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HomeMy WebLinkAbout040-1239-50-000 Wisconsin Department of Industry SOIL AND SITE EVALUATION Labor and Human Relations Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. ;� of Attach complete site plan on paper not less than 8 1/2 x t 1 Inches In size. Plan must County Include, but not limited to: vertical and horizontal reference point (BM), direction and .ty'�C�� , ' percent slope, scale or dimensions, north arrow, and location and distance to nearest road. �' Parcel I.D. # APPLICANT INFORMATION - Please print all Information. Reviewed Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). j r Dat T Properly Owner Property Location L 11W�PE�UCLG' 6U. /yl�/P/�l�/ �p�tRT.u,i2) Govt. Lot s'E 1/4 5 - 1 1/4,s Property Owner's Mailing Address Lot # I Block# Subd. Name or CSM# GU 9302- 6 0 Th 14 /z l5i 4 — 20uuT 0 City State. Zip Code Phone Number Nearest Road R1 F W 11 sy o �Z •7/5 � �,5 -9 °3z ❑ city ❑ Village [E Town Cea, 7,0 Y DVT a, /l_ T LJ New Construction Use: Residential / Number of bedrooms 3 t Addition to existing building NIP N O T ❑ Replacement ❑ Public or commercial -Describe: N�j� V PE�pyyF�vjJ 7 yso- Code derived daily flow 60 00 gpd Recommended design loading rate _bed, gpd/fl 3 trench, gpd/ft Absorption area required _ bed, ft trench, ft 2 Maximum design loading rate bed, gpd/il 3 trench, , 9Pd/it Recommended infiltration surface elevafion(s) _� P9 , .3 ft (as referred to site plan benchmark) Additional design /site co ations IAIaal4w ' : , 7 '/► 9 � M d uNt7 [vl /a SA &3D 'Fill . Parent material 5Z 82 �i°w ,}s "Tiif(r O. S, cT- StDavevT Flood plain ^levalion, if applicable tt S = Suitable for system Conventional Mound In- Ground Pressur AT-Grade �/ System in Fill Holding Tank U = Unsuitable for system ❑ S Q 0- S El El L 11 S L7 U ❑ S UK ❑ S [YU SOIL DESCRIPTION REPORT Boring # rHodzo Depth Dominant Color Mottles Structure in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots GPD /f(2 Bed Trench 0 1 iaY/? 2 /3 sit z f sht ph f� CS 9 /o �� 31 1 f, Ground 3 elev. 31 S/ 240 At /I'h�/ Depth to limiting actor In. Remarks: Boring # �fs,6k Z 2- 7'13 to rle 313 I fshf m - /i( I7` i : 3 ley Ground 7?7 1 40YR 140Y S C 5 eL IfS ,6 i C M1 �/ a I ,• 3 elev. Depth to / �Xm� ao 4 1 ,w 7z7 lei I! K_ limiting , factor S S s 4 r L7 in. Remarks: 7 CST Name (Please Print) ROGER T L Signature n ��tt Telephone No. R he t,� �c, 715 306 - 6? 1635 Address Date (:CT Kr, —k-. PROPERTY OWNER SOIL DESCRIPTION REPORT � Page Z of PARCEL I.D.# 2—or /Z — a(17A DAICC Boring # Horizon Depth Dominant Color Mottles Structure G in. Munsell Texture Consistence Boundary Roots P D/ft 2 Qu.Sz.Cont.Color Gr.Sz.Sh. Bed ,Trench 3 / ° s /0/, 2/3 c// JeL5-.4e 411 Ice , 3 2 f/3 /o/ie 3/3 /fS/fe ,e,e CS f74. Ground /3. y/ �� t 3/y J `// ;4145 1 4" 441 74'/' CS /of , 5 i elev. -11 9e_oft. 2 -y /oyR r/� s_yR 576 5/ 0,41 fi) -� / 3 // Depth to - - limiting factor _in. Remarks: Boring # • • Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Structure GPD/ft2 in. Munsell On. Sz.Cont.Color Texture Gr.Sz.Sh. Consistence Boundary Roots Bed ; Trench Boring # Ground / elev. — — — / ___ ft. Depth to - • limiting factor in. Remarks: Boring # -- _ • • Ground elev. ft. Depth to limiting factor in. Remarks: SBDW-8330(R.OB/95) t!`� ch Vt , LAO LA LA y o � C � g y , y T Qj --� U) 1 = 'ULBRICHT & ASSOCIATES CO. 655 O'Neil Road - Hudson, WI 54016 Reg. Designers of Engineering Systems 715- 386 -8185 Private Sewage Consultants SPECIAL NOTES TO THE BUYERS/ BUILDERS, REGARDING SEPTIC SYSTEMS AND SOIL TESTING ON LOTS #8 THROUGH 20 IN COUNTRY OAKS. All of the lots evaluated will require mound type septic systems. With only a few exceptions, the soils across the 1st Addition to Country Oaks had very fine weak textured silt loam in the upper 12 of topsoil (a soil loading rate of .3 GPD /ft2). These low soil loading rates will require larger trench type mound systems by design codes. Trenches can be no wider than 48 It is suggested, to the installer, if a 4 bedrm. home is proposed, some test areas provided may not be lonY enough for a single 4 trench, in which case a wider mound utilizing two tenches 4 63" may be more suitable. CAUTION: since all of the soil test sites are very heavily wooded, extra careful planning and site preparation is required. Great care will need to be taken in removing trees and brush without disturbing the fine delicate silt loam topsoil. If the site is carelessly disturbed, the Zoning Dept. will reject the site and require costly new testing and designing! Do not allow anyone to drive across or compact or distuyb the topsoil. Consult with the Zoning Dept. Inspectors, a qualified plumber, or designer for advice on how to properly prepare the site for mound system construction. The owners /developers have provided a complete approved soil test area, registered with the zoning office as required by subdivision ordinances. It is difficult to imagine today where a future buyer prefers to build upon a lot. Common sense Is used to select a site at this point. If the buyer intends to utilize the test area, careful planning between the owner and septic plumber (or designer) is very important. Careful planning with qualified designers/ installers is critical. THe final actual size and shape and location of the septic system is dependent on the size and type of home proposed. Test areas large enough for a 3 -4 bedroom home has been provided, but a larger home may require new or additional soil testing. The septic system can not be shifted outside of the recorded test area. pg. 4 of 4. ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner Se V tc Property Address 57 01, E p d N Z City /State Legal Description: Lot Block Subdivision/CSM # 5f-_ '/4 5 £ t /4, Sec. a 1 , T aU -R 19 W, Town of TKuu PIN # z SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION Tank manufacturer W -QA �- f Size ST/PC 1 0 "' Setback from: House ol � Well SO P/L S b Pump manufacturer Go %A d S Model 7 ) Alarm location N P D u S:4 (HOLDING TANKS ONLY) Setbacks: Servic o fresh air intake Water Line Meter to ' n Alarm ocation SOIL ABSORPTION SYSTEM V A N h Width S Len Type of system: r gth Number of Trenches Setback from: House I QJ Well P / Vent to fresh air intake 00' ' ELEVATIONS �r Description of benchmark � Z � b hi P► , Elevation o Description of alternate benchmark Elevation Building Sewer ST/HT Inlet 3 .g 4 ST Outlet 3 • y PC Inlet 1 1 3�_ S P� PC Bottom �i� •� 0 Header/Manifold V V Top of ST/PC Manhole Cover Distribution Lines ( ) 1 a • a a () ( ) Bottom of System Final Grade Date of installation / / Permit number State plan number Plumber's signature \& _ License number a� a Oy Date A/ Q v Inspector S r.. � � � �''� � I 1 Complete plot plan NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW 1310 ( 1 dp• yo luov gn! T� �i 6 /0 /0) 3a Iv INDICATE NORTH ARROW Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division Count8 . CROIX INSPECTION REPORT GENERAL INFORMATION Sanita (ATTACH TO PERMIT) g /.20 Personal information you provice may be used for secondary purposes [Privacy L IZ W s.15.04 (1) (m)]. 29 Permit Holder's Name: �❑ Village E] Town of: State Plan ID No.: X y W EBER, STEVE CST BM Elev.: Insp. BM Elev.: BM Description: -. Parcelocdo.1239-50-000 TANK INFORMATION ELEVATION DATA A9800116 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic uJ ;'� l�0, ' Benchmark Dosing Aerati Bldg. Sewer's ?