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HomeMy WebLinkAbout042-1102-50-200 \ 0 § K 0 � \ � ' ƒ � , k � , 2 � $ � � \ � # � � / \ � \ � 7 � � � \� )J � z : t 2 R § % 0 z ¥ Q « - U) ) . o � } � . Q 2zz .. � a mat I i 2 3 a 0. ) § z > \ k -� 4.; £ 000 � t 2] q i k 2 J § § / i § § m \ / « 0 § e e _ - _ « ® k I @ = c a � 0 2 a § � 4 z m m � co § 3 ° 2 8 § « ° $ 3 Q L9 (D / ])� /§ k � k / 0 2 ) ) § } ) 2 ® K G 2\ >c)§ \ 00 k ± / o z ) z ) & \ - , _ _ " a 4-, . w E ' k a § k 0 0- 2 0 U) j ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT 19 Owner sc0t mat °!` Property Address 10 41 D v e ► Cit y /State 444tS .' co /. ty D � ST CRO, Legal Description: r� g P NG0FF1 . Lot �_ Block — Subdivision/CSM # e SM t1&P /.2 • 33 ° -'' ` �°"t" l:. ,5 a) Y, u ) 1 /4, Sec. ,, TAN -RAW, Town of - SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer I� d wesi Size ST/PC /�geo 17s0 Setback from: House4A! � Well A-4 P/L > ,1 00 Pump manufacturer Oot _ Model n Fr Alarm location towcr• ;ns,clp /t o u se (HOLDING TANKS ONLY) Setbacks: Service ro Vent to fresh air intake Line Meter location Alarm loc ' n SOIL ABSORPTION SYSTEM Type of system: Width .30 Length 99.0 ' Number of Trenches Setback from: House -- /1Q' Well A A PAL ,ag1 )- Vent to fresh air intake > ice' ELEVATIONS Description of benchmark • Toio -04' n W. /0't- 560 -< Elevation 10e, CYO' Description of alternate benchmark 7 S�>� a-n ner' O . / ;ne Elevation 9�•� Building Sewer 11,3,03-'- ST/HT Inlet 109. 6 k ' ST Outlet i e? 5/3 PC Inlet /0 PC Bottom / o2. VZ Tr lie /!, (o P Top of ST/PC Manhole Cover Distribution Lines Bottom of System () / //• 0/ () ( ) i S Final Grade Date of installation /o I . Permit number 33 0 State plan number 2/3607 Plumber's signature 4 -!2 icense number 7- 2 - 5036 Date / / d %� 6 Inspector /'a ow Complete plot plan + 1 t 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 P ✓..e., Yce 0A a %'A 30.5 X A9� na du nnl /5'x ys bey✓ 7-0 l�i�,. cla..r 6�✓ I �e 5id enC¢ c�,tU nc� c(�'IIcJ o INDICATE NORTH ARROW Wisconsin Department of Commerce Safety PRIVATE SEWAGE SYSTEM Count S " and Buildings Division INSPECTION REPORT t ENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: ST CR IX Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 338810 Permit Holder's Name: ❑ City ❑ Village IN Town of: State Plan ID No.: FOLEY , SCOTT WARREN a (3 (.O : f CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: (c.32 1 alp -C N s,,, � CST 042- 1102 -50 -200 TANK INFORMATION ELEVATION DATA A 9900073 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ov Benchmar 44. Dosing Aeration Bldg. Sewer , $ .3 3( Holding St/Ht Inlet �,8� 0 , f TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. Airi to ntake ROAD Dt Inlet 7 9g 1z)(.. a.. 0 Air Septic /op NA Dt Bottom ,S� oz•`F� Dosing f00 ,1F 1 0 NA Header / Man. Aeration A Dist. Pipe 2" .- z Holding Bot. System PUMP / SIPHON INFORMATION Final Grade S �"�' Manufacturer Demand 5 ;; .DS __ 7-• �V Model Number At- PM D'(` a8S lot _g'+ y TDH Lift ,010 Lriction H ead TDH t-b it t 1 21 1 M Forcemain Length Dia. HH Z� Dist. To Well `� t / �, o Z �a , ZZ SOIL ABSDEPTION SYSTEM per - q.3 OR% Width Len t .— I No Of enches PIT No. Of Pits Inside DiDepth DIMEN I N 1 DIMEN I N SYSTEM TO P / L BLDG WELL LAKE/STREAM LEAC G Man SETBA CK CHAMBE INFORMATION Type O System: > /&D� OR UNIT DISTRIBUTION SYSTEM Header /Manifold Distribution Pipe(s) 0/L x Hole Size x Hole Spacing Vent To Air Intake IG Length Dia- Length Dia. Spacing f SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed / Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS (Include code discrepancies, persons present, etc.) S,O �g `� Z 3 s LOCATION: WARREN 36.29.18,SW,SW 1410 60TH AVENUE - LOT 2 5� o J%r 1 I q. O Z } Z)= J o `I • o Z JL A%- n - � cooe,- S ty t = YaLw 3 410 s� Plan revision required ❑Yes No Use other side for addi tional infor atlon. 2 � SBD -6710 (R.3/97) Date Inspector's Signature Cert No Safety and Buildings Division lfis�onsin SANITARY PERMIT APPLICATION 201 B 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 system, on paper not less County ,�[ n __ a than 81/2 x 11 inches in size. J'G , lr/x • See reverse side for instructions for completing this application State Sanitary Permit, umb r Personal information you provide may be used for secondary purposes ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION --2-J3 60 Pro erty O n Nam Property Location 2 �� O CL/' 1/4:5 01/4, S .(P T �,9 , N, R ��_W Propertt Ow i S M i g ddre Lot Number Block Number Ci Sta Gt / . (� !•' Z l�v Phone )Sber —(O� Subdivision Name M . Number AV -330c: II. TYPE OF B ILDING: (check one) ❑ State Owner o it Neare t R Je Public or 2 Family Dwelling - No. of bedrooms Z ll' n of ".) ' refl III BUILDING USE (If building type is public, check all that apply) Parcel TTa / x � Number(s) 3 . 1A. W. 5b7 Z A — o 1 171 Apartment/ Condo �7� ���Z��Q Z� 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 I] 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. w 2. E] Replacement 3, ❑ Replacement of 4_ E] Reconnection of 5, ❑ Repair of an _____,System ________ System Tank Only 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 Ergound 30 ❑ Specify Type 41 ❑ Holding Tank f 12 Q Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy C 14 ❑ System -In -Fill " VI. ABSORPTION SYSTEM INFORMATION: t 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade � Re qui red Its ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation S te ' 3 .� O. S /�� Feet 3. A5" Feet VII Capacity TANK in gallo Total # Of Prefab. Site Fiber- plastic Exper. INFORMATION Gallons Tanks Manufacturer's Name concrete Con Steel glass App. New Existing structed Ta nksl Tanks Septic Tank or Holding Tank 600 1 1 A &dax Swrl P oo" ❑ ❑ ❑ ❑ ❑ i I Lift Pump Tank /Siphon Chamber (/ I 7.W I I m-CaS Cot& • ❑ ❑ ❑ E] El Vill. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: Plumber's Signatu�No St ) MP /MPRS N .: Business Phone Number: 1 22S0 3(o 3X-S P mber's Address (Street, City, State, Zip Code): 10 - 7 014UNT91L IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sa ry Permit Fee (Includes Groundwater ate Issue Issuing gent Si ature ( mps) (Approved -� �-- harge fee) []Owner Given Initial ,�_` , � Adverse �-- Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R,11/97) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber _ Safety and Buildings 2226 ROSE ST LACROSSE WI 54603 -1905 Tommy G. Thompson, Governor *isconsin Brenda J. Blanchard, Secretary Department of Commerce March 10, 1999 CUST ID No.225036 ATTN: POWTS INSPECTOR ZONING OFFICE MICHAEL P MC DONELL ST CROIX COUNTY SPIA 1070 HUNTER RIDGE RD 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 03/10/2001 Identific rs° Transaction ID 4. 213607. . Site ID No. 167852 SITE: Please refer to both identification numbers, Site ID: 167852 above, in all correspondence with the agency. St Croix County, Town of Warren SW1 /4, SW1 /4, S26, T29N, R18W Facility: Scott Foley FOR: Description: Mound Object Type: POWT System Regulated Object ID No.: 453297 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The "K" dimension is actually 13.27 feet, and the "L" dimension is actually 101.54 feet. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to E inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, DATE RECEIVED 03/01/1999 FEE REQUIRED $ 180.00 E RECEIVED FE RE $ 180.00 Gerard M. Swim BALANCE DUE $ 0.00 POWTS Plan Reviewer - Integrated Services (608)785-9348, Mon - Fri, 7:15 AM - 4:00 PM jswim @commerce.state.wi.us WiSMART code: 7633ii I l SCOTT FOLEY 3 BEDROOM RESIDENTIAL MOUND DESIGN PROPERTY LOCATION: PROPERTY OWNER: Lot 2, CSM Vol. 12 Pg. 3303, Scott Foley SW%SW /., SEC.36,T.29N., 1216 Co. Rd. V R.18W., Tn of Waren, Hudson, WI St. croiz County, WI 54016 Pcl.# 042 - 1102 -50-240 INDEX TABLE PAGE 1 OF 8 TITLE SHEET PAGE 2 OF 8 WORKSHEET 10@9 PAGE 3 OF 8 WORK SHEET PG. 2 SA fETY & BLuuS. DIV. PAGE 4 OF 8 PLOT PLAN PAGE 5 OF 8 MOUND CROSS SECTION PAGE 6 OF 8 DISTRIBUTION PIPE DETAIL PAGE 7 OF 8 PUMP CHAMBER CROSS SECTION PAGE 8 OF 8 PUMP SPECIFICATIONS ATTACHED SOIL EVALUATION •► P.O.W.T.S. Cold itionally PREPARED BY: A PPR EPAR7 N7 OF COMMER jNGS Mike McDonell S FE7Y B D ov 1070 Hunter Ridge Road o WON Hudson, WI 54016 ENCE (715) 386 -8692 EE GORRESP �A SIGNATURE: I yl� R I • _'W'�(. CUSTOME # 220536 DATE: z ? i WORKSHEET Scott Foley, 3 bedroom residential mound ABSORPTION AREA SIZIN G 1. Daily wastewater load: 450 Qpd (3 bedroom)(150 gal/bedroom) 2. Depth to limiting factor: 28" to bedrock 3. Land slope: 7 4. Infiltrative capacity of soil at system elevation: 1.2 gpd/sq.ft. ASTM C33 med. sand area required 375 sq.ft. bed length (B) 75.0' bed width (A) 5.0' MOUND DESIGN 1. Mound Height: 2. Mound dimensions: fill depth (D) 2.00' end slope (K) ,12.00' ((2.00 +2.35)/2 +.75 +1.5)3 =11.78 downslope fill depth (E) 2.35' total length (L) 99.0' ` �` 2.0 +(7% X 5') = 2.35 (75.0')+ (2 X 12.0) = 99.0 aggregate depth (F) 0.75' downslope width (1) 16.00 (2.35 +.75 +1)(3)(1.27) =15.63 cap and topsoil depth (G) 1,0' upslope width (J) 9.50 (2.00 +. 