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HomeMy WebLinkAbout028-1048-60-000 0 N O o N O f 3 n d 0 d 0 m f c 0 c o c a 3 v (D m 3 - 0 to � to T 1l o V o m Z M O n N c n (D w 0 � �• rlJ <, p N N 00 a (D i (D O O. O T .. O N CO M 0 m c G� �1 -4 ° C . 7 3 n 3 C) m c CD 3 fD ( D pD C (D ° 'p a o 3 ° g o N 8 1 O O N N A y 0 �l�l m° o a v vv Dn m a C) o D a c m sz a c co ° z �aj ° c O c O c O OD o1 D o v a� o w a !� a e�ri O ° N C ° ° m s w O 3. a '0 3' m !mil • 0 0 0 z O O O '. lr'F'lii+il g o * * :*�I g g a **`t� rn< aQ =3 � 0 C' ca l6 D o o 5F CD y O CO N 1 A N 3 T N Cp ° z 0 3 m CD N n+ M CD D co o ° D co o O O a c c O a c T C� ° o ° CD (D h • CD U) ° 0 N m c 1 CD N c CD m CD CD CL w a 3 m n 3 CD (6 z o z CL n a �' Z w 0 .. Q c Z N) (;I z 0 3 c 3 p x 3 » 3 m V N ;u CD A N O N p� 7 O � fD W vi w o - O (A D N - 0 Q n a — I D 3 � 0- 3, c E; :3 , c s a �» w m m o a (D y ov3 =omwo3� o 0 <a g�3 a c » EP CL _. 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W N 7 (�. 0 co n CD — CD N n CD CD N z c o o 0 D a CD CD CD !►l• CD m CD N N c ry c m N m a 3 _ CD O A 2 N D N c C p 3 CL C N CT W G OD CL z 3 A A 3 N m N � CD A N p� 0 CC CD N < CL 3 x CD a C 7 C C A D c CD 3 z c Q o m N cn ° a CD A CD e n� 3?o v O `~ Cn CD = ,J D) Kj 3 0 cr b CD `3 I � A o b ° m 00 w 0 0 e ° CD ti o CD Wisconsin Department of Commerce Count Safety and Building Division PRIVATE SEWAGE SYSTEM St. Croix INSPECTION REPORT Sanitary Permit No: • 479497 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m) Permit Holder's Name: City Village X Township Parcel Tax No: Kunesh, Ernie I Rush River, Town of 028 - 1048 -60 -000 CST BM Elev: Insp. BM Elev: I BM Description: / ' / Section/Town /Range /Map No: 6o •c7 v4 , n, , S; l �` N j � 35.28.17.306 TANK INFORMATION LEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ( 67'S �' � /lose Benchmark Dosing ` Alt. BM ,I t ►�Gc' ST' �,� �p1.0 � �� Aeration — -- Bldg. Sewer 1l• r s �t •gs' Holding St/Ht Inlet I p� S-y r O TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ( c _ Dt Bottom c Dosing .6 r.-Q" Header /Man. Aeration Dist. Pipe Holding ; Bot. System � � PUMP /SIPHON INFORMATION Final Grade �� ZS ?3• �S Manufacturer / n � Demand St Cover (�( GPM Model Number TDH Lift Friction Loss System Head 1 7EH Ft � ti sD ti YD , Forcemain Length, Dia. 4 Dist. to Well / __ Z , h A 0 0 4-z- j S ABSORPTION SYSTEM Width Length No. Of Tr nches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth ENSIGNS ��t, SETBACK SYSTEM TO P BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of Sy tem: r t UNIT Model Number: DISTRIBUTIO ✓ ONSYSTEM J Header /Manifold Distris) tion I ` /L x Hole Size x Hole Spacing Vent to Air Intake Lang Length Dia � ' Spacing ( l SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over T Depth of xx Seeded /Sodded xx Mulched Edges soilBed/Trench Center Bed/Trench Ed g p � Yes [j] No Yes No CO Zor EN S: (In Jude code di r Gies er ns pr sent, etc.) Inspection #1: V � , (1 S� Inspection #2: Utz f Loc : 1 904 Cty. Rd. Y Baldwin, WI 54002 (NW 1/4 S 1/4 35 T28N R1 7W) Village of 6 1.) Alt BM Description = 4-P 2.) Bldg sewer length i - amount of cover = Plan revision Required? 0 Yes No - - Use other side for additional information. Date Insepctor•s Signature Cart. No. SBD -6710 (R.3/97) N C N O CD 0 V• ti O °� O y°g M h C O a> pC CO O v �3 h O.. C C O N � O a) y O m a7 0— w EO �p ,� (0 O a) U e c w r y L NCO rn w I N E 'c U O• .r O i L — c a) O •O fp Z C L d y L_O y a) Yo E Er —Ea`o +d c y a> ° ,n of twa O E �"� °� ti rn3 3w °°'-Cm E y can S Y E m co cc (3) y c� E Cr-, rnz EO9 3 2 aN CD .m r' O c a) a) y 0- M a) O r a ' c o�� EEo�Y�cmm 0 $ a c v c� o U y c« y Z d pia o N• L Ev c'� c o 0 m a) C m yyo �'`�rndv c o0 o y o o• y yz'v M c v z 8 a�c' a� a ti Z� c o a m m c'3 > I as S L w y Y c m:.�w 3 ig a) o c E O LL D U O p LL O O c c m O C c 0 a7 C Cc y 3 a E 3v> 0 3 o m E o m a c 3 mw U) E Q F act a Q U) a2 o 2'Vo o 0 m N O N � N I a) w E E U :: g ;; o € O € M IL m a m M F- z I I O Z • t O y = y m 2 a c E c E E d _ N C 0 CL O :3 a •� a m m I m m � I Q z m z z m z N •z I (a E •• E a � � 1° E I U m �' E o E I y Y ul V I H i y - 0 E! N 0 m 0 G d m 0 c a N C. V� f/1 N Cc N fA U� CO Co • s a a a a a a IL N J V v N z v N z m N m o } rn O } w d I (D 'O 0 Q C2:) 'C m Q o1 vv m azU) vv azin A I O O O V! C O CD N C H O r Q � o � E i. co M � w C I w C v y o �r o o C 0) L a) a o a d Cl) d Y !) ~ O N 7 7 O y N 7 N O y N • Q O m Y v o z d Y rn z c a. .. I � I °• L: a L: a E v c c O ; ns �1 A u La o U) 0 Safety and Buildings Division County N VIrs"nsin In 201 W. Wash' P.O. Box 7082 Mad ( I E� � � N to b Co . ) Department of Commerce Sanita Permit A lic do a Plan I.D. Nu / mt In accord with Comm 83-21, Va. Ada. Code, personal in YOU prov ine @ 100 N may be used fa secondary purposes Privacy Law, 5•�4( t) ROIX CO t Address (if differe then mailing address) I. Application Information — please Print All Iaformalloa OFFICE Property Owner's Name Pared 8 Lot Is Block tV L 134 )W A44 e s — U7 hopedy Owner's Mailing Address Property Location 3 — Y Y ® r y � C �., � �., section 'I J ny Zip Code Phone Numb 1 vele ) IL Type of Btt3ldimg (aleck all that apply) T N; RE o l or Z Faa»ly Dwelling — Number of Bedrooms �, 3 m �� Subdivision Name CSM Number O PUblicXAmmelcial — Describe Use ❑ State Owned— Describe Use ❑City OVilhge IDTO -owp of 4(/ III. Type of Permit: (Check only on bas on line A. tine B if appli ") A ❑ New System 0 RVIsoment System acutOnly RfOlber Modification to F.xi:tig System 12 t? CAM92 `C / B• Ex Revision of O Transfer to New List •c and Issued Bdm Iv. nR of PoVi+1'$ Cheat all that ==V ❑ Mound 2:24 hL of suitable soil ❑ Maud < 24 in. of suitable soil ❑ - Grade ❑ Single pass Send Filter ❑ la- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aembic Treatment Unit ❑ Recirculating Sand Filter ❑ Media Fiber ❑ Leaching (umber 0 Drip Lane 0 Gravel -less Pipe ❑ Other oxphie V. Ispersalfrreatinent Area Information: Desigtc Plow (gpd) Design Soil Application R D4enW Ara Requires► (so D4wsd Aron Proposed (si) System Elevation Ob , S� t3t 6 /D o�•�� VL Tank Info Capacity in Total Number MmtuStotm r Pmfeb Site Sted Fiber Plastic Gallons ' Gallons of Units Cent cte Constructed Glass New tbd� asks Tads Septic a Hd6ag Teak • 1 S Aaebie Tuesuww / a , Dedag CWx*w , VIL S'tattmnatt 4 the trrder:igred,.ssaaae respanibility for �V7'3'dor. oa thelst(ached plea:. : Nun ' �+� P !i Z/ as / �j9 l B �� 77 a- 9 S =V_ 9 Plumws Addess (Sweet, Ci , )d 7M Am elk -4)1 5 VIII ern t Use pal ❑ .d Sanitary Permit Fee (includes Groundwater Date Issued I Arm ( ) ❑ Owner Given Reasaa for Denial Swclarge Fee) 1X. Conditions of Approval/Reasons for Disapproval Al -J �opiefe (loan C an ary ash) er tYe f�ta� q vi, ,. Nr iMt at/= 1111a b d8 ((/Lt_ G _ �'�, p'/`�'• /l //T // /iii /�� � �., SBD -6398 (R. 08/02) FORM - STC 104 AS BUILT SANITARY SYSTEM REPORT hn� e hhch 14 eA y 14-g(4 R,vrA, OWNER TOWNSHIP SECTION S T a & N -R L 7 � ADDRESS 1goey 8A1-QWtP CROIX COUNTY, WISCONSIN SUBDIVISION G$A1 r.rti ;!