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Home My WebLink About014-1020-95-000 . . . n CO) o 7 � CD ' ° C � 0 f { o ~{ < 2\ 2/ e / O W "S . CD _ - : @ e / \ / ¥ § % ° _& : a = / , E ¥ ° ° \ \ M 0 \ ) ° / \ / \ § ) 8 2 2 2 /}{ /\ 6 § E \ @ C ƒ C e 2 CD g m R ƒ � k \ { $ § 0 \ CD C) ` ::z � : / 2 k_ o \ g o � ° Z ; M "D T E \ \ CL �, 9 \ \ \ } M Q o � M / a ; (A A; § ° : § r 2 m § z \ . o / ( 0 } 7 . ƒ 0?� \ ` CD \ 7 z m ` CA \ / z \ % § g S § 1 z a (o ( m \ } ; o \ . o ° 2 g 3 » » G D \f ° 0 \ CD �0�o- (D a efm \)\ CD � -4 0 ! / 0 \ J C/) -0 \ � �\\ . ( 0 \tee §(e ZL CD \ / � ¥ ) / \ \ a � \ 0 \ � \ 1 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY &BUILDINGS INDUSTRY, DIVISION LABOR AJV A ND L 1 LIONS PERCOLATION TESTS (115 MADISON WI 53707 (H63 & Chapter 145.045) LOCATION: SECTION: TOWNSHIP /X OT NO.: BLK. NO.: SUBDIVISION NAME: 9 / N/R 15k ( °r) W Forest I n/a n/a n/a COUNTY: OWNER'S B WE: MAILING ADDRESS: Polk —Thomaa A. Smit 1 8070 12th. Ave. Apt. 214 Bloomington, Minn. 55420 USE DATES OBSERVATIONS MADE [ ®R,sicl,nr, NO.BEDR: COMMER IAL DESCRIPTION: PROFILE DESCRIPTIONS: ER ATION TESTS: MS. 3 n/a [:]New Replace l 3 -19 -87 n/a RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN - GROUND - PRESSURE: SYSTEM- II 1 F ' � I ' LLHOLDING TANK: RECOMMENDED SYSTEM: (optional) ❑ S ®U ❑ S ®U [:]S ®U [IS Liu ®S ❑U I holding tank If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s.H63.09(5)(b), indicate: n a Floodplain, indicat Floodplain elevation: n/a i PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER- INCHES CHARACTER OF SOIL WI H THICKNE33, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B 1 4.50 n/a none .50 .50bl.1. 1.50 bn.mot. sil. 2.50 bn.mot.s.l. B 2 14.42 n/a none .67 .67b1.1. .83 bn.mot. sil. 2.92bn.mot.s.1. B- B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL - INCHES RATE MINUTES UMBER INCHES AFTERSWELLING INTERVAL -MIN. PERIOD PERIOD2 PERIOD PERINCH P- P- PLOT PLAN- Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION n/a .._ ( T T __�_._ P tN I i = i 4 jt E E e__ E 3 3 v V i { � A � i � : 9 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: Gary L. Steel �' 3 -19 -87 ADDRESS: CER yFICATION NUMBER: PHONE NUMBER (optional): 988 N. Shor Dr. New Richmond, 54 - - p p 198 STS N E: " OffiCE DISTRIBUTION: Original and one copy to Local Authority, Property Owner a Soil Tester. DILHR- SBD- 6395 (R. 02/82) ' — OV L �� - - ' r ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT ' Owner Property Address .2 2t City /State 19 0� !�{ ST CRUX Legal Description: COUNTY LONINGOFFlQE ; Lot Block — Subdivision/CSM # '/4 /4, Sec. T3/N -R / SS W, Town of SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION Tank manufacturer A Size ST/PC/ 00 Setback from: House 3y� We11 P/L ZL W Pump manufacturer Model E7/'O-C// Y' Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fr Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: Width 'j - Lepgth Number of Trenches Setback from: House a� Well 2 °J P/L Vent to fresh air intake ELEVATIONS Description of benchmark 1 6-.* / a Description of alternate benchmark Elevation, z 2 Building Sewe 3 - -Z 7 — ST/HT Inlet ST Outlet PC Inlet b PC Bottom ,�_S Header/Manifold Top of ST/PC Manhole Cover /Q 6 -L Z Distribution Lines ( ) 6� ( ) ( ) Bottom of System ( ) / 02 • ( ) ( ) Final Grade ( ) / -5. 