Loading...
HomeMy WebLinkAbout030-2006-95-000 rY o I m o o o pe 06q M Q N c� E E _O O C a Cb X C N O N 0 m j O E N S C E U @ L Y L L ._. a U C ry L L r- CD Q- E m3 v ai M N C F- C m co to y CM y o E 0 N N z N N C X N U) a7 'd z co N "� z y c t I c -.K U C O O. O lL O '@ « �- lL O N j +. C a 3 "3 mo cm 0.mr c `o vo o E QU) 3 E Q 5° E U N O co �} y N z N N rn z E E w O = O v - 0 0 v v v co a m a m Cl) 1- z 0 0 E z �► r - w Ln 0 Q z N z E a E N M Cl) N N C = d cn N C •'� � N O N U p m � p m Q z 2zz :w N - z z M c c ° H E d N E > N �v r L CL c. 'R - c co n m .��. U c v m y d ° o N N d N g 0 0 o a o o a if U) o n CL o z o 0 0 � o 0 0 z •N �aaa N aga IL y 0 m O W N 0 0 J ~ � N w' � N N O Co «. 0 CD > p E 'FU m co p E N N m a) 0 C v m c p d d >- « m a O d Y rn bt co w d N �a o N R O O .. w 0 3 ! o y E w E O LL O 1 'O N = N LA O = cc " O ^ N U d O 0 C U d 0 0 co v O o a o m c o c o a o: m O' *0 N M- 3 0 ;; o o c an N rn � r c N m N U co • O O M U) (n O z c m C� Q Cl) O z R �a �o c. m 0 m a �' l y C- _1 A cia2 o c ( I ,o LO) ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner r G- Property Address &26 1 V o w City /State ,Ll uQko t,Jt sqo/ Legal Description: Lot -- Block — Subdivision/CSM # ILM t/4 V ' /4, Sec. 3 , T :30 N -R�W, Town of 5" �' - ��s2Pk PIN # (5-30 SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: EXS/ L 7 p ack from: House 5 5 We114 � P/L Tank manufacturer N 9- - _�Size/PC Pump manufacturer out Model 3// Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: Width _ Length G, 9 Number of Trenche Setback from: House ,(�� Well 9 6 P/L S _ Vent to fresh air intake O ELEVATIONS Description of benchmark 76 42 Elevation ad d Description of alternate benchmark Elevation Building Sewer ST/HT Inlet ST Outlet `� �' PC Inlet , 7 PC Bottom YL 5 Header/Manifold Top of ST/PC Manhole Cover 9 Distribution Lines () 1 () ( ) Bottom of System O /O-5 O ( ) Final Grade Date of installation 6 114 P it number 3 3 �9 State plan number a a S 7 Plumber's signature License number ,-;� z o S 3 J Date 0/ c / Inspector r Complete plot plan � L l 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 V �o 1 9 6 INDICATE NORTH ARROW B l Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No ST CRO X Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 338968 Permit Holder's Name: ❑ City ❑ Village X] Town of: State Plan ID No.: ANDERSON, MARC ST. JOSEPH CST BM Elev.:- Insp. BM Elev.: BM Description: Parcel Tax No.: 00 -06 /oa. vo' 030- 2006 -95 -000 TANK INFORMATION ELEVATION DATA A9900195 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark aa� � 01DI,FJ f 407 i Dosing Aeration Bldg. Sewer Holding St/ Fit Inlet TANK SETBACK INFORMATION St /Ht Outlet ventto TANK TO P/ L WELL BLDG. Air Intake ROAD Dt Inlet 7 Septic > /ba , - /60' 5S' ;%;? 5 / NA Dt Bottom Dosing y� euu' S$ Ya S' NA Header /Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade ?,' Manufacturer Demand Qj Model Number GPM TDH Lift ljIt 1 Friction Sy �� TDH �� Ft Forcemain Length �6 Dia. Hv Dist. To Wel?5 SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Qf Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS `/ n2 � J DIMENSION SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manu INFORMATION Type of it-ri- System: m� jt �� //0 q/4 OR UNIT DISTRIBUTION SYSTEM Header /Manifold DistributionPipe(s) Ir x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length � Dia. � Spacing V '� a U SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of F xx Seeded/ Sodded xx Mulched Bed /Trench Center �� Bed /Trench Edges ��­/ Topsoil — [t� des ❑ No dyes E] No COMMENTS (Include code discrepancies, persons present, etc.) LOCATION: ST. JOSEPH 34.30.19.373F,NW,NE 670 PINE VALLEY TRAIL � /�� Plan revision required? ❑ Yes [3 Use other side for additional information. o SBD -6710 (R.3/97) Date lvsp or's Signature Cert. No ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: FT , � 1 A a � E A — a !--A- T tt- " All # b 11 . mE s , Ad t j 3 s ,. mA ,.... - 1 T T+ 1--4- j 7 4-4-- , 4 „ T JJ J e y £ t 4 �mea 3 s s 11 7 # c ., 0 .tea i .. g.........,. M.�m E i i a t E E i } � b # 6 s ®� f � 444 y .., e a E., e. e � r —.. ...... �.... . ,m ` _., m� k. ... �. ..» d m U, 2 e E A ' 4 � r r: # E � �t yl1 r e , �.. ....,.._, ., ., ,,, ..... 1 .. �. ;t ..._........ .. u_ .a me ... _..._v_ _..�___. .�.... Safety and Buildings Division AA scons SANITARY PERMIT APPLICATION 201 W. Washington Avenue ac with ILHR I na r m. P O Box 7302 Department of Commerce 83 05, Wis. Ad Code Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County s � than 81/2 x 11 inches in size. ` • State Sanitary Permit Num Personal information you provide may be used for secondary purposes er See reverse side for Instructions for completing this application �p oses � ��� " p ❑ Check i revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION S IS f Property Owner Name Property Location a C✓ QrSo,. w1/4 f 1/4, S � T , N, R E (or]o Property Owner's Mailingkddress Lot Number Block Number r Cit , St a I Zip Code Phone Number Subdivision Name oCCSM Numbe ( 74S) r I. I ' 063 :Q00 L 155 o / a6 �f . TYPE BUILDING: (check one) ❑ State Owned C it y Ne st Road v L Public 1 or 2 Family Dwelling- No. of bedrooms of S7 J Cec, �0 III. BUILDING SE: (If building type is public, check all that apply) Parcel Tax Number(s) q • 1q 3 P 1 ❑ Apartment/ Condo O – 00 — --S 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. ❑ New 2. 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 E] Seepage Bed 21 30 E] Specify Type 41 E] Holding Tank 12 ❑ Seepage Trench 22 - 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 (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation 50 7 37 /, i �! ,a /O 5 V Feet 10,ki Feet Ca acit VII. TANK in gallons Total # of Site INFORMATION Manufacturer's Name Prefab. Con- Steel Fiber- Plastic A per. , New Existing Gallons Tanks concrete structed glass App. Tanks Tanks Septic Tank or-Mvtd'irrtpTa'fAr ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ( sol 1 U i e.S ❑ ❑ ❑ 1 ❑ I ❑ VIII. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plu tier's Sign ure: ( Stam ) 9P/MPRSW No.: Business Phone Number: VA : O .52 . 