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HomeMy WebLinkAbout042-1096-60-000 r STC 104 ­ -AS BUILT SANITARY SYSTEM 1t'PORT S � 1 ADDRESS s '/ `v �/ (� S SUBDIVISION / CSM# f It S LOT SECTION . 33 T 2l N -R l a W, Town of ST,,CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ORIGINAL. INDICATE NORTH AP'_cOW i Provide setback and elevation 'information on rever of this form Provide 2 dimensions to center of septic tank ,%anhol cover. f o v So . G G 7 / * CST'S A-4f 0 , BENCHMARK* _ ALTERNATE BM• ,S�l - I c j . = SEPTIC TANK / PUMP CHAMBER / HOLDING..TANK INFORMATION 14. <0 - Liqui C apacity: >a /G _ Ag" - ��V Manufacturer: �[ isI x,,) `` � Other � Setback from: Well, House ,- GQ p 0 Model# r O _ Size / pump: Manufacturer Float seper ation ?' 0 Gallons /cycle: _ 2, 0-0 Alarm Location • a SOIL ABSORPTION SYSTEM M O Width: Length Number of trenches y � , • Distance & Direction to nearest prop. line: Setback from: well : N /A - House 7 Other ELEVATIONS Building Sewer ST Inlet: ST cutlet PC inlet PC bottom Pump Off Header /Manifold Bottom of system Existing Grade Final grade OPT 16 DATE OF INSTALLATION. �•, PLUMBER ON JOB: L 13 A' G� LICENSE NUMBER: Zz�e3 S �Yie/�87f-r7t po d o � A7 Q ,, ra �' n L � f�� r �.'1� o •� O" �o O m, m Q w 1 o O R a d o :A o n __� 7 C -lei G O. w r o l r -� d d li opa O F fT - f 3 All op 3 ZOLLER EFFLUENT PUMP MODEL 98 H. 3 6 - P � n Gly F7— � I � C✓ u� � 11EAD CAPACITY cu"VL MODEL " 9r1" s 7 / e a IN 2s- 3 5/e + r IS— te_ s 1 3/14 e _ 1 1 / 2- 111/2 NPT -� MLLtJNS 1020 40 so eo I SO FLOW PE E R MINUT _,� 3oeLl�. re•a tii.i„ � .. F t"? A-40 WATOWMA CAVAttly 1 2 UfnTS1MrN � r, /![I MtTtR[ OA ffls " ,0 Tt tr3 u 4 9r 41 231 1 It 110 teekvat" s7' ti /le CONSULT FACTORY FOR SPECIAL APPLICATIONS Electrlcel eNerrretors, for duplex systems, ere swillable end stpplled vAh an elerm. a Mercury 110111 ewhChes ere avellable for e conlrollin /.M0Chft* g singlA and WONXA e1 lemalore, tar duplex systems, ere aveileble with or • boubph I se syys Norm twitches. P ggy k mercury Iloal swrIches are available for Venable level 1011 cycle controls. 1111nderd ell mode - Wslphl 39 Ibt - r� ll 1. "* oral ( ELECTION Ouint �I werles O periled 2 pole rwhWeal switch. m exierntl eoM, Model Control 9e1e6110n ! elnple Plppybeck mercury soy Switch of doubts r of IequhSd. � h �p k � Mode AT S !Im let switch. Mla b FM0 /7I, Piprbeck mpeury, soy I sz— --!— u � 06 e Duplex a. Mechs"kelahe►nala 100072 or AM— _t► � cq 2 � L /. M re �7 tt, la oorrtct "aril of Eleclrkal AkernNor, Doe 230 �_4 -&AL . ury senew mam Switch 100225 U EN 1130 Hon t 1 w 1 t 7 _ duplex 1!1 a (f) Noel system y oonbd eellvdq 'McaY f! ' p 2 t E ! a 1 1 1 .. p �:(fl r►Ore "dPdc lunetbri pMr T t w duplex epeff Slim 10 0001. O/ pIM eolfneNlaT or wkSd In Son• T. we 04 hak'J 1`06". !er wslsrlle111 ew1r1.�, -•, tpllo♦. 