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HomeMy WebLinkAbout022-1017-40-000 / $ 0 :1 0 7 � . � m� � T $ � m ] _ ' r _ _ = z \ (D 0 3 = , k m o q § \ § § - � \ [ $ U) Cil �\i/ fk 3 >D § o ƒ m { \ ■ �§ ) in 0 o § 2 E § @ ? ■ = z > m R e Q e o � E % \ 3 \ - 0 8 k 0 ® 2 § 7 z = « ® o r ■ ° co co / § & % �- � o } o o o i oft © S v . k k \ \ ■ ( ■ �� Cl) E [ § k . � _ g = ! � \ ��� � (n ~ ; ®\ Sh \o \> o BCD � § S : m \ 3 ƒ k 2 � 0 z { 0 -- ( 2 2 � g k / 2 © rr z G 7 � 2 % k . cn ; / $ C , a,� "n j \ § 3 c) 4D / \ 0) / A CD` E3 § 7 }} k C D 4 � �/ E 2 � G o N CD § k -o kj Parcel #: 022 - 1017 -40 -000 11/17/2004 02:01 PM PAGE 1 OF 1 Alt. Parcel #: 7.28.18.99A 022 - TOWN OF KINNICKINNIC Current ❑X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): " = Current Owner ' THOMAS H & LISA M JONES JONES, THOMAS H & LISA M 970 COULEE TRL ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 38.300 Plat: N/A -NOT AVAILABLE SEC 7 T28N R18W 38.30A SW NE EXC 1.70A Block/Condo Bldg: TO CSM VOL 5/1302. Tract(s): (Sec- Twn -Rng 401/4 1601/4) 07- 28N -18W Notes: Parcel History: Date Doc # Vol /Page Type 07/23/1997 1239/418 WD 07/23/1997 1102/296 LC 07/23/1997 851/502 07/23/1997 425/602 2004 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 06/30/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.000 40,000 256,000 296,000 NO AGRICULTURAL G4 18.300 2,500 0 2,500 NO PRODUCTIVE FORST LANC G6 15.000 37,500 0 37,500 NO Totals for 2004: General Property 38.300 80,000 256,000 336,000 Woodland 0.000 0 0 Totals for 2003: General Property 38.300 80,000 245,900 325,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 520 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 V tWsconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM County: ST. CROIX INSPECTION REPORT L/ GENERAL INFORMATION (ATTACH TO PERMIT) Sanitaryini0t Personal information you provice may be used for secondary purposes [Privacy La s.15.04 (1)(m)j. JONHol , OM e. ❑ if y NP1 V 1& n of: State Plan ID N o.: CST BM Elev.: Insp. BM Elev.: BM Description: Parcel T IY �t'-1017 - 40 - 000 ) b t3 1176 _ I ' we TANK INFORMATION ELEVATION DATA A9800014 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. e�Ic - Bench ark o 3 ,J'I 1�3 Dosing VM' 4 ktt4 01) 1�• Z. 1 10 �a Aeration Bldg. Sewer Holding St /Ht Inlet TP 10(•77 13,E TANK SETBACK INFORMATION St/ Ht Outlet �p l of 7y 13,c�0{ 8 4'3 TANKTO P/L WELL BLDG. Air to I ROAD Dt Inlet r^ irntake /P I 0!•7 -� (OA Vi '(? eptic +Seo Nl (3 ► NA Dt Bottom P l Ot.�g I "1• ► s y , 6cj Dosing 2 S' $ ' NA Header / Man. (A 3 As 1 o t • qf Aeration NA Dist. Pipe In 3 ?4 462. /O Holding Bot. System / a.yS 2• 27 /oo• z PUMP/ SIPHON INFORMATION r� Final Grade Manufacturer C ad Dem�nd ? A i ;_ly- 4 ,, `y Model Number W �js (� `� GPM yr ,�, , ( 7.7 6 f 07 rim TDH Lift ((�,� L riction? & -7 System Z S TDH2,�'� 4 f4 Y3 — 1. /o3. +:w + /o / Forcemain Length2Vc Dia. H 2" Dist.ToWell SOIL ABSORPTION SYSTEM 2 ` 7 ` 1 AM ENCH Width f Length - No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth ME 1 N DIMENSION SYSTEM TO P / L I BLDG WELL LAKE/STREAM LEACHING Manufacturer. SETBACK CHAM INFORMATION Type O Model Nu er: System: - floe - �� OR U DISTRIBUTION SYSTEM HeaderiM.arlifold Distribution Pi e(s) x Hole Size x Hole Spacing Vent To Air Intake Lengtfi Dia. 2, Length Dia. (r Spacing r 4 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 I Id Bed /Trench Edges Topsoil ( I M Yes ❑ No M Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) 1 -2 s /, LOCATION: KINNICKINNIC 7.28.113.99A,SW,NE 970 COULEE TRAIL �' Sa' l 1907 (�44. -+> Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. I wo SANITARY PERMIT sT e 1i COUNTY �' DILHR TRANSFER /RENEWAL UNIFORM PERMIT # u (PLB 67•T) �2 a 5 PERMIT RENEWAL DATE: PERMIT TRANSFER DATE: ORIGINAL PERMIT ISSUANCE DATE: STATE PLAN I.D. NUMBER: © 2--a -, I? —erg oz PROPERTY LOCATION: CITY: 0 'l4 UV �' /o,S ,T 2P N,R IP E (or) TILL GE: , LOT NUMBER: BLOCK NUMBER: SUBDIVISION NAME: NEAREST ROAD, LAKE OR LA DMARK: L - r / n4 i (- PREVIOUS SANITARY PERMIT HOLDER (IF CHANGED): SANITARY PERMIT TRANSFERRED TO: NAME: SIGNATURE: NAME: PHONE NUMBER: ADDRESS: PHONE NUMBER: ADDRESS: I, the undersigned, hereby assume responsibility for installation of the private sewage system that has previously been approved for this property. PLUMBER' SIGNATURE: PREVIOUS PLUMBER'S NAME (IF CHANGED): o 447/,`- 1 PLUMBER'S ADDRESS: PRr=VIOUS PLUMBER'S ADDRESS: MP(MPRSW NUMBER: PHON N UMBER: MP(MPRSW NUMBER: PHONE NUMBER: //I �� G ( ?�s) 6�� `�73a ,27 U I?!S ) 3�G- t.2/ I S IGNe�TE �IS �GA ENT : DATE APPROVED: DISTRIBUTION: Original - County f0 t ,9� Copy - Bureau of Plumbing U v Copy - Owner DILHR -SBD -6399 (R. 5/82 Copy - Plumber Safety and Buildings Division Visconsin SANITARY PERMIT APPLICATION Po �X� n n g tonAve. 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 1/2 x 11 inches in size. 57' Gkd o k • See reverse side for instructions for completing this application State sanitary Permit Number y ou p rovide may be used b other g overnment agency programs 30 �� The information s a y p y y g g y p g Check if revision to previous a Ica►ion IPrivacy Law, s. 15.04 (1) (m)]: State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATI N '1740 Propert Owner Name Property Location e W114 ,6- 1/4, S 7 T a? . N, R IF E (or) (fpv Property Owner's Mailing Address Lot Number Block Number 221! E City, State Zip Code Phone Numbe Subdivision Name or CSM Number r e r cells r` 0.?.Z ( ) - a e r lcs- ll. TYPE OF WILDING: (check one) ❑ State Owned C] Cit Nearest Road Village Public 1 or 2 Family Dwelling - No. of bedrooms_ L Town of 111. BUILDING USE (if building type is public, check all that apply) Parcel Tax Number(s) 0e2a- /a/7 -G 4r I -iol�- yo e .0 /8/7- 7d 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. [gNew 2. E] Replacement 3. E] Replacementof 4. E] Reconnection of 5. ❑ Repair of an System System Tank Only 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 UK Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 []Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation d, 64 S"p61 jDD• Feet /(f /r Feet Capacit VII. TANK in Ca allons Total # of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturers Name Concrete Con steel glass Plastic App New Existing strutted T nks Tanks I , ep IcTan Pte(/ /o�6d rGcINCSi�QY.d ® El ❑ 1:1 ❑ 1:1 1 Pum T er n Q(1d ❑ I ❑ 1 ❑ 1 ❑ ❑ VOL RESPONSIBILITY STATEMENT. I, the undersigned, assume responsibility for installation of the onsite ejage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (No Stamps) P MPRSW No.: Business Phone Number: r Plumber's Address (Street, City, State, Zip Code): 5 - l)l IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate Issued Issuing ag ent S ignature (No Stamps) pp Owner Given Initial ae Surcharge Fee) A Adverse Determination Lo� 700 2, JN roved ❑ '2��� l/1 