HomeMy WebLinkAbout010-1049-20-100Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM
Safety and Building Division
~. INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)1•
Permit Holder's Name: City Village X Township
Olsem, Pat Emerald Townshi
CST BM Elev: Insp. BM Elev: BM Descri tion:
Q h.
TANK INFORMATION
' ELEVATION DATA
TYPE MANUFACTURER CAPACITY
Septic
Dosing
Aeration
Holding
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD
Septic ~~ ~ ~ ~- '~ ~ f ~ ~ a '
Dosing ~
y,s .~ /
Aeration
Holdin
PUMP/SIPHON INFORMATION =~' 3~ S
Manufacturer Dem nd
,~ GPM
Model Number ~ C ~~ ~ /
TDH Lift Friction Loss System Head TDH ( Ft
,~ ~ o z . !z • 1 ~
Forcemain Length Dia. Dist. to Well
~~ ~ Z /~
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length
DIMENSIONS s ~ q ~ Z /
SETBACK SYSTEM TO
INFORMATION _ _,
DISTRIBUTION SYSTEM
'/L BLDG WELL
~~Z ~/~ `~
County: , $t. CrUIX
Sanitary Permit No:
395126 0
State Plan ID No:
Parcel Tax No:
010-1049-20-100
STATION BS HI FS ELEV.
Benchmark ~• Z, !
T ~6*• `pD ,b
•
Alt. BM 3..(e p3•(~Or
Bldg. Sewer
~~s
~o z. yS
t/ t Inlet
lo.s
q
St/Ht Outlet ~
t Inlet
Dt Bottom
I'{ 3
93 _ s
HeaderlMan.
Dist. Pipe ,~~y ~bZ. ~ S
Bot. System ~ ~ jo ~ , /
/
Final Grade
St Cover
N/l ( / o .20 lOo,
Pits
Depth
CHAMB OR
IT Model Nu be `-o~
---
S,~il~ .rs rr~ ~ 4~ S'44) s•~•
Header/Manifold
/ //
~ Distribution
Pipe(s) / ~ 4 ~ ~
g x Hole Size
~ ,~ x Hole Spacing
~ ~ Vent to Air Intake
Length Z ~ ~ Dia Length Dia Spacin C
SOIL COVER x Prossnra Svs}ams Anly YY Mnund Or At-Grade SvStemS Only
Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched
Bed/Trench Center BedlTrench Edges Topsoil I~ Yes ~ No ~ Yes ~ No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection D ! ~ ~"I__~ Inspection #2: `t l to l~~
Location: 2381 County Road G Emerald, WI 54012 (NE 1/4 NE 1i4 21 T30N R1 W) N of /) Parcel No: 21.30.16.300810
.R...r-~s{I C~~st"s~a~e.~ ~4~~ `~~yto Svc ~~ ot~ ~~•,.a,~
1.) Alt BM Description = u 1
2.) Bldg sewer length = ~(~ ~
- amount of cover b ~~ _~ ,e ~ S•. ~ ~ (-~~ - t ~~• ~ `',
b~+dt' ~
3.) Contour = ~ p ~ . ._.
~-
Plan revision Required? Yes No ~ l ~~ j _---- ~ ~
Use other side for additional informati n. ~ i ~ i
,, Dat Insepctor's Cert. No.
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Safety and Buildings Division County /~
Sr
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~ ~ 201 W. Washington Ave., P.O. Box 7162 v/
~
~scons~n Madison, WI 53707 - 7162 Site Address
Department of Commerce ~~ 3~~
Sanitary Permit Appli~ion -` ~°~., Sanit^a~ry P~'t/z be
~
In accord with Comm 83.21. Wis. Adm. Code, perso ~h~ation you provide' `~
^ Check if Revision
ma be used for second ses Priva vs15.04 1 m)
I. Application Information -Please Print All Inform REc~ev~~ "a\
J State Plan I.D. N~ r
1. --H- s
Property Owner's Name
D _._
`
°' j
~ c ~ ~ ~ ~ 2nn1 Parcel Number
z/. ~o. /`. 30vg- is
~
s~~ -
j _ ID
/D~ moo- ~
Property Owner's Mailing Address
~, ' %
CQtJN?Y J Property Location
Q
~! ZOtdthIGOFFIGE `:~,.,~ ~
. /~-~ ~ ~~/
~- 'k/V~ ',4; S o2~ T N,
City, State Zip Code ~, `
y •_ hone Lot Num r Block Number
~ Subdivision Name CSM Number
~~~~ 1~~ ~ a is= 2~s= ~~ 3 9
s
.
