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HomeMy WebLinkAbout040-1265-40-000 n N O C m n d � 1 C F C T C A 7 n M n C A� 1 y 1 V1 w m z z �� I' e rn 0• _ 0 w N N O W FD III O 0 (0 A O O. (D N A , • .Z _ N O W (` A fD N w V N IC I £ co UOi O� N N N N d 7 p (D 7 A .A O rj 00 O CD O _ N � 0 a) 6 O O O _ ai y � rn CD w cn z i � a� m cfl D a m CL .A -0 n o v o w c�, 3 o a, v 0 0 00 00 CL O ff' A �+ (0 °° Ln N p p y co O O 2 � - u - u - V a it K H • O O O w N O 0 J 3 fn N o w c v 0 - CD Ln c s d a 0 Ln s N ° o 0 . z Z a O C) D D o O N = = 5 a (V m c I p Z c w A Cl) ill A z 0 I m wT (D m N ° z co 3 cn 'o - M I (0 I \ 3 A < y Z CD A � I D a � I o' v c z 'a o •• CD N i I I, I 3 0 I ti I ° 0 I 0 ti CD En O e o :E ° b o � ti ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner e s�Pr� J �,� „vim D” EIf s Address _ EI8 D,�,�l� �s�E nl?LyE A/ City /State /7 oS o nl 4-j, S ya�b Legal Description: Lot 9t5_ Block — Subdivision/CSM # Lo vai�T '' /, 5 w %, ,5�, Sec. 14, 1 N -RAW, Town of Toy PIN # CVb - /a45 - j10 -ooa SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer 40 / - 942 Size ST/PC- So / �Co Setback from: House e?o Well , � 6 ' P/L �8' Pump manufacturer moo c14,o W Lrd Model 3 S Alarm location 1'/, -'WA J1eAL iP -pl ��rsErr�ENr (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM: Type of system: AoHN/-) Width _ Length f3 Number of Trenches 6zo 7 n G'7 , Setback from: House 38' Well if,"' PAL -?G Vent to fresh air intake ­A' ELEVATIONS Description of benchmark - "I' -jVj),,4 PJ c �iOs Elevation �o yh. �o Qicb. Description of alternate benchmark Elevation Building Sewer ' -Sg ST/HT Inlet 1 �S" ST Outlet PC Inlet Ow ,( PC Bottom 91- 05' Header/Manifold Top of ST/PC Manhole Cover Distribution Lines O O ( ) Bottom of System () () ( ) Final Grade () () ( ) Date of installation 9 lo( Permit n mber 383 State plan number 1 /!.6_83S Plumber's signature f` ' ? License number �J '267 Date Inspector Complete plot plan NOTICE Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW � 54 Get+– • �EPr c 6 � -� �' O $� Ho AlC 3g Stw+ER �, �NL •?a �j w Q J J- V c�u INDICATE NORTH ARROW �— Id 0 �c dELE � I Wist,pnsin Department of Commerce PRIVATE SEWAGE SYSTEM county: St. Croix S 'ety and Building Division �y INSPECTION REPORT Sanitary Permit No: 383847 0 GEN►L INFORMATION (ATTACH TO PERMIT) State Plan ID No: t► Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. �'Sa $ � Permit Holder's Name: Village X Township Parcel Tax No: City Diers, Joseph Troy Township 040 - 1265 -40 -000 CST BM Elev: Insp. BM Elev: IBM Description: 0 ' log n t TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic � tl.Sb Benchmark 3.71 1043K. c/ Dosing Alt. BM 7 3 1 0 Ztt 1o>; A&Q L,on _ Bldg. Sewer -7 �Z 1Cµ3 •L�j Ing St/Ht Inlet 1041.1 t TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 4- 9s r `O t ` � � Dt Bottom Dosing / / , Header /Man. 1. ZY Aeration Dist. Pipe /0 r0• / .�Z s Holding Bot. System 3, ;; _ , Q 2.3 /0y 3, 3 S� PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Cover GPM Model Number TDH 1 1-i b , Friction Loss System Head TDH Ft Forcemain Length �{ Dia. Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT D No. Of Pits Inside Dia. Liquid Depth DIMENSIONS q /_ ' SETBACK SYSTEM TO cce P/L JBLDO WELL LAKE /STREAM LEACHING u INFORMATION Type Of System: Model Number. C S D � y 7 ��� r. DISTRIBUTION SYSTEM x Header /Manifold Distribution x Hole Size 7Hole p acing Vent to Air Intake Pipe(s) i 3 e I/ /( Length_ Dia Z Length 3 Dia �[ Spacing 7 � 1 7 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 discrepencies persons present, etc.) Inspection #1: to P L Inspection #2: /a /?�/ Location: 316 Gandy Dancer Circle Hudson, WI 54016 (E 1/2 SE 1/416 T28N R19W) Glover Stati Parcel No: 16.28 136 9.14 1.) Alt BM Description = 16V NOVA 7r� �� � ` � s � �W 14 (114 f 2.) Bldg sewer length = LO �� - amount of cover = Q 4. `fi r ti (��wf tv►t 1p •�k rl�"+l ,�,1 3.)Contour= b(.01 }.NZ. fr0 tpo�17•D fourr tmox& Aclev Plan revision Required ? Yes 10 18 61 tM l� Use other side for additional information. ZS Date Insep6tors.Jignature Cert. No. SBD -6710 (R.3/97) 1p w ::tr,3/6 � > a eer Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. t✓ SLR reverse side for instructions for completing this application PO Box 7302 sin personal information you provide may be used for secondan purposes Madison. WI 53707 -730^ j 6c46n Department of Commerce (Submit completed form to county if r [Privacy Law, s. 15.04(1)(m)j state owne� Attach com fete plans (to the county copy only) for the system. on paper not less than 8 -1/2 x 11 inches in size. County ro State Sanitary Permit Number ❑ Check if revision to previ State Plan 1. D. Number 838y s'' I. Application Information - Please Print all Inform ation \ c ion: Property Owner Name I cion .✓E - � t S ,e T AP,N, g� ( or Y%) Property Owner's Mailing Address _... , -4r LottArw r Block Number /� 3T City, State Zip Code Phone Nu er .} ub "nisi n Name or CSM Number T II Type o Building: (check one) ty ® 1 or 2 Family Dwelling — No. of Bedrooms: < r P a� S j�wt i 5 Village ❑ Public /Commercial (describe use): ® Town of ❑ State -owned III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Nearest Road A) 1. ® New System 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Addition to Parcel T Number( ) S stem Tank Only Existing S stem o v v B) Permit Number Gyp - (, S- 1/c - G O Date 'Issued ❑ A Sanita Permit was reviousl issued _ /y,� IV. Type of POWT System: (Check all that apply) ❑ Non - pressurized In- ground ® Mound (f , k �, ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: /r• ,c V Dispersal/Treatment Area Information: } r / S 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application S. Percolation 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 Informatton Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks ® ❑ ❑ ❑ ❑ 7 - 4"x O VII Responsibility Statement I, the undersigned, assume res on ibility for installation of the POWTS shown on the attached plans, Plumber's Name (print) Plumber's ignature (no stamps): MP/MPRS No. Business Phone Number oS Sv Plumbofs Address (Street, City, State, Zip Code) VIII County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) C�Approved ❑ Owner Given Initial Adverse Surcharge Fee) Determination Z spa d < X IX. Conditions of Approval /Reasons for Disapproval: II ! ih s/zc��Gr�PrV� "CCd pc r ;o CTC� rPr s veco� tv�Pv� �T ior^ 5_ SBD -6398 (R. 07/00) • Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 N *isconsin www.commerce.state.wi.us/SB Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary December 21, 2000 CUST ID No.691727 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 HUDSON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 12/21/2002 :Idenlfican Numbers Transaction ID No. 455839 Site ID N SITE Pleasxefer to both %�dertttficattott ttttmbers; Site ID: 202700, Joe Deers above,,,' 41[ci ' ondence- tinth:t�ie �" ei►c . "' St. Croix County, Town of Troy SE1/4, SWIA, S16, T28N, R19W Subdivision: Glover's Station - 5th Addition - Lot 75 FOR: Description: Four Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 773851 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 Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10572 -P (R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD - 10573 -P (R.6/99). • 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 component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • 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. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /instal lation/operation. ARTHUR L WEGERER Page 2 12/21 /00 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 12/05/2000 FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 Gerard M. Swim BALANCE DUE $ 0.00 POWTS Plan Reviewer -.Integrated Services (608)- 789 -7892, Mon. to'Fri. 7:15 AM to 4:00 PM jswim @commerce.state.wi.us I TITLE SHEET Page 1 of 7 MOUND SYSTEM FOR A L BEDROOM RESIDENCE This plan has been pre in accordance with the Mound Component Manual SBD -1057 P and the Pressure Distribution Manual SBD- 10573 -P C z. b / qq� C ca. b 199 LOCATED IN THE SL 1/4 OF THE skv 1/4 OF SECTION ) C ) T Z E3 N, R 19 W, TOWN OF S_^, (a- De-ptx COUNTY, WISCONSIN. U3 -1 S .OF GLu\j et - S`7'R' Okj ,- 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 VIEW -CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUMPING CHAMBER CROSS SECTION PAGE 7 of 7 PUMP PERFORMANCE CURVE PREPARED FOR RE CEIV ED -- 2?��SCA 19V�. s - �- .� -�L.� , ►� �; ___ s s_oq �� �'• ®5 2000 �& gLD GS DIV PREPARED BY WEGEF:ZEFzZ SO S L -TESTING AND. DES I Gil S1ERV ICE P.O. Box 74 421 N.Main St. River Falls, WI 54022° ())v Phone 715 - 425 -0165 `�� .••'" "••..�� Fax 715- 425- 6864,:' 4RTMR L i - � WEG5fYER D S;5 P FAL�WI%NTN, � W 5- p•o.Wo • ally , C pndid n j k APPRo ppR7MENT f COMAAERCE DE pPETY AND BUILDINGS Z - y - j ISION EE COR ONDENG RE E S JOB NO. 46 -3 S . c• - J Mound System Management Plan Page Z. of - 7 Pursuant.to Comm 83.54, Wis. 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 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. ty� l S P E�T2t11V -" u . _ . Pump Tank NZSU S p -Gt t-�'1 4'LZO - $sv - - -Z.S Lit p 2S C - .t'iUT 'S 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 getattve 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 BOD5, 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)] and 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. An opening deemed • Y P 9 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 revent accidental P adental or unauthorized entry into a tank