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HomeMy WebLinkAbout034-1040-50-000 I - n ti p ':! C - 0 n Cv _ o d f r c d o m c/1 M CD w :`►� V m o c v 3 m v 0 M M w ° w W v w `C • 8t C O n W C w _ 00 A N N N R3 N N m PL co C> C7 C C n ° O co Co M O N 0) 7 O O • C N O C� v _ ( A N 0. May � ° O O V N O A W _ � O I co co to ro N CD 0 0 9 ;Ili N a C !\i I � o I � 0. a o m D * < z I o QS NNN�'a D N� Q �ov 00 O N y A A O O O (DD �' A o (p C — w M N N 3 d o N CL OD I z °' o z z O 0 D D c m O � CD j d "me C Z N C I o j j N A Z N A v 0 W m N ° -• z c 3 a I O c M m z W CD A I n I o I � � c z o 0 N o zt I I � y 0 zt f � I � ti I o A 0 A CD N ti I o 0 � o O N I:k Wisconsin Department of Industry SOIL AND SITE E V A L U A T I S P O R T Page of 3 Labor arr Human Relations Division ot Safety BBuildings in accord with ILHR83. KVMs.Adm.Code COUNTY r Attach complete site plan on paper not less than 81/2 x 1 i inches 't�`sge;Plan mu a but not limited to vertical and horizontal reference point (BM), direction And% of dope, sdd?# ' PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road: APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION R D DATE Ame o PROPERTY OWNER: 'j��V2Pt JVp 1 OCATION -' E 1 /4 SE 1/4,S 11 T Zq ,N,R 1 S E (oro PROPERTY OWNER':S MAILING ADDRESS. $tft. NAME OR CSM # ZS t LpGzwooD P tL6\___nSL� cs" CITY, STATE ZIP CODE PHONE NUMBER ❑CITY []VILLAGE ®TOWN ' NEAREST ROAD 1ti10u��Vt WI S (C &98 ZcLct a `Ttt ST [>Q New Construction Use pCJ Residential I Number of bedrooms 3 [ J Addition to existing building j J Replacement (] Public or commercial describe Code derived dairy flow �L SO Recommended design loading rate bed, gpd/ft , 3 trench, gpd/ft Absorption area required 31 S fed, ft2 31S - bench, ft Maximum design loading rate wed, gpd/ft S ytrench, gpd/ft Recommended infiltration surface elevation(s) 100. O ' It (as referred to site plan benchmark) Additional design / site considerations YJ OUM W/ S KC S . M I AJ 1;V UM l Z OF Sf X b R Parent material L o t=s S - r t LL Flood plain elevation, if applicable S = Suitable for system CONVENTIONAL I MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN RLL HOLDING TANK U = Unsuitable fors stem I ❑ S ®-U 19 S ❑ U ❑ S 91.11 ❑ S (RU ❑ S IIU 1 ❑ S ® U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon Texture Consistence Boundary Roots in. Munseil Qu. Sz. Cont Color Gr. Sz. Sh. Bed JTrench llj`1 C..W .S 4 . `m Yl — s t t Z'P oQS1� �S S 6 Ground 3 1 - S 42- 31 — 1 6 - 1 0 12 �,., - e S 9 6 ft 31 -43 . S HR 31 s L 2tZ Sig �� in'F - •3 € •`/ Depth to limiting factor 3L_ Remarks: Boring # x z� _ _ K. z q Z�- -� S�IZ YIy s) 1csUk w►�H c-s "4 .5 3 guy 5 `1R 3/ Y z Ground •S I 5/p, L ©•., -, )nit- .3 -� elev. I M00 ft Depth to limiting fac�tor� 4 Remarks: CST Name Print Arthur L. We erer Phone: 715 425 - 0165 gerer Soil Testing & Design Service - P.O. Box 74 River.Falls,WI 54022 Signature: ,/ q 13 l Z sS Date: l O - z 3_ 9 9 CST Numbe 2 2 0 2 5 4 PROPERTY OWNER SOIL DESCRIPTION REPORT Page? of 3 PARCEL I.D. # ? hit ^j Depth Dominant Color Mottles Texture Boring # Horizon Structure Consistence in. Munsell Qu. Sz. Cont. Color BourtcJary Roots GPD /ft Bed ren • #:;:; >a o —q � d, ................. - 1 •S` V/y - S I cs �� e - ,y • s Ground S `ifZ. 3 ey �-7 Sy2 SAS L >n'F�. — •3 .y elev. °l S ft. Depth to limiting � f actor i Remarks: Boring # Ground I i elev. ft. Depth to 1 limiting I factor I _ Remarks: Boring # Ground elev. ft. Depth to limiting i factor Remarks: 3oring # around ' alev. ft. )epth to imiting actor Remarks: _ AN P 3 of 3 PLOT PL g J SCALE 1 "= n D� RIOT CA��•>t'R.i U12.. 