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HomeMy WebLinkAbout022-1020-50-100 ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner Property Address L4 D S (e e ol City /State I V--Vj4 n S Legal Description: \ ' Lot Block Subdivision/CSM # V U a 3 3 s W t /4 N L , Sec. �, TAN -R Ik'i N' W, Town of K tiN t/4 PIN # SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer 0 - "kS Size ST/PC 4 " / $dU Setback from: House Well sV PAL, a � , Pump manufacturer n k � A R - Model S3 Alarm location T 1, (HOLDING Setbacks: Service road Vent to fresh air in a er ------ ---... Meter location Alarm location SOIL ABSORPTION SYSTEM ���► ��} a3xiDt U Type of system: M b u �1'o Width Length I u o Number of Trenches Setback from: House I y X Well 1 P/L t Vent to fresh air intake ELEVATIONS Description of benchmark f4 iM 1 h Elevation Oy Description of alternate benchmark Elevation Building Sewer ST/HT Inlet 1 1 5 - ST Outlet a PC Inlet S PC Bottom T l a Header/Manifold Vy 31 Top of (S'I C Manhole Cover 4 Distribution Lines () 11 3 1 B e 4 m A h Y S L 6 V �n �` �p�P Icp�I 0►J� Bottom of System Final Grade () l y S-0 Date of installation / / Permit — number State plan number Plumber's signature ���rv^'�\ l� License number DX) VA Date Inspector Complete plot plan e 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 PO) 5 klu11 _, a3' a io r - S is 0 r34 1 Rob W4- �Ur4 INDICATE NORTH ARROW Wiiconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: Safety and Buildings Division INSPECTION REPORT ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary3irojtNq.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 2 ii // 11 Permit Holder's Name: ❑ Cit ❑❑� Villa e Town of: State Plan ID No.: HAHR, CHARLES & LAURA KI kCF IC CST BM Elev. Insp. BM Elev.: BM Description: Parcel T c IR._1020-50 -100 TANK INFORMATION ELEVATION DATA A9800258 "9 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic : 'rt..�... / `J� Benchmark Dosing Aeration - -..._� --- ..� Bldg. Sewer Holding �,,•'" St /J� Inlet /d 7 TAN.W<ETBACK INFORMATION St /)A Outlet TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic 414- NA Dt Bottom Dosing } 7, ° NA / Man. Dist. Pipe p . r Aeratio Holdi �" �g „�� _...e.,_._- Bot. System PUMP.JNFORMATION Final Grade Manufacturer Demand �` ° ° S. - 1 Model Number GPM TDH Lift Friction System TD H Ft Forcemain Length Dia. Fi Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIM NS SYSTEM TO P / L BLDG WELL LAKE / STREAM 1EACH11NG Manufacturer: SETBACK CHAMBER \ INFORMATION Type O iVlodel Number..._ _ System: OR UNIT DISTRIBUTION SYSTEM Header/manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. 2� Length Dia. Spacing A SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: KINNICKINNIC 8.28.18,SW,NW 460 SLEEPY HOLLOW ROAD / � ^t -� ,� t'1�;1 � iYr? 6 / J :l.i.s�C 0 .� ,�� u� ��'tc.