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HomeMy WebLinkAbout024-1043-80-000 ST. CROIX COUNTY ZONING DEP R AS BUILT SANITARY RE PRT'' , Owner Jtxc -nA4 Address City/State f'L -� �., U.� L - <,y >,- .: ���, ?�, ok Legal Description: Lot Block Subdivision/CSM #�. '/. *F '/, S E , Sec. 3 3, T Z N -R jW, Town of P I c tS~ ✓ -9il r PIN # J ' SEPTIC TANK — DOSE CHAMBER — HOLDING TANK INFORMATION: Tank manufacturer 6vac Size ST/PC /2D / dor Setback from: House Well P/L Pump manufacturer 2nellts Ca Model 9g Alarm location �-- �z % 92�tiLa, �� (HOLDING TANKS ONLY) i Setbacks: Service road Vent to fresh air intak Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: M001) A SYS, Width 5 f Length 76 Number of Trenches Setback from: House ? 80 , Well >S0 'P/L >60 , Vent to fresh air intake 35 ELEVATIONS Description of benchmark l /' /y" Z p/C p, Pe- Elevation 10 d Description of alternate benchmark Q ✓,- � o C SWp ,' c ' n K Elevation/ Building Sewer 6 I ST/HT Inlet � S ST Outlet- d� PC Inlet PC Bottom / Header/Manifold L of ST/PC Manhole Cover Distribution Lines ) /��' 6 () ( ) Bottom of System( ) / aZ Final Grade ( ) / 0 ( ) ( ) Date of installation / �I er it n ber� l J / State plan number � G Plumber's signature _ icense number �'� Date / �7� Inspector / � C (bmplctc plot plan W S 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. PLANT NUW G-el� e c � � 3� INDICATE NORTH ARROW WiscdMin Department of Commerce PRIVATE SEWAGE SYSTEM v: Safety and Buildings Division Count CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) SanitaryPeMY: Personal information you provice may be used for secondary purposes [Privacy , s.15.04 (1)(m)]. Permit BUGUHN TROY -PL�SNT Vo Town of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM Description: V Y Parcel &� i - :1043- 80-000 t o co I I I 1P I TANK INFORMATION ELEVATION DATA A9800201 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. eptic 000 Benchmark 61 , E . ( /Z 1�6.,Z / sln Co cc.: 13 fA loch Aeration Bldg. Sewer ,�j • 8- Holding (20 Inlet /01,r_ TANK SETBACK INFORMATION C2 Outlet TANKTO P/L WELL jBLDG. Ventto ROAD Dt Inlet Air Intake ( �- a ., NA Dt Bottom . 12,_ Dos' " t 5g NA Header / Man. a. (,a b b , 5. Aeration NA Dist. Pipe 2.S'a- `p Holding Bot. System Z 10a Holding PUMP/ SIPHON INFORMATION ( Final Grade Manufacturer a Demand 7, +. 2. 1 • p Model Number 'I -7 TDH Li ft� Lriction A System s TDHB.ZFt oss Forcemain Length SS Di H �.`� Dist. To Well SOIL ABSORPTION SYSTEM BED R . Width i Length i No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIM N S DIMENSION SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Ma acturer: INFORMATION Type of -7 0, CH M T R Moe , er. System DISTRIBUT SYSTEM Header / Magaifolcl Distribution Pipe(s) r n x Hole Size x Hole Spacing Vent To Air Intake Length 1 Dia. Length s ' Dia. Spacing 11 q SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over to Depth Over xx Depth Of r C xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil IZ es ❑ No . ? ��es ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) s2 7 , / 2 ��, /�,p,g 5 /y G S z-, h 0 - Z T> LOCATION: PLEASANT VALLEY 33.28.17.285A,NE,SE 1793 COUNTY ROAD M -- I,) U4-ee .S Sur c� l l d, Wi /( •1 jil �stt �lC l L -C/7T, 3 m - uv_& Plan revi ittin'�bgq ik+ $ No Yes Tabi Use other side for additional infor n. SBD -6710 (R.3/97) Date Inspector's Analure Cert. No. . . ra r. Safety and f Building Water Systems Division v��i�Inrlt SANITARY PERMIT APPLICATION Bureau o 2 01 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County Sr than 8 112 x 11 inches in size. ( A/ • 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 ❑ Check if reels o� 5 tto previiou3pplication (Privacy Law, s. 15.04 (1) (m)]- State Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION a 7 1 