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042-1066-60-100
Wisconsin Department of C&mmerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building t ivision INSPECTION REPORT Sanitary Permit No: 463141 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Torkelson, Jim Warren Township 042 - 1066 -60 -100 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 24.29.18.371 B TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. L Septic Benchmark 1049 Dosing t E y` Alt. BM A@;a#ea- Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION " TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. 1.13 1 o z.4 - 7 Aeration Dist. Pipe -7 , (� �� 4'7 Holding Bot. System PUMP /SIPHON INFORMATION Final Grade .-( 1 45 Manufacturer Demand St Cover Crt� GPM Model Number cam .,-► &.Ci to/. 3 r TDH Lift Friction Loss System Headj TDH Ft 1 . 1 4 Forcemain Length Dia. Dist, to Well �� 5�,roc b��l old yrl. ate- $.L'1 col. GZ_ SOIL ABSORPTION SYSTEM eseh +owT 9•w Ct .2A4 al .I A S BEDITRENCH Width Length No. Of Trenches PIT DIM NSIONS No. Of Pits Inside Dia. Liquid pth DIMENSIONS 17 C, I *'_� SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type s j tem: `. i , t ' f ' /� UNIT Model Number: ! D J 7 ' � \ DIST RIBUTION SYSTEM 1 Header /Manifold I D istributi / x Hole Size + / I x Hole Spacing Vent to Air Intake P. 1-ength_Dia Length �ZC� Dia I t14 Spacing 3 ` I� _ �" SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center / D BedlTrench Edges \ Topsoil (� I D Yes �. No es r] No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: /1 /, Inspec #2: Location: 1447 HWY 12 Roberts, WI 54023 (NE 1/4 NW 1/4 24 T29N R18W) NA Lot 1 Parcel No: 24.29.18.371B 1.) Alt BM Description 1? f4DQ0 7 S_C , P 3--p - e V" " Cl O 2.) Bldg sewer length = K� - amount of cover - t Plan revision Required? Yes Use other side for additional information. Date Insepctor's i nature Cart. No. SBD -6710 (R.3/97) y �' _ �► Q vn v � z m 0 z� rn F t *j o �o ;a m :i m X m Ol ==I 0 m x r = c � m o M C O d X z D N a m p c z CO) X 0 oro rn O z z — N Q rn z z �, T G rn � r' CO) a a ml 3: > CO) v r IiiiiiiIIiIiim z O C N rn p m o N _C z F O v m Z -� C ao ; C m 3 s ? G) m m �m�$ ga 0 m rn . s ct c _r 0 CD Ina, CL N 1 AA o« w n o g $ C m P's� S � 0 Safety and Buildings Division County /n�n 201 W. Washington A d4 .O. Box 7162 ' V&c�nsin Madison, 62 Site Address Dep artment of Commerce Sanitary Permit Appliea O sanitary Permit Number �/ I In accord with Comm 83.21, Wis. Adm. Code, personal info don 1,V Check if Revision may be used for secondary purposes Privacy Law, s .04(1 I. Application Information - Please Print All Information OC T I State Plan , ( an I.D. N 0 4 1& r Property Owner's Name �.. CR Parcel Number 5 a �e/I/� o w z oix urv� L Property Owner's Mailing Address Property Location G.t: -_5 Gil I �2 i4 6W 5i: S T:2 N, R City, State Zip Code Phone Number Lot Block Number S - 7171 — S v Name CSM Number II. 'Fpe of Building (check all that apply) / ^ ❑City i or 2 Family Dwelling - Number of Bedrooms t / ( ❑Vi // llage ,, ❑ Public/Commercial - Describe Use �l`I'ownship )(f) � 1 - - ► f z5� /)/J �� Nearest Road ❑State Owned 1 "' 7T? W , O f 2 as W M. Type of Permit: (Check only one box on line A (numbering sckeme use). Complete line B if plicab A For otnrty use 1 ❑ Ne 2 ❑Replacement System 3 ❑Replacement of 6 Addition to Tank Only stem Permit Number Date Issued C, B. Check if Sanitary Permit Previously Issued S q 17 IV. Type of Permit: (Check a ll that apply)(n bering scheme is for internal use) 44 11 Non - Pressurized In- Ground 21 Mou d > 2 '7'k 'n 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ pressurized In- Ground 41 ❑ Holding Tank 'J 48 C1 Single Pass 51 El Drip Line 45 ❑ At -Grade 46 El Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. D' rsalPl`reatment Area Information: p Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate< Aosd&Offftfion Final Grade Required Proposed Rate(Gals./Days/Sq. - -) (Min./Inch) 101,7 Elevation �{ < VI. Tank Im Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing I1'1 Tanks T WW Septic or Holding Tatilc q 0 0 Dosing Chamber / IN YL VII. Responsibility Statement- I, the tmdersigned, assume respond Ili or a PO shown on the attached plans. Plumber's Name (Print) Plum is Signature /MFRS Num Business Phone Number 7/5= 7�'I-33 Plumber's Address (Street, City, State, Zip Code) VIII, tmt /De artm t Use Onl Sanitary Permit Fee (includes Groundwater Date Issued Is Age Signature ps) Approved C3 Disapproved Surcharge ) ❑ Owner Given Initial Adverse ` Determination C� IX. Conditions of Approval/Reasons for Disapproval -./ s r� -/V cues n ^, (to the Catnta odY) t e per not less than 8112 x 11 Inches in size n SBD -6398 . 05101) • l jo; l e ✓a /u a&de7 / p, 4 bY 8. IAIbr; c1�� s /o3/4s� ■ S o,'le ✓a/ua4&6111oif by V - M* , npSori 91171 ♦ 6ICVa -jE- EXiSi�9 pt.S�k ���ce I -5 Ca A. s Top of lxy`,o✓c, p,pe 6c6 by 1 6. WA,-" oror, ,n So;l G✓ahka conaod moa,.,dd4�,0,i. P.O•WT.S. /15 u �.1 e. I &A = /co. vo! Conditionally DEPARTMENT OF COMMERCE a IVISION Of SAFE D BUILDINGS � t9 • ' SEE CORRESPONDENCE I � , EXis�r�99 8G1D � Wtt�.t C'oncr�e FX %Shin � �Dµ..,�o �..o►.�b.,� 1� be / ;n�o /ace. we ll `� I �I fo 4 So"d. =aS'ua- // s,�►,7'ec/ sTF- ,c�7At �/°� i ' I • -`Ae o , sale 50 e.•,ofp.G r 9/.70 I I I yo P. ✓.c. tcm 4i h . EXiSfi�! / G70 �- p. Gc�tuC�s Cone rx je. i It /c{- p /a ce. I I a-nd ba ACA � /RCar,��nf I 1' la/o3' cm i I EX /5 CS -�l ■� 3 btdroo.r+ reside a ce p 8 0( 9 e � Safety and Buildings commerce.wi. OV 4003 N KINNEY COULEE RD g LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 i sco n s i n www.commer isco govsb, Department of Commerce www.wisconsin.gav Jim Doyle, Governor Cory L. Nettles, Secretary October 13, 2004 CUST ID No.222781 ATTN: Alex ZONING OFFICE HENRY J NECHVILLE ST CROIX COUNTY SPIA 967 HIGHWAY 65 1101 CARMICHAEL RD ROBERTS WI 54023 -8510 HUDSON WI 54016 CONDITIONAL APPROVAL ` PLAN APPROVAL EXPIRES: 10/13/2006 Identification Numbers Transaction ID No. 1068165 SITE: Site ID No. 690718 James & Darlene Torkelson Please refer to both identification numbers, 1447 Us Hwy 12 above, in all correspondence with the a enc . Town of Warren St Croix County NE1 /4, NW1 /4, S24, T29N, R18W FOR: Description: 31111 Design, Coring out Absorption Cell Object Type: POWTS Component Manual Regulated Object ID No.: 985615 Maintenance required; Replacement system; 24 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01 /01); SimTech STF -100A2 Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders • This system is to be constructed and located in accordance with the approved plans and with the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0" SBD- 10706 -P (N.01 /01). • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD- 10691- P(N.01 /01). rR 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 1 required by the state or the local municipality shall be obtained prior to commencement of�.