Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
040-1227-40-000
.. m A 3 �►► CD 3 rr 3 R m 0 00 cn r Z T m o w co -{ o �s < G C N G, W N 'G N 1•r. 3 �N p� N d j (D W CO CL CD C (D O rQ S A \ CD 0 N N �_ O 1 ° o o °c' S, o o 0 c c O O W Q O N N p D1 T N -n C3 vA m a= R Z D ° j a (D D a 0 IO C N O O O- a) 2 N� _.. W N OD O O 00 f O O N N O) O N N Z = O - N O O O S O 0 3 N 0 C O O O a 0 0 0 < O Q O < r'u• ID d N N N a N y N a o °' m Q O 0 p a D O p o h N � � m •te C I � j (D ID ID < (Q d S < N N CD -f 3 m A 3 CL 3 O 3 O CL rn rn Z W Z p p Z c7 Z O D o m O o '° D a 0 m (n Pr 0 o c4 CD • CD y CD Cn N CD ro d c j m c N m ro' a a CD CD c n a a 3 O � W T W T : O< W W CL a Z 0 3 0 3 a o - o - No N y Z CD m < g an vi cn o' I �> CD cID m p v N O T O O T O I 7 N O (w 7 g z a o Z a O N G �O(D E N N O (D y N o d Q Q Q 0 =O CD N N N ( A n 0'a N ::r 3 w a 3 s O r v o 7 N 'n `s x C O CD N O in O Q N v 0 Q b +: CD (D ii C> O r� O C> (D o g a o f o a 5 o ■0)n c 2 a % n - : � (D / � 0 2 7 0// ` ® e § { \ \ \ ƒ ( / ƒ i / § CD ^ ° P w / Q \ \ a j 8 8 2 2( ) a e m i s G o - , \ { R \ & E / 3 \ \ 7 m : \ Z z \ $ } « § § & n r C CD ƒ § § & CA o c � f \ CD 0 0 0 < ƒ / ƒ g 2 ! 2 7 - 2 / M v § . r cn 0 }7) \ \/ ; ( \ \ \ z rr 8 : \ 0 % z = z ~ ® ' \ y © m 2 ƒ 2 ¥ \ J_ _0 \_ E / 2 § • � ° \ f ƒ k ( � \ / } a s G_m § .{f/ z E f o e G G \ 2 \ 2 § a R < [ 2 e § \ , ` ƒ C) , 2 ¥ \ { ƒ ƒ o % > z 3 ° \ � \ \ � ` \ CD � 5 0 \ � o � * ) \ @ / . § k E , \ r- i ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner THOMAS BRESLIN Property Address 286 SALISHAN DR City /State jRQY _ -1N1 _ S401fi _ , ,` � T Legal Description: Z�4;K; Or-fjcc Lot Block Subdivision/CSM # SALISHAN G QW Qrt'�, Sec. , T28 N- R2 -Q-W, Town of 1:E30 Y P SEPTIC TAM -- DOSE CHAMBER — HOLDING TANK INFORMATION Tank manufacturer WEISER Size ST/PC 15 00/90 Setback from: House 6,'J_ Well IDD- P/L 50±- Pump manufacturer ZQLAR Model _,53 Alarm location H011-SF (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system C HAM B E R Width 36" Length 75 Number of Trenches 3 Setback from: House I nn+ Well 100+ P/L 40 Vent to fresh air intake 40+ i ELEVATIONS Description of benchmark FRONT DOOR BASE : y Elevation 847.0 Description of alternate benchmark �_ M Elevation Building Sewer 835.08 ST/HT Inlet 83, -3'�, 7 ST Outlet 833.20 PC Inlet 833.20 PC Bottum 829.22 Header /Manifold 93A AO Top of ST/PC Manhole Cover 842.22 /S T Distribution Lines { ) 8 36.90 O ( ) 841.22 /PC Bottom of System O 835.79 O ( ) - Final Grade O 8405 Date of installation 6 - 2 - 00 permit number 353346 State plan number Plumber's signature License number Date Inspector KEVIN Complete plot plan •* a 3� 6re ----� ,o« y - " ti 0 0 Lr1 �s4 ,dam .� , a o � �� �cs�� � wis^.onsin Department of Commerce PRIVATE SEWAGE SYSTEM Count �Safsty And Buildings Division INSPECTION REPORT St. Croix GENERAL: INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 353346 Permit Holder's Name: ❑ City ❑ Village ❑ jown of: State Plan ID No.: Troy Tow CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: &42 .5110 r S�fZ..5 - 1" CST 040- 1227 -40 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATIO BS HI FS ELEV. Septic � -� // Benchmark c� 'I'D Xt y gs 04Z.51, Dosing Ls j�A O Alt. BM b, 33 ��. $'{�. oe Aeration Bldg. Sewer +# y 8 Holding St /Ht Inlet /�r�z� TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Intake Septic > too r r NA Dt Bottom J 2 9f N Jaso- 8 . I`t) g2 Z z Dosing ]( >70 IF im " - 1-70 NA Header /Marc 8 �y 36. Aeration NA Dist. Pipe (4 3 Holding Bot. System A r)� � 9, 9 :7-g PUMP/ SIPHON INFORMATION Final Grad a ti00 , S Manufacturer Demand St cover 5 Y S• 14) 9 ��� Model Number 3S GPM (�„e� 6 f 2�� p (� I q / • ZZ TDH Lift e 0 Friction System TDH 3x Ft /A r 3 4 b L • 3 me fi h4 6A � f I� Forcemain Length (� Dia. z �� Dist. To Well SOIL PTION SYSTE � _ (Z,a < 2 1f (6 f'o 4*W TRENCH Width Length 1 No 04 PI No. Of Pits Inside Dia. Liquid Depth DIME N 2. 2 i i t 1 DIMENSION SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: SETBACK INFORMATION Type O CHAMBER r r r Mod Numb System: , S�0 >in �(v >•2.40 OR UNIT �- DISTRIBUTION SYSTEM s 1y q-af - $Kl Y f Header/ Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length'�P Dia. I 7 SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only �_6 Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Y s ❑ No ❑ Yes ❑ � COMMENTS: (Include code discrepancies, persons present, etc.) Inspects #1: ob/ oI /oDInspection #2• oG /1(v / OD Location: 286 Salishan Drive, F� tdson, I 54016 ( 13 T28N R20W) - 13.28.20.112 Salishan - Lot 4 ' n 1.) Alt BM Description = �i ey 5 &tue oMc u" , (A s ;-4 . ks tee a^Q -'� 2.) Bldg sewer length = (� • r / 1. a L44+ 4^M - amount of cover= 7 �� (P D ` Ga�W 1 T 5�5� � w ce t-%"Z egad. u �8� Plan revision required? ❑ Yes ❑ No Z 6 Use other side for additional information. 