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HomeMy WebLinkAbout034-1060-10-000 $ , }§ 7 � o- % _ \ 0 k k k . m c awe o E. 5 g ( \)f g \ $8E SE , cc � c co ( > o e »k� z ƒ 06.0 _z A ? U. � 2 005 /e�a2 CU LL 73§3&2# « � § � . z � / \ \ $ § ± , CL w \ / z B ) % z . k z k { \ j c / % ! Q 0 z , } k . k � \ � . 0 . I . � § \ ¥ i FL 0 � -� " a a a z � . e B t 2 ;) m « § cc, f f / _ / k § \ ° � » o c 7 © �� D � �f f — m A % ;« , • w\ k 0 E CN w Q ®) ©® ± co a J 8 8 . k £ \ f > k \ k ■ o f ; 7 ) a c o® ' k CN 0) 0\ c k/} 2\ ( ® / % , m k ) _ S , » / m ) k a § k v a 2 2 o U) 2 � Parcel M 034 - 1060 -10 -000 02/15/2005 08:48 AM PAGE 1 OF 1 Alt. Parcel #: 27.29.15.416 034 - TOWN OF SPRINGFIELD 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 LEROY DANOVSKY * DANOVSKY, LEROY 743 HWY 128 WILSON WI 54027 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 743 HWY 128 SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 40.000 Plat: NIA -NOT AVAILABLE SEC 27 T29N R15W 40A NW SW Block/Condo Bldg: Tract(s): (Sec- Twn -Rng 401/4 1601/4) 27- 29N -15W Notes: Parcel History: Date Doc # Vol /Page Type 04/30/1999 602351 1423/207 WD 07/23/1997 1213/568 QC 07/23/1997 1182/485 WD 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 51245 208,200 Valuations: Last Changed: 05/26/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.000 6,450 160,900 167,350 NO UNDEVELOPED G5 39.000 32,200 0 32,200 NO Totals for 2004: General Property 40.000 38,650 160,900 199,550 Woodland 0.000 0 0 Totals for 2003: General Property 40.000 71,100 160,900 232,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 529 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 o3y- f640 rP7 29. fs, c/ /( Si. CROIX COUNTY ZONING DEPARTMENT5 AS BUILT SANITARY REPORT` Owner Z- -, Property Address City /State (.y�'�sa• -� Wi co�Roi- < d/Vi�y At Legal Description: Lot Block Subdivision/CSM # 1 /4 � ` /4, Sec. -2, TAN -R ^W, Town of ,� SEPTIC TANK - DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer /�Ii�w�s� /���� -rfi Size ST/PC/ Setback from: House /3 / Well / P!L y Pump manufacturer fi/i, t.. Model C �✓a 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 I Length �S Number of Trenches Setback from: House o')06 Well o YD' P/L 4 Vent to fresh air intake ELEVATIONS Description of benchmark "rOP Qf I gky 1p©s;' Elevation - 0 Description of alternate benchmark JAY yF et O A16 Elevation 8 Building Sewer "1 '.03 ST/HT Inlet qR 9 ST Outlet r- PC Inlet PC Bottom � . 09 Header/Manifold J4 . j I Z Top of ST/PC Manhole Cover 5 S 0 4 Distribution Lines( ) 1 - 1Z ( ) ( ) Bottom of System () qq • 3 ( ) ( ) Final Grade O 1 8" CoyE0, oc Date of installation / / Permit number , ?76 V State plan number 4 Plumber's signature N License number ~ Date /� Inspector Complete plot plan � `y Y • � 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 Y ky s c. o. g'M iF j pT g�0nuq ioi. Z6 Go. i a s it 5 MANS G CttJ69. 3 Ck j � f� t �< �p'f't �.Lt', ut PVM� C1M9�tQEQ MAN �tiN(ps r.aA 3 Z4-4 N ,itispEcT " /oti PIP4' ,fog 5. 'I, f,, f � � i INDICATE NORTH ARROW . 0 cn 0 -V 0 2 . § g 8 � [ � J ■ � 7 � _ z o o two 2 - w }k \/ ) § k / / d \ CL � k _ § ; 8 8 2§ @ E ¥ C « g \ f § 6 to 7 ® / ± ¢ " \ � & § CL q § § \ CD FT Q- ::�, N ° / co § n r �� CA S � 7 t � z o o o § - Q E , : I z / ( \ v v 8 > 0 m ■ E - _ w CL ( CL z ( J 0 2 \ § § f �- =3 /2} RL CL 7 {/ CD 2 z 0 SO z 0 /z ■ CD § %o z kE k$ /\ CD �© Nz SD CD 2 . �. [= 0 5D PD Q% a § P0 a fk §¢j * *� ® Z % k g)2i2 ID R »x M.7< 0 . kE2EmE ! //§CD ) . i§ 0) 09 . 