��e construction /installation/operation. y � 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. HENRY J NECHVILLE Page 2 10/13/2004 Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Dennis R Sorenson Wastewater Specialist, Integrated Services WiSMART code: 7633 (608)785 -9336, dsorenson @commerce. state. wi.us MOUND AND PRESSURE DISTRIBUTION COMPONENT DES k 4 00 Residential Application az OG INDEX AND TITLE PAGE A V O�Y Project Name: James & Darlene Torkelson 3 bedroom residential repla cement mound Owner's Name: James & Darlene Torkelson Owner's Address: 1447 U.S. Hwy 12 Roberts, Wi 54023 Legal Description: NE1 /4NW1/4, Sec. 24, T.29N., R.18W. Township: Warren County: St. Croix Subdivision Name: CSM Vol. 9 Pg. 2618 Lot Number: 1 Block Number: Na Parcel I.D. Number: 042 - 1066 -60 -100, 24.29.28.371B Plan Transaction No.: Previous plan ID S94 - 01371 Page 1 Index and title i 0 U 1 Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Site Plan Page 9 Soil Evaluation Report Designer: Henry Nechville License Number: 222781 Date: 09/29/04, Phone Number: 715 - 749 -3322 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 3.0 (03/01/01) Page 1 of 9 r Mound and Pressure Distribution Component Design Design Worksheet Site Info_ rmation ( ) - Residential or Commercial Design Note: Sand fill (D) calculations assume a rorc R 300.00; Estimated Wastewater Flow (gpd) Table 83-44-3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of <= 36 inches. 450.00 Design Flow (gpd) 4.00; Site Slope ( %) 101.20 Contour Line Elevation (ft) 60.00 Depth to Limiting Factor (in) 0.40 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 125.00'; Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft} ..................: 0.601 Dispersal Cell Design Loading Rate (gpd /ft 1 ' Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution L Y Pressure Disribution Information network? Enter Y or N ----- - - - - -, (c or e) c Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation (ft) 41 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 3.00 1 Estimated Orifice Spacing (ft) = 8.93 ft /orifice 2.00; Forcemain Diameter (in) 60.00' Forcemain Length (ft) Does the forcemain drain back? Y 91.70 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 9.79 Forcemain Drainback (gal) 9.50 Vertical Lift (ft) 78.63 5x Void Volume (gal) 1.51 Friction Loss (ft) 88.42 Minimum Dose Volume (gal) 17.51 Total Dynamic Head (ft) 34.60 System Demand (gpm) Lateral Diameter Se lection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x x 1.00 1.50 x 1.25 x x 2.00 1.50 x 3.00 2.00 x 3.00 x Gallons /Inch Calculator (optional) Treatment Tank Information 800.001, Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) 39.00! Total Working Liquid Depth (in) Weeks Concrete Manufacturer 20.51 gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.00; Dose Tank Capacity (gal) Zabel (Filter Manufacturer 20.51' Dose Tank Volume (gal /in) A100 Filter Model Number Weeks Concrete Manufacturer Project: James & Darlene Torkelson 3 bedroom residential replacement moL Page 2 of 9 Mound Plan View T 1/10 B . . . . . . . . :.. J F Observation Pipe L51 A W . ..I .. B . .. I ...... ............................... L Mound Component Dimensions A 6.00ft E 8.88 in H 1.00ft K 7.17ft B 125.00 ft F 9.25 in z 6.86 ft L 139.35 ft D 6.00 in G 0.50 ft J 4.74 ft W 17.60 ft 750.00 (ft 2 ) Dispersal Cell Area 1606.89 (ft Basal Area Available 3.60 (gpd /ft) Linear Loading Rate 12.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 103.47 (ft) F Dispersal .. ell 102.20 (ft) Lateral 101.70 (ft) --► — Invert Dispersal Cell : : : :' Elevation E . . D .:.:.:.:::: : :: : ::::::::. . . 1 4 101.20 (ft) Contour Elevation 4.0 % Site Slope Geotextile Fabric Cover Shading Key Dispersal Cell See lateral details on 10 Topsoil Cap o °- 1.5 ft � •.• .• , • • Page 4 for number, Subsoil Cap y o :4 lr size, and spacing of ASTM C33 Sand © ` " ; `+ F Tilled L laterals. Laterals are ® 0.5 ft ' Typical Lateral :; Layer N equally spaced from Aggregate v c 5 the distribution cell's — A centerline in the distribution cell (AxB). Project: James & Darlene Torkelson 3 bedroom residential replacement mou Page 3 of 9 Center Connection Lateral Layout Daigram Force main connection via tee or cross to manifold at any point. Laterals are identical P 5 •= Turn -up Mball valve or cleanoutplug IF X-- �IEKrz I x1241 Laterals force main of PVC Sch40 Holes drilled on the bottom of the lateral. per COMM Table 84.30.5 Number of Laterals 4 Lateral Diameter Orifice Diameter 0.125 in 1.25 in Orifice Spacing (X) 3.01 Lateral Length (P) ft 61.71 ft Orifices per Lateral Orifice D Lateral Spacing (S) 3.00 ft 9 Lateral Flow Rate Density 8.93 ft 8.65 gpm Manifold Length 3.00 ft System Flow Rate 34.60 gpm Manifold Diameter Total Dynamic Head 17.51 ft 1.25 in Forcemain Velocity 3.53 li/sec Dose Tank Information Locking cover with warning label and locking device and Electrical as per NEC 300 and ---- - sealed watertight Comm 16.28 WAC Disconnect 4 in. min. Tank component is properly vented Alternate outlet location Weeks Concrete Manufacturer Forcemain diameter Ca acit 800.00 Gallons 2 in. Volume 20.51 gal /inch A Dimension Inches Gallons Weep hole or anti - A 20.52 420.90 B siphon device B 2.00 41.02 C C 4.48 91.96 P u mP �ff (ft) D 12.00 246.12 92.70 Total 39.01 800.00 D 3" Bedding un er tank. DO�nk elevation (ft) 91.70 Alarm Manuafacturer LevelArm Alarm Model Number DLV Pump Manufacturer Zoeller Pump Model Number 98` Pump Must Deliver 34.60 gpm at 17.51 ft TDH Project: James & Darlene Torkelson 3 bedroom residential replacement moL Page 4 of 9 HEAD/CAFIACITV� CURVE HEAD CAPAC.TY CURYL EFF'_UENT MODELS TOTAL DYNA61C F,EAD CAPACIIY PER MINI TE iEFF JEN - AND )EWATUM -1 D7 - 1]5 1J1 10.1 6J ( gg ye i 3E ii Lb W 1 T - - - ' - - C' lti LV (,d. LP: r d LI � Lk l n LY - 1 0 0 l i I L !.R 34 127 —^ —.... _ . _ _ 0 17a tl i .Jl 7l JJv IA 0/u 5 �I 61 171 _ 2 a 1 �. a s r '� 41L , t YS t 7 a2 J O 60 1 2_ 5 7 C \ _r. - - _ .? /4 1 _ �) r .0 J.0 a ZZ, � - _ Ala �7 * - z u 4b 174 k I 56 <cv 2�3 _ I aJ b 7 I ? 1 J Z� 1 _ 1. :� .. _ ... I I ` r � -_ - -_l T I - _. ' L� 'Yi 1G 5 [:176 :(! St - - Et-ELU -- - --- -- - IE i� T & G� E WA7• E R I t i G 51 Wamin J: �Aod�.I !E,5 should rlc je sut,jec! _c 30 }lee+ T` - -, -- - - - - -I DH - - - r_ - -� -�_ Note F7� - lead C Ecit . 7.5/ 7 � �- -�- p.. yon ;\1ucc,>I 1 , 12 ..:c / �. 1 column t x - loslon proof purnp see FP.1 21 7t' G 0 7c S W A = E LL E N A _ - - -- VV;'a�NI�G: t`rlodt 1 293 shv..lo •io. bd 2aC _. „1 ail 56., to L: r r;, TO lA:. UYN 1.1' F,LAD/ ^A ac,try PER MIr1UiE :66 !67 SE ilt> 26[ 28 2 82 L1 G" L 1 G Lv 'LU r Un ai. LI 1 5 �r0 Sal 12t v8 '21 40a I I B'adz I 1 ) a9'. IBJ 661 40 _ Ir) !