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HomeMy WebLinkAbout032-2003-10-150 r w b (D C6 (D (D : 4 N A co) o A CA o 3 V n d f © ` ► A� 3 0 3 r* 1�1. N O m ?� F it O ?C X p F� ( ) 3 w Z N Z N r - 1 Z v Z ° w o w `C • O m o ro_ v Z w �, o ►+, N o ro - o - ro cc O �' (D H •� y o ` N o N v a %, Cl) �! SD m a W ro ro -1 W o C� O ¢' W C- I n ro v o w m o o ° y - sy a o a i CD CA r =y �y00 o 0 ( te n J o a I A a (� acn v>z ro acn u? v IA W a v cn D W a v 00 CD 00 6 - O _ ro Q o c O o CD o o 1 F�' O o cD ° O -4 n°i co CL =4 Z O Cr] m o 0 o co o n r to I tl FX, 0� 0 0 C N tD w 3 * Q O (D a o o o? o o o? !�1 • O g 3 3 �3 Ch CA cn > O w m= m y =" £ O A d �• m o j (D xz N D D o D D o O o a a N• CD CD CD V s N Z C CD p 2 tD A Z "'1 oo� w I mo CD a z 3 3 $ fr m � U) A CD A O W y j D D 3 CL 0 I � � 0 0 0 I m c v c o a o a N o y N I I A I � I I C� I I A I I � I I c I q I I a o o NJ b CD m oo A m o 0 o p p f CD o b DEPARTMENt OF INDUSTRY INSPECTION REPORT FOR Ol DM5 1 SAFETY &BUILDING LABbR & HUMAN RELATIONS DIVISION P.O. BOX 7969 ON - SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION MADISON, WI 53707 NE , AT ,1, 3 0 , 19W Sf assigned) Number: Town of Somerset CONVENTIONAL L1 ALTERATIVE Hwv 64 ❑ Holding Tank ❑ In- Ground Pressure Mound NAM OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Jo Rt . 4, Bx 145 New Richmond, WI 54017 7 -a j -ry y ID ,( BENCH MARK ermanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.: Name of Plumber: MP /MPRSW No.: County: Sanitary Permit Number: Calvin Powers 1 1563 St. Croix 119543 SEPTIC T ANK /HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER pp Q Q PROVIDED: PROVIDED: IJ 6, Jr/ U YES ON 0 ❑ YES 0 BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH C / ALARM: FEET FROM /v , p / L�svO i / `/� / AIR INL E:1 YES NO ( ❑ YES fZr NO I NEAREST DOSING CHAMBER: MAN FACTURER: BEDDING: LIQUID CAPACITY: CAPACITY: P PUMP /SIPHON�M / p / ��U /! Fj / yCTURER: WARNING LABEL LOCKING COV ER YES ❑ NO 298's C %�"� —' PR(yWDED: P OVI YE$ ❑ NO YES ❑ NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LIN AIR}NLF„T: ` PUMP ON AND OFF YES El NO NEAREST -� ms - 0 �s ( T SOIL ABSORPTION SYSTEM. Chec the soil moisture at the &pth of plowing FORCE LENGTH: DIAMETER: I MATERIAL AN MAKING: or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN � the soil is dry enough to continue.) CONVENTIONAL SYSTEM: BED /TRENCH WIDTH: LENGTH: N0. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID TRENCHES: MATERIAL: PIT DEPTH: DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV. INLET: ELEV. END: PIPES: FEET FROM LINE: AIR INLET: NEAREST —� MOUND SYSTEM: Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ❑ YES ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER I TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ❑ YES ❑ NO ❑ YES ❑ NO DEPTH OVER TRENCH /BED DEPTH OVER TRENCH /BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: BED /TRENCH WIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEVATION AND ELEV.: EL DIA.: ELEV: o / / PIPE DIA.: // DISTRIBUTION ` 0 f 7 / , D/ 7 'e HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERI : VERTICAL LIFT CORRESPONDS TO INFORMATION ! APPROVED PLANS [IYES ❑ NO IC`J YES ❑ NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEET FROM LINE: YES ❑ NO YES ❑ NO NEAREST — Sketch System on e a n in county file for audit. Reverse Side. SIGNATURE: T O n.ing Administrator SBD -6710 (R. 06/88) Thomas C. Nelson SANITARY PERMIT APPLICATION U, ILNR In accord with ILHR 83.05, Wis. Adm. Code COUNTY ATE SANITARY PERMI # —Attach complete plans (to the county copy only) for the system, on paper not less than ❑ l 9 8% X 11 inches in size. Check if revision to pre piication —See reverse Side for instructions for completing this application. STATE PLAN .D. NUMB I. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. S a PROP TY OWNER PROPERTY LOCATION C1 - A /7 wy�n '/a %a, S T , N, R f (Or PROP TY UW ER' S ILING AD RESS LOT # BLOCK # Vve CI DIVI TAT ZIP CODE PHONE NUMBER SUBSIO AME OR CSM NUMBER 11. TYPE OF BUILDING (Check one) ❑ State Owned O VILLAGE: NEARE ROAD El Public PO 1 or 2 Fam. Dwelling — # of bedrooms 1% � PAR EL TAX NUMBER(b) pp 111. BUILDING USE: (If building type is public, Check all that apply) 1,3 / l 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 /C Wa 5 El Hotel /Motel 9 El Office /Factory 13 ®Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ❑ New 2. �X Replacement 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 A Mound 30 El Specify Type 41 F Holding Tank 12 ❑ Seepage Trench 22 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) ELEVATION j Feet Feet VII. TANK CAPACITY Site I allons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Se tic Tank or Holdina Tank 11911t) lzigo I F1 Lift Pump Tank/Siphon Chamber El I El F VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the site sewage system shown on the attached plans. Plumber's Name (Pri Plu Signature: o Sta Ps) MP /MPRSW No.: Business Phone Number: P um s Add as (street City, t Zip Code): f011A.W. q - ;/ �7 IX. COUNTY /DE 'ADIMP&IT USE ONLY ❑ Disapproved Sani Surcharge Fee) Permit Fee (Includes Groundwater Date Issued 17�;Ur, o S mps) X Approved El owner Given Initial �� A vers Determin tion X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: I SBD -6398 (formerly Plb -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 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 tre properly maintained. The septic tank(s) must bepump6d by`a license pumper whenever necessary, usually every 2 to 3 years. 6. if you have questions concerning your onsite sewage system, contact your local code 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 numbers) 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 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 11.5 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- - water contamination investigations and establishment of- standards. SBD -6398 (8.11/88) .,,.--- �--- -- S STATE OF WISCONSIN uILHH PRIVATE SEWAGE SYSTEMS D IVISION OF SAFETY i BUILDINGS �' BUREAU OF PLUMBING 201 E. Washington An, Rm 141 -- -.�- �• -�-- PLAN APPROVAL APPLICATION P.O. Box 7969, Media". WI $3707 eos- s6s -�1s ISTRUCTIONS: Please fill in all applicable data and submit this form with plans. Plans will not be reviewed until all tees are received. The oack side of this form describes required plan Information. Plu of mbing codes can be purchased from the Department Administration, Document Sales, 202 South Thornton Ave., P.O. Box 7840, Madison, Wisconsin 53707, Telephone (608) 266 -3358• 1. PRO�IEC INFOR T t clearly) TO N (Type or rio Revlelon To Plan Number. J Name s bmilting arty ( lans returned to same) ti Sir et o o Project N ma Street d o. or RU I Route Project L aon - S . r egal Description / I f ri City or Village State ziP City u}� Coun Village Town OF:� Telephone o. (include area code Designer /1 Telephone No. (Include area code) Owners Nam6 Telephone No. (Include area code) i 1 rt Street 6 No. Street No. Zip City r Village State Zip City or or State J New Mound System (3a) El Groundwater Monitorinig (7) 2. APPLICATION FOR: ❑ Hold Tank 2 i Conventional System- Public Building (1) ❑ Replacement Mound (4a) 9 ( ) ? t; ❑ Replacement Pressurized System {4b) ❑System 1n Fill (1) Petition For Variance (6) El System in Flood Fringe (1) Other Alternatives (5) ❑ New Pressurized Sy stem (. 3b ) I FOR OFFICE USE ' 4: FEE , .,, MtTTED FEE COMPUTATIONS (Include existing tanks) t MAKE ALL CHECKS PAYABLE TO DILHR ` 3a. 750 1,500 gal lonseptic tank 50.00 %. 411• 1,501- 2,500 gallon septic tank _ 60.00 4b. 2,501- 5,000 gallon septic tank - 80.00 4c. 3d. 5,001 9,000 gallon septic tank - 100.00 4d. 3e. 9,001 15,000 gallon septic tank - 150.00 4e. 1 3f. Over 15,0( >gKllon septic tank 250.00 4f., ?: 3g. 500 1,000 gallon dose chamber 30.00 4g• �V R- - - - ,: 3h. 1,001 - 2,000 gallon dose chamber 50.00 4h. Iff 3i. 2,001 - 4,000 gallon dose chamber - 70.00 41. 3j. 4,001 - 8,(300 gallon dose chamber - 90.00 4j. I 3k. 8,001 - 12,00 gallon dose chamber - 110.00 31. Over 12,00) gallon dose chamber - 150.00 41.+ ! 3m. 500- 5,t)00 gallon holding tank 30.00 4m. _ 3n. 5,001 - 10,000 gallon holding tank - 55.00 4n. 3o. Over 10,000 gallon holding tank - 100.00 4o. 3p Revisions - 20.00 4p• 3q. Groundwater Monitoring Per Lot - 32.00 4q. (other than a proposed subdivision) Subtotal 3r. Priority plan review: walk through 4r. j Submittal of plans in person, j by appointment, with double fee 3s. Petition for variance k Setback 25.00 4s. Site evaluation - 50.00 Total Fee NOTE: Feer'gnuent to Wis. Adm. Code, Chapter Ind. 69 maybe subject to change annually -OVEFI SSD -6746 (R. 8185) El July 1, 1984 S89 - 40221 .ter ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE ` 911 FOURTH STREET • HUDSON, WI 54016 _ (715) 386 -4680 IW July 6, 1989 I Division of Safety and Buildings Bureau of Plumbing P. O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation of the Joseph La Mirande property located in the NE 1/4 of the NE 1/4, Section 1, T30N -R19W, Town of Somerset revealed suitable soils at a depth of 2.4 feet, below which high groundwater was noted. This site should be suitable for a mound system. Should you have any questions regarding this subject, please feel free to contact this office. sincerely, &J C Thoma6 C. Nelson �pning °Administrator TCNIVta ,egg -40 WORKSHEET MOUND SYSTEM DESIGN �� e ,��f�o l,0 .�.r ,.S 01 PROBLEM: Design a characteristicsrare: The site in. Depth to groundwater or bedrock Landslope min. /in Percolation rate Di ace from dos chamber to e. t distribution system �- f t. Elevation difference between;aump and distribution system � + ■ 7 r. T E R D WA o / / TE .3 . NAS X � J Ste 1 Step Step 2. SIZE 'THE ABSOgPTION AREA t. s . f. f required ■ .�S�c�� .r� ,�1 hl/j A) Area nth B) s _ nch le ( r 9 • t or Bed .. B) s ft» ;L C)...Bed or trinc h width (A) C. p) Trench.spacing (C) ., .�,.• ;1 1 2 /day B r asteweer load z .24 coal /ft tre lC e5 N Step 3. MOUND HEIGHT ft. : r D h , de t ) A) gill p l l de th (E) D + slope ft. "• . B) Fi P C) Bed or trench depth ,JF) 1`t. , o) Cap and topsoil `depth ,(G) s ft. E) Cap d topsoil depth (H) x 0 4 4 y • fit, �,�,� �/S " ,, I 402 2 -p Step 4. MOUND LENGTH A)i End slate (K) �+ �+E) + F + y x 3 2 B) (K)Total mound .l en th� L R B + 2 (K ft 0/1 A/7, Step 5. MOUND WIDTH A1) UpsIope correction factor .� . A2) Upslope width (J),^ (D + F + G))(3)(fa / tor) ` ■ ft. Bl) Downslope correction factor = r, B 2) D own slo pe width (1) (E + p + G)(3)(factor� . ft. /3 C1) Total rtr��und width (W) for bed J + A .+ I ft. ''C2) Total mound width (W) far trenches J + + (no. trenches -1)(c) + A + I " ti .. 1 ` Step 6. BASAL.AREA A ) I n fi1trative ca N S . " 9a1 /ftzlday P acit Y of natural soil r � . , tR B) Basal area required = wastewater fl Lsq ft:' natural soil infiltrative' capacity 46 0 C1)'Basal area available for bed for sloping sites B x (A + 1) d' {.r t_�� Sq. ft. E' C2) Bas are 'avail le for trench for sloping sites BVI B W J+ A +sq . r f t. C Basal area available for rench or bed for level .r s . .. tes B � � q ft �•� , License i ° r ; .St '7 7. DISTRIBUTION SYSTEMr� /.� $ 402 l , ..S'* / 7A) , SIZE,DISTRIBUTION SYSTEM k� ►cf/•�ro)J,� lJ ' N 1) Mole size ■ �C in. 2) Hole spacing = in 3) Distribution pipe length rn_ is r` 4) Distribution pipe diameter =._ in.` 5) Spacing between distribution pipes 6) Distance from sidewall to distribution pipe • _, in. 78) DISTRIBUTION PIPE DISCHARGE RATE .ft' 1) Number of holes per pipe 4� 2) Flow per pipe = � GPM 7C) SIZE,,MANIFOLD 1) Manifold is central/ end 2) Manifold. length �--� ft �_ 3) Number.of distribution lines =.. 4) Manifold diameter y 7D) ` SIZE FORCE MAIN 1) Minimum dosing rate =,GPM 2) force main diameter ■. ^' _ in i 3) Friction loss 360 f . 7E) TOTAL, DYNAMIC HEAD 1) Vertical lifts ft: 2) Friction loss 3) System head 2.5 ft. _ ft. 4) Total dynamic head = ft l Date • _. Y, 2 / 46 1F) PUMP SELECTION 1) Pump selected will discharge GPM at t. total dynamic head. 2) Pump model and manufacturer 1G) DOSE VOLUME 1) 10 times of volume f dist ibutlon lines 07 ga.l. /cycle (1 ter v ufne 4 doses 24 hrs. gal. /cycle 2 'Y as e a o Da y w ,1 doses/ 24 � ,�s•= rS' al . c cte 3) Mini un do a voFtume � / Y OL S) J 710 DOSE CHAMBER f • 1) Minimum capacity required . 6 - 7S'"O�q.j g al. i'j k, Licvn:w . u •�� Date • y i MEN ON imp m Q'i W-4 &S. OMN" mmmm MEEM IL M m }1f {T'11 ,'.� ��. j�' �* I y� " T ''�i 1 �• ` �f Pag, � '� Si, IJ F V�•/ ,, , ' �'w �. � ' •;,; .E' A J Sttow, Rorsh, Hay, Or 3 ' l Synthetit; . 4w ` ���H,u Disribut ion • Pi a t r . to r •� M i i ° 1% t,. ° , t` x Medium'. Sond., s , I r- y T ' y 1. s. y� Siopp 1 , �"� AfEWAGi� '$Y � E�led Of .. i Force I� in s P #owed > y ` Q•�� Aggregate e AR D ; Ft." .. { + t'P� /��w' yw rr e a s ,� E C ct #on, Of A Moun¢ System' U ir�g a F t r lit Ti,Y LR�i i ' �'hb Abaorptlon �ATea f µy VC! 1 I P'' t �v • ' Q TY ®lJ �� �1 "5 ". 1�• 1 " ' r t. • A �.;' '• F N Ft,} EEe r ORS Fy 2 a As 1 m rt . ` �. q � Sig \ }� B I t . ,.I h s. r � +i �' ' ' t ; 1 • YF .l Wr' A: Fy_ L ceps Num er: t ` -� r K :,�: "" T Y• ,.1 f, 0 1' J, ,`....,�. ,� _i1,. 5 s i 1. 'ii F r I Q r J1 1 f `4. t 4t • " .:,, �' ` .� � { r�C '� 3 � �',, r'i+'�� l,�t �. ,+ r ��pt t * tl p 1 "• 4 - Al 4G r1�a Y� i 4I obi i {j.i" s �J #'i. W ri ,l}, •t as ' x ' �, ;. F"^ ' 1 I d { i � ti a� x } "Ys "• Forcp Man P II t. ti +'� h �• i r } ObSefVQa�on`PIp� i I f f " ✓,I ,: b' t � ,,�, r , i � Y e ,i \ , K' Force Main ;-;t Distribution. Bed O f i *- 2 • ,ipe A99re9at i t i 'Y A'.1 1 Observation Pi e , p Permanent . Mdrkers• I • Cj R i'. Plan View Of'Mound Using A ^ sd For The Absorption, Area r T, J �� Sg9 4® � P a d 9 y e� J� Perforated Pipe Dstall En d Vio Perforated ' End Cap ' A PVC Pipe Halos Located On Bottom, t Ar e Equally Spocod T A O' `q Al Er� INS Ibr h60 Loaf Halo Should Be Neat To End Cop Y Distribution Pipe Layout P Ft. R y S X Inches Y Inches Signed: Hole Diameter „_Inch Lateral tt Inch(s:) License Number: _.,L�: �;.�. Manifold " r Inches Date: _U'TjE,'g;CVA9' 9'YS7Ehti Force Main " 5 Inclty; # of holes /p 1 pc,.Ii 0 Ihvert Elevation of LateraIs rt. �, W EPs' � a.. •L. i � <.i ,. .t e"+.,.w::kt9 rv± ' DEPAR ENT OF INDTSTRY, A HUMAN RELATIONS DIVISION Grr�l�s �� AND BUILDING S 5EE GOR l�Ir dCE _ s S , 8 . 9 J b O N rA rt 1p b w Ob 0 " 0O n M o N z K in Cl) to VV E� D - -- == �+ - - - - -- - - - -- r rt c�a 5 N r +. �. � � \ w rr r •rrr r +- F rrr •r +�'�. td tv rr r rr r ft K rt •rrr"• Ay . rrrr - 7 IN V' tr \ f• � rt o N h p w . r t S89 PAGE OF PUMP CHAMBER CROSS SECTION A SPECIFICATIONS .r VCMT CAP N,EtiJ �c3z/i /atalx> 1 ✓. 4"C.I. VENT PIPC WEATHER PROOF APPROVED LOCKING _frT > - . 7 JUNCTION BOX MANHOLE COVER 23' FROM DOOR, 12 "MIN. WINDOW OR FRESH AIR INTAKE GRADE _T • � � I.B.. "�Y CONDUIT INI..F, ®NSITE SRAJ V I � I I V APPROVED JOINT A Co ..tlp� " I I APPROVED JOINTS +. mr -6 x1..k.•G.A �� W /C.Z. PIPE "r ( III W /C.=. PIPE EXTCNDIAIC• 3'4 '' I I ( EXTENDING 3' ONTO 501.10 SC!;, B �I I I ALARM ONTO SOLID SOIL DEPART rI�EtV7 OF I: e - L ,, I oN �_!J' �I I C D!•V;Sdu' �i rt , ly'�I�T}di� _ 'L �S'� GIi��Li, rV c�7,i I �FR7 e�R_� —_.I r o��df9s dsi 0NDt��G „` OFF 1 D CONCRETE BLOCK RISER EXIT PERMITTED OULS IF TANK MANUFACTURER HAS SUCH APPROVAL ' SPECIFICATIONS ______. SEPTIC AND DDSE TANKS MANUFACTURER : - A -1 � A I, afrlf NUMBER OF DOSES: PER PA4 TAWK SIZE: GALLOMS DOSE VOLUME ALARM MANUFACTURER' S—j ��� 6 e7a< u, S/l� IMCLUD!!!C ZAC;;FLOW: "24 „// GALLONS 1 . MOQE L NUMBER: J A I CAPACITIES: A= c>( 4 INCHES OR 12�GALLONS SWITCH TYPE: ,r,L�2 2 la i Ar B= p, I?JCHES OK GALLONS PUMP MANUFACTURER: ��ao --••ll C=INCHES OR a v GALLONS MODEL NUMBER: D INCHES OR GALLONS SWITCH TYPE: E 1­4 NOTE: PUMP AND ALARM ARE TO BE PUMP DISCHARr.E RATE _ —._ GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE Bi'1 WECN PUMP OFF AND DISTRIBUTION PIPE., FEET + MINIMUM NETWORK SUPPLY PRESSUR�T //. . , , , ” , , 2.5 FEET + FEET OF FORCE MA X _L4 L! oofTFRItT1oN FAtTOR.� FEET TOTAL ObWAMIC. HEAD = Z IiJJ FEET / /i�� /✓l /1i.E��' GHQ INTERAIAL QIMLWSIO O TANK: LENGTH ;WIDTH ;LIQUID DEPTH SIGNED: LICENSE AJUMBE R -117- c V' . G4tlLDS SUBMERSIBLE S89 -40221 SEWAGE 'AID EFFLUENT PUMPS EP0311 LISP DISC• ooupFp0311 142 EP0311 1/3 HP 115 V Effluent Pure 1/2" soli 256. 172.10 1 WWI rtar ; k� Submersible ��,� /��,��r MODEL EP0311 ,� s�� 2S f 11 Effluent Pum Al r ,�,y�. f ti w • METER FEET SIZE ' /a SOLIDS r k. } 25 �1J /1 r��llr0rfi ��f t ' :kr'� '� •, � 6 20 t •1� t I 4 15 Tt 10 2 1 5 r.. 0. 00 4 6 72 16 20 24 26 32 36 GPM p 2.5 5.0 7.5 m'/l1 CAPACITY • •L Performance Curve 3885' L� 1Al7iM tER � � t: ; °° MODEL 3865 �,.,.,.,.. r� � SIZPA" Solids � - s 4 1 EO - N, w a +� .. 40 10 30 WE '10 _ k 10 sf ai, i f 0 0 0 10 m 30 40 w, w to 80 ao 100. 110 120 GM yr, t0 so s o"rm 0 CAPACM LIST DISC. aouwE0311L 142 WE0311L 1/3 111 115 V 1-w 11 3/4' wl.ids 22t,WE031114 142 WE0311M 1/3 HP 115 V Mod H 3/4" solids Gxp4B0511H 142 WE0511H 1/2 HP 115 V High H 3/4" solids COUPWE0712H 142 WE0712H 3/4 HP 230 V High W. 3/4" solids _ * +�} +SEE FaJ4WI,% PAGE FM PFRFU*%= AND SPECIFICATIONS. DATE 10/88 DEFT 30 PAGE Vu �� P69 SAFETY & BUILDINGS DEPARTMENT OF ' ON SOIL BORINGS AND DIVISION IN 'DUSTR`Y, ,,,,� ), P.O. BOX 7969 LABOR AND —' PERCOLATION TESTS (115), MADISON, W1 53707 HUMAN RELATIONS i : 4.i i4r (H63.090) & Chapter 145.045) —11 OCA ; ►'' TOWNSHIP /MUNI MUNICIPALITY: LOT O.: BLK. 0.: SUBDI .SION NAME: OUNTY: OWNER'.)/BUYER'S A E: MA LING DDR SS: Iff I USE ' DATES OBSERVATIONS MADE NO. BEDRMS.: COMM R A DESCRIPTIO RO S ONS: A 0 TESTS: ❑New Replace Residence J RATING: S° Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN- GROUNDPRESSURE: S STEM- N- FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) asOu sou as ®u ❑s ®u ❑s c�u If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAtt DEPTH TO GROUNDWATER - INCHES CHARACTER O OIL WI H TH CKNES OLOR, TE UR , AND D PTH NUMBER DEPTAk ELEVATION OBSERVED EST. IGHE TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) E B- ► ' // B- B- r n ' � B- ''j /' Y 7 '7 B_ PERCOLATION TESTS DROP IN WATER LEVEL - INCHES RATE MINUTES TEST DEPTH. WATER IN HOLE TEST TIME PF I Uj PER INCH NUMBER -WWvW" AFTER SWELLING INTERVAL -MIN. P RIOD 1 PERT 2 P- P- P- P-. P- P scale or distances. Describe what are the hori- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation / at all borings and the direction and percent of land slope. A SYSTEM ELEVATION -'tea a -�,- , x IN 1, 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 data recorded and the location of the tests are correct to the best of my knowledge and belief. TESTS WERE COMPLETED ON: NAME (prin CERTI CATION NUMBER: PHONE NUMBER(optional): ADDRE S: �7 / CS E• DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR -SBD -6395 (R. 02/82) — OVER — SAFETY & BUILDINGS DEPARft N7'0F .REPORT ON SOIL BORINGS AND DIVISION )NDUSTRY, �� , , P.O. BOX 7969 LA BOIR AND PERCOLATION TESTS (115),.- MADISON WI 53707 HUMAN RELATIONS ; ,;,, .q : (H63.0911) &Chapter 145.045) -w LOCATIO ► SECTION: TOWNSHIP /MUNI CIPALITY: LOT O.: BLK. O.: SUBDI ISION NAME: I /T N/R # (or r - OUNTY: O ER' YER'S A E: MA LING DDR SS: / / L / DATES OBSERVATIONS MADE USE PROF, D CR ONS: O TESTS: NO.BEDRMS: COMMER A DESCRIPTIO : r _ Residence o New Replace RATING: S- Site suitable for system U- Site unsuitable for system CONVENTIONAL: MOUND: ,N- GROUND - PRESSURE: S STEM -IN -FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) os ®u sou os2 os Emu os ®u F , I If Percolation Tests are NOT required DESIGN RATE: if any portion of the tested area is in the under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTA DE PTH TO GROUNDWATER-INCHES CHARACTER O OIL WI H TH CKN CK) S CL R, . UR , AND D PTH NUMBER DEPTH ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BA.) � B - / n B- I B- B- PERCOLATION TESTS DROP IN WATER LEVEL - INCHES RATE MINUTES 4ES�T� JD PTH WATER IN HOLE TEST TIME P R PER INCH Wr -S AFTERSWELLING INTERVAL -MIN. P RIOD1 PERT _ P P- P__ PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. 't SYSTEM ELEVATION .— — - - -- — - - _ • , 9 � 1, the undersigned, hereby certify that the soil tests reported on this four wercrmade by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. TESTS WERE COMPLETED ON: NAME prin le ADORE S: CE CATION NUMBER: PHONE NUMB Rloptionall: CS IGNATU E• DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR -SBD -6395 (R. 02/82) OVER — APPLICATION FOR SANITARY PERMIT STC -100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the ermit issuance. Should this development be intended for resale by P P form should be retained and owner /contractor (s ec house) then a s P r completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of property Location of property 1/4 AIZ 1/9, Section _ _ , T 0 N -R W Township Mailing address f a ZL Address of site 44 i„ s r Subdivision name Lot number Previous owner of property Total size of parcel Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house)? Yes N0 Volume at;' s and Page Number recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER,_ VOLUME AND PAGE NUMBER, and the SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I(We) certify that all statements on this form are true to the best of my (our) knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the Office of the County Register of Deeds as Document No. ; and that I (We) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of said system, and the same has been duly recorded in the Office of the County Register of Deeds, as Document No. ). S gnature of owner Signature of Co -Owner (If Applicable) Date of Signature Date of Signature r „ oawP , � - ..- ..a'a:'�t � ,: .,, .�^rr us ..:,... . - •..°rt7s^�r - - -cam^ ^,?., WARRANTY DEED. STATE OF WISCONSIN --FORM No. 1 " Mit�R CO.1 Miiw.ua[['Y44883 Andrew Lamirando and wf NUMB Received for Record this 22nd 'day of J 20()212 TO July A. D., 19 42 at9;15 A.M. Joscph Lamirande Gertrude Anderson Register of Deeds. f .This Indenture, Made this 2 0;Lh.' day of July A.D., 1942 , between Andrew Lamirande and Jessie Lamirande, husband and wife, and in her owls Right parties of the first part, and Joseph Lamirande part y of the second part. WITNESSETH, That the said part 1 Or of the first part, for and in consideration of the sum of, One Dollar and Other Valuable Consideration to Them in hand paid by the said part y of the second part, the receipt whereof is hereby confessed and acknowledged, ha vc given, granted, bargained, sold, remised, released, aliened, conveyed and confirmed, and by these presents do give, grant, bargain, sell, remise, release, alien, convey and confirm unto the said part y of the second part, IIis heirs and assigns forever, the. following described real estate, situated in the County of St. Croix and State of Wisconsin, to -wit: The Northeast Quarter of the Kortheast Quarter (1114- idSy). the South half of the Northeast Quarto (S ' E') 4) of Section Ono (1), Township Thirty (30) North, Range 11ineteen •(19) Ides L, Consideration Lc,-,^ than Ono Hundred Dollars. , wNw r• I I TOGETHER with all and singular the hereditements and appurtenances thereunto. belonging or. in any wise appertaining; and all the estate, right, title, interest, claim or demand whatsoever, of the said part of the first part, either in law or equity, either in possession or expectancy of, in and to the above bargained premises, and their hereditaments and appurtenances. TO HAVE AND TO. HOLD the said premises as above described with the hereditaments and appurtenances, unto the•said part y of the second part, and to IIis heirs and assigns FOREVER. AND THE SAID Andrew Lamirande and Jessie Lamirande, husband and wife. I for - TgeYns el ves ; their heirs, executors and administrators, do covenant, grant, bargain and agree to and with the said part y of the second part, Iiis heirs and assigns, that at the time of the enseallng and delivery of these presents They are well seized of the premises above described, as of a good, sure, perfect, absolute and indefeasible estate of inheritance in the law, in fee simple, and that the same are free and clear from all incumbrances whatever, and that the above bargained premises in the quiet and peaceable possession of the said part y of the second part,' His; heirs and assigns, against all and every person or persons lawfully claiming the whole or any part thereof, They will forever'WARRANT AND DEFEND. IN WITNESS WHEREOF, the said part! es . of the first part ha vo hereunto set their hands and seals, this 20th. day of July A. D., 19 d2 Signed and Sealed in Presence of Andrew Lartarande (SEAL) W. 11. Ryan Jc s s i e Lami randc (SEAL) Borna Black (SEAL) STATE OF WISCONSIN, ss. St Croix County. (SEAL) Personally came before me, this 20th. day of July A. D., 19' , theabovenamed Andrew Lamirande and Jessie Lamirande, husband and wife. to me known to be the person who executed the foregoing instrument and acknowledged the same. W. II. Ryan (Sea 1) Notary Public, SL. C ro ! x County, Wis. My Commission expires Fob. 10th. A. D., 194G I J STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER /BUYER xja"'z ROUTE /BOX NUMBER ] SIX.49 FIRE NO. L CITY /STATE Zaa &a a k Ill t ZIP PROPERTY LOCATION: A66 1/4 NE - 1/4, Section , T_30 N, R l W, Town of 5 ,�, , St. Croix County, Subdivision , Lot No. Improper use and maintenance of your septic system could result in its premature fail6re to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a LICENSED SEPTIC TANK PUMPER. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County Residents MAY be eligible to receive a grant for a MAXIMUM of $3000 of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of ALL NEW SYSTEMS :agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on- site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. I /WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Department of Natural Resources. Certification form must be completed and returned to the St.Croix County Zoning Office within 30 days of the three year expiration date. SIGNED DATE 7 - / 7 — d St. Croix County Zoning Office St. Croix County Courthouse 911 4th Street Hudson, WI 54016 (715) 386 -4680 Sign, Date, and Return to above address x ST. CROIX COUNTY k } WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE I 1 6 _ T HUDSON, W 54 911 FOURTH STREET UDSO 0 FOU • (715) 386 -4680 July 6, 1989 Division of Safety and Buildings Bureau of Plumbing P. 0. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation of the Joseph La Mirande property located in the NE 1/4 of the NE 1/4, Section 1, T30N -R19W, Town of Somerset revealed suitable soils at a depth of 2.4 feet, below which high groundwater was noted. This site should be suitable for a mound system. Should you have any questions regarding this subject, please feel free to contact this office. Sincerely, Jimme C Thomad C. Nelson ,` Administrator �sco Count nsinDepartmentofCommerce PRIVATE SEWAGE SYSTEM y: 5afeiy and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanita .. Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)l. Permit Holder's Name: ❑ City []Village ❑ Tbwn of: State Plan ID No.: LaMirande, Joel Somerset Township CST BM Elev.:. Insp. BM Elev.: BM Description: Parcel Tax No.: 6 Lj e.V_ 032 - 2003 -10 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic �S 00 Benchmark Dosing D Alt. BM A Bldg. Sewer Hol St /Ht Inlet s7-/ TANK SETBACK INFORMATION St/ Ht Outlet Ue TANKTO P/L WELL BLDG. Aelntake ROAD Dt Inlet Septic > to dl 7 Sb ' �Z r �� NA Dt Bottom �Y Dosing j�0 i > Sv ± Zp / NA Header / Man. n :�:� A Dist. Pipe O �� Holdin Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand St cover Model Number GPM TDH Lift Friction System TDH Ft iH Loss Head Forcemai nj Length Dia 3 �� Dist. To Well j 2� 300 ooc✓ S • � S SOIL ABSORPTION SYSTEM � e r � 11111- ED TRENCH Wi th Length No. Of Trenches No. Of Pits Inside Dia. Liquid Depth (DIME NSIONS I V/ ZS" DIMENSION SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHI acturer: SETBACK CHAM INFORMATION Type Of Moe er: System: DSO" yS0 > jd0 O IT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s)r x Hole Size x Hole Spacing Vent To Air Intake Length Di r 3 rl Length Dia. 2 rr Spacing / 1 30 1( SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed / Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1 • /a / if /00 Inspection #2• Location: 881 State Road 64, New Richmond, WI 54017 (NE 1/4 NE 1/4 1 T30N R19W) - 013019473A CoVel 1.) Alt BM Description = u,�, f �o�>' �� or��� r�dt( lilts wssh `-` 'kcrc a use,' s 'r yill� 2.) Bldg sewer length = tL' -amount of cover = -amo � Y 3.) �� in F�MIr(1r`ex �ro�n 1,r�5 {r`'l� S/OC�1e`w• /r�O/ f 7 /t 1 1 , P 7 Plan revision required? ❑ Yes �] No Use other side for additional informs ion_ I to VL SBD -6710 (R.3/97) Da Inspector' ignature Cert. No. I 1 ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: , I d a E 1 a �. € I .w g e a s a F x F , 3 B FiOM DS PHONE NO. : +715 247 5453 Aug. 0 4 199 08:50PM P01 Coun Sanity Permit Application � rY PP St. cRO1X COUNTY WUSCON8IN In accord with 15.04 St. Croix County Sanitary Ordinance ZONING OFFICE Personal Information you provide may be used for secondary purposes T CROIX COUNTY GOVERNMENT CENTER (Privacy Law. S. 15.04(1)(m 1101 Carmlchaef Road Hudson. M 64018 -nlo (7122L64680 FSx (716)385.4M Attach complete fans f o r the system art paper a `l s i n s ize. County Sands Pe It 1) Check If revfs us application App ileationinformation -Plas se Print all information �� lam roperty Owner Name AA/r �r ' /U� !4 A19 1l4, Sec �d9 LA M IRKK%C- ROtk �. R /9 E(or) roper y Owner's Malling Address GOJN' Y t r Block Number g8I .S - V fiZr pt, / q ZONINGt?FFI �^ /� ,Stale Zip Code Phone Numor �`� _j ca S Melon Name or CSM Number W\ A/ Q taNti�uNp vl/ ! t]rpe of building: (check one) � ty OVlllage own of 1 or 2 Family Dwelling - No. of Bedroom: O PoblidCommercial (desuft use)- El State -owned Nearest Road on nO 6Y Type of Permit: (Check only one box line A. Check box cn line 8 N appffcable) P— arces Tax Number(s) /. 3O - /9 fj A) 1.0 Repair 2A Reconnection ONon- plumbing 4. []Rejuvenation o3 Sanitation e) Permit Number Date Issu State Sanga Permit was e 195 d 1 Z/.3 7 / lB J� 9 Type of POW System: (Check all that apply), 0 Non - pressurized In -ground Mound p Sand Filter ❑ Constructed Wetland ❑ Pressurised In -Wound ❑ Holding Tank ❑ Single Pass 0 Drip Line 0 At—grade O Aerobic Treatment Unit 0 Recircula ft. ❑ Other Dis radlrreatmentArea Information: 1. Design Flow (gpd) 2. Dlsporsal Area 3. Dispersal Area 4. Soil Application Rate 5. Percolation Rate 6. System Elevation T. Final Grade Required Proposed (Gais./da / _R.) (Min./Inch) EtevaUDn 1 15b 2_7S_ 37S 7 7 JDA -5 T ank Information I Capalcty In Gallons Total fi Nanu=r Prelab Site Con. Steel flb N Exis" Gallons Tanks Concrete structed glees Tanks Tanks l000 0 ❑ p 61 E P6 VV9Jr_9 ❑ ❑ 0 . RosponeNflfky Statement Me undersigned, atsume responsibility for repair/ rekonnoncUon /roj"nationlmstallafion of non - plumbing for the POWTS shown on the attached plans. A se is not red for Wn tUt repair or fine Installation of r#*n :pIurnbLV sanitation system, lumber's Name print) ilrl�if�s M No. Business Phone Number roX \/ ZZ329 z - 7fS -Z7`1-2111 lumber's Address (WwK City, Stale, Zip EOK Z95 DRE&SE2 W1 5yaa4 Qt. County Use Only Disapproved Sanitary Permit Fee late ISCued Agent Slgnalwe (No stomps) Approved Owner Given initial Adverse " D etemunauon lO 1 f 0c) . Condltlons of ApprovsUReasons for Disopprovol: + DEL 1AWRAtZDE 88) 5TMC �Z 44 NF-vU APPox 3co 7 tlYw ty GARAGE ; Q _�aLE SHED. 'Fw R s _ MLL APQox IZ T&lh eX(3TJQG S.7 I I LI l �YVE IOW GAL, froPDSE�' SEPT a- 7A0 K " - 3 SEOIZCO NeoSr., FAQ P ®SRS Z.)Z) �,AL T I MPR-S ZZ32142 Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT J Page 1 of 3 Lg6or and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. ode OUNTY Attach complete site plan on paper not less than 8 1/2 x�rfc size. Plan must include, ESut St . CRoix not limited to vertical and horizontal reference point (B T Ind 5f -of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance o.k ro "ad: Y . `;' �'ti 032-2003-10-000 APPLICANT INFORMATION- PLEASE PRI �AL'L IN�QRIOATION WED Y 1 DATE� PROPERTY OWNER: PROPERTY LOCATION Joel LaMirande �, ,,, GONT:'40T NE 1/4 NE 1i4,S1 T30 AR 19 IE(or)W PROPERTY OWNER':S MAILING ADDRESS LOT # ; Y BLOCK# SUBD. NAME OR CSM # 981 by. . #64 '�'x Aa r na na CITY, STATE ZIP CODE PHONE 4rc, ❑VILLAGE [MOWN NEAREST ROAD New Richm WI. 54017 (7 15 247 . Somerset HY. #64 [x] New Construction Use [ )q Residential / Number of bedaeaa - 4 [ ] Addition to existing building I ] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate • 4 bed, gpd /ft . 5 trench, gpd /ft Absorption area required 1500 bed, ft 1200 trench, ft Maximum design loading rate • 4 bed, gpd /ft - 5 trench, gpd /ft Recommended infiltration surface elevation(s) 99.70 ft (as referred to site plan benchmark) Additional design/ site considerations trenches spaced to code 3.50' below grade Parent material glacial drift Flood plain elevation, if applicable na It S = Suitable for system CONVENTIONAL ES MOUND IN- GROUND PRSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem � 7 S 11 U KI S ❑ U CA El U El ® U ❑ S ®U ❑ S Egli SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color G Sz. Sh. Bed Trench .................. ................. 1 0 -10 10yr4 /3 none 1 2msbk mfr gw 2f .5 1.6 2 10 -30 7.5r4/4 none sl 2msbk mfr gw 1f .5 .6 Ground 3 30 -84 5yr4/4 none scl 2msbk mfr na na .4 .5 elev. 1 Depth to limiting factor +8 4" 1 Remarks: Boring # .6 1 0 -9 10yr4 /3 none 1 2msbk mfr cs 2f .5 2 9 -34 7.5 r4 2 y /4 none s icl 2msbk mfr gw 1f .4 .5 3 34 -84 5yr4/4 none scl 2msbk mfr na na .4 .5 Ground elev. 1 Depth to limiting factor N �� Y6 Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. Avuzew Ricjhmond,W1 54017 Signature: Date: 9 -15 -99 CST Number: m02298 PROPERTY OWNER Joel LaMirande SOIL DESCRIPTION REPORT Page � of 3 i PARCEL I.D. # 032 - 2003 -10 -000 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounday Roots GPD /ft .................. in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench ................. 3 1 0 -8 10yr4 /3 none 1 2msbk mfr gw 2f .5 .6 ................. 2 8 -27 7.5yr4/4 none sicl 2msbk mfr gw if .4 .5 Ground 3 27-88 5yr4/4 none scl 2msbk mfr na na .4 .5 elev. 1 02.6 ft. Depth to limiting factor +88" 3 v Remarks: Boring # 1 0 -9 10yr4 /3 none 1 2msbk mfr cs 2f .5 .6 4s 2 9 -27 10yr5/4 none sicl lcsbk mfr gw if .2 .3 3 27 -40 7.5yr4/4 none scl 2msbk mfr gw na .4 5 Ground elev. 4 40 -84 7.5yr4/4 none 1 fs Osg mvfr na na .5 .6 101.0 ft. — Depth to - limiting factor 84 Remarks: Boring # 1 0 -16 10yr4 /3 none lfs 2mgr mvfr yw 2f .5 .6 5 < 2 16 -45 10yr4 /4 none lfs Osg mvfr gw if .5 .6 3 45 -84 7.5yr4/4 none lfs Osg mvfr na na .5 .6 Ground elev. 1 00.8 ft. Depth to limiting factor +84" Remarks: Boring # ................. Ground elev. j ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) STEELS SOIL SERVICE Gary L. Steel Joel LaMirande 1554 200th Ave. CSTM2298 NE4NE4 S1- T30N - R19w New Richmond, WI 54017 PR W -3254 715 M S town of Somerset ( ) 246 -6200 N 1 BM.= top of 1" pvc pipe C el. 100.00 Alt.. BM.= top of 1" pvc pipe @ el. 99.60 ,nQ 1 /0 o s M o d m r' 3 �M 4 & 0 70 2 Gary L. Steel 9 -15 -99 i " SAFETY & BUILUINUa JD PARTMENTOF REPORT ON SOIL BORINGS AND DIVISION I F USTRY, ,,.� %r P.O. BOX 7969 LABOR AND - PERCOLATION TESTS (115) MADISON, WI 53707 HUMAN RELATIONS "4" • (j A, ;4r' (H63.09(1) & Chapter 145.045) -^ EO : I' TOWNSHIP /MUNI IIPALITY: LOT 0.: BLK. O.: SUBDI ISION NAME: M AL IN DDR SS: NA E. �, Y: OWNER'S/BUYER'S i a w ' DATES OBSERVATIONS USE MADE TESTS: R O NS: NO.BEDRMS,: COMM R A ES R PT O Residence CINew Replace, j C .• RATING: S- Site suitable for system U° Site unsuitable for system O N V E N TI ONAL: I MOUND: IN- GROUND - PRESSURE: S STEM -IN -FILL HOLDING TANK: RECOMMENDED SYSTEM: (optional) DSZU IWS ❑U CIS ® S 2 U ElS ®U If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS A. BORING TOTA P H TO GR UNDWATER- INCHES CHARACTER I0 OBS WI (SEE ABBRV. ON BACK )E UR , AND D PTH tt�� ELEVATION ES I HE TO BED -ROCK NUMBER DEPTHTia. OBSERVED B- 1 1 1 1,110 B- PERCOLATION TESTS DROP IN WATER LEVEL - INCHES RATE MINUTES TEST DEPTH. WATER IN HOLE TEST TIME RI PER INCH NUMBER •FW64LfiS AFTERSWELLING INTERVAL -MIN. ED P- ' P- P- P -. P- P__ PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale distances. Describe what are the percent zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation / at alll l borings and the direction end perccent of land slope. SYSTEM ELEVATION - - .�- __ - - - -� -- -- 40 l 1, 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 data recorded and the location of the tests are correct to the best of my knowledge and belief. TESTS WERE COMPLETED ON: NAME Tp rin : y C / ADDRE S: CE TI CATION NUMBER: j : ' HONE NUMBER optional ^: CSTi§IGNATU E• DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR- SBO.6395 (R. 02182) - OVER - /9Do .T R)E1J T TO AJO - 1liE Sor- L G ftiRM)(- RES , (88> S7 tjTE Rp 6q ,wl) - to 10"SPE0-T - MC S :SyST , e TH - 1h SEPT C - TrIlO C's 6: c flm� rz flrp - To 3C- itt) C� MO - R\E9Z- u AS UO 5u R IAJ(kTER AT IN C To6 OF 7ll,6 N1J �- - T"HC Igo cF BO C) L/ �iPGs ['U 1R& 0I 'V- U PO N �RO6) /NTD 7N� 'to fo`l - �HlS irw-- _ S`I STEVVZ l 1 N OW h/ORJ':�>!V C�a��J►Ti��. / F Oq /L cd KC To )9/o t( Pi K7 7"9/5 5`/svcwv �sHbutf) 6 cc ulk" 1 T IS T 9� C1 NEt <S G S Pua) 6 ) L 17 70 iPCA - 7/l E 9r - THE moc)iu(1 1 SMOULI) f-WlL Sort TE5z CcuL0 �3E pO(1F 4 yNC- wouruo 'RC 1 - 0 0- vgTC -V) OR -- T HE- H -+ 610 0OIT REOl o v6zo S Ronk EX t sTj iv & YT)()) () to (AS WILL E9 0 rAj -V M1106 � \ /57c ECEU ?a zT5 Pgo pE(2 �c)O K A duo mpa6 zz sz y z Rod Eslinger Subject: Sanitary Permit for LaMirande Entry Type: Phone call Start: Thu 09/07/2000 1:09 PM End: Thu 09/07/2000 1:09 PM Duration: 0 hours Categories: Kevin /Rod Jerry Viebrock asked if there was any way we could issue the reconnect permit for Joel LaMirande. Jeff Fox brough this in last week. Jerry's number is 715 - 294 -2188. We need to fax permit to: 715 - 294 -4444 0� q�0\ . 4 ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving the �ccL LAmE2FlN� residence located at : IVE 1/, AIE Sec. I , T 3L) N, R 1 W, Town of SDM£2SET , St. Croix County, Wisconsin. Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced t'I OF Did flow back occur from absorption system? Yes No (if no, skip next line. Approximate volume or length of time: gallons minutes Capacity: 100k�) CAL Construction: Prefab Concrete Steel Other Manufacturer (if known) : P6M-r) Age of Tank (if known) : 2 �&A2.S <Z:�D . 0'e�L v SLt= F 1S x (Signatur ) (Name) Please Print MP(L� 223Z (Title) (License Number) (Date) Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank, to the best of my knowledge, will conform to the requirements of ILHR 83, Wis. Adm. Code (except for inspection opening over outlet baffle) . Name �EF I- ) x Signatu e /f MP/ RS Z2 Z DEPARTMENT OF INDUSTRY INSPECTION REPORT FOR SAFETY & BUILDING LABOR & HUMAN RELATIONS DIVISION P.O. BOX 7969 ON -SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION MADISON, WI 53 :707 State Ptan LD. Numb NE , NE , 1 , 30 , 19W CONVENTIONAL El ALTERATIVE ALTERATIVE (It assigned) Town of Somerset ❑ Holding Tank ❑ In- Ground Pressure ,Mound N HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Rt. 4,Bx 145 New Richmond, WI 540.7 7 -�► -g BEN CH MARK ermanent reference point D SCRIBE t DIFFERENT FROM PLAN: REF. T. L V.: CS REF. P ELEV.: Name of Plumber: MP /MPRSW No.: County: Sanitary Permit Number: Calvin Powers 1563 5 St. Croix 119543 SEPTIC TANKIHOLDING TANK: c MANUFACTURER�� C LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER O � PROVIDE Oc PROVIDED: a YES ONO 1 0 YES O BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM: FEET FROM LIN �� / AIR INLET ET. ❑ ❑ YES NO C ` YES NO NEAREST ­11110- f DOSING CHAMBER: MAN FACTURER: I BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP /SIPHON MA TURER: N NING LABEL LOCKING COVER Q C / DED: P 0 IDED: z 05 D6 YES ❑ NO t7 29U! C7 YES ❑ NO YES ❑ NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DI FFERENCE MP ON AND OFF) BE TWEEN YES ❑ NO NEAREST ---► LIN SOIL ABSORPTION SYSTEM. Chec the soil moisture at the depth of plowing FORCE LENGTH: DIAMETER: MATERIAL AND M KING: or excavation. (If soil can be rolled into a wire, construction shall cease until the soil is dry enough to continue.) CONVENTIONAL SYSTEM: BEDITRENCH WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: COVER INSIDE DIA.: # PITS: LIQUID TRENCHES: MATERIAL: DIMENSIONS PIT DEPTH: GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: N0. DISTR. NUMBER OF PRO ERTY WELL: BUIL IN VENT )FRESH BELOW PIPES: ABOVE COVER: ELEV. INLET: ELEV. END: PIPES: FEET FROM LINE: AIR INLET: NEAREST ---- 00- MOUND SYSTEM: Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ❑ YES O NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER TEXTURE: - PERMANENT MARKERS: OBSERVATION WELLS; ❑ YES ❑ NO [DYES ❑ NO DEPTH OVER -TRENCH/BED I DEPTH OVER TRENCH /BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: El YES ED ❑ YES El NO ❑ YES ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: BEDfTRENCH WIDTH: LENGTH: NO.OF LATERAL SPACING: I GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: DIMENSIONS 3 /.A' (, TRENCHES: / 're, J (� r s MANIFOLD PUMP . MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEVATION AND ELEV.: EL t� DIA.: ELEV.: PIP7 DIA.:z DISTRIBUTION ` f , �D /.0& 11/ INFORMATION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATER I VERTICAL LIFT CORRESPONDS TO f j 7 APPROVED PLANS ✓ C I YES ❑ NO OfYES ❑ NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: FEET FROM LINE. OJ YES ❑ NO YES ED NO NEAREST —� Sketch System on ea in county file for audit. Reverse Side. SIGNATURE: T ning Administrator LE: ho SBD -6710 (R. 06/88) Thomas C. Nelson DOCUMENT NO, STATE BAIL OF WISCONSIN FORM 5 — 19U THIS SPACE RiSCRV%O FOR RtCOROING DATA PERSONAL REPRESENTATIVE'S OEEO 51.3941 ► V4I 1058 � ? hc.V),.j 161 � 01-rlCE �... J St CROIX CO., W1 l gex..Jh__I+s !ixxand�.. ---- •-- •----- • .. ........... ...... . Recd fw Remd as -. spe. cial •--- •------ '-- ..........- ••••'• - 7 1993 ........ ..... ............... ............................ - DEC 2 - administmato r ... .......... .7�t�CYlt]Q36]C�[DCO� of the estate of f ........ Emma.. made ... -.----•- --•----•-•--_- ... .......................... . 10 -,0 A• ("Decedent") j for a valuable consideration conveys, without warranty, to .............................. } Joel..A_ La. Mir -ande ..................................................... ----------------•-•--------•--------------....._...----------•------ ..----•--- •••- .......- ._._... ---- ••• - -- - --- -- --- -- •-••---- •-•--- Grantee the following described real estate in ---- fix ..._.CrQ1X ...... ........... - : S .. _.001iQtyr 532 M W - - :S i State of Wisconsin (hereinafter called the "Property"): MW 0110 M 17 !I Tax Parcel No: .............................. Northeast Quarter of Northeast Quarter EXCEPT West 170 Feet ll of East 320 Feet of North 150 Feet of that part thereof lying South of Highway. And Southeast Quarter of Northeast Quarter of Section 1- 30 -19. This deed is given in full satisfaction of that cer-ain land contract dated October 6, 1989 by and between Joseph Lamirande and Emma Lamirande also spelled LaMirande (Grantors) and Joel A. Lamirande !� (Grantee), recorded in Volume 854 at pege 400. The interest of Joseph Lamirande was terminated by application dated November 25, 1991 and II recorded in Volume 927 at page 149. The life estate of Emma Maria LaMirande was terminated by application dated October 8, 1993 and recorded in Volume 1042 at page 351. This deed corrects that warranty deed dated October 19, 1993, recorded in Volume 1042 at page 352 since no personal representative was appointed for the Estate of Emma Maria Lamirande. E ' , Personal Representative by this deed does convey to Grantee all of the estate and interest in the Property which ill the Decedent had immediately prior to Decedent's death, and all of the estate and interest in the Property which the (� Personal Representative bas since acquired. + �- . li Dated this ..................... I. ....... ............... day of ........- --- •- -- - -.... - -- December 19 9 f _a....�� -- (SEAL) (SEAL) -------------------------------------------------------------------- 4 .R_oger_ A. La Mirande • ......• •--- •- '--- ....-- - -' -•• - -. - - -- - '-- _ -.... 1� 1 Pecwe•l Revs nfauve 4!ll�l'1CB9l94"N!!" Special Administrator � AUTRUNTICATION ACENOWLBDGMBNT s(s) sTATE OF WISCONSIN -------------------------------------------•------- ------- ---- ------ ------ -- - --- A-""' �]" County. i authenticate3 this -------- day of--. ....................... 19... --- Personally came before me this .._...... ...----day of ....Deaelabe ...... 10..93. the above named . .T A M}rande.. ................... . _ TITLE: MEMBER STATE BAR OF WISCONSIN . ................... ........ ti (If not ------------•- --- •-----•-•-- -••-- --•-- ------ ............... ............ ............... .............................. ...... . authorized by 1 406.06, Wis. State.) to me known to be the person ------------ who executed the i; foregoing ins a acku w e y TNiS INSTRUMENT WAS DRAFTED BY JUDITH A. REMINGTON - _...__. .__.- - -• -_. _ . ... ................ ...... �. Remingtori Law drflC @5 •.. 1'" �L..... P,. �._ ...... .......... .. i New --Riobukend,_*1 ----- 5. 40.17-------------------- --- Notary Public ._..- St.F. 9 - - - - .... ..... - County, Win. (Signatures may be authenticated or acknowledged. Both My Commission is permanenf� (If not state expiration are not necessary.) ------- ----- - - -! date: - ---..- ..... �.........._ -• 19`�.�' - ;. �i