0 O ( ) Date of installation's S /9�Per t um � �J 9 State plan number A� 2 Plumber's signature License number Date 7 � , / 1x lpl Inspector _ Complete plot plan 1 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. PLAN VIEW 3 a� 7 b INDICATE NORTH OW �en> Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division County: ST. CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitarys2rif0v Personal information you provice may be used for secondary purposes [Privacy LaX, s.15.04 (1)(m)). tuffi ler'sk, ❑ Village ❑ Town of: State Plan ID No.: i CST BM Elev.: Insp. BM Elev.: BM Description: Parcel T._1020-95-000 —I T DY TANK INFORMATION ELEVATION DATA A9800527 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 5 l 06 I b enchmark g` �� og /DU �� I w t sS 1(s b. s Dosing ; "-AA 0� a m ' ? 164-72-- Aera Bldg. Sewer c /0 Z Z Hol 61� Ht Inlet �- /6> TANK SETBACK INFORMATION O Ht Outlet /00, Vent to q TANK TO P / L WELL BLDG. Air I take ROAD ®Inlet - 6 9 r - 4 Septic °f zoo 3 j 3� iw '/ NA 42DBottom d Z 9 Co- 5- 3 Dosing g-Z,QO� z r } (p0r 1 6b1 NA Header/ Man. d z•ff 0,3, 2- Ae n N Dist. Pipe (03, t / P Hol Bot. System 3 ldZ. Y PUMP/ SIPHON INFORMATION ,cQ Final Grade Manufacturer 6t Al A , I Demand �t Z 6L Z Model Number /_ 1pV 5 Z V GPM ° I 4 `/1 TDH Lift �� Friction 3 I SystemZ TDH Ft �,k!1� Forcemain Length` Dia. Z r` Dist. To Well *rO f SOIL ABSORPTION SYSTEM / TREN width Len h No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth 1 DIMENSION SETBACK SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACHING Manufacturer. INFORMATION TypeO pi i * CHAMBER Moe Number: System: p � <� A k OR UNIT DISTRIBUTION SYSTEM Header / Magi old Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Pr Length Dia. � Length � Dia. Z 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.) f 9Lr LOCATION: Fq ST 9.31.15 38 NW SW 2231 COUNTY ROAD Q o oz.9y � � �,toc k - FFf &- e /�o OT GOVPr Inc P�Ow�v�y `F+v G�6�06 L.' �i0u[��il�oC Plan revision required? ❑ Yes ❑ No / Use other side for additional information. SBD -6710 (R.3/97) Date nspector's Sig re Cert. No. I � ,- - SANITARY PERMIT APPLICATION Safet �B m I� Av D ivision sconsn P.O. Box 7969 Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI W707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County /1 than 81/2 x 11 inches in size. C • 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 if revi t o previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATI N oZ d Property Owner Name Property Location A_J" a a,5 T ,N,R E(or Property Owner's Mailing Address Lot Number Block Number City, State Zip Vde Phone Number Subdivision Name or CSM Number 4f S5, 5 II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ cit Ne , a rr est Road Public - 1 or 2 Famil Dwellin - No. of be drooms & Tow OF s - C 111. BUILDING USE (if building type is public, check all that apply) Parcel Tax Number(s) 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 jgReplacement 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 JE 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 -FiII 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 �; Sa 3 Feet , QFeet Capacit VII. TANK in Ca gallons Total # Of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- steel glass Plastic App New Exist in structed Tanks Tanks Septic Tank or Holding Tank ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber �Q ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Si n re: (No St ) MP! RS No.: Business Phone Number: P umber's Address (Street, City, State, Zip Code): IX. COUNTY/ DEPARTMENT USE ONLY ❑Disapproved Sanitar Permit Fee (InciudesGroundwater ate Issued Issuin ent Signature (No Stamps) Approved ❑ Owner Given Initial b� Surcharge Fee) 1 �/ Adverse Determination (/ � •dtv � X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: low 4m& ✓' u �Yc�c'�5 . SOD41=1 (FLTtAIG) DKTRIBUTION: Original to County. One copy To: Safety S Buildings Division, Owner, Plumber it Safety and Buildings 15837 USH 63 Hayward WI 54843 -8107 a mr ,scons® Tommy G. Thompson, Governor Philip Edw. Albert, Acting Secretary Dep o f Commerc October 19, 1998 CUST ID No. 226900 ATTN.• POWTS INSPECTOR ZONING OFFICE SHAUN R BIRD ST CROIX COUNTY 896 68 AVE 1101 CARMICHAEL RD AMERY WI 54001 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 10/19/2000 Identification Numbers Transaction ID No. 182056 SITE: ST CROIX COUNTY, TOWN OF FOREST Site ID No. 161999 NW 1/4, S�� 1/4, S9, T31N, R15W Please refer to both identification numbers, FACILITY: KENT 13GGERT RESIDENCE above, in all correspondence with the agency. FOR: DESCRIPTION: REPLACEMENT MOUND SYSTEM OBJECT TYPE: POWTS REGULATED OBJECT ID NO.: 430597 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: • Changes requested by the plumber are reflected on the approved plans. The installation shall conform to the approved plans and changes. • The county onsite report indicates that est. seasonal saturation occurs at 20 inches, and that there is a moderate grade of structure in the second soil horizon. Therefore, the loading rate could be as high as 0.6 gpd/sq ft. 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 /ins tallation/op c ra t i o u. 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 10/08/1998 FEE REQUIRED $ 180.00 Leroy G. ansky, Wastewater Specialist FEE RECEIVED $ 180.00 Field Operations Bureau BALANCE DUE $ 0.00 (715) 726 -2544 Voice (715) 726 -2549 Fax lj ansky @commerce.state.wi. u s PLOT PLAN PROJECT Kent Eaaert ADDRESS 2231 Countv Road Q Clear Lake Wi 54005 NW 1/4 SW 1/4S 9 /T 31 N/R 15 W WN Forest COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 10/6/98 BEDROOM 3 CONVENTIONAL IN-GQAD PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND XX)OC SEPTIC TANK SIZE 1000 Gallons LIFT TANK SIZE DOSE TANK SIZE 800 Gallon HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AREA 375 # of chambers IL BENCHMARK V.R.P. Top of Fence Insulator ASSUME ELEVATION 100' ❑ BOREHOLE O WELL *H. R. P Same as Benchmark SYSTEM ELEVATION - 4034 * B.M. Alt. County Road Q B.M. Scale = 1/4" = 15' P.O.W.T.S. Conditionally APPROVED DEPARTMENT OF COMMERCE CD D ISION OF SAFETY AND BUILDINGS ° EE ORRE NDE E Area 25' below system to remain undisturbed r 5% B-2 Slope w p N ❑ B -3 Tanks are to be ❑ System to be properly bedded B -1 installed along Dose tank is to be provided DT the 102.0 with lockdown cover with contour line approved warning label Line underneath driveway is to be insulated to code Existing 3 .� Bedroom Old septic tank to be House p umped and buried Well ST 182056 I t Z OS Page Of Cross Section Of A Mound Using A Trench For The Absorption Area H F 6" Topsoil 3 E D Trench Of 'Z" - 2 Aggregate, Plowed Layer 6" Below Pipe, Covered With D Ft. Straw, Marsh Hay Or Synthetic Fabric E Ft.'- "i r, Ft. F .