HomeMy WebLinkAbout028-1019-60-100 ST. CROIX COUNTY ZONING DEPARTMENT
AS BUILT SANITARY REPORT
Owner
Property Address ' d ew
City /State 1 w m' 13 u 2
Legal Description:
Lot Block Subdivision/CSM #
'/a W ' /4, Sec. TM N -R�W, Town of ! + PIN #
SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION:
Tank manufacturer F w CS t C , hSize ST/PC 160 /7 $b Setback from: House 2 u Well P/L
Pump manufacturer ? G l 1 e, rt Model
Alarm location 1? - 4i L c. t-
(HOLDING TANKS ONLY)
Setbacks: Service road Vent to fresh air intake Water Line
Meter location
Alarm location
SOIL ABSORPTION SYSTEM i
Type of system: k Width Length Number of Trenches #
Setback from: House '7 S'` Well P/L ) 5'' Vent to fresh air intake
ELEVATIONS
Description of benchmark N r G Ae Elevation
, �,, ¢
Description of alternate benchmark C o "
� � Elevation * ,
Building Sewer ST/HT Inlet � ?, `1 V ST Outlet .9 PC Inlet v
PC Bottom ?3. 3 G Header/Manifold 7 Top of ST/PC Manhole Cover / b
Distribution Lines
Bottom of System O v O ( )
Final Grade ( ) O ( )
Date of installation h /U/ Permit number 3 State plan number 22
Plumber's signature ,L License number e-1 2.>' Date /'� Q / f (
Inspector �t � U � �
Complete plot plan �+
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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
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INDICATE NORTH ARROW
Wisconsva Department of Commerce PRIVATE SEWAGE SYSTEM Count y
Safety and Buildings Division
INSPECTION REPORT St. Croix
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.:
Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)( 338937
Permit Holder's Name: ❑ City ❑ Village ❑ of: State Plan ID No.:
Ramberiz. David Town of Rush River tea° 3 3 9
CST BM Efev -: Insp. BM Elev.: BM Description: Parcel Tax No.:
(7n . 028- 1019 -60 -100
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic OW Benchmark d -D pfl, p�
Dosing p Alt. BM DT co 42 -"fro
Aeration Bldg. Sewer (3 4S� 88;45
Holding St/ Ht Inlet jq 4 p V
TANK SETBACK INFORMATION St/ Ht Outlet -q ( $� -•F>°f
TANK TO P / L WELL BLDG. vent to ROAD Dt Inlet �. 0 0
Air Intake 15.0
Septic > too Z 01 --- NA Dt Bottom
Dosing N\ �i �. NA Header/ Man.
31 9'x•69 Zo
Aeration NA Dist. Pipe 66
Holding Bot. System 5r O 94.
PUMP/ SIPHON INFORMATION Final Grade K¢, 4 `{
Manufacturer Dema St cover l o. 3o �j [ • �a
Model Number 21� 8 ��• GPM
TDH Lift ,j/ Friction Systema, TDH �?( Ft
m ead
Forcemain Length �� r Dia. Z Dist. To well
SOIL ABSORPTION SYSTEM 4. rLf 4 - q. r a = !S, `t-4
> FQI H Width r Length r No. Of UeRehev PIT No. Of Pits Inside Dia. Liquid Depth
DIMEN I N s .AM4 DIMEN 1 N
SETBACK
SYSTEM TO P/ L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION Type of CHAMBER � � Model Number:
System: • OR UNIT
DISTRIBUTION SYSTEM
Header / Manifold a Distribution Pipe(s) � t .� x Hole Size x Hole Spacing Vent To Air Intake
Length �— .� Dia. Length 3S e J -Dia. J____ Spacing V 1 54 11
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 [I Yes [] No ❑ Yes E] No
COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: I °/ t3/91 Inspection #2:
Location: 383 County Road Y, Baldwin, WI (NW1 /4, NWI /4, Section 13 T28N -R17W) - 13.28.17.102A -10
@4t(1 p4l.-Week
Plan revision required? ❑ Yes No
Use other side for additional inform tion. 00 d S 2
SBD -6710 (R.3/97) Date Inspector's Signature Cert. No.
