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HomeMy WebLinkAbout004-1004-40-000 \ / \ / § \ 0 2 \ � j \ \ 0 - \ f � & / k ) \ � k ƒ � \ _2 ® )n \ — ■ \ c k E k/% S � 3 m f E 0 z —\ �a IL m cN j $ \ § \ � / k \ ( D z 7 \ \ . � { � < 0 \ Q \ k z z : \ \ } � % c: n /2 Z 2 (D § k 2 } o ® @ k LO § § § k 0 CL \ \ ? \ \ \ \ . 2 j § \ \ ƒ a) \ \\ \a » \ E\ \/ 2 7% a) © ;) 2 0 _ � ) / S ) 0= k m 0 Q / } < c » $ Q ƒ R { / % S - \ \ a ® @ f e o $ / / § % - 7 G f » & @ , a -0 $ @ \ § = g f / 2 ° = a ; ; r , « £ f C) w o = Cl) o z a z Y 2/ 2 £k (C \ CL k \ CL k k ) \ r - Wiscatsin Department of Commerce SOIL AND SITE EVALUATION Page . 1 of 3 v Oivision of Safety and Buildings °° + ( Comm 83.05, Wis. Adm. Code Certified Soil Testing Attach complete site plan on paper not`la��f I inch in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. -- - - - - Parcel 1,D. CSM pending APPLICANT INFORMATION -�B ease-print all information. - - -- -- - - - Personal information you provide may a usbd k�ecdndary purposes (Privacy Law, s. 15.04 (1) (m)). Reviewed By Date Property Owner ' "' D Property Location Hawk, Jackie Govt. Lot SW 1/4 SW 1/4 S 2 T 28 N,R 15 W Propert Owner's Mailing A drams Lot # Block # Subd. Name or CSM# 1858 1' yy odd Drive C c ' CSM From 004 - 1004 -40 _......_i � �' -> St 6 �33b1693 -- Cit Cady e City Town [] ty [ ] g Nearest Road Arden Hills k 50Th Ave. New Construction U Residential) Nu r of bedrooms 3 [ Addition to existing building I Replacement ��ulbqr-cor ercial describe Code Derived daily flow 450 god Recommended design loading rate - bed, gpolft2 6 trench, gpolft A bsorption area required 900 bed, fP 750 trench, ft Maximum design loading rate - 5 bed, gpolft - tr ench, gpolft Recommended infiltration surface elevations) 105.05 ft (as referred to site plan benchmar Additional design I site considerations install 4' x 95' rock bed mound on 103.8 contour as upslope edge of rock w/ 1.75' sand fill Parent material loess over till Flood lain elevation, if applicable NA ft S= Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U= Unsuitable for system n X U X S❑ U ❑ S U f -I S X U S X U i S X U Depth Dominant Color Mottles Structure .Consistence Boundary Roots GPDIft2 Boring# Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Bed Trench - 1 0 5 10YR 3/2 - sit 2 m gr ds cs 2flm � .5 .6 2 5 -12 10YR 3/2 - sit 2 f sbk [ ds cs Im 5 .6 4 -- - -- - r - r -- Ground 3 12 -24 10YR 5/4 - sit 2 m sbk dh cs if .5 .6 elev — -- -- 10 -- 4.6 ft_ 4 24 -29 lOYR 5/4 02 sbk dh � sit 2 m s as - 5 _ 6 Depth to 5 29 -35 7.5YR 4/4 c2d IOYR 6/2 SO 0 m i dvh - - NP •2 limiting factor 24' - Remarks. -- -- - - - - - -- - -- - - - - - -- -- 1 0 -4 1 OYR 3/2 - sit 2 m gr ds Cs 1 f/m .5 .6 z -- - - - - _ 2 4 -16 1 7.5YR 4/4 _ - A 2 m sbk dh C I f .5 .6 Ground 3 16 -28 SYR 4/4 f2d 7.5YR 5/3 SO 0 m dvh - - NP .2 elev 104.4 ft Depth to .. l imiting 16 i facto -- -- - -- - - - - -- — - - rt - - - Remarks: common Gy si c oats on p eds in horizon 2 CST Name (Please Print) Signature: Telephone No. i lenry F. Grote 715- 665 -2681 _ __ Certifi - Sot esil - ig - -- — Address tg Date CST Number Ref # P.O. Box 57, Knapp, WI 93/1999 222774 1224 PA PROPERTY OWNER Hawk, Jackie SOIL DESCRIPTION REPORT pa e 2 o f , PARCEL I.D.# _ CSM pending - -__ � Crt ified Soil Testing J Depth Dominant Color Mottles Structure GPD /ft' Horizon Dep Texture onsistence Boundary � Roots Bed 'Trench in Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0 -3 l OYR 3/2 - sil 2 m gr ds cs I f/m .5 .6 3 2 3 -10 1OYR 3/2 - sil 2 f sbk ds cw I im .5 6 Ground elev 3 10 -21 10YR 5/4 - sil 2 m sbk dh cs I if .5 .6 - - - - -- - - - -- - - - - - - �L - 103.3 ft 4 - 21 -28 10YR 5/4 1 0YR 6/2 sil _ -- — c�dT.5YR�7b - 2 m sbk dh as 5 .6 Depth to 5 28 -34 7.5YR 4/4 c2d IOYR 6/2 scl 0 m dvh !, - - NP 2 limiting+ - factor - -` - I Remarks: - - 4 1 0 -3 10YR 3/2 - sil 2 m gr ds cs 2flm .5 .6 2 3 -8 10YR 3/2 - sil 2 f sbk dsh cw lm 5 6 - } Ground 3 8 -16 7.5YR 4/4 - sl 2 m sbk dh cw if 5 .6 elev 102.4_ ft- 4 16 -26 l OYR 514 f2f 7.5YR 4/6 sl 2 m sbk dh as - .5 .6 Depth to 5 26 -36 7.5YR 4/4 c2d IOYR 6/2 scl 0 m dvh - - NP .2 limiting factor 16" Remarks: -- -__ -__ Ground t elev Depth to limiting _ factor Remarks: I Ground elev Depth to limiting factor Remarks: • z e I�a \�- ��lo� ��1a.�. 3116 n S� n �ve. w 46Q, ,P.O �k f " 1 •�� v t9.v�w 1'1 -4 t8 to q.9 P.A* 3 . l Ltn38� w.,tl poq_ took_ c.l ` o66 ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner Address City /State Legal Description: Lot Block Subdivision/CSM # '/4 '/. 4gL3, Sec. , T2EN -R-JC-� W, Town of "PIN # QC2q- It by - f (2 SEPTIC TANK — DOSE CHAMBER — HOLDING TANK t Tank manufacturer (li>ze ST/PC J60Q Setback from: House hL Well P/L Pump manufacturer 1 Model Alarm location `t (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: MLOe�� — Width� Length Number of Trenches Setback from: House 1 S Well Vent to fresh air intake i Z) ELEVATIONS Description of benchmark � � � crcA Elevation Description of alternate benchmark C bi Cey7j � e U, cx-? A Elevation Building Sewer o ST/HT InletC . a� - ST Outlet PC Inlet PC Bottom8�om Header/Manifold Top of ST/PC Manhole Cover Distribution Lines O rxo 3 O ( ) Bottom of System Final Grade ( ) ) 0 - 7. ( ) ( ) Date of installation /1 /WP erm' number TS al 3 _ State plan number 0 7 Plumber's Sig nature License number c � � Date 16 Inspector 4t, Complete plot plan or f v � NOTICE Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW C) 4� LL INDICATE NORTH ARROW sv t _ Wisconsin Department of Commerce Count PRIVATE SEWAGE SYSTEM y: Sasaty and Buildings Division { INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 353234 Permit Holder's Name: ❑ City [] Village [3 Town of: State Plan ID No.: Hawk, Jackie Town of Cady 270 63} -- -r,,, , i p, #b CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: (M - 0 1 1 0 0 , r c.�, "ox =CSC e we ( 004 - 1004 -40 -000 TANK INFORMATION ELEVATION DATA a� 2 $" 1 5 - , '27 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ODD /& f 7' enchma fZ ` r Dosing 67 *_ Alt. BM .Z. p z Aeration Bldg. Sewer �, � �j� T Holding St/ Ht Inlet A �( q4 89? TANK SETBACK INFORMATION S Ve TANK TO P/ L WELL BLDG. Air i ntake ROAD DI lulat Air Septic > `f o r r r NA Dt Betters Dosing S c(u r �� .