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HomeMy WebLinkAbout040-1232-10-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM county: Safety and Buildings Division Si. Croix INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitar o.. Personal information you provice may be used for secondary purposes {Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: ❑ City ❑ Village ❑ T n of: State Plan ID No - Osburn, Alan Troy 'Township CST BM Elev -:- Insp. BM Elev.: BM Description: Parcel Tax No -: DU I /UU fz Z3 040 - 1232 -10 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic o Benchmark z 65� ILL /Ov C fr Dosing Alt. BM 3 Q3 TP I ation Bldg. Sewer 1 P3 er Pz- ,,-74� 01ding � 6 / Ht Inlet N. 00 ge - `<' TANK SETBACK INFORMATION TANKTO P/L WELL BLDG. ventto ROAD Bt Air Intake Septic �' / 2 a _u I NA Dt Bottom Dosing ± P0 , 2 3 Z ' NA Header / Man. A -- - NA Dist. Pipe /00, 75 olding Bot. System Q Z PUMP/ SIPHON INFORMATION Final Grade Manufacturer LAI Demand St cover (2 3 Model Number (�- v 3- q &M T Lift lS.�b Friction System 2 TDH2 3 It Q Forcemain Length S�/ Dia. Z r/ Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width r Length N Of Tr riches PIT No. Of Pits Inside Dia. th DIMENSIONS er D IMENSION S SYSTEM TO P/ L BLDG WELL LAKE / STREAM LEAC u acturer: SETBACK INFORMATION Type of CHAMB ER"' Mo el u System: Z DSO OR U T DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) it / x Hole Size x Hole Spacing Vent To Air Intake Length __ Dia. Z n Length Dia. ( r , � Spacing Z4 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 CQMMIFNTS: (IncVe cgV1e Sisffepanc f o. 811 IS eI nspect�on : & ro oo ns ecuon r _: o da ocat><on: 539 Trt tum ane tiuflson J4 1 f1 1V/4 3 T29N R19W) - 03.28.19.1 147 Countrvwood Addn. I - I.ol 11 1. Alt BM Description = L 5� ��- �,on,w ) P i.,° ko4,1' ��� �� - �r- Y _ r ) 1-0 ftJ"// ay S Z 2.) Bldg sewer length zo (� f PrC Vas ��l�� � mod' - amount of cover = IF P1 W- 3.) contour = q, Plan revision required? ❑ Yes q No Use other side for additional information. Cb 6 SBD -6710 (R.3/97) Da a Inspector' nature Cert. No. V ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: f , i r i t 2 /LU Caw) L�� &t- 5 ,) s c.��s �1,. sw «�� S Safety d Buildings Division V i scons i SANITARY PER N 201 W. Washington Avenue n f to, 4 t S -V-A- P O Box 7162 Department of Commerce In accord with C .05, W A Code ' Madison, WI 53707 -7162 • Attach complete plans (to the county copy only) for '`system, on panot I County than 81/z x 11 inches in size. r � tr .s' �titlt� ar Pu • See reverse side for instructions for completing this �apf3licatior> State S 3 anitermit N ber Gou wy Z y� Personal information you provide may be used for secondary purpose ZCp�,- �> E] Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. r f",g Pl an Review Transaction Number I. PPLI ATI N INF RMATI N - PLEASE PRINT AL Isdf� X Property Owner Name rty Location SIR /4 1/4, S T , N, R E (o W Property Owner's Mailing Address Lot Number Block Number GC — City, State Zip Code Phone Number Subdivision Name or CSM Number . TYPE B I DING: (check one) ❑ State Owned 0 cit Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms_ o V ows o f III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s 1 ❑ Apartment /Condo ^'213 2- _ 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. Z New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5, ❑ Repair of an __System _____ ___System Tank ank Only Existing System Existing System - _ xistin ________ 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 JaMound pe 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 [] In-Ground Pressure r 42 E] Pit Privy 13 ❑ Seepage Pit r 43 [] Vault Privy 14 E] System -In -Fill 8 . Q oZ.� S VI. ABSORPTION EM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev.: 7. Final Grade Required (s q. ft.) Proposed (sq. ft.) (Gals/da /sq. ft.) (Min. /inch) ' Elevation 4 1 1 0 1 .97 G Feet p Feet Capacity VII. TANK in Ca allons Total # of Prefab. Site Fiber- Exper. INFORMATION gallon Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existing structed nks Tank Septic Tank or Holding Tank I & t • s f v 0- ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber Q 'A" 7`c°`.[� ❑ ❑ ❑ ❑ 1 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite se age system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: { tamps) P PRSW No.: Business Phone Number: ( 2 l Plumber's Address (Street, City, State, Zip Co ): .lei 70 IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sa ' ary Permit Fee (Includes Groundwater D ate I ssued Issuing Agent Sign ture (No Stamps) � p Approved []Owner Given Initial Surcharge Fee) Adverse Determination c 6 6 7 "Z�fl X. CO DITIONS F APP OVAL /RE SON FOF� DISAPPROVAL,,• ��(5, �� + S�b� c-1� C�M 3zo� SBD -6398 (RA 2/99) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber I INSTRUCTIONS ` 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608 - 266 -3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to oe installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. Iii. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber 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; 8) 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. y Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 - TDD #: (608) 264 -8777 isconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary June 01, 2000 CUST ID No.691727 ATTN: POWTS INSPECTOR ARTHUR L. WEGERER \ ^:, ' OFFICE 421 N MAIN ST �T, CROIX COUNTY SPIA PO BOX 74 11, CARMICHAEL RD RIVER FALLS WI 54022 ON WI 54016 RE: CONDITIONAL APPROVALS PLAN APPROVAL EXPIRES: 06 /01 /Z{l' )2 � '' , au� Identification Numbers Transaction ID No. 312321 rr`�'� �j Site ID No. 191010 f' Please refer to both identification numbers, SITE: J ai Site ID: 191010, ALAN OSBURN `�' �,' i � � : above, in all correspondence with the agency. ST CROIX County, Town of TROY; TRILLIUN7L�1�T", RIVER FALLS 54022 SETA, SETA, S3, T29N, R19W FOR: MOUND, NEW, 450 GPD Object Type: POWT System Regulated Object ID No.: 660475 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: 1. This plan action is subject to designer comments on the plan. 2. The orientation of the mound system must be such that the mound's longest dimension is perpendicular to the direction of maximum slope. 3. Vehicular traffic is prohibited in the area 25' beyond the down slope edge of the mound. ➢ NOTE: A soil absorption system should be designed as long and narrow as possible. This system has a high linear loading rate of 9.57 gallons per foot. 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 law suit 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. ARTHUR L. WEGERER Page 2 6/1/00 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 04/24/2000 g r FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 PATRICIA L SHAl`1DORF , POWT PLAN REVIEWER BALANCE DUE $ 0.00 Integrated Services (715) 634 -7810, FAX: (715) 634-5150, M -F 7:45 AM - 4:30 PM PSHANDORF @COMMERCE.STATE.WLUS WiSMART code: 7633 cc: ALAN OSBURN - Safety and Buildings • 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264 -8777 Visconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary June 01, 2000 \, CUST ID No.691727 /y R . ATTN: POWTS INSPECTOR ARTHUR L. WEGERER ZONING OFFICE 421 N MAIN ST ST CROIX COUNTY SPIA PO BOX 74 ` " 1101 CARMICHAEL RD RIVER FALLS WI 54022 r w r r ' HUDSON WI 54016 �X>UN . 'CR'd;NGOF ^iGF / RE: CONDITIONAL APPROVAL f PLAN APPROVAL EXPIRES: 66/Q11/20Q2 L,4 V., Identification Numbers Transaction ID No. 312321 Site ID No. 191010 SITE: Please refer to both identification numbers, Site ID: 191010, ALAN OSBURN above, in all correspondence with the agency. ST CROIX County, Town of TROY; TRILLIUM LANE, RIVER FALLS 54022 SETA, SETA, S3, T29N, R19W FOR: MOUND, NEW, 450 GPD Object Type: POWT System Regulated Object ID No.: 660475 CO1 �,f,�d,dll t , The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes d�'r 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. CEFAR;� \'ENS The following conditions shall be met during construction or installation and prior to occupancy or use: Dtv (1(r Sf`:FE 1. This plan action is subject to designer comments on the plan. 2. The orientation of the mound system must be such that the mound's longest dimension is perpendicular SEE coo to the direction of maximum slope. 3. Vehicular traffic is prohibited in the area 25' beyond the down slope edge of the mound. ➢ NOTE: A soil absorption system should be designed as long and narrow as possible. This system has a high linear loading rate of 9.57 gallons per foot. 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 law suit 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. • ARTHUR L. WEGERER Page 2 6/1/00 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 04/24/2000 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 `PATRICIA L SHANDORF POW TS PLAN REVIEWER BALANCE DUE $ 0.00 Integrated Services (715) 634 -7810, FAX: (715) 634-5150, M -F 7:45 AM - 4:30 PM PSHANDORF @COMMERCE.STATE.WI.US WiSMART code: 7633 cc: ALAN OSBURN I i Page of 6 MOUND SYSTEM FOR A 3 BEDROOM RESIDENCE LOCATED IN THE 1/4 OF THE SC 1/4 OF SECTION ,T z - ° l N, R 19 W, TOWN OF - T\ - f ST•GZA COUNTY, WISCONSIN. LoT �\ o t= C oU►..