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Wisconsin Department of Commerce ~ e PRIVATE SEWAGE SYSTEM Safety and Building Division + ~ INSPECTION REPORT GENERAL INFORMATION ~ (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 'ermit Holder's Name: City Village X Township Olson, Bob Glenwood, Town of ;ST BM Elev: Insp. BM Elev: BM Description: c~ /~jvv~ ~ C5 t SANK INFORMATION TYPE MANUFACTURER CAPACITY Septic G aJ ~ ~ Sll~- Dosing Ga ~oQ~ GQCat+erj ~~,~.~ /1 /~ }- Holding t TANK SETBACK INFORMATION TANK TO P/ WELL BLDG. Vent to Air Intake ROAD Septic ~ (r 177 ~ /C)`J ~ ~ ~a~ `_' 9 ' Aeration Holding PUMP/SIPHON INFORMATION ~/ Manufacturer ~ errand ~~ Zd t°J ( GPM Model Number ~ A 1 I ~ ~ v ~~ TDH Li ' Friction Loss System He TDH ~ 3 v ~ ~ ,~1 /~ r ~ o Forcemain Lengt~ ~ Dia. Z •' Dist. to well 77 / SOIL /4gSORPTION SYSTEM ELEVATION DATA county: St. Croix Sanitary Permit No: 479209 0 State Plan ID No: Parcel Tax No: SectionlTown/Range/Map No: 28.30.15. - STATION BS HI FS ELEV. Benchmark ~ . Q V /~? •$ J (~ Alt. BM Bldg. Sewer ¢, ~ l~ ~ `7 m~,.2 7 ,.7 SUHt Inlet $ , l,5 95 . ~5 SUHt Outlet ~ ~ Dt Inlet ~ Dt Bottom f ,Z - G J cfi / ~ Header/Man. Dist. Pipe ~r ~ ~ C / Bot. System `1~~ / c l p Final Grade 2 ~~ ~ ~ Z st cover ~,1~c~, Z- ~ /09.Z~ $ ~ ~ td (, t Ce~~~ 5 .q q 7 ~ 5 BED/TRENCH DIMENSIONS Width g Length ~ No. Of TrencQQhes ~ PIT DIMENSIONS No. Of Pits Inside Dia. -` Liquid Depth 5 ~ k.Jet ~- SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer. INFORMATION CHAMBER OZ ~ Type Of System: / ~ ~ J UNIT Model Number: ~~ - z3 ~3z ~ 7~ n DISTRIl3l1T10N SYSTEM (l,.,. _l~ Header/Manif~ /~ Piserisution ~ // ~ x Hole Size ) ,, ~ x Hole Spacing ~ Veto Air Intake Z i Di ~ S Length Dia pac ng Length a RAII COVFR v Drnc~nrn Cvo4omc Anly vv Mnnnrl rIr• O+•rraCtP $VR}PmS Or1IV vvw~.v~v~ Depth Over , BedlTrench Center Depth Over Bed/Trench Edges xx Depth of Topsoil ~ xx Seeded/Sodded xx Mulched ~ ~ a ` • ryes ~ J No Yes [] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~! Zit U ~ Inspection #2: / / Location: 1365 290th Street Glenwood City, WI 54013 (SW 1/4 NW 1/4 28 T30N R15W) NA Lot 1 Ffa~t ~ Parcel No: 28.30.15. ~~.~~. a.~ ~-. plu vwla...A. ~-- ~~,,,~-.. ~~~ o ~ v rte. 1.) Alt BM Description = 2.) Bldg sewer length = ~ ~ 'a'p 1 ~ S r ~ s6 ('.~~ ~ o/' - amount of cover = I Z , ~'~'^ O J ~ q,~' 7Z, / ~ °~~ J~-~` ¢-~ S ' A`a w.. ~ d c15s~, ~. 5 d ~- ~ a .~ ,,,,.~ Use otherls de for add tional information' o _ ~_.1.2~_ b J ~~ ~L_____ _- _ _ __ ----- -- -- --- ,1 ~- J -1-~, Date Insepctor's Signa re Cert. No. SBD-6710 (R.3/97) Safety and Buildings Division County ~~ Q, ` ~ 20l W. Washington Ave., P.O. Box 7162 , ,~~o~~I~ , ison, WI lled in by Co.) Sanitary Permit Number (to be fi 60$) 2 -315 ~~r+ g y 7 g 2 Department of Commerce ll~i / ,~ Sanitary Permit Ap ~ ~~ ~ LD. Number In accord with Comm 83.21, Wis. Adm. Code, ersonal in r~i~t~ ~ ~ r rj~ lJ ili U dd ~ may be used for secondary purposes Privacy Law, s15. ress) ma ng a Prol Address (Ifdifferent Ski I. Application Information -Please Print All Information ~UNIN ~~~~ ! o~;- f ~ - ~ S` ,c , ~ ~ ~ 0,, . Property Owner'sName I # Lot # Block # / ^ A Property Ow`ner's Mailing Address Pro~Jperty~lLocati City, State / ~f ~, ~ J ~ ~ l , /) Zip Code !~ e Phone Number r _ ~ ~clr on T pe of Building (check all that apply) °-~ 1 II . ~ Ok cow Per v~oJS~_ ~ $~gbclivisi nN /~1 ~CSMNumber ' Family Dwelling-Number of Bedrooms I ~ Q,( u,~c.5,~ ~ ^ Public/Commercial -Describe Us e ~ 1(. -/tS59 - ~'o - 000 ~ /~ / C ^ State Owned -Describe Use / 1' IQy (_p ~ _ g ~ J ~ a+~- ~. - ^City ^Village Township of P YV r ~ III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A' y ew S stem ~~ ^ Replacement System ^ TreatmentlHolding Tank Replacement Only ^ Other Modification to Existing System B• ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Petmit Number and Date Issued Before Expiration Plumber Owner IV. T e of POWTS S stem: (Che k all that a 1 -Pressurized In-Ground euad_? 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ ~, Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain) V. Dis ersal/I'reatment Area Information: Design Flow (gpd) Design Soi Application ~ d~ Dispersal Area Required Dispersal Area Pr pos System Elevate VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing ~~ ~ /~ Tanks Tanks Septic or Holding Tank Aerobic Treahnent Unit Dosing Chamber VII. Responsibility Statement- I, the undersign , ume responsibility for iustallatiou of the POWTS shown ou the attached plans. Plumber's ame (Print) Plumber' afore MP/MPRS Number Business Phone Number - Plumber's Address Street, City, State, Zip e) /o~ /r'~Z ~ ~~ G~~ J ~ I ~ VI oun /De artment Use Onl Approved ^ Disa Sanitary Permit Fee (includes Groundwater Surcharge Fee) 7 C Date Issuq~ G/~ ~s Issuin gent Sign o ps) ^ O Gi ~ ~ LJ / er eason ial YX. Conditions of ApprovaUReasons for Disapproval %~ ~ (1 i~o~ ~ ~ ~~~ 4~ (,~~~ ~~~r ~C `JJ ,n d~ SYSTEM OWNER: ~ ~ ,~~~ ~ ~ ~ S ~,~~ ~ - Saptic tank, effluent filter and P dispersal cell must all be services /maintained as per management plan provided by plumber. 