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HomeMy WebLinkAbout022-1065-50-300 O d C b'r d° m T m m O A 0 Z O A< I Tj O y O W N 3 to O W Dl I 7 N N Y� • Ul o °D O p o y aD °c° CD :3 0 0 0 CA CL m m O d 'D v _� C A a l u� Z D a CD v e CD rn D I a '� 3 D W a C ° � a 0 (� I 0 N o SCI r O Z o ;I Z o (DD CD 3 lei 00 k 1 00 t 0 t 0 °1 N 3 g l a ca (A co g p N y i v v v I (1) v rn m a c N 1 0 �-� N c 3 w 3 °t w CD 00 � W o = D D X O a c u? O 7 ? (D n a CD CD m m CD o m c a c o Z O m y G7 U) A e m m °N° w CD CL 3 a P Z G :. p C :. Z co H Z m CD A w w CD 0 a CD CL 3 'o vo y ° -n a n 3 m c I CD d c a CL (D �� o a I m a- m 3 o a I m w m CD c 0 0 u c Q y MCD O O ° c I ° I � a y CD O $ ° s o g j c 0 0. O N CD O 1 I a F I f O N f�0 7 p O a 60 > > > m CD C N .y. kQ O O � N j �D CD 3 N I d I fD w O I O (D fD a A p y ON O O O a ti J Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 463268 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: Walters, John Kinnickinnic Township 022- 1065 -50 -300 CST BM Elev: Insp. BM Elev: BM Description: ` Sectionlrown /Range /Map No: 166 90 G5 23.28.18.356H TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic C) Benchmark Z 166 v /d Gb Dosing I T Alt. BM Aeration �� /� / Bldg. Sewer S / a • 76 Holding � SVHt inlet TANK SETBACK INFORMATION St/Ht Outlet t TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 7 4 # -7/60 Z g / Z Ft Bottom 1� Cie ' Dosing � i X00 Z � Z / Header /Man. ` 9 �� . 3 Aeration J Dist. Pipe 1. 3 Holding Bot. System PUMP /SIPHON INFORMATION Final Grade �J 1 3 Manufacturer + + Demand St Cover /� g �tf GPM �, y Model Number k y I zq, 3 Go }sV r 9 41 TDH Lift � Friction�Lo� System Head �• TDH ' �Ft Forcemain Length Dia. Z f Dist. to Well 7 /tom SOIL ABSORPTION SYSTEM C' BEDITRENCH Width Length No. Of Trench PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR -� Type Of System: r � � 7 00 r ! UNIT Model Number. DISTRIBUTION SYSTEM J I v Header /Manifold Distribution � j x Hole Iito Size x Hole Sppacing Ar Intake \ Pipe(s) M Z �� ✓ Z ' Length Dia \ Length Dia Spacing SOIL COVER x Pressure Systems Only xx M ound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Depth Over Center r l Bed/Trench Edges \1 Topsoil I 4 es 0 No Yes t No COMMENTS: (include code discrepencies, persons present, etc.) Inspection #1: 'T /171 O 5 P Inspection #2: ( _ _/ Cr rcel No: 23.28.18.356H Location: River I S alls WI 54022 SE 1/4 NE 1/4 23 T28N R18W ' C " 1 0 k a 264 Deennrood Court F ( ) NA Lot 1 1.) Alt BM Description = G i3J�r C �a : w °U 2.) Bldg sewer length = 2� - amount of cover = > 7 Plan revision Required? Yes No Use other side for additional information. -- Date Insepctor's Si nature Cart. No. SBO -6710 (R.3/97) I Safely and Buildings Division DO 201 W. Washington Ave., P.O. Box 7162 v /b Mir Madison, - 7162 Sanitary P 4 oC filled in by Co.) (608) ) 266 - 1 ( is De artment of commerce State PlanLD• �Q Sanitary Per ' S Comm 8 Wis tn ation yo pttm� ct � Address if Wwat ) In accord Ad w, s15.tl4(iX 0/e WAY be used for socondary P L Application Information - Please Print All Infortntttian i� Z G #f 20 0 %�� # Block P�yown .es , the 1 Z KING GobwY P7 22- 10(OSE Proporty owner's Mailing Adams V4, / � -' �. section yip Code Pbone Number (�/ city, state 3 � I 0 5� LZ T E t 3 d 1 n Subdivision Raw Number II. a of Bdldin8 (dteck all that apply) ?� vU y✓7� or 2 paroity Dwonin$ — Nurnt or of BoOaooms 7 Iv p�`72So �'► PublidCotnmercial - Descxibe Use a n / / _ �/ qty, VillagexTort`nshiF of it % state owned - 1)mcnbe Use J ny Type Permit: (Check only one box on lieu A. Complete line B applicable) System TteatmenWolding Tank Rat only Other Modification to E=dng System A. New System I on a of 1 owner Trmsfu to New List Previous Permit Number and Date hoed B. Peanit Renewal Permi Before Bxpicadon IV. ttf PO S �- all &At a -Grade Single Pas sand Filter Non -P worized L'-�►d Mound 24 in of suitable sotJ Mound < 24 in. of suttabl4 t Pressuf=d in- Chound Holding Tank Peat Fate Aerobic Treatment Unit lteciralating Sand Filter Constructed wetland p (,) • s 'cMedaFater Cdatnber Line Gravel -less Pi y ant Area Lafotma$an: Aces ltegnirod (af) D3speaal Area Proposed ( system Blevarij Design Plow Design Soil A placation Rate(gpds0 Dispersal �� s ` Number Manntacunst Prefab Site Sled C� Plastic VL Tank Info Capacity of Units t]ottaeoe Canatnrcoed Gallons dons rises t=- #isrint Tanks Tacks Septic or ttoldn6 Tact Aaobio Unit noalaa t�.,nder 3 lli Statement- 14 a:tarrae billty for lastallaHon of the 1'OWTS sbovm oa the attached. VII. the MP/MPRS Number Business Pbone Number pj s Name t T?) Plumber pamm - /.�' / Plumber's Address (Stwet. City, State. zip stamps) �, t Use Onl Date issued Si Sanituy Pamir Fee (urcluda Qroundwater � "Ill Appeovod Disapproved Surcharge Fee) (f n /a 0 owner Gives Reason for Donal of ro AMeasons far Disapprovsal EL Conditiq APP V 04 ptllt� S�- 0� _7� � Aii 00 Weer not lest t6att a1/2 s 11 inclka In sloe PLOT PLAN PROJECT John Walters ADDRESS 264 Deerwood Ct River Falls Wi 54022 SE 1/4 NE 1 /4S 23 /T 28 N/R 18 W TOWN Kinnickinnic COUNTY ST. CROIX SYSTEM ELEVATION 98.5 BEDROOM 3 CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1 000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none IL BENCHMARK V.R.P. Top of Walkout Foundation ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE Q WELL * H. R. P. Same as Benchmark 1:12 ki-V 305' Property Line Pro 3 Bedroom 502' Scale = Well is to meet all House B.M. setbacks found in Property 1/4 = 10 , Comm. 83 Line Tank is to have lockdown covers with approved warning Huffcutt combo tank labels B -1 Grading is to be done 7% Slope to divert run -off away from system :B- 3 Are 15' below system is to remain undisturbed ( rE B-2 180' 9' 98.5' 97' 236' Property Line DeerwoodCt H.R.P. C ST. CROIX COUNTY WISCONSIN ZONING OFFICE ° f .....M... ST. CROIX COUNTY GOVERNMENT CENTER • _ _�__: -_ - " 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 • Fax (715) 386 -4686 EROSION & SEDIMENT CONTROL PLAN Parcel #23.28.18. Site: 264 Deerwood Court, Lot 12 (Kinnickinnic Two ) — owner(s) John Walters Under St. Croix County Zoning Code 17.70(3)(b)5: "The (Zoning) Administrator may attach reasonable erosion prevention conditions to a permit approved for issuance." Comm. 21.125 also requires the building permit applicant and/or landowner to follow erosion control procedures and maintain them until the site has been stabilized. The owner is responsible for notifying all contractors performing construction on this site that an Erosion Control Plan is in effect and the following activities will be required in order to maintain compliance with the plan: 1. The primary source for construction site runoff will be the house foundation excavation, driveway, and any soil stockpiled until final grading and stabilization is complete. Septic system excavation/installation adds to temporary disturbance, but establishing cover on exposed soils will prevent erosion. Plan to apply seed and mulch as recommended in #5. Maintain existing vegetation wherever possible to minimize sediment movement off site. Surface drainage is to the northwest with >50 ft. from mound septic system to the road drainage swale and a minimum of 5 feet from Lot 11 (CSM #392275) to the south. 