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HomeMy WebLinkAbout012-1043-00-000 mot 30n O d C m O e - o ` o w o c o CA o ° m o' A CT N 3 O. ;; � N N 17 N N c O M N A C N N C1 7 CO .'Z1 N l�J rZ 00 CD OD ° �, o Nb O 3 e � a N C. O YI W cc M v cn A a cc m y o. S co N 3 0 K d O CD V a { co co 0 I o r to 0 coo Z I ,. C o O O O 0 c� o o Na) a a N O a) N K C 1 y CL IIIDDD N � o D D o I O 0 o 3 a !r m c I w � j O I J CD o OD A ;o 3 i m c O i o= D °o °' n Po m N p D) c Z fl w S N ID O bo Qb I ov I o � � I ° N A V N N A o CD va oNo N �O * O CL r - • ' ST. CROIX COUNTY ZONING DEPAR'c - -.- AS BUILT SANITARY REPORT Owner r "<• / ,� tr Address S•8'4 :' City /State_ -+ sT r Legal Description: Lot Block Subdivision/CSM # V e / y g •7 '/+ Fk /+ S Sec. /r� , T N -R ? W, Town of PIN Z -/o 913 0 0 SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer ko6ic"ew Size ST/PC /ZP / 71 ' Setback from: House Well P/L, �Jt1 Pump manufacturer Zot //c f - Model Ale 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: Width �— Length �'Y Number of Trenches j Setback from: House /17 Well 73 P2 7/0 if Vent to fresh ais intake 3a ELEVATIONS ' Description of benchmark ` r r Elevation �0 0 Description of alternate be nchmark Elevation Xs: 99 Building Sewer ST/HT Inlet $$; Z 2 - ST Outlet PC Inlet PC Bottom $3.99 Header/Manifold Top of ST/PC Manhole Cover 9S; 99 Distribution Lines Bottom of System Final Grade O O ( ) Date of installation ,q Ar Permit number 30 77 // State plan number c �f - /O z et Plumber's signature ai License number Date Inspector Complete plot plan sr NOTICE: Plcase 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 role Sys/ f 14Z 1 4 5 , j INDICATE NORTH ARRQW Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM y: Sa Count fety and Buildings Division INSPECTION REPORT �4 c wr GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary yP Permit No.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. d - 7 � Permit Holder's Name ❑ City ❑ Village •grown of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: B Desc ription: II __ Parcel Tax No.: b l 001 �0 a csF Lra i D L61 L r TANK INFORMATION ELEVATION DATA - t 'Te>oc hoc, TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic j� 12 So Benchm CD c> Dosing Cowt�o 75a l °I•Z 3 7"7.85 Aeration Bldg. Sewer 12.1 • // Holding St/ Inlet i3.D ASS 2Z TANK SETBACK INFORMATION St/ Outlet TANK TO P/ L WELL BLDG. Air l to ntake ROAD Dt Inlet Air I Septic NA Dt Bottom 17•z 3 �9 Dosing s qD NA Header/ Man. Aeration NA Dist. Pipe �oS'� S CJc7 Holding Bot. System PUMP/ SIPHON INFORMATION �X• M Final Grade Manufacturer Demand f,G t l � �D /.} S� gS97 Model Number 7 ' 2 a GPM 7- 6� �; � 7.7 loS �178 TDH Lift (s Z Friction System 5.24 TDHZp�jsFt Forcemain Length q3 Dia. 2 Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length , No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 1 � DIMENSI ON S SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type Of CHAMBER Q - Mucrgl umber: System:Moo t DU l l OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake `. g 11 ,4 1, w 1 j1 � Length Dia. 'L Length �� Dia. 7 i Spacin 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 (Z. r t v Bed /Trench Edges Topsoil It + Yes ❑ No ❑ Yes ❑ No COMMENTS (Include code discrepancies, persons present, etc.) /.532 G-� W C- 15 - T o 4 Wall a,6,,e_ 10 1d7 "e►+/G►" C. 5 — 97•S •) Vim `n � �►� �v (n r� 1 ,- s� c*b u ; j (— - 7 r, S9 5 v�/ + it v c G) S - 7' to J,[� Pt lw . ( 67/ 41-7/1 Plan revisio required? ❑ Yes XNo Use other side for additional information. ?