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016-1017-70-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County St. Croix Safety and Building Division INSPECTION REPORT sanitary Permit No GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No 624907 Personal na nation you provide may be used for secondary purposes [Privacy Law, s.15.04 (l)(ni Penn it Holders Name City Village Township Parcel Tax No: Dan Obermueller TOWN OF GLENWOOD 016-1017-70-000 CST BM EI¢V. map. BM EI¢V: BM Description. f,. Section/Town/Range7Map No (BO i r°f e 6 08.30.15.140B TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic W IcsEi2— Ic»n�600 Dosing I >'; 14y r5 G Holding TANK SETBACK INFORMATION L vc L--S LCL�ct vhs, TANK TO P/L II WELL to Air Intake ROAD SepticiDosing 7LS'Aeration JDGVent Holding PUMP/SIPHON INFORMATION & SiL- Perks /' Manufacturer / �2✓' Demand GPjN � Model Number TDH Lifh 06 S'l Fncti2 Loss Sy/stem Head 3.3 TD Ft .39 Forcemain Lengj(15 , Dia2 .. Dist to Well 7w ` SOIL ABSORPTION SYSTEM 61 L of STATION BS 5 HI 07. SS FS ELEV. o0 Benchmark I t6 oa.o' All BM Bldg. Sewer 1 123v r o2• S SUHt Inlet IS .� �1 AQ•� SVHt Outlet Dt Inlet Dt Bottom 8.ro ID.e 18.9 9 Header/Man 1,95 /p3. S Dist Pipe / 0 3.8 Bot. System f 3 O Final Grade St Cover oN 4vr BEDITRENCH DIMENSIONS Width I I Length /00 1 UQ-Qli TencTies 2 /' kv"I s- PIT DIMENSIONS No Of Pits Inside Dia Liquid Depth SETBACK SYSTEM TO P/L ��l BLDG WELL LAKE/ST E ACHIN Manutac er. INFORMATION C MB OR U T I z4_7 T fS lain � � �`�- 6�c �50 • il, Z -! � .JC) L'`` Mo I Number: DISTRIBUTION SYSTEM Header/Manifold Distributiont �7- ,• x Hole Size 3 it x Hole Spacing Ve t to Air Intta�k-eplip1,, �'f I �O� y Length Dia Length) 1 Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only rep rIv M L r— bRPM-ever t. k Depth Over xx Depth of t, xz Seeded/Sodded xx Mulched B nc Center -7 5 Bed/Trench Edges Topsatl J t� �1/ XYes No k Yes J Na COMMENTS: (Include code discrepancies, persons present, etc) Location: 2880 160TH AVE 1.) Alt BM Description = lii �i 10-' - 2 ) Bldg sewer length = 130' -amount of Cover =7y 3) 2r•r •o r seruA.le.� �3 S� e� �+(ier E 0 —, Inspection #1: 3��t^ ox) Inspection #2 ®%OW -.1k- / ( d Plan revision Required? J Yes INo 1q Use other side for additional information n SBD 71 (R.31 7) Date Insepclors Signature i �j L,sr &I t0 j"` I s Cert No _.. 'OF SfiN-aQa� -a19 -' ' InJt Coung 1401j L Vvieshingmn A,.e % Q 4 2020 1 - P0,R"7V-2 p$ p,rmn V'ambv(tabefined in b, Co.) _ Aludteon, VJi =_70 -?Ib- � � t / - a- r A}'p?icat.or, $,aze frn::nawn VumFxc to accordanu 1,11, SP9 ,8J 21(2). Wl, Adm C...4 mbmnsion of ihh loon to toe Jppzopnam em cmmenul volt t AY �� �_ lt%T 2.0� 1 3 L n regvlred poor to obwmng a san,tary ne.v irate_ Apolmatmo lom,a for+lace-ou t, j POW-1 _S are submnmd to _ Project Addrevs (,I dlflerew thT, mvlbna addre,.) ' the Dq,,v,Ocnl of Salem vm'. tau P .Idc mat be used for nmd.0 n�su' m;,c am.... line, avh Ib:_ PTInevy I v+. . IS6JI1(m) Sin=a _ i. Application Information-- Please Print All iuturm2tinn PI'oPen) O,snrr; Home i 4-A Na E[c ER_ _OBE.0 _________._�__ PNPCRI (}ATCf5iMallln1'kdd,,,, --- .d/G-�O/7- z7p0-000 PNOerh f.=aw,, OO.v� IS_ 146 t.lt\. SLM1IiIP CU:¢ l'hOni Vun�n� 56 '/.. Jr +-. Section $ / GLEwJ[l - one 3o iclrlc '� Ii. 'hpe of Building (check all that appltJ I-°'-- i � I of ' fynnly Oscclllnc- dumb:r of Bednrams p11111ICommcn.ia1-Df$CItIR. 1'11 LSt.ur U,: ncJ-D�acrthe Uxc r_S\l Cembv. 1 �titaa,e ni I I[i Toa„of G1&VAd000 _-- III T e Permit- (Chec WN one tin on Iinc _ ompleie line B if applieable) !RC s v.uc^t On-, [ Otbef Arou ad.:t un L. Eeleu v Srsl m ce --- - -- - L%t P'o wu. PcP'o wu. Pcrm,l 4umUcr and Dal, lssued a- q ❑ Pemv! Rcnmtal I'crtnv Rc.:'lan 'I Chantc n' P'.uniocr J P: mail 7mmicno ]gin Ciclrru i-sniratwn @,: m I}. Ttpe of PO`A'TS Si'stelWcrm nneriFl)es-;ce: (Cheer L ]'cn-Pre un_rcd Iv-Gnvund Pvs cfal LI-t,°c: v p. V q-adlc1 lmu I . n. of �u rrol_ mt. M,und Jy in a swt tble sod I, I (_J Nol IinC r.1k (nh r DI ! r<c' C mpt n_nt ..zpl w I -/�- ❑ Pr Ir at t t I Dc tc ( tplain) N. Dupers ]Tfmatment Vet InformationR. _ De V_ t I lots t P ti D.: ien \o ..1pph m i . _ru I Ou......Arca Rcqura.INl n c .vl iru rn'Pnexd isfl Swtem Cics mion _ 756 900 T r\ E. ank lnfn C p on , Tod \'anufaclnrcr �..,i a,es-- I.,I :_ra+ or �000 __ -_ I_/000 � I L✓/ESEc_ VIL Kesponsibilit} Statement- 1, ,lw undcl signed. aveme rcgmv.ibiliu :or utstallatiuu a: (hc PC :!'; S nLunn un tilt AUd iml Plumber'...\time (Prim) -� Piumbv naturd _-- - _ -- -- �f Pri'..ts \umber d3/3Y6 Bminess Phmlc humSC. N G198 Sr. /Y/wz ,7S iu�2n� �L[J1 S5'73� I Vln. C_ount}fDTar_tment Ilse Only Issul ngc _J�r��y/_���(�J 1 T P nml�Rjc� r- I Id,�y/cd, nt ll �te!u..- Cond o Appro, SYSTEM EM OWNER: JJj.Y_s'�JF1tip-{n�1D-- tl Septic tank, effluent filter and dispersal cell must be-serviced/maintained 41).w � N1-fp PIp�/t�2 Sy ww_A'* Cie te as per management plan provided by plumber. I 1 2.-ARsei�ack-r - PP---- - IvetmcuropecP:lns or!he nslxm vvl,uhlllitfunhu t per Prot tit ilia N d In .ir_ as per applicable codelorc�lnances. �� P 2 J a li tied% oa CseQ c Mar _PIAN ) AAI Db E4ivUS1LE2- 0?880 /Co D.4 Rd6. SE SE, 81 3oMl /S&I �: or GLE.dwaev, Sr. ��dixlo. �c yoor � L r /�.�• - 99.0 rep N dF � `rPip6 L` 1 i Qjy /uo' FARry f/E[d ��1 $ � yO s7Sr SOI Goo65 J" /dg3�,y. Yo fe.eC! .y/re! ()S) `'b �� 6/db /LOCK CALL <T 1' x /id' /1 r-GRRo� Fawrs /63.0 CFO bb eil Goara...�� I tic.