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HomeMy WebLinkAbout042-1101-90-000 0 a / J % k k � ® ■ � e � ° 4 2 % 2 CD ( ƒ $ § £ % Q ¥ _ - � e � E ■ R ® 2 @ « E ; @ R ¥ § e R 2§�� E E 2 c 2 c 2§ o ` E u c! % 8 r g■ S' ■ , E @ z E e > Cn R o m CD c 23 \ - �/@ CD CL cn \ \ \ � CD e o a� § E c � & k z 0 0 0 § - § } / I ) § § K z ov . §} ii BC c � SD § k � I • ■ « !? / ƒ z z I 7 Q > > § ! D / ' i i . � E ; � z C. ■ � ° � i � � ■ 7 # G 9 � & 03 2 § m CL . � R z $ k J2k \ \0 . J�a c CL CD % 000 2 ;i z ƒ� 7 }E 2( i �-n k k) i 2 ■ . a � 0 \ CD 69 _o \CL �\ Parcel #: 042 - 1101 -90 -300 11/29/2005 05:14 PM PAGE 1 OF 1 Alt. Parcel M 36.29.18.562A -20 042 - TOWN OF WARREN Current I X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner GARY F & JULIE A PETERSON O - PETERSON, GARY F & JULIE A 659 140TH ST ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description ' 659 140TH ST SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 4.001 Plat: 3891 -CSM 1413891 SEC 36 T29N R18W PT SW NW BEING CSM Block/Condo Bldg: LOT 1 14/3891 LOT 1 4.001AC EZ -U 1546/44 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 36- 29N -18W SW NW Notes: Parcel History: Date Doc # Vol /Page Type 07/18/2000 626578 1527/291 WD 2005 SUMMARY Bill #: Fair Market value: Assessed with: 0 Valuations Last Changed: 07/14/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.001 45,500 184,900 230,400 NO Totals for 2005: General Property 4.001 45,500 184,900 230,400 Woodland 0.000 0 0 Totals for 2004: General Property 4.001 45,500 184,900 230,400 Woodland 0.000 0 0 Lottery Credit Claim Count: 1 Certification Date: 10/19/2005 Batch M 05.35 Specials: User Special Code Category Amount 018 - RECYCLING SPECIAL ASSESSMENT 15.00 Special Assessments Special Charges Delinquent Charges Total 15.00 0.00 0.00 t . w; " n DApartment of Commerce PRIVATE SEWAGE SYSTEM Count y: S4t.` and Buildings Division INSPECTION REPORT St. Croix � R 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)). _11ra Permit Holder's Name: ❑ City []Village ❑ Tbwn of: State Plan ID No.: �rs+ Warren Township 5 CST BM Elev.: I Insp. BM Elev.: BM Description: Parcel Tax No.: r 042 - 1101 -90 -000 Q p TANK INFORMATION ELEVATION DATA 3t# q SCD 2 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic k G�w qUt� Benchmark I S loS:lS (5D O� Dosing Alt. BM c)b r I Aeration Bldg. Sewer Holding St/ Ht Inlet gs-, - so , TANK SETBACK INFORMATION St/ Ht Outlet 10 t o 94- W TANK TO P / L WELL BLDG. Air Intake ROAD Dt Inlet �G �� 91. 8b Septic 'i� ( p / — NA Dt Bottom a Dosing Y �� ` 3`4 NA Header / Man. 3. SW /a (, 6 Aeration NA Dist. Pipe 3, Holding Bot. System 10 '1 oo . c W PUMP/ SIPHON INFORMATION Final Grade ;(( \1e a g ceuer _ oil Manufacturer Demand St cover 0 1. , Model Number GPM TDH I Lift 10,.I6 `riction gs System 2 S TDH 25. SFt oss ead Forcemain Length D, b`O` Dia. a, �t Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width , Length r No. Of Trenches PIT No. Of Pits Insid Die. Liquid Depth D IMENSIONS DIMEN I N SYSTEM TO P/ L BLDG WELL LAKE /STREAM LEA CHI Manufacturer: SETBACK CHA ER INFORMATION Type Of r $�� '--" OR IT Num er: System: M411 i y S`o DISTRIBUTION SYSTEM Header/Manifold Distribution Pipes) i µ x Hole Size x Hole Spacing Vent To Air Intake Length --- Dia. Length 2 D ie. oZ Spacing I u 6 �� �'� SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (include code discrepancies, persons present, etc.) / Wilk ��``�`� � ��� Insk6on #1�: ( /04 / 4 Inspection #2: � Location: 659 140th Street, Roberts I 54023 (SW 1/4 NW 1/� 6 T2 91-4 W W) - 36.7,9.18.562A 1.) Alt BM Description= oa✓ cln a_ 2.) Bldg sewer length = k r - amount of cover= 1 �- so � cxm,r, 3.) contour =� q v) S a f >; 2,c- 4r - = I° 5- tS ` } I S�s 1 Lola o� Ge Plan revision required? ❑ Yes 9 No C Us ther s de for additional informat'on. 08 1 SZ� [ -PTJ--H tpa_ We Cv X56 710 ( 7 V, t � �� � y t 6 Ins ector's Sig atu�re i � Cert ` puf 11'j M 'Upec;t«n. 1 ADDITIONAL COMMENTS AND SKETCH ,- SANITARY PERMIT NUMBER: j a � � b C P f 6 i t t 3 t E .., -f- I i � d a � E € i Sanitary Permit Application Safety & Buildings Division `� In accord with Comm 83.21. Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 evnsin Personal information ou p rovide may be used for secondan purposes Madison. WI 53707 - 730' Department of Commerce y p p p [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if r state owne, Attach comp) te plans (to the county copy only) f the system. on paper not less than 8 -1/2 x 1 I inches in size. County ` State S a P�rtt�it mber Check if revision to previous application State Plan 1. D. Number I. Application Informatio - Please Print all In Location: Propertty� Owner Name �cgp�rt ,nL,ocation i L7 C{ �°� t` 2/t?�C < 1/411 4J1 /4, S3 ,N. R` or W Property Owneils Mailing Address Lot Number Block Number ?� l City, State Zip Code Phone Number Subdivision Name or CSM Number II Type of Building: (check one) ❑ City U"' I or 2 Family Dwelling – No. of Bedrooms: ❑ Village ❑ Public /Commercial (describe use): OXown of �� 13 State-owned 2 III Type of Perrot: (Check only one box on line A. Check box on line B if applicable) Nearest Road A) 1. 