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HomeMy WebLinkAbout040-1241-30-000 Q o : ° "'v ~ 0 ° 6r� d N c a 0 � I o I 0 N � I Q C I I O Z Q C z o 3 � I � I 3 Cl) � " I z " W E ' z °o � `m m 04 CL a m 0 o z a U N z a N O U) H r N z •� Q (0 Q 2 z z o w N z I � N E N 1� O d 2 E .�. A a a O cm G G a m T �� Z co O •�i a LL aaa IL t�l to V i rn rn } 0 c m -� E N m T m" c a O co I O y y C E O ° N L C U a o o l r� M V N " 0 d 3 o " D 0.4 p N >` 0) M w L O •O O N H 2 M 0 z C U) � I - d r `i w V E ` 7 c r A c o,Auo i t Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page \ of 3 ' Labor and Human Relations Division of Safety s Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY l Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER PROPERTY LOCATION - DON ' i : -'Z �> L, 6 .LAT SI�F 1/4 fJE' 1 /4,SZl T - - 7 b ,N,R lq E(or W PROPERTY OWNER' - S MAILING ADDRESS LOT If I BLOCK If SUBD. NAME OR CSM # S°t1 C.l�tNl�ock L 3 - w CITY, STATE _ ZIP CODE PHONE NUM ER E]CITY ❑VILLAGE ®TOWN NEAREST ROAD R1U1Z_t1tL ,Wj s�ozZ(�IS)'� 7 t•A} D!; [� New Construction Use Residential / Number of bedrooms [ ] Addikn to existing building I J Replacement [ J Public or commercial describe Code derived dally flow \o Uo gpd Recommended design loading rate O 4 bed, gpd/ft trench, gpd/11 Absorption area required S oo bed, trench, ft Maximum design loading rate O • S bed: gpd/ft n french, Recommended infiltration surface elevation(s) 3 • ft (as referred to site plan benchmark) Additional design/ Site considerations `� y �f X 5 ?, —'-b . `f-1t Pv . Z ` o F (-L . Parent material st L YLI oQI�E boson 1'rs, Flood plain elevation, if applicable N . fl, ft S = Suitable for System CONVENTIONAL MOUND I AT -GRADE SYSTEM IN RLL 7H TANK U = Unsuitable for stem ❑ S to u ®s ❑ U ❑ s M U ❑ s u ❑ S ®U s ou SOIL DESCRIPTION REPORT i Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed rW& >::_�:��:�;;. o _^l 10 `-f, � 3 ! 3 - � i ; Z ►n s U � ��'ti -- a:. S • 5 Z Ground 3' Z- S `t R a y _ Z >n s b C S _ �( elev. 2 t > — 'R 9 -8 ft � �- o�R ��� �S�k Depth to limiting factor Remarks: . Boring iz Ground ra .� 9 tt Depth to rmilrrlgg - - fac3 Remarks: ! CST Name: — Please Print Arthur L. We erer Phone: 715 -425 -0165 Tess: egerer Soil Tes -ting & Design Service -P.O. Box 74 River Falls,WI 54022 ; t _Date: .6 CST Num - M005 76 t y ` PROPERTY OWNER ROTA h L SOIL DESCRIPTION REPORT Page: Z 'of `` PARCEL I.D. # Boring# Horizon Depth Dominant Color Mottles Texture Structure ConsisteFce Baxidaiy Roots ;,'GP.D /ft. In. Munsell Qu. Sz. Cont. Color Gr. Sz..Sh. Bed Tr6nch L a -� � �t3 — si) 2 w , s� wt'�t^ a- . , ;=1 3 Ground 3 aS 2$ ) "S ,2 1`4 SU m`�. elev. l Z� Depth to limiting factor 4 I'i Remarks: Boring # Ground a. elev. ft. Depth to limiting factor Remarks: Boring # !rvs • .nix:. � Ground elev. ft. 1 Depth to limiting factor Remarks: Boring # r Ground elev. f t. Depth to I limitin factor Remarks: SRD- 8330(R.M92) PLOT PLAN Page of 3 SCALE 1 "= SD ' �1S1tiR�, `IZj RSA . �''t Di o � lv gq' �•� B't Nt 4� 8 P 84• $ •3 vS �O Qz- Vr LET ( 715 ) 4 2.5 - moo 5 7 6 ; CST Signature DateSlgned Telephone No. - CST # I ,� �Y J �V ^)� �� _/ \ � (� Y� V ST. CROIX COUNTY ZONING DEPARTMENT j J AS BUILT SANITARY REPORT Owner /l / lG Z Property Address ` City /State l Legal Description: / , Lot _ Block Subdivision/CSM # 4 Sec. LL T,2LN -RAW, Town o PIN # 6$0 4W-361 SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: I i / Tank manufacturer / CrA� iz ST/P /�o/ FdV Setback from: House Oe ' Well �So P/L � Pump manufacturer Mo e AD 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: Im Width Length Number of Trenches Setback from: House 2 '5Z2 ' Well > s o ` PAL /s ` Vent to fresh air intake ELEVATIONS /G�• d Description of benchmark D » � e Elevation Description of alternate benchmark ed. Elevation /dS' e5 Building Sewer ST/HT Inlet ST Outlet PC Inlet PC Bottom Header/Manifold Top of ST/PC Manhole Cover Distribution Lines ( ) ( ) ( ) Bottom of System O O ( ) Final Grade ( ) ( ) ( ) Date of installation / Permit number State plan number DD Plumber's signature License number �6 Date/ Inspector Q 9 TtA kcn 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 t _ 1 Q, 0 s epiic o, INDICATE NORTH ARROW Wisconsin Department of Commerce County Safety and [3uildings Bivision PRIVATE SEWAGE INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No -: Pe r so nal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 353201 Permit Holder's Name: ❑ City ❑ Village ❑ of: State Plan ID No.: own of Tro .�> ev.: Insp. BM Elev.: BM Description: Parcel Tax No.: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark :.t Dosing '� io�f /oD,�.:� 9 A* ?S - 7- odo.c Aeration Bldg. Sewer F olding St/ Ht Inlet 6,) 9.q TANK SETBACK INFORMATION St/ Ht Outlet TANKTO P/L WELL BLDG. Ai Intake ROAD Dt Inlet /�; q9 q r Septic >' ' a5` NA Dt Bottom , 9 Dosing , ` -; ,�' ,� ' NA Header/ Man. / $ y ` 002 Aeration NA Dist. Pipe /0 .2, 95 Holding Bot. System a ye /0.2•27' PUMP/ SIPHON INFORMATION Final Grade 3,93 Manufacturer ' Demand . 1 Model Number < 31,� GPM TDH I Lift Frictior� „ 3 System�.5 TDH a iS' Ft � H ead Forcemain Length/ Dia. ^ ” Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Len th No. Of Tr�W PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS +� r-) / — DIMENSION SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manu acturer: SETBACK CHAMBER INFORMATION Type O , Model Number: System: Oldl rJ -/,5* 1 _50 UNIT DISTRIBUTION SYSTEM 3, Gf 1 3SS" 3 • f =- 3 Header/Manifold Distribution Pipe(s) ize Length Dia. Length 1^ Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over 11�" xx Depth Of xx Seeded/ Sodded- xx Mulched Bed /Trench Center Bed/ Trench Edges I? Topsoil I 0Yes ❑ No c ''Y ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: / / Inspection #2• Location: 590 Wyngate Drive, River Falls, WI (SE 1/4, NE 1/4, Section 21 T28N -RI 9W) - 21.28.19.1224 1.) Alt BM Description= 2.) Bldg sewer length= - amount of cover 3.) Contour = 100 . 6 C S� N //- /a'91 ✓ 0 IC 6u 1.1 Plan revision required? ❑ Yes [1"No Use other side for additional information. SBD -6710 (R.3/97) Date �In efyor's Signature Cert. No ADDITIONAL COMMENTS AND SKETCH f SANITARY PERMIT NUMBER: - 7 -- i � ®m -4� .� � - _ d , C P i d x E E t t r 1 e , a t __.. s w . ............. ® r s J—� + D a __ __ 1--i I Vi s i liioniln Safety and Buildings Division SANITARY PERMIT APPLICATION 2 1 Box Washington Avenue Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the sys +m, 1 Couny� C than 81/2 x 11 inches in size.�� • See reverse side for instructions for completing this ap on Slate Sanitary Permit Number Personal information you provide may be used for secondary purposes '?