The URL can be used to link to this page

Home My WebLink About040-1229-10-000 r \ ST. CROIX COUNTY ZONING DEPARTM AS BUILT SANITARY REPORT Owner � 4,, All(- � ZEN a� T94 Address „', -% n� �. � - "GOP, y City /Stat Legal Description: Lot t Block WA Subdivision/CSM # 6 1.1 ' /4 rUw '/a .�.0 , Sec. ,�, T jW, Town of f r r PIN # I(,.2�. SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION Tank manufacturer Z,) Size ST/PC 1 ko Setback from: House Z4� Well 07 P/L Pump manufacturer � o 1 l J Model k'v .-r rt Alarm location 6,•�.. (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 7 4 Number of Trenches / Setback from: House Well 05 ' P/L _ Vent to fresh air intake ELEVATIONS Description of benchmark a Elevation d Description of alternate benchmark i idti Elevation Building Sewer ST/HT Inlet 7( ST Outlet PC Inlet PC Bottom lea I& Header/Manifold Top of ST/PC Manhole Cover Distribution Lines (/) 16q�5,. ( ) ( ) Bottom of System ( ) /vyf', flu ( ) ( ) Final Grade ( ) ( ) ( ) Date of installation / &o 9 Permit number 3676 - t "3 State plan number X80 06 rf.5 Plumber's si na e License number / e 2 V Date X/- 519 Inspector `l Complete plot plan � SANITARY PERMIT APPLICATION Safety W Washington B u i ldings e D ivision 1*6 onsin P .O. In accord with ILHR 83.05, Wis. Adm. Code O Box 969 Department of Commerce Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County C than 8 112 x 11 inches in size. l54 c p; • See reverse side for instructions for completing this application State Sanitary Permit Number The information you provide may be used by other government agency programs ❑Check if to rm 1 r ` application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Nu 1. APPLICATION INFORMATION - PLEASE PRINT AL INF RMATION mber o Prope7Y Owner Name �f Property Location �V ! t/45� 1/4, ` T ZA, N, R 1,9 kJor) W Property Owner's Mailing Address, Lot Number, Block Number off City, ate, Zip Code Phone Numb r Subdi i n Name or C umber All 40 9D 11. TYPE OF B LDING: (check one) ❑ State Owned it� Nearest Road Public 1 or 2 Famil Dwellin - No. of bedrooms C T own of I11. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s)/ 1 E] Apartment/ Condo ! // ei 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 _____________ Tank _nly______________ Existing System ---- --------- - ---------- -- 8) B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribu I ion Experimental Other 11 ❑ Seepage Bed 21N 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 �ay 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. rElievati Final Grade Requ�d(s ) Proposed (s . ft.) (Gals/day /sq. ft.) (Min. /inch) on 7� O yZ ]Feet Feet VII. TANK Capacity INFORMATION in gallons Total # of Prefab. Site Fiber- Plastic Exper. New Existin Gallons Tanks Manufacturer s Name Concrete Con- Steel glass App. structed Tanks Tanks Septic Tank ov410tfflff§TMit �(J�fa �J��,� ❑ ❑ ❑ I ❑ ❑ Lift Pump Tank f *WmEhe r j kay `CT1s•L ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage sys shown on the attached plans. Plu& Name: (Print) Plumbe 's Signature: (No S ps) MP / MPR . Business Phone Number: mow-- .i 7/� 77Z Plumbe s Address (Street, City, State, Zip Code): IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater D ate I ssued Issuing Agent Signature (No Stamps) A roved Surcharge Fee) ® pp El Given Initial nc� � Adverse Determination U7iV X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: ssD -6398 (R. t 1res) DISTRIBUTI : orb to ca one can re: safet a suaarmp ate. o,.,,kr, Pkunber Steve Nick - Mound 9820045 98-20045 Location: Lot 56, Glover Station 4th Addition NW 14, SE 1/4, Sec. 16, T 28 N, R 19 W Town: Troy County: St. Croix Date: January 14, 1998 Owner: Steve Nick Address: 327 Soo Line Road Hudson, WI 54016 Plumber: Roger Timm Signature: License # MPRS 226524 Attachments: 6748 -Plan Review Application SBD 8330 RECEIVED page 1: cover 2: calculations JAN 13 1998 3: plot plan SAFETY $ BLDGS. DIV. 4: system cross section 5: plan view, lateral detail 6: pump tank exit detail 7: pump curve page 1 of 7 p.o W G ori all y 0?IkOVED Of pEPARTME COMMERC DIVIS►0N of SAII AND ILI SEE GORRES NpENCE Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page \ 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.irtc iri�[ g. must include, but ST C O ) X not limited to vertical and horizontal reference point (B �dkebtior1 -ark f scale or PARCEL LD. # dimensioned, north arrow, and location and distanc �xlest road. APPLICANT INFORMATION– PLEASE PRI %itL INt ORMAT66N ey REVIEWED BY DATE ,. PROPERTY OWNER: ! r'., PROPE ....., 'OCATION C • I"► , B`'f E PIMj 1�� \ S( S C „t '; NL 1/4 S 1 1/4,S I T ZS ,N,R l 9 E ( w PROPERTY OWNER':S MAILING ADDRESS LOT # [, BLOCK # SUBO. NAME OR CSM # — 1 t O N , wl 1}t Na S T 'M 5 6 — G L pU P12 .SCRfi W CITY, STATE ZIP CODE PH MBER EICI v ILLAGE MOWN NEAREST ROAD Rw � l L 5 AJ I S p Z.Z. (71 '_ 8 L 61 °.� Y s uo LW E R -or�t� [5(J New Construction U se.[>q Residential / Number of bedrooms y [ ]Addition to ehasting building [ ] Replacement [ ] Public or commercial describe Code derived dairy flow b esp gpd Recommended design loading rate o • �{ bed, 9lXW trench. gpolfT Absorption area required S "a bed, ft S 1 4 1 3 trench, 0 Ma)6mum design loading rate o, S bed, gpd/ft 0 . 6 trench, gpdnt Recommended infiltration surface elevation(s) 1 b L•(2 • l ft (as referred to site plan benchmark) Additional design /site considerations M IAJ . Z' o F S rtMp FI LL Parent material Slb LM � r:. / 'n LL / On Uo M L Flood plain elevation, if applicable N •A - ft S = Suitable for system CONVEI TIONAL I MOUND I MI-GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable for sys 1 0 S ® U 0S O U 0S o U [IS W U 0S ®U 0 S O il SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consisberhce Bottxlary Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Tmnch Z s C-5 - 14•5 0.6 r - olm ,' 11. 1 Ground 3 ZA Z S S Ll k 3 l - C M► S Vk �► -►' - c S O . Z 14.3 elev. 103 ft. � 2.S -3d lo`T Q 43 L3 � LS 131 — — - Depth to limiting factor 2.5 " Remarks: Boring # 311 - Si Z `Fsbk ��tr cS o•S c.6 Z Z q -l1 A `ttz 31 S vn j C S o• s l a. 6 3 11-2t \� -,0 2`Qsb why►- C_ - o•S �•6 Ground elev. z-b 3Z �,S 4LZ 3! � c� 1 v sb k V" c IO Vb.7 ft. Depth to limiting factor 3 2•'' Remarks: T Name. Please Print Arthur L. W e e r e r Phone. 715-425-0165 egerer Soil Testing & Design Service -P.O. Box 74 River Falls,WI 54022 Signature: p' G q-30? S 6 Date: 1vS O ` � S CST Number: 5 7 b PLOT PLA N Page - S of SCALE 1 "= LK) ' LOT S'1 Lo t_S b M N r� x.1039 S e.orqPr1 cT O R y � � `SCR 8 `R•4 is 4'�12.�q , BoT of 8 l90 t• 3 8 `' t0�► °- \ i 3 $• Z ems, ►�y.v off' N wy a I.+t ov RtD6E �'� � (zai►J p�� S NOTE: House to be at least 25' from mound. Well to be at least 50' from mound. For a 3 bedroom home, install mound with a 6' X 63' bed. zqa44'V 9y- 3oZ - S6 1 -3p -95 ( 715 1 4L -0165 1400576 CST Signature Date Signed Telephone No. CST # Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page \ of 3 Labor and Human Relations pivision 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 ST • C CZ (3 ) K not limited to vertical and horizontal reference point (B4, direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION– PLEASE PRINT ALL INFORMATION rilWEDBY DATE PROPERTY OWNER: PROPERTY LOCATION C. M. B4 E Gow. Lef Nk3 114 SIE 1 14,S It T Z8 ,N,R 19 E( W PROPERTY OWNER' :S MAILING ADDRESS LOT # I BLOCK # I SUBD. NAME OR CSM # _ _103 N. " tit 11 5 T- 56 — C Lb\) f?)t S?"W tI V ftbjJ70N CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE MOWN NEAREST ROAD RL UeV_ ( S OL 'z_ (7151 U2S- 81 oY sob LIN pwrtD (�() New Conshdort Use.pq Residential /Number of bedrooms q [ ] AddifiT to existing btultfirtg j ] Replacement [ ] Public or commercial describe Code derived daily flow b otA gpd Reoanmended design loading ralo o • 4 bed, gp(W trench, gpolft Absorption area required Soo bed, ft S b a trench, ft Ma)dmtm design loading rate 0. S bed, gpol0 0. (o trench, 91)0 Recommended infiltration surface elevation(s) \ b LL Z • - i ft (as referred to site plan benchmark) Additional design /site cortsiderations "G &j h w / `d'xL C 3' s eD . M iti x . Z' or– S RAIci Fi L L . Parent material Sip LM 'n LL / t)Q Vo M L'rg- Flood plain elevation, if apprable ft [ S _ = Suitable for System CONVENTIONAL MOUND N-GR"O PREMRE AT -GRADE MEM IN FILL HOLING TANK U = Unstritable for tem ❑ S ®U O S ❑ U ❑ S ®U ❑ S [IS ®U CIS ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourft Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed jTWndh I 0 -8 ►��t�Z 3tz — si 1 Z 36k 2 $ -Zp 1 p`1Q�!!3 — st I Z Shk YnJV C - o•S o•L Ground 3 ZA ZS . S'd k wt.71,. cS - 0 0.3 elev. 103 -S ft ZS -30 1.04 e C f 3 _ I-S 1312 — — - Depth to limiting facto Z 5" Remarks: Boring # 0 - l c O.S:3 E l 10`1tZ 31 S I 3 V) - it �'i k? y j.j 0 .111 Z` q wL�� cS - 0.S :n.� Ground elev. Z.b - 7,S yR 31 _ C' 1 Urn 5�k vn �F �S - 0 •Z 0.3 10 yo.1 fc Depth to 5 3Z _ lOHR 8/3 t_S61� limiting factor 3 ZI, Remarks: T Name:— Please Print Arthur L. Id e e r e r Phone. 715- 425-0165 ess: egerer Soil Testing & Design Service 40X 74 River Falls,WI 54022 Signature: , I Date CST Number: �_ q �! -3oZ 5 1- -30 -95 M 00576 PLOT PLAN Pa 3 of SCALE 1 "= LIO ' LOT S'i LoT_5 b M N CuVtovR�L.10�10.'7 �y �\\ �`S1v \Z-8 "R}(S P11Z.�q. '6OTT0� OF B �D � q 7 9.3 e , 3 O\ N Z Z'* I�IGN vjy 3m ►•� ►uk �06E - -- o' oT< L1T%.f aft FM e,,JT - -- -- -- - -- — — BFI' .- tai.. \�y \.s$• or.� l`� �Ral1J PIPE SoD L11.1E 'R..v�� NOTE: House to be at least 25' from mound. Well to be at least 50' from mound. For a 3 bedroom home, install mound with a 6' X 63' bed. � 9y-30Z - S 6 d -� 1 -3� -95 ( 715 j 4�5 1400576 CST Signature Date Signed Telephone No. CST # Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM y: Safety and Buildings Division Count INSPECTION REPORT S�• C�i 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)j. 30 Permit Holder's Name State City ❑ Village � Town of: Plan ID No.: ��6vlp__ M I c k I ro CST BM Elev.: Insp. BM Elev.: BM Description: '�µ� &_ 0,4 C ST.S Parcel Tax No O I 1. l oh YmAkA& o TANK INFORMATION ELEVATION DATA MP q0 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. eptic ft�d.e� /W Benchmar (, log / osin Aeration Bldg. Sewer/ Holding St /Ht Inlet jogLy 94 1o3 0 TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P / L WELL BLDG. Air I ntake ROAD Dt Inlet Air t c o NA Dt Bottom j Dosing a-'7 f NA Header/ Man. Aeration A Dist. Pipe t t4 - jo 3•n 1 ogT.g7 Holding Bot. System 1046'0 3,47 JOW PUMP/ SIPHON INFORMATION Final Grade Manufacturer ma Demand 6of6 5- 0 ' IC41 13,33` 1 0:5(- , 4 3 Model Number 1 - 32--S - G PM f a'. 7 0 33 • t_ i. TDH Lift 1-7 of Friction t 2 Systema TDIUp 3gFt Forcemain Length 132,' Dia. 2 Dist. To Well SOIL ABSORPTION SYSTEM BED / Width Length r No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS S - 7 :5 - DIMENSION SYSTEM TO P / L BLDG WELL LAKE/STREAM LEAC acturer: SETBACK CHAMB INFORMATION Type O , Model Num System:Wbv �o Cc�S (ocb' OR UNIT D ISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing k Length T Dia. L Length 701 Dia. I 2 . Spacing — t14 (A.0 – 70 ' SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of It xx Seeded/ Sodded xx Mulched Bed/ Trench Center 1 L' Bed /Trench Edges t L� Topsoil t Z Yes ❑ No /� E] Yes E] No COMMENTS (Include code discrepancies, persons present, etc.) 3Z7 Sod Lrh2 d C, 16 Ue4 S 7h Lo sz. I 1M- S4 1Lty l K,- ,. w lw4cA -t LiLAI S cwt WJA4_�\ wnS n�� ( � a4- i pevFt�r� Plan revision required? ❑ Yes ,J No Use other side for additional information. I s l u I Ag SBD -6710 (R.3/97) Date Insp ctor's Signature Safety and Buildings Division SANITARY PERMIT APPLICATION 201 W. Washington Avenue VisConsin In accord with ILHR 83.05, Wis. Adm_ Code P O Box 7302 Department of Commerce Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County c than 81/2 x 11 inches in size. J� • See reverse side for instructions for completing this application State sanitary Permit Number 3 Personal information you provide may be used for secondary purposes ❑ Check if revision to previous application [Privacy Law, s. 15.040)(m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATI N & 2 - b Property wner Name Property Location /a S 1 /4, S T o 'tg , N, R (or) Property wner's Mailing Address Lot Number Block Nurr)ber City tate, L Zip Code [ Phone Number Subdivision Name or CS Nu b @r /[/ II. TYPE OF BUILDING: (check one) ❑ State Owned 0 c ity Nearest Road p Village Public 1 or 2 Family Dwelling - No. of bedrooms 3 Town OF III 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 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 Q $ Date Issued lqz 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 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 Feet / � Z Feet VII TANK Capacit in gal Ions Total # of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturer s Name Concrete Co Steel glass Plastic App New Existing structed Tanks Tanks Septic Tank /GR'13 i ❑ I ❑ ❑ Lift Pump Tank (S d L VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. A r's Name: (Print) Plumber's Signature: (No amps) MP / MPRSW N o.: Business Phone Number: 7/� 772 is Address (Street, City, State, Zip Cod ) IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater fee) ate Issued Issui nt ature (No Stamps) E] Approved Owner Given Initial D C Surcharge Adverse Determination X. CONDITIONS OF APPROVALI REASONS FOR DISAPPROVAL: SBD- 6398 (R.11 /97) DISTRIBUTION: original to county. One copy To: Safety & Buildings Division, Owner, Plumber + • Safety and Buildings Division 15837 USH 63 Wl 54M vi Tommy G. Thompson, G sconsin Hayward, Governor Department of Commerce William J. McCoshen, Secretary April 29, 1998 ROGER L TflvIM CUST ID No.226524 3128 20TH AVE WILSON WI 54027 RE: TRANSACTION ID NO.: 76807 CONDITIONAL APPROVAL APPROVAL EXPIRES: 04/29/2000 SITE: Site ID: 6380 ST CROIX COUNTY, TOWN OF TROY NW 1/4, SE 1/4, 516, T28N, R19W STEVE NICK FOR: Description: MOUND Object Type: POWTS Regulated Object ID No.: 15482 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. When making an inquiry or submitting additional information, please refer to Transaction ID No. 76807. Sincerely, DATE RECEIVED 04/29/1998 FEE REQUIRED $ 180.00 Leroy ;ky, ns tewater cialist FEE RECEIVED $ 180.00 Field ations Bureau BALANCE DUE $ 0.00 (715)726 -2544 Voice Ijansky@conunerce.state.wi.us i Steve Nick - Mound Transaction # 76807 (Moving mound upslope from Approval 9820045) Location: Lot 56, Glover Station 4th Addition NW 1/4, SE 1/4, Sec. 16, T 28 N, R 19 W Town: Troy County: St. Croix P'O.W.T.S. Date: April 30, 1998 C" u'lirionally . r Owner: Steve Nick r ROVE D r - i ' f: ? of COMMERCE Address: 327 Soo Line Road DI S:ON f skrETY ANDBURDINGS Hudson, WI 54016 Plumber: Roger Timm LE R SP DENC Signature: b License # MPRS 226524 Attachments: 6748 -Plan Review Application SBD 8330 supplement See 9820045 for original SBD 8330 page 1: cover 2: calculations 3: plot plan 4: system cross section 5: plan view, lateral detail 6: pump tank exit detail. 7: pump curve i page 1 of 7 System Calculations one family residence 3 bedrooms Loading rate ° ` gallons /sq ft per day Depth to ground water 3 Z in Depth to bedrock in Cross slope % Force main length Z ft of Z in Manifold /header length ft of in Drainback Z �'� O gallons Lateral length @ } ft of V "- i n Lateral elevation ft (bottom of pipe) Lateral hole size t' in @ B' in ( S ' O ft) spacing holes /lateral, holes total Lateral volume �O. gallons Total lateral discharge rate 's gpm @ ft head Elevation difference ft Friction loss °' 8 L ft @ g gpm Total dynamic head 23 ft Pump /siphpn 3 �'� gpm @ 2 �� ft of head Manufacturer �0 � , Model # Dose voluxge 35 gallons Lift /si )Aon tank � , � O `'�' ° gallons Septic tank , ° gallons Measurement pump on & off �'`� in Height alarm from tank bottom in Reserve capacity } gallons calcs page Z- of � t� T a vim.. N•; e.� . �� 1 0 � ' � •••, (( 4 n pry O w� t3 Z' �•` Pv� sJ�. � o 4D 2� g �•.� f f., /.11 CTVO ` v0 S nor S'1 ' �o�' S vi I � C�o42•S� - �o4S.�� 10� v T►1.1lY ��NT - - - -- - - 360.06' VO SO 3 r o \ 3 w►.a b s -k : l �•a'$.o` t;. 9.4• Z, t' 14L� lZ•i� K �( �,: ��L. s�e.{� QW1N Z er ..:N' 14�ar1�► � �+w��W� �r:va.... �o 1:.dsL Uo p ; �' P v .c c..► .a oho' :a.�. � .�� o .. �.....``L � � o� o �-. o � �.. c.�.. `s �p�; \a�4.r.1,1[ }�r�,.: �5 2. S � i r ow. v►� o f tom K `a� ' `� - PAC s.,�. • I , I , � I � S O� �Y •o• _. r --*- S c7 S.a� � i CL— �O ►'+ OM,► `.�'►� -•�• 0. M" ,•O, �a Vo :.Q ' WEA'1"11ERfROVF . .JUNCTION LOCIDUG CONLR �oit 4/Ab11NrM+K AABF14. aNt1t o�.�o�K� 40 C.T. I MDAAW1r1QPGWM` 7 6 • .. 12 PIIN. 3' wabzu�o 24M a ~c.t. 501L, =. Y. Yf " 011/ KM'I 1g •. 4 AIM* Zo .1N NG:t a A C.Z. PIN T 70NrS _� BAFFL A 3 Ow* GTIONSi � —� � OWN LA.J O {r" GO�C�tt7'E . [rrlG ! SPEGIFI'GATIOAJS A_� MAWUFACTUILCR: _ ti 4-4;. LAAMOER OF DOSES: PER D" TAWK SIZC : �..� ' E ' ^� &ALLOWS .. OOSC VOLUME IZ9.o ALA AAWIFALTY�iR: Vr e%� `� INCLUDIW6 SACKF160W: (.ALLO/JS AODCL IJUMkRS ° I ~w CAPACITIES: As U.1 WCACS OR GALLONS SWITCH Tur[: �" Q w46 "=h e • 1� I N CHES OR GALLOWS P t,�MP MAIJUFACTUQCRI �''o�•` i 3 �8� �•�- 12q.c7 C. ��1NCNCS OR �� G1►LLOIJS MODEL NUADER: 00 �O 1MCWES OR � * b GALLOuG SWITCH TV ►E: �` ~" ` MQTE1 PUMP AIJO ALARM ARE TO S[ MIWIMUP\ DISC11AR" RATL � g GPM INSTALLEO OIJ SEPARATE CIRCUITS VPRTICAL DIFFER[W.9 OCTW66M PUP1P OFF ACID CUTIMUTUM PIPE. f }' FEET MINIUM AICTWORK ' S� /PLy PREtSURE FLET .�_ 1 g 1 PEST OF ►ORCE AMU X O �. b: �I jRilIKT101JN►CTOIt.. /ECT� 7 S'if V Q = TOTAL DOWAAW. ,N[AD s .�� FEET �� TERLIAL. OIMEIJSIOUG Of TANKS LE.W(Mt ��MIOTN } _...= .�ILIQUIU OCPTI S_ S T C — 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner /contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. ------------------------------------------------------------------- Owner of property Steven & Sara Nick Location of property N_W _ 1/4 -.gF ��1/4, Section 16 ,T 28 N -R 19 W Township Troy Mai1 g address 705 Oak Knoll Avenue River Falls,; Wi 54022 Address of site 327 Soo Line Road, River Falls, Wi 54022 Subdivision name Glover Station 4th Addition Lot no. 56 Other homes on property? Yes XX No Previous owner of property C. M. Bye & Dennis S chultz Total size of property 3.694 acres Total size of parcel 160,901 SQ. Ft. Date parcel was created Are all corners and lot lines identifiable? x_ Yes No Is this property being developed for (spec house)? Yes __X.I_ Volume and Page Number as recorded with the Register of Deeds. ------------------------------------------------------------------- INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in e office of the County Register of Deeds as Document No. IMIS / , and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the o e of the County Register of Deeds as Document No. s us na f Applicant Co- ppl'c nt 20 �D Date f Signature Date df Signature STC -105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER Steven & Sara Nick MAILING ADDPMS Oak Knoll Avenue 'River Fall Wi 54022 PROPERTY ADDRESS 327 Soo Line Road, W (location of septic system) Please obtain from the Planning Dept. CITY /STATE River F a l l a r W i 5 A n 2 2 PROPERTY LOCATION NW 1/4, SE 1/4, Section 16 T 28 N -R 19 W TOWN OF Troy ST. CROIX COUNTY, WI SUBDIVISION Glover Station 4th Addition LOT NUMBE CERTIFIED SURVEY MAP , VOLUME , PAGE , LOT NUMBER S h Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I e undersigned have read the above requirements and agree to maintain the private sewage UWe, th gn Q g P disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintaine t be co pleted and returned to the St. Croix Officer within 30 days of the three t' ate. � County Zoning O y y SIGNED: DATE: St. Croix County Zoning Office ty g Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 Wisconsin Department of Commerce AND SITE EVALUATION Page 1 of 2 bivision of Safety and Buildings ip {-with Comm 83.05, Wis. Adm. Code • Supplement to previous report Attach complete site plan on paper not less than 8% x 11 Inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix percent slope, scale or dimensions, north arrow, and locatkan,a 1O distance to nearest road. parcel I.D.# APPLICANT INFORMATION - Please print all information. JSic7 - iz Z 9 — io Personal information you provide may be used for secondary pumas (Privacy Law, s.15.04 (1) (m)). Reviewed By Date Property Owner "f r ",.' Property Location Nick Steve tGovt. Lot NW 14 SE 1/4 S 16 T 28 N,R 19 W Property Owner's Mailing Address ! Lot # Block # Subd. Name or CSM# 327 Soo Line Road 56 Glover Station, 4Th Addition City State eNtImber ,� EJ City E] Village ®Town Nearest Road Hudson W1 Troy Soo Line Road ® New Construction Use: ® ' Ri"nbal t N`pr>Vber, edrooms 3 []Addition to existing building Replacement F Public oF'cbfnmercial describe Code Derived daily flow 450 gpd Recommended design loading rate .5 bed, gpd/ft' .6 trench, gpd/ft= Absorption area required 900 bed, ff 750 trench, ft- Maximum design loading rate .5 bed, gpd/ft' .6 trench, gpolft= Recommended infiltration surface elevation(s) • 1045.0 ft (as referred to site plan benchmark) Additional design / site consideration s . nstall 5' x 75' rock bed mound on (1042.8 - 1043.0) as upslope edge of rock w/ 2 - 2.2' sand fill Parent material loess over sandstone Flood plaiii n elevation, if applicable NA ft S= Suitable for system Conventional Mound In Ground Pressure AT - Grade System in Fill Holding Tank U= Unsuitable for system EIS ® U ® S ❑ U 1 ❑ S ® U ❑ S ®U ❑ S ® U ❑ S ® 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 1...' 1 0 -8 10YR 3/2 - sil 2 m cr mvfr cs 2flm .5 6 2 8 -23 10YR 4/4 - sl 2 m sbk mfr cs lm .5 .6 Ground 3 23 -31 7.5YR 4/4 - sl 1 m sbk mfr cs If .4 5 elev 1042.8 ft 4 31 -43 7.5YR 4/4 - sl 0 m mvfr cs - .3 .4 Depth t 5 43+ SSBR limiting factor 43" Remarks: considerable SS gr & cob below 31"; BR is monolithic below 43 but could be considered fractured 3143" ................. .....2 1 0 -4 10YR 3/2 - sil 2 m cr mvfr cs 2flm .5 .6 2 4 -12 10YR 313 - sil 2 f sbk mvfr gs lm • .5 .6 Ground 3 12 -18 10YR 4/4 sil 2 m sbk mfr gs lm .5 .6 elev 1042.9 ft 4 18 -26 7.5YR 4/4 - sl 2 m sbk mvfr cs Im .5 .6 Depth to 5 26 -34 7.5YR 4/4 - s1 0 m mvfr cs - .3 .4 limiting 6 34+ SSBR factor 34" Remarks: considerable SS gr & cob below 26'; BR is monolithic below 34" but could be considered fractured 26 -34 "; use 2' sand fill for conservative desi CST Name (Please Print) Signature: Telephone No. Henry F. Grote 715 -665 -2681 Address P.O. Box 57, Knapp, WI 54749 Date CST Number Ref# 4/20/98 222774 262 t �l lb 4a DoT S l loT 5 N � to1A.4 8.1 2."A'15.� `�k •� ( � � B�Y +cL ►moo? c ► ��,_, 85 S: L eu Soo DDITION NE 1/4 OF THE SW 1/4 AND ST. CROIX COUNTY, WISCONSIN. GLOVER STATION SECOND — — ?DDITION/ DETAIL OF DRIVEWAY EASEMENT FOR LOT 70 & LOT 71 L ' SCALE: 1"-50' SOUTHERN — ?A CIFIC _ — 70 ' 30 " E 27 0.00' ROAD 2 04.00' ' co 3 $ Q LOT r7 �M I 0 ° W LINE a� o W 1 z M in 71 N • $6�0 7 2 W I O N 59 2.124 AC 3 92,539 SF M 52 ° n 0 I GLOVER STATION 4 THIRD ADDITION EXISTING 40' WIDE POWER LINE EASEMENT f 53 54 — — 2639.98' 50�......•••••• S 89 E 900.67' ' , .....73.53.. . . ... . . ... 36 1s ........................... .. 69 .74'. ......... ....... ..,..... 2 1 -- 210.24' — -- -- -- -- _.. S8 / '/ 20' 10%• / / / 56 / 3.694 AC J' 160,901 SF a / � v �a 57 / 2.000 AC 87,116 SF 58 2.151 AC O 1 93,695 SF e0 ' °yo 6 ' e �c?% DETAIL OF DRIVEWA n S FO R 1 s 6y e$ p �N�� ' EASEMENT FOR LOT 58 8 HA DRIVEWAY Y && 6 ' / _. c�� . Da� ' ` SCALE: 1"=50