Pro7cty� wrier Name / P perty Loketion ILW a 4 1/4 srt /4, S T �� N, R/ E (or) Property Owner's? ailing AddresV_ t t Lot Number / Block Number 1 Al City, tate Zip Code Phone Number Subdivision Name or CSM Number �a ff 4"/1 d.k) ic I < — Aje ! ( )/s Y- 041,3S? C S4 -- �p 7 9 II. TYPE OF BUILDING: (check one) ❑ State Owned E] qty %oL Nearest Road E] Vil age �r�*s -7 ❑ Public R 1 or 2 Family Dwelling - No. of bedrooms - own OF 4 e Ill. BUILDING USE: (If building type is p ch all that ap ly) Parcel Tax Number(s) Apartment/ artment /Condo 3`7 /� A8. "IA8,6A •© -7 be J " �° 4 / 3 ❑ P 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 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 210Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (s ) (Gals/day /sq. ft.) (Min. /inch) � Elevation �_ , 2 �e�.5 Feet t/O�_t<? Feet Capacit VII. I NFORMATION in gallo Total # of Manufacturer's Prefab. Con- steel Fiber- Plastic Exper. facturer's Name Gallons Tanks Concrete glass App. New Existing strutted Tanks Tanks 4C Uc Ta 9 O "es -r/o 1719. ❑ ❑ ❑ ❑ ❑ ft P ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumberis Name: (Print) Plumber's igna ure: Stamps MP /MPRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Cod 11 i1 IX. COUNTY / DEPARTMENT USE ONLY ❑Disapproved Sanitary Permit Fee (includes Groundwater L te Issued Issuin Agent Signature (No Stamps) pp A roved N ¢� Surcharge Fee) ❑ Owner Given Initial d'tJV 1 - / Adverse Determination f X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: �ios/a1 � t�•�a� ®lr�n 76: J� -F� 4w� I, n"�Fr� SLID -6398 (R. 05/94) DISTRIBUTION: Original to County, One copy To: Safety & Ruildings Divr i n, Owner, Plumber Safety and Buildings 2226 ROSE ST LA CROSSE WI 54603 -1905 Isconsin Tommy G. Thompson, Governor Depa r t ment of Commerce William J. McCoshen, Secretary April 02, 1998 CUST ID No.267341 POWTSINSPECTOR WEGERER SOIL TESTING & DESIGN 421 N MAIN ST-- !` 1 PO BOX 74 tr ctrl RIVER FALLS WI 54022 RE: CONDITIONAL APPROVAL Transaction ID No. 71223 ' APPROVAL EXPIRES: 04/02/2000 SITE: Site ID: 4870 ST CROIX County, Town of PLEASANT VALLEY NEI /4, SEI /4, S33, T28N, R17W Lot: 1, Subdivision: (proposed CSM) TROY BAGUHN FOR: Description: MOUND Object Type: POWT System Regulated Object ID No.: 11524 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes listed in the regarding line above. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. 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. When making an inquiry or submitting additional information, please refer to Transaction ID No. in the regarding line. Sincerely, f DATE RECEIVED 03/30/1998 FEE REQUIRED $ 180.00 DENNIS R §ORENSON , WASTEWATER SPECIALIST FEE RECEIVED $ 180.00 Field Operations REFUND DUE S .00 (608)785-9336, MONDAYS 7 :00AM- 3:45PM DSORENSON @COMMERCE. STATE. WI.US • Safety and Buildings 2226 ROSE ST /� LA CROSSE WI 54603 -1905 I sco I /' � SI / I Tommy G. Thompson, Governor Department of Commerce William J. McCoshen, Secretary April 02, 1998 CUST ID No.267341 A7TN.• POWYS INSPECTOR WEGERER SOIL TESTING & DESIGN 421 N MAIN ST PO BOX 74 RIVER FALLS WI 54022 RE: CONDITIONAL APPROVAL Transaction ID No. 71223 APPROVAL EXPIRES: 04/02/2000 SITE: Site ID: 4870 ST CROIX County, Town of PLEASANT VALLEY NEIA, SE1 /4, S33, T28N, R17W Lot: 1, Subdivision: (proposed CSM) TROY BAGUHN FOR: Description: MOUND Object Type: POWT System Regulated Object ID No.: 11524 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes listed in the regarding line above. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. 