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ADDITIONAL COMMENTS AND SKETCH t
SANITARY PERMIT NUMBER:
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*; consin Safety and Buildings Division
SANITARY PERMIT APPLICATION pOBoW shingtonAvenue
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
33X'73 "`7
P
ersonal 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 RMATI N I f :?t � ��2
Property Owngr Name Property Location
A r/ 1r4, S /,3 T9 r N, R I IK(or) W
Pro erty Owner's Mailing ddress Lot Number Block Number
c' G. $ !, C C ��: V
City, Sate / Zip Code Phone Num Subdivision Nape or CSM Nu ber
4 /dr✓.,� 40- S , et co ( '�S 7 40r� 5L6 C�/Y1-
11. TYPE OF BUILDING: (check one) ❑ State Owned ❑ Cit Nearest Road
❑ Village
Public 1 or 2 Family Dwelling - No. of bedrooms own OF Il ?cr•r
III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 /�I 24. I j . `Q2)4 _ d
1❑ Apartment/ Condo v O U 1 ` U
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. �tfew 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
______System -------- System ------------- Tank Only --------------- Existing System ________ ExistinaSystem
B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non- Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 Mound 30 ❑ 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
Required (sy. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) p L Elevation
1Y.50 r ? S 3 ? 5 ' - C < Feet 16;& Feet
Capacity
VII. TANK in Ca alto Total # of r Prefab. Site Fiber- Exper.
INFORMATION New Existing Gallons Tanks Manufacturers Name Concrete strutted Steel glass Plastic App
Tanks Tanks
Septic Tank or Holding Tank t L f I �2� • a/ 4, se a: {J ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber r � y'�,y I 1 a" ❑ ❑ El ❑ ❑
Vill. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility #pr installation of the onsite sewage system shown on the attached plans.
Plumber's Name: (Print) Plumbg'r's Signatufe:ANo Stamps) /MPRSW No.: Business Phone Number:
Plumber's Address (Street, City, tate, Zi Code)y
IX. COUNTY / DEPARTMENT USE ONLY
E] Disapproved Sanitary Permit Fee (Includes Groundwater ate ssue Issuing Agent Signature (No Stamps
/Approved E] Owner Given Initial Surcharge Fee)
Ad verse Determination
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
r
SBD- 6398 (R.11/97) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber
'ti
INSTRUCTIONS
1 _ A sanitary permit is valid for two (2) years.
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2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the
Wisconsin Administrative Code will be applicable.
3. All revisions to this permit must be approved by the permit issuing authority.
4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD -6399) to be submitted to the
county prior to installation
5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever
necessary, usually every 2 to 3 years. s
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 the
system is to be installed,.
II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling.
III. Building use. If building type is public, check all appropriate boxes that apply.
IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair.
V. Type of system. Check appropriate box depending on system type.
VI. Absorption system information. Provide all information requested for numbers 1 through 7.
VII. Tank information. Fill,in the capacity of every new /or existing tank, list the total gallons, number of tanks and
manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and
holding tanks for this system. Check experimental approval only if tanks received experimental product approval from
DILHR.
VIII_ Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.),
address and phone number. Plumber must sign application form.
IX. County/ Department Use Only.
X. County/ Department Use Only.
Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must
include the following: A) plot plan, drawn to scale or with 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
included creation f surcharges for number fr I i 1983 Wisconsin Act 410 c uded the treat o o surcha g (f ees) o a o regulated practices which
can
effect groundwater.
The monies collected through these surcharges are used for monitoring groundwater contamination investigations
and establishment of standards.
i
DAVID RAMBERG
t r
3 BEDROOM RESIDENTIAL MOUND DESIGN S; G OI
REVISION ( changes shown in blue)
PROPERTY LOCATION: PROPERTY OWNER:
NW ANW /4 SEC. 13, David Ramberg
T.28N., R17W., Tn of 2048 Co. Rd. N
Rush River, St. Croix Co., WI Baldwin, WI 54002
Pcl.#
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INDEX TABLE
PAGE 1 OF 8 TITLE SHEET
PAGE 2 OF 8 WORKSHEET
PAGE 3 OF 8 WORK SHEET PG. 2
PAGE 4 OF 8 PLOT PLAN
PAGE 5 OF 8 MOUND CROSS SECTION
PAGE 6 OF 8 DISTRIBUTION PIPE DETAIL
PAGE 7 OF 8 PUMP CHAMBER CROSS SECTION
PAGE 8 OF 8 PUMP SPECIFICATIONS
PREPARED BY:
Joe Stang
506 Willow Dr.
Woodville, WI 54028
(715) 698 - 2266
SIGNATURE: � Credential # 223475
DATE: /0 - I �1
Z 1
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REVISED WORKSHEET (Revisions in blue)
David Ramberg, 3 bedroom residential mound
ABSORPTION AREA SIZING
1. Daily wastewater load: 450 Gpd (3 bedroom)(150 gal/bedroom)
2. Depth to limiting factor: 24"
3. Land slope: 6%
4. Infiltrative capacity of soil at system elevation: 1.2 gpd/sq.ft. ASTM C33 med. sand
area required 375 sq.ft.
