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HomeMy WebLinkAbout026-1102-60-200 v Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM y- r' Safety and Buildings Division Count 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.15.04 (1)(m)]. 370297 Permit Holder's Name: ❑ City ❑ Village ❑ 11own of: I J �ate Plan ID No.: Marek, Todd Richmond Township s iD. CST BM Elev.. Insp. BM Elev.: BM Description: rcel Tax No.: & / - 5 026- 1102 -60- D TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 1z� Benchmark Z Z Z4 n Dosing ` Alt. BM s Bldg. Sewer Ho ' My Ht Inlet I l•1 RS' TANK SETBACK INFORMATION St/ Ht Outlet ---- -� TANK TO P/ L WELL BLDG. Air i to ntake ROAD Dt Inlet Air Septic y y p' - 5 — NA Dt Bottom R3 •qo t Dosing " ZS ! 39r NA Header /Man. I II NA Dist. Pipe H ng Bot. System ( �S °($• a PUMP / SIPHON INFORMATION Final Grade Manufacturer Demand St cover Model Number 0 GPM lI0 �P S' ��• �' 1 `� aS� lob. s ! D Friction ! tem T Lift �. L 3 Z.5� TDH,o Ft 5j `I. a VMS - 0 Forcemain Length � p' j Di a . ` t Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width r Length ( Q f � ren S hes PIT No. Of Pits Inside Dia. id Depth DIM N I N W �[aa -1s DI SYSTEM TO P / L BLDG WELL LAKE / STREAM A Manufacturer: SETBACK CINFORMATION Type O o2S' i- � �� Num er: System O DISTRIBUTION SYSTEM Header / Manifold Distribution Pipes} / u x Hole Size x Hole Spacing Vent To Air Intake Length_Q, Dia. Z_ Length �•W Dia. 1 ! Z Spacing I 'r 30 it 1" SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Ye ❑ No S ,,I + zz COMMENTS: (include code discrepancies, persons present, etc.) q Im Inspection #1: /n / 9 /UDInspection #2: tt /O o � 4 Location: 1234 150th Street, New Richmond, WI 54017 (NE SE 1/ 66 T30NN R 2 36.30.18.564Lot S 1.) Alt BM Description — grow �,,� ($W,M? 2.) Bldg sewer length= 25 " - amount of cover = -.,, Z 3.) contour A '} (17 p)l y) SUld 41" (CM �l,nC I Z - zoo Plan revision required? ❑ Yes tN L a L� Us o ffer idefor additional inform Q_ 2-6 5 6710 (R.3 /97) u co Inspector's Sign t Cert. No. qN AL N, ,,,d� ,> ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: .n_. �m q W� 1 7 3§ _ i I € w � s 3 € - TT: �. r Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.2 1, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 lViscons Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of Commerce [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size. County State Sanitary Permit Number Check if revision to previous application State Plan I. D. Number L I. Application Information - Please Print all Informatio 1 � Location: Property Owner Name �+C Property Location RECEIVE t ECEIV c NE 1/4 S,1/4, S 3(.T3 �, F) laora Property Owner's M g Address Lot Number Block Number C✓ o X L is 6 2V00 { City, State Zip Code 0br@ er Subdivision Name or CSM Number COUNTY �1 fl�Cc'� C) ' `\ INGOFFIC — 35S . Type of Building: (check one) ❑ City 1 or 2 Family Dwelling -No. of Bedrooms: { ❑Public /Commercial (describe use):_ 4 Town of ❑ State -Owned kd�j Nearest Road Parcg Numb r) O — III. Type of Permit: (Check only one box on line A. Check box on line B if applicable) 3 S _ ,Io A) 1. New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to stem System Tank Only Existing System B) Permit Number Date Issued K A Sanitary Permit was previously issued - 3q62-9 Z 6 o C7 IV. Type of POWT System: (Check all that