line of said SW1 /4 of the NW11/4; thence N89 "21'12 "W 844.34 feet along lost said north line to the northeast corner of that parcel described on a deed recorded Volume 601, Page 337 at said office; thence S00 "W 170.01 feet along the east line of last said parcel to the southeast corner of last said parcel; thence N89 @21'12 "W 512.03 feet along the south line of last said parcel, and the south line of that parcel described on o deed recorded in Volume 449, Page 596 at said office, to the west line of said SW1 /4 of the NW1 /4; thence SOO "W 930.15 feet along lost said west line to the northwest corner of that parcel described on o deed recorded in Volume 445, Page 551 at said office; thence S88 "E 208.78 feet along the north line of last said parcel; thence S00'04'27 "W 208.78 feet along the west line of lost said parcel to the point of beginning, Above described parcel contains 33.299 Acres (1,450,509 Sq. Ft.) Parcel is subject to town rood right —of —way (Tower Rood and 90th Street) and all other easements, restrictions and covenants 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 mopping same. ,�� o W1S °O Douglas J. Zahler RLS 2145 'L S& N land Surveying y DO S J 2920 Enloe Street Hudson, WI 54016 4 I 9.S -v suFN 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. NOTE: THIS CERTIFIED SURVEY MAP IS INTENDED TO REPLACE THAT CERTIFIED SURVEY MAP RECORDED IN VOLUME 15, PAGE 4105, DOCUMENT NUMBER 647129. THIS INSTRUMENT DRAFTED BY: WILLIAM KANE JOB NO. 6000-01 DATE: 01/29/2001 REVISED 09 /05/01 SHEET 2 OF 2 SHEETS V01 ,1 5 Page 4166 Z A) r SURVEY ORU � ls C� �I . 9 200 �,I k 65G►071 a KATHLEEN H. WALSH REGISTER OF DEEDS E . CROIX CO. WI COUNTY RECEIVED FOR RECORD o = SHEET 1 OF 2 SHEETS 09- 06-2001 11 :45 AN cu C/) COPY FEE: Z ; RECORDING FEE: 13.00 rn PAGES: 2 Z x 0 �tJ - 10 m ;0 1 8 0 S C ^ m� Ca n Z ozccn O hi n ) - O \ 1 °m Z �� �� ,v O D �o2'QIn�J n o m ucn cn c o m a)m < m O m � O � � d a) m �7 �r z Zx �cn �° m p BOO "� LJ m '° m< KC Z m ;0 n rrlC� o Z oo �� ?z � %4 o 0 O cp m m z -{ -0 z m tl o r m c m � p CIO O 1,I�y� m i z --n z �� 'y S 2 w O Z m N Z K n m z BE ARE REFERENCED TO THE O - EAST - WEST 1/4 LINE OF SECTION 6, co 0 0 C� ASSUMED TO BEAR S88 °04'1 4 "E 1 g ----- - - - - -- m A OO 1�1f1v1CD o W Q)UM 02 90TH_STREET o J m n m n - - - -- S00 0 04'27 "W 26 46.01' -- ao n O O ?� 70 W SO °04 "W 930. _ _� 8. 417.84' 5 12.3 _ .�— I N 416.26 m 512.44' N I c N S00 °07'52"W 930.70' C 9 i O j I // �/O to ° N N w N zi p I I O 00 °� 0'. �,' N WEST LINE C; THE 66' ,���� cJO N n L" n ( �C C A) w SW1 /40F THE NWI /4 mM— m "� CA) I m cn c' cn --� °� m -+ I 3.02' 175.7 M i m 208.7$' ti ° Q� z W �' v w w .�-- - - - --� 33' 33 SOO °04'27 "Wr �3�4F r w a w i I �� N w 28 90'eLl �, 10 I ' Nla � Q W � D � � S `S' 3 „L4,E (D O 7 0° m 'i 00 cn cn c m —� H I I lJ I CD QQp z N 1 �I�, m o OD `” s 00 0 04'27 i� 9 � 3± S01 * 55'46"W 460.64' w d 0 33.00' ' 427.64' 1 w w W �} 00 g W m to w �+. "1 p Q Z °D D� D w orb N.r1 O I to w a m 8 r w w o Da D f ' rn M. I N� �mcn m 0 J CO c m m 0 !y I� A 0 O Q p Z ,s „Q w o c/) w n m r Z I� �C, 0 .. - p�'Q Z p �„� m aD o 33.02 434.03' .i m I m NOW07'51 "W 467.051 S T N co cn qr + o 03 AF @.I - - -1 j v 0 0 r%),, cn m 6 110 m c- O� p 0) 6 6 , "`S` N y � x m r A O T U 1 00 ^� I+ EAST LINE OF THE SW1 /4 OF THE NW1 /4 20 1 cp 4 C4 m -------- - - - - I - - -- - - - lcn�: , X X — x —x 00 °7'51 "W w M o MGvJPdLa44GD BAH [m @)m CAD o �'I ®�t'G�]1RR% I+ --------------------------------- ------- - - - - -- v„I � s pano u1 �a 4 . 