The URL can be used to link to this page

Home My WebLink About014-1068-40-000wisonsin L~3p2rtment of Commerce PRIVATE SEWAGE SYSTEM S ;fbty and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Heinbuch, Gar Forest, Town of CST BM Elev: Insp. BM Elev: BM Description: ~aD~ ~ /~Ol ~ I TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing 'IQ Aeration Holding TANK SETBACK INFORMATIOIjI. I ~~/.,.L~ ~ n.Qu~w TANK TO /L W~ LD G . Vent to Air Intake ROAD Septic ~ 2 I S, 7~ .I ~ ~s''/- ~~'~cT~-~ Dosing Aeration 1 D Holding PUMP/SIPHON INFORMATION ~~YQ Manufacturer Demand GPM Model Number TDH Lift Friction Loss tem Head TDH Ft Forcemain L Dia. Dist. to We SOIL ABSORPTION SYSTEM (n + ~ u ,,~~-N 7~ County: St. CroiX Sanitary Permit No: 515034 0 State Plan ID No: Parcel Tax No: 014-1068-40-000 Section/Town/Range/Map No: 32.31.15.500 ELEVATION DATA STATION BS HI FS ELEV. Benchmark 5~ 1 1 ~( I J I~1/\ t Alt. BM ~- Bldg. Sewer Sc N 5~7 93 . S t Inlet GZ I <~ t Outle ~ Z ~~,7J / J Dt Inlet ~ -~ Dt Bottom ~ _i Header/ an. „ v ~ /- yi' Dist. Pipe -e,,,.~s - 8 . v X11 • `f Bot. System .2 a. Z FiF~Grade f I~~~S[ ~ ~, ~ - 35 S>~over 2.Sr -- 3.~0 9s~s BED/TRENCH Width ~ Length^~ / /I No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ VV~iNV,, J SETBACK SYSTEM TO P/L~ BLDG WELL L E/STREAM LEACHING Manuf~ INFORMATION CH O Typ Of System: / ~~ ~ t ~ ~ ~) UNIT odel Number: DISIRIBUTION SYSTEM Header/M ifold 'L istribution I ~ t x Hole Size x Hole Spacing Vent to Air Intake I ~ Pipe(s) ~ D ~' h ~ ~ Lengt Dia Length Dia_ Spacing SOIL COVER Y Prceeiira Svetamc rlnly YY Mn~~nrl nr At-Grade SvstemS Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center L~ ~ (~~ ~ r I Bed/Trench Edges Topsoil ~ Yes ~ No ~ Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/~/~ ~~ Inspection #2: / /. ~t Location: 2795 Hwy 64 Glenwood City, WI 54013 (SE 1/4 NE 1/4 32 T31N R15W) 40 acres Lot / ~-~(P~arcel N 32.31.'1.5.500 1.) Alt BM Description =~ ~ ~`~~~ ~ ~~,. a~• - 7 y' - ~ ~,,c~ 2.) Bldg sewer length = 3~~°~b (/ ~ti~~ vv ~ - amount of cover = u ~ ~ ~ ~ hZ ~ ~'~~~%K~%L ~ y~~~ T r-, Plan revision Required? ^ Yes ~ No ! I ', Use other side for additional information. ~_ I _. -J - Date Insepctor's Signat re Cert. N . SBD-6710 (R.3/97) ~~~ ~~~ n~ ~e~ commerce.wi.gov Safety and Buildings Di ' ' n ty 201 W. Washington Ave., P.O x 7 S ix i sco n s i n Madison, WI 53707- Sanitary Permit Number (to be filled in by Co.) Department of Commerce 5 f 'Jr o3 .Sanitary Permit Application StateTransa'~ctig9onNumber Nry In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS aze ss (if different than mailing address) Project Ad submitted to the Department of Commerce. Personal information you provide ma b ndary oses in accordance with the Privac Law, s. 15.04(1 (m), Stats. ~ t Hwy 64 2 I. A lication Information -Please Print All Information Property Owner's N,~ 08 Pazcel # l1L ~ ~ Z~ v $ _ ~/d _ ~ ~~~ _ ~6~ G Heinbuch J 0 Property Owner's Mailing Address ST. CROIX COUNTY Property Location / ~~~ / 2929 St. Rd. 64 ZONING OFFICE , Govt. Lot ( City, State Zip Code one umber ~4, ~~j ~ ~ Section SE/a,1~ i( Glenwood City WI 54013 715-265-4962 ~, L ~ (cite a one) T 31 N; R 15w II. Type of Building (check all that apply) ~, r„p Lot # _ X 1 or 2 Family Dwelling -Number of Bedrooms 3 /~~ Subdivision Na~m/e~ G ^ Public/Commercial -Describe Use ~ ~- ^ City of ^ State Owned -Describe Use CSM Number ^ Village of r ~ ~ +.y ~ ~ A' X Town of Forest ~ L.~ III. Type of P mit: (Check only one bo online A. Comp ete line B if applicable) `~' X New System -~~ ^ Replacement System ^ Treatment/I Iolding Tank Replacement Only ^ Other Modification to Existing System (explain) 1B. ^ Permit Renewal ^ Permit Revision ^ Change of Plumber ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner ~~ IV. T e of POWTS S stem/Com onent/Device: Check all that a I r e ~ XIVOn-Pressurized In-Ground ^ Pressurized In-Ground At-Grade ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable sail ^ Holding Tank ^ Other Dispersal Component (explain) ^ Pretreatment Device (explain) ~ V. Dis ersaUTreatmenYArea Information: Design Flow (~ Design Soil~lication Rate(gpdsf) Dispersal Area ReAuired (sfJ / Dispers al Area oposed (sfJ System Elevation #~~=./22452: i / 450 .7 , 642.9 650 D VI. Tank Info Capacity in Total # of Manufacturer /'_ J Gallons Gallons Units ~ ~ c ~ c~+ New Tanks Existing Tanks J y~^ `~ c a U ~ ~ v~ y v~ p ~ C7 i~ ~ p. ~ / /11 C~AC~ ~~ i . , Septic or Holding Tank 10~~ 1 ~~~ 1 Weeks x Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum er's Si re MP/MPRS Nttrrlber Business Phone Number 227618 Thomas D Gustum 1-715-658-1344 Plumber's Address (Street, City, State, Zip Code) N13450 93T" Street New Aubum WI 54757 VIII. Coun /De artment Use Onl Approved Permit F~eje ~ , m $ ~ Da gIssu d G Issui gent Sign re O Given Reason for nial / ` I ~ IX. Condit~'~~~ easons for Disapproval 1. Septic tank, eftlt~nt filter and r dispe~ -ai cell must all be serv_~ces /maintained as per management plan provided by plumber. 2. All setback~equrements mns1; be maintained 8s code ! otdinallces. Attach to complete plans for the system snd submit to the County only ou paper not less than S t!t x 11 inches in size - ~ State Hwy 64 Approx 1/4 Wile LEGEND ^ SOIL PITS WITH BACKH^E Ga BM1 =NAIL W/MARKER IN TREE EL= ..100,0 ALS^ HRP 0 BM2 =NAIL W/MARKER IN TREE EL= 100.0 ALS^ HRP PART ^F 68 ACRES / ~ ~O ~ ?BM1 Z~ ~G B1 ~0 92,6' cAn ~ ~ .. \ ~ \ \ B 3 +~ \ 89' \ s~-°P~ ~ ~o ~. ~ SHED ~~ ~~ ,6~ ~ ~ ~ w~~ A 0 BM2 1000 gal tank sch 40 a- 3034 av PROPOSED 3 HDR H^ ~~,E ~~ o~ ~`'^' tw trenches V E2-F'to~ Chambers ~ ~ ~ B2 CQ 92.6' O ~QG~ c ~~QG 9~ ~ •~, 9 ~6- ~. . Chambers Page 1 of 4 Cover Page Project Name: Gary Heinbuch 450 GPD Conventional Owner's Name Gary Heinbuch Owners Address 2929 St. Rd. 64 Legal Description Township County Subdivision Lot# Parcel ID# Glenwood City, WI. 54013 se • +/, ruw • ~/ Sec(3 ~ T 31 N, R 15 w ~ Gnrocf ~~ Saint Croix • part of 68 acres Table of Contents P9~ 1 Cover page 2 Calculations and Drawings 3 Management and Contingency Plan 4 Plot Map total # of pages: 4 Designer Name: License #: Date: Ph. #: Signature: Thomas Gustum 227618 7/22/2008 Design Methods Used "IN-GROUND SOIL ABSORPTION COMPONENT MANUAL FOR PRIVATE ONSITE WASTEWATER TREATMENT SYSTEMS" (Version 1.0) SBD-10705-P (R.6/99) Chambers Page 2 of 4 Calculat ions and Drawings Site Conditions Infiltration Elevations Site Type: Private . Cell #1 Cell #2 Cell #3 %Slope 10 % Contour Elev: 90.80 Ft # of Bedrooms 3 Infiltration Elev: 87.80 Ft Depth to limiting factor 85 in Limiting Factor Elev: 83.72 N/A N/A Soil Application Rate: 0.7 gal/ft^2/day Treatment and Dispersal Zone: 4.08 N/A N/A Effluent Quality erf #i ~ Cover Material Required: 0 N/A N/A In Design Flow: 450 gal/day Finished Grade Over Cell: 90.80 N/A N/A Max BOD 220 mg/I Max TSS 150 mg/I Distribution Cell Septic Tank Choose chamber type: Ez pow 3 x ro ceu ~ Septic Tank Manufacturer: Weeks # of Cells Septic Volume Chosen: 1000 Laying Length: 10.00 Ft Effluent Filter Selected: Biotube FTS0854-36 EISA Determined Area: 50.0 Ft2 Note: Access opening of sufficient size to be provided to allow removal of filter. Open Bottom Area: 35.30 Ft2 Opening to terminate at or above grade. Chamber Height: 12 Inches Required Infiltrative Area: 642.9 Ft2 Actual Infiltration Area 650 Ft2 Total # of Chambers: 13 Total Cell Length: 130.0 Ft Cross Section of Septic Tank Cross Section of Cell Vent in a"Min _ . manhole covEr ° .\ 12" Min. I ~f1e~ \ 18"Min ~ V~ A j~~ ~ ~~ All joints to ~~ V~ ~ ~~ % ~ ~~ V~ ~ { ~ ~be water tight ~ X40 or \ J Efrluent pipe Filter Ch 3" Bedding Under Tank Plan View of Typical Cell J ~l ~ -v J ~ > ~ ~ ^ ~ n :~ Page 3 of 4 In-Ground System Management Plan pursuant to corrxn 83.54 W. A. C. Owner's Responsibility: The component owner is responsible for the operation and maintenance of the component. The county, department or POWTS service contractor may make periodic inspections of the components, checking for surface discharge, treated effluent levels, etc. The owner or owner's agent is required to submit necessary maintenance reports to the appropriate jurisdiction and/or the department. Septic Tank: Septic tank(s) and effluent filters are to be inspected routinely and maintained by department approved individuals when necessary in accordance with their approvals. The use of chemical/biological "treatments" is not required or recommended. If such additives are used, make sure they are approved by Department of Commerce, Safety and Buildings Div.. Effluent filters are to be removed & cleaned as necessary, with provisions to keep solids from passing the septic during removal. No more than 1/3 of the usable tank volume may be occupied by sludge/scum. 3 year inspection: If tank has greater than 1/3 volume sludge, tank contents must be emptied and disposed of in accordance with NR 113 Wisconsin Administrative Code by an approved individual. If the inspector does not recommend pumping of the septic tank, then the owner must be notified of when pumping should be done as to not exceed 1/3 sludge volume. Septic tank should be routinely inspected to be watertight and of good repair. Absorbtion Cell The absorbtion component must remain free of ponded surtace water prior to pump operation. If 4 inches or more water level is detected in the observation pipes, the owner must be notified of possible problems/failure. The designed daily flow capabilities of the component should never be exceeded. Trees and any other deep rooted vegetation should never be planted, or allowed to grow anywhere on the component. Activities OTHER than mowing/maintenance (i.e. excessive walking, pets, vehicles, etc...) could compress the component and reduce it's absorbtion capabilities andlor possibly cause it to freeze in winter conditions. Performance Monitoring: Performance monitoring must be done at least once every three years following the installation or at the time of a problem, complaint, or failure. Contingency Plan: If the septic tank or other components therein (including floats, alarms, etc) become defective, the defective tank or component must be replaced immediately to ensure that the system can operate as designed. If the absorbtion component cannot accept wastewater or ponds wastewater to the surtace, the component must be repaired or replaced in it's current location by removing the clogged bacterial mat, aggregate/leaching chamber cell, and distribution piping within the cell and replacing failing components in order to return system to proper working order as required. If repair is not feasible, a new system is to be constructed in a designated replacement area Gustum Septic Service 1-715-658-1344 Barron Co. Zoning 1-715-537-6375 I M I W I~ _U ~ W I ~ ~ ~ ~ W ~ ~ I I ~ ~ O I ~ F- o I w - ~ " M I ~ ~ i I ~ r I ~ i ~ 3 p~ I c/7 d +' i d ~ Q Q I I I I I I I I ~ Adn3niao I I I I I I o I y o0 I w~ I om I an I I a a z I = 0 ~ ~ I rn ~ q2b I ¢ a OJQ- I v 0~ ~ L 13 II I~ N N OIO~ = w w N ~ o, JQ- I v w f f ~.~o W o o W ~ `~' ~ ~~ O ~ IN W~ ~ ~ I oz z i Y~ ~ ~ ~ i I aw Y p ~' / I W Y d. t0 ~ / / I ~~ ~ ~ W0+ ~ i /Y/ I 33 3 ¢ '~ mm w I ~¢ Q ~ ONj OUR 8q ' w m Oi~i+ J~ ~ ~ C ~~r Z .... f H I ;°~~,~ I J~~~d I I I I I I b I N I I I I o 3 I ~ o ~ I u `° ~ I o Z I ~.,~ v M I d. ~ F- I U ~ T~ O {~ 4 ~ U U v~.,~~ I = rn o I >, 0~ 3 Z i N ~ d0~~ W l.7 N l7 (/~ ~ ~ { ~$f/,~ O VALUATION REPORT Department of Commerce ~ nce with Comm 85, Wis. Adm. Code f)ivicinn of Rafaty and Ruildinnc #2380 Page 1 of 3 Gustum Septic Service ~""'+ Attach complete site plan on paper n an 8'/z x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. O!y- 0!0 ~~ - ~-~ Please print alllnformation. Rev' ed By Da Personal information you provide may be used for sewn ~y~Law, s. 15.04 (1) (m)). 66--~~'' ~( v Property Owner Prop y Location Heinbuch, Gary Govt. of n/a SE1/4 NW1/4, S34, T31N, R15W Property Owner's Mailing Address t ~U Lot # Block # Subd. Name or CSM# 2929 St. Rd. 64 n/a n/a N!A City State Zip Cod P~gn~~Qt~OFFIC 'ty ,;;j Village Town Nearest Road Glenwood City WI 54013 71 Forest State Hw 64 1~ New Construction Use: ~ Residential /Number of bedrooms 3 Code derived design flow rate 450 GPD ;_f Replacement --~ Public or commercial -Describe: Parent material outwash plains Flood plain elevation, if applicable rUa ft. General comments Part of 68 acres. Recommend system el. 3' deep along contours. and recommendations: nn,w, ,, ~Y~-~- Qbl ~. ~ ('rN ~ 1Z. Z S .~~1GcJ ~_~ --- , 1 ~f Boring ~ ~ / Boring # ~ pit Ground surface elev. 92.6 ft. Depth to limiting factor > 100 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eft#2 1 0-7 10yr3/3 none sil 2mgr mvfr as if 0.6 0.8 2 7-18 10yr4/4 none gr. sil 2msbk mvfr cw if 0.6 0.8 3 18-31 7.Syr4/6 none gr. sl 2msbk mvfr cw - 0.6 1.0 4 31-50 7.5yr4/6 none Is 0 sg ml cw - 0.7 1.6 5 50-72 10yr5/6 none 5 0 sg ml cw - 0.7 1.6 6 72-100 10yr5/6,4/6 none ~ s 0 sg ml - - 0.7 1.6 tl Boring # --~ Boring ~J~ ~/ Pit Ground surface elev. 9 .6 ft. Depth to limiting factor >85 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10yr3/3 none sil 2mgr mvfr as if 0.6 0.8 2 9-26 10yr4/4 none gr. sil 2msbk mvfr cw if 0.6 0.8 3 26-40 7.5yr4/6 none gr. Is 0 sg ml cw - 0.7 1.6 4 40-85 7.5yr4/6 none s 0 sg ml - - 0.7 1.6 1 ti$ * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 * Effluent #2 = 6005 <_30 mg/L and TSS <_30 mg/L CST Name (Please Print) Signature: CST Number Tom Gustum 227618 Address Gustum Septic Service Date Evaluation Conducted Telephone Number N13450 937th St. New Auburn, WI 54757 6/25/2008 715-658-1344 SBD-8330 !12.07/001 Property Owner Heinbuch, Gary Parcel ID # Page ~ of 3 3 ~~ Boring Boring # 89,p g. De th to limitin factor >85 in. Pit Ground surface elev. P g Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •EfF#1 •Eff#2 1 0-10 10yr3/3 none sil 2mgr mvfr as if 0.6 0.8 2 10-17 10yr4/6 none gr, sl 2msbk mvfr cw if 0.6 1.0 3 17-55 7.5yr4/6 none gr. Is 0 sg ml cw - 0.7 1.6 4 55-85 10yr5./6 none s, gr. s 0 sg ml - - 0.7 1.6 u 1 J Boring Boring # ft. Depth to limitin factor .., ~ Pit Ground surface elev. 9 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •EtF#1 •Efi#2 Boring Boring # ft. De th to limitin factor .~J Pit Ground surface elev. P 9 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure " Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr: Sz. Sh. •Eif#1 •Eff#2 * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/Land TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services ~ need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-877 i SBD-8330 lR.07/001 GuStUm Seek Service Property Owner Heinbuch, Ga Parcel ID # Page 2 of 3 3 Boring Boring # 89.0 ft. De th to limitin factor >85 in. Pit Ground surface elev. p g Soil Application Rate "Horizon: Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#t *Etr#2 1 0-10 10yr3/3 none sil 2mgr mvfr as if 0.6 0.8 2 10-17 10yr4/6 none gr. sl 2msbk mvfr cw if 0.6 1.0 3 17-55 7.Syr4/6 none gr. Is 0 sg ml cw - 0.7 1.6 4 55-85 10yr5./6 none s, gr. s 0 sg ml - - 0.7 1.6 Boring Boring # ff, De th to limitin factor J Pit Ground surface elev. p g in• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eft#1 'Eff#2 Boring Boring # g, Depth to limitin factor _f Pit Ground surface elev. g in• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 "` Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 <150 mg/L 'Effluent #2 = BODS < 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 ~ need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-877 i SBD-8330 (R 07/001 GuStum SeOtfc Service ~~~ Department of Commerce Division of Safetv and Buildings SOIL EVALUATION REPORT in accordance with Comm 85, Wis. Adm. Code #2380 Page 1 of 3 Gustum Septic Service Attach com lete site lan on a er not less than 8'/: x 11 inches in size. Plan must P P P P i BM di ti County St. Croix nt ( ), rec on and include, but not limited to: vertical and horizontal reference po percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. Please