apply) , ❑ Non - pressurized In- ground !'Mound �� k (b (o ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: ,, IF - 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade PP Y Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) Elevation OCR vo S , G `- /0 1 y9, VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS showp.9n the attached plans. Plumber's Name (print) Plum is Signa re (no stamps M PRS No. Business Phone Number R� • a Plumber's Address (Street, City, SA, Zip Code) IX. County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuin ge t Signature (No stamps) Approved ❑ Owner Given Initial Adverse Surcharge Fee) Determination d Op X. Conditions of Approval /Reasons fo r Disapproval: // 71115 rp(/i Sro 6✓a S '5& / � �r� r77`�p *Ale rti. �✓a rn berS� SBD -6398 (R. 07/00) Safety and Buildings Division V isconsi n SANITARY PERMIT APPLICATION 201 W. Washington Avenue P O Box 7162 Department of Commerce In accord with Comm 83.05, Wis. Adm. N2 , Madison, WI 53707 -7162 e Attach complete plans (to the county copy only) for the system r not a P° ty than 8 vz x 11 inches in size. See reverse side for instructions for completing this applicat'a 1% I [ CE /VE9 St J itary Permit Number Personal information you provide may be used for secondary purposes J U N C eck f revision to previous application [Privacy Law, s. 15.04 (1) (m)]. 3T 1k ©O ttat F$anjReview Transaction .Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL I_ Property Owner Name Pr ion �a e t /4� / T1] ,N,R E(or C! Property Owner's Mailing Addrress u g Block Number C City, State Zip Code F hone Number Subdivision Name or CSM Numb V�• -e kl 4,t), ed , > S i e Z II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ Cit Near t Road / oe ❑ Village Public 0 1 or 2 Family Dwelling - No. of bedrooms o Town OF g, 111. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 3 0� / g • 4 A _/O 1 ❑ Apartment/ Condo © A 4 l �© `� ' � � / 0 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/ Factory 13 ❑ Other: specify IV. TYPE OF PERMIT (Check only one box on line A. Check box online B, if applicable) A) 1. 0 New 2. ❑ Replacement 3_ ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System ________ System____ _________TankOnly______________ Existing Syste ________ Exis -- - - - stem B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 210 Mound Specify Type 41 []Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pr ssure r 42 ❑ Pit Privy 13 ❑ Seepage Pit t 43 C] Vault Privy 14 [] System-In-Fill 0 VI. ABSORPTION YSTEM INFORMATION: 1. Gallons Per Day rR�quirecl(scl.ft.) Absorp. Area 3. Absorp. Area 4. Loading Rate S. Perc. Rate 6. System Elev. 7. Final Grade Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation CGS ci d s"'Od �r�• C Feet Feet VII. TANK TANK in Cap acit y Total # of Prefab. Site Fiber- Exper. INFORMATION New Existing Tanks Manufacturers Name concrete strutted steel glass Plastic App Tanks Tank Septic Tank or Holding Tank A ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamberl I t Q 0 1 yc I ®• 1 ❑ 1 Eli ❑ 1 ❑ 1 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (No Stamps) P PRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Code Ale" IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved nitary Permit Fee (includes Groundwater ate slue Issuing Agent Signature (No Stamps) t / �^ � Surcharge Fee) 1 -2fo 1 Approved [:]Owner Given Initial .