� Holdin St/ Inlet TANK SETBACK INFORMATION St /fit Outlet /J. 5� TANK TO P/ L WELL BLDG. Airi to ntake ROAD Dt Inlet Air I /r7, dos- Septic NA Dt Bottom ��Z' Dosing NA Fes/ Man. 3 ' Aerati n NA Dist. Pipe Holding__ -- Bot. System PUMP / SUNION INFORMATION Final Grade Manufacturer Demand , C Model Number GPM TDH Lift Friction System TDH Ft °F ,� S7; ' Loss Head Forcemain Length Dia. Dist. To well SOIL ABSORPTION SYSTEM BED/TRENCH width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMEN I SYSTEM TO P/L BLDG WELL LAKE /STREAM LEAC nufacturer: SETBACK INFORMATION Type O /717, MBER l Model Number: System: rn - _16 OR UNIT DISTRIBUTION SYSTEM + / Manifold Distribution Pipe(s) 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.) LOCATION: TROY 21.28.19,SE,SE 576 COUNTRY OAKS CIRCLE (x 1 ' � '�iL �r C �o. /S i �a S - 2 ) C / 1 Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert No. SANITARY PERMIT APPLICATION 20 Safety and 1 E. Washin �A e�sion N * Lc onsin 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 Count than 8 112 x 11 inches in size. drofx • See reverse side for instructions for completing this application State Sanitary Permit N The information you provide may be used by other government agency programs Check if revisl�to previou Ication [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATION Propert Owner Nam Property Location 'I /a — va, S T , N, R E (or Property Owner's Mai ing ddress Lot Number Block Nurrib C S Zip Code Phone Number S ivision Name or CS Number s f, > II. TYPE OF BUILDING: (check one) ❑ State Owned i ty N arest Road Public 1 or 2 Family Dwelling - No. of bedrooms O Town 0 I f O U III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s �s 1 [] Apartment / Condo ® " To — "1 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. [1rNew- 2 ❑ Replacement 3 ❑ Replacement of 4_ ❑ Reconnection of 5_ ❑ Repair of an ________System __ ____ _______ Tank Only___________ - __ Existing System ------ Existing Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued Z V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21,kMound 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/da /s ,., q. ft.) (Min. /inch) _ Elevation VII. TANK Capacity 9 Feet Feet in gallons Total # of r er. Prefab. Site Fiber- Ex INFORMATION Gallons Tanks manufacturer Name Concrete Con- Steel Plastic p New Existin structed glass App. Tanks Tanks eptic Tank a f ® E] ❑ 0 ift Pump Tank ip".G a / ® El Ej VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. P N (Print) P tier's Si Business Phone Number: nature: (No Sta ps) MP /MPRSW No.: 'w � Plumber's Address (St et, City, State Z' C de): IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater D at I ssued j ISsUiA g e Si a u e (No Stamps) A roved Surcharge Fee) )4 pp [] Owner Given Initial. j s [lg Adverse Determination X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: SBDe 98 (R.t 1196) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber SANITARY PERMIT APPLICATION 201E Washi lion *Lconsin In accord with ILHR 83.05, Wis. Adm_ Code P.O. Box 7969 Department of Commerce Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. -51. • See reverse side for instructions for completing this application State Sanitary Permit Number p - 7 - 7 Zz,, The information you provide may be used by other government agency programs ❑ Check if Yvision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATION 4 9 0 C) 411 -s Property Owner Name Property L cation �U � /a s 1 /4, S T ,N,R/ E(or)W Property Owner's MaAg A dress Lot Number Block Number CJx Alp- Cl Stat Zip Code Phone Number Sub ivision Name or CS Number / 1 II. TYPE 0 F B I IN : (check one) ❑ State Owned I Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms -3 ❑ village �. own OF r III. BUILDING USE (If building type is public, check all that apply) Parcel Ta 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.).R 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)jj'RAound 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 Req�fi red (sq. ft.) Proposed (sq. ft.) (Gals/ y /sq. ft.) (Mi / inch) (1 Elevation 1 3� �I `I S Feet 0 '.