2. Create temporary diversions graded ALONG CONTOUR between excavation areas and any potential receiving waters (this includes road ditches) by routing contaminated runoff into vegetated buffer areas on owner's property. Do not allow diverted runoff to be directed onto neighboring properties. (Refer to specification sheet for Temporary Diversions provided by Zoning Dept.) 3. If builder /excavator grades the site to create temporary diversions (see #2) to contain sediment and leaves adequate vegetative cover to protect areas of concern, installation of silt fence MAY not be necessary. Silt fence or other approved sediment control products will be required if sediment cannot be contained on owner's property with diversions and vegetative buffers. The POWTS inspector and/or building inspector will evaluate ESC plan effectiveness and make recommendations to owner for any action required to comply with applicable regulations. 4. Construction equipment and vehicles must utilize a stabilized driveway access off public road for heavy equipment; this includes cement trucks, well drillers, and other contractor's vehicles that access the property during construction. This helps avoid muddy, rutted conditions that may allow contaminated runoff to reach waterways and/or drainage ditches. Property owner must repair damage to ditches resulting from multiple access points and sediment tracked on public roadways must be removed at the end of each workday. 5. Stabilize new topsoil cover over septic system with seed and mulch immediately after installation — do not wait for final stabilization and/or landscaping of entire site to cover exposed soils on the system. If weather will not permit seed germination, a heavy straw mulch cover will prevent erosion until grass/vegetation can get established. Erosion control matting can be applied any time of year and if installed properly, will provide protection even if seed germination is delayed. The owner of record during site construction will be responsible for compliance with the C Plan. Please feel free to contact me with questions regarding erosion & sediment co ms lion. • Prepared by: Pamela Quinn, Soil Erosion Inspector #665054 Owner acknowledgement of ESC Plan re wire n : / /2004 \I INS Aoki 1 r� Safety and Buildings 4003 N KINNEY COULEE RD r commerce.Wi.gov LACROSSE WI 54601 -1831 TDD #: (608) 264 -8777 i sco n s i n www•commerce.wi.gov /sb/ www.wisconsin.gov 4 tc of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary December 14, 2004 CUST ID No.226900 ATTN: POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING, INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 12/14/2006 Transaction ID No. 1090840 Site ID No. 691220 SITE: Walters Please refer to both identification numbers, John John Walters Court above, in all correspondence with the agency. Town of Kinnickinnic St Croix County SE 1/4, NE 1/4, S23, T2 8N, R18W Lot: 12, FOR: Description: Three Bedroom At -Grade System Object Type: POWTS Component Manual Regulated Object ID No.: 997133 Maintenance required; 450 GPD Flow rate; 38 in Soil minimum depth to limiting factor from original grade; System: At -grade Component Manual, SBD- 10570 -P (R.6/99), 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. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. C071 liFl No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, P P R stats. The following conditions shall be met during construction or installation and prior to occupancy or use: DE N R 0 • This system is to be constructed and located in accordance with the enclosed approved plans and with the "At- SEE CORRES grade Component Manual Using a Pressure Distribution System for Private Onsite Wastewater Systems" SBD - 10570-P (R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10573 -P (R.6/99). • 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. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat SHAUN R BIRD Page 2 12/14/2004 I • Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz J GG POWTS Reviewer II , Integrated Services WiSMART 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 `; i Cover Page 4 Shaun Bird Bird Plumbing Inc. 1008 192nd Ave � New Richmond Wi 54017 G �'O� 715- 246 -4516 ��` Date: 12/10/04 Owner:John Walters Location:SE 1/4NE1/4 S23 T28 N,R18W Lot 12 264 Deerwood Ct Kinnickinnic System type: At -Grade Manuals Used: At -Grade Component Manual version 1.0 SBD 10570 -P (R.6/99) SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01 /81) Page# 1. Cover Page 2. At -Grade Plot Plan j y 3. At -Grade Cross Section 4. Pipe Cross Section /Pipe Layout Ak M41FRC6 �LDIN�S 5. Pump Chamber Cross Section , ONQON 6. Pump Curve 7 -8. Maintance and Contigency plan 9 -11. Soil test Shaun Bird Signature License num 226900 PLOT PLAN PROJECT John Walters ADDRESS 264 Deerwood Ct River Falls Wi 54022 SE 1/4 NE 1/4S 23 /T 28 N/R 18 W TOWN Kinnickinnic COUNTY ST. CROIX SYSTEM ELEVATION 98.5 3 BEDROOM CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none IL BENCHMARK V.R.P. Top of Walkout Foundation ASSUME ELEVATION 100° Filter Zabel A -100 ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark 305' Property Line Pro 3 Scale = Well is to meet all Bedroom B M 502' setbacks found in House Property 1/4 = 10 1 Comm. 83 Line Tank is to have lockdown covers with approved warning Huffcutt combo tank labels B -1 Grading is to be done to divert run -off 7% Slope away from system B -3 Area 15' below system is to remain undisturbed B -2 180' 99' e5' 97' 236' Property Line Deerwood Ct H.R.P. I_ :M >5 B ?5 PVC F O ACL r AA I N ..� > r 2 1 uPS" ... t-- atsre�� v°�Tle�t tA•tLRAL W A 08 *t ?-YAr'6P4 WELL 5� i /2B A = / L = Pt. CELL. OF `f?- - ?- Az A&GRE &ATE i t Distribution Lateral R0�RcVEa SY�.tTttr��c. Fabric STAI ItVtLb Obse rvation - ---..