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HomeMy WebLinkAbout026-1099-30-000 2 f \ > ® 7 0 « � K � % I ƒ � § � § � < W LL \ £ 3 0 � a k - � z _ ' § � Z k a. c n e z � k B ca / / D cy (D i § p § 7 \ k CD 0 Q ) k 7 ) } k \ D m k 2 \ E n § $ 2 1 & ® ; Q o a = a { 3 m m U) k Q E . .. � 0 a a E L 0 \ ) co co $ � q \ ! $ $ z 6 2 k § f § ) £ / ~ ~ E CN R @ ~ § % U) 2 \ a ■ % m § E 2 $ / Cd 2�/ ) k W 8}§ k k . k \ \ k © / k § ■ o f c6 § ■ t) e« 2§ m a - peg « ® « § 2 E 04 = g -� o n \ I m\ z_ z s■ n z' E ® © ; 2 ; . , _ _ � � � , E �) k a § k j a j 0 3 J ■ ■ ■■ ■NONE■ We IMM ■■■■ ■ \ ■ ■ ■ ■Ea ®mmmmmmom ®® ®m�ommmm� mmumm MR Umm ■■■ ■■■ E0 ® ° eme ° e ° e ° e ° e ° ° ° ° ° m ° °emmmeeemm ■■ ■EEomem ° e e ° e ° ommmem mmm OWN �■ ■� ■ ■ E � °emm0° °°°°° ° m °eoemOWN ems°■ E ■ ■ ■ � ■ ■ ■ ° °m ° sea ° e° ° ° ° ° ° °D ° °0 ■ ■WEI�EE� °em °e mmm°°°°°°°°mmm ° °°° °e °ee °e MMEEME MEN HIM 0 01 ON NEW ■ ■E11��E \EE ■E ■ ■■ 0o0m0 ®m °eommv ®mm�ra' ■1i \\ S, 1111 \ \ ■ ■1\ \NOON m° ° ®0oomommum m SME No mom no mm am mm ink m1m CRUMB ►�1�■ ■ ■�� ■■ ° °° ° sa ° mmommr ° �% 4��e ° isi0' 'm v O \\Iii:! \ \ \ ■ ■NOME ■ ■ \\ \101 \� \E \ ■E ■ ■\ , SEWAGEANb • 0� ■ ®m ®m mmm�■ WIN MW mmom �mmmm�0�.mm o® �mmm ®momom ■ ■ ■ ■ ■ ■ ■ ■ ■ ® °m°.mmmm °mm�m ®. ®mom ®mm.�m® m�mmmmmmmmmmm� mmmm ®mmmo■ - ■ \ ■■ ■■ ■ - ■O■■ ■■■ O ►. ■ ■ ■■ ■ ■ ■ ■■ • ■■■�� ■■. ■■ WE= NOON ■■■ �■.•�■■■■ NOON -• ■■►. ►NOON■■ ■��■I■■■ NOON NOON■ B .� ■■� ��■ NOON . , � ■ \ \� \NOON■ • . .. , Model 293/4293 should not be subjected to less than 15 feet TDH. NOON ® ■■r ■� ■iii■ °� ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner 0 a l e I , Property Address City /State jP 'e n l - Legal Description: Lot '— Block Subdivision/CSM # %a t T�N -R (�[ /4, Sea , W, Town of r U1 tai PIN # I 'V,6 .Tl 3 Sr�83 SEPTIC TANK — CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer A 411;c S P &3 � � Size ST/PC /��G Setback from: House 3� Well 5 7 6 P/L � s"v Pump manufacturer Model /�Fn S� Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: AmA l Width Length Number of Trenches Setback from: House - L5 / Well P/L 3 15 Vent to fresh air intake ELEVATIONS Description of benchmark /:�U. ay —wi e d Elevation l eLl. Description of alternate benchmark Elevation Building Sewer ST/HT Inlet ST Outlet PC Inlet PC Bottom Header/Manifold Top of ST/PC Manhole Cover Distribution Lines () () ( ) Bottom of System () () ( ) Final Grade ( ) ( ) ( ) Date of installation / / Permit number State plan number Plumber's signature `� '� f g � License number 2 / - Date Q/ Inspector Complete plot plan or a tnsin Department Commerce S PRIVATE SEWAGE SYSTEM Count Safety and Buildings Di y: INSPECTION REPORT ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Per -: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: ❑ City El Village Town of: State Plan ID No.: ICKS, DALE RICHMOND CST BM Elev,: Insp. BM Elev.: BM Description: Parcel S� Pl a o.: � 61 -r-n' A (.9 ` 1J1/ b2�- 1099 -30 -000 s . TANK INFORMATION ELEVATION DATA A9800356 c p1/ TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic F Benchmark v Dosing Aeration _ Bldg. Sewer Holding St /eft Inlet w (,� Z TANI INFORMATION St/ Outlet TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Airintake Septic NA Dt Bottom SD Dosing NA hio.'ukcl Man. Aeration NA Dist. Pipe C , Holding w..W °° Bot. System J Pump/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM !Forcemai n Len H Lift riction System TDH Ft e gth Did. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS D SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEAC Ma rer: INFORMATION Type of CHAMB Model Num er. System: n OR IT DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia Length Dia. . 