7 1 - 7 1-S a c0 51 Plum er's Ad ress (Street, City, State, Zi ('1 1 Av io— V --e-(-A� R%A ry Co( �g C " 1 IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater D ate I ssued Issuing a Signature (No Stamps) Approved E] Owner Given Initial Surcharge Fee) Adverse Determination ten X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROV.1�57 SBD- 6398 (11.11/97) 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 maybe 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. 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. Vlll. 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 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. - i ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I ( have inspected the septic tank presently serving the M 01 C- 4lfs ,o,rcovN— residence located at: IV W 1/4, t v g 1/4, Sec. , T N, R_�_W, Town of Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced Did flow back occur from absorption system? Yes No no, skip next line) Approximate volume or length of time: gallons minutes Capacity: /Ococp j Construction: Prefab Concrete Steel Other Manufacurer (if known): A) Age of Ta if known) : N/ IQ' - ��VV V����S (Signature) (Name) Please Print .����5 �� (Title) (License Number) (Date) Farm to be completed by licensed plumber (x.145.06, Wisconsin Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code) — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requirements of ILHR -83, Wis. Adm. Code (except for inspection opening over outlet baffle). Name \3►h` 10 c�cs li" Signature MP /MPR r-�--1 7 5/88 Safety and Buildings ' 2226 ROSE ST Visconsin LACROSSE WI 54603 -1905 TDD #: (608) 264 -8777 www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary May 28, 1999 CUST ID No.273085 ATTN.• POWTS INSPECTOR CALVIN POWERS ZONING OFFICE POWERS EXCAVATING INC ST CROIX COUNTY SPIA 1969 185TH AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 05/28/2001 Identification Numbers Transaction ID No. 225751 Site ID No. 172379 SITE: Please refer to both identification numbers, Site ID: 172379 above, in all correspondence with the agency. '- St. Croix County, Town of Saint Joseph NW1 /4, NEIA, S34, T30N, R19W Facility: Marc Anderson FOR: Description: Mound System Object Type: POWT System Regulated Object ID No.: 468260 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 05/07/1999 JtA t FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 eerard 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 iMAR cpd: 7U33' I J N vi sconsin APPLICATION FOR REVIEW WT es- -Complete lete all a p pages- Department of Commerce Safety & Buildings Division This page may be utilized for fax appointment requests Bureau of Integrated Services Complete and indicate date plans will be in our office NOTE: Personal information you provide may be used for secondary ----­ J1JgJg firmed appointments": purposes [Privacy Law s. 15.04(1)(m)]. r POVVTS at this time. 1. System N Priva Type age Submittal 2. Tye of Submittal: Transactio WRY 2 5 1 Groundwater Monitoring ) New ( ) g (y� Replacement Previous Related Trans. ID: ( ) Site Evaluation �+ POWT'S System ( ) Petition (attach form SBD -9890) 9 #kFEii YDAe - BL QGS D ■ ( ) At Grade ( ) Experimental Review Assigned Reviewer: ,e rf�/ ( ) Holding Tank ( ) Engineered System ( ) Nonpressureized In- Assigned Office: Ground- conventional "Plans must be received in the office of the appointment no later than ( ) Pressurized In- 2 working days before the confirmed appointment. Ground 3. Project Site Information - Fill in all known information. (?q Mound Site Number ( ) Aerobic System ( ) Sand Filter Number & St reet: (1 0 p, ec o T -L . ( ) Constructed Wetland Legal Description: Ivy:. 'I, j (v iE �_`� l.1 T S o ti «� ( ) Other: County cl- ` ( ) Ci ( )Village ( Town of < Gallons per Day: Facility Name: (individ al and /or b sines name of project) Building Type (check one): ( Dwelling, 1 or 2 family f- S ( ) Public Building Facility Address- (project address) Zip Code ( )State -owned Building ` O 4. After plans are reviewed, pleaseN(checi al l that apply) _ Call when completed. Mail plans to custome02, 3, 4 Requesting party will pick up Circle customer number from below. Other: 5. Complete the following designer /owner /requesting information. Utilize the check boxes when designer, owner or requesting party is the same to avoid repeating information. -Des1 her, Inforrrmation (Gusto .,,�..., ,, �, ) ,z,r »� � .F�.� :3-µ ,, ,�.N� Requesting Paity�ifdifferenttlian •designer(Customer�3) �..., , r F' e Name Last Name Customer Number . First Name Last Name Customer Number I S. Co ny Name `+� Company Name / t Ac(dr ss ? " e " - n Address I J J C Cit State Zip +4 (9digits) City State Zip +4 (9digits) Phone Number (area code) Fax or Internet Phone Number (area code) Fax or Internet Check others if applicable Check others if applicable ( ) Owner ) Payer ( Requesting party ( ) Owner ( ) Payer Qv✓rSe "r "tnfomiatiorr( "`torriep2OtheiPldasespecify "(CUstomef4) First Name Last Name Customer Number First Name Last Name Customer Number Company Name Company Name Address Address City State Zip +4 (9digits) City State Zip +4 (9digits) Phone Number (area code) Fax or Internet Phone Number (area code) Fax or Internet Check others if applicable Check others if applicable ( ) Payer ( ) Payer ( ) Other MAKE CHECKS PAYABLE TO DEPT OF COMMERCE TOTAL AMOUNT DUE ��� Attach check here Review Code 7633 SBD -10577 (R.10/98) PAGE/ OF 9 MOUND SYSTEM ' FOR A,3 BEDROOM RESIDENCE LOCATED IN THE 1/40F THE fif� /40F SECTION T N,R)f W, TOWN OF 3±,Zps4,0.1, COUNTY, WISCONSIN. INDEX RECEIVED PAGE IA OF 9 TITLE SHEET MAY 2 5 1999 PAGE 1 OF 9 WORK SHEET PAGE 2 OF 9 WORK SHEET SAFETY.