II. Type of Building (check all that apply)
o~ PQr
^City
Q~,
~`1 or 2 Family Dwelling -Number of Bedrooms ~ k~-~~~ '~ ~ (ew. 5 5 GG~. ` Village
^ Public/Commercial -Describe Use ownship //~~ ;~~
^ State Owned Nearest Road
~,\
/~-~
III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable)
A' 1 }New 2 ^ Replacement System 3 ^ Replacement of 6 ^ Addition to For County use
S stem Tank Onl Existin S stem
13 • ^ Check, if Sanitary Permit Previously Issued Permit Number Date Issued
N. Type of Permit: (Check all that apply)(numbering scheme is for internal use)
44 ^ Non -Pressurized In-Ground 2~Mound ~; X 9~ L '' 47 ^ Sand Filter 50 ^ Constructed Wetland
22 ^ Pressurized In-Ground 41 ^ Holding Tank 48 ^ Single Pass 51 ^ Drip Line
45 ^ At-Grade 46 ^ Aerobic Treatment Unit 49 ^ Recirculating 30 ^ Other
V. Dis ersal/Treatment Area Informat ion: = Q , S ~
Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade
Required ~~ ~ Propose ys,/ ~ Rate(Gals./Days/Sq.Ft.) (Min./Inch) Elevation
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber plastic
Gallons Gallons of Tanks Concrete Constructed Glass
New Existing
Tanks Tanks
Septic o=-ti~ldine'r~. ®h~ ~ ~i~~
Dosing Chamber D ~~
VII. Responsibility Statement- I, the untie fined, assume r onsibl-ity for installation of the POWTS shown on the attached plans.
Plumber's Name (Print)
~ Pl 's Sig cure
'~ MP/MFRS Number Business Phone Number
S/~v z l~~l ~ 9~1v z- 1~ Z~.S ~ Zb
Plumber's Address (Street, City, State, Zip e)
~
~ ~ ~
~~ ~Ll~ f ~ ~~1 ~~~
VIII. Count /De artment Use Onl
Approved ^ Disapgroved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps)
Surcharge Fee)
^ Owner Given Initial Adverse .
~
S
~
Determination 0 C~
J Z L
IIC. Cond
itions of~p rovaUReasons for Disapproval
/
J /' /
*c~'tt+kawf ~"a~i-cr ~o be r`ns~ac,(/~~ G!~-a~ '~'rU~Gca ptr yv~a~r..~'tac~Gcrerf v«o
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Attach complete plans (to the County only) for the system on paper not less than 8112 x it inchea in size
SBD-6398 (R. OS/Ol)
y
isconsin
Department of Commerce
C
June 18, 2001 -`
uq
CUST ID No.139462
TODD L SINZ
E5609 708TH AVE
MENOMONIE WI 54751-5520
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Safety and Buildings
4003 N KINNEY COULEE RD
LA CROSSE WI 54601-1831
TDD #: (608) 264-8777
www. commerce.state.wi. us/sb
www.wisconsin.gov
Scott McCallum, Governor
Brenda J. Blanchard, Secretary
POWTS Inspector
._
~ CLONING OFFICE
+~ 1
~'`~---.•.YA.._...- - ~`'; ST CROIXCOUNTY SPIA
1101 CARMICHAEL RD
HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 06/18/2003 Identification Numbers
Transaction ID No. 651179
SITE• Site ID No. 631171
BRIAN & WENDY OLSEM Please refer to both identification numbers,
CTH G above, in all corres ondence with the a enc .
TOWN OF EMERALD, 54012
ST CROIX COUNTY
NE1/4, NE1/4, S21, T30N, R16W
FOR:
DESCRIPTION: THREE BEDROOM MOUND SYSTEM
OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 796930
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:
• This system is to be constructed and located in accordance with the enclosed approved plans and with the
"Mound Camponent Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.O1/O1)
and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION
2.0" SBD-10706-P (N.O1(O1).
• 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 end monitoring duties as described in section VIII of the
mound manual, and section VI of the pressure distribution component manual are complied with. A copy of this
information must be given to the owner upon completion of the project.
• 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.
• 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.
TODD L SINZ
Page 2 6/18/01
• 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.
• The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating
to proper use and maintenance of the system Owners shall receive a copy of the appropriate operation and
maintenance manual and/or owner's manual for the POWTS described in this approval.
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.
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 maybe made to me at the telephone number listed below, or at the address
on this letterhead.
Sincerely,
~~~ti22~-~~c'4 ~f~~(
Charles L Bratz
POWTS Plan reviewer. II- Integrated Services
(608) 789-7893, Mon.-Fri. 7:45 AM to 4:30 PM
cbratz@c ommerce. state. wi. us
FEE REQUIRED $ 175.00
FEE RECEIVED $ 175.00
BALANCE DUE $ 0.00
WiSMART code: 7633
cc: BRIAN P OLSEM
~ ~
iscons~n
Department of Commerce
June 18, 2001
CUST ID No.139462
TODD L SINZ
E5609 708TH AVE
MENOMONIE WI 54751-5520
TOWN OF EMERALD, 54012
ST CROIX COUNTY
NE1/4, NE1l4, 521, T30N, R16W
FOR:
DESCRIPTION: THREE BEDROOM MOUND SYSTEM
OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 796930
ATTN.• POWTS Inspector
Safety and Buildings
4003 N KINNEY COULEE RD
LA CROSSE WI 54601-1831
TDD #: (608) 264-8777
www.commerce.state.wi.us/sb
www.wisconsin.gov
Scott McCallum, Governor
Brenda J. Blanchard, Secretary
ZONING OFFICE
ST CROIX~COUNTY SPIA
1101 CARMICHAEL RD
HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 06/18/2003 Identification Numbers
// Transaction ID No. 651179
SITE: pj~' ~~} b~s(a / Site ID No. 631171
& ' OLSEM Please refer to both identification numbers,
CTH G above, in all cones ondence with the a enc .
