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016-1047-30-025
r 0 1 Q 0 N Q ', � d C e °' c 3 r° 0 m v • ID m m S) d m rn c\ rn Q 3 H m? c o a m v oo °_ N v C Z Z O. O N C m -� 07 3 O O (D H. c\7 A O fD = 6 p O N D) Q of V �• ° O ° O C. > > N N ° ( f0 n O w w0 m O (O O N p ' ° < N e R° l� > > 7 N CD C H N L N 7 O Vt N .+ C O C S?o R !Y ID 0 m y (n Q N A o. ° n c\ rn CD ua y a Ut A C co A C Q °° zt W 0 0 CD N N 3 O ' p Cd N (Np CL 0 w O O C7 O co co �1 y CD 0 0 0 `` y 0 c rn rn o a !I 3 r cr Q. —° O O O O a O O O° �• go D * * * a I � � a ;I a a 3 N N N o m cn 0 fR w W O' - 0 G _C O W cr 'G G O cD CD O N •��• N O. Df 'y0 3 y n I •' _ 3 _ d N n D D o w l D D o cn a O Er CL N • A O N C C. N (D O m m m - 1 CO) CD 7 U) W N G a N Z 0 3 9. cn O r: ! 0 g CD �! CD A 0 0_ O n _ N CD CD O C N 0 d c N N Q N 0 CL CL m m _. m G T� 0 a, (D N 1 m_ c zo v c �� z CL a) z a 3 v:E o o 3 o a) a) � � o m N M (D C(A N '• (D _ N 7 Q. CL CD m a 3 ° 7 N =r C N. 0 O O CO 0 M (a CC 1 - 4 O• S cr CD 0. `G ( D C 0 7 O N CD O {p O D1 N • C Q cD (Oj cn ? 0 o c coo o ao 3 o 0 0 oe CD m' o �0 0 0 0 -L, CD o y a 02/22/2004 21:51 17158331381 GOTTFRIED ENV PAGE 01 Wisconsin Department ofComtnerce SOIL AND SITE EVALUATION Page Of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on papa not less than 8 %: x I I inches in size. Plan must include, but County St. Croix not limited to: vertical and horizontal reference point (BM), direction and percept slope, scale or dimensions, north arrow, and location and distance to the nearest read. Parcel ID # APPLICANT INFORMATION - Please print all information Reviewed By. Date. Nruma) i4omiarioo you provide may be uwe4 ror meondrry purpopes (Privacy IAw, S. 15.04(1 xm)). Property owner: Property location Kurt and Elizabeth Christensen Gov't lot: SR 1/4 SE 1/4 S33 T30N, R16 it (or) Properly owner's mailing Address: L'91 N Block N Subd. Nwnt or CSMN 877 Benoy Road 2&3 NA NA City / State / Zip Code Phone number: city Village Nearest Road Hudson / Wiscozlsi0 /54016 715 - 386 -6340 Emerald 240 Street © New Construction Use G1 Residential/Number of bedrooms Unknown Addition to existing building: NA 13 Replacement ❑ Public or commercial - describe Code Design flow Rate: Unknown - must be appropriate size for the contour and soil restrictions Parent Material: Glacial Till - ground moraine General Comments and Recommendations: Soils ere somewhat poorly glossoborelfs underlain by clay loam. Redox features are the result of perching above the dense clay loam layer. A lone narrow mound SAS is recommended for this site with 2.SD foot of sand till. ON -SATE REQUESTED DUE TO THE PRESENCE OF )REDOX IFEATURRS AT SHALLOW DEPTH. SOIL DESCRIPTION REPORT Goring # H.xizon Depth Dominant Rcdox Description 'roxture Structure Consistence Boundary Roots Soil Application Rate in. Munsell Color Qu. Sz. Cent. Color Gr. Sz. Sh. GPn /FI' Pit I ENS 1 Etls2 Ap 0-7 10YR 2/2 NA sil 2msbk mfr gw 2f 0.5 0.8 Ground Bt 7- 1 1 10YR 3/4 f1d 7.5YR 5/8 sil w/ cl 2msbk mtr aw If 0.5 0.8 E'lev (11.) 96.74 CI 11 -16 IOYR 5/2 m2p 7.5YR 5/8 sicl Ifsbk vmfi as NA 0.2 0.3 Depth to C2 16 -I8 5YR 4/4 m3p 7.5YR 518 cl massive vmfi NA NA NA NA limiting factor- Ilt. 7 Remarks: C2 - I OYR 5/2 + 5YR 414; C I - dense Boring Ap 0-7 l OYR 2/2 NA sil 2msbk mfr gw 2f 0.5 0,8 pit^ Bt 7- 13 IOYR 3/4 fld 7,5YR 5/8 sil w/ cl 2msbk mfr ON IT 0.5 0.8 Cl 13 -17 IOYR 512 m2p 7.5YR 518 Sid Ifsbk vmfi as NA 0,2 0.3 Ground I:.lev (H,) C2 17 -22 5YR 4/4 m3p 7.5YR 518 cl massive vmfi NA NA NA NA 95.59 Depth to limiting factor- in. 7 C 1, C2 very dense CC')' Namc: Eli M. Gottfried, Gontiied Privironmental Signature: / Mgr— Tel. No. 715- 833 -1400 Ave. , 54701 Date: 20 Oct 04 CST # 221981 Address: 124 -I/2 Graham A •Eau Claire, WI :Plisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 506185 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Branham, Steven I Glenwood, Town of 016 - 1047 -30 -025 CST BM Elev: Insp. BM Elev: BM Description. Section/Town /Range /Map No: 1N� 1 c 21.30.15.343A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. , 3. zz. /03. crb Septic ✓ I _ j_ , X000 Benchmark $Z 1el $� �0� lw/C�Kf 1 • t r ©o e I g G✓ �`) " ��L � ` o At Aeration �� Bldg. Se er � �� ✓ Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom aQ Dosing ( l �l� Header /Man. 5-9Z 9 7. 3 � 6 l Aeration S' Dist. Pipe s g q 7 2 Holding Bot. System l 1 `J Final Grade PUMP /SIPHON INFORMATION 7 S , 3 r9 Manufacturer � ' (t Demand lover 9 `/ ?T S T t 00CAS -` GPM of Model Number ( 9 8 3 , •� 1 S '7 TDH Lift , 11 Friction Lc)s System ead TDH Ft �, Forcemain Lent Dia. Dist. to Well Z SOIL ABSORPTION SYSTEM BED /TRENCH Width / Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTr=M TO `7 P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Typ , f Systei7c / ' / / //, UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold IDistribution \, x Hole Size x Hole Spacing to Vent to Air Intake / Z Pipe(s) 4S \ �, 3 v. 1 1-ength Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over / Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center / _ �( Bed /Trench Edges Topsoil i Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 23 / 6-7 Inspection #2: l / Location: 2944 County H y G Glenwood City, WI 54013 (SW 1/4 SW 1/4 21 T30N R15W) 40 acres Lot Parcel No: 21.30.15.343A �P ca�� Plow 1.) Alt BM Description 2.) Bldg sewer length =.� <�Q_ - amount of cover Plan revision Required? Yes to L TZ � Use other side for additional information. J to Date Insepct s Sig Ce rt. No. SBD -6710 (R.3/97) commerce.wi.gov Safety and Buildings Division County � 201 W. Washington Ave., P.O. Box 7162 s ?, ejto4 WI 5 3 707 -7 1 62 sanity Permit Number (to be filled in by Co.) '~ I t i s consin Madison, ry epartmertt of Commerce Sanitary Permit Application State Transaction Number /,3 9332$ In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appr 'ate gove I unit is required prior to obtaining a sanitary permit. Note: Application forms for state -own OWT - ect Address (if different thatimailing address) submitted to the Department of Commerce. Personal information you provide may be used for ondary `Jatw2 G OJw }4tni�y p urposes in accordance with the Privacy Law, s. 15.04 1 (m ), Stats. o 1. Application Information — Please Print All tpkrmation RECRI Property Owner's Name / arcel # srEVEhr 3,eot J ^ 1 /e - / - -30 - o25 Property Owner's Mailing Address roperty Location , 34 2 9'¢ t rvAjT T16 ff tw! P9 ovt. Lot r'T � y Y City, State Zip Code Phone Number w �, sw 'A, Section Z t /� 1 5 4-03 circle one GLE/( t�,a ccJ T R�Eoio H. Type of Building (check all that apply) Lot # I.or2. Family _ Dwelling - Numberof Bedrooms I — S rvtston f� Block# D � +GrG,�j r ❑ Public/Commercial - Describe Use ❑ City o ±v• CSM- Number ❑ Village of / ❑ State Owned - Describe Us � OTown of S A- 9a 1 ao [H. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System Replacement System g p Y ❑ Treatment/Holdin Tank Replacement Only Other Modification to Existing System (explain) MOU06 0AXY RGM AG t 9& B. ❑ Permit Renewal ❑ Permit Revision C1 Change of Plumber List Previous Permit Numbe nd Date !s d ❑ Permit Transfer to New Before Expiration Owner IV. Type of POWTS S stem /Com onent/Device: Check all that a 1 ❑ Non - Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade X Mound > 24 in. of suitable soil ❑ Mound 124 in. of suitable soil 5 ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) A V. Dis ersaVrreatment Area Information: ' Design Flow (gpd) Design Soil Application ga te(gpdsO Dispersal Area Required (s Dispersal Area Proposed f) System Elevation 45c .� . ✓ 2 2 S �,9 22 S � 1 4,. 70 VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units a !? � j New Tanks Existing Tanks 0 Septic or Holding Tank / b t / Dosing Chamber /, VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) I ber's Sign ure MP /MPRS Number Business Phone Number n,tcj� A 2� ?`185 ?rs G�3 -25ao Plumber's Address (Street, City, State, Zip Code) G- 155 Sfp•tE P 6.4 0etsC.Es✓ttte 7 VIII,County /De artment Use Onl Approved ❑Dis pprov Permit Fee Date Is ued Issuing t Signature $ g oo . Ob �j) a7 C] O rven Reason enial IX. Conditions of Approval/Reasons for Disapproval J v ��� SYSTEM OWNER:- 3 Co ^ d : E r 1. Septic tank, effluent filter and .� dispersal ceft must all be servkoe/maifthas! �-- ' `/` e ° ` �' as per management plan provided by plumber. + 2. All setback requirements must be maintained as per he system and submit to the County only on paper not less than 8 In x I 1 inches in size SBD -6398 (R. 01/07) Valid thru 01/09 a . 3 7;&W3 Al c ar e s R�� r— 20 f i i j . v _ a 2 :93.80� 0 rl l5 100.0' tiJ IL w � car >s°° s7' SGk Le r �. c-t q G u� • Q 3 ac�,�sc _AI Kr I���� qs•� ° I I S T�c E►J �rz���� V 8 2 :93 8c• Swv4 S�wy'1` B3 = 9 3 go" _w XA � M- (= 100 , o' h1 n I L S Crcotk �cwN -r�{ A > 5 0 0 ScA L ! \ C - t 1.4 Cz R � Y �4 Z Safety and Buildings 4 commerce.wi. OY 141 NW BARSTOW ST FL 4TH g WAUKESHA WI 53188 -3789 TDD #: (608) 264 -8777 tiepartment sco ns i n wWw•commerce.wi.gov /sb/ of Commerce www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary May 09, 2007 CUST ID No. 267985 ATTN.• POWTS Inspector MICHAEL J MYERS ZONING OFFICE NORTHLAND PLUMBING INC ST CROIX COUNTY SPIA E1556 STATE RD 64 1101 CARMICHAEL RD BOYCEVILLE WI 54725 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/09/2009 Identification Numbers Transaction ID No. 1393328 SITE• Site ID No. 724973 Steven Branham Please refer to both identification numbers, 2944 County Highway G above, in all correspondence with the agency. Town of Glenwood, 54013 St Croix County SW 1/4, SW 1/4, 521, T30N, RI 5W FOR: Description: Mound, 3 Bedroom Object Type: POWTS Component Manual Regulated Object ID No.: 1129358 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.01 101), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01 /01) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. 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.01 /01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD - 10706-P (N.01 101). 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, owner must comply with the operation, maintenance and monitoring duties as described in section VIII of the ,9o onent manual. A co u completion e E ` ='E copy of this information must be g iven to the owner upon p letion of the P roj All holding/treatment tanks are to comply with Comm. 84.25(7)(a). J/1 Maintenance information must be given to the owner of the tank explaining that penotlic— gleaning of did;filter is ' ' ns . r cleaning must be provided per Comm 84 product a r co rkh _ required. Access to the filter fo g p p p pp _ Q C( VP 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. ` MICHAEL J MYERS Page 2 5/9/2007 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. 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, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Julia Lewis - Osborne POWTS Reviewer 2, Integrated Services WiSMART!code: 7633 (262) 548 -8638, Fax: (262) 548-8614 julia.lewis@wisconsin.gov f Mound System Cover Page ppld e F ' m E8E1 Project Name: Branham -Mound Owner's Name Steven Branham Owners Address CTH G Glenwood City, WI 54013 Legal Description sty► % +, Y. Sec 21 T 30 1 N, R F1 5 W Township Glenwood County Saint Croix Subdivision Lot# Parcel l D# Table of Contents RECEIVED pg. APR 3 0 2001 1 Cover page 2 Mound Sizing Calculations SAFM & BUILDINGS 3 Pressure Distribution Layout and Dynamics 4 Dose Tank 5 Management and Contingency Plan 6 Plot Map total # of pages: 6 Designer Name: Michael J. Myers MP/License #: 267985 Date: 4/3/07 Ph. #: 715-J543-2520 r„ Signature: Mound System Design Methods Used per "Mound component Manuel For Private Onsite Wastewater Treatrnent Systems" (Version 2.0) SBD- 10691 -P (N.01101) " r per" Pressure DisttihWon component manual for Private Onsh Wastewater Trendnent Systems" (Version 2.0) SBD- 10706•P (N 01101) Spreadsheet by: 3hAdviserna t N12486 220th St, Boyor. WI 54725 Ph: 715 - 6436068 ernd: 3bs Mound System wQ.2 of 6 Mound Sizing Calculations Project Name: Branham -Mound Site Conditions • Design of Entire Fill Project Type: For 2 Family Dwel Cell depth at upslope edge (D): 12.0 in. 6 0 0 11.E 6 0 � Slope. 6 �6 XS � Cell depth at downslope edge (E): 15.6 in. # of Bedrooms: 3 Distribution cell depth (F): 9.5 in. -- Depth to limiting factor. 24 in. Cover thickness over edge (G): 6 in. Absorbtion rate of fill material: 1 gale /day Cover thickness over center (H): 12 in. Absorbtion rate of in -situ soil: 0.2 gale /day `) End slope width (In: 8.9 ft. Effluent quality Eff#i 'V I Fill length (L): 107.8 ft. Max BOD effluent value: 220 mg/I Upslope width (J): 5.9 ft. Max TSS effluent value: 150 mg/I Downslope width (Toe) (1): 20.0 ft. Fill Width (W): 30.9 ft. Design of the Distribution Cell Basal Area System Design Flow: 450.0 gal /day Basal area required: 2250 ft Distribution cell width (A): 5.00 ft Basal area available: 2250 fl? Distribution cell length (B): F 9 - 0 ft Area of Distribution Cell: 450.0 fe Observation Pipes Contour Elevation of Mound: 95.70 ft Location from end of cell (Z): 15 ft System Elevation of Mound: 96.70 ft Final Grade of Mound: 98.49 ft Mound Plan View Observation Pipes W K T B 1�K I Tilled Area/Fill Material L ' Mound Cross Section Final Grade T Observation Pipe Synthetic Fabric G Distribution Cell System Elevation 6 : , ��•o. ) d Cover Material Lateral 3. Fill Material' Tilled Area Slope �Forcemain System Contour 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 Z' above. Mound System P"o3of 8 Pressure Distribution Calculations Project Name: Branham -Mound Lateral Layout Lateral /Manifold Design Lateral elevation: 97.2 ft Lateral diameter. n ft In. Rows of Laterals: 2 Lateral spacing (S): Manifold type: veneer Lateral to cell edge: 1 ft Orifice diameter. o.12s In. Lateral discharge rate: 9.06 gprn # of Laterals: 4 System discharge rate: 36.25 gpm Distal Pressure: 5 ft Manifold diameter. Z . In. Lateral Length: 44.5 ft Manifold length: 3 ft Orifice Spacing/Distribution Forcemain Friction Loss Orifice spacing (X): 24.84 Inches Forcemain length: 7 ft Orifices per lateral: Forcemain diameter 2 In. Avg. felOrifice: 5.11 fl? Friction loss in forcemain: 2.064 ft Lateral Side View Manifold Lateral Lateral x x x x x x x x x x L ateral engt Lateral Length Lateral Plan View Lateral Lergith Turn -up wfiaA valve or cieenout plug o 0 a o Orifices on bottom of lateral equally spaced PVC laterals and forcemain to comply with specifications per Comm 84.30(2ne) I Forcemain connection via tee or cross to manifold at any pout Clean Out Detail Observation Pipes Clearrout plug Final Grade or ball valve Water fight cap or plug Lawn Sprinkler Banc lot 4 Note. Closet Co /ar Lon Swee 90 6" Minimum pl�ece�of used b 9 P ar or two 45's L 3/8" Bar Lateral Mound System Pm* 4 or 0 Septic, Pump and Dose Tank Project: Branham -Mound Tank Information Dosage Volume _r Pump tank manufacturer. Weser Concrete Forcemain drains back to tank? OQ Yes O No Pump tank size /model: W1000/650-MR Lateral void volume: 18.8 gal Pump tank gal /inch: 17 Dosage to absorbtion Cell: 90.0 gal Actual Pump Tank Volume: 646 ga l Forcemain volume: 13.1 gal Tank bottom elevation (inside): F 87 ft Total dosage: 103.1 gal Septic tank size/model: I W1000/650-MR � Ai 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) 9.20 ft Note: Access opening of sufficient size to be provided to allow 06 ft removal of War. Opening to terminate at or above grade. Friction loss in forcemain: 2, ^.M4� Pressure loss from filter. o$ Total dynamic head (TDH): 17.76 ft Pump Tank Diagram Dose Tank Levels Watertight Locking Cover In. Gal 4 Inch With Warning Label ins ad A Reserve 17.9 304.9 Minimum Grade B Pump off to Alarm 2.0 34.0 Aremalez C Total Dosage 6.1 103.1 Owlet Locafion ElecL per Comm D Effluent depth for pump 12.0 204.0 _J 16.25 and Total Ca 38.0 646.0 NEC 300 ��' t Weep Hole A or Anti- Siphon B Device FLOV- LITERS/F011t C 0 1000 2000 3000 D 30 10 W 73 20 F , 3 Pump must be capable of: 36.2 GPM to 2s and head pressure of 17.8 Feet 0 0 0 20 40 so so 4 Little Giant FLOV- GALLONS/MIMM 9EH PUMP PERFORMANCE CURVE MW Goa Mound System Management Plan pursuant to comet 63.s4 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 chemicallbiological "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 1S 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, t. 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. VOL 2388 MA 1.80 7 3 7 3 3 6 � STATE BAR OF WISCONSIN FORM I - 2000 WARRANTY DEED KATHLEEN H. WALSH Document Number REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Steven Todd Smith and Jody RECEIVED FOR RECORD Marie Smith husband and wife _ 08/25/2003 01:05PH Grantor, WARRANTY DEED and Steven G. Branham and Leanne E. Branham, husband EXERT # and wife as survivorship marital property REC FEE: 11.00 TRANS FEE: 968.10 Grantee. COPY FEE: Grantor, for a valuable consideration, conveys to Grantee the following CC FEE: described real estate in St. Croix County, State of PAGES: 1 Wisconsin (the "Property") (if more space is needed, please attach addendum):! The East Half of the Northeast Quarter of the Southwest Quarter (E} of NEB of SWi) and the East Half of the Southeast Quarter of the Recording Area Southwest Quarter (E} of SEJ of SWJ), all in Name and Return Address Section 21, Township 30 North, Range 15 West, Title One Premier Group, Inc. Town of Glenwood. 706 19th Street South Hudson, Wisconsin 54016 016 - 1047 -30 -000 & 016 - 1047 -10 -000 Parcel Identification Number (PIN) Together with all appurtenant rights, title and interests. This is homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Roadways, Easements, and Restrictions of Record. Dated this 11th day of August 2003 , * *Steven Todd Smith ji * *Jo Ma ie !;mi AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) ) ss. St. Croix County. ) authenticated this day of Personally came before me this 11th day of 0 9�� August 2003 the above named 0 Steven Todd Smith and r' a S mi th TITLE: MEMBER STATE BAR OF WISC EE J. * (If not, BUNE to me known to be the person s who executed authorized by §706.06, Wis. Stats.) cf' the foregoing instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED OF WIS Michael H. Foreck,R, Attorney Notary Public, State of Wisconsin Eau Claire Wisconsin My Commis ion is permanent. (If not, state expiration date: (Signatures maybe authenticated or acknowledged. Both are not necessary.) e *Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1 -2000 ttorney Michael H Forecki 1830 Brackett Ave, Eau Claire WI 54701 -4627 Phone: (715) 835 -3029 Fax: (715) 835 -4112 Kay Palm T4792858.ZFX Produced with ZipForm- by RE FormsNet, LLC 18025 Fifteen Mile Road, Clinton Township, Michigan 48035, (800) 383 -9805 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer S'(CVC-Xj ' St? jk&.StAnA,_ .. // Mailing Address S 94 - 4 — " �tr� y A G4w 4 �r Property Address 2, 1 4 4 G (Verification required from Planning Department for new construction) City /State 6L&Ji & _ aj ( Parcel Identification Number LEGAL DESCRIPTION Property Location S W `/4, Sw `` /4, Sec. V , T 3 0 N -R (S W, Town of GL&vkfe --* j Subdivision Lot # Certified Survey Map # , Volume , Page # Warranty Deed # . Volume , Page # Spec house ❑ yes Kno Lot lines identifiable yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) 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. I/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 Zoning Office within 30 days of the three year expiration date. y — e SI NATURE APPLICANT DATE OWNER CERTIFICATION are the owner(s) of statements on this form are true to the best of m our ) I (we) certify that all sta Y (our) knowledge. I (we) am ( the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. x � SIGNATURE O) APPLICANT DATE * * * * ** Any information that is mis- represented mV result in the sanitary permit being revoked by the Zoning Department. ** Include with this application: a stamped warranty dedd from the Register of Deeds office a copy of the certified stuvey map if reference is made in the warranty deed Parcel #: 016- 1047 -30 -0255 05/14/2007 03:42 PM PAGE 1 OF 1 Alt. Parcel #: 21.30.15.343A 016 - TOWN OF GLENWOOD Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - BRANHAM, STEVEN G & LEANNE E STEVEN G & LEANNE E BRANHAM 2944 CTY RD G GLENWOOD CITY WI 54013 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A -NOT AVAILABLE SEC 21 T30N R15W PT NE SW & PT SE SW E Block/Condo Bldg: 1/2 OF NE SW &E1 /2OF SE SW Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 21- 30N -15W Notes: Parcel History: Date Doc # Vol /Page Type 08/25/2003 737336 2388/180 WD 1217/318 WD 2007 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/26/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 12,000 261,000 273,000 NO AGRICULTURAL G4 27.000 2,800 0 2,800 NO UNDEVELOPED G5 1.000 100 0 100 NO AGRICULTURAL FOREST G5M 10.000 9,000 0 9,000 NO Totals for 2007: General Property 40.000 23,900 261,000 284,900 Woodland 0.000 0 0 Totals for 2006: General Property 40.000 23,900 261,000 284,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: 308 Specials: User Special Code Category Amount I Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 I f 05 RECENEO STC - 104 � AS BUILT SANITARY SYSTEM REPORT ` MAY OWNER °� ��� ADDRESS SUBDIVISION / CSM# LOT # SECTION 2 T -R W, Town of /�'eh Z"J� - oen ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM Q� 0 INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. I BENCHMARK: A coev^ ALTERNATE BM: l ei SEPTIC T / PUMP CHAMBE / HOLDING TANK INFORMATION Manufacturer: 1, -e f Liquid Capacity: Setback from: Well Aw I House L j Other Pump: Manufacturer ^ �o� ��r' Model Size Float seperation Gallons /cycle: /,36 Alarm Location Q 5 SOIL ABSORPTION SYSTEM �c9 Width: f Length !.�- 1 � — Number of trenches Distance & Direction to nearest prop. line: o ?�o Setback from: well: House 65 Other Vo ✓� /�i�� ELEVATIONS Building Sewer ST Inlet: • 7 7 ST outlet:• PC inlet PC bottom _Q Pump Off 6 Header /Man fold 6.�`f Bottom of system a Existing Grade �/ Final grade DATE OF INSTALLATION: PLUMBER ON JOB: /'t)/1 f/` �V/ . `f� 1i LICENSE NUMBER: Oe"Icd< INSPECTOR: ,/G ,97 111Z +Ahet 3/93:jt Wiscdnsm Depa Industry, PRIVATE SEWAGE SYSTEM County: "Labor and Human Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL'INFORMATION 284190 Permit Holder's Name: ❑ City []Village Town of: State Plan ID No.: SMITH, STEVEN T GLENWOOD CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: TANK INFORMATION ELEVATION DATA A9600439 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Aeration Bldg. Sewer Holding St /Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANKTO P/L WELL BLDG. Air to iri ntake ROAD Dt Inlet Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft oss H ead Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSION SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type Of CHAMBER Model Number: System: OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: GLENWOOD.21.30.15W, SE, SW, COUNTY RD G Plan revision required? ❑Yes ❑ No Use other side for additional information. I 1 11 [ I FF1 Ij SBD- 6710(R 05/91) Date Inspector's Signature Cert.No. r Safety and Buildings Division t��■Lr■■1t SANITARY PERMIT APPLICATION Bureau of Building Water s 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707 -7969 • Attach complete plans to the count co o for the paper not less Count 1 P p ( Y c Y) sy stem, on a pP y than 8 112 x 11 inches in size. - C r o • See reverse side for instructions for completing this application State Sanitary Permit Number The information you provide may be used by other government agency programs ❑ Check it revision to previous application IPrivacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION Property Owner Name /_ Property Loc tion l T /ai /a, S T (� , N, R (or . Property Owner's fling A dress Lot Number Block Number City, �e Zip Code P ne Number , Subdivision Name or CSM Number II. TYP F BUILDING: (check one) ❑ State Owned 1 !ty Nearest Road VII age vo Public 1 or 2 Famil Dwellin - No. of bedrooms Town OF u/ C III BUILDI G USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment / Condo 0 1 104 7 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station /Car Wash 5 ❑ Hotel / Motel 9 ❑ Office/ Factory 13 ❑ Other: specify IV TYPE OF PERMIT (Check only one box on line A. Check box on line B, if applicable) A) 1. ❑ New 2. 5rReplacement 3 ❑ Replacement of 4_ ❑ Reconnection of S ❑ Repair of an System ________ System____ _________TankOnly______________ Existing System ________ Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 Mound 30 E] Specify Type 41 []Holding Tank 12 E] Seepage Trench 22 In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade �,.� Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation 7 ' Feet Feet VII. TANK Capacity in gallons Total # of Prefab. Site Fiber- plastic Exper. INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass App. New Existing structed Tanks Tanks Septic Tank or Holding Tank X ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber 0 ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber' ame: (Print) , Plumber' nature: (No St am s) MP /MPRSW No.: Business Phone Number: Plumber' Address (Street, City, State, Zip Code): /�/� Aci / c wit% �/ IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sa Mary Permit Fee (Includes Groundw6fer ate ssue Issuing gent Signature (No Surcharge Fee) Approved r Given Initial e G e pp ❑ Owner Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -6398 (R. 05/94) _ DISTRIBUTION: Oliginal to Counly. One copy To: Safety & Ruildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608 - 266 -3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is -for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number.with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. i f SAFETY &c BUILDINGS DIVISION 201 E. Washington Avenue P.O. Box 7969 Madison, Wisconsin 53707 State of Wisconsin Department of Industry, Labor and Human Relations November ;; 1996 1340 Fast Green Bay Street SiIiTF 3Pn Shawano WI 541 SiRD. 1YR ^1 JR 896 68 AVE A\ r7n" art 1T Ann4 "{t•.rr;r t :Llr�l i F, 01 - AN 590 -3136% FFF ^'r -TvcD: 180.00 ST "AT11 STE 11! :n -.;rfF SF,sw,21,? ^,1kw TQwi n)F G ' G"d'vdOOD ^Qli1JTY OF ST CRGIX MOUND SYSTEM The Den 8 tIment has reviewed the above r eferenced submittal = Conditi.'onal .yr_,,roval is. hereby granted f or t he system plan submittal. All noted itr-.nc, must be corrected. The r" view and approval o f the syst is based on chapter. 146- Wisconsin Statutes. and c_:hapters ILHR. 83 and U. Wisconsin Administ.r-ative Code, an t i contingent. upon cotmoliance with any stipulations srlt_zwn o fh:e puns. This system has not been reviewed for the code re[?(!ire!iPnt SPt. fort in chanter i' HR n� :ir in than +er ° =; TL {F7 .5_Q —F1_ Wisconsin Administrative Code. -- This plan submittal approval will expire two years from the approval date, or if a sanitary permit. is obtained, plan approval will expire on tL day the initial sanitary pern exn ra=, The licensed plumber responsible for this installation �ha11 keep one set of plan wilu th.e Depart.ment.'s sta�i)p of ppr-val at the construction cite, The installer shall nr_.tify the appropriate c %Pe-t r when inspections can be made. " i to wns h ip L 1 3 A ll l bier "t?tit`; i "P itili red 1Jv 1L LN c it y , i L - ' vi ± 1 aqe, �.Jwnsrlie or coun Sr1a r l he obtained prior to installation. }tui bits shuld be directed to rile at the number listed below. Please refer to the plan number shown above, ._,,ricer "e1y - Keith Wilkinson 111 _ 1_. r ,: n nNy -ewe- r Section of Private SewaP SHUA -0828 (R. 10/84) PLOT PLAN PROJECT Steven Smith ADDRESS 6230 232nd. Ave NE Stacy Mn 55079 `- SE 1/4 SW 1 /4S 21 /T 30 N/R 15 W TOWN Glenwood COUNTY ST. CROIX Y 10/25/96 BEDROOM 3 y MFRS BYRON BIRD JR..' 318 - DATE CONVENTIONAL IN-Gii5ffl PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE l000 *Q11603, LIFT TANK SIZE DOSE TANK SIZE gbO HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 375 BED SIZE 8' X 47'* BENCHMARK V.R.P. Nail in Corner Post ASSUME ELEVATION 100' ❑ BOREHOLE (D WELL *H. R. P. Same as Benchmark t SYSTEM ELEVATION 9 6.70 E xisting 3 E) B edroom Well H ouse ST Tanks to be Properly Bedded DT LB.M. 0 B -1 ❑ C' B -2 []B-3 ❑ ONSITE SEWAGE SYSI EA 6% Slope Area Downslo Remain s T flF i ?� )USTRY, LABOR AND HUMAN DEPARTME RELATIONS DtVtStON OF SAFETY AND BUt SEE CORRESPONDENCE County Road G 8.96-31367 Designer 0 33t Date i , Non -Woven .. �� ven Fil Fabric rFbrc 4 Observation Pipe : • Perforated P Below Filter Fabric Distribution p; ASTH C -33 Sand e N n a Topsoil G r % Slope Bed 0f � -2!� Force Main Plowed' tl 2 � f Drain Rock From Pump Layer D ,� �•,Cross Section Of A Mound 'System Using .� E' — • J p15ITE SEWAGE SYS A Bed For' The Absorption Area F ' $ A Ft Ft. HUMAN �� ?10N5 BTENI I v�1'JSTF}Y, E.f�BOH AND A TY AND BUILDINGS I Ft.•�.(.O DE:p DIltISim OF SAFE ; I f. c �;� ,� Ft. , SPpNDEIdCE K. Ft... _ :; ..... 4 ., k SEE CORRE L k t . N L t .3i 3 40bservollon Pipe -� 5 'S oft e — K o A I I ._ ; r S I ------ -------------- ------- - - - - -- - .Force Main nS . — r� c - - - - -- ---= -- From Pump o I . I • • i � I D stribution • D Bed 0f / 2 2 P Drain RotK 2 Pi 4 Observation Pipe Permanent Marker ,r Pipe or Rods , 1 k Plan View Of Mound Using `A Bed For The Absorption Area t AC PUMP CHAMBER CROSS, .SECTI.ON. AND SPECIFICATIONS �s 411 . Vent Pi e P, vent ca , � owed locki 10'1 from door, weather proof manhole cover & window or fresh junction box warning label air intake 12" min grad 4." min conduit 18" min \h� 18" min % inlet o5, �� SE�iSA__ rovide , �t t' t 'seal NS II eep approved joint A �� •np lu n IA hole Xtending 3' �,�� AND N�5 1 a roved onto solid soil . B, i vr���spEj� ANO �� ALA joints xtending 3' $ 3 3S C as SPpr1� i ON Onto solid SSE Ca p D OFF ' of D . concrete b oc I°� 3" Approved Bedding Under Tank _ 0 .ci er 5Ta-T a .(Pr 6 .� Wfm SPECIFICATIONS L ,,K �( _ k a Letic and i . LL e Tanks Manufacturer': W �Q.�1� ___,.- j.N:umber of Doses - :' _per day _ Tank Size': QQc7 i Gallons Min Dose Volume: 13o gallons Alarm Manufacture's`':' — ���-2m.�p Capacities: A r inches gallons Model Number - B= i inch Switch .Type: <I es :��! gallons -a LA w•-2e C- T3 �inche's O allons g Pump Manufacturer: D'= __9,__�inches L g allons Model Number : R N.OTE: Switbh Type: �•� 6 PUMP AND ALARM ARE TO BE Pump Discharge Rat INSTALLED ON SEPARATE CIRCUITS GPM ump Off and Dzsfribution Pip Vertical Difference Between P • feet capacity + Mi imum Network •Sulply Pressure ........................'. + F.ee.t Of. For.cd Mairi X ✓; C t/10.0, ft Fr.i.c.tio gal/in n Factor; . •Total Dynamic Head = feet Internal Dimensions of Tank: Length�_Width _Liquid Depth' cJ �. S96 °31367 S i ned 2 � / . 9 xo. J �� ate D . o a�� TOTAL �■ 1 1 t 1' f. ..i .� . , mm clmmwwm� IN • ■ • ■, I ■ ■\ P ■ ■ ■ ■ ■ ■■ ■ \\ 1111 �� ■� � \ ■ ■ ■ ■ ■■ MEN \:111 I�� ■� \ \ ■ ■ ■ ■■ i ON S, W lb 9'b S. t N WAV N 0 0 0 K 0 �■ ■III \ ►! \ \� ■ ■ \'11 ■ ■■ • 170 801901001110120 ... i Page : Of Distribution Pipe Detai 1. For, A Lateral Network 4� •'i ONSITE SEWAGE SYSTEM P P 1. 0-`V E 4 TRY�;50+? AND: HUMAN RELATIONS DIlS DEPARTMENT iN VVGON OF SAFETY AN[l'BUI:LDINGS i f SEE CORRESPONDENGt i, AP PVC Distribution Pipe PVC Force Main ' P PVC Manifold Pipe X * Last Hole Should Be Next To End Cap I k ' Y PFt. u� S S Ft. I X_Inches Y Inches Signed: 1 j . dd Hole Diameter. y Inch License Nu er: 3 O ^ r Lateral Diameter �Z Inch(asj ; Date. Manifold Diameter. Inches > Force Main Diameter Inches " �r /Holes Per Pipe Y�4�q Invert Elevation Of Laterals.9Ft: r Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT e 1 of 3 LaborwW Human Relations 9 �O DitAsion of Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code COUN . Qa If S Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but Croix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or P I.D. # N dimensioned, north arrow, and location and distance to nearest road. 16 – 0 APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION R ED BY ST C ATE PROPERTY OWNER: PROPERTY LOCATION 20N1 Steven T. Smith GOVT. LOT SE 1/4 SW 1l4, �' 30 W PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR E 6230 232 nd. Ave. NE na na na 80 ac re CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE ZVOWN NEAREST ROAD Stacy, MN. 55079 (612)462 -3792 1 Glenwood I Co. Rd. #G [ .] New Construction Use [x] Residential / Number of bedrooms 3 [ ] Addition to existing building JK] Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate • 4 bed, gpd /ft - 5 trench, gpd/ft Absorption area required 375 bed, ft 375 trench, ft Maximum design loading rate • 4 bed, gpd /ft • trench, gpd/ft Recommended infiltration surface elevation(s) 96.70 ft (as referred to site plan benchmark) recommended Additional design / site considerations system el. based oncontour line of el. 95-70', 4x97'trench mound Parent material glacial drift Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for s stem ❑ S �U ®S ❑ U ❑ S EN EIS ®U El S ® U [IS ® U SOIL DESCRIPTION REPORT M Structure GPD /ft Boring Horizon Depth Dominant Color Mo ttles Texture Consistence Bo Roots g r r. Sz. Sh. in. Munsell Qu. Sz. Cont. Co lor G Bed Trench 1 0 -8 10 r3/3 none 1 2msbk mfr 2f .5 .6 2 8 -18 10yr5/4 none sil 2msbk mfr gw if .5 .6 Ground 3 18 -31 7.5yr4/4 none scl 2msbk mfr gW na .4 .5 elev. 4 31 - 7.5yr4/4 clf 7.5yr5/6 scl 2csbk mfr na na .4 : .5 9 6. l O ft. Depth to limiting factor 31" Remarks: Boring # 1 0 -12 10yr3 /3 none 1 2msbk mfr gw 2f .5 .6 ..::...........::: 2> 2 12 -22 10yr4 /4 none sil 2msbk mfr gw if .5 .6 3 22 -31 7.5yr4/4 none scl lcsbk mfr gw na .2 .3 Ground elev. 4 31 -50 7.5ry4/4 clf 7.5yr5/6 sicl M na na na np `.2 9 3.8 ft. Depth to limiting factor 31 " Remarks: CST Name: — Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 0th. Ave., NW Richmond, WI. 54017 Signature: Date: CST Number: 3 -19 -96 cstm 02298 PROPERTYOWNER Steven T. Smith SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL IA # 016- 1047 -30 ` Depth Dominant Color Mottles Structure GPD /ft , Boring # Horizon P Texture Consistence Bax>clary Roots in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench 0.0 : 1 0 -12 10yr3 /3 none 1 2msbk mfr qw 2f .5 .6 >: 3 2 112-24 10yr5 /4 none sicl 2msbk mfr gw if .4 .5 Ground 3 124-48 7.5ry4/4 c2p 7.5yr5/8 scl lmsbk mfr na na np .2 elev. 9 3.8 ft. Depth to limiting factor 24" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # w:w Ground elev. ft. Depth to limiting factor Remarks: Boring # 4•.v Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) PROPERTY OWNER Steven T. Smith SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL IA. # 016 - 1047 -30 ` Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Bo�x>dary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0 -12 10yr3 /3 none 1 2msbk mfr qw 2f .5 .6 2 12 -24 10yr5 /4 none sicl 2msbk mfr gw if .4 .5 Ground 3 24 -48 7.5ry4/4 c2p 7.5yr5/8 scl lmsbk mfr na na np .2 elev. 9 3.8 ft. Depth to limiting factor 24 Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # k 4( Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) ♦ f 7 STEELS SOIL SERVICE Gar L. Steel Gary Steven T. Smith 1554 200th Ave. t SE4SW4 S21- T30N -R15W New Richmond, WI 54017 MPRSW 3254 town of Glenwood (715) 246 -6200 N 1 = 40 ' BM.= nail in corner post @ el. 100' S` �����• Alt. BM.= top of corner post C el. 103.68' 7 lot= 80acres (2.0' a 9 ko Fr /© Gary L. Steel 3 -19 -96 STC -105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County n I j OWNERBUYER S e �;� T Q� C �O c[ i' I`� l Sin 4rl\ MAILING ADDRESS C.0 y.y\�, a G 2 woo c� C i T PROPERTY ADDRESS SO r) Q- (location of septic system) Please obtain from the Planning Dept. CITY /STATE 6 1 9- nw o o 8 C + r PROPERTY LOCATION EVz 5W 1/4, 1/4, Section 2-1 T 30 N -R W TOWN OF I-e n '_0 o O �-�, ST. CROIX COUNTY, WI SUBDIVISION , LOT NUMBER CERTIFIED SURVEY MAP , VOLUME ; PAGE LOT NUMBER 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 licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained usKbbe leted and re turned to the St. Croix County Zoning Officer within 30 days of the thr a expate. SIGNED: ' A14� DATE: St. Croix County Zoning Office Government Center ' 1101 Carmichael Road Hudson, WI 54016 11/93 STC - loo This application form is to be completed in full and signed by the . of the property being developed. Any inadequacies will only ' result in delays of the permit issuance. Should this development be intended for resale by owner /contractor, (spec house) , then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. ------------------------------------------------------------------- Owner of property S+F Q e.� '� �, �� - )0 ism -U1 Location of property e' 1/�j StiJ 1/4, Section Zt ,T 30 N -R W Townshi QenWooc- Mailing address 09t1q l 6LxA G Address of site ,�� Subdivision name Lot no. Other homes on property? Yes 7( No Previous owner of property 0, o f r � G r L' kj Total size of property gb 0.ur es Total size of parcel Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house) ? )X, Yes No Volume I I Cp and Page Number 5 y "7 as recorded with the Register of Deeds. ------------------------------------------------------------------- INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document No. SKIS and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of the County Register of Deeds as Document No. S' nature of Applicant Co- pli nt I s 0'c— ?G 1 1 -5-q6 Date of Signature Date of Signature C .^ L� { � s Y 5 7J STATE B AR LAN CON W ISCON SI N I1 — 1982 V OL 1 b4 pp 5,41 Individual and Corpor►le ' r ♦ °' °• w ITO BE USED FOR ALL TRANSACTIONS WHERE OVER q� S2S.000 IS FIN: %NCEl1 AND IN OTHER NON-CONSUMER VIl'1 +� 69 pr DOCUMENT NO. .ACT TRANSACTIONS) !I St CROIX Ma rgaret Grt� " 2 1996 Contract by and between APR ka_ L. Gr a single �, ( "Vendor" it at 9: 3� . �.�M and Jodi M. Smith. �,+►�aw•, cSYtJl. whether one or ra6rex•aed Steven Smith _huz nd_2z�j wi fe, P is:Grof Deems ( "Purchaser ", whether one or more). Vendor sells and aireet to 6onvey to Purchaser, upon the prompt and full perfor- mance of this contrdct 6Y Olirchaser, the following property, together with the rents, it $ profits, fixtures an¢ '�ifief appurtenant interests (all called the "Property "), In ;I THIS SPACE RESERVED FOR RECORDING DATA — — St., County, State of Wisconsin: !i — -- — -- NAM! AND RETURN ADDRESS kAttorney Kristina Cgland '',P 0 Box 359 ):Hudson WI 54016 016 1047 -10 & 016 - 1047 - 30 (Parcel Identification Number) E1 /2 of SW1 /4 of Section 21, Township 30 North, Range 15 West, St. Croix County, Wisconsin. o� This is not homestead property. Purchaser agrees to purchase the Property and to pay to Vendor at _ place Vendor directs.. the sum of S 5,5,000.00 in the fallowing manner. W$ 11 +000.00 ' at the execution of this Contract; and 'b) the balance of S 44 oo • ,together with interest from date hereof on the balance outstanding from time to time at the rate of ei ht 8x percent per annum until paid in full, as follows: Commencing on the 1st day of May, 1996, and on the 1st day of each and every month thereafter, equal monthly installments of principal and interest in the amount of $322.86. Provided, however, the entire outstanding balance shall be paid in full on or before the 1st day of April, 2001 X—)OC_KW (the maturity date). Following any default in payment, interest shall accrue at the rate of — per annum on the entire amount in defauh (which shall include, without limitation, delinquent interest and, upon acceleration or maturity, the entire principal balance)• r urchaser, unless excused by Vendor, agrees to pay monthly to Vendor amounts sufficient to pay reasonably anticipated annual taxes, special assessments, fire and required insurance premiums when due. To the extent received by Vendor, Vendor agrees to apply payments to these obligations when due. Such amounts received by the Vendor for payment of taxes, assessments and insurance will be deposited into an escrow fund or trustee account, but shall not bear interest unless otherwise required by law. Payments shall be applied first to interest on the unpaid balance at the rate specified and then to principal. Any amount may be prepaid without premium or fee upon principal at any timeaftes In the event of any prepayment, this contract shall not be treated as in defauh with respect to payment so long as the unpaid balance of princiQal, and interest (and in such case accruing interest from month to month shall be treated as unpaid principal) is less than the amount that said indebtedness would have been had the monthly payments been made as Pint specified above; provided that monthly payments shall be continued in the event of credit of any proceeds of insurance or condemnation, the condemned premises being thereafter excluded herefrom. ii Purchaser states that Purchaser is satisfied with the title as shown by the title evidence submitted to Purchaser for examination except- .? None i 1 Purchaser agrees to pay the cost of future title evidence. If title evidence is in the form of an abstract, it shall be retained by Vendor until the { full purchase price is paid. d of closing Purchaser shall be entitled to take possession of the Property on _ —Y - . - - --- -- ii Kross Out One. � 1169QA,. Purchaser promises to pay when due all taxes and assessments le%ied on the Property cr upon Vendor's interest it. it and to deliver to Vendor as JerAand receints show ins s-tch payment. Purchaser shat: -k"p the improvements on the Property insured against loss or damage occasioned by fire, extended coverage �4ici ocher hazards : Vendor may require, wi!heut co- insurance, through insurers a penis and p '_wa Vendor shall not require coverage in an amount more than the balance owed under this v Contr Contract. Purchaser shal pay the insurance premiums .irn due. The policies shall contain the standard clause in favor of t;:e Vendor's interest and, unless Vendor otherwise agrees in writing, the O"Vnal of all policies covering the Property shall he deposited with Vendor. Purchaser shall promptly give notice of loss to insurance companies and Vendor, Unless Purchaser and Vendor otherwise agree in writing, insurance proceeds shall be applied to restoration or repair of Property d. tuaged, provided the Vendor deems the restoration or repair to be economically feasible. Purchaser covenants not to commit waste nor allow condition and repair, waste to be committed on :he Property, to keep the Property in good tenantable regulations affecting the Property. keep the Property free from liens superior to the lien of this Contract, and to comply with all laws, ordinances and Vendor agrees :hat in case the purchase price with interest and other .noneys shall be fully paid and all conditions shall be fully performed all :be times and in the manner above specified, Vendor will on demand, execute and deliver to the Purchaser, a Warranty Deed, in fee simple. of rue PropenX, free and clear of all liens an4 ettcumbra n ces, rie ex e t any tens or en • mbrances reale by the act or default of Purchaser, and Ipt= — asl�teot re st�ons�nis- ori- o 'recorc i >__a. Purchaser agrees that time is of the essence and (a) in the event of a default in tht payment of any principal or interest which continues fix a period of __4_5_ - Jays following the specified due date or (b) in the event of a default in performance of any other obligation of Purchaser wise; continues for a period of _45 —_ days following written notice thereof by Vendor (delivered personally or mailed by certified mailx Area the entire outstanding balance under this contract shall become immediately due and payable in full, at Vendor's option and without notice �siich Purchaser hereby waives), and Vendor shall also have the following rights and remedies (subject to any ;imitations provided by law) in addition to those provided by law or in equity:( i) Vendor may. at his option, terminate this Contract and Purchaser's rights, title and interest in the Property and recover the Property back! rough strict foreclosure with any equity of redemption to be conditioned upon Purchaser's full payment afthe entire outstanding balance, with interest thereon from the date of default at the rate in effect on such date and other amounts due hereunder tin which event all amounts previously paid by Purchaser shall be forfeited as liquidated damages for failure to fulfill this Contract and as rental for tic Property if Purchaser fails to redeem): or (ii) Vendor may sue for specific performance of this Contract to compel immediate and full payment oftae entire outstanding balance, with interest thereon at the rate in effect on the date of default and ocher amounts due hereunder, in which event the Property shall be auctioned at judicial sale and Purchaser shall be liable for any deficiency; or (iii) Vendor may sue at taw for the entire unpaid Purchase price or any portion thereof; or (iv) Vendor may declare this Contract at an end and remove this Contract as a cloud on title in a quiet -title action if the equitable interest of Purchasers insignificant, and (v) Vendor may have Purchaser ejected from possession of 'he Property and have a receiver appointed to collect any rents, issues or profits during the pendency of any action under (i ), (ii) or (iv) above. Notwithstanding any oral or written statements or actions of Vendor, an election of any of the fo•egoing remedies shall only be binding upon Vendor if and when pursued in ikiptiion and all costs and expenses including reasonable attorneys fees of Vendor incurred to enforce any remedy hereunder ( whether abated or not) to the extent not prohibited by law and expenses of title evidence shall be added to principal and paid by Purchaser, as incurred, and sbal! be included in any judgment. Upon the commencement or during the pendency of any action of foreclosure of this Contract, Purchaser consents to the appointment of a receiver of the Property, including homestead interest, to collect the rents, issues, and profits of the Property during the pendency of such action, and such rents, issues, and profits when so collected shall be held and applied as the court shall direct Purchaser shall not transfer, sell or convey any legal or equitable interest in the Property (by assignment of any of Purchasers rights under tail Contract or by option long -term lease or in any other wav) without the prior written consent of Vendor unless either the outstanding balance payable under this Contract is fi paid in full p or the interest conveyed is a pledge or assignment of Purchaser's in..-rest under this Contract solely as security (or an indebtedness of Purchaser. In the event of any such trander, sale or convevance without Vendor's written consent, the entire outstanding balance payable under this Contract shall become immediately due and payable in full, at Vendor's option without notice. Vendor shall make all payments when due under any mortgage outstanding against the Property on the date of this Contract (except for any Mortgage granted by Purchaser) or under a,:iy time secured thereby, provided Purchaser makes timely payment of the amounts then due under this Cootract. Purchaser may make any such payments directly to the Mortgagee if Vendor fails to do so and all payments so made by Purchaser shall be considered payments made on this Contract Vendor may waive any default without waiving any other subsequent or prior default of Purchaser. All terms of this Contract shall be binding upon and inure to the benefits of the heirs, legal representatives, successors and assigns of Vendor and Purchaser. (If not an owner of the Property the spouse of Vendor for a valuable consideration joins herein to release homestead rights in the =*im Property and agrees to join in the execution of the deed to be mode in fulfillment hereof.) Dated this �ZIh day of March (SEAL) (SEAL) a r et Gr tmnons, a/k /a Ma rgare t L. Steven Smith rrulmons — (SEAL) (SEAL) k • o AUTHENTICATION ACKNOWLEDGMENT Stmatttare(s) _ Margaret Grtmmons. a/k/a Margar L. STATE o f wtscoNSt G Grtrr{arans, Steven Smith, Jody M. Smith as. ali�rf�ielic . this � of March , 19�? � County. , Personally came before me this da o f { the above named +~tfE1�11 E� AR OF WISCONSIN .06. Wins. Seats.) to me known to be the person _ who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY Krl Stlna / � ,, 1a17d Attorne - at Law Notary Public y _ County, win. - - - - -- _ _ _ (Signatures may be authenticated or acknowledged. Both are not My commission is permanent _ Of not, state expiration date: secessarv.