` ,��; „ , 'll�' � --Soil Cover Weli \ �La�AIED L AVER > 5` A ~2� 5' '7 a SL OPE a Plan view and Cross Section of Wisconsin AC _ grade Unit with Single Absorption Area on a Sloping Site Page Of Distribution Pipe Detail for Lateral lietwork ACce st TURK-UP (CLL+Rt4our) PVC Force Main �- PVC Distribution Pipe P * Last Hole Should 8e Next To 0 0 ft. Hole Diameter Inch P l Diameter Inch(es) X a inches Lateral - ------ Y/ Inches Force Main Diameter — Inches # Of Hales /Pipe Invert Elevation Of Laterals j� y Ft. Signed: License Number: Date: =ON AHD $P €Cti ICATI0'lS SEPTIC TANK Ft3MP C { ;A3"i9ER CRQSS SECT' W£ATHERPRO WROV ED ABOvE GRADE jUl4CTTOt BOX MANHOLE COY Eft PIPE I2" MYD1. WITH CONDUIT W1 PADLOCK 5 VENT WINUC QR WARKiIiG UR�EL R FROK DOOR, r 41A INTAKE � P 1 4" yZN- _ is M11f• i R GA INLET TIGHT SFAL APP ROVED F£ WATER TIGHT SEALS � . ALI S �1I,TE•R $ N 3 S MIDS IL AO�� C T OFF APP pIPE 3 50LID - � Ofd Pump OFF ELEV - FT T. D SOIL Y ED SEDD�NG V 1�DF •MANIC CoNCAETE PAD O � � A P�R SPECIE ; CA•:ZONS DAY: Nt}i'ibEB DOSES ?� / DOSE �� C DING ? i > Gw L- SE iNp,I+R1FAC'i�tIRER: DpSE aME FLpt BACK= TAN GAL- > a - ,GAL SEPTIC �" GAL. A /`S�INCkM SE _--- L. jtmt SIZE DOSE GAFACI _ GA _ 2 INCHES +8 q - 7, j"' CAL - A---� HpDELH C = �.. �! INCHES -7 I1QCl II 15.23 WAC PUMP mpwr,C'!'i�R£R = J Y'AR :48ER= .s'y'- ---- N �,7IRZNG AS PER HSWZTCH TYPE= GPM PU?4'P £ AL.AR � PE � FEET �£ �_ FEET REQUIRED DISCMRGE £3ISTRIBU - - '� FEET HETWEEN PUMP OFF AND /rFELT I•r{ ;CT tQK FACT R - VERTICAL OiFFERENC'£ SU PPLY pRESSU E NA?IC H� .. M ;HUM NETwGAK � IH x DTI 10Q • £ �flTAL gY � . DiaH'ETER --�' DTH + FEET FORCED TANK' 4� I,I{�i3ID , 0 -� ; n FpT�tNAL Dirt ENSIONS D AT £ . LICENSE S IGNED - C� b :188 TOTAL DYNAMIC M -,EAD CAPACITY PER HEAD CAPACITY CURVE EFFLUENT AND DE`fIATERING 153 MODEL i 152 153 NtODEL 152/ --� u W Feet Meters Goi. Liters I Gol. Liters i 50 5 1.5 6g 261 77 291 153 1 0 I 3.1 61 231 70 1 265 40 15 4.6 53 201 61 21 12 152 I 20 6.1 ! 44 167 52 ''S` 25 7.6 34 I 129 42 159 30 30 9 1 ' % 3 87 33 i 125 z 8 35 10.? -- - 22 i 85 42 4 12.2 ,L 0 I ? 1.6 1 44.0 Ft. (13. 4m) O I Lock VI vve: 38.0 (� ��_._ —.J 014500 4 t0 ) I 0 20 40 60 80 100 GALLONS 320 X 4 0 _ 3 v /�2 4 5/8 LITERS 0 80 160 FLOW PER MINUTE 2 ULT FACTORY FOR SPECIAL APPLtCAt1ONS CONS ® 3 � 2 panels available. � ' -- • Timed dosing p duplex systems, are available and supplied with • Electrical alternators, for an alarm. • Variable level control switches are available for controlling single phase systems. I •Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed awik - Box available foroutdoor installations. See FM1420. ( • Over 130 °F. (54 °C.) special quotation required. 152N53 Seriss ( a I 15 1 3 MODE Contra Mode Amt I Sim l ex Du le: Model voles Ph 1 2 or 3 eKZaa+ N752 115 1 Non 8 t I Auto 8.5 inciudetl 2 or 3 - ; aN152 116 .1 4.3 1 2- E152 230 1' 2 or 3 polo 4.3 Included BE152 230 1 105 1 2or3 SELECTION GUIDE N153 115 1 Non 10.5 ncluded 2 or 3 back variable level float SN153 115 1 Auto I 2 or 3 1. Single piggyback variable level float switch or double piggy Non 5.3 1 E153 230 1 switch- Refer to FM0477. 9E153 230 1 Auto 5.3 lnclutletl 2 or 3 2. See FM0712 for correct model of Electrical s Alterna can tor E d 3 A CAUTION 3 5 used as a control activator, specify P ( ) All installsdon of controls, protection devices and wiring should be done by a qualified . Variable level control switch 10 -022 or (4) float System. kenf do lectric Ali electr an d Co NEC andthe 0c�cupan n�i s be followed and H Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. - polUL To. P.O. BOX 16347 Louisville, KY 40256 -0347 Manufacturersof.. SHIP T0: 3649 Cane Run Road Quaurr PpS $,vc /939 Louisville, KY 40211 -1961 `O ® (502) 7 tDeller -com �0 pttp'�/ 0 Copyright 2000 Zoeller Co. All rights reserved. NAGEM hIj PLAN Page of 8�MA . . R 5 M pICATfONS S 0VVNE SYSTEM SPEC { pOVYT SYS �'[� al O NA Sep tic Tank Ca NA P ' SeP Ffl� INFORM ATION _______ tic Tank Manufa�rer • tc ❑ NA o / O "" r " ef Effluent t =liter Manu�ctumr e• Petm��. Effluent Fitter Model p NA DESIGN PASS O NA at pump-Tank ���' O NA Number of aW tnorris • t Units pump Tank Manufacturer Number of Comm �. atlda 0 NA antsfaKef �M ESQ tlOw {BYeCage) x 1.5) J"�v at/d Pump �"� ❑ NA pgsig W (P ' (Et{matad allda rftz Pump Model ` PCeb'oatment Unit O p Filter Solt APPOe' Raite Monthly avera90� p San d/Grave l Fitter O Wetiand Quality �i0 mgn- ❑ Mechanical Aeration Irrfluerrt/Efflu C3 Other Fats.. Oil b Grease tC') Q20 mg n, ❑ Disinfection mical OXygen Demand (BODe) Btoche ��,� golids (rSS) 5150 m � Manufacturer (pres surized) Monthly average" fl{spersal t:eil(s) O In -ground (Free p 1 -ground (9 ra ) Mound P E{Auent Quality 800x) S30 m9/L .grade 0xY9en Den ( 530 mgn- ❑ Other. Biochern OOmi ri ne Suspe Solids (TSS) ❑ Total SUSpe an) 510` dW r gan wastewaeer and Fec Colfom1 (geometric rrle . Values typ for d omeseie (noc� - �'� Y inchdiameter tank e ffluent. Septic ter. Maximum Effluent Particle Size .. typical W p �ted wastewa SS Service Frequent Maximum 3 yes.) MAINTENAN CE S p months ear(s) Service Event of tank volume At least once ever)' equals o e -third ( inspect condition of tank(s) When combined sludge and scum g r(s) ( M mum 3 Vs.) contents of tank (s) [3 Mon Pump out co At least once every E3 month r(s) Inspect dispersal of At least once every s) O NA �� -� p months Clean effluent filter AL feast once every -� jeor( p NA rep. pump controls & alarm ❑ months inspect lw At feast once every p months � yearts) O NA s and pressure tit s ) O NA Flush faterzd At least once every ❑months ❑ YOaK on+er. At least Once every other f1Censes or one of the following MAINTENANCE INSTRUCTIONS an individual FI itinspe�� POWTS Maintainer, SePMe of and dispersal Og1� shall be made by Sewer to identify any missing or broken inspe tanks Master Plumber. Master Plumber Restti on of the tank(s ) check for any back up Tan ns must induce a visual inspe� sludge and SCUM and to O r, e dispersal C811(s) shall be v k inspectio ure .the volume of combined to check the e ffluent levels SeMdM PP sny cra cks or leaks, me inspected nding of effluent on the idenft round po surface nding of effluent on the ground surface . The Po ulatory authority - o r � g of effluent on the g �r any not if i cation of the local reg obser AWn pipes and to check for any and requires the Immediate notifica tank volume. the in" indicate dicate a faiiin9 e-third (K) or more of the NR g accu mulation of sludge and scum in any eq uals on 'n9 Aerator and disposed of to accordance with When � f 70m steal be removed by a Se1�9e $e entire contents of the tank a Code. nents. PrellWtfinent oornPonent5, and a tairni f. 113, Wl�nsln Administrative t or pre ssurized POWT'S cornPo a Certified Po M rs, mechanics p per f o rmed by The SOrAdng of effluent filie of corrtpietion of any service event �nOB or monitoring at interyais of 12 months or less�I n 1Q days other main � to the local regulatory authority . A sef� Mport shall proms sting Products or other tank(S) for flte Pence of pal START UP AND OPERATION POWrS check. treatment ersat tor prior to use. cell(s). if high eonoen"60ns are row For n oonstrutlion, to use of the s and/or damage the disp e the treatment�rot:P by a septage servicing opera chemical$ thst may ont of the tank(S) detected have the contents - Page ! r at the infiltrative surface. eX0eS5 n ze ed the efro $ 0, conditions a Yvihen Poor is rector all not occur vvnen above normal hrghwater rloading levels. the celi(s) and may result in the System start UP sh all o ve a Sys es Pub tanks may ce ll(s) in one large dose. ntents of the primp tank removed by poring po`"r outa to tf�e � m id this st uation have me or intact a Plumber or P0VM Mtalntalner to wasw"a surfa I d- charge of Of . ng ppYYer to the effluent Pu p . in the pump tank backup Sepag e semis opefe1 tl� �t OtS to restore normal ievets w or otherwise �sturb or compatx, assist in manually ove tanks and dispersal cells- Do not drive or r D not drive or park t dawn slope of any mound or at -grade soil absorption area the PerfomlanCe and prolong the life the area Within i foe from the wastewater stream may imp degrsasem; dental floss: diapers; Reduction oC.eruninatlon of the folknivk►9 cigac>c� butts; condoms: cotton swabs � asoline; grease;, herbicides; meat gntiblabK .tom water, hull and vegetable pe g G r softener brine. of the PO dda on drain (sump Pum; , napkins; WMPons:'and Ovate disinfectants �� on; � products, Pesticides: sanitary P ��' steps shaft he taken to insure that the AgpNDONWENT anently.taken out of service the fottowi . Wisconsin Administrative Code: When the POWTS anc is perm ch. Comm 133. openings Seated. lairs abandoned in oomPliance with Pro perly = 14 'safely di and the abandoned Pipe oPe a Septage Servicing Operator. All Piping to tanks and ptts shall be u.. removed and properly disposed of by The contents of a n tanks end P Sha and the void space in all tanks and pits shalt be exca+mted and removed or their caVem r emo v e d After pump filled With so il , graver or another inert solid material. CONTINGENCY PLAN cannot be repay the following measures have been, or must be taken. m provide a code if the POWTS fails replacement soil compliant Cernent system evaluated and may be utilized for the location of a reps and should not a has be nt - are rotected from disturbance and comps p A suitable replaces ce ment area should bea d pr °posed stru lot lines and wells. Failure to absorption system The replacement existing wired setbacks at that time. be infringed upon by area � result in the need for a new soil and site evaluation to establish a suitabl protect the repiac*m mart systems must comply with the rules l l effect replacement area Replace replace t h e failed POWTS- nt area is not a vailable due to setbacko a nd/or soil limitations. Barring advances in PO +�plaoeme be installed as alas resort P O A suitable r may ti a suitable replacement a rea. Upon failure of the POW a sorb an echnology a holding tank oared to iden replacement area is available a The site has not been eval to mate a suitable replacement area. if no rep s evaluation must be Performed replace the failed POWTS t resort to r removal of the biomat at ordng tank may be installed a las be reconstructed in place following n systems may the rules in effect at that time. with Mouth and at-grade $oU absorPtio ystems must comply Itrative surface. Reoons�°n s of such s GASSES AND/OR DEATH MAY <<WARNIN ©> ENT TANKS MAY CONTAIN LETI q CIRCUM SEPTIC, PUMP AND OTHER TREATM p0 NOT ENTER A GISOMC, PUMP OR OTHER TREA'T'MENT TANK UNDER RESULT. , RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIB ADDITIONAL COMMENTS POWTS MAINTAMER POWTS INSTALLER Name 2 �✓ _ Name �rg Gln� Phone �l �'�� �,l c Phone j LOCAL REGULATORY AUTHORITY , SEPTAGE SERV[—jo OPERATOR PUMPER Agency �7 ' t T4 t� bu Name %�" Phone �j,� ��• �j Phone '(his document meets n LAM. Marquette and Waushara County Zoning and Sanitation agatdes ment does not This document was d6jIsd by i w tnaft of rho t"stse Cede. Use of this dote the minimum requirements of rh. Comm a3.22")(tXd) &(fl and 83.54(l).(2 a (3). Wisconsin AQmtNsUafim CMW (1101) guarantee the pe l6mlanoe of the POWTS. wsconsin Department of C erce EC "VED S Y I REPORT Page I of 3 Division of Safety and Buildin DEC "rd!rco with m �s. m. ode County C ` ) (J 4 coon �- n ✓L) ! 7� Attach complete site plan pa ess than 8 1/2 x 11 in hes in size. Plan must J include, but not limited to: erti ca r> tje nce nt (BM), direction and Parcel I.D. percent slope, scale or di �6Hnl�pr 4d do and distance to nearest road. 02-2- S'0- Please print all in o viewe y - Date Personal infonnabon you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). if Property Owner Property Location jo k ", WJ* IQ4::3 Govt. Lot -- 1 /4ke 1/4 S ? ST �N R E (or) Property Owner's Mailing Address Lot # Block # Subd. Name or City State Zip Code Phone Number ❑ City ❑ Vill� own N rest Road New Construction Use' esidential / Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: Parent materiaL Flood Plain elevation if applicable /'✓ I ft. General comments e and recommendations: ;3 4v- oak �(JxrA Boring # y� Boring dal pit Ground surface elev. + L) ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 . S 1 C �.�- �rT 1 a Boring # Boring R Pit Ground surface elev. t O ft. Depth to limiting facto in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 •Eff #2 PI -Z 3 rz -- _ 9 VI — A 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) Sig CST Number Bird Plumbing, Inc. Shaun Bird - 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 _ 715- 246 -4516 4 Property Owner _ Parcel ID # Page of a Boring Pit Ground surface elev. I ft. Depth to limiting factor in. FE ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots D/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#2 3/ � eJ 1-, Z 2-11 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 Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ❑ Boring # E] ❑ Pit Boring Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fP 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/_ ' Effluent #2 = BOD, < 30 mg/_ 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. sea8330 (R.6I00) Soil Test Plot Pla Project Name John Walters Sh ird Address 264 Deerwood Ct River Falls Wi 54022 STM #226900 Lot 12 Subdivision ---- - - -- Date 12/10/04 SE 1/4 NE 1/4S 23 T 28 N /R18 W Township Nnninckinnic Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Walkout Foundation System Elevation 98.5 *HRPSE corner of property Scale 305' Property Line = Pro 3 Bedroom 502' 1 /4" = 1 0 1 House B ' M ' Property Line B -1 7% Slope B -3 B -2 99' 98.5' 97' 180' 236 Property Line DeerwoodCt H.R.P. VOL 16 PAGE 4338 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX Co., xI RECEIVED FOR RECORD CERTIFIED SURVEY MAP 07 -23 -2002 3:30 PM LOCATED IN THE SE 1/4 OF THE NE 1/4 OF SECTION 23, REC FEE: ^ 15.00 T28N, R18W, TOWN OF KINNICKINNIC, ST. CROIX COUNTY, WISCONS 4PY FEE: BEING ALL OF LOT 1, CERTIFIED SURVEY MAP VOLUME 5, PAGE 14 � M U V ES: s � DOCUMENT NUMBER 392275, AND LOT 3, CERTIFIED SURVEY MAP, VOLUME 6, PAGE 1635, DOCUMENT NUMBER 409847. I NOTE P IPE I ' L O T 5, - - - • S. M. I L O T 3, C. S. M. ARE DIMENSIONED AS VO _1 _4 1 151 i OUTSIDE DIAMETER. I — UNPL A T TED I L AND I DOC. 4'649648 1 PA GE 31 18 S 89 °41' �5" E 672.43' . — — — 1" 305.51' 1" 305.53' 4 1 1 /4" IRON 79' PIPE 366.92' 12.60' FOUND N 77° 1 O' 19" W NORTH LINE OF THE IRON PPE OM 1" SE 1/4 OF THE NE 1/4 SCALE IN FEET 1 LOT 7 LEGEND I C.S.M i COUNTY SECTION CORNER I a 3 MONUMENT, , FOUND (TYPE 0 7S 1 SO 3Q0 VOL 6 1 1/4" (u LE�55� o a PAGE 1710 DOC. 4 7132 • OTHERWISE �' o rI l — 00 o IRON PIPE, FO D *� a I t- o�, �" 1 1 /4" x 24" 1 0 °$ LOT 13 1 V o PIPE WEIGHING 8#/ 5.011 ACRES 6 I z z= L I NEAR FOOT , S T W 4 z a 218,266 S.F. M I ` w vU'_ m W PROPOSED 2' WIDE o X "n0 o UTILITY E ENT. 1O I LOT 6 N o L O_r _1, S. M VOL UME 5 N p N PA GE 1 _ HOC. x ,.192275 VOL . 6 ju m3: "n V < ) LOT 12 ^ PAGE 171_0 RES /� c3 \ \ BUILDING MI DO -6p bJ2 Q 1 O 220,77 F. , 50' R =80' — SETBACK I ST. CROIX COUNTY LINE i�annln Zonino n g n d Parks Committee N N JUL 2 3 2002 87° 1 O' 16.. E I 290.38' nee riled to 3o ca of Ln z ON I N 78 ° p0' pp,. I I MWPAro nl e�Aii �q I sha ya ll be of wz QI 236 .09' W ' / h f FENCE I o ( �I �I�� >� �� �I ° Sp. V �3rr Lx I ° V 0 n �� j Z t ��� ors I v) �I�I DECK SEP T/C I \ 9 TANK i ~ IOIQIQ� LOT 10 LOT 8 Z ,�'� LOT 1 1 �-' �� \ \ 4.379 ACRES Zn 0 ~ 4.021 ACRES 190,746 S.F. o PA G' VOL 8 2269 I o 1 75, 139 S.F. �^ \ ` I _ \ ) ; \ I DOC. X462079 v APPROVED BY , c �1 �\ I 15 G EX /STING WO VEN 3 VVO F KINtVICKlNNIC ' I WIRE FENCE DAY J8'' - �ov y ° \ EXISTING MOUND 33' 33 _ - SEPT /C SYSTEM w 1/ 4 CORNER I SECTION 23 3 0 0 0 12 60' I E 1/4 CORNER T28N, R 18W p o 0 0 o b SECTION 23 ALUMINUM n ° :-I R T28N, 181 CAP) "' °D ° + 2 61 0''� (MAGNETIZED Y v ~ i LIS t (D 0 S P.K. ( I ICA H PU LIC N z N 89 °56' 55" W �i . I _ 3972_40 1 - N 89 °56' 55" W 672.68' � :Q, I I 647.79' V V POIN �_ EAST -WEST 1/4 SECTION LINE NN 89 °56' S5" W 5292.8 BEGINNING (PREY /OUSLY OAK DRIVE ---� RECORDED AS 647.47') THIS INSTRUMENT DRAFTED BY ROSS A. COLLINS UNPL A T TED LAND PAGE 1 OF 3 Vol. 16 Page 4338 RECEIVED——] ST. CROIX COUNTY ' WISCONSIN JAN 1 1 200 ZONING OFFICE CRO1AWOiN— ST CROIX COUNTY GOVERNMENT CENTER _ - - NING OFFICE 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 • Fax (715) 386 -4686 EROSION & SEDIMENT CONTROL PLAN Parcel #23.28.18. Site: 264 Deerwood Court, Lot 12 (Kinnickinnic Twp. ) — owner(s) John Walters Under St. Croix County Zoning Code 17.70(3)(b)5: "The (Zoning) Administrator may attach reasonable erosion prevention conditions to a permit approved for issuance." Comm. 21.125 also requires the building permit applicant and /or landowner to follow erosion control procedures and maintain them until the site has been stabilized. The owner is responsible for notifying all contractors performing construction on this site that an Erosion Control Plan is in effect and the following, activities will be required in order to maintain compliance with the plan: 1. The primary source for construction site runoff will be the house foundation excavation, driveway, and any soil stockpiled until final grading and stabilization is complete. Septic system excavation/installation adds to temporary disturbance, but establishing cover on exposed soils will prevent erosion, Plan to apply seed and mulch as recommended in #5. Maintain existing vegetation wherever possible to minimize sediment movement off site. Surface drainage is to the northwest with >50 ft. from mound septic system to the road drainage Swale and a minimum of 5 feet from Lot 11 (CSM #392275) to the south. 2. Create temporary diversions graded ALONG CONTOUR between excavation areas and any potential receiving waters (this includes road ditches) by routing contaminated runoff into vegetated buffer areas on owner's property. Do not allow diverted runoff to be directed onto neighboring properties. (Refer to specification sheet for Temporary Diversions provided by Zoning Dept.) 3. If builder /excavator grades the site to create temporary diversions (see #2) to contain sediment and leaves adequate vegetative cover to protect areas of concern, installation of silt fence MAY not be necessary. Silt fence or other approved sediment control products will be required if sediment cannot be contained on owner's property with diversions and vegetative buffers. The POWTS inspector and/or building inspector will evaluate ESC plan effectiveness and make recommendations to owner for any action required to comply with applicable regulations. 4. Construction equipment and vehicles must utilize a stabilized driveway access off public road for heavy equipment; this includes cement trucks, well drillers, and other contractor's vehicles that access the property during construction. This helps avoid muddy, rutted conditions that may allow contaminated runoff to reach waterways and/or drainage ditches. Property owner must repair damage to ditches resulting from multiple access points and sediment tracked on public roadways must be removed at the end of each workday. 5. Stabilize new topsoil cover over septic system with seed and mulch immediately after installation — do not wait for final stabilization and/or landscaping of entire site to cover exposed soils on the system. If weather will not permit seed germination, a heavy straw mulch cover will prevent erosion until grass /vegetation can et established. Erosion control matting can be applied an time of year and if installed properly, g g pp Y Y p P Y, will provide protection even if seed germination is delayed. The owner of record during site construction will be responsible for compliance with the C Plan. Please feel free to contact me with questions regarding erosion & sediment ns tion. Prepared by: Pamela Quinn, Soil Erosion Inspector #66505L7r- Owner acknowledgement of ESC Plan requirements: tit 1 / P / i Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division r ` INSPECTION REPORT Sanitary Permit No: 46 A 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)j. Permit Holder's Name: City Village X Township Parcel Tax No: Walters, John Kinnickinnic Township 022- 1065 -50 -300 CST BM Elev: Insp. BM Elev: BM Description: Section lTow ange /Map No: 23.28.18.356H TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS IF HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet SVHt Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. VeIv Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Ma . Aeration Dist. Pinif Holding Bot. r tem PUMP /SIPHON INFORMATION Fin Grade Manufacturer Dema Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft All Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DI ENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L JWEYL ILAKE/ST LEACHING Manufacturer. INFORMATION CHAMBER OR Type Of System: UNIT Model Number. DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Sp ng SOIL COVER x Pressure Systems 04Y xx Mound Or At -Grade Sys ms Only Depth Over Depth Over xx Depth of xx See d /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes No 1 n Yes No COMMENTS: (Include code discrepencies, persons pr ent, etc.) Inspection #1: / / Inspection #2: Location: 264 Deerwood Court River Falls, WI 54022 (S 1/4 NE 1/4 23 T28N R18W) NA Lot 12 Parcel No: 23.28.18.356H 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? Yes ] No Use other side for additional information. _._ _ _ Ll SBD -6710 (R.3/97) Date Insepctors Signature Cert. No. sdety and Buildings Division CVAIy 201 W. Washington Ave., P.O. Box 7 S Madison, WI 53707 - 7162 Sashay Permit Numbs (m be Elie by Co.) lswnsin (609) 266.3151 3 8 Department of Commerce Sanitary Permit Applic tiOIREC VEC '�''''' # In accord with Lamm g3.21, win Adnt Code, penaul you prov O may be used for aocoodwy putpows Ptivaay Lw, 3.01(lxm) act Address ( itdi heW thaw mailing address) 'k1f1 V 1. Application latormation - Pl ae Print Ali Information 26 `/ Property Owner's Name Z I N Paroel # I.ot # Block # G OF Property Owner's Mailing Adidmi b -e v- t v 5 VJ L v., section 23 city, state Zip Code N D5 S� ! `? 11 Zit �p (` ) IL Type of Banding (Check W that a ) A r T N; R i.Q__ E oe 01 or 2 Family Dwelling - Number of ❑PubHoC m urchtl- Deecribeule ❑state owned - Describe Use nWpof Ill. Type of Permit; (Check only am box an nos A. line B U applicable) (92-2- l 0 6 S- rO — 6 A- &New System 0 Replaoammtt System ❑ Tank Rephioerneot only aoe 0 Other Number B. ❑ Permit Rwal ❑ Permit Revision ❑ ❑ Permit TYsmfes to New Before P.xpitelm Pl owner 1V. of POWT8 tam: Check all that a X D . 0 Nac -P awriaed la4rouod OM*md > 24 is of le soil 0 Mamd a in of auitabb soil ❑ At -Grade 0 single Pass Sad Filter 0 Cam mucW Wedsmd [I Prmsudsed ln-Ghoaod ❑ Tank ❑ Fee Filter ❑ Amobic Treatment unit ❑ ltwlrrxdating sans Fiber 0 RwJrcul� S Media Fllter ❑ ❑ Lice ❑ors pipe Other V. Dispwinimptinwt Area Informations Design Flow (tom Design Soil Area Req (d) Dispersal Area (st) System Elevation �S • 3 o - o U DD q !z 7c) 1,ova 9 VI. Tank Info �� oiunits g Cannata Constructed Steel G�Lu Plastic = asirdas �Et� - rook, Acmbk heemcot Usk Deal%Cbunbw 6 t3 a . Yll. Responsibility Statement- 1, the =OrJW4 sea for law"oa et the Po attached Plumber's Name (Print) 's MP/MPRS Business Phone Number Plumber's Address (street, City. SwW, Zip r9 9 ? b F ` M VI II. Coon /De It use only Approved ❑ sanitny Permit Pee ( udes Grouodwees Dote lssued Surclarp Fee) 35-0 ^ O s;gnaa� ) ❑ u Reasm IX. Conditions Ap SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintdned as per management plan provided by umber. 2. All setback ruts must be- inaintained as, 4"e /ordinaries. ,►meb semyna pleas (to So Covaty only) for do qft= oa psper nos Im Max ern x 1 t taeba Is du SBD -6398 (R, 01/03) �,., E � .' ��' - � ,. �, � �: �f � � � d . � e . • �- i E a ��� i�k1 ��.:. -. �� — -_ " P -PLO 'Scale ��— vL LOT 13 I t+ -ML. qg^ '..'o►�'��` .� °3 /d�1A DMZ ► y1 -�1'�I . - IawG��.:F•t� . Np0 p• Op0 w a ; .. w . tt. �o0t.o� 6 4-o � O NO .� 83 a it-2 . o� q qb fur \,Z g'x o \—wr \Z v � --� \ � � �-o w. -- - -- Lu t3 Q sir � X I Lor io o 4 p Lor ►I Safety and Buildings 4003 N KINNEY COULEE RD commercemi.gov LACROSSE WI 54601 -1831 TDD #: (608) 264 -8777 i sconsin www.commer isco govsb, Department of Commerce www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary October 21, 2004 CUST ID No. 139462 ATTN. POWTS Inspector TODD L SINZ ZONING OFFICE T L SINZ PLUMBING INC ST CROIX COUNTY SPIA E5609 708TH AVE 1101 CARMICHAEL RD MENOMONIE WI 54751 -5520 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/21/2006 Identification Numbers Transaction ID No. 1071022 SITE: Site ID No. 691220 John Walters Please refer to both identification numbers, Deerwood Court above, in all correspondence with the agency. Town of Kinnickinnic St Croix County SE1 /4, NE1 /4, S23, T28N, R18W Lot: 12, FOR: Description: Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 987547 Maintenance required; 450 GPD Flow rate; 26 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.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. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. Cond No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, LJ stats. AR""'i The following conditions shall be met during construction or installation and prior to occupancy or use: DEPARTMFN N OF General Approval Requirements: SEE CORK • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /O1) and the 'Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD- 10706 -P (N.01 101). • Comm 82.30(4)(c) Wis. Adm. Code. The manifold diameter is reduced to 1.5 inches so as to provide for a pressurized flow of 2 feet per second. • 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 f SqF °CT 13 2po -Mound ' �o�s HIV Construction Materials and Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: Mound, SBD - 10691 -P (01 /01) Pressure Distribution, SBD - 10706 -P (01/01) Location: Lot 12, Pending CSM SE '/4, NE '/4, Sec. 23, T 28 N, R 18 W Town: Kinnickinnic County: St. Croix Date: October 19, 2004 Owner: - SbAv�a kp Address: 1810 Crestview Drive Hudson, WI 54016 Plumber: Todd Sinz Signature: License: MP 139462 Pionall tD Attachments: SBD -10577 - Plan Approval Application f SBD - 8330 Page l: cover F EY n iNGs SPOND 2: design criteria & calculations 3: plot plan 4: system cross section 5: plan view, lateral detail 6: pump tank exit detail 7: pump curve 8: system management page 1 of 8 Design Criteria Residential Wastewater Contaminant Load: 30 mg/L < BOD5 < 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/L 3 Bedrooms x 100 gal/bedroom/day x 1.5 6 o; - n gallons /day hydraulic load Design Calculations In situ designed loading rate (),16 gallons /sq. ft. per day Depth to estimated high ground water ; Z in. Depth to bedrock S "Z in. Cross slope at system q ` 1° % Force main length ft. of Z in. Manifold/header length ft. of in. Drain -back 3 - gallons Lateral length 2 @ S o ft. of " 'a in. Lateral elevation k , ' ft. @ bottom of lateral Lateral hole size ��t� in. @ 6 , o in. ( _�, o ft.) Spacing holes /lateral 3 holes total Lateral volume 31, gallons Total lateral discharge rate gallons /minute @ 2 — -e ft. head Network pressure compensation losses n }S� ft. Elevation difference b ft. i Friction loss c9 Z $ ft. @ z gallons /minute Total dynamic head x •43 ft. Pump /si *on ')'� gpm @ Z ft. of head Manufacturer Model # S F o Dose volume �.5 gallons Lift/sipigon tank 1 K - o 6 U"O gallons Septic tank � 1 O'ano gallons Effluent filter "o F 2 2 - 4, n Measurement pump on and off in. Height alarm from tank bottom b ° in. Reserve capacity gallons specs.calcs.res Page Z of L • , PLOT PLAN - - scale 1' 11 1 -me- . LET �2 LOT t3 I d 1•+L_t, q g`7. Z'.. "o►� "'I'�tctt,"3 /b DIA rY2 . ►�i /1�9'i"N M el-, 9q 6.0 ' _.. L 4z r ff � LL a- u.•. Ow� � Q• o q 1 \O QQ � 1•x,.4 � „. } p;.� a .0 G 6 13- O , I�uc c& q 6 ' I 4-0 B3 a t�-2 S `r1 �►� L.O c-11 ON Sk< s lo r Lu \ Z � Q Is 177- x nor io 0 4 Lor i I 4L ¢. �: ova s•.�51 _( a I V. 06 bob V19 I ....... �- g z.�• io•g S�•c�� 10 $' �� o�tLMV� .r �r�ll♦ �✓ b.1o+. taU1- b�a1 SEE CORRESPOND�:N" 7 \ 7 ( \ � / �'� Q V L S C.� 4o M►...: 4+ � be � .. T � �-� / r 1'1? " Pic s��, 4-0 IL �4v h 4�� •'/ T \� �� C+y.,�f To �•S w4/i �J►�.O�il. ( Q' ' • ��, b �'1 0 \ G� O r 1 1� RJ„ � Q�.� � � b o� o r. \ : •. y � � � • J A e , ► '� 1 � . J , / WEATHERPROOF LOCKING COVER 7LNCT�oh li W Y. iUC .4 NICK C ,� Q` 4 4 pyr -� -� IL ' 4m DIP6 no NoIbTuReZD _ v Soil. 24" I.D. 14" r A 2 b o, AWKQvL_0 cress \'L k r 'r ot wrs WFLE (ALA a �AL i 3' p.rr0 C.a NP l o1V —• O ~ n.ti Lp ��" O Bl.'L- 14.� T �TJ S o L u i 1 i PurlP CoArc,�E-r-� b�oC�C C� 0 1 3 , 5 14 SEPTIC t SPEGIFI-CATIOfJS DOSE i1 II TAL1.5 MAWUFACTURER. (DUMBER OF DOSES: b ` � PC CA_ TAWK SIZE: ` � (v GALLOWS • .DOSC VOLUME ALARM 14MUFACTURGR: S `� � ,. ,, INCLUDING 6ACKFLOW: MOOCL WUK!lCK: CAPACITIES; A= 26,0 IAJCHCS OK g} `� SWITCH TyP[: PuMP h AWU FACT U9CR; `� `�,<Y�o w. 71 O i C o luC NE $ OR } �'S MODEL I'JUMB[R: 5WIT �MQ.Vwv D� INCHES GR �� CH TaP[; PUMP AW ALARM ARC To 6C MIwIMUm DISCMA RATE � GrM INSTALLED 0►J 5EPARA7C �IaLs•�T$ VERTIC DIFFERCN OCTWCCU PUMP OFF AKJO DISTRIDUTIOW PIPE.. 6 '9 FECT •t- MiuIMuM KJETWORK SUPPLY PRCLSUIIC . . . . , . , 2,=1r_ FCCT + �O FEET OF FORCC MAIN X L_ , ri10,,,FKICTIOU FACTOR. '� FEET TOTAL "WAMIC. HEAD = � 0` �� FEET WTERKJAL. DIMEW610WL . \ '�C� %% Of TAWK: LEKIGTH ;WIDTH ; LIQUID DE ` P r v. s D Engineering e Pump Characteristics Performance Data ► Mota USit y "tow* me" SNEi30A1 � � Nay #" 30 I MI lead A i.0 p �..__..r_.... A9ola S6W h1S 14 1 R.Nd. I SSO � thou 8 V&4 *p Harr 60 Sompw two 12n WOW r5wh .lIx r t+ it � x eo 54 NENIA Ws4v A e 064w Sire 1 - / 2' Nn (310x.1 Total NOW foot ) 1 0 0 12 1 10 20 1 24 $#%& Nam 3/4' 091W 0 ►M (U.S.) 1, 44 1 =i J 39 1 23 12 0 USit W*kt 30 6s. hwv Cord 1 6/3, S1TW, 2W RL Dimensional Data Materials of Construction — r'" u �' " +•► ' Y � •• IfAI 4i, (�� br leweatimel wee. P wl 2 (""W1 b me} NwNo SM &IS Stool my: 1/1 ed Mq ,� I k Ip nmduaw, pope fabric OM DioiSCtrk Oi ,u WIN W" urr t hww" ml IVO R Nwtw k"wq Cost ho ,,;� am ROS sNr.siro. CeStM ae1 s. onrot+ a{amil PVW W" 1, % rw"16* g wob ,e*im to nr priiw ad rhea >oed�nae � nuk. Mednxkd Seel Fetas Csieit /taadc �,..•'�.,. Skft Sw Sae k*p AWk" Stul S'rix¢ SMbbu Stw 1wst IwrN E * „• yK Can 0" soew cx,� �il�f liso lower SiNk Rwe IeN 114arb, - 7� 1omm Rote TWOWAlk 31y4 >k Fost+un SbMInS 41xl — 0 1 W H dromaic' Pumps. Ashlo i, 06c. 0 R' Rewv". �� HYDROMATIC w - yow. Aulhorak Local DiWbmr - 1840 lortty Read AsHwil, Oho 44105 1d: 419.119.7011 Fir. 419-211.4017 web See: www.p nto omp com SAYS OFFKIS IN All FWOR CRIES AND COUNTRIES uom w: W- 02. ISM U System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, TL Sinz, 715- 235 -2644, or the St. Croix County Zoning Office, 715- 386 -4680, should be contacted for assistance. General Proper functioning of an on -site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a dose tank or compartment to allow a dose to be accumulated, a pump and controls or automatic siphon, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. 1. If the septic tank is installed prior to sheet -rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2. Install water - saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. 9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. If septic or dose tanks are no longer used, they must be properly abandoned. 11. If construction timing and weather could create a frozen infiltration system, weather - proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. 12. If possible, the upslope toe of the mound system should be landscaped with additional fill to blend this area into the upslope natural grade; this will minimize the possibility of the system trapping surface run- off; final settled slope should be 2 -3% over the system or 2 -3% diverting surface run -off around the ends of the system. Maintenance 1. The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the dose tank must be pumped, and the filter must be back - washed into the septic tank to remove accumulated material. System use may require more frequent filter cleaning; initial inspections of the filter should be made every 6 months until a minimum time sequence is determined. 4. Periodic observation pipe inspections should be made by the owner to examine the state of the in -situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down -slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run -off into the system area. 11. Warning: Do not enter septic, dose or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, and/or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 r ` Wisconsin Department;ofCommerce SOIL EVALUATION REPORT Page � of 3 } Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County S r_ CRA LX I include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. �DEKj\-- percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ({v G Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location 2w P ) M U ATM ajT s -L� S 114 N l� 114 S Z Z T Z$ N R 1 '6 E (o Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# cm Z g i b cs STV t U 2.t u C t Z rb !r� G CS wl City State Zip Code Phone Number [� City Village 21 Town Nearest Road 1 SoKJ I w 1 5 L 016 ( zL S) 3 $I - 5 3 3 y Le\fz lM v Lc �►nd,� GT . RL New Construction Use: Residential / Number of bedrooms �_ Code derived design flow rate b OO GPD Replacement [] Public or commercial - Describe: Parent material _ �j 14h l�� S`IZj N (Ja(_p S Flood Plain elevation if applicable ti Y:� General comments ft and recommendations: M r RECEIVED S Hrx 1- zt-r -. cofv�v� EDEN a 00 , C) r APR 2 2 2002 F-1 I Boring 4.0 ROIX COUNTY Boring # NING OFFICE pit Ground surface elev. I 0 0 0. 6 ft. Depth to limiting factor Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consi Wenceundary Roots GPD 1ft in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. Eff#1 •Eff#2 o -IO lb`t (Z 313 — S Z` 'q .le Z _zc� .sitliX16 - l�s lesbrz M \j +- eL-� I 1W-1R 6 �(�' � 'FS pv M v4,. — •� . 6 [7j] Boring # t❑ Boring tit Pit Ground surface elev. Q Q b . 6 ft. Depth to limiting factor L� Z 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 - Y l 1 �sbk, M V+', ew 3 Z S4l 5 /g ph,., y _ , 4 , 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) Signa re CST Number Arthur L. Wegerer 220254 Address Wegerer Soil Testing & Design Service Date Evaluation Conducted Telephone Number 421 N. Hain St. River Falls, WI 54022 3 -Zb -v2 715 -425 -0165 • Property Owner Rl/y p I lU U Z, 5 [ ' Parcel ID # ! N G Page Z of 3 ❑ Boring # E] Boring 3 pit Ground surface elev. Ci 9 ft. Depth to limiting factor 3 In. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Bounda Roois Soil Application Rate rY GPD /ft' In. Mll unse Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'E(f #2 0— t x`12 3 L3 — S1 T 1M v 0.1S Y2 ult; - l�s Zesb *\j 3 y g -L 10`1 R. 613 K L I I EE E Boring # El Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Depth Dominant Color R Soil Application Rate Horizon edox Description Texture Structure Consistence Boundary Roots 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 /ft= 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 servicp provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 60 - 266 -3151 or TTY 608 -264 -8777. SBD -8330 (R.6(00) L II PLOT PLAIT Page 3 of 3 Scale 1'= SQ" L \,Z. LOT t3 f4- 1:. - 0 O►.1 / . ° Z' Z - CL, • 6 • ff Lt It 0 1�O�00 q J S'o QV oSZ S S1'M �C Q`S L'L, zo- j Z i ��Sti2t3 nHs rrftm Lp S ON Sk�TC 1� a qb Uu r �Z "pit -1 L ET l� - - - -- LVT t3 S iTE X LOT M Lor tl oNclZ b�Zl 3 Zb -0Z 715- 425 -0165 220254 CST Signature Date Telephone No. CST No. Job NO . SEP. 8:22AM EDINA- REALTY -NR N0.143 P. 1 - ST CROM COUM SEPTIC TANK MAMI- M4ANCE AGREENOW AND i. OWNERSHIP CERTIFICATION FORM owner/Buyer Mailing Address property Address for saw coastructioa) (Veditoatlon requir - ftm PlannMg Dopartmeat City /State 1 J e t S parcel klvntifiaation Number C,L_' , N_ i� W, Town of kinn property Location J - 1., L 7 ._ ��, Sec Subdivision , Volume , . Pao # Certified Survey Map # b . volume Page # Wam.nty Deed # — Spec house O yes 0 no Lot lines identifiable yes E) no SY of our tic ayatem could result = its promaturo failure to W&c wastes. Props nsaintcawcc I=PMPer we sad amdnteoanco Y mp b lioesAsed pumper. What you put low Ow system cosh of pumping ON tramlc..very three yeas or aooncr� if needed by a as at3cu the fmrc�tioa of dse septic twat as >< tteatmt>nt asaLo is the waste disposal �m to submit to St. Croix Zoo, Dcpartm`1O ! oeati6eatioa foa#t, signed by the owner and by a M p owner mast.~ Vt=ber io�Yl'ntl�, reghk edp(tdmbaor t lianaadpstmPorv+oesf ryj tb a septic op-a Im than 1/3 fu pasal �cm is in Proper oparatiag condition and/or (Z) after iaspootioa and pumping (if pocosaary), the sep W& is ksa than I!� full of sludge . b sad agree to mtho n the P"tc ag stem wits. the standards �, & un�detsignod have cead the above rtxluirmuea of Nstmal Rawcea� � of Wisco�ia- Cerdfiation set forth, herein, as set by ft eat of Commerce and 6* Dope * to die so Cooix CotimtY Zoning Office within 3U that yea stptic system bas beta maintained must be comp da o the year expiration date. DATE SI g P APPLICANT p � � C �. we am are the owacrtsl or l (we) cutlfy that alI statements on this form are true to the best of my (our knowlodge}. I ( ) ( ) above, by virtue of a yr n=ly dead rcemdod in pcgUta of Doods OfGoc. P 1 �tifIo JL DATE SI OF APPLICANP • • • 0 Any inforM'tiou that is gds- MPmsented may eaailt iri the taniaty permit befog revoked by the Zoning Depataneur. •• include with this apPlicatioo: a atan**d wanaa;y dead from the Rogue of Deeds office a copy of rho ratified =MY mRA if "fac= is made In dw warranty deed i I U. z4 79 P zss 749853 KATHLEEN H. WALSH REGISTER OF DEEDS STATE BAR OF WISCONSIN FORM I — 2000 ST. CROIX CO., MI { WARRANTY DEED RECEIVED FOR RECORD Document Number 12/23/2003 08: 30AN This Deed made between RWP Inve s tments, LLC. a Minnesota Limited Liability Company Grantor, an a rs e R. W ad WARRANTY DEED husband and wife Grantee. Grantor, for a valuable consideration, conveys to Grantee the following REC FEE: 11.00 described real estate in St. Cro ce COP County, State of Wisconsin (the "Property") (if TRANS EE: a 330.00 more space is needed, please attach addendum): CC FEE: RAGES: 1 Lot Twelve ) of Certified Survey Map filed July 23, 2002 in Volume 16 of Cerh red Survey Maps, Page 4338 as Document No. 684833. Located in the SE 1/4 of the NE 1/4 of Section 23, Towns ip 2 , nge 18W, Town of Kinnickinnic, St. Croix County, Wisconsin. Being all of Lot 1 CSM in Volume 5, Page 1408 as Document No. 392275 and Lot 3 of CSM in Volume 6, Page 1635, as Document No. 409847. Recording Area Name and Return Address Scenic Title and Abstract, hrc. 220 Locust Street Suite One Hudson, WI 54016 x+ 2 z cf L< Together with all appurtenant rights, title and interests. 22- 1065 -50 -001 Parcel Identification Number (PIN) This is not homestead property. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Easements, restrictions and rights -of -way of record Dated this 14th day of March 2003. " PA{ W? OLV?::�W:!?fPP0.�i0+�".J}il.:• J Bin Sco ECkhoim ` • Notary u blic State ofWiscbusia AUTHENTICATION ACKNOWLEDGMENT Signature(s) authenticated this day of STATE OF WISCONSIN ) ) Ss. St. Croix County ) Personally came before me this 14th day of March 2003. _ TITLE: MEMBER STATE BAR OF WISCONSIN the above named Roger W. Platte. President of RWP Investments, (If not, authorized by § 706.06, Wis. Stats.) LLC, a Minnesota Limited Liability Company to me known to be the person — who executed the foregoing instrument and acknowledged THIS INSTRUMENT WAS DRAFTED BY the S c. RWP Investments, LLC 641 Hoover St NE 4�c , Minneapoli.s. MN 55413 * 11ijim Scaft Eckholm 4" k5qpnum may be auibadcated or scknowlodged. Bolh we not necessary.) Notary Public, State of Wisconsin My Commission is permanent. (If not, state expiration date: Se tember 11 2 *Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. I — 2000