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrarive 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:
• 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.O1/O1)
and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION
2.0" SBD-10706-P (N.O1/O1).
• 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 section VI of the pressure distribution component manual are complied with. A copy of this
information must be given to the owner upon completion of the project.
• A Sanitary Pernut 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.
• 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.
TODD L SINZ
Page 2 6/18/01
• 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.
• The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating
to proper use and maintenance of the system Owners shall receive a copy of the appropriate operation and
maintenance manual and/or owner's manual for the POWTS described in this approval.
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.
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 maybe made to me at the telephone number listed below, or at the address
on this letterhead.
Sincerely,
~~~~~~~i~~~21 ~i~
Charles L Bratz ~"
POWTS Plan reviewer II- Integrated Services
(608) 789-7893, Mon.-Fri. 7:45 AM to 4:30 PM
cbratz@commerce. state. wi. us
FEE REQUIRED $ 175.00
FEE RECEIVED $ 175.00
BALANCE DUE $ 0.00
WiSMART code: 7633
cc: BRIAN P OLSEM
[~
_*
Transaction #
Construction Materials and Techniques
All materials must comply with Comm 84 and be installed in accordance with manufacturer's
specifications. Construction methods must comply with the following Component Manuals:
Mound, SBD-10691-P (O1/O1)
- Pressure Distribution, SBD-10706-P (O1/O1)
Location: NE 1/4, NE 1/4, Sec. 21, T 30, R 16 W
Town: Emerald
County: St. Croix
Date:
Owner:
Address:
Plumber:
Signature:
License #
Attachments:
w Brian & Wendy Olsem -Mound
June 5, 2001
Brian & We y Olsem
r~
2399 CT G
Emerald 54012~~
3
6748-Plan Approval Application
SBD-8330
page 1: cover
2: design criteria & calculations
3: plot plan
4: system cross section
5: plan view, lateral detail
6: pump tank exit detail
7: pump curve
8: system management
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page 1 of 8
Design Criteria
Y ~°S Residential Wastewater Contaminant Load: 30 mg/L < BODS < 220 mg/L
Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L
Fecal Coliform > 10,000 cfu/100 mL
1~ ~ Treated Residential Wastewater Contaminant Load: 30 mg/L < BODS
Septic tank + "highly treated" effluent 30 mg/L < TSS
Fecal Coliform < 10,000 cfu/100 mL
3 Bedrooms x 100 gaUbedroom/day x 1.5 ~~ gallons/day hydraulic load
In situ designed loading rate
Depth to estimated high ground water ~ 3 c'
Depth to bedrock ? `~ ~°
Cross slope at system ~
Force main length ~ S
Manifold/header length Z • s~
Drain-back 2 • ~
Lateral length Z- @ g o • o
Lateral elevation ~ °'L. t.
Lateral hole size ~~- ~ in. @ ~ ° • °
~ ~ holes/lateral 3 g
Lateral volume ~ b.s b
Total lateral discharge rate 2• S^' ° B
Network pressure compensation losses ~ ' ~' S~
Elevation difference ~ • ~ S~
Friction loss ~ • z ~
Total dynamic head ~ 3.3 I
Pump/sipl~n ~l° gpm @ 14'
Manufacturer ~ ~ ~-''° `^• ~- ~~
Dose volume `'~ ~
Lift/si~on tank ~ J N- ~' ~ ~w~ - pro - t, ~o ~-o «+~o
,,
Septic tank ,,
Effluent filter ~o.-~ ~ - ~ ~'~
Measurement pump on and off ~ • $
Height alarm from tank bottom ~ 3- ~
Reserve capacity ~ Zd ~'
Design Calculations
~ • 3 ~ all s/ ft d
specs.calcs
g on sq. .per ay
in.
in.
ft. of Z in.
ft. of Z- in.
gallons
ft. of 1 `~ z in.
ft. @ bottom of lateral
in. ( 5 ` ° ft.) Spacing
holes total
gallons
gallons/minute @ ~' ~ ft. head
ft.
ft.
ft. @ Z~ gallons/minute
ft.
ft. of head
Model # S ~ ~'~ ~ °
gallons
~""° gallons
t `~'~'° gallons
in.
n.
gallons
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_ SpEGIFI•CATI~IJS
TAIJr.S MAAJUFACTURCR: w IJUMDER OF DOSES: ~ PEK DA.!
