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HomeMy WebLinkAbout034-1072-90-275 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 399429 GENERAL INFORMATION (ATTACH TO PERMIT) State P ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)j. (p T / Y212 Permit Holder's Name: City Village X Township Parcel Tax No: Stenzel, Lee Springfield Townshi CST BM Elev: Insp, BM Elev: BM Description: � O C O �wr►ov- t TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Bench /d ',8 1 f p� l� ol•$ I 0D•d Dosing C7(o l � r Aeration Bldg. Sewer + aD c f Holding St/Ht Inlet 1 9 - 4-0 o , 9 St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic + L( � Z _ Dt Bottom - f Dosing yo i ^ i __3�� Header /Man. 2, (P3 Aeration Dist. Pipe too . yS 2. S Holding Bot. System 3.S/ Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover G PM 9s Model Number 33 0 � �I 2 �,� Sr o S- 36 TDH Lift t Z• o Friction Los ys em Head TDH Ft / r Z S � 2/7S' i ForceFnain Length Diiaa. Dist. to Well z '> y 9 d'tP 3 SOIL ABSOR ION SYSTEM BED RENCH Width f Len th d DZIE NSIONS No. Of Trenches PIT DIMENSIONS No. f Pits Inside D' Liquid Dep s A I (r// r SETBACK SYSTEM TO P/L JBLDG IWELL LAKE/STREAM LEAC Manufacturer: INFORMATION Type Of System: i ER DISTRIBUTION SYSTEM T Header /Manifold Distribution x Hole Siz x Hole Spacing Vent to Air In ke M Pipes) I /I // I i Length-3g� Dia z Length q j' g Dia I /� Spacing V SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bedlrrench Edges Topsoil Yes ❑ No [] Yes ❑ No COMMENTS (Include code discrepencies, persons present, etc.) Inspection D / l ( / r.>( Inspection #2:�/�/ 4 - hawks P Q s Location: 2867 Highway 12 Wilson, WI 54027 (SW 1/4 NE 1/4 32 T29N R15W NA Lot N Parcel No: 1.) Alt BM Description % ij.,KT ��� ��'�` / & e li k eeW �► i 2.) Bldg sewer length = (,v� �� •Skis -� � ' " "�- �� - amount of cover c 1 3.) Contour = �Ig• CSk�T rat Ot _ Plan revision Required? [a] Yes 01 No Use other side for additional informati n. -z Date Inse cto nature Cart . No. SBD -6710 (R.3197) � �� � / � ��/ /� 1 s Z Va / � , �� ��� �� �� ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 FAX (715) 386 -4686 Friday, October 26, 2001 Lee Stenzel 2867 Highway 12 Wilson, WI 54027 Regarding septic inspection for Lee Stenzel. Location of Property in St. Croix County: Municipality: Springfield Township Subdivision or Plat: NA Certified Survey Map: Lot: NA Address: 2867 Highway 12 Dear Applicant: A septic inspection of the above reference property was conducted on October 12,2001. This property is located in the SW 1/4 NE 1/4 of Section 32, T29N R15W, NA (Lot NA), Springfield Township, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a 3 bedroom home. If you have any questions regarding this, please contact our office at 715.386.4680. Since ely, Grabau /Sonnentag Zoning Staff cc: file -386 - c?AF1 • e Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 ST. CRO Vi consin Madison, WI 53707 - 7162 Site A MR Department of Commerce z Z Sanitary Permit Application Sun 3 4 m YZ 9 In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ❑ Check if Revision ma be used for secondary purpo Pri cy Law, sl5. 