& gLOGS 111V, PAGE 3 OF 9 WORK SHEET PAGE 4 OF 9 WORK SHEET PAGE 5 OF 9 PLOT PLAN PAGE 6 OF 9 PLANVIEW CROSS SECTION PAGE 7 OF 9 DISTRIBUTION PIPE LAYOUT PAGE 8 OF 9 PUMP CHAMBER PAGE 9 OF 9 PUMP PERFORMANCE CURVE PREPARED FOR PREPARED BY OWE X ATING INC. c- tots lly cols 'D , �E ° j of GpN 1969 185th AVE amEN a �� k PR NEW RICHMOND, WISC. 54017 NIS`a SP 715 -246 -5135 s pi NpE r J MdL G rwvwp e�rSo`^ Tagt I WORKSHEET - MOUND SYSTEM DESIGN PROBLEM: Design a mound system for a 3 �� m The site characteristics are: Depth to groundwater or bedrock 3 in. 3 % Landslope Percolation rate Distance from dose chamber to distribution system ago 'ft. Elevation difference between pump and distribution system ,�,3 ft. Step 1. WASTEWATER LOAD = -�`�,,� gal. Step 2. SIZE 'THE ABSORPTION AREA A) Area required SV 5 sq. ft. B) Bird or trench length (B) 375 ft. ft. C) Bed or trench width (A) 'f D) Trench spacing. (C) r b A Wastewater load .24 (oal /ft.: ?_ /day B -- 'r= f`. yS __5 ` � Step 3. MOUND HEIGHT A) Fill depth (D) ft. B) Fill depth (E) D + slope (AY6 _ri�� ft. 4 1 03 11y A/ C) Bed or trench depth (F) _ - r -� Ft ' • I ft. �. D) Cap and topsoil depth (G):_. - -- d topsoil depth H s 5 ft. E) Cap an p p ( ) Step 4. MOUND LENGTH A) End slope (K) _ C D + E + F + H x 3 = / 2 ft. �/ ,334 ins 3 n � B) Total mound le g (L� B 2(K) _ 'Z /N Lft. ':q�,�i�z� = /J'J, Step 5. MOUND WIDTH Al) Upslope correction factor A2) Upslope width (J) - (D + F + G) 3)(factor) ft. C/ 4,%34 -),� /c,g1S B1) Downslopea correction factor = B2) Downslope width (I) _ (E + F + G) 3)(factor) il �, 1zi , g3 +- l,�X 3 x i•I :: 3� Cl) Total mound width (W) for bed = J + A + I fU ft. C2) Total mound width (W) for trenches 3 B� J + � + (no. trenches -1)(c) + A + I = ft. 9,a� - (, �x o -�-a4. Step 6. BASAL AREA A) Infiltrative capacity of natural soil . 3 gal. /ft /day B) Basal area required = wastewater flow 1 ' natural soil infiltrative-capacity = j sab sq. ft. q50 , 3 7 I S� Cl) Basal area available for bed for sloping sites = Bx(A +I)■ �sq.ft. C2) eas W are ; avail le for trench for sloping sites = - /,5 9375 Y 5 oq,y ft. C3) Basal area availab a for trench or bed for level sites = B x W = sq. ft. Sign: Licanse; 'zz: Date: Step 7. DISTRIBUTION SYSTEM 7A) SIZE DISTRIBUTION SYSTEM 1) Hole size = in. 2) Hole spacing = _. 3 in. 3) Distribution pipe length YD'S A 4) Distribution pipe diameter =_ in. 5) Spacing between distribution pipes = in. 6) Distance from sidewall to distribution pipe = .? in. 7B) DISTRIBUTION PIPE DISCHARGE RATE �,�' ft. 1) Number of holes per pipe 2) Flow per pipe _1__. GPM 7C) SIZE MANIFOLD 1) Manifold is „� central / , end 2) Manifold length aLeA, ft. 3) Number of distribution lines 4) Manifold diameter ,-3" _ in. 7D) SIZE FORCE MAIN 1) Minimum dosing rate = _ .3 GPM 2) Force main diameter =. a9a y� 3� 3 in. 3) Friction loss = 3" 49a" x , 003S = �� �3�1 / ),13 ft. 7E) TOTAL. DYNAMIC HEAD 1) Vertical lift = �' ft. 2) Friction loss = f G3 ft. 3) System head 2.5 ft..- ft. 4) Total dynamic head ft. l • i 1F) PUMP SELECTION 1) Pump selected will discharge aO GPM at 1 7 ft. total dynamic head. 2) Pump model and manufacturer 8S O f * 3114 lk3 _P 7G) DOSE VOLUME 1 p 1) 10 times void volume of distribution lines _ gal. /cycle 2) Daily wastewater volume 4 doses /24 hrs. _ / /,� gal. /cycle V50 :f = / p 5 3) Minimum dose volume = a�n,3� ` / ob j 7 X112, gal. /cycle 7H) DOSE CHAMBER 1) Minimum capacity required = Sa 75a gal. Ucunsc ::u: _ Date: _:° o —q9 P)6t P1a Marc. /Q hd� rS�^ Nw -Na sc 3}` 73a —1 G ro f k J� a 4L A 8-m Tvp � w lO '27. 3,x TM,rxQ I X ?. 3 , 7S v . w Fi,(t5 ' oc ' rs ��— ►^� a r c e, ova Pa Of Straw, Marsh Hay, Or Synthetic Covering i45T�1 Ci3,3 _ Distribution Pipe Medium Sand _ N 3 % Slope Of 2�- 2 % 2 Force Main Plowed Aggregate Layer D / Ft. E /. /.Z Ft . Cross Section Of A Mound System Using. - F Ft. I. — nC4,.: For The Absorption Area G / Ft. A 7 Ft. H y,5 Ft. B 93, ' S Ft. K o,z Ft. te. �$ -�D — `T� L I ,L Ft. j ,2. Ft. of Position I /,/ Ft. Force Main W .��� 3- Ft. Observation Pipe --., A — -- -- -- - - -- — — — — —- - — - -- i I i Distribution. \111coeh0 f 2 2 %2 Pipe Aggregate Observation Pipe Permanent Markers x Pion View Of Mound Using ATti,i &kFor The Absorption Area a rC Yv-A Q rs o V , . Page 7 0 Pertoratod Pipe Oeloll lJ End VI�w End Cop y Nftoroted o``o � PVC Pipe Ct . Hotee Located On 130110m, s • Are Equally Spored " G r� f. Lost Hof: Nest To End Cop Oittribulion Pipe Layout P Y45 Ft. R S X 3(v Inches Y -3( Inches 1101c DianIeLm' - ,)4j Inch Lateral Oate; 5 . �o,_ 99 Ftan if o ld " 3 1nchc:; Force Main " 4 I 11C11v; N of holes /pip" I't Invert Elevation of Laterals 1_ D6 Ft. /�nC�rc Rhd ersb•� l 5V Oi 7 PAG PUMP CHAMBER CROSS SEET1014 AND SPECIFICATIONS VCWT CAP 4'G.I. VENT PIPE WCATHCK PROOF APPROVED LOCKING LS' FROM DOOR. JUNCTION BOX P1AIJWLC COVER WINDOW OR FRESH AIR INTAKE I GRADE � '1 MIN. cououlT �-- WAIN. V INLET 'PROVIDE ( -- -- AIRTIGHT SEAL. APPROVED JOINT A I I' APPROVED .JOINTS W /C.I. /IPE I I I W /C.I. PIPE EXTENDIN4 3' I ALARM EXTEIJOING 3' OIJTO SOLID SOIL B I! ONTO SOLID SOIL I C ON E.LEV....__ FT. - -J PUMP --., Off CONCRETE BLOCK RISER EXIT PERMITrCD OULU IF TANK MANUFACTURER HAS SUCH APPROVAL-_j3$Ep A PP tKFO SEPTIC E SPEC_IFICATIOAJS DOSE - TAIJK MANUFACTURER: '� � NUMBER OF DOSES: PER DAIS TAWK SIZE: S � c-1 1 GALLOWS DOSE VOLUME aao GALLONS ALARM MAIJUFACTURLR: El;& C r: IIJCLUDINC� 6ACKr1,OW: / MODEL WUMBER: /o ( W CAPACITIES: A= 16 ' INCHES OR - % `TiALLONS SWITCH TyPC: 0_6L B = cqp IWCHES OR 35 W►LLOLIS__ _ PUMP "MUFACTURCR. G 3 b u C = ' INCHES OR al9'S9 GA MODEL NUMBER: - 39 K5 L A , ) i5p 3 D • 14,g INCHES OR /ga'� GALLON$ SWITCH TYPE: - r:: n CCr MOTE: PUMP A ALARM ARC TO bE MINIMUM DISCHARGE RATE - GPi�/7,f INSTALLED ON SEPARATE CIRCUITS �iSTR VERTICAL DIFFERENCE BETWEEIJ PUMP_OFF AND IQUTION PIPE.. 13. ! FEET + MILAKUM N£TWORIt SUPPLY PRESSURE 2 . 5 . FLET ♦ _Q _ FEET O F FO MAIN 'A _1 = F / upit,FRICTIOU FACTOR.- FEET TOTAL OyIJAMIC HEAD = FILET 67 • l / , i ii INTERNAL DIMEWSIOWS OF TANK: LEW&TH ;WIDTH ._.;LIQUID DEPTH 0DS37 - Goulds Submersible Effluent Pump .3885 APPLICATIONS • Overload protection must smooth operation. Silicon can be operated continuously Specifically designed for the • be provided in starter unit, bronze impeller available as without damage. following uses: Pp Shaft: threaded 400 series an option. ■ Bearings: Upper and • Homes stainless steel. ■ Casing: Cast iron volute lower heavy duty ball bearing Farms • Bearings: ball bearings type for maximum efficiency. construction. Trailer courts discharge � Power Cable: Severe upper and lower. 