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024-1010-60-325
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix safety and Building Division INSPECTION REPORT sanitary Permit No: 166 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)]. Parcel Tax No: Permit Holder's Name: city VillagEalle hip 024-1010-60-325 Wersal, Anthony P,Town of Insp. BM Elev: EBMription: Section/Town/Range/Map No: CST BM Elev: 07.28.17.53D10 ~G f TANK INFORMATION ELEV ION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing ~l 0 T_ I Alt. BM ~P Bldg. Sewer ~62_$ Aeration St/Ht Inlet 6 Holding 160-11 St/Ht Outlet ti TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing / Header/Man. Z Aeration Dist. Pipe Holding Bot. System FGrade PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to well SOIL ABSORPTION SYSTEM Liquid Depth DIM~ENSIONS No. Of Pits Inside Dia. BED/TRENCH Width Length No. Of Trenches DIMENSIONS CHLEACHING AMBER OR Manufacturer: ]-L LEACHING SETBACK SYSTEM TO k DG WELL KE/ INFORMATION Type Of System: UNIT Model Number: vent to Air Intake DISTRIBUTION SYSTEM lup:ptribution Header/Manifold x Hole Size x Hole Spacing e(s) Length Dia Length a Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over ,a Mulched Bed/Trench Center Bed/Tren h Edges Depth of xx Seeded/Sodded Yes ~ Yes No Topsoil 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: P cel No: 07.28.17.53D10 Location: 492 CTY HWY J Hammond, WI 54015 (NE 1/4 NW 1/4 7 T 7W) L 5 0 ~C. 1.) Alt BM Description 2.) Bldg sewer length = - 4-b Gl~,` Oc1k `7b amount of cover Plan revision Required? Yes No I lp Use other side for additional information. Date Insepctor ignat Cert. No. SBD-6710 (R.3/97) Unty Sanitary Permit App ST. CROIX COUNTY WISCONSIN In acc rd with Chapert 12 St. Croix County Sanitary PLANNING & ZONING DEPARTMENT Or tip, b 1TIonal in rmation you provide maybe used for secon urp ST. CROIX COUNTY GOVERNMENT CENTER q t [Privacy Law. S. 15.04(1)(m)] 1101 Carmichael Road $P~ lcot"Io'i~\G~ (715) 86-4680WFax(7 5)386-4686 ttach complete plans for the system on paper not less than 8-1/2 x 11 inches in size. unty Sanitary Permit # ❑ Check if revision to previous application ~ Q D 1. A lication Information - Please Print all Information Location: Property Owner a e /0 tE- 1!4 NW14, Sec 722 N, R E (or Property Owner's Mailing A ~s/s.. Lot Number Block Number It/ ? a c' l a- City, State Zip Code Phone Numer Subdivision Name or CSM Number. IT O/ -;2 519 - 03 6 8 380.635 - U as - P5736 11 Type of Building: (check one) 0 (3ity ❑ Village'Town of fW 1 or 2 Family Dwelling - No. of Bedrooms: ❑ Public/Commercial (describe use): ❑ State-owned Nearest Road II. Type of Permit: (Check only one box on line A. Check box on line B if applicable) Parcel Tax Number(s) A) 1Repair 12.ik Reconnection 3.❑Non-plumbing 4. ❑Rejuvenation 0 a/_!o /o --(cab -°~02 Ll r Sanitation B) Permit Number L/~ r Date Issued Q ~J.a n DU I ! ❑ State Sanitary Permit was previously issued / ~p r IV. Type of POWT System: (Check all that apply) ❑ Non-pressurized In-ground ❑ Mound 24 in. suitable soil ❑ Mound 5 24 in. suitable soil ❑ Mound A+0 ❑ Sand Filter ❑ Constructed Wetland ❑ Peat Filter ❑ Drip Line ressuri In-ground ❑ Holding Tank ❑ Single Pass ❑ Other At-grade ❑ Aerobic Treatment Unit 13 Recirculating reatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application Rate / 5. Percolation Rate 6. System Ele4ation 7 Final Grade Required Proposed (Gals./day/sq.ft.) / (Min./inch) levation q I/ V/ 0Q'5-Q'1 5_0 1700 goo I_5_0 10.- 40 VI. Tank Information Capaicty in Gallons Total # of Manufacturer Prefab Site Con- Steel Fiber- Plastic .Lo ~o New Existing Gallons Tanks Concrete strutted glass Tanks Tanks W ~4 s l~ ❑ ❑ ❑ ❑ o ❑ ❑ ❑ ❑ VII. Responsibility Statement I, the undersigned, assume responsibility for repair/reconnenction/rejuvenation/installation of non-plumbing for the POWTS shown on the attached plans. A license is not required for terralift repair or the installation of non-plumbi g sanitation system. Piu er's Name (print) Plume Sign re M /MPRS No. Business Phone NMmb o 3s 42 Plumbe ®dd,ess (St tCity StatZip odIII. County Use Onl Di Vl d JSanitar .y Permit Fee D e Iss d Issuin ent Si❑ Approved Owner Gi I Adverse 1 nation IXnditions of Approval/Reasons forDisapproval: C ~ 5~ Frog. be,~~ ptA, 7f-I-Z'i>9 17 t4 4) 'Lf LA-eml 11 x 13'-~ _ ~ ~ .sue ~ X13-_y7,oaf X S- y s ~ry) ~Lt -1 I / o / J cr3 a~ ~W' 9 c6 6A -7 9 17 yd :~C; ouzokyc x5-I= ~,sar 9 x ~3-a - y7, oa' 3 _j, 1 y M ~ ` i Ob V F v M} , tiv b J f ell ell/ •d 5~ Y1 '8 b ~ p m B it y J W W in ~L ~ 4 r X a u4~ a~ O d Q wOO SQW S N ;ww g 11 111 o r i a TI-M 0 w 0 b 'g Es kn a m In 0 wO w yyyyW 5 w ma, E 0' q u}l C-4 w In 'AOOSOUIONMmam a .1 1 U- 9 o i o N to N I EE] O Z o w } Ippli" w J w w TUB W- uj 7M z 0 IM T-1 w J w z i o ~ } rT-l ® w J HHl w HfA HTH LL w J I w 'g s U, 4 m S J SS 2 N Z , es LU e- W Q Lt wog.AA!D1A i S, Nft X ° O 'e3 o (CV l[1 cn Ick I I I ~ - I I _ I II I ® I I+ I ' I II A~ I i ;If gJl i I I 1 I I I / _ -------F llv I e ~ _ _ 1J / _ I III I s I "r / ~\I i Ili I a I ~ x m i L--- I ~ I I„ Q ry l l _ I@ 1 1 I I 11 1 11 . a r--_ 1 I ~ I oo° I ~ RN. I I I i 7 m I J 1 l tr I m -e 1 I 1 m I @ I 6 ~ ~7S ,R a g. Ia ~ ~ M 9 € pp R R ~ p @ ~ps M fill WIN ygygyg Fq $6 i ti. r °n A m In o C-4 LUI in 9 I I ~ I g a N I I I 1 I m i t ® ~ 1 Pi i aK I` - a O t--4j) A~ I W i W s€ I I I 0 I I I ~ r -ED - f I 1 I "I I I ~ I I I a I ; I I ~ ~ J I Ila t RR = "!y1RH d g 6pB EE J yyy xp kFg$ 3x s a§ ~ ~y # as$ q lilt a ~ In fill @@ q a i q~ a¢ ~R" all! I a b'g~ k N 4p 10 4 C14 tul in WW ' wc*-AnQW"jj4SMjaOWMMNk 11h ]1 2 ~i LL_ u~ a Z zS ~ z Ln Ali1111 IR = o a. o s ~{O €'...1=~ra'~( o8'ui.'" z~>$FW~ woyyt Ki t " l+g zq Rm!i Q yyob d° y n Rtlod._ ~AL7od.~ R~ tu W .B/l t b 9/t LA 0 H a-.OL A t o$ a m a y ~a J ~'I ITI-111_ Hu 1=1 wn:s= a =»s ^`6~ I I-III-M, 111-1 s -111 -111 ~ IIIIIIIIIIIIIIIIj ~ l III-III=1 III=III-III ; I III-!ail a 58 ni Y„ RIB III g I'4 p 2 ~3 R~~~ ~SBLa~ S 9~ ~Y d O v N H W__ FMJ - III ~ W CERTIFICXTE. . to hereby certify that on the day of 20/ 1 inspect the waste ed b disposal system located on property County, Wisconsin. and based on Paid inspection, 1 certi the following: Z . Type of system (describe): ~ - 2. Capacity. 3. Number of families occupying dwelling.: 1 4, Number of people usually occupying dwelling: 5. Distance of system from dwelling. ;;>60 6. Does system require pumping or.c leaning to operate properly- it YES. how often? 7 Were toilets, ink and other drains apparently working properly at time of inspecbon? /V-j22 B. Was there any seepage or discharge ft-orn the system evident? Afc) If YES, what i* the probable cause? 