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HomeMy WebLinkAbout034-1066-80-000 /* Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Buildings Division St. Croix INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). 383821 Permit Holder's Name: ❑ City ❑ Village ❑ wn of: State Plan ID No.: Smith, Harry Springfield Township CST BM Elev.:- Insp. BM Elev.: BM Description: wQc / Parcel Tax No.: V < r P 034 - 1066 -80 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic r `V J v Benchmark d /0( Y6 �� Dosing S Alt. BM 3, Y-!;— , 0 Bldg. Sewer ing lJ Ht Inlet �a 3. 7 TANK SETBACK INFORMATION t ut et TANKTO P/L WELL BLDG. Airi to ntake ROAD Bt Air I Septic >�Q' �f Z Z� NA Dt Bottom 1,09 Z rl [2 -5� Dosing > ) r� l Y ap NA Header /Man. 3- 3 __— NA Dist. Pipe Ho Bot. System 3 ' g PUMP/ SIPHON INFORMATION y S F' al Grade Manufacturer /� s Demand St cover Model Number Fl�, S P ffPM N �, TDH Lift q t Friction S Syste Z DH - 4 . ZFt 2, s� Qd oss Forcemain Length } 7 0 1 Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width length No. Of Trenches P No. Of Pits Inside Dia. Liquid Depth D IMENSIONS 15 -0 DIM SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM L G acturer: INFORMATION Type O CRAM um er: System: >30� �3/ IT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Z Length Dia. r, Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only De th Over De th Over xx Depth Of xx Seeded/ Sodded xx Mulc Top ❑Yes ❑ No ❑Yes hed ❑ No P P Bed /Trench Center Bed /Trench Edges p COMMENTS: (Include code discrepancies, persons present, etc.) 9S " 7S Inspection #1: I / I0 � b L Inspection #2: 7 / 1d Location: 771 270th Street, Wilson, I 54027 (SW 1/4 NW 1/4 30 T29N R15W) - 302915456B 1.) Alt BM Description ='J 4t>j it ( ik 3s 2.) Bldg sewer length = Z P . - amount of cover =1 3.) contour = q. f 0 G6 U/�a�; f Plan revision required? ❑ Yes P No Use other side for additional inform tion. SBD -6710 (R.3197) Dat ­inspector's Sig re Cert. No. �. � • '� N ,. �;,;' _. �_ ., - _ -- =�- . _ _ _ 0 t.. <. �'� `� �� ,, '� - . .. - .. � ��, � � I `°�� �, -, �,�, �� Sanitary Permit Application i S ac W. dh C.� =vA ZOS W, Wash)naton Ae•t !naccord.4•tn(=omr..63 ,, Aden Code P4 Box 73 , 02 Wis QnSln See reverse s,dc f.^: ,cstructrons for :3rrp:at:rj& this appucauon MadFson. Wi S3''t"•73C p�p�rtrinMt nt Commerce [Pr. informsitior ) o, ; provide mat br used for recondsr> purposes (Surma co m pleted form to eouiuy if r [Pri vaey LVA . s 15 .04 ;1)(m)l State owne. Attbch sn letC !ails it0 the tOU�tt' Co arliv br t g syste stn i er not 1es5 than $° l' i i inches in 1199- Cw* Stale 5er► it Number check , revision to pnvtous spptirat 4r e N s I. V. Numbe � t t t3 d - P t• t % fig., ame erh n � "OWlll ti a l��4. l� ; `f ti R� r M&114 Address; log trrnber R de one ,, br ubdivtsian Newts or M Number WSW 1 ' SG�Al u1 �' d9- GSA l/o� H Type of 341dln�: (exec one) 9-S sW� _ 0 Vil 0 1 or 2 Family DwuliiMS — No. of Bedrooms: ��� �� of 0 Pubt{olCarooetaial {delcriIs s use): 8 1U Type o tr�amlits ( heck only one ox on ine A. Chock ox on l e B f applies ie) N gr t Ra.a 9 7D ?/ S A) i. 04w Sysi m 2. Q Rol'aaement 3. 0 Replacement of 4. 0 Addition to area ax um er(s) 11111199 Adam" SY9 am T k OM i is S :sued �) C A Permit wts oreviously WW 0 3 I o 4 (. - -go - & 30. 45 a IV. Type o WT i9y�ternt halt all , *d d 9-p ) C A-- W © Non- preawriz d tn•5round q' X �' C Mound D sand Filter 0 Conswoted Wetland Q Pnllutieed a Holding Tank O 5in5le Pus 0 Drip Line 0 At.Snde k 0 Aero ie Treattne t Ir,i: O Recireulatlna 0 Other: t^,, 2.2 26 • ' S V Dj#gjUAj2wtM at 602 Ijbirmi Mo st: w Area A. $oil App uuuon ergo ion ysam vation 7. Fir ode R%wimd P"Ofod Rate tGall.tdsyisq . ft.) ; (Mfndlach) ; Elevation VI Task Capacity in Total *of Manufacwrer Site tal Fiber- Plum Irtot'tasatloa io oallons Tanks I Can• Con- Qia:l1 ; Existin crew strusted � ; T Tanks t VU 6{l�ty Stiww"t 1!1111101qt�J Per insi 1 tion of the POWTS sh o p thl ache 2 1404 . 1 Now w" 1 inswr� tno stamp!): a us nee Numb t:SK City, am, Zip off Vila Cotptp►/Depe "Mont U" only Dislipp aaitarY P&M he oncludas roe water va t# iss :: ants AWNS tprteture o trantpsi %Approval 0 Oww a[ven Inttlal Adveru 3 rr a S. Fee) fiat (3v ' — l -Z�sao <, fX. Coaditiow of Approvei Mason for Dlupproval: �� C Px, WOE s t a-, Lot&— . `1 IiND4398 (R 07 0Q) Safety and Buildings PO BOX 7162 MADISON WI 53707 -7162 - TDD #: (608) 264 -8777 *isconsin www.commerce.state.wi.us /SB Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary October 18, 2000 CUST ID No.691727 ATTN.• POWTS INSPECTOR ARTHUR L WEGERER N2 1 � - kONING OFFICE 421 N MAIN ST ROIX COUNTY SPIA - PO BOX 74 .�► 1101CARMICHAEL RD RIVER FALLS WI 54022 � RfiCElVEO HUDSON WI 54016 RE: CONDITIONAL APPROVAL - � + 2000 - . 0 L. T 2 Identification Numbers PLAN APPROVAL EXPIRES: 10/18/ �, S1 CROlX 'transaction ID No. 442558 il>ATY "'bite ID No. 200326 h� r, Please refer to both identification numbers, SITE: Site ID: 200326, MATT SMITH above,;in all correspondence with the agency, ST CROIX County, Town of SPRINGFIELD; 27tTTft'f SW1 /4, NW1 /4, S30, T29N, R15W FOR: Description: DWELLING / MOUND 450 GPD Object Type: POWT System Regulated Object ID No.: 766223 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Since ely, ^ DATE RECEIVED 10/04/2000 FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 ES B QUINLAN , POWTS PLAN REVIEWER BALANCE DUE $ 0.00 Integrated Services (608)266-3937, 7:00 AM 3:30 PM MON / FRI JQUINLAN@COMMERCE.STATE.WI.US cc: MATT SMITH I Safety and Buildings PO BOX 7162 MADISON WI 53707 -7162 - - TDD #: (608) 264 -8777 hsconsin www.�mmerce.state.wi.us /SB Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary October 18, 2000 CUST ID No.691727 ATTN: POWTS INSPECTOR ARTHUR L WEGERER 12 1L4G OFFICE 421 N MAIN ST COUNTY SPIA - PO BOX 74 4101 ICHAEL RD RIVER FALLS WI 54022 1 �i ; rr�JpSO`I@I 54016 RE: CONDITIONAL APPROVAL � ir� ` �• ti T �, , Identification Numbers , _ PLAN APPROVAL EXPIRES: 10/18/2002 ``,.