192001 THIS INSTRUMENT DRAFTED BY: WILLIAM KANE JOB N0, 6000 -01 DATE: 01/29/2001 REVISED 04/18/01 cn MU�Jp�tr��D dQ[�D� S m OO/[C D 04aIG°�� 90TH STREET m n m p SO0 °04'27' W 26 46.01 n 0 S0 0 0 4'27 "W 930. o� 8 7 417.sd' i � N N 418.26' 512.44' N I I K) o N 1 S00 °07'52 "W 930.70' W �� i�0 1 N to (n N 1 I�IO I , CD j g WEST LINE OF THE I I D I 1 0 ' a w 04 •� y ^ ? ' rn 8 C SW1 /4 OF THE NW1 /4 I I m 6 6 '' ti 7 m m m O o W 13 j l°J21 1 D I 3.02' 175.76 cn cn c_n -��� m 01 208.78' S S Q ° - z W w N 00 ':r=-== `` = =-t 33 33' S00 °0 4'27 "W `�` '� _ I 1 0 c� w N I I Q rn rn 1 ° �g L9Z 3 „L f;� °SOS TILED I o I I P. o �, W w JON 0 1 2001. 01 12' N m oo p C C W o c, -1 W j I C� 09. '�� Z � I I � m � OD cJ S00 °04'27” 3,+ 1 S01 °55'46 "W 383.39' w W 33.00' : 350.39' w N N I� P A V m A A � A A 7 Nnl 01) oDi D r w o`er+ - OI n w n — D D O 2 o C (1) C ) L- 0 o J U1 (n co mi A_ Cn p Q z pp \ N 1 1 389.80 I 33.02' 356.78' 7.25' d o m ± c� T♦ 434.03 o ?. N cn I m N00 0 07'51 "W 467.05' `— 9I M M ��11 C v a z 0H V 0L7D P@. U 0� O m 1 D n j O ' > M m ----------------- - - - -.a �"�� z w t r c z u� o °ter_ z OD OD w o ? uT �; ri K 0 ° 01 6 61 v 6w � x 0 N EAST LINE OF THE SW1 /4 OF THE NW1 /4 20 ---- ------ - ------ ---- I x X 00 °7'51" 872.43' w 03 UHDDD�QUUCD RAHD@ R I+ ----------------------- CA) OO WHIM o ly OO UHIE @ OD R ® �-- Z j R x . O N 3 iD ? m N N BEARINGS ARE REFERENCED TO THE 0? m a O C7 EAST -WEST 1/4 LINE OF SECTION 6, m 0 ASSUMED TO BEAR S88 °04'14 °E 0 m n '�] O h zz c, Z cn f1b =A z'm z rrri n���y� y M m <n Z _ N c d O �+ I O '�' �r N m z cz � om ny0 � y n O mr �6 ° m �n�pt� b M C O Om C �n gG)�� "0 N G) U)c N � 1r1 np'y0� -„ z o o C/) o °o d "" 'sj ''rJ 'A d 0 co o °z 1� o y O y 1 � m o m ; " �+ Vol. 15 Page 4105 CY) nI co UNTY PLANNING & ZONING EROSION & SEDIMENT CONTROL PLAN Site location: 918 Tower Road, Lot I of CSM #656071, Town of Kinnickinnic Owner(s): William and Angela Marie Ruka { Parcel ID #06.28.18.87D -10 Code Administ 715- 386 -4680 r 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." In Land Informatio addition, Wisconsin Uniform Dwelling Code Comm. 21.125 requires the building permit Planning applicant and /or landowner to follow erosion control procedures and maintain them until 715- 386 -4674 the site has been stabilized (Uniform Dwelling Code Comm 21 is available on -line at: www. commerce. state. wi .us /SB /SB- DivCodesListing.htmi) Real Property 715- 386 -4677 The Owner of the above parcel is responsible for notification of all contractors performing construction activities on this site that an Erosion & Sediment Control Plan is in effect and the Recycling following activities will be required in