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034-1058-10-000
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(n �+ N WJ � LO F- F- F- c ) uo 0 0 0 00 0 d C� •ti aaaa 2 aaaa ►� a @ m fq J U Y o ° Z o Y rn rn N rn rn 0) N N p > N (D *`� O @ O O .� Z µ� co N M �, O O cl CD C) c v o 0 � N � s' c 'O N a) o } C O m N N N N O O C � N C O N C p m O p C L C O 7 7 C O O O c ' °� a n n" 0 0 0 ' 0) g C � N � C N (6 � N rn ti o ., = - r c (D (D N O N d . •, 3 a C ,� N C C c L y O N U) CL m Z_ d Z d m 0 z `1 X V) cl cl V � E xt S a L (L • .� a d U N C (D C EC i C C C afety & Buildings Division Sanitary Permit Application 1 201 w. Washington Ave, In a"wd with Comm 83.21, Wis. Adm, Code PO Box 7302 Nvisconsin See reverse side for instructions for completing this application Madison, WI 53707 -7302 Personal information you provide may be used fors EQSub t completed form to county if not Department at Commerce L rivacv Law, s. 1 .04 lllnt)J R � f � � state owned.) Attach com let" lans 'to the noun v co p y only) for s 'stem, on a er nor less than 8 -1 /2 x 1 l in hes in size. Coun State Sanitary Permit Number he k if revision to reviou ca lan 1. . Num r a a I. A licat In ormation - Please Print all Info rmation . CROIX IIN lion: Property Owner Name ZONING ion f/_�IAA_l ' /4, S` c�' N R a W. Lot Number Black Number Property Owner's Mailing Address Z Phone Number Subdivision Name or CSM Number City, State Zip Code II Type of Building: (check one) i � r City J ,:1 / c? : l _: pVitlage • I or 2 Family Dwelling — No. of Bedrooms: ;Q Town of • Public /Commercial (describe use): • State -owned III Type of Permit: (Check only one box on line A. Check box an line B if a is Nearest Roa A) 1. ❑ New System 2. ❑ Replacement 3. ❑ Replacement of Ad ition to arcel Tax Nuntber(s) S stem i ank Oni Exi'stin S stern = 3 �) Permit Number Date Issued p A Sanitary Permit was previously issue: IV. Type of POWT System: (Check all that apply) 0 Sand Filter ❑Constructed Wetland • Non - pressurized In- ground IKMound • Pressurized In- ground ❑ Bolding Tank ❑ Single Pass Cl Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. DispersalArea 3, Dispersal Area 4. Soil Application i, Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals. /daylsq. 0) (Min. /inch) Elevation VI Tank Capacity in Total # of Manufacturer Prefab 1 Site Steel Fiber- Plastic Information Gallons Gallons Tanks f Con- Con- glass New Existing crete strutted Tanks Tanks ❑ ❑ ❑ ❑ ❑ a � p ❑ + O ❑ VII Responsibility Statement I the undersi ed assume re onsibility for installation of the POW sh own on the attached Tans. Business Phone Number Plu ber's Name (print) Pl m is Si azure (no stamps) MP /MFRS No. _ PI er's Address (Street, ciq State, Zip e) 4 VIII county epartment Use Only 13 Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued uing Agelit Signatu o stamps) Wppro,ed ❑ Owner Given Initial Adverse Surcharge Determination l� IX. Conditions of #pprovall /Reasons for Disapproval: ® a,*" a SBD -6398 (R. 07/00) _ O O co� — C w Z D z K m m z co o O m _x o X 1 O ` C 0 Z- c1n) ° N O 00 d m 0X r n c N O r- Z -� a G) m m z o n m n;u m 0 it z D z m Cn z N Z CD G N O m c� � Z cn 0z ;u c Z n zZ m Q Z] m' Q m m m a m w v m a m c' m m D o� a sm _s r -� y m °_ c m `° o `° o O m �y. 3 CD �a m� O m °-' ° m D ° °' T m m m ,z y N_ N N N N C y - OM f- N O CD N N f O 3 .�. 7 7 CD N _ ■ 2 X. C7 E X ~ w N y O o C) 2 = a m o D �y o �a a -I 0 '3 �fD - ma z ' Om m m - ° m y Q °� 2m o d 3m" j �v °m cflD �- - Z w 3 1 m �. r F. cr 'O O N y �O N v o v m o 3 D a c 0 o _� a o @ km< Z z a, ° w m - 0 y D o m m o :3 -0 m °.CDN ' :3. O OZ O D CL o Z Z m $ _ate ° m o�i m > B . ❑ ❑ 3 Q County Sanitary Permit Application ST. CROIX COUNTY WISCONSIN COX In accord with 15.04 St. Croix County Sanitary Ordinance ZONING OFFICE COX Personal information you provide may be used for secondary purposes ST. CROIX COUNTY GOVERNMENT CENTER _0 [Privacy Law. S. 15.04(1)(m)] 1101 Carmichael Road Hudson, WI 54016 -7710 (715)386 -4680 Fax(715)386 -4686 Attach complete plans for the system on paper not less than 8 -1/2 x 11 inches in size. Co U41 S i Permit # ❑ Check if revision to previous application S TG- 1. Application Information - Please Print all Infor tion Location: Property Owner Name A 16 - ? N, 114, Sec C..• a N, R (or W Property Owner's Mailing Address Lot Number Block Number `-/ - Vt/ C City, State Zip Code Phone Numer Subdivision Name or CSM Number kAJAPP, 1(7i!5_) 7 --'17b� 11 TTyp�'Of Building: (check one) ❑City Village wn of Ek 1 or 2 Family Dwelling - No. of Bedrooms: ❑ Public/Commercial (describe use): S. /GI RL/! > ; /,f_ V 8Z -�J ❑ State -owned Nearest Road a �, II. Type of Permit: (Check only one box on line A. Check box on line B if applicable) Parcel Tax Numb r(s) A) 1 Repair 1 2.U -- Reconnection 3. ❑Non - plumbing . ❑Rejuvenation Sanitation 3 B) Permit Number Datte I sued [State Sanitary Permit was previously issued J Z a q IV. Type of POWT System: (Check all that apply) ❑ Non - pressurized In- ground V ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other Dispe rsal/Treatment Area Information: - - 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application Rate . Per46lation Rate 6. System Elevation 7. Final Grade V Required Proposed (Gals. /day /sq.ft.) (Min. /inch) Elevation I. Tank Information Capaicty in Gallons Total # of Manufacturer Prefab Site Con- Steel Fiber- Plastic New Existing Gallons Tanks Concrete structed glass Tanks Tanks � iZ G bb r ❑ ❑ ❑ ❑ �v h ❑ ❑ ❑ ❑ II. Responsibility Statement 1, the undersigned, assume responsibility for repair /reconnenction /rejuvenation /installation of non - plumbing for the POWTS shown on the attached plans. A license is not required for terralift repair or the installation of non - plumbing sanitati system. Plumber's Name (print) Plum re er's Signa (no stamps): — MP /MPRS No. Business Phone Number Plum is Address ( treet, City, State, Zip de) 67 � s 4P - s 111. County Use Only Disapproved Sanitary Permit Fee Date Issued Agent SignatTR4No stamps) Approved Owner Given Initial Adverse Determination IX. Conditions of Approval /Reasons for Disapproval: -t�tv lam) �2 �� Q(¢�ac.ed Ui,, 381Z� L�S� fd l�wF• ��tiry�Q�LJ_ `�,� Q/ 1110 `_1 40 ��� X17 � � 5" 7qq t�tl� pa /oSg- /O / 3 n 1 PIPE U nkt' L7 L�tiStiNG F-�a us r� l i -'-',T7[4E STUDIO k4 � , 7_ .� R .a 4-1 U 1866 525 IS7M33M XATHLEEN H. VALSH REGISTER OF DEEDS ST. CROIX CO.. III Document Number Document TW RECEIVED FOR RECORD St. Cr oix Cou •4144 -2io2 9tW All Occupancy Affidavit F11i OTT # FtPaRVIT REC FEEL 11.09 ta i lu Pi c ,�0 TRAIiS FEE Name - (Owner) Typed or prin ted COPT M 2.00 CERT COPY FEE: being duly sworn, states, under oath, that: PAGES: 1 1. He/she is the owner /part owner of the foil arcel of located in St. Croix Corm Wisconsin, recorded in Volume T, Page Document Number St. Croix County Register of Deeds Office: Recardim Ares A parcel of land loeptjd to the# A of the % of S ction 6 Name and Retunt T�_N RW,Townof e; 471 / G St. Croix - q y �� R �v County, Wisconsin, being duly described as follows (include lot i D. and subdivision/CSM or detailed legal description): o3y o S- o-�oo Parc ei IdenufIcation Number (PIN) As owner of the above described prop owledge at the septic system serving this residence is sized for a bedroom home, or a design flow The d ign flow is calculated by as ming 150 go for 2 Individuals per bedroom. There are coccupant living in this residents; occupants are permitted based on the design flow. Therefore the septic system sery rig this residence is code compliant. However, I understand that if there are intentions to exceed the numbs of permitted occupants, the system will need to be modified to accomodate any increased wastewater flows and/or contaminant loads. I also acknowledge that I will make this information available to any future parties interested in purchasing this property. Dead y d r� dr i� ic .cr • AUTHENTICATION ACKNOWLEDGMENT Sigrature(s) STATE OF ISCONSIN ) ms. authertitcated Ws day of St. Cralz County. / Person My came beiore me this day of 4 / - i �� the above named TITLE: MEMBER STATE BAR OF WISCONSIN (if not, to me known to be the persons) who executed the foregoirp authorized by § 706.06, Wis. Stats.) ` 5 t{ instrument and acknowledge the same. THIS INS UMENT WAS DRAFTED BY >>�' , •" Aq :t' I a �l �` 0 � Notary Public, State of Wisemoin (Signatures may be authenticated or acknowledged. SOU► ar4flot Q My Com psm�anent. It rwl, state expiration date: rtsceesary.) �i, , . Date: "THIS PAGE IS PART OFTHM LEGAL DOCUMENT — DO NOT REMOVE" This Information must be completed by submitter d ument title. nomo& tetum address and EM (!f req koo. Other kift nration such as the grwWng clauses, leagol descNptbn, etc. may be placed on this first pogo 4 of the document or may be placed on additional gapes of the document. ML Use of this cover page adds one papa to your documentl and U OO to the reconfirw Am Wlsconslh statutes. 59.517. y M 1 .r ._... S - 31 .. �. t 3 � r le op 1G • � j _ CA LLI EF a P (71 .. .. • l._ �._�.._.. 0 CC cc 1 1 . S I n. •A y r r - 1 W6 ♦ DOCUMENT NO WARRANTY DEED TN'S S PACE 11ESEAVED FOR n EC011CINQ OAT& STATE BAR OF WISCONSIN FORM 2 --1982 REGISTER OFFICE 44 8425 sr. CROIX CO., W1 Recd for Record STATE OF WISCONSIN, DEPARTMENT OF VETERANS AFFAIRS UN 0:'.1989 _. _... _..._ ... ..... . ......_.._.. -... at 12:45 P.M _.. ... .... .. _ . .. r,mce�. and warrants to - MAATIN W.-- PIE PER_- And. �mv of DoA ... ...._ - -. MARTHA M. PIEPER, husband and wife, - survivorship ..... . ... .. ... .... ....... .. .. ..... RET I:I?N _ .. _ . 70 K Mak 8t PAX Box 287 the described real estate in _- .St.._CrQi %... .._...... _...._... Counts, State of Wisconsin: Tax Parcel No:... Q3 •1058�1D. -- I � The Northeast Quarter (NE 1/4) of i,he Northeast Quarter (NE 1/4) of Section 26, Township 29 North, Range 15 West. i I EXENSPT i i 1 i i This is not homestead proporty. XXibs) (is not) Exception to warranties: Municipal and zoning ordinances, recorded easements for 1 public utilities and recorded building restrictions. i hated this 10th day of May ly 89 STATE OF WISCONSIN, (SEAL) DEPARTMENT OF V7&R•PXS AFFAIRS I �E i1.1 _- .(SEAL) BY: �� atfo. //r d�+_t:�; ISEAL) JO J; MPII E pecretar , . tP AUTHENTICATION ACK -40*L jt&kNT Signature(s) _-- .... .... --. ..... ..... . .... .. ....... ...... . . . . .. . ..... STATE OF WISCONSIN .. Dane _ Count.. authenticated this -.- --._day of ... ... .. ....... ...... 19"----- Personally came betoro me this 10th dat of 1 May. _- - -._ _ , sv 89- the a0;ore nanro 1 - _- JOHN. J -._ NPRER, secretary M --- . - - -- ...-_ _ -.- __- .. ---- of the State of. Wisconsin Department Pa TITLE: ME STATE BAR OF WISCONSIN of Veterans Affairs, to me known to (If not. - ........... - -- authorized by § 706.06, Wis. FtatsJ be such Officer, and to me known to be tile ! e!.n rSee oed the fore;;oinV instrument and acknow C.e >:Irnc•. i T 1 11STPUMENT WAS DRAFTED nv as such officer as th - deed of said STATE O�' WLSCONSIN1 State Depar y autt{prity. . - - -- - _ fl DEPARTMENT OF VETERANS AFFAIRS r cf _ - ,n °b11,M. Bu t� (Signature I1ay he authenticated or acknowlrA,; e 1. Both M f'nn mi;.;inn 1, prrau 1r n1 ; tT tr , �: t1 •t !ire not neresv y a, - .�'s - date: April 21 s . •.• ,:, 91 , •Names of oem-, ? ;xninx in noy caf ncitY tppe .. , ,nt -1 1"I" 1h." WARRANTY DEED STA "f F. BAR OF Wj p'nntM rio. 2 — i ),%z !A'A l.