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HomeMy WebLinkAbout040-1248-10-000 ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner Property Addr ss c 2,36 i Lin City /State A Sb!$ Legal Description: �r Lot � Block Subdivision/CSM # , StJ '/4 , t /4, Sec. !? , TQBN -RAW, Town of wo PIN # SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: l5 Tank manufacturer (i Size ST/PC/ n / 4M Setback from: House e Well P/L Pump manufacturer Model L-- Alarm location (HOLDING TAN Y Setbacks: Service ro Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM: rn alb Width S Type of system: Len 7 Number of Trenches Setback from: House � Well P/I,, S _ Vent to fresh air intake b&' ELEVATIONS Description of benchmark N°-� � ,,.,�'r` . w�. Elevation AM Description of alternate benchmark Elevation Building Sewer ST/HT Inlet •+ 95.1 L ST Outlet 95. PC Inlet PC Bottom -W, Header/Manifold Top of ST/PC Manhole Cover ! 0 t Distribution Lines (t) 4y, Bottom of System ( Final Grade Date of installation / a / Permit number 3RY7 d State plan number Plumber's signature License number AZO 537 Date Inspector < Complete plot plan or 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 Ja 57' -Z91 • ! . 1 ew` �s J • \ -94 7S INDICATE NORTH ARROW Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count Safety and Buildings Division INSPECTION REPORT ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). 324708 Permit Holder's Name: ❑ City ❑ Village Town of: State Plan ID No.: TROY DEVELOPMENT TROY CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: pp,a ,�' -- - 040 - 1248 -10 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY 5TAT10 BS HI FS ELEV. Ut 5f Septic h;cSP✓ /0 0 Benchm �L D� � r Dosing (O ©� 4 - Z 11 y�p 06• lOd Aerat' Bldg. Sewer - Holdin St/ Ht Inlet TANK SETBACK INFORMATION Ht autreT__ TANK TO P / L WELL BLDG. Air I to ntake ROAD Air Septic NA Dt Bottom Dosing ;41v� ' NA Header /Man. Aeration NA Dist. Pipe ID Holding Bot. System K . -14 PUMP/ SIPHON INFORMATION ` Final Grade Manufacturer Demand I'FCAUa ,S�Zlo /o G Model Number (,U 3 L GPM TDH Lift Friction Read b/ System .5 TDHJ Ft Forcemain Length 0 I Dia. 3" Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Len th i No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS -- I DIMENSION SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION Type O I ( � _ CHAMBER Mode Number: System: >� 7ZS 7 70 OR UNIT DISTRIBUTION SYSTEM Header / Mani old M Distribution Pipe(s) r r rr A Hole Size x Hole Spacing Vent To Air Intake I Length Dia. _� Length � Dia. Spacing � '/ / u 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.) ((q`isi l0•4;1 / —� L3 LOCATION: Troy 24.28.2 ,SE ..2-e ST. ANNES PARK Y - TROY VILLAGE 41 I � -�2 ( 1 , -+, -&,�) Z,? 2__ Ad4ess %S ac /A./A. Z ,P Z (a 2 Yz) C lfl C U St 1* d' 2e irk A� ��� /1/ �ortlCr Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. Safety and Buildings Division Vi sconsin SANITARY PERMIT APPLICATION 2 01 W. Washington Avenue In accord with ILHR 83.05, Wis. Adm. Code P O Box 7302 Department of Commerce Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County than 81/2 x 11 inches in size. S C r • See reverse side for instructions for completing this application State Sanitary Permit Numb 7D� Personal information you provide may be used for secondary purposes ❑ Check if revision to previous application IPrivacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATI N Prope wrier Name Property Location fb �Zr 5,,, 1/4 S 1/4, S T , N, R fib) W Property Ow er's Mailing Addre s Lot Number Block Number O NQ Ry, state Zip Code Phone Number Subdivision [tame or CSM N� ber 11. TYPE OF BUILDING: (check one) ❑ State Owned !t ge Nearest Road Public 1 or 2 Famil Dwellin ❑ Vll a - No. of bedrooms Town o f I11. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1❑ Apartment/ Condo n I O 1 0 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office / Factory 13 ❑ Other specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. New 2. ❑ Replacement 3. ❑ Replacement of 4 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 OrMound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 2 ❑ 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 (s q. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) �- Eleva ion Feet 37$` S_ , 4P Feet Ca aat VII. TANK in g allons Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con-Steel glass Plastic App New Existin structed Tanks Tanks t epticTanko nk I0r "es `�— ❑ ❑ ❑ ❑ ❑ ift Pump Tank /S ptwi ..ber 4 �.00 ® ❑ ❑ ❑ ❑ ❑ VIII. ffESTFONSIBILITYSTATEM ENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name nt) P m er's Sig atur : (No S mps) [ MP/MPRSW No.: Business Phone Number: mo a,s o s 3 7 7/57 Plumber Address (Street, City, State, Zi Code): l� c• � 0 C IX. COUNTY / DEPARTMENT USE ONLY [I Disapproved Sanitary Permit Fee (includesGroundwat ate Issued Issui A ntSignature(NoStamps) roved �g, urcharge Fee) �pp t [ - ]Owner Given Initial Adverse Determination fir X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: SBD- 6398 IRA 1/97) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber Safety and Buildings 2226 ROSE ST LACROSSE WI 54603 -1905 a � I scores Tommy G. Thompson, Governor Philip Edw. Albert, Acting Secretary Department of Commerce November 24, 1998 CUST ID No.273085 A7TN.• POWTS INSPECTOR CALVIN POWERS ZONING OFFICE POWERS EXCAVATING INC ST CROIX COUNTY 1969 185TH AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 11/24/2000 IdentificatonNume A w' Transaction ID No. 194734 Site ID No. 164182 SITE: Please refer, to Both --identifxca Site ID: 164182 above, in all correspondencei'' a eyn St Criox County, Town of Troy SWIA, SETA, S24, T28N, R20W Troy Development Corp. - lot 41 FOR: Description: Mound Object Type: POWT System Regulated Object ID No.: 437578 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(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 11/16/1998 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 6erard M. swim BALANCE DUE $ 0.00 POWTS Plan reviewer - Integrated Services (608)785-9348, Mon - Fri, 7:15 AM - 4:00 PM jswim @commerce.state.wi.us WiSMART'code: 7633 WORKSHEET - MOUND SYSTEM DESIGN � ofiy r 6 l PROBLEM: Design a mound system for a 3 ` The site characteristics are: Depth to gFount*zTLFr 7 i n Landslope _ J % e� eP Percolation rate Distance from dose chamber to distribution system _�Q� , ft • Elevation difference between Dump and distribution systern g ft. Step 1. WASTEWATER LOAD = � '�� gal - Step 2. SIZE THE ABSORPTION AREA A) Area required 1 Z � sq. ft. B) Bred or trench length (B) 5 3715 75 'ft. C) Bed or trench width (A) a 5 _, ft. ` �D) Trench spacing.(C) Wastewa'er load .24 (aal /f!: /day B = — ft• t re ri'E ems Step 3. MOUND HEIGHT A) Fill depth (D) al"KX -1k 7 ft. B) Fill depth (E) = D�+ � slope (Arts) � a � ft. 0 .-Cos h ,5 = a ,.25 T.S. � V�J. C) Bed or trench depth (F) Conditionally ,33 ft. oVE� 0) Cap and topsoil depth (G) _ P pR ENTOfCOMM ERCE � ft. p DEPAR AND B U'L•E ' DI ► 0 $A E) C and topsoil depth (H) `._ � i. -n _. �E C ! 0, 1�v , ,.S � ue. Step 4. MOUND LENGTH A) End slope (K) _ D E1+ F + H x 3 �-3i5 ft. , / �� 3 +1,5 X, B) Total mound h (L) = B + 2(K) z /d ? ft. Step 5. MOUND WIDTH A1) Upslope correction factor z A2) Upslope width (J) D + F + G)(3)(factor) ft. � oZ 1-43 /0 3 B1) Downslope correction factor B2) Downslope width (I) _ (E + F + G)(3)(factor) ft. C-1-3 /c la V � /y,�z Cl) Total mc,und width (W) for bed = J + A + I a`j�� roil -x 1 17= a7, ` 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 gal. /ft /4ay r B) Basal area required - wastewater flow natural soil infiltratjve cap c*t - 7 sq. ft. C1) Basal area available for bed for sloping sites = B x (A + I) = sq. ft. C2) Base are avail le for trench for sloping sites B W-- �J +A) = I� sq. ft. 7S 9. /+1 � t j Basal area available for trench or bed for level sit B x W sq. ft. S� 'n • _ _ ��atr r o o.,J x.10 mom" is x3 0 j' Step 7. DISTRIBUTION SYSTEM6)a I rte Mry .93 30 � A) � 7A) SIZE DISTRIBUTION SYSTEM 1) Hole size = in. 2) Hole spacing 9 in. 3) Distribution pipe length -37 in. 4) Distribution pipe diameter._ in. 5) Spacing between distribution pipes = '� , in. 6) Distance from sidewall to distribution pipe = 30 in. 1B) DISTRIBUTION PIPE DISCHARGE RATE ft. 1) Number of holes per pipe = _ i-9 2) Flow per pipe 0 GPM 7C) SIZE MANIFOLD 1) Manifold is central/ end 2) Manifold length a O ft. 3) Number of distribution lines a a 4) Manifold diameter = in. 7D) SIZE FORCE MAIN 1) Minimum dosing rate = 'yy GPM 2) Force main diame_ in. 3) Friction loss e ft. 7E) TOTAL, DYNAMIC HEAD 1) Vertical lift ft. 2) Friction loss :3 ft. �.og a 3) System head 2.5 ft. ft. T al dynamic head ` ' ft. :,ice:. 6<::�aoS37 T ro 7 a 3 a J �C_Q,l�r 1 � 1 4 V � .� 3► S S;3a 1 7F) PUMP SELECTION 1) Pump selected will discharge GPM at /3 ft. total dynamic head. 2) Pump model and manufacturer 7G) DOSE VOLUME 1) 10 times void volume of distribution lines = �$��� gal. /cycle 2) Daily wastewater volume : 4 doses /24 hrs. _ �la'S gal. /cycle 3) Minimum dose volume a '/S ° gal. /cycle 7H) DOSE CHAMBER 137•S 1) Minimum capacity required a �3 7 gal. jACunsu .:u: r) Pago Of Da Straw, Marsh Hay, Or Synthetic Covering A5 TM C34 Distribution Pipe Medium Sand % Slope Bed Of -,? —2 Force Main Plowed Aggregate • Layer .D a Ft Cross Section Of A Mound System Using, E Ft. A 'Bed For The Absorption AT60 F Ft. G 1. Ft. l: A Ft. H Ft. gned B Ft. cense Number: P. K 13 Ft. te: Ci L /Oca Ft. 1 /o./ Ft. Alternate Position 1 /1,7 Ft. of W o??,e Ft. Force Main --------------- j Observation Pipe--, Force Main Distribution. �ed Of Pipe Aggregate Observation Pipe Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area i4 I I ' Al I I � I i � I 1 i I I I i I 1 `D'taD ,6�D_'Gc� � -:+-_► .�fJ>r_`i$ . ! � . _ I __ I I I I —I - — _ — - - -- - - x-04 - �7 I i I I � i ; i I � I a 3 L Pago 7 19 Perforolod Pipe Deloll n ' End View End Cop Perforaled PVC Pipe 0�` o r e Holee Located On 8011orn, c Are Equally Spaced LoO Hol• ouT6 e. - Heil To End Cop o(Ilfib.uliOn Pipe Layout P 37 Ft. R -- S X — I U r Inche --��,� s Y Q Inches Signed: Flole Diameter Inch 1. License Uumber: _ � �� - Lateral " ln 0 ( :) Manifold ._3 Inches Date: — �� _ . _� S{ Force Main " 3 I11cIIij N of holes/pipe-/Z_ Invert Elevation of Laterals_ Ft. SEPTIC TANK S' PUMP CEAMBE CROSS SECTION AND SPECIFICATIONS P $ LL 77 �� � l 4 CI VENT PIPE 12" MIN. ABOVE GRA� 'V /r1t� `G1E TF ER WO0 t ' 25' FROM.DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE- WITH CONDUIT MANHOLE COVER FINISHED GRADE 4" CI RISER W/ PADLOCK 6 6" MIN. WARNING LABEL ABOVE G ADE �— 4" MIN. 18" IN. 6" MAX. INLET i WATER TIGHT SEALS GAS- LIA IGHT: 4 " BAFFLE EAL i � APPROVED CI PIPE : ALM JOINTS W/ CI i PIPE 3' ONTO SOLI - ON SOLID SOIL SOIL PUMP OFF ELEV . FT. OfF RISER EXIT PERMITTED ONLY IF.TANK MANUFACTURER HAS APPROVAL 3" APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE !/ TANK MANUFACTURER: NUMBER DOSES PER DAY: T TANK SIZES SEPTIC �,-� GAL. DOSE VOLUME INCLUDING DOSE GAL. FLOWBACK: �3g GAL. i ALARM MANUFACTURER: 5`f-�' ��ec -�' rIC CAPACITIES: A = INCHES = . GAL. MODEL NUMBER: Jot tt •-J SWITCH TYPE: B = 2 INCHES = 3 .2 GAL PUMP MANUFACTURER: (�„ ��� C = 3 INCHES = 138 GAL. MODEL NUMBER: 3 /l SWITCH TYPE: oQT D = ),7 INCHES = 9 GAL. REQUIRED DISCHARGE RATE _7 GPM PUMP 6 ALARM WIRING AS PER ILHR 16.23 WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE S FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . % * * 2.5 FEET + 60 FEET FORCEMAIN X l.ag FT /100 FT. FRICTION FACOR TOTAL DYNAMIC HEAD FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH �– ; WIDTH ; DIAMETER LIQUID DEPTH SIGNED: LICENSE NUMBER:a- : O Ss'- DATE: //, ryi r,S� 1/88 'rl S U E�Ft.UN' RUI'RS ,. t ' s! 1 ' • P.' c:!•f;r•;• ,, __ ILW 1D t70t1PM0311 142 M311 - 1/3 M 115 V EEflumt 1 2" solids �• , / Pt2TS2 / 256 80 172.10 t,; ,�}n :: Submersible li`r� t �s MODEL EP0311 Y Effluent: Pump. r � 1 t ~ � y �. �';�;s?;; METEFl SIZE W SOLIDS I If�:r 20 ti O 2 • 1. 0 ° 0 4 E 12 16 20 94 2a 32 30 40 GPM 0 2.5 S.0 7.5 ,,'/h CAPACITY r �`-���• Periormance 8 8 Curve NtnnE rtct � � 90 MODEL 3(105 a SIZE' /," Solids 1 }O ri Q WE 0n1_.. r 16 10 30 wt 0 x .'�. 0 [ .... .. .. _ _ _ '' .ti •. 0 10 20 00 ' 40 ' '60 0p ' 70 00 00 t00 110 • 120 orm e .__....._....._ - -� • _ - j t0 20 30 W1% CArACIT► !p,,'s — LIST DISC. " 00UNT 03111• 142 HE0311L 1/3 M 115 V L0q H 3/4' solids X91.55 329.3S ,• ' 0 tIt 142 WE0311M 1/3 Itp I15 V mod R 3%4" solids 491.55 329.35' +' Odlwwsoi1111 142 WE05'1'1H 1/2 1SP 115 V high N 3/4" s6lidn 704.25 '41.1.II'3 ' a. 1; 1F:k. •. h,��,• OJVR,E0712II 142 hT071214 3/4 IIP 230. V Illgh W. ]/4'• solids 843.65 565.2S PIGS FClt PF711ChPd%= AM SS'D'IFICATMIS, DATE 10%80 DWT 30 PAGE Dh • I ✓eNau 1101 it v1 "VI 11111tl(La 1 • { m.lslon of safety and Buildings SOIL AND SITE EVALUATION bureau of fitegrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code Page of 3 —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 Y. percent slope, scale or dimensions north arrow, and location and distance to nearest road. e \ X I r - Parcel I.D. # _ APPLICANT INFORMATION- Please print all information. Reviewed by Date. Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Pro erty Owner S�r Property Location �. C I U � Govt. Lot �� 1/45 . 1/4,S�.� T �$,N.R oZ..d .{Eev)W(' Property Owner's Mailing. Address Lot # Block# Subd. Name or CSM# 0 N w r`o Qt%r IN e Ci S to Zip Code Phone Number ❑ City Village Town Neatest Road .•. I 6J l,J 5 a 17 ( '71 )z - 1 3 a r ,_ . P New C onstruction Use: Residential / Number of bedrooms :_ 'Addition to existing building ❑ Replacement Ll Public or commercial - Describe: Code derived daily flow _ 00 gpd Recommended design loading rate 1-9—bed, gpd/ft �� 2 trench, ppd/tt Absorption area required � bed, ft s trench, ft :. Maximum design loading rate Z bed, gpd%t1 ji'2 trench, gpd/fl Recommended Infiltration surface elevation(s) ft (as referred to site plan benchmark) ` Additional design/site considerations Parent material n p �c A L� Flood plain elevation, if applicable S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U =" Unsuitable for system ❑ S U X S El U `❑ S U ❑ S U ❑S U 0 U. SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/tt2 In. Munsell Qu. Sz. Cont. Color. Texture Consistence Boundary Roots Gr. Sz. Sh. . , . Bed Trench , 0 -4 Io Y 3/3 s -MAI< F c 3 2 MA K mfr S f:rr G Ground AA l� O N e1 NP fL Depth to ? F• I ;; <,, ; limiting factor # , in. Remarks:* Q p Boring #: t 2 2.837 o ,- 3_ Q Ground elev. I I oln Depth to limiting factor n_ n f' �J Y.dl `/ __ff Remarks: � ('(�� Q h CO to rl ?fro cd 3 . 7 ii. ... :._ ... *... #:,.,_ alrt}q:; ; CST Name Please Print -._ .. ._ . �' b ) Signature Telephone No. Addr ess R rn a s C I(1 ��C o n nddr�s Date CST Number, —. C 3 I �b h �`�- i� ri t:Q 10-30-79 22� 3 " a k PROPERTY OWNER SOIL DESCRIPTION REPORT Page of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 r te& in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed .Trench s oil 0 s s l �r►s r� r C�J 2 ..S •, Ground 3 p elev. Depth to limiting W in. Remarks: � � o D ro ck <.n Own �,��.tj —�--- 4 13 Boring # Ground elev. i ft. I Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles T exture Structure Consistence Boundar Roots GPD/ft2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench .Boring # 13 Ground elev. ft. Depth to limiting factor in. Remarks: Boring # i i Ground r elev. tt. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) I ., I ` A N ff B Y D SIGN 1432 120 STRE , NEW RICHMOND, WISCONSIN - 71 - 246 -2454 Troy Burne Vill e PAGE 3 SW Y SE Y, SECT N 24 T 28 N, R 20 W TOWNSHIP TROY COUNTY St. Croix Wisconsin I gso � R3 ,38 1 G. Crt5 - 7y Q3 `1 i SCALE 1" =40' Tom Nelson BM I. Nail with ribbon in Birch tree 100' 227387 BM 2. Top of 2" iron pipe Nw corner 89.81 . Wiscor,alh Department of Commerce SOIL AND SITE EVALUATION Division,of Safety and Buildings Page of Bureau of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code County include, Attach complete site plan on paper not less than 8 1/2 x 1 i�c'ki�s+rt siie 'Pfan include, but not limited to: vertical and horizontal refer (BM rection and percent slope, scale or dimensions, north arrow, and an P� nearest ros)d. parcel I.D. # / APPLICANT INFORMATION - Please print all infor wtioml -„. Re ' ed b I Date Personal information you provide may be used for secondary purposes (Privc�r A4 Pro erty Owner t � C3t� Prol?6' ocation ?t�iA1GOFFK.`. q I 'vt. 1/4 �, 1/4,S � T � ,N,R o 0 E (ec) W QM 1 n C t, Property Owner's Mailing Address Block# Subd. Name or CSM# 1 0 l W. (©� �`.� T r QG.rfN E .- City n( S ate Zip Code Phone Number ❑City Village Town lej Road 6J LJ( u) ( 715 )Z -�32.0 New Construction Use: Residential / Number of bedrooms 4 Addition to existing building El Replacement Public or commercial - Describe: Code derived daily flow L U 0 gpd Recommended design loading rate A )_ bed, gpd /ft trench, gpd /ft Absorption area required 5 bed, ft SOO trench, ft Maximum design loading rate / - L bed, gpd /ft 1i 2 - trench, gpd /ft Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design /site considerations Parent material pC- t C7 y r M '_ c S a n & Flood plain elevation, if applicable 6N_ ft S = Suitable for system Conventional I Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ S U X S El U El U ❑ S XU ❑ S gu I ❑ S U Jc� SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench ............................ n S Q -4o 10 r 3 2 ms Ground 3 n f Q NP �elev.. a,�� 'v ft• Depth to limiting factor 4 40 in. 10 Remarks: 0 t e. Boring # 2 837 toy -- 5 ► Dm Q a ro Ground elev. 01 ft Depth to limiting _ factor .37 in. Remarks: Q't�l ®C e h O rn ✓1 t �� 3 CST Name (Please Print) Signature Telephone No Address Date CST Number 3 a S+ VhAAno 1 /0 - 30 -79 29-2 38-7 f � ENVIgONME HL BY DESIGN 1432 120th ST , NEW RICHMOND, WISCONSIN 71 - 246 -2454 Troy Burne Vill a Lo PAGE 3 SW SE Y, SECT N 24 T 28 N, R 20 W TOWNSHIP TROY COUNTY St. Croix Wisconsin g s.ol s, GLCre Q3 1 SCALE 1" =40' Tom Nelson BM 1. Nail with ribbon in Birch tree 100' 227387 BM 2. Top of 2" iron pipe Nw corner 89.81 Wisco 0epartrnant of IndusuY. SOIL AND SITE EVALUATION REPORT Page 1 of I_ "Labor and Humans olauoons Oiv,s,on of Safety ng in accord with ILHR 83.05. Wis. Adm. Cade COUNTY Attach complete site plan on paper not less than 8 1/2 x es�� Plan must include, but . CROIX not limited to vertical and horizontal reference point 3* on and Vie, slope, scale or PA PARCEL I.Q. Of dimensioned, north arrow, and location and dista 1 areal road. � REVIEWED BY DATE APPLICANT INFORMATION— PLEASE P N> /►LL IN O � P ,'Avlf--n TION.