*� Feet VII. TANK Capacity INFORMATION in gallons Total # of Manufacturer's Name Prefab. Site Fiber- Ex per- New Existin s Gallons Tanks Concrete Con- Steel glass Plastic App Tank Tank structed ank W ee k 9 El 0 D 11 ❑ L Pump Tank r L I QQ J ❑ 1 El 1:1 11 El VII . NSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Nam: (Print) Plumber's Si nature: (No Stamps) MP/MPRSW No.: Business Phone Number: AA Plumber's Address ( treet, Cit , State, Zip Code): 10'76 4,ZU1J IX. COUNTY / D PARTMENT USE ONLY .��r777 [] Disapproved Sanitary Permit F e (includes Groundwater ate ssue Iss Agent Signature (No Stamps) AA roved Surcharge Fee) pp ❑Owner Given Initial /jQ'/� 0a 2Z �8 Adverse Determination p"Uv X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-6398 (R.11/96) DISTRIBUTION: Original to County, One coq To: Safety i Buildings Division, Owner, Plruvdw a v SAFETY AND BUILDINGS DIVISION 2226 Rose Street 00111 LaCrosse, Wisconsin 54603 N) Pisconsin Tommy G. Thompson, Govemor Department of Commerce William J. McCoshen, Secretary Transaction ID No. 114 Date: 7/21/98 • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(d), Wis. Stats. d rard M. Swim Integrated Services POWTS Plan Reviewer (608)785 -9348, Mon.— Fri. 7:15AM to 4:00 PM JS WIM @COMMERCE. STATE. WI.US W. �l l l ff �� 0� XT•� SBD- 5524 -E (R. 2/98) File Ref: HA000000LETTER.DOC f Page of 6 MOUND SYSTEM 9 �C 3 FOR A BEDROOM RESIDENCE - l X998 LOCATED IN THE . 1/4 OF THE SE 1/4 OF SECTION Z1 ,T N, R TOWN OF -U�f ,. ST• C\r-GI.X COUNTY, WISCONSIN. INDEX 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 PREPARED FOR �TEvE w��� �,� S• S�q 1 cyc 30 \�v� . ,vo��TN p•Q. ally oak h H� �rtfis, N ss� ittori �a�1d �o o� MERGE S M G dEPPR PF j �s�a Np oc RE PREPARED BY S � ^ E GO WEGEFZEF�Z SQ I L TEST I htCC AND. „ z3ES = Iry sEFZV z cE CON F.O. BOX 74 421 K. KAIK ST. �,••'" ~ "'• S ��/ RIVE? FALLS. YI 54022 715 - 4 -010 "� EA • WEGERER D9t5 ELLSWORTH, WB -t JOB NO. 9 a - VI � . PLOT PLAN Page Z of _( Scale 1 "= yp ' r • r 3 �d k 117 2 J Zk Pue. F.wi , 0' s_ 0 , %�h #41 - C'L. 100-0 oN 1 " �, -- 131"ltfZ- e1. WO-r ou CT �r etrRjc_ P� _ wle- _� 3 3I:-- ft t_" S So' Fs>ti tt- tuvn.p . ZS' F-Vz-o) Tmk, NOTES -1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. (_ required) 3. Install 4" observation pipes with approved caps. ( Z required) 4. - Septic tank to be tppp gallon capacity manufactured by Wele `Tmvh `t% Q s 8 t) p G m.. WEE Ls 1* 1AL _ 5. Bench Marks Sq Sao Ut: 6. Divert surface water around system to prevent.ponding at the uphill side. t, r Page 3 Of Approved Synthetic Covering FI STY'► c 33 Distribution Pipe Medium Sand H _ G Topsoil -- _ ___= F Eiev. g8jp _J -- p 3 E " h b y %Slope Bed Of 2"- 2 Force Main Plowed Aggregate From Pump Layer D \• Ft. 1 -3Z Cross Section Of A Mound System Using E Ft. A Bed For The Absorption Area F Ft. G 1 O Ft. A a Ft. H 5 Ft. Linear Loading Rate= GPD /LN FT B 4{ Ft. Design Loading Rate= y GPD /SQ FT j 1� Ft. J S Ft. K �O - S Ft. L 6b Ft. - --uf__ _ W 3Z Ft. L Observation Pipe A -- -------------------- �� - - -- -- - - - - -- - Force Main Distribution Bed Of 2 "- 2 j Pipe Aggregate Observation Pipe Permanent Mark (Anchbr securely) Plan View Of Mound Using A Bed For The Absorption Area Page � Of Perforated Pipe Detail 0 End View ) Perforated End Cop.) �" PVC Pipe Install permanent "marker at end of each lateral Holes located On Bottom, Are Equally Spored Q S PVC Force Main P PVC Manifold Pipe )istri ution Pipe Lost Hole Should Be I Next To End Cap End Cap P Z Z Ft. Distribution Pipe Layout S y Ft. X y Inches Y Y 8' Inches Hole Diameter t/y Inch Lateral Inches} Manifold 2 Inches Force Main Z Inches #of holes /pipe Invert Elevation of Laterals `38 -S Ft. t, Place 1st hole from center of manifold with succeeding holes at Ljf3 intervals. Last hole to be next to the end cap. ' PUMP CHAMBER CROSS SECTIOW AND SPECIFICATIONS ' PAGE S OF VCWT CAP 'i"C.Z. VENT PIPE WEATHER PROOF APPROVED LOCKING MANHOLE JIJUCTIOIJ BOX COVER WITH WARNING LABEL ? 