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024-1015-50-200
0 Cl) p m v n rw p E g c w p vj m m v y o c ^. � W cp A m n qy N •,c w Cz O C) 0 S ' '' (D A m - N p N W r c c N ? . V C 7 N r < CO O 0 m (a m O � o O c 0 3 C C7 d m 0 F o R w i',, v y m o. n :3 �. CD C 'P N p. O O zt U c 3 0 0 CD i Z M c o N N w a y N ° o - --1 O (p 0 C ! z 0 �E' _ (7 N N D �1 � D O O N A .�i N rn d7 OO (D d 9 A lti N = N O O N O1 N m N z N z o 0 0 D D o O j cn m �►1 ro y c ? v w � � e1 3 ^' z C A 1 N o y p Z A N a CD o. cn m N O m m m a Z 0 C Z M J H Z < CD A w � 2 '.> c a N O T CD 3 < N z G CD N < O a O N 41 N .i N - a , s°x y 7 � O O N O p v a ti 3 ti O O c O CL A K O CD ti O N o � a Parcel #: 024 - 1015 -50 -200 12/02/2005 01:55 PM PAGE 1 OF 1 Alt. Parcel M 9.28.17.84A -20 024 - 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): 0 = Current Owner, C = Current Co-Owner O - MOHN, JAMES L JAMES L MOHN C - JOHNSON, LISA F LISA F JOHNSON 1815 CTY RD N BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 8.840 Plat: 4287 -CSM 16/4287 SEC 9 T28N R17W SE NE LOT 1 CSM 16/4287 Block/Condo Bldg: LOT 1 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 09- 28N -17W SE NE Notes: Parcel History: Date Doc # Vol /Page Type 05/26/2004 763883 2581/320 WD 05/26/2004 763882 2581/319 WD 12/1711999 615668 1478/577 LC 10/04/1999 611498 1461/45 PR 2005 SUMMARY Bill M Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 06/03/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.000 13,500 11,100 24,600 NO AGRICULTURAL G4 7.840 900 0 900 NO Totals for 2005: General Property 8.840 14,400 11,100 25,500 Woodland 0.000 0 0 Totals for 2004: General Property 8.840 1,000 0 1,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount 003 - STREET SPECIAL ASSESSMENT 321.92 060 -AG USE PENALTY SPECIAL CHARGE 316.63 Special Assessments Special Charges Delinquent Charges Total 321.92 316.63 0.00 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County. St. Croix Safety andtuilding Division INSPECTION REPORT Sanitary Permit No: 506122 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)]. 1 Permit Holder's Name: City Village X Township Parcel Tax No: Johnson, Lisa F. -WIl keklrl I Pleasant Valley, Town of 024 - 1015 -50 -200 CST BM Elev: j Insp. W Elev: BM Description: Section/Town /Range /Map No: / () //1, -#-/ 09.28.17.84A20 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark V . 7 r�- Dosing J . �� Alt. BM�f, / ^ , r ,S • 7 � Aeration !(Jt Its Bldg. Sewer 30 3 y / Oo• 7, d 73 . .� Holding t/ t Inlet 7. TANK SETBACK INFORMATION s Ht Q 3' ht 7.45 y TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 0 , Septic i VV` / Dt Bottom 11 h� �v %(' Dosing , ,q� i Header a 2. q, , �p W 0 Aeration e Holding B ot. Syst Final Grade 1 � PUMP /SIPHON INFORMATION Manufacturer ..., n / _ ' _ GPM Dema St Cover ' Cwt Model Number / , I/O6(66� / // q6 3 TDH Lif •�^ Frictions Syste�He o,TDH Ft Forcemain Len th t Dia. 2 �� Dist. SOIL ABSORPTION SYSTEM 1�tt.Q�Q,e BED /TRENCH Width Length No. Of Trenches PIT DIME N ONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS U -75 SETBACK SYSTEM TO P/L BLDG WE LAKE /STREAM L ING Manufacturer: INFORMATION CH ER OR Type Of System: ` / k 2a / / U Model Number: DIST ION SYSTEM / 5j I O Header anifold Distributio�nf (� x Hole Size Hole Spacing� ent o Air Intake Length� Dia - Length / 3- / 'l Dia ' . J ' Spacing , , SOIL COVER x Pressure Systems Only r xx Mound r At - Grad e System Only 1 04 Depth Over Depth Over xx Depth �+ xx Seeded/ Sodded xx Mul Bed /Trench Center Bed /Trench Edges of (� 4 Yes X No T p Yes ? No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / /01 sspection #2: / ,07 Location: 470 County Road T Hammond, WI 54015 (SE 1/4 NE 1/4 9 T28N R17W) NA Lot 1 P f I' W /U Parcel No: 09.28.17.88AO 1.) Alt BM Description 2.) Bldg sewer length = M - amount of cover = L ision Required? Yes No �0 ?r side for additional information. % �— Date 41nsepcigna e Cert. No (R.3/97) CorYtimet`Ce.wl.gov Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 sco n s i n Madison, WI 53707 -7162 Sanitary Permit Number (to b filled in by Co.) Department of Commerce ") 50 6 1 ZZ S anitary P ermit Appllcat State Transaction Number p In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the a govemmewal / 3 t unit is required prior to obtaining a sanitary permit. Note m Late - Application forowned POWTS are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide ma econdary u oses in accordance with the Privacy Law, s. 15.04 1 m , Sta . 