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HomeMy WebLinkAbout016-1062-60-000 I Y •/* Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count y St. Croix INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary0 Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: E] City E] Vill e F] To of: State Plan ID No.: Kromschroeder, Jason Menwoo'S CST BM Elev.:- Insp. BM Elev.: BM Description: Parcel Tax No.: 100 / pD ', _ 016 - 1062 -60 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. l000 Benchmark ,� �( /Do /off Dosing Alt. BM o w.. (,� ��� r fy.� oc7 Aeration Bldg. Sewer Vt Holding St /Ht Inlet 13.d 8 Z S TANK SETBACK INFORMATION S(>/ Ht Outlet S�3 TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic oo - I�p' (`�' NA Dt Bottom ��• �3• SS Dosing q NA Header / Man. Aeration NA Dist. Pipe 7•rfs� S 3.2 Holding Bot. System $• 1 5 -' c/a LIMP /SIPHON INFORMATION 0 ,,, y..- r R O( Final Grade Manufacturer a ( /, / <-, Demand St cover �, .,�L j Model Number N C_: f' 7R GPM TDH Lift1j,0� Friction Systems S TDH13cj Ft Forcemain Lengt5.a Dia. H • �" Dist. To Well SOIL ABSORPTION SYSTEM `a BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liqu epth DIMENSIONS �J DIMENSION SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufactur SETBACK INFORMATION Type Of � CHAMBER el Number: System oD Sid � /5� N /1- OR UNIT DISTRIBUTION SYSTEM A (Da Header / Mani oid Distribution Pipes) x Hole Size x Hole Spacing Vent To Air Intake Length � Dia. Length � Dia. 2 I Spacing � ; 1I, -`� 3 6' 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 discrepancies, persons present, etc.) Inspection #1• Location: 1309 280th Street, Glenwood City, WI 54013 (SW 1/4 SW 1/4 29 T30N R15W) - 293015436 -7 .5 1.) Alt BM Description= t o / F s F_ P f : (. 4ct,,., K w.u» k. ( .ems 9 .6 2.) Bldg sewer length = 1 SCE 5k ,lt�lc..h 61-'f —70 tao w► L w4.t 4,7 C - amount of cpver 3.) contour= , S 'l� rK S�itt("O�Q(� GICj /� C{. ��1�r /t �• Pla evlsion required? ❑ Yes � Noy Use other side for additional information. /v Zo C SBD -6710 (R.3/97) Date Inspector's ignature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ¢ f-4 50 F i . i 9 @ 3 E � l i ire I - t L z J A Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.2 1, Wis. Adm. Code 201 W. Washington Ave. " See reverse side for instructions for completing this application PO Box 7302 COINS Personal ersonal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of Cammerce Submit completed form to county [Privacy Law, s. 15.04(1)(m)] ( P if not state owned. Attach complete plans (to the county copy only) for the system, on p2 er rLoLjqs§ than 8 -1/2 x 11 inches in size. State Sanitar P ber ❑ Check if revision t `` 4s plicph� State Plan I. D. Number K (.� V i _. I. Application Information - Please Print all Information I;o tion: Property Owner ame �a r�r Location r�Q _ So i� hoa D atsal l Q; et I , �i(� X _4) 1/4, S; T� >N> W9 (or Property Owner's Mailing Address 20 Lot er Block Number gtol)( C State Zip Code Phon ^ er 'ry S VS&Viiion Name or CSM Number II. Type of Building: c eek one) it L or 2 Family Dwelling - No. of Bedrooms: 1 a ] ! 