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HomeMy WebLinkAbout040-1092-60-000 ck: 2 2 J % ; E ¢ 2 g § A J § lot ƒ z o w ;- = E q o§ @ E a C4 K) m: ■ ) c; o 0 2: �) S o / E . o § q \ \ §) c §�a�6 E E �� 8 � Q � §2� © � e @ z > ■ a = r E > A " c i a 007 i a § z to § q v / § §a n0■ � 7� � � §_ . 2 z o 0 0 �_ �- Z § § § * § 0 [ § CO) CO) CA § E $ E J 0 gV\ w D CD & _ � E >> O 7 g a i \ / CD ƒ � � » y § z ■ �_ z 0 X i � z 9 . � E w T m § k a § k 2 § E 1 z CD W CD � %[/ § � � ƒ % 'ƒ � � k � � $ 7 , - m % ° o � E, � C � 0 % < % , � Parcel #: 040 - 1092 -60 -300 11/01/2005 02:31 PM PAGE 1 OF 1 Alt. Parcel M 24.28.19.372A -30 040 - TOWN OF TROY Current X', ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner CHRIS D & LINDA L JENSEN O - JENSEN, CHRIS D & LINDA L 840 CHAPMAN DR RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 6.000 Plat: 4257 -CSM 16/4257 SEC 24 T28N R19W LOT 2 CSM 16/4257 Block/Condo Bldg: LOT 2 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 24- 28N -19W Notes: Parcel History: Date Doc # Vol /Page Type 04/01/2002 674936 1863/636 WD 2005 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/20/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 6.000 77,000 237,900 314,900 NO Totals for 2005: General Property 6.000 77,000 237,900 314,900 Woodland 0.000 0 0 Totals for 2004: General Property 6.000 77,000 237,900 314,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 wsoonsin Department of commerce pRIVA E SEWAGE SYSTEM Safety WW SuMNs Division C INSPECTION REPORT Sanit Croix Permit Sanitary GENERAL INFORMATION (ATTACH TO PERMIT) Personal Information you provice may be used for secondary purposes (Privacy Law s.15.04 (1)(m)). 384121 Permi H er's Name: 0 City Village ❑gown of: tate Plan ID No.: ensen, Donald Troy Township 6(2— `(o =T•-e s ►b. T BM Elev. Insp. BM E ev.: BM Description: arce Tax No.: �dO'� l� •�' C r- %M* 1 040 - 1092 -60 -000 TANK INFORMATION ELEVATION DATA a4• a• i Q , 37Z A TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Cltit .W .P, (,-pv 6 Benchmark 8 p ' Dosing Alt. BM 7 rt r(p oZ -fin n Aeration Bldg. Sewer 12 (S. Holding St /Ht Inlet D,4n 1..4 TANK SETBACK INFORMATION St/ Ht outlet TANK TO P / L WEL BLDG. Air I to ROAD Ot Inlet Air Intake - --� Septic > / tvtit > you / NA Dt Bottom J3.�� 9�(. ZS' Dosing t Tp' > 1 00 , W } r pa NA Header / Man. �' �� �� • •� Aeration NA Dist. Pipe �' / Im -M , Holding eot. System as ,o' PUMP / SIPHON INFORMATION Final Grade6p ;q,( (Z`+ Manufacturer �, Demand St cover ( Model Number 3 GPM � Lift �•0 Friction •'-b/ S stem 2r TDH 11•Ft orcemain Length ' Dia. Dist. To Well > Imo I SOIL ABSORPTION SYSTEM dE0 TR CH Width / Length l f Ueaeh PIT No. f Pits Inside Dia. uid Depth DI I N z IM N N SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEA I anuacturer: I t CH INFORMATION TypeO f B R UNIT a Num r: Syste y � `—'_ DISTRIBUTIONS M � Hea er / Iyani old ll Distribution Pipe(s) 4 k x Hole Size x Holee Spacing Vent To Air Intake Length � �Q� Dia. Length Dia. ! 1 2 Spacing 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 El No El Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) g ' D - IOC . O Inspection #1:a- Jam' C (Inspection #2:- i --�- -4 Location: 840 Chapman Drive, River Falls, WI 54022 (NE 1/4 NW 1/4 24 T28N R19W) - 242819372A %A 4 1.) Alt BM Description 2.) Bldg sewer length = - amount of cover = y b p u ( Cje „ e ���,v �trc>arSeur� Plan revision required? ❑ Yes JX No b(* ZP c>•O ��S Use other side for additional information. SBD -6710 (R.3/97) Oate Inspector's Signature Cert. No. ' Safety & Buildings Division 201 W. Washington Ave. Sanitary Permit 1 Application PO Box 7302 " i scOns in In accord with Comm 83.21, Wis. Adm. Code Madison, WI 53707 -7302 Department of commerce Personal information you provide may be used for secondary purposes (Submit completed form to county if not [Privacy Law, s. 15.04(l)(m)] state owned. Attach complete plans (to the county copy only) for the s stem, on paper not less than 8 -1/2 x 1 1 inches in size. County Q / , / State Sanitar e t umber ❑ Check if revision to previous application State Plan 1. D. Number C x 3 I. Application Information - Please Print all Information r Location: Property Owner Name Property Location 6 IV At- D �S✓t/ ff �► . 