75 +1)(3)(0.83) = 9.34 Cap and topsoil depth ' total width (W) 30.5 9.5' + 5.0'+ 16.0' = 30.5' 3. Basal Area: Basal area required: 900900 sa. I 450gpd. /0.5gal. /sq.ft. /day per CSTM = 900 Basal area provided: 1,575.0 sq. ft. (75')(5' +16.0') = 1,575 Linear loading rate: 6.0 gal./linear foot 450 ga1J 75'= 6.0 PRESSURE DISTRIBUTION NETWORK 1. Distribution pipe sizing: Lateral length Z1 Lateral size Lateral spacing NA" Sidewall separation Hole size ' " Hole spacing JDU 1 st hole at 30" from manifold) Holes per lateral 29 . Distribution network discharge rate: 39.33 gal. /minute (1 lateral)(29 holes/lateral)(1.17gal/hole) 2. Manifold sizing: Location -End Length NA Diameter NA 3. Force Main: Diameter 2" Length 77'. Flow rate 33.93 lga /min. Friction loss 1.58' (77')(2.05ft./100ft.) =1.58 ft. 4. Total dynamic head: Min. supply pressure 2.50' Vertical lift 7.18' friction loss 1,58' Total dynamic head 5. Pump selection: Manufacturer: Zoeller Model number: 97— Discharge rate: 45 gpm 11.26' TDH 6. Dose chamber manufacturer & capacity: MidWestern Precast 750 gallon put chamber, liQuid doh 38,50" Qa 19.5 gal. /inch (750.75 gal. ac ) Minimum dose volume: (450ga1./4 doses/day) + (.164)(77) = 125.13 gallons per dose Float & alarm settings: A) One day holding capacity: 16.00" = 312.00 gal. B) Alarm setting: 2.00" = 39.00 gal. C) Dose volume + back flow: 6.50" = 126.75 gal D) Reserve storage: 14.00 = 273.00 gal. TOTAL CAPACITY: 38.50" = 750.75 gal. Scoff F CtY .Co �.Z off' CS _I/of. /Z, 3303, /.z /� �. � t� SwYyS 5c�._3G, T�z9/L, ■ S�;L observa�o� �'t �ccolSr.�•►, u' /. k. /BW •, T. of uia.rrcn, '_ • l oc�r►.�cd Prop..5ba�cs grade elced4cn - �' / "iron 1 4 ;,44f . xsscc . tD; - Scale : " 'l Top or- proposed 30-0 9?°_J� f�m C�.amb.u: , CORRECTION NEE �, S EE CORRESQONDENCE p roposed � ca�g� p 3 posed resld�rrc,c 1 .-�' o - Al Page Of 8 Cross Section Of A Mound Using A Trench For The Absorption Area AST' N Medium Sand Fill � 1 ° F 3 E D 1h L Trench Of 32" - 2-%" Aggregate, Plowed layer 6" Below Pipe. Covered With D Z.0 Ft. Straw, Marsh Hay Or Synthetic Fabric E Z.35' Ft. G _[, p Ft. F 0.75 Ft. H /. S Ft. Plan View Of Mound Using A Trench For The Absorption Area ,Z ";Se l(. y0 R ✓. G. F orce Main F ',, Distribution Pipe Permanent Markers Observation Pipe O ---------- - - - - -- -------------- - - - - -. W f B K I \Trench Of - 22" Aggregate —LL I L A S.0 Ft. I /6,0 Ft. K /Z.0 Ft. W 3 0.5 Ft. B 150 Ft. J 9 Ft. L W0 Ft. N�Lvt cE , SSE � Page_� Of$ Distribution Pipe Detail For Two Lateral Network Holes Located On Bottom Are Equally Spaced End Cap HY X PVC Distribution Pipe P k ,Z.• ScJ►. yo 4,v e Last Hole Should Be Next To End Cap P 72.s Ft. Hole Diameter %s/ Inch X 30 Inches Lateral Diameter M Inches) Y 36 Inches Force Main Diameter 2 Inches # Of Holes /Pipe 29 Invert Elevation Of Laterals ///50 Ft. •• PAGE . **JJ 1•_ OF • PUMP CHAMBER CROS5 SEC T IOIJ ANG SPECIFICATIMS VENT CAP `I"p1;e- VENT PIPE WEATHERPROOF APPROVED LOCKING - T 15' FROM DOOR, JUNCTION BOX MANHOLE COVER WINDOW OR FRESH 12 "MIU. AIR INTAKE I GRADE I � y" MIN. COUDUIT IB "MIN. \ • 1 1 INLET PROVIDE -7 AIRTIGHT SEAL *� A I (' I ALARM a i I. 1 *APPROVED I ON JOINTS WITH I ELEV. -All FT. APPROVED PIPE 3' ONTO PUMP----, OFF D SOLID SOIL CONCRETE BLOCK EUEK = 0 •. RISER EXIT PERMITTED OIJLH IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E SPEGIFfCAtIOUS DOSE - /� TANKS MAN UFACTURER: LYf.dw�.s n 1 aAst kIUMBER OF DOSES: PER DAS TANK