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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM ounty: St. Croi Safe ;cam- iHldi�ig Division INSPECTION REPORT Sanitary Permit (ATTACH TO PERMIT) j �3 9c 0 GENERAL INFORMATION s ian ID No: Personal information you provide may be used for secondary purposes[Privacy Law,5.15.04(1)(m)]. g Permit Holder's Name: city Village X Townshi Parcel Tax No: f' /D/1'1 L�1e��twax,c� ©!co— /61+7•— 76—C}et:) CST BM Elev: Insp.BM Elev: BM Description: Section/Town/Range/Ma No: TANK INFORMATION ELEVATION DATA TYPE aJ MANUFACTURER CAPACITY STATION BS HI I FS ELEV. Septic Benchmark /'� wlffet O M I�a (00 D .2D HIV3 1 t-D.O Dosing 2 t r „ Alt. BM fob_ (:) Amat Bldg.Sewer o 52 la1.`�( Hddtff§ St/Ht Inlet TANK SETBACK INFORMATION By!it eatfert TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Bt lAilo Septic Dt Bottom loo I �2 qz C Dosing /�I 16 r`I ��r 652 Z / Header/Man. �, 9 Dist. Pipe �.� q-7• Bot.System PUMP/SIPHON INFORMATION Final Grade Manufacturer Demand U)r�s GPM St Cover Model Number P tyi PI % TDH Lift Friction Loss System Head TDHL S�Ft 5 $� � 01 Forcemain Length�gi Dia. �_I I Dist.to Well SORPTION SYSTEM / NCH Width„, Length No.Of PIT DIMENSIONS No.Of Inside Dia. Liqu' th ENSIONS /�J� f I/ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LE ING Manufactur INFORMATION CHAMB _ Type Of System: � i 5OI ` �a _ /� UNIT /r TvVI Jl 1h' Model Number: DISTRIBUTION SYSTEM [L,ngth_�L_der/Manifold Distribution x Hole Size /^ x Hole Spacing Vent to Air I � Pipgs) P �� J t/l!(Dia Len th Dia Spacing_ DO SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over �I Depth Over I I xx Depth of xx Seeded/Sodded xx Mu ed Bed/Trench Center �� Bed/Trench Edges Topsoil �12— es No , Yes Q No COMMENTS: (Include code discrepencies, persons present,etc.) Inspection#1: / 15 / Inspection#2: /43/1 Z7 Location: Cn a�hs I cc - � Parcel No: 1.)Alt BM Description- . Ma/e wd,, 'r�, Sod � s ,�,� 0-� SgS* 2.)Bldg sewer length= I►I f( ,gyp -amount of cover= �jgf1nj, 11A� — �(UM�✓ ! GeGCl K- N(A q�nj ('Z �/ �% Plan revision Required? fin] Yes ❑ No Use other side for additional information. (� SBD-6710(R.3/97) Date Insepctor's ignature Cert.No. sut�, \ : QCp g3 a � I I Csc..E�cuoo*S f ew.•.15�1° 'l SC-'14 S2/ T3oN Rises a SE 4 l�t�'� - tau, a' - �RISE o F f o wEK•t��t,C, � ,' '', 5crtLe Z3 3 County = 1 „ Safety and Buildings Division 5 , CAW x n S RECEIVED 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) ry ` 5' Madison, WI 53707-7& o t~ - AUG 2 97011 55~3 z (,,o tafi Transaction Number it Application In accordance with SPS 3b3.Fll Wis. Adm. Code, submission of this forth to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(1 (m , Stats. S i 1. Application Information - Ple int All Information Property er's Name Parcel # 3F7!1C0&".jW1 V%. ~rw a 6~er 016, 7 -76- ow Property Owner's Mailing Address Property Location Yb b 1k 5+ Govt. Lot City, State Zip Code Phone Number 1/d 54C- 1/., Section ir! K~ 5L/61 (c cle E on l T~N; R II. ype of Building (check all t Vat apply) Lot # 1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name Block # ❑ Public/Commercial - Describe Use ❑ City of CSM Number ❑ Village of 11 State Owned -Describe Used Town of (p l~l dt1~-0 75 6 ✓ III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. Permit Rene ❑ Permit Transfer to New List Previous Permit Number and Date Issue Renewal El Permit Revision El Change of Plumber 9' 3 ~j t a q Before Exprration Owner YO r / / 12- 2 6 IV. Type of POWTS System/Component/Device: Check all that apply) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in, of suitable soil ound < 24 . of su1 le soil ❑ Holding Tank ❑ Other Dispersal Component(explain) ❑ Pretreatment Device (explain) 71 V. Dispersal/Treatment Area Information: Design Flow (gpd) esign Soil Application Rate( dsf) Dispersal Area Required (sf) Dispersal Area Proposed f) System Elevation ~ / z limo /~'o0 J bb 9~• Vr 9 VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units n t ° U y New Tanks Existing Tanks o a~ a R Q / a U rn h rn s. 0 Septic or Holding Tank /per Cry Dosing Chamber !i v VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. PI ber's Name (Print) P ber's Signature MP/MPRS Number Business Phone Number 4-ee-5- 0 79~ /S- 2 6 S- Plumber's Address (Street, City, State, Zip Code) VIII. Coun /De artment Use Only pproved rsappr Permit Fee Date Issued / Issuing nt Sign I ~ K n Reason foi`blenial $ Ua V 3a / IX. Condi"favw v Reasons for Disapproval 1. "Septictank,eMubntfikerand Jy lae/ d 4 dispersal cell must all be services I maintained as per management plan provided by plumber.' 