or component. Contingency 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 i in , and replacing P P 9 p g said components as deemed necessary to bring the system into proper operating condition. Questions on the operation or maintenance of this sy_st:em should be directed to the County Zoning office at `115_386- 4680 or to the licensed _ plumber who installed the system, ' PLOT PLAN Page 3 of 7 Scale 1 " =�o ' ti 9q �( 7' Tom:sv.. :j _-= .P�1CPPL wl S'c� -161 n a �i eo�1�� -T Ui2 [? Q C _ �►t�4�i��'z =mil is N 1�.qN PIPE w/S�L 3, P Qa -15 10�8�0) �tiZ y IO�F9lp. lb J • a C v GPcC. Q s Ot� L1iu� R.� D __"��► -moo =� c ��"� _tiT -;��I�s — n c�j.�.- NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved,caps. ( ?— required). 3. Septic tank to be \1 S0l7 s v gallon capacity manufactured by �ti� C p►J ` p1�D� LAJZ zPrtiEz h�l °F Lu fi 4. Bench marks -5. Divert surface water around system to prevent ponding at the uphill side.` Page Of - 7 Approved Synthetic Covering ASTM C33 Distribution Pipe Medium Sand Topsoil p - -- F Elev. 1bq0. _L S • _J I E ;�. o . _. 3 - u b 3.% Slope Distribution Cell of Force Main Plowed 2" to 2 Aggregate From Pump Layer E 0._�_ Ft. CROSS SECTION OF A MOUND SYSTEM F o,b Ft. G r,, s Ft. A Ft. H 1. 0 Ft. Linear Loading Rate= '&gSGPD /LN FT B 67 Ft. Design Loading Rate= D,VSGPD /SQ FT I 1Z Ft. J S Ft. ` K $ Ft. - - - " -'. Perna - te Position of L 8 3 Ft. Force Main W Z 6 Ft. - Observation Pipe • — - -- -- - - - - -- - - - - -- - - -- - - - -� Bow Distribution „ Cell of to 2 Pipe re ate a $ Observation Pipe (Anchbr securely) _ PLAN VIEW OF A MOUND SYSTEM Distribution Pipe Layout Page S of 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. _ ;cuss goy_ pVC F�1C Lateral Manifold PV C Lateral X x x x x2 x2 x x x I x Lateral Lenath — Lateral Length — p Distribution Line • P �� �- r�c�s 'sox Mn S 1 > >�C 1 =oQC.t ri�tH P 33 Ft. Hole Diameter ,Inch - S Ft, Lateral _ Inch(es) X Y inchPS Manifold Inches Force Main " Inches # of holes /pipe 1 Invert Elevation of Laterals _ Combination Sept,;ic: and PLI•MP CHAMBER CROSS SECTION ARID SPECIFICATIONS ' PAGE 6 OF NEWT CAP � I WEATN£R PROOF JUIJCTIOIJ BOX . ti C.I. VEIJT PIPC APPROVED LOCKIIJG 1 10' FR O M 0008, tIOWHOLE COVER wilt .hMDOW OR FRCSH 1 1'`'Ag fJl>JG La`gEr, "S?QCRQQ PIPE AJR IIJTAKE COJ1Dt11T wlrTlRrs4 -r zn'P t ' F! Iii lg Hfl rL 10 48 18 Mw. IAJLET L" PROVIDE •� �� AIRTIGHT SEAL I I I f Approved zPSa�- �t� A �If Approved joint w/ t joint w/ i II PVC pip ALARM PVC pipe - II I O w C I I CLEY. I PUMP,, OFF D COIJ CKETE !_-sLeo , l0 3 4 A .'O BLOCK RIS EXIT PERM 11TED OMLy IF TAW MAUUFACTURER HAS SUCH APPROVAL -a 3NAAPRcriE II 8i:D0 I N4 SEPTIC E SPECIFICATIOUS DOSE TA W KJ 1AAUUFACTU;LER: C&JeMe_f�� WUMBER OF DOSES: y PER DA" TAMK SIZC GALLOMS DOSE VOLUME r ALARM MAUUFACTURER: S • ' L SL(S l - L41 S INCLUDING 6ACKFLOW: \101'0 GA LLON$ MODEL IJUMBER: 1 0 W CAPACITIES: A= S I OR L L SWITCH TAPE: — M C1ZL -U2 Lt a= Z I u CHEi'OR 32- PUMP MAEJUFACTURCIt: "A k'_ S C= 8 WCHES OR IZIO GALLOUS MODEL IJUMBER: , I"1( Y 0 2' D - - I OR I a•2_L GALLONS SWITCH TYPE: — e)- t°U1Z -Lf MOTE: PUI1P AUO ALARM RE TO -) 4 ' iL MIMIMUM DISCKARGE • RATE L _ 11 -P Z GP INSTALLED OW SEPARATE CIRCUITS VERTICAL DIFFERENCE DETWCEU PUMP OFF AWD..DISTRIBUTION PIPE.. FEET t KI&JIMUM METWORK SUPPLY PRESSURE . • , .