HomeMy WebLinkAbout040-1230-50-000 C N 0
Qr O o
a � j �
o
o° I
N !'
d
U
� N i
O
O
h �
y N
i'
N o
v o E
c Z
LL C ;
O
C
� m
Q ..
V'
cp ci Z l a m
c C7 0
o z a v
CD 2 d o
cu Z
E -2
_� ch
c
O
O � �zz -
N Q
z
a
O N E E N
.. m
0
N d d N C p 0
> O d .a C N
^� O r � H 1 F 2 U - � o
- N
Nei Lo 0 0 0 d 0 _Z o f
m aao.
*� o N o rn rn
tq J V a rn }
= N N 503 N
O �-
C CO LL
J U� N ,C7;
}� L" O 7 w
N N
0
V V1 C
o M O V O
C') O co U O G O
U i N C N a 0
w O 0 O C N - N N
L. O F- C7 M 0 N z x UJ
o
= w
a
�i a N .0 N AL >1
v E a I''
w
f
1 0
CROIX COUNTY ZONING DEPARTMENT
AS BUILT SANITARY REPORT
Owner
Address1
City /State
Legal Description:
Lot Block Subdivision/CSM #
Sec., �N_RW, Town of
PIN #
SEPTIC TANK -- DOSE CHAMBER -- HO NG TANK INFORMATION :9t ���5
Tank manufacturer Size SUMP
/
Pump manufacturers Setback from: House Well P/L
Alarm location Model _ b �,* ?ill
(HOLDING TANKS ONLY)
Setbacks: Service road Vent to fresh air intake
Meter location Water Line
Alarm location
SOIL ABSORPTION SYSTEM:
Type of system: /��,,.,, Width
Setback from: House -- Length _:Z2_ Number of Trenches
_ Well /mom P/L _,:Z— Vent to fresh air intake
ELEVATIONS:
Description of benchmark
Description of alternate benchmark i Elevation 1gL
Elevation i,•,,
Building Sewer _ __ 22,2 y _ ST/HT Inlet 27, a ST Outlet 9l 2z PC Inlet .
PC Bottom Z Header/Manifold _ Z 2,1L' Top of ST/PC Manhole Cover ,T
Distribution Lines
Bottom of System
Final Grade ( ) ( )
Date of installation i / /9,? Permit number
:2 — State plan number
Plumber's signature
License number � Date
Inspector _ f�� �
Complete plol plan K
Wiscohsin Department of Commerce
Safety and Buildings Division PRIVATE SEWAGE SYSTEM County: ,
ST. CROIX
L 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)J. 315927
Permit Holder's Name: ❑ City _❑ Village Town of: State Plan ID No.:
MARK RK T R o}(
CST BM Elev... Insp. BM Elev.: FBM Description: Parcel Tax No.:
040- 1230 -50 -000
TANK INFORMATION ELEVATION DATA A9800316
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic . Benchmark 7 /511
Dosing
AerationJ r
Bldg. Sewer `>? -U
Holding St /-W Inlet ��✓' 97. J��
TANK SETBACK INFORMATION St/ Ht Outlet
TANK TO P/ L WELL BLDG. Air I to ntake ROAD Dt Inlet
ir
Septic NA Dt Bottom
Dosing NA Header / Man. 3 3` �<
Aeration NA Dist. Pipe
Holding Bot. System
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand
Model Number Alf0 bl GPM
TDH Lift, Friction System TDH Ft
Me
Forcemain Length I Dia. Dist. To well
SOIL ABSORPTION SYSTEM
BED/TRENCH width Length No. Of Trenches PIT No. O i s Inside Dia. Liquid Depth
DIMENSIONS 'J DIMENSION a �
SYSTEM TO P/ L BLDG WELL LAKE / STRE LEACHING ° Manufacturer.
SETBACK
INFORMATION Type O 4 > CHAMBER M odel
DISTRIBUTION
System:ry�A -r�',t A A D�13AttT ° "'..
DISTRIBUTION SYSTEM
Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
�Le / / II � � J
Length _L_ Dia. LengtWj I Dia. l Spacing (o / i if , i
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over „ Depth Over ,, xx Depth Of *X-�5 e / Sodded xx Mulched
Bed /Trench Center Bed /Trench Edges / 2 _ Topsoil [9Yes ❑ No es ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION TROY 16.28.19,NE,SW 344 SOO LINE RD — GLOVER STATI N LOT 70
,
�'�
M ~ -- Q..P.r ......+ '°�.k:,�(...6`t''� r � j� � �'' �.... t... -rl � F (u,/ r� �,.f - •T,.t.J
/ tom. ' t.. -,t. �Y;... a,CJ � 21 t,..z.. C - rH^ /
• f'
�
Plan revision required? ❑ Yes ❑ No
Use other side for additional information.
UTIJ
SBD -6710 (R.3/97) Date Inspector's Signature Cert No
z �
Vi sconsin SANITARY PERMIT APPLICATION 20 Safety and 1 E. W shngtonAve
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 1/2 x 11 inches in size.
• 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 E] Check it redrl�6 pfe ITous a placation
[Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number
I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATI N //
Propert Owner N e Property Location
1/4 1/4, T , N, R (or�
Property Ow er's Mailin
Ad ss Lot Number Block Number
I
City ate I Code Phone Number Subdivisio9 Name or CSM er
II. TYPE F ILDING: (check one) ❑State Owned E] its Nearest Road
Public 1 or 2 Family Dwelling - No. of bedrooms C] Town OF
III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s
1 ❑ Apartment/ Condo 1 / ?o
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 online 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 ❑ 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.) (MinAnch) Elevation
Feet 7 Feet
VII. TANK Capacity
INFORMATION in gallons Total # of Manufacturer's Name Prefab. Con- Fiber- Plastic Exper-
New Existin Gallons Tanks Concrete structed Steel glass App-
Tanks Tanks
Tiftp eptic Tan g an El El ❑ 1:1 ❑
Tank er — qm ( ® ❑ I ❑ I ❑ I ❑ I ❑
VIII. R STATEMENT
I, the undersigned, assume responsibility for inst ation of the onsite sewage system shown on the attached plans.
Plumber' Name (Pr t) Plumber Slwdl o p MP /MPRSW No.: Business Phone Number:
Plumber's Address (S eet, City, ate, Zip de):
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fe (Includes Groundwater ate ssue Issuing ge i t re {No Stamps)
XA roved Surcharge Fee) Y
pp ❑ Owner Given Initial �'Z� _7& I-VIP]
Adverse Determination —7ZI) V)
X. CONDITIONS OF APPROVAL / REA NS FOK DISAPPROVAL:
SBD.63W (8.11196) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, plumber
Safety and Buildings
15837 USH 63
N Visconsin HAYWARD WI 54843 -8107
Department of Commerce Tommy G. Thompson, Governor
William J. McCoshen, Secretary
July 13, 1998
CUST ID No.224263
KIM A O'CONNELL
504 3RD AVE
OSCEOLA WI 54020
RE: CONDITIONAL APPROVAL
APPROVAL EXPIRES: 07/13/2000 Identificatiori 1�Turnebe _.:.'''
Transaction ID No. 112837
SITE: Site ID No. 13829
Site ID: 13829 Please refer 10 othdenhficahonuiaub;
ST CROIX County, Town of TROY abcive; m all correspon dente. -with a agency.;
NEIA, SWIA, S16, T28N, R19W
MARK GREEN
FOR:
Description: NEW MOUND
Object Type: POWT System Regulated Object ID No.: 29307
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.
This plan approval is for a 600gpd mound with a high linear loading rate of 14.28gallons..
The following conditions shall be met during construction or installation and prior to occupancy or use:
• This plan action is subject to designer comments on the plan
• Correspondence Note:
• Per Comm. 83.23(3)(b)2, the area 25 feet below the downslope edge of the soil absorption system must remain
undisturbed. P. 0.W.
• The orientation of the mound system must be such that the mound's longest dimension is perpendicular to the Cond>;
direction of maximum slope.
P P
AFe
A copy of the approved plans, specifications and this letter shall be on -site during construction and open to DEP R ENT i.F "
inspection by authorized representatives of the Department, which may include local inspectors. All permits DIVISi SAF
required by the state or the local municipality shall be obtained prior to commencement of
construction /installation/operation.
SEE CORRES
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
Sincer y,
DATE RECEIVED 06/26/1998
FEE REQUIRED $ 180.00
TOM BRA , PLAN REVIEWER FEE RECEIVED $ 180.00
Integrated Services BALANCE DUE $ 0.00
(715)634-3026, M - F 7:45 AM TO 4:30 PM
TBRAUN @COMMERCE. STATE. WI. US
RESIDENTIAL MOUND DESIGN
INDEX AND TITLE SHEET
Project MARK GREEN
Owner MARK GREEN
Address 637 COUNTRYSIDE LN
HUDSON WI 54016
Legal Description NE-SW 16- T28-R19W
Township TROY County ST. CROIX
Subdivision Name GLOVER STATION 4 ADD Lot No. 70
Parcel ID Number T.S. 'nRlly
Plan ID Number 112837 *VE D
COPIMMS
INDEX SHEET PAGE ONE ;FA~
MOUND CALCULATIONS PAGE TWO
MOUND DRAWINGS PAGE THREE ONDENCE
PRES. DIST. CALCS. & LATERALS PAGE FOUR
PUMP TANK DRAWINGS PAGE FIVE
PUMP CURVE PAGE SIX
PLOT PLAN PAGE SEVEN
Designer KIM A OC NE L License Number_
Signature Phone No. 715 - 755 -3145
Date 6- 15-98
1 Warning messages in design
Notice, Tampering v*h this Me by unatithadzed persons is prohibited
Deliberate modiflcation will result In dWplirwy action under s. 146.10, VA& Stats.
SBEM04e2 -E (804197) Page 1 of 7
RESIDENTIAL MOUND DESIGN
Ef ht Bedroom Maximum
Complete lntbrmatlon to red framed nom as necessary.
(y or n) n Is the Lgpd2271 eviced bedrock?
Slope 12
Number of bedrooms 4
Wastewater flow rate 600 Lpd
Depth to limiting facto r 211 cm
In situ soil infiltration rate (code) 16.3 Um
Contour line below the upslope edge of absorption cell 112.27 ft 34.22 m
Use standard fill depths? OR Designer speed depth I in cm
Pike X & bw W u$e ataadWd dQPft ft2 A A+4l xkWvV OR 4MIfy demon am dew
Center or end manifold s care) Estimated hole space 4 ft Not a flea/ cakuki ion.
Lateral spacing 66 ft Minimum dose >= 10 times void volume
Use a 0l www speckv for &wwjn . Pump tank elevation 102.27 ft outsldo boa= at tank
Number of laterals 2 Force main diameter 2 in
Force main length j 40 Ift Force main actual dia. 1 2.067 in
SYSTEM SOLUTIONS Inch - pounds Metric Celt rtwdla " x " one ont,K
Estimated daily flow ®gpd 2271 Lpd x Aggregate and pipe
Absorption Dell Chamber and pipe
Design load rate & area 1.2 gpW 500.0 ft 46.45 m
Linear load rate 14.3 gpd/ft 177.3 Lpd/m LLR should be <12 gpdM1
Design width (A) 12 ft 3.66 m
Cell length (B) 42.0 ft 12.80 m
Depth of cell (F) 1 9.9 in 25.1 cm
Sand filter
Upslope fill depth (D) 12.0 in 30.5 cm
Downslope fill depth (E) 29.3 in 74.4 cm
Basal area required (gpdrnfiltration rate) 1500 ft 139.35 m
Suppmgglp components
Topsoil depth 6.0 in 15.2 cm
Subsoil depth at center 12.0 in 30.4 cm
Subsoil depth at cell wall 6.0 in 15.2 cm
End slope toe lend (K) 12.1 ft 3.69 m
Upslope toe length (J) 6.2 ft 1.89 m
Downslope toe length (1) 23.7 ft 7.22 m Includes basal acyusw3eat
Total mound length (L) 66.2 ft 20.18 m
Total mound width (W) 41.9 ft 12.77 m
Project: MARK GREEN
Plan I.D. 112837 Page 2 of 7
MOUND PLAN VIEW
observation pipes (typical)
J
419
W= ft A ft 3.66m
� A= 12.O
12.8m — B= 42ft 12.8m
B K J= 6.2ft 1.89m
I I = 23.7 ft 7.22 m
K = 12.1 ft 3.69 m
L = 66.2 ft
20.2 m �
A X B refers to absorption cell width and le (anc
h mess pipe
J = upslope width (anchored securely)
I = downslope width
K = end slope dimension T (150 mm)
MOUND CROSS SECTION T
T p subsoil ca D = 12.0 in 30.5 cm
lateral topsoil G H E = 29.3 in 74.4 cm
invert 113.8 ft F = 9.9 in 25.1 cm
elev. 134.69 m see note F G = 12.0 in 30.4 cm
D E ASTM C33 18. H= Oin 45.6 cm
sys• 113.3 ft sand Fill
elev. 134 .53 m 112.3 ft our 12 % ��
34.23 m slope
Nate: Absorption cell media will
D = upslope fill depth plowed layer consist of aggregate and pipe
E = downslope fill depth or leaching charnbers and pipe
F = absorption cell depth as specified x Aggregate
G = subsoil + topsoil depth at cell wall at right, Chamber
H = subsoil + topsoil depth at cell center
Designer notes:
If aggregate is used, it is covered with code compliant material
Project: MARK GREEN
Plan I. D. #!# Page 3 of 7
r
PRESSURE DISTRIBUTION CALCULATIONS
Absorption cell Inch -pounds Metric
Width (A) 1 12 ift 3.66 1 m
Length (B) 1 42.0 ft L 12.8 im
Lateral specifications
Number laterals 2
HolesAateral 10 holes
Lateral length 39.0 ft 11.9 m
Perforation dia. 0.25 in 6.4 mm
Lat. dis. rate 11.65 gpm 0.7 Us
Sys. dis. rate 23.30 gpm 1.5 Us
Hole spacing 52 ] in 132.1 cm
Lateral diameter Pipe diameter Design Desi choice
Designer must I 1 in25 mm Place X in red
W one choice 1 1 /4inr32 mm X box of chosen
from the options 1 12in/4o mm X x diameter.
Provided. zmw mm X
3iN75 mm I X
Manifold diameter Pipe diameter Design options Design choice
Designer must 1 in25 mm
")Ce one choice 1 1 /4inr32 mm X Place X in reed
from the options 1 1ran/4o mm X M box of chosen
provided 2N50 mm X di ameter
9inr/5 mm X
4in/100 mm x
Distribution system contains 2 lateral(s).
LATERAL DIAGRAM - END CONNECTION
Place correct /stern/ ftrem by cicking in one of the drawings at tight and dragging the clegram into this area.
tens cents over Iii last hole drilled neat to end cap cap
E P
AN laterals are identical x -. �I Holes drilled on the bottom of the lateral
etim ft spaced S
Fora+ man oarteodon via we or aoss to marrfold at •
� Pte- laterals & force main of PVC Soh 40
• .permanent end marker
[per COMM T" 64.30 -5)
Inch-pounds Metric
Lateral length (P) 39.0 Ift 11.89 m
Lateral spacing (S) 6 ft 1.83 m
Manifold length 6 ft 1.83 m
Hole diameter 0.25 in 6.35 mm
Lateral diameter 1.5 in 40 mm
Number of holes per pipe 10
Invert elevation of laterals 113.8 ft 34.57 m
Proieo- MARK GREEN
Plan IAL 112837 Page 4 of 7
n_
Total dynamic head
System head = 3.25 ft Alm m
Vertices lift = 10.60 ft m Are laterals the highest point in the
Friction loss = 0.39 ft m system? Yes W here.
Total dynamic head = 14.24 It no, what is the highest elevation
Dose Volume downstream of pump?
Lateral void volume = 8.2 gal 31.0 L Force main drain
Minimum dose = 150.0 gal 567.8 L back to tank? ('x' one)
Drain back = 7.0 gal 26.5 L x Yes
Dose volume = 157 .0 r7594 .3 L No
Typical Pump Chamber Layout
In combination with state approved treatment tank Tank construction as per Comm 83.20(3) WAC.
approved manhole cover
EI
weather proof J and wAvaming label and padlock
junction levels junction box quick disconect grade levels
4' y pi electric es per NEC 300 alternate
Comm 16.28 WAC
location 18" (46 cm) min.
wall of pump -- approved
chamber or outlet
combination joint
tank
A 1/4" weep Grade levels
alarm on hole as
pump tank nrnfwle =1' min. abaw 0niahed grade
Pump on B rxWesawy pump tank man. =10o mm mbn ab ove nriehed grade
31 5 ft `+ T vent = 12' min. above fWehed grade
off elev. 31
Pump 1 WI vert = 300 mm ndm above f"shed weds
.5 m
D
3 " (75 mm) of bedding under tank and anchor tank as necessary 102.3 ft Pump tank elevation
Tank specifications: WEEKS 31.2 Im bottom of tank
Pump tank = 19. gallln
Pump tank volume = awl Capacities; Inches Gallons
A= 23.8 452.6
Pump manufacturer: GO DS B= 2 38.1
Pump model number VVEO311 L C = 8.2 157.0
Project: MARK GREEN D = 8 152.3
Plan I. D. 112837 Page 5 of 7
■ ■ ■ ■■■■ ■ ■ ■ ■ ■■ ■
. \� ■ ■■■.■■.■■�
�ENE ■ ■� ■� ■■■
�\OM■■ ■ ■ ■■ ■■ ■■
a ■is ■ ■
Onamn
ONE NEON MRNNI
ME . .......:.
�■■■. ■ ■■ r r� MODEL 3885
NONE
�■
■■■■■ \ ■■■■ ■ ■■ ■/■ ■■ ��
NEENNEVIONE
WENINNEMEN
■■■■■■■■► ���■
■■■■■■■■ 1111
■■■■■■■■NI6 ■ ■■
MO■■■■■■■■ \ \ ■ ■■
M NNE
MINNI ■■ ■■
■■■■.►N■■■ ■ \�� ■ ■ ��
■■.■■■►■■ ■ ■■ ■■ ■ ■
■.■■■.■■■►R ■ ■■ `��� ■� ■�
■■■■■■■■ ■�. ME
■.■■■..■■■ ■. �� ■�
j
- t /moo I
i
i
I -
� � I
-
I
I
I I
I
i
l
j I I I I I I
,
L
I i
I
i
i
i
I
i N
i I
i
I
i —
I
I
V r s;
I __ i I , 721 �-
--
I,
S I _
I
f
I
JJJJ 1
I , 61 'I I
}}
L.
.� Safety and Buildings
15837 USH 63
HAYWARD WI 54843 -8107
, scOnsin
Department of Commerce Tommy G. Thompson, Governor
William J. McCoshen, Secretary
June 30, 1998
CUST ID No. 224263 DATE RECEIVED 06/26/1998
FEE REQUIRED $ 180.00
KIM A O'CONNELL FEE RECEIVED $ 180.00
504 3RD AVE
OSCEOLA WI 54020 BALANCE DUE $ 0.00
RE: REQUEST FOR ADDITIONAL INFORMATION Transaction ID No. 112837
SITE:
Site ID: 13829
ST CROIX County, Town of TROY
NE1/4, SW1/4, S16, T28N, R19W
MARK GREEN
FOR:
Description: NEW MOUND
Object Type: POWT System Regulated Object ID No.: 29307
The submittal described above has been placed on HOLD and the review and approval is pending subject to receipt of the
ADDITIONAL INFORMATION and/or revised plans requested by this letter. Upon receipt of the additional information
and/or revised plans, the plans will be reviewed for compliance to applicable Wisconsin Administrative Codes and
Wisconsin Statutes.
The following must be corrected/revised and accompany the resubmittal:
• The mound is not positioned in the area defined by the soil borings. Revise position or provide additional soil boring(s).
Send your resubmittal into the address listed above, unless otherwise noted, and the department will review the resubmittal
within 5 working days of receipt date.