X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SOD (8.11/96) DISTRIBUTION: Original to County, One copy To: Safety 8 Buildings Division, Owner, Plumber INSTRUCTIONS • , 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608- 266 -3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber into fill in name, license number with appropriate prefix (e.g. MP, etc.), address and hone number. Plumber must sign application form_ P 9 PP IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 81/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE I 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. i SAFETY AND BUILDINGS DIVISION 2226 Rose Street N isconsin R r " y yv �' D LaCrosse, WI 54603 Department of Commerce �f ` A Tommy Thompson, son, Governor t P 21- NOV -97 William J. McCoshen, Secretary IX -' COUN I T 20NINGOFFICE > ^t, Wegerer Soil Testing & Desig,, ti� JONES 421 N Main St PO Box 74 River Falls WI 54022 TOM JONES Plan ID 9720892 SW, NE,7,28,18W Municipality of KINNICKINNIC Inspector: Leroy G. Jansky County of St Croix (715) 726 -2544 Private Sewage plans including the following element(s): MOUND 600 GPD The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(2)(e), Wisconsin Statutes, is responsible for compliance with all code requirements. This plan action is subject to the conditions listed on the following page(s). A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department. All permits required by the state or local municipality shall be obtained prior to commencement of construction /installation /operation. This project is under the supervision of a state inspector. As inspection concerns arise feel free to contact the state inspector at the number listed. The inspector for this project is listed above. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Please refer to Plan ID number listed at the top of this page when making an inquiry or submitting additional information. Sincerely, a� -1 erard M. Swim POWTS Plan Reviewer (608) 785 -9348 SAFETY AND BUILDINGS DIVISION 2226 Rose Street LaCrosse, Wisconsin 54603 *isconsin Department of Commerce Tommy G. Thompson, Governor William J. McCoshen, Secretary Page 2 97 C - A Sanitary Permit must be obtained from the County where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats, prior to installation. - Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(d), Wis. Stats. SBD- 5524 -E (R.07/96) File Ref: Page of 6 MOUND SYSTEM FOR A y BEDROOM RESIDENCE LOCATED IN THE S1 , 0 1/4 OF THE k 1/4 OF SECTION ,T N, R I$ W, TOWN OF i�,1.ly�J L C 1t.1 NI`1 t C , ST'. tROIK COUNTY, WISCONSIN. RECEIVED INDEX N o V 1 2 1997 PAGE 1 'of 6 TITLE SHEET SAFETY & BLDGS. DIV. PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW -CROSS SECTION PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT .PAGE 5 of 6 PUMPING CHAMBER PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR - pom H►vt� t TS "R - _y JES - CZ�v�2 4�llrlt.S, lvl S�16Z.? PREPARED BY WEGEEZEF2 SQ I L TEST I f-4 (B AND. oil"f L3ES I GN SE= I CE � `SCiO•lvS`, '0 P.O. BOX 74 421 K. KAIK ST. ••� 1p O RIVFF FALLS. VI 54022 s ARTNURL. • /v l dittonally 715- 4�.r-0165 2 o-s � E rR r O�. ORTM, Ap R co .........