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HomeMy WebLinkAbout004-1085-50-100 .. 3 0 M O � O c a CL, p w CY a O N N � � I N 'O S O Q U w � 4 O � � I 'm 6L c c 'O 0 o a) c 00 f° c , ) Lo z LLI E = o Z < a w d M cwn a m o z a) Z c to F- < N � I III � I Q •~ O O O C Q cJ U Z Z 0 Z p Z o 0 N N 0) _ d CL r� m _ r - � ooa a ; Y Z r D '.. ll� f" �~ d d • R a a a Q J U m rn rn C } M U W a0 0 0 0 0 O O 7} N n O 1- N IL m U) �� W y O Cl) N C ° m o I I I ! � t co M `y T. O O 0 0 0 l O N Q. 0 F, j' 6 t 3 I' O O N N N N N N 1 W 0 O V .� O M W 6 N O F O �. u7 <� M 7- r r N 06 C) 'O >� 'S N ' ' N f� m N h m LO O M U > p L O O � U • U. M O a'» N d' U) v cz E d a • RS C d V N C i C C w 3 a <L O Vl U • 8 ST. CROIX COUNTY ZONING DEPART AS BUILT SANITARY REPORT Owner r> £ Wct r Address -. 60 3,� Q'''' ST � t City /State S IPr ; W i !; - 7 (off Legal Description: Lot Block -' Subdivision/CSM # t/4 a f, t/4 zvt, Sec. 3�, T S N -RL Town of LAA:�i PIN # b6y -/ o,,ci-!L ' So JM SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION Tank manufacturer 4u F F c- vrr Size ST/PC 000/ Setback from: House Well P/L Y& ' + Pump manufacturer ro MA-' Model S W 3,3 Alarm location a`L', h Pe c.scul+e T'Q-,k (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: A v v h j Width Length - (7 Number of Trenches , X BY) Setback from: House &W Well Q' P/L iDb'+ Vent to fresh air intake 90' �- ELEVATIONS Description of benchmark f3o d m daG or S. - A. - A o n �o y sc Elevation 1 Description of alternate benchmark n l` Cc Lv.T s l +I, Elevation q , q ' — Building Sewer � � 9 ST/HT Inlet 9 1) , 1 5 ST Outlet PC Inlet — PC Bottom to. h Header/Manifold S 08 I Top of ST/PC Manhole Cover G ` - 3 Distribution Lines Bottom of System `l I , Final Grade Date of installation 7 8D/ �' Permit number -3 1 59 50 State plan number 1 1 `f 1 3 / Plumber's signature License number 5 P CO 110 9 6 Date Inspector i�v rs� ; N �C-r Complete plot plan 1 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. F,arM SInG� Old F4 11e� w� 3 arN LAN VIEW _ pld OIAOt� F ;eld i w -o_1 Ha - i W cl1 W Aber L: N f PVC ---�i� - - P, Pc 113 / *1- 3- Ar op ceMe -7 1 SIAI, � hovs� i __.�' 3oo� of Pic C CAA 60 INDICATE NORTH ARROW O ---� Wiscort'nin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM County: INSPECTION REPORT ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Perso information you provice may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)). 315950 Permit Holder's Name: ❑ City ❑ Village M Town of: State Plan ID No.: WARHOL, JOE CADY CST BM Elev.; Insp. BM Elev.: BM DescriQtion: Parcel Tax No.: X00 7p Si1 o o 004- 1085 -50 -100 TANK INFORMATION ELEVATION DATA A 9 800331 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. eptic V 1000 Bench s ; Z' 7 56 ©3 Dosing ; , 3A / lacy ,iy � � Aerati Bldg. Sewer l po Holding St tkt' Inlet r ( 2-83 20.75 TANK SETBACK INFORMATION St/ Outlet 403 i �' q i3 33 `JO,L TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic //C) 6 ' - 7' 1- --1,, NA Dt Bottom toy s8 i 7 �� 1Z. og 'F(o . Dosing r• 'e 14 ` f NA Header / Man. z'1r / �f6 • a� Aeration - ---- NA Dist. Pipe. Holdin Bot. System �, , , 9y ?S L g t, PUMP/ SIPHON INFORMATION ,� Final Grade Manufacturer Demand Si. o C3 r>r 6 -24 Model Number 2g495PM TDH 1 Lift . Friction System2 TDHaobFt Forcemain Length6e Dia..D" Dist. To Well SOIL ABSORPTION SYSTEM BED CTR Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liqui epth DIMENSIONS DIMENSION SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHIN anufacturec_ SETBACK - -- INFORMATION Type of CHAMBER Model Num System: }V1 r 00 i3 ✓ / OR UNIT DISTRIBUTION SYSTEM Header /Manifold r � Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake rr .r , Length Dia.� Length z �Dia. � — Spacing ' ,� SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over r• Depth Over xx Depth Of f r xx Seeded / Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil X Yes ❑ No [Yes ❑ No COMMENTS (Include code discrepancies, persons present, etc.) rL 3 J `/ 10 Don TOue LOCATION: CADY 35.28.15.549B, SE,NE 60 - 320TH STREET A `o' z 5�d k -�r25 �, �► r - �, 1 s -Cap ,� ✓"a + vilov.~cl (v ,l ope) b-I✓} ��--��11 Plan revision requiredti ❑ Yes No Use other side for additional information. )A k{ / SBD -6710 (R.3/97) Date Inspector' Signature ert. o. ADDITIONAL COMMENTS AND SKETCH ' SANITARY PERMIT NUMBER: E } 4 , # s i i 1 s t S s 4 q i , , i r e � f , r t e i c r , b y 4 r t # i , a i 6 c e, q , e 1 � i v a o a a # s x � S y # 3 e Safety and Buildings Division SANITARY PERMIT APPLICATION Bureau of Building Water Systems 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County44 I t � + c than 8 112 x 11 inches in size. .�T Tom, • See reverse side for instructions for completing this application State Sanitary The information you provide may be used by other government agency programs El Check it revl'sion to previous application (Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. j�l ger I. APPLICATION INFORMATION - PLEASE PRI ALL IN FORMATION / j L Property Ow r Name Property L cation ©� 1/4 N 1/4, S T , N, R �S (or W Property Owner's Mailing Address Lot Number '�` Block Number 3 ID �► City State Zip Code Phone Number Subdivision Name um 6L d �. U. S (')/5') Z I �1 II. TYPE OF BUILDING: (check one) ❑ State Owned o vita Nearest Road S �pI �nrla Public 1 or 2 Family Dwelling - No. of bedrooms Town OF fJ �ZO 114 5 1 - X ►E) III BUILDIN USE: (If building type is public, check all that apply) Parcel Tax Number(s) �f'� ) (� 1 E] Apartment/ Condo 00 0, 55 - —/ C> `� 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.X Replacement 3 E] Replacement of 4. El Reconnection of 5. C] Repair of an System 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 21� Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 F1 Seepage Trench 22 In- Ground Pressure 42.❑ Pit Privy 13 ❑ Seepage Pit 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 Required (sq. ft.) Proposed (sq. ft.) (Gal day /sq. ft.) (Min. /inch) Elevation 7 --b Z �– Feet 9(, _ `2 Fee t s t Ca aut VII. TANK in allons Total # of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existing strutted Tanks Tanks l Zft eptic Tank pJ + U J / y F1 11 El 1:1 ❑ Pump Tank iVkieaAaber (j{/ ,. e- 1:1 11 ❑ ❑ ❑ VI11, RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Na mf (Print) Plumber's S tut o St a s) MP /MPRSW NNo.: Business Phone Number: Plumbers ddre (Street, City, StaC Zip ode): y AJ b Z ) a 4 1�„ 7 S� ti tie "S ` IX. COUNTY/ DEPARTMENT USE NLY ❑ Disapproved Sanitary Permit Fee (InaudesGroundwater D ate Issued sQAgen natur e (No Stamps) roved Surcharge fee) pp ❑ Owner Given Initial ®OO Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -6398 (8. 05/94) DISTRIBUTION: Original to County, One copy To: Safety & 9uildings Divi. ion, 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. 1 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 -3815. To be complete and accurate this anitar p y permit application must include: L 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. 111. 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 8 112 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 1340 E GREEN BAY ST STE 300 SHAWANO WI 54166 ,sconsn Tommy G. Thompson, Governor Department of Commerce William J . M ccoshen, Secretary July 17, 1998 CUST ID No.3409 AM.. POWTSINSPECTOR PELKE PLUMBING & HEATING & WELL DRILLING INC N6298 STATE HWY 25 DURAND WI 54736 -9105 RE:. CONDITIONAL APPROVAL Identification Numbers APPROVAL EXPIRES: 07/17/2000 Transaction ID No. 114131 Site ID No. 14340 SITE: Please refer to both identification numbers, Site ID: 14340 above, in all correspondence with the agency. ST CROIX County, Town of CADY SE1/4, NE1 /4, S35, T28N, R15W JOE WARHOL FOR: Description: MOUND SYSTEM FOR JOE WARHOL Object Type: POWT System Regulated Object ID No.: 30650 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • On the Index Sheet, the description for page #4 shall be "Plan View of Mound & Pipe Lateral Layout. • On page #3, "bed" shall be changed to "trench." • On page #4, "bed" shall be changed to "trench." • On page #5, it shall be shown that the dose chamber will supply 14.9 gallons per inch. • Page #6 shall be entitled "Pump Performance Curve." d this letter shall be on -site during construction and o A copy of the approved plans, specifications an g en to P 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 07/15/1998 FEE REQUIRED $ 180.00 AKUEIA WILKINSON, POWTS PLAN REVIEWER FEE RECEIVED $ 180.00 Integrated Services BALANCE DUE $ 0.00 (715)524-3630, M -F 7 AM - 3:45 PM KWILKINSON @COMMERCE. STATE. WI.US 1 PRIVATE SEWAGE SYSTEM SEX AND TITLE SHEET Property Owner(s): Project Name: Project Location: Strout Addcoss osc�tion �....- V oe�,✓ F roan or WGRi zEty Sr" o/X ocs.d rr c0=1 Contents: Pw 1: _ �i✓DEx►- liirrr .S.y��'�' Page 2: _ /i "G a F' G'L •�•✓ Page 3: /lass ��o r�o� of / /ou,✓ o _. CORRECTION NEEDED SEE CORRESPONDENCE Page 4: P.O.W.T.S. Page 5: � EOr y^v.✓,r /�.yP G.yyiY�nc Gila.rr- �� rtia Conditionally Pa 6. A PP RO VE D DEPARTMENT OF coM MERCE DIVISION OF SAFETY AND BUILDINGS ` SEE CORRESPONDENCE l lit l 3 I � ned: �.���� Name! �;g _ /iTEit6 �L .rE — Credential Nmnber: P- J W' Z Date: 7- f- f8 Address: .7 r Phone Nmnber: 7�s gg s z« 1-4K 7is' G7a?- s�t7 !V IP ' , o as , ya = .d emirs J Ae.Id t�,p�OEL ALe Gorr, l.�io SET6.Ra.aJ rs•r 7 4yelo F,4LCF,✓ . T , A 4,4AJ,J JE L 7 o �p 1 _ Zy 1 Es."1y 93. sa p? /�dL ear! �•f /�✓ �ss tl Oe Q j t✓ ELL Q P 6tlif,C0 Po�f� �i �O��LOO Go v,Qo 3' A.✓K loo - Qa rro,v ea oAe/!x of 6lv6.�T' Se.r6 � � LA /.sr /Nl a f di0i.✓s � �/st. �xi.rrwt .rrsrero so .QE LA/tAI f � AQs.✓o °.✓Ea Py�P�o t fie i ro �.� t - ,6uA /CO /�No,vt t ! L,ao r y /y/i r ro I� 0 b �a cY+ N LN w FT-1 c'� a w cn n � a Co m o "a Z �= k sk n Gl m ` Gy r M cr x .y O �, C1 c � 1 1p C y ti Z � t �t� 0 x a w N w ^} \ •O t C� x w I rr I w r" CIO �• I O ern r• I zZ I ,co � m. �' I ,, r C 0 I r N p re't a w m44 C O rrt I e 'C r *o ,� r,, a . `c, w rt cnwx a m ° c C �V K :I •doo lk F1 NC m R Co x oo J ri 0 �b m w w �Q rr Cr7 v H. Cl) ti7 w z ro m w oo .n a p• H C 7C c k w o 0 5 w o w w r* h r+ '+o � r• �( (D R Q1 ro 3 I� 0 Page .4- 0 / SEPTIC TANK E'PUMP CHAMBER CROSS SECTION'AND SPECIFICATIONS 4" Cl VENT PIPE 12" MIN. ABOVE GRADE E WEATHERPROOF > /p FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT M NHHOLE FINISHED GRADE WARNING LABEL 4" CI RISER {�Y f4" MIN. Y 6" MAX. i 18" ' I N . INLET. GAS- t ` WATER TIGHT SEALS `�-' TIGHT i t`► APPROVED A SEAL JOINTS WITH APPROVED --�-- ALM APPROVED PIPE PIPE 3' i , ON SOL�DT�OIL ONTO SOLID C SOIL PUMP OFF ELEV . 81.3 FT • — -- OFF * * RISER EXIT D J PERMITTED ONLY IF TANK MANUFACTURER HAS APPROVAL 3 APPROVED BEDDING UNDER TANK • CONCRETE PAD SPECIFICATIONS SEPTIC ! DOSE TANK MANUFACTURER: �FFGarr �.�t NUMBER DOSES PER DAY: 9 TANK SIZES SEPTIC /000 GAL. DOSE VOLUME INCLUDING /Xs /7 9" DOSE Goo GAL. FLOWBACK: _Z GAL. ALARM MANUFACTURER: s T, cEar�► CAPACITIES: A = �?,Z INCHES = GAL. MODEL NUMBER: /o/ SWITCH TYPE: �1����,�r /y, ��,, B _._? INCHES = �s8 GAL. PUMP MANUFACTURER: CORRECTKI`!'EDEDc 1L INCHES = GAL. MODEL NUMBER: SEE CORRESPONDENC SWITCH TYPE: 7 L, INCHES �y3 6A REQUIRED DISCHARGE RAT GPM PUMP E ALARM WIRING AS PER ILHR 16.23 WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . ... . . . . . 2.5 FEET + - FEET FORCEMAIN X FTI100 FT. FRICTION FACTOR ,q FEET T.OTAL DYNAMIC HEAD = //. 9 FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH. ; WIDTH X70 ; DIAMETER -- LIQUID DEPTH SUM • AW :1e a n Pe wS /DS25 WS25Ax • Completely submersible DSAVS25 - V4 HP - MAX. SOLIDS 112" - 3300 RPM automatic sump /effluent pump. 28 • Available with wide -angle "piggyback" float switch 24 (WS25A1) or diaphragm type "piggyback" switch (DS25A1). • Cast iron constuction with non- w 20 corroding ABS volute /base. LL • 1/4 HP, 115V oil - filled motor Z 16 with thermal overload °a protection. LU • Anti -clog thermoplastic z 12 FULL LOAD impeller. AMPS AT • Can be used without switch for o 8 lk 115v. DS25A1 portable dewatering pump. 8.5, • 1 1/4" =discharge with 4 adaptor included for 1 1/2" NPT discharge. J TPT±�± • 10' replaceable power cord. 0 • Weighs 14 lbs. 5 10 15 20 25 30 35 • UL listed sump pump. U.S. GALLONS PER MINUTE CORRECTION NEEDED SEE coRPF'SrOINDENcE yDitor.. ric S /SD25 33 For sump and effluent use. 26 SWISD25 - 114 HP - MAX. SOLIDS 112" - 1550 RPM • • Automatic models available SW25/33 with wide -angle "piggyback" 24 float switch (SW models) or FULL Logo BoPSAT diaphragm type switch (SD W 20 1e. nsv. models). Also available in Z 16 manual models. g • 1/4 HP (SW /SD25) or 1/3 HP i 12 (SW /SD33), heavy -duty, 115V oil - fllled motor with thermal 2 6 overload protection. • Rugged cast iron construction. 4 • Non -clog vortex impeller. • Long life lower ball bearing. ° 5 10 15 20 25 30 35 40 45 50 Sintered top sleeve bearing U.S. GALLONS PER MINUTE • Carbon and ceramic mechanical shaft seal. SWIS033 - 113 HP - MAX. SOLIDS 112" - 1550 RPM • 1 1/2" NPT discharge. ze • 10' replaceable power cord. (20' 24 SD25/33 optional). • UL listed sump pump. w 20 LL = 16 Q 6 w FULL LOAD 12 AMPS AT 4 10, 115v. 0 10.0 r 8 4 0 5 10 15 20 25 30 35 40 45 50 A Ii C Rtl I nNS PEA MINIITF *V iscon0n , Department of CoQmerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page _� of .3 Bureau of Integrated Services in a599r4an with s. ILHR 83.09, Wis. Adm. Code I � Attach complete site plan on paper not less than.$ 11 inch s in stz @.' must County include, but not limited to: vertical and horizonit'aF.`eferenc Qoif (BM , direcfiefi nd percent slope, scale or dimensions, north arrdw; and loca fl I t nce to npa st road. Parcel I.D. # :`. �... APPLICANT INFORMATION - P /ease priirt`aYl ifom.' nwed by Date Personal infonn you provide may be used for s�cpngary purposai (f4IKLaw, S. 1 (m)). Property Owner :'ONINGOFFiCE A operty Location ovt 'Lot ...SE 1/4� 1 /4,S�S► T®?8 .N,R /S & Propeity Owner's Mailing Address t, Lot # Block# 3nbd. Namor CSM# o 3,?0 7---f sr. _- City State Zip Code Phone NumberY [-}-Nilk3ge ® Town Nearest Road / �iy / >IINA S �r 4 w_r y7 1X > 7 - 3.? 9 1 swe ` C lee. ❑ New Construction Use: © Residential / Number of bedrooms - Addition to existing building ® Replacement ❑ Public or commercial - Describe: a Code derived daily flow S'v gpd �f FAy.4, Recommended design loading rate bed, gpd/ft - trench, gpd /ft Absorption area required bed, ft2 7.S o trench, ft Maximum design loading rate • X bed, gpd/ft trench, gpd/ft Recommended infiltration surface elevation(s) 13 2 F OlL�.J Co.✓ y'44.4 ft (as referred to site plan benchmark) Additional design /site considerations Z /S rA.dc ".Aric Syss'E.y re .Qa` .4em/o 4 +11' f /Lt�O /.✓ Parent material 'Zoer.s Flood plain elevation, if applicable Zoe ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ S ® U ®S ❑ U ❑ S ® U P� S ❑ U ❑ S ® U ❑ S ® U SOIL DESCRIPTION REPORT Boris # Horizon Depth Domirlant Color Mottles Structure GPD /ft Boring Texture Consistence Boundary Roots in. Munsell Clu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench L a •/J' r>t S 3 .E IV 1 d s Ground _ � -- elev. 3 •to rc s> t �' ft e -Wt' 10 Depth to limiting factor, skin. E' aoT rT �' •✓ Remarks: �o /� s �lE,r Y i��'.r /c uL.��t �✓> r.✓ tiu�iE.t... r �looT ►` �1eAr� l�b.tlS - - Bonng # t — / d Z L /- rR s _ ai. s- ,...... Ground — s ry s/d o c a f t elev. > 9 1.L ft. D w/GD�I..i r "r e Depth to limiting fact y4 in. Remarks: .Sal r CST Name (Please Print) Telephone No. Address �- Date CST Number loov PROPERTY OWNER �1oc� l. _ SOIL DESCRIPTION REPORT page Z of .3 PARCEL I.D.# Boris # Horizon Depth Dominant Color Mottles Structure 2 Boring Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Z -1 r .^ � t✓ v S , Ground -3 ;- S 3 1 1 4 1 — — 7 elev. s Yle 40 "- ,Xq vii10 Y-f L y� Acl A ' Depth to a rr 4 .✓ '--Oxy Nas limiting factors Z-in. Remarks: Boring # 13 Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Structure GPD /ft Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # ; 13. Ground elev. ft. Depth to limiting factor in. Remarks: Boring # 13 Ground elev. ft. Depth to a limiting factor '< in. Remarks: a= SBD -8330 (R. 07/96) r r �. ,. H r C n OF C C7 H H M H Cri N o Q ' A6Ac, ,Vo 1 s .4oi rs Cr4 Il k /i' Go.a � o • fA l 1 E.J y {SAO /J 9L Z T T / 8 c J'Y � 2 93. 3 A WOoOi y3. r S7 x , f3• s s° A - ----�I L 4VIV AQssp r f , p l0 A/EtL �Q p La4.4 fio,� #F _ cco rvrrci.✓! � AEl./!. - imo - A6o rroAy ao.�.✓ECc G< G i'l'ls•✓ r -LAD � � Ex /,S ✓c 0 � e'�r�c Fk�rs our AQdLO� j_A�t• SYs rr�v /s //�I /d0 �7 L �0 ✓•✓ /Hove• � � // ro -� � mss: C /�✓OiA/.✓A� �. � �,/w a ? 9 - ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 July 7, 1998 Herb Pelke Pelke Plumbing & Heating N6298 STH 25 Durand, WI 54736 Re: Joe Warhol's proposed septic system site (60 320th St.) Dear Herb: _ Recently you requested that the St. Croix County Zoning Office conduct an onsite soil verification for a possible at -grade site located in the SE % of the NE % of Sec. 35, T28N -R15W, Town of Cady, St. Croix County, Wisconsin. On July 1st, I was at the above mentioned property and verified the soil description report of soil boring 1 as described by the original soil tester Mike Hassett, ID # 224974. My inspection of soil boring 1 revealed that the B horizon was a loam textured soil with weak platy structure. Platy structure reduces /inhibits the ability of effluent to infiltrate t1fough the soil. Installing an at -grade septic system over this condition could lead to a premature failure of the system and is not recommended. My recommendation for this site is to use a long, narrow mound and to chisel plow to a depth of 10 inches to break apart the platy structure encountered in the B horizon. At -grade construction at this site should be avoided. If you have any questions regarding this matter, please don't hesitate to contact me. Si cerely, Rod Eslinger Assistant Zoning Administrator CC: Mike Hassett, CSTM 224974 flie cs�nsin Deparfinen_t of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page _____ of Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 112 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 and distance to nearest road. Parcel I.D. # APPLICANT INFORMATION - Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location jo Govt. Lot 1/4 N 1 /4,S3�T�g'N,R /�E (or) W Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# CO o Sao , City State zip Code Phone Number ❑ City ❑ Village (� Town Nearest Road I ❑ New Construction Use: Residential / Number of bedrooms :3 Addition to existing building X Replacement ❑ Public or commercial - Describe: Code derived daily flo gpd DD Recommended design loading rate bed, gpde trench, gpd/ft Absorption area required bed, ft 2 2 tr nch, ft M um desi n I in rate bed pdHt trench, gpd/ft w Recommended infiltration surface elevation(s) �"" n la reed fo si a pl ben ma Additional design /site considerations Parent material L oess Flood plain elevation, if a plicabI I V ft S = Suitable for system Conventund In- Ground Pressure AT Grade System in Fill Holding Tn�afnk U = Unsuitable for system ❑ S S El U El U R] S❑ U ❑ S ;0 U ❑ S U ESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD/f12 ots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 2 (0-6o 1 0YA 5/ Ground 3 d^ L elev. 1 Depth to 5 y(+ q e R limiting fa r �in. Remarks: N 4 S�t/C/ cc) . Sk a o Id b e L) w''� Carte P �l 1 (,, o O reatc U C4) Imo , f� I b ��� �s -�- P Mai it) 4 Cov C� 5 NO [ ->L v� se - 1 - 4 � - ST CROIX COUNTY M SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer `' ��� P 'r 0 Mailing Address �`'� 3 3'b T4 Property Address p� 3 �r - T14 - 5T (Verification required from Planning Department for new construction) City/State r r` : N V (( + 1 Parcel Identification Number lags so - + oc Is ky= LEGAL DESCRIPTION Property Location S>= ' /,, N1= a, Sec. 3S . T N -R 1 J W, Town of Ct�d Subdivision Lot # Certified Survey Map # Dc ` &oo , Volume r , Page # 1 d : Warranty Deed # 5 1 (O`t . Volume 1 33q Page # Spec house ❑ yes "R no Lot lines identifiable IO yes ❑ no SYSTEM MAINTENANCE use and maintenance of your ti system result ' its premature failure to handle wastes. Improper e y ep c ys em could res tin Proper maintenance p p 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 (ifnecessary), 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 sy stem 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 year expiration date. T k) /17 SIG ATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property des 'bed above, by virtue of a warranty deed recorded in Register of Deeds Office. - .,Z- I adw 4 Z J027/ C, 10 SIGN 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 s + . 113'4 w237 DOCUMENT NO. WARRANTY DEED REGISTER'S OFFICE This Deed, made between Fr r i$ :)chuitz ST. CROiX CO.. WI _Grantor, JUN 2 3 1998 and Robin Mark nka Robin Warhol aka Robin M Warhol and 9:45 45 A + Joseph F. Warhol, htl;:band �i wife as survivorship mari� prop *rty �n Grantee, �X,t}Q l,, -!� 'A./ t. Witnesseth, That the said Grantor, for a valuable consideration 39 +•r � o+ - ds,_,,._J conveys to Grantee the following described real estate in St. Croix RETURN TO County, State of'Nisconsin: Swanson & Loberg Ellsworth WI 54011 Tax Parcel No:004- 1085 -50 -100 Lot One (1) of Certified Survey Map, recorded in Vol. 7 of C.S.M., pg. 1923, doc. no. 432909, being a part of the Southeast Quarter (SE %' of the Northeast Quarter (NE%) of Section Thirty Five (35), Township Twenty Eight (28) North, Range FAeen (15) West. This deed is made in fulfillment of that land contract dated November 25, 1987, recorded December 21, 1987, in Vol. 799, pgs. 293 -294, as doc. no. 433107. TRAN�R , This is ngLhome: `ead property. Together with all and singular the hereditaments and appurtenances thereunto belonging; And grantor warrants that the title is good, indefeasible in fee simple and free and dear of encumbrances except easements, restrictions and covenants of record, and will warrant and defend the same. 3 Dated this I S 0 ) day of June 19 98 . (SEAL) (SEAL) rams A_ Schultz (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF VASCONSIN ) ST. C5001X )ss. F!dtMX County ) authenticated this day of 19, Personaity came before me this 15th d of June 19 98, the above named Francis A Sch.i11z to me known to be the person who executed i the foregoifV instrument and acknowledge the same. TITLE: MEMBER STATE BAR OF WISCONSIN (If not authorized by §706 06, Wis. S'ats.) M ar y t � ger. THIS INSTRUMENT WAS DRAFTED BY Notary pvt is St Cro ix' Co. Wis. SWANSON & LOBERG My Convrns—sics •s Firma +tent. (if not, state Robert L. Loberg expiraboo cue: M arch • 1999 (Signatures may be authenticated or acknowledged. Both are not necessary.) d 432309 CERTIFIED SURVEY MAP LOCATED IN THE SEI /4 OF THE NE 1/4 OF SECTION 35, T28N, R15W, TOWN OF CADY, ST. CROIX COUNTY, WISCONSIN. OWNED BY: FRANCIS SCHULTZ �NE CORNER OF SEC. 4 T28N, RISW. (I "x 24 RT. I IRON PIPE SET). WILSON, W I 54027 O: SET 1" x 24" IRON PIPE WEIGHING 1.13 LBS• PER LINEAL FOOT. UNPLATTED LANDS r 33' 3 3' I w S89 0 50' 21 "E 402.82 1--d 01 369.82' 33.00' W: M O I W.I 0m C6 sh•d dry fu n 0: cn: _ Z, .LOT I - Q' 2 3.20 ACRES ' J , (139368 S0. FT.) _ op CO W ° 2.9 AC. TO R.O. W. O) I u Z. (126, 221 S0. FT•) "� In Z 0% W \ t7` 63 dri I U. W X1.1 ' O J—•— W Z Z W Lu ! _ Q o ' •h•d p, M Q C7 W p Z CL O Indmlll� 0 O t' W Q I p C Z Z W Z O o O I zJm 0. ` \ I Z N Q ` drlvl W sc '_' • m � W Q � shed �--• W W 5 O • I �' W y E O= a 8 2' 33.00 N Z I- �- . ,� N89 ° 5021 w 282.82 w * \ S 3 3' 33 W PAL IRD _ DE0 .1 1987 _ • UNPLAT • TED LANDS �: W � J y �O�t15���Q1fPTYlld� p �y�+y W W P��` VO rV1�� •'L �i + I JAMES M. W WEBER � am 0 g iv 0 e O: � S- 1804 � Z SPRING VALLEY f 3T�Cwa COUNTY E 1/4 CORNER OF SE / WI �� �+ t�S PL& 33, T28N, RISW. AND 20f*W GOMMITTE5 (FOUND) • M O N U M E N T �dS�1�61i bt,�e SCALE 1 _ J orr .r w -.t. --_ JAMES M. WEBER S -1804 0' 50' 100' 200' ' WEGERER, WEBER AND ASSOC. DATED fJoV•zo $216- SHEET I OF . b 87- 540 THIS INSTRUMENT DRAFTED 8Y IdG+. -u- Volume 7 Page 1923 SANITARY PERMIT APPLICATION Safety ofB B u ildin gs iWater Bureau of Building Water Sy sterns 201 E. Washington Ave In accord with ILHR 83 05, Wis. Adm Code P O. Box 7969 Madison, WI 53707 -/969 • Attach complete plans (to the county copy only) for the system, on paper not less Countycl I ( r - , than 8 112 x 11 inches in size - 5T • See reverse side for instructions for completing this application State Sanitary Permit Number The information you provide may be used by other government agency programs ❑ Check it revision to previous apOicauun lPnvacy Law, s. 15.04 (1) (m)I State Plan I.D. (Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION / / / /� Property Ow r Name Property Location - -� - !& 1/4 1/4, S 5 T , N, R jc (or) Wj Property O ner's Mailing Address Lot Number Block Number City, State Zip Code Phone Number Subdivision Name <f um e 7 Cl II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ Cit Nearest Road E] Public 1 or 2 Family ❑ Village Dwellin - No. of bedrooms Town of ! ; III. BUILDIN USE: (If building type is public, check all that apply) Parcel Tax Number(s) (� n 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. E] Replacementof 4. ❑ Reconnection of 5_ [] Repair of an _____System 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 21 ® 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: 1- Gallons Per Day 2- Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation c. - pr — 1 Z ^ J V, L Feet �fb . Feet acit VII. TANK in a gallo s Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New Existing strutted Tanks I Tanks Septic Tank ❑ ❑ ❑ ❑ ❑ ft Pump Tank iplAo,raLbamber - J. !i . 0 ❑ El 1:1 El El VIII. ONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Namej (Print) ^� Plumber's Si n, ure ?(No Starryps) MP /MPRSW No.: Business Phon / e Number: Plumber' dress (Street, City, State, Zip IX. COUNTY/ DEPARTMENT USE O LY E] Disapproved Sanitary Permit Fee (includese(oundwater jD ate Issue Is "suing ge AMt-S nature (No Stamps) Surcharge lee) Approved ❑ Owner Given Initial Adverse Determination �D`� ma c. X. CONDITIONS OF APPROVAL /REASONS FOR ISAPPROVAL: