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038-1008-30-000
of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix ,tiJivision Sanitary Permit No: 430428 0 INSPECTION REPORT i AL INFORMATION (ATTACH TO PERMIT) State Plan ID No: final information you provide maybe used for secondary purposes (Privacy Law, s.15.04 (1)(m)J. Permit Holder's Name: City, 'V-A@;11 k X Township Parcel Tax No: Nutzmann, Charles Star Prairie Township 038-1008-30-000 CST BM Elev: Insp. BM Elev: BM Description: Sectionfrown/Range/Map No: COO..' ( `i ^ S' % - 02.31.18.23 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark ` 5y /0 Gv Dosing z a.t Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION 111W TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header/Man. Aeration Dist. Pipe Holding Bohm Final Grade PUMPISIPHON INFORMATION Manufacturer Demand St Cover 10 GPM e) Modell Number h.~ 1 '5 •7~ t,~ Lift Friction Loss System Head 4 2' JTDH Ft -F5 < T r►r► S, 4,11 13" 4C, C' J'a 8 51 3 IT/4 Forcemain Length v 'st. to Wei , SOIL ABSORPTION SYS agno Pe,,,,-' 1cr.~-" BEDITRENCH Width Length •-at Na Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS f SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufact X-1 INFORMATION CHAMBER OR ; C[ i F Type Of System: ~ , ~ UNIT Model Number: Y9 V-e-rl / ;e, n 112.- .-.-,300 Zo t. 5-r DISTRIBUTION SYSTEM '''=mot 4el C41-411 Header/Manifold Distribution x Hole Size x Hole Spacing nt to Air Intake r- Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/S ded xx Mulched Bedfrrench Center Bed/Trench Edges r Topsoil Yes Nn No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: /O 114e /_3 inspection #2:ty /0I_3 Location: 1239 Cty Rd H New Richmond, WI 54017-(NE 114 SW 1/4 2 T31N R1 8W) NA Lot Parcel No: 02.31.18.23 1.) Alt BM Description 2.) Bldg sewer length = ir~g-~G,✓I .e~1 rt a ~ 'e-1r- Vvtid ro 5 1 44 ~ 4), N Ch IP~IZ~ w - amount of cover = ~ 21 0 9'00S.c.~r,•~ ~i A) ~i _ i _ cv i ~ %Ak ~Itj L-'-, ion Required? Yes C No ( - - side for additional information. Date ` insepctor's Signature Cert. No (R.3/97) 'lit. 1 1 S-n 'fib -141 1~tf-(ds qv a dF 1~ -s-~ a ~~s, tr +s _5/776 nal s..,3 zM S`~ Oct L - -u 0 0 o c 3 a o C ~1 c 3 A Z M a (D M (D (D d ID T ' 3 r 3 C/); T. Z o CO Z (n $ Z o? Z to O O !~1 n (D O C n W C N W a CL N y w l a o N y w i-r _ nro ro 0 i O 1 J O W' M m m° to o I m not m > 00 0 ? N a m c o S C1 G' Cl 0 3 s o o y 1 0, H °o O h M N 0 N N y N~, C N c fD N) G N I 'O d to N ti W d Z y ID W CD > W o a o N cn I ti co roN o o a o R 0 , a Z Qoo a ro Fiz am o a' O i 00 N N S N N 2' N ro W O w W CD Sc? C' N aZ Z a 00, SOS SS0 = Z 0 0 S00 Z' O C j _h G 4 3 Z a 3 N to fA n 1 .mod. a CO) to to a j D Ig3 O P 'c 3g T' O o S ID ~e N ~ lD w N C GI b C d A I W I y o j ~ y o N ~ v N eD v l Z rr Z 7 o 0 I ii 7 p 0 I Er -7 0 7 ro' O Z O 7 v 7 J O 'O I R f D. O m v N o. m c CD X -n y 3< Q m N ro i N. 7 O ro N I C (D o p 3 C v fD W a a W ~ d O~ a O. 3 7 a N 3 =0 7 o o o Cn co o { si N C (D ro N C I 1 w n 0 63 a Gz0 v ro ~ W .v C= I Z N w V I m W C 0 (D s Z $ r: cn 3 N fA ;o d D p 3 o d o y i I roro I m a CD a m a a 3 R o a CD o a I H N CD co 3 I CZ I I ~ I 4 I i ~ I w , I I ~ A m a I A 0 0 I ro I N ~ 0p W '69 0 69 0 0 O Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings , in accordance with Comm 85, Ws. 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 Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Revi by ate Personal informati y provi a may be used for secondary Property Owner D r Loca on 2 Govt. Lot 114.5j, S T N R E (or) V 11 1a 6 I ~1 Property Owner's ng ddress WK 3 BI # Subd. Name or CSM# d, 70 i City to Zip Code (Phone N tuber . village wn Nearest Roa ) ZONING F GE _ - /J .5101 C ❑ New Construction Usk 'tesidential / Number of bedrooms Code derived des~n flow ate ~~r 6U GPD i~o Public or mmercial - Describe: Z42 l c.-R / V Replacement Parent material FJ ir-r i Flood Plain elevation if applicable ft. General comments ~S / ~,~f6.9 and recommendations: Sri,. V 5--We- Boring M # Boring Pit Ground surface elev/ i V ft. Depth to limiting factor t in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#1 -Eff#2 171 Boring lit Boring a Pit Ground surface elev&, 2 -ft. Depth to limiting factor/ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 "Eff#2 i / ~/v Gas- S / f^ S VKs- - 111,1,4 -7 Effluent #1 = BOD > 30 1220 mg/L and TSS >30 1150 mg/L ' Effluent #2 = BOD 130 mg/L and TSS < 30 mg/L CST Name (Please Print) , Signa CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 - p 715-246-4516 i T 7 t Property Owner _ Parcel ID # Page of Boring # Boring FN -Pit Ground surface elev.9 ft. Depth to limiting factor Z 1-') in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfff in. /M~unsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 ~3 r--- C rn sbl~ a!/ - a 3 AIJ4 P-1 Boring # p Boring A Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 /1- 4 Cy 059 01 = Fs" Zief 1 1-7 71 Boring # ~ Boring Pit Ground surface elev. Depth to limiting facto in. -7 LA Soil Application Rate Horizon Depth Dominant Color Redox Description. Texture Stricture Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 2- 3 - s i - s- U~ r C s Effluent #1 = BOD. > 30 < 220 mg/L and TSS >30 1150 mg/L ' Effluent #2 = BODS < 30 mg11 and TSS < 30 nVL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SB68330 (8.6/00) I Soil Test Plot PI Project Name Huntington Mobile Home Park S, , rd Address 1270 Cty Rd H New Richmond Wi 54017 STM #226900 Lot Subdivision Date 9/6/03 NE 1 /4 SW 1/4S 2 T 31 N/R18 W Township Star Prairie Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of nail in signpost System Elevation See soil test *HRpSame as Benchmark Alt. BM Top of nail in tree @ 100.0' Well 4 Existing Scale = 1/4 " = 15' System for different part of 5 trailer court Failed systems serves 12 m mobile home sites. One system serves 4 homes, another serves 8. Each site has a 2 bedroom or less trailer v 1 C CCD B-2 13 Alt. B.M. 98, B-1 O B-3 B-5 ❑ 97' N 2% B.M. ' Slope B-4 96' County Rd H 1 _a. \ -7;o- - o~ Jessie Nye Subject: S. Bird, Hunnington Mobile Home Park, 430428 Location: Star Prarie Start: Thu 10/16/2003 4:00 PM End: Thu 10116/2003 5:00 PM Recurrence: (none) Mark will do second inspection on Friday! 038-1008-30-000 02.31.18.23 1239 Cty Rd H III i it Safety and Buildings Division County 7 l to 201 W. Washington Ave., P.O. Box 7082, r N VISConsin Madison, WI 53707 - 7082 Sanitary Permit Number (to be filled in by Co.) (608) 261-6546 7)p t~2g Department of Commerce State Plan I.D. Number Sanitary Permit Appli - - raKS . In accord with Comm 83.2 1, Wis. Adm. Code, personal i format d D IZo$3 may be used for secondary purposes Privacy La s15.04(lxm) Project Address (if different than mailingaddress) 1. Application Information - Please Print All Information Property Owner's Name Parcel )~ieeicM cat'-so -0m Z Property 01wncr's M mg Ad& Property Location Gi J Section City, State Zip Code Phone Number c e) T Z/ N; J/E le W IL Type of Building (check all that apply) ❑ 1 2 Family Dwelling - Number of Bedrooms Subdivision Name CSM Number IICICOmmercial - Describe Use l(~ ❑ State Owned - Describe Use r ❑City ❑villag wnship o t u- -7 CLd III. Type of Permit: (Check only one box on line Complete line B If applicable) - A. ❑ New System Jaccment System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal 11 Permit Revision ❑ Change of 11 Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System; Check all that apply) Non -Pressurized in-Ground ❑ Mound ? 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At-Grade ❑ Single Pass Sand Filter ❑ Constructed Welland ❑ Pressurized In-Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel-less Pipe ❑ Other (explain) V. Dispersal/Treat -ent Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (st) spersal Area Proposed (so System Elevation '66& .J 7.z, 00 4 Lt/ VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks T ^ Septic or Holding Tank W4 aocl, z1/ Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the unde ed, assume resp asibili r Installation of the POWTS shown on the attached plans. Plumber's Name (Print) PlumbeA Signature MP/MPRS Number Business Phone Number Plumber's Address (Street, City, State, Zip NO VIII. Coun /De art " ent Use Only Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued I ui Agent Signature Stamps) Surcharge Fee) t C1 Owner Given Reason for Denial IX. Conditions of Approval/Reasons for Disapproval 3).6-V;5 SYSTEM OWNER: C0O 1 Septic tank, effluent filter and 1 dispersal cell must all be serviced / maintained , as per management plan provided by plumber. d.\1 IAA4 p 2. All setback requirements must be maintained 1 ~ s~ !\6e- as per applicable code/ordinances. Gem„ Attach complete plans (to the County only) for the system en paper not less than 8112 z 11 inches is size SBD-6398 (R. 08/02) i Safety and Buildings 4003 N KINNEY COULEE RD LACROSSE WI 54601-1831 TDD (608) 264-8777 .wis onsin.gov Visconsin www.commerce Department of Commerce www•wisconsi.gov Jim Doyle, Governor Cory L. Nettles, Secretary October 01, 2003 CUST ID No.226900 ATTN: POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING, INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/01/2005 Identification Numbers Transaction ID No. 920837 SITE: Site ID No. 665495 Huntington Mobile Home Park Please refer to both identification numbers, County Road H above, in all correspondence with the agency. Town of Star Prairie, 54017 St Croix County NE1/4, SWIA, S2, T31N, R18W FOR: Description: Commercial (Moble Home Park) In-ground Non-pressurized System Object Type: POWT System Regulated Object ID No.: 922017 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: General Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "In- ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD-10705-P (N.01/01). Co • The leaching chambers must be installed in accordance with the manufacturer's printed instructions, the plan approval and Comm 83, Wis. Adm. Code system sizing criteria. If there is a conflict between the f~ i ~ IIATl manufacturer's instructions and the plan approval, the plan approval and code requirements will take CE~ARTt: N OF precedence. ' FTI • The existing septic tanks must be inspected for structural soundness, size and baffles and must be brought into SEE CQ RE! conformance with the requirements of ch. Comm 83, Wis. Adm. Code. If they do not conform, a state approved tanks must be installed. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat • Comm 83.22(7) 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. SHAUN R BIRD Page 2 10/1/03 Y Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 275.00 -7 Fee Received $ 275.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789-7893 , 7:45 am - 4:30 pm Monday - Friday cbratz@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 s9~ sFA~ ~~F CoVer Page Fry o a BCp~ s Shaun Bird 4 Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date : 9/7/03 Owner: Huntington Mobile Home Park Location: NE1/4 SW1/4 S2 T31 N,R18W Star Prairie Cty Rd H System type: In-ground absorbtion system (conventional) Manuals Used: In-ground absorbtion system (version 2.0) Pressure Distribution Manual (version 2.0) Page# 1. Cover Page 2-3. Conventional System Plot Plan 4. Lift Station Cross Section 5. Pump Curve 6-7. Maintanance and Contingency Plan 8-10. Soil Test F CCjVj1ERCE Signature La.xcs License nu r 226900 'PONDEN PLOT PLAN PROJECT Huntinaton Mobile Home Park ADDRESS 1270 Ctv Rd H New Richmond Wi 54017 NE 1/4 SW 1/4s 2 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 9/7/03 GPD 3600 CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK I MOUND SEPTIC TANK SIZE 1-2000, 2-2000, 1-1600 gallons LIFT TANK SIZE 1368 gallon HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 7277 # of chambers 234 BENCHMARK V.R.P. Top of Nail in Sign Post ASSUME ELEVATION 1001 Filter Zabel A-300 ❑ BOREHOLE ve WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 92.2/92.0/91.8/91.6/91.4/91.2 Set @ 5' below qrade A6ng Standard Biodiffuser Leaching Chamber with 31.1 ft2 of Area Plans Designed Using Conventional Powts 1 " Manual Version 2 .0 Grade at System Elevation Well Existing for Scale = 1/4 " = 15' See adjoining different Failed systems serves 12 of plan part of mobile home sites. One 44 trailer court system serves 4 homes, m another serves 8. Each site has a 2 bedroom or less trailer To be insulated as per code v CD OSI Hydro- splitter B-2 6-3' X 244' Cells with >3' Spacing Alt. B. 13 B-5 B-1 p 2% B. M. R Slope B-4 I County Rd H Property Line Failed drainfield 2000 gallon tank 4 Trailer Houses Vent 1200 GPD 2 Bedroom or less Driveway Driveway To be insulated Inground Pressure System, not yet failed but near end of life 2-2000 gallon tanks F Tank is to be properly bedded and provided Area of 8 with lockdown covers trailer sites, with approved warning 2400 gpd, 2 labels bedroom or less v Huffcutt Combo Tank County Rd H To be insulated -C See other plot plan Scale = 1/411 = 15' Cross Section of Standard Biodiffuser Leaching Chamber Typical cross section for 2 of 6 cells Standard Biodiffuser Leaching Chamber with 31.1 ft2 of Area To be >1' above grade Finish grade elevation Typical Installation 97.0' Vent Vent Grade 4' 4" ~ 4 Ir~'3 /34 from hydrosplitter 1 " 4.5 6' Long 6' Long \ Grade at System Elevation 34" Grad~at System Elevation 34" Ud 74i~ ~IdV~ PSI S~ ~ Spacing 4.5' 6-3' X 244' Cells with Spacing Same on other end ri•'C, FTC i r :,.r Crcvl~c Observation tubeNent ~yc(a S~ l ffr 37.5' 244' 3%s 39 chambers per cell System elevations: A B C f/ D `)r E _A, L/ F z•d eal:aj Eo to 4oo ,09/30/2003 08:24 715-726-2549 S&B CHIPPEWA FALLS PAGE 02 Oren co SystemsJO Inc, Phone: 800-348-9843 • Fax: 541-459 2884 PRODUCT EXAMPLE , Model Ut,rlt, Description FC'.A 100 Plow Control Assembly, 1" diameter line, standard coupling ECDB IOOU Orifice Disc, 1" union diameter. blank FCDDl00U 375 Orifice Disc, 1" union diameter, drilled 0.31ti" Flowsplitter basins are used to split large variable flows, sttctt Its fluws from a dosinc siphon or return cttluenr Prom a sand filter. Effective on systems with low avuilahlc hcads, Also used fur level control in wetland systems. C'uslum configurations only. Call for more information. °~S; • Flowsplttttr Basin siphon to achieve pfuher dis• Hydrosplitter.c are used when dosing filtered effluent by pump or tribution of flow to gravity drainfield laterals of varying length. and/or elevatiMIS. Unaffected by settling ground, flow is pressurized to the Hydrosplitter and then flows by gravity to individual drainfield laterals. Fabricated with PVC components, each Hydrosplilter is dt:SQ-Med to meet the specific needs of a particular drainfield. Recommended minitntnressure 'u the llyclrn~ttlitt~ r Hydrosplimr is 2 feet, NOMENCLATURE Hsaooo.-oa-~ - DisLhar~. a line diameter: 10 l " , ]Number of outlet lines: U2=2 03 = 3 {y• 04 4 7 05=i 00 h 07 = 7 UK _K h" Q9-4 i 1U= 111 Manifold diameter: IM - I" lit) N ; ZM v, a. . llyJr unlrhncr a~~tmthly How To-SELECT A. Step 1: Determine the number of drainfield laterals. Step 2: Call Orenco Systems or your nearest distributor lcnr flow untro~l oh,o tti IficG sii.in PRODUCT EXAMPLE .h hlr del ('rrr/e De.wriptiun IISA1_5-05-10 Hydrosplitter, 1.25" manifold, 5 outlet;- I" diunleter disi.lhrrrc lnic" V Nair (udder//trhv,tplitlirurres.v enclosures and lidsavpur'arrlt. wimrlthawkItlrrlrv.rrttrti11ble. 1',I/l 1 Irnr inl,rrnrrurrur. Ii ,1~1 1,1000 Oreneo Systems` Inc. tntormlitton subject co change without notice P.r 1 y S£PT'IC iA2~K 6 PL?MP Ci.AMB£R CROSS 5£CTIO AND SP£C;r iCAIIc~NS ~nz~~ Ste' A 411 Cl VENT PIPE '12r MIN. ABOVE ~ ,~'NCT~u4 SOX A~FRt3V£~ > 25t FROM DOOR, ~'~A1I}0W OR 'WITH C~'ItivtliT MANHOLE 'COVER FRESH AIR INTAKE W/ PADLOCK E WARNING LABEL FINiSH£D GRADE -4,4- Kim. u y'•C. z. 4~Rwt%~- .r. a- u IN Is" ~IN. WE INLET f WATER 'L'IGHT SEALS GAS - TIG = VAPPiLd11ED g ' 7E+ A _ JOINTS VITH PROVED PIPE PIPPIPE 31 - - `TON 3SOLID XM O S I SOIL OA[YQLID C ' PUMP CSIE££Y -3 2rT. - OFF SOIL % . D ~ I 3 u APPROVED BEDDING UNDER TANK CONCRETE FAD SPECIFICATIONS SEPTIC f DOSE MIMBER DOSES PER DAY: 'TANK MANUFACTlJRER: DOSE vo:uj~FE INCIJIDING cam' CAL. rLp~nT$AC3C: GAL- TANX SIZESDL)SEIC GA:.. - V U ES - GAL. ALARM MANUFACTi3RER: ile--L S CAPACITIES: A g gNCFiES = GA,.. MODEL NUMBER: INCH SWITCH T: P£. d " ~ ~oC' C - INCHES ~GAL- PUMP MANUFACTURER: MODEL NUMBER : ~ d J- I NC ii£ S SNITCH TYPE: ffiR 1b.23 ~C RED:=RED DISCHARGE iiAl':: G_ p7uMF C ALARM WIRING AS PER :L _ 12i~E FEET F EET VERTICAL DIFFERENCE BETWEEN P'.73"iP OFF AND t~. fSTRIB;~T _ ~ _ 4--& FEET + P`tlNltit3'i NETWORK SUPPLY pR£SSUi'i ],QD-FT • FRICTION FACTOR - FEET = { • I'£.£T FQrtC£MAZN X ~ - - TOTAL DYNAMIC HEAD DIAMETER TAltic: s,IQU D INTERNAL DIMENSIONS. CF ?UK? L~~ LICENSE NUMIB£R = DATE= S iGi~fED: • • TOTAL DYNAMIC HEAD/CAPACITY HEAD CAPACITY CURVE PER MINUTE EFFLUENT AND DE4JATERING MODEL 152/153 W • x.41 MODEL 152 153 50 Feet Meters Gal. I Liters I G6. Liters 153 5 1.5 69 261 77 291 12 40 152 ~j 10 3.1 61 ` 231 70 265 a 15 4.6 53 201 61 231 a 20 6.1 44 167 52 197 _ 335 30 25 7.6 34 129 42 159 a 8 0 30 9.1 23 87 33 I 125 i I ¢ 20 - ~ 35 22 85 40 i 7.2 1 1 42 4 I j Lock Volve: 3a.0 Ft. (11.6m) 44.0 Fi. (13.4m) ousoa 0 2b 40 60 80 100 GALLONS LITERS 0 80 160 240 320 I _ 3 27/32 ~-~~-4 5/8 FLOW PER MINUTE I I / I I CONSULT FACTORY FOR SPECIAL APPLICATIONS 3 27/32 • Timed dosing panels available. e i • Electrical alternators, for duplex systems, are available and supplied with 3 27/32 an alarm. s i • Variable level control switches are available for controlling single phase T systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik-Box available for outdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. i 1521153 Series 12 I1/8 152/153 MODELS Control Selection Model Volts-Ph Mode_ Am_gs_ Simplex _I Duplex N152 115 1 Non 8.5 1 2or3 1/s BN152 115 1 Auto 8.5 Included 2or3 E152 230 1 Non 4.3 1 2 or 3 se<zow BE152 230 1 Auto 413 Included 2 or 3 N153 115 1 Non 10.5 1 2 or 3 8N153 115 1 Auto 10.5 Included 2 or 3 SELECTION GUIDE E153 230 1 Non 5.3 1 2 or 3 0E75 1. Single piggyback variable level float switch or double piggyback variable level float i 3230 1 Auto 5.3 Included 2 or 3 switch. Refer to F100477. o CAUTION 2. See FMO712 for correct model of Electrical Alternator E-Pak. All installation of controls, protection devices and wiring should be done by a qualified 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) licensed electrician. All electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). or (4) float system. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL T0: P.O. BOX 16347 L' - Louisville, KY 40256-0341 _ . 1. / ~ SNIP 70: 3649 Cane Run Road Manufacturers of. Louisville, KY 40211-1961 /y `aka a http:Nwww.zoeller.com PL/lL1P !O_ 1502) 778-2731.1(800) 928-PUMP QUGI7TY/~UMP9 /NCF /J O FAX (502) 774-3624 © Copyright 2000 Zoeller Co. All rights reserved. i i Page of _ POWt'S OWNER'S MANUAL & MAI1A SPE E~ C PL A SYSTF~ ! r~ ~!J FILE INFORMATION Septic Tank Capacity al ❑ NA owner k Septic Tank Manufacturer iC 11 t~n Pefmit Effluent Filter Manufacturer '2zc kil ❑ NA DESIGN PARAMETERS Effluent Fitter Model ft~ ' ❑ NA ❑ NA Number of Bedrooms Pump Tank Capacity ai ❑ NA Number of Commercial Units ❑ NA NA al/day Pump Tank manufacturer u Estimated flow (average) f 13 NA x 1 5) aVd Pump Manufacturer Design flow (peak), (Estimated ® S1 ❑ NA aVda 11f Pump Modal ❑ SoA Application Rate pretreatment Unit a Monthly average'nd/(3revel Fitter [I Peat Filter Influent/Effluent Quality Fats,. Oil & Grease (FOG) S30 mg/L [3 Mechanical Aeration Wetland en Demand (BODs) :220 mg/L [3 Disinfection ❑ Other. Biochemical OxYB ss s1 so m /L Total Suspended Solids (T ) t%ersal ufactrrer NA Monthly average❑ Celts} ressurized) Pretreated Effluent Quality -ground (gravity) ❑In-ground (p en Demand (BODs) 30 mg/L [3 At-grade ❑ Mound Biochemical Total Suspended Solids (TSS) 530 mg/L 13 Other. 10, cfu1100m1 ❑ Dri tree Fecal Coliform (geometric mean) 5Y inch diameter values typical for domestic (non,{) yasrater and Maximum Effluent Particle Size septic tank effluent « values typica► for pretreated wastewater- MAINTENANCE SCHEDULE service Frequency Service Event ❑ months ear(s) (Maximum 3 yrs.) At least once every volume inspect condition of tank(s) When combined sludge and scum equals one-third ya) of tank 3 yrs.) Pump out contents of tank(s) ❑ months %Jf:;war(s) Maximum PAt ast on=-4e"* Inspect dispersal cell(s) ❑ months rear(s) ast o nce every Clean effluent filter months ear(s) ❑ NA At least once every inspect pump. Pump controls & alarm ❑ months ❑ year(s) NA At least once every Flush laterals and pressure test p months ❑ year(s) ❑ NA Other At ie once every Other ❑ months ❑ year(s) ❑ NA At once every MAINTENANCE INSTRUCTIONS the following licenses or Inspections of tanks and dispersal cells shall be made by an individual carrying one POWI•S Maintainer, Septage certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector. of of to identify any missing or broken Servicing Operator- Tank inspections must include a visual inspection of the tank(s) hardware, identify any tracks or leaks, measure the volume of combined sludge and scum and to check check e ~f effluent k up evels or ponding of effluent on the ground surface, The dispersal cell(s) shall be visually inspected the in the observation pipes and to check for any ponding of effluent on the ground surface. The poching of effluent authority- ground surface may indicate a failing condition and requires the Immediate notification of m the to al regulatory When the combined accumulation of sludge and scum in any tank equals one-third on on th volume, the (X) or of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ch. NR entire contents of the tank 113, Wisconsin Administrative Code- retreat ment components; and any by a certified POVVTS Maintainer. The servicing of effluent filters, mechanical of 2 months or less shall be penisrnrforPed other maintenance or monitoring of completion of any service event A service report shall be provided to the local regulatory authority within 10 days START UP AND OPERATION for the presence of painting products or other the dsspersai cell(s). If high concentrations are For new construction, prior to use of the PO ores and treatment chemicals that may impede the treatment process septage servicing operator prior to use. have the contents of the tank(s) removed by a _ Page of surface- shall not OGCUf when Sal conditions are frozen at the infiltrative Yter is restored the excess System start up fill above normal highwater levels. When Po sand may result in the During power outages pump tanks rriaY dispersal cell(s) in one large dose, the the ceum tank removed by a wastewater will be discharged to the or surface discharge of efti3ont. To avoid this situation have e o n~ntad the umber or POWTS Maintainer to backup O for prior•trj i~°ring power to the effluent pump tank Septage servicing Pef~ controls to restore normal levels within the Pump . assist in manually operating the Pun1p park over, or otherwise disturb or compact, not drive or pack vehicles over tanks and dispersal cells. Doinaott ddriv absorption or area. t the area within i5 feet down slope of any mound or at-grade sot Reduction or-elimination of the following from the wastewater stream may improve the performance and prolong the fife of the POWYS: antibiotics; -baby wipes; cigarette butts-, condoms; cotton swabs; degreasers; dental floss; disinfectants; fat: foundation drain (sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oft Painting products; pesticides; sanitary napkins; tampons; and water softener brine. A13ANDONOMENT When the POWYS fails and/or is permanentlytaken out of service the following steps shall bte taken to Insure that the safety abandoned in compliance with ch. Comm 83.33, Wisconsin Administrative Code: system is properly and saffety a All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. Servicing Operator. The contents of all tanks and pits shall be removed and property disposed • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWYS falls and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: and may be u ❑ A suitable replacement-area has been a~lshoululd be prot tedbfrom disturbance and compaction and should not absorption system. The ed setbacks infringed upon by required will result in the n~ fora nepro w soLand site evaluation lines tion to establish a suitable structure, lot protect the replacement area will with the roles in effect at that time. replacement area- Replacement systems must comply failed POWTSng advances in POWTS suitable replacement area is not available a last resort to replace soil technology a holding tank may be installed as failure of the POWYS a soli and ❑ The site has not been evaluated to identify a suitable replacement area. Upon site evaluation must be performed to locate a suitable replacement area. if no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. removal of the biomat at ❑ Mound and at-grade soil absorption systems may be reconstructed in place following n effect at that time. the infiltrative surface. Reconstructions of such systems must comply with the <<WARNiNG>> RE O)CYGEN. SEPTIC, PUMP AND OTHER TREATMENT TKREATMAY CONTAIN LETHAL GASSES ME TANK UNDER ANY GiRCU~MSOTANCES~ DEATH MAY NOT ENTER A SEPTIC, PUMP OTHER RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAYBE DIFFICULT OR IMPOSSIBLE ADDITIONAL COMMENTS POVYTS MAINTAINER POWYS INSTALLER r Name ~ aN ENa, Phone - LOCAL REGULATORY AUTHORITY SEPTAGE SERVICING SOR PUMPER Agency r,. Name Phone Phone fdocufnent meets This document was drafted by the staffs of the Green Lake, Marquette and Waushara County Zoning and Sanitation agendas. This w does not ZOt) the minunum requirements of ch. Comm 83.22(2)(b)(t)(d)b(f) and 83"54(i), (2) & (3). Wisconsin AdminWraf~ Code. Use of this document GMyV ( guarantee the performance of the PaWTS. 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 mI f~-~'-ct residence located at: ~ J 1 C 4L~n~ Section 1- F, TN, RW, Town of 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: Did flow back occur from absorption system? Yes No (If no, skip next line) Approximate volume or length of Jtime: gallons minute s. capacity: 3 - Z rT-n~ l.~ccXX-~- tr-'L liC e~ ~ 1 Construction: Prefab Concrete Steel Other Manufacturer: (If known) :n Trb 6 Age of T (If known).: Z S C~51 "J (Si ature) (Name) Please print /1~1 & r_ b 06e) (Title) (License Number) Date or-m 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, W' Adm. Code (except for inspection opening over outlet baffle)., Name/ c*wGy\. J~ CJ Signature i MP/MPRS C ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM IV, OwaerBuyer~% • ~d~" Mailing Addresses ZO Property Address (Verification required from Planning Department for new construction) Ci /State Parcel Identification Numbe 23 LEGAL DESCRIPTION Property Location ,5 f c / r/4, Sec. 2" , T SIN-Town of ,lam Lot# Subdivision Cerhfied Survey Map # Volume g / Warranty Deed # Volume gL( , Page # { li Spec house ❑ yes;no Lot lines identifiable 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 fore, signed by the owner and by a mastorplumber, 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. Uwe. 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 da o e ear expiration date. SIGNATURE OF LICANT DATE OWNER CERTIFICATION the owner(s) of I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) 4p.crtydescribed above, by virtue of a warranty deed recorded in Register of Deeds Office. 3 O APPLICANT 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 a copy of the certified survey map if reference is made in the warranty deed i~.,>'..:x5ra~2s'ia7v~i'9~ .t T" • C R9S&"v`D'OR R"ORO'N6 04" • 9000MENT No. STATE BAR OF WISCONSIN FORM 5-19" PERSONAL REPRESENTATIVE'S DEED 445006 S41FAr,=166 REGISTER'S OFFICE ST. CROIX CO., W! 41 Raymond M. Nutzmann Recd for Record as Personal Representative of the estate of MAY .1 J ~9$9 Eleanore J. Nutzmann at 1; '43 A. M `A - ("Decedent"), for a valuable consideration conveys, without warranty, to oe~1lfMOfDa"~ i Raymond M. Nutzmann, an undivided one-half i; interest; and C)iarles W. Nutzmann, an undivided one'-half interest Grantee, n[ru"" to . the following described real estate in-._'...'___.'..'.'.."_ S t Cr o i x County, State of Wisconsin (hereinafter called the "Property") : Tax Parcel No: All that part of the Northeast Quarter (NE;) of the Southwe-c Quarter (SW;) of Section Two (2), Township Thirty ne (31) North, Range Eighteen (18) West, lying South d West of County Trunk Highway "H." The effective date of this deed is deemed to be January 1, 1989. This conveyance is made in final distribution of the above described real estate in the estate of Eleanore J. Nutzmann. Eleanore J. Nutzmann died testate on March 7, 1987, and the grantees in this deed are those people entitled to this real estate pursuant to the Last Will of Eleanore J. Nutzmann. Exempt $11 Personal Representative by this deed does convey to Grantee all of the estate and interest in the Property which a the Decedent had immediately prior to i~ec ` = ^°a '^rPre~+ in the Property which the Personal Representative has since acquired. Dated this .......1.70.1....... day of .....May , 18..a9.. re t .Y. ...----(SEAL) :r-~~. 177. )ft'~~./.1L-..~~~` •--•ss,^-s .....(SEAL) • ...Ray-mand..M _--dTut.zlaann Personal Representative Representative Y AUTHZNTICATION ACKNOWLEDGMENT f Signature (s) STATE OF WISCONSIN of Raymond M. Nutzmann ` _ ......................................County. - authenticated this 1-70ay Of....... Mdy 19.89. Personally came before me this ................day of 19 the above named t. E Orman TITLE: MEMBER STATE BAR OF WISCONSIN i (ZACtii6~Z xXS1X3iXX24iCXtG~.I4_. _ i authorized by § 708.04j, Wis. Stats.) who executed the to me known to he the person foregoing instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTEO BY G E. Nor_ma.fl . BAKKE, NORMAN & SCHUMACHER, S.C. New- Richmon-d, .WI . 54017. `ota-V F,:hlic County, Wis. (Signature; may he authenticated or acknowleel-zed. Both Nl:• Comm,-inn is permanent.:lf not, state expiration are not mrrP•~ary.) dater: 13 is 614--s or aianinK in any Capacity %I-,!'1 be typr•1 •.r r."n.ri .l i•I•... 'h•.r a- r Sr %T+ 6:.R OF w1.;e0x-iN FOR A No. i -1 J,2 Stock No. 13005 4:~ FIG RLIN¢, - a Q o ° I ° ° I ~ I . p 6 p °v3 a a o 0 o a) N cv o) a o aj c E co nr~ N N O 00O) O N of m~U E I N C c E j N c° d N co O. _ y C C .L-• N U tl C L ° C om ° z 8 3 a Q) Q) N .C a) C p m m N E> N E co 0 N N L '°-j N a 0-6 6 t y m a) 3 Vl C N° o m N - L O7 (n d L p mm w E m y Q) o o Zoe>=nEo) o~mm (r y~ O3Y 7 a°'D LL N N m C ~p z y N O N _N ~O m2 N o. o)°) a) O_0 m C Q) CU .0 ° V) C o a) .C C 'D o O U O a c z coa°izEEE c Z mo 'E o o Fu -°cxo U. 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N 'O M CO N N © Z Z S Z a Z o N i m z a E E M, }~y = CL m L ~i h a) ` I CLp G o a z 2 a *a o o o d ro • ry R m a n. CL a 0 v, 00 O O N _ ~ y fn J U ~ = O N } o o Cr O M Z U O O O _ E N ca Iola 'O d Q A JO N Oi O m 7 O N ~y o 3 w e ►~l 4 o t ° m a7 ~ v as cs d $ o 00 O N U C N N N C O p 0 'N c d ~ ~ 4.w O r E Co 0) M w C~ M O ty~, W nj 7 O Q N O a) U • ^^ll y'~,~' O O (:n Z M O Z n Z Y (n wc~y a+ ) Rt d N d 2 a • c~ d. m u m y c r.~ L = c w Property Line Ctv Rd H New Richmond WI 54017 wN Star Prairie COUNTY ST. CROIX Failed drainfield 2000 g Ion tank _ DATE 9/7/03 GPD 3600 Vent E --;NTIONAL LIFT )00( HOLDING TANK i gallons LIFT TANK SIZE 1368 gallon RPTION AREA 7277 # of chambers 234 Driveway ASSUME ELEVATION 100' Filter Zabel A-300 c Driveway - X2.2/92.0/91.8/91.6/91.4/91.2 Set @ 5' below grade Inground Pressure Plans Designed Using System, not yet failed 34, l Conventional Powts but near end of life v e ; Manual Version 2.0 Well O F Tank is to be properly bedded and provided Scale = 1/4' = 15' with lockdown covers m with approved warning Failed systems serves 12 labels mobile home sites. One system serves 4 homes, CCD another serves 8. Each site has a 2 bedroom or less trailer Huffcutt Combo Tank 6-3' X 244' Cells with >3' Spacing County Rd H B-5 C /I ~ a 2% Slope B - 4 Scale = 1/411 = 15' Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safeq and Building Division • INSPECTION REPORT Sanitary Permit No: 399439 GENrRAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s 15.04 (1)(m)]. 6 Permit Holder's Name: City Village X Township Parcel Tax No: Huntington Mobile Home Park Star Prairie Township 038-1008 30-000 CST SM Elev: p~ ^ / Insp. BM Elev: BM Description: - D - Z) TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS EL V. Septic Benchmark Dosing Alt. 8M 'l AeEgon Bldg. Sewer Nabdz~- G~ St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION 4^;- fe, TANK TO P/L WELL DG. Vent to Air Intake ROAD Dt Inlet Septic / Dt Bottom > ,I b Q 2 ~Sr i Dosing f i L( u a Header/Man. Aeration' Dist. Pi ~5 ~,,t~ 1.11 9o•~`fl Holding 5ot. System w 5 final Grade 460"t, so" PUMP ON INFORMATION Manufacturer Demand St Cover GPM 2•0ry0 7• q!;- Model Number .l~ 1 - p0 0~p , 3L H Lift Friction Loss System Head TDH Ft J (o I Forcemain Length I Dia. Dist. to Well \$0 SOIL ABS RPTION SYSTEM r WD(TRENCH idth Length No. f Tenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMERSTOW ~1 Z.C ID L SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING M cturer. t INFORMATION CHAMBER OR • 1-I • ✓av Type Of System: , ;Z Ofl UNIT Model Number. u DISTRIBUTION SYSTEM ~ (,s~,,f ~w,~• Header/Manif I Distribution x Hole Size x Hole Spacing Vent to Air Intake i IPipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth over xx Depth of Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil T ❑ Yes [W No r] Yes Vol No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:k0 /~31_/a Inspection #2: Location: 1270 County Road H New Richmond, WI 54017 (NE 114 SW 1/4 2 T3 N RI 8W) NA Lot 8.23 1.) Alt BM Description = -,&j prJUnx- Gam. ' ~ " 52" 2.) Bldg sewer length= - amount of cover = 3) 24& A - 30b Plan revision Required? ❑ Yes NO,`~j L, Use other side for additional information Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. See reverse side for i=ructions for completing this application PO Box 7302 14s COnSln Personal information you provide may be used for secondary purposes Madison, WI 53707-7302 Department of Commerce [Privacy Law, S. 15.04(1)(m)] (Submit completed form to county if not state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8-1/2 x 11 inches in size. County State Sanitary Permit Number ❑ Check if revision prvious application State Plan I Number G'~b g-fq:j35 I. Application Information - Please Print all Information Location: Property Owner Name tproperty Location C `d L l -XT As/4, /4, S , -,/~R E (o Property Owner' Mailing Addr W Number Block Numb r -Z, 70 l2T► City, State Zip Cadie P ne umber ubdivision Name or CSM Number CIS II. Type of Building: (check one) ❑ City Ile ❑ 1 or 2 Family Dwelling -No. of Bedrooms : ag wn of ;RIPublic/Commercial (describe use):_ ❑ State-Owned 11-5 L 3, k zec ` S Neare oad 2 5'3 CL"-,s Parcel ax r(s o 2 „ mil/ III. Type of Permit: (Check o one box on line A. Check ox n line B if applicable) , • $1 - 12-3 A) I. ❑ New 2. lacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System Permit Number Date Issued 11 A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) Et_ 4 -Soo 6f E. LAICe. on-pressurized In-ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In-ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At-grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate System Elevation 7. Final Grade Re ui d~ ~j31~ Proposed Ra (Gals./day/sq. ft.) (Min./inch) Elevation VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks /ZsQ n ❑ ❑ ❑ ❑ ,6_S 76 VIII. Responsibility Statement I, the undersigned, assume responsibility for insta do f the POWTS shown on the attached plans. Plumber's N e (print) Plumber's S' a (n stamps): MP/MP No. Business Phone Number ~~t~~ , ~ t~ G~4~ ~~C~' =off ~ Plumber's Address (Street, City State, Zi / . County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) g Approved ❑ Owner Given Initial Adverse Sur,7-15- e Fee) CD Determination 0$ ZGOI j, X. Conditions of Approsal /Reasons 1fy or D~is~ ppro_ nal: ~`=j~ `G L S~ r" • d"~ w~o~. ~N at~l`et^ S I s SBD-6398 (R. 07/00) _ J 4unlnftn Moble Hone p PLOT PLAN an~ DDRESS 1270 County / 4 § i /4S 2 Road H New Richrnor~ ~ 54017 /T 31 / 18 w TOWN Star Prairie ~ /R."'L S Shaun Bird 226900 COUNTY ST. CROIX 1 i CONVENTIONAL IN-GRO DATE 9/3/0 PRESSURE GPD 3900 CONVENTIONAL MOUND LIFT M HOLDING TANK i-- SEPTIC TANK SIZE 8000/1250 HOLDING TANK SIZE LIFT TANK SIZE 765 gallons DOSE TANK SIZE LOAD RATE -9 ABSORPTION AREA 4542 BENCHMARK V,R,P, Top of Well # of chambers 26~ 2.5 6 O BOREHOLE ASSUME ELEVATION 100 Q WELL .H R P Same as Benchmark Filter Zabel A-300 >12" SidewinderHi h SYSTEM ELEVATION 88.6 12"COmmercial Of Cover pacity ae Chamber g EX 1ST. 6' Long 16" INV.; 89.(0 m El Scale = 1/4, = 15' } SERVATIOMt/V r~N County Road H ENT rx 150, " IZ ABotq. CWA ~Rap~ D Site has <1% Slope, thus no contours can 0 0' B - 4 be established .w Vents are to be used as Failed system E ~ inspection ports ~ R r ~ D and will be Vent installed SEP - 5 2001 according to the - manual SAFETY & BLDG$ DIV. Plans designed using manuals Syrisvtae1mes0nVslte Wastewater Treatment 8-3' X 200' Cells ersion 2.0, SBD-10705-P 11o'Elilleliq F% with >3. Spacing (N.01/01) Well )rsion Alt. p B}. off" 8.11 .Onalty B6 Valve to divert C~dl~l B-1 flow to old system once R E system has ~p p OSI d ' O f ~OapN1ER0 ro Splitter N gu►W dried out ~ Not Tank is to be Building sewer properly bedded P0Sp~NGE going to 13 Huffcutt Combo Tank (IZSa) E GOR 13 unit mobile home unit trailer park Site manufactured Weiser 3 9 0 0 8000 gallon tank, baffles ST are in working order Safety and Buildings 4003 N KINNEY COULEE RD LACROSSE WI 54601-1831 / TDD (608) 264-8777 N*ionsin scwww.commercestate.wi.us/sb www.wisconsin.gov Department of Commerce Scott McCallum, Governor C Philip Edw. Albert, Acting Secretary September 24, 2001 ! x CUST ID No.226900 ,.:,.-TN: POW7S Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING, INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/24/2003 Identification Numbers Transaction ID .67484 SITE: Site ID No. 635812 Huntington Mobile Home Park - CTH H Please refer to both identification numbers, St. Croix County, Town of Star Prairie above, in all correspondence with the agency. NEIA, SWIA, S2, T3 IN, R18W FOR: Description: Commercial Non-pressurized In-ground System - 3900 gallons per day Object Type: POWT System Regulated Object ID No.: 811272 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: General Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "In-ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD-10705-P (N.01101). • The leaching chambers must be installed in accordance with the manufacturer's printed instructions, the plan approval and Comm 83, Wis. Adm. Code system sizing criteria. If there is a conflict between the manufacturer's instructions and the plan approval, the plan approval and code requirements will take precedence. • A Model A300-1206 Zabel Effluent filter will be used. Maintenance information mti§t be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • An OSI Hydro-Splitter will be used to help distribute the effluent to the leaching chambers. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Slats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. Note: The Huffcutt Combination tank can be buried no greater than 96" per the July 2001 Wisconsin Plumbing Products Register. SHAUN R BIRD Page 2 9/24/01 Owner Responsibilities: • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the at-grade component manual are complied with. A copy of the instructions and information regarding proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101. 12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 Gerard M. Swim POWTS Plan Reviewer - Integrated Services 608-789-7892 Mon - Fri 7:15 AM to 4:30 PM WiSMART code: 7633 jswim@commerce.state.wi.us cc: Huntington Mobile Home Park Safety and Buildings ' 4003 N KINNEY COULEE RD LACROSSE WI 54601-1831 TDD (608) 264-8777 Visconsin www.commerce.statemi.us/sb www.wisconsin.gov Department of Commerce Scott McCallum, Governor Philip Edw. Albert, Acting Secretary September 24, 2001 CUST ID No.226900 A7TN.• POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING, INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/24/2003 Identification Numbers Transaction ID No. 674846 SITE: Site ID No. 635812 Huntington Mobile Home Park - CTH H Please refer to both identification numbers, St. Croix County, Town of Star Prairie above, in all correspondence with the agency. NEI/4, SWI/4, S2, T3 IN, RI 8W FOR: Description: Commercial Non-pressurized In-ground System - 3900 gallons per day Object Type: POWT System Regulated Object ID No.: 811272 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: General Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "In-ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD-10705-P (N.01/01). • The leaching chambers must be installed in accordance with the manufacturer's printed instructions, the plan approval and Comm 83, Wis. Adm. Code system sizing criteria. If there is a conflict between the manufacturer's instructions and the plan approval, the plan approval and code requirements will take precedence. • A Model A300-1206 Zabel Effluent filter will be used. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • An OSI Hydro-Splitter will be used to help distribute the effluent to the leaching chambers. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. Note: The Huffcutt Combination tank can be buried no greater than 96" per the July 2001 Wisconsin Plumbing Products Register. r SHAUN R BIRD Page 2 9/24/01 Owner Responsibilities: • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the at-grade component manual are complied with. A copy of the instructions and information regarding proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, 01 FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 Gerard M. Swim POWTS Plan Reviewer- Integrated Services 608-789-7892 Mon - Fri 7:15 AM to 4:30 PM WiSMART code: 7633 jswim@commerce.state.wi.us cc: Huntington Mobile Home Park PLOT PLAN PROJECT iuninaton Motile Mme Park ADDRESS 1270 Gountv Road H New Richmond Wi 54017 ' 1/4 SW 114s 2 /T 31 ,18 , W TOWN Star Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 9/3/01 GPD 3900 CONVENTIONAL IN-GRO PRESSURE CONVENTIONAL LIFT XXX HOLDING TANK MOUND SEPTIC TANK SIZE 8000/1250 LIFT TANK SIZE 765 gallons DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .9 ABSORPTION AREA 4542 # of chambers 2% 2.5 6 BENCHMARK V.R.P. Top of Well ASSUME ELEVATION 100' Filter Zabel A-300 ❑ BOREHOLE WELL *H.R.P. Same as Benchmark 12" Commercial > 112" Sidewinder Hi SYSTEM ELEVATION 88.6 of aity ac g EX 1ST ChambeGRADE 6„ NV.: 6Scale = 114' = 15' 'Grade at System Elevation County Road H 0113SOwATtoo/VENT egreNbeb Site has <1% Slope, 150', W' ABOVE f;i+idAl. a gA(>F thus no contours can be established 600' B-4 Vents are to be Failed system REG ' D used as inspection ports Vents SEP - 5 2001 and will be installed SAFETY & BLOGS DI% according to the _ manual Plans designed using manuals Private Onsite Wastewater Treatment Systems Version 2.0, SBD-10705-P 8-3' X 200' Cells (N.01/01) with >3' Spacing n n Well Aft. O B~.$. p ; Valve to divert y flow to old B. 14@0 ~t~onlallY B- B-1 system once s iG 9system has OSI dro Splitter dried out be Nq? N; of ro~aeAE ~6 A Ir/ Tank is to be properly bedded Building sewer Huffcutt Combo Tank (1ZSa) D~NGC~ going to 13 Cpti, p~13 unit mobile unit trailer park Site manufactured Weiser home park GPD 8000 gallon tank, baffles 3 goo 0 are in working order .L } ~ ~ ~ ~ti, M. ~ i ,i • • 0 , . 1~t,SYtP Cf~i1~3F~i c1F~03o aycfi20N AND 3F7,3XF10ATIONS WITH ntSPT.= P111es yr~kTi11rR tRe+ a ?v~cet:oN AIY&itIt CRJ!>~t t?"` HiN~M.wr Internwl Tank Dimentions: PRWA POOR Length ,...._r„riuche+s Wt~c Dow OR PRO O ^1 N AiR t Width .....M..nohea 1nOhes Z.t u q r A~ltOVro LoaklNe o~b'MAX htANNrit dove R i I DEPTH of 80k%( OF w.%* 10 L.4:ei cillo t "TWA e ' ~ i ► s ~ ~~,TeNOiKs r A PR ROM ki" wMOSOUauo I Pump and Alarm are Separate circuits 4 l~uM/ vF~ e•Rrri► stack •VA t*r at.trl;~~ NNalta T~wIC 9At~~11.Vs Tank Marsutaoturer; jjL,;;P Nwnbaer of Donee :,r,2,,,,, peraay Gallons Pe* Aay/# of Dodgy s i t? „Gel. 57 Tank Si$e: Volume of Baakfloe Alarm i~lanufao tunnrar: UC.r- s q S4Y r;~-4 Total Dose Volume :..........p ft."i . Model Number: _ L1 r, CAPACITIES A ~ inahee or S Gallons Switch Typ+r: B inches or, Gallons Pump Mupnufacturer: - 1ti O inches tor„~?~,„~Gd7.lOna Model NumbersS _ D Inches or..~~tl'a~lon~s Minimum Discharge Rate:GPH Total. .....-~InChesz t;!allone Vertical Differenoe Between Pump Of'f' and Distribution Pip@:Feet li4nimum Required Supply Pressure: U +.12. Feet / ~C. Facet of rase riajn )e X~Fri,otion ftator/10o reet: Feat Porae Mai 2arietex; znohae TOtaI Dynsmic Head; ~ eat ~9 ff~ / 17 ya. t n ^4 Engineering Details • Performance D to 40 30 i Pum Characteristics I'MANOW va svWMlste 20 lR.erd Medleis sNl~o1111 S11M40112 Ag!g!g! A if SMF40A 1 SNIMU2 i0 4414 M few 12 ks beer 91WW rob 0 Q "A 1594 10 20 30 40 50 60 70 roes' is GPM n s 23o Total Head (fret) 10 1 17 21 23 26 90 SS Neli< 60 (m 120' f Mex. FMd Imp. t 1 A A QM (US 0PM) 70 60 80 40 30 20 10 0 letsAetl6n Close A sec) .4 ~ siee l yr Nr1• Dimensional Data 2i its. -Off At- - a c+ee.271 1. All dimensions in inches. (Metric for Fewer Cord 18/3, UMW 40' std e" 11771 international use). (S10' opttesei) sane 2. Ca"nenil dimension may Materials of Construction X42-1 1/8 inch. voyt ;re. I 3. Not for caeMuetfon purpose Alimb 91 oa M-49) ° unless terfifwd. FLO, MAN 1 FM s2ft --cog k" ~ a.OMNnlsiolts and weights ore approltialate. Aft Stw- lMed e~kel W Feeet t+ Oe/ta►aette S. We reserve the . right to make Sbaih s d sae! MS c;idrsrRted steel rrlv ~ ~ tlolts, .to our product gad thek ~ : spadflcGtimis•~►itheut natkpr itwre•N.: a a ~_.._.~.,,.4 r . Steel, ..+fi '"~",l~,,a' s~ raW .r. `fir n ~t + , j 0 1998 Hydrawfe Po", Ohio, % Rs O HYDRO MATIC ` - Y AAoi Luca) hl Ds 'll 1940 Roney Rood Ashland, Olio 4480S TW: 414.289.3042 Fox: 419-261.4067 f Web Site: w0W4pAlitelrpurnp.cotn S AIFS 0 ffKES IN ALL N1AJ0R CITIES AND COUNTRIES Refer to "Pumps' in the Yellow es of your phone directay ~ far your Iaa) Dirirr'betor Irern#: W-026660 1198 5M Mgr!? r Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the fitter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 Contingency Plan 1. If system fails, determine cause of failure, use altemate area and install new system or install system at a lower elevation. 2. Replace any other failing components as needed. Plumber: Shaun Bird 715-246-4516 fte A yo G r 1770A 66-",,0 71 a "O? et~ r J5 I'ye s 40~e 4-ee~ 71 , 3 Y6-Y6d10 Shaun Bird #226900 1 POWTS OWNER'S MANUAL & MANAGEMENT PLAN page, .4 ~ FILE I RMATION 8YWI M SPECIFICATIONS Owner ti ~r Septic Tanis lYrd a! d Ji Pen 0, Septic Tank Manuflsotur+er r- NA DI3$tON PARAM Effluent Filter Manufacturer U NA Nicobar of Bedla gMs ' ~{NA @Ithteet FNW Model o0 12 NA Numhel' of Gofnltlan~sl tJftits p NA Pump•Tw* Cape* 7 6 5"~ O INA Faiflrallebw ( } Pump Tank Manufacturer O paggn tiow awwft ~dmabd x 1.6) p~ M~ Soil AA!sudof► Rile aVd Pump MOM y O NA ktAuenMEmtrertt Qua ft Monthly average' Ri estrtrent Unit gyp, Fab, OA & Grease (FOG) 530 mg& O &md*rativel Fitter O Peat Fftw Bbtterl>foal n Demand (BODO x220 mgA. O MedtankW AsnOw C1 Wedand Total &APetxiad SMWs ITSS) 5150 131011. O DWIbe lots a Other. ftheabd EMuwtt Quadty Monthly average's oWparsel te(a) abchembW Oxygen Demand (SODJ 130 nrgll. (grw4 ty) O !n-ground (pressudzed) Total Suspended Solids (TSS) s30 mg/L O Al-grade 0 Mound FeCW Cotlforrn metric mean :Slw cfulloomi O Qdp4lne 4 Other': Maximum B&Mnt Particle we V. Inch diameter • Vsbm typaesaa for doenseea Qwft mmerddf wast~rabr arse ~ tank sgNrsfx. N Vaiuu typical for p Westsd WMW**er. MAMIW"CE SCHEDULE Scrubs Event Service Frequency Inspead condition of tank(s) At least once every 13 months jiil:.year(s) (Maximum 3 yrs.) Pump out contents of tank(s) When combined sludge and scum equals one-third (K) of tank volume /aspect coil(s) At bast once every 3 O months .year(s) (Msxlmum 3 yrs.) C19A11 ~t f1w At least once every (3 months .XfC Ws) - eh r mondhs aria) d NA controls & alarm At least once every Q C Ye Mllapect PPS pump O months O year(s) A Flush Mlbrab and prossure test At bast once every W.. At bast once ewary O months D year(s) A 06 otMr; At least once every O motes O year(s) Q:MA MAINTENANW VOMUCTIONS I cells shasq be made by an Individual carrying one of the foflowing Ncensos or Inspecdana of tllwriks rind dispersa r POVYTS MeinWner' Septage Plumber; Master Plumber Resblded Sewer' POWTS Inspect broken cam' Maw tndude a visual inspeedw of to elludge tank(s) to identl(y any m~n9 Or ryldltg Operator. Tank Inspections must and scum and to sheds for any back up ape. We* any am" or leaks. measure The dispersal oei(S)) shati be vh on inspectad to check the sfht+ent tide Of or pondlttg of &S AM on the ground surface an to g~ sue The PondkV o ►ativn p to check for any pondin9 of emuent of f the knot ~atpry WAhotity. in the the obe indicab a ~Ung oondwn and WF*es the Immediate natif[csdor► gmund suranface ~ arty ink equals are-third (9) or more of the tank volume, the NR When the oombined socumubtion of sludge and scixn to Operator end disposed Of In accor'd*r'oa vAth ch servicing peraattor enthae =ftnts of the tank shag Administrative C~ode. removed by a a5epcags . 113. Administrative S components, pretreat#maft components, and anY Of effluent filters, mechanical or pressurized PCNAIT by a OwdW POWTS Maintainer. } ssr+Aotng at intervals of 12 monlfis Or~ shall P' 0m'~ l other ~ or mo in9 au~ty,In 10 days of ~mpbtion of any service eve A s report shaft be gybed to the local ra~ulataY enoe of painting productsor other dons are START UP AND OPERATION cslI s if For new M, prior to use of the PODS cttecfc treatment tank(s) for the P~ consiruCl Im a the bvatment process and/or darrA servi 9 operator Prior to Use. chemk~ls OW then p detected have the contents of the tank(s) removed by a septa9 "System start up shall not oaax when soil'cundittons are frozen at the fnftltratfm surface. P"e Durinp power outa w hump tanks may !IM above normal highwater levels. Wbwn power is restored UM exoggs VJOAWNMW W* be dlronerQ" to the dieperaw een(e)>n am large doM gvmrlaaWng tM Oea(s) am may rlaaM in the baalaap or surface dhdwMe of e" To avoid this elhadion have the contents of /tie pump tank rOMOved by a ' Opatatlor Pd to -adm ktg P&' to the Nfluent pump or Contw a Plumber or Powra !Maintainer w assist In mstupl& oparating the pump controls to mar ore nomW levels wi tkt the pump tank, Do not drive or park vehicles over tanks and dl:persat cads. Do not drive or pack over, or WwMse disturb or compact, the arse S*dn 16 hat dawn slope of any around or at grade soft absbrpWn area. Reduction or.eftAr ation of the fopowtng foam the waebwralsr, strewn may Improw the pedWw ance and pm" the Qh of tfte P"CIWM N*bW ft baby %*w aiparMto butt; condoms; cotton swabs; degressam, dental floss; gore; dbinhobkf*K fat; liouridatibo drain (sump pump) water; fruit and vegetable peetkw; gasoane; greaser; harbioktes.- merit scraps; madodons; at poi nft pmduc* pe"oldes; sanitary napkins; tampons; and water sdlsner brow. At31WD0 . Wfwn the POWTS fob and/or is par meaermy taken out of service the fallo%4 a" am to taken to Insure Iftat the system Is p aps0l and satiety abandoned in compliance with ch. Comm 83.33, Wlsowisin /ldmkibbative Code: • AM p4ft bti tanks and plls else/! be disconnected and Ow abandoned pipe gmktgs sealed. • The comments of all tanks and pits shalt be removed and property disposed of by a Saplage 6ervbk>p Operator, • ARsr p n't*g, all tanks and pits shall be excavated and removed or their cotes removed and the void space tied w1h troll, gluvel or aft dw ktert solid material. CONTWO91W PLAN It the POWTS Wis and cannot be repaired the following mdesures have been, or must be taken, to provide a code oomplient rapFaoann "system: © A sWW* replacement area has been evaluated and may be ub"d fbr rte location of a replacement roll absorption ayvtem. The r0placernent area should be protacted from disturbance and compaction and should not be upon by requited setbacks from ex "N and proposed structure, lot Ines and wells. Faflure to PMW to reptaosmaat area will result in the need for a new soil and site evaluation to establish a suftable replacamment wea. Repfaoeatent systems must Comply with the rules in afW at that time. A VA" replacement area is not available due to setback aiWVm soil pmft dww. Barring advances in POWT'S tecI.nology a #toldirtg tank may be installed as a last resort to replace the failed POWTS. ❑ The sib has not been evaluated to identify a suitable replacement arelL Upon failure Of the POWTS a sal and she evaluation must be pedotmed to locate a suitable replacement area. If no repia0enwit area Is evafiabb a hoidkv tank may be lmatsMad as a last resort to replace the railed POW'TS. 0 Mound and stVrade soli absorption systems may be roconstrtx*d In place bilowhV remoVW of the blomat at the ktlNba" surface. Reconstructions of such systems must comply v ft the rules in effect at that tints. ~cWARNiNG>a SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL, GASSES, AND/OR WSUFFICW OXYGEN. 00 NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS P01M'S INSTALLER POWTS MAINTAINER Name Is 4CLI Name r j Phone ,-;7- -Z phone ? r SEPTAGE SERVK MQ OPERATOR PUMP LOCAL REGULATORY AUTNORITY Name EtE Pttorw J- 01 16' S1 y r- 3Y - 6 nh domwnsnt wee rlit W by the staft d the doer Wra. MaMushe and Wmatwe Coway zonbq and Saraooon gwidee. Thb documew mass dw miNrrrum n**w wnb O ch. Comm 4322('MX1t(dii(4 ww a&s4(1), (2) a (g), vl mwisM A#r,i *m)ve Cove, use d M document does not quarsnW the pwfomunce of the POWTS. Ca1NW f/01) OSI'Hydro=Splitter Orenco systems- (ncorWated 814 AIRWAY AVENUE SUTHERUN, OREGON 97479-9012 TELEPHONE: (541) 459-4449 FACSIMILE (541)459-2884 Effluent enters from the top (top picture) and pressurizes the manifold. In order to achieve the required flow to each lateral, PVC unions with properly sized orifices regulate the flow through each of the PVC flex hoses which connect to the drainfield lines. Engineers at OSI will design the Hydro-Spl(tter at no charge if the necessary field data is supplied. We have made up models with as many as 19 lines. Measured flow is usually within 10% of the design flow. A typical 3 line Hydro-SPlitter including a 21" diameter enclosure with fiber- glass lid is usually no more than $120. I A10 -12 x - Case Type VC = _ 1 1 1 • • • • • Package FP Filter • • • 111 By-Pass Protection (includes, Basin, Lid, Grommets, • •11 and Filter . •.111 • A30 -8x[ - Case Type Optional . . 11 BY-Pass Protection (iBLANK ncludes, Basin, Lid, Grommets, and Filter A A30 0 - 12 x L36 - - • . . 111 (in udes, Basin, Lid, Grommets, . 11 • , and Filter . ..111 TSS % BM GODS % Before After Reduced Before After Reduced Test Data Chart TN Tech'UniVersity'' `95.7 45.8 511.1 131.3 Kentucky Testing laboratory 93.2 31.0 66.7 To assist in selecting your effluent filter, wastewater Services ' 113 " sa.3' 2130 7 - a this test data chart provides valuable zaliel ` reference material regarding filter DNREC, Div. of 190.5 68.0 64.3. performance. Water Resources Zabel Proprietary 131.6 56.6 56.9 Please note filter performance is directly Test Program related to system use and waste strength. Range mgA. Range mgn % Reduction Without Filter With Filter Low End High End You may request a complete copy of the I ® research cited by calling Zabel. ,K en x> f `6o dyto New Mdgn~ rtese' `76 fb 1300 34 to 120 v5 3 G1sco s Mexican 96 to 1040 19 to 110 80.2 Gary Country Club 130 to 706 22 to 94 83.1 '86' Patio Restaurant 70 to 800 50 to 120 28.6 85.0 5 Wiscorin Department of Commerce SOIL EVALUATION REPORT Page of Divlsibn of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County c ~J Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must c~ ~fl include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Re sewed by Date Personal Information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). tJ O Property Owner Property Location 1/4s(,J114 S T 31. N R E (or O Pat Govt. Lot A/F Property Owrier's Mailing TO refas Lot # Bock # Subd. Name or CSM# 4,c ) 14 1- v city tats p de Phone umber City ❑ Village J~ Town Nearest Road New Construction Use: Residential / Number of bedrooms Code derived design flow rate GPD Replacement Public or commercial - Describe: 13 Aaf~ Parent material b~z~tiCca Flood Plain elevation If applicable k ~l 1? ft. General comments and recommendations: S Boring # Bring -pd Ground surface elev. ft. Depth to limiting factor in. Solt Application Rate 7a Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 - / S/2 •S' it L'~ ~ ~ 2 ad $8•• fo 0 Boring # ❑ Boring pit Ground surface elev~ 0 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 •Eff#2 y7 A/ Effluent #1 BODE 30 _220 mg/L and 7SS 30 150 mglL Effluent #2 BOD3 _ 30 mg1L and TSS _ 30 mg/L CST Na (Please Print) S at re J 3T Number J io~ell f74 Address a Evaluation Conducted Telephone Number SBD-8330 (1107/00) Property Omat Parcel ID # Page of Boring # ❑ Boring 3 O-Pit Ground surface elev. j~ft. Depth to Iimiting factor 1147-1 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 In. Munseli Ou. Sz. Conk Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 3~z s o~ni- C' . S , 7 //V o~ Boring # ❑ Boring Pit Ground surface elev. ft. Depth to limiting factor -in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 In./f Munsell y Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 w i Boring # ❑ Boring ~it Ground surface elev. ft. Depth to limiting factor in. J~Soli Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 In. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 r S ~9 Effluent #1 = BOOS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODY < 30 mg/L and TSS a 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SDD-8330 (8.07/00) ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address 2 Property Address (Verification required from Planning Department for new construction) City/State Parcel Identification Number 3 t~r / )O 9 ,3 0- b O LEGAL DESCRIPTION -2.3l. 19. Z3 Property Locatio'/,, ',i{, Sec. T N-R W, Town off Subdivision Lot # Certified Survey Map # Volume . Page # Warranty Deed # ~20d Volume Page # Spec hors Lot lines identifiable ❑ 7nb SYSTEM MARMNANCE Improper use and maintenanceof 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, restrictedplumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating oandition 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 r expiration date. S A-Mbi OF APPLICANT l(,/ 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 rty described shave, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT DATE Any information that is mis-representedmay result in the sanitary permit being revoked by the Zoning Department. Include with.this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is trade in the warranty deed Soil Test Plot Pla Project Name Huntington Mobile Horne Park Sh ird Address 1270 County Road H New Richmond Wi 54017 TM #226900 Lot _ Subdivision Date 9/3/01 NE 1/4 SW 1/4S 2 T 31 N/R18 W Township Star Prairie Boring 0 Well PL Property Line C t ST. CROIX BM or VRP Assume Elevation 100 ft. f System Elevation 88.6 *HRpSame as Benchmark It. BM Top of ell @ 100.3' County Road H Scale = 1/4' = 15' Site has <1 % Slope, 150' thus no contours can be established B-4 600 ❑ B-2 13 Vents B-3 ❑ Failed system Well It. 0 p B.M. ❑ ❑ B. B-5 B-1 Well Building sewer - going to 13 13 unit mobile unit trailer park home park ST Site manufactured Weiser 8000 gallon tank, baffles are in working order )OCUMENT NO. SPATE BAR OF WISCONSIN FORM 6--199 THIS SPACE RaaaRV[O FOR RE;ORDIHa DATA ` PERSONAL REPRESENTATIVE'S DEED 44SOOG "c: '~1P~~~1E6 REGISTER'S OFFICE Raymond M. Nutzmann ST. CkOIX CO., WI _ Recd for Record l _ as Personal Representative of the eztste of Eeanore J. Nutzmann Cl P9AY.19 19$9M - (:Decedent"), for a valuable consideration conveys, without warranty, to eoto ►of0 Raymond M• Nutzmann, an undivided one-half j inEeresE; and Charles W. Nutzmann, an undivided one-half---interest.......... - . Grantee, RETURN TO the following described real estate in St. Croix .County, State of Wisconsin (hereinafter called the "Property") : i Tax Parcel No: All that part of the Northeast Quarter (NE,) of the Southwe-c Quarter (SW;) of Section Two (2), Township Thirty ne (31) North, Range Eighteen (18) West, lying South d West of County Trunk Highway "H." The effective date of this deed is deemed to be January 1, 1989. This conveyance is made in final distribution of the above described real estate in the estate of Eleanore J. Nutzmann. Eleanore J. Nutzmann died testate on March 7, 1987, and the grantees in this deed are those people entitled to this real estate pursuant to the Last Will of Eleanore J. Nutzmann. Exempt #11 Personal Representative by this deed does convey to Grantee all of the estate and interest in the Property which ! the Decedent had immediately prior to __a ;ntPrect in the Property which the Personal Representative has since acquired. Dated this ....................1.7t day of May-y - - - - - - - - 41 (SEAL) `i.... (SEAL) ' ---Raymond.-M.... Personal Representative Personal Representative 'f. AUTHENTICATION ACKNOWLEDGMENT Signature (a) - STATE OF WISCONSIN of Raymond M. Nutzmann ss. - - -------Ccunty. authenticated this 17t_yay of~-........ , 19.8-9 Personally came before me this _ _.....day of ~-~-L . - • 19 the above named . G. E. Norman - TITLE: MEMBER STATE BAR OF WISCONSIN . . . (;CAibgyS. XX" XX S.; XX,IQf X `"9 IA... . authorized b Y § 706.06, Wis. Stats.) to me known to he the person _ who executed the foregoing instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY G. E.. Norman BAKKE, NORMAN & SCBUMACHER, S.C. New- Richmond,-.W_1.-_.54017---- - `"nta v P•:hlic County, Wis. (Signature. may he authenticated or acknowle•leed. Roth ommisvinn is permanent. if not, state expiration ire not n•:. accry,) fl:1tG r 1 J , ail -Names of persons a4.mR I. any cap-Ay eh-`hr typed -:4:..a• .r . c rrllRCr Sr%Tt. RAR OV K'1:1nN>tN SfOCI( M FOR1T No. , _ 1),x No. 13005 ~~1L n y 0 n N 0 o N O m o t7 r~ °c °c m f c c+ F , ° m o -0 1 m .may' M CD CD m 1 d ° 3 3 3 - l lot, 3 r 3_ -1 2 N Z O Z Z m c z ° Z z m N ° w Z Cn N W O m N O N C j O M N O 0) C j O N N CD C {y F7 W ° m rn o R 3 -0 Z o 0 3 CD a v N 3 1 a O ^ ° 00 > j m d3 c oo OD 3 m n O` CD N CD 0 COD. 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CD M N z v Z Z D-h 0 CD l = D co 0 CD O O -7 f WO CT O 0) -0 M Co Z D tD O (p O 7 n CD O C CD A. N S S O. N N S ~y CD ~ 3 Q CD N 3 ! 0 ° xk p O N 7 C s m a cn o CD 0. w m C7 a w 4x 3 m - Q. G d a O p 3 < N Cn C O ! ~7 0 a j n CD Z CL v A O m n~ 3 ,n 0 0 CD II < Z N rood R W~ m, ° a " z 00 3 Ch 00 3 a o j y OD N D A O N CD pOrow D 3 , CD~°°-v D 3 O X, CO d CD a N N (D CA C1 CD OR 3 C, c 3 F :E C) (o CL C, 0 CD pl0 ° G 3 ~.A +O <-n N"' O n O S°CD cn0 ~ N C ,7.N ox 3 C ~C~.O d C 7 A~ ~•CD O CL S 3° Q o ~ m 3 ED 0O N - S C O im N Q° x3 ! m a) (,(n to C 0 0 N DI Q O y CD n = N d D) _ C CD d fD O 3 7~, C p N K O" CD V CD d N D1 N ~ CD , 9 ^ CD X O C 'O y N ° X, 0) 'I A f c ° 0 CD (D =r CD = N 00 G ti n Cn O 'O ~ o nl O N j O 0) 01 CC CD V ODD A b O • O ~ II C D~q ONo OD N CD CD as f d V~ Plb 60 `"Wx ' NAME~ff~ AyUSINESS LOCATION ~o tp0j`41r street or highway city or township county OWNER_ Mailing address ARCHITECT OR ENGINEER Address PLUMBER Address { ii-r ~i'~ -~,it•~K A.~:-~~ , ,nom 1{ r ~ ~ 1. Check appropriate building usage(s) and fill in the information requested opposite I` each usage listed; Existing building New building _ Addition I If addition to existing building attach detailed memo for each. O Restaurant or dining room . . . . Seating capacity (10 sq.ft./person) O Motel O Hotel O Cottages Number of units; Regular Housekeeping 2 persons/unit 4 persons/unit TOTAL NUMBER OF UNITS O Bar or cocktail lounge . . . . . Seating capacity (10 sq.ft./person) Y f O Nursing or retirement home . Number of beds ~J(f Mobile home park . . . . Number of units - dependent - nondependent 1i O Service station . . . . . . . . Number of cars served (daily) O School . Number of olassrooms Meals served Yes No Showers provided Yes_ No O Factory or office building . . . Number of persons (total all shifts) O Residence Number of bedrooms O Other - specify 2. Indicate whether or not the following facilities are connected: Food waste grinder . . . Yes No v Dishwasher . . . . . . . Yes No X J Automatic clothes washer Yeses No-jU 3. Fill in the appropriate information for the following as indicated: n Septic tank capacity planned 2 C~2..-~ Normal septic tank capacity required 50% increase for FWG or IW Total septic tank capacity required Percolation test results - ATTACH P%FCOLATION TEST WORT SHEST Seepage trench bottom area planned = width V7442~*-flinear feet 06, depth -7 Seepage pit planned outside diameter . depth below inlet depth i ~d • r linear feet e Seepage trench bottom area required Twidth -:2 0 Seepage pit required outside diameter , depth below inlet Signature of pars completing form; STATE BOARD OF HEALTH, PLUMBING DIVISION P. 0. Box 309, Madison, Wisconsin 53701 Approved; . " i rI I. Q.r Ad a§`s• 41 Date Date OCT 3 0 1~ THIS A; PRCVAL IS EASED 0'1 STATE PLUMB- ING CODE REQUIREEMENTS AND DOES NOT EXEMPT THE INSTALLATION FROM CITY, VIL- LAGE, TO70'!SHIP OR COUNTY REGULATIONS OR PERMIT REQUIKi,iENTS. L f State of Wisconsin \ DEPARTMENT bF HEALTH AND' S©CIAl SERVICES' QIVISION OF HEALTH fttobw 201DISTRICT 7 OFFICE STATE OFFICE BUI1,D6NG TM WEST CL'AIREMONT' AVENUE EAU CLAIRE, WISCONSIN 54701, PHONE (71:5) 894-21231 A" *Atom" Iva" #1 R'~1wt> INOIIMiI~Ik ! wit"* "t"s" W"is 0aws" dim, p"4140 d",..:~l~.t AUle bow "*a t JavisA t tdw syseft ssrvft to w"t lbo rt e mid tit a is Uesm ` t p vi" % #011sag *igloo*. , app t b t it eftwu l taila+i with aft aqr . a 1 r ohm" f t~litYa t Nrt~ t srld t ""t"s 0 it e d skulAift *Llt be t"aft" to pef t t* m# tic self " . try l 1~r wait" rim 4*018" ftm am ftwim a#liur Awkd be l11r,tIrIGIi1i an " ripe` t w"Imay , u" Vii. "u). 8r Wit weft wat "****my p ."ptw"t to iood n 1MM~r~"00.' smsd#ay, -ban an ~ ~ 104018 i t o1r "s uttor A" the "ft a" ""M41 ! ois *91"0. 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IW a cwo l 0 CD r_ CD 2; a 0 CL r_ CL N3 O° = 0081 3 Oo CL ° m o c c=! 0 r N tai 0 N w w= 3- c °a o 0 3 0 0 o 0 00 33 o a3 (av) ca o a3 tnmmo D Z) CD =r A p l c e'p typ p N 7 3 O) (D N 7 m fD m a l o. d ` ~1 z r ~I z O ( 0 z O F D o m c~ z O 0 p f =r FF CD CD CD = c 3 y m c 3 M. o 5 m a Ln If m ! C.) m 0a w 903 m -=a a 3 5 a c' p 35 Z m m Z < m fn -i N 0 :3 c6 3 c6 pnj a v 3 n v A j co Z j N W A w m o I Q, a z ~ I m o 0 co rn m i o0XCO a a~m'mrnd a 2L 3 3 co, Co G) 0 w0 N T 01 C CD 3 v C CD 0 cp J- a a 0 Av CD o 0 m`==coed N 3 ° v 'OD ID CCo~3 m 3 oy m ~fc fwd' aPcx. a CO Nay S CD CDD d ti l N p~ N A w o 3 CCD x~JU v, ~CD g OCD y 3 I m CL . (A p~ CC N 52 °o o 0 0) Ol m oV l °d I -a' ~ A I ~ 0 o ry m (D j pn Oe CD 0 l 0 0 w v I oCD I o~ w APPLICATION FOR SANITARY P&iMIT for INSTALLATION OF A °FPTIC TANK (Sec. 144.03, VeTis. Stats.) A. 0v NF,R OF PROPERTY ~e. Addres ( tr et, Ci , , Zip ed r) ~f ` B. LOC JION ' F PgCP 'ZTY AfHER.E S 'PTIC TAP IS TC BP, INSTILLED Check 1. City Ma~ddre - Coun one: 2. + illage 3. ZTown ttj 'f C. IN'~TAIJ,7 . Give License nBer held: Wisconsin Restricted Licensed Sewer Plumber Services Name Address D. SP' CIFICATICNS OF {,PTIC TAIX Size in gallons: (check one) 1. A 1,000 Gal. 5. _ 4,000 Gal. 2. _+1,500 Gal. 6. _ 5,000 Gal. 3. 2,000 Gal. 7. If over 5,000 gal., give capacity. 4. `3,000 Gal. Materials: 1..LPrefab concrete 2. Poured concrete 3._Steel 3. TYPE OF OCCUPANCY 1. Sin<ple Family residence 3. Commercial establishment 2. Multiple family residence 4. Industrial establishment F. APPRCXIMAT U NUI4B --,R OF PERSONS S f RVED DAILY L G. PERCCLATICN TEST N1DE 1.[( Ye 2. No Date 147 ~ l By whom - r (To be completed by Count Cle k) Date a,plication is filed and ee paid fi Permit issued (date) / dl Permit Number sl l ~-A County1_ Clerk s Percolation Nate Minimum Absorption Area in Square Feet per Bedroom Minutes -iequired Normal With With With Both For Water to Fall Plumbing Garbage Automatic Grinder and One Inch Fixtures Grinder Washer Automatic Masher 2 50 65 75 85 3 60 75 85 100 4 70 85 95 115 5 75 90 105 125 5 - 10 100 120 135 165 10 - 15 115 140 160 190 15 - 30 150 180 205 250 30 - 45 180 215 245 300 45 - 60 200 240 275 330 60 - 90 240 290 325 400 I P l b 60'-~` y NAMMW $t3SI RSS LOCATION street or highway city or township county OWNER Mailing address ARCHITECT OR ENGINEER Address PLUMBER t ls" L Lcc-1.~ Address ''.7T 1. Check appropriate building usage(s) and fill in the information requested opposite each usage listed; Existing building New building Addition If addition to existing building attach detailed memo for each. O Restaurant or dining room . . . . Seating capacity (10 sq.ft./person) Motel Hotel Cottages Number of units; Regular Housekeeping 2 persons/unit 4 persons/unit TOTAL NUMBER OF UNITS Bar or cocktail lounge . . . . . Seating capacity (10 sq.ft./person) I K O Nursing or retirement home . . . Number of beds f v Mobile home park . . . • . . . . Number of units - dependent - nondependent n O Service station . . . . . . Number of oars served (daily) O School • Number of classrooms Meals served Yes_^ NoShowers provided Yes No O Factory or office building . . . Number of persons (total all shifts) O Residence Number of bedrooms Other - specify "t 2. Indicate whether or not the following facilities are connected; Food waste grinder . . . Yes No Dishwasher . . . . . Yes No X J Automatic clothes washer Yes X Nom U k3. Fill in the appropriate information for the following as indicated: Septic tank capacity planned t^No~al septic tank capacity -squired 50% increase for FWG or AW Total septic tank capacity required n Percolation test results - ATTACH PEFCOLATION TEST REPORT SHr-= Seepage trench bottom area planned width linear foot r , depth ~Y Seepage pit planned , outside diameter , depth below inlet depth ~QP / y Seepage trench bottom area required ~r cY d width Q , linear feet,/, Seepage pit required outside diameter , depth below inlet - Signature of pers9 completing form; STATE BOARD OF HEALTH, PLUMBING DIVISION P. 0. Box 309, Madison, Wisconsin 53701 Ad mess- Approved: Date Date OCT 3 THIS APP fi.0`JAL IS B ;SEO 04 STATE PLUMB- ING CODE REOUIR=-MENTS AND DOES NOT EXEMPT THE INSTALLATION FROM CITY, VIL- LAGE, TU4~1;HIP OR COUNTY REGULATIONS OR PERMIT REQUIRE-11ENTS. H/e 11 . z t7~ ` 'S l s ~ Q a, . A i C s y , tf ~ V y i uiOCT 01.,69 RATE s 53 THIS APM~ O~VA~ L IS PASED 0114 STATE PLUM S- WIS DEPT. 0; / 'l 1 CC, " TS `D GOES NOT CITY, VIL- ! ir' LAGF, State of Wisconsin \`DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH DISTRICT 7 OFFICE STATE OFFICE BUILDING 718. WEST CLAIREMONT AVENUE. tt A EAU CLAIRE; WISCONSIN 84701 vm er ,r,, ~7l 1 PHONE (715) 034-2931.. Bar. 'Jobs 111stsswa law IM6oute I~1 Riabwod, Nis. 54017 Dear Mr. Nutseians Attached is s report of a sanitary survey conducted at your mobile. how park on November 1, 1911 by a representative of this Divislon* - Recommeendations are outlined in the conclusion of the report. Those recaimeeendations are emade to insure adequate safety and health .pro- tection to your mobile holes occupants and are based on requiresnnts outlined in Wisconsin Administrative Code 977. Your cooperation is requested in mating our recommendations. If : you have say questions concerniog this survey report, please feel free to contact this office. Yours wry truly, Barold L. Moses, P.B. District Administrative Officer - JLJ:as attachment cat Robert Kill, 'Deputy Director, Bur, iav. Bea h Rarold Dauber, #t. Croix Co. Zoning 1dmilee. L f d t its; in, t '#r 3 3rd State of Wisconsin DEPRR-TMENT OF HEALTHAND SOCIAL SERVICES DIVISION OF HEALTH DISTRICT 7 OFFICE STAMOFFICE'BUILDING MOT OF A AWirk i SUVIRT 71.8, WEST C•L AIREK40NT AVENUE or "I EAV'CLAIRE,:.WISCONgiN 54701 "PHONE (7f5) 8.34-2991 MS= =0 ROM 91, OR RZIO 1lhe : fo1jwL & s a ° report of a sanitary survey of the faatlitios At 1ntNtb%ton X0b le Res Park, !Star Prairie township, St. Croix C+Memty. ft* sOMY V" too- Anted pavembe>r, 1, 1971 as part of the prop rams of MUSS MMYS Of Arils bom pe is Vithis,. the district. ) t ' Matiragtos M"ila 001" "it Donor is Mlame and Address-s Mr. John tlatsman Rt. 9 No Richmond Location of Parks W of Star Prairie in • the township of !Star Prairie ftsupoats of mobile boos* register with the park oMwer at. his tavern, Zjggs %U bark As toasted is are, area which to fairly well»drais , leers, is so Goom-lalation of storm voter or other drainage at the unit $Leos. lesinsd ,rat lA► Actual alas of park (in acres)could not be determined. It well saves are lMMlvrod bars, such, of which is wended. Capaaity of the 'park, 14 _:twesty oigbt (24) site$All ;its* were ocoupied at time of visit. , ftl a sia** vary is dept but are 60 11 wide and 801-1001 . d"p . Deite sbPt on .a drivesrap► sliplbtty In excess ' of !A' in width, sffordlft-le it W eacess to= all units. Driveway is not in good condition and tl►ltt portigro it aacass to farthest mobile bye was fowW almost Impassable because o! d~► rr~~lelart ftae a recent, fain. Driveway is to be repair" and kept 4 ' g+" bw" Oss litl►t is located above 441voMay near entrance and another apprrealt aV . half pse~ded. a~Irottrc: 'limit the dlstavat to a" of drOway* 1blieyved ibis so light - to shoalld be provided to illualsate entire driveway, Dries bock of the !call field wblob providos access to several units rails to met the Minimum 16' width sregpirswest and is In power to"Atios. 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K' i s o.• t•;c~:' ~ ~ Ar s`,l State of Wisconsin \ DEPARTMENT OF HEALTH AND SOCIAL SERVICES II DIVISION OF HEALTH DISTRICT 7 OFFICE January 15, 17/A-~r0 STATE OFFICE BUILDING 718 WEST CLAIREMONT AVENUE EAU CLAIRE, WISCONSIN 54701 PHONE (715) 834-2931 Mr. Harold Barber St. Croix Co. Zoning Administrator Courthouse Hudson, Wisconsin 54016 Dear Harold: After I received the copy of the violation notice that you sent to Mr, j John Nutzmann, I stopped at the mobile home park on January 13 to make a survey of the situation. I spoke to Mr. Nutzmann's son and he informed me that the problem apparently arose when mobile home occupants kept water running overnight to prevent any possible freeze-up. This, of course, would introduce an unusual volume of water into the system. This practice is being discontinued. There should be no freeze-up of water lines because they are wrapped with heat tapes and the mobile homes are all skirted at the base. The system has been pumped and there should be no recurring problem here. He indicated that you had a verbal agreement to extend the time for correction of this troublesome system. In view of the time of the year, I would feel that this is reasonable but we should watch this situation closely and insist that the work be carried out as soon as possible in the Spring. I will keep this matter in the pending file for follow-up. Yours very truly, Harold Naj t, R.S. Public lth Sanitarian cc: Eugene Hensel, P.E,, LaCrosse cc: Robert Hill, Asst. State Sanitary Engineer HN:aa I I o, f c ~o ~ a O a eD o A+ • M O .P Z C40 O O c 1 0 (D ca 0 44 <7 Z 0 14 Z OW, i4 9o p D. 7 W N W O p. N N M @ 0 G3 E CD 0 CO j d . o O CD M @ 00 el N O- O CT ? 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O° i N 5 09/09/2005 08:12 AM Parcel 038-1008-30-000 PAGE 1 OF 1 Alt. Parcel 2.31.18.23 038 - TOWN OF STAR PRAIRIE Current X] ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - NUTZMANN, RAYMOND M & CHARLES W RAYMOND M & CHARLES W NUTZMANN 1136 HWY 64 NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1239 CTY RD H SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 10.000 Plat: N/A-NOT AVAILABLE SEC 2 T31N R18W THAT PT OF NE1/4-SW1/4 Block/Condo Bldg: LYING S & W OF CO HWY "H" Tract(s): (Sec-Twn-Rng 401/4 1601/4) 02-31 N-1 8W Notes: Parcel History: Date Doc # Vol/Page Type 04/05/2000 620715 1500/390 WD 07/23/1997 841/166 07/23/1997 723/575 07/23/1997 453/381 2005 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/12/2004 Description Class Acres Land Improve Total State Reason COMMERCIAL G2 10.000 160,000 100,600 260,600 NO Totals for 2005: General Property 10.000 160,000 100,600 260,600 Woodland 0.000 0 0 Totals for 2004: General Property 10.000 160,000 100,600 260,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 0 CO) o yr 3 -0 on d r~ °c 3 ro ~1 T 7! 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CD U) CD N Q p) O cD O N -0 o a 5; CD 0 :3 N x :3 w 14 O O ~O (D CD 0p W R 40 O 69 0 ~v A O * O * CD M O L O 0 N t L - State'or T8consln ` Department of Industry, Labor and Human Relations Wst 2s 1982 SAFETY & BUILDINGS DIVISION Bureau of Plumbing 201 East Washington Avenue P.O. Sox 7859 Madison, Wisconsin 53707 Mr. John Nutzman Route 2 New Itichowtd, Wisconsin 54017 Dear Mr. Rutz n.* Re: Huntington Mobile Home Court Private, gage System SE 1141, SW `114, Secs 2s T31109 R18W Town of Star Prairie, St. Croix County, V1 A reinspection conducted on July 28s 1982, indicated the private sewage system serving the above building has not been corrected as per our directive of Ap ri l 6, 1982. tov are hereby directed to have the iastallatioi corrected to conform to the provisions of the Wisconsin Admintstrative Code and Wisconsin Statutes. 1. Partially treated sewage is ponding on the ground surface aear the septic tank. This is a health hazard and a (nuisance as defined in section 146.14 (1)6, Stats. The nuisance shalt he abated immediately. 2. The private sewage system is apparently failing and shall be corrected or its use discontinued as per the requirements of s. N 63.03 (3), leis. Arlo. Cade. Significant progress mast be wade toward completing the above corrections within 15 days of the date of this latter. Please notify Leroy Janskys On-Site Waste Specialist, 13 East Spruce Street, Chippewa Falls, Wisconsin 54729, telephone (715) 723-8786, for purposes of reinspectio,n. We expect fell cooperation is avoid any embarrassment or repercussions which ma result from legal action. YSincerely,, X71 Dome A. Strassman 3I M• Deputy Director DASf*1dh rya cc: ~I'haaeas Nelson, Asst. ZA - St. Croix County T Affidavit of Mailing DILHRSBD-6423 (N. 04/81) Wisconsin Department'af Industry, Labor Human :Relations P=1 INSPECTION REPORT` Safety & Buildings Division Bureau of Plumbing, Platting & fire Protection Nam o remises _P Date n o. Street 1_y oun Sanitary " ermrt Sf S~~~ S2 T~N P of Spay P2Ar2J s-,- cRoI as er Plumber Firm ame ess - Journeyman Plumber _Mdress owner ss tiJ U4T z "AAJ i i i I Discussed with 51 ginature :leached. , 6I92(N.09/$0) Signature o - Zs um in V. n e. a pec s pector Yellow-Local Inspector Pink4Plumber or Responsible Party:,.:-4reen- Vnner as rl (I r E i fr; n (Tl1 ra:>. i p,€F i. F " a j ..f . o._._.~.e.:..-a, ~ ...-wr-.. _swv~.. -...wir e--m...r m#nYf`aw+ -.m.tma~ - E t : F I P 1 _ I =w. ST. CROI X COUNTY ~~~`°2%y~v` W I S C O N S I N Z O N I N G O F F I C E 386-5581 Ex. 49 & 56 COURTHOUSE HUDSON 54016 May 7, 1982 Jim Sergent DILHR Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 Dear Mr. Sergent: Enclosed is a copy of the violations that have been sent to Mr. Nutzman for his trailer court. This problem has been going on for approximately one year or longer. We cannot seem to get the problem corrected, even with the assistance of our on-site waste specialist, Leroy Jansky, work- ing with the owner. Therefore, your assistance is re uested to alleviate this problem. Your truly, Harold C. Barber Zoning Administrator HCB:sl Enclosure I S E C 0 N U N O _'1_ 1 C L LETTER OF NO•IICL OF VIOLATION - Certified Mail/Return Receipt Requested DATE: May-6, 1982 John M. Nutzu►an R.R. 2 LOCATION: SE%4 of SWk, Se.ctlUll New Richmond, WI 54017 T31N-R18W, Star Prairie Township. uuav Mr. Nutzman As required under the ST. CROIX COUNTY 'l_O~JING u~:ulivAlJCI:, nog i - hereby given that you are in violation of Article _..._..6_ .1 tl"' ST. CROIX COUNTY ZONING ORDIA"CE. The violations noted are continuance of the n►a1Lu~►~ci.Utl1► S~.N_4~__.__ system. - and the following actions should be taken by.June 7~ lyt31 _ You must re lace the main sewer system b Jul 12~_ 0 Y1 ► _ fur stag: approval must be submitted to the state by June 7 _..__l_q}i2 , I The first violation is noted as having UcCUrr-Ld 5~i,ceui~~r Lei, 11~f1 and any Penalties provided for in the ST. CROIX C(JU1'4TY :'CMIAL UKI)111i NCF shall be applicable as of that date. Please feel free to contact this office, for wL Jr-L• <<va1-1,t1)11' 10 assist you in clarifying this matter. You s Lruly, / ( J J HAROLD C. BARBER Zoning Adn►inistr,tor NCti.sl CC: Town Clerk District Attorney l.vr oy luubky Statk• On Si i , W,jSj k• SI)L . I I • S E C O N D N O T I C E LETTER OF NOTICE OF VIOLATION Certified Mail/Return Receipt Requested John M. Nutzman DATE: May 6, 1982 R.R. 2 New Richmond, WI 54017 LOCATION: SE-4 of SW4, Section 2, _ T31N-R18W, Star Prairie Township. Mr. Nutzman Dear As required under the ST. CROIX COUNTY ZOL41NG ORDINANCE, notice is hereby given that you are in violation of Article 6.3 of the ST. CROIX COUNTY ZONING ORDINANCE. The violations noted are malfunctioning sewer system. and the following actions should be taken by June 7, 1982 The small system along County Trunk "H" must be replaced by Julv 121_82 _ By June 7, 1982 you must have contacted a certified soil tester and a licensed plumber to design your failing system, and at that time submit.___ plans to the state. The first violation is noted as having occurred_ November 25, 1981 and any penalties provided for in the ST. CROIX COUNTY ZONING ORDINANCE ~ shall be applicable as of that date. Please feel free to contact this office, for we are available to assist you in clarifying this matter. Your truly, HA~OLD C. BARBER Zoning Administrator HCB:sl CC: Town Clerk District Attorney Leroy Jansky, State On-Site Wastr. Specisii_,i 77 w. ! A • - .r . JAS . F F r Street sAfffit Ld f ~ ~YS 1030. Davis 7962239 , R, *pril 6-j'- 11.9 8 2 - k. s " Vern Valson tK . it ♦ "R i ~ k Star Pra3.rie, WI 5406 .r.~ a bear Vern : A On April 6, t he State ` 11 Site , west, S.p a G'i$; M tA_ and-.myself w*rc up at the Huntington. Tralor Park. Th.o;it s.ege diOposal s►atem Is fa311 Inclosed .1s a,;copy Hof the state' 0rdeIr0 - ur8 trurtx 'fihormea `C.. IQ.elw_6n . Axal-*-tint `Zoniaj Adz ntittr•a'9J TCN:sl ,r Eta lcsure s a,. £ y i x.. s v ?7~ ~Zi rip- v A-Y I "r. , i Y F . { l *t`~Y x I~[6Y~ 7 a 3V ~ti Oct C{' J If t ct Jl, k.: t ~ a T~: xy', ' j" s il.~ t IJ ~(c .i-5i• kr~'1.~~, ~ h'-p~~.~I~"j A~~~j~t "~~i 1 '~.-r'y~ ~r., r ~ z n~ yam.. `•s {I'~=~ ~ ~ ~s;; ~'T9~ ~ SII'~~ xd:s~y zN+' ~Fj*:Sc , 74 t ;~r ; a '~•Ci ~ A`Y' ~ S'' vi ~ i j t ~ i ~ s ~ ~ >.,8-c~ ~ ~i~ V f r`t. y y > ? 1, l ~'3 IT. i w IN Ail i,4~ c r~, - _ "3.. f Sri.. ~ 3.~, Y ~ c e S~ . •24, t.N"_ A. G 4~ `~`_j~i'1 J 3F 3!' fil Tip' L_ F j ~ c ] ~ ,•L~ ,F[ '~R~ ~ ~ ! eK a E& g4~ 't N yak ~ Plb. t-A WISCONSIN DEPARTMENT OF HEALTH & SOCIAL SERVICES Division of Health Section of Plumbing & Fire Protection Systems y ON-SITE WASTE DISPOSAL INSPECTION REPORT Name.of Premises Street city County _ Master Plumber Address .-r I Owner Address . ❑ County Permits ❑Appropriate State Permits Typeof Building:. Public ' ❑ Single Family or Duplex CHECK APPROPRIATE BOX FOR VIOLATION TYPE OF TREATMENT SYSTEM ❑ Building Sewer ❑ Conventional Soil Absorption System ❑ Septic Tank ❑ Conventional System-in-fill ❑ Holding Tank ❑ Alternate Mound System ❑ Seepage Bed ❑ Holding Tank ❑ Seepage Trench ❑ Seepage Pit ❑ Experimental System BRIEF, FACTUAL COMMENTS AND SKETCH: _F T ~m 3 i 1 t _ r ( f1 i 4 i 4 SEE ATTACHED DISCUSSED WITH PLUMBER ( Yes 1 } No SIGNATURE (Voluntary) DATE OF INSPECTION Signature of Inspector White - Inspector Yellow - Local Inspector Pink - Plumber or Responsible Party INSTRUCTIONS TO SENDER: 110 9 2 6 6 INSTRUCTIONS TO PERSON ADDRESSED: REMOVE YELLOW COPY FOR YOUR FILE. WRITE REPLY AT BOTTOM OF FORM; REMOVE CARBON FROM FORM. SEND REMAINDER OF FORM INTACT WITH CARBONS TO PERSON ADDRESSED. RETURN PINK TO SENDER, RETAIN WHITE FOR YOUR FILE. REPLY MESSAGE STATE OF WISCONSIN FORM AD-16 FROM JOHN R. GRUMP SUBJECT DEPT. OF NATURAL RESOURCES UNSAFE WATER SAMPLES AT HUNTINGTON 1621 WESTGATE ROAD TRAILER COURT EAU CLAIRE, WI 54701 TO-. Phone (715) 886 2862 MR. TOM NELSON P.O. BOX 227 HAMMOND.. WI 54ol5 DATE DECEMBER 15, 1981 MESSAGE THIS CONCERNS OUR CONVERSATION ABOUT THE UNSAFE WATER SAMPLES AT HUNTINGTON TRAILER COURT. THEY ARE REQUIRED BY NR 109, WISCONSIN ADMINISTRATIVE CODE, TO COLLECT MONTHLY BACTERIOGICAL SAMPLES. MR. NUTZMANN'S MONTHLY SAMPLE IN NOVEMBER WAS UNSAFE TO THE COUNT OF 25 MFCC/ 100 ML. THIS SAMPLE WAS TAKEN 11/3/81. A CHECK SAMPLE WAS TAKEN BY ME ON 11/9/81. THIS WAS ALSO UNSAFE TO A COUNT OF 22 MFCC/ 100 ML. ON NOVEMBER 12, 19812 MR. NUTZMANN DISIN- FECTED THE WELL AND WATER SYSTEM. ON 11/13/81, I TOOK ONE SAMPLE FROM THE WELL AND TWO FROM THE DISTRBUTION SYSTEM. THESE SAMPLES WERE LOST IN THE MAIL. ON 11/16/81 I RESAMPLED AND THE RESULTS WERE SAFE. I TOOK FECAL COLIFORM SAMPLES TO TRY TO IMPLICATE THE SEPTIC SYSTEM, BUT THESE CAME BACK NEGATIVE. WE EXPERIENCE SPORATIC UNSAFE CONDITIONS IN PUBLIC WATER SYSTEMS THAT ARE NEVER RESOLVED AS FAR AS CAUSE AMID EFFECT ARE CONCERNED. THIS APPEARS TO BE THE CASE AT HUNTINGTONIS. IF YOU WOULD LIKE FURTHER INFORMATION, PLEASE CALL OUR OFFICE. SIGNED REPLY DATE NO REPLY NECESSARY SIGNED THIS COPY FOR PERSON ADDRESSED Ne. k r, s . . - g!'.:. t.i-iTTER OF NOT I CC OF V I OLAT I ON Cart i t i.ed Mail/Return Rece-i-pt. Requested John Nutzman DATI?: November 25,- 1981 R.R. 2 New Richmond, WI 54017 LOCATION: 40of_ SW_i_ S_c.tiun 2, 'i'31N-R18W. Star Prairie Tuwaship. Dear Nut2tn:►u As required under the ST. CROIX COUNTY ZONING ORDINANCE:, notice is hereby given that you are in violation of Article '6~; iQ11 A Z Lhe ST. CROIX COUNTY ZONING ORDINANCE. The violations noted are failure of ry Rolla - _ _ - - and the following actions should he taken by You must have state and _ c o u n t_y_ ap p r q-y a 1 -j y_c1_u r__sanita r_ - y t~uU. _ _ I n s t a l l a t i o n of the system s h Y 1 1 Ja_~ ~Q m y lc~ t o d__ _h f .Ma y_ 1`382 The first violation is noted as having, occurred~y~mhar_19T_~_aszi and any penalties provided for in the ST. CROIX COUNTY ZONING ORDINANCE shall be applicable as of that date.. Please feel free to contact this office, for we are available to assist, you in.clarif.ying this matter. Yours 'ruly , /It~ROLH C. BARBER Zoning Admi_n.i st ra tor HCfi:sl CC: Town Clerk District Attorney Leroy Janaky} state on-site waste Sl,e, iA1 ir.1 X / 4. fRI ` i t' r- a LETTER OF NOTICE OF V I OLAT cUN Certified Mail/Return Receipt Requested lolm M. Nutzman DA'I'S:.. R. R. 2 New Richmond, WI 54017 LOCATION: Dear Mr. Nutzman As required under the ST. CROIX COUNTY ZONING ORDINANCE, notice is hereby given that you are in violation of Article __h__A__ of Hic ST. CROIX COUNTY ZONING ORDINANCE. The violations noted are__ tai i i ng e4_L1L-_syst-e» -as nn t p-d bLy __L:111.urul seeping to the s,irfaij, through- rnad pavement_-_I11L9al_--pt1.m)-1a4g--fir ~sPwaee nnto prnPP r ty ad jar Pnt -I-u- trailer .t.Jc.-_ and the following actions should be taken by jj.Ly_5_T--'-~8' Correct failing system h; rnniac ti_. n_~alicau--Ad_+-Iumb P1! aping The first violation is noted as havi ni occurred _$uptem6er _21.__l4til and any penalties provided for in the ST CROIX COUNTY ZONING ORDINANCE r shall be applicable as of that date. Please feel free to contact this ottice, for we are available lo assist you in clarifying this matter. You s truly, j /AKOLD C . BARBI-:R Zonirip, Administ ra[or- HCB:sl cc: Town Clerk District Attorney Leroy Jansky, On-site waste specialist Harold Dahl, Env. Health Specialist ~.r,p~r•~n.r ;;t ~ q. ,mot • x. a ' key. < v.' ` t t N Single Family or Duplex OF TR4 WENT SYSTEM +Fs 1 1 1 ♦ r yst , n . r :i6x'J1 k I r po- vim V :~rE t9L~,:pn. e 4 l Y+ V 1 r t l mm 'tr, per! M O e ,c ARA + I VII I A:t r 41 ;k ryt# t: ho I. PP w ~ I r State of Wisconsin DEPARTMENT OF NATURAL RESOURCES West Central District H adquarters 1300 West Clairemont Avenue Carroll D. Besadny Call Box 4001 Secretary Eau Claire, Wisconsin 54702-400.1 October 5, 1981 File Ref: 4410 RFC ~ Mr. John M. Nutzmann Little Johnnies, Inc. ~1 IAN/ps 98, f Route 2 New Richmond, WI 54017 Dear Mr. Nutzmann: Our office was recently informed that you are improperly disposing of septic tank wastes near a mobile home park in T31N, R18W, Section 2, SEk, SWk, Town of Star Prairie, St. Croix County. An inspection of the area was conducted on September 21, 1981, by representatives of the Department of Natural Resources and the St. Croix County Zoning Office. It was determined that the area violates, at a minimum, the following provisions of State Administrative Code NR 113: Disposal of the waste was on land with a slope greater than 12%. The waste was allowed to flow in a dry run and travel several hundred feet. The disposal area is within 1000 feet of numerous residences at the mobile home park. There was evidence that the waste was allowed to stand in open pools. This letter is to inform you that use of the disposal site and practices described above must be discontinued immediately. Failure to do so will result in the initiation of legal action. All disposal sites used in the future must' conform to the requirements stated in Chapter NR 113. If you do not have a copy of the code or need 'assistance in interpreting the requirements, please call me at 715/836-2948. Si cerely n n re R. Miller Chief, Solid Waste Management JRM:dd cc: Bureau of Solid Waste - SW/3 Stan Schneider - Willow River State Park Tom Nelson, St. Croix County Zoning Office, P.O. Box 227, Hammond, Wisconsin 54015 Jack Tritt - Eau Claire Area I.OCATION_ Section eL Lot # Subdivision SEPTIC TANK Size gallons Number of compartments Distance from: Well Building 12% slope _ Highwater____ PUMPING CHAMBER Size- gallons Pump Manufacturer V ----Model Number HOLDING TANK Size gallons Number of Compartments Pumper Alarm System Distance from: Well Building 12% slope Highwater ABSORPTION SITE I Bed Trench Distance.from: Well Building _ 12% slope____ i Highwater ABSORPTION SITE DIMENSIONS Width of trench It Required area ft. Length of each line ft Depth of rock below tile in. Number of lines Depth of rock over the in. Total length of lines ft Depth of tile below grade in. Distance between lines ft Slope of trench __in. per 100 ft. Total absortption area ft Type of Cover: PIT DIMENSIONS Number of pits Gravel around pits yes- no Outside diameter ft Depth below inlet ___ft Total absorption area ft Area required ft INSPECTED BY TITLE _ APPROVED DATE 198 _ REJECTED DATE 198 REASON FOR REJECTION D9PAR.TNIENT OF APPLICATION ' SAFETY & BUILDINGS INDUSTRYt FOR SANITARY DIVISION LABOR AND PERMIT P.O. BOX 7969 HUMAN REt.ATIONS (PLB 67) MADISON, WI 53707 Attach plans for the system on paper not less than 8'/i x 11 inches in size. Include a plot plan that is dimensioned or drawn to scale. Horizontal and vertical elevation reference points must be shown. All appropriate separating distances and physical characteristics as specified in chapter H-63, Wis. Adm. Code, must be shown. An index page or each page must be signed, sealed and dated by the designer. If designed by a Master Plumber, the date, signature and license number must be shown. The owners copy or a legible reproduction of the soil test report must be included. Property Owner: 7iling Address: S .G n Property Location: r City, V' )age r To ip: ~ County: % SIJ1/4S I /T .3 j N/R ld EJW W l e~~ ~ Lot Number: Blk No.: Subdivision Name: Neare Road, Lake or andmark: State Plan I.D. Number: (If assigned) TYPE OF BUILDING Number of Public* ❑ Variance* *Other (specify)* 1e e4 4t I' Bedrooms: 1 or 2 Family *State Approval Required. Q l uJ G Y/ / l TOTAL NU BER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify) SEPTIC TANK CAPACITY HOLDING TANK CAPACITY LIFT PUMPTANK/SIPHON CHAMBER MANUFACTURER: EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): ❑ New ❑ Replacement ❑ Experimental ❑ Seepage Bed ❑ Seepage Pit ❑ Alternative (specify) ❑ Seepage Trench Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner): PGr Private ❑ Joint ❑ Public I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Noa of Plum er: Sign at MPANPR9Y"U.- Phone Number: <c b 3 eo Plumbe 's Address: f t Name of Designer: !z P r ~ ~s 5 SLa ~ .40 COUNTY/DEPARTMENT USE ONLY ignatur of Issuing Ag t: Fee: Date: y. APPROVED Sanitary ~e it Nu ber: O rJ~ D "~7-p ❑ DISAPPROVED as n for Disapproval: Alternate course(s) of Action Available: i Change of ownership, building use or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to in- stallation. Failure to comply will void the sanitary permit. DISTRIBUTION: White-County, Canary-Bureau of Plumbing, Pink-Owner, Goldenrod-Plumber DI LHR-SBD-6398 (N.03/81) 4 • I~ 1 I QIr ON } fit I ~ q _ - - - DISPOSAL INSPECTION REPORT ON-SITE WASTE ~,al Name of Premises i ~C tY , Street r city County MY' Master Plumber Address Owner Address ❑ County Permits ❑ Appropriate State Permits - Type of Building: ❑ Public 1- ❑ Single Family or Duplex CHECK APPROPRIATE BOX FOR VIOLATION TYPE OF TREATMENT SYSTEM ❑ Building Sewer ❑ Conventional Soil Absorption System ❑ Septic Tank ❑ Conventional System-in-fill ❑ Holding Tank ❑ Alternate Mound System ❑ Seepage Bed ❑ Holding Tank ❑ Seepage Trench ❑ Seepage Pit ❑ Experimental System BRIEF, FACTUAL COMMENTS AND SKETCH: . i ~ t r r a 3 1 1 f _ 1 „ a 3 _ t € { f t 3 , r 1 F f i 77 , i E t .L, . t 1 r i r I , ' E ~ E I ❑ SEE ATTACHED DISCUSSED WITH PLUMBER ( ) Yes ( ) No SIGNATURE (Voluntary) DATE OF INSPECTION f Signature of Inspector , White - Inspector Yellow - Local Inspector Pink - Plumber or Responsible Party DWNER , TOWIvSHI~` SEC. T N, P.O.' ADpRI:SS Z , ST. CROIX COUNTY, WISCONSIN. SUBhIY~S20NOT LOT SIZE I 09:z a, PLAN VIEW Distances 6 dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM (A Ilk W ~ to ~~~rc Ti¢N ~ S r >EPTIC TANK(S)MFGR. E • ~CONCRETE~ STEEL NO. of rings on cover Depth' JR11 DRY WELL DRENCHES NO. of width length area 3ED no. of lines_ width length area - depth to top of pipe :30 1, ,GGREGATE ~ 'ERK RATE AREA REQUIRED,-,I ,/'AREA AS BUILT ;E 6 I - _ ;7, )isclaimer: The inspection of this system by St. Croix County does not imply complete :ompliance with State Administrative Codes. There are other areas that it is not possible ':o inspect at this point of construction. St. Croix County assumes no liability for system operation. However, if failure is noted the County will make every effort to tetermine cause of failure. ;LEASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. IN TOR DATED PLUMBER ON JOB LICENSE NUMBER z REPORT OF INSPEC11ON INDIVIDUAL SEWAGE SYSTEM Sanitaxy Penm.it 3- • Sate Septic J Tawnbhip'dC,=;v Cnoix County NAME Section SEPTIC TANK - Size eV e gattona. Numbers o6 Compaxtmen.tb U.istance Fxom: WetL 12$ on gxeatex mope jt- Bu.i.Ld.ing it. Wettand,6 ~ . H.ighwaxex a it. DISPOSAL SYSTEM . D.i.4zance Fhom: Wett 5#. 12$' on gxea#ex a.2ope it. Bu.itd.ing~it. Wet.LandA Ft. H.ighwaten it. FIELD DIMENSIONS: Width o6 txen ch 3 it. Depth o j nock b etow t.i.Le /).-in. ,L ~ Length o6 each tine it. Depth of nock oven Zite i Z n. a umbex. o6 tines Depth o6 .t.i.2e betow grade 1 zin. To at teng.th o f tines it. Stope o6 .txench i n pen 100 it. Z Distance between tines-i-it. Depth to bedrock ~ . Tota.L abdoxbt.ion axeaQ ~J At2 Depth to gxoundwatex it. - Requ.ixed area it2 Type oi Coven: Paper ax Straw PIT DIMENSIONS: Nu4en os p.it,6 Gnave.L around .p.ita ye•a no Outside d.iam Depth betaw .inlet 6t- 2 Totat abdo "o area it A Area ne it2 INSPEC TITLE A PROVED L~` DATE 8 197 ` s h REJECTED , DATE 197 N 01 1 kid, ~ State and Count RECEIVED y State Permit # PLB 67 . Permit Application N OV 71979 County Per t# for Private Domestic Sewage Systems County C ~y~ X EHM *DENOTES STATE APPROVAL REQUIRED PLUMBING c ,._~..OP. Date Approval Received from State if Required State Plan I.D. # 90617-1 A. OWNER OF PROPERTY Mailing Address: B. LOCATION: '4 Section 2-; T3L N, R {fr. (or) W Lot# City Subdivision Na a nearest road, lake or landmark Blk# Village 'l W Township-ywe Olj€'/g-I/Qi~E C. TYPE OF OCCUP CY: Commercial *Industrial *Other (specify) Variance Single family Duplex No. of Bedrooms No. of Persons D. SEPTIC TANK CAPACITY Total gallons No. of tanks HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete _X_ Poured-in-Place Steel Fiberglass Other (specify) New Installation Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation Rate Total Absorb Area a2 ZZ sq. ft. New Replacement x Alternate (Specify) Seepage Trench: No. of Li ea~lft. ~ .0 - . Depth D~pth Tile depth,(t_Qp~_No. of Trenches Seepage Bed: Length Width ~.,~~---Tile depth (top ~ No. of Lines :5r Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land -~,t Distance from critical slope WATER SUPPLY: Private ❑ Joint Community ❑ Municipal ❑ Owners name as listed on EH 115 if other than present owner: I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared by the Certified Soil Tester, NAME f,C C.S.T. # and other information obtained from Af- LC (owner/b=ddE4}. Plumber's Signature MPPhone #7/,s-~y-~~C) Plumber's Address G O PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca- tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors property. If well has not been drilled please indicate. F t w / ~7 C a h ~toM~ , 7~~' r Mj . • . acal r~ E g 5 a ; 3 v 3 ' RtJ- 4 CEiVEd p Do Not Write in Spacj Belo FOR COUNTY AND STATE DEPARTMENT USE ONLY 102 Date of Application / - - Fees Paid: State Co n y C~ Date DEC 1 9 Permit Issued d (date) /.;I -l / Issuing Agent N e O State Valid# Date Rec "J I inspection Yes N L 1. county (white copy) 3. owner (green copy)- DIVISION OF HEALTH, P.O. BOX 309, MADISON, Wl 53701 2. state (pink copy) 4. Plumber (canary copy) Revised Date 7/1/78 t _t - r h '.i .se~ +,~dp 1 61 s `bt f ^r~-t ~ bYY j per':; r "ti 1 aid W.. L '~3 7 ~t y tt T s hy, "i s v ~ a i < t. 3 of r ' L7 t s _ s .f~': 7 ~ i t tat r 9 T~ L, l+. ,p r<+T~11~►Y ~ it w r r- y ~e rF .5 6. ii sq ~ T ?a 7 LR~ ! - 1~ -I .f` x U~1 S ~ T~ fy 'y ! 1 1 r _ ry 3 'fy.~ Wev ~ rt i r,~ ~ ~ ~ j~' ,~_•'6 s r3 0~~. f~. ~ `~~I s f JIB `„A t . \ t N~yp~ r .YYIY ~ C• !a 9 b F 1. A> >k 2 a~'?r tpj~ x x'14. \"'le, y t:., 'M.• JJ ¢ f S ~y ~ . ~~f2!F.YI w ~Ct Y + ~ }cc y Y 4 j ~ ACE_ i ~~z 4F,.1 a r _V4 " a ,y~ 1 4'~ - x^ a 4 f! F ants Fir Ka.; iQF. x a, bne till, - ii, } r"Ifttt~~~; v+liB $~a7i!tl+ v~k rt c.`y tt~ i:1 aliX? x1f # Y ftf3 3iJ fn a~ b. .:S tt.3tit3 r~t` ~~►Q~~ ~'~~~}i2~,~iRE~ ' ~ , x AN, ~ V f Y C ; ~fill d4 as d r. 5 L'~r k ,?t g ~i3iiw, r ra~° . ~ • ~ {j•S ~ ~ fir.. •+Y'~~.-+; T rt-. ~u, Sf P l'b . # ; 60 1 /78 PROJECT DETAIL DATA SHEET NAME OF BUSINESS - / Gr LEGAL DESCRIPTION "f G~ iA,; OWNER T10 ~,(,I.~/~ MAILING ADDRESS ZIP ARCHITECT, ENGINEER, ~~'~Q,/ •J~ ~}jr ~ ADDRESS /'P- I PL! UMBOR DESIGNER ZIP Sy113c' TELEPHONE NUMBER roe e7 1. Check appropriate building usage(s) and fill in the information requested opposite. each usage listed. Please consult Section H 62.20. i~ Existing building New building Additiory~~ ( ) Apartments and condominiums . . . . Number of bedrooms ( ) Assembly hall . . . . . . . . . . . Seating capacity ( ) Bar . . . . . . . . . . . . . . . . Seating capacity # of meals served ( ) Bowling alley . . . . . . . . . . . Number of lanes ( ) With bar ( ) Campground and camping resorts . . . Number of sewered sites Number of unsewered sites Total number of sites ( ) Camps . . . . . . . . . . . . . . ( ) Day use only Number of persons ( ) Day and night Number of persons ( ) Catchbasin . . . . . . . . . . . . . Number ( ) Church . . . . . . . . . . . . . . . ( ) No kitchen Number of persons ( ) With kitchen Number of persons ( ) Dance hall . . . . . . . . . . . . . Number of persons ( ) Dining hall . . . . . . . . . . . . Number of meals served daily ( ) Dog kennels . . . . . . . . . . Number of enclosures ( ) Drive-in restaurant . . . . . . . Inside seating capacity Car-service Number of car spaces ( ) Dump station . . . . . . . . . . . . Number of dump stations ( ) Employees ( total of all shifts) . . Number of employees ( ) Hotel ( ) Motel ( ) Cottages . . . . Number of units with 2 persons per unit Number of units with 4 persons per unit ( ) Medical and dental office bldgs. Number of doctors, nurses, medical staff Number of office personnel Number of patients Mobile home parks . . . . . . . . . Number of sites -74 Nursing homes . . . . . . . . . . . Number of beds ( ) Parks . . . . . . . . . . . . . . . Number of persons ( ) Toilets ( ) Showers ( ) Restaurant . . . . . . . . . . . . Seating capacity ( ) Dishwasher and/or disposal? ( ) 24-Hour service ( ) Retail store . . . . . . . . . . . . Total number of customers ( ) Schools . . . . . . . . . . . . . . Number of classrooms __FT Meals ( ) Showers ( ) Self service laundry . . . . . . . . Total number of machines ( ) Service station . . . . . . . . . . Number of cars served daily w ( ) Swimming pool bathhouse . . . . . . Number of persons ( ) OTHER . . . (Specify) . . . . . . . RtCFfI~E;; COMPLETE OTHER SIDE ~ ~ , X979 PLU:--,, ;JG S,,~ O,+] 2. Indicate whether the following facilities are present. Floor drain yes no X Number of drains Food waste grinder yes no x Dishwasher yes no Automatic clothes washer yes no Number of clothes washers _Ae 3. Septic tank capacity J9's0 Holding tank capacity Septic or holding tank manufacturer © i ~t a oz cjetrA G 4. SEEPAGE TRENCHES: total square feet width of trenches length of trenches, depth number of trenches SEEPAGE BEDS: total square feet width length of bed 'J~.. depth SEEPAGE PITS: total square feet outside diameter depth below inlet total depth from top to bottom of pit Signature of person completing form: FOR DEPARTMENTAL USE ONLY Ze..- - 5, -a4c,' Address z i p Telephone Number Date , 19 7 i Jk C~`k C~5 k F t k . T MO.16 OFFICE '00" ot wafts *tow 11 1 1061u, IWO- oom 4 YOM Aiinatift. a* - stamift 40600 6M #A to be oil I e- low opommmm" 717 Apt" to, be", ilia ~!g - M z ar~i ~re,~r~+i~~ ~r14~ + ~ aNr►. ~Nld~~~':~1F:~ its .iA tR~rt rte ~ML~p► .~ri ~ ~ _ ~ _ 14640 -VON. 1 a 1, at 00 oopted' "*mesa, 4a Affiftem"m ~r~ r !Mi `fie *Pp ~_±Imw• YMW 71 ~ ~ ~ ~ ~ yes ~ ~ ~ ~ • r t - t ,r r a ~ tl ms's Syr jl~ l 'W1 .4'~~,ef f 1 L i ~r ri y t +.,fn .Sp r moo. { i Y t 3 : k cS z t3'• r . 3 ~1 x' ~ + ' `Sc ;#i T + . L'#~ . S . S' . ~ ° ff VON- lifio-c-.,r" ."~•x1'`, Ii'f~g+;!~ +'~3$+f'c`.~rY "s3s " fii ~s4'rt.is$ h `.,i°, '.:i•F+ -Yr _:T.•x `?'Y' 4f~t,t`ar .p'[3 _.c Y'( i^..+'F.r.**'~~~ ..->.rFr~ fk`: !gt~.fii"a.fA'r~ 3~s f;,^.~ k ?lct,~~,<' ' ~:'"''E~• 't~' "~Tdl"~~r:i`~ r loft ~ + ) ..~~a' ;'t ~l.-i •f~. ~I w. `ai~•if-f Y'.L¢ 9~a~~i~f :1;- i'1~ j:_F ~~.iL`F ~"'~Y~~~{3 .11.~ 41 1 b~'TYIC s."r:~^ `Fr}.~ ~,tF~df! rl?J`. Rio -tir aril ~'a w ' ~l`a- ~-.}~.~c: ,'$+r~ `1~'~',~1'3 3~,i'~ r:~y~s~'~i+~ K ~;.~`4F. ~"~'~,_;•P. •4 r.bYp:,f23~t~•,3: L, ::t~.~•,i. y - - v" i 'a f3u 3 $:9t Y~Tf (Tr . '.x~ ~`1Q r ' •:c1' i" 93.r s9'$~ L~ti w ;r,~%~~y'. . jvS . _ i._ F.~~ t1 . .`~fi ~ r -tik~~y'~'~'I 'rG,~ .~%~r ~ l a~+~~:.'~3`{ j'. :a~ .Y ' "i3t.i ~?"vt ~ t-. Y ~133@sr~ yk~~i L►$Y~a r`rr r 64r►:i.r 3~rt's.f`~.t ~%s sx ' b 39~_~ss t:S9C}1 b 3°~k'd323 qty " vC". rt • i ±f ~~yi C; :s ~ iVr;~f..wl,r~ r: ' otec ;~i~.h to ~';~i #'4,"f °q=' :11 '+f ,;S ,.gam ,>•s~'" • r i ' %F F~' f *.~f' ° -~?Fi a'< •7 • e f41 iG,~'~€~ki".~► i ~~ky3 YS , oEMRTa 131 Ilsey~.M~~M~IrAL iimicEs , wy ~~14 orn*'~..A : toopteta &WVW ..r.~rr y LIeensod PLATTING. RECRIGATOWt. 40 1WIRONlIt At tpICES SECTION Partiat Swwht 1.-i~ Praw hollow No of Park 1,41641 1, of~e k City, Village or Tiq. Cewety vn in ~ar . 1D 1"4rK of Owner Nailing Address City, pillage Zip Coda thee Nuo"r 'j 0 6 -A . a A_ . J~ 2L c -Y" o 5% Title and Address of lartgn'lpieontteKSd State License I.O. No, or Local kieeesor 400 The violations in operating procedure, facllftles.or physical arrangement indicated below oust be corrected by such period of time as may stiffed. 1 M .0 - REGISTRATION Ian 7°~'I C I" t ✓'r Se w a c/ t o s sfcM a Ii P • a) fS~ ~ly AH lQ~~ as G ,7 {e'r/r~' PsrK ~s - Mai 2 t2)( Sites Area ens j)(a) Sites, Unit0acopency ..3y,lpj~vYyG /Of's~+•p ti $Ca.a r e S, 9Cf/s ~IS )(b) Basic Unit Locations (3)(a) Street widths ())(b) Driveway Surfacing. Co ~ (4) Parking rc Wddgtr~ arc,4 at rero~.. (~f (3) Recreation Area f /tea 17n yS,,, a/. ~Q , I IL H ZZ, n WATER S PPL1f l ~ new S C f Ale- S-4041 if Public rya a v SO l I N #fi S )(a `d yf 1 ~'L a 3) Private Sewage SV"m(ii/ v 3) (b) Plans Approved (3) (c) Systems, Area &61loblo Q C tc► V- y.C W I f~ tyr + N . 0 - PLUMBING p ( , o I (2) water Connections L' ft, / i Cpl jI W It t ~C u h~~r f~C N . OII SOLID i^ Tff 1 a age. plspa~sei new S y , #r!M It S t 3-~.l fe/~,~ t /•S S¢t rH . (2) Cieaniiness ~ (3) Restriction 1 r (4) Rubbish Tp C p Ufa alC~ Q S O T ~C Gt :G `Yfr CC JS 4 11 IZI02 - '""EME11T 11 I t1i office 1' (2) Out I as - Owner / S G 1 t eel !e[ D '7,i 22 (2)(s) Register Available 4kc A rQUkd (2)(b) Sanitary Maintenance FT `J] (2)(c) Cooperates - Health Officials ' (2)(d) Regulations Posted (3) Duties - Occupants 26 (3)(a) Site - Sanitary Nrlne jl r 0 Gr /ryj c fe r• t r k"" I y~ e :.t.,... (3)(b) Compliance With Ryles d DO Age Q P-C l`Eerc rj 6~, r~~s:► -,n ar,j jcb~~~ . This is a//•` ;,e~~,y.u p• u6ovc - Na•*r,E a~ Ji'owe. ~e~►.Af ,ra btrn semi w4we•r i., l 111, ief 42; a CC a ovc ga re o r~or r s Representative gnature o er conducting urvey COUNTY OF ST. CR01.,k(, Plaintiff r"WIAWT in nit W-ro" Defendant 10) 21' tai -1 1i Li cl - ''.l _ OHIO, ~s of ° a i Puld belief, being Aly sworn, comp us. on oath on behalf of St. Croix County that (lid as affiarlt is formed and believes n the _____YP' _day of, in Y _-in St. (_rol,c Covnc, , Stoic I Ii. 4_on;b ,then and there unlawV11%, nylon Soma) to Y1,11 In violation of section Qc 4 become liable to Croix County for a forfeAre as pn3vhNd by M ` talo^iw, :"K ' :Y_i n co nDw l Ag hi force, as cwn- plain int believes, complalnant in'ays for judgment o iris, M ; r' of =;tf fcr f`-_nR i'tu_,c t'ndi costs therein ill favor of the County of St. Cioi.t. Subscribed a~ad sworn to be fore nie t1ils _day of CdreErrt 3a~~ff, , F~ta¢ _ `a ~ 'f r~ 7-H CO't NTY ©F ST. CROIX TO SAID D1k_ 1_,ND AT':r: : The original of the above Complaint having been hn C :.o,,, -r c t?;W t (,f the violation of of Cie St. Croix. Coun,y Ordi-~)a,nce. 'You are, th.erefore,.sumrnoned to (-pp^arbefoEc ",ranch. CiCourt r.~ tIt of 5t. Croix County at the f:ourthouse in the City of Idudson, to answer said Comphint, on_ '.t _ 1 0 " 00 N1., :.net in case of your fadure to appear, a warrant for your arrest n-.ay h'-, issued. Dated ~ FCt State'oi Wisconsin `DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH CERTIF.ILL) DISTRICT 6 OFFICE - STATE OFFICE BUILDING 116 WEST CLAIRMONT AVENUE EAU CLAIRE, WISCONSIN 34101 RHONE ()151 636-3362 September 5, 1979 i Mr. John M. Nutzman Route 2 New Richmond, WI 54017 Re: Huntington Mobile Park Dear Mr. Nutzman: This is written relative to the required new drain field at your mobile home park. During our telephone conversation of July 23, 1979, you informed me that Swan would do the work, that you had contacted Harold Barber concerning this, and that plans would be submitted shortly. As of this date no plans for the soil absorption system have been submitted. Because of the lateness of the season, it is imperative that these plans be sent for review and approval without delay. Your plan should be drawn and submitted to Madison within 5 days from receipt of this letter. The new system is to be installed immediately upon approval. Your continuing non-compliance in this matter will prompt us to take appropriate legal action directed towards your operating license. Sincerely, ~XJ> OF ~aC1 Harold Na jacht t- SQ Oo ti Public Health Sanitarian I DIVISION OF HEALTH HN:lr cc = Harold Barber St. Croix County Zoning Administrator I r P4 CA ILA 1 K zt RD JA rib cp 0. 9~ Oo 1 sr eo ~ n O ~ ~ ~ iQ N ~ y ! -vi 0 r~ ~1 T : ~ .T C~ • ~ ~ ~ x;71.. 75 o I r 2 ~ • ~ Q C0 n w W r+ g . 10 o a 1o t i ti?` 1 9 LA 144 • : • - ~ ~ ~ `its • ~ ~ t 7 ~r Ly 11 WWI 4r{ t-4 .r -Nx J'►!,' ? y Ti 7% RECEIVED r fVOV 1979 ..O:J r • r 77- APPLICATICN FCR S."~IIITAH P~ u2IT f or INST.*I L _TICN CF SE" TIC T INK (Sec. 144.03, 14is. Stats.) .1. CTATNEA OF ?`'20P2]RTY ~1~l:e Ftt, ey, Zip C de) ~t r✓LOCH' ION PRCP:IM ` THER ' Sr;"TIC TANK IS TC B L ~D Check 1. City M 1 A d46, s • G~ v County one t 2. Village 3. Town C. IWTALL.Ed Give license numbeheld: '!:'isconsin Restricted Licensed Sewer Pltunber Services w ~;ddres4 - Name (~G~-~ -7/" \X~' / D. SPBOIFICI~TICNS OF SEPTIC T, Size in gallons: (check one 1. _ 1,000 Gal. 5. T 4,000 Gal. 2. _ 1,500 Gal. 6. 5,000 Gal. 3. 2,000 Gal. 7. If over 5,000 gal., give capacity„ 4. 3, 000 Gal. Dope Materials: 1.~ Prefab concrete 2.4Poured concrete 3. _ Steel E. TYPT OF CCCUPNCY 1. Single Family residence 3. Commercial establishment 2. _ Multiple family residence 4. Industrial establishment F. APP ZCXIK;~TE. NUM-E.l CF P71SCNS S ERV";D D:1ILY ~ G. P' RCOLJICN T-ST MZE 1. s 2. No Dat e S-i /l liz- By whom (To be completed by County Clerk) Date arplication is filed and fee paid Permit issu A (date) Permit Number County Clerk Percolation Rate Minimum Ibsorption area in Square Feet per Bedroom Minutes Required Normal With -4ith With Both For TnTater to Fall Plumbing Garbage Automatic Grinder and One Inch Fixtures Grinder ?rasher Automatic ?hasher 2 50 65 75 85 3 60 75 ?5 100 4 70 85 95 115 5 75 90 105 125 5 - 10 100 120 135 165 10- 15 115 140 160 190 15- 30 150 180 205 250 30- 45 180 215 245 300 45- 60 200 240 275 330 60- 90 240 290 325 400 c 'Y W H ,4 `tj b `C7 `C _ +7 H cn cn y 3 Cz cOi 0 0 I 1 1 Ip H CO rid r a H C7 It F1 t7" t__, H H • R N W CD ~ co n O p v` g~'~ W td i yy G' -3 H C' O CD a O ~ Cn \ ` (T (D H- L ' H 1 a U? (r FZ 'y N • O co F '-d rG (7 cfJ+ N CD F I ~ m f~ NO ~ ~ H d ; ~ co ~ O H n (D 0 LA 11 D N. C7 N H b 1 N x O M W CD Cn G7 O' M 1,4 N N =v Cn ; N• H N H c+ R C N o O y N N. H H O r O C_-. co Oo R. W t P-4 n r c+ m O n t.., ( e. r a fi ~(D w vin y "C o to F-4 N C a Cf) O~ I H y OIQ H c0+ cFL* Cep " 1 O Q L ^ ~H3 CD -I-- O c+ fl r H co 7 K7 c3 "J (D 0 ITI (D P, FJ- C+ lz~ CD 0 CD C CD W v n e+ J x t r+ p. O O t1 N C+• H ~U) C+ C3, cy, C+ , rD O aCW+- C+j m ' x H Hx 2 C+ N c+ O R ~ rJ r O O v (D '13 c-F C(D V N ~WS C d C U. C i O O 0 O c+ c0+ P) 0 t <D O H n O~ p O H z1 O c+ N 11 CO+ 27 r GH O M O CD O , O CD (D H^ O 0 t& ~j x O M 9f O. "r: Cl ;1 h f C+ 1 p r n H I Hn ti Cn (D N d '.I c C= C (D CD (D O R (D c+ C -j N C-~ O V ~D 1 H H ~n aI- C)-,O \ (D OHG tr3 a co EOD cD \ c C+ ; cn (D r N N• s~ U ry O n x H" co t7 ~n D'Q O i O R (D .Q CD H a G', p 1-1 co CO P-4 H CD (D y N c~+ O CD (D OA N ' ) sy \ c+ CFJn. M _ H ' R. 'Lj v6 H R. P, W cr H 't O W c+ H~ 0 c+ O N N G H y CD 0 cl. M N ~5 C) R N O n N. O N v 't3 C + F-~ 010 ca 4 F-3 cl, C+ c-F (D U) - Cl) C7 C+ :_J C+ H C+ 'C 0 c 0 (D 0 CD W a y- • x v I M ~Oh CD r P. 4 p y `n O N N s FOB n (D ~s t1 O O O h-' Q \ W :1~ O H W (D CD s' tv N (n ! t F rJ t c+ c+ r 1. cFJF (D d ~ H v O O GL t-'• O O , I y W CD N CA C~ v 'p f1 T co w (D O n ~ (1 H { 0 P. 5 (At m y O 7LAA NIN, '4 -ITV Ck 1 G o ~ '~4 h "'F' r OF 0-0 ~j I s 5a~ r 5 a - J 4S pa o ; / /Do a.y _ -74' I o(AJ t'" S E' )*A `C v ~t-K ~T CF INSP CTICN---INDIVIM',L T iG j-DISPCS L `Y`: r^ 1 PODIA-1Y T11,TTvi-AIT consists ofXSeptic tank. Cther (Describe) .:.1PTIC TANK: Distance from: e11 ft. Lot Line ft. Building ft. High watermark ft. 12ib or greater slope ft. " etland ft. Cistern ft. No. compartments . Liquid capacity gal. t EFFLUZ14T DIS^CC'~L SYST;.; consists of Tile field, Seepage pit(s). Tile Field:Distance from: 'Tell ft. Building - ft. Lot line ft. Cistern ft. High watermark of water course ft. Slope 12% or gre-.ter ft. ' `etland ft. Total length of the lines ft. ;:Dumber of lines Length of each line ft. Distance between lines ft. ---idth of trench in. Total effective absorption area of trench bottom sq. ft. Depth of filter material below tile /,7,in. De th of filter material over , in. Cover over filter material tile/,? Depth of the below finished glade in. ` oDe of trench bottom in, per 100 ft. D:~-Dth to bedrock ft. Depth to ground water ft. Seepage "its:Distance from: ,ell ft. wilding ft. Lot line ft. Cistern ft. High i,jatermark of water ccurse ft. `-:lope 12'/-,' or greater ft. ;etland ft. Number of r'its Cutside diameter ft. D nth beloi,! inlet ft. Lining material Gravel around pit: Yes. No. Total -tbscrption area sq. ft. Square feet of seepage trench bottom area required Squa~Leeet -of seepage pit area required 7reaon"c Inspec Date of Inspeco on tio , 19 Inspected by: Title: Construction IY?srecticn Dat e_____,19 Date ,19 Date , lgz.L Anproved Q~ Date ,194 . dejected Date_;~E,ig/ ,NIBIT NC. 5 00 ' County, Town of Sanitary Permit Anplicaticn No. Cwner Sanitary Permit No. -Jroperty vd_dress~ 77 (j, Land use Permit No. Street or Highway Septic Tank P-rmit No.~ -subdivision x. r _ ALL n k •r , s. , ~ ~ VvTtlf' - - T. rv t L Y . c t e- ~ s ✓~h c.- r 'n IV I r Y ~ fe,~ S~ ~ s - - ' A. J- Is ~a f F sy'- Rlp~ y 33 C z -S , l .wft _ J5 ~ tir s ~ J ~ ~ ~ rte' r ~ v 440 paw 7i., v .4f4l P, ~ , s M"a .r r• T'~ ~ ,i ~ rti P - y5 ~ ~y~ , s', i r _ . f 07, k s ak r• sq+ra ~xLa ji, a` s'. - ~3'~A• kj g r ~ •~,y~~4 x +Ei 'sG C "4 4 , Z= to Y' yH lo r ,y R•~~ ~ ~ ~ ~ _ a ~*~~'~+`3~X`~~c' `-aura ~ ~~r~~~ f n - t 4 k s 7 Jn _ F { fr 4( 1r. y 'a ~',TI~~ `rim s5 4r I 11 ~4 y" - ~y- :iRR a',a, 'Y" ~a a` r1 '*f x ~r a aw .>z ::'Yt"1+ sh 1 pig •~.r~~ ~ - ~ ; F; ~ ~ Y_ e '~'~'F~' F 1 a'..,f~ r r ; x 5 #:_}r z$ ~ai:.FF it 7 au> 7 M, (,'F * - ~C4 a{~ y~.al uS~{Ma~` i APPLICATION FOR SAP3ITARY PM-U4IT for INSTALLATICN OF A !;~;PTIC TANK (Sec. 144.03, v7is. Stats.) A. OTrJNER OF P3CP.gRTY e _ Address (St ~et, Ci Y, Zip od) 1 w c~ J 1 r~C ' lllil tic~~-•~ 7 7 B. LOC ~TICN' F P?CPE2TY `WFEi.E SEPTIC TANK IS TC BF, INST-ILL_~D Check I. _City Mail one: 2. Village Cc.~`r~Q~/ 3. Town . u'dY4 dre _ Count Vii! C.~C l C. IN~TALI.:{, l Give License e held: Wisconsin Restricted Licensed Sewer Plumber Services.&I O / Name Address v D. SPTCIFICATICNS CF TIC TANK Size in gallons: (check one) 1.,A_1,000 Gal. 5. _ 4,000 Gal. 2. _1,500 Gal. 6. - 5,000 Gal. 3. 2,000 Gal. 7. If over 5,000 gal., give capacity. 4. 3,000 Gal. - Materials: l.Prefab concrete. 2. Poured concrete 3. Steel E. TYPE OF OCCUPANCY 1. Sin-=1e Family residence 3. Commercial establishment 2. M?:ltiple family residence 4. Industrial establishment F. APPsZC DLITE NUTIB T~i OF P--';.SONS 87-aVED DAILY G. PE'CCLATIC t3 T IES T MADE 1. -ff 2. No Date & f !a Z/': By whom ~L y j i (To be completed by Count Clerk) Date a-plication is filed nd ee paid Permit issued (date) .~?J /Permit Number ~1~4Count1 Clerk/mot DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LA0613 & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. @OX 7969 /1 BUREAU OF PLUMBING MADISOt1, WI 53707 So f alanl.D.Number: State El CONVENTIONAL DALTERNATIVE (i f ! assigned) D Holding Tank X In-Ground Pressure D Mound IS_~ ; y Cf NAME OF PERMIT HOLDER: } ADDREf`SSSS~ OF PERMIT HOLDER: I INSPECTION DATE: BENCH MARK (Permanent reference pointtl DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.: ~L4-C - Y L' JL I J L 1 l CL 1 1 Iz ~i. Name of Plumber: Imp,/,MPRSW No, County: Sanitary Permit Number: 1 ~Ck,1_ - SEPTIC TA /HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV. WARNING LABEL JLOCKING COVER PROVIDED: PROVIDED: DYES ONO DYES ONO BEDDING: VEN i~7 N T MATL. HIGHWAER PROPERTY WEG: VENT TO FRESH 0 ALARMFEET FROM LINEAIR INLETF ]YES NO NO NEAREST DOSING C AMBER: MANUF ACTUFtc° . BEDDING: LIQUID CAPACITY PUMP MODEL. PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER , PROV DED: PRO ED: 91!7 1 DYES NO YES ❑NO YES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF PROPERTY WELL BUI DIN : VENTTOFRESH (DIFFERENCE BETWEEN FEET FROM LINE D ( 1- AIR-57 W PUMP ON AND OFF) YES ONO NEAREST 3110 ~ l/T SOIL ABSORPTION SYSTEM. Check the soil moisture at th depth of plowing FNUIH JDIAMETER MATERIAL AND MARKING or excavation. (if soil can be rolled into a wire, construction shall cease until FORCE MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: WIDTH. LENGTH: N DISTR. E ING: COVER INSIDE DIA.. #PITS., LIQUID BED/TRENCH HES MATERIAL: PITS DIMENSIONS ter.. _cr FILL DEPTH IDISTH. PIPF R. PIPE DTERIAL: NO. DISTR. NUMBER OF PROPERTY B ILDI G. VENT TO FRESH BELOW PIPES ABOVE COVER ELEV. INLET EV D PIPES. FEET FROM LINE: AIR INLET: NEAREST--_ MOUND SYSTEM: Mound site plowed perpendicular to slope Check t texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mou ystems to~n med' saake c rtain that it ON REVERSE SIDE. SHOW ELEVA- me s e criteriarfor nd. TIONS MEASURED. DYES ❑NO SOIL COVER. TEXTURE. Z PERMANENT MARKERS: OBSERVATION WELLS. DYES ❑NO DYES ❑NO DEPTH OVER TRENCH:BED DEPTH OVER TRENCH/BED JDEPT OF OPSOIL. DDED rED. IMULCHED: CENTER EDGES DYES ONO DYES ONO DYES ONO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH. LENGTH: NO. OF LATERAL SPACING. GRAVEL DEPTH BELOW PIPE. FILL DEPTH ABOVE COVER. DIMENSIONS TRENCHES: MANIFOLD PUMP MANIFOLD DISTR PIPE MANIFOLD MATERIAL: IN O. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: -LEV.: ELEV. DIA ELEV PIPES: DIR.: ' ELEVATION AND Z~ 4 Qc~1~ /Z 1 DISTRIBUTION / HOLE SI E HOLE SPACING. GRILLE CORRECTLY. COVER MATERIAL. VERTICAL LIFT ORR ESPON DS TO APPROVED INFORMATION / I;/ YES ONO PLANS ffYES ONO 'IN COMMENTS: PERM AN ENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUIILLDING: FEET FR YES ❑NO YES ❑NO NEARESTOM _ Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE: TITLE: DILHR SBD 6710 (R. 01/82) i DEPARTMENT OF APPLICATION SAFETY & BUILDINGS INDUSTRY, FOR SANITARY DIVISION LAAOR AND PERMIT P.O. BOX 7969 HUMAN RELATIONS (PLB 67) MADISON, WI 53707 Attach plans for the system on paper not less than BYx 11 inches in size. Include a plot plan that is dimensioned or drawn to scale. Horizontal and vertical elevation reference points must be shown. All appropriate separating distances and physical characteristics as specified in chapter H-63, Wis. Adm. Code, must be shown. An index page or each page must be signed, sealed and dated by the designer. If designed by a Master Plumber, the date, signature and license number must be shown. The owners copy or a legible reproduction of the soil test report must be included. Property Owner: Mailing Address: Pr rty Location: City, Village or wnship County: iV6 %,S '/4S ~T,3 / NCR 2K (or) W Lys9-r~ .rrc o5 Lot Number: Blk No.: Subdivision Name: Nearest Road, Lake or Landmark: State Plan I.D. Number: (If assign TYPE OF BUILDING Number of [j4,Public* ❑ Variance* ❑ Other (specify)* Bedrooms: Q 1 or 2 Family *State Approval Required. TOTAL NUMBER PREFAB POURED-IN STEEL FIBERGLASS NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify) SEPTIC TANK CAPACITY ixs) HOLDING TANK CAPACITY LIFT PUMP TANK/SIPHON CHAMBER O I/ t/ MANUFACTURER: L EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): ❑ New ❑ Replacement ❑ Experimental ❑ Seepage Bed ❑ Seepage Pit 00 044 ' Alternative (specify) „r7yl- 91^©Icjn& A,I-SS[cry C3 Seepage Trench 12 A) Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner): Private ❑ Joint ❑ Public :/74/,, g LXN I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber: Signature: ~p M PR No.: Phone Number; -3-z 3 <L Div ►..~uro -~o2C c Plumber's A ress: Name of D igner; COUNTY/DEPARTMENT USE ONLY Sign ture of Issuing Agent: Fee: Date: APPROVED Sanitary Permit Number; <7 c ® ~ ~ L 1. , ~ E~ l~""~ L)_ _ ~ ❑ DISAPPROVED s Reason for Disapproval: Alternate course(s) of Action Available: Change of ownership, building use or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to in- stallation. Failure to comply will void the sanitary permit. DISTRIBUTION: White-County, Canary-Bureau of Plumbing, Pink-Owner, Goldenrod-Plumber DILHR-SBD-6398 (N.03/81) t, B r=te , t~ ~ _ a tel- Odd Y, OS s " 57~' r a ,i 9 WISCONSIN DEPARTMENT OF` INDUSTRY, LABOR AND HUMAN RELATIONS DIVISION OF SAFETY & BUILDINGS, BUREAU OF PLUMBING POST OFFICE BOX 7969, MADISON, WISCONSIN 53707 Verification of Exception Status for an Alternative Private Sewage System In the County of 44.1 an r 4- Location t~ 1/4 1/4 S e' T ~3 lAil, R (or) W Town or Nuft4e4-ty (fir r i Street Address IZ.t7.r•, 14~ ZC'h',c ir, x,✓ Lot No. Block Subdivision Landowner's Name: ) d 1a 421-4t2j•4*-73 •l The application for tnis site is to serve a: Onew construction use. Nlrepl acement system use. If this is a NEW CONSTRUCTION USE, the alternative private sewage system is to be included as: ❑ one of the 25 needing a quota number. This is number of the applications made through this office. for one additional homesite on a farm to be occupied by a parent, child, sibling, niece, nephew, or first cousin. grandchild, ❑ for an individual lot for which a sanitary permit was issued but was later ruled unsuitable due to new or changed soil criteria es~Ahlished w by the department f {~4` 6 ❑ an application on file prior to February 1, 1980. wv ❑ a lot that meets the site criteria for a conventional pri aiie e'Mia~ system. c ❑ one of the first five approvals guaranteed for this year. in-ground-pressure` If this is a REPLACEMENT SYSTEM USE, the M6tJ is replacing: a failing conventional soil absorption system. ❑ a,holding tank that was installed and in use prior to February 1, 1980. ❑ a privy tnat was installed and in use prior to February 1, 1980. a lot that meets the site criteria for a conventional private sewage system. I certify that the above information is true and accurate to the t__ my knowledge. Name ToM, s he 1) 0" (County Official) Titles s;s- Z4, wzi~.. Date 8)412 DILHR-SBD-6158 (R 5/82) AN APPROVAL DIVISION OF SAFETY & BUILDINGS BUREAU OF PLUMBING .PPLICATION PRIVATE SEWAGE SYSTEMS 201 E. Washington Avenue, Rm 178 P.O. Box 7969 Madison, WI 53707 INSTRUCTIONS: Please fill in all applicable data and submit this form with plans. Plans will not be reviewed until all fees are received The back side of this form describes required plan information. Plumbing codes can be purchased from the Department of Administration, Document Sales, 202 South' Thornton Ave., Madison, Wisconsin 53703, Telephone (608) 266-3358. 1. PROJECT INFORMATION (Type or print clearly) Name of Submitting Party (Plans returned to same) Project Na e Street & No. Project Location - Street & No. or Legal Dess riiptic / / . /v• City State Zip Code ❑ City County ❑ Village of •'r ~ ~ ~ 1 I ? .r r `F ( f f Town r N or 1 J f, 0 Designer Telephone No. (include Area Code) (10 ttr t / - ? ~-~2Ac~ 2. THIS APPLICATION IS FOR A: New Mound System (3) ❑ Holding Tank (2) ❑ New Pressurized System on site not suitable ❑ Petition For Modification (6) for conventional (3) ❑ Replacement Mound (4) ❑ Replacement Pressurized System on site not ❑ System in Fill (1) suitable for conventional (4) ❑ System in Flood Fringe (1) Pressurized System on site suitable for ❑ Groundwater Monitoring (7) conventional (1) Conventional System - Public Building (1) 3. FEE COMPUTATIONS (include existing tanks), 4. FEE SUBMITTED FOR OFFICE USE 3a. 750- 1,500 gallon septic tank 25.92 4a. 3b. 1,501 2,500 gallon septic tank - 32.40 4b. 3c. 2,501- 4,000 gallon septic tank - 45.36 4c. 3d. 4,001- 8,000 gallon septic tank - 58.32 4d. 3e. 8,001-12,000 gallon septic tank 71.28 4e. 71, t.FXStS 15~ 3f, Over 12,000 gallon septic tank - 84.24 4f, 3g. 500 - 1,000 gallon pump chamber - 25.92 4g. - f ~ 3h. 1,001- 2,000 gallon pump chambet - 32.40 4h. t` 1. 2,001 4,000 gallon pump chamber - 45.36 4i. 3j. 4,001- 8,000 gallon pump chamber - 58.32 4). 3k. 8,001 - 12,000 gallon pump chamber - 71.28 4k. 7 Z 31. Over 12,000 gallon pump chamber - 84.24 41. 3m. 500 - 5,000 gallon holding tank - 25,92 4m. 3n 5,001 10,000 gallon holding lank 32.40 4n. 3o. Over 10,000 gallon holding tank 3838 4o. 'a 3p. Groundwater Monitoring - 27.00 4p. 3q. Petition for Modification - 27.00 4q. P/L Subtotal R 3r. Walk-through plan review: 4r. 1 Submittal of plans in person, by appointment, with double fee Total Fee a. _ COMMENTS: -OVER-~ 61 t_IIR SFip 6748 IN, 03/e21 s Ilk P1 b_ # 60 1/78 PROJECT DETAIL DATA SHEET NAME OF BUSINESS LEGAL DESCRIPTION I'E)124 Z W y9 S 2 '31,►'tj 1`S ,~f3t~! OWNER MAILING ADDRESS 4?dJu=ftha ZIP A~ 40/? ARCHITECT, ENGINEER," . ADDRESS G L; IV. Sher)& )Pk-- PLUMBER OR DESIGNER 7 / 17 TELEPHONE NUMBER 7 /S"- Z 44 G, Zoo, 1. Check appropriate building usage(s) and fill in the information requested opposite each usage listed. Please consult Section H 62.20. Existing building New building Addition ( ) Apartments and condominiums . . Number of bedrooms ( ) Assembly. hall . . . . Seating capacity Bar . . . Seating capacity # of. meals served { ) Bowling alley . . . . . Number of lanes ( ) With bar ( ) Campground and camping resorts . . Number of sewered s tes Number of unsewered sites Total.. number of sites ( ) Camps r-Day use only Number of persons Day and night Number of persons { ) Catchbasin . . . . . . . . Number { ) Church . . . . . . . . ) No itchen Number of persons 4 With kitchen Number of persons ( ) Dance hall . . Number.o persons` ( ) Dining hall x Number o meals serve3 Bail ( ) Dog kennels . . . . . Number of enclosures Drive.-in restaurant . . Inside seating capacity Car-service - Number of car spaces ( ) Dump station . Number of dump stations O Employees ( total ~of all shifts) ..Number of employees ( ) Hotel Motel ( ),Cottages . . . Number of units with 2 persons per unit Number of units with 4 persons ;;per unit ( } Medical and dental office bldgs. Number of doctors, nurses, medical staff Number of office personnel Number of patients OO Mobile home parks . Number of sites ~p ( ) Nursing homes • . • . . • . Number of beds { ) Parks . . Number of persons ( ) Toilets { ) Showers } Restaurant . . . . Seating capacity ( ) Dishwasher and/or disposal? ( } 24-Hour service ( ) Retail store . . . . Total number of customers Schools . , . . . . Number of classrooms --s Meals ( )Showers ( ) Self service laundry . . . . Total number of machines Service station . Number of cars served daily Swimming pool bathhouse . Number of persons ( ) OTHER (Specify) . . . COMPLETE OTHER SIDE -2. Indicate whether the following facilities are present. Floor drain yes no Number of drains Food waste grinder yes no Dishwasher- yes' no Automatic clothes washer yes; no Number of clothes washers 3. Septic tank capacity ~3~an Els/.5 n tank capacity ` 7,T 17, 1~4'-rd d Se tic or Molding t nk manufacturer - 4. SEEPAGE TRENCHES: total square feet width of trenches length of trenches depth number of trenches SEEPAGE BEDS: total square feet pQ a~ width rF, 55 wr E. length of bed depth a10 SEEPAGE PITS:' total square feet outside diameter depth below inlet total depth from top to bottom of pit Signature f erson completing form: FOR DEPARTMENTAL USE ONLY lei Address Z i Telephone Number f.3~ Date t SAFETY &'BUILD DEPARTMENT OF REPOR 1 ON SOIL BORINGS AND DIVISION DIVISION INDUSTRY, LABOR AND PERCOLATION TESTS (115 P.O. Box 7969 HUMAN RELATIONS \ MADISON, WI 53707 (H63.09(1) & Chapter' 145.045) LOCATION- SECTION: TOWNSHI MUNICIP LITY: OT NO.: BLKI NO.: SUBDIVISION NAME- IV :N COUNTY: WNER'S AM~.E: ~~pp MAILING ADDRESS: .2,- USE cI7 'X DATES OBSERVATIONS MADE- NO. B DR : C O o Replace ❑Residence New oReplace Z tmE 26 BZ u~ 6~ ~2 RATING: So Site suitable for system Um Site unsuitable for system [ONVfENTIONAL: MOUND: IN- ROUN S -IN-FILL OL INGTANK: COMMENDED SYSTEM: (optional) S CJU RS EJU RS CJU EIS NU E S U J1! ~r`D a: Q,nF.S5 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 TOTAL T R UND AT R-INCH S ARA O -SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERV TO BEDR CK- F OBSERVED (SEE ABBRV. ON BACK.) " B_ i B- no P, e > SC? B- 3 B, - ad" 100 n B- 6 80" ~ non `7 y ,Ian. ILI) PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROPN WATER L V IN HES RA MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. ` P INCH P. P. n a G 4 w N P A r P- P- - PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale of distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surfaccje, elevation at all borings Ind the direction and percent S rd a of land slope. ~m N S EA P' E'" NO Y& 1lI PCB &,I All po SYSTEM ELEVATION r1 w~ r fib Is: loo s_~_'P ~ ~„P, rf_--~- a ~ - S~ . 10 k \ p ~ I W7 6171 oa I C! 3 cr~~ ( ~ } tT $1~t Cl r ~j 0 0 73 i `oo~ % J f~~nl C i 4 up 1 . fIONAL WORKSHEET 1. UND SYSTEM 11. IN-GROUND PRESSURE SYSTEM-Continued- Was Load, 7ata! Daily Flow = 10, Force Main: /6 a ,r r, Use section H 63.15 (3) (c), Wis. Minimum Dosing Rate = gpm. Adm. Code and PROVIDE A DETAILED Diameter = in. Lt 57 OF SIZING ON PLANS. 11. Total Dynamic Head: 7. Dept to Limiting Factor = ft System Head = 2.5 ft. = % Vertical Lift = . Sh 3. ope 00 ft 4. Dl, Dn from Dose Chamber to ft Friction toss = ft. 9,45 s istr ution System= ft. TDH o . it S. Elevation ifference Between 12. Pump Selection: Pump an Distribution System = ft. Pultj w II discharge at least G B 7 e~ gpm 6. Absorption A a Sizing: at ?I C19 - ft. total dynamic head. Area Requir - sq. ft. Pump o el and`m~^}jfacturer: Owl Bed or Trench aength (8) _ ft: r 1 D l Bed or Trench dth (A) _ ft. 13. Dose Volume: ,Trench Spacing ft. 10 Times Void Volume of 7. Mound Height: Distribution Lines= gal. Fill Depth (D) = ft. Daily Wastewater Volume + Fill Depth Downslope _ ft. 4 Doses In 24 hrs. _ gai. Bed or Trench Depth (F = ft, Backflow = gal. Cap and Topsoil Dept ft. Minimum Dose = 4 27, Wgat, Cap and Topsoil De h (H) ft. 14. Dose Chamber: S. Mound Length: Volume L d al, End Slope (K) = ft. C I /u Al, fAtim ,~o b>~ c4sfci} Total Mound L gth (L) = ft. 1. CONVENTIONAL PRIVATE SEWAGE SYSTEM 9. Mound Width: 1. Wastewater Load, Total Daily Flow = gal. Upslope Cor ection Factor _ Use section H 63.15 (3) (c), Wis. Upslope W dth (j) = ft. Adm. Code and PROVIDE DETAILED Downslo Correction Factor = LIST OF SIZING ON PLANS. Downs pe Width (1) = ft. 2. Required Septic Tank Capacity = ga . Tota ound Width (W) 3. ercolation Rate = in./in, 10. Basal ea:' 4. sorption Area Sizing: 1 iitrative Capacity of efer to Table 2 in chapter H 63 atural Soil = gal./sq.ft./day a d PROVIDE A DETAILED LIST OF Basal Area Required = sq. ft. SI ING ON PLANS. Basal Area Available = sq. ft. Req fired Area= sq. ft. 11. If Standard Tables from Chapter Leng = ft. H 63 are Used, Indicate Table No. Width ft. For the Distribution Network, Use Numbers 5.14 In Section 1. Number f Trenches = Trench Sp cing = ft. 11. IN-GROUND PRESSURE SYSTEM * S. Distribution Sy em: 1. Depth to Limiting Factor = ft. Lateral Lengt = ft. 2. Landslope = % Number of Lat also 3. Percolation Rate = min./in. Lateral Spacinin. m0 to Pi in. 4. Proposed System Elevation = ft. Distance fro 5. Wastewater Load, Total Daily Flow: 6000 gal. System Elevation = ft. Use section H 63.15 (3) (c), Wis. Adm. Code and PROVIDE A DETAILE9 IV. SYSTEM-IN-FILL LIST OF SIZING ON PLANS. ~E X5 t5~tr19~ Fill in All Items from Section II i, Required Septic Tank Capacity = 175o gal. 6. Absorption. Area Sizing: V. SEPTIC TANK Percolation Rate = min./in. 1. Capacity = gal, Area Required = ,1i90 sq. ft. 2. Manufacturer. System Length = ft. 3. Show Site Constru ed Tank Details n Plan System Width ft. 7. Distribution Pipe Sizing: VI. DOSING TANK Hole Sire in. 1. Capacity = / gal. Hole Spacing 2.. Manufactur ` Lateral Length 7/ it. 3, Pump Ma lecturer, cl: i.elerdi Siic / in. /4 I.elerel Speciox It. Head= ft, N I)isl,rn~c Irom Sidcw.dl•Ia Pipe ill. . gpm• N, utarihutioll Pipe Di%cherge Rate: Constructed Tank Details on Plans Numhet of I lulu, 1'ct 11Ipe low Pel 1'Ipc g11nL VII. K N. Meoiloid tilting: ai. IypC (Lentet t,I tend) rer Length = - It. Constructed Tank Detalis on Plans Diameter in. -SHOW ALL INFORMATION ON PLANS- Q, T DfLHRSB"761 (R.03182) y SZ (S) Wen Zc+o` ~PCvr✓!/~'7t//tQ ~47` S~c+/P~^' i;~~r~c~e~~p~ / r boa P,A 71-1 p i d ;j • Q JI'll 5 A rAers Ov. fl Y, Lc 8 ►~A C r 9 cn~ 4 l ~ ~iEt~• 44 Z,f Z 0/, v t Ice . aC 0/ APr»✓ed Coo p 0 C4, p Vol 'A'te OrCC /'Y►Ain ~A7f~Kl.i^5 pis S r v A-6 r 0 r1 Rer, W t+h p~ a v~ d 6 s? 0 rt 6 m t r~~6+ a r, d 0 E,& C°,or,a cr YO~P1r1~ E V`S E n t. . , ~rE Ec3~ 0 h E McA, @ amine,,. p .,p +-Op 6d RocK r7-. I' PA6L OF x ,caS CROSS SECTION QF A BED SYSTEM f M1 f~ 1 gw~ ' \'v~ SOIL FILL 2" OF AGGREGATE DISTRIBUTION PIPE--1 APPROVED SyiJTHETIC COVER MATERIAL OR 9" OF 5TRAW OR MARS14 HAy ~ ~ IeOF%p -P-', AGGREGATE /i. ELEV. OF~ FEET, DISTRIBUTIOM PIPE TO BE AT LEAST Z IIJCHES BELOW ORIGIIJAL GRADE AWD AT LEAST20 INCHES BUT IJO MORE THAIJ 42 IIJC14ES BELOW FINIAL GRADE MAXIMUM DEPTH OF EXCAVATION FROM ORIGI'IJAL GRADE WILL BE Z IIJCHES MINIMUM DEPTH OF EXCAVATIOIJ FROM OKIGIOAL GRADE WILL BE INCHES Y SIGNED: LiCEW5E IJUMBER: DATE: ' Z-3 9 Page _ Of _ Perforated PIPS 00011 0 End View )Perforated End COD PVC Pipe Holes Located On Bottom, S Are Equally Spaced S PVC Force Main * From Pump .7 PVC Manifold Pipe . Alternate Position Of Distribution Force Main From Pump Pipe Lost HOIe Should Be Next To End Cap End Cop Distribution Pipe Layout « P is 17 R 3o_ S _ 6 0, ' r X 1; Awsme- Hole Diameter Inch Signed: - 22~,~ e' Lateral " I Yz Inch(es) License Number: Manifold " Inches Date: - Z3 gZ Force Main _ Inches 4 ~ , PUMP CHAPIBER CROSS SECTION AND SPECIFICATIONS E KIT CAP 4"C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING MAAIHOLE COVER 25' FROM DCGR, JUNCTIOIJ BOX WIAIDOW OR FRESH 12"MIU. AIR 'INTAKE I GRADE I y" MIIJ. IV MIW. CONDUIT \ h INLET PROVIDE I AIRTIGIiT SEAL I II i I V I I APPROVED JOINT A "`7 I III APPROVED JOItiTS W/C.I. PIPE I III W/C.I. PIPE EXTENDING 3' I II ALARM EXTENDIIUG 3' ONTO SOLID SOIL B I I I OWTO SOLID SOIL I i ON G r` PUMP _ OF O iL CONCRETE BLOCK f Z RISER EXIT PERMI-ITED ONLY IF TAUK MNNUFACTURE.R HAS SUCH APPROVAL SPECIFICATIOUS SEPTIC AMC) WE TANKS MANUFACTURER. IJUMBER OF DOSES: PER DAS { TA.MK -IZE ; `l c 06 GALLOKIS DOSE VOLUME: GALLONS ALARM_ MANUFACTURER: CAPACITIES: A=SCINCHES OR(~9?91.3 CALLOUS MODEL. MUMBER: 5 IMC14ES OR 212.1 GALLOWS SWITCH TYPE: MEHCGt v ~T C= IWCHES ORGALLONS PUMP MANUFACTURER' Ce, 4441 D- I Z IWCHES OR A 71roGALLONS MUI)EL 1JUMBER: Q1 NOTE. PUMP AND ALARM ARE TO BE b W►iCH TyPE:._ Y1 r w'1 f INSTALLED OU SEPARATE CIRCUITS PUM)" DISCHARGE. RATE GPM VERTICAL DIfFER.ENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. .Se~sc~ FEET A + MIAIIMUM NETWORK SUPPLY PRESSURE , . . , 2.54 FEET a ♦ 04 FEET OF FORCE MAIN X Z1412FipoFTFRICTIOtU FACTOR..-LLL FEET TOTAL 051JAMIC. HEAD FEET ~o T IMTERNAL DIMEWSIONS OF TAUK: LEMGTH~.L= ;WIDTH-;LIQUID DEPTH DATE:1 SIGIJED:,.,. LLCEAISE IJUM6ER PERFORMANCE RATING Gallons Per Minute WPO511 Model WP0512 WP0712 WP1012 WPH101 WP0532. WP0732 WP1032 WPH103 3882 Series No. ► WP0534 WP0734 WP1034 WPH103 HP 0. t/z 3/4 1 1 RPM ► 1750 3450 Submersible i 5 Sewage 50 170 1 80 190 1 10 126 154 168 170 _ Pumps n ~ 15 94 i 125 152 150 Csp s m 20 56 90 121 128 139 25 17 49 81 107 0 30 14 40 86 Certified w 35 10 64 Canadian i Standards F~ 40 43 Association 45 24 50 4 SPECIFICATIONS Max. Series HP Volt Phase RPM Solids Amps. Wt. W P0511 '12 115 1 1750 2" 9.0 108 t WP0512 230 1 1750 2" 4.5 108 i 'WP0532 '12 208/230 3 1750 2" 2.2 108 `WP0534 '/2 460 3 1750 2" 1.1 108 WP0712 3/4 i 230 1 1750 2" 6.0 110 'WP0732 ?/4 208/230 3 1750 2" 3.6 110 ' W P0734 '/4 460 3 1750 2" 1.8 110 WP1012 1 230 1 1750 2" 9.0 114 t W PH 1012 1 230 1 3450 .2" 11.0 114 WP1032 1 208/230 3 1750 2" 4.2 112 4 WPH1032 1 208/230 3 3450 2" 7.0 112 WP1034 1 460 3 1750 2" 2.1 112 WPH1034 1 460 3 3450 2" 3.5 112 'CSA Listing pending. 50 o f Ai, 71 40 ~1 rese ~ ~ . U! m 30 P Hp. ~ e i co r FHj- S i G 20 - ~ ppa _ -~erte 10 - W COMPOSITE PERFORMANCE 20 40 60 80 100 120 140 160 180 CURVES Capacity-Gallons Per Minute SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE. 4414 Jtate of Wisconsin ` Depart dustry, Labor and Human Relations d"~r 16l 19~j~ SAFETY & BUILDINGS DIVISION r Sur 4 of P1 uet- I CB OCT GG~/~~O `rte 'c' f~°,~~ac X982 2#31 East W4shin ton Aveaw NO. Box 74969 hadison. Wisconsin 53707 r. John tmann Pr; I' Re* Ricl a wisc oosin 54017 Petition no. 8?-04gl1-P Dear r. tzmann: Re: Little Johnni Mobil Wy Part Private Sewage System only onventiorl*1 systm t ,SW,2,31,law T a of Star Prairie, St. Croix jaunty. Wt Jho sub ct Petftion for MOOM40ion of se+ctioo it 63.15 (3) (c) 2. of the Wisco sin Aesinistrative C944..- vas consi «*r an October 4, l9w, It Was *proved* T m rule r ims 'drat while oam septic tank capacity bas* on 3-00 gallons per mobile ham plus 75€1 gallons retention volow. Tnt~ variance r. st,~,J ipo-as t use existing septic tank rapacity that is -50 941100S short of t4i s figure. All of the data and statements sut itted in <eiialf of the petition were considered. This approval is specific to the subject pttiticn asl camot be used for bolt additional di# ications♦ Jerme o+ , n iei Section of Private Sewage and Platting cc: Le Ja osky, S - District 151, Chi a Fall Steel, ploww, lsaAq St. Croix County DILHRSBD-6423 (N. 04/81) I £~3 i State of Wisconsin ` Department of Industry, Labor and Human Relations Please Reply to: SAFETY & BUILDINGS DIVISION Bureau of Plumbing P.O. Box 7969 j Madison, WI 53707 Plan Identification Number L ~ J J -7 Re: PRIVATE SEWAGE SYSTEM ONLY- i The Bureau of Plumbing has reviewed plans, site survey information and installation details for the construction of an alternative private sewage system to be installed at the above-mentioned location. The plans and specifications were prepared by and received for approval on , f The soil and site evaluation was conducted by The site meets the soil and site requirements specified in chapter H 63, Wisconsin Administrative Code, for the use of The proposed system is for a ` ' Wastes from the building will discharge to a' gallon capacity septic tank which will discharge to a %gallon capacity pump chamber from which a pump having a capacity of gallons per minute against a total dynamic head of feet will discharge through a inch diameter pipe to the soil absorption system. It is of utmost importance that the system be installed in complete accord with the plans and installation details and the conditions of approval contained in this letter. The licensed plumber responsible for the installation shall notify the county inspector when the installation of the system will commence so that the county inspector shall be able to inspect this installation. The installer shall not deviate from this approval and shall follow the directions or orders issued by the appropriate local or state authorities. In accord with ch. 145, Statutes, and ch. H 63, Wis. Adm. Code, the plans and specifications are approved contingent upon compliance with the stipulations indicated on the plans. Please review your code for the requirements of each code section noted. The architect, professional engineer, registered designer, owner or plumbing contractor shall keep one set of plans bearing the stamp of approval of this department at the construction site. If the installation of this system has not commenced within two years from the date of this letter, this approval shall become void and new application shall be made for approval of these plans before work may commence. In granting this approval, the Division of Safety and Buildings does not hold itself liable for any defects in plans or specifications, plan omissions, examination oversight, construction or any damage that may result in or after installation and reserves the right to order changes or additions should conditions arise making this necessary. This approval is based on ch. H 63, Wis. Adm. Code, requirements. It shall be necessary to obtain and fulfill the permit requirements of the county in which this installation is to be constructed. Failure to obtain county permits will automatically void this acceptance. cc: OWS By: County i _ the Enclosures T71 DI LHR-SBD-6159 (R. 7/81) mes Sargent, B erector EIS 115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 " MADISON, WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS LOCATION c5 C- Section -a-, T4N, R Sf& (or) W, Township or Mt+wrLeFpRir y ~S~ 9 Lot No. Block No. 4t6N~I,~4V~i9/ / y' l~e7 County Su division Name Owner's Name: Mailing Address: d TYPE OF OCCUPANCY: Residence No. of Bedrooms EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT ✓~f DATES OBSERVATIONS MADE:: SOIL BORINGS n2. /q79 PERCOLAT ON TESTS 197q SOIL MAP SHEET Y SOIL TYPE _!"m TiAy n1 PERCOLATION TESTS TEST DEPTH HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS ICHARACTERN INCHES SINCE HOLE HOLE AFTER INTERVAL BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN 1-5141 P__3 31xl 13b I SOIL BORING TESTS 3 TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) l z " yu010e, -77Z " s. " -7 72 `3 7Z " o/Ur-, Z3 5. /1105 PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable ar s. Indicate number of square feet of absorption area needed for building type and occupancy. ~6~ 01 ~Indicate scale or distances. Give horizontal and verti cp p s. Indicate slope. /I 15V A. S~ a ~t I I" ' N 6 L o 135 , 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 location of test holes are correct to the best of my knowledge and belief. 17 Name (print) rti ' ation No. Z-- Address Address Name of installer if known COPY A -LOCAL AUTHORITY CST Signature SAFETY&BUIL DEPARTMENT OF REPORT ON SOIL BORINGS AND DIVISION ISION INDUSTRY, LABOR AND- PERCOLATION TESTS 115 nnaDls P.O. BOX 79607 HUMAN RELATIONS (H63.090) & Chapter 145.045) LOCATION : SECTION.:- TOWNSHI MUNICIP LITY: OT NO:: BLK, NO.: SUBDIVISIO NAME: r' `/4$w~/ T3 N/nor). i COUNTY- W ER'S ER'S NAME: USE N~Z I!!1 DATES OBSERVATIONS MADE yq A 3111 PROFILE DESCRIPTION IFER ESTS: r„ NO. B EDFM: CO MFR AL D ION: S: r.; ❑Residence 1,06 y NewRaplece fly L~J9.Z~r+1 RATING: S=; Site suitable for system U= Site unsuitable for system V jl S. OUT G®~ . ❑ YSTEM •EUL SGKrU : RECQMMENDED SYSTEM: (optional) v' E11t _nA~ 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 TOTAL P.EPIH T GR U DWATER•INCHES CHARACTER O SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) " :f B- a 4 ~ rl P_ > Q.1 ,~C7! T. ' •~T S, L, "r A, " . 7 84" a►'' is I~.. s ,I e- $0 100 fit 41 q B- 4 Sou T1s n 7 L eo° -SLI PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINU S' NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PFRIOD P ! D P INCH P AI R 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 locatiorf on the plot plan. Show the surface elevation at all borings and the, direction and percent of land slope. lying P, 54F-cl P#Pc-d.r0YE,n 9rol a0 A6S k F_ ( 1C.0 V P q 1"0,Pe- SYSTEM ELEVATION 917 pe uaFr po E. - - r --r P- 41,54 , I - ?o A1116.~% d i I k- ©96 P4 N Hof _ l t-, A K r ~ p a rJ . r~ k t ~t 1 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. NAME (print : TESTS WERE COMPLETED ON: .5 6,6 -8 z- ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): CST SIGNAT .+,~±rr...w..~ren... r Anri,.,. iri Prnnarl"rfl,nm Mr slnri S.A iI T DEP"TMENT of REPORT ON :SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND PERCOLATION TES LS (115) MADISOP.O. BOX N WI 53707 HUMAN RELATIONS (H63.0917) & Chapter 145.045) LOCATION: / :H g D,- TOWNSHI MUNICIP LITY: OT NO.: BLK, NO,: SUBDIVISION NAM s IV 5dl T.3 N1W *or) COUNTY: NER'S YER*S.NAME: M I AD 121 ffn 917~x JJ DATES OBSERVATIONS MADE USE Q NO, B DR : CQ MER A Iy/ DESCRIPTIONS: TESTS: ,,tl nE MNew WReplace ❑Residmce W Gu 2 6 BZ Ly~'1 ~ ..7~0 82. RATING: S- Site suitable for system U6 Site unsuitable for system ~ ~ ❑ ~ ~~LHO~L`DING TANK: RECOMMENDED SYSTEM: (optional) rONY-EN STL~~ . M~ ❑U IN-GROUND L SS (rKUU r If Pgrcolation 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 TOTAL P H TO GR UNDWATER-INCHES CHARACTER SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 12" L 9 p fil "S' ID 4 1- > B- B- 8a 1 SE.7 > So" 1.5.E . " "s ~5. B_ L94? „ c 1q 2 y "0.L if B- 6 So" Do I _n# n ion. 17 &"'S VA 6 "S L PERCOLATION TESTS DEPTH WATER IN HOLE TEST TIME DROP N WATER L V L-IN H S RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD P PERINCH P_ Y" P_ 2. 43 -1 ly- -T Y „ " 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. join = 1" 5440 PaPt Aro m In Oro" oil Ws 14'f- $ SYSTEM ELEVATION 177 A wf r PC I a 100'- -to e Q I„ P, p f I • s r~ N v 46" 4. P-1 0 % 07 I„ v► K f- ALMJ J, L 1i I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified In the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME print): TESTS WERE COMPLETED ON: ADDRESS: CERTIFICATION NUMBER: PHONE NUMSER(optional): her Fee CST SIGNAT