1 0(c SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. I ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: r e_ SANITARY PERMIT COUNTY ' 7 ffILHA TRANSFER /RENEWAL UNIFORM PERMIT # (PLB 67 -T) PERMIT RENEWAL DATE: PERMIT TRANSFER DATE: ORIGINAL PERMIT ISSUANCE DATE: STATE PLAN I.D. NUMBER: PiOJ'ERTY LOCATION: CITY: ,T 2-6 N,R )V E (or) Obi E ` LOT NUI BER: ] BLOCKNUMBER: SUBDIVIS N E: E R / O � D , , LAKE O LANDMARK: +-Il ah PREVIOUS SANITARY PERMIT HOLDER (IF CHANGED): SANITARY PERMIT TRANSFERRED TO: NAME: SIGNATURE: NAME: PHONE NUMBER: ADDRESS: PHONE NUMBER: ADDRESS: 1, the undersigned, hereby assume responsibility for installation of the private sewage system that has previously been approved for this property. PLUMP .ER'S G TU PREVIOUS PLU ER'S NA HANGED): PLUMBER'S ADDRE S: PREVIOUS P BER'S ADDRESS: MP /MPRSW NU BER: PHONE NUMBER: MP /#APR$VMUMBER: PHONE NUMBER: c( (71'-- 5 � - /- c/ ZZ � , ' �lsZ73 KKK SJG� O S ING AGENT: DATE APPROVED: DISTRIBUTION: Original -County Copy - Bureau of Plumbing Copy - Owner DILHR -SBD -6399 (R. 5/82) Copy - Plumber Safety and Buildings Division *scohsin. SANITARY PERMIT APPLICATION 201 Box Washington Avenue In accord with ILHR 83.05, Wis. Adm Department of Commerce i ? f i Madison, WI 53707 -7302 f ` • Attach complete plans (to the county copy only) for the system ft.paper not less than 8 1/2 x 11 inches in size. a ��T ' SC • See reverse side for instructions for completing this applicat' State�Sa Mary Permit Number Personal information you provide may be used for secondary purposes - Ch' revision to previous application [Privacy Law, s. 15.04 (1) (m)].,' Stag I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL I RMATION / Pro rty Owner Name f Pro L , 9 r! e !/H 6a d/4 (ter ( � %'� T �� N R (or)V Property Owner's Mailing Address Lo u et a Block Number City, fate ,, Zi Coe Phone Number Subdivision Name or CSM Nu ber II. TYPE OF BUILDING: (check one) ❑ State Owned Ej it Nearest Road Public 1 or 2 Family D welling - N o. of bedrooms _ ° Tow OF _�!'o X ras1 ri,,c, A-1 5 111 BUILDIN USE: (If building type is public, check all that apply) Parcel Tax Number(s) a G !s'4f C?, 0/' 1❑ Apartment / Condo D V C-/ 1 7 Y 0 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel /Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV TYPE OF PERMIT (Check only one box on line A. Check box on line B, if applicable) A) 1. 5jr ew 2. ❑ Replacement 3. ❑ Replacement of 4, ❑ Reconnection of 5. ❑ Repair of an - ______ystem ________ System _ ____________ Tank Onl�r_____ ________ Existinq System , _ Exlstinq System B) )A Sanitary Permit was previously issued. Permit Number 3 Date Issued 3 -l6 ,200 V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12gSeepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit /U f�iF sv'" 43 ❑ Vault Privy 14 ❑ System -In -Fill ,Le VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Re wired (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) �i Elevation 0 3S- Feet 0 /Feet TANK Cap acit y VII. INFORMATION in g allo Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper New Existing Tank Concrete glass App. Tanks Tanks CAM r%to�T:� . strutted Septic Tank or Holding Tank / f` ® ❑ ❑ ❑ ❑ r ❑�-`� Lift Pump Tank /Siphon Chamber j' c l eu % L.'I c 11 ❑ r Cl LJ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (No to s) MP /MPRSW No.: Business Phone Number: _ Plumber's Address (Street, City, State, Zip n Code '. / / 3 r!Ttti,t?T /� IX , c�rS �ic/ CY 1h IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate I ssued Issuing Agent Signature (No Stamps) Approved ❑ Surcharge fee) Owner �D ` _�_ Adverse Determination . OFF�APPR VALSO S FOR OVAL:�� - � / �s > pwllcl 4_4111 w� C COA S--- K WE�L_ 6 L o SBD- 6398 (A.11/97) DISTRIBUTION: original to tow ty, One copy o: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed beforethe expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608 - 266 - 3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. 11. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the -total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. z; t - N - N o ° ° • i N' O O to : Q � L i B�ogM ..� so 9 � COJn��= \ bi V� 1 \ � \ e ! j Q5� S y, • p S C� r j •r� � G v• I n / �1 W p.. / / n r a ro rn oor.non n..- co / 33; 1. 3 1p 33..-'•• . p ... Q � �/ � J OOYIOImi; ^•O•~ln N1'INIf 8$ g Wy .n ..om.........,. m NN22mmmmNNNNN"- w CL .. o o N / u 0 z � } , I i i , 1 i - ! 4 + GcC i i ! I � f i 1 1 ( U � �! _�, � �� E M x k � � '\ 9 � �' � �. "'o �' �"� ,� � � � � � ��� � ., � � .. �� � .s �-� � '� J © �, � � � � � � J � Ey ��n � � � `- a \� �� �� �� �� � �� � �. � � � Q � �� � ���� �, ��� ����� i ' T ° co F IL r—sl-- * a Z J Q# 0 N (n �`` d Lo o F in a v F a F �[ wa U� O v w g 800 (r g CL \� N Q Z (n 0 w m Mk Q O D O J J \J Q t� 4 U y z ��p� �� a t7 ��W O O m N I Y �MQ pW �0W 4 y UA �QON �Q�tt 4�l U U 3mU� =��m�33 Z z j I l i 1 LLI _ ` I .r 3 r� Ul . W . Jm N I i I I O .�tOt «�95 pLnyry SEi ' ao PCWca•tlol+ or • rrEC LUUML A. Determine pump capadty: a.. �•• - Gravity Distribution T.w 1. mum suggested is 600 gallons per hour Ci0 gpm) to d of " ; :: M .,.,,.. P.. 1W MW W4 rate. G" low YM lbw . a . OWN" 2. Maxim ted for delivery to a drop box a home system is 2,900 gallons per (45 gpm) to prevent build- of pressure in drop box. « � Lo "» a.. Pressure Distrbuiioa `" « 2 00 l MW 3. a. Select number of perfo la s b. Select perforation spacing c. Subtract 2 It from the la length. 2 ft. fee d. De the a Of t rpm, TABU OF PMWORATWN D�tARCSS W GPM Length .spacing ft. + spaeas Head Pafaneoe dbnwh r 8Pd" e. + I = perforati 'I: '�. f. Mul ' perforations per lateral by nu f laterals to tal number of perforations. , x perforations. 