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Sec 22_ . 36 . _0 Sd- J ase - ._ 636- ZozS -- 36 - 66a REC 515Zou E!vE. FEB 06,(1,7 -, , ,.OIyMCNI UN7b EY FIELD INSPECTION & SERVICE REPORT I INSTALLATION AUTHORIZED SERVICE PROVIDER ..% te,5Ye7rkemp . a04 Installation Address: Name: ,,4.C,C 50,-/ 4 5; e 5Va/aahti'?S,LG4- Owner Name:7 Y? ,�,, c14. G` , ta...[ Street: / � - I Mail Address: /x/70 Re r .e -rte. Mail Address:3y Atasn- Ga•ec £a.i . /fowl&, )/, Sy Qscc© CA, (,)/. 5 Yosd City State Zip City State Zip 1 1 Phone 0/5)5S19-6,029 Fax Phone L1'/ )246-7767 Fax e mail _ e-mail ace,5od(a 4' �r,n-6'ecb1 .•i1c INSTALLATION INFORMATION Model No. Blower Brand and Serial No. Date of Installation Date of last pump-out I...,i. /fra.6.- Size 14,44d;e{ - Q .P 8;.20/0 1 EQUIPMENT DETAILED COMMENTS OF SITE CONDITIONS- OPERATION YES NO MAINTENANCE PERFORMED OR REQUIRED Electrical Panel(s) / ^ Visual Alarm Operating - ✓ / Audio Alarm Operating / L.cJ' °" 40�1, //O��o� T.- 7 -,¢/� /� L (if present) ✓ Ay' le 4. t�•c t ,,,mob r/,4 -%°,c-e-ef i Blower(s); citrr y,e.0t Air Inlet Filter Clean J — Blower Hood Vents Clear - I_ Excessive Noise 66k. -1_ Excessive Vibration I Unusual Unit(s): —607------' I{{{ Unusual Odor System Vent _ • Pumpout Required: / 0 " f ' 4 L,i���l��i - #6t^44 ,44e r Primacy Settling Zone ✓ 13f At Gen ' a 1' � 4 ' • ' + 'C' - ,4 , Aerobic Treatment Zone /.Am.- 'V e� 174C '``� EFFLUENT: LIMIT RESULT occ..t.Qa,,,t6 - G� - �r Estimated Daily Flow ( nfit^" ! H (Standard Units) 6-9 S.U. _ � Color _ Clear o f 4- 71- -- emperature _ L Dissolved Oxygen (effluent) 2 mg/L Odor Slightly Musty odor . _ (not septic) .►J.i 1 OWNER SIGNATURE I ICIAN SI gr URE SERVICE DATE Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 515200 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Ockul , Thomas & Lynda I St. Joseph, Town of 030 - 2025 -30 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 22.30.20.437C TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing � Alt. BM Aeration USL rw Bldg. Sewer A Holding L_ : . , St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom x � b hp Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Cover I del GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: �� UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hale Spacing Vent to Air Intake Pipe(s) 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 reeded/Sodded j xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes [2 No ❑ Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 1470 Pine Tree Lane Houlton, WI 54082 (Gov't Lot 1 22 T30 20W) metes & bounds Lot Parcel No: 22.30 .2 437C 1.) Alt BM Description = 1 �+ 1. 2.) Bldg sewer length - amount of cover = V A_A.),ff f4ir.. Plan revision Required? ❑ Yes )<'No �1 4T Use other side for additional information. _ L_ SBD -6710 (R.3/97) JQ, C - -ZAP' � .1- Date P. Tr,. In/&'s ure Cert. No. .. 1 41 Orl OY / lS r K. STO CROIX C OUNTY #I- A�l PLAN - a: ?✓{ A4' m,,': g5k^ VA19GAl ''4iu�kb >i'ei+,s„ila,t.,. May 13, 2010 Thomas & Lynda Ockuly <. 1470 Pine Tree Lane Houlton, WI 54082 Dear Mr. & Mrs. Ockuly: Code Administrati Recently, the St. Croix County Zoning Department has received complaints about 715 - 386 -4680 the steady removal of trees along the bluffline of the St. Croix River in the Houlton area over the past few years. As you may know, your property is within the St. Land Information Croix County Riverway Overlay District, which was enacted as a means to protect Planning 715 - 386 -467 the river al with its natural and scenic bluffline. Since the enactment, this 3 g Department has worked with land owners to enforce the standards of the ordinance. Real P erty 71 6 -4677 Like many agencies, this Department relies strongly the eyes and ears of citizens such as you living in the Riverway District to alert us of concerns and complaints. R ycling Please be aware that in most cases, vegetation removal of any kind is not allowed - 386 -4675 in the Riverway District. If you see or hear any activity in your area which could be considered violations, please contact this Department as soon as possible to help us prevent violations before they occur. Please remember to check with this Department before cutting any trees on your property. Please note that this letter is not a notice of violation, but a public reminder to Riverway property owners. To review St. Croix County Ordinances, visit the following web link: http: / /www.co.saint- croix.wi.us /county ordinances.htm Under Land Use, click on chapter 17.36 — Subchapter IIIN — Lower St. Croix Riverway Overlay District. 1 0,1 If you have any questions, I can be reached at (715) 386 -4683 (8:00 A.M. to 5:00 P.M. weekdays). Respectfully, ` oUa�.w Dan Sitz Zoning Technician Cc: Town of St. Joseph Jay Kimble, Town Zoning Administrator File ST. CROIX COUNTY GOVERNMENT CENTER 1 10 1 CARMICHAEL ROAD, HUDSON W1 54016 715- 386 -4686 FAX PZ@CO. SA /NT- CROIX. W1, US W W W . C O. SAI NT -C R OIX. W I. U S coe.wi.gov Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 St. Croix 't i A t Z �' Madison, WI 53707 -7162 Sanitary Permit Number to be filled in by Co.) Commerce 61 S � �— Sanitary Permit Application State Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state -owned POWTS are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary purp oses in accordance with the Privacy Law, s. 15.04 1 m , Slats. Same I. Application Information — Please Print All Information Property Owner's Name p Parcel # 030 - 2025 -30 -000 Thomas C. & Lynda J. Ockul RECEIVED Property Owner's Mailing Address Property Location 1470 Pine Tree Lane NOV 2 0 2009 Govt. Lot I City, State I Zip Code Phone Number %, %, Section 22 Houlton, WI ST. C (% Q¢INTY (715) 549 -6029 (circle one) PLANNING & Z ] OFFICE II. Type of Building (check all tha app y Lot # T 30 N; R 20 W ® I or 2 Family Dwelling — Number of Bedrooms 4 Subdivision Name Na Na Block # ❑ Public /Commercial — Describe Use N City of CSM Number ❑ Village of ❑ State Owned — Describe Use Na ® Town of St. Joseph III. Type of Permit: (Check only one box on line A. Complete line B if applicable) `� New System E] Replacement Treatment/Holding Tank Replacement Only Other Modification to Existing System (explain) System Install Aquaworx Remediator A.T.U. into existing septic tank B. ❑ Permit ❑ Permit Revision Change of Permit Transfer to List Previous Permit Number and Date Issued Renewal Before Plumber New Owner 149126 7/29/91 Expiration IV. Type of POWTS System/Co mponent/Device: Check all that appl Non - Pressurized In- Ground ❑ Pressurized In- Ground At -Grade ❑ Mound ? 24 in. of suitable soil Mou d < 24 m. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ® Pretreatment Device (explain)Aquaworx Remediator A.T.U. V. Dis ersaVTreatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation 600 VI. Tank Info Capacity in Total # of Manufacturer w o Gallons Gallons Units U a H New Tanks Existing Tanks Septic or Holding Tank 0 1200 1200 1 Weeks Concrete N El ❑ ❑ Dosing Chamber 0 l0 3000 3 Weeks Concrete VII. Responsibility Statement- I, the undersi ned, assn responsibility for ins atio f the POWTS shown on the attached plans. Plumber's Name (Print) mbe ' Signature MP/MPRS Number Business Phone Number James K. Thom son 30021 715) 248 -7767 Plumber's Address (Street, City, State, Zip Code) 340 Paulson Lake Lane, Osceola, WI 54020 - 5413 VIIIL. /De artment Use Only r' pproved _ Disapproved Permit Fee Date Issued ssuing Agent i re _Owner Given Reason for Denial $ �� ✓ I O / �q �� G� Jew`_ IX. §prp1C*t4ffiRpval/Reasons for Disapproval A n 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber. `;U 2. All setback requirements must be maintained as, pArapplirable code/ordi Attach to complete plans for the system and submit to the County only on paper pg less fppR 8 1/2 a 11 inches in size SBD -6398 (R. 01/07) Valid thm 01/09 I Document No. * 9 0 7 0 5 7 1 POWTS AGREEMENT 907057 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI Owner name and address: RECEIVED FOR RECORD 11/13/2009 02:50PM Thomas C. & Lynda J. Ockuly AGREEMENT 1470 Pine tree Lane EXEMPT x Houlton. WI 54082 REC FEE: 11.00 PAGES: 1 This indenture, made by "owner" and their successors in interest, own a POWTS (Private Onsite Wastewater Treatment System) requiring regular Return to: monitoring and maintenance in accordance with the manufacturers recommended procedures. These procedures must be performed by a manufacturer authorized Jim Thompson service provider licensed by the State of Wisconsin to perform these services. 340 Paulson Lake Lane Results of these procedures shall be reported to the appropriate Governmental Unit as required by code. Osceola, WI 54020 Location of POWTS: Parcel ID#: 030 - 2025 -30 -000 1470 Pine Tree Lane; Lot Na Block Na . Subdivision/CSM: Na being part of: Gov't Lot 1 Section 22 T. 30 N. R. 20 W. Tn. Of St Joseph, St Croix County, Wisconsin. POWTS DESCRIPTION: Aquaworx Remediator, pre - treated effluent discharged to mound dispersal component constructed in compliance with Mound Component Manual, SBD- 10691 -P (N.01 /01). OWNERSHIP RIGHTS AND RESPONSIBILTY FOR POWTS: Property `owner" as described holds sole ownership rights. "Owner" is responsible for insuring inspection, operation and maintenance of POWTS. < a�,Q /J— 3- o S (own ignature (Date) ( Sign ) (Date) Acknowledgement: nain� ,comas C. Ockuly & Lynda J. Ockuly, known to me t2k the pZ executing the re g trttt>ft nt. Subscribe d sworn to before me this day of 2009. Tj UV ; �--- c� 1F RYCPUI3 • 'State of isconsin o My 'Fom� � Expires: October 23.2011 Instrument Drafted By: James K. Thompson 1 of 1 POWTS SERVICE CONTRACT The proper operation and maintenance of the components listed below will significantly influence the performance and life expectancy of the POWTS (Private Onsite Wastewater Treatment System). This agreement authorizes A.C.E. Soil & Site Evaluations, L.L.C. personnel (Service Provider) or their representative access to the POWTS components during regular business hours to perform regular inspections and routine maintenance of those components. It is herby agreed by and between Owner and Service Provider that in consideration of the payments provided for herein, Service Provider will provide a manufacturer trained and State licensed inspector to perform periodic inspections of the POWTS components as set forth below. Service Provider will prepare a written inspection report after each inspection containing any recommendations for the operation, maintenance, and or repair of the POWTS deemed appropriate by the Service Provider. A copy of the report will be provided to Owner and the appropriate Governmental Unit. Service Provider will supply additional services, parts, or labor only after authorization by purchaser. This agreement does not assume any responsibilities or obligations that are normally the responsibilities and obligations of the Owner and does not cover any costs associated with operation, maintenance and or repair of the POWTS. In no event shall Service Provider be responsible for any special or consequential damages, including but not limited to, loss of time, injury to person or property, or incidental economic loss due to equipment failure for any reason whatsoever. This agreement will be automatically renewed each year unless amended or cancelled by either party with 30 days written notice. This agreement may be cancelled by Purchaser only if replaced by a service contract with another service provider authorized to inspect and maintain the specific POWTS components in question. Purchaser agrees to pay Service Provider the sum of $125.00 per inspection. Four (4) inspections will be provided over the first two -year period at six -month intervals. Payment for the first four inspections will be included in the cost of the A.T.U. installation. One (1) inspection per year will be conducted thereafter with inspection fees billed at the time of inspection. Any additional fees for effluent quality testing (if needed) will be approved by POWTS owner prior to sample collection and submittal to lab. POWTS DESCRIPTION: Infiltrator Remediator Aeration treatment unit added to existing hydraulically failed POWTS with treated effluent discharge by effluent pump to existing mound dispersal component constructed in compliance with existing codes at time of construction. POWTS LOCATION: 1470 Pine Tree Lane, Gov't. lot 1, Sec. 22, T.30N., R.20W., Tn. of St. Joseph, St. Croix Co., WI. Parcel # 030 - 2025 -30 -000 Owner name and address: Thomas C. & Lynda J. Ockuly 1470 Pine Tree Lane Houlton, WI 54082 (Owner signature) (Date) Service Provider: A.C.E Site Evaluations, L.L.C. J es K. TT pson 40 Paulson L e Road sceola, WI 54(�ZD ice Provider signature) (Date) Instrument Drafted By: James K. Thompson n N O C) to O g C °: °c °.: c 3 3 CD CD = CD (D W , y �- �- m O m ° N N° <. 3 c C'J N C t_ W 0 o (0 ° - o N -N m o 3= C� o S CA ' o o m rr -� o w 0) 3 ° >> a w a o °' I I I N N N N S2o y N Qe ° O d CD r m r l o N w Z D m Q v ?> a [D O m C. a A 07 Q N O' \ D CO �_ O O J 1 j --4 n� N N O N O v V U1 _ N O 8 CD p :(1 ° CD n r N N CD w co N c -1 (/f O c :. C CD CD O O O w, a 00 0Q) CD to cn cn o o vi cn to o m s 3 3 3 v o c m m O ? o N = G0 d = 3= `D ? `° - o m 3 3 .. (A j CD A o a N cn co N N N° D D o D D o CD n a l"rt . O O CD N CD N c N c �( � 7 O N N N CCD A D CD A -4 CA = N C `n c `n _ N N p z O Q tT W F CD N N W .9 W m OC c) N M N o a z 0 3 c 3 N 0 N D D n A N A O n _ 3 y O C f A w 3 Q C 67 CD x d O _. O N 3 a O a ao 3' 3 � _ CD coo o CD a' CC n N 0 3 j O T li N N O D T N CD N 'O (D _ c 3 c - a N - = O O 7' Z O. 0 D Oc z Q. 7 n c a) -1 O O (D = O O 3 Cep COj~j "O (D d CD O !. ° 0 C () O N N N O 7 C 3 < CD (n a lD .N,. En CD O O 41 ' CD CD CD r O Q a v O N 3 (D. O W > n' �=3? En o CD W a a w o� d a a � (D C - m tv = a w CD CD N c tv CL - a o 0 o - �I o � 00 CD rn= oN .� x o 0 0 O I o I o 'a CD CD V O O O O w v O CD O CD a O O CL ._„ v y tt .JVi ;consin Department of Industry PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT St . Croix Safety end Buildings Division Sanitary ermit No.: (ATTACH TO PERMIT) Y GENERAL INFORMATION Gov't Lot I, Sec. 22,T30- R20,Pine Tr. 149126 Permit Holder's Name: ❑ City ❑ Village) U] Town of: State Plan ID No.: Thomas Ockuly St. Joseph S91 -01482 CST BM Elev.: Insp. BM Elev.: BM Description / � Parcel Tax No.: TANK INFORMATION t ELEVATION DATA 7 g _2p,,� lt �; y TYPE MANUFACTURER CAPACITY STATION BS HI ELEV. Septic w� /� Benchmark ., ?9 A 73 4. 2 ' Dosin G(1Q�J�S Can . pfed z ao ® / " 51 D Aer Bldg. Sewer 61 Au Holding St/ brt Inlet TANK SETBACK INFORMATION St/ bW Outlet I ' TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet / / (� Air Intake y • ' 2 �o•c0/ Septic y -' 1 NA Dt Bottom Dosing yam' NA Aera NA Dist. Pipe 2 �' 7 ' ,8 Holding Bot. System PUMP/ S411111iii" INFORMATION a.0 jcr �►' +-` Final Grade Manufacturer D Land A-577 5V Model Numbed -� I(ps I GPM a 4 .78 ' ' TDH Lift,�q, I Friction ab System _p TDH 1 45 , a,93 f Forcemain �er g`tTl � Dia. Fi ah Dist. To Well y2:5 t �d�7►+. -Z�� /�� ( SOIL ABSO6TION SYSTEM3 I /o V avya� - BED / TREPOW width r Length r No. Of renches PIT Inside Dia. Liquid Depth D IMENSION DIME I N SETBACK SYSTEM TO P / L I BLDG I WELL LAKE / STREAM LEACHING Manufact INFORMATION Type of � t , CHAMBER Mo a Num er: System: 7 > X5 94- OR UNIT DISTRIBUTION SYSTEM. Ord 6 m afs Heedw/ Manifold �� Distribution Pipes) t „ „ x Hole Size ` x Hole Spa�ing Vent To Air Intake Length �� Dia. a Length 7� Dia. 1 �c2 Spacing y 707 } �� (PO SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over / f Depth Over It xx xx Depth Of , xx Seeded/ Sodded xx Mulched Bed/ T*@m *Center /$ Bed/ T�,eH-E 1L _/ 0 Topsoil es Q No �l�rS� ❑ No COMMENTS: (Include code discrepancies, persons pre Z .y►G -�, (/[ C / 1 '" ICJ, / , — J r Plan revision required? ❑ Yes ❑ No Use other side for additional information. p SBD -6710 (R 05/91) a �d �„/.5 -��,� Date Inspector's Signature Cert. No. � 1 ADDITIONAL COMMENTS AND SKETCH e SANITARY PERMIT NUMBER: 01A fly. F f i 4 a. �ILHR SANITARY PERMIT APPLICATION - COUNTY v. In accord with ILHR 83.05, Wis. Adm. Code 5 fi` MEN �� x STATE SANITARY PER irevious # -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ /l / �J 8% x 11 inches in size. h if a .onto application -See reverse side for instructions for completing this application. STATE P AN I.D. NUMBER I. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. 1 J ` ! O PROPERTY OWNER PROPERTY LOCATION T .�►�'s DG (,�c y 4 4, S zZ T 300 N , R L v E (or) W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # Z710 $ /f'1 /S S! SS % / / - ut, 811). .... CITY, STA E ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER CITY NEAREST ROAD 179 4QWN OF: II. TYPE OF BUILDING: (Check one) ❑ State Owned ❑ VILLAGE: ST- 70S Al;vt TR ❑ Public ®1 or 2 Fam. Dwelling -#of bedrooms PARCEL TAX N BE III. BUILDING USE: (If building type is public, check all that apply) 7 1 ❑ Apt/Condo 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 in line A. Check line B if applicable) A) 1. ❑ New 2. VReplacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit # — Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 Mound 30 1:1 Specify Type 41 El Holding Tank 12 ❑ Seepage Trench 22 5 In- Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault 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) W O � 7- ELEV�TION �• 1 D Feet � L91 Feet VII. TANK CAPACITY Site in ga ons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name C oncrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdina Tank X F1 I El F1 Lift Pump Tank/Siphon Chamber 000 2. n Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plu er's Signature: ( Stam ) MWMPRSW No.: Business Phone Number: *;V,k xle'ui vi //� ( - 7yl) 33 Plumber's Address (Street, City, State, Zip C ): IX. C LINTY /DEPARTMENT USE ONLY Disapproved Sanitary Permit Fee (includes Groundwater Date Issued .suing ent signature (No m ) Approved ❑ Surcharge Fee) Owner Given Initial Adverse Determination 7 X. CONDITIONS OF APPROVALIREASONS FOR DISAPPROVAL: SBD -6398 (formerly Pib -67) (R. 11/88) 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 may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to fhis permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Penewal 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 p m ed 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 & Buildings Division, 608 -266 -3815. 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 ohly one and complete ## of bedrooms if 1 or 2 Family Dwelling. 111. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in 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 in ##1 -7. VII. Tank information. Fill in the capacity of every new and /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% 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) airsizing 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 for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD -6398 (R.11/88) s- APPLICATION FOR 11A11ITARY PERMIT 8TC -100 This oppllcetlon form Is to be compintad In full and signed by the ownst(s) of the property being developed, Any Inadoquacles will only result In delays of the pztn+lt Issuance. •Should this development be. Intended for resale by ovner /contractot,(spec house) then a second Loth► should bt retained and completed when the property Is sold and submitted to this oLtice with the spptopclate decd recording. '- -------------------•-------------.---------------------------------------------- Omar * of property Location of proper! /1 Aectlon ^� T 3 D 11 -R T o vn s h l p _ .- 7 ti ) n c ,Eit7 �j Ka111ng ■ddrtss _2 2 0 InISyls-r ;eV i 1?Lj10 Address at s1 t e /'/ , /ai Vic. 2 LA H �� �.� ,�.i.► �ti: S� /c��Z tubdlvlelon nawe • Lot number PrtYIOVS owner at pcopetty M! Lc>s Total slse of petcel _ 9 7s /- lc-y ' s Date petcel was created All all corners and lot liner ldentltlabls? .. A Yes __H Is this pro petty being developed Lot resale (spec house)? — _Yes —2L voln,.t and pegs Humber 2, a■ recorded with the Reglstet of Deeds. -------•-------------------------------------------------'---------------------- 111CLUD9 V1T11 71116 APPLICATION Tllit FOLLOV18Cl A VkARJWTr OVID which Includes a DOCUHIHT NUH©IR, VOL"t AND PAOt NU1teIR, and Ilia ©rkL OT THIC RB0111THR OP DgBD11. In edditlon, a eettilled survey, 11 available, would be helpful so as to avoid delays of the tevlewing process, it the deed desctiptlon tolerances to a CettlLled eucvey Hap, the CettlLltd Survey Hap shell also be tequlred. -------------------------------------------- PROPBRTY O "ER CERTIFICATION I(VI) certliy that all statements an this forth are true to the best of ■y tout) this we edgel that i thi () am (are) the owner s) at the property deeetibed In . lr+forn.atlon form, by virtue of a warranty d�s recorded In the Office of the county Regiatet of Deeds as Document No. pteeintly own the proposed alto Lot the sewage disposa a atenl an l that f (vel obtained an easment, to run with Ilia above descd (v ) hav construction at e. nystero, and the sa ibe p rt t me line been duly recorded In the oftice of the Coynty Regfnter of Deeds, as Document Ho. 1. signatute of owner Signature aL Co - owntr (IL Applicable) Date of slgnatuts Date 09 algnatuce 1 SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue P.O. Bog 7969 Madison, Wisconsin 53707 State of Wisconsin Department of Industry, Labor and Human Relations July 24, 1991 THOMAS C OCKULY 220 S MISSISSIPPI BLVD ST PAUL MN 55105 Plan I.D. No. S91- 01482 -P Dear Mr. Ockuly: Re: Thomas C. Ockuly - Residence Private Sewage System NW,NE,22,30,20W Town of St. Joseph, St. Croix County, WI Your petition for a variance to section ILHR 83.23 (1)(d), Wisconsin Administrative Code, has been reviewed. The rule being petitioned requires a mound system site to have a minimum of 24 inches of suitable natural soil. The variance requested was to install a replacement mound system on a site with 18 inches of suitable natural soil. The following comments were made in the petition analysis: 1. In reviewing the petition, it was noted that the request was similar to other petitions accepted by this department under petition numbers S89- 03304, S89- 03318, and S90- 00072. 2. Based on the precedent established by the previous petitions, this petition for variance is being processed as permitted by Wisconsin Statute Section 101.02 (6)(g). Departmental Action: Approved. ,n SBD 0828 iR.01/OU f SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue P.O. Boa 7969 Madison, Wisconsin 53707 State of Wisconsin Department of Industry, I,abor and Human Relations THOMAS C OCKULY Page 2 July 24, 1991 This approval is granted with the understanding that all of the petitioner's statements and any condi ns of ap rov cite above will be carried out. Prepared by: e er e Plan Examiner Private Sewa Section (608) 266 -28 9 Departmental Signature: Dater 1C . Byer, rC 1 ec I Director, Office of Divisi V odes and Application PEP:423WPP3 Enc. cc: Leroy Jansky, Private Sewage Consultant - District 6, Chippewa Falls T omas Nelson, Zoning Administrator - St. Croix County obert Ulbrigh t, Plumber SBD 6928 (R. 0 1/91 i SAFETY BURDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations PRIVATE SEWAGE PLAN APPROVAL Otfice of Division Codes and Application 201 East Washington Avenue P.O. Box 7969 Madison. Wisconsin 53707 HOMESITE SEPTIC PLUMbING Owner: THOMAS OCLULY 655 O'NEIL ROAD 220 S MISSISSIPPI RIVER BLVD HUDSON WI 54016 ST PAUL MN 55105 RE: Plan Number: S91 -01482 Date Approved: July 23, 1991 Gallons Per Day: 450 Date Received: July 5, 1991 Project Name: OCLULY, THOMAS - RESIDENCE t ation: NW,NE.22,30,20W Town of ST JOSEPH nty: ST CROIX The pluming plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped 'conditionally approved'. This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be correctea. All permits required by the city. village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. This approval will expire two years from the date approved or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. The Section of Private Sewage has reviewed these plans for private sewage system cone requirements only. These plans have not been reviewed for the code requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50 -64 of the Wisconsin Administrative code. This approval is for the following components only: - REPLACEMENT PETITION - REPLACEMENT MOUND SAFETY BL NGS DI'V M0\ State of Wisconsin Department of Industry, Labor and Human Relations NONESITE SEPTIC PLUMBING Paoe 2 Inquiries concerning this approval may ee maae oy calllnu (tub; 256-_SE'. Sin ely, f PETER E. P GEL Section of Private Sewage Division of Safety and Buildings PPP013 /0009n/ d cc: THOMAS OCLULY Private Sewage Consultant _Coii'n.r ` Uw- SS WM. P __Plum[;ng con_„ 1.•c _Omer ` Plumber _Lnvir- nmenta' SAFETY E BLHMINGS DIVISION 201 E. Washington Avenue P.O. Box 7969 Madison, Wisconsin 53707 State of Wisconsin Department of Industry, Labor and Human Relations July 2a, 1991 TROVAS C OCKULY 220 S I'ISSISSIPPI 3LY0 ST PAUL IM 55105 P1 �r. I.9. too. S3i -01 ►82 -a Dear "r. OckuIy: Re: Thous C. Ockuly - Residence Private Sewage System NW,NE,22,30,20W Town of St. Joseph, St. Croix County, WI r Your petition for a variance to section IL'R 83.23 (1)(d), Iiisconsin Ad- ministrative Code, has been reviewed. The rule being petitioned requires a around system site to have a minirAm of 24 inches o` suitable natural soil. The variance requested was to install a replacement mound system on a site with 18 inches of suitable natural soil. The following camaents were made in the petition analysis: 1. In reviewing the petition, it was noted that t!he request was similar to other petitions accepted by this department under petition numbers S89- 03304, S89 -03318, and S90 -W072. 2. Based on the precedent established oy the previous petitions, this petition for variance is being processed as permitted by Wisconsin Statute Section 101.02 (6)(g). Departmental Action: Approved. • SAFETY & BUILDINGS DIVISION ' 201 E. Washington Avenue P.O. Box 7969 Madison, Wiewasin 53707 State of Wisconsin Department of Industry, Labor and Human Relations THOMAS C OCKL'LY Page 2 July 24, 1991 This approval is granted with the understanding that 31', of the petitioner's state;ents and any candy ins of ap cited above will be carried out. f Prepared by: Plan Examiner Private Sewage, Section (608) 266 -28891 � Departmental Signature:; Date .� , ch : Mlyer, Arcl1i tect t Director, Office of Di vi si ors Codes and Application r PEa:423WPP3 Enc. cc: Leroy Jansky, Private Sewage Consultant - District 6, Chippewa Falls Thomas Nelson, Zoning Administrator - St. Croix County Robert Ul bri gn t, Pl umber I..L.H.R. 83.0 8(2) PROJECT IND SHEET Owner: - 'hom,45 3 OC v L y �� - 2- 2- 5q& Address: _ 6 ST. RA0L_ MiN�. SSIb5 Site Location: N j S 2-'2- , 7 0,V R .2-0 60 7 or - S T" J oSe 5 T. e eol'X COd vT Project Description: RE p Lnc n� T S p T'r c s N f o .4 aft - bpM . tje / .4 5*7'% M A-� D D+I'L y / l 4 5 TE"` /a 0 0 o rloLe , 6 L v� 7io,v5 5 * c o 74 1 -r 7 - QN y ,e/ O Sv.• ,61, z�O S r 0 E S r'� 2 p e .� A S �' iU (S c^ A �l oo-u ; yST� w �, ��t =- r i t Ti A 1 OP A PP -open S 'A J f I' I ( (3 v t ~tom - f'�e. S V S 7e , /-I � S S yS T�". -�► �cai // ,�'�� �,9�� ,4 - �.f1 /�,v G- c dv v�u Tio�.�t � .� yS 7 Al /o C4 h` 6- Page 1. PLOT PLAN V Pa ge 2. MOUND S V I E4& - -___ _ Page 3. PIPE L TE Page 4.tS DOSING CH Page PUMP PE A v r ell PLUMBER: CO COPYRIGHTED 1991 MAY NOT BE DUPLICATED He's i,-y N e C h U i l l E WITHOUT DES TGNERS PERMISSION 9-1 - 0 01.48 Z DATE: 17 SfTE EVAtbik R/ DESIGMER SIGMA URE HOMESITE SEPTIC PLUMBING CO. 655 O'NEIL AD., HUDSON, WIS. 5+016 ROBERT ULBRIGHT 0 11S. MASTER PLUMBER LIC. NO. 3307 M.P.R.S. "►SIN. INSTALLER d DESIGNEER,ILIIC. NO.00863 U J 1 � J S T . U, v7X s llcl,fj`icw.l L lw'1614�Fxl i.�i «�.- s ysTt'ti►. Ex�sra� y ET M , A r NEw ZV Tv 13 fl 9vDO,vtD IY014y , Tv a ' 106. 1.9 I 20 ` I yD 'y �Z� \ rC MA /.v � [.1 1 9 , 1200 0 4R, PRr � pump G RAN Ee ''i ,�D tyl I HA fpcTU RE P ti` M,i��EV RoC.rC, cvr'S TOTA L _ V L£.upy k of OA"CE MA I N ✓ I' prp-e 5C RH "�„ 39S' elCV4T Pc, v 7,Rak # L # 2 � isy� '/' i prl" sit a� �� '���- - FlE wrrfo,.. r o8 fast Pum ctigMg�� -- I Z f ouao. I F sM iQ7 E X(S T(NG- 6 ¢ •�� �,�QF\ 1 � � � = f3. M. SST' L 0 -r AK) • ST AR 1 47 utj 1) ;� - > � S oy ►5 , , y73 NO TE : 7 M l W (Z E - of FOPct= MA I1! lIJ 7�11�i2 COwy'�'�2p(.tL7 T'orgL or Ca 77 F 2 Avc foRct y 8 Hhi. ' Fc�RC MAi,J SkAll (3E F J ROM _ Nou,u O To � Z i _ 1 - �' s - � O z� o DRrU�w� �'obC ,�� � to y E l 4v, = /97.5 l (zt Sto SrDE Ztst� � , P � ) SL . TPC C k f u G- MAC h iAJ E Soi'o 7E`s 7 9 Sh�'� {es l.� riPEE. Ei6v.�Tioa = /4� gDT 1 7A4 /' AP f X Page ? Of Synthetic Covering To14 aF 0040 Distribution Pipe Medium Sand S y ST�17 Topsoil __ -_ _ c 0EVAPOW _J - -- -- F Z a O , ZO ' 3 E D b % Slope Bed Of zN Force Main Plowed Aggregate Layer 0 I , S Ft. GE Y ►s Section Of A Mound System Using E I - 9 Ft. S�NIA S A Bed For The Absorption Area F �� Ft. ON S1�E � �.�� G / Ft. A Ft. H r • s Ft. R X10 B 94 Ft. r,OR �N� GS K ► Z Ft lt�D FEj� o L / ,8 Ft. DEP NplOVlSlO OF E j /O Ft. O NO S GO � R ESP T Ft. Force Main W Ft. L L j Observation Pipe 8 K 0 0 ----7 ' N Distribution Bed Of i Pipe Aggregate Observation Pipe Permanent Markers !' � PdG G��PEl� Sf�sL ,PODS Plan View Of Mound Using A Bed For The Absorption Area 1 014 82 4 Page 3 Of • V 01 D (/ o /vm E yo R X077 FT of Z 7'uc Fob cF /,4 S f Axl Perforated Pipe Detail u/1 , 6� A T Fob VAC vft e ,r - VA v,q i f End View Perforated End Cap • \t ��. PVC Pipe t . Ja ,ab occ ` Or s Holes Located On Bottom, Are Equally Spaced R Isr 1401E Shhll af= 1JEXT To E,up * A, FOLD Manifold Pipe Distribution Pipe ` Lost Hole Should Be A 7 . ms Next To End Cop pQ End Cop Distribution Pipe Layout P �v Ft. y. o //7- " pV FORCE NMe3 X Inches Y 72 Inches Signed: 11 Hole Diameter Inch l� Lateral >�Z'Inch(es) License Number: Manifold 2 ' - Inches Date: Force Main 2 ' Inches Al off holes /pipe 1 3 Invert Elevation of Laterals 2pO Ft. P I TR%l3vT /OAJ Pi*5ek e 6 FOR 5444, 1RTERt1 /(n,39 �aQ /�+ t •, 'PA 0 I S . 2 -7 , ' 39 -7 & • To7 / rT /57 LDISa,- AR(w �P , 1TE .FOR 1 ONSI -T SEWa�E SYSTEM a S t?QR AidD A r IRS i• or �ti�'�� � r � • � i3u s S91-01482 DEPARTME p1V1510� S EE CORRESPON CE $.4/S . PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS VENT CAP y "C. I. VENT PIPfr WEATHER PROOF APPROVED LOCKING JUNCTION BOX MANHOLE COVER 25' FROM DOOR, 12 "MIU. �`' /►v�CAIIOG��A/gE� \ WINDOW OR FRESH AIR INTAKE yRAp� � ���rtTiO�✓ GRADE I I 'i" MIIJ. I CONDUIT ---- _ - -_ -. 11� INLET PROVIDE AIRTIGHT SEAL APPROVED JOINT A INS�I )00.so' I II APPR VEEDPJOINTS W/C,T. PIPE I ,('{n� I EXTENDING 3' p ` iDt I I I ALARM EXTENDING 3' OIJTO SOLID SOIL B I/ I II ONTO SOLID SOIL C E ri � v I ' I I ON 1 01•� c yy� � I I ELEY. FT. J 1 � PUMP —� OFF BLOCK 16, VA r fo�J RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E 5 P E C. I F MCAT I QM S DOSE (U ►�S6e C o.J CAE rE • TAWKS MANUFACTURER: IJUMeER�� DOSES: PER DA-4 TANK SIZE: /OQO GALLONS DOSE VOLUME �Ev � ALARM MANUFACTURER: INCLUDIAIG 9ACKFLOW: GALLONS by. s 1 MODEL NUMBER: _D LV CAPACITIES: A = lG' 40 INCHES OR y00 GALLONS 1 SWITCH TYPE: hE RC U F- y j10AT` c 2 - INCHES OR 3" ' ? G ALLOUS PUMP MANUFACTURER: 00'LL &R C= INCHES OR GALLONS MODEL NUMBER: I DS 1 f -2-:2- y D= � INCHES OR 33 GALLONS SWITCH TYPE: PI &6 (3AUK ME 12 Cv tZ � _ l0A7 JI OTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATE 2 -0 GPM INSTALLED ON SEPARATE CIRCUITS /NCET 7 2.v p ?#c. - rA ok ST,FG VERTICAL DIFFERENCE BETWEEN PUMP OFF AND Difif RIBLITION PIP S I FEET -I- MINIMUM NETWORK SUPPLY PRESSURE . . , , , . . . N,[ FEET EACt.. 0 -I- yoo FEET OF FORCE MAIN X • '7 � F >, / . O ,FRICTIOM FACTOR.. FEET - 1::_40A S Z3. o / r TOTAL DYNAMIC. HEAD = FEET J it INTERNAL DIMEWSIONS OF�Alglff",*F_MGTH /D O ;WIDTH o Z ;LIQUID DEPTH S SIGNED: LICENSE ►NUMBE DATE: V� R S91 -01482 lj � .4 o+ <_r PUMP CHAMBER CROSS SECTION ARID SPECIFICATIONS VENT CAP 4 C.Z. VENT- PIPE WEATHER PROOF APPROVED LOCKWG JUNCTION BOX MANHOLE COVER 25' FROM DOOR, 12 Mlll. /►Xf01NC! WINDOW OR FRESH AIR INTAKE GRADE I y" MIN. IQ. CONDUIT ` -- \ ---- - - - - -- PROVIDE I --- 1J INL ET AIRTIGHT SEAL nn o � I � ?J, E JOIN A SAV 4 ? 20 � I I APPROVED JOINTS AP PROV D J NT IN �A� I I W/c.1 PIPE w/ C.I. PIPE ( �Q /OC 1 EXTENDING 3' '00 ` INS ( � � ALARM EXTENDING 3 ONTO SOLID SOIL B v Qo71�� II ONTO SOLID SOIL o w ELEV FT. PUMP -� A OFF r 40 K f o� , BLOC ( �c ( VA _ 0 RISER EXIT PERMI'TT'ED OIJL4 IF TANK MANUFACTURER HAS SUCH APPROVAL. SEPTIC E 5PECIFICATIOU5 DOSE 60 /ES��' CO yt,( TANKS MANUFACTURER: I.IUMBER OF DOSES: PER DAy / D /so TANK SIZE: Ub GALLONS DOSE VOLUME ALARM MANUFACTURER: L &VE1 'gmem INCLUDING / / ACKFLOW: 2 � / GALLONS MODEL NUMBER: LV CAPACITIES: A= /� INCHE5 OR ya GALLONS SWITCH TYPE: P y F (OAT B= 2 INCHES OR / GALLONS PUMP MANUFACTURER: Zoe //5 "( p . C = l / INCHES OR Z( � ? ' / GALLONS MODEL NUMBER: /65- /ff %o' 2 2ov D = /2,2. INCHES OR Z9 GALLONS SWITCH TYPE Pf f5y&(e Ilf -VO/e y f /a,4 r S NOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATE 33 GPM INSTALLED ON 5EPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND 015TRIBUTIOM PIPE.. S0. Z FEET - rA,)k SPEC + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . 2 ' S , T E AGIn, + CO77 FEET OF FORCE MAIN X ' ' I F ooFtFRICTIOU FACTOR. FEET �UrIS Z ,4�5- a• TOTAL Dy3MAMIC HEAD = — FEET Y INTERNAL DIMENSIONS F,: LENGTH � UG ;WIDTH _� Z ;LIQUID DEPTH yZ pNg1TE gEWAG SIGNED: LICENSE HUMBER: DATE: aE r�oNS S 91 " 0 14 82 �v n. � QEPARih'�� t p SEE CoFst ON J Y _ H EADI W ~ ¢ W W W t15 CA 110 \. 32 105 URVE 28 90 26 65 I I EFFLUENT 24 60 MODEL and 75 MODEL 189 DEWATER/NG _ 70 ,65 rJ 20 85 - z 18 55 16 MODEL IN p 163 r MODEL 1— 14 198 12 40_ 35 10 MODEL 30 MODEL 137 138' 185 D � �i,R SMAGGEand 6 25 WA 4 •j I / G 8 20 MODEL ����ll 15 MODEL 181 4 7 t Q 2 MODEL 5 53, 55, i 57.59 0 GALLONS 10 20 30 40 50 60 70 80 90 100 110 21. j 7S LITERS 0 80 160 240 320 400 2; TO PER MINUTE 70 a D 1+ 10 - .. MODEL _ 0 50 �1 ;t U; 46 MODEL I v l� L �. 2 r II J 35 MODEL + s qL 1; 10 293 MODEL f' 264 - V 2 MODEL S 9 1 0 4 nQ 1 6 20. 282 — 15 I 4 1Q •, MODEL - , � 267, 288 _ 0 + 3280 Old MNkn Lens GALLONS 10 I ': 20 30 40 50 60 70 80, 90 100 110 120 130 140 1 151 180 1 160 190 P.O. Sam 1&147 Louingle, Kw.iftky.IO21t LiTEI$ 0 00 160 240 320 400 480 560 640 720 (502) 778 -2721 ' FLOW PER MINUTE i ` Hl,l HEAD "161 = "163* = "165 *" "185"-"18r-"18T Series (%s HP) (% HP) (1 HP)' HP) (1 /2 HP) (2 HP) { • Automatic or Non - Automatic. Hat++ r1l • 1 h H.P.,115V, 230V. 200- 208V,1 Ph. or 3 Ph., ,T M Go 4b. G.1 t.w. . dr L.. GM 4,, cu 46UV, 3 Ph. 6 , bx 106.01 01 271 to 310 1+6 4x M .7 » a xs1 ts, bix • 1 H.P., 1 H.P., 2 H.P., 230V, 200- 208V,1 Ph. 16 .bi +1 3w w m t.x pi ,4s y4e 20 610 u 10 s9 2x3 3 w GM+ x6 7+7 1. xW Sr 7tb Of 3 Ph., 460V, 3 Ph. 1x� M4 '33 507 • Passes 3 /4" solids (sphere). >o +1. bs x46 ss �+ a 340 1xt 46e ,x u, SC 1225 40 17 n 46 174 46 fix is M ,a+ W 114 471 • 1'h" NPT discharge standard. .0 1,x4 21 40 33 1x3 1 64 219 ae 341 t00 376 10 'bx` 57 47 : 61 36 1 3 6 4 J1 103 70 "` • Float operated, submersible (NEMA 6) 2 pole r0 213. 70 1N 10 >0 61 leg 70 xbs mechanical switch. +0 x476 14 w 4 Ud a x04 90 ;7 43 x + 37 143 133 7346 • Automatic reset thermal overload 00 30.8 21 iv protection, 1 Ph. only. no 72.03 ° a • Durable cast iron construction. " `�` "u +i 13 " „3 • 2" or 3" flange available. caitadian stsndwa0 • 20 ft. UL listed neoprene cord and plug. listed AHOO. Ap pioral Available Non- A ul omatic WARNING: Model 185 should not be subjected to less than NOTE: No UL listing for 200- 20BV /1 Ph. pumps I M"41 Pictured 30 feet TDH. Mercury float switches we avai"o for non - automatic models. n:: 6ra6w,r+�lsainrlairr i , DIVISION 1 JNfLi )l 0i DlJlwllvt�„ �I'An , Ivll_IVT OF REP ON SOIL - BURIN& �� V LABO TAN PERCOLATION TESTS (115) P.O. BOX 3707 LABOR AND, MADISON, WI 53707 _HUMAN RELATIONS (ILHR 83.0911) & Chapter 145) Gou . WT 1 - LOT NO.: BLK. NO.: SUBDIVIS ME ION NA: LOCATION: SECTION: [ OWNSHIP UNICIPALITY: (NL ►�E'X UNTY WNER'S Zz, T 3 o N/R ?A YER'S NAME: L Io JI Sv MAIL N - Zp S, t*'!IS`SI S S tPpI 2 lUE'i� BLtIt�. CO U "NJ DATES OBSERVATIONS MADE USE _F F I L S S: Nq, BEQRMS. - --- R - IAL DES RIPTION: ❑ New Replace TW1 A -let - O N R S= Site suitable for system U- S ite unsuita for system CONVENTIONAL: MOUND: IN- GROUNDPRESSUR :SYSTEM -IN -FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) � EDS (':'�`\jU ©S 0U DS ®U EIS ®U [�S ❑U - lv � � 2 I"7o 1 F G1 DlV — —v t —arm DESIGN RATE: ( I( Percolation Tests are NOT required 111 any portion of the tested area is in the N ,A `under s. ILHR 83.0915)Ib), indicate: �' Floodplain, indicate Floodplain elevation: 111___ PROFILE DESCRIPTIONS I DE PTH TO GR UNDWATER INGE$ CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH t EVATION OBSERVED E IGH TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) o ,g- �lzTct� �s 1 Ts ; 0 4' L3r1 V s l; 1.1' lz'�3q c1- B- W A- 1.� OKJ� %NbTe-1• � se-1 LSL3 R. Rr z - 8 olz. 6 L Ts ; C 1.S @ it Frr Qt-1. S I �!t-Bn is I TS ; 0.9'' t•tGtm an V 9 �,� r.�o1v,�01� I , s' v� s�c asE tsars AT 3.s' 0.9' Oh Bn �J { �.�' L% 6.1ir Q In V 'fs l ; t.1' $n C_ ►m B .O' 19 w Otiv� bT e at \ tJ4 Sit L. 582 AT 'S �� 'r0 IT �C�- (3ARJ� S 13 EA rJ01 L M- 1 0TTLE� 'sk'N12�t PWNj OIL el`OrLA�C i I Lam, p S `Tt- r {"C►`1 PERCOLATION TESTS RA TER TEST TIME DROP IN WATER LEVEL - INCHES RATE MINUTES IN HOLE PER INCH ER SWELLING INTERVAL -MIN. P RI 1 31 /D 1 � — Z-7 , ►�0 3fl %$jJ 1 Y 30 1 /1 6 Ilb u N O d the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori PLOT PLAN: Show locatiortf of percolation tests, soil borings an zontal and vertical elevation'reference points and show their location on the plot plan. Show the surface elev i d 3 a11 borings an the direction and percent _ sl•1y,�, S � Vfc t Q l=-t NLD is of land slope. L Z O O . Z v �SO I Lg lhot2r; Llht lZgC1f+:�N s )� SYSTEM ELEVJ TION / '>• -, i h,� . \$ OF S K&J'h � �,� -._ fit. `\ 4 ' 7 .3`x. o!s,.►._L�.� 3i'Tu °1�. SThh-E w LA / 1T1 Splh� 1tJ . __ _y.- M -- oon ��, rr . w__L �.�°l� -Bo e>A I �3 w. e• ' SITE W0 0VTM 6 baf t o I-ti e S co 2 N talc. cp 1 Nt �t iry 1 I Gov 8 t�wp w ttL - Cosh tst� 15' _�. ")lam't. w :oF.lhbus�lD SlT.Ri_! - -. - 7 6 l .... ►s .0 B.9 � � 1 tie ow S 5.� r PI C - I .0 T Sr1 f.y LnT -- L1WE.. _.. .. -- _ -_--- -- - T 1 0 car.+ 5T1t v c o J J I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the date recorded and the location of the tests are correct to tke best of my knowledge and belies. NAME (print): TESTS WERE COMPLETED ON: ADDRESS' OU-"> UX Z Z CERTIFICATION NUMBER: PHONE NUMBER (opt L � !.��^; IZ`f'}� , w 1 s y 11 - -- S'1 b 1 t S- t1 S • 0155 CST SIGNATUR oiST RIBUTION: 0, iginal and one copy to Local Authority, Property Owner and Soil Tester. DILHr, .Sl3D.6395 (R. 10 /F3) —OVER — SEPTIC TANK MAINTENANCE AGREEMENT • St Croix County 011NER/8UYER ;2 a2 a 5 0 • Fire dumber_________ ROUTE /BOX NUMBER •' t� p CITY /STATE " ' ZIP of PROPERTY LOCATION:" Secti T © N, R W Town of J•S/L St. Croix County, Subdivision Lot number______,• Improper use and maintenance of your septic system could result in its premature failure to handle wastes.* Prover maintenance con - sists of pumping out the septic tank every three years or sooner, if needed, by a licen's'ed' 's'e tank pump er. What you put into the system can aff t eunct ono t e septic tank as a treat - ment in the waste disposal system. St. Croix County residents`a2�X be eligible to recieve a grant for a maximum of 60% of the cost.of replacement of a failing system, 14111c was in operation prior to 1, 1978.. St. Croix County accepted this program in August of 1980, with the requirement that owners of all ' new " s y_ s't'ems agree to keep their system properly maintained. The property owner agrees to.submit to St. Croix County Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or. .a licensed pumper veri- fying that (1) the on -site wastewater disposal system is in proper operating condition and •(Z)•after inspection and pumping (if necc- certification Certifi io three year'expiration. .j 0 I /WE, the undersigned have read the above requirements and agree 0 to maintain the private sewage disposal system in accordance with l the standards set forth, herein, asset by the Wisconsin Depart- r ment of Natural Resources. Certification form must be completed v' and returned to the St. Croix County Zoning Office within 30 days of the three year expiration -date. SIGNED /� • DATE St. St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 386 -4680 Sign, date and return to the above address. P� t,. �t , 7 1 G e y � .4 3 1 d . pal a' G pia Ila y . V N- t i� 41y 2 '. t � ��� a•� t YQ � � I d q ir��ww' �, t • T1� 5 ,e k,x � 4 w% t; t AV ♦ di p 4 i ,� .� 1 `;� o �.. � *T �,d 'So; t►s 00 o ' 1 0, 4tL di Olf Vp A ' 4x4 *Cf V� 1&1 • 1 ' St. CROIX COUNTY 1 WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE - 911 FOURTH STREET • HUDSON, WI 54016 UAL (715) 386 -4680 1. �{W July 11, 1991 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation of the Thomas Ocluly property, located in the NW 1/4 of the NE 1/4 of Section 22, T30N -R20W, Town of St. Joseph, St. Croix County, revealed 18" of suitable soil requiring 6 inches of fill for an onsite sewage disposal making this site suitable for a mound septic system. Should you have any questions, please feel free to contact this office. Sincerel Thomas C. Nelson Zoning Administrator cj 1 I SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations PRIVATE SEWAGE PLAN APPROVAL Office of Division Codes and Application 201 East Washington Avenue P.O. Box 7969 Madison, Wisconsin 53707 HOMESITE SEPTIC PLUMBING Owner: THOMAS OCLULY 655 O'NEIL ROAD 220 S MISSISSIPPI RIVER BLVD HUDSON WI 54016 ST PAUL MN 55105 RE: Plan Number: S91 -01482 Date Approved: July 23, 1991 Gallons Per Day: 450 Date Received: July 5, 1991 Project Name: OCLULY, THOMAS - RESIDENCE Location: NW,NE,22,30,20W Town of ST JOSEPH County: ST CROIX The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped 'conditionally approved'. This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. This approval will expire two years from the date approved or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. The Section of Private Sewage has reviewed these plans for private sewage system code requirements only. These plans have not been reviewed for the code requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50 -64 of the Wisconsin Administrative code. This approval is for the following components only: - REPLACEMENT PETITION - REPLACEMENT MOUND I 'A) SHD64231k.01/9„ _ r s SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations HOMESITE SEPTIC PLUMBING Page 2 Inquiries concerning this approval may be made by calling (608) 266 -2889. Sinc ely, E E. P� Section of Private Sewage Division of Safety and Buildings PPP013 /0009n/ 4 cc: THOMAS OCLULY _Private Sewage Consultant _County UW -SSWMP _Plumbing Consultant Owner Plumber Environmental Health SBD -64'23 (K. 01 /81)