Loading...
HomeMy WebLinkAbout008-1007-90-130 r ST. CROIX COUNTY ZONING DEPARTMENT „r AS BUILT SANITARY REPORT Owner O an, 'Ll r,r c Property Address A So S City /State 1„/o u d v l! e. W s y a a f -_ Legal Description: Lot Block Subdivision/CSM # S� `/a NE 1 / a, Sec. 3 , T n N -RJ/0-W, Town of PIN # COS—: SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer Mi kIeste - n Size ST/PC Wel LSO Setback from: House /,?, Well tI A P/L Pump manufacturer Model 1 3 7 Alarm location 13 jj 4 e ,- t 19 a ' t" (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: fta h d Width Length Number of Trenches 2 Setback from: House G ' Well ri A P/L 0 Vent to fresh air intake ELEVATIONS Description of benchmark t c l�� z Elevation y Description of alternate benchmark ? 3a c t ��. & S �` c� �. c Elevation , Building Sewer 73 P � �3 ST/HT Inlet �3 • S � ST Outlet C Inlet PC Bottom S' Header/Manifold 1 G Top of ST/PC Manhole Cover / Distribution Lines Bottom of System( ) 2 • 9 !! _ O ( ) Final Grade Date of installation )0 / y l Permit number 33895 Z State plan number O 3 , G Plumber's signature L-f License number °.?:� 3 �' Date / k/ Inspector `�d.G � h Complete plot plan 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 0 i 1, 1 , r u 0 v a� u Sv 1b i INDICATE NORTH ARROW •Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety County and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: ST CRO EX Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). 338952 Permit Holder's Name: []City ❑ Village X1 Town of: State Plan ID No.: PETERSON, DANIEL R. EAU GALLE ;.334 CST BM Elev.: Insp. BM Elev.: M Description: � Parcel Tax No.: r m 'D O/ B 5�_ ao gam'" 1 008- 1007 -90 -130 TANK INFORMATION ELEVATION DATA A9900210 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic I� imp /65'Zl Benchmark p$', ao.0 Dosing 1-,g ski-, 5: f VEV 1a I. �— Aeration Bldg. Sewer /.;.0 9'S. Holding St/Ht Inlet S TANK SETBACK INFORMATION Outlet p I TANK TO P / L WELL BLDG. Air I to ntake ROAD Air Septic NA Dt Bottom ,S� Dosing >/ C►A ► �' ! ► NA Header /Man. ✓t• 2S 10 T. T"3 Aeration NA Dist. Pipe �' I D 3. 11q Holding Bot. System S- IQ.�• PUMP/ SIPHON INFORMATION Final Grade Manufacturer �Z Demand Model Number / ' 284 GPM TDH Lift L rictio System)• TDH C t H ead Forcemain Length I I Dia. 2 " Dist. To Well F 7 SOIL ABSORPTION SYSTEM ED 4tEfdt" Width f Length f N f 1lf PIT No. Of Pits Inside Dia. Liquid Depth EN 1 N 4-� pGn ..$B DIMENSION SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING manu INFORMATION Type Of CHAMBER Model Number: System: rA" I OR UNIT DISTRIBUTION SYSTEM '� = ,?• 5-7t)4 (a•'+ Header/ Manifold Distribution Pipes) �� ► x HoI Size x Hole Spacing Vent To Air Intake Length Dia. �- Leng Dia. Spacing 1 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.) I? LOCATION. AU GALLE 3.28.16,SE,NE 574 250TH STREET Q �Z•a' �! y ekk. 5 �w.o4Q � � � � «�-- (� .d.o�.Q_ e.sue.✓ o't,e�" �cx -�- -� � o— - � �- g A4 Plan revision required? ❑ Yes (g No "I 1� Use other side for additional information. ,'s ` \/ SBD -6710 (R.3/97) Date Inspector's Signature C� _ `-{P� ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: e a E t a 1 t L e i S x s _ T I d Y i t 5 f , r } S s x 1 a F t } r ° I a f K f a t t i # g 9 e } , i E y .a me _ I a P.,p. , ., k s.r . a h- .... t. c _ . __....- ... ., ._.... ... e.. ,.._..,.... ., _ ».._. a .... .. ..... _ �... .. .... ..._ .., _ .,. .� �e t ` �xw k _ t x t E i _d f z` t. SAN Safety andBuil gtonAvenue In Divis ITARY PERMIT APPLICATION Viscons P O W. 7302" Department of Commerce accord with ILHR 83.05, WIS. Adm. Code Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less county than 81/2 x 11 inches in size. S f t � r �ic • See reverse side for instructions for completing this application State Sanitary Permit Number 33Y7Y�- Personal information you provide may be used for secondary purposes ❑ Check if revision to previous application IPrivacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION I no 33 Property Owner Name Prope Location 04 If o Ce e, .5'C 1/4 4'= 1/4, S 3 T �� , N, R / E (or) W/ Property Owner's Mailing Address Lot Number Block Number 3 c s cc.; c. Sc City, State Zip Code Phone Number Subdivision Name or CSM Number II. TYPE OF BUILDING: (check one) ❑ State Owned o ity Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms Town OF 4 k ` T 5 v r III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo O O - / o o 7 - at - 13 v �+ 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 E� New 2 ❑ Replacement 3 ❑ Replacement of 4 ❑ Reconnection of 5 ❑ Repair of an ------ System ________ System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE Of SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 See Specify Type 41 Holdin ❑ Seepage Bed 21 Mound 30 p9 ❑ P Y YP ❑ 9 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 Required d (sq. ft.) Propose sq. ft.) (G ls/day /sq. ft.) (Min. /inch) Elevation Cf ? 2 c, Feet /os Feet Cap acity VII. TANK in Ca gallo s Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existing structed T nks Tanks Septic Tank o Ing Tank L " l U �' 4 ' ❑' ❑ ❑ ❑ ❑ ❑ 1 amber 5G� / 10' ❑ ❑ ❑ ❑ El VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumb rs Signature o amps) MPIMPRSW No.: Business Phone Number: Plumber's Address (Street, C State Zip Code)• ` �. IX. COUNTY / DEPARTMENT USE ONLY ❑Disapproved Sanitary Permit Fee (Includes Groundwater D ate Issued Issuing a Si ature(N Stamps) Approved ❑ Owner Given Initial ��� charge Fee) Adverse Determination vv X. CONDITIONS OF APPR9VAL / REASONS FOR DISAPPROVAL: I %, 144 3 41' 3 SBD- 6398 (R.11/97) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber i INSTRUCTIONS ` 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at 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 inownership or plumber requires a Sanitary Permit Transfer /Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608 - 266 - 3151,•. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where 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. ;i IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------- - - - - -- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices.which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. Safety and Buildings 15837 USH 63 HAYWARD WI 54843 -8107 TDD #: (608) 264 -8777 iseonsin www.cornmerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary April 19, 1999 CUST ID No.267341 ATTN.• POWTS INSPECTOR WEGERER SOIL TESTING & DESIGN ZONING OFFICE 421 N MAIN ST ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 J ; HUDSON WI 54016 RE: CONDITIONAL APPROVAL Identific rs APPROVAL EXPIRES: 04/19/2041 Transaction ID o.220334 d Site ID No. 17037 Please refer to both identification numbers, SITE: above, in all correspondence with the agency. Site ID: 170376 ST CROIX County, Town of EAU GAL SE1 /4, SE1 /4, S3, T28N, R16W DANIEL PETERSON FOR: MOUND SYSTEM, 450 GPD Y Object Type: POWT System Regulated Object ID No.: 462075 CFl:: 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: 1. This plan action is subject to designer comments on the plan. 2. The orientation of the mound system must be such that the mounds longest dimension is perpendiculiP' Sr, to the direction of maximum slope. 3. The area 25' below the downslope edge of the mound must remain undisturbed. 4. Maintain well and waterline set backs per COMM 83.10(1) and 83.14(4)(a). 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 stall be obtained prior to coninnencement 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 04/12/1999 z FEE REQUIRED $ 180.00 _ FEE RECEIVED $ 180.00 PATRICIA L SHANDORF , POW LAN REVIEWER BALANCE DUE $ 0.00 Integrated Services (715) 634 -7810, FAX: (715) 634-5150, M -F 7:45 AM - 4:30 PM WiSMART codes 7633 PSHANDORF @COMMERCE. STATE. WI.US I Oo x�p-` COw►Ptti oR f ti Q �131v \Z8 T1t1S PfReA gip' OF y � \�0 F r Z" Pv C irr.rl . %M ZrT O \ / u/ fit. t�3.o • G�, 0 Y j Q •3 NOTES -l. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. (V required) 3. Install 4 observation pipes with approved caps. ( -_ required) 4. Septic tank to be v 000 16SO gallon capacity manufactured by V 1 ;P1 1', ) AJ Q. 5 . Bench Mark ��v. too• o' o., q `` H 3 iy" -b1& l�y� �t1P 1�z vo/ LR'fll 6. Divert surface water around system to prevent ponding at the uphill side. Page 3 Of Approved Synthetic Covering c 33 Distribution Pipe Medium Sand _ H _ G Topsoil _ F Elev. D 3 E l � b y % Slope Bed Of Z'- 2 %2 Force Main Plowed Aggregate From Pump Layer D `. 0 Ft. Cross Section Of A Mound System Using E 1.31 Ft. A Bed For The Absorption Area F o -'6 Ft. G 1.O Ft. A `a Ft. H 1. 5 Ft. Linear Loading Rate =9.6 GPD /LN FT B q1 Ft. Design Loading Rate= c).1 .GPD /SQ FT j Ft. J Ft. K Ft. L 61 Ft. -- Fe r , �- e M- i n W I Ft. L j bservation Pipe K A W � - - -- - (• - - - -- ----- - - - - -- ------------------ - - --•I Force Main o Distribution Bed Of 2�- 2 2 I Pipe Aggregate Observation Pipe Permanent Markers (Anchor securely) Plan View Of Mound Using A Bed For The Absorption Area Page Ll' of Perforated Pipe Detail 0 i - End View Perforated End Cap � �` PVC Pipe Install permanent at end of each lateral Holes Located On Bottom, Are Equally Spaced Q S PVC Force Main P PVC Manifold Pipe 4. D'stri ution Pipe Last Hole Should Be I Next To End Cap End Cap P 2-Z-- Ft. Distribution Pipe Layout S L-(_ Ft. X 1 4$ Inches Y � g Inches Hole Diameter I , /Y Inch Lateral ) Inches Manifold Z Inches Force Main Z Inches # of holes /pipe b Invert Elevation of Laterals s Ft. Place lst hole ZV " from center of manifold with succeeding holes at l4e A intervals. Last hole to be next to the end cap. Combination Sept;ic;Tank and N PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS' PAGE S OF (� -VE►JT CAP WEATHER FFLOOF JUAJCTIOAJ BOX H 'C I VEIJT PIPE APPROVED LOCKIWG MAWHOLE COVER wJ"M i` ,10 FROM DOOR, - .JI NOOW OR FRESH T 1.v A(2LJIIJ� L_I48EL.. AjR WTAKE cor,�p�tT n i l b e x . 1 `f' MI►J. 18' MIIJ. y�lusvroN PIPk- PROVIDE --'- -- INLE T =— AIRTIGHT SEAL I I I V OlA1T �iaFF��S A l I APPROVED JOIAI APPROY ED J W/C.I. PI PEoR Tank construction i ill W /C.I. PIPE�p�� shall comply with _ I ALARM ILHIR ('13.15 and 33.20 a i II I I oIJ °tz _mss I L LCV. FL PUMPS - -� OFF O COAICRETE BLOCK 3" APPRo,; R15ER EXIT PERMITED OIJ Ly IF TAW MAIJUFACTURER HAS SUCH APPROVAL BF001� SEPTIC F SPECIFICATIONS 005E 1`'11Ot�1�T� 3•�Z TAIJIC MAAJUFACTURER: T kJUMESER OF DOSES: PER DAy TAWK SIZE: 1��C) 13 SO GALLONS DOSE VOLUME z ALARM MAIJUFACTUR.ER: S S E-k�'M S 1S`FCT 1WCLUDIA16 6ACKFLOW: S3 GALLONS MODEL NUMBER: 1L�L "w CAPACITIES: A_ 106 IAICHESOR 30 � GALLOUs SWITCH TYPE: B = cC - IIJCHES`OR _=_ )� L__ G(�LLOMS HUMP !'IAWUFACTURGR: ZOO LIZ C =�1._IIJCHES OR %5 3 GALLo1J5 MODEL NUMBER: 98 D - 2 I OR N g3 CALLOUS z. 6q6 SWITCH TYPE: MOT£: PUMP AUD ALARM ARE TO BE MIMIMUM DISCKARGE RATE Z g'og GPM IN5TALLED OW 5EPARATE CIRCUITS VERTICAL DIFFERENCE DETWEEU PUMP OFF AIJO.DISTRIBUTIOM PIPE.. '1S FEET + MINIMUM NETWORK SUPPLY PRESSURE 2 5 O FEET �3o F T. + FEET OF FORCE MAI X 1.b1 �o►r FAC70R -. Z FEET ...� TOTAL 09WAMIC HEAD = FEET Pump chamber DIAMETER �I IIJTERAJAL DIMEWSIOWt OF TAkJK: LEI,J&TH — ;WIDTH ;LIQUID DEPTH BOTTOM AREA — _ 231= r GAL /INCH AS PER MANUFACTURER = � 0 GAL /INCH I, pUMY P�1Z.F01Z ► kJ � �U��tid E w J LJ HEAD CAPACITY CURVE 3 7/8 6 1/4 L ` MODEL "98" 3p 4 5/8 8 25 ° I 3 5/8 6 20 ® O _ U + + r£ ° 15 ,3 O 1 4 4 3/16 I ° 10 2 5 1 112 -11 1/2 NPT 0 U.S. GALLONS 10 20 30 40 50 1 60 70 80 LITERS 80 160 240 0 FLOW PER MINUTE TOTAL DYNAMIC HEADIFLOW PER MINUTE EFFLUENTANDDEWATERING CAPACITY 12 HEAD UNITS/MIN FEET METERS GALS LTRS 5 1.52 72 273 10 3.05 61 231 15 4.57 45 170 4 3/16 20 6.10 25 95 Lock Valve 23' SKI 102 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and Variable level float switches are available for controlling single supplied with an alarm. and three phase systems. • Mechanical alternators, for duplex systems, are available with Double piggyback variable level float switches are available or without alarm switches. for variable level long cycle controls. SELECTION GUIDE 1. Integral float operated 2 pole mechanical switch, no external control required. Standard all models - W eight 39 lbs. - '. ', H.P. 2. Single: piggyback variable level float switch or double piggyback variable level, 98 Series Control Selection float switch. Refer to FM0477. Model I VoHs Ph Mode Amps Simplex Duplex 3. Mechanical alternator 10 -0072 or 10 -0075. M98 115 1 Auto 9.4 1 or 1 & 7 — 4. See FM0712, for correct model of Electrical Alternator, E -Pak. N98 115 1 Non 9.4 2 or 2 & 6 3 or 4 & 5 5. Control switch 10 -0225 used as a control activator, specify duplex (3) or (4) 098 230 1 Auto 4.7 1 or 1 & 7 — float system. 6. Four (4) hole J -Pak, junction box, for watertight connectiorror wired -in E98 230 1 Non 4.7 2 or 2 & 6 3 or 4 & 5 simplex or duplex operation, 10 -0002. 7. Two (2) hole J -Pak, for watertight connection or splice. CAUTION Forinformation onadd Zoellerproducts refer to catatog on Combination Starter, FM0514; Piggyback All installation of controls, protection devices and wiring should be done by a qualified Variable Level Switches, FMO477; ElectricalAlternator, FM0486; MechanicalAttemator ,FM0495;Sump / licensed electrician. Allelectrical and safety codes should be followed including the most Sewage Basins, FM0487; and Single Phase Simplex Pump Control/Alarm Systems, FM0732. recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16347 Louisville, KY 40256-0347 Manufacturers of. . SHIP T0: 3649 Cane Run Road Louisville, KY 40211 -1961 QUd&Tr)CLW s SNCE IS .7 PUMP !O, (502) 778 - 2731.1(800) 928 -PUMP FAX(5a2)774-3624 Wisconsin Department of Industry, SOIL AND SITE EVALUATION 1 P$ . Page 1 of 3 Labor aril Human Relations .'Division of Safety & Builings ; in accord with ILHR 83.05, Wis�,�drii',QOde ' ,? Attach complete site plan on paper not less than 81/2 x 11 inches in size. PI indpoe but• not limited to vertical and horizontal reference point (BkV , direction and % of �xi, scale,or PARqK I. A dimensioned, north arrow, and location and distance to nearest road. - 1 "a REVI BY DATE APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION PROPERTY OWNER: TY LOCATION_ - , T 'Z ,N,R 16 E (oro PROPERTY OWNERS MAILING ADDRESS LOT D,. OR CSM i Shy ZSO `Tl sT. - ; - �os� c,sm CITY, STATE ZIP CODE PHONE NUMBER 1?W1V NEAREST ROAD Wou�vh� t.vl S (4ozB PIS) bg�.Z�u3 ZSO `tit S7'. 14 New Construction Use [DQ Residential I Number of bedrooms L l [ ] Add' ' AddifiT to existing building [ J Replacement [ I Public or commercial describe Code derived daily flow bOD gpd Recommended design loading rate bed, gpolft2 © - S trench, gpolft Absorption area required Soo bed, ft 500 trench, ft Rmimum design loading rate o • S bed, 9pde 0.6 trench, W Recommended infiltration surface elevation(s) O 3.O ft (as referred to site plan benchmark) Additional design/ site considerations "O'J' 0� w/ 8'x 63' 8e6 • rat lAJ , I' Or— Parent material - '% h L•N S'LAlPlev= oUM S�'r S OUS Flood plainllevation,9applicable N A , ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem I EIS KU I R S ❑ U I [IS zu ❑ S EM [I S 9U ❑ S E SOIL DESCRIPTION REPORT consistence Barxfary Roots- Boring # Horizon Depth Dominant Color Mottles Texture Structure GPD /ft in. Munsell Qu. Sz. Copt Color Gr. Sz. Sh. Bed rerch 0 -8 z Z $ -la �o`tiZ�1L3 _ Sll Z�Sbk m'f� CS - o.s o.b Ground 3 1 -Z� s `/ IL ly — Grs 1 1 YnS MU�' k'\j - 0. o -S elev. CA 1 01•'1 R Z� -S' �.SK2��S/ S -t 2 313 Depth b limiting fact Remarks: Boring # o -$ 10'12 S t� Z wt`F4. � S o •S v _� Z 2- 1 gl tiu`LtiZ3 — s "1 Z �sbk �t e O.' b 3 N9 3ll y — G>"sl� Z►�sbk yvi�� Cs — o.S o_b Ground elev. -SIB l b `'t tZ- 61 S `'l R.- 313 �S C1tivh m U Dept b - limiting factor 4 34 tt( Remarks: ! CSTNarte: Please Print Arthur L. We erer Phone: 715- 425 -0165 egerer Soil Testing & Design Service -P.O. Box 74 River Falls,WI 54022 S' nab . Date: CST Number: t �S -I�Z -3 �— �l -q M00576 PROPERTY OWNER 1'L MC 5i:.M My SOIL DESCRIPTION REPORT Page? Pf PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence aaot � oPD /ft g In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trerxfi 3 0 –b 1tgv- 31Z — SL, Z �' s � k m`FI� ass Z sil Z�sk ��H C — c:S o. b -L`� b �� �,R. � 1.3 Ground l elev. 1 oS.o ft. to-V9 S `t cz 3! Y � S k 2 31 Z� 'M Depth to S g9 g //S ow, v'�� limiting ..... , _... , .� factor S l u 'R LL! �n U Remarks: Boring # I I Ground elev. ft. Depth to i limiting factor l I Remarks! Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # I f , Ground } elev. ft. Depth to limiting factor Remarks: RRn- A330(R (A /P?1 PLOT PLAN Page 3 of 3 SCALE 1 "= 14p ' �- 'R -�1�T Pt3 5 ttUivN Q H 7 � � 3.2 Z5 ` \ • Z $►^� - t'L. ON G'tttGlF 31y �, �`wp1 . �►Q- PtpE 8 •o ` coo 3 bo ►viT rAr' -►P RAY ot� � tuts CuL�CI VJ t Teb 0 �2-LoS - w�op� 5 USE `M We TVT 1-"ST ZS' FI Mu u`jb LAJ LTLL L4. so gb -�OZ- 3 (715 1 4L-01 M00576 CSTSignature Date Signed Telephone No. CST # W igeohsin Department of Industry, L E EVA 1 3 Labor and Hurnar, Rely ons SOI AND SlT EVA U A ION REPORT P ap Division of safety a Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but SY . C R.oIX not limited to vertical and horizontal reference pant (B". direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER. PROPERTY LOCATION O'N �11�'11� �lZl"'lf�tV 6A�F -L9� S E 1/41 1 /4,S 3 T Z8 ,NR 16 E (or(:W:� PROPERTY OWNER MAILING ADDRESS LOT # BLOCK # I SUBD. NAME OR CSM # Shy ZSO `Rt S1'. — - � �o�os C� Cswf CITY, STATE ZIP CODE PHONE NUMBER []CITY ❑VILLAGE MOWN NEAREST ROAD \AoUtNIL -tom, kil 540r -8 0157 b9r. 71U3 v 6P I ZSO `M ST. [ New Construction Use [kj Residential / Number of bedroorns I ] Addikn to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow b40 gpd Recommended design loading rate 3- bed, gpcW o -S trench, gpdttt Absorption area required 500 bed, ft 5 trench, ft Maximum design loading rate o • S bed, W* O.6 try. gpd/ft2 Recommended infiltration surface elevations) O 3.O It (as referred to site plan bendxnaN Addilonal design / site considerations w / 8'x 63" Bt . M OU, 1 ' o ►= S �►D Ft L t_ , Parent material S r L'T4 Sf I .nfQT 0UM Sr Y Sol—LS Rood plamAlevation, if applicable N• A, R i S = SUifable for system CONWWONAL MOUND I -CR D PRESSURE AT -GRADE SYSTEM IN FBI. HOLDING TANK U = Unsuitable for stem ❑ S E1U Q S ❑ U [IS ZU ❑ S RrU ❑ S EZU 1 ❑ S [91.1 SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD1ft ' Boring # Horizon Texture Consistence Bound3y Roots in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. gaff terrd� 0 -8 - vo 3 1z to`ty- Ll[3 _ s �1 Z�s�k m'Fi, C S - o.S °. b' Ground 3 1°t -Z7 • S 't R- 3 I — Gr s } 0 o- S elev. 1 t�L.� R Z� -S7 �.sKrz�ly c 1 s�.ti_ 3/3 Gas] o� w►�1- - _ _ ,. Depth b Uniting factor L Its Remarks: Boring # Z l.b-jv? X13 — S l j Z Fs�k wr�l e s - o.g o• L r 3 N9 - 3u � .s`1TZ3ly — G� sl` - ►�tsbk f� CS o_b ZLQ Ground t R 2, q -SL l b `t tz- 613 S y ve 313 am m u TF - Depth f cw S - ).Si iz 3/3 0 - Z limiting } faccttorr a 14 - T i i Remarks: TNaae:— Please Print Arthur L. We erer Phone: 715 - 425 -0165 e erer Soil Testing & Design Service -P.O. Box 74 River Falls,WI 54022 Sgnabe: /= Date: CST Nwnber:.. r M00576 PROPERTYOWNER '1' "MET l- 1k SOIL DESCRIPTION REPORT Page? of 3 PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Ekxndwy Roots',', -, QPD /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed JTmnch 3! i — SL1 Z 512 mi� Ground v` elev. %sIQ$ `itZ.3fy S 1 2 R.31Z %Iv Depth to S t494Z v'f i. limiting fac �,u1ZL�/ % LSTs FJ1 �O�J U t Remarks: Boring # 13 i t I Ground elev. ' ft. Depth to Iimiting factor I Remarks+' Boring # 13 i Ground I elev. 1 ft. Depth to limiting j factor i i Remarks: Boring # Ground elev. it. Depth to limiting factor Remarks: RRn- g3301R �fi/o21 I j P LOT P LAN Page 3 of 3 SCALE 1 "= �p ' eR. -C��T IBS S tt'O�vN 2 a .. x at - - ,p� —ae I w ou�� Grp 3 I Zs• s rt. gnu - ESL.. o's -Z oN Gi`' 6tF �c»��R �, 32 `,� 31y``�►�. V-Aj( P1 PE Ip 8 0 �• tp� �� 3 , _ � b o NAT �4 0 'mks M10 VI 0 C�JI. TIV P�fL'D B. t.LO s woop� _TyT LE)ltsT z. S' F-itom m wKib . watt_ k C4 So, . R wlovl. wv) N b' X b 3' 3eD i s �Cc.ow► D� . Z S3 Czouwl�"1E. G16 -lOZ- 3. ( 715 ) 42.5 -nl L5 - M00576 t CST Signature Date Signed Telephone No. CST # ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSIJIP CERTIFICATION FO Owner/Buyer �/ �°� �°l' 7� Mailing Address s � > A ✓� f Property Address ��/ G✓ (Verification required from Planning Department for new co truction) S1 l..l City /State �dD�ui P wl Parcel Identification Number LEGAL. DESCRIPTION Property Location ' /., V,, Sec. , T_,&N -R & W, Town of u Subdivision , Lot # Certified Survey Map # , Volume , Page # L Warranty Deed # S^ -/ (, � , Volume _ 2 , Page # f Spec house ❑ yesX 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 se been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days the a ye e i ti n date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION (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 o rty descri a, b virtue of a warranty deed recorded in Register of Deeds Office. i SIGNATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed VOL ?nJ . PAf E �?,j CUMENT NO. (DOCUMENT NAME) r • WARRANTY DEED REGISTEA'S OFFICE 5 499W ST. CRW MW1 Aidd tatlMooal SEP 2 4 1996 at 10:30 A: M fle9tatsar of Desds RECORDING nvMMAnON ............................... NAME AN!J RETURN ADDRESS Bakke NormA a, S.C. 900 Mair: Street Baldwin, W* 54002 $ 2 IVSFFER _(Parcel identification Number) DOOUMPff NO. WARRANTY DEED RECORDING INFORMATION VOL THIS DEED, nude between Donald W. 71mawrman and Rebecca L. Thnroerman, husband and wife, as survivorship mariW property. Grantor. and Daniel R. Peterson, Grantee, WITNESSETH, That the said Grantor, for a valuable consideration one dollar and other valuable consideration conveys to Grant" the following described real estate in St. Croix County, State of Wisconsin: ..ET-. R -. TO: N TO: - ........ ............................... RETUU Bakke Norman, S.C. Baldwin, WI 54002 Tax Parcel No : h of 008- 1007 - 90.108- 1007 - 80.008- 1007 -20 Sec attached Exhibit A. This is not homestead property. Together with all and singular the bereditaments and appurtenances thereunto belonging; and Gr -,ator warrants that the tick is food, iodekasible in fee simple and free and clear of encumbrances except: F.ussneuls, highways, rrtBlty rWft and reservations at record, and will warrant and defend the sate. Dated this 1 8 day of September . 1996 All J r-- (SEAL) (SEAL) -14 W. Timaw A�r�.LT.i',p• .L - ]l`D�. t w.....�s (SEAL) • jtdiecca L. Timmerman • AUTHENTICATION ACKNOWLEDGEMENT Signature(s) of Donald W. Timmerman and Rebecca L. STATE OF WISCONSIN } } ss. ST. CROIX COUNTY } is des f _ ' 1996 Personally came before me this day of , 19 , the above named Donald W. •'Ibomas R. Schumacher /104986 Timmerman and Rebecca L Timmerman TITLE MEMBER STATE BAR OF WISCONSIN (1f not, authorized by 1 706.06, Wis. Stats.) to me known to be the persons who executed the foregoing instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY. BAKKE NORMAN, S.C. •_ BALDWIN, WISCONSIN Notary Public, County, Wisconsin *Names of persons signing in any capacity should be typed or prinLed My Commission is permanent. (If not, state expiration date: below their signatures. l9_) , i43X4f.Nfaf. Nf`.r+A -.' Af W:._'Dw: i 'Y #!.F4fG "u.'drir.(i AFi„ .x �.. #'•:'?a+'_ C ..9AR R.".M1 "Li`+'/eR A�.ri -.r . f.: - i EXHIBIT A A parcel cif land .located in part of the Southeast Quarter of the Northeast Quarter. the Southwest Quarter of the Northeast Quarter and the Fractional Northeast Quarter of the Northeast Quarter; 811 in Section 3, Township 28 North, Range 16 Nest, Town of Eau Galle, St. Croix County, Wisconsin; described as follows: Commencing at the East Quarter Corner of said Section; 3; thence on an assumed bearing along the east line of said Northeast Quarter. North 00 degrees 52 minutes 08 seconds west a distance of 996.78 feet to the point of beginning; thence North 89 degrees 46 va inutes 10 seconds Nest a distance of 636.78 feets thence Soutb 04 degrees 21 ninutes 51 seconds East a distance of 545.43 feet; thence North 97 degrees 01 *Minutes 37 seconds West a distance of 1256.59 feet to a oneiinch iron pipe; thence continuing North 67 j degrees 01 ni�kte037 seeonds Neat *distance of 50 feet store or less to tbe„easterl - Fight - - way of the former, Chicagov et. Paul 'Kim&eapo�l* and oaaha RaiLr044« Said right- of-way being 00 tart distant as Measured at right � angles to and southeasterly of the centerline of said Railroad ; ,thence northeasterly along said right -of -way to the south line of said Fractional Northeast Quarter of the Northeast Quarter; thence; along last said line, North 88 degrees 23 minutes 42 seconds West to a point 50 feet distant as measured. at right angles to and southeasterly of said centerline, thence Northeasterly along said right - of- way to the north line of the south 25 rods of said Fractional Northeast quarteif -of the Northeast Quartet; thence, along last--said line, south 86 degrees,23 sisatea 42 seconds East a distance of X84 'feet . more nr" Iess to a on* inch iron pipet; thence ;ontintiingloaig last -said !late, South 88 degrees 23 ;wlsAties 12 ee4pou9 d Ea distance of distan of 891. 71 feet to "id *"it 1 itee 'of - the Northeast Quarter; thence along last said line, South 00 degrees 52 minutes 08 seconds East a distance of 767.63 feet to the point of beginning. Containing 36.25 acres more or less. Subjwt to the right- ofAvar of 250TH Street along the easterly slide of the above desoribed property and subject to all other easemente,•restrictions and covenants of record. r. g .f HEAD/CA M HEAD CAPACITY CURVE EFFLUENT mommma Mw ■ ■■■ m®mmmmm ® m0 ®® ® mom ® ■�� ■ ■io�m�® MMM ma Mm NOW OWN ' ■\■■■ lm��ommmmmmi�0�m�m ®m ®� ®�■�m��aa ®® ®ova ■ ■ ■ ■ ■I� ■ ■ ■ ■ ■iiioom ®mom ®gym® ■ ion ®�® \�i \ \� �r ■ ■ ■ ■ ■ ■ ■ ■ ■ ■■ . ■ \ ■ \I1 \ ■ ■ ■ mom ■ ■ ■ ■■ \�i ■� NO mom MOON \0N! ■111 ■■ ■ ■ ■ ■ ■ ■ ■ ■■ e .. . . less than 30 feet TDH. mom \I\lIII■ \VM 0■M M o d e l . IMM► ►�MMMMMMM 11111111119VI 119110011111151% MEN= MMMMM MM ■!■i 1►� 1► MAIM\ \MMMM ► • MMWMMM \NR NION i2.! ■ \ \����� \ ■ ■■ N\I!a11q, I \`\\MM LINO ■ AD CAPACITY CURVE SEWAGE MO DELS mm mmmm U-1 Fn NOME =MMMMMMMM ■ ■ ■ ■ ■ ■ ■� © ®mm�o�m�o ®oms�mmmmmm� ®® 0 m�mmm ° mm ©Mmmm ®mmmmmm ON M MOM I o mmmm so NE 1 mom RNMEMEM man NNEREMME 00 01 No MEN Na O MORE mom WE ON I 'm m o