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030-2007-70-200
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O Cn n CD n ti y N co Xt D 3 3 N °" O O Cn < Q CD w� °' � -« N N O C0D =3 T p N =) T y 0 Cll c a 3 N c � o 0 0 CD < CD o c. S CD N z S' N N uroi z o ° ° o CD °N c on O _ c n cr ro � x N N � Q O (0c CD F.3 w ?QID N 0 c O _' n O 7 Cll j N 0 O Q p N a 3 (a O. O -4 D OO (O + V 3 ° (' A 0 a o a 00 Q OO a ^' b V Wiscons an nARp dings Div sion artment of Commerce PRIVATE SEWAGE SYSTEM ai Isuili Count' Cro INSPECTION REPORT JJ GENERAL INFORMATION (ATTACH TO PERMIT) Sanit WYE tNo.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: ❑ City ❑ Villa e ❑ own of: State Plan ID No.: chackle, Kevin St. �oseph Township 1 , tsflo z CST BM Elev.; Insp. BM Elev.: BM Description: 'Parcel Tax No.: t 0 l t co i CST'bV,&* 1 030 - 2007 -70 -000 TANK INFORMATION ELEVATION DATA .�y', �4.�9� 376 C TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 5 Z01) Benchmark (a Dosing Alt. BM Aeration Bldg. Sewer Holding St /Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. Ai Intake ROAD Dt Inlet �� � Ql5% Septic t 3?/ _ NA Dt Bottom arl, &f Dosing - � �g� ti �/ NA Header /Man. `. 10 O/' Aeration NA Dist. Pipe 6 1 02 -Z( Holding Bot. System ( / 1 0b 6 PUMP / SIPHON INFORMATION Final Grade 19 s f Jw) Manufacturer o Demand St cover Model Number J�`SGPM vv\ �, `� 1pq,Iq ID T H Lift pL 3 Lriction System?, TDH Ft of Forcemain Length t I Dia. 2 It Dist. To Well 6�T] - SOI BSORP ION SYSTEM �- "p "zl,�o E / Width Length No. Of Trenches No. f Pits Inside Dia. Liquid Depth NSIONS DIMEN I N SYSTEM TO P/ L BLDG WELL LAKE / STREAM LEA G Manufacturer: SETBACK C A INFORMATION Type of ' � MB Model r: System: 5 R UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s)� a qrn N x He Size x Hole Spacing Vent To Air Intake Length �` ,Dia 3 Length /Dia. � Spacing Z N i ll 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 ❑ Yes ❑ No COMMENTS: (Include code discr�e�ancies ,persons re n tC. I nsp ection ns ec on Location: 641 Perch Lake Road, Hudson, fl 5401 t ( E 1�4 NW 1/4 34 T30N R19W) - 30.19.376C -Lot 2 . 1.) Alt BM Description= 2.) Bldg sewer length = 31 0 r - amount of cover= l8 "4- -k +�,:.� q�.••+t� 3.) contour = i .p � � r *vls c�`? es Use other side for additional �IS� Us mat o 3 ' SBD -6710 (R.3/97) pa A Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH ' SANITARY PERMIT NUMBER: fi 3 i _ E �� ....� ....:.....: . . .e .f —1 ,m�e. v ...� v -; i i z _, ..,_.. _. ---- .. ....., w ..�.. . �- e . 3,_.d.... .., ,... _. _ .. .... __ ... ...._ .s .�„�.z.n....�.a n tt 7 � e ( E .- --.. �. m ..mow ... --.:. .., .. e i [ g £ ! W £ 1 '� B ate. ..., � � -. . � �,.....« �.,. _....� �........... �,......... 3. w ...�..,.........5 ..,. d m, 1 � 'H � m . m... ....,.?......... ... i t - ---- � �.......�„ ..v� ..... . �e� ,.... �. ._,�,.e. ,. , >_� .� . A.-- c a [ t . __._.. .,.� >�. z a 'e . � 1 F { r Safety and Buildings Division SANITARY PERMIT �Iwl PP 20 1 W Washington Avenue ViiociiiiiInsin P O Box 7162 Department of Commerce In accord with Comm 83.05, , �e 7 Madison, WI 53707 -7162 • Attach complete plans (to the county copy only) for the syste g „ papa' ti co tt �. 1. than 8 1/1 x 11 inches in size. �. �' • See reverse side for instructions for completing this applicati 4 t : LVAk ateSan4 ary Permit Number 707 Personal information ou p rovide may be used for secon p urposes ,� Y P Y rY P P NN Cdeck 1 reviswn to previous application }{) [Privacy Law, s. 15.04 (1) (m)]. C-,* f; �nNLi tats Ne Review Transaction Number I. A PPLICATION INFORMATION -PLEASE PRINT ALL INF 1A4 d 7 (2 Property O er Name r gerfy ibn _5C OC G 3 T 3 , N, R `'p E (or)© Property Owner's Mailing Address � � / � � Lot Numb Block Number City, St to Zip Code Phone Nu ber Subdivision Name o SM Numbe / to s st) -rz 3 S 8 A v _7,0 � v2 11. T YPE OF B ( IN : (check one) ❑ State Owned a it Nearest Road - Ll Public 1 or 2 Family Dwelling - No. of bedrooms o V own of -T®S /_Q�L� �Ot 111. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 3� 3 p. L� 3� fo G 1❑ Apartment/ Condo p 3 0 — A oo 7 7 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining 4 Church Church/ School 8 Mo it H m P Service Station/ Car Wash ❑ ❑ rk 12 b e o e a 5 ❑ H ^ i-nI IRA—" � ^ Other: specify IV. TYP �) A) ,1 nnection of 5, ❑ Repair of an 3 I 30 �q _nQSystem ________ Existing System B) (( Date Issued V. TYPI Non -Pri 4#% r y S G ° Other 11 ❑ Se /, , tom re r�C4 � ���`"^ type 41 ❑ Holding Tank dr 12 h 42 Pit Priv 13 E] Se ❑ Se G� /� / ❑ y 14 [] Sy ' "' rr�� �[ / ��j 43 E] Vault Privy /o jj77 VI. ABS 1 l 1. Gallon! l" y ` ate 6. System Elev. 7. Final Grade h) 10 � Elevatio5 / Feet 0 ,3,9 Feet VII. t I _ S _ - -- ( w.+. -� INFORMATIOA 9 ;t Prefab i n k s Manufacturer' Name . Con Fiber- glass p steel A - k strutted Plastic Ap f�,b+ rice( �r►'� Concrete c Septic Tank or Holdin Tank �_ Z �a� Lift Pump Tank /S r I Soo ai a& coo ^-0 Vftr BILITY 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: (N St am s) r;7 M SW N : Business Phone Number: �x c/E` 7 7�5= ZY4 - Plumber's Address (Stree City, State, Zip Code): IX. COUNTY nFPAIZTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate ssue Issuing gent Signature (No Stamps) 'Approved [I Owner Given Initial -5� a 0 Surcharge Fee) Adverse Determination /� Za 00 X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: cq SBD -6398 (R.12/99) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 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 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 - 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 un line A. Complete line B if permit is for tank : e,.�lacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type_ VI_ Absorption system information- Pro ride all inforfoat on requested '4 nurnbe ?hrough 7. VII. Tank information. Fill in the capac ' y of every ntvv/or existing tank, ist the total gal Ions, number of tanks and manufacturer's name, indicate p e or site -cv strutted ant' tank Ywlterial C `or at/ septic, pump /siphon and holding tanks for this system. C' eck. exp�_rir , =r�tai apprtwal only _sfper'murotal product approval from DILHR. VIII_ Responsibility statement. Installing plumber is to t 1 �m��,'i: =r�s� number .,vi 1 ,ppropri-at�e prefix (e_cl. MP, etc.), address and phone number. Plumber must sign applirat on form IX. County/ Department Use Only X. County/ Department Use Only_ Complete plans and specificatin; < not sma0e Thar ° 11 2 x 1 1 nc� : L� S, , I tad t th« county The plans must include the following: A) plot plan, drawn 't0 scare ;,. with cf Folding tanl<(s), septic tank(s) or other treatment tanks; building scv °vers, rvcii,; a;;:1 lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement syst. ;:(eo�., of the building served; B) horizontal and vertical elevation reference points; C) complet,_ E i'o � l' ; pumps and controls; dose volume; elevation differences 4 friction loss; pump performance cury e, punk(p , n., maoufa(turer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 fora; a.)d F;� .111 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 e$tablishment of standards. Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264 -8777 Visconsirn www.commerce.state. Department of Commerce Tommy G Thompson, Governor Brenda J. Blanchard, Secretary May 30, 2000 CUST ID No.69172i ' ` ATTN. POWTS INSPECTOR ARTHUR L. WEGERER "c r' ZONING OFFICE 421 N MAIN ST � "��� r�x , �; I ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 ` s ; �.�' HUDSON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/30/2002 Identification Numbers Transaction ID No. 314470 Site ID No. 191414 SITE• Please refer to both identification numbers, Site ID: 191414, KEVIN SCHACKLE above, in all correspondence with the agency. ST CROIX County, Town of SAINT JOSEPH; PERCH LAKE RD, SAINT JOSEPH 54082 NEIA, NWl /4, S34, T30N, R19W FOR: MOUND, 600 GPD Object Type: POWT System Regulated Object ID No.: 661549 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes C01W i 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. ► PAFZTM OF OF S�aFi The following conditions shall be met during construction or installation and prior to occupancy or use: D 1. This plan action is subject to designer comments on the plan. 2. The orientation of the mound system must be such that the mound's longest dimension is perpendicular E Cpr iF to the direction of maximum slope. S� 3. Vehicular traffic is prohibited in the area 25' beyond the down slope edge of the mound. 4. If an existing tank is to be used, the existing septic tank must be inspected for structural soundness, size and baffles and must be brought into conformance with the requirements of COMM 83, Wis. Adm. Code. If it does not conform a state approved tank must be installed. 5. Maintain well and waterline set backs per COMM 83.10(1) and 83.14(4)(a). 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 otp ential for a law suit that may delay the effective date of the code so this status may or may not change. 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. } ' ' ARTHUR L. WEGERER Page 2 5/30/00 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 04/27/2000 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 PATRICIA L SHANDORF , POWTS PLAN REVIEWER. BALANCE DUE $ 0.00 Integrated Services (715) 634 -7810, FAX: (715) 634-5150, M -F 7:45 AM - 4:30 PM PSHANDORF @COMMERCE.STATE.WI.US WiSMART code; 7633 cc: KEVIN SCHACKLE I 7 17LE, Page of b MOUND SYSTEM FOR A y BEDROOM RESIDENCE LOCATED IN THE ME - 1 /4 OF THE NW 1/4 OF SECTION lY ,T N, R 19 W, TOWN OF �- gtz� H , ST. CCzoIX COUNTY, WISCONSIN. INDEX PAGE 1 'of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW -CROSS SECTION S. S PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT ,n _PAGE 5 of 6 PUMPING CHAMBER PAGE 6 of 6 PUMP PERFORMANCE CURVE ) f CdM F L pv% t`! PREPARED FOR LSPON DENCE. ti 012 G �R.I L 1 ST1\\-v tn e r�tJ SS08Z 3 PRERARED BY WEGEF�<ER SL7 I l._. . TESTING AND. @ ® �'�fetet0 DES 2 G1V S�l�V I GE AN � C® WS, . P.O. 801 74 421 N. 11AIK ST. r r• •• •• ti, r.� RIVED FALLS. VI 54022 ° ARTHUR t• 715 -42 -0165 o WEGERf -R D ELLSWpRTH, ; HIS. JOB NO. `` �Z PLOT PLAN Scale 1"=q Page Z of O•��i � � of � b �� n o r- Q ND J i 9 r, 1 t3•`f iT�LaO r� � � � �o ►von ������T ol, �/ ./ r DISU\LB TM3 fj� J / o � � � �- \S 6 3S 3 PVC 1�1- <y gyp' D / O 1 3ti� 2 \ p S -6 w a�rz► -, E?VsT11jG P z LQ LC L.c3afifiirYv_ - �ow►E 30` of q FIUC c�SU1 lU aF R UU�D F NT LZ"T_ SO rIEA)K-: vl)� P L�3T ZS ' NOTES .. 1. Elevations shown are existing ground elevations unless otherwise noted.. 2. Install permanent markers at end of each lateral. ( Y required) 3. Install 4" observation i es with approved caps. required P P ( e uir rr r z. s ) 4. Septic tank to be \ gallon capacity manufactured by -JEIFz P1? -00U cTS - ►n P `T f�V r- 'to BE" SOO Con-r- W 9fj-r-s `Twj,,, 5. Bench Mark g�yy _ �, 100,0 pR• at&Z Cp MpW - �\-IpLWW 2LgBo►v • EL •, r 1 M 6. Divert surface around mound to prevent ponding at the uphill side. Page 3 Of t Approved Synthetic Covering Distribution Pipe Medium Sand Topsoil G —J - - - -, -- F Elev. 3 E p ` b 3 % Slope Bed Of ;'i"-2 Force Main Plowed Aggregate From Pump Layer D ).b Ft. Cross Section Of A Mound System Using E 1.18 Ft. A Bed For The Absorption Area F b•$ Ft. G \•o Ft. A Ft. H \•S Ft. Linear Loading Rate= - 1.I GPD /LN FT B BY- Ft. Design Loading Rate= O -y .GPD /SQ FT I 2 Ft. J 10 Ft. K Z Ft. + tef == Position of L VO $ Ft. Force Main W Z $ Ft. 1, J L Observation Pipe $ K A � I - W a ---- 7 --------- - - - - -- ------------------ - - --�� Foree -pia Distribution Bed Of % p — 2 - 2 Pipe Aggregate I Observation Pipe Permanent Markers (Anchor securely) Ran View Of Mound Using A Bed For The Absorption Area Page Of Perforated Pipe Detail 0 End View ) Perforated End Cop) " PVC Pipe 1. -40e once o. Install permanent-marker at end of each lateral Holes Located On Bottom, Are Equally Spored Q S P PVC Manifold Pipe �.t Distrition PVC Force Main Distn ution Pipe Last Hole Should Be I Next To End Cap End Cap P �4(3_S Ft. Distribution Pipe Layout S 3 Ft. X 3 b Inches Y 36 Inches Hole Diameter 1 �� Inch Lateral 1 !z Inches) Manifold 3 Inches Force Main " 3 Inches # of holes /pipe_ Invert Elevation of Laterals V)2.1 Ft. 6 S. S 2. G V*1 , Place 1st hole 1S from center of manifold with succeeding holes at 3 6 ` 'intervals. Last hole to be next to the end cap. ' PUMP CHAMBER CRO55 SECTION AND SPECIFICATIOMS PAGE S OF (7 • VENT CAP 4 "C.I. VENT PIPE - f r WEATHER PROOF APPROVED LOCKING MANHOLE 10' FROM DOOR, JUMCTIOU BOX COVER WITH WARNING LABEL wiMDOW OR FRESH It�Mll!' I- AIR INTAKE I GRADE CONDUIT 18 "1'11N. - - -- 1� _ 1 PROVIDE ( -- -- . IIJLET � AIRTIGHT SEAL II v APPROVED JOIIJT A Tank construction shall comply i iiI APPROVED.IOIIJTS with COMM 83.15 and COMM 83.20 i II ALARM e I I I I I i I ow - - GLEN. Z � FT. PUMPS "� � OFF 0 �L qz OC) CONCRETE BLOCK 3' APIRADYED - RI5ER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL gEpp SPECIFICATIOAIS DOSE TAIJKS MANUFACTURER. 1 `� � RU �' 1JUMBER OF DOSES: 3 ' , PER DAU TA NK :+IZE: $ O© GALLOWS DOSE VOLUME z 1ZS, ALARM __At"FACTURER: S•T.� Sk S INCLUDING OACKFLOW: GALLONS MODEL NUMBER: IL H W CAPACITIES: A= Z � WCHE5 OR ' GALLOIJS SWITCH TyPC: � VZ�/' B = Z I NCHES OR 3 1.0 Gf LLOlJ5 PUMP MANUFACTURER: Zd �Z C = 9 INCHES OR EIS S GALLONS MODEL WUMBER: , �� Ds 9 INCHES OR 115'5 GALLONS SWITCH TYPE: - -- WLN'(ZCQJ�Z - �7 MOTE: PUMP AND ALARM ARE TO BE S MINIMUM DISCHARGE RATE SZ GPM INSTALLED OW SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWCEU PUMP OFF AU0,01STRIBUTION PIPE.. 9' 3S FEET + MIM IMLIM NETWORK SUPPLY PRESSURE .. , , . .. , 2 FEET + 3 S FEET OF FORCE MAIN X L F Y0 fT.FKICTIOk 1 FACTOR.. 0-3, FEET TOTAL OyIJAMIC HEAD = 1 �' Z FEET DIAMETER uu'' INTERNAL DIMEWSIOW� OF TANK: LENGTH ;WIDTH ;LIQUID DEPTH BOTTOM AREA — 231= — GAL /INCH AS PER MANUFACTURER = ... GAL /INCH • -�4 13/16 7 7/16 W W HEAD CAPACITY CURVE MODELS 137/139 I+ 6 1/8 E MODELS 137/139 Ft. Meters Gal. Ltrs. ° a 5 1.52 93 352 ° o a 13/16 zs 10 3.05 79 299 r _ 6 20- 15 4.57 64 242 20 6.10 36 136 1s 25 7.62 8 30 ° 1 1/2 - 11 1/z NP 0 4 Z_ Z 30 9.14 - - 1 o "LockValve: 26 ft. 2 e 65. Z 2• LL ' 1 0 «<TTT a 13 i U.S. GALLONS 1 10 20 30 40 50 60 70 80 1 90 100 110 LITERS 80 160 240 320 400 I I 4 0 FLOW PER MINUTE SK373 _ 009921 CONSULT FACTORY FOR SPECIAL APPLICATIONS ' Three phase pumps are available in 200/208V, 230V or 460V. • Variable level control switches are available for controlling single and three • Electrical alternators, for duplex systems, are available and supplied with phase systems. an alarm. • Double piggyback variable level float switches are available for variable • Mechanical alternators, for duplex systems, are available with or without level long cycle controls. alarm switches. • Over 130T. (54 °C.) special quotation required. • Combination starters are available for 3 phase pumps. • Refer to FM0806 for 200° F. applications. • Control alarm systems are available for 1 phase pumps. 137 Series - 47 lbs. 139 Series - 51 ibs. SELECTION GUIDE Single Seal Control selection Llstln s 1. Integral float operated 2 pole mechanical switch, no external control required. Model volE Mode Amps Simplex Duplex CSA UL M137/139 115 Auto 10.7 t or - 1& 8 - y y 2. Single piggyback variable level float switch or double piggyback variable level N137/139 115 Non 10.7 2 or 2 & 7 3 or 5 & 6 Y Y float switch. Refer to FMO447. BN137 t 15 Auto 10.7 - Y Y 3. Mechanical alternator M - Pak 10 - 0072 or 10 - 0075. Refer to FMO495 D137/139 230 Auto 5.8 - Tor 1& 8 - Y Y E137/139 230 1 Non 5.8 2 or 2 & 7 3 or 5 & 6 Y Y 4. Combination Starter. Refer to FM0514. H1371139 200.208 1 Auto 62 1&8 Y N 5. See FM0712 for correct model of Electrical Alternator E -Pak. 1137/139 200 1 Non 62 2&7 3 or 5 & 6 Y N 6. Variable level control switch 10 -0225 used as a control activator, specify duplex J137/139 200 -208 3 Non 2.6 2&4 3 &4 or 5 &6 Y Y ' F137/139 230 3 Non 2.6 2&4 3&4 or 5&6 Y Y (3) or (4) float system. G137 460 3 Non 1.4 2 &4 3 &a ors &6 N N 7. Four (4) hole J junction box, for watertight connection forhardwired simplex G139 460 3 Non 1.4 2&4 3 &4 or 5 &6 N N operation, 10 - 0002. No molded plug **Single piggyback switch included. 8. Two (2) hole J -Pak, for Watertight hardwired Pconnection or splice, 10 -0003. Pumps must be operated in upright position. CAUTION Three phase units require a control switch to operate an external magnetic or combination starter. All installation of controls, protection devices and wiring should be done by For information on additional Zoeller products refer to catalog on Combirlation starter, FMO514; a qualified licensed electrician. All electrical and safety codes should be PiggybackVariable Level Float Switches, FMO477: ElearicalAltemator ,FMO486; Mechanical Altema- followed including the most recent National Electric Code (NEC) and the tor, FMO495; Alarm Package, FMO732; and Sump/Sewage Basins, FMO487. Occupational Safety and Health Act (OSHA). 