� _ ". f - _ 0 227 3 :17 b1 / ti 7J% f -- I J7 5 7cl' ISd 590_ 2a ai5 t a 5 2 5 d5 1_B5 Sl 7h9 t J Ids V st I06 401 63 3 i5 74 2Bd Ud i] 1 ;01 I i aJ 4 1 1 %6 X 1 1 24 _ I� S f r B y _ a Je n IB' r 219 � ITS _._. 3 I 29: 292 262 26: ' 2Eb, td7, 266 t- - --� t 40 50 30 1 8J ( 50 To( 110 121 170 140 15C 16J 1:0 1J) 130 2 0 :li 220 2j J J - •60 2 ,0 720 40U 46u 5ov 6;0 - '70 2�J 160 p 7L 9 Mound System Maintenance and Operation Specifications Service Provider's Name H. Nechville,MPRS #222781 Phone 715- 749 -3322 POWTS Regulator's Name St. Croix County Zoning Dept. Phone 715- 386 -4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1000 gal Maximum TSS 150 mg /L Soil Absorption Component Size 750 ft Maximum FOG 30 mg /L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu /100 m Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test monthl Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished • ............. ............... Grade \ , 6 -8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box : : Plug or Ball Valve ...... . . . . .:. ... . Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: James & Darlene Torkelson 3 bedroom residential replacement mound Page 5 of 9 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals ISBO- 10691 -P (N.01 /01) and SSWMP Publication 9.6 (01/81)) 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. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank tents of the septic tank The septic tank shall be maintained b an individual certified to service septic tanks under s. 281.48, Stats. The con p P Y P 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. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg /L BOD 150 mg /L TSS, and 30 mg /L FOG for septic tank effluent or 30 mg/L BOD 30 mg /L TSS, 10 mg /L FOG, and 10 cfu /100 mL for highly treated effluent. 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 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. 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(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component falls 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 absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: James & Darlene Torkelson 3 bedroom residential replacement me Page 6 of 9 r jo %/ 2 ✓a /u a'ua,-7 1 p,'4 by 6.lA.1bric 4t'5 1o3A31 by - 47' - M- mp4or, 91271 ♦ e/eva &61 ••jF E XiS�in9 �sSfK�a r4nCe A I .SC12 /e : / /�� I �f s 4 :Top °� 1 yy "P. ✓. c, p,pe se£ by I6, wb, OYO!'� Oi a ✓a /aca�iana�d mou..,dde�s,�, P.O.W.TS. Conditionally 5S. 17' APPRrAlEn DEPARTMENT OF COMMERCE a \�� IVisioN OF SAFE D BUILDINGS SEE CORRESPONDENCE I i EXiS�i`.�q gGb WGe�s Concnvk- '60 be /e{-6 ;►, w e!! i ' SEr k c kra, ts e k �d ' LI fo be S ou -^ =., S ,6a // 61411-'ec,( 5rF.- /A7,4: �/ � i I I • E /e ✓, c.-E :ns,ale 5o•�e.., of'/?G. ' 9/. 70 r 1 i I I i I I ��tcmgin. EXiS�;n z6ve9o,P. t).fge eonex P/a ce. o e fa.� cg \ to ` o d batrig /C %o /Rcar"ort 4041,.7d � r l EX1s� %�J resit¢ a ce L _ J 1844 -'SOI EVALUATION REPORT Wisconsin Department of Commerce Page 1 of 3 Division of Safety and Buildings A.C.E. Soil & Site Evaluations in accordance with Comm 85, Wis. Adm. Code 1� County Attach complete site plart`on paper not less than 8'/ x 11 inches &ust a m St. Croix include, but not limited to! vertical and horizontal reference poin ti and Parcel LD. percent slope, scale or dimemsions north arrow, and location a to earest road. 042 - 1066$0 -100 Please print all inforr»atioA.. 7ev*0 l Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ` t Property Owner Property Location Jim & Darlene Torkels Govt. Lot NE 114 NW 1/4 S 24 T 29 N R 18 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1447 U.S. Hwy 12 1 CSM Vol.9, Pg. 2618 City State Zip Code Phone Number _j City _j Village ✓J Town Nearest Road Roberta I WI 1 54023 715 -749 -3981 Warren I U.S. Hwy 12 601 New Construction Use: 0 Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement _f Public or commercial - Describe: Parent material Glacial Till Flood plain elevation, if applicable na General comments and recommendations: Replacement of existing mound - effluent discharging above mound surface at inspection pipes. Propose to replace existing gravel and extend mound 61' along 100.70' contour. a Boring # Boring 1� Pit Ground Surface elev. 100.65 ft. Depth to limiting factor 30" in. 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 1 0 -9 10yr3/3 none ail 2fsbk ds as 2f 0.6 0.8 2 9 -14 10yr4/4 none ail 2fsbk ds cs 1f 0.6 0.8 3 14 -18 7.5yr416 none sicl 2%bk dsh cw - 0.4 0.6 4 18 -30 7.5yr4/6 none slAs 1 msbk dsh cw - 0.4 0.7 5 30 -46 7.5yr4/6 f2d 7.5yr5/8 slAs 1 msbk dsh - - 0.4 0.7 * Effluent #1 = BOD 30 < 220 mg /L an TSS >30 < 1 0 mg/L " Effluent #2 = BOD <_30 mg/L and TSS <30 mg /L CST Name (Please Print) Signatu CST Number James K. Thompson 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceol , 1 54020 9/27/2004 715 - 248 -7767 SOIL AND SITE EVALUATION 1844 Page 3 of 3 PROPERTY OWNER: Jim & Darlene Torkelson PARCEL I.D.# 042 - 1066 -60 -100 A.C.E. Soil & Site Evaluations REPORT MEMO Existing 3 bedroom mound (constructed 1994) discharging effluent to mound surface near inspection pipe at south end of mound. Interview with property owner indicates that system has been overused - parties, guests, excessive laundry, etc. Hand excavation at edge and beneath gravel dispersal cell revealed a bacterial clogging layer at the sand /gravel interface. Sand fill beneath mound appears clean. Native soil at lower edge and slightly downslope of dispersal cell in suitable condition to allow reuse of existing system location. Recommend removal of existing distribution network, gravel and contaminated sand fill and reconstruction of mound across current location. Extend length of dispersal cell 61' along 100.70' contour (total cell length = 125). Soil conditions require > 6" of ASTM C -33 sand fill at upper edge of contour. Recommend placing 12 "+ sand fill as needed to compliment existing dispersal cell elevation. Existing tanks to be re- used.Existing pump to be re -used with new float settings established. Install SIM -TECH STF -100A2 inline effluent filter at pump discharge line. r i 5 < 11 0i t Q ✓Q /Gl QUCl d/ by 6. W bri U4- S /o 3 /4s� • � Sole ✓a /ua- �ia.,�oiE ♦ EICVc�: o.� Ey,,JAi , 79P[Si-kie dente y� ", l Ay `P. d, c, p,pe set by & wbrakb / I eve _ icz , 00' SS. EXi5lbr,7q BOO gal! wttex 'Cercev6e EX�s�in9 �µM pnb..►- 40 be /eft 4 14 Ce. we :5& K G 4: k Q-f fr o c -6an e F� I � I i I n r►'I f cl� S A �i.11.