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Home My WebLink About004-1057-50-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 171 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Timm, Travis Cady, Town of 004-1057-50-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 25.28.15.391A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header/Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP/SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head T FH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM uid BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liq Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM to Air Header/Manifold Distribution x Hole Size x Hole Spacing Vent Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil xx Yes 0 No Yes ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 3253 20th Ave Wilson, WI 54027 (NE 1/4 NW 1/4 25 T28N R1 5W) >35 acres Lot Parcel No: 25.28.15.391A 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. County Sanitary Permit Application ST. CROIX COUNTY WISCONSIN GIp,,v►~~ Japccord with Chapert 12 St. Croix County Sanitary Ordinance PLANNING & ZONING DEPARTMENT GtO~f~YQ~ Personal information you provide may be used for secondary purposes ST. CROIX COUNTY GOVERNMENT CENTER [Privacy Law. S. 15.04(1)(m)] 1101 Carmichael Road $~~t►~ n r~W Hudson, WI 54016-7710 Q V arm, (715)386-4680 Fax (715)386-4686 0~omplete plans for the system on paper not les than 8- es in size. I- ate anitary Permit # ❑ Check if revision to previous ap ' _ _ d 1`7 ! 1. Application Information - Please Print all Information Location: Property Owner Name n Alt, 1/4 K,1/4, Sec c~~ m -2;3N, R 17 (or W Property Owner's Mailin Address Lot Number Block Number oL2 Q,4~,3 City, State rr Zip C de Phone Numer Subdivision Name or CSM Number ;JZ d Z? -765- 772 3t 57 II Type of Building: (check one) 103ity' ❑ Village Town of 1 or 2 Family Dwelling - No. of Bedrooms: -2-4 El Public/Commercial (describe use): ❑ State-owned Ne st Rgad n II. Type of Permit: (Check only one box on line A. Check box on line B if applicable) _rA / Vv"~ Parcel Tax Number(s) A) 1.El Repair 12.X Reconnection 3.❑Non-plumbing 4. ❑ Rejuvenation r Sanitation 06c/- L0: ` B) I !A Perm't Number Date Issued State Sanitary Permit was previously issued 8 - D3 Q IV. Type of POWT System: (Check all that apply) ❑ Non-pressurized In-ground Ji~ Mound ? 24 in. suitable soil ❑ Mound :5 24 in. suitable soil ❑ Mound A+0 ❑ Sand Filter ❑ Constructed Wetland ❑ Peat Filter ❑ Drip Line ❑ Pressurized In-ground ❑ Holding Tank ❑ Single Pass ❑ Other ❑ At-grade ❑ Aerobic Treatment Unit ❑ Recirculating V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application Rate 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed (Gals./day/sq.ft.) (Min./inch) Elevation ~ o i,4p I/ ~ L) 1-15 g~. /400, VI. Tank Information Capaicty in Gallons Total # of Manufacturer Prefab Site Con- Steel Fiber- Plastic New Existing Gallons Tanks Concrete structed glass Tanks Tanks ❑ ❑ ❑ ❑ 4d4,0 eA" El 13 ❑ ❑ 11. Resp nsibility Statement I, the undersigned, assume responsibility for repair/reconnenction/rejuvenation/installation of non-plumbing for the POWTS shown on the attached plans. A license is not required for terralift repair or the installation of non-pi mbing sanitation system. PIu er's Name (print) Plumbe Signature (no sta ps): MP/MPRS No. Business Phone Number -7r 222 32> Plumb Addr ~ (Stre-eit, Cyity, Sta, Zip Cod) D~ ~j VIII. Coun Use Only Disapproved Sanitary Permit Fee Dat Issue Issuin ent Signature s) Approved wne itial Adverse 7 ` O~ g. /Z Dete G• IX. Conditions of Approval/Reasons for Disapproval: ti ?so J O 1 n r /`l 7 cwt c~C ( r . 5 ~ j Az ~ °rr RECEIVED 03/06/2012 10:35 7157723134 STOCKMAN FARM SUPPLY P1 (TUE) MAR 6 '012' 11 ; 53;% T, 11 .53 NO i '338 2 7424 F an w ! ~4 I L9 m I , I 8' lot I I x II U 11 I II II ~ It II I~ I, , u I , Lu II ~ H I II 1 ~ ~ I I II I I 11 II I II i n I~ 1 I! II ~ II lL'-___- ! II Wisconsin Department of Commerce County: PRIVATE SEWAGE SYSTEM St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 404986 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m) Permit Holder's Name: City Village X Township Parcel Tax No: Timm, Travis Cad Township 004-1057-50-000 CST BM Elev: Insp. BM Elev: IBM D D /0 b 'em 0" E✓ 1~ L TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. B , Aeration Bldg. ewer aetou~ Cry s 8/ SP Holding St/Ht Inlet 7C TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WEL BLDG. Vent to Air Intake ROAD Dt Inlet 3 /L 3 Septic p, Dt Bottom X6 Dosing Header/Man. , Aeration Dist. Pipe GCj - 4P3 Holding Bot. Svstem Final Grade PUMP/SIPHON INFORMATION Manufacturer Demand St Cover GPM ~pZ, 2r Model Number S TDH Lift Friction Loss System Head TDH Ft Forcemai Len h IDia. /I Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Widt/ Length I No. Of Trenches PIT IMENS NS No. Of Pits Inside Dia Liquid pth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE REAM LE HING Manufacturer: _ R OR INFORMATION CrUINI Type Of System: rJ M odel Nu er: r 75 1 ` DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing VTIntake S 11 Pipe(s) 2 Spacing 2. 