1 j, p % 0.74 1j go CA 2,Ob GAO 146 SELECTED PUMP CAPACITY �s an L17 8Pm ao an 1N 4..0 1.13 1A+7 B. Determine head requirement: 3 0 I 1.26 1.66 1. Elevation difference between pump and point-of disdharge. &uw Lo tone atbad ,::!!dal Vow, �_ feet bUn U het of fwd 1w otllsr rbb nmb 2. If pumping to a pressure distribution system, five feet for pressne required at manifold if gravity "M zero. C? feet 3. Friction loss a. Enter friction loss table with gpm and pipe diameter. P L=tith Read friction loss in feet per 100 feet from table. ~ p F.L - -24V ft. 1100 ft of pipe T b. Determine total pipe length from pump to discharge ®evadm D�cmmx J point. Add 25 percent to pipe length for fitting loss, or use a fitting loss chart, Equivalent pipe length -1.25 times pipe length = �U feet R 1Eb �_ x 1.25 = 1.5 inch t0 inch Minch c. Calculate total friction loss by multiplying SpM Plbm.imr. friction loss in ft 1100 ft by equivalent pipe length. Total friction lose = x _ +lOp . �- 2-2- het 12 0.96 018 4. Total head required is the sum of elevation difference, U S special head requirements, and total friction lose. 14 6 1. M48 18 2.03 ado + e + 3.73 / - 3 Z 20 247. 1 .79 0.11 25 1.11 0.16 (l) (2) (34 35 35 7.90 2. 030 7i 3. 40 11.07 2.64 0.39 TOTAL HEAD ,feet 45 14.73 328 0.48 5o 3.99 038 53 4.76 0.70 C. Pump selection 60 5.60 os2 1. A pump must be selected to deliver at least 32 gpm (Step A) with at least Z j feet of total head (Step B). .� Lef . M HEAD CAPACITY CURVE EFFLUENT No ■■■■ I ®m�m�m�m�m�����m�m�m�v����mm�m� ■ ■ ■ ■I ®mmm ®mmm m0®mmmmmmmmmmmmmmmm ®� mm.mmmmmmmm0mmmm ®mmm ®mmommmmm ®m ■\■■ ■f�ommmmmmmmmmmm ®m ®0 ®mmmmmm ® ® ®m mmmmm■� ®mmimm ®rammmmmmmmmmm ®mmm ■\ ■ ■ ■I�mmmmmmmmomm ®mm ®mm ®mmmm ®rte ®mmm ■■■■■ I�mm■�mmmmmmmmmm ®mmmmm ®mmmmmm ®m 0�mmmmmmmmmmmmmmm ® ®�mmmmmmmmm�m ■\ ■■ Ism ■m- ■ ■ ■ ■� ■ ■ ■m- ■i�mm�� ■o�m�m ®� ■ ■ \ ■Im��mmmmmmmmmmmmmmmm ®mom ®mmmmmmm ■\■ ■ ■Immmmmmmmmmmmmmmmmmmmmmmmmmmm m �mmmmmmmmmmmmmmmmmmm■� ® ® ©ommm ■■\■ 1 \I��mmmmmmmmmmmmmmmmmmmmmmmmmm m less than 30 feet TDH. . \■\ ■111 \ \ ■ ■ ■ ■ ■ ■ ■ ■■ °�� .. - :.: .... - . - -. . 0 ■ \\ \ \II \1\ \ \ ■ ■ ■ ■ ■ ■ ■■ ....... \�■\`S ■ ■\ \\ ■ ■ ■ ■ ■■ ■ ■\.1111 \'\■\■ ■ ■\1 ■ ■■ M HEAD CAPACITY CURVE SEWAGE ONES ME ------ - - - - -- \ ■ ■I . ■■\101, M NMI ©�===== = = = = -■ � -■ ■mmm NONE OWN N N\■■■■■■■■ ■■ ENOWN Model 293/4293 should not be subjected to less than 15 feet TDH. Mt- Som 1113116311111111 Ln , W 1 NERD CAPACITY CURVE Model "53/55/57/59" UA MODELS 53- 55- 57 -5;1 25 Ft. Meters Gal. Ltrs. • % 5 1.52 43 163 6 20 34 129 r' 10 3.d5 15 4.57 19 72 v '• 5. M �r z 4 E Lock Volve: 19.25 ft. (5.9m) i � 3 15/16 6 5/32 --j 2 4 +i 5/8 / 1 1/2 -11 1/2 NPf i 0 3 15/16 U. . GALLONS 10 20 30 4 50 q LITERS O 80 160 � 4 1/16 FLOW PER MINUTE onaea, I — t CONSULT FACTORY I 1 FOR SPECIAL APPLICATIONS • Variable level Float Switches available. • Variable level long cycle systems available. • Available with special cord lengths of 1 , 25', 35'a 0'. _ /1 ( '♦ C�� 10 1 '16 — • Alarm systems available. C' • Duplex systems available. 3 3 / 3 2 { sxese SELECTION I1UIDE 1. Integral float operated mechanical swita. fro external oontroli required. •� CSA UL 2. Single piggyback variable level float swltcb or double piggytack variable level 1111104101 yew 1 float switch. Refer to FM047T. M531558M57/59 1115 1 Aub k 6.0 137 Y _ Y 3 Medianicaf aftemator'M -Pak' 10 -0072 or 10-0075. N53f55 77W 115 1 Nan e. 9 or r4 4 Y y 4. See FMD712 for correct model of Electrical Alternator. • BN53 115 - -- - --_ 1 Auto _ N y 5. Variable level control switch 1IN225 used as a control activator, with Elec4ical • SN57 115 1 to 8.0 m. • _ Aum BE53157 230 1 4.0 Y Y Alternator (3) or (4 ) float � D53156 3 D57159 230 1 Auto 4.0 10(1&7 - Y y . S. Four (4) hole J- Pak, junction box, for wa connection or'Mred �n simplex or E53155 3 E57159 23D 1 I Non 1 4.0 1 2 or 2 3 8 I 3 or 4 3 5 Y Y 2 pump operation, PIN 104002. single pilIgyback switch Included. 7. Two (2) tale J-Pak, junction box for watsrii hd cortr ftn or splice, PM 10-0003. I CAU7 N For inbroliononaddidmai Zoeller produdarelarlo cate4onPiggybadtVarlableLevel FloatSwltdks, FMO477; All Installation or controls, protection devices sad wiring should be done by a qualified Electrical Altemator, FM0486; mec Alternator, FMD495; SumplSevmge Basins. FM0487; and Single Plhese licensed electrician. All electrical and safety codis should be followed including the most Simplex Pump ControllAlarm Systems, FMD732. recent National Electric Code (NEC) and the occepational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor Is engineered into the design of every Zoeller ump. I _ AKk M. P.O. BOX 16347 _ Lwsr^ KY 40256.0347 L SNIPTO: 3618Cane Run Road OO Lotisv* KY 40211.I90 7TyPld Swax fi7.�s7 r f50?J 7 humlAtnvw zoeNer.t:an PUMP !O, F AX(50s) 4 g 4 PUMP © Copyright 1998 Zoeller Co. All rights reserved. peJUeseu s146P IIV ' JellaoZ 9661 14OUAdoo 4 S laol lexe7 algeueA >IaegF661d 41u+ adwnd ogewolr 41lM sJeuJg 6ulsop JD sopAo Budwnd pe6e>ped elgeliene MOONS 9 MUM PcJlnbQ "0140e of sulseq pezls dyadoid pus spquoa (sbeos Aluo A9 L L 'dH V - AS - SS. WGI apeuen 8"nb9J AllOtL ou auJalsAS lusnlpe l0 64zls e41 :WN AOM JO A91 L 'dH 6' - .19 - BS. op"a'"B"°N" OPwaft • 318dlIVAb SW31SAS . 31OVIl'VAY S1 300W 10alNO3 13A31318VINIVA 'sBuueeq Papo Aliueueuued 14 MP - 1 0 1 NO a3 ld3S All11a113Wa3H 3181Sb3W8nS A13131dW03 MY S13OOW lld ezuop Uoil M pot #o Addn g Jawq - Buuoeg . pet po Jaddn 9 mml - 6uueog . ' 4 pi" kale sseluleis . 'Bipuey f pien6 pozluegeo . uoporup= ezuauq IN • 'Wprulsuoo uoy ow AV . " 69 1300W [S 1 •azuolq uaJ ! peo pet 1p Joddn q 19=I • &W" • Pet No addn g JeJnol - Buueeg . L a 3113d w l •epue4 4 pJenB lees ssapJ!alg . •olpuey I p en6 uueApo . f yas ul pJlew yyrn �epedux W !elaw t" Apdwl 3dJ11X31ZI0A �Id'PQl�16'PQwulBu3. opseld'pellL4-ssel6'peJaeul6u3. ' '�q •eaeq euW4wdApd Pell4• • auaytdoiAod poly -mlo . •Bu!sno4 duJnd •Bumio4 dwnd • 4 WWI= ypPme azuaJB . p Jolow 'em Lq.w uaul m . SS 130OW ES 1300w manlv3d 130OW IMUS 1 3w " sin 01 14 • '.Zia£ of - 41P!M j*l �I1rwOlntl l "pd 00 • .V,"I uo . 8e1 09 , 09s i rwN 4 pue ® "Mamv ��JWWosialdN: /r6 ae�e4�!O1dN.