/l Lc- !' LOT LOT SIZE PLAN VIER SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM � rI' ) bib a ' gttiJ { RRO�: ,touS� v � m aa�xory` SID- d UR No C' r -� r. L, " 1 �j AL- r o l� � a�b�,►� �one E NORTH ARROW BENCHMARR:Elevation and description. d F Alternate benchmark - SEPTIC TANK: Manufacturer: 4j j o/! l.Lx- CQ o. '&& iquid Cap. Rings used — cover elev:__ 'inal grade elev: Combination S_ep.t Tank and PUMP CHAMBER CROSS SECTIOW AWD SP EC I FI C ATIO MS PAGE S OF b - VEIJT CAP WEATHER FILOOF JU►JCTIOU 80X ti C.I. VEWT PIPE APPROVED LOCKIIJG ' -10' FROM DOOR, MANHOLE COVER ;"-'I :✓IWDOW OR FRESH 2 Ll4$EL. ALP, IuTAKE \ wAVLIQKX r bM" . 1:11 O S 'G "MIK r-Otp-06 if ( `I' MIIJ. ---- - - - - -- 18'Mil`1. �\ PROVIDE I - - - -- fIJLET AIRTI&HT SEAL APPROVED JOIUT A I I APPROVED JOIIVTr W /C.1 P►P[aR Tank construction I I w /C.z. PIPE t�c shall comply with _ I I I ALARM ILH 83.15 and 3 3.20 C I 1 oIJ ' I LLCV. FT. PUMP - -j OFF 0 COUCKETC BLOCK 3" APPRovc-t� RISER EXIT PERMITTED OIJLy IF TAW MAIJUFACTURCR HAS SUCVJ APPROVAL E SoDINr. BOOING SEPTIC E SPEGIFICATIC)KJS DOSE 1`•tIOW�' TALIK MALI NUMBER OF DOSES:_ _ PER OAS TANK :,IZE: J 6-S 1 3 GALLOWS DOSE VOLUME r ALARM MAUUFACTURCR: S S• � �-t !S IMLI -UDING bACKFLOW: 1 5 GALLONS MODEL NUMBER: IZA \aW CAPACITIES: A �$ IIJCNCSOR 3 " GALLOIIg SWITCH TYPE: WCNES`OR 3 `I G( LLOL15 PUMP MAUUFACTURCR: C= 9 IUCHES OR � GALLOIJS MODEL NUMBER: 381 D - 2. INCHES OR \ S 3 GALLOmr, SWITCH TYPE: MOTE: PUMP AIJD ALARM ARE TO 6 �° MIfIIMUM DI5CHAR6E RATE GPM �� OIJ SEPARATE CIRCUITS VERTICAL DIFFEILEWCE DETWECIJ PUMP OFF AUD_DISTRIBUTIOIJ PIPE.. *fI _— ee FEET + tAtuIt1UM NETWORK SUPPLY PRESSURE . ; , , , 2 -SO FEET + 1 - S FEET OF FORCE MAIM X ` �I F �oFLFRICTIou FACTOR._ \' FEET TOTAL 04UAMIL HEAD = � b ' y1O -FEET Pump chamber DIAMETER I&TERAIAL DIMEUSIOLIf OF TAIJK: LELI&TH ;WIDTH ;LIQUID DEPTH BOTTOM AREA _ - 231*— _ GAL /INCH VAj Y - IN - o 'r Goulds Submersible Effluent Pump �..- EPO4 EP05 APPUUTIONS • Fast 300 series • Fully sr�rrwrged tugh ■ for Housing: Cast iron Sp aly designed for the steel. grade turbine oil for for elfcient heat transfer, following uses: running to lubrication and efficient slrengtit, and durabilityM%of damage heat trar�fer. • Effluent systems componernts ■ l Carer: Thermopias- • Homes Awailahis automatic and tic cover with Viral handle • Farms tN magi mom. and float attachment • HEN duty sump • EPO4 Sale phase OA HP, models Wide Mail OWL • Wader transfer 115 or 230 V. 60 Hz, 1550 Float %fth =NOW a d ■ Pow fie: Severe duty • wing RPM, built in overload with lueset at flee factory. rated oil and water resistant. automatic reseL ■ Bean Upper and lower SPEgFN:ATNNt;S • 11 Single phase: 0.5 , FEATURES �N �y bap g 115 V. 60 Hz, 1550 RPM, Punk: EPO4 built in overload with ■ EPO4 k Vier: Thermo- � . • Solids handlirig capabW. automatic reset. p Semi - open design A6ENCY t.iSTIN6 3 /: mmd mum. • Power cord: 10 foot with pump out vanes for • Capacities: up to 55 GPM. standard length, IN SJTO mechanical seal protection. cp. U • Total heads: up to 24 feet. with three prong grounding • Discharge size: 1IM NPT. plug. Optional 20 foot pl EP05 enclosed Thermo- design for (CSA listed model numbers • Meclakal seal: carbon- length, 16/3 &M with u B e end in "F" or "AC ".) rotary/ceramic- stationary, three prong grounding plug p d p p 0 6UNA -N elastomers. (standard on EP05). m Casing and Base: Rugged • Temperature: therm design provides 104•F (40•C) continuous superior strength and 140•F (Wq intermittent corrosion resistance. • Fasteners: 300 series NETM nit stainless steel. 10 ? • Capable of running dry without damage to s - .scram components. 1 Pump: ENS a ! -- - 2s Fr • Sol han dling capability: o 7 a • Capacities: up to 60 GPM. 6 • Total hems up to 31 teet 20 • Discharge size: 1W NPT. z 5 • Mechat W seal: carbon- >_ i rotary /CeraMiC-Slatl0rl uY, Q 4 15 --r —' BUNA -N elastarrers. • Temperahn: 3 10 104•F (4Oq continuous 140•F (6O°C) intermittent 2 . -- 5 ..,�� 0 00 10 20 30 40 s0 GPM 0 2 4 6 8 10 12 m31h Put`suant to Comm 8334, Nis.Adm. Code Sectic Tank The septic tank shalt be maintained b sepic tank shall be dis an service septic tanks under S. 281.48, filets. The C7ntents of e th Fosed of in accdrdance wfih NR 113. Wis. Adm• Code. The operating conew of the septic tank and outlet fitter slid be assesst d at least once e' Y 3 years by 1nspec5on. The outlet later shatl be Leaned as necesw, to ensure proper operatics. The filter cartridge should not be the removed unless provisions are made to may slough o retain solids in the tank that off filter when removed from its enc:.rure. If the filter is the alarm is actvated conMwu*' Intemnttent filter alarms ma kdmteeped with an .. the later shad be serviced if sepic tank shad have Rs q Y surge Rows or an impehdishg antlrurous atahn. The the tank If the me nts rived Me volume of sludge and scum in the tank e=*& 143 the vokuee of of the tank are hot removed at the tune of a ttietWW LssemneK � Pel30� shall advise • OWowner of when Me next Mrike needs to be performed to mak tgn teas than main scan and S kWp ord r&w ac didves to entice se* tank Pe is genet � '" g gs Division. they shall be approved for seplk tank use by the Departn "of Cmnm:% Safely VW urn Tan . ' Th e POP (doskhg) tank shalt be inspeCed at least once everY 3 yam AN svf:.hes, ate. &W pugs shad be test6d to !EY proper opaatkm. If an subset fter is instWW vAft to to * k Strad be khpeded arid serviced as terry, At tads Con onaat and Pressure Distribution system o.trees.or a a s ou e p ante or allowed to grow on the component. Plantings may be made around the perimeter and the component 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 component is not allowed. Cold weather install- ations require the component to be heavily mulched for frost protection. Influent quality into the at -grade system may not exceed 220mg /L BODS, ISO mg /L TSS and 30 mg /L FOG. influent flow may not exceed the maiimum des for this installation. ign flow specified in the permit be te Ad �k provided g a point at the end of each lateral, and b Is ro�ended that ego to the when least am every 18 nhonths. When a pressure test is pa>3o =d it Shedd be regtrUed fo eQW Cott C detatrmhe fotNke ca99kg has oc�rred atsd Zartltice is Observation pipes within the dispersal cell shall be•checked for effluent ponding. Ponding levels should be reported to the owner and any levels above 4 inches considered" as an impending hydraulic failure requiring additional, more frequent monitoring in accordance with• Comm 83.52 (2). General 'L�s ayStem shall be operated is accordance with Comm 12.84 Qis.adm-Code and shall be maintained in accordance with it',s component manual SBD 10570- P•(B.6 /99) and state rules pertaining to system maintenance and maintenance reporting, punip abarrdortrnent be In g am ma P that gttld emus de�h. Septic and ..r POW S compmmtL Cam 83.33, Wls. Adm. Code when the tanks ate no larger used as $ems tarot MWhote dsas, access tillers arts Covers &&& be bspected former tightness and mxmdness. Axes MW auBsMft shad be sealed upon the of servka. Arty deemed be s=d by an or = to fame must be axess opah6hgs greater than 8-ieh� in r8arrheter SW �CehehUnosntarPW d . e 10 WNW �tshsa�hor�sd et�y into a lank ore;imponee#, p^ °Pr .cm ddon. tart a Strad be tepsked ar ra to keep I* p d ttritlh as smarm or relied %* becaata dNeclNe the dekc w waWotherd sibs! be o?mponmht of the awns or equal paw. t he a ' ""'.- - -• _. _. tR'ade componiie - fails to atcepti trastevit . 0 lischarge wastewater to the giouad surface, it nay be necessary to Install as aerobic pre - treatment unit or .replace the component. Additional site and s additional plans mar need oil•gvalnstions say need to be done and to be prepared and approved by the Department of Conherce, S&fety and Buildings Division. . Q�teaaioas.ibont the operation or'iaintenance of this system should - be i direeted to: The Couaty,Zoning Office at -A Z) — 6 p1. [ '� - T J� , �f` DiX 38'� ��i8 the system installer at -- - Nis- The tank manufacturer at The effluent filter' manufacturer at > ®mota, b 3© -. I -to _ 4.p g C-,ci�s i r , , , < , --i > CO) -I T O z r = m C/) vn C - z m O Zic rn ❑ $ m -1 � Orn Cf) - n i r - -n ' X rn O m -r CA N 2 m S� n X Z rn� �'1 c O �'1 z 0 c Vr M o O z X r z rn 0 >* Z c v i n z z 7C C7 G) m CI) C i CO) _ CO) m m C M > r . m O to m O -q z F O 0 0, m Z V m< VJ M < z m op on z X m �� �cl Z O /v ""� .o �. o��•Z ova c n O m rn � : g � 8 � 151 0 rn. rn m S gem a n o z M �� �7t►► �r s $ CO tll n m w � � � s CO � A �a m a m,^ o z° n ° 0 o S J a c l m 1 =r �� m C fn O g ' °__ W ~ Z 7 7 �J' 4-tAe . i,9 G s5 Pit, ST. CROIX COUNTY ZONING OFFICE ZOfViN� Ufy ( y CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the se tic tank presently serving the kl H — 00 cn A, residence located at: 1 /4, YE Section t< N, Range ( W, Town of T (1Sl-/ P i V 6�L , St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of Comm. 84.25, and it (they) appear(s) to be functioning properly. Most recent date of service g���Os Ce'j-& W Did flow back occur from absorption system? Yes No (if no, skip next line.) Approximate volume or length of time: gallons minutes Capacity: /000 f - 5 - 0ZU 6' 8 D Construction: Prefab Concrete _� Steel Other Manufacturer (if known): IA)/ LSEX- Age of Tank (if known): O arrt// (Licensed Plumber Signature) (Print Name) 97? (Title) (License Number) MP/MPRS (Date) Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) i i �✓ County Sanitary it/9►p licat! h ST. CROIX COUNTY WISCONSIN In accord with 15.04 St. Croix Count Ordinance ZONING OFFICE Personal information you provide may be us�;d or econA�iiuraoas .I hi ST. OIX COUNTY GOVERNMENT CENTER (Privacy Law. S. 15.04(1)(m) 1101 Carmichael Road 1. CROIX COUNT ' Hudson, Wl 54016 -7710 (715)386 -4680 Fax(715)386 -4686 Attach complete plans for the system on paper no ss - in size. County Sanitary Permit # ❑ Check if revision to previous application 2 . Application Information - Please Print all Information Location: P roperty Owner Name / , ' / � 1/4 ,�� 1/4, Sec 3S_ �v W U/1 S T'Z�/ N, - 7 R E or Property Owner's Mailing Address Lot Number Block Number City , State zipfcode Phone Numer Subdivision Name or CSM Number ' BA - L.D W iA Wnc 11 Ty of Building: (check one) 0ity ❑ Village wn of (v/ /� 1 or 2 Family Dwelling - No. of Bedrooms: 3y- M 6.D (I/ -A -K— 4-v Q O Public/Commercial (de 'be 13 state -owned VL t' Eon earest °a II. Type of Permit: (ChecF-Reconnection x ine Check box on line B if applicable) Parcel ax Numbe ) A) 1 1.0 Repair ❑ Non - plumbing . ❑ Rejuvenation oL x.l o yY —6o - Q �1 Q Sanitation s t0 B) Permit N� Date Issued State Sanitary Permit was previously issued (.� 0 ? IV. T of POWT System: (Check all that apply) Non - pressurized In- ground ❑ Mound ❑ Sand Filter In-ground ❑ Constructed Wetland ❑ Pressurized I �J ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other V . Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application Rate 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed (Gals. /day /sq.ft.) (Min./inch) Elevation 36 0 0 30 ( 6, 6.5 /3 /02. %L /0 7_ 8-S 1. Tank Information Capaicty in Gallons Total # of Manufacturer Prefab I Site Con- Steel Fiber Plastic New Existing Gallons Tanks Concrete structed glass Tanks Tanks 00 ❑ ❑ ❑ 1 ❑ It U ❑ ❑ ❑ ❑ 11. Responsibility Statement 1, the undersigned, assume responsibility for repair/reconnenction /rejuvenationCnstallation of non- plumbing for the POWTS shown on the attached plans. A l icense is not required for terralift repair or the jnstallation of non - plumbing sanitation system. PI is Nam nt) Plu s Signature n mps): M PRS Business Phon Number a 6 ya k - � s� Plumb% A fr ss (Street, ' yte, Code) 0r VZ1 Ho fl. County Jihe Only (/ Disapproved Sanitary Cernit Fee G Q ate Issued Issuing Ag nt Signatu , o stamps) Approved Owner Given Initial Adverse �/ 0 /O O � EC etermination v SL IX. Conditions of Approval /Reaso s for Disapproval: 2212_'A-�_ �_d - 2 8 7 Br�2s97 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO.. WI Document Number Document Titia RECEIVED FOR RECORD St. CPoiX my oU 08/08/2005 10:30AN C ZONING AFFIDAVIT Affidavit of Reconnection to Existing POWTS EXEMPT # REC FEE: 11.00 ff__ TRANS FEE: tA COPY FEE: Name - (Owner) Typed or printed PAGES 1 being duly sworn , states, under oath, that: 1. He/she is the owner /part owner of the following parcel of land located in St. Croix County, Wisconsin, recorded in Volume Page 070 Document Number k0L3St. Croix County Register of Deeds Office: Recordina Area 4 4 Name and Ret rn gd�re s A parcel of land located in the &#' /, of theZ V. of Section ) S SH/P T]_2 f N — R I _Z W, Townigf St. Croix / 90 y C R ID- 1 1101, County, Wisconsin, being duly described as follows include lot no. and D Gc1/It/= d Z subdivision/CSM or detailed legal description): /- 'Re L3 � /NG Sz V ACATED Arl9r � 2 �' ��/ 0 - a0 � Parcel Identification Number (PIN) til 0 F L er 6 QK l3 Vj As owner o e above described property, l acknowledge that the existing Private On -site Wastewater Treatment System (POWTS) serving this residennot) undersized by current code standards for a bedroom 1 -2 family'dwelling. The system components have been inspected and certi i a licensed master plumber to be in good condition and appear to be functioning properly. There was no indication of failure i.e. ponding or surfacing of wastewater in the distribution portion of the system at the time of inspection. I understand that the Issuance of a county sanitary permit to allow the reconnection of the septic system does not imply that the system meets current code sizing requirements, nor does it imply that the system will continue to function after it is placed back in service. I also acknowledge that I will disclose this information to any future parties Interested in purchasing this property. , Dated this. day of i * �• r AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) )ss. authenticated this day of St. Croix minty. ) Personally came before me this r+ day of ,200.9' the above named t1 & n #t e•n k «.nPt TITLE: MEMBER STATE BAR OF WISCONSIN (if not, to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Slats.) instrument and acknowledge the same. THIS INSTRUME - alke i2 F Notary Public, State of Wlsconaln (Signatures may be authenticated or acknowledged. Both are not My Commsio is pem anent. If not, state expiration date: necessary.) Date: "THIS PAGE IS PART OF THIS LEGAL DOCUMENT — DO NOT REMOVE" This information must be completed by submitter document title. name & return address. and PIN (if required). Other information such as the granting clauses, leagal description, etc. may be placed on this first page of the document or may be placed on additional pages of the document. Note: Use of this cover page adds one page to your document and $2.00 to the recording fee. Wisconsin Statutes, 59.517. o _ D z y ; v O m ; O - x 0 0 70 tTi -� � o m �o m U) (1) J o C < o � L o o o s r Z. m D 0 n X x I t n c _ U) i N - C7 0 m Z o o� m n o 0 zD m z o C a Z Z �° m C O ;U -n CO c ° Cn n ;O C/) Z < � —1 C7 5 lz -1 Z o 0 � Z2 m C ? z L r m , m C6 a v .. 8 to ° �� �� n mg m m� m s.m 0 . co -� O a OQ IN ° � F d N ,�- A�� 3� a m 0 o =gy Sim O m Z O °_ �" a m m < Z r Z ° ° 3' a8 =� Lp m m � D � m D 20 Z m r 0 0 0 d o o M L Z O i Z ;a Ca 0 A U1 N • O 3 N p y l N N �•• (D 3 m O O O O ? 1 CL W N n= '0 0 O 6 \ b 3 a o !a to 7 (v ID a 7 CD c y �c po 3 O N 0 T C { CL iW A o __ <. O V 0 O O A v N W O ca x ? w CD N fD fD 0 _ 0 - w Z Z C N Z o a CL .ZJ 'O CD C N e� (D fc c N N I CJ 3 T z CD (6 0 a A 2 m �r • N C i �. Z 9 � p_ A W T ao Ln a i Z 3 ' $ �- m 4 w CD v CD N pj I C CD N C > O 1 X (OA O ti fD n0 Z a o ° O O O_ O T7 n CD CD AA � CL Op o fi O' O O O H A O 3 OQ A n 0 1 � l0 � 0 R O CD b O CL y Parcel #: 028 - 1048 -70 -000 08/05/2005 05:20 PM PAGE 1 OF 1 Alt. Parcel M 35.28.17.307 028 - TOWN OF RUSH RIVER Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner ERNIE &SHANNON KUNESH O - KUNESH, ERNIE & SHANNON 1904 CTY RD Y BALDWIN WI 54002 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 0231 BALDWIN - WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 0.000 Plat: N/A -NOT AVAILABLE SEC 35 T28N R1 7W LOT 7 BLK B & INC S 1/2 Block/Condo Bldg: VACATED ALLEY N OF LOT 7 BLK B VIL CENTERVILLE Tract(s): (Sec- Twn -Rng 401/4 1601/4) 35- 28N -17W Notes: Parcel History: Date Doc # Vol /Page Type 08/05/2002 686003 1941/070 RD VA 07/23/1997 1235/182 WD 07/23/1997 864/379 07/23/1997 776/305 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 7230 300 Valuations: Last Changed: 09/03/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 200 0 200 NO Totals for 2004: General Property 0.000 200 0 200 Woodland 0.000 0 0 Totals for 2003: General Property 0.000 200 0 200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 FORM STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP Ll�A SAdJ� �IhGGEY Rk�l -I (�iv!^l�. SECTION 36' -R J-7 MA A004 ADDRESS gDy •4 8 Ai Lv ST. CROIX COUNTY, WISCONSIN SUBDIVISION Ala to C $,rV r rA, V LOT (j+) LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM L�r/V'r t rpop. '-writ tiC' cLu 13 -� C Y 1_ INDICATE NORTH ARROW BENCHMARK: Elevation and description: � OP OP Gam, L Alternate benchmark SEPTIC TANK: Manufacturer: CQ�rj; Liquid Cap.'���� Rings used: / Manhole cover elev:_ -final grade elev: Tank inlet elev.: Tank outlet elev.: No. of feet from nearest road:Front�, Side , Rear Ft. From nearest prop. line:Front °, Side, Rear Ft. No. of feet from: Well ? Building: r w (Include this information in the above plot plan) ,�` - c (2 reference dimensions to septic tank) x �, SEE REVERSE SIDE I J i y PUMP CHAMBER Manufacturer: C�yu�-� Cam Liquid capacity: Pump Model 9'7 Manufact. id Pump Size t /1 lA v Elevation of inlet: Bottom of tank elevation r Pump on elev.: Pump off elev.: / Gallons /cycle: Alarm: Man.: . tt,C CTRO Switch Type At - ACA'Al LocationHCq '6 Distance from nearest ro line: Front p p. _, Side,�r I P q Rear_Ft. Distance from: Well — Building '� (c SOIL ABSORPTION SYSTEM Bed: Trench: Seepage Pit: i Width: Length of Lines: �� Area Built `�f/`. Exist. Grade Elev. /D Proposed Final Grade Elev. jf 4 1A Fill depth to top of pipe: N o. feet from nearest prop. line:Front Side Rear Ft. No. feet from well: �_ No. feet from building HOLDING TANK Manufacturer: Capacity: No. of rings used: Elevation of bottom tank: Elevation of inlet: No. feet from nearest prop. line:Front , Side Rear Ft. J No. feet from: Well , building , nearest road Alarm Manufacturer: INSPECTOR: DATE: Z6`= PLUMBER ON .JOB : / ` 4 !/ C. ! LICENSE NUMB: 6 / XV 4` fj e' 9 a• 1 ` y. rI r A-Qi00 k DERARTMENt OF INDUSTRY INSPECTION REPORT FOR SAFETY & BUILDING LABOR & HUMAN RELATIONS DIVISION P.O. BOX 7969 ON -SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION MADISON, WI 53707 170 5Q/ State Plan I.D. Number: NW, SW, 35,28,17W X❑LCONVENTIONAL ❑ ALTERATIVE (If assigned) Town of Rush River ❑ Holding Tank ❑ In- Ground Pressure ❑ Mound NeW N0JRft eWVjf JBjL@ER­ Lot 6 & & ADDRESS OF PERMIT HOLDER: INSPECTION DATE: BE er rence point) DESCRIBE IF N L Ba:Zdwin REF. PT. E .: 7 CPT. ELEV.: , / Name of Plumber: i MP /MPRSW No.: County: - Sanitary Permit Nu MI-hae'I R Wilson -W 1 SEPTIC' TAN o ! ," ; � & � : / 4D. /� MANUFACTURER: LIQUID CAPACITY: TANK INLET EL .: ANK OUTLET ELEV.: WARNING LABEL LOCKING COVER ' ) L �I PROVID PROVID (N/ e /� p � � / CXX� S B, y ES ❑ NO ES [::] NO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUM ER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH st ALARM: F ET FROM LINE: t' t a� r AIR IN E_ YES E4igo `� ❑ YES NEAREST ­110- � — – , 7 DOSING CHAMBE : /5 oi o4_ / fly r 2" MANUFACTURER: BEDDI LIQUID CAPACITY: PUMP MODEL: PUMP19"1141 MANUFACTURER: WARNING LABEL LOCKING COVER / e-5 "i PROVID P Ipm. ❑ YES C' O S� P di /- ES ❑ NO U� t5 ❑ NO GALLONS PER CYCLE: ' PUMP AND CONTROLS OPERATIO AL: MBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN J F�E E T FROM LINE: / AIR INLET: PUMP ON AND OFF ❑ YES ❑ NO N REST DIAMETER: MATERIAL AND MARKING: l�Q SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE 1 f or excavation. If soil can be rolled into a wir � construction sh I cease until the soil is dry enough to continue.) 9B, 73 g 7 Jfl, 7; MAIN Do.SeCONVENTIONAL SYSTEM: �o ' 9'P %F. ,,..: d. r ` r c � ®7 &Q 1� = BED /TRENCH WIDTH: LE NO. 0 DISTR. PIPE SPACING: VER � �IA : # PITS: LIQUID ' TRENCHES: MATERIAL: PIT DEPTH: DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO IS R. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOV� COVE : ELEV. INLET ELEV. E PIPES: FEET FROM LINE: �� AIR INLET: U NEAREST --- 91g 7S , MOUND SYSTEM MaUn_d site plowed perpendicular to Check the of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems t o ma� s ain that it ON REVERSE SIDE. SHOW ❑ YES ❑ NO meets the criteria for medium s ELEVATIONS MEASURED. SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ❑YES ❑ NO ❑YES ❑ NO DEPTH OVER TRENCH /BED DEPTH OVER TRENCH /BED DEPTHS OF TOPSOIL: SODDED: SEEDED: ULCHED: CENTER: EDGES. ❑ YES ❑ NO ❑ YES ❑ NO ❑ Y NO t. PRESSURIZED DISTRIBUTION SYSTEM: ✓� � WIDTH: LENGTH: NO. OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: BED/TRENCH TRENCHES: ` DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE I MANIFOLD MATERIAL: NO. DISTR. D PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEV: ELEV.: DIA.: ELEV: PIPES: DA.: ELEVATION AND DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑ YES ❑ NO DYES �2VO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEET FROM LINE: ❑ YES ❑ NO ❑ YES ❑ NO NEAREST e in in county file for audit. Sketch System on Reverse Side. sIGNA RE: TITLE:�� 2 SBD -6710 (R. 06/88) on ing. �7/ (, SANITARY PERMIT APPLICATION u ' QHLNR In accord with ILHR 83.05, Wis. Adm. Code COUNTY STATE SANITARY PERMIT # - Attach complete plans (to the county copy only) for the system, on paper not less than t`ri" o° 8% x 11 inches in size. ❑ Check if revision to revious application –See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER I. APPLICANT INFORMATION - PLE PRIN ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION' a '/a S i.,2 %4, S T zi Q , N, R 1 E (or) JO PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # o d- !3 CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER 11. TYPE OF BUILDING (Check one) El State Owned 0 VILLAGE ^/ NEAREST ROAD QysL 'c . �Gr ❑ Public 91 or 2 Fam. Dwelling –## of bedrooms j2-_ PARCEL T AX NUM BER(S ) 111. BUILDING USE: (If building type is public, check all that apply) 6)4n— _(O a 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales /Repairs 11 ❑ Restaurant/Bar /Dining 4 ❑ Church /School 8 ❑ Mobile Home Park 12 ❑ Service Station /Car Wash 5 ❑ Hotel /Motel 9 ❑ Office /Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ❑ New 2. .Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit ## — Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 'rZL - Seepage Bed 21 El Mound 30 El SpecifyType 41 ❑ Holding Tank 12 '❑ Seepage Trench 22 ❑ In- Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals /day /sq. ft.) (Min. /inch) ELEVATION -700 6.3o 6 3 G . s /3 /0.2 S Z Feet /07. /7 Feet VII. TANK CAPACITY Site in gallons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name C oncrete Con- Steel glass Plastic App Tanks Tanks strutted Se tic Tank or Holdin Tank ✓ /oov ` Lift Pump Tank/Siphon Chamber , VIII. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) /MPRSW No.: Business Phone Number: L✓ 'L C. c.✓'ezo.- Plumber's Address (Street, City, State, Zip Code): Q �O A IX. COUNTY /DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater a e ssue Issuing em: Sign re (No Sta s) Surcharge Fee) pproved El Owner Given Initial � / p Adverse Det rmination �j X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: SBD -6398 (formerly Plb -67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS ` 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 1 All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer /Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608 - 266 -3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete ## of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1 -7. VII. Tank information. FIII in the capacity of every new and /or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County /Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8'h x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains /water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD -6398 (R.11 /88) r APPLICATION FOR SANITARY PERMIT STC - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner /contractor, ( "spec house "), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of Property G1.Zd A � (� Location of Property AZ ],g / w ' , Section 3 ,,6 , T -R jfj _ W Township Ro.c) Mailing Address a o u _aidL -1.-7 Address of Site Subdivision Name d6u Lot Numbe ^J Previous Owner of Property r M p a n Total Size of parcel ` Date Parcel was Created -if J6 Are all corners and lot lines dentifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume and Page Number, as recorded with the Register of Deeds. 1XICLUM WITH THIS APPLICATION THE FOLLOWING I 1t,6 „�as, .:hich includes a Document number volume and page number and the Seal of the Register of Deeds In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description refer- ences to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATIO I (We) eentiby that attC statements on this bonm ane true to the best ob my (oun) knowledge; that I (we) am (ane) the ownen(.$) ob the pnopWy desehibed in this inbonmafiion boAm, by vL tue ob a warvcanty deed neconded in the Obbice ob the County Regidten ob Ueed,sas Document No. s- ; and that I (We) pnesen y own the pnopab ed 6 to bon the d ewag a dis pa.d b yes em (on I (we) have obtained an eadement, to nun with the above de cAibed p ban the condtnucti.on o6 said 6y6tem, and the dame had been duty teco&ded in the 066iee ob the County Reg"ten ob Veedb, as Document No. ). c SIGNATURE OV OWNER SIGNATURE OF CO -OWNER (IF APPLICABLE) E SIGNED DATE SIGNED k � . VWSI&SIN REAL ESTATE TRANSFER RETURN - CONFIDENTIAL Wisconsin Department of Revenue �? '1. GRANTOR ' ; • V. PHYSICAL DESCRIPTION AND PRIMARY USE 1. Name a Z r Vii, i: . y e 15. Kind of property 16. Primary use 2. Full Address - New address if property transferred was residence ❑ Land only aE] �R ❑ Land and buildings IJ Single family /condominium i t i., .. • ❑ Other (explain) ❑ Multi- family - #t units 17. Estimated land area and type ❑ Timeshare unit 3. Grantor is Individual ❑ Partnership ❑ Corporation ❑ Other a Lot size x b.❑ Commercial Manufacturi II. GRANTEE: b. Total acres a ng «seep ❑ 4. Name =` ;; _ r �_ �'_ �� c = . = a MFL / FC / WTL acres d.❑ Agricultural 5. Full Address d. Ft. of water frontage Adjoining land? ❑ Yes ❑ No e.❑ Other (explain i �a3. .. �._.. it;v �43� ��.�i VLTRANSFER ❑ Other (explain) 18. Type of transfer: ❑ Sale ❑Gift ❑Exchange (ex aln ) 6. Is grantor related to grantee? E9 vae n No If yes. explain how related - 19. Ownership interest transferred: El Full ❑Other explain) 7. Name and address to which tax bills should be sent if different than grantee's address p, Does the grantor retain any of the following fights? Life estate ❑ Easement 21. ❑ Deed in satisfaction of original land contract? Dated 22. Points (prepaid interest) paid by seller $ 23. Value of personal property transferred but excluded from (25) $ III. ENERGY 8. Is this property subject to the Rental Weatherization Standards, ILHR67? 24. Value of property exempt from local property tax Included on (25) $ n W -11, El Yes D, No Exclusion code explain VII. COMPUTATION OF FEE OR STATEMENT OF EXEMPTION IV.PROPERTY TRANSFERRED ) 9. El city ❑ Village , Town LULL 3 t - V e :� 25. Total value of REAL ESTATE transferred $ a • ti . 0 0 I County t _ ? r fs r 26. Transfer fee due (line 25 times .003) $ _ 7 • 1 it 10. Street addr - -- - 27. TRANSFER EXEMPTION NUMBER, sea 77.25 11. Tax parcel number 12. Lot no.(s) Blk. no.(s) 28. Grantee's financing obtained from a. ❑ Seller Plat name If box a or b is checked, b. ❑ Assumed existing financing 13. Section Townshi P R ang e complete Part VIII - c. F Financial institution / Other 3rd party Financing Terms 14. Legal Descdptfon metes and bounds: d. ❑ No financing involved (attach 4 copies if necessary) s +. „ La.. 5_± ai %c ! a .j�:4x' li.'. ;1� v,_:i3 'e t7 ic�ar t�( "!tTV2: _�1tvTi Chi :21`.x_ a- Vlll. FINANCING TERMS (FOR SELLER/ASSUMED FINANCED TRANSACTIONS ONLY) 29. Total down payment $ 30. Amount of mortgage/land 31. interest 32. Principal and interest 33. Frequency 34. Length of 35. Date of any lump sum 36. Amount of lump sum contract at purchase rare (stated) paid per payment of pymts contract (balloon) payments a $ -• -- $ -- / - - / -- $ b. $ - -- $ -- / - - / -- $ a $ - -• - -- $ - -/- -/- - $ 37. If the dollar amount paid per payment (32) is scheduled to change (not as a result of a change in the interest rate), fill in the line letter from above Enter the d ate of change - - /- - / - - and the amount it will change to $ IX. CERTIFICATION We declare under penalty of law, that this return has been examined by us and to the best of our knowledge and belief it is true, correct and complete. Grantor or agent Grantor's social security number or FEIN Date Grantor's telephone number SIGN "f2i /fir ( Its) - ;'sc 1 HERE Grantee or agent Grantee's social security number or FEIN Date Grantee's telephone number t _._. Print name and address of granto s agent Agent's telephone number Document number Vol. Page Date recorded Date and kind of conveyance Conv. code 456257 F64 379 x/1/90 2/27 WU 1 2 3 4 LEAVE Parcel number Sales number THIS AREA Assmt year 19 - 1:1 Field BLANK L County - - ❑ Use Parcel classification I Tax dist. - - - - - A B C D E F T Assmt. dist. -- ❑ Reject PE -500 (R.10 -87) PROPERTY OWNER'S COPY •uunlaJ oql woJ3 ldwaxa oslu an (1 I) JO (17) `(I)SZ'LL uotloa$ 3o osmoaq aa3 aql woJ3 ldwaxa sOqurA AOD * , •uotlaos sigl Japun ldwaxa oq pjnom isnrl agl jo kmiOT3auaq oql 01 Jolum2 agl woi3 Ja3sureA p31 lsiul r oZ (9I) •s=A £ lseal w Jo3 AuadoJd oql paumo uoilmodioo otp `suoilmodioo woJ3 sJalsuuA ,lo om aql uT `3t pup digsiouurd aril ui lsaJalut up Jo uopriodJoo oql 3o ijools ldooxo uotlriopisuoo ou Jo3 st Ja3supA ay1 Ji `Joglo yaps 3o slu epuoosop Jo sluepuaasu Team * Jo sosnods 'amu sJauued agp llp Jo `Aq paumo st Tools agl jo Up j! sJauuud Jo sJaplogaJuys slt put digsJauuud Jo uoprJodioo U uaamlag (SI) - immuoo purl r Japun Jallos r o1 Jo afpfuow u 2wploq uosiod u o1 amsoloaio3 p jo nail ut poop p Jo amsoloaJo3 u Japun (171) - ssol Jo OOl$ 3o amen p Buinpq olulse Imi 30 (£I) •uoguuwapuoo jo nail ui Jo of lupnsmd (ZI) •d!gSJOnTnms Jo luaasap `IPA% AE[ (i 1)* (N(Z)ZZ LL .s Aq paJinbaJ su ldooxo uotie8ilgo Jo lgop p Jo3 Alunoos asualaJ Jo optnoid o1 Japio ut AloloS (01) •uotlriapisuoo lunlou inoip!m AmoUouaq r o1 aalsm r woJ3 Jo ludimtiud pup luoft uaamlag (6) (•poims aq lsnw (SZ) outi `IIA 1 uo onluA) uotluJapisuoo ou Jo luutwou Jo3 mel- ut- JalgBnrp rue 1uaJUd Jo mel- ut -uos pup luaJpd `pinlodols pup maJuddols `pltyo rue 1uaJrd `a im pup pupgsnq uaamlag (g) •uoquJodioo Aimpisgns puu luoied uaamlaq Tools Irudpo ;o Ja3suuJl Jo Japuauns `uopellaoueo Jo uotlrJopisuoo Ojos ut Jo uopraap►suoo luuiwou `uotluJapisuoo ou Jo; luamd su rn uopLjodloo kmTpisgns u Aq (L) •suoprlodioo jo siaSJaw of lumsmd (9) •uotlpmd u0 (S) •sluowssom Jo soxm luanbuilap Jo3 ales u0 (b)* •pap.i000i AisnotnaJd 23ULIAOAUOO p swJOJOJ Jo s1oaJJO3 `suuiluoo `uopr.iapisuoo ou Jo alrnbopuut `Iuuiwou Jo; Palnooxo `goigM (£) Jai{lta 3o uotsinipgns Jo `AouaBr `AIiluluownpsui Aur woi3 Jo oluls sitp woJ3 Jo sa1El$ Paliun 211 woJ3 (Z) 16961 `1 Jagol30) Jaldrgogns stye 3o alpp 0nn0a330 ayl of JotJd (i)* :aour,Canuoo r of Alddu lou op Jaldrgogns sell Aq posodwi saa3 aq.L •dg3 L OHO SNOLLdWaXH - SZ - LL AI0I133S LZ HAITI `IIA .LIIdd - dd3 MHA SMOLLdWHXd •(2IH"II(l Aq asn Jo3 uopLuuldxo uall" gOelle) Ola `uotsJanuoo opuOO `ale)sa a3i1 •2•0 luOJ ou `(1I)SZ'LL sopisog alrgoJd Jaupo `luaiu2pnf lino 2utpnlOut `JatilO 11 - M •XoldnJ:lueq paJeloop unoo ut aalsmn of Jo `(oilojliod s,Ja:4oJq.io3 IOU) alas alel!pmj of Alolos Ja3loJq of JalsurJZ Oi •lsaialut 3utllopuoo r a8urg3 Jo MEWO 1ou saop 1pgl lu0wu81sse /0ouefC0nuO3 Jaylo Jo Tools `dtysiouued 6-M •asnOH 2uiwoog lsuno,l/laloyv/laloH Jo `auioH 8uismbl `lplidsoH palulnBaJ soowgS irtOOS Pure glluoH 3o luowuudaQ p st 8 utpling 8 •awoq opgow Jo Al.iadoid lrpuapisaJ -uou 'purl luuoeA L-M •plo SMA 01 ureup ssol St Puu `(9L/SI /b anp3033a `(LI) Pue (9I)ZO'IS lUi AIJOuuO3) £9 'qD UH 3o sluowaJinboi alp Japun palonnsuoo `shun lmual oml uegl aJow seq 8 utpling 9 - PTO sJuaA Ol uugl ssol st Puu `(8L/i /Zi aniloa33a) ZZ 'qD - dH - H 3o sluowaJinboi aql Japun palonAsuoo `shun leluoi Z -1 suq Sutpling S-M goea 3O I £ qojuW Pur I JagwanoH uaamlaq paluoi oq lou llim (s)ltufl lmuoW b (•moloq polsil we aal woJ3 suopdwoxg) •((Z)SZ•LL 2 uipnloui lou) SZ'LL uonoos Jod JalsureA ldwaxa up st sitLL £ wenuoo PueI Aq S8 /1 /1 of Joud p , 3mojsureA sum fmodoJd Z •(shun lurluopisoi b Ja3surA Jallu Aloluipawwi jmX ouo isual lu Jo3 Jasugomd Aq patdn000 oq iitm $uipltniI i-M ADHHNH - III lHVd - SAIOISfI IJXd . sa7nlp]$ UTSUOSTM ails JO LZ'LL Pup (8 )9Z'LL suopoa$ aa$ •sonlen JO mote elsiopun pup suotldwaxo pawtulo AlJadoidwi Jo3 possossu oq ltim sopluuad DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1 — 1982 THIS SPACE RESERVED FOR RECORDING DATA WARRANTY DEED _ i '' °` REGISTER'S OFFICE This Deed made between _Daniel A Morrow, a ST. CROIX CO., WI single_ man; and Jeffrey C._ Harvey_ and__Steffanie R @C CI f 01' RP.COt'd ' Grantor, and wife y Y at MAR 61 090 I Morrow Harve formerl Steffanie Morrow hu_ an 8: 30 A M jj�� and - Howard N Nels- on__and__ — — I —_n_ M, - -- Nelson,- - - - - -- C ��"'�RJtIJC husband wife, as ---- pr- opert-y -- - - - - -- -- - - - - -- - - - - -- -- - - - - - -- ----- - - - - -- - - - - -- - - - - - -- ----------- - - - - -- Re9b*ofDemb ------------------------------------------- - - - - -- Grantee, Witnesseth, That the said Grantor, for a valuable consideration TWO Thousand__ Five__ Hundred --- -- -_ RETURN TO conveys to Grantee the following described real estate in S t-,-- _ Croi. - - - - - -- County, State of Wisconsin: Lots 6 and 7, Block "B ", in the Village of Tax Parcel No_ ____ ___ __ __ _____ ___________________ New Centerville, Town of Rush River. I �i ii This - - -- S_.n0t --------- homestead property. �) XRtx §tXX Together with all and singular the hereditaments and appurtenances thereunto belonging; And Grantor - ------- - - - - -- warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances $KeXXX and will warrant and defend the same. ii Dated this ----------- 2 _ 7 ttl--------------------------- day of ----------- - - - - -- February----------------------- - - - - -- 19__90 - -. I �' � --- - - - - -- - - - - -- (SEAL) l - -- - ) E * Daniel - Morrow * J f -e C -_ Harvey (SEAL) c ( ) * - n - --- w Steffanie Morrow ----- Hary formerly' , --------------------------------- - - - - -- ---- Steffaie Morrow ACKNOWLEDGMENT ature(s) ------------------------------- ----- ------ ------------ - - - - -- STATE OF WISCONSIN SS. - - - -- - ------------------------------------------------------- - - - - -- Pierce ------ - ----------- --- ----- --- - --- -- ---County. i authenticated this ---- __day of_________ ___ _______________ 19_ - - -_- Personally came before me this __2�t .... day of February ____ 1999 -__ the above named - --- ------------ ---- --- --- -- - - -- -- - - - --- Dani el A. Morrow a singl ---------------------------------- „sman�,s,,�and --- - - - - - -- - * _______ __ ___ _ _____ Jeffrey C _ Harvey and -------------------------------------------------------- TITLE: MEMBER STATE BAR OF WISC N Morrow Harvey, former�� ; tif"ahi�;.• - Morrow husband and w •, (If not, ' authorized by § 706.06, Wis. Stats.) to me known to be the person S___ = c� executed the z. . foregoing instrument and acknowled me: THIS INSTRUMENT WAS DRAFTED BY L S� / Charles__E. White, Attorney at Law -- * Mary E Cahalan R Falls, WI 54022 - - -- ------------------------------------------------------------ Notary Public ------ ierce county, wis. ( Signatures may be authenticated or acknowledged. Both My Commission VXNM*)0(=XdXXNyy_)@0KM0b are not necessary.) ------ e-xpi_ r_ e- s--- A_9129J__91- , --- _X__XX,XA� *Names of persons signing in any capacity should be typed or printed below their signatures. WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Co. Inc. FORM No. 1— 1982 Milwaukee. Wis. ' H ST C- 105 r H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z r7 OWNER/ BUYER 1�sL aC /Vr �S ROUTE /BOX NUMBER /q d(h y Fire Number 1 CITY /STATE �` .r �► �i(�I 0 - 4 4 _ ZIP i dQ�. PROPERTY LOCATION: ;4, S W 'k, Section T j N, R W, Town of St. Croix County, S u b d i v i s i o n &=W (%Qj `7"a yl/j 1►C' Lot n u m b e rj���� Improper use . and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this.program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on -site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. '. 0 I /WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with x H the standards set forth, herein, as set by the Wisconsin Depart- b ment of Natural Resources. Certification form must be completed and returned to.the St. Croix County Zoning Office within 30 days C of the three year expiration date. S I G N E DATE St. Croix County Zoning Office P.O. Box 98 Hammond, WI 54015 715 -796 -2239 or 715 - 425 -8363 Sign, date and return to above address. INDUSTRY, OF REPORT ON SOIL BORINGS AND SAFETY &BUILDINGS INDUSRY, � cc DIVISION BOX 7969 LABOR HUMAN REDLATIONS PERCOLATION TESTS (1lJ) MADISON WI 53707 6'3 y � y , 0 LHR 83.090) & Chapter 145) LOCATION: SECTION: p T _ /MUNICIPALITY: OT NO. BLK. NO.: SUBDIVISION NAME: 1 /4 S w 1 /4 2S` /T28 N r7 E a..�r (t L , . pu p, , v 6 1 B CO MAILING ADDRESS: USE DATES OBSERVATIONS MADE L� A NO. BEDRMS.: COMM ER IAL DESCRIPTION: TS: Residence El New Replace - 5+� - °' / RATING: S= Site suitable for system U= Site unsuitable for system ONVENTIONAL: MOUND: IN- GROUND-PRESSURE: SYSTEM -IN -FILL OLDING TANK: RECOMMENDED SYSTEM: (optional) S EA I CAS Ou IZS DU I EI EA I EIS CCU I ci , s3' If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s. ILHR 83.0915)(b), indicate: A P Floodplain, indicate Floodplain elevation: T P e .