1 ` t', ' 16 Village • Public /Commercial A describe use):- r�ekr� },�� - - -- *Town of ( ) -a Ip d Co �.. • State -Owned y II, , �teu tooc Neare t D � _ d- ' - ?eo"" 1 Paz 1x ) v III. Type of Permit: Check only one box on line A. Check box on line B if applicable) 3 A) 1. ew 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System $) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) ❑ Non - pressurized In- ground 4<ound ❑Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At-grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Informa ._4G , l0G r/ Q t O U 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. Sy 6e le 7. Final Grade va n Re6 ired Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) , Elevation t LIDO 15 VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks at &'Oo t7 .>} tar ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, theyndersigned, assume responsibility fo install ion I AfA POWTS shown on the attached plans. Plu s Name (prin;0 Plum a Si n ps): MP RS No. I Business Phone Number v L /�z 31� S r z� Plumber's Address (Street, City, State, 7,i C (te) IX. County /Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) pproved ❑ Owner Given Initial Adverse Surcharge Fee) j j o 7 �—�( Determination /va X. Conditions of Approval /Reasons for Disapproval: AGj • QQS . 1i:� S X S a •I b tJl,- e, lO e, e e �Lct/� e e12 pwxaA („� �aan.d�„ : OCttis �Lo - klk l A — 2«n c�. % �' �� o cc�F w�� �� Qw( s� � wcy drvrw_ u_-`� - W o..L( t �. C✓b�,� iNc- K 6398 R07 /00 o,,.ers7 �1 Ptf �f �oK ✓sr w /Jasat� uvt VJ0 be / vse�(.�af Parsnn4l`U j n.G r3u/ri./.l. � r' < -/ � - {i�, �,.,,.. iil`f�tr � �St��`/ws � t� /(.r.t «.� , > � DC� Safety and Buildings 4003 N KINNEY COULEE RD LACROSSE WI 54601 -1831 TDD #: (608) 264 -8777 Vi www.commercestate.wi.us Department of Commerce Tommy G Thompson, Governor Brenda J. Blanchard, Secretary October 07, 2000 CUST ID No.139462 ATIN. POWTS INSPECTOR ZONING OFFICE TODD L SINZ ST CROIX COUNTY SPIA E5609 708TH AVE 1101 CARMICHAEL RD MENOMONIE WI 54751 -5520 HUDSON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/07/2002 Identification Numbers Transaction ID No. 438195 Site ID No. 199639 SITE: Please refer to both identification numbers, Site ID: 199639, Jason Kronschroder above, in all correspondence with the agency. St. Croix County, Town of Glenwood SWIA, SW1 /4, S29, T30N, R15W FOR: Description: Two Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 764072 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. 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 Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10572 -P (R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10573 -P (R.6/99). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • An 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. • 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. 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. TODD L SINZ Page 2 10/7/00 i Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, DATE RECEIVED 09/20/2000 --1 FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 Gerard M. Swim BALANCE DUE $ 0.00 POWTS Plan Reviewer- Integrated Services (608)-789-7892, Mon. to Fri. 7:15 AM to 4:00 PM jswim@commerce.state.wi.us WSMART code: 7633 • Y Jason Kromschroder - Mound Transaction # F F� or 0 Location: SW 1/4, SW 1/4, Sec. 29, T 30 N, R 15 W Town: Glenwood O �lj County: St. Croix Date: September 13, 2000 Owner: Jason Kromschroder Address: 9406 Inve Grove Trail Inver Gr e Heights, MN 55076 Plumber: Tod nz Signature: License # MP 139462 Attachments: 6748 -Plan Review Application SBD 8330 page 1: cover P. O.W .-T.S. ' �io u�dy 2: design criteria & calculations con 3: plot plan ) ON [,. [I 4 A? F R : system cross section EpgR "MFNT OF GUNNER D gUiLDl1 5: plan view, lateral detail � ss FE DIV15iDN 6: pump tank exit detail 7: pump curve CGRR SP DENCE 8: system management StE page 1 of 8 Design Criteria T Residential Wastewater Contaminant Load: 30 mg/L < BOD < 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L Fecal Coliform > 10,000 cfu/100 mL Treated Residential Wastewater Contaminant Load: 30 mg/L < BOD Septic tank + "highly treated" effluent 30 mg/L < TSS Fecal Coliform < 10,000 cfu/100 mL Bedrooms x 100 gal/bedroom/day x 1.5 l o-o gallons /day hydraulic load 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 most current, pertinent Component Manual(s). MouNO SBD- ko S V7 - 1 SBD- \'O t; 1-3 - n Design Calculations In situ designed loading rate O. Z j gallons /sq. ft. per day Depth to estimated high ground water - 11, ? 6 in. Depth to bedrock > S in. Cross slope at system 2 - Force main length 3 ft. of Z in. Manifold/header length 2 - ft. of Z in. Drain -back ` gallons Lateral length 21 @ 2 ft. of Z in. Lateral elevation 9 3 ft. @ bottom of lateral Lateral hole size 3 / 1 b in. in. ( 1 -1 0 ft.) Spacing Z,:� holes /lateral holes total Lateral volume gallons i Total lateral discharge rate 39 gallons /minute @ ft. head Elevation difference � ft. Friction loss Z• e ft. @ gallons /minute Total dynamic head ft. Pump /si*n 1�_o gpm @ ft. of head Manufacturer Model # S Dose volume gallons Lift/sip' on tank �'� K � V gallons Septic tank gallons Effluent filter Measurement pump on and off in. Height alarm from tank bottom 2 - in. Reserve capacity - S 64 t {" gallons specs.calcs Page of a .� �1101�rwbb.� ♦ Fkµ�.,6,b�, w 4 0. . , -� M eA, ♦ 3 90 � � !.t sd �„ jsu.► �I I .30 f 410 Ax �• t �l �..� Of0. , 11 1 � g 1 w E5•s `� �. � � c ti� 1 urn • �. cn7 t CA .... a�, :(d:f A � ProPastd oaa��o�� a /1'W'F •� �di � %r1 KLAN /'��1, CL 3 0 S Sy` %a,^ c S 4L ; o%0 % 0. M! R� t (Pal �, i l O w ,► t ?s'� AA , z w� � (.� 1.5 c.13 3 + lop o... i.,. I Z . e �L2.Y y2 r ,�►z. s ► �. s • N � ' l N o�6 a � M TQJr w.'. no Y� ��� vw w aJ�rxS O M.C�c r0C-� I (( � }� V w�vt �• xtC Gr• \n.:ver,�aw't � >JJ L d " ,� WEATHERPROOF LOCKIwG COVER .JUNCTION QUICK Olacad��GT --1 as 4'?F'" .1.. 4'I , J7�i 7Ti/7 4m GIP6 3' no ND16TuRBED � G So1L. 24`' %m. �� 4 V 0 M4NNOiE k lo /.Mts r I H L q" P'- L pWROVt.O A _ Z4,`b s...k S"T IzM'J oKro ^� WFLES 11 4o L. PIM q 1 AL 3' .►SECTI w/ o" � Q (-A V.� rj RDIJmo Ziv ; h O OtF Pu�IP 40A . ��"• 6coCK SEPTIC f _ R SPECIFI'CATIOIJS ck DOSE -S- � 7 Z .S� TAWr.S MALIUFACTUCR: IJUMBER OF DOSES: PEK DAy TAWK SIZE: �� V� GALLOWS DOSE VOLUME S c1 t } � o� }v IAICLUOING 5ACKFLOW: ALARM /'IMIUFACTUfICR: GALLONS MODEL WUK6'EK: \ ° 1 �'� ``� CAPACITIES; A= Z WCNES OK '� .S/ GALLOws SWITCH TYPE:``` " \4 ' Z 2R.9 nn e = �uc►+ES OR GALLO�,s PUMP h1AWLIFACTURER: �"�b`` iw'�" C a I 'Z IQLH OR \3� GALLOU5 MODEL IJUMBER: S vk e r- a-o � qgq 4, 0� I►J�HES OR CALLOW. SWITCH TZjPE: .11 MOTE: PUMP AWD ALARM ARE TO BE MIWIMUM DISCHARGE RATE-:2 GPM INSTALLED OW SEPARATE CIKCUiTj VERTICAL DIFFERENCE OETWEEIJ PUMP OFF AUO OISTRIDUTION PIPE.. ?T FEET + MIWIMUM KIETWORK SUPPLY PRESSURE ✓ . . . . . . . 3.1 FEET + X13 FEET OF FORCE MAIN X Z '��" Fi,00FtFKICTIOU FACTOR. FEET TOTAL DyWAMIC. HEAD = FEET Q IMTERAIAL DIMLWSIOWS OF TAWK: LEAIfsTH \�—;WiDTH �2' ; LIQUID DEPTH P AS+ - 6 0R g 1 1 _. • • Deta Performance Data 40 N 30 Pump Characteristics 20 /Me Is,rn seieowrAll � S1IwoA11 :�+� A01ealali< Mail k SMF40AI SW40A2 10 Aumr— 4410 I'd (god 17 1 64 1A,eer shd,d Pak 0 NW 1111 1330 0 R 10 20 30GPM 0 50 60 70 Mras>e 1! wh 115 230 T H*0d tom) 1C 14 17 41 1 223 28 30 35 Nwft 60 (m 41. 6.1 7,6 0.S X 1 7 Taqw0we 120° F fAax. Fiala GPM (U! am) 70 60 SO 40 30 20 10 0 NIVAA kdr A .S 1. hmdsal,a 41m A I ,tie • " N" Dimensional Data Solis !81k we 2 9 6e. (UZI a a>r lsee.rrl 1. All d'imeMsions In Indies. S eft for Power Coed 11/3 sow irltorndtioM01 use]. 134f eptlonell) 17— 2. Compoand diRiee ons may Materials of Constru YM *' i " h ' 0=6 101111111 Sea[ 3, Not for rnndrudlb0 purpose 66w" 01 ti l ols/2, c Unlee (emllu. No w swrTCH 4. Dicosioas and wo11his ore apprmdmale. to o � Sw fF m cow cadmic I 5- m re+risians reserve o t rd a t o a Hake Shah send Sad I*. W" W" seat D nd lheh Seal I Steel specifications wkhout notice, kww usw low k=6 66M Down � +sre• ' t2aa.ex) tsee T o, cue) o - slad"s Lots t+l tleee.,'t.Nt —+— 0 1998 40roZfe Pumps, As loud, Oho. Al! Rights Reserved 1 qf W HVDROMATIC - - 'tour Authorised ;cool Distributor 1840 Banty Road lshlond, 06io 44MS Tel: 419. 211.3042 Fax: 419.211.4061 Wth Silo: www.peetoirpunpam « .. SALES OFFICES IN ALL MAJOR (MIS AND 0)UNiRIR '3�. O Refer to "Pumps' in ttw yellow poles of goer phone d!reaory for your Ieml Olstnhotot / — -- Vii' u O I +emit: W- 02.1680 1198 SM X01 System Management Management of this system is critical. As a condition of approval of these plans this system management must be reviewed with the homeowner, and the homeowner must be provided with a complete set of plans including this management section. General Proper functioning of an on -site disposal system, "septic system," is significantly dependent on the volume of water which 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. L.. If the septic tank is installed prior to sheet -rock and/or painting, pump the septic tank before normal residential 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. Maintenance 1. 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, and 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 pump. 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. Wastewater monitoring of volume and quality is not a normal requirement for residential 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, designing, and /or installation of additional treatment components or conversion to a holding tank may be necessary. Page 9 of g 2f/� ` Lc2. ST• Lt�o��' � - Y1iiG � 7/� �3gb� �b p w �rGav►S P(UKA.ber 7 �1E �CLKGi -� ►'oGk— i)l Glo9�cd e 5�r<GE�oreS� � f��e��rJ � a�P� 10/12/2000 20 :09 FAX 17152352592 TLSINZPLUMBING IMO2 F7 i E SIJ[1+taieryKbb i w lord � 1 ? ZCQO • F,ttp•d�n ST CROIX COUNTY or�t 4t ZONINGOFFICE k1J d • N� WSW CjM400 0 5 �,9 4 ' �SL� �a9 I -M fg A off- I a. b' s.lc.:k 1 _ cl TS-C' D c'AT Bfw� MA CL NA-i I I N ICEn i, r- 10/12/2000 20 :09 FAX 17152352592 TLSINZPLLTnING fa01 T.L. Sing Plumbing Inc. i E5609 708th Aven ue Phone: (715) 236 -2644 Menomonie, W! 5 751 Fax: (715) 235 -2592 ]FAX XBANSNO33ML Date: No. of Pages: (including cover) To: ► N le Attn: From 1 Subject: Message_ L D rA W,& Low ems" Signature: dr I. 1212 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Sal & Site Evaluations ?, — County Attach complete site plan on paper not less than $W z 11 i0do irvsize. l'la� must St. Croix include, but not limited to: vertical and horizontal reteteoaepoirit (BM), directioR.and percent slope, scale or dimemsions, north arrow, and location and stance to nearest road. Parcel I.D. 016 1062 -60 ID #29.30.15.436 Please print all information, , : - r !! By � D / ate ll Personal information you provide may be used for secondary purposes (PrivaLy taw, s. 15.04 0))Im)). %� /•t Q O Property Owner :F Property Location Randy Thompson S7 , GoA. SW 1/4 SW 1/4 S 29 T 30 N R 15 W Property Owner's Mailing Address ,; � fi� rY ct'# E Block # Subd. Name or CSM# 2785 130th Ave. '�' oFF,c� City State Zip C6e -P er - -� City village Town Nearest Road Glenwood City WI 54013 1 Glenwo od 130Th Ave. & 280Th St. jo New Construction Use: OA Residential / Number of bedrooms 4 Code derived design flow rate _ 600 GPD Replacement j Public or commercial - Describe: Parent material Glacia till _ Flood plain elevation, if applicable NA General comments and recommendations: Mound to be installed in a "cresent" shape following contour as staked. System elevation to be 92.5' at 12" above 91.5' contour. Boring # Boring Pit Ground Surface elev. 88.77' ft. Depth to limiting factor 28" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Q 1 0 -8 10yr4 /3 None sl 2fsbk mvfr as 2f,1m 0.5 04 ,q 2 8 -16 7.5yr4/4 None sl 2fsbk mvfr aw 2f,1m 0.5 0. , 3 16 -28 7.5yr4/6 None Is Osg ml aw 1f &m 0.7 4 28 -48 5yr4/6 2mdl0yr6 // L scl 2ms bk mfi - if 0.4 .5 (p F21 Boring # Boring Pit Ground Surface elev. 93.55 ft. Depth to limiting factor 30" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIft 1 0 -10 10yr4 /3 None sl 2fsbk mvfr as 2f,1m 0.5 0. ,q 2 10 -21 10yr4 / 4 None Is Osg ml gw 2f,im 0.7 [t .aa 3 21 -30 7.5yr4/4 None Is Osg ml aw 1f&m 0.7 •a 4 30 - 5yr4/6 m m2d10yr 5 6 / / 3 & scl 2msbk mfi - if 0.4 Effluent #1 = BOD s' 30 < 220 mg/L and T S>30< mg/L ffluent #2 = BOD < 30 mg/L and TSS <30 mg/L CST Name (Please Print) ignatur . CST Number James K. Thompson _ � — 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number Osceola, WI 54020 4/25/00 715 - 248 -7767 r property owner Randy Thompson Parcel ID # 016 - 1062 -60, ID #29.30.15.436 Page 2 of 3 31 Boring # 3j Boring Pit Ground Surface elev. 88.52' ft. Depth to limiting factor 26" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 2 *Eff#1 *Eff#2 1 0 -10 10yr4 /3 None sl 2fsbk mvfr as 2f,1m 0.5 0. 2 10 -18 10yr4 /4 None sl 2msbk mfr gw 2f,im 0.5 0 3 18 -26 7.5yr4/4 None sl 2msbk dsh aw 1f &m 0.7 0 8 9 4 26 -43 5yr4/6 m2d 7.5yr5/8 scl 2msbk dsh - - 0.4 � -5 F—I Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP *Eff#1 *Eff#2 F—I 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 GpDtft *Eff#1 *Eff#2 * Effluent #1 = BOD 5 > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 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. P 3 c43 R � oli3 �oZ> 1.`% o, S76 't r W, . nl Grad t 0 �+ 0. 390 ■ 9/. SO' c S! � 1 I .4 U�e 1 a 1 P p osAd as std nck mark ' 1. . geld ASSIA c %w .06!02/00 FRI 10:71 RU 715 786 4686 ST CRY CO ZONING: 16 001 ST C ROI X COUNTY SEPTIC TANK MAIN F-NANCE AGRBEMIINT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer _ �A - -so lj Mailing Address �D /U v2 rZ Z N 2 - � 1 7 IJ Property Address �J © a $ (Verification required from Planning Department for new Construction) City/State Parcel Identification Number L EGAL DESCRrpT�oN Property I,ocatian Y" Sec. � T S_W, Town of �41I�G1DJ Subdivision Lot # A/ o1 ZeQUI J, Volume Page If tranty Deed # > - 7 A -, Volume Page # J �. o Spec house ❑ yes X no Lot lines identifiable yes ❑ no S YSTEM MAINTENANCE Improper use and maintenancnof 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 a licensed pumper. Wbat you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. submit to Croix Zonis Department a certification form, signed by the owner and by a e property owner a St. g Pam Th p perry ETc cs to sub tnas orplumber, journeyman plumber, restrictedplumbcr or a licensedpumper verifying that (1) the en -site wasttwaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (i£ necessary), the septic tank is less than 1/3 full of sludge, Uwe, the undersigned bave 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 tho 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 da the year expiratio date. 'PM ATURE OF APPLICANT DATE OV g CERTIFICATION I (we) certify that all statements on this form are true to the best of ray (our) Lnowledgc- I (we) am (arc) the owner(s) of the p rty des bed above, Oy virtu d i of a warranty decd recorded Register of Deeds Office. �J OF APPLICANT DATE ,_ <.±Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. « * « « «« _. ude with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey trap if reference is made in the warranty deed 7 M Not (ter iwd t W ak I`? o u2 � J hA�S ,vo ,eXS�s� ��r fdV sI�S r ` 623172 STATE BAR OF WISCONSIN FORM 2. 1998 KATHLEEN H. WALSH REGISTER OF DEEDS WATY DEED ST. CROIX CO., WI Document Number LeJ11PAGE369 RECEIVED FOR RECORD 05-17-2000 9:45 AM This Deed, made between Randy R. Thompson and Doris IIARRANTY DEED M Thompson, husband and wife EXEIWT N MRT COPY FEE: Grantor, COPY FEE: and Jason A. Kromachroeder and Melissa M. Kerler TR(WSFER FEE: 249.00 RECORDINg FEE: 10.00 as • cint tennanta in common PAOESs 1 Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin: The SW 1/4 of SW 1/4 of Section 29, Township 30 RewrdingArea North, Range 15 West, Torn of Glenwood ' Name and Return Address 0 � P. Bank (_, P. 0. Box 128 New Richmond, WI 54017 016- 1062 -60 Parcel ldcmification Number (PIN) - "RTT""lll /// This is not homestead property. (is) (is not) Exceptions to warranties: easements, roadways and restrictions of record Dated this � ay of , 41�2ngs n • ; Doris M Thompson AUTHENTICATION ACKNOWLEDGMENT ; STATE OF WISCONSIN ) ss. Signature(s) St. Croix County Personally came before met s day of .. above teamed authenticated this day of - - whom son and Randy Doris M. 1homRson • ho TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person w executed (If not, the fore inir ent and act wledge�tuhle me . authorized by § 706.06, Wis. Stars.) THIS INSTRUMENT WAS DRAFTED BY -Tracy L. r Micha el H Forecki Attornoy Notary Public, State of Wisconsin Eau Claire Wisconsin My mmission is anent. (If not state expiration dat - (Signatures may be authenticated or acknowledged. Both are not necessary.) Tracy L, Tumor Notauy Publ �oonsin 'Names of persons signing in any capacity must be typed or printed below their signature. STATE BAR OF W ISCONSIN WARRANTY DEED FORM Na 1 -1991 ProWeaO wn 2pFarm" bs Vwuat W_ ISMS Fn•an MW Rao CW nTowWhV. r�yW^ 4W36• 'SW' 31S•aaaS C••awy rl lr•w•r Gaut/ 70619tA tii, Nudcn Wlsp1F7M fm.. plss»atms Fa• (nspwast CD I N N tb O N 7 - 4 O I s O > L N I O v :D M � � O IIJ 3 — O c co CN 1-1 Z I ct- N LL nl , V ° I o 1 I - -- - 0 f— C) 'c LL - - — — — — ° c + T V) - - -- - - - - -- - - -- T-- - - - -�o - - -� 0 o o r O �- > o -- - - - - - -- - - - - -- N@ O c z -� - o O CO N N J (D I O °� O JU -- — - -- # - - - - - -- Q O r7 J -, a I co °O - 7,1 -1� - - - - ---�- o �u a 5 - -x :.a- .g�--- - - - - -- o 0