� ° iphecRIT a revisionrevious application (Privacy Law, s. 15.04 (1) (m)l. .7 "'{? Sd , 1 5tafte Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT F N Property*wfier Na e o tion f l a /4; $ o( T v N, �/ E (olog-) Prop y ner' MailincyAcUre6s f bo tuber ` Block Numb City, S ate f t Zip Coe /� Php�te�Vumbgr Subdivision Npm�or CSM Num II. TYPE OF BUILDING: (check one) ❑ State Owned o v � e ' it it I Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms Town of / 111. BUILDING USE (If building type is public, check all that apply) Parcel Tax Numbers) 1 ❑ Apartment/ Condo d z a�°� � = 2-1. VT • M • 1 ; 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. Pb -New 2 ❑ Replacement 3_ ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an System ________ System____ _________TankOnly_____________ - 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 294 Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22E] In- Ground Pressure r r 42 ❑ Pit Privy 13 ❑ Seepage Pit 1 g x63 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Requ lr d (so. ft.) Propo d (s . ft.) (Gals/day/s . ft.) (Min. /inch) �� ,,,,�� Elevation b OD O d� IV A nn s O?I Feet Feet VII. TANK Capacit g allons Total # of Prefab. Site Fiber- Exper. INFORMATION New Existing Gallons Tanks Manufacturers Name Concrete strutted Steel glass Plastic App Tanks Tanks Septic Tank or Holding Tank - D t L� L ® ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber y`DU ❑ 1 ❑ 1 ❑ I ❑ 1 ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sews m shown on the attached plans. Plum per's Name: (Print Plum ' Signature: (N S mps) M PRSW Business Phone Number rX Plumber's A�Idress tr et, City, Stat �: �� t f ` D �� IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sqpit y Permit Fee (Includes Groundwater D ate I ssued Issuing Agent Signatu a (No Stamps) Approved ❑ Owner Given Initial Surcharge Fee) p Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11197) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1 _ A sanitary permit is valid for two (2) years. 2. Your sanitary permit 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: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI_ Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII_ Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with 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. Safety and Buildings 2226 ROSE ST LACROSSE WI 54603 -1905 V isconsin TDD #: (608) 264 -8777 www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary October 14, 1999 CUST ID No.267341 ATTN. POWTS INSPECTOR WEGERER SOIL TESTING & DESIGN ZONING OFFICE 421 N MAIN ST ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 10/14/2001 Identification Numbers Transaction ID No. 251319 Site ID No. 182206 SITE• Please refer to both identification numbers; Site ID: 182206 above, in all co deace with the agency. St. Croix County, Town of Troy SE1 /4, NE1 /4, S21, T28N, R19W Facility: Charles & Jacqueline Hughes Proposed Residence' FOR Description: Four Bedroom Mound System - - Object Type: POWT System Regulated Object ID No.: 495283 s r` CnutA' G43A:dNG OP The submittal described above has been reviewed for conformance with applicable Wisconsm X&inistri*e Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVIID� 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. Sin6erard erely DATE RECEIVED 10/05/1999 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 M. Swim BALANCE DUE $ 0.00 POWTS Plan Reviewer - Integrated Services (608)- 785 -9348, Mon. - Fri. 7:15 AM to 4:00 PM jswim @commerce.state.wi.us WO ART 6 " 0 7633 Page 1 of 6 MOUND SYSTEM FOR A BEDROOM RESIDENCE LOCATED IN THE SE 1/4 OF THE NE 1/4 OF SECTION Zl ,T 2- i� N, R V9 W, TOWN OF _`�2.pll , ST• C.G -yLX COUNTY, WISCONSIN. Q3T - -*:s OF W 41V GP� INDEX PAGE 1 'of 6 TITLE SHEET "'� 41999 PAGE 3 of 6 PLAN VIEW-GROSS SECTION: aLQ� PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT 5�� .PAGE 5 of 6 PUMPING CHAMBER ` PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR n a l t livosaxj , ►-u sg0i6 - 0 1pt o y Ic 1p � qCoM NO � f DIE? A 1S\a I p �NG4_ PREPARED BY SP EE L 0 C)KF` WEGEFwEF=Z SO I L TEST S NG AND a ��,9�a99®4lq I>ES I CSM SEFRV I CE P.O. BOX 74 421 N. 11AIM ST_~ RIVU. FALLS. V1 54022 ; ; ARTHURL wp r,EflER 715 -4 �. 15 fz :_ 1151'iJNTH, _ WIS. gfl 1 IC JOB NO qq PLOT PLAN Page Z, of (7 Scale 1"= SO' 2 W 1'lb � cv - 0 WL I- SO n ov n f 1 y � Zti OC- -y / v ti app �� �z..D �"v \ � Z � P� �" 'F• �'�- �-$� � �� � O tTLq°1 °- % J J Bh itt - o_ IUU.p' ON _2k �3► ea tioa.ti' o ni 'CUP OF '7>`ze ?WO)Nl: -p f NOTES •1. Elevations shown are existing ground elevations unless otherwise noted. 2 Install permanent markers at end of each lateral. ( 4 required) 3. Install 4" observation pipes with approved caps. ( 2 required) 4. tank to be VU3018 gallon capacity manufactured by 5. Bench Marks SEE ft 8L) VE 6. Divert surface water around system to prevent.ponding at the uphill side. Page 3 Of b Approved Synthetic Covering c 33 Distribution Pipe Medium Sand _ H _ G Topsoil - - -- - -_ -= F Elev.loZ.ZS E D 3 ' b 3 % Slope Bed Of V- 2 % Force Main Plowed Aggregate From Pump Layer D Z.0 Ft. Z•z`� Cross Section Of A Mound System E Ft. Using F o.0 Ft. A Bed For The Absorption Area G l•o Ft. A Ft. H 1 -S Ft. Linear Loading Rate= 0 1-S GPD /LN FT B 63 Ft. Design Loading Rate= o.4.GPD /SQ FT j Ft. J Ft. K Ft. L c`1 Ft. Femme --1+4a i n W 3S Ft. L 1 Observation Pipe g K i A �.- - -- --------- - - - - -- - - - - - -- -- - - - - -- - - - --� W o -� Force Main --- p oPPQSt r D Of z - 2 2 EXA� . Pipe Aggregate I Observation Pipe Permanent Markers (Anchor securely) Plan View Of Mound Using A Bed For The Absorption Area Page H Of b Perforoted Pipe Detail 0 End View Perforated End Cap f� PVC Pipe Install permanent 'marker at end of each lateral o. Holes Located On Bottom, Are Equally Spaced S PVC Force Main Q PVC Manifold Pipe Distri ution PiQe Lost Hole Should Be . Next To End Cap End Cap P 3D Ft. Distribution Pipe Layout S Ft. X 4 Inches Y a Inches Hole Diameter ' Inch Lateral l < <y Inch(es) Manifold Z Inches Force Main Z Inches # of holes /pipe Invert Elevation of Laterals 1 OZ -' Ft. \4 3Z.Y`l Gti t/ Place lst hole z-y from center of manifold with succeeding holes at 42' intervals. Last hole to be next to the end cap. Combination Sep.tic;Tank and PUMP CHAMBER CF,055 SECTION AMD SPECIFICATIONS ' PAGE S OF -VE►JT CAP WEATHER PKOOF JUUCTIO►J 9OX 4'C. I. VENT PIPE APPROVED LOCKING � 10' FROM DOOR., MAWHOLE COVER PQIV +JiA1pOW OR FRESH WARNING LPt6EL. ALRIAITAKE Cor.�DurT tj 6� G "M1e GRA _ � � 18 MIU. F, � . 