HomeMy WebLinkAbout004-1077-50-000 O
o c c
ti
O
C
O
t a
0
o
a I
0
CL
m c
Z m o I
w
z
L N N N
LL O
w (O >
3 �-C
N
i, C
LO Z = C / \
z (D d 7
co
c H Z a m \�
c t9
o
(D 2 a c
N
E
N
0 0 C)
0
I
� o o r
N t
tLS
C (�
c-,
�
_ O
O - V/
� w
(O O
�Ql Z Z O
Z o
c I
_ N m
a
N 10 0
�
) .N Q
A a)
mo o a aI�
a X 3 3 3 a
0 0 0
• 4i �(L ao.
�y a 4)
�i Q o 0
N f0 O
� N
00 N N O E
I'! N O O TJ
•� m y d
N y N ) N
O o 0 C
O N O 0 U d N O
O .-T O O
O U N N tl d 0 0
r � C m Vl O "a N N
w ^ O E y 3 0 7 N N
T7 C6 T N r O
•PV O ( U Q M O z y Ud fA
O � r
i+ I
a
m CL
• a m .� j', m d c
r '�V E
`o1 A U a 2 0 (`n v
ST. CROIX COUNTY ZONING D I1�,�rx
AS BUILT SANITARY RE Q r s! 2C
Owner �pU
`9 p015 2 d .e -.
Property Address __.
City /State S D/�i,[9�r f/� 1�E'�/ 4JI. 3�y� "� � ra n
S7 COUNTY L/
~ � '?taNiN C �
FIGE. �
Legal Description: r etc /da
Lot Block Subdivision/CSM # ,r z
N - 1 / 4 " 1 /4, Sec. 2i , T :9 N -RAW, Town of e? # O d �/ • /O 7 7 • S�j
SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION:
,tfl�W,Es jte,✓ Aar1f5* T � >
Tank manufacturer 'F'V C - Size ST/PC � �/ � � D e y � Setback from: House 3 Well P/L
Pump manufacturer AfeYifXX Model 6 l �
Alarm location �k =
(HOLDING TANKS ONLY)
Setbacks: Service road to it intake Water Line
Meter location
Alarm location
SOIL ABSORPTION SYSTEM
130
Type of system: DUB! J9 Width Length 75 Number of Trenches
Setback from: House Well . o0 P2 D Vent to fresh air intake > -5 d
ELEVATIONS /{•5 RA4
C 5q& '$ 9�
Description of benchmark ' "r- � L 31 � 1 r)1 1"e- Elevation
Description of alternate benchmark _!ZbP Q d100 Elevation
y,Pa vtiD ,
n C'
Building Sewer � • � D ST/HT Inlet ff 2,5 ST Outlet d �' PC Inlet 00 N- & 5 5S S elr r c rfiA. - X9 . 3 3 (A)v ,e, Ser-
PC Bottom Header/Manifold Top of W/PC Manhole Cover '
Distribution Lines () () ( )
Bottom of System ( ) O ( )
�• O
Final Grade
r
y 2 S
Date of installation / / Permit number 3 State plan number l 3
Plumber's signature License number 2437 5 Date
Inspector ��� �f f
P oo Complete plot plan �
�
OR IGNAL
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
INDICATE NORTH ARROW
l,, a
o � z
w �n
Q
b -- I
o\
2z
C�
I
/ ( J
I I � •
I
0
H
+ c .A
-� w s
I
I
ME40 Series
00 HP Effluent
and Drain Water Pumps
Performance Curve
MODEL ME40 EFFLUENT PUMP
CAPACITY LITERS PER MINUTE
0 50 100 150 2.00 250 300 350
40 12
35
10 to
30
r e �
Z 25 Z
H
20 _ 6
15 a
O _ 4 ~o
10 ~
2
5
0 O
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.
r •
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County:
Safety and Buildings Division
INSPECTION REPORT ST. CROIX
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary 2 0261
w
Personal information you provice may be used for secondary purposes (Privacy L , s.15.04 (1)(m)].
Permit Holder's Name: ❑ El village Town of: State Plan ID No.:
AN DERSON, GORDON & IRENE CC � DY 13 4
CST BM Elev.: ��, Insp. BM Elev.:d fs BM Description: * Parc Tax No.:
/D 004- 1077 -50 -000
TANK INFORMATION ELEVATION DATA A9800449
TYPE MANUFACTURER CAPACITY STATION BS HI I FS ELEV.
