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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT sanitary Permit No:
405002 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: City Village X Township Parcel Tax No:
Eback, Dante Troy Township 040-1222-80-000
CST BM Elev: Insp. BM Elev: BM Descripton:
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
•
Septic Benchmark Z CT-1. -zL
Dosing Alt. BM
'10
Aeration Bldg. Sewer
jdwAgL - s
Holding S~i Inlet Z5f
13.
St/Ht Outlet
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
{O~d ~IL S ~
Septic Y ~ S ` D-f 6(~ y l 611 Dosing II i Header an.
Aeration Dist. ipe T)
Holding Fol. System 5 `iS I (0 • I, 5
J
"
PUMP/SIPHON INFORMATION Final Grade
35 CI
Manufacturer Demand St~erD--
S 7d
GP
Model Number CP 11-19
TDH Lift Friction Los System He TDH Ft
.9 1. q !.J A ,1-7
Forcemain Length / Dia. y Dist. to Well 1 6-3
SOIL ABSORPTION SYSTEM
BEDITRENCH Width / Length / No. Of Trenches PIT DIMENSI NS No. Of Pits lnsi Liquid Depth
DIMENSIONS
SETBACK SYSTEM TO P/L BLDG WELL ) LAKE/STREAM LEACHING M turer: S
USC^R
INFORMATION C'
Type System: f I CHAMBER Model Numb
DISTRIBUTION SYSTEM A Q~~. ~►tif
Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air, Intake _ d
9 Pip gs) QV' f ~p .~-g Ej • (05
Len th Dia Len th Dia' tr~ Spadn SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over t Depth Over jxx Depth of xx Seeded/Sodded xx Mulched
Bed/Trench Center' Bed/Trench Edges - Topsoil j Yes No Yes No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~e J '7 Inspection #2:
Location: 344 Southern Pacific Rd. River Falls, WI 54022 (SE 1/4 NE 1/416 T28N R1 9W) Glover Station Addn. III L Parcel No: 16.28.19.1086
1.) Alt BM Description = S7 •C0UIL kkuu- I 4J
2.) Bldg sewer length = by j n t- 4t Xt..
- amount of cover
Plan revision Required? *1 Yes No GC~vt^- ~ ert. N .
Use other side for additional information.
Date Insepctor's ignature
SBD-6710 (R.3/97)
I '
I
I'~
Safety and Buildings Division County
201 W. Washington Ave., P.O. Box 7162 Sy. 01'Q >X
Scnnsin M71 WI 53707 - 7162 Site Address
Department of Commerce VI 3` IK S&,,
Sanitary Permit App 'cation Sanitary Permit umber Z
In accord with Comm 83.21, Wis. Adm. Codr!!02 de
ma be used for secondary ses IV= 1 ❑ Check if evision
I. Application Information - Please Print All InfoState Plan I.D. Number
Property Owner's Name
APR Parcel Number
F LQ C- AT. G-RE))(e6btjT7 L N6 -r4) --OD
Property Owner's Matting Address ING OFFICE Property Location /(o, 2
l Qz. e 1 1 1L).00d ZON J~• r% S Tc N.R
City, state Zip Code Phone Number Lot Number 3 Block Number
S Paul Subdivision Name CSM Number
J U l y! I61) Py`
H. Type of Building (check all that apply) as s ~'•rs ❑City
1 or2 Family Dwelling - Number of Bedrooms
❑ViUage
0 Public/Commercial - Descn'be Use "~Towaship / / ~d
❑ State Owned 31 x m 5z Nearest Road
M. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable)
A. 12P New 2 0 Replacement System 3 ❑ Replacement of 6 0 Addition to For County use
stem Tank ON System
B. ❑ Check if sanitary Permit Previously Issued Permit Number Date Issued
IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) e q
a tl ~`1 c S C' All 12NO'S a
44 p Non -Pressurized In-Ground 210 Mound 47 0 Sand Filter 50 0 Constructed Wedand a to t`ct
22 0 Pressurized In-Ground 410 Holding Tank 48 0 Single Pass 510 Drip line
45 0 At-Grade 46 0 Aerobic Treatment Unit 49 0 Recirculating 30 0 Other A n a Q k a e be r S
V. Dispe r'saUZYeatment Area Information:
Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade
Required Proposed Rate(Gals./Days/Sq.Ft.) (Min./Inch) q V. 6 1-? Elevation f C'. e
6 100 X57, i~ 5'7.1y .7 NA n. 6 7 9$'v
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic,'