�. '; ST CRO�X po T ction ID No. 442558 t -�, z �'� U OFFICS II No. 200326 SITE: r� efer to both identification numbers, ' ove, in all correspondence with the agency. Site ID: 200326, MATT SMITH ST CROIX County, Town of SPRINGFIELD; 270TH SW1 /4, NW1 /4, S30, T29N, R15W FOR: Description: DWELLING / MOUND 450 GPD Object Type: POWT System Regulated Object ID No.: 766223 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, DATE RECEIVED 10/04/2000 FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 MES B QUINLAN , POWTS PLAN REVIEWER BALANCE DUE $ 0.00 Integrated Services (608)266-3937, 7:00 AM 3:30 PM MON / FRI JQUINLAN @COMMERCE.STATE.WI.US W SMART 0odC :,'Z633 cc: MATT SMITH TITLE SHEET Page` of - 1 FOUND SYSTEM RECEIVED A 3 BEDROOM RESIDENCE ���� This plan has been prepared in accordance with the Mound Compon DIV. Manual SBD- 10572 -P and the Pressure Distribution Manual SBD- 10573 -P C \Z-. b C z- 6 /9 q LOCATED IN THE SW 1/4 OF THE M W 1/4 OF SECTION 3D ) T.. Z-CI N, R IS W, TOWN OF 6 ST- COUNTY, WISCONSIN. INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEM MANAGEMENT PLAN PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW -CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUILIPING CHAMBER CROSS SECTION PAGE 7 of 7 PUMP PERFORMANCE CURVE PREPARED FOR 619 _- kj I LSO K3 t 1.t11 S_q d L7 PREPARED BY WaCCEFtER !0 C3 I L . TEST I NG AND . DES I G!V S�F�V 2 CE P.O. Box 74 421 N.Main St. a�� ®�od.C()aj River Falls, WI 54022 �.� ~�`s� s Phone 715 - 425 -0165 e `' Fax 715 - 425 -6864 • AgTh Up • WFGERER D.915 P CiUVVORTH, i Wt$, 'L'R j G - � Y c / rt � 7� J tIY N7tiu (lLliNGS E Gpf-�;E�;pCNCEIVCE JOB NO. CO - Z--)2 Mound System Management Plan Page Z of Pursuant to Comm 83.54, Wis. Adm. Code Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. Theo erating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. Th o tlet fil shall be cleaned as necessary to e nsure proper oo eratao The filter cartridge should not be removed unless provisions are made to retain solids in the ank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of � the tank. If the contents of the tank are not removed at the time of a triennial assessment main tenance P ersonnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October - February) dictate that the mound be heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg /L BOD5, 150 mg /L TSS, and 30 mg /L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manual [SBD- 10572 -P (R. 6/99)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. • Continciency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions on the operation or maintenance of this system should be directed to the County Zoning office at - 7[5- - 596- Q 80 or to the licensed plumber who installed the system. - / PLOT PLAN Scale 1 " =3p ' Page 3 of 7 LOT LWtz- \56•ZS tf j - - LVO.b' O►;3 lh�t LS " UV� 6RZiStx� =D �ou w 1 eZ YNT Llcyt - s r SO' FizuWr M Wjw R o J woobZ:) 0 J '7 I t'z.. C 4.2 9 \- qS'o 2tic F_ w1_ O �6� PV N N -SME ril CT' N N 3 a A 0 b�Z I tS6 _Z.S' DoT Ll)Q L NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observa ion pipes with approved caps. ( Z required). 