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HomeMy WebLinkAbout040-1242-40-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM ' Safety alAd Buildings Division Count INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanita o.: Personal information you provice may be used for secondary purposes [Privacy LawA.15.04 (1 m)]. 3SS85"7- 113a j§ H1Q0ifi6p ne: ❑City ❑ V 16Qy Ip State Plan ID No.: CST BM Elev.: r Insp. BM Elev.:� Description: Parcel 1061242 _40-000 WJ (30 . c`� S w 1 Itt t tLA, < <s�°'� =L� o - 17 TZ TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATI N BS HI I FS ELEV. Septic Dosing Aeration Bldg. Sewer Z t.5'o Holding St /Ht Inlet Z3.3 TANK StilfACK INFORMATION St/ Ht Outlet 2- 3 82•Sb ` TANK TO P/ L WELL BLDG. pe Intake ROAD Dt Inlet 2 3 - 4-0 <RZ.3$ Septic + 3(m' z z NA Dt Bottom 2 0.� -F- Z }.cp' T 1, 0 Dosing ^• Z5 r r NA Header /Man. 1' 9 8 off -olt L Aeration NA Dist. Pipe �0 t{ �V Holding Bot. System L �3� ?; /03.1 PUMP / SIPHON INFORMATION R,ytalh�yre --�je Manufacturer Demand I c� Model Number L„} ,.. GPM S C` L0, at Cv�rcl 0 TDH Lift Friction System TDH Ft ead Forcemain Length..,350 Dia. Fi if Dist. To well SOIL ABSORPTION SYSTEM Z'v. 3 4-0) O� EN IEN#4 Width r Length t f� . Ofj-; aes PIT o. Of Pits inside Dia. Liquid Depth '{ 1 �Groa4S DIMENSION SYSTEM TO P/L BLDG WELL LAKE /STREAM LEA NG Manuf urer: SETBACK CHAMB INFORMATION Type O Mod Number: System: o ,,.� ` OR UNIT DISTRIBUTION SYSTEM �-�• �'�, • `f Header / Manifold if Distribution Pipg s ll t �! x Hole Size x ole Spacing Vent To Air Intake Length S- Dia. 2— Length Aia. ('� Spacing �° ] , tt 3( y SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over 7Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed !Trench Center Trench Edges Topsoil I ecti0 # Yes/ No In i@il #Rj No {� M MENTS' I co a discr a ties o r e t — - Location: 5.38 ril�Ium uasotS, � � �' ? ie X1 E 1/4 3 T28N R 9 /) - 032 [ 1 1233 Countrywood Addn. II -Lot 75 - te , r� 1 � X) we 1.) Alt BM Description = C **N 1 s � - -- '- 2.) Bldg sewer length = Z,� " - amount of cover = la contour )0'3, u (un otrel rc_ fert Plan revision required? ❑ Yes X No Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert No. q3g 5 38 ( e i LU UA Sanitary' Permit Application Safety & Buildings Division In accord with Comm 83.21. Wis. Adm. Code 201 W. Washington Ave. Ivi sconsin See rc%erse side for instructions f PO Box 7302 for completing this application Madison, WI 53707 -7307 Personal information you provide may be used for secondary purposes Department of Commerce (Privacy I.a%%. s. ' 15.04( 1)(m)] (Submit completed form to county if no state owned. Attach comp lete plans (to the count\ co v only I tier the system. t less than 8 -1/2 x I 1 inches in size. County St a S3 ' Number ❑ Check i( •� to i s pP tion State Plan 1. D. Nunibe 3T/ 3� T 1. A lication Information - Please Print all Information `! Location: Property Owner Name I Prop E erty Location r ! I14 114, N, or 1 � Property Owner's Mailing Address tJ' ± ,, , Lot Number Block Number City, State Zip Code r G pFFi CE ` Subdivision Name or CSM Number II Type of Building: (check one) ,, O Cit Y I or 2 Family Dwelling -No. of Bedrooms: 3 .5 ❑ Village O Public /Commercial (describe use): Town of O State -owned III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Nearest Road A) 1. f0 New System 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Addition to Parcel Tax Number(s) System Tank Only Existing System — 1� -.2 B) Permit Number Date Issued ❑ A Sanitary Permit was previously issued 0 - / a 4 1 A — 4 ffl IV. Type of POWT System (Check all that apply) • Non- pressurized In- ground Mound ❑ Sand Filter ❑ Constructed Wetland • Pressurized In- ground (�7 Holding "rank ❑ Single Pass ❑ Drip Line • At - ad , qq,, Aerobi � Treatm t Unit ❑ ecirc lacing []Other: * G�.4.r� a�( /03•o k �s' Ms d COQ p _ V Dispersal/Treatment Area Information: ~- 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percorattbn'Rate• 6. System Elevation 7. Final Grade Required - - Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) Elevation VI Tank Capacity in 'Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks aD J L Con- Con- glass New Existing crete structed Tanks Tanks ❑ ❑ ❑ o A mp II Re ponsibility Statement I, the undersigned, assume responsibility for installation of the PO4 shown on the attached plans. Plumber's Name (print) Plumb r^ Plumber Signature (no stam s 44WMPRS No. Business Phone Number Et Zt&22251 b ?� // _ umber's Address tree , City, State, " tp Code) VIII County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) l�Approved ❑ Owner Given Initial Adverse Sur rge Fee) rm / t Determination � _ - 1- - PAW a 200 I Co ditigns of A ppp /I ,easoons ff 9 h �� e. appvaJ: 102 S ��CCS f x: X-l� P11 C Oak ( S �na. &Vs� - S C N tut n �cu�n t SBD -6398 (R. 07/00) PLOT PLAN Page 3 of Scale 1' y3, — r N COT Ta SC t ( g • 0 N a.3 t't 103 $ ,��k y h ovC J 0 1 0 c� i � Z VI PVC F, H, g.i i'Z LO Z - b01v01 � i S'Rh�A T�i-iS t't1Z - - PVT-- t-e"T -S t1: - -F ►vl Yt'I UL3i�C5 NOTES: _. I. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required), 3. Septic tank to be l oop gallon capacity manufactured by L`J� -S CCbu c�� 1 Z��'.L F LT �n�1�D� `ID 1��_ YiOOC f 1"'L , 4. Bench mark • t1..1 Op.O' cYJ _MP OF LOT STA-k F?-T Sk3 Lvr CoRijER • S _ nivart ciirfne+n Safety and Buildings r 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 V insconsin - /� \� TDD #: (608) 264 -8777 www.commerce.state.wi.us /sb 0�� www.wisconsin.gov Department of Commerce Scott McCallum, Governor Brenda J. Blanchard, Secretary May 07, 2001 CUST ID No.691727 ATlN.• PORTS Inspector ARTHUR L WEGERER ZONING OFFICE 421 N MAIN ST ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/07/2003 Identificat e Transaction ID N . 637341 Site ID No. 6284 6 SITE• Please refer tobo entification numbers, ; SITE ID: 628466, Kemon Bast above, in all corres ondence with the> agenc St. Croix County, Town of Troy SETA, SETA, S3, T28N, R19W Subdivision: Country Wood Second Addition - lot 75 FOR: Description: Three Bedroom Mound System Object Type: POWTS System Regulated Object No.: 788256 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED.The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD- 10706 -P (N.01 101). • 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. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound manual, and section VI of the pressure distribution component manual are complied with.. A copy of this information must be given to the owner upon completion of the project. • 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. • 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 b authorized representatives of the Department, which may include local inspectors. All permits P Y P required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. I • ARTHUR L WEGERER Page 2 5n /oi I 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, DATE RECEIVED 04/10/2001 &V FEE REQUIRED $ 175.00 _ -_— FEE RECEIVED $ 175.00 Gerard M. Swim