�y�oD INDEX PAGE l 'of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW -CROSS SECTION. CJ) PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT 7` .PAGE 5 of 6 PUMPING CHAMBER PA GE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR ;},til CA S36 T�ZII LUU N L_r)JE.Tf' � Sq Ul P 5,00V4 PREPARED BY L�IEGEF�ER E3 I L TEST I NG AND. ,o�4lHltpy DES z ism E31aRV I +CE �SClOks %, P.O. BOX 74 421 K. KAIK ST. s ` ? ;e0 't RIV9.. FALLS. MI 54022 j WEG.zHER 715-42`r -01b5 Ei SWORTH, wrs. Ll '� �S IGN� ► JOB NO. PLOT PLAN Page 7- of (� � Scale 1 "_ �� � ' I TJO rvoT`��T o yZ. O L S'1uR -13 nti S Vt)jt - 14 . S Y11lV, s. e. t�S'o� y ,< S ykPl'C c ouNvlZ L 98.0' N W c C (T) WE PTT LMT So' TI6_1 )"1 uuxA - 3 7tS FIVT 2:S' P1_Wj►_ i 1_ ljGt _ S�[S.oq i NOTES 1. Elevations shown are existing ground elevations unless otherwise noted.. 2. Install permanent markers at end of each lateral. ( required) 3. Install 4" observation pipes with approved caps. ( required) 4. Septic tank to be gallon capacity manufactured by . 5. Bench Mark gM *J- L�-- t axe Litz" 1�UC1pFP� w 1 LP" e� 42 - EL, 1 J) L . of ♦ A If I • w 6. Divert surface water around mound to prevent ponding at the uphill side. - Page Of b Approved Synthetic Covering F-s7 C 33 Distribution Pipe Medium Sand H __ G Topsoil — F Elev. 1.10.0 3 E D b 6 % Slope Bed Of 2— 2 %2 Force Main Plowed Aggregate From Pump Layer _�,�Of Ft. Cross Section Of A Mound System Using E 1M R. A Bed For The Absorption Area F o -'b Ft. G L- 0 Ft. A 'e) Ft. H l- S Ft. Linear Loading Rate =9.� GPD /LN FT B Q7 Ft. Design Loading Rate= O• `4.GPD /SQ FT j 1 Ft. J Ft. K \L Ft. Alternate � n L Ft. W L 3� Ft. i Observation Pipe fl K - -- A W to - - -- - - -- ------ -�- - -- ---------- a -------- - - --•I Force Min --------- --- --- - -- Distribution Bed Of %~— 2 % 2 2 Pipe Aggregate I Observation Pipe Permanent Markers (Anchor securely) I Plan View Of Mound Using A Bed For The Absorption Area I :. IP Page 1 4 Of b Perforated Pipe Detail 0 End View Perforated End Cop PVC Pipe ads° C'15 Install permanent marker at end of each lateral Holes Located On Bottom, Are Equally Spaced Q S PVC Force Main Q PVC Manifold Pipe i pistri ution Pipe Last Hole Should Be Next To End Cap End Cap . p Z Ft . Distribution Pipe Layout S y Ft. X 36 . _;nchPs Y :1b Inches Hole Diameter 4 I y ,finch Lateral '40 Inch(es) Manifold 2- Inches Force Main '2 Inches # of holes /pipe g Invert Elevation of Laterals \o3.5 Ft. ti Place 1st hole lg from center of manifold with succeeding holes at 16 u intervals. Last hole to be next to the end cap. P Combination Septic;Tank and PUMP CHAMBER CR055 SECTION AMD SPECIFI ' PAGE S OF � VEUT CAP WEATHER PROOF JUUCTIOW BOX 4 "C.I. VENT PIPE APPROVED LOCKING X 10' FROM DOOR, MAWHOLE COVER kQ11•i '•iiUDOW OR FRESH u'AR►.a11.16 LA6EL. AJR IMTAKE S co►�D�IT 6uMPX. = I I -- WNW. y PI?t � �� — IAJLET W /yLCZTt6e{T eltp PROVIDE AIRTIGHT SEAL I I Approved A I (� I Approved joint w/• Tank construction I joint w/ PVC pipe shall comply with ALARM PVC pipe ILH1 1 and 83.20 o I II ( I I I aJ C ( I S'-' CLEY. FT. PUMP .� OFF � D COUCKETE C BLOCK 1 3" APPRoyE�- RISER EXIT PERmj7TED OWLy IF TA MA ►JUFACTURZK HAS SUCH APPROVAL SEPTIC F SPECIFICATIONS DOSE TAUS MAWUFACTUR.ER: t AIDw -I`J P12- �t�}3 WuMbER OF DOSES: 3 ° PER DAy TAUK �AQC: GALLOWS DOSIi VOLUME r ALARM MAWUFACTURGR: S•S, M.qptp S LI,SI - IMr LUDIAJG BACKFLOW: X 53 G AGLONC MODEL ►.!UMBER: CAPACITIES: A= 1 � 3c �, IAICHCS OR CALLOUS SWITCH TYPE: 8 = z ' IISCHES OR 4 G( LLOU5 PUMP MAUUFACTUR C-G ULAy,s C W CHES OR GALLOUS MODEL ►DUMBER: L S 1� ` SWITC y"1, D = INCHES OR CALLOUS H TYPE MOTE. PUMP AMD ALARM RE TO bC MIUIMUM DISCHARGE RATE 3�GPM INSTALLED OU 5EPARATE CIRCUITS VEKTICAL DIFFERENCE DETWEE)i PUMP OFF A►JO..DtSTRIBUTIO►J PIPE., tiy.