2. A# se~wA requifarnents must be maintakW , I nn 1. n as code) T e 1• o w r ,A Attach to complete plans for the system and submit to the County o on paper not les1s~haa : `11 inches_'^ ize W P C.l 1N~ o 1/N SBD-6398 (R. 11/11) PAID commerce.wi.gov Safety and Buildings Division Coun 201 W. Washington Ave., P O. Box 7162 )t~O~ at s e o n s i n Madison, W1 53707-7162 Sanitary Permit Number (to be filled in by Co.l Oof Commerce Al-8 -3 ?Cy- 7 Stare Transaction Number Sanitary Permit Application /6657/"7 In accordance with s. Comm 83.21(2). Wis. Adm. Code, submission of thts form to the appropnate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-mvned POWTS are Proiect Address (if different than mailing address) submitted to the Department of Commerce Personal in' e used for secondary u oses in accordance with the Privacv Law, s 15 (,In L Application Information - Plca Tint Al Infor I, Property Owner's Name / Parcel a oM U l" 11 6/4;l, - 16#7-76 •600 Property Owner's Mailing Address Property Location /e/14 IF "?do 74 511"t- ST. CRQIX COUNTY Govt. Lot J aim g Z7 GiRE City, State er SEC- Section 24 4-r f w 5410 i3 (tittle on 11. Type of Building (check all that apply) Lot # Z Subdivision Name ~I or 7 Family Dwelling- Number of Bedrooms aC~~G Block # ❑ Public/Commercial - Describe Use ❑ Gh of ❑ State Osvned - Describe Use CSM Number ❑ Village of S - y 7C XTown of ~eGEit/W'~J'e~ III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System Replacement Sysicm ❑ Treatmeni/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal LJ Permit Revision 4[jist re "o is Permit Number and Date Issued El Change of Plumber ❑ Pcimit Transfer to New Before Expiration Owner IV. Type of POWTS System/Com oncitt/Device: Check all that a Iv ' ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in ofsuitable soil 9CSI Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) A,..6x A-111, TIT- V. Dis ersal/i'reat ent Area Information: Design Flow (gpd) Design Soil Application R:uc( dsl) Dispersal Area Required (st) Dispersal Area Propos sn System Elevation 300 .2 /,SOO ~ /s•,o ~I Q 9G.G9' V1. Tank Info Capacity in Total # of Manufacturer c Gallons Gallons Units LL a C N j u ew Tanks, Existing Tanks ~aM1r 5G. C o. V ti rn ii V o- Septic or Holding Tank ~irr1 / 6'r Dosing Chamber (~f • - VI1. Responsibility Statement- I, the undersi,,ned, a3sume responsibility for installation of the PONVTS shown on the attached plans. Plumber's Name (Print) f mber's Signature MP/MPRS Number Business Phone Number /K a. - 26? r-2-a s- y~~s Plumber's Address (Street, City. State. Zip Code) 29113 VIII. Count'/De artment Use Only X pproved d Permit Fee Date Is ued Issuing nt Signature S rte 9~ ro Own rven Rea, Denial IX. Condi*&Tk*M*easons for Disapproval 1: Septic tank; effluent filter and SAO, dispersal cell must all be services /maintained expee~ ` as per management plan provided by plumber. r 2., All setback requirements must be maintained `t T 01A j 64w., e~1G ,~,~L c ie system and submit to the County only on per not less than 8 V2 s 11 inches in size SBD-6398 (R. 01/07) Valid thrv 01/09 Safety and Buildings 141 NW BARSTOW ST FL 4TH commerce.wi.gov WAUKESHA WI 53188-3789 . 0 Contact Through Relay i sco n s i n www.commerce.wi.gov/sb/ Department of Commerce www.wisco isconsinsin.go .gov Jim Doyle, Governor Richard J. Leinenkugel, Secretary May 17, 2009 CUST ID No. 267985 ATTN: POWTS Inspector MICHAEL J MYERS ZONING OFFICE NORTHLAND PLUMBING INC ST CROIX COUNTY SPIA 2943 130TH AVE 1101 CARMICHAEL RD GLENWOOD CITY WI 54013 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/17/2011 Identification Numbers Transaction ID No. 1665819 SITE: Site ID No. 747777 Tom Weber Please refer to both identification numbers, 1408 300TH St above, in all correspondence with the agency. Town of Glenwood, 54013 St Croix County SETA, SE1/4, S21, T30N, R15W FOR: Description: Mound, 2 bedroom Object Type: POWTS Component Manual Regulated Object ID No.: 1225776 Maintenance required; Replacement system; 300 GPD Flow rate; 18 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.01/01), Pressure Distribution Component Manual - Version 2.0, SBD-10706-P (N.01/O1) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.01/01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD- 10706-P (N.01/01). In the event this soil absorption system or any of its component parts malfunctions so as to eaC~heal®dd, the property owner must follow the contingency plan as described in the approved plans. In , the t comply with the operation, maintenance and monitoring duties as described in sectio~yV$ e onent manual. A copy of this information must be given to the owner upon completi of the~(~~{tr ' All holding/treatment tanks are to comply with Comm. 84.25(7)(a). S ~~F gF6TU~ FF lr c Maintenance information must be given to the owner of the tank explaining that periodic0 g of the filter is required. Access to the filter for cleaning must be provided per Comm 84 Product app royal cditions. A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. MICHAEL J MYERS Page 2 5/17/2009 Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated coup official in accordance with the provisions of Sec. 145.20 2 d , Wis. Stats. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). I • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Beginning October 1", 2008, small wastewater holding tanks with estimated flows less than 3,000 gpd that are based completely on approved POWTS component manuals must be submitted to the appropriate governmental unit and will no longer be accepted by the Safety and Buildings Division for review. Please refer to s. Comm 83.22, Wis. Adm. Code for further information. 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. S' ly, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Julia Lewis-Osborne POWTS Reviewer 2, Integrated Services WiSMART code: 7633 (262) 397-6005, Fax: (608) 283-7481 julia.lewis@wisconsin.gov J Mound System Cover Page pg 1 of 6 MIEIEN inamTE Project Name: Weber-Mound Owner's Name Tom Weber Owners Address 1408 300th St Glenwood City, WI 54013 Legal Description SE SE SecF-2171 T 30 N, R -1-5- 1 Township Glenwood RECEIVED County Saint Croix MAY - S 2009 Subdivision SAFETY & BUILDINGS Lot# Parcel ID# Table of Contents pg- 1 Cover page 2 Mound Sizing Calculations 3 Pressure Distribution Layout and Dynamics 4 Dose Tank 5 Management and Contingency Plan 6 Plot Map 7 PyntP Cv*5VlS total # of pages: 6 Designer Name: Michael J. Myers MP/License 267985 I Date: Ph. 715-265-4115 Signature: Mound System Desi9 n Methods Used yN cF per "Mound Component Manual For Private onsite Wastewater Treatment Systems" (Version 2.0) SBD-10691-P (N.01/01) per " Pressure Distribution Component manual for Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD-10706-P (N 01/01) J~/~O c~ is Spreadsheet provided by: 3bAdvisement N12486 220th St, Boyceville, WI 54725 Ph: 715-643-6068 email: 3ba@3badvise---' --m` Mound System Page 2 of s . Mound Sizing Calculations Project Name: Weber-Mound Site Conditions Design of Entire Fill Project Type: 1 or 2 Family Dwelling • Cell depth at upslope edge (D): 18.0 in. % Slope: 14 % Cell depth at downslope edge (E): 24.8 in. # of Bedrooms: 2 Distribution cell depth (F): 9.5 in. Depth to limiting factor: 18 in. Cover thickness over edge (G): 6 in. Absorbtion rate of fill material: 1 gal/ie/day Cover thickness over center (H): 12 in. Absorbtion rate of in-situ soil: 0.2 gal/ft2/day End slope width (K): 10.8 ft. Effluent quality Eff#1 • Fill length (L): 96.6 ft. Max BOD effluent value: 220 mg/I Upslope width (J): 5.9 ft. Max TSS effluent value: 150 mg/I Downslope width (Toe) (1): 17.4 ft. Fill Width (W): 27.3 ft. Design of the Distribution Cell Basal Area System Design Flow: 300.0 gal/day Basal area required: 1500 ft2 Distribution cell width (A): 4.00 ft Basal area available: 1605 fe Distribution cell length (B): 75.0 ft Area of Distribution Cell: 300.0 fe Observation Pipes Contour Elevation of Mound: 95.19 ft Location from end of cell (Z): 12.5 ft System Elevation of Mound: 96.69 ft Final Grade of Mound: 98.48 ft Mound Plan View Observation Pipes K~ Distribution Cell A B k-K Tilled Area]Fill Material I L ' Mound Cross Section Final Grade Observation Pipe Synthetic Fabric Distribution Cell 11 System Elevation F 1 Cover Material Lateral 3 Fill Material Invert Tilled Area Slope ~-Forcemain System Contour Notes: Fill material to consist of ASTM C33 Sand Distribution cell aggregate to comply with Comm 84.30(6)(1) Synthetic Fabric covering on cell per Comm 84.30(6)(g) Distribution Cell to have minimum 6" aggregate below lateral and 2" above. Mound System Page 3 of s Pressure Distribution Calculations Project Name: Weber-Mound Lateral Layout Lateral/Manifold Design Lateral elevation: 97.2 ft Lateral diameter: In. Rows of Laterals: z Lateral spacing (S): I JI ft Manifold type: End Lateral to cell edge: 0.5 ft Orifice diameter: 0.125 In. Lateral discharge rate: 12.36 gpm # of Laterals: 2 System discharge rate: 24.72 gpm Distal Pressure: 5 ft Manifold diameter: In. Lateral Length: 74 ft Manifold length: 3 ft Orifice Spacing/Distribution Forcemain Friction Loss Orifice spacing (X): 30.62 Inches Forcemain length: 80 ft Orifices per lateral: 30 Forcemain diameter: 2 In. Avg. if/Orifice: 5.00 If Friction loss in forcemain: 1.084 ft Lateral Side View Manifold Lateral x x x x x Lateral Length Lateral Plan View Lateral Length I 0 Turn-up w/baN valve or cleanout plug S 0 Orifices on bottom of PVC laterals and forcemain to comply with lateral equally spaced specifications per Comm 84.30[21e] Forcemain connection via tee or cross to manifold at any point Clean Out Detail Observation Pipes Clean-out plug Final Grade or ball valve Watertight cap or plug Lawn Sprinkler Box Slot Note: Closet Colar Long Sweep 90 6" Minimum place of in g p l of 318" bar or two 45's L 3J8' Bar Lateral Mound System Page 4 of 6 Septic, Pump and Dose Tank Project: Weber-Mound Tank Information Dosage Volume Pump tank manufacturer: Wieser Concrete Forcemain drains back to tank? OQ Yes O No Pump tank size/model: rw1000/650-MR Lateral void volume: 15.6 gal Pump tank gal/inch: 17 Dosage to absorbtion Cell: 60.0 gal Actual Pump Tank Volume: 646 gal Forcemain volume: 13.9 gal Tank bottom elevation (inside): 91.5 I ft Total dosage: 73.9 gal Septic tank size/model: W1000/650-MR Pump and Filter Total Dynamic Head Pump Manufacturer: Goulds Are laterals highest point? y Pump Model: PE41 P1 if not, enter highest elevation: 0 ft Effluent Filter: Polylock 525 System head (distal x 1.3) 6.50 ft Vertical Lift ("D" to lateral) 5.02 ft Note: Access opening of sufficient size to be provided to allow Friction loss in forcemain: 1.08 ft removal of filter. Opening to terminate at or above grade. Pressure loss from filter: ~ft Total dynamic head (TDH): 12.61 ft Pump Tank Diagram Dose Tank Levels Watertight Locking Cover In. Gal 4 Inch With Warning Label mished A Reserve 23.7 402.1 Minimum Grade g pump off to Alarm 2.0 34.0 - =1~ 7 Aftemate C Total Dosage 4.3 73.9 Outlet Location Elect. per Comm D Effluent depth for pump 8.0 136.0 16.28 and Total Capacity: 38.0 646.0 FF-orcemain NEC 300 Weep Hole A or Anti- Siphon B Device C D -=W Pump must be capable of: 24.7 GPM and head pressure of: 12.7 Feet • Mound System Management Plan pursuant to Comm 83.54W. A. G. page 5 of 6 Owner's Responsibility: The component owner is responsible for the operation and maintenance of the component. The county, department or POWTS service contractor may make periodic inspections of the components, checking for surface discharge, treated effluent levels, etc. The owner or owner's agent is required to submit necessary maintenance reports to the appropriate jurisdiction and/or the department. Septic Tank: Septic tank(s) are to be inspected routinely and maintained by department approved individuals when necessary in accordance with their approvals. The use of chemical/biological "treatments" is not required or recommended. If such additives are used, make sure they are approved by Department of Commerce, Safety and Buildings Div.. Effluent filters are to be removed & cleaned as necessary, with provisions to keep solids from passing the septic during removal. No more than 1/3 of the usable tank volume may be occupied by sludge/scum. 3 year inspection: If tank has greater than 1/3 volume sludge, tank contents must be emptied and disposed of in accordance with NR 113 Wisconsin Administrative Code by an approved individual. If the inspector does not recommend pumping of the septic tank, then the owner must be notified of when pumping should be done as to not exceed 1 /3 sludge volume. Septic tank should be routinely inspected to be watertight and of good repair. Pump/Dose Tank If an effluent filter has been installed in the pump/dose tank, it must be removed & cleaned as necessary, with provisions to keep solids from passing to the mound component during removal. The pump, float switches and alarms must be inspected at least every three years for proper operation. Pump/dose tank should be routinely inspected to be watertight and of good repair. Mound and Lateral System The mound system component must remain free of ponded surface water prior to pump operation. If 4 inches or more water level is detected in the observation pipes, the owner must be notified of possible problems/failure. The designed daily flow capabilities of the component should never be exceeded. Trees and any other deep rooted vegetation should never be planted, or allowed to grow anywhere on the component. Activities OTHER than mowing/maintenance (i.e. excessive walking, pets, vehicles, etc...) could compress the component and reduce it's absorbtion capabilities and/or possibly cause it to freeze in winter conditions. Lateral distribution pipes should be flushed outhested every 18 months using the cleanout points at each end of the component to remove scum that may clog orifices. Performance Monitoring: Performance monitoring must be done at least once every three years following the installation or at the time of a problem, complaint, or failure. Contingency Plan: If the septic tank, pump tank or any of their components therein (including floats, alarms, pumps, etc) become defective, the defective tank or component must be replaced immediately to ensure that the system can operate as designed. If the mound component cannot accept wastewater or ponds wastewater to the surface, the component must be repaired or replaced in it's current location by either: extending basal toe to provide added absorbtion area; or by removing the clogged bacterial mat,aggregate cell, and distribution piping within the mound and replacing said components in order to return system to proper working order as required. Z~ v0 i 'At/ o'`y1 L loll $ - V x15 C~itP I ~ A D I Q I a 3 13 sf(kC6~,~ri SE'/{ S~'~~ S2/ T3oN ~ISw ~o°~ i3qsE eFfo wt~cc,c C17 2~Y'o SCALE a 3 ~ 93~9 i LT9 C I ITT GOULDS PUMPS Residential Water Systems APPLICATIONS MOTOR Specially designed for the following uses: General: • Mound Systems • Single phase • Effluent/Dosing Systems • 60 Hertz • Low Pressure Pipe Systems • 115 and 230 volts • Basement Draining • Built-in thermal overload protection with automatic reset. • Heavy Duty Sump/ • Class B insulation. Dewatering • Oil-filled design. • High strength carbon steel shaft. SPECIFICATIONS PE31 Motor: Pump - General: • .33 HP 3000 RPM • Discharge: 11/2" NPT • 115 volts • Temperature: 1040F (4000 maximum, continuous when • Shaded pole design fully submerged. PE41 Motor: • Solids handling: 1/2" maximum sphere. • .40 HP, 3400 RPM • Automatic models include a float switch. • 115 and 230 volts • Manual models available. • PSC design • Pumping range: see performance chart or curve. PE51 Motor: PE31 Pump: • .50 HP, 3400 RPM • Maximum capacity: 53 GPM • 115 and 230 volts • Maximum head: 25' TDH • PSC design PE41 Pump: • Maximum capacity: 61 GPM AGENCY LISTINGS • Maximum head: 29' TDH PE51 Pump: C~p • Maximum capacity: 70 GPM • Maximum head: 37' TDH us Tested to UL 778 and CSA 22.2 108 Standards By Canadian Standards Association METERS FEET File #LR38549 40 1 7- PE51 MODELS' PE31, PE41, PE51 HP:.33. 40_50 35 10 2 GPM Goulds Pumps is ISO 9001 Registered. 30 PE4 - 1 FT 25 c - Z 20 i a 15 - 0 + f f„ I I 5-- L i 0--- i - 0 0 10 20 30 40 50 60 70 GPM 80 0 5 10 15 m3/h CAPACITY I i SOIL EVALUATION REPORT PA 11) #58 f N*Isconsln Department of Commerce in accordance with Comm 85, Wis. Adm. Cod Page 1 of 3 Division of Safety and Buildings ' Northland Plumbing, Inc. Attach complete site plan on paper not less than 8%x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. 6 A VA At 7 r Please print all information. Revie By Dat Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Tom Weber Govt. Lot SE114 SE1/4, S21, T30N, R15W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1408 300th St City State Zip Code Phone Number ❑ City ❑ Village ❑ Town Nearest Road Glenwood City WI 54013 715-781-3267 Glenwood City 300Th St ❑ New Construction Use: ® Residential /Number of bedrooms 2 Code derived design flow rate 300 GPD ❑ Replacement ❑ Public or com erciall:Me Parent material Glacial Till Flood plain elevation, if applicable ft. General comments JUL 12 2010✓~~ and recommendations: ST. CROIX COUNTY ® Boring i, Boring # Pit Ground surface elev. 98.24 ft. Depth to limiting factor 18 in. ❑ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-7 10YR3/2 sil 3sbk mvfr Cs 3f .6 .8 2 7-17 10YR5/4 sl 3sbk mvfr Cs if .6 1.0 3 17-18 10YR64 sci isbk mfr cs if .2 .3 4 18-35 10YR6/4 7.5YR6/8fif spots sc lsbk mfi gs 0.0 0.0 5 35-60 10YR6/6 7.5YR6/8fif spots sc isbk mfi Cs 0.0 0.0 ® Boring MI Boring # ❑ Pit Ground surface elev. 95.19 ft. Depth to limiting factor 22 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-8 10YR3/2 sil 3sbk mvfr Cs 3f .6 .8 2 8-18 10YR5/4 sl 3sbk mvfr Cs if .6 1.0 3 18-22 10YR6/4 sd isbk mfr cs if 2 .3 4 22-47 10YR6/4 7.5YR6/8f1f spots sc lsbk mfi gs 0.0 0.0 - 5 47-72 10YR6/6 7.5YR6/8flf spots sc isbk mfi Cs 0.0 0.0 * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 < 30 mg/L and TSS <_30 mg/L CST Name (Please Print) Signa re: CST Number Michael J. Myers 267985 Address Northland Plumbing, Inc. Date Evaluation Conducted Telephone Number 2943130th Ave Glenwood City, WI 54013 11/18/08 715-265-4115 SBD-6330 (R07/00) I ` Property Owner Tom Weber _ Parcel ID # Page 2 of J_ F3]Boring # ® Boring Pit Ground surface elev. 93.49 ft. Depth to limiting factor 22 in. ❑ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-6 10YR3/2 sil 3sbk mvfr a 3f .6 .8 2 6-13 10YR5/4 sl 3sbk mvfr a if .6 1.0 3 13-22 10YR6/4 sd lsbk mfr a if .2 .3 4 22-40 10YR6/4 7.5YR6/8f1f spots sc lsbk mfi gs 0.0 0.0 5 40-58 10YR6/6 7.5YR6/8fif spots sc isbk mfi cs 0.0 0.0 * Effluent #1 = BOD? 30 < 220 mg/l_ and 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. Property Owner Tom Weber Parcel ID # ~ Page 2 of-_.,3 Boring # ®Boring ❑ Pit Ground surface elev. 93.49 ft. Depth to limiting factor 22 f a in, Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Ett#1 •Eff#2 1 0-6 10YR3/2 A 3sbk mvfr Cs 3f .6 .8 2 6-13• 10YR5 /4 sl 3sbk mvfr cs if .6 1.0 3 13-22 10YR6/4 sci isbk mfr Cs if .2 .3 4 22-40 10YR6/4 7.5YR6/8flf spots sc lsbk mfi gs 0.0 0.0 5 40-58 10YR6/6 7.5YR6/8fif spots sc isbk mfi cs 0.0 0.0 Effluent #1 = BOD5> 30 < 220 mg/I- and TSS >30 <-1 50 mg/L • Effluent #2 = BOD5 < 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 m - need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. y M SRt~ I Ab \ P yg Sc cyl 1 g `P I A D wo g A I I~ ~IN _ 4 I S f ~~c.v c.r ~6 v~.f 7 SE'/14 592l T3 0N Rlsw M /N.. ~ i = E v a , a ' f3 ~S~ ©F loo wEK.1~cc.~ 133- _ , T4 C ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT • AND _ OWNERSHIP CERTIFICATION FORM CEIVED Owner/Buyer ~nt GeJe~,dE/Z~ Mailing Address u • o,rc 4~~10~ Csc E.~u~o a,~ C' >`1, u.~~ .s~d/,~ f. CROIX COUNTY PLANNING & ZON Property Address _ /y0 R' .?o ar4 4-c , Ge_&w fo~ 47-~', AU1 (Verification required from Planning & Zoning Department for new construction.) City/State 6f_6A1eA1&&A (5 -r17 eu / Parcel Identification Number LEGAL DESCRIPTION Property Location SE '/4 , S~ in , Sec. _2 T _30 N R 1 S _W, Town of G e~,~(wc,ofj Subdivision Plat: , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # (before 2007)Volume , Page # Spec house yes nog Lot lines identifiable,),/yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that ( I ) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 113 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Comnierce and the Depaitnieitt of Natural Resources, State of':.'isconsin,. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms / oQ SIGNATURE OF APPLICANTS DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) r ST CROIX COUNTY • SEPTIC TANK MAINTENANCE AGREEMENT AND ..~i OWNERSHIP CERTIFICATION FORM Owner/Buyer /o/!t Mailing Address ~yd 30 o f,C Property Address (Verification required from Planning Department for new construction) City/State GeEwe«.roe~G'~S W/ Parcel Identification Number LEGAL DESCRIPTION Property Location SC- '/4, 5e Sec. Z / T 3110 N-R /5' W, Town of 6zc- loooa~ Subdivision , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # Volume , Page # Spec house ❑ yes fz no Lot lines identifiable Jk' yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of.your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stattem has been maintained must be completed and returned to the St. Croix County Zoning office within 30 dairation date. 7 / 7 SIGNATURE OF APPLICANT DATE OWNER CE RTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the o%vncr(s) of the perty described above, by virtue of a warranty deed recorded in Register of Deeds Office. X ?l-I lly SIGNATURE OF APPLICANT DATE Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. Include with this application: a stamped warranty dedid from the Register of Deeds office a copy of the certified stuvey map if reference is made in the warranty deed L-_ J I !11111 {1111 Ill{I VIII VIII {1111 I{II III{II IIII IIII State Bar of Wisconsin Form 3-2003 * 8 5 6 G 2~++ 9 6 1 QUIT CLAIM DEED 856296 KATHLEEN H. WALSH DocumentNumber Document Name REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD THIS DEED, made between Linda F. Weber 07/26/2007 10:40AM - QUIT CLAIM DEED - - - EXEMPT I 8M ("Gran tor," whether one or more), and Thomas W. Weber REC FEE: 11.00 PAGES: 1 ("Grantee," whether one or more). Grantor quit claims to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix Recording Area County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): Name and Return Address E 1/2 of SE 1/4, NW 1/4 of SE 1/4 EXCEPT a strip of land 2 rods wide off North Thomas A. McCormack side of said NW 1/4 of SE 1/4 and North 5 acres of the SW 1/4 of SE 1/4; All in PO Boa 2120 Section 21-30-15. Baldwin, WI 54002 016-1047-40;016-1047-60;016-1047-70; 016-1047-80 Parcel Identification Number (PIN) This is homestead property. (is) (MZ) THIS DEED IS GIVEN PURSUANT TO A JUDGMENT OF DIVORCE BETWEEN THE PARTIES. Dated ~ dt c)-0 (SEAL) ~ ~ ~ ~ (SEAL) * * Linda F. Weber (SEAL) (SEAL) s * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF Florida n ) authenticated on gr(;ct dr. COUNTY) 7/ mac,/c7 7 Personally came before me on Q - >e g e , * the above-named Linda F. Weber TITLE: MEMBER STATE BAR OF WISCONSIN _ (If not, to me known to be the person(s) who executed the foregoing authorized by Wis. Stat. § 706.06) instrument and acknowledged thZ LWAJ LEE utISStON N DD s22aaa F I THIS INSTRUMENT DRAFTED BY: MY COM _Thomas A. McCormack No biic, State 4Fo a Baldwin, WI 54002 My commission (is permanent) (expires:_ - ) (Signaturn may be authenticated or acknowledged. Both sere not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATION TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. QUIT CLAIM DEED 02003 STATE BAR OF WISCONSIN FORM NO. 3-2W *Type name below signatures, INFO-PRO"' Legal Forms • j80QW&2021 • wapidortnl.com 1 of 1 CROP COUNTY 0 PLANNING ZONING November 30, 2007 Thomas & Linda Weber 1408 300th Street Glenwood City, WI 54013 Re: Failing sanitary system at 1408 300th Street, further described as in the SE/SE quarter in Section 21, T30N R 15W, Town of Glenwood, parcel # 20.30.15.346, Code Administration computer # 016-1047-70-000. 715-386-4680 Land Information Dear Mr. & Mrs. Weber: fr Planning 715-386-4674 On November 29th' 1 spoke with Mr. Weber regarding the failing sanitary system on the property mentioned above. You asked if I would send some additional Real Property information on grant/loan programs. Enclosed is the information you requested. 715-386-4677 Please keep in mind, you have (1) year to replace the current failing sanitary system with a code complying system. I advised contacting a plumber from the list 1 Recycling 715-386-4675 sent you previously as soon as possible. Plumbers get very busy in the spring and can book up quickly for the year. Please keep me updated on your progress. If you have any further questions or concerns, I can be reached at (715) 386-4683. Respectfully, Carrie Stoltz Zoning Technician /cs Cc: Town of Glenwood File Enclosures: grant/loan info ST. CROIX COUNTY GOVERNMENT CENTER 1 10 1 CARMICHAEL ROAD, HUDSON, Wi 54016 715-386-4686 FAX r 00'0 00'0 00'0 le)Ol sa6Je43 )uenbullaa s86Je43 leloedS s)uewssessy leloadS )unowy AJOBeleO opo0 leloedS Jasn :s1epedS 43)e8 :a)ea uo!)eol;lliaa 0 :)uno0 wield :}Ipaao AJOIJOl 0 0 000'0 puelpooM 0 0 0 0000 A:pedOJd IeJaua!D :LOOZ JO; sle)ol uoseaa a)e)S le)ol ano.idwl pue-l saJOy sselo uol)dlJosea 9002/b0/ZL :pa6ue40 )sel :suoije IBA 0 :4)!M passassy :anleA )a)IJeW J1ed Me ANvwWnS LOOZ 99L/[U L66 L/EZ/LO 29/906 L66 L/£Z/LO L8 L/E£6 L66 L/EZ/LO WSO E L£9/ZZ OZO6£8 90OZ/L L/L L ads .L abed/10A # ooa a)ea :AJOIsIH IaoJed :sa)oN M9 L-NO£-LO (b/L 09L b/L Ob bu8-umi-oaS) :(s))oeJl (Od b8'Z) L LO 10-i :Bpla opuooplool8 10l ELE9-ZZ ASO 3S MS Id M9 L2] NOEL L 03S 90-9L0 Mg-ZZ WSO-ELE9 Ield Ob8'Z :saJoy :uol)dlJosaa le6a-1 OlIM OOL L dS A110 400MN3-1J 861Z OS and HAL L L9ZE uo!)dlJosea # )s!a adAl tiewiad = :(se)ssa,ippy A:padOJd leioadS = dS IooyoS = OS :s)o!J)s!a ELOb9 IM AiIO QOOMN3-10 XabllON0993 SW`dab' -1 IOHVO'81 NO(MOO I -10HVO'81 NOMHOO `SNVGV - O jaunn0-oo waiino = o 'aaumo juajino = 0 :(s)Jaumo :sse ippy xel 0 00 90OZ/L L/ L L adA1)!wJad # )!wJad # uoI)eollddy easy sales # deW a)ea IeoIJO)s!H ale(] uol)eaJO NISNOOSIM `AiNno:D XIObO '1S X MaJJnO a00MN319 d0 NMOl - 9 LO SL L'9 L'OE' LO IaoJed ')I`d L 30 L 3E)Vd Ad Os:ZO LOOZ1901b0 OO t"O6' X0U-M IODJBd n to O! 3-0 n d _1 'a c MAD m~ II ..NO~ O Z Z N Z ° % G7• o c j n Q m N i CD m m 7 O py I m m~ g cn a' o ~ ~ N ~ a to -4 "t > CD o o a, o 0 CD CD CL a o w a Co, T Si c o ! O _ O. ao R cfl D N d w Q ~W o b of 0O C ~ ~ ^o °rr O O O n s CA (fi (fi' v v g ~m m N _ m 15 N O 3 d Ca I 7 ' D D o o m ° C CD co CD 0) A X I A Z I Wm CD Z I a 3 X I ° ~ cCn U) m G m p A y O CD c m -O 7 00 p N a f3D ' j3 E*r 0) CD 11 Er : ~p7 C J5. Rr f~D O O• G C N n CD ~ oy N d N. N- o 3 a =oo~ OZ a y a9 c'D m~ m N m w fD N? N (n 0 (n (n 0 Oc c m Zm (O O O m n S n Cn CD C' 8 1 1) cL (D a. cc =r M Er O 7 (n n m o O N O =r D - \ } 7 (~D (OD (Sp O O' D. (p A S O N 7 a y CD 7 0S ~ y c N 7 N 3 m n O m v CD N 3 cr CD CD M Zy ~n m n to ' o_ b CD ao ti 4\, O owe °o CL • Parcel 016-1047-70-000 11/22/2005 09:51 AM PAGE 1 OF 1 Alt. Parcel M 21.30.15.346 016 - TOWN OF GLENWOOD Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - WEBER, THOMAS W & LINDA F THOMAS W & LINDA F WEBER 08 300TH ST GL Y WI 54013 -3 Districts: SC = School SP = Special Property Address(es): Prim yl1 ^Y"r v" S Type Dist # Description SC 2198 GLENWOOD CITY SP 1700 WITC /JO % //,j tm , o AJ- r7 Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 21 T30N R1 5W SE SE Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 21-30N-1 5W Notes: Parcel History: ` Date Doc # Vol/Page Type 07/23/1997 1086360- WD 07/23/1997 2/28 ' LC 07/23/1997 73 2005 SUMMARY Bill M Fair Market Value: Assessed with: Use Value Assessment Valuations: jo Changed: 06/08/2004 Description Class Acres Land Total State Reason RESIDENTIAL G1 2.000 12,000 100,600 NO AGRICULTURAL G4 29.000 4,300 4,300 NO UNDEVELOPED G5 9.000 6,800 6,800 NO Totals for 2005: General Property 40.000 23,100 88,600 111,700 Woodland 0.000 0 0 Totals for 2004: General Property 40.000 23,100 88,600 111,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 520 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Owner: Weber, Tom Computer 016-1047-70-000 Address: Parcel 21.31.15.346 Unknown Municipality: Glenwood, Town of Address: 1408 300th Street Glenwood City, W 154013 0111212006 Weber, Tom Pam Quinn During archive permit and soil report updates on database, discovered these older soil reports that indicated a failling septic system that does not appear to have ever been replaced or at least never obtained a permit to do so. SOIL AND SITE EVALUATION REPORT Qj~HR in accord with ILHR 83.05. Wis. Adm. Code .,..r...,,...~.R,.COUNTY e Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. N dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION -ITEVIf DAT~ /I PROPERTY OWNER: PROPERTY LOCATION l-G/ 9 GOVT. LOT 14j 1/4,5& 114,S T ,?,o N.R 45- Wor) W PROP TpY~OWNER'S MAIILIN ADDDR SS LOT BLOCK # SUBD. NAME OR CSM # L yQ 0 - 3aa / 1l , STATE _ 21P CODE PHONE NUMBER []CITY []VILLAGE QdTOWN NEAREST ROAD e w d C ' o/ (r,~1 ads = c,, 3 00 7` New Construction Use ( J Residential / Number of bedrooms A/,4 j ] Replacement ( ] Public or commercial describe Code derived daily flow 4ZA _ gpd Recommended design baling rate , bed, gpd/t12 , trench, gpd/Tr Absorption area required AIA_ bed, ft2_/yA trench, ft2 Maximum design loading rate -z-,Z-bed, gpdV-y -_trench, gpde Recommended infiltration surface elevation(s) Al It (as referred to site plan benchmark) Additional design / site considerations Parent material A Gr / A L y"/L L Flood plain elevation, if applicable It S = Suitable for system CONVENTIONAL MOUND WGROUNDPRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable forsystem OS 14U ❑ S ®U 0S W U ❑ S ®U 0S ®U j4S ❑ U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boutdary Roots GPD/ft in. Munsel) Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trend YN 4-1 -Z Ground YR 31,4 C 0/ G M F" z 1,3 elev. Depth to limiting factor /i Remark's:_ r Boring # 04 m 4v I C.201 Ground - elev. 8 9 Depth to - /b-y 'Q -X limiting ~ p factor - - 2 Lo CI I-r7 Remarks: 'n CST Name:-Please Print ti Phone: Address 2 2 2 F i 1, - , ' 7U e- wo a lair .~`yo/3 Signature: Date: CST Numbe( z 2 ~ y~ 1.7 X.P 1 Borin # Horizo Depth Dominant Color Mottles Structure G P D/f l~ g in. Munsell Texture Consistence Borrx33ry Roots Clu. Sz. Cont. Color Gr. Sz. Sli. Bed Tmrxf r? Ground el v. q-6 - Depth to limiting facto Af F-I Remarks: Boring # ° ° M F &-4j 2 Al .......i'i:G:a Ground = V 1-6 -Y I 6 C. .2 0/ S .z C 2 . elev. Depth to limiting factor Remarks: Boring # - 13 ~2, a.a~ M F~ w F r s~ A-M Ground 8 3 C Z S~% as6lt-c 3 elev. 9/~1 it Depth to limiting factgrd~ Remarks: Boring Ground _ elev. ft. Depth to limiting 1 factor T-' - Remarks: - I I C I I 1 I I : : I _ D B/ ~ _ I I ~ _ 100 ~ NA/L ' !G,~~t,p><PAN~~, .~4' ~~62N I I I ~`1 II I _ I ~ 1 67 j I ~ I ; , 1 i I r I I I f ' I I I I ' I ~ ~ : I j i 1 I 1 I ' d t'e , I - y, : s~ _s ~ I, -rid ~ ' - ~ _ _ - 'I3 . _ _ : 57 : I I ~ I ' I I I 1 ~ I I ~ I I i : I t i I_ ~ I I I I i I I ' I I I i ' i i I : i I r SOIL AND SITE EVALUATION FsEPORT ;D MWMRLHR in accord with ILHR 83.05. Wis. Adm. Code ' COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but fe ~X not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. +r dimensioned, north arrow, and location and distance to nearest road. 9 / ?p APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIE DBY Y DATE PROPERTYOWNER s PROPERTY LOCATION .Z/W VAJd / eN GOVT. LOT ,S 1/4 5,E va,S a / T 349 N.R /_-y- Ao,) W PROPE ONNER'S MAILING ADDRESS LOT N BLOCK N SUBD. NAME OR CSM r I1421 - 300 t11. S/- - - CI , STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE (@TOWN NEAREST ROAD G<eNc~ o o~ G /1` !~i , 5 %~17,C~') = .5~8' G~ ~7{r woo ?DO r'1_1 Sr' New Construction Use [XI Residential /Number of bedrooms j~ Replacement [ ] Public or commercial describe Code derived daily How _A64 0 gpd Recommended design loading rate 1 W. gpd1ft2_ 1 trench, gpd/ft2 Absorption area required4kjo bed, h2e200a trench, h2 Maximum design loading rate , ; ?Lbed, gpd/ft2_,,3 oench, gpd/ft2 Recommended infiltration surface elevation(s): $7. 7d It (as referred to site plan benchmark) Additional design /site considerations 0 ' / add/ ~'/a/Ir.%L S,r Ne/ /N rrsz~L eo! NN o/e$ S y S~`~M Parent material 6,4 A, Z A r I-A Flood plain elevation, if applicable H S = Suitable for system OONVEWMAL MOUND WGROUNDPRESSURE AT GMDE SYSTEM W FILL HOLDING TANK U= Unsuitable fors tem O S [~1 U ~I S O U ❑ S U ❑ S 14U ❑ S ®U ®S ❑ U T SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots G P D/ft in. Munsell Ou. Sz. Cont Coke Gr. Sz. Sh. Bed ITtend r z o- a 511- M yl:~r 24v 2/07 4 51e,4 a F Z_ -a-A/ 2 M 3 Ground ,3 i6- :t o?.5 311&1 cl.d2 $ L' SbiC" C V I . elev. sb,~yft. Depth to f limiting factor J Remarks: Boring # r>? ~'RPf ; l 0 T 313 :57// A 6i~M vA= 0-4--l 3AJ 14 .2 6-YR 3 64_ c Mir Ground Plev. ~ a Depth to - - limiting lacy - - 1 Remarks- 1V CST Name:-Please Print /.tom S • ~ ~ ~ ne: 71.5 - ZS Address: - ~ .~~2 Z j v 170 Alil,-.Joa Signature L Dat Numter. i Depth Dominant Color N, V Borin # Horizon -..,cure GPDD/7 9 Texture Consistence BOXCt ry Roots in. Munsell Qu.. C ont. (.,tor G .;z. Sh. Ede Trerxi y f v F 95e, LCI 2 M a o' G A' 6K M M lr=iQ cc, cv, Ground LI a, M A elev. Depth to limiting factor Remarks: Boring # f.c. Ground elev. ft. Depth to limiting factor Remarks: Boring # xi7 i• Ground elev. ft. Depth to limiting factor Remarks: Boring # t r; Ground elev. h. Depth to limiting factor i Remarks: • I ~ ~ 1 I j t na- : i - I I i y. - 1 . I ! i - i I I I : ' I I ire ~ , I TIA - - - ' I- I I I : Lei j - I gN_!. ely _ ~vo~g 1 I , I 1 4. i i i 1. J Lo~ - C_ - G Fib e v I _ 1i I + - - i I I i f I ,I I . i I ~ 1 c SEE PAGE 60 / OTy j' DUNN GOUNTYAVe • fN. Rr • Lawrence u x s Rodire Cara. • d s e/a~a ¢art `9 L .Pau/us z bb za Zola, ' iT 22 62 •1 1 uU7 /o i3 Q./ er n z .Pay .P 2 9B 1 7 Sckince 12Q Pitt e y •IJettm¢n 2 O R senberr y L. 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Ha ye r At3-o h 7i• yC p /i sc4tt Bo .Boo .y • < l/e/ a Qt • nn nv vF ° vQ~ Ter9en c~ Sby Bo o n D •rzo ~ti ~ ~ 1 - 3 J 5 Mart nsorr U//am o ~ Z ,~°d- /3373 /S55 Ea~•~i_ ~tl • Ba /o/ i < ~ 0 • jxy~ q • ~ 4o q. c7-7-77=77 Marc 6/s J < DO 1 SEE PAGE 37 V^fCroix Court w/sue . GLENWOOD CITY CO-OP SERVICES GLENWOOD CITY WISCONSIN 54013 Glen oo 0 w d City Ex-PRO 1 Ford Phone: 265-4224 FARM SUPPLY 1 Mill: 265-4827 0 Fertilizer Plant: 265-7212 Custom Blended Protein Sales & Service Computer Balanced Rations 1 Phone: (715) 265-4877 GAS * FUEL OILS * LUBE OILS * TIRES Custom Extruded Soybeans Glenwood City, Wisconsin LP GAS ACCESSORIES * SEED * AG CHEMICALS ON 170 - GLENWOOD CITY 54013 FERTILIZER * ANIMAL HEALTH * FEED, BAG & BULK 265-4239 1