HomeMy WebLinkAbout016-1002-710-100 Safety and Buildings Division County
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Sartltary Permit Number (to filled in by Co
De artment of Commerce (608) 266-3151
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In accord with Cornm 83.21, Wis. Adm. Code, persona! information you provide ~ QQ
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may be used for secondary purposes Privacy Law, s15.04(1)(m) ~~, Project Address (if different than mailing address)
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I. Application Information -
Property Owner's Na me ~~arcel N Lot k Block X
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of Building (check all that apply)
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1 or 2 Family Dwelling -Number of Bedroorru ~ ~~~
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III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A' ^Ncw System Replacement System
^ TreatmendHoldin Tank Re lacement 0:.~
g p y
^ Other Modification ro Exisnn S stem
B Y
B. J Permit Renewal ^ Permit Revision j ^ Change of ^ Permit Transfer ~o '~e~~ List Previous Permit Number and Date Issued
Before Expiration I Plumber Owner
IV. T of POWTS S stem: (Check all,that a l) _ _
r Non -Pressurized In-Ground Mound > 24 in. of suitable soil ^ Mound < 2a ir, of suit:!;le so;l ^ At-Grade ^ Single Pass Sand Filter
Coruwcted Wetland .~ Pressunzed In-Ground ~' Holding Tank ^ Peat Filter _: ~\er bic ' reatment Unit ~.' Recirculating Sand Filter
~ ^ Reurculaung Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pc~ ~' Other (explain)
V llirnorcal/TrratmPn[ Area information: {~l~il /111 Ai40t~ l2~ Shin ~
n Flow (gpd)
Des
ig Design Soil Application t Requ' ed (s f1 '~ Gislxrsal Area Propo
Dupersal Area (sf) I System E
lewation "'
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j VI. Tank Info Capacity in Total Number Manufacturer ', Pr ab Site Steel Fiber Plas[iC
~ Galloru j Galloru of Urtia ~ Concrete Coruwcted ~ I Glass ~
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Ncw '1
Existing I ; i
Tanks Tanks
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Septic or Holding Tank ~ i - _ ._
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Aerobic Treatment Unit - -~
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Dosing Chamber /~~,
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VII. Responsibility S , assume respotuibility !or installation of the P0~{_"'."S sho«'n on the attached plans.
PI ber' Na me (Pant) Plumbe 'S Si cure P MPRS Numtxr Business Phone Number
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Plu tier's Addre ss (Stmt, C ry, State, Code)
I VIII. ount /De artment Use Onl
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t
~' Approved ~ Disapproved Sartitary Permit Fee (in ludes Gro.:ndµa~ r e Issued
Surcharge Fce) ~
~ ~J umg Age Si nature o Stamps)
2 ~0/~
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^ Owner Given Reason for Denial
IX. Conditions of ApprovallReasons for Disapproval~~l lM .S _,(!~Ph~ Grate vs.
~YSTEM OWNER:
1 Septic tank, effluent filter and
dispersal cell must all be serviced /maintained, n~x~~~~ ~~.~ n L,
as er management plan rowded byinlalnber f7L-~G'rn~• ~'3 (J~il'~O"`"
2. All setback require
as per applicable codelordinances. ~~ /t/J~~ ~~~~ ~~~ ~~yyt~'+-• ~'Z, 3-
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L.~ ry
Attach complete picas (to the Counr7pa}x) for a t7ste oa apcr of less > > `J`i2 x 11 lrtc/~eu'~ _/.,~ `~~~1.~W~./~"' ,{
SBD-6398 (R. 01/03) U ~ /j~~(f(/L C (J
Wisconsin D•3partment of Commerce
Safety and Building Division
PRIVATE SEWAGE SYSTEM
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Personal information you provide maybe used for secondary purposes (Privacy Law, s.15.04 (1)(m)j.
Permit Holder's Name: City Village X Township
Kusilek, Daniel Glenwood Townshi
CST BM Elev: Insp. BM Elev: BM Description:
1
TANK INFORMATION ELEVATION D A
TYPE .~~ {{ ~MANUFACTURER
w (,~-wa,ajC A -~~ ~F CAPACITY
Septic
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~ e~ ~lps~
Dosing , `
r•~1 ~~~ . ~ t
Aeration
Holding
TANK SF~Y~ACK INFORMATION
TANK TO P/L WELL BLDG.
..r. ~/ r Vent to Air Intake ROAD
Septic ~ S~ r ~ ~~ ~ ~---~
Dosing ~, ~ << 9 5 f
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Aeration
Holding
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RUiHfP/SIPHON INFORMATION
Manufacturer ~ Q /• ~ .~~
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Model Number ~ ~ ~ 1
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TDH Li ~ ~"" Friction Loss System Head TDH Ft
Forcemain Length t Dia. ff Dist. to Well P
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SOIL ABSORPTION SYSTEM
county: St. Croix
Sanitary Permit No: 453486 0
S to Plan ID No:
o SS3 =T~zr4as. ~ a . ~
arcel Tax No:
016-1002-70-100
Section/TownlRange/Map No:
02.30.15.256
STATION BS HI FS ELEV.
