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S'I'. CROIX COUN'I'Y ZONING DEPAIU'M[;N�= AS BUILT SANITARY REPORT i • u��n� mew ;s 1.5as A A 4 f City»tatc OI I ag g crtptton: r tip' Lot --0 Block P P Subdivision/CSM 11 c I a. ' ? ' y.S '' /. 5 . Sec. ate, V T C) Town o PIN # O SEPTIC TANK - DOSE CHAMBER - HOLDING 'TANK INFORMATION: Tank manufacturer +` � �f Size ST/PC 5 l� Setback from: House �� Well �)A P/L 76 Pump manufacturer Model -3 11 L Alarm location vrt (HOLDIN `"T AJ C= ONLY) Setbacks: Service roaiY-� - --- Vent to fresh air..intske Water Line Meter location _.. Alarm location SOIL ABSORPTION SYSTEM Type of system: Width Length Number of Trenches Setback from: House d Well -A�J - PAL 5 " Vent to fresh air intake 6 5 ELEVATIONS Description of benchmark S CO Po v� n e 0 l t t Stye kv Elevation 1 66 Description of alternate benchmark rno4 c,*,, k Elevation � Building Sewer t! ST/HT Inlet A_.5 ST Outlet c l �� 2 - PC Inlet 1� �• PC Bottom 7 6C Header/Manifold /o y, (/ Top of ST/PC Manhole Cover Day Distribution Lines O 16 O ( ) Bottom of System( 163 () ( ) Final Grade 3 -)cbtq7 Date of installation /D,B' Permit numbcr State plan number Plumber's signature License number gao 7 Date Inspector c om plot Plan i Y 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. PLA. VIEW 4-- ems•" A, ' /5 c� 3 -S INDICATE NORTH ARROW / t Vsconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM County: INSPECTION REPORT ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy L s.15.04 (1)(m)]. 320247 6�� ?CKr S a6%TRUCTION /TROY DEV 1 TROJI village n Town of: State Plan ID No.: u CST BM Elev.: Insp. BM Elev.: BM Description: 3 ,51P 241 p I1 ' Parcel Tax No.: ov , p W �,� 1 � 040 - 1248 -00 -000 TANK INFORMATION ELEVATION DATA A9800434 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Q�U�� 5'/ Benchmar zli �� 0 Dosing 0 m: 0 OV , e) Aeration Bldg. Sewer t1Q_k& Holding St/ Ht Inlet Q TANK SETBACK INFORMATION St/ Ht Outle 736 9'4- TANKTO P/L WELL BLDG. vent to ROAD Dt Inlet Air Intake 11 '1 D Septic �- 5' r _ NA Dt Bottom Q �o 0.90 95:gO ' Dosing ' g � �'S E I 30 NA Header/ Man. 2.20 DL( (0 p Aeration NA Dist. Pipe Z tz 0 Holding a , Bot. System .9 1 PUMP/ SIPHON INFORMATION Final Grade Manufacturer s Demand 4;r 70 �`. to Model Number Wo 3 (� L � $GPM �� 3 1 O ' y4 -� tM. 1 o O g k TDH Lift j Friction A System s TDHIO,��Ft L If Forcemain Length Dia. " Dist. To well SOIL ABSORPTION SYSTEM B MEN Width Length / No. s PIT No. Of Pits Inside Dia. Liquid Depth DIMENSION SETBACK SYSTEM TO P/ L BLDG WELL LAKE / STREAM LEACHING Manufacturer: INFORMATION T M f �� f OR UNIT CHAM Moe Numb DISTRIBUTION SYSTEM Header /Manifold- ? 1) Distribution Pipe( ii x Hole ize x Hole Spacing Vent To Air Intake Length - Dia. J Length � r Dia. Spacing .�J y N �� _ SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed / Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Z'P. Z8. Zo, (Z4 2 / LOICAIT_IO-N: TROY 24.28.205 ,SE 280 ST. ANNES PKWY — TROY VILLAGE LOT 40 Planrevisio$required7 ❑ Yes No Use other side for additional information. ] (� ( K�(p SBD 6710 (R.3/97) Date Inspector's Signature Cert. No X ` Safety and Buildings Division SAN %6consin ITARY ERMIT AP ATI.O 201 W. Washington Avenue In accord with ILHR 83.0 i Adrn te'dll; I Department of Commerce P O Box 7302 40 Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the � ( t �In o r t lasso unty "k, 9 2 � ♦ � than 81/2 x 11 inches in size. • See reverse side for instructions for completing this ap I>tition t to Sanitary Per it Number a©R Personal information you provide may be used for secondary purposes W (Privacy Law, s. 15.04 (1) (m)]. :3 Unit) A Check if revision to previous application J +JTV Sete Plan LD. Numbe I. APPLICATION INFORMATION -PLEASE PRINT AiL 1N OR'I�A° C Q S 10:§. Property Owner N me pert dt 4, n l S T a &, N, R E (od Property Owner's Mailing Address too ^ LtstPFnm6rtr Block_Ntynber V5 O o N N f �} City, State ` Zip Code Phone Number Subdi ision Name or CSM N ber 3-I 0 V II. TYPE OF BUILDING: (check one) ❑ State Owned It� Nearest Road Public 1 or 2 Family Dwelling o a - No. of bedrooms ge own OF V III BUILDIN USE: (If building type is public, check all that apply) P rcel Tax Number(s) 1 ❑ Apartment/ Condo 0440 _ —QC7 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. jQ 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 3 2 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 E] Pit Privy 13 E] Seepage Pit r (` ��� • 4D , 43 [3 Vault Privy 14 E] System-In-Fill G. x 0 - 0 VI. ABSORPTION SYSTEM INFORMATION: 1_ Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate S. Perc. Rate 6. System Elev. 7. Final Grade 7Sz Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) Elevation AS 6.-- 1 9 11 b- 3 1 Feet / a5- & Feet VII. TANK Capacity in gallons Total # Of Prefab. Site Fiber- Ex er. INFORMATION New Existin Gallons Tanks Manufacturer's Name Concrete Con Steel glass Plastic A p p s Tank Tank str Se isT or S 1 Lo6`es,eCS ❑ ❑ ❑ 11 1:1 Pu iiSPONSIBILITY �,�� ❑ [D [:3 El ❑ sTA1rEM ENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Pri ) Plu er's Sign ture: No S mps) IMR /MPRSW No.: BBusine Phone Number: ! f 1-5 — Q t - 5/,R Plum is Address ( treet, Ci Sta e, Zip Code) IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitar Permit Fee (Includes Groundwater D atelssued Issuin A ent Signat a (No Stamps) ) A pP roved E] Owner Given Initial Surcharge Fee) ,,��//�� Adverse Determination 50, OD X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11 DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber Safety and Buildings 2226 ROSE ST LACROSSE WI 54603 -1905 TDD #: (608) 264 -8777 • isconsin www.commerce.state.wi.us Department Of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary October 13, 1999 CUST ID No.273085 ATTN.• POWTS INSPECTOR CALVIN POWERS ZONING OFFICE POWERS EXCAVATING INC ST CROIX COUNTY SPIA 1969 185TH AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 10/13/2001 Identification Numbers Transaction ID No. 251022 Site ID No. 182078 SITE: Please refer to both identification numbers,' Site ID: 182078 above, in all correspondence with the agency. St. Croix County, Town of Troy SETA, SETA, S24, T28N, R20W Subdivision: Troy Village - lot 40 Facility: Derrick Construction Company, Inc. FOR: Description: Five Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 494918 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • 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(2)(d), Wis. Stats. 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. Sincerely ` DATE RECEIVED 10/04/1999 FEE REQUIRED $ 190.00 FEE RECEIVED $ 190.00 Gerard M. Swim BALANCE DUE $ 0.00 POWTS Plan Reviewer - Integrated Services (608)- 785 -9348, Mon. - Fri. 7:15 AM to 4:00 PM jswim @commerce.state.wi.us W G7 3 - I AW cons in APPLICATION FOR REVIEW.. De artment of Commerce - Complete all pages- POWTS Safety 8 Buildings Division Bureau of integrated Services This page may be utilized for fax appointment requests NOTE: Personal information you provide may be used for secondary Com lets and Indicate date plans will be in our office________ purposes [Privacy Lary s; 15.04(1)(m)1. Complete fOr cOn firmed appointments S Private Sewaoe Submittal 2. T pe of Submittal: Not available for. POWTS at this time. System Type ( ) Groundwater Monitoring New Tn ID: ( ) Site Evaluation ( ) Replacement Related Trans. ID: ( POWTS System ( ) Petition (attach form SBD -9890 At Grade ( ) Experimental Review ) ent Date ( )Holding Tank Reviewer: ( ) Nonpressureized In j )Engineered System Ground conventional Office: ( )Pressurized In- st s received in the ofice of the appointment no later than Ground a s before the confirmed a ointment. ( -'4 Mound 3. Project Site Information -Fill in ail known i ( ) Aerobic System Site Number nformation. ( ) Sand Filter 1 Number $ Street: p ( ) Constructed Wetland Legal Description: ( ) Other. Gallons per Day: — Coun Cl Building Type (check one): ac Name: ( Intl' Village )Town of r0 al and/ business name of prof ) (?q Dwelling, 1 or 2 family t h �� ( )Public Building Facility Address: (project add (. )State -owned Building h5 EIS ress c �.L2t s Zip Code 4. After plans ar reviewed, please: (check all that a © O -_ Call when completed. �,_ PP Y) Requesting party will pick up — Mail plans to 'custom 3, 4 Other. Circle customer number from below. 5 Complete the following designer /owner /requesting Information Utilize the check boxes when designer, owner or requestin a same to avoid repeating information. W l I 9 p Is the rst Name Last Name u€'tiPa ; f iffit i r Customer Number First Name any Name vS Last Name Customer Number Company Name A � L (Q Address City ca State Zip +4 (9digits) City Phone Number (a a code re S 01 State Zip +4 (9digits) Fax or Internet Phone Number (area code) Fax or Intemet Check others if ap Ucable. Owner Payer Check others if applicable ) Requesting part Owner Payer First Name Ot, PI 'a 4 in Last Name Customer Number First Name Company Name Last Name Customer Number Company Name ����'��� Address Address city OCT 1 1999 State Zip +4 (9digits) . City. Phone Number (area code State Zip+4 (9digits) Fax or Intemet Phone Number (area code) Fax or Intemet Check others if applicable ( )Payer . Check others if applicable MAKE CHECKS PAYABLE TO DEPT OF COMMERCE TOTAL AMOU — ttach check here NT �DUE A � BD-10577 (R.10/98) Review Code 7633 , r 6. Caiculatlon of Fees Required (circle all that apply.) - System Type (Include new and existing tanks) Up to. 5,000 gallon holding tank ........................... .........................$60.00 ............................... ............................... 5.001 10,000 gallon holding tank ...........:.............. ........................$100.00 ................................ ............................... Over, 10,000 gallon holding tank .................... ..............................$ 150. 00................................. ............................... Up to 1,500 gallon septic tank ...................... ..............................$ 110. 00................................. ............................... 1,501- 2,500 gallon septic tank ............................. ............. ......$12040................... �O 2 ,501 - 5,000 gallon septic tank ...................... ..............................$ 160. 00.......................:........ .............................;. 5,001 9,000 gallon septic tank .................................................... $200.00. .......................... .......;....................... .... ... . . . 9,001- 15,000 gallon septic tank ..................... ............................... $ 300. 00................................ ............................... Over15,000 gallon septic tank ....................... ..............................$ 500. 00......:......................... ............................... t Up to 1,000 gallon dose chamber ....................... .........................$70.00 ............................................. ,................. 70 1,000- 2.000 gallon dose chamber ....................... .........................$80.00 ................................ ............................... 2,001- 4,000 gallon dose chamber ...................... ........................$100.00 ................................ ............................... 4,001- 8,000 gallon dose chamber ...................... ........................$120.00 ................................ ............................... 8,001- 12,000 gallon dose chamber ....:........... ..............................$ 140. 00................................ ............................... Over12,000 gallon dose chamber ................ ..............................$ 160. 00................................ ............................... Experimental System (additional one time fee) ........... ........................$300.00 ................................ ............................... Revisions Approved Plan .......... ............................... .........................$60.00 ................................ ............................... Petitionsfor Variance Setback ............................ ........................$100.00 ................................ ............................... (Include Form Site Evaluation ................. ........................$225.00 ................................ ............................... SBD -9890) Plumbing .................... ..............................$ 225. 00................................ ............................... Revision ............................ .........................$75.00 ................................ ............................... roundwater Monitoring - Per Site . ............................... .........................$60.00 ................................ ............................... o ther t han a proposed subdivision) ite Evaluation in Lieu of Groundwater Monitoring ........ .........................$60.00 ................................ ............................... Subtotal..... ............................... Priority Review: Enter same amount as subtotal ..... ............................... Prior approval from a section chief is required for a priority review. If approval is granted, the priority will be reviewed within 5 days of receipt. Enter TOTAL here and on bottom of FRONT PAGE $ Note: Fees for aerobic or prepackaged treatment systems that may include trash tanks shall be calculated based on the rated capacity of the aerobic unit or prepackaged treatment system as compared to an equivalent septic tank size. Note: Fees are pursuant to ch. Comm 2 and are subject to change annually; please contact any of the offices listed below for the, most recent copy of this form. Note: Comm 2 provides for a partial fee refund if a plan action has not been taken within the 15 days of receipt of all required information. 7. Appointment, Scheduling Information, and Plan Submittal Checklists. At this point in time appointment options for POWTS scheduling is not available. . If you wish to schedule a review appointment in advance, call any of the full service offices. At the time of making an appointment, you may request review for a specific office or desired (beginning) date for review. You may also FAX the front page of this application and receive a FAX back with an Appointment Date, Transaction ID No. and Assigned Reviewer. Plans must be received in the office of the appointment no later than 2 working days before the confirmed appointment Non - scheduled submittals or submittals received without a confirmed appointment date and transaction number on the form may be assigned to offices other than the receiving office depending on reviewer availability. To obtain a submittal checklist call the material order unit at 608- 266 -1818 or one of the full service offices listed below Madison S &BD Hayward S &BD LaCrosse S &BD. Shawano S &BD Green Bay S &BD Waukesha S &BD 201 W Washington Ave 15837 USH 63 2226 Rose St 1340 E Green Bay 2331 San Luis Place 401 Pilot Court PO Box 7162 Hayward WI 54843 LaCrosse WI 54603 Shawano WI 54166 Green Bay, WI 54304 Waukesha WI 53188 Madison WI 53707 -7162 608- 266 -3151 715- 634 -4870, 608 - 785 -9334 715 -524 - 3626... 920492 -5601 414 -548 -8600 Fax: 608-261-6699 Fax: 715-634-5150 Fax: 608-785-9330 Fax: 715. 524 -3633 FAX: 920492 -5604 Fax: 414-548-8614 TDD 608- 264 - 8777 Email: haywardsch@ Email: lacrossesch@ Email: shawanosch @. Email: greenbaysch@ Email: waukeshasch@ Email: madisonsch@ commerce.state.wi.us comme.rce.state.wi.us commerce state.wi.us commerce.state.wi.us commerce.state.wi.us cc enmerce.state.wi.us PAGELAOF_�- MOUND SYSTEM FOR A5 BEDROOM RESIDENCE LOCATED IN THB 1 /40F THL 1 /40F SECTIOIQ- ,T2f�ARc -OW, TOWN OF TV., _ COUNTY, WISCONSIN. • INDEX PAGE IA OF 9 TITLE SHEET PAGE 1 OF 9 WORK SHEET PAGE 1 O 9 WORK SHEET PAGE 3 OF 9 WORK SHEET PAGE 4 OF 9 WORK SHEET PAGE 5 OF 9 PLOT PLAN PAGE 6 OF 9 PLANVIEW CROSS SECTION PAGE 7 OF 9 DISTRIBUTION PIPE LAYOUT PAGE 8 OF 9 PUMP CHAMBER PAGE 9 OF 9 PUMP PERFORMANCE CURVE PREPARED OR OBrrtCK �onS; I 1 i� 150 q w yy (4g -. x 4 N ktchrmon 45Z BY POWERS EXCAVA G INC. c- o nd itiOna ll y A , ? P R(3\j E 1 pf COMMER pEPAR1MfKV A UILDINGS 1969 185th AVE S E NEW RICHMOND, WISC. 54017 D1V1S 715- 246 -5135 S PENCE SEE G J • Q6,.s Tiro Y WORKSHEET - MOUND SYSTEM DESIGN PROBLEM: I Design a mound system for a ___ —� A roo The site characteristics are: Depth to groundwater or bedrock. • _�y in. Landslope _ y % Percolation rate Distance from dose chamber to distribution system ft. Elevation difference between Dump and distribution system Co ft. 'Step 1. WASTEWATER LOAD gal.' Step 2. SIZE THE ABSORPTION AREA A) Area required = 756 av d� sq. ft. B) Bed or trench length (B) )o ft. C) Bed or trench width (A) = Co• �S ��?sft. :c !D.) Trench spacing. (C)' ;�.. .- Was ? tewa er load .24 gal/ft /day S _ ft. t re �c- e s Step 3. MOUND HEIGHT A) Fill depth (D) = 31 �o Roc ft. ` B) Fill depth (E) = D + slope (Arfp) a • ft. C) Bed or trench depth (F) _ .83 ft. D) Cap and topsoil depth (G) ft. E) Cap and topsoil depth (H) II _1 ft. i� %n•___ _ _ 'J, mate _ ........