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HomeMy WebLinkAbout016-1059-95-100Wisconsin Department of Commerce i PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Maes, Michael Glenwood Townshi CST BM Elev: Insp. BM Elev: BM Description: (fxa ~ 1 C•rrcc~ cam' ~ct5e. X1'1 5`'"Cl,i~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic , , ^ w ~ O D~ Dosing Aeration Holding TANK SETBACK INFORMATION U TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ 5",5 i ~ ~ ~ b / ~ ~ Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number I ~ ~ ~~~ f TDH Lift ~ ' `~ Friction Loss 5 System Head ` TDH Ft g • l l 3.2 f d ' Forcemain Length ~ Dia. ~ ~~ Dist. to Well o G ~ SOIL ABSORPTION SYSTEM BEDITRENCH DIMENSIONS Width 8 ~ Length ~ ~ ~ No. OfItenG~es ~ PIT SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/ST M HING CHAMB Manufacturer: Type Of Sys eri7: p Q ( ~ r ~ ~~ ~ 7 ! D D UNIT Mo e DISTRIBUTION SYSTEM HeaderlManifold I ~~ Length~_ Dia ~ /Z Distribution ~ !~ ~ P() Length S ~ Dia ~ /1' Spacing ~ x Hole Size // ~ ~ x Hole Spacing ~ Vent to Air Intake 7~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Onlv Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed n Bed/Trench Edges Topsoil -- -- - COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ ~ / ~ ~ / U3tGL Inspection #2: G`l / !l / D3 1 V'.30f-~ -~~ Location: 1337 290th Street Glenwood City, WI 54013 (NW 1/4 SW 1/4 28 T30N R15W) NA Lot 1 Parcel No: 28.30.15.. 1.) Alt BM Description = ir>ZCS~I ha, ~ VvP~ 55"L'~~"off "52.~'~3 c 2.) Bldg sewer length = ~5 ~ ,J a ~ r/l~wwwt~,. 1~~'/ - amount of cover = (~ ~ ~ ~~/\ ~ ~ ~ ~yy~ ~j~,~~~ -Ylv~ b ~"~^'~' 2' wlari< hvl~ r-~~'S ~ e~~. ~z~~3~ fx.~) -Fo"-ro~ ~_~ s~_ _r _ _ Use otherlside for additional tnformatio~o I I' Ij ~ _ O / I~ ~ _ ' _ . ~' _ _ ~ L v 1_~~_ ~ ___ _ SBD-6710 (R.3197) Date Insepctor's Signature Cert. No. ELEVATION DATA county: St. Croix Sanitary Permit No: 430488 0 State Plan ID No: Parcel Tax No: SectionlTownlRangelMap No: 28.30.15. STATION BS HI FS ELEV. Benchmark 6, (S ~piq,f~ 1aa ,c~ Alt. BM Bldg. Sewer ~ 5,33 / d ~,~ St/Ht Inlet ~,~~ ~ ~' St/Ht Outlet Dt Inlet Dt Botto~m~ .a Hea er/Ma '~ / b ~ ~~ ! Dist. Pipe ~,o Ja~,3 Bot. System SF, 6b / aD • ~O Final Grade ~es 3~a ~ o z.3 St Cover i. 1D . 'u~ .1S 1 oQ.v ~ 5.3~ 1oS-3 /oo• is ~ lob.l5}- 3 gg o•03 lO.~, bS ~.. f' X17 n L e~- `Fo W~155 G --~ . 53 °">/d/ 6 • ! S-f IMENSIONS No. Of P' nsi a ia. Dept ~i rO, D a~~ C '_ T Safety and Buildings Division 201 W W hi Coon C ,,, ,,;, ' . as ngton Ave., P.O. Box 7162 s r j~ ~~ Madison, WI 53707 - 7162 Sanitary Permit Number (to be, led in by Co.) Qe artment at Cemmerce (bob) 266-3151 Sanitary Permit~Application State Plan I.D. Numb In accord with Comm 83.21, Wis. Adm. Code, personal information you provide 05 f 3 may be used for Secondary purposes Privacy Law, s15.04(1)(m) Project Address (if different than mailing address) ~ 3 p C~+ CC I. Apgllcatiou Inlprltlatlon -Please Print All Informatio s . i 3 ~ a9o `~ n ~~\.ri~~ V i~ Property Owner's Name ~ // r.- f'7'~G Parcel Lot # lock < ~ ~ ~ ~ ~ O r ' ry ~f ~ ~ /D I ~ ~ ~ . P operty Owuer s Mailing Address Prop ocahon 7 w tr s~_ ~ ~,~,>:~ _~.~~~ ~~~ a ~ 5~ City, State Zip Code p _ %<, %,, Section /~ / /C~I~G~oo C..f Y• .S ~lO~ 3 oZ ~jS ' Y / ~ /~ T ~ N R lJ c~ I~~ T II T e pf I3 ll li g h th l ; E f i . yp u n e . t (s at aPP y) • n-' ~#-or 2 Family Dwelling -Number of$edrootns _ ~ "' .~X- (S ~ yl!'., d(Gt/ `r/~ S ubdivision Name ~ CSM ^ PuhliclCommruraal-Describe Use ~ / y. ~ • ~,$- ~~ ~ 7oZ ^ State Owned^tlesCribeUse I`ST~ ~ 6'.S ~ ~ ^Ciry,^Village ownship of III, Type pf I'Qrlnkc (Check poly cue box online A. Complete line B if applicable) `~~ ^ New S stem y p lacement S stem i~Rep y n ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System B- ^ .Permit Renewal Q Perntit Revision ^ Change of ^ Permit Transfer ro New List Previous Permit Number and Date Lssued Before lxpiration Plumber Owner IV. a of POWTS S stem: Check all that a 1 ^ Noe Pressurized In-Ground ound? 24 in. of suitable soil r3ofound < 24 in. of suitable soil ^ At-Grade ^ single Pass Sand Filter ^ Constructed Wetland ^ Pressurized ln-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter ^ Leachin Chamber ^ Drip Line ^ Gravel-less Pipe ^ Otber (explain) V. Dis creel/Treatment Area Information: Resign Flgw (gpd) De ' Soil Applicatio to Dispersal Area Require (sf) Dispersal Atea Propos (sf) System Elevation / ~~~ r-~ ~-.-$ , v /7 g. y ~~ ~ Y tom. 5 / VI. Tank Info Gapaci Gallons Total Gallons Number of Units ,, ~ ~Qufacturer ~ `Z _ Pre b Co Crete Site Conahvcted Steel Fiber Glass plastic New Existing /~ %`~"L` O ~ Tanks Tacks Septic or Holding Wank p(- dlvl~ ~ ~O ~ 0 Aerobic Trr atuteat ITnit' / ~ ~~ 7)osing Chamber >,L lOmC7 VII. Reslipnsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number ~~~ ° r o t .r- s o ~s ~3 /l3 Z Plutber's tlddreSs ( et, Gity, State, Zip Code) VI . Cpuu /De artment Use Onl Approved ^ Disapproved Sanitary Permit Fee (ipcludes Groundwater Surchazge Fee) ¢Fj 1~ Dnatf Issued 1 suin A e i lure ps) ^ Owner Given Reason for Denial ?~ ~~rttee•• J /~!~ ~ 3 ~ IX. ColltlitipAa pf Apgrpval/Reasons for Disapproval (,~ YSTEM 01/VNEK. o / Septic tank`, effluent filter and ~m ~ 0 3•~ ; a( OZvrl~ U'JQtit~ ~ ~Z~-~- lN= 64Gr.~ l~ dispersal cell must all be serviced /maintained ~. ~~~ 2~e~a-~ra-~` ~tu`f~ h ~k ~S s~i+-. , . l~ as per management plan provided by plumber. ' ~ y 7 All setback requirements must be maintained ~a~~ ~~ ~'et,~t_~'v ~'~ -rCh~Cr1 a ' as per applicable code/ordinances~~ m. ~3•y~~ Attach complete plans (to the Caunty only) for the system on paper not les than 81/2 x 11 inches In size ~~ . i,t ~~Lta~~nt.a/ va,. 'S~ .~h. ~y// z,/o3~ ~ ~t~ r'~LGp SBD~639$ (R. O1l03)~ ~ .~,~„~.{~,..e.~ .,~~ ~-d 3 v ! r ~ ~ ~ ~ d ~ l Z ° ~ {~~~ . o • `~- th .~ d '° 9 ^ S ~'~ ~~ ~~ ~~ ~- i (`~..- ~ o ;, o ~ J N r+ .Y d ~s T O \ ~ ~ - o o l~ o ~ v 3 f a e~1 ti ~ ~ .J ~ O 3 U O ~ W 5 V~ pro ~~s =~ + / ~~ `~~. _ Y 9 ~~ ~~ ,s ~ ~~ ~ ~ ~ S~ ~-°~.~ 3 ~ .~ s n~ ~~ r IO ~ ` ~ r N .~ ~~ `d s 9 C ~~ `` (, ~ ~\~ 4 r• °' r ",~ U r s 1 1 ~~~n ~ ~ ~ `~ ~; o ~ ~-+- ~ o -~~~ ~ ~~~ a ~o~ ~ 9 s ~ - .~ N N J ,_„~, d ~~ ~ ~ ' f -I O~ ~ ~ j ~ ~ ~, A ~ --'~ ~ ~ "~ n J ~ .w H ~J a r+ T ,,,~ ~ ~~~ • j~~ ~ ~ `-6 1N J ~ y a ~~ r B o Ix~ -- ~ t ~ ~ ~ ~ ~ ~~ ' ? ~ s I ~ o ~ ? ~ , ~~, ~_ m Y~=' "~>' _ =~~Y= -~= isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi. us/sb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary September 12, 2003 CUST ID No.225094 MICHAEL P ROGERS ROGERS PLUMBING N4563 320TH ST MENOMONIE WI 54751 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/12/2005 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Francis Obermueller 2929 County Road G Town of Glenwood, 54013 St Croix County NW1/4, SW1/4, S28, T30N, R15W FOR: Description: Three Bedroom Mound System Object Type: ystem o.: 919147 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Requirements: ~OTZI I~€~1 D ARTMEI N OF SEE CORE • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.O1/O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD-10706-P (N.O1/O1). • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. The location of the lot line in question is to be verif~ied~ Tphe county shall request proof of the location prior to the issue of the sanitar~nermit. ~ (.:~t-l:~- I E'l~2 ~~63 • The existing septic tank must be inspected for structural soundness, size and baffles and must be brought into conformance with the requirements of ch. Comm 83, Wis. Adm. Code. If it does not conform, a state approved tank must be installed. ~ ~ ~ Q bra ~ C'~e-~,,Y-~ ~'3. 33 , • The existing POWTS must be properly abandoned per Comm 83.33 Wisc.Adm. Code. Identification Numbers Transaction ID No. 905183 Site ID No. 664491 Please refer to both identification numbers, above, in all correspondence with the agency. • 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 P ROGERS Page 2 9/12/03 • 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. Stat • 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: • 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left 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, o a Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@commerce. state. wi.us WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 Henry F Grote ,Certified Soil Testing ~ ~iV 1 I Construction Materials and Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: Transaction # Francis Obermueller -Mound Mound, SBD-10691-P (01 /01) Pressure Distribution, SBD-10706-P (O1/O1) Location: NW 1/4, SW 1/4, Sec. 28, T 30 N, R 15 W Town: Glenwood County: St. Croix Date: September 10, 2003 Owner: Francis Obermueller Address: 2929 CTHW G Glenwood City, WI 54013 Plumber: Mike Roger Signature: License # MP 225094 Attachments: 6748-Plan Approval Application SBD-8330 page 1: cover 2: design criteria & calculations 3: plot plan 4: system cross section 5: plan view, lateral detail 6: pump tank exit detail 7: pump curve 8: system management RECEIVED ~~ ~; ~ 2 2003 SAFETY & BLDGS DIV.~_ `~~`~~Ity ~~ F COMMERCE ~ ~~BINGS 'PONDS page 1 of 8 %'i i Design Criteria Y~ Residential Wastewater Contaminant Load: 30 mg/L < BODS < 220 mg/L Anticipated septic tank effluent 30 mglL < TSS < 150mg/L Fecal Coliform > 10,000 cfu/ 100 mL Fats, oils, grease < 30 mg/L 1 Bedrooms x 100 gal/bedroom/day x 1.5 ~~ gallons/day hydraulic load Design Calculations In situ designed loading rate °•'~ g gallons/sq. ft. per day Depth to estimated high ground water ~ 3 o in. Depth to bedrock ~ ~ b in. Cross slope at system ~ •~~ Force main length 3 g ft. of Z in. Manifold/header length `~" ft. of Z in. Drain-back ~ • ~ S~ gallons Lateral length Z @ s`F•o ft. of 1 `~ z in. Lateral elevation ~ ~~ • o ft. @ bottom of lateral ~'~ Lateral hole size ~/~b in. @ 3b:~ in. ( ~•~ ft.) Spacing ~ ~ ~ holes/lateral \ 3 g holes total \~ Lateral volume x.93 b gallons ~~ Total lateral discharge rate Rs,e g gallons/minute @ Z-~~ ft. head Network pressure compensation losses ~ • }~~ ft. Elevation difference ~• ~ ft. Friction loss ~•s"~ ft. @ ZL~ gallons/minute Total dynamic head `~ •~-ZZ ft. Pump/si~aon ~-°~ gpm @ ~ Z- ft. of head Manufacturer ~-~ .1,~0 ~.~.~ ~:~- Model # s ~~ ~= Z ~ Dose volume ~3•~ gallons Lift/sipi~on tank W ; w ~ ~ ~ - to ~ C.u M-~o L ~ gallons Septic tank ~ ~ gallons Effluent filter ~ ~ 1' ~ "~`'~ p IZ ~ ~l ~QC.~ Measurement pump on and off ~~ ~ in. Height alarm from tank bottom t ~ • o in. 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Q~~o / D ~~ 4~ ~FLE, ~-+ ~ 't" ~v h O w t l ar 2 .~ -ti - ~o2c~r M.~-..W WEATHERPRGJF I~.3ZJNCT~OH ~~ ~ ' I~ , ,~ ~~~/~; ice,;? . l,tl; _~ I i ~ ~ , _ ~- ~.-: .,, j., ~ ~ ~, 1 i~ -- - -~. Z.O.O • H C;::= ! j ~ ` . ' , - 4 c A l 1 ~ ~ J~ Crr' C 1 T I ~ „•..,~..C s. o 3 „ ~ P w•lP ~,~ Co~E-r"~ 6~oCK SEPTIC E SP EC`I•CAT101.15 __ OOSf ~ ;~~~• T~U~.S MAUUFAOTURCR: IJUMBER OF DOSCS; ~• g P~K T^-JK SIZ C : I ~~ ~ ~~ CALLOUS D05C _ VOLUME _ 1 S J tS~ ~c,i'~s IAICLU ALARM M/WUFACTURCR: DIti1G 6AGKFl.04/ ~3- g ;, ,. _. v^;: A10001. A.IUlM~CR; 1 ° ~ ~~ ``~ CAPAC : : ITIES A. Z~•`~ IUCHCS Ok 3~' Z ; SWITCH TyPC: ~Q~w. ti~~ , , ..: Z 3~'S Z g c _ - iuCHE s Cq v - PUMP MA1.IUFAGTURCR: -~ ~'"'O `"~~-+`~ C • S•~ 83"g ~ - MODCL 1JUMOCII' SI-lL'~ Zo ~,,.~UCHCS ph _ IS"o.BY y ~ V^ D~ iN~HES GR . J V ~ W I T C }i T b P f: ,_,~, ~M QJv ~..~ v w IJOTE' . PUMD A-JO ALARi~ %. R; TO EC M4UIMUP~ DISCNARG~ RATE Z~'~ G-h1 fNSTAlLEO 01,.1 S~P~R~rE C.K~_ -_ VCRTIC^L DIFFC1l[IJCt pCTWiCU PUMP pFf AAJO DIJTRIDUTIO-J PIPE,. ~•a FECT + MIUIMUM -JCTWORK SUPPLY PRELLUIIC ~"S FCCT '~c' •~-S' + 3g FEET OF PORCC MAI-J X l_ ~~ F/'po~~,FRICTIO-J F/-CTOIt. ~•~~ FECT ~ Z~~ _ Tor~L DyUAMIC HERO = 9'~g FE.Er ~l I-JTERUAL DIMEU6101Jt •0/ TA1JK~ 4.EUC,7H ~~T ;WIDTH ~-g ' 3 ~° ;LIQUID pC PT H -~ --- I .~i • L Puma Characteri~ctics -we JMera lS,lt S-ebee~ts>rlr~, A-rtenotit Atod~~ SFIEE]CA1 Hortapswor .S4 F.31 loud A~ t.0 ~110I ,,~. sl-o~ed ra. r4 ~ R.-JA. 1350 Phast @ 1 Yek lls Hate b0 kmperehr• 140`F A~-ionf NEAtA D.d~e A hso{atia Cns A Dicslar She 1-I /2' M-i ~Jie+~t? Sol-~Sds Hud'a-q 3/~' I141nn11 Urtlr Wetg11 JO Irs. Nwer Cad 16/x, 5J11Y, 20' sri. Perferml~nce Data ~ x 6 -~ ~ 3 !IIt~ IF I I a ` o ,a sa Gpa4~JS.FJ.M 1 le ~ ?~_~ 10 L.....,........._._.._~~.. .. i......._ ...__...,. WNS~m.d 0 I 1 J Tvtral Eta hvt , >< 12 16 ZO 4, OEM (Uet.l 44 36 29 13 12 0 Dimensional Data i ypq '"~ i. AEd'i~s ^gimd uw. ,.,~ I~ 1141 2. (oepo~alt dr~waow "~ a• ,n rar : In nr! nol •,-+••,~ ~. Ma+ fa txep~n'.n ptr'~s- 'yJ wJra cst~.d i I evr t 64n-nao,e ad +nipM are I ~,•~ C~eCaMROf Ipr/1~'~0~ d, Yk rwm tV ri~ln a a,ale irgbn a ou prihn and rAK Jgdimtio» ~tfloul naJt;e 11. ~. .~ ` e,' T/6 (~tl f4~~ D'•7N 1) -~ I N2w06u r y~ s'.ye I (961 h~~ r'.` 1999 H drrn}otia' Purnp~, Aehlorna, Chao. a.l! R' r: Reavcd. ~~ HYDROMATICW -raxuAuJhcr~z.dl~:da~b~~- ~ . 1810 Barep R-od A-Nand, Cho 44105 TJ;119•IB9.30d1 hz 419•YIt •AOp Web Site: wrrr.penldrpunp.rom TM' SAIES OFFICIS IN Jtll ALIJOR CI11Ef AND COUN7RIE5 ;o(.~ ~ a, ~- g~ ~ 'I -x.-• ilem w' W-ri4.8350 120A CiM ~"~ ~ ~ ~' I I I i ~ ~ I i r ~ T .. ,. Y. Materials of Construction v System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, Rogers Plumbing, 715-235-I 132, or the St. Croix County Zoning Office, 715-386-4680, should be contacted for assistance. General Proper functioning of an on-site disposal system, "septic system," is significantly dependent on the volume of water wh ich flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a pump tank or compartment to allow a dose to be accumulated, a pump and controls, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. 1 , If the septic tank is installed prior to sheet-rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2 Install water-saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly. 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. 9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. ] 0. If septic or pump tanks are no longer used, they must be properly abandoned. 1 1. If construction timing and weather could create a frozen infiltration system, weather-proofing with plastic sheeting and heavy mu Ich inU may be required to maintain a functional system at start-up. Maintenance I . The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must be back-washed into the septic tank to remove accumulated material. 4. Periodic observation pipe inspections should be made by the homeowner to examine the state of the in-situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pomp. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down-slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run-off into the system area. 1 1. Warning: Do not enter septic, pump or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, desi~nin~, and/or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 POWTS OWNER'S MANLIAI. MANAGEMENT PLAN I+r~{.~.:fl~Ii+O]121'~~.TXC}l~T t~vtu~r Permit ~ ~3ESG1'~ PAR.A.1rr,1rT`~]~S' l~iur~ber of Bedrooms 100gpdibedrown p NA NyunlaerofCommerci nits ------_NA Estimated flow (average)* v® gaUday Design flog! (peak), estimated x i.5* YS-dgaUday Sail Application IZ.ate ~ g~~y Iatluent(E$1uent Quality (NAq) Monthly Average** Fats, Qil & Grease-(FOG) ~ 30 mg/i., Bio~:hemical {~xygenDemand(BODs) Total Suspended Solids (TSS) ~ 220 mg/L <_ 2S0 m Pretreated : cent Quality p Mon verage*** $iochemical Demand: (BODs ~ < 30 mg/L Total Suspen e Fecal Colifozrurn x7c mean, 5 30 mg/L _ + 100m1 lvlaatirQ~uu E cent Particle Size 1/8 inch diameter ~'G~3steWateX~~OW Ve~l~lCat1011021 a11d GalCUlatiOnS: (Other than bedroow based) '~ * 'iialues typical for domestic (noa-commercial wastewater and septic tazzk ef~uent. * **Values typical fore pretreated wastewater. SYSTEM SPECIFICATIONS Septic Tank Capacity gal a. NA Septic Tank Manufacturer ^ NA Effluent Filter Manufacturer ^ NA Effluent Filter Model ~ m a p NA Pump Tack Capacity n gal ^ NA Pump Tank Manufacturer wi ~ !~-. p NA Pump Manufacturer ~ ~,... Q NA Pump Model Z ^ NA Pxetreatment Unit ~ A p Sand/Gravel Filter ^ Peat Filter ^ Mechanical Aeration ^ Wetland p Disinfection ^ Other: Manufacturer: Modeh Dispersal Cell(s) ^ In-ground (gravity) - res u = ed) ^ At-grade Mound ^ Drip-line r: ^ Leaching Chamber Manufacturer Model Approval Stipulation Soil Application Rate~gpd/ftz Area Req. ~ Absorption Area Credit per unit ft2 Minimum Number of Chambers p Aggregate Design F1owlLoading Rate= ~ min Materials: all materials must comply with WI Adm. Code COMM84 and be installed per manufacturers specifica#ions and approval letters. DESIGN CRITERIA Q Wisconsin Mound SailAbsorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. 1'ubiication 15.22. Q "Design of Pressure pistribution Netv~orks for Septic Tank-Soil Absorption Systems" Publications 9.6 Q `Y)esigb of Conventional Soil Absorption Trenches and Beds". RJ. Otis - ASAE Publications 5-77 and "Design Manual - C3r~site Wastewater:Treabnent andl~isposal Systems". EPA 625/1-80-012 October 1980 L7 SBD -1Q570-P' (R..Gf99) "At Cuade Component Manual Using Pressure Distribution" SBD - 30567 P (R..6l99) "In Ground Absorption Component Manual" Cf SBD -107Q~-F {N.Oi/Oi) "In Ground Soil Absorption Component Manual" Version 2.0 Q SBD -~ I062~P (N.6/9~} "Recirculating Sand Filter System Component Manual" Q SBD -=1U6~6--1' {N.b199) "Split Bed Recirculating. Sand Filter System Component Manual" iw1 SBU » 10572: P (R.6/99) "Mound Component Manual" e~SI~D. R 1.Q691 F {I~t.Olf41~ "Mound Component Manual" Version 2.0 S$D . I05~~--F {R.S/H4) "Single Pass Sand Filter Component Manual" Q SHD -1065? : P (8,6/99) "Drip-line Effluent Disposal Component Manual" Q SBD. ~ 10573.. F (R 6/99) "Pressure Distribution Component Manual" D SBD '-10'7Q6-P (N.QiIQI) "Pressure Distribution Component Manual" Version 2.0 ^ ]drip-line luentDispersal Component Manual for Multi flo Onsite Wastewater Treatment Units ~. MA.YI~tTENANCE MONITORING SCHEDULE Service Eveat Service Frequency Inspect coztditon of tank(s) At least once every p months year(s) (Maximum 3 yrs.) Pump nut contents of tank(s) When comibined sludge and scum equals one-third (1/3) of tank volume At least once every D months 3 year(s) (Maximum 3 yrs.} Clean: effluent filter ~ At least once every ^ months 3 [~' year(s) ump controls & alarm At least once every ^ months 3 1~' year(s) ^ NA Mush laterals and pressure test At least once every ^ months 3 ~ Year(s) ^ NA Valves At least~once every p months ^ year(s) NA ether. At Ieast once every ^ months '^ Year(s) ~ NA Page of it.e~l~'P i71? kor new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that m.~.ty impede the treatxneni process andlor damage-the dispersal cell(s). If high concentrations are detected have the contents of the taxyk{s) removed by a seepage servicing operator prior to use. ' System start up shall not occur when soil conditions are frozen at the infiltrative surface. O~'1~;it2ATY(dS~i The property owner is responsible for the alteration and maintenance of the POWTS and submission of required reports. Tlie quanrity axd quality of the. wastewater stream will affect_tbe performance and longevity of your POWTS. The installation ofwater-saving appliances and fixtures along yKith prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does rant include laundry waste, showers, dishwater, etc. 'I'bis system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetablelfruit peels and seeds, bones, and food sorts such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should lie discharged into the system, Other non-biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiptics, solvents, etc,, should not be flushed into the system as they can seriously damage your POWTS uud coutatninate your drinking water supply. Iif%asntaiu a regular steady flaw by spreading lau-rdry washing throughout the week. Avoid vehicle traffic over all system componens. Compaction of scow over the dispersal unit may cause it to freeze up. ^ Valves Valves shall be. operated in the following manner: rsus Alarui.s should be. tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service Pt3WT~, There is norna~allyi a 1 day reserve under regular operating conditions, however water should be conserved until any ptobletns:vvithtbe system ate corrected to prevent hack up of sewage into the dwelling or surfacing. rrrPl~cTxolvs Inspecpiwn shall be na~de by an individual carrying one of the following licenses or certifications: Master Plumber, Master Pllttmunber i~,estricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). .Tanks-Component Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks or.leal~, measure the valums of combined sludge and scum and to check for any backup or parading of effluent to the ground surface. Access apenjngs used for service or assessment shall be sealed andlor locked upon completion of service. Any _ defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locddu~ device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one-third (1/3) or more of the tank volume, the entire contents of the #anltr shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR113, Wisconsin Administrative Code. Tire. outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specification's. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more frequent intmvals thap stated in the maintenance schedule to keep the system operating. c~CFutz-P GttaxnlierfTreatznent Tanks Component 1fie inspection must include a test of aA electrical equipment such as pumps, alattns and floats. A visual check must be made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of the filter. Any service needs or repairs shall be promptly taken care of. C.l Iu:.Graund Gravity Component Dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority, Pt~nding at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. Page of y- ~ ~nd, At Grade, In-Grouted pressure The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidettce:of surface seepage or discharge. Any dischazge to the ground surface must be promptly reported to the xegulatory authority. Ponding 8reateY' than ?5 /o of the height of the component may indicate overloading or impending hydraulic failure necessitatingmore frequent monitoring. The pressure distribution. system is provided with an opening at the end of each lateral to be used for flushing. The laterals shouldbe flushed at least once every three (3}years. Pressure checks of systems with multiple-laterals should be done to ensure:that equal distxa'bution of effluent is occurring to promote the longevity of the system. RI?,I'Oft.TS Reports for maintenance, inspection, and moni#oring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Coda. ~i]fiANDOI~IMENT When the POWTS fans and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Cade. - All piping to tartks and-pits shall be disconnected and the abandoned pipe openings sealed. - The contents of all. tenets and pits shall be removed and properly disposed of by a Septage Servicing Operator. - Aft' ptuttPing, all tant~s.and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel.or +other inert solid material. ~COI~ITINGENCX kLAN It the Pt~'S fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system:. Q A suitable: replacetnent:area has been evaluated and may be utilized for the location of a replacement soil absorption system. The xeplaceaweut area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement azea will result in the need for a.nevr sail fxoan existing and proposed structure, lot lines and wells. Failure to protect the replacement azea will result is the:-weed for a new sail and site evaluation to establish a suitable replacement area. Replacement systems must Gomply with the rules in effect at that time. Q A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a ho>*Clipg taul~ way be installed as a last resort uj replace the failed POWTS. D The site ias not been evaluated to identify a suitable replacement azea. Upon failure of the POWTS a soil and site evaluation mnst ire performed: to egrets a suitable replacement area. If no replacement area is available a holding tank may be installed as a fast xesart to replace the failed POWTS. uttd and at gxade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface: of such systems must comply with the rules in effect at that time. «~rA~Ri~NG?> ~ ' S EI'TI+~, P~7Nl.F AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND/OR INSUFFICIENT OX1rtGF.~i ii?Q NOT: ENTER ~ SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DIEAT$ MA.I''RESI.JLT: RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR I1viPt1S A3313ITII!aNAL'COiNTS ]~C1WTS I[i~iSTALEER Atatne Phone . .raEPTAGGTt~°SER`[~CING OPERATOR (Pum er) Name Phone K\WP]~AUTAt~18UWTS QWNER'S MANUAL.doc POWTS MAINTAINER __ ame ' Phone LOCAL REGULATORY AUTHORITY Agency Phone Page of Y''ri~a#e t}n-Si#e'UYastev~ater Treatxnea.t System (PQWTS} ~ixdex and 'title Sheet 1~rn,~ect N~ S~stem.Type: ~ =~u~ t{~ i=,c~u%ti~n: o'~ 907 9~.~G~ S~x~~t Add~~ss Sw ~~~ T 30,,~1~~- ~~ Descmgti~n ~ / '~c~~x>,p~Cc~uuty Cort~x~: `: ~ag~ 1: ~, l'a~e ~: Page 3: ~ ~~~~ 4: __~ P~,~e 5: GC/i2.t. ~ ~ ~~ .Page fi: ~~Si'1~ gage 8: Page ~: ~a..s~- ~~~~SX~- -.~~~~~ Signe ~ 9 .~redei~~Iux~~x:~ ~ ©~'~ Date: 5~'~ ,Q? f o~ LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 ~/~~~_ REAL ESTATE TOWN OF GLENWOOD .--' /hQ~~' ^" COMPUTER NUMBER 016-1059-95-000 Parcel Number 28.30.15.419 ~4 OWNER NAME: First FRANCIS E & KATHLEEN A Last OBERMUELLER ~~~c,~' ~~ PROPERTY ADDRESS: Hse # 1/2 PD --Street Name-- Type SD Apartment 2919 CTY RD G SECTION 28 TOWN 30N RANGE 15W'/.160 '/<40 Line Description Line Description TOTAL ACREAGE 40.000 PLAT LOT BLK 01 SEC 28 T30N R15W NW SW 15 02 16 03 17 04 18 05 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1-General, F4-Prev. Parcel, F5-Next Parcel, F7-Valuations, F8-History, F10-Exit F"~ ~ R d .~ '~ G t3; * G,f xx~~0 .fi, o t e~ (' 1 ~, t . t ,,~ '~'' - P ~'' ~, r, ~ ~ s- ~ *-- ,r- o v aG ~ ~ ~. ~~ ~ ~ .w ~- s ~~ i. r, ,+ i ~ ~ E ~ .N ~ ~ ~ ( f ~~ ~~ ~ ~ G .'~ 's ~ ~ ~ ~ ~~ ~ ~` 5'~'1~` . ^N ~ ~ ~ P o~ s P 3 P g ~~ p ~I ~ ~ 3 ~~ F ~ ~ b ~ ~ ,t ' ~ ~ ~ `3 r~C7J N~ ~ -- - 0 _ - .. ~- 1 .. ' ~..~... ~ ~ J a ~ , .. ~ o ~ ~ ` r. o f ~ s x ~' vi ~ ,. ~~, ---~ z l~ ~ ~ ~- f F "'' ~ t~ _ 9. _ .. ~ L~ f ~ ~ t -~ ~ - ~ ' _ ' ' ~ !'~ . ~. ,~, ~ , _. j'{ ~ o _' ~ ' c + . ' ?. ~ f . ~ ~~~~ ~~r o ,i ~ ~"7 S _ ~ . ~ ~~ ~ F ~ ~ t Fd' ~. ~, , ~RIG~I~AL; w ~ ~ Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings ;n ~ecnrrhnno with Rnmm A5 Wis Adm. Cnde 1;60 Page 1 _of__3 _ Certified Soil Testing County Attach complete site plan on paper not less than 8'/z x 11 inch Ian must ' St. CroiX _ _____ _ include, but not limited to: vertical and horizontal reference po t (BM), Parcel I D percent slope, scale or dimemsions, north arrow, and locatio and dist r f D . . - 3 a C Pending Please print all informati Rev' wed B Date Personal information you provide may be used for secondary pur ses (PriVYt~.~v, s25.0d (1 m)). ~ ~ '~ Q Property Owner S C Prope y catio ~0/ Obermueller, Francis z GdND NW 1/4 SW 1/4 S 28 T 30 t`) R l~ 1,N Property Owner's Mailing Addre~ t~bCE Blo k # Subd. Name or CSM# 2929 CTHW G _________ City State Zip Code Phone Number ~~ City j Village ~/'I Town Nearest Road Glenwood City ~ WI 54013 715-265-4412 Glenwood ~ 1337 290Th St. _ _; New Construction Use: V Residential /Number of bedrooms 3 Code derived design flow rate, 4~0 _ GPD / Replacement Public or commercial -Describe: ___ ________ ___ Parent material l oess over till Flood plain elevation, if applicable ___ NA _ General comments and recommendations: install 8' x 57' rock cell mound on 100.0 co ntour as upslope edge of rock w/ 0.5' sand fill Boring # Boring 10 34 Pit Ground Surface elev. 0.9 ft. pepth to limiting factor in• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary ~ Roots GPDIft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. _ 'Eff#1 'Eff#2 1 0-9 7.5YR 312 - sl 2 m sbk mvfr cs 1 f/m 5 ` 1 9 - - -- -- - ----- ------ -- -- - 2 9-19 10YR 4/4 - sl 2 m abk mvfr gw 1f 5 ~ 9 3 19-34 10YR 5/ - Is 1 m sbk mvfr cs 1 m ~7 12 4 34-63 10YR 5/8 f2d 7.~YR 4/6 1 OYR 6/2 Is 1 m sbk mvfr - ~ - 7 r 1.2 horizon 4 is near field capacity w/ perched groundwater observed @ 63" ^ Boring # __ Boring /' Pit Ground Surface elev. 100.0 ft. Depth to limiting factor 34 in. Soil Application Rate Horizon Depth Dominant Cclcr 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 7.5YR 3/2 - sil 2 f sbk mvfr cs 1flm 5 8 2 4-20 10YR 4/3 - sil 3 m sbk mvfr cs ~ 1 m 5 .8 3 20-34 10YR 5/8 - Is 1 m sbk mvfr cs 1 m 7 i 1.2 ___ __ 4 34-37 10YR 5/8 f2p 10YR 6/2 Is 1 m sbk mvfr cs ', - _ 7 ~ r 1.2 5 37-48 10YR 5/8 cap 10YR 6/Z Is 0 sg ml - ! - 7 I 1.2 _.__ -- 1---- _ horizon 4 is near field capacity w/ side seep observed @ 37"; horizon 5 has some inclusions scl w/ occasional gr ' Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L CST Name (Please Print) Signat e: Henry F. Grote Address Certified Soil Testing E. 4366 353rd Ave., Menomonie, WI 54751 ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mgC. CST Number 4 222774 Conducted Telephone Number 5/19/2003 715-233-0398 ~~ Property Owner Obermueller, Francis Parcel ID # ^' 3 a CSM Pending Page 2 _of__3 __ Boring # ~ Boring /~ Pit Ground Surface elev. 97.4 ft. Depth to limiting factor 30 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots SPD1fL_ __ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 1 0-6 ~ 7.5YR 3/1 - sil 2 m gr mvfr cs 1f/m .5 _8 2 6-30 10YR 4/3 - sil 2 m sbk mvfr cw - 1 m ~, ----i .5 - --- .8 --- - 3 30-38 10YR 5/8 f2d 10YR 6/2 scl 1 m sbk - mfr cs t 1 m .2 .3 --- 4 38-53~ 10YR 5/8 c2p 1 OYR 6/2 scl 0 m mfr- ~ 0 0 I { -- ---- - I -- ~ -i - --- - li Boring # -- Boring ^ ;pit Ground Surface elev. _ ft. Depth to limiting factor in. Soil Application Rate Horizon Depth ', Dominant Color Redox Description Texture Structure Consistence Boundary Roots _~aP~'f1' _ __ in. Munsell Du. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 it i - ~ - I ---- -~--- - - I ' l - ~ -- - --- - -- --- --_ - ; i I i 1- li -~-- - -- Boring # Boring _ Pit Ground Surface elev.. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots _ _SzPQ/Q' _ __ in. ' Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 *Eff#2 --,I-- -------- --------T------ T- - - - -- - - ---- --~--- - - -- ---------- ------- - - i - i ~- - - ~--- --- - -- --- -, ---- ~ -- --- ------- _ _ ~- _ i i~_ - L. -- -- `Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 = BODS < 30 mglL 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. SBD-Bi30 (R.07/00) Certified foil Testing i, ._ 3 0 e v ! s+ .,t .,. .~} t ~ z ° ~ V" ~ ~_~~ o a ~ 1~-- M d _A~ r' ~,,,. ..!^ 9 1 C~ t 3 ~~ V r_ J t a y 1-~- J z ~----- ~, ~,~ ~; a l~~ ,. .Y d `~ T n ~(, l ,i ~ h _ ~ _.. ~` .~ `V ~ ~ .~ a ` ~ o ,' J S 6 ^ ~~'. Q 3, c p ,~- ~i- .}~/~ &' ~~ 4 0 6 ~ ~~ ~~ \ f~ ~ ~fi ` P ~ ~~ \ ~t 6 ~ -. ~d ~g4 b .~ I ~ M d ~ ~AA / ~1 0 ~ ~ N ~ yy ~~ •` 3 r. ~ ~ ~~ S L~ o ~ s .-C `~ ~i ~~' ~} ~.~ i ~( ~~ ~- r ~ ~~ f ~ ~ 7 ~~ ~ ~ ~ ~ ~ ~ ~ > l ' q ° -:lr -°; ~ -~' ~ d '"' ~~~~~ ~~ ~ ' Np ~ N i f ~ (°~ ~~ ~ .1 J r 1 ~~J00 (.~ U ,1"' ~Sg G N s PaA- ~N 88€z~ r ~ 'i 3 ~~ - m~ --~ f~~Rj' m~~s ~vOC~ J ccc_ _ >~Pa~ > r~.n TTY FROM ROGERS PLUMBING 4wnerBuyer FAX NO. : 715 235 0867 Apr. 26 1998 ST CROZ7~C COUN'T'Y ' SEPTIC TANK MAINTENANCE AGREEMENT' AND OWNBRSI~iIP CEkTIF1CATION FORM Mailing Address Property Address (Verification required from ~- ~ Cc .~ -m a ~ S ~ ~~ n ~~~~ cam, . ~.~, s ~ __ .S-T ~ ~..f' .-n t„7 c~ n d ` 1 ~ ! `.'v ~ . ~ fl0 /. J Department for new corastructiop) City/State ~%' ~ ~' n ~ . `1 ~ Paroel Identific;~tion Number '- ~ ~ ~ ~' LEGAT. YJESCRIP~'ION Property LocatiorN ~ ~'/,, ~ ~., Sec, ~~ T 3 ~ N-It~W, Town of ~ ~ t;J O o . I.ot # ~ 3A.e~,1 Subdi~rision - Certified Survey 1Viap # ~ ~ ~' ~ ~ 1 _ Vohu11e .T ~ ~ .,Page # ~ ~ ~ s Warranty Decd # /~ y ~ ~ ~ .Volume 2 ~ ~' ~ --. Page # 3 Z 1 Spec hottso D yes l~ no I,ot Iines identifiable [yes G7 no SYSTEM MAINTEIN',ANCE Improper ttsc and maintenance of your septic systeta could result fn its ptetnature faIIure to handle wastes. Propar 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 tan affect the function of the septic mdc as a treatment stage in the waste disposal system, The proporry owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner sad by a tuast~esplua-ber, jouttuymanpltuabec, t+estric>icdplutnber or a lieeasedpttmper vetityiag that (1) the Qn-site aaatewatetd~isposal system l3 in proper OpClat7ttg CanditiOn and/Ql' (.Z) ditCr t[1SpCCtIOA dtld pt]it]p~ (!f aCCCSSAry), the septic, teak is less thaw i13 ru11 of sludge. Ilgre, t~ aodetsiSned have read the above requireaiwts and agree to maintain the private. sewage disposal sysum with the oeandards act forth, herein, as set by ~e Department of Cotttmerce and the Department of Natural Resources. State of Wisconsin. Certihcatior- stating that your septio system bas been maintained must be completed and roturned to the St. Croix County 7.oning Office within 30 days of the three year cpintion date. X f QJ ~ ~ ~l (7 3 SIGNATURE O>A API'I.ICANC DA'I'Ts O`~VNER CERTIFI A~: TION I (we) certify that all~atatetrums on this form are true ro tun best of my (our) knowledge. I (wa) ant (are) the owner(s) of p perry descnbed above, by virtue of a warranty deed reoorded in Register of Deeds Ofyicc. ~`~~~~ ~' ~I ~~, ~~ SIGNATURE OF AFPLIC,AN'f DATE •++•*" A.ay itifotmatioa that is mis-roproscnted may result is rho sanitary permit being nvokad by the Zoning Dapatuwent. ""'"' •' Include with this appticatiott: a atampad warranty deed flrom the Register of Dccds office a copy of the certified survey map if reference is made in the warranty decd 'J 2321P 329 STATE BAR OF WISCONSIN FORM 2- 2000 ~cumentNumber _ ~ WARRANTY DEED THIS DEED, made between Francis E. Obermueller and Kathleen A. Obermueller, husband and wife, Grantor, and Michael E. Maes, a single person, Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin: Lot 1 of Certified Survey Ma recorded in Volume 17 Pa e f ertt a Survey aps as ocument No. 716729 located in part of the NW '/. of the SW '/. of Section 28, Township 30 North, Range 15 West, Town of Glenwood, St. Croix County, Wisconsin. Recording Area 73Qa987 KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CO., fiI RECEIVED FOR RECORD 07/21/2003 08:00AM MARRANTY DEED l:XE1~T REC FEE : 1l . 00 TRANS FEE: 352.50 COPY FEE: CC FEE: PAGES: i Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. Metro Legal Services EDIRET 391584 A 276462 WD 203401 Dated this 12th day of June, 2003. /~ Q Tur/1 G ; /~~e ~~~ L. e~qA ~ 016-1059-95-000 Parcel Identification Ntttttber (PIN) This is not homestead property. ~~ * Francis E. Obermueller * Kathleen A. Obermueller btu-- . AUTHENTICATION Grg Qv~ OAS` ACKNOWLEDGMENT '~-- ww,, G Signature(s) N~'`a ~v~'~SSTATE OF WISCONSIN ) ~ ST. CROIX COUNTY. ) ss. authenticated this 12th day of June, 2003 TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) THIS MSTRUMENT WAS D12AFI'ED BY Edina Realty Title -Doug Berg 400 South Second Street # 11 S, Hudson, WI 54016 (Signatures may be authenticated or acknowledged. Both are not necessary.) 'Names of persons signing in eny rapacity must be typed or printed below their signature Personally came before me this June 12, 2003 the above named Francis E. Obermueller and Kathleen A. Obermueller, husband and wife to me known to be the person(s) who executed th ~~ornegoing instrument and acknowledged the same. ~~ ~ ~~ *Cheri Brown Notary Public, State of Wisconsin My commission is permanent. (If not, state expiration date: 3/11/2007 ) WARRANTY DEED STATE SAR OF WISCONSIN FORM No.2-2000 7 1 6 7 2 9 ~~ m ~O O~ zz rom ~~ ~~ w rn S z c v, o m o = C Z ~'Z m m! O O i~~ ~~ m W_'S ~, ~N n~~ D;mA~ r. O ° ~Q „W ~; ~~ nl~m ~; ~o O~ ~~ ZoAm m'N i w o'O N i f~ ~~Z w ov o .. IW ,; WO ~~ I ;_ m~ ~,N O N m F BEARINGS ARE REFERENCED TO THE - -WEST LINE OFTHE SW1/4 OF SECTION 28, ASSUMED TO BEAR S00°25'34"W. VOL ~ ~ PAGE 4495 KATRGEEK H. M~CL~A- REGISTER OF DEEDS ST. CROIR CO. , WI RECEIVED FOR RECORD 04!10!2003 01:00PK CERTIFIED SURVEY KAP REC FEE : 13.00 COPY FEE: 3.00 PAGES: 2 , UNPLATt'ED L,AiVDS_OWNED_BY_OTHERS WEST DINE OFTHE SW1/4 290TH STREET - - - -'" SOO°25'34"W 981.94' _ -w w 444.59' w ' ~ ° .-g S00 2 34 5 o v ~~o `~ ~v . ....................... ..... -,p....................... • v c Q O ~ V ~ 02\~O v - 1 ' - - ~ ~ o (31 V O V ~ T ~_ o i ~ V N _ W Q +'_ g . 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