•• pEPART SP& l G S110% SAfEIY AN e ~ �fiKN� SEE OORRE JOB NO. G f PLOT PLAN . Page of 6 Scale 1"= 1z, ' y BID" Go v SE LS' .FizOr1 Tl1 �p' y '' p�,� z6o' of z pvc F h. i / 9N- EL .10�(O�oUSP�k.F;53trYgp�FGRo�n� W6.O��•�4l'E. L Page Of ` Approved Synthetic Covering A� 4 M C3 3 Distribution Pipe Medium Sand :era H as G Topsoil F Elev . t l� b . Lt E p " 3 � � - b 1 % Slope Bed Of 2- 2 %2 (Force Main Plowed Aggregate From Pump Layer 0 0 Ft. 1. Cross Section Of A Mound System Using E 06 ft. A Bed For The Absorption Area F o.$ Ft. G 1. o Ft. A S Ft. H 1,S Ft. Linear Loading Rate = Lt - GPD /LN FT B 63 Ft. Design Loading Rate = 0•y GPD /SQ FT j Ft. Ft. K \-(3 Ft. A ltern a te Pesit: n L 83 Ft. „r �_ W 3Z Ft. L Observation Pipe $ K ---- - - - - -- ---- - - -_1 �. - - - -- --- - - - - -- ------------------ - - --�I Force Main W R I i Distribution Bed Of 2�— 2 2 Pipe Aggregate Observation Pipe Permanent Markers (Anchbr securely) Plan View Of Mound Using A Bed For The Absorption Area Page y 0f l6 Perforated Pipe Detall 0 End View Perforated End Cop. �` PVC Pipe Install permanent marker JG a�C` at end of each lateral Holes Located On Bottom, Are Equally Spaced Q S PVC Force Main Q PVC Manifold Pipe Distri ution P1 Lost Hole Should Be Next To End Cop 1 End Cop / P -i Ft. Distribution Pipe_ Layout S 9 Ft. X V9 Inches Y V b Inches Hole Diameter 'ELI Inch Lateral It ) Inches; Manifold Z Inches Force Main " Z Inches # of holes /pipe $ Invert Elevation of Laterals Ft. Place lst hole Zy i �from center of manifold with succeeding holes at VS" intervals. Last hole to be next to the end cap. PUMP CHAMBER CROSS SECTION ARID SPECIFICATIOMS PAGE S OF a VENT CAP ti" C.I. VEIJT P{PC WEATHER PROOF APPROVED LOCKING MANHOLE 10.' FROM ODOR. 12 'MIU. JUUCTIOIJ BOX COVER WITH WARNING LABEL � WINDOW OR FRESH AIR INTAKE I � GRADE `i" MIIJ. WAIN. AIN. CONDUIT • PROVIDE ( - - - -- INLET � AIRTIGHT SEAL I II v APPROVED JOI A Tank construction Shall comply I I APPROVED JOIN with ILHR 83.15 and ILHR 83.20 I I I I I ALARM I I I ON C I I LLI:V. FT. PUMP -� ` '� � OFF cad v0" CONCRETE 6LOCK I 3" APPROVED RISER EXIT PERMITTED OWL'J IF TAWK MANUFACTURER HAS SUCH APPROVAL UDDINQ G 5PEIFI CATIOKIS DOSE TAUKI MAIJUFACTURGR: 1 '" D"J eSTWAJ p 2 IJU r MBER OF DOSES: 3 PER DAy TANK 51ZE: 1 O 0 p GALLOWS DOSE VOLUME Z ALARM MAUUFACTURt`R: S ' S '���� S�1S`CZl'►S INCLUDING OACKPLOW: 2 3 GALLONS MODCL WUMBER. 1p H CAPACITIES: A= 5 I TCHES OR L101 GALLONS SWITCH TYPE: fn Q_1 13 = Z INCHES OR 5 Z ((LLONS PUMP MANUFACTURER: Goy`bs G - 9 INCHES OR Z1 V _ GALLOM5 MODEL NUMBER: 3 $a S D- �_- INCHES OR 312 GALLONS 10v. �OI, SWITCH TJPE: � - NOTE: PUMP AND ALARM ARE TO OE MINIMUM DISCHARGE RATE INSTALLED ON SEPARATC CIRCUITS VERTICAL D DETWEEU PUMP OFF AUD_ ASTR1BUTIOM PIPE.. 1$ ' q � F£ET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . .. .. . . 2.50 FEET + Z6O FEET OF FORCE MAIM X Z' F �of,FKICTIOM FACTOR.. �' \Z FEET TOTAL DtIWAMIC HEAD = �' SZ FEET DIAMETER 38 llZh INTERNAL. DIMEIJSIOM� OF TAWK: LENGTH ;WIDTH -iLIQUID DEPTH BOTTOM AREA - 231= GAL /INCH AS PER MANUFACTURER .. .... GAL /INCH _ Goulds Submersible i Effluent Pump 3885 APPLICATIONS • Overload protection must smooth operation. Silicon can be operated continuously Specifically designed for the • be provided in starter unit. bronze impeller available as without damage. following uses: Shaft: threaded, 400 series an option. ■ Bearings: Upper and • Homes stainless steel. ■ Casing: Cast iron volute lower heavy duty ball bearing • Farms • Bearings: ball bearings type for maximum efficiency. construction. upper and lower. 2 "NPT discharge adaptable ■ Power Cable: Severe •Trailer courts duty • Motels • Power cord: 20 foot for slide rail systems. rated, oil and water resistant. • Schools standard length (optional m Mechanical Seal: SILICON Epoxy seal on motor end • Hospitals lengths available). CARBIDE VS. SILICON provides secondary moisture Single phase: • Indust ry •'/3 and'' /2 HP -16/3 SJTO CARBIDE sealing faces. barrier in case of outer jacket • Effluent systems Stainless steel metal parts, damage and to prevent oil with 115 V or 230 V three BUNA -N elastomers.. wicking. prong plug. SPECIFICATIONS • 3 /4 -1'/2 HP -14/3 STO with ■ Shaft: Corrosion - resistant ■ 0 -ring: Assures positive Pump bare leads. stainless steel. Threaded sealing against contaminants • Solids handling capabilities: Three phase: design. Locknut on three and oil leakage. 3 /4 " maximum. • '/2 -1'h HP -14/4 STO phase models to guard • Discharge size: 2" NPT. with bare leads. On CSA against component damage AGENCY LISTINGS • Capacities: up to 128 GPM. listed models - 20 foot on accidental reverse rotation. • Total heads: up to 123 feet length SJTW and STW ■ Motor: Fully submerged in SP Canadian standards Association TDH. are standard. high -grade turbine oil for • Mechanical seal: silicon lubrication and efficient heat UL Underwriters Laboratories carbide -rotary seat/silicon FEATURES transfer. carbide - stationary seat, 300 ■ Designed for Continuous series stainless steel metal •Impeller: Cast iron, semi- Operation: Pump ratings are parts, BUNA -N elastomers. open, non -clog with pump out vanes for mechanical seal within the motor manufacturer's • Temperature: recommended working limits, 104 °F (40 °C) continuous Protection. Balanced for 140 °F (60 °C) intermittent. METERS FEET • Fasteners: 300 series 90 -.--- -- stainless steel._. SERIES: 3885 I SIZE:' /: SOLIDS • Capable of running dry 25- 80 wE1 RPM: VARIOUS without damage to __ -+5GPM - components. 70 WEI- Or� 5FT Motor a 60' ; Single phase: _ ,wrEO • '/ HP, 115 V, 200 V, 230 V, 15 50 - - --j-- 60 Hz, 1750 RPM;' /2 HP, Z..___' ..._ i .- 115 V, 60 Hz, 3500 RPM; 0 40: NfE J { '/2 HP- 1'/2HP, 230V, -- 60 Hz, 3500 RPM. 0 10 3 0; • Built -in overload with we - - - i f ' o ' automatic reset. 20 i 1 ; • Class B insulation. 1 Three phase: 10 -� - -- -- - - - - I - - - -- - 37 -y •'Y2 HP -1'/2 HP 200/230/ 0 0 460 V, 60 Hz, 3500 RPM. 0 10 20 30 40 50 60 70 80 90 too 110 120 130GPM • Class B insulation. o 10 20 30 m /h CAPACITY C 1995 Goulds Pumps, Inc. Effective May, 1995 11 83885 Wwonsin Department oflndusvy, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations J.Wsion of Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but 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 REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION — [ $ LA Iv F= S St.v 1/4 N E - 1 /4,S 'Z T Zf3 ,,N,R 18 E PROPERTY OWNER':S MAILING ADDRESS LOT If BLOCK# I SUED. NAME OR CSM # CITY, STATE ZIP CODE PHONE NUMBER ❑CITY []VILLAGE ®TOWN NEARESTROAD yllwq�L c4S,k)I sgozz ( Ljzs_ &z,6 )CCaA)k)1CNUUAUL CcsaL�M ]Jq New Construction Use IM Residential / Number of bedrooms 4 [ ] Addikn to existing building j ] Replacement [ ] Public or commerdal describe Code derived daily flow vo gpd Recommended design loading rate bed, g;x:W - trench, gpolft Absorption area required Sloo bed, ft S y trench, 11 kWmum design loading rate Q .S bed, gp ° _ 6 trench, gpdtft Recommended Infiltration surface elevation(s) 1 o O - \4 It (as referred to site plan benchmark) Additional design / site considerations W1uukjb w/8 `)c cS BOD - m it . 1 o F s rt, F L% - = l 6 Parent material Ly Z% S - IZ eL TLL. t_ Flood plain elevation, if applicable P-3-A. It S.= Suitable for system CONVENTIONAL MOUND 6V0OUND PRESSURE AT -GRADE SYSTEM IN FILL. HOLDING T U = Unsuitable for stem I ❑ S Ej U I 0S ❑ U I [IS ®U [osoul ❑ S ®U ❑ S IffU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Corlsisbence ftnda y Roots GPD /ft in. Munsell Qu. Sz. Corot Color Gr. Sz. Sh. Bed tench E31 a> lb'-t(i 3! 3 — s sbk �►� a.s - o. S o• 6 Z 8 -Zy 1 LO `f R V /fir - 5 i I sbk vwfV_ (a S ), S 0-6 Ground 3 24 - 30 - S `t2 3!Y - S \ CS b k ti+► U'�1. �s _ o - �j 0. S q It L/ 30 - �[3 tb`2fL S!3 �? S `1R slY, to limiting factor w Remarks: Boring # I o -q �o�l� �! 3 — s l 1 Zwt sbk w►`�- ox-s o -s lr�- 6 vo �v 2 Z °t - ZY 1��t1ZYly — si f Z`Fsb1� cs — -s �•L 3 Zt# -3 Z i 31 y _ S � 1 �S b, -c UT l Ground elev. 3Z -34 lO �t 2 S l3 s yR s78 Sic,l Oti►, tm`FI� f rG L Dept to limitin N Remarks: T Name :—Please Print Phone: ; Arthur L. We erer 715 - 4150165' ; ess: eg Soil Testing & Design _Service Box 74 River Fal1s;14f_5'4r1$,�'' SgnaUxe: Date: CST Number: qc/_ l�16 6 - Z-3 -gyp M00576 PROPERTY OWNER — S'bP'- 3 eS SOIL DESCRIPTION REPORT Page ?Of PARCEL I.D. fi ' A Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tmrch 3 0 -9 M sbk Vh `F►� CLIS — o.s 0.6 Z�s�ic cS — o -S o.� Ground 3 1Z 3 �1.S YP Sly — S Z ►� s D1z +n v `�h cs 0.5 °• 6 el ev. SLILZ "3 O�R�6 2 � i 7 ft. 2$ -�tS v S O w, `M V h Depth to limiting factor„ Z Remarks: Boring # E31 Ground elev. ft. Depth to limiting : Remarks: Boring # i i Ground elev. ft. Dept, to — -- limiting factor i I Remarks: Boring # i j Ground elev. ft. . Depth to timfting factor . Remarks: SBD- 8330(R.05/92) PLOT P LAN Pa 3 of 3 SCALE 1 3b ' �x.e -LspT Prs s[{awN x �)qpmxIi-1 " �h -�. ►oY,o'ou SPti�k.l GD_ot,Y� uu 6`��A.`Te.�. � awl - LSL, too. o' �" 3 ve !PE w /41TN - � � N isN, !y AIA • P P zLg9 y e ao tiio7 Cc PkCT IV - i e 83, 99 B.3 o Lao %. _ pugE �O W�. AT LCASr Z S' F - lint 1�1DUk>D w So' I- v I F_ A 3 T3 bTLM �r �t4 -i�16 ( 715 ) 4 .5 —n1 65 M00576 CST Signature Date Signed Telephone No. CST # Ki%onsinDeparbnentoflndusVy SOIL AND SITE EVALUATION REPORT Page-!—of 3 Labor and Human Relations Division of Safety a Buildngs in accord with ILHR 83.05, Wi Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but ST= CUC 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 REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION. 70m d Li �>v E=`S A9KW a S W 19 N (rt /4,S - 1 T Z8 .,NR 18 E PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # I SUBD. NAME OR CSM # z.�l E. �ttAJ Son, _ _ CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE ®TOWN NEARESTROAD . Rwq�L Fw 4S SgoLZ ( 47 6 7 -&Y I vzi 1c.1z1Zlj Cx3jum `t'%m K New Construction Use [A Residential / Number of bedrooms 4 [ ) Ad6Qn tD e)asting txdldutg j ) Replacement [) Public or commercial describe Code derived daily flow kCiO gpd Recommended design baling rate o • 4 bed, gpdgl 1 trench, gpdA Absorption area fequired S bed,11 SO ( 3 trench, 0 Mandmum design loading rate o -S bed, gpollt 0. trench, gpol(t Reconu vended Infiltration surface elevation(s) X;6 o - y it (as referred to site plan benchmark) Additional design / site considera6or15 *IVJ'\!D w /8'X (.3' ISS - *1 Ili , t ` a F S "-Z� j=r L%-. Parentmaterial s ors TL - rLLt_ Flood plain elevation, if applicable N -A. ft U = Uns Mable fo ten ❑ SS � P U L O S D ❑ U [IS U U AT- S Rl u [IS ®U ❑ S Wu SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Moffles Texture Structure Consistence Bourd3y Roots GPD /ft in. Munsell Qu. Sz. Coin Color Gr. Sz. Sh. Bed T oth 13 1 o -S lb`t(� 3l3 — s i 1 Zw� sbk �►� a� - o.s 0.6 Z 8 - ZY VZ m v /u — s i I 1 2 Sbk Y4 `f cg q S 0•6 Ground 3 Z4 30 `l -S 't2. 3/y - S 1 C-S bk 'M U'�v C_S o. S elev• c2 P q q . y 30 - 1 43 1 b 5 l3. DepthIo limiting F I factor K Remarks: _ Boring # I o -9 l3 - S 1 ZW► Suk M'fF CL o -S 61 2 Z Of -zY )Nz t Y /y - si l Z`�sb1� m�� o.s o.� Ground 3 2- -3 Z -S `i 1Z 34 y S � 1 �s bk wh u f lr elev. 1 4 3 Z 34 to `ttZ st3 s ytz SJ8 SIC-1 C��., yn`F►� 9 - O fL Depth to limiting f3r w Remarks: CST Name- Please Print Arthur L. We erer Phone: 715 -425 -0165 egerer Soil Testing &- Design ..Service -P.0. Box 74 River Falls,WI 54022 SglraUlre ;�, q y- 1 V 6 Date: 6 - Z3 _ g � CST Number: 0 5 7 6 PROPERTYOWNER SOIL DESCRIPTION REPORT Page? of PARCEL. I.D. # Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft Boring # Horizon in Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed ITmrch p _ q �'Z) �!'� s i I �.M S w, `fit- C,S o•S 0. b 3 Z 4 -12 VOj4V -Vv 5) Sbvx m'f'g- O.S — 0.5 °.6 Ground 3 1Z-'t a - 1.S `i R '31 _ S) Z rr1 S elev. 3`1. R 316 Qft t{ 2$ -CIS SLl R_ 31� 9 tcKR 6/ S1 Depth to limiting factor�,� Z i Remarks: Boring # Boom LMA Ground elev. . ft Depth to Qmiting . factor Remarks: Boring # ' Ground i elev. it Depth to limiting ` factor Remarks: =Boring # Ground elev. ft . Depth to Wiling . factor Remarks: SBD- 8330(8.05/92) • PLOT PLA Page 3 of 3 SCALE 1 "= 3b ' 9�► -e1. Wj, W SPIke /53 Gizou^rY� W 6`b jA. - Te..NL'. C wooer�� i4m _ t loo.o' aN -)" HLGH, 3 IV , D]A- PUe PIPE w /4ATN. - -- L'7.q R � ' � � e �p ►-�oT C.L)wlpftCT N m B.r , L s SuLr" IJE f<11% FV H044it — 0 8 3- � N Q q 2 0,� • 9 8.3 ' so to ` y , y LSL- l�Ov3E �'O 3Q. FfT LEAST ZS' F t 1 IOUkJb • F hE p -- Vy��- V WII t} A b` X 6 3' I3�m 2r co u L ff)�F T u-#� J L _ _ - 0.3 C`(Z{ "SS" R4 -t�16 6- L3 -4 ( 715 ) 42t-016'; M00_ 576 CST Signature pate Signed Telephone No. CST # ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 110 wnG:S 4 :6N e5' Mailing Address '_�1 E, >Q A1u 5 oN ST i Uf 5 ws Sy 0;2� Pro ert Address (Verification required from Planning Department for new construction) oD:? - /as -i - Gd City /State A .`ul r �a /ls rJ Z Parcel Identification Number 6 ;27 - Id / 7 -'rd d �Z -A 11V LEGAL DESCRIPTION Property Location o G 1 /4, h�� '/4, Sec. 7 , T a F N -R Town of ' 4 1 . "V AI ` .'IV/&, Subdivision _ 9'J 0_cves , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # S' r 9 S 9� — 123 9 . Page # 0 0 Spec house ❑ yes ® no Lot lines identifiable ❑ yes 91 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, 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 expiration date. ) / 2 / ff6 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 property described above, by virtue of a warranty deed recorded in Register of Deeds Office. v+� / 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 (!� VOL 55J54 V ST %TE BAR OF WISCONSIN FORM 1 - 1982 WARRANTY DEED COCU1 TENT NO This Dec i, made hctweitt Lucile M. A -- - - MAY 19 .!,i9 Grantor, 1 9 :45 A M and T homas H. Jones and Lisa M. Jones hu sband _ and w ife as s urv iv orship marital property. - -- — A u.d" -- - - -` __ —_ Grantee, Witnesseth, ilut thr sold Grantor, for a valuable considera _o dollar and other good and val considera coneys to Grantee the following described real estate in S Croix THIS SPACE RESERVED FOR RECORDING DATA County, State of Wisconsin: NAME AND RETUHN ADDRESS Davison & Vlack Law Office 200 East Elm St. i River Falls, WI 54022 *SEE ATTACHED* PARCEL IDENTIFICATION NUMBER This Warranty Deed is given in full satisfaction of that Land Contract between the parties hereto dated November 8, 1994 and recorded in the Oftice of the St. Croi:c County Regist6r of Deeds on November 10, 1994, in Volume 1102, at Page 296, as Document Number 523345. F� ri This i s not homestead property. 1 Qs not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And Grantor _ -- «arranis that the title is good, Indefeasible in fee simple and free and clear of encumbrances except easements, restrictions, reservations and covenants, if any, of record, and highway rights -of -way and liens or defects created by acts or defaults of the grantees. and will warrant and defend the same. Dated this day of May „l9 97 — -- ,5EAL) e•l? ��✓vr. 7'vc,m 2r+r✓ (SEAL) • Lucile M. Abrahamson (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Slgnautrets) State of Wisconsin, ss — Pierce County authenticated this day of - 19_ Perscnally came before me this 14th day of May. , 19 9 7 , the above named Lucile M. Abrahamson I I I LE MEMBER STATE BAR OF WISCONSIN y (If not, — authorized by §70606, Wis. SLats.) to me known to be the person who'ertecuted the foregoing instrument and acknowledge the same: THIS INSTRUMENT WAS DRAFTED BY 2 Ed wardF. Vlack, DA VISON & V LA CK Arlen E. Vadnais K1yj �J - Notary Public, -- ? E (3- Cow.,y, WIS. iSlgnatures rna} he authenrcated or acknowledged Both are not My commission is "i6angrx.,t(f, not 1,`?a� ex iration date: ^ <e n:r. ni pr!>ans s. {n;ng In and ,apa.m ,h—td 6y I,ped - primed below the,, signdr'ures S fATE BAR OF WISLO%5IN W,sconse Legal Blank Co Inc WARR ,N rY DFFD Form Nu. I - 1982 M Wes 2 % i ,,, NO E BAR ON WJSCON�;IN F0 LAND CONTRACT IWD %N� , ON 'HoNS • 11 ANII IN IPIIII*! C 523.345 FINAN-t t� UAI}At A 'T THA N.S A 4 11 � I N S ) N IN-CONS 1, M. Abrahamson Contract, by and between ...... .. ....... - ---- 4 ................. ...... ........ ------ NOV 0.- 19 ............ ... ("Vendor", A. H. Jones and Lis M. Jones -c.r more) a .............. .......... — ..... ....... - ....... I I tj b - wife pro .... ........ -s an o and a ...... f. ........ .... ("Purchaser", whether one or more). ja r - a a j ag 1 to convey to Purchaser, upon the prompt and full per- ,rmance of t-lis contract by Purchaser, Li f property, together with the rent prcrts, !�xtures and other appurtenant interests (all called the "Property"). in St Croix --- _-- ._•- •-- ••• -•_ County, St o f Wisconsin: RETURN TO The S1,!2 of the NF1 /4 of Section 7-28-18 KXCEI'T Lots I & 2 of C Survey Map recorded in Vol. "S", page 1302, also excepting Lot I of Certified Survey Map Tax Parcel No. ... ... found in Vol. "2", page 470. Also excepting: A parcel of land located in the SEI/4 of the NEI/4 of Section 7-28-18, Town of Kinnickinnic, St. Croix County, Wisconsin, more fully described as follows: Commencing at the E1/4 of said Section 7-28-18: Thence North along the East line of the NEI/4 a distance of 950.69'; Thence West 33.00 to the POINT OF BEGINNING: Thence Sct-th 69.60'; Thence West 313.08'; Thence North 69.60'; Thence East 313.08' to the point of beginning. SD A-