1'o 146 M sYwexel Meer Marls refw b fat ff tt "'"'1 Itlef flecbkr ek9 °^ Cembirv.eon G'Ae` f►folsll; CAUTION Itft1t ' Psdye' It I ese 9"4u, r�"04?; sne fr;a d A ,eol a, 04 A 00016 4 eleelrloI4 % AN e1 1"I CU (N lone 6 S 1wM plea Cen60t tau{, �Y eedee eAcYW w 1640. Mre1Y1• (nt % Ad (otN way reee. NutA A1. A Nellenei (N[ tl.eyle Cs/e CI en/ We a esupetewe) tebly en1 RESERVE POWF""ED DESIGN For unusuei conditions a reserve safety factor to dn d glneere Into life desi ._� gn of o fiery Zoeller puma. M�II 1Q r .U. 110X FOR oul�rlrt.rxY 10756.0317 Manufacturers of... /1 501) SHIP 10; 3 ?I0 011 Alillers lane lerl. A; ` gale - s ,f cv�r /9.,'9" --- ----�� .. _ lre•7»r :. r A rso71 71#-367f t ' Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count y Safety and Buildings Division INSPECTION REPORT St. Croix 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)]. 344671 Permit Holder's Name: ❑ City ❑ Village Q Town of: tate Plan ID No.: Ba I I Town of Warren Z (Z —TM- CST BM Elev.; Insp. BM Elev. BM Description: Parcel Tax No.: . 19 . S`{ r CH-57 C ST 3lu' Z = P%fC - 042 - 1096 -60 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark -IP Dosing IMM ci Alt. BM 5 -� ( S 95.9 4 V1�a Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/ Ht Out et (o.SL 9�,sSr TANK TO P / L WELL BLDG. Ai Intake ROAD Dt Inlet Z Septic ? SV NA Dt Bottom Dosing ? r NA Header /Man. 3.0 99.4-2' } 5- ` ,� 1 s� NA Dist. Pipe 3.0 Holding Bot. System 3- -10 o Z PUMP/ SIPHON INFORMATION Final Grade /$ t __ Per Manufacturer CL6e_ dc�' Demand St cover [b N Model Number GPM 1�„uZ_ CLE Friction System TDH 4.0 yi- � I L gth ` 5` Dia. F Dist. To Well ... SOIL ABSORPTION SYSTEM S Z �• �3 Ilan QRENW Width I Len t No. f renches PIT N Of Pits Inside Dia. Liquid De D IMENSIONS 5 DIMENSION SETBACK SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACHING Manuf r: INFORMATION Type Of nn r , CHA Model N r: System: PAOUA � 3. > l5D R UNIT DISTRIBUTIO SYSTEM yr & ,,..� ( g. (off -F-(q. Header / M of Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. iL Length 1 I Dia. 2 Spacing 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 1 ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection # :B9 /13 /aa Inspection #2:"7 ID °W Location: 601 Highway 65, Roberts, WI (SEI /4, SE1/4, Section 3 T29N -R18W) - 34.29.18.534B (�Cm. r - 8 .0' C y(„ '�, `s �P = t�Z • ro g �� l� C�..b�.r `4 6 8 s 4, re- 1 + k XA R "—/ 4 6` o Plan revision required? ❑ Yes XNo Use other side for additional information.• BS SBD -6710 (R.3/97) l - O�katl% n „ Inspector's Signature Cert. No. ife. M - �d� Y � Ro&,�TT Safety and Buildings Division N vis * consin SANITARY PERMIT APP TION 201 W Washington Avenue Department of Commerce In accord with ILHR 83.0 Is,1��Ih. d� p�! - - Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the , on p*pier�ot P County Sr GxOi than 8 1/2 x 11 inches in size. " r • See reverse side for instructions for completing this a Lion to Sanitary Permit Number Personal information you provide may be used for secondary purposes Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]- " ate Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT A L =1NF Property Owner Name Prope eZAyp v ,t3o4eR % T z- �'{� 1 !X 33 T , N, R E (or)f� Pro pe y Owner's Mailing Address ck Number . p & ( �-- Cit ,0atS ,r,�/ Zip cje (hone Number Subdivision NamtY�C� ?u _ r j /3 � a. 11. TYPE F B IL ING: (check one) ❑ State Owned 3 ❑ It g e w /0/ pd�N G rest Road o a Lam' Public 1 or 2 Family T Dwelling No. of bedrooms Town of 6 J 111 BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 4 U-/9- F 4 B 0VZ -10fCe — 699-0 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 ------- ystem -------- System ___ __________ Tank Only_ __ Existing System ________ Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21leound 30 E] Specify Type 41 ❑ Holding Tank 12 E] Seepage Trench 22 In- Ground Pressure , // r 42 ❑ Pit Privy 13 E] Seepage Pit S f�! 43 ❑ Vault Privy 14 ❑ System -In -Fill Z VI. ABSORPTION SYSTEM INFORMATION: 6p lplv e l, 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade e cared (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) 4A144r4� 9y0 Elevation 75' 0 / Z 7 --Feet /02 •s Feet VII. TANK in gallo Capacity Total # of Prefab. Site Fiber- Exper INFORMATION New Gallons Tanks Manufacturer s Name Concrete st un- steel glass Plastic App Tanks Septic Tank oP4@46W%t+"k / f' ZSQ Z ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber &" / 6J'� / 0� ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (No Stamps) /MPRSW No.: Business Phone Number: ROf36i,T UL B P-1C4a - 1 2 -&3 �S 7!s •3�'G • ���5 Plumber's Address (Street, City, State, Zip Code): ���� G SS p' �jW4 A0 - �v S „ /- Y O/ ee- IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater ate Issued Issuin Agent Signature (No Stamps) Approved E] Owner Given Initial Surcharge Fee) q Adverse Determination � cad 2 f . CONDI / TIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: 5 ��GC rt'S r vc> v+� rr� a 5' �='� -esr �ar-� vc i`� t.� mac' SBD- 6398 (R.11/97) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber r • Safety and Buildings PO BOX 7162 MADISON WI 53707 -7162 TDD #: (608) 264 -8777 Visconstn www.commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary August 26, 1999 CUST ID No.226375 ATTN.• POWTS INSPECTOR ZONING OFFICE ROBERT W ULBRICHT ST CROIX COUNTY SPIA 655 O'NEIL RD 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 08/26/2001 Iderttification Numbers Transaction ID No. 241295 Site ID No. 179090 SITE: Please refer to both identification numbers, ST CROIX County, Town of WARREN above, in all correspondence with the agency. SE1/4, SE1/4, S33, T29N, R18W Facility: CLAY BARRITT 601 HWY 65, ROBERTS 54023 FOR: Description: MOUND SYSTEM Object Type: POWT System Regulated Object ID No.: 486356 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. 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/instal lation /operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincere DATE RECEIVED 08/11/1999 FEE REQUIRED $ 190.00 - �J FEE RECEIVED $ 190.00 R E PAL , r00745 S AN REVIEWER 11 BALANCE DUE $ 0.00 Integrated Services (608)266-2889, M - , - 1630 HRS PEPAGEL @COMMERCE.STATE.WI.US WOMW cc: CLAYTON BARRITT ORl GttANL UL.RRIC & ASSOCIATES CO. 655 O'Neil Road - Hudson, WI 54016 Reg. Designers of Engineering Systems 715- 386 -8185 Private Sewage Consultants RECEIVED PROJECT INDEX AUG 1 1 1999 SAFETY & BLOBS. DIV. DILIIR Plan I .D. N � s .. I' � >? Date Owner exAyTov 134/ele i % T Phone Gf/• - 1 2 • !Z� / Address P6. 6 ex (fit //IM- -.94) 4y/• Legal Description 18 1-f ews . LD r 2 - CS•y S'q,?f i7 1/0 /- 13 p� p/N 011 /o ,VG • G o • voc .s'9 yE S,c C. 33 , 7 W, R /8 w Town of County �tRR� sue. c.�o�• X -- .- - - - - -- C.S.T. Installer Local Authority/ Supervision sr. ex w c T y PROJECT DESCRIPTION NRW <e,✓s7'vCM9 --, 4 PiPo s 3 /3 PM eVVE os& s 7b I'VSf5/ �9 Es P� / �' r A9 t., tee- L. T� P O/,= - /3 /o . � o w,v ' w/*re - saris rme f4lW -y S�¢- Tv�rt -Tev �f-r 2 93 - / Gv-v y .v4, �'*w - `1ov,CV S f/ST, � P� eo, #OS16 P.O.W.T.S. Conditionally AP ROVED r „ on , nunpr, / y c 0 ` sf�r ` > DEP MENT OF CO ERC DIVISI S Y A BUIL I S ULBE W. � - U1160 - SEE CORRESPO DENCE .q HUDSON. WI 1 P9.1 PLOT PLAN VIEWS %�' I Gti Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWS Pg.3 PIPE LATERAL LAYOUT Pg.4 DOSING CNAMBER CROSS SECTION P9.5 PUMP PERFORMANCE SPECS Ahd design for installation is based entirely on measurements, elev ations, landscape rot - et ions (slopes c. 1111, accurar- and soil suitability y of his specs, as reported, shall remain thepsoledresb of the onsi CS'I?`f. p ability Any usq of this POWTS design by any licensed plumber, or any related unlicensed parties or persons (excavaters, laborers) shall not be construed as an assumption of responsibility by the designer for the workmanship, construction, placement, substitution or selection of any components not specified, or any assumptions by the pluntuer that any unspecified components are state approved or proper, or tine effects of poor judgement if working under adverse damaging weather conditions (wet /frozen soils) by any such parties or persons. D � � h o C 0 0 r ° c CVp titi y 0 �y .o a CMD °- o� ,,• � 0 n tA 0 t�� l i 2-7 aL . ' F COOSS SECTIOU OF M oUk) D wi Tti T3 ED 13@n a % ro T)I ST Ri(3uT +nN ' :x AygQcjrATE" G, rkt ckoFss PIPING- or T °P sorb SysTEM !~ Ievh T U0; FORM T O E ��• i �i•� E F ,- 3 i// IT% //// Piouumo ToPSof t % SI o PE FoRcE uu FORM o MAW E l EvATYoa LW DER E /. 2 FT. INVERr OF IATERA(5 �/•7� F; r-T To o RC)Ck (' /• 0�0 0 F P G � 2 M �. (v � N /•5' FT. Top °F IATERAIS PLAN VI 0 Moo wi rte 13 FORUZ MAikJ A FT• F r K /0 F r UV I b ---- - - -___ __- - - -- i j q FT w 2 8 I Fr 1 Bev o f �2 PVc. cAppEp To (913SRRVhrIoN A 95 PEI ATE pt�ES PI~ RMA#J tNT M ` t REG?ViRED BASAL. AReA S 01L 10 - fi 1 TI?/1TW E C APAci ry • 7 sat. Fr. PR v?o5Ed BASM AReA = B A z S Q. F T. ��utRA MA"i FoLp D pipe �jETwoR k TO v O L u tit e o f= L A T'G 2 N C_. �� �- w o 12 I� 11• !� f. r q%STRtf3uTl LATERAI. RN cAP Y p�G �oRcE NAT Td �5/f3Ow L AST VSO l E s EI A 11 fie NE,�r rd 13Nb CAP VOID V0IuME' F 225 Fr, - tuvERr � IEVAr�o� dF F oRc t= M A W 33 gA�s, �9 50 ' I PER FvRATED (PIP DETA+ L ` I B OT roM SH All BE7 I VARiA(3LE' y � (RoNlly 5p/EC.ED. Y DISTA�NCR 7 Rr NoIE DiAMgT'e R R /� ATERA L. If - 2. , y� MAQl FOLD If X i,��h�s �oRcE MACk) Z.. Y y8 iucl.� s � of Ijol p i P E. / 9 . o. DISTRi t3u-t-,v� D � • Z3 . 5c A 2 N R v E RAT E 2 P ER I.ATERi4t.. 6al / TOTAL - DtS cti AR bE RATE NErWOR 2 2.23 � k GA i. PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS p,416 IOF S J. -VENT CAP 4 "C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING JUNCTION BOX MAIJHO�.E COVER 25' FROM DOOR, w/ 41,1,01 1 AAF1 WINDOW OR FRESH 12 "M111. AIR INTAKE 1/�AD� L r� � l,iiT�ON GRADE I 4 MIIJ t 16" MIN. CONDUIT -- ---- _ - -_ -- ---- - - - - -- 11,4 r7 on. PROVIDE I --'--- — INLET AIRTIGHT SEAL I I I I I APPROVED JOINT A y I I I APPROVED JOINTS IJPC.I. PIPE IN N M� I I W /GI. PIPE aXTENDING 3' _ �0�� Q I I (I ALARM ONTO SOLID SOIL ONTO SOLID SOI a �1 1 I II. z c y �I E. LEV. FT. - -J ' PUMP -� OFF 'I,/SE' J9 4iQ p �lD�E' eF 'E 6-- I B�octc Sittil> 0 0K Ie vAf iod v G-- n� RIStR EXIT PERMITTED GUL4 IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E SPEC,IFICATIOIUS DOSE TAIJKS MA NUFACTURER. IJ UMBER OF DOSES: PER DAy O Q TAWK SIZE: GALL //01J5 IJCLUO IJG bAGKFLOW: �" GALLONS ALARM MANUFACTURER: G��G '�� '-Tl MODEL NUMBER: Z - CAPACITIES: A= ' INCHES OR GALLONS SWITCH TYPE: r - s4Y ��/� g= ' INCHES OR GALLOIJS ,( PUMP MANUFACTURER' 1 &Ya 5 <2 - C = � - Q - / INCHES OR "" -� GALLOAIS MODEL HUMBER: ME --- 4 D =' _IMGHES OR GALLONS SWITCH TYPE: , r 104- T — NOTE: PUMP AMD ALARM ARE TO BE MINIMUM DISCHARGE RATE 3q GPM LNSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. FEET fiANk ! {P C S + MIIJIMUM NETWORK SUPPLY PRESSURE � 2.5 FEET , - 2 LJ7 7 FEET OF FORCE MAIN X F/oo FrFRICTIONFACTOR.. 3`5 FEET �YL1 2 � = TOTAL DYNAMIC. HEAD = 17, 3 FEET IMTERNAL. DIME."SiOMS. OF TAMK: LEAIGTH ;WIDTH & ;LIQUID DEPTH T f„ M E40 Series 4/10 HP Effluent and Drain Water Pumps Performance Curve MODEL ME40 EFFLUENT PUMP CAPACITY LITERS PER MINUTE 0 50 100 150 200 250 300 350 40 12 35 l0 +n W 30 tL g � 25 Z 0 20 6 J d 15 Q 4 O F- 10 z 5 O 0 0 10 20 30 40 50 60 70 80 90 100 CAPACITY GALLONS PER MINUTE F.E. Myers, A Pentair Company • 1101 Myers Parkway, Ashland, Ohio 44805 -1923 419/289 -1144 FAX 419/289 -6658 Telex 98 -7443 K3326 7/91 Printed in U.S.A. t t , � ME40 SERIES 4/10 HP Effluent and Drain Water Pumps POWER & FLOAT CORDS PLUG DIMENSIONS Q.ifck- connect, watertight Replaces switch assembly fittings are interchange- for manual operation. able, replaceable from .�,_ I h" NT PUMP exterior. 1 ® ol��ree MEC FLOAT r SWITCH, _ Mercury-free, 90 angle operation iim 5.66 �. _.. (144mm) 11.68 (296.5rnm) - -._._ - - -- --� "ON" MOTOR HOUSING Cast iron for efficient r — heat transfer. - 1 1 OVERLOAD SWTI'CH Built -in to protect against overload conditions. 4/10 HP MOTOR 1600 rpm, 60 Hz, 115 or N - 230V, single phase. Oil- cooled and lubricated. 1 ROTARY SHAFT SEAL Carbon, ceramic faces. m 0 = l\ I m - PERFORMANCE CUM —� - CAPACITY LITERS PER MINUTE 1 0 50 100 150 200 250 300 350 tj 40 , � VOLUTF/IIIBUIUR SEAL 35 � Maintains high efficiency _ l o 30 and reduces recirculation, ; e replaceable. zs ENCLOSED TWO VANE zo 6 IM111LER High efficiency, passes HIGH EFFICIENCY ADS 15 _ 4 'A" spherical solids, with VOLUTE ~ 10 stainless steel wear ring. Corrosion resistant. Passes '/4 spherical solids. Ph" 5 _ z TSj UST WAS�R SLEEVE NPf discharge. BEARINGS 0 �:` 0 Btum smooth operati O 10 20 30 40 50 60 70 BO 90 100 and extend pump life. CAPACITY GALLONS PER MINUTE K3319 5/92 ® F. E. Myers, A Pentair Company Printed 'n u.s.A. ? 1101 Myers Parkway Ashland, Ohio 44805 -1923 419/289 -1144 FAX: 419/289 -6658, TLX: 98 -7443 1 r Wiscolgin Department of Industry SOIL AND SITE EVALUATION Page of 3 Labor and Human Relations Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County e Include, but not limited to: vertical and horizontal reference point (BM), direction and 5 • C F 49 f ' YL percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. If APPLICANT INFORMATION - Please print all rm Information. Re wed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). r Property Owner ��[[ n Property Location G p C.11AY row r(• 13/} k -f-t. Govt. Lot Sg 1/4 s£ /4,s-73 T r ,N,fi �O E (oe Property Owner's Mailing Address Lot # lock# Subd. Name or CSM# P 0. 13 dX CAI 2 CSm Sf'3f�-1 0O I. 13 • ('� . 3571 City State Zip Code Phone Number _ Barest Road ff V PSO a ❑ City illage Town 4U4 A Ll New Construction Use: residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow KO gpd loading n 2 3�S 2 Recommended design 9 rate bed, 9f� trench, gpd/ft Absorption area required -� 5 bed, ft trench, ft Maximum design loading rate bed, gpd/fl� trench, gpd/ft Recommended Infiltration surface elevation(s) 3 9y- O ft (as referred to site plan benchmark) Additional design /smite considerations 5 /PE LD,t� ( �tl /'�� LJ �4Q �J.t9 j) SYST . Parent material ! ocs s OV 4E x n/.6c Flood plain elevation, if applicable S = Suitable for system Conventional MM ouu In- Ground Pressure AT -Grade System In Fill Holding Tank U = Unsuitable for system ❑ s IBS El El f El El L7'�i [- SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /112 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench /. 0 - 1 /O YR 313 — L. Irj A lmfR cs i� . q :..g • /oY)e 31 Si L 2 fSAe f cs /f .. C .. Ground 3 7 SL l fe I C �— • y S 9P• v ft. f y / 7•s Y L A rt e s S- Depth to limiting factor 2. f n. 5 • Remarks: Boring # © .� /D v 3/3 — L 1jF5jX_ A " F CS / f . y . S •� /aYR 31 Stmt! )f AW 4 ft 7 Ground Q c 2 M i'ff' S G L / T �'M �� • — • 2 - ' • 3 elev. Depth to limiting fa or 2- in. Remarks: CST Name (Please Print) Signature Telephone No. Ra 2lG1 P- ct4T - 7lS S. Y3gG • /0 Address Date CST Number WA 2 o3 Ulb rkht & A Private Sewage Consultants 655 O'Neil Rd. Hudson, Wis. 54016 Y SOIL DESCRIPTION REPORT ,. 01, PROPERTY OWNER Page of PARCEL 1.01 &7�. Boring # Horizon Depth I Dominant Color Mottles Structure 2 Texture Consistence Boundary Roots In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench i 14 �oY S/ L 2,w, ' ex C f• wf • S ' • 4. alev foe 'tdo Depth to limiting C 2 rLDtS factor VoL .7 • Remarks: Boring # Nw l Ground elev. Depth to I limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PDT 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; SBDW -8330 (R. 08/95) i 1 D c � o � fl 7 �r m 4' � ti ti o a 0 a � o 4. ' s o S to v l �ffsT Go 7 L /27a ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer CL ,4 row 7 Mailing Address / /34 Property Address (Verification required from Planning Department for new construction) City /State Parcel Identification Number y2' _ /Or — G O .4= LEGAL DESCRIPTION b Property Location s � 'l,, S� ' /a, Sec. 33 , T yI N - R. /d W, Town of Subdivision , Lot # Z Certified Survey Map # 5f 10-7 —,Volume 7-3 , Page # 7S71 Warranty Deed # 51-fD SG' , Volume / y 0 ! , Page # Spec house ❑ yes Kno Lot lines identifiable dyes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained mus: be completed and returned to the St. Croix County Zoning Office within 30 days of h three year pica ' ate. *j NATdkE 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) 9m (are) the owner(s) of 4 pre described ov by virtue of a warranty deed recorded in Register of Deeds Office. OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed I VOL 1469FAcf /o 599rt]►56 DoC(RtsrrT No, DEW KATHLEEH H. WAISH REGISTER OF REEDS 3r. L'..O.IX CO., WT Dan L. Nelson and Jacque L. Nelson, husband and wife, Grantor, conveys RECEIVED FOR RECORD and warrants to Clayton H. Sarritt, Grantee, the following described D3 -08 -1399 3:00 P" real estate in St. Croix County, State of Wisconsin: WARRANTY DEED That part of SW 1/4 SW 1!4 Sec. 34 and SE 1/4 SE 1/4 Sec.33- T29N -R18N EXEMPT k described as follows: Lot 2 of Certified Survey Map recorded in Vol. CERT COPY FEE 13 of Certified Survey Maps, page 3571 as Doc. No. 593927. Together COPT FEE: with a private driveway easement for ingress and egress as described in TRANSFER FEE: 216.Oti Vol. 1387, page 280 as Doc. No. 593845. RECORDING FEE: 10.00 PAGES: 1 NAME AND RETURN ADDRESS St CROIX VALLEY TITLE SERVICES. W. PO 80% 750 109 N. MIAM SL RIVER FALLS. VA 540Yt 022- 1008 -10 -000: 042- 1094 -60 -000; 042- 1096 -60 -000 This is not homestead property. Parcel I entification Number (PIN) Exception to warranties: All easements, restrictions and rights -of -way of record, if any. Dated this day of 1999. _ (SEAT.) " (SEAL) an Ne son - (SEAL) - 4-1 .k 1..LJL �.��C_J�1-Vi�1�_ Ja que Nelson 1 ACTSEARICATIOK ACXXOWLiDG101p'f Siy STATE OF WISCONSIN ) ) ss. COUNTY ) au!.henticated this _ day of 19� Personall came before me thi day of , , 19 the above named 11;,n L. Nelson 5 Jacque L. Nelson to me known to be the person(s) who executed the • ` Pw� foregoing instrument and acknowledge the same. T'ITLR: MEMSER STATE SAR OF WiaCONSIN ` �C � 3 (If not, E. authorized by 5706.06, his. Sta ts.r OLSON _ v TE28 IEBIRVI®1t WAR DEAATED 8Ys $4���'• �' Not PuS.ic C (C; County, Wia. 4 5j'�.. ,ef? My iss:on is permanent. (If not, expiration date: Joseph D. Roles CIF W Rodli, Seskar, Soles 4 Krueger, S.C. AL D ) P.O. Box 138 River Fails, NI 54022 G s FILED DEC 1 6 1998 ► C� KATHLE H. WALSH Reg Deeds 1 � ) 593927 SL Croix Co.. W1 chi V-3� CERTIFIED SURVEYMAP DANAND JACQUE NELSON Z ° Part of the Southwest 114 of the Southwest 114 of Section 34 and the Southeast 114 of the Southeast h 114 of ,Section 33, Township 29 North, Range 18 West, Town of Warren, St. Croix County, o Wisconsin. w n 3 h Legend. • Indicates I " iron pipe found. ; m Indicates 1 1, "iron pipe found a Indicates 1 "x 24" iron pipe weighing 1.13 lbs.11in. ft. set. ;� Q - Indicates fence. UN PL A T T E D LA „ W R (1.0) Recorded data. M y SO /•19'04 "W 1272 . 1 O'R(SO1'O9'20 "W 1272.249 CM 3 0 O � h y m y N y COI W Q: " y Q) ` h v d A h J O W y WI Q I p, � ° 7 ,j � '� m �j Q tu Q r WEST L JN£ SW 114 SEC. 34 y mil[ Ix l I EAST LJN£ S£ 114 SEC. 33 w Z I O NOO.07'07 "E 933.91' JI 807.91 ' ss.oa 2 &u ip JI a UN T TED LANDS �I 3 This instrument drafted by Laurence W. :�-In �► o ° N p Murphy 31 "' ti o 2 41� W QD G On NOO.2 /'08 "E 3/7.26' ��` .