2 . :rt 5P' 5 Length Z Dia LL I Length Dia T 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 Cen er Bed/Trench Edges Topsoil Yes [ffl No 0 Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: & 1'2f /0 Inspection #2:f/ Location: 3253 20th Ave Wilson, WI 54027 (NE 1/4 NW 1/4 25 T28N R1 5W) NA Lot 'tv~ Parcel No: 25.28.15.391A 1.) Alt BM Description = -ST" Covoc-45;6_4e~~ nj~' 2.) Bldg sewer length = ?j C f 4-o S Z G -4v w -JOI& Vy'~ - amount of cover = f _ U / epTi'~-ut, r rt/ •ns~- -)-W• (!1t 47 y laGty U'Zj SZt,,.e~Je~~ 3.) Contour= doo Plan revision Required? E] Yes No ~j ZSn Us e other side for additional information. p Insepctor's re r~ Cert. o. SBD-6710 (R.3/97) Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT, CROIX ' 404986 0 GENERAL INFORNhZO,#=_``"" ' (ATTACH TO PERMIT) - - WISCO ID No: Personal information y eafiar es [Privacy Law, s.15.04 (1)(m) ZONING O Permit Holder'sNa City Village X9CIW POIX COUNTY G NtWr CENTER Timm, Tr 004-1057-50-000 Cad Township el Road CST BM Elev: Insp,BM Efev: BM Description: Hudson, WI 54016-7710 (715) 386-4680 • x (715) 386-4686 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header/Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP/SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dist, to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia length Dia Spacing 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 Bed/Trench Edges Topsoil Yes No El Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 3253 20th Ave Wilson, WI 54027 (NE 1/4 NW 1/4 25 T28N R1 5W) NA Lot Parcel No: 25.28.15.391A 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = 3.) Contour = Plan revision Required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R3/97) Date Insepctor's Signature Cert. No. Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 404986 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Prv,j3cy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Timm, Travis Cad Township 004-1057-50-000 CST BM Elev: Insp. BM Elev: BM Description:, TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header/Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP/SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number f ~is7t 7~d1 dti. At o~ 4/ 7 73 - 9 7 TDH Lift Friction Loss System Head TDH Ft H2 /0Z,-;0 ,-.I& 9a- Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth -1 1 DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) LLength Dia Spacing 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 Bed/Trench Edges Topsoil Al Yes U No ] Yes F ] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 2t Inspection #2: / / ex je Location: 3253 20th Ave Wilson, WI 54027 (NE 1/4 NW 1/4 25 T28N R15W) NA Lot w lb Parcel No: 25.28.15.391A 1.) Alt BM Description = AeA Ili 2.) Bldg sewer length = - amount of cover = 3.) Contour = Plan revision Required? zJ Yes ; No I Use other side for additional information. L L~1~_J _ - - Date Insepctor's Signature Cert. No. \ -6710 (R.3i97) SBD Au& Sanitary Permit Applicati Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application Box 7302 Wilsconsfrx Personal information you provide may be used for secondary purposes Madison, W1[ 5 53707-7302 Department of Commerce e (Privacy Law, s. 15.04(i)(m)] (Submit completed form to county if not state owned. Attach complete plans to the county co only) for the stem, on paper not less than 8-1/2 x 11 inches in size. County State Sanitary ecmQ be ❑ Check if revision to previous application State sPlan 171). ~ 8 umber 1. Application Information - Please Print all Informatio Location: Property Location Property Owner Name RECEIq71 l/4nWt/4, S~i'iZBN, Rj \V Property Owner's Mailing Address Lot Number Block Number APR 0 1 3 ~ City, State Zip Code S P6Kb Subdivision Name or CSM Number rXTO60t~ SGr~ !5q62,? N rF) S7 k ❑ City pe of Building: (check one) s.' ❑ Village II. Ty L~r 1 or 2 Family Dwelling - No. of Bedrooms : r'a s awn of ❑ Public/Commercial (describe use)- w r Ir 10 ❑ State ed 80 Nearest Road ZQ 1 !1 t tr = ~.Otl.~Ztt Il. P axN~r er(^)~_~ III. T e of Permit: Check only one box on line A. Check box on line B if a licable G. ❑ Addition to A) 1, ew 2. ❑ Replacement 3. ❑ Replacement of 4. 