� o•- / 7 SBD -6710 (R.3/97) Date Inspector's Signature o. l - J SANITARY PERMIT APPLICATION 201eE w shington�Ave A nsin 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 County _ than 8 112 x 11 inches in size. S —, . • 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 E] Check it`►15vQn t6 previou� application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION 7 Ob`7 3 Propertl Nam Property Location /7 E (or) 40 !3 40 R F .e wp/v4 Sk :r 1 /4, S 18' T To N , R AOF Property Owner's Mailing Address Lot Number Block Number ep C C' y, State Zip Code Phone Number Subdivisioo N ame or CSM N mber ew ic�/�oR b 1 S y oo ! (7/3' ).ryY-?83Y G �7/ a . ZZ II. TYPE OF BUILDING: (check one) ❑ State Owned City /�-h Nearest Road ❑ F /tl /� ct /rat lYlf� Public 1 or 2 Family Dwelling - No. of bedrooms Town Town of III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo O /Z - /D 40 - oo 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. ja New 2. ❑ Replacement 3. ❑ Replacement of 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 B 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) qq Elevation 496 1 4 X00 All — / /, Feet �fb /,'P �r Feet Capacit VII. TANK in Ca allo s Total # of Prefab. Site Fiber- Exper INFORMATION g Gallons Tanks Manufacturers Name Concrete Con- Steel Bless Plastic App New Existing strutted Tanks Tanks t an uk /2,5 – /ZSd -Z 14 v 66c ,71 El ❑ ❑ ❑ ❑ ❑ Pu an er - 7sV r '75 ❑ 1 ❑ 1 ❑ 1 ❑ 1 ❑ I ❑ W17 - RESP ONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plu er's Sig ature: ( o tam TP/MPRSW No.: Business Phone Number: Ito . �Ys /'' -2C 2 G155 Plumber's dress (Street, City, Sate, Zip Code): Avz 60 IX. COUNTY/ DEPARTMENT SE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued ISSUI gent Signature (No Stamps) A roved G Surcharge Fee) � pp ❑ Owner Given Initial �O d o� X51 � �� Adverse Determination nation VD X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL SBD -63M (R 11/96) DISTRIBUTION: Original to County. One copy To: Safety 8 Buildings Division, Owner, Number I RESIDENTIAL MOUND DESIGN INDEX AND TITLE SHEET Project ROD HAFFNER Owner ROD HAFFNER Address 1586 CTY G NEW RICHMOND WI. 54017 Legal Description NW SE S 18 T 30 NR 17 W Township ERIN PRAIRE County ST CROIX Subdivision Name Lot No_ Parcel ID Number 012 - 1043 -00 Plan ID Number 98 -10288 INDEX SHEEP PAGE ONE MOUND CALCULATIONS PAGE TWO . O ' VV T,S. P DIST. CA CS. & LATERALS PAGE FHd nditionatly PUMP TANK DRAWINGS PAGE PROVE13 MEN Of COMMERCE DEPAF7 E7Y AND BUILDING S Div ON of S&M , DENCE see Designer BRADY UTGARD License Number 7456 Signature RZ Phone No. 715 - 268-6995 Date 3 -18-98 Notice; Tampering with this file by unauthorized persons is prohibited. Deliberate modification wits result in disciplinary action under s. 145.10, Wis. scats. SBD- 10462 -E (R.0"7) Page 1 of 70073 RESIDENTIAL MOUND DESIGN Si ht Bedroom Maximum Complete information in red firamed boxes as necessary. (y or n) C Is the s stem over creviced bedrock? Slope 5 % Number of bedrooms 4 Wastewater flow rate 600 gpd 2271 Lpd Depth to limiting factor 24 in 61.0 cm In situ soil infiltration rate (cede) 0.4 g 16.3 Urn Contour line below the upslope edge of absorption cell 1 98.05 ift _ 29.89 m Use standard fill depths? u OR Designer speed depth in cm Place X in box to we standard depths (iZ 24, A+4 IncYuslre) OR specify design fill depth. Center or end manifold E c a e) Estimated hole space 3 ft mot a final calalladon. Lateral spacing L 6 ft Minimum dose >= 10 times void volume Use a 0 lateral spacing for trenches Pump