1. Application Information — Please Print All tsl6rimatipin Property Owner's Name 1 M „ p „ Parcel # " A/��` PR 03 2007 _ S� Property Owner's Mailing Address Property Location ST. CR01X COUNTY A ZD Govt. Lot l City, S e Zip Code P /a ri C � /g Section 6d=r ` (circle one 11. ype of Building (check all that apply) Lot # T N; R E or&) 1 or 2 Family Dwelling - Number of Bedroo J y g ms Subdivision Name i A I S�rNt l Block# ❑ Public /Commercial - Describe Use ❑ City of El State Owned - Describe Use CSM Number El Village of 0 Town of t jr 75 4cl 7 III. Type of Permit: (Check only one box on line A. Complete line B If applicable) A. J X Y p Y g p Y g Y (explain) New S stem ❑ Re S El Tank Replacement Only El Modification to Existing System B. El Permit Renewal El Permit Revision ❑Change of Plumber ❑ List Previous Permit Number and Date Issued Permit Transfer to New t Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all that apply) o ❑ Non - Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil X Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersal/Treatment Area Information: , Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Require Dispersal Area Propose )) System Elevation VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units c a New Tanks Existing Tanks o is = w P lob. szsF a. � n ti w ii Septic or Holding Tank Dosing Chamber VI1. Responsibility Statement I, the undersigned, assume resp si ility for install n of the POWTS shown on the attached plans. Plumber's me ( int) Plumber' Si ur r MP /MPRS Number Business Phone Number Plumber's Address Street, City, Sta e, Zip Code) Vlll. Coun /De artment Use Onl k pproved tsap ven Rea or Denial Permit Fee Date sue Issuin gent Signal e $ // d 7 O er Gi t6 7 IX. Conditions of Approval/Reasons for Disapproval 3 SYSTEM OWNER: 1 1. Septic tank, effluent finer and ^ �ec�c- t J L � �+ De w �'^ dispersal cell must all be setvlces / maintained I as per management plan provided by plumber. 2. All setback requirements must be maintained as per 8 e system and submit to the County only on paper not less than 8 1/2 x I1 inches in size SBD -6398 (R. 01/07) Valid thru 01/09 vuf hrf- OL Ak- ` ^ J- f t 1 --t ioo AN wi i r �^ F vl7 A r�i'7 /�?�j"fi, /[Z,� •��r _ . z l ii = �c s4�� ''j„1 N Er4 5e) t"L ? i r � �7 7 . V L 16 PAGE 4287 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO.. WI i RECEIVED FOR RECORD 04 -29 -2002 9:15 AM CERTIFIED SURVEY MAP REC FEE: 13.00 COPY FEE: 3.00 U) Z C/) � BEARINGS ARE REFERENCED TO THE EAST LINE OF THE NE1 /4 OF SECTION 9, z APPlt3 V tU ASSUMED TO BEAR N00°40'32"W. o ST. CROIX COUNTY �N0 o NPR 2 g 2002 n ? ZMm c� if not recoraeu N v approval date approval shaft O,p�Yf�� ,Z z O 4 WEST LINE OF THE NE1 /4 OF THE SE1/4 OF THE NE1/4 co 800 0 44'27 °E 587.80' C o �m� m� N oc OM Q H ` Z � ACC M w �� ° m uo j m S as O W ��T 1 i w N y c fj 4 Z % m rn i ;� f. j R A o N m O ?22 'gh � Q ink o w °-' R m Of T n PIZ) ..... ............................... -4 rn IQ Pnn �j l A V m Z Z 9 8 hi L NOO °40'32"W 586.78 0 _� � T 2 Z — �_ — — — — �i 1305.40 `O m 718.70 EAST LINE OF THE NEt /4 — m ® 0 N00°4'32W 586.70' NOT ---0 Z N00 °4032 W -" — m m �— C.T.H- -T g � n to MGvJpdLa__5�__i._C�D_LLa[rJD Oo--- ---- - _r_l_D[D - -C3 1- pdLa4u -�G3 0 0 m z > r . m � m �x y ^� O m " C m O Z 0�� N cn� O O� z ZSoS�z C � - i n O m v � o � z O g (7) Vol.16 Page 4287 Safety and Buildings ' 4003 N KINNEY COULEE RD commerce .Wl.goV LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 isconsi www.commerce.wi.gov /sb/ Department of Commerce www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary March 28, 2007 CUST ID No. 224263 ATTN: POWTS Inspector KIM A O CONNELL ZONING OFFICE K.O. CONSTRUCTION ST CROIX COUNTY SPIA 504 3RD AVE 1101 CARMICHAEL RD OSCEOLA WI 54020 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/28/2009 Identification Numbers Transaction ID No. 1382959 SITE: Site ID No. 723682 Lisa F Johnson Please refer to both identification numbers, County Hwy T above, in all correspondence with the a ene Town of Pleasant Valley St Croix County SETA, NEIA, S9, T28N, R17W FOR: Description: Three Bedroom Mound System / New construction Object Type: POWTS Component Manual Regulated Object ID No.: 1124229 Maintenance required; 450 GPD Flow rate; 19 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 101), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01 101) , 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: • 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 of Sec. 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. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • 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. P.O.W.T.S. Conditionally Fm AP KIM A O CONNELL Page 2 3/28/2007 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. • Comm 83.52(1)(a) - 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 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. 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 acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utiliz in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions shoal 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 addres on this letterhead. The above 1e addressee ddressee shall rovide a co of this letter to the owner and an other who are responsible for the P PY Y s P installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 A Fee Received $ 175.00 1001r, Balance Due $ 0.00 erard M Swan 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. RECEIVED MAR 2 7 2007. SAFETY & BUILD AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: LISA F JOHNSON Owner's Name: LISA F JOHNSON Owner's Address: 26 IDA ST ROBERTS WI 54023 Legal Description: SE-- NE - -SEC9 - T28N - -R17W Township: PLEASANT VALLEY County: ST CROIX Subdivision Name: NA Lot Number: 1 Block Number: Parcel I.D. Number: 024 -- 1015 - -50- -200 Plan Transaction No.: Pagel Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page Page 7 Pump curve and specifications plan x` of � AD gu � R o►N 9 p pEPPR pN0 Page 8 I %OJ' �,r��l �,� bF poNVE cFE � Designer: KIM A OCONN License Number: 224263 Date: 03/22/07 Phone Number: 715 - 755 -3145 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 4.01 (R. 09/04) Page 1 of 8 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) F -- R Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 83 -44 -3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 % coliform of - 36 inches. 450.00 Design Flow (gpd) 9.00 Site Slope ( %) 95.39 Contour Line Elevation (ft) 19.00 Depth to Limiting Factor (in) 0.50 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 75.001 Dispersal Cell Length Along Contour (ft) F _____ 6 _ 0 _ 01 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /ft 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution t Y� Pressure Disribution Information network? Enter Y or N (c or e) I e1 Center or End Manifold 3.001 Lateral Spacing (ft) If N above, enter the elevation ft 21 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimated Orifice Spacing (ft) = 9.00 fl?/orifice 2.00 Forcemain Diameter (in) _ 55.001 Forcemain Length (ft) Does the forcemain drain back? Y F __ 8 _ 6 '001 Pump Tank Elevation (ft) Enter Y or N i 6.50 System Head (ft) x 1.3 8.97 Forcemain Drainback (gal) �1 11.64 Vertical Lift (ft) 67.38 5x Void Volume (gal) 0.53 Friction Loss (ft) 76.36 Minimum Dose Volume (gal) 18.67 Total Dynamic Head (ft) 20.60 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options ch 0.75 1.25 x x 1.00 1.50 1.25 x 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons /Inc Calculator (optional) Treatment Tank Information 1000.00 1 Total Tank Capacity (gal) 1000.001 Septic Tan Capacity (gal) 1 49.001 Total Working Liquid Depth (in) (WEEKS j Manufacturer 20.41 gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.001 Dose Tank Capacity (gal) PLOY -LOK IFilter Manufacturer 21.761 Dose Tank Volume (gal /in) I PL -525 Filter Model Number WEEKS � I Manufacturer JhV Project: LISA F JOHNSON Page 2 of 8 1 9 'D' Mound Plan View 1/1 B Observation Pipe : F K (� Q A W I I ......... B ...... .. .....:......:......'. ....: I 3 :. •. .:• :•:•:•: L —� Mound Component Dimensions A 6.00 ft E 23.48 in H 1.00 ft K 10.44 ft B 75.00 ft F 9.50 in r 13.35 ft L 95.87 ft D 17.00 in G 0.50 ft J 6.40 ft W 25.75 ft 450.00 (ft Dispersal Cell Area 1451.20 (ft) Basal Area Available 6.00 (gpd /ft) Linear Loading Rate 7.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 98.60 (ft) —► u H G .,.,,,..,..,.,.., 2 F Dispersal Cell . 97.31 (ft) Lateral 96.81 (ft) — Invert : i 3 `;i ' i i i i :`:? i i i i`• i'i i i : ' 'i i'i i i' i i'i i i•. 1 Dispersal Cell .... ....[�.....•.•.