1/4 /4 , S T z8 N, l or Property Owner's Mailing Address Lot Number Block Number EF Ci State Zip Code , ne Number ubdivision Name or CSM Number sr -- )CO UN T Y COUNTI' C� �— II Type of Building: (check one) n ❑ Vil 1 or 2 Family Dwelling — No. of Bedrooms: i -�_ `� g ❑ 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, J$&New System 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Addition to Parcel Tax Number(s) System Tank Onl Existing System q0_ Q o — 0 00 B) Permit Number Date Issued p ❑ A Sanitary Permit was previously issued f [ 172 J4 IV. Type of POWT. System: (Check all that apply) ❑ Non - pressurized In- ground d ❑ Sand Filter ❑ Constructed Wetland ❑ ressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line 'At -grade , ❑ Aerobic Treatment Unit Recirculating ❑ Other: ---- t do . p p' V Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade �/ Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) I Elevation `7`J 4 � ?0­0 o 10D.o VI Tank Cap• ity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete strutted Tanks Tanks El 11 El 0 ❑ ❑ ❑ ❑ VII Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plu er's Name (print) Plumber' Signature (no stam MP /IrfFR9 ��o. Business Phone Number od ,(�C� Z 2 9 z 7,3- K Plumber's Address (Street, City, State, Zip C E_ L Lf j 0 4* 44 6.0 15 6 VIII County /Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued I ing Agertt Signature (No stamps) Approved ❑ Owner Given Initial Adverse Surcharge Fee) DO Determination IX. Conditions of Approval /Reasons for Disapproval: a Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 I scores n www.commerce.state.wi.us /SB Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary January 26, 2001 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: 01/26/2003 Identification Numbers Transaction ID No. 612940 Site ID No. 62 SITE: Please r t~ totibollt identification numbers, SITE ID: 625938, Donald Jensen above, ryes ndence with! e agenc f � St. Croix County, Town of Troy rrF� NE 1/4, NW1 /4, S24, T2 8N, R19W FOR i j �4 non'! Description: Three Bedroom At grade System SY CR r Object Type: POWT System Regulated Object ID No.: 779030 CC3Ura�+ The submittal described above has been reviewed for conformance with applicable Administt4tive and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED The wing._sortditions 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 "At -grade Component Manual Using a Pressure Distribution System for Private Onsite Waste Treatment Systems" SBD- 10570 -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 at -grade 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. 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. 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. a ARTHUR L WEGERER Page 2 1/26/01 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 01/24/2001 FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 Perard 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 WiSMART.code: 7633'. Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 N*hsconsin TDD #: (608) 264 -8777 www•commerce.state.wi.us /SB Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary January 26, 2001 CUST ID No.691727 ATTIC 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 ]IUDSON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 01/26/2M3 Identification Numbers 'Transaction ID No. 612940 1A r , i ite ID No. 625938 '> SITE: ,1 i +• Please refer to both identification numbers, , .. ._ Bove, in all correspondence with the agenc SITE ID: 625938, Donald Jensen St. Croix County, Town of Troy NE 1/4, NW 1/4, S24, T28N, R19W / l FOR: Description: Three Bedroom At -grade System' Object Type: POWT System Regulated Object ID No.: 779030 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 "At -grade Component Manual Using a Pressure Distribution System for Private Onsite Waste Treatment Systems" SBD- 10570 -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 at -grade 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. 