`SU 'I`GET �_px X_3, + OF FORCE MAi1J X 3 -S9 FT/ L.O$ / fEFRICTIOU FACTOR.. FEET TOTAL DYNAMIC. HEAD =_b' 3� FEET As per manufacturer 16. \Z gal /in. Liquid depth `l 3 t �R6E ? or- 7 r ME40 Series Myers . 1 4/10 HP Effluent and Drain Water Pumps Performance Curve MODEL ME40 EFFLUENT PUMP CAPACITY LITERS PER MINUTE 0 50 100 150 200 250 300 350 40 12 35 10 N 30 .. LL H 25 13 Z p H 20 g J 16 .33 2 F 15 J F 4 H 10 0O i 5 2 0 0 0 10 20 30 40 50 60 70 80 90 100 CAPACITY GALLONS PER MINUTE ' 1101 Myers Parkway, Ashland, Ohio 44805 -1923 419/289 -1144 FAX 419/289 -6658 .Telex 98 -7443 K3326 7/91 Printed in U.S.A.- Wisconsin Departrnent of Industry SOIL AND SITE E V A L U AT I O R T Pa e of 3 Labor and Human Relations 1 L -\ g « Division ofSafery,8 Buildngs in accord with ILHR 83.0 i�S. m�. 6od"e �r� OUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in s: PYan must pirkAl S � C '� �X not limited to vertical and horizontal reference point (Bfvt), direction a % ©f slope, scale or P CEL I.D. # P�wl7 W G dimensioned, north arrow, and location and distance to nearest road. ' "� �,° APPLICANT INFORMATION PLEASE PRINT ALL INFORMA -1dN ST DB OAT PROPERTY OWNER: ;PR (�9tT 1°thJD E L� $ f7Ai� �r.1 \S S C NU es ken SE .., ",$ /4,S J�T ,N,R l g E(oi W PROPERTY OWNER':S MAILING ADDRESS. #t' t CK NAME OR CSM;i Z SS 21UE1?S tDE _D1ZlUE, — 1 `' GL !EM lu S CITY, STATE ZIP CODE PHONE NUMBER []CITY ❑VILLAGE ®TOWN ' NEAREST ROAD 1�tU PU -S wl Sy,oZZ ( q ZS - - �lbt �cp�{ I GMAull Ip9Jtn_ (2TZLIt New Construction Use Residential / Number of bedrooms V [ ] Addition to existing building J Replacement [ J Public or commercial describe Code derived daily flow Edo gpd Recommended design loading rate 4 bed, gpd1ft - trench, gpd/ft Absorption area required 5bt-1 bed, ft S ab trench, ft Maximum design loading rate • 5 bed, gpd/ft -� trench, gpd/ft Recommended infiltration surface elevation(s) \ � 1. S It (as referred to site plan benchmark) Additional design / site considerations MDUn�b WZ o' x 63 g M Nu _ 1Z' OP s t=1 c.L - Parent material LAFM pupa lit. cel fit - fl LL. Flood plain elevation, if applicable NZ ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem El E U Es ❑ U E3 S O U EIS Cad U ❑ S RU I❑ S IR U SOIL DESCRIPTION REPORT Boring# Horizon Depth Dominant Color Mottles Structure GPD /ft heLA) in. Munsell lQu. Sz. Cont Color Texture Gr. Sz. Sh. Cons�stence lBarraly ( Roots Bed Olerch Code Sal - L-P 3 biz wt.'s d.1-i 1-F S '6 , S Ground 3 �-> �Y - 1 -SY 2 V/V — S11 6 -:so t `ht ft- kio — • z - . 7 - elev tti 3�1 S9 . �-S`i R Sl i s�lz 3 !y S O-1 o w"- 0.� Depth to S 59- 10`m- 613 limiting f actor q . Remarks: Boring # O -8 1 0� R 3 L 1 3 - 3 �a _%4n - i's Ll y ty S Ground t ol6 ft LJn - S `Z2 3/ S ►ZS 3a.1 ova yn`�{., _ Z 4•Q Depth to limiting factor q Q0 Remarks: CST Name: — Please Print Phone: Arthur L. We erer 715- 425 -0165 egerer - Soil esting & Design Service -P.O. Box 74 River Yalls,WI. 54022 . Signature: Date: S ' CST Number.. • "Q �� 220254 1 PROPERTY OWNER SOIL DESCRIPTION REPORT Page?