1L� 65 zn ri I G 1 � � N obi g.Z Cl °lo C017U` V L a . °i9 -(3 6 Tv M OF - Vtfb j C.14 tr 2 t`l or) — N N r J OL v Smug- t�Rc1p� - 21'y LtAJe -> Q' LSL.- 1�0 =::0 �►v �d "�1►Gw, 314" PIVC X-LP�=_ ►vl Lfl� - '- 0 ] W e-r Ol=_ i"I u V I.vD . - - - -- cr $S q ZZo2.S41 d_ 10 -Z — / (715 ) 425 -016 -MEMO — CST Signature Date Signed Telephone No. CST # Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page � of 3 Labor and Human Relations . g .— Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # / w G dimensioned, north arrow, and location and distance to nearest road. ' APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: V} P� 1_b `al ap N) 'r PROPERTY LOCATION $\3 �; 31Zft)k,D _r GOVT. tOf - NE va SIT 1/4 ,S 1 T Zq ,N,R NS E (oro PROPERTY OWNER':S MAILING ADDRESS. LOT # I BLOCK # SUBD. NAME OR CSM # ZS I LQ� C.bt_W 0012 - P tZ4 --nso� 0-s" CITY, STATE ZIP CODE PHONE NUMBER OCITY []VILLAGE ®TOWN ' NEAREST ROAD WOC��� ULLL� WI S hIS) 6g8 Z°t`t0 ST2I)u6 - Z`�c� `Tt ST, [>Q New Construction Use pCj Residential / Number of bedrooms 3 [ ] AdditiQn to existing building [ ] Replacement [ ] Public or commercial describe Code derived daily flow ALSO gpd Recommended design loading rate bed, gpd/0 � trench, gpd/ft Absorption area required 3-1 S bed, ft 31S trench, ft Maximum design loading rate • bed, gpd /ft • S trench, gpd/11 Recommended infiltration surface elevation(s) 1 Ob • O ' ft (as referred to site plan benchmark) Additional design / site considerations _ Y OUM':) Wl S X S . Wf I hJ 1-? Uwi 1 o1= Sftn- f= r C-L_ Parent material L o Z g 'r t LL Flood plain elevation, if applicable It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT.GRADE SYSTEM IN RLL HOLDING TANK U= Unsuitable fors stem 0 S ®-U I 2S ❑ U 1 ❑ S )rU ❑ S IC ❑ S [au O S ® U SOIL DESCRIPTION REPORT Depth Dominant Color I Mottles Structure GPD /ft Boring # Horizon Texture Consistence Bandary Roots Bed Trends in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. w o -� 31Z. si\ Z`Fsb`rc As 0-W � , 5 `I ; a F ?— S —t�f to `m R yjy S 1 I Sblz oQS 1� cS S Ground - 1 - S `l2 3! - elev. ` I- ft y 31 - . S%- R 31y �Z S`22SI$ L �"� WL'F% - •3 •�/ 4 . Depth to limiting factor 3I ,, Remarks: Boring # Yly - s1 �csUlz -F►� cs — .� .s S`tIZS /B L o� ��� •3 •`F Ground elev. I W:b ft Depth to limiting factor � Remarks: CS T Name: Please Print Arthur L. We erer Phone: 715- 425 -0165 egerer Soil Testing & Design Service -P.O. Box 74 River.Falls, 54022 Signature: ° 1 Z �5 Date: t O` 3_ 9 CST Number: i 1 PROPERTY OWNER SOIL DESCRIPTION REPORT Page? of 3 PARCEL 1.1). # ?may w 6 Boring Horizon Depth Dominant Color Mottles Structure g Texture Consistence G P D /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Y Roots Bed Trends 104 V- 31 Z — sb az s env s C, Z.3 R V/ - s csbk m�►- es - ,y . ,s Ground 3 Z6-SI S `1fZ 3!y � Sy2 S/P, elev. ft. Depth to E limiting i factor i Remarks: Boring # i Ground i elev. f t. i Depth to limiting factor i Remarks: Boring # six Ground elev, r ft. Depth to . limiting i factor Remarks: 3oring # around _ ?lev. ft. )epth to imiting actor Remarks: _ i� F PLOT PLAN Pa 3 of 3 SCALE 1 "= LLO ' n z J Ni ( ' r 1 " • $.2. Cl C ITL . °19 - U � U'1'►'U►" I oF- 77-&! C1 or) 6 �L . 100.0 N I N - r DiP, PVC 'C-1 �k-: h1 I �lvSE -- ��D- �1L �O .$G> 7.__ S��_ :.in/t�T- Ot- __wlu- V►vD..- - - -_ __. - -- -� cT ,,,,II Z 4'I ( 715 4 ) .5 -n7 65 CST Signature Date Signed Telephone No. CST # r Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division Count y 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)l. 353328 Permit Holder's Name: ❑ City ❑ Village ❑ TXwn of: State Plan ID No.: Brandt, David Springfield Township cg052D CST BM Elev.:- Insp. BM Elev.: BM Description: Parcel ax No.: ft . D' M . () ' CS - $w1� - Z J W r pending TANK INFORMATION LEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic S �� Benchmark �� SD.O O ' Dosing (�L Alt. BM 6), 6 S l 1 ZO ' C� Aeration Bldg. Sewer x.30 /p�,S - j ' Holding St /Ht Inlet (D.SB oS:2� TANK SETB CK INFORMATION St/ Ht Outlet d I o•8O 0S, 0 TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet ( w / r ' Air Intake D Septic > 5o y ` NA Dt Bottom 0 5-0 r Dosing r ,r 9 r >�g� / NA Header / man. �D Aeration NA Dist. Pipe ( v O pp Holding Bot. System ✓�� 3 PUMP/ SIPHON INFORMATION Final Grade S--L &- (e� Manufacturer Demand St cover 4 ) 0 Model Number ?7D GPM TDH Lift t j � Friction O ��V Systema s TDH- Ft Forcemain Length Dia. Z " Dist. To Well SOIL A PTION SYSTEM TRENCH Width Length _ No. enches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 5 DIMENSION SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer. INFORMATION Type Of CHAMBER i el Number: mej System: j ^` ZZ0 — OR UNIT DISTRIBUTION SYSTEM x(-oZ Header / M�nifol u Distribution Pipe(s) r x Hole Size x Hole Spacing Ven o Air Intake " 1 w Length Dia - Length Dia. Spacing U. 1, SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over G ,� Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center I D + Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: q /18 / 0V Inspection #2: Location: 926 290th Street, Woodville WI 54q28 (NE 1/4 SE 1/4 17 T29N R15W) - 17.29.15. -Lot 1 34, 1.) Alt BM Description= � S' 6 - 2.) Bldg sewer length = S`( , ^ � I k 3 - amount of cover => 60 3. contour = 6. 3 tt � 4 ILK 5 Nye �Yns- I - C^^ 4�ew '-� �" LSr= Pt+ Plow -�U�••�1� /�' Plan revision required? E] Yes �j No Us other side for additional i f r ation. 4 ZO aD �qy �. � 6 14F -6 , Dote Insp Signa ore Cert. No. SB -6710 (R. /97)' K1 1 4 ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: i 3 0 ee - eP� e i 3 � E i a .m � � .m .... m. .. _ ..... ' l emma.. �mmE F a k 3 t 5 I 3 i 7 e } m. e : e € d } ,M a d � �......._.. _ .A .. a .. ..,. . } } Y d t � � °tee wx sm .«..a d. �ma. .. e� ,, e�.m — ✓- ..�.., .�.� - a E ' e _— } C � l � G� } P .... 3 , } � i } } _o Z Safe and Build s Division 9_ Vi sconsin 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, on paper not less County J . than 81/2 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary. Permit Wmber . 3s - 3 3 -X$ Personal information you provide may be used for secondary purposes ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan Review Tranction Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION 0AfJS i ts = 3 arogaO Property Owner Nam Property Location e i p � /a t /a,s /7 T ,N,R E(o W I C Property Owner's Mailing Addre Lot Number Block Number City, State Zip Code Phone Number Subdivision Name or CSM Numbe � ( 1/0 / /1 SV C7 11. TYP OF BUILDING: (check one) ❑ State Owned V It Nearest Road k v illage Public 1 or 2 Family Dwelling - No. of bedrooms Town OF K.I Ill BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) r 1 C] Apartment / Condo Q jF?IKC ` 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—L;a- Vew 2. ❑ Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5_ ❑ Repair of an ystem ________System _____________ Tank Only______________ Existing System ________ Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11 []Seepage Bed 26Mound ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure / / n 1 42 ❑ Pit Privy 13 [] Seepage Pit / 3 X � 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 R uired (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) ? Elevation 57,5-- t • Z 1� / Feet Al Feet Ca acit VII. TANK in allo s Total # of r Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existin strutted Tanks Tanks Septic Tank or Holding Tank X �� ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber X ❑ I ❑ I ❑ I [:] _ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for insta tion of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's n • (N St m ) MP /MP SW No. Business Phone Number: Plumber's Address (Str City, State, Zip C de _ ! , S > 'Ifz IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved anitary Permit Fee (Includes Groundwater ate Issued Issuin Agent Signature (No Stamps) 'Approved E] Owner Given Initial 2 ^ CD Surcharge Fee) r3_1_21 Adverse Determination sr X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -6398 (11.12199) 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 a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608 - 266 -3151. To be complete and accurate this sanitary'permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to oe installed': II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber into 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 sc-rvice; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas, and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. -- - -.. -- - - - -- — - - - - - -- ---------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. Safety and Buildings 1340 E GREEN BAY ST STE 300 SHAWANO WI 54166 TDD #: (608) 264 -8777 isconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary March 03, 2000 CUST ID No.226900 ATTIC• POWTS INSPECTOR ZONING OFFICE SHAUN R BIRD ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/03/2002 Identificat Transaction I o. 300520 Site ID No. 18 SITE: Please refer to both identification numbers, Site ID: 184124 above, in all correspondence with the agency. ST CROIX County, Town of SPRINGFIELD; 290TH ST NE 1/4, SE 1/4, S17, T29N, RI 5W DAVID BRANDT 290TH ST FOR: Description: MOUND SYSTEM FOR DAVID BRANDT Object Type: POWT System Regulated Object ID No.: 651067 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, DATE RECEIVED 03/02/2000 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 KEI A WILKINSON, POWTS PLAN REVIEWER BALANCE DUE $ 0.00 Integrated Services (715) 524 -3630, FAX: (715) 524-3633, M -F 7 AM - 3:45 PM KWILKINSON @COMMERCE.STATE.WI.US WiSMART code: 7633 cc: DAVID BRANDT PLOT PLAN PROJECT David Brandt ADDRESS 251 Lockwood Woodville Wi 54027 NE 1/4 SE 1 /4S 17 /T 29 /R 15 OWN Springfield COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 2 /29/00 BEDROOM 3 CONVENTIONAL IN -GROU PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 800 gall HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 375 # of chambers none IL BENCHMARK V.R.P. Top of 1" pipe ASSUME ELEVATION 100' ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark . I SYSTEM ELEVATION l0 Pro 3 $� Bedroom Well is to meet all setbacks House found in Comm. 83 Building sewer is to Scale => 1 /4" = 1 O'have >42" of cover or else stated Weeks ST 150' 65' Tanks are to be properly bedded a and provided with approved DT warning labels, dose tank is to B 1 have lockdown cover 10% Slope � B -3 Area 25' below System is to be installed system is to remain along the 10 1. 