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 construct ion/instal lation/operation. 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. ' ARTHUR L WEGERER Page 2 1/26/01 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 01/24/2001 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 WiSMART.eode -,103' TITLE SHEET Page 1 of - 7 AT - GRADE SYSTEM FOR A 3 BEDROOM RESIDENCE This plan has been prepared in accordance with the At -Grade Component Manual SBD- 10570 -P and the Pressure Distribution Manual SBD- 10573 -P tz. b/aa C cz— 6ie9� LOCATED IN THE 1yE 1/4 OF THE MW 1/4 OF SECTION ZY , T Z8 N, R Iq W, TOWN OF Tc�-OY ST- ", 1m Ix COUNTY, WISCONSIN. INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEM MANAGEMENT PLAN 48 W 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 SECTIO�� a 2P PAGE 7 of 7 PUMP PERFORMANCE CURVE �j_A v PREPARED FOR i R tv F-" uS , yv 1. S X10 't PREPARED BY WaC3E: :;tEF2 SC3 3: t_ _ TEST S NG AND . DES Z GIRT ial= SCE P.O. Box 74 421 N.?Iain St. River Falls, WI 54022 Phone 715 - 425 -0165 r,�� Ar Fax 715 - 425 - 6864" .4rtT X046 c 6LL94i;NT;, P.O.W.T.S: Y, Conditionally •b APPROVED��� � T G �,.P DEPAR ?MENT Of COMMERCE = SEE BUILDINGS - CORRESP DENCE JOB NO. 01 - o� • At -grade System'Hanagement Plan Pursuant to Comm 83.54, Wis.Adm. Code Page 7 of Seetic 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 c:e_aned 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. I the the alarm is activated continuously. Intermittent filter alarms may l su ge flow�s an impen ng alarm. if 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.. At - grade Component and Pressure Distribution System No trees or shrubs should be planted or allowed to grow on the component. Plantings y e may be made around the perimeter and the component shall be seeded and mulched as ing prevent erosion and to provide some protection n ece ss ar y from frost penetration. Traffic than for vegetative maintenance) on the component is not allowed. Cold weather installe ations require the component to be heavily mulched for frost protection. Influent quality into the at -grade system may not exceed 220mg /L BODS, 150 mg /L TSS and 30 mg /L FOG. Influent flow may not exceed the 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 eac lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be h j compared to the initial test when the system was installed to determine if o ogging has occurred and if orifice cleaning is cl required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be for effluent ponding. Ponding levels should be reported to the owner and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring in accordance with 83.52 (2). General This system 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 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 may be present that could cause dea Pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no to ger 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 secure by an effective locking device to prevent accidental or unauthorized entry into a tank or component Contingen Ptan If the septic tank or any of its components become s in proper opera defective the tank or component shall be repaired or replaced to keep the ng 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 co_ mponent of the same or equal performance. If the at- ride component fails to accept wastewater o to discharge castewater to the ground surface, it may be necessary to install an aerobic pre- treatment unit or -replace the component. Additional site and soil evaluations may need to be done and additional plans may