7 Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil 70 Yes ❑ No E] Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: RICHMOND 35.30.18.537B,NW,NE 1349 130TH AVENUE 6 - In- :t/0 k; le. 12. attar a�4PO imnd, y l 6p ' Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. Safety and Buildings Division SANITARY PERMIT APPLICATION 201 W. Washington Avenue Asconsin In accord with ILHR 83.05, Wis. Adm. Code P O Box 7302 Department of Commerce Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 1/2 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Permit Number + Personal information you provide may be used for secondary purposes ®'Check it re si ` mb to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. N im er I. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATION Property Ow r N me , Property Location Q S *6j14 F1 /4, S % T ,j70 , N, R 4E (or6 Property Owner ' Mailing Addres Lot Number Block Number /3d A< C , Stat t Zip Cod Phone Number Subdivision Name or CSM Number k 6 ( ) 11 . TYPE OF BUILDING: (check one) ❑ State Owned 0 't h Nearest Road vili Public 1 or 2 Family Dwelling - No. of bedrooms o .Town OF IC ` 3 I ll. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo I CAA 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) 1 157 New 2, IS 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 21-P Mound 30 ❑ Specify Type 41 []Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 16. System Elev. 17. Final Grade Reqy7d�sq. ft.) Pr Qsed,(sq. ft.) (Gals/,d�sq. ft.) (Min.li h) �� ' E e tion V 5 Feet 1 2 Feet Capacit VII. TANK in Ca allo Total # of r Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existinc strutted Tanks Tanks Septic Tan or Holding Tank f 4 �C ❑ ❑ ❑ ❑ ❑ Lift Pum Tank iphon Chamber Q i�1A El El El E3 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sews shown on the attached plans. Plumb ame: (Print) Plumb ignature: (N S ps) / Business Phone Number: Plumber's�Addr s (Street, City ,$ to ip C e): ��� U� '/ c ` IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (IncludesGroundwatef D ate Issued Issuing A ent 'gnature Qto Stamps) Surcharge Fee) Approved E] Owner Given Initial Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11/97) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber • Safety and Buildings '\) 2226 ROSE ST LA CROSSE WI 54603 -1905 isconsin Tommy G. Thompson, Governor Department of Commerce William J. McCoshen, Secretary September 09, 1998 CUST ID No.227469 ATTN: POWTS INSPECTOR THOMAS A WANG W9672 770 AVE RIVER FALLS WI 54022 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 09/09/2000 Identification Numbers Transaction ID No. 136863 Site ID No. 15303 SITE: Please refer to both identification numbers, Site ID: 15303 above, in all correspondence with the agency. St. Croix County, Town of Richmond NW1 /4, NEIA, S36, T30N, R18W Dale Hicks FOR: Description: Revised Mound Object Type: POWT System Regulated Object ID No.: 33386 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: • The approved changes will become an addendum to the plans previously approved. All other portions of the installation shall conform to the original approval. • 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. • 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. S' cerely, DATE RECEIVED 08/11/1998 FEE REQUIRED $ 60.00 ERARD M SWIM, POWTS PLAN REVIEWER FEE RECEIVED $ 60.00 Integrated Services BALANCE DUE $ 0.00 (608)785-9348, MON - FRI, 7:15 AM - 4:00 PM JS WIM @COMMERCE. STATE. WI.US Page of 6 MOUND SYSTEM FOR A BEDROOM RESIDENCE LOCATED IN THE NW 1 /4 OF THE NF- 1/4 OF SECTION 3S ,T 30 N, R lg W, TOWN OF R�C!\I^'1OM� , ST.Ct?OtX COUNTY, WISCONSIN. INDEX PA GE 1 '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 P.0 \N. PREPARED FOR conwitiona . OVED TJP�L 1� l C`�S , CDMMER �3y`� �� Tl� AVE • DkFARTMEF o Y AND I.DiNGS 1`l� 2�CN Y�10Y�D, �'J 1 Sy Old D V►S�o SEE CORRESP ENCE NO 'T�1'tS ��m,1 �s A v ts,p►�, �F rvp, Z��z�� �zZvtdvSLy �RP�uIU p1J 8 C 4 $, RF qv Fo SgFEr G 1 1 1998 aGS acv PLOT PLAN • 6 _ Scale 1 "_ yp ' Page Z of - nv hu _ i D e ri -M r U L► � Q- ►,,,o � e�S 8uR1n1 G S e� So' Fzuh w►uv�j H-0m kF l `\, ��2 C � t J i i O O S5' DF ? 