Loading...
HomeMy WebLinkAbout012-1014-30-105 t. ST. CROIX COUNTY ZONING D AS BUILT SANITARY ��r rf, Owner�� Property Address 7 X 3 0WC -- t � City/State ,,r ei- _) ze, „�. 44- �` Q 17 ; .� 4 'i♦ Q Legal Description: Lot Block Subdivision/CSM # s Li t &�/4, Sec T 3 N -RL.W, Town of =, SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer Size ST/PC /?d / OG Setback from: House .36 Well Pump manufacturer Model S r Alarm location {,A�' (HOLDING TANKS ONLY) Setbacks: Service road esh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: Width Z `� Length S Number of Trenches Setback from: House 206 , Well 7P/L 3O Vent to fresh air intake 150 N� ELEVATIONS i Description of benchmark 7 S 1 Elevation d� Description of alternate benchm Elevation/ - Building Sewer ArZ 6 ST/HT Inlet ®� ST Outlet /4 PC Inlet fl" PC Bottom 1 Y �� Header/Manifold ®� Top of ST/PC Manhole Cover Distribution Lines( Bottom of System Final Grade () / G • G () ( ) Date of installation l /tl Per it umber State plan number Plumber's signature License number 42'�'Zl9 ®6 Date 7 Y l Inspector 1` Complete plot plan p' I 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. •�' '� b PLAN VIEW �1 it 1� 1 0 2 � M � 2 d So V o INDICATE NORTH ARROW ,/ Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM y: Safety and Buildings Division Count INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: IX Personal information you provice may be used for secondary purposes [Privacy La 1 s.15.04 (1)(m)]. 338904 Perrr�jt,.kipb�.r fW PAT ❑'I V IQy�cp�f: State Plan ID No.: b�1 L NCi 11`� lt{1 �/J_ CST BM Elev -: Insp. BM Elev.: BM Description: Parcel Talc NQ_1/0114 -30 -105 t oo' lJ 1 L TANK INFORMATION 0 U ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark , 3 Dosing 6 Z w�. i Z Aeration Bldg. Sewer S. /0.2. b Holding 6 TANK SETBACK INFORMATION TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic I NA Dt Bottom 13,6 q 44 Dosing NA Header / Man. 3 . SQL /O Aeration NA Dist. Pipe 3.5 /a V, eY Holding Bot. System SL ' r Z PUMP/ SIPHON INFORMATION Final Grade `(p Manufacturer a � � Demapd S / 1 3 2 Model Number D 3�'�GPM TDH Lift o,tq Lrictio%- ( System S TDH ) 3:tjFt Forcemain Length Dia. HH a Dist. To Well S ABSORPTION SYSTEM �. �� �i%�O = I66 •sg BED RENCH Width 1 , L ( No. Of Tfenthes PIT No. Of Pits Inside Dia. Liquid Depth EN I N S 01 I DIMENSION SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACHING Manufacturer: SETBACK CHAMBER INFORMATION TypeO r Model Number: System: ,25 / >1,sb OR UNIT DISTRIBUTION SYSTEM Header / Manifold it Distribution Pipe(s) 1 x Hol Size x Hole Spacing Vent To Air Intake Length 5 r Dia. Length � Dia. Spacing ��� 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.) �' LOCATION: ERIN PRAIRIE 5.30.17.66C -20 NW,N 783 160TH STREET LOT 6 © � G B � w.e `tom �J.� • S 1Mwr• � . :• 0.SJ4 q0 . Q ZUMA- wed %6& d 8IM - c Plan revision required? E] Yes No Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ' ° 3 { , sp.° a . ..,.... .... .. .. e ... .�.. .. _ ° R e s k 4 E ° ° °.... °... } £° S e e £ _ g m £ �.��. ...E _ r E t t � k 0 e e e E r e i s .... ° �. °,.... .... m - °° �.. «,.....£ E —.._ E s 3 { i E 3 3 � M x 1 3 e e e a k e s s £ e if Safety and Buildings Division Vi sconsin SANITARY PERMIT APPLICATION 201 Box Washington Avenue Department of Commerce In 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 8112 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Permit Number 3 'R z3 b Personal information you provide may be used for secondary purposes ❑ Check if revision to previou application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Numbe[ I. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION a o 5 6 Property Owner Name Property Location y wc S W 1/4L 4, S T 30 , N, R I '1 E (or W Property Owner's Mailing Address Lot Num er Blq�. lumber ZlQ� Cit ,, S� i, ; Zo e � � (hone ;umber Subdivision Name or CSM Number � 0 /a . TYPE F B I IN G: (check one) E] State Owned t N eares oa V Public 1 or 2 Famil Dwellin - No. of bedrooms �_ town OF ! it III. BUILDING USE (If building type is public, check all that apply) Parcel Tax�um,' 1 1 ❑ Apartment /Condo O /� -' /� /Z/ a — / 49 dr - 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Diming 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. ❑ 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 ❑ Seepage Bed 21;PtMound 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 S. Perc. Rate 6. System Elev. 7. Final Grade ft.) Proposed Required (sq. (sq. ft.) (Gals,day /sq. ft.) (Min. /inch) Elevation 600 ('� �} �' L d�{ Z $' Feet ! CJ Feet acit VII. TANK in Cap allo Total # of r Prefab. Site Fiber- plastic Exper INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass App. Nev Existin structed Tanks Tanksl Tanks eptic Tank or / ZQp a El 1:1 1:1 1:1 Pum Tank bet QQ El 1:1 ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumb s Name: (Print) Plumber's I ture: (No S m ) MP /MPRSW No.: Business Phone Number: s a -2 6100 Plum e 's Address t t, Ql 5 ty, State, Zip Code 7 IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate I ssued Issuing A tSi nature (No Stamps) A roved Surcharge Fee) E3�pp ❑OwnerGivenInitial Z�� Adverse Determination �/� I� X X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11197) 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 besubmitted 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. Propert� owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the systemis 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 1/2 x 11 inches must be submitted to the county: The plans must include the following: A) plot plan, drawn to sS#M or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building se rs; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorptions ems; 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 onitoring groundwater contamination investigations and establishment of standards. I - Safety and Buildings 15837 USH 63 HAYWARD WI 54843 -8107 TDD #: (608) 264 -8777 N visconsin www.commerce.state.W.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary April 26, 1999 CUST ID No.662968 ATTN• POWTS INSPECTOR ZONING OFFICE PATRICK SEIDLING y / ,;� T CROIX COUNTY SPIA 1442 CO RD K ,' 1 CARMICHAEL RD NEW RICHMOND WI 54017 HUD WI 54016 RE: CONDITIONAL APPROVAL Identification Numbers APPROVAL EXPIRES: 04/21/2001 F . Iransaction ID No. 220516 SITE: ite ID No.170821 f t ' Please refer to both identification numbers, Site ID: 170821 ST CROIX County, Town of ERIN PRAgUE above, in all correspondence with the agenc W1/2, NW IA, S5, T30N, R17W '� PATRICK SEIDLING FOR: MOUND, 600 GPD Object Type: POWT System Regulated Object ID No.: 463388 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 mound's longest dimension is perpendicular 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). 5. The septic tank shall be a 1200 gallon state approved tank. 6. The minimum dose for this design (C capacity) shall be 205 gallons. The minimum reserve capacity for this design shall be 400 gallons. 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. S DATE RECEIVED 04/16/1999 FEE REQUIRED $ 180.00 ?PATRICIA FEE RECEIVED $ 180.00 L S ORF , POW LAN REVIEWER BALANCE DUE $ 0.00 Integrated Services (715) 634 -7810, FAX: (715) 634-5150, M -F 7:45 AM - 4:30 PM PSHANDORF @COMMERCE.STATE.WI.US WiSMART code: 7633' cc: SHAUN R BIRD SAFETY AND BUILDINGS DIVISION 15837 US Hwy 63 Hayward, Wisconsin 54843 TDD #. (608) 264 -8777 www.commerce. state. wi, us isconsin G. Thompson, Governor Department of Commerce Brenda J. Blanchard, Secretary April 26, 1999 Shaun Bird 513 55 St Clear Lake, WI 54005 Dear Shaun: Enclosed please find two copies of an approval letter for Transaction Number 220516 for Patrick Seidling. The letters are dated April 26, 1999, and supercede the letter dated April 21, 1999. Please attach these letters to the plans. I apologize for any inconvenience. Sincerely, PATRICIA SHANDORF , POWTS PL REVIEWER Integrated Services (715)634 -7810, M -F 7:45 AM - 4:30 PM PSHANDORF (d-)COMMERCE.STATE.WI.US Cc: St Croix County w SBD- 5524 -E (R. 4/98) File Ref: HABIRD APRIL 26.DOC Safety and Buildings 15837 USH 63 HAYWARD WI 54843 -8107 TDD #: (608) 264 -8777 Vhsconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary April 26, 1999 CUST ID No.662968 ATTN.• POWTS INSPECTOR ZONING OFFICE PATRICK SEIDLING ST CROIX COUNTY SPIA 1442 CO RD K 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 04/21/2001 Identification Numbers Transaction ID No. 220516 SITE: Site ID No. 170821 Site ID: 170821 Please refer to both identification numbers, ST CROIX County, Town of ERIN PRAIRIE L above, in all correspondence with theagenc W1/2, NW 1/4, S5, T30N, R17W PATRICK SEIDLING FOR: MOUND, 600 GPD Object Type: POWT System Regulated Object ID No.: 463388 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 mound's longest dimension is perpendicular 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). 5. The septic tank shall be a 1200 gallon state approved tank. 6. The minimum dose for this design (C capacity) shall be 205 gallons. The minimum reserve capacity for this design shall be 400 gallons. 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 04/16/1999 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 PATRICIA L SHANDORF , POWTS PL REVIEWER BALANCE DUE $ 0.00 Integrated Services (715) 634 -7810, FAX: (715) 634-5150, M -F 7:45 AM - 4:30 PM PSHANDORF @COMMERCE.STATE.WI.US WiSMART code: 7633 cc: SHAUN R BIRD Safety and Buildings 15837 USH 63 HAYWARD WI 54843 -8107 - TDD #: (608) 264 -8777 ,sconsin www.commerce.statemims Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary April 21, 1999 CUST ID No.662968 ATTN. POWTS INSPECTOR ZONING OFFICE PATRICK SEIDLING ST CROIX COUNTY SPIA 1442 CORD K 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 04/21/2001 Identification Numbers Transaction ID No. 220516 SITE• Site ID No. 170821 Site ID: 170821 Please refer to both identification numbers,, ST CROIX County, Town of ERIN PRAIRIE above, in all correspondence with the agenc W1 /2, NW1 /4, S5, T30N, R17W PATRICK SEIDLING FOR: MOUND, 450 GPD Object Type: POWT System Regulated Object ID No.: 463388 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 mound's longest dimension is perpendicular 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). 5. The septic tank shall be a 1000 gallon state approved tank. 6. The minimum dose for this design (C capacity) shall be 205 gallons. The minimum reserve capacity for this design shall be 400 gallons. 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 04/16/1999 �y FEE REQUIRED $ 180.00 - FEE RECEIVED $ 180.00 PATRICIA L SHANDORF , POWTS P REVIEWER BALANCE DUE $ 0.00 Integrated Services (715) 634 -7810, FAX: (715) 634-5150, M -F 7:45 AM - 4:30 PM PSHANDORF @COMMERCE.STATE.WI.US WiSMART code: 7633 cc: SHAUN R BIRD Lh., • PLOT PLAN PROJECT Patrick Seidlino ADDRESS 1442 Countv Road K Lot #25 New Richmond Wi 54017 W 1/2 NW 1 /4S 5 /T 30 /R 1 TOWN Erin Prairie COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 4/9/99 BEDROOM 4 CONVENTIONAL IN -G ND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND X)00( SEPTIC TANK SIZE 1200 Gallons LIFT TANK SIZE DOSE TANK SIZE 800 HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 500 BED SIZE 8'X 63' IL BENCHMARK V.R.P. Top of Survey Pipe ASSUME ELEVATION 100' ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark Alt. SYSTEM ELEVATION 104.25 B.M. 49 9' Property Line Scale = 1/4" = 10' All tanks are to be properly bedded with approved warning labels and ,d lockdown cover on dose tank System to be installed along the ST DT 104.6 contour line B -1 W Pro 4 w�`� �� ❑ Bedroom Well is to meet all setbacks House - - B -2 5% � -3 Area 25' below Slope system to remain ` undisturbed 499' Property Line B.M. Designer =/ No� r Date Non -Woven Filter Fabric 4" Observation Pipe Perforated ted Below Filter Fabric ,Distribution Pipe ASTM C -33 Sand ; V Topsoil _ _ _ o p^ � r a Slope ~ Bed Of ��- 2 %2 Force Main ` Drain Rock From Pump Layer ID E �. C Section Of A Mound System Using A tied For The Absorption Area F ' g< G A $' Ft. 6 Ft. 02 I Ft.- J 7,5" Ft. K. Ft. L YS Ft. W e ,, / Ft. L F, J4 4! Observation Pipe ---" 1 - A I 1 1 1 W V) o - - - -- --------------- - - - - -- Forte Moin C .—_{_ -- - -.___ __ _ - - -_ From Pump 3 p Distribution Bed Of % 2 % Pipe Drain Rock 4 Observation Pipe Permanent Morker Pipe or Rods Pion o View Of Mound In A For T� A r Using Bed o e bso Lion Area p PAGE OF r Page Of Distribution Pipe Detail For A Lateral Network PVC Distribution Pipe PVC Force Main P PVC Manifold Pipe X S 1�X X 2 * Last Hole Should Be Next To End Cap * Y P�Ft. S S Ft. X Inches Y Inches Signed: � / Hole Diameter Inch License Number: o2�p9Q(� t1 Lateral Diameter � Inch(es) Date: � Manifold Diameter Inches Force Main Diameter c�, Inches Holes Per Pipe Invert Elevation Of Laterals / O.SO. Ft. • •' PJh1P CHAMI;ER CROSS SEC'IoI•J AKJG :PECIFICATIOK!5 �- -VCQT CAP C - WEATHERPKOOF APFROVED LOCKi:;G JUJDCTIOfJ BOX MAIJHOLE COVEF. 2 T' .ZESH I AIR IM7,AKE GRADE I y„ MIJJ COJDDUIT _ IIDLET PROVIDE I - - -�- AIRTIGHT SEAL * A I III I ALARM e I II i *APPROVED i I OK, JOINTS WITH I ELEV. FT. APPROVED PIPE __� 3' ONTO PUMP -� OFF D SOLID SOIL CONCRETE BLOCK RISER EXIT PERMITED OKJLy IF TAWK MA N UFACTURER HAS SUCH APPROVAL F I SEPTIC f SPEC I CAT DOSE TAJJKS MANUFACTURER: ►DUMBER OF DOSES: PER DAy TANK SIZE: _ �QU GALLOQS DOSE VOLUME �- Zbs U I ALARM MANUFACTURER: INCL D ►JG 6AGKFLOW _ /j ALLON MODEL KlUMBER: .C//� y CAPACITIES: A= 12 1 IMCNE5OF, � jY () GALL OU 5 SWITCH TYPE: S ' ( " 5= 01 IMCHES OR ` - , L 6 � GALLONS _ PUMP /'1AUU FACTURE R: Gd C= N ICHES OR L2 GALL0US Zc, `100EL ►DUMBER: L-7P(9,5 D= 40 INCHES OR 1_0 GALLONS SWITCH TYPE: �In MOTE: PUMP AMD ALARM ARE TO BE MI►JIMUPI DISCHARGE RATE 3�, GPM INSTALLED M 5EPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEU PUMP OFF AAJO DISTRIBUTIOJJ PIPE.._JL_ FEET + MIJJIMUM NETWORK SUPPLY PRESSURE . . . . . 2 5 FEET + S - 0 FEET OF FORCE MAIN X 0� 42 F /ppFTFRICTION FAC rm. _/_-,�L_ FEET TOTAL 0 HEAD = � FEET IIDTERMAL DIME.W I Qf. OF IJK: LEK7GTH _;WIDTH ;LIQUID DEPTH SIGKIED: /� LICE E U . I ' K1S Kl MBER. A b � q� DATE. I __ Goulds Submersible 1F Effluent Pump 3871 EPO4 EP05 APPLICATIONS • Fasteners: 3001 series Fudy submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel grade turbine oil for for efficient heat transfer, • Capable of running lubrication and efficient strength, and durability. following uses: d without lama e to heat transfer. •Effluent systems dry g ■Motor Cover: Thermoplas- • Homes Motor: components. available for automatic and tic cover with integral handle and float switch attachment • Farms nanual operation. Automatic • Heavy duty sump • EPO4 Single phase: 0.4 HP, ,lodels include Mechanical Points. 115 or 230 V, 60 Hz, 1550 ■ Power Cable: Severe duty • Water transfer RPM, built in overload with loat Switch assembled and rated oil and water resistant. • Dewatering ,,reset at the factory. automatic reset. ■ Bearings: Upper and lower SPECIFICATIONS • EP05 Single p lase: 0.5 FEAT heavy duty ball bearing 115 V, 60 Hz, 1550 RPM, , _ construction. Pump: EPO4 built in overload with ,i EPO4 Impeller: Thermo • Solids handling capability: automatic reset. 1astic Semi -open design AGENCY LISTING J /a" maximum. • Power cord: 10 foot with pump out vanes for • Capacities: up to 55 GPM, standard length, 16/3 SJTO mechanical seal protection. SP Canadian standards Association • Total heads: up to 24 feet. with three prong grounding • Discharge size: 1'12" NPT. plug. Optional 20 foot ■ EF05 Impeller: Thermo- (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 S.1TW with plastic enclosed design for end in "F" or "AC ".) rotary/ceramic - stationary, three prong grounding plug improved performance. BUNA -N elastomers. (standard on FP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (4(, -C) continuous superior strength and 140 °F (Ot) intermittent. conosion resistance. • Fastenefs: - -00 series METERS FEET _ stainless steel. to • Capable of running dry without damage to 9 30 -- — __. _ _ —.�. —S GPM components. Pump: EP05 8 2.5 FT 25 • Solids handling capability: o z 3 • Capacities, up to 60 GPM. s 20 - - -- Q • Total heads: up to 31 feet. • Discharge size: 1 NPT. z 5 • Mechanical seal: carbon- 0 15 __ _ i _ .___ rotary/ceramic- stationary, a 4 BUNA -N elastomers. ! EPOS 0 • Temperature 3 lo --- , - - - - - -- - - -- - - - -- 104 °F (40 °C) continuous ePOa 140 °F (60 °C) intermittent. 2 A 5 - -- �i' 0 20 .30 40 50 GPM f o U - - - - - 2 - - i II II 10 12 m /h CAPACITY G' 1995 Couios Pumps. Inc. Ellective May, 1995 B3871 t ; Engin - t Performance Data 40 SHEF40 30 Pump Characteristics 20 Pump/Motor Unit Submersible Manual Models SHEF40MI SHEF40M2 — Automatic Models SHEF40A1 1 SHEF40A2 1 Horse o we/ 4/10 Full load Amps 12 1 6.5 Motor Type Shaded Pole (4 Pole) R.P.M. 1550 f) 10 20 30 !40 50 60 70 Phase 10 GPM Voltage 115 1 230 Total Head (feet) 10 14 17 21 25 28 1 30 35 Hertz Max. (m) 3.0 4.3 5.2 6.1 7.6 8.5 8.8 10.7 Temperature 120° f x. fluid Temp. NEMA Design A GPM (US GPM) 70 60 50 40 30 20 10 0 Insulation Class A (liters /sec) 4.4 3.8 3.2 2.5 1.9 1.3 .63 0 Discharge Size 1 1/2" NPT _Dimensional- Data Solids Handling 3/4" Weight 28 lbs. 3 -7/8" 6.5/8" (168.27) 1. All dimensions in inches. (Metric for Power Card 18/3, SJTW, 20' std. (98'42) --5" (127) international use). (30' optional) - 3 -7/8" 2. (omponent dimensions may (98.42) vary ± 1/8 inch. Materials of Construction Handle Stainless Steel t 3. Not for construction purpose 3 -7/8 "` : DISCHARGE Lubricating Oil Dielectric Oil (96.42) 1 -1/2" NPT unless certified. Motor Housinq Cast Iron FLOAT SWITCH 4. Dimensions and weights are Pump (using Cast Iron approximate. Shaft Steel Mechanical Seal Faces: Carbon /Ceramic (ti 5. We reserve the right to make Shaft Seal Seal Body: Anodized Steel revisions to our product and their Spring: Stainless Steel specifications without notice. Bellows: Buna -N Impeller Engineered Thermoplastic Upper Bearing Bronze Sleeve Bearing 288.9 " 12-3.16" (288.92) (258.76) Lower Bearing Single Row Boll Bearin Bottom Plate Polyester Coated Steel —� 3 -5/8" Fasteners Stainless Steel 2' (50. 8) (92.07) Legs Engineered Thermoplastic —t— 0 © 1998 Hydromatic` Pumps, Ashland, Ohio. All Rights Reserved. ` HYDROMATIC C -Your Authorized Local Distributor - Ohio 44805 Tel: 419- 2893042 Fax: 419 -281 -4087 Deb e: tvww. entoiram;.mm p��rsm,F I i �'`� its 1N All MAJOR CITIES AND COUNTRIES S S -iluso pages of yours phone directory for your local Uislribulon tams: W -02 -6680 1198 5M CD Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings -- — Page of Bureau , 9f Integrated Services �1 gcbrda de with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not 1 S.1 8 1 x TTi s in size. ' Plan must County include, but not limited to: vertical and n tal re (BM), direction and C /'O iX percent slope, scale or dimensions, no a ow, and location and distance to )nearest road. parcel I.D. # APPLICANT INFORMATION se pnki tffibilirmadon., wed by, Date Personal infortnetan you provide may be used .04 1 (m)). Property Owner ; ti Property Location = Govt. Lot t I , /4,S S T 30,N,R 1 E Property Owner's Mailing Address Lot # Block# I Subd. Name or CSM# z <52 7 Z-e-� ar 7�- 1 - City State Zip Code Phone Number ❑ City ❑ viil a ,t Town �� New Construction Use: gResidential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: n Code derived daily flow �{/� gpd Recommended design loading rate bed, gpd*_Z! '` trench, gpd* Absorption area required ,�ao bed, ft trench, ft mum design loading rate / o2 bed, gpd* 1!� 2 trench. gpd/f? Recommended infiltration surface elevations) ��� ft (as referred to site plan benchmark) Additional design/site consi erations i Parent material Flood plain elevation, if applicable 1 It S = Suitable for system Conventional Mound In -Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ S Ku ;Ees ❑ U ❑ S / 4u [Is U ❑ S ,W-U EIS 5d U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 a �-IA -.5 AC A2�� in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench es­ Ground , 4� 04 /, / Depth to limiting r c�in. Remarks: Boring # 3 v r S -,; .t/ , Ground left. Depth to limiting factor 4�Z? in. Remarks: CST Name (Please Print) 99A ture Telephone No. Address Date CST Number Z IL DESCRIPTION REPORT Page of PROPERTY OWNER l PARCEL I.D.# Boring Horizon Depth Dominant Color Mottles Structure 2 g in. Munsell ` Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed ,Trench Ground 3 7 .� �'/? Sr' �/?l' y17 r' �� . , AV- �C�sc --'eft• Depth to limiting factor in. Remarks: Boring # 13� Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # -1 U Ground elev. ft. Depth to limiting factor in. Remarks: Boring # 13 Ground elev. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) r - Soil Test Plot Plan Project Name Richard Tibbett Shaun d Address 207 W 21st. Neillsville Wi 54456 CSTM #3922 Lot 2B Subdivision Date 4 W 1 /2 NW 1/4S T 30 N /R W Township Erin Prairie ❑ Boring ()Well PL Property Line County S T. C ROIX BM or VRP Assume Elevation 100 ft. Top of Survey Pipe System Elevation 1 * H R p Sam as Benchmark Alt. BM Top of Survey Pipe @ 104.6 Alt. 499' Property Line M. Pro 4 Bedroom Building Site 00 100' -1 c� B -2 45' 451 B -3 30' Slope 45' It B.M. 499' Property Line f ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT` AND OWNERSHIP CERTIFICATION FORM i Owner/Buyer i° SQL Mailing Address ���, 2 C�/f Zip 7" L' Property Address (Verification required from Planning Department for new construction) City/State �� ��� Parcel Identification / Numer LEGAL DESCRIPTION Property Location 62 %, %,, Sec. - , T WN -R 7 W, Town of Subdivision Lot # � . Certified Survey Map # / ° 1 , Volume Page # 3 5 Warranty Deed # 5 � Volume 13 7Z . Page # �-� 3 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. Itwe, 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 the three year expiration date. SIGNATURE QP&PLIC 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 PLICAN , DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with 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 13 i�WE?03 STATE BAR OF WISCONSIN ORM 2 - t98 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI DOCUMENT NO. RECEIVER FOR RECORD Richard G. Tibbett and Joanne R. Tibb _ 591838 bu ss - and wife, —` - -- -- — -- 11 -17 -1996 2:30 PM — _ WARRANTY DEED conveys and warrants to _ Patrick J . Seidlina and -_ RECORDING FEE: 10.00 �horah L husban a nd wife PAGE 1 THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS the following described real estate in St Croix ccunty, i b 1 X0­� State of Wisconsin: 1 1 0 U3 3 S 9 i� w,,F Pt 01 - 1014 -3 -100 =ARCEL IDENTIFICATION NUMBER Part of W1/2 of NW1 /4 of Section 5 -30 -17 described: Lot 6 of Certified Survey Map filed November 6, 1998, in Vol. "13 ", page 3546. St. Croix County, Wisconsin. TRANSFER $ 5y- �FEE - Ihis is n ot -__ homestead prorx:ny. )CX)= us not Exception towarrannes: Easer..ents, restrictions and rights -of -way of record, if any. Dated this - �! day of - -- October - - - -__. AD, 1 y_, 98— lSEAl.1 ��'9i_�ivtJ ,-�- __ (SEAL) • Richard G. Tibbett 1 / joanne R. Tibbe (SEAL) —_ iSEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) Richard G. Tibbett, State of Wisconsin, Ss Joanne R. Tibbett Luu-tq authenti cated this Jay o[ October 19 98 ?;r;.mall) came before me this day of -- _ - -• �_ —, the ab,ne named -- - - - -- -- - -- . Kri Og and TITLE. MEMBER STAI E BAR OF WISCONSIN — — - -- ----- - - - --- Of not, authorized by §706.06, Wis. Stats.) to -2 r:-oHTt to be the person echo executed the Ic c;oing acknouledRe the ;ante THIS INSTRU'.IENT WAS DRAFTED BY Attorney K ristina Ogland -- - -- _Hud WI 5401 - tSignatures may be mithenticated or, acknowledged. Both are n ,t "N — mmissn,n is i,enn.In—it- ,if not, eatr ,xp +r. ion Jane necessary) STAIIf B\R •JF - 1 %AkR' \IY11.1D :ems 591098 THIS INSTRUMENT DRAFTED BY MICHAEL ERICKSON JOB NO. 98 -15 BEARINGS ARE REFERENCED TO THE WEST LINE OF THE NW1 /4 OF SECTION m �. 5, ASSUMED TO BEAR S00'17'10 "E. Z UNPLATTED LANDS z 6 0 cn o� Z - WEST LINE OF THE NW1 /4 �" M 16 STREET S 00'17'1 E L' CE NTERLINE S 0 0 17 '10 " E _4 03.1 6 ' _ S 0 0.17 '10" E 1511.55' 2 01.5 8 ' - 2 - — 683.16' 201.45' 201.44' fV o N S00 °00'00 "E cA 402.89' O 00 00 00 rn J N n ............ ............................... h N p n m c/) z z 0� p y cn O z i< N N 00 00 itV � b 0 00 �2 m r C, tD (rl u N N m L O N co 10 L-4 U c), ((1) � N rn c D 0 � o IW G7 m cp pX pz wm jm Ln P CF - -T'i n � V) V ) CJt 0) CO y 00 (0 X M x z r ; J p I-- C:) O � ( - 4 0 y L~ 0 - O o o cy) 00 ii o o c° CD 198.16 198.16 p , L� N00'00'00 "E 396.32' ,'? y QG c UNPLATTED LAND y C o 0 • r ,.r,.... FILED o p V NOV 0 6 1998 r o J J D r KATHLEEN H. WAM ti °- co z ° m Reg ter of t)eeda y o W N z � z m St Croix CoA ri y ► r"C D N� ZC z y � --I D m o m - n o p t�j ti Cn p ° m z� O c o� z0�� '=j (�� 1 m m z D D N N* D z v b r_ 0 O m in Its 0 N D 2 Z z rt Z N G7 z 4, m m ° W n m '" Vol. 13 Page 3546`, :��,