tank elevation 88 ft outside bottom of rank. Number of laterals E125ft Force main diameter 2 in Force main length Force main actual dia. 2.067 in SYSTEM SOLUTIONS Inch-pounds Metric Cell media "x" one only. Estimated daily flow ®gpd F 2 Lpd x Aggregate and pipe Absorption cell Chamber and pipe Design load rate & area 1.2 500.0 ft 46.45 m Linear load rate 12.0 gpdfft 148.8 Lpd /m Design width (A) 10 It 3.05 m Cell length (B) 50.0 ft 15.24 m Depth of cell (F) 10.4 in 26.4 cm Sand filter Upslope fill depth (D) 12.0 in 30.5 cm Downslope fill depth (E) 18.0 in 45.7 cm Basal area required (gpdrinfiftration rate) 1500 ft 139.35 m Supporting components Topsoil depth 6.0 in 15.2 cm Subsoil depth at center 12.0 in 30.4 cm Subsoil depth at cell wall 6.0 in 15.2 cm End slope toe length (K) 10.9 ft 3.32 m Upslope toe length (J) 7.5 It 2.29 m Downslope toe length m 20.0 ft 6.10 m Includes basal adjustment Total mound length (L) 71.8 It 21.88 m Total mound width (W) 37.5 ft 11.43 m Project ROD HAFFNER Plan I.D. 98 -10288 Page 2 of MOUND PLAN VIEW observatim pipes() J W= 37.5 ft A A= 10.0 ft 3.05 m 11.4 m T B= 50 ft 1524 m B K J= 7.5 ft 2.29m l I = 2O.O It 6.10 m K = LIPMft 3.32 m IL t = 71.8 ft 21.9 m typ. obs- pipe A X 8 refers to absorption cell width and length (a,dKmd ma y) J = upslope width I = downslope width K = end slope dimension li (150 mm) MOUND CROSS SECTION topsoil T subsoil cap D = 12.0 in 30.5 cm lateral I G H E= 18.0 in 45.7 cm invert 99.6 ft F = 10.4 in 26.4 cm elev. 130.36 m see note G = 12.0 in 30.4 cm D E H = 18.0 in 45.6 cm ASTM t;33 Sys. 991 It Sand F� elev- 1 30.21 m 98.1 contour 5% 29.90 m slope Note: Absorption cell media will D = upslope fill depth plowed layer consist of aggregate and pipe E = downslope fill depth or leaching chambers and pipe F = absorption cell depth as specified eAggregate G = subsoil + topsoil depth at cell wall at right. Chamber H = subsoil + topsoil depth at cell center Designer notes: It aggregate is used it is covered with code compliant material Project ROD HAFFNER Plan I.D. 98 -10288 Page 3 of PRESSURE DISTRIBUTION CALCULATIONS Absorption cell - inch-pounds Metric Width (A) 3.05 m Length (B) ft 15.24 Im Lateral specifications Number laterals 2 Holes/lateral 16 holes Lateral length 47.5 It 14.3 m Perforation dia. 0.25 in 6.4 mm Lat dis. rate 18.64 gpm 1.2 Us Sys. dis. rate 37.28 gpm 2.4 Us Hole spacing 38 in 96.5 cm Lateral diameter pip &umter Design options Design chme Designer must 1vd25 mm Plac X' one choice 1 114in132 mm box from the options 1 vzn<4o mm X dian provided. 2in/5o mm X X 3W5 mm X Manifold diameter Pipe diameter Design options Design choice Designer must 1 Qr125 mm '9(` one choice 1 114ird32 mm Plat from the options 1 v2inl40 mm X box provided. W50 mm X X dian Sin 75 mm X 4ird10 rmm X Diskibution system contains 2 lateral fs). LATERAL DIAGRAM - END CONNECTION Place correct lateral diagram by clicking in one of the drawings at tight and dragging the diagram bier IN 4S aver test driednexttc end P AN laterals are identical 1<-X---4 iiol es drilled ra ed on the bottom of the iati + i eWA seer Fotc truir c '#r+e+ it via toe of cross O aaMo! at *4 pm. t.atera6- i& kme mmn at PYc sch 44 perrnanerk end Marker OW COMM Table 84.10-5) Inch -pounds Metric Lateral length (P) 47.0 ft 14.33 m Lateral spacing (S) 6 ft 1.83 m Manifold I 6 �9� ft 1.83 m Hole diameter 0.25 in 6.35 mm Lateral diameter 2 in 50 mm Number of holes per pipe 16 Invert elevation of laterals 99.6 f .26 m Project ROD HAFFNER Plan I-D. 98 -10288 Page 4 of I Total dynamic head System heard = 3.25 It 0.99 m Vertical lift = 10.50 ft 3.20 m Are Werals the highest point in the Friction loss = 2.90 ft 0.88 m system? Yes W here. Total dynamic head = 16.65 5.07 If whet is the nigr>est elevation - Dose Volume downstream of purnp? Lateral void volume = 16.4 gal Z82.5 Force main drain Minimum dose = 164.0 gal back to tank? ( "x" one) Drain back = 21.8 gal x Yes Dose volume = 185.8 1 No Typical Pump Chamber Layout In combination with state approved treatment tank. Tank construction as per Comm 83.20(3) WAC. approved manhole cover weether proof wMramkrg label and padkxic grade levels lemon box "—"� _ quick disoonecx grade levels alternate 4" vent pipe electric as per NEC 300 and outlet Comm 16.28 WAC location 18" (46 crn) min. wall of pump charrlber or L — approved outlet combination joint tank / A 1 � " Grade levels alarm on +1ola as Pump ta* awnha e = 4" mrt above r wAW grade pump On _B neoesSary PAP tank amn =1 mm min abwa *wW grade C vend = 17 min. above I i I , d ft gra pump 89.1 ft off elev. ,rent = 3W am am above s:sfned grace 27.2 m D 3 " (75 mm) of bedding under tank and anchor tank as necessary 88.0 Ift Pump tank elevation Tank specifications: huffcutt 26.8 m bottom of tank Pump tank = 12 gain Pump tank volume = 750 1 Capacities: Inches Gallons A= 35.0 420.2 Pump manufacturer Lzoeller B = 2 24.0 Pump model number. 98 C = 15.5 185.8 Project: ROD HAFFNER D = 10 120.0 Plan I.D. 98 -10288 61N (1,f Jk5�lGjoftM Page 5 of 1 Q`I I l • : I I CIS , f � I , I I , I _a_ let Alm I....- JI I .. i f I I , i 1 : I � I I, : I ' I • I I I l 11 I � 1 I i I L I i . 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", t.:wnfcAl klMn•fe 10-0e1�.,. fn nms Y + I X101 j 9 J or 2 i d i a RM a ; s..awr i=i.iG7 i3:. i►� ea. et twOr1M W f :ivrGil M•+IAMa. "f Yil�'. D!e '— r— — � L '.' r i _f 'bNra' «ti. A it,. a . _ mss • t „ - ` d► ira r� a (a) am N 1 r 7 ■':� r�•++ t +) raa'J•i•x' °■p ry fwtr ' , - r'ak- a wstsr" connsnrion or spis•. FR �wd1 all �r011M �� `�• 1�� p �: �. fasri�rfstglwrM �+�_� �'•t� 1 tMr•ar, iIIGlta, CAUTION iY^' • • •• __ .. . rw�.A' iala w No ilwtorialMln of eq!iR•era xa![rtvtn JriR�..J1J r. y � F•O ■ Ihlwe Itell■tK fsgit�: S. -- ■s■lMMrrleNw Yq ul■al.w /•ssalrrrw.vw WL�+ +, grafl►�t) - -` a .; ..tsr., `!"- ..lCL`, K:.: •:�••M. a....i'vi sn. f.sanl►:�li+�MEMtI�'.ac� �'I�F�LI.w/M.be:. oeot WA �dr•nflA■wrrM FOr u►:►.s::: me" 38fw,' tacic.- e + �1�A'JC� 1 Z J OW . 4r ry .. - Mba to, PD twwxt6J17 %Wi ,p Lomb* my W16 a► a'QN�tt ea Wisconsin Department of Commerce S� SIT rALUATI : ?N Division of Safety and Buildings Bureau of Integrated Services in accordant, ,th S. IL: R 83.09, Wis. a ,dm. Code Page of 0 �e L4J �/CtiS a Attach complete she plan on paper not less than 8 1/2 x 11 inches In :e. Plan r ist Linty include, but not limited to: vertical and horizontal reference point (Blw ilrection i d r pa percent slope, scale or dimensions, north arrow, and location and dis1 :e to rise at road. Cf i % ;oi I. D. s APPLICANT INFORMATION - Please print all Information. C I Personal Information you provide may be used for secorWury purposes (Privacy Law. e. 16.041 (m)). To, dewed by Date Pr rty Owner - I -- Pn ;arty Location -- ✓1 Xk ! 4 F ? r Gc . t. Lot �� 1 � 1/4,S � 8 T3 O ,N.R / 7 E (or) V) Property Owneed Mailing Address Lo f Bkrcki► Su :d. Name a CSMit city / Sla Zip Code Phone Nu r [ city ❑ ViUa ,C- lki > lfvz U- rY01 (7iy�) 25l� --3Y3 g' Town Nearest Road gEA,Aj [New Construction Use: Residential / Number of bedrooms ,., Addition to e: isting building ❑ Replacement ❑ Public or commercial - Describe: &j± Code derived daily flow gpd Recomrr Tided design loadir jr rate t � L b�, gpd ^_� gp 2 Absorption area required 06 bed, ft DD trench, ft2 Ma mum design loadin ;� rate _ �_ 7' bed, gpd/ h trench, gpdV Recommended Infiltration surface elevation(s) 7 d US ft (a; referred to site plan benchmark) Additional design/site cegnsiderations j Parent material 5 1 T i P✓t t D 410 r/ Flood pl; ,n elevation, If applicable i - Suitable for system Conventional Mound In -Gr and Pressure (T-Grade System in Fill Holding Tank = unsuitable for system CI S® u S O u C s® u ! :] s fk� u ❑ S Q! u 0S o u SOIL DESCRIPTI4 N REPORT 3oring # Horizon Depth Dominant Color Mottles TO ure Structure Consistence Boundary Roots GPD /ftz In. Munsell Qu. Sz. Cont. Color Gr. Sz. St Bed , Trench mfr 2 ;round 2 3 --� s n rvl� w • 3 , , epth to siting tin. in. ; Remarks: ;oring # , 3 6-72. 7�.�r� � � in _ rz �,• �v 3 round 1 �, Sys rn �� — s � ;2 7 epth to niting t in. Remarks:.,. ST Name (Please Print) } Signs ty re Telephone No. - 715 -2VZ —5'057 I PROPERTY OWNER « SOIL DES CRIF 9 1PONT Page of PARCEL t.D.► Ll / Z Boring # Horizon Depth Dominant Color Mottles Stru :ture 2 exture Consistence Boundary Roots In. Munsell Qu. Sz. Cont. Color Gr. S r.. Sh. Bed , Trench 3 / D -y w' 5 1Z.- — 5 L ;z 4� s k rrt r c s /oF y k L -� R �Z Sic ��F d k w� c S • �{ ; • S s� Ground Depth to limiting fact in. Remarks: — Boring # L3 Ground elev. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Sti .icture Texture Consistence Boundary Roots In. Munseil Qu. Sz. Cont. Color Or. ;z. Sh. Bed ,Trench Boring # , Ground elev. ft. Depth to limiting factor ` ' Remarks: Boring # Ground elev. tt. Depth to limiting factor n r t �oU/9+tY Ct h U - 7L r l � Stu 6w� i r .,1 3 i 9 n 64re CrC /� ' II �7 c ti� h 4 n Y L � It j' f WsconsimDepartment of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of ` Bureau of Integrated Services � with s. ILHR 83.09, Wis. Adm. Code 1 Attach complete site Ian on County pl p paper not les 1/2 x 11 ' i z . Ian must include, but not limited to: vertical and refe BM), and S-� , Cr6 I )c percent slope, scale or dimensions, no w, and dista earest road. P I.D. If n1 Z APPLICANT INFORMATION - se pri 11 of do R viewed by Date CRO Personal information you provide may be u r ry pmracy La 1 .04 (1) (m)). Pro rty Owner Property Location �^ ' ` GovL Lot k1(,{..} 1/4. � 1 /4,S g T3 ©.N,R / 7 E (or) Property Owneed Mailing Address h Lot # Block# Subd. Name or CSM# 15 f /.via G - - — City Mate Zip Code Phone Nu ❑ City ❑ village [9 Town Nearest Road ,V�w 2;ctirno� uJ yo/ (7/5 ) 2`�� -3�3 i Cow f New Construction Use: [Residential / Number of bedrooms _ Addition to existing building "— ❑ Replacement ❑ Public or commercial - Describe: &± Code derived daily flow gpd Recommended design loading rate � ' L bed, gpd1fiF S ,* trench, gpd Absorption area required DC bed, ft2 DO trreench, ft Maximum design loading rate T bed, gpd!(l - 4 trench, gpd,* Recommended infiltration surface elevation(s) d ° U6 ft (as referred to site plan benchmark) Additional design/site considerations Parent material , , �// ii"P✓1 DUPES rJ .� G ° ` Flood plain elevation, if applicable 1Q� ft FT Unsuitable Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank for system [0:1 S ® u ®s ❑ U El ® U El ®U [Is ® U El ® U SOIL DESCRIPTION REPORT Boring Domin ant # Horizon Depth Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench E 6-/ Fs- 0 YhPr C S 2 . 6-:' (� 2 -25 S /cry 2�r s 6 k Y7" r GS ! vj� -`f Ground 3 2f,65 'Y 41 S' L Yl't � w • 3 T Depth to limiting Remarks: Boring # ` a 2-F `'6 fir c 5 -`� ;, 5 Ground 7 / m ,Y„ Depth to limiting � or in. Remarks: CST Name (Please Print) Signature Telephone No. .DQ v,, --17 71S25411 _ Address ' Date CST Number Cie L6 (� )L U/ / /U 7 VR 9S� l {�o�d� {� SOIL DESCRIPTION REPORT PROPERTY OWNER Page r of,��_ PARCEL I.D.# Boris # Horizon Depth Dominant Color Mottles Structure 2 Boring in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots '3 Bed ,Trench / 0- 1 / 6"� 3 z, S -'r" M c 1u . :, '-7- - 7 3 — Slc L 2-Fs d k vtA'i;P c 5 I . ' . 5 Ground 3 _� y� SL L — N�T1 7 oe Depth to limiting factor Remarks: Boring # Ground elev. ft. 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 # 'M V , Ground elev. ft. Depth to limiting factor in. Remarks: Boring # p L Ground elev. Depth to limiting factor in ' Remarks: SBD -8330 (R. 07/96) --------- . �c r i a " � Oun P VW 5 44�L p /Q� -13 3 i ti 83- 95 C04 ftire 17 AL ' V � t II L l � Fro "n C-en i i oe 11 S (GA Y U0 Stn d !►'I t � Co y IQ� rk't fh� � s 14c f F /1 Pr ST CROIX COUNT' SEPTIC TANK MAINTENANCE AGREEMENT AND ,� OWNERSHIP CERTIFICATIO'; �1 FORM Owner/Buyer .` \ a /`f a �/ /! -e /' Mailing Address �� �' 0 /5 Property Address C_ t I G (Verification required from Planning Department for new +construction City /State Ak w/ Parcel Identification Nul nber a /'z -- /o Y3 - Q o LEGAL DESCRIPTION Q Property Location NW ' /4, SC %4, Sec. N -R12. W, Town of Subdivision , Lot # Certified Survey Map # , Volume / , Page # Warranty Deed # _ S� 11 Y 9 , Volume /� �� Page # 3 Spec house ❑ yes 1K-no Lot lines identii iable ❑ yes ❑ no SYS M MAINTENANCE Improper use and maintenance of your septic system could result in its pri inature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed bS a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste dispo, A system. The property owner agrees to submit to St. Croix Zoning Department i certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri lying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if neces ;ary), 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 N ,;tural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and return td to the St. Croix County Zoning Office within 30 days 1 9 f th three year a piration date. SIGNATURE OF AHLICANT 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 ps bove, by virtue of a warranty deed recorded in Register rf Deeds Office. / SIGNA O A LICANT 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 referenc is made in the warranty deed t PERSONAL RE PJiESENTATIvE S DEED S.- Jack Gritfith,_ as Ec o:a! F,ipresentaL o 'r nt A PR Z 199 E 0 Cleo -- vriff>.th, _ gt 10:30 �.�. �� for a valuable consideration conveys, without narranty. to 7ti11". Haffner and Rodney R. Haffner, wife an' hLSband, a survivorship marital property, the following described real estate in .. St. Croix Cn -unty r / State of �1 iscun—in (hereinafter ralh•d tlw "Proper' ") : Tne N 1/2 of SE 1/4 of Section 18- 30 -17; Tax Parr' x•,_ .. _ -- AND the SE 1/4 of SE 1/4 of Section 18 -30 -17 EXCEPT Lot 1 of Certified Survey 'lap i- Vol. "1 ", Page 155 and EXCEPT Lot 1 of Certificu 6urve; -ap in Vol. "3 ", page 786 in Town of Erin Prairie, St. Croix Cc Wisconsin. TRA'FEn E 4 Personal Representative by this deed does convey to Grantee a :*. o: the estate and i ^terest in t e Pre; erty which the Decedent had immediately prior to Decedent'; deat`, an.j all of t'r.e e °ta'e and interl :t !n the Prcpert) which th Personal Representative has since acquired. Dated this .. . " y '/le�, - -- - 19 7 ca of .