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HomeMy WebLinkAbout022-1092-50-100 r ' ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner / L - Address Sr C �%, �. 1 City /State e �� A k� Legal Description:,; Lot �_ Block Subdivision/CSM # C %, 59 '/, N�. Sec. 3L, T ti8 N -RAW, Town of 4�.bok,'ann_ PIN # 0:2 2 -- /G X12 - S SEPTIC TANK — DOSE CHAMBER — HOLDING TANK INFORMATION: Tank manufacturer w� frq/ Size ST/PC j c!2 / and Setback from: House , -�? j ` Well P Pump manufacturer Model dJe�� ��' Alarm location a -V (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM: Type of system: ,1�rdL ,, Width V? Length /d Number of Trenches Setback from: House = Well ,:�-4;/- P 1 " Vent to fresh air intake ,N' 1 ' ELEVATIONS Description of benchmark / 40�! Elevation l6d , 10 Description of alternate benchmark /.��, �, �, �,,,/ Elevation 7.2 S y Building Sewer 17 ST/HT Inlet F,3. 5 7 ST Outlet PC Inlet PC Bottom - I-q, Header/Manifold `I q Top of ST/PC Manhole Cover G/ 5 Distribution Lines Bottom of System Final Grade ( ) ( ) ( ) Date of installation // / /? /Q� Permit number 2 S t G' State plan number q 8U/2a Plumber's signature dijy, Li cense number Date Inspector �© complctc plot plan or • y 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. J PLAN VIE 3 INDICATE NORTH ARROW Misc6Mirt Department of Commerce o I I I n ( Safety lkQd Buildings Division PRIVATE SEWAGE SYSTEM county: INSPECTION REPORT ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Sanitaryp�,rsi�lyi�..; Personal information you provice may be used for secondary purposes [Privacy La s.15.04 (1)(m)]. 3i ll ((�� �� Permit Holder's Name: ❑ Cit ❑❑ Villa e Town of: State Plan ID No -: BELISLE, KYLE K?NNIC1 IC CST BM Elev.; Insp. BM Elev.: BM Description: Parcel TaOc :_1092 -50 -100 X00 IJLL TANK INFORMATION LEVATION DATA A9800255 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic r- Benchm rk Dosing Aeration ---- - - -- -- - _.." Bldg. Sewer T c' Holding Stf Inlet 73 !C'o 93- TANK SETBACK INFORMATION St% Outlet TANK TO P / L WELL BLDG. V e Intake ROAD Dt Inlet Septic N 4 /,)IA- NA Dt Bottom Dosing Ir ;0 NA Header/ Man. SV , /(f Aera Ion Dist. Pipe qr Holdingl- ._ .° Bot. System PUMP /SIPHON INFORMATION 90 W'� Kkx Final Grade Manufacturer C mid Demand P 1 4 . � 7 � .f 1D I � (�,l Model Number 's 77 GPM GI' (pr 7 l� TDH Lift 1q. Lriction� s Syestem TDF Forcemain Lengt h,_4r;o I Dia. I Dist. To Well SOIL ABSORPTION SYSTEM 10 ED N Width i Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DI EN 1 5 10 DIMENSION SYSTEM TO P/L BLDG WELL LAKE /STREAM LEAC G M Manufacturer: SETBACK CHA ER INFORMATION Type O JJ odel Num er: System.M '1 t X36 OR UNIT - - -- DISTRIBUTION SYSTEM Header / M,anifold Distribution Pi j e(s) y x Hole Size x Hole Spacing Vent To Air Intake Length 1 Dia- Z Length 't) Dia- I I �y r 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 y" Topsoil Yes ❑ No Q Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: KINNICKINNIC 32.28.18,SE,NE 69 LIB RTY ROAD 1'N ��a�, -�. [Ilr Ai 4 76 (� � , 6- (,) l C, Cne re . � � � tXC � Ian revision req�d? ❑ Yes�CR ttb W �t1��Jk- ��Irevt�LY Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature ert. o.l ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: s _ a 3 E � E i e % e .. °_ , . .. ., m_. ode ..t .. s ... .. .._. .. . _ ... ... k m S E t s e e i E fi a t 3 e i Vi s _ cons i n Safety and Buildings Division SANITARY PERMIT APPLICATION Po Bw �� 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. STCYo a`� • See reverse side for instructions for completing this application State sanitary Pe The information you provide may be used by other government agency programs ❑Check it revision to previous ft ication [Privacy Law, s. 15.04 (1) (m)]. /„ Q /,'L.. pr► d �p State Plan I.D. Number 1. APP LICATION INFORMATION - PLEASE PRINT ALL INFORMAT ?� Property Owner Name Property Location C s�i�av, i/a, 5 &_z T N, R /e E (or)W Prop rty Owner's Mailing Address Lot Number Block Number <'c T City, State Zip Code Phone Number Subdivision Name or CSM Number II. TYPE F BUILDING: (check one) ❑ State Owned ❑ !t Nearest Road ❑ Village , Public fg 1 or 2 Family Dwelling - No. of bedrooms &r Town III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 3a .39 -/F. 5©0C /a 7 z - 5 6 -/6 d 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. g] New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5_ ❑ Repair of an System ____ ^ ___S Tank Only______________ Existing System ExlstfngSystem B) ❑ A Sanitary Permit % vD Date Issued V. TYPE OF SYSTEM: (Che Non - Pressurized Distribution ' ^'� , a } ierimentat Other 11 ❑ Seepage Bed VU��(,�,Ql ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEA 1. Gallons Per Day 2. At - �' 5. Perc. Rate 6. System Elev. 7. Final Grade Regt (Min. /inch) Elevation OB lela- 1 f7, 5 D Feet I , lJ Feet VII. TANK ��! Site INFORMATION I Name Prefab. Con- Fiber- Exper. lass Concrete strutted Steel g Plastic App T ptic Tan r0 El 1:1 11 11 1:1 P iphonChamber X (< Dr? �- oil � 1 ❑ 1 ❑ ❑ ❑ ❑ VIII. RESP NSIB Y STATEMENT I, the undersigned, assume responsibility for installation of the onsite sew ge system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (No Stamps P/ PRSW No.: Business Phone Number: /A /,,/, �,. , 1 4 Plumber's Address (Street, City, State, Zip Code): / O C rf 5 G IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater ate ssue Iss0in Age ture (No Stamps) .� �] Approved E] 0 Owner Given Initial zgo o i y ` Adverse Determination CC<A� oz Surcharge fee) X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD4 8 (R.11/96) DISTRIBUTION: Original to County, One copy To: Safety d Buildings Division; Owner, Plumber 1 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 San"tary 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. I 6. If you have questions concerning your onsite sevrage system, contact vour local code administrator c r the State of Wisconsin, Safety and Buildings Division, 608 -266 -3151. To be complete and accurate this sanitary permit application must includ 1. Property owner's name and mailing address. Provide the lega! descr "ption and-parcel tax nurnber(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 newior 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 approvai 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 nk r other reatment tanks; building sewers; wells: water mains/water service; streams and lakes; um or siphon tank(s) o t pump 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 i 9Qt3 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can ough these surcharges are used for monitoring groundwater contamination investigations idards. r SAFETY AND BUILDINGS DIVISION 2226 Rose Street N*isconsin La Crosse, WI 54603 Department of Commerce Tommy G. Thompson, Governor 18- Feb - William J. McCoshen, Secretary ter .- Wegerer Soil Testing & Desig KYLE BELISLE 421 N Main St PO Box 74 MAP 191 . River Falls WI 54022 998 ` k BELISLE, KYLE Plan ID 9820190' SE,NE,32,28,18W Municipality of KINNICKINNIC Inspector: Leroy G. Jaksky County of St Croix (715) 726 -2544" i 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, M. Swim POWTS Plan Reviewer (608) 785 -9348 I SAFETY AND BUILDINGS DIVISION y 2226 Rose Street LaCrosse, WI 54603 a � hsconsin G. Thompson, Governor Department of Commerce William J. McCoshen, Secretary Page 2 98 20 190 - 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- 5529 -E (R.07/96) File Ref: Page 1 of 6 MOUND SYSTEM �GrG I R A BEDROOM Eg 1 2199a F S ON - � S LOCATED IN THE 5 E 1/4 OF THE NF 1/4 OF SECTION 3 Z ,T Z �a N, R W, TOWN OF t �►� ti.1 L c ,CML COUNTY, WISCONSIN. TO l C hl hJ , ST X 3Z 9 1> 9 8 2 - 01 9 0 INDE% PAGE l 'of 6 TITLE SHEET 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 1 tJ tJ l (1 0 DU\�T - R I U�EZ T— PrLUS, , j I PREPARED BY W EC EEC E FR !3C3 I L TESTING e �`m��000tr6�a A► AND. e �► DES = Gl�i S�RV = CE b 0 P.O.W.T.S..,.••' Conditionally P.O. BOX 74 421 N. MIN ST. ARTHUR RIVET? FALLS. MI 54022 e i wECERER 0. P APPROVE 715 -4c r-0165 ELLSwo / w XON PARTMENT Of CANMME WINGS O SAFE? 0 NDENCE E CORRE 3 �. [ j l `l cl b JOB NO. 9& y? PLOT PLAN Page 'Z-- ( v Scale T '= L4 Q' � J S opyyPUC $� � 9 Q� _ o .o G� o rl V% Wt, 1 ti t Ct �. 1 IA kri; -�9 e•3 2Q• Zs - - � �J I � j I -j A s °1D i to �" l i o l s c�� 11� t PCtt1 - - -- Z cc�►.rmwz � , q�, S 13 E PrT LL!`f1s r So ' F-Y-om M OQQ , . NOTES 1. Elevations shown are existing ground elevations unless otherwise Voted. 2. Install permanent markers at end of each lateral. ( Z required) 3. Install 4" observation pipes with approved caps. ( 7 required) 4. Septic tank to be \ ZSo 1 gallon capacity manufactured by w C-OU AzZ -tm p �ZO t1 U e� S 5 Bench Mark -Cv • bl�o.0 'OLS2 7 1 ' 1 4 1 GH 6. Divert surface water around mound to prevent ponding at the uphill side. Page S Of Approved Synthetic Covering Distribution Pipe Medium Sand _ H —�G Topsoil ' 3 E " D b % Slope (Force Main Plowed - Trench of k" -2k" From Pump Layer Aggregate Undisturbed D Ft. Soil E 1 -Z S Ft. Cross Section Of A Mound System Using F o a Ft. I Trench For The Absorption Area G 1 n Ft. A S Ft. H i• S Ft. B tioo Ft. I tS Ft. Linear Loading Rate= 6.3 GPD /LN FT j a Ft. Design Loading Rate= p.3 GPD /SQ FT K 10 Ft. L lzZ 3 Ft. �41tet°natz -r s;z t�-e# -0r�- e- �laa+� W - Z 1S Ft. L Force B K Main — A – - - - -- — -- – - W Distribution Trench Of 2 ? 2 Pipe Aggregate Observation Permanent,/ Pipe s (Anchor securely) Mound Using I Trench For Absorption Area Page Of i - Perforated Pipe Detail I 0 End View ) Perforated End Cop) b\e PVC Pipe Install permanent at end of each lateral Holes located On Bottom, Are Equally Spaced Q End Cop t PVC Force Main i Distnoution Pipe Losi Hole Should Be Next To End Cop I Distribution Pipe Layout l P 4 � Ft. X �`7 Inches Y 37 Inches Hole Diameter " Y Inch Lateral 1 Inch(es) Manifold Inches Force Main Z Inches # of e holes / i 1� P P Invert Elevation of Laterals Ft. 16 .-) Z, >4. 2._ 3 ) . V Glut - 4 Place 1st hole )8 11 1,from tee with succeeding holes at 37 intervals. Last hole to be next to the end cap. VAGIr PUMP CHAMBER CROSS SECTIOU AND SPECIFICA'rI0k1S VEAJT CAP 4`C.I. VENT PIPE WEATHERPROOF APPROVED LOCKIA JG > ? FROM DOOR, JUIJCTIOM BOX MANHOLE COVER — WINDOW OR FRESH IZ "MIU. AIR INTAKE { GRAD£ I `1" MIK1. l_ 18 "MIN. CO►JDUIT 18 "MIAI. — _ — __ -- -- f r7 IKILET !''\'° PROVIDE I -- R.Ec vT IR T I G HT SEAL I II - - -1- -. -� A `= JU'' i ST CROIX p COUNTY i :` I II \ F ZON NGOrRCE. ALARM c Oti JOINTS WITH I ELEV. FT. APPROVED PIPE - -� 3' ONTO PUMP "� OFF D SOLID SOIL COMCRETE BLOCK RISER EXIT PERMITTED OIJLH IF TAWK MAULIFACTURER HAS SUCH APPROVAL SEPTIC f SPECIFICATIONS DOSE TAWKS MAW UFACTURER- e--, T `QJ/.l� IJUMBER OF DOSES: PER DAy TAMK SIZE: /e2�d/.PUS % GALLOKIS DOSE VOLUME ALARM MAMUFACTURER: dtie/ iii , w IMCLUDIMG BACKFLOW: 1 4 , �G / ALLONS MODEL NUMBER: CAPACITIES: A= a20, y C juCHE5 OR ._Y �GALLOUS SWITCH TYPE: "/t' g = -� IUCHES OR y CALLOUS i / PUMP MAIJ UFACTUR>LR: /c.ciJ�S Z !Le IN CHES OR 1 �GALLOIJ 5 MODEL MUMBER: - 2, ?F-g ede D= - F IKICHES OR y? GALLOWS SWITCH TYPE: �� G NOTE: PUMP AMD ALARM ARE TO DE MIKIIMUM DISCHARGE RATE INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFEKEMCE BETWEEU PUMP OFF ARID DISTRIBUTION PIPE.. I- FEET + MIKIIMUM NETWORK SUPPLY PRESSURE " 2.5 FEET + _/_ FEET OF FORCE MAIM X _Z2-21 _ F /pOFLFRlG7{OU FACTOR. =5`�r FEET TOTAL DHMAMIC. HEAD = ��FEET I IMTERKIAL DIMEWStoMem OF TAIJK: LEKIGTH ;WIDTH ;LIQUID DEPTH Combination Septdc; Tank and PUMP CHAMBER CRO S E CT IOM ,ARID_ SPE PAGE S OF - VEIJT CAP WEATHER PROOF Ju1JCTION Box 4"C.Z. VENT PIPC APPROVED LOCKING 1O' FROM DOOR, MANHOLE COVER rvty I wARr.>' �aBEL. .hUDOW OR FRESH AIR WTAKE S: C010DU11 I ti y PIPC PROVIDE I — - -- IDLET AIRTIGHT SEAL I I 8 ra>r>=L�S I II I APPROVED JOINT A I III APPROVED JOIIJTS w C.T. PIPEaR I III W /C.I. PIPEI*P'c / Tank construction I II shall comply With I I ALARM ILHP ('33.15 and 33.20 I I i oD C I - 7°I.67 I CLEV. FT. PUMP � Off 0 COAICRE F — t 4.00 »LOCK 3" APPRovFD RISER EXIT PERMITTED ODL'J IF TADK MA IJUFACTURER HAS SUCH APPROVAL g 5PEGIFICAT10KIS SEPTIC 005E w1ESMz- UIQC3z � NUMBER OF DOSES 3. 69 PER DA4 '(AI.JK MAIJ UFACTUR CR: . TANK SIZE: Vow3 /DSO GALLOWS DOSE VOLUME r - , � e rT2 D - a � j S LU o S - INCDIM6 15ACK *LOW: �� �° '�' _ GAI.LNS ALARM MAUUFACTURER: MODEL wutABER: apt w CAPACITIES: A= ZS IMCHESOK yo 3 GALLOUs SWITCH TYPE: � L12 C UR I B = Z I►JCHES`OR 3Z '� G�LLOIJS PUMP MAUUFACTURER: C = 17 IMCHE5 OR GALLO MODEL DUMBER: .0 LVEOS � D INCHES OR GALLODS SWITCH TYPE: FZC'• 1�1 CU I y MOTE: PUMP AUD ALARM RE TO 5E��� M1IJIMUM DISGtiARGE RATE 3 ?•y INSTALLED ON 5EPARATE CIRCUITS _�._GPM VERTICAL DIFFERENCE 5ETW11N PUMP OFF AUD.D15TRIBUTIOW PIPE.. 18 FEET + MIDIMUM DETWORK SUPPLY PRESSURE .. 2.5';Zi F•CET �FT• 5' FEET O F FORCE MAID X Z'7 ooFLFRICTION FACTOR -. FEET TOTAL OtlUkMIL HEAD =_ ' FEET DIAMETER - Pump chamber Z " IUTEKUAL DIML1.1510kif OF TAUK: LEMGTH ;VA►IDTH ;LIQUID DEPTH BOTTOM AREA - 231_= GAL /INCH AS PRR MANUFACTURER - L3_ GAL / INCH � 4 Gouids Submersible 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 duty •Trailer courts ■Power Cable: Severe d • Power cord: 20 foot for slide rails stems. • Motels standard length (optional y rated, oil and water resistant. • Schools ■ Mechanical Seal: SILICON Epoxy seal on motor end • Hospitals lengths available). CARBIDE VS. SILICON provides secondary moisture Single phase: Industry •, , CARBIDE sealing faces. barrier in case of outer jacket • Effluent systems % and /2 HP —16/3 SJTO Stainless steel metal parts, damage and to prevent oil with 115 V or 230 V three prong plug. gUNA -N elastomers. wicking. SPECIFICATIONS • % -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: dlin ca ilitie : Three phase: design. Locknut on three and oil leakage. 1 <' maximum. 3 g p •'/2 -1'/2 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 U� 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 open, non -clog with pump - parts, BUNA -N elastomers. within the motor manufacturer's • Temperature: out vanes for mechanical seal recommended working limits, 104 °F (40°C) continuous Protection. Balanced for 140 °F (60 °C) intermittent, • Fasteners: 300 series rre�ERS FEET stainless steel. s0 ` -- — — -- - -�� -- —} -- -- SERIES: 3885 • Capable of running dry 25 80 �� ' ; RPM: VAR O without damage to V�E' I f— - -► }t -5GPM — components. zo , 5 F -r 20 - — Motor g fro i Single phase: • % HP, 115 V, 200 V, 230 V, 15- 50 60 Hz, 1750 RPM; %2 HP, Z 115 V, 60 Hz 3500 RPM; o 4q E % HP —1'% 4, 230V, - il 60 Hz, 3500 RPM. 0 10 30 • Built -in overload with wEO + I automatic reset. 5 i ! _ • Class B insulation. 10 Three phase: + 1 a • % HP —1'/ HP 200/230/ oL o i 460 V, 60 Hz, 3500 RPM. 0 10 20 30 40 '50 so zo 80 90 100 110 120 130GPU • Class B insulation. L 0 10 20 30 m" CAPACITY ®1995 Goulds Pumps, Inc. Effective May, 1995 83885 Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT P age \ of 7S Labor and Human Relations Division of Safety a 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 Clkz - `x 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. Z - l h q. Z - 4 p APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION DAT PROPERTY OWNER: U-1 NM S PROPERTY LOCATION S l ; 1 c ` 1 L W E L V S L - POW, tOf Sl� 1/4 N E 1/4,5 Z T ZS ,N,R L Z E (orCW) PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # l81 kt"itj1 Courzr \ — Cswl CITY, STATE ZIP CODE PHONE NUMBER []CITY OVILLAGE (MOWN NEAREST ROAD 5ZLu(2 Ems w1 Sg6ZZ. (7tS) 4ZS_ 6L3E5 `cc�t'j1'j tx,nj LC waek - N! -k?w D N New Construction Use W Residential / Number of bedrooms 1 4 [ ] Addition to existing building [ ] Replacement [ ] Public or commercial describe Code derived daily flow boe gpd Recommended design loading rate — bed, gpdffll ' 3 trench, 9pd/ft Absorption area required S a'Zs bed ft Suo trench, ft Maximum design loading rate ^ 4 bed, gpdfil S trench, gpol11 Recommended infiltration surface elevation(s) 0\-1 • S ft (as referred to site plan benchmark) Additional design / site considerations "Uvftj�, w f S'x- t p L)' - 7 .tF . m 1 AJ . 1 oV= S" R cs . Parent material ouCT2 S 1 'Z t tr` Rood plain elevation, if applicable tQ • 6 • ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U =Unsuitable fors stem ❑ S QU ®S ❑ U El S LRU ❑ S ®U ❑ S [RU ❑ S .IK[U SOIL DESCRIPTION REPORT Texture Boring # Horizon Depth Dominant Color Mottles Structure Consistence Botrxiary Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Mench )p er 0,1 10 `'11z � S11 Z S�`FI� aS - .S .� Ground 3 Z9 -ttD - 1 S I�- Y� f; S H R S�� s� T�� �� �'A — elev. ° • � ft. Depth to limiting factor Remarks: Boring # 1 -q �u �` viz s it Zbk� 0.S Z Z 9 - S 1 b H f2 31 S L Z'F5�1t Wl i L - S . S 3 ZS 1•S`f2Y/ �� =s�1tZ s�8 sl T� c�M Ground elev. / Depth ° 1 ft. J to N' limiting 197 — factor ZS" � Remarks: J TName: Please Print Arthur L. We erer Pace 715 - 425 - 016 eggerer Soi Testing & Design Service -P.O. Box 74 River Fa11s,WI 54022 Signature: �3 � � - t Z � Date: S ; � .� CST Num 0 0 5 7 6 C�= PROPERTY CWW 4ER dZL\- SL\ SOIL DESCRIPTION REPORT Page Z of 3 PARCEL I.D, # 0 - 7- - L— L 0 'CL — 1 4 0 ' Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bar iary Roots GPD /ft in. Munsell Chu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3 s i t Z s �k W, Ground 3 fLl 21 �koM 4 ly — s I 3 S�� `��. S — • s elev. `r ° °eft. L4 2 -37 - �.S -1 Orly n. SyR S Jg Sl -Tw�. I = Depth to limiting factor i Remarks: Boring # I Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(R.05/92) • PLOT PLAN Pa of SCALE 1 "= Ft� � 4 d 0 _ ,2 tj © @o \ZING � d I I" tt AO _1 I ' v � I _j I I S�1 I I I I ® UtvS uRl}B�� B.z � L QL lao�w� � I I I ice- Do u T e oti-� p k e T U�Z I � 1s~►��� `�1t13 t'CRE`'�1 I I � I - Zs - --I - � 6 u F'1 OF `f �gveK lact)v g To W _ Wr PVT 2-s" l=-;?-U>'1 " tuwb Sc►v`f>}_ _k_WZ OF WT- Va QI�F A'r LL4'?rST m OU ivQ . ( 715 ) 42S -0165 1:400 CST Signature Date Signed Telephone No. CST # Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page % of _�s Labor and Human Relations Division of safety s Buildings in accord with IL.HR 83.05, Wi Adm. Code COUNTY Attach complete site plan on paper not less than S 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. OZZ _ L Oct Z, - Y 0 APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION 7I/A Y ` PROPERTY OWNER: G �T CcA�.D wt t l l rrwt S PROPERTY LOCATION 3v`'l �1 �c�t L Q �� �S L - ►fitOfi Sir 1/4 N ZS ,NR 1 j E (or W� PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # l8 h tr.sN1 Cwu:r \ I — asm CITY, STATE ZIP CODE PHONE NUMBER OCITY []VILLAGE (MOWN NEAREST ROAD SZtv�Z 1 J.5 wl S�EUZZ (NISI 4ZS- 6�4$ �cTlvt��C�t/`►N LC° L�A�Z'N New Construction Use Residential / Dumber of bedrooms Y [ ] AddiQn to existing building [ j Replacement (] Public or comme rcial describe Code derived daily flow bob gpd Recommended design loading rate — bed, gpd/ft ' 3 trench, gpolft Absorption area required 5 ao bed, ft S loo trench, ft Maximum design loading rate • L ) bed, gpd/ft ' S trench, WW Recommended 'infiltration surface elevations) 0 n • S ft (as referred to site plan benchmark) Additional design/ site considerations "� w/ S 'x- t b (3 T �t} . v"t l &U . 1 I o}=" S R" 1� R L-L . Parent material Flood plain elevation, if applicable TU - R • ft S _ Suitable for ten [is U OMONAL MOD IN- GROUND PRESSURE AT GRADE SYSTEM IN F L1 HOLDWG TANK U = Unsuitable for � ® S ❑ U [Is S (R 1 ❑ S ® U ❑ S IqU ❑ S 13jU SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon in Munsell flu. Sz. Cont. Color Texture Gr. Sz. Sh. Roots Bed ntdt "� � o _1 �o `�►�- 3 t1 — s 1 Z. Sb wt �>^ a- g - • S . � z -Zq s Lt tL - 1 eS� �,� � � - -� . S Ground 3 Z9 -qO - l.S L! IZ 5(I' f,S X12 Sf� s� ��� 0� m �'►-. — — — elev, o e ft Depth to limiting factor ZgI Remarks: Boring # C LS 11 o t Z Z 9 -ZS fib` -tSZ 3 l` — S L� Z�S�1t h'1 Tt- � — • S . �' 3 zs �•s�f2�/ Ground S'1rZ s/a elev. ° •l IL Depth to limiting factor z. S" Remarks CS T Name: —lease Print Phone: Arthur L. We erer 715 -425 -0165 egerer Soi Testing & Design Service -P.O. Box 74 River Fa11s,WI 54022 Signature: Date: CST Number: M00 5 76 PROPERTY OWNER %qU1 S L L. SOIL DESCRIPTION REPORT Page bf 3 PARCEL I.D. # 0 Z.Z -1 0 ' — 110 Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench 3 o-?--, 9 �1� si1 - Z,- b W%ii S - .5 .1, L $ -1Y ",,q , e S _ ' .1 Ground 3 �! 2� ti�� R u ly • s elev. S 4 R S 1 g g ��� v ►-►� Yn '�� — — — Depth to limiting factor N { i Remarks: Boring # 13 Ground elev. ft Depth to limiting factor Remarks: Boring # i i i Ground elev. ft. Depth to limiting i factor i Remarks: Boring # i 13 Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(R.05/92) of PLOT PLAN Pa I SCALE I"= r pp Y � ' o ® @ wivi Aj C. v i fl 3 /y�` DAR . RUC PLC W"M rb ( M � I J � I I I i ® v N S y'ST1'r�L� I I i LSZU�20 - Tin g "J t1 I I � I - is - - - � stl 2 Ib , �caM - owes �1. °t7 -5" @off► t of ��,e.� 1�rUll�k', .�TO 13L 'R'[[':- ��►�' .Z S � t =�U)"1 . ►";i �V�D .__ _ _ _ _- - -- - -- - Soli f?} _l lk1E U� E-*&TLQNw3SQD WT Tb Q Per L 4, kYT -- 1 zv — M 00576 715 4 -5 n� �s CST Signature Date Signed Telephone No. CST # I ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Lie— f Mailing Address / Lf 7 1�� ✓� /! c Cf Property Address z z . `6 ek±zz /P�/ (Verification required from Planning Department for new construction) C City /State /C " U?4 4ia� s Parcel Identification Number LEGAL DESCRIPTION S r r 3 2 Z _ tj Property Location E /,, � /4, Sec. , T � N R rtJ W, Town of 1(��N 1 C1 ,4.+ :G Subdivision GS M Z 3� Lot # Certified Survey Map # ft / , Volume Z Page # 32 g Warranty Deed # , Volume 1 , Page # 5 Spec house ❑ yes X no Lot lines identifiable K yes ❑ no SYSTEM 1♦L4EV17ENANCE 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 f the three ear Te2 n date. /� / JJ7 SI U� OF APPLICANT DATE OWNER CEATWICATION 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 pr perry described above, bD virtue of a warranty deed recorded in Register of Deeds Office. S(7 1; SIGN 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 i� VOL 1-260 S j G45W WARRANTY OEM Document Number: REGISTER'$ OFFICE ST. CROIX CO,, WI Res'd for Rscgrtl AUG 2 9 1997 Return Address: Kyle and Trisha Belisle 9:30 A M s 187 Kinni Court ` River Falls, WI 54022 Ro ter of Deed. i Pmcel I.D. Number (PIN): r S • y This Deed, made between Gerald A. Williams and C— -1 Williams, Grantors, and Kyle Belisle and Trisha Belisle, husband and wife as survivorship marital ,property, Grantees. Witnesseth, That the said Grantors, for a valuable consideration, conveys to Grantees the following described real estate in St Croix County, State of Wisconsin: LOT ONE (1) OF CERTIFIED SURVEY MAP IN VO+_UME TWELVE (12) OF CERTIFIED SURVEY MAPS, PAGE 3291, AS DOCUMENT NUMBER 561772, FILED IN ST. CROIX COUNTY REGISTER OF DEEDS OFFICE ON JULY 1, 1997, BEING LOCATED IN THE SOUTHEAST QUARTER OF THE NORTHEAST QUARTER (SE 1/4 OF NE 1/4) OF SECTION THIRTY TWO (32), TOWNSHIP TWENTY EIGHT (28) NORTH, RANGE EIGHTEEN (18) + WEST, TOWN OF KINNICKINNIC. This is not homestead property. Together with all and singular the hereditaments and appurtenances thereunto belonging: E And Gerald A. Williams and Carol Williams warrant that the title is good, indefeasible in fee simple and free and c: •ar of encumbrances except easements and restrict+ons of record and will warrant and defend the same. Dated this day of August, 1997. T %SFFR Gerald A. Williams Carol Wilhan'ts ACKNOWL E EDGW WT s' STATE OF WISCONSIN )33. ST. CROIX COUNTY ) Personally came before me this day of A xjuesa, 1997, the above named Gerald A. Williams and Carol Williams, to me known to be the persons who execu f trument and acknowledge the same. N St. Croix isconsin THIS INSTRUMENT DRAFTED BY: MY u nn S sa a M. Glasser - Bye, Goff & Rohde, Ltd. PO Box 167 River Falls, WI 54022 *'6 t � 9� 1 FILED 1� JUL 0 1 1997 ► g KATHLEEN H. WALSH SLC mi ► 561772 � w C ER T -T E I ED SURVEY MAP Located in the Southeast quarter of the Northeast quarter of Section 32, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin. Owner: Gerald & Carol Williams Purchaser: Kyle Belisle 1056 E. Cty Tk M 187 Kinni Ct River Falls, Wi 54022 River Falls, Wi. 54022 • denotes 1 "X24" iron pipe weighing 1.68 pounds per lin. N89 °56'11 "E 2637.08' foot set. N1/4 Corner 1318.54' NE Corner Section 32 Section 32 (County Surveyor's N M (1" iron pipe found) monument) � ° o � UNPLATTED LANDS N 89'47'40 "E 416.87' 32.5 384. 37' C): QI o' z I (L ®T 1 Q -li 6 6' 217, 800 square feet pp I (5.000 acres) co (n, Bearings referenced I 'q including right -of -Way: o, to the North line of C\j v 200, 794 square feet N Q� the Northeast I N (cv W; (4.610 acres) N J quarter of Section 32 U-) CU J excluding right -of -way. � assumed to be W w 3 N89 1 "E. I n Im N U) N . I° W: • Q)` O O O Z O �I Oi Z I ?' W` W' O: I Q i m: JI 0- �� O: ZI '97 1 32.5 384.28' ,,, d�� S 89'47'40 "W 416.87' UNPLATTED LANDS_ `, ,rg1ltNNy��� i . - 01V Vo be • i /oo' '`'fir G HARVEY • � G. � JOHNSON o ioo Zoo soo M 8 -1899 • HUDSON 0 0 Wf This instrument drafted by. i � 4972566 Vol. 12 Page 3291 �' '� - °• D-De �`gr 'Bi I I f ka ��'�s.�- - �_ - 15 48 !� � � r � � _> - r 7 O V s i p I I u f( ff b M III X8 AI ( ~ ll TI _ I fs 11 tl r -� I�I f r ca? I �I { Iv N 8 I II� I f I � i - F J ✓'a9"Ya 4 . s . 'S Net � I � N I� N L4i a I !� o II ,: ! [I! zi itfl it N 07 lu I NT I {t o Iw Xn I { I I nil N a oZ I — 1 qua ► °)illll l_1_J �k s H I " II ({ CI Ill v �lUl I li t , x� it I m II I fl N0 0 � T p !I { �o i I 1 8 -0 % 7 -0 O.H. 9 -0 % 7 -0 O.H. ►Im � � i