HomeMy WebLinkAbout022-1019-10-040 Wisconsin Department of CP nmerce County:
PRIVATE SEWAGE SYSTEM St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No: 405086 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:Q
Robe ,Ran I Kinnickinnic Township 022- 1019 -10 -999'
CST BM Elev: Insp. B I IBM Description:
1 ' l � ' N ova-) --f -Fj c. C45 sr EIM
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark 1
Dosing d� Alt. BM �,p Zr
Q e -S q
Aeration Bldg. Sewer 13-9
`
Holding St/Ht Inlet
� b
St/Ht Out
TANK SETBACK INFORMATION
TANK TO /L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
� O
Septic / J I f Tr %5r.
25 / Dt Bott . 71-4 1 4, o
Dosing ✓ Header /Man.
Aeration Dist. Pipe
Holding Bot. Syst m !
(� .0 a
Fin a Grade
PUMP /SIPHON INFORMATION P
Manufacturer Demand St Cover vy c}
GPM I - �y 7"6
Model Number /L'j �� C
r �L / (O
TDH Lift Friction ss� S 1 TDH t
Forcemain Lengt Dia. �/ Dist. to Well 71
Qof Id
SOIL ABSORPTION SYSTEM
BEDITRENCH Width ILength No. I Of Trenches PIT DIMEN NS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS
SETBACK SYSTEM TO P/L BLDG IWE LL LAKE /STREAM L G Manufacturer:
INFORMATION Type Of System: �) CH ER OR
1 \ 4n" d 25 / t I � U T Model Number:
DISTRIBUTION SYSTEM j >S , pt e3 / 1 a 4 e r -
Header /Manifold Distribution x Hole Size x Hole Spacing VftoA!r take I Pipe(s) / / '/ � 3 1 I Length Dia Length
Dia Spacing 7 g
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over Depth Over xx Depth of eeded /Sodded xx Mulched
T
Bed/Trench Center lBedfTrench Edges Topsoil r
; J Yes � No L _1 Yes D No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #11:, / 1 2 Inspection #2:/�/
Location: Unknown (NE 1/4 SE 1/4 3T�28N R18W) NA Lot 3 � Parcel No: 07.28.18. '
1.) Alt BM Description = 1 --r— If of 7p �'^vt• (UQ J1 �s� -4r> -
�iz
,oar 2
2.) Bldg sewer length= 'Z,Lj
- amount of cover
3.) Contour
G� -- -
Plan Use other formation. de for additional �n Yes /No
_ " __ I
I�
SBD -6710 (R.3197) Date Insepctoes Si nature Cart. No.
III E40 Series
4/10 HP Effluent
and Crain Water Pumps
Performance Curve
MODEL ME40 EFFLUENT PUMP
CAPACITY LITERS PER MINUTE
0 50 100 150 200 250 300 350
40 12
35 a
10
30 m�
i' H 25
Z
20 6
O 4
10
2
5
a
0 L I I
0 10 20 30 40 50 60 70 80 90 100
CAPACITY GALLONS PER MINUTE
F.E. Myers, A Pentair Company • 1101 Myers Parkway, Ashland, Ohio 44806 -1923
419/289 -1144 FAX 419/289 -6658 Telex 98 -7443
���1 "1 Y�ttYt
K3326 7/91 Printed in U.S.A.
3 `f C.T:44 _ A SS
' Sanitary Permit Application Safety & Buildings Division
In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave.
See reverse side for instructions for completing this application 15 Box 7302
lViscons Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302
Department of Commerce [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not
S i h Z- 4115 state owned.)
Attach c omplete p ans (tb the county copy only) for the system, on paper not less than 8 -1/2 x 11 inch in size.
County State Sanitary Permit umber ❑ Check if revision to previous application State Plan I. D. Number
C D 22 /S a'a45. /Q,#
I. Application Information - Please Print all Information Location:
Property 0 Name) �/ RECEIVED Property ' P / Location Q
17 !V 9 �i 451/4 ,5* 1/4, S To�J,N, Ij�(
Property Owner's Mailing Address Lot Number Block Number
1 3 F LtIv v C-n/ o zoo2 3
Ci , State Zip C ode ST. il'WKeG Subdivision Name or S Number '
f, 5 » Z Z NING OFFICE 0 2 07/ Z 7
I. Type of Building: (check one) s rae s,. t..r. . . ❑ City 10
❑ 1 or 2 Family Dwelling -No. of Bedrooms: ❑ Village
❑ Public/Commercial (describe use):_
R Town of
State -Owned 1t Y1VAYC /-rlNA/j C
q Nearest Road
X 4 e w 3 ���
c o
Parcel Ta
Number(s)
III. Type of Permit: (Check only one box on line A. Check box on line B if applicable)
A) 1. RWew 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to
System System Tank Only Existing System
$)
11 A Permit Number Date Issued
Sanitary Permit was previously issued
IV. Type of POWT System: (Check all that apply)
-toW
❑ Non - pressurized In- ground ound ❑Sand Filter ❑Constructed Wetland
❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line
❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other:
V. Dispersal/Treatment Area Inform
1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade
7 uired Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) c� Elevation
VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic
Information Gallons Gallons Tanks Con- Con- glass
New Existing crete structed
Tanks Tanks
G gob ❑ ❑ ❑ ❑
VIII. Responsibility Statement
I, the undersigned, assume re sponsibility for installation of the POWTS shown on the attached plans.