� /�i •(aie4ds) spps 4pul .i sassed . SO1'lOS .`h S3SSVd ('ox) 'J,pci 6uueiemp ti38W31Y ° Jo )usnWe iot airgeiedwel wnw!xew . V (MiSAS MNVI OI1d3S)1N3n 'll�s lis4s o!uJet� uo4jea ap 'Aiquresse AVe pom wnssaud pun atqu3 . (dwnS) JNIa31VM30 " "'m 4empWo �'mow posi!o ' BOA uwepd peopano 1am41)e w ageux>3rrV Bu!snoy dWnd 3181S213W8nS dwndpuegmuaamag6uu, wNogwm . 1dW H J I W 6 opolsue e" e l N . 'wee y�uns pue sMebs !eels sselu!e)S < < Y Y •opouoo jo lsru of s>Jed lelaw leeys ON . (9900 SMOM I SMBN SOS uog ONUOPI MOM dmnd JO 'op wo)neuou joi piepUels • u 9 'ogewolne x4 p opuels 'g 6 -•6nld pue pjoo ej!m-E Pori in - 96 P OS BzU�� 6 c^ �� •epef!ene swe)s�ts alob Buol leAel olgeuen g spurns leo!uey�ew alOd Z (9 tlW3N) a!q!Mu gns'PWJOdo lead - SOM19S UO JI ;Se3 L5 C �elledwl 3H. 6tJ166o1 . S3?Jn1V3d 3S3H13?JVdWOO part a (ZOS) XVd • dtWid (00@) t • tw (SOS) Woo iettaoz esNJ�yr y t96t - 490k A)f'O! • Pwd Oil WOO 6W :01 Ad •senue ersuooul LCrE0 9M AX 'QMMn07 •ItM X08 '0'd 'al VWX ao selauedejosip ouip osei G uagewlojui Ajoloel ll nsuoo •uopeollgnd c690 to ewll le suapi 1pu slaaltej eJay paluasaJd sopowWnS Q ® // ��//sslonpoJd Rato E640Wd N Ar 39N� Bd/Y/!d Al/7Jf97� Oi0'OZ'Z MUM r. Safety and Buildings Division SANITARY PERMIT APPLICATION 201 W. Was hington Avenue ` ISC�IISI Q P O Box 7302 Department of Gomm a c, 11 j 91 In accord with Comm 83.05, Wis. Adm. Code Madison, WI 53707 -7302 • Attach com la ns the cooty' opy only) for the system, on paper not less County than 81/2 nch is t� ! Y yR' StateSanitar • See rever esi;de for instructions for cpm leting this application y Permit Number - , _ Personal inform 131Ff you (3rov1 a rfiay_be� used for . a Clary purposes ❑ Check if revision tq00revious application IPrivacy Law, S. Q4 M . 1 v, State Plan I.D. ber 1. APPLI AT ' + A A E PRINT ALL INF RMATION Prop r t y - Owner Na / P o Location tR� P, 5 ". Y c_ �S� ( N ('io Ul 2.1/4, S T Z $ , N, R 2�OE (or)�jp Property Owner's Mailing Lot Number Z Bloc Num ber fW Cb LJLfL-I- City, Sta a '6 I' '` Zip Code Phone Number Subdivision Nam CSM Nu ber II. TYPE OF BUILDING: (check one) ❑ State Owned it Nearest Road o Public 1 or 2 Family Dwelling - No- of bedrooms V ow a n e O S L t1-'v Dig 111. BUILDING USE (If building type is public, check all that apply) Parcel x Number(s) 1 ❑Apartment /Condo d (7 Z Q 2 E] Assembly Hall 6 ❑ Medical Facility/ Nursing H e 10 E] Outdoor Recreational Facility 3 E] Campground 7 E] Merchandise: Sales/ Rep ' s 11 E] Restaurant/ Bar/ Dining 4 E] Church/ School 8 E] MobileHomePark 12 E] Service Station/ Car Wash 5 [] Hotel /Motel 9 E] Office/ Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. C ck box on line B, if applicable) A) 1. mNew 2. ❑ Replacement 3. El lacement of 4. E] Reconnection of 5, [] Repair of an yytem System 'ink Existin ________ ____________ ______________ g System ---- --------- -- ----- ------ Exi sting S ystem -- -- - B) ❑ A Sanitary Permit was previously issued. ermit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressuri d Distribution Experimental Other 11 JgSeepage Bed 21 ❑ ound 0 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 n- Ground Pressure r X 0 f 42 ❑ Pit Privy 13 [] Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFOR ATION 1. Gallons Per Day 2. Absorp. Ar 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Re ui ed (s . .) Proposed sq. ft.) (Gals/day ft.) (Min.Jinch) Elevation 4---ew 75 () iZeet o Feet VII. TANK Capl f IN ORMATION in ga ons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- plastic Exper. New Existing Gallons Tanks Concrete glass App. strutted Tan Tanks Septic Tan r Holding Tank St J a ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber 1:1 El El El 1:1 W. KI:bF0Nb1B1L1TV_ I, the undersigned, assuro responsibility for installation of the onsite sewage sys em s own on the attached plans. Plumb 's Name: (Print) Plumber' Signature: (No a ps) MP / m mto.: Business Phone Number: e- � N M� z 7 3 Plumber's Address (Street, Cit� ate Code): IX. COUNTY / DEPARFMENT USE ONLY l C] Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No Stamps) JA Approved ❑ Owner Given Initial A Surcharge Fee) �/ Adverse Determination aas: CD - S`� , X. C0 N�TI L /��REASO DISAPPROVAL: 1 0, � . 7o t� l e t tre/� `� ( ems t SBD -6398 .4/99) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber i - - r i INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Admiriistrative,Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildingfs�Division 608- 266 -3151. To be complete and accurate this sanitary permit application must include: I. Property.owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the ' system is to be installed. 11. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. IC V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. V11. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fitl in name, license number with appropriate prefix (e.g. MP, etc.) address and phone number. Plumber must sign application form. IX. County/ Department Use Only.. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 112 x 11 inches must be submitted,to county. The plans must include the following: A) plot plan, drawn to scale or with complete'aimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; aricUj all sizing information. .l 'A t GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practites which can effect groundwater. 