- /o3.0 r r xo� O, "Roll Yee, M - /00. o L, L Y:"plM Yod z Ss9 Lor�sRur1) gyp% �441 S/S 383. V3 deref[ei I rrc r 4lLEf6t /O60l66 gb p sLE«rs ly /I/d/4 )AIdE W A4 048O atUS);� ►'REFS k. j art i S rPS July 8, 2020 CONDITIONAL, APPROVAL PLAN APPROVAL EXPIRES: 2022-07-08 Plan Review: PWTS-072001377-C JOHN PELKE. N6298 State Highway 25 Durand WI 54736 SITE: Dan Obcrmuellcr 2880 - 160"' Avenue Town of Glenwood Saint Croix County SE. SE. S8, T30N, R15W Total Amount: $250.00 DIVISION OF INDUSTRY SERVICES 2850 MIDWEST DR STE 104 ONALASKA WI 54650 Contact Through Relay http://dsps.v,i.gov/programslDefault.aspx w .wisconsin.gov Tony Evers - Governor Dawn Crim - Secretary Conditionally APPROVED DEPT OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES P� �i<�i%fil SEE CORRESPONDENCE FOR: Description: Three Bedroom At -grade System \ Sloping site At -grade Component Manual — Ver. 2 0. SBD-10845-P(N 01'01, R.10/12), Pressure Distribution Component Manual — Ver 2.0. SBD-10706-P(N.01 /01, R I0112). 450 GPD, 45" depth to limiting factor from onginal grade, Maintenance required, Effluent filter, New construction The submittal described above has been reviewed for contormance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 10 L0100), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage m or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of See. 145.19, Wis. Slats. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Proper <oil nun,wre content LIM be deteimnied h� follint. a ,od smuple between the hands. If it rolls into a 1 4- inch wire, the site is too wet to prepare if it crumbles, site preparation can proceed. 11 the site is too wet to prepare, do not proceed until it dries • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. Owner Responsibilities • The current owner, and each subsequent owner, shall receiv e a copy of this letter. Owners shall also receive a copy of the appropriate operation and maintenance manual(s) and he responsible for ensuring that POWTS is operated and maintained in accordance with this chapter and the approved management plan under s. SPS 383.54(t). • In the event this sod absorption system or any of its component parts malfunctions so as to create a health haz:ud, thepropeM loud utn<I foll"�� the "ontnnnenev hi.m.1' drank,-d In thcrd plans. • The owner is responsible for submitting a maintenance � ertfication report acceptable to the county for maintenance tracking purposes, Reports shall be submitted at internals appropriate for the component(s) utili/cd in the POWTS .A copy of the approved planySecrfications and this letter shall he on -site during construction and open to inspection by authorized reprgsentatives of the Department, which may include local inspectors in grantinu this approval tho Dr: icon of lndustry Services reserve the right to require chances or additions should rondw„us n i'c oaks, 111:m nei esnar'r, for a•d, arnpiWnce A, pci -1d11 Aata I(11.1_'I'1, nuthtng ur this rev icnc shall relieve the designer of the responsibility for designing a safe building. structure. or component. Inquiries concerning this correspondence may he made to me at the telephone mmriber listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS Sincerely, v_ v� Gerard M Swim POWTS Plan Reviewer, Division of Industry Services f 608 )789-7892 — voice \ (608 )785-9330 - IhN Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter. Owners shall also receive a copy of the appropriate operation and maintenance manual(s) and be responsible for ensuring that POWTS is operated and maintained in accordance with this chapter and the approved management plan tinder s. SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. A copy of the approved plans specifications and this letter shall be on site during construction and open to inspeettouOy-authorized tyirescntatives ofthe nepartment, which may mcluda local inspectors in granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arse making them necessary for code compliance, AN per state stars 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 :eft addressee shall provide a copy of this letter and the POWTS management plan to the owner and anv others who are responsible for the installation, operation or maintenance of the POW'f5. Sincerely, Gerard NI Swim POWTS Plan Reviewer, Division of Industry Services (608)789-7892 — voice \ (608)785-9330 — fax PW11 PLAhI NAB ObEc nuEG [E2- ,7880 /10 �A AdE SE/ SE 8t 3oNt /Sid `oF �7CE.etWaoAt Sr. C.�.etz Ca. %A2ty f/£td 0e --- C3 UooDS � r 1 /OJ.O sys Joo r of !oo T b.n.� 99.Gtreo N d.0 Yn�/P6 rr 1 SO r $1 O .tS So a f- .M r- /04. o r r Yi" dAE Ydd x SY! Lor �,sAu ea� ALL 3/S 38J, Y3 S6rofeei I —J r+E J" F' GJrESEa /Odo�Geo /ec ScN.t1/0 fo.cG6 ^"4 C7Jr) �d•76o TA.rK t /(a LK GELL fr-GAAOF /ours /d3A Cf0 tier✓ Gaorern.� L Ar. /✓u r E'c. • /a3. C 9L+R14) Yddt It sGE«es Y t.o. tr , /'uc 3031/ /3,5 ) �7 YT tr.6£Ls✓ L4A00) P,ce pa s £0 Quacwrr � A,cusHE e788o P SYSr A = '% ft B = /00 ft C = I? ft D = G ft E = ft F = 9 ft G = /. / ft H = Z0 ft I = S ft L = //0 ft W = ?? ft 1/2B = SO ft 1/6B = /6.7 ft 4" sch 40 PVC observation pipe m � o m 0 oa �15ft N� Y 3 0 a 3 rO5ft l v_ � U Page 3 of 9- CROSS-SECTION OF AT- GRADE GEOTEXTILE FABRIC COVERING // . UPTURNED LATERAL & ACCESS BOX OBSERVATION PIPE & / DISTRIBUTION LATERAL(1%' sch 40 PVC D2665) W DISTRIBUTION CELL (%"-2/V aggregate)= // ft x 00 ! TOE H . r SI TOPSOIL ,� � 12°�'� � / ` r �2„' v Lateral InvertEl.= 63.6 R �. Q1/, • 6r ••,� F,/',;" Contour&Sys El= /03.0 ft L PLOWED SURFACE Notes, /O % SLOPE H is measured from directly below the "�� a5' lateral to finished grade o A c E - Bend as necessary to follow Contour Prohibit disturbance and vehide traffic wthin 15 ft of downslope toe Effective Distribution Cell = % If x /oo ft = 9 oe 112 Mm Required = Y.JO - , G = 73-0 ft` PLAN VIEW OF AT- GRADE E I Jr Distribution) pipe( /%4 in. scn.40) W2IW I 1112')r OX 2' Force Main sch 40 PVC D2665 1 O� D L� 1/66 /l,7 Distribution Cell I 1/6B/�,7 Observation pipe (%2'-2/:' aggregate) 1/26 — Sa Prohibit disturbance and vehicle traffic within 15 ft of downslope toe OX= Upturned Lateral with Access Box T� B- (I' _S71 r.]U I-L, i„L 1'Til1 I-T M,11 POT TEE, DI!S. ' �Ih I:? t, �,.ja �"!.:.._�_,,, .a;. ,r 1 V.'.;wl'' ; � : ;_1 ce' ks•:. (Ca)(er INalliiolrl) La .._ ✓{ � _,i. r (scf�. 'to PVC JI pipe 112665) HOLE : I.0(V\ fLD c-7PI TI IE_ B0I1 c,V OF I I it: I'll=' 10 :(,UAL Y;,PFlCI:D, - Accc s f Ilc�: ,a 7 7 Not I-Icle NlimmIUuu i\lunlbC:l Of I toles :.-- %p!i tt - :' .: 5 o Hole, RS tole,/r.id crul ;: p La(er:71c --_50_ (":LI oes -.-GG_ opm / QM2 ; Hole - 33 GPM 2 ;'ST'I: W 71 OR PIPF ` OLUIVIF: __-`%$_ H I awals oolvl) a O.002 gal/ft, _ . -_{CYAL x 5 ys _ GAL = IUIIiV81lfIPJCiIi I)C+3L VOLUME PII'F INVEl't-i" El' -VA I"!UN - /o3,-G_ it. Page 5 o`r C..sQlif BI §e ,.101,0 SEPTICADOSE T NIK CROSS-Sy-C a 10N (1)RAVJI NO NOT TO SCAI E) "TNAL GRADE {slope "n.rn v.i _c a:.-_ imr I rannd_sm2 l for olter dmag e} i oUILDING SE)NER / jeer SPS 322 31)(11)1 I ! % _ S' cover > 18' iJANHOLE RISER. 0 COVER, jrer5P538<.?-. ;bql bc: Eo e :-r d S IR G vammg tab.: n,t. d manr•ee riser as necessary t I I ='+5m Sch'O PVC Tan:: VeraELECTRICAL Iccated!I- above Vrane or 24- JUNCTION BOX ` above Regiana: Flood E!a,.uvn J (comply ,0n SPS'!S i end NEC 300) sego o n ,.r I � n•� _; � I IIL j� j � II I i it / J� I r -ca.ag Or.owei I. Wm Scn. 40 PVC Tank'Vent ICr tad 12" above grade or X above Regional Flood'clevahor M ININIUM, OF 3' OF SUITAB( F BECIDING BENEATH TAidK & N14;t1iv1UM BURY DEPTH, OF 96' Ancrenng 01 tan:: may be reou:red per SPS 38J 4' (81(g FORCE MAIN OPTIONS a^Fba: =Mt' 97.0. 0 - ank kianufaciurer. _ �.//65 E.c �o„�c2frE DallyVtrastewater Flo" (DAIF) `/Sa G?D Septic/Pump Size. _ /doa /Gbo_ _ gallons tylumnerofdallyooses: S.3 (/9%i Alarm Manufacturer S JTE Xi1'oe.'l0S Model Number Y-4.jic q[Enr / Force main volume, _L`ix /Z3gal/f, 1.? gal Switch Type /'iEu1.4�/cat Actual dose volume- 97. Z cal - AU gal = 83.6 gal ftoral dose volume - volume of force main) Efi!Ueni PUMP 101anllfamirer Z4ELCE.4 Mode: Number /5/ Nllmmum Discharge Rate. 33 GPIA Vemca! lift (pump off to lateral invert).. 4 d ft System head (distal pressure .75 x 1 3 ft) 3 - 7S ft Force main x d. 1 /100 friction factory ft Fi ter friction loss -otal Dynamic Head (TOH) It DOSE TANK CAEACI I ES: Reserve above alarm .JO..? in = 339.4 gal (D) A',arm float above an float r? In = 33. S gal(c) On/Or float measuramem .S8 to - %7.,2 gal (13) Off above canl< bottom 8 In = /3Y.1 gal (A) DOSE TANK DIMENSIONS: Length /-To in Outlet height -34 In Width 8y it Gallone4nuh /471 VS 75 E L— PUMP PERFORMANCE CURVE MCDEL 151 `1521153 S f m iin 90 ui w m 'a t0 sc 'W LTcac —T__- er - 11 ^LW =.NeT; Timed dosing panels available. Electrical alternators, for cuplex systems, are available and supplied with an alarm. Variable level contra switches are available for conVolline single phase systems Double piggyback variable level real switches are available for variable level long and short cycle coni Sealed Owlk-Box available for outdoor installations See FM142u. Over 130°F (54'C- special quotation required 1511152.753 MODELS Contm_I Sele"oa Model _ Voftl Mode 0.mps _ Smplex - _Duplex__ N151 115 1 Nan 6n _ . Za�3 _ BN151 115 1 Autc 5 3 nCudec E151 230 i Nan 32 2,3 BE15' 230 1 Auto 32 f^ uded 2cr3 N152 11$ 1 Non BN162 !15 1 Auto 85 locluded 21r3 Etat 230 1 T Non 43 __ - 2:r3 _ BE152 230 ! Al 43 Iccloded - 222 - N53 115 1 --Non t_5 aN153 115 t Auto IC5 inGaited 2^ S E153 230 No" 5 3 1 2 or 3 BE153 23C 1 Auto 53 Inellderl 2or3 TOTAL DYNAMIC HEADIFLOW PER MINUTE —" EFFLUENT AND DEWATERlNG MODEL eel Meters 151 152 153 Gal iurrs _Gal f Lie S Gat lnees 5c 1 H3 6e 26, 11 29' 45 t is 38 'y 3 2L 6' =. _ * 23 6 29 0 11 161 52 1 ter —~ r 1-. 6 B !2 a2 151) "� 75 'gi _ _ l 22 1 85__ __,I:Ror _ t 1^aaKIf1p1i, 3efln 6m Nft 341, 1 .. Model 151 y \ 1 1 _ �e6 1 sn.+u 1 Single c,ggyback varil level foal switch or double piggyback vanab.e leve, floalswrtch Referte FN10477 2. See Rv10712 for correct model of Electrical Alternator E-Pak 3. Variable level control switch 10-0743 used as a contra! achvzla. specly duplex l3) or (d) eoat system A CAUTION Models 1521153 1 I 6-1 - n7. s�cos. ? _ \ "Easy assembly" rl IpurR� ft tl5cha'ge pipe t na viCk def ) , a 1 v Reduces potential clogging by debris Replaces rocks or bricks under the pump. Made of durable, ncriconosive ABS Raises pump 2" off bottom of basin. Provlces the ability !o raise intake by adding sections of 11r'z" or 2" PVC pipng Attaches securely to pump Accommodates sump, dewate ring and effluent applications. NOTE. Make sure float is free from obstruction For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump, dJ Copyright 2008 Zoally Co All rights aaFlrvan POWTS OWNEWS NIANUI YL AND va vat ur rt a PLAN P 11,1C IAEORY14TlON On.ner_�JAN O6ER/•fuFLLER _DLSIGN PAI AMEl CRS _ Dili her a Bedrooms f 100 2pCned: ooml 3 \'um.,el ui comniecial I,nin - ----- -- Fsuniated now (aver c•, _ I Desltn now tDAVP) = r,timated s I _ - yS0 �andac ' Sml Application Bate .I G paf(d'avl h' j InlluenVEflloem Quality L1 ��1-Mondth, 4vcrao� 1'ats. Oil L Grease (FOC) `;O.nJ= B;orhentical Ox, �cr. Demand 1 ROD=1 5'_10 tie t_ "Coral Suepenaetl Cnlids fTcei ,�0 m., I, P pleated t.11ucnt QU i 0� i T \ \ �''s�o-t h' '.vcra -.. B'odt mica, Oxygen Demand (BOil i _ 0 ln_ 1. 