3. Septic tank to be ou1,�lb So gallon opacity manufactured by 4. Bench mark S S = ►°g _ --- S. Divert surface water around system to prevent ponding at the uphill side. Page 4 Of Approved Synthetic Covering ASTM C33 Distribution Pipe Medium Sand G �! Topsoil 3 E p � - u i „ b 6.% Slope Distribution Cell of Force Main Flowed 2" to 2 Aggregate From Pump Layer D Z• Z Ft. E �-- - )`I Ft. CROSS SECTION OF A MOUND SYSTEM F O• $ Ft. G n 5 Ft. A 9 Ft. N Ft. Linear Loading Rate = G• () GPD /LN FT B SO Ft. Design Loading Rate= o- 3 1GPD /SQ FT j l 5 Ft. Ft. K tI Ft. L Ft. W 3 Ft. .. L - Observation Pipe g � K o- -�-- -- - - - - - - -- ------- - - - - -- o --- - -- �6 B Farce Main o ---- -- -------------------- - -�,Zg �fi I 1 7 -- == L $ � Dist?,to 2 % " Cell of 2 2 aggregate Observaope (Anchbr securely) r - PLAN VIEW OF A MOUND SYSTEM ` Distribution Pipe Layout Page 5 of Place the holes at the bottom of the distribution pipes at equal spacing. Remove all burrs from the pipe and holes. Extend the end of each lateral up with the use of long turn or 45 fitting to a point within six inches of the final grade. Terminate the ends of the laterals with a valve,:threaded cap or . threaded plug. Provide access from final grade for the valve, threaded cap or threaded plug. - T `t P 1 CI) L .. Z; Z ps s PVC F\1C PVC Lateral Manifold Lateral X x x x x12 x2 x x x x Lateral Lenoth — Lateral Length — p Distribution Line IT — —o hYS�1Po� S • PVC �oQ� n� _ i o —_ 1roA �tii P Z y Ft. Hole Diameter J/6 Inch S 3 Ft. Lateral n 1 Inches) X Z Inches Manifold " Z Inches Force Main " Z Inches # of holes/pipe-l- Invert Elevation of- Laterals 9 a - Ft. `�. x O. 1 4 1 = S. 33x 6 = 3L. °r Gp" _ Combination Septic; Tank and PUMP CHAMBER CROSS SECTIOM AMD SPECIFICATIONS ' PAGE OF 7 -VEtJT CAP ` WEATHER P9001r JUIJCTIOIJ BOX . -1 VE1JT PIPC APPROVED LOCKIPJG 1 10' FROM DOOR, 7MkQHOLE COVER wt'M .hUDOW OR FRESH wAptJlsJG LAgEC.- u�,sP P In ALiz IIJTAKE J cor�Cutr wlNftV' Wr GtQ t �- �.� # 6"••w. j i 'iMILI. + -� tAl LE T 'PROVIDE I ' �• AIRTIGKT SEAL Approved zt�s�. u� i j I APProved joint w/ I II I joint w/ pipe II PVC ALARM PVC pipe 'I is I t • . I i Ou C LLEV. — 8—,S F T. PUMP —� __J OFF 0 CONCRETE aLOCK ' 1 RISER EXIT PERMITTED OULy IF TAWK MAIJUFACTURER HA U DD: NQ S SUCH APPROVAL �D aEpC) t SEPTIC F SPECIFICATIOUS DOSE TA MALIUFACTURER: Y�'11 1�` f2lV P1Z�A ►DUMBER OF DOSES: 4 _ l s PE R DAB TAWK SIZE. 1. OC)O /(-3:s<) &ALLOWS DOSE VOLUME Z ALARM MAIJUFACTURER: S S `���ZO S�s`Tt 1 3 IMCLUDIU 6ACKFLOW: lOZ GALLONS MODEL WUMBER: ID Nw � CAPACITIES: A= Z I OR 3S GALLOU5 SWITCH TYPE: iz ( 8 = 11JCHES'OR 3 V G( LLOA15 PUMP PXAWUFACTURER: __ GAL L-I)S C= 6 I & KHES OR 0 Z GALLONS MODEL 1JUMBER: 3 I - APO S • D= G IAtCHES OR 1 S 3 GALLOIJS SWITCH TYPE: � u OTE: PUMP AUD ALA AR TO DC MIMIMUM DISCKARGE RATE 3 L - q 13 GFM INSTALLED OA] SEPARATE CIRCUITS VERTICAL DIFFERENCE DETWEEID PUMP OFF AIJD..DISTR►BUTIOIJ PIPE.. FEET + MIIJIMUM METWORK SUPPLY PRESSURE . , , 6'- -S FEET + �AS FEET OF FORCE MAIM X 2' 19 F o fLFRIC71oN FACTOR.. ` q FEET TOTAL MAJAMIC. HEAD = I $' 1 9 FEET As per manufacturer 1 3S'` p gal /in. Liquid depth . I ' • 'rti5' p�R..Fp R.