�ff - Ft.o -e H Ft. Plan View Of "found Using A Trench For The Absorption Area Force Main Distribution Pipe Permanent Markers Observation Pipe W I I" B K I \Trench Of - 2z Aggregate f' L , A Ft. I Ft. K -= L Ft. W Ft. B 9 Ft. J Ft. L Ft. g License �9U�j Date: Si ned: '� Number: J ' Page Of Distribution Pipe Detail For �.. Lateral Network I f I` a i l Holes Located On Bottom Are Equally Spaced �. PVC Force Mai FAJ * Cr I Y 1 X f X'1 PVC Distribution Pipe P P * Last Hole Should Be Next To End Cap i P Ft. Hole Diameter ! `7 Inch X Inches Lateral Diameter Inches) ,i *� Y Inches Force Main Diameter off. Inches j # Of Holes /Pipe Invert Elevation Of Lateral. / i Signed: _ t License Number: a - 0 00 Date: ZO 6 _ 8 S II I ' i j PAt (;F PUP"1P CHAMFER CROSS SECT ION AQ0 SPECIFICATIDIkjS VE IJT CAP WEATHERPROOF APPROVED LOCKIMG �/Q c�C,r JCOR, JUAICTIOKJ BOX MAIJHOLE COVEF. WIIJJ0Ow OW, FRESH 12MIU. AIR IKJTAKE GRADE 4' MIIJ. I / COQ DUIT 18 ° MIN. \ ---- - - - - -- 11� IKJLET PROVIDE I - - -�— AIRTIGHT SEAL I / _T A I I I III I I ALARM a I II I I *APPROVED I oN ELEV 2 K - g'F JOINTS WITH T. APPROVED PIPE 3' ONTO PUMP -� ` OFF D SOLID SOIL C.000RETE BLOCK RISER EXIT PERMITTED OQL'J IF TAIJK MAIIUFACTURCR HAS SUCH APPROVAL SEPTIC f SPECIFICATIOUS DOSE )� TAWKS MAWUFACTURER: —14 IJUMBER OF DOSES: PER DAy TAIDK SIZE: - 600 _'` C GALLOWS DOSE VOLUME ALARM MA►JUFACTURER: &e-4y , t A.0 INCLUDIMG 5ACKFLOW: GALLONS MODEL ►DUMBER: l- L r _� c ►�L� J vr� n CAPACITIES: A- IA1CHCS OR GALLOWS SWITCH TYPE: - / � ° s B = C _ IMCHES OR �- GALLONS PUMP MALIUFACTURER: _yt7L[.�l:G4 G= INCHES OR GA L LO l US MODEL ►DUMBER: D =INCHES OR R 1 0 1(9 0 GALLONS SWITCH TYPE: KJOTE: PUMP AND ALARM ARE TO DE MI►JIMUM OISCNAKG RATE INSTALLED OU 5EPARATE CIRCUITS VERTICAL DIFFEKEIJCE BETWEEIJ PUMP OFF AAIO DISTRIBUTION PIPE.. ' - VEET + MI►JIMUM NETWORK SUPPLY PRESSUR . . . . . . , . . , /2.5 FEET + �SC� FEET OF FORCE MAIIJ X a /oo rT FKICT101J FACTOR..I�! _ FEET TOTAL 0y3MAMIC Z HEAD = j FEET 1 '�' )UTERAIAL DIME.WSIO►Jt OF TAIJK: LEIDGT — ;WIDTH __. ;LIQUID DEPTH SIGIJED: LICEWSE ►DUMBER: fpe(2 �y� DATE: _ �� Goulds Submersible Effluent Pump 3 EPO4 EP05 APPLICATIONS • Fasteners: 30C series Fuily submerged in high ■ Motor Housing: Cast iron S ecificall desi ned for the stainless steel grade turbine oil for for efficient heat transfer, p y g • Capable of running lubrication and efficient strength, and durability. following uses: without damage to heat transfer. •Effluent systems dry g ■Motor Cover: Thermoplas- • Homes components. Available for automatic and tic cover with integral handle Motor: and float switch attachment • Farms nanual operation. Automatic • Heavy duty sump • EPO4 Single phase: 0.4 HP, ;,oriels include Mechanical points. 115 or 230 V, 60 Hz, 1550 ■ Power Cable: Severe duty • Water transfer RPM, built in overload with - loaf Switch assembled and • Dewatering ,reset at the factory. rated oil and water resistant. automatic reset. ■ Bearings: Upper and lower SPECIFICATIONS • EP05 Single pease: 0.5 HP, h duty ball bearin g 115V, 60 Hz, 1550 RPM, FEA Pump: EPO4 built in overloud with m EPO4 Impeller: Thermo- constructi on. • Solids handling capability: automatic reset. Mastic Semi -open design ' /a" maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING • Capacities: u to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. P P p $P Canadian Standards Association • Total heads: up to 24 feet. with three prong grounding 0 ■ EF05 Impeller: Thermo- • Discharge size: 1'/2" NPT. plug. Optional 20 foot plast enclosed design for (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with end in "F" or "AC ".) rotary /ceramic - stationary, three prong grounding plug Improved performance. BUNA -N elastomers. (standard on FP05). ■ Casing and Base: Rugged • Temperature then ioplastic design provides 104 °F (40'C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET,____ stainless steel. 