HomeMy WebLinkAbout030-2101-90-000 CROIX COUN'T'Y ZONING D A`tf'I'IV1�3�� 11th, .
AS BUILT SANI'T'ARY RE
Owner
Address 'l IeNV r
City /State - flQDSot,
s� fax 1.
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'UNTY
Zo N'NG
Legal Description:
Lot 2A Block Subdivision/CSM It HI6t(l.RNO Fk 1 LLS �` � D l� l a ►J
SYZ Sec. Z2 TAN -RjJW, Town of -a QC,Q Pt-t PIN # 0 2,01 —go =00n
30
SEPTIC TANK — DOSE CHAMBER . HOLDING TANK INFORMATION:
Tank manufacturer 1Wrg;K5 Size ST/P L Z Setback from: House Well P/L
Pump manufacturer (,a uL L) S Model 38 ( Pb �
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: -IRCKMh Width _ Length A0 _ Number of Trenches 3
Setback from: House Well AA p/L Vent to fresh air intake
ELEVATIONS
Description of benchmark AIL CM)60- S-TflK Elevation O(7
Description of alternate benchmark �p �,t= - ,f1RpC,F EouNORTin u Elevation /v 8.z3
Building Sewer '?11. P ST /HT inlet 8.5 ST Outlet PC Inlet 98, /
PC Bottom 9S Header/Manifold / 5 Top of ST/PC Manhole Cover _/QS &2
Distribution Lines
Bottom of System ( ) 161.8 () ( )
Final Grade ( ) JQ.S: ( ) ( )
Date of installation 10 3 /9� Permit number 3Z07-( State plan number
Plumber's U License number �Z3?VZ Date /601?
signatu
Inspector (.l NG
Coniplcic plot (llpn K
M ODEL / 3 MODEL 38
. • '0' '0
Su bmersible •
t A 1 ' GOULDS
zr
r + �
3 p-
a
Pump Specifications
' /3HP METERS FEET
Up to 40 GPM ( 10 — MODEL: 3871
Discharge size 1'/<' NPT 9 30
Solids: 3 /s" maximum a
Motor 25
N; 7.
Single phase: 115V
Materials of Construction 6 20 —
Brass/thermoplastic ; 5 ,5
z 4 EP05
Features and Benefits o
•Top suction eliminates '°
impeller clogging. 2 5 EM
• Corrosion resistant ,
construction.
0 00 10 20 30 40 50 U.S.G9A
*Float actuated switch. 0 i 4 6 6 10 12 "OAK
CAPACITY
METERS FEET
Pump Specifications Features and Benefits
C 6 20 MODEL DVP03 4 /,0 and ' /z HP • EPO4 impeller- semi -open design
5 Up to 60 GPM with pump out vanes to protect
15 Maximum head to 32' mechanical seal.
4 Discharge size 1'/2" NPT • EP05 impeller - enclosed design
0 3 ,o Solids: 3 /4 ' maximum for improved performance.
i; 2 5 1 1 1 1 1 11 Motor Rugged glass - filled thermoplastic
All motors feature ball casing and base design provides
° 0 bearing construction. superior strength and corrosion
0 5 10 15 20 25 30 35 40 U.S.6PM resistance.
Single phase: 115V
0 2 CAPACITY 6 6 10WAmr Materials of Construction ' Cast iron motor housing for
Cast iron efficient heat transfer, strength,
Thermoplastic and durability.
Stainless steel • Corrosion resistant threaded
stainless steel shaft.
• Available for automatic and
manual operation.
• CSA listed models available.
All Models are designed for continuous operation and feature stainless steel hardware.
PAGV r,�F
PUf iP CHA.M.BtR CfiL55 SEC -IC ANG SPECIF IG�!.`_
rVE:QT CAP
4 "C.I. VENT PIPE
WEATHERPROOF i 4PFROVED LOCKVNC..
JUAICTIOIJ BOX MANHOLE COVEF.
coon,
WIIJDOW OR FRESH 12 MIU.
AIR JUTAKE I
GRADE I —
4 MIIJ.
I Ai k � -
I8" PKIN.
COQDUIT -- - -__
PROVIDE I - - - --
IIJLET � AIRTIGHT SEAL I I f
I v
APPROVED JOINT A I I APPROVED JOMTS
W/C.I. PIPE I II I W /C.I. PIPE
EXTENDING 3' I II ALARM E%TEW DIIJG 3'
OWTO SOLID SOIL E I I) ONTO SOLID SOIL
i I
I 1 O
c I I
I
ELEV. FT. PUMP - ' j
OFF
D
CONCRETE BLOCK
RISER EXIT PERMITTED OIJL9 IF TAUK MAIJUFACTURER HAS SUCH APPROVAL
SEPTIC e SPECIFICATIOUS
DOSE
TANKS MA NUFACTURER. r" KS I.WMBER OF DOSES: PER DA-4
TAIJK SIZE : AMY) S�rfIC A60 P GALLOIJS DOSE VOLUME
ALARM MAMUFACTURER: - T RQ4 ALE INCLUDING BACKFLOW: 17? GALLONS
MODEL WUMBEK: 101 A CAPACITIES: A= Z3 INCHES OR 1 A 10 GALLONS
SWITCH TYPE: IY\Ee uR Y 5= Z INCHES OR , 41 0 GALLOWS
PUMP MANUFACTURER: GOULI)lc C q
= / INCHES OR 46 0 GALLOU5
MODEL ►DUMBER 3871 EPO / D- L INCHES OR 1 2e) GALLONS
SWITCH TYPE: rV)EKCUI l MOTE: PUMP AND ALARM ARE TO BE
MINIMUM DISCHARGE RATE 52 GPM INSTALLED ON SEPARATE CIRCUITS
VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. .__A FEET
+ MIIJIMUM NETWORK SUPPLY PRESSUR .. , .a ! FEET
+ `I b FEET OF FORCE MAIN Y, �' F /)OFTFRICTIOLI FACTOR.. FEET QO
TOTAL Dy1JAM L HEAD = /O "L`r FE. ET GACA,
IMTERMAL DIMEWSIONC OF TAQK: LEL.,CITH ;WIDTH ;LIQUID DEPTH
51G C aL � - -____. LICE.NSF UU —_ DATE:
' �JIvS xl-NDRA MA RGL
YL'Y �J/M 2AN0 It'l /Ile �y < W � sECZ`t Tao N -R P? v✓
AlYL)Sati/ 14/1 5y0 S icaptt T6wA/ShHjP
X07 ZS
BM.
£�o' I;fgA L- *S
133
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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County:
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 Law, s.15.04 (1)(m)]. 320262
M RGL � & KENDRA ST y cJ O SEP Town of: State Plan ID No.:
CST BM Elev.:- Insp. BM Elev.: BM Description: Parcel Tax No.:
030 - 2101 -90 -000
l as ldb
T012 NA r' o+ $
TANK INFORMATION ELEVATION DATA A9800450
TYPE MANUFACTURER CAPACITY STATION BS HI I FS ELEV.
Septic coil r�OV Benche ar
Dosi n ��
Aeration Bldg. Sewer
Holding (�DW Inlet poi RS -S3
TANK SETBACK INFORMATION SGty lit Outlet rn g6 oi8.3
TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet 4 11.1 ° /
Air Intake
'Sr epti i✓� ✓�� NA Dt Bottom I ti. 2- s
Dosing NA Header / Man. / t 3- 35
Aeration A Dist. Pipe l! Sr sV �c� .7
Holding Bot. System 7.3$ -740 /o/ .g'
PUMP/ SIPHON INFORMATION qs wt '"Co.. Final Grade
Manufacturer — 7oc� S Demand S•I. yvn bL,k ec' 5.feg � ° 3•sa
Model Number 6;P p tt ?� GPM
TDH Lift . Lriction2 I System TDHIC.<Tt
oss Forcemain Length /p5 Dia. H ead
' Dist. To Well
SOIL A TION SYSTEM
BED TREN Width Length No. Of T enches PIT No. Of Pits Inside Dia. Liquid D th
DIM DIMEN I N
SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manua
INFORMATION Type / CHAMBER M el Nu er:
Syst m '] r't /V OR OR UNIT
DISTRIBUTION SYSTEM
Header/Manifold Distribution Pipe(s)r t C k x Hole Size x Hole Spacing Vent To Air Intake
Length W Dia Length Dia. '1 Spacing �D_ cI* PyT Z--72
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.)