_ 15 71__. 0 6' 7fo LO Step 4. MOUND LENGTH A) End slope (K) _ C D +1+ F + H x 3 �3�y ft. �^ f ,83 --S X f3 3b5 C a a �alp�8 B Total mound 1e + ft. o nth L 8 2K Step 5. MOUND WIDTH Al) Upsl ope correction factor z A2) Upslope width (J) (D + F + G (3)(factor) _ ft. (a 4 483 4L) e3 )r , 891 ,-1 a � �6 01) Downslope correction factor = 69 t A Iq B2) Downslope width (I) _ (E + F + G)(3)(factor) _ ft. Cl) Total mound width (W) for bed = J + A + I 30�d ft. 163 td .-XS t C2) Total mound width (W) for trenches J + � + (no. trenches -1)(c) + A + I = ft. Step 6. BASAL AREA A) Infiltrative capacity of natural soil y _ gal. /ft /day - 750 B) Basal area required = wastewater flow natural soil infiltrati y e• capacity = /Y sq. ft. Cl) Basal area available for bed for sloping sites = a 0 � 5 B x (f + I) = sq. ft. C2) Bas are •avail le for trench for sloping sites = B W — �J + A J = sq. ft. C3) Basal area available fo'r trench or bed for level sites a B x W = /sq. ft. Sij;n: _ License: l:u: c77 Z�V � Date: ��4 -/51--9 • � Q r n i ck �O vS T r ttC,�� ° � O T�o ` 14 a Step 7. DISTRIBUTION SYSTEM 7A) SIZE DISTRIBUTION SYSTEM 1) Hole size Xy in. 2) Hole spacing = in. 3) Distribution pipe length = 'y in. 4) Distribution pipe diameter a in. 5) Spacing between distribution pipes 6) Distance from sidewall to distribution pipe in. 1B) DISTRIBUTION PIPE DISCHARGE RATE ft. 1) Number of holes per pipe = _ 2) Flow per pipe = /S GPM 7C) SIZE MANIFOLD 1) Manifold is central / end 2) Manifold length a_ ft. 3) Number of distribution lines = 4) Manifold diameter = -3 in. 7D) SIZE FORCE MAIN 1) Minimum dosing rate = _� GPM r 2) Force main diameter =. .` in. 3) Friction loss = • 1 ft. 7E) TOTA4 DYNAMIC HEAD 1) Vertical lift e ft. 2) Friction loss = �� ft. 3) System head 2.5 ft..- 0?,5 ft. 4) Total dynamic head ft. U cerse O 3 • ; '�` r-0 Y col' yc7 ` 7F) PUMP SELECTION 1) Pump selected will discharge . GPM at ft. total dynamic head. 2) Pump model and manufacturer 7G) DOSE VOLUME 1) 10 times void olume gi tribution lines has "y gal. /cycle �X5�9 ` I L , s 4/ � 7,S al . /cycle 2) Daily wastewater volume 4 . 4 doses /24 hrs. _ •„ ,9 3) Minimum dose volume = J DO gal. /cycle a1 y 7H) DOSE CHAMBER 1) Minimum capacity required R /0 gal .P/641. ' Sim: r Lict:nsc ::u � Date cay Po 15�s 1 L+e.,.� � Mo►1�.� 1A1� SqOG _ to t - 0 Iro y • I i i i a� : `` F: j � . , �e rr•: C:� ch r��'�..�c., �c�,� gyp, Pageu r ' Straw, Marsh Hay, Or Synthetic Covering �45W7) Distribution Pipe Sand N G Topsoil F p E r u 3 Slope Bed Of 2 %2 Force Main Plowed Aggregate Layer D Ft.. Cross Section Of A Mound System Using E /;'t Ft A Bed For The Absorption Area F ! Ft , G 1 Ft. A to , � S Ft. H Ft. k ..Signed: B Ft. f License Nurpber: _ado S3 7 K 13,1 Ft . Date: L /ab � SFt. q l s 1 1 1 /0,3 Ft. Alternate Position l Ft. of ,. Force Main W �Ft, Observation Pipe. B K A � --- -- --------- - - - - -- ---=-------------- - - --•I �Distrlbutiom Bed Of % "_ • Pipe, Aggregate 2 Observation Pipe Permanent Markers Plan View Mound Using A Bed For The Absorption Area LOS 40 �d Perforated Pipe -Detail End Vlsw ' Eno Co p Perforated ;. ;f' PVC Pipe Holes Lotatt¢ On Bott'orn , t �y. R q , p ,:.. S At o . uotip ocea 7. PVC ' MoNfotd Pipe i , ' OiUri�•�tion _ Position Of ' 'Force µpin y ,: 1.091 Hots tAoutd Be m Noll TO End Cop •' � : End Cop - Distribution Pipe Layout P 4 19 Ft. A S XnchPS r rA Y 3C� Inches Signed: Hole Diameter, Inch License number:. -- �s-7- -- Lateral ". %S/ Inches) Manifold " p " � � ' I Date: Force Main " -3 Inchs # of hol es /pipe 13 Invert Elevation. Laterals 033 Ft•: Po B oyF, �4 / I PAG C .1.Z.. 0 F • - NQ,.�1i�:_� WZ4, Lai Stroh ♦ �. , . .•. ' PUMP CHAMBER CROSS WT101� AAIO SPECIFICATIONS VC NT CAP + 4 0 C.Z. VENT PIPE TT WCATHEK PROOF APPROVED LOCKING �: Ls' FROM ODOR, JUIJCTIOIJ BOX AUMLC COVCK It WINDOW OR FRCsM I AIR INTAKE I GRADC _ =own 4' MIN. COIJDUIT 10'/'IIAI.v ---- - - - - -- IMLET 'PROVIDE _T AIRTIGHT SEAL. I I �i APPROVED JOINT A I I I APPROVED .101AIT W /C.I. PIPE I I I W /C.I. PIPE EXTENDING 3' I II ALARM EXTEUDIIJ6 3' OUTO 601.10 &OIL e I II ONTO SOLID SOI I 1 oN c j i ELEV. FT. PUMP -� -_J Off D '� CONCRE.TC BLOCK RISER EXIT PERMITfCD ONLY IF TANK MANUFACTURER HAS SUCH APPROVALgg� SEPTIC E SPECIFICATIONS DOSE — . TA U KS MANUFACTURCR: - IJUMBER OF DOSES: PER DA3 TANK SIZC: - GALLONS DOSE VOLUME h ALARM MANUFACTURER: J INCLUDING pACKFLOW: c &ALL.ONS MODEL NUMBCR: _1O w CAPACITIES: A= �3 INCHES OIL GALLOyS SWITCH 'TUPC: - \ oaf B = a INCHES OR I LL 0ALLOLJ5 _ _ PUMP MAN UFACTURER: .o S 9 _ - r --- -. C • IIJCHES OR /Y 12- GALLOWS MODEL NUMBER: - 3111 _3 If Do — INCHES OR GALLONS SWITCH TYPE: Q� NOTE PUMP AN ALARM ARE TO bt MINIMUM DISCHARGE RATE GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFEKE14CE BETWEEN PUMP_OFF AND 01STAlBUTION PIPE.. FEET t MAIUtI'K�UM NETWORK SUPPLY PRESSURE , . ?.S_ FEET + ..� =FEET OF FORC MA X ____._, ofxFRICTIOU FACTOR.._.!AO_ FEET -j- TOTAL .DtlWAMIC. HEAD = li kk p FEET 1 7 d INTERNAL. DIMENSIONS Of TAUK: LEKICPTH.;WIDTH - ;LIQUID DEPTH .._ t tie N e c , clnw. OAJ_ uU-11 4¢ al o� c ' Goulds Lo 10 P 0. J ' Submersible Effluent Pump .3885 APPLICATIONS • Overload protection must smooth operation Silicon can be operated continuously Specifically designed for the • be provided in starter unit. bronze impeller available as without damage. Shaft: threaded 400 series an option. following uses: � :• , ■ Bearings: Upper and • Homes stainless steel. ■ Casing: Cast iron volute lower heavy duty ball bearing Farms • Bearings: ball bearings type for maximum efficiency. construction. Upper and lower. 2" NPT dischar a adaptable • Trailer courts 9 P ■Power Cable: Severe duty • Motels • Power cord: 20 foot for slide rail systems. rated, oil and water resistant. • Schools standard length (optional m Mechanical Seal: SILICON Epoxy seal on motor end • Hospitals lengths available). CARBIDE VS. SILICON provides secondary moisture • Indust Single phase: Industry CARBIDE sealing faces. barrier in case of outer jacket •'' and' /: HP -16/3 SJTO • Effluent systems Stainless steel metal parts, damage and to prevent oil with 115 V or 230 V three BUNA -N elastomers. wicking. prong plug. SPECIFICATIONS • 3 /4 -1'/2 HP -14/3 STO with n Shaft: Corrosion - resistant ■ 0 -ring: Assures positive Pump bare leads. stainless steel. Threaded sealing against contaminants • Solids handling capabilities: Three phase: design. Locknut on three and oil leakage. 3 /4 " maximum. •'/2-1'/2 HP -14/4 STO phase models to guard • Discharge size: 2" NPT. with bare leads. On CSA against component damage AGENCY LISTINGS • Capacities: up to 128 GPM. listed models - 20 foot on accidental reverse rotation. • Total heads: up to 123 feet length SJTW and STW ■ Motor. Fully submerged in SP Canadian Standards Association TDH. are standard. high -grade turbine oil for • Mechanical seal: silicon lubrication and efficient heat U� Underwriters Laboratories carbide -rotary seat/silicon FEATURES transfer. carbide - stationary seat, 300 ■ Designed for Continuous series stainless steel metal •Impeller: Cast iron, semi- Operation: Pump ratings are parts, BUNA -N elastomers. open, non -clog with pump- within the motor manufacturer's • Temperature: out vanes for mechanical seal recommended working limits, 104 °F (40 °C) continuous Protection. Balanced for 140 °F (60 °C) intermittent. METERS FEET • Fasteners: 300 series 90 stainless steel. SERIES: 3885 SIZE: • Capable of running dry. 25 80 RPM: VARIOUS without damage to E ' — - -► SGPM — components. 20 zo WIC EO 5FT � - -- Motor ° a 60 Single phase: _ C — -- • %3 HP,115 V, 200 V, 230 V, 15 5 0 —I— 60 Hz, 1750 RPM; ' /2 HP, 115 V, 60 Hz, 3500 RPM; i; 40 Eo H '/2 HP -1'/ HP, 230v,.. a - - - -- 60 Hz, 3500 RPM. a 10 30 • Built -in overload with 20 wE0 automatic reset. • Class B insulation. i 0 Three phase: Vol ZZ • '/2 HP - 1'/2 HP 200/230/ p� 460 V, 60 Hz, 3500 RPM. ° 0 10 20 30 40 5o s 70 80 90 100 110 120 130GPM • Class B insulation. ' 10 20 30 m3 � CAPACITY 0 1995 Goulds Pumps �(� Effective May, 1995 v 83885 Wisconsin Ddpartment of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of 3 Bureau of 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 S1, C O \ K percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # APPLICANT INFORMATION - Please print all information Reviewed b Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner 4 /� Property Location !