` n A PROPERTY DINNER: .— A Phi LOcAnON E 1/2S 24T 28 NR 20 W TOM RUEMMELE & JOHN AND BARB , LOT t /�W 1 / 2S 19T 29 NR 19 4(40 W PROPF_ATY OWNEA':S MAILING ADDRESS COU O /,� OW& * SU80. NAME OA CSM 8 260 COUNTY ROAD F `t 20 N/ MTh' ffl TROY VILLAGE CITY, STATE ZIP CODE NUM9 CF ILLAGE CrOWN 7s- AR ST �� HUDSON W 54016 1 OY r Odes ' t42k%JAv M New COMIrtl ion use [X J Residential Number of 4 ( [ Addition to existing building L ] Replacement [ I Public or commeraal desa'be Code derived daily flow 600 gpd Recommended design loading rate D ¢ bed. gpd/tt Vim• gpdff� Absorption area required d0 bed. ft < N trench, 9 Maximum design loading rate D, s bed. gpd/ft D• G trench, gpdM Recommended infiltration surface elevations) BY DESIGNER It (as referred to site plan benchmark) Additional design I site considerab 5469 A10 T Parent matenal TILL m Flood plain elevation, if applicable N/A ft S - Suitable for System CONVENTIONAL MOUND IN- GROUND PRESSURE AT4RAD SYSTeA IN FILL HOLDING TANK U- Unsuitable for system I Q S 1'U I ffs C2 C3 l9r I ❑ S I [� S �'U I (] S ,WU SOIL DESCRIPTION REPORT 1 ;:;:;70ep; Dominant Color Mollies Structure GPO /ft Texture l Conssterica l eounday l RioOtsl in. Munsell Du. Sz. C ont. Color Gr. Sz. Sh. I Bed ITM" Baring # A —15 OYR 3/3 - -- Isil 2msbk Imfr Ica L vf >109 B1 5 -33 OYR 4/4 - -- sil 2msbk mfr I 0.vf 0.5 '0.6 B2 �3 -54 .5YR 5/4 If2f 2.5YR 4/6 sl kcsbk mfr Lcw Lvf - -- - -- Ground eiev. B3 4 -64 .5YR 4/4 I c3d 5YR 5/8 sc Ilmsbk Li T I - -- --- 94 tt. R 4 -68 10YR 8/3 - -- lmst I - -- - -- - -- - -- I - -- - -- Depth to limiting facto I I Remarks: Boring # A 0 -22 1OYR 3/3 - -- sil 1 3vf 0.5� '176tl B1 22 -43 lOYR 4/4 imam - -- sil 2msbk 0.6 B2 43 -55 7.5YR 5/6 flf 5YR 5/8 sl lcsbk mfr CS l - -- - -- Gmund elev. R 5 -58 10YR 8/3 - -- lmst - -- - -- - -- _—_ 94 It Depth to limiting la= I I Remarks: FNa Print JAMES D. FILKWS Ph0°e (715) 425.7831 OGDEN ENGINEERING CO., 113 WEST WALNUT ST., RIVER FALLS, WI 54022 � - Oates �d CST Nu mber. CSTA1103988 PROPENTYOWNEIi SOIL 0ESCRIPTION REPORT Page of �- PAHctt.I.D. s Oeptn Dominant Color Mottles Structure Roots GPO1tt� Boring # [ Honzon i in. Munsell Du. Sz Cont. Color (Texture I Gr. Sz. Sh. (Corisst rice BovXW I Bec ITrerc I I A 0 -7 10YR 3/2 - -- sil 2f of -mI0.5 b.6 1 - -- B1 7 -22 10YR 4/2 I sil 2msbk mfr w 2f -eo Grotuid B2 22 - 10YR 5/6 - -- sil 2msbk mfr cs if 0.5 13.6 9 ft. B3 28 -46 7.5YR 4/6 I - -- scl lcsbk I I if 0.2 0.3 Otto R 46 -50 I10YR 8/3 - -- - -- WON t 46 — Remarks: Bonng # Ground eW. ft. Depot to lirmang factor Remarks: Boring # Ground efev. It. Depth to limiting factor Remarks: Boring # Ground eiw. ft Depth to lirtn6ng fart T Remarkv. SBC -8S:i 0.06MM PAGE 3OF3 SITE PLAN G o T ¢3 � �,uC��r,�C,,e ?off mi � .• G o T ¢/ 0 0 SCALE: 1" = 40' D © T ¢o 0 f 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. Y • OGDEN ENGINEERING CO. JAME ILKINS, CSTM03988 Civil Engineers & Land Surveyors DATE: l°ZQ7 / 113 W. Walnut 425 River - 76315 WI 54022 Wiscorcsu+ Deparwwrit of induSVY. SOIL AND SITE EV ALUATION REPORT Page I of I_ Labor and Human Relations Division atSatety S 8wtdings in accord with ILHR 83.05, Wis. Adm. Cade COU Attach complete site plan on paper not less than 8 1 rthe ig Plan must include, but ST. CROIX not limited to vertical and horizontal reference poi di ecuon anti 9� slope, scale or PARCEL I.D. as dimensioned, north arrow, and location and diet nearr estAad. APPLICANT INFORMATION— PLEASE P ALL YN _ #10NC REVIEWED BY OATS PROPERTY OWNER: QP� ERTY LOCATION E 1 / 2S 24T 28 NR 20 W , 3 TOM RUEMMELE & JOHN AND B `R EMME �997 LOT 14 W 1 /2S 19T 29 NR 191H► PROPERTY OWNER':S MAULING AOORESS Cpu I Steel( 0 SUBO, NAME OR CSM 8 260 COUNTY ROAD F , ZONING TROY VILLAGE CITY, STATE ZIP CODE UMBER CITY ILLAGE QrOWN NEAR� ROA HUDSON W 54016 ►+rlrlt3 (yQ New Construction Use [X ] Residential / Number of bedrooms 4 [ ] Addition to existing building Replacement [ J Public or commercial describe Code derived daily n 600 gpd Recommended design loading rate _ bed, gpd/tt — trench, gpdM Absorption area required d0 bed. ft _ � W trench. ft Maximum design loading rate D, S bed. 9Pd/ft G trench. gpd/tt Recommended infiltration suftw elevations) BY DESIGNER ft (as referred to -site plan benchmark) Additional design / site considerad SeGC n/a re ' Poo/ d: 3 Patent matenal L �.�i s T/L L m t3 Flood plain elevation, if applicable N/A ft S . Suitable for System CON1 emoNAL MOUNO IN-GROUND PRESSURE AT -GRAD SYSTEU IN FU HOLDING TAW TA U =Unsuitable for system I 13 S ZU I zS ❑ U ❑ S 11U I ❑ S � Q S ICU I ❑ S 2!PU SOIL DESCRIPTION REPORT Horizon Depth Dominant Color Mom Texture Structure Consistence f�ourtciefy Roots GPD /ft in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. Bed ITrginctt Boring # A —15 �OYR 3/3 I — Isil 2msbk Imfr Acs 6 vf 0 `109 `'' B1 5 -33 OYR 4/4 - -- Isil 2msbk mfr I w pvf 0.5 '0.6 B2 3 -54 p.5YR 5/4 If2f 2.5YR 4/6 I sl 2csbk mfr IC Lvf I - -- Ground elev. B3 4 -64 .5YR 4/4 c3d 5YR 5/8 sc Ilmsbk L fi T s 1 1 yf I-__ - -- 94 ft. R 4 -68 10YR 8/3 - -- Ilmst - -- I - -- Depth to limiting factor Remarks: Boring # A 0 -22 10YR 3/3 - -- I Isil ' 1 2msbk I mfr r. T.7 1 3vf 1 0.5'0 176v B1 1 22-43 1 10YR 4 / 4 - -- s it Zmsbk mfr t1w 1 7.qyf n q:0.6 B2 1 43-55 7.5YR 5/6 flf 5YR 5/8 sl lcsbk mfr Ground - -- - -- ew. R 5 -58 10YR 8/3 - -- lmst - -- - -- - -- —__ 94 ft Depth to linting fa= I Remarks: Name — ifew Print jAmES 0. mK1NS (715) 425 -7631 OGDEN�ENNGINEERING CO., 113 WEST WALNUT ST., RIVER FALLS, WI 54022 Dam CST 11jnit:er: Q7 CSTM03988 PtaOPERT'LOwNEfi SOIL DESCRIPTION REPORT Page ? of 3 PARCEL I.0. r Depth (Dom Munsell Du. Sz. Cont. Color inantColor I Mottles Structure Roots GPOirtGPO/ft, T B # Honzonl ;n. Texture I Gr. Sz. Sh. I �I � I Bee ITFK= -ri A 0 -7 10YR 3/2 - -- sil 2f k of —m1 0.5 b.6 - -- B1 7 -22 10YR 4/2 sil 2msbk mfr w 2f —eo Ground B2 22 -28 10YR 5/6 I - -- sil 2msbk mfr cs if 1 0.5 D.6 9 MN. B3 28 -46 7.5YR 4/6 I - -- scl lcsbk I if 1 0.2 :0.3 NO to R 46 - 110YR 8/3 - -- ilmst - -- u�9 t actor 46 1 ' Remarks: Boring # Ground elev. ft. 080 to liftng factor Remarks: Boring # Ground elev. ft Oeptn to limiting tartar Remarks: Bonng # Ground ew. ft Depth to lino" FaClOr I Remarks: SBOas.'t01R.0�! ' PAGE 3OF3 SITE PLAN G oT ¢3 ,B�vC .�Mi��! 70,o mi , •, 9103.7 N 0 D SCALE: 1 " = 40' -p a 0 Z © T ¢� ° 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. 1�� / e A t U " — _ OGDEN ENGINEERING CO. JAME ILKINS, CSTM03988 Civil Engineers & Land Surveyors 113 W. Walnut St. River Falls, WI 54022 DATE: �/A - / (715) 425 -7631 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer 1 1 roli &) e C5 Mailing Address 1 a 3 iz ( a h fi?M �553a Property Address A (V required from Planning Department for new construction) City /State 6 LM Parcel Identification Number LEGAL DESCRIPTION Property Location KJ V., '/4, Sec. T_,MN -R �D W, Town of O Subdivision V i ' l Lot # _ 4 1 Certified Survey Map # . Volume . Page # _ Warranty Deed # 6 �5 q Q �R .3 , Volume 1 Page # .25 Spec house yes O no Lot lines identifiable N yes O no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature fail= 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, journeymanpl} mber, 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 fuL' 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 SL Croix County Zoning Office within 30 days of the three year expiration date. Mt� - S. 11 , 2igj 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 p perry described above, by virtue of a warranty deed recorded in Register of Deeds Office. 6 -5 � (�67 // / al 'j d 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 ofbce a copy of the certified survey map if reference is made in the warranty deed WAAMAMV Darn aL : ti • Tbb oudaitieb u .i.�• Y • • �• bldtroM Si= {.•u Straaosala ar bl.n e_ - -- - - u--+� 1Mr11N111M *MAX 2 T Ivor ma Gtsatsr. A 3 :13 m N o wN !" Wlhu Tbst the ftw ormwr. 6r d, • *All coltddaatioa �.••�w.sa.aw.+istr. +usweaauw „�� eoaveYs to (iranlea dr folbwlt>s dpp,�ad coral arcs is qtr O��,T' Canny, slam or 1WWAMID: ..eH wea`tladeutrr.bsf) Lots I though 43. Lots +T though 65 ad Lft &i We%% TO of ds plat of Troy VIIM&L s: Ctoi: Cast'. Vieonsin and that portion of OIAW t of the Plat of Troy Vlllaje A 10 m fthlba A attached bet and dalots 1 WA J to the Plat of Thy Vitllm SL Cmk emwr. wbeemb A Pmm of dx above Nlubd p po qp _j bMINW /A/rtl� a<h GeMmn, loAa 1. lt.aa7rte ra Mrs A larrY (*) (and AEI �e � as �aa1l.Ntwaoaoap ianwls 6skasrap .wrwc 1111 rb. rw : Md, i+a�•auble I/ fw �M � Mrallat a[aaY•aaAi�an •swap . "Mmut. oOY MO& I''dMictlono and k*bway roe a(my of s cm aM wIII wawaa Jaw ddud OW ./ p•IN11wa �.J day of OVAL) AKbnAJkmmdi • A.1h y � AUTHOMCATION ACiNOWLAMMIM SiaeauMa) STATE Or WISCONSIN 'fMs�e f. In•�ei� .r NJd L lr��� has wids t aWIlaallCtlad thla Of I 9! ` Cowey .. + Parsmtally caste babe. Ise this _ . day of 4 oppmop — W-- • y the above named ANNA It- bw TI1 V � ATB HAI OF WISCONSIN % tf,.t. .obsnad by "Kok WIL Sw to me Imams M be the Person tabo aeaosd dee �g� 61shamatt aced adneo�rlsgitbe efw. TIM Oo7R A111WWAS ORAL: M AT _ D. am MAJ111111111116 W MIA • Nowy PML- CaeMy. wis. aWras art N arbt•reead •t It.IY «« Ny caanisaiop is pstrmeent. (lf aataw eet/frWoO dslk amimmer.l - M14I• rawyatw •�•1ir+0uawraaaa.wr�larw+rgaa� '_- 1'S*I LOCATED IN THE NW 1/4 OF THE NW 1/4, THE NE 1/4 O THE NE 1/4 OF THE SW 1/4, THE SE 1/4 OF THE SW 1/4 NE 1/4 OF THE NE 1/4, THE SE 1/4 OF THE NE 1/4, TH THE SE 1/4, THE SW 1/4 OF THE SE 1/4, OF SECTION 2 ' P ART_OF JOT 10 �� PACE_ 1287, S 1 ,' U N P LA_TTED_ LANDS ` ` I JSJ 76• ' �i N 89 t5" E 943.06' �ti � 372.37• 1 570.6 1 11 I AC E s .'� OUTLOT 3 PAG 1287 8. � DOC. Jt381691 � I 409706 S.F. 46 tid >,rS 9.406 ACRES 208233 S 4.780 ACF ? z , - - S 89 20~ E SW 1/4 OF THE 0 285.3E' S 89.46' 20" E NE 1 /4 OF SEC. ; 20• 376.07• ^ N 89.46'20" w 5 24, T28N, R20W 44 tib (LOWER ST. CROIX 53275 S.F. ;1g' RIVERWAY DISTRICT) 1.223 ACRES . !* 45 CT) e : a J79 N 2 68287 S.F. �•y�e �' �►' - " ' 568 ACRES N 49343 SF Q / 1.133 ACRES 47 Z S 1 C77 A 71513 SF. Q / X06 /p �0• / 1 1.642 ACRES 11 f ° R =80' 1 / 2• • s 4,1 �- 42 3.4 09" E z 7041 S.F ^ 48259 SF.' + ACRES a 108 ACT 8 8 48 t 'a I J 49 3m ST. gig U* 00 . 00~ w 2I $ ,1064 ACRES 778 ACRES 14 4' �: n — - _ _ OUTLO . 71514 SF. S 1.642 ACRES 1 � - 16-I ? j� 21149 \ 84�pp. � _w 2 92.19 • -Cde •40.24 " E 2eo.as „- 33 - � 32 cJ V j r' v " - - - - - - ^ 56237 S.F. 44107 sF. '► 1 1.291 ACRES 1.013 ACRES / w I c _ 3 ' y pOt E 44 � �._ ,39 58819 S F. ST. '� 28 �" E s • I I I rl'. / 3 1300 ACRES .310 ACRES 0 f s� 31 _ a 34 43560 S.F. 1 �� j • s ' ,� I 43201 S.F. 0 1.000 ACRESIj 241-49- E 1.038 ACRES „v e 80•pp. I 1 s NI: 2p _ :3 S 2 4� E 8 /` 8 ' 22 Nn OUTLOT J W. �, $ 1 I 43738 S.F. o 8 1.004 ACRES 111446375 5 sF. g N 30 „ N �o gyp 3 1 1.026 ACRES o "- SJ539 S.F. 1 I 2 9. 1 . W a S p ^ y 1.229 ACRES i v Q. �52. E "� / x A- ^' 7 , 238 o 7t - 4 - 24p W �- ! $4287 SF. ^ $ N 89.00. w / �... .Y 36 °p' y t1.246 4e ACRES orb Z 353.34' • u 46824 S � :: I 4/ 1.075 ACRES ^ '' Z' 1 29 a� N 57 S 7 7 � S - %37 S.F. 1. 7 ACRES �, •'� S ,' i �i r,AO 44 � N 28.00.00" w 1 y d" ti p , /' N i 3005 �S • �; 88.00' 4 \ ,t -- -2v .n N /. •.._ ^ e� =