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HomeMy WebLinkAbout016-1022-95-000 Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor qn4 Human Relations Divisio! of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code i COUNTY St. Croix Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but 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. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REV ED DATE PROPERTY OWNER: PROPERTY ATIO Robert P. Forrest GOVT. LOT S 1/4 N W 1/4,S 11 T 30 N R 15 r) W PROPERTY OWNER':S MAILING ADDRESS] // LL LOT # BLOCK # SUBD. NAME OR CSM # , t f 1655 310th St. ( .�HP1. �gjArA4o /6 aclLau - 7 CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE MOWN NEAREST ROAD Glenwood City, WI 54013 (715) 265 -4130 Glenwood 310th St. (� ] New Construction Use k Residential / Number of bedrooms 3 ( j Addition to pxis ' ilding - j ] Replacement (] Public or commercial describe J Code derived daily flow 4 gpd Recommended design loading rate • 5 bed, gpd 1ft trench, gpd/ft Absorption area required 900 bed, ft2 750 trench, 11 Maximum design loading rate • 5 bed, gpd /ft • trench, gpd/ft Recommended infiltration surface elevations) 96 '6 ft (as referred to site plan benchmark) Additional design / site considerations install 5' x 75' rock bed mound on 95.6 contour as upslope edge of rock w! 1' sa f / Parent material loess over till Flood plain elevation, if applicable NA ft rU= Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT•GRADE SYSTEM IN FILL HOLDING TANK Unsuitable for s stem ❑ S El U M S ❑ U ❑ S ®U [IS ®U ❑ S ®U - Is ® U REPORT SOIL DESCRIPTION REP O Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft Boring # Horizon in. Munsell Du. Sz. Cont. Color Gr. Sz. Sh. Bed Trends 4 2 3 -9 OY - sil 2 f sbk mvfr cs if .5 .6 10YR 4/6 - Sil 2 m sbk mfr xa 1m .5 .6 Ground w/ common Gy si coats on p elev. 4 26 -41 10YR 4/4 - si 1 c abk mvfr gs if .2 .3 9 6.6 ft Depth to 5 41 -58 10YR 4/4 f2d 7.5YR 4/6 si 0 m - - - NP .2 QYR. 6. limiting factor 41" Remarks: one 4 diameter vertically oriented R -Gy root mottle about 12_40" Boring # 1 0 -4 10YR 313 - sil 2 f cr mvfr cs 2f /m 5 .6 >`: 5 2 4 -9 YR 3/3 - Sil 2 f sbk mvfr cs 1m .5 .6 3 9 -17 10YR 4/6 - sil 2 f sbk mvfr gs if .5 .6 w/ Occasional. Gy .9i coats nn PpIq Ground 4 17 - 27 IOYR 4/4 - sil 1 m sbk mvfr gs if .2 .3 elev. 9 8.7 ft. 5 27 -38 10YR 4/4 - Si 1 c abk mvfr gs if .2 .3 Depth to 6 38 -70 10YR 4/4 f2p 7.5YR 4/6 si 0 m - - 1m NP .2 limiting factor 1nYR A/3 38" Remarks: CST Name:— Please Print Henry F. Grote Phone: 715- 665 -2681 A ddress: PO Box 57, Knapp, WI 54749 - 0057 -- Signature: Date: 9/ 16/95 CST Number: 3065 PROPERTY OWNER Robert Forrest SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL I.D. # .. 1 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0 -3 10YR 313 - sil 2 f cr mvfr cs 2f /m .5 .6 ti 6 �._ : `'''`' 2 3 -11 10YR 313 - sil 2 f sbk mvfr cs if .5 .6 ...:.:.::::• 1 10YR 4/6 - sil 2 m sbk mfr cs 1m .5 .6 Ground w/ occasiona vertically oriented R-Gy ioot mottlin elev. 4 31 -40 10YR 4/4 f2d 7.5YR 4/6 sil 1 c sbk mvfr cs if 1.2 .3 93.7 ft. 10YR 6/3 Depth to some mottling w/ roots & some w out limiting factor 5 40 -57 10YR 4/4 c2d R-Gy si 0 m - - - NP .2 31" Remarks: Boring # 1 0 -7 10YR 313 - sil 2 f sbk mvfr cs 2f /m .5 6 7 2 7 -20 10YR 4/6 - sil 2 m sbk mfr cs if .5 .6 3 20 -34 10YR 4/4 - sil 1 c sbk mfr gs 1 f/m .5 .6 Ground 4 34 -48 10YR 4/4 f2d 7.5YR 4/6 si 0 m - - 1m NP .2 elev. 95 .6 ft. Depth to limiting factor 34" Remarks: Boring # 1 0 -7 10YR 313 - sil 2 f sbk mvfr cs 2f /m .5 i .6 8 2 7 -17 10YR 4/4 - sil 3 f -m sbk mfr cs if .5 .6 3 17 -33 10YR 4/6 - sil 2 m sbk mfr gs if .5 .6 Ground w/ common Gy si coats on peds elev. 4 33 -53 10YR 4/4 f1f 10YR 6/2 si 0 m cs - 90.9 ft. 5 53 -76 2.5YR 5/4 c1p 7.5YR 5/8 scl 0 m - - - NP .2 Depth to limiting factor 33" Remarks: Boring # Note: Cross slopes in excess of 12% require a petition for variance fo new co struc ion; DILHR has historically granted these petitions 1)ut approval is not guar nteed Ground ? elev. i ft. i Depth to limiting factor Remarks: SBD- 8330(R.05/92) l � � O��► � � y v � - � I o � 1� 14 ... S �-�+ - N �"� - � 1 - 3rc� - I�i w CO -k 146 rA"- GI Qa.Q� �a J VVV il. 1 l � � � o c..1+�7� ►"• C 2 t� 1 d.�j � �• a�l .1�• �1: � aXG-v • � ml � .11 u` J Oy Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY St. Croix Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (Bnd % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distai� Eo o�c/r APPLICANT INFORMATION- PLEASE iNT ALL INF(�RNi REVIEW BY _ DATE n PROPERTY OWNER: Robert P. Forres r = OPERTY LOCATION NW 11 30 15 VT. LOT 1/4 1/4,S T N,Rr) W PROPERTY OWNER':S MAILING ADDRESS �- ` # BLOCK# SUBD. NAME OR CSM # 1655 310th St.��¢`. CITY, STATE ZIP COD H ON4 MBER ` CITY ❑VILLAGE MOWN NEAREST ROAD Glenwood City, WI 54013 A 15) f 5- 4130 Glenwood 310th St. [� ] New Construction Use kX] Residential / N rofjb pert s 3 [ ] Addition to existing building j ] Replacement [ ] Public or commercial d cri6e Code derived daily flow 450 gpd Recommended design loading rate • bed, gpd /ft • trench, gpd/ft Absorption area required 900 bed, ft2 750 trench, ft Maximum design loading rate • bed, gpd /ft • trench, gpd /ft Recommended infiltration surface elevation(s) 96 ft (as referred to site plan benchmark) Additional design / site considerations install 5' x 75' rock bed mound on 95.6 contour as upslope edge of rock w/ 1' sand fi Parent material loess over till Flood plain elevation, if applicable NA ft r S = Suitable for system CONVENTIONAL I MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL I HOLDING TANK U= Unsuitable fors stem ❑S L]U EN ❑U [IS OU EIS ®U ❑S ®U ❑S ®U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 4'. 4 - 2 3 -9 10YR 313 - sil 2 f sbk mvfr cs if .5 .6 3 9 -26 10YR 4/6 - sil 2 m sbk mfr xa 1m .5 .6 Ground w/ common 3y si coats on peds elev. 4 26 -41 10YR 4/4 - Si 1 c abk mvfr gs If .2 .3 9 6.6 ft. G Depth to 5 41 -58 10YR 4/4 f2d 7.5YR 4/6 Si 0 m - - - NP .2 1QYR 6- limiting factor 41" Remarks: one 4 diameter vertically oriented R -Gy root mottle about 12 -40" Boring # 1 0 -4 10YR 313 - sil 2 f cr mvfr cs 2f /m .5 .6 2 4 -9 10YR 313 - sil 2 f sbk mvfr cs 1m .5 .6 3 9 -17 10YR 4/6 - sil 2 f sbk mvfr gs if .5 .6 Ground elev. 4 17 -27 10YR 4/4 - sil 1 m sbk mvfr gs if .2 .3 9 8.7 ft. 5 27 -38 10YR 4/4 - Si 1 c abk mvfr gs if .2 .3 Depth to limiting 6 38 -70 10YR 4/4 f2p 7.5YR 4/6 Si 0 m - - 1m NP .2 factor 38" Remarks: CST Name:—Please Print Henry F. Grote Phone: 715- 665 -2681 Address: PO Box 57, Knapp, WI 54749 -0057 - Signature: Date: 9/16/95 CST Number: 3065 PROPERTY OWNER Robert Forrest SOIL DESCRIPTION REPORT Page 2 of 3 l PARCEL I.D. # Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0 -3 10YR 313 - sil 2 f cr mvfr cs 2f /m .5 .6 2 3 -11 10YR 3/3 - sil 2 f sbk mvfr cs if .5 .6 11-37 10YR 4/6 - sil 2 m sbk mfr cs 1m .5 .6 Ground w/ occasiona vertically orien d R-Gy root mottlin elev. 4 31 -40 10YR 4/4 f2d 7.5YR 4/6 sil 1 c sbk mvfr cs if .2 .3 93.7 ft. 10YR 6/3 Depth to some mottling w/ roots & some w out limiting 5 40 -57 10YR 4/4 c2d R -Gy si 0 m - - - NP .2 factor 31" Remarks: Boring # 1 0 -7 10YR 313 - sil 2 f sbk mvfr cs 2f /m .5 .6 7 2 7 -20 10YR 4/6 - sil 2 m sbk mfr cs if .5 .6 3 20 -34 10YR 4/4 - sil 1 c sbk mfr gs 1f /m .5 .6 Ground w elev. 4 34 -48 10YR 4/4 f2d 7.5YR 4/6 si 0 m - - 1m NP ': .2 95.6 ft. 10-YR 6-43 Depth to limiting factor 34 11 Remarks: Boring # 1 0 -7 10YR 3/3 - sil 2 f sbk mvfr cs 2f /m .5 .6 2 U 7 -17 10YR 4/4 - sil 3 f -m sbk mfr cs if .5 .6 8 3 17 -33 10YR 4/6 - sil 2 m sbk mfr gs if .5 .6 Ground w/ common y si coats on peds elev. 4 33 -53 10YR 4/4 f1f 10YR 6/2 si 0 m cs - 90.9 ft. 5 53 -76 2.5YR 5/4 c1p 7.5YR 5/8 scl 0 m - - - NP .2 Depth to limitng factor 33" Remarks: Boring # Note: Cross slopes in excess of 12% require a etition for variance for new co struc ion; DILHR has historically granted these petitions ut approval is not guaranteed Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) o .w� � M v.t,� � _ �� 1 0 � 1� � a •. S w _ N w -/-% 1 - '�Vn -1S' w v -t - CPA- I ,- vc.� C9e a� Q S'. A- 1 � � � 1 o e� l� r,. C 21� 1 � � � �OC-1 � w-� � oXG-v • � al a.. �� o�� 1 awe �s1t ST. CROIX COUNTY ZONING I)AR AS BUILT SANITARY REPOR3 Owner m�e�x� t�'a .� ,-- fit'�` Ad .E �y � dress i, k City /State L - Legal Description: Lot Block 6?1#4 Subdivision/CSM # J ' ZW, Sec. , T3�N -RAW, Town of 4 FW - 4 00 00 SEPTIC TANK — DOSE CHAMBER — HOLDING TANK INFORMATION: M ,P uLsc;sTe:rr J Tank manufacturer r 1�i '(� -sir l Ax- Size ST/PC oti /2'o6 Setback from: House Z Well P/L Pump manufacturer Model Alarm location 8fls��, -I T uy7G, rz� 2vy� (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM: Type of system: _/4,A n - Width Length _ Number of Trenches Setback from: House 2' Well P/L 3 Vent ' to fresh air intake ELEVATIONS Description of benchmark' �.'l ^<;_•:,. �.,,� a. �k : �' Elevation / -7 Description of alternate benchmark Elevation Building Sewer �� 5 ST/HT Inlet ST Outlet PC Inlet PC Bottom Dj-- Header/Manifold _l /O� Top of ST/PC Manhole Cover Distribution Lines Bottom of System Final Grade ( ) ( ) ( ) Date of installation/ / / Permit number State plan number Plumber's signature License numbe Inspector /0d r complelc plol plan K r NOTICE: Please Provide the followins: • A plan view sketch showing everything within M feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW • /-��� Zo rn �` / -- 1 1' ,� ,3 e 4 I 1 2- f L , I �c,3u � t3►'� � Ef INDICATE NORTH ARROW t ` Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Buildings Division INSPECTION REPORT ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 315953 Alt Permit Holder's Name: ❑ Cit ❑ Villa e Town of: State Plan ID No.: FORREST, ROBERT GL1 61 CST BM Elev. Insp. BM Elev.: BM Description: Parcel Tax No.: 016 - 1022 -95 -000 TANK INFORMATION ELEVATION DATA A9800340 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Iwo Benchr� Aeration Bldg. Sewer Holding St/ Ht Inlet I Of, 0_ , rF TANK SETBACK INFORMATION St/ Ht Outlet TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septi , 7V NA Dt Bottom 11 y,IZ 2 Z,5 of A /3 Dosing NA Header/ Man. lI LQ I -_.� •5'Z, 1162, Aeration NA Dist. Pipe 1q,)2- 3.51 /)do (o ( Holding Bot. System 11q,12_ q .2_3� /o - , rg PUMP/ SIPHON INFORMATION Final Grade Manufacturer v /Z Demand rr _ tT $ d 2- Model Number PM TDH I Lift Lriction System T � Fi Forcemain Length ��( Dia. Dist. To well S BSORPTION SYSTEM B RENCH Width , Length No. Of Trenches PIT No. Of Pits Inside Dia. IMEN I N lod DIMENSION SETBACK SYSTEM TO P/ L I BLDG WELL LAKE/STREAM LEACHI [ :; Number- acturer: INFORMATION Type O CHAMB SystenMoVyV �3 OR UNIT DISTRIBUTION SYSTEM Head/ e an' Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length /� d�ia. � Length 5_ Dia. 2 Spacing '1q a L q +' 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 (Pj Bed/ Trench Edges lZ Topsoil (o Yes ❑ No F5 Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) I Irc.'� y a► 3 Z _ �z 3 33 2 g l•�� »� -7 13 `� 3 s-,k I v �'L LOCATION: GLENWOOD 11.30.15.179,SW,NW 1655 310TH STREE � o� S ►- 4 � f, 6 M- 1 vp Pc Y "� - �' u 5 Plan revision required? ❑ Yes ❑ No Use other side for additional information. �q Z SBD -6710 (R.3/97) Date Inspector's Signature C CerYMj y Safety and Buildings Division vp`'■'■; 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 coo than 8112 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Permit Number 315'G 53 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.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION Pro pe Owner Name P perty ion � oc l4 k)WA, S t T 36 , N, R IS E (or) W Property wner's Mailing Address Lot Number 1 f Block Number S• 4l *" .9T /� / dit State Zip Cood�e/ Phone Number Subdivision Name or CSM Number II. TYPE OF BUILDIN . (check one) ❑ State Owned E] �t� > Nearest Road E] Public 1 or 2 Family Dwelling,- No. of bedrooms O Town OF (:) t W a 5 1E) III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) O 1 (6 — 1 7,n qC —000 1 E] Apartment / Condo L 7 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 pK Replacement 3 E] Replacement of 4_ ❑ Reconnection of 5 F] 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 21XMound 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/ q. ft.) (Min. /inch) Elevation eS) 2- //, G Z Feet z0z Feet VII TANK Cap acity allons Total # Of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturer's Name Concrete con- Steel glass Plastic App New Existing strutted Tanks Tanks Septic Tank or Holding Tank Tanks ❑ 1:1 1:1 1:1 Lift Pump Tank /Siphon Chamber do `"�� ❑ ❑ ❑ ❑ El VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumbe "s Narlte: (Print) Plumbe Signa re: (N Stamp M MPRSW No.: Business Phone Number: /71 (/ � 2 .5'� 3 �5�c Plug' Address Street City, 5ta ,Zip Code): IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (IndudesGroundwater ate Issue Issuing Agent Signature (No Stamps) Surcharge Fee) S ❑ Approved F] Owner Given Initial s6 �� � q: Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: A� 0" SBD -6398 (R. 0"4) DISTRIBUTION: original to County. One copy To: S,rety & Buildings Diviaon, Owner, Plumber Safety and Buildings 15837 USH 63 HAYWARD WI 54843 -8107 isconsin G. Thompson, Governor Department of Commerce William J. McCoshen, Secretary July 24, 1998 CUST ID No.227618 TOM GUSTUM N13450 937 ST NEW AUBURN WI 54757 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 07/24/2000 Identification _umbers Transaction ID No. 119145 Site ID No. 7372 SITE: Please refer tQ bath ideii fication nu abers, Site ID: 7372 above, u� aU,or>�espde4ceith ST CROIX County, Town of GLENWOOD; , GLENWOOD SWIA, NWI /4, S11, T30N, RI 5W ROBERT FORREST RES MOUND FOR: Description: MOUND REVISION Object Type: POWT System Regulated Object ID No.: 18103 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. This plan approval is for a 600gpd mound. This plan is a revision to plan # 78773 The following conditions shall be met during construction or installation and prior to occupancy or use: • This plan action is subject to designer comments on the plan • Correspondence Note: R.ON • Maintain well setbacks per Comm. 83.15(4) & 83.10(1). Condit 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 APPR required by the state or the local municipality shall be obtained prior to commencement of DEPARTMENT i construction /installation/operation. D VIS10 SAFE' Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the addr on this letterhead. SEE CORRE Sincerely, DATE RECEIVED 07/13/1998 J / FEE REQUIRED $ 60.00 TOM BRA LAN REVIEWER FEE RECEIVED $ 60.00 Integrated Services BALANCE DUE $ 0.00 (715)634-3026, M - F 7:45 AM TO 4:30 PM TBRAUN @COMMERCE. STATE. WI.US MOUND SYSTEM DESIGN Residential Application INDEX AND TITLE SHEET Project Four Bedroom Septic Owner Robert Forest Address 1655 310th St Glenwood, WI 54013 Legal Description SW NW SEC11 T30 R 15 W Township Glenwood County St. Croix Subdivision Name N/A Lot No. N/A Parcel ID Number 036- 22400 -43 Plan Transaction Number 4 E 7 3 - // I J Y5— I.T.S. '011ally ) S� Index and title sheet Page 1 OVED Mound calculations Page 2 Y AND M COMM NGS 0 THOMAS D. N Mound drawings Page 3 �j GUSTUM — Pres. dist. calcs. and laterals Page 4 1201 TDH and um tank drawing Page 5 P p 9 •. Plot Plan Pa 'PONDENCE Page 6 0 /9/9 g �GNE¢ Pump Curve Page 7 Designer Tom Gustum License Number D1201 Signature Phone No. 715 -658 -1344 Date 7/9/98 Notice: Tampering with this file by unauthorized persons is prohibited. Deliberate modification will result in disciplinary action under s. 145.10, Wis. stets. Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). :BD- 10462 -E (R.05t98) Page 1 of 7 MOUND SYSTEM DESIGN Complete red boxes as necessary. 1000 gpd maximum design flow. Inch - pounds Metric Residential or commercial? r (r or c) (y or n) Replacement system? Creviced bedrock site? n (y or n) Slope 12 % Wastewater flow rate 600 gpd 2271 Lpd Depth to limiting factor 13 in 33.0 cm In situ soil infiltration rate 0.5 gpd/ft 2 20.4 Lpd/m Contour line elevation 109.1 ft 33.25 m Use standard fill depths? x I OR Design depth? in cm Place X in box to use standard depths (24 and A +4 inclusive) OR specify design fill depth. Center or end manifold (c or e) Hole diameter 0.25 in 0.121, o o o.2s, 0.281, 0r r 0.3 0.313 3 inch only. Lateral spacing 0.00 ft Use 0 lateral spacing for trenches. Estimated hole space 4.00 ft Not a final calculation. Number of laterals Pump tank elevation 85 ft Outside bottom of tank. Forcemain length 80.0 ft Forcemain diameter 2.0 in 1.5, 2, 3 or 4 inch only. 2.067 in Actual I. D. HOLE DIAMETER CONVERSIONS 1/8 =0.125 1/4 = 0.250 SYSTEM SOLUTIONS Inch-pounds Metric 5132=0.156 9/32=0.281 Estimated daily flow 600 gpd FT271 1Lpd 3116 = 0.188 5/16 = 0.313 7/32 = 0.219 Absorption cell Design load rate & area 1.2 gpdhY 500.0 ft 46.45 m Linear loading rate (LLR) 6.00 gpd /ft 74.4 Lpd /m Design width (A) 5.00 ft 1.52 m Cell length (B) 100.0 ft 30.48 m Depth of cell (F) 10.0 in 25.4 cm Sand filter Upslope fill depth (D) zft2 in 58.4 cm Downslope fill depth (E) in 76.7 cm Basal area required (gpd /infiltration rate) 111.48 m Supporting components Topsoil depth 6.0 in 15.2 cm Subsoil depth at center 12.0 in 30.5 cm Subsoil depth at cell wall 6.0 in 15.2 cm End slope toe length (K) 13.65 ft 4.16 m Up slope toe length (J) 8.30 ft 2.53 m Down slope toe length (1) 20.40 ft 6.22 m Total mound length (L) 127.30 ft 38.80 m Total mound width (W) 33.70 ft 10.27 m Project: Four Bedroom Septic Transaction Number: -79??3 Page 2 of 7 MOUND PLAN VIEW observation pipes (typical) J 33.71 ft q A= 5.00 ft 1.52 m 10.271 m B - 100.0 ft 30.48 m W B J= 8.30 ft 2.53 m I K I= 20.40 ft 6.22 m K= 13.65ft 4.16m _ 127.30 ft 38.80 m typ. obs. pipe (anchored securely) I = down slope dimension = absorption cell (AxB) J = up slope dimension �� = plowed area (LxW) K = end slope dimension 9' (152 mm) MOUND CROSS SECTION subsoil ca p D = 23.0 in 58.4 cm lateral topsoil G H E = 30.2 in 76.7 cm invert 111.52 ft F = 10.0 in 25.4 cm 33 99 m - - - - - - + - '' ::::`'':`;' G = 12.0 in 30.5 cm elev. - ASTM C33 H = 18.0 in 45.7 cm Sand Fill E sys. 111.02 ft elev. 33.84 m 109.10 ft contour 33.25 m elev. 12 % slope D = upslope fill depth plowed layer E = downslope fill depth Note: Absorption cell media will consist F = absorption cell depth of aggregate and pipe with laterals G = subsoil + topsoil depth at cell wall centered across AxB media. The cell H = subsoil + topsoil depth at cell center media is covered with geotextile fabric. Designer notes: Project: Four Bedroom Septic Transaction Number: -WW7 Page 3 of 7 PRESSURE DISTRIBUTION CALCULATIONS Absorption cell Inch-pounds Metric Width (A) 5 ft 1.52 m Length (B) 100.0 ft 30.48 m Lateral specifications Number laterals 1 Holes/lateral 25 holes Lateral length (P) 98.00 ft 29.87 m Hole diameter 0.250 in 6.35 mm Lat. dis. rate 29.13 gpm 1.84 Us Sys. dis. rate 29.13 gpm 1.84 Us Hole spacing (X) 49 in 124.5 cm Lateral diameter Pipe diameter Design options Design choice Designer must 1 in (25 mm) Place X in red X' one choice 1 1/4 in (32 mm) box of chosen from the options 1 1/2 in (40 mm) diameter. provided. 2 in (50 mm) X X 3 in (75 mm) X Manifold diameter Pipe diameter Design options Design choice Designer must 1 in (25 mm) 'X' one choice 1 1/4 in (32 mm) None required. from the options 1 1/2 in (40 mm) No choice necessary. provided. 2 in (50 mm) 3 in (75 mm) 4 in (100 mm) Distribution system contains: 1 Lateral(s) LATERAL DIAGRAM - END CONNECTION Place correct lateral diagram by clicking in one of the drawings at right and dragging the diagram into this area. Laterals centered over the A & B dimension end cap P rHoles — rilled next to end cap k - X ). Laterals & force main of PVC Sch 40 d on the bottom of the lateral (per COMM Table 84.30 -5) ced e = permanent end marker Inch-pounds Metric Lateral length (P) 98.00 ft 29.87 m Lateral spacing (S) 0.00 ft 0.00 m Hole spacing (X) 49 in 124.5 cm Manifold length 0 ft 0.00 m Hole diameter 0.250 in 6.4 mm Lateral diameter 2.00 in 1 50 Imm Forcemain diameter 2.00 in 50 mm Project: Four Bedroom Septic Transaction Number: -7&7" Page 4 of 7 110 r TDH and Pump Tank Drawing Total Dynamic Head Operational head 2.50 ft 0.76 m Vertical lift 25.62 ft 7.81 m Are laterals the highest point in the Friction loss 1.17 ft 4. G6 0.36 m system? Yes 'W here. —J Total dynamic head 29.29 ft 8.93 m if no, what is the highest elevation Dose Volume downstream of pump? L��J Dose is > 10 times lateral volume Forcemain drain Lateral void volume 17.1 gal 64.7 L back to tank? ('Y' one) Minimum dose 171.0 gal 647.3 L I x JYes Drain back 13.9 gal 52.6 L No Dose volume 184.9 gal 699.9 11 L Typical Pump Chamber Layout In combination with state approved treatment tank. Tank construction as per Comm 83.20(3) WAC. approved manhole ever with T weather proof warning label and locking device grade levels junction box -� rade levels disconnect g �1 alternate 4" vent pipe electric as per NEC 300 and F— alt Comm 16.28 WAC location 16'(46 cm) min. wall of pump � approved I chamber or outlet joint combination tank A Provide 1/4" weep hole or anti - alarm on siphon device as necessary pump on B Grade levels pump 85.9 ft C - pump tank manhole = 4 (10 cm) off elev. 26.2 m minimum above finished grade D - vent = 12" (30.5 cm) minimum above finished grade IF 85.0 ft Pump tank elevation 3 " (75 mm) of bedding under tank 25.9 m bottom of tank Tank manufacturer Midwestern Precast Pump tank capacity 21 gal /in Pump tank volume 800 gal Pump manufacturer JHydromatic Inches Gallons Pump model number S.H.E.F. 50 o A 19.3 405.1 B 2 42.0 Alarm manufacturer JSW Electro E C 8.8 184.9 Alarm model number 1101 1 p D 1 8 168.0 Project: Four Bedroom Septic Transaction Number: -78T79 Page 5 of 7 I i e <S - I fl Con tIQ•3� � (Ulo�7 Gu nfU�r . I i � � � i c °oar – — ��,5 /,77, Sox 33, 7' � s f3�)ow , /6s;S', 3 /a� S,+ �;I< w J ,I Y ° M oved 427Vopc �W NW ,s 11 Tr? 57 °rlTour' i � i I 2 7 p L. c y cn d i • I aoc� - 8 0o j O co .3x34 P✓C � �- -� -- - -� -- r"1P��t / r i soy • 1 , Qo w/ eM ❑ ��<J �, f. An k EgiS i h onnL ri ve- wa, J- - - - , ,S�bO to i 1 ENGINEERING DETAILS - SHEF5 00 Performance Data Pump Characteristics • 30 Pump /Motor Unit Submersible 90 Manual Models (SO) MI M2 M3 M4 M5 Automatic Models Al A2 25 60 Horsepower 1/2 70 1 hp Full Load Amps 14.5 17.6/7.113.2/3.11 1.6 1 1.2 d 20 Motor Type Capacitor Start 3 9 6 so E R.P.M. 3450 — t 5 150 Phase 10 30 = x 112 hp 40 Voltage 115 206.230 209-23a 460 575 10 Manual Model (100) M2 M3 M4 M5 30 Automatk Models A2 - - - PO Horsepower 1 5 Full load Amps t3.o/11.5 co /SA 1 2.8 1.9 10 Motor Type Capacitor Start I 30 0 0 RPM 3450 Capacity, US GPM 0 10 20 30 40 50 60 70 80 90 Phase 10 30 liters /second 0 1 2 3 4 5 6 Voltage 209.230 1206-2301 460 1 575 Hertz 60 cu meters /hr 0 5 10 15 20 Temperature 140° F Max Fluid Temp. NEMA Design L B Total Head (feet) 13 22 40 SO SS 63 70 90 90 Insulation Class B GPM 1/2 HP 63 57 41 27 13 0 — 1 HP — 98 1 77 69 1 63 55 42 22 0 Discharge Size 2" NPT Std. Solids Handling 3/4" Unit Weight 5 IS V , 14 /3, SJTW -A Power Cord , 230 V, ( a, Dimensional Data 115, 14; T30 lo, 16/3 SJTW -A; 30, 16/4, STW -A, All cords 20' std. with 30' opt. 1. All dimensions in inches. 2. Component dimensions may vary +/- 1/8 inch. 3. Not for construction purposes unless certified. a Materials of Construction 4. Dimensions and weights are approximate. 5. We reserve the right to make revisions to our products and their Handle Stainless Steel specifications without notice. IF 6. Float switch (automstio models only). 5'glP v Lubricating Oil Dielectric Oil I I u x ] 1,16 - •' V Motor Housing Cast Iron -� 5.1 a -1 B U 3-1 Pump Casing Cast Iron r I 491 DiSCNARGE 2' NPT Shaft Stainless Steel I 1 9.11119 D15UNAR11( 2 - NPT Mechanical Seal Faces: Corbon /Ceramic Shaft Seal Seal Body: Brass � Y Spring: Stainless Steel It I 1 Bellows: Buno -N bra nAlu,l 19P1 I — j NUI d Impeller Engineered Thermoplastic Nu UULU D —HANVL PIPE N01INCLDDED 16516 Upper Bearing Single Row Boll Bearing FLOAT 4 [ 12.14 swITCN FLOAT W11DN Lower Bearing Single Row Ball Bearing Bottom Plate Polyester Coated Steel 4 9 16 A 4 Fasteners Stainless Steel ' legs Engineered Thermoplastic SHEF50 SHEF 100 0 C � AURORA /HYDROMATIC Pumps, Inc. g 1840 Baney Road, Ashland, Ohio 44805 (419)289 -3042 P q 9 6 7 0 c Wisconsin Department of Commerce Division of joifejy and Buildings SOIL AND SITE EVALUATION Page _L_ 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 1/2 x 11 inches in size. Plan must Coun include, but not limited to: vertical and horizontal reference point (BM), direction and 844 6 - 0 1 x percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # APPLICANT INFORMATION - Please print all information. Re , wed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner l Property Location PrT �Ut-oe_4 Govt. Lot S jj 1/4 q w' 1/4,S� T ,N,R 1, �(or V�V Property Owner's Mailing Address Lot # Block# I Subd. Name or CSM# W 316'a ikee 1 A tY - N A City State Zip Code Phone Number ❑ Cit ❑ Village Town Nearest Road eotenwood W1 i .5 , 4 oi 3 1 0 1Y )- &s g13 310 S4T ❑ New Construction Use: ® Residential / Number of bedrooms 3 Addition to existing building Replacement ❑ Public or commercial - Describe: Code derived daily flow 45-0 gpd Recommended design loading rate I- bed, gpd/ft trench, gpd/ft Absorption area required bed, ft trench, ft 2 Maximum design loading rate 0 • S bed, gpd/ft O �o • trench, gpd/It Recommended infiltration surface elevation(s) d10 1 0! , I Cvn ric f ft (as referred to site plan benchmark) Additional design/site considerations $ I yl Air ' - L = f d 1. 1 I o P o L• P 'fa k Parent material 1 6 ,9 55 Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system El 19 u El s❑ u ❑ S lS u I [Is au I ❑ s ,t-u ❑ S 19 u SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench _1 1(}uky t�& S i d Y1 5b 0 :a& '1- ID )bytLq1 fJ Ow 51 amsbk mu �r G uy f D 0• lv Ground 3 d- 13 ) L ` K '4 IC 1 vrQ 51 I m sbK vay C,W o ;0.4p elev. lift. y I3 ! t��{12'l C: fvY � L 51 a msbk ►n� -- S '01(v Depth to limiting factor j3—in. Remarks: Boring # (o I UK 3 13 N ola i I m 5bk rnV�r 0.S ax M I 2 4 3 9, m s bk m Cud I S D lZ' 3 II- IS )IIYK �{ y 51 ci m,5 bk e ,5 Ground IS"dS 16 'fit q IG`f-, s 1 °e l ev. p rJ li ft. f 1f Depth to limiting factor _d�in. Remarks: � CST Name (Please Print) Si nature \' . %` `.� one No. Address Date J er N I �>ySO 937 S�ref4, Net Ptalown WE 54757 y - ?_Z - V a_a 7(o I ff 1 PROPERTY OWNER �� �Qr�O i f PS"1 SOIL DESCRIPTION REPORT Page _rof ' 3 PARCEL I.D.#I Boring Horizon Depth Dominant Color Mottles Structure 2 . . . Cont. . . . 9 in Munsell Qu Sz Cont Color Texture Gr . Sz Sh Consistence Boundary Roow ;......:._.......: Bed ,Trench si amibk M 0 a s 59 1t, 0-S : ® .(o a `. Z iO o a M 5b e, M i CiJ i f 1 0.5 ; Ground )2-ZD IGK,Z f�a SII a mSbk D• :o' ('P IV k >/ i1.LIft. 4 26-2S C 2S It 57 a. mS b IC m CAA) - p .s O. (P Depth to limiting ; factor _aajn. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD/fl in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # ; Ground alev. tt. Depth to limiting factor ' Remarks: Boring # E3 Ground elev. ft. Depth to limiting factor � Remarks: SBD -8330 (R. 07/96) " P q l r 4 0 r� 1��1.(. Car'►�ur 11(�•3�lU(v'•7 Gm�:cr i Cc R 4bK�T T.a rr s t _ 3 ion 5+ , /e✓iwaocJ! SW A IJ s/f T30 I _ fa lei -uj coJ f- cs � I uM l 61 /60(D o - - _ _mot - �� �, fi °►� off' l., P, Pia �srd 1Uc(..' EL = /ol z _ Aml Q {�� _ 13,o i N o me- 1 0 e- �aw✓1 �DrI Ve- w&., 5 e ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM /S �;z 19Cve s OwnerBuyer Mailing Address /0 5 S .� /Q 1-1 C t Property Address (Verification required from Planning Department for new construction) City/State i5J 4146 D Parcel Identification Number ©3 -Z2 4 16e) — V 3 LEGAL DESCRIPTION Property Location S GJ %., NoIJ /,,Sec. / / , TN -R1�W, Town of (Qr Subdivision s�J/i4 Lot # �. Certified Survey Map # , Volume , Page # Warranty Deed # -:!-5 7 6 / , Volume Page # Spec house ❑ yes /' no Lot lines identifiable X yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, joumeymanplumber, 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. 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 three year expiration date 7 SIGNATURE 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 proverty described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE 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 STATE BAR OF WISCONSIN FORM 1— III= WARRANTY ( DEED DOCUMENT NO. VO I.310?Q603 This Deed, madebetween J-- � ; T. Ross, a /k /a James T. EGISTQ S OFFICE Ross and L. Lorraine Ross, : - C/a Lorraine Ross, $T CR IX CO., WI husband and wife ft`y M fte# Gmmwr. APR 0 8 1998 told Robert P. Forrest and Melodee A. Forrest, husband end Nife as survivorship marital property 8 A sk tr of o..a. Witnesseth, Tit the said Gnat; for a vAwbk conveys to Grantee the following described rd estne in St. Croix rrN SPACE RESERVED RDR RECDRM4 DATA C=M State of Wiaconsin: NAME ANo RETUM ADDRESS NW} of Section 11- 30 -15, excluding railroad right of way WESTconsin Credit Union P.O. Box 160 Menomonie. WI 54751 016 -1022- 80,90,95, THIS DEED IS GIVEN IN FULL SATISFACTION OF THE PAACELIDENTWICArroNNUMISIM LAND CONTRACT dated June 23, 1995, recorded June 016 - 1023 -10 28, 1995 in Volume 1127 of Records on Page 569 as Document #530571, in the Office of the Register of Deeds, St. Croix County, Wisconsin. I^ FM This is homestead property. (b) XOflibE)CX Together with all and singular rho hereditaments and appurtenances dwrea belonging; And Grantors warrants that thi: title is good, indefeasible in fee simple and free and clear deacwnbsances except Easements; Township and Zoning Ordinances; Recorded Building and Use Restrictions; Covenants and Real Estate Taxes levied in year of closing. and will warrant and defend the same. Dstcd this 20th d o f March ! 19 (SEAL) T. Ross, a /k /a James T. Ross (SEAL) (SEAL) . L_ 1,orraine Ross, a /k /a Lorraine R oss AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, as. P. i Cou nt y ty authenticated this day of , 19� lkneea8y came before me this day of MarcS , 19 98 , the above named Jams T. Ross, a/k a James T. Ross and L_ a.arraine Ross, aka Lorraine Ross, TITLE: MEMBER STATE BAR OF WISCONSLW hu--rband and w ife (If not, authorized by $706.06, Wis. Scats.) to zar kDamm t�e t executed the foregoing asortr� �5� ct� 3aArrt� , THIS INSTRUMENT WAS DRAFTED BY 1 : � r'y t y •; Robert F. Muza /MUZA S MUZA Broa way, ox _ —T Menmm i �ne, WT 54751 Not'y ✓' County,,WM (Signatures may be authenticated or acknowledged. Both are not my ammatiss i� pcs[� t�ent'.(ff iia, state expiratiwt date: necessary.} • Names or persons signing in m opacity should by t yped or primed below tWt signatures. �— — — STATE BAR OF WUSCOMOWc W�s:i t.epel Co.. Inc - WARRANTY DEED form No. 1 - 1962 pa N 4*WkPe. Wis. - #