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HomeMy WebLinkAbout006-1056-50-100 ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER n e 0 �� "" _ 1101 Carmichael Road ue Hudson, WI 54016 -7710 (715) 386 -4680 June 5, 1998 First Federal Attn: Tammy Herbst Hudson, WI 54016 RE: Septic Inspection for Linda McDuffy located at 2572 Highway 64, Town of Cylon, St. Croix County, Wisconsin Dear Tammy: A septic inspection of the above referenced property was conducted on May 27, 1998. This property is located in the SW'Y4 of the SEY4 of Section 25, T31 N -R1 6W, Lot 1, Town of Cylon, St. Croix County, Wisconsin. At the time of the inspection, this septic system was found to be code compliant for a three (3) bedroom home. If you have any questions regarding this, please contact our office at (715) 386 -4680. Sincerely, 4w r — p 4j � Mary J. Jenkins Assistant Zoning Administrator /sm ��- ST. CROIX COUNTYONNO D EPA RTMEN * , AS BUILT SANITARY REPORT j ~ � Owner 4 I Address 1 hl City /State fry, t�.► % S —y 1 2 - t c . AUikf R 1 Legal Description: k/V 11 2 Lot Block Subdivision/CSM # T V4 '/, , Sec. Z S , T, I N -RAW, Town o PIN # SEPTIC TANK -- DOSE CHAMBER -- HO G TANK INFORMATION: Tank manufacturer M of w eat een Size ST/PC / 41 &0/ 4 <qetback from: House A C Well W Pump manufacturer 2 -Model P/L Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM: Type of system: /Me it n d Width Z Length Number of Trenches Z. Setback from: Mouse 22 frO Well "3 0 P/L _ '� Vent to fresh air intake 1 ` ELEVATIONS Description of benchmark t a m& w a r f j' 0 Elevation Description of alternate benchmark t C- R, #— ) , S'' Elevation Building Sewer �'I 2 / ST/HT Inlet 1 f + ST Outlet PC Inlet PC Bottom � Header/Manifold I ei&. /j Top of ST/PC Manhole Cover Distribution Lines () — L O - 0 , f ,, () ( ) Bottom of System O q % (-/ � O ( ) Final Grade () / U Z , Is' () ( ) Date of installation S '� U 223 5' A l /yyPermit number State plan number Plumber's signature License number �2 3 '� Date /S'/ Inspector 0 4 e w Complete plot plan or 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 -_ 1J o s , � 3 � ti ,t= : r INDICATE NORTH ARROW Safety and Buildings Division SANITARY PERMIT APPLICATION 2 01 E. Washington Ave. Vi sconan P.O: Box 7969 Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less co unty ` than 8 112 x 11 inches in size. z &11 • See reverse side for instructions for completing this application State Sanitary Permit Number 3o - 773S The information you provide may be used by other government agency programs ❑ Check it revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.Q. Number / 1. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATION .� 2 O wi Prop rty Qwner Name Property Location i Jo X L w 411 /4 /t 1/4, S T 3 l' , N, R / � (or) W Property Owner's Mailing A dress Lot Number Block Number City Uate Zip Code one Number Subdivision Name or CSM Num r X / �,r/, s�Y� c ?ls� �� ,�Iuy S`� y c 3 b la133 �5 11. TYPE OF ILDING: (check one) ❑ State Owned ❑ 't ge 43 Nearest Road Public 1 or 2 Famil Dwellin - No. of bedrooms [] villa Town OF 111 BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment / Condo 0 V 6 ' ) - S'U 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 S ❑ 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. p Replacement 3_ ❑ Replacement of 4. ❑ Reconnection of 5_ ❑ Repair of an ------ System System Tank Only ____ ______ stem _____ ExistingSy ____,____ExistingSystem 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 [R] Mound 30 ❑ Specify Type 41 ❑ Holding "rank t 12 []Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Priory 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 /- 3 ?