< t FILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER- IN@"ES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH it& ELEVATION OBSERVED E T TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- sC i'U h a , SY f 12C S C S'� �.-S ., Co . -g,• ad S" B- B- B- { �- r - PERCOLATION TESTS } TEST DEPTH . WATER IN HOLE TEST TIME DR 1 WATER LEVEE-INCHES RATE MINUTES r NUMBER IP*@Ht'S AFTER SWELLING INTERVAL -MIN. p RIO 1 PERIOD 2 p PER INCH P- d It 1 / 8 P- y z. S' Nn 2 0 3 ✓8 r i 6 -C / G � P- 3 al V 8' r3/ —33/ P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM EL 7 ­ 1 e F r tr c 4f< ° I �� he r I t r 4 i� �� ti r F r.Y cS CXa l o to tv KI i i tN 2 j(k f _... ._ ....te —.i. ._....._.... s t € i i 11 ' l 3 � , { I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: 7 ' - G G G �— 1 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): ( Q o u ! S'3 D } ,.. P l. ,' S'r� r S7 8 2 , S - _> �'- CST SIGNATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. �DILHR -SBD -6395 (R. 10/83) — OVER — INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 To be a complete and accurate soil test, your report must include: 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 3. MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement system; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing scale is prefered. A separate sheet may be used if desired; 8. Make sure your benchmark and vertical elevation reference point are clearly shown, and are permanent; 9. Complete all apropriate boxes as to dates, names, addresses, flood plain data, percolation test exemption, if appropriate; 10. If the information (such as flood plain, elevation) does not apply, place N.A. in the appropriate box; 11. Sign the form and place your current address and yur certification number; 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st — Stone (over 10 ") BR — Bedrock cob — Cobble (3 - 10 ") SS — Standstone gr — Gravel (under 3 ") LS — Limestone 's — Sand HGW — High Groundwater cs — Coarse Sand Perc — Precolation Rate mod s — Medium Sand W — Well Is — Fine Sand Bldg — Building Is— Loamy Sand > — Greater Than 'sl — Loamy Sand < — Less Than 'I — Loam Bn — Brown 'sil — Silt Loam BI — Black si — Slit Gy — Gray cl — Clay Loam Y — Yellow scl — Sandy Clay Loam R — Red sicl — Silty Clay Loam mot — Mottles sc — Sandy Clay w/ — with sic — Silty Clay fff — few, fine, faint 'c — Clay cc — common, coarse pt — Peat mm — Many, Medium m — Muck d — distinct p — prominent HWL — High water level, surface water Six general soil textures BM — Bench Mark for liquid waste disposal VRP — Vertical Reference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Department may request verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local authority in order to obtain a permit. The sanitary permit must be obtained and posted prior to the start of any construction. v H � ? d A a o . c if 3 S C-1 v a �i c h W 's oc ' tf' : lu .0 � CA o O t5b V S -c C1 V o J 4 3 s o � 0 - r a o � v c.1 J a L � S A n v _ p e co p U N .� C] p o. % a � -� o xQ q PAGE OF.... • PUMP CHAMBER CROSS SECTIOIJ AMD SPECIFICAT {ONS' r VCWT CAP 4 C.I. VENT PI ►C -T WCATNEK PROOF A►P�OVCO LOCKING JUUCTIOW PDX MANHOLE COVER ? 25' FROM DOOR. Ij•Mltt. `.WINDOW OR FRESH I AIR INTAKE GRADE I � -- � le•rllu. COWDUIT - - - - -- Ib'KIAI. - - -- INLET PROVIDE -T ©K` AIRTIGHT SEAL APPROVED JOIUT A 1 I �.1 APPROVED JO W /C.I. P PL t 9 o y y I III W /C.X. PIPE EXTENDIUG 3' �a Cc�b+ ` 9'40 OZ I i 1 ALARM EXTENDING ONTO SOLID $ OIL 0 p ca { ,� N I I ONTO SOLID f I t s ON r' z �- w R • � e,. ( LLCV.r FT p � ~ � �`',� PUMP .,� OFi CONCRETE hLOCK RISER IwXIT PCRMIII'ED ONLY IF TAWK MAUUFACTUR"' ' HAS SUCH APPROVAL. -;w C �opu�4 ScPrlc E SPEC- IFICATIOMS DOSE , TA IJ KS MANUFACTURER: W' es ee-1. : 1.0 UUM6ER OF DOSES: y — PER, DAU TAWK 51ZC: 000 LE ° GALLOIJS DQSE VOLUME . ALARM MAIJUFACTURGR: �._� �S GALL01 MOOCL wulAbCK: CAPACITIES: A WCIIES OR . ? GALLO► SWITCH TyPt: �^�+ { • c N YM 8,! i(. IWCwts OR 4 9 GALLO& PPUTAP MMJUFACTURGR: : L L C ■ ...INCKEs OR GALLOI MODEL WUMeCR: S p s 6 INMCHES OR Z GAL.LOI S W ITCH T %I P C: IJOT.C:. PUMP. AMD ALARM ARE TO OC MINIMUM DISCHARGE RATC 3 0 GPM INSTALLED ON SEPARATE CIRCUITS j VERTICAL DIFFERENCE OETWEEIJ PUMP OFF AM DISTRIpUTION PIPE.. - f EET i + MIAJIMUM NETWORK SUPPLY PRESSURE FCCT + kO FEET OF FORC M AIN X —a-1. f ,,,F RICTIQU FACTOR.. —Ji.. FEET TOTAL Dy1JAMIC HEAD = -- = FEET IQTERLIAL DIMLN6I01JG OF TA1JK: LEMGTH ;WIDTH ............LIQUID DEPTH s.. �...�- SIGIJED: ,�.,� ;k. LICENSE HUMBER: -�''Ip 1 _3 ?_... DATE:.:�:e�.t� HEAD /CAPACITY CURVE EFFLUENT and DEWATERING "rr WARNING: Model 185 should not be subjected to less than 30 feet TDH. cc W TOTAL DYNAMIC HEAD /CAPACITY PER MINUTE H LL EFFLUENT AND DEWATERING W 53 -55 1 1 5 SERIES 57 -59 97 137 -139 161 163 165 185 lee 189 FT. M Gal. Ltr3. Gal. Ltrs. Gal. Ctrs, Gal. Ltrs. Gal. Ltra. Gal Ltrs. Gal Ltrs. Gal. Ltrs. Gal. Ltra. 34 110 5 1':52 43 163 57 216 104 394 106 .401 61 231 61 231 155 587 155 587 10 3.05 34 129 51 183 1 79 300 100 378 61 231 61 231 148 560 151 572 15 4.57 19 72 43 163 64 242 91 344 60 227 60 227 142 537 145 649 32 1 05 20 6.10 27 104 36 136 82 310 59 223 60 227 136 615 140 530 25 7.62 8 '30 74 280 57 216 59 223 128 '484 133 503 low 30 9.14 65 246 55 206 58 220 90 340 121 458 127 481 30 40 12.19 46 174 46 172 55 206 75 283 105 397 114 431 .50 15.24 21 80 33 125 51 19Y 58 '219 90 341 100 379 95 60 18.29 1 15 57 43 161 36 136 71 269 85 322 70 21.34 30 114 10 38 51 193 70 265 28 80 "24.38 14 53 28 106 54 204 90 90 27.43 2 8 37 140 100 30.48 21 79 26 85 110 32.00 8 30 Lock Valve: 19' 24.5' 1 26' 56' 66' 87' 73' 91' 110' 80 24 M DEL 75 89 22 a 70 W = 20 V 65 1115 Z 18 60. O -J 16 55 EL a MO DE O , 50 16 O188 14 - SN 45 12 40 MDDEI. 10 35 185 30 8 25 17,19 6 20 OD L 161 4 15 7 __ 10 2 53, , 5 , 0 GALLONS 10 20 30 40 50 60 70 80 90 100 X 110 120 130 140 150 160 LITERS 0 80 160 240 320 400 480 560 640 FLOW PER MINUTE Note: For Head Capacity on Model 112, industrial column - explosion proof pump, see FM 219. Jessie Nye Subject: Wang, Kunesh, 479497 Location: Rush River Start: Tue 10/11/2005 10:00 AM End: Tue 10/11/2005 11:00 AM Recurrence: (none) Meeting Status: Meeting organizer Required Attendees: Kevin Grabau 028 - 1048 -60 -000 35.28.17.306 1904 Cty. Rd. Y 1