2" NPT dischar a adaptable duty • •Power cord: 20 foot for slide rail sy stems. • Motels standard length (optional y rated, oil and water resistant. • Schools ■ Mechanical Seal: SILICON Epoxy seal on motor end • Hospitals lengths available). CARBIDE VS. SILICON provides secondary moisture Single phase: • Indust ry CARBIDE sealing faces. barrier in case of outer jacket *% and HP -16/3 SJTO • Effluent systems Stainless steel metal parts, damage and to prevent oil with 115 V or 230 V three BUNA -N elastomers. wicking. prong plug. SPECIFICATIONS • 3 /4 -1'/2 HP -14/3 STO with ■Shaft: Corrosion - resistant ■ 0 -ring: Assures positive Pump bare leads. stainless steel. Threaded sealing against contaminants • Solids handling capabilities: Three phase: design. Locknut on three and oil leakage. 3 /4" maximum. • %2 -1'/2 HP -14/4 STO phase models to guard • Discharge size: 2" NPT. with bare leads. On CSA against component damage AGENCY LISTINGS • Capacities: up to 128 GPM. listed models - 20 foot on accidental reverse rotation. • Total heads: up to 123 feet length SJTW and STW ■ Motor: Fully submerged in SP Canadian Standards Association TDH. are standard. high -grade turbine oil for • Mechanical seal: silicon lubrication and efficient heat U� Underwriters Laboratories carbide -rotary seat/silicon FEATURES transfer. carbide - stationary seat, 300 ■ Designed for Continuous series stainless steel metal •Impeller: Cast iron, semi- Operation: Pump ratings are parts, BUNA -N elastomers. open, non -clog with pump- within the motor manufacturer's • Temperature: out vanes for mechanical seal recommended working limits, 104 °F (40 °C) continuous Protection. Balanced for 140 °F (60 °C) intermittent. • Fasteners: 300 series METERS FEET 90 _ _ _.__ _ -_ stainless steel. SERIES: 3885 — _. -_ .---- -- —_-.— • Capable of running dry 25 80 RPM: VARIOUS W:Et _ ._- — — —► 5 GPM without damage to - ....- ._.........._._...._.. ........ -_ -. -. � components. 70 W.E1 5� i Motor Single phase: _ so • %a HP,115 V, 200 V, 230 V, 1 5- 50 60 Hz, 1750 RPM;' /2 HP, Z ' - - — — - -- - 115 V, 60 Hz, 3500 RPM; 0 40 EO H ' HP -1'/2 HP, 230 V, a - -- - 60 Hz, 3500 RPM. o t0 30 '" • Built -in overload with weo3L automatic reset. 5 20 _ • Class B insulation. o - Three phase: • '/2 HP —1'/2 HP 200/230/ 0 0 460 V, 60 Hz, 3500 RPM. 0 10 20 30 40 50 60 70 80 90 100 110 120 130GPM • Class B insulation. o io 20 3 m CAPACITY ©1995 Goulds Pumps Effective May, 1995 83885 WisconsinDepprtmentofIndustry SOIL AND SITE EVALUATION REPORT Paged ofd Labor and Human Relations Division of Safety & Buildings in accord with ILH R 83.05, WIs. Ad Code COUNTY St. Croix Attach complete site plan on paper not less than 8 1/? x 11 inches in size. Plan must include, but PARCEL I.D. # not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or dimensioned, north arrow, and location and diatance to nearest road. 030-2006-95 APPLICANT INFOIRMATION- PLEASE PRINT A�L INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Marc Anderson GOVT.LOT NW 114 NE 1 /4,S 34T 30 N,R 19 :R(or)W PROPERTY OWNERS MAILING ADDRESS LOT # I BLOCK* SUED. NAME OR CSM s 670 Pine Valley Trl. na I na na CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE [MOWN NEAREST ROAD Hudson, W1. 54016 (715 549 -6267 1 St. Jose h l (j New Construction Use Qc ) Residential I Number of bedrooms 3 ( ) Addition to existing building PC] Replacement [ j Public or commercial descr Code derived daily flow ` 150 gpd Recommended design loading rate • 2 bed, gpd/ft trench, gpd/ft Absorption area required np bed, ft 375 trench, 11 Maximum design loading rate . - 2 bed, gpd/ft 3 trench, gpdM Recommended infiltration surface elevation(s) 105.40 ft (as refetred to site plan benchmark) Additional design/ site considerations system el based oncontour line of 0-1 104._401 Parent material to i t t e d glacial drift Flood plain elevation, if applicable In a ft S = Suitable for system. CONVENTIONAL I MOUND IN- GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem S g] u [� p U 13 S 0 U ❑ ❑ S Chu SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourdary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trerr}t 10yr3 3 none sii lcsbk '- mfr gw 2f .4 55 1 )k€ 2 9 -26 7.5yr4/4 none sicl lmsbk mfr gw if .2 .3 Ground 3 26 -$2 7.5yr4/4 none sl 2mgr mvfr na na .5 .6 elev. 10 Depth to limiting factor +82' - Remarks: Boring # 1 0 -10. 10yr3 /3 none sil 2csbk mfr gw 2f 1 .5 .6 2 1 - : 2a: >: 0 30 10 r4 4 none sicl lmsbk mfr w if .2` .3 3 30 -40 7.5yr4/4 none sl 2mgr mfr gw na .5i .6 Ground elev. 4 0 -80 5yr4/4 none Scl M NA NA na np .2 10 Depth to limiting factor 40" Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. ew Ric on 54017 Signature: ��.. Date: 10 -Q2 -97 CST14amber: m02298 PROPEIVOWNER Marc Anderson SOIL DESCRIPTION REPORT Paget 01 PAKE1.11.64 030- 2006 -95 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda y Roots G Dfft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Twch 1 -10 10yr3 /3 none sil 2csbk mfr gw 2f .5 .6 3 2 0 -31 10yr4 /4 none sicl 2msbk mfr gw if .4 .5 Ground 3 1 -60 7.5yr4/4 c2d 7.5yr5/ scil M na na na np .2 elev. loft. Depth to limiting factor 31° Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # N Ground elev. ft. Depth to limiting factor Remarks: Boring # r : J Ground elev. ft. Depth to limiting factor r STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave CSTM2298 M arc Andrerson New Richmond, WI 54017 MPRSW 3254 NWkNE4 S34- T30N -R19w (715) 246 -6200 town of St. Joseph N 1 =40' BM-= top of well C el. 100' -E- k x fill 00 �' q �, 14 ' Gary L. Steel ' 10 -22 -97 Wisconsin' 13eP1rtment of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Hurtln Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY St. Croix Attach complete site plan on paper not less than 8 h inc es.in,size. Plan must include, but not limited to vertical and horizontal reference r ,.birection ah� lll of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and to wrest road 030-2006-95 APPLICANT INFORMATION -PLEAS NT - RMATION� r EVIEWED BY DATE PROPERTY OWNER: ROPERTY LOCATION Marc Anderson ' t � ' ; OVT. LOT NW 1/4 NE 1/4,S 34T 30 N,R 19 :k(or) W PROPERTY OWNERS MAILING ADDRESS # BLOCK # SUBD. NAME OR CSM # 670 Pine Valley TriVA Cflu tCE na na na CITY, STATE ZIP COD -`;, HO ER �� �, ❑CITY ❑VILLAGE [ZrOWN NEAREST ROAD Hudson, WI. 54016 `(r7''b St. Joseph lPine Valley trl. (] New Construction Use (x ] Residential / Number of bedrooms 3 ( ] Addition to existing building PC] Replacement [ ] Public or commercial describe Code derived daily flow 450 g pd Recommended design loading rate • 2 bed, gpd /ft trench, gpd /ft Absorption area required np bed, ft 3 7 5 trench, ft Maximum design loading rate . 