-1S FEET + MWIMLIM KIETWORK SUPPLY PRESSURE . . . . . .. . . . _ 2.50 FEET f FEET OF FORCE MAIN X !3 - � , _ F yoFrFR►CTIOU FACTOR.. 3.tis FEET TOTAL OtWAMIC HEAD = 1 _ 40 FEET As per manufacturer ` gal /in. Liquid depth 18 `� 6 Gould S Submersible Effluent Pun EPO4 38 71 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- •Homes Available for automatic and g components. tic cover with integral handle • Farms Motor: manual operation. Automatic and float switch attachment • Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical points. • Water transfer 115 or 230 V, 60 Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, built in overload with preset at the factory. rated oil and water resistant. automatic reset. ■Bearings: Upper and lower RP 115 V, 60 Hz, 1550 RPM, SPECIFICATIONS • EP05 Single phase: , FEATURES heavy duty ball bearing Pump: EPO4 built in overload with ■ EPO4 Impeller: Thermo- construction. • Solids handling capability: automatic reset. plastic Semi -open design 1 /4 " maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. ". Canadian Standards Association * Total heads: up to 24 feet. with three prong grounding ■ EP05 impeller: Thermo- • Discharge size: 1 1 /2" NPT. plug. Optional 20 foot (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for end in 7" or "AC ".) rotary/ceramic - stationary, three prong grounding plug improved performance. BONA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. Fasteners: 300 series METERS FEET stainless steel. 10 • Capable of running i d without damage to 9 dry 30 g —�5 GPM components. ' Pump: EP05 8 I _T • Solids handling capability: 0 25 3 /4" maximum. a • Capacities: up to 60 GPM. 0 s 20 zo.yo • Total heads: up to 31 feet. • Discharge size: 1 NPT. z 5 i • Mechanical seal: carbon- c 15 ��- rotary/ceramic-stationary, _j 4 BUNA -N elastomers. o :� EPOS • Temperature: 3 10 104 °F (40 °C) continuous ; I EFL 140 °F (60 °C) intermittent. 2 5 �~ i 0 0 0 10 20 30 40 50 GPM , 0 2 4 6 8 10 12 m�/h CAPACITY © 1995 Goulds Pumps, Inc. Effective May. 1995 Wisconsin Department of Industr SOIL AND SITE EVALUATION REPORT g 1 of 3 Labor and Human Relations f 0 Divisn of Safety &Buildings in accord with ILHR 83.05, Wis. Adm. Code g j C , Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but t . not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or EL I.D. # dimensioned, north arrow, and location and distance to nearest road. 11 A MU 0 1995 APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION WED BYST CraOuc D VPA OOWTY PROPERTY OWNER: PROPERTY LOCATION Richard Stout GOVT. LOT SE 1/4 SE 1/4, or) W PROPERTY OWNER':S MA!I_ING ADDRESS ��, LOT # BLOCK# I SUED. NAME OR 1353 Awatukee Trl. 1-69- na (tniRsncht CITY, STATE ZIP CODE PHONE NUMBER ITY ❑VILLAGE SOWN NEAREST ROAD 16 (715 49 -6731 Troy Tower Rd. [)q New Construction Use [x] Residential / Number of bedrooms 3 (J Addition to existing building j J Replacement [ J Public or commercial describe Code derived dairy flow 450 gpd Recommended design loading rate • 4 bed, gpdm • trench, gpd/tt Absorption