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042-1023-10-000
04Z- /6Z3-- /O— tjc,rrG.-_ State of Wisconsin Scott Walker,Governor DEPARTMENT OF NATURAL RESOURCES Cathy Stepp,Secretary 101 S.Webster Street Box 7921 Telephone 608-266-2621 Madison WI 53707-7921 FAX 608-267-3579 WIStRESOURCES TTY Access via relay-711 DEPT RECEIVED September 5,2014 i Ci 2014 Sp 10) No. S-2014-0485 Mr.John Schmitt ST.CROIX COUNTY Wastewater System Designer ONIMUNrrY DEVELOPMENT 606 150th Avenue Somerset,WI 54025 Sub: Holding Tank Installation To Serve Vehicle/Equipment Garage For Matt Herink-- Roberts,WI Dear Mr. Schmitt: I have received and reviewed your recent transmittal of completed WDNR form 3400-185 in reference to your proposal for installation of a new 2,500 gallon wastewater holding tank to serve the vehicle/equipment storage garage for Mr. Matt Herink located at 1092 120th Street, Roberts,WI. According to y our transmittal,the proposed holding tank will be used to store non-domestic wastewater,and the stored wastewater will be hauled by Marko Septic Service to the Red Wing, MN municipal wastewater treatment facility for ultimate treatment/disposal. Based on this review,the proposed holding tank installation is acceptable to the Department of Natural Resources. As part of this acceptance, please also review and discuss the conditions of approval as outlined on page 3 of WDNR form 3400-185 with the owner prior to installation I startup of the proposed holding tank. If any questions concerning this acceptance notice, please contact Steve Smith,WDNR Madison office, 608/266-7580. Sincerely, Stephen J. S Ith, P.E. Wastewater Section Bureau of Water Quality Cc: Mr. Matt Herink -- owner, 1092 120th St., Roberts,WI 54023 --� Mr. Kevin Grabau-- Admin., St. Croix County Zoning Dept., 1101 Carmichael Rd., Hudson,WI 54016 Pete Skorseth -- Baldwin Service Center dnr.wi.gov wisconsin.gov Naturally WISCONSIN Pr nted on Roo ycle d Paper c m o N ti O E9 FL o ~ � M C N N h j X C co - N N N y w y w b N t 3 O y ' O a C y a O E c. m cc a0 v o o�ao a a�irn . LUN y N E 'SS a O O U �. E L Ot EE O dU € y 0) y. Ca — 'Um y E y ° cv L - 9 c, � o €cg 3 m °coaca�iaio o y c C z C C NZY t `E C-0 tL Q U 1 d D a N O@ c �+ 0 C 3€ N -O y y a FO m rn U j, N Q7 E a C C N M 0. m y C 0. U O M CL Li co w Z = O Z O rn z a m I °- o z l U o 0 ut Z c z U) F- r tT N E v m co , N Of 7 N y •N a N C co � Q 0 Z m Z O p N Z y � C C_ R > m � H (0 a to +�. U C 0 M G G a - y co w E N v� m t� 2 3 • v l�l +U i 5 a a Z Al R aaa IL y N O ZZ m V o Z N a N O E 1 c m C U CL L N O azcn o N ►Z' 04 O O I O H E CL Q a C d L M t0 0 Co C Y to w OU r .O . � C N .d. Q N C N � rx V ) F_I N N C 0 y CQ m U U ed C ��t a L: a. • a m � d E c c .Ti A vat 1 , U h } DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BOX 7969 BUREAU OF PLUMBING MADI��JN, WI 53707 WCONVENTIONAL 1:1 ALTERNATIVE State Plan I.D. Number (If assigned) ❑ Holding Tank ❑ In- Ground Pressure ❑ Mound L 3 -d' NAME OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: John Herink R. R. 1, Roberts, WI BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.: NE NE, Section 9, T29N — R18W, Town of Warren Name of Plumber: MP /MPRSW No 77� t _ - _ Cro Sani tary Permit Number: Cal Powers 1563 ix 54925 SEPTIC TANK /HOLDING TANK: MANUFACTURER. LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: DYES ❑NO ❑YES ❑NO BEDDING: VENT DIA.: VENT MATL. HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: JAIR VENTTO FRESH ALARM -. FEET FROM LINE: INLET: ❑YES ❑NO ❑YES 1:1 NO I NEAREST DOSING CHAMBER: MANUFACTURER. BEDDING: LIQUID CAPACITY PUMP MODEL. PUMP /SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑YES ❑NO ❑YES FIND DYES ❑NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER 'OF PROPERTY WELL. J BU I ILDING I (DIFFERENCE BETWEEN FEET FROM LINE AIR INLET: PUMP ON AND OFF) ❑YES El NO DEAREST SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing LENGTH DIAMETER MATERIAL AND MARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: WIDTH: I LENGTH. NO. OF DISTR. PIPE SPACING. COVER J INSIDE DIA.. #PITS. LIQUID � toft�ENeff TRENCHES. MATERIAL: PIT DEPTH: D#M1ENSIONS GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR NUMBER' OF PROPERTY WELL BUILDING: VENT TO FRESH BELOW PIPES ABOVE COVER. ELEV. INLET ELEV. END. PIPE Sfr. FEET FROM LINE: AIR INLET: NEAREST MOUND SYSTEM: Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. DYES ONO SOIL COVER I TEXTURE PERMANENT MARKERS OBSERVATION WELLS ❑YES ❑NO El YES NO DEPTH OVER TRENCH /BED DEPTH OVER TRENCH /BED DEPTH OF TOPSOIL SODDED. SEEDED. MULCHED. CENTER. EDGES. ❑YES El NO DYES ONO ❑YES 1:1 NO PRESSURIZED DISTRIBUTION SYSTEM: -,I B 1 1 . 11 1 : WIDTH: LENGTH. TRENCHES: LATERAL SPACING: GRAVEL DEPTH BELOW PIPE FILL DEPTH ABOVE COVER: Ei1 IlEl i NISi , MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING . ELEV.. ELEV.. DIA.. ELEV.. PIPES: DIA.: C71TR4B1�1'i'�11 HOLE SIZE HOLE SPACING. DRILLED CORRECTLY. COVER MATERIAL. VERTICAL LIFT CORRESPONDS TO APPROVED i a1 F RNAT8i !, PLANS: ❑YES El NO DYES ❑NO COMMENTS. PERMANENT MARKERS: OBSERVATION WELLS: NUB O(F PROPERTY WELL: BUILDING. FEE,►" FR gO.M,° LINE: DYES 1:1 NO [:]YES ❑NO NEAREST Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE: TITLE. DILHR SBD 6710 (R. 01/82) unsconsln APPLICATION FOR SANITARY PERMIT L DIL HR � C e (PLB 67) UNIFORM SANITARY PERMIT # OEPRRTTErIT OF y+ IrIOUSTR 0, LRBOR SMUTRrIRELRT10r75 (� 9112S — Attach complete plans in accord with s. H 63.05, Wis. Adm. Code for the system, on paper not less than 8' /2x 11 inches in size. —See reverse side for instructions for completing this application. PLEASE PRINT PROP TY OWNER MAID ADDR IS PR PER Y L CATION CRY: V I L- L- -A•f; E: 1/4 1/4, S C , T' , N, R (or TOWN OF: LOT NUMBER BLOC I SUBIDIV1SION N E NEAREST ROAD, LAKE OR LANDMARK STATE PLAN I.D. NUMBER i TYPE OF BUILDING OR USE SERVED 1 or 2 Family Number of Bedrooms. ' ❑ Public (Specify): THIS PERMIT IS FOR A: ❑ tem ink R eplacemen t ❑ Repair Replacement Soil Absorption System ❑ Revision ❑ Privy LJ Alternate bystem ❑ Reconnection ❑ Petition for Modification IF THIS IS A CONVENTIONAL SYSTEM COMPLETE THIS BLOCK. X Seepage