1 contour line undisturbed con-dition ally [3 B -2 1 R"n it" t DEPARTMENT OF COMMERCE Dt`ASION OF SAFETY AND BWLDINGS I SEE CORRESPON CE Alt. 3 L p S O I S O B.M. B.M. 290th St. ' s l Page Of Cross Section Of A Mound Using A Trench For The Absorption Area ,45 rM t-- 33.5 H — . F 6" Topsoil Trench Of hu - 2h" Aggregate, Plowed Layer 6" Below Pipe. Covered With D f Ft. Straw, Marsh Nay Or Synthetic Fabric Ft. O l Ft. F ,�� Ft. N Ft. Plan View Of "laund Using A Trench For The Absorption Area On Farce Main ' F1 Distribution Pipe Permanent Markers Observation Pipe W o iL Trench Of jj" 2 Aggregate L I, /' K Ft. , W L-6, Ft. 6 Ft. L ' Ft. Signed: License �� GG Number: ` +Date: Page Of Distribution Pipe Detail For '. Lateral Network ` Notes Located On Bottom Are Equa»y Spaced PV Force Main End Cap H Y ' X X PYC Distribution Pipe P * last Note Should Be Next To End Cap a P Ft. Hole Diameter / Y _ Inch X 3 Inches Lateral Diameter 0 Inch(es) Y 3 Inches Force Main Diameter c� ... Inches # Of Holes/Pipe .� Invert EIevation Of Lateral t. /oz. 6 », Signed: License Number: e�zao a Date: - 9— O VIEWr CAP 1 C.T. VE MT Pip O� -- i M/EAT�FERFR i T ; A"PROVr O L.C?L.K 1A);,, E FROM DoCit,, I JuucrioM sox I �MAk;H0%. t COVER w l ft,� K A'R W"Ow OEg1t { Ie (, MAL 1NlrAKE I ! � � lJ�l� -►Jl MG LA4FL { ( 6KA DC 1 I t ! COW DU1T 8 . � A ! f i t ALARM S M *APPROVED �_�!'' J4I yTS WITH l+ %L E Fr -- fi•. APPROVED PIPE 3' ONTO Pump—,. ? SOLID SOIL L1 ? '> 0 o J CONCRE bLOC.x ( I ing 15ER CXST pC>7.A�TT1:0 0441 -ti 1 AWK i+ HAS SUGM AP iRP OVAL scpr,c p s$p r, c `r X Jo � Va. _ P� G I F I GAT r p>U g lb ,'� �asc Val,u_w. r G t/ TAVK3 MAtitttFACTLP U ER; Z 2 ' J d „ Ul", OF DosC3: pER DAy r AAJK SIZC :.... GAL.L Okis A vol. 4iARhe MA JUJ U �s �NCLIJL'tA1G 6AtKfi.OW: �G'� MOACL WU MDtIt: 1/ 2),7� ...�""" -- CAPAC'"I£$: A m �AtCH£S CR swITCH lrspc , 1 e. QALLCNS OUMP h1AKiUFACTt lktpt- a ■ '? INCkts Dot / fiALL�4A�5 "100EL MUMQ[R: GAL.1. 0tJ6 s W ITCH T'bpC: �- 0 ` mES OR _412„ OALLOus PUMP A�JD J�LARr+� /�Rf T4 s!E P" INIMUM QiSr.K PUMP E aN .S AKE TO ClR CS#trs VERTICAL CiFFCRCNCt OCYW[CAw POMP OFF hhIL OiS; Itll�u ; :^ � �uE�?t'no t M+NtIM M AlE T -'w PIPE.. - --- FE Er / t 2U q TWORK SLrPPL� PRESSLIR£ .. 2.� / 4. a .... FEET OF PQRCt t X K� ..5.., CEE . 'F T fAQ 1LFR:C1101.J FACT��,�, 1` EE', ; 7'O'r,AL C11JAMIC HEAD = �- :..�. _ FEET !L+TERA.'A}L. OEMC11J6fp t QF E ;7 1/D�'� TA Nts , -ip�aD DEPYH r: Engin eering i Y Performance Data 40 30 Pump Characteristics moror t)ob Se6asenl4le` k i t Mawal model Mom] 1 SH04M 1 I Aatomat4 Models SHEr40At _ SI{E40A2 Hor w.r 441 fig toad s 12 1 63 1 Mow Ivot Mabel Iola L4 Pak RAK 11550 0 10 20 40 50 60 70 P1" 18 GPM Yd a I15 Y30 T oto1 "*W (fow) 10 1 14 17 21 25 28 30 33 Hart: 0 9 120° f Man, fla (m�3.0 r 4.3 5.2� � 6.1 7.b .3 • 8.8� 10.7 k ran il EMA aaa ++ A GPM (US GPM) 170 60 SO 40 30 20 10 1 0 N Inse A De Clods A sit) 4.4 ._ • 3.8 3.2 �2.� _. 1.3 I " — ds' .� -- - 01scimp Size 1 1/ 2" RPT Dimen Data Solids HandlingS 4" Wdo rip ,re" a srD' 040.27) 1. AR &*-Aons i n inches. (Metric for ` Power Cord 10% S �,I20, S1 e't1a >>-»� j internotiona! use). tai 2. Component dimemions MOy Materials of Construction vary * 1 /0 inch. H E 3. Not for conitruction purpose Staa11 FI . " tubricar oit _ DNIeclrk ON ! • 7!z" N PT Unless certified. Mo m H aasip —;— 9 CH 4, Dimensim and weights are i fun (asilm Cut IM aPlxoximote, t 5. We reserve the tight to ma e slerha *01 sal faun UAWCeremlc shalt Saul Seal eadr: Astedlaad Stoef revisiom to our product and their Sid" Slrsal 1 u specifjcations wiiilout notice. SPdW i ads sll+tr E t.AW Ir t2ea.w4 1. . Lowe S koft wom P bk"HLSN te W StIll 3•srs° 1 cad a�� faetMet 2" tSa b) E ; eys Enow" Tw mopleft — �----' 1 — 0 1946 ry ; Purnn, As1` and. Ohio. A! Riphts Itorsrvati� HYDRQMATIC o to i�riho 1 fir ,.. r +shlat+d Ohio 44805 tel: 419-289.3N? Few: 414.281.4081 , Nab Site www,pentairp mp cor+ ;, I .rfif45 ft +Alt MA)ON CITIES AND C4ttHiR11S puyr, ct yrw pl+cnc rl CClo+y lo your 1o:a! Tsvibuloi CH i f •v+iiscohsinbepartment of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of Burbau of Integrated services in accordance with Comm 83.09, Wis, Adm. Code Attach complete site plan on paper not less then 8 1/2 x 11 inches In size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and 54. C t percent a", scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. # APPLICANT INFORMATION - Please print all Information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property location Govt. Lot 114 f 1 /4,S T ,N,R f J'E ( tN Property Owner (ling Address Lot # Block# rsubd. Name or CSM# S/ a _ City State Zip Code Phone Number ❑ City El Village wn Nearest Road y JRNew Construction use: 073eeidential / Number of bedrooms 3 Addition to existing building ❑ Replacement /tt••��,'/0 Public or commercial - Describe: Code derived daily flow _ L2 1 ] gpd Recommended design loading rate �� bed, gpd/ff� trench, gpolft Absorption area required �r bed, ft .17 trench, ft2 / Maximum design loading rate / + Z bed, gpd/tt �• Z trench, gpd/ft Recommended Infiltration surface elevation(s) t ft (as referred to 'site plan benchmark) Additional design/site considerations Parent material e Flood plain elevation, If applicable —A-' /� ft S Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Ili Holding Tank u= unsuitable for system ❑ s7 u s Cl u O s ,$(,u El s u ❑ s 'Id u O su L SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/Et2 In. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench uT t Ground S` T . 6 +i�� IN ✓ /�/ N ot t & r Depth to limiting ator Remarks: Boring # 7 G .� 0 ALP .� —�--� Ground Depth to limiting r in. Remarks: CST Name (PI MS Print) Signature Telephone No. Address i Date CST Number D/ - � :. ®...1 .. Co C o l or ®�� ®� MM mm mm mm M . Mim Dominant Color Motues --7M i Munsell Ov. Sz. Cont. Color Soil Test Plot Plan Project Name David Brandt Shaun r Address 251 Lockwood Woodville Wi 54028 CSTM #226900 Lot ----- Subdivision --- - --- Date 2/29/00 NE 1/4 SE 1/4S 17 T 29 N/R 15 W Township Springfield ❑ Boring ()Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 1" pipe System Elevation 102.1 *HRpSame as Benchmark Alt. BM Top of Wood Lath @ 100' Pro 3 Scale= 1/4" = 10' Bedroom House 150' B -1 10% Slope B -3 c ❑ B -2 Alt. B.M. B.M. / 5 d' 290th St. Wisconsin Department of Commerce SOIL AND ikLUATION Division of Safety and Buildings Page of Bureau of Integrated Services in accordance wytl`i� bdwh 83.6 ,'Wis. Adm. Code ^� Coun Attach complete site plan on paper not less than 8 1/2 x 11 inches irygize, Plan tj i C include, but not limited to: vertical and horizontal reference point (B� , and , � percent slope, scale or dimensions, north arrow, and location and distance torneafest road. Parcel °I D. IF P a� APPLICANT INFORMATION - Please print all inforfnarlon. 6G',14; r ed by G Date Personal information you provide maybe used for secondary purposes (Privacy COW, s. 15.04 (f)`(�{r)jr` r l 3_ Property Owner 'fop ,L 1/4� 1 /4, S T N,R /5 E ( ) W Property Owner ailing Address Lot # Block# Subd. Name or CSM# S/ v r L-M�rj — — — I — I City State Zip Code Phone Number � ❑ City El Village wn Nearest Road l y� -5 /"� /� �, . �t ,R New Construction Use: Residential / Number of bedrooms Addition to existing building El Replacement _Public or commercial - Describe: Code derived daily flow � gpd Recommended design loading rate /- 'P - , bed, gpd /ft2 2 trench, gpd /ft Absorption area required ��$ bed, ft 3�.1 trench, ft / Maximum design loading rate / bed, gpd /ft Z trench, gpd /ft Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design /site considerations Parent material �� Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank u= Unsuitable for system ❑ S'Z U S❑ U ❑ S U ❑ S U ❑ S xf U ❑ S U SOIL DESCRIPTION REPORT Boris # Horizon Depth Dominant Color Mottles Structure GPD /ft Boring Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench � s Ground S /�. 6 �� �� ✓ A IV 4 P i 0' Depth to limiting ctor in. Remarks: Boring # d' �Q•� r7 S a o Ground "s ft Depth to limiting A k Remarks: 126 Name (Please Print) Signature Telephone No. Address Date CST Number loo d ) / S ©/ - -� Q6 SOIL DESCRIPTION REPORT PROPERTY OWNER Page of PARCEL I.D.# Boris # Horizon Depth Dominant Color Mottles Structure 2 9 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench a 3 s Ground 3 ��/ 7` $ ^/�� � j 't/l! `✓Jsoe /• 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 ' Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) Soil Test Plot Plan .project Name David Brandt Sha Address 251 Lockwood Woodville Wi 54028 M #226900 Lot ----- Subdivision ------- Date 2/29/00 NE 1/4 SE 1/4S 17 T 29 N/R 1 5 W Township Springfield R Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 1" pipe System Elevation 102.1 *HRpSame as Benchmark Alt. BM Top of Wood Lath @ 100' Pro 3 Scale= 1/4" = 10' Bedroom House 150' B -1 � 10% Slope B -3 ❑ B -2 Alt. * g B.M. S C) 2 St. ST CROIX COUNTY • SEPTIC TANK MAINTENANCE AGREEMENT AND 0 RSHIP CERTIFICATION FORM Owner/Buyer Mailing Address ' / Go z- . 2 Property Address _ O (Verification required from Planning Department for new constru tion) City/State �� �xX�, t c >; Parcel Identification Numbe 3 `-- /o i LEGAL DESCRIPTION Property Location r /4, & r/ Sec. , 1t N -RZEW, Town of Subdivision _ Lot # Certified Survey Map # �� �� �� , Volume 11'� . Page # �a� Warranty eed # 6 2 c ty , Volume f � Page # Spec house ❑ yes7ffto Lot lines identifia yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a 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/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. f `Z CJ ,`�� ✓ l / SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. / k a , l CMG SIGNATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed Y i t STATE BAR OF WISCONSIN FORM 3 - 1998 6.18291 QUIT CLAIM DEED. KATHLEEN H. WALSH is REGISTER OF DEEDS ST. CROIX CO., WI Document Number _.... _..__.VOL 1 OPALS RECEIVED FOR RECORD This Deed, made be ween ,rte 02- 14 -2000 4:15 PM QUIT CLAIM DEED Grantor, ii EXEMPT 1 8 CERT COPY FEE: ii and Ln UL a 84 wt r)'L iz - -- COPY FEE: TRANSFER FEE: RECORDING FEE- 10.00 PAGES- 1 Grantee. Grantor quit , clalms to Grantee the following described real estate in County, State of Wisconsin: ,; ! 4lccoi a,,> /t Name and Return Address Sccfio n (�' 74q� P. 0 6c a3 / fvo�d /fie, Iti 1 �SG e�Q as l~o f 16 S -400 �etflej S'u 1 (/C Mai-P Parcel Identification Number (PIN) This L S 71 6f_ homestead property. � � / / . Vo /U / ^y - (is) (is not) � J i i� i Together with all appurtenant rights. tit and interests. Dated this _ day of t"' e b LU Q b y 7-0(f 0 (SEAL) (SEAL) • 4 r� l�l Y 13rr<)i dT -- — r t i1 ! t • /L®t. rtdLdC� ` (SEAL) — (SEAL) Betty 1?, Bravxdt AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, - ss. � Count r authenticated this day of Persortally came before nie t1As day of MK . 44000 , the above named i in TITLE: MEMBER STATE BAR OF WISCONSIN _ -___ -- to (If not. known to be the person S who executed the foregoing authorized by §706.06, Wis. Slats.) �pV ent and acknowledge the same. J THIS INSTRUMENT WAS DRAFTED BY S, . � ul k, ,: O t 3? f +1� L° e Ply! • Gl��� Sal Z' -� mV '4 ubllc, State of Wisconsin 'y j '{commission Is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not 1 2 - necessary.) ' Nerves of parsons signing In any capacity must be typed or printed below their signature. STATE BAR OF WISCONSIN Wisconsin Legal Blank co. . inc. QUIT CLAIM DEED FORM No. 3 - 1998 aaiawa,a «, Wis. • FOAM NO. 905-A M 41tc.— N Stock No. 26273 61 1� 90 is ��'E20oo � s CERTIFIED SURVEY MAP NO. 3808 CID VOLUME 14 , PAGE 3808 PART OF THE NORTHEAST 1/4 OF THE SOUTHEAST 1/4, SECTION 17, TOWNSHIP 29 NORTH, RANGE 15 WEST, SPRINGFIELD TOWNSHIP, ST. CROIX COUNTY, WISCONSIN. EAST 1/4 CORNER +ya SEC.17, T29N, R15W }j � AM[-:S J', '* 3/4" X 36" LONG y V NANSON * w REBAR, SET S- 1 : :±32 o a o �AENOMONIE, N n r ` WIS. 0 5 M S1: � ��� rt►vaT 1'cPn Ir►ND3 8 EAST LINE OF THE " I I SE 1/4 OF SECTION 17 N89'52'23 "E 630.62' I us 590.62' 111�� 4 I O • I ^ 5 3 LOT 1 > dl a o, 183 121 S0. FT.(4.20 ACRES±); ' o INCLUDING TOWN ROAD t /oZ / -I o1 g l� N 171.790 SO. FT13.94 ACRESt) pov'� = z EXCLUDING TOWN ROAD orr Q + =NIA I POINT OF 592.62' 100 0 BEGINNING S89'52'23 - W 630.62 3 SOUTH LINE OF THE NE 1/4 OF THE SE 1/4 �o r � N M O V1 SOUTHEAST CORNER SEC.17, T29N, R15W 0 0 w COUNTY MONUMENT F.D w 2 (BERNSIEN MONUMENT FOUND) j (A in PREPARED FOR OWNED BY N DAVID BRANDT HAROLD K. BRANDT, JR. w 251 LOCKWOOD R.R.1 WOODVILLE, WI 54028 GLENWOOD, WI 54013 0 1-- N LEGEND GOVERNMENT CORNER (AS NOTED) Z ^ a 0 SET, 3/4 "X24" IRON REBAR N �+ WEIGHING 1.502 LBS. PER a o LINEAL FOOT. APPROVED SCALE: 1 "=200' ST.CROIxCOUNTY R I z PIan*g Zoning and Parks Committee w w w o 2' 400 m � m FEB 14 2000 N U not feoorded Within 30 days of approval date approval shall be null and void NOTE: THE PARCEL ON THIS MAP IS SUBJECT TO STATE AND THIS INSIRUMENT WAS DRAFZED BY COUNTY LAWS, RULES AND REGULATIONS (i.e. WETLANDS, JAMES T. SWANSON ARCEL ETC. LOT SIZE, ACCESS TOP ) BEFORE PURCHASING OR DEVELOPING ANY PARCEL, CONTACT THE ST. CROIX COUNTY ZONING OFFICE FOR ADVICE. CEDAR C0RP0RAn0N 604 WLSON AVENUE ((716 0 ) 11�� a �S4751 V01.14 Page 3808 PAGE 1 of 2 1 •. NOTICE• Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW N � o 4, << OV INDICATE NORTH ARROW ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner � IW�l� 't Q,� D t Propert Address 42(0 290 City /State we&hWLL&- , W - 3: 7 Legal Description: Lot Block Subdivision/CSM # N 6 — t /4 SE ' /4, Sec. /:?--; T N -R / S W, Town of PIN # SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer Size ST/PC / Setback from: House Well P/L Pump manufacturer Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: Width Length Number of Trenches Setback from: House Well .P /L Vent to fresh air intake ELEVATIONS Description of benchmark Elevation Description of alternate benchmark Elevation Building Sewer ST/HT Inlet ST Outlet PC Inlet PC Bottom Header/Manifold Top of ST/PC Manhole Cover Distribution Lines ( ) () ( ) Bottom of System () () ( ) Final Grade ( ) ( ) ( ) Date of installation / / Permit number State plan number Plumber's signature License number Date Inspector Complete plot plan �+