7 . ;7 Jig ; 0 a A J � &,� � 3 / §' # w . § 0 § ® @ ) % �/ �k _ k� �4 Wisconsin Department of Commercd PRIVATE SEWAGE SYSTEM Count y: Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No -: ST CROIX Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 338964 Permit Holder's Name: ❑ City ❑ Village ® Town of: State Plan ID No.: DANOVSKY, LEROY SPRINGFIELD r,,,,,-4 4Z7 Gr PI CST BM Elev -:- Insp. BM Elev.: BM Description: 'Parcel Tax No.: t9� T CROA,& 034- 1060 -10 -000 TANK INFORMATION ELEVATION DATA A9900218 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic w 6UD Benchmark L_- • /0 Dosing f 8A Aeration Bldg. Sewe (-d,d) 96__- a3 Holding St/ Ht Inlet (3 •(o TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. ventto ROAD Dt Inlet Air Intake Septic >5 >/50 > rep NA Dt Bottom 2 O Dosing > NA Header / Man. '( Sv 9 ,/ Aeration NA Dist. Pipe F z Holding Bot. System S•`I� ' 3 PUMP/ SIPHON INFORMATION Final Grade yea- Manufacturer Demand ( _z � P 0, 0 Model Number w z s 23 GPM S� censer $„2 9� o y TDH Lift •7J� Lrictiorb Systema. TDH 1(.6 ,`� 9G, /o Forcemain Length Dia. FFii Dist -To Well �- SOIL ABSORPTION SYSTEM �L• BM/ UN 11IM/a Width Length No. f renches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS `'E• 76 DIMENSION SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type of /� CHAMBER Model Numb ` System: JllLO,,n,6[ sa > 1 0 - 0 > 11D OR UNIT DISTRIBUTION SYSTEM Header / Manifold Distributi Pi e((( N x Hole Size x Hole Spacing Vent To Air Intake Length�� Dia. Z Length �,, ' Dia. ��� Spacing `— tty W I S, 0 SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed/ Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes No COMMENTS: (Include code discrepancies, persons present, etc A) -`•� I l ('`o S: 9•a� LOCATION: S N �` 1 IA � GFI LD 27.29.15.416,NW,SW 743 HIG Y / 2 ®��" x'3•,2 ' � • t � �,�-) ®let A I �tu wic. �. M c*, `� _.. p �ri.. �o . o rte$ - �� 5t%wel > S• D C. 0 ® f , " l'�"' to ll;`" y.�Q w,el eve✓ w.w..� ae �¢. /�dtre, �k a t = 3 5 Plan revision required? ❑ Yes No Use other side for additional information. t 3o - SBD -6710 (R.3/97) Date I s ector's Signature Cert. No. P of S my - _ , ki �. ADDITIONAL COMMENTS AND SKETCH ' SANITARY PERMIT NUMBER: f Em. ... n e a � a i a e € b i d... , _. i f i S e a„ i F 3 f ,..m., .<. ,........ W....e .e.� ,. �...e .... � � 1 3 v s r t s 3 .. .. e e a t E F - e ' a f 5 ` f € a r ` 4 � a e a w.. E SANITARY PERMIT APPLICATION Safety and Washington Avenue n �. . n 201 W. Washin ton ` isconsi In P O Box 7302 Department of Commerce accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8112 x 11 inches in size. C - . , a /' • See reverse side for instructions for completing this application State Sanitary Permit Number Personal information you provide may be used for secondary purposes ❑ Check if �vj iol 7s a lication [Privacy Law, s. 15.04 (1) (m)]. State Plan I,!?, Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION ProperV Owner Name Property Location O �&j1/4 Std 1/4, 5 a T a , N, R /S E (or)oV Property Owner's Mailing Address Lot Number Block Number Cit , State Zip Code Phone Number Subdivision Name or CSM Number II. TYPE B ILDING: (check one) ❑ State Owned ❑ it Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms o Iowan 111. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) V 21 . I . 41 b 1 ❑ Apartment/ Condo -03� /0,rio0 — iq — 00 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 Q Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sates/ 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. p3� New 2_ ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5_ Q 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 21,4 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 V ABSORP SYSTEM INFORMATION: 1. Gallons Per Day 12. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade I Re�luired (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation oS 3 7 • '3�f �%i Feet Feet Capacity VIL TANK in gallons Total # of r Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existin struded Tanks Tanks Septic Tank g an ��lp /� G✓ ❑ ❑ ❑ ❑ ❑ Lift Pj&mo Tank er ❑ I ❑ I ❑ 1 ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (No Stamps) /MPRSW No.: Business Phone Number: .� u,-s Plumber's AOdress (Street, City, State, Zip Code): O /f IX. OUNTY / DEPAFff MENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing Ag Si ature (No Stamps) Approved E] Owner Given Initial �y rcharge Fee) Adverse Determination X. CONDITIO OF APPROV / RE�S ROVA ' FO ISAPP tiGa,t� 011 -���1/ SBD- 6 8 (R.1 1/97) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber Safety and Buildings 2226 ROSE ST LACROSSE WI 54603 -1905 TDD #: (608) 264 -8777 isconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary May 24, 1999 CUST ID No.4171 ATTN. POWTS INSPECTOR HVAC ZONING OFFICE HALVERSON BROS INC ST CROIX COUNTY SPIA 1020 N BROADWAY 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 05 /24/2001 Identification Numbers Transaction ID No. 226754 Site ID No. 172818 SITE: Please refer to both identification numbers, Site ID: 172818 above, in all correspondence with the agency. St. Croix County, Town of Springfield NW1 /4, SW1 /4, S27, T29N, R15W Facility: G & G Smith LLP FOR: Description: Mound System Object Type: POWT System Regulated Object ID No.: 469476 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. i 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 05/13/1999 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 WiSMAWncode. 7Q G. & G. Smith, LLP - Mound Transaction # Location: NW 1/4, SW 1/4, Sec. 27, T 29 N, R 15 W Town: Springfield County: St. Croix Date: May 10, 1999 Owner,: G. & G. Smith, LLP RECEIVED r Address: Box 78 MAY 13 1999 Downing, WI 54734 SAFETY & BLOGS 01V- Plumber: Brady Dahms Signature:, G� -rte License # MP 220355 Attachments: 6748 -Plan Review Application SBD 8330 Coritiirjo (,'fl page 1: cover rLi 2: calculations oMnnERc 3: lot plan ��� � SAf Y � AN ► �p►N �S rp p tv►s r,F saf T 4: system cross section 5: plan view, lateral detail DENGE 6: pump tank exit detail EE GV'�KES 7: pump curve page 1 of 7 Syst6m Calculations One family residence 3 bedrooms Loading rate x ' 34 ' gallons /sq ft per day Depth to ground water �' Z� in Depth to bedrock ' in Cross slope % Force main length ft of Z in Manifold /header length �yFk ft of in Drainback gallons Lateral length ' \ � @ 4'��14z'S ) ft pf 1114 in ` s/ %,6 bottom of pipe) Lateral elevation ft � ( P P ) Lateral hole size 1 / 4 in @ 60-0 in ( �' ° ft) spacing O /WN O01'6- holes /lateral, 1 cj holes total L ateral vo 1, u, ` ` me '' 6 gallons Total lateral. .discharge rate 22'23 gpm @ �'�� ft head Elevation difference ft Friction loss ft @ �'� gpm Total dynamic head X1.0 ft Pump /sib�wn gpm @ 2 ' ft of head Sw Z� Manufacture °� T' °M�a*�� Model #- Dose volume » gallons Lift /sip%on tank K'+ , � s--° y,illons Septic tank , gallons Measurement pump on & off 1 o'g in Height alarm from tank bottom in Reserve capacity 3 � gallons talcs page of i _ - �vs .l <� 113, t ,Ivy i.. .. ..j...