11� J _ y IN51�c PPt PROVIDE I --- -- IIJLET AIRTIbHT SEAL I I I I I APPROVED J 1 r APPROVE A I our. D JOIAIT I W /C.z. PIPEaR Tank construction I III W/ C. I P!PE�T'�G shall comply with ALARM ILHP ('33.15 and 33.20 8 j I Ow C I I CLEY. FT PUMP -� -'� OFF 0 CO►JCRETE BLOCK 3" APF`ko,eD R15EK EXIT PERMITTED 0►JLy IF TA MAIJUFACTUR6R HAS SUCH APPROVAL BEDDtNt SEPTIC E 5 PEC.IFICAT10KIS D05E TA MANUFACTU NtIDWi1J , 1�5'� NUMBER OF DOSES: 3 PER DAy TAWK SIZE: '111 ��u0o GALLOW DOSE VOLUME Z ALARM MANUFACTURER: S.S. Z �IJ S yZ g IWCI-UD114G BACK ►LOW: "16-9 GALLOWS MODEL 1JUMBCR: 131 W CAPACITIES: A= \9 INCHES OR L l'�o - O GALLOAJS SWITCH TyPC: )L1 e�ZCJAZL( 8= Z IUCHES"OR L L Z - � G�LLOLJS PUMP MANUFACTURER: C�OUL.Q % C- t IMLHES OR x-1$'9 GALLOWS MODEL NUMBER: I +OS D- a "I INCHES OR 'Z"' -9 CALLOUS SWITCH TYPE: � �z IJOTE: PUMP AMD ALARM ARE TO BL -% MIW IMUM DISCHARGE RATE 3�' GPM IN5TALLED ON SEPARATE CIRCUITS VERTICAL DIFFEREIJCE DETWEEU PUMP OFF AWO.DISTRIBUTION PIPE.. �612f FEET + MI �1..htMUM METWORK SUPPLY PRESSURE . . 2-51�) FEET + �-� FEET OF FORCE MAIN X 2 '�� F ',,,.FKICTI0LJ FACTOR_. Z' 33 FEET TOTAL DYNAMIC HEAD = FEET Pump chamber DIAMETER - 3S LI IMTERLIAL DIMLWSIOWI OF TAIJK: LENGTH ;WIDTH ;LIQUID DEPTH BOTTOM AREA — 231= — GAL /INCH AS PER MANUFACTURER = 21.075 GAL/ INCH Goulds Submersible Effluent Pump i 3871 EPO4 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel, grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- • Homes components. tic cover with integral handle Available or automatic and • Farms Motor: f • EPO4 Single phase: 0.4 HP, manual operation. Automatic and float switch attachment c Heavy duty sump g p models include Mechanical Points. • Water transfer RP , 230 V, v Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty RPM, in overload with Dewatering automatic reset. preset at the factory. rated oil and water resistant. SPECIFICATIONS • EP05 Single phase: RP M, , FEATURES ■Bearings: Upper and lower 115 V, 60 Hz, 1550 RP heavy duty ball bearing Pump: EPO4 built in overload with ■ EPO4 Impeller: Thermo- construction. • Solids handling capability: automatic reset. plastic Semi -open design AGENCY LISTING 1 /4 " maximum. • Power cord: 10 foot with pump out vanes for --� • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. SP Canadian Standards Association • Total heads: up to 24 feet. with three prong grounding • Discharge size: 1 1 /2" NPT. plug. Optional 20 foot ■ EP05 Impeller: Thermo- (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for end in "F" or "AC ".) rotary/ceramic- stationary, three prong grounding plug improved performance. BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 • Capable of running dry without damage to s 30 - y -*--5 GPM components. 0 Pump: EP05 8 _ • Solids handling capability: o 25 /4 maximum. w • Capacities: up to 60 GPM. X s 20 — za.e� • Total heads: up to 31 feet. 2 • Discharge size: 1 NPT. z 5 • Mechanical seal: carbon- } �� `! rotary/ceramic - stationary, _j is BUNA -N elastomers. 4 EP05 -- • Temperature: 3 ip 104 °F (40 °C) continuous i 0 o EPO4'— 140 F (60 C) intermittent. 2 I 0 00 10 20 30 40 50 GPM L -L L 0 2 4 6 8 10 12 ml /h CAPACITY ©1995 Goulds Pumps, Inc. Effective May, 1995 Q'Q_ - - Wisconsin Departrnent of Industry SOIL AND SITE EVALUATION 13F -Pt3RT Page \ of 3 t�,arxt Human !