Plu ber's Name (print) Plum r' Signature s MP3 PR9-No. Business Phone Number
Dew - 22(o Y9 7 z7�- 54V
Plumber's Address (Street, City, State, Zip Code)
6 C L� w p-n -�- 1�- 0
IX. County/Department Use Only
❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued ss d ing Agent Signature (No stamps)
�I Approved ❑ Owner Given Initial AdverseSurchar Fee)
Determination 3
X. Conditions of Approval /Reasons for Disapproval:
SBD -6398 (R. 07/00)
PLOT PLAN
Scale 1 "= SQ •Page I of
a
L.v T Z
• p J
r
�� o _ o� ' 8� r� ► 00 LOT 1.1 wE U8 6.9 0 o
�olo� cz; i J -
f 0 � <
of r2
N
Op �j c ito w1 E
� o K--)o-r Cr�tj f>lo j Oyt-
p lS NVz g ,fit Lg t1 yZLs A
. DoT 3 i
NOTES.- - - - � --
1. Elevations shown are existing ground elevations unless
11 4 observation pipes with a otherwise noted.
2. Install approved caps. ( Z required).
3. Septic tank to bet
3-�U /SOD gallon capacity manufactured by
w t��Z e.Qry (:�Z•��'E. w� lg -ISOp Zt�2Z F � Z
4. Bench marks S
,l
5. Divert surface water around system to prevent ponding at the uphill 'd
p si e.
I /
Safety and Buildings
4003 N KINNEY COULEE RD
RECEIVED LA CROSSE WI 54601 -1831
TDD #: (608) 264 -8777
iscons�n www.commerce.state.wi.us /sb
Department of Commerce
MAY 1 0 2002 wmmisconsin.gov
STI CROI COUNTY Scott McCallum, Governor
Philip Edw. Albert, Secretary
May 07, 2002
CUST ID No.267341 A7TN: POWTS Inspector
ARTHUR L WEGERER ZONING OFFICE
WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA
PO BOX 74 1101 CARMICHAEL RD
RIVER FALLS W1 54022 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 05/07/2004 Transaction ID o IdeD Y o ' " bets
. 73211
SITE: Site ID No. 64432
Ryan Robey Residence Please refer to both identification numbers,
County Hwy SS above, in all correspondence with the agency,
Town of Kinnickinnic
St Croix County
NEIA, SETA, S7, T28N, R18W
Lot: 3,
FOR:
Description: Four Bedroom Mound System
Object Type: POWT System Regulated Object ID No.: 850471
J YP Y g J
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in
chapter 101.01( 10), Wisconsin Statutes, is responsible for compliance with all code requirements.
The following conditions shall be met during construction or installation and prior to occupancy or use:
General Approval Requirements:
• This system is to be constructed and located in accordance with the enclosed approved plans and with the
"Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /O1)
and the 'Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION
2.0" SBD- 10706 -P (N.01101).
• 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
litdih� requirements of Sec. 145.135 and 145.19, Wis. Stats.
'ROv ,cD Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the
1wT� designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat
C OMMERCr<
RC6 Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be on -site during construction and
o en to inspection by authorized representatives of the Department, which may include local inspectors.
'D�OENCE
ARTHUR L WEGERER Page 2 5/7/02
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 $ 175.00
Fee Received $ 175.00
Balance Due $ 0.00
3
Charles L Bratz
POWTS Reviewer lI , Integrated Services WSMART code: 7633
(608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday
cbratz@commerce.state.wi.us
cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544
TITLE SHEET Page ! of - 7
MOUND SYSTEM
FOR
A BEDROOM RESIDENCE
This plan has been prepared in accordance with the Mound Component
Manual SBD- 10691 -P and the Pressure Distribution Manual SBD - 10706 -
(N.01 101) (N.01 101)
LOCATED IN THE NE 1/4 OF THE S 1/4 OF SECTION - 7 , T 2 8 N, R ) 8 W,
TOWN OF �` jk " I(sW jly ti) C SZ : 0-e-6 Ix COUNTY, WISCONSIN.
INDEX
PAGE 1 of 7 TITLE SHEET
PAGE 2 Of 7 SYSTEM MANAGEMENT PLAN
PAGE 3 of 7 PLOT PLAN
PAGE 4 of 7 PLAN VIEW -CROSS SECTION
PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT
PAGE 6 of 7 PUMPING CHAMBER CROSS SECTION
PAGE 7 of 7 PUMP PERFORMANCE CURVE
PREPARED FOR RECEIVED
MAY - 6 2002
SAFEW & BLOGS DIVIK
PREPARED BY
WEC3EF<EF2 E30 I L
AND .
DES I (SM SEFRW I CE
P.O. Box 74 421 N.Main St.
®wa
River Falls, WI 54022 ®p,�
Phone 715- 425 -0165 0 00,'10)vs �1►
Fax 715- 425 -6864 ®"�,••'"" "••••. ® �i ;
VVEG
YI L 9is P
ELLSWOHT�
Cc a!� tiyS
i
V te i
SEE COR
JOB NO. OZ -C1 0
Mound System Management Plan --�
Page of
Pursuant to Comm 83.54, Wis. Adm. Code Z
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the
septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and
outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to
ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that
may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if
the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The
septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of
the tank If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise
the owner 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, Safety and
Buildings Division.
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 S stem
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 for frost protection.
Influent quality into the mound system may not exceed 220 mg /L BOD5, 150 mg/L TSS, and 30 mg /L FOG. 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 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring.