9. Was there any portion of the system in obvious need of repair or replacement?Q If YES, what pert? 10. Distance of system from nearest lake, river or ether body of water. Was there any evidence of discharge from said system into a take, river or other body of t water? /U© If YES, describe: 11. OTHER COMM. ENTS: ; The inspection of this sewage disposal system was based upon a surface inspection of said system and, did not involve any excavating or chemical tests of the system. Accordingty, there is the possibility of hidden defects in the system not discoverable by this inspection. This inspection certificate does not in any way warrant or guarant a the continued proper functioning or opar~ation of this system- Data: Inspect b3s Plumber's Licen a Number d Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix ' Safety and euil`dirig Division INSPECTION REPORT Sanitary Permit No: 514976 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: Wersal, Anthony Pleasant Valley, Town of 024-1010-60-325 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: Vol _C_~9 MJ/ 07.28.17.53D10 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER V. +r CAPACITY STATION BS HI FS ELEV. 15,3u J DS - i o tS Septic BencWar 7 ~~f~ Dosing an Alt. BM 3yq 2. 9X x,02 ! t Q Aeration wQ / Z,kr Bldg. Sewer ,ly Holding St/Ht Inlet '7P TANK SETBACK INFORMATION St/Ht O flit G` 179. TANK TO P/L W EL BLDG. Vent to Air Intake ROAD Dt Inlet 7 Q4 vfAw r 7.9 Septic Dt Bgjom - Dosing J Header/Man. J• Aeration Dist. Pipe V ' Holding Bot. System I 72 Final Grade to PUMP/SIPHON INFORMATION 66 • q7i Manufacturer r - Demand St Cover / GPM Model Number yt r '7S, 137 TDH Lif) ; Friction Loss System each TD Ft l r I Y Forcemain Length , r Dia. r Dist. to Well SOIL ABSORPTION SYSTEM D cv r (0.12- , Sg BED/TRENCH Width Length if No. Of Tf nche PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS le, /3- - SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type f System: UNIT Model Number: t 00 DISTRIBUTIONS STEMv>ut-,. i I Header/Manifold Distribution Ix Hole Size; Hole Spacing V to Air I e Pipe(s) Length Dia Length Dia Spacing + r ` ,..r SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges .yam ^ Topsoil Yes No 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:/ inspection #2: ) Location: 492 CTY lyd,Hyamm WI 54015 (NE 114 NW 114 7 T28N R17W) NA Lot 5 i K4 PL~ Parcel No: 07.28. DIIOt~~ 1.) Alt BM Description - I _ f• 2.) Bldg sewer length = a-7 - amount of cover b_~ n~z, J 1~/c- 6Q r" r---- - Plan revision Required? ❑ Yes X 'No I awl / Use other side for additional information. L1 SBD-6710 (R.3/97) /ore's Date Insture Cert. No. Safety and Buildings Division Count~7 201 W. Washington Ave., P.O. Box 7162 onsin Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co ) Ivi-sic Department of Commerce (608) 266-3151 / , 7 7 Sanitary Permit eation state Plan I.D. Number in accord with Comm 83.2 1, Wi e nformation you provide 5 7 33 may be used fors at u s 15.04(1)(m) . ~Q Project Address (if different than mailing address) 1. Application Information - Pleasent or ti Property Owner's Name Parcel # Block tl N L U .S/~ SEP NAY s.",- ..S`- Property Owner's Mailing Address GR0 CF~1C roperty Location 773 11 S Z~~1~~1G Mt Ldl, Section 7 City, State Zip Code lone Number 6ti J P4 /U ZFw J6 ? 6S7 - aVY-"W o (circle QQ~~e) _QN; R~E oU II. Type of Building (check all that apply) Il(J') k- T 1 or 2 Family Dwelling - Number of Bedrooms 1~• Subdivision Name SM Jklumber J 8O 5,5- IPerJ 30*9 ❑ Public/Commercial - Describe Use 23 ❑ State Owned - Describe Use ' ❑ it it ❑Village~eT wnship f III. Type of Permit: (Check only one box on line A. Complete line B if applicable) 1610- A70 L'.Ufs A. New S stem y ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision El Change of El Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: Check all that apply) p t7>v e ❑ Non -Pressurized In-Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil *At-Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In-Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel-less Pipe ❑ Other (explain) V. D' etsallTreat cut Area Information: Design Flow (gpd) Design Soil Application Rate( dsf) Dispersal Area Requir (sf) Dispersal Area Proposed System Elevation / lys-o , sa Il~~ 9nD //o© - 58 V VI. Tank Info Capacity in Total Number Manufacturer Prefa Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks 24 Septic or Holdin_ Tank ~ /Od o /O oo , Aerobic Treatment Unit Dosing Chamber " ao VII. Responsibility Statement- I, the undersig ed, assume responsibility for i allation of the POWTS shown on the attached plans. Plumbee'N a (Print) Plum Si ure MP PRS Number Business Phone Number 0? ao 357 716 - 057 Plumber's Address (Street, City, State, Zip Code) VIII. C unt Department Use On1l Approved Disapprove Sanitary Permit Fee (incl des Groundwater Date ue Issuing A Signatur tamp Surcharge Fee) ❑ er Given R eason for I (i(J IX. Conditions of Approval/Reasons for Disapproval / /I SYSTEM OWNER: 3\ J boo cC s'C. G 1. Septic tank, effluent fher and Q,~, E~dr t=ce7t - 11/Z 146; to dispersal cell must all be services / maintained as per management plan provided by plumber. ?J) 2. All se%ack requirements must be maintained »s tide / ordmar>ces. 6✓: l d d uGo ~n~c 56✓ Attach complete plans (to the County only) for the system on paper not less than 81/22xx 111 inches in sift J Y~ ✓ ~ A. Ac)C.rA.. YZ7 b~+ l1lJ~ 5~ tJiA~J.~ SBD-6398 (R. 01/03) 0 a~ s 9 17 13--1 X 13-~_ obr gpl, 13PA - a~ y~~y .0 Cb xl' f/ S- ~b/ / I c3 a ' ~ I ® ~d I L X 7of llte~ L5,t~d f ~ L ~3ru - a q; - Y. o -IV l~Q ti An •d 1. Safety and Buildings y + 3824 N CREEKSIDE LA commerce.Wi.gov HOLMEN WI 54636 TDD (608) 264-8777 sco n s i n www•commer isco.wi.gov/sb/ Department of Commerce www.wisconsi.gov Jim Doyle, Governor Jack L. Fischer, A.I.A., Secretary August 25, 2008 CUST ID No. 220357 ATTN: POWTS Inspector BRADY J UTGARD ZONING OFFICE UTGARD PLUMBING & HEATING ST CROIX COUNTY SPIA PO BOX 413 1101 CARMICHAEL RD AMERY WI 54001 HUDSON WI 54016 CONDITIONAL APPROVAL REVISION - TYPOGRAPHICAL ERROR / 4BR to 3BR PLAN APPROVAL EXPIRES: 08/25/2010 SITE: Identification Numbers Anthony Wersal Transaction ID No. 1579133 CTH J & N Site ID No. 741382 Town of Pleasant Valley Please refer to both identification numbers, St Croix County above, in all correspondence with the agency. NE 1/4, NW1/4, S7, T2 8N, R17W FOR: Description: Three Bedroom At-grade System / New construction / 4% slope Object Type: POWTS Component Manual Regulated Object ID No.: 1196543 Maintenance required; 450 GPD Flow rate; 48 in Soil minimum depth to limiting factor from original grade; System(s): At-grade Component Manual, SBD-10570-P (R.6/99), Pressure Distribution Component Manual, SBD-10573-P (R.6/99) 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. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders: • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. • 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 inspction shall be made with the designated county official in accordance with the provisions ofSec. 145.20(2)(d), Wis. Stats. • The area within 15 feet horizontally down slope of the dispersal cell shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the effluent filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • 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. p.O.W.T.S. Crn i~ ~1~ a t R 0 W wb BRADY J UTGARD Page 2 8/25/2008 Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS dcscribed in this approval. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s.Comm 83.