SIZE: �T =�� 1 •C� 11 5 0 C,ALL0NS DOSE VOLUME LARM1 MANUFACTURER: 5 • �C« S S`�NLS INCLUDING BACKFLOW: �•Z �` GALLONS MODEL AIUM15EK: - yid CAPACITIES: A = 16.60 INCHES OR Z•M GALLOWS SWITCH TSPE: g = A• INCHES OR 39 GALLONS PUMP MANUFACTURER: C. INCHES OR 1 26- GALLONS MODEL NUMBER: - #97 D = LL`•= INCHES OR - GALLONS SWITCH TUPE: Wf ,46 a NOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATE 33. ,3 GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. -1• 18 FEET + MINIMUM NETWORK SUPPLY PRESSUR // . , . .. . . .. 2.50 FEET ♦ 77 FEET OF FORCE MAIN X L F /pprx FRICTION FACTOR. FEET TOTAL ODUX141C. HEAD = JI..zG FEET INTERNAL DIMENSIONS OF TANK: LENCsTH ;WIDTH - ;LIQUID DEPTH S10'ai i M HEAD CAPACITY CURVE EFFLUENT \\■■■■■■■■■ nn ® ®� ■ AM ■ ■ ■ ■ ■ ■ ■■ Comm, Ru ■■ \■■■■■■■■ a Elm loom �mm MM KE= ■►\ \ ■1� ■■ ■ ■■ ►` \ \ \� Ali'M 0 W311MMMMMIMM o laffilwAlum 01M NKMWMMM�-� %0 IN ski ■■■\ \IIIski ■ON \ ■ ■ MEN ONO ■ \III ■ ■0 ■� \ ■ ■ ■ ■■ .. -.. W-ftl ON lW44murponl"Mm, am ■■■1911\ I' ►a ►� \ ■■ ■MME _ NE III No Q ■ ■ ■ ■ ■ ■■ ■��■■■■ �s © ®sesese�E ■■���■■ ®m ®® ®mom ® ®�� �; \� ■ \�N ■ \ \� \ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■■ ���� \� ■MEN \one ■ ■ ■ ■ ■ ■ ■ ■ ■■ MEN MEME N ■ ■ ►�■ \�1 ■ ■`►.1 ■ ■■ ■MEMO \son ■ \\\ \ ■ ■ ■ ■■ ME ME HNNEEM MEN ■E No liqlIlill Wisconsin Department of Industry SOIL AN D ill VALUATION / 3 tabor and Human Relations - i Page of :, Division of Safety and Buildings in agz6,ed4n6d 3.09, Wis. Attach complete site plan on paper not less than 81/2 x 1 (riches in siAE ffiMst GOU " Include, but not limited to: vertical and horizontal referen • `nt (BM), direction and percent slope, scale or dimensions, north arrow, and I ti nd d ate �p ea d. ;" u IV T 1�( i - Parcel I.D. # C44t4Q� f•L-y ST CROIX 04/2., //,*L -5101 APPLICANT INFORMATION - Please print a p#OrmatldnIMTY Reviewed by Date Personal information you provide may be used for secondary purpos `�Priv�y, Property Owner \ �...._ .Govt. Lot _7� 114 SW 1 /4,S 34 . T l ! ,N,R & E (or W Property Owner's Mailing Address //70 Ctou,&e, Lot # Block# I Subd. Name or CSM# �O A�src . Sit! OIL yE oS 7 ,*1L 7 - CSi"C PH4 - J G--- aty �' TS state z5 3 (11f N ys5,- &730 ❑ city rage IU' Town N d U� IV 0 New Construction Use: Residential / Number of bedrooms ^� Addition to existing building ❑ Replacement yfb ^ ❑ Public or commercial - Describe: Code derived daily flow 6100 g pd Recommended design loading rate K bed, gpd/ft trench, gpd1W Absorption area required fl" bed, ft2 37s S t oo trench, ft Maximum design loading rate = bed, gpd/f trench, gpdflt Recommended Infiltration surface elevation(s) 3 ft (as referred to site plan benchmark) Additional design/site considerations u' � .S '"v f . /~ 4o'tP (i - - Parent material Y W ( }t 3 5A,,, Ti 1Kra SO i S F A"-1 Flood plain elevation, If applicable N ft Fc. Suitable for system Conventional Moou In- Ground ;! s AT- GradeSystem in Fill Holding Tank Unsuitable for system El S [B U L7 5 ❑ U El S El S L�'U ❑ S U El S 9 SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench o -!Z 1, *YA 313 T W sik S Cs Z f- . 1,17 . 4 - 2- /s • LA / YA 31 ,S /L /fS,6iC� �� ' a4> / f , 2-:. 3 Ground 3 P f7- 131 elev. Depth to limiting faoor in. QDlo.ft/f�-- Remarks: Boring # I o -$ /0 3 L. l 1s CS z S bid -3 s- 26 /0 YX VY S l -f sh ,c _ • 4 : • S Ground 1 16 -39 /OY $/& Z CL f SA4 'tsl tr�/ 4 S r z' • ,3 Depth to limiting factor Ss 2�t_In. Remarks: S CST Name (Please Print) Signature Telephone No. RO SSE R T' 2403R i "T f RZ� 7/3 3 $6 • gi S 5 Address Date CST Number 5 Ct ?-- e%S7_ -2 ye --- Wisconsin Department of Industry, SOIL ANB VALUATION l 3 Labor and Human Relations Page of 'Division of Safety and Buildings in acct de eneewittt - s�. h fi 3.09, Wis. Attach complete site plan on paper not less than 81/2 x 1 f inctios in sIAEP st l County Include, but not limited to: vertical and horizontal referen nt (BM), direction and percent slope, scale or dimensions, north arrow, and loci nd dat" io neaF��j egad � ; _; Parcel I.D. # CGf 4,&OPL y : ST CROIX y( `' 04'2— MOZ - 5.0 / APPLICANT INFORMATION - Please print a i!> brmatl6A1 MTY f Reviewed by Date Personal information you provide may be used for secondary purpos `f Priv�s��(rm)). ' • Property Owner ,/,/ 0 /,, A .p j' Property Ltication /,, / 114 7— t��� \� --.___ Govt'Lot 7W 1145 1/4,S T 2 ! q ,N,R I8 E (or (W Property Owner's Mailing Address /170 Ci�Z Lot # Block# Subd. Name or CSM# elo ivlw . S� OE YEul3 0 7,e°� / L Z• CSNt 1DEtiA'•) ( City State Zip Code Phone Number �,f Nearest Road it'c E ?T'S CV / . Syo �3 (Af y��• X ❑City El V'llage L!J Town d �Lt 1,3 New Construction Use: (Residential / Number of bedrooms 3 Addition to existing building ❑ Replacement 6 El Public or commercial - Describe: Code derived dally flow 100P pd - O � Recommended design loading rate — gpd/f? trench, gpd/ft Absorption area required 3�s �� bed, ft2 3�s s trench, ft Maximum design loading rate bed, gpd/il gpd/ft Recommended Infiltration surface elevation(s) •s 3 ft (as referred to site plan benchmark) n Additional design/site considerations �-r� 1 V S '"v f'� �~ 4G� � tiif �/eDGcJ /y e,,vD Parent material (�wi 56 v� Wf Flood plain elevation, If applicable N ft S Suitable for system Conventional ,Moon In-Ground ,Prresss AT- Grade System in Fill Holding Tank U = Unsuitable for system El S I/ U E 5 ❑ U ❑ S L�U ❑ S Ly'U ❑ S U ❑ S SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench r 1 0-17- /o y R 313 5 e e s L /z • /o A 3/ S/L 11 ,��' aw / f , z 3 Ground 3 P IF elev. Depth to limiting fa for �In. Dole EWf — Remarks: Boring # i 0 '8 io yX 3 L I S44 0S CS z f- . �{ ' . S U 2_ L 8 .15 /0 Ye / L - r" SLi r ,4.i, -r4 C-S /f Ll Ground ' 3 /10 5/& o Z CL Lf E,& �' Ole Depth to limiting factor SS tin. Remarks: S CST Name (Please Print) Signature Telephone No. 1R0f3E1Rr Z403R�"J 7l5 3916-93105 Address Date CST Number .5 - CST -2 Ve Z-- Private Sewage Consultants 855 O'Neil Rd. Hudson, Wis. 54018 OR IGIN AL M M C/f v -e— SOIL DESCRIPTION REPORT e PROPERTY OWNER Page Z of 3 PARCEL I.D.# G Z CSC-/ O y.Z ' 1/ 0 1 — 5 O I Boring # Horizon Depth Dominant Color Mottles Structure 2 Texture Consistence Boundary Roots In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench o -& •lo le 3/3 L. ifSA& ,,.,,,c e CS z f i . � :. S Z !� -1 /o y 3/ L I f Shy i ce CS l v Ground 3 _ Of ^/ 2� el v. � Z , �ft. s•2 /0 5 /lo s S /cL /f sly � ' c — ,, , Depth to limiting factor Z $ in. S.SS Remarks: Boring # Ground elev. n. Depth to limiting factor In. Remarks: Horizon Depth Dominant Color Mottles Texture Structure p Consistence _Boundary Roots In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # ; Ground elev. n. Depth to limiting factor In. Remarks: Boring # Ground elev. ft. Depth to limiting factor In. Remarks: SBDW -8330 (R. 08/95) s 7 i o y , -A z c \ z N o o� � N W ;o j FIZI o ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 5e-&6� wee V Mailing Address Property Address / / y / / 0 �o 0 a - , 4A (Verification required from Planning Department for new construction) City /State Parcel Identification Number O ' //002 - SO o2 (o LEGAL DESCRIPTION Property Location 5 C '/4, , ' / 4, Sec. T g N -R_ff W, Town of Subdivision e6jg !//� / D 3303 , Lot # e_ Certified Survey Map # 5(0 , Volume Page # 33 Warranty Deed # , Volume , Page # Spec house ❑ yes 2'1 Lot lines identifiable 9? es ❑ 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 wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days the three year expiration date. „3 / SIGNATURE OF APPL1 DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. / / SIG TtJRE 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 food P�el) Dy,,7 Z c t: Yy z ry W trl� -9� y �. X1.2 3 wry 5G2'729 v - o > ERTIFIED SURVEY &U N MARGARET CAVE,. etal. Part of the Southwest 1/4 of the Southwest 1/4 of Section 36, Township 29 North, Range 18 West, Town of Warren, St. Croix County, Wisconsin. Note: An erosion control plan must be submitted to the St. Croix County Zoning Office prior to construction on 'these lots. UNPLATTED LANDS _meth STREET WEST LINE -SWI14 SECTION36 N 00 12'00"W 2637.44'-- - T2 ° c - 'r _ - -- 9 R= 809.2 - -- � � � - 1 J - 1829.55 - y oi N00 °l7 01 "E 741.67= - t Droo Of�� IW i „ �'2 �� _� Q� •OJ mwa 2jp� .l• p N �-�/� _CO C (r g4 ' Q,OGI i ` � y O st I�� C - - - -N 00° 20' 24" E 59705' - -- ID N O C y C y (R'S °,� 7 Z � a - IQ i 0 2 8 ' 2 - Z C N N �? a S 84 034'53" �(R- S84 °30 'Ea , %84.3 8408,' to r ►• w D 49 .B4 , , W - - -N OO° 20 24 g 531.67 - 6 Owhe r' s Address: I to o y c ON - qq ya C/0 William Snoeyenbos c>, ka 1170 Coulee Trail c c o a r V �v !Roberts, WI 54023 O w A I� '�� 0 1� Q C �% /� L THE'SW14 OFSECTION pST , � b � o ,� RECORDED BEARING N 00 w. w � r I n a 414.23' y -� 'o r S' - 1,4 I - k zH �w 0 w W F. f O Oi O u V V 2 I C y O M (O 01 - 0 2O %2 O r 9 O� o � y V N rn `` n 1fN ..o► :w n b� � Z O Ca a I o . i rn 4 y > S42° £, 159 N O Cy M rn -293 (R= S 42 20 E, 147.4 J C " 0 IS 00 11'23 E nk Nyy -S EAST L/NE- WI /2- s o y .A a I * Z:40 I ~ SW 114 SEC T101 htitttlf��F n: 2yy UNPLATTED LA; $ \SG0/VS+�y��i'i ° o +► a '' 2 � m yZ I •LAUREN•• N- ? b I – ;t � �► y :RIVER FALLS-4 J � � . • ..... '. Q' Dated: March 22 1997 i or Laurence W. Murphy •• •••••••' � �� Registered Land Surveyor �• 0 $ ��� "Revised this 2nd day of fill I Is � Y t EQN � July, 1997. This Instrument Drafted - by Mark W Peavey SHEET i OF .Z — Vo1.12 Page 3303 -