�3 in line eF¢'lus �%I tt/ at / o u...,�r, al %scliar�e. o I I , i i o I I i ex, S47 ! co D � uJu� Cone r4 je /t{^6;n 0 / , t ce. „� , • � , sfr K C Eu .o-/ s�� /, fy c � f�+ �E' A /0 /,o3'1 i I I i Exls� %nJ ED' residence P�. z oF3 LaMr and Human Helauons `' "' '`' u %j i $ L_ L v P% V v H 1 I V 1 n r — r V n 1 r Q6 ! of - Division of Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY s'T c'�Po �' X Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. i dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION :T, * M _r0 R kl L ScN GOVT. LOT NE �/ 1/4 A 1/4,S T 1 / ,N.R 16' E (q W PROPERTY y � NER'� AILING ADDRESS LOT X BLOCK #� SUBD. NAME OR CSM # CITY, STATE ZIP CODE PHONE NUMBER ❑CITY, ❑VILLAGE WN NEAREST ROAD Ro (3E9TS k01. SYc 2.3 (715) 74'f- 3 1P / k fA 9 RE 6ACU Y. Z I''rNew Construction Use I <Residential / Number of bedrooms .3. ( ) Addition to existing building ( J Replacement I I Public or commercial describe Code derived daily flow Y.4'a gpd Recommended design loading rate • S' bed, gpd/h • trenCh, gpollt Absorption area required 3 ? bed, ft ,31 trench, ft 2 !,aximum design loading rate S bed, gpd/ft • trench, gpdm Recommended infiltration surface elevation(s) -5 r `� 3 ft (as referred to site plan benchmark) Additional design / site considerations 5 Svc Tfi/j / E_ Fao .Ae o L) v-v D Parent material SCS (P A a L^ a D Si / , 14 Ce;f/ Flood plain elevation, if applicable N�4- • ft � a S = Suitable for system CONVENTIONAL m IN- GROUND PRESSURE A SYSTEM IN F1U. HOIr ;VC, TAW U = Unsuitable tors stem ❑ S ©U D ❑ U ❑ S Q� LH'S ❑ U ❑ S 0U C a C SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles Structure GPD /ft 9 Texture Consistence 8p.ndaly Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed mrch • ?�'a�.5of.av''' it R o- iy /o YAO 3/Z S� /. Z ,w, shw v fie e- 2 A Ground L G G5 7.5' Vie Y /�/ fi ' ,' S � I Tit 'M v r' r.i N p elev. ft. Depth to limiting -- facto N 3( i sss •�- ; Remarks: �OP i UO It C X — FRA G-i PAP,) C 6',y E-v Boring # '7 / Pe 3Yz - S�'� z j, sd< f o y /y / 2 8t 7 • � � y si L 41 d.0 Y' lE' CS 2 v f • S i • G zG ► /P . 33 7S VP Ground elev. 2C 3 y ?•S ft. t/R 1 5 / Z .w+ She n.t fiP G S S I •� Depth to — 2.5 y S/ 5.4 �r 7i ' G S 4 X limiting 2C G. 7p .S y S 3 S' SGI 2 ,fn A v vf/' Aj >u YA fac tor � —� sSS• Remarks: CST Name: — Please Print &_R 7- Z 46 46 r •C 4 7— Phone: Address: ( SS d ' �E"1�/ /etX • '/ VVSD.J 6 S�GY ro 3 • 1 C' ST�t Z Sgnature: ��j�p C _ Date: CST Number: PROPERTY OWNER Td) 1? k E Ste.✓ SOIL DESCRIPTION REPORT Page Z c PARCEL I.D. i Depth Dominant Color Mottles Texture Structure Consistence Root.; GFiirt� • Boring # Horizon in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Y A o • 8 /o roe s /2 S� /. 2-,-, 4& v f 2 CS .3 f B S Ground f 3 7. S YA f fs /, /1* 117W of elev. 0 SS - 7. 5 YR Sl si Depth to 40 Ye s/ z limiting r factor 2C S -GS' 16 AI URh'rFt7 5 s'.s•s' Remarks: ��'' 2 5,4 r44A-no& Boring # J :Naas" `>z '• t Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. fG Depth to limiting factor -- Remarks: Boring # z Ground elev. tL Depth to limiting factor Remarks: Con OOO(VO /1CK)nk Zr- i � V. 0 L o - -- L-v - L . 0� 3 . ' p o ' N Q 0 $ o O � Z b W m U 3' 41 (n , n N I u r r 24 C r a o. o ocs \A aam-1_ alai a DOCUMENT NC. STATE BAR OF WISCONSIN FORM 3 -198$ nIU $PACK RK$$eVKD foe R9CVe91no oATA QU 50057 YO a REGISTER'S OFFICE — ST. CROW CO.; WI Earl C. Mueller and Evelyn M. Muelier, husband .... JUN 1993 AP Reo'd for Reoord _ f 1 d wife, and Dean A. Mueller and Jennifer L:_ Mueller_, ._husband_, and._ wife..... _... 8:30 �' A. quit - clams to James T4rkelson and Darlene A. aC[. Torkelson„ husband and__wif.. holding as auxY . X4 h P..inar tal..PropertY . ....................... . .. . ... . . . ....... .................................................. ............................... the following described real estate in ........... r� �1r4?114 ............... County, State of Wisconsin: RKTURn To Tax Parcel No: .............................. Lot One (1) in Volume 9, page 2618, as document number 499537, Certified Survey Maps as recorded in the St. Croix County Register of Deeds Office, located in part of the Northeast Quarter of the Northwest Quarter (NE 1/4 of NW 1/4) of Section Twenty Four (24), Township Twenty Nine (29) North, Range Eighteen (18) West, Town of Warren, St. Croix County, Wisconsin. ` The Grantors hereby reserve for themselves all water usage rights for livestock at no cost. It is agreed between the parties hereto that should the Grantees herein transfer the above - described property, that the Grantors shall then have the water metered and shall pay the current owners of said land a price equal to that being charged by the City of River Falls for similar water usage. All well and line maintenance costs shall be paid for by the Grantees, their heirs and assigns. �) FE£ E This ....... ._...hv .... homestead property. f 9" (is not) I Dated this ............... .a........................ ..... day of .- .- ..------------ - - - - -- June............. , 1�. g 3... SEAL) .A...-P-tee- - ..- + ...�GG (SEAL) �'.� _P�. .. .................. .. fff e Dean A. Mueller Earl C. Mueller ....... -- ... es...s............( SEAL) nni er L. Mueller Evelyn Me Mueller . ......... ____________ AUTHRNTICATION ACKNOWLEDGMENT Signsture(s) _of__ Dean A. Mueller STATE OF WISCONSIN ell E 11 Mueller and as. . ............................ ........ _County. anth thin .f ._day of .... Jul?@ _...•.._... 29_13 Personally came before me this ................day of ........ the above named c _ ........................r._., i9 _ ..... ... - - ----..... .......... . .......... _ .......................• •- ••••- ---••........... L eo . Beskar - - ... ....................... . • ....................... A. t.........,....... ...- ••..........._............. ............•..._._.. TITLE: MEMBER STATE BAR OF WISCONSIN ... --................................................................. - (Ii ....... ............................... •.................. .- - - -- --------- . --- --- ---- --------- .............. ------------ ------ ------------ .---- anthorized by 5 ?06.08, Wis. Stab.) to me known to be the person who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY L eo A. Beskar,_ Attorney ....... . ............. . ._..- ... - - R ........................'.. _ ......_ ODLI, BESRA & BOSS ", .C: • ....................... ...................................................... .2 19 No -� M A Altz.P_Q. � . - - - - -- Notary Public .......... ...... ....... ...................County, Wis. (a Pea maple Stutlienticated o D ac7cnowledged. Both My Commis is permanent. (If not, state expiration I are not necessary.) date: -----• ..................... ... •......_.._......_......_., 1st --------- ) p _ VUrr CLAIM DEED STATE BAR OF WISCONSIN wieeonete L.K$I Blank Ca lee i FORS[ N$ 1 —1163 Mihwkee, Ww. r i • � i CERTIFIED.SURVEY MAP Located in part of the NEa of the NW4 of Section 24, T29N, R18W, Town of Warren, St. Croix County, Wisconsin. 