1 m State Plan I.D. N Site Id #103244 I. Application Information # 6 - Please Print All Information Trans. Id # 671416 Property Owner's Name Parcel Number 03 — • 3 — 72 -80; LEE STENZEL — = Property Owner's Mailing Address Property Location o3 �� �C7 t -9 2867 HWY 12 �� SW iA NE %; S 32 T 29 N R 15W City, State Zip Code Phone Number Lot Number Block Number N/A N/A WILSON, WI 54027 715/698 -3246 Subdivision Name CSM Number N/A II. Type of Building (check all that apply) ❑City 1 or 2 Family Dwelling - Number of Bedrooms 3 ❑Village ❑ Public /Commercial - Describe Use [Township SPRINGFIELD ❑ State Owned Nearest Road III. Type of Permit: (Ch k only one box on line A (numbering scheme for internal use). Complete line B if applicable) A For County use 1 New 2 Replacement System 3 ❑ Replacement oTFxi 6 ❑Add T ition to S stem Tank Oni snn S stem Permit Number Date Issued B. ❑ Check if Sanitary Permit Previously Issued IV. Type of Permit: (Check all that apply)(numbering sche a is for internal use) 44 ❑ Non - Pressurized In- Ground 2111 Mound 6f. �Y "()U 47 ❑Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 El Aerobic Treatment Unit 49 ❑Recirculating 30 ❑ Other V. Dis ersaMeatment Area Information: _ ( Design Flow (go) Dispersal Area Dispersal Area Soil Application Percolation R to System Elevation e Required Proposed Rate(Gals. /Days /Sq.Ft.) (Min./Inch) e a tQ 450 ✓ 450 ✓ 450 ✓ 1. N/A 99.8 '��' 101 1. VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Fiber �las Gallons Gallons of Tanks Concrete C tedas� New Existing o Tanks Tanks Septic or Holding Tank 1000 1000 ✓ 1 HUFFCUTT CONCRETE X Dosing Chamber 600 600 1 I HUFFCUTT CONCRETE X VII. Responsibility Statement- I, the undersigned, assume responsipility for installation of the POWTS shown on the atta Plumber's Name (Print) Plumber's Signature 1 = 92 PRS Number Business P BENNIE HELGESON 715/772 -3278 Plumber's Address (Street, City, State, Zip Code) W1229 770TH AVENUE, SPRING VALLEY WI 54767 VIII. County /De artment Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Is Agent Signature (No Stamps) (` - Surcharge Fee) El Owner Given Initial Adverse . y�, 32 s O Determination �' IX. Conditions of Approval/Reasons for Disapproval 1. Effluent filter to be installed and maintained per manufacturer's recommendations. 2. The existing system shall be abandoned per code requirements (Comm 83.33). 3. Property is zoned Ag- residential - only one principal dwelling is allowed on this property. Attach complete plans (to the County only) for the system on paper not less than 8]/2 x U inches in size :,: W -6398 (R. 05101) Safety and Buildings ' 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 er �sconsin www.vvisconsin.gov .vvis c ons .wisonsin.gov Department of Commerce Scott McCallum, Governor Philip Edw. Albert, Acting Secretary September 10, 2001 CUST ID No.220292 AM. POWTS Inspector ZONING OFFICE BENNIE W HELGESON ST CROtX COUNTY SPIA W1229 770TH AVE 1101 CARMICHAEL RD SPRING VALLEY WI 54767 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/10/2003 Identific Transaction I o. . 671416 SITE: Site ID No. 10 Lee Stenzel - RT 2 HWY 12 Please refer to both identification numbers, St. Croix County, Town of Springfield I above, in all correspondence with the agency. SW 1/4, NEI /4, S32, T29N, RI 5W FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 809658 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10572 -P (R 6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD - 10573 -P (R 6/99). • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Slats. • 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. Slats. Note. It is recommended that the mound area be -deep chisel plowed to help break up the platy soil � was rep�'the