[. ID Adverse Determinatio ZWD 4MLAA� X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -6398 (R.12/99) DISTRIBUTION: Original to County. One copy To: Safety s, Buildings Division, Owner, Plumber INSTRUCTIONS j 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe 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 instaklatibn 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 sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permitis for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information_ Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, purnp /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. 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; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system 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 on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- 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 • 1340 E GREEN BAY ST STE 300 SHAWANO WI 54166 �sconsin Tommy G. Thompson, Governor Philip Edw. Albert, Acting Secretary Department of Commerce November 02, 1998 CUST ID No.267341 ATTN.• POWTS INSPECTOR WEGERER SOIL TESTING & DESIGN —, ZONING OFFICE 421 N MAIN ST s_! _. �..._ {' ' �.. ST CROIX COUNTY PO BOX 74 .1101 CARMICHAEL RD RIVER FALLS WI 54022 � ' �, • ; 14tMSON WI 54016 RE: CONDITIONAL APPROV APPROVAL EXPIRES: 11/02/2 ' 1 98 >I hder tific! ,, �� Transaction ID o. 184964 Cote ICE Y Site ID No. 1635 ZONING OFF SITE: Please refer to both identification n'�nbera, Site ID: 163540 above, in all correspond�e rxoth the.agen f ST CROIX County, Town of RICHMO NE1 /4, SE1 /4, S36, T30N, R18W TODD MAREK FOR: Description: MOUND SYSTEM FOR TODD MAREK Object Type: POWT System Regulated Object ID No.: 433820 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. 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. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, DATE RECEIVED 10/26/1998 FEE REQUIRED $ 180.00 KEI A WILKINSON, POWTS PLAN REVIEWER FEE RECEIVED $ 180.00 Integrated Services BALANCE DUE $ 0.00 (715)524 -3630, FAX: (715)524-3633, M -F 7 AM - 3:45 PM KWILKINSON @COMMERCE. STATE. WI.US T 1 L S Vi f-L T Page ` of 6 MOUND SYSTEM FOR A ,� BEDROOM RESIDENCE 18496 LOCATED IN THE � 1/4 OF THE Se 1/4 OF SECTION 36 ,T N, R I& W, OF �, . e.Ct.C1 COUNTY, WISCONSIN. TOWN `�, C'tk'N►t�iVD � ST 1.J( INDEX PAGE 1 •of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW -CROSS SECTION: OF 1 AouKi D PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT , PAGE 5 of 6 PUMPING CHAMBER C SLc £ Sh4- iFICATI0tSS ' PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR _- '�•o. PREPARED BY WF= CGE= =ZcEF? 80 S L TEST I P4 C-3 Oo�OtttltA�j AND. 0 Co p4 % I3 F= I GN SF F;z � I CFA • ,. ""'•••.` J F.O. BQI 74 421 K. tSA1M ST. ARTHUR L WEGERER RIYFF. FALLS. 91 54022 a FLLSZ n� e,s P , P.p.W.T.S. 715 -4rj- -0165 wrs. Conditionally ��•`,,.,�' APPRO �•o��SIGI1�'4� VED F COMMERCE Nf SN i DEPARTMENT DIVISION OF SAFETY AND)WILDINGS SEE CORRESPONDENCE JOB NO. ' PLOT PLAN Page 7 - of �o Scale 1"= "= L) O •pC ZSu'A� OL 01 �YtoM of `TNtk4 C.t; i I _ tl. 99.p� I uolo i i I I y / I I F-- M o u�N D 6 piv nt 1S y,, o� p`'c y Both x SvG��s'Ra� W TALL L 11 cJ1'til OTv I I I j NOTES -1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. ( a required) 3. Install 4" observation pipes with approved caps. ( _ _ required) 4. Septic tank to be Y z_%O /kOp gallon capacity manufactured by 5. Bench Mark - W-A - L-L tou O' oN2 'tee or 11, kAtITE 51*il-� w /o2N6e CUBSOQ MT 'bM - T. 6. Divert surface water around system to prevent ponding at the uphill side. " Page 30f Approved Synthetic Covering tsT�wr: ci33; Distribution Pipe Medium Sand H e Topsoil - 3 E D e y % Slope (Force Main Plowed Trench of -2"-2-2" From Pump Layer_ Aggregate Undisturbed 61 . Q,, Ft. Soil E 1 • Z Ft. Cross Section Of A Mound System Using F o Ft. I Trench For. The Absorption Area G a Ft. A S Ft. H I• S Ft. B xoo Ft. I Ft. Linear Loading Rate= 6 -Z GPD /LN FT J $ Ft. Design Loading Rate= 0.3 GPD /SQ FT K l 0 - Ft. L \ Z� Ft . W Zy Ft. L Force B K Main �— M � w W Distribution Trench Of Pipe Aggregate Observation Permanent J Markers Pipes (Anchor securely) Mound Using I Trench For Absorption Area PageN.Of Perforated Pipe Detail End View End Cop. ) Perforated j bra y PVC Pipe as Install permanent marker at end of each lateral Holes Located On Bottom. Are Equally Spaced Q End Cop F �-2 * PVC Force Main Distreoution Pipe Lost Hole Should Be Next To End Cop Distribution Pipe Layout V , I Sft. X %\I Inches Y 316 Inches Hole Diameter 11'-- ".finch Lateral " .; Q nch(es ) Manifold — Inches Force Main " `���� inches # of holes /pipe 2 Invert Elevation of Laterals g g -5 Ft. �oxt.k')_ z3.vxZ, �.46.boGw� 4 Place 1st hole \ from tee with succeeding holes at : intervals. Last hole to be next to the end cap. _ Combination SeptAc; and PUTAP CHAMBER CROS5 SECTION. AND SPECIFICATIONS PAGE S OF VENT CAP WEATHER PROOF JUIJCTIOIJ 8OY- =' '1 VENT PIPE: LOCKING -- - --- t. - ''lO FROM DOOR. MAIJHOLE COVER /ut•M . JI WDOW OR FRESH wA�LNItJG L.Pa$EC.. AL IWTAKE S� cor�cuIT tj 6!'m A e On f 16 "MIN r+RA I �{ MIiJ. ,,/i I-V ---------- � � 113 Mlu. y PROVIDE I - - -- IW AIRTIGHT SEAL. II v APPROVED JOIN �A LAS A I I APPROVED JOINT: C.I. PIPEDIZ I III W /C.I. PIPE�Pjc w / Tank construction I II ALARM shall comply with I II ILHk (83.15 and 33.20 Is I 1 I I ow C I I 8 4 -\ LLCM, FT. PUMP AJ 0 COUCRE LLB . 5Q .00 BLOCK APPRovF. K15ER EXIT PERMITTED OIJLy IF TAWK MAWUFACTURER HAS SUCH APPROVAL1 SEPTIC f SPECIFICAT10hJS 005E ►��b Z� .L�' IJUMBER O DOSES: �' Z PER DAU TA1.IK MAIJUFACTUiLCR: F . TAWK 51ZC: ti1-00 1 $ GALLO DOSE VOLUME r lb$ y ALARM MANUFACTURCR: S -S. �1,�e`T1?� S�L� INCLUDING 6ACKFLOW: 6ALLOMS MODEL WUMBER: ��t � CAPACITIES: A= 1q IMC14ES OR GALLO►15 SWITCH T:JPF: 1p1 CU1ZLf 8 = 7 IULWES�OK 141 I CP �LLOL15 PUMP P'\ANU FACTURE: K* 'O S C a IUCHE5 OR 16pj' l GALLOWS MODEL NUMBER: 3 L?0 S D = 9 INCHES OR L q' S GALLOWS SWITCH TYPE: MOTE: PUMP AUD ALARM ARE TO 15E O' O _ MINIMUM DISCHARGE RATE � GPM IN5TALLED ON SEPARATE CIRCUITS VERTICAL DIFFEREWCE OETWEEW PUMP OFF AtJD..DISTRIBUTIOW PIPE.. 8 FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . .. . . . . 2.50 FEET + F OF FORCE MAIM X �'�� F 0C rj.FKICTIOU FACTOR_. ?' �)o FEET TOTAL 0y1JAMIC HEAD = 11 1S FEET Pump chamber DIAMETER 1 3a IIJTERIJAL DIMEIJS1OWJ OF TANK= LENGTH ;WIDTH - ;LIQUID DEPTH BOTTOM AREA 231= - GAL /INCH AS PER MANUFACTURER - Zk OS GAL /INCH 4 Goulds :;, o b Submersible Effl Pump 3871 EPO4 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- Homes Available for automatic and components. tic cover with integral handle • • Farms Motor: manual operation. Automatic and float switch attachment • Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical points. 115 or 230 V 60 Hz, 1550 ■ Power Cable: Severe d • Water transfer RPM, built in overload with Float Switch assembled and � • Dewaterin 9 preset at the factory. rated oil and water resistant. automatic reset. ■ Bearings: Upper and lower • EP05 Single phase: 0.5 HP, SPECIFICATIONS 115 V, 60 Hz, 1550 RPM, FEATURES heavy duty ball bearing construction. Pump: EPO4 built in overload with ■ EPO4 Impeller: Thermo- • Solids handling capability: automatic reset. plastic Semi -open design " AGENCY LISTING 3 /a maximum. Power cord: l0 foot with pump out vanes for �-� • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. SP• Canadian Standards Association •Total heads: up to 24 feet. with three prong grounding • Discharge size: 1 NPT. plug. Optional 20 foot ■ EP05 Impeller: Thermo (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for end in "F or "AC.) rotary/ceramic- stationary, three prong grounding plug improved performance. BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 • Capable of running - - - - dry without damage to s 30 50eM'. components. 6 Pump: EP05 - - - -- -- - - - • Solids handling capability: 0 25 3 /" maximum. a - - — - -- W. • Capacities: up to 60 GPM. s 20 • T otal heads: Discharge size 1 to 31 /2" NPTt z 5 • t a • Mechanical seal: carbon- r rotary/ceramic - stationary, a 15 BUNA- Nelastomers. Temperature: 104 °F (40 Conti us - Peoa 140 °F (60 °C) i mittent. 1 -_- -- - -- -- -- - - -- - jp,►�` ,O•o 5 tl 1 i 'I 1 0 00 10 20 30 40 50 GPM L -L 0 2 4 6 8 10 12 m °/h CAPACITY 0 1995 Goulds Pumps, Inc. Effective May, 1995 W� nnsba C; ;6partrr ' 61 of.Commerce T SOIL AND 517E EVALUATION tyfv*Qn c 1 t aitary a 4 Ouilding I'sye w : or • t3uresu o (f isgr�tod;5ervices in accordance with s. I LHR 83,0$ Wis. Adm. Cade Att o ao,T Me 8+t8 plan on paper not less than 8 112 x 11 inches in size. Plan must Coun Includc i {L t' not lfi f6d to: verftitl and horizontal reference pant (9M), direstiot► an* � 7 ., � r'a psf4ornt SAC 9-9, scala.Or dimensions, north arrow, and location and distance to nearm road. Parcel I.D. N APPLIC.a NT INI=OFMATION • i print all Into Fieviewod by (h!• Perms 4nl;x.7%;0A Yin provide used for secondary P "rpvs t 1) firpperty :� r+er . . 1 V! "1 Property t* etion A L01 Pj r 1/4 � 'E1/4,6 T J � � �; $ ( W Property tvner"s MAit"usg Address' I tt Bloc N Subd. Name or MMil City State zip Qo�ttg�}c� P Mb@r ST CRG X] Ci village C9 Tows Nears ;yiti�s ; COUNT Inc - ew. C. Vse'' flepid9rWe1 / Number rpia(iq Aadition to 'existing building. ❑ Ftspi�� :merit Pubiio or commercial - D L . Cede do » *ed daily flow L,C 0 Opd Rawmimended design loading rate AbsOrptit;s; erop' W4vlr#d _bed, it 2 �_Uench, ft2 Maximum dealgR loading rat! Lam b4od. gpd/ft? .- t►WY4t! 'DPW R *oo v.iy*A %d'Jml itra0on surface elevations) g. III (as relerred to sia:a plan benchn.GA) Additions . d;esignlsite considerations Parent rZ tterial' _ Flood plain alevptlprt, 6. `,itabte.tcr sysiem Conventional Mour4 ln•0100d rraaure AT•Gta .9 ystern :; i7 : „ inq.Tank U %i lrit tii lor.syeWm s u s f u } s u Q s Ru SOIL DESCRIPTION REPORT BpliTtg f 'Norlsoo depth Dominant 'Color Mottles $tfYChJrr fn Murtseli Om 5z Copt Color B�oundaq . Raiot . s tiP IT Texture croslste /ff Trench �I .�t;, � • ��y' -cam : Depth to limiting +»01 i Boring tti P. •e•b. ..Ground �. � • •" � 5 �Y /.� .. i ,: 04 tom'+ to limiting � � tar '.....�,.»..� p i , I C5t rVarnfr �'�iease Pant}_.. nature Te1Etd l it q Vo Addrgss (" 1. ll� .r 7 4. / :. Data CST.f trrb i f Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of Bureau of Integrated Services in ( fd � S i h s414, 3.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 in in si Pin must ! County include, but not limi ted to: vertical and horizontal refere ro BM)rW)r d `. . / percent slope, scale or dimensions, north arrow, and to distance ton est road. ° Parcel I.D. # T 1 � fg APPLICANT INFORMATION - Please print mitrml4o Reviewed by Date Personal information you provide may be used for secondary puM* M&4 (t) (m)); Property Owners `.. ropeit�� ation T ke 1 11 j\ �dvt. 1/4 1 /4,S T N R E (o W t__ Property Owner's Mailing Address of # Block# Subd. Name or CSM# D a(3 1 kre- 3 � __� I City State Zip Code Phone Number City El Village [ Town Nearest Road ❑ JKNew Construction Use: - E5 esidential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: / Code derived daily flow �� 0 gpd Recommended design loading rate / ' 0 bed, gpd/ft trench, gpd /ft Absorption area required bed, ft _ i C trench, ft 2 Maximum design loading rate gy bed, gpd /ft �' trench, gpd/ft Recommended infiltration surface elevation(s) 1 v ft (as referred to site plan benchmark) Additional design /site considerations Parent material __ _ _ Flood plain elevation, if applicable /✓ 1 ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system El S U S❑ U ❑ S 126 El S U U El S UU El S U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 r in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench -C Ground a- 1 S 1 /i el v. 7. Depth to limiting P &I P Remarks: Boring # g r .2rn i� C_r S Ground ,S J `��� ✓n I Y1 71 S W) ✓� `7 Depth to limiting � fa tgr in. Remarks: CST Name (Please Print) Sionature Telephone No. 5 -c 68 7 b 1-6 Address Date CST Number vl �0 -g a a b d D SOIL DESCRIPTION REPORT ' PROPERTY OWNER — Page of . PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench ......................... . Ground 7 s f `� y�0� I'» S elev. Depth to limiting factor in. Remarks: Boring # [ ' Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # 13. Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) t Soil Test Plot Plan Project Name Dean and Debra Fergusson Shaun B' Address 720 S. 11th Ave St. Charles Illinois 60174 CSTM #226900 Lot 3 Subdivision - - ----- Date 10/8/98 NE 1 /4 1/4S36 T 3 0 N /R W Township Richmond ❑ Boring ()Well PL Property Line County S T. C ROIX BM or VRP Assume Elevation 100 ft. Top of White Stake with Orange Ribbon System Elevation 98.1 * H R P Same as B Alt. BM Top of White Stake with Orange Ribbon @ 100.7 150th St. Pro 4 Bedroom House 250' B -3 0' LB.M. 40' 10 70' 30' B-110' iw 0 15' B -2 4% Slope c� r W N O O N r 660' Property Line ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATIGN FORM Owner/Buyer �0I-U A7a>'e!a Mailing Address /' C) ) e,�,; Property Address �cl (Verification required from Planning Department for new construction) City /State Parcel Identification Number 6' C, -% /y - LEGAL DESCRIPTION Property Location '/,, 5F ' /,, Sec. T 9 N - R_,�LW, Town of , G'�h��.v� Subdivision Lot # 3 Certified Survey Map # �`i' /�r' , Volume l 3 , Page # S"'S Warranty Deed # ;;17 , Volume 1-'IPP , Page # S7 Spec house ❑ yes 01 no Lot lines identifiable Byes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal 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. Croix County Zoning Office within 30 days of the three year expiration date. SIGNATURE OF APPLICANT DATE OWNER CEATMCATION 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 pr rty desc 'li�ri above, by virtue of a warranty deed recorded in Register of Deeds Office. 6 ,� / 00 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 rep 1118pA�F 519 iv Ij STATE BAR OF WISCONSIN FORM 2 — .1982: ACP 1' M 1 REGISTER WARRANTY DEED R H. DEEDS REGISTER OF' DEEDS DOCUMENT NO. Yoe 1488PE 5 7 ST. CROIX CO., WI , - --� RECEIVID FOR RECORD �._....._._..� : -- __.. Debra L. Ferguson. n/k /a Dph T._ Fercfugon 04-15 -1999 9:30 AM (Milligan). a singiperson. MAO M UM I CUT W FEE: conveys and warrants to Todd R. 'rgk a single person, i TRRNSFER� � FEE: 56.40 �i RECORDING FEE: 10.00 ' PAGES: 1 I I I T1i15 SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS the following described real estate in St. Croix County, ` State of Wisconsin: KRI, ONA OGLAND II Zi1Z, Estreen & Ogland E P.O. Box 359 j Hudson, WI 54016 0 26- 1102 -60 PARCEL IDENTIFICATION NUMBER Part of the NE1 /4 of the SE1 /4 of Section 36 -30 -18 described as follows: Lot 3 of Certified Survey Map filed November 11, 1998, in Vol. "13 ", Page 3554, Doc. No. 591432, St. Croix County, Wisconsin. This deed is being re- recorded to correct the legal description in that certain deed recorded April 15, 1999, in Vol. 1418, page 549, as Doc. No. 601277. I This is not homes[ead property. Cis nod XXX Exception to warranties: Easements, restrictions and rights -of -way of record, if any. J i ( Dated this 13ta� day of October A.D., 1.9 98 . (SEAL) (SEAL) �I Deb ra L. Fe r uson ( fl (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT I S ignature(s) State of Td'll3t7dHX=Florida i ss. 1 County 1 � authenticated this day of .19— Personally came before me this day of October 19_, the above named Debra L. Ferguson (Milligan) • f /k /a Debra L. Ferguson, II TITLE: MEMBER STATE BAR OF WISCONSIN a .single person, _ II (If not, authorized by 9706.06, Wis. Slats.) � to me known to be the person who executed the foregoing i instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY K. ROGERS Attorney Rristina Ogland I LAKE CM FL. C UIOfIA Hudson, WI 54016 I it Notary Public. County, Wis. j� (Signatures may be authenticated or acknowledged. Both are not My IN �nn a expiration date: necessary) a 1 " ° °, MNAIAK FOBERS 19 ) a signing Y P Y by typed or printed below Ihcu sigmwns- __— ; • y „P. • Names of persons si nin in an to an should STATE BA OF WISCO R N sin WARRANTY DEED 119a Inc i Form No. 1 - 1981 AWweJwa. We, !1 w VOL 1488PAGE 56 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 02 -02 -2000 3:50 PM WRANTY DEED EXEMPT M 3 CERT COPY FEE: COPT FEE: TRANSFER FEE RECORDING FEE: 12.00 PAGES: 2 Reeoedba Am "Ii s"A LA lei D r:treen & Oglane %'•``. Box 359 Jiud::ua, W154016 I 026- 1102 -60 PARCEL IDENTIFICATION NUMBER Part of the N of =he SE1 /4 of Section 36 -30 -18 described as follows: Lot 3 of Certified Sjrvey ESap filed November 11, 1998, in Vol. ":3 ", Page 3554, Doc. No. 591432, S Croix County, Wisconsin. This deed is being re- recorded to correct the legal description in that certain deed recorded April 15, 1999, in Vol. 1418, page 549, as Doc. No. 601277. Ibis Iofoemetioa must be completed by mbmi6ar. decra" Wk. mm A MM INCCEL 04 fZ df ►egatnQ, Odor bI(ornladon tack ae dre lrmMnd alawes, legal drnrlp+lon, ese. may be placed ae ddr pm page of dm docamen, or nary be placed on addidmd pagee ofd e docwoen,. Note; We ojrF4 cover pace a&b oae page ro ya..r deemnent and x.00 re gW aggo g ka. W4eauln Sannee, S9.517. WRDA 2196 10/13/98 00:05 FAX 1001 IT 1 R NASD F t7' JOHNSON 1 c -1106 Q U AMERY. was. ,.If A00 SUR-4 eNeeeeM ERTIFIE,D S URVEY M,AP Locate-4 in part of the Southeast Quarter of the Northeast Quarter, the Northeast Quarter of the Southeast Quarter and part of the Southeast Ouort¢r of the Southeast Ouarter, all In Section 36, Township 30 North, Range 18 West, Town of Richmond, St. Croix County, Wisconsin, ­w MW415R 1 SEC. dO - JO - IC Prepuied for and at the request of: Prepared by ��` (�[tw CR aaw) 01 9- ONMER: A & E: 3 Deon and Oebra uSon For + % 720 South 11th Avenue LAND SURVEYING k CIVIL ENGINEERiNC N n _• Phone No. (715) 246- 4319 ° c s St. Charles, IL 60174 r' 109 East Third Street, P.O. Box 325. l N �' N0, f" Or or KrGti A. E7londt New Richmond. WI 54017 u , T , „ j JOB #96242 � ( � � 2 � UNPLATIEO LANOS_DF OWNER J3.00 - . e 1 I 6nQ 12 ,c CQ z N69'58'30" E 1316,64' �' nt xf , T v d 0 1283.8 ®� �'—t :DRIVEWAY C LO I ® � (�tIOUSE 4 l � # 7 SHED 9ARk •�YVELL � t u rn o b ��> • ' v 652,447 50. FT. / 14.9111 ACRES �j AREA EXCLUDING R O.IM. 3 nF0 I I � s 635,113 SQ. FT. / 14.16 ACRES ul i T s d • - w 5284.21'---- - - -- � � •r � N89'56'30'E 1319.465' ��.� �' (n .4 311 . 1266.465' c� 3964.745' S v�T /I 1 a i r I i Asr -orsr I /.f NE Llr EC .00 . J ' - "'r !� a- i � � 3 � 0 A • u , 1 t 1 ► r c ti I I C7 ° •\ 6 ,047 S • f! J / 1 A E � ul ! v y, ( ! t � 079 10p' n7 845, SQ / '9.41 R ;~ i.,._�•'z W �.. •ti I � i I 1 Il t � I I Ica � s NO tTH im III Il t ^ ( •� z I o 1 z H -4Wm H $, TOTAL ARE A; � : 866,638 SO. FT. / 19.90 ACRES : z N m , o -, AREA EXCLUDING ,j 4,�,,' C T 844,948 SQ. FT. / 19.40 ACRES Y � D a StRJIH UVE Of VC AC 11 Qr THE SC F14 a$ y ` � zr �' rn 1285.27 10 i I NGR7H 11NE OVr THE Sr 114 &F 7HE SE 114 LOT 4 � �I I • jOTAL AREA: - 1 � c I J 866.229 SO. FT. /19.89 ACRES �) !I 3 me rJ Q1 I nt AREA rXC L UQ1tjG R.O.W_ • '4 n r .s i I I 844.538 S0. FT. / 19.39 ACRES ( I d' / o � a 8 � W 0 � � °■ � . R �3 $ EfCF 2 $2C2 3�, $§§_ _ o to §kk ) /&Sa ! \ ) z _ ; _2 � 2 : } E /cG © sae §$ J4 /c , 0 / w § E & \ % � co § j CL m n R z § \ § z . - ; § ■ R k 7 @ n � V � a _ § ) R lz / ) } z \ .. z § _ 0 ] IL C % £ J - 27 e m / E . IL \ £ k if � k } u) t2 � 15 \ k \ k a 2 a \ \ \} \ \ 4 Cl) If \ Cl) / w / o \ ( / co f ° CL \ƒ I— CD 2 0 0 !¥ ■ 2 a Q } } } \ c S } Cl) § o c - B §§ 2 i4 &@ @ 2 2 a % — a § e? \ ƒ � ) -� § \ d ] § \ z � � k 7 E�'� \f ■ c k a. \ / k k LEGAL ST. CROIX COUNTY, WISCONSIN NEW TXSCR02 REAL ESTATE TOWN OF RICHMOND COMPUTER NUMBER 026- 1102 -60 -200 Parcel Number 36.30.18.564A -20 OWNER NAME: First TODD R Last MAREK PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name -- Type SD Apartment 1234 150TH ST SECTION 36 TOWN 30N RANGE 18W Y<160 SE 1 /440 NE Line Description Line Description TOTAL ACREAGE 2.620 PLAT -4657 FKA PT CSM 13/3554 LOT01 BLK V ESE 15 EING LOT 3 CSM 13/3554 16 9.90AC) NKA CSM 18 -4657 17 OT 1 (2.620AC 1 19 06 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit