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HomeMy WebLinkAbout030-1065-95-100 r" o y C Si F c 0 0 �1 c co (D co v • CD m I 0 m o o v o ° N on o o cn o ° CD C • cn °w • CL rn a '• m CD m y Ul m CD m ai p m v°`i ° c O c !D y N .-. N -� O ►'9 3 . m -� cu CD :3 _� j v co ° rO� N N y 3 y 3 ? ( G �° c A y CD n W a G 0 -' 3 a s 7 y W 7 y W y y C N to p Q W W M m cn D (D a a v> Z D a CD (Q y y a co (O D y a A 3 CL I W o cc m a W im O y O v qo fD O Q y N f .... f l co y 00 w .0 p co o �!! N M co) '� aD oo S . Q 3 3 000° 000° �' �• o z tS tS CS C //1�.�� A O 0 Z1 i -i C � -i < < N Z V Q i N 3 co cn cn 3 y w y o D - �f ° o m c F* m e o lQ m M .y U! w y N p hD 2 v p f c0 l� cu 3 d < 3 d I a =• = I 7 ; o ` �1 Z 0 0 O D D c O D o a N• ' ` y I N CD CD C CD N. OIQ I a 3 I 3 7 Z � y o A?t„� =; y c CL A � � N 0 CD M CD C) o on 3 a z y Z y Z < cn F � a+ I I I a � a I 0 a o w T =r v m o a m o z a m z o CD y 0 S y I I � I I � I I y a I V N O I I ° a ti 0 0 N m m do ti ffl 0 Efl N p p O a O a �„ Wisconsin Department of Industry SOIL AND SITE EVALUATION Labor and Human Relations Page of 3 Division of Safety and Buildings in accordance with S. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County ' clude; but not limited to: vertical and horizontal reference point (BM), direction and S percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # ; 30 S APPLICANT INFORMATION Please print all information. Reviewed L 6 Dat Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Proper7wner Property Location 2( NTy aA—,_ 4L" Govt. Lot S� 1/4 AjV1 S T 19,R 4'. E (or Property Owner's Mailing A dress Lot # Block# Subd. Name or C # 33 q,4 City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road w-' S /7 (7is' V Y6-3J vZ — ST. Fr -�.� s ❑ New Construction Use: ® Residential / Number of bedrooms Z Addition to existing building ® Replacement ❑ Public or commercial - Describe: Code derived daily flow L $�(� gpd Recommended design loading rate S bed, gpd /ft trench, gpd /ft Absorption area required 3 ?r bed, ft 3 7 5 trench, ft Maximum design loading rate bed, gpd /ft trench, gpd /ft Recommended infiltration surface elevation(s) d 7 L S ft (as referred to site plan benchmark) Additional design /site considerations Parent material 0,2� - Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system I ❑ S 0 U EIS ❑ U ❑ S ®U ❑ S ®U ❑ S Fl u ❑ S R] U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench -/Z 73-Y 2Zs 3 W sZ- S, Ground elev� Depth to limiting factor Remarks: Boring # S FsdX inv R w /c�� , s' , G .2 AS,9K Melek 5W Ground elev. ? Depth to limiting facto ) in. Remarks: CST Name (Please Print) Signature Telephone No. S r-6�37 Address / T� T Date 7 CST Number , I I I ' I I I i i - P I � el I pf I I : i f I I I I I I 1 1 I f I ! , I �o I I I I I I I I I I I I I i I i I 1 I 1 I I I I ! f ! , I I I ' , t j i + �4 FILED AUG 2 7 1996 ► `' ` ' 71996 KATHLEEN H. WASH l 9 Register of Deeds ST. 548'745 St. Croix Co.,WI CROIX � SORVCRO' COIN D � w CERTIFIED SURVEY MAP 25 SECEC. . 25 Located in the SEJ of the NWj of Section 25, T30N, R19W, Town of St. Joseph, St. Croix County, Wisconsin. z _w OWNER 10 m David Railsback 4 845 133rd Ave. v New Richmond, WI ni 54017 UNFL/AT T ED �AN C , S West line of the SEk of the NWk S00°05'.32 °E 1319.43 5��1� �T��c� i - _ w m 50.01' — 6 59.72' -- — 659. ?1 Lq — w 35' 659.75 —�-- W � 659, 74' jL io S00 °26'52 "W N 1319.49' A 1 1i - -- - - -- - - - -- w IL ID I� TS n l I 10 1 -1 1 -1 1r-1 J� z m w z � �' H CQ L J $ `! (D Cb K m p M O w- v� oo C O a M �,. o. r I LD O 00-4 V V O m �> `rv J ma m> a d —1 U7 V1 0) N N W a N N �p W _ m co IV _ 7 ZA CL U N n n N 3 _x o AUG 2 7 4' Z o o am _ O Z ✓ 25 iL �o s y N C N c: to ti ! % � m . �, a'r . CROIX COUNTY 1 O1 I` C C) �, e 0 Icy n '� `�ompret►ensive Plannir o IG� 9 I Q) «, L., ` n Zoning and +� (�� �;e Parks Committee m �� d If not recorded fi within 30 days of approval date y 659.16' approv Shall b% 59.16 `* - Kjnr) 17 1� "W+' -- IZI * s aw ccL _a _ ►n.,t 1• a ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner Address /,TSB R312, Sr .s City /State ovp Legal Description: Lot 2— Block �&A— Subdivision/CSM # j ? A1 , 13acX -0 y,g �/ j/ ,q '/4 %. ". Sec. A.E, TAN- R-jjW, Town of 5, , rjo5=g j4 PIN # 030 � ©6 f 9S = a�i g - SEPTIC TANK - DOSE CHAMBER - HOLDING TANK INFORMATION: Tank manufacturer W - 's Size ST/PC � / /an Setback from: House Y,5 Well l02' 6 P/L Pump manufacturer Model _ 5?h Alarm location -- HOLDING TANKS ONLY) Se 'ce road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM: Type of system: M-Oq A/D Width _ � Length 7 Number of Tv=hes —�f,Z Setback from: House / 3:y Well .,L042 `` P/L 167 Vent to fresh air intake / 3 4e ` ELEVATIONS Description of benchmark /d " f�[Je /� //�� Elevation / O Description of alternate benchmark l3 t7 / Elevation `uilding Sewer 11Y, / 3 ST/HT Inlet D ST Outlet 2,6 PC Inlet .9 Bottom Header/Manifold Top of ST/PC Manhole Cover bution Lines O � 7 O ( ) of System tde ( ) O ( ) tallation /0/ / Permit number _ / -)3 55 V State plan number 3,2 ,o 2 �2 ;nature - License number 2217 y1 Date / / / 1 w 1 r 1 4 Complete plot plan er e e e M HEAD CAPACITY CURVE EFFLUENT 0000■■ 00�0� ' ®�������■ \ \ ■ ■ ■ ■ ■ ®mmm ®mom ® ®� ®m ®mom ®m ®��m� ®� ®� ®� ■ \ ■ ■ ■ ■ ®omm ® ®gym ®mom ®m ®0® ■ imp ®m ® ® ® ®® ■\ ■ ■ ■ ■ ■ ■ ■ ■ ■ i��omm ®mom ®�® ■ imp ® ® ® ®® . 00 \ ■�m�m�m�m�������������mm��mm�® 8■► 1 \ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■�� ■� ■ ■■■ ■gym \�\ ■111 ■ \ ■ ■ ■ ■ ■ ■ ■ ■■ \\ \11\1\■\■■■■■■■■ \I� ■I ■ ■ ► ► \ ■ ■ ■ ■ ■ ■■ column-exp less than 30 feet TDH. \�■ \`1111 \ ■ ■ \ \ \ ■ ■ ■ ■ ■■ NOTE: For Head .... . ■� \1►V1 ■\■M0000 ■■ �■■INO1\ ■101■\\ ■ ■ ■■ 51 -4 N0N00 \■■■■ ►&\\►i.b � \ \\■■■0;\000 K \9■11 N! N's ■■■0000 ■1 \�■11■�' I ► \QMm ■ ■■ \■■ M HEAD CAPACITY CURVE SEWAGE ■ ■�, ■ ■ ■ ■ ■■ ■mom ®oo�omommmmmm ®mm� ®��� - ■■►e ■ ■■ ©�������������m�o ®mom ®moo ■��m o • \�� \�� \�� ■ \� \� MEMO ■MEMO Mod should not be subjected to less than 15 feet TDH. . . .......:..............:........ cousin Dep artment dings Division Commerce PRIVATE SEWAGE SYSTEM County: Safety and Buildings Division INSPECTION REPORT 64. Croi,R GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. ,320 2 51- Permit Holder's Name: ❑ City ❑ Village &WTown of: State Plan ID No.: A Lave os H 1 3 35 CST BM Elev.; Insp. BM Elev.: Mescription: Parcel Tax No.: 0 6 , (� 2 " � G �� <i 03 - 16& - TANK INFORMATION ELEVATION DATA 4980 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. eptic O 2 8 O Benc c ar / 2. Z2 (t2 12- loo osln CJ (DDo 4C, {.6 7 !? 3 lot 1 Aeration Bldg. Sewer 0 L , 10 •03 (/cF• 13 Holdin W* inlet It' I Ig,sq g,q1 I wol.13 TANK SETBACK INFORMATION 19/1t Outlet r 1(aB�I q. /g / row TANK TO P/ L WELL BLDG. qe Intake ROAD �t Inlet 4 z (08 By it-#& /oS• S pti ZSJ't toot S� ^'l NA 5t v "�' X 3,1 J14.00 G 105.71 osing 2,5 /o0 /r8� /(f NA Header /Man. ►12.22 10- eOi !d't•r Aeration -- NA Dist. Pipe p lr�•Z2. Io•�Y /oz•o7 Holding Bot. System I c�. Lam• (o,�y l o ! •�� PUMP/ SIPHON INFORMATION S, _ Final Grade Manufacturer j Nt r - Demand PC ., !12.22 12, 9 ?• 7 Model Number 1 7$ 32,76GPM PG "en rrUtiL /6Ai6 g'S 3G TDH Lift 4 •"11 L oss riction �� System L$ TDH • /o. 13 Ft ' t , &. Z H e ad [�,,� 19.6 //2.2L Forcemain Length ZIV Dia. Z" 1 Dist. To Well �L /f g•$ 9 •f 7 1 o q. 3 7 n SOIL ABSORPTION SYSTEM TRENCH Width r Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS g �' DIMENSI SETBACK SYSTEM TO P/L BLDG I WELL LAKE /STR LEACHING Manufacturer: INFORMATION Type O C o e Number: System:rryl 107 (3 r +1So ` OR UNIT DISTRIBUTION SYSTEM Header /Manifold Distribution Pipes) x Hole Size x Hole Spacing Vent To Air Intake Lengt Dia. a Length `r7 Dia. 1 X1 2 Spacing 3' It .r —7 Z," 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 1.2' Topsoil �,. ®Yes ❑ No Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) 3 S3 8'3 (07 2 wl = 6.3q k te 5 " q41 T.T• SewW - h u /'i e4 wf S � lnsk1u,.-� OL .14,1d1w Di (P V on r,VfL-Y Fi ►�p/� tiv �1 Plan revis on requrr � d? ❑ Yes dNo Use other side for additional information. 10 1 SBD -6710 (R.3/97) Date Inspector's Signature Cert. j FROM SCHMTT & SONS EXC PHONE NO. : 715 549 6651 Oct. 07 1998 11:55AM P1 -soft 1 �o �00 Dolv F2�r7 �3 _. 2-2 12. CP - -- 0� o z 67 uF . -- _ - 1 2s Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count Safety and Buildings Division ST . CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy L 11 s.15.04 (1)(m)]. 320252 %y ldeq t ffe: I City fLV�I Town of: State Plan ID No.: I SST J U CST BM Elev.; Insp. BM Elev.: BM Description: Parcel Tax No.: ���� U� (Qp 2 " UC 030 1065- 95 -$@O TANK INFORMATION ELEVATION DATA A9800437 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. eptic (�1 !_e.�2d Z koz> Bench mar I 1 2 -Z7r 112. Z2 osing w I wo Aeration Bldg. Sewer Holding St /# Inlet s TANK SETBACK INFORMATION C5T?4iy Outlet /(S �Y9� 4• I ' ! 0 O ( TANK TO P/ L WELL BLDG. Air l to ntake ROAD gt Inlet (I t 8 12 10- ir Septic C/ s' NA Bt Be�tter+� �z Dosing NA Header/ Man. 0q 10.2 , / 3 Aeration A Dist. Pipe to. i7 O.IS - Z'7 Holding Bot. System G7 10.1� PUMP/ SIPHON INFORMATION 54 m Final Grade Manufacturer t I � � Demand Model Number 8 ""-'GPM z�4- * 'X e ? . �0 TDH Lift4,71 Friction q2 System1t TDFI/O,� Ft PG ��I''G� Iz•{(o 9y,7 Forcemain Length qS/ Dia. 2 Dist. To Well � p� art- -r- S IL ABSORPTION SYSTEM BED / TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid D th DI MENSIONS Y -75 L DIMENSION SETBACK SYSTEM TO P / L BLDG WELL LAKE / STREAM LE HING Manufacturer: INFORMATION Type O r ' I � CH odel Number: System:p4 f'D i Jv --� OR UNIT DISTRIBUTION SYSTEM Header / Manifold Distribution Pi e(s) x Hole Size x Hole Spacing Vent To Air Intak Length e 2 � /�� �• ply, -7 Z,. _ Dia. Length 7 Dia. 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 ❑ Yes ❑ No ❑ Yes ❑ No r. COMMENTS: (Include code discrepancies, persons present, etc.) 0•0 9. 7• ,5' LOCATION: ST. JOSEPH 25.30.19.241,SE,NW 1353 83RD STREET - LOT 2 <v 3c � � � , Ei . >�' r. .� , ,�' ,r, :.. U4�� R f .,,�.x. . .. '�" s '.,= sw °`'� . S ya , � � ���-�..,. � r. �. • .;�,c,. /c;; i c%j'' Plan revision egqu6r�P ❑ Yes M Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. Safety and Buildings Division cw SANITARY PERMIT APPLICATION 201 E. Washington Ave. 14sconsin In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Department of Commerce Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. • See reverse side for instructions for completing this application State sanitary Permit Number 2oZSa- The information you provide may be used by other government agency programs ❑ Check if revisio� previous application [Privacy Law, s. 15.04 (1) (m)]. St ` )VA State Plan I.D. Nune� I. APPLICATIO INFORMATI - PLEASE PRINT ALL INF RMATION Property Owner Name Property Location E 1/4 NO 1/4, o95 T 30 . N, R /� E (o W Property Owner's Mailing Address Lot Number n Block Number 3 S C o L City, State Zip Code Phone Number Subdivision Name or CSM Number II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ it Nearest Road ❑ Village r . Public 1 or 2 Family Dwelling - No. of bedrooms Town OF r D 83 A0 5/ 111. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 95.30• /9-51 / 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. X New 2_ ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Only Existing System__ Existing System B) ® A Sanitary Permit was previously issued. Permit Number 30 7 2 Y Date Issued V �8 V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 []Seepage Bed 21 J3 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 I Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation 7 ,5 " 0 1 6 5 6 32 . Feet 3, Feet VII. TANK Capacity gallons g Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glaze Plastic App New Existing structed Tanks Tanks Septic Tank or Holding Tank 800 (,00 `S r El ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber Q 00 1 I lei ❑ ❑ ❑ ❑ ❑ VI11. RESPONSIBILITY STATEMENT I, the undersigned, assu responsi for installation of the onsite sewage s stem shown on the attached plans. Plumber's Name: (Print) Plu is Signatu�MP / Business Phone Number: v /7 s - ?!s S G 6s / u bei s Address (Street, City, State, Zip Code): _ �yo� s IX. COUNTY/ DEPARTMENT USE ONLY Q Disapproved Sanitary Permit Fee (Includes Groundwater Date ssu Issuing A ent Signature (NO Stamps) Surcharge Fee) WApproved [:]Owner Given Initial 2 0v 0o / act Adverse Determination /, X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -6398 (R.1 V96) DISTRIBUTION: Original to County, One copy To: Safety Z Buildings Division, Owner, Plaerber y Safety and Buildings 2226 ROSE ST LA CROSSE WI 54603 -1905 i sconsin Tommy G. Thompson, Governor Department of Commerce William J. McCoshen, Secretary August 27, 1998 CUST ID No.221741 ATTN: POWTS INSPECTOR DONAVIN L SCHMITT 586 VALLEY VIEW TRL SOMERSET WI 54025 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 08/27/2000 Identification Numbers Transaction ID No. 133554 Site ID No. 157454 SITE: Please refer toboth identification numbers, Site ID: 157454 above, in all correspondence with the agency. St. Croix County, Town of Saint Joseph SETA, NW1 /4, S25, T30N, R19W Tim Lange FOR: Description: Mound Object Type: POWT System Regulated Object ID No.: 416794 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: • This system is to be constructed and located in accordance with the enclosed approved plans and Y IM 004A with the Wisconsin At -Grade Soil Absorption System Manual (Pub. 15.21). I • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard by discharge of partially treated or untreated liquid wastes to ground surface or into surface waters or groundwaters of the state, the owner will employ a properly licensed plumber to repair, modify or replace this system (including the possibility of installation of a holding tank with proper disposal) with such action approved by the Division and appropriate local officials. • 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 /instal lation/operation. MOUND SYSTEM for 17s c'elvs o TIM LANGE 4 IJG 2 5 1998 !s FF 1 14 N- W 1 14 S 2 5 T3 ON Rz 19W St. joseph Township ni Cn I ,St. C r � -mty Page 1 Work Sheet Page z Soils Report Page 3 Plot Plan Page 4 System Cross Section Page 5 Pipe, Lateral Layout Page 6 Dousing Chamber Page 7 Pump Curve Prepared by- Dona L. Schmitt 586 Valley View Trail Somerset, W 54025 LL 715 5449-6651 ) MPRSW 221741 P.0A fly August 20,, 1998 Coilditl'otta '��, r 133 SYY g'-A 9- 5V OPTIONAL WOR Page � KSHEET V 1. MOUND S'r S I LM 11. IN GkUt;tv;) i`I :'. ,URL SYSTEM-Continued- 1. WasteM'atc Load, Total Daily Flow= 10, frilly A1.IIn: Use S. IT 83.15 (3) (c) k'i,„n:um Dosing Rate = l ;4 Pm. Adm. Code and PROVIDE A DETAILED i)ometer - /Z in. LIS I OF SIZING ON PLANS. ` 11. Tn:ai'iyn,,mi:. Head: 1. Depth to Limiting Factor = f1 Sys:crn Head = 2.5 ft. 3. Landslope = 6 % Ve itcai Lift = ft. 4. Distance from Dose Chamber to Friction Loss = ft. Distribution System = /DO ft. i DH = s/I ft. S. Elevation Difference Between 12. Pump Selection: Pump and Distribution System ft. Pump will discharge at least • Spin 6. Absorption Area Sizing: at 5 ft total dynamic head. _ Area Required = sq. ft. Pump model and manufacturer: M Bed or Trench Length (8) _ ft. - Bed or Trench Width (A) = ft. 13. Dose Volume: Trench Spacing (C) _ ft. 10 Times Void Volume of 7. Mound Height: Distribution Lines= al. Fill Depth (D) _ ft. Daily Wastewater Volume r Fill Depth Downslope (E) = ft. 4 Doses In 24 hrs. _ g al. Bed or Trench Depth (F) _ � ft. Backflow = gal. Cap and Topsoil Depth (G) = � t � ft. Minimum Dose = 6JL gal. Cap and Topsoil Depth (H) _ ft. 14. Dose Chamber: S. Mound Length: Volume = gal. End Slope (K) = ft. Total Mound Length (L) _ 4 ft. Itl. C NVENTIONAL PRIVATE SEWAGE SYSTEM 9. Mound Width: p / 1, astewater Load, Total Daily Flow = gal. Upslope Correction Factor = , 8 (, a S. ILHR 83.15 (3) (e) , Wi Upslope Width (1) = 7 '� ft. dm. Code and PROVIDE DETAILED Downslope Correction Factor = ' Z L T OF SIZING ON PLANS. Downslope Width (1) = ft. 2. Require optic Tank Capacity = gal. Total Mound Width (W) _ a 217 < ft. 3. Percolation e = min. /in. 10. Basal Area: 4. Absorption Area izing: Infiltrative Capacity of Refer to Tab 2 in c . ILHR 83 Natural Soil = • S gal. /sq.ftjday and PROVIDE A D ILE LIST OF Basal Area Required = sq. ft. SIZING ON PLANS. 1 Basal Area Available - sq. ft. Required Area = sq. ft. 11. If Standard Tables from Chapter ILHR 83 Length = ft. are used, Indicate Table # Width = ft. 12. For the Distribution Network, Use Numbers 5.14 in Section I1. Number of Tre hes = Trench Spaci I= ft. 11. IN- GROUND PRESSURE SYSTEM S. Distribution 5 stem: 1. Depth to Limiting Factor = ft. Lateral ngth = ft. 2. Landslope = % Num of Laterals = 3. Percolation Rate min. /in. Lat al Spacing= in• 4. Proposed System Elevation 161,41 ft. stance from Sidewall to Pipe = n. 5. Wastewater Load, Total Daily Flow- _Z5 �) gal. System Elevation = Use s. ILHR 83.15 (3)(c), Wis. Adm. Code and PROVIDE A DETAILED IV. SYSTEM-IN-FILL LIST OF SIZING ON Fill in All Items from Section III �j M j��/ 6r�� Required Septic Tank Capacity = I N� gal. t1 ` v Gf 6. Absorption Area Sizing: V. SEPTIC TANK U/ R �� �C e PWaseia6en Rate = _141' min. /in. 1. Capacity = , ') �;� lr LT C= gal. Area Required = (° � sq. ft. 2. Manufacturer: W h A System Length = ft. 3. Shots Sire Constructed Tank Details on Plan System Width = ft. 7• Distribution Pipe Siting: 1 VI. DOSING TANK Holc Siic = in. 1. Capacity = 04170 gal. Hole Spacing = IL M.Inu(aclurre Lalcr.il Length It. .1. Pump Manul w iurct: I �" L.L 1 .,Icial Svc in. 1. Pump Mo.lel: Fyn 1 .rlcral .Ifon � I "". t al' c Held= gp D-0.141 D-0.141 Irodew.rll lu Pipe � n, (. I I,n, I:.,li 1 gpm. A. Di.urbution Piles Di.,h.ulc R.ue: Sho,, ?ac C n7atrut(cd Tank Details on Plans Number of I luly% I 1'ila• I low l'er 1 Will. VII. 1101 1. /. 