Site. Owner Responsibilities • 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 must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of the instructions and information regarding proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. BENNIE W HELGESON Page 2 9/10/01 • The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. • 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 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/instal lation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, FEE REQUIRED $ 175.00 69tcoA FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 Gerard M. Swim POWTS Plan Reviewer - Integrated Services 608 - 789 -7892 Mon - Fri 7:15 AM to 4:30 PM WiSMART code: 7633 jswim @commerce.state.wi.us c INDEX SHEET PROPERTY OWNER: LEE STENZEL 561 170TH STREET SOMERSET, WI 54025 PROJECT NAME: LEE STENZEL PROJECT LOCATION: SW 1/4, NE 1/4, S 32, T29 N, R, 15 W MUNICIPALITY: TOWNSHIP OF SPRINGFIELD COUNTY: ST CROIX 1p oAN-T -S- �+,�y��� 0 DESIGN: PRESSURE DISTRIBUTION MANUAL SBDAW1 MOUND COMPONENT MANUAL SBD -105 �P o f Co MERC B ►� 1N N E pRSM �! CONTENTS: o,VD p oe►4 a�E Page 1: Plot Plan sells- Page 2: Cross Section and Plan View of Mound Page 3: Distribution Pipe Layout Page 4: Septic Tank & Pump Chamber Cross Section & Specifications. Page 5: Huffcutt Concrete 870650 Tank Specifications Pg. 1 Page 6: Huffcutt Concrete 870650 Tank Specifications Pg. 2 Page 7: Pump Specifications Page 8: POWTS Owner's Manual & Management Plan - Pg. 1 Page 9: POWTS Owner's Manual & Management Plan - Pg, 2 Name: Bennie Helgeson Signe ti i Address: W1229 770Th Avenue Spring Valley, WI 54767 Credential number: 220292 Date: August 21, 2001 I VN y _ f ' rc. � S "e 4 � c � f C• n7P � n ,L� IOU C 3 it r c t a S,cQ�n Howe r f _ I _ —_ - 'may I ' I I 1 ..�1�3►1 e,� ; 1.�� ����7 e,L_ Page -2-Of q Synthetic Covering Distribution Pipe ,4 srM c -3.3 Medium Sand G Topsoll i D E . b 1 =E at . I % Slop© Plowed Of 2— 2 %2 Force Main From Pump Loyer Aggregate D - /,_J_ Ft. E S Ft. Cross Section Of A Mound F Ft. G , 5 Ft. H _� Ft. Signed: K �I,? < Ft. License Number: L �� ,4g Ft. Date: j Ft. Ft. Ft. L----- - - - - - -- Observation Pipe � K F A ---- B - -- i W _ - -- Lt- O 2 „_ 2 �2 Distribution Pipe A99re9ate I Observation Pipe r Plan View Of Mound 1 ' --------------- N+ x- 1 =� I r r I rn D I r r I vt o r, � I � ❑ 2 _ A c r d n 55' r1 I ® ~ ❑ 47' 8" 1 I n Z � l CD I Z O 3' 44' cn z 1 n o 4' DIA. c w 75" = 1 °o c m e Z I o m r o II I o � � Ln z v N C, c� d ri I i - - - - - - - D 20' 2' - - - - - m n m r m n£ ❑ <A D 1 2" Z Ln X Ln 0O� AO m Pl rZZ CD n ❑ COQ Nr�•, D r G c Z m 1 N ro "' N N m m -n m = A J Z u . 'D A f', C O C b C d b 0 o O m p W n D D p D D - -1 C O D o A Wp px 4 • _ =O h f'1 G Z r1 2 -4 -4 A O 0 m 9 m O Z cl D n cc m n Z H T1 a7 m d D m m O V) Z < ' 6 m r- A 4' DIA. ri D m � r ? n f', N N ,0 O t7 17 45' ut =42' � n ' DIA. � itl( C Co ` 1 �. L V o 0 ❑ w ri 5' DIA. r � cSP� o 0 S m A N = TANKS 870650 HUFECUTT CONCRETE 737 HERBERT STREET MEMBERS ❑F. CHIPPEWA FALLS, V1 Sa729 NATIONAL PRECAST CONCRETE ASSOCIATION R r WISCONSIN PRECAST CONCRETE ASSOCIATION 1000/600 GALLON (715) 723-7446 r FAX (715) 723 (800) 924 -1516 N '� SEPTIC AND PULP TANK THIS DRAVIK SHALL NOT BE COPIED OR SUBMITTED TO OTHERS WITHOUT CONSENT Or THIS COMPANY Performance Dimensions OSP33 — MAX SOLIDS 5/8" SPHERE — 1750 RPM 24'' g° ZO /A 20 ru LL 16 Z 12 �e�ir Y,flAka h� J - t 8 l.