If the above requested information and/or plans are not received within 30 days of the date of this correspondence, this
submittal will be returned unprocessed. No fees will be refunded, and a new fee, application form and submittal of
plans /specifications may be required should you desire to continue with this project.
Sincerely
TOM RAUJ PLAN REVIEWER
Integrated Services
(715)634-3026, M - F 7:45 AM TO 4:30 PM
TBRAUN @COMMERCE. STATE. WI.US
i
SAFETY & BUILDINGS DIVISION
State of Wisconsin
Department of Commerce
May 12, 1997 2226 Rose Street
La Crosse WC54
19; `.
WEGERER SOIL TESTING
ftE�EIVED � ..r
421 N MAIN STREET � � �� PO BOX 74 � RIVER FALLS WI 54022 �'
RE: PLAN S97- 40355 FEE RECEIVED:
GREEN, MARK
NE,SW,16,28,19W
TOWN OF TROY COUNTY OF ST CROIX
?;QV- DDV0 -7 T,,, !T,/1 ,...,, SYSTEM
The Department has - reviewed the above- referenced submittal.
Conditional approval is hereby granted for the system plan submittal. All
noted items must be corrected. The review and approval of the system is based
on chapter 145, Wisconsin Statutes, and chapters Comm 83 and 84, Wisconsin
Administrative Code, and is contingent upon compliance with any stipulations
shown on the plans. This system has not been reviewed for the code
requirements set forth in chapter Comm 82 or in chapters ILHR 50 -64, Wisconsin
Administrative Code.
This plan submittal approval will expire two years from the approval date, or
if a sanitary permit is obtained, plan approval will expire on the day the
initial sanitary permit expires. The licensed plumber responsible for this
installation shall keep one set of plans with the Department's stamp of
approval at the construction site. The installer shall notify the appropriate
inspector when inspections can be made.
All permits required by the city, village, township or county shall be
obtained prior to installation.
Inquiries should be directed to me at the number listed below. Please refer
to the plan number shown above.
Sincerely,
� .yard M. Sw'
Plan Reviewer
Section of Private Sewage
(608) 785 -9348
SOD -7997 (R.11/96)
Page of 6
MOUND SYSTEM RF �FI VF D
R A BEDROOM RESIDENCE $ MAY 7 1 997
AFE B�OGS.
HIV,
LOCATED IN THE NE 1/4 OF THE SW 1/4 OF SECTION 16 ,T N, R 1 W,
TOWN OF COUNTY, WISCONSIN.
INDE%
PAGE 1 'of 6 TITLE SHEET
PAGE 2 of 6 PLOT PLAN
PAGE 3 of 6 PLAN VIEW -CROSS SECTION:
PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT
PAGE 5 of 6 PUMPING CHAMBER
PAGE 6 of 6 PUMP PERFORMANCE CURVE !
IL
E�
�y
PREPARED FOR
35p Gn- �1S`I�►�C �R , # �b� ,.,;���1, F�'1
sp
1t�V C�ft C)VE NC�1GtfTS, l�l 10
G OA
PREPARED BY
WEGEE EF? SC] = L -TEST I MC3
AND .
DES Z (SM f�EFZ`J I CE ���"•�
F.O. BOX 74 421 N. MAIN ST. ~•'`
RIVER FNJ S. YI W22 A RTHUR
a9 §
W(iEFEN
715 - 425 -0165 eta swo"T .
JOB NO.
PLOT PLAN
Scale 1 "= LlD l Page of
`z- 6
�v�s
P7 3T0•�0�
O
y P +Pt
N /
J
�J
N v
xI
�- °► a s b
Page 3-.Of b
Approved Synthetic Covering
Rs c 33 Distribution Pipe
Medium Sand
Topsoil =: _ H- G
—J -- -- „- -- F Elev.
E
D
u
b
8 % Slope
Bed Of 2- 2 %2 Force Moin Plowed
Aggregate From Pump Layer
D V O Ft.
Cross Section Of A Mound System Using E 1-6 F t.
A Bed For The Absorption Area F c3.8 Ft.
G I-0 Ft .
A 8 Ft. H l•S Ft.
Linear Loading Rate =` -S GPD /LN FT B 6S Ft.
Design Loading Rate= o•q .GPD /SQ FT I Ft.
J - 7 Ft.
K V Ft.
Position L 8S Ft.
of
Force Main W 31 Ft.
L
j Observation Pipe
$ K
A
W . ----- j--------- - - - - --t ----------------- - - --•I
�Oistribution Bed Of %�- 2 %
2 2
Pipe Aggregate
I
Observation Pipe Permanent Markers
(Anchor securely)
Plan View Of Mound Using A Bed For The Absorption Area
Page y Of
Perforated Pipe Detail
0
End View
) Perforated
End Cop.) v�6� PVC Pipe
1.
� `onc
�' a5 Install permanent -marker
at end of each lateral
Holes Located On Bottom,
Are Equally Spaced
Q 1 -1 s
e
PVC
Manifold Pipe
PVC Force Main
4
" t)ISt(I Utlan _
PiQe
Last Hole Should Be I
Next To End Cap
End Cap
P 3 Ft.
Distribution Pipe_ Layout
S _� Ft.
X X18 Inches
Y � Inches
Hole Diameter � Inch
Lateral ) Inches)
Manifold Z- Inches
Force Main " Inches
# of holes /pipe g
Invert Elevation of Laterals 48 q; OFt.
It
Place lst hole - Z ( 4 from center of manifold with succeeding holes
S
at 48 intervals. Last hole to be next to the end cap.
TOTAL HEAD IN FEET V6" 9/-VC"
O cn O cn O c O
� o 0
o �
0
N
O o
n
D
D W
C7 O N n
H o �
H
Vl ° -
D o r
H
O 0
� O
H
z
° C
H �
Z o m
C N
� m
cn
m °
O
W
N
O
(D
O
W
0)
O
O
O
O - N W -P Ul 01 J CD (D
TOTAL HEAD IN METERS
" 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
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. parcel I.D.
APPLICANT INFORMATION - Please print all infwmdon. Date
Personal intimation You provide may be used for secmr fiery purposes (Privacy Law. S. 15.04 (1) (m)).
Property Owner Property Location
- Govt Lot 1/4 1/4,S T ,N,R l or)V
Property Owners Mailing Address Lot # BIocW / Subd. Name or CSM#
"'
city
" Zip Code Phone Number A s
( ) ❑ city ❑ village JZ Town Nearest R jad
iA
r
New Construction Use: ® 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 & 21 bed, ft :E 20 trench. ft 2 Maximum design loading rate _,,gi bed. gpdtf? — trench, gpd/ft
Recommended infiltration surface elevations) I 4d.:—&z.27 it (as referred to site plan benchmark)
Additional design/site conside rations ,� _ - - " _
Parent material ' Flood plain elevation, if applicable ft
S = Suitable for system Conventional Mound Pressure AT -Grade System in Fill Holding Tank
U = Unsuitable for system E] S ® u ®s ❑ u ❑ S ®u ❑ s O u ❑ s ®u EIS O u
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2
ry
13 L 21 in. Munsell Qu. Sz. Cant Color Gr. Sz. Sh. Bed , Trench
AA 14
-
Ground ,
elev.
AZ
- r�A
Depth to
limiting
factor
1�_ in.
Remarks:
Boring #
13
Ground
elev.
ft. ,
Depth to
limiting
factor
in. Remarks:
CST Na Pleas Print , �gnae Telephone No.
Address Date CST Number
I � I 1 � ��✓ /9w j ', r
I
Z's)
I �
1 1 1 1
I I 1
I ,
4 I
I
i I
�p
- I
I I i
-�f I
I �
I I
_ I
I
_ I
I I 6
� I
I
I _
-
I
I ' I
� r I
I
I I I i i I i I i t
I I I I
I /
.eG
GO
I '
I - I
I
I
I
I I
i I 1.6'ih o �41
7 I
' I I
I
I I
Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page \ of 3
Labor and Human Relations
Aivision of Safety & Buildings in accord with ILHR 83.0
a . � COUNTY
Attach complete site plan on paper not less than 8 1/2 x 11 inches ii s'tge� Ian ust include u�,�
not limited to vertical and horizontal reference point (BM), directio ° /A, of sld e or '�� PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest r6ad. r t�
APPLICANT INFORMATION— PLEASE PRINT ALL INFOIRMATION REVIEWED BY DATE
A
PROPERTY OWNER: PROPERTY - t OCATION,•
0 - m - B` l E P1hJ\j 17�1J►J \ S S L L .Z s 1l4,S I {� T Z8 ,N,R 1 E( W
PROPERTY OWNER' :S MAILING ADDRESS LO71 BLOQK#, D. NAME OR CSM #
PIrt W S T. '7 ' ''�z LOU ts12 •SI T10►J L4 t'rD�(77ON
CITY, STATE ZIP CODE PHONE NUMBER E &fOWN NEAREST ROAD
RLU � �PtLLS ,WI S (S Z (71S) LI- a - B t6 1 O 1 Sao Lj, R-bt�D
(Sq New Construction U se .[aq Residential ! Number of bedrooms (] AdditiQn to ebs*V building
[ ] Replacement [ ] Public or commercial describe
Code derived dairy flow bop gpd Recommended design loading rate • q bed, gpddt - trench, gpdM'
Absorption area required Su O bed, 9 Soo trench, ft MaAmum design loading rate o . S bbd, 9pollt d . b trench, 9polft
Recommended infiltration surface elevations) gI 213. S ' ft (as referred to site plan benchmark)
Additional design / site considerations V wl M @v V1 % Jk;b w 11 8' X 6 3' 8 0:� - M LN
Parent material S IM1M evr - /1n L.L / Rood plain elevation, if applicable N A . ft
S = ystem CONVENTIONAL MOUND NJ PRESSURE AT - GRADE SYSTEM IN FILL HOLDING TANK
U tem ❑ S U S❑ U ❑ S CRU 11 S N ❑ S au I ❑ S WU
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mofffes Texture Structure Corsistence Boundary Roots GPD /ft
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Tmnch
o_ \Z to Q. 3 L - s1 I Z fSbk Ct,� - o•S o•b
A Z 12.49 Z`Fs bk ho
Ground 3 19 -2.9 1 p� \Z 3 ! r s t r_ 3 '� Sb k vvl ��, C n,� - • y o • 5
elev.
98 ft. y Z -4n w� tZ316 t,.s kQ Depth to S t40 "1P - 3l -
limiting
factor
Remarks:
Boring #
o -tS 1 p`1R
EZ S -z o to _t 31Y s t l Z s bk w► 'F1� S -- ° s °° 6
3 Zo -3o � o �.2 3!(, — s t c-1 Z �f s bk m F4. �- S - °-`� ' o• 5
Ground
elev. c elev. 3D - 3$ 1°`12 3/6 S 485 C-� ��+t Sbk 1 i1'�►^ C.
9.8L. ft
1
lo S 38 z 0�tR v /6
Deepth Al oti �► v h - —
limiting 5 C..O►v `StlJ v -1 - S `11Z- 3 / OwA w �.
factor
3
Remarks:
T Name: -- Please Print Arthur L. W e e r e r Phone. 715-425-0165
t
egerer Soil Testing & Design Service -P.O. Box 74 River Fa11s,WI 54022
Sgnature: Date: CST Number:
G i( -30Z- 1O 1 - 0 -9 M00576
PLOT P_ LAN Pa •3 of 3
!! SCALE 1 "= 4D '
2.
a•Y
L - 1 O
80
o
/ 0IRUt� PIPE
eti q9 S - /
i
8S' i
i
i
t" M. a sz .S
883.5
N
L b �' 1 1 i �� � v Erwh•c �` i3r� 1�- Z tom. q - 1 S. z8
Y Tr ° `xv" 1.1 kQ 41Z I o,u � u t "Vu) pi x
ots}z,LZ�, �rrZ.LA , �sti�►�,T
L_
ti
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.
i
9c{_ 302 -
I- 3 0 -9.s ( 715 42.5 -()1 f,5 _ M 00576
CST Signature Date Signed Telephone No. CST #
Wisconsin Department of Industry. SOIL AND SITE EVALUATION REPORT Page of 3
Labor and Human Relations
Division of Safety & Build ngs 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_
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. 0
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORMATION— PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
8T tvF 1/4 SW 1 /4,S T Z8 ,N,R 1 E( W
PROPERTY OWNER'S MAILING ADDRESS LOif BLOCK ff SUED. NAME OR CSM S
- l. l0 N . " tit. w S T'. 7 0 1 — 6Lp\) f31Z SM W Ll `CH ft b I ON
CITY, STATE ZIP CODE PHONE NUMBER (]CITY (]VILLAGE RrOWN NEAREST ROAD
Rw �LL5,AJI S ozz_ (71St �lZS- B ► 61 o Y Soo UsUI` 11-5"
�] New Construction Use.[>q Residential / Number of bedrooms 4 [ j Addti�r b elas*V building
[ 1 Replacement [ ] Public or oomrnerdal describe
Code derived dally flow bon gpd Recorrmerided design loading rate .y bed, gpolft - trends, gpW
AWXpn area ed s u o bed, ti2 Soo trench, ft Makimum design loading rate o . S bed, gpd* 0.6 Irench, gpW
Recommended infiltration surface dwAon(s) q a 3 • S ' ft (as referred to site plan bertdmark)
Additional design / site oonsiderations V*C_0wt 1 (EKit wt Wk..;b w / £3' x 3
6 ' 8 di - h IN . I r o F- .41" RLL.
Parent mraterral Flood plain elevation, l applicable NA- It
S = S uitable for fo � . a0 S Jo RI ° ❑ u [IS M 2U E o s ° Pru 11 Ku a �? 11
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color kbt� Texture Structure Bound3y Roots GPP(.
[3 D in, Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed 10�IR 3 t i — si1 Z`�Sbk ct.,, — o•S
Z \1 -49 S,) Z`Fs 1 k V.
Ground 3 19 -Zq IO`1�z 3!6 - s 1'e-[ 3 tAvr VA V, 4 o.5
elev.
98 R. q 29 -y0 �o_,tZ316 l �.s �tQ stg cl o Depth to S
limiting yo 7.S '% 2 3t
factor a
Remarks:
Boring #
1 1 0-Is 2 - +Sbk 'el. cS 6-S b
Z 2 xS -ZO \042 31 -' S11 Z �-s b k
Ground
st C-i Z �s �k m o•Y O -S
elev. -3$ 10`12 3/6 S 4P-5/8 W1 Sbk M ' - C
qa� It.
Depth to „S sk _-) 2 I O'i R VA. q. oM iw► v �• _ _
limit or 5 CO N �4Cliv 1. g 2 3/ Owe w Z 9 _ (F)r.1 factor.
Remarks:
T Name.— Please Print Phone:
Arthur L. tde erer 715- 425 -0165
ress: 7
egerer Soil Testing & Design Service — P.O. Box 74 River Falls,WI 54022
Signature: Date: CST Number:
G �1- 30Z -�O 1 - -95 M00576
• PLOT PLAN Page 3 of 3
SCALE 1 "=
2.
X984`
LOY
- - •009 `
k-L% L YS' / 0 Pipe
so do
coula�R M. 162
BDTTO� OF 8®.e1.. 983.
X1 17, IZ, �Tt.°il�ly g.z I C O t "�+f0 ' O
1J U t�T �U1h { � 4 ' av N l Gds► pipe!
�l S}11LLa Y1 1�-rZ�
L_
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.
a4 �? 9y- 302 - 10
v /- 3 O -9 -S 715 ) 425 -01 11 00576
CST Signature Date Signed Telephone No. CST #
• Wisconsin Department of Industry. SOIL AND SITE E V A {V — tf.R T P 1 of 3
Labor and Human Relations r � — _
Nisknof Safety a Bindings in accord with ILHR W dA! de CE NTY sT
Attach complete site plan on paper not less than 81/2 x 11 inches i . Plan must include, but I X
not limited to vertical and horizontal reference point (8WQ, direction of sal9'07 Lo•;
dimensioned. north arrow, and location and distance to nearest roa S1 C'R01X
APPLICANT INFORMATJO*- PfEASE PRINT At�"`1"f I oBY DATE
zoNN600scei
PROPERTY OWNER c It L�
SW 114 ) T Z8 .N.R 1 E ( W
PROPERTY OWNER':S MAILING ADDRESS LOT t BLOCK # SUBO. NAME OR CSM i
- 11 1 3 r-3- "At % 7 - 70 — G tA) t .S7n'' v,) t1 `Lk RDOIT]
CfT STATE DPCODE PHONE NUMBER DCITY (]VILLAGE MOWN NEAREST ROAD
R LU21L PrlL Slit LZ- 00 LI a- 4I 61 o Y sop L)Aje RA hb
�] New Construction Use.pq Residential / Number of bedrooms () Ad&Qn b e>osting buildiN
I J Replacement I I Public or con meraal describe
Code derived daffy lbw btO gpd Recommended design lowing f o •y bed, gP - trench, WW
Absorption area required - ""o bK n2 Soo trenA b2 1 bads g rate o . S bed, gpW 0.6 _IrenA gp W
Rawmended infiltration surtace detrdbl(s) Z 3. S ' R (as referred lo site plant berrcfmarkj
Additional design / site corsidera6ors VjLXU YA w1 pv wt Wk.; D w / S' Y- 6 3' B dl� - r'1 W. 1 ` o F - WJD F c.
Parent material _ S M1M 1LQ►vt -/TT LL / Flood plain elevation, I appicabie
S = SUtfabl8 for system COMI8lT10NAl I MOUND 114611111M PRESSURE AT GflADE Syn N FILL HOLDNGW
U= Unsu for ❑ S JO U JO S O U ❑ S [RU_ El S 0 [IS 19U ❑ S
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure C.orsiSIM Bot - day Roots GPD1ft2
in. Munsep OU. Sz Cora COlor Gr. Sz. Sh. BW Twit
I 1Z)4 V- 3 I.Z — Sid - L f S bk mi - Cw — O -S D- I.
Z 1i - xb4rt_
Ground 3 19 -Zq 1rz I i VK, 1„ CtU
elev.
9t3 n y 29 - 4 0 w-tt�31r, ��.s 'm slg -
Depth to S y o -6 y 7 -S 1 -1 2 I 1 I r S 1 - °-
limiting
factor
2,9
Remarks:
Boring # ,
o_1S lo`1R 31z
Z 2 1 S -ZO lv"(Q 3 ly S t: I Z. �-s �k �•, 'Fi- c g -' o. S ' o. 6
Groin 3 Zo 30 \o�IQ 3/6 — S1 C-1 Z � s dk ��- g _ o -Y 0 -S
etev 30 - a 1 0`12 3 /b t I. S k R - S/S
9.a1.� tt -
Depth to VAa
limilirg
bcw 5 Co AJ 1- S ¢ 31 ow► w �
factor
Remarks:
CST Name: -- Please Print
Arthur L. We erer Phone. 715- 425 -0165
egerer Soil Testing & Design Service -P.O. Box 74 River Falls,WI 54022 t
S' nature: , _ _ Date:, — CST Number:
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer
Mailing Address
Property Address n� ��'' /^ •'' - 1 `l on, „���
(Verification required from Planning Department for new construction) �.
City/State UD5 � �Z. Parcel Identification Number 1,,7367 - 'Iro
LE GAL DESCR
Property Location A '/4, _ ' /4, Sec. -/&-, " 2 9 N -R f , Town of
Subdivision (9L009t S74' , Lot
Certified Survey Map # Volume , Page #
Warranty Deed # J f Volume 3� , Page # f _.
Spe• house ❑ yes K no I -ot lines identifiable yes ❑ no
SYS ' 'EM 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 o�nrner and by a
master plumber, journeyman plumber, restricted plumber or a 1 i-ensed pumper verifying that (1) the on -site wastewater di ,posal system
is in proper operating condition and/or (2) after inspection and humping (if necessary), the septic tank is less than 1/3 full of sludge.
I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards
set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification
stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30
d,.cs of the three year expiration date.
SIGNA E OF A PLICA 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 property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
-Lie!
GNATVRE OF 4PLICA&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