10 • Capable of running dry without damage to 9 30 -- __ ►�. -5GPM components. — — — Pump: P05 8 - —z.5Fr p� i . • Solids handling capability: 0 1 LU 25 t • Ca P acitiesUU P to 60 GPM. U s 20 -- • Total heads: up to 31 feet. • Discharge size: 1 1 12" NPT. Z 5 . 1 • Mechanical seal: carbon- >_ _. - - -- -- rotary/ceramic- stationary, -1 4 o t BUNA -N elastorners. o ( �PO5 • Temperature: 3 10 — ---- - - -+_. 104 °F (40 °C) continuous EPO4 140'F (60 °C) intermittent. 2 -- OL 0 -- t ;p -20 - - -. - 3 = 4 -- - 50 _- GPM / L C 2 i 6 8 10 12 ml/h CAPACITY (c, 1995 Goulds Pumps. Inc. .� 6 -'+ 9 J Effective May, 1995 B3871 7,,;; n4in r�epartmant of Commerce SOIL AND SITE EVALUATION Dhtision of Sara:y and Buildings Page of Bureau of inteyratec Services in accordance with s. ILHR 33.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County _ include, but not limited to: vertical and horizontal reference point (BM), direction and ( L percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. If 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 _ Govt. Lot 1 /4 J ( JI /4,S T �, ,N,R E (or Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# City State ode Phone Number Nearest Road � - ❑City El Town .cam El New Construction Use: X5Residential / Number of bedrooms -- Addition to existing building Replacement ❑ Public or commercial - Describe: Code derived uaiiy flow � _ Recommended design loading rate ✓ li � bed, gpd /ft / o trench, gpd /ft bed, ft2 2 f Adsorption area required L _trench, tt Maximum design loading ra.<_ _w__beu, gpd /ft /l" r c��. _.rencn, ypd /ft Recommended infiltration surface elevation(s) it (as referred to site plan benchmark) Additional design /site considerations Parent materia, �' �� t? � c — le' -. CL�' Flood plain elevation, if applicable i Fu = Suitabie for system Conventional Mound In- Ground Pressure AT -Grade System in Fill T olding Tank = Unsuitable for system ❑ S US ❑ U ❑ S � U ❑ S � U ❑ S U S--Z SOIL DESCRIPTION REPORT Boring fr Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench Ground .� �r ./ i CI ✓ / �I r ( el v. e - 51 Depth to lirnirny tactoi Remarks: Boring ## v i � /m o_ fy- AllY.�ft. — -- C Depth to limiting j�ictor in. Remarks: CST Name (Please Print),--, nature , Telephone No. Aodress , Date CST Number G �/ PROPERTY OWNER f'�''�` �� SOIL DESCRIPTION REPORT :. Page of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Structure 2 in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots g� :z Bed . Trench t Ground �'�� -< K >� C-S !° Vt P elev. Depth to limiting G ,c_ j in. 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 # Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) AF Soil Test Plot Plan Project Name Kent Eggert Shaun EVrcV' Address 2231 County Road Q i_ Clear Lake Wi 54005 TM #3922 Lot ----- Subdivision - ---- -- Date 6/12/98 NW 1 /4 SW 1/4S T 31 N/R 1 5 W Township Forest Boring Q Well PL Property Line County ST. CROIX IL BM or VRP Assume Elevation 100 ft. Top of Fence Insulator in Power Pole System Elevation 10 * H R p Same as Benchmark Alt. BM Base of Road Sign 