General
This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its'
component manual �i�P 6f99jj and local or state rules pertaining to system maintenance and maintenance
reporting. 'S SID
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.
Contingency Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the
system in proper operating condition.
If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component 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 adsorption
and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper
operating condition.
Questions about the operation or maintenance of this system should be directed to:
The County Zoning Office at 14680 �r Q-VLO `<
The system installer at s
The tank manufacturer at �pO - 3.zS F- S6 vI.�IzL1Z
The effluent filter manufacturer at S - )qz - Zp Q
The pump manufacturer at -- -. la - Zkg' = I l qy- V l uj�12$
PLOT PLAN
Scale 1" = ' 'page 1 of
r
LIJ
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. L
J
r
\ f —
AU O 1--
r a , �� �• U
as
\ S' o F
y`(P�jc ttc3 E
� 0 K_30 CD&j P j OYL
p Ls -B TirLS ftgk- q
� 3
DT
N. > SO I FU wl h1 U ZS FEU W( wiz .
u �Z tU 100.0 Orj l Pt PE.
NOTES:
1. Elevations shown are existing ground elevations unless otherwise noted.
2. Install 4" observation pipes with approved caps. ( Z required).
3. Septic tank to be 12. /�00 gallon capacity manufactured by
I-,i "pj w / A -4Y 0o ZP�F-L F i L`�
4. Leach marks
5. Divert surface water around system to prevent ponding at the uphill side.
Page q
Approved Synthetic Covering
ASTH C33 Distribution Pipe
Medium Sand
Topsoil - - - Ic �
p — - -- F El ev.
E -
3 `
b
�. % Slope
Distribution Cell of Force Main Plowed
2" to 2- Aggregate From Pump Layer
/D 1 . 3 y Fr
E 0 Ft.
CROSS SECTION OF A MOUND SYSTEM F O ea Ft.
G 0• S Ft.
A _9 Ft. P. 0 Ft.
Linear Loading - Rate M - 5GPD /LN FT B 61 Ft.
Design Loading ..Rate= 0.39 GPD /SQ FT I l y Ft.
J - 7 Ft.
K \Q Ft.
Alternate Position L 16'1 Ft.
of -
Force Main W 3 Ft.
I
- Observation Pipe
- -------------------- --------- - - - = -- - - - -�
Ac— �-- - -� 8 - - -- --- - - = - -- -------- - - - - -- --- - --
F 0 rce Main
�� Dstribution i
Pip ,�
Ir Cell of Z to 2
Pipe
ag gregate
Observation Pipe
(Anchbr securely)
PLAN VIEW OF A MOUND SYSTEM
Distribution Pipe Layout Page of
Place the holes at the bottom of the distribution pipes
at equal spacing. Remove all burrs from the pipe and holes.
Extend the end of each lateral up with the use of long turn or 45 ° fitting to a point within six
inches of the final grade. Terminate the ends of the laterals with a valve,:threaded cap or
. threaded plug. Provide access from final grade for the valve, threaded cap or threaded plug.
-
-77t P_ L .. C\-ZZS S _ - SIZC- - nQ ),7
PVC. p�jy
Lateral Manifold C
Lateral
X x x x x!2 I xf2 x x x I x
Lateral Length — Lateral Length —
Distribution Line
• � —� � t�C� �OjS
— — o
h t3'1J 1 Fc7 �
S
o --
- �
P 31. Ft. Hole Diameter 1 �� Inch
S 3 Ft. Lateral ) Inch(es)
X 31 6 Inches Manifold Z Inches
Force Main " Z Inches
# of holes /pipe 1)
Invert Elevation of Laterals M. Ft.
llY -Q1,g1 = 4.3(x Grp
Combination Sept,3c;Tank and
PUMP CHAMBER CROSS SECTION AIJD SPECIE {CATIONS ' PAGE G OF
VENT CAP � ' WEATHER PKOO)r
JUAJCTIOAJ BOX
ti C.I. VCMT PIPC APPROVED LOCKIPJG
210' FROM DOOR. MAIJHOLE COVER IAJIV
,AWDOW OR FRESH Z wAt-tJlQG LABEL.
�3P�CppN PIPE S . cot�pulT
' J 1Prt -n a - T - e4rp A.Laj JJ TA I
FI W Is
Iry E Z t
i
IIJLET �" PROVIDE I —
„ �AiRTIGHT SEAL I I
8 tyS =Fl_C 1
Approved zf8�. r-ic A I Approved
joint W/ _ ��00 I 11 1 joint W/
PVC pipe ALMA PVC pipe
6 �I 11
I
i ou
C I
CLEY. fL — T
I OFF
C OUCR.ETE
1 BLOGK
- RISER EXIT PERM11TED OQLy IF TANK MAIJUFACTURER HAS SUCH APPROVAL 3 "RPPRot�.