(e Feetl Cpl � , Feet Capacit VII. TANK in Ca g Total # of Prefab. Site Fiber- plastic Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con Steel glass App. New Existin strutted Tanks Tanks f v v v 1 �/a;d wes�c- n ❑ ❑ ❑ ❑ ❑ m , Tank er M' ❑ 1 ❑ 1 ❑ 1 ❑ 1 ❑ Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility f r installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumb s Signature: tamps) rP/MPRSW No.: Business Phone Number: Plumber's Ac dress (Street, Ci State, Zip Code): 5 - 0 4 G./, 1 a v O.2 t-_ G ce IX. COUNTY/ DEPARTMENT USE ONLY ❑Disapproved Sanitary Permit Fee pndudesGroundwater D ate Issue8 Issuing Signature (No Stamps) A roved ^ — © �Su'� 7/9 Adverse Determination Su Fee) pp ❑ Owner Given Initial ,( //(F./ �SuL.J X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -8398 (R.1 1196) DISTRIBUTION: Orig nal to County. One copy To: Safety & Buildings Division, Owner. Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD -6399) to be submitted to the county prior to installation S. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608 - 266 -3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III_ Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. i V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X_ County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and fakes; 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. ---------------------------------------------------------------------------------------------------- r 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. i N 5 rb SAFETY AND BUILDINGS DIVISION 1 I'.��! �t 2226 Rose Street f \ Mr La Crosse, WI 54603 r Department of Commerce � Rk�i� e197 - { "', 2 . � ST CROIX Tommy G. Thompson, Governor 21- Nov -97 COUNTY f..� William J. McCoshen, Secretary Wegerer Soil Testing & Desig ��` �1�� �a HARVEY HIELKEMA 421 N Main St PO Box 74 River Falls WI 54022 HARVEY HIELKEMA Plan ID 9720888 SW,SE,25,31,16W Municipality of CYLON Inspector: Leroy G. Jansky County of St Croix (715) 726 -2544 Private Sewage plans including the following element(s): MOUND 450 GPD 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(2)(e), Wisconsin Statutes, is responsible for compliance with all code requirements. This plan action is subject to the conditions listed on the following page(s). 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. All permits required by the state or local municipality shall be obtained prior to commencement of construction /installation /operation. This project is under the supervision of a state inspector. As inspection concerns arise feel free to contact the state inspector at the number listed. The inspector for this project is listed above. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Please refer to Plan ID number listed at the top of this page when making an inquiry or submitting additional information. Sincerely, "erardM. POWTS Plan Reviewer (608) 785 -9348 SAFETY AND BUILDINGS DIVISION 2226 Rose Street LaCrosse, Wisconsin 54603 Visconsin Department of Commerce Tommy G. Thompson, Governor William J. McCoshen, Secretary Page 2 9"7 0 8 rn ..i - 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, prior to installation. - 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(d), Weis. Stats. SBD- 5524 -E (R.07/96) File Ref: Page of 6 MOUND SYSTEM 97 FOR A 3 BEDROOM RESIDENCE LOCATED IN THE SW 1/4 OF THE 1/4 OF SECTION ,T 3 i N, R 1 4 W, TOWN OF C y LpN , s ( lzotx COUNTY, WISCONSIN. INDEX RECEIVED PAGE 1 'of 6 TITLE SHEET pIV. PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW -CROSS SEC bN PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT .PAGE 5 of 6 PUMPING CHAMBER ' PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR BAt..��1lu �I s Flo °Z PREPARED BY WEGE[�ER SO I !_ TEST S NG AND. DES = Ghi S�F -��1 I CE ��a ®OO�N F.O. BOX 74 421 K. KAIM ST. �DIN p.O.W.T.S. RIVQ? FALLS. WI 54022 ............... �, ��' �.• Conditionally 715 - 425 x16; WEGEF L ' wGcraEp A PPRS �:.+s � DEPARTMENT COMMERCE _ � . •.•.•.•M• ISION Of SAFETY AND LDINGS � S j G 14 PENCE SEE CORRESP Li 3 -97 JOB NO. 9 - 3 PLOT PLAN Page z- of Scale 1 "= H ' 3 � 1010 LSL. OF \0 "kaG 1, 31 ,1" pvc . PLP� w�wpop ..l.nTr� • •,�' 9 8. BOTTOM of - rkj&v c "S — L�t, S� i iN N I B �*L. 9$ 3 ' 2 - - - - - - - - - -a s� �+ z • � CIy�PPre.•� �C' OR. G 1 STS \2 - t3 J C. T wi S fMWN . N O` Ill V am • �l W tTL+L � -- Ilk Page 3 Of 6 Approved Synthetic Covering 7 C 3 3 Distribution Pipe Medium Sand H _ G Topsoil - __== _____� _= ____ —= ___,� =� =- __ F Elev. )b01 3 .3 E %Slo Trench Of 2- 2 Force Main Plowed Aggregate From Pump Layer Undisturbed D 1. Ft. Soil E 1.00 Ft. Cross Section Of A Mound System Using F o •% Ft. 2 Trenches For The Absorption Area G k. o Ft. A _V Ft. H Ft. B ( 4`7 Ft. C 1 (c, Ft. Linear Loading Rate= V. /LN FT I )Z Ft. Design Loading Rate ."10 GPD /SQ FT J l0 Ft. K \ - L Ft. L '1 Ft. w y2 Ft. L J B K A -- - - - -_— _ - -- O bservation Perm D Pipes ~— Markers - - - (Anchor securely) — — — — — — — Force S AT ------------ - - - - -- -- - - -- -� -J Main �tPosrt W Distribution Trench Of 2~ - 2 i Pipe Aggregate Mound Using 2 Trenches For Absorption Area Page Of Perforated Pipe Oetail 0 End View Perforated End Cup PVC Pipe Install permanent marker • i . d� e .4 s`a� at end of each lateral Holes Located On Bottom, Are Equally Spaced Q S PVC Force Main Q PVC Manifold Pipe Dist] ution P1 Lost Hole Should Be I Next To End Cap End Cap P 2 Z Ft. Distribution Pipe Layout S 1 (> Ft. X 48 Inches Y _ ' 4 8 Inches Hole Diameter l'`1 Inch Lateral 1 Inches Manifold Z Inches Force Main Z Inches # of holes /pipe 6 Invert Elevation of Laterals Ft. Place lst hole _L4" from center of manifold with succeeding holes at y8 intervals. Last hole to be next to the end cap. Combination Sept,Lc;Tank and Pd CHAMBER CRO55 SECTION AAmO SPECIFICATIOMS ' PAGE S OF 6 - WT CAP WEATHER PKOOF Ju1JCTIOLI 90X . H'C.I. VENT PIPE APPROVED LOCKIMG '' -10' FROM OoOR. r 'Du MA►JHOLE COVER AJIV './IIJDOW OR FRESH � wA(2.N1IJG Ll48EI... ALP, IIJTAKE s S i tj i 6" I•t PrX .-�- I (!:l. got - 11l y�1uS1��11oN PIPt PROVIDE I - -- — LE: T AIRTIGHT SEAL '3gFt =uz-- A I I I APPROVED JOIIJT: APPROVED JOIWT I I I ( W /C.I. PIPE�P'c W /C.I. PIPLOV Tank construction i I I 1 with ALARM shall comply Y I II R b I ILH�, x ,3.15 and 33.20 i I ow C I I g`1.6� I CLEY. FY PUMP - -j OFF D COAICRETC BLOCK 3" APPRavF'. RISER EXIT PERMITFED OULU IF TAW MAIJUFACTURI`R H#AS SUCH APPROVAL BEDDIN4 SEPTIC f SPEC.IFICATIOQS DOSE K /+iA►1UFACTURCR: ElIb1V� RAJ p sr WUMBER OF DOSES: 3 Fat, PER D" TAWK SIZE: ��Ob /� GALLOWS DOSE VOLUME I ALARM MAIJUFACTURE.R: 5.5. IMCLUDIMG OACKIFLOW: �,� GALLONS MODEL WUMBER: CAPACITIES: A= 1 '�C' IUCHES OR 3 O ( O GALLOQ5 SWITCH TtJPC: I�'1� SZCC1bZ�/ B = IRICHES OR -3 I 'l G�LLOIJS PUMP MANUFACTURER: 0. C = 1O IUCHES OR GALL01J5 MODEL WUMBER: » D- $ INCHES OR � GALLONS SWITCH TYPE: LCuS2Y IJOTE: PUAP AMD ALARM AR TO 6C � MIUIMUM DISCHARGE RATE Z 'l'zb GPM INSTALLED OW SEPARATE CIRCUITS VERTICAL DIFFEKEMCE DETWEEU PUMP OFF AIJO..D15TRIBUTION PIPE.. 13' �3 FEET t KII.IIMUM WETWORK SUPPLY PRESSURE , , , , , .. .. . . 2 FEET + Z `-' FEET OF FORCE MAIM X FY orcFKICTIOU FACTOR_. FEET TOTAL DtI JAMIC HEAD = z 0' B I0 FEET DIAMETER - Pump chamber IMTERIIAL DIMLWWOLI i OF TAWK: LENGTH ;WIDTH LIQUID DEPTH BOTTOM AREA — 231= GAL /INCH AS PER MANUFACTURER = . I . X-1 .. GAL /INCH . M 4 13/16 7 7/16 W W HEAD CAPACITY CURVE MODELS 1371139 6 1/e MODELS 137/139 Ft. Meters Gal. Ltrs. o 5 1.52 93 352 4 13/16 e z 10 3.05 79 299 _ i ZU 15 4.57 64 242 ° 6 20 20 6.10 36 136 ° 1 1/2' - 11 1/2 NPT < 25 7.62 8 30 Z a 137,139 9.14 - - o , Lock Valve: 26 ft. 2 s 1 13 0 U.S. GALLONS 10 20 30 40 50 60 70 80 90 700 110 uTERS 80 160 240 320 400 I I 4 0 FLOW PER MINUTE SK373 009921 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Three phase pumps are available in 200/208V, 230V or 460V. • Variable level control switches are available for controlling single and three • Electrical atemators, for duplex systems, are available and supplied with phase systems. an alarm. • Double piggyback variable level float switches are available for variable • Mechanical alternators, for duplex systems, are available with or without level long cycle controls. alarm switches. • Over 130 °F. (54 °C.) special quotation required. • Combination starters are available for 3 phase pumps. • Refer to FMO806 for 200° F. applications. • Control alarm systems are available for 1 phase pumps. 137 Series - 47 lbs. 139 Series - 51 lbs. SELECTION GUIDE r le Seal Control Selection Lis tin s 1. Integral float operated 2 pole mechanical switch, no external control required. del Volts -Ph Mode Amps Simplex Duplex CSA UL 37/139 115 1 Auto 10.7 1 or 1 & B — Y Y 2. Single piggyback variable level float switch or double piggyback variable level 37/139 115 1 Non 10.7 2 or 2 & 7 3 or 5 & 6 Y Y Iloat switch. Refer to FM0447. 137 115 1 Auto 10.7 " Y Y 3. Mechanical afternator M -Pak 10 -0072 or 10.0075. Refer to FMO495 37/139 230 1 Auto 5.8 1 or 1& 8 -- Y Y E137/139 230 1 Nan 5.8 2 or 2 & 7 3 or 5 & 6 Y Y 4. Combination Starter. Refer to FM0514. H137/139 200 -208 1 Auto 62 1&8 Y N 5. See FM0712 for correct model of Electrical Alternator E -Pak. 11371139 200 -206 1 Non 62 2&7 3 or 5 & 6 Y N 6. Variable level control switch 10 -0225 used as a Control activator, specify duplex J137/139 200 -208 3 Non 2.6 2&4 3&4 or 5&6 Y Y F137/139 230 3 Nan 2.6 2&4 3&4 or 5&6 Y y (3) or (4) float system. Gt37 460 3 Non 1.4 2 &4 3&4or5 &6 N N 7. Four(4) hole J-Pak, junction box, for watertight connection forhardwired simplex G139 460 3 Non 1.4 1 2&4 3&4 or 5 &6 N N operation, 10-0002. No molded plug "Single piggyback switch included. 8. Two (2) hole J -Pak, for Watertight hardwired Pconnection or splice, 10 -0003. Pumps must be operated in upright position. CAUTION Three phase units require a control switch to operate an external magnetic or combination starter. All installation of controls, protection devices and wiring should be done by For information on additional Zoeller products refer to catalog on Combination starter, FM0514; a qualified licensed electrician. All electrical and safety codes should be PiggybackVadable Level Float Switches, FM04T7: Electrical Alternator, FMO486; Mechanical Aftema- followed including the most recent National Electric Code (NEC) and the tor, FM0495; Alarm Package, FM0732; and Sump/Sewage Basins, FM0487. Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO. P.O. BOX 16347 Z El Louis 364 40256. MamAadurersof.. SHIP TO: 3649 Cane Run Road LkxristiAe, KY 40211 -1961 Quwrr Awpff 51Aar /4939 PUMP !O_ (52) 778- 2731.1(800) 928 -PUMP FAX(502) 774 -3624 ft4onsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations Division of Safety & Buildngs in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site - plan on paper not less than 81/2 x 11 inches in size. Plan must include, but ST not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. d 0 6 - 1 b S b - So APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION YIEWEP BY DAT PROPERTY OWNER: PROPERTY LOCATION pc V hf VetEuw {efF -EAT SbJ 1/4 SF 1/4,S23 T 3 N,R 16 E(Qw- PROPERTY OWNER':S MAILING ADDRESS LOT # I BLOCK # I SUBD. NAME OR CSM If S40 5o"" LT C - - -' CITY, STATE ZIP CODE PHONE NUMBER []CITY ❑VILLAGE ,®TOWN NEAREST ROAD 13PclOw►/v, wl S ( fey -Z8"Z I V�km 63 -6Y (] New Construction Use [.)I Residential / Number of bedrooms 3 [ ] Addition to existing building K Replacement (] Public or commercial describe Code derived daily flow 4 SO gpd Recommended design loading rate _ bed, gpd/ft • 3 trench, gpd/ft Absorption area required 3_}S bed, ft 11 S trench, ft Maximum design loading rate' y bed, gpd/ft ' S trench, gpolft Recommended infiltration surface elevation(s) % � 0, 3 it (as referred to site plan benchmark) Additional design/ site considerations +y/z.'Mt1Z jcM - �cq y' x«l L*Aoa , M ►A.0' . I. 6' oT: S•Po.A FILL Parent material (Z-�L Pvm -1 fit_ Tl LL Flood plain elevation, if applicable Iv. A, ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN ALL HOLDING TANK U= Unsuitable fors stem ❑ S ®U RS ❑ U ❑ S O U [IS O U ❑ S O U [I S O U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed w- & S: {i :xvtiif:i 3L S ` S yIZ 3)y - SCI Zm 3 vn - 9 '5 Ground 3 23 -y1 S LR y/Y �� Sb2 s! Sel caw, wfv- - 1�P • Z elev. Depth to limiting factor Z 3" Remarks: Boring # 1 O -`1 10`t�Z zLZ � s i` Z`�5�1•t wt'�h � - •S -L ,. io yv - Y/ - si I Zs w,�l� eg - • 5 .6 3 Zb -y0 S Y R Y/y -�,S y (z Sig s c l o Yh� - N� . 2 Ground elev. 4 la ft Depth to limiting r factor `' s j 'Remarks: CST Name. Please Print Phone: Arthur L. We erer 715 -42 egerer Soil Testing & Design Service -P.O. Box 74 River Fa11s Signature: Date: CST Number. M00576 PROPERTYOWNER SOIL DESCRIPTION REPORT Page 't of 3 PARCEL I.D.# W6— 1uS6 -SO Boring # Horizon Depth Dominant Color Mottles Texture Structure. Consistence Boundary Roots D/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 0-10 Vo�z Zl z — s t' Z'-ab m L - L1 .1, - . ­ L tz, R_ V/y T I) I M �I J. Ground 3 v) iL •S yfZ y! .S- s/� S c OY+, 1ni�, elev. 9 i 8•Z ft. Depth to limiting factor Remarks: Boring # .13 i Ground ` elev. ft. Depth to limiting factor 7_ Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) • s PL P LAN Page 3 of 3 3 9 . P 1 V �L,484 B). Lam-. 48,$'0► -A OF �� kAMIA, 31y" D A. e.z w_ o dQKM\.tt lam, q 8. 7 " � _ � .— rL ae b 8ol`fuw, of - rTZ.L, C" — L'Z., 100.3' sal S� I N N NLCts - - - - - - - - - -I Do DoT CpwlPl�t.7 ofit T tt1 S R•it4�R , v rim • 3'8D�w1 UL t- y Z a W1 , `to Zss T* ST. -, (71 S L-J z s- 01 6 5 M oo S'7 b CST Signature Date Signed Telephone No. CST # .Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 • Labor and Human Relations Division of Safety & Buildngs in accord with IL.HR 83.05, Wis. Adm. Code COUNTY Attach complete site -plan on paper not less than 81/2 x 11 inches in size. Plan must include, but ST C_tZU not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. o o 6 - I b S b - SO APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION R BY DATE �/• •9 PROPERTY OWNER: PROPERTY LOCATION N4 iE l-t i�LW_em A iaeVi-L-AT S w 1/4 S E 1 14,S ZS T 31 ,N,R l 6 E (okjW_ PROPERTY OWNERS MAILING ADDRESS LOT # [ UE ! # SUBD. NAME OR CSM # 54.0 Svr'11� it Q_L2La ui _ CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE ,®TOWN NEAREST ROAD 13P�Owt/v, ttil S ( I's) &8y -2850 wty I Vw&" 63 -6y [ j New Construction Use [ A Residential / Number of bedrooms 3 [ ] Addition to ebsting building j Replacement [ ] Public or commercial describe Code derived dally flow 4 SO gpd Recommended design loading rate bed, gf>lt? ' 3 trench, gPdIft' Absorption area required 31S bed, ft2 11S trench, ft Mabmum design loading rate' `] bed, gpd/ft ' S trench, glxW Recommended infiltration surface elevation(s) O O.3 ft (as referred to site plan benchmark) Additional design /site considerations 4' x y-)' Lb� • M !ti . 1. 6' ol= S•Po- A FI LL Parent material yt_ f ° Lt f)L_ Tt L.L- Rood plain elevation, if applicable )+j. A. ft S = Suitable for system CONVENTIONAL MOUND IN GROUND PRESSURE I AT - GRADE SYSTEM IN RU_ HOLDING TANK U= Unsuitable fors stem ❑ S ® U E' S❑ U I El S® U ❑ S O U ❑ S OU EIS o U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color totter Texture Structure Consistence BounJ3y Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tmnch J. - I, S y tZ 31 y - S C Z m S bk S Ground S'I VJY 3 led S �� b►t `fl• _ lvP . Z elev. 58 b ft. Depth to limiting factor Z 3" Remarks: Boring # ZL Z 5 i� Z `�S�lt �'�h � - •S 1 - - B Z Z q -Z n to ti tz Y1 - s i Z s bk wn'F'►r e • S 3 Zo - - 1-S `t it- V /Y -�. S `1 R s/8 SCI Z Ground el ev. & It Depth to limiting 2 facto 'Remarks: O T Name: -- Please Pratt Arthur L. W e e r e r Phone. 715 - 2 Ad dress Soi Te sting & Design Service -P.O. Box 74 River Falls, Signature: Date: CST Number: M00576 PROPERTYOWNER SOIL DESCRIPTION REPORT Page — Z of 3 PARCELIM4 W6- U)S6 - Boring # Horizon Depth Dominant Color Mottles Texture Structure . Consistence Boundary Roots G P D /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3 o -io tio�rL Z! z �o - �`t t.u`-�IZ v� — s r'1 Z �sdk � �►- cs �` • S . b Ground 3 IL S y (Z V/ � .T slg S c l 0 , elev. g Depth to limiting factor 1 Remarks: Boring # .13 i 1 Ground ` E elev. ft. Depth to limiting 'factor Remarks: Boring # i Ground I elev. ft. Depth'to limiting factor Remarks: Boring # Ground i elev. ft. Depth to limiting factor Remarks: S13D- 8330(R.05/92) _.._..._�_ PL P LAN P age 3 of 3 3 3 P 2 tE qb WITP:Z- Lam- 48 oN: ) OF. X\" kNkQA, 31y" �� LOQ•V• J JY' N Nj 8 .3, I 2 'mil, 48 e�o >.wr cowP�cT oil. p 1 STS+ \L\3 i V ram *� ► (� ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer I Mailing Address Property Address h - e-- (Verification required from Planning Department for new construction) City/State t' !ter 6 r11 - /d/ Parcel Identification Number LEGAL DESCRIPTION Property Location %,, S/r ' /,, Sec. 9 - �5 , T 3 N -R W, Town of C �✓ /0 "t Subdivision Lot # Certified Survey Map # S� 7 o q --__ , Volume Z , Page # G / Warranty Deed # S^ L G 3 Volume 1 , Page # Spec house ❑ yes ❑ no Lot lines identifiable ❑ 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 fimction 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 must be completed and returned to the St. Croix County Zoning Office within 30 days of the �duu=eeea • expiry ' date. - he S TORE 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 prope above, by virtue of a warranty deed recorded in Register of Deeds Office. SIC-NATURE OF Mq 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 570484 SfAI F BAR of %%I S I,[ N FOR %1 2 I OF ED VOL "'JF"r'j DOCUMENT NO Harvey N. Hielkema and Suzanna H. Hielkema, REGjSTc-:?'c3 OFFICE C O., _. husband and wife ST, CRbiX CO., WI Ir DEC 2'J 1991 - Linda R. McDuffy, a single person 11:00 ROGIS'er of Doods THIS SPACE D ESERVED 1 ­ 1 4 RECCRD,N�, CATA NAVE >NC = ET,RN ADDRESS the following descnlwd i.:al estate in State of Wisconsin 006-1056-50 PARCEL 11 —4 F �ATIUN NUMBER Part of Southwest Quarter of Southeast Quarter (SW's of SE4) of Section Twenty-five (25), Township Thirty-one (31) North, Range Sixteen (16) West described as fellows: Lot One (1) of Certified Survey Map recorded in Volume 12 of Certified Survey Maps, page 3385, as Document No. 569034. TRANSFER FEE T his is not hornesead property XX (u, not) Exception toAarranties Easements and restrictions of record. Dated this le AD,iq97__ (SEAL) X` (SEAL) Ha� N. Hielkema kSEAL) EAL) Suzanna H. Hielkema .. AUTHENTICATION AC KNOW LIE DiGt4tN4 -.0 Slate of Wisconsin, 0 St- Croix authenticated this day of 7_­7_ came before me thi> da of N FILED 6 NOV 2 5 1997 KATHLEEN H. WALSH Register of Deeds 5(;9034 SL Croix Co.. W, ARTIFIED SURVEY MAP HARVEY AND SUZANNA HIELKEMA Part of the Southwest 1/4 of the Southeast 1/4 of Section 25, Township 31 North, Range 16 West, Town of Cylon, St. Croix County, Wisconsin. OIndicates 1" x 24 iron pipe weighing 1.13 lbs./lin. ft. set. N // 4 C 0 R. S z 5. r 3 I N, R 16 W, (RAIL ROAD SPIKE sEr) This parcel is being created for purposes of farmland consolidation. UNPLA rrED LANDS ' N89*31'52"E 1000-21' Q p b 33.00' 1 Lai 967.21' LU I zt -4 LOT C /0. 000 ACRES SH S Q4 in W k 435,594 SO. Fr. 0 /00 W 8.449 ACRES EXC. ROAD W �3 LU QI LU R. WELL SO. F 7. 36 8,02 LING z � I I� � � � W to /00 D R I V E WAY J 589*JI'52"W 967. 2/' O 1637. 47' H. "63 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM v Safety and Buildings Division Count ST . CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) SanitaryPOe�pjtfVD-: Personal information you provice may be used for secondary purposes [Privacy L s.15.04 (1)(m)). 3 // // 33 �� Permit MCDUF , LINDA I � Ea Village Town of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: 7 77 ption: Parcel 1 16r--:1056-50-000 TANK INFORMATION ELEVATION DATA A9800120 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Aeration Bldg. Sewer Holding St /Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. Airl to ntake ROAD Dt Inlet irl Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System PUMP / SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH I Lift Friction I System TDH Ft oss Fi Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Di;77 Liquid Depth DIMENSIONS DIMENSION SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type of CHAMBER Model Number: System: OR UNIT DISTRIBUTION SYSTEM Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. 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 ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS (Include code discrepancies, persons present, etc.) LOCATION: CYLON 25.31.16.388,SW,SE 2572 HIGHWAY 64 Plan revision required? ❑ Yes ❑ No Use other side for additional information. F7 SBD -6710 (R.3/97) Date Inspector's Signature Cert No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM Count b . CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitar�rgetts�iY31o.: Personal information you provice may be used for secondary purposes [Privacy Lim, s.15.04 (1)(m)]. Permit CDUFFY , Holder' LINDA I�¢ty� village ❑Town of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM Description: Parcel X60- :1056 -50 -000 TANK INFORMATION ELEVATION DATA A9800120 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ) ,.} - r /69 3'., Benchmark Dosi 9 _4j -i �, ,— Aeration Bldg. Sewer Holding St/ Ht Inlet q -q TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. Air I ntake ROAD Dt Inlet ir Septic NA D B tto , -l.r -3 Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number (j GPM TDH Lift Friction System i TDH Ft oss mead Forcemain Length �T Dia. 1i Dist. To Welf ;, ` SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS l DIMENSION SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type O 1 CHAMBER Model Number: System: y�6 A-il OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Siz x Hole Spacing I Vent To Air Intake Length Dia. Lengt Dia. Spacing 4 / 8 ' SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ S wkied xx Mulched Bed /Trench Center Bed/ Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: CYLON 25.31.16.388,SW,SE 2572 HIGHWAY 64 - Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: Q � e C �q _ ,;I 1 � e i