Bed ❑ Seepage Trench ❑ Seepage Pit ❑ Holding Tank EJ System -In -Fill ❑ In- Ground Pressure ❑ Vault Privy ❑ Pit Privy ❑ Existing, For Which A Previous Permit Is On File, Permit # issued ❑ An Existing System That Has Been Inspected And Is Compliant As Far As Soil Conditions. Total #of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity Lift Pump Tank /Siphon Chamber Holding Tank capacity Manufacturer: IF THIS IS AN ALTERNATIVE SYSTEM COMPLETE THIS BLOCK: ❑ Mound ❑ In Ground Pressure Total *of Prefab. Site Steel Fiberglass Plastic Gallons Tanks Concrete Constructed Septic Tank Capacity F ft Pump /Siphon Chamber anufacturer: PERCOLATION RATE ABSORPTION AREA ABSORPTION AREA WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square- Feet): E9 Private 1:1 Joint ❑Public I, the undersigned, hereby assume responsibility for installation of th'a pl ivate sewage system shown on the attached plans. Na of Plumber (Pr t): Sig tur MP /MPRSW No.: Phone Number: Plumb is Address: Name of Des* ner COUNTY /DEPARTMENT USE ONLY Signature of Issuing Agent: Fee: Date: ❑ Disapproved dw _ El Owner Given Initial f✓y 6 x274 Approved Adverse Determination Reason for Disapproval: Alternate course(s) of Action Available: DILHR -SBD -6398 (R. 5/82) DISTRIBUTION: Original to County, One Copy To; Bureau of Plumbing, Owner, Plumber APPLICATION FOR SANITARY PERMIT S T C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by.owner /contractor,( "spec house "), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property JQL(� Location of Property _'4 _J/2_ Section , Tj N - R W i Township Mailing Address Pjf�� i Subdivision Name Lot Number Previous Owner of Property Total Size of Parcel Date Parcel t4as Created Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume and Page Number as recorded with the Register of Deeds INCLU WITH THIS A ONE O TH FOLLOW 1. Warranty Deed 2. Land Contract 3. Other recordings filed with the Register of Deeds Office In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the the Certified Survey Map shall also be required. — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — PROPERTY O CERTIFICA 1 (We.) eeAtic � y that att statements on .thus 4ohm rice tAue to the best o6 my (o uh) knowledge; that I (we) am (cute) the owners (a) o4 the pnopeAty deg cubed in -thin inAonmation 6otm, by vi tue ob a walvcanty deed neconded in the 066ice o� the Pffl]O.tu ROn.iA n.( 1)00r1A nA nnI Nn ';) JaZ i 9 - awd that T (WOI • , �" �1 fie, #'ij Q�.y 1L � x t.6'F • iB h r + . 2 }.s t• �,,; . i f,. ", M , i�i. �x r�t l "L j xi'..t1,�.{�' - ' � I � '. , ./} 1. •1 .. 5 [j m ;� i s air R W r has and �ixaii'f, 1 ' � �*Q� ����f� � • as ,:2 .. 