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 .t Louisville, KY 40256-0347 � Manulactwersoi.. SHIP TO. 3649 Cane Run Road ® Louisville, KY 40211 -1961 r&AUr IA0 19 ,7Y PUMP !O. (502) 778 - 2731.1(800) 928 -PUMP FAX(502)774.3624 Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264 -8777 Visconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary May 30, 2000 CUST ID No.691727 ATTN: POWTS INSPECTOR ARTHUR L. WEGERER " ' ZONING OFFICE 421 N MAIN ST ,ST CROIX COUNTY SPIA PO BOX 74 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 RE: CONDITIONAL APPROVA PLAN APPROVAL EXPIRES: : 05: 0/2002 S ' Identification Numbers IR rat' Transaction ID No. 314470 4� , Q Site ID No. 191414 SITE• Please refer to both identification numbers, Site ID: 191414, KEVIN SCHACKLE, above, in all correspondence with the agency. ST CROIX County, Town of SAINT JOSJPEPR-PERCH - LAKE RD, SAINT JOSEPH 54082 NEIA, NW1 /4, S34, T30N, R19W FOR: MOUND, 600 GPD Object Type: POWT System Regulated Object ID No.: 661549 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: 1. This plan action is subject to designer comments on the plan. 2. The orientation of the mound system must be such that the mound's longest dimension is perpendicular to the direction of maximum slope. 3. Vehicular traffic is prohibited in the area 25' beyond the down slope edge of the mound. 4. If an existing tank is to be used, the existing septic tank must be inspected for structural soundness, size and baffles and must be brought into conformance with the requirements of COMM 83, Wis. Adm. Code. If it does not conform a state approved tank must be installed. 5. Maintain well and waterline set backs per COMM 83.10(1) and 83.14(4)(a). 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 potential for a law suit that may delay the effective date of the code so this status may or may not change. 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 /instal lation/operation. i I ARTHUR L. WEGERER Page 2 5/30/00 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 04/27/2000 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 PATRICIA L SHANDORF , POWTS PLAN REVIEWER BALANCE DUE $ 0.00 Integrated Services (715) 634 -7810, FAX: (715) 634-5150, M -F 7:45 AM - 4:30 PM PSHANDORF @COMMERCE.STATE.WI.US WiSMART code: 7633' cc: KEVIN SCHACKLE ilapaartmentOf C3rnmarea SOIL AND SITE EVALUA11ON Page 1 of 2 Diviiion of &slaty and Buildings in accord with Comm 83.05, Wis. Adm. Code 1 Ely D-igu Attach complete site plan on paper net lees than W- x t t itches in site. Plan must minty ir"We, W not united to vertical and horizontal reference Point (BW, direction and St. Croix percert dope, scale or dr trsions, norU� arrow, and cation lo and *#w" to sparest road, PO ,,rr�� APPLICANT INFORMATION - Please print all information. " - �� L 70 — o oa PersaW kdormiffien you private ter to used fu eaaat%ryr i am L, a 16 04 ( (m))- Property Owner Property Location Shackle., Kevin Govt Lot NE 1/4 NW 1/4 S 34 T 30 N,R 19 W Property Owners Maling Address Lot # M Block # Subd. Name or CSM# 1840 Oak (ilea Dr 2 l l City Stale Tip Code PhoneNumber El city ❑ Vilaw MTown Nearest Road Stillw MNC 55082 651 -439 -7715 fst.Iowph It Pamh Lake Rasa New Construction Residential / Nurrrber of bectioorrls 4 ElAdnttiat to existing building g Repiaceflteat Public or commercial describe a. Code Derived daily flour 600 gpd Recommended design boding rah -� boat, tencl% f area r+equxed ba bed, IF ba kenck fF Ma4mum design loading rake S bed, gpd1V . Co tr ench, WN Recormterided inliltralon surface eievalion(k) ft (as referred fo site plan Wichrrar Additional design / site considerations P6" site Parent material l okss Ova Glacial OutlWash Flood plain elevation, 8 ft FU--U=dW* 1� 8�! Conventional Mound In- Ground Pressure AT -Grade Stem in Fil Folding Tank for system S 0 U g I�t S O U A S U p cJ S N U B Ei S tan U g 0 S u U SOIL DESCRIPTION REPORT Depth Dom Willes Dominant Color Structure Roofs GM/r Bairtg# in. Muell Qu. Sz Cont Color Texture Gr. Sz. Sh. Bed Trench 1 0-9 10yr3/2 - sit 2 nsbk mfr cW 2f .5 .6 2 9 -15 I1111yr44 - sit 2msbk mfr eW 1f .5 .6 Ground 3 N 15 -17 N 7.5yr414 N fif l.5yr5 /8 N st I tmsbk N N - N - q .4 5 elev 100.62 8 N q N N N I N q q Pepth to lknbg tailor 17 N N q N N N q N Remarks: 1 0-10 10yr3/2 - sal 2msbk mfr cW 2f .5 .6 . 2 10-22 10yr4/4 - is 2msbk mvfr cW if .7 .8 Ground 3 22 -30 7_5yr4/4 f1f7.5yr5 /8 s1 lmsbk mfi cw - .4 .5 elen 8792ft II N q N N N II q Depth to N fl q N II N N N I limiting factor 22 Remalfcs: CS Name (Please Signature Telephone No. Thomas C. Nelson 715- 246 -2454 Address Environmental By Desip Dale CST Plumber Ref # 1432 120th Street, New Richmond, W1 54017 //_ -y5 227397 258 PROPEWY aMBL Mw*le� Kem SOIL DESCRIPTION REPORT F -2MI Page 2 of 2 MiMl- I Vi '' . wab By Design DVM DW"W COW GPDfiF !HMiZGn I Texture ���ftmdaryl Roofs in. Munsell Cast. Color Sz- Sh. EW Tmnch 3 10yr3i2 0 2msbk mfr Cw 217 .5 .6 2 6-17 1 OyA/4 Is 2msbk mvfr Cw if .7 .8 Ground elev. 3 it 17-28 p 7.5yr4/4 a W )TW p sl q I m-.bk q rnfi q Cw .4 .5 ion-.16ft Depth to UNIX 17 L Remarks: 4 1 0-8 1 OyrM I 2msbk Cw 2f .5 .6 2 1-5 10yr4/3 Sil 2msbk 5 Cw If i .6 Ground F elev 3 t5_18 I oyr4/4 sil 2msbk mfr cw If .5 .6 98.94ft 4 18-28 7.5yr4/4 fIf7.5yr5/8 sJ Imsbk n4i -4 .5 Depth lO limding factor 18 Remarks: Ground elev it D" to factor RmTkift: Ground A elev Depth to factor L Remarks: IMViPOKA[KTAL Y PE514H 1432 120' STREET, NEW RICIMONI3, WISCONSIN 715 - 246-2454 Tom Nielson Certified Sad Tester 227387 -- Registered Saakariau SR00713 ET r � c �- e,3 q9 q i !� F, f�� n Lj'1y sec 34-/ T 30 N �-} T o wn o SA. Jo39 SCALE Its = Tom Nelson BM i OF r5 r ;6..j e lej 00,79 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 11 r JV a C � Mailing Address 8' Al Q !1 /�' ` ^• �7'lltc�� , l(.�� -6Fl Property Address to V / �` hG !1 4 a ' -� - (Verification required from Planning Department for new construction) 5-`t&C.- City/State Parcel Identification Number D 3 © — ©a7— —O ©O LEGAL DESCRIPTION I Property Location ` /. NlWz'/4 Sec. , T O N -R Town of Subdivision al , Lot # Certified Survey Map # -� . Volume 3 . Page # 4", O 2 Warranty Deed # ©$ �.�.5' _ , Volume J '514 , Page # 3 Co Spec house ❑ yes no Lot lines identifiable 1� 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 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. 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 that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the year piration date. q SI TURE OF APP ICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of the property d sc ' d a e y virtue of a warranty deed recorded in Register of Deeds Office. ' 1 ` A T * * * ** O 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 WARRANTY DEED DOCUMENT NO. I This Deed made between STEPHEN M. ALLEMANI and KIMM E. ALLEMANI, husband and wife and each in their own right, Grantors and KEVIN L. SCIIACKLE and ROXANNC M. SCIIACKLC, husband and wife as survivorship marital property, Grantees, RETURN T D. Peter Seguin MUDGE, PORTER ET AL. Witnesseth, That the said Grantors convey to 1 10 Second St, PO Box 469 Grantees the following described real estate in St. Croix Hudson, WI 54016 County, State of Wisconsin: TaxIU# 030 - 2007 -70 -000 Lot 2 of Certified Survey Map recorded May 26, 1978 in Volume "3 ", Page 602, Document Number 348873, except the Westerly 48 feet thereof. This is not homestead property. "Together with all and singular the hereditaments and appurtenances thereunto belonging; and Stephen M. Allemani and Kimm E. Allemani warrant that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and reservations, if any, of record. Dated this G:: day of 1 1999. (SEAL) ol't'W (SEAL) *Stepenv1. emani Kimm E. Allemani AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signatures of Stephen M. Allemani and Kimm G. Allemani ) SS authenticated this day of 1999. ST. CROIX COUNTY ) _ Personally cnnre before me this — L - day of ,/ fl "fLE: MEMBER STATE 13AR OF WISCONSIN 1999, the above named Stephen M. Allcmani and Kim E Allemani, to me known to be the persons who executed the (Signatures may be authenticated or acknowledged. Both are not foregoing instrument and acknowledged the same. necessary) THIS INSTRUMENT DRAFTED BY: D. Peter Seguin Notary Public, State of Wisconsin MUDGE, PORTER, LUNDEEN & SEGUIN, S.C. M Commission (expires): 1 10 Second Street, Post Office Box 469 Hudson, Wisconsin 54016 FILED �f,J MAY' 26 197f: 1AMES O' CONNED 1e9131or of Deed, 54 Gelx County, js Wisconsin <A, CERTIFIED SURVEY MAP THOMAS ALL194ANI Part of the Northeast 1 of the Northwest 1/4 of Section 34, Township 30 North, Range 19 West, Town of St. Joseph; St. Croix County,'Wisconsin OWN N ROAD NI/A- COR. SEC. 34. T30N,R19W — — — N 90 °000_ W 3 33. 'Z 1. 648 33 5. 8 9' 33 1 �- 2 STORY FRAME DW E LLING � I 1 OO D ,� F- nO SHEDS ( e O'f0 1 Zno LOT i 'rn :W 3 °jam N 5 vACRE5 La in. 5O ACRE5 ki 0 9 D,q re p 0 oc 4 O o, (n ° Ul 0 1 0 11 O ZZ D Ul crL-Ltn 9Q� Z MA45H �. � < W OQ AREA 10113` I I t _.YZ 0 333.21 4 `` 335.89 ; 4J- N 89 41' 3 5'' � 1321. W o Indicates 1" x 24" iron pipe stake set weighing 1.13 lbs./ft. set. 5 CA LE 1"-2( Description: That certain parcel of land located in t> Northeast l /4 of the Northwest 1/4 of Section 34, Township 30 North, Range ;, West, T61.rn Of St. Joseph, St. Croix County, Wisconsin, more fully described as follows; Commencing at the North 1/4 corner`o£',said Section 34, the POINT OF BEGINNING of the parcel to be herein described; ; thence gQ'N 90 ° 00'00 "W 1317.15' along; the North line of the Northwest 1/4 of sai&,'Section 34; thence go S 00 ° 38'30 "E 654 thence go N 89 041"35'tE .541; 1321,14'; thence'`go N''01 ° 00'00 "W 647. 4 line of the Northwest 1/4 of said Section 34, to the POINT OFBEGINJING above described parcel, containing 19 acres, more or less, and is subject to easement over the Northerly 33' thereof for Town Road P r'P u oses. ( For purposes of this description all bearings are referenced to the North line of the Northwest 1/4 of Section 34, T 30 N, R i9 W, assumed N 9O ° 00' OO "W) ( State of Wisconsin ) r ( County bf St. Croix ) I, James L. Murphy do hereby certify that by direction of the Owner, Thomas Allemani, I have surveyod and divided f.he 1 and a Qhn,..,, t n_ nn., � 1 , ' o JG � / may Zti0 T -S `Q` AHd21f1 uzsuoos ' W �M �.,,. it S3Wbf sdsW - Xan,zng pe ��i �'••. . ' r �� sP- dlunoo xi OA �i��iiiuuulllu�lul►�►�►����` gL � q�.zE .zoAe.zng pus? peaels,2a -SgcUnW •Z sawep - .. 1 pus anal s ass uotqd�.zosap pus dsw ano s a •3oa.zayj uoTgsquasajda.z • 9 �� �s�� pus ..��.uttio0 x �S 3o saousut Pao auj pus sagn� s� g utsuoos -fM Jo 9C as jdEFl;j 'sn.100a.1 TP_T 1 T T Tn T _ 61-111 Pn rnn- -,n r.-.- ......, -- • ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner t Property Address r Y' City /State I R </� �/� Legal Description: t t Lot _� Block Subdivision/CSM # 6 2 3 12al 3 1 a f s lft E Sec. _1 T N -R 1,9M Town of PIN # SEPTIC TANK --DOSE CHAMBER — HOLDING TANK INFj11 -- TION: Tank manufacturer Size ST/PC / Setback from: House Well P/L Pump manufacturer Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: Width Length Number of Trenches Setback from: House Well P/L Vent to fresh air intake ELEVATIONS Description of benchmark ' (�� Elevation lT Description of alternate benchmark Elevation ��dro+ Building Sewer ST/HT Inlet yL, 7 3 ST Outlet PC Inlet PC Bottom Header/Manifold Top of ST/PC Manhole Cover Distribution Lines () () ( ) Bottom of System O O ( ) Final Grade () () ( ) Date of installation / / Permit number 35 2- �� State plan number Plumber's signature . 2 License number 27- -7 Date Inspector Complete plot plan � NOTICE Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW �D 2-q3 Ado- p ,� 60 -2- INDICATE NORTH ARROW II r Wisconmin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division Count y: INSPECTION REPORT St. Croix G Sanitary Permit No.: 'GENERAL INFORMATION (ATTACH TO PERMIT) 353250 Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: ❑ City []Village ❑)Town of: State Plan ID No.: Schackle, Kevin Town of St. Joseph CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: Qp -E) ' I I M , D + — in*/ a;'" 030- 2007 -70 -000 TANK INFORMATION 4 WNAMN DATA 4. Z� TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 2,� Benchmar � Dosing Alt. BM Aeration Bldg. Sewer Holding St/ Ht Inlet ?6_ 73 TANK SETBACK INFORMATION St/ Ht Outlet P.,3 0 /6 • y 5 TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic ';K NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding '>1 00 Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand St cover ,8 �� • ° r� Model Number GPM TDH Lift Friction I System TDH Ft Forcemain Length Dia. Fi Dist. To well SOIL ABSORPTION SYSTEM BED/TRENCH width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSI SETBACK SYSTEM TO P/L I BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION Type Of �-s r OR UNIT CHAMBER mod Number: System: DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. 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 I ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: Qj - 9 ?Inspection #2: Location: 641 Perch Lake Road, Hudson, WI (NEIA, NW1/4, Section 34 T30N -R19W) - 34.30.19.376C 1.) Alt BM Description= 2.) Bldg sewer length= �l - amount of cover = Plan revision required? ❑ Yes No Use other side for additional information. I IZ QQ y SBD -6710 (R.3197) Date Inspector's Signature Cert No. ADDITIONAL COMMENTS AND SKETCH • e s ' SANITARY PERMIT NUMBER: ` ..., m M iq gg r a f j 3 4 f ' I 1 t p _ r l o . mry .mm.m�� k a . fl F e a , � 3 f f T f L T �— <m <mm- em.< ; g..._,.,.«.E ., m: ,,.,.,.......,m....<:..b..P,..a gy m.®. <. ....�........._.... cc .ya «...... .... _ .�.. E f A I t w _ w Safety and Buildings Division 4.46onsin SANITARY PERMIT APPLICATION 201 Bo Washington Avenue 'Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. V • See reverse side for instructions for completing this application State Sanitary Permit Number Personal information ma ou p rovide be used for seconds Y p Y secondary purposes � Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION Property rX Z er V e d• n 4 G I F_ petty &cation 3 y �^ /� le is � // 1 �4, 5 T Jv N, R E (o W Property Owner's Mailing ddr `�� Lot Nu�r Block Number /5 tk 0 04 ! / City a Zip Code Phone Number Subdivision Name SM Number ' ave> F�/�? 5308' ( > Y-'T?- 771 7 Ud • 3 O i ll. TYPE OF B I ING: (check one) ❑ State Owned ❑ C it Nears Road n Public i or 2 Family Dwelling - No. of bedrooms ovine / �.� i, e� E III. BUILDING USE (If building type is public, check all that awly) + ' Parcel Tani Wmber(s) a 9 f (D — 0 00 1 ❑ Apartment / Condo ;,. I cr I 2 ❑ Assembly Hall 6 E] Medical Medical Fa/;Nursing Home .10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandisei.Sales /'(Wpaim ' �nrg9 '111 E] Restaurant/ Bar/ Dining 4 ❑ Church/ School 8 ❑ Mobile Hom�Park St ORC4, h 2 E] Service Station / Car Wash 5 E] Hotel/ Motel 9 E] Office/ Factor�i . a;t IUN3Y r`13 ❑ Other: specify IV. TYPE OF ERMIT: (Check only one box online A, Chec (lox on ine B, if applicable) A) 1. L!F 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an _System -------- O ------ _._____- ________ Existing System ________ Existing System 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 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ P Privy 13 E] Seepage Pit 43 Ault Privy 14 ❑ System - In - Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation r Feet Feet VII. TANK in gall Total # of Prefab. Site Fiber - Exper. INFORMATION Gallons Tanks M anufacturer's Name Concrete Con- Steel glass Plastic App New Existin strutted Tank Tanks Septi o 'r o0 &V Z6 CIO Al L ❑❑ 1 ❑ ❑ i ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plum is Signature: ( St a s) M Business Phone Number: r Prd er's ddreu Street, City, State. Zip Code)* O W IX. COUNTY / riFPARTMENT USE ONLY []Disapproved Sanitary Permit Fee (includes Groundwater D ate Issued IssuinQAgentSi nature (No Stamps) - Approved ❑ Owner Given Initial Surcharge Fee) Adverse Determination X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: .-1%6 Y � (I� ►�►, b � v� d w J // � / K.Sl�e rIeol it. nr v / °ne P /wvK�•r�f w:lr ter rn5 trot /in ule' ��'<<n�5 -5 5"rar � /0 / r i 5� D r a ip i S hkD- 6398(R.11197) DISTRIBU N: Original to County. One copy o: Safety & Buildings Division, Owner, PlurnKer r ^ ! to .y.�lSflh -- lijQS 6e��cn' 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 sysfem, 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 permit is 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, pump /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 differenn�es; friction loss; pump performance curve; primp model-and pump rrLanufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) 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. pro aQ � � ��. P ,�. • Y - x • :. vw a: 3rd a r , v Al 4 53 f, wig i } c 4 t f t 1 � ... :t' • h ; _.. .. �, ' n „ } ', �T mow• Sol zy Jt , y o or Co cow �70 Pr S /O/aX - X-4 3 Ole rte' 160, � g ': �. , . ..a i h .. .. . � �, � .. ,�� � :. '. } J,r.�.1� ... , 2 �.. £ A :. a � �'+ r �� � ,� P �.� 1 �� �., �',�. ` { �� .� r airy, .. _ � y � :. 1 , � ' 1. .Olt 4 » t - .� r v {{{��� V �.., r. 1 j' `` ,.. ��' ,... ;.xr ..�.,�w '� . . . , _ _ ., ,� �� '""'t k -,...a .. c.j - - ,�„y ` ...; . ' .. .R.0 SOIL AND SITE EVALUATION Page 1 of 2 oivOn of Soft and Buidr w in accord with Comm 83.05, Yrs. Adm. Code FA W Mach co"Veie site plan on paper reef less theme 8'.+- x 1 ! inctees in size. Plan must Canty wx*We, but net Imbed 10: verficW and horizontal reference point (BM), dreciion and St. Croix perr� Aope, scale or OF"09ns, north arrow and l —h— and &stance to nearest road—Parcel 1.151 APPLICANT -- APPLICANT INFORMATION - Please print all iMormation. o30 — — — 0&�) PMWM yaA FWAM Mr tM UM SW Monday pffiW" (RWVW LAW s. 16 04 (t) (es))_ Properly Owner Property Location Shackle, Kevm Gowt. Lot NE 1/4 NW 1/4 S 34 T 30 KR 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# i84t3 Oak 01m Dr 2 N i Cloy Stale Zp Code PhoneNumber Culy ❑ Village ®Torn Nearest Road $ti11Waff MC 35082 651-439-7715 SLloseph p Fomh 1.siW ROW New Corstruciot Use: _ Residential / Number of bedrooms 4 MAddilim m "irt� existing W r� Replacernent Pubic or commerr iai describe L� i—II Cole Denied d* 11= 4i gpd Recorrrnendetl din badirt$ rate bed, ---- tench, gpd.4F Absor Uon area renuired bed, ff trench, fly Mmd urn design loading rah bed, WW tench, Ili Recommended Wbalon surface elevai;on(s) it (as referred to site plan bencirnar Additional design / site considerafion " site Parent material Locss Ovcr Glacial OutWash Flood plain elevation, if applicable It S sY conventional Mound In -Ground Pressure AT -Grade System in Fib HokiN Tank U- - um for spstarn [I S 0 U a 0 S M U N � S U j 0 S U G I3 S N U u S U SOIL DESCRIPTION REPORT Dominant Color Mt>ftles Strutctir e GPDAP Horizon Depth in. Munsel Qu. Sz Cox. Color Texture Gr. Sz. Sh. Roots Bed q Tnvlch 1 1 0-9 1Oyr3/2 - sir 2msbk mfr cW 2f 5 6 2 945 10yr4/4 - sil 2msbk mfr cW if .5 .6 Ground 3 II 15 -17 7.5yr4/4 i W7.5yr5/8 B sl i lmsbk i mvft q - q - i .4 .5 etev 100.62 ft Depth 0 tlmffin factor 17 q q d i l l h i Remarks: 2 1 0-10 10yr3/2 - sil 2msbk mfr cW 21F S .6 2 10-22 IOyr4/4 - Is 2msbk mvfr cW If .7 .8 Ground 3 22 -30 7.5yr4/4 f1f1.5yr5/8 A Im mfi cW - .4 .5 elev $1.92 ft II i i l l i i q q to II limiting fad 22 Rerrtark.& CM Nam (Please P" Minaiure� Thomas _ fielepirone No. omas C. Nelson / 715- 246-2454 Address firviranwmWBYDesign Date Number Ref# 1432120th Street, New Richmond, W1 54017 l / 2 3 4 9 227387 259 PROPERTYOWNER: Kevin SOIL DESCRIPTION REPORT p � NN Page 2 of 2 PARCIEL l d Fav mi Dk-si Hwimn tl Qorrinert CoW d man I Texture I q Rooks I GPDIW M. Munsel Qu Sz Cont. Color Gr. Sz. Sh. gW ;Trench 1 0-6 10yr3/2 - sil 2msbk mfr ew 2f .5 .6 2 6-17 10yr4/4 - is 2msbk mvfr cw if .7 .8 Ground *v 3 II 17 -28I 7.5yr4/4 I ftfl.5yr5/8 I A I Imsbk I mfi I tw d - I .4 .5 100.16 ft II d I p I I I d d Depth to X 17 R G Lil 0 Remarks: 4 1 0-8 10yr3/2 - I 2msbk mfr cw 2f .5 .6 2 8-15 10yr4/3 - a 2msbk mfr cw if .5 ? .6 Ground elev 3 15 -t8 10yr4/4 - sa 2msbk mfr cw if .5 .6 9824 ft 4 18-29 7.5yr4/4 ftf7.5yr5/8 sl Imsbk mfi - - .4 .5 Depth to h I d I I I N I limiing fados V I I d I d I I d 18 d I I Remarks: A4 W Ground elev II d d I d I I I b Depth 11D factor Rea kilt Ground elev II I d I I I I I to d I d d d I p d I li nnrbv factor tl tl I d B l I I Rerraks: ` . EMV i 1 120 J i 1�iET, NM RI41'Mv4VA,/, Wt►K O R4 7I5 -246 -2454 Trim Nelson Certified Sail Tester 227387-- R,e&tered Sanitarian SR00713 +•t' rtrz' �'- F ii�E�R## +R+1�ii�i�+ #�esk� #1�a1i # # # # # # *8 #Yt3 #$'- F #3i$ *$ #i�ilflkaC ## t0 Q-n t , f C 9 97.92 1 4 � i t ------- - -- e. L) ; n s n t / ,,! n W' /y Se 3 LI T3 0N 12 19LJ oS S4. Jo5Q p�1 SCALE I _ Tom 1VeLson RM to N5 Pen L v/ le.floj Tj bow ���v {o e'ej 400,7 NOV -24 -99 09:58 AM GTI PARTiGULICH TRUCKING 715 749 3878 P -01 PRIVY INSTALLATION AGREEMENT COPY TORE ATTACHED TO THE SANITARY PERMIT APP Property 0 ner(s): LIGATION Prope jr., lr, N / 'r PAGE ! eserve or ecordng ate ailing Address: locgtion: — r '�. /. S T N, R E o W ity, V1111 9, ownship Of: arcel Tax Numbsr. �n r F Legal Desori tlon, � ` Ina" 1 y - PMV n"y R/poN/ 1. No plumbing will Installed In the privy. 2. No plumbing will be installed In the premises served by the privy unless a code compliant soil absorption system or holding tank exists, or a valid sanitary permit to Install such a system has been Issued. 3. A privy vauit/pit shall maintain minimum setbacks as specified In Table 1. Table 1 Well Well Lake /Stream Additional County Setbacks Open Pit 50 Ft 25 Ft Min. 75 Ft Sealed Vault 25 Ft 25 Ft Min. 75 Ft 4. Privies for public buildings shall comply with ILHR 52.63, Wis. Adm. Code. 5. Privies used for one - and - two- family purposes shall be constructed In such a manner so as to exclude files, rats and other vermin. Doors should be self - closing and vault ventilators should terminate at least one foot above the roof. 6. A privy vault shall be constructed of watertight plastic, fiberglass, coated steel or monolithic concrete . Materials shall comply the intent with Comm 83.20, Ws. Adm. Code. Counties may by ordinance, establish minimum sealed vault sizes and type or construction within the guidelines of Comm 83,20, Ws, Adm. Code, 7. The privy shall be kept clean and sanitary. The contents of the pit or vault shall be disposed In accordance with NR 113, Ws. Adm. Code. 8. This agreement shall be binding on the owner, their heirs and assignees. This documentation shall be recorded by the register of deeds In a manner which allows Its existence to be determined by reference to the property where the Privy Is Installed, Subscribed date: Notary Public- Minnesota r � Anoka County or a) Ignatu My Commission _xf, aaZ . Notary Public My commission expires 8004432 (R.Ttes) NOU 24 1 99 10:10 715 749 3878 PAGE.01 1473PAGE 643 3 614451 KATHLEEN H. WALSH REGISTER OF DEEDS Document Number Document Title ST. CROIX CO., WI RECEIVED FOR RECORD P #eZ 11 - 29 -1999 8:50 AM �5 44 t t C� t^ 745 `� m 61 AGREEMENT y EXEMPT N / CERT COPY FEE: COPY FEE: 3.00 TRANSFER FEE: RECORDING FEE: 12.00 PAGES: 2 Recording Area Name and Return Ad re eE oi-rx s OSC) 4O 7 - 70 -000 Parcel Identification Number (PIN) 60 A)um 6---(- -3 Y4( o sc -C.3 Z.1 7 3G A/ / W T� L-,, This information must be completed by submitter: document title. name & return address. and PIN (if required). Other information such as the granting clauses, legal description, etc. may be placed on this first page of the document or may be placed on additional pages of the document. Note: Use of this cover page adds one page to your document and $2.00 to the recording fee Wisconsin Statutes, 59.43(2m) WRDA 10/99 215-32 (2199) ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer F 1 - a c' Mailing Address 1 '�' Al // Property Address to a- /r (Verification required from Planning Department for new construction) C� City/State [.L).� Parcel Identification Number O5 © — 0a7— O ©O LEGAL DESCRI L ' /s, Sec. , T �e N -R Town of Pro Location ;, i Subdivision Lot # Certified Survey Map # - y� 73 , Volume 3 . Page # Warranty Deed # ©S l j � , Volume AA/ Page # 3 �o Spec house ❑ yes gr Lot lines identifiable 1Y 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 rnasterplumber, 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 that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the year piration date. Si V 7 OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements or. this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property d sc ' d a e y virtue of a warranty deed recorded in Register of Deeds Office. I A Oli 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 VOL H48mzf 436 608�3'S WAR]Et 4Wff DEER REe S T TE E R OF DEED into 8T. CROIX CO.. YI k�'' • M IEIIQ FIR M= WWII" 9131 M MOO CM CM Fffs (/ CM FEE: This Dad made between STEPHEN hL TV M90 FEE: 91.01 ALLEMANI and KIMM L ALLEMANL husband and Erfl I IN FEE1 10 .00 wife and each in their own right, Grantors and KEVIN L. SCHACKLE and ROXANNE M. SCHACKLE, husband and wife as survivorship marital property, Grantees, RETURN TO: D. Pets Seguin Witnesseth, That the said Grantors convey to I IO SM PORTS: TO Grantees the following described real estate in St. Croix Hudson, WI 54016 -. County, State of Wisconsin: f Tas IDAI 030 - 4007 -70 -000 Lot 2 of Certified Survey Map recorded May 26, 1978 in Volume "3 ", Page 602, Document Number 348873, except the Westerly 48 feet thereof. This is not homestead property. C Together with all and singular the hereditaments and appurtenances thereunto belonging; and Stephen M. Allemani and Kimm E. Allemani warrant that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and reservations, if any, of record Dated this day of ' 1999. " % � r E (SEAL) 4( �1C�C (SEAL) Step en M. emani Kimm E. Allemani AUTHENTICATION ACKNOWLEDGMENT f Signshm of Swpben M. Allemani and Kimm E. Alkmani STATE OF WISCONSIN ) authenticated dis day of ) SS 1999. ST. CROIX COUNTY ) F TITLE: MEMBER STATE BAR Cr WISCONSIN Fasona�' came before me this _rte day of s, 1999, d w above named Stephen M Alleaml and Kimig I- (Signatures may be audKnticated or adnowledged Both are not Allesaas, io me known to be the persons who exeased the fmcgoing mtrwrKm and adnowl�dg / ed the same. THIS INSTRUMENT DRAFTED BY: D. Peter Seguin MUDGE, PORTER, LUNDEEN dt SEGUIN, S.C. %orb r+b1i, state of Wisconsin My Coma union (expires): , , • 110 Second Street, Post Office Box 469 KA a — T * OM 1 � Hudson, Wisconsin 54016 NOTARY SYEAFC ' f'U8t'C - MINNESOTA . my Cam. F "-p a.lan • r ,FILED r MW 26 1971 JAMES O' CONNED I Se9 6lor of Deeds Sk Croix" Counly, js Wisconsin CERTIFIED SURVEY MAP THOMAS ALLII4AN I Part of the Northeast 1� 4 of the Northwest 1/4 of Section 34, Township 30 North, Range 19 West, Town of St. Joseph; St. Croix County, Wisconsin TOWN ROAD N I /A- COR. SEC. 34. T30 N, R19W -- -- N 90 O 00 W 131 - 1.15 -- - - - - - -- f_ _ , 648 1 �, 33 5. $9' 33 2 STORY rRAME A P PROVED r 1 l Z 6 I I 00 r ' O owe LL1N i 9ARN O ,r I `� 000 MF0 �SHED5 N 4 0 MAY 17 1979 1 It °�� � ° Q0 I �1JV'Y•' V.1� 1� 1� � : � 0 � 5, O 1 Ma rt �,'*a ;a "Nib � Q LOT 3 3 4� Z N 5.pAGRES 0 5.0 ACRES 111 b t: s v�s►o 10 0 0 c>c W O R v1 O Kq M1N FO o IV VAS f f F o 0 O PPR � CY) bOE jE OR SEPS C Sy,jEM• f cn �9� O - LL in O� O 11 D1 � Sl - < Q a 01 tAEAVA O O BV N 62.e0. 9d 2 Z REFER 1O MAR 5 H z w d UJ A R A 1 � Z 0 333. Z I' �52.04� �� 335.e9 4Ja 1 P N 89` 41" 3 5 "E 13 2 1. 14" o Indicates 1" x 24 iron pipe stake set weighing 1.13 lbs. /ft. set. SCALE 1 "z 2C Description: That certain parcel of land located in tvie Northeast 1/4 of the Northwest 1/4 Of Section 34, Township 30 North, Range 19 West, Town of St. Joseph, St. Croix County, Wisconsin, more fully described as follows; Commencing at the North 1/4 corner of said Section 34, the POINT OF BEGINNING of the parcel to be herein described; thence go N 90 ° 00'00'W 131'7.15' along the North line of the Northwest 1/4 of said Section 34; thence Ro S 00 ° 38'30 "E 654.54 thence go N 8 9 0 41 "35 "E 1321.14 thence go N 01 ° 00'00 "W 647.54 along; the East line of the Northwest 1/4 of said Section 34, to the POINT OF BEGINN''ING of the above described parcel, containing 19.72 acres, more or less, and is subject to easement over the Northerly 33 thereof for Town Road purposes. ( For purposes of this description all bearings are referenced to the North line of the Northwest 1/4 of Section 34, T 30 N, R 19 W, assumed N 90 ° 00' 00 "W) ,, ( State of Wisconsin ) r ( County bf St. Croix ) I, James L. Murphy do hereby certify that by direction of the Owner, Thomas Allemani, I have surveyod and divided the lands shown hereon in accordance with official records, Chapter 236 of Wisconsin Statutes and the Ordinances of St. Croix County; and that the above map and description are a true and correct representation thereof. ' James L. Murphy Dated: X 78 �� egistered Land Surveyor Z5 March Ij r` os ������nl narmrr nrnr�i� 11/z Vol. Page. 602 ��` ' ••° V / / /' i St. Croix County Records Ce rtified JAMES L', rtifie d MURPHY " St. Croix County Wisconsin S • 1 0 4 = � Z C p'; RIVER FALLS, :'�O WISC '� t M 7, / Volume 3 Page 602 a - , lsvi l (mss �3 ,� -, � �s L13 -- 7 715- ' t Kevin Grabau From: Shawna Moe Sent: Tuesday, December 14, 1999 4:22 PM To: Kevin Grabau Subject: Privy Kevin - Kevin Shakle called today. He wanted to let you know that his privy is on his property at 641 Perch Lake Road, and is ready to be looked at anytime you are out that way. It is in St. Joseph township. If you have any questions, please call him at (651) 503 -4973. Thanks, Shawna 1 I