area required 375 bed n 2 375 trench, ft Maximum design loading rate • 4 bed, gpd/ft ' S trench, gpdm Recommended infiltration surface elevation(s) 96.66 ft (as referred to site plan benchmark) Additional design / site considerations system el. based on contour line of el. 95.66' Parent material limestone highlands Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for system 1 ❑ S 13 ®S ❑ U ❑ S ]CI U ❑ S ®U 1 ❑ S ®U ❑ S 91 U SOIL DESCRIPTION REPORT Boring# Horizon Depth Dominant Color Mottles Texture Structure Cons;stencelBandary Roots GPD /ft in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. Bed JTmnch 1 1 0 -10 10 r4 2 none sicl 2msbk mfr gw if .4 .5 M EM O 2 10 -25 10yr4 /4 none sicl 2msbk mfr gw if .4 .5 Gr 3 25 -34 10 r4 4 none scl 2msbk mfr qw na .4 .5 96 ft. 4 34 -55 2.5 7 2 none Fract red Limes one Depth to limiting factor 34" Remarks: Boring # 1 0 -12 10 r4 2 none sicl 2msbk mfr Crw if .4 .5 2 12 -32 10 r4 4 none sicl 2msbk mfr qw if .4 .5 Ground 3 32 -39 7.5 r4 4 none scl 2msbk mfr crw na .4 .5 9 4 39 755 2.5 7/2 none Fractured Limes one Depth to limiting factor 39" Remarks: CST Name: Please Print Phcne: Gar L. Steel 715 - 246 -6200 Address: y � i , 10 -27 -95 1554 200th Ave., New Richmond, 54017 _ 1 Signature: _ CST Number: PROPERTY OWNER Richard Stout SOIL DESCRIPTION REPORT Page 2' i PARCEL I.D. # Pending + I I Structure I I � Boring # Horizon Depth [Dominant Color Mottles +Texture Strt Consistence IBourxiary Roots GPD /ft in. Wnsell Cu. Sz. Cont. Color Gr. Sz. Sh. Bed !Trench 0 -$ 10 r3/3 none s>_cl 2msbk mfr cs i f .4 .5 Ann " 2 8 -21 10yr4/4 none sicl 2msbk mfr gw if .� .5 Ground 3 21 -3 10 r4 4 none scl 2msbk mfr gw na .4 i . 5 93 e11 ft 4.- 31- 2.5y7/2 none Fractured Limestone Depth to limiting factor 31' Remarks: Boring # Ground elev. ft. Depth to *siting actor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. I Depth to limiting factor Remarks: SBD- 8330(R.05/92) STEEL'S SOIL SERVICE Gary L. Steel Richard Stout 1554 200th Ave. CSTM2298 SE4SE4 S3- T28N - R19W New Richmond, WI 54017 MPRSW 3254 town of Troy (715) 246 -6200 I lot #62- Country Wood � " =40 6m.= top of 1 "steel pipe C el. 100' )Alt. BM. - top of wooden post C el. 103.6' )39 s� S r i \ y � Gary L. Steel 10 -27 -95 I Wisconsjn Department of Commerce 2✓�e'� -' f Divisionoof Safe and Buildin s SOIL AND SITE EVALUATION G � & age j_ of Bureau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and — /, x_ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. # APPLICANT INFORMATION - Please print al'Ir>!a /? Reviewed by Date Personal information you provide may be used for secondary p �s,(kvacy L rl s.'1 5,U4 (1 )). }`� `axio Property Owner / [' (I Prope Location A" Q �� , Govt. tbt s� 1/4 1/4,S T Lc� ,N,A [ E (or)�VJ Property Owner's Mailing Address (.ot # Plock# Subd. Name or CSM# tz City State Zip Code Phone Number ❑ ❑Village Town Nearest Road New Construction Use: Residential / Number dkoocr3s Addition to existing building Replacement M Public or commercial - Describe: Code derived daily flow 6 4 = gpd — Recommended design loading rate f S bed, gpd/ft trench, gpd/ft Absorption area required iPoG bed, ft trench, ft i esign loading rate - 5__ bed, gpd/ft _ - (0 