BFOD s N4
SEPTIC F SPEC.IFICATIOUS
DOSE
TAWKS MAAJUFACTU;Lr �Z C 1JUMbER OF DOSES: S •� PER DAB
TAA.MK 51ZL: GALLOUS D05E VOLUME r l`
ALARM MAIJUFACTURI`R: `T��- O S�(ST��/ S INCLUDING 6ACKFLOW: GALLON:
MODEL LIUMBER: L1` CAPACITIES: Ac �8 L{p0,3
IAJCHCS OR GALLONS
SWITCH TyPG: — " �2�� -Y 8 =�_ IIJCHES'OR �� " G�LL01.1S
PUMP !"IANUFAGTURCK: � Li C = � INCHES OR t3 3 •� GALLONS
MODEL MUMHER: F" 33
DE �_ INCHES OR —_L GALLONS
SWITCH TYPE: C-UV DOTE: PUMP AND ALARM ARE . cz)00.6
MIAJIMUM DISCHARGE RATE 2 b GPM INS7AlLED L)Q SEPARATE CIRCUITS
VERTICAL DIFFERENCE DETWEEIJ PUMP 0",J .- O15TR16UTIOIJ PIPE..
+ MIAJ IMUM METWORK SUPPLY PRESSURE , , , , , , , b -SO FE
+ l�s FEET OF FORCE MAIN X 1 k' Z F YoFLFRICTIOU FACTOR 2 - FEET
TOTAL DyWAMIC HEAD = 6 3 �' FEET
As per manufacturer Z,'- gal /in. Liquid depth 36 y
(N GE - 7 o t 7
ME Series M"M
1/3 through 1 -1/2 HP
Effluent Pumps
Performance Curve
CAPACITY LITERS PER MINUTE
0 50 100 150 200 250 300 350 400 450
i 1
100
90 28
.80
24
70 W
W Op 20 2
60 Z
z 0
w 50 MFjs 16
= J
40 M�$0 12 O
p H
H
30
6.3b 8
20 ME33
10 2`1. 6 4
0 0
0 10 20 30 40 50 60 70 80 90 100 110 120 130
CAPACITY GALLONS PER MINUTE
• 1101 Myers Parkway, Ashland, Ohio 44805 -1923
419/289 -1144 FAX 419/289 -6658 Telex 98 -7443
K3327 8/92 Printed in U.S.A.
B� s -a/ -a i
Insin Department of Commerce SOIL EVALUATION REPORT Page of
R • v Division of Safety and' Buildings
in accordance with Comm 85, Wis. Adm. Code
T • e` �,
Attach complete site plan on paper not Jess 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. �vD)AJ 6
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information Revi we by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). I 's
Property Owner Property Location
AZT Z Gaut._LaL N E 1/4 S E 1/4 S T Z f8 N R L E (or W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
P• o - L -(z X ZC1 - Z 3 - �z o�os Eb c_
City State Zip Code Phone Number E] City E] Village 0 Town Nearest Road
t'cU L >✓t N S (61 7-) - 7 '23 -10 8 - 7 `rc l I�11J 1 C 1�! Q rV I '-':T 1 , Ss ,
®. New Construction Use: ® Residential / Number of bedrooms Code derived design flo te 0 Q GPD
E] Replacement F] Public or commercial - Describe: >
Parent material __ G L �� L �• l.l. Flood Plain elevation if a ble
General comments .;
Y r .
and recommendations: 0h/� U cj
i ' ) b `` bF S f� LL ppnX i
� C)J
❑
Boring # Boring (
� ` pit Ground surface elev. qq Z ft. De P th to limitin 9 factor
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
@• -2 -�f LO`l (2-
'r/1'
F Boring # ❑ Boring
® Pit Ground surface elev. ft. Depth to limiting factor Z.Z 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. 'Etf#1 I 'Eff#2
Z g -ZZ l0Y /L 3� - S i � Z`FSb k h�'F1- CS � • S . $
3 2.Z -qo - y.s`123t Z.sLY tZslB stcJ les6k m - 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) S'p riatyre CST Number
Arthur L:. Wegerer 4. ` 220254 '
Ad dress W e g e r e r Soil T e s t i n g & Design Service Date Evaluation Conducted Telephone Number
421 N. Main St. River Falls, WI 54022 715 - 425 - 0165
I�
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- Boring # ❑ Boring
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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.
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ANGi �C) F
EROSION CONTROL RECEIVED
MAY 1 6 2002
FOR HOME BUILDERS ST CROIX COUNTY
ZONING OFFICE
Controlling Erosion 'is Easy
Erosion control is important even for home sites of an
acre or less. The materials needed are easy to find and
relatively inexpensive —straw bales or silt fence, stakes,
gravel, plastic tubes, and grass seed.
6 � y
Putting these materials to use is a straightforward pro -
3 l cess. Only a few controls are needed on most sites:
• Preserving existing trees and grass where possible to
prevent erosion;
• Silt fence or straw bales to trap sediment on the down -
slope sides of the lot;
By controlling erosion, home builders keep our streets • Soil piles located away from any roads or waterways;
and waterways clean.
• Gravel drive used by all vehicles to limit tracking of mud
onto streets;
Erosion Is a Costly Problem
Eroding construction sites are a leading cause of water * Cleanup of sediment carried off -site by vehicles or
quality problems in Wisconsin. For every acre under con- storms;
struction, about a dump truck and a half of soil washes . Downspout extenders to prevent erosion from roof
into a nearby lake or stream unless the builder uses ero- runoff; and
sion controls. Problems caused by this sediment include:
k Local taxes— Cleaning up sediment in streets, sewers and • Revegetating the site as soon as possible.
ditches adds extra costs to local government budgets.
