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HomeMy WebLinkAbout040-1231-60-000 A - ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner Property Address 667 City /State 1 Legal Description: Lot (.o Block Subdivision/CSM # CouNA rte WOU0 L 1L 1 /4 5 G 1 /4, Sec., TAN -R W, Town of TRo PIN SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer Size ST/PC (UO(800 Setback from: House � Well 7 5 , + Pump manufacturer Zv e `Q fti- Model Alarm location N Pou Sk (HOLDING TANKS ONLY) Setbacks: Service road a in a Water Line Meter location Alarm loc n SOIL ABSORPTION SYSTEM vver� �� � ►x ay _ � a Type of system: —Width �_ Length 10 U Number of Trenches Setback from: House ' lI U Well Nod in► P/L `f S Vent to fresh air intake �GG' ELEVATIONS Description of benchmark To - ot Sf n6 Elevation �G Description of alternate benchmark Elevation Buildin g Sewe ST/HT Inlet N ) ST Outlet Vy PC Inlet ya D U PC Bottom I � - a U Header/Manifold ( b 3 ( Top o �C Manhole Cover Distribution Lines ( ) I QS O ( ) Bottom of System ( ) y O ( ) Final Grade ( ) ( 0 (j , (7 l ( ) ( ) Date of installation / / Permit number '351 State plan number �g1 Plumber's signature (j License number � Date 3 0/ Inspector GKpbP Complete plot plan r 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 <_ a' T, dy T 800 Pu ^nC� Y U Nom N INDICATE NORTH JOW y isconsin "DepartmentofCommerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count INSPECTION REPORT St. Cr oix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). 3531 Permit Holder's Name: ❑ City ❑ Village [2 Town of: State Plan ID No.: Town of Troy 1057 ev_: Insp. BM Elev.: BM Description: Parcel Tax No.: fod j C -I'.5 040 - 1231 -60 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic � Benchmark �,�� /08. Dosing Alt. BM D Aerati Bldg. Sewer UAA Ho St / Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet do l TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet o Air Intake /0 2 • 7 Septic 7�p NA Dt Bottom l3•` o q'p;;Z0� Dosing '� ( NA Header / Man. Aeration A Dist. Pipe ; � Bs-, 3 16 Holding Bot. System 1 49y - 70 PUMP / SIPHO TION Final Grade #e� Manufacturer DeNnd St cover Model Number 9 } GPM 12617 t00 , a r Friction S ste TDH Lift F �'y L -�� mj,.S TDH%. Ft (- I VA_ mead Forcemain Length -15 1 Dia. 2 u Dist. To Well SOIL AB PTION SYSTEM BI`B Width ; f Length ( No. f T nches PIT No. Of Pits Inside Li d Depth D IMENSIONS too 1 DIMENSI SYSTEM TO P / L BLDG I WELL LAKE/STREAM LE Manufacturer: SETBACK CH BER INFORMATION TypeO Lit O UNIT Mo a Numb System: II DISTRIBUTION SYSTEM Header / anifold K Distribution Pipe(s) �ew t x Hole Size x Hole Spacing Vent To Air Intake LengthQ -/ Dia. Length Tvo3 Dia. Z Spacing 1-i- _ t it — – 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 ❑ Ye ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: JV126114 Inspection #I /t'124111 Location: 697 Buttercup Court, Hudson, WI (NEI /4, SE Section 3 T28N -R19W) - 3.28.19.1142 ��1ov.� - �.R -e��y 5a�..v[ �•�Z `i -Z �•� [I� Ina •2v eo�•3Z 5�sk�+. i�_� i- �t�+M._ U�"+� -art-` , '�•�'(,�� ��«s1' Q�. � cones �. � " Plan revision required? ❑ Yes J4 No 6 3 Z2 pp �iS2G Use other side for additional information. SBD -6710 (R.3197) Date r feCel � __ jI Inspector's Signature Cert. No. MCI— nu _ t '�0( ADDITIONAL COMMENTS AND SKETCH ' SANITARY PERMIT NUMBER: ' p # Y f } 5 F i i e ., 1 4 IP w �_- _ _� �_ ,. I _ __.�_ _.. _�. 