� . 51 �... .... I z""�� �,.• -I -• - : I J j I _' i 3 � e.S� a re O 46�t (i'' � \ Q %fft Zu V. ee_,,C, ` I i 1 1 100 \ 1 ��. ct4.z 1 w..&6 to % JICOA IIL —�� c t 0 11.5' C ��� 4.� s.w�w \�►�a.� s U.��� +i T _4__ 4.0 IO,Z' S�nA, �}�•o' � to. E- 9 �: ` / S • Y.f„� Q W h► �O V � .w t1' 1 LT W ✓� l � �+ yr ( �Gn.� p�,�y : v �... Yo 1 7 : 1 � 0; 'T P V G C.w► app O 1p I a.b v a. iv V`� �: `I�.� �r ��r rw: •w� 2.'S ' �1 v o w. o .�Co,..SZ �,p� � � S"•p' IZ.S �Z.r' I S•o' I 5 0' I S.o' Q0.O' • ��4 �01 o�. \..� +K cf�+�.Jw �O�o... `:..� �. �O'p�' f S'O� � � o.r.� o t J �v . MAIN • lairaTlIERPROVF LOCKING COVER JUNCTION Lc/A�NG QUICK OIac4mvaCT -- 4 C.I. IN Rparrtwm opGwwi 4 977=7177 firrifel fx I. PIPS 3' TO NDIbSuabiD SD1L, y4" Z.D YENT . I 4"C.L. M/W IS C: MIN. Iwtsr • l wuv 23.2" NOa pPOROVtQ A c.z. xF-T ,NT's BAFFLES AL 3' olio . Pam - 4 UI+DIToftm trI ECTIOMi ` G RpNwo C . ow PuNP p ' • b" CavC�eFr'E . mow, 6coC�C SEPTIC APE I'CATI DOSE M TAIJKS MAMUFACTURER: � `"� IJUMBER OF DOSES: PER DAB TAAIK 512C: ,*-%Iro' I°esO GALLOWS DOSE VOLUME ALARM AAUUFACTUKER: S S IUCLUDIIJ(s BACK /LOW: GALLONS MODEL WUTADCR: 1 oL ~ ``� CAPACITIES: A= 23. WCAES OK 394.4- GALLOA15 SWITCH TUPL: Iu CNES OR 3�f GA LLOWS i PUMP MAMUFACTURER: := °� C • �' lkJLhE5 OR III GALLOWS MODEL N1.1145M. D � IN%HES OR GALLOWS SWITCH TJPC: MOTE: PUMP AIJD ALARM ARE TO EE MIIJIlAUM DISCNAR" RAT G►M INSTALLED OW 5EPARATE CIRCUITS VERTICAL. DIFFEREMCE OETWEEU PUMF OFF AUD OISTRIOUTIOU PIPE.. �` FEET ♦ MIA11MtUM UCTWOKK SUPPLY PKE6$URE .... . .. . . . . 2. FILET 1.1 T o 1 1 25� ♦ —L E M FEE OF FORCAIM X F /pprxiRICTIOU iACTOR.._. =_ FEET TOTAL DyWAMIC. 14 Ap = I I 06 FEET o . n fig., IAITERNAL DIMEIJ6kO1Jt 01 TANK: LEW&TN it _;WIDTH ;LIQUID DEPTH 1 VP _q n_ Performance Data Pump Charact 32 Pump/Motor Unit _ Submersible Mamrol Models SW25M1 SW33M1 p � z4 Automatic Models SW25A1 SW33A1 Q 1/3 HP Horsepower 1/4 1/3 is Fell load Amps 8.0 10.0 > 1/4 HP' Motor Type Shaded Pok (4 pole) a R.P.M. 1550 0 8 Phoso 0 1 Voltage 115 9 1 1 , Hertz 60 0 0 10 20 30 40 so 60 CAPACITY -U.S. G.P.M. Operation Intermittent Togwoture 1201 Aa6ient Total Head (feet) 4 6 8 10 12 14 16 18 20 22 24 NEMA Design A 1/4 HP 44 41 36 33 29 26 23 18 12 6 0 Insulation Class A GPM 1/3 HP 47 45 43 40 37 34 30 26 22 16 10 Discharge Sin 1 -1/2" NPT � - Solids Handling 1/2" Dimensional Data Unit Weight 30 lbs. 1. All dimensions in Wo Power Card 18/3, S1TW,10' std. 3.1/2 5 -7/8 2. C omponent dwoemi M moy (20' optional) 4.1/2 --{ ' my t 1/8 inch 3. NW for (WOO Yan purpmn 1 - ti2 NPT Unlessteoiw 3 - 1/2 DISCHARGE 4 Dimensions and III we Materials of Construction S. on/oH level 04US e Handle Steel 6. We reserve do right to Lubricating Oil Dielectric OB 3.1/2 make revisions to ow products and dwir Motor Housing Cost Ira spenfiI WA0W now Puaw Ca sin t Iron I shaft s Mechanical Seal Faces: Carbon /Ceramic Shah Seal Sod Body: Anodized Steel Spring: Stainless Steel Bello Bwa-N PUMP 10.1/8 ON 9 -1/2 Impeller tic Upper Bearling Bronze Shove Boorbs DISCHARGE HEIGHT Lower Bowing Single Row Bell Bowing T 3 3 -1 /2 Strainer /Base Plastic PUMP OFF Fasteners Stainless Steel AURORA /HYDROMATIC Pumps, Inc. w y , �- " 1840 Baney Road, Ashland, Ohio 44805 (419) 289 -3042 i Wisoo&i n Department of Industry $ OUAW SITE EVALUATION Labor and Human Relations • g ) Page of Division of Safety and Buildings .r{t�a sr�a#lc'e-�vi . ILHR 83.09, Wis. County Attach complete site plan on paper not less than r 11 in Plai us include, but not limited to: vertical and horizon rence point ction and sf 0 / X percent slope, scale or dimensions, north arro an locat�rppn¢ distance to nearest road. Parcel I. D. # �'�`� STL }` p ���� � p .r 0 � 0 •• O O O APPLICANT INFORMATION - Please t all i AO on. l ; evi Date l Personal information you provide maybe used for secon , os s Af�A�$Es. ^ 1I m)). p Property Owner operty Location z Govt. Lot 1. 