Gallons Gallons of Tanks Concrete Constructed Glass
New Existing
Tanks Tanks
septic or Holding Tank ;K
Dosing Chamber 5 ( 1
VII. R illty Statement- I, the undenjameA assume rope y for POWTS shown on the attached plans.
Phm*Ws Name (Prim) s MP Number Business Phone Number
Plumber's Address (Street, City, S kad, Zip Code)
P1 /C7/ 2Z~ ke
VIII. Coup /De ent use
Approved 0 Disapproved Sanitary Permit Pee (includes Gro+mdwater Date Issued Issuing Agent Signature (No Stamps)
0 owner Given Initial Adverse . v
Determination ZZS AV j eS 2VD
IR. Conditions
ofApprovel/Reasons fDisaoval
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d~-r~►f t tt~ 3¢1 G s ~C~.~i/.law.~X' nWLpr c o.~ .
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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3
bivision of Safety and Buildings
in accordance with Com is. Adm. Code _
County .
Attach complete site plan on paper not less than 8 1/2 x n 4 Pian st
include, but not limited to: vertical and horizontal refer p ' (BM), dire'
Parcel 1.D.
percent slope, scale or dimensions, north arrow, an nand rJ~lenc~ to naa(ea ad.
U
Please print R
all infi fion.~~ Reviewed by • Date
Personal information you provide may be used for seco v purposes (Privacy ~aWrft4) 04 (1.) (m)~ P~ . s (}t
Property Owner , Property Lo ion
W NL
1/4 1
1 /4 S
• 6 T ~ N R ~C( E(o W
Property Owner s Mailing Address
MOORE,
Lot'" ` lock # Subd. Name or CSM#
i ~
L S'l V ZELI~WOb S7- _ ,;5 w, _ IGLZU~1t S lU1ll 3 1 D
City State Zip Code Phone Number City ❑ Village & Town Nearest Road
S i _ ~r~uL w~.rv ss to ~ (651),-~ ~E -148 ~-R.~ Soy-r1~-~v ~ ~=1c tZ
New Construction Use: ® Residential / Number of bedrooms Code derived design flow rate 60c) GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material G I~c~1 1f11- 0Ur^J Ilk Ss I Flood Plain elevation if applicable ~ 14 ft.
General comments
and recommendations: QZOMVA &Jb Z N~sLLS , L`P 0-4 3 'x °t3 .ZS r LD?J IS '000-S OF
L~ G N- e-f~ R CCl"'.( S i DN~1ti~L''i? LN~C1J Ctti1'I~! ~ ~'R.S ~~Z e~-t-,
%0-MM Or- UP SLUP`- at-LL - 0'~E1V , qk-4. q '
Bo`17'IMVI Ut= Do>^n~awr e tl-f_ - e_LL3V : au,Z ' &EE rvo,- oN P9 Z)
El Boring # ❑ Boring , _ q OU
® 'pit Ground surface elev. a. ft. Depth to limiting factor 0 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
o - (O LCH P- 313 S 1 1 Z g Wl,` O_S Z v • S . $
Z 6-ZZ loIit31L - Si Z`fSbk K 0--S • S z
3 zZ 36 n'sLm Y/6 - s esbk m`f --v-P, eS - • 6
y 3tRo tDt-i rL 6 - o s9 m I - L. 2
Boring # ❑ Boring
El
pit Ground surface elev. ft. Depth to limiting factor '2 cl C)
in.
ate
R
I Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I *crr±~
D-q lo`~11L3 L3 ~ sL 1 Z~ sbh ~1`Fh ~S ZUf . 5 _
Z °t-ZZ t~~2316 - sib Z`Fsbh ~,,,y`~t ~g v~ .5 .g
3 Z2 37 ~.S~2lb - s l 1 esbk w~`f~ - .b
3~ `t0 Lb "t 2316 - S dGt- D S - V. 2
T-1
• Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) ~Si natu 3 CST Number
Arthur L. Wegerer 220254
Address Date Evaluation
4degerer Soil Testing & Design Servi e Condu ted, Telephone Number
421 N. Main St. River Falls, WI 54022 ~-)a-93 C~~'2 715-425-0165
1i-z.9-01 C
t,.
Property Owner C~' ` Parcel ID # Page Z of 3
❑ Boring # ❑ Boring
® Pit Ground surface elev. 06 • S ft. Depth to limiting factor ~lY in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2
I 0-~I 10LI 2- -s)2 sal Z~-sbk m~v- S Zvi
Z U-3b -1.SLOOL i s e b c .w z
Y s k wt `Fr 1 ~
3'-q ~.Syrz3t S~LG~ og~ yh 1 - >.Z
i
Boring # ❑ Boring -
Pit Ground surface elev. ~3 to ft. Depth to limiting factor -2 q. Z in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Bow idary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2
o-~ 1e~1 ~Z 3 ~ 3 - s • ( Zug >n~ s Z • S • ~
Z-l6 lo~rZ~~ - sI l`Fsbk >nv`F~
3 46-Z~ SLlV- 6 is a 0,
9 wt 1 g - rZ Z
F-1 Boring # ❑ Boring
El Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2
}~lc~i'E = ~ u lv - 1 A.1 s'r~.-~. ►~,a s ► i~-~ ~ 1 `R , c,~ s ~ ~ wl P t P l;
oar ~ ~w on
O ew ~F Z tti,`-~( R S fT-E EZ-Q:t-*rL 1,22 i'su =o` )aft ~-le~j r
S v~c~ w ~n~ M"KJ t K) G~ CUT U e
Effluent #1 = BOD6 > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BODE < 30 mg/L and TSS < 30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or 'I W 608-264-8777.
SBD68330 (R.6/00)
PLOT PLAN Page 3 of 3
Scale 1' = qo '
LOT S3
a~ ~R is h
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00, 6
0 19'Lmzv-ym dews 6 "4 LL q5 S
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I 15-425-0165 220254 O~-3Za
CST Signature Telephone No. CST No. Job NO.
Wisconsin Department of Commerce SOIL EVALUATION REPORT
Division of Safety and Buildings Page of 3
in accordance with Comm 85, Wis. Adm. Code
County, .
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road.
Please print all information. Reviewed by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner
Property Location
E7S~ Gev e4- SW 1/4 ML-i/4 S 16 T N R 1~( E (o R
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
L-1 S 1 l W -EL- W a b S i 5 3 - G L.0 U )-s-rft 3 ~~c D
City State zip Code Phone Number E) City ❑ Village Town Nearest Road
ST_ vL j"lru sst~l, ( 651) L-)~ - N-2 `7"rLo Y Sou_+k~w C11=1C 12
New Construction Use: [a Residential / Number of bedrooms Y_ Code derived design flow rate 6 O 0 GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material G l~P~L1,{P~L t>u `~Y}~ 1-I Flood Plain elevation if applicable i4 ft.
General comments
and recommendations: 1Z~U~Iw1 ~ Z - r S , L*e,4 3 ')c 9.3 -Is r Lopj& w/lS'ljol`rs pF
%drm" cat= vp 3
wPL~ e.o-LL _ el_r_'v . aid. q
Bo nvti mot= ~owti,C° NLL - 0-L L3V . 9q Z ' CSC YZO 6- ON P9 Z)
a Boring # ❑ Boring
® -pit Ground surface elev. Q.Ot - ft. Depth to limiting factor OLD
in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
o -(O bK2313 - sl 1 7`-q1^ h i. \ co S Zvi. . S . 8
Z 6-ZZ IoLm_31L - si Z`~sbk K 'F t- 0--S v • 5 z
3 ZZ 3(, ~.sLi 2 y/6 - s ~eSbk m`Fr_V-P' 0S - • 6
y C S9 M1 - L. 2
Boring # ❑ Boring
El
Pit Ground surface elev. Ols ft. Depth to limiting factor -2 .1 C) 1 77 in. ^
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. CCnr_.. c_. c! te
~ O-q lD`-11Z 3 L3 - sj, l Z~ sbk ~'ch ~S zv~ • 5 ' -
Z a-Z2. ~~`t2316 - sit Z`Fsb>z`~ e-S 1v'F . S
Z Z-
3-) ` C) lb"LR316 - S dGt- o g - .-2 v• 2
Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Si natu CST Number .
Arthur L. Wegerer,..
Address W e g e r e r Soil T e s t i n or & Design S e r v i c e Date Evaluation Conducte Telephone Number
421 N. Hain St. River Falls, WI 54022 C511'20 ~l4 715-425-0165
12.-Z9-01 C k3
Property Owner C~ Parcel ID # Page Z of 3
Boring # ❑ Boring
® pit Ground surface elev. C1.5 , S ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2
1 0-II 104 (L -'s) -Z S L 1 2`~Sbk w~`F~- S z \3
Z 11-3P -7 •SLroI - 1 s ~~Sbk Wt V `Pti- c ~"j lv~ •1 Z
3 ~-9 ~.Sy231 ~ St;L6h Dgg Y~ 1 - -`l ~-Z.
Boring # ❑ Boring
pit Ground surface elev. q 3 • b ft. Depth to limiting factor 2 q Z in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft=
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2
1 -P 1 pKiZ3t3 - s•( Z`f-gt^ wtf - S zv~ •S
Z g_16 lu-tZL/ - SI YTsbk ynvT-I- ,s v~ •y •b
3 tb -z~ -1•sLIQVl6 Is 00") W1 Z.
L7-q2 1D 4[LY - S 031 Boring # ❑ Boring
F-1 El pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2
PW S I ( ~u~► t )tc " . PIPER:
oL)r 1~1 CLOA-1 V`bOT-M&S
op Z t ~sTpr~L R s E E R e~j r
S~srvlc~ wl' Oi Tnz Mpoi,'r 1 tPJZ U el.-I
S bN 1NPtL~- . G"\J I
Effluent #1 = BODs > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BODE < 30 mg/L and TSS < 30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TY 608-264-8777.
SBD-8330 (R. W00)
PLOT PLATT Page 3 of 3
Scale 1'= qo '
Lo T S.3
04 L
m
F-L• ot3 -
0 I~LT>~Z1Np1'(~ C.QIS 6 "i EL q5 S ~
a0 _ °
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ns jEL Cq.bs
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ELL _ ~ ~ LAS J '~t`19 Y C erg
D
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:P~,----------
1 715-425-0165 220254. O~-aZ8
CST Signature Date Telephone PTO'. CST No. Job PTO.
Wisconsin Department oflndusuy, SOIL AND SITE EVALUATION REPORT Page \ of 3
f~or and Human Relations
to is ion of Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plait must include, but Ste' GRsJ 1X
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCELI.D. #
dimensioned, north arrow, and location and distance to nearest road.
DATE
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION R VJ WED BY
s
ia~
PROPERTY OWNER: PROPERTY LOCATION Za , N,R \9 E
0- t -*-S 1 S SCl V L Z GOvT. LOT S t.V 1/4 tut: 1/4, /E, T (d
PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM #
-7 l 0 til . t" l ~Ll`1 9T- S3 - 6~ov~R s'Th`CtoN 3 ~~D tTJ oN
CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE MOWN NEAREST ROAD
1u~iZ 1 Ct l S LAJ 1 5 V o Z Z., (71S) q L S. ?)(W t o So~rC~t~Rlu Phct FI C
[x] New Construction Use [)Q Residential / Number of bedrooms y [ ] AdditiQyn t existing building
] Replacement [ ] Public or commercial describe
Code derived daily flow boo gpd Recommended design loading rate - bed, g o.8 trench, gpo1ft2
Absorption area required 8 S 8 bed, ft2 -1 S10 trench, ft2 Ma)dmum design loading rate o bed, g /ft2 0,$ trench, gpolft2
Recommended infiltration surface elevation(s) StEE- >yol uju tPfy%e- 3 ft (as referred to site plan benchmark)
Additional design / site considerations ETC eM 1~t ~1J Z. - tehic C S `K -)S t_ 6 .
Parent material S>F_M1 h E'K)T ou M SA)QD + Gtzk:Nv'C L_ Flood plain elevation, if appG N, A\ ft
S = Suitable for system coNviB`1TIONAL MOUND IWMUND PRESSURE AEPRADE SYSTEM IN RILL HOLDING TANK
U=-Unsuitable fors stem ® S ❑ U IN S❑ U ®S ❑ U S[] U MS ❑ U ❑ S MU
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bwx y Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tench
1 0 77 l6 42 X13 - si l Z rn' C'. -S Zu7 o.S u-6
Z ^7 - 27 O'-J Q Vl6 - S ! - 'F S bk WL f c- s \%A c -S 0 . L
Ground 3 Z-7-3b --)•S `1Q Y/6 S 1 o S bK to ~1--y, c 4 - o'Y o's
elev.
3b-9o Io'tIZ d, 61• 0 S9
Depth to
limiting
factor q
010
2c,.(e~~ to
Remarks:
Boring # s
0-8 1li~~ 4 IZ 311 s t~ 2 `F 5i- Yn V- CS Zug' o, S n, 6
3z' Z g-Jb fo~tra y/y - sl N~5bk U*f V- «.S 1`04 o.y o.S
3 16-n 7•Sytz V/6 - is 6 gg m I C S - o•~ c,t
Ground
elev. a V14 10,%
Depth to
limiting
>9 Z'r
Remarks:
TName:---Please Print Arthur L. We erer Phone: 715-4 . 25-0165
egerer Soil Testing & Design Service-P.O. Box 74 River F lls,WI 54022
Signahue: Date: CST Nw1lw: _
q3-L/Y -g3 M00576
II
PROPERTY OWNER ! `54 - SC4iuLTZ SOIL DESCRIPTION REPORT Page Z.
PARCEL I.D. # • "
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GP.D/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
v<'>•.:v>:: ,...y 0-9 v.m 3l3 St gk 1~ Zug O• S 6
N. 3
€<:k Z - z lo~xR 6 I Z Shirt c 1~~ v.
>;w 9 2 31 S. t. m H S S
Ground 3 z.2-37 7.s 11 V V& s 1 c- S\0yc 1, q` - c s o~y C3. S
elev.
9 ft. y n-4 0 10 7 2 3 CiH O S5 \ - p•7 O• $
Depth to
limiting
factor 4- 1(k I'
Remarks:
Boring # -
-'7 10 `11Z 3 /3 s Z gh ~H CS z u ~ o. S 0, 6
>`J Z ~-19 10 `iR 31~ _ S) ~ ~-'F SCR ~ ~h cS 1 v'F p• S o• 6
3 )9-32 ~•S`Jt2 Y/~ - S o S9 m cS - 0.7 o•~
Ground
elev. 32-tea 31(, _ S v s9 w~ - o•~ o• $
91.9 ft.
Depth to 5 8 -9 a l b R 311 - S O S iryl o. 8
limiting 4 Cwj rU S SLSUL el- t OF Yn U 1r 5
factor ,
Remarks:
Boring # S'
~ti w O-L Q v - 3 3 S 1 l 2 `F 91^ h1 `~h S Zv, o - O,1,
;4:;\A ti': ii0:
k Z 6-2.Z 113912 3/L - SO -ZSbk m'~h C$ lv~ o.S o b
3 zz-3l 7•S`f R v16 - g e S\bk Yl;--m v( c S - o-K u• S
Ground
elev. Mlliz 3)L - S Sg - o•~ 'sd•$
94. Y ft.
Depth to
limiting
factor
>
Remarks:
Boring #
Sit
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(R.05/92i
li
PLOT PLAN Page 3 of 3
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Combination Septic;Tank and
PUMP CHAMBER CROSS SECTION. AND SPECIFICATIONS ' PAGE S OF F~
VENT CAP WEATHER PROOF
JUIJCTION bOX
4'C.I. VENT PIPC APPROVED LOCKING
10' FROM ODOR. MAWHOLE COVER k'JIV
',ItuDOW OR FRESH 2 wRg tuilJ6 1.P.6EL .
