HomeMy WebLinkAbout231-1041-90-300 Safer jnSIn Department of Commerce PRIVATE SEWAGE SYSTEM y:
SafeY� Count
Buildings Division INSPECTION REPORT St. Croix
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No -:
Personal information you provice may be used for secondary purposes [Privacy Law, s.15. (1) (m)]. 363816 KV
Permit Holder's Name: ❑ City ❑ Village ❑ Rown of: ate Plan ID No.:
Schemionek Gerald I City of Glenwood j jfiW6 /Yt� ; = 31� 6
CST BM Elev.; Insp. BM Elev.: BM Description: -Parcel Tax No.:
I M .D rya. (, r , = CST 6vw1 -- 231- 1041 -90 -300
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic (' � Benchmark 3b
Dosing 1��'� Alt. BM 91f q r
Aeration Bldg. Sewer ��9a q p. , f 0
Holding St/ Ht Inlet r ( r
TAN SETBACK INFORMATION St/ Ht Outlet -
TANK TO P/ L WELL BLDG. Ai Intake ROAD Dt Inlet
Septic 20 t 6 ` 2 a ` NA Dt Bottom I�• I �' - / 3
Dosing u 0 NA Header/Man.
Aeration NA Dist. Pipe
Holding Bot. System
PUMP/ SIPHON INFORMATION Final Grade# 5
Manufacturer emand St cover
Model Number �7 GPM
\ 1D TDH Lift �v •7, Friction System , s TDH 1`r� t mead
oss Forcemain Length , C)Z,' Dia. Z u Dist. To Well Z`�f
SOIL ABSORPTION SYSTEM /�lS' 1Tr�
BED/TRENCH Width Len gth No f renches PIT No. O s Inside Dia. Liquid Dept
DIMENSIONS 5 't DIMENSION
SETBACK
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING anufa
INFORMATION Type O / CHA Mode Num
System: " OR UNIT
r w t. p¢ v ayt
DISTRIBUTIO swop,
SYSTEM P r U •
Header /m if d Distribution Pipe(s) ,r x Hole Size x Hole Spacing Vent To Air Intake
-���---
Length Dia- Length � - • S Dia. 2 Spacing
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 Y o El Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.) Inspection 1: A'e/3D / I spection #2: —'
Location: 110 3rd Street .Wenwood CjtX, WI 54013 (NW 1/4 NE 1/4 26 T30N R15W) - 26.30.15.713A30
1.) Alt BM Description = °'� w GaD 5 `�- S — ��., ?SL. sd
2.) Bldg sewer length = 2 a f
- amount of cover = �� 5 C�
3.) contokir = S •'�S" + Ct'f
' 11 w u e -
Plan revision required? ❑ Yes o
Use other side for additi ormatlon. 1 (3 O I
SBD -6710 (R.3/97) Date Inspector's Signature Cert. .
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
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Safety and Buildings
PO BOX 7162
MADISON WI 53707 -7162
TDD #: (608) 264 -8777
iscons�n www.commerce.state.wi.us
Department of Commerce Tommy G. Thompson, Governor
Brenda J. Blanchard, Secretary
May 21, 2000,x'
CUST ID No.227819 , ` A7N. POWTS INSPECTOR
ZO ING OFFICE
WILLIAM J BERGH 3 ; `�y ST' ROIX COUNTY SPIA
2667 113TH ST Ste " ay j, ; . I W CARMICHAEL RD
CHIPPEWA FALLS WI 54729 SON WI 54016
RE: CONDITIONAL APPROVAL �' Identificati'' s
PLAN APPROVAL EXPIRES: 05/21/2666
Transaction ID N . 317896
Site ID No. 192626 -
SITE: Please refer to both identification numbers,
GERALD SCHEMIONEK - RESIDENCE above, in all correspondence with the agency.
ST CROIX County, City of GLENWOOD CITY
1453 320TH ST, GLENWOOD CITY 54013
NWl /4, SETA, S26, T30N, RI 5W, Outlot 48
FOR:
Description: MOUND SYSTEM
Object Type: POWT System Regulated Object ID No.: 664741
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:
+ On page 3, the lot lines were not shown and the parcel size was not indicated. Therefore, this approval
assumes that the entire onsite sewage system is contained on the same parcel as the residence it serves
and that no portion of the system is closer than five feet to any lot line. Refer to s. Comm 83.07(2)(a).,
83.10(1)., and 83.15(4)(a)1., Wis. Adm. Code.
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.
CAUTION: Wis. Stats. 145.135(2)(b)., indicates that the approval of a sanitary permit is based on regulations
in force on the date of approval. The effective date of COMM 83 revisions is expected to be July 1, 2000.
Thus, depending on the type of system and your design, this plan approval may not be eligible for sanitary
permit approval if submitted to the issuing agency on or after July 1, 2000.
Note: There is a ot� ential for a lawsuit that may delay the effective date of the code so this status may or may
not change.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
WILLIAM J BERGH Page 2 5/21/00
Sincerely, , DATE RECEIVED 05/18/2000
/ FEE REQUIRED $ 180.00
l FEE RECEIVED $ 180.00
ItE PAGEL , P fLAN REVIEWER II BALANCE DUE $ 0.00
Integrated Services
(608)266-2889, M - F, 0745 - 1630 HRS
PEPAGEL @COMMERCE.STATE. WI.US WiSMAR code. 7
cc: GERALD SCHEMIONEK
Cover Sheet RECEIVED
MAY 1 7 2000
SAFETY & BLDGS. DIV.
GERALD SCHEMIONEK
1453 320` Street Glenwood City, WI 54013
MOUND SYSTEM
Location: NW 1 /4, SE 1 /4, Sec. 26, T30N, R15W
City: Glenwood City
County: St. Croix
Plumber's name and license #: Edward Bergh MFRS (221889)
1 the undersigned state that these plans were designed
and submitted authority.
Plumber's signature:
Plumber's address: 1422 Prairie Lane
Eau Claire, Wl 54703
Plumber's phone number: 715- 834 -6194
Attachments: private sewage system review application
soil & site evaluation w /plot plan (copy)
application fee
CORRECTION NEEDED P °•w r.s.