bed length (B) 75.0'
bed width (A) 5.0'
MOUND DESIGN
1. Mound Height: 2. Mound dimensions:
fill depth (D) 1.00' end slope (K) 10.50'
((1.00 +1.30Y2 +.75 +1.5)3 =10.20
downslope fill depth (E) 1.30' total length (L) 96.0'
1.0 +(6% X 5') =1.30 (75.0')+ (2 X 10.5) = 96.0
aggregate depth (F) 0.75' downslope width (1) 11.50'
(1.30+.75 +1)(3)(1.22) = 11.17
cap and topsoil depth (G) 1.0' upslope width (J) 7.50'
(1.00+. 75 +1)(3)(0.85) = 7.01
Cap and topsoil depth (H) total width (V) 24.0'
7.5' + 5.0'+ 11.5' = 24.0
3. Basal Area:
Basal area required: 900 sq. ft. �,�
450gpd. /0.5ga1. /sq.ft. /day per CSTM = 904` ~ - ' =.1
1
Basal area provided: 1,237.5 sq. ft
;:7 CMC`sk
> = C
(75 1.5) 1,237.5 �..ouNTV
' .. CCNIN
Linear loading rate: 6.0 gal. /linear foot i
450 gal./ 75'= 6.0
I
' 1 j j
• PRESSURE DISTRIBUTION NETWORK
1. Distribution pipe sizing:
Lateral length 35.0'
Lateral size 1 ' /z"
Lateral spacing NA"
Sidewall separation 30"
Hole size '/4"
Hole spacing 56 G st hole at 28" from manifold)
Holes per lateral 8 .
Distribution network discharge rate: 18.72 galJminute
(2 laterals)(8 holes/lateral)(1.I7gal/hole)
2. Manifold sizing:
Location Center
Length NA"
Diameter NA"
3. Force Main:
Diameter 2
Length 150'
Flow rate 18.72 alg /min.
Friction loss 0.24'
(150'x0.68ft. /100ft.) = 1.02ft.
4. Total dynamic head:
Min. supply pressure 2.50'
Vertical lift 15.00' ,
friction loss 1.02'
Total dynamic head = 18.52'
5. Pump selection:
Manufacturer: Zoeller �r
Model number: 98 `
Discharge rate: 28 gpm f Aa, 18.52' tgk
6. Dose chamber manufacturer & capacity:
Midwestern Precast 750 gallon pump chamber,
liquid depth 38.50" @ 19.50 gal. /inch (750.75 gal. actual)
Minimum dose volume: (450gal./4 doses /day) + (.164)(150') = 137.10 gallons per dose
Float & alarm settings:
A) One day holding capacity: 15.50 " = 302.25 gal.
B) Alarm setting: 2.00" = 39.00 gal.
C) Dose volume + back flow: 7.50" = 146.25 gal
D) Reserve storage: 13.50" = 263.25 gal.
TOTAL CAPACITY: 38.50" = 750.75 pl.
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d�c�K way " 5CA.40 p, v
3 bedra�n E /e �f aft -Eqa 0,0 -f"�ng
res�de,tce V
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Page $ Of 8
Cross Section Of A Mound Using A Trench For The Absorption Area
U
'OFF /
Medium Sand Fill -, 1 ° F 6" To soil
3 E D �`�� -
Ca n coww
A M61
Trench Of - 2h" Aggregate, Plowed Layer
6" Below Pipe, Covered With D /.00 Ft. �
Straw, Marsh Hay Or Synthetic Fabric (�
E _/ 30 Ft. G 60 Ft.
F 0.75 Ft. H • 50 Ft.
Plan View Of Mound Using A Trench For The Absorption Area
lot Sd 40
Force Main
Distribution Pipe
Permanent Markers Observation Pipe
A ---- ------ - - - - -- - ------------ - - - - -.
W L
B K
\ ' , Trench Of - 2k" A re Aggregate
9
L
L — —
A S.O Ft. I //45 Ft. K / O.SO Ft. W ZjIa0 Ft.
6 -50 Ft. J 7 60 Ft. L 96.49 Ft.
Page�Of
Y
Distribution Pipe Detail For Two Lateral Network
Holes Located On Bottom
Are Equally Spaced PVC Force Main End Ca�
4 =L *
'Y X X PVC Distribution Pipe
P P
X
* Last Hole Should Be Next To End Cap 'f
P 35.0 Ft. Hole Diameter Y4 Inch
X 56 " Inches Lateral Diameter Inch(es)
Y 56 Inches Force Main Diameter ,Z Inches
# Of Holes /Pipe
Invert Elevation Of Laterals Ft.
97.60
a.
Y PAGE _Z IF S
PUMP CHAMBER CROSS SECT101A AWri SPECIFICATIMS
I
VEUT CAP
yP.Y,L VENT PIPE
WEATHERPROOF APPROVED LOCKMIG
/5' FROM DOOR, JUNCTION BOX MANHOLE COVER
WINDOW OR FRESH 12 "MIU.
AIR INTAKE
GRADE I
COWDUIT _________
18 "MIN. ---- -- - - --
INLET PROVIDE ( __
AIRTIGHT SEAL
I
I I I I
I I I ALARM
a I II.
� I 1
*APPROVED I I ON
JOINTS WITH ( I
ELEV -D FT APPROVED PIPE I
3' ONTO PUMP --�
OFF f°
D SOLID SOIL
a C�/ COMCRETE BLOCK r r-
,N�
RISER EXIT PEFtmrED OWLH IF TANK MAIJUFACTURER HAS SUCH] APP"'OOtLPFICF
SEPTIC E 8PEC. IFItATIOkl
DOSE p -
._ ..
TANKS MAWUFACTUREK: _M d .a S&-n ftCdS IJUMBER OF DOSES: _ PER DAS
TANK SIZE: - ZSO GALLONS DOSE VOLUME
ALARM MAIJUFACTURER: S •T tZCCC - .�o 6vS INCLUDING BACKFLOW: Z� GALLONS
MODEL MUM6EK: /0///")- CAPACITIES: A = /3.50 IMCHES OR 39?. 2 T CALLOAJS
SWITCH TYPE: g = _ INCHES OR MALLOUS
ALLONS
PUMP MAMUFAC.TURER: .ZU� C = �, IIJCHES OR ALLONS
MODEL NUMBER: �9® D= Ip►CHES OR
SWITCH TYPE: &mL MOTE: PUMP AIJD ALARM ARE TO BE ,
MI NIMUM DISCHARGE RATE IAZZ GPM INSTALLED ON SEPARATE CIRCUITS
VERTICAL DIFFERENCE BETWEEAI PUMP OFF AAIO DISTRIBUTION PIPE.. 8 FEET
+ MINIMUM NETWORK SUPPLY PRESSURE �.. . , , . . . , 2.50 FEET
♦ FEET OF FORCE MAIN X V �' F / fxFRlCTlp11 FACTpR. FEET /•OZ
TOTAL OyNAMIC HEAD = °•!�_ FEET
/ S�-
INTERUAL DIMEIJSIOUS OF TAIJK: LENGTH 3S•S�/?
;WIDTH -;LIQUID DEPTH .._._
+_ r
HEADICAPACITY CURVE
EFFLUENT &DEWATERING TOTAL DYNAMIC HEADICAPACITY PER MINUTE
53.65
11 j4 SERIES 57.69 99 137mn 16114161 16]/4163 16514165 19514165 16644196 16014166 16914169
n FT ;t/i! GAL
70
40
Ll'It: GAL .'6TiF': GAL SLTR>:: GAL :. L7R <:. GAL LTR`:': GAL LTit GAL Lm GAL .:LTt(:: GAL: FYI# GAL ,:iLM
12 s ,os 5 .1.52
43 167: 72 .773 17 .r152 106 :601 N 2fl 1 61 231 <I S9 220: 155 '567 153 1667
100
10 1.03 34 1bi. 61 :331 79 :i219 100 376 <i 61 231.: 61 231 i, 56 Y 144 +St <
�_; +S 4:67 19 72: u' '.1741 N : ZU 91 34( <. 60 227:::: 60 2V: 56 220: 142 tq7 14S ::1649`.
>. 95 20 a,tb 25>S 76 .136 : 92 3tb 59 323 ». 60 227:1: Sa .:....;' 176 <i 1 .: 140
2e'.`: 25 ..1�2 6 i'SO:: 74 :260:;: S7 216; <: 59 227; ?; Sa 729..i1�6.. 177
90 '. ..
Z: '
as .. 65 :.246:; SS 2065 S6 320::!: w 7/0 < so " 121 137 .: i.ftlt:
:. ..
26 46 :','1X3', i; 46 1730:: SS 209: 75 ':213 ii st %i 214 ' 105 " j9i!. 114 : `:171:
SO 21 i, 6a:;i 13 i25i: St 19t S6 21941: Stl x220 90 `351 100
w 60 '1/29 15 Ali; A 161:i` 76 :U6::: ad !:'2261: 71 :;1l9r a5 E,ii321>
:. » 70 ;ty31 30 1t4,i t0 If .: 52 Ej;�97< at i91: 70
4156 29 :'n06 54
= fo 2it3
72 i 2 37 1
65
.65 100:30./4 .? ..
21
o fs 110 6
Lock Valve: 1935' 23• 26' S6' 66' 9r 77 175' f1' 112
j 55 63.
WARNING. Model 185/4185 should not be subjected to
w
Ni l
less than 30 feet TDH.
j4 . NOTE: For Head Capacity on Model 112, Industrial
1z" '10 column- explosion proof pump, see FMO219.
1es.41es
30
189,4169
a'
161. '61
/0 .7 188.4 1"
4 , 53.55 137.139
s7s9
U S:
GLLONS w l 1110 120 140 SO I • ' "y
as;. 60 460 2fC 4 SKS4113
- 3i0 , 4o te0
Aw ri y,.
SEWAGE & DEWATERING TOTAL DYNAMIC HEAD /CAPACITY PER MINUTE
- - ;n: SERIES 262 266 267 266 26274262 26414294 29214292 29314293 29414294 295/4295
-: 70 FT (it' Gal Uea: Gal t.OS Gal. Ltrf: I. Lin Gal. 41. Gal Los; Gal. L27s;, Gal. :tlls: Gal ib Gal.'1.t+1
zu 5 5 t#2 90 341 :: 126 �6t: 124 461 1 ;1141 130 ast ISO 6H 137 1447: +96
0 ::w 225 #53
i6
+0 . ate: 60 227: 99 337: 99 337' 89 ; 117 95 366 159 695: +1a tat ti$6: 205 77fi:
1S . f.47'. 223 t16�.;: 50 ;a0.;: 50 169. SO >1a9 67 236 135 St1: 100 176::: +30 iaQ: +63, ;425 195 7 010:
55 20 6,581 10 761: 10 >a 10 :>a 33 123 106 401': a3 322,: 119 4369; ISO 566 168. 636'
16 :
so 23 `. 76 29a> 66 2341': 106 4 1136
al 167' 46 174:1 90 3101 121 140 510'.
40 :1X,'7A 26 9E SO 1661 94:176 115.475-
i 11 2 ': Qo 50 t5,w ...
56 220 69 337::
35 60 401,101; +3 {9 59 227.
j 10 70 11 K' 25 ..95'
o JO
.6" 293.429 793
Lock Valve: 1a' 21.51 21.5• 21.5• 26' Is' 39• 50' 62, 7r
g2D WARNING: Model 293/4293 should not be subjected to
262.4202 less than 15 fee
,4264
t TDH.
u
4 64 -
,o
362 291 4292
S
266. 67, 6e ? 0 OS,..DS
295A295 U.S. CAILONS 10 2D 30 40 SO w 76 e0 90 ,00 110 170 130 140 50 1w 701 IO 230 NO 250 2w 270 w 790 IjpO Jt0 3�0 JJ074°I 350 3!J 310 JR°I390 .001410
- o eo 160 Igo 3zo' 4zJD 460 Se0 6+0 730 e00< eeo 960 1140 „a0 l 60 1440 ,3 4O : ,4710
FLOW PER MNVTF
SKS53
Safety and Buildings
2226 ROSE ST
LA CROSSE WI 54603 -1905
TDD #: (608) 264 -8777
�sconsin www.commerce.state.wi.us
Department of Commerce Tommy G. Thompson, Governor
Brenda J. Blanchard, Secretary
April 16, 1999
CUST ID No.223475 ATTN: POWTS INSPECTOR
ZONING OFFICE
JOE STANG ST CROIX COUNTY SPIA
506 WILLOW DR 1101 CARMICHAEL RD
WOODVILLE WI 54028 HUDSON WI 54016
RE: CONDITIONAL APPROVAL
APPROVAL EXPIRES: 04/16/2001 Identifi bers
Transaction ID o. 220338
Site ID No. 17038
SITE: Please refer to both identification numbers,
Site ID: 170380 above, in all correspondence with the agency.