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. When making an inquiry or submitting additional information, please refer to Transaction ID No. in the regarding line. (Sincerely, ' DATE RECEIVED 03/30/1998 REQUIRED UIRED $ 180.00 Q DENNIS R SO RENSON WASTEWATER SPECIALIST FEE RECEIVED $ 180.00 Field Operations REFUND DUE S .00 (608)785-9336, MONDAYS 7:00AM- 3:45PM DSORENSON @COMMERCE. STATE. WI.US Page of b MOUND SYSTEM FOR A 3 BEDROOM RESIDENCE LOCATED IN THE 1/4 OF THE 5E 1/4 OF SECTION 33 ,T Z-$ N, R I1 W, TOWN OF pL -_"W11 T - 4 COUNTY, WISCONSIN. INDEX REC EDED PAGE 1 'of 6 TITLE SHEET MAR 3 Q 1998 PAGE 2 of 6 PLOT PLAN SAFETY g BLOGS. PAGE 3 of 6 PLAN VIEW -CROSS SECTION: DIV. PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUMPING CHAMBER PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR TCLO�( R S'prtrun,,A B�Gvt�tN `_ 1` o BEIZTS , wl 5 � oz.3 PREPARED BY LJEGERER SQ I L . TEST I NG N`t!4!0 AND. � DESIGN SEFZ�1 I CE jr .� C® ARTHUR L. F.O. B01 7 4 421 R. KAIN ST. a '. RIV9.. FALLS. VI 54022 wErERER Z S D P 715 -4 --0105 E " Wis. r " � .... SIC ,o �� • � MIME � JOB NO. 96- PLOT PLAN Page Z of 6. Scale 1 "= 4 0' ,v1 O.l O.w. LIN _ ti T PLrlL7�f UIut Q I 02 y d► 3 . 3 WL L .S i U To L� p1'gpp�AUhIL''D ^ � �` j B Z �• o � dub 1 LLLOS L'aUC F•M. / so 0 P KW • yz. � � ° i RxP uk� ►t.► Fv1vRS2' / o o 1�?1 �C1R (( \l N'11�1a ll lC 9h NF I � AML - - L Q tLm nor PQcP• UNr` s `1s`I'L'rit s�z.+�t, wR 3 QOWy , PRIVATE SEWAGE SYSTEM Conditionally , ;a,m 't - l=1, 31y` K 7 x1' �° �o" DtA• `"oU� �'�vcF PosT. (VISION OF SAFETTIND BUILDINGS ►XuTE' ; W �'1JL TO B E 'PYT LUST S o ' P►z awt wt �v t'1zU" TrKkLs. SEE CORRESPONDENCE NOTES -1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. ( 2 required) 3. Install 4" observation pipes with approved caps. ( Z required) 4. tank to be woo Iboo gallon capacity manufactured by tiJ � �s � ' C�h1 e.R,� t�tZao u �-7 - S • W � 1� �-T- l 600 5. Bench Marks SSE MauL- 6. Divert surface water around system to prevent .ponding at the uphill side. i Page 3 'Of b Approved Synthetic Covering rysTM c 33 Distribution Pipe Medium Sand _l` H - � Topsoil F Elev. 1 b3 • S _-1 o - 3 E - b - 7 % Slope • ( Force Main Plowed - Trench of k"-2-2" From Pump Layer Aggregate Undisturbed D Z. Ft. Soil E Z -3S Ft. Cross Section Of A Mound System Using F b Ft. I Trench For The Absorption Area G 1. a Ft. A S Ft. H I. S Ft. B - 75 Ft. I \b Ft. Linear Loading Rate= �,.o GPD /LN FT d 10 Ft. Design Loading Rate =o.Za GPD /SQ FT K �_ Ft. L X03 Ft. ;4 Position of Force Main -----_.__ W I_ Ft. L =8 K iMain W Distribution Trench Of 2 - 2 '2 Pipe Aggregate I Permanent- Observation Markers Pipes . (Anchor securely) STEM Conditionally A P R0 Mound Using I Trench Fa( Abso i SQfETY�NC BUILDINGS SEE CORRESPONDENCE Page Y Of Perforated Pipe Detail t e End View Perforated End Cop. �``� PVC Pipe 1 _ " ic e Install permanent at end of each lateral Holes Located On Bottom, Are EquoUy Spaced Q End Cap PRIVATE SEWAGE SYSTEM e Conditionally * � PVC Force Main 4 APPROVED Distribution DIVISION OF SAFETY aND BUILDINGS 1 Pipe 1 � Lost Hole Should Be Next To End Cap SEE CORRESPONDENCE Distribution Pipe Layout P 34 Ft. X 3J, Inches Y 3 b Inches Hole Diameter ' Inch Lateral 1 ��y Inch(es) Manifold — Inches Force Main Z Inches # of holes /pipe �Z Invert Elevation of Laterals % Ft. Place 1st hole L8" from tee with succeeding holes at 36" intervals. Last hole to be next to the end cap. Combination Septac; Tank and PUMP CHAMBER CROSS SECTIOM. AAJD -SPECIFICATIONS' PAGE 5 OF 6 - VCWT CAP WEATHER PIIOOF JUIJCTIOIJ 60X ti C.I. VEAIT PIPC APPROVED LOCKIIJG 10' FROM DOOR. MANHOLE COVER OJIV .rIAIDOW OR FRESH wAELI.JIWG Ll4gEC.. caauul T A�IUTE ( 4' (. .N r MIN. 18 "KIN. 11 , y "lus�ca� PIPt PROVIDE I - -- IAILE T " AIRTIGHT SEAL I I I APPROVED JOIIJT A I I ' APPROVED JOI PIPEaRPuc w /C.2. PIPEaR Tank construction A shall comply with "I I A ILHR 7;3.15 and 83.20 I CLEV ay.83 FT -- PU MP --�— D COUCFRETE N OF �7. , I q O o pLoc S ON��NG'G R — 1 3" LL EOO I � R ISER EXIT PERM ITrED