ALP, IIJTAKE cor~DWUI
s
P41AJ.
Lam.- Los .1,
L.~.~
y"lus?C'~.ttora PIPt 113
PROVIDE I
11JLE T AIRTIGHT SEAL. I i l l
- ~ I I
84PP~~S A I I I APPROVED JOIAJT:
APPROVED JOINT
W/C.I. P1Pfa1t Tank construction i III W/C•I• FIPE~~'~
I II ALARMt
shall comply with
ILH;; ('33.15 and 33.20 e j i I
I I Ow
C I
I
LLCM. IFT PUMP-` --J
OFF
0 COMCKETE
9L0CK
K15CK EXIT PERMITTED OWLS IF TANK MAIJUFACTURER HAS SUCH APPROVAL 31•Apf'Qove-
<3EDOtNG
SEPTIC f 5PEGIFICATIOKIS
DOSE itst ^ PI:R D"
TAUK MAA.IUFACTURCR. NUMBER OF DOSES:
TAWK 51ZE: ~ D'_ 0 GALLONS DOSE VOLUME l
ALARM MANUFACTURER: S•S .~Z~C(RQ S~lSTI:s~„l,, IMLLUDIIJG BACKFLOW: ~og'y GALLONS
MODEL WUMBER: 3C~1 NW CAPACITIES: A= WCHESOK LItJo`O GALLOIJS
SWITCH TtlPC: f;-1ZC~ s►~-~t 5= Z IMCHES OR G( LLOUS
PUMP MANUFACTURER: GovC = S IM[HES OR GALLOUS
MODEL NUMBER: D=INCHES OR GALLONS
SWITCH TYPE: L2CC 1 -~f MOTE: PUMP AMD ALARM AR TO OE .D
MIMIMUM DISCKARGE RATE 3q,$ GPM IN5TALLEO ON SEPARATE CIRCUITS
VERTICAL DIFFERENCE DETWCEIJ PUMP Off AUD.DISTRIbUTION PIPE.. FEET
+ MINIMUM NETWORK SUPPLY PRESSURE . . , 2.5 O FEET
+ v _ FEET OF FORCE MAIN X F
O&A rtFRICTIOU FACTOR-. LI 32 FEET
TOTAL Dy1JAMIC HEAD FEET
Pump chamber DIAMETER - ,
IIJTEKLIAL, DIMLWStokl~ OF TANK: LENGTH ;WIDTH ;LIQUID DEPTH 3g 1~.
BOTTOM AREA - - 231= GAL/INCH
AS PER MANUFACTURER = Z l~5 GAL/INCH
Submersible MODEL: 3871
SIZE: 3/4" SOLIDS
Effluent Pump HP 0.4550
METERS FEET "
a
25
7
0
= 6 20 39.78
a 5 _
p 4 ,
J
3 10
2
5
a
1
0 00 10 20 30 40 50 GPM
0 2 4 6 8 10 12 m3/h
CAPACITY
GOULDS PUMPS, INC.
FAMoem ,m am
EtbWw Octobw,19a
O tree c3c" Pumps. im SPECOCATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE PRATED IN U.SA.
C3871
"C. System' Management Plan
Pui`suant to Comm 83.54, itis.Adm. Code
Septic 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 8c6rdance with NR 113, Wis. Adm. Code. The o eraGng condition of the septic tank and
outlet filter shall be assessed at least once every 3 years by inspection. T n 6fl fiite~ fall be 'anneal as necessary to
e lion. The fitter cartridge should not be removed unless provisions are made to retain sa in a tank that
may slough off the fitter when removed from its enc!csure. If the filter is equipped with an alan, 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 shag 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. d such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and
gunidfngs Division.
Pumo Tank
The pump (dosing) tank shall be inspected at least once every '3 years. AU switches, alarms, and pumps shall be tes'&d to
verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary,.
At- rade omponent and Pressure Distribution System
No.trees.or hrubs soul a plaate or allowe to grow on th omponent. Plantings may
be made aroun the perimeter and the component shall be s ed and mulched as necessary
to prevent eros n and to provide some protection fro rost penetration. Traffic (other
than for vegetati maintenance) on the componeied . not allowed. Cold weather install-
ations require the omponent to be heavily mu for frost protection.
Influent quality into t at-grade syst may not exceed 220mg/L BODS, 150 mg/L TSS and
30 mg/L FOG. Influent flow ay not Geed the maiimum design flow specified in the permit
for this installation.
The pressure distrI'bution system 1 vided with
intend be flushed of a~rrmul g point at the end of each kterd, and it is recommended that eac.'i
compared to the initial soids at least once ry 18 months. When a pressure test is performed It should be
squired to en the system was lnstan etemrine if orifice Logging has oc aired and if orifice Leaning is
Maintain distribution within the dispersal
Observatio pipes within the dispersal cell shal 'checked for effluent ponding.
Ponding vels should be reported to the owner and any levels above 4 inches considered'
as an pending hydraulic failure requiring additional, more frequent monitoring in
ac dance with-Comm 83.52 (2).
eneral
2h s.syttem shall be operated in accordance with Comm '82-84 Wis.Adm.Code and shall be
maintained in accordance with it!s component manual SBD 10570-P•(ILA/99)•and.local and
state rules pertaining to system maintenance and maintenance reporting..
No one should ever enter a septic or pump tank since dangerous gases my be present that could cause death Septic and
Pump tank abandonment shall be in accordance with Comm 83.4 Wis. Adm. Code when the tanks are no longer used as
POWTS components. .
Septic or pump tank manhole risers, access risers and coversshould be inspected for water tightness and soundness. Access
openings usW for service and assessment shall be sealed watertight upon the completion of service. •Pny opening deemed
unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall
be se=ed by an effective locking device to prevent accidental or unauthorized entry into a tank or cimponenL
C 99AW cv Pt9n
If the $ePf1G lank or any of its components become defective the tank or component shall be repaired or replaced to keep the '
system•in proper operating Condition.
`doh link PAP. Pump controls, alarm or related wiring becomes defective the defective component shall be
MPahad or replaced with a component of the same or equal performance.
I th t- de" Pont'fa" t cce" Cilia- ew' "ell ` -"to ' isc ge sta ter o
o s a e es to in 11 a i ~e- a or
addiXiona A ditional site and soil evaluations may need to a done.and
p acs miy_need to be preparedand appioved by the Department of Commerce.,
Safety and Buildings Division. .
Questiona.about the operation or maintenance of this system should~be directed tot
- The County,.Zoning office at rlG ~~x 3 ~d ^VRb
The system installer at -11 S _ LLZS- Q,g SR W ;
The tank manufacturer at SE, ~Vl X12
The effluent filter' manufacturer at kp - ZZt- S?tjZ•
rho
u
ST CROIX COUNTY
SEPTIC TANK MAINMNANCC AGREEMENT
AND
OWNERSHIP CER'fIFICAT[ON FORM
Owner/Buyer (~)Ol
e
nac
Mailing Address az(~ S S 1~. a l
Property Address 3
(Vc ificadoa rcquircd from Phnniag Dquttmwt for new coasttudioaj
Uity/StatcS ~ I A u 1 °/jr , S~S'1'd
~P
anxt
- ~ ~ Identification Numbs Q~~ , ~a a a -rd-we
AL DES LW AL
Property Location S ~j IV E % Sac. _l~ .Tag N~t~9 W Town of
Subdivision I UP` S to 0)-) p/C~
-
,^,11 Lot #
CertMed Smvey Map #
Volume _ Page #
Watramty Deed 0 S
Volume 9 7 Page #
SPcQ omo ❑ yc s ❑ no Lot limes iden ifiabla 0 yes no
• ~aPu'+csem3~y,~s~oat~lda~tmits j • •
o~ofpamppiogoattEeesc~ct.. Pac~aonetobaod6evraste's.Pmpermavabeaaaoe
caasffadti~e~'umd`anofQie7°raOOacSifnrodod6yat~iuoeusodpampcz Vhfty*MPUtfiftdWzySt=
. septa'ta°°1cua~eiad~a~steds_g~,~, .
. n~s~cplim~cb9`oveaa~8~'s~t~att~oSt~CC~~~.~►8reo~rxesad~y:
(i)Qyeoaai~civa iacr gMa
ismpcoper
JUS
P~9P nooexxsAftiqpfi-.tis
is kss$m 1!3 ~idt of 3dge.
=4=i8modkenc.tcad tEre,bor,c
t~6migtbatynata~tie ~ tE''eDc~ctm~tofNa~ma[R,e.9oazoefistateofwisooasio<<
-efdotSnmy a dam. O0n0 dand=Wcwdt the3L0 wtxCm=yZ *jF=vA im3o
SI<:'NA1URF OF ~LPPLi 10310
DAZE
~CAZZON
I (we) entity tbant all a Ukwcots on this foam arc tnec to the best of my (oat) k owkdgc. I (arc) am (are) the owner(s) of
by virtue of a vmraty dood wcotdod in R cgjaw of Doody Office.
s~c~uztn~a OF~Ix 5 f~ji ~1~
DAIM
ssssss Aj iufOmfioa theft is vdzA may r~dt is the anitaty permit bcigg revoked by the Zoning Depattmowt. sssa..
ss Indade with this application: a stampod w matyr flood EMM PLC Rc&W of Doody otftoc
a ooPy of the oMWW aftypy map if Mferm a is made is the watmaty dcod
VOL 1394PAcE158
WARRANTY DEED 5953$6
KATHLEEN H. WALSH
REGISTER OF DEEDS
ST. CROIX CO., WI
Document Number: RECEIVED FOR RECORD
01-11-1999 10:00 AM
WARRANTY DEED
Return Address: ATTN: Mortgage Dept. EXEMPT #
CERT COPY FEE:
First National Bank of River Falls COPY FEE:
PO Box 166 TRANSFER FEE: 144.00
River Falls, WI 54022 RECORDING FEE: 10.00
PAGES: 1
Parcel I.D. Number (PIN): 040-1222-80-000
This Deed, made between Dale D. Fayerweather and Kelly A. Fayerweather, husband and wife as
survivorship marital property, Grantors, and Dante F. Eback and Sherry L. Hawkins-Eback, husband and wife as
survivorship marital property, G; antees,
Witnesseth, That the said Grantors, for a valuable consideration, convey to Grantees the following
described real estate in St. Croix County, State of Wisconsin:
LOT FIFTY THREE 3) GLOVER STATION THIRD ADDITION, TOWN OF TROY.
This is not homestead property.
Together with all and singular the hereditaments and appurtenances thereunto belonging:
And Grantors warrant that the title is good, indefeasible in fee simple and free and clear of encumbrances
except easements and restrictions of record and will warrant and defend the same.
Dated this A-day of January, 1999.
Dale D. Fayerwe er
Keil Vayervveatt~dr
at
ACKNOWLEDGMENT
STATE OF UT"
1 ss.
UTja-t-1 COUNTY 1
Personally came before me this day of January, 1999, the above named Dale D. Fayerweather and
Kelly A. Fayerweather, to me known to be the persons who executed the foregoing instrument and acknowledge the
same.
Nota Public
LvrA-O- County, UT-A N
My Commission _ 1'f tatic+ K. /(oF / IGi~
THIS INSTRUMENT DRAFTED BY:
Dean R. Rohde NOTARYPUBLIC
Bye, Goff & Rohde, Ltd. ~,,maT+~~ STATE OF UTAH
PO Box 167 MyComeriWmExpirn
River Falls, WI 54022 9 March 15, 109
DRR/Misc/Deed "•Y. JAN 13RONM
• • • 11334 North T= radc Drive
Highland, Utah 84003
ON
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