4 I S t ----------- Safety and Buildings Division N VI scons i n SANIT ARY PERMIT APPLICATION 201 W. Washington Avenue - P O Box 7302 Department of mmerce In accord with ILHR 83.05, W�Sr oAdm iCode Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the systo'61, p „g +t�h'Q>; Vss Count St�fe San than 8 1/2 x 11 inches in size. 1 I vL • See reverse side for instructions for completing this applic tioi itary Permit Number s Tr a i 9 3S3 IS 1. 1 I u` Personal information you provide may be used for secondary purpo s �. T t. ROiX ❑'Check if revision to previous applIca ion . [Privacy Law, s. 15.04 (1) (m)]. 9 ; 2 J (Q G ate Plan I.D. Num er F +G I. APPLICATION INFORMATION - PLEASE PRINT ALL I P erty O ner Name e,rty Location 14 ;56- ?/a, S 3 T a , N, R E (or Pro ert Owner' aiIin Address Lot NuiTSbeT Block Number IJA 0- 6i l, City S to Zip Code Pho N ber Subdi ision Na a or CSM Number ( ) IL. P F BU (check one) ❑ State Owned ❑ Cit Nearest Road 1 Public 1 or 2 Family Dwelling - No. of bedrooms V own OF �_ L —Tr 111 BUILDING USE (If building type is public, check all that apply ko arcel Tax Number(s) I ;�. 1':) . 11 ;)- 1 ❑ Apartment/ Condo 0 - ACA 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 S ❑ 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 E] Replacement 3 E] Replacement of 4_ E] Reconnection of 5_ ❑ Repair of an ___System ________ System Tank Only 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,k 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 i 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 600 Required ((sq. ft.) Proposed sq. ft.) (Gals/+y/sq. ft.) (Min l' �1 Elevation ' � (� � P 1 • V Feet 10 �-1 0 Feet Cap acity VII. TANK in Ca gallo s Total # of Prefab. Site Fiber- plastic Exper. INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass App. New Existing structed Tanks Tanks eptic Tank r a I 9��- I 1 e ❑ ❑ ❑ ❑ ❑ ift Pump Tank /Si amber — 6 ® 1 ❑ 1 ❑ 1 ❑ 1 ❑ 1 ❑ Vill. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's (Print) Plumber's nature: (No S amps) MP /MPRSW No.: Business Phone Number: aaa 940 7/j .� 7�� 9� Plumber's Address ( treet, City, State, Zip Code): IX. COUNTY / DEPARTMENT USE ONLY ❑Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued ZSjg Signature (N Stamps) Approved ❑Owner Given Initial Surcharge Fee) �S I�Z sl Adverse Determination I� X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11197) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, plumber i INSTRUCTIONS . p 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD- 6399) to 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: 1. Property owner's name and mailing address. Provide the legal description and parcel tax numbers) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g.,MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 81/2 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 Safety and Buildings 10541N RANCH ROAD ' HAYWARD WI 54843 TDD #: (608) 264 -8777 i sconsin www.commercestate.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary October 18, 1999 CUST ID No.240146 ATTN: POWTS INSPECTOR ZONING OFFICE BOUMEESTER & SONS EXCAVATING INC ST CROIX COUNTY SPIA 1070 HIGHWAY 35N 1101 CARMICHAEL RD HUDSON WI 54016 ;¢" HUDSON WI 54016 RE: CONDITIONAL APPROVAL _: APPROVAL EXPIRES: 10/18/2001 Identificati rs Transaction ID o. 251051 Site ID No. 1820 SITE: Please refer to both identification numbers, Site ID: 182097 L above, in all correspondence with the agency, ST CROIX County, Town of TROY; BUTTERCUP CT, RIVER FALLS 54022 NE1 /4, SETA, S3, T28N, R19W Facility: BRAD DAVISON BUTTERCUP CT, RIVER FALLS 54022 FOR: MOUND, 600 GPD Object Type: POWT System Regulated Object ID No.: 494968 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: 1. This plan action is subject to designer comments on the plan. that the mound's longest dimension is perpendicular . The orientation of the mound system must be a g p P to the direction of maximum slope. 