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HomeMy WebLinkAbout231-1049-30-200 o o § ; ; ■ ° �$$ k fT r 0 3 3 £ ° t ƒ o% U - w £ E m E 2 k §{ X777 : 3 �, CA to \ \� f § 2 ; i m 3 E E § S f o ) w g / >£ C 3 CL k oo§ 3 o ® -4 E C 4 o k k a n r■ a S S @ ® & ° - � � J � { 000 % § § q K) z 0 « 1 32 ■ ■ (A > P Er T o q. � CD CL \ ' La z E > E R 0 k � \ ■ % E C \ \ C . / -1 CO) i ( ( E � $ � / i z o I P R ( , ■ -0 / ) U 2 § e ® G z ;mi > [ § @\2� §�k C-L a C , \ E E ¥ =EEa ° §C'L . g_ o E , \J[\��,/ a ` \ \k� \k� CD 0' § §E E � Co =- �R E . =r CA 0 � 7 ƒ} o2g'§� 0 k� + =2 k& = [77��o S ` ° Z =r ` CD'D<o =r a0C �__®£�o crCD ° -CL K 2 ± K 0 b < § \ f ? s \ 0 N J 8 � t Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County. St. Croix , Safety and Building Division ' INSPECTION REPORT Sanitary Permit No: 430169 I GENERAL INFO (ATTACH TO PERMIT) State Plan ID No: ::: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). o Permit Holder's Name: X City Village Township Parcel Tax No: Vierkanst, Joe I City of Glenwood 231 - 1049 -30 -200 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: r b d o • O cYl? ze / 23.30.15.771 E20 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic huh Benchmark p Dosing b� (J �V Alt. BM Y Aeration n Bldg. Sewer tJ an AJ v _ Holding SVHt Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent t it Intake ROAD Dt Inlet ' Septic \ ( E D' 26 01 Dt ttom Y3 Dosing �t.40 Header/Man. Z cs­-iP 10``- a Aeration Dist. Pipe l.s'' �fS 09 Holding Bot. TV / PUMP /SIPHON INFORMATION Final Grade + 11f�" - 7 S' Manufacturer j 1 Demand St Cover I , y k ^ 1Grrn >� GPM .. W_ 'j yjr4 7• Model Number 0/ ov 31.3 -7- /0 TDH Lift 11 Friction Loss Syste He TDH Ft ,-I �- � 0.o-7 Forcemain Len t / Dia. �, Dist. to Well Jj 6- SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length D ! No. Of� ruches - IT DIMENSIONS No, Of Pits Inside Dia. Liquid Depth DIMENSIONS e SETBACK SYSTEM TO PILW BLDG WELL LAKE /STREAM LEAPVNG Manufacturer: INFORMATION Type Of System: CHAM R OR �'' ANR Model Number: DISTRIBUTION SYSTEM I Header /Manifold Distribution x Hole S e x Hole Spacing Vent t Air Int e O r " 3 �� Length 3 Dia Length Dia Spacing 0 Q 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 /y Bed/Trench Edges Topsoil 7 h Yes I � No J Yes ] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 1�- 0 l of Inspection #2:�/ � 03 Location: 1323 N Bon W �t ff 2 Parcel No: 23.30.15.77 EI 2D ry Rd Gle wood City, WI 54013 ( N E 1/4 SW 4 23 T30 N R15 ) NA o 11 1.) Alt BM Description S �y��n/�`L gc�lJry 92, 83� 2.) Bldg sewer length =/ ! yep ° s'hrb�io�► YI►�t�� 7r `� " {'a I TG,m� if1� Z !! S'7l - amount of cover = i elr CQinY�Gd7QN D�cf jet/ a O o� Plan revision Required? Yes /,N - -- t%d�f/1411r�- - J . Use other side for additional Information g i S ate — Ins c s Si � na re - SBD -6710 (R.3/97) ��� � � n � `Grp, / � � SafetyandBuildings1,(VJ!,ion County /J 201 W. Washington Ave., P.O. ]sox 7162 is �e r� � Madison, WI 53707 -- 71 i2 Sanitary Permit Number (to be Filled in by Depar a Commerce (608) 266-3151 fl (o Sanitary Permit Application smote P'an °. Number In accord with Comm 8121, Wis. Adm. Code, persona! information you prargida g ��O / = ��-w15 • /�. maybe used Ibr secondary purposes Privacy law, s 15.04(l)(m) Project Address (if different than mailing address) I. Applicaiden Information - Please Print Ali Information / 3 2 3 Al. e-0 d AJMJe Y R D 6C6CA/A/ Property Owner's Name Pawei # Let Block # Jae V eX- Al ,4�t/ ,AT Property Owner's Mailing Address Property Location // 8/ ¢ sf�e Are n /E,, a , s t/.� sestina 2 3 City, State Zip Code Phone Mu tnwr�' ,S¢oo/ 71 5-24G - 5o5(r T 3o N; R II, Type of Building (cheek all that apply) V , or 2 Family Dwelling - Number of s Subdivision Name mba N _. 5—�-- (f�., p �icfl� ►G F +Y s �`' v ❑ Public/Comnterciai- Dsscribe se J 0 - 4 • D _. ) AY, .._ C2 State o wned - Describe use 5 / X 0 u/sod III. Type of Perralt: (Check only one box on 11# X Complete line B if applic it e) Mal 0 - 0> A New System ❑Replacement system ❑ t 1j$di>,t "Res: •c mM Only ❑ Other Moddleation to Existing System a. El Permit Renewal CI Permit Revision ❑ }!of O Pern>it ' nussfer m New List Previous Permit Number and Date Is>axd . , Before Expiraticu P �� C}wtner IV. a of POWTS System; Check as that ❑ Non - Prmuriwd In -Cre ❑ Mound > 24 in. of suitable soil KMound < 24 in. of su itable soil ❑ At4mile ❑ Sic& Pass Sand Filter ❑ Constructed Wetland ❑ Prossurixod in -Ground ❑ Holding Tank ❑ Prat Filter I.1 Aerobic Treuttnmt Unit ❑ Recirculating Sand Filter ❑ Recircu 3 tic Media Filter ❑ Chamber ❑ Chi Line ❑ Gravel U:ss t9pe ❑ other (explain) V. Dis l/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsQ Dispersal Area Required (if) Dispersal Area Propomd (so System Elevation -15"d 1 v r 5 1 'fSa -%-<d /o''. a 8 VL Tank Info Capacity in Total I Number Mahufactim Prefab Site Sted Fiber Plastic Gallons Gallons I of Units Concrete Constructed Glass New Existing Tanks Tanks Septic orHolftTank k ��V !�IlSEK- tG Aerobia Tnatment Unit ~- > K VII. Responsibility Statement I, the underdgaed, assume responsibility for installation of the POWTS shown an the attacbad puss Phmber's Name (Print) Plumber's S. tore MP /MFRS slumber Business Phone Number /t ✓ /Y1 ors �a� /7 - ¢3 -25 Plttmbees Address (street, City, State, z #ieode E ! 55 5 7 - 5 - 4 - 7.2 - 5 VIII. Conn /De t we—M Use Only__ Approved ❑ Disapproved Sanitary Permit Fee (inchtdes Gnlwtdamter Date Issued t SizuUM, (No Stamps) SnuGharge FCC){ 3 50 2I 2e8 ❑ owner Given Reason for Denial `�' IX, Conditions of Approvd eaaons for DLwpproval • ��.� - r _ Ik - �Xr-L nt�� MJ-4�- OAa;� , - �- Attach eomptele pbss (to the County only) for the system on pqw, not less thou 81/2 ill taetres is %in SBD -6398 (R. 01/03) P V4 INN -lab { try N M cb AM tv1 �• '.k � v i' •� tC i, .:, ' + Safety and Buildings 141 NW BARSTOW ST FL 4TH WAUKESHA WI 53188 -3789 TDD #: (608) 264 -8777 ,S�On www.commerce.state.wi.us /sb S I www.vAsconsin.g Department of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary June 30, 2003 CUST ID No.224617 ATTN. POWTS Inspector LYLE J MYERS ZONING OFFICE NORTHLAND PLUMBING INC ST CROIX COUNTY SPIA E1556 ST RD 64 1101 CARMICHAEL RD BOYCEVILLE WI 54725 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/30/2005 Identification Numbers Transaction ID No. 878890 SITE: Site ID No. 660866 Joe Vierkandt Please refer to both identification numbers,` 145TH Avenue above, in all correspondence with the agency. City of Glenwood City, 54013 St Croix County NE1 /4, SW1 /4, S23, T30N, R15W Lot: 2, FOR: Description: Mound, 3 Bedroom Object Type: POWT System Regulated Object ID No.: 908930 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: • This system is to be constructed and located in accordance with the approved plans, the "Mound Component Manual for Private Onsite Wastewater Systems Version 2" SBD- 10691- P(N.01 /01). • The pressure network is to be constructed in accordance with publications SBD - 10706- P(NO1 /01) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems - Version 2.0" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) ". • 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 comply with the operation, maintenance and monitoring duties as described in section VIII of the mound component manual. A copy of this information must be given to the owner upon completion of the project. • Maintenance information must be given to the owner of the tank explaining that perioft ckhd'n the filter is required. Access to the filter for cleaning must be provided per Comm 84 product_approG� ( Ons. \, a • A Sanitary Permit must be obtained from the county where this project is located i rdance with the requirements of Sec. 145.135 and 145.19, Wis. Slats. Q • 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. LYLE J MYERS Page 2 6130103 Owner Responsibilities: • Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Julia ALewis- Osborne POWTS Reviewer 2, Integrated Services WiSMART code: 7633 (262) 548 -8638, Fax: (262) 548 -8614 jlewis@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 M S P t d 6 Mo Sys Cover P Y 9 RECEIVED MEIER iie =TE JUN 2 2003 Project Name: VIERKANDT -MOUND BARTY & BLDGS. DIV. Owner's Name Joe Vierkandt Owners Address 1181 45th Ave. Amery,Wl 54001 Legal Description NE %4, sw %. Sec 23 T 30 N, R 15 w Township Village of Glenwood City County Sai Croix • Subdivision N/A Lot# 2 Parcel ID# Table of Contents pg- 1 Coverpage 2 Mound Sizing Calculations 3 Pressure Distribution Layout and Dynamics 4 Dose Tank 5 Management and Contingency Plan 6 Plot Map total # of pages: 6 Designer Name: Lyle J. Myers MP /License M I.D.# 224617 Date: 5/27/03 Ph. #: 7156432520 Signature: Mound System Design Methods Used 4 +, , o tf F per "Mound Component Manual For Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD- 10691 -P (N.01 Ml) JA e Gi��e'F O per" Pressure Distribution Component manual for Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD - 10706 -P (N 0101) Spreadsheet provided by: 3bAdvisement N12486 220th St, BoymAlle, WI 54725 Ph: 715 464346068 email: visenent cx>t' Mound System Pi 2 of e Mound Sizing alculations IpO 9 � Project Name: VIERKANDT -MOUND AJ Site Conditions Design of Entire Fill 3 Project Type: 1 or 2 Family Dwelling 9 „y vx Cell depth at upslope edge (D): 25.0 in. % Slope: 10 — % r _� 1 Cell depth at downslope edge (E): 31.0 in. # of Bedrooms: 3 ,� Distribution cell depth (F): 9.5 in. .� K Depth to limiting factor: 11 i Cover thickness over edge (G): 6 in. Absorbtion rate of fill material: 1 gal /ft /day Cover thickness over center (H): 12 in. Absorbtion rate of in -situ soil: 0.5 ga M 1day End slope width (K): 12.4 ft. Effluent quality Effl • Fill length (L): 114.8 ft. Max BOD effluent value: 220 mg/I Upslope width (J): 7.8 ft. Max TSS effluent value: 150 mg/I Downslope width (Toe) (I): 16.7 ft. Fill Width (W): 29.5 ft. Design of the Distribution Cell Basal Area System Design Flow: 450.0 gal/day Basal area required: 900 ft Distribution cell width (A): 5.00 ft Basal area available: 1953 ft Distribution cell length (B): 90.0 ft Area of Distribution Cell: 450.0 ft Observation Pipes Contour Elevation of Mound: ft la7,ou'f'^l.ocation from end of cell (Z): 15 ft System Elevation of Mound: 482-86 ft Iv9x)VA tt) � AVV Final Grade of Mound: 409. Wft I � Mound Plan View Observation Pipes 6 . B k–K I Tilled Area/Fill Material L ' Mound Cross Section Final Grade Observation Pipe Synthetic Fabric Distribution Cell kQ y t k System Elevation ' e d ,t y. T3- :: •�tyt 4� Cover Material "It f Itrv�t# k Fill Material Tilled Area j er 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)(8) Distribution Cell to have minimum 6" aggregate below lateral and 2" above. Mound System Page 3d 6 Pressure Distribution Calculations Project Name: VIERKANDT -MOUND Lateral Layout Lateral /Manifold Design Lateral elevation: 102.6 ft Lateral diameter. 1% 'v in. Rows of Laterals: 2 Lateral spacing (S): 3 ft Manifold type: Center . Lateral to cell edge: 1 ft Orifice diameter: 0.125 In. Lateral discharge rate: 7.83 gpm # of Laterals. 4 System discharge rate: 31.31 gpm Distal Pressure: 5 ft Manifold diameter: 2 J w I In. Lateral Length: 44.5 ft Manifold length: 3 ft Orifice Spacing /Distribution Forcemain Friction Loss Orifice spacing N: 28.86 Inches Forcemain length: M ft Orifices per lateral: 1g Forcemain diameter. P2 In, Avg. f?/Orifice: << �.,5.92 ft Friction loss in forcemain: 1.678 ft Lateral Side View Manifold Lateral Lateral x x x x x K"Xlr x Ir x x I x If x 2 2 e- L ateral Length Lateral Length Lateral Plan View ( Lateral Length ` ( Turn -up wa/ball valve or cleanout plug 0 0 T 0 c -L Orifices on bottom of PVC laterals and forcemain to vAth lateral equally spaced specifications per Comm 84.3O(2 y Forcemain connection via tee or cross to manbld at any point Clean Out Detail Observation Pipes Clean -out plug Final or bail valve Water tight cap or plug Lawn Sprinkler Box lot Note: Closet Colar Long Sweep 9t7 6" Minimum `, bar or two 45's +L 3/8" Bar Lateral Mound System ft 4 of s Septic, Pump and Dose Tank Project: VIERKANDT -MOUND Tank Information Dosage Volume Pump tank manufacturer: Wieser Concrete Forcemain drains back to tank? © Yes Q No Pump tank size /model: W1000 /650 -MR - -� Lateral void volume: 18.8 gal Pump tank gaVinch: 17 Dosage to absorbtion Cell: 90.0 gal Actual Pump Tank Volume: 646 gal Forcemain volume: 13.9 gal Tank bottom elevation (inside): I g2 ft Total dosage: 103.9 gal Septic tank size /model: I w1000 /650 -MR Pump and Filter Total Dynamic Head Pump Manufacturer: Little Giant Are laterals highest point? y Pump Model: 9EH if not, enter highest elevation: 0 ft Effluent Filter: Zabel A100 System head (distal x 1.3) 6 ft CA Vertical Lift ( "D" to lateral) 9.92 ft I b e -7 Note: Access opening of sufficient size to be provided to allow removal of filter. Opening to terminate at or above grade. Friction loss in forcemain: 1.68 ft Pressure loss from filter. �ft Total dynamic head (TDH): 18.09 ft Pump Tank Diagram Dose Tank Levels Watertight Locking Cover In, Gal 4 Inch � h Warning Label Minimum finished A Reserve 21.9 372.1 Grade B Pump off to Alarm 2.0 34.0 A temate C Total Dosage 6.1 103.9 Outlet Location Elect. per Comm D Effluent depth for pump _ 80 7 1 136.0 16.28 and NEC 300 Total Capacity: 38.0 646.0 Weep Hole A or Anti - Siphon B Device FLOW- LITERSMOUR C 0 1000 2000 3000 tD 30 IO 7.5 R $ Pump must be capable of 31.3 GPM to 2.s and head pressure of: 18.1 Feet 0 0 0 20 40 W 80 Lift Gant FLOW GALLONSIMINUTE 9EH PUMP PERFORMANCE CURVE 115V 60HZ ,� 1'` t�l• � F 1 1 J � 1 C/r WO I Wisconsin Department of Commerce SOIL EVALUATION REPORT page —�- of l— Division of Safety and I§uildings in accordance with Comm 85, Ws. Adm. Code County U Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Rev' ad by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Z 1 3 Pro Owner Property Location I 4( M � � � Govt. LotA/ � 1/4 /4 SQ TW N R j for Prope 's Mailing Address Loth I Block # I Subd. Name or CSM# a e., City State Zip Code Phone Number 0 City Affyiliage ❑Town Nearest Road RAJ New Construction Use idential /Number of bedrooms Code derived design flow rate U GPD ❑ Replacement � �� P c� Public ar mmerciai - Describe: r Parent material l a- - 71d Flood Plain elevation if applicable ft. General comments and recommendations: Boring # Boring C] Pit Ground surface elev. -6��7;r Depth to limiting factor r� in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Rood in. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 oYlz s -/ -o (Z- 3A". . 5 .8 5 s if a 5 8 s b may r s .� S vn , 9 , 3 Li ❑ Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Sal ADdication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ffz in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. "Eff#1 •Eff#2 " Effluent #1= BOD > 30 220 mg/L and TSS > < 150 mg/L ' Effluent #2 = BOD < 30 mg/t. and TSS < 30 mg/L C Sig N '� I S Address Dat Evaluation Conducted Telephone Number �l .S ^ C/ ✓ T7 r I , I Property Owner Parcel ID # Page of ❑ Boring # E3 Boring 11 Pit Ground surface elev. fL Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz Sh. 'Eff#1 "Eff#2 F-1 Boring # ❑ Boring pit Ground surface elev. ft. Depth to liming factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Efr#1 '01#2 I Boring # ❑ Boring ❑ Ground , ft. Pit surface elev Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots G AF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 - Efr#2 i * Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L " Effluent #2 = BOD < 30 mg/L and TSS < 30 mg& The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or reed material -in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SBn -8330 (Ie.mioo) l 1 i +o K �. �7C q°e � 1 r '�tl Wisconsin DepartmantofCommerce SOIL EVALUA REPORT Page of 9- Division of Safety and Buildings in accordance with Comm 85, Wis. lednt. Code Attach complete site plan on paper not less than 8112 x 11 inches in Size. Plan must include, but not limited to: vertical and horizontal reference point (BM), directian and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to neari)st road. Please print all Information. R owed by Data Pomona) information you provide may be used for secondary purposes (Privacy Law, s. I5.04 (1) (m)). � � G :? Proper Owner f� Prc�ieny Location VoLE. IE �� �T &m. t.ct 114S V14 Sep3T N R l 5 W - Property Owner's Mailing Address — Cr, 1 # Block # Subd. Name or CSM# (i 5t e, g City State Zip Code Phone Number [] Citt Ilage ❑ Town Nearest Road RED w 1 5�a0 (�(5� ^sas - _�I C� S & . XNew Construction Use: esidentiai I Number of bedrooms � -3- Code derived design flow rata .> GPDI 13 Replacement [] Public or comime ctai • Des Parent material �cr _ �'tx;l ation inapplicable ft. General comments y RECEIVE and reccmmendaticns: YD JUN - 2 2003 Boring # ❑ Boring f i Pit mound surfac a eisv. — / 0 9 , F 2 - ft. Depth to limiting factor in. _ Sod Application Rate Horizon Depth Dominent Color Redox Description Texture Structure Consistence Boundary Roots P in. Munson Ou. Sz. Cont. Color Gr, Sz, Sh. 'Eff#1 'Eff#2 v I I sit 3 b U r o " 2 S r►-) - - ,j �- oYK '� d Vti R'�3 5I 3 rl�t r S S' O -A '? 3 (DrK 'I 4Z 16YK f 5 cl AVI e� r Boring # ❑ Boring ��/ 0 Ground surface elev.I [ : I L. ft. Depth to limiting factor in. W1 ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDTF In. Munseil Ou. Sz. Cont Color Gr. Oz. Sh. `Eff#1 'Eff#2 C 3m . s • S f- 6 -1 to y2 S Zs MV(r qS . S • 8 3 5 -l� nYR¢ c 2sbK rnV-�r S a • t7 -3P I y1Z 5 1 4 fPZ 16 c Zsb I G el ; -- 0.0 o o s > a 1160 ...� " t < TSS 30 a n1 Land TSS 30 EtAuen #2 = BCD 39 Land Effluent #1 9017 30 _220 g/ rrigYL _ m9+ _ < rrg& C T Name (Pl � t t) / Yt Si lure ....._. CST� �r YS 0 5 Address .+ate Evaluation Conducted Telephone Number Y'.1�T 1f'.'1A lh /Y1MM Property Owner "OE v I EV-K & Parcel ID # r Page a of a �' � Boring # ❑ Boring I gplt Ground surface elev, J°s � ? ?t Depth to limiting factor, Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W in, Munsell Ou. Sz. Cont. Color Or. Sz. Sh, I *Eff#1 *Eff#2 o- /o YX .51 3s6 A v-F'r c s - ?m .5 . S .;7- /3 -& 1.6 2 3 / 25bk .67 S %e ` j sic/ MV--P j` ei S 2r IeYR '� sic/ & S 2, ❑ Boring ❑ pit Ground surface elev. _ ft. Depth to limiting factor in. Soli lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Ou. Sz. Cont. Color Or. Sz. Sh. *EM#1 *Eff#2 I \ - Q Soong # ❑ Boring - ❑ Pit Ground surface elev. 't. Depth to Iimlting factor in. S R Awkeffon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots OWN In. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. *Eff#1 *Eff#2 i 6 ' Effluent #1 =HOD > 30 220 mglL'ind TSS > '-.'160 mgfL " Effluent #2 = BOD < 30 mglL and TSS <_ 30 mgfL The Department of Commerce is an equal opportunity senlice 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 'PTY 608- 264 -8777, saD -8770 (R.ouO() , 1 � 1 1 \ \4 t ��M acs o, `N LU L o tti � ti W M 1 A �rj� kD .., 7W, UJ x a ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND // OWNERSHIP CERTIFICATION FORM Owner/Buyer dJcJ 19K x Mailing Address / y _ Property Address /c3•Z 3 j 6 r l, 4['Qol�elL�t72 & •S / • 3 (Verification required from Planning Department for [kern construction) City /State 1 Parcel Identification Number LEGAL DESCRIPTION Property Location &L Sec. 3. T R. N --L. W, TV of Inwood �� Subdivision Lot # . Certified Survey Map # 7 /t1 , Volume Page # Warranty Deed # �d - 7 Z 0 !Volume ., Page # _. Spec house ❑ yes Xno Lot lines idetrufiable k(yes ❑ no SYSTEM MAINTENANCE improper use and maintenance of your septic system could result in its )remature 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 Departmeat a certification form, signed by the owner and by a masterplumber, journeymanplumber, restrictedplumber or a licensedputnper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if ne xssary), the septic tank is less than 1/3 full of sludge. Vwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed anti returned to the St. Croix County Zoning Office within 30 days of the three year �expiration date. Sl OF APPLICANT DATE OWNER CERTIFICATION 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 F.egi }Ker of Deeds Office. 'V - lezr� a //,, L_ . s /! , '0 - S SK3N OF APPLICANT DATE Any information that is mis- represcnc °d may result in the sanitaty p! %rmit being revoked by the Zoning Department. *« Include with this application: a stamped warranty deed from the Ru- gisler of Deeds office a copy of the certified survey reap if reference is made in the warranty deed V 2 12 1 P 4 9 3 - 70 - 7 ;-RKD - � STATE BAR OF WISCONSIN FORM 1 - 2000 KATHLEEN H. VALSH WARRANTY DEED REGISTER OF DEEDS Document Number ST CROIX Go. VI This Deed, made between Michael R. Main and Jan L. RECEIVED FOR RECORD Main husband and wife 01/27/2003 09:30AN Grantor, EXEWT # and Joseph A. Vierkandt, a single person - REC FEE: 11.00 TRANS FEE: 42.60 COPY FEE: Grantee. CERT COPY FEE: Grantor, for a valuable consideration, conveys to Grantee the following PAGES: 1 described real estate in St. Croix County, State of Wisconsin (the "Property") (if more space is needed, please attach addendum): Lot 2 of Certified Survey Map recorded in Volume 14 on page 3941 as D ocument No 628910 being a part of the Northwest Quarter of the Southwest Quarter Recording Area (NW1/4 of SWl /4) and the Northeast Quarter of the Name and Return Address Southwest Quarter (NE1 /4 of SW /14), Section 23, Title One Township 30 North, Range 15 West, City of Glenwood 706 19th St. S City. Hudson, WI 54016 231- 1049 -30 -200 Parcel Identification Number (PIN) Together with all appurtenant rights, title and interests. This is 0 homestead property. uw (is net) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Reservations, restrictions and easements of record, if any, and public highways, zoning and building regulations. Dated this 10th day of January 2003 + * Michael R. Main * L. Main * s AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) ) ss. Polk County. ) authenticated this day of Personally came before me this 10th day of January 2003 the above named Michael R. Main and * . Jan L. Main TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the pers �Q d authorized by §706.06, Wis. Stats.) the fore oin instrurrke ` oyq�dgedthb THIS INSTRUMENT WAS DRAFTED BY qj *Sidne v nes Michael H. Forecki Notary Public, State of Wisconsin` "` "�` Eau Claire, WI 54701 My Commission is permanent. (If not; > 1 i on date: (Signatures may be authenticated or acknowledged. Both are not necessary. ) Au crust 31 2003 . *Names of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1 -2000 entury 21 Premier Group PO Box 56, Saint Croix Falls Wl 54024 -0056 Phone: (715) 483 -3244 Fax: (715) 483 -1501 Roger Panek T6736176.ZFX Produced with ZipFonn- by RE FormsNet, LLC 18025 Fifteen Mile Road, Clinton Township, Michigan 48035, (800) 383 -9805 �a- O tnA3 W a FILED ;-LIG ^ 3 2000 ► 1 N N � g�W \ fla°rcleeAt w � Q W y n C7� Z� � O �• zqd A o 3 X� N W Q _z 8 '_•'� u m CD SUNNY HILL AOOl7101t 3 m z �, G I H� � — — — S 00 01' E W IO 221.97 m o m $1 to C / n 310ZZ.00SI I D m t 00 I C sh7 a... n � m �°• �' I 'n � cn d' 9 o, 11 1 Z 1 0 b ` 33.00 I u a, y -4 9 z, Novivor �Z�W ^ O I' I� IC I o r z g Ir to 8j jz - i� b b y �nN ri n� N 1 06' 422. I I I� --q o w 389.22 33.00 I 2 0 mo O I y 3 m iy a I I 7d m I (4 N cn a, - - -- N � $ �� I I m n n I r- II��II 8 r- o- r O LJ �• O alb I m ° IN SCE bbW gI� I o Z z r.. J I I o g � CL MCAN 11'a O « «•• fte M JSIL W .00 N * LL91r AA.SM .00 N C) - 'H - *. -r z I o - ° o L89d 3JVd'9 3W/170/1 dtlW A.Mu11S U31dI11J35 n o m o y. Z;2 o A � n v� Zy �y m �. 8 N R .`['Sd ... J SHEET 1 OF 2 VOL 14 PAGE 3941