81 _ _ — _ ��S T11M of 13n, i�1. W I.pl M BL 1» rvOT eor• -A k� -CT 02 O�S`rv�z(3 ))" PrR oU \vvv� NOTES -1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. required) 3. Install 4" observation pipes with approved caps. ( 2 required) 4. Septic tank to be N 1 0 0o gallon capacity manufactured by 5. Bench Mark S 6. Divert surface water around system to prevent ponding at the uphill side. P age - z� - Of L Approved Synthetic Covering TV97 " c 33 Distribution Pipe Medium Sand G Topsoil '` H— __�__ F . Eiev. \O .0 3 E D u � • b �p % Slope Bed Of 2 2 %2 ( Force Main Plowed Aggregate From Pump Layer D \-O Ft . Cross Section Of A Mound System Using E 1 '$ Ft. A Bed For The Absorption Area F e Ft. G Ft. A $ Ft. H 1 -S Ft. Linear Loading Rate CI GPD /LN FT B Ft. Design Loading Rate= O,y .GPD /SQ FT I Ft. J `7 Ft. K 11 Ft. - Alt - er e Position L b 9 Ft. of Force Main W 3 1 Ft. L Observation Pipe --,,, 8 K I A W o ------- - - - - -- f::0 44 �, Distribution ed Of 2 2 2 2 I Pipe \,- Aggregate Observation Pipe Permanent Markers (Anchor securely) Plan View Of Mound Using A Bed For The Absorption Area Page - Of b Perforated Pipe Detail 0 End View Perforated End Cop. 7 c E PVC Pipe Install permanent 'marker at end of each lateral Holes Located On Bottom, Are Equally Spaced Q S PVC Force Main Q PVC Manifold Pipe Distri ution Pipe Last Hole Should Be I Next To End Cop End Cap P Ft. Distribution Pipe Layout S 4 Ft. X 3�- Inches Y 3 b Inches Hole Diameter "Y. Inch Lateral I Inches Manifold Z Inches Force Main Z Inches # of holes /pipe S Invert Elevation of Laterals oi.S Ft. vx 1. ��= °i.Vbx (l= 3 - )-q� GtIJ-1 Place 1st hole �`� N from center of manifold with succeeding holes at 3(z� intervals. Last hole to be next to the end cap. Combination Septic; Tank and PUMP CHAMBER CROSS SEC1104 AKID SPECIFICATIOUS PAGE S OF -VC IJT CAP WEATHER PROOF JUUCTIOU BOX . 4'C.I. VEMT PIPE APPROVED LOCKIMG 110' FROM DOOR.. MAIJHOLE LOVER AJIV dIN00W OR FRESH wARNlWG LI48EL.. ALP IMTAKE s r b" h I-x . _;k .? PROVIDE I - - - -- IA1LE T — T AIRTIGHT SEAL 3 4FFL�S I I II v APPROVED JOIWT A I I I W ��' I ' ��PE APPROVED J011,�T: W /C. PIFF Tank construction i II I « tpjc I I I shall comply with ALARM ILHR ('33.15 and 33.20 rs i i I i ow C I CI S. oo LL1-V. FT. PUMP -�, � OFF D CO UCKETE DO BLOCK 3" APPQo+: R15ER EXIT PERMITTED OIJLy IF TAWK MAUUFACTURER HAS SUCH APPROVAL BEDDIN4 SEPTIC E 5PECIFICATI0hJS DOSE TAWK MAUUFACTURC M Zl L- J��T�IJ ` WUMISER OF DOSES: -Z 8 L PLR DAy TAWK SIZE: &ALLOWS DOSE VOLUME I ALARM MANUFACTURER: S -S� �� � INCLUDING BACKFLOW: GALLONS MODEL WUMBER-- 1 CAPACITIES: A= IUCHES OK GALLOU3 SWITCH T�JPC: 1' E;1ZCUV-Lr B= 1WCHE5`0R ' G(LLOLJS PUMP MAWUFACTUREK: 4 C= g IUCHES OR CALLOUS MODEL WUMBER: D- IMCHES OR ZS2 6 GALLONS 5WITCH TYPE: MOTE: PUMP AUD ALARM AR TO K 9 MIMIMUM DISCHARGE RATE GPM INSTALLED OW SEPARATE CIRCUITS VERTICAL DIFFEKEWCC DETWCEU PUMP OFF AUD.DISTRIBUTIOW PIPE.. 6• Sy FEET t mimIMUM WETWORK SUPPLY PRESSURE , , , , , , , , , , 2.5 o FE.CT 7. + SS FE E7 O F FORCE MIN X F pfT, FRICTtoU FACTOR.. `' S FE TOTAL OtIMAMIG HEAD FEET Pump chamber DIAMETER -- ` IIJTF -KkIAL DIMEIJ51Ofd� OF TAUK: LEKIGTH ;WIDTH ;LIQUID DEPTH 3$ r BOTTOM AREA 231= GAL /INCH AS PER MANUFACTURER = �� GAL /INCH r Goulds PfZ Submersible Effluent Pump 3871 EPO4 - EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- • Homes components. M tic cover with integral handle Motor: Available for automatic and • Farms manual operation. Automatic and float switch attachment • Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical points. • Water transfer 115 or 230 V, 60 Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, built in overload with preset at the factory. rated oil and water resistant. automatic reset. ■ Bearings: Upper and lower SPECIFICATIONS • EP05 Single phase: 0.5 HP, FEATURES heavy duty ball bearing 