250' *B.M. Alt. County Road Q 30' d <' 150' c� w o B -2 /5% lope ° B - 3 r 45' System to be installed along the 102.0 Contour Line 0 , hp-n-d by 45' B -1 45' Overflow Septic Tank not to code 120' for setbacks or design 35' 0' Existing 3 T 20' Bedroom 0 , House Well Y%U, consii�Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of Bureau of Integrated Services in accordance ILHR 83.09, Wis. Adm. Code 8,.. Attach complete site plan on paper not less than 8 1/2 x 1 1 c n size. P11i ai County include, but not limited to: vertical and horizontal refers nt (B� di*Ion and,.' percent slope, scale or dimensions, north arrow, and I and di4'1Drtppresf u$d� , YYCC UU ( Parcel I.D. # APPLICANT INFORMATION - Please pri 1 ini`orl»auavl. * j J b Date Personal information you provide may be used for secondary rpsies (Privy T L�iA ®/J�. O () (m Property Owner , =� 11 VG O fiFi Prop L tion 6 1/45�1/4,S T3/ ,N,R �J E (or Property Owner's Mailing Address Block# Subd. Name or CSM# City State El ❑ Vill ode Phone Number Town Nearest Road Ci l�v Z-611 G �� (,� • �1,( 2Q i ❑ New Construction Use: j2lResidential / Number of bedrooms ,�_ Addition to existing building ;Replacement ❑ Public or commercial - Describe: / / Code derived daily flow ,p �opd Recommended design loading rate `v _bed, gpd/fl C trench, gpd/fl Absorption area required . f bed, ft trench, it Maximum design loading ra�� ed, gpd/ft gpd/ft Recommended infiltration surface alevation(s) ,��J� �� ft (as referred to site plan benchmark) Additional design /site considerations Parent material S Flood plain elevation, if applicable ft S = Suitable for system Conv ntional Mound — In- Ground Pressure AT -Grade System in Fill Holding Tank U = unsuitable for system ❑ S U 4 S❑ U ❑ S `0 u ❑ sY1 U I ❑ S ART U I ❑ S-4 U SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles Structure GPD /ft 9 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench azk Ground 3 6 / D ! -5; Z6 d f el v. � ft. Depth to limiting fact �in. I Remarks: Boring # �' 0_8 ✓ ��'`� ✓►� /' �' C� oZr''�- ,, �u a Ground "'/ /V )A I I' �4 1- /I !, ft. Depth to limiting cto in. Remarks: CST Nam (Please Print) nature , Telephone No. ��Q -7b1� AdSLress Ea �� 6 D �� CST Number PROPERTY OWNER ��i SOIL DESCRIPTION REPORT ''' Page of PARCEL LD.i 61 - �7 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3 O- 2 :. /h a 6 k /71 Ground 3 Im a-o< 1776 QS /a ft ��5,, G� r� /1 ,M r r/, 9 /V ;4 W to Depth to firm" jr in. ; Remarks: 131 Boring # Ground elev. ft Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Stricture 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 # 13 Ground elev. ft. Depth to limiting factor ' Remarks: SBD -8330 (R. 07/96) Soil Test Plot Plan Project Name Kent Eggert Shaun r Address 2231 County Road Q 4 -z-- C Lak Wi 54005 TM #3922 Lot ----- Subdivision ------- Date 6/ 12/98 NW 1 /4 1/4S T 31 N/R 1 5 W Township Forest Boring ()Well PL Property Line County ST. C ROIX BM or VRP Assume Elevation 100 ft. Top of Fence Insulator in Power Pole System Elevation 103.0 * H R p Same as Benchmark Alt. BM Base of Road Sign 250' * B.M. XB.M. County Road Q 30' d 150' w o B -2 5% Slope ° B -3 c� r 45' System to be installed along the 102.0 Contour Line 0' 1 45' B -1 45' my Overflow Septic Tank not to code 120' for setbacks or design 35 KO ' Existing T 20' Bedroom 0' House Well NW Sw Sec 1 3 - llq to YR'� -r S_. 3 n k� 7 f 10!15/1998 18:22 715 -726 -2549 S &B CHIPPEWA FALLS PAGE 01 Safety and Buildings Division . 15837 USH 63 Hatward W 1 54843 -8107 r rr iscons rn Tommy G. Thompson, Governor Department of Commerce Philip Eder. Albert, Acting Secretary October 15, 1998 DATE RECEIVED 10/08/1998 FEE REQUIRED $ 0.00 SHAUN R BIRD CUST ID No. 226900 FEE RECEIVED $ 180,00 896 68 AVE REFUND DUE $ 180.00 AMERY WI 54001 RE: REQUEST FOR ADDITIONAL INFORMATION TRANSACTION ID NO. 182056 SITE: SITE ID: 161999 ST CROIX COUNTY, TOWN OF FOREST NW 1/4, SW 1/4, S9, T3 IN, R1 SW FACILITY: KENT EGGERT RESIDENCE 2231 CO RD Q, CLEAR LAKE WI 54005 FOR; DESCRIPTION: REPLACEMENT MOUND SYSTEM OBJECT TYPE: POWTS REGULATED OBJECT ID NO.. 430597 The submittal described above has been placed on HOLD and the review and approval is pending subject to receipt of the ADDITIONAL INFORMATION and/or revised plans requested by this letter. Upon receipt of the additional information and/or revised plans, the plans will be reviewed for compliance to applicable Wisconsin Administrative Codes and Wisconsin Statutes. The following must be corrected/revised and accompany the resubmittal: • pipe lateral sizing is too small. The proposal to use 92 feet of 2 inch diameter pipe with a 4 foot hole spacing appears adequate. Submit appropriate revision. • Dose volume is too small. It appears that the minimum dose required is 10 times the void volume of the distribution laterals. Submit appropriate revision. • An onsite report signed by the county verifying the soil test report. Contact the county for an appointment, Due to low chroma horizons reported by the CST an onsite is required. An "E" horizon to depths of 28 -32 inches is unlikely. One possible explanation is that the horizons are glcycd. Send your resubmittal into the address listed above, unless otherwise noted, and the department will review the resubmittal within 5 working days of receipt date. If the above requested information and/or plans are not received within 30 days of the date of this correspondence, this submittal will be returned unprocessed. No fees will be refunded, and a new fee, application form and submittal of plans /specifications may be required should you desire to continue with this project. Sincerely, Leroy G. J ky, VVastewattr Speci st Field Operations Bureau (715) 726 -2544 Voice (715) 726 -2549 Fax ljansky @cornmerce,state.wi.us cc: ZONING OFFICE - ST CROIX COUNTY Safety and Buildings 15837 USH 63 Hayward WI 54843 -8107 � ,�c®n�® e Tommy G. Thompson, Governor Philip Edw. Albert, Acting Secretary Department of Co October 19, 1998 CUST ID No. 226900 ATTN.• POWTS INSPECTOR ZONING OFFICE SHAUN R BIRD ST CROIX COUNTY 896 68 AVE 1101 CARMICHAEL RD AMERY WI 54001 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 10/19/2000 Identification Numbers Transaction ID No. 182056 SITE: ST CROIX COUNT)', T(1 \UN OF FOREST Site ID No. 161999 NW 1/4, SW 1/4, S9, - 1'31N, R15W Please refer to both identification numbers, FACILITY: KENT hGG1;RT RESIDENCE I above, in all correspondence with the agency. FOR: DESCRIPTION: REI ACENIENT MOUND SYSTEM OBJECT TYPE: POkv'rS REGULATED OBJECT ID NO.: 430597 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 he met during construction or installation and prior to occupancy or use: • Changes requested by the plumber are reflected on the approved plans. The installation shall conform to the approved plans and changes. • The county onsite report indicates that est. seasonal saturation occurs at 20 inches, and that there is a moderate grade of structure in the second soil horizon. Therefore, the loading rate could be as high as 0.6 gpd/sq ft. 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/opera t i o n. 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 10/08/1998 FEE REQUIRED $ 180.00 Leroy Tasky, Wastewater Specialist FEE RECEIVED $ 180.00 Field Operations Bureau �� J p i ` 1 ��• . , BALANCE DUE $ 0.00 (715) 726 -2544 Voice (715) 726 -2549 Fax,, ljansky @connnerc�,state.wi.us �\I� ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer Mailing Address Property Address (Verification required from Planning Department for new construction)) / L City /State 4� � Parcel Identification Number LE GAL DESCRIPTION G� Propert Location / � /o, � /a, Sec. J , T IC' -R ��S VV, Town of Subdivision , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # , Volume �E� , Page # 7a Spec house ❑ yesz no Lot lines identifiable 194es ❑ 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 wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, 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 three year ex p ation date. % Q/ SIGNAT 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, described abov , by virtue of a warranty deed recorded in Register of Deeds Office. SIGNAT F APP ICANT 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 ->0' 1 MENT NO WARRANTY rA.ro STATE BA it OF WISCO" FORM 2 — 1982 _ 4930 .9 ,> 986PA 3 REGIViRls QFFICE T . q-golx Co., W) D011y S. Smith, a single person Rec for Record DED18 im OI 10 -5 ? A . f� M conveys and Warrants to Kent L. Eggert _ Rehr of Daada Northwest Federal 532 S. Knowles Ave. New Richmond WT. 54017 i i the following described real estate in .__ ...St. Croix County, State of Wisconsin: i Tax Parcel No: 014 - 102- 0 -95__ ii i The Northwest Quarter of Southwest Quarter (NW 1/4 SW 1/4) of i� Section 9 Township 31 North, Range 15 West. fl li ;1 I FEE ii This is IIOt- homestead property. (is) (is not) i� Exception to warranties: Subject to municipal and zoning ordinances and recorded easements and restrictions of record, if any. Dated this _ 14tt, d of December Iy 92 (SEAL)��r�./ (SEAL/ ��" Dolly S. Smith iI - (SEAL) ISEALI AUTHENTICATION ACKNOWLEDGMENT i Signature(s) -------- ..--- -- . -_---- --- _--- - ------- --- STATE OF WISCONSIN - - --•-- - - - ---- - St. Croix 's Cost }. authenticated this - -- _ day of. _ ... _.._ ;9 -_ Yeraonall� came before me ti:is .. 14th day of December 1392 the above namad - -- - - ---- - -- - - - - -... Dolly S. Smith, _a single person ---------- - -- - -- - - . TITLE: MEMi3ER STATE BAR OF' WISCONSIN (If not, -------------------------- - authorized b y § 706.06, Wis. Stats.) 'a me known to be the per_on whFsa, ted the {� re <roms; ro- rum /tnd , .t!le THIS INSTRUMENT WAS DRAFTED BY Daniel M. Byrnes of CWAYNA & BYRNES fff ............................. -- -- - -... Paul A. Paulsen Jr. y .54001 _ Notary Pubtic St. Croix t , ; ; t •, W ;s. (Signatures may be authenticated or acknowledged- Botn Mv Commission is permarent If not, state exp ration are not c,cessary.) gate. 10/13_ )g 96 .) No WY /-M A p li . 1 ,{ . � A k PA N �( • ames of Jeraota situing in any capacity sh- :A be tl "ped cr v.'.nt—i Ik � .. ..8 - .a :cn�n. +..rr.'•J - State of �i ../�.... Wt_RRANTT DEED STATE BAB C? WISCONSIN %' >c Legs °:Ara Co __ - FORM %� 2 — 1 +n? , era k «a N�sc 'S"