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028-1041-40-200
. / sr ' 0 r ° M — � � s-0 z z CD -P, Ca 0 2 : a ° ® E K) 0-4 ' § ( I 2 � (D \ # 00 ■ ` ; 9 E } \ \ o CD k i m k\\ q c , CD ® E E k §§ K E g # 0 a © E m z > E % E 3 > / E ƒ ; } a o § / 8 � ® > \ CL ) / S 8 =: CO) C L E : � � cr 2 / 0 0 0 - ■ "m ., \ / / r § 2 ) / K) > �\E (7 J » ®� co ; \D \ § / § z .. � > > o =-F g , 7 :3 = " _ CD \ CD / ¥ § 9 ƒ ■ 2 2 0 A / q o r z \ N z CA) % $ ± 0 § \ ƒ 0 R CD � . � � ) Iv � \ _ o § § � & 660 1 59 VOL 16 PAGE 4301 APPRO'''"° a � � � �,„�. KATHLEEN H. MALSH sT.c REGISTER OF DEEDS Planninn ? 1(; 7 ��1 ST. CROIX CO., MI u. t., MAY 2 8 2002 L _ _ RECEIVED FOR RECORD _., " 05 -28 -2002 3:00 PM I 1 ': . If not recoraea wm a° 11 be CERTIFIED SURVEY MAP CE1%,TL IFn� m ' SURVEY MAP COPY 3. Joel and Kathy Afdahl PAGESs 2 Located in part of the Southeast Y4 of the Northeast 1 14 of Section 35, and part of the Southwest Yo of the Northwest Y4 of Section 36, all in Township 28 North, Range 17 West, Town of Rush River, St. Croix County, Wisconsin. WEST 114 CORNER I Iz SECTION PIPE w JMPLA___TTEV.IAN_0S 6 N 00 0 32'39" E 1314.81' m z �- i o0000000 ,28,.8,' _" i Z 3 , t^, � p0 Na Q. A y ;mi ` N ;a z ' y x Q 4z 0 `° I ► ° °00 `��. ° a o PO ICJ z ,� 0 0° OR CC ( q�T m A n G A mm C-) 1 �4 `" N 00 0 4625" E 1314.28' m ; 1281.28' (- I , 1 ZZ N-r r j " ��0 , � �a ( o" , co co N 00'46 2828.06' — _ N 10 4 625' E 13 14.03' ��_1� — _ E AST LINE S_E1 - NE114 SEC 35 % N W46W E f 11314,03 LO V, 1 1281.03' a n WEST SECTION 36 I aO ny « in N z t/! N 00 °4625' E 1014.14' v }r y A 981.141 ^ 0 C- _ -- z on I o RZ I 1Q:70Z z 1 z r • O 'y x C W p _ m :O O MIMI I T $�' ��o m t 'Cq ti p O 25 o a C� h3 ' IBC ..► .� N i � A C n y n y y / 349.98' 300.02' x I T S 00 °40'5T' W 650.00' m, too' � a� 0 �� w � 1 1 l ' CD y : � �• i 631.9Z m �O �Z JJ I6 S 00"40'57"W 664.92' 1� I I d 1 T - T ED_(�4NDS � ca � EAST 1k CORNER SECTION 36, T 28 M R 17 W (FOUND COUNTY BERNTSEN NAIL) THIS INSTRUMENT DRAFTED BY JERALD L LARSON I SHEET 10F 2 Vol. 16 Page 4301 onsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix ,afety and Building Divis:an INSPECTION REPORT Sanitary Permit No: 420457 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: onzbpa Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. I OU Permit Holder's Name: City Village X Township Parcel Tax No: Afdahl, Joel I Rush River Township 028- 1041 -40 -200 CST BM Elev: Insp. BM Elev: BM Description: o `afq. U f U S1c� 1� ' I� TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY T TION BS HI FS LEV. �.c Septic � / , � UU� Benchmark �• �C w V Dosing n L ,,,l Alt. BM Dor 72v Aeration toJ l/ Bldg. Sewer pZ Holding St /Ht Inlet :5) /46 - 1 co / TANK SETBACK INFORMATION St!Ht Outlet ` TANK TO 4 1L WELL BLDG. Vent to Air Intake ROAD Dt Inlet �i . Septic � �.- \ I � Dt Bottom J• -.7C1 J r Dosing Header /Man. Aeration Dist. Pipe / o t 3 Holding Bo t. System q7.17 Final Grade �( R 6 PUMP /SIPHON INFORMATION E Manufacturer v Demand St Cove GPM Model Number ��, C.� / o dr r� D /•Z TDH Lift Friction Loss Syste Head TD Ft .2 Forcemain Len th Dia. .4 Dist. to Well NOT r� "T SOIL ABSORP ION SYSTEM BED/TRENCH Width Length f No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. a th DIMENSIONS SETBACK SYSTEM TO P/L BLDG WEL LAKE /STREAM LEACHI Manufacturer: INFORMATION CHAMB R Type Of System: ' 1 Mo tuber: DISTRIBUTION SYSTEM (/F / " 03Y � Header /Manifold Distribution 3 0, x Hole Size x Hole Spa i g V nt to Air I take (f f/ 1 Z T / Pipe(s) / 1 /T Length Dia Length 1 s Dia ' Spacin �� �{ SOIL COVER x Pressure Systems Only xx Mound Or At -Grade S ystems Only Y Y Y Y Depth Over Depth Over xx Depth of xx SeededlSodded xx Mulched Bed/Trench Center ' Bed/Trench Edges Topsoil LFAI Yes No Ed Yes J No COMMENTS: (Include code discrepencies, persons present, etc.) Inspectio #1: /2--T 1 02 — Inspection #2: 2 / 2 l �Z Location: 1996 County Rd YY Baldwin, WI 54002 (SW 1/4 NW 114 35 T28N R17 AL t2 8 /� Parcel No: 35.._17.260A20 p 1.) Alt BM Description = �T � `� `�' �� C� (Luca- 'A-46 2.) Bldg sewer length , G✓ (J�C Of/00 amount o cover= 4 r(0 tf2e_. 51A Y3�f 0 3.) Contour �qs � ��' $�`� � Plan revision Required? [ Yes o Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No - Safety and Buildings Division City //++ 201 W. Washington Ave., P.O. Box 7162 j Madison, WI 53707 - 7162 Site Address DD ) 11 to Dep artment of Commerce 10 - _. -L__ 3 ad 9 % h 4 t Sanitary Permit Application Sanitary Permit N umber / c- �/ In accord with Comm 83.21, Wis. Adm. Code, personal information you prov' 7�QJ J ma be used for secondary purposes Privacy Law, s15.040 ❑Check if Revision I. Application Information - Please Print All Information __ � State Plan I.D. Number REC q 94 o xv 65'0 33 Property Owner's Name , Parcel Number 35 -dr. l '7 • �o>, �( - JOel �T- �a�►I SEP 3� 0X- /oy / -V6 -�� Property Owner's bliHing Address T CRD1X G C U" Property Location W t qq6 Gh Rd YY S ZON�N�' W. W .,V ,,;,, Q 3 T�// N. R City, State Zip Code ne Number Lot Number Block Number (.