/ � r+ � t c -X_ ct) i Y) Co , 1 Govt. Lot S 1/4 ,Se 1/4,S a 7 T � � N,R a D ftp W Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# L os " Pb A Y Tro Y U 1( I q e City State Zip Code Phone Number ❑ City ❑ Village Pq Town Nearest Road p N� o 7r-o S7r �}>1hesY �rkwy 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 o 4 bed, gpd /ft gpd /ft Absorption area required 6.25 bed, ft G-� trench, ft2 Maximum design loading rate . 4 1 bed, gpd/fl - 9 trench, gpd /ft Recommended infiltration surface elevation(s) O / y ft (as referred to site plan benchmark) Additional design /site considerations Parent material ! d DcA es, rO It e Flood plain elevation, if applicable f4 It S = Suitable for system Ggo6ventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ S � U S ❑ 'U El S K U ❑ S ®U EIS (0 U ❑ S ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 1 -I io z aw. ry) w of ,s 1- 1 n !o FS l 9 m5w YY\ r I qL w a , y s Ground y -y a�$ ..� elev. A / all I ft. Depth to limiting ; Remarks: Boring # rnsbk try•" a S ,.5 02 2 J o � b )z Ground e�lev �- ft. Depth to limiting ,.Yin. Remarks: CS Name (Please rint) Signatu Telephone No. Address Date CST Number PROPERTYOWNER ; IL DESCRIPTION REPORT Page _c2_ of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Structure 2 Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench y ; a 1 -3p z ' - 4,, S.bK m Ground I, ,q , N elev. Depth to limiting fact Remarks: Boring # F� Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # ; �ys<:lzs >t�xaa Ground elev. ft. Depth to ; limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor ' Remarks: SBD -8330 (R. 07/96) �`Qwnfw� (RS: rOB �Q S r 1ifS[� y 1c G�rnon;d..� lx�`1' S"c�0 /T T o. �/ (9 -b l7bY+► one, t 4 y . C., 1 ��rti� �aa d 5 37 a ` �36 l i r °c; w isGorbn Department of Commerce SOIL AND SITE EVALUATION g ;Division Safety and Buildings Pa of Bureau of Integrated Services in accordance wit . ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches Wsize. Plan must County -} include, but not limited to: vertical and horizontal reference point (am), direction and S 1 O \ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. pane) I.D. # p_( —boc7 APPLICANT INFORMATION - Please print all information. Revi d b Date Personal information you provide may be used for secondary purposes (Privacy law, s. 15.04(1 (mt ). , h Id Prope Owner /� Property Location v 1 Lk Ct) �S Yl 00 • � Govt. Lot s 1/4 -Se 1/4,S a� T � � NCR @tpr) W Property Owner's Mailing Address Lot# Block# Subd. Name or CSM# (as PO � r 4 Yd 1 / Tro Y V l q e City State Zip Code Phone Number rb ❑ City [:1 Village � Town Nearest Road NQ,,, o (tom 71"0 57+ A ne -�rk ► 4 New Construction Use: .gResidential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow 750 gpd Recommended design loading rate + 7 bed, gpd /ft2 ► J trench, gpd /ft Absorption area required (was bed, ft G-Z trench, ft Maximum design loading rate , bed, gpd /ft i J trench, gpd /ft Recommended infiltration surface elevation(s) O ft (as referred to site plan benchmark) Additional design /site considerations Parent material ! e Flood plain elevation, if applicable N/ f0 It S = Suitable for system C ventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ S �g U S ❑ U El S ® U ❑ s ® U ❑ S ri] U E:1 S ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft Texture Consistence Boundary Roots in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 I - J 10 z �r� 5 ti� m . 13-31 v n Fs l a— s w m r �,� a , y S Ground J 7 - y ars elev. A Depth to limiting factor �in. Remarks: Boring # d_g f R L St a rnsbk ►-K4 lo w /5 oZ .' >� +5,/ b)z h��r LZ a / Ground glev Depth to limiting f r �in. Remarks: Cn me (PleasP ee,>U.PQV-S int) Signatu Telephone No. r v` �7 I S � S1 Address Date CST Number PROPERTY OWNER 1�}Q r: �r.S�'.4 c� `r SOIL DESCRIPTION REPORT Page g of 3 PARCEL I.D.# .tics ( c 4& —bO Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. OBed TTrenpn 3 / 0s )_3 /5YR 0 5 ) 2msbk ►�• a -� 5 /3-37 At'? 446 s/ 5.6k in s-r ,Z5 �y rs Ground 37 4/0 a•a)/ �� )erl — -- Vio N/A Depth to limiting I in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed Trench Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD-8330(R.07/96) ���•� �r�e`�,��,,�,Cc.T�,.` 50:' a v►c� S; �v� �;w� p Y,( CF� S'.2 Troy i l�aec,�2__. Lo o . Noll 43 a p,,t f ti� , � x ,Ca'F A r SANITARY PERMIT APPLICATION 01eE. W and ashinlgton Division ` N*6cons In accord with ILHR 83 -05, Wis. Ad m. 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. - t - C ` • • See reverse side for instructions for completing this application State sanitary Permit ,,Nu` ber The information you provide may be used by other government agency programs ❑ Check it revision to previous application [Privacy Law, s. 15.04 (1) (m)). State Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INFO MATION P arty Owner Nam p� Property Location c C. 1 SE 1 /4, S a T ge, N, R 20E$r) W Property Owner's Mailing Address Lot Number Block Number f �^ City, Stat f Zip Code Phone Number Subdivi5jga [Vame or CSM Nu er ( (s) f �b V 11. TYPE OF BUILDING: (check one) ❑ State Owned itr Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms _� ❑ own of 1 l4 4t III. BUILDING SE: (If building type is public, check all that apply) Parcel Tax Number(s) 1❑ Apartment/ Condo 0-yo — l a — 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, E] Replacement 3. E] Replacementof 4. E] Reconnection of 5_ E] Repair of an __System System _____________ Tank Only______________ Existing System ________ Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 Mound 30 E] Specify Type 41 E] 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. 1 7. Final Grade Required (sq_ ft.) Proposed (sq. ft.) (Gals/da /sq. ft.) (Min. /inch) Elevation 5 C� �o Feet / / 3• f Feet Capacit VII. I NFORMATION in gallons Total # of Prefab. Site Fiber- Exper. g Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Exist in structed Tanks Tanks eptic Tank o k 15 1 W es /��S ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /S ber X I ❑ ❑ ❑ 1 ❑ ❑ VIII. RESPONSIBILITY ST TEMENT I, the undersigned, assume responsibility for insta ion of the onsite sewage system shown on the attached plans. Plumber's Name: (P P er' Signa re: (N S mps) MP /MPRSW No.: Business Phone Number: s 5! Plumber's Address (Street, it , Sjaxe, Zi Code)- JS T�V11 N f IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit pp []Owner Given Initial / Fee (Includes Groundwater ate Issued lssuin ge t Signature (No Stamps) MA roved n �O 0 (/ 0 Surcharge Fee) v' I/ Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: �qlkt-01 tuf SBD-6M (8.11/96) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, owner, Plumber I Safety and Buildings 1340 E GREEN BAY ST STE 300 �- - SHAWANO Wl 54166 I scons� Tommy G. Thompson, Governor Department of Commerce William J. McCoshen, Secretary September 04, 1998 CUST ID No.220537 ATTIC POWTS INSPECTOR CALVIN W POWERS JR 1969 185TH AVE NEW RICHMOND WI 54017 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 09/04/2000 Transaction ID No.133828 Site ID No. 157569 SITE: Site ID: 157568 abov' ST CROIX County, Town of TROY;, TROY SETA, SE1 /4, S24, T28N, R20W Lot: 40, Subdivision: TROY VILLAGE DERRICK CONSTRUCTION LOT 40, TROY FOR: Description: MOUND SYSTEM FOR DERRICK CONSTRUCTION Object Type: POWT System Regulated Object ID No.: 417136 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. The following conditions shall be met prior to issuance of the sanitary permit: • On the Plot Plan, the septic tank, pump chamber, force main and mound shall be labeled. • On the mound cross section, the center distribution pipe shall be eliminated • On the mound cross section, it shall be noted that the sand fill will comply with the "ASTM C33" specification. • On the mound cross section, the site slope shall be noted. • On the mound plan view, the word "alternate" shall be eliminated • On the mound plan view, the force main that enters from the end of the mound shall be eliminated. 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/opemtion. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead Sincerely, DATE RECEIVED 08/24/1998 FEE REQUIRED $ 190.00 KEITH A WILKINSON, POWTS PLAN REVIEWER FEE RECEIVED $ 190.00 Integrated Services BALANCE DUE $ 0.00 (715)524-3630, M -F 7 AM - 3:45 PM KWILKINSON @COMMERCE.STATE.WI.US PRIVATE SE1fIAG"E" SYSTEM Department of Commerce Safety and Buildings Division REVIEW APPLICATION � Bureau of Integrated Services Hayward Office LaCrosse Office Madison Office Shawano Office Waukesha Office 209 W. 1st St. 2226 Rose Street 201 E. Washington Ave. 1340 E. Green Bay St. 401 Pilot Court, Ste. C Rt 8, Box 8072 La Crosse, WI 54603 P.O. Box 7969 Suite 300 Waukesha, WI 53188 Hayward, WI 54843 .Phone (608) 785 -9334 Madison, WI 53707 Shawano, WI 54166 Phone (414) 548 -8606 Phone (715) 634 -4804 - Fax (608) 785 -9330 Phone (608) 266 -3151 Phone (715) 524 -3626 Fax (414) 548 -8614 Fax (715) 634 -5150 Fax (608) 267 -9566 Fax (715) 524-3633 INSTRUCTIONS. To save time, schedule your review with one of the offices listed above prior to submittal. Fill in all applicable data and submit this form together with fees and planslinformation. Your submittal must be received at least two working days prior to the appointment at the office where your review was scheduled. Please call any of the listed offices if you need help filling out the form or have questions on what information to submit PLEASE PRINT VERY CLEARLY. A sample of a completed form is on the reverse side for your reference. Personal Information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1)(m)]. 1. APPOINTMENT INFORMATION - If you have scheduled an appointment, fill in the information requested below to save time: Appointment Date Reviewer Name - Flan Identification Number 2. PROJECT INFORMATION If this review is ;revision or extension to your existing ! Pro Name Ian Identification number, provide that number here: t� � o E] City ❑ Village Town of: County Project Location rr GOVT. LOT . 5F 1/4 SF 1/4,S a ! a ,V N Wr) W C 3. APPLICATION FO 4. FEE COMPUTATIONS FEE SU MiTTED System Type (check one): System Type r (include now and existing tanks) A❑ At -Grade Up To 1,500 gallon septic tank ... ............................... ..$110.00...................... H C] Holding Tank 1,501- 2,500 gallon septic tank. '**p,* ............... V20.00 ...................... /an M Mound 2,501- 5,000 gallon septic tank .............. J.................... ..$160.00...................... NNon - Pressurized in- Ground (Conventionaq 5,001 - 9,000 gallon septic tank .... ............................... ..$200.00...................... P. ❑ Pressurized In- Ground 9,001 - 15,000 gallon septic tank .... ............................... ..$300.00...................... O❑ Other. Over 15,000 gallon septic tank .... ............................... ..$500.00...................... Up To 1,000 gallon dose chamber . ..............................$ 70.00...................... — In f o Building Type (check one): 1,001 - 2,000 gallon dose chamber . ..............................$ 80.00...................... D Dwelling, 1 or 2 Family 2,001- 4,000 gallon dose chamber ............................. ..$100.00...................... P • ❑ Public Building 4,001 - 8,000 gallon dose chamber ............................. ..$120.00...................... S ❑ State -Owned Building 8,001 - 12,000 gallon dose chamber ............................. ..$140.00...................... Over 12,000 gallon dose chamber ............................. ..$160.00...................... —y Up To 5,000 gallon holding tank .... ..............................$ 60.00...................... Code Derived Daily Flow [ s gpd 5,001 - 10,000 gallon holding tank .. ............................... ..$100.00..:................... Over 10,000 gallon holding tank.. .................. ❑ Check If Replacing Existing System Experimental System (additional one time fee) .............. ..$300.00...................... Revisions to Approved Plan 2 ........... ..............................$ 60.00...................... Petitions for Variance: Setback .. ............................... ..$100.00...................... ❑ Petition for Variance Site Evaluation ..................... ....$225.00.................... Plumbi ng . ............................... ..$225.00...:.................. R evision ..... ..............................$ 75.00...................... ❑ Groundwater Monitoring Groundwater Monitoring - Per Site .... ..............................$ 60.00...................... other than a pro posed subdivision ❑ Site Evaluation in Lieu of Groundwater Monitoring Site Evaluation in Lieu of Groundwater Monitoring ..........$ 60.00 ...................... Subtotal: ................... c Priority Review: Enter same amount as Subtotal:....... ............. MAKE ALL CHECKS PAYABLE TO: SAFETY AND BUILDINGS DIVISION Total Fee: I 5. SUBMITTING PARTY INFORMATION on Telephone r�c: No. (i nclude area code &extension) Co ny Name ers n P10 No. & Street Address or P.O. Box City, Town .or Villa o, late Zip Code s Aerobic or prepackaged treatment system fees are calculated based on equivalent size septic tanks and dose chambers. Revision fees are not applicable to temporary holding tanks or extensions to existing approvals. NOTE: Fees are pursuant to Wis. Adm. Code, Chapter ILHR 2, and are subject to change annually OVER -- -j► SBD -6748 (R. 07196) Ck 1 SO5 fl w Lo S pO &"c N P.C\ mon X Q 1,;r WORKSHEET - MOUND SYSTEM DESIGN PROBLEM: i Design a mound system fora ��] Y`o o rv�, ...,............... The site characteristics are: Depth to or bedrock � 3 9 in. Landsl Percolation rate _"'��'T "• Distance from dose chamber to distribution system f ft. Elevation difference between sump and distribution system ft. Step 1. WASTEWATER LOAD �V co CO gal Step 2. SIZE THE ABSORPTION AREA A) Area required - 7.5 O as sq. ft. B) Bed or trench length (B) /a l00 ft• C) Bed or trench width (A) _ �'a5 6AS ft. :0) Trench spacing ICY Wastewater load .24 coal /ft /day B f._.�. ft. tr.c e�i s Step 3. MOUND HEIGHT A) Fill depth (D) - 3 t�C��....• - ft. B) Fill depth (E) - D + slope (A)4 a• ft. r._.. C) Bed or trench depth (F) _ #93 ft. D) Cap and topsoil depth (G) - _ - ft. E) d tansoil depth - ft• C.. 0 r a n \I , ter'. CJf- -. �� �15� �.a C � c� r. Cam a 01� Sys o ,, (o e, P0 x c.\ rti Step 4. MOUND LENGTH A) end slow (K) _` (D +E +F +N'x3= ,934J 5 5 B) Total mound lengt (L) = B + 2(K) ft. Step-5. MOUND WIDTH Al) Upslope correction factor = •VT = J A2) Upslope width (J) (D + F + G = (3) (factor) I 3 ft. (a 0r3X n i B1) Downslope correction factor B2) Downslope width (I) _ (E + F + G)(3)(factor) / ft.. 01 ;?5 f-, y3f I)x3X A/X: r'3t�S CI) Total mound width (W) for bed = J + A + I 3 6, b ft. 1d,3tto 5+ 1 �3oss i C2) Total mound width (W) for trenches = - + + (no. trenches -1)(c) + A + I = ft. j , AQ Step 6. BASAL AREA A) Infiltrative capacity of natural soil = g4l. /ft /day 750-' y B) Basal area required -wastewater flow natural soil infiltrative- capacity sq. ft. j C1) Basal area available for bed for sloping sites = B x (A + I) so. • ft. C 1 J 7 aoas C2) Bas are avail le for trench for sloping sites = B W .,.,. �J + A 1 sq. ft. f C3) Basal area available for trench or bed for level sites = B x W = -,sq. ft. License ;: r Data' �. V --- S o S v (p S PO o�c 14 Step STRIBUTION SYSTEM t p 7. D ISTRIBUTION It I� a�- 7A) SIZE DISTRIBUTION SYSTEM 1). Hole size = in. 2) Hole spacing = in. 3) Distribution pipe length � 9 *• 4) Distribution pipe diameter = ! in. 5) Spacing between distribution pipes = 6) Distance from sidewall to distribution pipe = n4 in. 7B) DISTRIBUTION PIPE DISCHARGE RATE ft. 1) Number of holes °r pipe 2) Flow per pipe _ /s GPM 7C) SIZE MANIFOLD 1) Manifold is central / end 2) Manifold length ft. 3) Number of distribution lines 4) Manifold diameter = 3 in. 7D) SIZE FORCE MAIN j 1) Minimum dosing rate !( GPM 2) Force main diameter = 9 .3—in. � 3) Friction loss by L ft. 7E) TOTAL, DYNAMIC HEAD 1) Vertical lift = _ ft. i 2) Friction loss ft. 3) System head 2.5 ft. _ '-5 ft. Total dynamic head = / / g ft. L..... - I Licers - Dato " - lJ^Q„rr �C�-� � /1�j���.lC.�C9 T ...1 -1/� -1 : : ' O ;• y Cf- J 1 i 7F) PUMP SELECTION 1) Pump selected will discharge 0 GPM a G ft. ' total dynamic head. 2) Pump model and manufacturer i 7G) DOSE VOLUME I 1) 10 times void volume of distribution lines = 4 1 4 gal./cycle y j( y9 K , 66 f i 2, S y 2) Daily'wastewater volume : 4 doses /24 hrs. 17,5 gal. /cycle 3) Minimum dose volume - /bd j'�, a a 9'6 gal. /cycle 3 7H) DOSE CHAMBER IR 7 1) Minimum capacity required gal. P�a n. _ _ i,icunsc .:u:��QS Date:— 9' /S --98 l ■■■■■ ■■■■■■,�iv�w�, ■■■■■■■■■■nw WEN ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ Mro ■ ■ ■r ■ ■■ I■ �0�� I ■ IMMOMMI llGipiplu !i ■ ■MA ■ ■ ■ ■!k ■ ■ ■ ■�3'�1�■!.�■'"�. - ■■ IMMM ■■■■■.MEMO ■MMMM ■Our ■ ■ ■ ■M ■■Ir ■ ■■ I■■■■M■ ■ ■■RI /rNIMM■ ■M ■MUMM�!!lJ � MEN, IM MMMMMMENNrMM■ IMMMM ■III■■■ , � , W '. 