1/45k) 1/4,S ( 2 Ta 9 1F N,R ��r' OW W Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# Q City State Zip Code Phone Number W A/ f Nearest Road w - .! .� �/ > 6y3 .�"9l/ El city El a a Town V OF New Construction Use: Residential / Number of bedrooms Addition to existing building Replacement ❑ Public or commercial - Describe: Code derived daily flow gpd Recommended design loading rate _ bed, gpd/fl trench, gpd /ft Absorption area required _ A ed, ft ^trench, It Maximum design loading rate _gibed, gpd /ft trench, gpd /ft Recommended infiltration surface elevation(s) 9y,.20 f ft (as referred to site plan benchmark) Additional design /site considerations ,c Parent material & 4 Q f A. X r/Z/— Flood plain elevation, if applicable ft S = Suitable for system Conventional I Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system [- X U ®S ❑ U ❑ S ®U 1 ❑ S PC U I ❑ S K U ❑ S ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Ai Al r-If d -5 3 . 6 , � Vj — a I v : Ground elev. Depth to limiting factor 2_kin. Remarks: Boring # 0- 8 /O M F'R S 3Nl ,�"' � •6 a 2. 2. �1 � � L aS �•S• � S vG - S d M F s _ — 64 N` Ground elev. 9a�ft. , Depth to limiting factor 7 L 0R 25'—in. Remarks: �. CST Name (Please Print) /� Si ature Q Telephone No. mil L e SAII / a lJ 71- _5 1-6 Address Date CST Number SOIL DESCRIPTION REPORT PROPERTY OWNER � 6 SM� t4 J-// J-// P age �- of ` PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench lu3" 04 6 Z Al Ground 136q C'- �6 /r M .s .� /i/.� AM elev. , Depth to limiting factor r Remarks: Boring # r *0 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 # ; O N Ground elev. ft. Depth to limiting factor in ' Remarks: Boring # 11, i ., <s- Ground elev. ft. Depth to limiting factor in. Remarks: SBDW -8330 (R. 08/95) I ! lolp _ vv _ I i � 9 1 1 c -- .� -4,41 _ ,- - - - -- - r r ST CROIX COUNTY SEPTIC- TANK MAINTENANCE AGREEMENT AND = OWNERSHIP CERTIFICATION FORM i Owner/Buyer �-, g o Ani o ✓s k y Mailing Address P 6. ®k 3 1S �o (� ,`s Sy 7q `J Property Address 13 9 W L4 J (Verification required from arming Department for new construction) Sop o LV City /State ` � 1 ' l Parcel Identification Number 0 3 y - D 6 O - 10 - ©o e> LEGAL DESCRIPTION Property Location 0 W 1 /a, 5W % Sec. '- 7 , T 2 9 N -R 15 W, Town of `n= Subdivision Lot # Certified Survey Map # Volume . Page # Warranty Deed 4 — 4 A , Volume l VP3 Page # 4 Spec house ❑ yes ❑ no Lot lines identifiable 51"'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 wastewaterdisposal 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 days of the three year expiration date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. 2 SIGNATMIE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed • vo1.1423 PAGE 20'7 602351 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS DOCUMENT NO. ST. CROIX CO., WI RECEIVED FOR RECORD This Deed made between G & G SMITH, LLP, 04 -30 -1999 3:15 PM Grantor and LEROY DANOVSKY, a single man, Grantee, EXEMPT XEMPTTY DEED E N CERT COPY FEE: Witnesseth, That the said Grantor cones to CRAY FEE: y TRANSFER FEE: 117.00 Grantee the following described real estate in St. Croix t RECORDING FEE: 1 County, State of Wisconsin: Northwest One - quarter of Southwest One - quarter (NW -1/4 of SW -1/4) of Section 27- 29 -15. T_� zs T A1&LCr1CJ &Afl c G � 9 JgG Ma,:" Street f1�E. Sp y This is not homestead property. Sy Do� Tax Parcel No. 034 - 1060 -10 -000 Together with all and singular the hereditaments and RETURN TO: appurtenances thereunto belonging; And Grantor t warrants that the title is o od, indefeasible in fee le and free and clear of simple P encumbrances, and will warrant and defend same. Dated this Z C day of , ` , 1999. T G & G SMITH, LLP d (t-4 (SEAL) By: Gerald C. Smith STATE OF WISCONSIN )SS ST. CROIX COUNTY Personally came before me this z4 ff day of April, 1999, the above named G & G Smith, LLP, by Gerald C. Smith to me known to be the person who executed the foregoing instrument and acknowledged the same, being authorized so to do. Notary Public, State of Wisconsin My Commission (expires): Notary Rub A l e r ot xviscons THIS INSTRUMENT DRAFTED BY: M Commission Expires Mamh 17, 2002 Robert W. Mudge, Attorney state of Wisconsin MUDGE, PORTER, LUNDEEN & SEGUIN, S.C� k County of St. Croix 110 Second Street, P.O. Box 469 ,� v 1 hereby certify that this instrument Is a full; true and correct copy of the docurnes on Hudson, Wisconsin 54016 - ' _ file and of record in my office and has been +� compared by m Atte Ap 3 0 . 19 9. — Kathleen H. Walsh ' Kau'ileen H. Walsh Register of Deeds Deputy Safety and Buildings ' 2226 ROSE ST LA CROSSE WI 54603 -1905 TDD #: (608) 264 -8777 *hsconsin www.commerce.state.wi.us Department of Commerce Tommy G Thompson, Governor Brenda J. Blanchard, Secretary August 25, 1999 CUST ID No.264898 ATTN: Plumbing INSPECTOR MUNICIPAL CLERK HALVERSON BROTHERS �� TOWN OF SPRINGFIELD / t % 1020 N BROADWAY 280TH ST. MENOMONIE WI 54751 P) WOODVILLE WI 54028 -7122 RE: CONDITIONAL - •APPROVAL wJ APPROVAL EXPIRES: 08/25/2001 ,�r^ Identifica,46ANumbers; •� } � Transaction ID No. 242753 ST - r'Site ID No. 179363 SITE: �,n ��CF= r Please refer to both identi fication numbers, Site ID: 179363 above, in all correspondence,with1he agency- ST CROIX County, Town of SPRINGFffihD; 743 HWY 128, ORINGFIELD 54027 NW1 /4, SW1 /4, S27, T29N, R15W '~ Facility: DANOVSKY 743 HWY 128, SPRINGFIELD 54027 FOR: Description: PIMS - House / Shed Object Type: Sanitary Drain & Vent System Regulated Object ID No.: 488355 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 installation of the Sanitary Private Interceptor Main Sewer(s). • This approval does not include the private sewage system. Plans for the private sewage system must be submitted and approved before beginning construction on this project. The following conditions shall be met during construction or installation and prior to occupancy or use: • Provide the cleanout at the most upstream point of the private interceptor main sewer as required in s. Comm 82.35(3)(d)1, Wis. Adm. Code. • Provide frost sleeves per Comm 82.35 (5)(a), Wis. Adm. Code. • Provide approved materials, as per s. 84.30, Wis Adm Code. C(� 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. HALVERSON BROTHERS Page 2 8/25/99 Sincerely, DATE RECEIVED 08/24/1999 FEE REQUIRED $ 80.00 FEE RECEIVED $ 80.00 HERMAN J DELFOSSE , PLUMBING PLAN REVIEWER BALANCE DUE $ 0.00 Integrated Services (608)789-5535, MON - FRI, 7:45 AM - 4:30 PM HDELFOSSE @COMMERCE.STATE.WI.US WiSMART�odeti65' cc: THOMAS L BRAUN, PLUMBING CONSULTANT, (715) 634 -3026, MON. 7:45 -4:30 1 i . j / Aj .3 elo RECEIVED VED AijU p 1999 �FE� JIV Vas o�gc °a X151 'tiotzally R OVED =NT OF COMMERCE SAFETY %40 BUILDINGS JRRE PONDENCE Safety and Buildings 2226 ROSE ST LA CROSSE WI 54603 -1905 TDD #: (608) 264 -8777 Ivisconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary May 24, 1999 CUST ED No.4171 a ATT N POWTS INSPECTOR HVAC ZONING OFFICE HALVERSON BROS INC ST CROIX COUNTY SPIA 1020 N BROADWAY 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 05/24/2001 , . t Tdeht 5cation9u m beers Transaction ID No. 226754 Site ID No. 172818 SITE:' Please'r"efer toboth id eprificatl`ontnutri'bers, r. Site ID: 172818 above, in 'all corxcspoadcnce'wtht * agency: ` St. Croix County, Town of Springfield NWI /4, SWI /4, S27, T29N, R15W Facility: G & G Smith LLP FOR: Description: Mound System Object Type: POWT System Regulated Object ID No.: 469476 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. Slats. • 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 05/13/1999 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 WW5..1v1RT,c6de »',7G 3 r LGt s 3- s�►o,. - L-s�v 2 rrr I b I I I I .i _....i_ qiv I' f STre.t. A. Lj ol ri i iv to I I j ses an et<istlr� pr — - - • - - - •- -- — . ... . ! The plu ing Ilor t is pr ,ect r stark of nY I - - - - - (— a agent sta F r uire •t© onsttucti a Irevi of sYs tand�rds nd 18 - i _ • _ i - - e er ttraMt co piie Lei cu . -- - -- - - - —: - PC 1 hat' will be aQver IY l -siv ..� -- -- - --�- - - -=- ,- Keving Grabau From: Jansky, Leroy [Ijansky @commerce.state.wi.us] Sent: Thursday, February 10, 2000 2:25 PM To: Weving Grabau' Subject: RE: question He should have received two approvals prior to installation. 1. Comm 83.03 (1) states that unless otherwise approved by the department (i.e. state plan approval) the private sewage system of each building shall be entirely separate and independent of that of any other building. So DComm approval is required to have one POWTS serve more than one building. 2. Comm 82.20 (1) (b) states that approval by either the department or agent municipality is required, among other things, for private interceptor main sewers (Table 82.20 -2). Based on the above referenced rules, I believe that the plumber should be submitting in for both approvals. He should accurately locate the cleanout he installed since cleanouts in private interceptor main sewers must be installed immediately up stream of the point where the two sewers join together. If the installed cleanout location is unacceptable to the reviewer it will have to be relocated. Note that cleanouts must also have a frost sleeve installed pursuant to Comm 82.35 (5) (a) 2, Wis. Adm. Code. Any questions, please call. Leroy G. Jansky Wastewater Specialist 13 East Spruce Street Chippewa Falls, WI 54729 Ljansky @commerce.state.wi.us E -mail (715) 726 -2549 Fax (715) 726 -2544 Voice • - - - -- Original Message - - - -- • From: Keving Grabau [ SMTP :KevingG @CO.Saint -Croix.WI.USJ • Sent: Thursday, February 10, 2000 10:40 AM • To: 'ljansky @commerce.state.wi.us' • Subject: question > Leroy, > On inspection for septic system the plumber had the builing sewer piped to > the tank that was over 100 feet long and had a cleanout. About 40 feet > before the tank, he had a sewer running from the garage and connected to • the • building sewer of which both go to the tank. Was he supposed to get a • interceptor main sewer plan to you beforehand? what should I require him • to • do now? I looked in the code and can't find an answer. • Kevin Grabau • Zoning Technician • St. Croix County Zoning Department 1