1 Total Suspenoee Solids ( ISS) = 30 m2il. 1 Fecal Cohfolm (eeolnetnc mean) ', <ID start OOml. ' Maaunun; Effluent Pai;icle Sire -_ I �S inch diameter--� ;)isoersal C'oit y1 rg.AMu6ei t`.0 tuber. Calculi'ions: - �av Dispersal P:no Cap UWF — '.00licauon Rate = _Area Reauired - EISA - ,QE 7 0_ 9 S'. STEM SPEC .I FiC::\l fONS -Septic Tank Capaan %066 __a _7 Septic Tank IManulacturer w/ES E� e.um. 7 CAI Effluent Filter Manufacturer j 6E.5 T_ :1 \ill C Effluent Filter Model � G /r-/O 7 T \I Pimp Tank Capac.its _ aal _7 \ A', Pump lank Manufacturer !✓/Es£a Ca✓ra. 17 N A. I'ump manutacturel I Zo£CC£R O NA, j Pump M(Id,a _ - /S! O N.AI, l Prcticatmcnt Unit (511 \A) " 7 Sandi Giavel Filter 7 11catFilLer , 7 Ml chanical Aeration �7 Welland 71 DIswizutwit 71 Other Mt")'llat.UFCT IMocel Soli Absofpuon Component NA) ' :In-2ro,md l_nvlo.) 7In-gromidlpressurized) I$ At-_raac O ,\-lound 771 Dtlp-llae O Other V'•_vocal Di stem Tanis B ottom to ScrvIcc Pudgy /O It HOri/_txltnl D,mmice Tank(s) to Scn•Ice Pad: _ Gd ti ! (Fiisocrsal Unil EIS'\, or(Tench W i,uh'i = _Ut_its_oi Total Length of Tench(s) /00 t DCSIGN CRI"P_ A _ �900 3 "Des,en of Pn:,su,a Disu a ution \IM C-,k5 fm Septi, Tank-Soi: Absonxion Sgstuns" Publication 9r 'ICC Flowlech \Mond Companeal M inual' kcislon L? 1 r "E7_ Flow Mount, ComD.�ncm h'lanual' \ erstnn S 2G '_097 7SAD-IOSSl-P(R.1"2) At-GmdoContponcn,A4anuaa DD,MbtLLlOn",.: ersion l0 .11 SBD- 1070N-P I A 0 POI 1 ':n Grouna soil Aiisorpnon Component Manual" `.'colon6 SBD - 106`il-P u, 01)0! 'Mt uno Compoumu Manual" Version' 0 7 SBD - 1065'-P (R 6,1191 "Dnp-I.nc 1",,m O,sposal Coutpopcut Manua!" 7 SBD - 1070o-P 1A1 Ol,gl 'P-cssutt Dl,ioouty n (.omponeni Manual' Version 2U (SSN']•i I' Manual) bi_' iINTENANCi. MONI CORING SC_iEM,LL - 1MAIN"I ENANC'E . ND IVi \1Af:c ViENT Service Event — - -- Service Frcqucncc r'ump:`insl pees disper5sl cell(s). clean filter _ _ _ At least once eterv' = li months ®3 years O Other: Inspect pump pump controls.:darm pretreatment unr. _ a; teat once e, en: .73 m_onths 9_3 years O NA i Clush and pressure test laterals i A: feast once cvcn 7 months Sd 3 _years Q NA T? RT UP AND OPLRATIOA: Conc:, construct n. op,io, :o asin9 he POlA 75 chec;, tr.-atmen: lank(,) w the presence or pamtm 01'odticl5 Oi Othel" chcmiciils !11'w M, Ifnp"Ce tpc tltc: 'F PI; (.)ltOM$ Uut!01 ddF7 C lid-, OISPC5Ui G'i1151. 11 rnh cUnuntrudons aP dOtcad Ilil1 c the contentS of Ih.: taak(sJ removec h_, a septagc sen icin. npa2m� Pnor io use. System start at) shall notoccur when ru asail conditions it trocct the infiltrative surface. l"h, propels} 0,e11c1 is ,csponsiole I_'or the oocranon and maintenance of the 1'O1\ T9 and subolission of lcquucd sports. The ouunuv, and quality oRhe ,cas(e,vatet stream ,vdl affect the oc.Fonuancc and loncecity .r ow POWTS. The fnstallal.on of ,aiet-saving appliances and fimmres along o: ilh prompt Iepalr of leaks redeccs tile .,aste„ai-,v volumc. Atso 'die brine or waste Inin ,later nolieners. iron removal units. oche, fear wate1 ucmmcnt dcrices and Foundation drams should he discha,2ed to the around surface ,:hemmer possible Nom this sloes not include laund',' ,casteshoweis. dish,aier. co - This system is designcu to 'nandlc domesoc .ticngth „astcwaicr, h,,cr, the u,sposal of fuud ba,cd greases. oils, ve8ctablCifruit peels. seeds. hones, and toad soiLds. such as those ,ttdUced fix a sarhage d ,pail should he mimmiz_ed. Toilettissue is the only paper that should be WtltaleCd Into UIL a?'SILin. Otlivi not b.odc_, adablc tic ma, su0' ua baby ,•A p.,. uuui:on s.'culuaty nupklns condom+, cigarette ban, dental Floss. and cotton swabs. should no: enter the system. Chemicals. such as peuoleurn products. paint. disinfectants, pesticida ❑nuhiotics, ,olvent+, cu. , should not be flu.*hCd into thrt syncm lx1,1, zlhcy coo oorio,aly Jomnpe your PO W 11, „nil yonl@mingle yons Page $ of q dririlcing watersupply. i\•latntain a.-cyular steady tlov, by spicadmg laundry washing throughout the week Avoid vehicle ttaftic over all system components. Compaction o'i ;now o•'er the dispersal unit may cause it to ficeze up. INSPECTION'S &: IgAINTENA:NCE: Inspection shall be made b-, an individual carrying one of the following Iicenses or :e: ii5cations. NIdstel Plumber Plaster piumhe: RestriCea Se:eet. POW"'S Maintainer, or Septage Servicing Operator (per the attached :Maintenance Schedule) -lank inspections mus, include a risual nsoeetin, of the tank to identify any missiu_ )I hruka, haidwaic. 