•..... E D s Elevation :.:� 95.39 (ft) Contour Elevation 9.0 %Site Slope Geotextile Fabric Cover Shading Key T Dispersal Cell r See lateral details on D MTopsoil Cap c a 1.5 ft r� Page 4 for number, size, Q " " " "' Subsoil Cap c U and spacing of laterals. © ASTM C33 Sand a R / F Laterals are equally Z T y p ical Lateral spaced from the ®[ Tilled Layer c 0.5 ft �m a distribution cell R5 [„ Aggregate o centerline in the �--- A - -- P distribution cell (AxE Project: LISA F JOHNSON Page 3 of 8 End Connection Lateral Layout Diagram Laterals centered over the A & 8 dimension • = Turn-up o f ball valve or oleo n out pl u g I = P Iaterals cal I<- X—> I Hot es drilled on the bottom of the lateral eguially spaced tion Via tee or cross to manifold at any point. Laterals & force main of PVC Sch 40 (per COMM Table 84.30 -5) Number of Laterals 2 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 3.06 ft Lateral Length (P) 73.44 ft Orifices per Lateral 25 Lateral Spacing (S) 3.00 ft Orifice Density 9.00 ft /orifice Lateral Flow Rate 10.30 gpm Manifold Length 3.00 ft System Flow Rate 20.60 gpm Manifold Diameter 1.25 in Total Dynamic Head 18.67 ft Forcemain Velocity 2.10 ft/sec Dose Tank Information Locking cover with waming label and locking device and sealed watertight Electrical as per NEC 300 and —► Comm 16 Disconnect .28 WAC 4 in. min. _ Tank component is properly vented iz Alternate outlet location Forcemain diameter WEEKS Manufacturer 2 in. Capacityl 80070 Gallons Volume 21.76 gal /inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 23.26 506.04 B 2.00 43.52 C Pump off e levation (ft) C 3.51 76.36 1 85.67 D 8.00 174.08 D Total 36.76 800.00 Dose se tank elevation (ft) 3" Bedding under tank. 1 85.00 Alarm Manuafacturer SJE RHOMBUS Alarm Model Number TANK ALERT 1 Pump Manufacturer 1GOULDS f Pump Model Number IWE031 1 L Pump Must Deliver 20.60 gpm at 18.67 ft TDH Project: LISA F JOHNSON Page 4 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name KIM A OCONNELL Phone 715- 755 -3145 POWTS Regulator's Name ST CROIX COUNTY ZONING Phone 715 - 386 -4680 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 450 ft Maximum FOG 30 mg /L Type of Wastewaterl Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test monthl Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepage once every 3 years Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Tum -up Detail Finished ..�.,..•......•. ............... Grade �1 6 -8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve .... .. .. Distribution Lateral --- ---- -- Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: LISA F JOHNSON Page 5 of 8 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals ]SBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the finer shall be serviced if the alarm is activated continuously. Intermittent fitter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verity proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD 30 mg/L TSS, 10 mg/L FOG, and 10 cfu /100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: LISA F JOHNSON Page 6 of 8 MGOULDS PUMPS Submersible Effluent Pump MODEL WE Series PROSURANCE AVAILABLE FOR RESIDENTIAL APPLICATIONS. APPLICATIONS ■ Shaft: Corrosion - resistant, Single phase (60 Hz): can be operated continuously Specifically designed for the stainless steel. Threaded • Capacitor start motors for without damage when fully following uses: design. Locknut on all models maximum starting torque. submerged. • Homes to guard against component • Built -in overload with ■ Bearings: Upper and on accidental reverse automatic reset. • Farms damage lower heavy duty ball bearing • Trailer courts rotation. • STTOW or STOW severe duty construction. • Motels ■ Fasteners: 300 series oil and water resistant ■ Power Cable: Severe duty • Schools stainless steel. power cords. rated, oil and water resistant. • Hospitals ■ Capable of running dry '/3 —1 HP models have Epoxy seal on motor end • Industry without damage to y NEMA three prong provides secondary moisture • Effluent systems components. grounding plugs. • 1 /z HP and larger units have barrier in case of outer jacket ■ Designed for continuous bare lead cord ends. damage and to prevent oil SPECIFICATIONS operation when fully wicking. Standard cord is 20. Pump submerged. p g Three phase (60 Hz): Optional lengths are available. •Solids handlin ca abilities: ■ 0 -ring: Assures positive 9 P MOTORS must be provided in • Class 10 overload protection 3 /4" maximum. sealing against contaminants *Discharge size: 2" NPT. ■Fully submerged in separately ordered starter unit. and oil leakage. • Capacities: up to 140 GPM, high -grade turbine oil for • STOW power cords all have AGENCY LISTINGS • Total heads: up to 128 feet lubrication and efficient heat bare lead cord ends. TDH. transfer. Tested to UL 778 and ■ for Continuous Designed CSA 22.2 1 o8 standards •Temperature: ■ Class B insulation on g C� By Canadian Standards /3 104 °F (40 °C) continuous ' -.1 Y: HP models. Operation: Pump ratings are Association 1401(60 °C) intermittent. ■ Class F insulation on 2 HP within the motor manufacturers S rile #LR38549 • See order numbers on models. recommended working limits, Goulds Pumps is ISO 9001 Registered. reverse side for specific HP, voltage, phase and RPM'S METE FEET 130 available. I SERIES: WE 120 WE15HH SIZE: 3 /4' SOLIDS 35 110 1750- WE20H RPM: 3500 & ._._ FEATURES " " _ —► SGPM - - ■ Impeller: Cast iron, semi- 30 100 open, non -clog with pump- 90 -WE15H---- _ out vanes for mechanical w 25 80 10H _ seal protection. Balanced for 70 - - -- _ smooth operation. Silicon q 20 E07H bronze impeller available as o 60 - _ an option. a 15 50 W W E — _.- E05H_ _ ■ Casing: Cast iron volute ° 40 type for maximum efficiency. 10 30 - WE03 M 2" NPT discharge. wE03L.- _ ■ Mechanical Seal: SILICON 5 to CARBIDE VS. SILICON CARBIDE sealing faces. 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160 GPM Stainless steel metal parts, BUNA N elastomers. o s l0 1s A 25 30 35 m CAPACITY Goulds Pumps p < ITT Industries www.goulds.com �/ t 1792 Wisconsin Department of Commerce SOIL EVALUATION REPORT page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations Attach complete site plan on paper not less than 8Y: x 11 inches in size. Plan muss County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. 024 - 1015 -50 -000 I D#28.17.9. 84A Please print all infonnation. Revi By Dat Personal information you providq - m be (Fria Law, s. 15.04 (1) (m)). D '7 Property Owner ( Property Location Jim Mohn Govt. Lot SE 19 NE 1 S 9 T 28 N R 17 W Property Owner's Mailing Addresc, IV, jA i Lot # �Blocl Subd. Name or CSM# 1815 Co. Hwy. N 1 Proposed CSM City tate 21 � I City _j Village 01 Town N earest Road Baldwin IV I 1 540132 71 53ETM864 (M) Pleasant Valley I Co. Hwy. T Vj New Construction Use: Residential / Number of bedrooms 2 Code derived design flow rate 300 GPD I Replacement j Public or commercial - Describe: Parent material Glacial Till Flood plain elevation, if applicable na General comments and recommendations: Ins mound system at elev. 9 6.89' a t 18" above 9 5.39' c ontour. ❑ Boring # _j Boring 1 Pit Ground Surface elev. 95.44 ft. Depth to limiting factor 22" _ in. Sal Application 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 1 0-9 10yr32 none sil 2fsbk mvfr as 2f 0.5 0.8 2 9 -22 10yr5/4 none sil 2fsbk mvfr cw if 0.5 0.8 3 22 -28 10yr4/4 ff233dpp7.5yr5 /8 sl 2msbk mfr cW - 0.5 0.9 4 28 -51 7.5yr4/6 mzd 10yr 6/2 SI 1 csbk mfi - - 0.4 0.6 a Boring # J Boring t/ Pit Ground Surface elev. 95.39 ft. Depth to limiting factor 24" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I j*E ff91 "Eff#2 1 0 -7 10yr4/3 none I 2fsbk ds as 2.6 0.8 2 7 -16 10yr4/4 none sl 2fsbk mfr gs .6 1.0 3 16 -24 7.5yr4/4 none sl 22msbkj msbk mfr cW .6 1.0 4 24 -30 7.5yr4/4 f2f 5yr5/8 sl mfr g W 1vff 0.6 1.0 5 30 -36 7.5yr4/4 f2d 7.5yr5/8 sl 2csbk mfr aw lvf,f 0.6 1.0 6 36-40 5yr5/8 f2d 5/8 s & Is 0 sg ml aw - 0.7 1.6 7 40 -52 7.5yr4/6 m2d 10yr 6 scl 1 csbk mfi - - 0.2 0.3 -- Effluent #1 = BOD 30 < 220 mglL rid TSS >30 < 1 mg/L ' Effluent #2 = BOD <_30 mg/L and TSS <�p mg/L CST Name (Please Print) N. Signatu : CST Number James K. Thompson c-V7 t - 3602 Address A.C.E. Sal & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola WI 54020 5/32004 715- 248 -7767 r Property Owner Jim Mohn Parcel ID # 024- 1015 -50 -000, ID #28.17.9.84A Page 2 of 3 3] Boring # _j Boring vi Pit Ground Surface elev. 93.17 ft. Depth to limiting factor 19" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GE in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -10 10yr3/2 none sil 2fsbk mvfr as 2f 0.5 0.8 2 10 -19 10yr5/4 none sil 2fsbk mvfr cw 1f 0.5 0.8 3 19 -24 10yr4/4 f2d 7.5yr5/8 sl 2msbk mfr cw - 0.5 0.9 4 24 -38 7.5yr4/6 m3p 5yr5/8 & m2d 10 6/2 sl 1csbk mfi - - 0.4 0.6 4] Boring # - j Boring ✓�{ Pit Ground Surface elev. 96.82 ft. Depth to limiting factor 30" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 - 12 10yr4/3 none sil 2fsbk ds as 2f,1m 0.6 0.8 2 12 -22 10yr5/4 none sil 2fsbk mvfr cw 1f,m 0.6 0.8 3 22 -30 7.5yr4/4 none sl 2msbk mfr cw 1vf,f 0.6 1.0 4 30-43 7.5yr4/4 f2d 7.5yr5/8 sl 1csbk mfr cw 1vf,f 0.4 0.7 5 43 -56 7.5yr4/4 m1p 5yr5/8 & sl Om mfi - - 0.2 0.6 Y m2d 10yr 6/2 F-5 I Boring # Boring ✓� Pit Ground Surface elev. 95.39 ft. Depth to limiting factor 18" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -9 10yr3/2 none sil 2fsbk mvfr as 2f 0.5 0.8 2 9 -18 10yr5/4 none sil 2fsbk mvfr cw 1f 0.5 0.8 3 18 -25 10yr4/4 f2d 7.5yr5/8 sl 2msbk mfr cw - 0.5 0.9 4 25-46 7.5yr416 m3p 5yr5 /8 & sl 1 csbk mfi - - 0.4 0.6 m2d 10 6/2 * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < mg/L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. ♦ E/era,'o� N. - m 1 / t See. 9 T. di Pleasa�.r� �/Q //c 'cr ix TrcC „7—„ 5 h u b cmueac l rkbb'(e Pale ' - D(54;w ■ Q-r'c q y►o p dab /e ko 81 ■ lb zi V) 6 2: O u 1 g3 B2 � � a v� 'E /M tree, fJssw• el. = /c�t�iJ' F} o po sQd AIE.e,A Tpo/'M "Ile hw. Tccs ¢ easa.n�rt 38 Sk ,-u6s 85 3 a , 3 _ ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Mailing; Address _x- y�T 1 .iL��Y� Property Address 0"el 1fication required from Planning Zoning Department for new consWuction.) ITT City /State , ¢� , ,,)'�:/64y Parcel Identification Number LEGAL DESCRIPTION Property Location ;'q, J S �� 'l` � N R- 7 W, Town of - Subdivision ; Lot # Certified Survey Map # / �7�� , Volume Page # _ Warranty Deetl # ,Volume 1 age Spec house yes Imo Lot lines identifiable Ces uo 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 tluc:c 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 stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 clays of the three year expiration date. Uwe certify that all su itemej)ts oil 1I11s tu1711 arc trtie to tliv best of my /our knowledge. 1/we ani/are the owner(s) of the property described above, by virwe of a warranty deed recurde.d in Register of Deeds Office. Numbe of bedroom 3 �C& 1 Z iii oa SIG URE OF APPLICANTS) 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 mop if reference is made in the warranty deed. REV, 08/05 U 2 5 8 1 P 3 2 0 ?6384B 3 )\ KATHLEEN H. WALSH STATE BAR OF WISCONSIN FORM I - 2000 REGISTER OF DEEDS Document Number WARRANTY DEED ST. CROIX CO., WI RECEIVED FOR RECORD This Deed,.made between GLEN S. MOHN and DAWN M. MORN, husband and wife, HOLDING AS SURVIVORSHIP 85/26/2804 10:08AN MARITAL PROPERTY WARRANTY DEED _ E(ENPT 11 Grantor, and JAMES L. MOHN and LISA F. JOHNSON, AS JOINT REC FEE: 11.00 TENANTS, _ TRAILS FEE: 27.00 COPY FEE: CC FEE: PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in ST. CROIX County, State of Wisconsin (the "Property") (if more space is needed, please attach addendum): Part of the Southeast Quarter of the Northeast Quarter (SE 1/4 of NE 1/4) of Section Nine (9), Township Twenty -eight (28) North, Range Recording Area Seventeen (17) West, Town of Pleasant Valley, St. Croix County, Name FIRS I Iv�L BANK OF HUDSON Wisconsin, more particularly described as follows: 1660 11th Ave Lot One (1) of Certified Survey Map filed April 29, 2002, in Volume 16 PO Box 17 of Certified Survey Maps, at Page 4287, as Document No. 677426, office Baldwin W l 54002 of the Register of Deeds for St. Croix County, Wisconsin. 024 - 1015 -50 -200 Parcel Identification Number (PIN) This is not homestead property. Together with all appurtenant rights, title and interests. fig) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Dated this a day of May 2004 * * GLFK S. MOHN )am s * DAWN M. MOHN AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ) ss. ST. CROIX County ) authenticated this day of Personally came before me this day of May , 2004 the above named Glen S. Mohn and Dawn M. Mohn * T TITLE: MEMBER STATE BAR OF WISCONSIN ,%%% E i-- (If not, to me kfown to be th erZD e:tec foregoing authorized by § 706.06, Wis. Stats.) instru nt and ackn THIS INSTRUMENT WAS DRAFTED BY * racy R of s JIM W LEO A. BESKAR Notary Public, State of WORM13 s RODLI, BESKAR, BOLES & KRUEGER, S.C. My Commission is perman fbo; sta tion date: December 5 i QFC, 0% %%'2005 ) (Signatures may be authenticated or acknowledged. Both are not necessary.) * Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN INFO -PRO (800)655 -2021 www.infoproforms.com FORM No. 1 - 2000 B34S 75c3 KATHLEEN H. NALSH REGISTER OF DEEDS ST. CROIK CO., NI TERMINATION OF DECEDENT'S RECEIVED FOR RECORD PROPERTY INTEREST DECEDENT'S NAME DATE OF DEATH 11/14/20M 10 :38AM James L. Mohn Dec ember 26, 2005 TERM OF DECEDENT PRO EXEMaT # ADDRESS OF DECEDENT AT DATE OF DEATH CITY ST zip REC FEE • 25.00 4 County R oad T Hammond WI 54015 TRAITS FEE: -- COPY FEE: CC FEE: PRESENTATION OF DEATH CERTIFICATE PAGES: 4 1 certify that I have viewed a certified copy of the decedent's death certificate. A.R:u 04�� 1q/0 REGISTER OF DEED'S StGNATURE 1 DATE Recording area Interest in property is terminated under (please check appropriate statute): Name and return address: Leo A. Beskar X s. 867.045 which pertains to property in which the decedent was a joint tenant, Rodli, Beskar, Boles & Krueger, S.C. had a vendors or mortgagee's interest, or had a life estate. (You must provide a copy of 219 North Main Street the document establishing joint tenancy or life estate.) J PO Box 138 p( s. 867.046 which pertains to (1) property of a decedent specified in a marital River Falls, WI 54022 property agreement, and also to (2) survivorship marital property. (You must provide a copy of the document establishing survivorship marital property.) s. 705.20 Nonprobate Transfers on Death. A provision for a nonprobate 024 - 1015 - 50.200 transfer on death in a trust, conveyance deed of gift or marital property agreement. PARCEL IDENTIFICATION NUMBER (You must provide a copy of the document establishing transfer at death.) Presentation of recorded document establishing joint tenancy, life estate, survivorship marital property, vendor interest, or mortgagee interest in real estate. This document number is 763883 volume 2581 page 320 of (check one) Records, Deeds X . This document number is volume page of (check one) Records Deeds This document number is _ _ , volume page _ of (check one) Records Deeds Description of the real estate. Include only the extent of ownership (or vendor or mortgagee's interest) in land at the time of the decedent's death If the extent of land is exactly the same as on the document, a copy of that document may be attached to describe the real estate. Attach tax bill(s) for year immediately preceding death, if applicable. (See directions.) The legal description of the property and the persons receiving the property are as follows: (if more space is needed, attach pages.) See Attached. uescription of personal property (if any) tieing transferred. You may list savings accounts, checking accounts and securities on attached pages. Indicate person(s) receiving property. DECLARATION: I (We) declare that this document is, to the best of my (our) knowledge and belief, true, correct and complete and is in conformity with the provisions and limitations of the Wisconsin Statutes. (If more space is needed, attach pages.) Name and address of Persons Receiving Property Relationship to Decedent Signature Notarized Date Lisa F. Johnson Fiancee 26 Ida Street Roberts, WI 54023 This document was drafted by: STATE OF WISCONSIN, County of g •• hh (print or type name below) f Leo A. Beskar Subscribed and sworn to before me on fj _ C� "(`c bN1 Rodli, Beskar, Boles & Krueger, S.C. person(s). �j I _ Signature of notary r other person / NOTE: SEE DIRECTIONS. a thorized to administer an oath y do Wisconsin Register of Deeds (as per s. 706.06, 706.07) Association Form HT -110 Print or type name: l n � h&.4 version 6/2003 Title: ( ,[ _ Date commission expires: —� —( INFO -PRO 800 -655 -2021 www.infoproforms.com 1 of 4 u ME s a , L \ I i I I NNW N 98 i a� h T n z �- 061 se o- o � cp $ s• o tO s W 000 + b d SOSLLZMO 'ON /U: L l '1S /L I: L I LOOZ OZ 21 � M1) WNd ; s � ■ LLI A =E © &z U§ b2 CC R O [ - - - -- -- _ I it |I ,I I! �I || '14 i1 I| II E g |I t| § |I � ■ �� L J E I �I EII w � L a I , I �� I i II ° g: . 711 L / % 2 v92 mll f % �� b & mo o ■� o Q |I z m L6 2@� U 6 0 n ■ $ LL m § °§ ° � � � z 0.% I, li 2 w «OUJ < / 2 �� 7)- II 2 �3a �w ■� I �� K �o ICL k2 I| w k §��KRUL 2 ou ■ � � O @ �Lu0) ® Eq M %F-$F2min |��®< �� |/� .$ &� %R 0 � « w 0Fu . 2 $ @ 2 < U § ® o U % � M \ U M , K�A� @ o � 7 0 C6 .- a ► f E b$ 7 �� g A�b� _ z_ � _ it q �OQ�20 k0 � a E «x LON ); Q � =g°w a g N VO � , s � Ni o z y0 i o En J / Y � / � f � ` f s B , , o J G \/ ® < o 0 s a � 8 d 909LLZ8H9 'ON /9l L l 'A /L l L l LOOZ OZ 033 (Inn) WOa3 r - Parcel #: 024 - 1015 -50 -200 04/05/2007 10:48 AM PAGE 1 OF 1 Alt. Parcel #: 9.28.17.84A -20 024 - TOWN OF PLEASANT VALLEY Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Ma # Sales Area Ap # Permit # Permit Map pp Ty 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - JOHNSON, LISA F LISA F JOHNSON 26 IDA ST ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 2422 ST CROIX CENTRAL SP 1700 WITC i Legal Description: Acres: 8.840 Plat: 4287 -CSM 16/4287 SEC 9 T28N R17W SE NE LOT 1 CSM 16/4287 Block/Condo Bldg: LOT 1 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 09- 28N -17W SE NE Notes: Parcel History: Date Doc # Vol /Page Type 11/14/2006 838759 TI 05/26/2004 763883 2581/320 WD 05/26/2004 763882 2581/319 WD 12/17/1999 615668 1478/577 LC more 2007 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations Last Changed: 04/20/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.000 13,500 21,600 35,100 NO AGRICULTURAL G4 7.840 900 0 900 NO Totals for 2007: General Property 8.840 14,400 21,600 36,000 Woodland 0.000 0 0 Totals for 2006: General Property 8.840 14,400 21,600 36,000 Woodland 0.000 0 0 Lotter redit � 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 ~ 1366 Wisconsin Department of Commerce SOIL EVALUATION REPORT page 1 of 3 Division of Safety and Buildings A.C.E. Soil & Site Evaluations in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper n t>gri'•,$' x# 11F i ci1s ize. Plan must St. Croix include, but not limited to: vertical d Tr eferenY(BN :,direction and p�� l D percent slope, scale or dimemsi arroVd I lion Mod distae4pe to nearest road. 92A- ID #28.17.9.84A Pleas t al Vin. P R Date � �= Personal information you pro" used f ndary pu rivac l aw, . 