1 The monies collected through these surcharges are used for monitoring groundwater contaminat investigations and establishment of standards. T 4 a � j • � O� � , i 44 E 1 � � RO M& � �� "EA � rc : Yst� ism qp � ;e l3xtoo 1 � r -� 0 tv 3�� 6aR Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page of 3 ' _'jmr and Human Relations ` . Division of Safety & 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. Plan must include, but 5 T= Cttp tx not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION IEWEDB DATE - (b-2rW PROPERTY OWNER: `c�tPct2QtS0�J GvDD GI�DQ PROPERT`fLOCATION c.Qp tp GOVT. LOT Z 1/4 1 /4,S 13 T Z'i3 ,N,R 71J E (o, W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # S Sf1l,lS1i PttJ y — �RAPaSL� 'P�PrT OF CITY, STATE ZIP CODE PHONE NUMBER E]CITY []VILLAGE ®TOWN NEAREST ROAD 2�v�z '�� W S�loZ2(']IS) +�tS -z�s� �zo`•f t�11SZ" Guu� RAf�f� pQ New Construction Use [)(f Residential / Number of bedrooms 1 4 [ ] Addit(n to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 6 0 0 gpd Recommended design loading rate bed, gpd/11 d • 8 trench, 9 polft Absorption area required $ 5$ bed, ft - 7.5 0, trench, ft Mabmum design loading rate o . 1 bed, gpd/rt 0 a trench, 9Pd1ft Recommended infiltration surface elevation(s) 5 URGE 3 of 3 ft (as referred to site plan benchmark) Additional design / site considerations loo SeZD Parentmaterial $kQ" Sgt,wLWr ou Lf ShK3t> 4 C r"ULW_ Flood plain elevation, if applicable N- Q . ft . S = Suitable for syStern CONVENTIONAL I MOUND INGl0UN0 PRESSURE I AT -GRADE SYSTEM IN FLL HOLDING TANK U = Unsuitable tor. Stem ®S ❑ U ®S ❑ U 19S ❑ 1 [9S ❑ U OS ❑ U [IS ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Iar>d3y Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed T iench i t 3 10 ti z. I t L Z `F S bk -W) i �' t o -S ' a- s d- 6 Z l3_ 1Z`l2 � . 3/6 L Z S� & hi `F►- S (sS U.0 Ground 3 )6 ZI 10 VIZ. 3/6 s 1 C_Sbk `n u C_ _S elev. 8 40.E ft. z1 -4/ - 7.S'/P- 31(/ )S g m eS Depth to V /"y limiting factor > $1 Remarks: Boring # o_1z �o�e ZIZ 5t 6 �t S o.L 13 -, .., cjNINOZ � Z �" 5 bk "L N'n00 ` yQ „ ,,*� Ca ( l c T lak �n Ground _ �� �; , elev. �.S y i' ►�� �' C n.S' v• % go.s 4 - �s s� w►1 S Depth to S y6 -q Hoye %r"+ ����`� � S� w, } o•� o.a limiting IaCtDr q3 Remarks: TNartte:— Please Print Arthur L. We erer Phone: 715- 425 -0165 Addrm egerer Soil Testing & Design Service -P.O. Box 74 River Falls,WI 54022 Signature: Date: CST Number: X13 -03- �-�► M00576 I 1 PROPERTYOWNER 4Cw SOIL DESCRIPTION REPORT Page 'Z'of 3 PARCEL I.D. # — +, Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench ti _JS t v M 3A. — 1. Z 'F5 h ) o.s o.6 Ground 3 ! $ - to `? r2 3/t wr u'Fh c S O • y ti's elev. 8 qo.y ft. y 8 -qt -7.s%fk 3 - is o.s rn 1 0-S O• S ;u•` Depth to 5 yy- 9 l o 4Q l y w) 1 r�• � 0.8. limiting 1 ST 9 I. Z Remarks: Boring # _ o - �Z IoyQ z[Z - Z `F s bk �VN f a-S a S; 0.6 b 3 �6 -i3 1 oy1 -3/6 MU eS o.y 1 o.S Ground elev. 23 40 - .5 Lf IZ 3/ y '� S O 5 g kn c S o. S p, g yo.s ft, Depth to 5 yo - Z J o X rz V,/v o sa �, 1 a a• limiting o r factor��' Remarks: Boring # 11aw • 5' M cL 3 Is -Z 3 �o yQ j /t, - G>� 1 C3bk Mv'F1� CS o•y o.S Ground elev. 4 13 -yS -), S y R 3) — �S 4 �S O S9 ►^'l c I o. s �o . 6 8 Ko.1 ft. Depth to S �5 -90 1oytL L�/ — _ _ S O Sg ►+, � d.7 �O,g limiting �p i factor 790 Remarks: Boring # > _ i i Ground I elev. ft. - Depth to limiting factor; > . Remarks: SBD- 8330(8.05/92) PROPERTYOWNER tCW SOIL DESCRIPTION REPORT Page of 3 PARCEL I.D. # Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Consistence Baxxiary Roots Bed rprench 3 I o -tz vo 41V- z[ z o. 5 0. b tz_t8 toYtz 3/� — L Z, u•S o.6 Ground 3 1$ -Z$ to 1 1 i2 3 /( S ` \ C S)* wr u q b , S elev. 8qt�--qit. 2'8 -4y - 7•Sy2.31y — lsa+5 o.S 1 CS o•S:u•C Depth to 4Y -ql o4tz / — S;. ; o , a� rn 1 0•� ': limiting.,. factor �l l ----------� Sa• � g� .. i Remarks: Boring # NY\ V, a.S O. 5 ( b•6 y Z 1i -1 b 1D %1 0-- 3 — L Z $ 5 >r `�a ohs S I 6.6 3 r6 -z3 P- 3A. YnU cS o,ylO.s Ground eiev 9 Z3 -4 -S VfZ3 /y '" )s 9°FS O 5g CS o.S p,6 g yo.5 ft. Depth to 5 yo -9 Z 1 0 `12 Y/ limiting factor I i 1 Remarks: Boring # L Z�Sbk �`F�. a.g Q•S 0.6 Z T56, r,.r .fit,- CL o• s ?n, 6 3 1S -Z 3 It) Ve 3JL C-3bk �Av -t, 0-S o•4 ; o.s Ground . ' elev. . ZS -YS' -),SyR 3J \Sd4�5 O S ►n) eS o.S'b % 0-1 ft. Depth to S �s -qo 1oytZ 03 ;/ — _ S O 5. limiting factor Remarks: Boring # : w i Ground i elev. ' ft. - Depth to limiting factor , . .... Remarks: SBD- 8330(R.05/92) PLOT PLAN Page 3 of 3 SCALE 1 "= Sol LuT Z • 8 PcC 0 0 NwW l�Q st RE W k -%--hS r Z S' PF-oN D�hl>v FI e bS . 4 a DT'[otil OF s u s - tt�)" 1 s lv It hT eL.QJ, g 3 6. Z q 0 0 r L� $ V L. sb oN E1.84 0 eL aqo 5 �3/ '` I I `r-" S. l +2c -8 RR w /LptTH - I 8ta. von mo o' s :y ac SYo s j S� 0 �.7 L� 0t �t3 - 03 - y. I_ ZQ -93 ( 715 ) 425 — ol 6s M 00576 CST Signature Date Signed Telephone No. CST # PAGE OF C rrJSS �ec }ton O� A ben SyJer r Fresh Air Inlets And Observation Pipe Q Approved Vent Cap Minimum 12" Above Final Grade 20- 42" Above Pipe _ 4" Cast Iron To Final Grade Vent Pipe Marsh Hay Or SyntMtk Covering Min. 2" Aggregale O t P Distribution Pipe — 0 0 — Tee { S o Perforated Pipe Below B - Coupling Terminating At Bottom Of System Ppopo e �I�k ` g r �.�lt ��cJr r ton �� V1_ SOIL FILL DISTRIBUT101.1 PIPE APPROVED S4MTMETIC COVER OR 9 OF STRAW Q OF g6GREGAlE -�� � OR m ARSN HA`j (e OF 12 -2. AGGREGATE ALE V. OF FEET 6 DISTRIF3 PIPE TO BE AT LEAST 11JCHES BELOW ORIWIJAL. GRADE AMU AT LEAST20 INCHES BUT 1.10 MORE THAM 42 IAICNES BELOW FINAL GRADE 2 � MAXIMUM DEPTH OF FXCAVATioo FRoM ORI &VIAL 69AoF WILL BE I 7 It s rdKIMUM W114 of EXCAVATIoN FR OM 0lK I(,1WAk . GRAp€ WILL 6E 3,2 1*G* -5 SIGIJED: LIGE►JSE UUMBER: a DATE: 3 �✓ �D� Combination Sep-tic-Tank and PUMP CHAME)ER CROSS SECTION AND SPECIFICATION ' �(F A/ •VE1.1T CAP WEATHER PKOOIr JURJCTIOA! 