1 1Nk 9. M.ualold Lung. I, l - JOJ,rN - gal. (ypr (.role, m earl) ! C, 1 en):111 3 I1. 3 S',, . s , c , n.tru,led Tank Details on Plan 1)lameh•r __�_ rn SHOW ALT- INFORM AT ION ON I'L ANS - D1t 11R %Ill) 1.11,1 (R n , 1 i 1 --r i 'firl � cnNrou71 -zi i a i t a I I : , , i i i Wisconsin Department of Industry SOIL AND SITE EVALUATION Labor and Human Reiations Page of 3 Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County Include, but not limited to: vertical and horizontal reference point (BM), direction and 54 , 6 6 ) percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # 30 — APPLICANT INFORMATION - Please print all information Reviewed by Date Personal Infnrmation you provide may he used for secondary purpnses (Privncy Law, R. 15.04 (1) (m)). I'lul+aily lwua� I'1411 uuly I iu+nllun h Govt. Lot < 114 / V W 1/4,S a S Q T ,N,R 1 W) W Property Owner's Mailing Add ess Lot # I Block# I Subd. Name or CSM# 4 511/81c�s" I'U3 51, AIR I /q/,* sc S PA k 11!L . — Via . City State Zip Code Phone Number Nearest Road OYI " (71S) _78 3 394 ❑City ❑Village Town f New Construction Use: Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow 7Sb gpd / Recommended design loading rate _! bed, gpd /ft � / trench, gpd /ft Absorption area required _ _bed, it � trench, it 2 Maximum design loading rate _ _5' -_bed, gpd /ft ' C2— trench, gpd /ft Recommended infiltration surface elevation(s) /0/ . 7 r it (as referred to site plan benchmark) Additional design /site considerations S 7e H EL 6�+s e� ©" C i Tov2 61 NE 16 4 /5 /1 � � n / fin• � �/ Parent material S��& DoeI'A A 6 +i al/'Li a / 41 Flood plain elevation, if applicable / Y /`� it S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ S [a U as El El S IS U El S N'U ❑ S ®U ❑ S 9rU SOIL DESCRIPTION REPORT Boring # rorizon D epth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench S - r) v 7 RS . Ground Alm ft Q S elev. . - l Depth to limiting ; factor 42Z in. Remarks: Boring # 13 3/.? S fir I,J . Ground '� 7 oe y� -5 el� , Depth to limiting factor ,sin. Remarks: Lm a (Please Print) ignature + _ Telephone No. �7 /S) S� /cj -�(s s �� ` �-y/ Date CST 7 Numberr Ild , i � � � L ' I i i i � i J _ O I ;! i ! i 1 o3 3Q o } �- el. T I i Y 1 i Q I � � � )L �i '�° i 1 r� � h y 1 t7�:� I d..��uc•:lS�'''t� �' i - , o Page — C Straw, Marsh Hay, Or Synthetic Covering Distribution Pipe Medium Sand H G 6" Topsoil 3 ED , b % Slope Bed Of 2'- 2 1 2 Force Main Plowed Aggregate Layer (6" Below Pipe) D Ft. Cross Section Of A Mound System Using E Ft. A Bed For The Absorption Area F • Z� Ft. G / Ft. A Ft. H � Ft. Signed: B JL Ft. License Number: ; z K �_ Ft. Date: 7-30ZE L Ft. d Ft. I_ Ft. W O Z 7, Ft. — L Observation Pipe B K I -- A W I �----- 1------------------------------- - - - - -- I Force Main 0 Distribution Bed Of 2 2 % Pipe Aggregate 'I Observation Pipe Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area Perforated Pipe Detai / 1 End View (Perforated End Cop 1 ,^ PVC Pape Holes Located On Bottom, OS S Are Equally Spaced Q �rrp MAW - o P Distribut � Pipe Lost Hole Should Be Next To End Cop Distribution Pipe Layout P 2 — Ft. `v S 3 ' X InchPr, Y Inches Hole Diameter Inch Signed: Lateral J/ Inches) License Number: i� /7 y� Manifold_ Inches Date: 2 -30 �B Force Main �_ Inches #of holes /pipe - 7 � M Invert Elevation of Laterals /o),/ Ft. /, / 7 s 75 X;- i i ' PAGE OF • PUMP CHAMBER CROSS SECTIOM AK1D SPECIFICATIOKIS VENT CAP _T 4 "C.1. VENT PIPE WEATHER PROOF APPROVED LOCKING JUNCTION IBOX MANHOLE COVER 1 25' FROM DOOR, WINDOW OR FRESH It'M111. I AIR INTAKE i GRADE `I' MIN 1 A'Aim. cOIJOUIT ______ 10'MIN. \ PROVIDE ( - - - -- . INLET � A►RTIGMT SEAL II v APPROVED JOINT A I I I APPROVED JOINTS W /C.T. PIPE I I I( W /C.I. PIPE EXTENDIN159 3' I II ALARM EXTENDING 3' oNTa soLlD sol L e � 11 ONTO 30LID SOIL ' i I ON C I I I LLEV FT--s- � '-� PuMP OfF D COWCRETE BLOCK RISER EXIT PERMITTED OWL1 IF TANK MAWUFACTURE:R HAS SUCH APPROVAL 3•APPRovQp 8¢OOING SEPTIC E SPEC.IFICATIOKJS OO S E �� K . q TA MAM UFACTURER: NUMBER OF DOSES: PER DAU TANK SIZE: GALLONS DOSE MI VOLUME 9 ALARM P UFACTUK K L GR: LANK AL�R r INCUOIWCs BACKIN.0w: fiAULONS MODEL NUMBER: NA CAPACITIES: A= IL I1JCHE5 0R SLi ..YG ALLON S SWITCH TYPE / C U2 4 g = INCHES Oft 1130 2 GrLL0N3 PUMP MANUFACTURCR: Z/3 ELC.E_1_ C ■ 10 I U CHES OR .61r I GALLOIJS MODEL NUMpER: yD D - / 1 1 INCHES OR A 4 ^ - GALLONS lNGA't /O 70,G � SWITCH TYPE: MC �C',U t/ MOTE: PUMP A 0 ALARM ARE TO BE MINIMUM DISCHARGE RATE GpMM I' INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEIJ PUMP OFF AIJO..0I3TR18UTION PIPE.. FEET + MINIMUM NETWORK SUPPLY PKE .. . . . .. .. . . 