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HomeMy WebLinkAbout016-1042-90-100Department of commerce PRIVATE SEWAGE SYSTEM 9uilding Division ~ • INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT] Personal information you provide may be used for secondary purposes [P:-ivacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village x Township Boehmer, Gre Glenwood Townshi CST BM Elev: ~ / O /t Insp. BM Elev: ~ i BM Desc~7'ption: ~ " ~ y ~~C ..5~ TANK INFORMATION " U kLEVATION DATA TYPE MANUFACTURER CAPACITY Septic r~~~~,uf~ ~ ov a G 3 0 Dosing ~t~ `w A-- tJ7~ Aeration Holding TANK SETBACK INFORMATION TANK TO P/L 0 WELL BLDG. Vent to Air Intake ROAD Septic , ~ J~J ~ ~ ~ I Dosing b ~ 8~ ~K n' Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number ~ / ~~ ~ /~ J TDH Lift i-/ Friction Loss System Head Ft TDH ,•S ~~ 3• 17. Forcemain L t~ ~ Dia. p 2 Dist. to well .uo T ..J ~ T SOIL ABSORPTION SYSTEM BED/TRENCH Width ~ I Length_ ~~ No. t~Tre~hes , DIMENSIONS ~(~! ~~~ SETBACK SYSTEM TO INFORMATION Type Of System: ~ zoai ~o~~l ,', DISTRIBUTION SYSTEM county: St. Croix Sanitary Permit No: 420351 0 State Plan ID No: Parcel Tax No: STATION BS 2. D HI ,v FS ELEV. oD-o Benchmark Alt. B~ ~ '~ 2~ ~~~5 Bldg. Se r 3. ~' SUHt Inlet 3.~ 9~ `~ SUHt Outlet ~ ~- Dt Inlet T C~~- I . ~ ~' ~ / Dt Bottom ~` Q ! ~G i U H de Man. /oZ~a Z• 3 ~ - ~ Dist. Pi ~oz~ z. ~F R~- ~ Bot. Sy~te 3 .! ' ~ p j) Final Grade St Cover 8 .c~ 9g . / •3 a7- JS No. Of P' Inside Dia. Liquid Depth M L C G Manufacturer: CHA R OR UNI Model Number: fie. e-yl rf'1 Header/Manifold ~l / Length -/ Dia •~ h y Distribution Pipe(s) t~ / Length ~ / Dia ~ ~ ~,[ ) Spacing / x Hole Size ~ ~ ~ x Hole Spacing (,~ h ~ / Vent Air Intake SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only ~ ~ Depth Over ~ fi Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ~ Bed/Trench Edges Topsoil ~-- (_~ Yes ~J No ; J Yes (~'~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: FU / ~ / ~L Inspection #2: l ~ / / / Q Z Location: 1467 County~Road D/G Glenwood City, WI 540)1~~(SW 1/4 NW 1/4 19 T30N R15W) NA ~ Parcel No: 1.)AItBM Description = ,O~ ~~~~'W~I ~/r'w'~~'~ ~^+~t dlrM+•~t.~'L 2.) Bldg sewer length = ~j (p f [/t//~,~/ ~t:Qli>~~~~^4~ 4~~~Gt~l.(~^' - amount of cover = ~ ~'j ~ / - ~ ~-~w~-- q ~ -$' _ Plan revision Required? ~.~ Yes ij/No i~_~ ~~_- D,~ ~~ ~-- - - ------ ~~C%G-YYi~ --~i ~I- ----~~-_- ,~ Use other side for additional mformatlon. i__._---~----_ ~ I - _ - - - ----__---- L--~ '_(~--'L___ SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. pl`~~ ,- i ~~ ~ . ..... , ....- _ Ave.. P.O. Bax T162 ?Al w. w~ 'T I De artmeat of Commerce tion li it A Pmmit Number ~~2Q 3~ ca pp Sanitary Perm In accord with Comm 83.21. ~Tis. Adm. Code. persamal t~'orna-don You proves a tax ig Revision be used for Law s15. i plan I.D. Nutttber 1" Appiicatfon Infotanstfon - Ptesse Print Alt Inforniadon RE ~~`EZ.~o Tr s ~ f x. N~ (~ l r0 '" t© Property Gwne ~s Nanx ` J ~ ~'~(Y. Property Owner's Addrtss I~ sr. CROIX CAJUN ~ ~ ~~; s ~ / T ~. Stagy ~ Code FICE Bio~C N Name ~~ ~ ~ ~ V. II, Type of Building (check all that t+pPiY) ~ CtS ~ ~ "`'`" ~ o~Y ar 2 gamy I?welling -Number of Bedmoma o V~age ^ PublicJCommerciai - Use wttshig ~ N ^ Stone Ownod ~ °'~" ~~„yi„ t,r $ ~ fr3' KS~' ~ III. Type of Permit: (Check only o~ box on line A (numbering scheme for internal use). Complete e B if applicable) '~' ew 2 a Repiuemenot Syanem 3 ^ Replacement of s a Addition to For C~ use Tank au:m Permit Number Date Isauxl >a. o c~k if sanitary Petmu Previarsiy issued IV. Type of Permit: (Chec3c nll t6st ttpply)(nambering scheme is far internal :~:) ..~(„ "'{(~ - 4a aNan P~ 1n-Gra0.md Z1~M~d 47 a Sand I~ilber 50 a Consuu!cted'Wedand ~ ^ p 41 ^ Holding Tank 48 ~} Siogic Pass Sl ^ Drrp Line 45 ^ At-Gn~de 4G a Aombie Treatment Unit 44 a RsciccnlatioB 30 a Other y. Arent Indarmation: ~ Aztia soa Per+colatiou Rase sYate~ B~va6on Design Flow (bpd) Dispersal Area APIA Proposed gane((;als.lDayalSggt.) (Mm./lach) p /~ / Srte VL Task Info Capacity irm Tani Number Mararfaaturer Prefab C>allons GatkmS of Tanks Concreee Cormtrucoed New Tardcs Tams Sgxic or Holdir~ Tank ~affi ' VII. ility the ~ fay ~ Ste PDW1S alawn cos the PhmQber's {Print) Flambe ' MP RS N ,~?; ~ % ~ VV PNrmber'a Ad/dress (Street, City. State, Cade /~ ~{. ~ ~~ ~4/ i VIII. /De Use Anl Approved ^ Disapproved ~~Y Pemmt gee'('mcludes Groundwater Dace Issued e Fee) ^ Owner Gives Initial Adverse ~~~r,r„_ Deuruimatiou I~x. ~ld ~~~~p,~o~[_ ApprovallReas~s far ~ ~ ~,. 1AtiQr~M~tt+Kt~ t:Y~ >v~ ~ t SBD-6398 (R.. O5I01) ' PL ,,rea Boehmer 1~/4 IVVV 1/4S 19 /T 30 N PLAN DRESS 2995 Helena Ave. Oakdale Mn 55128 w~ Glenwood couNTY ST. CROIX ='MPRS Shaun Bird 226900 DATE/25/02 BEDROOM 3 CONVENTIONAL A R CONVENTIONAL LIFT HOLDING TANK 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 MOUND SEPTIC TANK SIZE 1.0 A 450 none HOLDING TANK SIZE LOAD RATE ABSORPTION ARE # of chambers ,BENCHMARK V.R.P. Top of 1" Pipe ASSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE O WELL *H.R.P. SE corner of property SYSTEM EL ATION 99.0' ~~r B~- k°P o~ 2" Pipe le~.o' 500' Property Line Scale = 1 /4" = 10' Tank is to be properly bedded and provided with lockdown covers with approved warning labels Pro 3 Bedroom House Huffcutt Combo Tank B- ~ ~~ ~~r~-aln V ~~ 9 B -1 ~o d~-c~~ 11~[~ 9 7' 95' Grading is to be done to divert runoff away from system 200' -3 10% Area 15' Below System Slope to remain undisturbed Well is to meet all setbacks found in Comm. 83 15 0' co rn 0 'o ', -a m r m County Road D i ~ r -scons-n Department of Commerce Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264-8777 www.commerce.state.wi.us/sb www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Secretary August 16, 2002 CUST ID No.226900 SHAUN R BIRD BIRD PLUMBING, INC 1008 192 ND AVE NEW RICHMOND WI 54017 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/16/2004 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Greg Boehmer Cth D Town of Glenwood St Croix County SW1/4, NW1/4, S19, T30N, R15W FOR: New mound, 450 GPD Object Type: POWT System Regulated Object ID No.: 864100 Identification Numbers Transaction ID No. 774210 Site ID No. 648707 'Please refer to both identification numbers, ; above, in all correspondence with the agency. The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the C(l, "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD-10691-P ~ r,,,,~ ( N.O1/O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment N Systems" 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 ,_ - ~_ C(' the mound 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. • The maintenance plan for this system must be given to the owner of the POWTS. Key Item(s) • The proposed pump settings have been adjusted provide a dose volume that is greater than 5 times the void volume and less than 20% of the design wastewater flow plus drain back. Note • The bottom of the distribution cell shall be level per the Mound Component Manual. SHAiJN R BIRD Page 2 8/16/02 • The maximum fuushed slope of the mound surface shall be equal to or less than 3:1 per the Mound Component Manual. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • Maintain well and waterline set backs per COMM 83.43(8)(1). 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 may be made to me at the telephone number listed below, or at the address on this letterhead. The above left address hall prov`ir~e a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenanc of the POWTS. Patricia L Shandorf POWTS Plan Reviewer , Inte d Services (715) 634-7810, Fax: (715) 634-5150 , M-F 7:45 am - 4:30 pm pshandorf@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 r~ Cover Page Shaun Bird Bird Plumbing inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date : 7/25/02 Owner: Greg Boehmer Location: County Road D System type: Mound System Manuals Used: Mound Component Manual version 2.0 (01 /31) Pressure Distribution Manual version 2.0 (01/31) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-9. Maintance and Contigency~J lar 10-12 Soil test // Signature License nu er 226900 7/25/02 °~~i~~ ,~'~y s 5, ~_~ ~ ~;~ =}~,r,~r~C=_NCE n~~z~ . ` PLOT PLAN PROJECT Grea Boehmer DRESS 2995 Helena Ave. Oakdale Mn 55128 ,• SW i / 4 I~IVN 1 /4 S 19 /T 30 N 1 w To Glenwood couNTY ST. CROIX MPRS Shaun Bird 226900 DATE?/25/02 BEDROOM 3 CONVENTIONAL A R CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 450 # of chambers none BENCHMARK V.R.P. Top of 1" Pipe ASSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE O WELL *H.R.P. SE corner of property .._. SYSTEM EL ATION 99.0' ~~.T• {3 v~.t - '~'° P o~ 2 " PIPS IGU • o 500' Property Line Scale = 1/4" = 10' Pro 3 Bedroom House Tank is to be properly bedded and provided with lockdown covers with approved warning labels Huffcutt Combo Tank B- .. 200' ° 9 B-1 97° B-3 9 5' ".."'..-.-~' Grading is to be done to divert runoff away from system ~- County Road D 10% Area 15' Below System Slope to remain undisturbed Well is to meet all setbacks found in Comm. 83 15 0' co rn 0 0 m r m . _~L11 V G- ~i~j U v Date7`C-`! Z`~" ~r-~ 4" Observation Pipe Perforated Below Filter Fabric ASai C-33 5 o n d "Topsoil ~J t /', 7. Slops Non Woven Filter Fabric D+siribution pips R_ d e T i~'_ r d O f ~~ 2 %2 rain Rack -- Tg-o~ Force M.oin f ram Pump Cress Section Of A Mound "SYsfem Usinq A Bed For The Absorption Arco A $ F . 6 ~ t. I ~ ft.- " ~ J Ft. _ K_~ Ft. ~k ~n u-1°s - k.~Di Ft. J m ~ ~. L - 0 0 I .._ ~_ ~Piowe d layer ~D ~ -~ ~ .-~=~-_ F~_ s' G ~~ h --~-- J . -- _~ _ _ L E 40bservotion Pipe-~ E _ - K ,_ r_~__.~_-.._.._.. _-__-_-_----_ ~ ~" ~~~--~ -- --~------ ------ i Force Moin o From Pump Distribution Bed Ot f2~- 2'2 Pipe ' Drnin RocK 4 Obt;arvotian Pipe Permonet-t Morker " Pipe or Rods Pton Vity+ Ot Mound Utlnp A Bed For TAe Absorption Areo a ~ located On Bottom. s Etwdny spoeed FIRST Kat.t. tltttT z-e Cennec~~' 1 t.c. r ~y - u~o s ' ~ ~ _ . Signed: Qislributi0n Pipe LOyOUt License N~ ~Z~ ..~..~ Date : .~ ~~ ~ U~- ~ ~~~ Ft. R ~ F{. X Z Inches Y ____.,._ Inches 3 Hoie Diameter It b Inch laterai ~" ~ 'Inch{es~ Manifold vt- Inches Force Mlain " j2 Inches ~` of holes/pipev2-~ Invert Eievation of Laterals Ft... Ptsrforoled Pipt Otioi! ., rave Ut `'~ SEPTIC TANK ~ PUMP CIfAMBER CROSS SECTION AND SPECIFICATIONS V" CI VENT PIPE 32" M2N. ABOVE GRADE 5 1t£ATHERPR~F ~ Z5' FROli DOOR. WINDOW 4R JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT MANHOLE COYER W / PADLOCK S FINISHED GRADE WARNING LABEL 6"~:w. y,f NIH. 26 IN y c.z. aeac~Mwue,~+ 3 ~. ~ " . r1tE. ~ • «ntiM. t8 , IkL~r , . ' WATER TIGHT SEALS ..~ i ~°` S" ' ~. TIGHT ~ ~\~~j D FILTER ----•- ~ SEAL ~ PP JOINTS tilTli APPROYEfl ALM ~ APP'I~YEO PIPE PIPE 3' B "~"" ~ ~ ~ ON • S~~SOIi ONTO SW.IU AIL cc~~ ~~T ' ~ - -- i ; OFF . . . . ELEV .f>, PUMP OFF ~ D 3" APPROVED BEDDING UNDER TANK ` COAiC~'j,RJ~E~T~E PAD SPECIFICATIONS /%~~~GU~~ SEPTIC / DOSE ,s TANK MANUFACTURER: NUMBER DOSES PER DAY: TANK SIZES: SEPTIC GAL. DOSE VOLUME INCLUDING DOSE GAL . ~ F LOWBAC K : ,~,.~ sue' GAL • 5;y~,~,_, CAPACITIES: A = ~~•'S INCHES = ~~ GAL. ALARM MANUFACTURERS ~,j "'"-"" MODEL NUlIBER • ~ S = - 2 INCHES = ~D „GAL. SWITCH TYPE: C = '. ~~ INCHES = 7.5~ GAL. PUMP HAI+NFACTURER ~ o `~"! MODEL NU!'IBER : D = ~ INCHES = GAL SWITCH TYPE: ct REQUIRED DISCHARGE RAT£~,~3~ GPK PUMP ~ ALARM 1rlIRING AS PER ILHR 16.23 WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AHD DISTRIBUTION PIPE ~~/F E SUPPLY PRESSURE - - - .~ ~ ~~--FEET ~ UH NETWORK ~ FEET t FEET FORCENAIN X y~~FT/100 ~T~LiCTIONICA~~D j ~..~.~2...FI:~r ~ ~~ INTERNAL DIMENSIONS M TANK: LENGTH D ~H~~-rO~-" DIAMETER „r_ ,~~!~~ LigU ID tSEP'i`H-~!'z~Y.., . SIGNED: LICENSE NUMBER: ~ ATE: ~~ •~ ~' }./88 _ - - - ~ ~ _ ! • ' ~ ! - -- - - - Perfoin~!zce DQfi~. ..~ -. - .. . secs- . =` - ~~- , - _ - ~~ ~ ~ - - _ _ tittm : - p _ ,~ - -~ 60-_ 7D: - .. _ _ - _ .U3 ~ ~ ,lid tt~ ' 7b _; 8.3 . $.S IOJ 1 b ~ ~ ~ .Ali.. -. - .:, ~ .- . ~lYl ~~ ~ dp 54__ NS - - - ; . ~0 40_ ~ Q . tb i 4- - - . - . . 23; : . d~si l1 : - - _ S~iis , a " ~ ~ BSB~- ~ ~ - ~ ~ :_ i~ ~ Vials ~CQ~tis~c#iQ~t .': - ~ ~~ - ,~ ~ ~ .: - . - ~~: _ . . - - - -_ _ ~~ s~eet = - ~ ,~ s: ~ ~ n aa~ i~eir - ~. ~ - °°~ ~ sdi ~ ~`~ - _ _ - _ - = ~ _~ ,,.~ - - -- - ®19981 -_:: -- 0 ~~ ~~o~a~c° -~~~~0~°`- _ _ ___~ ~~~~ ~~~ ~~.~.~~~ Maintenance and Contingency Plan for a Mound System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Dose Chamber is to be pumped at the same time as the septic tank. 3. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 4. Once every 3 years the mound is to be inspected via the inspections pipes in the at- grade. The laterals are to be inspected via the cleanouts. 5.Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 6. Pump and electrical components are to be checked at the time of the pumping. 7. Owner agrees to leave the area 15' below mound undisturbed. 8. The owner agrees to save this plan. 9. Trees, shrubs, and other similiar vegitation are not be planted on system. The system is not be driven over. 10. Effluent Quality is not to excede the requirements found in Comm. 83 Contingency Plan 1. Pump alarm goes off, call pumper and pump out dose chamber and septic tank if needed, then bypass pump float and try pump with out float. If this works, float is bad, replace float. If pump still does not work, check power at the pump with a electrical device such as a hair dryer. If no power, check breaker inside house and call a electrician. If there is power, then pump is bad and needs to be replaced by a plumber. 2. If mound fails, determine cause of failure, test another area or remove pipe and sewer rock, retill soil, install new mound system. 3. Replace any other failing components as needed. Important Phone Numbers Plumber: Shaun Bird 715-246-4516 Pumper: Tom Mondor 715-246-5148 St. Croix County Zoning 715-386-4680 Shaun Bird #226900 7/25/02 r ,~ Page ~ or ' POWTS OWNER'S MANUAL & MANAGEMENT P[AN ~..~x.. cou`aFtCAT10NS E pdFOftMAT10N rtt~ a B[itt~ ~. ~ PaRai~~ ~ 3 ' a NA ~ eedraoms 'umber ~ C~ Urns d flwv (average) ~ ~~~x1.5) ... . Apps Rate / d Montl><y average' uerd Qu~ht Fats Ofl ~ Grease (fOG) S30 mg1L gipchetttk~l tJxyge~ Decriattd tBOO~ Totat S Solids i?~~ ~ m9n- s150 NA Monfhy e« ~ Oxygen Demand (t30D~ 530 m9n- Total Suspe~ Soflds (TSS) 530 mglL Fecat Co~Ortn [4 mean) s10' cftd100rn1 ~ Efit>ect ~ She $ inch diameter ~ SGHEDUt.E Service C-vent inspect oortd'itton of tanks) p~yp alt oonterds of tanks) trtspt~ct dtspetsai oeflis) q~, ~tuent>~ lr> ~~ pip cartrots ~ aNarm arrd pr~sur+e test Septic Tank Capa~Y b 0 Cpl al a NA" Septic Tank Manula~urer NA F'~ Meulufacturer O NA EfAttertt Fflbec Mods .~ O NA pump Tank Chi ~ a ~ NA pump Tank Manufacturer NA Pump M~ ~. . ~ S t1 NA Ung ' ~ S ~ ~ter a Peat F ^ Meatar>icai a w~a D Other. s ~ O In-ground (9rav~Y) p ground ipnessurized) ~ D At-grade ~' j~~ ~ n r..;.._r...a 0 Other u v+ ... Vatuas ~YPtcat tot dornes6c (non-~+~ vvas~vaosr and septic raric eteuet~t •• Yatues tyP~ tot ptetn~atied wasoewater- Service Frequency At least once every ~ ^ ~t~J°"~`°Ks) (Maximum 3 yrs-) ~~ ~~~ sludge and scum equals one-thad (Y~ of tank volume At Mast once every 3 ^ months7dlteaKs) (tiAa~dmum 3 yrs.) At least ortoe every l G months nsl At Mast once suety ,~ rrronths] i~s) O NA At least onoe every ~G months (s) DNA at least once every D months D year(s) O t~lA At least once every D months O year(s) O NA ~aiNrENaN~ ~~dT.w~ ~ shaa be mace air powrs~ir>spe~tor: Powys M~ta-~r: sep~e Master PNtrriber; Master Plumber Restricted of the tank(s) ~ idly ~y tt9 or broken Sew Tank ~ must inchrde avohrcrte of oombiiied sludge a~ saim and to c~tedc for anY bark up i>erdwar'e. identltY any crad~ or Males. merit ~ oe~s) stiaN be visuaflfl t° ~c ~ went levels a, P of a a, the ground surface- of effluent on the ground ~~• The pOt1dd19 °f etftuent on the M tlm ~ t and M dtedc for arty P ~ ~ of the bcal reguiat~l authority. ate a fang ~~ and ~u~ ~ ground surface maS/ and scum in ~Y tank ~M one-thad (K) or more ~ the tank vdume. When the combined aocu remo`-~ by a e Serv~t9 pP~or and dtsPos~ ~ to aa~rdance ~ ch. NR entk+e contEUtts of the tar~c . t73~ W Administrative Code. ~ . pretreatrFrrtent oorrtportetrts. and arty The 9 ~ effluent t1i tens, mechank~l or pressurized POWTS oomph by a certified pOWTS Maintainer- other ~tenanoe or monitodn9 at intervals of t2 months or less shag be p~fomted _ ~~ event. A setvige r+ePort shag be ptovtded to the krcal regulatory authority v ~ 0 days of completion of arty STARTUP ANO OPERATION s ~ ~ presestce of pain~g prodc~s or other For aew ~. p~ to use of the POWTS cht~ic treahtent tanks) s if concentrations are chernicats (hat may imPe'de the treatment P andior damage the d ~ )- to use. detected have fhe contents of the tank(s) removed by a septage servidrtg !~ _ Page ~{ Systen, Stan up Shall riot occur when svp~conditions are fronert at the infdhative sutface_ ~_ ~9 power outages pump tanks may Bt abov+a nom>at t~gfrwater Ievets_ when power is restored the eooess Mra~ewatec wip be disdiaraged h the d Dap(s) ~ one ~ dose, ovetioada~g the cep f S~ a~td maY r+esu# in the or srirhaoe discharge of etl~nt To avoid this sif,~tion have the of the purrs fork removed' by a assist hfi mater opeta~g the Pure~conbrails restore normal leNe[s within the pump ta<dc. °r PONVi ~ Mainta~r ~ Do notdrive spark vehicles-over tardcs and dispersal Daps. Oo not drive a park over, or atlrenr~se drsturb or compact, the area wpt~r 15 fleet doom skroe of any motatd a at~rade sop absorption area Reduction ot=~ of the t~o9owtrtg from the wastewater stream may hrprove the perfiortrlanoe and prolong the 6fe of the POyVTS: ~ ~ vYipesr-ce bugs: oondams: Dolton swabsr deed dental !loser ~ f~ trotuida~on dra6t (sump pumpj watery brut and vaegetable peepr~gs: gasaliner grr herbiddes; meat soaps; medicationsr oil P~9 P PdAB: smrt~- naplafns; : "and water softener brine. At3ANDON~MENT When the POWTS tells andlor Ts perrlrarretrdy.takerr out of service the f+opowing steps strap t~ taken to henna that the system h properly and safety abatrdoned h cotoe wplr ch. Comm 83.33. IArrsoonsilt Admhisbrative Code: • Ap p~hg to tairks anti pts shag be disoorrneded arM the abandoned pie apenMgs sealed. • The contents of ap tanks and pts strap be tertrov~ed and properly domed of by a Sepfage Servichg Operator, • After pumpMg, ap tanks and pps shalt be e~acavated and reproved or ttretr covers removed wrd itre void space tSed wth sop. graMei rx anod>er inert solid matertal. CONTINGENCY PLAN if the POWTS taps and caturot be repaired the folb+Ning measures have geen, or must be taken, to provide a code comphrrt re~aoement system: ^ A suitable n~~rnent'area has been evaluated and maybe uCbzed for the focatiiar ~ a replaoernent sop absorption • The replacement area should be pr'oteded from drsturbanoe and carry and stroukt not be infringed upon by required setbacks from existing eyed proposed stnrcture, bt ~ and welts. Failure to protect the replaoernerrt area wilt result ~ the need for a new sot and ste =evaluation to establish a sutable replacerrrent area. Replacement systems must oanpiy with the roles in effect at that time. ^ A suitable replacement area is not avapab~ due to setback andlor sop Gmtlations. t3arring advances in POWTS echrtotogy a trokierg tonic maybe hStd~d as a last resort >o r+epiaoe the fatted P01fYTS. ~~ ste Ines not been evahated b identify a suitable replacement area. Upon (allure of the POYVTS a sop and srte evaluation must be pelfomred to k>cate a suitable n~taoernent area if no rrra<rt area is available a tank may be hshaped as a Last resort to repNaae the Bled POWTS. and at-grime soti abon systems maybe n:oor~s6uded in place fopoMrirrg resrrovai of the t>iomat at the infiltrative surface. Ret~trstEUC~iorrs of such systems must comply with the rules h effect at that time. <•cWARNiNG» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANOVOR INSUFFICIENT OXYGEN. DO NOT ENTER A SEpTiC. PUpI[P OR OTHER TREATMENT TANK UNDER ANY C~CUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAYBE DIFFICULT OR IMPOSSIBLE AoomoNAL coMMExrs pnwTS MSTAt_t~2 Phone S- Z -- caarer_F CFRVrt`~Nt~ ARERATOR (PUMPEltI Name l~ /'-'~ ~d~ Phone ,~-~~ ~` l~virrs mlatNratNER Nance Qu..-- l3! .- Phone ~ 1i '' .) r nr_er arrt ri sTARY dtrTH(IRiTY Agency , Phone ~/J--,_,- 8 ..- This doaanant was draRed hY tl~e stalls of ~o green Lake. Maiqueae and Waushara Camp/ ~D and S~n~atlon agaldes. This dodm~eM meek tla sniff ~ of ch. Cenun 831I1X~? and 83.54(1), (~ ~ (3), Wisconsin admM~ffiva Go~ie. Use cl tlds doctrmet~t does not guarantee tl~e Pe~fonnance of the POWTS. (SAW (2/p1) ;t Wisconsin Departrnent of Commerce Division of Safety and But'Idings SOIL EVALUATION REPORT 0 Page of m awuaanve vrtai a,arnm aa, was. ream. a.o~e rlete site lan on aper not less than 8112 x 11 inches in size Plan must Attach oorrr ~ty C t~ - - C p E p . inckide. but rat limited to: vertical and horizontal refererx:e po'art (BM). direction and Parcel I.D. perr~rtt slope, scale or dimensions, north arrow, and bcation and distance to nearest road. Please print all information. R ~' Date rovide ma 04 (1) (m)) nN krforrrration ou d for seoorrd P be Pri 15 l ~ '~u y y p . erso use ary purposes ( aw. t. . vacy Property Owner Property location G r _ Govt. lot '/j 1/4 /4 S' T N R S E( ) W Property Owner's Mailing ress Lot # Bloctc ~ S~ubd. N~ am ~e or / / ~~ / / / r City State Zp Code Phone Number ^ City ^ village own Ngarest R Construction Use;,I~Residentiai / Number of bedrooms 3 Code derived design flow rate ^ Replacement ^ Public or ` Describe: ._-- Parent material T '~~~ Flood Plain elevationrf applicable _ rations: 5 y ~- is l $ / ~= ~~~ 2 5 2002 ST. CROIX COUNTY ZONING OFFICE ~__ R I ~~ 8orhg ik ~ ~~ '~ Pit Ground surface elev. ft. Oepth to Cwniting factor ~ ~. Sot aalion Rate t`i0rfaon Oepth DaMrvlatt Redooc Desaiption Texture Structure Car~sistence Boundary Roots GP OAF in. Munsefl flu. Sz Cont. Color Gr. Sz Sh. 'E~1 'E~ ~ -"" S ~' T w ~ ~ ~~ S !n /' / ~v / [7~- ~ / i I o ~d b 3 ~ ~ ~rn ~ N/IQ 3 ~9 ~ ~~ ~~ Pit Ground surface ele ft. Depth to fanning factor „'~. Soil ication Rate Horiaon Depth Dominant Redox Descxiption Texture Stnrcture Consistence Boundary Roots GP D/f~ in. Munset (]u. Sz CoM. Color Cx. Sz Sh. •Eff#1 'Eff#2 I o - r3/ ~---- S L' ,T ,~- ~ S' ~ ~ _--- s/ - ~ ~ 3 D C'z ~ -~.r a/i • Effluent 1F1 = BOD > 30 < 220 rtxyL and TSS >30 < 15l) mglL ' trrarerx sc = ow ~ x~ ~nyr~ w ni ~ a~ - ,,., „y,.. CST ( Prirrt, ~~ 6l~ c.~'/t-~uu~~n-/ q ,cite Evaluation Conducted Telephone Number /. +~ Parcel 10 # Page of 3 # ~^( JCI, Pit Ground surface elev. S t ft Depth m Nmitin8 factor ~ in. soN Rye Horizon Depth Dominant Cal Redox Desa~tion Texture Structure Cansistence Boundary Roots GP Dlff in. MunseN Qu. Sz. CoM. Color Gr. Sz. Sh. 'EfT#1 'Etf#2 1 D- ~ ~3c 1----- Cs ~ .~ 3 X6/3 C !/ - - ~ ~r~ , a ^ Pit Ground surface elev. ft. Depth to feniting factor in. ~ ~~ Rate ~ ° ~~ Horizon Depth OominaM Redox Descripton Texture Structure Consistence Boundary Roots GP D/It° in. MunseN Qu. Sz. t:ont. Color Gr. Sz. Sh. 'Eff#1 'Etf#2 ~~ # ^ Boring ^ Pit Ground surface elev. ft. Depth to Nmitin9 factor ai. SoN icetion Rate Horizon Depth Dominant Redox Description. Texture Structure Consistence Boundary Roots GP D/tF ~. MunseN Qu. Sz. Corrt. Color Gr. Sz Sh. - 'Eff#1 'Etf#2 • Effluent #1 = BODS > 30 < 220 rtxl/L and TSS >30 < 150 mglL ' Effluent #2 = BOD3 < 30 my/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. sswaw (R.dao~ ar•.se ar•ar ~ a-"or s• runseo.s ~ ~ ~ N ~ _ ~s n ~ ~ - ~ ~ O ~ e ~ ~ N W a '1 O t t ~ ~ n ~ 1 ,,\~_ 1~i~ O O m I m Q n ~ ~ _ 7N ~ ~ 1 $ u ~ ~ ~ ~' 5 ~ ~ m~ I N ~~ 1 Irt' N5-~O I I 11 n 11 II ~ I! ~ ~ ~ II i ~ ~' II ~ I t ~ ~'• II II ~ v II O U ~ II II II In 6 $• ~3 S -1~ m~$~ L V N N 1L 3 al,;e~ Vaault W 6~ 6+ N N a 0 8 b = • ~ 0 O ~ - ~ ~ • s • ~ II n II ~~ ~ ~ 1 _ '1'~ r I ~[ U z I L II 11 ~ ~ ~ ~ ~ I - 1 1 I 11 _ ~ ~ ~~ i i O5£ s ii a di I 1 L II 0 ~' 1 f ~ m 11 ~ It N ~ 6~ ~ 6 a ~~ ~ a ~ It ~ Q II L ~ II ~ 11 :n ~ ~ <V m _ V L . ~ R 3 \ ~ u n E u. f` ~b~ r--------------~ r-----------~-~ ----------- r-- ~ r I 9o.eo I 1 g.a.ea I s~.ea I I $ 1 1nWKee 5eee ooa I 1 Nwwed steel Door i 1 a«n+re/ sr~d Door I g 1 I I I 1 1 I 1 1 m 1 I 1 1 1 I I 1 I I 1 I I 1 I I I I 1 I I I I I I I I 1 I I 1 I I I 1 1 1 1 1 - ~I I I I ~? v= N _~_ u N ~' ~' X~ W OwnerB er Mtu'limg Address Property Address ~? ~Y Parcel Identification Number LEGAL DESCRIPTION n / '~ Location~_~1.,~ %,, Sec. ( T~N R.L=_~, Town pY Subdivision (Verification regtuaod firm Planning Department for new ss of ~~~ ~ Certified Spivey Map # ~ / ~ ~~'~ .Volume Page Warranty Deed # ~ ~ ` ~' ~ ~ .Volume ,~°~' ~ .Page ~.~ yam. ~. Spec house ^ yes no Lot lines ideutifiable~yes ^ no CE Improper use aad mambcaancxof your septic system could result m its pc+emature tailuc+e to handle wastes. Properanoe consists of g art the septic teak eveay thc{ee years or soot if needed by a liodrsod puarpen What 3~ p~ Imo ~ can affect Sue fime~'aat of the septic teak as a treatQUent stage in the waste disposal system. Tire property ownex agt+ces to submit to St. Crone Zomag ~ a eesNficatian fawn, stgned by tba owaex and by a mast~plamb~ • condibionp andl ((2 after nnaa pmr~ng C~' ~ (l~ ~ ~d~~ is is pmper operating Uaae~, Sue tmaed have read the above rogairem~ and agave to maiataia due private sewage disposal with fire ids set fiorth, herein. as set by the Depa~nt of Cwmmerce and the Department of Natural Res~outa;s, Sts-tie of Wisoa~in. statm8 that Y~ bas barn maw mast be coanpletcd and retinrnod to the S't. Crone Coaanty Zoning oiI"rx wi!9sin 30 days three expirntion date. ' ~ti_.~ ,2 ~ o~ SIt`Ir TATURE OF APPLICANT DATE O'G'VNER CERTIFICATION I (we) cetrdy that all statements on this farm are true to flue best of my (our) k4owledge. I (we) am (are) the ownr~(s) of Bra property 'bed above, by virtae of a warranty deed recorded in Register of Deeds Office. TtJRE OF APPLICANT ATE t being revoked b the Zoning Department- `~'""«`* «**+r«« pry information that is n~is-represented may r~csult in the sanitary permi y SEPTIC TANK MAIN'i'BNANCS AGRBSMI3NT AND OV~~l~18RSHIF CERTIFICATION FORM 1, *« Indnde with this application: a stamped warranty deed from 6se Register of Deeds office a copy of the certified survey maP if refetena is made in the vvarraaty deed Wisconski Department of Commerce Division of Safety and Buildings Bureau of Integrated Services in ac Attach complete site plan on paper not less than 8 1/2 x 1 include, but not limited to: vertical and horizontal referent percent slope, scale or dimensions, north arrow, and Iota SOIL c ALUATION or v~v'Itfi^s. ICHR 83' Wis. Adm. Code ~~ f .~ iaF sin sizAti} ",~ County ~~b' t (BM), direction and °; ~- ~n~nd di~t~r~fe~ib r~ear~~~road. J: ~ parcel LD. # Page ~ of .r ~.~`~~ ..QdO APPLICANT INFORMATION -Please print al "n~_n~~ ~ ; f.,,, Revi wed b Date Personal information you provide may be used for secondary purposes ri4~ Law, s. 15.04 ~'r(~,, ~; u ` = ,. erty~. ation Property Owner Prod Q r7 ~'. ---_ ` "Lot ~[,~ 1/4 ~1/4,S ~~ T3~J ,N,R ~Jr'~:W Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# ~`" ~'- v~ -' -- ~--o ~/~-~. ~ b rya City State Zip Code Phone Number Nearest R ad ^ City ^ Village Town New Construction Use: (Residential /Number of bedrooms ~_ Addition to existing building ^ Replacement ^ Public or commercial -Describe: Code derived daily flow -~ gpd Recommended design loading rate bed, gpd/ft2 ~ trench, gpd/ft2 Absorption area required """~ bed, ft2 ~ trench, ft2 Maximum design loading rate~1' _bed, gpd/fl2 ~ trench, gpolft2 Recommended infiltration surface elevation(s) ~~. ~ / ft (as referred~tyo~-site plan benchmark) Additional design/site considerations ~± / 02 ~~ O ~ SA~ Jy p // L/ /j/~fa R .S~.f'/ ~ /V/ A, Parent material ~L /¢~ /~i .~ r/~ L• Flood plain elevation, if applicable /l' ~ ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system ^ S [~ U I~ S ^ u ^ S ®u ^ S I~' u ^ S (~' u ^ S ® U Boring # I Ground elev. ~' Depth to limiting factor ~_in. SOIL DESCRIPTION REPORT Horizon Depth Dominant Color Mottles T e Structure i C t B d Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color extur Gr. Sz. Sh, ons ence s oun ary Bed ,Trench o- ~ /v - i~ ~1 Mss M t~F r~ S ~ ~ ~ G ~- ~-~ e ----' ~/~ A~d ~ R ~- s ' -~ S~ X16 ~R ~ S ~= ' ~8~1 s a c ~6k .~ ~- - ~ 3 Boring # ~- Ground elev q , ft. Depth to limiting Remarks: ~- ~,~ 6r ~ ~ :~„S- M/- ~ -~ - , factor ~in. Remarks: C(S/T~^,~~Name (Pleas~e/Print)\'` Signature ~ .//~ A` Telephb/on/e/~No. J/~y r{'~ fir/ //~ / s / /V ~"~ ~V ~ V V Address Date CST Number PROPERTY OWNER ~O/I N I~I~ ~ SOIL DESCRIPTION REPORT PARCEL I.D.# O~O "` `~~ d~ ~ /O`' ~~ ~ Boring # 3 Ground elev. n~~, Depth to limiting f ctor ~in. Boring # Ground elev. n. Depth to limiting factor in. Boring # Ground elev. ft. Depth to limiting factor in. Boring # Ground elev. tt. f. Page ~ of ~~ Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed ,Trench Remarks: Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed ,Trench Remarks: Depth to limiting factor in. Remarks: SBD-8330 (R. 07/96) -, ---- 0 v ~ M ~ I - - C ._ .. '~/~'` 1.-_I (1y(~ _-_. _ _.L~..._ I _ _ _ _ 1 _ `~ _ __-._ -- _ _-_. ~ .__._ -. i _~ r _ __ I ~ -_.~a ~ ~ _.___ ___ - I 1 1 -_ _ Q __ _ -- __._- -_ ~_._ ~ I "-" - - ., i I ~ ~ ~ ~ ___ , I ! ~ ~ ~ _ -~ -- ? - I - ~ i ~ I ' , ~ ~ --- - -- - -- --_ 1 ._I - -_ - I -- --- i __ - -- I - - 1 - ~ - ---- - --1 --_ _ - - -- -- _ - - - - --- -- i ' --f -- -- --- - I ~ ~ ~ - - - --! -- -- - -- -- - ~ - ~ - -- - - - -- - -- -- - ~ ~ ~ - _ _ Nji _ y-- , o - -- -- - ~-- -- I ~- { ~ ~ o ~ , __ - i - - - - ' ~ ,, ~ . - - -- - ~ / _ 6 d C I - - ~ - - -- i I--- --_ _-- ___ _ __ . -F- - -- . --_ 8 ~ - -jl _ ~ ---- _ - _ -- - -- - - --- ~ -- -- - __ _ - - -- -- - - -- -- ~ - 6 - - 1- -- ~-- - - - ~ - - -- - - - _ _-- ~- - ~~ -- d t-- -- - - -- - -- -- - I-- - i --- - ~ __ ~ 1 ` ~ I ~ ' ~ _-- - __~ - _ ___ ___ i ~-- ~ -_ _ __ - - __ _ . -- _ - 0 - ---1 - -- - - - - - -- i -- ~-- ~ -- j ' ~ ~ -- - - _ --- ,--- --- - _ - - -- -- _ __ _ - - __ 1-_ - - ~ - - - - -- -- - ~ ~ i _- _ -__ __ _ ~_ _- -- - _ _ ~_ - __- _ ___ _ _ __ ;_~ - , _ ,- . ~---m ~~~~lilE® 1599 Wisconsin Department of Commerce SOIL EVALUATION REPO T ,~~~ ~ 1 2002 Pag 1 of 3 Division of Safety and Buildings in arxordance with Comm 85. Wis. Adm. Code Gu m Septic Service Attach complete site plan on paper not less than 8'/: x 11 iodise in size. Plan must oun~ ZO~J I NG Q ~U 7 to z include, but not limited to: vertical and hodzonta! reference pant (BM), direction and percent slope, scale or dimemsions, oath arrow, and bcation and distance to nearest road. Parcel I.D. Pl ease print all information. Reviewed By Date Personal information you provide may be used far secondary purposes (Privacy Law, s. 15.04 (t) (m)). Property Owner Property Location Mce, John Govt. Lot n/a SW 1/4 NW1k1 g 19 T 30 N R 15 W Properly Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2904150th Ave. 1 n/a CSM Doc. #677955 Vol. 16 Pg. 4290 City State Zip Code Phone Number J City J Village t/ Town Nearest Road Glenwood City ~ WI 54013 715-265-4110 Glenwood County Road D / G New Construction l1se: 1/ Residential /Number of bedrooms 3 Code derived design flow rate 450 GPD _f Replacement _f Public or commercial -Describe: Parent material ground moraines or glacial drift Flood plain elevation, if applicable n/a General comments and recommendations: Part of 12.87 acres. BM #1= 100.0' el. BM #2= 99.7". Recommend mound system along 94.3' contour. I '~ I Boring # J 'ring l__J V' Pit Ground Surface elev. 95.8 ft. Depth to limiting factor _ 16 in. c~,a n.,~r~r;,,~ Rim Horizon Depth Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots GP D in. Munsell Uu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 •Eff#2 1 0-8 10yr3/2 none sil 2msbk mvrf as 2f,1m 0.5 0.8 2 8-16 7.5yt3/4 none gr. sil 2msbk mvfr cw 1f 0.5 0.8 3 16-22 7.5yr4/4 c2 ~ 5~~7/2 gr. sil 2msbk mfr cw - 0.5 0.8 4 22-45 7.5yr4/6 c3~s~jg 2 gr. scl 2msbk mfr - - 0.4 0.6 Z I Boring # J Boring L_l ~J/ Pit Ground Surface elev. _ 91.0 ft Depth to limiting factor 16 in. c,a e~,vrMx,.., a~+o Horizon Depth Dominant Color Redox Description Texture Strudure Consistence Boundary Roots P D/R' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 1 0-10 10yr3/2 none sit 2msbk mvrf as 2f,1 m 0.5 0.8 2 10-16 7.5yr3/4 none gr. sil 2msbk mvfr cw 1f 0.5 0.8 3 16-34 5yr4/4 c3p5 ~g/2 7 gr. sil 2msbk mfr cw - 0.5 0.8 4 34-60 7.5yr4/6 ~5 ~5/g/2 c3 gr. scl 2msbk mfr - - 0.4 0.6 • tmuent rr~ = rsV u5> 30 <_ 220 mg/L and TSS >30 <_ 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Pnnt} Srgna CST Number Tom Gustum 227618 Address Gustum Septic Service Date Evaluation Conducted Telephone Number N13450 937th St., New Aubum, WI 54757 6/19/02 71558-1344 Property Owner ~. John Parcel ID # Page 2 of 3 Boring # J Boring Pit Ground Surface elev. 94.3 ft Depth to limiting factor 1$ in. SoU Application Rate Horizon Depth in. Dominant Color MunseU Redox Dascxiption Qu. Sz. Cont. Color Texture Strudure Gr. Sz. Sh. Consistetu ee Boundary Roots z "Eff#1 "Eff#2 1 0-10 10yr3/3 none sil 2msbk mvrf as 2f,1m 0.5 0.8 2 10-18 7.5yr3/4 none sil 2msbk mvfr cw 1f 0.5 0.8 3 18-30 7.5yr4/4 c2 ~ 5~~7/2 gr, sil 2msbk mfr cw - 0.5 0.8 4 30-50 7.5 r4/6 y cap 10yr7/2 7.5 5/8 gr ~ 2msbk mfr - - 0.4 0.6 ^ Boring # J Borng Pit Ground Surface elev. ft. Depth to liming factor in. Soil Appication Rate Horizon Depth in. Dominant Color Munsell Redox Desaiption r]u. Sz. Cont. Cobr Texture Shudure Gr. Sz. Sh. Consistence Boundary Roots *Eff#1 "Eff#2 ^ Boring # J Boring J Pit Ground Surface elev. ft Depth to limiting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Cobr Texture Strudure Gr. Sz. Sh. Consistence Boundary Roots *Eff#1 "Eff#2 * Effluent #1 = BGDS> 30 < 220 mglL and TSS >30 < 150 mg/L " Effluent #2 = BODg { 30 mglL and TSS <30 mg/l. The Department of Commerce is as 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. u ~~ ri v Z i ~ ~ ~ ~ F a, M a ~ ~ q- ~~U\ E ~y use sso~ vu~ae _ 1~ ~ ~ .~ ~ ~~ ~~ ~ ~ N m ~ ~~ ~~ 1-,~,~ ,8~ss a ~ _ -~----------- N10~U0~ ~E~~ ~ ~-- b ~~ ~ a ~ i ~ ~ ~ ~ ,t ~~ O ~~ ~ WO ~ ~ ~ ~ m W p ~ "` ~ ~ g ~ u a W ~ ~ '~~' ~ w ~~ u u ~, c a ~ S ~~~ ~ r ~ n t ~ Cfl of '; 1JZSf' U9`I STATE BAR OF WISCONSIN FORM 2 - 1999 I ~ 8 4 ,2 7 7 KATHLEEN H WALSH WARRANTY DEED ` Document Number . REGISTER OF DEEDS ST. CROI% CO., WI This Deed, made between John R. Moe, a single person RECEIVED FOR RECORD 07-16-2002 9:30 AM WANRANTI' DEED Grantor, and Gregory H. Boehmer, EREIIGT i REC FEE: 11.00 TRANS FEE: 108.00 COPY FEE: CERT COPY FEE: Grantee. Grantor, for a valuable consideration, conveys to Grantee the PAGES : 1 following described real estate in St. Croix County, State of Wisconsin (ifmore space is needed, please attach addendum): Recording Area Lot 1 of Certified Survey Map recorded in Volume 16 on aP gee 429,0 as Name and Retum Add~'N~ '~~. T~ p~ p~M1ER GROUP ANC ocumen No. 779 5 being a part of the SoutTQuarter of the . , ~ ~~ STREET SOUTH orthwest Quarter (S '/. ofNW %.), Section 19, Township 30 North, Range 15 West, Town of Glenwood. HV~$~a ~ ~~g /1 ~"' -l~~a-9o-bao mber (PIN) Parcel Identification Nu 3 7 Q ~~ w L This IS h07 homestead property. (is not) ~ Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. Dated this f ~ ~~L ~ day of July , 2002 ~, Y~Jfs'~-_ + + hn R Moe AUTHENTICATION Signature(s) authenticated [his day of ~py'.`4~ t~Y -~ n v. REVERS TITLE: MEMBER STATE BAR OF W[SCQNSiN (If not, `- authorized by § 706.06, Wis. Stets.) ,1-y~F WIS < THIS INSTRUMENT WAS DRr~'~~`€j~~g,~ Attorney Kristine Ogland Hudson, WI54016 (Signatures may be authenticated or acknowledged. Both are not necessary.) • Names of persons signing in any capacity must be typed or printed below that ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. ~~f ~ ~ County ) Personally came before me this L~ day of Jaly , 2002 the above named John R. Moe, a single person to me kn n to be arson(s) who executed the foregoing instru and edged the same. l r r + _ F 1 /1~ Notary Public, State of Wisconsin M Commission is petTrtanent. (If not, state expiration date: WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2. 1999 Information Profesaiorok Company, Fond W lac, lM eoo~ss-zo2~ ,~ k • Tl' ~.. •,,ti g. i;,;~~ 6 7'7ySS - V%IL 76 PAGE 4290 • •• KATHLEEN H. WALSH " • „Y,tO~,e`~ REGISTER OF DEEDS ST, CROIX CO. , WI CERTIFIED S U~•~R V• E Y MAP RECEIVED FUR RECDIiIi Located in part of the Froctlonal Southwest Quarter of the Northwest quarter of 05-03-2002 8:00 AM Section 19, Township 30 North, Range 15 West, Town of Glenwood, St. Croix County, CERTIFIED SURVEY MAF Wisconsin. REC FEE• 13.00 I FrcNn• COFY FEE: ~~~~~NAR7Hl4£5T CGt4NER ~ Section Corner Monumd~AGE5: 2 ~~ ; N SECnCN 19-30-15 of Record (FCUND ALUM/NUM • Set 1" x 18" Iron Pipe weighing i ~ N COUNTY MQNUA/ENTJ 1.13 pounds per linear foot r ro ~ I '- • • • • • • • • - -Building Setback Line (100' from Right of Way) ~Ij Prepared for and at the request of: 3 ~~; I John Mos iv I 2904 150th Avenue Glenwood City, WI 54013 ~~~ N I SW 4L/pF 7}/E HEy ~;CnGYVAL Drafted by. Ty R. Dodge ~ I T / UNPLATTED LANDS 16• ' S0' S89'36'41 "E 966.40' 11 I ~ t. o E snvc ~ X~` ~ - ~ - - .. _ 45, 00' ~4i I MAY BE POSSESSED BY OTHERS. I~ I CONTACT AN ATTORNEY AND ADJOINING IAND OWN I ~ I REGARDING RIGHTS I THIS REA. 12 I C9~I~ a to LOT 1 VED io ° ° 5T. CROIX COUNTY ° ~, ~ I ~ I ~ TOTAL AREA• Planninn To"h~ ~".+ n,.i,. r"".". it 560,511 S0. FT. 'O t2.87 ACRES MA Q 2~~2 ~~ ~~ AREA EXC. R-O-W: zl I ~I I 534,408 SQ. FT. <I , ~ i I ~ ~ 12.27 ACRES If not recur wi~~ ~ Su Days u! w~ p i ~n ~ I I O I ~ approval data royal shall be of ~ I ~i g ~ to I `° nnu an~i „nW r ~ °I z~ n 3j1; ~ S89'36'41'E 966.40' ~ °j i ~ ~ w ~~ I ~ 921 40' o ~ ~ =i'ro 45.00' ~ ~ f ~IIN 2 I W 3 440111 O 21~r- 4' ~ ~ ~ FI ~iIZ ~ I N LOT 2 r a ~ ~r i I z TOTAL AREA: rQ ~ j I d +~^ 697,355 SQ. F7. ZI ~ ~ I of 16.00 ACRES it ,°n' ~'n AREA EXC. R-O-W: 670,805 Sq. FT. ~j~ I I> 15.40 ACRES N I 45'~ ~ ~ n I3 ~~ I 45.01'~~~ 100.02 i I Iw ~ .55.01' EAST 1/4 COIRNER ~ • w ~ SECTON 19-30-75 I ~: h I ~ ~ (FOUND ALUM/NUM ~\ N ° ° COUNTY MONUMENT) \ ITIO I^ NO \~ ~ Z' ~ I/ 1 ~ V7 ~~~tDO.02' z ' EASr-w£sT r 1 uNE N89'ST49"W 4065.92' 10 .. -. I N89'S7'49"W 886.48' ~I I ~ - ---N89'S7'49"W---SD32.42'--- ___ WEST 7/s CORNER UNPLATTED LANDS OF OWNER ------------------- SECTION 19-30-15 (FOUND AL!/M/NUM COUNTY MOWUMENT) NOTE: The parcels shown on this mop are subject to State, County and JOB ;,~ W1057SU68 Township laws, rules and regulations (i. e. wetlands, min(mum lot size, access Prepared by. to parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office and the appropriate Town Board for advice. JEO Consu/tingGroup, lna 200 o zoo Phone No. (715) 246-4319 GRAPHIC SCALE NO TH Fax No. (715) 246-3830 SCALE IN FEET: 1 inch = 200 feet P.O. Box 325 BEARINGS ARE REFERENCED TO THE WEST LINE OF THE New Richmond, WI 54017 NW 1/4 OF SECTION 19, TOWNSHIP 30 N., RANGE 15 W. Sheet 1 of 2 WHICH IS ASSUMED 70 BEAR NOt'12'56"E. Vo1.16 Page 4290