St. Croix County, Town of Rush River
NW1 /4, NW1 /4, S13, T28N, R17W
Facility: David Ramberg
FOR:
Description: Mound
Object Type: POWT System Regulated Object ID No.: 462079
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED.
The following conditions shall be met during construction or installation and prior to occupancy or use:
• A Sanitary Permit must be obtained from the county where this project is located in accordance with the
requirements of Sec. 145.135 and 145.19, Wis. Stats.
• Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with
the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats.
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 04/12/1999
FEE REQUIRED $ 180.00
FEE RECEIVED $ 180.00
Gerard M. Swim BALANCE DUE $ 0.00
POWTS Plan reviewer - Integrated Services
(608)785-9348, Mon - Fri, 7:15 AM - 4:00 PM
jswim @commerce.state.wi.us WiMART code. '633.
DAVID RAMBERG pD
3 BEDROOM RESIDENTIAL MOUND DESIGN R ECEIVED
APR 1 2 1999
SAFVY & BLDGS DIV,
Q ff, D t Qf ATION: PR
,,. OPER- OWN �.
David Ramberg
NW%NW %, SEC. 13, 2048 Co. Rd. N
T.28N., R.17W., Tn of Baldwin, WI 54002
Rush River, St. Croix Co., WI
Pcl.#
INDEX TABLE
PAGE 1 OF 8 TITLE SHEET
PAGE 2 OF 8 WORKSHEET
PAGE 3 OF 8 WORK SHEET PG. 2
PAGE 4 OF 8 PLOT PLAN
PAGE 5 OF 8 MOUND CROSS SECTION
PAGE 6 OF 8 DISTRIBUTION IPROES IL SECTION
PAGE 7 OF 8 PUMP CHAMBER
PAGE 8 OF 8 PUMP SPECIFICATIONS
ATTACHED SOIL EVALUATION P •o
Con diti�)nat l y
o f �Ut:,MER DINS r
�idEN E( AND 8
M F.D BY: DfPAR gAF
D ►v►s►o
Joe Stang C� �GSP ENCE
506 Willow Dr. EE Rt
Woodville, WI 5402
7 698 -226
r dential 2 4
SIGNATURE. G
DATE:
,Ba Cda�h, cJ1. 5
Loss` / 0�'�0� %1►�sed (vol 13,
f pro I�:liritd
/�wyrn�yy, &c. /3
`� d�sb�rb+►NCC� -rig /t., R. 17 0).,Jown
C
,e g-. 1'cree wtam
6 -1
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ire po�x.� pa(.t• pr%bscd _
A�su id twr =�oo.�' so rc. Pu^4° � E CORRESPONDEN
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o �--- P roPo %Qd !,
3/8.7/ •
Propt�std
3 be.&
rc s ' drncc
'�. ProposcdWCU
Y, Page 1 of 3
'V�►is=%sin Department ofCommerce SOIL AND SITE EVALUATION
Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code
Environmental By Design
Attach complete site plan on paper not less than 8'h x 11 inches in size. Plan must County
0 include, but not limited to: vertical and horizontal refer mp
oht (BM), direction and St. Croix
percent slope, scale or dimensions, north arr 3� loc4tlory and, distance to nearest road.
Parcel LD.# ° - -60
APPLICANT INFORMATION - W e grin all infon;igtion. R By Date
Personal information you provide m vacy may be fQi pil es (Pri l� s. 15.04 (1) (m)). //
...... ,. r! f�i(crt GEC +/d
Property Owner ` " ' o ,, G cj Property Location
__ 1. "A .�'
Ramberg Da�1id sr Govt. Lot NW 1/4 NW 1!4 S 13 T 28 N,R 17 W
�..
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
2048 C Rd N 1 Lindquist
City St ;Zip Co*-AN, q*I*er El City ❑ Village ®Town Nearest Road
Baldwin W1\54 Rush River CTH T
New Construction Use: ®Rdsidnat7 of bedrooms 3 ❑Addition to existing building
❑ Replacement Public or commercial describe
Code Derived daily flow 450 gpd Recommended design loading rate 1.2 bed, gpd/f 2 1.2 trench, gpd/IF
Absorption area required 375 bed, ff 375 trench, fl? Maximum design loading rate 1.2 bed, gpd/f? 1.2 t rench, gpd/fl?
Recommended infiltration surface elevation(s) 98' ft (as referred to site plan benchmar
Additional design / site consideration
Parent material loess over glacial till Flood plain elevation, ff liable NA ft
S= Suitable for system Conventional Mound F 71n3round Pressure AT - Grade System in Fill Holding Tank
U= Unsuitable for system ❑ S ®u ® S ❑ u ❑ S ® U ❑ S ®U ❑ S ®U ❑ S ® U
SOIL DESCRIPTION REPORT
Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/fF
Boring# in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed ' Trench
1 1 0 -9 10yr3 /2 - sit 2msbk mfr cw 2f .5 i .6
2 9 -29 10yr4/4 - sit 2msbk mfr cw if .5 i .6
Ground 3 29 -34 10yr4/4 c2d7.5yr5/8 sit lmsbk mvfi - - .2 .3
elev
92.53 ft
Depth to
limiting
factor
29"
Remarks:
... ..............
2 1 0 -12 10yr3 /2 - sit 2msbk mfr cw 2f .5 .6 '
2 12 -24 10yr4 /4 - sit 2msbk mfr cvv if .5 .6
Ground 3 24 -30 10yr4 /4 c2d7.5yr5/8 sit lmsbk mvfi - - .2 .3
elev
95.34 ft
Depth to
limiting
factor
24
Remarks:
CST Name (Please Print) Signature: �. ,✓ Telephone No.
Thomas C. Nclson — '" 715 - 244 - 2454
Address Environmental BY Design Date CST Number Ref #
1432 120th Street, New Richmond, WI 54017 2/10/99 227387 210
- PROPERTY OWNER: Ramp, David SOIL DESCRIPTION REPORT zoo Page 2 of 3
PA bEAU Environmental By Desi
Horizon Depth I Dominant Color Mottles Texture Structure onsistence Boundary Roots GPD/fis
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed 'Trench
3 1 0 -12 10yr3!2 - sil 2msbk mfr cw 2f .5 6
2 12 -25 10yr4/4 - sil 2msbk mfr cw if .5 .6
Ground
elev 3 25 -30 10yr4 /4 c2d7.5yr5/8 sil lmsbk mvfi - - .2 .3
96.40 ft
Depth to
limiting
factor
25
Remarks:
Ground
elev
Depth to
limiting
factor
Remarks:
Ground
elev
Depth to
limiting
factor
Remarks:
Ground
elev
Depth to
limiting
factor
Remarks:
z .
r
[NVI ONA[KTAL 15
1432120 STREET
NEW RICHMOND, WISCONSIN
(715) 246-2454
Dave Ramberg — Lot
NW / 4 NW ' /4, SECTION 13 T 28 N, R 17 w
Troy Township, St. Croix County, Wisconsin
Page 3
N �,�► Q3
v II 1
Prq A r t y * 0 �e_
� 5 k� Cll VIC�21�
SCALE 1" =40 50 Thomas C. Nelson
BM 1. Top of nail in power pole ELEV 100 Certified Soil Tester #227387
BM 2. Ground surface next to fence post w/ ribbon ELEV 99.52'
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer 01 `� j �� �`�;;j r
Mailing Address
Property Address 3 C
(Verification required from Planning Department for new construction)
City/State �� ��'�4. C✓ Parcel Identification Number
LEGAL DESCRIPTION
Property Location L L ' /a, Sec. , T � N -R 1 7 W, Town of l? k .i 4 e
Subdivision , Lot #
Y p
t 12 6 , e l
Certified Surve /.3 , Page# 262
fi Ma # �- , Volume
Warranty Deed # 6 0 2 � � � �Y , Volume N � S � , Page # '2
Spec house ❑ yes ❑ no Lot lines identifiable Z yes ❑ no
SYSTEM MAINTENANCE
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance
consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system
can affect the function of the septic tank as a treatment stage in the waste disposal system.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system
is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge.
Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards
set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification
stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30
day of \\ the a year expiration date.
�
J 05
SIGNATURE O LICANT 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 Un ty esc 'bed above, by virtue of a warranty deed recorded in Register of Deeds Office.
0b YA
SIGNATURE OF ICANT 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
V(tl. 142 P I' 276
KATHLEEN H. HALSH
' REGISTER OF KE!IS
Document Number
WARRANTY DEED ST. CROIX CO., YI
KMIM FOR R
This Deets, made between Leroy D. Lindquist and Carol L Lindq� 45-14 -1999 10104 AM
Grair-tor, huz and and wife, as survivorship marital property and David P.
Ramberg, Grantee. Mqm BEEN
Vritness+eth, That the said Grantor, for a valuable consideration of ogee
EMT r FEE:
dollar and other valuable consideration conveys to Grantee the W FEE:
following described real estate in St. Croix County, State of Vvwxu^ sin: TWOU FEE: 12.00
KWING FEE: 10.00
Recording Area
Name and Return Address
Bakke Norman, S.C.
900 Main Street
PO Box 54
Baldwin, Wt 54002
I
Part of: 029-1019 -60
(Parcel Iden;iFcation Number)
Lot 1 of Certified Survey Map fiW April 1, 1999, at the St. Croix County Register of Deeds Office in Volume 13,
Page 3623 as Document number 600406, described as a parcel of land located in the NW % of the NW % of
Section 13, T28N, R17W, Town of Rush River, St. Croix! County, VVisconsin.
This is not homestead property.
Together with all and singular hereditaments and appurtenances thereunto belonging;
And Grantor warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances
except easements, highways, utility rights and reservations of record, and will warrant and defend the same.
Dated this 30t 1 day of April, 1999.
C
' 'Leroy Lindquis
'
*Card L Lindquf&st
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) Leroy P Lindquist and STATE OF WISCONSIN
ST- CROIX COUNTY
Car i_. Lindquist PersAnally came before me this 30th day of April, 19% the
above named Leroy D. Lindquist and Carol L. Lindquist to
authenti is 30th day 999. me known to be the person(s) who executed the foregoing
— insbionent and acknowledge the same.
signTre
Thomas R. Schumache.
type or print name —
type or print name
TITLE: MEMBER STATE BAR OF WISCONSIN �7 Public St. Croix County, Wisconsin.
MY commission is permanent. (if not, state expiration date:
(If not
authorized by §706.06, Wis. Slats.) -
'Names of persons signing in any capacity should be typed or
THIS INSTRUMENT WAS DRAFTED BY pr* eed below their signatures.
Thomas R. Schumacher
Baldwin, Wsconsin
(Signatures may be authe nticated or acl Both a r e not
Mor ie,:on Profess—fs Company Fond & Lx, Ktsconsm e0C.655 -2021
L y
r� `\
Rn
199 9
G00406
CERTIFIED SUR VEY MAP
Located in the NW 1 /4 of the NW 1 / 4 of Section 13, T28N, R17W, Town of Rush
River, St. Croix County Wisconsin.
NW CORNER OF SECTION 13, Bearings referenced to the West line of the NW' /4 of
T28N, R1 7W, RUSH RIVER Section 13 previously recorded as and assumed to be,
9 ( FROM TIES) NO(P07'05 '
0
ip
0
0
Z UNPLATTED LANDS
N
33 33' N 89° 52'54" E 275.00 Scale 1" =100'
33. I
66
' 242.00 SCALE IN FEET
j., I = 0' 25'50' 100' 200'
' Y
•v
° : N LOT 1 g IZ
1 0) a 87,135 square feet o '�
W, (D' I C9; : 3 ( 2.000 acres) 4
U , ' S including R.O.W. o LAND OWNED BY:
O ' ZJI a ' _ 0 r 76,733 square feet `' 'm LEROY & CAROL
� N ' —°' I -Cl Z� c ( 1.762 acres) m ip LINDQUIST
01 W, W, IY, o 1 excluding R.O.W. Z 2027 C.T.H. "N"
o r 0D p Baldwin, WI. 54002
o
� Iz
Wig, I ; Z
V�
� " _ r 242.02 co, ' N 89° 20'43" W 275.02
Zi I z I b' I SOUTH LINE OF THE NW 1/4 OF THE NW 1/4
QI I = o
-�� UNPLATTED LANDS
N
W, I z ' 50' LEGEND
F'I
i
Q� W - Indicates Section Corner
J. 3
t o
Monument ( as noted )
Z, I 50' ° O - Indicates 1" X 24" iron
c pipe weighing 1.13 lbs.
Z W1/4 CORNER, SECTION 13 lin. ft. set.
T28N, R17W, RUSH RIVER
( P.K. NAIL FOUND)
n
Prepared b "
eP Y�
GRANBERG SURVEYING r
t
1239 C.T.H. "E"
4
New Richmond, WI. 54017
Phone ( 715 ) 246 -7529
Job No. 99 -005 Q
. z
THIS INSTRUMENT DRAFTED BY: JOSEPH W. GRANBERG SHEET 1 OF 2
Vol. 13 Page 3623