TA1JK SIZE : ~ ~~ ~ V~ GALLOIJS • .DOSC VOLUME ~ ~j
ALARM NIA~JUFACTURCR: S `, ~?~`~-~'~~ IAJCLUOIIJ6 6ACKFI.OW: GALLONS
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PUMP MA-JUFACTURCR: -- ~ ~"" `""' ~ 8=
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'' IJOTE; pUMP A1J0 ALARM ARC TO DE
MIIJIMUM DISCHARGC RAT[ 2;;~ OrM INSTALLED 0-J SEPARATE clkcu~r;
VERTICAL DIifERf-JCC DCTWCCU PUMP OF/ AUO OISTRIpUTI OAJ PIPE.. ___
FEET
+ MIAIIMUM AIETWORK SUPPLY PRfr,iURE ... ~
~~ ~ ~ ~ ~"~ FEET } ``~'~'~
+
FEET OF FORC[ MAIIJ X ~~ ~~ ~'Z't ~ Z~
IOO/tFRICT101J FACTOR.--~ FEET
~^ ~~~„~
TOTAL. DyUAMiC NEAO = I'll FEET
~
IIJTERAIAL. DIMEIJSIOIJ~i •OF TAA1K: LEAIfiTH~~~~ ~~ 4 2 „
~`,/;pTH. ~? LIQUID DEPTH-
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Punta Characteristics
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Norcepawor .to
F.a lAaa Aa~s ~.o
IRotor Slaisd PaM {4 l
R.pA. 1 iS0
Phaso 6 1
Y 115
Hertz b0
lelpporatwo 140`F Aatlisnt
NEIRA Desna A
itsolatla Clogs A
Dtr~d-nr Sha 1-I/~' NP'i Wiarrl
Solids HoodFny 3/4" {1pnW
u~r vitq-t sa ~.
Power Cord 1 d/fir Sl'CNG ~0' std.
Materials of Construction
Nrp~/lo _ r SMlalass Stwl
lnbrlr t0 0l 01
Nbtor Nona Caa kou
Cgs Cwt koa
Nlockl~
daft seal se.l rbt~: CsiaalCaraaic
saal ~ Aao~d st..l
ssluialatl St«I
wss Iaole~N
E tk
Gst Ina Sloaw
lows Rwr MN
tottoe Plan >k
~ ~
FastoMrt ~ Stoialoss S1n4
~1art~nrrne~'1~® Data
,.
6 ~ ~
i
t~~lo
I
l
~ s is :o ~ ~ ~
c~rru.sa,M. 1 i _. .,{,~__ -t-
uwelfuw~ a .,,., 1 . , r t
Total N~ hNt 0 i 12 10 ZO 44
a~w tuna u sb s' zs ~: o
Dim.hsienal Data
.~ IDA ISM ~ ~ AE Nerlcre w ildln.
~, I~ Ia 1Wreetienel ~.
0 w z co.ooknl mry
wy:1/1 ink
''a+i •.in i NM tw cMekua'wn puNw
crl Iglu arl~iei
Nr+• t ors ~ ,raw a~
e,•~ c~ecwROe epK~e
wt s. al/oN Mnl o~O61e
6, Mk rwrw tV risllr a eelh
~~ a or prNeu sld th~i
>pClimlae rltboul MMte
n. ~,. .~
I
~~' 7K
t)
raw
s•.si4 s~T~"~ye°
Ss5) ru-,I-~rr ~
~~ HYDRDMATIC'~
1844 BeneT Revd AsNeed, Oho 441~i Te1:119489.3019 Fox, 419•e81 ~40p
Web Site: axrr.p.Mdrounv.tom
SAlFS OFFKES IN A!t NWQN CRIES ANF~ tOUNTt1ES
item ~: W-u2.83S0 ~2G8 6M
p 1949 H~drort~cAic' Purnp~, Ashlarn~, Qhlo• N! Rig
- Ywr Author~xed lo:d dismiburor -
',osw~ , ~ ~ ~ o
i
.. ..~
! .. .
,, .._ .__ ..
l I ... _ _..
I
.~
~V,. ~.
..
System Management
Management of this system is critical. As a condition of approval of these plans this system management section must be
reviewed with the owner, and the owner mint be provided with a complete set of plans including this management section. If problems
develop with the adsorption system or any other system components, the installing plumber, T.L. Sinz Plumbing, 715-235-2644, or the
St. Croix County Zoning Office, 715-386-4680, should be contacted for assistance.
General
Proper functioning of an on-site disposal system, "septic system," is significantly dependent on the volume of water which flows
into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the
better and longer the-system will function. Typical system components include a septic tank or compartment to settle out solids and
contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a pump tank or
compartment to allow a dose to be accumulated, a pump and controls, and finally some type of soil adsorption cell to recycle the water
in a manner to protect ground water quality and public health.
1 . If the septictank is installed prior to sheet-rock and/or painting, pump the septic tank before normal use begins to ensure adherence
to contaminant load design criteria.
2 Install water-saving appliances whenever and wherever possible.
3. Repair even small water leaks as soon as possible.
4. Never pour grease or oil down any drain or stool.
5. Garbage disposals are not recommended; if you must have one, use it spazingly.
6. No paper products other than tissue should go into the system.
7. No chemicals should go into the system.
8. Avoid surge flows of water; try to spread laundry throughout the week.
Maintenance
1. The septic tank must be inspected every three yeazs by a properly licensed person.
2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume
equals one third of the tank volume.
3. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must be back-washed into
the septic tank to remove accumulated material.
4. Periodic observation pipe inspections should be made by the homeowner to examine the state of the in-situ soil adsorption cell.
Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption
cell.