OIJLti IF TAW MA NUFACTURER AS SUCH APPROVAL I3 EDD:Nra SEPTIC E SPECIFICATIOL]S W L P �T -�bou DOSE I y��s eo 2T� 3 4 9 T�.1JK MAlJUFACTURCR: IJUMISER OF DOSES: PE.R DAy TAWK SIZE: 1Ox-l:� 6nO GAL-LOWS DOSE VOLUME I ALARM MAIJUFACTURGR: S,S, QIZT -gyp 3`f611& IMLLUDIAI6 5ACKFLOW GM. LOWS MODEL WUMBER: 1 0� �W CAPACITIES: A= �$ IUCHESOK 30 1 " 3 GALLOy5 SWITCH TyPC: IUCHES`OR GrLLOLIS PUMP MANUFACTURER: IUCHES OR GALLOIJS MODEL NUMBER: D IMCKSOR GALLOUS V�'1 LVLCCJ�L 1 r 6 Z.b SWITCH TYPE: Y NOT£: PUMP AND ALARM ARE TO 6E MIIJIMUM DISCHARGE RATE GPM INSTALLED Oki SEPARATE CIRCUITS VERTICAL DIFFERENCE DETWCEU PUMP Off AUO.DISTRIBUTION PIPE.. 3"D FEET + MIIJIMUM METWORK SUPPLY PRESSURE . .. . , 2 5 O FLET + �O FEET OF FORCE MAIN X !' F YOFCFRICTIOLS FACTOR -- • FEET TOTAL OyIJAMIC HEAD FLET Pump chamber DIAMETER - -2110 INTERWAL DIMEWSIOIJ� OF TAIJK: LEAIGTH ;WIDTH --= -;LIQUID DEPTH BOTTOM AREA 231= GAL /INCH AS PER MANUFACTURER = 1 b -'�� GAL /INCA HEAD CAPACITY CURVE 3 7/$ 6 1 / P+tG( b or- 6 MODEL "98" 4 5/8 ►{ 8 r Q I 3 5/8 = 6 0) + 0 15 4 4 3/16 L2.15 10 2 5 1 1/2 -11 1/2 NPT 0 r. s U.S. GALLONS 10 20 30 40 50 60 1 70 80 j ? LITERS I 80 160 240 0 FLOW PER MINUTE i TOTAL DYNAMIC HEADIFLO W PER MINUTE EFFLUENTANDOEWATERING CAPACITY 12 HEAD UMTSIMIN FEET METERS GALS LTRS 5 1.52 72 273 10 3.05 61 231 15 4.57 45 170 4 3/16 20 6.10 1 25 95 Lack Valve 23' SKI 102 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and • Variable level float switches are available for controlling single supplied with an alarm. and three phase systems. • Mechanical alternators, for duplex systems, are available with • Double piggyback variable level float switches are available or without alarm switches. for variable level long cycle controls. SELECTION GUIDE Standard all models - Wei ht 39 lbs. - Y: H.P. 1. Integral float operated 2 pole mechanical switch, no external control required. 2. float Sing switch. p ttt F a O float switch or double piggyback variable level, 98 Series Control Selection Model Volts -Ph Mode Amps Simplex Duplex 3. Mechanical alternator 10.0072 or 10-0075. M98 115 1 jAulo to 9.4 1 or 1 & 7 — 4. See FM0712, fa correct model of Electrical Alternator, E -Pak. N98 115 1 n 9.4 2 or 2 & 6 3 or 4 & 5 5. Control switch 10-0225 used as a control activator, specify duplex (3) or (4) D98 230 1 4.7 1 or 1 & 7 — float mom. 6. Four (4) hole J-Pak, junction box, for watertight connection or wired -in E98 230 1 n 4.7 2 or 2 & 6 3 or 4 & 5 simplex or duplex operation, 10-0002. 7. Two (2) hole J-Pak. for watertight connection or splice. CAUTION Forirdomtatmonaddit nalZodWpmductsrefertocat WonComlxrobonStader ,FM0514;Piggybadc All installation of controls, protection devices and wiring should be done by a qualified Variab1elevelSwi1ches, FM0477; EkbicalAllemator, FMO486;Mecim=lAlterrwlor,FM0495 ;Sump) licensed electrician. All electrical and safety codes should be followed including the most Sewage Basins, FM0487; and Single Phase Simplex Pump ConhdlAlwm Systems, FMO732 recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. .. 11 E TO. P.0 BOK 16347 Louimllfe, KY 4MM -0347 I SW P 710: 3649 CamRm Road Yaralaaraars d.. Louiswlte, 1961 PUMP ! M 773MI- 1(8n9Y9~ FAx(5M 774,VX i Wwonsin Department oflndusuy, SOIL AND SITE EVALUATION REPORT Page 1 of S Labor and Human Relations n of safety & Buildings in accord with ILHR 83.05, Wis Adm. Code COUNTY _ Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BR, direcctioon:and % of slope, scale or PARCEL I D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION= PLEASE PRINT ALL INFORMATION R�MEWED BY DATE PROPERTY OWNER: VJZ$eZt 4 S *!►'t2.ttta > g PROPERTY LOCATION $ Pcr�y1. $ pt 6 V -GOW -LOT• K.� IM S L'' 1/4,S 3 3 T Za ,N,R 0 E (o&W PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK #f SUBD. NAME OR CSM # Z Ipf, ST. 1 i?V_Qpase3c� 0 CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE &)TOWN NEAREST ROAD RoBTS IN s4 oZ. 3 q4 - go_1 9 �L t'v�T VRL Govry ' I „ l y [ ] New Construction Use [xj Residential / Number of bedrooms 3 [ ) AddQn to existing building �4 Replacement [ ] Public or commercial describe Code derived daily flow \ASZ gpd Recommended design loading rate - bed, gpd& o•z9 trertdt, gpddt Absorption area required 3 _ bed, ft2 3ZS trench, ft Maximum design loading rate • 1 4 bed, 9polft • S trench, gpolft Recommended infiltration surface elevation(s) X03• S ft (as referred to site plan benchriwl ) Additional design /site considerations woo v w/ 5 'x=1 S �-` �->uef MI #u# I4 Z LI ° C3F S'AO_A Fi cL . Parent material l.o S S oy t Tt C Flood plain elevation, if applicable 'N. A. It S = Suitable for system CoM►ENT1oNAt MOUND IN GROtAVD PRESSURE AT GRADE SYSTEM W FILL HOLDING TAW U= Unsuitable for stem [I S 0 U ®S ❑ U ❑ S ®U [I Pa U ❑ S ®U [IS O U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color KWM Texture Structure Boundary Roots GPD /ft in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. Bed IT iench 9 Viq �j_ a,'3 1 -S Z 6 -f8 tb�2 3t st cl Z'F� m`�- � lv� -4 .S Ground 10 `1 R. S 12 C -S �1 2S , /8 C\ C� Y►t'�t N� ' elev. I OS, 0 f Depth to limiting factor t�h Remarks: Boring# w s ) Y4 fl. cS t )� y .S � 16 -�0 1o`LR -s12 c �.S `its S 7 $ C� Cam► FY)'�,- � NP .2 Ground elev. .ft. G Depth to -A limiting v � /I r. bcw C Y Remarks: CST Cp Rork ., Name- PlaasePmt Arthur L. We erer 715-4 Y-')n 65 egerer Soil Testing & Design Service —P.O. Box 74 River Falls, 4 $`� I sonkm 0447 Date: Zy $ M00 5 7 6 Wisconsin Department of- Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 =Safe Human Relations pprLSion of Safety & Buikings In accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2'k 11 inches in size. Plan must include, 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 ne � .1N 6 APPLICANT INFORMATION— PLEASE PRINT `4 ATOM R DAY ATE PROPERTY OWNER: 'iW$e�LT 4 S t'C'R'R a rya' , . F9OPF,9TY LOCATION �vvtSRS' �ZO�'($ f cT� \'N $ GU1� IV `� GA1� -L$1; ► 3� 1/4 S L'' 1/4,S 35 T Z% ,N,R I E 0@ PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # lDA ST. t�2�►POse� ( CITY, STATE ZIP CODE ! PI QNE NUM86RCRax ❑CITY ILLAGE ®TOWN NEAREST ROAD [ J New Construction Use N Residential / Nu 4bedr.Qoms. AdcrWgn to existing building (� Replacement (J Public or commeraa } Code derived daily flow Q \Slr_*� gpd Recommended design loading rate bed, gpdfit 0• trench, gpolft Absorption area required 3 bed, ft 21-15 trench, ft Maximum design loading rate '[ bed, gpd/ft • S trench, gpd/ft Recommended infiltration surface elevatiai(s) _ _ 103• S ft (as referred to site plan benchmark) Additional design/ site considerations �N10 v1W w/ 5 'x 1 S Wit{ . M !vl " UM 2.y ° 0E Sf1 Fi L- - . Parent material Lo eS s o v ert C I Rood plain elevation, if applicable 'N • A - It $ = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ❑ S (� U OS ❑ U CIS ®U ❑ S ffl U ❑ S ® U ❑ S ® U SOIL DESCRIPTION REPORT�a' Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boun Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tmnch [3 Z 6 — lb`(2 3! Iv S1C� Z`�S 1C w.�1^ � �V� �4 •S Ground 3 1$ 10 `1 f2. S t Z e - 1 L-/ 25 '/8 C Owl elev. 1 S. 0 ft. Depth to limiting factor Remarks: Boring# C" 1 Z z 846_ 10�! ►Z 3l6 _ sic l Z`Fs >n cs -Is 1W SIz c-i.S `'LR SIB CI C�Vk n 11 Ground elev. �. ss tt Depth to Smiting factor Remarks: CS T Name:— PleasePreit Arthur L. We erer P hone: 715- 425 -0165 Add ress: Soil Testing & Design Service —P.O. Box 74 River Fa11s,WI 54022' Signature: , �! �8 —33 Date: ` Z 9 ,- ` j � CST Numb 0 0 5 7 ti y� 1 �' s +� PROPEMYOW R �'P�GU�1 ►J SOIL DESCRIPTION REPORT Page Z- �- PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 10L1 R Liz -- 5 L :3b Z Z- IZ 1O`Z IZ 3/6 S) e-1 Z�'S�h '�1- �S ��� - •S Ground 3 r 2 . - - L b 1 r N IZ 31G c ` L.'s j 13 S 1 eA v - 6- — tvn • 2 elev. �3-Y ft. Depth to ` limiting factor Remarks: Boring # 13 1 3 I i Ground elev. ft. i Depth to ' limiting I factor ' Remarks: Boring # [31 1 i Ground elev. ft. Depth to limiting factor Remarks: Boring # i i Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(R.05/92) PLOT PLAN Page 3 of 3 v - SCALE 1 "= 1 40 ' o.LS mi lU �•0•w. LINK 7 L n 3aoti''s-owt o� TTY �!I QL Lp3. S \ CL 0 A S .7 2s i P%uwt 1ELLOs / i �W SST ( ro i o a -3 zs / gwi+4 Z - .EL °1 y 0 \ ��I n � ti�pdoP• Un�N DIA. iPvQ- PIM w /LtM - . _ -- . B5"►1} Z. , tTt • L0 3.6' ON 1.3" a �. � K � gg,33 -` ( 715 ) 42.5 -ni 6S 1400576 CST Signature Date Signed Telephone No. CST # Waconsin SOIL AND SITE EVALUATION REPORT Page 1 Of 3 D on of Safety & Bui . in accord with lu-la 83.05, Wis. Adm. Code F COUNM Y Attach complet e site plan on paper not less than 81/2 x 11 inches in size. Plan must include, tut S � not limited to vertical and horizontal reference pant (BNQ. direction and % of slope, scale or . # dimensioned, north arrow, and location and distance to nearest mad. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION BY DATE met- PROPERTY OWNER: Cuit3e1' 4 S *MW PNj %1VAki PROPERTY LOCATION %Q�- ms • `jTM4 4 Zlck - QLz 114 S L 114,S 3 3 T 7 8 ,NR 1') E (o (W PROPERTY OWNER'S MAILING ADDRESS LOT # B UBD. NAME OR CSM # Zq LDR ST. 1 ��pose� csry CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE WraWN NEAREST ROAD Ro�3 TS s4oZ3 (�IS)�\19- C161i t'v�T V �ovti " [ ] New Construction Use [xJ Residential / Number of bedrooms 3 [ ] AdwQ, to existing building Replacement (] Public or commercial describe Code derived daily flow LSD gpd Recommended design loading rate bed, gpol11 0._LB trench, gpo(tt Absorption area required 3 S bed, ft2 37S trench, tt Mabmum design loading rate • y bed, gpd/ft • trench, gIXW Recommended infiltration surface elevation(s) 103• S _ft (as referred to site plan benchmark) Additional design / site considerations Y'1� Urvp w/ S '>< 1 S TIZ�'>vctF . MI Aji X4 um ?-L4 OF SArAA Fi (-L- . Parent material L%z za s oven c 1 Yi v-i Flood plain elevation, if applicable 1-a - A. R S = Suitable for system CONVENTIONAL MOUND KGROUND PRESSURE I AT -GRADE SYSTEM IN FL L HOLDING TANK U = Unsuitable for stem 0S o U ®S [] U I 0S ®U CIS o U [IS ®U [IS ®U . SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Corzistenca Bour Roots GPD /ft in. Munsell Qu. Sz. ConL Color Gr. Sz. Sh. Bed ranch E - ?_L Z Si 1 2, 9 ►- ►►�� a,S 1 - S •� Z 6 - tb`t M 316 — s 1 CA �-'F s b� wl'fi t°-S 1v� •4 . S Ground 3 1$ 3V 1p `'I 2 S 1 e O 1 S ti tz- S'/8 C O V►t'F►- - NP elev. 1 p S, 0 ft Depth to limiting factor t $h Remarks: Boring # b -� lo�tr�ztz - si � Z'F9 �,`f►. ws 1� -5 • ) Z z 8 -1,� lo�tR -316 si�l Z�sbk ►»'Ft� �S tv'� •y .5 �6_�o tio`1.R - Slz .S `tt2_ sl$ Ground elev. q-S tL Depth 1D limiting factor M Remarks: CST Name- AeasePrint Arthur L. We erer 715 - 425 -0165 egerer Soil Testing & Design Service -P.O. Box 74 River Falls,WI 54022' 98_33 Date: 3 �Zy f3 I Numb 0576 PROPERTY 9W 1 R3tKG Ut4 1 -1 SOIL DESCRIPTION REPORT Page?- 0f PARCEL I.D. 0 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed mrxh 3 0 -1 104 R Z 2 - s' L �b rn'f ►- a- 1 S G Z Z. 1.1 10 - 1lZ 316 ln 1 4 •S Ground 3 TL 3 1 D Y P- 31 G c ` Z. ` S 3 13 S1 D- No elev. C9.4 ft Depth to limiting factor ` Z,N f Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # 13 i ; Ground ; elev. ; ft. ' Depth to limiting factor Remarks: Boring # . Ground elev. ft. Depth to limiting factor Remarks: SBD- e330(R.05/92) PLOT PLAN Page 3 of 3 SCALE 1 "= 1 40 ' c.T�1 • T �� tv mE� P p e(Lry U )UE -- d /� $�Ytuxa of Ttts�,i 41 Qx- 1U3. S EL I � a , � 8E � � po S 1vR8 nth S f�R�A 0 3i• $ -3 z r -/ �.EL 99 4 anal F o PUP. Q/+&� Aw►tt l - �. 100.0 Cri �1" `c' QA , 31y` DE A.. �vC P�►'�` '^'/ �r'Ri -- to.O _98 9$33 ( 715 ) 42 M00576 CST Signature Date Signed Telephone No. CST # I STC -105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER MAILING ADDRESS PROPERTY ADDRESSC (location of septic system) Wease obtain from the Planning Dept. CITY /STATE gA, y, e .4 &,) , PROPERTY LOCATION /y E 1/4, L� 1/4, Section T _2y N -R W TOWN OF 0 lice Ile �4 ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAP , VOLUME / -, PAGE y� ZOT NUMBER 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 licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating conditioq and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. 1/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. a SIGNED: JI DATE St. Croix County Zoning Office Government Center 101 Carmichael Road Hudson, WI 54016 11/93 8 T C -'.100 1S This application form in to be completed in full hlid � Nby the owner(s) Of *he property being developed. Any iA&degd&d 'es - ill only result in delays of the permit issuance. Should -his • develop=en*- be intended for resale by owner/contractor-". ( pec house), then a- second form should be retained and completed 'hen the property is sold and submitted to�this office with the appropriate deed recording. :;_ p t-: Ig +. ------------------------------ - - - - -- ------- - - - - -- a=te= .:►L - - -- - -- Owner of property Lo of property 1/4 5 1/4,= ;Section 3 3 T N -R ) '� W Township Plea. -'a"t () w Mailing address Address of site 3 - C 7 d Subdivision name _ 7 �j�s f Lot no. e Other homes on property? Yes No Previous owner of property 6 /`jUrn Total size of property Total size of parcel Date parcel was created 19 / ° I �Jp ' Are all corners and lot lines identifiable? Yes Is this property being developed for (spec house) ? Yes No Volume �- - )and Page Number Ste as recorded with the Register of Deeds. ----------------------------------- ---------------------------- INCLUDE WITH THIS APPLICATION THE POLLOWING. __.. A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIPICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded i offi a of the County Register of Deeds as Document No. , and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for t`le construction of said system, and the same has been duly recorded in the Tce f the County Register of Deeds as Document 14 SlgnaUre fo Applicant Co- Applicant _ fl 'Bate of Si nature Date of Signature � ct�yQp VOL 13 ' PACE053 S r ` x ` 709 STATE BAR OF WISCONSIN FORM 3 — 1982 QUIT CLAIM DEED DOCUMENT NO. � /1 �dElfE :fr FFic . _ a 1 �( [t /' v �i /V d /�.� �.� �i 7 R -a- M Q quit- claims to MAY 2 8 199 8 and 9: 30 A Al 6 /�4 u t n + RA lsfer of Deads the following described real estate in C5 / X County, State of Wisconsin: THIS SPACE RESERVED FOR RECORDING DATA a r 1 Q 0 ^ E NAME AND RETURN ADDRE T �.M � A M cnJ �� 1�1 � 5"Ll PARCEL IDENTIFICATION NUMBER A'E EXEMPT M �..�� This homestead property. (is) is not) Dated this day of � Y A.D., 19 T E . ( -L 5 _ Cb ((SEAL) (SEAL) 7 C.(_ M (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, County authenticated this day of 19 Personally came before me this day of 0, 1 191 9 the above named TITLE: MEMBER STATE BAR OF WISCONSIN ���►i �t n (If not, u 5 V Ll WI authorized by §706.06, Wis. Stats.) �• v S. t, to me known to be the person 3 who executed the foregoing Q _j U7 instrument and acknowledge the same. T HIS INSTRUMI u. ENT S DR TED BY u1 .Cc `."' s•TA - I eki 14 a l� Notary Public, -'T. P `( D I ' Y County, Wis. (Signatures may be authenticated or acknowledged. Both ar nor My commission is permanent. (If not, state expiratio l d � te:' necessary.) l oZ 19 K' � .) Names of persons signing in any capacity should be typed of printed below their signatures. STATE TSAR OF WISCONSIN Wisconsin Legal Blank Co., Inc. QUIT CLAIM DEED Form No. 3 - 1982 Milwaukee, Wis. I � • 1 579851 CERTIFIED SURVEY MAP Located in part of the Northeast Quarter of the Southeast Quarter of Section 33, Township 28 No Range 17 West, Town of Pleasant Valley, St. Croix County, Wisconsin. t4 Prepared for and at the request of: OWNER: E � ' Robert E. and Sharon A. Austrurn 1811 County .Road "M" t7 8 1998 Hammond, WI 54015 n� al Z IO N -S KpTHIEENH Drafted by. Kristl A. Eyiandt iS 1 e � of Deeds UNPLATTED LANDS WEST 114 CORNER EAST —WEST 114 LINE OF SECTION JJ EAST 114 C SEC. 33 -28 -17 C T. H. *M* SEC. 33 -28 -17 (ALUM. CO. MON.) - - - - -- - -- (ALUM. CO. MON.) -- - - - - -- -- S89*58'37 "W 5252.35- - -- - ------------------ — w N89'58'37 "E 527.38' CENTERL /NE �N89'S8'37 "E 4113.45 `. w 7 " ,' S89'58'3W 611.52' _ �.. —. `,— N89 "48 '34 527.38 — — —1 — — — i R.O.W. IZ co O CENTERLINE DRIVEWA Y. ... co ........ . N W I D I� HOUSE ...... m O� SOP im° Z Z BUILDING SETBACK L IN£ j PPR P�� I z B I i r- 0 0 pf l 0 I > d a; I cn 10 I� W Im I r u, BARN 1 PGE� O Z LOT 1 oRP'1� N \� n o g$ R E P z G E P 1 0,' p R P oC SG O - `�- MAY 2 RONALD F. TOTAL AREA "° JOHNSON 217,922 SQ. FT. S —f 1 @6 5.00 ACRES AMERr, AREA EXCLUDING R.O.W. WAS' Y ' 9 i .4." L� .A h YRs 200,432 SQ. FT. �4 •••' l ! w " ra w s :.r, ._ :�:.,::�• 4.60 ACRES rly��eA 1 Ws• M� %lb` NOTE: The parcels) shown on this map is /are subject to State, County and Township laws, rules and regulations ( i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office and the appropriate Town Board for advice. LEGEND County Section Corner Monument of Record • Set 1" x 24" Iron Pipe weighing a minimum of 1.13 pounds per linear foot. tso 0 150 NO TH JOB #98038 (R14) Prepared by. A & E SCALE IN FEET: 1 LE inch 150 feet LAND SURVEYING & CIVIL ENGINEERING Phone No. (715) 246 -4319 BEARINGS ARE REFERENCED TO THE EAST —WEST 1/4 109 East Third Street, P.O. Box 325 LINE OF SECTION 33, TOWNSHIP 28 N., RANGE 17 W. New Richmond, WI 54017 WHICH IS ASSUMED TO BEAR S89'58'37 "W. Sheet 1 of 2 VOLUME 12 PAGE 3457 r ST. CROIX COUNTY WISCONSIN r ZONING OFFICE � 7 ST. CROIX COUNTY GOVERNMENT CENTER i �,..� � MMMpN11MNA 1101 Carmichael Road :.rte ;t• :� Hudson, WI 54016 -7710 - - (715) 386 -4680 i = - June 9, 1998 �Q� Robert E. & Sharon A. Austrum 1811 C. T. H. "M" Hammond, WI 54015 Dear Mr. & Mrs. Austrum: At the May 26 meeting of the St. Croix County Planning, Zoning & Parks Committee, approval was given to your one lot minor subdivision of the property located in part of the NEX of the SE /, of Section 33, Town of Pleasant Valley. There were no conditions on the approval, however, during the review process, it was recommended by the Land & Water Conservation Department that an erosion control plan, following the submittal for 1 and 2 family dwellings, be submitted and reviewed prior to house construction on the lot. This office recently issued a permit for the sanitary septic system for a mobile home that is being moved onto the lot. It is my understanding that at a later date the mobile home will be removed and a new house will be constructed. In accordance with the Land & Water Conservation Department recommendation, the Reconnection Permit to allow the new house to connect to the existing septic system will not be issued until an erosion control plan has been received by the Zoning Office. A building permit for the new house may not be issued by the township until the sanitary permit has been issued by this office. Should you have any questions, or if I can assist you in any way, please contact me at the above number. - S . ...�Q,u� Mary J. Jenkins Assistant Zoning Administrator c: Clerk, Town of Pleasant Valley File