need to be prepared and approved by the Department of Commerce, Safety and Buildings Division. . Questions about the operation or maintenance of this system should be directed To - 71 .The County Zoning Office at - '_)1S - 3&'6 -- 4/680 ST -- cl�lx � 1. The system installer at `"115- 38�- 317 S0- WJMA,3zL�2. The tank manufacturer at g00 - �°I� - ZSlO {�1lpyJ� - lv I I The effluent filter' manufacturer at Boo- ZZl - S7t� PLOT PLAN / Scale 1 "= y p '✓ Page 3 of 7 — Nor �tzo> > � — tz Y uN E Q N - r LIN E of 6 nzcz� � ('�2 c� _ t S 1v , • lo I e Qn, IoZ 80'0 'Z vw3 u �a. too.o L31. )rib, 5 ct'rP � � I Ve otZ b" e Zaw p _ 1 t=-tro 3 T pNsn' ' y ` pve 8uti�,p,w G S�C''R. I C L� -t.l off, j- o L� -E�39 S��`1'701V I j 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 v 00016SO gallon capacity manufactured by W/ zPrtez E�LUF_Wj F) t_TtER , 4. Bench marks. /p0.o`oti ��Z PtPtZ• �L 9� 3 'o>v e�z4�►, �l PF, 5. Divert surface water around system to prevent ponding at the uphill side.. - S Page L > 5' B 5 I I >5 1 2' —1 W T L 0 0 > � �o s By �v �� _ �t'(1 �3 D . i 1/68 1/6 B A= )0 Feet B= q D Feet m —. - -- Linear Loading Rate= 'S • 0 GPD /LN FT L= 1 �p Feet Design Loading Rate= O- 5 GPD /SQ FT W= ZZ Feet Fabric /, - z ,, Distribution • Latencl Observations Soil Cover " � Well - �� 12 c.'torz > 5' A 2' > 5' Plan View and Cass Section of Wisconsin At -grade Unit with a Single AbsorPtion Area on a Sloping Site Distribution Pipe Layout Pzce S of 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 Iona rumor 45" fitting to a point within six inches of the final grade. Tern hate the ends of the laterals with a valve,: threaded = or . threaded plug. Provide access from final grade for the valve; threaded dap or threaded plus. T` -t L LZpS i10NQ C. PVC Lateral pV C' Lateral X x x x x/2 xQ x x x x Later) Length — . Lateral Length — p Distribution Line �' L Ptly V kEW - 0-- f Runs Boy, Fro2e� w,mN PI Ft Hole Diameter 3 / /f6 Inch Lateral l < <Z Inch(es) X Za� /z Inches Force Main " Inches I of holes /pipe Z - 1 Invert Elevation of.Laterals iW S Ft. Z3X 0.6b- IS. LIES x.Z= 30. GPI • _ . - Combination Sept.;3.c: and PUMP CHAMBER CROSS SECTION AW SPECIFICATIOMS' PAGE OF —] NEWT CAP � WEATHER PROOF JUIJCTIOU 90X ti C.Z. VENT PIPE APPROVED LOCKIMG 110' FROM DOOR. M"HOLE COVER Pjly , .huooW OR FRESH �.uP'pr�l►JG ��gEC ttJ3p *�C'101J PIPE � CotJDutT w�fYttLrswr merp ALP INTAKE t t i F! Iv P "Ikl Ar Mill. u IAILET PROVID• AIRTIGHT SEAL L�s Approved A � Approved joint w/ il l joint w/ PVC pipe ALARA PVC pipe a • I II I ' i I oIJ c •i I 9u.Z I CLEV. g FY __� PUMP OFF D COU' RETE X13. 024 -00 BLOCK RISER EXIT PERMITTED ONLY IF TAwK MAMUFACTURER HAS SUCH APPROVAL 3NApPQorFD E3>:pD s>v4 SEPTIC F SPEC.IFICATIOUS DOSE T,4 ►J KS MAsJUFACTURCR: � �� � -r IJUMBER OF DOSES: �' Z S PE:R DAB TA 51ZIL : 0 L y S O &ALLOWS D05C VOLUME z ALARM /'4AUUFAC7URCR: INCLUDIIJG 5ACKFLOW: __ 11 I C ALL 0N: MODEL 1JUMBrFL: I"Z�l HL L� CAPACITIES: A= I INCHCSOR 3 6 GALLOrJS SWITCH TyPC: P\ � -�IZ• I g c Z ' IAJCHES'OR 34 G�LLOAl$ PUMP MAIJ UFACTURCR: ___ GOU L �S C= - IUCHES OR 1 19 GALLOLIS MODEL NUMBER: _ - 3 �� - �O� D= IIJCHES OR `k7 GALLOIJS 5WITCH TYPE: ���V4 � °LI ►DOTE: PUMP AMD ALARM ARE TO 5L b MINIMUM DISCHARGE RATE 3CI••3�o GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFEFLE DETWCEII PUMP OFF AUO..DI5TRIBUTIOW PIPE.. S S$ FEET + MI I.IIMUM AIETWORK SUPPLY PRESSURE , ; , , 3 ' 2 S FCET + FEET OF FORCE MAIM X l ' q � F � FRICTIOU FACT _ �- S9 Ioo f[. OR FEET TOTAL OyNAMIG HEAD = l =y —FEET L As per Manufacturer 1 gal /in. Liquid depth 3S ' ` . '1"1.x' ��- F GU�• �. �s�, — c ,_ � uouias Submersible s Effluent Pump 3871 EPO4 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerge ■ t s' : Cast iron Specifically designed for the stainless steel. grade turbin f transfer, following uses: • Capable of running lubrication ent S t d durability. • Effluent systems dry without damage to h tra or Cover: Thermoplas- • Homes components. over