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Home My WebLink About022-1020-20-100 j 2 t ! \ K 0 I \ � �. k i * � 2 I D § e # , � \ LL § � � \f � 7 0 . n » � f ) / i § . E � � t & � _ § % 2 § B 2 :t } « ■ ® 2�f a) 7 \ 7 _ � .� § � 2 / � } k ) . ) § ' 2 § < § 2 § ~ �.� } ƒ: E CL G k 2 k 2 / \ ƒ \ / U) % E ) (D K K k FL ® t -� % a a 2 IL o co 0) 2-j Co 0 j f f D G ^ D / \ ƒ / e (D # \ / (D 0 co § 2 ° § / §}) k ) = E Q C- Li ¥f�S£§\� § a { \ _ / [ 7 § k \ k ) @ $ \ f D § - § C) / C, z $ }) 2 \ 2 .. � � 2 «L — �_.:,�» E 'E § a § k J a 0 3 U � Wmcpnsin Department of Industry, SOIL AND SITE EVALUATION REPORT g l of 3 Libor and Human Relations 4 Division of Safety a Buildngs in accord with ILHR 83.05, Wis. Adm. Code COU 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 PARtEM. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION R DBY y PROPERTY OWNER: PROPERTY LOCATION ��VY� F}► �D �-t� V01�NE 1'IID�Ls;� T NE 1/4 M�_r 1/4,S T PROPERTY OWNER'S MAILING ADDRESS LOT # I BLOCK # I SURD. NAME OR Z l SYt wo6b - T 1 m � cN Z - cs ►" t UO L , Z CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE ®TOWN NEAREST ROAD I�v\S[O>\lsl�l� 1�t�'p1t�S WI Sww ( u2- 3 -32 (4Z l gz_vNj J to- h1)N►j1C 1 ,Z L E� " H L\.0►U DR. New Construction Use M Residential / Number of bedrooms 3 [ ] Addition to existing building [ J Replacement [ ] Public or commercial describe Code derived daily flow q3r,� gpd Recommended design loading rate - bed, gPcW °' 3 trench, 9PdM Absorption area required bed, ft 3a5 trench, ft Maximum design loading rate o• S bed, g �2 a. L trench. gp2 Recommended infiltration surface elevaticn(s) a, o r ft (as referred ;o site Ian benchmark P ) Additional design/ site considerations 'I" lovKA�, w/ S' K l S T cTI . WLrti . l o F - Sk"�, R LL _ Parent material sL L`r t ova c, 11 LL Rood pkvn_elevation, if applicable ti- It I i S = Suitable for system CONVENTIONAL MOUND "ROUND PRESSURE AT -GRADE SYSTEM IN FU HOLDING TANK U= Unsuitable fors stem [i EIU I ®S EI U ❑ S Z U [I If U ❑ S OU [I IN SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft. i Boring Horizon Texture Consistence Roots i g in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench <.. a U 1 0 - . Z a — L 6 lL� 2 3/ -- S 1 Zrn S � k fit_ 0-S — o.S 0. C �_ Ground w 0 -5 elev. f 1 ►' O� h� i 9 32 -T0 z.Sy2 spy S`1 y/ C - — — Depth to limiting factor Remarks: Boring # ° -� vb"q Z f I S 31 S V. 3 zo -zR 14`0- 31` - S1 Z'Fs t c > — S b Ground elev. Z$ -y I z . s y Q s 1 y S P 2 v/ C) ON-, —— q z.. o it Depth b limiting ng fac tor i Remarks: 1 T fine : Please Print Phone: Arthur L. We erer 715 - 425 -0165 egerer Soil Testing & Design Service -P.O. Box 74 River Falls,WI 54022 Signatwe: p 6 _� Date: S `� CST Number: - M00576 PROPERTYOWNER SOIL DESCRIPTION REPORT ' Page ?• of 3 PARCEL I.D. #E Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence .Bounde y - Roots GPD /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ITW& 3 0 -_1 D- �,Z — s� I Z�'s� `F�- c w — o. s o, L Ground 3 Z 3L 1V`1 1Z 3/L — S Csbvz L, C a.V o.S e lev. v. Q -1 .0 ft. Depth to C N-) ni s YL a S limiting factor,� r Remarks: Boring # 13 Ground elev. ft. Depth to limiting factor Remarksi Boring # Ground elev. ft. Depth to limiting ' s factor F Remarks: Boring # i; i Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(R.05/92) 3 of PLOT PLAN t�PLAN 3 SCALE 1 "= WPt�Foy -. ls� Lk ►Q ol= l Jll - q 01 I y I Q I 8 .7 . I ' I 36 u X00 .0 dr. SP I z.r� FfBouF- i t�o rvuT CJC i" cT 02 ��Sw�2B VOu S E ZD $e WT Let%S"T Z PIS►" 1 M wL>� ; — WtiR,L l♦ h h y J�' •� �t � r 7, UAJ C?