•ri���,,r %�i , , �,�a �,, iii: c ,t':' .,�:. i required? E] Yes ❑ No for additional information. R) Date Inspector's Signature Cert. No ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: i e P e _ 3 , : mm E e E i a. M a t x 3 { 3 .r w Vis SANITARY PERMIT APPLICATION 20 E Washiin nA °e � In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Department of Commerce Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. •J"� 2" • See reverse side for instructions for completing this application State Sanitary Permit Number The information you provide may be used by other government agency programs El Check if r�visio o previous application {Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATI N 'l/ Pr erty Own r Name Propert ` Location 1 �a NG(I / U) 1 /4,S S 8 T a8 , N, R /8 E (orw PrgpQr#y owners Melding Address Lot Number A Block Number Ci tat Zip Code Phone Number Subdivision Name or CSM Number 10 S ( ) o 3 II. TYPE OF BUILDING: (check one) ❑ State Owned !t( Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms Town OF / ' 1 III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 00A _ /OA o ` 5 " /00 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_ ❑ Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5_ ❑ Repair of an ______ System- _____ -_ System l�r_ ____ _______ Existing System ________ Existing 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 21.4g3Aound 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 S. Perc. Rate 6. System Elev. 7. Final Grade 1� Req red (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min.AQch) Eleyatio (0 V b t o o S b 0 0 1 , 3 Feet 06' d Feet VII. TANK Capacit g allon s Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturer Name Concrete Con Steel glass Plastic App New Existin structed Tanks Tank t _ I A00 1 W -t El ❑ 11 iftPumpTa /S am er $Olt ( S 11 1111 1:1 0 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (No Sta ps) MP /MPRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Code): 1090 js�" IX. COUNTY / DEPARTMENT USE ONLY nppp���s [] Disapproved Sanitary Permit Fee (includes Groundwater ate slue Issuing Ag nt Sig re (No Stamps) ///��� Approved []Owner Given initial �I S urcharge Fee) Adverse Determination V X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SB13439 I (R 11M) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber i 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 o 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 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(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 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 2226 ROSE ST LA CROSSE WI 54603 -1905 Nv l' isconsin Tommy G. Thompson, Governor Department of Commerce William J. McCoshen, secretary June 18, 1998 CUST ID No.222904 ATTIC• POWTS INSPECTOR JAMES W BOUMEESTER 1070 HWY 35 N HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 06/18/2000 Identification Numbers Transaction ID No. 89180 Site ID No. 10416 SITE: Please refer to both identification number`s, Site ID: 10416 above, in all correspondence with the agency. St. Croix County, Town of Kinnickinnic SW1 /4, NW1 /4, S8, T28N, R18W JOE & LORI OKANE FOR: Description: Mound Object Type: POWT System Regulated Object ID No.: 26305 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. Sinc rely, DATE RECEIVED 06/17/1998 FEE REQUIRED $ 180.00 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 RECEIVED JOE & LORI O' KANE 4 BEDROOM RESIDENTIAL MOUND DESIGN g � D GS DIV. REVIEW DATE: JUNE 20, 1998 SAFETY & PLAN REVIEWER. GERRY SWIM PLAN IDS► - X180`4' PROPERTY LOCATION: PROPERTY OWNER: SW%.NW' Sec. 8, T.28N., Joe & Lori O'Kane R.18W., Tn of Kinnickinnic, 400 North Robert Street St. Croix County, WI St. Paul, MN 55101 Pcl.