'dclntap am• cracks or Icaks. measure the volume or combinca siudec and scum and check Fortify, backup or pondm¢ of ctllucnt to the glotnid surracc and itsl'it electne:il eGugm,em such ::s pumnS anri Llf Fris. Any defects shall be promptly corrected. Bsposed openings 2,ealer I;•all R mchcc in diameter shall be cccurrc; with effective loc!on g cevices to prevent -accidental or unauthorized envy the tanks SF hen the combination orilud ue and seem ;n :my tank exceeds one-third (U3) ormore of the tank volume: the entire contents of the tank shall be ;emoved by a Supiagc Sur. icing i )peraun and dispobed of in accordance with Cin. NR I I ;- W ismnsin Adn, ln. Code- Specitic ser icin_ mechuns� iuust ix p1m acd ii c1tKai fs>15 feet 0r ifh31nZOiltal is>I]0'i= and instructions to be ntoiideu bcio,i. I he outlet fit l ter s) +ha 11 be inspeciec antcica:icd to, cillo, cany accumulated solids according to manufacturer, %specifications -Sold-% washed fl om the filter small he rctaineu IT, the Lank. filter cleaning nnay be necessan' at mole Ilcqucnt intervals than statcu in ,tic intamenanceschedulc to keep thesy Steil, opta nin_- Alarms should he tested on a reaulzr basis b:: the home owner. (fan alarm sounds. contact an individual licensed to seance PO\\'l S. There is normally a I day reserve node. mgulal operating_ conditions. however viler should he conserved uutii any ploblcm5 pith the system are ron-ccicd to prevent hack -tip of se.va3c ilno the dweilin, or surfaeins. A13ANDO1IN (VENT: When the PO\VTS (ails and.;m is permanently taken o!t of service the li lluwin�g steps shall be taken to casun that the system is propUlIV and Safely Ill andoned in compliance WI h Ch SPS 333.33. Wisconsin Adnnin. Code. All piping to tanks and snits shall l,e disconnected and the abandoned pipe openings sealed The contents of all tanks and pits ;:hall he removed and properly disposed of by a Septage Servicing Operator. Aliei pumping- all tanks and pits shall be escaralcd and removed or their covers removed and the void space filled with soil. eravel. vu other inert solid nmtenal. CONTINGENCY PLAN: [I the PONY IS hills and carrot be repairer) the foilo%ving measures have been. or must be taken. to provide a code compliant leplacemcn c, siem: 7 .t suilublc icolaccinent iron has beer ataluatcd and may be utilized lot the lunation of a ,eplacement soil absorption system. The -eoiaWnCot area should he pirnrcled Float dismrb.ume and compaction and should not he infringed upon by required setbacks 'rom exist:ri_ and piopose:l soucm,e. Ion lines and .yells. Failure to Intellect the replacemem area renders it unusable Replacement systems must comply wth the rules to c`icct at thr Jmt: of r'olact lri J 't suitable rcpfacemcnt area > not av,:iiui,lc due to setback amPor soil Limitations Barring advances in POWTS technology it loWina tall, Ilm oc Installed a, It 1 ,'I •t Oil to i.:p!acc the failed PUFvTC_- $ "fhL Si[e ins not beta evaluated to Ident.1� a stownle r eplacemem area. Cpun !allure of the PO\vTS a soil and site exalumion most he per lbnncd to kwau: it xutablc renlaeeurera area. ICno replacement aca is available a holden; lank may be installed as a last reson to rcolacc the lulled I'U \ 1 S. :\found and w-grade soil absorption s sterns may be reconstructed in place foliowing removal of the biomat at the infiltrative surrace. Reconsimct tans o rsuc h systeros must comply .v ith the vies in effect at that time. WARNING"" SFPTiC. PIMP. \ND OT kirl2 TIZFk I-Nil"\T C:iUs5 W CONTIAN LLULU, GASSES AND/OR INSUFCICIENI OXYGEN. DO NO'I EXIISR A SE.Pt I(.. Pl-l•IP OR O"IUER '1 RCATNIENT TANK UNDER .ANY C€RCfI\IS'I:ANC ES. D%A-11 MAN-RESUC.T. RESCIT OF A PERSQ\ GROlt 1"HEIN! I':RiOR OF 4 TANK.'PLY 3E DIFFICI I;P OR IMPOSSIBLE. ADD:TIONAI_ COM1,4GN I POWTS iNST ALUR POWTS :MAINTMNER —'I \ante' 16NA _ ACLKC /7P-dd/3YG1 Nantes t ,r 4urrdll6 Phone: -- —_7js G71- 5-.t66 Phone: 7/S G7a-S.vtt SEP"rAGG SERVICING OPERATOR (Pumper)? LOCAL REGAL ATORY AUTHORITY _ .— Name- - -t `---- — — ----- — — --- — - - _----�r. C.eoax Lonn�.✓.rr i%�u�eao�Eyl i phone: J Phone: 0 linstall at*Rori Inst cacti, oils for the Gig I O Filter Slap 1 Locate II d mmove the septic tank cover, on the atdlnt "ano of tank Step fioforc Installation, Step 3; For lnstallallnns that place the film case an to terl or clove addltlonal thooutlet pipe Maknsute support (If addlllonit stg,purt is the case Is posltlonccl so not needed, go to Sell 4) Glues the Nisi can be removed soalnn of I, Sd. EO pipe to the it art the tank in, mninte. Ivm li. Iis lamed uI the hmtoin kiln", and cei vice of tl,o cnse and rho huh lor.ned art Iho "fie at thr cna• Ste p4 Glick the filter rasa onto 5tep5 Far lmtal l.dunn whet e It will the o'-ttI et pi lie Insail the fillet be diff oilt to rcl 1, the hmcil% jia rc ca, tndg Into the wse (Muhe I'Schkid uto 10 ppc ono th o tee oil the Sul the Glte Is completely handle and extend it to hutght chat wig Inserted into the rase I make It easy to unnove the filter. 1 TECHNOLOGY Installation of an Same as anew systeln an ly the septic tank C'{1St7t1g SYStenj.'arusthoptnnperior dptolnstellation. ma"* -At ell a>iace, of the GFIO figlter 11Ea Ie franca cat wlucl WIN uuanks ac Seed Ced s sec by 6('ile and l ood"do, Althoog6 tm hey ay bAt m e diflere ast rek)ulatoay agencles sugGml hive to five um years Wecoatetd tie G1 in Hill, IV. decree Whoa the Seolic tOlk a namally r ezncd ,,,it pumped, ar as needed Uilt4fdfAM,1 : if the liquid level in the tank is above the tors ofthe filter, pLIMID the tank prior to removing the filter cartridge. 46•'a11q'&'BON: USE RUBBER Q:oiLOVES 1( HEM HANDLING PURRS! Step t Remove the Septic tank Coves and pump the tank If aecesaty to prevent any solid: ir.w escaping to the field when the Rllel is renwvcd. MKIIIIIIIIIIII WAN Step 2 Pull file filt<a Step3'. Whllcheldmgthe handle and altdn Iho filter filter carcudge over the our of tho case access cpening of(lie tank , I iiuc tha kiln ldgc off With freshwater Takecareto make sure all sohd matedal falls back into the tank — I / P'EGMAJOLOGV 3 Fc4fiald civil, Wolllnpfine, Cr 06,I92 1"817"155-95fi5 Fax 203"20,111514 r4 L��j Step 4 Insert the cp«ttiCge Lack into the cares maW�g sure t'not I ii prcperir alignrk!,md an"IDICIep, mset ten. rote the case. � f F UiJr' ay�� 3'a 4 �r iY ZA • �' " yew"• , A � : Ir � rY X w�l � �:. K x '� 1 1 R t r- ♦+n . rrig;.: n t , 9 ^i .