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HomeMy WebLinkAbout231-1066-20-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and�Building Division INSPECTION REPORT Sanitary Permit No: 420762 0 GENERAL INFORMATION (ATTACH TO PERMIT) ate ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. $as PI zz_ - TMSK • �• Permit Holder's Name: X City Village Township Parcel Tax No: Hierlmeier, Gordy City of Glenwood 231- 1066 -20 -000 CST BM Elev: Insp. BM El �: BM Description: Section/Town /Range/Map No: t3fl . m - a & c,rvMar 1rcr,. = gt�• ( 23.30.15.901 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark r ton AD Sp i ,40( I ore . J >SU - Dosing � y Alt. BM T O Aeration Bldg. Sewer t ,q 92 - Holding St/Ht Inlet illll re TANK SETBACK INFORMATION St/Ht Outlet t .fro TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic i � � � Dt Bottom t Dosing t � It Header /Man. Aeration Dist. Pipe 10 33 r Holding B ot. S P. l PUMP /SIPHON INFORMATION Fi al Grade w z LL i . tic. Manufacturer Demand St Cover GPM Model Number TDH Lift Pe Friction Loss System Head TDH Ft , X•O 2- 3.2 5" 3 Forcemain Length I Dia. ti Dist. to Well Z SOIL SYSTEM ( , 8 A - I ENCH idth Length No. Of Trtenctte& PIT pIMENSIONS No. Of Pits Inside D . Li h / DIM t l7 If I) --: (z) ( , J \\ SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHI nufacturer: INFORMATION CHAMBE Type Of System: Q.� 3 L-)�-_ �,� Model Num e . DISTRIBUTION SYSTEM g �o u ac Header /Manifold Distribution t'r x Hole Size It x Hole Spacing Vent to Air Intake _ Pipe(s) 3 •t Length Dia Length qy 5w Dia Spacin —T /6 23.1 �— 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 q, �� Yes U No � Yes � No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection # 1;�ll f� 2�,3 Inspection #2: Location: 441 Walnut Ridge Dr Glenwood City, WI 55,40013 (NE ;1/4 S 1Ft3 23 T30N R1 5W) Walnut Ridge Estates Lot 6 Parcel No: 23.30.15.901 1.) Alt BM Description 2.) Bldg sewer length = V .p�- -� Li9 3, - oUgt of cover t9y*� "`c�C & Plan revision Required? Yes X Nor,l• 1 Use other side for additional information. SBD -6710 (R.3/97) ate ^ Insepctors Signature Cert. No. ` Safety and Buildings Division County N 201 W. Washington Ave., P.O. Box 7082 3 7 - Q p / X M adison, on, WI 53707 - 7082 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 261 -6546 �Q 7. &Z- Sanitary Permit Application state Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal in f //G #711r !I 402. maybe used for secondary purposes Privacy Law, s 15. (i XnR E C E I V E D P. 'ect Address (if different than mailing address) I. App ` tion Information,- Please Print All Information O i � 2nni Property Owner's Nafne b 2 . / 4 /� i �t ST. CROIX COUNTY P I # Z3/ -/[�t � Pr 6 _ �BI�k operty Owner's Mailing Address Location D 3 Ci fate C %. S tf % a Section �_ ty. Zip Code Phone Number T �C7 N; R �� Eck W ) d 9d I�I. of Building (check all 1 th apply) r`!, �� 1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name� CSM Number ❑ Pub&JComum=ial - Describe Use _ ,gyp 14 j �f/ JC i r $�� ❑ State Owned - Descrbe Use p ! �-2L C �9 4�L2fGL City Village ❑Township of III. Type of Permit: (Check only one box on line A. Complete One B If applicable) Lc� n --.. Tank Replacement Only ❑Other Modification to Existing System ❑ Permit Transfer to New List Previous Permit Number and Date Issued r✓ Owner found < 24 in. of suitable soil 1 At -Grade b Single Pass Sand Filter ❑ -� � %3 'eat Filter ❑ Aerobic Treatmen Recirculating Sand Filter ❑ ❑ Gravel -less Pipe ❑ Other (explain) va Required (st) Dispersal Area Proposed (sf) System Elevation 1 z1_ V - _ 11 . Manufacturer Prefab Site Steel Fiber Plastic 2 6 Concrete Constructed Glass P ity for i allatlon of the POWTS shown on the attached plans. ;o I P PRS Number Business Phone Number / 0 ZZ Z / e (includes Groundwater Date Issued g t Signs Stamps) 3Z5 . a 0 3 Pain ��9 �i> �3• If 3 sr t he system on Paper sot kss o)ln : u t to size _0_&v —� �1tia 11.Jta&C&;L J OD11 -0.370 kn. UZTIVL) v J f �y e e o 1�3�► , j I M Al G s / • , 7 r 0- D m Cp CA a Safety and Buildings 141 NW BARSTOW ST FL 4TH WAUKESHA WI 53188 -3789 TDD #: (608) 264 -8777 Visconsin www.commerce.state.wi.us /sb Department of Commerce www.wisconsin.gov Jim Doyle, Governor Cory L. N S ecretary March 25, 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 `f20 74 Z PLAN APPROVAL EXPIRES: 03/25/2005 Identification Numbers Transaction ID No. 851622 SITE: Site ID No. 656966 Gordy Hierlmeier Please refer to both identification numbers, Walnut Ridge Dr above, in all correspondence with the agency. City of Glenwood City, 54012 I 24/o3 St Croix County �/ l �. fir,, -e2O - , 4 US NE1 /4, SE1 /4, S23, T30N, R15W Lot: 6 Subdivision: Walnut Ridge A41- FOR: 7c�t Object Type: POWT System Regulated Object ID No.: 896316 ✓� C���T� Description: 4 gpd design wa stewater flow At Grade system system. f�7 1)/�G 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 enclosed approved plans and with the "At- Grade Component Manual for Septic Tank Effluent for Private Onsite Waste Treatment Systems" SBD- 10570 -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 At- Grade component manual are complied with. A copy of this information must be given to the owner upon c ompletion of the e ject. • Maintenance information must be given to the owner of the tank explaining that p i c in the filter is rL-quire ccess to the filter for cleaning must be p rovided p er Co mm 84 proCldct d c �o ipv • A Sanitary Permit must be obtained from the county where this project i( ated t'� ®� ith the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements f�y &tion shall be made with the designated county official in accordance with the provisions of Sec. 145. (2 is. 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 i ` LYLE J MYERS Pare 2 3 /25/03 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 n Fee Received $ 175.00 t n ^^ Balance Due $ 0.00 Thomas J Perkins POWTS Plan Reviewer, Integrated Services WiSMART code: 7633 (262)521 -5064 , 7:30 -4:00 tperkins @commerce. state. wi.us cc: Leroy G Jansky , Wastewater Specialist, (715) 726 -2544 FROM NORTHLAND PLUMBING, INC. FAX NO. : 715- 643 -2520 Mar. 28 2003 03:51PM P1 v d' W,, ee f - At -Grade er 2 or o Sizing Calculations Project Name: HIERLMEIER AT- GRI%DF Site Conditions Design of Entire Component 1 Private Dwelling or Commercial: p (P or C) UpsloFe Width added to A (E): 2.0 ft I I 9b Slope: 16.8% Total Width of Distribution Cell(C): 12,0 ft. !I i # of Bedrooms 3 Perimeder Beyond Aggregate (D): 5.0 ft Depth to limiting factor: 42 in. Overall Width of Component(W): 22.0 ft- I AbsorbWn rate of in -situ soil: r 0.5 galtif /day Overall Length of Component(L): 100.0 ft. Effluent quality Eff*1 v Elevation of Lateral in Cell: q41 Z 1904wi1q. Max BOD effluent value: 220 mg/l Height of Component Over Lateral: 16 in. RAmv TCC ofNiion! verso• ME^ -....n k r�bi'4i`�oRI nL ' r' �� TITT�TI Design of the Distribution Cell System Design Flow: 450.0 gal/day Distribution cell credit width (A): 1 10.00 ft i Distribution cell length (B): 90.0 ft Observation Pipes I Area of Distribution Cell: 900.0 ft Location from end of cell: 15 ft Contour Elevation: 1 D:90 ft eTGI f I of I I At -Grade Plan View i I� D� 116 Observabon 116 D B Pipes W JC. i. �� C lB �. A`r.�rrar�ry� t D At -Grade Cross Se cdon Final Grade Lateral Invert Synthetic Fabric l Cover Material" +xN r C)i stri buti on Cell I System Contour 6 4 a �.0 .,F. Observati Pipe a= iAy 1P 0 Tilled Area ;,4° ; C1 A_' Slope Notes: Distribution cell aggregate to comply with Comm FA.30(s)(1) Synthetic Fabric covering on cell per Comm 64.30(6)(g) Distribution Cell to have minimum 6" aggregate below Ibt and 2' above. At -Grade Pogo 3 d 6 Pressure Distribution Calculations Project Name: HIERLMEIER AT -GRADE Lateral Layout Lateral/Manifold Design Lateral elevation: 9 Lateral diameter: 2 � I Rows of Laterals: 1 Lateral to upper cell edge: 2 ft Manifold type: center + Lateral discharge rate: is. 15 qPm Orifice diameter. o.iae + In. System discharge rate: 30.3�gpm # of Laterals: 2 Distal Pressure: 2.5 ft Lateral Length: 44.5 ft Orifice Spacing/Distribution Forcemain Friction Loss Orifice spacing (X): 23.73 Inches Forcemain length: F 75 ft I Orifices per lateral: 23 Forcemain diameter. L_u In. Avo. ft /Orifice: 19.57 ft Friction loss in forvemain: 1.482 ft Avg. Lin ft/Orifice: 1.957 Lateral Side View Lateral ManIT010 x x x x ti" x x x x x Lateral Length Lateral Length Lateral Plan View Lateral Length Turn -up wA-4 valva or oleanout plug a a Oririce* on bottom of lateral equally *Paced PVC laterals and forcemain to rprnply with specifications per Comm 94.3Q12Xe) Clean Out Detail Observation Pipes Clean-cut plus Inel Grade or ball valor- V1later tight cep or plug l.ttwn Spririkler Box lot fNotec Cbm CcU 6" Minimu � of 3� ba Long Sweep 90 r or two 45's L 3/9" Bar Ed WdFS : C0 2002 BE ' - OZSZ -Eb9 - S Z L : 'ON Xtid ' ON I ' JN I awnld QNdOHidON WOdJ At -Grade PN" a of 6 Septic, Plump and Dose Tank Project: HIERLMEIEF: AT -GRADE Tank Information _ Dosage Volu Pump tank manufacturer W Does forcemain drain Pumip tank `, rrrcel: T G60 back to to ^X? Pump tank gal inch: Lateral void volume: 15.5 gal I Tank bottom eievabon Cinside): 82 ft Dosage to absorb Ceti: 77.5 gal I Septic tank manufacturer WEIk Forcemain volume: 13,1 gal Septic tank size /model: !A-LIM Total dosage: 90.6 gal I Pump and Filter Total Dynamic Head PurnM N!anul� - .CtUrer: Little Glard Are laterals highest point? Pump Model: _9EH if not, enter highest elevation: Dft Effluent Filter. Zaar-,Y All 00 System hoe.. (ds441 z 1.3) 325 ft �. . *40 A — _ !►rran! V of suffi ent size tone pmvl1 h+ -�lfir. Vertical removal of filter opening to tenMnary at or aoove grade. Friction Lift ( "D" to l Fl .� in forcomain: 1.48 ft Head loss from filter: 0 ft Pump Tank Diagram Total dynamic head (TDH): L Wimtsf�* Locking ►:over 4.Inch With blaming Label Nt inimu Lo m' rFinished Dose Tank �. Grade - Ir.. Gal, Ahernate A Reserve 18.9 321.4 t �� B Pump off to Alarm 2.0 34,0 El aition ecL ._ per Comm I 16.28 and C Total Dosage 5.3 90.6 r min `1 NEC300 G Effluent depth for pump 92.0 204.0 Weep Note A Total Capacity: 38.2 650.0 or Anti - Siphon B Device C Pump Curve: 9EH I FLU V- LiTE1 &3i Lt 0 1000 2000 3000 f I I ao i I Pump must be capable of: 30i� xo and heed pressure of: ti a la � 1p X MF 11111 2.5 0 0 i eY 4Y bu eu LI Giant r w- w uwtMINUTE H PUMP PERFORMANCE CURVE 1S 5\ RLWY 2d WCES:20 2002 BE 'spW 0ZSZ- 2b9 -STL 'ON XHd 'ONI 'JNIewn QNH11-lidON WOdA At Grade ppld RECEIVED Cover Page MAR 1 9 2003 SAFETY & BLDGS. DIV. Project Name: HIERLMEIER AT -GRADE Owner's Name Gordy& Angela Hierlmeier Owners Address 5th St. Glenwood City, WI 54013 Legal Description NE / se %. Sec 23 T 30 N, R 15 w �_ Township Village of Glenwood County Saint Crobr - - n Subdivision Walnut Ridge Lot# 6 Parcel ID# Table of Contents pg_ 1 Cover page 2 At -Grade Sizing Calculations 3 Pressure Distribution Layout and Dynamics 4 Dose Tank Calculations /Pump Curve 5 Management and Contingency Plan 6 Plot Map total # of pages: 6 Designer Name: Lyle J. Myers License #: ,�?� 7 �. Date: 3/5/03 Ph. #: 715-643 -2520 Signature: J �r�� At -Grade Design Methods Used ,�� V per "At -Grade Component Manual For Private Onsite Wastewater Treatment Systems" (Version 1.0) SBDA0570 -P (RAW) �� per " Pressure Distribution Component manual for Private Onsite Wastewater Treatment Systems" (Version 1.0) (06199) ��. At -Grade Pap x of s Sizing Calculations Project Name: HIERLMEIER AT -GRADE Site Conditions Design of Entire Component I Private Dwelling or Commercial: p (P or C) Upslope Width added to A (E): 2.0 ft % Slope: 16.8 Total Width of Distribution Cell(C): 12.0 ft. # of Bedrooms 3 Perimeter Beyond Aggregate (D): 5.0 ft Depth to limiting factor. 42 in. Overall Width of Component(W): 22.0 ft. Absorbtion rate of in -situ soil: 0.5 gal!f0day om nent L): 100.0 ft. Effluent quality Eff#I • =Elevation al in Cell: 100.50 in. Z Max BOD effluent value: 220 mg/I Height of Component ver e in Max TSS effluent value: 150 mg /I Hei ht Over Re;;f 14.0 in. Final Grade of nent: 101.83 Design of the Distribution Cell System Design Flow: 450.0 gal/day Distribution cell credit width (A): 1 10.00 ft Distribution cell length (B): 90.0 ft Observation Pipes Area of Distribution Cell: 0 Location from end of cell: 15 ft i Contour Elevation: j j�q �_elo� „ i A _ e �� �9 i At -Grade Plan View Observation B Pipes 116_� W C t B --i D L At -Grade Cross Section Final Grade Lateral Invert Synthetic Fabric Cover Material ��x� Distribution Cell System Contour �, " Q ° �� Observation Pipe 4 r C ti a Tilled Area - o d- E ! Slope Notes: 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. I At -Grade P 3 of e Pressure Distribution Calculations Project Name: HIERLMEIER AT -GRADE Lateral Layout LateraltManifold Design Lateral elevation: 100.5 ft y0, a Lateral diameter: 2 In. Rows of Laterals: 1 Lateral to upper cell edge: 2 ft Manifold type: Center • Lateral discharge rate: 15.15 gpm Orifice diameter. o.if3fa In. System discharge rate: 30.31 gpm # of Laterals: 2 Distal Pressure: 2.5 ft Lateral Length: 44.5 ft Orifice Spacing/Distribution Forcemain Friction Liss Orifice spacing (X): 23.73 Inches Forcemain length: 75 ft Orifices per lateral: 2g Forcemain diameter: 12 • In. Avg. ft /Orifice 19.57 ft Friction loss in forcemain: 1.432 ft Avg. Lin ft/Orifice: 1.957 Lateral Side View Lateral MantT01a x x x x x lrxllxt x x Ir x Ir x it x Lateral Length Lateral Length Lateral Plan View Lateral Length T urn -up wlball valve or cleanout plug 0 0 Orifices on bottom of lateral equally spaced PVC laterals and forcemain to comply with specifications per Comm $4.30(2)(e) Clean Out Detail Observation Pipes Clean-out plug final Grades or ball valve y--� -- -�.. Water tigfrt cap or plug Lawn Sprinkler Box lot Notes Closet Collar 6" Minimu mW be used in Long Sweep go place of 3M' bar or two 45's 3/8" Bar Lateral At -Grade Page 4 or 0 Septic, Pump and Dose Tank Project: HIERLMEIER AT -GRADE Tank Information Dosage Volu Pump tank manufacturer. WEISER Does forcemain drain rump tank Size /model: 650 back to tank? Pump tank gaUnch: 17 Lateral void volume: 15.5 gal Tank bottom elevation (inside 82 ft Dosage to absorbtion Cell: 77.5 gal Septic tank manufacturer. WEIS Forcemain volume: 13.1 gal Septic tank size /model: W1000 Total dosage: 90.6 gal I Pump and Filter Total Dynamic Head I Pump Manufacturer Little Giant Are laterals highest po int? ., I Pump Model: 9EH if not, enter highest elevation: 0 ft i Effluent Filter Zabel A System head (distal x 1.3) 3.25 ft Vertical Lift ( "D" to lateral) 17.50 ft � S- Au g: A egg nn�?nir�s of gr�{firiant -size to nmlritled to a {(o,k Friction loss in forcemaln: 111 removal of filler. Opening to terminate at or above grade. . ft Head loss from filter. �ft Pump Tank Diagram *Total d namic head TDH : 12-111 - n ��� Watertight Locking Cover / -Q �'/'� "I k 4 4 Inch With Label Waming Minimum finished Dose Tank Levels I i Grade In. Gal I Alternate A Reserve 18.9 321.4 I Outlet E rump off to Alan, 2.0 34.0 Location Elect per Comm 16.28 and C Total Dosage 5.3 90.6 NEC 300 D Effluent depth for pump i1•U 204.0 Weep Hole A Total Capacity: 38.2 650.0 or Anti - Siphon B Device C Pump Curve: 9EH FLO-°- L:TERIV iC RE 0 1000 2000 30 D ' I I ` 1- 30 _ 10 N Pump must be capable of: 30.3 GPM l220 I and head pressure of: 22.3 ft ' s 25 0. U 2U 4U bU !!U LW Giant FLOV- GALLONS/MMTE 9EH PUMP PERFORMANCE CURVE 11'9b eo!•�z I Z I At Grade Management Plan pursuant to comm 83.54 W.A. C. page5 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 keen solids from passing the septic during removal. No more than 1/3 of the usable tank volume may be occupied by sludge /scum. - veer inspecti If tank has greater than 1/3 volume sludge, tank contents must be emptied and disposed offff 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. At -grade and Lateral System The at -grade 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 out/tested every 18 months using the cleanout points at the end of the distribution laterals 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 at -grade 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 cell and replacing said components in order to return system to proper working order as required. Av. rp CAJ, / f 71 1 o p � � P A � 5 p 'i1 .�. a Cfiy o. CA "GRIGINAL 1363 SOIL EVALUATION O 1 1E.0 a 0 V Wisconsin Department of Commerce `'� r .__ ��_____ - of 4 Division of Safety and Buildings in accordance with Comm 85 `ode I Ce ' i d it Testing Attach complete site plan on paper not less than 8'% x 11 inches in si . Plan O CT t. C cL include, but not limited to: vertical and horizontal reference point (BM), irection and V percent slope, scale or dimemsions, north arrow, and location and dista to nea srd.v N I Please p rint all information. GO P 6Q OF ewed B Dat Personal information you provide may be used for secondary purposes (Privacy Law, 15.04 6*1 N�C1G 3 oZ� 3 P rope rt y Uwner rope a ion Brewer, Mike G Lot NE 1/4 SE 1/4 S 23 30 N R 15 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM p 03 361 29 St. 6 Walnut Ridge ` City State Zip Code Phone Number M Cit ll Village M Town Nearest Road 54072 715 - 772 - 3472 Glenwood City Walnut Ridge Drive New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate R0 GPD Replacement Public or commercial - Describe Parent material till Flood plain elevation, if applicable NA General comments and recommendations: install 10'x 120' effective (12'x 120' overall) rock unit at -grade system w/ laterals following 89.7 contour ❑ Boring # A Boring i Pit Ground Surface elev. 89.7 ft. Depth to limiting factor > 108 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0 -4 10YR 3/2 - sl 3 m gr ds cs 1f /m .5 .9 2 4 -11 10YR 3/2 - sl 2 f sbk ds cs 1 m .5 .9 3 11 -23 10YR 4/4 - sl 2 m sbk ds cs if .5 .9 4 23 -39 7.5YR 4/6 - s 0 sg ml cs 1 m .7 1.2 5 39 -108 10YR 4/6 - s 0 sg ml - lm .7 1.2 2 Boring # M Boring in Pit Ground Surface elev. 86.5 ft. Depth to limiting factor 42 in. Soil Application Rate Horizon Depth I Dominant Color Redox Description Texture Structure Consistence Boundary I Roots GPEF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 � 0 -4 10YR 3/2 - sl 3 m gr ds cs 1f /m .9 2 ! 4 -12 10YR 3/2 - sl 2 f sbk ds cs if .5 .9 3 12 -20 10YR 4/4 - sl 2 m sbk ds cs 1m .5 .9 4 20 -42 10YR 4/4 - sil 2 m sbk mvfr cs if .5 .8 5 42 -55 10YR 4/4 f2f 7.5YR 4/6 sil 1 c sbk mvfr - 2 3 * Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 50 mg /L ` Effl ent #2 = BOD < 30 mg /L and TSS < 30 mg /L CST Name ease rent) Iiignature I Number Henry F. Grote 222774 Address Certified Soil Testing Date Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 54751 7/20/2001 715- 233 -0398 r Property Owner Brewer, Mike Parcel ID # Page 2 of 4 Fil Boring # Boring \ Pit Ground Surface elev. 92.1 ft. Depth to limiting factor 45 in. Soil Application Rate Horizon Depth Dominant Color`' ' Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0 -4 10YR 3/2 - SI 3 m gr ds gs 1f /m .5 .9 2 4 -15 10YR 3/2' - sl 2 f sbk ds cs If .5 .9 3 15 -23 10YR 4/4 - sl 2 m sbk ds cs 1M .5 .9 4 23 -45 10YR 4/4 - sil 2 m sbk mvfr cs if .5 .8 5 45 -58 10YR 4/4 f2f 7.5YR 4/6 sil 1 c sbk mvfr - - .2 .3 Boring # Boring Pit Ground Surface elev. 84.7 ft. Depth to limiting factor > 112 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0 -5 10YR 3/2 - SI 2 f sbk ds cs 1f /m .5 .9 2 1 5 -19 10YR 4/4 - sl 2 m sbk ds cs 1M .5 .9 3 19 -40 7.5YR 4/6 - SI 1 m sbk mfr cs if 4 .6 4 40 -60 7.5YR 4/6 - Is 0 Sg ml cs - .7 1.2 5 60 -112 7.5YR 416 - s 0 sg ml - - .7 1.2 i a Boring # Boring IM Pit Ground Surface elev. 83.5 ft. Depth to limiting factor 5p ' in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boun ry Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0 -5 10YR 3/2 - sl 2 m gr ds cs 1f /m .5 .9 2 1 5 -9 10YR 3/2 - SI 2 f sbk ds CS 1 m .9 3 9 -14 10YR 4/4 - SI 2 m sbk dsh cs if 5 .9 4 14 -39 10YR 4/4 - sil 2 m sbk mfr gs 1M .5 .8 5 39 -50 10YR 4/4 - sil 1 m sbk mvfr cs - .2 .3 6 50 -70 10YR 4/4 f2d 10YR 6/2 sil 0 m mfr - - 0 .2 Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD < 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. SBD -8330 (R.07 /00) Certified Soil Testing w Property Owner Brewer, Mike Parcel ID # Page 3 of 4 F i-I Boring # Boring in Pit Ground Surface elev. 80.0 ft. Depth to limiting factor / Q(1� in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence — Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr: Sz. Sh. 1 0 -4 10YR 3/2 - sl 2 m gr ds cs 1f /m .5 .9 2 4 -8 10YR 3/2 - sl 2 f sbk ds cs 1M .5 .9 3 8 -24 10YR 4/4 - sil 2 m sbk mvfr gs if .5 .8 4 24 -40 7.5YR 4/4 - sil 2 m sbk mfr gs 1M .5 .8 5 40 -60 7.5YR 4/4 f2d 10YR 6/2 sil 1 c sbk mvfr - - .2 .3 Boring # gA 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 GPDN in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ❑ 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 ' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. � I ' I I ' Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD < 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. SBD - 8330 (R 07/00) Certified Soil Testing l � 6 F9 Jw (5. _� Jw � & s —� ' i I ri— � 0 9 A s J _ n J a,ocr r t r i a J � � r ST CROIX COUNTY F SEPTIC TANK MA1N`TENAN(. E AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer . Mailing Address Property Address . _ _. , Alc[ '' del t2 c, �„_. /?� , 0-e l y (Verification required from Planning Department for new construction) ` City /StateG cr.[�4ic� D l t Parcel Identification Number Z 31 '10(o�i� - �O LEGAL DESCRIPTION C Property Location v., S� ' /, Sec. ,Z3 . T,,� N -k�W, �of o �a� � Subdivision n l — - ^ Lot # Certifie Survey Map # , Volume / . Page # 3� z ✓ . Warranty Deed # ��� o '7 , volume D Page # _ (� Z �' '4 Spec house ❑ yes X no Lot lines ideritifiable gf yes ❑ no SYSTEM MAINTENANCE Improper use and maintenanceof 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 Deparlme -nt a certification form, signed by the owner and by a mastorplumber, 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 stating that your septic system has been maintained must be completed and returned to the St. Croat County Zoning Office within 30 da T 'V - 7 three year expiration date. i _ SIGNATUKE OF APPLICANT �.. DATE J 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 prr y described above, by virtue of a warranty deed recorded in R-egiaer of Deeds Office. SIGNA F APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary parnrit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed I J 2 0 7 8 P, 4 18 702057 +l REGIS REGISTER OF DEEDS � STATE BAR OF WISCONSIN FORM 1 • 1998 $T. CROIX Co. VI WARRANTY DEED Document Number RECEIVED FOR RECORD This Deed, made between Michael E. Br and B L. 12/12/2002 10:00AN Brewer, husband and wife, _ _ EXEMPT t REC FEE: 11.00 Grantor, and Gordon M Hierlmeier and Angela M. Hierlmeier, hu sband TRANS FEE: 39.70 COPY FEE: and wi fe, as survivorshi marital proper CERT COPY FEE: - PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (The "Property"): Recording Area Name and Return Address Citizens State Bank 113 West Oak Street Lot 6 of Certified Survey Map in Volume 11, Page 3224, Glenwood City, WI 54013 Being part of ut ots and J7 ATSI!MZr City and part of the Northeast Quarter (NE 114) of the Southeast Quarter (SE 1/4) of Section 23, Township 30 North, Range 15 West, City of Glenwood City, St. Croix County, 231- 1066 -20 Wisconsin. Parcel Identification Number (PIN) ThisI NOT homestead property. (is) (is not) Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements and encumbrances of record. e—. Dated this day of November 2002 ■ ■ Michael E. Brewer ■ Brenda L. Brewer AUTHENTICATIO0 H' 'r'9,�zji ACKNOWLEDGMENT �OTAR• STATE OF WISCONSIN ) SS. Signature(s) — St Croix * . * County.) S Personally came before me this 8 day of authenticated this day of N (/81y� �� November, 2002 the above named !• g � Michael E. Brewer and Brenda L. Brewer OF wt, — rnnultqut — -- TITLE: MEMBER STATE BAR OF WISCONSIN - - - - -- — (►f not to me known o be th xecuted the foregoing -- ins 1 t and ac o led th e. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY James H. Krave, Attorney at Law _ ■ ,- _.____— __._____. Glenwood City, Wi sconsin 54013 -0 N tary Public, State of Wisconsin — — -- (Signatures may be authenticated or acknowledged. Both are not J`'y Comm is permanent. (!f not, state expiration date: necessary.) 1. ... - 1 ---nQc *Names of persons signing in any capacity should be typed or printed below their signatures WARRANTY DEED STATE BAR OF WISCONSIN FORM N. 1.IM INFORMATION PROFESSIONALS COMPANY FOND DU LAC, WI 500 -6SS -2021 v w,° J •� FORM N0.985 -A 4i1.C11�ar � w r Stock No. 26273 6 MqFQ RA 219,7 55696+3 $ go y Wq� ► CERTIFIED SURVEY MAP NO. 3224 VOLUME 11 , PAGE 3224 U` BEING A PART OF OUTLOTS 36 AND 37 OF THE ASSESSOR'S PLAT OF GLENW000 CITY, ANP LOCATED IN PART OF THE N.W. 1/4 OF THE S.E. 1/4, ANP PART OF THE N.E. 1/4 OF THE S.E. 14 OF SECTION 23, T.30 N., R.15 W., CITY OF GLENWOOP CITY, T. CROIX COUNTY, WISCONSIN. LEGEND p is 0 15� \\\\`.,� UtUtt1�1111 � GOVERNhENT CORDER (AS NOTED) Fd 1 Iron Pqe ��•� • • • • it �•�y o--....SET 3/4" x 24" RE-BAR WE104NQ I _ � STEVEN J. s 1.502 LBS. PER LWEAL FOOT •��N W AAK s-1s10 SCALE:I" =150' � 8 /ZOjj % `• MENOMONIE ; Q Q b Wis. : t v I ' %i��/O •.. .. •� \ �Ci��� 0' 75' 150' 300' U A .` rrrnuntttaa I UnPlotted L,,6 `- 924.76' � S84- sr2se 35 PREPARED FOR: h Mr. Mory Booth K 1444 320th Street v% Glenvood City, Wt 54013 / K� ( WT 7 0 Q / 123,324 SQ. FT. r 2.83 AC. �' t`0 T 7 �h�u -� le 7 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code .S C Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must County o / include, but not limited to: vertical and horizontal reference pant (BM), direction and Parcel I.D. / Q percent slope, scale or dimensions, north arrov(; andlotallrrarid•distancelenearest road. Please print all Oforniafion. R Date c Personal Irdonnabon you frwiWe may be used for Purposes (lacy Law. s. 15.ON (1) (m)). Property Owner r_ a rty Location 067 Govt`: u'r L1J 114 1/4 S.2_7 T N R/ J WW 7 Property Owners Mailing Address i k # Block # Beb Wilmm or CSM# 1 -7 10 A/ milt AiWez State Zip Phone Number ❑ Village ❑ Town Nearest Road e nueutalk'i S�prr/yld�� - 0v t?N At eP V4( X New Construction Use: Op Residential / Number of bedrooms Code derived design flow rate GIRD ❑ Replacement ❑ Public or commercial - Describe: Parent material G- A Flood Plain elevation if applicable General comments �� / e l'� il - - Jul ��/ 71 5( and recommendations: (� 3 223, z2 3 2Z - / n wiz ?1 o Boring a � # Pit Ground surface elev. o �` a ft. Depth to lirniting factor in. Soli Application Rate Horizori Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP In. Munsell Qu. Sz. Cont. Color Gr. Sz Sh. 'Eff#1 'Eff#2 , O R �/Av Si L M 14 - k Al R I CE a r Borft a # 0 Pit Ground surface elev. ft. Depth to limiting factor —�— in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence: Boundary Roots GPDJ" in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 - BOD > 30 < 220 mg& and TSS >30 1 150 mg& ' Efluent #2 = BOD 130 mg& and TSS 1 30 mg& CST Name (Please Fruit) , lure CST N1Jmber Address Date Evaluation Corxluded Telephone Number N Property Owner NA 406w 8 m r—/— Parcel ID # � ®y 7 • - � �d Page —L?-- of Boring # ❑ Boring a 0 Pit Ground surface elev. i d ft. Depth to limiting factor in. Sol Rat Horizon Depth Dominant Redox Description Texture Structure ure Consistence Boundary Roots GPD in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. •Efl#2 1914 ?F P� /a M A G= S C L 2 M "� F - 1 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 GPD/if In. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eft#2 F BodW # Boring und ❑ Pit Gro surface elev. ft. Depth to limiting factor in. 5d Application Rate Horizon Depth Dominant Color Redmc Description. Texdre Stricture Consistence Bourxlary Roots GPD/ff in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. •Efl#1 •Etf#2 Effluent #1 = BOD, > 30 _< 220 rng& and TSS >30 � 150 rng& • Effluent #2 = SOD, 130 rng& and TSS S 30 mglL 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. seaaM(R.sroo) :7 X .23 -VA -- - -- _�_ -- _ -I - -- -- - - 41 'or /40' reW ej "/&;0 e, , x I , I , i I ;I - i I j I� -- - - - - -- -- -- - - - - - - - - ' - - - !--- j - - - - -- _ I Parcel #: 231 - 1065 -90 -050 08/08/2007 10:28 AM PAGE 1 OF 1 Alt. Parcel #: 23.30.15.898A -05 231 - CITY OF GLENWOOD CITY Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 03/30/2006 00 0 Tax Address: owner(s): O = Current Owner, C = Current Co -Owner O - BOOTH, MARVIN C & JEAN M MARVIN C & JEAN M BOOTH N11026 50TH ST DOWNING WI 54734 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description SC 2198 GLENWOOD CITY SP 1700 WITC 4 � Legal Description: Acres: 14.250 Plat: 3223 -CSM 11/3223 SEC 23 T30N R1 5W PT D37 OF CSM'S Block/Condo Bldg: OUTLOT 37 11/3223,11/3224,11132 2 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 23- 30N -15W Notes: Parcel History: Date Doc # Vol /Page Type 05/26/2005 796013 2809/627 WD 07/17/2003 730652 2318/128 WD 09/16/2002 690600 1979/220 WD 1217/580 WD more 2007 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations Last Changed: 04/30/2007 Description Class Acres Land Improve Total State Reason UNDEVELOPED G5 3.000 4,500 0 4,500 NO 06 PRODUCTIVE FORST LANDS G6 11.250 28,100 0 28,100 NO 05 Totals for 2007: General Property 14.250 32,600 0 32,600 Woodland 0.000 0 0 Totals for 2006: General Property 14.250 28,500 0 28,500 Woodland 0.000 0 0 Lottery Credit Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 I