0 07 n a �o� M _ �n 0 Z n� -n �z M gm M z 00 N �o � N UNPLATTED LANDS I C SOO ° W 291.17' 33 1 f 33' 0 IF 261.05' I D cn t� rt iC T�! Im 1 (n I � OD D ID m I vN yN oz W O � 0 Iz Q I f�l N �.0 CAN I IQ o w (TI .4 LO W D r; N r a z M x1 N � �n c m n � . y zo CO M X z Ln N I _.m o �0 N �� �� Ln IN z — W i o 01 �D m i o = 07 o M p C9 s / • mNj ICf) w z R 151.37' � i I� N U (A 9 I NO2°I8'16 " D E 17 7 ' � ;4 O IF 0) .A I OD frt 0) c NO2816 E 153.60' I� 0) o - z ( I m o co �D 0 0 c W j o 66' ACCESS EASEMENT VOL. - -- PAGE w° p N I� UNPLATTED LANDS �jf Ac PO PO � r N l0 X H 7 LJ oz W S - 3 rl• TI tzj :' 4- m ` U) n Q -t) is ❑ Q— Z n 0 z o �-• (n 0 � -{ Z N rF - o rt- p> > C/) i--• 'a CO N rt rr - T n A Q N 'O O O p (D C '7 T N Q. f0 N (D rt Bearings are referenced to the North line of the NW} of Section 24, assumed to bear N89 IL awes butddew pue 5UTA@Aans uT xTojD ' qS To Xjunoo aT41 To aoueuiplO uozSTATpgns pUPq aTT4 PTTe Sagngeqs UT STTO;),TM '471 ZO s,£' OCU 3a _PTT Tn suoTSTAOid quaiino @Llq T qTM paTIdwoo 4ITng GAPq I JET14 :pagTaosap pue paAaAjns Aiepunoq joTjagxa atjl 90 aTeas 04 uOT4P4uasa'daJ goajaoo e sT dew AaAins pai ;TgaaO S TT 4 4etjq AJT41@3 OSTe 'I •piooa.z go s4uawassa jTe pup ,ZT,, AeMTjbTg •S•n DoT AVM- To- gTjbTI 04 4oaCgns si jaoied pagTaosap anogv uruur aq jo qurod aT44 04 4aag 5L'8LT 'S „9T,8ToZON aouaT 4 : 4aa3 96'V8 aou9TT : - 4aag 9V'09 ' S „66 , O -£ON aouaT4; :4aa; ZZ'L8Z '21 „ZZ,TTo68S GOUaT44 :49aT LT'T6Z 'M „9b,OT -005 aoualg4 :4aa3 ZL'SS£ 'auTj Tjq.aou pies buoje 'M „ZZ,TTo68N buinuTquoo aouaTj4 uruur eq Jo 4UTOd a144 04 la93 OT'99£ ' UOT4oas peas To V /TMN aTT4 To aut T T.T741ou at,I buo Te ' M„ZZ , TT o68N aouaTTq : VZ uoTgoag pies To aauaoo b /TN aTjq qe buTOUawwoo r : sMO T TO; se pagTjDsap aaT qan; : UTSUOOSTM , Aqunoo xzoaa •qs 'u9JlPM To uMOy 'M8Td 'N6ZZ 'tZ UOT40as 3 t /TMN aT44 go 6 /TSN aTjq To 4.zed UT paleoo T pue T To Tao.zed V :sMOTjo3 se pagTaosap si paddew pup padaAZns Taoied pue T aqq go Aiepunoq 10TIa4xa aT44 gp'g4 'dew AaA.znS paT ;Tglao sTgj Xq paquasa.z ST q;DTim jaoaed puej aT q pagi -iosap pup padd ' paAaAins aAeTj I ' JG T Tanw TIPS To UOTgOaJTp aTT4 Aq gelgq A;Tgjao Xgaiaiq ' IOAaAans pueq utsuoosTM pajagsibal UG6Pgxm 'D ua T Ty 'I SSH� I3I,L2I5� S , 2T0�SA2In5 0 � f � § 4 -a q E 2 � ■ , 2 � E � � §f .f _ § $ ƒ o § / �® - _ / \ k # § ° $ ¥ § $ = 2 N ° § _ 2 2 8 7 ® 3 CD �r E @ * > 2 a =! \ CL \ / \ \ ƒ C -4 _ 4 c c CD o r■ � $ 2 2 / � co & % �. } 0 0 o i � O j \\ 2 2 2 0 / > E £ E � R o �� m / ƒ ] M % k a _ 7 .. / / / o / ° _ C q § % 2 2 7 Co / \ \ k \ ° f Z ¥ . \ m m # r 3 % \ } , m , D CL ) 0 0 f ƒ � � $ § � t 0 \ ; CD t ® \� k I STC - 104 AS BUILT SANITARY SYSTEM REPO A, OWNER ,�7 o G ADDRESS 7 5 1 l SUBDIVISION / CSM# L6T-T SECTION 2 A T jZ�N -R_/ � Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW I " SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM z i l39' i JjA l' �g y 1 (p� s 7r V ` I ce t` ,r &T t 14 $ I r e 6� -A--I DIC TE OR H ARROW sG Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: � I! / ,4a �J'OE" ALTERNATE BM• SEPTIC TANK / PUMP CHAM / HOLDING TANK INFORMATION Manufacturer: WrFks Co# ( /n Liquid Capacity: Setback from: Well / House Other �2 /dg Pump: ` M Manufacturer Zor Model4 Size Float seperation ,5. Gallons /cycle: by , Alarm Location �C3p.do.�,rr.�.• -� �Dc�.,�_- SOIL ABSORPTION SYSTEM p Width: Length 0 1 Number of trenches Distance & Direction to nearest prop, line: Setback from: well: 5 0 ! House Cc 7 / Other ELEVATIONS Building Sewer ST Inlet. ( l� / ST outlet PC inlet 9 l{� r PC bottom Pump Off //rr ! Header /Manifold Bottom of system #/i Existing Grade Final grade DATE OF INSTALLATION: Q PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: 3/93:jt i Wisconsin Department of Industry PRIVATE SEWAGE SYSTEM County: l*ca-.*nd Human Relations INSPECTION REPORT ST. CROIX Safety )nu Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Permit Holder's Name: ❑ City ❑ Village p Town of: State Pla .. TORKELSON, JIM X WARREN lQ66-60-300 CST BM Elev.: Insp. BM Elev.: BM Description: /f Parcel Tax o. 1290 r /0 0 '...E%6 - � �' :1f r TANK INFORMATION V ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV- Septic // II5 ,6 �(1 Benchmark l� 4a Dosing G� e 4 �/a - /00 Aeration Bldg. Sewer D. / Holding St /Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet t.A q TANK TO P/ L WELL BLDG- Ventto ROAD Dt Inlet Air Intake /3,00 y� Septic >,A /Sy' q5 X50 NA Dt Bottom jL$c/ g/, 8 Dosing >d T' l' 'lp 5 1511' NA Header / Man. Aeration NA Dist. Pipe &.`� /o a 7 I.lS Holding Bot. System 7,,A- bt• PUMP / SIPHON INFORMATION Final Grade Manufacturer 20lne� Demand +; � � 1 f_ to X03• Model Number Q$ �� GPM �i �s ,,k U`/ TDH Lift C��a Friction t System TDH��j Ft ✓ Forcemain Length 9K 1 Dia. " Dist.ToWell j$p SOIL ABSORPTION SYSTE BED/TRENCH Width en th No.Of PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS a 44 ,/ DIMEN I N SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION TypeO CHAMBER , Mod Number: System: /V)JGr✓yi,Q o2 / �7' >C 1J .A OR UNIT DISTRIBUTION SYSTEM ftLr d r / Ma 1 ul � N � nifold Distribution Pi e s x Hole Size x Hole S acin Vent To Air Intake Length -2)— Dia. 0 Length 'D Dia. L Spacing 3 rl y J' 7 5� SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over `� Depth Over ( t%i xx Depth Of xx Seeded/ xx Mulched Bed /Tre nch Center ' Bed /Trench Edges 0 Topsoil Ip 'Yes ❑ No Yes ❑ No COMMENTS (Include code discrepancies, persons present, etc.) LOCATION: WARREN.24.29.18W,NE,NW,LOT 1, US 12 ZZ n ScfS�y JJam�}} :' ta • a v: Plan revision required? ❑ Yes VNo Use other side for additional information. 1 1 7 7 `1' SBD -6710 (R 05191) Date Ins 'e is Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: o x 3 l ILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code Cou STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than 1:1 a a 35 8% x 11 inches in size. Check if revision to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER I. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION -' M 4E'/4 NOY4, S ;P-I T , N, R 9' E (r W PROPERTY OWNER'S M LING ADDRESS LOT # BLOCK # 7 t 12 C ST TE ZIP cCODE � PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER l 11. TYPE OF BUILDING: Check one CITY ) State Owned LAGE : NEAREST ROAD OWN PF. �f� ❑ Public 2 Fam. Dwelling -# of bedrooms PARGE TAX N MB / 111. BUILDING USE: (If building type is public, check all that apply) En 1 ❑ Apt/Condo 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: (Checkkoo one in line A. Check line B if applicable) A) 1. ❑ New 2. LJ Replacement 3., ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit ## — Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 El Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System -In -Fill 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 � /� REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min. /inch) ELEVATION ' l 7 0 s <5 -331 1 " 1' lot. 7� Feet /63,. 