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptible to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or addtions 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 erard M Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code:' 7633 jerty.swim@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. i OIVIS~C,t+tJF SAFL7Y ANU WiLUING5 LL,- CUi i~L U''L LLivCc Safety and Buildings { 1 3824 N CREEKSIDE LA commerce.wi.gov HOLMEN WI 54636 i ■ TDD (608) 264-8777 sco ns n www.commerce.wi.gov/sb/ Department of Commerce www.wisconsin.gov Jim Doyle, Governor Jack L. Fischer, A.I.A., Secretary August 25, 2008 CUST ID No. 220357 AT7W. POWTSInspector BRADY J UTGARD ZONING OFFICE UTGARD PLUMBING & HEATING ST CROIX COUNTY SPIA PO BOX 413 1101 CARMICHAEL RD AMERY WI 54001 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/25/2010 Identification Numbers Transaction ID No. 1579133 SITE: Site ID No. 741382 Anthony Wersal Please refer to both identification numbers, CTH J & N above, in all correspondence with the agency, Town of Pleasant Valley St Croix County NEIA, NW1/4, S7, T28N, R17W FOR: Description: Four Bedroom At-grade System / New construction / 4% slope Object Type: POWTS Component Manual Regulated Object ID No.: 1196543 Maintenance required; 450 GPD Flow rate; 48 in Soil minimum depth to limiting factor from original grade; System(s): At-grade Component Manual, SBD-10570-P (R.6/99), Pressure Distribution Component Manual, SBD-10573-P (R.6/99) 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. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders: • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. • 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 ofSec. 145.20(2)(d), Wis. Stats. • The area within 15 feet horizontally down slope of the dispersal cell shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • Maintenance information must be given to the owner of the tank explaining that periodic clewing of the effluent filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • 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. P.0'r- .T.S. Conditio~~am' r --h Rox, } BRADY J UTGARD Page 2 8/25/2008 Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s.Comm 83.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptabb to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions slauld 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 Received $ 175.00 0Fee Balance Due $ 0.00 ard M Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swim@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. } RESIDENTIAL AT-GRADE DESIGN INDEX AND TITLE SHEET Project ANTHONY WERSAL Owner ANTHONY WERSAL Address 773 LIVINGSTON ST. PAUL MN. 55107 Legal Description NE/N1 M-7/T-28/R-17W Township PLEASANT VALLEY County ST. CROIX Subdivision Name VOL.22 PG.5309 Lot No. 5 Parcel ID Number Plan Transaction Number index sneer rage 1 Calculations Page 2 At-grade drawings Page 3 Laterals and dose tank Page 4 specifications Page 5 Management & contingency plan Page 6 Designer BRADY GARD License Nuirnbsr MP 220357 Signature Phone Number 715-760-0946 Date W1131~1~ Designed pursuant to: At-grade Component Manual for POWTS SBD-10570-P (R.6/99), and SSWMP Publication 9.6 Design of Pressure Distribution NeMarks fbr ST - SAS (01/81) Version 3.11 (05/01) P e 1 of 6 NlSiONOF SAfLlYANU EuiLbliiGS C(A PRESSURIZED AT-GRADE DESIGN Flows and Site Data Entry. r Residential or commercial? 300.0 Estimated wastewater flow (gpd) 450.0 Design wastewater flow (gpd) 3.80 % Site slope 98.58 Contour elev. below lateral (ft) 48.00 Depth to limiting factor (in) 0.50 In-situ soil application rate (gpd/ft^2) Distribution Cell Information 1 Influent wastewater quality 4.50 Linear loading rate gpd/ft 9.00 Effective absorption width (ft) 9.00 Max. effective width permitted (ft) 100.00 Aggregate length (ft) Pressure Distribution Data Entry M c Center or end lateral connection 21 Number of laterals 0.188 Orifice diameter (in) e.g. 0.188 2.00 Estimated orifice spacing (ft) 2.00 Forcemain diameter (in) 3,37 Forcemain flow velocity (ft/sec) 115.00 Forcemain length (ft) y Does forcemain drain back? 91.00 Pump tank elevation (ft) y Are laterals at highest point? to NA 3.25 System head (ft) x 1.3 18.8 Forcemain drainback (gal) ~7.08 Vertical lift (ft) 45.0 5x Lateral void volume (gal) 2.66 Friction loss (ft) 63.8 Minimum dose volume (gal) 12.99 Total dynamic head (ft) . 33.0 System demand (gpm) Lateral Diameter Selection Gallonsfinch Calculator Pipe diameter Design options Design choice 800 Total Tank Capacity (gal) 1 in 37 Total Working Liquid Depth (in) 1.25 in 21.6 Gal/in (enter result in cell G46) 1.5 in X x 2 in x Treatment Tank Information 3 in x 1000 Septic tank capacity (gal) weeks Manufacturer Effluent Filter Information Dose Tank Information Zabel Filter manufacturer 800.0 Dose tank capacity (gal) A100 Filter model number 21.7 Dose tank volume (gal/in) weeks Manufacturer Project: f }IUT 1q" N 5 Transaction Number: ( Page 2 of 6 6 d AT-GRADE PLAN VIEW 116 B Observation pipes (2 typical) A 9.00 ft T D B 100.00 ft 1/6 B 16.67 ft W C 11.00 ft D 5.00 ft E 2.00 ft D B L 110.00 ft W 21.00 ft A x B 900.00 ft^2 L E--- Cap obs. pipe. = Total aggregate cell A x B Typical Slotted in n the lower C] =Plowed area L x W 6", and anchored securely. 4 6" AT-GRADE CROSS SECTION Synthetic fabric cover 100.37 ft Finished grade Lateral elevation invert elev. 99.08 ft Observation pipe at aggregate toe E Surface contour -9-8-5-8 ft C 3.8 % Slope and system elevation D ® = 12 in. topsoil and subsoil over aggregate and tapered to toes. Plowed layer below L x W :::I = 6 In. aggregate Delow pipe(s), and 2 in. above pipe. Nroject: AN 1 NUNY {NLKSAL Transaction Number. Page 3 of 6 PRESSURE DISTRIBUTION AND DOSE TANK Lateral Diagram - Center Connection P If X-3If 812 I 023` Laterals & force main of PVC Sch 40 Last hole drilled next to end cap (per C dMM Table 84.30.5) Hoies drilled on the bottom of the lateral, equally spaced • = Turn-up vvtball valve or cleanoutplug Lateral Specifications 0.188 Orifice diameter (in) Center Lateral connection point X 2.00 Orifice spacing (ft) 2 Number laterals 25 Orifices/lateral P 49.00 Lateral length (ft) 16.5 Lat. discharge rate (gpm) 1.50 Lateral diameter (in) 2.00 Forcemain diameter (in) 33.0 Sys. discharge rate (gpm) 115.00 Forcemain Length (ft) 12.99 TDH (ft) Typical Pump Chamber Layout Approved manhole cover with Weather-proof warning label and locking device junction box Final grade 4" disconnect Tank component is Alternate properly vented 'r outlet location 1 a" min. Elechical as per NEC 300 and /c Comm 16.28 WAC Approved outlet Tank full joint = Inches Gallons JA Provide 114° 2 A 19.9 432.4 Alarm on weep hole or B 2.0 43.4 g antisiphon Pump on device. € C '2.9 63.8 C o D 12.0 260.4 92.00 ~ft Totals 36.8 800.0 Pump off D Bedding under tank 91.00 ft GOULDS Pump manufacturer SJ€ Alarm manufacturer EP05 Pump model number 101 Alarm model number Project: /tit~'/a'v Transaction Number: Page 4 of 6 15 _15 7 At-grade System Maintenance and Operation Specifications Service Provider's Name UTGARD Phone 715-760-0946 POWTS Regulator's Name ST. CROIX Phone 715-386-5680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 900.0 fe Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Inspect and clean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Inspect for ponding and seepage once every 3 years Miscellaneous Construction. and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the at-grade component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis_ Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The at-grade structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. 