- of 3 � PARCEL I.D. # NDQJJy Boring # Horizon Depth Dominant Color Mottles Texture Structure GPD /ft in. Munsell Qu. Sz. Cont. Color Consistence Botx�ary Roots : >:• > >; Gr. Sz. Sh. Bed ITirench Ground 1 -33 - I .S `t P_ y/y — S' I elev. °i9.6 it. - .sL4 R.3 SCI 0h, ►�P ! •2 0 • D Depth to limiting factor Remarks: Boring # Ground elev. it. Depth to — limiting factor Remarks: Boring # <_ . • �:<: Ground elev. it. Depth to limiting factor Remarks: 3oring # around , lev. tt. ' )epth to imiling actor Remarks: _ L±j `h rr •r •rnrh .'.r .•••.. PLOT PLAN Page 3 of 3 I \� SCALE 1 "= SO ' o ry `IIt �twV, Sly „ /. Z -�1 .°LZ.`d atv Dl1R PUC PlPLT wI �iP6 \ �> i 00.103 -- 1S - - zzoZSy ( 715 ) 425 -01 69 _ CST Signature Date Signed Telephone No. CST # Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page I of 3 L L� a abor and Human Relations Division of Safety & Buildrgs in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not Tess than 81/2 x 11 inches in size. Plan must include, but ST -��0 not limited to vertical and horizontal reference point (BM), drection and % of slope, scale or PARCEL I.D. >3 dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION r EVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION (\1t;- SW • ft.)D ft AD D _'CEQ),J \S S C hU L k Z G99. 6G SE 1/4 S LAI 14,S 14jT Zj:. .N,R lq E( W PROPERTY OWNER':S MAILING ADDRESS • LOT # I BLOCK # SUBD. NAME OR CSM S - Z S 8 Tz) vE12S L DE � 2l uE �S — (5 STMO)i S D . CITY, STATE ZIP CODE PHONE NUMBER E3CITY []VILLAGE OrOWN NEAREST ROAD 1Z4U�^'(Z �L!-S wl Sy. uZZhIS) �1 ZS- �16t �t_p�{ Gt9•A`t Lf9JC�4- CIRCI,Er p(J New Construction Use Residential / Number of bedrooms [) AdditiQn to existing building [ ] Replacement [ J Public or commercial describe Code derived daily flow 60g gpd Recommended design loading rate 4 bed, gpd /ft ` trench, gpd/ft Absorption area required Sb'Z� bed, ft Sob trench, ft - Ma)dmum design loading rate • 5 bed, gpd/ft • trench, gpd/ft Recommended infiltration surface elevation(s) 1 '�3 1- S It (as referred to site plan benchmark) Additional design /site considerations Y'10U>W wl 5' x63 ' e ED . Ml/U . LL` 01r- r LL. Parent material _Lo'�S.g oUkm • G L•PcCL f'5L Tl LL. Flood plain elevation, if applicable -it S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TAM( U= Unsuitable for stem 0 S 9 U I ®S ❑ U I D S 1J U I [Is ® U I O S 2LU I D S ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth I Dominant Color I Mottles (Texture I Structure Consistence Bour&dy Roots GPD /ft in. Munsell 4 Qu. Sz Cont Color Gr. Sz. Sh. I 4 ( I Bed f Z s%J z - P :5 b lz wt'P a.L j 1 �' s •E, Z 8 -*✓� �o�rz �/y — sly z�sb - -6 m� � - s Ground - 'SL12 V /Lf — St I �sb 1z `n1`ft- k — • Z- - 3 el Ly y S9 z,S`tR 3 Ly rz 3�� s al orti m ew – lug; -2 Depth to S SR- 1012 6 13 limiting fac if Remarks: Boring # O -a 3 L - . S! I z- 'Fsbl� wi'� l� .S • 6 3 1� Flo - t Ground sLl P VIV l 6 n y q0_61 7 S `Z 2 -1,/ S- 11Z -S7f3 sc.[ o vYt h?