95- Feet VII. TANK CAPACITY Site in oallons Total ## of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name oncret Con- Steel glass App Tanks Tanks s truct Septic Tank or Holding Tank Lift Pump Tank/Siphon Chamber, Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the ttached plans. Plumber's Name (Print): Plumber's Signature: (No Sta s) 1 701 W No Business Phone Number. Plumber's Address (Stree City, State, Zip Code). IX. COUNTY /DEPARTMENT USE ONLY ❑ Disapproved Sam ary Permit Fee (Includes Groundwater ate Issued ing Agent Si at (No Stamps) Surcharge Fee) , Approved ❑Owner Given Initial Adverse Determination X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: SBD -6398 (formerly Plb -67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber 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 the 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 & Buildings Division, 608 -266 -3815. 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. ll. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. Ill. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in 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 in ##1 -7. VII. Tank information. Fill in the capacity of every new and /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. Vill. 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% 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 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, ground - water contamination investigations and establishment of standards. SBD -6398 (R.11/88) r - T SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations June 2, 1994 201 East Washington Avenue P. 0. Box 7969 Madison WI 53707 ULBRICHT & ASSOCIATES ROBERT ULBRICHT 655 O'NEILL ROAD HUDSON WI 54016 RE: PLAN S94 -01371 FEE RECEIVED: 180.00 TORKELSON, JIM NE,NW,24,29,18W TOWN OF WARREN COUNTY OF ST CROIX MOUND SYSTEM The Department has reviewed the above - referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval of the system is based on chapter 145, Wisconsin Statutes, and chapters ILHR 83 and 84, Wistgnsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter ILHR 82 or in chapters ILHR 50 -64, Wisconsin Administrative Code. This plan submittal approval will expire two years from the approval date, or if a sanitary permit is obtained, plan approval will expire on the day the initial sanitary permit expires. The licensed plumber responsible for this installation shall keep one set of plans with the Department's stamp of approval at the construction site. The installer shall notify the appropriate inspector when inspections can be made. All permits required by the city, village, township or county shall be obtained prior to installation. Inquiries should be directed to me at the number listed below. Please refer to the plan number shown above. Sincerely, , e Stiemke Plan Reviewer Section of Private Sewage (608) 266 -8230 7:00 to 3:45 Mon. thu Fri ORIGINAL SBD -6423 (R. 01181) l r UL :BRICHT & ASSOCIATES CO. 655 O'Neil Road Hudson, WI 54016 Reg. Designers of Engineering Systems 715- 386 -8185 Private Sewage Consultants PROJECT INDEX DILHR Plan I.D. # 5 �4 " v 131 Date TUBE 3 Owner -i Phone *7 7 '- 3fFl Address 144-1 } f w y . 12 RO QE2TS IS • .5 462-3 Legal Description :?.p + A(At tue*+a L.oT • r PeaAeNG- . )o (-- PLO , See . 2 4 , TZ9'A Town of (, AstP County S T'• GE2O f � C.S.T. (IC_R r Z tL.8 p Ch1` Installer Local Authority/ Supervision ST- CRO IX CO OA- ZOZ1�(-r -• �E�' 1'• PROJECT DESCRIPTION Ne C0 x3S'TR0cT(ea -- P*0posED 3 (36v�>h . lfvAi t= w.� dj. E S i M h"r� - LP ( &-y w „S T S ��a") - yso 4s 5 &ix r 4,e PL- t 1 A61 : 13uT 5 eA S o.0 R 11 SA'h v RNTe � A I - y _ M a- M d V.,4J 17 S y S r� w i -Y� 1'3_ S A AJ D f i �� I • S Pg.l PLOT PLAN VIEWS % ,% S CONS° Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWS AX 4 r' Pg , 3 PIPE LATERAL LAYOUT aoees�w. = UUMUCHT 0 1160 Pg.4 DOSING CHAMBER CROSS SECTION - H�K Pg .5 PUMP PERFORMANCE SPECS 'yip I tStdN� P ORIGIN O . o � PRopa W ES T Lvr L • '� p� � 1 p , r � N � O � i N c eo Q o � v v- WOO C= 6'L7 C" 0 4=11 m > O _ L N -c rn m ro U► S`�S C 1VA' n N �► m diti°nally M 0 tl AZ1QNg n � � N up�AN � R b %Qks m N eo OV a Q F OD o ', ' S AF AND L O 07 SEE v �m LPEY %Itzo G� U ;'k- Z7 CA lA Ns� ° 894-013 p 2 of Ij C SECT o t-= JAI OU AJ D w iT tj ae* i peD OF ; To y` A51ec5 �iSTRif3uTto,J G- , Tlni �k,a ES S PI p f 5 y STEM e lc v Ar ioij UJi FO TO E �-I E X 19. 6,0 i ;Amp I //// piewco u F R►H Y aIo SlopE F R c EtEv/1T�4a VMM t3�p /0 0. 7 Z) 1•D Fr. — ELEVAr -S F (.2- Fr. lmvERr OF IATERA(S 1 o Z. Zo F 1 Ft'. • 1 of Rock 1 02..SD •Top ° F IATERA1s t o z. 3o H 1- FT. Ys E OF MouJJD -- Wi rri 13E ,vA itiona lty `io F OR C E MA ( F 1'. tow, A uM �K f L `� Q F - -- ,-� — F r k ° 6 •' i FT F r � o r W Zg Fr Bev O y2�, To 1= PVC. cAppEp '- o(3 5ERVA T IO a A P65 ATE' pf p E5 PF -PMA,a EuT M hR VERS RE(QuMeo 13ASAt_ AqeA _ 'DAi�y w hst�'Flow - y - / / Z5 Stil 1010 TR AT)vC C AfAci Tr � x t� 59�� -b1371 PRnpoSEb (3�ksA -� AReN = l � ! O - A 2 cEM TRAL. MAA) F OLD D►STR; pi NE rwoR k p 1 9 ►y-rR ►13UT R PVC CF►JTRAL- LATERAIS MAN ► Fo L o �- --_— — Epp CAP I x I X Y M AW LAST' 1iOle S HA 1 t3E N e%.T T O EN C AP S (S - PIRIVA''fe S O A0 L X0 1 D Vc) i u E Fo R T. 1 / go ndlitio C7 Z ii FO Rce M � 6p .O �A15 3:63u G IeVAT ' ED ,�o►as Np UtaNN Re tRY. SU11 . O V ►S 0% OF SAFET w0 E FORAT PIPE DETA+ L. Q �Io1Es I�cATED oN G oTroM Sti A ll BE' y y VAR,'AQLE y CC�uhll�� SpA D tSTANce Allow FOR ?' F T C E,�n�,vh!lS H 01 E D i A K E T e R y I N. ,OR y L ATER/4 L+ R �'� ¢ 110, F r Sipttdi4 //S u MANI FOLD 2 W FoRce MA k) Y X #' °F ° IES P P E II�1 cl,�s DISTRi (3uTjoxj V►SCHARGE� RATE PER LATERAL 10.53 GAI Mt1J. I TOTAL. 'D15ckAR6IF RATE hJErWOR IC / 2. /L GAL, S94- 413'71 1 PUMP CHAMBER CRO55 SECTION AND SPECIFICATIONS VENT CAP 4"C.I. VENT PIPE APPROVED LOCKING WEATHER PROOF N BOX MANHOLE COVER 25' FROM DOOR, JUNCTIO l•� /;�rl1 E { IA/3� I WINDOW OR FRESH, 12"MIU. g A AIR IMTAKE 1VA V,AP,5 '�- /E GRADE r dit 4 " MIN. C/ I B" Mal. 1o2. �, ---- - - - - -- G l�v ,4n. ati of sty 770• INLET D °3'L� Itud - 7 APPROVED JOINTS APPROVED JOINT A h � � K I I � IN I I I I W /C.I. PIPE W /C.I. PIPE /�(U�. I EXTENDING 3' N ZXTEDIW6 3' /60 ,,(� r I I ALARM / I I � ONTO SOLID SOIL ONTO SOLID SOIL B ', 3q I I ow c I i ELEV. �' Z FT. 1 ! PUMP - -� OFF 4 M g3.50 *RISER EXIT PERMITTED OULY IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC f 5PECIFICATIOUS / DOSE WE �CJaGvC� Cp • y TAWKS MA NUFACTURER: 40 OF DOSES: PE•R. DA.i it ll� TAMK SIZE: D GALLONS DOSE VOLUME 6 ALARM MAAIUFAGTURER: L LOt AlA ItK Co INCLUDING BACKFLOW: GALL DNS MODEL NUMBER: • CAPACITIES: A= 1 1/ 4 INCHES OR 304) GALLONS SWITCH TYPE: Lift R �Y F T l 5= / 2- INCHES OR _ 1 GALLOWS PUMP MANUFACTURER: 7.0 C = - S * o INCHES OR ( (19 GALLOWS MODEL NUMBER: 4? P2 ttp 'I'S D = &' INCHESOR 3 y / GALLONS SWITCH TYPE P(ys9 �hcK 'KCke'vx fla or - MOTE: PUMP AND ALARM ARE TO SE INSTALLED ON SEPARATE CIRCUITS MINIMUM DISCHARGE RATE �.LL�GPM VERTICAL DIFFERENCE BETWEEN PUMP OFF ARID DISTRIBUTIOW PIPE.. 70 FEET �'AA�k 0 - + MIAIIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . 2.5 FEET EACk � 0� ✓ : P ♦ 3� FEET O F FORCE MAIN X 3. 2,7 F Yo FT.FRICTIOW FACTOR.. /.. FEET C-40r I S zO• uA �S• TOTAL DYNAMIC. HEAD = /Q. 7 FEET bum 0 9/ 3 INTERNAL DIMEWSIONS of TANK: LENGTH ;WIDTH ;LIQUID-DEPTH A S94-01 3 71 • rr HEAD CAPACITY CURVE 3 7/8 6 1/4 MODEL "9d3" 30 4 5/8 -1 .... 25 S Q 3 5/8 t � 6 ID + 15 O 4 3/16 � 4 ,�. e Fo 10 - �• 1 i /2 -11 2 1/2 NPT 5 - 0 U.S. GALLONS 10 20 30 40 50 60 70 80 uTF.RS — so 160 240 0 FLOW PER MINUTE TOTAL DYNAMIC HEAD /FLOW PER M!NUTE EFFLUENT AND DEWATERING CAPACITY 12 • HEAD UNITS /MIN FEET METERS GALS LrRS 1.52 1 61 9'3 . 10 3.05 81 15 4.57 45 110 20 6.10 25 95 — 3 5/16 Lock valve CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are av__iilable and • Mercury float switches are available for controlling single and supplied with an alarm. three phase systems. • Mechanical alternators, for duplex systems, are available with or • Double piggyback mercury float switches are available for without alarm switches. variable level long cycle controls. SELECTION GUIDE Standard all models - Weight 39 lbs. - /2 H. P. 1. Integral float operated 2 pole rnechanfoal switch, no external control required. 2. Single piggyback mercury float switch or double piggyback mercury, float 98 Series Control Selection switch. Refer to FM0477. Model Vi .iiR -Ph I Mode Amps Simplex Duplex 3. Mechanical alternator 10 -0072 or 10-0075. ' M98 115 __ 1 Auto 9.0 , 1 or 1 & 7 -- 4. See FM0712, for correct model of Electrical Alternator, "E- Pak " 1 . N98 115 Non 9.0 2 or 2 & 6 3 or 4 & 5 5. Mercury sensor float switch 100225 used as a control activator ,pecih• D98 230 1 1 Auto I 4. 1 or 1 & 7 — duplex (3) or (4) float system. 6. Four (4) hole "J- Pak ", junction box, for watertight connection or wired -in sim- • 230 1 Non 4.5 1 2 or 2 & 6 3 or 4 & 5 plex or duplex operation, 10 -0002. 7. Two (2) hole "J- Pak ", for watertight connection or splice. For Information on additional Zoeller products refer to catalog n Combinmion Starter, FM0514; All installation o1 controls, protection devicaa CAOTfO °9 N and wiring should a done b!' a quNi Piggyback Mercury Switches, FM0477; Electrical Alternator, FM0486; 10- �!chanical Alternator, tied licensed electrician. All electrical and selely codes should be followed Includ- FM0485; Alarm Package, FM0513; Sump/Sewage Basins, FM0487; and I>Implex Control Box, ing the most recent National Electric Code NEC and the Occu tional Sal FM0732. Health Act (OSHA). ( ) W NY and RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is dngineered into the design of a tery Zoeller pump. MAN. T0: P.U. sox 16347 Loukwil KY 40256 -0347 Manufacturers of.. SNIP 70: 3280 0 Millers Lane a Louicvide, KY 4;i' Pi 16 i , QUAIl7Y gou S�cE AVY y (502) 778 -2731 a FAX (502) 774 -3624 594 -013 r� 1 Wisconsin Departrnent of Industry SOIL AND SITE EVALUATION REPORT P of 3 Labor and Hyman Relations — Dkl*n of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less tharn$1 X inc Z ' e.1 • ]an must include, but 5r. • X not limited to vertical and horizontal reference poirflBM), dirftion a °IaA lope, scale or PARCEL I.D. # dimensioned, north arrow, and location and to t rr r �jj APPLICANT INFORMATION - PLEASE PRINT ALL INFOA161ATI f fIEVIEWEDBY DATE PROPERTY OWNER: PR PERTY LOCATION . Zi m `1" o R ikE L S ON r -�. VT. LOT iUE 1 /4 AIW 1 /4,S Z y T 21 ,N,R /� E( W PROP 7NER' MAILING SYo 'DESS � v GN h{g � r, ; }�, ` T # BLOCK # SUBD. NAME OR CSM # CITY, STATE ZIP CODE Q�I�, VILE E WN . NEST ROAD oRTS k91, Z 3 (7t [&"New Construction Use [ - rResidential /.Number of bedrooms 3 § (] Addition to existing building j ] Replacement [ J Public or commercial describe Code derived daily flow d gpd Recommended design baling rate . S bed, gpd/ft trench, gptilft2 Absorption area required 37 bed, ft 3 �5 trench, ft Maximum design loading rate • S bed, gpd/ft • trench, gpd/ft Recommended infiltration surface elevation(s) 5 • 3 ft (as referred to site plan benchmark) Additional design / site considerations $ Svc T'f /3 /F foK . e o y D Parent material SCS 610 A (-A -J P S r /. C14 C. Flood plain elevation, if applicable It a S = Suitable for system CONVENTIONAL MOON IN•GROUN P AT FA DE SYSTEM IN FILL HOLD :AG T U= Unsuitable for system 0 S 0'U C��S ❑ U 0 S hall CC'S 0 U ❑ S 2�u C S C� SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed tench r. R' o -iy /o yip 3 /2- 5/14 2 sdt 4 v)w cs 3'F .5 . G 2 a t- V- 34 /-0 V f'/f/ s�/ 2 . At Mn-6e ICs . s Ground 2- & ?•S y R y /!/ S f fit' Aw►v'C f • N elev. fl Depth to limiting fac S sss 4- i '• Remarks: �0 i Zo j It C X - f RA 6 r AN EA k. Ly C �'`•'.f F� T� L� Boring # Z ,bt SAk V C s 3 'F- -S • G D 2- 2 9t- 7' !g f yR fAV Si / z4, 44,-Fie cs a u fT S1.4. 2-C- ► /P'33 7•S Vie y/ _ y�,�� " / �R cs Ground elev. 2 - 6 1 - 3 • / 7-5' Yl s / L .,* SAK ^4 " 'CS' _ : S •� ft. S/ S. T .tT� • G S �� W D.S Depth to -- limiting 2C G . 7p 2 .S" y S 3 5 .3. r SG� 2 .i.. 6� in► kf/ • — N >u fact .f 5-5 . Remarks: CST Name : - Please Print 12o,a6'&7- V /6R f ' 4 7— Phone: - 7/.0r -- M . Pl"- dress: SS a' �E'/ / �PaQ • / 401.5 0/ ,�: 3 • y C S'T-Ai Z YdQ L Signature: Date: CST Number: ORIGINAL r 1 PROPERTY OWNER 0 • Td Rk - F s °•✓ SOIL DESCRIPTION REPORT Page Of 3 PARCEL I.D. If Boring # Horizon Depth Dominant Color Motties Texture Structure Consistence Bounday Roots' GP ift in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Mmrch 3 A o• /o ► 3 — S :/ Z,� s6�C A%v•FR CS 3 - F- .S . 6 g • /f 7- ye y/ _ y, � S/ 1 4 ., f 4" vfe I s ff . y • S Ground 2 � / ' �� 7. S yR y /s /. �'", i1M yfiP GS' • , .9 elev. tt f � 55 '7• S YR . 5' , 51 1, Of sk-- f R " . c S �( . 5' Depth to /b yie S/ Z ' limiting Z C S•G i face ,, S /d /p G (� S �'r �Rh7�i sA,•+ S Ai N s. S• s Remarks: Vo Ie t•20, 2 3 TS 44 s ,ve,*e s a 7ziP1 Boring # I Ground elev. ft. Depth to limiting factor Remarks: Boring # h t T• Ground elev. ft Depth to limiting factor Remarks: Boring # E3 Ground elev. ft Depth to limiting factor Remarks 00r% 0-313^10 ^c1^rn i i z �O �L . r 0 of o a o m N Q -o -rte P O N � b W 00 m s kA T L Z 4 t.► � I � u r 11� n1 � "� -o it R1 w " IN o n .. 