BALANCE DUE $ 0.00 POWTS Plan Reviewer - Integrated Services 608 - 789 -7892 Mon - Fri 7:15 AM to 4:30 PM jswim@commerce.state.wi.us WiSMART code: 7633 I I TITLE SHEET Page of I FOUND SYSTEM FOR A .3 BEDROOM RESIDENCE This plan has been prepared in accordance with the Mound Component Manual SBD- 10691 -P and the Pressure Distribution Manual SBD- 10706 -P (N.01 101) (N.01 101) LOCATED IN THE SE 1/4 OF THE Se 1/4 OF SECTION 3 ) T Z & N, R Ig W, TOWN . OF , S�' • t°_1X COUNTY, WISCONSIN. INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEM MANAGEMENT PLAN PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEtid -CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUI.IPING CHAMBER CROSS SECTION PAGE 7 of 7 PUMP PERFORMANCE CURVE PREPARED FOR +4 - 1crvo�a - air -_ �CEID Aw At L. PREPARED BY WEGEFZ E =FR. .. 53 C3 X L . TEST S NG AND. L?E =S 3: G;V S] S CE P.O. Box 74 421 N.Main St. River Falls, WI 54022 Phone 715 -425 -0165 GDP��' Fax 715 - 425 -6864 ` • ""' "'••• �r ® 'ti AP.ToUr L P • W T.S. , 0. . � C1.915 P Conditional t y GLLS .�,,. FT RO�`E r ...., A MENT Of C0 MERCE .r cry• 4 "Q . - Z y ti OEPART p gU11AfNG= � - AeS tM G ORRESPONDENG JOB NO. OI'�� Mound System Management Plan p age Z- of - 7 Pursuant to Comm 83.54, Wis. Adm. Code • ' Seotic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October - February) dictate that the mound be heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg /L 6005, 150 mg/L TSS, and 30 mg /L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. - Code, and shall maintained in accordance with its' component manual [SBD- 10572 -P (R. 6/99)] arid local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Continaencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions about the operation or maintenance of this system should be directed to: The County Zoning at qVS - V6b SC`. ai_w lX The system installer at 6S�- 40Z 2.113 6 The tank manufacturer at - 11 S 2LL6 - S2 a5 INE The effluent filter manufacturer at ado - ZZl - S7 qZ ZI era V_L __. The pump manufacturer at PLOT PLAN Scale 1 'Page 3 o f 1 uY _Z S or ec�u�,Y�zy' wooer 2-�`� 1'n»Z�vyv N)OT Ter ScA-LC -P �aA 4 030 3 3DRM _ 6. V' 1 T-\" r- N Z�8 O pk'c r-- J ! 17.v'pF r i � r i hr- LO Z DO 1voT Cam" 1PPe-T O\r- o BM NOTES: I. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required),. 3. Septic tank to be l Ooo gallon capacity manufactured by L`' S CCU 1 !IJ/A - LOob , Fi - M ?iooc,�t cr wN 4. Bench mark • tL. op,o' cJr`l 'MR OF LOT STI'kF F)T S1.J LoT COtulEEp 5. Divert surface water around system - to prevent ponding at the uphill side. Page OT Approved Synthetic Covering ASTH C33 Distribution Pipe Medium. Sand Topsoil -" _ H +' G _� ,• F Elev. . 3 E b S %. Slope Distribution Cell of Force Main Plowed Z" to 2- Aggregate From Pump Layer D o •� . Ft. E \-oS Ft. CROSS SECTION OF A MOUND SYSTEM F o - 8 Ft. G o-S Ft. A Ft. h 1 -O Ft. Linear Loading Rate= � -o GPD /LN FT B - 15 Ft. Design Loading Rate= b;33GPD /SQ FT I 1'Z Ft. J 6 Ft. K 9 Ft. A�te L g3 Ft. W 2 Ft. L ' �y - Observation Pipe 8 --� -- K C�- ------------ - - - - - -- - - - - -- - - - -- - Bok .. I - -- -- -- - - --- - -- - - -- -- - -- ` W `� Force Main Distribution Cell of to 2" Pipe aggregate , Observation' Pipe (Anchbr securely) t PLAN DIETS OF A MOUND SYSTEM Distribution Pipe Layout pA & S o f — 7 Place the holes at the bottom of the distribution pipes at equal spacing. Remove all burrs from the pipe and holes. Extend the end of each lateral up with the use of long turn or 45" fitting to a point within six inches of the final grade. Terminate the ends of the laterals with a valve,: threaded cap or - threaded plug. Provide access from final grade for the valve, threaded cap or threaded plug. i -CC`SS 8�x_ 7`1 ? I Ct3 L CZAS S. SnL.�1g 1�7 FV C F\1C PV C_ Lateral Manifold Lateral t x x x12 x!2 x x x x Lenoth — Lateral Length — P Distribution Line P r PrC.cl�s st,X �'1Y'�5.1 \FAW S W 12� n Rt�7 �;�'byt2�?'kyt4�o� • P F Hole Diameter }�a Inch S Ft. - Lateral Inch(es) 3. . X 3� inches Manifold �_ Inches Force Main " _ z Incdes # of holes/pipe 19 Invert Elevation of Laterals lbq Ft. Z.�qx PUMP CHAMBER CROSS SECTION ARID SPECIFICATIOMS PAGE OF _] YEIJT CAP '1" C.T- VENT PIPC WEATHER PROOF p.PPROVED LOCKING MANHOLE 10' FROM DOOR, JUAJCTIOIJ 80X ' COVER WITH WARNING LABEL WINDOW OR FRCSH I2�MIU. I AlR INTAKE 7 I GRADE � 8 g t 'I' AIM. • I - �. 18' MIN. COMDUIT 18'MIAl. ---- -- - - -- - 11� IMLIET PROVIDE _- AiRTIGNT SEAL ( I APPROVED JOIlJT A I I i APPROYED JOINTS . LL64�LIS FT. PUMP OFF 0 dlffV, s l - 00 , CONCRETE BLOCK • RISER EXIT PERMITTED ONLY IF TAWK MAIJUFACTURGR HAS SUCH APPROVAL 3'•A ?P12oYED 8b01� I p1� SPECIFICATIOUS DOSE Twi.I � R:- � � C2 Z, IJLI S _ OY K� MANUFACTURER. MBER OF DOSES: PER DM TAWK SIZE: g0c) GALLONS DOSE VOLUME r ALARM _ _1yA13tJFACTUR¢R: -- S•S �O Sy'si INCLUDING bAGICFLOW: 1�1 '� GALLONS MODEL NUMBER: 101 `cit-J _ - CAPACITIES: A = g - ---- - -- 3 S. j. 0 -- - -- UJCHES OR GALLONS SWITCH TyPt: L1Z �J-�' B o Z I NCHES OR 30 Gr LL01J5 PUMP MANUFACTURER: ul-bS C: �' ILICHE5 OR 11 C GALLOWS MODEL IJUMSER: 39$S w 0sN D: `S INC RE �,S09 Z S GALLONS SWITCH TYPE: iJOTE: PUMP A>uD ALARM ARC TO bC �" S MINIMUM DISClikRGE RATE 3r�GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE OETWEEN PUMP OFF AUO.015TRI15UTI6w PIPC.. I _�S) FEET t MINIMUM • NETWORK SUPPLY PRESSURE .. , 6 S� FLET - 1-10 FEET OF FORCE MAID! X Z F �o fT.FKICTIOLJ FACTOR. 3 �_ S S FEET TOTAL OyWAMIC. HEAD = 3Z.> S 8 -FEET \ q.5 _ gal /in. - - -- Liquid depth... tl PUti`1P PE1ZFOa-M n C-E C UZUE 1 � � 1 or- R — �, I uoulas Submersible Effluent Pump aT 3885 APPLICATIONS • Overload protection must smooth operation. Silicon can be operated continuously Specifically designed for the be provided in starter unit. bronze impeller available as without damage. following uses: • Shaft: threaded, 400 series an option. ■ Bearings: Upper and • Homes staiMess steel. ■ Casing: Cast iron volute lower heavy duty ball bearing • Farms • Bearings: ball bearings type for maximum efficiency. construction. upper and lower. g p ■ Power Cable: Severe du Trailer courts •power cord: 20 foot 2" NPT dischar adaptable ty • Motels for slide rail systems. rated, oil and water resistant. • Schools standard length (optional m Mechanical Seal: SILICON Epoxy seal on motor end • Hospitals lengths available). ry CARBIDE VS. SILICON provides secondary moisture • Industry .. Single phase: • '/3 Effluents stems • and /2 HP -16/3 SJTO CARBIDE sealing faces. barrier in case of outer jacket Y Stainless steel metal parts, damage and to prevent oil with 115 V or 230 V three prong plug. BUNA -N elastomers. wicking. SPECIFICATIONS • % -1'/2 HP —14/3 STO with ■ Shaft: Corrosion - resistant ■ 0 -ring: Assures positive Pump .` bare leads. stainless steel. Threaded sealing against contaminants • Solids handling capabilities: Three phase: design. Locknut on three and oil leakage. 