4New System 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Addition to Parcel Tax r>)ber(s) System Tank On Existing System ((oo 2 ) / B) Permit lumber Dade Issued _ U A Sanitary Permit was previously issued 3G 2 (� — 2 IV. Type of POWT System: (Check all that apply) 1 ❑ Non - pressurized In ground Mound ❑ Sand Filter ❑ Constructed Wetland 000 ❑ Pressurized In- ground Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) Elevation q5 - o �?s� 39V L & 1 () 1 G9,34� VI Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks v / 1 - ❑ ❑ ❑ 13 VII Responsibility Statement I, the undersilyied, assume responsibility fb tnstallation of th OWTS shown on the attached plans. Plu bet's Name (print) Plumb 's Signature (nos ): /MPRS No. Business Phone Number Plu bet's Name (print) Plujmbs Signat Plumber's Address (Street, Cityj State, Zip C e) VIII County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued I ng A ent Signature (No stamps) Approved ❑ Owner Given Initial Adverse Surcharge Fee) r I Determi 'on L^_/ 61mi IX. Conditions Approv /Reasons for Disapproval: �e r6_6on .Corr -one � i s t c> n S bfco uSe— Ak(�\ IMvj Vws -vav�s �r 40 c m�rw15 + C� n'ea b ck 1 -cev) e SBD -6398 (R. 07/00) ag SANITARY PERMIT — COUNTY ` 0JLHR TRANSFER /RENEWAL UNIFORM PERMIT # (PLB 67 `7 PERMIT RENEWAL DATE: PERMIT TRANSFER DATE: ORIGINAL PERMIT ISSUANCE DATE: STATE PLAN I.D. NUMBER: PROPERTY LOCATION: CITY: S W' /a Al W ' /a,SI ,T N,R 1 $ E (oro VILLAGE: AJM 6A) LOT NUMBER: BLOCK NUMBER: SUBDIVISIO NAME: NEAREST ROAD, LAKE OR LANDMARK: ^'lf4 / 4j 1 - 7 O` rr PREVIOUS SANITARY PERMIT HOLDER OF CHANGED): SANITARY PERMIT TRANSFERRED TO: N ME: SI TURE: / NAME: /� PHONE NUMBER: av k d C d W r �-.� + 6 S �i�l.� c 4. 0- Ili d rS - 79(a- 23 s r AD RESS: PHONE NUMBER: ADDRESS: —► �-o I--a.�rk St ru a : Ce s i U S "h 7 0 �� �v ti �.1 - 7 , -I , d w I. sg a w (S , 461 3 I, the undersigned, hereby ume responsibility for installation of the private sew system that has previously been approved for this property. PLUMBER'S SIGNATURE: PR OUS PLUMBER'S NAME (IF CHANGED): PLUMBER'S ADDRESS: PREVIOUS PLUMBER'S ADDRESS: MP /MPRSW NUMBER: PHONE NUMBER: MP /MPRSW NUMBER: PHONE NUMBER: X. SIGNATURE OF ISSUING AGENT: DATE APPROVED: DISTRIBUTION: Original - County Copy - Bureau of Plumbing Copy - Owner ) DILHR -SBD -6399 (R. 5/82) Copy - Plumber HEAD /CAPACITY CURVE 44 ,40 MODEL 42 48 5759 72 76 98 139 135 Feel Meters Gal. Liters Gal. Liters Gal. Liters Gal. Liters Cal. Liters Gal. Liters Gal, Liters HEAD CAPACITY CURVE 40 130 91 0 30 11 42 zs 94 3a 129 30 114 40 159 SUMP 1 EFFLUENT MODELS 50 1 18 77 61 231 79 299 38 38 ,25 1 120 15 4.6 6 23 15 57 19 72 14 53 30 114 45 170 64 242 3/8 1�2" & 314" 36 186 20 6.1 -- -- -- -- -- -- -- -- 17 E14 25 95 36 136 115 4186 25 7.6 - -- 8 30 -- -- -- -- -- -- -- -- -- SOLID PASSING CAPACITY 34 Lock Valve: 19ft. (5.8m) 19ft. (5.8m) 19.3ft. (5.9m) 18ft. (5.5m) 25(l. (7.6m) 23ft. (7.Om) 26ft. (7.9m) 110 32 105 MODEL 140 161 163 165 185 186 188 189 191 0D 4140 4161 4163 4165 4185 4186 4188 4189 30 Feet Meters Ga). Liters Gal. Liters Gal. Liters Gal. Liters Gal. Liters Gal. Liters Gal. Liters Gal. Liters Col. liters 95 28 5 1.5 91 344 100 379 61 231 61 231 -- -- 58 220 145 549 145 549 45 170 90 10 3.0 84 316 93 352 61 231 61 231 -- -- 58 220 140 530 140 530 45 170 26 85 15 4.6 76 288 85 322 60 227 61 231 -- -- 58 220 134 507 135 511 45 170 20 6.1 68 257 79 299 59 223 60 227 -- - 58 220 128 484 131 496 45 170 8 -- 2a 0 4665 25 7.6 59 223 70 265 57 216 59 223 58 220 122 462 125 473 45 170 75 22 30 9.1 49 185 62 235 55 206 58 220 85 322 58 220 116 439 120 454 45 170 70 163 40 12.2 21 45 45 170 46 172 55 206 70 285 58 220 104 394 109 413 45 170 41 20 68 50 15.2 -- -- 20 76 33 125 50 189 51 193 58 220 90 341 97 367 45 170 60 18.3 -- - -- -- 15 57 39 148 32 121 58 220 71 269 85 322 45 170 18 60 161 189 70 21.3 -- -- -- -- -- -- 23 87 9 34 52 34 51 193 69 261 45 170 4161 4189 55 80 24.4 -- -- -- -- -- -- 10 38 -- -- 45 170 26 106 51 193 45 170 Is 50 90 27.4 -- -- -- -- -- -- -- -- -- -- 31 117 2 8 34 129 45 170 14 41188 100 30.5 -- -- -- -- -- -- -- -- -- -- 16 80 -- -- 17 64 40 151 45 1 110 33.5 -- -- -- -- -- -- -- -- -- -- 4 15 -- -- -- -- 30 114 4 12 40 - 120 36.6 __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ 20 76 35 1 130 39.6 46f1. (14.Om) S6ft. (17.1 m) __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ 10 38 t0 Lock Valve: 66ft. (20.1r,) 89ft. (26.4m) 73ft. (22.3.) 114ft. (34.7m) 91f1. (27.7m) 110ft. (33.5m)137ft. (41.8.) 30 185 8 9 4185 25 6 20 98 15 4 A CAUTION Model 185/4185 should not be ° subjected to less than 30 feet TDH. 2 5 42 e 2 sass 7s NOTE: For Head Capacity on Model 112, Indus - 57,59 o trial column explosion proof pump, see FMO219. 10 20 40 50 60 ]0 80 90 100 110 120 130 140 150 �a7n GALLONS LITERS 0 80 160 240 320 400 480 560 FLOW PER MINUTE MODELS 264 2617 267 268 270/4270 _ I.. I Liters Gal. JR- G.I. Lit- Gal. Gal. -e HEAD CAPACITY CURVE w 5 1 I.5 90 1 341 126 484 128 484 128 484 132 500 10 3.0 6 89 337 89 337 89 337 ,01 382 SEWAGE MODELS 80- 15 4.6 50 189 50 189 50 189 77 29, 24 20 6., 10 38 ,0 38 ,0 38 56 212 2" SOLID PASSING CAPACITY 75 25 ].6 - - - - - - 29 1,0 22 70 Lock Valve: 18 Ft (5.5 m) 21.5 Ft (6.6 m) 21.5 Ft (6.6 m) 21.5 Ft (6.6 m) 29 Ft (8.8 m) 2° 65 MODELS 282/4282 284/4284 292/4292 293/4293 294/4294 295/4295 18 60 5 Feet Meters Gal, L'ilers Gal. Lifers Gal. Lifers Gal. Lifers Gal. Liters Gal. Liters 16 5 1.5 127 481 179 678 140 530 - - 196 742 214 810 _ 50 10 10 96 363 157 594 124 469 - - 181 685 199 753 14 15 4.6 64 242 133 503 108 409 118 447 165 625 184 696 45 20 61 34 129 106 401 91 344 108 409 150 566 168 636 12- 40 25 71 6 23 73 276 75 284 96 363 136 515 154 583 30 9.1 - - 42 159 56 212 82 310 121 458 140 530 t0 35 10.7 - - - - 33 125 65 246 108 409 128 483 30 93, 40 12.2 - - - - 10 38 48 182 94 356 115 435 8 4293 50 15.2 - - - - - - - 58 220 89 337 25 1 27 0, - _ - - _ - - _ 4262 60 18.3 13 49 59 223 4270 6 20 70 21.3 - - - - - - - - - - 23 87 Lock Volve: 26 Ft (7 -9 m) 35 Ft (10,7 m) 42 Ft (12.8 m) 50 Ft (15.2 m) 62 IT (18.9 m) 75 Ft (22.9 m) 15 4 10 2 266. 267, 268 5 292, 284, 2 4, 295, ° GALLONS 4292 4264 4294 4295 A CAUTION Model 293/4293 should not be 0 20 30 40 50 60 70 80 90 100 110 120 130 140 150 160 no 180 190 200 210 220 230 subjected to less than 15 feet TDH. LITERS 0 80 160 240 320 400 480 560 640 720 800 FLOW PER MINUTE coeeoe © Copyright 2000 Zoeller Co. All rights reserved. 