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CROIX COUNTY ZONING DEPARTMENT ` AS BUILT SANITARY REPORT 0 Owner Z Property Address 3 _\ City /State U1 /` ,smao Legal Description: Lot &_ Block NA Subdivision/CSM # ANA N-W- 3 - L ' /4, Sec. 3 , T3J_N -RAW, Town of S7AA(7,oA PIN # 35�7 3/ - - ELM SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer GUIES" Size ST/PC lipol s6o Setback from: House 2 Well P/L Zgd! Pump manufacturer acs -cc& Model 137 Alarm location / -Ions (HOLDING TANKS ONLY) Setbacks Service roa e Water Line Meter location ocation SOIL ABSORPTION SYSTEM Type of system: ,4&amo Width _ 5 Length 3_ Number of Trenches Setback from: House 56 Well P/L Z Vent to fresh air intake 7,T ' ELEVATIONS Description of benchmark 02 ? `' /gy ° Elevation /OD.o Description of alternate benchmark �De 2 PIIC Elevation Building Sewer ?7,0,5 Inlet 85 ST Outlet 8 PC Inlet PC Bottom ? /,/,? Header/Manifold Top of ST/PC Manhole Cover FZJ Distribution Lines O Y g G 1 O O Bottom of System () % 9. O g ( ) ( ) Final Grade () X00. L / () ( ) Date of installation 1 Permit number -?VgSo / State plan number . 1 7 - 3 A DO Plumber's signature - License number 12z 7 Date 1281 Inspector SON►fl• -WIAJ Complete plot plan p' 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 53 ` pouK� O &V& wq eon .�h 4 r� CoMg 7 oC X 000 u/lES�� ISOp GAC, 5C14 11 6�' yo INDICATE NORTH ARROW Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Buildings Division I , INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary 3445 01 Permi IX Personal information you provice may be used for secondary purposes [Privacy La I s.15.04 (1)(m)j. Per s N ❑ Cit V Town of: State Plan ID No.: "2���, ITT y SyAl�� 2.7.1 }SD o - rm%S• A). CST BM Elev.:. Insp. BM Elev.: BM Description: Nrcel Ta No.: b0 /ov Zip L t 36- 1091 -70 -000 TANK INFORMATION f - 13- ff ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic I� Benchmark , /�y 9 /do Dosing C`.e•vM �` 4 97--30, eration Bldg. Sewer olding St /Ht Inlet $'gy .6z' .TANK SETBACK INFORMATION tl t TANK TO P/ L WELL BLDG. Air I ntake ROAD Air Septic > loo ;ZO — NA Dt Bottom Dosing 1Ivv ''t a6 ` NA Header / Man. .6q Dist. Pipe Ing Bot. System Lf 38 51 4/lyz cam, p.), PUMP/ SIPHON INFORMATION Final Grade .v ,U � g t Cow . Manufacturer '� a d 1o3,10 loo n 1 Model Number tl 35 PM TDH Lift { -S6 Friction ,p 1 , System 6 TD 23 -�' t oss Forcemain Length t Dia. H u Dist. To Well SOIL ABSORPTION SYSTEM 7f P BED/TRENCH Width , Leng �jj i f No_ Of Trenches PIT No. Of Pits Inside i Liquid Depth DIMENSIONS 3 2 I DIMENSION SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEA CHIN nu acturer: SETBACK ER INFORMATION Type O , C I Number: System: j) - OR UNIT DISTRIBUTION SYSTEM Header / Manifold iI Distribution Pipe(s) � t x Hole ize,, x Hole Spacing Vent To Air Intake t. Length 5-401 Dia. 2- Length �� Dia. jz Spacing 31 I)� . 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 I Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) 6 o Art 44m LOCATION: STANTON 3 .31.1 8B,NW,SE 1843 COUNTY ROA T vs�6. J d .7/ `j�', 6y f-*T 7, 441 � Wv P t" ) Ju +U �� )�Q Ian revision required? ❑ s j' No p4& L��?eo; X526 Use other side for additional information. ` all SBD -6710 (R.3/97) Date AS- � Insp�or's Sig, a re /. Cert. No. w uq 1 V iscons i n SANITARY PERMIT APPLICATION 0 Safety and 1 E. WashngtonAv vision P.O. Box 7969 Department of Commerce In accord with ILHR 83.05; Wis. Adm. Code Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 81/2 x 11 inches in size. 5f • C m)e ' • See reverse side for instructions for completing this application State Sanitary Permit Number 3 ,-> 4 50 t The information you provide may be used by other government agency programs ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)1. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT AIL INF RMATION Property Owner Name Property Location z /a S 1 /4, S 3 L 5 1 T , N, R E (or Property Owner's Mailing Address rot Number Block Number 8 7 * 57. Ah Cit , State I Zip Code Phone Number Subdivision Name or CSM Number ( ) L TYPE OF BUILDING: (check one) ❑ State Owned Cit Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms ° rown of T rO ;71 111. BUILDING USE (If building type is public, check all that apply) Parcel Tax Num _ 1 0 — 10 —Coo 1 ❑ Apartment/ Condo 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 SysstemSystem 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 ® Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit X Z 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: G -:�, q3 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 3 ?S, 7 Feet / Z Feet Capacit VII. TANK in gallo Total # of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New Existing strutted Tank Tanks Septic Tank or Holding Tank Q0© / ® ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber 6' 1 ®' ❑ ❑ ❑ ❑ ❑ Vill. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plu r Signature: (No Sta s) I M W NnW I Business Phone Number: 11*44J1W 221.7V 'Gea .S Plumber's Address (Street, City, State, Zip Code): E t IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate Issued Issuing Agent Signature (No Stamps f K pproved []Owner Surcharge Fee) Owner Given Initial �.. Adverse Determination u! X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: ,���.. C &� S J JA ,� & s &I1(0I'l SBD4M (8.11196) DtSTBIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Pkwdw Safety and Buildings ' 2226 ROSE ST LACROSSE WI 54603 -1905 TDD #: (608) 264 -8777 r►sconsin www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary June 05, 1999 CUST ID No.645687 ATTN: POWTS INSPECTOR ST CROIX EXCAVATING ZONING OFFICE SCHMITT & SONS ST CROIX COUNTY SPIA 586 VALLEY VIEW TER 1101 CARMICHAEL RD SOMERSET WI 54025 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 06/05/2001 Identification Numbers Transaction ID No. 229750 Site ID No. 173800 SITE: Please refer to both identification numbers, Site ID: 173800 above, in all correspondence with the ageney. St. Croix County, Town of Stanton NW 1/4, SE 1/4, S35, T31N, R 1 7W Facility: Matthew Zeuli FOR: Description: Mound System Object Type: POWT System Regulated Object ID No.: 472596 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. Xote: The changes made to this plan on 6/5/99 by this reviewer were acknowledged and approved by the plumber in charge of the project. 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 05/28/1999 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 @comerce.state.wi.us WiSMART code: 7633 m MOUND SYSTEM for MATTHEWZEULI NW 114 ,S"E114 S 35 T 31 R 17W Stanton Township St Croix County RECEIVED f0A Z 8 1999 SAFETY & BLDGS DIV, Page #1 Work Sheet Page #2 Soil Evaluation Report Page 43 Plot Plan Page #4 Pipe Lateral Layout Page 95 System Cross Section Page #6 Dosing Chamber Page #7 Pump Curve �fio by Donavin L. Schmitt 586 Valley View Trail Somerset, WI 54025 715 -549 -6651 MPRSW 221741 5 -24 -99 P.o •i vn ley N?v RIV E CE Tmiwl of COOM- IA 1 OkPAR f Af AND iv►s!a S GORR�S p�NCE SE r • Page .) f JPT)nNAL woRkSHCET I, MUUNU )Y)IL>•1 11. IN•Gk/lt::.:) I'kl SYSTLM -Continued- I. W atttwattl Lord. Iotai Daily F low a gal• I nrte NIA's � Use s. 7LIIR 83. 15 (3) (c) mmintuni Dosing Rate a 3J. Rpm Adm. Cu k • do and PROVIDE A DETAILED Dwrileter - i^ LIS I Ul SIZING ON PLANS. �r i 1. 1'nlai liinrmr: Mead: 2. Depth to Limiting Factor o z ._4 I System Head ■ 2.5 fl. 3. Landslorre = VtltKal Lift ft. at 4. Distance from Dose Chamber to Friction Loss= .. Distribution System a �QD ft. TDi{ _ ft. S. Elevation Difference Between 12. Pump Selection: t Pump and Distribution System ■ _,l S ft. Pum$ 111 har{e at ksst ._,,LS.L.L Wm 6. Absorption Area Siting: M IMI. total dynamic head. t Area Required = .. sq. It• Pump model and anufacturer: 10 27. A- Bed or Trench Length (B) t• Bed or Trench Width (A) _it. 13. Dose Volume: Trench Spacing (C) ■ ft. 10 Times Vold Volume of 7. Mound Height: Distribution Lines ■ S 3 ... =r gal. , Fill Depth (0) • Daily Wastewater Volume r Fill Depth Downslope (E) 4 Doses in 24 hrs. ■ NI• Bed or Trench Depth (F) ■ ft. Backfiow = Cap and Topsoil Depth (G) _ �.�� 1t, Minimum Dose ■ 1N1• Cap and Topsoil Depth (H) ■ /. 5 ft. 14. Dose Chamber: Q gal. B. Mound Length: Volume End Slope (K) • Total Mound Length (L) a Itl. C V1 NI PRIVATE SEWAGE SYSTEM 4. Mound Width: 1.. Wastewater Load. Tout Dally Flow - NI- Upslope Correction Factor ■ se s. ILHR 83.15 (3) (C), W illi Upslope Width ()) ■ ft. dm. Code and PROVIDE DETAILED Downstope Correction Factor ■ ' L T OF SIZING ON PLANS. Downstage Width (1) ■ 2. Require eptic Tank Capacity ■ gai l. Total Mound Width (W) ■ 3. Percolation ate ■ in./ln. 10. Basal Area: 4, Absorotion A a SttiitR: Infiltrative Capacity of j Refer to le 2 in c ILHR 83 Natural Soil ■ 1 ial./tq.h./day and PROVIDE DETAILED IST OF Basal At" Required a 1 7 SD eq. R. SIZING ON FLA Basal Area Available ■ 10-1, L tq. ft. Required Ans. • sq. ft. a 11. If Standard Tables from Chapter ILHR 83 Length it. are used, Indicate Table +1« Width = ft. 12. For the Distribution Network. Use Numbers S•14 In Section 11. Number of Trent s T ■ ---••� rench Spacl a� ft. It. IN- GROUND PRESSURE SYSTEM S. Distribution Sym: 1. Depth to Limiting Factor ■ G ft. Lateral Length 2. Landslope a % Number of Laterals ■ 3. Percolation Rate • minjin. Lateral Spacing = . 4. Proposed System Elevation ■e ft. Distance from Sidewall to Pipe ■ ...�. In. S. Wastewater Load. Total Daily Flow: 300 gal. /System Elevation • •. -••�•• It• Use s. ILHR 83.15 (3) (c) , Wis. Adm. Code and PROVIDE A DETAILED IV, SYSTEM-IN-FILL LIST Of SIZING Oil •PLANS. / ,�, Fill in All Items from Section III Required Septic Tank Capacity • .1 o .,._ey gal. 6. Absorption Area SiLMg: V. SEPTIC TANK _.L. g Percolation Rate ■ • =y min. /in. 1. Capacity ■ J /� S �� at. Area Required a TO $4. ft. 2. Manufacturer: System Length a ? 2 A - 3. Show Site Constructed Tank Detallson Plan System Width a A_b'v 7. Distribution Pipe SlAng: VI. DOSING TANK Holc Site iw•� r 1 1. Capacity ■ S .�2 =3t� gal. "ilk Spacinit • ab 24 Atanulacturer. L.ilrral Lenit +h It. 1, Vamp Manularturrr;�,;�.. 1 a0rral Li" in. t. t'umr AlrBtcL 1 .104,1.11lora.inx � 3 !� It. t. Ore'Atotc Head= •/ ft. 1lf�t. /QN Ilt.rg +N' - ClL_ 111 (•. 1I. R.11C• Rp ,. Shpw site t'nnauuticd Tank Oetatls o n Plans K. 1)ianhrpion 1 r {k Diylhar{;r K.rtr: Nunll.rr n! 111014,♦ 1'4,1 Pipe I, 1 luw flirt I'q■• pmree VII. )1 I)INt. 1WA la gal.. /t. Maodukllvh+p. ,. I yl ". Itvoll4,1 rtr rrtr M� �ul..:u 1 rote +b "'J +t t err.• C onmiu.lyd Tank Details on Plans tlianwlrr _.a4._ in %110W ALL INrORM AT ION ON PLANS- / D t►1l list %110 r,lat Ik ntrll:l ol ��{ � ;i wl slri.Department of commerce SOIL AND SITE EVALUATION on of Safety and Buildings Page of E areau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County � Include, but not limited to: vertical and horizontal reference point (SM), direction and S' I C 01" percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. If - 31 _19 -0 APPLICANT INFORMATION - Please print all information Reviewed by Date r IIIt1 /IIIUII /1111U11111110114 llllltl lie Impoi bbl aQP1111 my igll(wgna 0 I /1W, a IR 114 (1) (m)) Property Owner Property Location MoAt'102 go J Govt. Lot Aw 114 5 c% 1 /4,S,3,C T 3/ ,N,R 7 =M Property Owner's Mailing Addr ss _[_o_t#__j Block# Subd. Name or CSM# 6 s~N P"I 5�. IV NA City State Zip Code Phone Number El city El village Town Nearest Road BO 12) - y71 Cvl Re' New Construction Use: Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow _ 0 gpd Recommended design loading rate., w bed, gpd /ft gpd/ft Absorption area required o? y bed, (t2 07 trench, i1 Maximum design loading rate _bed, gpd /f1 trench, gpd/ft Recommended infiltration surface elevation(s) - - IC7- Yi _ft (as referred to site plan benchmark) Additional design /site considerations S 3 / Parent material Q C /'G[ / 10- Flood plain elevation, it applicable ft S Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U Unsuitable for system ❑ S ®U ®S ❑ U ❑ S ®U ❑ s ®U EIS ®U ❑ S WU SOIL DESCRIPTION REPORT Boring # r r lzon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /fl in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed 2 , Trench — I D 3 1 �� o7r + r C � . a 7 -f3 0 y .Si I ati� �A' m r Ground 3 - r' lev. _ �n. 7 -74 , S` - ( J Depth to limiting : f cl or _Kin. Remarks: Boring # a i� / /o -7 •� r a� • -� CA 5 p r� 3 -A a .. , Ground v. Depth to limiting fgqtpr in. Remarks: CST Name (Please Print) Signature Telephone No. / //l0/HSi � Addre // ' / .� �-,-/ Date CST Number �� � �/B (/ /r ene, .., 7'd.�S� r9 — R I P ate.? f�a� PROPERTY OWNER �7G �['� L�?�s`'i• �� � 9 (L DESCRIPTION REPORT Page of PARCEL I.D.# ' Boring Horizon Depth Dominant Color Mottles Structure 2 9 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench �✓ x y rz *4-7 9 CRb L a w! /r Lzue Depth to - limiting M r in. Remarks: Boring # Ground elev. ft. Depth to - -� limiting factor In. - -- Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. B ed , Trench Boring # , Ground ft. Depth to limiting factor in. Remarks: Boring # Ground elev. tt. Depth to _ limiting factor in. Remarks: SBD -8330 (R. 07/96) - - h f _ — -� - - -- , — Q Y f n, ,3 -- -- - /Y S � . o _ S p A qL f o c J - Of Z� oo� 02 - - -a - - -- N o 2 - _ -- �t - - -- i Lr 13Z 1 ; 1 ; ; ; 7 WIV ;S _ - � �E,vr eE • 1 -- i `l p A CA 81 PA ; -� i i + ` I - 1 i I ' " 1 t - 1 I i I V w , • I i r I , 6 - , F'd�Jt'� Perforoted P Detail �0 End View (Perforated / End COP { ^ PVC Pape Holes Locvted On Bottom. �S S Are Epually Spaced P MgfUfaO P Distribution � Pipe Last Hole Should Be Next To End Cop Distribution Pipe Layou P Ft. S- p X Z+ Y � Inches �'- 3�0 Hole Diameter „Zs Inch Signed: Lateral Inch(es) License Number: Manifold _�2_ Inches Date: _ �� y�� /� Force Main �_ Inches # of holes /pipe Invert Elevation of Laterals" Ft. P age Straw, Marsh Hay, Or Synthetic Covering Distribution Pipe Medium Sand _ H _ _ G 6" Topsoil F E p 3 b % Slope Bed Of Z�— 2 z Force Main Plowed Aggregate Layer (6" Below Pipe) D_ Ft. Cross Section Of A Mound System Using E /,yB Ft. A Bed For The Absorption Area F 9 Ft. G �_ Ft. A _$ Ft. H Ft. Signed: ` B �,� Ft. License Number: 1YI /7y/ K 0,s Ft. Date: j — ��/ - 9, L ,53,18 Ft. j 7,;t Ft. I �_ Ft. W , j,z Ft. L d Observation Pipe g J (---------------------r------ A ------ T-------------------------------- - - - - -- 1 1 Force Main W— - - - - - -- - - - - - -- Distribution B ed Of 2 «— 2 2 Pipe Aggregate . I Observation Pipe Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area Pa4e 4 Of SEPTIC TANK & PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS 4" CI VENT PIPE 12" MIN. ABOVE GRADE 8 WEATHERPROOF 25' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT MANHOLE COVER W/ PADLOCK 8 FTNTSHTD ARA1)F WARNTN(, LARFt, 4" MIN. 18" IN. 6" MAX. ** l ' INLET PUMP OFF ELEV . ? -1 ' FT. -�- GAS - � WATER .TIGHT SEALS TIGHT i , p SEAL i \/APPROVED �_ JOINTS WITH APPROVED -A LM APPROVED PIPE PIPE 3' B ' ON 3' ONTO ONTO SOLID ' SOLID SOIL SOIL I OFF RISER EXIT D PERMITTED ONL IF TANK MANUFACTURER HAS APPROVAL 3" APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE TANK MANUFACTURER: wj 5')�:__a_ NUMBER DOSES PER DAY: y TANK SIZES SEPTIC /000 GAL. DOSE VOLUME INCLUDING DOSE ,TOO GAL. FLOWBACK:�, GAL. ALARM MANUFACTURER: :UNK AGtZ2i CAPACITIES: A = INCHES = ,5� GAL. MODEL NUMBER: SWITCH TYPE: L7e ltUs2� C1, 8� B = 2 INCHES = GAL. PUMP MANUFACTURER: Z4,6FL C 12 � � H C = _ INCHES = MODEL NUMBER: 137 SWITCH TYPE: tzE a I, D = INCHES = I /B.OB GAL. REQUIRED DISCHARGE RATE :GPM PUMP & ALARM WIRING AS PER I LHR 16.23 WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE _ - FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . 2.5 FEET + 70 FEET FORCEMAIN X j.�z FT /100 FT. FRICTION FACTOR j,3/ FEET TOTAL DYNAMIC HEAD = ,8 FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH /O WIDT DIAMETER LIQUID DEPTH S/" SIGNED: LICENSE NUMBER: J2�12ZI DATE: ,5 _�y -��' 1/88 fa)a/ Dynamie Neod /Copoeily SEWAGEMASTE PUMPS GRINDER PUMPS oil oil be subjected to less than 30 feet TDH. 'NOTE: For Head Capacity on Model 112, Industrial column-explosion proof pump, see FMO219. 1 01 on N i3l ILI �i W ON MENEM ONE �1 • � �b5 i� G Uk�Y o � �a ✓' � ati..s� t ��u�C Wisconsin Department of Commerce SOIL AND SITE EVALUA ION Division of Safety and Buildings Page of Bureau of Integrated Services in acc ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 2� inches i ize. P1� 61st County include, but not limited to: vertical and horizontal ce po���ctio4' Rd percent slope, scale or dimensions, north arrow, cation d to neate!jL ad. Parcel I.D. # i ...� APPLICANT INFORMATION - Please " t all infgrm�i'1.9 Re ' wed by Date S Personal information you provide may be used for secon acy�rposes (f�i�,,, s. 15.04 ). � 9 Property Owner -,. rty Location A0 #A t > / t. Lot /Ypo 1/45�%1/4,S3S' T 3/,N,R / 7 AM W fnj Lie AGt 1 Property Owner's Mailing Addr ss Lot # Block# I Subd. Name or CSM# r ty City ❑ Village �f Town Nearest Road ❑ SO- r N I fSW3 I ( 1d) ?Y- 5 rah h i, I CZy RW 9 New Construction Use: XResidential / Number of bedrooms �_ Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow _?_QO gpd Recommended design loading rate ' bed, gpd /ft 2 __-__�_ *_ trench, gpd /ft Absorption area required c25V bed, ft a trench, ft Maximum design loading rate gy bed, gpd /f1 gpd /ft Recommended infiltration surface elevation(s) /8• y3 ft (as referred to site plan benchmark) g S . L` l /Q e r C Additional desig n /site consickeration n / cLSee� o� �.L-�•'�U �1NL� ��T- � 7 7 l3 Parent material Q C I / / / 1 Flood plain elevation, if applicable 7y 31 ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill 0, Holding Tank U = Unsuitable for system ❑ S ® U © S ❑ U ❑ S ®U ❑ S ® U ❑ S ® U ❑ S gU 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. �y Bed , Trench 10 D e �/2 S` L o�rn r �� C Y• �o -� 7 -13 AQ vg y/ y 5" a1� �� Il / r 11 9 _S Ground S' 1 327 1Y B fn p, Lj a� 1 • �elev�.p 7� e S' 7 , ft. iu cap Depth to limiting ; factor -? 7 in. Remarks: Boring # 3 - s D Ground Depth to limiting �in. Remarks: CST Name (Please Print) Signature Telephone No. Addre s Date CST Number PROPERTY OWNER �� T//lN�L1?rSh E !S /jlL DESCRIPTION REPORT Page of - PARCEL I.D.# Boren # Horizon Depth Dominant Color Mottles Structure 2 9 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench O /a X311 S� A Y12V -----`-' See �i �✓ w l e Y Ground CAD 2M5 94 - ft. 7 ,S /� �y ec4 Depth to limiting M r in. Remarks: Boring # Ground elev. ft. Depth to limiting factor 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 # Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) } ' - - - - -• — - e f�44. ' L b r ti.,: f - alley- /Ko - 5 U Al LOPI - ode 0 ''!' e ,6z a. - _� - -- t I Standard Erosion Control Plan for 1 & 2 Family Dwelling Construction Sites Acx�ortiitt to ,filers 20 & 2I ut the VVisayns� tfoa lll[ng Cod a sotl emsiot[ �cu>ntrol plan ttetda to isubthitted and "approved pr,or [a the>is�uance, ofbuilding permits for 1'& 2 family dwelling units iri tl► 4tf � E l thi' y1tat tii„ autl dt t ,��,ui,ul, ptuvl tuns cal tlta t iirlht„►[ lawaltl,lg +C�,►ta �n,a a►►ra,c�nct 'Y�da .Standardrecsioa Oki provided to assist fn meeting this requirement . i `::.ta..r..`uest ;. erasion .?Ciiiatxol >ttiera�sui'��>aot�� ° fic?ll r iiiretl by C�de�vhen ;�' ::.lY...:::::.::: :. :.::�:: : ::..:: !44. >;ttlt msttdmdttecsa ton�teCSde`;nvrati rformnce standard of keep[n salt qrt s[te { <: ......:... :.., }. *..:...., : , :.... . Y .. a :.:.< »:: >,<.;•: > < levelo inert: that disturbs . mart✓ han 5 >:; . :; Coasucttgn { ro acts that d[stur[t mare th n S acxes, nr are part of a. }, . . p . ::: ,:...::: ....:.......:...:::.: J :: t % � i c?' ':. u..ttCd::<tq t?t►fstn a �caoscn�cctpn;:$t[e 6t4t t tt=r tl[scharge : permit 6ofO. the:: ` ! nstn :...;:.;..:,:::{.:'{::::.;}}>:::::.>::......,< .:.<.. "•.:::::::;; .... :..:...:: ::::..:.: :.......... L....:...... .:.............:............... ,:::::...:;::. ...... . � }��: ':' iii: {i { {•i % {{' •::•i; Si:•:•: }:': is {•i'•: :: •: }S'w::. . :: '... Applicant: A TTff EUJ Z ELa L Name Daytime telephone number 6-66- ND . 8 ' 0,0 7 Street address, city, zip code Landowner. M,4 TT„9F� 9'-? 9 - �' — Name Daytime telephone number 6 fJ //J 8 7N S%- A��oR��/`�N xl�Vo3 -- Street address, city, zip code Location of the building site (complete as appropriate): ,U)_ quarter of Section 3,5 • Town 3 1 N., Range f • 7 Iff W Lot Al Block A(A 4� aWS A:; T / D r. A, SW i sV .5 Y Street address Instructions: 1. Complete this plan by filling in requested information, marking (./) appropriate boxes, and completing the site diagram. 2. In completing the site diagram, give consideration to potential erosion that may occur before, during, and after grading. Water runoff patterns can change significantly as a site is reshaped. 3. Chapters ILHR 20 & 21 of the Wisconsin Uniform Dwelling Code, the DNR Wisconsin Construction Site Best Management Handbook, and UW - Extension publication Erosion Control for Home Builders can be referred to for assistance in completing this plan. - The Wisconsin Uniform Dwelling Code and the Wisconsin Construction Site Best Management Handbook are available through State of Wisconsin Document Sales, 608266 -3358. Erosion Control for Home Builders (GW0001) can be ordered through Cooperative Extension Publications, 608262 -3346. 4. Submit this plan at the time of building permit application. s Check (.1) appropriate bones below, and complete the site diagram with necessary information: s CPS � Site Characteristics Pf North arrow, scale, and site boundary. Indicate and name adjacent streets or roadways. �i ❑ Location of existing drainageways, streams, rivers, lakes, wetlands or wells. ❑ Location of storm sewer inlets. The gradient and direction of slopes before grading operations. The gradient and direction of slopes after final grading operations. Location of existing and proposed buildings and paved areas. ❑ Overland runoff (sheet flow) coming onto the site from adjacent areas. Erosion Control Practices 19 ❑ Location of temporary soil storage piles. Note. Although not specifically required by Code, it is recommended that soil storage piles be placed behind a sediment fence or more than 25 feet from any downslope road or drainageway. Location of gravet access drive(s). Note. Recommended gravel drive design is 2 to 3 inch aggregate stone laid at least 7 feet wide and 6 inches thick Drives should extend from the roadway 50 feet or to the house foundation (which ever is less). )0 ❑ Location of sediment fences (filter fabric fence, straw bale fence) or vegetative strips that will prevent eroded soil from leaving the site. ❑ Location of sediment barriers around on -site storm sewer inlets. ❑ Location of diversions. Note. Although not specifically required by Code, it is recommended that concentrated flow ( drainageways) be diverted (re- directed) around disturbed areas. Overland runoff (sheet flow) from adjacent areas greater than 10,000 sq. ft. should also be diverted around disturbed areas. ❑ �' Location of practices that will be applied to control erosion on steep slopes (greater than 12% grade). Note. Such practices include maintaining existing vegetation, placement of additional sediment fences, diversions, and re- vegetation by sodding or by seeding with use of erosion control mats. ❑ Location of practices that will control erosion in areas of concentrated runoff flow. Note. Unstabilized dramageways, ditches, diversions, and inlets should be protected from erosion through use of such practices as in- channel fabric or straw bale barriers, erosion control mats, staked sod and rock rip - rap. When used a given in channel barrier should not receive drainage from more than two acres of unpaved area, or one acre of paved area. In- channel practices should not be installed in perennial streams. ❑ �j Location of other planned practices not already noted. I I Indicate management stritegy by 'checking (.*) the appropriate box: Management Strategies ❑ 1I Temporary stabilization of disturbed areas. Note: Although not specifically required by Code, it is recommended that disturbed areas and soil piles left inactive for extended periods of time be stabilized by seeding (between April 1st and September 15th), or by other cover, such as tarping or mulching. IQ Permanent stabilization of site by re- vegetation or other means as soon as possible. IF ❑ Use of downspout and/or sump pump outlet extensions. Note: Although not specifically required by Code, it is recommended that flow from downspouts and sump pump outlets be routed to stable areas such as established sod or pavement. ❑ IQ 'Napping sediment during dewatering operations. Note. Although not specifically required by Code, it is recommended that sediment -laden discharge water from pumping operations be ponded behind a sediment barrier until most of the sediment settles out 19 Proper disposal of building material waste so that pollutants and debris are not carried off site. 10 Maintenance of erosion control practices. • Sediment will be removed from behind sediment fences and barriers before it reaches a depth that is equal to half the barrier's height. • Breaks and gaps in sediment fences and barriers will be repaired immediately. Decomposing straw bales will be replaced (typical bale life is three months). • All sediment that moves off -site due to construction activity will be cleaned up before the end of the same workday. • All sediment that moves off -site due to storm events will be cleaned up before the end of the next workday. • Gravel access drives will be maintained throughout construction. • All installed erosion control practices will be maintained until the disturbed areas they protect are stabilized. t- ereby certify that I understand the construction site erosion control provisions of the:: Wisconsin T h Uniform I?welting.Code, and that I accept <responsib�lity;for carrying out the above.erostott controlplan a approved b y the code enforcement authority. tgnature of applicant Date A publication of the University of Wisconsin- Extension, Ron Struss, UWEX Water Quality Education Specialist (12192). This publication may be freely duplicated Additional copies are available through the UWEX Environmental Resources Center, 216 Ag Hall, 1450 Linden Drive, Madison, Wl, 53 706 6081262 -3652 -Site Diagram - Note: Any base map of useable scale can be substituted for this sheet. 2 Le b"" Site Diagram Legend Please indicate north direction L PROPERTY SILT FENCE by completing the arrow. EXISTING STRAW DRAINAGE BALES —+ TD TEMPORARY ia'; GRAVEL I DIVERSION FINISHED TREE — —� DRAINAGE PRESERVATION I LIMITS OF STOCKPILED ` GRADING TOPSOIL VEGETATION O SPECIFICATION Scale: AREA 1 inch = �fQ , feet EVEN MONO ONE 71yal PT IN MEN ME ME ME ENO ■ C� NEI NMI NMI NEI ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer � j �E�Sff� a� 2fCK Z , ! Property Address (Verification required �� from - Planning Department for new construction) ,��00 City /State /vim RJLILA D! 4t Parcel Identification Number 35 .31.17e 55-0 LEGAL DESCRIPTION Property Location A/ W %,, ' /,, Sea S3�, T 3/ N -R�W, Town of 5 Ti�yTU.�.� Subdivision , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # 11 - 70 '9q0 , Volume — U / , Page # Spec house ❑ yes ❑ no Lot lines identifiable U1 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 licensedpumper 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 expiratio date. GL�� - ': // /�/ SIGNATURB OF AP ICANT 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, b virtue of a warranty deed recorded in Register of Deeds Office. oe- `8/ 9 S16NATURB OF OKLICANT 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 .,.,:;_ ".,_ �;..•� a�::� �_..,�;.�siz yam ., ..�.e; ,< :....�,,• . - ,_: :.._. OOCUMENT NO. �- I RVEOFOR RECOAOIN6 DATA STAI c BAR O F WISCONS FORM 2 --152 THIS SoACE RESE WARRANTY DEEO 4780'.90% YOL c7•D� PA�f 86 REGISTEWS OFFICE ST. CROIX Ca., WI �t2sk -W,rZ i4 S �� .c%y - % �C.L -aycf JAN 20 1992 of 8:00 A. M canveys and warrants to T._ -Z'n 4 RETURN TO the following described real es +:.'e In 5 i • C Zo IV Cowry. State of Wisconsin: Tax Parcel No: Ihs North 12 acres of the NWk of the SE% of Sectiata 35- 31 -17. EXCEPT OaQmencing at the N 1/4 cOtrter of said Sectim 35; d write South 2642.5 feet to the center of said Section 35; dunce East 33 feet to the Ely Lim of C.T.H. 'T' and the Point of Begiming ; dvrxe S 86 E 334.0 feet; hence S 0 E 352.4 feet; thence N 06 °56' W 334.0 feet to the Right of Way of C.T.H. 'T', thence North on said Rig}w of Uhy 352.0 feet to the Point of Beginning. This legal description is the sane as the North 396 feet of the NWk of the SFk of Section 35- 31 -17, EXCEP (same exception). This legal description was formerly kr:own as the North 12.7 acres of the NW% of the MF of Section 35- 31 -17, EX(EPP (same exception). which was determLned to be erroneous. This /S NOT homestead property. (Is) (Is not) Exception to Warranties: Dated this day of- (SEAL) —ISEAL) (SEAL) i TO a IQ AUTHENTICATION ACKNOWLEDGMENT II i re .. C - Signature(s)- I�t_ +\ t c� "� _� � ii — STATE OF V..- 5G-4)SIN ss County. Il 4I\ authenticated this 1 ('h\ day of —_� �) -. t9 P �,_.� rally came before me this--- _____ day of ^• 19_. theabovenamed -- - ----- - -- - -- - I � r 1 TITLE MEMBER STATE BAR OF WISCONSIN (If not.. - --_- - -- -- ---- - ---_- to me kraw o 5e the per$on _ _. -__who executed the author zoo by § 706 06, W s Stats I forego , g *rs - --er-t and ack now leJge the same I 'I roc - 2 - 2ClC r JOAN C. UATKAM i i-_ - -+ s MO► ARY f� v i No r 111S1G0 CQ�1H 'u W4 9 y le1g date t : � are not necessary .......WK1+ j 19, on be authent�catPd or acknow o ee Both M ta C Co -t?XSU't+Er� ro I i ' B2 ti •r.a.^„ ;,o ,.,.e � . $ - _ - rF 002 i i i WAR Ty OEED r STATE BAR OF WISC:ONS�N Nk-<o Tax Foams. PO Box 10208. Greer Bay. W15n 307 0208 F � Nr 2 9A.? i _ ._. . -.. . ._. _.�_. __.......--__...-.... �, �.:... o.- v... �. os ...rv�.sd4;:mew.ec.- mwe:.W.a.. vow!• s...•. c rtr•.;-rnz- 'x. :a�a.:eau -. 'rCO:: �:.tiiRaNmv±6,�y'.,g".t; ...� a . , �- ^vF.'ii.'..- tA - - -- — 334.00' - - -- - - -- -- — CA cn CA :�7 l I o 5580 7DO' 799/457 558B 851/321 620/448 / 864 374 699/30 750/630 334.00 558C I - _ I I I NW 114 --SE 114 z 558A 867/417 I