3. The area 25' below the downslope edge of the mound must remain undisturbed. 4. The designer proposes to install a 1000 gallon Weeks septic tank. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to A ll p ermits inspection b authorized representatives of the Dep artment, which may include local inspectors. A p p Y P P Y 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. ` 1 S y , ! DATE RECEIVED 09/30/1999 l FEE REQUIRED $ 180.00 _ FEE RECEIVED $ 180.00 PATRICIA L SIA ORF , PO S PLAN REVIEWER BALANCE DUE $ 0.00 Integrated Services (715) 634 -7810, FAX: (715) -5150 , M AN 7:45 AM - 4:30 PM PSHANDORF @COMMERCE.STATE.WI.US WSMART code: 7633 �I MOUND SYSTEM DESIGN Residential Application INDEX AND TITLE SHEET Project Brad Davison 4 bedroom residential mound Owner Brad Davison Address 466 Ashland Avenue St. Paul Park, MN 55071 Legal Description NE1 /4SE1 /4, Sec.3, T.28N., R.19W. Township Troy County St. Croix Subdivision Name Plat of Countrywood Lot No. 6 W .T. S . tionally Parcel ID Number 040- 1231 -60 -000 D Plan Transaction Number JF ETYAN CE DINGS Ind ex and title sheet Page 1 Mound calculations Page 2 ZESPONDENCE Mound drawings Page 3 Pres. dist. paics. and laterals Page 4 TDH and pump tank drawing Page 5 Pump performance curve Page 6 Site plan Page 7 Attached soil evaluation report Page 8 Designer Jim Bour license Number 222904 Signature � 1 D � w � Phone No. 715 -386 -9020 Date 8/26/99 Notice: Tampering with this file by unauthorized persons is prohibited. Deliberate modification will result in disciplinary action under s. 145.10, Wis. Slats. Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. SBD- 10462 -E (R.05/98) Page 1 of 8 i MOUND SYSTEM DESIGN Complete red boxes as necessary. 1000 gpd maximum design flow. Inch- pounds Metric Residential or commercial? r (r or c) (y or n) _ n Replacement system? Creviced bedrock site? n (y or n) Slope 7 % Wastewater flow rate 600 gpd 2271 Lpd Depth to limiting factor 30 in 76.2 cm In situ soil infiltration rate 0.6 gPd/ff 24.4 Lpd/rn Contour line elevation 103.1 ft 31.42 m Use standard fill depths? x OR ign depth? in cm Place X in box to use standard depths (24 and A +4 inclusive) OR specify design fill depth. Center or end manifold c (c or e) Hole diameter 1 0.25 in 0.125, 0.1 58, 0.188, 0.219, 0.25, 0.281, or 0.313 inch oniv. Lateral spacing 0.00 ft Use 0 lateral spacing for trenches. Estimated hole space 5.00 ft Not a final calculation. Number of laterals Pump tank elevation 96 ft Outside bottom of tank. Forcemain length 35.0 ft Forcemain diameter 2.0 in 1.5, 2 3 or 4 inch only. 2.067 in Actual I.D. HOLE DIAMETER CONVERSIONS 118 = 0.125 1/4 = 0.250 SYSTEM SOLUTIONS Inch-pounds Metric 5132=0A56 9/32=0.281 Estimated daily flow �gpd 2271 Lpd 3/ 16 =0,188 5/16=0.313 7/32 = 0.219 Absorption cell Design load rate & area 1.2 9pd 500.0 fe 46.45 m` Linear loading rate (LLR) 6.00 gpd/ft 74.4 Lpd/m Design width (A) 5.00 ft 1.52 m Cell length (B) 100.0 ft 30.48 m Depth of cell (F) 9.5 in 24.1 cm Sand fiker Upslope fill depth (D) 12.0 in 30.5 cm Downslope fill depth (E) 16.2 in 41.1 cm Basal area required (gpdfinfiltration rate) 1000.0 ft 92.90 m Supporting components Topsoil depth 6.0 in 15.2 cm Subsoil depth at center 12.0 in 30.5 cm Subsoil depth at cell wall 6.0 in 15.2 cm End slope toe length (K) 10.40 ft 3.17 m Up slope toe length (J) 6.90 ft 2.10 m Down slope toe length (1) 11.90 ft 3.63 m Total mound length (L) 120.80 ft 36.82 m Total mound width (W) 23.80 ft 7.25 m Project: Brad Davison 4 bedroom residential mound Transaction Number. Page 2 of 8 MOUND PLAN VIEW observation pipes (typical) J 23.8 ft q� A = 5.00 ft H3. m 7.251 ; B = 100.0 ft m W B J= 6.90ft m I K I= 11.0 ft m K= 110.40 ft 3.17m _ 120.80 ft 36.82 m typ• obs. Pipe (anchored securely) I = down slope dimension = absorption cell (AxB) J = up slope dimension = plowed area (LxW) K = end slope dimension &'(152 mm) MOUND CROSS SECTION D = 12.0 in 30.5 cm lateral to H subsoil cap E = 16.2 in 41.1 cm invert 104.60 ft F= 9.5 in 24.1 cm elev. 31.88 m : :: F G = 12.0 in 30.5 cm 'r ASTM C33 H = r 18.0 in 45.7 cm D Sand Fill E Sys. 1 4 - 1 - 01 ft Y elev. 31.73 m 103.10 ft contour 31.42 m elev. 7 slope D = upslope fill depth plowed layer E = downslope fill depth Note: Absorption cell media will consist F = absorption cell depth of aggregate and pipe with laterals G = subsoil + topsoil depth at cell wall centered across AxB media. The cell H = subsoil + topsoil depth at cell center media is covered with geotextile fabric. Designer notes: TMee1in 4sfadMwvd *wie1 M wM tie !!gtilineSd under oeder portion of gravel bed to compensate for 3' Project: Brad Davison 4 bedroom residential mound Transaction Number: Page 3 of 8 PRESSURE DISTRIBUTION CALCULATIONS Absorption cell Inch -pounds Metric Width (A) 1 5 Ift 1 1.52 Im Length (B) 1 100.0 Ift 30.48 m Lateral specifications Number laterals 2 Holes/lateral 10 holes Lateral length (P) 48.29 ft 14.72 m Hole diameter 0.250 in 6.35 mm Lat. dis. rate 11.65 gpm 0.73 Us Sys. dis. rate 23.30 gpm 1.47 Us Hole spacing (X) 61 lin 154.9 cm Lateral diameter Pipe diameter Design options Design choice Designer must 1 in (25 mm) Place X in red 'X" one choice 1 1/4 in (32 mm) x box of chosen from the options 11/2 in (40 mm) X x diameter. provided. 2 in (50 mm) X 3 in (75 mm) X Manifold diameter Pipe diameter Design options Design choice Designer must 1 in (25 mm 'X' one choice 1 1/4 in (32 mm) None required. from the options 1 1/2 in (40 mm) No choice necessary. provided. 2 in (50 mm) 3 in (75 mm) 4 in (100 mm) Distribution system contains: 2 Lateral(s) LATERAL DIAGRAM - CENTER CONNECTION Place correct lateral diagram by clicking in one of the drawings at right and dragging the diagram into this area. P end cap 1%, I--�I x123) Laterals & force main of PVC Soh 40 Last hole drilled next to end cap (per COMM Table 84.30 -5) Holes drilled on the bottom of the lateral. i =permanent end marker equally spaced Inch-pounds Metric Lateral length (P) 48.29 ft 14.72 m Lateral spacing (S) 0.00 ft 0.00 m Hole spacing (X) 61 in 154.9 cm Manifold length 0 ft 0.00 m Hole diameter 0.250 in 6.4 mm Lateral diameter 1.50 in 40 mm Forcemain diameter 2.00 in 50 mm Project: Brad Davison 4 bedroom residential mound Transaction Number: Page 4 of 8 TDH and Pump Tank Drawing Total Dynamic Head Operational head 2.50 ft 0.76 m Vertical lift 7.50 Ift ft 2.29 m Are laterals the highest point in the Friction loss 0.34 ft 0.10 m system? Yes "x' here. Total dynamic head 10.34 3.15 m If no, what is the highest elevation Dose Volume downstream of pump? L__J Dose is > 10 times lateral volume Forcemain drain Lateral void volume 10.2 gal 38.6 L back to tank? (•Y. one) Minimum dose 150.0 gal 567.8 L x Yes Drain back 6.1 gal 23.1 L No Dose volume 156.1 gal 590.9 L Typical Pump Chamber Layout In combination with state approved treatment tank. Tank construction as per Comm 83 .20(3) WAC. approved manhole cover with T weather prod warning label and locking device levels junction boot "—� g rade � disconnect grade levels aitemate 4" vent pipe electric as per NEC 300 and a= amt Comm 16.28 WAC location 18" (46 cm) min. wall of pump k- approved charmer or outlet joint combination tank A Provide 1/4" weep hole or anti- alarm on siphon device as necessary pump on B T Grade levels pump 97.1 ft C W - pump tank manhole = W'(1 0 cm) Off elev. 29.6 m minimum above finished grade D - vent =12" (30.5 cm) minimum above finished grade 96.0 ft Pump tank elevation 3 " (75 mm) of bedding under tank 29.3 m bottom of tank Tank manufacturer Weeks Pump tank capacity 19.5 gallin Pump tank volume 800 gal Pump manufacturer JZoeller _ Inches Gallons Pump model number 153 o A 21.0 409.9 'M B 2 39.0 Alarm manufacturer LevelArm E C 8.0 156.1 Alarm model number JDLV p D 1 10 1 195.0 Project: Brad Davison 4 bedroom residential mound Transaction Number: Page 5 of 8 1 Owntr • I y 40, 13rod 1�a�iSon .�L�e� I <1loGA5 1,anc1,(de. O6serU"dn S ' n 'Lot cqr cawl- 56'07/ i9EY11 SEYs, See„ 3, T. 2BN ,Q, /90 ♦ E) t✓a�-'on �. of Tro Cr a loc"zcl prop. 54aI< 4(.*Fc47 ct 6n lo P IM6. 73 P ro pos e. 4 bedecc�, res; d ¢rice, Al _> 3o' off',( 3034 P• U• e, b a: td: viq ge u ow. Proposed Sapf. c.ta.►�S' —� Asr«t 3034 Pd e• Q�F'F'ltctnE /:►t P�oposed goo�a0. Pa ,"p C k&Mbtr A "5c1,. NO P. dC IPbrcl Ma;n o � - /o3. o7 Cbtrour i ■I peok ;b. A �•sumt d ,2/7,50 , a Py.7oir HEAD /CAPACITY CURVE EFFLUENT and DEWATERING WARNING: Model 18514185 should not be subjected to less than 30 feet TDH. TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE N W 5335 W FUMES 4] 41 S1 -s9 9 N933S-2 14014140 16114161 16314189 1691163 16514163 IM4116 1M4189 14914189 lot Gal. LIM Gal. Ua. Gal. U6 Gal. Lln Gal. Lora Gal. Lb Gal. LM. Gal. U& Gal. Lim Gal. LOa. Gal. Lola. Gal Lora. Gal. LYO1 4 16.5 62 21 106 43 163 72 273 94 356 106 401 61 231 61 231 51 210 155 Sol ISS 507 45 17042 131 So 23 11 N 12! 61 231 90 341 100 61 U1 61 231 S4 no 141 S60 151 qY 4S x:171 4.9 1s 19 l 45 1] u 91 60 1 60 1 54 210 142 i 143 . 4s 17 20 6.10 2.S 9 3 11 2S 19 73 216. 12 316 59 .: 223 so .227 is 220. 136 .515'. 140 S30 45 -179 40 25 W t 30 63 231 74 210- 57 116 59 223 - 31 421 121 414 133 :503 4$ 170 130— 30 9.14 53 Ni , iS 746 : 55 101 So 220 90 'Us is 120 121 40 117 411 4S :171 40 .12.19 30 .114 46 114, 46 174 35 2e1 75 '..267 So 2201 105 397 114 A31 45 38 1 2 30 , 1514 21 00 ;, 33 123. $1 M 50 ;219 9 121 90 341 100 :779 43 Ill.;. 60 1519 15 17. 43 : 161. 36 .146 54 224 71 296 15 32 4S >110. 12 70 21.34 30 _1u 10 L 52 Nls $1 193: r0 - 205 IS <11e 36 191 40 2411 14 $l 4S Ile 26 101 S4 204 45 111E 1 1 90 21A3 32 111 2 4 37 140 45 :110 100 "Al to a 21 19 40 >'.1 11 34 110 2100 - 1 25 s - 36 30 - ,114 :: 1 10 120 36M 20 is 105 uo x.12 10 16' 32 Lmk Valre: 11.4• 21• 112s• 2T x' K' SC K' 1T 7Y 115' !1' 117 13T 100 30 95 28 90 186, 26 4186 85 165, 24 80--4 165 75 0 22 1iJ 70 x 20 65 4 Z 0 18 60 163, 4163 169, 1 55 4189 0 �- 16 50 14 45 12 40 140, 188• 35 4140 Ik 4188 10 30 137, 185, 8 25 N43 4185 6 20 15 4 2 5 7 3, 98 161, 7, 4161 0 U.S. GALLONS 10 20 30 401 50 601 70 80 90 100 110 120 00 140 1150 160 LITERS 80 160 240 320 400 480 560 640 0 FLOW PER MINUTE 009922 ,23.30 p1y/. /�In. re al. 6 44 / + Note: For Head &pacity o Model industrial column - explosion pr000f pump, see MOM. Wisconsin'Department of Commerce SOIL AND SITE EVALUATION Page 1 of 3 y Division of,Safety and Buirdings in accord with Comm 83.05, W is. Adm. Code A_C.E. Sod & site Evaluations Attach cornplete site plan on paper not less than 8%Z x 11 inches in size. Plan must County include, but riot limited to: vertical and horizontal reference point (BM), direction and St. Croix percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel LD.# APPLICANT INFORMATION - Please print all information. 040- 1231 -60-000 Personal Information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). R By Date 7 g_�_ Property Owner Property Location Brad Davison Govt. Lot NE 1/4 S 1/4 S 3 T 28 N,R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 466 Ashland Ave. 6 Plat Of Countrywood City State Zip Code PhoneNumber ❑ City ❑ Village ❑Town Nearest Road Saint Paul Park MN 55071 Troy Buttercup court ❑ New Construction Use: ❑ Residential / Number of bedrooms 4 ❑Addition to existing building ❑ Replacement ❑ Public or commercial describe Code Derived daily flow 600 gpd Recommended design loading rate •5 bed, gpd/fe .6 trench, gpd/ft Basal area required 1200 bed, flz 1000 trench, ft Maximum design loading rate •5 bed, gpd/fF .6 trench, gpolftz Recommended infiltration surface elevation(s) 104.07' at 12" above 103.07 contour ft (as referred to site plan benchmark) Additional design 1 site co nsiderations Mound to be installed in a "creserif shape following contour. Finish grading should include placing fill at upper t Parent material Glac ial till over limestone bedrock Flood lain elevation, If a licable NA ft ble for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank itable for system ❑ S® U ❑ S❑ u L] S M U ❑ S ®u ❑ S ®U El S❑ u SOIL DESCRIPTION REPORT goring# Horizon Depth Dominant Color Mottles Structure GPD/W in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Bed Trench 1 1 0 -13 10yr4 /2 None sl 2fsbk mvfr as 2f 0.5 0.6 2 13 -21 10yr3 /4 None A 2fsbk mfr gs if 0.5 0.6 Ground 3 21 -31 10yr4 /4 None sl lcsbk mvfr aw if 0.4 0.5 elev 101.58 ft 4 31 -58 10yr4 /4 f2p7.5yr5/8 A Om mfi - - 0.3 0.4 Depth to limiting factor 31" I Remarks: — I 2 1 0 -9 10yr4 /2 None sl 2fsbk mvfr as 2f 0.5 ! 0.6 2 9 -20 10yr3 /4 None sl 2fsbk mfr gs if 0.5 0.6 Ground 3 20 -36 10yr4 /4 None sl lcsbk mvfr aw if 0.4 0.5 elev 101.65 ft 4 36 -59 10yr4 /4 f2f10yr5 /6 is 0 sg ml - - 0.7 0.8 Depth to limiting factor 36' Remarks: CST Name (Please Print) Sign e: Telephone No. James K. Thompson 715- 248 -7767 Address A.C.E. Soil & Site Evaluations Date CST Number Ref # 340 Paulson Lake Lane, Osceola, W1 54020 8/7199 3602 1083 MPERTYbN %M- Brad Davism SOIL DESCRIPTION REPORT Page 2 of 3 'PARCEL LDA o4o- nm- 60-000 AC.E. Soil & Site Evaluations Depth Dominant Color Mottles Structure GPDfftz Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz, Sh. E nsistence � Boundary Roots Bed Trench 3 1 0 -9 10yr4/2 None sl 2fsbk mvfr as 2f 0.5 0.6 2 9 -20 10yr3 /4 None sl 2fsbk mfr gs if 0.5 0.6 Ground elev 3 20 -30 10yr4 /4 None si Icsbk mvfr aw if 0.4 0.5 103.44 It 4 30 -36 1Oyr4/4 f2p7.5yr5/8 L.S. Om mfi - - N.P. N.P. Depth to limiting factor 30' Remarks: Ground elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor i Remarks: �I .• 3 o-F'3 Owntr: i3 r'aad 1b a d i so n ir I �lo(oflsl�lan4l,(ve. ,Lodz -�i�» ■ Soy( Obses'Ua► -fan S� . /°a u.� Pa, -�E; rrJn • o !� P/� aF Ccx� .� PA ' y 5507 / i'lEYY SEY�, `See, 3, T. ,28h .P /964 ♦ 6 e✓a�;'on Tn.' of Trey,. G-o;,r Prop. 4*.*re4ce kne lo 14 I tcdreo n fc 5 � d once, ■ /03 o7 'Coa -Lour `Slope az ■ 81 -r o of 1 A,6iwte. A d 21750` 3, eke✓ /��, Wisconiin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUN J Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but C i z, not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or P ffC D . e�1E0 �� dimensioned, north arrow, and location and distance to nearest road. p aTn C APPLICANT INFORMATION— PLEASE PRINT ALL INFORMATION WED�`OV 3 0 1995 AMI PROPERTY OWNER: PROPERTY LOCATION Richard Stout -- - GOVT OT NE v4 SE l , 9 W PROPERTY OWNER':S MAII -ING ADDRESS �, LOT # BLOCK# SUBD. NAM 1353 Awatukee Trl. e_46 na I :emu CITY, STATE ZIP CODE PHONE NUMBER _ []VILLAGE PgOWN Hudson, Wi. 54016 (715) 549 -6731 Trc Tower Rd. ]x] New Construction Use Residential I Number of bedrooms 3 [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 450 g pd Recommended design loading rate • 2 bed, gpolft • trench, gpdm Absorption area required na bed, ft 375 trench, ft Maximum design loading rate • 2 bed, gpd/ft • trench, gpdm Recommended infiltration surface elevation(s) 1 02.9 ft (as referred to site plan benchmark) Additional design / site considerations system el- based on contour line of el. 10:.9' Parent material l imestone mestone uplands Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ❑ S © U 0 ❑ U I ❑ S O L I ❑ S C U ❑ S CCU ❑ S f3 SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Du. Sz. Cont Color Gr. Sz. Sh. Bed Tmnch 0 -11 10 r3 3 none 2msbk mfr if .5 .6 <�_ << 2 11 - 10yr4 /4 none sicl 2msbk mfr yw if .4 .5 Ground 3 30 -42 7.5 r4/4 none sl 2mgr mfr gw na .5 .6 elev. 1 02.6 ft. 4 42 -48 7.5yr4/4 c2p7.5yr5/6 sl 2mgr mfr gw na .5 .6 Depth to 5 48 -60 2.5y5/4 c2p7.5yr5/6 cl m na na na np np limiting factor 42 " Remarks: Boring # <: > >; 1 0 -11 10 r3/3 none 1 2msbk mfr crw i 2 ` 2 17. -21 10yr4 /4 none sicl lmsbk mfr if .2 .3 . x �ii�A'4 h6 Ground 3 21 -3. 7.5 r4 4 none sl 2m r mfr •5 • elev. 4 31-44 7.5 r4 4 c2 7.5 r5 6 sl • 10 ft. Depth to 5 44 -5 2.5y5/4 c2p7.5y5/6 cl m na na na np n limiting factor 31" Remarks: CST Name-.—Please Print Garx L. Steel Phone' 715 -246 -6200 Add ress: 1554 200th ,Ave . , New Ri hmond , Wi . 54017 10- 2.9 -95 Signature: Date: CST Number: MO2298 G� PROPERTY OWNER Richard Stout SOIL DESCRIPTION REPORT ' Page 2. of 3 PARCEL I.D. # pending Texture Structure n Boring Horizon extu a Consistence Boundary Roots GPD /ft g Depth Dominant Color Mottles in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I Bed iTrench 1 0 -9 10 r3 1 2msbk mfr crw if .5 .6 2 9 -25 10 r4 4 none Si 1 .2 1.3 Ground 3 - 2 2.5v5/4 none C1 M nR gw na n n elev. 100 ft. 4 32 -38 2.5y5/4 7.5 r5 8 cl m na na n n Depth to 5 38 -55 2.5y8/2 none limiting 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 i Remarks: SBD- 8330(R.05/92) N STEEL'S SOIL SERVICE Gary L. Steel Richard Stout 1554 200th Ave. CSTM2298 NE 4SE a S3- T28N -R19W New Richmond, WI 54017 MPRSW 3254 town of Troy (715) 246 -6200 lot #67- Country Wood N 1 =40' BM.= top of 1" steel pipe C el. 100' Alt. BM.= top of wooden corner post @ el. 103.6' Z�z ' �i 0 � Go o' Gary L. Steel 10 -29 -95 Z S - ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address ±LE A Property Address (-e °��'� rC C OLL r� (Verification required from Planning Department for new construction) City /State LkT_�) So Parcel Identification Number it 4O 1 Z 3 1 " X00 000 LEGAL DESCRIPTION Property Location ` /s, S E '/4, Sec. 3 , T za N -R__d _W, Town of Subdivision u ��(��� 17 . Lot # Certified Survey Map # , Volume , Page # Warrant Deed # 51 �� Z , Volume IS(2, Page # 5 Z- Spec house 13 yes no Lot lines identifiable yes ❑ no SYSTEM MAINTENANCE could result in its premature failure to handle wastes. Proper maintenance Improper and maintenance of our septic stem co p r Y p Y 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 sal system lum or a licensed um er verifying that 1 yste er lumber, restricte plumber ) the on -site wastewater dispo masterplumb , j ourneyman p p P 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. /o Zo 94 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 p N�descriibed above, by virtue of a warranty deed recorded in Register of Deeds Office. , SIGNATURE OF APPLICANT DATE * * * * ** Any information that is mis-reprosented 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 ST ATE BAR OF W I ICON ,1,1 FORM Z - IYU f WARRANTY DEED �. c cocura+EuT rto. K..:. -- ST. C0. W{ -51D Lt— APR u 71998 conveys and wars nau.�.snn attd. Debra A..Davi 9'30 AM � husband anc { 1 THIS SPACE RESERVED FOR RECORDINO DATA 7Ash ine following described real estate in V Crp X County, a Davison State Wis consin: e of Wiscin; ., - -.._,. , . , Ave. Lot #5, Plat of Country Wood in the Town , Minn, 55071 Troy, St. Croix County, Wisconsin __ 040- 1231 -60 PARCEL IDENTIFICATION NUMBER I TRANSF ER � � b This is not homestead property. Exception to warranties: Easements, restL fictions and rights -of -way of record, I , if arty. 4 Dated this 5th day of April ._ .__ , A.D., 19 (SEAL) (SEAL) t Richard 0. Stout _. (SEAL) (SEAL) ; I AUTHENTICATION ACKNOWLEDGMENT t Signature(s) _ State of Wisconsin, 55. St. Croix 4i 1 authenticated this day of , 19.,.,____ Personaliv cattle before me this 6ti+ day - .April, , 199$_,_, the above named - RW,c:iard .C.. -- S t - - --- autlturized tiv $7MU6, Wts. Stars ; to me k' to be the pet n ,S______ who executed the loregoing II Brenda Poulin instrum and acknow get same. TKtS (MSTRUMENT WAS DRAFTED BY Notary Public State of Wisconsi Richard 0. Stout -owner da Po lit No ry Public, St. Croix County, Wis. (Signatures may be authenticated or acknowledged. Both are not M Y commission is nermarient. P (f sae ex icalion date: necessary) t • Natffii of persons signing in any opacity should by typed or printed below their signatures, STATe BAR OF WISCONSIN bVlsCtx * teed Wnk Co., Inc. WARRANTY DEED Fonn No. 2 - 1962 %*"� Wis, iJ #!U� 08 14N 12:38 FAX 715 386 4686 ST CRX CO ZONING r„ sr Z . 1 Al Fkg n, ,u n t J! P5 3 C� TEMPURA�iY {$4' =lAC1JSi Q / _uL - GE - SAC % BE 3 2' La ��. / REMUvEC ,,PON ROA C ` -*XIENSION. rm o 2.04 ACRES z.pa ACRES a i N N � f 7 So,FT 89,85 2 atH� 1.76 AC. ERC ES ?nr Ul IM G 76,584 SO, FT. 9,846 SQ. 30' 1 rn VV f ti T t i � R c 217.50• � r z 23 t'_ 165.24' m I te7 50 ' 3U.0 z �--- -- S89 ° 52'31"E 0.17.85 T s t �e 1 1 0 N 1 ' r v I r- W 3,:3 ACRES 1 �, ri 136,189 So. FT Iro N89 °58'31`W 581.47' a Q QWWRS vil r Ak 4 i� w� W tit ✓d 4 'h i"' w $NEEt } ....._ ...... .r ..# " coo �L �►,` n3o .z4� l� • 1t�2�� STREET - - -- ft. jw 2.04 ACRES 88,827 SO. FT. • •�� 1 TEMPORAR gi �. �— Cud - DE - 332,2'S�• I REMOVED a i 7 8 6 2.04 ACM v 2.04 ACKS \ �s57 30.PT: 88,789 LoDt \ m 1.76 AC. EXC. ESM[ i 2.04 ACRES a! ` 76,584 SO-FT I \ 88,846 SO. FT. of so t 1 247.50 1 1 187.50 30.001 O 235-11' 165.24 1 G S89 °52431 0E 617.65, 1 � � C-) I� ^' I 0 N W O° I o 3.13 ACRES � 33 33 � 136,189 SO. FT. 1 11 i C7