80X , Cc.I. VEMT PIP[ A PPROVED LOCKING x.10' FROM DOOR„ /Y0,WfOLE COVER, --)IV .iWOOW OR FRC5H �ARr.OlIJ6 LA6EL AJK IJJTAKE � couDU�r 5 � I „ l y IIJS ✓�cnon7 ply � 11 _ _ _ _ IML_ET PROVIDE AIRTIGHT SEAL APPROVED JOIAIT A I I APPROYED JOWT: w /C.I. PIPCORP Tank Construction i IiI W /C.I. PIPE°RPOC shall comply With ALARM Iffim 83.15 and 33.20 I it eon � I I I I oti C I i PUMP q OFF D C 5LOCK BLOCK 4 . K15ER EXIT PERMITTED ORJLy IF TAWK MA1JUFACTURZ -V HAS SUCH APPROVAL 3kPP�c�c` SEPTIC f 5PEC.IFICATIOKIS DOSE TnuK 5 MAIJUFACTURCP:W���� �C�� AJLIMbER OF DOLES: P E R DUB TAMK SIZC : - �C,��y`� GALL01�J5 D05[ VOLUME z ALARM t%AUUFAC 7URER; S 5 S�fs��"23 I►JCLJDI -IG OACiCrLOW: - '--�� - �= — GALL.OW,� MODCL RJUM6ER: 1 Qs � \4w _ CAPACITIES: A_ NCHCS OK ... �a CALLOUS SWITCH TJPE: ),-- LZL U�-Y 5 = Z I CHES"OR � vrL.LDIj5 PUMP 11IJ AUFACTURWK: t 'I �jS 7 / CHES OR L.,�Q wtiLLO MODEL IJUM6ER: �� qQ D"- - =INCHES OR � ® GA , LLOA15 SWITCH TYPE: ��'1ZCuSzY 1JOTE' PUMP AMD ALAK, -, ,yKL TO 6E MIQIMLJM DISCHARGE RATEOc P M IN5TALLED OU 5EPARATE CIRCUITS VEKT ICAL DIFFEREAJCE DETWCCRJ PUMP OFF AUC)..DI5TRIpuTIORJ PIPE.. j H- MIRIIPIUM NETWORK SUPPLY PRESSURE FEET f _ - - FEET OF FORCE AIM X ,¢c Rio• FLFKICTIOU FACTOR- i 7 r EET ' � TOTAL DyRJA,MIC. HEAD - 1 FEET Pump chamber DIAMETER - ILITERKIAL DIMEAJSROMJ OF TAQK LEM&TH ^__ ;WID1 H , ; L. I Q U i O DEPTH BOTTOM AREA 231_ lAL /INCH r M E40 Series M� 4/'10 HP Effluent and ?rain Water Pumps Performance Curve MODEL ME40 EFFLUENT PUMP CAPACITY LITERS PER MINUTE 0 50 100 ISO 200 250 300 3SO 40 12 35 10 � 30 1Z 25 8 ` Z { 20 6 15 4 O F- 4 O 10 2 5 0 0 0 10 20 30 40 50 60 70 80 90 100 CAPACITY GALLONS PER MINUTE F.E. Myers, A Pentair Company • 1101 Myers Parkway, Ashland, Ohio 44805 -1923 419/289 -1144 FAX 419/289 -6858 Telex W7443 K3326 7/91 Printed in U.S.A. ST CROUC COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATIO FORM Owner/Buyer I1 61nds e ? I - Mailing Address r a #t,,� S P�/' Q� Property Address Y ' A-) 6-P Tro (Verification required from Planning Department for new construction) _X TDZdA of 7R!vy City /State P ljd S'Aii, VVl' Parcel Identification Number LEGAL DESCRIPTION Property Location V4, %4, Sec. 3 . T SN R o 6 W, Town of TIC0� Subdivision 1 [ S'n Q r7 , Lot Certified: Survey Map # , Volume , Page # Warranty Deed # 6 17119 , , Volume N Page # a Spec house ❑ yes ❑ no Lot lines identifiable X yes ❑ no SYSTEM MAINTENANCE Improperuse and maintenanceof .your septic system could result in its premature failure.to. handle wastes. Propermaintenance consists of pumping out the septic tank every three years or sooner, if neededby 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 SL Croix Zoning Department a certification form, signed. by the owner and by a masterplumber, journeyman plumber, restrictedplumber or a licensedpumper 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. Uwe, 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. SIGNATURE 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 erty described abo e, by virtu a wananty deed recorded in Register of Deeds Office. SIGNATURE 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 ° �� ' �S �� J (Apo V /) S� 1 Z I VOL 14N)PAGI Z4 STATE BAR OF WISCONSIN FORM 1 - 1998 6171. 1$ WARRANTY DEED KATHLEEN H. WALSH REGISTER OF DEEDS Document Number ST. CROIX CO. WI RECEIVED FOR RECORD This Deed, made between Timothy P. Deis and 01 -19 -2000 10:00 AM Laura A. Deis, husband and wife WARRANTY DEED EXEMPT Y Grantor, ; i CERT COPY FEE: and Thomas R. Breslin and Frances L. Breslin, COPY FEE: husb d and wife as joint tenants TRANSFER FEE: 555.00 i! RECORDING FEE: 10.00 dvaru PAGES: 1 r Grantee. Grantor, for a valua a consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (the "Property "): i Recording Area Name and Return Address I' Th & Frances Breslin 124t6 th Court LOT FOUR (4) AND AN UNDIVIDED 1 /10th INTEREST 1246 th Court IN OUTLOT ONE (1) , PLAT OF SALISHAN IN THE New Bri on, MN 551 Pa TOWN OF TROY, ST. CROIX COUNTY, WISCONSIN. OlSon+- at - j I ( �'1 n a,�ia, l Q �t i., it , 2q Ob n'c P 040- 1227 -40 Parcel Identification Number (PIN) This is not homestead property. ]6) (is not) �I .I i! I �i Together with all appurtenant rights, title and interests. j Grantor warrants that the title to the Property is good, Indefeasible in fee simple and free and clear of encumbrances except easements, restrictions, reservations, and covenants, if any of record, and highway rights of way. Dated this 18th day of January: 2000 rcc. I% (SEAL) (SEAL) 03/16/00 'THU 17:10 FAX 715 684 2666 ST CROIX CO- UWE% /LWCD 0 002 dr w 1960 &h Ave St. Croix County Land and water p a eix ps Conservation Department e&rdWx w1 54002 Phone: 715-684-2874 Far: 715 - 684.2666 March 16 2000 Mary Jenkins St. Croix County Zoning Department St. Croix County Government Center 1101 Carmichael Rd. Hudson Wise. 5401.6 Re: Salishan Subdivision Lot #4 Mary The Land and Water Conservation Department has received and reviewed the site plan and erosion control plan submitted from Bruce Lenzen, Salishan Subdivision Lot ##4. Per phone conversation with Bruce on 3/16/00 we. had discussed the following items to be included into this plan. r 4) 1) Area "A" shall be sized on site plan to reflect calculations for Area "A ". r 4 1) Install additional sift fence to encompass the entire construction area. This will require silt fence to be extended to the North and the South property line. 3) The spoil pile shall be seeded with oats or annual ryegrass for vegetative protection. Discussed small retention ponds could be constructed larger during construction for additional storage. 