� 177 Subdivision Name CSM Number 6 VJ IC 4 301 6 SG 15T H. Type of Building (check all that apply) ,/ 0 -' ❑City 1 or 2 Family Dwelling - Number of Bedrooms ❑Village ❑ Public/Commercial - Describe g us h VI'tI Use /� ❑ State Owned .25 , c-Q U �I J� �O n dotty' / 5 S_ ownshiP Nearest Road !ZZ, & "& It at '(Z) % III. Type of Mink: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A. QV New 2 ❑ Replacement System 3 ❑ Replacement of 6 ❑Addition to For County use S stem Tank Onl Existin S stem B. ❑ Check if Sanitary Permit Previously Issued Permit Number Date issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) 44 ❑ Non - Pressurized In- Ground 21)f Mound 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. Dispersal/Treat ent Area Information: Design Flow (gpd) Dispersal Area / Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed j Rate(Gals. /Days /Sgq.Ft..) h) Elevation 1r I N / /_/ 1� 5 { S ~ v /ate ��'` ` I l�lo FF• D ✓ 5A Jrrw 1 Z o s VI. Tank Info Capacity in Total Number Man acturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank Y _ 1 000 Dosing Chamber 6 VII. Responsibility Statement- I. the undersigned, assume responsibility for installation of the POWTi shown on the attached plans. Plumber's Name (Print) PI be 's Signature MP/MPRS Number Business Phone Number D svvc& 0 1pi I ekPv 1 jVyj? _ 14P6117 1 7MY 4 1Y .3070 Plumber's Address (Street, City, State, Zip Code) N 39'" C 41qa V c 6� /s o 1 VIII. ount /De artment onl pproved ❑ Disapproved Mary Permit Fee (includes Groundwater ate Issued Age Signature PS) ❑ Owner Given Initial Adverse. surcharg 1 0 Determination ./� IX. Conditions of_ ppro ' R � ons for Disapp val r i f� "n e /e v. 97• 7 /►?9r1• el�va��-ta►ofi+� o �7 R ofo�f� �t � /ot p��.- �idJc�r� � - �t�a��aact.� 9 /a�la a-• C a d o�p pl# (to the ) for we sysfid papeftot less than 81/2 x u Inches in size SBD -63989.U01) _ (� � t Iri• �.�• VY- RECEIVED S E P 2 6 2002 ^ ST. CROIX COUNTY tn l ZONING OFFICE Ep o_ d d %o d � vj o _ u� N tn u v ' m u m V 1 a S C NO1 u [ 1 L N m t M y .O +' i pq m d N sYO MNO o �N a'od %> wo.i w O> Y O y _ Na a l � L, i O a0. u0. ou, c u C O L uo} coo uao d d+0+i 4'�a NY cm w 4 c � s uj � c O O� £o L Gm o i u \ u ` S S a� u A n � m «�: N b n L 4 O� N O1 Q N O CD r 3 / d o U UI- A p� d. O ;Q- `D 0) M O 3 _O u C/) -p u O Lf) E O S i a 4 SlOOOM r Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 hsconsin www www.commerc .wis c ons .wisonsin.gov Department of Commerce Scott McCallum, Governor Philip Edw. Albert, Secretary September 23, 2002 CUST ID No.220499 ATTN: POWTS Inspector ZONING DIVISION PIERCE COUNTY SPIA BRUCE ALLEN WEBSTER 414 W MAIN ST N3659 CTY RD C PO BOX 647 ELLSWORTH WI 54011 ELLSWORTH WI 54011 -0647 CONDITIONAL APPROVAL -4 La2 Y b Y PLAN APPROVAL EXPIRES: 09/23/2004 Identification Numbers Transaction ID No. 788260 SITE: Site ID No. 650533 Joel Aftdahl Please refer to both identification numbers, County Road YY above, in all correspondence with the agency. Town of Rush River, 54002 St Croix County SWI /4, NWI /4, S36, T28N, R17W FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 870816 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: c General Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD- 10706 -P (N.01 /01). • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. COfPdl • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c t EP RTMENT • A Sanitary Permit must be obtained from the county where this project is located in accordance with the N OF FT requirements of Sec. 145.135 and 145.19, Wis. Stats. SEE CORRE; • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat • Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be on -site during construction o inspection y aut or�ze represen t which may include local inspectors. • The changes made to this plan on 9/23/02 by this reviewer were acknowledged and approved by the system designer. BRUCE ALLEN WEBSTER Page 2 9/23/02 Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation /operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday cbratz@commerce.state.wi.us cc: Leroy G Jansky , Wastewater Specialist, (715) 726 -2544 r T � p SU/ 1 / d fq k/ %y sec, 3� T- )7w oWh o � st" j ,r P7 wYr w►►° T k I'�'✓ 16 2 � y� S�'� 7 Ps�fr� B''�e WO $��ce dill 3 ? I/L � f� , e�- 76 Cyr Lekph , P &� - Co ) 5 Lot der Sf,gcfh� 3 Put ih wP�►►+ ah ain �l� . a ar, �y R ►a �- i he vraSPS fi� "� M a, n r tO `a st-- F/ 7- �Ymto lob pf)lfv 054 yl6lf- 0 We i Se,- T4 h �.� {era � 10 iiII t e� L�feraf 7 rt ®IpS P a— 0 0l e s 10 2.17 �3 EP CVM �- 050 and P ar ' le ' ,D n�ert- eleon'- f"n IdOt m Is 17, pf ez vf MAJI&)e 124 ���y j d � `���- - -r'_� e ey p pt l{„ .1 � C OA4 MERCE ,1 ILQINGS 4 �PON a rtDW F �q,'� �5 N h v e oL 717N e� I. � e 5S c atA FPO 9i� OTS ' O 0 Icy r 8 t N! Woods � ence n �i ? no ro � m � hNn °7 • OLO fiI 3 Z 10 ■ Py� N O e r [ t c I gf z �! O ro ti O O `J' w UUO�D -- i �1 a z S ' O J ro 7 ` 0 - 0 V ' ) n <-+ n �• O � O .� � -, L am• ,� � � North W rl �n o ` -. rn O Z ,* 0 Q� o � m -h t " m td 3 J n 3 n n j• .�. %a fU w' —3 S !i f p of 20 ED ° sj Ns � qq p D A O h g 0" A 1 �{C L' g Q• a 0 • a 10 _ � -h D w y �Ca AOe1• h ` w A A et tr " c ` q lb N b m cr N � I�JI P n I�ji S 3 Ln — Ln N N W C7 W 0� v � P O IA Page Of I a ,• Distribution Pipe Detail For A Four Lateral Network a� I - End Cap P ,'PVC Distribution Pipe PVC Force Main 4 r " P P Holes Equally Spaced µ Y, PVC Manifold Pipe On Bottom X : S t \ x' X 2 * Last Hole Should Be Next To End Cap P Z�, Ft. S Ft. X 17 Inches Signed: IIN�1N aches i g r Hole Diameter ` q / Inch License Number. Lateral Diameter 114 Inch(es) a Date: Z 4. E Manifold Diameter Inches Force Main Diameter Inches Holes Per Pipe �© s Invert Elevation Of Laterals P Paged Of i Straw, Marsh Hay, Or Synthetic Covering ����� �•�� i d 0 Distribution Pipe �v Medium San I•�� _ H G 6" Topsoil _:__ —J i E R-I.1 D � 3 Slope - 7 - r � G7 Bed Of 2•- 2 %2 Force Main Plowed Aggregate Layer �w• (6 Below Pipe) � 7'0 D Ft .------ Cross Section Of A Mound System Using E Ft. A Bed For The Absorption Area F 0 U Ft. G Ft. Si — �1 -lL�r� A Ft. H Ft. B Ft. License Number: ���37 X0 y ?� K �_ Ft. Date: �� �� 00 L Ft. 1 2. olS Ft. I 1-S_ Ft. r W , Js Ft. Observation Pipe �--- -- --------- - - - - -- ----------------- - - - -�I Force Main Distribution Bed Of 2 - 2 i v S Pipe Aggregate ecf e Observation Pipes Pw9 Plan View Of Mound Using A Bed For The Absorption Area ( f e �y Pa S Of Sy ►� SEPTIC TANK 6 PUMP CHA BER CROSS SECTION AND SPECIFICATIONS l�U � • - Tank Vent shall termina e in WEATHERPROOF BOX APPROVED accordance ;;ith C 1(16) WITH CONDUIT MANHOLE COVER W/ PADLOCK & FINISHED GRADE — WARNING LABEL —4 MIN. MIN. 18" IN. i,rt INLET I' WATER TIGHT SEALS GAS- 1 . IGHT VAPPROVED _ A SEAL JOINTS WITH APPROVED ALM APPROVED PIPE PIPE 3' lna�rut�,s B ON 3 ONTO ONTO SOLID l�?o�lel L FDa i SOLID SOIL OIL PUMP OFF ELEV. _ FT. C I OFF ** RISER EXIT D PERMITTED ONLY IF TANK MANUFACTURER HAS APPROVAL ���3edded in accordance with product approval undo 7 mr�4. 10 �5 v ,� Q �K► CONCRETE PAD SPECIFICATIONS 0 � SEPTIC / DOSE TANK MANUFACTURER: NUMBER DOSES PER DAY: S G &N ) TAN_ K SIZES' DOSE SEPTIC 1600 GAL. C, OSE VOLUME FLOWBACKG GAL. S� ALARM MANUFACTURER: JJ ED9rT:� 5 -• CAPACITIES: A = 5 INCHES = _ GAL. MODEL NUMBER: 101 Ak) SWITCH TYPE: B = 2 INCHES = 3q GAL. PUMP MANUFACTURER: C = 6, INCHES = /Cj a GAL. MODEL NUMBER: r O-�5 SWITCH TYPE: �0.� K4b D = 2 INCHES = jL? GAL. REQUIRED DISCHARGE RATE LL,_� GPM PUMP E ALARM WIRING AS PER ILHR 16.23 WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE F EET ! " + MINIMUM NETWORK SUPPLY PRESSURE X - 3 _=, , , , , , , , , 7 // O ppp FEET + FEET FORCEMAIN X 1.3 q FT /100 FT. FRICTION FACTOR G FEET �--- TOTAL DYNAMIC HEAD INTERNAL DIMENSIONS OF PUMP TANK: LENGTH ='C ; WIDTH -7(> LIQUID J- A-, P- I ` f GOULDS 'PUMPS Submersible Effluent Pump EPO4 l 3871 EP05 a e I V APPLICATIONS •.Fully submerged in high ■ EP05 Impeller. Thermoplas- ■ Bearings: Upper and lower grade turbine oil for tic enclosed design for heavy duty ball beating construction. Specifically designed for tine lubrication and efficient improved performance. following uses: heat transfer. ■ Casing and Bass: Rugged • Effluent systems thermoplastic design provides AGEMCIf LISTIN r atic and ion • Homes Available forauto n superior strengUl and corms � P �• (,anarianSWdxd rA, • Farms manual operation. Auto- resistance. — • Heavy duty sump matic models Include a Motor Housing: Cast iron (CSA listed model numbers end • Water transfer Mechanical Float Switch for efficient heat transfer, in "F" or 'C".) • Dewatering assembled and preset at the strength, and durability. factory. GouldsPunrpsa1509001 Re9istae SPECIFICATIONS d ■Motor Cover: Thermoplastic FEATURES cover with integral handle and • Solids handling capability: Moat switch attachment points. 3 3 1q* maximum. ■ EPO4 Impeller: Thermoplas- N Power Cable: Severe duty u to 60 GPM. tic Semi•open design with rated oil and water resistant. 1 • C p p' mechanical vanes meth Total heads: up to 31 feet. pump out � - Q Q • Discharge size: I I /j' NPT. Seal protection. (� 1 • Mechanical seal: carbon- GUNA • N stationary, elasto BUNAN elastOmers. • Temperature: 104°F (40°C) continuous METERS 25 FEET _ 140`f (60°C) intermittent. to • Fasteners: 300 series 5 GPM stainless steel: s 30 • Capable of running _._ — —_ I I —r 2.5 cr ._ dry ; without damage to a l z components. , Motor: _ • EPO4 Sin le phase: 0.4 HP, `—' so 115or2 0V, 60 Hz, 1550 S RPM, built in overload with c 1 automatic reset. 4 _ -- -- - ---- ....... _... .....EP09 • EP05 Single phase: 0.5 HP, o ; 115 V, 60 Hz, 1550 RPM, ' 1 10 I built in overload with Epoa automatic reset. —_� _.I • Power cord: 10 foot standard length, 1613 SJTOW with three prong SO GPM grounding plug. Optional 20 ° ° 0 — 10 20 M 30 ao foot length, 1613 SJTW with to mih three prong grounding plug 0 2 4 6 s 19 (standard on EP05). CAPACITY Goulds Pumps ITT Industries O 2000 Goulds Pumps - EVKtivc kbruary, 2000 8387? • 1' r / tL Pe rinit POWTS OWNER'S MANUAL MANAGEMENT PLAN Page_ FORM ATMIU SYSTEM SPECIFICATIONS Se tic Tank Ca acit 1 d G 0 al ❑ NA Se tic Tank Manufacturer k/i eser" ❑ NA DESIGN PAIZANIE'TERS Effluent Filter Manufacturer S r ❑ NA Number of Bedrooms I 00gpdibedrooni 9 p NA Effluent Filter Model t ❑ NA Number of Commercial Units NA rump Tank Cap acity So g al ❑ NA Estimated flew (average)* p D _ � al /day Pump Tank Manufacturer lt/#'G eH ❑ NA Design flow(peak), estimated x 1.5* gal Pump Manufacturer GOV Id ❑ NA Soil Application Rate gal/day Pum Model pa ❑ NA Pretreatment Unit ❑ NA Influent/Effluent Quality (NA❑) Monthly Average ** ❑ Sand/Gravel Filter ❑ Peat Filter Fats. Oil & Grease (FOG) < 30 mg /L ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BODs) < 220 mg /L ❑ Disinfection ❑ Other: Total Suspended Solids (TSS) Manufacturer: Model: <_ 250 rn /L Dis ersal Cell s Pretreated Effluent Quality El Monthly Average * ** ❑ In- ground (gravity) ❑ In- ground (pressurized) Biochemical Oxygen Demand (BODs) < 30 mg /L ❑ At -grade 7KMound Total Suspended Solids (TSS) Fecal Coliform (geometric mean) 30 mg /L C] Dri -line ❑Other: 10`cfu /l00rn1 ❑ Leaching Chamber Manufacturer Maximtmn Effluent Particle Size 1/8 inch diameter Model Approval Stipulation *Wastewater Flow Verification on and calculations: Soil Application Rate gpd/ft Area Req. ft (Other than bedroom based) Absorption Area Credit per unit ft Minimum Number of Chambers ❑ Ag regate Desi n Flow /Loading Rate = ft nun ** Values typical for domestic (non- cormmercial wastewater Materials: all materials must comply with W1 Adm. Code and septic tank effluent. COMM84 and be installed per manufacturers specifications ** *Values typical for pretreated wastewater. and a roval letters. i DESIGN CRITEIZIA ❑ "Wisconsin At -grade Soil Absorption System, Siting, Design & Construction Manual" (Converse et.al.1990) ❑ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. Publication 15.22 ❑ "Design of Pressure Distribution Networks for Septic Tank -Soil Absorption Systems" Publications 9.6 ❑ "Design of Conventional Soil Absorption Trenches and Beds ". R.J. Otis — ASAE Publications 5 -77 and "Design Manual — Onsite Wastewater Treatment and Disposal Systems ". EPA 625/1 -80 -012 October 1980 ❑ SBDj— 10570 —P (R.6/99) "At -Grade Component Manual Using Pressure Distribution" ❑ SBD;- 10567 —P (R.6/99) "In Ground Absorption Component Manual" 'SBD — 10705 —P (N.O1 /O1) "In Ground Soil Absorption Component Manual" Version 2.0 ❑ SBD,— 10628 —P (N.6/99) "Recirculating Sand Filter System Component Manual" ❑ SBD'— 10656 —P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual" ❑ SBD - 10572 —P (R.6/99) "Mound Component Manual" ❑ SBD - 10691 —P (N.O1 /01) "Mound Component Manual" Version 2.0 ❑ SBD; - 10595 —P (R.6/99) "Single Pass Sand Filter Component Manual" ❑ SBD' - 10657 —P (R.6/99) "Drip -line Effluent Disposal Component Manual" ❑ SBD ; - 10573 —P (R 6/99) "Pressure Distribution Component Manual" SBD. - 10706 —P (N.O1 /01) "Pressure Distribution Component Manual" Version 2.0 ❑ Drip -line Effluent Dispersal Component Manual for Multi -flo Onsite Wastewater ent Units MAINTENANCE AND MANAGE NT )\MAINTENANCE MONITORING SCHEDULE Service Event Sen j uency Ins ect condition of tanks At least once ever ❑ months ears Maximum 3 s. Pum out contents of tank(s ) When combined slud a and scum a uals one -third 1/3 of tank volume Ins ect dis ersal cells At least once ever ❑ months ears Maximum 3 s. Clean effluent filter '' At least once eve months ❑ ear s Ins ect um , um controls & alarm At least once ever ❑ months ears ❑ NA Flush laterals and ressure test At least once ever ❑ months ears ❑ NA Valves At least once ever ❑ months ❑ ears ' NA Other: At least once ever ❑ months ❑ ears NA q 6 3 /Cia, �iikk,(s) page e. T UP w construction, prior to use of the POWTS check treatment tatrk(s) or the presence of painting products or other chemicals that pede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the removed by a septage servicing operator prior to use. 1 ;! System start up shall not occur when soil conditions are frozen at the infiltrative surface. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity I f the wastewater stream will affect the performan ce acrd longevity of your POWTS. The installation of water- saving and quality appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable /fruit peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non - biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. p Valves Valves shall be operated in the following manner: C3 Alarms Alarnts should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back -up of sewage into the dwelling or surfacing. INSPECTIONS ne of the following licenses or certifications: Master Plumber, Master Inspection shall be made by an individual carrying o Servicing Operator (per the attached Maintenance Schedule). Plumber, Restricted Sewer, POWTS Maintainer or Septage Septic Tanks Component Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any backup or surfacing of effluent. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one -third (1/3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR113, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more / frequent intervals than stated in the maintenance schedule to keep the system operating. Pump Chamber /Treatment Tanks Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of the filter. Any service needs or repairs shall be promptly taken care of ,al Gravity Gontponeut Dispersal Cells i'he inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface inust be promptly reported to the regulatory aulhority. Pondiug at depths greater than. 75% of the height of lire component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. ❑ Mound At -Grade, In - Gruumd Pressure file inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Pondiug greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. The pressure distribution systelu is provided with an opening at the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3) years. Pressure checks of systems with Innitiple laterals should be done to ensure that equal distribution of effluent is occurring to promote the longevity of the system. RPORTS �Co 'd eports for maintenance, inspection, and monitoring shall be submitted in accordance will' COMM 83.55 Wisconsin Administrative e. ABANDONMENT When the I'OWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Code. All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or other inert solid material. CONTINGENCY PLAN to provide a code compliant If the POWTS fails and 'carurot be repaired the following measures have been, or must be taken, replacement system: 2 9 1 / �9 A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption paction and should not be infringed upon by required system. El �a The replacement area should be protected fiomr disturbance and com m D setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new'soil from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result ill the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. C] A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS teclwulogy a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. Mound and at -grade soil absorption systems stay be reconstructed in place followin g removal of the biomat at the infiltrative e surface. Reconstructions of such systems must comply with the rules in effect at (flat time. «WARNING» SEPTIC, PUMP AND OTHER 'TREAThIENT TANKS MAY CONTAIN LETHAL GASES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUNIP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INS "TALLER YOWTS MAINTAINER Name (�UG �✓ Name v' �✓_ v Phone 55 J d S _D Plrone f — y 3 O Ba SEI''I':1GE SERVICING OPERATOR (Pumper) LOCAL REGULATO AU " V Name 3 6%5uH $�t,�}NPti1 A enc C .5 :Z . Phone 5 , D T Phone i _ j T J - gL 1,812 L 3 .75 ' 32.75 28 ul 16, 375 q ;flow GAG SIM /TECH FILER �,p 06598 HORTON BAY NORTH RD 1 K -3 7 BOYNE CITY, MI 49712 .9 -0 1 888 -3290 FAX 1 -231 -582 -7324 / SIWIECH FILTER ASS'Y DETAIL PATENT 5885452 J HOWERY I STF -100 1127100 GARY KOTESKEY OWNER OWG -002 41^ c 84 .. r y rn , 1 i 1 1 1 r '`I 1 ' 1 1 1 ? I 1 1 j t. Hi 1 ' 4 I Z ' N I 1 u� fTl mom m 46 I 1 2 I / I I I I 1 I j w 0>-u -u 4 m 2 O - NRD r c rn o _ �3 r r Z z zmp ~ rm r2Znm�g O �-+ az n o�z a =z mo�oZr *Inoo rn i z0 rn v 1�n xm° io g 0 - S io.�. ° �� z - Z gx mN n< z �ZFJ n A m XA .I � ,IWN En Q ♦ oo N O z ° � � N f� C pN mmr 0 C i m mO o -4 N aD �Y Nc �vo �� °zr� Zz Aa.v mo m n A - D OC D I vp� OO V) -1 0 -4 N \ OI O Z f'I {l Z ° fT1 C r "� T. ��� N4 LA o a o m`� Z F A 1 AO m � ° c , V) 5 2 03 O r � z 8 v v'"Gzl °z 0 rn o s o� -4 F v e IMAM KIW rae an" ens - RECEIVER s`P. _ L SAFETY & BLDGS Dit • ` ' Np�r►, dv r �, fir Cv H� (r `.' v Wisconsin Dep.artmenttfCommerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code (_ , G iro' Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County J 1. include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 'L percent slope, scale or dimensions, ; north arrow, and location and distance to nearest road. --)-6 (� Please print all information. eviewe � Date Personal information you provide may be used for se ndary s. 15. 4 (1) (m)). G� /`/O 7 r� Property Owner Prop rty Location Govt Lot 1 /4 P /4 S T ; N RI 7 f (or) Property Owner's ner's Mailing Address Lot Block # Subd. Name or CSM# / 8 Ch l If I ST. CROIX COUNT City State Zip Code P one "NOWNG OFFICE L a l ity ❑ Village .Town Nearest Road New Construction Use: ❑ Residential / Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable ft. General comments p - IOU and recommendations: j 6'e, Boring # Boring Pit Ground surface elev. � /� Q E� , / ] ft. Depth to limiting factor � y in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 0 - $ 161 �li_ s; 2 V�ctk M fr c ave Q. ©.S o r2 ---- -- s j i 2 V hk M lPr I W D. a 3 2$ o . a 519 5/V c 6 i 0 0, SY9 S p, 0. F �!Boring # Boring �� 8 Pit Ground surface elev. 7 ft. Depth to limiting factor ! / in. [ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consiste a Boundary Roots GPD /fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 4'I0 1019 r1 rv- cs 2 v f^ o,5 0 9- 10 1 0Y94/ 3 5 ° ,2vFabk w, py C, n -5 ® -F — 17- - 7 9 — co s ;Ld 03 V 7 WARqlt r- zJ S o 1 2- 0.3 Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L CST Name (Please Print) S nature � CST Number r y /IYti U0 (w Address Date Evaluation Conducted Telephone Number f'� 3 C4, be C wr�✓1L, li' 2 2-00 I Property Owner j e I t� �� JQ I Parcel ID # D Page of Boring # ❑ Boring • G�` f 0 't k "4,l pit Ground surface elev. ft. Depth to limiting fact in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /f? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 D- II 1019 4/2- f M a4- 01 �, 0'q �2 II lb °1 v CS [03 nk 5li F )2J F1 c 1 1 P cA M p c 5 0 .2 0,3 23 ME / E 9 d 5A 512 M — — D -X- 10,3 F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 Boring # F Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I i * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD, < 30 mg /L and TSS < 30 mg /L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 - 264 -8777. SBD -8330 (R.07/00) RECEIVED 5EP 2 6 2002 ST. CROIX COUNTY ( ZONING OFFICE m c 0 a v � N n ( o LQ in %D Lff -' m s C N � u m u Nml) c_ N cu _� 9i+� y�N Qrm L i sN ++o6 s �> �n> s on V CL ma° ° 04 aw� o aU' d Y 0 0 C° L w S W Ln 11.1 t of V S U S q C C v A w °a t° P7 (la L � O O V C 2 Nd f °Q a as a h I+4 b ^ ka O CD N4- N L` O 3 C3 ° a9J ail-,AON o `O Q M 03 u� u o I E 0 s cu L '6 s m S�OOOM RECEIVED S E P 2 6 2002 ST. CROIX COUNTY ZONING OF FICE H Pa V vi h o 0 2 a c N Q v O v r ai o b a cu cu Qj m 0 ti m fi m nW' W O 4 O C5 O ° U m (� 0 m 4 „� gw0 � qq- JON rya d, 0, 9 ydS` OO uj m u U7 S U If7 pl U N O� U N N L UIT U C. N N N CND 9+' d UI Si' N� LA w t' Ci "I > -N O N N O. UI 1 O N O a W 0 o m a— 0 1 2 a4 v as o 0 o c o 4 - -0 a - 0 U a Lo U a W O U: 3 W 4- rOL CO Ua p��0 c � i f D L Y O L E O LEO+ i E... i £T CLJ m E t S S U O K S a cu fn P-1 pi m M 4 r Fax for Charlie Bratz Re: Joel Aftdahl Project RECEIVED After reviewing notes and visiting Site I found my error. I had deleted half of the 96 contour from a preliminary plot. The correct contours are included A new plot has been sent to St. Croix County V To amend the soil evaluation cfe" J� I✓ �i 4 To "p C IeUC, I � �a) C 6 vvc (t) 0 - 1 , -tt r a orb evot ( f5 l C C,V� P r 'r _O d 01 1� (rj p N in ID m in If1 u i' N O. S U Ut U C N0 R1 0 L ap cu sr o, rod swd roy +•oo o > a r0o o tO a-- aw a c CL a o '' aa-� d °a C CL a)c m W° C O u a 0 d° O m Yin Lo 4 Yuj 0% OC) ieo E� ° d L E� E,°' Ri M "t X u t u �0 I m Os _ nj O Qa � a k o% o� N O N � d- LLO C O 11 �--1 CLI C CD 3 p z cn Ala - -AON 4— < 0 M 03 u� p i Cl— o) O Ln J O O O O O U1 4- O S � +1 � II O (4 Z S , 0 t jrt 1 a Fg u4 1 ioa � y 8� / ae u Vl aaua� l o l l SPOOM r i Safety and Buildings 4003 N KINNEY COULEE RD RECEIVED LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 >.seonsin www.commerce.state.wi.us /sb Department of Commerce S EP 2 3 2002 www.wisconsin.gov ST. CROIX CO Scott McCallum, Governor ZONING UNTY Philip Edw. Albert, Secretary OFFICE September 23, 2002 CUST ID No.220499 ATTN: POINTS Inspector ZONING DIVISION PIERCE COUNTY SPIA BRUCE ALLEN WEBSTER 414 W MAIN ST N3659 CTY RD C PO BOX 647 ELLSWORTH WI 54011 ELLSWORTH WI 54011 -0647 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/2312004 Identification Numbers Transaction ID No. 788260 SITE: Site ID No. 65053 Joel Aftdahl Please refer to both identification County Road YY numbers, above, in all Town of Rush River, 54002 correspondence with the agency. St Croix County SW1 /4, NW1 /4, S36, T28N, R17W FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 870816 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01/01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD- 10706 -P (N.01/01). • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c BRUCE ALLEN WEBSTER Page 2 9/23/02 • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat • 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. • The changes made to this plan on 9/23/02 by this reviewer were acknowledged and approved by the system designer. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation /operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. r BRUCE ALLEN WEBSTER Page 3 9/23/02 Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , Integrated Services (608)789-7893, 7:45 am - 4:30 pm Monday - Friday WiSMART code: 7633 cbratz @commerce.state.wi.us cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 6 A Mailing Address `O Property Address 1 (Verification required fr4 Planning b4artment for new construction) City/State Parcel Identification Number D ,Z73 l b EGAL DESCRIPTION Property Location . V4, `4, Sec., T. N -RII—W, Town of Subdivision /1/ . Lot # Certified Survey Map # , Volume Page # Warranty Deed # , Volume , Page # Spec house ❑ yes P no Lot lines identifiable yes ❑ no SYSTEM CE 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. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeyman plumber, restrictedplumber or a licensedpumper verifying that (1) the on -site wastewaterdisposal 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 Zoning Office within 30 days of the three year expiration date. I DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. I A AP ICANT DATE **s *ss Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed • VOL 1588PAGE KQ (O STATE BAR OF WISCONSIN FORM 2.1998 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX CO., WI This Deed, made between Dean Monicker alWa Dean IL Monicken, RECEIVED FOR RECORD a si ngle person 02 -16 -2001 9:30 AM WARRANTY DEED Grantor, and Joel D. Afdahl and Katherine E. Afdahl, husband and wife, CERT COPY FEE: 17 h olding as survivorship marital property COPY FEE: TRMSFER FEE: RECORDING FEE: 10.00 PAGES: I Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin: Recordine Area Name and Retum Address r (SW 1/4 of NW 1/4 of Section 102010 A. McCormack Southwest Quarter of Northwest Quarter ) 1020 10th Ave. Thirty -six (36), Township Twenty-eight (28) North, Range Seventeen (17) PO Box 2120 West, EXCEPT part to Dean R. and Doreen Monicken in Volume "514 ", Page Baldwin, WI 54002 97; ALSO Southeast Quarter of Northeast Quarter (SE 1/4 of NE 1/4) of Section Thirty -five (35), Township Twenty-eight (28) North, Range Seventeen (17) West EXCEPT West 340 feet thereof, EXCEPT South 912 feet of East 477.7 028-1045-20,028-104140 �'+ feet of West 897.7 feet of the Southeast Quarter of the Northeast Quarter (SE Parcel Identification Number (PIN) 1/4 of NE 1/4), of Section Thirty -five (35), Township Twenty -eight (28) North, This is not homestead property. 3$ 2Tf ./ Range Seventeen (17) West. (XS) (is not) fulfillment of that certain Land Contract between the parties dated This Deed is given in full p February 11, 1994, and recorded, February g 11 1994 in Volume 1064 of Records at Page 408, as Document No. 512964, office of the Register of Deeds for St. Croix County, Wisconsin. Exceptions to warranties: Easements and restrictions of record, and except any liens or encumbrances created or suffered to be created by the acts and defaults of the grantees, their heirs, successors or assigns. Dated this day of t ✓cl 1 2001 . Dean R. Monicken AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) ) SS. Signature(s) St. Croix County. ) Personally came before me this �// � 16 . 11-- - day of authenticated this day of w es 2001 the above named Dean , a/k/a Dean R Monicken TITLE'. MEMBER STATE BAR OF WISCONSIN to me known to be he person( who execu the foregoing (If not, _ instrument and lowl edg a same. authorized by ' 706.06, Wis. Stats.) - _-__... _. - THIS INSTRUMENT WAS DRAFTED BY E I is No Public, State Tho mas A. McCormack , s Baldwin, WI 54 0_0 2 of Wiscons n My Commission is permanen . no , s e expos o e: r U, (Signatures may be authenticated or acknowledged. Both are not necessary.) •Names of persons signing in any capacity should be typed or printed below their signatures STATE BAR OF W IBCONSIN - WARRANTY DEED FORM No. S - 1998 '+ po -65,- -:021 INFORMATION PROFESSIONALS COMPANY FOND DU LAC. . �rmEl- VOL 6 P APPRO' XATHLEEN H. WALSH REGISTER OF DEEDS ST. C' ST. CROIX CO., WI Planning 'I MAY 2 8 2002 RECEIVED FOR RECORD 05 -28 -2802 3 :00 P If not moorOeA nnmio •;u "1" a CERTIFIED SURVEY HAP REC CE be SURVEY MAP COPY 3. PAGES: 2 Joel and Kathy Afdahl Located in part of the Southeast % of the Northeast % of Section 35, and part of the Southwest' /. of the Northwest -/, of Section 36, all in Township 28 North, Range 17 West, Town of Rush River, St. Croix County, Wisconsin. M 1 14 CORNER 1 Z (FOUL T I RON PM UNPLA_T_TEL7.LANL)� 5 N 00 1314.81 1281.81' ■ -r� ■ z Y3 �Q :F °00 0c ° 2 ,:1! I 194 � � jam..._._ ►� i f ' 100' ' (rt • • : 1 (1 � g � ('� y A ` I� , 2 17• 2 � T oo •�11Z o f4A rjj f� a �j z Q z ..{ O ni �p a f—I �' 0. m' 2 (/ "h G5 0 O ly z !CO5 q%"mo ! I ? �A I { CD to I L N 00.48'2r E 1314.28 I { 12812F i { W O c a 'y A a I al ; G)c� Mgt t 8& d �'N N 00'46'25 E 2628 /3 14.3' v � N E ASTLME SE1 1 4 NE114SEC Tp_1314 . 07 N35 00'4825 D SS O 1281.03' y WESTLMESWf m � S� g A N OV46W E 1014.14 �.}X Al I 981.14' D �i c w o m :'v � 49 r4 ER 9 z all o � � { N Z c{ 1100' _ z S 00 0 40'5T W 650.00' {� w i , 0 3 1 I { _ m z S 00 - 'W5T W 86CO I * EAST /N CORNER UN_P_LAT_TED. EC :1 T281�(R 17 W roum, ms INSTRUMENT DRAFTED BYZMW L LARSON: SHEET 10F 2 Vol.16 Page 4301 APPRI V;ED ST. CROI COUNTY PlarWno 7nninn n�A oe� • - -._ ..,. MAY 2 8 2002 If not MWrdeo -dun 3u (as of approval date OPProval sham De no- VIERTIFIED SURVEY MAP Joel and Kathy Afdahl Located in part of the Southeast j/, of the Northeast Y, of Section 35, and part of the Southwest Yi of the Northwest Y� of Section 36, all in Township 28 North, Range 17 West, Town of Rush River, St. Croix County, Wisconsin. Description That certain parcel of land located in part Of the Southeast' - of the Northeast ' /< of Sectior: 35, and part of the Southwest' /. of the Northwest 1 /4 of Section 36, all in Township 28 North, Range 17 West, Town of Rush River, St. Croix County, Wisconsin, more fully described as follows: BEGINNING at the East' /. corner of said Section 35; thence N 89 21' 59" W, (assumed bearing on the East-West ' /. section line of said Section 35), a distance of 978.59'; thence N 00° 32' 39" E, 1314.81'; thence along the North line of the Southeast '/. of the Northeast '/. of said Section 35, S 89° 19' 16" E, 983.85'; thence along the North line of the Southwest' /. of the Northwest' /. of said Section 36, N 89° 57' 31" E, 929.32'; thence S 00° 40' 57" W, 650.00'; thence N 89 57' 31" E, 351.00'; thence S 00° 40' 57" W, 664.92' to a point on the East-West '% section line of said Section 36; thence along said East-West ' /. section line, N 90° 00' 00" W, 1282.39' to the POINT OF BEGINNING, containing 2,745,768 square feet or 63.034 acres, being subject to an easement for county highway purposes over Southerly portions of said parcel as shown on this map and to all other easements and restrictions of record. State of Wisconsin) County of Pierce) I, Laurence W. Murphy, Registered Land Surveyor, do hereby certify that by direction of the Owners, Joel and Kathy Afdahl, I have surveyed and divided the landb sho•hr hcroon in accordance with official records, Chapter 236.34 of Wisconsin Statutes and the Ordinances of St. Croix County and that this map and description are a true and correct representation thereof. Dated: March 29, 2002. NOTE: Each parcel shown on this map is subject to State, County, and Township laws, rules and regulations (i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office and appropriate Town Board for advice. SOON$�� C AM • LAV 6CIC�r MRPHV • 907'13 .� RIVER p FALLS. WL . J • LANG •�� THIS INSTRUMENT DRAFTED BY JERALD L. LARSON SHEET 2 OF 2 Vol. 16 Page 4301