6. Areas within 15 feet of the downslope toe will be protected from compaction. 7. All other construction details are as per the at-grade component manual SBD-10570-P (R. 6/99). Lateral Turn-uo Detail Finished 0*000**0000000• Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral ~i Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: ANTHONY WERSAL Transaction Number. Page 5 of 6 At-grade System Management Plan Pursuant to Comm 83.54, Vft. Adrn. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10570-P (R OWN) and SSWMP Pub. 9.6 (04/81)] and local or state ntles pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or purrs tank manhole risers. access risers and corers should be inspected for water tightness surd soundness, Access openings used for service and assessrrien t shy be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be med. Exposed access openings greater than 8-inches in diameter shall be secured by an effective kmdntg dance to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Vlrs. Adm. Code. The operating condinon of the septic tank and nutlet filter sly be assessed at once every 3 yeas by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filler cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the flier when removed from its enclosure. If the MW is equipped with an alarm, the filter shall be serviced it the alarm is activated corinrwousty. Intermittent filter storms may idic ale surge flows or an impending continuous alarm. The septic tank shall haw its contents removed when the vole ns of sludge and scum in the tank nsmoeed 1 113 the liquid vofurne 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 nand service needs to be performed to maintak lase than maximum scum and skdge accunxdetio n inthe tans The addition of biological or chemical additives to enhance septic tank performance to generally not required. However; if such Products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at (east ace every 3 yeas. AN , atams, and pumps shah be tesid to verify proper operation. If an effluent filer is installed within the tank it shall be inspected and serviced as necessary. At-wade and Proem" DtotrNmA m Stem No trees or stubs should be ptormted on the at-grade. Plar&W may be made around the at-grade's perimeter, aid the at-grade shall be seeded and mulched as necessary to prevent erosion and to provide sours protechorm from frost penetration. Traffic (odmer than for vegetative rt mane) on the at-grade is not recommoanded sane sod com pacbon may hinder aeration of time infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather i tions (October-Fehtuay) dicfa6s that the at. grade be heavily mulcted as protection from freezing. Influent quality into the at-grade system may not exceed 220 mg/L BOD5,150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5. 30 mg/L TSS, 10 mg& FOG, and 104 c W100 mL for highly boated effluent. kmfkient flow may not emceed nmadmum design flow specified in do permit for this ' . The pressure distnbuti orm system is provided with a fkalarg point at the end of each toted, and it is reconnow d that each lateral be flushed of accumulated solids at Nast once every 1S months. When a pressure test is performed it shouted be compared to the initial test when the system was installed to determine W orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the disperse' cell shy be checked for effknermt ponKling. Pording levels std be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or oompone t shah be repaired or replaced to keep the system in proper operating condition- If the dosing tarns, pump, pump controls, alarm or sew wiring becomes defective the defedive component(s) shall be immediately repaired or replaced with a component of the same or equal perforrraroe. If the at-grade component tab to accept wastewater or begins to discharge wastewater to the ground surface, it vrdl be repaired or replaced in its' present location by increasing basal area it toe leakage occurs or by renovating the biologicaYy clogged absorption and dispersal media. it g new, piping, and replacing other components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan fbr the new and telephone number of your local POWTS regulator and service provider Project: ANTHONY WERSAL Transaction Number. Page 6 of 6 Goulds Submersible A OI-i I I Effluent Pump N 3871 EP04 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover. Thermoplas- • Homes components. Available for automatic and tic cover with integral handle Motor: and float switch attachment • Farms manual operation. Automatic • Heavy duty sump • EP04 Single phase: 0.4 HP, models include Mechanical Points. • Water transfer 115 or 230 V, 60 Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty • Water Dewatering RPM, built in overload with preset at the factory. rated oil and water resistant. automatic reset. ■ Bearings: Upper and lower SPECIFICATIONS • EP05 Single phase: 0.5 HP, FEATURES heavy duty ball bearing 115 V, 60 Hz, 1550 RPM, Pump: EP04 built in overload with construction. automatic reset. ■ EP04 Impeller: Thermo- Solids handling capability: plastic Semi-open design 3/4' maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. CP .camwlanSiaWwftASSWAN • Total heads: up to 24 feet. with three prong grounding m EP05 Impeller: Thermo- - • Discharge size: 1lb" NPT. plug. Optional 20 foot (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for end in "F" or "AC'.) rotary/ceramic-stationary, three prong grounding plug improved performance. BUNA-N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104°F (400C) continuous superior strength and 140°F (600C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless stainless steel. 10 ' i - • Capable of running _ dry without damage to s 30; - - 4----- - - sGawn components. 1 E i Pump: EP05 a Zs Fr • Solids handling capability: 34"maximum. w 7 i • Capacities: up to 60 GPM. s • Total heads: up to 31 feet. i • Discharge size: l'z"NPT. a - ~ z 5 ! ! I i • Mechanical seal: carbon- rotary/ceramic-stationary, 4 ~j BUNA-N elastomers. o f_ i "I EPOS • Temperature: 3 10 - - - - ' - _ I__ 104°F (400C) continuous 140°F (60°C) intermittent. 