`�y, _ ►`r? Z Depth to limiting factor Remarks: FR Print Phone: Arthur L. We erer 715 - 425 -0165 egerer.Soil esting & Design Service -P.O. Box 74 River .Falls,WI.54022 Signature: Date: CST Number. . oo- LU3 -�S S -Q �pp 220254 PROPERTYOWNER ��-f - ! SQH'ULZ'Z SOIL DESCRIPTION REPORT Page Z- of 3 PARCEL I.D. p J�►� Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bour>dary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed T �' " � o _� l0 `'t 2 3 I Z — S i I z- �Fsblz_ m•`Fr � rends to-l V/y - Sri Z`f sbV7 Ground :�j 1 -33 - 1 -S Y R- V/v — sr f Z'Psb it- hi es . S , elev. °19.6 ft. y 33-b �•S `�it- 31V ��,•SUr2S��. Set O _ b1 fl- Vj • Z Depth to limiting factor 3� Remarks: Boring # r t i Ground elev. It. Depth to limiting factor Remarks: Boring # Ground elev. it. Depth to limiting factor Remarks: 3oring # around , lev. ft. )eplh to imiting actor Remarks: * PLOT P LA N Page 3 of 3 \� SCALE 1 "= 50 ` Dl1R pUC PIPE w/ _ �`� �2cw PIPE S'ckl61+pvC w� 2h�2 9iP6 I ��01b a �,t1 u Q �C S I 00.1 o3 -1S zzoZSy ( 715 ) 425 -oi 65 CST Signature Date Signed Telephone No. C #- I , ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM r Owner/Buyer e55e 4 nl £ ►2S �`P�, ► h f� 1 t° f Mailing Address 3 $ 04t Dy V y it/ 314 F Property Address , e l Y (Verification re ired from Planning Department for new construction) City /State ,�o,.� . _ *10 -iO6 s _ 90 - txo _ Parcel Identification Number LEGAL DESCRIPTION Property Location ' /a, '/4, Sec. 1 , T _ N -RAW, Town of `'77icoy Subdivision r Zo ue tr 5-t 41"o,n *� 4 d ,2z 4 d , Lot # _ Certified Survey Map # , Volume , Page # Warranty Deed # 4rPSCF`17 , Volume XSA `/ Page # Spec house ❑ yes 10 no Lot lines identifiable lid yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification 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 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. ~ 5 - 1 , 9101 =� '4 4 "71 SI 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. n,�,.Qti,N tl SI wRE 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 V 612 432 9316 DOMESTIC DEVELOP P02 rift KAT 14 R ra I Doourrient Number: 'q Co. EE 6 . III KU1YU FOR AM 0743-IM 13H ?A Fieturin Addrmt Arm Wy Dub : Morlignoe Doot. rai First Ns' tional Bank at Rivet F:wm repY PO Bak 7" rivet Falls, W1 Uw;. It IL60 PW; I Parml I.D. Number (PIN): This David, made between C M. Bye, kmliy4ushy: Dtlionis R. & Sandra C, lioKultz F1q Trust, Dennis n, Sohul%Z & Ifti- C, Tiwatese, both with full poser of sale or atrilrum i3 rial) t ut , atijjosaph A. Diem, Groriev, Wltnessaith, That the said Grantor, for a valuaoie consicisralmn, convoys 10 Qrwite the f dusuitutsu oudi estate in St. Croi,4 e.:4nimily, Stele Of W-300FIGin; of 75, Glover tavon 51h Addif ofl. it, fhp rown of Troy, St. Croix County, This is not homestead PloPol Together with all 1111IJ aj,19 ter the Wadnomonta and qi theraunto belonging: And C. M. Bye, Dennis Schultz and Sandra Schulte warrants that the Ifflill Is good, 11joeteamblar in fee simple and fFtW End UW-21 O r r..n cumbranesa nxcwp soamm and restrictions of eaeord and will YU&IF011L dill defend tho sari-it Dated this day ol 'lunrl. ntxs C. M. Bye Dennis R. Schultz, individually cif ttic 0ennia R. and Samive C. Schuitt r4"06 Sandra C. Sr. iu Q ln i div_�lW of Wus tmu hi individ; the Dennis R, and Sandra C. Schultz Revocable r cost 612 432 9316 DOMESTIC DEVELOP P03 VAl't524mt UO ACKNOWLEDGMENT DAAgFTCQ 13Y: STAT9 OF WfScONSINI C. M. Bye, Attorney at Law S 1 se. r c�olx couNnr I Rived Fatly, Wlsconain porsunally Came Wore me this -�— day of J LmW 2000 Ilia ehnve nomad C. M. Bye, Dennis R, fthultZ i+nd Sandra C. Schultz, to me known t5**Ahe pa WhO executed tho Ivregoing insirurr>�It * , lwkfinvA440e the edrna. '�+.