5 EASY DO'S & DON'T'S FOR INSTALLING A SUMP PUMP 1. DO read thoroughly all installation material provided with the pump. 2. DO inspect pump for any visible damage caused by shipping. Contact dealer if pump appears to be damaged. ` 3. DO clean all debris from the sump. Be sure that the pump will have a hard, flat surface beneath it. DO NOT install on sand, gravel or dirt. 4. DO be sure that the sump is large enough to allow proper clearance for the level control switch(es) to operate properly. 5. DO Always Disconnect Pump From Power Source Before Handling. DO always connect to a separately protected and properly grounded circuit. SSPMA DO NOT ever cut, splice, or damage power cord (Only splice in a watertight junction box). MEMBER DO NOT carry or lift pump by its power cord. DO NOT use an extension cord with a sump pump. 6. DO install a check valve and a union in the discharge line. ANOSE ace DO NOT use a discharge pipe smaller than the pump discharge. PUMP MFRS. ASSN. 7. DO NOT use a sump pump as a trench or excavation pump, or for pumping sewage, gasoline, or other hazardous liquids. YOUR ASSURANCE 8. DO test pump immediately after installation to be sure that the system is working properly. OF QUALITY 9. DO cover sump with an adequate sump cover. 10. DO review all applicable local and national codes and verify that the installation conforms to each of them. 11. DO consult manufacturer for clarifications or questions. 12. DO consider a Two Pump System with an alarm (Page 5) where an installation may become overloaded or primary pump failure would result in property damages. 13. DO consider a D.C. Backup System (See the Basement Sentry page 5) where a sump or dewatering pump is necessary for the prevention of property damages from flooding due to A.C. Power disruptions, mechanical or electrical problems or system overloading. Service Checklist ® A WARNING ELECTRICAL PRECAUTIONS- Before servicing a pump, always shut off the main power breaker and then unplug the pump - making sure you are not standing in water and wearing insulated protective sole shoes. Under flooded conditions, contact your local electric company or a qualified licensed electrician for disconnecting electrical service prior to pump removal. A WARNING Submersible pumps contain oils which becomes pressurized and hot under operating conditions - allow 2% hours after disconnecting before attempting service. CONDITION COMMON CAUSES A. Pump will not start or run. Check fuse, low voltage, overload open, open or incorrect wiring, open switch, impeller or seal bound mechanically, defective capacitor or relay when used, motor or wiring shorted. Float assembly held down. Switch defective, damaged, or out of adjustment. B. Motoroverheats and trips overload Incorrect voltage, negative head (discharge open lower than normal) impeller or seal bound mechanically, defective or blows fuse. capacitor or relay, motor shorted. C. Pump starts and stops too often. Float tight on rod, check valve stuck or none installed in long distance line, overload open, level switch(s) defective, sump pit too small. D. Pump will not shut off. Debris underfloat assembly, float or float rod bound by pit sides or other, switch defective, damaged or out of adjustment. E. Pump operates but delivers little or Check strainer housing, discharge pipe, or if check valve is used vent hole must be clear. Discharge head ex- no water. ceeds pump capacity. Low or incorrect voltage. Incorrect motor rotation. Capacitor defective. Incoming water containing air or causing air to enter pumping chamber. F. Drop in head and/or capacity after Increased pipe friction, clogged line or check valve. Abrasive material and adverse chemicals Could possibly a period of use. deteriorate impeller and pump housing. Check line. Remove base and inspect. If the above checklist does not uncover the problem, consult the factory - Do not attempt to service or otherwise disassemble pump. Service must be by Zoeller Authorized Service Stations. I Limited Warranty Zoeller Pump Company warrants, to the purchaser and subsequent owner during the warranty warranty is in lieu of all other warranties expressed or implied; and we do not authorize any period, every new Zoeller Pump Company product to be free from defects in material and representative orother person to assume for us any other liability in connection with our products. workmanship under normal use and service, when properly installed, used and maintained, for 1) Contact Zoeller Pump Company, 3649 Cane Run Road, Louisville, Kentucky 40211 -1961, Attention: Standard Warranty - a period of one year from date of installation or 18 months from date of Customer Service Department to obtain any needed repair or replacement of part(s) or additional manufacturer, whichever comes first OR 2) Optional Three (3) Year Warranty - a period of three(3) information pertaining to our warranty. years from date of installation or 42 months from date of manufacturer whichever comes first. Parts that fail, (within standard orthree(3) year optional warranty) that inspections determine to ZOELLER PUMP COMPANY EXPRESSLY DISCLAIMS LIABILITY FOR SPECIAL, be defective in material or workmanship, will be repaired, replaced or remanufactured at Zoeller CONSEQUENTIAL OR INCIDENTAL DAMAGES OR BREACH OF EXPRESSED OR IMPLIED Pump Company's* option, provided however, that by so doing we will not be obligated to replace WARRANTY; AND ANY IMPLIED WARRANTY OF FITNESS FOR A PARTICULAR PURPOSE an entire assembly, the entire mechanism or the complete unit. No allowance will be made for AND OF MERCHANTABILITY SHALL BE LIMITED TO THE DURATION OF THE EXPRESSED shipping charges, damages, labor or other charges that may occur due to product failure, repair WARRANTY. or replacement. Some states do not allow limitations on the