115 V, 60 Hz, 1550 RPM, g Pump: EPO4 built in overload with construction. ■ EPO4 Impeller: Thermo- • Solids handling capability: automatic reset. plastic Semi -open design AGENCY LISTING 3 /4" maximum. • Power cord: 10 foot with pump out vanes for • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal rotection. • Total heads: up to 24 feet. with three prong grounding p SP Canadian Standards Association • Discharge size: 1 /z" NPT. plug. Optional 20 foot ■ sc Impeller: Thermo- (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with plastitic enclosed design for end in "F" or "AC ".) rotary/ceramic- stationary, three prong grounding plug improved performance. BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 •Capable of running � _- dry without damage to s 30 �I -5GPM components. Pump: EP05 $ i _. _ is Fr . • Solids handling capability: 0 25 3 /4" maximum. a W -- - - -� - -, - -- - - -- -; - -- • Capacities: up to 60 GPM. = Y • Total heads: up to 31 feet. 6 20 • Discharge size: l' /2 "NPT. z 5 • Mechanical seal: carbon- 0 15 rotary/ceramic- stationary, 4 j BUNp -N elastomers. ° 3 10' _.__ _ _ sl — _ - -__ _ - -_ - -- EPOS a - Temperature: to _ 104 (40 continuous EPO4 ` �— — 140'F (600C) intermittent. 2 - 5 1 I � 0 00 10 20 30 40 50 GPM L L 0 2 4 6 8 10 12 m /h CAPACITY ©1995 Goulds Pumps, Inc. Effective May, 1995 B3871 Wisconsin Department Rela Industry Labor and Human Relati SOIL AND SITE EVALUATION REPORT Page of Z Division of Safety & Buildings in accord with IL HR 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 • t4 - toly not limited to vertical and horizontal reference point ite�c� % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and di erc�i.�bl;' O Z 6 9q _ 3 0 APPLICANT INFORMATION- PLEASE 1} ALL WORM AYIQN, REVIEWED BY DATE PROPERTY OWNER: .P PERTY LOCATION C� _ Q °, 1 N W 1/4 I3Z 1/4,S-S S T 3O N,R 15 E PROPERTY OWNER':S MAILING A ( W - DDR E � 'tb # BLOCK # SUBD. NAME OR CSM # CITY, STATE ZIP COD PHONE EFtGE I R ❑ ` V C ILLAGE ®TOWN NEAREST ROAD 1 NUJ Z1�, 113w wl *4d a1 (...,) r; m►"'111�J\Z�l 1 30`ti?} IvUfa - [ J New Construction Use Residential / Num' sbe aff 3 [ J Addition to existing building P4 Replacement [ J Public or commercial describe Code derived daily flow gS gpd Recommended design loading rate • y bed, gpd/ft — trench, gpd1ft Absorption area required 3D bed, ft2 3- S trench, ft Maximum design loading rate S bed, gpd /ft trench, gpd/ft Recommended infiltration surface elevation(s) l b d . b ft (as referred to site plan benchmark) Additional design/ site considerations w')0 Ut'A w / 8 `K U1 ` gIp Parent material s t u� Oy n.(- `n L t_ Flood plain elevation, if applicable N A . It S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT - GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ❑S ®U LA S ❑U EIS OU ❑S ®U EIS [RU ❑S ®U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft in. Munsell Qu. Sz. Cont. Color Texture Consistence Boundary Roots ::::• -= ; Gr. Sz. Sh. Bed ITrench o _ t 4 S11 st1 s b� — S b Ground 3 1$ -3- 1 •S i R elev. s C�2.o ft. z 1,s'YR Ch-1 Depth to limiting factor g�2t G IRS DU wl $ Remarks: Boring # 9 —M] �t µ `; Q WlUU y Ground elev. ft. Depth to limiting factor Remarks: CST Name : — Please Print dress: Phone: Arthur L. We erer 715- 425 -0165 egerer Soil Testing & Design Service -P.O. Box 74 River.Falls,WI 5402 Signature: 2 ,. // _ ` 9 fJ - 1°l� Date: � CST Numb: " "��'% M00576 Labor and d Human Relations Industry SOIL AND SITE EVALUATION REPORT Page of Z • Labor Division 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 (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. 0 Z 6 0 C19 _ 3 0 APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REDBY DATE PROPERTY OWNER: PROPERTY LOCATION UZ kA L cVr-S ee1f .-EeT ts W 1/4 NZ 1/4,S3 S T 30 ,N,R 15 E PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # -- CITY, STATE ZIP CODE PHONE NUMBER OCITY �1/ILLAGE ®TOWN NEAREST ROAD RuH�io�,wl s�o�� ( ) R LC�twiuti� t3o-n+ Rv�• [ J New Construction Use f M Residential / Number of bedrooms [ J Additi.Qn to existing building P4 Replacement [ J Public or commercial describe Code derived daily flow q SD gpd Recommended design loading rate • 1 4 bed, gpd1ft — • trench, gpdtft Absorption area required 3 _ AS bed, ft2 3--) S trench ft2 Maximum design loading rate S bed, gpd/ft trench, gpd/ft Recommended infiltration surface elevation(s) _ 1 b 0.0 ft (as referred to site plan benchmark) Additional design/ site considerations X1 U1.A Parent material s t ulyj Ov n `n L L Flood plain elevation, if applicable N A . It S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ❑S ®U L$S ❑U 7 ❑S ®U ❑S ®U ❑S ®U ❑S OU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft in. Munsell Qu. Sz. Cont Color Texture Gr. Sz. Sh. Consistence B I Roots Bed rerxh o _ t Ground — elev. "- °Loft Ly 3�_�lz s Depth to limiting factor - ` Imo Bu�LI G BAs bU Y_ Pry C ZA Remarks: Boring # Y L - \�'O;-'jI'j S L. Ground elev. ft. Depth to limiting factor Remarks: CST Name: — Please Print Phone: Arthur L. We erer 715- 425 -0165 egerer Soil Testing & Design Service -P.O. Box 74 River.Falls,WI 54022' Signature: Date: l CST Number: ` -��' M00576 N SANITARY PERMIT APP LICATI ON S afety and Buildings Division N � 201 W. Washington Avenue Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code P O Box 7302 Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County than 81/2 x 11 inches in size. gf- Clep ` X • See reverse side for instructions for completing this application State Sanitary Permit Number Personal information you provide may be used for secondary purposes 4 8 [Privacy Law, s. 15.04 (1) (m)]. ❑ Check if revision to previous application State Plan I.D. Number I. APPLICATION INF RMATION -PLEASE PRINT ALL INF RMATI N /7 Prope w r Nm a , .e C Property Location Property ners ailing dregs �f 1/4 e 1/4, S ?'5 T �Q , N, R1JOE (o� I e Lot Block Num r Ci tate Zip Code Phone Number �(� V ol h�ati ol t7 ( Subdivision Name orCSMNumber II. TYPE B IL ING: (check one) ❑ State Owned ❑ Ity Public 1 or 2 Fa Dwelling - No. of b e ❑ Vil /� Nears oad Town OF (Ir( ��Q �� G I11. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 [1 Apartment/ Condo Ua6 ! - 3�9 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 E] p 3 Replacement of 4. ❑ Reconnection of 5 Repair of an ____ S , stem _ __ -_ ___Y_________ _ _ __ Tank Only_- ___ - - -__ Existing System ❑ Existing System ❑ ASanitary Permit was previously issued. Permit Number B) -- -D Date ssueate ssue d I ------- V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21t&Mound 30 S S pecify T y p e 12 E] Seepage Trench ❑ p Y 41 ❑Holding Tank 22 E] In- Ground Pressure 42 ❑ Pit Privy 13 E] Seepage Pit 14 ❑ System -In -Fill 43 ❑ Vault Privy 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 Requiredq. ft.) Pro ed�q. ft.) (Gals/d y/s . ft.) (Min. /i h) Eleva VII. TANK Capacity ` d � U Feet J d Feet INFORMATION In gallons Total # of Site Gallons Tanks Manufacturer's Name Prefab. Fiber- Ex per- New Existin Concrete Con Steel glass Plastic A p p Tanks Tanks structed Septic Tan or Holding Tank a Ob t 'ft Pump Tan iphon Chamber f CC rl V 11 1 1310101 El III. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibilit or i nstallation of the onsite sewa tem shown on the attached plans. P m is Name: (Prin PI ber' nature: ( s) M /MPR Bu si ess PhQne�t�l� umber's Address (Str et, i e ip Code S ((� IX. COUNTY /DEPARTMENT USE ONLY 1f ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate Issu e suing A nature (No Stamps) Approved El Owner Given Initial �� V l � pp Surcharge Fee) . � Adverse Determination I . CONDI ION OF APPROVAL / REASONS FOR DISAPPROVAL: r 27 SBD- 6398 (R.11/97) DISTRIBUTION: Original to County, One copy To: Safety &Buildings Division, Owner, Plumber SAFETY AND BUILDINGS DIVISION 2226 Rose Street N)Pisconsin CM LaCrosse, Wisconsin 54603 Tommy G. Thompson, Governor Department of Commerce William J. McCoshen, Secretary Transaction ID No. 117286 Date: 8/3/98 The Transaction ID No. noted above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval of the system is based on chapter 145, Wisconsin Statutes, and chapters Comm 83 and 84, Wisconsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter Comm 82 or in chapters Comm 50 -64, Wisconsin Administrative Code. This plan submittal approval will expire two years from the approval date, or if a sanitary permit is obtained, plan approval will expire on the day the initial sanitary permit expires. The licensed plumber responsible for this installation shall keep one set of plans with the Department's stamp of approval at the construction site. The installer shall notify the appropriate inspector when inspections can be made. 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. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(d), Wis. Stats. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, &,aur. Swim Integrated Services POWTS Plan Reviewer (608)785 -9348, Mon.- Fri. 7:15AM to 4:00 PM jswim@commerce.state.wi.us. SLD- 5524 -E (R. 2/98) RESIDENTIAL MOUND DESIGN INDEX AND TITLE SHEET 1 p . 0 V T- S ' Project Dale Hicks Prol CDMMEitCE T MENT D� � KG S Owner Dale Hicks D Sio wof E NCE Address 1349130th Avenue coRRESp� New Richmond, WI 54017 Legal Description NW -NE, 86 T30N, R1 8W RECEIVED County St. Croix Township Richmond J - 6 1998 Lot No. - Subdivision Name - SAFETY & BLDGS. DIV. Parcel ID Number - Plan ID Number S98- 117286 INDEX SHEET PAGE ONE PAGE TWO MOUND CALCULATIONS PAGE THREE MOUND DRAWINGS PAGE FOUR PRES. DIST. CALCS. & LATERALS PAGE FIVE PUMP TANK DRAWINGS PAGE SIX Site Plan PAGE SEVEN Coil Test Page 1 PAGE EIGHT Soil Test Paae 2 PAGE NINE Soil Test Site Plan L 'PA6,f, - T64 License Number MPRSW#3231 Designer Tom Wan Phone No 715 -425 -9958 Signature Date 5115198 Notice: Tampering with this file by unauthorized persons is prohibited. Deliberate mod cation will result in disciplinary action under s. 14510, Wis. Stets. Page 1 of 10 SBD- 10462 -E (R.04197) MOUND PLAN VIEW observation pipes (typicel) T .I W= 31 R O A= 8.0 ft 244 m 9.46 B= 47 ft 1433m J = 5 ,4 ft 1.95 fin l 1 I = 16.6 ft 5.06 m - -•�•�- �' K = 11.3 it 3 44 »I 69.6 ft I 21.2 m typ obs pipe A X B refers to absorption cell width and length (anrhgrpn,P(:111r1 J = up910pe width I downslope width 1 K = end slope dimension Illl'l� s•• riso mill) MOUND CROSS SECTION .. lateral topsoil 14 subsoil cap D = 120 in 30 5 cln 103 R R G E = 22,6 in 57.4 cin invert F = 9.9 in 25.1 cm elev, 31.85 m note F G = 12.0 in 30.4 cm H= 18.Oin 45.6 cm I Sand D E AS7M C33 Sys. 103. ft Y / FAI elev. 31.3 m P contour 11 % 1.09 m slope /- Note: Absorption celi meow wad D ■ upslope fill depth plowed layer cont+let M aggregate and pipe E v downelope fill depth or leach chm"bers and pipe F 0 absorption cell depth as specified Aggregate G * subsoil + topsoil depth at cell wall at right. } L — J� O h ambe ( H - subsoil + topsoil depth at cell center De signer notes: K 0909 0e Is L"K It If OOV"d with Code Compliant material Project: Dolt) Hides Plan l.D. $W1 172a9 Page 3 of # 10 PRESSURE DISTRIBUTION CALCULATION Abagrptl4>n Cott Inch-pounds Metric Width (A) 8 ft 2.44 m Length (8) 47.0 it 14.33 m Latero apeoflkallons Number laterals 4 Hoteslteteral 11 holes Lateral length 21.9 ft 6,7 rat Perforation dia. 0.25 in 6.4 rural Let. dis. rate 12.82 gpm 0.8 Us Sys, dis. rate 51 -28 gpm 3.2 Us Hole spacing 25 M 63.5 cm Lateral dle"Wer Plin dlameter 0■abn ■~9 oe■gn a "ee Designer must 1 W2s mm X .� plat x■ one choiCe 1 114W32 mm X ■.■ box f►vm the options 1 1RW40 mm X x dial, ptotrlded. 2W50 mm X 3W75 mm X Ma Wold diameter PiP4 diameter Gwgn opbro D"n c r Ke Designer mu8t i W25 mm "X' one choice 1 1 /4W32 mm Plac from the options 1 1/2W40 mm X box provided- 2W50 mm X x diar. I 3W75 mm X 41n1100 mm X DWribat/on system contains 4 laterals) LATERAL DIAGRAM - CENTER CONNECTII Py°cs o°^Of 100"W Cftm n by cNck/np in one or the drawings at right and dragging the diagram i urw nrwn v<ArnW�� we, tea w wustr lu �« d «q Vvr�l, • Laterals are Identlod I�xiir al E P end cap ' X — / IF■�T I M2+1 Laterals 6 Foroe main or PVC Soh 40 lent hoN ttlaed neat to and gap (pew COW Table 94.30 - 5) mows MW on py bottom of ew lateral • ■ permanent end marker ��loe0ed Inch -pounds Metric Lateral length (P) 22.0 It 6.71 m Lawn spacing (S) 4 ft 1.22 m Mangold length 4 fl 1.22 m Hole diameter 0.25 in 6.35 mm Lateral diameter 1.5 in 40 mm Number of holes per pipe 11 Invert elevation of later 103.5 Ift 31.44 m Project. Dale Hicks Plan I.D. SWI1 Page 4 Of i Total dy� I*W System hwrd " 3.25 tt Vertic of Ila a 0.88 m 8 -40 ft 2.56 m Friction loss = 1.28 ft 0 . 38 %+rn loiaaiti i %le iGytlea) twnli ar 61'r Tota! dynamic head o m system? Yen 7X here. x Ouse Volume m if no, whet 1s the INalledt nl.y(t U� /II Lateral void volume = 9.3 Qowrlstrealn g Minimum doss tlr 112.5 loaf �e1 35.2 L Force ma4l dl Pill Drain b4ft = gal 4 25-9 L back to funk? Ux- one 5.2 19.7 L Dose volume = oil �c Yes L No In combination with stele NPP �a PunW Chamb Layout rvved treatment tank- Tank construction as per Comm 83.20(3) WAC Ir w.W++r proof aPProved manhole cover Grade WVb 1<a>o41al box —� -- �. w6varr*V k cal and Padlock Quick dlawneq grade levels 4" vent pipe Oleobk M per FaC 300 and atternnte COMM 10.28 WAC „ outlet T location 18" (45 ('41) mil, WON of punw l d*R*w or � approved .I. a n> aNOh — ,�. olhlet — k tank eferm on A , 114 warp Grade levels p P ump mP O n B rode I wmp bnM manhMe - T mm • R � � 4n r ry,hnA arn.t.. �� r>•o�lssry PUT rynR m■n 10 0 mm nrn •t-vo nhlJ 4 IM prnM Pump . ft C writ . 12' rrtln wWv, flru.q•r.d pre,, off elev 29 I r ' 'IS"t'Mn main wt—. nnlsh.., prni. D I � 3. 6 may of y ur** It" Om anchor tank as 94 R PUMP tank elevation Tank specifications: 28.7 m bottom rtf link i'{;I�iW" i P, f4 Pump tunic = n PUMP tank volume l CaPacitles Inches Gallons PurnP manufacturer: A = 40-7 488.3 Pump model number: 0 ^ 2 24.0 C ° g 117.7 Project: Oele Hicks D - 20.0 Plan I.D- 398- 117286 Page 5 of 10 WANG EXCAV 7154255344 P.91 x � pale N� � � � �t�n � �e1"► ^L x NL ^NE /y 3 ;' YON k)91L) boo, 4a A� r e ea Pc e Az 973 IA Pte��,od y V) x � a n/ x x X p 64e �8e dr oom f-s f yC O a lt Fo riC a /��a! a I "a e,�. �a lC Eiev,l0�,� x o (0O' x ga � #I 7E b,, �j.W Corner a� c j`ic°d Ird Fk x )oo, o x x P Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must �� ' include, but not limited to: vertical and horizontal reference point (BM), direction and County percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. _ St. C Parcel I. D.# APPLICANT INFORMATION - Please print all information. Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Reviewed By Date Property Owner Property Location Dale Hicks Govt. Lot - NW 1/4 NE 1/4 S 36 T 30 N,R 18 W Property Owner's Mailing Address Lot # I Block It Subd. Name or CSM# City State Zip Code PhoneNumber City ❑ Village r Town Nearest Road Richmond 130Th Avenue ❑ New Construction Use: FN Residential / Number of bedrooms 3 ❑Addition to existing building Replacement E] Public or commercial describe Code Derived daily flow 450 gpd Recommended design loading rate 1.2 bed, gpd/ft 1.2 trench, gpd/fF Absorption area required 375 bed, ft 375 trench, ft- Maximum design loading rate 1.2 bed, gpd/ft 1.2 tr ench, gpd/fF Recommended infiltration surface elevation(s) ft (as referred to site plan benchmar Additional design / site consideration t Parent material Floo d lain elevation, if licable ft ble for system Conventional Mound In -Ground Pressure AT -Grade System in Fill Holding Tank itable for system ❑ S ® U ® S ❑ U ❑ S ® U ❑ S ® U I ❑ S ®U I ❑ S ® U SOIL DESCRIPTION REPORT Horizon Depth Dominant Color Mottles Structure GPD/f 2 Boring# in. Munsell Qu. Sz. Cont Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench 1 I i T30_48 0 - i 2 i 0yr3/ i - sii lmsbk mfr gw if .5 ! ti 2 2 -30 10yr3/3 - Sl 2msbk mvfr gw if _5 .6 I Ground 3 7.5yr5/8 - s1 2msbk mvfr elev - - 5 .6 99.65 ft Depth to limiting factor >48 Remarks: 2 I 1 0 -10 10yr3 /1 - sil 2msbk mfr gw 2f .5 .6 2 10 -24 10yr3/3 - sl 2msbk I I� —� mfr gw if .5 ! .6 Ground 3 24 -36 7 5vr4�4 el 2mchk mfr I elev - a _ s F 99.62 ft 4 36 - � /8 A lcm/ mvfi - - NP NP Depth to limiting factor 35" Remarks: CST Name (Please Print) Signature: Telephone No. Thomas C Nelson 715-246-2454 Address Environmental By Design Date CST Number Ref If 1432 120th Street, New Richmond, Wl 54017 5/22/98 MO2605 89 PA (-f -7 . PROPE$TY OWNER: Mcks SOIL DESCRIPTION REPORT PARCEL I.D.# r ® Page 2 of 3 Desi By Horizon Depth Dominant Color Mottles Structure Environmenta By in. I Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. onsistence Boundary Roots Bed ' Trench J ? 1 0 -9 10vr3 /1 - ail 2msbk mfr Sw 2f 5 6 Tt9-16 10yr3 /3 - sl 2msbk mfr gw if .5 .6 I Ground elev 3 16-40 7.5yr4/4 - sl 2msbk mfr gw - 5 ! 6 102.8 ft 4 40 -44 7.5yr4/4 c2d2.5yr5/8 sl 1 cm mvfi - _ NA NA Depth to limiting factor 44 Remarks: -7- I Ground I elev Depth to limiting factor Remarks: Ground I elev Depth to limiting factor Remarks: Ground elev Depth to limiting factor Remarks: �A E c��� WANG EXCAV 7154255344 P.01 { x x Yc ° /oo► r e Pa PC t �V1 X, x It l x x x DldS�s�em a x �a� doh @c� pb4e Be r ooA J•JOus E x 9� o g a 1 pu x pe 1 a jc .. ` (P o o x � ►b . x ga A B,rn, H•ta Corner a l S`it_J jrd Fk, x loo, o )c E::J x V 9 9 a:: X Y y Moon, DVP03 MODEL 3871 • • Submersible Effluent • • 5 MEIEp° FFF7 S mlmii,m a �5 IE p S tillofdr I Single pttm:115v BrasaM mOpils* 5 ,s FeWM no e US *T OP ssuctton eliminates � p Impeller clogging. z rlro+ • Corrosion resistant ' construction. I I • Float actuated switch. o %- _ 0 70 METERS PEn CAPACITY _ -- ' MODES. UVPO3 pump Specifications Features and Benefits • m _ '/a and I/F HP • FPO4 wilreller scnli olrett +tcsitpl s Up to 60 GPM with Ilunlp oilt valves lu Inoflrca 7° Maximum head to 32' rtteChani+:al seal. , . Discharge size 1 VF" NPT • EP05 Inil)eller - wido( e(l design __ )roved Solids 'h for im ° maximum i per l+ll rn. +nc +! ' • Ru ecl htiti fiucll Ih(:nno )I)ISGr: • .. .._ . _ _ _ Motor All motors feature ball 1 ' casnu Intl hale dfaiyn Irrovi(Ics bearing construction sohrnnr ,twmjlh ;md (mFio ll p ° p ^•••° ••,.• . 75_ . - - e0 U.B.OPM Ig$ISlall(:1'. o i a e Fo�F. Single phase: 115V m Materials of Construction •Carl coil illol(11 II(I+Itiiny for Cast iron ef(wivrll heal Irantilf:r, stren+llh, Thermoplastic Intl clill,11)ilily Stainless steel -Corrosion reSjm;wt thrf�txle(I stainless steel shalt • Available for aotonr)lir. an(J manual operation • C5A hS1P,(I fno(lels nv,iil,tl)le Ad Mbdefs are designed for continuous operation and feature stainless steel l /0 �� /0 i ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Own Buyer 0 a I C ` r _ R,'J� Mailing Address l 7 13 e) Property Address 'n Zj�ar� (Verification required from Planning Department for new construction) City /State L� el�� �� D s� (� 1. Parcel Identification Number _ Dad - / v 29 - 3 LEGAL DESCRIPTION Property LocationN42 '/ - ', C h `/a, Sec. J b / , T 3b N -R /? W, Town of fA ACAd . Subdivision , Lot # Certified Survey Map # Volume , Page # Warranty Deed # 0 6 Y Volume �� d , Page # Spec house ❑ yes ,j no Lot lines identifiable �3 yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal 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 our septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of a three year exp' n da$e. 1 / ll � SIG OF APP I ANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the pro .-Z---\ descri d above, v f y u a warranty deed recorded in Register of Deeds Office. SIG OF RANNT 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