� e r NA Header/ Man. Aeration NA Dist. Pipe 146,- Holding Bot. System e MM7 2 - PUMP / SIPHON INFORMATION Final Grad w (,( I. ewer l Manufacturer Demand St cover \ q Model Number 5 1�� GPM t I TDH Lift 0 Friction System {�- f � L Fi S TDH 2 Z ZAt Forcemain Length 43� Dia. 2 tr Dist. To Well � ( O0" SOIL ABSORPTION SYSTEM BED/TRENCH WidthLen No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS `1S DIMENSION SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHt anufacturer. SETBACK CHA R INFORMATION Type Of r r System: '� �'j0 " �0 OR UNIT j DISTRIBUTION SYSTEM z r Header / Manifold -1 Distribution Pipes) -7 It x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length 9D Dia. L- Spacing l r � (pp SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only (( ZO t Depth Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched s Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: /Z q Inspe tion 11 2• Location: 3116 50th Avenu Wilson, L (SW1 /4, SWIA, Section 2 T28N -R15W) - pending.,p w. 1.) Alt BM Description 11 2.) Bldg sewer length = g i - amount of cover = ? 3.) Contour= a t- *0 - 5 .8 C CID I Plan revision required? ❑ Yes No Use other side for additional information. SBD -6710 (R.3/97) �atQ . rk � Inspector's Signature Cert Na ADDITIONAL COMMENTS AND SKETCH f -- SANITARY PERMIT NUMBER: i I r r Safety and Buildings Division Visconsin ` SANITARY PERMIT APPLICATION 201 Box Washington Avenue Department of Commerce In accord with Comm 83.05, Wis. A e 8 Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the syste per t leis tdu than 8 1/2 x 11 inches in size. -_ r Ar P • See reverse side for instructions for completing this applicat'�r ��?�, , State ; Sanitary Permit Number Personal information you provide may be used for secondary purposes 1 Sr7 ❑ Cteck, i revision to previous application (Privacy Law, s. 15.04 (1) (m)l C�j� (� v7 StatZ,P1ap I.D. Numb I. APPLICATION INFORMATION - PLEASE PRINT ALL I �` 3 Propert Owner N me property atio ti'J _ T , N, R SE (or&� ) Prope wner's Mailing Addr ss Lot Block Number City, S to Zi Code Phone Number Subdivision Nam or CSM Number 6 S ( coo . TYPE B ILDING: (check one) ❑ State Owned " It ❑ Villa Nearest Roa age Public ja 1 or 2 Family Dwelling - No. of bedrooms _1- gLTown OF 111 BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo aD � - 1 00 4- V0 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. ❑ New 2_WReplacement 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 Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21A Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Pr 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 L J� Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation 77 7 5'E2 S' cj eet /07, 55Feet TANK Capacit VII. I NFORMATION in gallo Total # of Manufacturer's Name Prefab. Con- steel Fiber- Plastic Exper. New Existing Tanks Concrete strutted glass App. Tanks Tanks Septic Tank or Holding Tank enA 4)e j 42 ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ,0 1 & S; 0 1 / ❑ I ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plum er's N _pme: (Print) Plumb % Signature: (No St s) MP /MPRSW No.: �Buusiness Phone Number: ivy Plumber's Address Street, City, St a e, Zip Code): y 7 IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate Issued Issuing Agent Signature (No Stamps) surcharge Fee) t Approved ❑ Owner Given Initial Adverse Determination t X. CONDITIONS OF APPROVAL / REASONS FOR ISAP P OVAL: ass D-5 -,d. SS SBD -6398 (R. 4/99) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin 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 most be properly marntained. The septic tank(s) must be pumped by a licensed pumper'whLbnLaVer necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin; Safety and Buildings Division, 608 - 266 -315a = - 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. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A)' plot plan, drawn to scalp Or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if'required by the county; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. Safety and Buildings PO BOX 7162 MADISON WI 53707 -7162 TDD #: (608) 264 -8777 *isconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary November 02, 1999 CUST ID No.5176 ATTN. POWTS INSPECTOR ZONING OFFICE RED CEDAR PLUMBING & HEATING ST CROIX COUNTY SPIA 4792 STATE RD 25 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 11/02/2001 Identification Numbers Transaction ID No. 270637 Site ID No. 182947 SITE: Please refer to both identification numbers, Site ID: 182947 above, in all correspondence with the agency. ST CROIX County, Town of CADY SWIA, SWIA, S2, T28N, R15W Facility: JACKIE HAWK 3116 50TH AVE, WILSON 55112 FOR: Object Type: POWT System Regulated Object ID No.: 497511 MOUND/ DWELLING 450 GPD 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: • Existing septic tank and soil absorption field shall be abandoned as per ch. COMM 83 Wis. Adm. Code. 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. Sincerely, DATE RECEIVED 11/02/1999 FEE REQUIRED $ 180.00 C FEE RECEIVED $ 180.00 ROBERT KANTER , POWTS PLAN REVIEWER BALANCE DUE $ 0.00 AP Integrated Services D PA (608)261-7735, 8:OOAM - 4:30PM, MON -FRI D N RKANTER @COMMERCE.STATE.WI.US WiSMART';code:• 7633' SEE cc: JACKIE HAWK Jackie Hawk - Mound Transaction # Location: SW 1/4, SW 1/4, Sec. 2, T 28 N, R 15 W Town: Cady County: St. Croix Date: October 11, 1999 Owner : . Jackie Hawk Address: 1858 Todd Drive tkA Arden Hills, MN 5511 Plumber: Kevin :non �. Signature: •f License # MP 224229 Attachments: 6748 -Plan Review Application SBD 8330 P.O.WT.$. nditionally P ROVE D ?T 0 MMERCE OT SAF BUILDINGS page 1: cover -, 2: calculations ;ORRESPONDENCE 3: plot plan, F? O,W.T S. 4: system cross section 7nditionally 5: plan view, lateral detail 6: pump tank exit detail PROVED 7: pump curve RTMENT OFAbMMERCE OF SA D BUILDINGS 7,ORRESPONDENCE page 1 of 7 System Calculations One family residence bedrooms Loading rate gallons /sq ft per day Depth to ground water �� � �O in Depth to bedrock > 1 6 in Cross slope - Force main length _ ft of Z in Manifold /header length _ N q ft of in Drainback 71 1 9 .4 gallons Lateral' length @ '10. ft of Z in Lateral elevation ft (bottom of pipe) Lateral hole size �' 'in @ in ( S•O ft) spacing \ holes /lateral, � � holes total Lateral volume �' (O gallons i Total lateral- discharge rate zZ•Z3 gpm @ �'� ft head Elevation difference Zo•�a ft Friction loss x.66 ft @ 23 gpm Total dynamic head 'g �O ft Pump /si n IS gpm @ ft of head Manufacturer G oc Model # • It" + ' � `�'' Dose volur eq gallons Lift /si tank M'�"``i� ""�� � o• ob- t,a�o gallons Septic tank �'_'_Q gallons Measurement pump on & off k A in Height alarm tank bottom kg'6,r in Reserve capacity 1 + gallons Z � calcs page 0 f Kv►a •s.z�t i- �- J 4o � 0 . � o f J �• t a.G.w Li � �d'� �f` w...l O 2..e � / ` j► ` i • ', 004 O. w.,ll }'+ �e r. �a ( S 1 ( o N rX• ( +o e VC .� t ("' \Da\ o'% V. 45�4N. \ 1 u Lq w. 4. 