2 5 FILET + „L0 D FEET OF FORCE MAIN X jL: Y,..tEFRICTIOU FACTOR.. FEET TOTAL DtIWAMIL HEAD = FEET INTERNAL DI ENS104 Of TANK: ;WIDTH / ;LIQUID DEPTH ���y !r SIGKIED: LICEWSE NUMBER: � DATE: 101A1 DYNAMIC HEAD /CAPACITY _ A e HEAD CAPACITY CURVE PER MINUTE MODEL -10.4140 EffLUCNT ANO DEWATERINC L. - MODELS C )4 MODELS 137/139 140/4140 o Ft. M W. Lt'.. C.I. Lt'.. D a 1!r 93 352 12 Sea >• rN 90 141 140,4140 1a 4 at a, 241 u 114 9 » 9.1e 19 136 n its 10 ra ry 9 e 1 1 /!' - 11 1/2 NPI A a 138 10 ^ — — _ -- - f0 9 14 !a rot I M 1 ti1,11'1 �i lilt ,i i.i •9' \ 1 E ro 4 to I I rr 2 s A B C 0 E F D 009921 1371139 4 314 7318 8118 4 314 1 314 4 us GALLONS +0 30 4o so w 7o w 90 +oo + +0 140 4314 8 5118 813132 4 15 81/4 uTERS e0 1w 240 3 io 4 00 4140 4 314 85115 81 2 4 314 1 114 0 now PER MWuTE CONSULT FACTORY FOR SPECIAL APPLICATIONS • Three phase pumps are available in 2001208V or 230V - 137/139 Models. - Variable level control switches are available for controlling single and three • an la cal alternators, for duplex systems, are available and supplied with - Double piggyback variable level float switches are available for variable level an alarm. • Mechanical eNemators, for duplex systems, are available with or without - L cords e available in lengths of 15- 25 -35 -50 feet, (Maximum 25' length Glenn switches. • Combination starters are available for 3 phase pumps. for 140 /4140 models Q 115V) • Control alarm systems are available for 1 phase pumps. • Over 130'F. (54'C.) special quotation required. 137 Series - 47 bs. 139 Series - 51 lbs. 140 Series - 53 lbs. 4140 Series - 73 lbs. • Refer to FM0806 for 200' F. applications. N Sal ConUol Simon s Model V0ft h M AnVo Si D CSA UL SELECTION GUIDE M113711139 115 1 Aulc 10.7 1Or138 — Y Y N1371130 115 1 Non 10,7 2 or 2 3 7 3 or S 8 8 Y Y 1 1. Integral float operated 2 pole mechanical switch, no external control reed' • BN 1 — Y Y 2. Single piggyback variable level float switch or double pi99Yba* verwe level D1371139 230 1 Aub 5.8 1 Or 18 8 — Y Y float switch. Refer to FM0447. E13 TH39 230 2 or 2 6 7 3 or 5 8 6 Y I Y 3. Mechanical alternator'M -Pak 10 -0072 or 10.0075. I M206 AUIA 55 Isl — Y N 4, Combination Starter. Refer to FM0514. • 1137!139 200.208 1" Non 5.5 ' 2&7 3 or 5 8 6 Y N 5. See FMO712 for Correct model of Electrical Aftemalor • E -Pali • J1371139 204208 3 - Non 2.8 2&4 334 or Ste Y Y 6. Variable level control switch 10-0225 used as a control adWw, specify duplex F1371139 230 3 Non 2.6 2&4 334 or 588 Y Y (3) a (4) float system. G137 460 3 Non 1.4 2&4 334 or 586 N N 7. Four (4) hole'J -Pak', lurx2!on box for watertight connection awired -in simplex 0139 460 3 Non 1.4 2 8 4 334 or S88 N N or 2 dump operation, 10.0002. 14014140"' MODELS Control Selection lbtlrl s 8. Two (2) hole 'J - Pak', for Watertight connection or sp5ee,10-0003. Mj&j Model I vorw- Mode A SI DD x SA UL H140 N4140 115 1 Non 15.0 2or237 3W5 1 N I N 140 I E4140 1 230 1 Non 1 7.5 2 or 2 3 7 — Tor — 516 N I N &- 230 1 1 Non 1 7,5 2or2&7 ;Or H§ N GN1401 Bt441401 115 1 t Non 15.0 2or287 3or538 N N CAUTION • No all 10M •• sio 099016ut.wedt:lduara All installation of controls, protection devices and wiring should be done by •� DOUaa eat pla+p an at airbla war aplbnM lroiaeae wrara. Sal Fai il+diotar lot araibla in WJ A t o r NW 4 x a qualified licensed electrician. All electrical and sally codes should be ooiI ° 9onft followed including the most recent National Electric Code (NEC) and the Pumps must be operated in++Pd9blposf Occupational Safety and Health Act (OSHA). Ttxee plisse un4s require a control PAM to Operate an external magnecc or combination starter. Fa infannaeon on eddi8one12oder products mfer b cowN on Combination starter, FMo514: Pgabe dkVwmbN," FbatSwitch. FM0477 :CkcolcoAeemstw,FM04e8;ML•cAa -WAllerna- to, FM0495: Alarm pedtape. FM0513; and SWVUwage Basins. FM0487. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16347 LOUiswae. KY 40256-0347 Manubdurersof. . . SHIP TO: 3619 C an# L 40211 -1961 ouisvlse, KY 10211 -1961 Qvaurr Putiv6 Shff /9499 r. PUMP !O. (302) 778.2731.1(600) 928 -PUMP FAX (502) 774-3624 4� z , Wiscopsin Department of Industry SOIL AND SITE EVALUATION Labor and Human Relations Page —L of 3 Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. County Attach complete site plan on paper not less than 8 1/2 x Wdh) ln�slZe include, but not limited to: vertical and horizontal refer fic'e j*ht (BM irection� percent slope, scale or dimensions, north arrow, and location and�CRtpinear K Parcel I.D. # v;_ 1►►'� LAS �! ®- - Fr APPLICANT INFORMATION - Please �tiorm tion.�r�o all i p rint � ' Revi ed b Date p Personal information you provide maybe used for seconds purposes (PrivajjXLM (NA5.04 (t) ( �) ( (o ° N S Property Owner , P ro p6 ocation �,1 /� 2(�'tl}V (.iflp!"t G©Vf'�L e 1/4NtJ1/4,Sar Tao ,N,R f )W Zct Property Owner's Mailing Add ess ° ',i Block# Subd. Name or CSM# 4 Sy/glyS- a ' . %yA �� Q �� r sb City / Staate Zip Code Phone Number Nearest Road W 4, I OYI G,1Z, 4 � / ( 7 /S) � w'-3394 El City ❑Village t Town XNew Construction Use: I9LResidential / Number of bedrooms J Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: p Code derived daily flow gpd Recommended design loading rate • bed, gpd /ft b trench, gpd/ft Absorption area required bed, ft 2 /ft 2 Maximum design loading rate . bed, gpd/ft ji�__ trench, gpd/ft Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design /site considerations 5VS - I&I EL base 4 11 67 70'R GiEVE '6 Parent material .S( -1 / 54W 40 ( Sr'ld u-arem Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In Ground Pressure AT Grade System in Fill Holding Tank U = Unsuitable for system 1 ❑ s [9 U [mss El ❑ s [S U ❑ S Eru El S ®'u El s &"u SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles Structure GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 9 Texture Consistence Boundary Roots Bed ,Trench S a - S �- T J • fD y� r S —z Ground 3 - 0 5 - f f� L-) ift - D ile Depth to limiting factor 422- in. Remarks: Boring # , 3 sic 3/3 Col / 9 0 1/Z � n °� ��- Ground y� ,l Y t c L !"'r eli Depth to limiting factor 15 in. Remarks: CST N ame (Please Print) / ignature _ Telephone No. !4DM43 S !1vrl. / (7159 Address Date CST Number I I r i f I • I f , i i I I - -- - -- - -- - -1 ` -- r T r I I ' z , I I i ►� asst n` AT -93 e6 :..( G�T , 7� I i • • • op r . 1 i I , , , I ; z I ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer _ 7 , , ,_/l, Mailing Address 12.2.3 Property Address / 3 S 3 83 2d (Verification required from Planning Department for new construction) City/State St.. vsroti f Parcel Identification Number C :30 LEGAL DESCRIPTION Properly Location SC_ %, A za , Y Sec. 2.5 _ T 3U N -R Town of 5'f, JoseAG, Subdivision 9Rhiz 3 DACE Lot # Certified Survey Map # Volume / I . Page # 3 I Sc' Warranty Deed # _ �s - s 2 7 Volume / 7 # 31 Spec house O yes P no Lot lines identifiable I,�' yes O. no SYSTEM M_AiN'rENNNCE consists o lmpropoc se u and maiatenanoeof your septic systemcould result m its pmmatur+e.failure to handle wastes. Propermaiateaa = P um p in g out the SePfic tank every throe 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. T7ue property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a is PSG joumeymaaplumber; restricted licensedpumper verifying that (1) the on -site wastewaterdisposal system Prgpa operating condition and/or (2) after inspection and pumping.(if necessary), the septic tank is I= than 1/3 full of sludge. lfwc, the und=igned have read the above requirements and agree to maintain the your rivate sew dispoW rce and the P gm with the standards set forth, herein, as set by the Department of Comme staling that tic � of Natural Resources; State of Wisconsin.. Certification cep system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of th e three year expiration date. SIGNATURE OF APPLICANT DATE .OWNER CER MCATION 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 property described . b virtue of a warranty deed rc=rded in Register of Deeds Office. SI NATURE OF APPLICANT x/17/ 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 t Y ) ST. CROIX COUNTY -- WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER _ rolv�f : 1101 Carmichael Road Hudson, WI 54016 -7710 (715) 386 -4680 June 19, 1998 Tim Lange 1223 St. Croix St. Hudson, WI 54016 RE: Proposed septic system Dear Mr. Lange: This letter is regarding the proposed septic system on your property (1353 83rd Street) located in the SE 1/ of the NW 1 /, Sec. 25, T30N -R19W, Town of Saint Joseph, St. Croix County, Wisconsin. Specifically, the installation of the proposed conventional septic system as designed by Donavin Schmitt. Based on the on - site investigations by staff on May 19 & 21, 1998, the sanitary permit #307742 is being rescinded for your property by the St. Croix Zoning Department. On May 21, 1998, Jim Thompson and I verified the soil conditions as described in the soil and site evaluation report by Dennis Gille dated July 22, 1996. Our findings revealed that a conventional type septic system could not be installed in the soil conditions according to the state plumbing code -- COMM 83. I also visited the site on May 19, 1998, when you were present. The soil descriptions of the three borings investigated were similar to one another. These borings were dug within the area tested by Dennis Gille. Soil description report: Horizon 1, 0 -8 inches, 10YR 4/4, sandy loam, weak fine angular blocky, friable, clear wavy, common fine roots. Horizon 2, 8 -24 inches, 10YR 4/6, sandy loam, weak to moderate coarse angular blocky, friable, gradual wavy, few fine roots. *Limiting* Horizon 3, 24 -80 inches, 10YR 8 /1 - 10YR 7/1 very fine sand (vfs) at depths of 24, 20, and 39 inches, structureless, single grain, moist friable, that resisted knife penetration at 28 inches, 30 inches, and 52 inches in the three soil borings respectfully. This horizon also had 1% inch to 1 inch bands of vfs at internals of 12 inches in all three borings. 1 Tim Lange page 2 June 19, 1998 This horizon has the characteristics of monolithic sandstone. Monolithic sandstone often grades from a weakly cemented state to hard with depth. The weakly cemented sandstone does not transmit water and therefore is treated the same as hard sandstone. The accepted means of determining the upper limit of sandstone bedrock is to identify where resistance to penetration by a knife blade is encountered. The area reported by Dennis Gille is suitable for a mound system. In order to proceed at this point, a mound system will have to be designed, approved by the state and issued a sanitary permit by our department. Other options available are to soil test other areas of the property to locate a system. If there are any question regarding this issue please contact me. Sincerely, Rod Esli er Assistant Zoning Administrator CC: Tom Schmitt Dennis Gille file Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and 5+_ C IAO percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # j03 0- I Dom • - C1 S APPLICANT INFORMATION - Please print all information Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Govt. Lot 56 7 1/4 NW 14,Sg5_ T }. N,R E (or) W Property Owner's Mailing A dress Lot # Block# Subd. Name or CSM# ZO a � ✓�l City State Zip Code Phone Number ❑ City El Village W Town Near <7 Road ® New Construction Use: ® Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: /' Code derived daily flow 750 pd Recommended design loading rate � a bed, gpd/ft gpd/ft Absorption area required �e bed, ft 2 Co trench, ft 2 Maximum design loading rate I V bed, gpd/fl - 6-- trench, gpd/ft Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design /site considerations Parent material .�V'd S + Flood plain elevation, if applicable n 1 a ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ S ❑ U ❑ S ❑ U ❑ S ❑ U I ❑ S ❑ U ❑ S ❑ U ❑ S ❑ U SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color Mottles Structure GPD /ft 9 Texture Consistence Boundary 1 Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench o YK yl 5 l.• -�a b M4; e- i 2 8�2s.1 o YIR � l+t `- S L Z� ab K wt•Fr � Ground ?> ��. 1 0 4R all V-CS o S � ' elev. , ft 14 tTLt OGGt Depth to �I limiting 40 0 factor Remarks: di _0 Boring # 16 TK 1 19K 1 � 3 2o- vk 0 s r •� •S Ground �/ I Vt elev. r UN 1r ft. Depth to limiting in. Remarks: �l CST Name (Please Print) Signature Telephone No. Address Date CST Number , Wisconsin Department of Industry SOIL AND SITE EVALUATION ,Labof and Human Relations Page / of Ctvision of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and S' percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. � ► Y ,3o s- t ) APPLICANT INFORMATION - Please print all information. Reviewed oat Personal information you provide may be used for secondary purposes (Privacy Law s. 15.04 (1) (m)). Pro Owner �i n Property Location alft rS � �a Govt. Lot S� 1/4 &, 1 / E (or) 40 Property Owners Mailing Address Lot # I Block# I Subd. Name or C j dA_) �_ Sow .� d A �, City f State Zip Code Phone Number ❑ City Village JS] Town Nearest Rolf lcJ I gV,0/7 01r ),;2Y6-3IVa 1 T ® New Construction Use: ® Residential / Number of bedrooms 3 Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow gpd Recommended desi n loadin rate q g g _.bed, gpd/ft z S trench, gpd /ft Absorption area required Absor Z,S' 2 /DO trench, ft � bed, ffp Maximum design loading rate bed, gpd/ft • S trench, gpd/ft Recommended infiltration surface elevation(s) / y S� ft (as referred to site plan benchmark) Additional design/site considerations Parent material - Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system E9 S ❑ U 49S ❑ U E4-S ❑ U EIS E U ❑ S e- U I ❑ S R U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed , Trench /fA,B ' �,ci? 4w MP ; X / Ground 3 elev. Depth to limiting factor 127 in. Remarks: SyR3 /y Boring # /0 3/Z SL /F �ivFif w IUi= .y , S' , ... -5. A YRS z — yFs � • �nG � y �� Ground elegy(. Depth to limiting � fact r in. Remarks: CST Name (Please Print) Signature Telephone No. Address Date CST Number S /4 Guy ,S 7- i z • 94 M Y SOIL DESCRIPTION REPORT PROPERTY OWNER Page 2 of 3 PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench .3 16K j v 2— 4 1-27 16he 31Y Y4 I q Gro und `? -S9 10 w 8/2 X. ; Depth to limiting factor inin. , Remarks: Boring # E3 o -io 1a 3/z SL 0,0 1 U/ 4 1 S' Z_ /0,3G o 3/ f S� ,� Cc �„d S� 1ay� �/z f s �' • r�� '— G , y Ground elev. Depth to limiting facto Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring #, , loe /Z S4 1A4K MAV lle , 0 -L V q /d d 31 el S " lwla a w ­7 1, q V. RP /2 Ground lev. Depth to limiting fact r � S �' n. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBDW -8330 (R. 08/95) YIT • 30 I � I ! I � I I I i I y I - I I i i - 4-- - -�--- — - r I - -r—l- a - - ;--- -I i I � 4 Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of gafety and Buildings Page of Bdreau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. # 3o totes -fir APPLICANT INFORMATION - Please print all information Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location T on Le Govt. Lot $E 1/4 AIW1 14,S XS' T 96 ,N,R 1 E (or) W Property Owner's Mailing Address �-+ Lot # Block# Subd. Name or CSM# City State Zip Code Phone Number ❑ City ❑Village ® Town Nearest Road c I(S) 38'b S+ . T oro is h I v 3eA S +. �$ New Construction user ® Residential / Number of bedrooms — Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow gpd Recommended design loading rate bed, gpd/ft trench, gpd/ft Absorption area required bed, ft trench, ft Maximum design loading rate bed, gpd/ft trench, gpd/ft Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design /site considerations I Parent material Flood plain elevation, if applicable AJ 1 a ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = unsuitable for system ❑ S ❑ U. ❑ S ❑ u ❑ s ❑ u ❑ s ❑ u ❑ S ❑ u EIS 9 U SOIL DESCRIPTION REPORT Boren # Horizon Depth Dominant Color Mottles Structure GPD /ft 9 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench WAFV' C1N 2 i^� L 2c— a KA Ground Z elev. n. Depth to limiting factor in. ' Remarks: c -� b^� -o�Si �'F (� I oY( t u-FS , f �� 1 .k- at Sl_ I `iK Jl� Boring # 19 .r a,A=-t i Li 2. Ground elev. _ n. Depth to limiting factor in. Remarks: CST Name (Please Print) Signature Telephone No. Address Date CST Number r � � Co D L Gh, f Oha, G d /ex Ok G 0?�'�+/ �'lAl -� Self /OcIt , - fa 12- Za 33 zo s v Am ltd ,z L FILED 12 1 AUG 2 7 1996 0 — KATHLEEN H. NlALSH , t Register of Deeds St. Croix Co.. Al W1/4 Co R. CERTIFIED SURVEY MAP SEC. 25 Located in the SE} of the NW} of Section 25, T30N, R19W, Town of St. Joseph, St. Croix County, Wisconsin. z w OWNER �o m David Railsback 845 133rd Ave. p New Richmond, WI Ri 54017 _U T EtD. I AN01S West line of the SEk of the NWk S00 "E 1319.43' � e_ STREE.L -1 _ 01 6 59.72'— _659.71 W 0? — — — — — _ w 35' 659.75' 0 659,74' N �L S00026'52 "W w 1319.49' 1` If" IT 1> � .f I —I Iy I -I I -I N. 1 - IC) Irl x z m C� m (D to OD r'n v CO r W m p 3 a? rn Lit C 0 I tV a 00 00 OD OD M V„ . o. r o. �o. C) N Ct N N v Sao O W-1 v`i O 0) a U1 l0 (.O> N at> T 0~1 a� n� tN N o o� C U! to to m to _ m tp W °L W : : .4 N cr n Ct W N U1 N �� � /� yy � f � r1 r' P it V M ED F3 3 o z CT x 404 25 N �;� AUG 2 7 '96'. �i t z VP ,rs u1 ' II - 0 I L a, Ir' rn a C 6 ' r �± ;r . CROIX COUNTY 1` m r e IC) v 1.1 p c x 3 Comprehensive Piannir Ln tr i' n Zoning and ,, 0) o j- ' m Parks Cornnnittee CD rn It not recorded � within 30 days of 23. approval date n 659.16' approval shag b% jr ., � = r N00 ° 07 ' 13' W �` 1318 .' l i n e i ne of the SE>A of the Nw>r, 1 lo Wiscorisin Department of Commerce PRIVATE SEWAGE SYSTEM 6and Buildings Division Count bT . CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitn8 jrxjihN2_: Personal information you provice may be used for secondary purposes [Privacy , s.15.04 (1)(m)]. Permit Holder's Name: �,�,ity �a(�3 p p Town of: State Plan ID No.: LANGE, TIM 11 v fit' CST BM Elev.: Insp. BM Elev.: BM Description: Parcel 64.:1065-95-000 TANK INFORMATION ELEVATION DATA A9800131 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Aeration . Sewe Holding St /Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. Ventto Air Intake ROAD Inlet Septic NA Dt Bot Dosing A Header / Man. Aeration NA Dist. Pipe Holding ot. System PUMP/ SIPHON INFORMATION Final de Manufacturer Dem d Model Number GP TDH Lift friction System TDH Ft Forcemain Length ia. Fi D� t. To Well SOIL ABSORPTION SYST M BED/TRENCH Width ength No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIM N I N SYSTEM TO P / L BLD L LAKE / S EAM LEACHING Manufacturer: SETBACK INFORMATION Typeof CHAMBER Model Number: System: OR UNIT DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length D Spacing SOIL COVER x Pr System Only xx M and Or At -Grade Systems Only Depth Over Depth Over xx De t f xx Seeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topso ❑ Yes ❑ No E] Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: ST. JOSEPH 25.30.19.241,SE,NW 1$3 83RD STREET 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 E. Washington Ave. *1 1 ; ;wnsin I n accord with ILHR 83.05 Wis. Adm. Code P.O. Box 7969 Department of Commerce Madison, WI 53707 -7969 I • 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. V _ &0 . 1 /, • See reverse side for instructions for completing this application State Sanitary Permit Number 3 0 - 1 - 7 4Z The information you provide may be used by other government agency programs ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATI N Property Owner Name Property Location _ gi /a y 1 /4, 5 g S T 30 , N, R E (or )o Property Owner's Mailing Address Lot Number Block Number 3 S7, Cit , State I Zip Code Phone Number Subdivision Name or CSM Number # v 0/ G 1 ( 7Z5' ) 3,8o9 - 33S'ta V? c II. TYPE F BUILDING: (check one) ❑ State Owned ❑ it Nearest Road C] Village Public 1 or 2 Family Dwelling - No. of bedrooms K Town OF % ll 83RD ST, III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 030 —/065 9S 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 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 [KSeepage 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. 1 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation 75 0 J 506 IV F Y. ,5 Feet /do, Feet Cap acit y VII TANK jn T ota l # Of Prefab. Site Fiber Exper. INFORMATION gallo Gallons Tanks Manufacturers Name concrete Con- steel glass Plastic App New Existing structed Tanks Tanks Septic Tank or Holding Tank r s P IR ❑ 1:1 1:1 1:1 E] Lift Pump Tank /Siphon Chamber ❑ 111 ❑ 1 ❑ 1 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plu a 's Signature: (No St) /MPRSW No.' Business Phone Number: 1 492112 Z Plumber's Address Street, City, State, Zip Code). 58 GG.` SC & , 1 2 IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater D ate Issued ssuing Agent Signat a (No Stamps) A roved Surcharge Fee) pp ❑ Owner Given Initial $^� -q9 Adverse Determination X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: S91343911) (R t 1/96) DISTRIBUTION: Original to County. One copy To: Safety 8 Buildings Division, Owner, Plumber - d 07 Y /`j�UC DENT o- We' � � _ � p so", So IL UJ /NOC/1 A r e G'LU /N/)c/Z IG — 3 p R► �Ew/�y� PRo�a HOC/$ I0 0 0 3 - /00 S/oEW 1NOE2 TR. Atf �$1 / d 13 y 31 s4 F r EA 8 13 O LT a 03 al S'cAc.r' / '= 1 /0 0/7 ToP Ouc p/ per= EL, /aa, 0 5yS7ell 9'1 S to /4c12E pg2 zsz' 750 I�RACU //UG �aQ e �' - ,2 x D/? 13y: j3 S3 83 0,41-(-F y vi,�Fcv 7 5 y 5017E/r SET a) / rrv�.sw z� i7 y/ Wis oA Department of Industry SOIL AND SITE EVALUATION Labor arld Human Relations Page / of Ctvision of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County Ilk� include, but not limited to: vertical and horizontal reference point (BM), direction and S F percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel 1. D. b..Us: 30 44 S-4 �` APPLICANT INFORMATION - Please print all information Reviewed )r Dat Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). r• %s;�JC Pro Owner Property Location '// ,�t�k►? ti � Cl Govt. Lot S 114 4 1 / � '+ E (or) Property Owner's Mailing Address Lot # I Block# Subd. Name or C , 33-L..Q 4. S64 ad A crt City r State Zip Code Phone Number ❑ City Village Iff] Town Nearest Ro New Construction Use: ® Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow cS�O gpd Recommended design loading rate bed, gpd /fi i S trench, gpd /ft q i Absorption area required // bed, ft2 /Oo trench, ft2 Maximum design loading rate bed, gpd /ft • S trench, gpd /fie Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design /site considerations Parent material OV—*' A'I�a Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure I AT -Grade System in Fill Holding Tank U = Unsuitable for system I E9 S ❑ U 49 S ❑ U F!!5�s❑ U ❑ S a u EIS R U ❑ S ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench f / 0-/ w yR 3/ ........................... �R Ground 3 �� 1� �- PCs elev / ft. Depth to limiting factor 12?in. Remarks: 7. 55743 Boring # a �d /OV3/Z sZ 11-" *WAO CjW IU% 0 3G /oYR36 s4 /Fste C/ w �/ S Ground q . e o ft. Depth to limiting 2V fact r in. Remarks: CST Name (Please Print) Signature Telephone No. Ana s // 7 /S =nz6*I -6C 3 7 Address Date CST Number 37 2 /Yo ST Guy Sydo 7- z z - 9 .?Yo 5 I , 4 lj Shy!U I Z YI Z j_ 30 -r SS - f I I , f : /J r 'j' j - 410 i I I I I I I : I j I , _ III i II I j, _ - I 1 I j I , I I I I 1 : 1 I I : I I I I I , : I i I I I : i I I I I I 6 1 Gz' I I I I I I f l I I I I ' I I I i I I i I I I I I E I I I I I I