with integral handle Farms manua eration. Automat Motor: Avail automatic and d float switch attachment • • Heavy duty sump • EPO4 Single phase: 0.4 HP, el nclude Mec points. • Water transfer 115 or 230 V, 60 Hz, 1550 F t itch ass e ■ Power Cable: Severe duty • Dewatering RPM, built in overload with pr at the facto rated oil and water resistant. automatic reset. • EP05 Single phase: 0.5 HP, ■ Bearings: Upper and lower SPECIFICATIONS FEATURE ball bearing 115 V, 60 Hz, 1550 RPM, nstruc Pump: EPO4 built in overload with EP le hermo- Solids handling capability: au tom set. las ' i desig '/4' maximum. • Pow cor . 0 foot ith t vanes f Y STING • Capacities: u to 55 GPM. Stan rd len h, 16/3 p Canadian Stand ardsAssociation P ech a eal rot i otal heads: up to 24 feet. with ree p ng ng Discharge size: 1 1 /2" NPT. plug. d ■ EP05 Impeller: Th mo- o 120 tic enc losed des n for (CSA listed model numbers • Mechanical seal: carbon- length, ved lsted es end in "F" or "AC".) rotary/ceramic stationary, thr ee pro o ng plu BUNA -N elastomers. (standard o 5). asing and Base: R • Temperature: ermoplastic design pro ' s 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS stainless steel. 10 • Capable of running` 1j j dry without damage to 9 30 — i- s GPM+ � components. Pump: EP05 8 - 2.5 FT • Solids handling capability: c 25 1 /a' maximum. W i I • Capacities: up to 60 GPM. s 20 • Total heads: up to 31 feet. 2 i 1 a Discharge size: 1 NPT. z 5 I Mechanical seal: carbon > c 15 rotary/ceramic- stationary, BUNA -N elastomers. 0 4 I ( EPOS • Temperature: 3 1 10 `tZ 104 °F (40 °C) continuous I EPO4 140 °F (60 °C) intermittent. 2 30 - 5 it 1 0 0 0 10 20 30 40 50 GPM P 2 4 6 8 10 12 ml /h CAPACITY C 1995 Goulds Pumos. Inc. f # Ak a- Woeronsin Department of Commerce SOIL EVALUATION REPORT Page — L of Division of Safety and Buildings ' • in accordance with Comm 85, Wis. Adm. Code • County C a ' Attach complete site plan on paper not less than 81/2 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 an information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). D2— Oto O� Property Owner Property Location I u � ` e/? 5.z:, Govt Lo4 114 II!tJ 114 S 01' T N R / E (or) Q Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# Gl _ O, h City State 2'rp Code Phone Number ❑ City ❑Villlage ® Town Nearest Road y M New Construction Use: R Residential / Number of bedrooms _ Code derived design flow rate flS O GPD Replacement ❑ Public or commercial - Describe: Parent material 6 C� �U—Y -" k Flood Plain elevation if applicable 4 :2 A-4 ft General comments 5'/57 N'( P-/ C V. /v Z.• $ O and recommendations: � i�li ICnsr ¢fie Y. /U �' C- ❑ Boring F Boring W Pit Ground surface elev. �O ft. Depth to limiting factor in. Applica Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. *011#1 'Eff#2 Fil Boring # ❑ Boring ® pit Ground surface elev. '? 7 z - 30 ft Depth to limiting factor _ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. *Eff#1 *Eff#2 010 tovr3 /l 5.'( wabk ( • f 5 - y� 1m 5 7u v ' Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg1L ' Effluent #2 = BOD, < and TS CST Name (Please Print) Sign s 6} ke Address Date Evaluation Conducted r 2 -'!? f 51-102f Property Owner S'e h_ _ T'� Parcel ID # Page z of Banng # 9 Ord' ft. Depth to limiting factor �/ Z in. F- 31 � Pit Ground surface elev. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eft#2 1 6-16 /c 3/ -- S,'i! Zmab4 r c S 1 v , S , Z -Go / F2 7 S F � # F1 Boring ❑Pit Ground surface elev. ft. Depth to limiting factor in. son A Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff l" `Eff#2 F—I Ong # ❑ Boring Ground surface elev. f - Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 1150 mglL ' Effluent #2 = BOD < 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 TTY 608- 264 -8777. SBU4030 (R.07/00) PAGE 3' OF_:�- NAME s A- C o►1 LOT# — LEGAL DESCRIPTION VW '/4 t/[V/< S 24T2$,N,R h( E (or) (10 SCALE: I "= �O 1 ELEVATION /bO.O x BM I DESCRIPTION `3I,V12 ELEVATION q 7.1 B_M DESCRIPTION i6P o J. caved SYSTEM ELEVATION [(? L. X O ALTERNATE ELEVATION VZ 4- CONTOUR ELEVATION 3i I v �. v 06 o U t7 � i3 - 7, op j �3 I SIGNATURE ` ` J � ` � DATE /—/7-0Q.) ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer :110ti- ]I Ll��L Mailing Address / o� Property Address R (Verification required from Planning Department for new construction) City /State A W Parcel Identification Number ©� 17 �b `' rob — 00 0 LEGAL D1nrSCRIPTION Property Location /V y Sec. Z T N -R�W, Town of 4K 0 Subdivision A 1 , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # 2 �� , Volume Z , Page # Z Spec house C yes 10-no Lot lines identifiable yes C no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper .naiatt ;nance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put; in.) 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 wastewate:. dispou system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic rank is less than 11 &.1 of :,I adge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with ti! , taudards set forth, herein, asset by the Department of Commerce and the Department of Natural Resources, State of wisccn. in, �e:-:if ration stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning ? fi.e :tltin 30 days of the thre year expiration date. SIGNATURE APPLICANT - DATE OWNER CERTIk'ICATION _ I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owaer(s) of the property described above, by virtue of a warranty deed recorded in Register'- of Deeds Office. SIGNA APPLICANT — -- -- DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Depa►;menc, ** 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 WARRANTY DEEll. - - To husband and Wife as Joint Tenants FORM 399 R­lw,l This Indenture, Made this _ ls� _ day of h in the year of our Lord, one thousand nine hundred and_ = Sixty- ,f-i_ve -. . -__. _between. Cari:3<_-h, hu,,band and wife, River Falls, :visconsin - -- ---- - - - - -- - - - - - -- -- -- ------ ---- - - - - -- - - -- - - -- - _._...part.ies - of the first part, and__. D -o: laid_ .Tenser. and - ,Inane t.te.-- Je_nSe -n -_ - -_ -- -. -- _. -- - - - - - of_Route 2, ?diver Hal ls, '�'isoonsin husband and wife, as joint tenants, parties of the second part. Witnesseth, That the said part - JC S S - _ of the gust Dart, for and in consideration of the sum of r,+ v'1 7 la ;+t2raLion _. Dollars, to them . in hand pail) by the said parties of the second part, the receipt tt hereof is hereby confessed and acknowledged, ha V.G given, granted, bargained, soul, realised, released, aliened, conveyed and confirmed, and by these presents do give, grant, bargain, sell, remise, release, alien, convey and contirm unto the said parties of the second part, as joint tenants, the following described real estate, situated In the County of t a and State of Wisconsin, to -wit: Thos Nor thwe>;t t�uarter (N.:' ) of ,section Twt;nt;-- T­, e,?,,lit (2`3) anti i(aiip._ Nineteen (19) to 1' 1 Together �i iih .Ill .1nd ,111�4_iihl the lmcly�- .nrl ,ypi rl n.lnce, thereunto belonging fir in ml% \\I,(. ,ipper- t.lining; and ,ill the est,ite, right, title, interest, 1 - laim or dcmrind %whatsoever, of the said part ie 5of the first part, tither in law. or equity, either in possession or expectancy of. in and to the above bargained premises, and their heredita- ments and appurtenances. To have and to hold the said premises as above described, with the hereditaments and appurtenances, unto the; saki parties of the second part, as joint tenants. (ME40 ries M"M Is P Effluent and Drain Water Pumps eui eux+ Performance Curve GA o o MODEL ME40 EFFLUENT PUMP CAPACITY LITERS PER MINUTE 0 50 100 150 200 '250 300 350 40 12 35 � 30 10 U) j L {!— Z 25 8 x O z 120 6 J p. 10 C 0 0 10 20 30 40 50 60 70 80 90 100 CAPACITY GALLONS PER,MINUTE � • 310 _� F.E. Myers, A Pentair Company • 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. � _ 1 3 ,� � Y �. C� �x ,�. 5 ail, " } �J �, 1 Q j Y Y w( � (�] i V N