duration of an implied warranty, so the above limitation This warranty does not apply to any material that has been disassembled without prior approval of may not apply to you. Some states do not allow the exclusion or limitation of incidental or Zoeller Pump Company, subjected to misuse, misapplication, neglect, alteration, accident or act consequential damages, so the above limitation or exclusion may not apply to you. of God; that has not been installed, operated or maintained in accordance with Zoeller Pump Company installation instructions; that has been exposed to but not limited to the following: sand, This warranty gives you specific legal rights and you may also have other rights which vary from gravel, cement, mud, tar, hydrocarbons or hydrocarbon derivatives (oil, gasoline, solvents, etc), state to state. wash towels or feminine sanitary products, etc. or other abrasive or corrosive substances. This © Copyright 2000 Zoeller Co. All rights reserved. 6 S+ Safety and Buildings Division ` N*I sconsin 201 W. Washington Avenue S ANITARY PERMIT APPLICATION PO Box 7162 Department of Commerce In accord with Comm 83.05, Wis. 2 Madison, WI 53707 -7162 • Attach complete plans (to the county copy only) for the syste aperr of le my than 81/2 x 11 inches in size. I RE CEIVED `1/ (�iPA/ 1 P '\ L1 • See reverse side for instructions for completing this applic fia , a � a nitary Permit Number Personal information you provide may be used for secondary purposes z 2000 ❑ if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. ST S n Review Transaction Number L - APPLICATION N INFORM TIO PLEASE RRINT ALL S b = 31Z0 flay erty Locati e o Gocu FS t/4 pit r T , N, R j$�o wner's Mailin Addr flidm L Block Numbe 7 City to Zip Code Phone Number Subdivision Name or CS NI Number j j� fS u D ',;L--3 (7 ) 7f? - �•'98D II. YP F BUILDING: (check one) El State Owned O Iil Near Ro ❑ Vit e Public or 2 Family Dwelling - No. of bedrooms -3 own OF Ck k �b 111 BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 4( 7A . 1 17. ( 1 ❑ Apartment /Condo 0/ 00 T' 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, �ew 2, ❑ Replacement 3, ❑ Replacement of 4. ❑ Reconnection of S. ❑ Repair of an ______System ________System __TankOnl�r______________ Existing System _________ExistingSystem B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11 []Seepage Bed 21 (Mound 30 4 Specify Type 41 [] Holding Tank 12 ❑ Seepage Trench 22 E] In-Ground Pressure / - rA 42 E] Pit Privy 13 ❑ Seepage Pit r S - C 10 ilYl 43 ❑ Vault Privy 14 ❑ System -In -Fill ( Q"Xt-1r 0:t 0 VI. ABSORPTIO 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/da sq. ft.) (Min. /inch) 4e Elevation/ Al � D 3W .390 �� �p 5'i4 Feet 1p7,3 Feet Cap acit VII. TANK in allo Total # of Site INFORMATION Manufacturer's Name P refab . Con- Steel F'�'- Plastic Exper New Exist' Gallons Tanks Concrete strum- glass App. Tank Tank Septic Tank or Holding Tank OHO Lift Pump Tank /Siphon Chamber `/ ` ` VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sews a tem shown on the attached plans. Plumber's Name: (Print) Plum rs ur : (N Sta MP PRSW NO. Business Phone Number: €cl �� Signat 2 T$ Plumber's ddress (Wet, et, City, State, Zip Code): CO - S"" �'t ps oiL 3 IX. COUNTY / DE ARTMENT USE ONLY ❑ Disapproved Sa&itary Permit Fee (includes GroundwateJ ate I ssued Issuing Agent Signature (No Stamps) §3Approved ❑ Owner Given Initial 3�s_ A Surcharge Fee) - ,.. - Adverse Determination CONDITIONS; OF APPROVAL /REASONS FOR DISAPPRQVAL: IAAA�_, IC A" �0 D SBD -6398 (R.12/99) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS . 1. A sanitary permit is valilfor two (2) years. 2. Your sanitary prermit may renewed before the 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 Stateof Wisconsin, and Buildings Division 608 - 266 -3151. . Y 9 To be complete and accurate this sanitary permit application must include: �. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. 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. Typa 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 8 112 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 (ontrols; 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. s NOS2IH.LHd AZIdrJ :oo ££9L :PpO Z2Pv WSiM Sn'IM'H Lt� LS'HO2IHY�iNiOO�Nd INInaf `L£6£ saoinaaS p1pe.60jul 00'0 $ HfIQ 3ONd'Idg X31AHIAU NVId S.LMOd ` NWINInb g S3wdf 00'081 S Q3AIHO32I 339 OO'081 S Q3UIfIbU HH3 OOOZ /17Z /170 QHAIHOHU aIVCI ``�Ia Dais •pt,aq,ioual slip uo Ssa.tppE ai.I1 1E 10 ':V,0Taa palsij laaumu auogdalal Pill it am op aprm Pq Arm Pouapuodsauoo Snip 8utuiaouoo SPumbul uou Exado/uouellepsut/uouonspsuoo Io o1 ioud pauielgo aq Ilt,tls ,�pilt,dioiuntu It,00l Pip io apt,ps gyp Ag pannbat slittuad IId - si=Pdsui It,00l Ppnloui Arm u0ignn `puaun1udaQ atlp3o saAuEpuasaidai pazuogpne Aq uolloodsui op uado puE uouonnsuoo 8uunp alis -uo aq llt,tls canal Sitl1 pue suoileogioads `sueld panoidde Pip 3o Moo d :osn io Aouedn000 of loi.id put uoipt,llepsui so uotponnsuoo 2uiinp jam aq Ilt,gs suoipipuoo 8uinnollo3 Qqj, •spu;)wPnnbai apoo IIe tlpinn Pout,ildtuoo .io3 algisuodsai si `salmuls uisuooSiM `(01)10'101 iapdEgo ui patnJPp se `iaunno PIT, 'Q9A0Xddd A- I'IVNOLLIQNOO uaaq sEtl IEuiu gns aq •samlels utsuoosiM put SapoO PAIjVASiuitupd msuoosiM Plgeoildde Tlpinn a3ut,tut03u03 J O3 paenainPi uaaq sEq anogt, paquosap It,lutugns atl,l, £9L099 :'ON QI loafg0 palein8P2l tualsXS ,LMOd :adds poo fq0 0917 QdJ qNI I IHAAQ QNn0W :uogduasaQ :HOA M81'H `N6Z.L `9£S `b /IMN `i7/IMS IS H.LObI `NMVMJO umOJ, `JC1unOO XIO2IO IS - Aouaft, Pip tlplm oouapuodsomoo i1e ut `anoge NOSXIL3d AXVD 'OCT 161 :GI 0 1iS `staqumu uoipeoUguapi ails ippoq of jojoi oseald 3 ! �sr�cX • 0£1161 'ON QI aHs ..a 889ZI£'ON QI u0113esue.1L szaqumN uolpeotUguopl s a �LOOZ /�Q /5� :Sa2iIdXg'It�A02Idd�' l�iV'Id A02Iddd'IdNOLLIQNOO :3H 910179 IM NOSQnH` , �' 910179 IM NOSQfIH Crd '19VHOIMV0 1011 : ' Q2I 'II3hL0 959 vidS AINnOO XIOX3 ZS ~ ~ - - -__� - - d LHDrdg'Ifl M IX9902I HOId30 JNINOZ Y0.LO9d9l11 S.LAIOd -A(I LV SL£9ZZ'ON QI ISnO OOOZ `£0 Xew tiepajoag `pJeyouelg 'r epueje JouJanoE) `uosdwoyl •g A wwol aoaawwoo ;o juawliedaa sn U1SUO261 .r, LLL9 (909) :# Pal Z9LL IM NOSIO`dW Z9 L L X08 Od s5ulp pq pue A1aleS Safety and Buildings PO BOX 7162 MADISON WI 53707 -7162 TDD #: (608) 264 -8777 Visconsin www.commerce.state.wi . qs Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary May 03, 2000 CUST ID No.226375 ATTIC• POWTS INSPECTOR ZONING OFFICE ROBERT W ULBRICHT ST CROIX COUNTY SPIA 655 O'NEIL RD 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016 RE: CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 05/03/2002 Transaction ID No. 312688 Site ID No. 191130 SITE: Please refer to both identification numbers, Site ID: 191130, GARY PETERSON above, in all correspondence with the agency. ST CROIX County, Town of WARREN; 140TH ST SW1 /4, NW1 /4, S36, T29N, R18W FOR: Description: MOUND DWELLING GPD 450 Object Type: POWT System Regulated Object ID No.: 660763 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. The following conditions shall be met during construction or installation and prior to occupancy or use: • A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation /operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sinc ely, DATE RECEIVED 04/24/2000 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 JAMES B QUINLAN , POWTS PLAN REVIEWER BALANCE DUE $ 0.00 Integrated Services (608)266 -3937, JQUINLAN@COMMERCE.STATE.WI.US WiSMART code: 7633 cc: GARY PETERSON ORIGINAL LBRICHT & ASSOCIATES CO. 655 O'Neil Road • Hudson, WI 54016 Reg. Designers of Engineering Systems 715- 386 -8185 Private Sewage Consultants RECE��E APR 2 4 200 PROJECT INDEX D1V. SpFEYY & 6LDGS. DILHR Plan I.D. # Date April 20, 2000 Owner Gary Peterson Phone 715- 796 -2351 Address 720 Larcom St. P.O. Box 67, Hammond, Wis. 54015 Legal Description A pending 4.0 acre CSM lot. PIN 042- 1101 -90- SW1 /4, NW1 /4, Sec.36, T29N, R18W. Town of Warren County St. Croix C.S.T. Robert Heise 226153 Installer Local Authority/ Supervision St. Croix Cty. Zoning Dept. . PROJECT DESCRIPTION ' New construction. For a proposed 3 bedroom home. Estimated daily wasteflow: 450 gals. Soils are permiable in the upper 12" of soil (.4/.5 GPD /Ft2) but found to contain fine sandy materials derived from sandstone, but at depths below 39 ". A long narrow mound system (curved convex to match the slopes and contour) using 12" sand fill is proposed. Highly recommended: install a Zabel filter in the 1000 gal precast septic tank for ultimate pretreatment of the final effluent. An approved above grade locking manhole shall be provided for serving access. C O1V tis . ... . . . S ROBERT ULBFttCH + 01160 HUDSON, WI S I Gi g, Pg•1 PLOT PLAN VIEWS Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWSz�.'�.`,`;;"' Pg.3 PIPE LATERAL LAYOUT �►- ►r Pg.4 DOSING CHAMBER CROSS SECTION Gt:PAPTi'VEtj0O Cot, ERCE VISION OF SAFETY AND NGS t 6 ILDi Pg•5 PUMP PERFORMANCE SPECS - !' SEE CORRESPONDENCE This design for 9n insta llation llation is based entirely on measurements, elev landscape conditions (slopes etc. a a The accuracy of hiss ) an d soil suitability provided by CSTM of the CSTM. sp ec as reported, shall remain the sole res o p nsibilit ,Y Any use of this POWTS design by any licensed plumber, or a ny related unlicensed parties or persons (excavaters, laborers) shall not be construed as an assumption of responsibility by the designer for the Forkmanship, construction, placement, substitution or selection of any components not specified, or any assumptions by the plumk-er that any unspecified components are state approved or,proper, or the effects of poor judgement if working under adverse damaging weather conditions (wet /frozen soils) by any much parties or persons. �D +s SCALE ` "= yo P o� �i �? -- �-- W I f''RoPos .......... _ ............ . A �. ipP - I)p O c: aVAY �IVA Of op z � Q � o A 1 y00 • �3 jqy 17 0 C'S % S 19 : 70/ OF 6 waoi) ' J200 POST 1 - 0 7- <oPA)to'L 5 p G F I .2U, _ / D O .O P5 2. Of 5 F C R ca 5 s SEC T I o N O ICI o U Aj L) -- w i r ti f3 e D 0eo O F % ro y" Agget-S V i ST12 i(3uT% n,J rs• TNi ckaFSS Pip 11J �-- sysrEM OF T OP soft. EIEV/�1"i0� LW i Fo PA To E7 11 rr N "� /ds•o -��E — RATIO r'' 5Au [ . 1 P l o w s t7 T o P's uu ► FoRM 8 % 5I)pE F O R � EIWAT100 U uaER BED Fr. — ELEVArjo►J s -- Fr. INVERT' of 2 lATE RA (S �a S, 3o / U Top o f R ock G. F r. i f F T T ° F '� _ IATERA PLA V►Ew of Mou,�JD wi rtt 13E o FvRc.E MAIN A 5 FT• I . - -- - - -- -- - -- -- - - -- _- - -- - . + B 7(o FT 13 T w ` -- __ -___ __ 1 F K ,I - -- T /6 Fr 0 01 - l fr - PVC. CAPPED A I vase- RVAT'1o0 9912E5/}TE P ►pEs PERM,�,�E,uT MhRKERS REG2viRED (3ASAL AR eA 'A AiCy �vllST� F► ow - ��o �� S SOIL, 10 i I rRATW E C APACi ry 54. Fr, PRopoSEv BAS ARL-A = X ( A + z _ 7& x s + i� � � sy� C FT «►J�.Rn MAK)i FOLD D Pipe UErwoR k 'TOTAL- voLume of= LA t� _ _ T .. 9�9tR1(3 LATERAI- ENO CAP I� x R/ 4C� N cT T'd /l ow ✓'J M AW LAST llolE 5 NA ll (3F- To END CAP VO ID Vo PA E Fo R �uvERr � IEVAr�v� d F 2" Fo Rcr= M AW N yy gA1S, /oS .5"0 PERFoRAVED PIPE DET•Ai L a � F{OIEs 1 (9tATF17 �� G OT'l - OM SH All BE7 I - Y `I VARiA(3LE y IR gohll%/ SPACED. D<STgNCE _1Z P rr HoIE Di/,K�T'e IR R N/A LATERA Z MAW FOLD 3 roRct? MAiN Z I 1P N . Y i►��I,� S or (lo1Es / p i p E Z S DIS I Ri t3uT ic��f D�S�KAR�E R..ATIE 2.�, 2S pe.� L Q TC7TAt- "DiSGkAR RATE l NEtW0Rl< 2l 6rAL, L � ~♦ PUMP CHAMBER CROSS SECTIOU A U D SPECIFICATIONS P,4 1E ¢ of _5 -VENT CAP 4"C.I. VENT PIPE WEATHER PROOF APPROVED LOCKIMG - j JUMCTION BOX MAMHOLE COVER 25' FROM DOOP„ [✓�/Gl IAA, WIMDOW OR FRESH WMIU. AIR IMTAKE I rFr^ pt ( /'I n/ GRADE I 4 " M IN. JJ � COIJDUIT 3,50 _ `\�\ ---- - - - - -- f PROVIDE AIRTIGHT SEAL L.PPROVED JOIN A y I I7v I I APPROVED JOINTS W C.I. PIPE IN I I� M I II W/C.I. PIPE EXTENOIIJG 3' � � I I ALARM EXTEMDIMG 3 OVJTO SOLID SOIL / I V I I) ONTO SOLID SOIL _B $7 , ,, , I ' � � I I oIJ b I 2° c ELEV. FT. j -_J 2 PUMP—, OFF �SE J � k ,gE D pw 6- ° 'r � BLOCK lE v!I RIStR EXIT PERMITTED OIJL9 IF TAWX MAMUFACTURE.R HAS SUCH APPROVAL SEPTIC E SPECIFICATIONS DOSE MIAVIS7 W J�� e f� TAMKS MAAIUFACTURER: �jJ Z IJUMB5 DOSES: PER DAy TAMK SIZE: /� " " QQ IJ GALLOS DOSE VOLUME ALARM MAAIUFACTURER: 1,jaZ" /l/fett `'9 INCLUDIAIG BACKFLOW: GALLOWS MODEL 1JUMBER: T L- CAPACITIES: A= /L INCHES OR GALLONS SWITCH TSPE: I� T B= 2_ IMC14ESOR � GALLOWS PUMP MAIJUFACTURER: GoLn-0`7 C - INCHES OR GALLOWS Q - p MODEL MUMBER: 3885 G�IEo S � D= � IMCHES OR �'� GALLOMS SWITCH TYPE: f ijjYar\ck F(O MOTE: PUMP AUD ALARM ARE TO BE MIMIMUI'1 DISCHARGE RATE 30 GPM INSTALLED OM 5EPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEU PUMP OFF AMD DISTRIBUTIOM PIPE. / 3 FEET - lAA-)k S' kC S - MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . 2.5 FEET L 0{ - w tt + ?(P S FE OF FORCE MA X r• F Yo rT.FRICTIOM FACTOR / L FEET tgoA S 2- TOTAL OHMAMIC. HEAD = Z J FEET INTERNAL DIMEKISIOIJS OF TAUK: LF-KIGTH ,WIDTH / ;LIQUID DEPTH 0 J . 4 Submersible Effluent Pumps 3885 r AVAILABLE CERTIFICATIONS ETA LISTED SUBMERSIBLE PUMP CLASS I AND 11 DIV. 2 AND - CLASS III DIV 1 AND 2 ETL TESTING LABORATORIES, INC. CORTLAND, NEW YORK 13045 G1086131480 CANADIAN STANDARD ASSOCIATION s`t PERFORMANCE RATINGS (gallons per minute) MODELS WE0511H WE051111H Series HP Volts Phase Max. Amp. RPM Solids Wt. (Ibs.) Series WE051211 WED712H WE1012H WE1512H WE0512HH WE1512HH WE0311L 115 9.4 N0. WE0311L WED311M WE0532H WE0732H WE1032H WE1632H WE0532HH WE1532HH WE0312L 230 4.7 _ WED312L WE0312M WE0534H WE0734H WE1034H WE1534H WE0534HH WE1534HH 1 1750 56 HI % Y3 Y2 % 1 1'/ '/2 1'/: WE0311 M 73 115 9.4 4 1750 1750 3500 3500 3500 3500 3500 3500 WE0312M 230 1 4.7 5 100 70 80 90 106 — 60 — WE0511H 115 13.0 10 80 65 76 87 102 112 56 84 WE0512H 230 6.5 1 5 60 57 72 84 100 108 53 82 WE0532H 208/230 3 WE0534H 460 3.4 1.7 20 36 45 ,65 79 95 105 48 77 y - 60 �� 25 / 59) 74 91 100 45 75 WE0511HH 115 13.0 w 3 0 67 85 96 40 72 WE0512HH 230 1 6.5 _3 40 61 79 92 35 70 WE0532HH 208/230 3 WE0534HH 460 3.3 1.65 , 8 40 26 52 72 86 30 67 a5 10 43 64 80 25 64 WE0712H 230 1 10.0 ° 50 30 54 73 18 60 WE0732H 1. 208230 3 5.4 3500 w ..._ WE0734H 460 2.7 ¢ 5 5 6 6 42 65 3 58 WE1012H 230 1 12.5 70 i 65 16 40 3 51 WE1032H 1 208230 3 7.0 70 5 26 47 WE1034H 460 3.5 75 14 43 WE1512H 230 1 15.0 - 80 WE1532H 208230 9.2 90 4 40 WE1534H _ 460 3 4.6 100 24 WE1512HH 1 ` 230 1 15.0 80 11 15 WE1532HH 208230 9.2 120 5 WE1534HH 460 3 4.6 metal parts, BUNA -N elastomers. METERS FEET • Temperature: 160° F (71 ° C) 90[ 1-1-1 1 1 .__.__ maximum. E MODEL 3885 • Fasteners: 300 series 25 so SIZE 3 /a" Solids stainless steel. • Capable of running dry 70 _.. _... without damage to 20 wEt µN { ..... components. c so ._. __ __ _ -► scPM Motor: W v .0 .. sFr L ..... • Single phase: 1 /3 HP, 115 or a 15 50 230 V, 60 Hz, 1750 RPM; o WE06H 3500 RPM; /z HP through (� _ .. /2 HP, 115 V, 60 Hz, 1Y2 HP,230 V, 60 Hz, 30 ` ...... ..... 3500 RPM. 20 1 _..... _ .. Built -in overload with E0 ; 5 ......... . automatic reset, class B insulation. 10 __ ----- __ • Three phase: V2 HP through o o 1 HP 208/230 V, 460 V, 0 10 20 30 40 50 60 70 80 96 100 110 120 GP 60 Hz, 3500 RPM. L I I , Class B insulation, overload 10 20 30 I protection must be provided CAPACITY in starter unit. 8 "t a�L'f+.x'Rx Wisconsin. Deparmwnt of Industry SOIL AND SITE EVALUATION REPORT Page I of Labor and Human Relations Division olSafety & Buildings in accord with ILHR 83.05, Wis. Adm. Code ►� , COUNTY Attach complete site plan on paper not less than 8 1/2 X 11 inch .,j,D size. Plan must include, but not limited to vertical and horizontal reference point (BM Qtjon!apol% of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance ,�nealrdst road. - - APPLICANT INFORMATION- PLEASE PRINT L-L INf ;QR*' AT ON R IEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION G ' X - C 2 T CY 0ll a „ < ; GOVT. LOTS w 1/4 N W 1/4,S3 T 29 ,N,R Ig wit) W PROPERTY OWNER':S MAILING ADDRESS LOT* ' BLOCK # SUBD. NAME OR CSM # 7 o2O S� CITY, STATE ZIP CODE PHONE NUMBf A u s: ��>.. ' 0CITY ❑VILLAGE ®TOWN NEAREST ROAD z C. 57 go/ Ois) 29,9 -.235 &-'j'9 2 O f = [)q New Construction Use [x] Residential / Number of [ J Addition to existing building j J Replacement [ ] Public or commercial describe Code derived daily flow 5 0 gpd Recommended design loading rate - 2 bed, gpolft . 3 trench, gpd/ft Absorption area required Z2 bed, ft 1 SSOO trench, ft Maximum design loading rate . 2 bed, gpd /ft trench, gpd/ft Recommended infiltration surface elevation(s) /O 5. ° ft (as referred to site plan benchmar k) / Additional design / site considerations o� &Iccz f/ °' °�/�7yv/�O -,4 �rlS/ - 61"d Q22i15k . Parent material Wiz` . 'Pe fe r s ��/V� S - 7 - 0/U J- Flood plain elevation, if applicable al �� ft S = Suitable for system CONVENTIONAL I MOUND 71N-G PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable for s stem ❑ S [RU ®S ❑ U S U ®S ❑ U ❑ S ]� U ❑ S S U 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 Trench j 3 /z .� .Z M Ak M G S 2 ,� - 39 s a N/G 51 / z Ground 3 9 -CIS ? :: 5 ,, R 8/3 '3,' ►�'1 �- - - ,� 5 elev. ft. Depth to ► �Sf . Pe �s 4 V I r� S - limiting f ac3� UJ �'6e t Sa►nc� Remarks: Boring # 3 kv Z 1 ,24. �, s e �l � C 3 M :56 10A b k � F , G s 1 F .2 3 ;t: X. «; v 3 5 D M Sq M A [ v-E .2 � Ground lev /D eft. SI -s� 7. K 8�3 S O Depth to limiting factor Remarks: CST Name: — Please P L J / Phone: /S .2 ,3,1, c7 4 A ddress: A / "7 / 10 Signature: Date: 1� ate✓ .