7 >I,l„ � t i,• MR an i►arra6tf to ohit a d r.' HeriiNk' d AOr�bht ��er�ti�c; husband a>sil a 4i 'o, W t1, aa, i if "One 16oi�.ar aid co Either va able tie`ira on' the ollowi� eiact o# - land hd St Croix f 'oda` j►, t ti of 1 lsoosi : Qrthw . ` at . e�� Quarter' oi`, t]x Nor+t�8a:lt,,Qnarter l�� of ��$��; the s duth- east, Quarter of the,Northwe �Q>fartbr'(98f of W ) the Iasi Half,of P: Northeast Quarter of Northwest Quarter 13jef, NE* of NWk) ;-..aad the Northea Quarter of-Northeast Quarter NEof,NEJ)i-.all;lotated in Section Nine ( �) Tevneh ;'went, -Nine (29 North, of-Range Ei teen . r1$0,West,'exceptinx the following described ,T tract: ra t of land ire th6ftrtheitst Quarter or morzn Nz; of NE ) . of said Section.Nine (q)j (q)j described as follows: Beginning on the North line of 4 said NE4 of NE 630 feet .WtlsterlT-og -the Northeast corner thereof; t hence Westerly.,along said.line on an assumed bearing of North $5 20 ' West, 511.17 feet; thence South 5 15' 30" West 209.07 feet; thence South 35 7f East, feet; thence North 5 l8' 1 East, 211 feet, more or less, to the point of beginning.., containing 2.46 acres, more or less. FEE EX � This conveyance is pursuant to a land contract between the parties, dated March 31, 1969 and recorded April 27, 1972 inl 133 of Records on pages 310 do 311, Document No 309$96 Edi ERS ORRICE' �^ ST. CROIX CO., WIS. AEd(!§ OFFICE ST. CROIX CO., WIS. Reed for Record this_?JLtb_ ' Reed for Record this.AUb. day df__$AP_fA!L day 19, --- P �--- A., M. ___$sue_ _At_, M. trii . of er vibe yn 40ttntoo Wituat, the said grantor S gjeteunto set e r d tat. 21st day of September ., t 73. ` nod and Sealed in Presence of '�A Sed) kx; Minnesota eaa a alL�Maivalts, R nm a e� OAF• Personally came btlore me, ,� day of September , A. D. 1 #73 the above named Daniel D. Wo>+niak avid Anxel�T�, Woaniak, husband and wife H U) _ H - y r S T C 105 r y _ H SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z d y OWNER /BUYER a � ROUTE /BOX NUMBER Number l E ZIP CITY /STAT '�,,X y�` �,J' PROPERTY LOCATION: , ', Section , T� N, R _W, Town of Lde"l St. Croix County, Subdivision / Lot number. Improper use'and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County h the requirement that of 1980 q accepted this program in August , wit owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on -site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to H three year expiration. o I /WE, the undersigned, have read the above requirements and agree U , to maintain the private sewage disposal system in accordance with H the standards set forth, herein, as set by the Wisconsin Depart - 'b ment of Natural Resources. Certification form must be completed and returned to the St. Croix County 'o •ng Office within 30 days of the three year expiration date. �( SIC f DATE St. Croix County Zoning Office P.O. Box 98• Hammond, WI 54015 715- 796 -2239 or 715 -425 -8363 Sign, date and return to above address. DEPARTMENT OF REPORT ON SOIL BORINGS AND . SAFETY & BUILDINGS INDUSTRY, DIVISION LABOR AND. PERCOLATION_ TESTS (115) MADISON WI 537069 HUMAN RELATIONS (H63.09(1) & Chapter 145.045) LOCATION:, SECTION: T j p p W TOWNSHIP/MUPNCIPALITY: 'LOT N .:BLK. O. SUBDIVI ION NAME: AL �/4,1/ Cji /'�'!jl/R,I T��'(or)n i UI//�X >T , 1✓./r- j✓`- ,r.: COUNTY: O,fJNE 'S/BUY/E.R'S NtME: MAILI(VG ADDRES : i Q)7-7- (6)/7 — /0 W/0 /1-4...- /lie .1 / -en .