order to maintain compliance with the plan: 715 -386 - 5 1. Maintain existing vegetation wherever possible to minimize erosion and sediment movement. The primary source for construction site runoff will be the house foundation and driveway excavation, well drilling, and soil stockpiled until final grading and stabilization is complete. Septic system installation adds to temporary disturbance, but establishing cover on exposed soils will prevent erosion. Apply seed and mulch as recommended in #5 below. 2. Install construction entrance before any excavation begins!! 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 require access to the property during construction. 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. I 3. Do not allow contaminated runoff to be directed onto neighboring property or into surface water conveyances. Create temporary diversions graded ALONG CONTOUR between excavated areas and any potential receiving waters (this includes driveway & road ditches) by routing contaminated runoff into vegetated buffer areas on owner's property. (A specification sheet for temporary diversions is available from county). 4. It is likely that contaminated runoff will not be contained with temporary diversions, so installation of approved sediment control products (straw wattles, silt fence, etc.) as shown on engineer's site plan will be required. The POWTS inspector and /or building inspector will evaluate ESC plan effectiveness and recommend additional action required to comply with applicable regulations. Control measures should be installed prior to mound plowing. ST. CROIX COUNTY GOVERNMENT CENTER 110 1 CARMICHAEL ROAD, HUDSON, W1 54016 715386 -4686 FAx PZC>CO.SAINT-CROIX.W /.US WWW.CO.SAINT-C US Page Two — ESC Plan Acknowledgement Form 5. bilize exposed soils (septic system included) with seed and mulch immediately after installation - DO OT wait for final stabilization and/or landscaping of entire site to establish permanent cover on the site. n late- season weather conditions will not permit seed germination, a heavy straw mulch cover will pre erosion until vegetation can be established. Erosion control matting can be applied any time of year and tailed properly, will provide protection even if seed germination is delayed. The owner rd during site construction will be responsible for compliance with state and county code requirement pecified in this Erosion & Sediment Control Plan. Please feel free to contact me with questions regarding ero & sediment control product installation. PLAN PREPA BY: RYAN YARRINGTON, SOIL EROSION INSPECTOR #683475 Owner ac wiled ement of ESC Plan requirements: 3//2009 (Please and return original ESC form to Planning r & Zoning Dept. A copy is attached to the owner's permit and mair'iance agreement, which is given to the plumber at time of permit issuance.) ovide copies for excavation contractor, plumber, and town building inspector as needed �w Sr. CRO1X COUNTY GOVERNMENT CENTER 1 101 CARMICHAEL ROAD, HUDSON W1 54016 715- 386 -4686 FAX PZ@CO. SA /NT- CR01X. W1. US W W W.CO.SAINT -CROM W I. US I __