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Cross Section Of A Mound System Using . - .F � Ft. A Bed For The Absorption Area G l Ft. A (o, 25 Ft. H Ft. Signed: g Ft. License Number: X 53 10 N �EEDEO K /'3• YFt. Date: - 5 - 9 COW C� ESQON�ENC� L Ft. � - - r E RR j 11).3 Ft. X lternat Position I_ Ft. D�(o Force Main W Ft. F 1 Observation Pipe �Q���O�' I I L- - -- -------- - - - - -- -------------- - - - - -- Force Main W ° - -� — - - ---- Distribution• P.O.W. Bed Of Pipe T.S. Aggregate Conditionally Observation AROVP Markers rrm i DEPARTMENT OF COMMERCE S nim SEE CORRESPONDENCE Plan View Of Mound Using A Bed For The Absorption Area k r i• Y in:. C.✓�r�.0y�' t� 133828 Perforaied Pipe Detoll j End View Enq Cap Per(orotId =� PVC Plp� '' si�O do e a ,�`.: `r . �•', Hotu l.oto.t�d`On 801 "� q k� ke,Egiioily $paced ,w , C F w; PV force Main• r A PVC .� s . Monlfotd. Pipe •�. ��� l N N Di�lrit!•I�ioA � . Position Of �1 Pipe force m ain LGO." HWO' Should Be , Ww Rex 1e End 'Cop ff rR End Cop Distribution Plpe Loyout ' oz Tt X Inches. Y 3 �O Inches Signed: Hole Diameter � InGh License Humber:, a z o 7 Lateral " _ �!/y Inc (es Manifold " 3 Date: k `� S — ' Inches Force M h u 3 Inch 3 # of holes /pipe 13 APP Invert El evatl on : of Laferal s'` �.� Ft, DEPARTMENT OF COMMERCE DIVISION OF SAFETY AND BUILDINGS , SEE CORRESPONDENCE Uq bs;t �y p Tro la PA&c or " PUMP CHAMBER CROSS SfETI01s AIJO� SPEtIfICAT10WS VCWT CAP y'C.Z. VENT ' ditional pipC W[ATHCR PROOF APPROVED LOCKING JUNCT10h1 OOX MAUWLC COVER yl t t t H w ►ROM OOOR� IL'JrIN. WINDOW OR FRCSN WACtN�N� (, AIR INTAKC 1 GRADC 1 'I� 1MIIJ. COUDuIT ♦_.... 'MW 'PROVIDE I - - - -- UJLC T AIRT16HT. SEAL 1 1 T 1 P.O.W. APPROVED JOIUT A ,l APP1t 0VtD ~J01WTS Con ep w1ca. PIPE Y 1 1 1 1 w /C.T. plpt CXTONDI 50 1 `.Q TOIL . ® � ID ' 1 11 ALMM DE LXTCUOlu6 3 . OUT e ONTO SOLID 101E /'� PARTMENT OF COMMERCE S 1 I DIVISION 4F SAFETY AND 13UILDIN. • •. • i ; ON C ILLCV q� 3 ft __� g3I/ �. SEE GORRESPONDEN�E PUMP 1'. Off COUCRfTC OLOCK • RISCR EXIT PEKni - fCD OWLV IF TAUK MAMUFACTU HAS SUCH APPROVAL 3"APNG �BAOO I NG °$1wre' SEPrIc E� pF%z fatiK SPCC-IFICATIOUS Dose - T ALIK MMJUFACTURER: �! a�l'l1.5 a 1�. IJUMOER OP GOSC3: PCR D" TANK 5IZC: GALLOWS DOSC VOLUME ' . I>ucLUD1NG eAClcrtow: °; LARA MAUUFACTURER:. S "! .r.• 6AlLONS MODEL WUMBER: d/ CAPACITIESt A: S /.S`.0 t wsAES•OR ..__ GALLOy3 SWITCH TUPC: 8 a a+A INCHES OR.' y(o PUMP MAIJUFACTURCR: ` �•� �. iNCHES OR 1 • b 'GA -L01J5 MODEL UUMDCR: $ 1.. 0 • INCHES OR I OA LLO1Jfi SWITCH TUPE: IJO�i PUMP AND ALARM ARC TO bC MIWIMUM OISCHARGC "RATE Gp/� INSTALLED ON SEPARATC CIRCUITS 'VERTICAL DIFFER[NCC .OETWCCU Pump OFF ANO pISTRibUT10N PIP C.. f ET. a f MIUMUM WCTWOKK . SUPPLU PRESSURE ..:..... .`_ f CET � C •l FEET OF FORCE MAIN X Al l . v � f � DILFR ICTIOW FACTOR. ♦ _& FEET • < TOTAL .DIJUAMIC HEAD = O FEET, IWTERUAL DI t01Jt. Or. T K. LENGTH - W - D H ILIQUID DEPTH r �i�d �V l�Y�lil SIBLE w . f ` ,t SEWAGE AND EFFLUENT PUMP . r� , , i�:, s:�: E 0311 z DISC. OOtJPFp0111 142 EP0311 1 HP 115 V EEElumt Pure 1/2 solids 1 156.801 112.10 1 A . Erbil � .r •::.,: Subm " MODE E ffluent:. EP0311 (Effluent :. Pump . METERS FEET SIZE'A" SOLIDS � 25 . !•gat, :� ... 4 _ . � 0 0 0 4 e 12 18 20 24 28 32 38 40 GPM t • 0 2.5 5.0 7.5 m'/h. CAPACITY r_ • .G . Performance Curve tj tu a MMAS ►uT ;.•'y:. — — — — #01)EL 3885 a ZE' /a" Solids r �r 7:r, � » to �I • 6 wcom -• Io wro t �: 20 Mto — �,. 0 7 10 » oo 40 to 60 to M to 1 00 tto 120 arm o._......- ....__ 10 ao Awlk CAPACITY . ' �,: r ; .. • LIST DISC. ;r •'; �'r..' . ' CCt1R,E0311J. 142 HPA311L 1/3 HP 115 V tAV H 3%4' solids x91 .55 729.75 " r '�,��;,��.. 1•.ti. O;x,Tt+'EOSIIM 142 M31 IM 1/3 VP 115 V t'bd H 3%4" solids 491.55 729.75' :+, •'• .,, omwvr 142 WE05'1`1H 1/2 tip 115 V ltigh H 314" .oblids 704.25 ! " 00MT0712H 142 UT071i1i 3/4 HP 230. V High 111. 3/4" polids $43.65 565.25 fx �' f . ' • • ••SFE FCE.i.CHIw. PAGE FM PERFChI•SAIJCE AM SPE=T1CATICR3- PAGE 07u DATE 10/88 Calf 30 wscons�n !?eaar0Mnt of anousay, SOIL A N G SITE EV A 1_1J ATION REPORT Page L at 1 t �usar ana'Puman Ro"Oons �vsan at sat*w s sixongs in accord with ILNR 83.05, Wis. Adm. Cade CCUNry ST. CROIX Attach complete site plan on paper not less than 8 12 x 11 inches in size. Plan must include, but PAFiCcLLO. notiimRed to vertical and horizontal reference point (SM), direction and % of slope, scale or dimensioned. north arrow. and location and distance to nearest road. gEVIEWED BY OATE APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION a PROPERTY OWNER: PROPERTY LOCATION E 1/2S 24T 28 NR 20 W TOM RUEMMELE &JOHN AND BARB RU G�•LOT 114W 1 /2S 19T 29 NR 19 �(w)W PROPER ( OWNERS MAILING AOORESS L0 0 .flit . S NAME OR CSM s 260 COITNTY ROAD F TROY VILLAGE CITY , STATE 71P CODE PHONE NUMBER CITY ILLAGE OWN HUDSON NEAREST ROAD 54016 h 1 ) - TROY li:�r JwJFs �M 2NdA1� rw Cort action Use (X j Residential / Number of bedrooms 4 (j Addition to existing building °tom (� Putriic or commercial desaibe 600 Recommended design lading bed. gpolft — trertch. gpolft derived d* flow _ gpd Absorption area required OD bed. ft trench. It Maximum design loading rate D ¢ bed, gpditt L- s trercf. gPdM Recommended infiltration surface elevations) BY DESIGNER R (as referred to site plan benchmark) Aftdotal design I site asiderati E No:� 411 / 3 Parent material / 4Dil�l/ T� Flood plain elevation, if applicable N/A It S a Suitable for system CONVeMONAt. MOUND INGROUNO PRESSURE ATGRAOE SYSTeA IN FILL HING TANK I ®'S ❑ U I❑ S ICU 1 o S 9U 1 as 1s U I OLD Q S W11 SOIL DESCRIPTION REPORT Depth 10amolor inantC M0190 I I Structure I Roots GPO /ft wm� F orizon in Mun Texture Consistence I ftrwy Pear, IT Bonng Al 0 -12 110YR 4/2 1 - -- I sil 1 2msbk (mfr i gw 13vf 10.5 0.6 557 A2 12 - 21110YR 4/3 - -- l sil 2msbk mfr 1 w 12vf 10.5 0.6 B1 121-36 110 4 I - -- 12mabk mfr Ls 1 1yf 1 0.4 Ground elev. B2 I36 -44 I7.5YR 5/6 I - -- sl 1 lcsbk I mfr 1 w llvf 10.4 0.5 9 39.9 it. 1 1 I Oebtn to B 3 144 1 7.5YR 4/6 1 - -- linnung R 55 - 58 110YR 8/6 I - -- Ilmst I - -- - -- �-° --- --- '° 13C55 Remarks: - Boring air E 10YR 4/3 - -- sil 2msbk mfr cs . 3vf- 0.5;0.6 58 7 OYR'4 /4 - -- sicl 2mabk mfr aw 2vf 0.4 0.5 2 7 -47 .SYR 4/6 - -- sl lcsbk mfr cs lvf .4 '0.5 Ground 5,(.. s e 9 3 elev. 6 3 7- - -- NP tL R 53 -56 10YR 8/6 - -- lmst I - -- - -- -- --- --- I 0epm to I am," lacsrx 1 1 1 Nrtctt� —Awe Print JAMES a FUNS Phonic (715) 425 -7831 OGUEN ENGINEERING CO.. 113 WEST WALNUT ST, RIVER FALLS, WI 54022 Sgri>ttire: Oanc CST Numbr: f CSTM03988 PRoPERTY OWNS SOIL OESCFIIPTION REPORT Page )1 3 , •- PARC.t.1.1.0. IHanzoni 0 ePtn 1 Dominant C3ior Mots1es Texture Structure 1 calststence easray I Room I GP 0/11' i Munsel1 Cu.'IL(.2.1rit.Col& I ' Gr. Sz. Sh. I I Bea Trenal i Bonng 4 A 10-22 1-10YR 3/3 --- 1 sil 2msh k I mfr. I gw I 3vf-1 0.5 0.6 108 ...., ::.:, 31 22-39 110YR 4/4 1 --- 1 sil 2msbk mfr Icw 2f 1 0.50.6 B2 39-6517.5YR 4/4 flf: 5YR 5/8 Isl lmsbk Imfr lcw lvf ---:--- Gmund V. R 65-67 10YR 8/3 * --- lmst --- --- --- --- --- 917 7 It. I I I 00016 liming 1 • I 39" 1 i I Remarks: Boring 4 1 . : . 1 "1,0....a.1..i - Ground . It. Copt!)to liming WM - Remarks: Boring # 1 1 Ground elev. It. Depth to . 1 limning tamor 1 Remarks: Bonng # I M"..74.. q 4 , t....:1 Ground elev. Oep to . limning Remarks: •- . . .. PAGE-I�bF 3 I SITE PLAN -. SCALE: 1" = 40' i Go T �a pF � •, /,eov Pi�E U T /L /TY �ftS.Ei�i�ir/T GoT r ti NOTES: PROVIDE MINIMUM 0�',VSAND BETWEEN BOTTOM OF BED AND FUdSTING GROUND. MOUND TO BE A MINIMUM OF: - 25' FROM DWELLING; 50' FROM WELL; "5' FROM LOT,JaNE. i OGDEN ENGINEERING CO. . FILKINS. CSTM0398 Civil Engineers & land Surveyors JAM / 113"W. Walnut St. River Falls. WI 54022 DATE: �l f7 (715) 423.7631 r wluonsm q* of indust SOIL AND SITE EVALUATION RE P O R T Page t of 3_ L. tlor, i A, " FIMauons piv�swl+of s auddings in accord with I L.HR 83.05. Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 , 1/1 i if ze. Plan must include. but . CRO not limited to vertical and horizontal reference rtt on fad of slope. scale of PA A 0 RCEL I.O. fe dimensioned, north arrow, and location and to now road.: APPLICANT INFORMATION —PLEAS NT AIJUaI oATI REVIEWED BY DATE PROPERTY OWNER: 3 1997 -a . LOT 11 4W 1 I 2S 24T 28 NR 20 w /2S 19T 29 NR 19 4«IW TOM RUEMMELE &JOHN AND B U RU PROPERTY OWNER':S MAILING ADDRESS -''� COUNTY rr �t9C!( rt SUBO. NAME OR CSM 8 260 COUNTY ROAD F 'i� ZONING 40 TROY VILLAGE qTY STATE ZIP CODE P E NUMBER CITY IL AGE PgOWN NEAREST ROAD� HUDSON W 54016 � / — 6 TROY jjEi "Mn2t!%/AV New Construction use [ Residential / Number of bedrooms 4 ( ] Addition to existing building j� Replacement ( Public or commercial describe Code derived daily flow 600 9Pd Recommended design loading rate 0 bed. 9WR -- trench. gpdrtt Absorption area required SOD bed. ft —<O-O trench. ft Maximum design loading rate 9 — , - -t - - - bed. gpd/lt L-s trettch. 9poltt Recommended infilVation surface elevations) BY DESIGNER It (as referred to site plan benchmark) Additional design / sit# consider ati E No 5 ew 1 3 Parent material ��� %LL API"- Te Flood plain elevation. if applicable N/A ft S - Suitable for system CONIIENTIONAI. MOUND INd9R0UN0 PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U Unsuitable for system 1 ❑ s I`�'u I ®' O u I ❑ s at I❑ s IK u 0 s ®U 1 I] s wu SOIL DESCRIPTION REPORT Horizon) Depth I Dominant Color Texture Structure ICor> mence Bouxtry Roots GPO /ft in. Munsell h. I Rod iT rmmryh Boring X Al 0 -12 11 OYR 4 / 2 1 - -- I sit 1 2msbk 1 mfr i gw 3vf ! 0.5 0.6 557 A2 12 - 21110YR 4/3 - -- lsil 2msbk mfr gw 12vf 10.5 0.6 Ground B1 121— 6 I10Y 4 — 1 llvf eiev. B2 36 - 44 17.5YR 5/6 1 - -- sl llcsbk mfr 1 w 11vf 10.4 0.5 93 1 1 1 I Oeot to B3 44- 17 - -- limiting R 1 55-58 �10YR 8/6 1 - -- Ilmst I - -- - - - - -- - -- - -- - -- factor Remarks: Boring l# -10 0YR 4/3 - -- sil 2msbk mfr cs 3vf- 0.5 558° 1 0 -27 10YR 4/4 - -- sicl 2mabk mfr aw 2vf 0.4 :0.5 2 7 -47 -5YR 4/6 - -- sl 11csbk mfr cs 11vf .4 0.5 Ground elev. 3 L 7-53 - -- NP NP 9 R 53 - 10YR 8/6 - -- lmst - -- - -- - -- - -- - -- - -- Depth to limiting factor 4711 1 t�amaJtfs: N Pmd jAmES 0. RAws P � (715) 425 -71331 OGDEN ENGINEERING CO., 113 WEST WALNUT ST- RIVER FALLS. WI 54022 e O CSTM03988 PROPERTY OWNER SOIL DESCRIPTION REPORT raye _.lt__j_ PARCEL t.0.A t l Depth Dominant Color monies ' Texture Structure Consistence .� Roots, GPOitt4 Horizon in Munsell Cu.Sz.Cont Color Gr. Sz. Sh. Bea Trenrn Boring # I --- I gw I3vf-nt 0.5 0.6 MZUM ,, A 0-22 1 OYR 3/3 s it 2ms_bk mfr 108 B1 22-39 1OYR 4/4 --- sil 2msbk mfr cw 2f 0.5-0.6 B2 39-65 7.5YR 4/4 flf 5YR 5/8 sl Ilmsbk mfr cw Ilvf --- --- Ground elev. R 65-67 10YR 8/3 --- lms t --- --- --- --- ___ ___ )17 7ft. Depth to limiting factor 39" Remarks: Bonng # 1 , i Ground I I — elev. ft. Depth to firming factor Remarks: Boring # I II 1 1 1 1.. Ground I Nev. ft. I I Depth to limiting I factor I I I Remarks: Bonng # :arse_•.... 'i Ground elev. ft Depth to limiting factor 1 I Ill , . Remarks: S8O-8330(R.O514Z �,• I`- PAGE 3 OF 3 SITE PLAN SCALE: 1" = 40' c/—,!:�:' T c� G o r -v-e� ss8 $�NCi//1/Rfzt.; Toro El /o ' w ry �eF&r %D J a 3Y h NOTES: PROVIDE MINIMUM OF 1' SAND BETWEEN BOTTOM OF BED AND EXISTING GROUND. MOUND TO BE A MINIMUM OF: 25' FROM DWELLING; 50' FROM WELL; 5' FROM LOT LINE. OGDEN ENGINEERING CO. JAMEEtb. FILKINS, CSTM03988 Civil Engineers & Land Surveyors ¢ / / 7 113 Vi'. Walnut St. River Falls, WI 54022 DATE: / (715) 425 -7631 Wa3consin Cecarfmnnt of Indust SOIL AND SITE EVALUATION REPORT Page .L at I_ LaWr and Human Rolanons oivision of Safrrry 3 Buildings in accord with ILHR 83.05. Wis. Adm. Code COUN iY Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must include, but ST. CROIX riot limited to vertical and horizontal reference point (BM), and % of slope, scale or PARCEL I.O. dimensioned, north arrow, and location and distance, td ?ire*a road. APPLICANT INFORMATION- PLEASE PRJNT,� `L-L INFORMATI,N REVIEWED BY DATE PROPERTY OWNER: ` P. ERTY LOCATION E 1/2S 24T 28 NR 20 W TOM RUEMMELE &JOHN AND B 1-PX • LOT I /4W 1/2S 19T 29 NR 19 -640 W PROPERTY OWNER•:S MAILING ADDRESS `_ T -stem 0 SU80. NAME OR CSM 8 260 COUNTY ROAD F ± sr c, 1 `4 TROY VILLAGE CITY, STATE ZIP CoOE ILLAGE OWN NEAREST ROAD HUDSON WISCONSIN 54016 1 Oy Sy' A JdF3 3t!dAV New Cortsmx:tion Use pC ) Residential / Nil 2VS'P ( )Addition to existing Ixliitng I) Replaciament ( ) Public or commeraa Code derived daily n 600 gpd Recommended design loading rate f- ¢ bed. gpolft trench, gpdM Absorption area required 4OV bed. f1 —< trench, ft Maximum design loading rate bed, gWft 9 's irerx:h. gpoltt Recommended infiltration surface elevation(s) BY DESIGNER ft (as referred to site plan benchmark) Additional design / sl considerati Parent matenal Rood plain elevation, if ap*2ble N/A It S Suitable for System CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U Unsuitable for system I Q S I'C' I f'S 0 U ❑ S ff U I❑ S MU I 0 S E U 1 S mot, SOIL DESCRIPTION REPORT I Depth Dominant Color Mottles Structure GPO /ft Honzon in Mun Texture l Consistence l &unday Roots sort IT 13onng i I I Al 0 -12 I lOYR 4/2 I - -- sil 2msbk 1 mfr I gw 3vf ; 0.5 0.6 =557 A2 12 - 21 110 YR 4/3 - -- I sil Zmsbk mfr w 2vf 10.5 0.6 Ground B1 121 -36 I l0Y 4 I_ 10. elev. B2 1 36-44 17.5YR 5/6 I - -- sl Ilcsbk mfr I w lvf 10.4 0.5 93 ft. I I Depth to B3 44— - -- limiting R 55 -58 �10YR 8/6 - -- I lmst 1 - -- - -- - -- - -- - -- - -- factor Remarks: Boring # .� A D-10 10YR 4/3 - -- sil 2msbk mfr cs 3vf— 0.5':0.6 -558> 1 10 -27 10YR 4/4 - -- sicl 2mabk mfr aw 2vf 0.4 0.5 Ground 2 7 -47 7.5YR 4/6 - -- sl llcsbk mfr cs lvf 0.4 0.5 011111W. 3 7— - -- NP NP 9 R 53 -56 lOYR 8/6 - -- lmst - -- - -- - -- - -- - -- ( - -- Depth to li rrntittg t�arrtat�: Ns'"��ssfe Pmt JAMES D. FIU(INS (715) 425 -7631 OGDEN ENGINEERING CO., 113 WEST WALNUT ST.. RIVER FALLS, WI 54022 Sgnattue: _ Oats: CST Numbw. ��1� Q 7 C STMO3988 PFIOP,FR"OW"ER SOIL OESC'RIPTION REPORT Page i at 3_ PARCEL I.O. r f Own (Dominant Color I Mottles (Texture I s tructure ICons�encelf3aroatY ( Roots GP Oiftl- Horizon in Munsell au. Sz. Cont. Color Gr. Sz. Sh. II eea Trenat Boring # A 0 - 22 I10YR 3/3 I - -- I si I gw 0.5 0.6 3vf — rd €108`.; <' B1 22 -39 10YR 4/4 - -- sil 2msbk mfr Cw 2 B2 39 -65 7.5YR 4/4 If If 5YR 5/8 sl lmsbk (mfr Cw lvf - -- - -- Ground elev. R 65 -67 10YR 8/3 I - -- lmst - -- I - -- __— 9 7 ft. Oepth to limiting t 39 Remarks: Boring # b I Ground elev. ft. 080 to liirnhng f actor Remarks: Boring # I I I Ground eiev. ft. Depth to limiting I I factor I Remarks: - Boring # Ground elev. ft Depth to limi" faCalx I Remarks: 38D�to(R.061�1 ` PAGE 3 OF 3 SITE PLAN Q - SCALE: 1 " = 40' Z-0 T Go T 4,!:� ,e sss /° wi�E o h� 0 GOT 39` a NOTES: PROVIDE MINIMUM OF 1' SAND BETWEEN BOTTOM OF BED AND EXISTING GROUND. MOUND TO BE A MINIMUM OF: 25' FROM DWELLING; 50' FROM WELL; 5' FROM LOT LINE. OGDEN ENGINEERING CO. JAM FILKINS, CSTM03988 Civil Engineers & Land Surveyors y7 113'W. Walnut St. River Falls. WI 54022 DATE: _ _ (715) 425 -7631 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer : f i' O wl ) ( M Mailing Address �a.� C� l (', P,� y' *r-, �(� T Q �' /fe j _5 Jam{ Property Address, (Verification required from Planning Department for new construction) City/State _.�Parcel Identification Number 0: f O - l p'�jg - og LEGAL DESCRIPTION Property Location L %4, %,, Sec. �� , T J6 N- R W, Town of Subdivision Lot # �. Certified Survey Map # , Volume . Page # _ Warranty Deed # 66q C � D 3 , Volume Page # Spec house A yes ❑ no Lot lines identifiable 34 yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeymanploniber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. 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 days a three year expiry 'on date. &�c 9 /x" / 7 7!r SIGNATURE OF APPLICANT 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 pr rty described above, by virtue of a warranty deed recorded in Register of Deeds Office. &L - I / &/ SIGNATURE OF APPLICANT 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 WARRANTY UEFA K 77s This Dud, made between bT (AM:; L !,. VA _ o11a 1. Rnlmnlsk d Hubw A gni + his wifeed Thug _ lWp1r IM1w $Hamm* Ad Mall 1. it`. -e._+. his: A _ , orlrmor. *MAX 2 7 199! and 0 4 3:15 li)Ilr Trov Develoelnant n -- -:a-- %VQ%6.. 41 IYMIrr d ti+eaoll J Grantee, Witneseth, That the said Ormwr, for a valuable cordideration np,..•wnerl.m,agtl.. wutsuollmnw �ooeeu oonvoya tc Grantee the following descrbed real awe in SL Croix Cnttnty At County. State of Wisconsin: /`' ( 111MNumber) Lots I through 45, Lots 47 through 65 am lots 66 through 70 of the Plat of Troy Village. 4: Croix County, Wisconsin and that Portion of ('A/t)nt g of tine Plat of Troy village described on Exhibit A attached betoto. and Outlote I and 3 to the Plat of Troy viliep, St. Croix County, Wisconsin ER A potnoa of the above dewibed pgrrp y_ ttolnemeeed ptopyq ottlr OreM�t lobo r, Rca11 tleh aed 9nbara A a.rllery (a) (e soli Togai w wiln all Od eblgnter the helsdteme u end app aaelfaleta thaellta balwA ft Amt ""Mti U1Y tha tiW is Fad, inddglible it tee Smog and Sw eW deer of Mea 1 c exempt easetnents, covenants, reurietioro 111d highway rights of way of record OW wnl warm end debw the acme. Dow this ZJ dal of /aAT ty (SEAL) ,'.+ (SEW) Thon11 9 ]�111..Bttsmosdt !I AUTN EWICATION ACKNOWLEDGMENT Sipawr te) lolml ?�;�_ — ..a Ba A R�mla 1a STATE OFWISCONS!N 1 )lllma[1. Rueeurle xwwlJma 1. 1, rna,yy t; rib authenticated this, of LC- Personally cane before me this day of • ` ! 9 the above named TIRE. MME, ATF BAR OF WISCONSIN gnot, eldmaed by 5706.06. Wis. Swe.) to me bum to be the pa um who eaeamt the fome�oing instrument and acknowladpe the are. THR IN4'fEtUMQM! W AS QRAf'T!� BY Hosmigiod A Cori. &C., Slnw.l a r Ad • 204_L2W IL PO Ho1r 12S Nun- L^ ion1c Notary Public_ County, wig, XWw"o efey be w1henftoW or akaow pnlb am we My commission is permanent. (If not. stoat: ex piratiwt chin. fHW III, h118 wbU�.el Developed roy Development Corporation . 12311 Central Avenue NE Maine, MN 55431 (612).757-7568 TROY BURNE V1 LL/ TOWN OF TROY, ST. CROIX COUNTY, WISCOP 57DSY.0; OU OUTLOT 3. 4 COMMON AREA — PARK 409706 S.F. 2082 9.406 ACRES 4.780 a 285.38' 376.07' 02. n 4,� 5321 S.F. N 45 1.223 AC 68287 S.F. I 1.568 AC r; m of coo 6, 49343 S.F. to 6 4 1.133 AC (1 i- i s4 Ac • . SCALE: 1 " = 30 ?0n�6^ ry , ° � DATE: 9 -3 -97 e� 1 - 42 } .47' REVISED: 2 -16 -98 704 6 sF. 48259 .1 1.617 AC m 48 49 v d 1.108 68676 S.F. 71 14 S .F* ' 1.577 AC 1.642 AC , a —�1 mss GOLF COURSE ,� a 32 -- ass. i 3 44107 S r 39 } 291 AC F 1.01 1 3 A� °i• 5 9 S.F .5405 144170 SF.1 I 24 6 8 0. 0 ro I 1.24' 3.310 AC Q c. ' 287.83' 31 1 1 300 AC I ,9,+ ' .2 3� F. v> 45201 S.F. $" 1000 A 4 j• 4 9' I 'b4) 5 2 , I a 1.038 AC m 22 I 13 N 47106 S.I �� ' • v ` 273 2 240.00 4 738 SF. I 1 , 0 56197 1S.F. 1.081 AC I fn .m I i Q 1004 AC 5 1.290 AC a Jj , 35 ► • ' 4 I Y� is Z 44675 S F. 53 39F 0 „o� O 9.1 ' I I X 617080 S.F. 1.540 AC , ?• 0� Q 1.026 AC 1129 A iv7 1 I 30' 186. 48 •� 38 ' . /� N N 1 N 240 .00 5 .246 2.506 A AC 21 " 109141 S.F. /'•. '? 3S �! 1 Q 77.32' C k6824 S.F. 0 1 / h / 1.075 AC v 291 ?36. 1' k6h .. 1.3 3 • 22' �— , 46202 o S F. r J ^ 24 N 20 '$ 1.061 AC 54( 71 1 1 ' �' / m 158 S.F. .2• 005 AC Z p 45670 S F. 50 9 S. , , `O' 2 p �? "7 1.048 AC 6, ? 57 AC � / ? 53922 S.F, b, �j 1.238 AC �� / �g6 1 7 44 @ ' 51815 S.F. 54 58 S.F. 1.190 AC ryti, 27 ° o• �� 57 nc�� ......�.., w 53160 SX GOLF i COURSE fall f j 1.220 A EASEMENT FOR ? ° *s. 43721 IF. TEMPORARY X26 1.004 AV CUL -DE -SAC, R -80' � 53799 S.F 1.694 AC Z0 1 icy c FUTURE LOTS � SCALE IN FEET g h� � 704 ?e. } 0' 150' 300' 600' '+era', 028 AC 50.0 ' DOC. J384691 ? ;• b°' 9.406 ACRES 6 -- r" z 2 1 .- _ - - _ - - - - - - - - S 89.46'20" E S 89'46'20" E by 285.38' ; 20' 376.07' N 89.46' 20" W 502.3J' SW 1/4 OF THE 44 Wis. ryry� 24 , 28 ROW 53275 SF. n� ►� e (LOWER ST. CROIX 1.223 ACRES 45 RIVERWAY DISTRICT) J a z SSg ACRES w° ^,b w .j 1O C 16 c N �� ' •�q ¢ w •y `mo 49343 SF. 71513 S.F. 5 1.133 ACRES 1 C77 ° 1 1.642 A( RES R =80' S 8Y 2 ' 0 9' E 2 / ,, s 41 42 _ n _ 2 / J : 7 g o 08 $' g 3 E z 1.81 �SF. 686 In ,1064 ACRES 4 1.577 ACCtES ±� OUTLOT 84 ' s I ACRES N '00' oo" W : r� N 40 / 58 - o 71514 S.F. s' 1'� z� 2 11.69 ' Z 1.642 ACRES 292.19' z J ��� ,,/ 1� X0.245' 280.82' ' 3 5623 � F. 4410 cr9 h 1.291 ACRES 1.013 ACRES] ' 21 S 00 ' ' ~ S.F. _ 9 1 S e0•o0 0p. E 2 1 E 56619 S 40.00' ' 1.300 ACRES 114170 S.F. _ 1 1 c 3.3 0 ACRES, QI I I 87. 31 ry �« E 63 I ry I S ry �� 43560 S.F. 1 1 34 n 1.000 ACRES' i r 241.49 45201 S.F. 4d �• 1.038 ACRES n S ; Ig 0 a) r I 200 00" I ; 40 E g 43 SF. c^ 0 U T L O T Q� NI , , 23 $ 1 1.004 ACRES m Y Z, L O/ Z I _ 35 $g 30 44 II675 SF. $ No 'tn 239.1 X17, I v� Q ev ^ 53539 S.F. 1 111.026 ACRES c $ ' 3 r , ^ H 1.229 ACRES "i Q� ' b UW N e o0 / d 5 SF. y 06 in 3$' ... ti . 109 1 s r I c { / � . 24°.Op. w Q 1 1246 ACRES N g 8 0 6 Ad& T I' �� N N ^. 0 N q J _ N 89'00' 29" W �' u 46824 S.F. ' ,�'� Z 1.075 ACRES 00, N ► ; z c 353.34' i. S 1 2 9 1 J x'00. W u ^ 57187 SF. ?' v ° �' y 1.313 ACRES "t *'BB• s 6 �' ^ '- - ' f� bA 37 . J f� i/) % / 1 1 1 1 2 _ SF. =i �� , 43756 SF. �; 1 / , 1. 7 ACRES 4, Q� ' i/ /' u /1.005 ACRES �? i y' d' ry G 4f 1 ....J�, + ^~ N 28`00' 00" W 28 ° p'•. .w . 88.00' 1 V ) 1' 53922 S.F. i +9. FLy9 �^ 1.238 ACRE ; 4 ti �/ / �y +•....... <. N 89.43' 56" E ' - 7o.9z' SCALE: 1 - (TO RADUS POINT) S 62- ' W ,C� �t� 1 0 0 , 'i!T 9 � /25 , iuo 27 yI_ 54758 SF. y ,o .t 53160 SF., '� �, ti, 1.257 ACRES by SCALE IN f 1.220 ACF(E 1 EASEMENT FOR ? F,, � TEMPORARY CU - -DE -SAC. , � A� / S�.Ar + O' 75# 150' R -80' Ir 0 VA. 8 e V / 73799 S.F. There am no objections to this plat with rt 1.694 ACRES 9 1 Secs. 236.15. 236.16. 236.20 and 236.211 OUTLOT 9 ti Wis. Stats., and ch. Comm 85 of the Wis. 5 413.0 " w i �� , C as pro%ided by Sec. 236.12 (6). Wis N 07.53' 45" E Cert ified _. I J� 148.48 (TU R ' ' ADIUS POINT) n ■ o . ■ M n = \j :10 / �■ § i \ t � � O « z 7 { z 0 \ § / \ / % f $ q_ $ / } / J k / k E `- m _ ^ ° CD � ° m & g » ( 0 \ / \ \ § CO C) _ m o e i¥ / S- . m « M y E CL E 0\ $ § ® ^ 0 m ' & ƒ C . ) 7 \ \ ) $ $ \ � \ \ � - / ) CO \ 0 ° � \ » 0 0 0 { \ ' \�� ; \ \ \ E j j j ^ � / N) Q\ § c o o± @ E { . / ; m E . f a) m 2 - g-0 q J co } C C G u\ z e . � I § 0 \ o , Z & 7 a . CD \ : \ \ 3 . f / 7z7 \ < / ) ° m ; Cl) 2 k CD CD \ / z CL 0 \ $ § ƒ \ / cn K \ CL § CO z / z \ . o \ � \ i � ƒ , \ \ � \ 2 � \ � ' \ ' \ $ � w f / \ ON 8 E \ \ Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page i of __3_ i abor and Hurnan Relations liviSn of Safety &Buildings in accord with ILHR 83.05, Wis. Adm. Code OUNTY St. Croix Attach complete site plan on paper not less than 8 1/2 x 11 inch s.i size. Plan must include, but not limited to vertical and horizontal reference point (BM) r tio d ° slope, scale or ARCEL I.D. # dimensioned, north arrow, and location and distance tn5 ,,� 040- 1248 - - J RE EWE BY DA 7 APPLICANT INFORMATION- PLEASE PRINK IN ORt�FA N ; r PROPERTY OWNER: - PROM LOCATION Continental pey. Cor . Y - tf 0 . ' t, NW 1/4 SE 1/4,S24 T 28 N,R 20 gXor) W PROPERTY OWNER':S MAILING ADDRESS LOT BLOCK # SUBD. NAME OR CSM # ST C(317t 12301 Central AVe. NE. Suit na Troy Village CITY, STATE ZIP CODE P UM26%INpOF9G ' I ❑VILLAGE ®TOWN NEAREST ROAD Blaine, MN. 55434 (6 57 -7568 Troy St. Annes Parkway [x] New Construction Use [ x] Residential/ Number of be c, 4 [ ] Addition to existing building (] Replacement [ ] Public or commercial describe Code derived daily flow 600 g pd Recommended design loading rate • 4 bed, gpd /ft • trench, gpd /ft Absorption area required 500 bed, ft2 500 trench, ft Maximum design loading rate • 4 bed, gpd /ft trench, gpd/ft Recommended infiltration surface elevation(s) 10'$.60 ft (as referred to site plan benchmark) Additional design / site considerations system el. based on contour line of el. 106.60' Parent material limestone uplands Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDING ANK U = Unsuitable fors stem El S ® U 13S El ❑ S ®U ❑ S LJ U ❑ S l U ❑ S U SOIL DESCRIPTION REPORT Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounday Roots GPD /ft .................. in. Munsell Clu. Sz. Cont. Color Gr. Sz. Sh. Bed Tmnch ................. .................. ................. .................. ................. .................. 1 1 0 -10 10 r 3/3 non 10 -22 .4 .5 Ground 3 22 -31 10 r 4/4 none elev. 10 ft. 4 31 -36 7.5 r 4/6 n Depth to 5 36-50 1 limiting factor 36" Remarks: Boring # 1 0 -9 1 2 9 - 10 r 4/4 none sil lcsbk mfr aw If .4 .5 Ground 99 scl 2csbk mfr aw if .2 .3 elev. 1 4 26 -48 1 Depth to limiting factor 26" Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. Av . ew Ricbraond, WI 54017 Signature: - Date: 8 -10 -97 CST Number: m02298 t ~ � pROPEA?YOWNEfl�»ot1neotal Den. SOIL DESCRIPTION REPORT page 2 of 3 PARCEL iC\0 040-1248-00-0000 Depth Dominant Color Mottles ^ Structure GpDm2 Boring # Horizon Texture Consistence8oum�� Roots ''^ in. N1unoeU C]u�Sz�ConLCw|or (�r� Sz� Gh� Bed Thench l 0-11 10yr '3/3 none nil �� 2mobk mfz 9w 2f -5 '6 La3 II-21 lOyr 4/4 none sil 2mab-k nnfr 9w if .5 .8 Qm«»d 3 31-34 lOyr 4/4 none sirI lrqbk mfr 9e If '2 '1 elev. ' 105^8 ft. 4 34-41 7.5yr 4/3 none ecl 2oob« om,fr 9w ua .4 .5 Depth to 5 41-55 I0yr 7/6 Fractured Limestone oa np ug limiting factor 411, Remarks: Boring# l Boa Ground ---ft. - Depth to limiting factor Remarks: Boring # | Ground -- h. Depth to limiting factor Remarks: Boring# Ground okm. ' ft. Depth to limiting factorRemarks: 000*330n.05m2 U m r . STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 Continental Dev. Corp. New Richmond, Wt 54017 MPRSW 3254 NW4SE a S24- T28N -R20W town of Troy (715) 246$200 lot #40 -Troy Village N 1 =40' BM-= top of SW lot stake C el. 100' Alt. BM.= nail in Oak tree @ el. 104.70' r � l X40 f ��r 2� 3� aS . Gary L. Steel 8 -10 -97