Benchmark
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ILY1. ~'I
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Alt. BM
Bldg. Sewer /L, ~ ~.3 `
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SUHt Inlet /~~ ~~ ~'~
SUHt Outlet
Dt Inlet
Dt Bottom 8. ~ 9 ~Z • S ( /
Header/Man. IZ IZ.~Z- ~ g /
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Bot. System
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B D Width , Length No. Of TrertCttLS PIT DIMENSIONS No. Of its Inside Dia. Liquid Depth
ENSIGNS ~ ~,r ~ ~c1 ~~
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SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHI nufacturer:
INFORMATION CHAMBERS
Type Of System: t -
f ` yy7~
U Model
~o „ ~ ~ s ~ ~ ~ _ /
DISTRIBUTION SYSTEM ( q-b ~~ IL• a. W- )
Header/Manifold ff Distribution ~ ,~ ~ x Hole Size q x Hole Spacing Vent to Air Intake
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Length
. Length
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Spacing 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 Center Bed/Trench Edges Topsoil J; Yes ', No L', Yes ,_] No
COMMENTS: (Include code discrepencies, persons present, etc.)
Inspection #1: ~ /„~/nnO ~ Inspection #2:~p~ • D (I ~~
Location: 1768 320th Street Glenwood City, WI 54013 (Part of Gov't. Lot 6 & 7 2 T30N R15W) NA Lot 1 T' ~ rcel No: 02.30.15.256
1.) Alt BM Description = /~/~}' ^ ~.
2.) Bldg sewer length = ~- 160 ~~~ iS i,ti `~ C
-amount of cover = ~Z "-f , ~1
Plan revision Required? ~] ~ ~ i I /
Yes _ No r- .. ~. 0 ~D i - -../ _--- - - ------- ----- ~ _~
Use other side for additional information. L /_._
SBD-6710 (R.3l97j / _ ~ t Insepctor's Signature Cert. No.
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commerce.wi.gov
isconsin
Department of Commerce
Safety and Buildings
141 NW BARSTOW ST FL 4TH
WAUKESHA WI 53188-3789
TDD #: (608) 264-8777
www. commerce. state.wi. us/sb
www.wisconsin.gov
Jim Doyle, Governor
Cory L. Nettles, Secretary
August 17, 2004
CUST 1D No.224617
LYLE J MYERS
NORTHLAND PLUMBING INC
E1556 STATE ROAD 64
BOYCEVILLE WI 54725
ATTN: POWTS Inspector
ZONING OFFICE
ST CROIX COUNTY SPIA
1101 CARMICHAEL RD
HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 08/17/2006
Identification Numbers
Transaction ID No. 1049553
Site ID No. 688144
SITE: PIease refer to both identification numbers,
Dan Kusilek above, in all comes ondence with the a enc .
1768 320TH St
Town of Glenwood, 54013
St Croix County
NEI/4, SE1/4, S2, T30N, 815E
FOR:
Description: Mound, 3 Bedroom
Object Type: POWTS Component Manual Regulated Object ID No.: 975544
Maintenance required; Replacement system; 450 GPD Flow rate; 24 in Soil minimum depth to limiting factor from
original grade; System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/O1), Pressure Distribution
Component Manual -Version 2.0, SBD-10706-P (N.O1/O1)
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.
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06,
stats.
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
comply with the operation, maintenance and monitoring duties as described in section VIII of mound com~lottent
manual. A copy of this information must be given to the owner upon completion of the project. ~;~,~ , _ ~ `; /
j
Maintenance information must be given to the owner of the tank explaining that periodic cleans ~g ;of the fi r is
required. Access to the filter for cleaning must be provided per Comm 84 product approva)7dq~ tfgn§'.
A Sanitary Permit must be obtained from the county where this project is located in acco ce with fhe
requirements of Sec. 145.135 and 145.19, Wis. Stats. `SCE ~.,
r
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.
LYLE J MYERS
Page 2 8/17/2004
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.
Owner Responsibilities:
• 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).
• 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 83.55 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.
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.
The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the
installation, operation or maintenance of the POWTS.
Sincerely,
Julia ALewis-Osborne
POWTS Reviewer 2 ,Integrated Services
(262) 548-8638, Fax: (262) 548-8614
j Lewis@commerce.state.wi.us
Fee Required $ 175.00
Fee Received $ 175.00
Balance Due $ 0.00
WiSMART code: 7633
cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544
Mound system Cover Page ~, yr 6
1~~~ conc~~rE
~ Project Name: Kusilek-Mound
Owner's Name Dan & Sue Kusilek
Owners Address 1768 320th Street
Glenwood City, WI 54013
Legal Description NE ~j '/<, SE ~ '/. Sec~2~ T 30_ N, R 15 j w i ~
Township Glenwood
County Saint Croix
Subdivision N/A
Lot#
ParcellD# 0-6-1002-70-1000
Table of Contents
p9~
1 Cover page
2 Mound Sizing Calculations
3 Pressure Distribution Layout and Dynamics
4 Dose Tank
5 Management and Contingency Plan
6 Plot Map
total # of pages: 6
RECENED
~~ i,r ~ ~. ~~Q4
Designer Name: Lyle J. Myers SAFETY $ BLDGS. D1U.