�'t f � Ct_. Gv�.V �. � E � c -,_ � ' r Goulds Submersible Effluent Pump 3871 EPO4 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. Effluent dry without damage to heat transfer. ■ Motor Cover: Thermo las- • Homes systems components. tic cover with integral handle Available for automatic and Farms Motor: � and float switch attachment • EPO4 Single phase: 0.4 HP, manual operation. Automatic • Heavy duty sump 115 or 230 Vp60 Hz, 1550 models include Mechanical Points. • Water transfer RPM, built in overload with Float Switch assembled and ■ Power Cable: Severe duty • Dewatering automatic reset. preset at the factory. rated oil and water resistant. • EP05 Single phase: 0.5 HP, ■ Bearings: Upper and lower SPECIFICATIONS 115 V, 60 Hz, 1550 RPM, FEATURES heavy duty ball bearing Pump: EPO4 built in overload with construction. ■ EPO4 Impeller: Thermo- • Solids handling capability: automatic reset. plastic Semi -open design AGENCY LISTING 1 /4" maximum. • Power cord: 10 foot with pump out vanes for Capacities: up to 55 GPM. standard length, 16/3 SJTO p 0 Canadian Standards Association with three r mechanical seal protection. otal heads: up to 24 feet. prong grounding ■ EP05 Impeller: Thermo- ` Discharge size: 1 1 /2" NPT. plug. Optional 20 foot plastic enclosed design for (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with improved performance. end in " F" or "AC ".) rotary/ceramic- stationary, three prong grounding plug BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 I • Capable of running + dry without damage to s 30 I I >5 GPM components. Pump: EP05 $ • Solids handling capability: c 25 3 /4 " maximum. w I • Capacities: up to 60 GPM. 6 20 I j • Total heads: up to 31 feet. 2 l 8.'t • Discharge size: 1'/2" NPT. z 5 • Mechanical seal: carbon- >. rotary/ceramic- stationary, a 4- 15 BUNA -N elastomers. EPOS; • Temperature: ° 3 10 104 °F 40 °C continuous I i 140 °F_(60 0 C) intermittent. 2 EPoa. I 5 OL 1 0 10 20 30 40 50 GPM 0 2 4 6 8 10 12 ml/h CAPACITY ©1995 Goulds Pumps, Inc. _ Fffpcfivp MAV Iao5 FROM Schumdk =_r• Piumbi PH 1X MO, 7153853121 Sep. 19 2000 38:43AM P1 pws�tirhi sarrrw+d�tAtMa+ ►►Law. — . 1b.0_ ( " m (fir to r„i t11 �sK/11d T N R E Wye Me L01* i► rronre a � � � �� qpi �AAa9e Tevw► f�7rvOtl� �NswCaalru� u�eea��a�id�nwarhrr�ar�atb�ecm. ....3.--- ceevd�t�adwianliarr�rs `ar° 1 Few mo(ww 3,,! _� Leoaa+ai!+oI ationif _.. ce"Wo aan„r,rt, ( oy} G r! /'" ar,r waa+urra�aade►� SYr.�c �1 a J. q g , Mp 0 0r - zYw �' rtcl� Sao i p.pa, onnamont R„dac T wuom croske9w so tav Roads UM all t �.. 2 I ► - 5i1 r,�bb ft FOB c�xa Radm naaa:l,ann TO*M ti. elan r c�onr Horizon ;m, Nosmaa ck,. ft, Omt dolor cr. sn. +Elirz r 2 5•a .o ry —„ .$ • went �(n = sW ' 3o a ago wVL and Sss *� a t5o t rx Mama ( ftradl ►1nq �'g►�1�"° �- '` Vic �' cn car p P ,++ CJ�_%F. � ..tiC• `;, lam' .• _ EWA;Ii1R�8 CeFldt1Clat1 TalaQhone �* Id Wd98:e.f3 eam to ''fib" 'DN S 7 1:01:L Vftconw Department of Commerce SOIL EVALUATION REPORT Page I of . DWW= of Safaety and Buildings in accordance with Comm 85, M. Adm. Code County Attach complete site plan on paper not less then 81/2 x 11 inches in site. Plan must include, but not limited to: vertical and horizontal iatjBM), direction and Parcel I.D. percent slope, scale or dimensions, north off � ; i�nq ^ _ tb¢ and nce to nearest road. Please pdn0,aK1'Armarlii t Reviewed by Date Pemo al kdonna*m you Provide may be ui(acFlpq seconds Lpwr s. 15.04 (1) (m)). Z^ii Property Owner Property Location Govt Lot SW 1/4 iGGt/)l4 S j TZ N R JS E (or� Property Own Mailing Address CROIh dot # Block # Subd. Name o CSM# 1 C <d 4- A IV ��`� �/ City S Zip Code., N ❑ City ❑ Village ® Town Nearest Road t1 n W i 5`IbZI Y t r�� S r ' ► rh (� New Construction Use: P Residential l Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe. T Parent material Flood Plain elevation if applicable 4"47 R General comments ('v ✓l - o d r` c f t J• 1 17. 2 C) and recommendations: S f [ ( t/.- 9 9 • yd '�- A/. F1-1 Boring # El Boring p © Pit Ground surface elev. ft Depth to limiting factor / Z in. Safl Applicstion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Coat Color Gr. Sz. Sh. i 'Eff#1 •Eff#2 I 313 —lo I O r 5, I Z m�+ c 5 1 4 5 8 Z -0- r'41q — 5�1 2►r5bk nnc-; 3 12 -1$ 16 4 13 C ZP 5 L41U s T i 2rnslok g # Boring F ® Pit Ground surface eb v. ft Depth to lint" factor �y in. ..— Sod Application Rata Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munseii Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 '011#2 ! 0-5 i D 'C311 --- 5; �r c-.5 [ VI , 5 .8 Z 5 -1D l ry I 5; I m b k 5 1 .5 8 3 ID 16 r 9l 3 I Cz - 115 P .S 4 r 4 m Sit Z k — 5 .8 • Effluent #1 = BOD > 30 220 mg/L. and TSS >30 < 150 mg/L ` Effluent #2 = BOD < 30 mg/L and TSS < 30 mg1L CST Name `e P i � _ aCST 33 Address pate Evaluation Conducted Telephone Number Property Owner �� + Parcel ID # Page Z of 3 F 31 Bori # © Pit Ground surface elev.7 + 0 ft. Depth to laniting factor /� in. Soa Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Cons�sbenoe Boundary Roots GPD/it? in. Munsell Qu. Sz Cont Color Gr. Sz. Sh. 'Eff#1 "Eff#2 f O -y 1 0 ux- 513 Sri Z r �s Ivy 5 S Z 4 I ib 3 ip -il t0 3 7.5 y�lo 5' 2mSbk m -�-', — . 5 • b F-1 Bori # ❑ Bonne ❑ Pit Ground surface elev. R Depth to limiting factor in. Sofl Application Rat Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDff in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Efr#1 'Eff#2 Boring # ❑ Boring F ❑ Pit Ground surface elev. ft Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Ef1#1 'Eff#2 ` Effluent #1 = BOD > 30 _< 22o mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 mg/L and TSS —` 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608- 264 -8777. SBD4330 (R07M) L PAGE 3 OF 3 NAME Vy� , V LOT#A LEGAL DESCRIPTIONSw ' /4Nu/ /4,S30TZq ,N,R K E (or &0 SCALE: 1 BM 1 ELEVATION JQU , y BM 1 DESCRIPTION Na I I i r, (o Do o b a koo K e(cQt - r' N �C BM 2 ELEVATION /OO •O 3C) BM 2 DESCRIPTION J,rj A U � Iu t'h (P �¢bo e. (� round SYSTEM ELEVATION 1 t y ALTERNATE ELEVATION Nl� CONTOUR ELEVATION 9 3 _ O • BL �, � pal t � a3 N 0 Dr ;ucw z SIGNATURE DATE / / — ST CROIX UU MN i x SEPTIC TANK MAINTENANCE AGREEMENT � : AND }..�,� -a.-R� 5.�►.� R,eTIFI.�r ON EORM wnerBuyer [ailing Address ro Per Addres 1f cq 7 ,49 7 s --e -f 1 % (S a r) �P (Verification required from Planning Department for new construction) Sty /State Parcel Identification Number LEGAL DESCRIPTION ',. PertY Location S ` /•, '/4, Sec. - -3 0 TAN Rj--5-`c-)W, Town of � subdivision Lot # Certified Survey Map # Volume /q 9 . Page # -6 1 Volume � a . Page # � Warranty Deed # o IBS . -- I Spec house ❑ yes no Lot lines identifiable Ja yes ❑no SXSTE':'I =MAIN'TENANC Improper use and maintenance of your septic system could result in its pre nature failure to handle wastes. Proper main ce consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper- Wbat you put into the em can affect the function of the septic tank as a treatment stage in the waste disposal property owner agrees to submit to S syst�- ent a certification form, signed by the owner and by a The t. Croix Zoning DePartmv that (I) the on sits w+�waterdisposal s* stem Jouraeymanplumber, reshzctedplumber or a licensedpumper the se pti c tank is 14= than 1r3 full of 9109e- is in proper operating condition and/or (2) after inspection and pumping (if necessary) disposal to maintain the private sewage- system with the Uvve:, the undersigned have read the above requirements and agree State of Wisoonsim lion set forth, herein, asset by the Department of Commerce and the Department of Natural Resources, Offce wi 30 stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning %fthe �tion date. 1775/77 t DA OF APPLICANT OWNER CERTIFICATION our knowledge. I (we) am (are) the o r(s) of I (we) certify that all statements on this form are true to the best of m ( our) Deeds Office. the p rty described above, by virtue of a warranty deed recorded in Regist D S? 6p S N A OR APPLICANT ®� �u �rn i f DATE Any information that is mis represented may result in the sanitary permit being revoked by the Zoning Departmen «« Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed t I 4 • pp . ' vl . l 4 l 0 601252 KATHLEEN H. WALSH UI E REGISTER OF DEEDS D cu N mbar ST. CROIX CO., WI RECEIVED FOR RECORD Harry Smith a/k/a Harry M. Smith and Donna Smith, a/k/a Donna M. 04- 14-1999 10:00 AN Smith, husband and wife, quitclaims to Harry M. Smith and Donna_M Smith-husband husband and wife, holding as survivorship marital property t e WIT CLAIM DEED ollowtng described real estate in St. Croix County, State of Wisconsin: C X E MPT I BM FEE: COPY FEE: TRANSFER FEE: RECORDING FEE: 10.00 PAGES: 1 Recordi Area Name and Return Address Thomas A. McCormack 740 Main Street Baldwin, WI 54002 034- to66 -8o / 034 - 1073 -20 � ,•o (Parcel Identification Number) fl 0� C • A piece of land bounded by a line commencing at the Eight post, Eighty (80) rods South from the Northwest corner of Section Thirty (30) in said Town of Springfield and running thence South on the Section line, Thirteen (13) rods and Fifteen (15) Feet; thence East Eleven (11) and one -half (1/2) rods; thence North Thirteen (13) rods[ and Fifteen (15) feet to the eight line; thence West on Eight line Eleven (11) and one -half (112) rods to place of � , (, beginning, being a part of the Southwest quarter of the Northwest quarter (SW '/. of NW Y.) of Section Thirty (30) of Township Twenty Nine (29), Range Fifteen (15) West of the 4"' principal Meridian containing one acre. West Half of Southwest Quarter of Southwest Quarter (W 'F. of SW '% of SW 'h) of Section Thirty -two (32), jgtj Township Twenty -nine North (T29N), Range Fifteen West (R1 5W). , Yv� r � l , This is homestead property. Dated this day of 1999. , • `H ry M. ith Q t J • Donna M. Smith AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ST. CROIX COUNTY C /tL / Personally came before me this _day of ! ` 1999 the above named Harry M. Smith and nna M. authenticated this _ day of t9_ Smith to me known to be the person(s) xecuted the foregoing in nt and acknowledge a sarhe. signature _ signature type or print name type or print name TITLE: MEMBER STATE BAR OF WISCONSIN Notary Public St. Croix County, Wisco 1 s NUn - (If not, My commission is permanent. (If not, s*te'ixpir4�rt o}a1Es: authorized by' 70.06, Wis. Stats.) .19 , ` I , 1. THIS INSTRUMENT WAS DRAFTED BY 'Names of persons signing in any capacity should be typed or Thomas A. McCormack printed below their signatures. Baldwin, WI 54002 kdorm.t n Pr4ba.w $ ComD Fad du Lac. Wl� 600 -655 f t c — �\ � � D0 VI Q MAP OF SURVEYS, LOCATED 1N THE OF A PARCEL AS DESCRIBED IN VOLUME 1 99 0 PAGE Sty 1/4 OF THE NW 1/4 OF SE I ON 30, T 2 0 9 WISCONS 5 N • T OWN OF SPR 1 NGF I EL D, ST- CTION PREPARED FOR= NORTHWEST CORNER MATT SMITH y ` SECTION 30 - SET RAILROAD SPIKE L ANDS UNPL A TTED • ... I ........ APPROX 7' E. ........ e t y I ....... - .., 4' S. OF FC. COT. I� ' I t I NORTH LINE OF THE SW-NW FiL S SOUTH 3 EAST S 89 46 /89.71 SW-NW` y 22. 14' 1s7. s 1' I x j I s 6' I I i � I � i o I VOL UME .... 199 g a 0 w :a I 1.00 ACRES I c 43, 546 SO. FT. a © I 1 I '^ 0. ta 89 AC. EXC. Ri 38.9!6 S0. FT" 'r PAGE v, I , i I 33' �. - - -D-R J'VE� I 33' N O 4 J' 03" W 1 15. 89' I I f8. 49 171.26' 89 ° 59' 46 "W 189-75' ON F/L EAST i I 8 I UNPLATTED LANDS_ e WEST QUARTER CORNER BEARINGS REFERENCED TO THE SECTION 30 -FOUND rn i ALUMINUM CAPPED MONUMENT MEASUREDEASFNOO °33'14 W (ST. CROIX CO. COORDINATE SYST €M)- SURVEYOR'S CERTIFICATE hereby certify: 1, Domes M. Weber, Wisconsin Reg Land Surv of o lond and that this That 1 have surveyed and mapp t5GON8� representation is a correct rapraaeatlon of the boundary thereof. Doted JAM M. LEGEND WEM O = SET I" X 24" IRON PIPE WEIGHING Sao 1.13 LBS. PER LINEAR FOOT ® Q ( ) = RECORD DATA �/� S SHEET I OF I M. WEBER 5-1804 0 30 60 120 NELSEN LAND SURVEYING 2000237A THIS INSTRUMENT DRAFTED BY JIM WEBER C\ - ZZ--��