2 bed, gpd /ft 3 trench, gpd/ft Recommended infiltration surface elevation(s) 105.40 ft (as referred to site plan benchmark) Additional design/ site considerations system el based oncontour line of el 104,40 Parent material pitted glacial drift Flood plain elevation, if applicable 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 ❑ S 91 U a s ❑ U ❑ S 0 U ❑ S [i ❑ S [a ❑ S Gi SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trend& 1 0 -9 10yr3 3 none sil lmsbk mfr gw 2f .4 .5 ...1 2 9 -26 7.5yr4/4 none sicl lmsbk mfr gw if .2 .3 Ground 3 26 -82 7.5yr4/4 none sl 2mgr mvfr na na .5 .6 elev. 10 a ft. Depth to limiting factor +82" Remarks: Boring # 1 0 -10 10yr3 /3 none sil 2csbk mfr gw 2f .5 1 .6 LaLa 3 2'`< 2 10 -30 10yr4 /4 none sicl lmsbk mfr gw if .2 .3 30 -40 7.5yr4/4 none sl 2mgr mfr gw na .5 .6 Ground elev. 4 0 -80 5yr4/4 none scl M NA NA na np .2 10 Depth to limiting factor 40" Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715 - 246 -6200 Address: 1554 200th. ew Ric on I 54017 Signature: Date: 10-22-97 CST Number: m02298 it 1 PROPERTYOWNER Marc Anderson SOIL DESCRIPTION REPORT Paged of PARCELI.D.# 030 - 2006 -95 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft .................. in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench ?4> 1 —10 10yr3 /3 none sil 2csbk mfr gw 2f .5 .6 <, 2 0 -31 10yr4 /4 none sici 2msbk mfr gw if .4 .5 Ground 3 1 -60 7.5yr4/4 c2d 7.5yr5/ scil M na na na np .2 elev. 10 3 * 3 ft. Depth to limiting factor 31" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) y STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 Marc Andrerson New Richmond, WI 54017 MPRSW 3254 NW4NE1 S34- T30N -R19Z (715) 246 -6200 town of St. Joseph N 1 " =40' BM.= top of well C el. 100' " o 0 J e o l' ks4 -vr Gary L. Steel 10 -22 -97 J ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND nn OWNERSHIP CERTIFICATION FORM Owner/Buyer ma.rr Mailing Address n 7 n P% h V cMu I - L u A So,, to-t- 's o l Property Address (Verification required from Planning Department for new construction) City /State Parcel Identification Number Q30- bt)ko - !{S LEGAL DESCRIPTION Property Location 1� ' /4, '/,, Sec. _34, T__3C)N -R_j_2_W, Town of ST' J04 . Subdivision , Lot # Certified Survey Map # , Volume , Page #_ Warranty Deed # y 113 -510Q , Volume � � ,Page # Q Spec house ❑ yes l d no Lot lines identifiable 1y 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. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with 1 q g p g p y em h t ie 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 da s of the three year expir ion date. S GNATURE OF PLI ANT IJATE 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 abov , by virtue of a warranty deed recorded in Register of Deeds Office. N Lfi i A 4 'p, S NATURE F A ICANT bATE * * * * ** 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 t STC1354 ' 1 DOCUMENT NO. STATE BAR OF WiSCO .NSI.V FORM I — 1Y63 * "a .."It eaaaw•u roe eaeoeorwe oaa � + _�YARAANTY DEED y., 443562 498 REGISTER'S OFFICE ' This Deed, made hccween ST. aoix Co., %" ' Sandra Lee Gilbert, F /tc /a Sandra G. Kidd Recd for Record t a Single person A:; Grantor. DEC 2 1%8 , d and Mare A. Anderson at 1:00 p Regiaw of 0084 3 Grantee, •�; WitneSBeth, T ^At tl.. .;.a.,•„r •,.r a valuable cnnsiderat cn �•- h Sandra Lee riilbert conveys to Grnntee the t. on,,- ,I t " ,J real rstme in St. Cro i X .a "' "' ' ••t Cu�nq', Sate of R'i.cnnrn ry., Tax parcel No »•.._..�... »...._...».. 'td , Part of the N'W% or the NE': of Section 34, .j • Township 30 North, Range 19 West, Town of St. Joseph, St. Croix rrJ! County, Wisconsin, described as Follows: Lot 1, Certified Survey: Map, recorded May 26, 1931 in Vol. 4, Page 1063, E3 Document No. Jn 371008; ALSO commencing at the NW corner of said 1 it 1;• thence S1 "E,'along the West line of said Lot 1, 126.94 feet to the POINT OF BEGINNING; thence continuing 51' 29'27 "E, along said West :!�{ line, 264.90•feet; thence N73 ", 104.87 feet; thence N1* 29 233.30 Feet; thence N89 29'49 "E, along the South -Iinei of Lot 3, Certified Survey 'Amp, - ecorded in Vol. 3, a p ge 617, 100.0(3 fast •to - the POINT OF ?EGIVNIN'G. FED h This . Ili) IIa not) ;,,• i Together v::th ail and •c-e Jar t`e t 1 x <: e • ...anrr.0 and ;.es :ceret:rtto GeSo. ^.Sing;. And Sandra Lee Gilbert t s : a rants th A the cs!e is C,x+d, • r � , . . < . . . r'e m te< 3imp!e And -rev except t easements, restrictions and rights- oF_way of record, if any. noel Will warrant and ,i.•1.•nd :�•e -, .• A • Ceee ^ber � / t9 8 8 a SEALI t • S_r.dra Lee Gi.oerte F /k /a Sandra i „ r itiEAW AUTHENTICATION ACKN0IVLEDGMEXT Signadtre(s) tiT\'i: r.r 'XI V \ =•\ r, 77 ', as. ant hcr,tcar „I :',.� : t .. r o t....r • me tl• s �� • : 5��. nI ♦: ' t7 39 r - -_3 1 -- - Gi Ibert F /c /a TITLE is 1E1I tF.0 -,. ?_ 3 0. �<idd • - n ..