`� ,nY i.., ni FULL LOAD sw AMPS AT 115V 6.5 :, + 0y Ski l+ JT ,1 - } n 0 10 20 30 40 50 60 U.S. GALLONS PER MINUTE #'T> s r r} NOTE" CASTING fi1 /8 Distributed by: M�R�ev THE MARLEY PUMP COMPANY �Le HYDROMATlC PUMPS �1 Bulletin 110.3 Rev. 12/84; Supersedes 210.1 Box 327, Ashland. Ohio 44805 (419) 2893042 LITHO I N U.S.A. n Canada - Marley Fluid Systems, 126 East Dr., Brampton, Ontario L6T 1C2 International Sales - Mission, KS Telex 716875045 MARLY UW ^ POVVTS OWNER'S KXANUAL & MANAGEMENT PLAN Page 8 «« _9 FILE ' INFORMATION SYSTEM SPECIFICATIONS Owne LE 77T. septic Capacity --i onn gal 13 NA Permit # Septic Tank Manufacturer C DESIGN PARAMETERS Effluent Hter Manufacturer ZABEL 13 NA Number of Bedroom$ 3 0 NA Effluent Filter Model A-100 (12-16)' [3 NA Number of Commercial Units EI N A Pump Tank Capacity 600 gal 0 NA Estimated flow (average) 300 Pump Tank Manufacturer HUFFCUTT CONCREVENA Design flow (peak), (Estimated x 1.5) 450 PLIMp.ManufaCtUrer HYDROMATIC 0 NA Soil Application Rate __ ttZ PLIMP Model OSP 33 0 NA InfluenittEffluent Quality Monthly average' Pretreatment Unit 0 NA Fats, Oil & Grease (FOG) <30 rng/L 0 Sand!Gravel Filter 0 Peat Filter Biochemical Oxygen Demand (BOD -�220 irrc�,![_ 0 Mechanical Aeration 0 Wetland Total Suspended Solids (TSS) -5 50 MInUfaCtLirer _Ige­ Dispersal Cell(s) Pretreated Effluent Quality 0 NA Month!yavci. Biochemical Oxygen Demand (BOD -<.,* 3 0 111 g / 11. 0 In-ground (gravity) 0 In-ground (pressurized) Total Suspended Solids (TSS) �;30 ing/t, 1 1:1 At-grade 0 Mound' Fecal Coliform (geometric mean) _.�l 0 CfL]/*! 0010 0 Dr - ip-lino 0 Other Maximum Effluent Particle Size Y. inchdiarneter ' vu/uc�i typical for domestic wastewater and septic tank effluent. . ^~ Values typical for pretreated wa MAINTE NANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once evf 2 11 months 5P year(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combincid sludge �_md scum equals one-third %) of tank volume Inspect dispersal cell(s) At least once evOiy 2 LE-linonths §Oyear(s) (Maximum3yrs.) Clean effluent filter At least of ice every 0 months year(s) Inspect pump controls & alarm At least once every 1 El months year(s) 0 NA Flush laterals and pressure test At least once every 3 0 months year(s) 0 NA Other At least once evefy 0 months 0 year(s) 0 NA Other At least unce evi.?fy C) months 0 year(s) 0 NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall bo made byunindividuu|oanying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer P0VVTS |noyeuhur; POVVT8 K8ointo{nar, Seotoge Servicing Operator. Tank inspections must |n " |udea visual /nspecbonof the tanh(u) toidonbh/ any nn/solngorbroken hardvm*F$./de any cracks or leaks, measuoathe vn|ur�anf combined sludge and scunnand to check for any back up orpondlnQofafR'an�on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of etfluent on the ground surface. The pondingof effluent onthe groUndsUrfacenlay|ndico(oohaiUnQoondiUnnoodrequireudminMIc(liatenoUDcabonofU)e/ooa/r When the combined accumulation of sludge and scual i!, , ,iny tm�k equuls one-third %) or more of the tank volume, the entire contents of the tank shall be removed by o Sap1ugn Cpenz(o/ onu disposed of in accordance with ch. 0R 11@. Wisconsin Administrative Code. The servicing of effluent fi|tam.mechanical o/ pressurized PON/|'S components, pre(routtnnontoornponants', and any other maintenance or monitoring at intervals of 12 months or less, shall be perforf ned by