MP/License #: I.D.# 224617
Date: 8/9/04
Ph. #: 7156432520
Signature:
Mound System Design Methods Used
per "Mound Component Manual For Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD-10691-P (N.01/01)
per" Pressure Distribution Component manual for Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD-10706-P (N g1JOtj ~ -
il
..~ :,
Spreadsheet provided by: 3bAdvisement N12486 220th St, BoyCeville, WI 54725 Ph: 715-643.6068 email: 3bar~3badvisem. '~~
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Mound System
Mound Sizing Calculations
Project Name: Kuslick-Mound
Site _Conditions __
Pro ect T e: 1 or 2 Family Dwelling ~
Slope: 19
# of Bedrooms: 3
Depth to limiting factor: 24 in.
Absorbtion rate of fill material: 1 gal/ftz/day
Absorbtion rate of in-situ soil: 0.4 gal/ftz/day
Effluent quality ',1=r~#i I ~
Max BOD effluent value: 220 mg/I
Max TSS effluent value: 150 mg/I
Design of Entire Fill
Cell depth at upslope edge (D):
Cell depth at downslope edge (E):
Distribution cell depth (F):
Cover thickness over edge (G):
Cover thickness over center (H):
End slope width (K):
Fill length (L):
Upslope width (J):
Downslope width (Toe) (I):
Fill Width (W):
Page 2 of 6
12.0 in.
25.7 in.
9.5 in.
6 in.
12 in.
10.1 ft.
95.2 ft.
4.4 ft.
24.0 ft.
34.4 ft.
Design of the Distribution Cell Basal Area
System Design Flow: 450.0 gal/day Basal area required: 1125 ftz
Distribution cell width (A): 6.00 ft Basal area available: 2250 ftz
Distribution cell length (B): 75.0 ft
Area of Distribution Cell: 450.0 ftz Observation Pipes
Contour Elevation of Mound: 86.35 ft Location from end of cell (Z): 12.5 ft
System Elevation of Mound: 87.35 ft
Final Grade of Mound: 89.14 ft
Mound Plan View
~ ~-Observation Pipes Z~
~ K-~- ~~ C~istrit~~_rtion Cell ~~
~ ILK
I Tilled AreatFill Material
L '
Final Grade-
Synthetic Fabric-__
Distribution Cell ,-•
System Elevation ,-~=
1
Cover Mate
Fill Material
Mound Cross Section
-, F~ ~
Invert
bservation Pipe
~~ - -
~..
~ ~--
3
Tilled Area
u
Slope Forcemain
Notes:
Fill material to consist of ASTM C33 Sand
Distribution cell aggregate to comply with Comm 84.30(6)(1)
Synthetic Fabric covering on cell per Comm 84.30(6)(g)
Distribution Cell to have minimum 6" aggregate below lateral and 2" above.
Contour
Mound System Page 3 of s
Pressure Distribution Calculations
Project Name: Kuslick-Mound
Lateral Layout Lateral/Manifold Design
Lateral elevation: 87.9 ft Lateral diameter. ivz~ In.
Rows of Laterals: ' z ~ Lateral spacing (S): ~~ft
Manifold type: center ~ Lateral to cell edge: 1.5 ft
Orifice diameter: ' o.i25 ~ In. Lateral discharge rate: 7.83 gpm
___
# of Laterals: 4 System discharge rate: 31.31 gpm
Distal Pressure: 5 ft Manifold diameter: 2 ~ In.
Lateral Length: 37 ft Manifold length: 3 ft
Orifice Spacing/Distribution Forcemain Friction Loss
Orifice spacing (X): 24.00 Inches Forcemain length: 60 ft
Orifices per lateral: 19 Forcemain diameter. z ~ In.
Avg. ft2/Orifice: 5.92 ft2 Friction loss in forcemain: 1.259 ft
Lateral Side View
Manifold
Lateral ~ Lateral
x x x x x x x x x x x x
2 2
Lateral Length Lateral Length'
' Lateral Plan View
Lateral Length ~ Turn-up w/ball valve ar cleanout plug
° °~
S
0 0 ~-
Orifices on bottom of
lateral equally spaced FNC laterals and forcemain to comply with
specifications per Comm 84.30(2J(eJ
Forcemain connection via tee or cross to manifold at any point
Clean Out Detail Observation Pipes
Clean-out plug
Final Grade or ball valve
Water tight cap
or plug
Lawn
Sprinkler
Box
Slot
Note: Closet Collar
6" Minimum may be used in
Long Sweep 90 place of 3/8" bar
ortwo 45's L 3/8" Bar
Lateral
Mound System Page 4 of 6
Septic, Pump and Dose Tank
Project: Kuslick-Mound
Tank Information
Pump tank manufacturer: Wieser Concrete
Pump tank size/model: w>.ooo/65o-MR
Pump tank gal/inch: 17
Actual Pump Tank Volume: 646 gal
Tank bottom elevation (inside): ~- 80 ft
- - - ----
Septic tank size/model: wiooo/65o-MR ~
Dosage Volume
Forcemain drains back to tank? Q Yes O rvo
Lateral void volume: 15.6 gal
Dosage to absorbtion Cell: 78.2 gal
Forcemain volume: 10.5 gal
Total dosage: 88.7 gal
Pump and Filter - Total Dynamic Head
Pump Manufacturer: Little Giant Are laterals highest point? y
Pump Model: 9EH if not, enter highest elevation: 0 ft
Effluent Filter: Zabel A100 System head (distal x 1.3) 6.50 ft ~
Vertical Lift ("D" to lateral) 7.18 ft
Note: Access opening of sufficient size to be provided to allow Friction loss in forcemain: 1.26 ft
removal of filter. Opening to terminate at or above grade.
Pressure loss from filter: C~ft
Total dynamic head (TDH): 14.94 ft
Pump Tank Diagram
Watertight Locking Cover
4 Inch With Warning Label
Finished
Minimum Grade
Alternate
Outlet
Location Elect. per Comm
16.28 and
NEC 300
Weep Hole A
or Anti- B
Siphon
Device
C
D
Pump must be capable of:
and head pressure of:
31.3 GPM
15.0 Feet
Dose Tank Levels
" In.
A Reserve 22.8
B Pump off to Alarm 2.0
C Total Dosage 5.2
D Effluent depth for pump 8.0
Total Capacity: 38.0
0
30
W
~ 20
i
A
Q
W_
10
Gal
387.3
34.0
88.7
136.0
646.0
FLON- LITERS/HUUR
goo zooo 300 ~•.
~'' ,~~ r
to
D 20 40 60 80
Little Giant F"L[]W- ALLONS/MINUTE
9EH PUMP PER ^RMANCE CURVE
115V 60HZ
N
7.5
H
W
S a
2
2.s
0
Mound System Management Plan pursuant to Comm 83.54 W. A. C. page 5 of 6
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) 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.
Pump/Dose Tank
If an effluent filter has been installed in the pump/dose tank, it must be removed & cleaned as
necessary, with provisions to keep solids from passing to the mound component during removal.
The pump, float switches and alarms must be inspected at least every three years for proper
operation. Pump/dose tank should be routinely inspected to be watertight and of good repair.
Mound and Lateral System
The mound system component must remain free of ponded surface 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 and/or possibly cause it to freeze in winter
conditions. Lateral distribution pipes should be flushed out/tested every 18 months using the cleanout points
at each end of the component to remove scum that may clog orifices.
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, pump tank or any of their components therein (including floats, alarms, pumps, etc)
become defective, the defective tank or component must be replaced immediately to ensure that the system
can operate as designed. If the mound component cannot accept wastewater or ponds wastewater to the
surface, the component must be repaired or replaced in it's current location by either: extending basal toe to
provide added absorbtion area; or by removing the clogged bacterial mat,aggregate cell, and distribution
piping within the mound and replacing said components in order to return system to proper working order as
required.
Wisconsin Department of Commerce
Division of Safely and Buildings
SOIL EVALUATION REPORT
in accordance wkh Comm t35. Wis. Adm. Code
1809
Page 1 of 3
A.C.E. Soil & Site Evaluations
Attach complete site plan on paper not less than 8'/ x 11 inches in size. Plan must °"- County
St. CfOD(
include, but not limited to: vertical and.horizontal reference point.(BAfl)* direction and
Parcel LD
percent slope, scale or dimemsions north a ~ 'distance to nearest .~
~a __., , .; ~ C_, .
01
6-1002-70-1000
Please print afi information. Reviewed By ° ' ~ ~ ~--
Personal informatan you provide may de used for secondary purposes P ' acy Law ;s. 15.04 (1) (m)).
i ~
~ ~' ~_,
Property Owner + Property Location
Dan & Sue Kuslick , ~ ~, ~,~,,; ~;v~,;~; ; , ~ Govt. Lot NE 1M SE 1/4 ~ 2 : ~ ;T~ '~0 15
Property Owners Mailing Address BONING OFFICE.: Lot # Block # Subd. Name or SM#
1768 320th Street ~~ na na Na ~~~~,~ „~!.;,v "`,
City State Zip Code Phone Number ~ City ~ Village ~ Town _ 'n ING OFFICE
Glenwood City ~ WI 54013 715-265-7716 Glenwood 1768 320Th Street
_j New Construction Use: ~ Residential /Number of bedrooms 4 Code derived design flow rate
/,~ Replacement ,J Public or commercial -Describe:
Parent material Glacial drift Flood plain elevation, if applicable
General comments
and recommendations: Install mound system at elev. 87.60' at 15" above 86.35' contour. 600 GPD
na
Boring # ~ Boring
Pit Ground Surface elev. 86.35 ft
!~
. 21 ~~
Depth to limiting factor
in.
Application Rate
Soil
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roois GP D/ft=
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-4 10yr3/3 none sil 2fsbk mvfr cs 2f 0.6 0.8
2 4-12 10yr4/4 none vfs 1 msbk mvfr gw 2f 0.4 0.6
3 12-21 10yr5/4 none vfs 1 msbk mvfr cw 2f,1 me 0.4 0.6
4 21-48 10yr5/4 f2f 7.5yr5/8 Ivfs 1 csbk mvfr aw 1 f 0.4 0.6
5 48-66 10yr6/4 f2d 7.5yr5/8 vfs Om mvfr - - 0.4 0.6
H# 5 constitutes sand stone bedrock as determined by resistance to knife penetration.
Boring # ~ Boring
i~' Pit Ground Surface elev. 86.90 ft. Depth to limiting factor 48° in• Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eti#1 *Eff#2
1 0-14 10yr3/3 none sil 2fsbk mvfr gs 2f 0.6 0.8
2 14-22 10yr5/4 none sil 2fsbk mvfr gw 2f,1mc 0.6 0.8
3 22-48 7.5yr4/4 none sl 2msbk mvfr gw 1fmc 0.6 1.0
4 48-63 7.5yr4/6 f2f 7.5yr5/8 fs O sg mvfr - 1vf,f 0.4 0.6
* Effluent #1 = BOD 5> 30 <_ 220 mg/L a d TSS >30 < 1 L * uent #2 = BOD <30 mg/Land TSS <30 mg/L
CST Name (Please Print) Signatur CST Number
James K. Thompson _ 3602
Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number
340 Paulson Lake Lane, O a, WI 54020 6/152004 715-248-7767
Property Owner Dan & Sue Kuslick
Parcel ID #
016-1002-70-1000
Page 2 of 3
a Boring # ~ Boring
// Pit Ground Surtace elev. 83.29 ft. Depth to limiting factor 25" in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2
1 0-4 10yr413 none sl 2fsbk mvfr cs 2f 0.6 1.0
2 4-14 10yr4/6 none sl 2msbk mvFr cw 2f 0.6 1.0
3 14-25 10yr4/6 none Is & gr 0 sg mvfr cw 2f,1 me 0.7 1.6
4 25-48 7.5yr4/6 f2f 7.5yr5/8 Is & gr 0 sg mvfr aw 1f 0.7 1.6
5 48-61 10yr7/3 f2d 7.5yr5/8 vfs 0 sg mvfr - - 0.7 1.6
H# 5 constitutes sand stone bedrock as determined by resistance to knife penetration.
^ Boring # ^ -f 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
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Etf#2
^ Boring # J Boring
~ Pit Ground Surtace elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
Effluent #1 = BOD 5> 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 or
need material in an alternate format, please cflntact the department at 608-266-3151 or TTY 608-264-8777.
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Wisconsin Department of Commerce
Division of Safely and Buildings
SOIL EVALUATION REPORT
in accordance with Comm 85. Wis. Adm. Code
1809
Page 1 of 3
A.C.E. Soil & Site Evaluations
County
Attach complete site plan on paper not less than 8'~ x 11 inches in size. Plan must St. Croix
include, but not limited to: vertical and horizontal reference point (BM), direction and ~a~D
lo
e
scale or dimemsions
north arrow
and location and distance to near
t
Parcel I.D.
p
,
,
,
percen
s 016-1002-70-1000
Please print all information. Ravi Da
Personal information you provide may ~ usod.for vacy.Lmu,.s_.15.04 (1) (m)). ` Z~
Property Owner ~ ~' ° --- °' t operty Location
Dan & Sue Kuslick Govt. Lot NE 1/4 SE 1 /4 S T 30 N R 15 W
Property Owners Mailing Address ; ~ ~ ~ (,~ ~? ~ ~ ~ Lpt # Block # Subd. Nam r CSM# ~ Z7i
1768 320th Street na ~ na Na
City State Zi Cody Phahe~NutT.~tied, • ~ City _j Village 1 Town Nearest Road
Glenwood City ~ WI L(_'i~~~i~' ~ Glenwood 1768 320Th Street
New Construction Use: ~ Residential /Number of bedrooms 3 Code derived design flow rate
1_ _f/ Replacement Public or commercial -Describe:
Parent material Glacial drift Flood plain elevation, if applicable
General comments
and recommendations: Install mound system at elev. 86.35' at 12" above 86.35' contour. 450 GPD
na
Boring # Boring
Pit
/~
Ground Surtace elev. 86.35 ft. 24"
Depth to limiting factor
in.
Soil A ication Rate
ppl
Horizon Depth Dominant Color RedoR Description Texture Structure Consistence Boundary Roots GP D/ft~
in. Munsell Qu. Sz. Corit. Color Gr. Sz. Sh. "Eff#1 'Eff#2
1 0-4 10yr3/3 none sil 2fsbk mvfr cs 2f 0.6 0.8
2 4-12 10yr4/4 none vfs 1 msbk mvfr gw 2f 0.4 0.6
3 12-24 10yr5/4 none vfs 1 msbk mvfr cvv 2f,1 me 0.4 0.6
4 24-48 10yr5/4 f2f 7.5yr5/8 Ivfs 1 csbk mvfr aw 1 f 0.4 0.6
5 48-66 10yr6/4 f2d 7.5yr5/8 vfs Om mvfr - - 0.4 0.6
H# 5 constitutes sand stone bedrock as determined by resistance to knife penetration.
Boring # :~ Boring
Pit Ground Surface elev. 86.90 ft. Depth to limiting factor 48" in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2
1 0-14 10yr3/3 none sil 2fsbk mvfr gs 2f 0.6 0.8
2 14-22 10yr5/4 none sil 2fsbk mvfr gw 2f,1 me 0.6 0.8
3 22-48 7.5yr4/4 none sl 2msbk mvfr gw 1fmc 0.6 1.0
4 48-63 7.5yr4/6 f2f 7.5yr5/8 fs 0 sg mvfr - 1 vf,f 0.4 0.6
' Effluent #1 = BOD ~ 30 <_ 220 mg/L an TSS >30 < 150 g/L ant #2 = BOD < 30 mg/L and TSS < 30 mg/L
'~ CST Name (Please Print) Signature: CST Number
James K. Thompson ~-~-- 3602
~ Address A.C.E. Soil & Site Evaluations ate Evaluation Conducted Telephone Number
340 Paulson Lake Lane, Osceola, 20 6/152004 715-248-7767
Property Owner Dan & Sue Kuslick
Parcel ID # 016-1002-70-1000
Page 2 of 3
Boring # ~ Boring
F Pit Ground Surtace elev. 83.29 ft. Depth to limiting factor 25" in. Soil Application Rate
Horizon Depth Dominant Color Re x escription Texture Structure Consistence Boundary Roots P
in. Munsell Qu S Con Color Gr. Sz. Sh. 'Eff#1 *Eff#2
1 0-4 10yr4/3 none sl 2fsbk mvfr cs Zf 0.6 1.0
2 4-14 10yr4/6 none s1 2msbk mvfr cw 2f 0.6 1.0
3 14-25 10yr4/6 none Is & gr 0 sg mvfr cw 2f,1mc 0.7 1.6
4 25-48 7.5yr4l6 ®f2f 7.5yr5/8 Is & gr 0 sg mvfr aw 1f 0.7 1.6
5 48-61 10yr7/3 f2d 7.5yr5/8 vfs 0 sg mvfr - - 0.7 1.6
H# 5 constitutes sand stone bedrock as determined by resistance to knife penetration.
Boring # ~ Boring
Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boun~ry Roots P
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2
^ Boring # .J 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 G
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
'Effluent #1 = BOD ~ 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 or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
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ST CROIX COUIV'I'Y
SEPTIC TANK MAINTENANt:"E AGREEMENT
AND
OWNERSHIP CERTIFICA'T'i~JN FORM
Owner/Buyer ~~ ~~~L ~ r L~=~~
Mailing Address ! 7/b ~ ~ ~~' ~3`-~~~^"~
lf~c~S 3~~zx S'T"
Property Address ~ - `~~1 ~c ®~ i , ~-~ "" ° ~~D/~'--
{Vcrification required from Planning Department for new construction)
fe-
City/State ~~ ~ ~ 1~.~. Parcel Identification Number D/ ~ ~ 1 GYr~- _ 7U -ld U
LEGAL DESCRIPTION
~as~
Property Location ~ '/<,Su~ `/,, Sec. ~ . TAN-R,.~~W, Town of '' ~ .
Subdivision _ .Lot #
~~ ~ ~ g ~ ~ .
K Certified Survey Map # _ ~ ,_._, Volume _ 8 ~ Pa e # __~~--
~.e ~~ 's
eed # v y ~ ~~ S~ _ .Volume _ /S 9 Page #
Sped house ~ yes ~ no Lot lines identifiable ~ yes D no
SYSTEM MAINTENANCE
Improper use and maintenance of your septic system could result ixi it, premature failure to handle wastes. Proper maintenance
consists of pumping out We soptic tank every three years or sooner, if needed by a licensed pumper. What you put into the system
can affect the function of the septic tank as a treatment stage in the waste disposal system.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
master plumber, louraeyman plumber, restricted plumber or a licensed ptttziper verifying that (1) the on-situ wastewater disposal system
is is 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 sot by the Department of Commerce and rho Departnycnt of Natural Resources, State of Wisconsin. Certification
stating that your septic system has been maintained must be completed and raturned to the St. Croix County Zoning Office within 30
da of the three year cxp' Lion date.
~ C ~ ,~,Z,o~/
SI NATURE OF APPLICANT DATE
O R CERTIFICATIO
I (we} certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) rho owner(s) of
the operty described above, b virtue of a warranty deed recorded in Register of Deeds Office.
~ ~ZZy ~
SICiI~iATURE OF APPLICANT DATE
«.*•.« Any information that is mis-represented may result in the saniGsry permit being revoked by the Zoning Department.'`*'`*'`*
"• Include with this application: a stamped warranty deed from the Itcgister of Doeds office
a copy of the certified survey map if reforonco is mado in the warranty deed
.....,..w:...~;.:::
~~.
Yoe 1599~,-~ '77 w
64q 1 05
~:RTF•li.rr:!ti ri.. WRL.SH
SHERIFFS ~:~x ~;itD FOR F.ECQRD
Document Number DEED
~~,t-C9-?901 8:00 AM
Drafted by:-Terry R. Gray SHERIFFS DEED
EXEi~!pr p
Return to: iel and Susan Kusilek
1331 2nd Str ~
~ ~ CF~T COPY FEE:
COQ Y F«:
TRAriSFER FEE
2
'a'u'`,~
Hudson, WI 5 6 L-.,t J
_ :
23. BO
kECL~RDIkG FEE: 10.00
PAGES: 1
Parcel Identification Number
016-1002.70-1t)0
RE= WMC Mortgage Corp.v. Michael J.
Lindquist
Casc No. 99-CV~1
Pursuant to a judgment of foreclosure entered in this matter, the subject premises was sold at auction to the highest and
best bidder, Daniel and Susan Kusilek. 3'herefore, the sheriff does hereby grant and convey unto said successful bidder,
all of the following described land, located in the County of St. Croix, State of Wisrnnsin, to wit:
Certified Survey Map in Vol. 8 of Certified Survey Maps, Page 2216, as Document
i Number 458784, filed in St. Croix County Register of Deeds Office on May 22, 1990 •.`
being a Part of Government Lot 6
Fract oaa Section Two 2 , $ Part of rnment Lot 7, All in ?
Town of Glenwood. St. Croix County~PWisconsin30) north, Range Fifteen (IS) West,
Pin Number: 016-1002-70-100
STATE OF WISCONSIN )
)ss
/~..~ ~
SHERIFF -
(Strike the inappropriate title)
CO[IN1'Y OF St. Croix)
Personally came before me this ash day of , 2001, the above-named s/tuTfF, /,(q~ /Y%//S/~[.t~,
, personally knows to me as the officer describ above, and who executed this document as the sheriff or on
behalf of the sheriff of this county.
/f'1i?/1
• ,Notary Pu~Uc
MAf9Y .1. il!AC{T~'!.L St. Croix County, Wisconsin '
!q?ARV PUiiIIC STATE OF `.NISC6taSOr
My comtttission expires: Q~ -30-a
to
~ -
.l ~~ . j
V
458'784
FORM N0. 985-A
IIt YMbrC•.ery®
Stock Na. Z6273
't~ ) \.
FILED ~
MAY 2 21990-
JAMES O'CONNELI
R6~StBf D1 o~eda ~
CERTIFIED SURVEY MAP NO.~
2216
VOLUME__$ ,PAGE
BEING A PART OF GOVERNMENT LOT 6 AND A PART OF GOVERNMENT LOT 7, ALL
IN FRACT ZONAL SECTION 2, T. ~15 W., TOWN OF GLEN , .R IX
COUNTY, WISCONSIN. N.E. CORNER
2-30-13 ..
FDUND 3/4"RE-ROD••
NOTE ~ THIS MAP SUPERSEDES ST. CROIX , •r-'
COUNTY CERTIFIED SURVEY MAP N0. `:_ °-
1826, VOLUME 7, PAGE 1826, ST. CROIX ~.',
COUNTY REGISTRY, ~ a'w
c a ,
UN,~,{,AT.T.EQ Is.A.y.~ ' . x
STEVEN J. ••~
• WAAK . ~n
`J ~ ~
• $-~~1~ •
• ~ MENOMONIE ; Q-;
`9/~•. WIS. .•~Q
~~~~~90
NORTH IS. REFERENCED TO THE EAST LINE
OF THE ~ FRACTIONA L NORTHEAST 1/4,
WHIC~1,13 ASSUMF.'D TO BEAR N00428=34°W.
cuRVE A -e DArA
RADIUS = 967.15'
CENTRAL ANGLE _ !2444=54"
CHORD LENGTH = 21 4.75 '
CHORD BEARING = S07427=34"E
ARC = 215.!9'
B. TAN. BEARING = S 134 50 = 01 "E
F. TA N.BEARING = SOJ403'07."E
$Y Q7H~,$~, ~ .
~6
NORTH LINE- G. L. 6 .w \
ro 589443=35"W 678.51'
65(.26'
- - ~
y~ 27.25' I
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110.07'
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LEGEND
QI,,,,,,GOVERNMENT CORNER (AS NOTED )
0.......SET 3Af "x 24 "RE-ROD WE IGNING 1.502 LBS. L.F:
®..,...EXISTING BUILDINGS
.....SEPTIC VENT
-x-.....EXISTIIJG FENCE
GRAPHIC SCALE ~ 1'~= 300 '
O 20l! 400 b00 800
PREPARED FOR ~ DAVE AND JOHN LOGGHE
RourE 2
GLENWOOD CITY, WIS. 34013
1
LOT 1
881,619 S,'F./20.24AC.
EXCL. R. W./EASM~T. '
871,485 S.F./20.01 AC.
1
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FOREST PAGE 72
See Pa a 112 For Additional Nam .,
g es.
2 ey 2900 S 2 3000 3100 180th AVE 32~DTJNN CO.
Fai 3300
do Sheila F Fd a t --
t Wagner ' ~ Paul Clara N e A z1 N ,'+.,t 2 oseph 1
103 2 t
'.
63 3 '+ !t< Wanda
5 s ~ s a~ s o s Emma a ~ 4 John 3 ckelen 30 I
E ' Michael a Her~rtien& ~.~ 5 ~ s lackelen a o s s 8, 3 a s s
108 & Sarah ~ A 128 Pitt u ~ ~ ~ 2s, Jeffrey
s t. Cassellius s e ~ '~ ~; o b 136 ioi ~~ N & Enid
7' ~ S~~g~ to s~Aaa s ~~ ~ to s L Bahnub
74 s N to sj s ~I
394
BUSH ~ : 151 175th AVE 80 ~. , ~ X
4 I
LAKE „ Ernest Harold ~ Pao ~
~ ' ~ RFF I
tarcella ' ~ d Clarence a Severson ~ lone ~ David c K
rlnsen ~'~ Bacon )a~clceien e ~ °~ a Trust M Gabower I '~ -~ " ,d.,' Gordon
217 .dr ~ °°"°""' ' ~ ~ ~ Adams 1
146 -.elm" 80 92 100 1 170th AVE °v3i r ~ 258 I ~~ 170t
Ma~ddeea a8 $ Gerald c 0 0 0 - ~ ' - ~-- - - -+- - AVE _182
~aie ~ LOS $ttab~ih V t° , ~ O~,y ~ N N ~ N n ' ~ ~ ~
00 67 8o t;~ ,. ~ ~ E ~ Robert I'o ~ Daniel I
Thom ~'" .qg William ~ ean sac to ,a & Melodee 80 Stansbury
ug a1 w Meyer Marko Forrest s ~~ o
o. 20 65 °j.5 ~ ~ 152 ~oY , 165th
`p Ober- es & g ~~~ ~ ~~ 1 O ,a, Peter & 4o AV 2 160 ~~H~
D&L
JO .c a h ~ ao Bontes ~ ~ a .: ~ Wayne ° o Sheila ~ 23 0
~'O ~ ~ ~l ~ 3 ~o~rleta Newcombe 151 seems ~~; Anderson I
Ee-, 35 ~ N N e~man Theresa a 3 at ~ X etal I
~ x u i s 40 80 ~ ~ 160 79 ~ RUTSON
I zl 77 226 Hoffman I
,°n` 160th AVE JOE 20 °e c c 1 2 I Zl 59 0 ~ 159
~" lilchard ~r~° ~ ^ °p Herbert w ~ z 2 i a c ~ ac
JB:D 20 ~.. Gregory Fte~ra ~- • aam a!>a 4 to,Rh a .^~ m I
Bt Grace f- ~ --~ & Rose ~o=erae °Kma ao,o a 4 reae weo-_
Ober- ~ B7OW° ~ C C n v Desmith sat ae ~~ i Alma +o .w ~ ~ Afl Pau18r
ueller ~ SdtA 20 +° ~ ~ ' $ N .~ 5^i Luks s~ 76 15 got 35 39 ~ 13 Susan
o Stone '~~ ~~ °'~ '~ o.. Harold C I Sween I
E K °' '~ oZ 6 p ^ $ Rhodes 00 Robert Wesley Sams Gre o laF so I
160 a tx,,,aa~ $ p a4 a'ti aG 60 Palewicz Tuttle a ~° 6L Lygtln n
j llo r 7o b,~ 2 aama ~ B 74 ,~ v
apo M 20 James Jr ~ (G o ~ ~ ~ 39 ,w arih3ger D is m^
n '~ L 85
& Dona
er C 97 Wayne S
c o John Weyer 80 a ~pC ~ °i ~ Dale 8c ICarta Peterson ~" O 92
o N Y
i ;.~ Moe Ricbara 3 a Y '~ ~ Obermiller 4U Fr 909 ~ ~
w V a Dome Att~bad isz~a ~ z ~ '~>+~ Robert DaWd a ed & tn~ .,~
a oa
ttai„ , r AVE $ a ~ v, Pair ~ Barbara ~ o a d
es ~ 71,eresa
120 Graeae w F°
140 ao ~ 3 ~~f slat w[a40 Hoff Drinlanan ~
~ ~ti N Eillsoa ~ - 100 mi° 79 119 1150th AVE z
~ 217 ss z
sa dt
1 el S
usaa
Krai D ~- Ande 20 s w ~ A
g & °"°` 4~ ~ ~ ~O° ~ Bruce O
C Maureen 70 '~ to io 60 Sharon 5 laves & ~ D
a Konder ° Clifford Hess Jotene 40 ~-
& antat Iaberee of e ~ etuK
_ ~ er a twee gic Kirby a .c ,° u C p
~ q o 121 40 a 143 lZ 145th AVE 133 78 ~°° ~Ai'OCra ~~~
' G N 40
yII 8r S°,
117 ~,
Tibia ~ ~ C Thomas ~ ~ David inc ,ty 0
198 x~~ ~,, °° & l:inda ~' ~,~y :GLEN pD is o
N N rzaet a u o~ Weber o~,,.y ft T JD o X
tI 12 ~ ~ ~ ~ ~~ ~ Hantsoa 124 ~~+ ~ ~1~ s ndn0 Da91da U~
T ~~ 0 5 Slcow Shirley --
4 r 13 38 „Schroeder ~
n ~ O i zo - _ 120 Z
IS :° °D Tar -- David Z
'd ''' ~ 8 P°tisMcula John & ~ r t* ~ Schroeder o
~ ~ ~ ~ Mna- 'Rose ~'~. 58 78 z
0L dd pq ~ F p pq oq ~ ~ ~ I McCutchIn Faaj James & ~ a
Yi Patrida gin,
_ b~~ 80 i 140 tr ~ Wider schmcder
om eiut= w ~ O ~ Joseph James & ~ ~ 170 34 ao so
Tone~e 4 FFK & Gloria , ,oseP~~~a y ~ Joseph Qt
L ~ .. Charlene
~. reiber waiter I O X118 ~.. ~ Draxler ~
60 219 ° g~ . Albrecht 12 M ~ CREEK David &
40 a ~ ao cerof There
Aa~ All to 130th AV o <~knwooa tlty
.r 32 °s~ is °'°. ~ ~ & )ulie ~ N mouse ~ G David 8 t P _ L`RE _ so ~ - 119 ~ c~n
~--
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