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HomeMy WebLinkAbout038-1025-30-200 0 Cl) O m v 0 O �1 d �1 m m 1 d 3 Cn T T. F .c O rn M cn O I u) 3 < < „,: W j Co to rl) (O W C G) G) N � C @ p7 N N ^S N N d µ ✓7 O' 0. N O O O "CD 0 C C � N -D po co w 3 o < O a OD O V C D m O CL � :3 C ° ° M"tny a O C) O C:?7 O N N a 0 CD N (D O O z (p 0 C fp 'y •" �_ CL O O O 0 � • W e O a N ? d A 90 d .. N — Co a � V � N O IZ_ Z z �O D D S tr n� Iv 3 ° ! • O im N N A @ 2 C 3 � O p Z O N C N O_ Cl) C-n a z 3 A 3 c M c< !�! Z C A A N (a OD N (n Q + =: Q N O_ + < n O 7 O N C 3 LD C 3 v z o Z n � 0 N O � O X co W ' Q O C O C C C a @ @ N N �v CD n• N O E O co O N CD R N dC O �O 0 „ O Parcel #: 038 - 1025 -30 -200 11/26/2007 12:29 PM PAGE 1 OF 1 Alt. Parcel #: 5.31.18.109A -10 038 - 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 - MOE, JEROME A & MICHELLE J JEROME A & MICHELLE J MOE 968 CTY RD H NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): = Primary Type Dist # Description " 968 CTY RD H SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 11.703 Plat: 3989 -CSM 14 -3989 SEC 5 T31 N R1 8W SW SE BEING LOT 2 CSM Block /Condo Bldg: LOT 2 14/3989 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 05-31N-18W SE Notes: Parcel History: Date Doc # Vol /Page Type 01/19/2001 637074 1577/159 WD 07/23/1997 1212/491 QC 07/23/1997 1059/227 WD 07/23/1997 738/402 LC 2007 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 08/27/2007 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 37,000 269,900 306,900 NO AGRICULTURAL G4 8.700 1,700 0 1,700 NO 05 i Totals for 2007: General Property 11.700 38,700 269,900 308,600 Woodland 0.000 0 0 Totals for 2006: General Property 11.700 38,600 269,900 308,500 Woodland 0.000 0 0 Lottery Credit: C l a i m Cou 1 Certification Date: Batch #: 547 Specials: User Special Code Category Amount Special Assessments Special Charges, Delinquent Charges Total 0.00 0.00 0.00 Parcel #: 038 - 1025 -30 -100 11/26/2007 12:24 PM PAGE 1 OF 1 Alt. Parcel #: 5.31.18.109A 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 - RIVARD, RODNEY D RODNEY D RIVARD 1047 CTY LINE RD NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): = Primary Type Dist # Description ' 968 CTY RD H SC 3962 NEW RICHMOND SP 1700 WITC Legal Description: Acres: 28.550 Plat: N/A -NOT AVAILABLE SEC 5 T31 N R1 8W SW SE EXC PT TO CSM Block /Condo Bldg: 14/3989 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 05-31N-18W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 1212/491 QC 07/23/1997 1059/227 WD 07/23/1997 738/402 LC 2007 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 10/05/2005 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 28.000 5,300 0 5,300 NO OTHER G7 0.550 11,000 66,400 77,400 NO Totals for 2007: General Property 28.550 16,300 66,400 82,700 Woodland 0.000 0 0 Totals for 2006: General Property 28.550 16,300 66,400 82,700 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 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count y: `Safety and Buildings Division INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). 363921 Permit Holder's Name: ❑ City ❑ Village ❑ Tyawn of: State Plan ID No.: R ivard, Rodney I Star Prairie Township S. 10 : 3 7-3 CST BM Elev.:- Insp. BM Elev.: BM Description: Parcel Tax No.: (� o� • 0 1 -1 Il 038-1025-30-000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 1 *Z > 1 v Benchmark - Z . Zo 1 00.0 , Dosing Alt. BM 2 ao , 20 Aeration Bldg. Sewer ((, 3 Qp- 9G Holding St /Ht Inlet 2,cL. q / TANK ACK INFORMATION St/ Ht Outlet 2 , }S — ?I. , 4s - ' TANK TO P / L WELL BLDG. Air i to ntake ROAD Dt Inlet IZ -?-?- �, cf3 ' Air Septic > 5 }� --_, NA Dt Bottom I , 3 S. 8 Dosing > 5V / �S f -5? NA Header / Man. `f ,36 r Aeration NA Dist. Pipe -4, r Holding Bot. System s, '%, PUMP/ SIPHON INFORMATION Final Grade 5 t Manufacturer 5 (� Demand St cover Model Number 4 " GPM 9• TDH Lift� Friction Head -�a; System TDH 16Jll t L oss Forcemain LengtF`i Dia. 3-`� Dist. To Well S L ABSORPTION SYSTE B JIMMeN Width 8 t LengtFj 3 r fU4. Qf Tjfer+di�s PIT No. Of P Inside Dia. Liquid Depth DIMENSIONS t o O `eo1�r��1 5 DIMENSION SETBACK SYSTEM TO P / L I BLDG WELL LAKE / STREAM LEACHING anufa INFORMATION Type Of , r � � CHAMP Model Num System: t 2D 'i S� OR IT DISTRIBUTION SYSTEM Header /Manifold Distribution Pipe(s) x Hole ize x Hole Spacing Vent To Air Intake r I/ a 2 S p acing f rr lr Length � D Dia. Length � Dia. p g SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed / Trench Center Bed / Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) L) Inspection #1: 9/28/ Inspection #2: Location: 968 County Road H, New Richmond, WI 54017 (SW 1/4 SE 1/4 5 T3 IN R18W) - 0531 I& 2 . Z o 1.) Alt BM Description t,vvw.r 2.) Bldg sewer length= 4T t o o - amount of cove > q Z D Z •,Zo 3.) contour = 1 5 - . (p O CYhly ' 6.6 O A- o4 pA, za Lit ft* lt Plan revision required? ❑ Yes bd No Use other side for additional infor ation. © O l ( z SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. r ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ..� F E P m � S g I � l Z6� C ff Safety and Buildings Division SANITARY PERMIT AP CATION 2 01 W. Washington Avenue Viiconsin P O Box 7162 Department of Commerce In accord with Comm 8 . 9�1Llf _ clm. ¢ e Madison, WI 53707 -7162 • Attach complete plans (to the county copy only) fort 1e m, on 4�pr nod: s County / than 8 1/2 x 11 inches in size. V EfVED �� C/✓b<X • See reverse side for instructions for completing this g icati State Sanitary Permit Number 3b3R2 -� Personal information you provide may be used for secondary purpos ST Check it revision to previous application [Privacy Law, s. 15.04 (1) (m)]. �AOrx COUNTy State Plan Review Transaction Number I. APPLICATION INFORMATION - PLEASE PRINT 0 S /D = 3,23O Property Owner Name �G / a � , rop of 1/ S T , N, R E (o Property Owner's Mail ing Address r Block Number City a Zip Code Phone Number Subdivision Name or CS M Number /� CAP/ ( 11 . TYPE OF B ( DIN check one) ❑ State Owned 0 cit Nearest Road Village ao" Public Vrl or 2 Family Dwelling - No. of bedrooms a Town OF III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) e' 1 E] Apartment/ Condo 5 3 �. �• ��g /��S_ �0 8 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel /Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV TYPE OF PERMIT (Check only one box on line A. Check box on line B, if applicable) A) 1 V New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System Tank Ol ____ _________ny E System ______________ Existing Syse ________ Existinq System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 Mound 3 Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 12 ❑ In- Ground Pressure / 42 ❑ Pit Privy 13 ❑ Seepage Pit 8 �D 9 4 A 43 ❑ Vault Privy 14 ❑ System -In -Fill --70 r ) A S) VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /s ft.) (Min. /inch) ; Elevation y r� - '�"� /E - — Feet _ $ Feet 1 1 VII Capacity TANK in allo Total # of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existing structed Tanks Tanks Septic Tank or Holding Tank X B r T ❑ 1:1 ❑ 1:1 1-1 Lift Pump Tank /Siphon Chamber �/ El ❑ ❑ ❑ ❑ VI11. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumbe ' ame: (Print) Plumbe " 'gnature: (No St s) MP/MPRSW No.: Business Phone Number: Plumbe ' Address (Street, City, State, Zip Co e): IX. COUNTY/ DEPARTMENT USE ONLY ❑Disapproved gnit P ermitFee (indudesGroundwater ate ssue Issuing Agent Signature(NoStamps) X Approved ❑ Surcharge Fee) Owner Given Initial r Adverse Determination �' • (t✓'3� 'Z X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: SBD -6398 (R.12/99) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS R , 1. A sanitary permit is valid for two (2) years, , ,�N 2. Your sanitary permit maybe renewed before the•expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved *the permit issuing-authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly mairttairied The septic tank(s) must be pumped-by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608 - 266 -3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. ll. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan,drawn to scale or with complete dimensions, location of holding tank(s), septic. tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater: The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. Safety and Buildings 1340 E GREEN BAY ST STE 300, SHAWANO WI 54166 TDD #: (608) 264 -8777 V„ isconsin www.commerce.statemims Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary June 19, 2000 CUST ID No.220527 ATTN. POWTS INSPECTOR ZONING OFFICE BYRON BIRD JR ST CROIX COUNTY SPIA 896 68TH AVE 1101 CARMICHAEL RD AMERY WI 54001 HUDSON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/19/2002 Identific n b s Transaction ID o. 323023 Site ID No. 194 8 SITE: Please refer to both identification numbers, Site ID: 194238, RODNEY RIVARD above, in all correspondence with the agency. ST CROIX County, Town of STAR PRAIRIE; COUNTY HWY H SW 1/4, SE 1/4, S5, T3IN, R18W ---- FOR: Description: MOUND SYSTEM FOR RODNEY RIVARD M Object Type: POWT System Regulated Object ID No.: 668556 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes A and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in 10 chapter 101.01 Wisconsin Statutes is responsible for compliance with all code requirements. P ( ), � P P CAUTION: Wis. Stats. 145.135(2)(b) indicates that the approval of a sanitary permit is based on regulations in force on the date of approval. The effective date of COMM 83 revisions is expected to be July 1, 2000. Thus depending on the type of system and your design, this plan approval may not be eligible for sanitary permit approval if submitted to the issuing agency on or after July 1, 2000. Note: There is a otp ential for a lawsuit that may delay the effective date of the code so this status may or may not change. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, DATE RECEIVED 06/12 /2000 _ w. { FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 AKEITA WILKINSON , POWTS PLAN REVIEWER BALANCE DUE $ 0.00 Integrated Services (715) 524 -3630, FAX: (715) 524-3633, M -F 7 AM - 3:45 PM KWILKINSON @COMMERCE.STATE.WI.US W SMART code: 7633 cc: RODNEY RIVARD PLOT PLAN " PROJECT Rodnev Rivard ADDRESS 1047 Polk St. Croix Rd. New Richmond Wi 54017 SW 1/4 S E 1/4s 5 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX MPRS Byron Bird Jr. 220527— DATE6 /2/00 4 BEDROOM CONVENTIONAL IN- GROUND 4ESSURE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1200 Gallons LIFT TANK SIZE DOSE TANK SIZE 800 HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 500 Bed Size 8'X 63 ' BENCHMARK V.R.P. Top of White Stake ASSUME ELEVATION 166' ❑ BOREHOLE O WELL - H.R.P. Power Pole SYSTEM ELEVATIO Scale _ = 10' H.R.P. County Road H 750' Septic and Dose tanks are to be properly bedded and provided with approved warning labels, dose tank is to have q3Iggkdown cover Area 25' below _ ❑ 6 % system is to w Weeks Weeks F, OA- Slope remain o Pro 4 ST DT undisturbed Bedroom o Ma��t� -a House Alt. B.M.L\ CD L� B.M. B -2 r B -3 co R OWT. S. Conditional'y Well is to meet all System is to be Aw"TPR U V ED setbacks found in i &WjV&along the DEPARTMENT OF COMMERCE Comm. 83 onto D1 OF SAFETY AND UILDINGS 0 EE CORRESPONDENCE 7 323023 7� Perforated Plot Detati End View Perfora�ea End Cap) . I PVC P.pt 1, e a ,;,00 Melts Logaied On 110110M. Art E qudily Speotd t P / PVC Force plain f iR�T 14oLG NtiXT t4 Cann" ' PVC Manifold Pipe Qislria� awn o'iP! Lost pole $h*Wtd 9# Nest 70 End Cop End Cop Disiribuf'on PIPS t► Layout P Ft. R _.. _. R. X Y �� Inches InChaS 3� Signed: ��� ��� 11 H Diameter , _2 License Humber: SC2 Lateral N �; Inch(es) Date: e l- _ Manifold Inches_ Force Main " Inches # of holes/pip- Invert Elev4tion of Laterals9� Ft... i • Desigaer� Date =_ a0 4" Observation Pipe Perforated Non -Woven Filter Fabric Below Filter Fabric ,Distribution pipe AST![ C - 33 5 o n d� �'� Topsoil ~ _ _ G � r ` % dope Bed 0! y�- 2 Force Main ~ Flowed Drain Rock Z From Pump layer 'D Cross Section Of A Mound System Using E 7 A Bed For The Absorption Area f .A G A Ft. h 6 Ft. I Ft. Ft. K Ft. G Ft. h'o Ft. L J 40bservation Pipe PF M W From Pump Distribution Bed Of % I Pipe Z 2 2 Drain Rock n 4 Observation Pipe Permannt Marker Pip�®r ods Plan View Of Mound U61MG A Bed For The Absor tion Areo PA O E „___OF,..,..._ PU ^�F CHP,r�,�EP, 0055 SECT!oti AkjC, -'PLCIFICAT IC1k;5 VENT GkP — wr�.�llllRao E T �- �AovE.ta �.acKw& FROM 0004 ! t w .Ju�rn eQ>4 M3E►- WOew oP. FReSN MR tNT/!!lE � I I GRADE ! I tests Ira A - I AIRTIGHT SEAL I I f , I .i A i III 1 1 it ALARM n i I *APPROVED I 1 ohs c I G JOINTS WITH I !' L ��� I L > FT �"'- � APPROVED PIPE �_J1 ! +! 3' ONTO IhP -� J ! G' OF I D SOLID SOI f 1 CDAJCRETE ClOi"K ! ►� Y' � R J SER E=XIT PF -KM17 ro SJLtJ IF TAWK MAIJUFA,CTURER HAS ,$UCH APPROVAL. SEPT!c E � - fiZ � SP FI T101j ECI CA S OCSE s-� 'A Al KS /`1A►JLFACTIJRER: tiJUN',$ER OF DOSES'. PElk DA TAlJK SIZE: _.._._. GALLD. JS DOSE VOLUME zOS ALARM MAWUFAGTUKCR' U INCLUDING 5ACKFLOW: 0At6ON$ Mo�EL QUMeeR: L yz 3 CAPAC!TIES.' A = !ucAES OR GALE OUS SwrTCH T�iPC: 8=.At�—_IKICNCi OR 04L6. Y 0135 PUMP MAIJiJFA:TURC C e" Il IkJCNE3 OR 1`� GA20U5� " CraF:l_ �1UMDER: S _ F JI 0 D. !kC DES OR GAL101. S'rlTr_N TYPE: N07E.* PUFF AWO ALARM ARE TO DC Mir, lMUM 015CHAR E RATC�._GPM INSTALLED OW 5EP,%RArE C4RCUITB VERTICAL 0IFFEREWCE DETWEEW PUMP OFF AWD DISTR18UTlolj PIPE..._ FEE'' IJETWORK SJPPLIS PKESSUKC 2,5 FLET ��.._ FEET OF FORCE MAIN F �ppFTFRlCTt4♦tiJ FACTQR.. � • FEET ,� 11 ` TOTAL Q'dIJAMlC. HEAfl = l FFLgT C f :arTLtt�:A� G!ME EOJJC OF TAQK: AJGTh ; ...G�.. :WIOTH. ;LIQUID COPT►. 1��- L!CEWSE kJUM Gf�C /S 7 6 O b i Engineering Details SHEF40 Performance Data 40 � I P ump Characteristics PUMP/Mom Unit Submersible �' �0 Manual Models SHEF401NT SHEF40tY12 - -- Automa MaJets { SHEF40A1 SHEF40A2 10 I Harse o„�er - 4/10 i - Full load Amps 12 1 6.5 Motor type Shaded Pole (4 Pole) 0 R.P.M. 1550 10 20 30 40 0 40 10 Phase 10 G PM Voltage 115 F 230 Total Head (feet) 10 ! 14 17 21 25 28 r 30 35 Hertz60 ___--- .,�.___.__- ....,.. _-_.....1..--___.._.-- Temperat 120° f Mace. Fluid Temp. (m) 3.0 4.3 5.2 6.1 7.6 8.5 18.8 i 0.7 NEMA Design A ( ) GPM US GPM 70 ! 60 SO 40 30 20 i 10 : 0 — 1- - -.- _. Insulation Class A (hers sec) 4.4 3.8 - 3.2 2.5 1.9 1.3 1 .63 1 0 Discharge Size 1 1/2^ 11" Dimensional Data Solids Handling 3/ We hi 28 Brs. _ 3. 778'.. e-5l8' (,6927) 1. All dimensions in inches. (Metric for Power Cord 18/3, SJTW, 20' std � tse.a2, a" (12'1 international use). (30' optl000i) I 3 -7/0' 1 2. Component dimensions may Materials of Construction (g9.a2, vary t 1/8 inch. Handle _ Stainless Steel i ;fit 3. Not for construction purpose 3.7/8° I UrSCHA> IGE t9e ZP 1 -112" NPT unless certified. f lubricatin , O il Dleleciric W t .. • +• iYlo Huusiri Cast Iron FLOAT sWiTCM 4. Dimensions and weights are Pump Casing fast iron approximate, Sha ft —_ V 141111 Mecbani(ai Seol Faces: Carbon /Ceroodic - �- -(', S. We reserve the right to moke Shaft Seal 5414 Body: Ano" Steel revisions to our product and their Spri�gg Stainless Steel I specifications without notice. _ ' 8 1 %ws Bunn -N I impeller I Engineered Thermo stir f ' Upper Bearlm Broo Sleeve Boorla 11-3/8' } o•sne (259.79; Lower Bearia SI a Row Bab Bear Bottom Plate Polyester Coated Steel Fasteners S tainless Steel 2 "(50.8) r — Legs Engineered Tbermoplasf& 1- 0 1998 Hydrornaiic ° ' Purrms, Ashlana, Ohio. All Rights Reserved HYDROMATIC - - Your Aithorized Local Oigtrib for •; aililaid, Ohio 44805 Tel: 414- 289.3042 Fax: 419- 281 -4091 t / Web Situ www.penfakpump.tom 'S riiCFS IN All MAJOR CITIES AND COUNTRIES , c u{ your plrane di�edory for ycm !oral Dislribvtor 'w G68G 1 178 SM Aronrin Department of Commerce SOIL AND SITE EVALUATION DivisioA of Safety and Buildings Page of Bureau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 81/2 x 11 inches in si Plan must County include, but not limited to: vertical and horizontal reference point (BUY, c irection and' percent slope, scale or dimensions, north arrow, and location and diqtanco to neare�st'r T Parcel I. D. # APPLICANT INFORMATION - Please pri all infortoafbn. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacyow s. 15.04 Ali 6-30 - Property Owner ` Prop on ; > G¢ 74 P21 -IV T N,R/ E (o Property Owner's ailing Addr / #,' . c Subd. Name or CSM# City to Zip Code Phone Number X ��i ❑City [:1 Village [X Town Nearest Road { 6New Construction Use: ONesidentiai / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: p Code derived daily flow gpd Recommended design loading rate , bed, gpdfft trench, gpd/ft Absorption area required L� OO bed, ft 2 5___�!Q_ trench, ft2 Maximum design loading rate . ,` ' bed, gpd/ft gpd/ft Recommended infiltration surface elevation(s) ��,"= oZ� ft (as referred to site plan benchmark) Additional design /site considerations [[ Parent material ` C2 l ° G L Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ S tig U �4 S ❑ U EIS 5- U ❑ S ;�F- 11 I ❑ S [au ❑ S D�r U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed , Trench �: I �/ • s= Ground G �� l� b ft. Depth to W�i or i T L. Remarks: Boring # Ground elev. Depth to limiting factor Remarks: C T Name (Please Print) gnature Telephone No. Address Date CST Number SOIL DESCRIPTION REPORT PROPERTY OWNER n ' Page ' ot, PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench a �,.�' �— � ✓jar � � . /, �-: Ground Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # ; Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) Soil Test Plot Plan Project Name Rodney Rivard Byron Bird Jr. Address 1047 Polk St.Croix Rd i �� a_�— 4 1-01, New Richmond Wi. 54017 CSTM #250527 Lot --- Subdivision ---- Date 5/31/0 SW 1 /4 1/4S T 3 N /R W Township Prairie F Boring Q Well PL Property Line County ST. C R O IX ,BM or VRP Assume Elevation 100 ft top white stake System Elevation 95.2 H.R.P. powerpole o n r oad Alternate B.M. top of white stake 75' co rd H 750' 1320' - 135' / 6% slope 70' 1320'p 4bed house mound t . . 8' An B 0 , B2 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM �j r Owner/Buyer %.; /'I e GC' l r Mailing Address Z ' 7 6�3� Property Address �6� �� /Z/ (Verification required from Planning Department for new construction) City /State l_� «��G��„sl,/1 Parcel Identification Number - o LE GAL DESCRIPTION Property Location y4,c2 ''/4, Sec. _. T _,7 N - R,J!5;-�, Town of SSG► �, - � v Subdivision , Lot # Certified Survey Map # , Volume - - , Page # Warranty Deed # Volume Z S ,Page # Spec house ❑ yes 0' no Lot lines identifiable ❑ yes R no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. 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 days of the three year expiration date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the pro erty described above, by virtue of a warranty deed recorded in Register of Deeds Office. /� a�_� co SIG ATURE OF 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 ;` r• OOCUMFNT NO WARRANTY DEED T­ SPA L RL�EPVED FOR RECnR[ >!NG DADA STATE BAR O F WISCONSIN FORM 2 -1982 s�.isss i�� a9�a 227 Isa REGISTER'S OFFICE Fern Mullen, a single. person ST. CROIX CO., W1 P ^::'ff f -r P-^nb _. JAN 7 1994 conveys and varrnnts to Rodney D. R ivard.... . .... _ j 8.30 A y, U ` I M the following described real estate in St.. .Cro.ix___._.- ----- ...County, Stair of Wisconsin: Tax Parcel No- ------- ----------------------- All of that part of the Southeast Quarter (SFI) of Section Five (5), Tcwnship Thirty -one (31) North, Range Eighteen (18) hest, described as follc.ws: Ccnrlwncirg at a point 202 _ods South and two (2) rods west of the Northeast corner of Section Five (5) ; thence West 158 rods; thence South to the quarter po;,t on the South line of said Section Five (5) ; thence Fast to a point two (l) rods 4vest of the Southeast corner of said Section; thence North to the place of beginnirg, FxCFPT the follcwirxl described parcel: Part of the Southeast Quarter of the Southeast Quarter (SFI of SFI) of said Section Five (5) descrilw<! as follows: Lot One ;1) of Certified Survey clap filers July 28, 1989 in Volume "8" of Certified Sur<,ey Maps, page 2132 As rcctunent No. 450094. '. A' This conveyance is given in satisfaction of that certain Land Contract between Sigward H. Mullen and Fern Mullen, as Vendors, and Rodney D. Rivaerd, as Purchaser, dated April 30, 1986 and recorded May 1, 1986 in Volume "738 ", page 402 as Document No. 411438. y' This -is not ......... homestead property. f (is) (is not) Exception to warranties: � N L Dated this n,y day of - December 19 93 - - - - - (SEAL) (SEAL) ` Fern Mullen `.. (SEAL) _.. (SEAL) _.... -- ----- - - - - - -- -..... AUTHENTICATION ACKNOWLEDGMENT Signature(s) ------------------------------------------------------------ STATE OF WISCONSIN ` ss. ----- -- ---- -- --•-----•-- ----- ------------ -•-•----- .......................... St. Croix County. ............... 27th ' authenticated this - __. - -. day of_ ___ _ _ _ ____ _______ __ ___ ___ 19 ...... Personally came before me this .... day of - ------ - - -- 19.93- -- the above named .... Mullen. -- - - - - -• -• - _ TITLE: MEMBER STATE BAR OF WISCONSIN (If not- ---------- -- -- --- -- ---- -- --- ------ _.., i authorized by $ 706.06, Wis. StatsiJ to me known to be the person _.. . .. . .. who executed the f ' foregoing instrument and acknowledge the'samo. THIS INSTRUMENT WAS DRAFTED BY " '4st• ��Kr "" GGGLLG :i1p��L'�^4.�'t�� Reinstra Van Dyk & Needham, S.C. o Sharon G. Balcerek k 201 South Knowles Avenue, Box 127 ' - -- ...... .. - ° Notary Public .. St._ .Croix urgt� Wis. a` =. •l�e•� •ills ---- 54017--- --• ---- -- --- ------ --- C3b i My Commission is permanent. (If note 0"tm- oxPfl•ation Y (Signatures may be authenticated or acknowledged. Both are not necessary.) date: ... November.- 30, - - e ; K •Names of persons signing in any capacity should be typed or printed below their signatures. Wisc owauke e. W�stcnsn Legal Blank Co. Inc. WARRA.NTT DEED STATE BAR OF WISCONSIN M -' FORM No. 2— 17.12 ,t.vke 3'!