2 i EPm _ 5 i ' 0 30 40 - - GPM 0 2 4 6 8 10 12 m3/h CAPACITY ..'T'he r at- !p-t3 uh0 L r v"~O LA ~'G GO Mflsotxlsin De afimentof Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85. Wis. Adm. Code County Attach complete site plan on paper not less than 8 112 x 11 inches In size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Patel I.D. percent slope, scale ordimensions, north arrow, and location and distance to nearest road. Please print all Information. Reviewed by Date PeROnat Information you provide may be used for secondary purposes (Privacy Lew, s. 15.04 (1) (m)). Property Owner Property Location Govt. Lot F 114 NW114 S 7 T N R E( w Property OVY iers Malting Address Lot # Block # Subd rte CSM# ty State Zip Code Phone Number ❑ City ❑ Village Town serest Road MfJ s5)0 ) - o S& 4 e t New Construction Use: 1A Residential / Number of bedrooms 3-4 Code derived design flow rata &b GPO ❑ Replacomont ❑ Public or commercial - Describe: Parenl material jD-,wg : h over bee, h tam food Plain e.evalion if applicable ^ p e R• ! D • S$ r General comments T%2 s t 'Ourt "Qt- 5tt`O..Ose \ M D V en91 5(2+-O,-"F and recommendations: Boring # ❑ Boring pp Ground surface elev. S• 5g ft. Depth to limiting factor- In. Soy Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/If in. Munsell Qu. Sz. Cont. Color Or. Sz. Sh. •Eff#1 '0112 a-~3 7.SyRy/y "y ar, r+n ~ G w / t~ 3 a3-3 7,51(Z Y - S, L FS rn C W t q 3)4Z 7.511ZY 5 FSb M e- c. . D - -s a F-21 Boring # ❑ Boring •9 Pi) Ground surface elev. 985 it. Depth to limiting (actor In. Soy Appillce tiorl Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPWK In. Munsell Qu. Sz. Cont. Color Or. Sz. Sh. 'Eff#1 0112 n`f ~a L a r~ ativ a . S 9 J 9 S1W11y S Gtr G it O 9-a 75 yR~ ik r G >a ► 52, 'Effluent #1 =180D > 30 220 mVL and TSS >30,5 150 mq& ' Effluent #2 a BOP .5 30 mgA. and TSS 130 myL i n Name {Please Print Sg ature am/ CST Number as H f Telephone Number Date Evaluation Conducted C Proporty OKner T i__ /1 ! f71~ ~/-A Parcel ID # Page of Boring # - ❑ Boring 1-21 59 pit Ground surface elev. 7• wg ft. Depth to limiting factor G D In. Sod A"lleation Rar qj Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#l 'Eff#2 DIV%L a .12. M F _7 'S Y F6 16W. mfr- cam, ho F .1.11.0 w Boling # ❑ 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 Clu. Sz. Cont. Color or. Sz. Sh. *001 'Eff#2 ❑ Eoring # ❑ Boring T ❑ Pit Ground surface elev. ft. Depth to Ii"Ung factor in. Sod AwficaLion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff i h. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -Ett#1 'Eff#2 i ' ENuent # 1 =13OD+ > 30 < 220 mg/L and TSS >30 < 150 mg& ' Effluent #2 = BODr < 30 moll. and TSS < 30 moll The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or raced material in an alternate format. please contact the department at 608-266-3151 or TTY 608-264-8777. 5e0433era ~Wr I r ~ h L. to Y" U4 ~ ~ ~aQbS L ~o v5 e- a 00. 99 ~q I-bo s , CA r6 t.3 co co 3 ~ e _ o9-19t _ - - . - 3 838Lm3e5 DEC - ~ ~ VOL 22 pAGE 5309 REGISTER OF DEEDS ST. CROIX CO. MI ST. CROIX COUNTY RECEIVED FOR ECORR„ SURVEYOR'S RECORD CERTIFIED SURVEY MAP CERTIFIED SURVEY MAP PAGES: L 2 3• We FIRM .90 David D. and Kristin L. Juen Located in part of the Northeast Ve of the Northwest Y4 of Section 7, Township 28 North, Range 17 hest, Town of Pleasant Valley, St Croix County, Wisconsin, being Lots 3 and 4 of that Certified Survey Map recorded in poltonel3, Page 3602 of St. Croix County Certified Survey Maps. o. NORTH 114 CORAM 1 ' 33', y: SECTION 7, T2814 R I W j~ I G1; (FouNO COUNTY 8SWiTSM / NoRTHwESrCORNER !1N_P_LAT-nw.t.mv--S ALUA WWOONUMOM SEaC=7, r28At R 17W 4• (R-seo'3anwE ae~.m 4~- wron~~--: ALIMNNU MONUM S etiL4 E ~8 69_ +F7-its, • NORTH LINE r+wt~s~ 4 lC. •T,.H 3 aq•45`W E 412.19' i i 6 68'd633 E ?386.15 ' =-4b.00 VAR. s W4S r a 31 ~s t.z TsM, Z• OWNER-SAROMS '478 C.T.H."X GUM HAMMOND, WI 54015 3ET8AQKLNME trji.{7 L- 1,0167.00' & CH1 a N LOT 7- CO- s41 8 ear e 'R 2ORS~AG 'qy I TAN~2 818•a1rE / t f SEARWWAOICREFERSWED TO THE NORTH40UYH ~ ix SECTION LAVE OF SECTION T. (19118?9 SQ FT 30*VMIEw.,AS31AM®AS $ RIGHT OF WA" ' Lo- T_21 LOT-3 CERT1F-!W $QI?Y-fY_MA_ P SCALENFEET 1•=2w ;s e S 89.4677- W 410,89' 180 10 260 44 CD N N ~~r--f' 1 W ,il LEGEND .4 4,, zo..e DoE ' O /NDNCATES f'O.D. x 18• IRON II FNPE SET (MWN. Wr. -1.13 LBA.F.) L T 6 - - & INONCATES 1'IRONPNFEFOUND d 44 SO Fr 222N559: ' 24 SEC1iON CORNER MONUMENT OR 0.228 AQ s' I £ (AS NOTED) -,y- ' $ I f zJ (R•) RECORDED AS LOT 1 , s VQ4tlME 13_, -T~ ' 12 tnvEZaN~(,, ~oRwv y zs. P: 3445 ~~~si•y, i _ ~ tar 4f. 9 N 89•a~'os• W 70"JI't1~ 859.1T (Ry N AD I G ~N3i 'UNPLATTEVIANDIS MV • 'i ~ i 1 13 • ~ 'OENVI4LH, p WI. i DATED. OCTOBER • 4. 2008 SOUTH 114 CORNER u,,ao (FO! Sec )KALUM/NUM MiOI1NMA9Y7) • TM MfSTRUMENT DRAFTED BY JERALD L. LARSON SHEET t OF 2 ~ 1 of 2 Vol 22 Page 5309 ~,-~-p;~-~a.~ij -q$se..-rhea C,0 L214 I AGa+~ h F; G1a9,. Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1- of Division of Safety and Buildings in accordance with Comm 85. Wis. Adm. Code County D ~ Attach complete site plan aper not less than 8 1/2 x 11 inches In size. Plan must include, but not Ii to I and horizontal reference point (BM), direction and Parcel I.D. Z D+ • percent sl r ns, north arrow, and location and distance to nearest road. 46 Z ~i print all Information. Revte d by Date Persdltil lnr n you provide may be used law, s. 5.04 (1) (m)). Z0? Property Owner Pr pertyLocation We e-840. Go . Lot e 1/4 0014 S Ta N R E (o C Pck # Subd.~me or M# Property04ees Ma ngAddress %Sty City State Zip Code Thong f(G 0FF1 ity ❑ Village E~kTown Barest Road . L.. 14" "Ji ( D QASez e en. Q1 fi New Construction Use: E9 Residential /Number of bedrooms 3-4 Code derived design flow rate 0 GPD ❑ Replacement ❑ Public or commercial - Describe: - Parent material .0_t?'4. 4..5 h 0%2eW btoKCA )njajltj~Klood Plain e!evation if applicable _ J tt• General comments 1 S'175rj d-S t 4un ' r 0.'t ~e \ t'r1 o V ex g s 42+ '-O' 1" 9 g . S r and recommendations: T Boring # Boring Q pit Ground surface elev. v 58 f(. Depth to limiting factor6 _ 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 r I o- 1 o'f R'`I a o a w r . 1'P D. s a-~► 7.SyRy/y "y am m G w 3 4-3425 IR Fsb v-J mc w • y q 3a-3 7,5yRy S FSb MFr' Cw - . D IS C. D. h I K•~ ~--771 FZ-1 Boring # O Boring r '9 Pit Ground surface elev. 984A ft. Depth to limiting factor . - In. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Etf#1 'Eff#2 9-19 7:51W-01 R`&-" d c-'o r D -a 75~R`~ L k hnEr C ~ 12P *L. JoD - r c -A--' C- V-+v in e D h ' Effluent #1 = BOD > 30:5 220 mg/l- and TSS >30 5 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS : 30 mgIL %ak Name (Please Print Signature CST Number as ) -qLv e,,,,,Qse t~oDate Evaluation Conducted Telephone Number Ir0 _ - o S 1. W 5 I ~ r. Property Owner A1Tf,9h%j Parcel ID# Page of F131 Bring ❑ Boring D~ It. Ground surface elev. _97_ - . Depth to limiting factor 01 In w. Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Etf#2 { 0-1~ oyRa - I± a G Q M r~.w OF 8 a-a ~,syQ~ 1141114-411 K w - ,"-7 e- I 3 ab- 7.SY~yI a 16WL Kifr- en, 1oF , b Boring # ~ Boring ❑ Pit Ground surface elev. h. 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 # ❑ Boring F-1 pit Ground surface elev. _ R. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP /ff In. Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 'Effluent #1 =GODS > 30 5 220 mg/L and TSS >30 150 mg& ' Effluent #2 = SODS < 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 608-266-3 15 1 or TTY 608-264.8777. sao•uio ta.aroor • f Property Owner ~LJ_k Parcel ID # string ❑ aBgdng Page _G7(_ of Pit Ground surface elev. 97 ;D ft. Depth to limiting factor in, Horizon Depth' Dominant Color ficaGon Rate . Redox Description Texture Structure Consistence Boundary In. Munsell Qu. Sz. Cont. Color GPD/ft' Gr. Sz. Sh. 