�► rF ,r � • .:fin: vN%f na'' �rr�"� I ���.. A N 5• � 1111 0 50 100 150f1 -r • "�, rALA, ". DI9CUIMER: TM1is,Eay ls-nol gudrenlEW lra z �'MT.' X.Z. u0rtvtil G.HIFI•.1. Cr ,mbkB and :AIN:IUBW'IS O'd\V18(fl IBC !E9IJOIV.Wbi1KY OI VIO uSC' h4✓ ., _ 1-1 v-f-4W 5(2 VC-1 Vrr !� a ---„ )/, � { 'A' !/r -� if u-C �/r � Y-u 7/f ti Y•! �fc-i s �/f -a Se # 20d'1QTraw tarcaft Red 720 237 OE TOWN S COUNTRY 700 ROW TO US[ 8DI DETA&S' C208-11� � Parcel* 016-1017-70-000 04IM007 04:29 PM PAGE 1 OF 1 AIL Parcel #: 8.30.15.1408 016 - TOWN OF GLENWOOD Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s)I G = Current Owner, C = Cjaen: Co -Owner 0 - OBERMUELLER, RICHARD A 8 GRACE M RICHARD A 8 GRACE M OBERMUELLER 2885 160TH AVE GLENWOOD CITY WI 54013 Districts: SC = School SP - Special Type Dist# Description SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: R15W S 544.5' OF W 400' OF SE SE SACRE Pro Address(es): '= Primary 3 160TH AVE I 2g�b �{�uc�e ul ativ �-Z oQ� 5,000 1 Plat: WA -NOT AVAILABLE Slock/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 0830N-15W Notes: Parcel Hlstory: Date Doc # Voupage Type I 08/22/2002 687703 1954126 WD 2007 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/26/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 10,000 0 10.000 NO j AGRICULTURAL G4 3A00 400 0 400 NO Totals for 2007: General Property 5.000 10,400 0 10,400 Woodland 0.000 0 0 Totals for 2006: General Property 5 000 10,400 0 10,400 Woodland 0 000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: 223 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charge Total Parcel #: 016-1017-60-000 007 04105 2 PAGE I of Alt. Parcel><: 8.30.15.740A 016 - TOWN OF GLENWOOD ST. CROIX COUNTY, WISCONSIN Current X Creation Date Historical Date Map N Sales Area Application 0 Permit N Permit Type 00 0 Tax Address: Owner(S): O = Cowen, Owner, C = Current Co -Owner 0 - OBERMUELLER, RICHARD A 8 GRACE M RICHARD A & GRACE M OBERMUELLER 2885 160TH AVE GLENWOOD CITY WI 54013 Districts: SC = School SP = Spec+& Property Address(ea): ' = Pnmary Type Dist N Description SC 2198 GLENWOOD CITY SP 1700 WITC i Legal Description: Acres: 35.000 Plat: N/A -NOT AVAILABLE SEC 8 T30N R15W SE SE EXC S 544.5' OF W Slock/Condo Bldg: 400' 35 ACRES Tract(s): (Sec-Twn-Rng 401/4 160114) 08-30N-15W Notes: Parcel History: Date Doc # VoUPage Type 07/23/1997 9931379 WD 2007 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/26/2006 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 34,000 3,900 0 3,900 NO UNDEVELOPED G5 1000 100 0 100 NO Totals for 2007: General Property 35000 4,000 0 4,000 Woodland 0.000 0 0 Totals for 2006: General Property 35 000 4,000 0 4,000 Woodland 0000 0 0 Lottery Credit: Claim count: o Certification Date: Batch N: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charggeess Total 0.00 g00 0.00 ST. CROIX COUNTY SEPTIC PANIC MAINTENANCE AGREEMEN AND OWNERSHIP CERTIFICATION FORIM Owner/Buyer tom. a.n; e l t- ibb, m aj i Mailing Address G05 /te24 / der 61ea�jcod Ci'6 i 1 � 3 _0- _ Property Address _c;7 n 0 i (ct D ii)- /iSe (V en6cation requited from Plarmine for new construction) IA City/State ('i enw nr C l�ts� Parcel Identification Numbcr Nto-1_61-7-70-bDc) !_ LEGAL DESCRIPTION V-t H.l- -k'+�f �v t+, 5 1. -.,,> k Property Location 6t 'A, .�� iy , Sec. �-, i 2�- N R 1� w; Tomm of Subdivision Certified Survey Map # Volume , Page It Warranty Deed # . _ . �, �----.___—,-�.-----__, Volume Page tl Spec house 41es no Lot lines identifiable Gi) no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Lot 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 aeeded, by a licensed pumper. What you put ntto the system can affect the functioYn of the septic tank as a treatment stage in the waste disposal system Owner maintenance responsibilities art specifted in yCU. tin S; 52111 and in C'napter 12 St. Croix Courry Sanita,v Oreinan-�e The property owner agrees to submit to St. Croix Comity Planning & Zoning Department a cernfrcattoo fort, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposes 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. ]/we, 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 Depailvient of Commerce and the Department of Natural Resources, State of Wiscousnl. Certification stating that your septic system has been maintamed must be eompietcd and returned io thr 51 C mLx Coumv PWrairig X 7.oning Department within 30 days of the three year expiration date Uwe certify that all statements on this form are true to the best of my/our knowledge, U'we amlare the ownei(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms �!) SIGNATURE OF APPLICANT(S) DATE `"'Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zomug Department Include with this application a recorded warranty deed from the Register of Deeds OtTice and a cupy of the certified survey map if reference is made in the warranty deed. (REV.68W GLENWOOD 1««4 T 30 N.-R. 15 W 49 E - _ v� �L:; �. '- J¢.;,cs ✓en.