� V 2 EW' • t ;I, 1. an Bsrwdict Nr,,tei y Public, St. Croix County, Wis. Mr L:ornmissikm is a13/03 I Trial And Road Map For Glover Station S? N N ....... ..........�.................... 777V7= .......................�....:.. :...... T )• er 9 8 7 6 5 4 ev 10 3 L i o n ` OMAHA ROAD 2 11 0 119y 19 20 21 22 23 Rp 1 12 °- 24 . . . .... .. . o ^1 13 v °, 18 17 30 31 26wP 16 27 28 29 32 14 15 35 40 moo_ 41 39 38 37 36 33 43 34 42 PA ROAD 44 �0 47 48 I 50 59 52 53 a 54 55 1 45 0 46 :. ... -. 68 0 -67 60 92 0 56 57 1....... R OPE 58 69 61 91 0 70 62 66 90 71 63 64 89 72 SW 65 88 v � Ro 87 74 73' 86 93 SCALE IN FEET �o 79 80 g 75 $5 fat 94 95 ' 0 200 400 800 84 6 77 78 LEGEND 7 N 81 63 96 97 98 WH40TCRIZED RECREATION TRAIL.TO BE MAINTAINED ( BY THE HOME OWNERS ..................... 1.. ............................... ................... (20' WIDE WITH 50' RADIUS CURVES 62 CHATTANOOGA DRIVE AAT HE FIOTFD}SS 20' 20' — - NDN4M0T0t1I ZED RECREAT I ON Civil O I Land SurO. 101 : TRAIL S AINEo 113 W. Walnut St., River FaA& WI 540 2 100 99 — A590CiAT10N (20' WIC, (715) 425 -7831 103 102 T D' EITHER SIDE OF . FF .. }1E COAMJN LOT LINE). ...........1.. ...... ••� - -• CLIENTS --' C.M. BYE AND DIANE L. BYE DE R %2 IETZ AND S ANDRA c. gg1UL DATE: 5 -30 =0 P.0. Box 187 99 -2380 RIVER FALLS. WISCONSIN 54022 (2JItiERLAND, WISCON IN 54629 71 Hudson - - - - \ School District I g \ \ I N '79-35. g•35' 156 E 533 .9 V) l I / 0 190A0. w 72 Q I - X50 2.652 ACRES 115,513 S.F. LJ 1 N 79• 0., W 1 \ Z N 34 387 �o ' h 2 $0, ry \ LA —j I rn 0 1-- 74 N 1 , 73 2.762 ACRES I � \� 2.516 ACRES % 120,325 S.F. — �_ 1109.602 S.F. ~ \ \ C4 C 3 ` / G N M o p RLQ T F-- �y / G^ a° w 20 �SfE O R yew / J� / / . 750. M N Z f� O ErAAL j AY 75' B ) O N n ! O / 79 / z I UO 6 to h 0' ^ ?sp $ $ �y �G� / 3.065 ACRES N ? OD ,•' 'S P I I 2.501 ACRES I o �; Q , 133,498 S.F. sp .n- n •�► O I 108,943 S.F. Z 0 1.0 6�' NORTH LINE OF _ _ I N LOT 1 wl ® 6 GP�O�0 THE SW , OF / -- - -- -- g- -. w (— 75 � N� R =8D, , i,,; . �� / /, "S9. , / ate$ 2.574 ACRES 15�v r- �� a F. ? 1 / o N v C14 C e i 112.126 S.F. v 1 kfO 'k i O� \� cy 01 VOL. G�� ® � ) may a� \\ Z 1 P. -168 328790 I •k 9 y � n EASEMENT FOR N 76 ° o SHARED DRIVEWAY / i 300• ,,� 'r 0 1 �� (SEE DETAIL) LOT 2 / �I o / I y 76 a hN 77 2.603 ACRES p o° W 16 5 ACRES 7C7 =I 113,373 S.F. 162,712 S.F. ° / 6.868 ACRES ; 0 $ 1 I o (/7 7 /�, 299,175 S.F. N , I S0, ° / o 1 S 4.104 ACRES N �---� .� o ,� N ,° 78,780 S.F. = g � = N / ^� ' c r I 3 :I / 12 z v I I S0, N S0, I , a F- I - . .... ......... - .. -.... ...�.r. —.. - � .. ......... .. ' l�.. - - F — 2iti:db . �bo:d0 F— �o 'd8b:bb .. ..... '' QI -'� N 89 0 18'09" W 1317.34' CL w� UNPLATTED LANDS a Z 3 � N O: DETAIL OF DRIVEWAY EASEMENT DETAIL OF DRIVEWAY EASEMENT FOR LOTS 73 AND 74 FOR LOTS 76 AND 77 Z; SCALE: 1" = 50' 7 SCALE: 1" = 50' 5812, 6 ( C CANDY DANCER m .: ° CIRCLE 4 °o N 88 74 ,6 °24 50" E �—, 7 \ G2 w S 88 N C25 / : N a , j3.0 Z ; f •o, \ C3 7.12' 0 �Sk w n ro °