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HomeMy WebLinkAbout004-1069-90-000 \ � \ 2 0 E ° J■ } _2$ § t«;E [ =�> aEc E $ &rsa£E $ 222 §%/ 2 @/ 7J . \ -�$ a • ; ƒ ( �0cm )& r 2 ,® $ § fJ , V =%a\ -» ;& � $ o m—co 0 ƒ £�kJJJJ77)} \ U CO k .e &S =)p o \$�S$E0) 4)E % < _: r— CL 0 C $ q \ \ 2 § z ¥ ) t § f 2 U) _ § E m [ \ j % $$0 \ z z 0 } ) z i $ � G } w § Lo ° 0. ; � § 2 2 R / A \/ • > \ \ g B ° ƒ ■ U \ % 7 § ƒ 0 v co ' \ / f 6 © 0 & < § § e q � / I = @ 2 \ ® � �$ m co � ■ ] � k <« ' U k c, G Q § a o 0 m\ j -0 o 0 0 2 \ \ J ; a / / / / f § / p � \ R k § § k ] \ j § 0 § 0 0 ) n o ;D mm o z 2 E$ a � 2 # k I - ,ft uIL a § , . ƒ J a 2 o$ J Page 1 of 1 Pam Quinn From: Doug Clary [DClary@co.chippewa.wi.us] Sent: Thursday, March 04, 2010 9:49 AM To: Barron -David Gifford; Buffalo - Paul Van Eijl; Doug Clary; Greg Gruna; Tony Roder; Clark - Steve Kunze; Clark - Steve Schwanebeck; Dunn - Cleo Herrick; Dunn - Mike Helgeson; Eau Claire - Mary Lemke; Eau Claire - Rod Eslinger; Marathon - Dale Dimond; Marathon - Dean Johnson; Marathon - Jake Sedivy; Marathon - Jim Burgener; Marathon - Justin Cavey; Pepin - John Egli; Pierce - Brad Roy; Pierce - Emily Lund; Pierce - Jim Kleinhans; Polk - Gary Spanel; Polk - Nancy Snouffer; Polk - Roxann Moltzer; Alex Blackburn; Daniel Sitz; Kevin Grabau; Pam Quinn; Ryan Yarrington; Trempealeau - Carla Doelle; Trempealeau - Emery Palmer; Trempealeau - Kevin Lein; Trempealeau - Kimarie Estenson; Trempealeau - Rod Stenulson Subject: When is a structure a dwelling unit? All - A little humor - hopefully! I am assuming that Jim Burgener would be the only individual that would know the true definition of "yurt". For those who do not - read below. (This appears on the DCOMM safety and buildings website.....) - When is a structure a dwelling? A dwelling means any building that contains one or 2 dwelling units. "Dwelling unit" means a structure or that part of a structure which is used or intended to be used as a home, residence, or sleeping place by one person or by two or more persons maintaining a common household, to the exclusion of all others. Examples of dwellings would be: a year -round site -built home, a modular home, a duplex, a vacation home, a home that is rented out, a cabin that is rented out, or a yurt structure that is left in place as a residence or rented out. According to Webster's New World Dictionary, 2nd College Edition, a "yurt" is a circular tent of felt or skins on a framework of poles used by the nomads of Mongolia. Please do not confuse this with a "tepee ", which is defined as "a cone shaped tent of animal skins, used by the Plains Indians." Lesson learned: If Genghis Khan would have built a cone - shaped shape tent - we would not need any type of UDC permits to live in a Yurt. See you later - I heading home to my YURT! �^" 4" Planning & Zoning Administrator Chippewa County, Wisconsin (715) 726 -7941 Planning & Zoning Department Website 3/4/2010 ', � o � !' 30 I ry .. � M � 01 b �O i O M 0 C ! g E ti 0 c c o Z O ,orn cu 1 m o a> a L ?� o. N m 3 'r f6 2 O_ 7 N •C Q In O 'U 0 a 0 N O N O C t_ Ol N N U c6 y 3 f6 0 N O C Y U N C L C l O Q' O O �0 a U •� N 0 O N ! "O N Er m mv ��� a 0 (6 O U c O to N Q Z N a N 0 c c O c9 .- (n O .r N c c Z amY E (0tn. O E ° C -9 lL C@ C ik p a j c9 N O) U '- N C = N C O ) E Q m.5n.� a3� `otn °? N M 0 CD I o cn 0 Z N y y 00 a m N H U) ! • O N o Z ! a d Z u> N E 0 N ` E QA `0 0 0 N O O O • �i N C U \O ' O Q U +_ •- _O Q z z o z O Z N O 2 CL co D a u LO 6 0 0 0 a •N _@ > a a a L 9 N oyl U ) a N J U rn O } Z� 0 0 0 f > (D LO Q o _ O D N N O O C) i f) L m O CL N Q A (A m '- O O o N W C �+ .� r O E O O Q O O U > O O V I� V 0 m ua °oo L 30 X N O B • [ O T U O a+ N w C NM 0 N - O ;; dt 3 € n. • C d .2 m a E c c :: t A va2ii 00) i State of Wisconsin 1 DEPARTMENT OF NATURAL RESOURCES 101 S. Webster St. Jim Doyle, Governor Box 7921 Matthew J. Frank, Secretary Madison, Wisconsin 53707 -7921 WISCONSIN Telephone 608 -266 -2621 DEPT. OF NATURAL RESOURCES FAX 608 - 267 -3579 TTY Access via relay - 711 RECEIVED OFFICE March 15 2010 g 2010 Project No. S- 2010 -0245 MAR Mr. Robert Ulbricht gT. NRO►X ta4G O PLANNING & ZONyNG OF Robert Ulbricht & Associates 2812 10` Avenue Spring Valley, WI 54767 Subject: Proposed Holding Tank Installation For Fish Processing Room -- Spring Valley, WI Dear Mr. Ulbricht: I have received and reviewed your recent transmittal of completed WDNR form 3400 -185 in reference to your proposal for installation of a new wastewater holding tank to serve your fish processing room associated with the private fish pond operation at 2812 10` Avenue, Spring Valley, WI. According to your transmittal, the proposed holding tank will be used to store non - domestic wastewater, and the stored wastewater will be hauled by Robert Ulbricht & Associates to a DNR approved land disposal site. Based on this review, the proposed holding tank installation is acceptable to the Department of Natural Resources. Please contact Pete Skorseth (WDNR Baldwin Service Center, 715/684 -2914, ext. 108) for information regarding coverage under the WDNR land disposal discharge permit for non- domestic wastewater prior to installation of the proposed holding tank. Also, please review the conditions of approval as outline on page 2 of the submitted WDNR form 3400 -185 prior to activation / startup of the proposed holding tank. If any questions concerning this acceptance notice, please contact Steve Smith, WDNR Madison office, 608/266- 7580. Sincerely, Stephen J. Smith, P.E. Wastewater Section Bureau of Watershed Management Cc: --�' Mr. Kevin Grabau -- Admin., St. Croix Co. Zoning Dept., 1101 Carmichael Rd., Hudson, WI 54016 Pete Skorseth -- Baldwin Service Center dnr.wi.gov wisconsin.gov R ded, d Paper Wisconsin De rtm F -JFnrmerce PRIVATE SEWAGE SYSTEM County: Safety % and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: ST. QRD Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 3 30972 Per ilMa N : El City E] Village Town of: State Plan ID No.: UL R ROBERT 314 - P� _ j ~i; • 1✓� ) CST BM Elev.: r Insp. BM Elev.: / BM Description: Par Tax No.: /O , Z� pz- Z/ C57"gwl Z 004 - 1669 - 90000 TANK INFORMATION ELEVATION DATA Agsiatz7v TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic � � � Benchmar 2 1q.02 03' oz • Zi Dosing -L ao ,� �Sd s ( Y. (c6 - z( (� - Z—( Aeration Z ►�Qcsir� Bldg. Sewer Q, 7-L( 1/6 . Holding St/ Ht Inlet 3, [( 1/; - $ } ` I TANK SETBACK INFORMATION St/ Ht Outlet 3 6y Ventto TANK TO P/ L WELL BLDG. Ai Intake ROAD 4ikt-Inle N. J tot- la$ Septic > ' ''3a �{- NA W Bottom STAG ��,2a oZ, }S Dosing > >C(p t > �� > NA Header / Man. NA Dist. Pipe I rng Bot. System Z `�`�• PUMP/ SIPHON INFORMATION Final Grade Manufacturer '2OEcie - Demand �` _ L � 1 , $V //S . 53 Model Numb C 1 $ - �,� ('( P /O S. 3� bN TDH Lift F ction System TD 1 t / Ca Forcemain Length-t.570' I Dia. 2 '' Dist. To Well f SOIL A SORPTION SYSTEM -� 3 " = J�(c�►''c { BE-DkTRENCHJ Width / Le h f No. f T nches PIT No. Of Pits Inside Dia. Li uid Depth ' DIME I S 46 1 DIMEN I N SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEAC G ufacturer: INFORMATION Type O n s �p� y (fi > 3CsD t CH UNIT el Number: System: .- DISTRIBUTION SYSTEM Header / Man Id 4 Distribution Pi e(s) t u x Hole Size x Hole Spacing Vent To Air Intake Length Dia. 2 Length Dia. _Z_ Spacing I/ ft O � SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Dep Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed/ Trench Edges Top i ❑ Y s ❑ No Yes E] COMMENTS: (Include code discrepancies, persons present, e T (Ll f ( = 9 - 9 Z ' — ,291 LIXATION: CADY 29.2 . A , S, Sin] 2812 10TH AVENUE ,__ 13 A Plan revision required? ❑ Yes Y3 No Use other side for additional information. Z� SBD -6710 (R.3/97) �Irpector's Signature Cert. No ADDITIONAL COMMENTS AND SKETCH ' SANITARY PERMIT NUMBER: e } e . e s i w e s e e ° F 4 i E g e , e E a E e f a , . .. ., _ ._ .. } + t } 9 . 3 3 ,... .... ro me ........ �.F. ...... s .. _ ..._ .... ... ._._ . .. i d u _ r E � 1 s � v . re .w I q a am o-n .� F « } q s E 3 } F a _ e E } � � 4 i a e 3 q e d E t F s � I k a � � 3 j } F „ I f i7� a•�,e,l.K /102 /DA l9 -e � y Safety and Buildings Division ,,�► SANITARY PERMIT APPLICATION 201 W. Washington Avenue lsconsin P O Box 7302 Department of Commerce In accord with Comm 83.05, Wis. Adm. Code Madison, WI 53707 -7302 • Attach'complete plans (to the county copy only) for the system, on papor not I0ss than 81/2 x 11 inches in size. 57 _ • See reverse side for instructions for completing this application % StatOUUAkry Permit Number Personal information you provide may be used for secondary purposes k i i on to previous application (Privacy Law, s. 15.04 (1) (m)]. ` e Plarill.W.Number I. APPLICATION INFORMATION - PLEASE PRINT ALL 'INF I ' AT + 1 0 111 V 17J 7 YS P e Owner Name_ 0 45701f L& _,�� K • �l!l�IZ �'�}.57�7/P l�i'Y /F /.rLt /W `I y0 t /4 f (ti � 1 , N, R � s E (o'tC =" / Property Swner Mail in Address L N ter Block Number Cit ,Stt Z� Phone )3P6i�/ Subdivisl a e umber II. TYPE F B IL ING: (check one) ❑ State Owned 2 p ci y Ia e C,9- J Nearest. Road Public 1 or 2 Family Dwelling - No. of bedrooms Town OF /0 ' 7 III BUILDING USE (If building type is public, check all that apply) Parcel Tax J� 1 ❑ Apartment/ Condo u� 3 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 online B, if applicable) A) 1. 4New 2. ❑ Replacement 3_ ❑ Replacement of 4. ❑ Reconnection of 5, ❑ Repair of an Syrstem System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number 3 3 Date Issued 7 V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21,§ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 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 �SD R 3 uir� (sq. ft.) Proposed (s .� (G�s1�ay /sq. ft.) (Minh) ��• �j� Elevation 7 T Feet Feet Capacit VII. TANK in Ca allo Total # of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturers Name Concrete con Steel glass Plastic App New Existin , structed Tanks Tanks 1 7 Septic Tank @e44otdrRgiartk � ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber 7 Sd ❑ I ❑ ❑ I ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (No Stamps) P /MPRSW No.: Business Phone Num er: T-oB�,z - - ?W&BR z2037s ��s•3�'G - Plumber's Address (Street, City, State, Zip Code): 37 6 / r IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate Issued Issuing Agent Signature (No Stamps) Approved F1 Owner Given Initial su rcharge Fee' Adverse Determination �`�,? J� 11 � i u 1 X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -6398 (R. 4/99) DISTRIBUTION: Original to county, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS # 1 1. A sanitary permit r; vaIWJor two (2) years. ` 2. Your sanitary permit may be renewed befo&ea Ie expiration date, and at a time of renewal any new criteria in the Wisconsin AdministratiVe bd�eU' d1l be applicabl4r'; • o 3 All revisions to this permit must be approved by the perr 1 issuing authority. 4 Changes 1 Mp or ptumber�equires a Sanitary Permit Transfer/ Renewal Form (SBD -6399) to be submitted to the county prior to installation ; 5. Onsite sewage systems must be properljrmaintained. The septic tank(s) must be pumped by a licensed pumpefwhenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the,$tate of Wisconsin, Safety and Buildings Division, 608 - 266 - 3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide th6legal tlhescriptiori and parcel taxp'umber(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. V11. Tankinformation. Fill in the capacity of every hew /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. .(. <ounty/ Department Use Only. Complete plansand spgcifications not smaller than '8 1/2 11 inches must be submitted to fhb county. The plans rnust 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 specKications for pumps and dose volume; elevation differences; friction loss; pump performance, curve pLfPnp moq* -,pnd pump maFlufacturer` D) _cross section of the soil absorption system if required bythe county; E) soil.test data on a 115 form; and F), all sizing information. ------ ----------- --------------------- ------------------------------------------------- ----------- --- GROUNDWATER SURCHARGE r t 1983 Wisconsin Act 410 included the creation of surcharges (fees) fora n6mb.er of regulated practices which can effect groundwater: ` The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. r T • I Safety and Buildings PO BOX 7162 • MADISON WI 53707 -7162 TDD #: (608) 264 -8777 Y"isconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary May 25, 2000 CUST ID No.226375 ATTN: 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 Identific N. 374 N umbers PLAN APPROVAL EXPIRES: 05/25/2002 Transaction ID No. 317745 Site ID No. 172995 Please refer to both identification numbers, SITE: above, in all correspondence with the agency. Site ID: 172995, ROBERT ULBRICHT - CASTORVILLE FISH FARM ST CROIX County, Town of CADY; 1028 10TH AVE, SPRING VALLEY 54767 S1 /2, SWl /4, S29, T28N, R15W Facility: ROBERT ULBRICHT - CASTORVILLE FISH FARM 1028 10TH AVE, SPRING VALLEY 54767 FOR: Description: REVISION TO TRANSACTION ID. 227340 Object Type: POWT System Regulated Object ID No.: 470085 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 onditions shall be met during construction or installation and prior to occupancy or use: g g P P Y • 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. CAUTION: Wis.stats 145.135(2)(b) indicates that the approval of a sanitary permit is based on regulations in force on the date of approval. The effective date of COMM 83 revisions is expected to be July 1, 2000. Thus depending on the type of system and your design, this plan approval may not be eligible for sanitary permit approval if submitted to the issuing agency on or after July 1, 2000. Note: There is a otp ential for a lawsuit that may delay the effective date of the code so this status may or may not change. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. ORIGINAL r ROBERT W ULBRICHT Page 2 5125100 Sincerely, DATE RECEIVED 05/18/2000 FEE REQUIRED $ 60.00 FEE RECEIVED $ 60.00 JAMES B QUINLAN , POWTS PLAN REVIEWER BALANCE DUE $ 0.00 Integrated Services (608)266-3937, 7:00 AM 3:30 PM MON / FRI JQUNNLAN@COMMERCE.STATE.WI.US i 3 cc: ULBRICHT & ASSOCIATES i I i U;-BRICHT & ASSOCIATES CO. 655 O'Neil Road • Hudson, Wl 54016 Reg. Designers of Engineering Systems 715-386-8185 Private Sewage Consultants RECEIVED P MAY 1 7 2000 � � -f D PROJECT INDEX SAFETY,& BLOGS. DIV DILHR Plan I.D. # 2- - 3 VO Date AAY it ryy9 Owner RVAER7 k'ATIfy 2AL(3RiCkT 3 j o/ 0 0 S Phone Address ' A-- I -e it 0 PSO ^0 , 40 S 6 t (10 Legal Description 3 f- 5 4" 7 166 1 SO 0 Ilk Y2. 0 PO kq S T . R 1,5 4-7 Town of r -- County caoe - V -------- A-p, _ __ _ ____ ._ _ ....... C-S.T. 'Reseer 2{tgjejcA7 z ,&3-)-5 Installer Local Authority/ Supervision 5 egoN Cry. Zo6jA3& PROJECT DESCRIPTION REPIAC&-tEA5 T SY S &A-i j 13 v bole 4 "U&CO - 2 - 3 13EVRM. #etmff. (0 Z- P e'*f1;0 7 / P- X^- 6 V� J . JDA f (-y W A S T e F to L,, svils l ��/��� �lE' �• Y�S� �'1��� `l�j�.2 Qty T" :5 e+S&A -1 ' 4 ",y S*r 4 3. 4 10 A�5 - - 140omp Svs 101W,- /.2." Sjov /5 ?,edlpeselo RE,// 5/0,V pe, 4 V S At lCit, *UE- h,*u, / f /3&k 1 up j e eo ,,, A 4PPI % 770W,4 Z-- JW4 5 7 C�IGU G,f-T� . �U S�" yo�v Lrv��P �,v S �vc� -�o� ov �y 9- lleFPkta- 1 3V7 - 5 Y57 - -`A1 5/7/f// Pg.1 PLOT PLAN VIEWS O"`" . Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWS ocoly Pg.3 PIPE LATERAL LAYOUT DEBT VL Pg.4 DOSING CHAMBER CROSS SECTION OWN. VW81 P9-5 PUMP PERFORMANCE SPECS I G, \0 This design for installation is based entirely on measurements, elevations, landscape conditions ( slopes etc.) and soil suitability The accurac provided by CSTM of the csTmi Of his specs, as reported, shall remain the sole responsibi ( - .-- • "0 C ".. Any use of this POWTS design by any licensed Plumber or any related unlicensed Parties or Persons (excavaters, laborers) ,- 1 shall not be construed as an assumption of responsibilit by c0T. A%L; "ia"G; t he designer for the workmanship, construction, Placement, any assumptions by the plumt substitution or selection of any components not specified, or are state approved or proper er that any unspecified componentsi if working or of Poor . C , g under adverse damaging the weather effects ti condi jt, 80118) by any such Parties or Persons. (we judgement j L /frozen m rte. r 6` 4j i = O VN C r jd i 1 y O o O ? /lot \ \ �1 O I � r �• J � a :,1 v • o Ki 4 9� w SE3 � y V i � M N =� 1A o Q 1 P5 z of 5 EC—P�O�ss SE IOAJ OF M O uAJ D -- w i r h f3 e [> Den OF 0 '' ro Di STRi(3vTiok Z A5liPt -SgTE' G, pip ►>v6 -- 'IF Tclp S V i L s Ys TEM e Vui FARM ToE E RATIO Mao. I •. �9 PlowEa T o P 8 % ��� SIopE r E OR F °RM E t rvAT BEV Q � • UQ F r — E.t_ E V h T'l o ►J 5 --- E. +�f Fr. • IMVERr OF ?i IATiE - RA(S !• �a F FT. G l•0 Fr. TOP of R ock /Do• 3y N . ' • To ° r IATU Is / 5 FT. P R A PLA VIEW of Mou-�jD -- wtrri 13Eo F r K �Z Fr w --- - - - -_- - - -j! 1 —8 FT a r 9 . 00 l e F r f3�17 OF /2 PVC. cAPPEU To l y'► 013SF-RVATICAJ A 93 PEI ATe PipEs PERMAuE MARKERS RECgviReo BASAt- /!R T Ni r_y whSrE Fl ow S 01 t_ 1 r 1 1 T E C APAci ry I PRopo5Ed 1 ASM APe _ B t z 7& x ( 5 + /4P l,SgC� ` s r T. r �c►�rr��t �`^A EFc�Lp 10 k) Pipe tiErwoR k TOT V vLUMe- d F L A - re Ri L I r P 1�r 5 r30T 10 0 ../ LATER I;NV CAP I � Y \3 C, FoRIC E Tv 9/ M �. i N ,vC 91136 5)60 LAST violE 5 I1 (3E NE >CT To END GAP V O I D Vv l uM t FO R 1 I.I VER T fv IEVA rIO aJ d F Z N FORCE M �• • . JA / / • �d r I PEI ?FvRArED PIPE DET-Ai I a HolEs 10CATED oA, (3VTI SHAII 13E I - `I VARiA(5LE' y 5PACED . Y DtSTANcE p 7 2 r -r HoIE DiAK1 =TeR IN• D N/� T! ATERA t- r` // MAoi FoLD " /- IN . - �uRc� MAirV a„ t�• Y yf3 IIJ�l.ES o 1401Es p; PE . 4? DlGTRi C3oTIokj DrS�HARvE RATE E Z•�" ' P R LARA L Z GA T OT'At, - D15C:11AR bE BATE NErtk)0R I • 2Z. 6 k / M 'P -�s PUMP CHAMBER CROSS SECTION A N D SPECIFICATIONS pf}y,r , ef o r 5 -VENT CAP 4 "C.I. VENT PIPE ooa, WEATHER PROOF APPROVED LOCKING P FROM D JUNCTION BOX MANH E COVER WINDOW OR FRESH 12 "MIU. w Gi,?r«lv / 6! ,144/ AIR INTAKE �E1/^TYOn/ GRADE I 11�A�D� � I 4 " MIN. kill �D A CONDUIT y� -- -------- PROVIDE -- INLET AIRTIGHT SEAL I I I I II APPROVED JOINT A y 11 9 `' K 1 I APPROVED JOINTS 1J /C.i, PIPE IN 1 �' fo { l I I W/C.I. PIPE EXTENDING 3' '06 1 1 1 11 1 ALARM EXTEUDIAIG 3' OVJTO SOLID SOIL ONTO SOLID SOIL ow Fl o I I ELEV. FT. __) 2 1 PUMP OFF u 3 SE Ore �� �DO 'g� BLOCK (r K I I n� RIStR EXIT PERMITTED OIJL4 IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E 5PECiFi DOS t .3 TANKS MA"U FACT URE. R. WMBER OF DOSES: PER DAS TAN SIZE: 750 GALLONS DOSE VOLUME �DD ALARM MANUFACTURER: �_U -LL , Af U INCLUDING SACKFLOW: GALLONS MODEL NUMBER: _P V L CAPACITIES: A= / INCHES OR GALLONS SWITCH TYPE E 101-r- S 1 Yeg 8 = 2- INCHES OR 321.5 GALLOWS PUMP MANUFACTURER: ce - C Q = � 5 INCHES OR /&o GALLOWS MODEL NUMBER: H D= � INCHES OR 21 -LE GALLONS SWITCH TYPE: �75Y/...�'T 7 'T NOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATE ��/ �GPM, INSTALLED ON SEPAR CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTIOU PIPE. FEET - rA� F /� SP IE L' S y� F- M NETWORK SUPPLY PRESSURE .. . . . .. . 2 . 5 FEE? EAC,(_ Of' �� P ik -t- �C7 FEET OF FORCE MAIN X ZlS FyoFLF RICTION FACTOR.. FEET .-kvr Ads. TOTAL DYNAMIC D HEAD = 0 Sao FEET INTERNAL. DIMENSIONS OF TAMK: LENGTH ;WIDTH • ;LIQUID DEPTH f - ZOELLER EFFLUENT PUMP MODEL,'98 11EAD CAPACITY Cuhve MOIDEL "91)" 3 7/6 I 1 1 s 5/e is— s 4 33 /14 e _ 1 1/2 -11 1/2 NPT UTUS I-- -- - ---� 0 40 �o eo Iso 210 o 4 - fLDj PER MINUTE tor,u pryr,Aya Nt�M*eW ttA l CAPAtrl f2 - .. VNt►tvM,N mt U211ne tU1to trne V � e I'" it pis U t la o s1 � 5 t to l 10 t1 110 � s Lock V" y_ J S /IS CONSULT FACTORY FOR SPECIAL APPLICATIONS Electrical 8"9111elors, for duplex ayslems, are avallabte and Supplied with an alarm. a Mercury float switches are available for controlling ►.MschW*W als natore, tar duplex eyelema, ale available w e three phase systems. single and wllhoN Harm switches. e with Double 1 yback mercury float ewdches are available fog variable level long cycle controls. Standard all mode - Weight 39 Ibs y eILICTtom ouIDa s I .P. 1, snleprd "*at opell"d 2 Pole rnOahe,k:d swheh, to s ""bol required. N aeries t. elnela P199Ybeck mercu W Am s el C ,s lrol 9e1se11on__ ewkch. nebr b FM0 /77 1V ew h of double p�i0y k mercury, 0.6 L' Du lax 2. Mechurkal dlernstoi io 0072 or 10 i °t 1 . 1, aao fM0712, lot correct modeld 1' - i`4L,��j_ . Mercury arrow aoat switch IOVM.us;d — 1 oocf 1 t 7 _ duplex (2) or (I) scat syslerrt y control aellvala ,peep►• a a 1 2 a 1 i 1 f ' hole 1 7 Peh". lunetlori bore (or ry4 d p1.x �neown or wired ekn• a duplex op•ndon to om. in T. two M hole ".0 Pak", I" wMertleld eerrn.�__ ..,t splice. /Y M�s�ha M ed�W 2eetgr MGM rerw b Wsb9 an ComUtrv,eon , ms's• T Itb*111 EMet+kM Manua, rMD*AI; Nvch"Al Ilxt r CAUTION kr. Piekal•. q; 1 � AM Irukdallorl el tonlr fe "004 tlewrkk N l. oli 94 1 1 orw en1 wk{n9 efiertd w lone w 1 N 11M /f! j '"" �• • tlulry /MO�tlt; and (I;e,pl,■ Gensd box. wrb.t .M a.f e vs , Me the weN Feat,* National Etacuk Cent se4ia thcuW W IexeweA Inel..e. H-11% Ad 10011A). C1 and M [ seupesenat e.(etr .,N RESERVE POW"ED DESIGN i r For unusual conditions a reserve safety factor la dn ginee ►eel Into the design of o,ie: Zoeller ----,— — ry pump. ,�' , • MAIL 1Q r.0. BOX 16317 p za, �/P / Mallulacturers o!, , . �[. L SNIP r0: 3 80 01. 011011 ► ant ixr / dos 1502) 778•,efV s /At j502) 77I 3671 Qtat Safety and Buildings Division ALonsin S ANITARY PERMIT APPLICATION 2 1 Box Washington Avenue Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707 -7302 i .Attach complete plans (to the county copy only) for the system, on paper not less County than 81/2 x 11 inches in size. ' G /` • See reverse side for instructions for completing this application State Sanitar0elan Number Personal information you provide may be used for secondary purposes ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION I z7-7 37C/ Pr"AR 5je 7 — e 74 1,01% � L Pcgp� rty Locati /, � � , , �� ( ) �QI 7 �/ s v4 S Z T Z N R E or Propgrty Owner'ss M�ihng Address Lot Number Block Number itle i L 1� clt v p soa �_ y l • 2p � (,? 7) u0 11 b � - ivisio /ameorCSMNumber 11. TYPE B IL ING: (check one) ❑ State Owned � It Nearest Road d Cj Public 1 or 2 Family Dwelling - No. of bedrooms 3 v o w a n OF CAD �� " / v' III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) voy. �oG �o 1 ❑ Apartment/ Condo •?3?.IS; `o 2 ❑ Assembly Hall 6 ❑ Medical Facility /Nursing Home ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchan0ip: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining 4 ❑ Church/ School 8 ❑ Mobile Hom Park 12 C] Service Station / Car Wash 5 E] Hotel /Motel 9 ❑ Office / Factor 13 ❑ Other: specify IV TYPE OF PERMIT (Chet only one box on line A. V a B, if applicable) A) 1 E] New 2. eplacement 3 ❑ Rep q. ❑Reconnection of 5. [] Repair of an ______System _____ -__ System Tan_______ Existing System ________ _ _ ing System B) ❑ A Sanitary Permit was previously issued. Perm Date s V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressuriz d /ndPressure on \Ex Other 11 []Seepage Bed 21 foun Specify Typ 41 ❑ Holding Tank 12 [] Seepage Trench 22 ❑ In -Gr 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATI IMF: 1. Gallons Per Day 2. Absorp. Area . Absorp. Area 4. Loading Rate 5. Pe . Rate 6. System Elev. 7. Final Grade Ryuired (sq. ft.) ro ose (sq. ft.) (Gals/day /sq. ft.) (Min. /I ch) 10.9 Elevation �f , /• L Feet Feet VII. TANK Capactt in allo g Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete con- Steel glass Plastic App New Ex' tin structed T nk T nks Septic Tank cr- Hfeldrrtg k ; 6 El El Lift Pump Tank /Siphon Chamber ? d ❑ Ill 1 ❑ 1 ❑ ❑ VIII. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signat re: (No Stamps AAWMPRSW No.: Business Phone Number: l�ER GE u�/ ?,?o 7 7tS • 3g� • �s�S Plumber's Address (Street, City, State, Zip Code): G r-•� D /��',L AV. 11 tf !/ n Pz� IX. COUNTY/ DEPARTMENT USE ONLY 7 ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issu g A t Si a re (No Stamps) Surcharge Fee) p g ❑ Owner Given Initial / {p Adverse Determination ` X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROV SBD- 6398 (R.11/97) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS - ' w ' 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'�pl:umber, 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 3 years. ' 6. If you have questions concerning your opsite sewage system, contact your local code administrator orthe State of Wisconsin, Safety and Buildings Division, 8 08- 266 - 315 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 theppacity 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 81/2 x 11 inches hiust.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 poirts;,'C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump - performance curve; pump mod'eiand 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. r Safety and Buildings • c PO BOX 7162 MADISON WI 53707 -7162 TDD #: (608) 264 -8777 yi l sc onsin www•commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary May 27, 1999 CUST ID No.226375 ATTN.• 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 APPROVAL EXPIRES: 05/27/2001 Identificat on•Numbers Transaction ID No. 227340 Site ID No. 172 SITE: Please refer to both identification numbers, Site ID: 172995 above, in all correspondence with agency. ST CROIX County, Town of CADY S1 /2, SW1 /4, S29, T28N, R15W Facility: ROBERT ULBRICHT - CASTERVILLE FISH FARM 1028 10TH AVE, SPRING VALLEY 54767 FOR: Object Type: POWT System Regulated Object ID No.: 470085 MOUND / DWELLING 300 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: • 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. Perely, DATE RECEIVED 05/18/1999 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 JAMES B QUINLAN , POWTS PLAN REVIEWER BALANCE DUE $ 0.00 Integrated Services (608)266 -3937 , P.O •V JQUNNLAN@COMMERCE.STATE.WI.US W4 , P F , m Condit kPR RTMEN Nt`E aN OF SAF SEE CORF [ C ROSS SEGTIoXJ of M oUAi D rti T3 eD 3ftv nF % ro DiSTRif3t�T +nom All ec -SATE- G , TNi cka E's s P► P'"' G - oF Top s o ( s ysr�M . E IEVh r iot o p. Vu F o(?M To E- w 11 N �, �[• yd E I -r- RAW Mao. 1 ,i' 5Aup o p so Vt.) 1 Fp p m 8 % Slop F ORCE ElW nr00 u "PER MAW Z7.49 J# / T FT. __ Et_EVAD S -- E, 44 Fr. INVERT• O F Z IAT£RA (5 FT TOP OF Rock /bQ 3y Fr• • To O 2 � ( /00.6 r H �,S FT p I ATER A PL N VI OF MDUND Witt 13E D F T. �. -- - - - -- - -- . I 13 7 F r w D ---- ____ - - - - -- -- - -j! 1 FT k 'I a F r �Q w z Fr Bev OF To 1 y" PVC- <Appep A 93Pr jATE v 3 sER Vhr1 ok) Pipes PER MA,J EuT MARKERS Rrz(QufRED BASAL, AReA -_ v Ar�Y IUhSrE fl ow y✓� / /Z XVIt r,Jf� — C A r y y 54. Fr, PRoposev BAS M AReN = B ( A + I '7 & X S + l.54� C S 4. FT. j- 1=0 L D - Ui5fiRi130 T 10 N pipe uErwoR k TOTA V (2LU b LATG 9�5TRtr3uT l..A- 'eRAi. eNO CAP 2-, _Y '` /E� Z FvG Fo RCE MAW LAST NO 1 E S N A II f3E NEST TO l;Nb CAP VOID VoluMt Fo �uvERr t✓ IEVAr�o� dF 21 it FORCE MAW �•Z..- ..gA�S PERFoRArED PIPE DET L Q Holes IocATev ox G OT rOM SHAH Be I ' Y - I VARiA(5LEF y (� SN14cep. DtSTANcE p 7Z r r Hole Di,NhET'eR �N. R N/A " T! ATERA L . �' Z 1►J MAw FoLE) " FoRct MMO a �� �1� ICJ Y iucl,E S o (4oIE5/ P j PE. [�15TRi 3urty� MSCHAR&E RATE PE LATERAL ZZ'� - 3 G AI /Miu. TO T A L~ `D 1SG k AR 6t PAVE NEtWO k 2 " L G,AL o S PUMP CHAMBER CROSS SECTION AN D SPECIFICATIONS p�yE `f OF 5 -VENT CAP 4 "C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING JUNCTION BOX MANHOLE COVER 25' FROM DOOR, w /4 &,I Prl WINDOW OR FRESH WMIN. AIR INTAKE gppir �Ev�1T /o ni GRADE ' I 4" MIN. �Q CONDUIT y0 ---- - - - - -- �lEv�+n oti 97.d WLET PROVIDE I I - - - -- ��r. AIRTIGHT SEAL IT n G I I I v APPROVED JOINT A �1 K I I APPROVED JOIMTS IJ /C.T. PIPE `VIA I III W /C.I. PIPE EXTENDIIG 3' '00� ALARM EXTENDING 3' ONTO SOLID SOIL �(/ I I I ONTO SOLID SOIL O B � I 0 " ELEV. FT __) 1 a � PUMP � OFF 'I,�SE' ,3 Dw 40 sl O B L OCK SitvD RIStR EXIT PERMITTED OFJLy IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E SPECIFI'CATIOfJS DOSE TAIJKS MA NUFACTURER. IJ UMBER OF DOSES: PER DAy TAIJK SIZE : 7So GALLLLOMS DOSE VOLUME �0 ALARM MANUFACTURER: Ztr - rL ,VM `"y IMCLUDIMG BACKFLOW: GALLONS MODEL HUMBER: Y V L CAPACITIES: A= /I!0 INCHES OR 3� GALLOAIS SWITCH TYPE: E /0,47- -5w? / /� B = 2 ' INCHES OR 3'7.S GALLONS ' 7 PUMP MANUFACTURER: L `U C= 0 " INCHES OR GALLOIJS MODEL MUMDER: �+ /�Q H I � D- /2 " f INCHES OR Z5-2 GALLONS SWITCH TYPE: �� , Yi-�' X r r � Q 7 NOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATE GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE. 5 9 FEET -rANF L 9T EC5 �{ } MINIMUM NETWORK SUPPLY PRESSURE . . . . . .. . 2.5 FEET ( � GL I " O' { P ILL + FEET OF FORCE M X I' S F Y0 rT FRICTION FAC TOR.. ' 7g FEET (�Uy1 S l d , l 5 TOTAL DYNAMIC HEAD S�O FEET J INTERNAL DIME."SIONS OF TAIJK: LENGTH ° ;WIDTH / ;LIQUID DEPTH ZOLLER EFFLUENT PUMP MODEL 98 F V CITY cunvE L "811" a 1/1 3 s/11 0 + s a_ I I /z -11 1/2 "P !. auoNS 10 20 utus -- 30—!0 i so so 1'o so so 1 140 FLOW PER MINU ?E TOIAI DYNAMIC "tAINlOW tilt pa W 11 /rhutlr/ Are otwAtttirle IItA• eAPACn/ i>f VNIterMIN • , ''. poll 18111"1 OAt•l tins 1 1.62 is t o are w el »I 1 11 a I ? 11 Ito l to ae os tack vetw ;� 3 5 /Ie CONSULT FACTORY FOR SPECIAL APPLICATIONS ENclrlcal sherrlelors, for duplex systems, ar• BYAlable and tupplled with an elsrm. • Mercury 11081 switches are available for controllin 0 Meg single and dtarticat ekernelore, tl�r duplex eyetems, ere available wit a • boubl piggyback wkhotrl alarm ewhchee. it 11081 switches are available for varlable level long cycle controls. Standard all mode - Welghl 39 obi h ll.p, 1. Inleerd HLECTION oulnE N cartes ___ ... Moat opelded ? pole "chenkd twhch, no external control lewl,ed. Control seteello^ twheh. to fMOg1,ry NOW ewhch o/ double Piet' k mercury, (toy Model Yohe Pfi Mode Am s Mlf1 1 1 u � i 6 ilmple>t Ou b n N ?. Meclukal sherrulor to e0l2 01 10 e01& 1 —°f i_1 — /. ace f M1T1 t ?, ra xrreet moiler d El.epkei Aryernaror, "E Pdc^ Ooi ?JO l 4 � 1. Mercury sensor nod ewhch loOM EM t or t s r _ duplex (3) a N) noel tytlern sJ0 1 °! • tO"Irol tteNvda 1 f l i .Death• i f rl /) hpte "J Pd ". I�neltori l lo/ us a duplen o"rdbn too" d ealneclbn a wMed b eon• t. Awe pl Aele'J.PeA •, la ws1WON11 Dolrle„__ , spllof. far �seAel p stleenel MeM P"A% MM le to" en CemNrv,eon 9Urter f1A061 / CAUTION r P. Itblltl ttec4kel Merntla, ►I.btse; Vvthenktl After ' AN trublltlloe M t rubtl .MME Pttl'gt. If e ,.xat gut#, fi"?: enA A nt1a, 11.1 Ne.nwJ d.elrk INort� f'tbte en/ w41n/ ehe.,W U 40" ky a ,us* �Olex tre1 S° '� 1 ^s IAA wall stunt Ntllen N M ettle Meutet) en1 0 4* eo&$ eAcu4 ►� IeNo vt1 Int1.r1. NttllA Ad tONNAl C94 MEC) eM we [ewNVewtl Etb►y en1 RESERVE POWFPED DESIG • '1 unus uAl �o N �or ndilion ._ s A reserve solely laclor la dngineered Into the design of o,il3ry Zoeller pump. --r— Man ra r.u. aox rai p rola�pp,,,xr lOrss 0341 ManuActuiers of... , INII 10: 3 d0 04 A611011 fate 1OLMa; pry 46P I6 --- _______._____ Isol»re•�rsr �. rt'PA & •s : Wisconsin Department Industry SOIL AND S' E EVALUATION Sy76 ,> 3 •' Labor and,Human Rela Page of Division of Safety and Buildings `in accordance wi' s. ILHR 83.09, Wis. Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County ST: Include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # o o y- /G�Gf- 7 APPLICANT INFORMATION - Please print all information. e 7 Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location db R j /6,t'� � Govt. Lot ,-• 1 14Sw 1 /4,S 29 T 2F, ,R E (or W Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 6 Ss o 1 /v iE-z � �i 'ap � - � r of 3 V 44e � .- City State Zip Code Phone Number Nearest Road //vosonJ W/• S7/Girlo (�!S) 3�'( • �/ S E] City El VIII e Crown ❑ New Construction Use: esidential / Number of bedrooms 2 3 Addition to existing building 59'feplacement 5 5V _ ❑ Public or commercial - Describe: Code derived daily flow yStO gpd Recommended design loading rate bed, gpd/ft • S trench, gpd/ft Absorption area required 379 ad, n 3 75 trench, n Maximum design loading rate bed, gpd _ - Y trench, gpd/ft Recommended infiltration surface elevation(s) S A g / I Q - • V g ft (as referred to site plan benchmark) Additional design /site considerations .✓ r5'" /� a ��E-S A 0 V AJ p 5Y,57 Parent material 16.4--SS C_&e DW4,1 /J n %'C Flood plain elevation, if applicable L ft S = Suitable for system Conventional 1 4 Mound In- Ground P AT -Gr a System in Fill Holding %Iul U = Unsuitable for system ❑ S ❑ u ❑ S R's ❑ U El C ❑ s SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Ground / 7` elev. j � •�o io Y Y/6 sit -roxe 1�51- `P�' _ • y :. s Depth to limiting factor 0 s �in. J!ZE" 55S Remarks: Boring # 2 T. Y /o /m1iC' c 4-11 Apr- Ff ft P 49 1- 17 n„ — Y •s Ground Depth to limiting f for �j —In. Remarks: CST Name (Please Print) Signature Telephone No. �POl.3F 7 s• PA Address Date CST Number • 2.� Ulbricht & Associates Private Sewage Consultants 655 O'Neil Rd. Hudson, Wis. 54016 ORIGINAL j � /J�f SOIL DESCRIPTION REPORT L 3 ' PROPERTY OWNER ` Page of PARCEL LD,ff b O 7 '�� 6 y` Boring # Horizon Depth Dominant Color Mottles Structure 2 Texture Consistence Boundary Roots In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed . Trench 3 o •i 10 Yk 313 2 S! G 2,,1 6W /,e-- Ground p elev L, Depth to limiting A A 1 20 factor Remarks: or7 1/ Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD In. Munsell Qu. Sz. Cont. Color Gr. Sz. •Sh. Bed , Trench Boring # ; Ground elev. ft. Depth to , limiting factor in. Remarks: Boring # L ' Ground elev. ft. Depth to limiting factor in. Remarks: SBDW -8330 (R. 08/95) I r �_ 1 o - r . =o m LA R, it \ W ° n 1 � o ° R r� - N a : 011 � o � C W e`i n 1 � p W Q � d . - C�4S7�iwilh2 . ST CROIX COUNTY • SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM w D ..Q.2�. u O ner/ �� T" �/}O'z � �,,6 • / R,, ,Pr Mailing Address �Oss • ��.G�C /�1' • `�'"�l��T.�� /,S. ��D`� Property Address �d � Z � • `sp/ !/ i!�,I/ - 76 � (Verification required from Planning Department for new construction) City/State //i � �1� �� A� 0 9 Y ._ Parcel Identification Number LEGAL DESCRIPTION sd� s GJ , / c D Property Location � /,, /�, Sec. , T N -R � W, Town of Subdivision ��/¢' Lot # Certified Survey Map # Alllo,�- , Volume , Page e # Warranty Deed # yy�f�Z Volume �` ( Page # 33 Spec house O yes nLA�o Lot lines identifiable CTyes O 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 lumber or a licensed pumper verifying that 1 the on-site wa p p p y g O stewa'terdisposal 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. I/we, 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 stet' ,ng that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) Am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT I 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 DOCUMOT No. STATE BAR OF S WAIIIIIIIIAMW DAD [Hd8 dIAACE RIEBERYEO fool RE400004 DATA 447412 rot: �t� w REGISTER'S off,t Joleph H Sandvia and Lois A, Sandvig, husband and iKife, ST CR•, WI MAY 01 Robert W U bricht and Kathleen L. of 8:45 AM A con an b d warrants �KJCJC U1brcht, husband and wife as survivorship marital property alb RETURN TO the following described real estate in St . ro x cw"Ily, State of Wisconsin: Tax Key N o. 004- 1069 -90 The Southwest Quarter (SW'1 /4) of the Southwest Quarter (SW 1/4) of Section 29, Township 28 North, Range 15 West, Town of Cady, St. Croix County, Wisconsin, except the WhN sfis following: Commencing at the Southwest (SW) corner thereof, thence North 429 feet, thence East 107.25 feet to the center S line of a highway, thence Southwesterly on said centerline to the point of beginning. FM THIS DEED IS GIVEN IN FULFILLMENT OF THAT CERTAIN LAND CONTRACT BETWEEN THE ABOVE -NAMED PARTIES DATED JULY 22, 1988, AND RECORDED IN THE OFFICE OF THE REGISTER OF DEEDS IN AND FOR ST. CROIX COUNTY, WISCONSIN. This is not _. homestead property. (ice (is not) Exception to warranties: easements, restrictions, covenants, conditions, rest ;•vacions, or zoning ordinances,if any, of record. Dated this 28th day of April � (SEAL) � , Joseph H. Sandvig • r c,[�i 0� �. J 7 (SEAL) i��iC�-t (SEAL) Lois A. Sandvi AUTHENTICATION ACKNOWLEDGMENT Signatures authenticated this day of STATE OF WISCONSIN I 19 SS. .1FFi F'RSON County. = Personally came before me, this 2Ath_ day of April 19_A9_ the above named TITLE: MEMBER STATE BAR OF WISCONSIN jaspph H_ Cwnriy - (If not, ---- authorized by § 706.06. Wis. Slats.) THIS INSTRUMENT WAS DRAFTED By to me wn to be the person Vdtt xeeuted to ping instrument /and a knowled ame. Raymond E Krek Attorney at Law, P.O. Box 399, Jefferson WI+ Pan A- Wri 53549 otary Public Jef fer .'Cqunty G Vis. (Signatures may be authenticated or acknowledged. My Commission is permanent. (if not, state expiration Both are not necessary.) date: Noy _ 1 1992 -J The use of witnesses is optional Furnished by: JEFFERSON COUNTY ABSTRACT CO., INC. ' P.O. 80X 58, JEFFERSON, Wt. 53549 r L _ _� • - -+ (414) $74.3434 ABSTRACTS • TITLS INSI'RANCE + BSCROMS I 'Names of persu ❑s s19 - in any capac. I, 0 + .!d be typed or prnted telow t•,:lr sly-a - ..yes i 0 3 o I �o p v, M a a t E O a) a 2 z a� N O O L > a N of w a s rn o I E o N H O c o c Oi y — m om- O N M 0 a� t O1 C C U a1 C— O O .0.. O- U ir. C_ Z! M O U w ca O O O) Mr a) N -ONO.- L m O r Z N ag H '25-03: C f O O O N C Z r C � (n N O LL p 0 C) f6 N O c � I CD II M CL N a 9 O N E °z° a m N F- U) o Z t a I y I N F r i � I c o c o_ o • A� C V U N 0 Z Z O o o !�► O v z ZO N m .. m I ti c — ! m v to a) N M N E c M taOOO a� • m > a a a *� if c M 3 o w a rn a�i ti v U) J V O O } 7 N O O a OD Z O O o N m O N O1 A CO !J N O 09 Oi Q O U 7 CD O O O r G 3 O D c -O N N N V O O, Ui O C y c j O N H n CD 'D C C i0 O O) co O O y N O U • Cl N c o z Z Y to • '� a d � m a c t A ti IL 2 0 ai() k ST. CROIX COUNTY WISCONSIN " ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 - (715) 386 -4680 August 31, 1988 Division of Safety and Buildings Bureau of Plumbing P. O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation for the Robert and Kathy Ulbricht property located in the SE 1/4 of the SW 1/4 of Section 29, T28N- R15W, Town of Cady, revealed suitable soils at a depth of 2.5 feet, below which high groundwater was noted. This site should be suitable for a mound system. Should you have any questions regarding this subject, please feel free to contact this office. Sincerely, Thomas C. Nelson Zoning Administrator rc T Y, OF REPORT ON SOIL BORINGS AND -.. �- ,SAFETY &BUILDINGS INDUS TRY, MADISON, INDUS DIVISION LABOR AND PERCOLATION TESTS (115" P.O. BOX 7969 HUMAN RELATIONS SON, WI 53707 (1 & Chapter 145.045) L A 10 - s SEC TOWNS HIP /�: LOT NO.:BLK. NO.: SUBDIVISION NAME: s c 1 / 1/ 2 y /T 1 N/R is E (or) W �,�D�' / 4,4e © �a 7�rl,P.r Sj� �/1Q/ J( �O BEPf/77/yr E Z�L/,�,P / lLl� L14 MAILING S.S A DD R ESS NEi/ ,t • / J 'S -t`f0/ �o USE DATES OBSERVATIONS MADE 0 rOMMERCIALCRIPTION: PR TS: Residence PNew ❑Replace �U�E =Z , ej) oat 5-1746- Sukjp 2 9 RATING: S- Site suitable for system U- Site unsuitable for system W - r L J C Is .0 iJ ONVENT NA : MOUND: IN- GROUND - PRESSURE: S STEM -IN -FILL OLDING TANK: RECOMMENDED SYSTEM: (optional) OS[ U ElS ❑U EISZU EIS DO EIS ©U I Movwp If Percolation Tests are NOT required DESIGN RATE: .�^— ( If any portion of the tested area is in the under s.H63.09(5)(b), indicate: Gti} f S r+t• I Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL P H T GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED EST.HIGH EST TO BEDROCK IF OBSERVED (SEE ASBRV. ON BACK.) /- r�� QuvO/ �T 3 f f . 67' ►3a -yy S. 2. 16 ✓`')! f�1Ty s, - �ov,t?K B- ! 7, (od �/ 2 ro15 ':�P S/ ?3'of.c1 B -Z. 7 ' C' / / /�0 Z S 0 t4Q hT' 2. S ' hafs , S s�' / a w�T S'�sy w/ rr aR i B --3 i ! )aLA� A7 'fff L0 ' 'B . S.' S' tj R a Sy. LA Y 5T 4 2E.use B- B- ' B- PERCOLATION TESTS EST DEPTH . WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL -MIN. PERIOD 1 PERIOD PER INCH P. Z 3 o r� S/ z I Z O 5 i0 1t P- P- p_ PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. F0 P_ H0t)N S, .54A.I QODIC fN YA t SYSTEM ELEVATION TOP or 1" /0 2 , I j I , TN I - -- I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME print : TESTS WERE COMPLETED ON: HOMESITE SEPTIC PLUMBING CO. o L b HUDSO WIS.54016 L7 C! ADDRESS: ROBERT ULBRIGHT CERTIFICATION NUMBER: PHONE NUMBER (optional): t WIS. MASTER PLUMBER LIC. NO. 3307 M,PA.S. Z y f ' MINN. INSTALLER & DESIGNER LIC. NO. OOM CST SIGNATURE: i { DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR -SBD -6395 (R. 02/82) -- OVER 0 1► $A ZZ ri IV 0 � O e I 'i+ 7 I - 4. C1„ � I oW t v I I g c I ti - I � I 4 t b j M i \ `4 R ry W rz n � o ��.. 0 a ED �l Q cx: — W �OOCU aomJT — — r = W p w .LL,M a) Cc to Co O �W Cl -Uv -1 1 71 W ac - 80 ,z �� C�� Parcel #: 004 - 1069 -90 -000 12/12/2006 10:32 AM PAGE 1 OF 1 Alt. Parcel #: 29.28.15.460A 004 - TOWN OF CADY Current X, ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - ULBRIGHT, ROBERT WALTER ROBERT WALTER ULBRIGHT 2812 10TH AVE SPRING VALLEY WI 54767 Districts: SC = School SP = Special Property Address(es): = Primary Type Dist # Description SC 5586 SPRING VALLEY SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 39.500 Plat: N/A -NOT AVAILABLE SEC 29 T28N R1 5W 39.5A SW SW EXC COM SW Block/Condo Bldg: COR, N 26 RDS, E 6.5 RDS TO CL HWY SYLY ON CL 27 RDS TO POB Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 29- 28N -15W Notes: Parcel History: Date Doc # Vol /Page Type 07/22/2005 801098 2848/615 QC 07/23/1997 839/334 07123/1997 817/333 2006 SUMMARY Bill M Fair Market Value: Assessed with: 164877 Use Value Assessment Valuations: Last Changed: 04 /18/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 28,000 153,800 181,800 NO AGRICULTURAL G4 24.000 1,200 0 1,200 NO AGRICULTURAL FOREST G5M 13.500 20,300 0 20,300 NO Totals for 2006: General Property 39.500 49,500 153,800 203,300 Woodland 0.000 0 0 Totals for 2005: General Property 39.500 69,600 153,800 223,400 Woodland 0.000 0 0 i Lottery Credit: Claim Count 1 Certification Date: 0411712001 Batch #: 568 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel #: 004.1070-10.000 12/12/2006 10:32 AM PAGE 1 OF 1 Alt. Parcel #: 29.28.15.461 004 - TOWN OF CADY Current I X I 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 ROBERT WALTER ULBRIGHT O - ULBRIGHT, ROBERT WALTER 2812 10TH AVE SPRING VALLEY WI 54767 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description SC 5586 SPRING VALLEY SP 0100 CHIP VALLEY VOTECH I Legal Description: Acres: 40.000 Plat: N/A -NOT AVAILABLE SEC 29 T28N R15W 40A SE SW EXC Block/Condo Bldg: TRIANGULAR PARCEL 16 FT ON N & E SIDES IN NE COR Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 29- 28N -15W Notes: Parcel History: Date Doc # Vol /Page Type 07/22/2005 801100 2848/618 QC 07/23/1997 840/85 0712311997 817/335 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 164879 Use Value Assessment Valuations: Last Changed: 04/18/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.000 6,000 3,100 9,100 NO AGRICULTURAL G4 20.000 2,800 0 2,800 NO AGRICULTURAL FOREST G5M 19.000 28,500 0 28,500 NO Totals for 2006: General Property 40.000 37,300 3,100 40,400 Woodland 0.000 0 0 Totals for 2005: General Property 40.000 37,100 3,100 40,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 04/17/2001 Batch #: PRGRM Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00