10' FROM DOOR, 12�MIU. wIMDOW OR FRESH I - AIR INTAKE I GRADE EL q. L4 i 4� MIM. COWDUIT -- --------- ---------- PROVIDE I - ---- IAILCT AIRTIGHT SEAL i .II v APPROVED JOI A Tank construction shall comply I lil APPROVED JORI with ILHR 83.15 and ILHR 83.20 I ALARM e I II I 1 I 1 ON C I i -- - g3. � O F I LLEV. T. PUMP ---- _ -� �. OFF D per' CONCRETE 5LOCK 3" AVPROVE RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL gEDp SPECIFICATIOMS DE TAWK MALI UFACTUR EIR '� �IJL S IJUMBER OF DOSES: PER DAU TANK 51ZE: GALLOWS DOSE VOLUME ALARM MANUFACTURER* S.S, S'-fST2-M INCLUDING O GALLONS MODEL NUMBER: 101 �W CAPACITIES: A= �q INCHES OR 310' GALLONS SWITCH TyPC: ��OC1R'Y B = INCHES OR 32, GQLLOM5 PUMP MAMUFACTUKER: �OV `'\-z S C $ INCHE5 OR l C 6' I GALLOWS MODEL WUMBER: �S 0= lZ INCHES OR 23 GALLONS mk� -)* Lq . cu�z 9 SWITCH TYPE: Y MOTE: PUMP AND ALARM ARE TO DC MINIMUM DISCHARGE RATE Z�'d8 GPM IN5TALLED ON 5EPARATE CIRCUITS VERTICAL DIFFERENCE OETWEEM PUMP OFF AUD..DI5TRIbUTI01J PIPE.. S•So 'FEET + MINIMUM NETWORK SUPPLY PRESSURE , . , , . .. .. . . 2.50 FEET F l FEET OF FORCE MAIN X �'� F yoFr.FRtGTIOU FACTOR_. �'6.� FEET TOTAL 0t)WAMIC HLAO = l3 6 FEET DIAMETER — INTERAIAL DIMLIJSIOW� OF TAWK: LENGTH - - ;WIDTH ;LIQUID DEPTH BOTTOM AREA 231= GAL /INCH AS PER MANUFACTURER = l9 S) GAL /INCH _ Goulds�F of b Submersible Effluent Pump 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 durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- components. tic cover with integral handle •Homes Available for automatic and • Farms Motor: and float switch attachment p hase: 0.4 HP, • EPO4 Si manual operation. Automatic • Heavy duty sump g p Water transfer models include Mechanical points. 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 SPECIFICATIONS • EP05 Single phase: 0.5 HP, heavy duty ball bearing FEATURES 115 V, 60 Hz, 1550 RPM, Pump: EPO4 built in overload with ■ EPO4 Impeller: Thermo- construction. • Solids handling capability: automatic reset. plastic Semi -open design 3 /4' maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING �� • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. SP Canadian Standards Association • Total heads: up to 24 feet. with three prong grounding • a size: 1 NPT. plug. Optional 20 foot ■ EP05 e nclos e d (CSA listed model numbers Mechanical seal: carbon- length, 16/3 SJTW with Thermo - Discharge • plastic enclosed design for , /ceramic- stationa three prong improved performance. end in " For or "AC ".) rota ry ry, p g grounding plug 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 I dry without damage to s 30 components. I s Pump: EP05 8 • Solids handling capability: 0 25 %* maximum. a 7 _ - - --T -- - -- -- - -- • Capacities: up to 60 GPM. _ • Total heads: up to 31 feet. 2 6 20 �q�l • Discharge size: 1 Z 5 • Mechanical seal: carbon- 0 15 rotary/ceramic- stationary, 4 i BUNA -N elastomers. 8 • Temperature: 3-- 10 V 104 °F (40 °C) continuous , 140 °F (60 °C) intermittent. 2 5 1 0 00 10 20 30 40 50 GPM L 0 2 4 6 8. 10 12 m °/h CAPACITY ®1995 Goulds Pumps, Inc. Effective May, 1995 B3871 _ YYsconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page Of 3 LabSr and Human Relations g DfvOon of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance toad. O � O APPLICANT INFORMATION PLEASE PRINT RMATION I ; ! DATE T R PROPERTY OWNER: ,y PROP LOCATION S V w B ����;' ` S F 1/4 SE 1/4,S ZI T Z8 ,N,R 19 E (or 4� PR PERTY OWNER':S MAILING ADDRESS i . OT # K # SUBD. NAME OR CSM # ` tiJ'TRs{ 014k S CITY, STATE ZIP CODE P �V , ERC) " .O/ ` . CITY LLAGE [WOWN NEAREST ROAD o A 1 1�R Rk H�j Stf f S K 4lf sso82 (b 1- 3Z5''t �.." eovilSR�{ ORkS G RcL� [V4 New Construction Use [ )k] Residential / Number f bedrooEny __._ - .' [) AdditiQ to existing building j ] Replacement [ ] Public or commercial de srdibe - l Code derived daily flow �-\ S b gpd Recommended design loading rate • `( bed, gpd/ft 1 trench, d/ft 9P 2 Absorption area required - In S bed, ft 3`1S trench, ft Maximum design loading rate • 5 bed, gpd /9 - 6 trench, gpd/ft Recommended infiltration surface elevation(s) 4 `3 . p ft (as referred to site plan benchmark) Additional design / site considerations 'I 0 Ul , �v /b g �-i M I N • \Z OF= SrrvD F--r L �, Parent material t<o�Iss ovtva Flood plain elevation, if applicable iV 1) ft S = Suitable for system CONVENTIONAL I MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ❑ S o U INS ❑ U EIS O U I [IS ®U [IS ®U 1 ❑ S I U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Consistence Botxtdary Roots Structure GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. g� re xdi sil Z�sdk m�►- s 1 't, s Ground 3 z S R YJ , lS -1 izs!� sej �sb1� �(►1 elev. � Depth to limiting factor Remarks: Boring # 0 -6 1 "w - AV_ Z -CZ S►( L`�S�1Z Y►1'F1- 0..S 1 • 5 • ( o - }•hvihYt. �vh Z 6 z5 1b` -11Z 31 � - S M es �� 5 b 3 ZS- S yR V� - 1, 0, \ccz. S wt`F►.. Ground elev. aft. Depth to limiting factor Remarks: TName : Print Arthur L. We erer Phone: 715- 425 -0165 egerer Soil Testing & Design Service -P.O. Box 74 River Falls,WI 54022 Signature: cl $ 6 Date. CST Number. 7 — M00576 ' 1 PROPERTY OWNER wEs-8 -12 SOIL DESCRIPTION REPORT Page 2-- of 3 4. PARCEL I.D.# 040 \Z39 - sO Depth Dominant Color Mottles Structure GPD/ft2 Boring# Horizon Texture Consistence Paindary Roots in. Munsell Qu.Sz.Cont.Color Gr. Sz. Sh. Bed Trench Mao 0. 41 - 1 o-m_ 2—La s i wi`Et_ 0.- s \k1 •S • 6 Ground 3 Z(�-�(, S �ccz V/Y SLtR SIB Sti o ivi '�f- elev. q-1.cl ft. Depth to limiting factor Zb , Remarks: Boring# ray o_(0 o i c zLZ. si 1 Z`F5Pik m'�1- — — •'AN 64 Z b_t tiu`-t cZ 3/b — s i1 Z-rnS tic try • 5 3 1,6=4.5 NZ\'111. s 1 _ s�C,\ • Zyri s�k F_ ,`{ •s Ground delev. l v.6ft. 2%S \,u`L4�.- 3C� �r�s�g c-1 Depth to limiting "factor S« Remarks: Boring# _ scSi y wP19 by G D Prkic) R�v1 U v s U- L V we Lv `t-t `�a`1 �^-t L �-E c �YL (31,,J P►Le Ground -3�-�8_ C 9r�e`z)*O e-' 'P tr% elev. ft. y-T3vyvD LUe 't )13K) \5 SANG 1^,)c.W W�'STh�rfe.0 �j 1JU� Depth to I `NI.) U2c u o r C.4} c�u\ t \c V1 0 l `t;j'' �r(GM-11)-L limiting factor 1`ft� � '�'Cl3 U>�+V S ►. i L 5 tf `CO ��Ci�Ss Ls 1Z C!Ev' S ,?'1►�r✓k Remarks: Boring# ! T Ground elev. ft. Depth to limiting factor _ Remarks: SBD-8330(R.05/92) PLOT P LAN Page I. of 3 SCALE 1 "= L Qj ( 3 �d �'7 % s 47H J a � � l / S, 3 y i a.y ms s, , � ` a 0 lub.p' ow w� �Co 3t AT UEyvST S e v p ( 715 425 - o16s 14 00576 CST Signature Date Signed Telephone No. CST # 'WisconsinDeparbnentoflndusby, SOIL AND SITE EVALUATION REPORT Page of 3 Lab" and Human Relabors Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code _ COUNTY Attach complete site plan on paper not less than 8 112,x,, s in-sie. Plan must include, but -ST o l� not limited to vertical and horizontal reference poi Ejrection and 9?o`bi slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and di d earest road. �� O O - \Z 9 - So f R 1 APPLICANT INFORMATION- PLEASE " 'r' t41 BY D T �TION b X 98 PROPERTY OWNER: RRO RTY LOCATION Ip S`_S 1�U�B R � a 19 T -S E 1/4 SE 1/4,S Z1 T ZS ,N,R 1 E(or V& PR OWNER':S MAILING ADDRESS ST CROIx )'T' BLOCK # SUBD. NAME OR CSM # 1-1 S g q ] ©x 3� Qv t°`v� - t� COUNTY ,� �` — \ S�' f'sDD.10 COUJQ t1v{ QAVr_ S CITY, STATE ZIP CODE - PHON []VILLAGE (MOWN NEAREST ROAD OA1-c 1 HCl6tff3 W sso92 iii .. - Ski ( this ml t [V4 New Construction Use [�P] Residential / Number of s 3 [ ] Addikn to existing buikfing L ] Replacement [ ] Public or commercial describe Code derived daily flow �A S,) gpd Recommended design loading rate • `4 bed, gpolft - trench, gpdrrtt Absorption area required - In S bed, ft 3`1S tench, 11[ Maximum design loading rate ' S bed, gpd/ t - 6 trench, gpd/ft Recommended infiltration surface elevation(s) °t Q S ft (as referred to site plan benchmark) Additional design / site considerations "0IJNjD wl`d L(7 .3(S m (/u . \1" �1= Sws t Lt, Parent material Lv;_�s5 ovt_'tt s c \ Yi t_L Flood plain elevation, if applicable 1y 1) ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for system 11 S oU [NS ❑ U ❑ S O U ❑ S ®U ❑ S ®U [IS RU SOIL DESCRIPTION REPORT Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Bo Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed T w& 1 -i }� AVSY:w I C)_6 � -b lotZ z1z sit 2.��bk M��. Q s 6 (. s t 1 Z � S bk wt'fi- 0-S \ � Ground R y / , lg R S./ elev. g g•9 ft. Depth to limiting factor Remarks: Boring # Z� S alt Yrl'�1- Al S 2 Z t; zS \b�11Z 31 _ s� Z`Fs�k t»`Ft- cs • s 3 ZS- S R Y6 -I's \-,CZ_ Sit Sc Ground elev. Depth to limiting factor Remarks: TName. Please Print Arthur L. We erer Phone. 715- 425 -0165 egerer Soil Testing & Design Service -P.O. Box 74 River Falls,WI 54022' Sgnature: / , l S Date: - CST Number: ��� -98 M00576 . . . . PROPERTY OWNER \A-) -1E1Q--IR SOIL DESCRIPTION REPORT Page 2-of Z , PARCEL I.D.# Depth Dominant Color Mottles Structure GP D/ft2 Boring# Horizon . Texture Consistence Boundary Roots in. Munsell Qu.Sz.Cont.Color Gr. Sz. Sh. Bed Trench gROM:',i M ,i:s ) c.-Co ‘0`1,C-r__ 2-L a s" si\ "?_ a\)k vvi - (k- s \wi .% • 6. m tt bona Z. 6 -z.C, ‘o-trz_ v/ • ...._ sil 7S 351..r Wei- ciS 1 -- - sL Ground 3 -2_6-qc, S Lt c _ V/y -1,s Licl Sib SC-1 Cily‘ hi -Ft- f..N -z elev. ckm-cl ft. Depth to limiting factor I 1. Remarks: Boring # 1 0 Og.na Ground elev. ft. Depth to limiting factor Remarks: Boring # 0 0...: M m mmHg Ground elev. ft. • Depth to limiting factor Remarks: Boring# IT vai*:51:0 ., • IA INftiii3 Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) PLOT PLAN Page 3 of 3 SCALE 1 "= I4() ' lv a@ fFT LLz� So' F" l M o"vp 3 8p Gq.. l J r� � c P 0 tq D 3 G Y oR 4 00 $.3 Zo" t29�9 3 715 425 -n1 M 00576 _ CST Signature Date Signed Telephone No. CST # Wi onsinDepartmentofIndustry SOIL AND SITE EVALUATION REPORT Page of 3 Labor and Human Relations Division of safety & Buildings in accord. with ILHR 83.05, Wis. Adm. Code COUNTY 5T - -c-mo 1K. Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference pant (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. O 1,4 O - \7Z-3 9 _:S b APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION FRT �BY _ DAT PROPERTY OWNER: PROPERTY LOCATION S�'EV WEB GOW-WT 5 E: 1/4 SE 1/4,S Zl T M ,N,R l 9. E (or@ PR PERTY OWNER' - .S MAILING ADDRESS LOT # I BLOCK # SUBD. NAME OR CSM # 6 91 Ox 3� 20 t`rUF . tvo 2ti'N \Z. - \ sr PIDD.Iv CovrttliR�{ 0141zS CITY, STATE ZIP CODE PHONE NUMBER OCITY []VILLAGE [MOWN NEAREST ROAD 0 AN-r- k He 6hTS, W &5c8 (wt) 43o - -iSst3 eov► lulu OP+U C LLI [etj New Construction Use [Y.] Residential / Number of bedrooms 3 [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow Q\ Sri gpd Recommended design loading rate 4 bed, glxW - trench,'gpwir Absorption area required 3"ZS bed, ft 3`1S trench, ft Maximum design loading rate • 5 bed, gpd/ft - 6 trench, gpolft Recommended infiltration surface elevation(s) °l q- S ft (as referred to site plan benchmark) Additional design/ site considerations I''1ov►. k� /$ >c �(� .t3� - "I \2. of Step R e_ " Parent material Lo';zrSS ovt_'cz s C_ \ 11 k_L Rood plain elevation, if applicable NJ 0 ) ft S = Suitable for system HO CONVEN110NAL MOUND IN GROUND PRESSURE AT GRADE SYSTEM B4 FILL LDAVG TANK U= Unsuitable fors stem O S O U ®S O U O S o U ❑ S ®U O S ®U O S Lq U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounday Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Tmnch ] o -6 to'-t tZ 7 sit ` Z`Fg a,S . x Z 6 -21 1 O'1(Z. 3 J Ground 3 i 1 -SO SC R- Vjy � S4V_ Slg \�sVK elev. 9 8.9 ft. Depth to limiting factor Remarks: Boring # sx 2 Z 6 ZS ( 3 ZS -I M y tz V -, .S \-(2 SIP, SCI `v► `Ft-- Ground elev. a ft Depth to Wrig belorr Remarks: TName.-- Please Print Arthur L. We erer Pte: 715 - 425 -0165 e Testing & Design Service -P.O. Box 74 River Falls,WI 54022 Sgnature. / l $ -S1 Dater c CST Number M00576 PLOT PLAN Page of SCALE 1 "= I4p ' ffT SST So'.- m ovvp 3 8�R jr I s N i dYJ o' P rJ � a o j I I !v 4a r -�_ s•Z ` ►p .�Y.. � EGG - 2 .) t� a O O y Zit l e 210 � D � !r Z ` ` 1 �4.�� i o,� yes cl�Z Ct�L. 3 -3c, Z r ( 715 ) 425 - 0165 M00576 CST Signature Date Signed Telephone No. CST # ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer S e ( �, ,-� lA e bQ_ Mailing Address (� Property Address S o k- .s G r ( ( ,e-- (Verification required from Pla4iing Department for new comstruction) City /State I ��1 Svc �. s �` iJ� 5 c Parcel Identification Number 0q6 - / a 3 9- Sb LEGAL DESCRIPTION S Lj S Properly Location S y., Sec. T 18 N R_ L_ __W, Town of -"fu Subdivision lL, r AvILIz. .la C,,g jc4, pay s Lot # / Cert'if'ied Survey Map # Volume . Page # Warranty Deed # 1 1 v Volume I a9 o . Page # 3 7 o Spec house ❑ yes IX no Lot lines id n ifiable yes 0. no WSTEM_Z4AEMNANCE o consists lmgmperuse andmaintenauceofyourseptic systemcouldresult is itspcemattu+efafl�eto bandlewastes. Propermamtenanee pumping out &C Septic tank every dirce years or sooner, if neoded by a licensed pumper. What you put into the rystem can affoct the function of the septic tank as. a fteatment age in the; waste disposalsystem. The property owner agrees to wbn* to St Crone Toning Department a certification form, signed by the owner and by a PGJoYmanPl rridodphumberor a licensedpumpervecifying that (1) the oa =site vvastewaterdisposal system is m Proper operating condition and/or (2) after inspection and PoMPing.(if necessary), the septic-tank-is less than 18 full of sludge. Ywe. &c undersigned have read the above requires and agree to maintain the private sewage disposal system with the standards set fottb, herein, as set by the Department of Commerce and the Department of Natural Resources, stating that your septic State of Wisconsin.. Certification system has been maintained must be completed and returned to the St Croix County Zoning Office within 30 da of the three year expiration date. TORE O DATE OWNER. CERTMCATION 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. 00 / ?v SIGNATURE OF APPLICANT DATE J « « « « «« 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 SIATr BAR OF W11,CO i 2 - 1082 NVAIRRANIC) 01 VOL1290PAC N1 NO REGIST R'S OFFICE ,� W �Iacke y. Sir. CR iX CO Ray GaICP, �obe - rt Q j Rjeord d No JAN 2 7 1998 - - - -- - Laura -L-- Weber,- 9-30 A M 'tO Steven_j--Weber-and L :IAIA k Toil '.I'Ar Oq "`E'�O NAXIF- AN(-1.,cTunN -1 00F1Ff-- C ... KRISTINA OGLAND Fj t Zilz, EsIrccn & Ogland the f d real mate it' P.O. Box :,59 State of Wisconsin: Iludson W1 54016 - 040-123 t414 CArl()N "'WRIEF V,4 of Troy, 1i Lot 12 St- First Addition Ale, t Country Oaks in the Town , Wisconsin. Croix County, T RANS FER FEE is not h pw This is notT recor(i, 4 Exccpfionto-�.•ariinfies: Easements, restrictions and rights-of - w-'Y Of if any. II A 1) 9 a- day of - 7 DaIcki this ' � • � _�— (SEAL) �?-� -- '�-- '�« III S -Al � - 'Llnd N ma j. kl a rence Murphy (SEAU (SEAL) -,7 �' a ren7,e m ACKNOWL.EVIC AUTIJENTICATION State of Wisconsin. _Laur Mu rphy Si ence, _Mu col.viv Norma J. Eckjund day of V ll a y Cttle I tile this januai�_ io--2�8 . l l(.)ve named I da of the I authenticated Its o `i I :d s Kritina O land II ri — ----------- TITLE: NIENIBER STATE BAR OF WISCONSIN to Ine k11t-11 I authorized by §706.06. Wis. St"Is Ill.- Same instrument and THIS INSTRUMENT WAS L)RAFTED By ►., J. \� \ \ OD o LM V D m \ \n \ Q W c y n \ R1 W w m _ _- 4 130 -0-0 54 1.30, 478. x109 420-8 1 � n E 46 pp pg °41 ' S r — (� 207 52 335.00 � 1 6133.63' �� cr ko Na y 0 o u 01 375 4 �IV /�d 0� / s , (V w w ` fill LM O � O w O kO t Q O C� O ti �rrI 23 � O O 0 s ss- . 0 , e p1 I o N 0 � N I (J)' (� V � CA N •Q ^ n r I v 1 q r►1 O m - y � � y