LOCATION: ST. JOSEPH 29.30.19,NE,SW 464 HIGHLAND VIEW
0 30 - rwln#eg brihWtt
�owsrr p6Y�ti�'✓ui�vl vLO sltu ltG�cvFrncr�Jc -G1
nbca wt
.4VJ5(an (_4<AU` (Cie) alc
Plan revision required? Yes ❑ No
Use other side for additional information.
SBD -6710 (R.3/97) Date lnspectoOGSignalture Cert. No
Safety and Buildings Division
201 W. Washington Avenue
Vi scons i n SANITARY PERMIT APPLICATION P O Box 7302
Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code 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.
• See reverse side for instructions for completing this application State Sanitary Permit Number
3�Do?4b?
Personal information you provide may be used for second pu o es t7 ❑ Check if revision to previous application
[Privacy Law s. 15.04 (1) (m)]. L��. 4 owd v /,c��w / Sorb 6 State Plan I.D. Number
I. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION
Property Owner Name Property Location
Q L S� U S W1 /4, S Z7 T 3C , N, R 19 E (or) �v
Pro Owner's Mailing Address , Lot Num�b Block Number
Z 1 IN
L i l l , / ' Z V
City, St+ Zi�Co�Je Phone Number Subdivision Name or CSM N ber
d L 1 5-5 / 10 5 ( > /6//L9 /U0 # IX45 2 h d A C c
II. TY PE OF ILDIN : (check one) ❑ State Owned ❑ it Ne rest Road
Public 1 or 2 Family Dwelling vil lage
- No. of bedrooms Town OF _J�)4.sPff la KIVO /�(?�
III. BUILDING USE (If building type is public check all that a pply) Parcel Tax Number(s)
1 E] Apartment/ Condo a T • 30• /7 8ag 630 — 2101 5?o
2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 Q 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 E3 Replacement 3_ ❑ Replacement of 4 E] 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 21 ❑ Mound 30 ❑ Specify Type 41 [:]Holding Tank
12 gseepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy
13 ❑ Seepage Pit 43 ❑ Vault Privy
14 ❑ System -In -Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade
/ Required (sq. ft.) Proposed (sq. ft.) (Gals/d q. ft.) (Min. /inch) Elevation
f0 "46116 200 , /40/. 80 Feet Feet
VII. TANK Capakity
in gallons Total # of Prefab. site Fiber- Ex p er.
INFORMATION Gallons Tanks Manufacturers Name concrete Con Steel Plastic Ap
New Exist in strutted g lass pp-
Tanks Tanks
Septic Tank or Holding Tank / KS ❑
Lift Pump Tank /Siphon Chamber 13 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 i nature: St ps) MP /MPRSW No.: Business Phone Number:
TES nature: 2Z3 yz,. 715- zfy 3/ y r
Plumber's Address (Street, Cit , State, Zip Code):
S E R l
IX. COUNTY/ DEPARTMENT USE ONLY
Q Disapproved Sanitary Permit Fee (Includes Groundwater D ate Issued Issuing A ent Sii ature (No St
Surcharge Fee)
Approved [:]Owner Given Initial / h J19 -
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
i
- ZANIES -¢ Kea M RR GL
zoa 6wbRin A ve se: 1 y $vv ley SC 29 T ad, /V, l9 t�✓
ST P1VL MN 5 5105 'ST - N To\rvNsxlP
W� 8AI
AIN
TR£xWgs
o/ z
0
o
1- GAL vV E& S T)WK
�PbPd SED
y &DAMM
hbUSE.
GARAGE
DoT Z 8
A BE NUMARK TaP of AC 1A7 STAKL-
n SOIL SoxinG
v -
578
Sri PRE 22,3 2 4 2 563'
J
Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3
Labor and Human Relations
Division 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 r dim ensioned, north arrow, and location and distance to nearest road. P
APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION D B D
PROPERTY OWNER: PROPERTY LOCATION ; --
Joanne Persico GOVT. LOT SE1 /4 SW W-129 T;� t�_,N,R 19 ro W
PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # I SUBD. N Y
iCi c. ,-
400 S. Second St. 28 na I High- n.
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE j UOWN
.cznn . WT 94n16 (.,r.E
[ New Construction Use [ 3] 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 .5 bed, gpd /ft .6 trench, gpd /ft
Absorption area required 900 bed, ft 750 trench, ft Maximum design loading rate gy bed, gpd /ft trench, gpd /ft
Recommended infiltration surface elevation(s) 101.80 It (as referred to site plan benchmark)
Additional design / site considerations na
Parent material lei .ti-ed glacial drift. Flood plain elevation, if applicable n= ft
S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem KI S El £7 S El CAS El ® S El ❑ S ®U El 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 -14 10 r4 3 none sit 2msbk mf
10 r4/4 none sicl lcsbk mfr QW if .2 .3
Ground 3 34 -84 7.5 r4 4 none sl 2mcrr mvfr na na .5 .6
elev.
1
Depth to
limiting
factor
+84
Remarks:
Boring #
1 0 -12 10 r3 3 none sl 2msbk mfr cs 2f .5 .6
' 2 2 12 - 32 7.5yr4/4 none scl 2msbk mfr if .4 .5
3 32 - 88 7.5yr4/4 none is osg mvfr na na 1 .7 1.8
Ground
elev.
10 ft.
Depth to
limiting
factor
+R8
Remarks:
CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200
Address: 1554 200th. Ave., New Richmond WI 54017
Signature: Date: 11 -12 -96 CST Number: m02298
J
STEEL'S SOIL SERVICE
Gary L. Steel Joanne Persico 1554 200th Ave.
CSTM2298 SE4SW4 S29- T30N -R19w New Richmond, WI 54017
MPRSW 3254 town of St. Joseph (715) 246 -6200
lot #28- Highland HIlls Seocnd Addn.
N
1 =40
BM.= top of NE lot stake C el. 100'
I Z3 ' 2D - 6e' 5
'4
1�
A ary L. Steel
11 -12 -96
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
O wner/Buyer OT M XP ✓d &A A R 4 I
Mailing Address 2 01 1 & and R i c Q ✓e . Tt pul. A i NJy. .'1'.9'10.
Property Address i � � A4 Ui f ,a
(Verification required fro fanning Department for new construction)
City /State N u d sv i . 6)',. Parcel Identification Number
LEGAL DESCRIPTION
Property Location Al j5 ' /�., �� '/4, See. T A N -R1 _?_W, Town of St. z e4f �.
Subdivision _ 11;sh 1AA'Jj 1 SL*Coad R dd, 10011 , Lot # _
Cr
Certified Survey Map # , Volume , Page #
Warranty Deed # 31Y 7 7 A, , Volume 1335' , Page # 7
Spec house ❑ yes M no Lot lines identifiable ® 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 wastewater disposal system
is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge.
Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards
set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification
stating that your septic system has been maintained must be completed and returned to the St_ Croix County Zoning Office within 30
days of the three yea piration d /�
x / : ;�
IGNATURE OVAPPLIC#NT 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 p operty described ove, by vi of a warranty d re prded in Register of Deeds Office.
*SGNATUk]E F PPLIC T 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
MAP OF SURVEY
FOR
JIM & KENDRA MARGL
1" i.p. fnd.
N 87° 12' 43" W 271.85 1" i.p. fnd.
20' sideyard setback line
Scale 1" = 80' / / Q i, AP PROXIMAT E S SEPTIC.
CO
A� 12' utility. PROPOSED
/easemeilt
i HOUSE AS STAKED
2" i.p. fnd. 08/12198.
50' roadway setback One
C6
LOT 28 OF 72,
CURVE INFORMATION HIGHLAND HILLS 9 w
Radius- 233.00' iO
Detta- 82 30'15° SECOND ADDITION "
Chord- 241.7V
S34 02'24.5"W sb o
Arc 254.18' Z
!15�,
F • s
• - indicates iron survey monument found.�
( as noted) s� ;
DESCRIPTION.•
Lot 28 of the Plat of Highland Hills Second Addition. Said 1" i.p. fnd.
plat being located in the NE1/4 of the SW 1/4, the SE 1/4 of the I
SW1 /4 and the NW1 /4 of the SEl /4 of Section 29, T30N,
R19W, Town of St. Joseph, St. Croix County, Wisconsin. /