•�,, ttv.l trv Attarney _r - PL "d M�rc A! Anderson . • S 81 N LAND SURVEYING HUDSON , WISCONSIN 54016 ( 715) 366 -2007 Nome St. Croix County Abstract Co. Address 212 Walnut St. Hudson, WI 54016 Description Part of the NWa of the NEB of Section 34, T30N, R19W, Town of St. Joseph, St. Croix County, Wisconsin, described as follows: Lot 1, C.S.M. Vol. 4, page 1063. PLAT DRAWING N This is not a complete Land Survey N88 408.26' W E S N88 ° E 100.00 co L T s s o � M 10 6ti`� house and garage s L a deck ti N M N O 11`rN? N M N M C N ) C N 1 - 1p4 168 - 39, R- 686.27 N73057144nh, C- 204.22 CB- N82 Pr1yate road eas 44.341 ement S8805512911W The location of improvements on this drawing are approximate and.are bcfsec! on a visual inspection of the premises. The lot dimensions are taken from recorded plats and deeds of county records. This drawing is for informz.tic.a'' purposes only and should NOT be used as a complete Land Survey St. Croix County Abstract Co has agreed to waive the minimum standards of AE -5 Mop No 88- 01 -<45:1 Drawn By B.B. 11/23/88 Scale • 1 "= 100' 1 t A r� c FILED MAY G Y 2 1981 1p JAAEa a CONNELL bower of Dead$ St. Ceoix Comf .16 Wisconsb 7 ST. CROIX COUNT Y CERTIF /ED SURVEY MAP LOCATED IN PART OF THE NW 1/4 - NE 1/4 OF SECTION 34, T. 30 N., R. 19 W., TOWN OF ST. JOSEPH, ST. CROIX COUNTY, WISCONSIN CENTERLINE OF SJNPL47'TEp- PERCH LAKE ROAD : 50' 42' • R/W L /NE N I14 CORNER N ORTH L INE OF THE NE 114 OF SECT /ON 34-30 SECT /ON 34-30-19 N. 88 29' 49' E. 903.04' N.88 29' 49 "E. 409.66' ( EAST 418.75') I RAILROAD SPIKE • . .. _ X . (. * — ->F — fF — — C : NE CORNER ( EAST 903.00') R /�y L /NFL 33.OdN. 88 29' 49" E. 368.44' SECTION 34-30-19 l 1 9 o y COUNTY N I I 0000 0� O 77 molVUMENT P"" C I 0 1 w l0 LOT 2 ^? w e �ay � � , `EXISTING Ir-4 1n7 h TOTAL AREA HOUSE OT4 0 LA o I 4 166,006 SO. FT. p I q C.S. M. ly I ro (3.811 ACRES) w VOL.3 1D IC z I p0 .. �; PAGE 816 � t �- AREA EXC R/W I - h I� ro 136,896 SO. FT. m Iv {D 1, ( 3.143 ACRES) I� rn 365.73' ( 365.85') 42.53' :R, r N.88 28' 43" E.(WEST) 408.26' ' F) LOT / 1 rn — t A TOTAL AREA o0 A W E 181,992 SO. FT. IIZ) w (4.178 ACRES) O S m �- AREA EX C. RI OD c? rro 161,369 SO. FT. A �' L EGEND y 0 I ( 3.705 ACRES) �? y �p � � N LA O 1" X 24" IRON PIPE SET O I& - WEIGHING 1.68 LBS. /UN. FT. 0 1" IRON PIPE 'FOUND �` �� n I �` CURVE DATA I m `I 1 I a= 17 06'47" b • I" IRON ROD FOUND , R = 686.27' -1 0 6 .� y /g S L = 204.97' 00, o P. K. NAIL FOUND �! 73 8 3g' C = N. 82 31' 07.5 "W. �� y r� p 44 „ 204_.22' s, Q "i ^� O • POWER POLE OCCUPYING O' 661 � qTE W 4434' O y ♦ OAK LO OCCUPYING `U SAN 0AD : EASEjyElVr xS.88 55 29" W. M CORNER LOCATION �Y P 0 50' 50' >F--x EXISTING FENCE A � TE R X O t la to ( ) DATA OF RECORD NOTE: LOT -2 IS AN EXISTING PARCEL, THE NORTH LINE OF THE NE 1/4 RECORDED IN BOOK 525 OF SECTION 34-30-19 IS ASSUMED PAGE 601 , JUNE 2, 1975. TO BEAR N. 88 29' 49" E. SCALE ONE INCH EQUALS ONE-HUNDRED -FIFTY FEET Iva 100' 50' 0 100' 200' 300' 00 µ +� ALL .. C. APP ROVED 'ROVED NYH HEN � r N&Y 2 0 1981 r lf,, HuDS(m, J" , ST. CROIX COUNTY ��? <'4, j' ;': 1 -, COMPREHENSiYE PARKS PLANNING `�� O ��'@�� AND ZONING COMMITTEE SIGNED Q_L4— C- _ DATED Z 8 ALLEN C. NYHAGEN R.L.S. 1407 VOLUME 4 PAGE 1063' CERTIFIED SURVEY MAPS this instrument wns cirnfted by ken hodkiewicz. JOB N° 81 -09 ST. CROIX COUNTY WISCONSI i +-cam `�i �t�ru..✓' 4 ',.'✓ ti £90T aovd aunTon udasop 'rS TO 31a@TO uh1oT, 686 6 Z, �S�p 1 L(dOSOr ' ;0 ut1OS, our . g porioTdc?r uaag s "eu d t;I SGAJ =nS pa T�TTtaO STur 1 "ou; �3z� zao �Cgazau op�I HrIrSOr 'ZS 30 AI!10Z HIE 'r CIO ?S�T0I3II2330 �% n F b � `hu:;GRH `�, 9 60t C 'Tj 'uospnN r nu r !a uTSar�zn pUCT TS o S ,, r�?r•t��i1N �. I LOtb 'ONI 'S'Z' }? `tfa � tll_T 0 uaTTFT Jr�� .. � � ,.,; �, ,;.� p � Its UTSUO33T11 'uospnil rT- 686 TO r�zrp `�t sTttr paT ;Traa0 aures 2UTdd'euz pu•e 2UT- RGA,znS UT 'sarnr -@qS pasTn821 UTSUO001,1 ;. •�� Z zard' uO ;o suoTsTnozd ruazznO auk tToTM paTTdIT10o �TTn; ar�ttt I � I4. :pagT,zosap pur pal'aAans �xepunoq lO'i..z 7'iXa aU ^} :L0 'e 'T CTLI;4 �E31jr(Y t�aT rT za!1 aTU� �U r .d, 1,aa.znS paT ;Trla0 Sltlr uO t<<!O771s 073 sruauzas7,'G pCOIT s }.unoti pu ,-. -q j, or roc) Cgr,::; sT pur Sa..10"0 66-L sUT134.u00 Tao,z d paq tosop - -)AOgy '3UTUUT ?aq TO ruTod atl o raaT 06' `' ,�L� - ► 6� - 0 6 Yl aOUauq- : raa3 6 *99[ auTT 11 /2r liT.xau pT ?UOTr OOUaur ! q.uauzas'ea pro.z arrnT�zd roo; 99 pasodoad J, Jo @U . "'; /ld Tzaurzou pT�sa.zo ;� auk �u OSTa o.zn pTr.;s ',boazaur �OUa�u�q To ruTOd atir o r raaJ: ZZ'�OZ `," ► ►5'LO 6C M 11 zurl ;o pzouOuoT atZr 'anznO ?sir J0 Otx our �uoTr raa� L6'bOZ �Tzarsar•� aOUaur 1aa LZ'989 so srTpr.z I -u 4 ►L - ►90 - oL 6 ;0 aT�uT: Te.zruaO p uTnrru pu r FTzaurzou paArOUOo kjno 0 a,znrrAtnO ;o ruTOd our PUS u I �► 'H• r • 0 J0 auTT !1/23 1�Tza�sar�, DUr or raa? �'tIti `!1 ��6z —►55 - 088 S aOUauq.. :q-aa; L8'088 `lv/6 '3?I auq.-J:O t/6 l2I Gt1 ;To auTT rsrd7 atlr �uOTr 77 S 0- OU 01 4q- ! raa3 99 ' 60 W6 'ICI our To aUTT tlrio I PT 2UOT- T n -9u a.ouaur !uozrd- ra0Sap slur ;o T: r rUT g �,.0 TU atir Or q.@ tO' X06 6 'I1? atrr ; 0 ouTT tlr zo' our uoTr 6c aoUaur UO .00q pTrs ;o zauzoO t/ 6 r44 ,10 atlr Ve 9 UTOuar=00 :s ° >OTTOT s,, pGgT,zOSap .zaur,zn� 'UTSUOOSTI,. '�rLMO3 xT0,10 'rr 'udasor -;S 70 U .oI; `: 6 6 Z ` "I 0� I ` ✓� uOTrOaS TO ti/ 6 UIS atir ;0 t/ 6 auq- 30 r.zrd N L O.T sz, pagtsoSG sT racldrm pur pa .Ran.zns Zaoj purr[ our To jxrpunoq zoT zarxa a�,r q-13ur �q paq.uasa,zda t ST uoTLIM. TaOJzad put:[ our paddzuz pua pagT,zasap 'P@- a@Azns aAru I `rnor piCuo -cu jo UOTrO@aTp aL,r .fig r"rLIT TTr.zaO Aga zau ' iO, a@AJnS purl pa zarsT a z r ' ua9z Tu IN • 0 u 'I :7ZV3IJIlH 0 S2IU;T112II1S 1101 Carmichael Road Hudson, WI 54016 St. Croix County Phone: (715) 386-4680 Fax: (715) 386-4686 Zoning Department Fax To: Nancy Johnson From: Shame Moe Fax: 386 -0238 Date: June 30, 1999 Phone: 386 -1502 Pages: 2 Re: Septic Report - 670 Pine Valley Trail CC: ❑ Urgent x For Review ❑ Please Comment ❑ Please Reply ❑ Please Recycle •Comments: ST. CROIX COUNTY =° WISCONSIN ZONING OFFICE p n n x x u n n■ ST. CROIX COUNTY GOVERNMENT CENTER d "■ �, 1101 Carmichael Road u Hudson, WI 54016 -7710 (715) 386 -4680 June 30, 1999 Edina Realty Attn: Nancy Johnson 400S.2 nd Street Hudson, Wi 54016 RE: Septic Inspection for Marc Anderson located at 670 Pine Valley Trail, Town of St. Joseph, St. Croix County, Wisconsin Dear Ms. Johnson: A septic inspection of the above referenced property was conducted on June 16, 1999. This property is located in the NW' /4 of the NE% of Section 34, T30N -R19W, Town of St. Joseph, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to comply with the state and local septic codes. The installing plumber was Calvin Powers, license #220537. If you have any questions regarding this, please contact our office at (715) 386 -4680. Sincerely, Y *&-T cticaJ Mary J. Jenkins Assistant Zoning Administrator /sm 0NO 000 K 0 n W � C d C M d A M m .. `° cn v o (n o o C4al 0 m N o o °� ° o ;'o ` ' o o Q Q o m m (D o (o o(D m co o` o_ N p CL 0 N N sz 3 ? N d CD w S v "! c N) m y c o o T o •� (O� 3 3 3 rn - 0 4 , :3 o p !