�� Date: CST Number: 3,(9/0 aa6/s3 PROPERTY OWNER C- , �CrSV. SOIL DESCRIPTION REPORT Page of PARCEL I.D.# Q 45L ' JJ - 70 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft . in. Munsell Qu. Sz. Cunt Color Gr. Sz. Sh. Bed rends �.3 - 7. ' 5 u 313 5 Z m S k Yn �(� f W1. Ground 3 22 - 7 '-� R .5 elev. .� LD 5 .e 813 I'r') l � D v �F s �.• — — �/ S Depth to limiting factor,, I A t C3-1 . I Remarks: Boring # Boa Ground elev. ft - Depth to limiting factor Remarks: Boring # , r Ground elect. ft Depth to limiting factor Remarks: Boring # w >xn n Ground elev. ft . Depth to limiting factor Ll i T- Remarks: SBD- 8330(R.05/92) ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP P CERTIFICATION FORM Owner Buyer � N - w _.v�� � C�rtei' Mailing Ad tress g 7Q RID Property Address - "- (Verification required from Planning Department for new nstruction) City/State � ('[� ' Parcel Identification Number c* : !V 2 LEGAL DESCRIPTION Property Location S W y JV W 4, Sec. 3 6 . 7 N -R I !& Town of _ (�c�.�,.•r . Subdivision CcSn'I / y MY Lot # Certified Survey Ma p # Volume Page # W arranty Deed # 3 3 3 B G/ 6� Volume _ � s _ Page # Spec house O yes Eno Lot lines identifiable 0 ❑. no SYSTEM. ANCE Yeats or Impropecuseandma ofy,��cqd=oonldmmkkits consists Of p out the septic tank every three premature farTure to handle wastes. Proper�anee can fists Ofp func[ioa of the if neededby a licensedpamper. What you pat into the system tank - as. a tieatmeat stage is the waste avosalsyst m. Ile property owner agrees to submit to St. Croix Zoning Depart a catific adon form, signed by the owner and by a plumberjoumcym=pkmjxw ; =stridedphmg=or a hcrosedPM3pervmfymg fat (I) the on-uw viastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping.(if we=ary), the septic-tank-is less than in tall of shrdge. Ywc, the undersigned have read the above rcqakcments and agree to maintain the Prorate sewage with the standards set � fork 'as set the �m. by Department of Commence and tier Department of Natural Resources; State of Wisconsin.. Certification statin that �g Year septic system has been maiatamed must be completed and days of the three year expiration date. redumd to the St. Croix _County Zoning Offiic a within 30 ��L .e,- GNATURE 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 owners) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT F /171 / 6 O 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 r FROM : Thomas A. McCormack FAX. NO. : 17 Aug. 15 2000 08:25W P2 Yo1.1527 291 KATHLEEN H. WALSH REGISTER OF DEEDS D msnt m bar WARBANTY PEED S.F. CIROIX Co., uI RUM FOR RECORD Dorwes Farms, Inc., a Wisconsin Corporation, conveys and e7- 1 6 -RM 9:30 Re warrants to Gary F. Peterson and Julie A. Peterson, Ifrlf IVITr DEED husband and wife, holding as survivorship marital property �T FEES the following described real estate in St. Croix County, State C OPY E F ES 7 00 0 FEE, of Wisconsin: RECURDIRB FEE: 10.00 ' PA6ES: i Reeordi Name and Retum Address Thorne* A. MCCoMM* 1020 Iff AVC PO Sm 2120 f 8mWxin.'WI &W2 I� 042 - 1101 -90 (Parcel Identification Number) Part of the Southwest Quarter of the Northwest Quarter (SW '/4 of NW ' /a) of Section Thirty -six (36), Township Twenty -nine (29) North, Range Eighteen (18) West, Town of Warren, St. Croix County, Wisconsin, more particularly described as Lot One (1) of Certified Survey Maps filed July 11, 2000, In Volume 14 of Certified Survey Maps, at Page 3891, as Document No. 626218, office of the Register of Deeds for St. Croix County, Wisconsin. TOGETHER WITH, a right of first refusal on the balance of the South. PL of Northwest Quarter (S'j of NW,) of Section Thirty -six (36), Township Twenty -nine (29) North, Range Eighteen (18) west, owned by Grantor. Exception to warranties: all easements and restrictions of record. This is not homestead property. Dated this / 1 4— , day of July, 2000_ DORWES FARMS, INC. Js 'David Cowles, Presidemw kc.� AUTHENTICATION ACKNOWLEDGMENT Signffiure(s} STATE OF WISCONSIN ST, CRAIx COUNTY (�✓ " Personally came before me this j d 2000, the above named David Cowles to me kno n to be . pamon(s) autWnticated this J day of -- --- -- who executed the foregohg Inst um t an " Ove the same. / r agnsture rypa or prirrt nay type or pro ire TITLE: MEMBER 37AT 9AR OF WISCONSIN Notary Public 3t. Croix Cour ft tAliaC �: TI is not, My commission is permanent. �c ernhorizedby §70( � ) Tt'' THIS INSTRUMENT WAS DRAFTED BY •Names or parsons eigMng in any capaCltyeAordd be typed or Thames A. McC orma ck printed below their signatures. Baldwin WI 54002 + kdprnodan prersesiorcda Kona du lee. WimrN aWe6<�7l1 C 4 ..r►y m o f -•z U o o c 0 0 �0 CD W lD O S y w � ; �, , o _co 3 moR°`� °m °0o Q o 00 o N 0 fDa f1 rt a (r N y N x O n C 0 > > rtO O j 0O� a rt CO y 0 O C - _ N (T O -� y o �, w UNPLATTED LANDS o a rt t D rt M j• Q 0 07 O �< `G (A c a 3 Z to CD rt CD ZO y O (A N00 °14'48 "W 2645.72' N - -- N00'14'48 "W 2645.92' (record) ID —� - -- / — - - - -- -- \ Ct ` -#- 1 218.00' N00°14'48 "W 412.00' STREET 140TH •� - -- - - - - -- = ,' 2015.72' -'� 0 �1 o S00 °14'48 "E 412.00' f�' i CO N o N CO o 0 w — C - 0 w U o cn I Z -- ------- - - -- -o I Z o m C CD �< °' LA ° I r g(0 O (D r*i I r P D o ® y o D 0 0 to m 0o1 o I—I —1 p N ® W 0 rt S w !D ID o o ID o Z �� Z h 0 w I S00 ° 1 4'48 "E 412.00' I o J o w D D 0 O O z O� a) x O N '+ 00 V A O J C Ln c0 v c �+ o z n I W o 0 p n p 0, UNPLATTED LANDS � UO 0 m -n cn — cn -, Q Q O I L CA 0 rn East Quarter Cor. Sec. 36 Fd. P.K. Nail OF k a 0 CD o a t� ° , 3 cn > u' 0 0 N 2.0 � � c � D a 51 to b '0 y p I--a IT n y n f ►-► 6 n O �►��, 0 3 0-1 MCI dog o < N5 p � w ° N -� tZI O' O CD 3 V 1 O N -n rt cn m . 