Dredging —The expense of dredging sediment from lakes,
harbors and navigation channels is a heavy burden for
taxpayers. This fact sheet includes the diagrams and
Lower property values— Neighboring property values are step -by -step instructions needed by builders
damaged when a lake or stream fills with sediment. on most home sites Additional controls
Shallow areas encourage weed growth and create may be 'needed for sites that have, steep
boating hazards. slopes, are adjacent to lakes and streams,
Poor fishing —Muddy water drives away fish like north- receive a lot of runoff from adjacent land,
ern pike that rely on sight to feed. As it settles, sediment or are larger than an acre.
smothers gravel beds where fish like smallmouth bass find If you need assistance, contact your local
food and lay their eggs. building inspector or erosion control office.
Nuisance growth of weeds and algae— Sediment carries
fertilizers that fuel algae and weed growth.
GWO001 Erosion Control for Home Builders. Additional copies are available from Cooperative Extension Publications, 30 N. Murray St., Madison, WI
53715, 608/262 -3346 or DILHR, Local Program Services, P.O. Box 7969, Madison, WI 53707 -7969, 608/267 -9360.
i
Erosion Cont
For Ho"
STRAW BALE or SILT FENCE
Put up before any other work is done.
• Install on downslope sides of site parallel to contour of
land.
• Extend ends upslope enough to allow water to pond 1
behind fence.
• Bury 8 inches of fabric in trench (see back page). I I
• Stake (2 stakes per bale) SAMPLE EROSION
• Leave no gaps. Stuff straw between bales or overlap sec- C ONTROL PLAN I \ \
tions of silt fence. FOR 1 OR 2 i iL
FAMILY
• Inspect and repair once a week and after every V2 inch DWELLINGS i
rain. Remove sediment if deposits reach half the fence
height. Replace bales after 3 months. \
• Maintain until a lawn is established. i \ I
\ I
SOIL PILES
• Locate away from any downslope street, driveway,
stream, lake, wetland, ditch or drainageway. TD
• Temporary seed such as annual rye or winter wheat is D /
recommended for topsoil piles. AREA TO BE roPSOILED, i
SEEDED AND MULCHED
BY OWNER AT THE
GRAVEL DRIVE COMPLETION OF HOUSE
I GARAGE
• As soon as possible, install a single access drive using CONSTRUCTION ITD TDI
2-1 3 inch aggregate.
• Lay stone 6 inches deep and at least 7 feet wide from
s FFY
the foundation to the street (or 50 feet if less). O \� s
• Use to prevent tracking mud onto the road by all rD �
r
_. vehicles.
• Maintain throughout construction.
R/W LINE r — w+s ,'•
1 1 Vr'
SEDIMENT CLEANUP
• By the end of each work day, sweep or scrape up soil SOIL TYPE: SILTY CLAY STREET NAME
tracked onto the road SLOPE: 3%
• By the end of the next work day after a storm, clean
up the soil washed off -site.
SEWER INLET PROTECTION
• . Protect on -site storm sewer inlets with straw bales, silt
WARIVING� `measures may be need6&
fences or equivalent measures. your'ste�_
wi • Inspect, repair and remove sediment deposits after every • IS`
-300 feetof a stream or wetland
storm. • Is wthm .1000 feet of a lake
•Has <a waterway or ditch
DOWNSPOUT EXTENDERS • Is steep (slopes of 12 or more)
• Receives runoff from 10,000 sq. ft. or more of
• Not required, but highly recommended. adjacent. and
• Install as soon as gutters and downspouts are completed Has more than an, acre of disturbed ground:,
to prevent erosion from roof runoff. Forinformation�'on appropriate measures fore"
• Use plastic drainage pipe to route water to a grassed or these sites, call yourrlocal building inspector or
Paved area. erosion control office.
• Maintain until a lawn is established.
rol Practices
ie Sites
PRESERVING
EXISTING VEGETATION
• Wherever possible, preserve existing trees, shrubs, and
other vegetation.
• To prevent root damage, do not grade, place soil piles,
or park vehicles near trees marked for preservation.
EROSION • Place plastic mesh or snow fence barriers around trees
CONTROL PLAN LEGEND to p rotect the area below their branches.
PROPERTY
LINE
N _ _ EXISTING REVEGETATION
TOPSOIL DRAINAGE Seed, sod or mulch bare soil as soon as possible.
— T TD TEMPORARY
DIVERSION
DRAINAGE FINISHED SEEDING AND MULCHING
SWALE DRAINAGE
• Spread 4 to 6 inches of topsoil.
LIMITS
— - — GRADI GF • Fertilize and lime if needed according to soil test (or
SILT apply 10 lb. / 1000 sq. ft. of 10 -10 -10 fertilizer).
' • FENCE • Seed with an appropriate mix for the site (see table).
STRAW • Rake lightly to cover seed with I /a " of soil. Roll lightly.
BALES • Mulch with straw (70 -90 lb. or one bale per 1000
GRAVEL sq. ft.).
CONSTRUCTION VEGETATION • Anchor mulch by punching into the soil, watering or
ENTRANCE/EXIT SPECIFICATION
by using netting or other measures on steep slopes.
TREE • Water gently every day or two to keep soil moist. Less
PRESERVATION
watering s needed once
g grass is 2 inches tall.
I STOCKPILED
SOIL
SODDING
SCALE: V= 40' • Spread 4 to 6 inches of topsoil.
PROJECT LOCATION: • Fertilize and lime if needed according to soil test (or
EXISTING CURB PROPERTY OWNER: apply 10 lb. / 1000 sq. ft. of 10 -10 -10 fertilizer).
AND GUTTER ANTICIPATED STARTING DATE:
CONTRACTOR: • Lightly water the soil.
ANTICIPATED COMPLETION DATE: • Lay sod. Tamp or roll lightly.
PREPARED BY: DATE: • On slopes, lay sod starting at the bottom and work
toward the top, laying in a brickwork pattern. Peg each
j piece down in several places.
• Initial watering should wet soil 6 inches de ���ypiral Lawn Seed�Mixttires g p (or until
water stands 1 inch deep in a straight -sided container).
Percent by Weight Then water lightly every day or two to keep soil moist
Grass _Sunny Srte Shady Site but not saturated for 2 weeks.
Kentucky „bluegrass 65 0 70 , 15 %u • Generally, the best times to sod or seed are early fall
Fine fescue ` : 20% 70% (Aug. 15 -Sept. 15) or spring (May).
- ryegrass 15% 15%
If construction is completed after September 15, final
seeding should be delayed. Sod may be laid until
Seeding rate 3 - 4 4 - 5 November 15. Temporary seed (such as rye or winter
(lb. / 1000 sq. ft.) wheat) may be planted until October 15. Mulch or mat-
ting may be applied after October 15, if weather permits.
Source. R. C. Newman, Lawn Establishment, UW- Extension, ivsa. Straw bale or silt fences must be maintained until final
seeding or sodding is completed in spring (by June 1).
Commonly Used Erosion Controls
Straw Bale Figure 2 —How to Install a Straw Bale Fence
Fences 1. Excavate a 4" deep trench. 2. Place bales in trench with bind-
ings around sides away from the
- -;� ground. Leave no gaps between
Figure 1 —Cross Section bales.
of Straw Bale Installation
Staked and Entrenched
Binding Wire Straw Bale Flow f� Bale
Width
or Twine Compacted Soil to 1 1 1 -
I I Prevent � ' 4
t Piping 1
Filtered (Il �i Anchor 3. Ahor bales using two steel re
Runoff Sediment Laden
Runoff bars or 2 " x 2 �� wood stakes per Flow
.l I I I bale. Drive stakes into the ground
► I i I II at least 8 ". 4. Backfill and compact the
=111 _ I 1 II, j l `� excavated soil.
Source: Michigan Soil Erosion and
Sedimentation Control Guidebook, 1975.
Flow Flow
Silt Fences Figure 4 —How to Install a Silt Fence
1. Excavate a 4" x 4" trench along 2. Stake the silt fence on downslope
Figure 3 — Cross Sections the contour. side of trench. Extend 8" of
of Trenches for Silt Fences _�, /, fabric into the trench.
Filter Fabric �� •�
Flow
„ it 111 III LI I q:, ; llil- 4^
r '�III Ilr' I_III 3. When joints are necessary, over-
—III I pl�III 1 ry'
'rf =� Lllllk w
V- trench lap ends for the distance between Flo
ITi= �•�lil two stakes. /
i
4. Backfill and compact the
excavated soil.
Filter Fabric —► �'I
A _ 1r-- -
i
1 III 4,.
Source: North Carolina Erosion and Flow
Sediment Control Planning and Design FIo J�� /�j /�
Manual, 1988.
Gravel Entrance 1 • Install as soon as possible after Figure 5 —How to Install a Gravel Entrance
start of grading.
2. Use 2 to 3 inch aggregate stone. Hard surface
road
3. Drive must be at least 7 feet wide so or distance
to foundation J
and 50 feet long or the distance to 1
the foundation, whichever is less. i
6" minimum 7, 1
depth 1
4. Replace as needed to maintain
6 inch depth.
j
A publication of the University of Wisconsin- Extensioh, in cooperation with the Wisconsin Department of Natural Resources and Depart-
ment of Industry, Labor and Human Relations, Carolyn D. Johnson, Urban Water Quality Educator, UWEX Southeast Area. ,
University of Wisconsin - Extension is an EEO /Affirmative Action employer and provides equal opportunities in employment and programming, including Title Ix requirements.
GW0001 Erosion Control for Home Builders R -06- 93- 15M -25-S
F
Standard Erosion Control Plan
f,
for 1 & 2 Family Dwelling Construction Sites
According to Chapters ILHR 20 & 21 of the Wisconsin Uniform Dwelling Code, a soil erosion control plan needs
to be submitted and approved prior to the issuance of building permits for 1 & 2 family dwelling units in those
jurisdictions where the soil erosion control provisions of the Uniform Dwelling Code are enforced. This Stan-
dard Erosion Control Plan is provided to assist in meeting this requirement.
Instructions:
1. Complete this plan by filling in requested information, completing the site diagram and marking ( ✓) appropriate boxes
on the inside of this form.
2. In completing the site diagram, give consideration to potential erosion that may occur before, during, and after grading.
Water runoff patterns can change significantly as a site is reshaped.
3. Submit this plan at the time of building permit application.
Site Diagram Scale: 1 inch = feet
EROSION
CONTROL PLAN
LEGEND
PROPERTY
LINE
EXISTING
DRAINAGE
-� TD TEMPORARY
G I DIVERSION
FINISHED
-' DRAINAGE
LIMITS OF
GRADING
_ SILT
FENCE
STRAW
BALES
GRAVEL
O VEGETATION
SPECIFICATION
® TREE
PRESERVATIO
STOCKPILEr
SOIL
Please indicate r C
by completing tr
arrow below.
PROJECT LOCATION (_`, SS 1y I S �.J� ,So Z2
BUILDER LONJI A,.� OWNER kyAO +A'�gi �
6_ RP O
r
WORKSHEET COMPLETED BY 0 �� ^yC -��r`� _ DATE �"�b"
i
I
EROSION CONTROL PLAN CHECKLIST
Check ( ✓) appropriate boxes below, and complete the site diagram with necessary information.
Q ��Q
UoF = o Site Characteristics
North arrow, scale, and site boundary. Indicate and name adjacent streets or roadways.
Location of existing drainageways, streams, rivers, lakes, wetlands or wells.
C u W�4 - 144- o) n Cas 'es 54vym ru.V1 o4
❑ Location of storm sewer inlets. Svv3'- 1 Iti i4
�`S vw G� lit
Location of existing and proposed buildings and paved areas. 4-gi nnff
(� The disturbed area on the lot. Cc_n_ awn,-
[ Approximate gradient and direction of slopes before grading operations.
M' Approximate gradient and direction of slopes ,after final grading operations. '
V ❑ Overland runoff (sheet flow) coming onto the site from adjacent areas.
Erosion Control Practices
ILocation of temporary soil storage piles.
Note: Soil storage piles should be placed behind a sediment fence, a 10 foot wide vegetative strip, or should be
covered with a tarp or more than 25 feet from any downslope road or drainageway.
Cz' Location of gravel access drive(s).
Note: Gravel drive should have 2 to 3 inch aggregate stone laid at least 7 feet wide and 6 inches thick.
Drives should extend from the roadway 50 feet or to the house foundation (whichever is less).
Location of sediment controls (filter fab 'c fence, straw bale fence or 10 -foot wide vegetative strips) that will pre-
vent eroded soil from leaving the site. KV—d-
",r+Y Z. — l !�^ t�
❑ Location of sediment barriers around on -site storm q" inlets. = d r a,� e, Wit
��� Location o f diversi (� i (I`2� d � l� ✓516
1-6 M`'ta(r rla. � 6 t
t � 10 e Via, v t eea - te r! aX J l net
Note: Although not specifically required bo , it is recommended that concentrated flow (drainagewaA�),6e
diverted (re- directed) around disturbed areas. Overland runoff (sheet flow) from adjacent areas greater than
10,000 sq. ft. should also be diverted around disturbed areas.
❑ [R* Location of practices that will be applied to control erosion on steep slopes (greater than 12% grade).
Note: Such practices include maintaining existing vegetation, placement of additional sediment fences, diversions,
and re- vegetation by sodding or by seeding with use of erosion control mats.
❑ V Location of practices that will control erosion in areas of concentrated runoff flow.
Note: Unstabilized drainageways, ditches, diversions, and inlets should be protected from erosion through use of
such practices as in- channel fabric or straw bale barriers, erosion control mats, staked sod, and rock rip -rap.
When used, a given in- channel barrier should not receive drainage from more than two acres of unpaved
area, or one acre of paved area. In- channel practices should not be installed in perennial streams (streams
with year -round flow.)
❑ Q Location of other planned practices not already noted.
a
` c am Indicate management strategy by checking ( ✓) the appropriate box:
�a
Management Strategies
❑ Temporary stabilization of disturbed areas. 5-400 A-J /JM' LL/J"V6 8
ge e s l fi �
Note: It is recom � t at rf ' .and soil Iles left inactive for extended periods of time be�t3tlized 1�7 10C
y seeding (between April 1st and September 15th), or by other cover, such as tarping r mulching.
CM Permanent stabilization of site by re- vegetation or other means as soon as possible (lawn establishment).
t
i
Indicate re- vegetation method: Seed'd Sod ❑ Other ❑
Expected date of permanent re- vegetation: '�joP� Zba Z 13 y l� 02 trA�U
f. Re- vegetation responsibility of: Builder ❑ Owner /Buyer
Is temporary seeding 3r mulching planned if site is not seeded by Scpt. 15 or sodded by Nov. 15? Yes ❑ No ❑
❑ 2�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
I pipe to stable areas such as established sod or pavement.
❑ C3'" Trapping sediment during dewatering operations.
Note: Sediment -laden discharge water from pumping operations should be ponded behind a sediment barrier until
most of the sediment settles out.
i
I "
Proper disposal of building material waste so that pollutants and debris are not carried off -site by wind or water.
I 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.
F • Gravel access drives will be maintained throughout construction.
• All installed erosion control practices will be maintained until the disturbed areas they protect are stabilized.
f For more assistance on plan preparation, refer to Chapters ILHR 20 & 21 of the Wisconsin Uniform Dwelling Code,
i
the DNR Wisconsin 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 (GWQ001) can be ordered through Cooperative Extension Publications, 608/262 -3346
or the Department of Industry, Labor and Human Relations, 608/267 -9360.
i
I
EROSION CONTROL REGULATIONS
UNIFORM DWELLING CODE (DILHR)
PROJECTS AFFECTED MAINTENANCE AND WASTE DISPOSAL
• All new 1 and 2 family dwellings in Wisconsin started • Sediment controls must be maintained until the site is
on or after December 1, 1992. stabilized by mulching and seeding, sodding or
• Additions to dwellings built after June 1, 1980. landscaping
APPLICATION PROCESS • All building waste must be properly disposed to pre-
vent pollutants and debris from being carried off -site
• Erosion control plan must be submitted with building
permit application to the local building inspector in ENFORCEMENT
communities where the dwelling code is enforced • Erosion control inspections will be made during other
• Erosion control plan must show: regular inspections (footing and foundation, rough con-
- Location of the dwelling, other buildings, wells, sur- struction, final, etc.)
face waters and disposal systems on the site with • Violations must be corrected within 72 hours
respect to property lines • Stop work orders may be issued for noncompliance
— Direction of all slopes on the site FOR MORE INFORMATION, CONTACT
— Location and type of erosion control measures • Local building inspector
CONTROLS REQUIRED • Department of Industry, Labor and Human Relations
• Silt fences or straw bales along downslope sides and side (DILHR), Safety and Buildings Division, P.O. Box
slopes 7969, Madison, Wisconsin 53707, (608) 267 -5113.