2. Aq setback requirements must be maintained as per applicable code /ordinances. Attach complete plans (to the County only) for the system on paper not less than 812 x 11 inches in siu SBD-6398 (R. 01/03) P . • ' ~ PT,OT PLAN PROJECT Bob Olson ~ ADDRESS 1552 Ctv Rd GG New Richmond Wi 54017 SW "1/4 NW 1/4S 28 /T 30 N/R 15 W TOWN Glenwood COUNTY ST.CROIX SYSTEM ELEVATION 99.8' BEDROOM 3 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE ~ 000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 454 # of chambers none BENCHMARK V.R.P. Top of Steel fence post ASSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE O WELL *H.R.P. Same as Benchmark I~ Property Line Scale = 1 /4" = 10' 817' property Line Well is to meet all setbacks found in Comm. 83 Tank is to be properly bedded and provided with lockdown covers with approved warning labels B-2 100' 98.8' . 9 8' -_ 9 6' B.M. 290th St. 10% Slope Pro 3 Bedroom House B-3 Area 15' below system is to remain undisturbed ~~~~ Huffcutt Combo Tank B-1 Grading is to be done to divert run-off away from system .. ' ~ PLOT PLAN PROJECT Bob Olson t ADDRESS 1552 Ctv Rd GG New Richmond Wi 54017 SW " 1 /4 N1IV 1/4S 28 /T 30 N/R 15 W TOWN Glenwood COUNTY ST. CROIX SYSTEM ELEVATION 99.8' BEDROOM 3 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 454 # of chambers none BENCHMARK V.R.P. Top of Steel fence post ASSUME ELEVATION 100' ^BOREHOLE O WELL *H.R.P. Same as Benchmark Property Line Scale = 1 /4" = 10' Filter Zabel A-100 817' property Line Pro 3 Bedroom House Well is to meet all setbacks found in Comm. 83 B-2 100' 98.8' . 9 8' . 9 6' 10% Slope B.M. Huffcutt Combo Tank Tank is to be properly bedded and provided with iockdown covers with approved warning labels B-1 Grading is to be done to divert run-off away from system B-3 Area 15' below system is to remain undisturbed 290th St. Wisconsin Department of Commerce ~ SOIL EVALUATION REPORT Division of Safety and Buildings in accordance with Comm I . u Attach complete site plan on paper not less than 8'/: x 11 inches in s¢e include, but not limited to: vertical and horizontal reference point (BM), ' n percent slope, scale or dimemsions, north arrow, and location and dicta t nearest d a ~~~ `~ `fin. Please print all information. ~ ~:a,;v - Refit Personal information you provide may be used for secondary purposes (Privacy L , s t 5.04 ( ) : ~ ! ' Property Owner Pr 1627 Page 1 of 3 Steel's Soil Service, Inc. St. Croix Date Olson, Bob G na SW 1/4 NW 1/4 28 T 30 N R 15 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1552 Cty Rd GG na na CSM Pending 7 Acres City State Zip Code Phone Number ~ City J Village ~ Town Nearest Road New Richmond ~ WI 54017 715-246-5580 ~'~PiJ wooer 290Th St New Construction Use: /~ Residential /Number of bedrooms 4 Code derived design flow rate ~) Replacement ~ Public or commercial - Describe:na Parent material Arland,Sandstone uplands Flood plain elevation, if applicable General comments and recommendations: Mound design, system elevation 99.80ft based on contour line elevation 98.80ft -~ --~ 600 GPD na Boring # J Boring Pit Ground Surface elev. 99.80 ft. Depth to limiting factor 27 min. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-4 10yr3/2 none I 2msbk mfr cs 1vf .6 .8 2 4-27 10yr4/4 none sl 2msbk mfr gw na .6 1.0 3 27-48 10yr8/2 c2d 7.5yr5/6 andston residuum na na na .0 .0 Boring # J Boring 1/ Pit Ground Surface elev. 99.80 ft. Depth to limiting factor 27 ~n• Soil Applicatan Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 1 0-8 10yr3/1 none I 2msbk mfr cs 1vf .6 .8 2 8-27 10yr4/4 none sl 2msbk mfr cs na .6 1.0 3 27-36 10yr4/4 f1 d 7.5yr5/6 sicl 2msbk na na na .4 .6 'Effluent #1 = BODS> 30 <_ 220 mg/L and TSS >30 <_ 150 mg/L * E nt #2 =GODS < 30 mg/L anq 155 < su mgi~ CST Name (Please Print) //. CST Number David J. Steel 248956 Address Steel's Soil Service, Inc. Date Evaluation Conducted Telephone Number 994 200th St., Baldwin, WI 54002 1/29/2005 715-684-5680 Property Owner Olson, 13ob ~ Parcel ID # Pending _ __ Page 2 of 3 Boring # J Boring fl Pit Ground Surface elev. 95.90 ft. Depth to limiting factor 29 'min. ~~ Ap~n Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-4 10yr3/1 none I 2msbk mfr gw 1vf .6 .8 2 4-21 10yr4/4 none sl 2msbk mfr gw na .6 1.0 3 21-29 10yr4/4 none sl om mfr di na .2 .6 4 29-48 10yr8/2 c2d 7.5yr5/6 ;andston residuum na na na .0 .0 ^ Boring # .:~ Boring _] Pit Ground Surface elev. fl. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ^ Boring # -~ Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots D in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODS> 30 < 220 mg/Land TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. ' STEEL'S SOIL SERVICE INC. 3 of 3 David J. Steel Bob Olson 994 200' St. CST-POWTSM SWl/4,NW1/4,S28,T30N,R15W Baldwin, WI 54002 Lic. #248956 Town of Glenwood City, St Croix Co. Bus.(715) 684-5680 CSM 7 Acres Pending Fax.(715) 684-3449 end N 1" = 40' 1 • =Benchmark Ele. 100.00 ft Top of Steel fence post ~ =Alt Benchmark Ele. 97.70 ft Top of Steel fence post ^ =Borings Boring Elevations B 1 = 99.80 ft B2 = 99.80 ft B3 = 95.90 ft B4 = 0.00 ft i 1~'~, r ~'S S `~~` h~ ~j~ _ _ ___ k ~~~ 1 ~`y ~ '/" rc,~ 4i Lam'" ~ %- Zvi'-~ r. ----.- commerce.wl.gov' isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. co m m e rce . w i. g o v/s b/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary May 24, 2005 CUST ID No.226900 SHAUN R BIRD 1008 192 ND AVE NEW RICHMOND WI 54017 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/24/2007 Identification Numbers Transaction ID No. 1140279 SITE: Site ID No. 698828 Bob Olson Please refer to both identification numbers, 290th Street above, in all corres ondence with the a enc . Town of Glenwood St Croix County SWI/4, NW1/4, S28, T30N, R15W FOR: Description: Proposed Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1019353 Maintenance required; 450 GPD Flow rate; 27 in Soil minimum depth to limiting factor from original grade System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/O1), Pressure Distribution Component Manual -Version 2.0, SBD-10706-P (N.O1/O1); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD-10691-P(N.O1/O1). • The pressure network is to be constructed in accordance with publications SBD-10706-P(NO1/O1) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems -Version 2.0" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS • 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 area within IS feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. ~.~'~f.T.~. Co~clitioyially ~~~~~~® SHAUN R 33IRD Page 2 5/24/2005 • Comm 83 22(7) - 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. Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) -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. 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. • 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, `~~~ Gerard M. Swim POWTS Plan Reviewer -Integrated Services (608)-789-7892, Mon. -Fri. 7:30 am to 4:15 pm j swim@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 Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 RF~~ s ~qy ~~Fo qF~~ ~ ~~oo ABU`` s D`f'~'s Date: 5/13/05 Owner: Bob Olson Location:SW1/4 NW114 S28 T30 N,R15W Lot 1 290th St. Glenwood 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 7-8. Maintance and Contigency plan 9-11. SC Shaun B Signatu License number 226900 _ _...,,. .,. ~ yr ~utrtMtk~:E DIVIS-gN SAFETY AND BUILDINGS SEE CORR PONDENCE -,___--_ ~,... Designer_ ~ No Date 4" Observation Pipe Perforated Below Filter Fabric ASTM C-33 5 o n d ---~ YJ " Topsol( ~. Stope ~ ~~ < ~~ ~,,~ u,Ps F 0 W `n C 0 0 !J~ E Bed Oitf~-2%Z Brain Rock r Non-Woven Filter Fabric ~pistribulion Pipc Force M-o;n From Rump G Cress Section Of A Mound S stem Us;n A Bed For The Absorption Area _._._--- p '~ Ft. g ~ Ft. I , Ft.~ 3 ~o' - Ft. K ~ Ft. ~ ~ i Ft. },- ~, ~t . t= Iowe Q t_oyt r/ ~~ ~ i E. ~ ~ F,~ „_~ G ~_ H ~~ -- L 4~Observotion Pipe--~ ~ ~ _ . r ~ - -__--~--' K A ~j ----- - l Force Ma;n l° ,.~._..~_-~_...._~._..---__~.. -- From Pur*-P -- -- --- ~ ~ '. Distribution Bed 04 /2 -' 2 2 Pipe -Drain RocK I \ " ~~ Permanent Morker 4 Obcervotion Pipe =..?Cc: ,,,._ ~ ~ -- ~ ~ Pipe or Rods Plon Vitw Of Mound Ucin A Bed For The Absorption Area PAG E,~„- ~F ~~~~ ~ Located Qn 8orrom. e Equa~ty Spo=ed ~tRST >{oLL NsxT so Connsc}ion Signed: ~.icense Numbpr: date: ,~ X ~ i nc~+eS "- ~ ~ ~ ~ inches l/ Hale Diameter 3//bInch Lateral ." Z Inch4es) "ianifold ~ Inches __.___ _ Force Main ~-- Inches of Holes/~iFe~ Invert ~7evation of i.atex~alsf~_J?~'t. Per¢cra'td PsD! Qet4it ' x- CRt15S S£CTifl?`~ SEPTIC TANK ~ F'~MP Ci:p,~i$,..R Z~,. HIl+3 . ABOV L' GRADS ~ ~„ C} SENT PIPE ~jpJi}aw QR ~.XR iKTA~ci: ~; r ^ J FRESI* ~ ~ f~, ~ 9~v g,~ I S ~- INL£T z:ATER 'S'IG HT S ~~ A F i LT ~R .-~--- B '~_ APP~YEfl C D~ 3~I0 gU2+~P QFF ELEV -~-- FT ~ D SOIL z pND SP£Cti ICA_ ~EatN£~PRt1tIF APPROVED Ji3~tCTItZi+~ BOX BOLE CQVEg WITH CO~;DUZT W/ pppLOCK £ -w~xNI~G u$~~ _ _._.k+' HZN . S. D. ~8uMiN- i 7 ~. i ~ CzAS ~ '~pPf~1E¢ TIGHT , ' JOItiTS iil~ : SEAL : ' ~ ALI'L APPRbY£Q giFE 3 ~S ' N OII ~~D t a 3 K pYEI~ BEDI3~NG tTi~~ '~A3+i/K ~/.~ A:~/ CU Ci~ETE PAS APPR ~ i SP£CZFrCA;Ipi~S DOSES P£R DAY = .r-------~-- DOSE ~HBER SEPTIC / ~.AC~Jg£IZ: DOSE vt~~31ME FL~BAC~ 7i ~t;AL- TAAi 1C MANU - UAZ.. _ ~,~'~ SEPTIC` -~ GAL. - A _ ~ f. ~ Z2~iCHES = _.s~=~----`- L- TANK SIZES = DOSE ~, ~~ ~~w0 CRPAGZTZ~' GAL- C1LiRER:- g = 2 INCHES = ;-----...~ ~SA~+NFA ', .~ ~,L. ALN~ HpDEL ~~~ : ~ n ~~c.G~s,-- ~ ,0 = l~ ' J INCHES = ._.~~-- ~sTCa ~ ~/~ -~-- ~~FAC1'flR£R ? 'n = ~% '" IHCfIES =~.,~. ~~-~~ pUKP /~-~ C~ .lG~~'~-° PER I LHT~ 15.23 WAI - I30DEL t+tUi'FSER y~;TCIi TYPE= / £. M i~JIRING AS ~u GPM PunF AL.AR FEET ZRED DISCHARGE ~+T~ ----- -~1,pN PIPE- - ~~~~~FEET REt3i3 PU~'IP OFF ANB DiSTRI~ - - FEET CE B£Tir1EEN - - ~ VERTICAL BKETf~TL?R SUPPLY PRESS~RE - FRZC'TIflN FACTOR . ~'T/ 1Q Q - £'~` - NAT`IC MEAD ~Si.----' FEET + MI~t~ _~:.~- FEAT FflRC£TSAIN X ~'OTAL DYE I1~T£g~tAL DIM£N~IfJN ~A-:£= ~f~8 w w g °a w s U a 8 z 0 0 4 vv ~~ - FLOW PER-MINUTE TOTAL D YNAMIC HEAD/CA PACITY PER MWUTE EFFLU ENT AND DEWATE RING MODEL t52 153 Feet Meters Gol, Lifers Gol. Liters 5 1.5 69 261 77 291 10 3.1 61 231 70 2Ei5 15 4.6 53 201 61 231 20 - 6.1 44 i 167 52 197 25 7.6 34 129 42 159 30 9.1 23 I 87 33 17.5 35 1(1.7 -- -- 22 E5 40 12.2 -- -- 11 42 Loci< Volve: 38.0 Ft. (11.6m) 44.0 Ft. (13.4m) J145Da 3 27 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Timed dosing panels available. "' • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed owik-Box available for outdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. 15y133 Series !2 32 i ~ 12 ~/e s ~/ i t ---1- s SK2064 SELECTION GUIDE O CAUTION All installation of controls, protection devices and wiring should be done by a qualified licensed electrician. All electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). 1. Single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0477. 2. See FM0712 for correct model of Electrical Aftemator E-Pak 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) or (4) float system. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL 70: P.0. 80X 16347 Louisville, KY 40256-0347 Manu(acfurersof. SHIP 70: 3649 Cane Run Road p qp ® Louisville, KY 40211-1961 QlWUTY/w~~°s ~NL'E ~Jdi7 N Q (502) 778-2731.1(800) 928-PUMP hnp;//www.zoelfer.com ~ ~/ PUMP ! FAX (502)774-3624 © Copyright 2000 Zoeller Co. All rights reserved. poWTS OWi+IER'S MANUAL 8~ MANAGES EF CA io s SYSTEM SP ~sIGN PARaM___- - Number' of Beds Number ~ ~mrnerdal Units Estimated flow (average) pesign flaw (Peaky. (Estimated X '(_5) ~~ gPpr~ation tRate influentlEfflt+ent Quality Fats,. Gil ~ Grease (EGG) Biochemigl Oxy9~ pemand (BODE .i-Olaf SugPeRded Solids {TSS) cent QuaCdY ~` Pretreated Effl 80D5) B-~ochemrcal Oxygen Oemand Total Suspended Solids {TSS) Fecal Conform (geometric mean) Maximum Effluent Partide Size ,_~ SCHEDULE Service Event lnsped condition of tank(s) Pump out contents of tank(s) Inspect dispersal Celt(s) Clean effluent filter Inspect pump, Pump Controls 8, alarm Flush laterals and pressure test NA y__ a Monthly average` S30 mg/L 420 mg/L Septic Tank CapadtY Septic Tank Manufacturer Effluent Etter Manufactumr Efi9uent FIIer Model Pump Tank CapadtY pump Tank Manufacturer .Pump Manufaduref Page of 'L~?t7 at ^ NA ' _ ^ NA :. /III. ^NA ~L'/ll~ ^NA ~~ ~ gal ^ NA ~. o,i'/,r~~ ~C7 NA Pump Model ' v pretreatment Unit w ^ Peat Fitter ^ SandlGr"dvel ~~~ Wetland ^ Macfianical Aeration ^ ^ Other. ^ Oisinfecfion ~~7v ^ MonihN va erage•• Qispersal Cell(s) ^~{n~round (pressur¢ed) 530 mgJl- ^ In{Jround (9mvity) ~' tFiund ^ At-grade ^ O er_ 53o mg/L p Dri ine 510' cfu/'f OOm! rqa, rrasteweter end Y inch diameter values typ~car for domestic (non-comma n optic tank etgueni ,.. Values tYP~i ~ PretreateQ ,,,~stevrater. Service Fre months At feast once every When combined sludge and scum equals At least once every At least once every At Least once every At least once every At least once every At least once every months / / ' m_ onthsT: .L~-p months ~~-"- '~^ months (Maximum 3 yrs.) (Y,) of tank volume ;) (Maximum 3 yrs.) ^ NA ^ NA ^ months ^ year(s) ^ NA ^ months D Years) ~ NA M~rn'ENpNCE INSTRUCTIONS an ind'tviduai Catrrying one of the following licenses or of tanks and dispersal cells shall be made by Steer ppWTS insper~or POWTS Maintainer, Septage Inspections to identify any missing or broken ~~: Master plumber. Master Plumber Restricted a and scum and to check for any back up Ser+ridng Gpera~r• Tank inspections must indude a visual inspection of the tank(s) to ~~ ~e effluent levels hardM+am. identify any ~Cks or (ealcs, measure'the volume of combined siudg of effluent on the round surface- The dispersal Cell(s) shalt be visually inspected nding or pond'u1g of effluent on the g nding of effluent on the ground surface- The P° ulatory authorrtY- in the observation Pipes and to check for any Po uires the Immediate notification of the local rag indicate a failing condition and req or more of the tank volume, the ground surface may uais one-third (Y) NR e and scum in any tank eq erator and disposed of rn accordance +~ ~- When the Combintd aocurrrulation of siudg a Septage Servicing Op entire contents of the tank shat) be removed by t mart components, and any 113, Wisconsin Administrative Code• ~ onents, preirea f The servian9 rformed by a certified POWTS Maintainer. of effluent filters, mechanical or pressurized POWTS comp at intervals of 12 months or less shall be A~ of cempletion of any service event other mafntenanoe or morittoring A ~~ report shall be provided to the loco( regulatory authority within 10 days resence of painting produar or other s for e p START UP ANO OPERATION ff hi h conoenirabons are For new oonsbvction, prior to use of the POWTS check Treatment tank() ersat cell(s). g Chemicals that may impede the treatment Process and/or damage the lisp riar to use. detected have the contents of the tank(s) removed by a septage servicing operator p r- ~ ' - - - fitrative surface. Page of shall not coral when 5~l conditions are frozen at the rn ~ is re~r~ ~ excess System start up ~ above normal h'Eghwater levels. when ~~ and may result in the outages pump tanks tray overloading the ceC(s) During power ~ discharged to the d'~Pe~l cell(s) in one large dose. tank removed by a ~~ Yv~l a of efff~f- To avoid this situation have me o n~n~d ~ P{u ~F or POYYTS Matrttainer to pup oc surface ~ ~ ptTOf ~tD.reStQnng power tQ the efnuent pu P um tank. septage Servicing tin the pump oontrr~ls to restore normal fevers within the p . p assist in manually oP~ti g and dispersal cells. Do not drive or park over, or otherwise disturb or compact, Oo not drive or patio vehicles tatter tanks - the area within 15 feet dawn slope of any mound or at-grade soil abserptio ~ rove the performance and prolong the Gfe Reduction or~el-untnatron of the follo~n9 ~m the wastewater stream may ~ P deQ~~~ denfatt floss: diapers; of the POWTS: arttibioftt~; t~aby ~F~~ dgarerte butts, condoms: cotton swabs: 9~-. herbicides' meat ds;nfecLattfs: fat: foundafion drain {sump Pump) water, fruit and vegetable peelings: gasoline; medications; ot1; painting products; pesfiddes; sanitary napkins; tampons;'and water softener brine. ABANDOP1~lItlENT taken out of service the fot[owing steps strait ~ taken to Insane that the When the POWTS falls andlor is penmanentiY artd safety a~ndoned in compliance with ch. Comm 83.33, IA/isconsin Administrative e. ~~ ~ proPeriY 1 be disconnected and the abandoned pipe openings sealed. Alf plpfng to tanks and pits she! _ . disposed of by a Septage Servicing Operator. The contents of art tanks and pits shall be removed and property . um ing, al[ tanks and pits Shan be excavated and removed or their covers removed-and tfie void space Auer p P felted with soli, grave! or another inert solid maferia(_ CONTINGENCY PI..AN aired the following measures have been, or must be taken. to Provide a code If the POWI'S (alts and cannot be r+ep compliant rep[aoernent system: O A suitable replacement-area ~ ~ t areafsho~utd be p otected Pram d stu~rbance and compalcti~onmandt should not absorp~n ~~m' The repla from existing and proposed structure, lot lines and wetls_ Failure to be infringed upon by re4uired setbacks protect the replacement area a 1t res terns must comply with the'rules Sntefi'ect at that trrn tab~sh a suitab e replacement area. Replacem ~ p A suitable replacement area is not avaijlaebdt as a last resort to rep arcethe failed POWTSng advances in POWCS ology a holding tank. may be insta n failure of the POWTS a soil and The site has not been evaluated to identify a suitable replacement area. Upo . s evaluation must be performed to locate a suitable replacement area_ If no replacement area is available a ceding tank may be installed as a last resort to replace the faller! POYYTS_ ound and st-grade soD absorption systems may be reconstructed ~n place f°ll°v+nng removal of the biomat at the in ' e surface. Recansfnrctions of such systems must comply with the rules in effect at that time. «1fflARNINW~ SEPTIC, PUMP AND OTHER TREATMENT T~KS MAY CONTAIN LETHAL GASSES AND10R INSUFFICIENT OXYGEN. UO Nt7T ENTER A SEPTIC,EPRSON FROM THE t TER10R OF A TANK MAY B YD FIR Ct1MT OR MPO S BLE. ~Y RESULT. _ RESCUE t7F A P Alaomot~tAL COMMENTS POWTS JNSTALL/ER ? Name !.~[,c ,ti./ ~ ~ ~,./ Phone ~ ~{~ ~ '-'~.~ POVYTS MAIPTT'I4INt:R Name ~u -'/ // . '/ Phone ~/~.-- Z 6 ~ L` .f! SEPTAGE SERViCtNG OPERATOR PUMPER LOCAL REGULATORY AUTHORITY Name ~ Agency ~ ,^ ~t9 1 ~- / Phone 7/J " Z- b ` ~ Phone ~/J -- ~ D ~ ~ uetfe and Waushara County Zoning and Sanitation agendes. Th1s doarment meets This document was dialled bl! the staffs of the !;teen Lake.lVtafq the minimum requirements of ctt Comm 83.22(Z)(bHtl(~~(~ and 83.56(1 }, (2} &. (3}, yyuoonsin AQmtrrtstratiYe Code- Use of this doarment doeSGMW (yor) guarantee the performance of the pQWT'S_ 1627 - SOIL EVALUATION REPORT Wtsootlsin Department of Commerce Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8%2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D. percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Please print all information. Reviewed By Personal information you provide may be used for secondary purposes {Privacy Law, 5.15.114 (1) (m)). Page 1 of 3 Steel's Soil Service, Inc. St. Croix Pending Date Property Owner Nroperry r_vrauun Lot na SW 1 /4 NW 1 /4 S 28 T Govt 30 N R 15 W . Olson, Bob Lot # Block # Subd. Name or CSM# ' s Mailing Address Property Owner CSM Pending 7 Acres 1552 Cty Rd GG na na City State Zip Code Phone Number City 'Village ', Town Nearest Road 290 New Richmond ~ WI 54017 715-246-5580 (~-` ~ ,~ Th St Use: Residential /Number of bedrooms 4 Code derived design flow rate New Construction V 600 GPD _ Replacement .,,~ Public orcommercial - Describe:na Parent material Arland,Sandstone uplands Flood plain elevation, if applicable na General comments 80ft based on contour line elevation 98.80ft elevation 99 t i . em gn, sys and recommendations: Mound des Boring # 'Boring 27 in. 1/i Pit Ground Surtace elev. 99.80 ft. Depth to limiting factor Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 PD/ft~E~ Munsell Qu. Sz. Cont Color Gr. Sz. Sh. in . 1 0-4 10yr3/2 none I 2msbk mfr cs 1vf .6 .8 2 4-27 10yr4/4 none sl 2msbk mfr gw na .6 1.0 3 27-4.8 10yr8/2 c2d 7.5yr5/6 andston residuum na na na .0 .0 ^ Boring # ~ Boring ! Pi t / Horizon Depth Dominant Coh in. Munsell 1 0-8 10yr3/1 2 8-27 10yr4/4 3 27-36 10yr4/4 Ground Surface elev. 99.80 ft. Depth to limiting factor 27 in. Soil Application Rate tence i C Boundary Roots GP DIft' Redox Description Qu. Sz. Cont Color Texture Structure Gr. Sz. Sh. ons s 'Etf#1_ _ _ "Eff#2 none I 2msbk mfr cs 1vf .6 •8 none sl 2msbk mfr cs na .6 1.0 f1d 7.5yr5/6 sicl 2msbk na _ na na .4 .6 i i ~ " Effluent #1 = BOD S> 30 <_ 220 mg/L and TSS >30 < 150 mg/L CST Name (Please Print) ,~--°°'~ignature: ~ David J. Steel _..: , . . Address Steel's Soil Servide,lac-°"'"'~ 994 200th St., Baldwin, WI 54002 `Effluent #2 =GODS < 30 mg/L and tSS <_30 mg/L CST Number 248956 Date Evaluation Conducted Telephone Number 1 /29/2005 715-684-5680 Property Owner Olson, Bob ~ Parcel ID # Pending Page 2 of 3 ^ Boring # ~ Boring ~ Pit Ground Surface elev. 95.90 ft. Depth to limiting factor 29 in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots *Eff#1 FD *Eff#2 1 0-4 10yr311 none I 2msbk mfr gw 1vf .6 .8 2 4-21 1Oyr4/4 none sl 2msbk mfr gw na .6 1.0 3 21-29 10yr4/4 none sl om mfr di na 2 .6 4 29-48 10yr8/2 c2d 7.5yr5/6 ;andston residuum na na na .0 .0 ^ Boring # -Boring ~, Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate St t Consistence Boundary Roots D Horizon Depth in. Dominant Color MurSell Redox Description Qu. Sz. Cont. Color Texture ruc ure Gr. Sz. Sh. *EfF#2 *EfH~1 Borin ^ g Boring # ' Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots *Eff#1 FD *Eff#2 Effluent #1 = BOD 5> 30 < 220 mg/Land TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. ,, , ~_, STEEL'S SOIL SERVICE INC. 3 of 3 David J. Steel CST-POWTSM Lic. #248956 :"~~ ~~ ~r y' 3 Bob Olson SWl/4,NW1/4,S28,T30N,R15W Town of Glenwood City, St Croix Co. CSM 7 Acres Pending 1" = 40' • =Benchmark Ele. 100.00 ft Top of Steel fence post • =Alt Benchmark Ele. 97.70 ft Top of Steel fence post ^ =Borings Boring Elevations B1 ° 99.80 ft B2 = 99.80 ft B3 = 95.90 ft B4 = 0.00 ft 994 200' St. Baldwin, WI 54002 Bus.(715) 684-5680 Fax.(715) 684-3449 N ~ h~o~~ 4 ~'~ ~~•~ _._._ i ~-' 1J i~~ ~~~~ ,~ `~4~9~w f ~~ ~3 ~ ~ ~~ f COUNT E1viENT . sT c~~NpNCE ACRE SEPTIC ~T,~'NK ~~ ~ ATION FORM . .. "" DyvNER~c~IP CERT~'IC / f pwner/guYer --~--- ~ /,srs ~ Mailing Address - ~ ~ ~ o? f ~~`-`~~~ traction) . ~ ~ ~ ~ ~ ent for new cons a (~ o Pro ertY Address na P1aaa~S Deps~ _ ~ ,~~ P erificarion required fm ~ ~ ~j ' ~ ~ S 9' ~ parcel Identification Number _.._----- . City/State gIpTION ycr Town of ` `" ~ LEGAL_DESC ~ ~y °~ ~ ,r3(~ N_g ~J ~(,e~ i/,, Sec. p`_---- Z,ot # r cation _.--.-- 1"' '_.-"__ 1 Prope~5' Lo ~ 1~ ~ ~ Page # Subdivision ~ Volume _~ # i Map ~ ~ ~ page # ____ ~-- Certified Survey ~ ~ J.,~~ Volume ~Ya~ a~ ~ ~ le YeS ~ no Warrant3'~eed # Lot lines identifiab Spec house [~ Y~~IIO ~urefailt1fetohaadlewastcs.Propezmaiu~a~e t m its presua what you gut into the system ,.~~~A1tiTCE rio system could resin d b a liunsed pamper. _•cr~~cTT+ M ~~ = ' ice of your seP ears or sooner, if neede o ~ System. consists of p~ g °ut the septicnt ~~ ~ ~ ~~at stage in the waste disp a ccrGfi~tlon form, s~~ b ~ ~osa~sYst~m can affect the fitaction.of the P Croix Zoning Department that (1) the on-sitewaste of slud8e. -owner agrees to submit to fit' or a licensed p~u ~ Fer verifYmg ~o s~tic tan]c ~s less thar-1/3 full The Pr°Po~' plwmber,'~~ Ply ~~oa and p~P if necessary), ~ sy~em with the standards masterpiumber, jauraeyn~, tnsPe ~~ the private sewage d~spo anon ~ m p1Op~ operating couditioa attd/ eats ~ agree to ~ of riattttal itesouzees, State of ~ °~ m" n 3D Office g'aed Svc read the above fierce and the D ~ ~ returned to the St Croix County Uwe, the the 1?tpa~~~g must be comp set forth. heresn. ~ set by S ~ J ~ - ~'- stating tb1t Your septic sys~~~~u~ r of the three y~ °xp DATE Si NA1't7RE OF AP our) laiowledge. I (We) am (arc) the owner(s) of ICAT'I N e try to the best of tnY { p,~ER CER that all statements oa this f °~deed recorded in Register of Deeds Office. ~ ~~~~ I (we) ccttifY virtue of a warranty the gropeny described above, by ~D T - cat. **,~«« egg OF APPLICANT .~, pe~llt being t~voked by the Zoning Departm IGNA v result in the sane . ~y ~o,~n~nthat is ~~~n~fltedaza. ===:*s the Register of nCe~ °ffice deed d warranty deed from ~ Teference is trade ~ the watraz1~ lieation: a stan~f ~~ certified survey nsaF ** Include with this aPP a copy ~~ 1' 7 7'9287? CERTIFIED S V RVEY MAP LOCATED IN PART OF THE SW'1 /4 OF THE NWy /4 OF SECTION 28, T30N, R15W, TOWN OF GLENWOOD, ST. CROIX COUNTY, WISCONSIN; BEING OUTLOT 7 OF CERTIFIED SURVEY MAP RECORDED IN VOLUME 19, PAGE 4940 AT THE ST. CROIX COUNTY REGISTER OF DEEDS OFFICE. NW CORNER SECTION 28 I OWNER SURVEYOR ROBERT 8~ SUZANNE OLSON EDWIN C FLANUM Z 1552 CTY RD "GG" NORTHLAND SURVEYING, INC. n°Oi g NEW RICHMOND WI 54017 P O BOX 14 VOL 19 PAGE 4972 KATALTsEA b. REGISTER OF DBEDS ST. CROIR CO. MI RECEIVED FOR ~tECORD A~!/21/2005 •2:0APN CERTIFIED SURVEY MAP REC FEfi z 13.00 COPY FEE s 3. N PAGES: 2 ROBERTS, WI 54023 LEGEND "' MMn p[~GQ44C D [~ C1Gvl DDS ---------------------- ~ ALUMINUM COUNTY SECTION N89°S2'23"E 37 8.47' x CORNER MONUMENT FOUND 3 3.00 285.4T m MASONRY NAIL FOUND 6 ~ ~ 1 5/16" O.D. IRON PIPE FOUND ~ H ~ 23/8" O.D. IRON PIPE FOUND m ~ 3/4" X 18" IRON REBAR SET WEIGHING 1.50 LBS. PER LINEAR FOOT 0 'll = PROPOSED - • • - • • • • • 100' BUILDING SETBACK LINE r^ DRIVE - - - - - 75' SETBACK FROM ORDINARY p i N HIGH WATER MARK O X X EXISTING FENCELINE ~ ~ _ L.B.O. ELEV. LOWEST BUILDING ~ i - ' OPENING ELEVATION ~ ~ 100 X O.H.W.M. - ORDINARY HIGH WATER i ~ ' ELEV. MARK ELEVATION Z i m , , J " N - SOIL TEST ~ , i~ i ° jS C ~ Z $ ~ tQ 1~1 i m ~ ~ LOT 7 1 ~ ~~ a ~ ~ ^~ ~ ' I m ' 7.00 ACRES INC. RNV ~ ~ t% ~ ~ ~ 304,920 SO. FT. ~ ~ ~ i i ~ ~ I ~ ~! 6.39 ACRES EXC. R/W j 278 FT ~ 204 SO I I ~ ~ 0° ~ ~ Q Cil V I , . ~ L.8.0. ELEV. = 1130.0 Q ~ ~ ~ 1 n Z ~ nn nn IVU I ~~ ~ X ('') J ~ 1 ~ Q p Z m / i I i~l ~ ~m / O.H.W.M. ~ m 33' 33' ~ ELEV = 1122.00 ~ m / ' ' ~ ~ v S, ~ ~ / ~~ ' m POND ` WATER ELEVATION = 1122.0 I \ DATE 1-18-05 1 5/16 O.D. IRON PIPE FOUND \ N38°15'S7'W 0.69 FEET FROM ~ E1/4 CORNER COMPUTED POSITION. \ EAST -WEST 1/4 LINE SECTION 28 3 3.00' 401.82' S89°52'23'W 4655.83' - _- S89°S2'23"W 434.82' W1/4 CORNE~ - S89°52'23"W 5290.65'- secrloN 28 Lt J1 [v]pf~Lp44C~D dIQG] oD~ SCALE IN FEET 1' = 100' THIS INSTRUMENT DRAFTED BY SAM ADAMS SHEET 1 OF 2 SHEETS 100 O 100 JOB NO. OS-01 DATE 2-08-05 Vol 19 Page 4972 ~' CERTIFIED SVRVEY MAP LOCATED IN PART OF THE SW1 /4 OF THE NW1 /4 ~~~ v OF SECTION 28, T30N, R15W, TOWN OF l ~ D~ GLENWOOD, ST. CROIX COUNTY, WISCONSIN. p~ ~ G NW CORNER / ~J sECTION 2a PREPARED FOR OWNER U D I ( ( /~ Z ROBERT & SUZANNE OLSON FRANCIS OBERMUELLER ~v ~OO 1552 CTY RD "GG" w 2919 CTY RD "G" v ~ NEW RICHMOND, WI 54017 GLENWOOD CITY, WI 54013 cNO ° m MI~]G?dLa4~C~D dLQ~]D~ SURVEYOR EDWIN C FLANUM N89°52'23"E 318.47 X NORTHLAND SURVEYING, INC. 33.00' 285.47' P.O. BOX 14 ; ROBERTS, WI 54023 6 6' LEGEND ALUMINUM COUNTY SECTION ,- CORNER MONUMENT FOUND z ~ : m MASONRY NAIL FOUND T m PROPOSED ~ 1 5/16" O.D. IRON PIPE FOUND DRIVE ~ ~ I ~ 2 3/8" O.D. IRON PIPE FOUND ~N A ~ , ~ (Q ~ 3/4" X 18"IRON REBAR SET WEIGHING ~ ~ ~ 1.50 LBS. PER LINEAR FOOT I ~ _ ~ ^ 3/4" IRON REBAR FOUND • 100' ROADWAY SETBACK LINE • I ~N 100' '•' i~ x I ~ I -- -- - 75' SETBACK FROM ORDINARY m HIGH WATER MARK O ~ ~ ~ N X X EXISTING FENCELINE ~ ~ I~ O I~ ~~ m ~~ ~ ~' i ~ t0 I~ ~ 0 ( V_ 33' _~ m ~ • O ' I o o : ~ I~ ~ o ~ LOT 1 I ~ 1~ • I~ m 7.00 ACRES INC. R/W 1 304,920 SQ. FT. ~ ~ 6.39 ACRES EXC. R/W ~ ~ ~i(~1U N 278,204 SQ .FT ~ 0° O i W ~~ ~~~ D ~ ° ~ ~~ ~~ ~ ~ _ oz / ~nn~n~ 1 ~ CaX~ ~ ~ 1vv O ~ 33' i C m T i ~ JS ~m ~ m i zz / m C7 ~m 0 i ~ ~ O ~ POND ~ • 1 m 0 1 5/16 O.D. IRON PIPE FOUND N38°15'57"W 0.69 FEET FROM ~ E1/4 CORNER a3.nn, COMPUTED POSITION. ~~, ~ry A ^^^ l^~~ ^^^ ^~ SECTION 28 Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT in accordance with Comm 85, Wis. Adm. Code 1627 Page t of 3 Steel's Soil Service, Inc. County Attach complete site plan on paper not less than 8%: x 11 inches in size. Plan must St. Croix indude, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I D percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. . . Pending Please print all information. Reviewed By Date Personal information you provide maybe used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Olson, Bob Govt. Lot nor SW 1/4 NW 1/4 S 28 T 30 N R 15 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1552 Cty Rd GG nor nor CSM Pending 7 Acres City State Zip Code Phone Number ~ City ~ Village Town Nearest Road New Richmond ~ WI 54017 715-246-5580 ~jr 290Th St ~') New Construction Use: f~ Residential / Number of bedrooms 4 Code derived design flow rate Replacement J Public or commercial - Describe:na Parent material Arland,Sandstone uplands Flood plain elevation, if applicable General comments and recommendations: Mound design, system elevation 99.80ft based on contour line elevation 98.80ft 600 GPD nor Boring # ~ Boring 1/ Pit Ground Surface elev. 99.80 ft. Depth to limiting factor 27 in. Soil Application Rate Horizon th De Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP Dfft2 p in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 `Eff#2 1 0-4 10yr3/2 none I 2msbk mfr cs 1 of .6 .8 2 4-27 10yr4/4_ none sl 2msbk mfr gw nor .6 1.0 3 27-48 10yr8/2 c2d 7.5yr5/6 andston residuum nor nor nor .0 .0 Boring # ~ Boring iV'' Pit Ground Surface elev. 99.80 ft. Depth to limiting factor 27 in• Soil Application Rate Horizon De th Dommant Color Redox Description Texture Structure Consistence Boundary Roots GP DIftZ p in. Munsell Qu. Sz. CoM. Color Gr. Sz. Sh. "Eff#1 *Eff#2 1 0-8 10yr3/1 none I 2msbk mfr cs 1vf .6 .8 2 8-27 10yr4/4 none sl 2msbk mfr cs nor .6 1.0 3 27-36 10yr4/4 f1 d 7.5yr5/6 sicl 2msbk nor nor nor .4 .6 * Effluent #1 = BODS> 30 <_ 220 mg/L and TSS >30 <_ 150 mg/L 'Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) ~ ~•"~~ T / CST Number David J. Steel __....''~ ~ i9nature: 248956 Address Steel's Soil ServiQe,.lnc--~-"°" Date Evaluation Conducted Telephone Number 994 200th St., Baldwin, WI 54002 1/29/2005 715-684-5680 '. U 2765P 172 State Bar of Wisconsin Form 1-2003 WARRANTY DEED Document Number Document Name THIS DEED, made between Francis E. Obermueller and Kathleen A. Obermueller ("Grantor," whether one or more), and Robert Olson and Suzanne Olson ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following descnbed real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): That certain "Outlot 1" in the SW 1/4 of the NW 1/4 of Section 28, T30N, R15W, Town of Glenwood, as more fully described in the Addendum attached hereto as /l¢~ f f A!i and incorporated as if fully set forth herein. Certified Survey Map Volume 19 page 4940 769654 KATHLEEN H. NALSH REGISTER OF DEEDS ST. CROIK Ci7. , NI RECEIVED FOR RECORD 03/16/2005 08:30A1I WARRANTY DEED EXEPIPT # REC FEE: 11.00 TRANS FEE: 37.50 CUPY FEE: CC FEE: PAGES: 1 Recording Area Natne and Return Address ~/~ Gt~~- C9.~Q..Q.rsN ~~ ~~ ~~ .5~~/7 Parcel Identification Number ~1M This IS NOT 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: All encumbrances of record, including without limitation, use restrictions pursuant to the Farmland Preservation Act or other similar Acts. Property is granted to Grantee "As Is" with no representations being made as to the condition or available uses thereof. Dated "' l ~ c--~ 7 ~ ~v ~ S~ ~..2A~,~ Zl/ (SEAL) r~crZl`s"y C~~~~~ (SEAL) * Francis E. Obennueller * Robert Olson * Kathleen A. Obermueller AUTHENTICATION Signature(s) Not Applicable authenticated on * Olson ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. ~~ . C2o /X COUNTY ) * Personally came before me on Nl Arc. 4. 7, Loa~t TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) ``~~~~~`~ Q ~~~ FPM . THIS INSTRUMENT DRAFTED BY: ~~ v~ ' ~'"'a.~ 2.' (Sipatnres NOTE: TNIS IS A STANDARD F WARRANTY DEED • Type name below signatures. - the above-named ,St~r,de:s fi Q bs..ru~/~i,`k+ ><,t k~., .f . (9b~.w.ue/loi, ,eo,bei><- Olson, Scc2Gn~e ~~sei. rt~t~ fo me known to be the person(s) who executed the foregoing ~}tment and acknowledged the same. * •.~d it ~ L F[,~ art Bf t ~ 1TOt~P1tblie, State of Wisconsin ~$+ mrrission (is permanent) (expires: /O ~ 7 r ° 7 ) -. >t' " ~vledged. Both are nat necessary.) 'NS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. AR OF WISCONSIN FORM NO.1-2003 Parcel #: 016-1059-80-00(~ a. ~'~ Use Value Assessment Last Changed: 10/06/2003 Class Acres Land Improve Total State Reason G4 37.000 4,300 0 4,300 NO G5 3.000 600 0 600 NO Alt. Parcel #: 28.30.15.417 016 -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): ` =Current Owner ' OBERMUELLER, FRANCIS E & KATHLEEN A FRANCIS E & KATHLEEN A OBERMUELLER 2919 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 28 T30N R15W SW NW BlocklCondo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 28-30N-15W Notes: Parcel History: Date Doc # Vol/Page Type 9(lA~ CI IMMARV Bill #: Fair Market Value: Assessed with: Valuations: Description AGRICULTURAL UNDEVELOPED Totals for 2005: General Property 40.000 4,900 0 4,900 Woodland 0.000 0 0 Totals for 2004: General Property 40.000 4,900 0 4,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code 05/31/2005 04:24 PM PAGE 1 OF 1 Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00