5) Submit seeding plan and mulching requirements. If you have any questions or concerns please give me a call. Robert Heise County Conservationist 09 /16 /00'THU 17:10 FAX 715 684 2666 ST CROIX CO- UWE% /LWCD 16001 AVV r 1960 8th Ave 5t. Croix County Land and Water P a BOX 9s Conservation Department Btrldwin WI 54003 Plione; 715- 684 -3874 Frig: 715494 -1666 l To. � �. r Prom: �7 - Fam Ph <; C�. 7 < Re: ^� © Urgent Cor Review O Please Comment 0 Please Reply © Please Recycle -Comments.- MAR.- ;4 "iO4(TUE) i5 :06 BRUCE LENZEN INC TEL. ? N.O(�3 a F• ..J . r1, ' I •i r ` • 1 f i t o \10 W1 at W"K• Cam Itt lot / r �" ( `�• Cal, t d ► d s ,' ;, o w = not f � J AG i ¢ Tfn r J � 1' .cx.'�,, ,. �% , lhl / / d { i J' loo or, on Tb / J ' ,/ I t �� A ,`O+vr ✓ cAiy� , i� 1 — ' I' IF ` Q t~ 1 s♦ \ ([3 1 \ r yl Z TP " I o I ��iM�►1K[tA�rr �' s.,:• l �p , 3 W • � O < TI r !140' co Ti O o i l 6L x LU a too z ep / a 4' n� 1® f1i1N70�10'W ITT.0'1 ��r / ,^ �` ` \ �` oa ®,es.n _ 4 �, Act. Z ly EKItiTING70'•WIOEr ROADWJTkACSMENIT 14 JPA �� 030 o > ONE •rrr�cli ' ..+r r P Cpl /d ► OJi 1� �'`+ 1 � � � � � , a l � I r q jf in ,� j S1 BtYef! p �_ 1 1, Ja►KC �i• a D- � � r E <tvnlmm aoln 20 porocni . March 14, 2000 Mary Jenkins St. Croix Valley Zoning 1101 Carmichael Hudson, WI 54016 Re: Erosion Control Calculations — Lot 4 Salishan Drive, Hudson, Wisconsin nzen Enclosed are calculations for lot 4, Salishan Drive, in Hudson, Wisconsin for your records. A copy has been forwarded to Bob Heise. 0 If you have any questions, please let me know. LO LO 3 Sincerely, o N 7 2 � 4 ruce G. Lenzen o President N a� BGL:Iwc ` Enc. a� a� cq 7 c 0 U N phone 715 -386 -5050 0 f ax 715 -386 -1999 In LOT 4 — SALISHAN, HUDSON, WI March 14, 2000 AREA "A" CALCULATIONS Area "A" = 1,731 Sq. Ft. of Lot Area x 30% = 519.30 sq. ft. + 1,074 Sq. Ft. Roof Surface Impervious -100% +1,074.00 sq. ft. Total Area - Square Feet 1,593.30 sq. ft. X 10 year event 4.2" per Sq. Foot or X .35' =Total Amount of Water from 10 -year Event 557.66 cu. Ft. Retainage Basin 28' x 30' wide x 2' deep- Capacity: 1,680.00 cu. ft. AREA "B" CALCULATIONS Area `B" = Lot area 1,217 sq. ft. x 30% = 365.10 sq. ft. + Roof Area 100% +1,243.00sq. ft. Total Area 1,608.10 sq. ft. 10 Year Event x .35 cu. ft. 562.84.cu. ft. Retainage Basin 19' x 15' wide x 2' deep — Capacity: 570.00 cu. ft. AREA "C" CALCULATIONS This water is flowing away from the St. Croix River per development drainage plan. Area "C" = Lot area 603 sq. ft. x 30% 180.90 sq. ft. + Roof Surface 100% 251.00 sq. ft. Total Area 431.90 sq. ft. 10 Year Event x .35 cu. ft. 151.17 cu. ft. Retainage Basin 8' x 10' wide x 2' deep — Capacity: 160.00 cu. ft. LOT 4 — SALISHAN, HUDSON, WI March 14, 2000 AREA "D" CALCULATIONS Area "D" = 3,503 Sq. Ft. of Lot Area x 30% = 1,050.90 sq. ft. + 1,551 Sq. Ft. Roof Surface Impervious -100% +1,551.00 sq. ft. + 420 St. Ft. Driveway Area + 420.00 sq. ft. Total Area - Square Feet 3,021.90 sq. ft. X 10 year event 4.2" per Sq. Foot or X .35' =Total Amount of Water from 10-year Event 1,057.67 cu. ft. Retainage Basin 24' x 24' wide x 2' deep- Capacity: 1,152.00 cu. ft. AREA "E" CALCULATIONS Area `B" = Lot area 9,872 sq. ft. x 30% = 2,961.60 sq. ft. + Roof Area 100% +2,350.00sq. ft. + Driveway Area 100% +2,830.00 sq. ft. Total Area 8,141.60 sq. ft. 10 Year Event x .35 cu. ft. 2,849.56 cu. ft. Retainage Basin 37' x 40' wide x 2' deep — Capacity: 2,960.00 cu. ft. AREA "F" CALCULATIONS This water is flowing away from the St. Croix River per development drainage plan. Area "F" = SLOPE TO ROAD APR. - 06' 00(THU) 14:37 BRUCE LENZEN INC TEL:7153861999 P.001 o: /0t) /go , 10:69 FAX 716 366 4688 ST CRY. CO 7,uNING ST. CROIX COUNTY WISCONSIN ZONING OFFICE 5T. CROIX COUNTY GOVERNMeW CENTER 1101 Carmichael Road •,. �� Hudson, WI 54016.7710 715) 386.4680 APPLICATION FOR BUY DING PERMIT REVIEW (ST. CROIX RIVER VALLEY DISTRICT) property owner: f A6 JSK t Fro n , � L1d Contractor /Agent (if not owner: OM � � Mailing address: 12Sr6 uvfdl rd' /L�91� YOn Mailing address: �, CO/� � 2 f '0" _ rlN M N. 55'11 Daytime phone: t 9-3 ad _ Daytime phone; 7( �J�) . V go VT toT - a— Property location: 1 /4, 114, Sec. 3 T. DF N•, R. PQW,, To of i py Computer #: Parcel g, Zoning District: _,2 VA,9, l b4 two Applicant is requesting, to add on boil remodei 1 expand / alter / replace: AnDltcnt will not be accented until t e ar i ■ ■ et with Den rttnent staff to review then 'c a n deter lnQ I all neeessary inf lrMlien has been_ptpvided" To be considered complete, the application must r y a minimum, [he items listed below per Article'17.36(7)(b)2 oftl►e Si. Croix County Zoning Ordinance. After a pre review agditional information may be needed, 0 A gcneral written statement that specifically identifies what is being requested. ito uSe IU A stattment indicating whether or not aprivate water or sewage system is to be installed, re-42 0. #0 50.1414cary f`f'Pj 'fit D SITE DEVELOPW PLAN – A ��plete site plan showing at a minimum the location of the fol lowing: ■ Identify all bluftline9 (any slopes 12% or greater) and show setbacks from bluf[line3, • /D eneions and ttrca of lot, oeatioit of any structures with distances measured from the lot lines and centerline of all abutting streets or highways, ■ Locution of any existing or proposed on-site septic system or private water