3 /a" maximum. •'/2 - 1 ' / 2 HP —14/4 STO phase models to guard • Discharge size: 2" NPT. with bare leads. On CSA against component damage AGENCY LISTINGS • Capacities: up to 128 GPM. listed models — 20 foot on accidental reverse rotation. Total heads: up to 123 feet length SJTW and STW ■ Motor: Fully submerged in 0 Canadian Standards Association TDH. are standard. high -grade turbine oil for Mechanical seal: silicon lubrication and efficient heat Underwriters Laboratories carbide -rotary seat/silicon FEATURES transfer. carbide- stationary seat, 300 ■ Designed for Continuous series stainless steel metal • Impeller: Cast iron, semi- pen, non-clog Operation: Pump ratings are parts, BUNA -N elastomers. open, with pump- within the motor manufacturer's • Temperature: out vanes for mechanical seal P 104 F (40 a C) continuous protection. Balanced for recommended working limits, 140 °F (60 °C) intermittent. METERS FEET • Fasteners: 300 series so stainless steel. !SERIES: 3885 • Capable of running dry 25 80 ! SIZE: SOLIDS WE1 ? ( ! RPM: VARIOUS without damage to I ? — — - -- —. 5GPM — ! — components. 70 v u E, oH 5FT i Motor W 2° so I : I ! ! Single phase: _ ' EO •'/� HP, 115 V, 200 V, 230 V, 2 15 60 Hz, 1750 RPM; Y HP, z 115 V, 60 Hz, 3500 RPM; 'c 40 igEO x Y2 HP -1'/2 HP, 230 V, a ! I 60 Hz, 3500 RPM. 0 10 30 3 •05 • Built -in overload with wEO automatic reset. 5 20 ! t Class B insulation. — J Three'phase: 10 APill ,lE •' /2 HP -1'/2 HP 200/230/ 0 o i ? I ! ! ! 460 V, 60 Hz, 3500 RPM. 0 10 20 30 40 50 60 70 80 90 100 110 120 130GPM • Class B insulation.- sulation..: z 0 CAPACITY 10 nt :. 2 0 30 m /h ®1995 Goulds Pumps, Inc. Effective May, 1995 11 B3885 o.I Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of _ I hor and Human Relations Of Safety & Buildings in accord with ILHR 83.05, Wi :-£ne COUNTY Attach complete site plan on paper not less than 8112 x 11 inches in si must i clude, ;a rrnjx not limited to vertical and horizontal reference point (BM), direction an ° slop fir, PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. , _ pending APPLICANT INFORMATION- PLEASE PRINT ALL INFORM 1 ' 166 WED BY DATE � � r' E PROPERTY OWNER: PROP�RT.YtXATION 1/4 1/4,S 3 T 28 N,R 19 XR(or) W Richard Stout 1 ° �,, GOVT 20T,� r 1 SZ PROPERTY OWNERS MAILING ADDRESS OCK # " NW . - NAME OR CSM # 1353 Awatukee Trl. , n� " - Cb untrZv Wood Second CITY, STATE ZIP CODE PHONE NUMBER VVILLA - OWN NEAREST ROAD Hudson, WI. 54016 (715 549 -6731 1 Tro [X] New Construction Use [ :1 Residential / Number of bedrooms 3 [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate .4 bed, gpd /ft .5 trench, gpd/ft Absorption area required 375 bed, ft 375 trench, ft Maximum design loading rate • 4 bed, gpd/ft •5 trench, gpd/ft Recommended infiltration surface elevation(s) 104.6 ft (as referred to site plan benchmark) Additional design / site considerations ssytem el. based on contour line of el. 103.6' Parent material limestone uplands Flood plain elevation, if applicable n ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ❑S $7U ®S ❑U ❑S ZU ❑S EIU ❑S ®U ❑S ®U SOIL DESCRIPTION REPORT ' 2,�D Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon Texture Consistence Bouidary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Ttend't __ L l 1 0 -11 S 2 Ill-17 10 r4 4 none sicl 2msblc mfr •'w if .4 .5 `{ Ground 3 17 -34 .5 4 elev. 10 ft. 4 34- I Depth to limiting factor 34" i Remarks: Boring # 2 2 14-21 1 Ground 3 21 -27 7. elev. -- -- -- -- II 102 ft. 4 127-45 0 Depth to limiting factor 27" Rem arks: CST Name:— Please Print Phone: Gary L Steel - A ddress: 1554 200th. Ave. New Richmon Signature. Date: CST Number: 8 -14 - PROPERTYOWNER Rinhare3 gtni3t SOIL DESCRIPTION REPORT Page 2� `of y 1 I PARCEL I.D. # pendincr Lot #7 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GP in. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 2 10 -23 10 r4 4 none sicl 2msbk mfr - w if .4 .5 Ground 3 1 23—L8 7.5 r4 a none scl 2csbk mfr -, w na .4 .5 103 -- — -- -- ft. 4 Depth to limiting factor 38" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor FT i i Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) i 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 lot #75-Country Wood Second Addn. i `' 1 " =40' , top of SW lot stake C el. 100' N ti� i �3 lo ((jJ GAry L. Steel 8 -14 -96 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer ��",L'al.��/ KIEL Mailing Address Property Address 3 (Verification required from Planning Department for new construction) City /State 4�eWf G4 T t loI4 Parcel Identification Number - d VO — 12 V.) — OCO LEGAL DESCRIPTION Property Location � '/,, <&r, '/., Sec. 3 , T �g,-Y_ N -R_Zf W, Town of v Subdivision (i,edl cwmy ,z -�`� , Lot # _1 Certified Survey Map # , Volume , Page # Warranty Deed # ,63.zF'G3 , Volume _ /S , Page # S' Spec house O yes [/no Lot lines identifiable pf yes O no SYSTEM MAI Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resource$, 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 o the three year expiration date. SIGNAVRE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. / ; S / I / C) SIGNATURE OF APM ICANT 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 155 PAc,537 632563 STATE BAR OF WISCONSIN FORM 1- 1998 KATHLEEN H. WALSH REGISTER CROI OF DEEDS WARRANTY DEED ST. CFt]IX CO., WI Document Number RECEIVED FOR RECORD 11 -01 -2000 3:30 PN This Deed, made between Elizabeth A. Hanlon, a single person and Marilyn R. Neafus, a single person OARRANTY DEED EXEMPT N Grantor, CERT COPY FEE: COPY FEE: and Kernon J Bast a married person TRANSFER FEE: 117.00 RECORDING FEE: 10.00 PAGES: I Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (the "Property "): Lot 75 Country Wood Second Addition, Town of Troy Ru :ordi� Area _ Nane and Return Address Title one Premier Group 706 19th Street South Hudson, WI 54016 000 -124 -000 Parcel Identification Number (PIN) Ttis is not homestead property. (is) (is not) Together with all appurtenant rights, title and interests. Grantor,warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Roadways, Easements, and Restrictions of Record. Dated this day of --tl/ �, C� + & & abo th A. Hanlo • Marilyn R- Neaf AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) ) ss. C, ( - ( - )1 ! 4 County. ) ersoni(ly came before me this day of authenticated this day of �DL]� +Q the above named Elizabeth A d Hanlon an Marilyn 12 Neafus w TITLE: MEMBER STATE BAR OF WISCONSIN to me knowlt to be the person who executed (If not, the o egoin; ins ent d acknowledged the same. authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Michael H Forecki Attorney Notary Publ c, State of Wisconsin Eau Claire Wisconsin My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are 0! y •) not necessary.) Kw* L Tehwh01D Pith W -Names of persons signing in any capacity must be typed or printed below their signature. o STATE BAR OF WISCONSIN WARRANTY DEED FORM No. 1 -1998 Pros d with ZpFo - by VwtuM Im. 1a025 Fiaeen Mile Road, Ortm Township, Mchgw 49035, (800) 383-980` Any MwhadtiFmedd 1830Brsdtw AM Ew CLirtw154701-4627 ph— :015)835 -3029 Fes. 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