16 S.aSI 1 Atr+y 1 h 3 a Z•2� 4' 0 15.0, Ir 0 4 •o' s. • ' � .., E-- f ' ` I L ` Tea. Q a.tD 0�►► c9 N .4 : tJ.) 1 w �... ..r It nv .� � 7 (` �y �0 1 ► O � o T Y Oa.lt wo.11 OS 4 f 0-46.6 641— z „- S•o� I S•a' • o o h a. 4.1. GiLu. � C \ ` cq 1.�'} •. WEA'r11ERPR0r)F JUNCTION LOCKING COVER - �c Lv iil►iv�++'� A ABE.0 . QUICK 4" C.I. 194%pu wape —T fair i ow c. vlvc 3' NOL�'TIJRB�Q 4 , C.L . SD IL. 24" I -D• VENT :LQY/ MANUOLE ., 3 . AiYit T � _ It. b•• ao.t pPta""M A c.s. vu CT O Wrs WFLES 1 nL 3' ono PINK - a T.- ON — lawastusl� +ECTIOKi �— 1 GRD41rD � � o • 4. , 3 g •� r� D ( CavGtEfE z • 6�o CMG Lev. n c a �ti� • (C T I SE /TIC t TANKS MANUFACTURER: I `•��� ~�� WUA6ER OF DOSES: PER DAy TANK SIZE: �� - O 6ALLOIJS DOSC VOLUME ALARM MAIJUFAGTI,II�LR: S , L�a-a `O IUCLU01/JCs OALKFLow: ' b GA LL0#4S 1 MODEL 1.JUJI 1& , Ot ~ CAPACITIES: A= 10 ���• Z° WCHES OR GALLONS SWITCH TYPE' ' L IbicHes OR 34 GALLOWS PUMP MAAJUFACTURCR: G_ G ` O.4- IiJLHLS OR 1 } GALLOW5 MODEL NUMBER: IF O D• L7A INCHES OR �O Z GALLOWS SWITCH TYPE: IJOTE' PUMP AND ALARM ARE TO EC MINIMUM DISCHAR" RAT -4 GPM INSTALLED ON SEP^RATE CIRCUITS VEKTICAL DIFFERENCE OETWICU PUMP OFF AAJO 013TRISUT101J PIPE.. FEET + MINIMUM NETWORK SUPPLY PKE66UILC ......... .. Z ' � FLET + ' FEET OF fORCC MA X 0 .9 1 F /pp/tFRICTIOU FACTOII. ' FEET � '2 ' w TOTAL Dy1JAMIC. HEAD 2 FEET lb 1 v - Sig " 10TERNAL DIMEW6101J6 OF TANK: LEW&TH ;WIDTH � ;LIQUID DEPTH Vertical ��' P0 MODEL DVP03 MODEL 3871 • • Su bmer§ib lQ kopt Pump GOULD5 r 1 a „ — J- Pump Specifications METERS fEET 7311P 10- MODEL: 3871 Up to 40 GPM Discharge size 1"N NPT s '° _ Solids: W maximum e Motor Single phase: 115V 6 20 Materials of Construction S Brass/thermoplastic ,5 ENS Features and Benefits ,° *Top suction eliminates Ef'04 impeller clogging. ' s *Corrosion resistant ' construction. 0 1 0 20 30 *Float actuated switch. ° 2 . C PACITY METERS FEET Pump Specifications Features and Benefits MooEL ovPO3 I/ and '/2 HP • EPO4 impeller- semi -open design ° 20 Up to 60 GPM with pump out vanes to protect s 16 Maximum head to 32' mechanical seat. 2 ° Discharge size 1 NPT • EP05 impeller - enclosed design o ,0 Solids:' /." maximum for improved performance. 2 Motor • Rugged glass -filled thermoplastic s casing and base design provides All motors feature ball superior strength and corrosion ° ° 0 S 10 is 20 25 30 46 .0 U.S." bearing construction. resistance. Single phase: 115V ° 2 cAPwcin • • WM Materials of Construction • Cast iron motor housing for Cast iron efficient heat transfer, strength, Thermoplastic and durability. Stainless steel • Corrosion resistant threaded stainless steel shaft. • Available foI automatic and manual operation. • CSA listed models available. All Models are designed for continuous o ration and feature stainless steel hardware. o S Wi scgptin'Department of Com SOIL AND SITE EVALUATION Page _ 1 of 3 D�visiorfof Safety and Building n accord with Comm 83.05, Wis. Adm. Code F Certified Soil Testing Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix percent slope, scale or dimensions, north arro ovation and distance to nearest road. -- - - - -- Parcel I,D.# I � ; CSM pending APPLICANT INFORMATION - print all information. - -- - Personal information you provide may secon4pry purposes „(Privacy Law s. 15.04 (1) (m)). evieWed B Dale,_ /S ^ q 2 Property Owner i >.+ Property Location (( I 1 Hawk, Jackie Govt. Lot SW 1/4 SW 1/4 S 2 T 28 N,R 15 W Propert y Owner's Mailing Addres I C r ',y Lot # Block # iSubd. Name or CSM# 1858 "Todd Drive \ D Rptx CSM From 004 - 1004 -40 sla {� ;�(� ry �� - Nearest Road Cit yftden Hills t� S� N66 =�33 ❑ city Village Town ti 693” _ Cad 50Th Ave. C New Construction 'I I'e�t0liJ N ., of bedrooms 3 { {Addition to existing building Use: X Replacement ❑ Pu mercial describe Code Derived daily flow 450 gpd Recommended design loading rate • bed, gpd /ft2 .6 trench, gpd /ft Absorption area required 900 bed, ft' 750 trench, ft' �i eslgn rate - 5 bed, gpolft2 .6 t rench, gpd /ft Recommended infiltration surface elevation(s) o ft (as referred to site plan benchmar Additional design I site Considerations install 4'x 95' rock bed moun 3.8 conto pslo�e dge o ock w/ I 5' sand ti C Parent material loess over till ood plain a vation, if a livable NA ft S= Suitable for system Conventional Mound In Ground Pressure AT - Grade System in Fill Holding Tank U= Unsuitable for system ❑ X U S❑ U El ®U ❑ S X U S X U i- ! S X U Horizon Depth Dominant Color Mottles Texture Structure iConsisten GPD /ft2 Boring# in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Boundary Roots Bed Trench i 1 0 -5 10YR 3/2 - sil 2 m gr ! ds cs 2flm .5 .6 j 2 5 -12 10YR 3/2 - sil 2 f sbk ds l cs lm .6 t Ground 3 12 -24 l OYR 5/4 - sit 2 m sbk { dh cs If .5 .6 elev - - — - - -- - - — - -- + fId - 73I'R 4T6 -- - 104.6 ft 4 24 -29 10YR 5/4 tOYR 6J2 sil 2 m sbk dh as S ! 6 _ Depth to NP .2 limiting - - -- - 5 29 -35 7.5YR 4/4 c2d 10YR 6/2 scl 0 m I dvh i i factor 24 - --e- Remarks: - __ _ _ _ _ ___. __ _ 2 1 0 -4 I OYR 3/2 - sil 2 m gr ds cs 1 f/m .5 .6 „. 2 4 -16 7.5YR 4/4 - sl 2 m sbk dh cs If .5 .6 r .. Ground 3 16 -28 5YR 4/4 f2d 7.5YR 5/3 scl 0 m dvh - - NP .2 elev- - - - -- - - -- — - -.. - - - -- -- - -- -- — - -- 104.4 ft_ Depth to limiting _ T factor 1 6' - -- -- - - - - -- -- _ �- Remarks: common Gy si c oats on peds in horizon 2 CST Name (Please Print) Signature: Telephone No. Henry F. Grote - 715- 665 -2681 --- CertiileaS — Ol estm Address g Da CST Number Ref # P.O. Box 57, Knapp, W1-54749 9/3/1999 222774 1224 PROPERTY OWNER: Hawk, Jackie SOIL DESCRIPTION REPORT page 2 of, 3 FARCd I.D. #._ pending Certified Soil Testing Depth Dominant Color Mottles I Structure GPD/ft Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz, Sh. Consistence Boundary Roots Bed Trench 3 1 0 -3 10YR 3/2 - sil 2 m gr ds cs 1 f/m 5 .6 2 3 -10 10YR 3/2 - sil 2 f sbk ds cw IM .5 .6 Ground elev 3 10 -21 l OYR 5/4 - sil 2 m sbk dh cs If .5 .6 103.3 ft_ 4 21 -28 10YR 5/4 c 1OYR 6/2 sil 2 m sbk dh as - .5 .6 Depth to 5 28 -34 7.5YR 4/4 c2d IOYR 6/2 scl 0 m dvh - - NP .2 limiting — — — -- - -- - factor 21" — — - -- - -- }. Remarks: 4 1 0 -3 IOYR 3/2 - sil 2 m gr ds cs 2ft m .5 .6 �m 2 3 -8 l OYR 3/2 - sil 2 f sbk dsh cw IM .5 .6 Ground elev 3 8 -16 7.5YR 4/4 - sl 2 m sbk dh cw If 6 102.4 ft_ 4 16 -26 10YR 5/4 f2f 7.5YR 4/6 sl 2 m sbk dh l as - .5 6 _ Depth to 5 26 -36 7.5YR 4/4 c2d IOYR 6/2 scl 0 m dvh NP .2 limiting factor Remarks: - - - - -- — - -- — - - _ - Ground - elev - -- -- - - - - -- t j D epth to ng - -- -- -- - - - - -- - factor - Remarks: Ground- _ - - -- - - - - -- - - - - -- __ - - - - -- -- - - - - -- — _ _- _ _ -_ - - -- .- - � - _ � __ elev -- Depth iting -- - - - factor Remarks: I 31 \6 S - +R4- JL— o L.a 40 IN 40 �+� z4-) ;q 3 0 0 4 •�) � t 5- w <« �l L oe .o� p,,%n 2. Lt "a Q L 9 \ S�. `- �.J_Qi1►: I ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer A �' c 1�L O *W K Mailing Address ( 9- 2 25 =C) C r Property Address I( � i� �1 _6: I (Verification required from Planning Department for new construction) City /State d 1 1 .6vil c ZT - ,S& / Parcel Identification Number On LEGAL DESCRIPTION Property Location LJ ' /4, ' /a, Sec. ,a, T c� N -R L5 W, Town of e&-� s Subdivision , Lot # 1 Certified Survey Map # �o l(Z� , Volume Z 3 , Page # Warranty Deed # .,( ��D� , Volume , Page # Spec house ❑ yes ❑ no Lot lines identifiable ❑ yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of a three year exp' "on date. NATURE OF APPLICA NT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of e roperty describ above b virtue of a warranty deed recorded in Register of Deeds Office. IGNATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application; a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed �M.1464 381 612363 SEATS BAR OF WISCONSIN FORM I - 19" KATHLEEN H. WALSH Document Num WARRANTY DF" REGISTER OF DEEDS ST. CROIX CO., WI This Dad, made between Galen R. Thompson, Thomas L. gEMiyp FOR RECOIS Thompson, and Randall G. Thompson by Galen R. Thompson, his attorney -in -fad, Grantor, and Jacqueline D. Hawk, Grantee. 10 -1999 9s00 AM Grantor, for a valuable consideration, conveys to Grantee the following VMM" bka described real estate in St. Croix County, State of Wisconsin (The "Property"): EXERPT i (AR FEE: FEEs TR MV8 FEE: 273.00 R I16 FEE: 2 .00 Part of the Southwest Quarter (SWtb) of the Southwest Quarter (SW%) of Section Two (2), Township Twenty-eight (29) North, Range Fifteen (15) Recording Area West, St. Croix County, Wisconsin, described as follows: Lot One (1) of Nam and Return Address Certified Survey Map filed September 29,1999, in Vol. 13, Page 3737, Doc. Jacque D east No. 611219 3116 SOtb Avenue Knapp, W1 S4749 004- 100440 Parcel Identification Number (PIN) 4 This is not homestead property. t t i Together with all appurtenant rights, tide and interests. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of enctunbrances except easements, restrictions and roadways of record. Dated this Y of 0 e46 ' 1999. r• • *Thomas L. Thompson �•'� /�� n. *Galen R. • attorney -in -factt for Randall G. Thompso " ys . AUTHENTICATION . ACKNOWLEDGMEI .-- .4p o , .12 Signature(s) y . . STATE OF WISCONSIN authenticated this day of Dunn County ) • Personally came before me this 4Y dlj of 1999, the above named Galen R. Thompson, Tbomm L. ompson, and Randall G. Thompson by Gallen • R. Thompson, his attorney- In4wt, to me known to be the TITLE: MEMBER STATE BAR OF WISCONSIN person(s) who executed the foregoing instrument and (If not, acknow )Vge the same. authorized by 1 706.06, Wis. Stets.) n ( THIS INSTRUMENT WAS DRAFTED BY William H. Tbedinga, Thedinga Law Firm • J'a �t.�� A. L— P.O. Box 3250, Menomonie, WI 54751 Notary Public, State of Wisconsin (Signatures may be authenticated or acknowledged. Both are not I Commission ip permanent. (if not, state expiration date: necessary.) 4 •Names of persons signing in any capacity should be typed or printed below their signatures wARRAIrrT DAD ' " sT s AR Or WISCONSIN . to" N..t.Ala INFORMATION PROFESSIONALS COMPANY FOND OU LAC, sal e00- 6552021 ` VOL 1 464PAGE382 Y5 f' _.fy.SnY4` ,s da SPECIAL POWER OF ATTORNEY - r I, RANDALL G. THONIPSON, of 3753 Chickasaw Ave, Springfield OH, r% 45502 hereby appoint GALEN R. THOWSON of 1105 Hwy N Roberts, Wl, 54023 my attorney in fact to act in my capacity to do any and all of the following: Closing of the sale of the following property located at 3116 50 Ave. Knapp. WI. The rights, powers and authority of my attorney in fact to exercise all of the rights and powers herein granted shall commence and be full force and effect on 28 September, 1999, and shall remain in full force and effect until 31 December 1999, or unless specifically extended or rescinded earlier by either party. Dated ' 1999 BY: fir- KE STATE OF OHIO, COUNTY OF w 4 Y�' A.E W LSOK Notary , ar n aid for L'^e State of My t3omn'kWm June a. H•» ty' . DRAFTED BY: RANDALL G. THOMPSON .- ;i , r ti 5EP 2 9 w� N di C ! CERTIFIED SURVEY MAP Galen Thompson et q I Located in the Southwest 114 of the Southwest 114, Section 2, T 28 N, R 15 W, Town of Cady, St. Croix County, Wisconsin. OWNER'S ADDRESS - 1 /05 C. T. H. "N " SCALE IN FEET 500 ROBERTS, W/ 54023 O 50 /00 200 400 600 D.O.T. Approval # 55 -94- 2914 -1999 BEARINGS AREREFERENCED TO THE SOUTH LINE OF THE SOUTHWEST I 14, SECTION 2, T. 28 N., R. 15 W. ASSUMED ! /l1 P As AS s 90 °00'00 "W. WEST 114 CORNER `'411 0I"j'i1/E1� 45Y 0/i•'/i_ /!C / 1 SECT /ON 2, T. 26 N., R. 15 W. N'LY R/W INTERSTATE HIGHWAY "94" b � N o, �o O �H 2 t~ i CJ �O W� M INTE - H /GH ,�VAY�g " ( EA ST B L 0 3 _ 4 '3 Q1 y p� NO ACCESS 3 O� S89 ° 5337'' ' I " Riw-x- SB9 ° 53 37 E /NTERSraTE /264.675cH /GHwar, 94" � 3't 50.00' F = - N 00 0 19 '16 "E 73.00 ' IJ— H /GHwAY sEreACK LINE Note: Soil boringswere -17.00' a conducted on Outlot 1- 3.00 C-) � OUTLOT / y o � no suitable area e a I r�33 I i W '` was found for a CONTAINS 1,025,514 30. FT. OR 23.543 AC. N nJ /00' I ' (965,962 SO. FT. OR 22./75 AC. EXCLUDING RIGHT OF .4 z N ) private septic 390.00'00 WAY) W :'_ rL � system. Outlot 1 341.92' M is not a build - NOTE- a 0S&O e ° 3 j able lot at this i I o I Q LOT I CONTAINS LOT / a o ' �;I i � time. i . rt M � 204,092 30. FT. OR m ; W a Ji �, 3 4.685 AC. 'n S WELL \ i C,I (192 SO. FT. OR N lJ� CSI 01e -' 3 ^'� DWELL /NGy �I C I I� w W 4.426 AC. EXC. R /W) o h Ex n` ubi o 'Z �� I p! I = /00' I , 1 DRwrl T 1 -- S 90 °0000 " 1279 45' W O . Ki LIKE ��; � ' - ` SETBAT `� S. L INC Z'I W I i f3�t" o i 3 00 d�� [h °o. I ►�l SWV4 "I M 660.90' �l 34/:92' P76.63 M — CVaVV7 r - -- S90°00'00 "W /3/2.36 S90 M /3/2.36 —_ —� -- SW CORNER SOUTH 114 CORNER SEC. 2, T. 28 N., R. IS - S90 0 00'00 "W 2624.72' -- SEC, 2, T. 26N.,R. 15 W. , ^ cr I , _, /_ h/ ILL. L•+I ✓� I ✓V7 /V�,J / , L,�I /LI,/ `J C �'i CAUTION ���� N S/� ��'i HIGHWAY SETBACK RESTRICTIONS �V- ••'•••_••"••. PROHIBIT IMPROVEMENTS INCERTAIN •• ��� (I �j AREAS. SEE SHEET 2 FOR DETAILS. 9 - LAUR C • m • W o. LEGEND APPROVED eft IVER FALLS, ST. CROIX COUNTY ' J • W o SET / "X24 "IRON PIPE Plonning Zoninq and Parks Committee F .... (MIN. WT. /./3 LB. /L.F.) �'•. LANO 19 COUNTY SURVEYOR'S MONUMENT(BFRNTSEN MONUMENT) *- FENCE LINE (f not maotdod within 30 days of OPPMV41 date mpproval shah be D0 and void DATED. JULY 2, 1999 THIS INSTRUMENT DRAFTED BY ✓ERALD L. LARSON SHEET / OF 2 Vol. 13 Page 3737