# 022 - 1020 -50 INDEX TABLE PAGE 1 OF 8 TITLE SHEET PAGE 2 OF 8 WORKSHEET PAGE 3 OF 8 WORK SHEET PG. 2 PAGE 4 OF 8 PLOT PLAN PAGE 5 OF 8 MOUND CROSS SECTION PAGE 6 OF 8 DISTRIBUTION PIPE DETAIL PAGE 7 OF 8 PUMP CHAMBER CROSS SECTION PAGE 8 OF 8 PUMP SPECIFICATIONS ATTACHED SOIL EVALUATION PREPARED BY: Jim Boumeester 1070 Hwy. 35 N. Hudson, WI 54016 (715) 386 -9020 SIGNATURE: , MPRS# 3404 Credential #222904 DATE • , 1998 P.O.W.T.S. Conditionally APPROVED DEPARTMENT OF COMMERC DIVISION OF ETY AND B ` INGS, EE GORRESP ENGE WORKSHEET ABSORPTION AREA SIZING 1. Daily wastewater load 600 Gpd (4 bdrm) (150 gal /bdrm) 2. Depth to limiting factor 25" 3. Land slope 3% 4. Infiltrative capacity of soil at system elev. 1.2 gpd /sg.ft. ASTM C33 med. sand area required 500 sq.ft. bed length (B) 100.0' bed width (A) 5.0' MOUND DESIGN 1. Mound Height: 2. Mound dimensions: fill depth (D) 1.0' end slope (K) 10.0' ((1.0 +1.15)/2 +.75 +1.5)3= 9.98 downslope fill depth (E) 1.15' total length (L) 120.0' 1.0 +(3% X 5 1 ) ( 100.0 1 )+ (2 X 10.0) = 120.0' aggregate depth (F) 0.75' downslope width (I) 10.0' (1.15 +.75 +1) (3) (1.10) =9.57' cap and topsoil depth(G) 1.0' upslope width (J) 8.0' (1. 0 +.75 +1) (3) (0.915) = 7.55' cap and topsoil depth(H) 1.5' total width (W) 23.0' 8.0' + 5.0'+ 10.0' = 23.0' 3. Basal Area: Basal area required 1,200 sq. ft. 600gpd. /0.5gal. /sq.ft. /day per CSTM = 1,200 Basal area provided 1,800.0 sq. ft. (100')(5' +13.0 = 1,800.0 Linear loading rate 6.00 gal. /linear foot 600 gal./ 100' = 6.00 PRESSURE DISTRIBUTION NETWORK 1. Distribution pipe sizing: Lateral length 47.5' Lateral size 1 % if Lateral spacing NA" Sidewall separation 30" Hole size 1 /, " Hole spacing 60" jist hole at 30" from manifold) Holes per lateral 10 Dist. network discharge rate: 23.40 gal. /minute (2 laterals)(10 holes /lateral)(1.17gal /hole) 2. Manifold sizing: Location Center Length NA" Diameter NA" 3. Force Main: Diameter 2 Length 30' Flow rate 23.40 gal. /min. Friction loss 0.33' (30 ( 1.10ft. /100ft. ) = 0.33 ft. 4. Total dynamic head: Min. supply pressure 2.50' Vertical lift 7.00' friction loss 0.33' Total dynamic head = 9.83' 5. Pump selection: Manufacturer Zoeller Model number 53 Discharge rate 34.0 Gqpm @ 9.83' TDH 6. Dose chamber: Manufacturer & capacity: Weeks concrete 800 gallon liquid depth 41.0" @ 19.5 gal. /inch (799.5 gal. actual) Sizing: A) One day holding capacity 21.00" = 409.50 gal. B) Alarm setting 2.00" = 39.00 gal. C) Dose volume + flow back 8.00" = 156.00 gal. (600gal. /4 doses per day) + (.164)(30 = 154.92 gal. min. D) Reserve storage 10.00" = 195.00 gal. TOTAL 41.0" = 799.50 gal. (.gO cl- c L� r 8 Q o o Irv -o fi V% o iQQ� CL EA h o \ N o p 9 `� o 0 i n OLIU o � �� 3 LA cq � p /F , Zh S 7 1 b ��O P"Y� /so 815E I Page S Of$ Cross Section Of A Mound Using A Trench For The Absorption Area _ _ H Medium Sand Fill � 1 0 F 6" Topsoil .�(�,/ ,02 3 E ID o Trench Of '2" - 22" Aggregate, Plowed Layer 6" Below Pipe. Covered With D /, 00 Ft. Straw, Marsh Hay Or Synthetic Fabric E /, /S Ft. G 40 Ft. F o. 7-5' Ft. H /. SD Ft. Plan View Of Mound Using A Trench For The Absorption Area Force Main Distribution Pipe I Permanent Markers Observation Pipe A o ---------- - - - - -- - ------------ - - - - -. W r B K I \ Trench Of - 22" Aggregate L �— A S.b Ft. I /O.O Ft. K /o,o Ft. W X3.0 Ft. B lco.o Ft. J 8.o Ft. L 1.7.o.0 Ft. raye to vi Distribution Pipe Detail For Two Lateral Network Holes Located On Bottom Are Equally Spaced PVC Force Main End Cap I I Y X X PVC Distribution Pipe P P X * Last Hole Should Be Next To End Cap P q7 - Ft. Hole Diameter Inch X 6_ Inches Lateral Diameter If'�, Inch(es) Y & 0 Inches Force Main Diameter .2. Inches # Of Holes /Pipe /O Invert Elevation Of Laterals / a , 3 Ft. _ P5 PUMP CHAMBER CRO55 SECTION AND SPECIFICATIONS See ILHR 16.19 VENT CAP For Electric ti" ScJ.'aV E NT WEATHER PROOF APPROVED LOCKING �! 15' FRCM DOOR, JUNCTIOAI BOX MANHOLE COVER WITH PADLOCK WINDOW OR FRESH 12 "MIU. AIR INTAKE i Warning Label GRADE I `1" MIAI. CONDUIT INLET PROVIDE I -_ - -- Approved Joint AIRTIGHT SEAL APPROVED JOINT A I I APPROVED JOINTS I I I I I ALARM B I II I 1 I i ON ✓. tLF r/T I PUMP � -'� � OFF D CONCRETE BLOCK See ILHR 83.15 95.37 for 3" bedding RISER EXIT PERMITTED OULH IF TANK MANUFACTURER HAS SUCH APPROVAL 8PECIFICATI0MS MANUFACTURER: �'��� (!a//e-re,& IJUMBER OF DOSES: 4 PER DAy SEPTIC TANK SIZE: q PUMP TANK SIZE: gU� gQ QQ p ti"� oosE voLUME lctin:nnWyk: /S pL GALLONS ALARM MANUFACTURER: S -.1 ro Systems CAPACITIES: A = 2/.0 INCHES OR y • GALLOWS MODEL HUMBER: 101 HW B= 2 • 0 INCHES OR 39. GALLONS SWITCH TYPE: — Mercury C= 8 • 0 INCHES OR 'p /St'o. GALLONS PUtAP MANUFACTURER: ���'✓ D /0. INCHES OR /95.0 GALLONS MOUEL NUMBER: df S3 NOTE . PUMP AND ALARM ARE TO BE SWITCH T'dPE:._._Merc INSTALLED ON SEPARATE CIRCUITS PUMP DISCHARGE RATE .2-3• Sl0 GPM Min;YAL rr% /'eQW. VL KTICAL DIFFERENCE BETWEEN PUMP OFF AND 015TRIBUTION PIPE.. ' 700 FEET f M'"IMUM NETWORK SUPPLY PRESSURE , . . . . . . 250 FEET + 30 FEET OF FORCE MAIN X � 10 F YoFCFRICTION FACTOR.. 0 - 3,3 FEET TOTAL DyJMAMIC HEAD = 9.83 FEET INTERNAL DIMLWSIONS OF TANK: LEAIGTH ;LIQUID DEPTH GALL005 PER =n► L -. 5 py.80,108 HEADICAPACITY CURVE ' EFFLUENT & DEWATERING TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE 53-65 $749 $749 98 1]7/1]9 16114161 16314167 16SI416S 18SI4US 186711K /84t1K /41/4119 ]+ - n - FT, at, GAL LTR GAL (LfR;: GAL :LT K GAL OW: GAL LT* ij GAL LTR % GAL ltR: GAL LTR GAL iLTR: GAL - LTR' ;77 f S 1.52 43 ::167 72 ,x373 ?; f] ]62 ' 106 101:.: '00 f0 3:OS 3• 1129 it ? %3]1 `: 79 299.;'. 100 it 211 t1 271'.: St it 141 <: 151 -. 15 4.67 19 .�72 45 :?170 64 347 91 341::: 60 227 w 237 K :330 142 ;::677 :. 113 N!` 95- 20 't,,0 23 9! % 176 S 12 310 : 39 .737 w 227 SI 176 110 28 '.. - IS 7,i2 S 30 74 7w::i. 57 216 59 223.":.: 58 ;220 126 . li484;; 173 S07' 90 30 9:14 6S 146.; SS 206 64 220 :: w 310:: K 1214 177: btu I6 t0 ' 1119 - K 171::. K .472 u 2K :': 75 2d`. ss ..110::; 105 .`::;39t; 114 U1: SO S i 21 M i 77 . 12S :' S1 K 319'<.: K 10 2{ w w 16:39 .. . q 161.: 76 S• 1iD:': 71 »:2s9: is 321: - ) 70 71;34 ]0 114 - f0 ><;'- 62 ,197.:1 51 197 70 7 4, {156 w 71:36 70 .,` 11 63.::: 43 170> 28 >t06 -- 64 ;E loss' 27.43 l' .: 65. : 32 f31 2 ::. 1. 37 140: u :: :.:.: .: t i 65 +16 100'30:41 >: .:i:> N Lech _ 79 .. .. . . _. o e... 6a 110:i>i1A0 j V&Fn: 192 K K 5' 23' 26' ' ' a 73' 115' 91' 117 55 6!. S.t 5a 6 WARNING: Model 185/4185 should not be subjected to less than 30 feet TDH. +5 NOTE: For Head Capacity on Model 112, Industrial i2 i0 column - explosion proof pump, see FMO219. 1e5,41e5 35 e9,4169 d 25 6 20 61!161 IS i h 1ee.41w {2 4 53.55 1!7.1!9 5),39 ...:.:.:.. V.s. uttws 10 7o W 50 60 >D eo 90 too ilo 120 30 110 50160 uTEas _ 4D9. ae0 ` � < >�•o, slcslu 0 ROW KR MNUTE '- 3 t 6,P rA ro idfJ SEWAGE & DEWATERING TOTAL DYNAMIC HEAD /CAPACITY PER MINUTE )5 22 SERIES 262 266 267 268 28214262 2644264 292/4292 29314293 29414294 2951429S )o - FT '.M. Cal Uitf Gal tk1 Gal Ovis: I. t.tn - Gal. tV Gal. Ltis:. G+1 ttiti.. Gal tL.a. Gal 12is Gal. Lp7 5 s 1;52 w 3U `: 121 464:': 128 411 177 464 130 .443 180 411 1]7 50>:: 196 >0 . 225 W D 10 - OS w 227:x: 89 3J72 $9 377;: 89 3]7: 96 760 1S& 96K 116 {M` 181 6K I05 77ti. to 1S 4Ji7 223 16 w 109;; so 105': so 189: 63 378 135 611 100 J76 130 W1 165 675 tK ,700. » 30 6.64 10 ]iii 10 361 10 f6 I6! 73 12S 106 '.401 83 312!. 119 430:! 150 360 16S.:6 36 so 76 261 66 270:' 106 136 :416 153 680 i Sa +5 30 '9.14 s] 167 46 174:: w J49: 121 :/E6 110530 '? 40 12.11 .. _ 26 90: SO 169:: 94 ]S6 115 133 p 7 7 40 w 152 S6 .. 110 $9 377 j t o » - - w 1829 13 :69 59 :223 v 3D 70 23 95 e 797..)9! Lock Vahre: it' 41.5' 21.5' 21.5' T6' ]s' 39' SO' 62' )r 75 _ WARNING: Model 293/4293 should not be subjected to 7e7. - lVthan t TDH. __ - - - N -044 767 797. 0 -. 794.{794 295,4295 •05•+{D5 U SCRSM l ON$ 10 201 �D.�. }p - - � _ IU eU� 9U 10011 to I)01130 1 +050 160�)O,ap 19 700 ]1 770 2 7 {0 1X1 760 710 !ID ]90 bD 7 ] 330]{ ]SD 7 !!0 Sao 790 {DO 0 - + 1 - __ I - .-- .. - -I° I - __ -I -- I 1"_ D e0 ,eD 7 w 770 {DO +eD 360 6+0 720 6w ee 9w 104O „70 1700 1260 1360 ,110 1570 $tog, f•IR 1Mµ/11 SK553 LWisconsin : d HumanRe tofI use, SOIL AND SITE EVALUATION REPORT Page 1 of t 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 (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. 022-1020-50-100 APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Joe & Lori O'Kane GOVT. LOT SW 1/4 NE 1/4,S8 T 28 N,R18 5(or)W PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # I SUBD. NAME OR CSM # 400 N. Robert St. 9 na csm vol8 - page 1337 CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE JgOWN NEAREST ROAD St. Paul, MN.. 55101 1(809 950 -4666 Kinnickinnic I Coulee Trl. [X] New Construction Use Residential / Number of bedrooms 4 (] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 6 0 0 g pd Recommended design loading rate • 5 bed, gpd/ft • trench, gpd/ft Absorption area required 500 bed, ft2 500 u2_Ich, ft Yaxi,i�u,,, desigri'ioauitig iaLe • 5 bed, gpdrft • 6 trench, gpdjft Recommended infiltration surface elevation(s) 102.95 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material g round moraines Flood plain elevation, if applicable na It S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for system 1 13 S M U I ]E1 S ❑ U ❑ S 49U 1 ❑ S MAI ❑ S ®U ❑ S M1 SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trertd ; 1 0 -13 10 r3 3 none 1 2msbk mfr CIV 2f .5 .6 - X 2 13 -2 10yr4/4 none sil 2msbk mfr gw if .5 .6 Ground 3 29 -4 7/5yr4/6 none sl 2msbk mfr gw na .5 .6 e 02 .ft40 4 40 -6 7.5yr4/6 c 1 q : ;W//9 sl 2msbk mfr na na .5 ' Depth to limiting factor 40" Remarks: Boring # 1 0 -12 10yr3 /3 none 1 2msbk mfr gw 2f .5 .6 2'Y 2 12 -23 10yr4 /4 none sil 2msbk mfr gw if .5 .6 wti.. CIQ 3 25-33 7.5yr4/4 5yr5/8 dvl lmsbk mfr gw if .2 .3 Ground elev. 4 33 -5 7.5yr4/6 2.5yr 5 scl 2msbk mfr na na .4 `.5 10 2 . 4 Qt. Depth to . limiting factor _' ✓ 25" rt. Remarks: CST Name:— Please Print . Phone. Gary L Steel • X - 6 Address: d 4 th. Ave. New Richmond, WI. 54017 155 0 s Signature: A�0 Date. ! '',�� CST Number: 7 -13 -9 - - cstm02298 PROPERTYOWNER Joe O'Kane SOIL DESCRIPTION REPORT Page-2of 3- PARCEL I.D. # 022 - 1020 -50 -100 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence �Bo rivy Roots GPD /ft in. I Munsell I Qu. Sz. Cont Color I Gr. Sz. Sh. I I Bed !Trench 3 1 0 -12 10 r3/3 none 1 2msbk mfr gw 2f .5 .6 =` ='> 2 12 -23 10yr4 /4 none sicl 2msbk mfr gw if .4 1 .5 Ground 3 23- 7.5yr4/4 none scl 2msbk mfr gw na .4 .5 eev. C2 101 30 ft. 4 36-60 5yr4/6 5 P 5/8 sicl M na na na lip Alp yr Depth to limiting factor 3 Remarks: - Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. 1 ft. � Depth to limiting factor Remarks: SBD- 8330(R.05/92) STEEL'S SOIL SERVICE Gary L. Steel ,Joe & Lori o' Kane 1554 200th Ave. CSTM2298 SW4NE4 S8- T28N - R18W New Richmond, WI 54017 MPRSW 3254 town of Kinnickinnic (715) 246 -6200 lot #9- Sleepy Hollow N 1 =40' BM =top of mid lot survey stake at el. 100' � S r y i , Al _ Id 1 bz� Gary L. Steel 7 -13 -94 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer I. V /&S ,,/ a k w V Q t/rc �T A� �' N Mailing Address - `f 1� e 4�- t- v t1 i -► �a /ls W-�� j �� 0 Property Address 5 - ePy / w (Verification required from Planning Department for new construction) U City/State Parcel Identification Number 0 ..5 0 / 6 0 LEGAL DESCRIPTION ' . i T/ Properly Location %, y., Ste, T ' � N - 41 - W, Town of A; n n i ; e ;t' Subdivision Lot # � . . Certified Survey Map # Volume c . page it o 33 Warranty Deed # _ .�'�3 �o Volume (� . Page # S 3 Spec house 0 yes P,( no Lot lines identifiable yes 0 no SYSTEM;1Vi4RMNANCE kWop rmea ndmaintenanceofyoursg3ticsystemcouldresaitinitsIremptf faffnretohaadlewastcs .Propermaintenaaee' consists of pumping oat the septic tank every three y= or sooner, if needed by a licensed pumper. What you put into the system can affect: &c function of the septic tank - as a ftatment stage in the wade disposal systm 11e property owner agrees to submit to St. Croix Zoning Department a certification faun, signed by the owner and by a maxt= phaziber. jotrneymanplumber, rest ictedpluml=or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in Proper operating condition and/or (Z) after inspection and puuq=g.(if necessary), the septic.tank is less than 1/3 full of sludge. Uwe, &c undersigned have read the above revirtments and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by fire Department of Commerce and the of Natural Rasp stating that your tic t �: State of Wisconsin.. Certification uP has been maintained must be complded and returned to the St. Croix.Couaty Zoning Office within 30 days 1 'o a SIGNATURE F APPLI 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 owners) of the property described above, by virtue of a wamanty deed recorded in Register of Deeds Office. SIGNAMW OF APPLICANT DATE « « « « «« Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. « « « « «s «« 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 !TATE BAR OF WISCONSIN FORM 2 - 1982 5 6 j� WARRANTY DEED UOCUMENT NO. VIL V-1t - bT. CRC . Alta M. Monk a sin le person, Keith S. Kenned i eaamrlta�r,. eri, Fenn husband and wife, it EG 31 .99EI } 9:00 conveys and warrants to (ttarl s Hat1r �ty„� • (� husUand end wife, A� survivorship marit l ' i nomw %A Dow" !I Ii THIS Sr'ACE REStRVEO FOR RECOADoRG DATA NAME AND RETURN ADORE St Croix County, it cet (,Ct. `(C{ State of Wisconsin' ( 1, the following described ml estate in &0 ' J , �(1 jj 00 U J`T O t I I 022 -1020 -50 PARCEL IDENTIFICATION AJWSER (See Attached Exhibit " A R' ) T NOFER s This ` is not homestead property, (is rat) Exception to warranties: Easements, restrictions and rights -Of -way of record, if any. 5 I y Dated this 13� — day of December A.D., 19 (SEAL) . (SEAL) - Alta M. Monk Ceith S. Kenned j ^ f (SEAL) `I (SEAL) j Keri Kennedy - ' — I AUTHENTICATION ACKNOWLEDGMENT j� II State of Wisconsin, � j Sivature(s) u• St. Croix County I II authenticated this day o[ 19� Personally cattle before the this _ �7 day of the above named j `Leith Kennedy and Ke ft • ennedy TITLE: MEMBER STATE BAR OF WISCONSIN — (If trot, „ who executed the fore to l authorized by §706.06, Wis. StatO .'�,.� jo rat: known to be the person .�_ g° g 4iir(ent and acknowledge the saute.. THIS INSTRUMENT WAS DRAFTED BY A �W Attorney 0 l and L County, WIS. F ,t son WI 54016 ,. � L Nc��iytPu -- Hudson I4 ��'3 i � Com pion is pe rmanent . (if ncx, state expiration date: j (Signatures may be authenticated or aclo3owed. BtitJt+3� not M) 1 ' Names of pervxts signing m any capacity shoold by typed or pnnted beiow- their signatures. i .. Wi�s:c~ Leo et2i Co. t++e STATE BAR OF WISCONSIN I,�., -, We ?i WARR.�'<TY DEED Form No. 2 — 1982 iI t a 4,i 1 4 Vot 121.5 PAck 5*40* Part of the East 1/2 of Northwest 1/4 and the West 1/2 of Northeast 1/4 of Section 8-28-18 described an follows: Lot 9 of Certified Survey Map filed March 22, 1991 in Vol. 8, Page 2337, St. Croix County, Wisconsin, Together with the right of ingress and egress over the road right of way as shown as OutlOt • 1 • of Certified Survey Map filed March 22, 1991 in Vol. 8, Page 2329, St. Croix County, Wisconsin. 4 1V $iillw 4* 7� . 10 A A. I? . lm CERTIFIED SURVEY MAP LOCATED A IN TED THE NE1/4 OF THE NW1 /4, THE SE1/4 OF THE NW1 /4, THE SW1 /4 OF THE NE1 /!, AND THE NW1 /4 OF THE NE1 /1, OF SECTION 8, T�BN COUNTY, WISCONSIN R18N, TOWN OF KINNICKINNICK ST. CROIX C.S. LOT 2 C.S.M. — LOT 1 �•� ASSUMED BEARING REFERENCED TO THE. �� —^ NORTH LINE OF THE NW1 /4 OF SECTION OUTLOT 1 _ _ -•� 8 WHICH BEARS S88834'57 "W N N of SCALE IN FEET v v w 0 W i c ° LEGEND O 200' 400' G w x H ST. CROIX COUNTY SECTION CORNER W En MONUMENT, FOUND. • 1" IRON PIPE, FOUND. F N c 1 "x24" IRON PIPE WEIGHING 1r H H 1.68# /LINEAL FOOT, SET. ° „sj r N ^+ H a co a +l - ? z in � V m y °��y • h Z N [N•� ' .-I o `o a Vpz71 cn \ V • CON Go d l .9 1 In .41 r4 r4 'V N c W :c v ^i N i H 4 M wl r Q M d C 1 p u o o u N rl v � W � 3 L0.' �.. O „•, W 01 N -A n H W • v W awl O 14 W W W m I. NO °02'51 "W 391.45' NO ° ,07'11 "N 416 z �. N .12' " SO °34'11 "W� 1422.80' .WEST LINE OFTI• r•+ iC NE1/4 OF THE NW114 AND THE WEST LINE OF THE SEIA OF THE NWI /4 UNPLATTED LANDS :c co N This Instrument drafted by James T. Swanson 0 c°i t: NH I ' SURVEYOR'S CERTIFICATL I T. "Swanson, Reg istered I h T." S wa gistered band Surveyor, hereby certify that ave su rv e yed , , divided and mapped this certif NEl /9 and the NW1 /4 ied Survey Ma ed xn the N£1 /4 of the NW1 /4, the SE1 /4 of the NW1 /4, the SW / 0 £ the NE1 /4 of Section 8, T28N, R18W Kinnickintiic, St. Croix Count , Town o f � ing at the North 1/4 corner OfsaidcSectiond8; thenceaS88*34'5711WCommene- (Assumed bearing referenced to the North line of the NWl /4 which bears • S 9 34 1 57 11 W) 1318.62' along the No 1422.80' along the West line o rth line of said NW1 14; thence 50 034111 1.w line of the SE1 14 of the NW.1 /4f thence1N88 °15t55''NW1/4 and the West Of beginnin then ° � �� E 21.40' to 9, ce NO 07 11 W ,, the point thence S74 °95'02 "E 416.12 , thenee�NO °02'51 "W 39 1.45 ' .20 �. thence Southerly 5 3 1 ` 1572 radius curve concave Easterly whose chord bearsS0 °42'26 "EQ349. 04;00' thence S88 15 55 W 1520.65' to the point of begi This parcel contains 20.001 Acres, more or less,bein 871 ua .,236 S Feet, more or less. S re Subject to easements record. I certify that I have made such sur land divis Survey Map by the direction of the owners of said land, a that r such e map is a.correct representation of all the exterior boundaries of the land surveyed and the subdivision thereof made, that I have fully complied with the provisions of Chapter 236 of the Wisconsin Statutes and the Subdivision Regulations of Ki Township and St. Croix County in surveying, dividing and mapping the same. Date: December 26, 1990. miuuinru���� James T. Swanson S -1482 Job No. � Ogden Engineering Co. 90 -1872 113 W. Walnut Street JAMEST. x River Falls, Wisconsin 54022 SWAN s•t4ez OWNER AND SUBDIVIDER 4 FINER FALLS. Robert Richter wis. O�� 1152 Riverside Dr. N. v �.� Hudson, Wisconsin 54016 S UFI non CURVE DATA TA BLE CURVE RADIUS ARC_ CHORD CHO10) CENTRAL 1ST AND ZND NO. LENGTH LENGTH LENGTH BEARING ANGLE BEARINGS 1 -2 633.00' 352.58' 348.04' S0 0 42 1 26 1 % 31 ° 54'4 " ' " S S1� 14 58 W S16039'50 "E