HomeMy WebLinkAbout030-2095-60-000 1
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count y
Safety and Buildings Division
INSPECTION REPORT St. Croix
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.:
Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 370217
Permit Holder's Name: ❑ City ❑ Village ❑ jown of: ate Plan ID No.:
Zues ch, Todd St. Joseph Township r-t iT_ows 1 0 # 31 $ 7-
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
r 0 U U o{ 5 030 - 2095 -60 -000
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark /0 j
Dosing F6KS gf3� Alt. BM
A —r Bldg. Sewer 12 3 r
C) Z .11
Holding Ht Inlet
TANK SETBACK INFORMATION / Ht Outlet +2. ct3 SS
TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake (3 - Q+, 2r
Septic ± l U Z U ZSej' NA Dt Bottom (� g $� 1.0'
Dosing >cfa' �cj�' D' NA Header/ Man' �p 46
Ae 3• 0!5- NA Dist. Pipe p + 43'
Holding Bot. System
C
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand St cover
Model Number
TDH Lift ` n ,. L oss Syste 2 TD 23 i
Forcemain Length *�cyD Dia. Z r Dist. To Well '> Ja'
SOIL ABSORPTION SYSTEM
t tI E15 / TRENCH N Width Lenyth r No. � PIT No. Of Pits Inside Dia. Liquid Depth
(o a S DIME
SETBACK SYSTEM TO P/L BLDG WELL LAKEISTREAM
L act,re,:
INFORMATION Type O , r CHAMBEl I Number:
System: OR UNIT
DISTRIBUTION SYSTEM "'ts '4 9 5je_- 6e-4'° n°,► ` L L.
Header / anifold Distribution P x Hole Size x Hole Spacing Vent To Air Intake
Length Pi' Dia 2 Length wd Dia. I �L N Spacing 3.Q I to Y%e
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched
Bed /Trench Center Bed /Trench Edges Topsoil ❑ Y s No Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.) Ins ection #1: / / Ij c n :
Location: 1470 24th Street, Houlton, WI 54082 (SE 1/4 1/4 24 T34N R26W) - 24.30.20.799 Country Side Estates -Lot 6
1.) Alt BM Description = f .(ra fe look s,vi��Qeye+
2.) Bldg sewer length = 33'
- amount of over = ' YZ"
3.) contour = y , S) fq 6 IF
`� �'. � A�� (uo 5 • �' (� �l� S� cs� �tRr �,�.. � w,,su.� , o►dp�, �I.�. �
PE2 evI Io equiro? ❑ Yes W No ,
Use other side fora additional infor ation.
1 03 1 1 S 0 IS
SBD -6710 (R.3/97) Date Inspector's Signature Cert. No
k 3 r /G /o Q SIB 6 S - 7 1117G, (1/
I ADDITIONAL COMMENTS AND SKETCH
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SANITARY PERMIT NUMBER:
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Safety and Buildings Division
V iscons in SANITARY PERMIT APPLICATION 201 W. Washington Avenue
P O Box 7162
Department of Commerce In accord with Comm 83.05, Wis. Adm. Code Madison, WI 53707 -7162
Attach complete plans (to the county copy only) for the system, o r qob County
than 8 1/2 x 11 inches in size. �- !.,�
• See reverse side for instructions for completing this applica A- e Sanitary it Number
R� o� 'EO S: 3 � � - -k7--__
Personal information you provide may be used for secondary purposes h k it revision to previous application
(Privacy Law, s. 15.04 (1) (m)I.
fi `��o StIwPlan Review Transaction Number
I. APPLICATION IN ORMATION -PLEASE PRINT AL U / 6;:=1 3 8
Propert ner Name Pgcation
1 T , N, E (or
Property Owner's Mail ing Address t er < Block;Numbe
City, St a Zip Code Phone Number di i>�b a PCSMNumber
5- 1 ( )•
II. P BUILDING: (check one) ❑ State Owned It Nearest Road
ED Village
El Public 1 or 2 Famil Dwellin -' - No. of bedrooms _ To
wn n OF
III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) a y 3C7_ ;R 799
1 ❑ Apartment/ 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 box on line A. Check box on line B, if applicable)
A) 1 p& New 2_ ❑ Replacement 3, ❑ Replacement of 4 ❑ Reconnection of 5 ❑ Repair of an
System System Tank Only 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 7or[] erimental Other
11 E] Seepage Bed 21 'Mound Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ In- Ground Pressure i I 42 ❑ Pit Privy
13 ❑ Seepage Pit / 43 ❑ Vault Privy
14 ❑ System -In -Fill row S 6 ,- p RP,
VI. ABSORPTION SYSTEM INFORMATION:
1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev.1 7. Final Grade
Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /i ch) Elevation
—' Feet / Feet
Cap acity
VII. FORMATION Manufacturer's in gallons Total # of M Name Prefab. Con- steel Fiber- plastic Exper.
New Existing Gallons Tanks concrete strutted glass App.
Tanks Tanks
Septic Tank or Holding Tank -- " ❑ ❑ 1:1 1:1 El
Lift Pump Tank /Siphon Chamber RM ❑ ❑ ❑ ❑ ❑
Vlll. RESPONSIBILITY STATEMENT
I, the u dersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumb is me: r 1 Plumber' ig r ) MP /MPRSW No.: Business Phone Number:
Plu ber's Address Nfreet, City, State, ip Code):
�/°
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved S1 -3,� itaryPermit Fee (Includes Groundwater ate ssue Issuing Agent Signature (No Stamps)
A roved Surcharge Pee)
pp ❑ Owner Given al 5
Adverse Determination
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SBD -6398 (R.12199) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS
r'
1. A sanitary permit is valid for two (2) years. -
2. Your sanitary permit -may be renewed before the expiration date, and at a time of renewal any new criteria in the
Wisconsin Administrative Code will be applicable.
3. All revisions to this permit must be approved by the permit issuing authority.
4. Changes'in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD -6399) to be submitted to the
county prior to installation
5. Onsite sewage systems must be properly maintained._ The septic tank(s) must be pumped by a licensed pumper whenever
necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of
Wisconsin, Safety and Buildings Division, 608- 266 -3151.
To be complete and accurate this sanitary permit application must include:
1. Property owner's name and mailing address.. Provide the legal description and parcel tax number(s) of where the
system is to oe installed.
II. Type of building being served. Check only 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 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 differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section
of the soil absorption system if required by the county E) soil test data on a 115 form; and F) all sizing information-
-------------------------- ---------------------------------------------------------------------------
GROUNDWATER SUR J CHARGE
1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can
effect groundwater. `
The monies collected through these surcharges are used for monitoring groundwater contamination investigations
and establishment of standards.
Safety and Buildings
PO BOX 7162
MADISON WI 53707 -7162
TDD #: (608) 264 -8777
"
fisconsin www.commercestate.wi.us
Department of Commerce Tommy G. Thompson, Governor
Brenda J. Blanchard, Secretary
May 22, 2000
CUST ID No.224263 ATTN.• POWTS INSPECTOR
ZONING OFFICE
KIM A O'CONNELL ST CROIX COUNTY SPIA
504 3RD AVE 1101 CARMICHAEL RD
OSCEOLA WI 54020 HUDSON WI 54016
I
RE: CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 05/22/2002 IdI 1
Transaction ID No. 1 824
Site ID No. 185332
SITE: Please refer , to botb identition hbers,�
Site ID: 185332, TODD RUESCH �above,4q all correspq Bence i�t'the -
ST CROIX County, Town of SAINT JOSEPH; 24TH ST, SAINT JOSEPH 54082
SETA, NW1 /4, S24, T30N, R20W
Lot: 6, Subdivision: COUNTRY SIDE ESTATES
FOR:
Description: NEW MOUND DWELLING 450 GPD
Object Type: POWT System Regulated Object ID No.: 663874
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.
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. DI
The following conditions shall be met during construction or installation and prior to occupancy or use:
A copy of the approved plans, specifications and this letter shall be on -site during construction and open to
inspection by authorized representatives of the Department, which may include local inspectors. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction/installation /operation.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
Sincerely, DATE RECEIVED 05/15/2000
FEE REQUIRED $ 180.00
FEE RECEIVED $ 180.00
ROBERT KANTER , POWTS PLAN REVIEWER BALANCE DUE $ 0.00
Integrated Services
(608)261-7735, 8:OOAM - 4:30PM, MON -FRI
RKANTER @COMMERCE.STATE.WI.US_
cc: TODD RUESCH
RECEIVED
MOUND SYSTEM DESIGN MAY 12 2000
Residential Application
INDEX AND TITLE SHEET SAFETY & BLDGS. DIV.
Project TODD RUESCH
Owner TODD RUESCH
Address 1415 MAIN ST 41 C
HOULTON WI 54082
Legal Description SE- NW- SEC24- T30N -R20W
Township ST. JOSEPH County ST. CROIX
Subdivision Name COUNTRY SIDE ESTATES Lot No. ##If#
Parcel ID Number 030 - 2095 - 70-000
Plan Transaction Number.
P.O.W.T.S.
Index and title sheet Page 1 onditionally
Mound calculations Page 2 ")P ROVE D
Mound drawings Page 3
Pres. dist. calcs. and lat Page 4 ARTMENybF COMMERCE
TDI- and pump tank drawing Page 5 N aF s �t IIDINGS
PUMP CURVES Page 6 j
PLOT PLAN. Pale 7
:- SPCNDENCE
Designer KIM A. O QN ELL, - License Number 224263
'�� / 2��
Signatur Phone No. 715 -755 -3145
Date 5-7-00
Notice: Tampering with this file by unauthorized persons is prohibited.
Deliberate modification will result in disciplinary action under s. 145.10, Wis. Stats.
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
slD -10402- E (R.,Q6W) Pagel of 7
MOUND SYSTEM DESIGN
Complete red boxes as necessary. 1000 gpd maximum design flow.
Inch- pounds Metric
Residential or commercial? R (r or c) (y or n) I N Replacement system?
Creviced bedrock site? N (y or n)
Slope 2 %
Wastewater flow rate 450 gpd 1703 Lpd
Depth to limiting factor 28 in 71.1 errs
In situ soil infiltration rate 0.7 gpd/ft 28.5 Lpd1m2
Contour line elevation 98.6 ft 30.05 m
Use standard fdl depths? x OR Designdepth? in =cm
Place X in box to use standard depths (24 and A +4 inclusive) OR specify design fill depth.
Center or end manifold (C or ®) Hole diameter r 0.25 1 in 0.121, o 0.3 o 025, s,
a
0.281, 0.313 3 inch h only. nly.
Lateral spacing 3.00 R Use 0 lateral spacing for trenches.
Estimated hole space 4.00 ft Not a final calculation.
Number of laterals 2 Pump tank elevation 87.5 ft Outside bottom of tank
Forcernain length Forcemain diameter 2.0 in 1.5, 2,3 or 4 inch only.
2.067 in Actual LD.
HOLE DIAMETER CONVERSIONS
1A5 =0.125 1/4=0.250
SYSTEM SOLUTIORS Inc"ounds Metric 5M=0.155 8132 = 0.281
Estimated dagy flaw F - 4 - 5 - Gl gpd 170& JLpd 3/18=0.188 S/1e = 0.313
7M=0.219
Absorptioncell
Design load rate & area 1.2 gpd/e 375.0 ft 34.84 m
Linear loading rate (LLR) 7.14 gpd/ft 88.5 Lpd/m
Design width (A) 6.w It 1.83 m
Cell length (B) 63.0 ft 19.20 m
Depth of cell (F) 9.5 in 24.1 cm
Sand filter
Upslope fill depth (D) 12.0. in 30.5 cm
Dowrtstope fill_ depth (E) 13.4 . in 34.0 cm
Basal area required -(gpdfmfiltration rate) 642.9 fe 59.73 m
Supporting components
Topsoil.. depth _ 6,0 in 15.2 cm
Subsoil -depth at center 12._0 in 30.5 cm
Subsoil depth at cell wall 6:Q.. in 15.2 cm
End slope toe length (K) -10.05 ft 3.06 m
Up slope toe length (J) 7.90 ft 2.41 m
Donlon slope toe length (1) 9.30 ft 2.83 m
Total mound length (L) 83.10 ft 25.33 m
Total mound width (W) 23.20 ft 7.07
Project: TODD RUESCH
Transaction Number: Page 2 of 7
MOUND PLAN VIEW
observation pipes (typical)
�J
23:2 ft A A= 6.00 ft 1.83 m
7.071M B = 63.0 ft 18.20 m
V1t B J = 7.80 ft 2.41 m
{ K i = 9.30 ft 2.83 m
K = 10.05 ft 1 3.061 m
_ 1 83.10 ft
25.33 m typ. obs. pipe
(anchored securely)
1 = down slope dimension = absorption cell ( Ax B)
J = up slope dimension CD = plowed area (LxW)
K = end slope dimension s" (152 mm)
MOUND CROSS SECTION
H subsoil cap D - 30.5 cm
lateral topsoil G E = 13.4 in 34.0 cm
invert 1 100.10 ift _ _ _ F = 8.5 in 24.1 cm
elev. 1 30,51 m ..:...: -.. TF G= 12.0 in 30.5 crrt
* ASTM C33 H = 18.0 in LS.7Jcm
D Sand Fill E
Sys. #� +
elev. 30.36 m AM contour
30.05 m elev. 2 % -y
slope
D = upslope fill depth plowed layer
E = downslope fill depth Note: Absorption cell media will consist
F = absorption cell depth of aggregate and pipe with laterals
G = subsoil + topsoil depth at cell wall centered across AxB media. The cell
H = subsoil + topsoil depth at cell center media is cowed with geoteQile fabri
Designer notes:
Project: TODD RUESCH
Transaction Number: Page 3 of 7
PRESSURE DISTRIBUTION CALCULATIONS
Absorption cell Inch - pounds Metric
Width (A) 6 ft 1.83 m
Length {B) 63.0 ft 19.2 m
Lateral specifications
Number laterals 2
Holes/lateral 16 holes
Lateral length (P) 60.00 ft 18.29 m
Hole diameter 0.250 in 6.35 mm
Lat. dis. rate 18.64 gpm 1.18 Us
Sys. dis. rate gpmrs 2.35 Lis
Hole -spacing (X) 48 in 121.9 cm
Lateral di ameter Pipe diameter Design options Design choke
Designer must 1 in (25 mm) Place X in red
'W" one choice 1 in (32 mm) box of chosen
from the o ption s 1 12 in (40 mm) x X diameter.
provided. 2 in (50 mm) x
3 in (75 mm) I x
Manifold diameter Pipe diameter Design options Desi choice
DeSigfW MUSt 1 in (25 mm)
W one choice 1 1/4 in (32 mm) Place X in red
from the options 1 12 in (40 mm) x box of chosen
provided in (50 mm) x X diameter
3 in (75 mm) I x
4 in (100 mm) I x
Distribution system contains: 2 Lateral(s)
LATERAL DIAGRAM END CONNECTION
Place correct lateral diagram by clicking in one of the drawings at right and dragging the diagram into this area.
Laterals ce5tered over the imension Last hole drdlod next to a ad Cap fn cap
P
s
All laterals are identical I X —}1 Holes drilled on the bottom of the lateral S
equa% spaced
Forge main connection Ilia tee or Cross to manifold at any point. Laterals & Foroe main of PVC Soh 40
a =permanent end marker (per COMM Table 84.30 -5)
Inch -pounds Metric
Lateral length (P) ft 18.29 m
Lateral spacing (8) ft 0.91 m
Hole spacing {X) i;�#8 in 121.9 cm
Manifold length 3.00 ft 0.91 m
Hole diameter in 1 6.4 Imm
Lateral diameter : ,° in 1 40 Imm
Foncemain diameter lin 1 50 mm
Project: TOQQ RUESCH
Transaction Wmber: Page 4 of 7
TDH and Pumps Tank Drawing
Total Dynamic Head
Operational head 2.50 ft �� '0.76 m
Vertical lift 11.70 ft 3.57 m Are laterals the highest point in the
Friction loss 6.49 ft 1.98 m sysWm? Yes "x' here: L�
Total dynamic tread 20.69 8.31 m If no, what isthe h ighest elevation
Dose Volume downstream of pump?
Dose is > 10 times lateral volume Forcemain drain
Lateral void volume 12.7 gal 48.1 L back to tank? ("x' one)
Minimum dose 127.0 gal 480.7 L x Yes
Drain back 48.8 gal 184.7 L No
Lie volume 175.8 al 665.5 L
Typical Pump Chamber La
yp p out C Y
In combination with state approved treatment tank. Tank construction as per Comm 83.20(3) WAC.
approved manhole cover with
weather proof roaming label and locking device
grade levels !unction box
grade levels
disconnect
outlet e
' 4. vent �� utlet
electric as per NEC NEG 300 and ��
Comm 16.26 WAC \ F location 18" (46 cm) min.
wail of pump �— approved I
chamber or outlet joint
combination tank
A Provide 1 14 - weep hole or anti
alarm on siphon device as necessary
pump on B
Grade levels
pump 88.4 ft �L - pump tank manhole = 4'(10 cm)
Off elev. 26.9 m J minimum above finished grade
D - vertt =12" (30.5 cm) minimum
above finished grade
87:5 ft Pump tank elevation
a" 75 mm) of bedding under tank 26.7 I m bottom of tank
Tank manufacturer WEEKS CONCRETE PRODUCTS
Pump tank capacity 19. galtn
Pump tank volume $00 gal
Pump manufacturer IGOULDS Inches Gallons
Pump. model number WE0311M A 22.2 430.2
w B 2 38.8
Alarm manufacturer 1S.J. ELECTO SYSTEMS E C 9.1 175.8
Alarm model number JHW 101 7= i5 D 8 155,2
Project: TODD RUESCH
Transaction Number Page 5 of 7
:turves Pumps Hof
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0 10 20 30 40 SO )0 of a Iw III I:U Go"
0 10 �0 :a0 m�/►►
3 �' CAP ACITY
•�„� r� 1�•• , iJ , ;. , ' ,, •�'Iv .��N. . N• ;•: t.. ' !, .. •� , ' -` - :IDULCa PUMPS. INC.
METERi fE[T —
�� �uDEL 305
SIZE';'4' Solids
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30
20
0
~ WE H -
15
-- �- l —�-
1
0 0 �p yp !A Ju w 'o 1161 %;.Q GPM
p 10 20
CAPACI7 r
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s Wisconsin Department of Commerce SOIL AND SITE EVALUATION
Division of Safety and Buildings o , I thin Page of
Bureau of Integrated Services ' ! [t rdance with s. ILHR 83.09, Wis. Adm. Code
and horii
Attach complete site plan
�� f r County
o i � not Ie k 1 on� x 11 in size. Plan must
include, but not limited to: a ipal onfal �e rence point'(BM), direction and
percent slope, scale or di ions, r)pF"rr w and location and distance to nearest road.
Parcel LD. #
APPLICANT INFORI"'1(10N P
qWint alf id l mation. Reviewed by Date
Personal information you provide RA4t j5urpose3 ( rivacy Law, s. 15.04 ( (m)) 2' Z ZOtT1J
Property Owner _ Property Location
Govt. Lot 1/4 1/4,S T N,R(or) W
Property Owner's Mailing Address Lot # Block Subd. Name or CSM# 1� J s
City State Zip Code Phone Number Nearest Road
❑ City ❑Village ® Town
1 (7 1-l ' )
New Construction Use: X Residential / Number of bedrooms_ Addition to existing building
❑ Replacement ❑ Public or commercial - Describe:
Code derived daily flow :5 � gpd Recommended design loading rate �_ bed, gpd /f F 11 ? _ trench, gpd /ft
Absorption area required bed, ft X75 trench, ft2 Maximum design loading rate _ _ bed, gpd /ft 2 _ T P___ trench, gpd /ft
Recommended infiltration surface elevation(s) Wre It (as referred to site plan benchmark)
Additional design /site gonsiderations
Parent material c.'a1 „ Q e . T Flood plain elevation, if applicable ft
I TU - 7 Su itable for system Conventional Mound In Ground Pressure AT Grade System in Fill Holding Tank Unsuitable for system ❑ S O U M S ❑ U ❑
S N U ❑ S ®U ❑ S E U ❑ S f� U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
1
Ground 1 _
elev. `
Depth to
limiting
factor
c � in.
Remarks:
Boring #
1114 O-S
e�
3
3
Ground Q
elev.
Depth to
limiting
factor
0 -in. Remarks:
CST Name (P ase Pri t) Signature - Telephone No.
Address Date CST Number
1
SOIL DESCRIPTION REPORT
PROPERTY OWNER — �n Page 12J of
PARCEL I.D. #
Boring Horizon Depth Dominant Color Mottles Structure 2
g in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots
Bed ,Trench
Ground 3 Sc d
elev.
1, ad
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
in.
Remarks:
Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
in. Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
in.
Remarks:
SBD -8330 (R. 07/96)
V lrXA),
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ST CROIX COUNTY
SEPTIC 'DANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
OwnerBuyer / it- 'R e
Mailing Address / /! , Y
Property Address I 7 D Q 4 1 + 1 ` \ e e
(Verification required from Planning Department for new construction)
City/State )'1 Parcel Identification Number (,�,.;'[„
LEG DESCRIPTION f
�' T 4 N -R W Town of Sy Jas
Property Location J� ' /,, /'�� ' /�, Sec. � _�• �6 � !e
Subdivision v:�i± is �, _� . 's Lot #
Certified Survey Map # , Volume 1 3 , Page # 37
Warranty Deed # , Volume �y _, Page #
Spec house ❑ yes A no Lot lines identifiable yes ❑ no
SYSTEM MAINTENANCE,
Improper use and mat ntenanceof 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 b� a
master plumher, journeyman plumber, restrict( -d plumber or a licensed pumper verifying that (1) the on-site wastewaterdisposal system
is in proper operating condition anti. -or (2) alga inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge.
1 /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the stand(.- ±s
set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certtfcat,un
stating; that your septic system has been maini :imed must he cruripleted and returned to the St. Croix County Zoning Office
days of the three year expiration dates,
SIGNATURE OF APPLICANT DATE
OWNF,R CERTIFICATION
1 (we) certify that all statements on this form are tnre to the best of my (our) knowledge, I (we) am (are) the ownerts) of
the property described above, by virtue of a .\arranty deed recorded in Register of Deeds Office.
SIGNATURE OF APPLICANT DATE
•''••' Any information that is mis- represcntcd 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 cope of the certified survey map if reference is made in the warranty deed
T
vi 1454 192
G09?SO
STATE BAR OF WISCONSIN FORM 2 - 1998 KATHLEEN H. WALSH
REGISTER OF DEEDS
Dncumpnt Number WARRANTY DFFD
ST. CROIX CO., WI
This Deed, made between Vernell A. Skoglund and Stephen L. RECEIVED FOR RECORD
Skoglund
09-03 -1999 9:00 AM
WARRANTY DEED
Grantor, conveys and warrants to Todd A. Ruesch EXEMPT #
and Christin R. Ruesch, husband and wife, CERT COPY FEE:
COPY FEE:
TRANSFER FEE: 86.70
RECORDING FEE: 10.00
PAGES: 1
Grantee.
Grantor, for a valuable consideration, conveys and warrants to Grantee
the following described real estate in St. Croix County, State of Wisconsin Recording Area
(The "Property "): Name and Return Address
.AGL E: VALLEY BANK, N.A.
1 301 Coulee Rd., Unit 2
Hudson, Wl 54016
030 - 2095 -60
Parcel Identification Number (PIN)
This is not homestead property.
Lot 6, Country Side Estates in the Town of St. Joseph, St. Croix County, Wisconsin.
Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any
Dated this 2� day of August, 1999.
* * Vernell A. Skoglund
* * Stephen L. Skoglund
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) V F/44- •R.QI�. A- I(IiYV(— STATE OF WISCONSIN )
L- ) ss.
authenticated thisZ_ y of J -/ County )
a Personally came before me this day
0 A 6 G, L A h of August, 1999, the above named Vernell A. Skoglund
and Stephen L. Skoglund
TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) who
(If not, executed the foregoing instrument and acknowledge the same.
authorized by § 706.06, Wis. Stats.)
THIS INSTRUMENT WAS DRAFTED BY
Attorney Kristina Ogland Notary Public, State of Wisconsin
Hudson, WI 54016 My Commission is permanent. (If not, state expiration date:
(Signatures may be authenticated or acknowledged. Both are not )
necessary.)
i
*Names of persons signing in any capacity should be typed or printed below their signatures
' I
WARRANTY DEED STATE BAR OF WISCONSIN
FORM No. 2 - 1998
INFORMATION PROFESSIONALS COMPANY FOND DU LAC, WI 800 -855 -2021
°
CERTIFIED SURVEY MAP
LOCATED IN PART OF THE NE1 14 OF THE NW1 14 AND IN PART OF
THE SE1 14 OF THE NW1 14 OF SECTION 24, MON, R20W, TOWN OF
ST. JOSEPH, ST. CROIX COUNTY, WISCONSIN; BEING A PART OF
LOTS 6, 7 AND 8 OF THE PLAT OF COUNTRY SIDE ESTATES.
THE NW1 /4 N1 /4 CORNER
NORTH LINE OF
NW CORNER SECTION 24
N SECTION 24 S89 °53'01 "W —
�. —_ — + - -- —/ S00'16'03 "W
2601,70' / z 45.75'
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QV " I COUNTRY_- _SIDE_ - ESTATES
-- - LET_ 5
WEST LINE OF THE SEI /4 OF THE NWI /4
CURVE DATA
NUMBER RADIUS CENTRAL ANGLE CHORD BEARING CHORD LENGTH ARC LENGTH TANGENT TANGENT
01 267.00' 35 ° 41'51" S17 °34'52,5 "E 163.67' 166.35' S35 °25'49'E S00 °16'02'W
LEGEND I SCALE IN FEET 1" = 200'
ALUMINUM COUNTY SECTION CORNER
MONUMENT FOUND 0 200 400 600
• 1" IRON PIPE FOUND
1" X 24" IRON PIPE SET WEIGHING OWNER
0 1.68 LBS. PER LINEAR FOOT VERNELL A. SKOGLUND
149 HIGH STREET
• • • • • • • ' ' ' ' ' ' ' ' • • 100' ROADWAY SETBACK LINE NEW RICHMOND, WI 54017
Ut111ty aasetaaiALa a.,
ublic bodies and private
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