trench, gpd/ft Recommended infiltration surface elevation(s) U ft (as referred to site plan benchmark) Additional design /site considerations Parent material ' •: I ( Flood plain elevation, if applicable S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ S [a U Q S ❑ U ❑ S R U ❑ S P U I ❑ S &� U I ❑ S 9 U SOIL DESCRIPTION REPORT Boris # Horizon Depth Dominant Color Mottles Structure GPD /ft Boring in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench ass 3 b rnr 5; la _ Ground 3 2� - F( 1.J 4 I QD 5 L Gbl � C S 4 elev. 9&-� ft• ' Depth to limiting factor Remarks: Boring # i 0-41 (D r 5; ( Z CY C 1'JS S 2 2 N Ow 'A F-co. r 1t I n e- Ground elev. Depth to limiting factor Remarks: CST Name (Please Print) Signature Telephone No. alcL Sch ke (7i - )2V7 -Y-')o Address Date CST Number Z 11 96 4 Sf• 25 36 � PROPERTY OWNER SOIL DESCRIPTION REPORT Page Z cif 3 ' 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 3 b -Zy l Z m K m4i C-5 J C S' Zy r 3( ( Ground 3 i 114 F 1. `t (o 5. �. 3 k r� C_ 5 elev. Depth to limiting factor Sin. 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 # L a .kal�n...., .... Ground elev. ft. Depth to limiting ; factor ' Remarks: Boring # Ground elev. tt. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) PAGE S OF NAME d S b c.) C e\ LOT# ] LEGAL DESCRIPTIONt E %.5 E` /4,S 3 T 2 9,N,R aE (or) SCALE: 1 "= BM 1 ELEVATIO�( U BM 1 DESCRIPTION � A' e BM 2 ELEVATIO . 3 BM 2 DESCRIPTION +ap d i ✓c. �; p 1 j SYSTEM ELEVATION 100. ALTERNATE ELEVATION q / v 14 x CONTOUR ELEVATION [ 0. Od . 3 rA ,r Gy w DATE SIGNATURE `U� i . i s`r��`. �i�.JCl rf .. C.� � tM• .� 'i.'�, 1.,i « rf ;, 1 ',. A {. a rt irCi : fat unk SE py ! [,�ia.4s�. �:.� - u � `�rj Y Sp. .0 i'a ��� -�. �� X •� eI A� •� �. :�:.> R\ i .. ... - ._ 1 . w .. A` - ,t..". ° � -.. .`:4. � +•,. �✓`!S�Th'•' '.l'�.1. .. .. i aT.��C 3'• �Yf,' ''�` ?.�.°>. �:.1'P.fi..; � .,. - , t.'S'?'K7{ S:i„` f� iXt �. .xr.lD �:',rr•',: ,. . #.aiY- 'G':tt9C b lr.; �„�.c-�t..;< ,.. e.:' . -.. .. k <, . e4,wN.@ , :.,, w!>:'.�;;,:,�^�,3t. ^.:�','� �;•x ': "'.V.ait� C' {, „ .r`"Yt. ... 'd +� > .. •�:...� �;.� i'�.v`:,' s:.. .. : ?:� "�-' �, r . «y ' #.'�� r"�:.:Z"n'M � �,+r * dpi �' •.� f 1, .. :..., r r. y f...i w'r a,` }_ .., ... L ONrtlaa .. r .:,Z ,.'..s,a : /�? .. j :: w:�r -, *`. >f ^sia.'i '.r r;tr` k.�,..:r: d Y =.�'1tL�. 'x. „r. ,-^ � .a .. .s :t� c,.s•': I -- - - - - - - - - - - - - - - - - - - - - - - STATE BAR OF WISCONSIN FORM 2 - 1998 621396 WARRANTY DEED KATHLEEN H. WALSH REGISTER OF DEEDS Document Number n(� ST. CROIX CO. WI VD.Ll1PAGE�1�.._ RECEIVED FOR RECORD This Deed, made between - 4� -l7 -2000 11:30 AN RICHARn 0 STQCIT — ._._ WARRANTY DEED --- -- — Grantor, EXEMPT I CERT COPY FEE: and E- �O SBURN and JO H. O SBURN COPY FEE: husband and wife, -- _ TRANSFER FEE: 128.70 RECORDINB FEE: 10.00 - ' Grantee, PAGES: 1 __ ......_ , Grantor, for a valuable consideration. conveys and warrants to Grantee the following described real estate in qt- rrni x County, Slate of Wisconsin: Ht4.:or,4ng Amug Lot 11, Plat of Country Wood, Town of Troy, Name and Return Address St. Croix County, Wisconsin. �toa s aa.d 5t• E..