5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany
their specifications.
6. The pumping components for this system include an alarm which must be installed and remain on a sepazate circuit from the pump.
[f the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve
capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or
two days should pass before any necessary repairs can be made.
7. Avoid compaction such as vehicle traffic within 15' down-slope of the adsorption system.
8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system.
9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth.
10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run-off into the system area.
1 l . Warning: Do not enter septic, pump or other treatment tanks; death may result because they may contain lethal gases or insufficient
oxygen.
Contingency Plan
Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring
may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54
(2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing,
and/or installation of additional treatment components or conversion to a holding tank may be necessary.
Page 8 of 8
i ~ Wisconsin Department of Commerce
Divisibn of Safety and Buildings
SOIL AND SITE EVALUATION
in accord with Comm 83.05, Wis. Adm. Code
Page 1 of 3
A.C.E. Soil & Site Evaluations
Attach complete site plan on paper not less than 8%s x 11 inches in sue. Plan must Gounty
include, but not limited to: vertical and horizontal r~aference point (B1Vn, direction and
l
• St. Croix
percent s
ope, scale or dimemsions, north arrow, and kx
,ation and distance to nearest road.
~ parcel I
D
#
^ ~""•~
APPLICANT INFORMATION - p
lrtail ir
fo
~
ati
n
i .
.
010-1049-20-000
r
-
~i
o
.
~
t
Personal information you provide maybe ry rposes (Privac , s. 15.04 (1) (m)).
'
Reviewed By Date
~
,
{ ~~ ~ ¢
Property Owner ~
l• nw Property Location
.
~
Brian & Wend Olsem 4 Goat. Lot NE 1/4 NE 1/4 S 21 T 30 N,R 16 W
Property Owners Mailing Address ~ ~ j Lot # Block # Subd. Name or CSM#
2399 Co. Rd. G ~ _ ~ ~ Pro osed CSM
City Ste- `Zip Codex tS mt>er ; ` ^ City ^ Village ^Town Nearest Road
Emerald ^-'5401 `-~ p't~tis;~?548` Emerald ~ County Hwy G
^ New Construction
ltesld@rlttalJ Numb~~ti~edrooms 3 ^Addition to existing building
Use:
^ Replacement ^ Pubii~ nteom_r~.rstall'describe
Code Derived dairy flow 450 gpd Recommended design loading rate .4 bed, gpolft •5 trend, gpd/ft~
Basal area required 1125 bad, ft~ 900 trench, RZ Maximum design bading rate •4 bed, gpd/t12 .5 trench, gpdffl?
Recommended infiltration surface e~vation(s) to2.e az 12" above 101.6' contour. ft (as refemrd to site plan benchmark)
Additional design /site considerations
Parent material Glacial Tilt Flood lam elevation, if a livable NA tt
S=Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank
U=Unsuitable for system ^ S ®u ®s ^ U ^ S ®u ^ s ®u ^ s ®u ^ s ® u
SVIL DESGRIPTIVN REPVRT
Boring#
1
Ground
elev
100.64 ft
Depth to
limiting
factor
36'
2
Ground
elev
100.09 ft
Depth to
limiting
factor
43'
i
H Depth Dominant Color Mottles
t
T Structure
Consisten
Bounda
Roots GPDlft2
zon
or in Munsell Qu. Sz. Cont. Color ex
ure ~ Sz ~ ry Bed ;Trench
1 0-10 10yr3/2 None 1 2fcr mvfr as 2f,lm 0.5 i 0.6
2 10-16 10yr4/4 None sil 2fsbk mfr cs lfm 0.4 ~ 0.5
3 - 16-36 7.Syr414 None sl 2msbk mfr gw if 0.5 ~ 0.6
4 36-96 7.Syr4/4 f2d7.5yr5/8 sl lcsbk mfi - - 0.4 0.5
Remarks: High sand content observed in H#3 & 4.
1 0-10 l 0yr3/2 None sl 2fcr mvfr as 2f,1 m 0.5 ~ 0.6
2 10-15 10yr4/4 None sil 2fsbk mfr cs 1 fm 0.4 0.5
3 15-19 10yr4/4 None sicl 2msbk mfr cw if 0.4 0.5
4 19-43 7.Syr4/4 None sl lcsbk mfi gw - 0.4 0.5
5 43-82 7.Syr4/4 12d7.5yr5/8 mixed sl Om mfi - - 0.3 ~ 0.4
Remarks:
CST Name (Please Print) Sigk(ature: Telephone No.
James K. Thompson ~~ 715-248-7767
Address A.C.E. Soil 8c Site Evaluations Date CST Number Ref #
340 Paulson Lake Lane, Osceol 54020 3/20/00 3602 1186
ht ~
,ode
:s
.S
,~
,y
,s
,~
,~
,7
-3
v
PROPERTYOVYWER: Brian & wend o~sem __-_-_____-_- SOIL DESCRIPTION REPORT
PARCEL I.D.# 010-1049-20-000
3
Ground
elev
98.63' ft
Depth to
limiting
factor
30"•
4
Ground
elev
102.00 ft
Depth to
limiting
factor
34"
Ground
elev
Depth to
limiting
factor
ttas Page _2 of _ 3 __
A.C.E. Soil & Site Evaluations
Horizon Depth Dominant Color Mottles
Texture Structure
sistence
Boundary
Roots GPD/ftz
,
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh, Bed ~ Trench
1 ~ 0-10 10yr3/2 None sl 2fcr mvfr as 2f,lm 0.5 0.6
2 - ~o
~ 14
10yr4/4
None
sil
2fsbk
mfr
cs
Ifm
0 4 0 5
3 - 14-21 10yr4/4 None sicl 2msbk mfr cw 1 f 0.4 0.5
4 21-30 7.Syr4/4 None sl lcsbk mfi gw - 0.4 0.5
5 ~ 30-85 7.Syr4/4 fZd7.5yr5/8 mixed sl Om mfi - - 0.3 0.4
Remarks:
~a I.J
cods
,~
's
`/
,~
.3
,s
`~
s
. `~
"~
1
2 0-10
10-22 10yr3/2
10yr4/4 None
None sl
sil 2fcr
2fsbk mvfr
mfr as
cs 2f,lm
lfm 0.5 ~, 0.6
0.4 0.5
3 22-34 7.Syr4/4 None sl 2msbk mfr cw if 0.4 ~ 0.5
4 34-48 7.Syr4/4 f2d7.5yr5/8 sl lcsbk mfi gw - 0.4 ~ 0.5
5
48-96
7.Syr4/4 f2d7.5yr5/8 &
12fl0yr6/2
mixed sl
Om
mfi
-
-
0 3 0 4
Kemarks:
Ground
elev
Depth to ---- - ---- ----- --- -- --- --
limiting '
factor
Remarks: ----- --- ---_ ----
r
K
y8 ~ 33
P~. 3~3
,/~ ~ /0% loO Con~e~r
~ ~lelf: ~ !
r
~ ~
!
~ ~
^~ i
3 ~ ,
~/~~ i
~ B~
~ ^
3Sl0't i
^ i
.8~ ~
i
~.cxa-~en Fence ~Sf . ~~
/~Sfcr.rrtC,d a ~~e~: = /cam cv'
C~ad¢ = 44.x:
ioS. 03'
ioS 01
/OS. Q~l'
trb L/
~-FJ. 1, ~ .
ProposQd
~es~dence
as S-taKcd
~ 50; ~ O~SeI~IQ~iOn
p; ~
• G~.de eltw`'
ScA..C4: ~ ~- ~/o
~wne ~'~
~r.an ~ ~w~+dy O/sem
,2 3 99 Co. fib. G
l-ova-~i'orn =
iQ. /( cJ, T , a {'Ems /'a. ~;
S~- 'lroir C'o., c.~J~
/,/G~,~:
iir"_s;'26Giiiii i~s;~~ r~~ iri~2::"s52o~+;: TL~i?VZri.uisi~sZrvc ig",~ii2
tyS.~11?~t111 FRT IA tt Csl~ TtR ,cc .Qpa
~.r. .-+tv ATi) /wf1TTR7'7~V
~- _~.?-__ - ~P - -
evtrrr~ re~,rrc i~,fATNTTiNANC'~ AC~RBEN~3N'T
ii~.TRR~FiTP ('.1?RTIFTCA7IQN Ft~PtiM
C}evnerlBuveY S~1~I
Maiiittt Adder ~ L"!? . /~~J ~ L~`~iI1~'~I~ li(~~ ~~~ f7i
PropcRty Aderess d 3 ~ ~, ~r
y~ICntlcaiIVSZ 7G~[ui[ct[i yT uFii r'i6uuiis~ iic~ra. a.~Yi i ••:i ••~ ••--.~~.'~'~'s_`.j.-. ~,
x we.. ~ r rrnt"i7TU'!`Tf1h
ivv S.LSL P A ° vs'
~~: ,, . __ _,:...; ~ +f ; /U,~ ~~ c t.~. ~_ T~ 1<I-It~~V. Tawn of ~~'~
~liPtI 17S~7~(S}~ ~~ IT ~~
~~!'*_i~~d ~~rvey Map # /_~Q'(~'f,) __ . Voltun0 / Page
iL_41_ n .._.. n ~L
~~ L~~q~ ~ V r~ ~ ~Q j..Vi lt~14V iuGi: ii ii~:v i~ i-= j =-
'a3 ~t~~' ~_ - -,-~. Rj - :~.-=~ _ . i~ro pittiatcnaoac
iu~ :se 3:.:: ~=:Ec=~==::° ,,.r - ~~ A .••a~ ~',..+ra ~r~~~,t± ~ a~~ nrrn.syhisse failuCa l4 handle vVAStCS Imo'
---__sy _e ... ,.,,~ ~t~y6...,+',+ ra~4 c.,wrv drreivr~rs or sooner- if needttlbY a liccnsedpumpcr. What you put iota the iyst4m
~~ -sr~.a A ~ n~r}7P s±n+tic t8~ as'a tCCSl~leotstelte iA idYO [wf3uti clirpaS81 sfatcta.
Ths property owutr agtra~s to spvmii to ,ji Cmi~c %bnu~y •`.:a~az°;,.a,= :. - --~ '~="~= = -
a _. c _ r___.. rl.,..~_ ....-~....i+R.in~sihx[ (~~ 1hB 86.ittC WHS~BtKal ~~rm
s3ta..fiCrP~zfS~~~~~•,`~'~:,r ~..~Y_.-~~L_, =-..=..~...,,~.._ ._, - less than 1/3 full afaludge.
__...,:~.. ..ar„r n~ ew.-' ~.,~s;n~ and rnemnide !if neccasarY3. ~ ~ptie tank is
is .cc ~i.;;r.-°z ;sr~=.-:e ~ - _ -' ®.,. -. -- - -
rlme; tS,e andexsir~eci bt.vc read Ch8 ahovo tE eases and arc to maintain tits pdvaie scsvagc ivnYvsa: sys:-.., ^ s ~ ==:sue=-,=
lei fat' ~'C>a, ~ sct by t1tC cpailm~ of L.auR~ei'~e end fy`3a iicydaiwv~ FYI ~=. =3a~ :-"., ':~:c vc a- - ~~ 30
'h' _~.....s ~.,.~ -r,~„;r.~ r., rho Ct. CSraix lAttfltY ZOwnA OPPiOe
~S3tYng t~RL y9tic ~'gVc Sya'~ci2° iiv ::.Gu i +_~%~%~iiiw :....~.. ~~ _-:--i:t_ •• - -- - _
1.-_ . .._~.._a_. Aar•
__._ .;ice ~ ~~~"~
f SIG~IpZTJRE OF AP 'AN ~•
,.. Y
- !fit-Tf'Pl ~.ii t_:nll~l~iii.:F~iii.;, G ~s~c[{S} v2
_ _ _ _ -- .~,: r` ~.- , -- - _ ::.;~ .;~~; .;r ~y (~.,r) Irnowiedge. i (ael asaf (arc} m
_ ~ L^~t ~ z ..>+...`T}.., .,;r„~d}nt P ~.a~nr.:-aeec} eecotded is R.egistar CP Deeds ~[fica.
i ! T?A'f E
~ SiCrNATUP~13 tJT' ~+rru" I'
volccd b the Zca I-]ep8nmcn~ ®"°"
____ :,:,__.: .t... s i':':SS-_ .-.._Et.,w1 .n~v !'re~~14 Las {has t$C1SaIY PCTIIItf 13'ETIf~ C#+ Y ~~
-- ~~ ~...-a_er- -- - -- ~ .
it ~neipderr[tb ibis ><pplleatiea: A ataaigad ~vatt-~vty deed fsosn ipc Fte~tBiv. i.+u~+ :+:::c.~
It tupy 6~ ti32 ici uiic~. "uw: ~vY ~:.s ~, •- --' - .
' von X538 ~a&f ~~~
Es28976
IiA~'NLEEM H. WALSH
REGISTER OF DEEDS
ST
CROIX CO
WI
.
.,
RECEIVED FOR RECORD
Brian P. Olsem and Wendy J. Olsem, husband and wife, 08-~9-000 11:30 AM
conveys and warrants to Patrick Olsem and ~t~a~blsem
the following described real estate in St. Croix County
State EXEMRTTtE DEED
,
of Wisconsin: CERT COPY FEE:
CORY FEE:
TRANSFER FEE: 11.40
RECORDING FEE: 10.44
PAGER: 1
Recording Area
Name and Return Address
e-w.d~ Q(s ~,
3 ~~ ~~,~ `~~ad G
i~
Ern -ter ~. l d c.J I S~ o t 1--
010-1049-20-000
(Parcel Identification Number)
Part of the Northeast Quarter of the Northeast Quarter (NE'/4 of NE'/4) of Section Twenty-one
(21), Township Thirty (30) North, Range Sixteen (16) West, Town of Emerald, St. Croix
County, Wisconsin, more particularly described at Lot 1 of Certified Survey Map, filed July 26,
2000, in Volume 14 of Certified Survey Maps, Page 3908 , as Document No. 627097, Office
of the Register of Deeds for St. Croix County, Wisconsin.
Exception to warranties: all easements and restrictions of record.
This is not homestead property. Dated this:~S day of '~ , 2000.
~~~:~. ;~ C~i~~.
*Brian P. Olsem
,-
*Wendy J. s "
AUTHENTICATION
Signatures
authenticated this day of ,
ACKNOWLEDGMENT
STATE OF WISCONSIN
ST. CROIX COUNTY
Personally came before me this ~J~ day of ~ ~~5~
2000 the above named Brian P. Olsem an~}~idy J.
Olsem, to me known to be the person(s) who executed the
fflrCfYfli Y~iY ~Nn{r~.rh ~.-{ ."....I ....L........I~J_.- iL. _.__ _
.WEST. CU. -BRLDWIN
•
Fax:715-684-4750 Jul 24 '01 16:15
P. 02
627'09'
CERTIFIED SIJR.~EY MAP
BrAen .P. 01sem and Wendy J. Olsem
Part of the Northeast 1/4 of the Northeast I,/4 of SeetiQr~ 21, T 30 N, R 16 W,
~ Town of Emerald, St. Croix County, Wisconsin
r F1LED
JUG 2 6 2000 ~
It11THtFEN M. WAI.SH
pepisler of D~
41 Sl Cralx Co„ Wf ~(
~. / ~'r'(~ \ CS NoM Line NE 1/4
_ _?)~ (Centerline C'T.ti.
UNPLATT~D I A,IYD}S Nathea~t Comer 1 ~ 3f~~p~i6
- • EAST 267~.8I' - - _ Section 21 T 30 N, R 16 W -~ - - -
-EAST 1169,29' - - - (FounO'PI~" Naiq 93''~ ~ _ ~ _.
i~ .._-- - --- --- - - ---~ - ~.~ L -
EAST 1505.56' 3 ~,- ~`~°~~~ , ~',_
North Quarter Comer
Sedion 21, T 30 N, R 18 W c ~ ~ •~' ~ ~
(Fourd'PK' Nail ~I ~ ~ ~»ee----,---M ---
I~~`~ ~.
~I g O 1 ~~
~1 d' a
AREA BUMMARIE3
LOT 1
2.500 acres or 108,916 sq. tt.(incl. rlw
2.185 acres or 94,316 sq. ft, (excl r/w)
LOT 2
7.512 acres 327,219 sq, ft. (incl. Nw)
B.260 acres 272,686 sq. ft. (excl. r!w)
LE
~ Soil Boring location
~ Indicates 1" x 24" Iron Pipa Set
(Min. Wt. -1.13 Ibs.IJin.1t. )
fa Section Corner Monument
(as Hated)
~ Indicates Fence
OWNER'S ADDRESS:
2398 Count~yy Trunk Highway "G"
F~nerald, V1N. 54012
Dated: May 4, 2000
a
S A IN FEET 1" = 00'
N,Ntl~t161ee 1 0 75 1 3 4 0
~~a C ~ Bearirt3s are refere+tGed to the East Line of the NE 1l4
r ~~~3 .Q . i et Seetbn 21. assumed ixarina S 02'~~' E.
EAS7 1
100' 6tNsack LM+e ~ d~- ~ Sh...
F'C'C
~ Area ~ ~F.eat Line NE 116 Sea 21
(Cerarins 2~Od~ 8th
-- ; 33'~ ~ ~1~~~~
' '~~
~.,: ~ ~ UNPL~iTTED
-u ~
s~ ~'4 y
~Ciy ~ I '
N '
h
t ~ ~~
zor _~
1138.23'
84
~_ e
---WEST 1169.26-••
UNP~ATTW ~ND,~
Est pusrter Canter 0~
30cfinn 21, T 30 N, R 16 W
(sd 1' tt 2~' iron pate n per
witness manumetts)
~.
WEST. CU. -BALDWIN
l
Fax:715-684-4750 Jul 24 '01 16:16 P. 03
CERTIFYED SURVEY MAP
Brun .F~. ~y~.~ei;~ ant! V'Vendy J. ()rlsenn
Part of the Northeast 1/4 of the Northeast I/4 of Section 21, T 30 N, R 16 W,
Town of Emerald, St. Croix County, Wisconsin
DE5CR11'TIf?rT:
That certain parcel of land located in the Northeast 1/4 of the Northeast 1/4 of Section 21, Township 30
North, R$nge 16 W, Town of Emerald, St. Croix County, Wisconsin, more fatly described as follows:
Beginning at the Northeast corner of said Section 21; thence S 02 39' S0" E (assumed bearing on the East
line of the Northeast 1/4 of said Section 21, recorded as South) a distance of 3'73.40 ;thence West, 1169.26 ;
thence N 02 39' S0" W, 373.40' to a point on the North line of the Northeast 1/4 o~said Section 21; thence,
along said North line, East, 1164.26' to the Paint QF~i3eginr4pg, cantainirg '.0.012 arras o: 49,135 square
feet being subject to an easement for 240th Street over the Easterly 33' thereof, an easement for County
Trunk Highway "G" over the Northerly 50' thereof and any other easements, covenants or restrictions of
record.
GENERAL NOTICE S'TATEI~IEN1':
Note: Each parcel shown on this trap is subject to State, County and Township laws, rules and regulations
(i.e. wetlr~ds, minimum, lot size, access to ;~acGel, et4.1 Before ,~urcha~ing ar developing any parcel contact
the St. Croix County Zoning Ufftce and ti;e appropriate Town Board for advice.
State of Wisconsin)
i:outtty of k'ierce)
I, L>itirence W. Murphy, Registered Land ,<«rveyor, do hereby certify that by direction of the Qwners, $rian
P. Olsem and Wendy J. Olsem, l have surveyed and divided the lands shown hereon in accordance with
official records, Chapter 236.34 of Wisconsin Statutes and the Ordinances of St. Croix County and that this
map and description are a true and correct representation thereof.
Dated :May 4, 2000.
Revised: July 21, 2000.
~~~••' CSC O/y ''~y
~ ~ ••`
~ ~ f WAMRENtr
1 13 o
N :RIVr;R FAlL3, ,rj ~W