supply systems, ■ Location of the ordinary high water mark (OHWM) of any abutting navigable Waterways and show all sctbncks from the OHWM. ■ Location and landward Ilmlt of all wetlands, specifications and dimensiens For areas of proposed wetland alteration ■ Existing and proposed topographic and drainage features and vegetative cover. ■ Location of floodplain and floodwny limits on the property as determined from tloodpl8in toning maps used to dchncaw floodplain areas, ■ Location of existing or future access roads ■ And any other unique limi ;ing eondilicvn or the property Signature Date_ — � Q Once Zoning approval % obtained form the County; the applicant for the project within the St- Croix River Valley District l a l ile W li e roc 0ship to obtain a b ildirt e it. 1 Application Accepted and complete: 1 - j, 7- 000 By! Canificatc of Zoning Compliance; Non•Complimcc: The application materials will remain on file in the Zoning Department. /" 6idy,.Qr CCrn t�ca� (21-- "IA4 l� °Gel k7 �z ,L Ole- I d o>". d Ve l% / �, O , e . 9frk Q f RA-L vwwo -` & W4.et A. I I (f- C ire �-k C 'k ✓ 15 • �pi� k VV 12ive� • p�� Jct..lv•swvl�(% .: Safety and Buildings Division SANITARY PERMIT APPLICATION 201 W. Washington Avenue • cnnsi P o Box 7302 • artment of Comm e d I I n accord with Comm 83.05, Wis. Adm. Code _t_ Madison, WI 53707 -7302 %7 Attach com ansAo the c6w5ty ` opy only) for the system, on paper not less County than 81/2 nch tn' V Q State Sanitary Permit Number See rever "—I a for Instructions for cpm leting this application -1 T i z, iu�� _; 35 33 1 ersonal inform rlriyoulovide ma used fors, dary purposes rival Law, s. 4 1 m v • [] Check if revision to previous application y )( )I• S � f. !' State Plan I.D. Number PPLI AT IN A �P ASE PRINT ALL INF RMATI N o rtyOwner �Na �� (Al 66Uoq rt � L Z1 /a S T Z $ , N, R (or� opert j Owner's S Mailing Lot Number Block Number 1 _7 f�F Cb ut2_ t , Sta e '6 � � Zip /� Z Phone ' r Subdivision Nam or CSM Nu ber P BUILDING: (check one) ❑ State Owned V 0 ❑ it� Nearest Road Public 1 or 2 Family Dwelling- No. of bedrooms I own of O S A_ ail 1. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo d i & Z Q 05 ?R - Z 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise:. Sales / Repairs 11 ❑ Restaurant / Bar / Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel / Motel 9 ❑ Office/ Factory 13 ❑ Other: specify ✓. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. 51 New 2. ❑ Replacement 3_ Q Replacement of 4. ❑ Reconnection of 5_ ❑ Repair of an ____yfstem ________ System _____________ Tank Only______________ Existing System ________ Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued f. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 JnSeepage Bed 21 ❑ Mound 0 ❑ Specify Ty 41 [3 Holding Tank 12 [] Seepage Trench 22 E] X In- Ground Pressure r (a 0 f j:k 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 Q System -In -Fill b _1090 Cb /I. ABSORPTION SYSTEM INFORMATIONS Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Re ui ed (s q. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Q Elevation - / ✓ v " — � p i�Feet 0. Feet acit 111. TANK in Cap acit y Total # of Prefab. Site Fiber- Exper. IN ORMATION New Existin Gallons Tanks Manufacturers Name Concrete strutted Steel glass Plastic App Tanks Tank optic Tan "r Holding Tank l lu b es j a ❑ ❑ ❑ ❑ ❑ ft Pump Tank /Siphon Chamber Cdy✓1 O ❑ 1 ❑ 1 ❑ I Cl ❑ 1 111111. KE51FUNSIOTIM STATEMENT q I, the undersigned, assume responsibility for installation of the onsite sewage Sys em s own on the attached plans. Ilum 's Name: (Print) Plumber' Signature: (No a ps) MP/IV4RRS9V Na.: Business Phone Number: 0- em N Sd � Z 7 3' - , lumber's Address (Street, City, State, Zip Code): 1,J edZ Gc> It S �o X. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate I ssued Issuing Agent Signature (No Stamps) Surcharge Fee) A gyp. �J pp roved ❑Owner Given Initial Zip as. L Adverse Determination C CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: 3D -8398 .4/99) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber PL 4 4'/ 4�5 R F ( L f2 5L �/ / / v L tr' 0k f PRA' I Ad SEA I �sn qp I �P p A) � P L L Q� 1960 &h Ave. St. Croix County Land and Water p a aax 95 Conservation Department BaldWA W/ 54002 Phone: 715-684 -2874 Far: 715 -684 -2666 March 16, 2000 Mary Jenkins St. Croix County Zoning Department St. Croix County Government Center 1101 Carmichael Rd. Hudson Wisc. 54016 Re: Salishan Subdivision Lot #4 Mary The Land and Water Conservation Department has received and reviewed the site plan and erosion control plan submitted from Bruce Lenzen, Salishan Subdivision Lot #4. Per phone conversations with Bruce on 3/16/00 we. had discussed the following item,"i0 be included into this plan. 1) Area "A" shall be sized on site plan to reflect calculations for Area "A ". -' ^ 2) Install additional silt fence to encompass the entire construction area. This will require silt fence to be extended to the North and the South property,iine. 3) The spoil pile shall be seeded with oats or annual ryegrass For vegetative protection. 4) Discussed small retention ponds could be constructed larger ding construction for additional storage. 5) Submit seeding plan and mulching requirements. If you have any questions or concerns please give me a call. Robert Heise County Conservationist � / u a `i r +� �, 4 M .;:. I o Q r 31 0 t QAC N ` z a 480 A _ uj YO 0 R 842. N \ R00 V N Z z 490 « AY s )V Cj Zee � ' . •ti 4 4 / Q _ __ 830 ... . •� � - � ... _ - � Q � � � "' "637 + _ co N e`ORlV e., —� \ 1 nJ SST