'Etf#1 'Eff#2 IS 1 kit loF Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor _ in. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil GPO fF n Rate in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Effr11 •EfF#2 Boring # ❑ Boring F-1 ❑ pit Ground surface elev. _ ft, Depth to limiting factor in. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil GPQ~ti Application Rate In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Etf#2 I ' Effluent #1 = BODE > 30 < 220 mg/L and TSS >30 < 150 mg& ' Effluent #2 = BODS 5 30 nxA and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and cmpioyer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3 15 1 or TTY 608-264.8777. $6D4JJQ (8.6=) I/D l, E.. -00 yia. ~9 r~C [ a~~G~ . Y~L G Fe C- of V) 0 _ ` hn -IIQ ot 01010~o f31 ...s s o o r VI) O % ° CD lzf 6-71 C. -t- RECED 3 sA 3 B 6 3 5 G DEC r 5 2006 VOL 22 PAGE 5309 KA'rl . fiA H. W^Lbtf REGISTER OF DEEDS ST. CROIX CO. MI ST. CROIX COUNTY RECEIVED FOR ftECORD SURVEYOR'S RECORD 11/14/2006 03:15PM CERTIFIED SURVEY MAP REL. r EIS: 1 tow PY FEE: ES: 2 3.09 CERTIFIED SURVEY MAP PAG David D. and Kristin L. Juen Located in part of the Northeast 1% of the Northwest % of Section 7, Township 28 North, Range 17 West, Town of Pleasant Valley, St. Croix County, Wisconsin, being Lots 3 and 4 of that Certified Survey Map recorded in Volumel3, Page 3602 of St. Croix County Certified Survey Maps. C. NORTH 114 CORNER I 33' I Co. SECT70N r T 28 N, R 1 W (FOUND COUNTY BERNTSEN NORTHWEST CORNER C[NPtrATTED_ MP$ ALUMINUMMONIIMEN7) I . mcnoN 7. T 28 N, R 17 W N ~ VAR. 7G. . B&• WIOTM i•:; (FOUND COUNTY BERNTSEN (R" S 89.3009• E 2838.237 ALUMINUM MONUMENT) S 89.46'33" E 2838.59 - _ ` _ - __1 NORTH LINE NW114 C. _T_.H. "N" S 89°45'33• E 412.19' t 4V = SW46.33•E 2385.95 =•45.00 _ _ S 89.45'39' E 31 .15 0 1. ~••r•~~i 71 476 C.T.H."J" HAMMOND, WI 54015 sETSAC?ctiNe I tXlIRUE f-! t 5 u I R• 167.00" b 49'49'39• 1017 L- 145.25' CH-140.70' N LOT 5 , 8 42'59'38.5' E F~ 217,811 SQFT. TAN 1 8 87.54'26' E BEANNOS AM REFERENCED $ OR &000;4c. I TAN 2 8 18.04 47' E 70 THE NORTH49OUTH 1k 1 f SECTION LIME OF SECTION 7, $ (195, 822 SQ. FT. T 28 N, R 17 W, ASSUMED AS OR 4.496 AC. EXC. I S 00.00'28' E. z u3 RIGHT OF WAY) LQr- LQL3 I QERVI EF-4 $_v_R_Y_FY_-MAP (:e l SCALEIN FEET 1' " 200' ~ tl S 89'45'27' W 410.89' 1 00 b 10 2 Cli ' N 6g•OS:S7' ~ * 1'~y- an I , ~ ~ ►II 07 LEGEND 20 A9 W1 NAC E INDICATES 1"O.D. x 18' IRON O PIPE SET (MIN. Wr. - 1.13 LBA.F.) ° L r 8 I I=; • INDICATES I'IRONPIPE FOUND 445,,24 SO. Fr. 0 SECTION CORNER MONUMENT o~ • OR 0.226 AC. (AS NOTED) N I vi (R=RECORDED AS "3~7-;y•.EASEME T lit I 3 ~cQ' `,gam"' ~1~ 7~!~ly~ Nei '3py9.W P11 .oY'~ LOT 4 SHED , a ` LOT I C.S.M.'' PAGE 3602 I VOL, _ 12, KELL ~ 41 iTl~fu P-3445 ,,3°~'~~•y- ( ¢oRwv. 10a 41. 5' N 89°47'05' W 859.1r (/?-,V 89.30'54' VV ( I . • LAURE••• MU Y A • B OENVILVE. 1 DATED. • • • OCTOBER 4, 2006 RF LAND SOUTH 114 CORNET, SECTION 7, T 28 M R 17W (FOUN ALUMINUM D COUNT BBlr N) THIS INSTRUMENT DRAFTED BY JERALD L. LARSON SHEET 1 OF 2 1 of 2 Vol 22 Page 5309 ' "1 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer tAA~ , Mailing Address -7? 3 Al Property Address y ! c- fi (Verification required from Planning & Zoning Department for new construction.) City/State Parcel Identification Number C~ oZ ` l K, 6 a1 b O LEGAL DESCRIPTION Property Location N J6~ 1/4 , /U UA '/4 , Sec. , T N R l 7 W, Town of f,&91J-6A0i Subdivision , Lot # . Certified Survey Map # 3 a Volume o ?c- , Page # ~-3 a Warranty Deed # Volume , Page # Spec house yes Lot lines identifiable es no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification staring that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms SIGNATURE OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) I Ililll 1111! IIIII ill!! 1)111 1!111 IIII IIIIII Ill! IIII State Bar of Wisconsin Form 2-2003 * 8 5 54 8 3 5 1 WARRANTY DEED 855835 KATHLEEN H. WALSH Document Number Document Name REGISTER Of DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD THIS DEED, made between David D. Juen and Kristin L. Juen, husband and 07/19/2007 08:30AM wife WARRANTY DEED EXEMPT I REC FEE: 11.00 ("Grantor," whether one or more), and Anthony A. Wersal F A s; nctle ~Pfson TRANS FEE: 187.50 PAGES: 1 ("Grantee," whether one or more). Grantor for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant Recording Area interests, in St. Croix County, State of Wisconsin ("Property") (if more Name and Return Addre s space is needed, please attach addendum): 4 itf fit 0 Afr tt b ~ L Lot Five (5) of Certified Survey Map in Volume Twenty-two (22) of Certified 773 1_6 if A, Survey Maps, Page 5309, as Document No. 838835, filed in St. Croix County A t A~ - 3 S7 Register of Deeds office on November 14, 2006, being located in the Northeast y Quarter of the Northwest Quarter (NE 1/4 of NW 1/4) of Section Seven (7), d 1-C Township Twenty-eight (28) North, Range Seventeen (17) West, Town of Pleasant Valley, being Lots 3 and 4 of Certified Survey Map in Volume 13, Page 3602, as 024-1010-60-200 Document No. 597555. Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: Easements and restrictions of record. Dated I 0`1 (SEAL) (SEAL) + * David D. Juen _ -(SEAL) -(SEAL) * * Kristin L. Juen AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ) ss. authenticated on ST. CROIX COUNTY) Personally came before me on _ the above-named David D. Juen and Kristin L. Juen TITLE: MEMBER STATE BAR OF WISCONSIN (If not, ; ' tq,' e+• 'CS t~'' .die the person(s) who executed the foregoing authorized by Wis. Stat. § 706.06) t"'~" wtedged a e. r~ THIS INSTRUMENT DRAFTED BY: or, Thomas A. McCormack ;?,lot i , St#e, WISCONSIN Baldwin WI 54002 ` ~dycollltnissis permanent) (expires: OF r~ ` j (Signatures may be authenticated or ac&boyYledgcYd. tigtll'arc not necessary.) NOTE: THIS IS A STANDARD FORM- ANY MODIFICATION T(j rl t1 FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED STATE BAR OF WISCONSIN-_ FORM NO. 2-2003 *Type name below signatures- C State Bar of VAsconsin 2003 INFO-PRO legs) Forms - (eoo)656.2021 • infoprofo ms.com 1 of 1 ~H ~w o❑ aDv ~®r a f ag` ar ao \a~ 4-1 a ~ ~ ~ C 1 \ r/ ~J r ~ ~ 1 II ~ F f- r. Wrls6onsln Department of Industry, SOIL AND SITE EVALUATION Labor and Huata Relations Page ` of J Division of Safety and Building in accordance with s. ILHR 83.09, Wis. Attach complete site plan at nat4gss thai>f 1/2 >t:JA i hes In size. Plan must County Include, but not limited t : v' is r borizo-0 referee nt (BM), direction and 57. GiPD~ X ~S ~3St~ percent slope, scale or sionlt;~h arrow, d Ia nd distance to nearest road. Parcel I. D. # 3 , o;_ y- /oro APPLICANT INFO ION - a t ormatfon. R sewed by Date Act Personal Information you pro e~ma be us6ior secon ry p o'se (Privacy aw, s. 15.04 (1) (m)). Property Owner . \ Property Location ~~L) Govt. Lot N~,, 1/4 NAI 1/4,S 7 T 24 N,R 17 E (o C W) Owner's Mailing Address of # L.Block# Subd. Name or CSM# o'ZEIZ42j~' - tiJk14 3-lg CT CS city State Zip Code Phone Number N( ares Road , q /aC%U f I~~. SyDaL (~iy ) yis~ ~y3i ❑ City ❑ Village GT ~?f1 New Construction Use: C-fResidential / Number of bedrooms 3 ^ Addition to existing building ❑ Replacement U10, ❑ Public or commercial - Describe: Code derived daily flow gpd 3v - Recommended design loading rate - 7 bed, gpd/ft2 ' S trench, gpd/ft2 Absorption Area required 6,4Z) bed, ft2 'S" trench, it2 Maximum design loading rate bed, gpd/ft2 •.S trench, gpd/ft2 Recommended Infiltration surface elevation(s) Y-1 3 ft (as referred to site plan benchmark) L ~d'V ~QW ~OU~v sl sT 5-fvd9 le" t Additional design/site considerations w Parent material Old''' ~li /~s Flood plain elevation, If applicable ft Conventtiion~al ,-M-,ou~nd In-Ground 7Prere AT-Gradee System In Fill Holding Tank S = Suitable for system U = unsuitable for system El S t~ u L7 5 u El s ❑ S S U El s 0u/ ❑ s u l gi_ SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft2 Texture Consistence Boundary Roots In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench jj~q-lg 10YX 212 04 1W ellv /T U y /~•3 100 3/q'- ,s/L 2/f-Silt' n,+®fi/ CS 1 S ~ Ground 3 /Q yi~° y/~? ,clo s~i /T s ~1.~ " s/1 f S elev. ADD_ft. s Y i w o a 2 s/ co 4K 44 4 Depth to limiting factor V-in. Remarks: Boring # rbYie 2,2- G 2f5l~ie /WW CIV `U 7 • S ' •G v *A3 /OYX JW SQL L -'six ^Ic / CA/ /lei`' s ; . lO Ground .7 /b X Yl& f 1-F nor5 SL /f elev. 7.,S Y /00 eft. Depth to limiting factor -In. Remarks: CST Name (Please Print) Signature Telephone No. ;eo1.3E/er ~ T ✓06' B/f3S Address Date CST Number 22-4t3 7_5' Ulbricht 8 Associates Pchfste 8ewag* Consultants 05 aNetl Rd. Hudson, Wis. 54016 C_' ~ PROPERTY OWNER SOIL DESCRIPTION REPORT Page L- of PARCEL LDA Boring # Horizon Depth Dominant Color Mottles Structure 2 Texture Consistence Boundary Roots In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench IL 2- z .3 /0 Yye 313 5 7^ s cw 17a 157 Ground /p y2 S/L 2 S~ie GP`i CGtJ S elev 12 Yft 17 Depth to let limiting M O f factor ° s Cv Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # Ground elev. ft. Depth to limiting factor ln' Remarks: Boring # Ground elev. ft. Depth to limiting factor in' Remarks: SBDW-8330 (R. 08/95) r tP 0 ~P 77 3 M # FQU~, Top o F S L) faa~,/Oe s CSM 4:7p 9, sy' (1 3~ ~I i d SET Bar #2- ,.T . Top OF 6OV. d7 ~'~'DN~BvL~ ~I oU.v}~ ywl~ ~CGv, hjl N SySr. 3 o-f ' RECEIVED 3 - 5 2006 8 3 A a 3 !!5 DEC VOL 22 PAGE 5309 KATffL-C A H. ALSW REGISTER OF DEEDS 3T. CROIX COUNTY ST. CROIX CO.L MI RECEIVED FOR ![ECORD SURVEYOR'S RECORD 11/14/2006 e3z15Ptl CERTIFIED SURVEY HAP CERTIFIED SURVEY MAP COGESFEE2 3.00 PA: David D. and Kristin L. Juen Located in part of the Northeast l/. of the Northwest of Section 7, Township 28 North, Range 17 West, Town of Pleasant Valley, St. Croix County, Wisconsin, being Lots 3 and 4 of that Cert fed Survey Map recorded in Volune13, Page 3602 of St. Croix County Certified Survey Maps. NORTH 114 CORNER I SECTION I, T 28 N, R 1 W 1 1 F~ CO; NORTFIWESTCORNER (1NPLATTED_l ANDS (FOUND COUNTYSERNTSEN ALUMINUM MONUMENT) 'VAR SECTION 7. T28 N, R 17 W (R,,, $ eD.~g. E 293D N 2(FOUND COUNTY BM ENT) ERNTSEN (S 88.45359- E 2838.69' - YHOTFA *.1 ALUMINUM MONU NORTH UNE NW114 S 89°45'33• E 412.19' F. '°•fs~' S 86'46`33" E 2386.15 =-45.W v~ AR - - - e OWNER'S S 89'45'33 E 31/15' O ^ 1.2 ~!•T H ~~i~ 476 C.T.H. "J" 8 ` 41. HAMMOND, W 54015 or sETawpcLAWE , 02 CURVE 1.2 Rs 187.00' b 49.49'39' N Lori 1oa L CO- s r/W~36.ETa 217,811 SQ. FT ' TAN 1 8 87.5428' E BE4RWW ARE~JCW , OR aowiC. y ~ qy $i I ~ TAN 2 S 18.04'47' E TD IMNORTMSO1ml fAt SECTIONLNE OFSECf7ON 7, '952 SQ. FT. T 28 N, R 17 W, ASSUMED AS o OR(4, AC. EXC. , 0011020"E. E z •`3 RIGHT OF WAYJ m I LQT71 LQT3 scALEavf r 1"•2aa QEBT_tf_!E!? $UR3_V_EY_A II -fAP Ise., S 89.45'2r W 410.891 'd' 130 160 260 N 1 b' ~:I c2i ,I LEGEND ~ N N 20499 r' W~Ajl o; =1-'& /NAGE -2I O INDICATES 1' O.D. x 18" IRON Z, I - g PIPE SET (MIN. Wr. - 1.13 LBA.F.) L T6 • INDICATES 1-)RONPIPE FOUND Luf - - - - - 445, 24 SQ. FT. co O CORNER MONUMENT - OR 11.228 AC m I £ (R=) RECORDED AS r! 4..FASEMEIIIT Lor 4 ~ I 17 LOT 1 Q ❑ SHED S 141 ~ PAGE 3602 VOL,_12, - - 0*11U °.'~`'z~O, zte - -4.25'I - P 3445 g'ty DRWV- ^,3.. ~ ¢ _ - ` 100' 41..V N 89°47'05• W 859.1r (R- N 89-30'54- M I ~`gCONg~~ UNPLA7TEQ LAn1D$ I I LAURE MV Y 1Uy * i l 13 N A • r OENVILLE, O DATED: • • • e • ~ OCTOBER 4, 2008 P~ • LANV sv SEC77ON 7, T28 N• R 1 W SOUTH 114 CORNER (FOUND COUNTY B N THIS INSTRUMENT DRAFTED BY JERALD L. LARSON A /MY ) SHEET 1 OF 2 1 1 of 2 Vol 22 Page 5309 z R~d[~r 0 I; =AY2 I~~ST. CROIX CO ~(.1•~~~G`o~G SURVEYOR'S RECORD CERTIFIED SURVEY MAP Viola Liddle Part of the Northeast 1/4 of the Northwest 1/4 of Section 7, Township 28 North, Range 17 West, Town of Pleasant Valley, St. Croix County, Wisconsin. Owner's Address: 518 Marcella Court I River Falls, WI 54022 is (R=589°3009"E 2839.23) C. r. H ✓ 3I - - -S 89° 45'33" C 2838.59-" - / VAR. NORTH 114 CORNER UNPLA77_ ED LANDS W/OTH f SEC.7, T28N R 17W (COUNTY MONUMENT) 389°45'33,'E N89°45'53"W 4625. N.L1NL --865.63-- C. . m I'm IVW 1931.71' ` 453. 4 ` 412. /9 NORTHWEST CORNER `v 4 53. 3' .l 3 / C. r H. z see. 7,T2BN,R17W ,IFS S O NOS (COUNTY MONUMENT) gyp. Ci -V • Q TANGENT ` S_89045'33"E 769,48'--- BUILDING SETS co LINE y NOT TANGENT LOT 3 + LOT 2 CONTAINS 320,441 ~O 100 ' 2, 5D 41.25' S4. FT. OR 7.356 AC. of CONTAINS 474,588 Sa FT, OR 10.895 AC. 4W x 4/:25' (454, 187 S4 FT. OR /0.427 AC $ W r` N 4 EXCLUD/N H1* OF. WAY) ,,qq to 11~11~~~Iq !n f f - <l-1 ``tN eVei~ O M. > ~d o c"oo ^ ~o o (,?98,453 .54:,FT 'OR o s. a~ 0, O 6.852 AC.EXCLUA/NGy I T ~C % Q:1 tci LAURENC•.2 R/GH7-OF- WAY) h! N` ..M • m • W MUR °C 59o5BU,j5 i 1 Z R ALLS,•:. v N86°0857"B__0- , e W J C~ wISC. JQ o~gti99 204.49' N M F _j N o •LAN5 Q1pin09e Eoselnenf °o 890 9" Q:2 Lou ce W. Murphy 4 ''I W O 3 Registered Land Surveyor =4'i T o1 410.28' 1 V1 W o0 Dated 1//5/98 p ; 69 A ` 4/.25 co 0 Revised 02199 O, Revised ?1I199 0• o~ i ~y •i~o J. 00 /00 10- ~W O~`y1~C lp1 LOT I'' 4 N8/~ 19"W • O~ ~1 41! W h goy3 CONTAINS 342; 794 SO. FT. nso I~~II o 06~0 i ,ja~r!4 OR 7.869 AC. N 21 5~, a k , ,/y~% • ti~ WATERCOURSE O (TYP.) o 0-11 Q O J! O~ y V I 2 5 k~ cYi a Q O Iq too 09'13"W y O. ZQQ Q~ `~h yS10152°.98' _ 69 ` y z 41.25' _Cs81'0,4'51"W 1~. 141.67 89.79' j I1I b9 OUTH LINE NE 114 - NW 114 m Qz~~, 3 ,gyp' 8 Q, SE COR. N B9 °447 p5„ W y~~ C.s.ALOT/ (R_S89°3054 E) 2.150 1%4 UNPLATTEn LEGEND LANDS QON 0 SET I "X 24 "IRON PIPE (MIN. W7; 1.13 LB./L.F.1 0 FOUND 314"REBAR 0 COUNTY SURVEYOR MONUMENT SCALE tN FEET I "=200' R= RECORDED AS 1 O 50 100 zoo 400 ; SOUTH l coR sec, 7, r2 28 N, (CO41HTY MONUME THIS /N.grRUMENT DRAFTED BY ✓ERA4 D i t ARSGIN Vol. 13 Page 3602 SHEET / OAF 2 DEC--10-98 08:3e AM MURPHY LAND SURVEYING 1154269711 P.03 ^0.~ CERTIFIED SURVEY MAP Viola Liddle - --p&rt-at the Northeast V4 of the Northwest 114 of Section 7, Township 28 North, Range 17 West, Town of Pleasent Valley, St. Croix County, Wisonnsin. oener•■ A9drese: 518 Marcella Court River Falls, W1 54022 1 , fR•S09°J_q'Q9;W Z8392J"J [ -989045 33 E 2631-99'--- 1 cc " uNPt 4 rTfJ7 !yam t raouN►r 1 Y N, tA17 - - _ _ - ' _ 453.44 1~ 1931 i!'LULIM f~r/bS f 4 -N'--• - _ , ~orrkwFtrooN,vErr T 13.33 Tye :d:s.r~~,\` ~ sfC.7, r t1 N, RI7 w k ad6lNr teoe;Nrr poNawrNrl 51 i ~".