-elation g Di of Safety 8 Buildings in accord with ILHR 83.05, WIS. A 'V;G`oc�e' \' ' y COUNTY \ Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan m sbr�lude, bt§t­ ' not limited to vertical and horizontal reference point (BM), direction and % of slop tcele o P CEL I.D.,# dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION � ; EV. DBY DATE PROPERTY OWNER: PROPS LOC "t �! - Pt 2 T5 � 5f� gvgLlstl � II G S - GAtfftOT. s iEE' 1/4 M;_= 1 /4,S,Z /'( _Lb ,N,R l g E (orCJW PROPERTY OWNER':S MAILING ADDRESS • LOT # BLOCKS_ SUBD. NAM CSM # 16 C, A 1.v LLFAZ et> (Z,b � — CITY, STATE ZIP CODE PHONE NUMBER ❑CITY []VILLAGE ®TOWN ' F ROAD uND I j l St{ t�l (� (1 t S) l_ 3 b q Nty l6r R Iq New Construction Use [x] Residential / Number of bedrooms 4 [ J AdditiQn to existing building ] Replacement [ ] Public or commercial describe Code derived dairy flow 6 0o gpd Recommended design loading rate • y bed, gpd/0 — trench, gpd/ft Absorption area required S00 bed, ft -S trench, ft Maximum design loading rate • S bed, gpd /11: , �c trench, gpd1ft Recommended infiltration surface elevation(s) 1 Z)1- - Z. S ft (as referred to site plan benchmark) Additional design/ site considerations M b\jrv� w /8'x63' Vn Lkj% y-1 Q M Zkj" of:- _SAP-0 f . Parent material Ly s ova F \,44 Flood plain elevation, if applicable - iti fl • It S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ❑ S ®'U ® S 1:1 U [I S ®U ❑ S ®U ❑ S QU [is ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed rer>ch ::, k o- g ► o K %z I Z rk.S - s • `� 1 x A Z 8 - o tZ 3 t to — s t J Z s�k mfr C_S Ground S'tR guff- eS • Z . � elev. q o ft y 6 l3 Depth to limiting factor Remarks: Boring # il O -� l o`-I, ¢.-. 3 ! Z - s t � 2`�S b ►'c wl`F'h 0..S - . S • �o 3zm Z $ =Z1. 10 `t 2 3�b _ si 1 Z�'sbk brt f►- cS — 5 b Ground 3 Z, 3 - I-S't Iz Vy fin Fv ea _ -Z ; -3 elev. y 2 _ 1.0 `T 1\ � iyj 1 06 S It Depth to limiting factor 32h Remarks: F T Name-- Print Phone: Arthur L. We erer 715- 425 -0165 egerer Soil Testing & Design Service -P.O. Box 74 River.Falls,WI. 54022 Signature: °L q- L -Z Date: to` l_ g 9 CST Numbe 220254 PROPERTY OWNER �N� G` E-S SOIL DESCRIPTION REPORT Page Z of 3' PARCEL I.D. # 0\4 D Zy I - 30 Boring # Horizon Depth Dominant Color Mottles Texture Structure GPD /ft in. Munself Gr . Sz Sh Consistence Roots . Qu. Sz. Cont. Color . . . Bound�y Bed Trends ' S i l l Z`PSb 1� t`Fl C>--s Z 8 -Z$ Lo `t2 3l6 1 si l Z`�s1�h Yn`f f- cs Ground - 7 - IL Sly S1C� �eS�� y�`Fh �S — ^ Z •3 elev. - - 7 ft. 32- 1O`tcZ6[3 Pli NP Depth to limiting factor I Remarks: Boring # Ground 1 i elev. it. Depth to _ limiting ! factor ! Remarks: Boring # Ground ! elev. f t. Depth to . limiting I factor j Remarks: 3oring # <2" around ! ?Iev. ft. )epth to imiting actor Remarks: _ PLOT PLAN Page 3 of 3 SCALE 1 "= 50 ' 2 7 lbS•lZ.' 7 n <) 'A t 3 ° 10 J -- _ � - r1* Z_ Nt, �oz�s.& aY, TDP OF - TLz Lev wut zz ozs`f ( 715 ) 42.5 -n1 h5 CST Signature Date Signed Telephone No. CST # ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM J Owner/Buyer Mailing Address /� (� t l ��/ �° �[ (►� Sd ° �� 6�� Property Address �' s (Verification regained m laaaing Department for new coastructiou) City/Stafo _f /4 dS D), l.�r Parcel Identification Number - `-.� • 1 LEGAL DESCRIPTION Property Location -5—L '/<, � ' /<, Sec. P . 1 . T L" 4 N RZY f , of Subdivision 0 q 2 Lot # Certified Survey Map # Volume . Page # Warranty Deed Volume ! 3 ( . rage # b S1= house ❑ yes no Lot Imes identifiable (, yes ❑. no SYSTEM���IA'R�1'I'�IArIC� - kgmpwc=smd ofy,muptcsysocm z miap tohaadlev�rastes.Propera iaU e consists of pumping cat the septic tan CV CEY three y== or sooner, if aecded t aff Hccased ' can. cct&c fmmctioa of the - - What you pat.into the system optic tantiYS -a strgc is the aiastcdi;pos. - Ti property-ow= agrees to sabmit St roc Zoning Dgkrft rat iL caffim ion form. signed by the ewnec and by a P ] ptuanbcr,=Seutodptmmbao - .Ec=odpampervc fyhgeat(l)&cca- ia wastawatordisposdsystcdL is is prop«' operating coaditioa and/or (2) after iaspmdx and p=4 ag.Cmf necessary), the septictank-is less than W tuII of - sludge. the = -read the above requires and sg= to maiatam de private sewage disposal system with - dw standards ,as set by the Dep atm c a of Coon er = and the Dcp:rtmeat of 'Hit acd R= mecS. Side of Wisconsin.. catmcatioa statingthat septic has 6 eea maiaiainedmustbeeompleted and r Wmedto& cStQroi x- County ZoningOffmcewwaft30 days .0 ' SIGNATURE O APPLICANT DATE OWNER CE TWjcATXON I (�) on this four are true to the best of my (our) knowledge. I (we) am (arc) the own er(s) of tine ve, of a wuranty deed rocordod in Register of Deeds Office. O APP ' TUItE DATE ass « « s Any infotmation that is mis 4 •sss. - repmrseated may rcxult in the seaitary permit being revoked by the Zoning Department. " Indndc with this application: a stamped wacraaty deed from the Register of Deeds office a copy of the ooctifcd vuvcy map if reference is made in the warranty deed 1 DOCIINEN4' NO. MAasAWM Dam 583163 VOL o� >; IL Donald O. Rodahl and Joyce J. Rodahl, husband and wife, Orantoi, conveys and warrants to Charles Hughes and Jacqueline Hughes, hua.and and wife as survivnrehip marital property, Orontes, the following described real estate In St. Croix County, State of Wisconsin: ST. CROIX CO,. WI i. Lot Three 131, plat of Wyngate, Town of Troy. 1998 y} Said deed is given in satisfaction of the Land Coolness becwNn the JUL U parties dated December 12, 1997, recorded December IS, 1997 in Volt:me 3:00 P 1282, Paqe 498, as Document Number S69898. - Regi sfor at FEE : IMAGE AND REf RN ADDRESS i *Wµ 8&-.k• • P. c • 6alr S?�' � ' '�r..dsox, W ( 5G10Fti. f ( F { This is not homestead property. Pa----el identif Number (PIN) Exception to warranties: r All easements, restrictions and rights -of -way of record, if any fi Dated this I r a r H day of July, 1990. x w�..a -Qe� Q aZs[ (SEAL) Dona 0. Roda (S SAW (SEAL) X n I JL_i (SEAL) - y``tA . "danx a" • tr . AOTR=NSIGTION AC33KWLRDGkM Signature(s) STATE OF NISCCKS=W .'rk authenticated this _ day of 19_ Perso fI y case before me this A day of �. 19 the above named Douai . �"�aii 'hl and JOy a J. KOda I i • to me known. to be the persons) who executed the foregoing instrawent and acknowledge the same. TITLE: MEMBER STATE BAR OF WISCONSIN aA7a r✓ 11f not, r � � _ /�_� out by $706.06, Nis. StatS.) • 7tav !w G - Tats INSTxuwsNT NAS DRArM M Notary Public Mix 1p County, Wis. Joseph D. Boles My commission :s permanent. (If not, expiration date: �(�f Rodli, Beskar, Boles L Krueger, S.C. 7 Q 9 ) P.O. Box 138 River Falls, WI 54022 �±+, ILA. t: /4 F11062 WMAWMnsin Bankers Asmo lstion Igoe �srtog DOCUMENT NO. PARTIAL RELEASE OF REAL ESTATE MORTGAGE - BY LENDER The undersigned Lender hereby releases from the lien and the operation of a mortgage executed by Donald 0. Rodahl and Joyce J. Rodahl husband and wife as survivorship marital property to Lender and recorded in the office of the Register of Deeds County Doc. of St. Croix Wis., as No. 473724 ROCINdk Am (Reel) 915 (Records) (image) 533 N MSM RgtumAddress In (Vol.) of (Mortg's), on (page) F & M Bank - Landmark only the following portion of the mortgaged real estate in said county, P.O. Box 808 State of Wisconsin: Hudson, WI 54016 Lot three (3), Plat --of Wyngate, Town of Troy, St. Croix CouuLy, Wisconsin. 