••••••••.. / �ZI -�I b R' N 00• 10'23 "WJ I b �� `• �� �� 411 i. I N L O T / , C. S.M 'LAURE CE', W� a _ _ _ PAGE 92/ �n�1 WM Y � °�40 COI a IXM o Z S 1 13 o �. • RI W ,� v b R FALLS % S 4I 411 41; a W roI a WISC. O � h I 31 ♦ ° h /IN�ItN� W 3 �oI 'U ID W M Laurence W. Murphy ° `" I " 4 Registered Land Surveyor ALL BEAR /NGS REF. TO THE SOUTH LINE O a Dated: September 4, 1998 2 2 use N OF THE SW 114 OF SEC. 34, T 29N, R 18 W, o REVISED OCTOBER 9, 1998 OO O— - ASSUMED $89.48'40 "W 8 VAR. W 10TH S. T. H. 65 Owners Address: Q o o NS 1188 C. I: H. "N" Roberts, WI 54023 LO T /� M., V O L SHEET 1 OF 2 PAG 2 300 Vol. 13 Page 3571 I CER TIFIED SUR VEY MAP DANAND JACQUE NELSON Part of the Southwest 114 of the Southwest 114 of Section 34 and the Southeast 114 of the Southeast 114 of Section 33, Township 29 North, Range 18 West, Town of Warren, St. Croix County, Wisconsin. Description: That certain parcel of land located in the Southwest 114 of the .Southwest 114 of Section 34, and the Southeast 114 of the Southeast 114 of Section 33, Township 29 North, Range 18 West, Town of Warren, St. Croix County, Wisconsin, more fully described as follows; Commencing at the Southwest corner of said Section 34, the POINT OF BEGINNING, of the parcel to be herein described thence S 895639 "W 61.78' on the South line (f the Southeast 114 c f said Section 33, (recorded as N 90 ° 00'00 "W); thence N 00 ° 07'07 "T" 953.91',- thence S 89'46'18 "W 342.61,- thence N 00 ° 21'08 "F, 317.26' (recorded as N 00 ° 10'25 "W) on the Fast line of Lot I (?f that certified survey map recorded in Vol. 4, Page 921 of St. Croix County Certified Survey Maps; thence N 8946'18 "F, 886.00' (recorded as N 894935 "E 889.32); thence S 01 ° 19'04 "W 1272.10' (recorded as S 01 ° 09'20 "W 1272.24); thence S 89 ° 48'40 "W (assumed bearing on the South line of the Southwest 114 of said Section 34) a distance of 456.28' (recorded as S 89 ° 39'16 "W), to the POINT OF BEGINNING, containing 18.001 acres or 784,106 square feet, being subject to easements of record Note: Each parcel shown on this map is subject to State, County and Township laws, rules and regulations (i. e., wetlands, minimum lot size, access to parcel, etc). Before purchasing or developing any parcel contact the St. Croix County Zoning Office and the appropriate Town Board for advice. This instrument drafted by Laurence W. Murphy Dated: September 4, 1998 State of Wisconsin) County o f Pierce) 1, Laurence W. Murphy, Registered Land Surveyor, do hereby certify that by direction of the Owners, Dan and Jacque Nelson, I have surveyed and divided the lands shown hereon in accordance with official records, Chapter 236.34 of the Wisconsin Statutes and the Ordinances of St. Croix County and that this map and description are a true and correct representation thereof. 4 `,` �����u�����i „ ate' % onl %. • IAUR C rn = W MU HY•'s s • 13 �°. CA ER FALLS,; U '� ••••. WISC. '•., • LAND 1 urence W. 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