a cerdfied POWTS MaIntallner. A service report shall bg provided to the local regulatory authority within 10 days o( completion Of any service event. START UP AND OPERATION For new construction, prior to use of the POWTS check ti eatmerit tallk f0f the Presence of painting products or other chemicals that may Impede the treatment pnocosxand/of Ulu dispersal coU(o). |[ high concentrations are detected have the contents of the tank(s) removud by u/;u`go "�e':kj'ig ope/u(or prior to use, • � S�stem.st -art up shall not occur when soil cunditici;s :, (fuzcir ut !!;u infiltrative surface. Page of During power outages pump tanks may fill above nor j iii higiiwz,tei levels. When power is restored the excess wastewater will be discharged to th,� disp11 rs�,l cull (L;) r ) ;a u(r l , rcr c ,j us o, over! uading the cell(s) and may result in the backup or surface discharge of effluent. 1'o avoid this situ:uiun fiery(; the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintalner to assist in manually operating the purnp controls to restore norrr,al levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do riot drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of an mound or at - rade soil absorp area. P Y .� P Reduction or elimination of the following from the wastewater sire:_rn, may in the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss;'diapers; disinfectants; fat; foundation drain (sump pump) wat(:r; [( and vc:)etable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides, sc:,r,it;,ry rn:rpl; ins; tampons; and water softener brine. ABANDOAMENT When the POWTS fails and/or is permanently taken out of service tt,e following steps shall be taken to Insure that the system is properly and safely abandoned in compliance with ch. Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and this abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated .uid removed or their covers removed and the void space filled with soil, gravel or another inert solid twill 2ri<il. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the follovv.,,g i;:,ve teen, or must be taken, to provide a code compliant replacement systern: ❑ A suitable replacement area has been evaluated and may t:e utilized for the location of a replacement soil , absorption system. The replacement area should be protected from disturbance and compaction. and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the n( ed for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must Comply vVith the rules in effect at that time. • A suitable replacement area is not avail�Jll_rle crt,e tu soil limitations. Barring advances In POWTS technology a holding tank may be installed us , ,:is to rep;L,re the failed POWTS. • The site has not been evaluated to identify a suit::,b!e replac:(�rricr,t area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable repi tt. ;rnent area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. 13 Mound and at -grade soil absorption systems may be reconstructed in piace following removal of the blomat at the infiltrative surface. Reconstructions of Such sySterr,S must Comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT" TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTI lLR TREA'I tvll-N'l T AN't, UNDER ANY CIRCUMSTANCES. DEATH MAY T RESULT. RESCUE OF A PERSON FROM HE Ifni i f�ioi: Oi /� TiNI�K MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POeiTS MAINTAINER Name HELGESON EXCAVATION INC ; l r +un�; JOHNSON SANITATION Phone 715/772 -3278 715/273 - 5811 SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULA AUTHORITY Name JOHNSON SANITATION Agency ST. CROIX COUNT ZONING Phone 715/273 -5811 Phone 715/3864680 This document was drafted by the staffs of the Green Lana, Marquette :rod Waushara County 'Zoning and Sanitation agencies. This document meets the minimum requirements of ch. Comm 83.22(2)(b)(1)(d) .