11I Identifier No. ❑ If checked here, real estate description continues or appears on attached sheet. Lender retains its lien and mortgage on the balance of the real estate not released. STATE OF WISCONSIN Dated July 16, 1998 County of qt- Crni w F & M Bank- Landmark NAME OF LENDER This Instrument was acknowledged before me By S on July 16, 1998 Tide President by Daryl Standafer and Karen E. Ostby s Daryl Standafer (Nemec or peraon(s)) as Pracid nt and Vice President Attest �• (Type of rumor y. e.g.. officer, trustee, et. tf any) of F & M Bank- Landmark Title Vice President (Name of p my on behatt of whom ptslniment was executed) \CftAkt * Karen E. Ostby * -- J. Schmitz _ This instrument was drafted by: Notary Public, Wisconsin F & M Bank - Landmark /Bonnie J. Schmitz My Commission (Expires) (Is) October 8, 2000 (YPEORPRINT) *Type or print name signed above_ S1. LKU1X LU., Wl Douglas F. Sigwarth and Renee' S. Sigwarth, husband and wife, Grantor, grants a perpetual easement to the owners of Lot 3 T Croix Coup RECEIVED FOR RECORD t of W Tuwn of St. County . Pta Yn�� '' , i with the right to lase driveway access acro ss/through W scotrsin. shared do the land of the , Y Grantor together with the right of ingress and egress to Lot 3 over the described land of the 14 -Q4 -1999 d: QQ AM Grantor. EASEMENT EXEMPT II Said land is described as follows, Lot 2, plat of Wyngate located in section 21, Town of Troy, CERT COPY FEE: St. Croix County, Wisconsin. The easement shall be 133 feet in length, he COPY FEE: 2. QO � as measured along TRANSFER FEE: shared property line with Lot 3 (bearing N13 59' 30" W). The easement shall be 66 feet in RECORDING FEE: 10.00 width as measured from the aforementioned shared property line. PAGES: 1 General maintenance and upkeep of the shared portion of the driveway sball bt tit joint responsibility of the owners of lots 2 and 3. ....... . .... . Hama and Raurn Addraaa All terms, descriptions, and gtarrting clauses contained in this docnn►ent shall be binding upon the heirs, le representatives, successors and assigns of this property. Douglas and Renee' Sigvrarth gal 14121 Whiterock Road Burnsville, NIN 55337 This is not homestead property. 040 -1241 -204M Parcel Identification Number (PIN) Dated this day of , AD., 1 17 (SEAL) u F. Si (SEA-) Rerlee' S. AUTHENTICATION ACKNO LEDGEMENT gnaturt( s } Si S � S& authenticated this day of , 19 �_ County, ) Pe ISonally came before am s �1 day of 19 o f the above named Douglas F. Sigwarth, Renee' S. Sigwarth to me known to be the persons) who executcd the • foregoing instrument and acknowledge the same. TITLIr: mrmDBR STATE BAR OF WISCONSIN (If not, * ; E L • N�STI�I� Authorized by §706.06, Wis. Scats.) No tary Pubfi m5� County, State of My commission is permanent (If not state expiration THIS INSTRU&JI WAS DRAFT , D BY date Charles P. Hughes yy77 ��, 766A Wilfred Road Year �� Hudson WI 54016 e nnw.e •Names of p ersons sipping in any capacity should be printed below their siepeWra HERINE L NEPSTAO AR Y NU9uC - MINNESOTA My Enpiree is& 31. WW 1 \ o = SL t7o r I CA ep �r \ 5ti ° N C3 cil m 19 CD r"I C2 me \ \ I � \ M +y / O A ) r,4— s l ,3 C9`1 3