\ U � y . o o :7 d o DI v� D a cn D CD (D (Q CD c d o (D (Q N (D CL CD 0 CD N O "' � �_ 3 O O (D I r y iz CD N N rn a Z C ( r CD Oho (D = 0 r CO) o m o 2 (n a 3 ' cr D O ra n cn = cn v, v, („ Cl) v, 0 > 010 m cr C G A v o a m G a o O Cl) m CD r y �_ O ( D C . y CA A < M y w H N d_ N 3 d Q w Q Z z N o D D o D co o O n� O O o' n o' 3 fn h CD y �� C (D �. 0 cc c - (D m CL a 3 n 3 5 z _ z O ? chi N cn z 7 o. o. W Z m W w ( C,' a a Z 0 3 0 3 A;o m y y Z m D CD C) n N (D d CD f' x V Q L1 .•r 7' 3 � n. C T 'O d � T N C d X O v C z O. c 0) �, z CL O 3 : o 0 a N O j N N 02 W y < x M i rr CD a (D �. �• 21 (o 00 I (Q. m ka O N O W cz 3 A v ti O O N CD m dv o0 (0 w O i CD I O t• ti 4 Parcel #: 030 - 2006 -95 -000 02/28/2005 12:21 PM PAGE 1 OF 1 Alt. Parcel #: 34.30.19.373F 030 - TOWN OF SAINT JOSEPH Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): " = Current Owner " JOHN E & VICKI J DEAN DEAN, JOHN E & VICKI J 670 PINE VALLEY TR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description " 670 PINE VALLEY TR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 4.750 Plat: N/A -NOT AVAILABLE SEC 34 T30N R19W NW NE LOT 1 OF CSM Block/Condo Bldg: 4/1063 ALSO PARCEL IN NW NE COM N 1/4 COR SEC 34 TH N 88DEG E ALG N LN NW NE Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 903.04 FT, TH S 1 DEG E ALG E LN LOT 3 34- 30N -19W CSM 3/617 533 FT TO POB: TH S 1 DEG E ALG W LN LOT 1 CSM 4/1063 264.9 FT TH N more Notes: Parcel History: Date Doc # Vol /Page Type 07/02/1999 606165 1439/219 WD 07/23/1997 828/498 07/23/1997 656/343 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 5725 228,000 Valuations: Last Changed. 07/09/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 4.750 96,900 127,400 224,300 NO I Totals for 2004: General Property 4.750 96,900 127,400 224,300 Woodland 0.000 0 0 Totals for 2003: General Property 4.750 56,800 111,000 167,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 203 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 8 19 FiLVDI MAY 261981 JAAIEE a CONNELL ughter of Dead$ \ St, Lois ' Comfy, ST. CROIX COUNTY CERTIFIED SURVEY MAP LOCATED IN PART OF THE NW 1/4 - NE 1/4 OF SECTION 34, T. 30 N., R. 19 W., TOWN OF ST. JOSEPH, ST. CROIX COUNTY, WISCONSIN CENTERL /NE OF s[NPLATTEQ L,AIYPS PERCH LAKE ROAD 50 4 i 2' • R/W L /NE �ar 1 r. .. ...)..Ai.: N 114 CORNER NORTH LINE OF THE NE //4 OF SECT /ON 34-30-19 SECT /ON 34-30-19 N 88 29' 49" E. 903.04' �/ N.88 29' 49 E. 4 .66 (EAST 418.75') RAILROAD SPIKE' X / i' "�` - � NE CORD✓.- M ( EAST 903.001) R/W L/NFi 33.00'N' 8 29' 4 " E. 368.44' �� C; SEC TI 'l * �' 34-30- 1 190. b(J1 0o R ~ COUNT N Z I ° �( , 9 MC.�NUMEi' 9 ° F tr In o ( ' L OT 2 0 N r y o EXISTING I jr -- t O m TOTAL AREA C� HOUSE -0 g. 0 �: O �> 0 , V, o jw 166,006 SO. FT. `�� A � C.S.M. roh (3.811 ACRES) w� ,- - VOL.3 81c p z AREA EXC, R/W I = h N 136,896 SO. FT. I m ( 3.143 ACRES) 1,0 \ 365.73' (365.86) 42.53' N. 88 28' 43" E. (WEST) . 408.26' . I N LOT / I TOTAL AREA ~ A W E 181,992 SO. FT. CK) S p w (4.178 ACRES) m o AREA EXC. R/W OD LEGEND � a? N 161,369 S0. FT A .p ( 3.705 ACRES) 1 y I O I" X 24 IRON PIPE SET 'C 0 WEIGHING 1.68 LBS. /LIN. FT. h I I r • 1" IRON PIPE `FOUND I D I. / CURVE DATA e ~ I I I I 6," o = 17 06'47" • I' IRON ROD FOUND h \ R = 686.27` �% �tU y \ S., L = 204.97' 1 o P. K. NAIL FOUND /6 8 39, C= N.82 73 57 07.5 "W. �� y pRO p q 204.22' • POWER POLE OCCUPYING O. ss se W. -op- CORNER LOCATION U�oLA1T E ROgp/ L I Q 44:34 ♦ OAK TREE OCCUPYING LPN O' E4 ME/V 55' 29" W. M CORNER LOCATION x - EXISTING FENCE �A�l X50 50 o brn ( ) DATA OF RECORD NOTE: LOT -2 IS AN EXISTING PARCEL, A THE NORTH LINE OF THE NE 1/4 RECORDED IN BOOK 525 OF SECTION 34-30-19 IS ASSUMED PAGE 601 JUNE 2 , 1975. TO BEAR N. 88 29 '49 �� E. g ss SCALE: ONE INCH EOUALS ONE-HUNDRED -FIFTY FEET ,0'' .. �,•• +"r d'Z, 100' 50' O T00' 200' 300' APPRO y° ALM C. NYi'11 4;EN � .ci - 1DT 0` t MAY 2 181 F , Hu�.:�r(�, t ST. CROiX COUNTY c4 ,,_ < COMPREHENSIVE PIt,!:S PlalIvlNG ��,�,�. �U�:,'•(G ��ls AND ZONING COMM111EE SIGNED CJ_Q_Qj�__ C. DATED Z O &I ALLEN C. NYHAGEN R.L.S. 1407 =SURVEY 3 FO FILED w JUN 25 1 979 JAMES O' CONNELL J Sl. CRDIX COUNTYI'h' n•.d, SURVEYORS <RECORD cmix c omtv, wkcaftio CERTIFIED SURVEY MAP NE CORNER SECTION 34 T30N, R19W NI /4 CORNER COUNTY MONUMENT FOUND P.K. NAIL FOUND NO RT H LINE - NE 1/4 S 88 ° 45' 31" W w 668.40' fV iA — LEGEND— M U_NP_L_AT_T_E_D LANDS iq o 0 — .75 ° X 24 IRON BAR WEIGHING NOTE ENCROACHMENT TO BE REMOVED rn 1.502 LBV. /L.F. SET ' N88 ° E POINT OF SECTION CORNER, BERNTSEN CAP 42' $ ° 595.27' ,o BEGINNING *-Y Y EXISTING FENCE I I � BARN oy 0 j 1 9 I HOUSE ❑ SCALE IN FEET I 04 N t 3.936 ACRES 3 0 100 ZOO 300 400 1 N 88 ° 4531 ° E NE I 597.33' o O Z of t ul I�„ 42• S89 ° 11'12��W 0 wl al N a 8.00' Q = o r 0 J 1 O O I (D �.o� (D 0 I = 50' 5.676 ACRES ` w of I p �: W V a W; dp 10 N it W� FI OD M H� I W Z JI ( z IA 2 M Q� U- a l J -J I 0_ =I I I r N88 * 31 °E co Z, U) F w 1 (, -�' 3 592.33' OI ZOM I 'd O a Z WJ_ I>. O N a: u') U, 1 1... 0 1 - I Z Z N In uj to (D T 0) g W Z j i a a 4.000 ACRES 0 11 m cc e co w w I U o 0 SOUTH LINE OF NE-NE �'q 1 h 50' 314.92' 279.52'' 1 I I S 99 594.44' I I NOTE: EXISTING fENCE TO BE REBUILT ON t/4 -1/4 LINE I 1 I i E 1/4 CORNER i 1 UNPLATTED LANDS THIS WAS DRAFTED BY I I 3/4 „ IRON BAR SCOTT B. LOHMAN FOUND I APPROVED JM 211979 ST. CROIX .._ COMPREHENSIV. p,j+ KS FLAN, AND ZO,4It4G COMMITTEE lz APPROVAL OF THIS MINOR SUM VISION NOT MEAN VISION Q BUILDING SITE OR SEPTIC S OC T FOR REFER TO H62.20, Vol. 3 Page 816 X� "5 AS BUILT SANITARY SYSTEM REPORT T OWNE 1`�; TOWNSHIP SEC ,'�TN -R !�W •R ADDRESS �� ST. CROIX COUNTY, WISCONSIN. �� :,;��. �__ SUBDIVISION � � , LOT �! _ LO- SIZE < C LP PLAN VIEW Distances and-dimensions to meet requirements of H63 M EVE THING WITHIN 100•FEET OF SYSTEM > o r Idiae othArrow SMLL la BENCHMARK: (Permanent reference Point) Describe: C . Elevation of vertical reference point -` fir Slope at site:/,-7 SEPTIC TANK: Manufacturer: ../� ,:� Liquid Capacity. l Number of rings on cover : 2 1 � #o Tank manhole cover eleVation: W Tank Inlet Elevation: 2 11 y Tank Outlet Elevation: PUMP CHAMBLR Manufacturer: S 1 4 Number of g allons Number of gal. pump set for a cy cle gallons; total capacity o distribution lines gallon: size of pump head; gallon per minute horsepower ran name of pump and model number ; Type of warning device _ HOLDING TANK: Manufacturer Number of gallons Elevation of manhole cover Type of warning device SEEPAGE PIT.SIZE: Number ot pits teet diameter feet liquid dept seepage pit inlet pipe- elevation bottom of seepage pit c e3 vat�on feet. SEEPAGE BED SIZE: number of lines wi t length tile depth SEEPAGE TRENCH: width length PERCOLATION RATE MA REQ BUILT , INSPECTOR DATED ' j PLUMBER ON - LICENSE NUMBER REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM / vo Sanitary Permit / State Septic /00X 'MME TOWNSHIP St. Croix County CATION / � Sectio Lot # Subdivision PTIC TANK 1 Size gallons Nu of compartments / .stance from: Well Building / 12% slope Highwater_ > MPING r:H AMBER Size gallons Pump Manufacturer Model Number o LDING TANK Size gallons Number of Compartments _ Pumper Alarm System ,istance from: Well Building 12% slope Highwater BSORPTION SITE 7� Be �✓�ir / Trench stance from: Well Building 7 12% slope 7 Highwater - � BSSORPTION SITE DIMENSIONS Width of trench l ft Required area b ft. Length of each line 3 ft Depth of rock below tile in. Number of lines 3 Depth of rock over tile 2 :­ — in- Total length of lines ft Depth of tile below grade in. Distance between lines ft Slope of trench e '- in. per 100 ft. Total absortption area /0 ft Type of Cover: lJ IT DIMENSIONS Number of pits Gravel around pits yes no Outside diameter ft Depth below inlet ft Total absorption area ft Area require ft NSPECTED BY TITLE \PPROVED Azl DATE ,.? 198Z ..EJECTED _ DATE 198__ ;<EASON FOR REJECTION _ - - - - -- - DEPARTMENT OF APPLICATION SAFETY & BUILDINGS 40us `RY, FOR SANITARY DIVISION LABOR AND PERMIT W P.O. BOX 7969 HUMAN RELATIONS (PLB 67) MADISON, WI 53707 Attach plans for the system on paper not less than 8' /z x 11 inches in size. Include a plot plan that is dimensioned or drawn to scale. Horizontal and vertical elevation reference points must be shown. All appropriate separating distances and physical characteristics as specified in chapter H -63, Wis. Adm. Code, must be shown. An index page or each page must be signed, sealed and dated by the designer. If designed by a Master Plumber, the date, signature and license number must be shown. The owners copy or a legible reproduction of the soil test report must be included. Property Owner: Mailing Address: i 111J >R Z Bo K 3#0 4J L ' - , Sala /C,e P ar ty Location: City, Village or Township, CounW ty: At-'14S 3 /T 20 N/R W S7L T S* C.✓.O Lot Number: Blk No.: I Subdivision Name: Nearest Roafl, Lake or Landmark: State Plan I.D. Number: — (:-- _ h / 11 Z W (If assigned) TYPE OF BUILDING O Number of ❑ Public* ❑ Variance ❑ Other (specify)* Bedrooms: 5 1 or 2 Family * State Approval Required. c? TOTAL NUMBER PREFAB POURED -IN STEEL FIBERGLASS NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specif ) SEPTIC TANK CAPACITY HOLDING TANK CAPACITY rJ LIFT PUMP TANK /SIPHON CHAMBER UA MANUFACTURER: EFFL UENT DISPOSAL S YSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per inch): PROPOSED (Square feet): D/New ❑ Replacement ❑ Experimental L0 Seepage Bed ❑ Seepage Pit 2d+ 6 3(a ❑ Alternative (specify) ❑ Seepage Trench Water Supply: Owner's Name as Listed on Soil Test Report (If other than present owner): Private ❑ Joint ❑ Public r S 1, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name of Plumber: Signature: /MPRSW No.: Phone Number: ,.1 S le J `c: 3L,Z (7 1S ),T66•'�99 6 Plumber's Address: Name of Designer: COUNTY /DEPARTMENT USE ONLY ign to of Issuing A nt: Fee: Date: APPROVED Sanitary Permit Nu bar: CJ ❑ DISAPPROVED ea on for Disapproval: Alternate course(s) of Action Available: Change of ownership, building use or plumber requires a Sanitary Permit Transfer Form (67 -T) to be submitted to the county prior to in- stallation. Failure to comply will void the sanitary permit. DISTRIBUTION: White- County, Canary- Bureau of Plumbing, Pink - Owner, Goldenrod- Plumber DI LHR -SBD -6398 (N.03/81) r 1 , 1.... �•� �,� �.,, "ry{ � ! � � � p � , y ��� ✓ el 8 .4 *I �, 1 � tY c1`7. L.1, A o l47 _, __ ___�._ �, , , ' � � �ti. .. � : ,r �, . �� . ? 1 I / �+- ..; .j � ��� _ _ -- 1 EH 115 R ev. 9/76 4 REPORT ON SOIL BORINGS AND PERCOLATION TESTS WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION,%,ZV6 Y%, Section_23�_T N,R rl A (or) (&To i or Municipality Lot No. , Block No. �° C �. S.. 1 /,A Coupty sn ° 1 b ubdiviftpri Name +!� Owner's Name: �� f° �- Mailing Address: uclso ' qCo TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS !&08IE 1 PERCOLATION TESTS SOIL MAP SHEET �Z_ NAME OF SOIL MAP UNIT S 2,G 7-- PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTEF INTERVAL MIN /IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P_3 3�" S�� G 73 0 3Q Yi P- 3�3" S ic 13 - Q ) - l I { !lo Z P 5" 3 �e �3 - Z b - Il i G 1 31 y« z� P- P- P- SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, MOTTLING AND DEPTH TO BEDROCK NUMBER INCHES l OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES / B- ooel 8 C + 10 Z. �. 8 d 5L ab C sc. ..c! B Z `` /lla 8 ►z" 1t B— 3 /CJdv� �i !U"�� 1s7 �S 1 '7SG _ B- 44 ij0 6 l lo rt .S. I " Si - 3 S 1 3® 5 B- 3 `' 8 3 " I t `T'�. a� S 1 IZ" A40 t1 1-.S Gv� B- PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan th location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy o 1 LI J .Indicate scale gr distances. Give horizontal and vertical reference points. Indicate slope. �Z�c.� t-lo�. �Cv E _. _ _ M e '._._. to fN) , s , E _ 1, the undersigend, hereby certify that the soil tests reported on this form were made by me in accord with the procedures nd methods specified in. the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. /� l Name (print) ) C 1 I e ✓1 / V y c3„C &A Certification No. Address 10 Vj a(n L,+ 14-L. d Scv1 W 1 - S CQ .Name of installer if known �- Copy A —Local Authority CST Signature ' � _ J