print all information. ~ Reviewed By Date Personal inforrnation you provide may be used for secondary purposes a aw, s. 15.04 (1) (m)). Property Owner J Property Location Heinbuch, Gary ~ ~ Govt. Lot n/a SE1/4, NW1/4, S34, T31N, R15W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2929 St. Rd. 64 n/a n/a N/A City State Zip Code Phone Number ~ City ~ Village ; Town Nearest Road Glenwood City WI 54013 715-265-4962 Forest State Hwy 64 >~ New Construction Use: ~ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD J Replacement public or commercial -Describe: Parent material outWash plains Flood plain elevation, if applicable n/a tt. General comments Part of 68 acres. Recommend system el. 3' deep along contours. and recommendations: Boring # -~ Boring ^jy Pit Ground surface elev. 92.6 ft. Depth to limiting factor >100 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GP D/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 1 0-7 10yr3/3 none sil 2mgr mvfr as if 0.6 0.8 2 7-18 10yr4/4 none gr. sil 2msbk mvfr cw if 0.6 0.8 3 18-31 7.5yr4/6 none gr. sl 2msbk mvfr cw - 0.6 1.0 4 31-50 7.5yr4/6 none Is 0 sg ml cw - 0.7 1.6 5 50-72 10yr5/6 none s 0 sg ml cw - 0.7 1.6 6 72-100 10yr5/6,4/6 none s 0 sg ml - - 0.7 1.6 Boring # --~ Boring t/ Pit Ground surface elev. 92.6 ft. Depth to limiting factor >85 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GP D/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 *Effl/2 1 0-9 10yr3/3 none sil 2mgr mvfr as if 0.6 0.8 2 9-26 10yr4/4 none gr. sil 2msbk mvfr cw if 0.6 0.8 3 26-40 7.5yr4/6 none gr. Is 0 sg ml cw - 0.7 1.6 4 40-85 7.5yr4/6 none s 0 sg ml - - 0.7 1.6 "Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BODS < 30 mg/L antl TSS < 30 mg/L CST Name (Please Print) Signatur ~ CST Number Tom Gustum ' 227618 Address Gustum Septic Service Date Evaluation Conducted Telephone Number N13450 937th St. New Auburn, WI 54757 6/25/2008 715-658-1344 titlU-8330 I Ii.U7/UUl I ~ I w i.~. I v ~ o I > ~ v I ~ ~ I w ~ a. I ~ ~ I ~ ~ I ~ ~ o I Wi I ~ ~' ~ ~ I ~ ~ i ~ ~ I f- a v rn d +~ ~ d I ~ QQ I I I I I I i ~ ~,vn3n~aa I I a I E I I o I a I N H I w= I °no om I I I 2 = ~ t I +~ g w ~ ~ ° & ~2b I I ¢¢ ~~ 4 J~ I ~ c o ~.~0 I ~ °o o ... e LO 3 u ~ I w w `'' ~ $ B ~ °' ~~OJ IN W ~ ~ I oZ z i i _~ '" ~ i f ~f~~ ~~ ~ 33 3 ¢ ' m o+ ~' ~ ~Q z ~ cpNjO~R 69 ' w m ON_ ci I aZo •°' I wo$ E ~' I ~ww w ~~BOa I I I I I i b N ~ 0 3 I m `O ~ I ~ c~ i oz I M ~ ~ v ~ ° ~~D~v ~ ~ ~ ~ ~ I -~ ~ w I = vii o >, 0~ 3 Z d0~~ W ~ ~ ~ ~ L7 CU l7(~ ~~~ X654 PacF 5 ~6 \TE BAR OF WISCONSIN FORM 1 - 2000 I WARRANTY DEED Document Number This Deed, made between George Westlake and Kay H. Martinen, both married persons Grantor, and Ga_~ W. Heinbuch and Frances M. Heinbuch, husband and wife, as survivorship marital property. _ Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (the "Property") (if more space is needed, please attach addendum): The Northeast Quarter of the Northeast Quarter (NE1/4 of NE1/4), and the Southeast Quarter of the Northeast Quarter (SE1/4 of NE1/4), Section 32, Township 31 North, Range 15 West, Town of Forest. Grantor, by this deed, hereby expressly conveys any and all interest in Inineral rights to the above described property. UOT Cert. #: 55-64-3246-2001 Together with all appurtenant rights, title and interests. 647'536 KATHLEEN N. WALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 06-Ob-2001 9:30 Ate YARRANTY DEED EXE11F'T D CERT CORY FEE: CORY FEE: TRANSFER FEE: 39b.00 RECORDING FEf: 12.00 RAGES: 2 Recording Area Name and Return Address WESTconsin Credit Union 860 Cedar Street Baldwin, WI 54002 014-1068-10-000; 014-1068-40-000 Pazcel Identification Number (PII~ This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is geed, indefeasible in fee simple and free and clear of encumbrances except Roadw3ls, Easemer_ts, ?nd Restrictier_s of Record. Dated this 30th day of May 2001 . AUTHENTICATION Signature(s) authenticated this day of TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by §706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY *George Westlake - * Ka H . Ma i.nen ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. County. ) Personally came before me this day of the above named to me known to be the person who executed the foregoing instrument and aclrnowledged the same. Michael H . Forecki , Attorney Notary Public, State of Wisconsin Eau Claire, 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. WARRANTYDEED STATE BAR OF WISCONSIN FORM No. 1-2000 ll~ttomey Michael H Forecki 1830 Brackett Ave, Eau Claire WI 54701-4627 Phone: (715) 835-3029 Fax: (715) 835-4112 Michael H. Forecki T7707538.ZFX ( Produced with ZipFormTM by RE FonnsNet, LLC 18025 FiReen Mile Road, Clinton Township, Michigan 48035, (600) 383-9605 ~~~ r~ ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer (~(~~'` Mailing Address Property Address City/State LEGAL DESCRIPTION & Zoning Department for new construction.) ~`~ Parcel Identification Number (~~ ~ -/(~~/-L~ -~ Property Location~;~%~ '/4 , ~-%'/4 ,Sec. ~, T _~ ~N R ~S~ W, Town of ~/Z°.S f Subdivision Plat: Certified Survey Map # Volume ,Page # Lot # Warranty Deed # (~1~7~ 3(p (before 2007)Volume ~~~~, Page # ~z~(,~ Spec house ' ?yes ':' no Lot lines identifiable _ yes . no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (I) 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. 1/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the 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 Planning & Zoning Department within 30 days of the three year expiration date. 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. Number of bedrooms C~C IGNATURE OF APPLICANT(S) /~~=~ ~ DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. *** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. ~` rn !7 ~1~ fcJ/t~'`~p/3 ~~ q ~ ~~~ ~ (Verification required from (REV. 08/05) I c-~ t I ~ ~ o ~ ~,.~ I ~ ~ m I W ~ ~ I ~ ~ I ~ ~ I ~ ~o i w ~ I ~ ~~ I ~ ~ i ~ I ~ 3 ~' ~ d +' ~ Q Q I I I I I ( I AtlM3h]?JQ I I I I I a a a I w N I I am I an I I ~ S = z J J q,Zb I 0 I ¢ c JQ- I o o .~O S J J NN SOB w w N w m J~ I v w f f ~.~o I Woz z i ~ i _~ `" i I ~~ W ~ -~~ ~~ ~ a w x O ~' ~ I ~~ ~ ~ , ~ i I ~f ~ ~ ~~ ~- Y~ 333¢ '-/cow °' RZ ~~ O •~l ZiJi.-. N WOE Y ~ L7NW ~ W ~ ~ ~ d I I I I I I I N I I I I o 3 I ~ ~ ~ I r r~ I o °z M ~ M I ~ ~ S ~ II O u `D ~ v 4 ~ U U ~ ~ W S Vl O 3 ~ L~ ~Z I dog °'w ~cu~v~