{a �' � G • � � ,^e • �'S doer .r> vz H./io3 y ° � NP i. c ,S 1•C a �a S f'P � � ^ �7 a V 4 Po a Sf1Y Niche °J\ lL� /n. />d A i Ken cube. /S> . F J f L/Icr • .h6.rod E g B >.s S° B S f pp "/pHN STA.Ucn /OJs L U N Sfoo.f 221r v'9 'r F Den; • O x/zE �yc4 a ? d9 "P'9r' ° � y C \ o /•9 en �ronb Jams 6 h Edw wn /IB dv ro t" Jamrs S onnon H / �' i5/ons6,f. ` � \^ A?o,./ 7 d C Wamer � /ev � \ d ev • ro Ba Dana/ 5 anc FG/ad s vcw ev CAA 7vo -"If; / • \'� C-P • , < Ma es � � • P /ss by And<.wn, Y> f.° • -,, Bd �� a C n �E V _ Fd c ; Lin 4 X /✓.//.om r • • � WC � • H bcryf ca Pa'y � L<onvi E`T = O 3e l7e//A2/` fp j® \y u Y • U \ .5$3., ,Qose Lu.ftS Jm.//i "\ o '1 TiJ/i/G /f4 sow Go s<qr n C n <d aiK sNa�e � tl\U >v ,e /> /✓/// E'b�z ° ui< LoERALD �. SK i 71.If � /8 EST lz?< �r wtic. rv.° •Lv w � °Qi� + nim° . �vc<sf E :f E✓cncf° o oc2 TON do V � . M Idn c. <' <Y� cir r. ,ss/ v^ >,zv c9nnc s izo tip0 / i'9u M �•C e Cv / v dr •Po6<ify• H / f v�>Lrd <o _ YWi Sch.> 9 < w n . C s Fho/m yv$ By o/<>✓c c>L,r, ]s .Qobcrf IJJ/z�./<,- 8o s �� t^�y N''j.TM /> SC ISfo�< Q�3�. Rl0 „E��• /9SJ L✓¢ mnn /91 B r;o 4'/ SQn y �•a� • b P 'C c' G h i�?I n^ zv Y T/FFP�/'�. ': C3LEN YV�O�D CITY 5 Y< ` • � h u Y yq � c�.. a n u C n <e�� •o. ��. ` __ r ° � rn« `• a{„x ..� ��ta YWh �\° c�� ��� iF .v,>d s • yN4 v1Q • 26 eo Y • G,ris{C L�<r_ 1 N N 0 f himLc' e% 0 6.L.//m sc/i I o�j 04 y V b Y dQ /u5 /SO /l0 �� �� \ " 6 �! `f 9s . //oP,,, `y� � ^JcP �ww °l.4) ,J 6° IO• ' _ - „� ' C d 1 OWNING , ,Tc f .6 ue'e • Ku/ea J �•- Mahe/ lO T✓ ed • Norse/ /7vnv/4 v0 ,f-vnd</' t9 es so F eb..y ez�_' � .e t 6/�c/< JZ%/reJ lu aural>Sa ✓oa v •Da �,d a..m H S Y 6vofh �r{s Bo°fh, 9/6 fx4 A' •Hnn �"��,� . tm. Lbn f Go%/ D°P ,a fo i.TB w d ed Thom zco ; t K jo.�• fe/d ,6 gip �� h'vwvv' EC ,.Pobert f e o." h sBr n 966,c - E.• F*a �� /z.o � pp0 >B />re� tl Q•C cn�;6y`e» ;C s fv°n 'o Y u.�l �bcrta � dn+o �C W s N u itl0 Ou; • 2 \ �• c®e.cr/yy f 4 '9 a F rl & � My 1 s ``0 ♦ � son yh Co.sf� B° u zzb DO .Tc, ev.v>4 By •,Pchrva]d{ _ , 4'o ®/9ls �ieijb^7 P SEE PAGE GLENWOOD Lundeen L£ON LEE'S CITY AUTO Co. Frame & BERENSCHOT DRUG STORE Body Shop INSURANCE Glenwood City, Wisconsin 0 AGENCY INSURANCE & LOANS Congratulations to PHONE: 265-4877 GLENWOOD CITY the4-H GLENWOOD CITY 54013 PHONE:265.4080 Program WISCONSIN GLENWOOD CITY 54013 i wleoartsM DWsronax of Commerce SOIL EVALUATION REPORT page / of F l n aemda+ra with Comm 85. Wrs. Pdm Code Aeegt odwptep Me PW on pWm net 1easNwn 6IM x t t mches In size. Plan must edude. WR not kyWed to: vertical end horizontal reference pant (BM), direction and peroW slope, scale of dimens,ons, morn+arrow, and location and distance lc nearest road. please print al! lnfornrotlon. PWW^W Pm.'eamay MeaaaM ery--"jpMeglew. (1)(mp. County Paroet /�/ 7 0 . s L7 1w _ R cwad ty Date �7 �/ / powtY Dew . P Location Goon t�la1.5 �� 114 /y�l4S TJDN R E( PAp«tr—Walling Adds 4�. Loi Bbdc . . Name a 6 /G7LPr IPtwta Nyadler VilNge Nearest 9-0 901 ❑ New Use. evdeNWl / Nunba of bedrooms ._y„z.___ Code ciedved design sow refs _ � tl GIRD R,,08M"ent ❑ P or Parent masnal �Q� �t �_ Flood PIS elevation if WPkG" b. newel ooWnerds and Mwomrmndabonw BOf49 BafYp Pit Ground euAara Nev R. Depth to frn" fades _ n. Spy ApffiC20MRole Hoc mn DepM in. Dominant Color Muuel Redox DescrOon 0u. Sz. Cont. Color Texexa Seucluro Gr. Sz. SR Consistence Bourday Rode Gppff 'E}b'1 'Etla2 Zd iy/l y i 3 J Rarlrm s' ❑ Bong Pit Ground surface elev. 4AZ/ G7 -n DaPth to NmitM fade _ m Soo Rate Hwimn Depth in. Dwwwrt Com Mtnsel Redox Deeafpeon Ott Sz. Cori Color Tedure Sttvcwre Gr. Sz Sh. Catalslatoe BourderY Roots GpC& •Effa1 'Etfa2 �— G ' J aEfflLwo • EfhwA a1 • 800 > 30: 220 mpt and TSS s30 150 = BW < 30 rngk and TSS c 30 MkA CQT Hsea Plsssa pone) CST NL~ Bird Plumbing, Inc. Shaun Bird 226900 Address ✓ are Eva22uat=on CondlRled Teiepnone Numoer 1008 192nd Ave, New Richmond, WI 54017 — 7z 715-246-4516 F- Pmpany Ovetar Parcel ID # Pago pia • ..© ri■r��©��r...���■yam®s�� ■■■■■■■■■■■■■■■■ EIII #1 . BOD > 30 < 220 nVL end TSS >30 < 150 myL . Ef jwA 92 - BODE < 30 myL and TSS < 30 mp4 The Departzmt of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or teed material in an alternate forma; please contact the department at 608-266-3151 or TTY 608-264-8777. ssawupsuot Soil Test Plot Plan Project Name Richard Obermueller Shau Vrd Address 2885 160th Ave Glenwood City Wi 54013 CFFM #226900 Lot ----- Subdivision ....... Date 6/27/03 SE 114 SE 1/4S 8 T 30 N/R15 W Township Glenwood Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 1 /2" Pip System Elevation AT -Grade •HRpSame as Benchmark Alt. BM Top of 1/2" Pipe @ 99.6' Alt u 25 c ..7 C B-1I 0 c 60 N M 10% 25 40 150' 17 B-2 Ot' i 3' 105' 100' Id Scale is 1" = 40' unless otherwise noted Old Hous (not Fhabitable) Well _ 15' 1320' Property Line C 500'� ♦I r 3 V1 -i- 0 Property Owner Parcel ID # Page —of ❑ Boring �_ Burin # �[' g F2 Pit Ground surface elev. t ft. Depth to limiting factor � in. Sal I'�tion Rate Horizon Depth in. Dominant Color Redox Description Qu. Sz. Cont. Color Texture Structure Gr Sz Sh Consistence Boundary Roots GPDM 'ER#1 'Eff#2 ,}Munsell 2> Ll 1-1Bodng # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDM 'Eff#1 'Eff#2 Boring ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. ' Soil Aoalication Rate Horizon Depth in. Dominant Color Munsell Redox Description. Qu. SL Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDM 'Eff#1 'Eft#2 Effluent #1 = BOD_ > 30 < 220 mglL and TSS >30 < 150 mg1L ' Effluent #2 = BOD, 130 mglL and TSS < 30 nVIL 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. Ben-8130 (R 6A07 Jw I (?� ° Wisconsin Department of Commerce SOIL EVALUATION REPORT Page / of Division of Safety and Buildings in accordance with Comm 85, Wis Adm Code / r County Attach complete site plan on paper not less than 8 112 x 11 Inches in size Plan must include, but rat limited to vertical and horizontal reference point (BM), direction and Parcel I �� , S percent slope, scale or dimensions, north arrow, and location and distance to nearest road B AN 7 Please print all information. R Cewed by Date Personal information you provee may "used fw sekcrdaryeytposss(Prtvacy Lew,.s_15,Qg(1)(m)) L e /` i i 1�� j`p I f �f.-� ✓ GOA o1,5 1 /4-f/�114 S T </ n1 O N R J E (o Property �wner's Mailing Add r u „ .., �_! Lot Block # Sut4 Name or CSM# - City / State Zip,, //Code Phone Number ity J���jjjJJJ Village can NeareesttRRoa� 6le/! I/,i)l 1�7't%i�1757 4S-4 i7 ❑ 6'(, P, I I-/xTr �2 1 ❑ New Contra Use esidential / Number of bedrooms Code derived design flow rate ��J b GPD Replacement ❑ Publi or corrV/�/q� I - Describe: Parent material Flood Plain elevator if applicable �'�//7- it General comments and recommendations C a e! S4 �- - 4Son / 4-� Boring # j�( Boring Y %J /iAA pit Ground surface elev _V � Z It Depth to limiting factor in � Shc lication Rate Horizon Depth Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr Sz. Sh.'Eff#1 Roots GPD/ffin. •Ef1#2 17 AConsjsten�Boundary f9iLl Boring # ❑ Boring Pit Ground surface elev Lzl/—Z-ft Depth to limiting factor in Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sin Consistence Boundary Roots GPD/ff 'Eff#1 •Eff#2 ` - /, /6 Effluent #1 = SOD > 30 < 220 mg/L and TSS >30 < 150 ' Effluent #2 = BCD < 30 mg1L and TSS < 30 mg& CST Name (Please Print) lure CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address &11 ale Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 --C2 'OZ 715-246-4516 4. Property Owner Parcel ID # Page of Bon nng � #T261t Ground surface elev. � ft. Depth to limiting factor in. Sal —Application Rate Hodzon Depth in. Dominant Color Munsell Redox Description Qu Sz Cont.Cdor Texture Structure Gr Sz Sh Consistence Boundary Roots GPDIff 'Eff#1 'Eff#2 J ❑ Boring # ❑ Boring ❑ pit Ground surface elev. ft Depth to limiting factor in. Soil Applicaifion Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu Sz. Cont. Color Texture Structure Gr. Sz Sh. Consistence Boundary Roots GPDM 'Eff#1 I 'Eff#2 Boring ❑ Boring # Ground surface elev ft. Depth to limiting factor in ❑ Soil Applicabon Rate Horizon Depth in. Dominant Cola Munsell Redox Description. Qu Sz. Cont. Colo Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIff 'Eff#1 'Eff#2 ' Effluent #1 = BOD > 30 < 220 mg(L and TSS >30 < 150 mgrL ' Effluent #2 = BOD, < 30 mg1L and TSS < 30 mg1 The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need matenal in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. saru330(F6 ) Soil Test Plot Plan r1rd Project Name Richard Obermueller Shau Address 2885 160th Ave Glenwood City Wi 54013 C8YM #226900 Lot ----- Subdivision ------- Date 6/27/03 SE 1/4 SE 1/4S 8 T 30 N/R15 w Township Glenwood ❑ Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 1/2" Pip System Elevation AT -Grade *HRpSame as Benchmark Alt. BM Top of 1/2" Pipe @ 99.6' Scale is 1" = 40' ' unless otherwise noted Old House (not habitable) 151 ' Well 15'. 10' „ 25 .a B-1 I c. 0 f 0 60 N M 10% 25' !' O1' 103' 105' 100' 1320' Property Line ♦ _ ( 500 Parcel #: 016-1017-70-000 04i05r2007 04 29 PM PAGE 1 OF 1 Alt. Parcel #: 8.30 15.140E 016 - TOWN OF GLENWOOD Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - OBERMUELLER, RICHARD A & GRACE M RICHARD A & GRACE M OBERMUELLER 2885 160TH AVE GLENWOOD CITY WI 54013 Districts: SC = School SP = Special Prope Address(es): ' = Primary Type Dist # Description 73 160TH AVE SC 1700 GLENWOOD CITY SP 1700 WITC z VA 2g0 / L(�l r 7y , -L G-00 C�(/ (�(I%4'T�ND,I/� Legal Description: Acres: 5 000 Plat: N/A -NOT AVAILABLE R15W S 544 5' OF W 400' OF SE CRES� Block/Condo Bldg: SE 5�A33QQ�� Tract(s): (Sec-Twn-Rng 401/4 1601/4) 08-30N-15W Notes: Parcel History: Date Doc # Vol/Page Type 08/22/2002 687703 1954126 WD 2007 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/26/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2000 10,000 0 10,000 NO AGRICULTURAL G4 3.000 400 0 400 NO Totals for 2007: General Property 5.000 10,400 0 10,400 Woodland 0.000 0 0 Totals for 2006: General Property 5 000 10,400 0 10,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: 223 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 000 0.00 000 Parcel #: 016-1017-60-000 04/05/2007 04 28 PM PAGE 1 OF 1 Alt. Parcel #: 8 30 15 140A 016 - TOWN OF GLENWOOD Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - OBERMUELLER, RICHARD A & GRACE M RICHARD A & GRACE M OBERMUELLER 2885 160TH AVE GLENWOOD CITY WI 54013 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 35.000 Plat: N/A -NOT AVAILABLE SEC 8 T30N R15W SE SE EXC S 544 5' OF W Block/Condo Bldg: 400' 35 ACRES Tractl (Sec-Twn-Rng 40 1/4 160 1/4) 08-30N-15W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 993/379 WD 2007 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/2612006 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 34.000 3,900 0 3,900 NO UNDEVELOPED G5 1.000 100 0 100 NO Totals for 2007: General Property 35 000 4,000 0 4,000 Woodland 0 000 0 0 Totals for 2006. General Property 35 000 4,000 0 4,000 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 000 0.00 000