� �l (h) 1 y ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT f Owner Mot r k f ,'e r- j - , ' Property Address ki ' City /State Wr S" Le al Description: tion: �, ��'� OFFr� NTr g P <:cNrry Lot _ Block Alk Subdivision/CSM # 1V k ; ,• Alt ' /4 P /a, Sec., TZ_N -RAW, Town of r,,, g PIN # .r• SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION Tank manufacturer Size ST/PC ) 000 /9'0J Setback from: House 7 0 L Well 0 P/I, 7b Pump manufacturer 1 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: M.000i Width _ 33' 4 Length d � V Number of Trenches 7 Setback from: House Well P/L Vent to fresh air intake j02 ELEVATIONS Description of benchmark L , Elevation Description of alternate be nchmark a r e- Elevation 1 10, 2 4 Building Sewer q t STMT Inlet y 7, /3 ST Outlet 76 PC Inlet 72 , 7 3 PC Bottom ff9 Header /Manifold �`y, `/ Top of ST/PC Manhole Cover 06, Distribution Lines Bottom of System (} 313 () ( ) Final Grade () 24. ( ) ( ) Date of installation 9 l?yl ? Permit number J� (b State plan number 7_ Plumber's signatur License number a'-_ JV Date Inspector Rt ✓i n I y Complete plot plan � s, 9 l I . Y NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. I • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW INDICATE NORTH ARROW ,I Y --WELL Mart in P ie P er PIbt P(dn •794 County Rd. W 660p W ( 54749 3 BRM Town p ( Spr i ng ( ie I d , FEES IDENCE NE NE Sec 26 T29NR 15W pert of 4O Acres LECENll o t o BM 1 = ELEV 100.0 'GROUND LEVEL AT POLE - 6M2 = ELEV 103.2 'GROUND LEVEL AT POLE SCALE : T' = 32 ' BM2 _,.: ---- -1,000 CALLON SEPT I C BM 1 `. DRIVEWAY- 8 GALLON PUMP. TANK —� - EX I S T 1 NG FA (LING ` 0 RYWELL --------- - - - - -- -- ------------------- - - - - -, F R , f ' I. f , 1 ' I f , q aq/3o ' Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM County: 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)). 344697 Permit Holder's Name: ❑ City ❑ Village Town of: State Plan ID No.: PIEP Martin I SPRINGFIELD 33 Y+ CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 034- 1058 -10 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Se <5 fed^- P 'e- g^ ' per Benchmark 1 ,V os;O •� Dosing Q�� - $O'D j i v Aeration Bldg. Sewer b, fig, &O Holding St /Ht Inlet c( -7,13 TANK SETBACK INFORMATION St/ Ht Outlet S,zO , gc) TANK TO P/ L WELL BLDG. Air Intake ROAD Dt Inlet Air Septic >Z5 X1 t NA Dt Bottom Dosing -> `> dap In, S /o � NA Header/ Man. Aeration NA Dist. Pipe ( . s Holding Bot. System I I" �/ 3. - 3 PUMP/ SIPHON INFORMATION Final Grade 1 4P b Manufacturer Q, w Demand A4. 6 , 30 ap, :? Model Number 411 2(. 'x` gnAPM TDH Lift ,4,6-5' 1 Friction, - Sy, 5 TDH ( Loss FF - i f Forcemain I Length a� Dia. 2 11 Dist. To Well >1 0 1) SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No.O Tr aches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS S l DIMENSION SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type Of I Model Number: System: INN" 0 5 (w > w --®-- CHAMBER OR UNIT DISTRIBUTION SYSTEM CAN / Header/Ma nv4ow if Distribution Pipe(s)f it x Hole Size x Hole Spacing Vent To Air Intake Length w6 ia. 2 Length - 7 - 122- Dia. _ _2_,_L Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched Bed /Trench Center Bed/ Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) -�-r _ 2. r p ID 4 /z9 In c? fi PRINGF ELD 26.29.15.401,NE,NE 794 Cou Road W �n�"e�t3.p � _ �l: D C.a►.�let.✓ � sl� � L P an U revision required? ❑ Yes J<No ' 13 t 5 Z 5 U e tVMd r di naLinf ation. , z 10 (R. / 7 Date r n Spector s Si tur Cert . No IV-ear ,,,,,,,,,cQ�ll �aed7$ "Q Ceue/oi�,/ rec(r t do v ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: P� e # # } } p ° } } E J I( } C } } e e £ gg E C 3 f Y I # € t _,.. i c i i { € s k : v.. b } 1 l { z gy m. m_ d t t E } 5 t Safety and Buildings Division MSCO/1S %/1 SANITARY PERMIT APPLICATION 201 Box W ashington Avenue Department of Commerce In accord with IL 83.05, Wis. Adm. Code Madison, WI 53707 -7302 • 'Attach complete plans (to the county copy only) for the sre .county than 8112 x 11 inches in size. r C r01 X • See reverse side for instructions for completing this appli at Sanitary Permit Number Personal information you provide may be used for secondary purposes 3 k if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. Std an I.D. Number I. APPLICATI N INFORMAT N - PLEASE PRINT AL IA 33q Property Owner Name / V ;, _ ocatio - 2r l T a�J �N 1SE(or� Property Owner's Ming Address + =,b r Block Number w - ` /� y � N!7 City, St to Zi Code Phone Number Sme or CSM Number II. T BUILDING: (check one) ❑ State Owned it r Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms ° Town of Lic 7C (A) III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(S) 1 ❑ Apartment /Condo 0 --1 5t ^ �� 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, ❑ New 2 Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an _____System ________ System _____________ Tank_ Only______________ Existing System ________ ExistinqSystem B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21;3 Mound 30 ❑ Specify Type 41 []Holding Tank 12 ❑Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑Seepage Pit 1 � �� 43 ❑Vault Privy 14 E] 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 7cSC7 Required ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation 3 75 - /, Z_ : .r ? Feet 9 r 63 Feet Capacit VII TANK in Ca gallo Total # Of Prefab. Site Fiber- Plastic Exper INFORMATION New Existin Gallons Tanks Manufacturers Name Concrete strutted Steel glass App. Tanks Tanks Septic Tank or Holding Tank /600 1poo Pre as ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamberl X©b I $aa Ct s ❑ I ❑ 1 ❑ 1 ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plum er Signature: (No Stamps) M PRSW No.: Business Phone Number: 4 M ayslv 76 /9 4.9 4 Plumber's Address (Street, City, State, Zip Code): Al l ,Q0 73 7�l 34 Ale j AV ta rri S'y 75' IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved S itary Permit Fee (Includes Groundwater D ate Issued Issuin Agent Signatu a (No Stamps) Approved []Owner Fee) Owner Given Initial � Z!51 � �_ �-9 Adverse Determination X 6-x1 DITION APPS�I� / , REQ ONS FOR DI P,PRQV�Q►L o� C647 / g 3. o CZ) . GeN►,µ.. . SBD- 6398 (R.11/97) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS ± s . t 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 be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mainstwater 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 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. i Safety and Buildings PO BOX 7162 MADISON WI 53707 -7162 TDD #: (608) 264 -8777 �seonsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary September 03, 1999 CUST ID No.227618 ATTN: POWTS INSPECTOR ZONING OFFICE TOM GUSTUM ST CROIX COUNTY SPIA N13450 937 ST 1101 CARMICHAEL RD NEW AUBURN WI 54757 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 09/03/2001 Identific ' ' ''hers Transaction ID o. 243347 Site ID No. 1795 SITE: Please refer to both - identification numbers, ST CROIX County, Town of SPRINGFIELD above, in all correspondence with the agency. NEIA, NE1/4, S26, T29N, R15W MARTIN PIEPER 794 CTY RD W FOR: Description: MOUND SYSTEM Object Type: POWT System Regulated Object ID No.: 487663 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: + On page 6, the existing system shall be properly abandoned as specified in s. Comm 83.03(2)., Wis. Adm. Code. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors.. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /instal lation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincer DATE RECEIVED 08/19/1999 FEE REQUIRED $ 180.00 � c FEE RECEIVED $ 180.00 TER E PAG' O PLAN REVIEWER II BALANCE DUE $ 0.00 Integrated Servic s (608)266-2889, M - F, 0745 - 1630 HRS PEPAGEL @COMMERCE.STATE.WLUS MO 1 . cc: MARTIN PIEPER c �ECEI VEp AU6 19 So MOUND SYSTEM DESIGN Wrrw R . Residential Application Jl , INDEX AND TITLE SHEET Project 3 Bedroom Mound Owner Martin, Pieper Address 794 County Rd W Knapp WI 54759 GJ• ��� 1- 715- 772 -4769 O o� Legal Description NE NE SEC 26 T 29 N R15W Township Spingfield County St. Croix �Iq Subdivision Name N/A Lot No. N/A G� Parcel ID Number Plan Transaction Number Z � 3 3 `{ 7 OF S �y►� N EEDED ���"''•.,C� Index and title sheet Page 1 �rv�Q NEED �`� Mound calculations Page 2 KE CO�SMEO CO: THOMAS D . N Mound drawings Page 3 GUSTUM 2 Pres. dist. calcs. and laterals Page 4 1201 TDH and pump tank drawing Page 5 .. Plot Plan Pag� Sl GNEQ' Pump Curve Page 7 Designer Thomas Gustum License Number D1201 Signature .�4411� Phone No. 715 -658 -1344 Date 8/16/99 Notice: Tampering with this file by unauthorized persons Is prohibited. Deliberate modification will result in disciplinary action under s. 145.10, Wis. Slats. Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)j. SBD- 10462 -E (R.05/98) Page 1 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) Replacement system? Creviced bedrock site? n (y or n) Slope 12.5 % Wastewater flow rate 450 gpd 1703 Lpd Depth to limiting factor 14 in 35.6 cm In situ soil infiltration rate 0.5 gpd /ft z 20.4 Lpd /m Contour line elevation 92.0 ft 28.04 m Use standard fill depths? I x OR Design depth? 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 e) Hole diameter 0.25 in 0.121, o, 0.188, o 0.25, 0.281, or r 0.3 0.313 inch only. Lateral spacing 3.00 ft Use 0 lateral spacing for trenches. Estimated hole space 3.00 ft Not a final calculation. Number of laterals Pump tank elevation 88 ft Outside bottom of tank. Forcemain length 70.0 ft Forcemain diameter 2.0 in 1.5, 2, 3 or 4 inch only. 2.067 in Actual I.D. HOLE DIAMETER CONVERSIONS 118 =0.125 1/4 = 0.250 SYSTEM SOLUTIONS Inch- ounds Metric 5/32=0.156 9/32=0.281 Estimated daily flow 4 7/32 0..2121 50 gpd 1703 Lpd 3/15 = = 0.313 7/32 = 9 Absorption cell Design load rate & area 1.2 gpdrttz 375.0 ft 34.84 m Linear loading rate (LLR) 6.00 gpd /ft 74.4 Lpd /m Design width (A) 5.00 ft 1.52 m Cell length (B) 75.0 ft 22.86 m Depth of cell (F) 10.0 in 25.4 cm Sand filter Upslope fill depth (D) 22.0 in 55.9 cm Downslope fill depth (E) 29.5 in 74.9 cm Basal area required (gpd /infiltration rate) 900.0 ft 83.61 m Supporting components Topsoil depth 6.0 in 15.2 cm Subsoil depth at center 12.0 in 303 cm Subsoil depth at cell wall 6.0 in 15.2 cm End slope toe length (K) 13.44 ft 4.10 m Up slope toe length (J) 8.00 ft 2.44 m Down slope toe length (1) 20.60 ft 6.28 m Total mound length (L) 101.88 ft 31.05 m Total mound width (W) 33.60 ft 10.24 m Project: 3 Bedroom Mound Transaction Number: Page 2 of 7 MOUND PLAN VIEW observation pipes (typical) J ......... 33.6 ft q A= 5.00 ft 1.52 m 10.24 m B - 75.0 ft 22.86 m W B J= 8.00 ft 2.44 m I K I= 20.60 ft 6.28 m K= 13.44ft 4.10m L _ 101.88 ft 31.05 m typ. obs. pipe (anchored securely) I = down slope dimension = absorption cell (AxB) J = up slope dimension = plowed area (LxW) K = end slope dimension 1W 6'(152 mm) T MOUND CROSS SECTION D = 22.0 in 55.9 cm lateral topsoil H subsoil cap E = 29.5 in 74.9 cm invert 94.33 ft _ _ F = 10.0 in 25.4 cm elev. 28.75 m €; F G = 12.0 in 30.5 cm ASTM C33 H = 18.0 in 45.7 cm Sand Fill E Sys. 93.83 ft y elev. 28.60 m 92.00 ft contour 28.04 m elev. 12.5 % 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 covered with geotextile fabric. Designer notes: Deep chisel plowing to break up top layer Project: 3 Bedroom Mound Transaction Number: Page 3 of 7 PRESSURE DISTRIBUTION CALCULATIONS Absorption cell Inch-pounds Metric Width (A) 1 5 Ift 1 1.52 Im Length (B) 75.0 Jft 1 22.86 Im Lateral specifications Number laterals 1 Holestlateral 25 holes Lateral length (P) 72.00 ft 21.95 m Hole diameter 0.250 in 6.35 mm Lat. dis. rate 29.13 gpm 1.84 Us Sys. dis. rate 29.13 gpm 1.84 Us Hole spacing (X) 36 in I 91.4 cm Lateral diameter Pipe diameter Design options Design choice Designer must 1 in (25 mm) Place X in red X' one choice 1 1/4 in (32 mm) box of chosen from the options 1 1/2 in (40 mm) diameter. provided. 2 in (50 mm) x x 3 in (75 mm) X Manifold diameter Pipe diameter Design options Design choice Designer must 1 in (25 mm) X' one choice 1 1/4 in (32 mm) Place X in red from the options 1 1/2 in (40 mm) box of chosen provided. 2 in (50 mm) x x diameter 3 in (75 mm) X 4 in (100 mm) X Distribution system contains: 1 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 centered over the A & B dimension end cap P Last hole drilled next to end cap l<-X--fl Laterals & Force main of PVC Soh 40 Holes drilled on the bottom of the lateral (per COMM Table 84.30 -5) r < -- equallg spaced • =permanent end marker Inch-pounds Metric Lateral length (P) 72.00 ft 21.95 m Lateral spacing (S) 3.00 ft 0.91 m Hole spacing (X) 36 in 91.4 cm Manifold length 0.00 ft 0.00 m Hole diameter 0.250 in 6.4 mm Lateral diameter 2.00 in 50 tm m Forcemain diameter 2.00 in 50 Project: 3 Bedroom Mound Transaction Number: Page 4 of 7 TDH and Pump Tank Drawing Total Dynamic Head Operational head 2.50 ft 91m m Vertical lift 7.80 ft m Are laterals the highest point in the Friction loss 1.03 ft m system? Yes "x' here. 1� Total dynamic head 11.33 ft If no what is the highest elevation Dose Volume downstream of pump? Dose is > 10 times lateral volume Forcemain drain Lateral void volume 12.5 gal 47.3 L back to tank? (Y' one) Minimum dose 125.0 gal 473.2 L Yes Drain back 12.2 gal 46.2 L No Dose volume 11 137.2 gal 519.4 L Typical Pump Chamber Layout In combination with state approved treatment tank. Tank construction as per Comm 83.20(3) WAC. approved manhole cover with weather proof warning label and locking device grade levels junction box — �� disc\onn_ect grade levels y aRemate 4" vent pipe electric as per NEC 300 and outlet Comm 16.28 WAC location 18" (46 cm) min. wall of pump approved chamber or outlet joint combination tank A Provide 1/4" weep hole or anti - alarm on siphon device as necessary pump on B Grade levels pump 92.8 ft C - pump tank manhole = 4 cm) off elev. 28.3 m J minimum above finished grade D - vent =12" (30.5 cm) minimum above finished grade 92.0 ft Pump tank elevation 3 " (75 mm) of bedding under tank 28.0 I rn bottom of tank Tank manufacturer Skaw Pre -Cast Pump tank capacity 19.83 gal /in Pump tank volume 800 gal Pump manufacturer JHydromatic Inches Gallons Pump model number Josp 33 0 A 25.4 504.1 N B 2 39.7 Alarm manufacturer JS&J Electro C 6.9 137.2 Alarm model number 101 Q D 6 119.0 Project: 3 Bedroom Mound Transaction Number: Page 5 of 7 " Mar7i h f i Qpt r J ).t pl" 79y. CO. n4y Rd w Qri W�l pp Taws of Spr;n' Fodo nrt _NE Su..26 ,2 9 A K S 1✓ Yo A ( v B. PA_ I .= C4 /Co. 6' Goa "n d 4cvelllifd G,* V n j Lt vt t..+ Polk. P 3 Pi''G � S oi � Qo��„ � 47ACK�o -4 � QI►��'� �s l insulaf� p I/ 3 2 = eT e' ^4 _ _ $•- _ -�.r ash C e -�or►r A Co K400 Mo d �.,d J,,,- le CORRECTION NEEDED SEE CORRESPONDENCE V •r ` I I �1 P q ' I, &.F ���s�w����� �� m D ETAILS t Performance Data 32 Pump Characteristics Pump /Motor Unit Sebnwrsible Memel Models OSP33M1 I OSP33M2 z4 Automatic Models OSP33A1 OSP33A2 113 NP Z Horsepower 1/3 16 Fell load Amps 1.8 4.6 a Motor Type Spot -Phase R.P.M. 1750 0 0 Phase 0 1 Vetter 115 230 0 Hertz 60 0 10 20 30 40 so 60 CAPACITY -U.S. G.P.M. Operation Intermittent To nlwature 140 °F Ambient Total Hood (foot) 4 8 12 16 20 24 25 NEMA Design S GPM 1/3 HP 60 55 48 39 28 7 0 Insulatiw Cass F DisdYerge Sin 1.1 /2" NPT Solids Handing 5/8" Dimensional Data Unit woigbt SO Ibs. 3 .1/6 6- 314 Fewer Cord EII , SJTW, 18 SJTW 5.1/6 (20' opt.) 20' std 1. a x , m1f101e; Wo 1 -1/2 NPT t 4 -1/4 o" very t 1/9 loth Materials of Construction 3. �'' r Handle Stool 1 4 /. Derekas Nw "#A ON gMnxW* lebricating 011 Dielectric Oil S. wr mom ** 1* a Motor Hw* Cast Ira r„dom aw #wk Pump Using Cast Iron `r Khol0A omw Wks Skh Steel Mecbenknl Seel Fans: Carben /creak Sbah Seal Sol Sody: kess Springy Stainless Stool we Iwo-N 12-1/8 s - 1 /a Impeller kaw 11 -3/4 PUMP ON Upper Ioaritg Single Raw ad 10W4 Lower Soaring Single Raw Id kw4 —� Soso Cast Ita 2-314 3 Festeeors Stoinless Steel PUMP OFF AURORA /HYDROMATIC Pumps, Inc. t 1840 Baney Road, Ashland, Ohio 44805 (419) 289 -3045 Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Safety and Buildings in accord with Comm 83.05, W is. Adm. Code Gustum Septic Service Attach crotnplete site plan on paper not less than 8'/ x 11 inches in size. Plan mcet County ifclude, but not limited to. vertical and horizontal reference pant (BM), direction and St. Croix p2rc:ent `slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D.# APPLICANT INFORMATION - Please print all information. gy Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Not 4 - 26 -°c Property Owner Property Location Pi er, Martin Govt. Lot NA NE 1/4 NE 1/4 S 26 T 29 N,R 15 W Property Owner's Mailing Address Lot # Block # Subd. Name or GSM# 794 County Rd W NA NA NA City State Zip Code PhoneNumber ❑ City ❑ Village ❑Town Nearest Road Knapp WI 54749 1- 715- 772 -4769 Springfield I County RdW ❑ New Construction Use: ❑ Residential / Number of bedrooms 3 ❑Addition to existing building ❑ Replacement ❑ Public or commercial describe Code Derived daily flow 450 gpd Recommended design loading rate .5 bed, gpd/ft2 .6 trench, gpd/ft Absorption area required 900 bed, ft 2 750 trench, fF Maximum design loading rate .5 bed, gpd/ft .6 trench, gpd/ft Recommended infiltration surface elevation(s) along 92.0' contour ft (as referred to site plan benchmark) Additional design / site considerations part of 40 acres. BM # 1 = 100.0', BM # 2 = 103.2' Parent material n/a Flood plai n elevation, if applicable n/a It S= Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U= Unsuitable for system El S❑ U ❑ S❑ U ❑ S Z U El S❑ U ❑ S NU ❑ S® U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft B a f ng # Horizon in Munsell Qu. Sz. Cont Color Texture Gr. Sz. Sh. C Boundary Roots Bed Trench 1 1 0 -6 10yr3/2 none sil 2mcr mvfr as 2f,1 m 0.5 0.6 2 6 -13 IOyr3 /3 non gr. sir 2msbk mvfr cw lm 0.5 0.6 Ground 3 13 -18 10yr4 /6 none gr. sil 2msbk mfr cw - 0.5 0.6 elev c 7. pp y / 6/1 90.9' ft 4 18 -30 7.5yr4/6 5y 0 r5/6 gr. sil 2msbk mfr - - 0.5 0.6 Deptlii to limiting factor 18" Remarks: 2 1 0 -4 1 0yr2/2 none sil 2mcr mvfr as 2f,lm 0.5 0.6 2 4 -7 10yr4/4 n one gr. sil 2msbk mvfr cw Im 0.5 0.6 Ground 3 7 -10 10yr3/3 none sil 2msbk mvfr cw - 0.5 0.6 elev 93 . 4 ' ft 4 10 -14 10yr4/4 none gr. sil 2msbk mfr cw - 0.5 0.6 Depth to 5 14 -25 7.5yr4/4 c3.5yyry5/6 gr. sl 2msbk mfr - - 0.5 0.6 limiting factor 14" Remarks: CST Name (Please Print) Signature: Telephone No. Tom Gustum 715-658 -1344 Address Gustum Septic Service Date CST Number Ref# N 13450 937th St., New Auburn, WI 54757 6/25/99 227618 1107 PROPERTY OYIIIt M P'iem Maw SOIL DESCRIPTION REPORT Page _ 2 - 4 _ - - 3 PARCEL Ltd.# Gustum Septic Service Horizon Depth Dominant Color Mottles Texture Structure Texture s Boundary Roots GPDW - � in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed : • Trench 3 1 0 -5 1 0yr2/2 none sit 2mcr mvfr as 2f ,lm 0.5 0.6 2 5 -14 10y73 /3 none A 2msbk mvfr cw IM 0.5 0.6 Ground -- ~— - - - -- __.___ -- none elev 3 14 -20 10yr5 /3 none sit 2msbk mvfr cw - 0.5 0.6 90.9' ft 4 20 -30 10yr5 /4 c 5y� 6/ /1 sit 2msbk mfr - - 0.5 0.6 Depth to - -- limiting factor 20' Remarks: Ground - - -- -- - — elev Depth to limiting factor Remarks: Ground — - — elev Depth to — limiting factor -- -- -- — - - -._ . . Remarks: Ground elev Depth to limiting factor Remarks: m � � a 4 i P r e pt ( r � F Ptah I / 7 (O., y �d W Qri ✓c W4 kh p pp �'� sy 7 y9 Tow o'r Spr ;ll F, dol N6 /Vie' s a� rag�Rjs�' pq p p �' � EL 100. 6� ( G n_ rain ISM -= C 103,2 Crov L CVf/4f Pe NI e 601 c or;,)S wl &CL/ 0- -r D PI vC- W q I� k o EX ISTI nq J 5(6 �L — ✓ r�q i nc{ Q�-�/ W - - � 63 Bi Qo, � C on400r � Co n4ou r 1 -- I i i 1 4�� 3GF3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer t A fl, P j "er Mailing Address '1 X 14 Cc- a n ty koAa , kJ Property Address SQ rna (Verification required from Planning Department for new construction) City/State Kna D A u3 Parcel Identification Number 0 LE DESCRIPTION Property Location AIC 4, y,, Sec. o 2 & , T j N -R f - W, Town of i fi"ld , Subdivision _ ,� A Lot # Certified Survey Map # Al A Volume . Page # Warranty Deed f ? 5 Volume T . Page # Spec house ❑ yes ❑ no Lot lines identifiable ❑ yes ❑. no SYSTEM :MAINTENANCE Iripmpause and mainteaanceof your septic systemcould result in, its prematcsre.failureto handle wastes. Propermaintenance consists of pumping out the septic tank every throe 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 nMAaP lo�epmanphmmber, restrictedplumber or a licensedpumper verifying that (1) the oa -site wastewaterdisposal system is is proper operating condition and/or (2) after inspection and pumping.(if necessary), the septic-taok is less than 1/3 full of sludge. Uwe, the wed 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. um+ces State of Wisconsin.. Certification 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. E� —/�� SIGNATURE OF APP CANT DATE OWNER CER ICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of the property describe above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APP LICANT DATE « « « « «« Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department''"` « ` • Include with this application: a stamped warranty deed from the Register of Deeds office 4 ,5opy of the certified survey map if reference is made in the warranty deed pp i 1IOt v��E DOCUMENT NO. W eaAwY DOD THIS ssACI aeasRVVaD acc V ea � er � wwTA M 1'! STAT& BAR OF WISCONSIN FORM 9 —U EGMER S !"r a -448425 a. CRM Co. %" % d for Ramd STATE OF KISCONSIN, DIPPARTKA.. OR VETERANS AFFAIRS JU 0 2 ...... .... I ......... ..... I .... _.... ....... ......... ........ .I ....... ............... fit i2:45 P.M ...... . ....... ..... ..I ................. . _ ...... I ....... A .. ............................... OMB conveys and warrants to .- , si ..Ka.. ..APP .. .............. MAMMA- "L. PIBFER.... hue. band.. and. wife ,..8W*ViTnrAbip........... rritrx_ Property - ---• ........... ........._..................... ......................... _.. ........... ....... ... .... . ...... ......... I............... .......... .... ..... -. ... ..................................... ......................... ...... .... .... RCTURN IN NW ,e. ............... ............ I ........ ....... ------ ................ lMlei !W!. ?m UK 267 ........... ........ . . ...... ........ ..._... alw aft " M the following described real estate in ... 3tx..Crol_% :. ........................County, State of Wisconsin: Tax Parcel No:... 43R••1058..-1D..- The Northeast Quarter 0 ;Z 1/4) of the Northeast Quarter (NE 1/4) of Section 26, To4mship 29 North, Range 95 Kest. l � I i I ` This iA .nOt.. ......... .homestead property. XXts) (is not) Exception to warranties: Municipal and zoning ordinances, recorded easements for public utilities and recorded building restrictions. Dated this - 10th May 13 oy _. .... _.. ".... -- - - .... -. day of ........ STATE OF 1i- - SfiONSIN, DEPAR.TMUT OF. "13 Ai IRS (SEAL) _...... ....(SEAL) _ .. _ I _.- _... ....... ..... --- ....._...(SEAL) BYe - t.a .(SEA1 ) y 'wtf6 JG J E �"' jl* 'us AUTHENTICATION ACHNO I VVO4AN - T Signature(s) ...•-- -- • -• ....... ...................... STATE OF WISCONSIN ss. °...-••- • ...1}aCn "... ,_.... _.. County. authentieated i =.is ........ day of ........................... 19 ...... Personally came before me this .- "10th _day of 19 89 -- the u',ove named ---- •- .. ...... ..... ......... .....JOI] j •)._.C'.'L">[TR£R,_Sec. retarY- � • .........-.•-.---• ... ..... .......... ................ .of- the-- State - ot- Wisconsin, Department i TITLE; MEMBER STATE BAR OF WISCONS.- -N ...of - Veterans - Affairs, to me known to I (If not. ........ be suc-#- iffioer, &FA authorized by 1 706.06. Wis. Stats.) to me known to be the person who cxecutad the J .oregoing inst:umcnt and lcknowle-lt;e the �an1e. INSTRUMENT WAS ORArrED BY as su officer as -'lha "deed of said State De pa y' ids. ut rity. STATE OF.- WI.SOQN31% - .- - - - - -- 4" BEP011'TMIsNT OF VETERANS AFFAIR � pp ob M. . .. .. . . . .. ......... ... ------------ =atarp Pu�filic _ p + , r'nunt }. R i:: (Signatures may he R•i1 or acknowledgwi. Both 'My Commission is t lar i �i�;�te can rition are not necessary.) A r 2 21 �^ p 91 date . p r f , . ) - NA." of PaM' .. sgai.g !n Roy he tsp'.1 or WARRANTY DEED STATE FAR OF WNCON`N e'C!tiv.[ 140. 2 — 1•142 OVA 3?' + (h) HEAD /CAPACITY CURVE HEAD CAPACITY CURVE EFFLUENT MODELS 140 MODEL 42 48 53 55, gg 137,139 140, 161, 163, 165 t223 5, 186, 188, 189. 191 71 7_1 42 57,59 4140 4161 4163 41685 4186 4188 4189 135 . G FT. M. GAL. LTRS. GAL. LTRS. GAL. LTRS. GAL. LTRS. GAL. LTRSAL. LTRS. GAL. LTRS. GAL. LTRS. GAL. LTRS. GAL LTRS. GAL. LTRS. GAL. LTRS. GAL. LTRS. 5 1.52 15 57 32 121 43 163 72 273 93 352 91 344 100 379 61 231 61 58 220 145 549 145 549 45 170 40 130 10 3.05 11 42 25 94 34 129 61 231 79 299 84 318 93 352 61 229 61 $58220 140 530 140 530 45 170 15 4.57 6 23 15 57 19 72 45 170 64 242 76 288 85 322 60 227 61 134 507 135 511 45 170 38 125 20 6010 25 95 36 136 68 257 79 299 59 223 60 128 484 131 496 45 170 120 25 7.62 8 30 59 223 70 265 57 216 59 122 462 125 473 45 170 36 191 30 9.14 49 185 62 235 55 206 5B 322 116 439 120 454 45 170 115 40 12.19 21 79 45 170 46 172 55 206 70 265 104 394 109 413 45 170 34 50 15.24 20 76 33 125 50 189 51 193 90 341 97 367 45 170 1 60 18.29 15 57 39 148 32 121 71 269 85 322 45 170 70 21.34 23 87 9 34 51 193 69 261 45 170 32 105 80 24.38 10 38 45 170 28 106 51 193 45 170 100 90 27.43 31 117 2 8 34 129 45 170 30 100 30.48 16 60 17 64 40 151 95 110 32.00 4 15 30 114 28 120 36.58 20 76 90 186 130 39.62 10 38 , 26 85 4186 LOCK VALVE: 19' 19' 19.25' 23' 26' 46' S6' 66' 86.5' 73' 114' 91' 110' 137' 24 80 165. 75 416 0 22 A CAUTION Model 185/4185 should not be subjected to 20 N\ 6s less than 30 feet TDH. 6 60 i s3 89, NOTE: For Head Capacity on Model 112, Industrial 0 5— 4189 column- explosion proof pump, see FMO219. 1s 50 009922a 14 46 12 40 140, 88, 35 4140 4188 10 30 185, 8 137.139 4185 25 6 20 4 15 0 42 67, 2 5 T 4161 53,55 98 57,59 0 U.S. GALLONS 10 20 30 40 50 60 70 80 90 100 110 720 130 140 150 160 LITERS 80 160 240 320 400 480 560 640 0 FLOW PER MINUTE HEAD CAPACITY CURVE SEWAGE MODELS 24 MODEL 264 265 267 268 270 282 284 292 293 294 295 75 4270 4282 4284 4292 4293 4294 4295 22 1. METERS GAL. LTRS. GAL LTRS. GAL. LTRS. GAL. LTRS. GAL. LTRS, GAL LTRS. GAL. LTRS. GAL LTRS. GAL. LTRS. CAL. LTRS. GAL LTRS. 70 5 1.5 90 341 128 484 128 484 128 484 132 500 130 492 180 681 140 530 -- -- 196 ]42 214 B10 10 3.0 60 227 89 337 89 337 89 337 101 382 95 360 158 598 124 469 - 181 685 199 753 15 4.6 22.5 85 50 189 50 189 50 189 ]] 291 63 238 135 511 108 409 118 447 20 165 625 1B4 696 65 20 6.1 10 38 10 38 10 38 56 212 33 125 106 401 91 344 108 409 150 568 168 636 25 7.6 29 110 5 19 76 288 75 284 96 3 136 515 154 583 18- 60 30 9.1 43 163 56 212 82 310 121 458 140 530 40 12.2 10 38 48 182 94 356 115 435 55 50 15.2 58 220 89 33] 16 60 18.3 13 49 59 223 50 70 21.3 23 W 87 LOCK VALVE 18' 21.5' 21.5' 21.5' 29' 2fi' 35' 42' S0' 52' 75' = 14- 45 V z 12- 40 r I 35 < 10 CAUTION Model 293/4293 8 294293 should not be subjected to less than zs 15 feet TDH. 282 282 27Q 6 20 4270 009904a 15 4 10 4 � 11 2 5 264 292, 284, 294, 295, 4292 4284 4294 4295 0 U.S. GALLONS 10 20 40 50 60 70 80 90 100 110 120 130 140 150 160 170 180 190 200 210 220 230 LITERS 0 80 160 240 320 400 480 560 640 720 800 880 FLOW PER MINUTE © Copyright 1999 Zoeller Co. All rights reserved. ` 5 EASY DO'S & DON'T'S FOR INSTALLING A SUMP PUMP 1. DO read thoroughly all installation material provided with the pump. 2. DO inspect pump for any visible damage caused by shipping. Contact dealer if pump appears to be damaged. 3. DO clean all debris from the sump. Be sure that the pump will have a hard, flat surface beneath it. DO NOT install on sand, gravel or dirt. 4. DO be sure that the sump is large enough to allow proper clearance for the level control switch(es) to operate properly. 5. DO Always Disconnect Pump From Power Source Before Handling. DO always connect to a separately protected and properly grounded circuit. SSPMA DO NOT ever cut, splice, or damage power cord (Only splice in a watertight junction box). MEMBER DO NOT carry or lift pump by its power cord. DO NOT use an extension cord with a sump pump. SUMP 6. DO install a check valve and a union in the discharge line. ANDSEWAGE DO NOT use a discharge pipe smaller than the pump discharge. PUMP MFRS. ASSN. 7. DO NOT use a sump pump as a trench or excavation pump, or for pumping sewage, gasoline, or other hazardous liquids. YOUR ASSURANCE 8. DO test pump immediately after installation to be sure that the system is working properly. OF QUALITY 9. DO cover sump with an adequate sump cover. 10. DO review all applicable local and national codes and verify that the installation conforms to each of them. 11. DO consult manufacturer for clarifications or questions. 12. DO consider a Two Pump System with an alarm (Page 5) where an installation may become overloaded or primary pump failure would result in property damages. 13. DO consider a D.C. Backup System (See the Basement Sentry page 5) where a sump or dewatering pump is necessary for the prevention of property damages from flooding due to A.C. Power disruptions, mechanical or electrical problems or system overloading. Service Checklist ® A WARNING ELECTRICAL PRECAUTIONS- Before servicing a pump, always shut off the main power breaker and then unplug the pump - making sure you are not standing in water and wearing insulated protective sole shoes. Under flooded conditions, contact your local electric company or a qualified licensed electrician for disconnecting electrical service prior to pump removal. A WARNING Submersible pumps contain oils which becomes pressurized and hot under operating conditions - allow 2% hours after disconnecting before attempting service. CONDITION COMMON CAUSES A. Pump will not start or run. Check fuse, low voltage, overload open, open or incorrect wiring, open switch, impeller or seal bound mechanically, defective capacitor or relay when used, motor or wiring shorted. Float assembly held down. Switch defective, damaged, or out of adjustment. B. Motor overheats and trips overload Incorrect voltage, negative head (discharge open lower than normal) impeller or seal bound mechanically, defective or blows fuse. capacitor or relay, motor shorted. C. Pump starts and stops too often. Float tight on rod, check valve stuck or none installed in long distance line, overload open, level switch(s) defective, sump pit too small. D. Pump will not shut off. Debris under float assembly, float orfloat rod bound by pit sides or other, switch defective, damaged or out of adjustment. E. Pump operates but delivers little or Check strainer housing, discharge pipe, or if check valve is used vent hole must be clear. Discharge head ex- no water. ceeds pump capacity. Low or incorrect voltage. Incorrect motor rotation. Capacitor defective. Incoming water containing air or causing air to enter pumping chamber. F. Drop in head and/or capacity after Increased pipe friction, clogged line or check valve. Abrasive material and adverse chemicals could possibly a period of use. deteriorate impeller and pump housing. Check line. Remove base and inspect. If the above checklist does not uncover the problem, consult the factory - Do not attempt to service or otherwise disassemble pump. Service must be by Zoeller Authorized Service Stations. Limited Warranty Zoeller Pump Company warrants, to the purchaser and subsequent owner lieu of all other warranties expressed or implied; and we do not authorize any during the warranty period, every new Zoeller Pump Company product to be representative or other person to assume for us any other liability in connec- free from defects in material and workmanship under normal use and service, tion with our products. when properly installed, used and maintained, for a period of one year from Contact Zoeller Pump Company, 3649 Cane Run Road, Louisville, Kentucky date of installation or 18 months from date of manufacturer, whichever comes first. Parts that fail, (within one year of installation or 18 months from date of 40211 -1961, Attention: Customer Service Department to obtain any needed manufacturer, whichever comes first) that inspections determine to be defec- repairor replacement ofpart(s) or additional information pertaining toourwarranty. tive in material or workmanship, will be repaired, replaced or remanufactured ZOELLER PUMP COMPANY EXPRESSLY DISCLAIMS LIABILITY FOR at Zoeller Pump Company's option, provided however, that by so doing we will SPECIAL, CONSEQUENTIAL OR INCIDENTAL DAMAGES OR BREACH not be obligated to replace an entire assembly, the entire mechanism or the OF EXPRESSED OR IMPLIED WARRANTY; AND ANY IMPLIED WAR - complete unit. No allowance will be made for shipping charges, damages, RANTY OF FITNESS FOR A PARTICULAR PURPOSE AND OF MER- labor or other charges that mayoccurdue to productfailure, repair or replacement. CHANTABILITY SHALL BE LIMITED TO THE DURATION OF THE EX- This warranty does not apply to any material that has been disassembled PRESSED WARRANTY. without prior approval of Zoeller Pump Company, subjected to misuse, Some states do not allow limitations on the duration of an implied warranty, misapplication, neglect, alteration, accident or act of God; that has not been so the above limitation may not apply to you. Some states do not allow the installed, operated or maintained in accordance with Zoeller Pump Company exclusion or limitation of incidental or consequential damages, so the above installation instructions; that has been exposed to but not limited to the limitation or exclusion may not apply to you. following: sand, gravel, cement, mud, tar, hydrocarbons or hydrocarbon derivatives (oil, gasoline, solvents, etc), wash towels or feminine sanitary This warranty gives you specific legal rights and you may also have other products, etc. or other abrasive or corrosive substances. This warranty is in rights which vary from state to state. © Copyright 1999 Zoeller Co. All rights reserved. 6 Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page 1 of ` Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code Gustum Septic Service Attach complete site plan on paper not less than 8' /z x 11 inches in size. Plan must County indlude, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D.# APPLICANT INFORMATION - Please print all information. Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). viewed By a Date 0 -111-9 Property Owner Property Location Pie er, Martin Govt. Lot n/a NE 1/4 NE 1/4 S 26 T 29 N,R 15 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 794 County Rd W n/a n/a N/A City State Zip Code PhoneNumber City Village [KTown Nearest Road Knapp WI 54749 1- 715- 772 -4769 Springfield County Road W ❑ New Construction Use: Residential / Number of bedrooms 3 ❑Addition to existing building Replacement [] Public or commercial describe Code Derived daily flow 450 gpd Recommended design loading rate bed, gpd /ft trench, gpol11: Absorption area required bed, ft trench, ft Maximum design loading rate bed, gpo1it trench, gpd/ft Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations Soil boring to verify soils at existing drywell. Parent material Flood plai n elevation, if applicable n/a ft $= Suitable for system Conventional Mound In Ground Pressure AT - Grade System in Fill Holding Tank U= Unsuitable for system ❑ S ®U ❑ S ® U ❑ S ❑ U ❑ S ❑ U ❑ S ® U ❑ S ® U SOIL DESCRIPTION REPORT Boring# Horizon Depth Dominant Color Mottles Structure GPD/ft in Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consisten Boundary Roots Bed Trench 1 0 -5 10yr3/2 none sil 2mcr mvfr as 3Qm. 0.5 0.6 2 5 -10 10yr4 /3 none gr. sil 2msbk mvfr cw lf,lm 0.5 0.6 Ground 3 10 -18 7.5yr4/4 none gr. scl 2msbk mfr cw - 0.4 0.5 elev 99.0' ft 4 18 -24 7.5yr416 c3p5 03/61 gr. SO 2msbk mfi - - 0.4 0.5 Depth to 7� limiting factor 18" Remarks: CST Name (Please Print) Signature: Telephone No. Tom Gustum 715 -658 -1344 Address Gustum Septic Service Date CST Number Ref# N13450 937th St., New Auburn, WI 54757 9/30/99 227618 1141 Jw ar7 A; ep{ r Mot Plgn • C p r 7 C ni Rd W Qri �e. wa i�;Fpp Va s '/f Town _oF Spr;.,' P it PL frovlq 6ute; NE_ 4J6' Scc.. G Ta 9 n! K ►S - , pgr.T__op . 4 1 0 A ce s d AA-1 ICO3 6f G ravn O cvC1wT AO S� a.M_2 - ._4!� L Io3.2 _ lsr.yhdl• rvt�a+ �elo, �,3yP�G S OS I QOriq S W 470.C�Ilo� � BM'T� I 9 f insulaf� Pr II 3 (.CIkG L�+rt $�, 2nPvC , �air r mai,q c on Q Co n4ov r• A40vA�J fO. �aG ��O.S�YILId i 1 F f ^fir