• Gravel access drive
• Straw bales, filter fabric fences or other barriers to
protect on -site sewer inlets
• Additional controls if needed for steep slopes or other
special conditions
STORMWATER PERMIT (DNR)
PROJECTS AFFECTED — Proposed erosion and storm water pollution control
• Any construction protect that disturbs 5 acres or more practices during and after construction
• Smaller sites that are part of a planned development — Documentation that an erosion control and storm
involving 5 acres or more of land disturbance water management plan which meets DNR standards
•Effective October 1, 1992 for any new or continuing has been prepared (plan does not need to be submit -
ted with the application)
project
• Exceptions: Indian tribal lands and work done by local —Other information related to site location and per-
mit holder
government staff
APPLICATION PROCESS CONTROLS REQUIRED
• File a "notice of intent" application (Form #3400 -161) • Erosion control measures specified in the Wisconsin
with the Department of Natural Resources (DNR) 30 Construction Site Best Management Practice Handbook
days before construction begins • Measures to control storm water after construction
• Application must include: FOR MORE INFORMATION, CONTACT
— Timetable for land disturbing activities and installa- • Department of Natural Resources, Storm Water Per -
tion of erosion control measures including project mits, P.O. 7921, Madison, WI 53707 -7921, (608)
start and completion dates 266 -7078
LOCAL ORDINANCES
Check with your county, and city, village or town for any local erosion control ordinances including shoreland 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 Depart-
ment of Industry, Labor & Human Relations, Ron Struss, UWEX Water Quality Specialist, Western Area, and Carolyn D. Johnson, UWEX
Water Quality Specialist, Southeast Area.
University of Wisconsin - Extension is an EEO /Affirmative Action employer and provides equal opportunities in employment and programming, including Title IX requirements.
r:wnnn1 a Ctnnrinrrt Frncinn f nntrnl Plan fnr 1 A 2 Famiiv Dwellina Construction Sites 1- f 93- 15M -10—S
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STATE BAR OF WISCONSIN FORM 1 - 1998 6 - 7 2 5 B
W TY DEED KATHLEEN H. WALSH
REGISTER OF DEEDS
I"1 4 F1f.,106 ST. cROIx C C,, MI
Documen Number RECEIVED FOR RECORD
This Deed, made between Lenertz Farms. Inc. 03 - 05 -2002 9 :40 All
WARRANTY DW
EXDFT t
Grantor, REC FEE: 11.00
and Ryan H. Robe Yand Ancrela J. Robey, husband and wife TRANS FEE: 125.70
COPY FEE:
CERT COPY FEE:
PAGES: AGES: 1
Grantor, for a valuable consideration, conveys to Grantee the following
described real estate in St. Croix County, State of Wisconsi
(the "Property"): Rec2rQ
N and Rehm y� 2&:n 1�1 e � . ;'"� �
Ang a J. YYtKkQ roc x 3 S inc
Rive'r`Fal s, WI 54022 �5
0a SON /0 000
Parcel Identification Number (PIN)
This not homestead property.
QL
of , CSM Filed in V ol. 15 , P age 4103 Certified Survey Maps, ( P9cfte n 89in Part of the NE
1/4 of the SE 1/4 of Section 7, Township 28 North, Range 18 West town of Kinnickinnic,
St. Croix County, Wisconsin.
Together will all appurtenant rights, title and interests.
None
Grantor warrants that the tide to the Property is good, indefeasable in simple fee and free and clear of encumbrances except
Dated this 28th . day of _February 2002
(SEAL) (SEAL)
Lenertz Farms, Inc.
(SEAL) (SEAL)
« s
AUTHENTICATION ACKNOWLEDGEMENT
Signature(s) .wrw��
'"MDY SWA 1 �.1s � � Wisconsin,
--I �5uyl, t `�►- } ss.
� �
F WISCONM fY t. Croix County.
authenticated this � Personally came before me this 28th day of
February 2002 the above named
�arcwV S'wA Le r z F rms Inc.
« NOTARY PUBUO 0,0 ohaa;t
TITLE: I CONSIN to
(If not, me t be the who a ted the egoing
authorized by §706.06, Wis. Stats.) i ent edge th&id e.
THIS INSTRUMENT WAS DRAFTED BY
Coldwell Banker Burnet 02 -01382
1301 Coulee Road
Notary Public, State of Wisconsin
Hudson. WI 54016 My commission is permanent. (If not, state expiration date:
( Signatures maybe authenticated or acknowledged. Both are )
not necessary.)
Names of nersons signing in any ca ac' must be or winted below then ai lure.
A A N IN Wisconsin o.,lnc.
WARRANTY DEED FORM No. 1 -1998 Milwaukee, Wis.
CERTIFIIE]3 SURVEY MAP
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