(t) and 03.1,-r, (2) & (a), VVI_,consln Administrative Code. Use of this document does not guarantee the performance of the POW] S. GMW (2/01) 1361 Wisconsin Department of Commerce SOIL EVALUATION REPORT page I of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Sal & Site Evaluations Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. 034 - 1072- 30 - 000, ID #32.29.15.484 Please print all information. y Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). �� s rv_ Property Owner Property Location Mabel A. Thompson Trust Govt. tot SW 1/4 NE 114 S 32 T 29 N R 15 W Property Owner's Mailing Address Lot # Block # �Subd.ame or CSM# 2891 Hwy. 12 City State Zip Code Phone Number I City _ Village V Town Nearest Road Wilson I WI 1 54027 715 -698 -3122 Springfield I U.S. Hwy. 12 t/ New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate J Replacement _f Public or commercial - Describe: — m , Parent material Glacial drift Flood plain elevation, if appli General comments i and recommendations: System elev. = 99.80' at 20" above 98.10' contour. S a Boring # J Boring -" COu IM Pit Ground Surface elev. 98.10 ft. Depth to limiting factor 32" in. XA, Rate i Horizon Depth Dominant Color Redox Description Texture Structure I Consistence Boundary R DI :.. E €ff#2 . 1 0 - 12 1Oyr3/2 none sit 2fs mvfr as 2fm 0.5 0.8 2 12 -28 1Oyr4/2 none sit 2msbk mvfr cw 1fm 0.5 ✓ 0.8 � 3 28 -32 7.5yr4/4 none sl 2msbk mfr aw - 0.5 0.9 4 32 -54 1 Oyr4 /6 f2f 7.5yr4/6 s Osg ml aw - 0.7 1.2 5 54-68 1 Oyr6 /2 m3 7 5yr5/82& vfscl Om mfr - - 0.0 0.0 �, Boring 2 Boring # � Pit Ground surface elev. 98.10 ft. Depth to limiting factor 32" in. Soil Application Rate Horizon Depth Dominant. Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft •Eff#1 - Eff#2 1 0 -9 1Oyr3/2 none sit 2f mvfr as 2fm 0.5-- 0.8 2 9 -18 1Oyr4 /2 none sil 2fsbk mvfr cw 1fm 0.5- 0.8i 3 18 -32 1Oyr5/4 none sil 2msbk mfr aw - 0.5 0.8- 4 32 -49 1Oyr5/4 f2fd 7.5yr4/6 sl 2msbk mfr aw - 0.5 V- 0.9-' 5 49-62 7.5yr4/6 f2f 7.5yr5/8 sl Om mfr - - 0.3 0.5,- Effluent #1 = BOD ? 30 < 220 mg/L and TSS 30 < 50 nt #2 = BOD < 30 mg/L and TSS <_�0 mg1L CST Name (Please Print) Sig ure: CST Number Jame K. Thompson 3602 Address A.C.E. Sal & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, W154020 2/27/01 715- 248 -7767 r pr Owner Mabel A. Thompson Trust Parcel ID # 034 - 1072 -30 -000, ID #32.29.15.484 Page 2 of 3 3� F Boring # Boring 16 Pit Ground Surface elev. 94.56 ft. Depth to limiting factor 16" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 2 *Eff#1 *Eff#2 1 0 -10 10yr3/2 non sil 2fsbk mvfr as 2fm 0.5 ✓ 0.8 2 10 -14 10yr4 /2 none sil 1thinpl mvfr as 1fm 0.2 0.3/ 3 14 -16 10yr6/4 none sil 2fsbk mfr aw - 0.5 0.8 ✓ 4 16 -28 10yr6/4 f2fd 7.5yr5/8 sil 2fsbk mfr aw - 0.5 0.8 L 3 5 28-47 7.5yr4/6 f2f 7. 5yr5/8 scl 1 msbk mfi - -� 9.8'✓ Boring F # J 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 : *Eff#1 *Eff#2 Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Sal .J App lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 * Effluent #1 = BOD 5 > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS <�0 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. 1 A Ele 1/4-4 a+-, „ ■ � v S 1oPf- 83 9 v s6 ' a ad ° °• o •/ zz' SG�afPro/oaSZd /0e corROr, - /eV.. 102.9y' 7 5.3 2, Tn. of � a tonK O PcL, z4 32. Z9.1-- X ('e5ic�e�ce 1 o-F S di /4s5 u," ed da�c 1 e let a,f Meuse = 98.3. w� ,!e o 10 e 4;-r S , a re / Qrcfoosed lot e, Q J4-00 G�, w �' Sc. vetrir, /larf� /a /:n be dtKcd` fer.S s+?Xo & at[drs�agft�C /1cyDl�Cer+,,��rf' Sep'�c. ��S-�c..• /oca.E,'or�. Qe C36/ ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer LEE STENZEL - Mailing Address 561 170TH AVENUE, SOMERSET, W 540 Property Address oZ- r& U ° (Verification require from Planning Department for new construction) City /State V W Parcel Identification Number Deto It LEGAL DESCRIPTION I�'� Property Location SW4 y NE y Sec, 32 , T 29 N -R 15 W, Town of SPRTNGETELD Subdivision Lot # Certified Survey Map # , Volume . Page # Warranty Deed # % C0 01z— . Volume ZZ, Page # Spec house O yes ko Lot lines identifiableyyes O no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensedpumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that our septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of e e ira ' ate. al- SIGNA O L ANT DATE OWNER CERTIFICATION I we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of the pro describe ove, b virtue of a warranty deed recorded in Register of Deeds Office. //7/ 4 S GNAT O LICANT DATE * * * * * Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is trade in the warranty deed iz VOL 1686ro173 STATE BAR OF WISCONSIN FORM 7 - 1999 5196.2 TRUSTEE'S DEED REGISTER DEEDS H. Document Number REGI OF D DEEDS 5T. CRDIX CO., WI Mabel A. Thompson RECEIVED FOR RECORD -- 07 -24 -2001 10:30 AN as Trustee or Mabe Thompson Trust dated November 10 , 199 TRUSTEES DEED – - -- EM # — CEP.T COPY FEE: for a valuable consideration conveys without warranty to Lee R. S tenze l and CrIPY FEE: Mary Beth Stenze husba and wife, RAHSFER FEE: 615.00 –. -.- – RECORDING FEE: 12.00 AGES: 2 Grantee, the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Name and Return Address (See Attached Exhibit "A") 034 - 1072- 30;034 - 1072 -80; 034- 1072 -90 & 034- 1073 -50 Parcel Identification Number (PIN) Dated this day of _ July 2001 _ + Mabel A. Thompson _ Trustee Trustee AUTHENTICATION ACKNOWLEDGMENT Signature(s) Mabel A . T hompson, Tr orthe M abe l STATE OF WISCONSIN ) Thom pson Trust da ted November 1 1995 ) ss. - _ County ) authenticated this day of _ J uly _ 2001 Personally came before me this day of the above named + K_r istina O gland 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. Stats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY Attorney Kris Ogland Hudson, WI 54016 - - -- --- -- -.__ _ -- -- - ..- - - - - -- ° -- - --- - — -- Notary Public, State of Wisconsin My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ) ' Names of persons signing in any capacity must be typed or printed below their signature. kdormaron Pmreasionaia company. Fond du Lw, vm 800655.2021 TRUSTEE'S DEED STATE BAR OF WISCONSIN FORM No. 7- 1999 ' VOL 1686Pttf174 EXHIBIT "A" That certain parcel of land located in the SE'/4 of the NW' /., the NE' /4 of the SW' /4, the NW'/, of the SE' /4 and the SW' /4 of the NE'/. of Section 32- 29.15, Town of Springfield, St. Croix County, Wisconsin, more fully described as follows: Commencing at the N' /4 corner of said Section 32; thence S89 °50' 13 "E (assumed bearing on the North line of the NEIA of said Section 32) a distance of 932.34; thence S00' 13'48 "E 2024.42' to the POINT OF BEGINNING, of the parcel to be herein described, thence N90 0 00'00 "E 128.69'; thence SOO'00'90 "W 425.43; thence S88°22'33 "W 856.59; thence S01 0 26'53 "E 1512.08'; thence S89 °57'58 "W 266.14' on the South line of the NW' /4 of the SE'/. of said Section 32, thence S89 °59'32 "W 1327.97' on the South line of the NE' /4 of the SW'/4 of said Section 32; thence N00' 13'50 "E 1324.78' on the West line of the NE' /4 of the SW'/4 of said Section 32; thence N00° 12'23 "E 552.08' on the West line of the SE' /4 of the NW'/4 of said Section 32; thence S89 °50'32 "E 2137.71'; thence N00 0 07'50 "E 225.69'; thence N90 °00'00 "E 137.38; thence SOO' 13'48 "E 13 5.00', to the POINT OF BEGINNING. Also, the above described parcel including an easement for ingress and egress, more fully described as follows: An easement for ingress and egress located on the NW' /4 ofthe NE' /4 and the SW' /4 of the NE'/4 of Section 32- 29 -15, Town of Springfield, St. Croix County, Wisconsin, more fully described as follows: Commencing at the N%4 corner of said Section 32, thence S89'50'1 3 "E (assumed bearing on the North line of the NE'/4 of said Section 32) a distance of 932.34% thence SOO' 13'48 "E 33.00' to the South R.O.W. of U.S.H. "12" and the POINT OF BEGINNING, of said easement; thence S89 0 50'13 "E 66.00' on said R.O.W.; thence S00 °13'48 "E 1991.23'; thence N90 °00'00 "W 66.00; thence N00 °13'48 "W 1991.42', to the POINT OF BEGINNING. St. Croix County, Wisconsin. TOGETHER WITH an easement for ingress and egress over the following described property: Beginning at the E' /4 Corner of Section 32, T29N, R 15 W, Town of Springfield, St. Croix County, Wisconsin, thence N00'13'45 "E 33.00'; thence S89 "56'3 1W 1395,97'; thence Northwesterly 262.49' along the arc of a 167.00' radius curve concave to the Northeast whose chord bears N45'01'45 "W 236.29'; thence N00'00'00 "E 9,36'; thence S88° 22'33 "W 66.03'; thence S00^00'00 "W 7,49'; thence Southeasterly 366.23' along the arc of a 233.00' radius curve concave to the Northeast whose chord bears S45 °01'45 "E 329.68'; thence N89 "E 1395.64'; thence N00"13'41 "E 33,00'to the point of beginning containing 113,435 square feet ( 2,604 acres ) more or less and being subject to any easements, restrictions and covenants of record, if any P 3�� re Y � HELGES N EXCAVATI 0 N, Inc. SEWER AND WATER SPECIALISTS Plumber /CST Cert. #220292 BEN HELGESON Office (715) 772 -3278 W. 1229 770th Ave. Home 715 772 -3127 Spring Valley, WI 54767 Fax (715) 772 -3387 November 29, 2001 St. Croix County Zoning Office `'/ RECEIVED Attn: John' 1101 Carmichael Road ` i 200 Hudson, WI 54016 <� Sc"N RE: LEE STENZEL 5� �� ►� f ; � � 3 z. 7- (5 SANITARY PERMIT # 399429 Dear John: The effluent pump which was specified on the state plans for this project, a Hydromatic OSP 33, was replaced with a Gould Model 3885 (WE05M). Sincerely, Bennie Helgeson President BH: cb Performance _ Effluent Curves METERS FEET — -- 1 -- - - I -- — — I_.- - - - -- MODEL 3885 25 80 — r- - -- - -�- SIZE 3 /4" Solids WE15H I 1 7 70 Y 20 WE10F1 - I WE07H - I j 15 ao 10 30 WE03M -- 20 5 0- 0 0 W 20 30 d0 90 100 110 120 GPM —. -- - -- -- - - -- - - -� -- - p 2U 30 m /h IO CAPACI fY . GOULDS PUMPS, INC. 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