15.04 (1) (m)). Property Owner acs �X G Property Location GLen Mohn Y:``; ; �� �� Govt. Lot SE 1/4 NE 1/4 ,9 T 28 N R 17 W Property Owner's Mailing Addres - NGO� �!` Lo�#Block # Subd. Name CS f� Co. Hwy. T �d City State�ip'C P)aepsiQurYf I City _j Village y Town Nearest Road Hammond WI I 5404§ __ - 2331 Pleasant Valley I Co. Hwy. T 0 New Construction Use: a Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD J Replacement _f Public or commercial - Describe: Parent material Glacial Till Flood plain elevation, if applicable na General comments and recommendations: System elev. = 97.00' at 19" above 95.40' contour. Boring # J Boling f/ Pit Ground Surface elev. 95.44 ft. Depth to limiting factor 22 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' *Eff#1 *Eff#2 1 0 -9 10yr3/2 none sil 2fsbk mvfr as 2f 0.5 0.8 2 9 -22 10yr5/4 none sil 2fsbk mvfr cw 1f 0.5 0.8 3 22 -28 10yr4/4 f2d 7.5yr5/8 sl 2msbk mfr cw - 0.5 0.9 4 28 -51 7.5yr4/6 3 10� 6/&2 sl 1 csbk mfi - - 0.4 0.6 m Td ❑ Boring # —) Boring 0 Pit Ground Surface elev. _ 95.39 _ ft. Depth to limiting factor 1 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' *Eff#1 *Eff#2 1 0 - 10yr3 /2 none sil 2fsbk mvfr as 2f 0.5 0.8 2 9 -17 10yr5/4 none sil 2fsbk mvfr cw 1f 0.5 0.8 3 17 -25 10yr4/4 f2d 7.5yr5/8 sl 2msbk mfr cw - 0.5 0.9 4 25-46 7.5yr4/6 r 10 6/&2 sl 1 csbk mfi - - 0.4 0.6 * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >3q< 150 mg/L 2Mt #2 = BOD 30 mg/L and TSS <_,0 mg/L CST Name (Please Print) Sign re: CST Number James K. Thompson 3602 Address A.C.E. Sal & Site Evaluations ate Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020 3/19/01 715- 248 -7767 property owner GLen Mohn Parcel ID # 024 - 1015 -50 -000, ID #28.17.9 Page 2 of 3 3 ] Boring # Boring Pit Ground Surface elev. 93.17 - -- ft. Depth to limiting factor 19" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 2 *Eff#1 *Eff#2 1 0 -12 10yr3/2 non sil 2fsbk mvfr as 2f 0.5 0.8 2 12 -19 10yr5/4 none sil 2fsbk mvfr cw 1 f 0.5 0.8 3 19 -24 10yr4 /4 f2d 7.5yr5/8 sl 2msbk mfr cw - 0.5 0.9 m3p 5yr5/8 & 4 24 -38 7.5yr4/6 m2d 1 Oyr 6/2 sl 1csbk mfi - - 0.4 0.6 ❑ Boring # J Boring — Pit Ground Surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft *Eff#1 *Eff#2 ❑ Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608- 264 -8777. l ♦ E/e ✓anion cl.en nloka pro"o. s�nE sec. 9, T. or Pleaw l& Aacy, 66. CroFjc 0 40/. 9. z8, i ?. 8 J Pro posed &L' td - 5,4-e. c rade qg, S hr�b3 ♦ �� �. ma . I �I � AI I `Trtt3/ li 4 9537 ■ 63 I� 1 � rl � na % /ir► &"E /m twee. 1-54r(AhS Of I I ■ 82 ALE. $, w(.: 7-o od �B "/`tb�i; E /ed : 910..?8: x ;strn� �nae %rie -not �proP 1 ►n4 4-7 - 7 6 A V L 16 PAGE 4287 I.� KATHLEEN H. YALSH REGISTER OF DEEDS SURVEYOR'S RECORD ST. CROIX CO., MI RECEIVED FOR RECORD 04- 29-2002 9:15 AM CERTIFIED SURVEY MAP REC FEE: 13.00 COPY FEE: 3.00 2 BEARINGS ARE REFERENCED TO THE EAST LINE OF THE NE1 /4 OF SECTION 9, Z �p��J� tU ASSUMED TO BEAR N00 °40'32 "W. CC r off' ST. CROIX COUNTY G N PlBnninn 7 . O APR 2 ^2002 O ? > 0 it not recut ucu �.. Z�� r approval date approval shall bu c e D e D f�! n'iii n - �+,,.,;.+ MGvIpdL-- --- _4mm -! JG�_l_p� Z Z rn m - �n CLf 0 0 WEST LINE OF THE NE1 /4 OF THE SE1 /4 OFTHE NE1 /4 0 S00 0 44'27 "E 587.80' ZOOM o I �S� �m� 66' m I N � b �� _ N =.Q -�O m I w �m � �1C oo� -, 0 i@ r m m m°' i8 ^�M ..� °' W �' � ;o m m ° QN o o °- -� T - m N m 166' 0 - .................. ............................... r m m m '° O d 0m � 0 Cn Z Z = O I N00 °40'32"W 586.78' 0 Zz -- --- --- - -- 718 70 CA 1305.40' EAST LINE OF THE NE1 /4 —� ®— N00 °40'32"W tn N00 586.70' — — — _ Np0 °40'32"W z (n m 0 0 CTH 'T' 0z m o t N ' Mly]pdQ44GD _ dGQ[nv__]_D ----- ----- m o Z C.) r . $ N WX 0 C m f� MID 6 C � A 0 m =000 V/°_°� LIF z O C7 Z O m 70 01 Z Z m 0 � O m m ((/�� ��Z o � vA II Z m c o �s CC O QQ J 0 I L� z0 - W � N 0 , = 0 Z Q z 0 t7 O Vol.16 Page 4287