0 N � 0 0 o m m � x� �roxN = 3. ° �' co p CD 01 0 0 Oil 0 5 c tn, 0 to r — w w frl = O X Z J w� y 0 '< 0 Z o m C7 `t a cn y p p O " iA rt 0 j � D 3 (A 10 04 o 0 c N m ODOD O x- m o O 3 ° cD CD 0 If � 7 � 0 00 p rt m 3 m ° -2 CD r, m N p = 0 -•, W N Ql LEGAL DESCRIPTION A parcel of land located in the Southwest Quarter of the Northwest Quarter of Section 36, Township 29 North, Range 18 West, Town of Warren, St. Croix County, Wisconsin. Commencing at the West Quarter Corner of said Section 36; Thence North 00 degrees 14 minutes 48 seconds West, along the west line of the Southwest Quarter of the Northwest Quarter of said Section 36, a distance of 218 feet to the POINT OF BEGINNING; Thence North 00 degrees 14 minutes 48 seconds West, 412.00 feet; Thence South 89 degrees 54 minutes 01 seconds East, 423.00 feet; Thence South 00 degrees 14 minutes 48 seconds East, 412.00 feet; Thence North 89 degrees 54 minutes 01 seconds West, 423.00 feet to the POINT OF BEGINNING and there terminating. Containing 4.001 acres (174273 square feet). Subject to all easements, restrictions, and covenants of record. SURVEYOR'S CERTIFICATE I, Clarence E. Schultz, Registered Land Surveyor, hereby certify: That in full compliance with the provisions of Chapter 236.34 of the Wisconsin Statutes and the provisions of the St. Croix County Subdivision Ordinance and under the direction of Julie and Gary Peterson, on lands titled to DORWES FARMS, INC., DAVID COWLES PRESIDENT, I have surveyed, divided, and mapped the above described parcel and that such map is a true and correct representation thereof. L& 7 �G Clarence E. Schultz, S -2031 Melchert Walkky, Inc. Ql SCHULI E = SCH�UUZ 126 South Second Street ST 1 Hudson, WI 54016 MN WIWI rnNcTnx� v O =� -1 =­1 •+ HS � m�aea o P -n X e ";VZO -� N m . % o0= c� to t7 .`+" heep2 of 2 ea m r po g o mdEn H(n Vol. 14 Page 3891 �, yyyyyy . .lx+.v�Yftlr' /4PIP'�CaYM1aG' a= K...�.. o,9.aM9FrssN�aa.6adWSS4M'Me _'RdCt.�'+s+m .. •�'•"•- a:•••• Gpili�'YCiiat :uiOta9�11t�'0�is 7T . • 'WiculffNT No. STATR BAN or WISCONSIN -irorm 3 QUIT CLAIN NO 0! 1j�� PAG€ �� Tai SPACE sESE11VE0 ilia 1UGOe01NG DATA � REQ16M OFFICE ST. QW11 M, w+ , _JIQ 4 wstst Wiscons Cnrnnra iOn d April a X983 8 :30 A 11�: the following described real estate in rOIX _ County, 1 State of Wisconsin: aETUaii See Rider attached for real estate description. Tax Hey No. f This i8 homestead property. (is) (is not) Dated this 1st day of March , 1983. i _(SEAL) (SEAL,) We ley G Cowles G (SEAL) — (SEAL) Doris A. Cowles AUTHENTICATION ACKNOWLEDGMENT J-45i) gnatures authenticat d this_ —IS t day of STATE OF WISCONSIN g _$ as. _ County., Personailf cacao before me, this day of A . Beskar the above named TITLE. MEMBER STATE BAR OF WISCONSIN (If not. authorized by § 706.06, Wis. Stars.) l This instrument was drafted by Leo A. Beskar, Attorney to me known to be the person,.,_who executed the fore. 2 going instrument and acknowledged the same. I R iver Falls, WI 5 (Signatures may be authenticated or acknowledged. Both Notary Public County, Wis. are not necessary.) My Commission is permanent. (if not, state expiration j date: _ , 19 _ .) i 4 4 QUIY Z.LAIM DSID -fir ATE BAR Or WISCONSIN. FORM NO. 3 -1977 STOCK NO. 13003 ' VO RIDER attached to Quit Claim Deed - Nesley G. Cowles and Doris A. Cowles, to DORWE.R FARMS, INC., a Wisconsin Corporation Description of Rear I stue 1. The Northwest Quarter of Northeast Quarter (NWkM) of Section Thirty- Six(36), Township Twenty -Nine (29) North,,.,of Range Eighteen (18) West, St. Croix County, Wisconsin. (Per Land Contract between John J. MueTler,et a1,Vendors,to Wesley GXowles and Doris A. Cowles, dated Dec. 1,1981.recorded 12/2/81, at 9:45 A.M., in Vol.638 , crn pages 534 -535, Doc. #3747281 in the Office of the Register of Deeds for St. Croix Co., WI.)' 2. The Northeast Quarter of Northwest Quarter (NEkNW%) of Section Thirty - Six(36), Township Twenty -Nine (29) North, of Range Eighteen (18) Wsst,- St. Croix County, Wisconsin. (Per Land Contract between John J. Morrisette, et al,Vendors,,to Wtslsy G. Cowles and Doris A. Cowles,,Aeted December 1, 19$1:4. recorded 12/2/81, at 9:45 A.M. in Vol. 638, on pages 530 -531, as Document No. 374726, in the Office of the Register of Deeds for St. Croix Co.,.WI.) 3. The West One-half of the Southeast Quarter "(W-%SEk) and the Southwest Quarter of the Northeast Quarter (SW#Nft),`and West One - quarter of East One -half of Southeast Quarter (Wk Ell of SEk ),, Section Twenty- Five (25), Township Twenty -Nine (29) North, Rangy Eighteen.(181 West. (Per Land Contract between Leon M.Delanderand Marilyn T. Delander', Vendors, to Wesley G. Cowles and Doria.A Cowles, dated April 2,1980, i recorded April 4, 1980, at 11:00 A.M. in Vol. 610, pages 215- 216,as Document No. 363544, in the Office of the< Register of Deeds for St. Croix County, Wisconsin) EXCEPTING from the above described at #3., the following described parcel: That part of the Southwest Quarter of Southeast Quarter (S`JkSEk) and Southeast Quarter of Southeast Quarter (SEISE%) of Section Twenty -Five (25), Township Twenty -Nine (29). North, of Range Eighteen (18) West, Town of Warren, St. Croix County, Wisconsin, described as follows': Lot One (1) of Certified Survey Map filed November 10, 1981, in Volume 4, page 1129, Document No. 374388, in the Office of the Register of Deeds for St Croix County, Wis. ,. 4. Northeast Quarter (NEB }; also East One- 11a1 Northwest Quarter MjNWk) , Section Thirty -Five (35). Northwest Quarter of Northwest Quarter (NW%NWk),'except the North 24 rods of the West 10 rods thereof. Also South Half of Northwest Quarter (SkNWk), except the South 218 feet of the West 423 ,feet thereof,, Section Thirty -Six (36). All in Township Twenty -Niiie (29) North,. Range Eighteen (18) West. The above described premises contain �356'acres, more or less. (Subject to wortgRge to The Federal Land Bank of Saint Paul, recorded Jan.17,1975, Vol`. 519, pa 380 - Doc.+ #325402) St. Croix County, Wisconsin. I