5• S stem S stem Tank Only Existin S stem Permit Number Date Issued i B) ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) . ❑ Non-pressurized In-ground 85r,_Zd ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In-ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At- de ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: gra V. Dis ersal/Treatmettt Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6.S ystem Elevation 7. Final Grade Required Proposed Rate (GalsJday/sq. ft.) (Minlmch) Elevation IV60 1/f 0 Y5'0 0,!5-C) 4 9 9. c0 Geo. 9' VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing Crete strutted Tanks Tanks ❑ ❑ ❑ ❑ 77-=c] - 50 VIII. Responsibility Statement I, the undersigned, assume resxrsihilit for installation of the POWTS shown on the attached plans. 7 Number's usiness Phone Number Name (print) PlusnbefZi MP/ MPRS No. Cz2Sa3~ is 336Z PI ber's Address (Street, City, State, Zip Code) /d 76 h"_41,' ral opal -05,a (,t)l, Syd/6 IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Si nature (No stamps) )FIApproved ❑ Owner Given Initial Adverse Surchar Fee) j ?,v0 Determination 3 2$ Apj X. Conditi ns of Approval /Reasplls for Disapproval: Lit- • Eled2on ca/ yp' Ga,rald $ ✓;cK,'c Clamp I nE~w 5. Zs nOle CCLz SE• Croix a Fa- Ti'a vi's 77,,,,, 3 0 C.. AW), rt syo27 3 0 w Vso "c Co Cl etc; s k e- ld /a ne ' "83, ■ Propascd -75o eu.mio CAhambo-r, - _ 984 V iis.r j 3031 C SSu," e rev- _ /DO. co ' Pao posed 2 bedivo kome. A LL ~a; I -.n proposed xv ir"P. -syfrc,.{zi,, K / "As A &,-e e. W Za6cl A-,cn fFFlue.tt lEcr Elev. at 0L Lt (,q) 1,7 vo loge. in voa& of s.T. $ PC'.. Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD (608) 264-8777 N*hsconsin www.commerce.state.vA.us/sb www.vAs .wisconsin.gov .gov Department of Commerce Scott McCallum, Governor Philip Edw. Albert, Acting Secretary November 15, 2001 CUST ID No. 225036 MICHAEL P MC DONELL ACE SOIL & SITE EVALUATIONS 340 PAULSON LAKE LANE OSCEOLA WI 54020 TYPE SUBJECT OF COMMUNICATION HERE Identif ers Transaction Ili i' . 685568 SITE: Site ED No: 638214 Travis Timm Please refer to both identification numbers, 20TH Ave above, in all correspondence with the agency. Town of Cady St Croix County NE 1/4, NW 1/4, S25, T28N, R15W FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 818397 This letter is to inform you of a discussion among the POWTS review staff and supervisors in regards to the straight mound design on a sloping site. An interpretation, has been reached that in cases where the basal area has a cross slope in excess of one percent, the cell is to be orientated to follow the contour. This plan shows, the cross slope in the basal area is close to two percent along the length. This means that the cell is to be oriented along the 98.0 contour. This is a change from the approved plan that has been sent back to the designer. The calculation supplied in the original approval letter under bullet no. 5, as well as those added to the plan by this reviewer are to be ignored. The new dimensions I have calculated are as follows: B = 91 feet; L = 108.25 feet The approved changes will become an addendum to the plans previously approved. All other portions of the installation shall conform to the original approval. As a reminder, in granting the approval, the Division of Safety & Buildings has reserved the right to require change or additions as necessary for code compliance. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Please refer to Transaction ID No. 685568 when making an inquiry or submitting additional information. Sincerely, Charles L Bratz POWTS Reviewer II , Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday - Friday cbratz@conunerce.state.wi.us cc: James K Thompson Zoning Office St Croix County Spia Travis Timm Safety and Buildings LA CROSSE WI 54601-1831 Nvisconsin 4003 N KINNEY COULEE RD TDD tt: (608) 264-8777 www.commerce.state.wi.us/sb www.wis .wisconsonsin.gov .gov Department of Commerce Scott McCallum, Governor Philip Edw. Albert, Acting Secretary November 05, 2001 CUST ID No.225036 ATTN: POWTS Inspector MICHAEL P MC DONELL ZONING OFFICE ACE SOIL & SITE EVALUATIONS ST CROIX COUNTY SPIA 340 PAULSON LAKE LANE 1101 CARMICHAEL RD OSCEOLA WI 54020 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/05/2003 Identification Numbers Transaction ID No. 685568 SITE: Site ID No. 638214 Travis Timm Please refer to both identification numbers, 20TH Ave above, in all correspondence with the agency. Town of Cady St Croix County NE1/4, NW1/4, S25, T28N, R15W FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 818397 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: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.01/01) and the SSWMP Publication 9.6 Design of Pressure Distribution Networks forST_SAS (01/81) • 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. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the Mound manual, and the pressure distribution component manual are complied with. A copy of this letter including instructions and information relating to proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • Limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. • The bottom of the distribution cell is to be laid level and a minimum of three to one slope constructed in the upside and down slope area of the component. In the center of the cell the (D) fill depth will be 1.24 feet, and the (E) fill depth will be 1.75 feet. The components dimension (J) will be 6 feet, and the (I) will be 13 feet. MICHAEL P MC DONELL Page 2 11/5/01 • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). In addition, 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. • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.52(3) 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. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The upper edge of the top cell is to follow the 97.8 foot contour. The orientation of the cell is to follow parallel to the surface grade contours on sloping sites. This is stated in Table 2 of the mound manual, and Comm 83.44(6)(a)2. 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 / Fee Received $ 175.00 rr! l Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789-7893 , 7:45 am - 4:30 pm Monday - Friday cbratz@commerce.state.wi.us cc: James K Thompson Travis Timm MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Travis Timm 3 bedroom residential mound Owner's Name: Travis Timm Owner's Address: 3//off Wilson, WI 54027 Legal Description: NE1/4NW1/4, Sec.25, T,28N., R.15W. Township: Cady OC County: St. Croix S~ O Subdivision Name: na Lot Number: na Block Number: na ~O Parcel I.D. Number: 004-1057-50-000 Plan Transaction No.: Page 1 Index and title Page 2 Data entry qm&&naffy Page 3 Mound drawings APPROVED Page 4 Lateral and dose tank Page 5 System maintenance specifications iEW OF COMMERM Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Site Plan SEE CORRESPOND E Page 9 Soil Evaluation Report Designer: Mike MCDonell License Number: 225036 Date: 09/05/01 Phone Number: 715-386-8692 Signature: gp-au Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 3.0 (03/01/01) Pagel of 9 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 83-44-3 in-situ sal treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150%) coliform of 36 inches. 450.00 Design Flow (gpd) 10.00 Site Slope 98.00 Contour Line Elevation (ft) 24.00 Depth to Limiting Factor (in) 0.50 In-situ Soil Application Rate (gpd/ff) Distribution Cell Information 90.00 Dispersal Cell Length Along Contour (ft) = 5.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ftz) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) c Center or End Manifold 2.50 Lateral Spacing (ft) If N above, enter the elevation (ft) 4 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 2.50 Estimated Orifice Spacing (ft) = 6.25 ft /orifice 2.00 Forcemain Diameter (in) 30.00 Forcemain Length (ft) Does the forcemain drain back? Y 92.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 4.89 Forcemain Drainback (gal) 6.50 Vertical Lift (ft) 81.25 5x Void Volume (gal) 0.57 Friction Loss (ft) 86.14 Minimum Dose Volume (gal) 13.57 Total Dynamic Head (ft) 29.66 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 x 1.50 x x 1.25 x 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator (optional) Treatment Tank Information 750.36 Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) 37.00 Total Working Liquid Depth (in) Wieser Concrete Manufacturer 20.28 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 750.36 Dose Tank Capacity (gal) Zabel ✓ Filter Manufacturer 20.28 Dose Tank Volume (galAn) Al 00 Filter Model Number Wieser Concrete Manufacturer Project. Travis Timm 3 bedroom residential mound Page 2 of 9 Mound Plan View T - 1/10 B . ;Q' J Observation Pipe 3 _ 1 FK O" A W i B I • . . L Mound Component Dimensions SEE CORRESPONDENCE A E 18.00 in H 1.00 ft K 9.13 ft qT , B 0. F 9.50 in z 11.96 ft L ft D .00 in G 0.50 ft J 5.29 ft W 450.00 (ffl Dispersal Cell Area 1526.79 (fta) Basal Area Available 5.00 (gpd/ft) Linear Loading Rate 9.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 100.79 (ft) -D 1 r' 1ii~f~f~i 2 iii Wiii -C 99.50 (ft) Lateral Dispersal Cell Invert 99.00 p-101 y Dispersal Cell s 1 Elevation E D . _-A .1- 1 A 98.00 (ft) Contour Elevation 10.0 % Site Slope Geotextile Fabric Cover Shading Key m c Dispersal Cell See lateral details on Q = Topsoil Cap c a 1.5 ft Page 4 for number, F-1717-1 Subsoil Cap tlD o size, and spacing of • ~ : ASTM C33 Sand F laterals. Laterals are TYP 'cal Lateral equally spaced from 0 5 ft Tilled Layer % Aggregate o the distribution cell's A _ } centerline in the distribution cell (A)dB). Project: Travis Timm 3 bedroom residential mound Page 3 of 9 Center Connection Lateral Layout Daigram force main connection via tee or cross to manifold at ang point. Laterals are identical I P f-F Turn-up wiba l l valve or IE- X---.) IEa12 1-1 ..12.3) Laterals & force main of PVC Sch 40 cleanoutplug per COMM Table 84.30.5 Holes drilled on the bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.53 ft Lateral Length (P) 44.28 ft Orifices per Lateral 18 Lateral Spacing (S) 2.50 ft Orifice Density 6.25 fe/orifice Lateral Flow Rate 7.41 gpm Manifold Length 2.50 ft System Flow Rate 29.66 gpm Manifold Diameter 1.50 in Total Dynamic Head 13.57 ft Forcemain Velocity 3.03 ft/sec Dose Tank Information Locking cover with waming label and locking device and sealed watertight Electrical as per NEC 300 and or- Comm 16.28 WAC 4 in. min. Disconnect Tank component is properly vented Alternate outlet location Forcemain diameter Wieser Concrete Manufacturer 2 in. Capacityl 750.36 Gallons Volume 20.28 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 18.51 375.46 C B 2.00 40.56 Pump off elevation (ft) C 4.49 90.98 93.00 12.00 243.36 D 750-5 l 37.00 750.36 ~ Dose tank elevation (ft) s Bedding un er tank. 9200 .Alarm Manuafacturer LevelArm Alarm Model Number DLV Pump Manufacturer Zoeller Pump Model Number #98 Pump Must Deliver 29.66 gpm at 13.57 ft T D H Project: Travis Timm 3 bedroom residential mound Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name J. Thompson, POWTS INSP.#4819 Phone 715-248-3271 POWTS Regulator's Name St. Croix County Zoning Phone 715-386-4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 f? Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Should inspect and clean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every_ 1.5 ears Mound Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box !P, Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Travis Timm 3 bedroom residential mound Page 5 of 9 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01) and SSWMP Publication 9.6 (01/81)) 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 co rrpawd. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 289.48, Stats, The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet fitter shall be assessed at least once every 3 years by inspection. The outlet fitter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank 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 113 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel 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. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be bested to verify proper operation. If an effluent fitter 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 as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BObs, 150 mg/L TSS, and 30 mg/L FOG for septic tank eff luent or 30 mg& BOD5, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. 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 o+nmer, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency 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(s) 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 fts' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page ~ of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Travis Timm 3 bedroom residential mound Page 6 of 9 HEAD/CAPACITY CURVE EFFLUENT and DEWATERING WARNING: Model 185/4185 should not be subjected to less than 30 feet TDK TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE In w S- w 1i1 SERIES _ I 81 46 _ 3731 11 iJil19 16114161 16Yt361 _6YA165 _18SllliS I6ti 1166 _I 1611_111 1~9~~I6i I~ W _ - S 2. M Cll. Lln. Gll. Lt., G11. Lh G11. UI G11. Lbl G11. Lbl G.I. Lb. G11. LV, G11. Lbl. G11 Lim Gll Lt, I(rl Lim G11 X111 G. l Lll 1 4_- 3 1.33 16.5 61 II- 106 11 111 77 271 91 357 H 356 106 101 61 731 61 111 36 11o ISS S17 35 SIB 1! 116 42 - 10 - LOy 11.1 50 2J 17 3/ 129 it 171 79 30C 10 NI 100 371 61 111 61 7J. _ S1 110 ~1! 660 S Si, t t;0 t 3` -15-! 1/ !_1__s 1 $7 _ 19 71 1s 170 N-J/ 31 II __!L }tl 60 ~o _7t ss -uo~ 1 s~_ 14 1 s 1 1 - 1 20 1 t0 2.5 9 3 11 2S IS J6 136 71 226 17 310 59 121 10 271 sl Z2o JE 31S C M 1 Ili 113 0-- - - u 61 6 J0 63 271 N 160 31 216 39 21) sa u6 ! 21 41 a al Is rc 30 111 sJ 201 6s 266 ss 706 56 _ue 90 J+0 $41 u6 12' 166 M1 c 1;2 60 12,11 - - Ja 111 16 IN 16 121 s5 201 15 211 sb no I_as J17 n 111 1 171 I 33 - 1 1- SO 1511 21 10 J1 173 51 111 56 119 Sb 221 90 NI 'tOC 3-11-1 IS I.3 10 1119 - _ IS 51 6J 16, A 116 56 2:20 1 n 2151 IS IS , 112 .10 111 17 31 $2 192 51 192 0 `b:45 17 19 1 10--- 24.34 a 31 - As 170 21 106 >1 271 1 17; - 1 r- - - to 21.17 - --r 2 171 2 1 I 100 X,441 _ 16 its 1 9 1' 151 - - Ito uoo 1 U - - - - - 26 - e 3 120_ ttsa _ _ _ I UJ IJO 39.67 Las V11.<. II II' 1115 23' 26' 16' 36' 66 /r 1 115 i 10' - 95- 7g - - - 186, 25 4 186 - - - 165, 80 4165 - - - - - - - - - - - 24 75 - 22----- 7C- - - - - 23 05 - - - - -i-- 8 60- - 163, - f i- 4163 189, -I- 5t- - _ 4189 ---I-- - - 5 -I 5 C - - - - - 45- - - - - - - - - - ~40 _ 2 --T-- r 140, 188. 4140 4188 t --1- - - 185, 137, - 25- 1,39 4185 - 20 /357 ~~a ~ 1 - - l - - 5 43 48 53,55 -16 1 57,59 98 4161 y'.' ~_ONS tG_20~ 0 40~ 50 60 70 80 90 100 ~-10 120 1130 I40 ~II50-1GO 80 !60 240 320 400 480 560 - - 6n0 0 FLOW PEI? MINUTE JU 79:7 Note: For Head~pc'm-on M'nn;M"~en9 'i f race l~yd a ahy odelrnu112, i dl75trial col min-explosion prooof pump, see FM0219. ~ ~ ~ o~ 9 die • E/ed~z~ion y cl,cra n Err w 5. 2s o,!' Cade SE. Croix G., j~. a Fd-r r Tea v/:s 7 m m 3 /0 Co. Wwk. rr 6J,'lsen, col. 6-yo,Z7 v c (,)CO Ci ,~'c--Uaw /ald \ a ~Ac- c e,K /a ` o `~~a • 82~ Ile P,-Opasl-C4 -75V y:4sTwl 3031 - - - - - e~'Jkcn~ n C %ji : 7- of/1 ' r 6e pro pesed 2 beds Y"-b;lc kome Proposed 1, czLJ Sapl~c{an K q A &ree. 4 Za6d A-tcn f.FF'luenE, Pltzcr Elev. = /o/. cd ' at o,,..tl-(k . F-1111.- our Ny in" Sc~.'/0 101/ in 6ccE 0 ~ 1462 • Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 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 pant (BM), direction and - - - - - - - - percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. 004-1057-50-000, ID#25.28.15.391 A Please print all Information. Reviewed BY - - - Date - - Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Gerald & Vicki Glampe Govt Lot NE 1/4 NW 1/4 S 25 T 28 N R 15 W Property Owner's Mailing Address Lot # Block # 8ubd. Name or CSM# 216 320th Street ✓ Town Nearest rest Road City State Zip Code Phone Number City 1 Village Wilson WI 54027 715-772-3252 Cady 20Th Ave. ✓ New Construction Use: V, Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial - Describe: Parent material Glacial Till _ Flood plain elevation,ff applicable na _ General comments and recornmendations: Mound system elev. = 99.00' at 12" above 98.00' contour. Boring # Boring Pit Ground Surface elev. 98.11 ft. Depth to limiting factor - - -38----. --in. Soil Application Rate Horizon Depth 7 Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIft2___ 'Eff#1 `Eff#2 1 0-6 j 10 r3/3 -none - - - sil ! 2fsbk ds_ as - 2f,1 m - 0.5 t 0.8 - - - 1 fm 0.5 0.8 2 6-16 10yr5/4 -----none - sll - Y--- 2msbk-- -ds cw 3 16-38 7.5yr4/6 none sl 2msbk dsh aw 1f 0.5 0.9 4 38-60 7.5yr4/6 f2f 7.5yr5/8 sl 2msbk mfr gw - 0.5 0.9 5 60-82 7.5yr4/6 m2d 7.5yr6/8 sl 1csbk mfi 0.4 0.6 I - - - 1-- - - - - Y - - - - } - - _ _ . - - I FYI Boring # Boring 24" ✓ Pit Ground Surface elev. _ 97.98 ft. Depth to limiting factor Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence I Boundary j Roots _ GPD/ft?__-_ 1 0-7 1 0 "Eff#1 -Eff#2 none r3/3 - n - sll - - 2fsbk - - ds - as 2f,1 m 0.5 0.8 - -y 7-17 'I 10 r5/4 none sil 2msbk ds cw - . - - - 2 y ~ 1 fm - i 0.5 ~ 0.8 rt--- _ - - 1 - - i 17 24 7.5 r4/6 none i sl 2msbk dsh aw 0.5 0.9 3 ---y- - - -t - - - - - t- - - 4 24-36 7.5 r4/6 m2d 7.5 r5/8 sl 2msbk mfr gw 0.9 i - - - - 0.5 5 36-66 7.5yr4/6 m2d 7.5yr6/8 I sl 1 csbk mfi 0.4 0.6 j I I Effluent #1 = BOD 5> 30 < 220 mg/L and TSS > < 150 rng/ fflu t #2 = BOD < 30 mg/L and TSS <-30 mg/L CST Name (Please Print) Sign re: CST Number James K. Thompson 3602 - - - - 2- - Address A.C.E. Sal & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54 9/1/01 715-248-7767 ' property Owner Gerald & Vicki Glampe - Parcel ID # 004-1057-50-000, ID# Page of 3 _ 37 Boring # Boring ✓i Pit Ground Surface elev. 95.78 ft. Depth to limiting factor 26" in. So i Application Rate Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots -GPDIft?_ Horizon i, 'Eff#1 "Eff#2 1 0-10 10yr3/3 none sil 2fsbk ds as 2f,1m ! 0.5 0.8 - - r----- - - - - - - - - 2 10-18 10yr5/4 none sil 2msbk - ds cw 1 fm ! 05 0.8 3 18-26 7.5yr4/6 none sl 2msbk dsh aw I if 0.5 0.9 4 26-36 7.5yr4/6 m2d 7.5yr5/8 sl 2msbk mfr gw - 0.5 0.9 5 36-57 7.5yr4/6 m2d 7.5yr6/8 sl 1csbk mfi - 0.4 0.6 I I I 7 Boring # ; Boring Pit Ground Surface elev. Depth to limiting factor 23" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure 1 Consistence Boundary Roots GPDift `Eft#1Eff#2 1 0-7 10yr3/3 none sil 2fsbk ds as 2f,1 m 0.5 0.8 2 7-16 10yr5/4 none sil 2msbk ds cw I 1 fm 05 0.8 3 16-23 ! 7.5yr4/6 none sl 2msbk dsh aw if 05 0.9 4 23-35 ! 7.5yr4/6 m2d 7.5yr5/8 sl 2msbk mfr gw - 0.5 0.9 5 35-48 7.5yr4/6 m2d 7.5yr6/8 sl 1csbk mfi - 0.4 0.6 i i i ❑ Boring # Boring Pit Ground Surface elev. ft Depth to limiting factor in. Soil Application Rate Horizon ! Depth Dominant Color Redox Description Texture Structure Consistence ! Boundary Roots _ _ _GPQIff_ _ _ _ `Eff#1 'Eff#2 i I_ I _ l - - - . - } . a-- - - - - I Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 < 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. Qe{ "IVC2 ■ So;/evQ/(4 a~lori #0,'& • E/eda lion Gerald$ ✓ice;e 6/aml~ nEnu; 5.2s; n, of" CU-01 SE• Croix a,., "?t. Fe- r~ Tea vi:s 77 ►m m 3~oeo.~~•~ ~ ~so'* U-)CO C~ 0 4'a-Uaw sky . /a icl 0 ~A o 4 ■ - - - _ /e~ _ 9,6 co - ■ - 980' ~e of Pro Pesecd 2 bedrMrn ssc~.n ¢ f,&" = r00, co,' 1'vto ~ hcme, . B. a; ~ ~ n &r'ee. Ete~ = iot. ct~• , 3 of'S 1462 Wisconsin Department of Commerce SOIL, EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in acxxlydance with Comm 85, Wis Adm Code A.C.E. Soil & Site Evaluations Attach complete site plan on papeFZaon t less than 8% nze Plan must County St. Croix include, but not hmted to: vertu horiti(B, and percent slope, scale or dimensionorth and d~sfarx tp newest road. Parcel I.D. 004-1057-50-000, ID#25.28.15.391A Please prin MW n•.* By Date Personal ftmiagm you provide may secondWY C law, s, tS.64 (1) (m)). 3 Property OwnerProperty Location Gerald & Vicki Glampe r Lot NE 19 NW 114 S 25 T 28 NR 15 W Property Owner's Mailing Address x Lot Block # Subd. Name or CSM# 216 320th Street ZQr ."Nn City State Phone Cily Village ✓ Town Nearest Road 2 Cad 20Th Ave. Wilson WI 540 j7r ✓ New Construction Use. ✓ Residential ! Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial - Describe: Parent material Glacial Till Flood plain elevation, if applicable na General canmerrts and recommendations: Mound system elev. = 99.00' at 12" above 98.00' contour. Boring # Boring 4/ Pit Ground Surface elev. 98.11 ft. Depth to limiting factor 38 in. Sol Apps Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *E GPOrf *EfW 1 0-6 10yr3/3 none all 2fsbk ds as 2f,1m 0.5 0.8 2 6-16 10yr5/4 none sii 2msbk ds cw 1fm 0.5 0.8 3 16-38 7.5yr4/6 none sl 2msbk dsh aw if 0.9 4 38-60 7.5yr4/6 f2f 7.5yr5/8 sl 2msbk mfr gw 0.9 5 60-82 7.5yr4/6 m2d 7.5yr6/8 sl 1csbk mf - - Or. 0.6 El Boring # Boring ✓ Pd Ground Surface elev. 97.98 ft. Depth to limiting factor 2~! in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Et~ PD1lP 1 0-7 10yr3/3 none sil 2fsbk ds as 2f,1m 0.5 0.8 2 7-17 10yr5/4 none sil 2msbk ds cw 1 fm 0.5 0.8 3 17-24 7.5yr4/6 none sl 2msbk dsh aw 1f 0.5 0.9 4 3,4.-36 7.5yr4/6 m2d 7.5yr5/8 s( 2msbk mfr gw - 0.5 0.9 5 36-66 7.5yr4/6 m2d 7.5yr6/8 sl 1 csbk mfi - - 0.4 0.6 * Effhrent #1= BOD ? 30 < 220 mg/L and TSS > <150mg~ ffl #2 = BOD <30 mg/L and TSS <,30 mg/L CST Name (Please Print) Sign CST Number James K. Thompson yft4 3602 Address A.C.E. Solt & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, W1 9/1/01 715-248-7767 property Owner Gerald & Vida Glampe Parcel ID # 004-1057-50-M ID* Page 2 of 3 Boring F3 Boeing # ✓ Pit Ground Surface elev. 95.78 ft. Depth to limiting factor 26" Soil Application Rate Horizon Depth Dominant Cola Redox Description Texture Structure Consistence Boundary Roots GPDAr *Eff#1 *Eff#2 1 0-10 10yr3/3 none sil 2fsbk ds as 2f,1m 0.5 0.8 2 10-18 10yr5/4 none sil 2msbk ds Cw 1fm 0.5 0.8 3 18-26 7.5yr4/6 none $l 2msbk dsh aw 1f 0.5 0.9 4 26- 6 7.5yr4/6 m2d 7.5yr5/8 sl 2msbk mfr gw - 0.5 0.9 5 36-57 7.5yr4/6 m2d 7.5yr6/8 sl 1 csbk mfl - - 0.4 0.6 4 ] Boring # Boring ✓ Pit Ground Surface elev. 98.13 ft. Depth to limiting factor 23" in. Sod Application Rate F Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW *Eff#1 *EffW2 1 0-7 10yr3/3 none sd 2fsbk ds as 20m 0.5 0.8 2 7-16 10yr5/4 none SO 2msbk ds cw 1 fits 0.5 0.8 3 16-23 7.5yr4/6 none sl 2msbk dsh aw 1f 0.5 0.9 4 23-35 7.5yr4/6 m2d 7.5yr5/8 sl 2msbk mfr gw - 0.5 0.9 5 35-48 7.5yr4/6 m2d 7.5yr6/8 sl 1 csbk mfi - - 0.4 0.6 11-T I I i - i i I E-T-1 F-I #ng Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant color itedox Description Texture Structure Consistence Boundary Roots = "Eff#1 *Eff#2 ' Effluent #1= SOD 30 < 220 Vt. and TSS >30 < 150 mglt. * Effluent #2 = SODS - 30 mglL and TSS <~0 mgll. The Department of Cornmeroe is an equal opportunity service pmvider and employer. If you need assistance to access services or need material in an ahwisic forrnat please contact the department at 608-266-3151 or TrY 609-264-8777. , ~e{~ ~ /~l62 vl~ 3ZO S c,,/ e va /ual6'or1 00,'& ♦ E/eda-4on Y e4rafd$ Ll"C'eif b/amaf AEA~.~•; 5. Z5; i or Cadr, SE • Croix (1 91. fir: Tea vi:s 7 im m t 3 / o (2o. Wwx. f 4- uJ,'lsen, 1.,)/. S'/O,Z7 4 t c LOOD C~ k etcis4" /a E p 99 ♦ `moo - - - SSu..n _ /OJ. c0 ' Pro posed 2 bt. =ON Y~to home. a -.n ~ ~s wee. Elegy _ /oi. c+~., 3 oF3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owne~~a ✓ i 5 ~ i ►-n Mailing Address 31 / O eo Acov. ~chi /Sa i. c,J1. S ,/0,2.7 Property Address 32 S3 26 *c Aet • - (Verification required from Planning Department for new construction) City/State Parcel Identification Number Off- /OS7-SO-~ LEGAL DESCRIPTION Property Location '/a, /711)1/a, Sec. 2s, T 20 N-RAW, Town of Subdivision 0 , Lot # Certified Survey Map # Y IA- , Volume r14- , Page # VKara ~e~d # ~4 (oSS4y' , Volume / 79<3 ,Page # Spec house ❑ yes o Lot lines identifiable yes ❑ 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 masterplumber, journeyman plumber, restrictedplumber or a licensedpumper verifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. L a I 1~ 10 / IS / 0l SIGNATURE OF APPLICANT 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 owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. ✓ 7,1 10 115,101 ~ SIGNATURE OF APPLICANT 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 made in the warranty deed 7 STATE BAR 6 AS' AIN FOR1MM 11 - 1982 6~55Q9 LAND CONTRACT c/ I(ATHLEEN H. WALSH Individual and Corporate REGISTER OF DEEDS (TO BE USED FOR ALL TRANSACTIONS WHERE ST. CkOIX C(). y WI Document Number OVER $25,000 IS FINANCED AND IN OTHER NOW RECEIVED FOR RECORD CONSUMER ACT TRANSACTIONS) 2j 2 12-17-2001 1:30 GM CONTRACT, by and between Scott G. Glamae, a single LAND CONTRACT Person ("Vendor", whether one or more) and Travis D. Timm_ a single EXEMPT li 0 Person ("Purchaser", whether one or more). Vendor sells and agrees CERT COPY FEE: to convey to Purchaser, upon the and full erfomance of this 31 I v !PA COPY FEE: prompt p ~ TRANSFER FEE: 118.20 contract by Purchaser, the following property, together with the rents, K RECORDING FEE: 13.00 profits, fixtures and other appurtenant interest (all called the "Property"), PAGES: 2 in St. Croix County, State of Wisconsin: W f The Northeast Quarter of the Northwest Quarter (NE'/4 of NW"/.) ~U 2 7 of Section Twenty-five 25 Township Twenty-eight (28) North, Range Fifteen (15) West, TOWN OF CADY. EXCEPT7Gertified. '-1- •v Survey Map in Volume 10, Page 2801, as Document No. 520009. Subject to easements, restrictions, rights of way, and well rights of record. Recording Area Name and Return Address ROBERT J. RICHARDSON S233 McKay Avenue P.O. Box 399 Spring Valley, WI 54767 004-1057-50-000 Parcel Identification Number (PIN) ap This is not homestead property. (f&)-(is not) Purchaser agrees to purchase the Property and to pay to Vendor at where ever directed, the sum of $59.400.00 in the following manner: (a) $1,000.00at the execution of this Contract; and (b) the balance of $58,400.00, together with interest from date hereof on the balance outstanding from time to time at the rate of 6 percent per annum until paid in full, as follows: Monthly installments of $350.00 commencing on January 5, 2002 and due on like day of each month thereafter until the balance is paid in full. Provided, however, the entire outstanding balance shall be paid in full on or before the 5'h day of December, 2031 (the maturity date). Following any default in payment, interest shall accrue at the rate of 8% per annum on the entire amount in default (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance). Purchaser, unless excused by Vendor, agrees to pay monthly to Vendor amounts sufficient to pay reasonably anticipated annual taxes, special assessments, fire and required insurance premiums when due. To the extent received by Vendor, Vendor agrees to apply payments to these obligations when due. Such amounts received by the Vendor for payment of taxes, assessments and insurance will be deposited into an escrow fund or trustee account, but shall not bear interest unless otherwise required by law. Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any amount may be prepaid without premium or fee upon principal at any time after January 5. 2002 (914) there may be me prepey.iie it of prineiveA without perrmiia-siom of Yemdor.* In the event of any prepayment, this contract shall not be treated as in default with respect to payment so long as the unpaid balance of principal, and :ntei fist (and ir, bind i ca56 a i;cruii q in to est fro ^ti to ^'cnh ehe'! be treated qc i!nnoid principal) is legs than the amount that said indebtedness would have been had the monthly payments been made as first specified above; provided that monthly payments shall be continued in the event of credit of any proceeds of insurance or condemnation, the condemned premises being thereafter excluded herefrom. Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except: None. Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall be retained by Vendor until the full purchase price is paid. Purchaser shall be entitled to take possession of the Property on January 5, 2002. Cross out one. STATE BAR OF WISCONSIN Information Professionals Company, Fond du Lac, WI LAND CONTRACT - Individual and FORM No. 11 -1982 800-855-2021 Corporate