1 I %„ O O �- v1 -►, i _- % 499 CERTIFIED.SURVEY MAP Located in part of the NEk of the NWa of Section 24, T29N, R18W, Town of Warren, St. Croix County, Wisconsin. c9 ~ s o FILED g N MAYZ 41993► M o M2 z JAMES O'CONNELL �Z C�, Register of Deeds R , ^ - St Cro►xpo., WI / 2M z OD to 10 O V �., NNN N U NPLATTED LANDS IC 1z S00 ° 10'46 "W •291.17' 33 133 �r y 261.05' i J> N C iC F N im IT 0) ID Ir OD z I > -h ID I --A — VF 0) Z I — I N �N rt0i^� lo? (D. I � n O I frl nF Fo CA — -I Ip Cr a. to ro I Q rr J� O �1 P N I. = I (� m N " 7 C ' W D M o ..• N D r N m a 3. w o m 020 O D i� I f — 00 rn -1 _ v I { � e N ID N X^ z� _m _ I z �' X N L IN �— n Cr APPROVSD ❑ � c Pn 2 �'� .- MAY Z Q 151.37' CA 1� N o •mss? NO2 18'16" E — 17 - d.7 ' iD 5 eFto l)( COUNTY :4 m Ir CD I C ahWWve Plan** 0� a L Zarft and M o N0�16 E '153.60' I�Vka Committee C D - I--I o W I 1n it not faGOrded m Co O velthkv 30 days Vf 66' ACCESS EASEMENT VOL. 1010, PAGE 80 S, o 1A vwlshalbe UNPLATTED LANDS �f Holt b v00 a to X oz w -3 r•r n A rc -s w ro o C � t is 1► } o r 0 . 1 . Z 2 �• f�+' rnn ! O r ►•• N C1 Z CY d rt - 7 •O M. �c rn o ►..... S O rn CA y� �a Bearings are referenced to the North line of the NW} of Section 24, assumed to bear N89 "W. VOLUME 9 PAGE 2618 I I . STC -105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OwNER/BIIYER darn e5 E. Tor ke s o N MAILING ADDRESS I ��- I �1 AAw 1 Z obeys WQ:- % 5 y ya3 PROPERTY ADDRESS P (location of septic system) Please obtain from the Planning Dept. CITY /STATE yb e `(�t� � I- PROPERTY LOCATION NE 1/4 yV 1/4, Section a'` T _4� _ N -R g W TOWN OF 030, rre Y1 ST. CROIX COUNTY, WI SUBDIVISION , LOT NUMBER. CERTIFIED SURVEY MAP - VOLUME , PAGE, / ,LOT NUMBE 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 licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost, of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED: DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 S T C - 100 This application form is to be completed in full and signed by the owners of the ro ert being n developed. A y g Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner contracto house), then ►a second form should be retained and completed when the property` is sold and submitted to this office with the appropriate deed recording. -------------------------------------------- Owner of property Location of property NE 1/4 NW 1/4, Section C T j N -R 6i) Townshi C n - Mailing address Address of site Subdivision name hcA 0.ppticab \ Lot no. Other homes on property? � _ yes - N Px0s i- kouse- --}o 6 em� r' mew },bKSC 7S bud l Previous owner of property �QY� °1 - �bea�n VY1uejt&r Total size of parcel 40..04 o,eres Date parcel , was created _ Inez Ak . M Are all corners and lot lines identifiable? YeS _No Is this property being developed for (spec house)? Yes -,�(_No Volume and Page Number as recorded with the Register of Deeds. --------------------------------------------------- INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER & THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I(we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document No . `] `sue p._; ? l and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of County Register of deeds as Document No. �-� ASS Signature of applicant PP Co- applicant / ! I Date of Signature Date bf ignature DO-GUMENT NO- STATE BAIL OF WISCONSIN. FORM 3 -1962 THIS SPACE RESERVED WOR RECORDINO DATA • QUIT CL DEED 5005`7 vu A REGISTER'S OFFICE ST. CROIX CO., Wi Earl C. Mueller and Evelyn M. Mueller, husband Reed fof Record and wife, and Dean A. Mueller and erin Per Y:� JUN 11 1993 Mue - ller, -- ---------------- husband and wife --- ------- - -- --- 8 A. M quit - claims to ....Ja?�?es.-Torkelson and .. arlene A. To rkelson, and wife holding as s >lyvorship-- marital_ •--•----•-------------- •------ ......---- ••............ --- -. - - -- ••- - - -• -• .................... - •- •-- ......... the following described real estate in ----------- S.t - - crow ............... County _ State of W'sconsin: RETURn TO I. ,I Tax Parcel No : ......................... ..... Lot One (1) in Volume 9, page 2618, as document number 499537, Certified Survey Maps as recorded in the St. Croix County Register of Deeds Office, located in part of the Northeast Quarter of the Northwest Quarter (NE 1/4 of NW 1/4) of Section Twenty Four (24), Township Twenty Nine (29) North, Range Eighteen (18) West, Town ' of Warren, St. Croix County, Wisconsin. I The Grantors hereby reserve for themselves all water usage rights for livestock at no cost. It is agreed between the parties heretoI that should the Grantees herein transfer the above - described property, I � i that the Grantors shall then have the water metered and shall pay { the current owners of said land a price equal to that being charged I� by the City of River Falls for similar water usage. All well and line maintenance costs shall be paid for by the Grantees, their j heirs and assigns. 1 FEE I I 1 E r I This - --- --i4--•--hV....... homestead property. IM (is snot) Dated this . ............j------ ---- ••.. •-- -- -- - - - -- day of - -- ... -_ -- June ---- 19. . --- - - - - -- I (SEAL) /.__.''- `.._ -._ ........ (SEAL) . P_"t. lf. Dean A. Mueller Mueller _ Earl C. S y - - -- - - -- • --- - - - - -- -- - -•- .......... # - - ---- -(SEAL) nni er L. Mueller Evelyn M. Mueller •x ---- _- - -_ - -- ............... AUTHENTICATION ACKNOWLEDGMENT Si gnature(s) _of Dean_A. Mueller,_ Jennifer STATE OF WISCONSIN Nl e r " l C. Mueller and �. Ye ..M..._.1�7t1� eX . - -•- - - -- County. 3 auth i this . ._day of ..._June 93 P ersonally came before me this ... .............day of 19.._ __ C - ------ -- --- ---- --- ....... 19 ........ the above named - ----------- - ---- -- - -- - -- -- - -•---- -.- ....- ---•-...... Leo A. Beskar ._..... - -.. - - - - -- -- - - - - -- --•--- •-- •-------- •----------- • - - - - -- ------- - - - - -• ------------------- TITLE: MEMBER STATE BAR OF WISCONSIN --- ....... (If not, ---•--------•---•--- -- -•- •----- -- ---- ----- -- - -- -- -- ........ ---------------- ---- ----- -- ---- ---•-•--- -- - --- ............- -- .............- I authorized by § 706.06, Wis. Stats.) to me known to be the person - .---- . ---- who executed the foregoing instrument and acknowledge the same. '- THIS INSTRUMENT WAS DRAFTED BY LeoA. Beskar, Attorney ---- •---------- •------- ••---- - - - - -- - - - - -• ---- - - - - -- -----•------•------------- fi_-. -----' ... .. .................... ... .. RODLI, BESKAR & Bol-SI S - . - . • -•- ...... 4 19...No t � ' Ma.1 Stre - - - - ... Notary Public - ---- -------------- - - - - -- County, Wis. (i riauregmay be r authenticated o occnowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) date- --- ---- ----- -------•- ------------------ ---------------- 19 ---- ---••) � QUIT CLAIM DEED STATE BAR OF WIS CONSIN