$89°41J3~f 7b9.48';•.___}_,_~` NOr 140' OVA0IN6VCTEACK IINF ar+o[a/ roams 4I.z4' Ldr 2 CONTAINS 474,50 $G Fr. ^ 4, 2?' om 13.693 AC, eov, e7 so. ),'r OR IO.417AC., m I~ E`XCL~a~~~i~~yT OFWIYI I'll 1.0r3 b ' I~? 4I is ~~~~,~`.....«N$/Ir • C0NrAINS392,80.sQF/ 3 i) ~I~ ab ti r' t 088.094 AC I >~tA1JRENC y J296 453 50. Fr. OR 6652 , • v 41 W MUR AC%e a;i4iA R/GNS- 1 : S ' rJI N t! a Q i 3•. AL3L% 1 z it t i +I (it tit. I (c~ 2'© ZSa _ b LAND 4's•.i ' w u ~Vq. Murphy 1 • Regis ered Land Survey #08`46'/49"W 45I.Ai' Dated: 1:-5-1998 / i~ wRg bM 1.V/'` 4 N 411 0p !u CONWNS 369,051 SR Fr ' O ` !F'•I *ql WA TEN coyote OR 0. 381 AC. AOO -4 •41 y, A ' rk rd4e.i94 So. Fr, DIP 7669 AC ✓i j 8 '1~ i Zt WS c 60 £xci UOING NIGHT OF WAY)'A ;0 I i J- 6 in ~Ka sr' i ~n ~ $ $ i ~•4Lrs' ill w ±w iWENe:/4-MW u4 i 4 '"1 si coN Qj3 16 CON. • 7'QS;,w 100.42' -Ip~,, Sd{ "'l~•s-Nw,n ".N tON llRrjS4~T054 EP r' ~$a UNPLATTfO LANDS ( ! tt 0 SET I "x24"rRON RIFE fMIN WI: 1.131,41 /L FJh ~ F04/NO 514"RREAR e CQUNry SlIRYfYOR MONVMENr ScAtE IN FE6r Rr gre0ADED AS , l 1y~pw tON,Afit 0 40 too ' . e^40 400 ttiP f'4ebwrY rQN1I•Mk TN/S INSTRUMENT DRAFTED Sy JERALD L. LARSON 2 Z Parcel 024-1010-60-325 04/17/2007 03:43 PM PAGE 1 OF 1 Alt. Parcel 07.28.17.53D-10 024 - TOWN OF PLEASANT VALLEY Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 11/14/2006 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - JUEN, DAVID D & KRISTIN L DAVID D & KRISTIN L JUEN 476 CTY RD J HAMMOND WI 54015 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 492 CTY RD J SC 2422 ST CROIX CENTRAL 1547 CTY RD N SP 1700 WITC Legal Description: Acres: 5.000 Plat: 5309-CSM 22-5309 024-06 SEC 7 T28N R17W PT NE NW FKA LOT 3 CSM Block/Condo Bldg: LOT 05 13/3602 BEING CSM 22-5309 LOT 5 (5 AC) Tract(s): (Sec-Twn-Rng 40 1 /4 160 1/4) 07-28N-17W Notes: Parcel History: Date Doc # Vol/Page Type 11/14/2006 838835 22/5309 CSM 08/14/2006 832072 WD 08/14/2006 832070 WD 04/22/2003 718343 22141573 LC 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 12/06/2006 Description Class Acres Land Improve Total State Reason Totals for 2007: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 I 04/17/2007 03:35 PM Parcel 024-1010-60-200 PAGE 1 OF 1 Alt. Parcel 7.28.17.53C 024 - TOWN OF PLEASANT VALLEY Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 11/14/2006 00 6 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - JUEN, RETIRED RETIRED JUEN Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 7.356 Plat: 3602-CSM 13/3602 SEC 7 T28N R17W NE NW BEING LOT 3 CSM Block/Condo Bldg: LOT 3 13/3602 (CSM 22-5309 TAKES ALL) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 07-28N-17W Notes: Parcel History: Date Doc # Vol/Page Type 08/14/2006 832072 WD 08/14/2006 832070 WD 04/22/2003 718343 2214/573 LC 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 12/06/2006 Description Class Acres Land Improve Total State Reason Totals for 2007: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 024-1010-60-200 06/22/2006 05:15 PM PAGE 1 OF 1 Alt. Parcel 7.28.17.53C 024 - TOWN OF PLEASANT VALLEY Current ;X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area . Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - DEFIEL, WILLIAM M & JODI R WILLIAM M & JODI R DEFIEL 936 3RD AVE S STILLWATER MN 55082 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 7.356 Plat: 3602-CSM 13/3602 SEC 7 T28N R17W NE NW BEING LOT 3 CSM Block/Condo Bldg: LOT 3 13/3602 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 07-28N-17W Notes: Parcel History: Date Doc # Vol/Page Type 04/22/2003 718343 2214/573 LC 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/22/2001 Description Class Acres Land Improve Total State Reason RESIDENTIAL 1 7 NO G .356 41,600 0 41,600 Totals for 2006: General Property 7.356 41,600 0 41,600 Woodland 0.000 0 0 Totals for 2005: General Property 7.356 41,600 0 41,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 12/2911997 Batch M PRGRM Specials: User Special Code Category Amount I Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wtsconsirt Department of Industry, SOIL AND SITE EVALUATION / Labor and Human Relations Page 6 of Division of Safety and Building n accordance with s. ILHR 83.09, Wis. Attach complete site plan er na" ss thi" 1/2 tj 1 ches in size. Plan must County include, but not limited t u ic>rtgorizl refereri nt (BM), direction and .5~ Goo/ X percent slope, scale or _ sion ~~th ar/o d I a d distance to nearest road. ~s rt r► ~ Parcel I.D. # T APPLICANT INFO ION - At ormatfon. R 'awed by Date Personal Information you prov be us6Qor sewn y p (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location - Ur oGff I l Govt. Lot N~ 1/4 41,W 1/4,S 7 T Z a N,R 11 E (o W Prop/Owner's Mailing A 4 cr. Lot # Block# Subd. Name or CSM# re 141 ? 3 eS 13 3 City ` State Zip Code Phone Number Nearest Road fi~`lf ~f~ s~OaL (7iy yis' ~o/ ❑ City ❑ Village LT y~f1 . 41 CJ'New Construction Use: Residential / Number of bedrooms 3- Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow 600V gpd Recommended design loading rate - 7 bed, `S 3 gpd/ft2 trench, gpd/Ft2 Absorption area required 6,,,)cV_bed , ft2-,,S" _trench, it 2 Maximum design loading rate ' y bed, gpd$ ' s trench, gpd/(i2 Recommended infiltration surface elevation(s) Y--45v- • 3 it (as referred to site plan benchmark) Additional designtsite considerations 1-0 A) X4W 11fPaVv S7vs7_ W Id- 5'160,0 7e, 'j, L 2~ Parent material 0l7'~ %~S Flood plain elevation, if applicable ft S Suitable for system Conventional rM-,ouunnd In-Ground Pres~ AT-Grade System in Fill Holding Tank U = unsuitable for system ❑ S LrJ u 1~ s U ❑ S Q u re❑ s L"I u ❑ s ~ ❑ S u SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft2 In. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench l D'/8 10YX 21(2 L z S K ~/P CGU 77 -s- .20, y 10.3 /OYR 311Y' S/L 2 f -s r, fi' Gs s Ground and 3 to yip y/l - ,Ke r SG sl~i~ ~s! f S ~D ~n 7• sY G ~v o U 2° s~ co Depth to limiting factor Remarks: Boring # y /o yip 3/~ SQL L ~'s;6.e • C'w' , s Hors Ground p • J /a X f//& +1f 4h P2(-l elev. S'L /fsk 7•SYA S/!.e Depth to limiting factor 0-In. Remarks: CST Name (Please Print) Signature Telephone No. Ro/3E2 T N~3/~i ~~T 715. 3g~ • B/BS Address Date CST Number ~Z-12 •/I~~ 2,2_613 7,5- PROPERTY OWNER ~-DOGE SOIL DESCRIPTION REPORT Page Z- of 3 PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Structure Geptft2 In. Munseli Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench 3 0-13 10Ye 2/ L /r~s k C5 O z 3 10 Y,~ 3/ SQL /f' 3,; s c~v 17a. - Z ' • 3 Ground e -2-5 /O yR / 5-11 2-,* 5-k 4eh eV ~ S , -6 elev. Q ft. s. ~oyp y '411;r JIL /fs .Y v a ,e - .2- 3 Depth to limiting factor V401 Remarks: Boring # Ground elev. ft. Depth to limiting factor In. Remarks: Horizon Depth Dominant Color Mottles Structure GPD/ft2 In. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed , Trench Boring # Ground elev. ft. ' Depth to limiting factor in' Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: