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Home My WebLink About030-2101-40-000 ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner ,ev,• ��4 .Uet�'Q.rJ �'� f, �r�� \� Address �, a City /State �5,z , Al Z4J � `� Cc ��: �� i � d FiG ; Legal Description: �'/ ` Lot �?3 Block Subdivision/CSM # ' /4 4 sG✓ Sec. 9-f-, T 3 d N -R. W, Town of PIN # SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION goo Tank manufacturer d'h,`,(w est� Size ST/PC / �lUf d'S etback from: House - 2d Well v& P/L ,� ^ f Pump manufacturer Model i; ,n c 51 Alarm location /lo u,sG (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: Width Length �� Number of Trenches l Setback from: House Well c _o PAL .S' Vent to fresh air intake 2 ELEVATIONS Description of benchmark Elevation 4 Description of alternate benchmark .��,,. G ,yz` - -/,�� IL Elevation . 7e' Building Sewer ??'al ST/HT Inlet 3 ST Outlet PC Inlet PC Bottom Header/Manifold Top of ST/PC Manhole Cover Distribution Lines () 9 7. Bottom of System( Final Grade Date of inst ation / / Per number �d��2 State plan number Plumber's signature /; �-�� ' License number Date / 1 Inspector A6 eL Complete plot plan �* i i , L SAN S af e ty E. W e shngto Ave. lln Division . `�s SA PERMIT APPLICATION consin In acco r d w i thfLHR 83 05, Wi s A d m. Co de ode P.O. Box 7969 Department of Commerce / Madison, WI 53707 -7969 • Attach complete plans (to the county Toy dnly) for the system, on paper not less County than 81/2 x 11 inches in size. • See reverseside fpr fstructlons for compleb " hi�'a'pplication State Sanitary Permit Number t d 3C, The information you prbylde may be used byptF er Oovern`ment agency programs heck it revision to previous application [Privacy Law, s. 15.04 (1) (m)). I ; V - State Plan I.D. Number I. APPLICATiON4NFOR#ATION -PLEASE PRINT ALL INF RMATI N Property Owner NIB Property Location �� _e if �� d_ t/ y�J 1/4_ ` 1/4, S 9 T r N, R /% E (ory - .•v Ice J1 Property OT�r's Mailing Address �• r (� Lot Number , Block Number vw City, State Zip C Ph ; mber Subdivision Name or CSM Number / II. TYPE OF 51 PILDING: (check one) State Owned Ity Nearest R Public 1 or 2 Family Dwelling - NO. of bedrooms W To OF 17 �iL2_1 ('° V/ III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number �� 2 O. 1 ❑ Apartment/ Condo 2 ❑ Assembly Hall 6 ❑ Medi"Cal 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 M — TYPE OPPERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. ® New 2. ❑ Replacement 3. ❑ Replacement of 4 ❑ Reconnection of 5 ❑ Repair of an System System 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 ❑ Seepage Trench 22 ❑ In- Ground Pressure r 420 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 F a LPG % /�z 9 �' Feet Feet acit VII. TANK in Cap llo s Total # of r Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturers Name Concrete Con Steel glass Plastic App New Existin structed Tanks Tan epticTa an El 1:1 1:1 1:1 1:1 1:1 oft Pump Tank 6 dQ �/ r.,t.G✓>° 1` .� ❑ ❑ 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) Plumber's Signature: iNo Stamps) P/ AIIPRSW No.: rBusine s Phone Number: J J,. ' ,� is {lt <� 6 lec� c Gv— %' ` `l' ) 7 G Pl umber's Address (Street, City, State_, Zip Code): / 6� 7 ✓c 77 f / 11/ IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate Issued Issuing e tsi ature (No Stamps) �j Approved E] Owner Fee) Owner Given Initial Adverse Determination 6 X12 X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: SBD -6398 (R.11/96) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber s r SANITARY PERMIT APPLICATION Sa fety 1 E. W shingto f *-tconsin , P.O. Box 7969 Department of Commerce I n accord with ILHR 83 "05, WIS. Adm. Code P 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. C, ± o K • See reverse side for instructions for completing,thi5' application State Sanitary Permit Number The information you provide may be used by other government agency programs Check it revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLI ATl NJNF RMATI N PLEASE PRINT ALL INF RMATION Property Owner Name Property Location ,.; 1/4 �, Zia, S T ;/ , N, R i'J E (or ) W Property Owner's Mailing Address P Lot Number Block Number sl *S % �f;,., ..,it' % /,,,► �`�'j ,! ,-..:_.. ;1; City State Zip Code phd mber Sybdivision Name or CSM Number v 11. TYPE OF BUILDING: (check one),, ❑ State Owned it Nea rest R � Public 1 or 2 Family Dwelling - No. of bedrooms 4,/ ! g] Tow OF ` !' c'f:f, a K III. BUILDING USE (if building type is public, check all that apply) Parcel TaxNumber(s) J 1 ❑ Apartment/ Condo 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 OFI.PERMIT: (Check only one box on line A. Check box on line B, if applicable) ,.A) 1. ❑ New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. E 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 - u21 [1 Mound 30 ❑ Specify Type - 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure ,� r 42 [] Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation t c/ 9 - %:� 1 Feet Feet VII. TANK Capacity in gallons Total # of Site INFORMATION Manufacturer's Name Prefab. Con- Steel glass Plastic App New Existing r Gallons Tanks concrete strutted EL e�tic Tanks Tan s an / ? 'J r7 , ,e ±, r❑l ❑ ❑ ❑ ❑ ❑ Tank v yV f L1r.dt e4 f f'? K ) El 11 ❑ El 1:1 I. VII RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (No Stamps) I MP/MPRSWNo.: Business Phone Number: c =�I l! /fl ri r {,�'ri .�G r-_ i .r Plumber's Address (Street, City, State, Zip Code): / /) T IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved I Sanitary Permit Fee (includes Surcharge Fee) Groundwater ate Issued issuing 7t Signature (No Stamps) �j Approved ❑Owner Given Initial --= -�'`"� ,. Adverse Determination L' X. CONDITIONS OF APPR VAL / REASONS FOR DISAPPROVAL: SBD-6398 (R.11/96) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber A� SANITARY PERMIT APPLICATION 201 E and Was hington A si i c©nsin P.O. Box 7969 In accord with.lLHR 83.05, Wis. Adm. Code 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 vi x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Permit Number r '2' 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 1. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATI N Property Owner Name Property Location 1/4 1/4,5 T , N, R E (or) W Property Owner's Mailing Address Lot Number Block Number City, State ~ Zip Code [ Ph one Number Subdivision Name or CSM Number ) II. TYPE OF BUILDING: (check one} ❑ State Owned ❑ ita � Nearest Road j - Public 1 or 2 Family Dwelling - No. of bedrooms `` °. Town of 111. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 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 [2 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 - ___41 0 Mound 30 ❑ Specify Type 41 []Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 E] Seepage Pit ..,�,.. 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation r : Feet Feet VII. TANK Capacit g all on s Total # of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturers Name Concrete Con- steel glass Plastic App New Existing structed Tanks Tanks Septic Tank ❑ ❑ ❑ ❑ ❑ ❑ Sift Pump Tank ipHen6hambe� . ] ;, 1:1 El El 13 11 Vht: "RE`SPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (No Stamps) MP /MPRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Code): IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Inciudes Groundwater Date Issued Issuing Agent Signature (No Stamps) Q Approved ❑ Owner Given Initial Surcharge Fee) Adverse Determination f "� X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: _ i # SBD -6398 (R.11/96) - DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber - Wisconsin Department of Commerce Count S PRIVATE SEWAGE SYSTEM y' Safety and Buildings Division 'S T. CROIX INSPECTION REPORT 'GENERAL INFORMATION (ATTACH TO PERMIT) S t t: Personal information you provice may be used for secondary purposes [Privacy L , s.15.04 (1)(m)]. iET98 1V er' KfEK ❑ City []Village ❑ Town of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM escripti Parcel bS�2101- 40-000 Q , TANK INFORMATION ELEVATION DATA A9800125 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. B//e/nch rk ; •0(0 0- 00 Dosing Co b d � r] U ,� l r Aeration Bldg. Sewer q Holding J)4:h Inlet TANK SETBACK INFORMATION St Outlet 7 TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic /t- ?® NA Dt Bottom � 2 �GI , Dosing NA Header / Ma S Aeration NA Dist. PipeS�` Holding Bot. System ,d PUMP/ SIPHON INFORMATION Final Grade ? �� Manufacturer 5 1 Demand gC� Model Number p GPM TDH 1 Lift Fricti n System TD Lo Forcemain Length 1 Dia. ' Dist. To Well SOIL ABSORPTION SYSTEM BED RENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. squid Depth N I N ! �� I DIMENSION SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHI G Manufacturer CHAM ER INFORMATION Type / Mo el N be r: Syste O ylGl OR UNI DISTRIBUTION SYSTEM Header/Manifold K Distribution Pi (s) r /♦ / x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length 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 COMMENTS: (Include code discrepancies, persons present, etc.) 02/" tOCATION: ST. JOSEPH 29.36.19,NW,SE 454 HIGHLAND VIEW ��- �ov� Z�' I Plan revision required? ❑ Yes M No Use other side for additional information. �J 1 1;q l qclt 7 7 Cert. No. SBD -6710 (R.3/97) Date Inspector's Signature Safety and Buildings Division N)L consin SANITARY PERMIT APPLICATION Po Bo ��hinngtonAve. Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. S l C ,tee "Y' • See reverse side for instructions for completing this application State Sanitary Permit Number 3c7 7c;k;k— The information you provide may be used by other government agency programs heck 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 1 e c✓ 114se 1/4, S 9 q T.G , N, R l�7 E (or Pro �✓✓a ' c-, a UL 7y Block Number perty Owner's Mailing Address Lot Number o o a^ City, State Zip Code Phone Number Subdivision Name or CSM Number / e I1. TYPE OF BUILDING: (check one) ❑ State Owned 0 !t y 7 �,/ Nearest R / Public 1 or 2 Family Dwelling - No. of bedrooms i Tow OF t✓as� c III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo Q'3 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 1V= TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. Ea New 2_ ❑ Replacement 3. ❑ Replacement of 4 ❑ Reconnection of 5. ❑ Repair of an ,______System -------- System Tank Only Existing System ExistinaSystem 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 110 Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 []Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure f 42 ❑ Pit Privy 13 ❑ Seepage Pit 49111 43 ❑ Vault Privy 14 ❑ System -ln -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation a"Id I I I rs - Ir _ 7 Feet 9Q, c1 Feet VII. TANK in Capacit g Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con Steel glass Plastic App New Existin strutted Tanks Tan eptic an 0240 G� ,rte ® ❑ ❑ ❑ ❑ ❑ lift Pump Tank W I 1B I ❑ 1 ❑ 1 ❑ 1 ❑ 1 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite se age system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: No Stamps) P/ PRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Code): GD ?O Sc aJ. • QlG IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater D ate Issue . Issuin e t Si a ure (No Stamps) surcharge Fee) PjApproved []Owner Given Initial .�" 4 q, % Adverse Determination 6 0 X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: t r 4 1 SOD-63M (R 11/96) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber SANITARY PERMIT APPLICATION E. a nd NO sconsin In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Department of Commerce Madison, WI 53707 -7%9 • Attach complete plans (to the county copy only) for the system, on paper not less County than 81n x 11 inches in size. 57 Pip 4f x • See reverse side for instructions for completing this application State Sanitary Perm-iitt N , 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 RMATION Property Owner Name Property Location 1 /4 1 /4, S a q T g g , N, R j E (or) Property Owner's Mailing Address Lot Number Block Number r 623 City, State Zip Code Phone Number Subdivision Name or CSM Number II. TYPE OF BUILDING: (check one) ❑ State Owned It Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms _K j own of III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo a 036 21 — y d 2 ❑ Assembly Hal[ 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 Eg 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 ®.Seepage Trench 22 ❑ In- Ground Pressure ii , 42 ❑ Pit Privy 13 ❑ Seepage Pit 6 S K dno 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation ev d 75 97 10 Feet Feet Cap VII. TANK In �IOnS Total # O Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturer's Name concrete Con- Steel glass Plastic App New Existin strutted Tanks Tanks P i � o?OQ l ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ 1 ❑ 1 ❑ ❑ ❑ VI11. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite evAage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (No Stamps) P PRSW No.: Business Phone Number: ` ;2 4Vd / -3 /_r Plumber's Address (Street, City, State, Zip Code): `7 74 O IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issue gent Signature (No Stamps) A roved Surcharge Fee) Zc pp ❑Owner Given Initial I Adverse Determination 8"�n /DO X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD }6398 (R.11/96) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, P mnber PAGt (; F PUMP CHAMBER CROSS SECT IOU AAJG SPECIFICA VE IJT CAP 'i"C.I. VEAJT PIPE WEATHERPROOF APPROVED LOCKING > 25' FROM DOOR, JUNCTION BOX MAWHOLE COVER - WIIJDOW OR FRESH 12 "MIU. AIR IAJTAKE I I GRADE MIN. 18" /wI U. COIJDUIT 18 "MIAI. - ________ \ 11 , INLET PROVIDE _T AIRTIGHT SEAL i III *� A I I I II I I I ALARM Is I I I o *APPROVED i i ow JOINTS WITH I ELEV. FT. APPROVED PIPE __� 3' ONTO PUMP OFF D SOLID SOIL ` CONCRETE BLOCK RISER EXIT PERMITTED OIJLH IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E SPECIFICATIOAIS DOSE TANKS MAN UFACTURER: ,/ IJUMgER OF DOSES: 7 PER DAM TANK SIZE : ?wl:' GALLONS DOSE VOLUME ALARM MANUFACTURER: IMCLUDING 6ACKFLOW: /73 fwd r rh GALLONS MODEL 1.IUM15ER: at ` CAPACITIES: A= 9G IAJCHES OR GALLONS SWITCH TyPC: A -e lrC B= 2 INCHES OR y2 GALLONS / p ��/ PUMP MAIJUFACTURER: �avlD�_t C= IUCHES OR l � GALLONS I MODEL NUMJSER: f �2Q D- INCHES OR GALLONS i SWITCH TYPE: NOTE: PUMP AND ALARM ARE TO DE MI DISCHARGE RATE 3'::� GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE DETWEEAI PUMP OFF AND DISTRIBUTION PIPE.. 2S FEET + MINIMUM NETWORK SUPPLY PRESSURE . , , , . . , . FEET + Ld FEET OF FORCE MAIN X Q,DS 0 loo FxFRlCT1oN FACTOR_ FEET TOTAL 09MAMIC. HEAD - 27 I'7 FEET INTERtJAL, DIMEWSIONI: OF TANK: LENC,TH ;WIDTH ;LIQUID DEPTH 3� Goulds Submersible Effluent Pump C� ` 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 ddrati t . •Effluent systems dry without damage to heat transfer. ■Motor Cover..Thermoplas- • Homes components. tic cover with integraf handle Available for automatic and • Farms Motor. and float switch attachment • EPO4 Single hose: 0.4 HP, manual operation. Automatic • Heavy duty sump g p 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 RP 115 V, 60 Hz, 1550 RPM, , SPECIFICATIONS • EP05 Single phase: FEATURES heavy duty ball bearing Pump: EPO4 built in overload with ■ EPO4 Impeller Thermo- construction. • Solids handling capability: automatic reset plastic Semi -open design AGENCY LISTING 3 /; maximum. • Power cord: 10 foot with pump out vanes for • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. SP- anadianstandardsAmciadon •Total heads: up to 24 feet. with three prong grounding • Discharge size: 1 1 /2' NPT. plug. Optional 20 foot ■ EP05 Impeller. Thermo- (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with plastic 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 components. + Pump: EP05 8 f • Solids handling capability: o 25 1 Y; maximum. W • Capacities: up to 60 GPM. _ • Total heads: up to 31 feet 6 20 • Discharge size: I NPT. a • Mechanical seal: carbon 0 5 rotary/ceramic - stationary, 4 BUNA -N elastomers. • Temperature: ° 3 10 104 °F (40°C) continuous 140°F (60°C) intermittent. 2 s 1 I 0 00 10 20 30 40 50 GPM ' 0 2 4 6 8 : <::710 . 12 nWh CAPACITY O 1995 Goulds Pumps. Inc Eflecdve May, 1995 �De r.` f° /� ✓yP� /SG-✓ ; 1J GJ y S�' %i' S' 29 r'36' �P /9 !.J �o�''�,� �o''��.la.va�.�„ /ls ror�,yo�s ' 3 6� � ra Ba .� U b Hv4J a 5, +t e Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor -and Human Relations t�ision of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY ' Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PAR „� .� dimensioned, north arrow, and location and distance to nearest road. ing APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION R D E PROPERTY OWNER: PROPERTY LOCATION '� C Joanne Persico GOVT. LOT NW 1/4 SE 1/ 19 PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME # 0; : - 400 S. Second St. 23 na Highland 1 econ CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE MOWN .; P Hudson WI. 54016 (715 386 -9060 St. Joseph [X] New Construction Use Residential ! Number of bedrooms 3 [ ] Addition to existing building I ] Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate • 7 bed, gpolft • trench, gpolft Absorption area required 643 bed, ft 563 trench, ft Maximum design loading rate .7 bed, gpd /ft .8 trench, gpolft Recommended infiltration surface elevation(s) 97.00 ft (as referred to site plan benchmark) Additional design /site considerations alt. area= trenches C 96.5 & 94.7' Parent material pitted Glacial drift Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL I HOLDING TANK U = Unsuitable fors stem 1 9J S ❑ U 97 S ❑ U [3 ❑ U CAS ❑ U :k7 S ❑ U ❑ S ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft .................. in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench ................. .................. ................. `= 1 0 -7 10yr3 /3 none sil 2msbk mfr cs 2f .5 .6 1 2 7 -22 7.5yr4/4 none sicl 2msbk mfr gW if .4 .5 Ground 3 22 - 36 7.5yr4/4 none sl 2msbk mfr gW if .5 .6 elev. 100. 4 36 -82 7.5yr4/6 none ms osg ml na na .7 .8 Depth to limiting factor + Remarks: Boring # 1 0 -6 10 r3 3 none sil 2msbk ml cs 2f .5 .6 2 2 6 -20 7.5yr4/4 none sicl 2msbk mfr gW if .4 .5 ................ Ground 3 20-24 7.5yr4/4 none sl 2msbk mfr gW na .5 � .6 elev. 4 24 -80 7.5 r4/6 none ms osg mvfr na na .7 ' .8 96 ft. Depth to limiting factor +80" Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 20 Ave., New c on WI 5417 Signature: Date: U-13-96 CST Number: m02298 STEEL'S SOIL SERVICE Gary L. Steel Joanne Persico 1554 200th Ave. CSTM2298 NW 4SE4 S29 T30N - R19W New Richmond, WI 54017 MPRSW 3254 town of St. Joseph (715) 246 -6200 lot #23- Highland Hills Second Addn. N 1 " =40' BM. -= top ofNW lot stake C el. 100' a1 40' V �. Gary L. Steel 11 -13 -96 P annaa ,• " . ra nuI r �e i�: R 1� a W 13 "� 3 :4'3 r a Sffr EF'.'� r 1 1'0 5li,'i d�'�`tiv P. i ST C:ROIX COUNTY S EPTIC TANK M A1NTBN.P.Na AGREEMENT AND - OWNERSHIP C$RTIMCATION FORM 01.kk er/Buy c:r . HELU m Denek 9 rIggy -- M+ ing At d :4. . �r -t1�l:-- �17et�d-- n. ■ t�� eJI - � .. - i ii- !-___ �Verfttca:9ot6egniced G P I" Ddpsrttnent for raw construction) Parcel ldentWoetion Nuatbcr t ab - '-PAQ) I , `�c Pro) ':t'IY L + ;c a :ion ;21P. T J N -RZf_ W, Town of _ . -e � Sub , iyisiot LOT X V HILLS 2n4- AV21 r7 Ccr.:ifitxd .71C! {:y Map Valtimt: - -- Page # Wit fy f]c,; d # .- 561t2.rr - vollmae ] 242 Page # $ — Spe : 116use t. tires •0( ac lot linos identi'tableq � Q no bnpz -+ k-, Lw. sad masatemnotof your 6aptic system could mattt in its ptewcuue•failuro m EsWiie wane2- Proparmut ;teoanee CREW; ;.ft of pt rr i+ ; sg out the a.:ptic tank awry three ycan or aaonez, if wAded by a lt:cssed ptttztper. Wbat you put iato I ^e system can; ,Tw the f 111 :lion of the mptie teak is a t;reAw -ut stage in the wam dispcW synem, The!wol:!vrW ovMcr ;gees to submit to SL Croix Zoniq Dqpadmmit a ctrtificafidaforca, signM b' thr owr4orad.by a malt ,r plumb :r .1 : ;.nrnnymaaph b9r, resekte dph>mhsx Ora IktAwd pooa w vmi yiAr. t t (1) the on,21re tsrc{'dbPD ii,. ay%c= is is ',rdper o istu.`ing conditica azWor (2) 4er iapqcdm and pumpSng (if wcewry), the acptictwk is loans wf a tz ,t+t Uwe. the turd :r_ i.:p %ed izuve x=d the above requirements and agm to maintain -dw private; sewage disposal with dw :;%andard set 4• h. heri ie.:: s set by else Departmew of � Comwwfte tnd't& Dtp = ofNattrt;sl �SMlrre:l. Stw of W` st iion ctsttit t}sat y� tr a ;Emo syst ba btwtx maintained snusi be :caaplebr+d sari ret�ncrt m the St Croix Coutety ?.,t ate Ofd *O him 30 days it the U Pt :: 'w t:xp' oa tt;. ;--� vlGt '�TURI t: APPLICAl T DA U tify t nl] ttatemtatd oa this ftm are no to mho beat of my (car) knovAedge. I (we} ami(s!G) t)le rrtrr (x) of the F it ibe t, by virtue of u •wwrauty doed wcocded is l istar of Deeds Office. SI A - t C' P CAly'i' DA f M' • • •, • Any; it {r. mation that is mis-repre=ted way mull ii, the senituy permit bting rev6ke d, t y the zoning! Deparauer . •` Ii uete wits t i hif Apptieazloa: A sYUnprd Harzanty decd from the Register of Dccda trfficc a copy of Ow certified survey rump if reftwenQc is made in the wumwty d.04 76 3` `�drr L3 D :Gr, �aET168�vr, • .• * * 2422 Enterprise Drive Mendota Heights, MN 55120 LAND SURVEYORS CIVIL ENGINEERS (612) 681 -1914 FAX:681 -9488 ii� i('� ®�1r�`'"' LAND PLANNERS • LA OSCAPE ARCHITECTS 625 Highwa 10 N.E. Blaine. MN 55434 (612) 783 -1880 FAX:783 -1883 Certificate of Survey for: _ CLA HOME DESIGN House Address: Hig hland View S0034'5 7 "E 518.67 _ ? 00 v� 23 M: s TERRENCE E. fr R ' �ENSACNER COLUMPlr, ii! AIN, . 10 ♦ 24 to o _ O xR1.R Hi 9A PROPOSED HOUSE U• zo 01 2 oa 1— 959 1" = 30' O 843 � 22 7"sr — .e) 8 PR 12 . 00 � 2o' 0A9 S'''L 1e. 12 p H� -7-- io7. 41.7 X ^� �' -'. � / ?Q b Y93.52 n / es, g• � � 7 WALKevT' aA RAQE / 8 12 178 rD `Zp 91.1 W $9 S Ovi. nc p�- -A 4 � �WM'A Y 90.4 _�� v1A1 Ko it e1Q r�.�7un F ' t I S 5 lo o,o �.35' /HIGHLAND Y1EW PROPOSED BUILDING ELEVATIONS x goo.o Denotes Existing Elevation Lowest Floor Elevation: $s•' '(j� Denotes Proposed Elevation Top of Block Elevation: 93.1 Denotes Drainage now Direction q2,7 Garage Slab Elevation: Denotes Drainage & Utility Easement --o Denotes Monument NOTE: Proposed building site grading is in accordance with the —+-- Denotes Offset Iron Bearings shown are assumed grading plans approved by the city engineer. NOTE: Contractor must verity oll dimensions & driveway design. LO T 23 HIGHLAND HILLS 2ND ADD.