Septic ✓H �� f0� Benchmark
Dosing��
Aeration Bldg. Sewer
Holding St /bPfInlet q��p P.
TANK SETBACK INFORMATION St/ bl't Outlet l�/.T8 I /�� •l
TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet • $ / /.�� 88.C5
Air Intake
Septic > fdo 10-4 � J � A) NA Dt Bottom -�8
Dosing 1 17 / NA Header/ Man.
Aeration NA Dist. Pipe
p f. &. 7- y S', LIS
Holding Bot. System S;
PUMP/ SIPHON INFORMATION Final Grade��`
Manufacturer ��t Demand qR•
Model Number (' 9 GPM C 6 (3 -9 .4Z 1 Q. lo 98'. 2 6
TDH Lift jD$* Friction S stem � TDH .%Ft � 2
L ,� H e a d rw ,o lora. 3
,%D Forcemain Length r2! i Dia. 2 u Dist. To well �� �(,� g w. FT
SOIL ABSORPTION SYSTEM
TRENCH Width Length No. f T nches PIT No. Of Pits Inside Dia. Liquid Depth
DIM DIMENSION
SYSTEM TO P/ L BLDG WELL LAKE / STREAM LEACHING Manufacturer:
SETBACK CHAMBER
INFORMATION Type Of / mp 7 ZS 7q0 OR UNIT Mod Number:
System: �,p�(d.
DISTRIBUTION SYSTEM
Header / Maryfol0 Distribution Pipe(s) x Ho, Size,, x Hole Spacing Vent To Air Intake
A�fD,, Dia. t fQ ��
Length s" Dia- Length �_ Spacing TD
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
LOCATION: C Dot 32.2 5 2,NE,NW 2843 10TH AVENUE
( #' 0tv) W tf (w ( l( bQ G / r �GC�
N,*., e.�Pc, X40- �. L e,
9`f. 0 '('S•6
Plan revision required? ❑ Yes ❑ No ( 2
Use oth r side fo r additional inf mation. ('t 0'0
'� w0 t gKp Date I spector's Si ature Cert. No.
D -6710 (R.3/97)
�1��
ADDITIONAL COMMENTS AND SKETCH .
SANITARY PERMIT NUMBER:
e
Safety and Buildings Division
SANITARY PERMIT APPLICATION 20 E. Washington Ave.
As In accord with ILHR 83 .05 Wis. Adm. Code P.O. Box 7969
Department of Commerce Madison, WI 53707 -7969
• Attach complete plans (to the county copy only) for the system, on paper not less County s.�v co o! - y.
than 81/2 x 11 inches in size.
• See reverse side for instructions for completing this application state sanita Permit Nu� i r
The information you provide may be used by other government agency programs ❑ Check it revision to previous spolication
[Privacy Law, s. 15.04 (1) (m)]. State Plan I . N mber
I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMAT 13 ADS
Prop Owner Name ee�� � Property Location p
p &0/? ,9 D . j ��G�•^i[. �d"�� ji 1 y Ct/ 1 /4, S 7 ? 2 — T 1 d , N, R /sE (or
Property Owner's M ling Address Lot Number Block Number
o S'a,v C
`mo a l l�.e Cv/ Zip Code Phone Number Su ivision Name or CSM Number
S4'o '? c G 2-7- 7 6 F /Oa
11. TYPE OF BUILDING: (check one) ❑ State Owned �f !t Nearest Road
Ej Public or 2 Family Dwelling - No. of bedrooms — v own OF
Ill. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s)
1 ❑ Apartment/ Condo dd y • 16 • s
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. ----- System 3. E] Replacement of 4 ❑ Reconnection of 5_ ❑ Repair of an
_____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 21A 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
VI. ABSORPTION SYSTEM INFORMATION: 5
1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade
�,q Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) �j'�j. 0 Elevation
3 0 2 Feet Feet
Ca aclt
VII. TANK in allons Total # of Prefab. Site Fiber-
INFORMATION g Manufacturer's Name Con- Steel Plastic Exper.
New Exlstin Gallons Tanks Concrete structed S glass App.
Tanks Tanks
< ❑ ❑ ❑ ❑
? So S� eD ❑ El 1:1 ❑ 1:1
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 Signatu e: (No Stamps MP /MPRSW No.: Business Phone Numbe
T_ ZeW (' QA 1- 22.63 "ZS ?!S• 3�� '��B.S
Plumber's Address (Street, City, State; Zip Code):
6 5 - 5 6 t A. eX L
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate I ssued Issuing Agent Signature (No Stamps)
A roved Surcharge Fee) �� n
�l pp El Given Initial Sr ap /�
Adverse Determination
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SBD6= (R.1 1/96) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber
i
INSTRUCTIONS
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit maybe 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 plu fiber 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.
11. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling.
Ill. 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.
Vlll. 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 modeLand 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
15837 USH 63
HAYWARD WI 54843 -8107
isconsin Tommy G. Thompson, Governor
Department of Co William J. McCoshen, secretary
August 31, 1998
CUST ID No.226375
ROBERT W ULBRICHT
655 O'NEIL RD
HUDSON WI 54016
RE: CONDITIONAL APPROVAL
APPROVAL EXPIRES: 08/31/2000
Transaction ID o. 136859
Site ID No. 15803
SITE: Please refer to both3 tentiflca�c�n nuiaabers;
Site ID: 158033 above,,n all ccrrrspoadence with the,
ST CROIX County, Town of CADY
NEIA, NW1 /4, S32, T28N, R15W
GORDON ANDERSON REPLACEMENT MOUND
FOR:
Description: REPLACEMENT MOUND
Object Type: POWT System Regulated Object ID No.: 418366
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.
This plan approval is for a 450gpd mound.
The following conditions shall be met during construction or installation and prior to occupancy or use:
• This plan action is subject to designer comments on the plan
• Correspondence Note:
• Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the outlet
filter will be required. Outlet filter to be installed per manufacture's recommendations and product approval
stipulations.
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.
Sincere R �,
DATE RECEIVED 08/25/1998
C0 114
FEE REQUIRED $ 180.00 APP R
ATOMBRAa, PLAN REVIEWER FEE RECEIVED $ 180.00 DEPARTMENT
Integrated Services BALANCE DUE $ 0.00 DivISioN F SAFE
(715)634-3026, M - F 7:45 AM TO 4:30 PM
TBRAUN @COMMERCE. STATE. WI. US
TE COR17E,
I
ULBRICHT ASSOCIATES CO.
655 O'Neil Road • Hudson, WI 54016 Reg. Designers of Engineering Systems
715- 386 -8185 Private Sewage Consultants
PROJECT TNOEX
DILNR Plan I.D. # 3 g.7 Date 8-2-7.- ! 9 _
Owner �rp�j�,t� �4 - 'E 4NPkT-5OA, - *Phone 7 /jr• �o C l9" Z 2- C.
Address 320 II,DOfW. 1114- 40 /. S yD L e
Legal Description PIN 00 /0 77. —e fNX7 Or /OD e Gc�
N �1', �v�v , S e. 3 2- , 7'. g A 15 w
Town of ���� County
C.S.T. 4 7 2111XI44"7' ,2- 4/F2— Installer
Local Authority/ Supervision d
PROJECT DESCRIPTION
Plfl' �—'y
W.T.S.
Z /For
s s�-�., a4 �.s : VED
OF COMMERCE
4AND
DI i = Y�(' t07'X l� Sam �,G
C, po we?,Q-
ltw
Pg.l PLOT PLAN VIEWS ```\`a��unnu�tunnrq�ri����
Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWS
:'' ROBERTW
Pg . 3 PIPE LATERAL LAYOUT = UL11RICHT
01160
Pg.4 DOSING CHAMBER CROSS SECTION (� =�y' ; UOSON, W1 ;
Pg.5 PUMP PERFORMANCE SPECS % 4!' I• o`````\
lands 711is.design for installation is based entirely on measurements, elevations
cape conditions (slopes etc.
The accuracy of his specs, aT*te and soil suitability provided by C.SThi
of the csTM. Ported, shall remain the sole responsibility
Any use of this POWTS design by any licensed plumbe , or any
related unlicensed parties or persons (excavaters, 1 borers)
shall not be construed as an assumption of responsib lity by
the designer for the workmanship, construction, plac ment,
substitution or selection of any components not ape ified, or
any assumptions by the plumt-er that any unspecified components
are state approved or proper, or the effects of p r judgement
If working under adverse damaging weather conditions (wet /frozen
soils) by any such parties or persons.
J
0 m -a D
3)
m d W
c,OZ d
n O
°va0
zz
IgON0 b
MME O
E � �' � 7i c .• C
Z1DZ gQ mz
�r
J � m
7
J �
TQ
O
I o —�
O
LA
QJ
I I& .