� 7O P Q 3 x 1S 7 L s t`�. q6 -8� ( 715 42A-0165 M 00576 CST Signature Date Signed Telephone No. CST # Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 tabor and Human Relations Division of Safety s Buikings 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 S� not limited to vertical and horizontal reference pant (BM), direction and % of slope, scale or PARCEL I.D. If dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION P LPG VO1JtJE V1 tbDLF� N T NE 1/4 MZ 1 /4,S 8 T Z8 ,NR 1% E012) ) PROPERTY OWNERS MAILING ADDRESS LOT # I BLOCK # SUBD. NAME OR CSM # Z l 0 SWoR.EwooD -z - CS r voL , 8 P�q Z X30 CITY, STATE ZIP CODE PHONE NUMBER []CITY ❑VILLAGE ®TOWN NEAREST ROAD I-v1.SCWS1Aj "u ,W/ Swig ( 4L3 -32gZ I 1c..1t 3Wj0_ �U/JIvIC Sly`( ttOLvo►v DR. New Construction Use (Xf Residential / Number of bedrooms 3 [ j Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow LSO gpd Recommended design boding rate bed, gpdJfttt 2 � trench, WW Absorption area required bed, ft 3-LS trench, ft Maximum design loading rate o S bed, gDdM2 a. �- trench, gpd/ft Recommended infiltration surface elevation(s) It (as referred to site plan benchmark) Additional design/ site cDnsiderations 'I"iWKA Yq LA, , V o F- S1 F= LL _ Parent material SX. L` 4 ov" c. � - R LL Flood pOnglevation, if applicable N It S = Suitable for System CONVENTIONAL MOUND ttGROIJND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for stem [IS RIU ®S ❑ U [IS O U ❑ S Ou ❑ S In [Is [1 U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft_ Boring # Horizon Texture Consistence Botrdafy Roots ..Bed rerld� in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. o - S - p. o.(; e S Ground 3/C cw p .5 0 _ (, elev. 3Z_To Z.S V P_ S/y S (Z.- y/ C Depth b limiting WIN 7?L1 Remarks: Boring # 91- M ' 1_ CL- S 1 Z Z zo \k� -sl si 1 Zwm 2b V4 c — o. S IDA Ground elev. z$ -y) 2 . S S 1 y s v/ e } (J� , w► F i - - - q o f Depth ID limiting i Remarks: TNime:- Please Print Arthur L. We erer Phone. 715- 425 -0165 egerer Soil Testing & Design Service -P.O. Box 74 River Falls,WI 54022 sgnatae: _8 6 Date: S _�� / CST Num 0 0 5 7 6 PROPERTYOWNER SOIL DESCRIPTION REPORT Page? of 3 PARCEL I.D. # Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon in Munsetl Qu. Sz. Cont Color Texture Gr. z Consistence ,Boaxhdary Roots'" ' S . Sh. Bed Trench �- S o •.: S o.� � �� C Ground 3 zq 3L C- �1r7 m v' CI-v O.l( I o.s 4 O ft. 1�- Sb 1v` 1 IZ Depth to limiting facto 14 L" i ' r Remarks: Boring # i 1 .. i Ground elev. ft. Depth to ' limiting j factor i Remarks' Boring # Ground elev. ft. Depth to -- ' limiting factor '• F Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SAD- 8330(R.05/92) of PLOT PLAN Pa 3 3 SCALE 1 "= I' Z i I I ,I i 9l I I B _ 36 ovE fi3 I G1Z -ovNO �N Z.B �I N _ o14�r ..- i 02 D�Sw�zB U,0j1 C)T Z0 PE-- 1 — L o ..��_ of -�+►c. I J I J� Q - out, 11ZML —� q6 -8� (715 425 -01 M00576 CST Signature Date Signed Telephone No. CST # S 'T. CROIX COUNTY TONING DEPARTMENT ; l ";` AS BUILT SANITARY REPORT Owner llkdI114h Address City /State 4 k,C °bN Legal Description: �`'��cfi Lot ; Block f Subdivision/CSM # C.5 ® 6 Sec. -e—, T18N -R�_W, Town of k'�� t E. . *,t PIN # z Z SEPTIC TANK -- DOSE CHAMBER HOLDING TANK INFORMATION: Tank manufacturer ins r r Size ST/PC 1,9od /6m Setback from: House ��' Well B P/L /01 Pump manufacturer Model Alarm location (HOLDING TANKS ONLY) Setbacks: Service road / Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM: Type of system: /YZGrz� Width 5�" Len Setback from: House /o Well / /�s' p/L 3 �' t to fresh air intak T / ELEVATIONS: Description of benchmark /alo Description of alternate benchmark Elevation �— D <!' �� Elevation /a Z5 Building Sewer 7� ST/HT Inlet Z ST Outlet - PC Inlet PC Bottom `�D_ , 7� Header/Manifold iy /, / j Top of ST/PC Manhole Cover Distribution Lines Bottom of System Final Grade ( ) ( ) ( ) Date of installation /6 / /3 /yO Permit number State plan number Plumber's signature _ License number /V 3 2 2 `f Date Inspector X01 Complelc plot plan a 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 i o / f i I i 0 1 s INDICATE NORTH ARROW` 1 VVisconsirl,, Department ofCommerce SY SEWAGE SYS Safety and Buildings Division PRIVATE S Count : INSPECTION REPORT T. CR GENERAL INFORMATION (ATTACH TO PERMIT) Sanit 3y1593 t6o Personal information you provice maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 1 Permit Holder's Name: ❑ City ❑ Villag ❑ Town of: State Plan ID No.: IDDLETON, DAVID KINNICKINNIC CST BM Elev.:- Insp. BM Elev.: BM Description: Parcel T o.' w.e JfT-2 1020 -20 -100 TANK INFORMATION ELEVATION DATA A9800324 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. re644_� 10 � Benchm r * a 7$ � 107 / Di 6 ,0 r _ 0 '441 y , 6 5 . qZ /0Y. LS Aeration Bldg. Sewer tt � N IZ ti2 Holdin t * Inlet /3 glo t�.3 — � 32- TANK SETBACK INFORMATION St/ Ht Outlet TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake NA Dt Bottom 8� T Dosing n NA Header /Man. S ' / Aer A Dist. Pipe • lD 5 °►Z D. 7 Hold _._ -- — ` _ Bot. System V u 7.610 /Dd - 07 PUMP/ SIPHON INFORMATION [ Final Grade Manufacturer (;It, Demand 4 2- bqjj (0 7 Model Number G Pa 44 GPM TDH Lift Lriction 3.- Systems TDH t Z ea oss Forcemain Length 2 M Dia. HH 2 #' Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length G� / No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSION SYSTEM TO P / L I BLDG WELL LAKE/STREAM LEA G r. SETBACK — INFORMATION Type Of !, CH MBER odelNumber: Systemvsov � OR UNIT DISTRIBUTION SYSTEM Header /Manifold Distribution Pipe(s) 1 x Hole Size x Hole Spacing Vent To Air Intake Length Dia Z Length " 70 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 E] Yes E] No [:1 Yes E] No COMMENTS: (Include code discrepancies, persons present, etc.) `? 1.t 7•67 B 71 LOCATION: KINNICKINNIC 8.28.18,NE,NE 481 SLEEPY HOLLOW ROAD C�Ce $ "jz. cq.os " —� I Do•v 7 F.,: � '� Plan revision required-? ❑ Yes dNo Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert. N ADDITIONAL COMMENTS AND SKETCH ' SANITARY PERMIT NUMBER: E a F._ . ..v _.., ....._.. I Y I � E a i a e � � t i r E E a 3 _ . . . m . e .,,., .... e<...m ...._ .._..._.. a ... _......._. .._. ... .mv i 3 � mm e e e Safety and Buildings Division *6consin S ANITARY PERMIT APPLICATION 201 W. Washington Avenue In accord with ILHR 83.05, Wis. Adm. Code P O Box 7302 Department of Commerce Madison, WI 53707 -7302 • 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. , • See reverse side for instructions for completing this application State Sanitary Permit Number y ou p rovide may be used for seconds �' Personal information y p y second purposes ❑Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLI INFORMATION -PLEASE PRINT ALL INF RMATION Pro ert Owner Na a Property cation p ,� A4 8 N, R!,y &ve 1 /a 1 /a, S T or W Propert®� ner's Mailing Address Lot Number Block Numb City, Statq Zip Code , _ Z__ Phone Numb r Subdivision Name or CSM Number � tJ c ) �f s� d -� P F B ILDI : (check one) E] State Owned Its arest Road p ` Public 1 or 2 Family Dwelling - No. of bedrooms �_ ° own OF.C,f' n r��innic� l /�. III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 08• aR g • / 11 4 A 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. ra,New 2. E] Replacement 3, E] Replacementof 4_ E] Reconnection of 5, ❑ Repair of an ____!_ ________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 21M 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 RequiSed (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation 1411x; .69 Feet Feet Capacity VII. I NFORMATION gall in allo Total # of Prefab. Site Fiber- Exper. Gallons Tanks Manufacturer's Name Concrete Con Steel glass Plastic App New Existing strutted Tanks Tanks Septic Tank or Holding Tank 16W ✓Goo / /e°14Qr < ® ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber Q to 0 0 / OCb cosx& IR ❑ 1 ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumb 's Name: (Print Plumber' Signature: (No amps) MP/ PR .. Business Phone Number: J ti,.,✓ J� -.'5 - - 7 7Z- 3� Plumbe s Address (Street, City, State, Zip Code): /A IzJ! 15n a4e J� iP g IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved sa nitary Permit Fee (includes Groundwater ate Issued Issuing Agent Sig natu a (No Stamps) ' � l Surcharge Fee) 0 pproved ❑ Owner Given Initial VJ) Surcha /) _ l Adverse Determination OC/ / X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11197) DISTRIBUTION: Original to county. One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD -6399) to be submitted to the county prior to installation 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. 11. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. 111. 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 is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; um r siphon (s ) es o s o 9 pump n p 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 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. ` Safety and Buildings "\ t6consin 2226 ROSE ST LA CROSSE WI 54603 -1905 Tommy G. Thompson, Governor Department of Commerce William J. McCoshen, Secretary July 08, 1998 CUST ID No.226524 A7TN: POWTS INSPECTOR ROGER L TIMM 3128 20TH AVE WILSON WI 54027 RE: CONDITIONAL APPROVAL Identification Numbers APPROVAL EXPIRES: 07/08/2000 Transaction ID No. 112308 Sit ID No. 13449 SITE: Please refer to both identification numbers, Site ID: 13449 above, in all correspondence with the agency. ',' St Croix County, Town of Kinnickinnic NEIA, NEIA, S8, T28N, R18W DAVE MIDDLETON FOR: Description: New Mound Object Type: POWT System Regulated Object ID No.: 28211 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • 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. Adm. Code. • 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. 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/operation. 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 07/06/1998 FEE REQUIRED $ 180.00 d 1 RD M SWIM, POWTS PLAN REVIEWER FEE RECEIVED $ 180.00 Integrated Services BALANCE DUE $ 0.00 (608)785-9348, MON - FRI, 7:15 AM - 4:00 PM JS WIM @COMMERCE. STATE. WI.US Dave Middleton - Mound Transaction # 112308 Location: NE 1/4, NE 1/4, Sec. 8, T 28 N, R 18 W Town: Kinnickinnic County: St. Croix Date: July 8, 1998 Owner: Dave Middleton Address: 210 Shorewood Terrace Wisconsin Rapids, WI 54494 Plumber: Roger Timm f Signature: License # MPRS 226524 Attachments: 6748 -Plan Review Application SBD 8330 RECEIV E� page 1: cover jut 2: calculations SAFETY 3: plot plan 4: system cross section 5: plan view, lateral detail 6: pump tank exit detail 7: pump curve P•�•�'T lly page 1 of 7 C O nditio 4 p 4p DF CDMNIER ppRTMENT ED►NGS DE . E Y AND ptV►S�ON OF '°► r P ENCE SEE CORRES I _ System Calculations one family residence 3 bedrooms Loading rate �'� gallons /sq ft per day Depth to ground water �- O in Depth to bedrock �` in Cross slope ' % Force main length 2 ' O ft of -' in Manifold /header length N ft of in Drainback 3 Z g gallons Lateral length 1 @ °'� ft of in Lateral elevation ' (° ft (bottom of pipe) Lateral hole size �fy' in @ ° ' O in ( '5 O f t) spacing ` holes /lateral, holes total Lateral volume l 4 '� �° gallons Total lateral discharge rate gpm @ ft head Elevation difference �'� ft Friction loss ° ft @ �-� gpm Total dynamic head '� ft Pump /si"'Pdon 4-0 gpm @ '�/ ft of head Manufacturer c' °```� , Model # Dose voluige �� gallons �' fin"' • �� C.o'ti�''° al lons Lift /si�on tank , l ' `� g� Septic tank ~ , "'""'� gallons Measurement pump on & off �'`� in Height alarm from tank bottom ' in Reserve capacity + gallons calcs page 2 of iJcx.•�c :dC �(.�� -�r.+. , , ° �o � 6..1 �e� z , CA N� -Kv -S� ' Zw - tg ... 4,d Ito Z." � 221'��r} L4�tS� �ww �3w +oaf o La Qn t� 's t «A40'..Q 4 pvc a .Sk 4o S,w�e 1�. ti nom. nn c ( �° Q.a woo • V op �+....DC �r �•� a it �r � t Co •�S.o 5�... t�. nn K 1� icy %a." C va .. t"A o gS; , l 0 s a�1 to �.Ac �� a.,, V. o ••� ¢ ..01' � r 3 YOC� 9� 0. Ve oo� 4L 04Ll0w! Z�1 ♦ 4161 owe rkwll 3 ..�. 4 4.1 11.3 25.21 _ - - - -- - -- _ N o��.; , •. oa.l� �ra� � `�� = p.S7 3 i 1 dL y1e..... I r c k ►4•q ` k'. �I L S � Q. t.\ Q o.r�0 w l c'J �r ..: u.) 1 rrY �.�. t JZ �..`�C �+• �.r It a�, t �.v: v n,�. `4� o i:.� .�l �1r «�-i� Q ; �'' � � V � e..►. t.� O�p i p� v .� �}i' OM w i. \� S �-O MO� o � o } Y o..1c. y � /v\ n f�� O �L', ' � �. OAr -o7( `� OM M: w�. t+� Z • � / � � v w► �{ o S Y u e. K � +r 0 1 /g• K o) R o y 1 �T Wr waC cY.r► "i' � `O 1 + O r.► � :... t � l7 C7. C7 a� o�� (� � � , •T _ \3 ¢.A. R o a& r WEATHERPROOF ' - JUNCTION C.OVIR U p111CK aRGOrwK.T -� 4 C.I. %v4 %p"xtm *p6 "& ct p N 12 \ b '� � W I. V►PG 3' molvusuo SOI 2 4a 2.1D. VEMT iEL 4 I 'i MIN. At"r • �� wci. f = = = A ca. Pw AW ItET ,UNt' BAFFLES 1 AI. 3' o.Ro ON cwECT10Mi 1 r GiiDYNO T Slo c Lev. D y'� � i . O .. 1 � L g��l sEPTIt 8 PC G I F I'GATI OAI S UU Doe TA MAIJUFACTURCR: �� LRIMAER OF DOSES: PER DAU TAIJK SIZE: to-6-%0 6ALL01JS OOSC VOLUMC A LARA MAMUFACTYRCR: c T '� 1tc� -o INCLUOIN6 SACK /LOW: ' &ALLONS AOOCL WUM►pER: �� ~' CAPACITIES: A= k �' O IWCHE5 OR 3 \$ '� GALLOWS SWITCH Tyr[ V .__ p r- � Iuc►+cs OR 4ALLOUS PUMP MAIJUFACTURCR: Q--r- C C a q.0 uJCHES OR ` GA LLOWS MODEL WUMOCR: jz d ow 6 14.;HES OR IsO .I° 6ALLOW6 SWITCH TWPC: ��'`" �` A)OTE: PUMP AWU ALARM ARE TO OC IKIIJIMUMI OISCK^R" RAM �3 F.PA INST kLLED OW SL PARATE CIRCUITS VERTICAL DIF FCREWA &ETW99M PUAP OFF AWO OISTItIbUTIOW PIPE.. g S FEET 1 + MIAIIMuM NCTWORI Wil PR(tiURE ........... FCGT + �` FE T OF FORCC MAIN X 1 .. ��3r*" pILFRICTIOU FACTOR. Z FEET TOTAL OyWAKIC 14CAID = FEET U 1 1 b" N IIJTERWAL OIMCIJ6104 OF TAUK: LEAIFiTM `� ;WIDTH � ;LIQUID DCPTH M ODEL 1 MO DEI v 3871 Vertical Sump Pump EPO4 EP05 Su bmQr§J4 1Q GOULDS � +; "kva . ,.. • r �.. � A • I I Pump Specifications METERS FEET / HP 10 Up to 40 GPM MODEL: aa�� Discharge size 1 NPT ° 30 Solids: % maximum • Motor zs Single phase: 115V • p Materials of Construction a Brass/thermoplastic 1S EP0.5 Features and Benefits ' *Top suction eliminates 3 10 impeller clogging. EP *Corrosion resistant construction. 0 l [] 1O zo 30 40 w ysa„ *Float actuated switch. ° , 4 6 i CAPACITY METERS FEET T 26 Mooel ovPO3 Pump Specifications Features and Benefits 4 /,i and' /: HP • EPO4 impeller- semi -open design -> Up to 60 GPM with pump out vanes to protect 16 r Maximum head to 32' mechanical seal. ' Discharge size 1 1 1: " NPT • EP05 impeller - enclosed design 0 3 10 Solids: 1 /4" maximum for improved performance. 4 2- e g Motor Rugged glass - filled thermoplastic 1 All motors feature ball casing and base design provides ° o bearing construction. superior strength and corrosion ° S TO tb 20 W 30 SS 40 U. . 111.61 , 01 resistance. Single phase: 115V o x Pr�PAGn e e 10M3A*W Materials of Construction • Cast iron motor housing for Cast iron efficient heat transfer, strength, Thermoplastic and durability. Stainless steel • Corrosion resistant threaded stainless steel shaft. • Available for automatic and manual operation. • CSA listed models available. All Models are designed for continuous ration and feature stainless steel hardware. g � o �- Nscousin Department of Commerce AND SITE EVALUATION Page 1 of 3 Division of Safety and Buildings ih Comm 83.05, Wis. Adm. Code Attach complete site plan on paper not less than 9r4 x 11 Inches in size. Plan must [ n St. Croi include, but not limited to: vertical and horizontal referencep*t (BM), direction and x percent slope, scale or dimemsions, north arrow, and lo6a Arid d)stance to nearest road. t. \ 1iol Parcell.D.# APPLICANT INFORMATION - PI i all i formation. R Da Personal information you provide may be used f dary p (Privacy Law, s. `15.04 (1) (m)). r7 CI Property Owner PfOperly Location Middleton Dave �, !' ►r Got Lot NE 14 NE 1/4 S 8 T 28 N,R 18 W Property Owner's Mailing Address iot Block # Subd. Name or CSM# 210 Shorewood Terrace sr CROIx 2 CSM Vol 8, P 2330 )I 1AIP City State Zi Cloth'. �CE City E] Village ® Town Nearest Road Wisconsin Rapids WI 544Q4 -715- 423 - 3242'', " Kinnickinnic Sleepy Hollow Road New Construction Use: ® Residen ' ufntSe rooms 3 ❑Addition to existing building ❑ Replacement F Public or commercial describe Code Derived daily flow 450 gpd Recommended design loading rate .5 bed, gpdm .6 trench, gpdtW Absorption area required 900 bed, fF 750 trench, ff Maximum design loading rate .5 bed, gpolW .6 trench, gpdtW Recommended infiltration surface elevations) 100.1 % ft (as referred to site plan benchmark) Additional design / site considerationo 4 'x 95' rock bed mound on 99.1 as upslope edge of rock w/ 1' sand fill Parent material loess over till Flood plai n elevation, if applicable NA ft S= Suitable for system Conventional Mound In Ground Pressure AT - Grade System in Fill Holding Tank U= Unsuitable for system ❑ S O U ®S' ❑ U El NU E] S® U E] S ®U ❑ S® U 'SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD& Boring# Horizon in. Munsell Qu. Sz. Cont Color Texture Gr. Sz Sh Consistence Boundary Roots Bed Trench ................. i i < 1 0 -4 7.5YR 3/2 - sl 2 m cr ds cs lf/m .5 .6 2 4 -10 7.5YR 3/2 - sl 2 f sbk mvfr gs lm .5 .6 Ground 3 10 -20 10YR 4/3 - sl 2 m sbk mvfr cw if .5 .6 elev 97.4 It 4 20 -30 10YR 4/6 - A 2 m sbk mvfr cs if .5 .6 Depth to 5 30 -36 10YR 4/6 f2d 7.5YR 5/8,5/3 sl 1 m sbk mfr cs if .4 .5 limiting 6 36 -53 10YR 4/4 c2d 7.5YR 5/3 scl 0 m mfi cs - NP .2 factor 30" 7 53 -70 2.5Y 5/6 f3p 7.5YR 4/6,5/8 scl 0 m mfi - - NP .2 Remarks: occasional is inclusions 20 -30" ................. .................. ..,.2 1 0 -6 7.5YR 3/2 - sl 2 m cr ds cs 2flm .5 .6 2 6-24 7.5YR 3/2 - sl 2 f sbk mvfr cs if .5 .6 Ground 3 24 -30 10YR 4/3 - sl 2 m sbk mvfr gs if .5 .6 elev 99.1 it 4 30-41 IOYR 4/6 - sl 2 m sbk mvfr cw if .5 .6 Depth to 5 41-48 1OYR 4/4 - Is 0 sg ml cs if .7 .8 limiting 48.65 10YR 4/4 c2 7.5YR 5/3 scl 0 - - NP .2 factor p m mfi 48" Remarks: CST Name (Please Print) Signature: _Telephone No. Henry F. Grote 715 -665 -2681 Address P.O. Box 57, Knapp, WI 54749 Date CST Number Ref # 6/8/98 222774 296 PROPERTY OWNER: Middleton, Dave SOIL DESCRIPTION REPORT z9s Page 2 - of PARCEL I.D.# E on Depth Dominant Color Mottles Texture Structure nsistence Boundary Roots GPD/ft' < in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 0 -5 7.5YR 3/2 - sl 2 m cr ds cs 2flm .5 .6 2 5 -9 7.5YR 3/2 - sl 2 f sbk mvfr cs if .5 .6 Ground elev 3 9 -15 10YR 4/3 - sl 2 m sbk mvfr gs if .5 .6 99.1 R 4 15 -24 10YR 4/4 - sl 2 m sbk mvfr cs if .5 .6 Depth to 5 24 -33 10YR 4/6 - sl 2 m sbk mfr cs if .5 .6 limiting factor 6 33 -40 10YR 4/6 f2d 7.5YR 5/3 sl 2 m sbk mfr cs - 5 6 33" 7 40 -75 2.5Y 5/6 f3p 7.5YR 4/6,5/8 fi scl 0 m m - - NP 2 Remarks: Ground elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: — ................ Ground elev Depth to limiting factor Remarks: Z , CA r. �r S O Lo 4ic- Q� l I� r r , wow: N. w?( tree .w.Gti L b I , -kl. �-*Q T t 3a�3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer uyer /� L- 6�i lam" Mailing Address Property Address clew l //zcJ /� // (Ve required from P arming Department for new construction) City /State 16�teyIlr AJ-E Parcel Identification Number d as — /9 ZO ` Z0 -- e &J LEGAL DESCRIPTION Property Location A/E 1 /4, I / 4, Sec. �, TN -R_[, W, Town of Subdivision Lot # Certified Survey Map # '�� 7 9 , Volume , Page # 330 Warranty Deed # , Volume Page # Spec house O yes N( no Lot lines identifiable Or yes 0 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, restrictedplumber or a licensedpumper 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 dayse I le three ear expiration date. '�>/ �/ - /20/ fe SIGNATURE OF APPLIC DATE OWNER CERTIFICATION I (we) cer that all state owner(s) menu on this form are true to the best of m our knowledge. I we am are the o ( ) fY Y( ) g ( ) (are) r(s ) of the ro rty described above, by virtue of a warranty deed recorded in Register of Deeds Office. &A; ✓1 /Z / `a' SIGNATURE OF APPLIC 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 ff/t7 5 14'"1 :3 ' STATE 9AR OF N'ISCON�tN FORM 2 - 1+t3 WARRANTY DEED DOCUMENT NO. Pay 11 82 - _ 99 REGISTER'S OFFICE ., ST. CROIX CTY. WI Robert K. Richter - _ _ ` PAc'dbrRAMd - - - - — - - - -- - -- JUN 3 1996 2.30 P. M conveys and warrants to David H__Middleton and_LaVonnv B ly4vj — * tJ," Midd husband and wif as 6urvivors _maki-ta1 -_ pegisterofDeeds - pro erty, THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS the following described real estate in St. Croix Cuucu � State of Wisconsin: r � 022-1020 -2 -100 PARCEL IDENTIFICATION NUM6ER Part of SW} of NE} dart of NW} of NE} of Section 3- 2Ei- -18 described as follows: Lot 2 of Certified Survey Map filed March 22, 1991 in Vol. "8 ", Page 2330 TOGETHER WITH the right of ingress and egress over t°' road right of way as shown as Outlot "1" of Certified Survey Map filed Mar ^h 22, 1991 in Vol. "8 ", ° Page 2329. Ell $ V - itf t This is not homestead property. XUX (is rto4 _c Exception to warranties: easements, restrictions and righter -of -way of record, if any. Dated this �� day of lq 96 4J r ' (SEAL) BY= (SE.4L) Stuar Atto e -in.-Fact — (SEAL) (SEAL) ° AUTHENTICATION ACKNOWLEDGMENT N ` Signature(s) Star -_f Wisconsin, ss F * --rce County. authenticated this day of 19_ PeLSwnally came before me this 30th day of X4 7 19 , the above named — S J. Krueg TITLE: MEMBER STATE BAR OF WISCONSIN -- a (If not, authorized by §706.06, 4VLs. Scats.) to rrtr Rrttts vn who executed the foregoing same. THIS IN iTRUMENT WAS DRAFTED BY / l me. St uart J. Xrueger, Attorney at Law River Falls, Wisconsin 54022 4' "hc ---it" Cr ' x _ County, \his (Signatures may br authenticated or acknow' dged. Both are not !tr la +" If not, state expiration date: w � necessary) - -- OF N_;:xs of persons signing in any capacity should by typed or onmed below !heir signatures. STATE BAR OF W tSCY�+'�E� ` ' CO. ;M WARRANTY DEED Form No. 2 — t•+tw,'. Mo aL*a W's i- LED *FM 2199181. ` 1 4.f' -f,9 � ��,M 4 CERTIFIED SURVEY MAP t� LOCATED IN THE SW1 /4 OF THE NE1 /4, THE NW1 /4 OF THE NE1 /4, THE NE1 /4 OF THE NE17 THE SE1 /4 OF THE NE1 /4 OF SECTION 8, T28N, R18W, TOWN OF KINNICKINNIC, ST. CROIX COUNTY, WISCONSIN NOTE: THIS MAP IS EXEMPT FROM TOWNSHIP AND COUNTY REVIEW BECAUSE THIS LOT EXCEEDS 20 ACRES IN SIZE. ASSUMED BEARINGS REFERENCED SCALE IN FEET TO THE EAST -WEST 1/4 SECTION LINE WHICH BEARS S88 0 16 1 08 11 W 0' 200' 400' LEGEND w ST. CROIX COUNTY SECTION CORNER MONUMENT, FOUND. o z 00 • 1" IRON PIPE, FOUND. U NPLAT T ED o z 0 1 "x24" IRON PIPE WEIGHING 1.68# /LINEAL FOOT, SET. LANDS w w H 8 3 5 S 97 °9'W 8 .1 �� .96' 9 " 0 5 / L n z i 00 N I o N / rn al U) / LOT 2 3 WI o 20.871 AC.± �,, �I 3 AI // 909,122 S.F.± N I al H 00 i ° z 07 W al / 00 ° �� w 66' / 356.26' 28.00 10'09 12 W � 3 N0 12 44 z C4 Ln 1 N C7 o� 1 C-4 off O E__4 H o 1 N p O W a cn 2 z o \ o C.S.M. LOT 1 \ ;v OWNER AND SUBDIVIDER N Robert Richter ^� 11(52 Riverside Dr. N. M Hudson, Wisconsin 54016 - - z 00 0 o z'x This instrument �� _ ,�',fl " o drafted by James T. 1 - - - _ _ _ _ �° •' r __0 co Swanson. _ 3 W F, UNPLATTED LANDS Vol. 8 Page 2330 TO K 1 W . K ." �F ��i'�i�... Carole Hoopman, Clerk Gerald Larson, Chairperson 179 State Rd. 65 David Wittig, Supr. 1 River Falls, WI 54022 Charles Andrea, Supr. 2 Brenda LaValley, Treasurer i St. Croix Government Center September 23, 1998 1101 Carmichael Road Hudson WI 54016 Attn: Zoning and Planning Re: Hudworth Homes, Inc Agent Dave Middleton, Property Owner 481 Sleepy Hollow Road It has come to our attention that a home is being onstructed at g th e above location and a driveway has been located at the site at a place that would not have been accepted if the builder /owner would have obtained the proper permits before beginning constructidn. Chairman Larson has requested I notify the County of these violations and request a citation be issued. They have not attempted to obtain any permits from the town. Sincerely, Carole Hoopman, Clerk Letter requested by Chr. Larson c� � , 5T CFC;!t,