SEE CORRESPONDENCE C °nditionall
P,
Page 1 -cover sheet
DE R ENT P V D
DIVIS S CE
Page 2- system calculations Y A ILD s
Pag 31- etailed plot plan
Page 4 -cross section (end view schematic) SEE CORRESPp
Page 5 -plan view & lateral schematics ?�� p� EN
Page 6 -pump or siphon chamber schematic
Page 7 -pump or siphon curve
Page lof 7
?t:
L:. «.ai
�iiih.r'i4l�aer..�JS •
SYSTEM CALCULATIONS (3 bdrm dose /combo)
ONE FAMILY RESIDENCE WITH 3 BEDROOMS AT 450 GPD.
DESIGN LOADING RATE 1_2 GAUSQ FT /DAY.
BASAL AREA DESIGN RATE 0_5 GAUSQ FT /DAY. goo MINIMUM SOFT.
DEPTH TO BEDROCK >24 INCHES.
DEPTH TO GROUND WATER >24 INCHES.
SYSTEM AREA CROSS SLOPE 8 PERCENT.
FORCE MAIN LENGTH 85 FEET OF 2 INCH SCH 40 PVC.
MANIFOLD /HEADER LENGTH NA FEET OF INCH SCH 40 PVC.
FORCE MAIN VOLUME 13.9 GALLONS.
MANIFOLD VOLUME o GALLONS
LATERAL LENGTH 72.5 FEET OF 2 INCH SCH 40 PVC.
NUMBER OF LATERALS 1 ELEVATION 98.3 (bottom of lateral).
LATERAL HOLE SIZE ' ,o255 INCHES.
LATERAL HOLE SPACING 20 INCHES OR 2_5 FEET.
HOLES PER LATERAL 29 TOTAL HOLES 29
TOTAL LATERAL VOLUME 11.89 GALLONS.
LATERAL DISCHARGE RATE 33.79 GALLONS AT 2_5 FEET OF HEAD.
ELEVATION DIFFERENCE 10.0 FEET.
FORCEMAIN FRICTION LOSS 2 FEET AT 24 calculated gpm.
TOTAL DYNAMIC HEAD 14.7 FEET.
PUMP 33.8 GPM AT 14.7 FEET OF HEAD.
PUMP MANUFACTURER Little Giant MODEL 9EH
DOSE VOLUME (approximate) 131 GALLONS. 134.29 ACTUAL DOSE
PUMP /SIPHON TANK 600 GALLONS.
SEPTIC TANK l000 GALLONS.
MANUFACTURER OF TANKS SKAW
PUMP MEASUREMENT ON /OFF 9 INCHES.
ALARM FROM TANK BOTTOM 16 INCHES.
DOSE TANK RESERVE CAPACITY 378.81 GALLONS.
SCHEMIONEK
page 2 of 7
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C w ) CORRECTION NEEDED
Tvrs ! SEE CORRESPONDENCE
C l-ry CXry
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��� 5Y5T�M G�055 SECTION
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1/2" WA511E0 HAKO AGGREGATE
6" 06LOW 2" A0OV6 TH6 LATERAL. j
# TO 0E GOVEREO OY 1YPAR OR EOUIV.
f
00TTOM OF LATERAL. _ELEV. 3
MINIMUM 6" TOP5011.
00TTOM OF 060 6116V. .1.5'
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AOTM G-R M601 UM
WA5H60 AND FILL.
If �
PLOW60 AREA \ \� MINIMUM 6" OU05011.
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YAK05 OF KOGK KE0U1
c YAK06 OF 5ANO K6OUIK60.
5Y5TEM GKO66 SLOPE.
Yew mloVE
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13ERGH COWRACfORS W_ NOT TO SCALE
PLAN NO
PAGE 4 OF 7
PLAN VIEW
= =___= i z.s' t �, '
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zs' i COS
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fi a s , - ,•
10,
NOTE: LATERAL TERMINATE5c -f FROM END OF ROCK BED /TRENCH.
Q 4" CAPPED PVC OBSERVATION WELLS
ANCHORED TO E OTTOM OF ROCK BED/TRENCH.
f LATERAL DETAI
2 SCHEDULE 40 PVC COUPLING 2 SCHEDULE 40
CONNECTS FORCEMAIN TO LATERAL. PVC ENOCAP.
2 " SCHEDULE 40
i lst HOLE PVC LATERAL.
._'.
P 50 •A.
11 l
y
•
��.. HOLES ON CENTER OF LATERAL BOTTOM LINE AT � fAPART.
E 9ERGi Camams m NOT TO SCAM
PLAN NO .
PAGE 5 OF 7
M
" COMBINATION SEPTIC TANK /PUMP CHAMBER
APPROVED LOCKING MAN-IOLE
COVER WITH WARNING LABEL
WEATHERPROOF JUNCTION BOX 4" VENT PIPE W /APPROVED
+' WARNING LABEL CAP > 25• FROM BUILDING
ON COVER
FINAL GRADE
6 IK 0- MIN
6. MAX. I 4" MIN.
I& MIN _T APPROVED QUICK
4' INSPECTION PIPE DISCONNECT
BAFFLES V4" WEEP
HOLE
M A ov
PUMP ON G /
. - - UMP OFF
MIN 3" OF SUITABLE BEDVING UNDER TANK
�. CONCRETE PUMP PAD
TANK MANUFACTURER: SKAW NUMBER OF DOSES +3
"`" - - -- _PER DAY
TANK SIZE- 5EPTIC/PUMP QrJ b Q� GALLONS PER DAY /N0.OF DOSES
GALLON5
ALARM MANUFACTURER: S.J. ELECTRO
VOLUME OF BACKFLOW:_....____,_„ 13. GALLONS
MODEL NUMBER: HW 101 TOTAL DOSE VOLUME:_.._.
GALLONS
SWITCH TYPE MERCURY GAP
AGItIE :
5
PUMP UMS
A A � t NCHES OR 3 G ALL ONS
MODEL NUMBER- O + B 2 INCHES 04 i iG ALLON5
MINIMUM DISCHARGE RA 33 a +C I g• GALLONS
+ v 5 INCHES ORFj, 3
GALLONS
TOTAL_ = 3l INCHES 0 GALLONS
VERTICAL DIFFERENCE BETWEEN PUMP OFF AND LATERAL ELEVAT16M
FEET
MINIMUM REQUIRED SUPPLY PR
49 FEET FEET OF FORCE MAIN
. • �i �i S� T
� n
FRICTION `C
CTION FACTOR/10p FEET:.._+ � � FEE �
2 INCH DIAMETER FORCE MAIN /� -
TOTAL DYNAMIC HEADIt L_ FEET
INt6RNAl. LANK DIMENSIONy:
LENGTH: _'' --
WIDTH
LIQUID DEPTH S 1 ' col- ieg,,.
PUMP CHAMBE BERGH CONTRACTORS MC
NCH NOT TO SCALE
PUMP AND ALARM MUST BE PLAN NO.
v.
ON SEPARATE CIRCUITS! PAGE 6 OF 7
4
TO , 1 715 652 8827 2000.01 -26 08 #001 P.03/03
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Specifications
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9E14 CIA So9330 WCU 41 0 its W4 13,0 log 71 a 6p Ws.) Ar t 1c NJ
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IICSA 410 230 N4 61 1000 27 9,1 x11J4z
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O-OA40 609350 IA/f;SA V10 115 Sa 20' 27 9.11 x11.64xa94 .
9M-RFS w 13A 1000 }ti g 60 49 32 17J 20' 27 .Nx6.94
UIICSA 0 290 34 6.9 1000 11 66 so 49
v a 1 1 11,64 Kim t
o I ooa cV- ` zo SMoU aoon Construction 1
Motor How, Coated Cast Iron
30 10 Im er Material Poly Carbonate
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Wolutc ABS
to '' i'owa Cord STTW A
MechWeal Shaft Seal
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Nitrite with carbon and .
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e� haft Steel -
0 0 Ss Upper Sleevo imd Lower
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PUMP PER F RMANCE C URV E
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Cfty, OK 73157 Fax: 408.95I.S674
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wiscor^n Department ofCommerce SOIL AND SITE EVALUATION Page 1 of 3
Division of Safety and Buildings in accord with Comm 83.05, W is. Adm. Code
A.C.E. Soil & Site Evaluations
Attach complete site plan on paper not less than W12 x 11 inches in size. Plan must County
include, but not limited to: vertical and horizontal reference pant (BM), direction and St. Croix
percent slope, scale or dimernsions, north arrow, and location and distance to nearest road. Parcel I.D.#
-- 231- 1041 -90 -000
APPLICANT INFORMATION - Pieas $l� i�pfo, Wtion. Reviewed By Date
Personal information you provide may be used for Rd� Ufpiisis`s" (Privacy l aw, s. 15.04 (1) (m)).
..
Property Owner y r� ,Property Location
vt Lot NW 1/4 SE 1/4 S 26 T 30 N,R 15
Draxler, Joe r. i
Property Owner's Mailing Address 'Lot # Block # Subd. Name or CSM#
JU r 1
1453 320 th Street � f 1999
City State '� Code Pfibfir City Village Town Nearest
Road
Glenwood City WI 3 - 7023 ° Glenwood City Third Street
® New Construction Use: Z k iQ ' Number. looms 3/ _ ❑Addition to existing building
Replacement ❑ Pub &A e�Cll�l d be
Code Derived daily flow 450 gpd Recommended design loading rate •5 bed, gpdi"ft .6 trench, gpd/ft
Basal area required 900 bed, ft 750 trench, ft' Maximum design loading rate •5 bed, gpd/ft .6 trench, gpd/ft
Recommended infiltration surface elevation(s) 96.80' at 12" above 95.80 contour. ft (as referred to site plan benchmark)
Mound to be installed in a "cresent" shape following contour. Finish grading should include placing fill at upper
Additional d esign / sit considerations
Parent material Glacial till over limestone bedrock Flood plain elevation, if applica ble na ft
S= Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank
U= Unsuitable for system ❑ S ®u M S❑ U El S® U ❑ S ®u [:1 S M U ❑ S® U
L
SOIL DESCRIPTION REPORT
Boring# Horizon
Depth Dominant Color Mottles Structure GPD/ft
In. Munsell Qu. Sz. Cont Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench
1 1 0 -4 10YR3 /2 None Ifs 2fgr mvfr cs 2fm 0.5 0.6
2 4 -16 10YR4 /4 None sl 2fsbk mvfr gw 2f,m,c 0.5 0.6
Ground 3 16 -31 10YR4/4 None A 2msbk mfr gw lf,m 0.5 0.6
elev
94.38' It 4 31 -42 10YR5/4 f2f 7.5YR5/6 gr. ifs lmsbk mvfr ci lf,m 0.5 0.6
D to 5 42 -60 10YR7 /4 None L.S.B.R. - - - - - -
limiting Horizon #5 consists of 2" -10" X 2" thick limestone fragments comprising >509/o of horizon. Voids and crevices between limestone fragments filled with
factor 10YR4/4 sl & 10yr4/6 Is.
31'
Remarks:
2 1 0 -4 10YR3/2 None ifs 2fgr mvfr cs 2f,m 0.5 0.6
2 4 -19 10YR4 /4 None sl 2fsbk mvfr gw 2f,m,c 0.5 0.6
Ground 3 19 -25 10YR4 /4 None sl 2msbk mfr gw If,m 0.5 0.6
elev
96.61'ft 4 28 -40 10YR5/4 f2m 7.5YR5/6 sl 2msbk mfi ci if 0.5 0.6
Depth to 5 40 -53 10YR7 /4 None L.S.B.R. - - - - - -
limiting Horizon #5 consists of 2" -10" X 2" thick limestone fragments comprising >50% of horizon. Crevices between limestone fragments filled with 10YR4/4
factor sl & 1 4/6 Is.
28'
Remarks:
CST Name (Please Print) Signat Telephone No.
James K. Thompson Cyi� -- 715- 248 -7767
Address A.C.E. Soil & Site Evaluations Date CST Number Ref #
340 Paulson Lake Lane, Osceola, 54020 4/27/99 3602 1027
PROPE97YOWNER: Dmxier, Joe SOIL DESCRIPTION REPORT tozl page 2 of 3
PARCH LD.# 231 - 1041 -90 -M A.C.E. Soil & Site Evaluations
I Horizon D?Pth Dominant Color Mottles Texture Structure nsistence Boundary Roots GPD/ftz
E in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed I Trench
3 1 0 -4 10YR3 /2 None ifs 2fgr mvfr cs 2f rn 0.5 0.6
2 4 -17 10YR4/4 None Sl 2fsbk mvfr gw 2f,m,c 0.5 0.6
Ground
elev 3 17 -37 10YR4/4 None s1 2msbk mfr gw lfm 0.5 0.6
96.75' ft 4 37 -45 10YR7 /4 None L.S.B.R. - - - - - -
Depth to
limiting
factor Horizon #5 consists of 2" -10" X 2" thick limestone fragments comprising >50% of horizon. Voids and crevices between limestone plates filled
37" with10YR814 limestone residuim and 10YR4/4 sl.
Remarks:
Ground
elev
Depth to
limiting
factor
Remarks:
Ground
elev
Depth to
limiting
factor
Remarks:
Ground
elev
Depth to
limiting
factor
Remarks:
iy'
303
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5 16pe in ayeess ■ ---�
01r / art
- Seal e : / = �D
ow Ilvde IopeS in QXCesS
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3.ld St. 5 kclw n 9e
GCQ�acq Cii w. is I v WAWA lit
Ssyoi3 Ossso �/, 5y�s"8 / ,41ternaAtc -
o all yF C, 6 of cAfi ")r4& � iy, cabin
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t -, 4 Safety and Buildings Division
PC
�+ SANITARY PERM t`i' PLKATION; `, 201 E. Washington Ave.
`
ISC P.O. Box 7969
>17Iii A' t �
Department of o Rlerce In accord with ILHR .A3. , Wis. �r Code'
`pr�~ 1 Madison, WI 53707 -7969
• Attach corn ans (to the Clai it�,ifcopy only) for the Sys m, onneaReir niif! As r6u t
than 81/2 x 11 ' h�e:trsriZe r "f
• See reverse side for `� s for completing this apple n t,5s=';,, &Nf Sanitary Permit Nu ber
The information you provide may be used by other government agency prograni aa� V Check if revision to previous application
[Privacy Law, s. 15.04 (1) (m)]. j
i' � i' ����"� �� State Plan I.D. Number
I. APPLICATION INFORMATION - PLEASE PRINT ALL INFO R 1-6 = oZ 3
.Prope Owner `q e / Property Location )
'(J 0 5erleol 1 & JAA /4 /6/C ' S T 3j:) , N R /5 E (or)
Property Owner's Mailing Address Lot Number Block Number
W /57v 61-01AIAl
City, Stat Zi V a Phone Number Subdivision Name or CSM Number
It Nearest Road
II. TYPE BUILDING: (check one) ❑ State Owned Vil age
Public 1 or 2 Family Dwelling - No. of bedrooms o� n of '� + O
111. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) � 713
1 ❑ Apartment/ Condo — 3
2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing H me utdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise:Sale Repa' estaurant /Bar /Dining
4 C] Church / School 8 [] Mobile Home P Service Statio Car Wash
5 E] Hotel /Motel 9 E] Off ice/ Factory ❑ O er: specify ilk 0
IV. TYPE OF PERMIT: (Check o ne box on line I' icable)
A) 1 jWNew 2 E] Replacem 3 E] Replac E] con epairofan
_____
System ________System______ _____Tank __ly__ stin __m Existing System
B) ❑ A Sanitary Permit was previously iss Permit Number D I ed
V. T YPE OF SYSTEM: (Check only one)
Non - Pressurized Distribution Pressurized Dis ' ution Experim al r
11 ❑ Seepage Bed 21 JENound ❑ Speci Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ In- Ground Pres e / r 42 ❑ Pit Privy
13 ❑ Seepage Pit X �� '' 43 E] Vault Privy
14 ❑ System -In -Fill "-+ 0Z , 3 (')
VI. ABSORPTION EM INFORMATION:
1. Gallons Per Day 2. Absorp. Area 3. Absorp. Are 4. Loadin to 5. Perc. Rate 6. System Elev. 7.. Final Grade
,r Re uired (sq. ft.) Pro p osed (sq. (Gals/day /sq. .) (Min. /inch) Elevation
Feet I0-5. Feet
Capacity VII. TANK in Ca allons Total of Prefab. Site Fiber- Exper.
INFORMATION g Gallons auks Manufacturers Nam Concrete con Steel glass Plastic App
New Existin strutted
Tanks Tanks
Septic Tank or Holding Tank QO ❑ ❑ ❑ ❑ ❑
Lift Pump Tank - /Siphon Chamber ❑ 1:1 E] El E] VI11. RESPONSIBILITY STATEMENT C 0 0
I, the undersigned, assume responsibilit r installation of the onsite sewage system shown on the attached plans.
Plumber's Name: (Print) Plumb Si ature: (NA Stamps) MP /MPRSW No.: Business Phone Number:
Plumber's Ac dress ( reet, City, State, Zi Code):
I R,�n . $ o�
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (includes Groundwater [Dat;elssu:ed I ssuing Agent Signature (No Stamps)
Approved ❑ Owner Given Initial Surcharge Fee) 4 Adverse Determination '2�
X. CONDITIONS OF APPROVA / SONS
DISAPPROVAL:
��4
�SBD -6398 (R.11/96) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber
r
INSTRUCTIONS
1. A sanitary permit is valid for two (2) years_
2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the
Wisconsin Administrative Code will be applicable_
3. All revisions to this permit must be approved by the permit issuing authority.
4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD -6399) to be submitted to the
county prior to installation
5. Onsite sewage systems must be properly maintained. The'septic tank(s) must be pumped by a licensed pumper whenever
necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of
Wisconsin, Safety and Buildings Division, 608-266-3151..
To be complete - and accurate this sanj!MIlV permit application must include:
I. Property owner's name and m lingaddress. Provide the legal description and parcel tax number(s) of where the
system is to be installed.
II. Type of building being served. coe and c lete A,kf bedrooms if 1 or 2 Family Dwel g.
III. euil use. If, ilding type is put36 k all pr box 5.that apply.
IV. Type it ec on line A. te, f erm ` is for tank repla ent, : reconnection, or repair.
V. Type of s M. e p ate x depen n t , type.
VI. Absorption st r forma P ide allinfor on requ d for nun ers 1 through 7.
VII. Tank informatio I in the c every new /or existing tank, list -the total gallons, number of tanks and
manufacturer's e, indicat pr or site constructed and tank material. Complete for all septic, pump /siphon and
holding tan this system. Che xperimentat approval only j,,f tanks received experimental product approval from
DILHR.
ti
VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.),
address and phone number. Plumber must sign application form.
IX. County/ Department Use Only.
X. County/ Department Use Only.
Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must
include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic
tank(s) or other treatment tanks; buil4fng sewers; wells; water mans/water service; streams and lakes; pump or siphon
tanks; distribution boxes; soil absorption systems; replacement systerp areas; and the location of the building served;
B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume;
elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section
of the soil absorption system if required by the county; E) soil test data oh ' a 115 form; and F) all sizing information.
V,
'---------------------------------------------------------- - - - - -- --------------------------- - - - - --
GROUNDWATER SURCHARGE
1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can
effect groundwater.
The monies collected through these surcharges are used for monitoring groundwater contamination investigations
and establishment of standards.
- - Safety and Buildings
PO BOX 7162
MADISON WI 53707 -7162
TDD #: (608) 264 -8777
Vhsconsin www.commerce.state.wi.us
Department of Commerce Tommy G. Thompson, Govemor
Brenda J. Blanchard, Secretary
August 05, 1999
CUST ID No.252324 ATTN.• POWTS INSPECTOR
ZONING OFFICE
BERGH CONTRACTORS INC ST CROIX COUNTY SPIA
1422 PRAIRIE LN 1101 CARMICHAEL RD XD
EAU CLAIRE WI 54703 HUDSON WI 54016
RE: CONDITIONAL APPROVAL Idenrifcatron tier
APPROVAL EXPIRES: 08/05/2001 -- - -
Transaction ID 8703
Site ID No. 177812
SITE: Please, refer to both icl iic hon munbers,
Site ID: 177812 vT above, in all, corres ence: Inc
ST CROIX Coun own of GLENWOOD
NWl /4, NE1 /4, ; -T30N, R15W
Facility: GERALD SCHEMIONEK
FOR:
Description: MOUND SYSTEM
Object Type: POWT System Regulated Object ID No.: 482916
The submittal described above been reviewed for conformance with a icable isco A ve Codes
and Wisconsin Statutes. The sub 1 has been CONDITIONALLY A OVED. The o er, as d '
chapter 101.01(10), Wisconsin Statut is responsible for compliance th all code re q ments.
The following conditions shall be met during c ction or insta tion and prior to occupancy or use:
+ On page 3, the well was not shown. The well sh e n loser than 25 feet to the septic /pump t and
no closer than 50 ft. to the mound system. Refer to omm 83.07(2)(a)., 83.10(1)., and 83.15( 1., •
Wis. Adm. Code.
A copy of the approved plans, specifications and this le r shall be o ite during construction and op
inspection by authorized representatives of the Dep ent, which may Jude local inspectors. All
required by the state or the local municipality shall obtained prior to co ncement of
construction /installation/operation.
Inquiries concerning this correspondence may made to me at the telephone number d below, or at the address
on this letterhead.
Sincer, , 7 DATE RECEIVED 07/22/1999
FEE REQUIRED $ 180.00
P EL, FEE RECEIVED $ 180.00
E
WTS P AN REVIEWER II BALANCE DUE $ 0.00
Integrated Services
(608)266-2889, M - F, 0745 - 1630 HRS
PEPAGEL @COMMERCE.STATE. WI.US
•
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Gerald Schemionek ✓ti
W15744 Brown Road Osseo, WI 54758 `
MOUND SYSTEM Z^
O
Transaction #:
Location: NW '/4, NE '/4, Sec. 25, T30N, R15 W
Town: Glenwood
County: St. Croix
Plumber's name and license #: Edward Bergh MPRS (221889)
I the undersigned state that these plans were designed
andsubmittedMzder lrryputho
Plumber's signature:
Plumber's address: 1422 Prairie Lane
Eau Claire, WI 54703
Plumber's phone number: 715- 834 -6194
Attachments: private sewage system review application
soil & site evaluation w /plot plan (copy)
application fee
COR RECfif ON NEEDED
Page 1 -cover sheet � P ri OwENCE
Page 2- system calculations
dge detailed plot plan
4 -cross section (end view schematic)
Page 5 -plan view & lateral schematics
Page 6- pump /siphon chamber schematic p �, . r•
Page 7- pump /siphon curve oy W S .
q � fiO �ally
01V jS EPA ENT F
1 �T oM �D
' M1p IL H 3
c GR RESPp N p
CF
Pagel of 7
SYSTEM CALCULATIONS (3 bdrm dose /combo)
ONE FAMILY RESIDENCE WITH 3 BEDROOMS AT 45o GPD.
DESIGN LOADING RATE 1.2 GAUSQ FT /DAY.
BASAL AREA DESIGN RATE 0_5 GAUSQ FT /DAY. goo MINIMUM SQFT.
DEPTH TO BEDROCK >24 INCHES.
DEPTH TO GROUND WATER >24 INCHES.
SYSTEM AREA CROSS SLOPE 7 PERCENT.
FORCE MAIN LENGTH 30 FEET OF 2 INCH SCH 40 PVC.
MANIFOLD /HEADER LENGTH NIA FEET OF wA INCH SCH 40 PVC.
FORCE MAIN VOLUME 4.92 GALLONS.
LATERAL LENGTH 72.5 FEET OF z INCH SCH 40 PVC.
NUMBER OF LATERALS 1 ELEVATION 103.80 (bottom of lateral).
LATERAL HOLE SIZE 0.25 INCHES.
LATERAL HOLE SPACING 30 INCHES OR 2 2 5 FEET.
HOLES PER LATERAL 29 TOTAL HOLES 29
TOTAL LATERAL VOLUME 11.89 GALLONS.
LATERAL DISCHARGE RATE 33.79 GALLONS AT 2_5 FEET OF HEAD.
ELEVATION DIFFERENCE 5.0 FEET.
FORCEMAIN FRICTION LOSS 1_1 FEET AT 34 calculated gpm.
TOTAL DYNAMIC HEAD 8_6 FEET.
PUMP 33.79 GPM AT 8_6 FEET OF HEAD.
PUMP MANUFACTURER ZOELLER MODEL 98
DOSE VOLUME (minimum) 124 GALLONS. 126.84 ACTUAL DOSE
PUMP /SIPHON TANK 600 GALLONS.
SEPTIC TANK 1000 GALLONS.
MANUFACTURER F
A UFACTURER O TANKS sKAw.
PUMP MEASUREMENT ON /OFF 8 INCHES.
ALARM FROM TANK BOTTOM 15 INCHES.
DOSE TANK RESERVE CAPACITY 395.28 GALLONS.
Gerald Schimonek
page 2 of 7
I
• ' 1�o AVM
N w'/4 - W&Ylt
40
t tn�ets S�awv+
b �r lv� iK
C SY T IL- 1 4 Mar To SCA(Z)
`Y 195TALA- S' -c ?5'' Y OCX r3E 9
NIo�Na w �-rH uP5ZoP6 D� �D
CORttECtlnN NEEDED �Nu � toa.s Conlydu�,
SEE CORRESPONDENCE
MfXc E � 4 - PV-a N Tb - MM r`
S 3 - Ez BALD &
53� 3�� E9ClE,NT tF i�iow,niC� i
o% - tbF a O 1 L
n
�4 4 NU+r►�A2�k. = too • o "( of A " 1ZESIR)
IM51Au- Se-AW 14,00 roob C4K4G '4Anonl
5ER C- / �i u w� P TArJ1L
I 05TAc c. �A' - 4 " 3o 4 Pvc E tLv W& 5 wex-
SYSTEM G�055 SECTION
1/2" - 2 1/2" WA5HE0 HARD AGGREGATE
6" 66LOW &, 2" A00V6 fM6 L AtERAI..
# t0 06 GOVER60 0Y tYPAR OR 6OUIV.
00t TOM OF LAtERAI,_ EI,EV. �� S
' I MINIMUM 6' tOP601I,
00ttOM OF 0E0 ELEV. I.5' ���
�.\ A6fM GIR MEDIUM
WASHED AN F I I.I.
PLOWED AREA 3 � MINIMUM 6' SU660
a•S I
4.1,
4
��- YAK05 OF KOGK K60UIKE0.
YAK05 OF 5ANO KEOUI
5Y5T GK066 51.OPE.
5ERGH CONTRACTORS III F NOT TO 5C&E
Na PAGE 4 OF 7
i
FLAN VIEW
i T z.s I 0'
p :2.5 p
NOTE: LATERAL TERMINATES FROM END OF ROCK BED /TRENCH.
Q 4" CAPPED PVC OBSERVATION WELLS
ANCHORED TO BOTTOM OF ROCK 6ED /TRENCH.
LATERAL DETAI
2 11 SCHEDULE 40 PVC COUPLING 2 " SCHEDULE 40
CONNECTS FORCEMAIN TO LATERAL. PVC ENDCAP.
211 SCHEDULE 40
PVC LATERAL.
702. S
HOLES ON CENTER OF LATERAL BOTTOM LINE AT 3o APART.
BERCH CONTRACTORS INC NOT TO SCALE
PLAN NO. PAGE 5 OF 7
NA
I
COMBINATION SEPTIC TANK /PUMP CHAMBER
APPROVED LOCKING MANHOLE
COVER WITH WARNING LABEL
WEATHERPROOF JUNCTION BOX 4" VENT PIPE W /APPROVED
WARNING LABEL CAP > 25' FROM BUILDING
ON COVER
FINAL GRADE
6" MIR
6" MAX. 4" MIN
18" MIN APPROVED QUICK
DIS
4" INSPECTION PIPE CONNECT
_ BAFFLES 1/4" WEEP
HOLE
ALARM ' A
0
PUMP ON' G • 7 8-i v j
o 0
• . - • PUMP OFF 0
MIN 3" OF SUITABLE BEDDING UNDER TANK
CONCRETE PUMP PAD
TANK MANUFACTURER: SKAW NUMBER OF DOSE5 ` S
PER DAY
TANK SIZE - SEPTIC /PUMP /4000 l 4900 -
ALARM MANUFACTURER GALLONS PER DAY /NO.OF DOSES A21 • GALLONS
. J. ELECTRO �� t�
VOLUME OF BACKFLOW:......_ „. „. „_. „..+ GALLONS
MODEL NUMBER: S HW 101 I31. �-r,
TOTAL DOSE VOLUME .............. „ GALLONS
SWITCH TYPE: MERCURY GAPA_ G I T I Eg,
PUMP MANUFACTURE ZOELLER A 3d I Np E5 OR
MODEL NUMBER' 98 + B 2 INCHES 0 !a- GALLONS
MINIMUM DISCHARGE RA 3 3. 4 +C ----8�— INC ES OR1-3L' l(* GALLONS
+ 0 5 INCHES O K A' 3 S GALLONS
TOTAL = 3 INCHES O G 7 33 GALLONS
VERTICAL DIFFERENCE BETWEEN PUMP OFF AND LATERAL ELEVATION`
5' O FEET
MINIMUM REQUIRED SUPPLY PRESSURE ...... „._.. „...•,• „ „• „_•. . .. . ...... _...._........._...+ FEET
FEET OF FORCE MAIN'L!LT- FRICTION FACTOR /100 FEET:..-+--L- I FEET
2 INCH DIAMETER FORCE MAIN
TOTAL DYNAMIC HEAD � b FEET
I NfORNAL LANK 01MEN510N5,
LENGTH 69 ”
WIDTH 5rJ �• / C�, I
LIQUID DEPTH
PUMP CHAMl5E t . :f .GALLONS /INCH BERGH CONTRACTORS INC. NOT TO SCALE
PUMP AND ALARM MUST BE PLAN NO.
ON SEPARATE CIRCUITS! NA PAGE 6 OF 7
to
HEAD CAPACITY CURVE 3 7/e 6 1/4
MODEL "913" 4 5/8 -1
0
25
3 5/8
6 20 �- +
v_
15 4 3/16
4 A
10
1 1/2 -11 1/2 NPT
2
5
0
U.S. GALLONS 10 20 30 40 50 60 70 60
LITERS 80 160 240
0 FLOW PER MINUTE
TOTAL DYNAMIC HEAD/FLOW PER MINUTE
EFFLUENT AND DEWATERNO
CAPACITY 12
HEAD UNITI MIN
FEET METERS GALS LTRS
5 1.52 1 2 273
10 3.05 at 231
15 4.57 45 170 3 5/16
20 5.10 1 25 95
Lock Volvo 23'
1
CONSULT FACTORY FOR SPECIAL APPLICATIONS
• Electrical alternators, for duplex systems, are available and • Mercury float switches are available for controlling single and
supplied with an alarm. three phase systems.
• Mechanical alternators, for duplex systems, are available with • Double piggyback mercury float switches are available for
or without alarm switches. variable level long cycle controls.
SELECTION GUIDE
Standard all models - Weight 39 lbs. - 1 /2 H.P. 1. Integral float operated 2 pole mechanical switch, no external control required.
2. Single piggyback mercury float switch or double piggyback mercury, float
98 series Control Selection switch. Refer to FM0477.
Model Volts -Ph Mode Amps Sim x Duplex 3. Mechanical alternator 10 -0072 or 10 -0075.
M98 115 1 Auto 9.4 1 or 1 3 7 — 4. See FM0712, for correct model of Electrical Alternator, "E - Pak'.
N98 115 1 Non 9.4 2 or 2 b 6 3 or 4 & 5 5. Mercury sensor float switch 10 -0225 used as a control activator, specify
D98 230 1 Auto 4.7 1 or 1 b 7 — duplex (3) or (4) float system.
6. Four (4) hole "J -Pak', junction box, for watertight connection or wired -in
E98 230 1 Non 4.7 2 or 2&6 3 or 4 3 5 simplex or duplex plex operation, 10 -0002.
7. Two (2) hole "J -Pak ", for watertight connection or splice.
CAUTION
For information on additional Zoeller products rotor to catalog on Combination Starter, FMO514; AN Installation of controls, protection devices and wiring should be done by
• qualified
Piggyback Mercury Switches, FMO477; Electrical Alternator, FMO486; Mechanical Alternator, licensed electrician. Alielectrical end safetycodes should berollowedincluding the
most
FM0495; Alarm Package, FMO513; Sump/Sewage Basins, FM0487; and Simplex Control Box, recent National Electric Code (NEC) and the Occupational Solely and Heallh Act (OSHA).
FMO732.
RESERVE POWERED DESIGN
For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump.
MAIL TO. P.O. BOX 16347
Louisv/Ib,KY40256 -0347 Manufacturers of ... l
`
z "JuLff f ffAr SHIP T0: 3280 Old Millers Lane
0 Loulsvilb, KY 40216
(501) 77 FAX(5 . 7 (800) 928 PUMP �ILl1YPAGNIIfD d/ � I
FAX (502) 774-3621
Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page 1 of 3
Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code
A.C.E. Soil & Site Evaluations
Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County
include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D.#
APPLICANT INFORMATION - Please 016 - 1055 -70 -000
Ili ation.
Personal information you provide may be used for d�rY s. 15.04 (1) (m)). R e Y Date
Property Owner f Property Location .
Draxler, Joe ' RECF(*f ED '� ovt. Lot NA NW 1/4 NE 1/4 S -2� T 30 N,R 15 W
Property Owner's Mailing Address t'`- ! t# Block # Subd. Name or CSM#
1453 320th Street 2 NA Proposed CSM
City State, Code P r 1' City ❑Village ❑Town Nearest Road
Glenwood Ci WI ` S.4'013 7 6tSn(7 023 ' Glenwood 320Th Street
❑ New Construction Use: `Real I Number ot,64 ms 4 ❑Addition to existing building
r _. __
❑ Replacement ❑ P" rgia e
Code Derived daily flow 600 gpd Recommended design loading rate .5 bed, gpd/ft' 6 trench, gpd/fts
Basal area required 1200 bed, ft' 1000 trench, ft Maximum design loading rate .5 bed, gpolft .6 trench, gpolft
Recommended infiltration surface elevation(s) 103.30 at 12" above 102.30' contour ft (as referred to site plan benchmark)
Additional design I site considerations Mound to be installed in a "cresent" shape following contour. Chisel plow mound site to >15" to disturb platy
Parent material loess over glacial till Flood plain elevation, if a plicable NA ft
S= Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank
U= Unsuitable for system [I S N U ❑ S❑ U El N U 1 S❑ U ❑ S M U ❑ S N U
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Structure GPD�
Boring# Horizon in Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench
1 1 0 -8 10YR3 /2 None sil 2fgr mvfr as 2f, lm 0.5 0.6
2 8 -15 10YR4 /4 None sil lmpl mfr cs 1f& m 0.5 0.6
Ground 3 15 -28 10TY4/4 None sit 2msbk mfr gs if 0.5 0.6
elev
99.00' ft 4 28 -40 10YR6 /4 f2f 7.5YR5/6 sil 2 thick pl mfr gw - 0.5 0.6
Depth to 5 40 -82 10YR6/4 f2d 7.5YR5/8 sil 0 m mfr - - N.P. 0.2
limiting
factor
28 "/
Remarks: Platty structure readily parts to 2fsbk when disturbed.
2 1 0 -8 10YR3/2 None sit 2fgr mvfr as 2f, Im 0.5 0.6
2 8 -13 10YR4 /4 None sil lmpl mfr cs if &m 0.5 i 0.6
Ground 3 13 -32 10TY4 /4 None sil Icsbk mfr gs if 0.2 0.3
elev
103.37 ft 4 32 -41 5YR4/6 None fsl 0 m mfr gw - 0.3 0.4
Depth to 5 41 - 62 7.5YR4/6 f2d 7.5YR5/8 sl till 0 m mfr - - N.P. 0.2
limiting
factor
41"
Remarks: P structure readily Pans to bk when rbed.
CST Name (Please Print) Signature: Telephone No.
James K. Thompson ,) 715- 248 -7767
Address A.C.E. Soil & Site Evaluations f Date CST Number Ref #
340 Paulson Lake Lane, Osceola, Wl 54020 4/27/99 3602 1028
I,
'kWKRTYOWNER: Drexler Joe SOIL DESCRIPTION REPORT Page 2 of 3
-OARCEL I.D.# 016- 1055 -70 -000 A.C.E. Soil & Site Evaluations
Horizon Depth Dominant Color Mottles Texture Structure nsistence Boundary Roots GPDtw
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
3 1 0 -8 10YR3/2 None A 2fgr mvfr as 2f, lm 0.5 0.6
2 8 -20 10YR4 /4 None A 2msbk mfr cs lf& m 0.5 0.6
Ground
elev 3 20 -29 10TY4 /4 None sl lcsbk mfr gs If 0.2 0.3
98.73' ft 4 29 -33 5YR4/6 None fsl 0 m mfr gw - 0.3 0.4
Depth to 5 33 -62 7.5YR4/6 f2d 7.5YR5/8 A till 0 m mfr - - N.P. 0.2
limiting
factor
33"
Remarks:
Ground
elev
Depth to
limiting
factor
Remarks:
Ground
elev
Depth to
limiting
factor
Remarks:
Ground
elev
Depth to
limiting
factor
Remarks:
3 of3
■ 5o;1 chawa4 P,'t
C/e p"ier ,
IsX�O'er
I 320�St.
� syae�
lob 2 of'P %ooscd Cs�ry �.
fIww acrry, S, zs,T. Sort,
S-E• Croix Co•, wl-
�J
AI terna- A lre 8•PC roocT Ix
C. N.C. driver, ;" o 9�owwd .
O` ��o. �' ,�.� i SOoQ
-
Z
8 -3
7
a *�V^
\ br
0 .
a wr Top oFYy" t•cbar
,assu a.l cit _ 10.00
f%'cLd
)e A,
L ox— Ole
04/10400 MON 07:55 FAX 715 386 4686 ST CRX CO ZONING 002
Ili ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
O WNERSHIP CERTIFICATION FORM
Owner/Buyer dhad l et j9Lfi C M l'o ey ,C
Mailing Address / 3/0 D
Property Address _ lid 3 a 't S&- F-' t
(Verification required from Planning Department for new construction)
City/State 44 &10(4 6'6 Parcel Identification Number
LEGAL DESCRIPTION "/
Property Locationl�✓' /,, C ' /,, Sec. ZS , T 3 N -R 1.5 W, Town of Glen C✓ooc�
Subdivision rr // Lot #
Certified Survey Map # ,Volume -3 Page #
Warranty Deed # �o/ (o 1 , Volume NSD . Page # 3 5 7 1 (
Spec house ❑ yes ® no Lot lines identifiable 5� 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
masterplumber, 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.
Uwe, 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
t�a your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30
days o � ear expiration date
SIGNATURE OF APPLICANT DATE
OWNER CERTIFICATION
I (w ) rtify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of
the pro d cn d bove, by virtue a warranty deed recorded in Register of Deeds Office.
� G� � G
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 deed from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
�l 14S& AGE 3 54 �a
616124
DOCUMENT NO KATHLEEN H. WALSH
WARRANTY DEED REGISTER OF DEEDS
ST. CROIX CO., WI
RECEIVED FOR RECORD
12 -28 -1999 9:30 AM
VARRAIM DEED
Joseph R. Draxler and Charlene Drexler, husband and wife EXEMPT N
CERT COPT FEE:
as survivorship marital property COPT FEE:
conveys and warrants to Gerald W.Schmdo and TRANSFER FEE. 82.50
Monica K. S dw:dc RECORDING FEE: 10.00
. husband and wife as survivorship PAGES: 1
marital property, the following described real estate in St.
Croix County, State of Wisconsin:
a�.3o -Is 7/34-30
RETURN TO: S Fq;K . CD OF MON
Parcel Identification Number (PIN) 10th Street
X23 /_ /oyj_Qo -3ar1 P•O. Box 187
Osseo, WI 54758 -0187
Lot 1 of Certified Survey Map recorded in Volume 13, Page 3707, as Document 11608847.
Located in the Northwest quarter of the Southeast quarter of Section 26, Township 30 North, Range 15
West, City of Glenwood City, St. Croix County, Wisconsin.
This -4s not homestead property.
Exceptk/n to warranties: highways, easements and restrictions of record.
Dated this day of _ �,Q& -1 1999.
(SEAL) ` /SEAL)
Joseph R. Drexler
ISEAL) ,/ d 4 �9/vL 2J &" / 6 /SEAL)
i
• Charlene Drexler
AUTHENTICATION ACKNOWLEDGMENT
Signatures) STATE OF WISCONSIN Iss.
S1.Ceot'l County. J }t
authenticated this day of 199_ Personally came before me this _ 30
day of AuiAt� 1999, the above named
tM s nd a R�raxle�r and Charlene Drax ter,
husband wife as survivorship marital property
to me known to be the persons who executed the
•
TITLE: MEMBER STATE BAR OF WISCONSIN instrument and acknowledge the same. o
(!f not, authorized by 3706.06, Wis. Stats a JOHN E. LAFWN
Q1pv , NolEY Pdit
THIS INSTRUMENT DRAFTED BY C*1
John K. Higley, Atty. Notary Public .(toi>L County, Wisconsin.
_ Menomonie, WI 54751 My commission is permanent ((f not, state expiration
(Signatures may be authenticated or acknowledged. date: 1 4 , 19_)
Both are not necessary.)
I
*Names of persons signing in any capacity should be typed or printed below their signatures.
%5%URYEY� M
Located in the Northwest quarter of the'Southeast'`quarter of Section
Township 30 North, Range 15 West, Gity of Glenwood City, St. 'Croix;
Couniv, V"' it; co1'lSin
Owner: Joe Draxler
' Glenwooc+. t it �i
x
1/4 corner
ti ..`t1UIII nY - E?i
(hertitsc! i -,p) . v
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N 88'59' 11 A
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i 1319.49' W
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LEGEND
} 6�. Croix County sv -tion corner '
t
j monument (as
1 "X24" Iron pipe ii*hing 1.68
pounds per lin. t. set.
1 j i.iearings referenced t4, the West
o: the Southeast quarter of Section 2'6;
assumed to bear N00` tip'.
rip
r
I HARVEY G. 1!Y + �
JOHNSON M
i�I S -1899
IX
of % HUDSON
., W IS r 1
3 2� /�IQI�rU
SUN
i
EIoui: r corner �.
SCALE IN FEET 300
A pa: cei of iar t': l oc:,ted In the N quarter of the Southeast quarter of Section 26,
NO!-:, ' tinge 15 West, City of Glenwood City, St. Croix County, Wisconsin de
r
gem nerc,ng at tt;c :�uuth quarter corner of Section 26; thence North 00 degrees 44 minutes
U` seconds West 1632.5 , feet along the West line of -the Southeast quarter of Section 26 to the
1'olnt of nhi rig, thence continuing North 00 degrees 44 minutes 0_5 seconds West 522.97
i ct, a,erIC &LYiees 59 minutes 11 seconds East 1319.49 feet; thence South 00 de-
�;rre :� nninutes 5 7 sec=onds East 309.6'1 Beet; thence South 79 degrees 49 minutes 02 seconds
V�'.st 1338.09 feet to the Point of Beginning, contain ing square feet (12.617 acres
rror� or itss, a,►iI b ei ng subject to all easetnents;``restrtcfions'and covenants of record. "�'' e-
i, Harvey G..iohnson, registered Wisconsin Land Surveyor, hereby certify that tinder direc-
001 of Joe Uraxier. r„�.rer, I have surveyed and mapped the above described property; that such
'n tip is a representation of the exterior boundaries of the land surveyed, and
thm i have iullt, cempi!ed with the provisions of Section 236.34 of the Wisconsin Statutes, the
: Fount•, Subdivision Ordinance and the City of Glenwood City Subdivision' Ordinance
to the ;)c: l c.' oofessional knvivledge, understanding and belief.
.. ��,tttutnit,,
w AfS
A f�j q S + r . w
.!t,hnsor! , �; i HUD 9 i
nc. i s 1
r
corn Sir 5 40 16-1 128 *o'j� 'U '�" »..�..•" (7� a :�
:•,,, ner by approved by the City Council of the City 0 f Glenwood City .