Ot t
I
P z of 5
L C � PO SS S O M ouk) D w i r tj Be D
o of % ro
Di ST Ri(Ju Allet-5ATE
T� o�
pJ
G Th cka r s s s Ys r E M
OF T °P 's a( L
' E IEVA rioo
VM F OPM T O E
E r-
R Alt 0 Map.
�i' SAuD •
P I o w 6 0 T o e s
i t
% 51 r -ORCE' EtF-VATlv LWOER
M REP
.17 A O FT — ELEVAr S --
E / 3 Fr. IMVERr of Z I ATGPA( S
T o P O F R a c k 97 �
N /• S T ' Top O �
F IA TE RA Is 9�
PLAN VI EW OF Mou.�jD - Wirt{ 13 D
F vR c E MAix J A ,l' F r•
Fr
i
K o Fr
Q T L—
I L
- --------- -_--_- -- o �_ Fr
8
1141 F ,-
• W Y w z 7
`9 Fr
Bev OF
PVC. cAPPEp To .
I?E /4TE
9
9
035ERVhri00 A 5
Pipes
PERMA,JEuT MAR
REc2UiReo BAS AL hQeA - `D y Wlt S rE - Fl o w � �C/ �U'�i
ApAci Ty r 54 • Fr.
PRopoSEV BASM AReA = B ( A + z
s dZ , F T,
FOLD D '5tR;l3oTiok) pipes �Er woR k
TOTA v L n f= LATE JV�'I'wole
'P -�
�t5tRlr3uT1
`
Y PUG, �o
M A i N
LAS( V�olE 5 II10 1 13
"EEt To END CAP
Vo I D Vv 1 uh E Vo R 35 F�•
Y:uvERV u IEVA 1-1o" dE Z FoRtE MAW � 7
gAls,
�,�• 5U
PEI,FoRNrED PIPE DETAi L
F{o1Es lfjcATev oX3
g �, I rare SH All 13E
I -)
Y VARiABLt± y E gOPvlly spACeD.
bt s TA{�icE
P 7z r r HDIE DiAhr=Tr-R
L ATERA L
�j MAM FOLD
ropm MMk 2
Y IN� s oK 14OIE5 / p 1. P �9.
DISTRi t3uTloxj D%SCVIARGE RATE PER L T R ZZ'Z3
A E hL
GAI
rafiAl, "D15CAiAR vE PATE NEB w k Z2,Z3
PUMP CHAMBER CROSS SECTIOU A ND SPECIFICATIONS PAJE of J
—VENT CAP
y.. C.I. VENT PIPE
WEATHER PROOF APPROVED LOCKI"G
25 FROM DOOR,
JUNCTION BOX MAMHOLE COVER
W
WINDOW OR FRESH 12 "MIU. 4vfXV 6- 1AAE
AIR INTAKE I
Or r/E b�1T�On/ GRADE I
� I 4" MIIJ.
Z___ DiO f I I n
MIIJ.
r^ COUDUIT
3.0 v ---- - - -___
�IEUMrn c1. F ,
IIJLET PROVIDE I - - - -_
AIRTIGHT SEAL I
APPROVED JOINT A INy h �K I I APPROVED JOINTS
wlc.I. PIPE �UM 1 I III W /C.I. PIPE
EXTENDING 3 0 /1 ( II ALARM E X TENDING 3'
OUTO SOLID SOIL / I I II ONTO SOLID SOIL
—I- g/ 3,3
c 1 I 1
�� I o
I
E. L E V. FT -
1 PUMP - -�
� OFF Z/SG' 3 D,F
/t/ eF
BLOCK
�A /E V f io ^)
.r -Z-- --
RISER EXIT PERMITTED ONLY IF TAIJK MANUFACTURER HAS SUCH APPROVAL
SEPTIC E 5PEC.IFI'CAT10KJS
DOSE �j
TANKS MANU U
FACTRER: - /, S T� IJUMBER OF DOSES: PER DAy
TAMK SIZE 7
: /SO GALL.OMS, DOSE VOLUME /d
ALARM MANUFACTURER: _ 44060- �� - INCLUDING SACKFLOW: 6 GALLONS
MODEL IJUMBER: 'D y CAPACITIES: A= INCHES OR 3a� GALLONS
SWITCH TYPE: M��i� �!/� g _ Z' INCHES OR _ 3C' GALLONS
�
PUMP MANUFACTURER: �/� C= , INCHES OR - GALLONS
MODEL NUMBER: 3 ' 5 7 _ 9g �j� D =! INCHES OR �S� - GALLONS
SWITCH TYPE: aI 41Y,C�/¢Cle /`/ 0 0 17 — M OTE: PUMP AND ALARM ARE TO BE
MINIMUM DISCHARGE RATE ZS GPM INSTALLED ON SEPARATE CIRCUITS
VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. /0 FEET fi A A-
M[ JIMUM NETWORK SUPPLY PRES . . . . . . . . 2.5 FEET
- JI
_1_ FEET OF FORCE MAIN X /i /y F �o FTFRICTION FACTOR.. 3 FEET tg S /Q 7S r
TOTAL DYNAMIC HEAD - l FEET oo c��r
IUTERNAL DIMEMSIONS OF TAIJK: LE-MGTH v ;WIDTH _ ;LIQUID DEPTH _
I
Y
r
HEAD CAPACITY CURVE
MODEL "9N" 3 7 /° 6 1/4
e 4 5 /e
t25
N
e I 3 s/8
m
is t t
4
10 6 4 3/16
5 1 1/2 -11 1/2 NPT '
0
U.S. OA LONS 10 20 30 40
ttTle:Jts so so 7o e
0
160 240
FLOW PER MINUTE
TOTAL IITMAMx; N[ACOLOW rig WIW I
EFFLUENT ANo DEwATEWNO
NERD CAPACITY 12
UNITti/MIN
•
FEET METERS GALS L
0 .1.52 72 213
10 2.05 01 231
4.57 5 9 5
0 +
� N.10 2 2 5 Ns
Lockvotvs � 3 S /16
CONSULT FACTORY FOR SPECIAL APPLICATIO
• Electrical alternalors, for du lex NS
P systems, are av tllable and
supplied with an alarm. • Mercury flofit switches are available for controlling single and
1: aNernatore, for duplex systems, are available with or • three phase systems.
Without . steam switches. p Piggyback mercury float switches are available for
variable level long cycle controls.
Standard all -mode 39 Ibb - ri, H.P. 1 . Integritl0oalopsrated2 BELECTIONOUIDE
N6 8srtss - ---� ----- 2. sing Piggyback marc rnechardcal switch, no sxletnal control r
Model V his Control Sstecdon fl p O{)Y wy bat switch or double squired.
Mods A. Sim lox switch. Rslor b FM0477. Pioyback mercury, 6�
M98
its 1 Auto V. lot i - Du bx 3. MechanlW allarrtatot 100072 or 10.0075,
4, ess FM0712, lot correct model of EWuk,A) Algrnalor, "E•Pak ",
0�0 230 1 Auto 4 5. Mercury sensor Opal switch 1 G-0Q25
2J0 i No + or 1 i 7 _ duplex (a) of (4) float ues y a coned activator .
4,5 .2 Or.R 4 4 30(4&5 a :FA1rt,(4) hgls "J Pak", lurw4 o
box. for hi
plex W duplex operaUon, 10 -0002, �orinec11or1 Or wktrd In sim•
7. Two'(2) halo "J- Pak lot watsr1181q�__ spliq.
Fa Intama5on m 6 Zosasi Ptoducts fM073t k MNe �`.0, FMD51 Bum w IUbr nat�or MOLSS; 6 o.Ch ,kj AN br AN Inatƛ a of "1*91 , Wq�clbn CAUTION
FMWSS; Naar P
B.sina FM
a67: one ewo caws eo. Itad Neanaad alastrkba *41ces and wit4p shorn be does
Ins " moat rawnl Natlon4l E�b.l an/ a.l.y solos &1 _WW be
IONowW Mq„d
I+saxh Ast (ONNA). 'lo Cods (NEC) and IM (ssupatlanal Nasty and
RESERVE POWEp
For unusual conditions a reserve safety factor )a do Ere DESIGN
9 irleered Into the
design of la-My Zoeller pump.
l MAIL r0:r.0. 80X 16347
O �E / /�o ; O, 1 (502) tOtllSYir9, Af 06 10756 0317 Mallulacfurers 01...
L L /j" SNIP 70: 3 ?80 , Millets tare Q
- -_
torS * KY r,�r r 40 216 PS ,f'cvcE /9.�9 v
-- --- 77e- 773 ;s 02) o2l x71.3671
Wisconsin Department of Industry SOIL AND SITE EVALUATION Page of `
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 81/2 x 11 inches in size. Plan must County
Include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimensions, north arrow, and location an d distance to nearest road. Parcel I.D. #
5iTE ff'D1��S'= �Sy3 /4 ds`'u,P. 4vl ' - pay - 1077 - .��
APPLICANT INFORMATION - Please print all information. Sy 7Ce 7 Revie d by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). �J gj
Property Owner Property LocLocation GD d��� 3 jp�,tlE � Govt. Lot Ns 1/4 V&�14,S 3 T 2 -0 ,N,R /S E (or) W
Property Owner's Mailing Address Lot # Block# Subd. Name or CSM#
32.0 �,vsa,� cT'• P,+,er o� ion f
City �/ / n State Zip Codes p Phone Number Nearest Road
fly oopodQ- /U� 5 ` d ( Z 1 5 ) &Ofg 2.2�P ❑ City e ill ge Town `O�� 4a-e .
❑ New Construction Use: esidential / Number of bedrooms 2 w3 Addition to existing building
Replacement ❑ Public or commercial - Describe:
Code derived daily flow 7 7 O gpd Recommended design loading rate _ - 5'
bed, gpd/it trench, gpd/f1
Absorption area required 3 5 bed, ft 3 trench, ft Maximum design loading rate • S bed, gpd/ft gpd/ft
Recommended infiltration surface elevation(s) S_ t 3 ft (as referred to site plan benchmark)
Additional design /site considerations
Parent material l6lie eaAk, Flood plain elevation, if applicable /v ft
S = Suitable for system Conventional Mound In- Ground Pressure AT- Grad, / System in Fill Holding Tank
U = Unsuitable for system ❑ S LA ❑ U El 2 El 9 S ❑ S I u ❑ S
SOIL DESC RIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /tt2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
1 0- 0- 10 S/L z f She S� CS ' S • �
a -1 /0 YR C. 2 ,3 5't f Shk dSk S ,� f • 5 "
'/,h • /
Ground . Z / Q ---- �l L �M� �� /1'M T C • S • C�
elev. C h S C
tIZI Depth to
limiting
factor
2 4
0, Remarks:
Boring #
p• y /o W3 --- i 2 - fshe d s A C S 3
/0 S� L e c — .2-:- 3
Ground 69 C /
G �elev. /0 y/Z c�12
f l •
&R— ft. �, ��
Depth to '
limiting
factor
2-6a— Remarks:
CST Name (Please Print) Signature Telephone No.
Address Date CST Number
Pfivate Sewage Consultants
665 O'Neil Rd.
Hudson, Wis. 54016
.r
r N
,
ORIG
PROPERTY OWNER in OIL DESCRIPTION REPORT Page of .
PARCEL I.D.# �d 7 7 — 5 - 0
Boring Horizon Depth Dominant Color Mottles Structure 2
g Texture Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
3
[ 77 - o� 1oY Y1 i lc sk eS 3f
.r is y4e ! es . s .
Ground —ZS �/, r�� • 2— ' 3
elev. ft 2 /oy/Z c
gam
Depth to
limiting
factor
?-S- in.
S.55 Remarks:
Boring #
I
Ground
elev.
n.
Depth to
limiting
factor
in.
Remarks:
Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
Boring # ;
Ground
elev.
ft.
Depth to
limiting
factor
in. Remarks:
Boring #
m
Ground
elev.
ft. ,
Depth to
limiting
factor
in. Remarks:
SBDW -8330 (R. 08/95)
o
0
n
� w
- t's � a
tz,
O
N
v, N
�w o C)
0 0 ` V154
o_
ti o
w �
o
' d
ST CROIX COUNTY
E
S PTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer
Mailing Address 3 20 ff���� Cl�• -2 ��' ,S X02 S
Property Address SOV l A"fl • 7
(Verification required from Planning Department for new construction)
City /State �i�lT' vTG( �� Parcel Identification Number eO AD 77• SD
LEGAL DESCRIPTION
Property Location /(/� '' /4, N '/4, Sec. 3 , T 2 9 N -R S W, Town of Cam!
Subdivision _ P 7 —
1 07 — dF� /W � y ' G �� • , Lot #
Certified Survey Map # -
�J 7
Warranty Deed # 7 �V''' " Volume ragc # � 3 L
,�
Spec house ❑ yes no Lot lines identifiable Q yes ❑ no
SYSTEM MAINTENANCE
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance
consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system
can affect the function of the septic tank as a treatment stage in the waste disposal system.
The property owner agrees to submit. to St. Croix Zoning Department a certification form, signed by the owner and by a
master plumber, journeyman plumber, restricted plumber or a 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.
I/we, the undersigned have read the above requirements � gn q is 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.
SIGNATURE OF APPLICANT "L_1 2� 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.
SIGNATURE OF LICANT 2T 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
0411 7N—Wr CLAIM DUM.—By County Cjwk. (Coramittoo Autborhation.)
1301M 59.37 17) Amass ZUUO)
4397510 P
3V W
e0ox a g 1 1 36 8
Thi Indenture, Made this.. twenty—second ......... day of ....... July .......................... ...... 19.8.8....,
by and between the County of.. ...... St....Czoix ............. ................... in the State of Wwonsin, party of the first part,
and. ............. Gordon..Anders.on ................................................................................ . ....................•..............................
of ........ S,_t_.Cy:QiX .. ....................................................... County, and the State aforesaid, part .............. of the second part.
Witnesseth, That:
Wherlas, at a legal meeting of the County Board of Supervisors of said--.----- ............ ....... County
held on the ..... 10.t:_h. . .................. day of ........... May ................................ 19 $8.., said Cewnty Board delegated its power
to se;i lands acquired by said County by tax deed, to a committee consisting of.. --- F-i-nanCe ...... Building .... 6, ........
... Bond.-pez ... Qrdirt_ance...A2G9.j_8R) ........ and.,...June ... c Q- a i -tt ee. ... action.. .......... V ....... ...
And W hereas, said committee for the sale of such lands in the...QQMntY.._ -.4
has sold the lands, hereinafter described, which are situated in said .... coLaty___amd were so acquired by tax deed,
to said part_.. .__........ of the second part, and said part., ................ of the second part ha-S ...... paid the sale price fixed
therefor by said committee.
Now, Therefore, said .............. S-t. Croix. ---- -- --------- --------- County, for and in consideration of the sum of
... six _thCLuz.and,___se.vea ... hundred ... seventy --- thr_eeL__and_6_1-/
to it in hand paid by the said part .............. the second part, the receipt whereof is hereby confessed and acknowledged,
has given, granted, bargained, sold, remised, released and quit-claimed, and by these Ares, its does give, grant, bargain,
sell, remise, release and quit-claim unto the said part .............. the second part, and to ___............... ......_..................._....
heirs and assigns forever, the following described real estate, situated in the County of ...... St....Croix ......
...............
State of Wisconsin, to-wit:
TOWN: Cady
Gordon Anderson ,�
Parcel #502, Sec 32 T28N R15W, NE NW
Parcel #505, Sec 32 T28N R15W, SE NW
CERTIFICATE #Is: 11E, 118 REGISTER'S OFFICE
YEAR OF SALE: 1983 ST. CROIX CO., WI
Roc'd for Record
-JUL 22 1988
-"ENO ni 3% y5 P m
R.qistcr of Deeds
To Have and to Hold the same, together with all and singular the appurtenances - -nd privileges thereunto
belonging or in anywise thereunto appertaining, and all the estate, right, title. im-lerest and claim whatsoever of the said
party of the first part, either in law or in equity, either in possession or expec=Lncy of, to the only proper use, benefit
and behoof of the said part ...... the second part, ---- ---- heirs and assigns forever.
In Witness Whereof, said ............ . . ... ..... County has caused this deed to be executed in its behalf
by.• Jill Ann Berke._.. .. . ..... its County Clerk, and its o6cial County ,�ere
k( affixed,
this --- ...... . 22nd - - --- ------- day of... -Jul- - ----------- ------ 19 V . - -
IN ESENCE OF
'S't /C r 91"X -.COUNTY
4 U-1-TY)
By.
......... Count� qler 4117 41
State of Wisconsin,
...... _.CR.QLX ----- - County.
Personally came,hefore rn this day of ` V'
19 --- c
the above named C intv ( 0_7k c47
......... County,
Wisconsin, to me known to be such offircr and to be the person wh - j 'he foregoing instrument and acknowl-
edged that he t-x(Tuted the same as the act and deed of sa
Land b% its authority. ...... ..... ......... County
4
.( Wis.
ti