� LU,1 -s4ot - a9a�op 040 - 1232 -10 -000 Parcel Identification Number (PIN) This — 110t homestead property. (is) (Is not) Exceptions to warranties: easements, restrictions, rights -of -way and covenants of record. Dated this 1 4th day of __Anr i 1 ')000 .an& (SEAL) (SEAL) * Richard O_ Stout (SEAL) _ (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, ss. St. Croix County. authenticated this day of Personally came before me this 1 4th day of April 21300 the above named - Mich &rd - a Stout TITLE: MEMBER STATE BAR OF WISCONSIN __ to (I[ not, me known to U446 iecuted the foregoing authorized by §706.06, Wis. Slats.) Instrument and CONSIN �- ON J. BAST THIS INSTRUMENT WAS DRAFTED BY "" __._ Janet P. Stout 1 Awaf; ulcee TL. - - Hudson, Wi. 54016 Nola � Publlc,Stateof Iconsin My ommission is pc anent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) Names orpersorn signing in any capacity rn be typed or printed below their signabire. STATE BAR OF WISCONSIN Wisconsin Legal Sunk Co., Inc. WARRANTY DEED FORM No. 2 - 1998 Milwaykee. W.S. a , 1 } I ? 217.50' i 235.11' 165.24' 187.50 30.00' i m S89 ° 52'31 "E 617.85' y m 1 _L 0 N T W �� 10 N I v O I t' 3 $ 3.13 ACRES 136,189 SO. FT. In 1 IC7 N89 ° 52'31 "W 581.47' 1 1 N � 1 1 $ W rn 2.94 ACRES N v v o w 127,921 SO. FT. I 1 N89 ° 52' 31 "W 545.09' 1 N OD i ®$ w 1 � =' 12 r- i 4.77 ACRES I v i� 207,717 SO. FT. l �) I L7 O r � � F 62! S3 13 5.78 ACRES S F Ao 251,941 SO. FT. 0 3,E F 6' g �41 P � , ` o FILED 110 /iy JAN 0 9 1997 1- s G 1� Q 9 �'P� o' �o�fv log y 3a uK Q SLCroIxCo „WI 554333 0 -� w r CERTIFIED SURVEY MAP i Located in part of the SE 1 /4 of the SE1 /4 and the NE1 /4 of the SE1 /4, all in Section , T28N, R19W, Town of Troy, St. Croix County, Wisconsin; being part of Lots 9, 10, 11, 12, plat of Countr 13, and 14 of the p . Y Wood. OWNERS ! 4 Corner of . E1 i LEGEND Section 3 c !� Aluminum County Section Corner Monument Found Richard & Janet Stout 2” Iron Pi a Found 1353 Awatukee Trail P Hudson, WI 54016 3 • 1 Iron Pipe Found\ ' ON ® Berntsen Survey N M Marker Nail Found ` '^ N 1 x 24 Iron Pipe Set, N weighing 1.13 lbs. per LOT 9 N ° o linear near foot.\ o >_ b — -- — 12' Wide Utility asement �� *2.03 Acres y ` 88,449 Sq. Ft. D O4� U o * Area remaining in previously v platted lots excluding that �3 4) E lying in Outtot Q. 227.09' �cn S89 2 609.83' c W Ar W 00 w e cS LOT 10 ,,, co *3.04 Acres n r= c Co G�i 132,274 Sq. Ft. N o ' n o NOTE: The . creation of Outlot 2 1a £ 1 _ nl$9 °52'31 "W shown on this Certified 1 555.02' o 0 Survey Map is f the �O .0 a G purpose of realignment and Ira o dedication of additional ltd L_O_T_ 11 0 ;-a°+ W y lands for the public IN It'' IH t o *2.75 Acres c 8 street; P , m M due to unstable soil.conditions. 10 - �'� 119,820 Sq. Ft. N a 4J 1N %- at m N89 d 1 -- Soo 0 N Z) �i ' `' �• v � n.rwE LOT 12 00 +� 4. 0.66 Acres *4.52 Acres o s rr.'..i 28,750 Sq...Ft:. / 196,815 Sq. Ft. n S ° w i S3 r N81 ° "E 6 �-- S81 0 12'15 "W p y �� 36.22 S LOT 13 W � *5.67 Acres 246,900 Sq. Ft. 'Li LOT 14 •5�- $ 001 C1 0% y o *5.98 Acres Z 260,368 Sq. Ft. — 1059.48' — 247. 0 1567.03' 812.48' SE'Cornerof S89 0 38 1 39 11 W 2626.51' Section 3 �— S114 Corner of South line of the SE114 of Section 3 Section 3 I SCALE IN FEET o loo 200 aoo I SHEET 1 OF 2 SHEETS i VOL. 11 PAGE 3201