-ii-lr".5 //di J USE DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIFyL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: Residence -- 7 ❑New ElReplace ,1 , RATING:S=Site suitable for system U=Site unsuitable for system /a.A- �j/ _Li.. i'< f C 1t-/f �,/' I,- CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL HOLDING TANK:RECOMMENDED SYSTEM:(9ptional) 7STU ❑S ❑U .' SLIU ❑S dU ❑S XU -, . If Percolation Tests are NOT required DESIGN RATE: _ If any portion of the tested area is in the / under s.H63.09(5)(b),indicate: , Y Floodplain, indicate Floodplain elevation: �/�/ 0 C f• PROFILE DESCRIPTIONS BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS,COLOR, TEXTURE, AND DEPTH NUMBER DEPTH It4", OBSERVED EST.HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.) B- /- 1 L /,`j (i., _ ' 7l % ,<SA,/�1..s-•,�,8, ,�: - k rl ,) ,0,,,,:u,ok,,em,L. j S'=r, l B- ,G'x,t'.,A..l5 7- ,.�,RiiL� 6. ? ; 7 Ras/(1 7/R,.'/s B 8 g 7, 8 A)64, _!'%-(/R% l/,, /-,,2,5-sJs./.-3,:L3.Z%?1ali,5'S,‘tS'1sj.5:G-‘,,78&K:-0.5' B- ,-. - A) 6).i,s • B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. PERIQD 1 PERIOD 2 PERIOD 3 PER INCH P-.) 1.-':? Afti,t)..; /.5( _7(i.,? . - P- . P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori zontal and vertical elevation reference points and show their location on the plot plan. Show her lace elevation at all borings and the direction and percent of land slope. ¢ ' SYSTEM ELEVATION we - , J ,. 1.411H44,1 itv.i 'a, ' ,,,j4-- 4 ._..L.,i4,/4. 1,..J:2"/ .1, ,_1_, Y } E itr. i i I E �J t7 E - /�l /r ( )y' i I ( i i 1 I 1 in.«...„....r- gym. .-_ ... __ a 7 � � ---—.- 4, 1 f al I 1 t FE i �� �__ i N I , i 1 "'-�— d ,U 1 TO 4 ! t t t i d j 1 I { t 7 tt i I 1 ...., I t ! k f _I , i i A_ ±Lft I,the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code,and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME,-(print): TESTS WERE COMPLET DON: (-- .,/d/1 :1,4, °s i ZI , 6- - -8s ADDR CERTIFICATION NUMBER: PHONE NUMBER(optional): i 11 3 ficAJ it/>76:„J.6. Gtii- „S Vic?/7 S--- --3i 7/__-22&-J5-i3'S CS S UFIE r DISTRIBUTION: Original and one copy to Local Authority,Property Owner and Soil Tester. -D*---- DILHR-SBD-6395 (R.02/82) —OVER — PAGE OF T r n Fnch Air I0101c And Obcervallon Pipe Approved Vent Cap Minlmam 12" Abov T Fr�I Grad• 20- 42" Above pipe _ 4" Cost Iron To Final Groao VON PIP* Marnh Hay Or Syalh.lic Covering win 2" Aggraool• Over PIPa OI�IrIDullon PIP$ 0 0 -- Too 6` A9greg Benso1D P ipe Pertardlod Pipe 94ior I — CowpliAg Ter minating At bottom 01 Syclam P ru�o�e p 1'In�.' 9ri%ci< �IeJ•�� I on SOIL FILL DISTR PIPE APPROVED $yNTHETIC COVER """'MATER141- OR 9" OF STRAW 2u � A�GR� GA TE --�'� ° OR MARSH HAY OF E�-EV. OF �J FEAT FEET, 12 AGGREGATE o8 �� �• { DISTRIf3'JTIr.DM PIPE TO BE AT LEAST _ WCHES BELOW ORIGIIJAL GRADE AQU AT LEAST20 IIJCHES BUT L10 MORE THAIQ 42 IIJCHES BELOW FlUAL GRADE /'MAXIMUM DkerH OF EXC/WATIOW FR OM OKIGNAL 6KADF- WILL BE _ 1� IM NUt"UM QEFT'h of EXCAVATION FKoM OR44IaAL Ca RAPE WILL BE INCHES SIGIJED: 'i LIGEIJSE .,UUMBER: DAT E :- a -- -�- -_- -- - -� . _ �l - -, — — — .; n � .., _ __ _ � , —� __ - � _ __— - — .t � , __ _ -� '' . .- �,_- . � �, _. J ;.> -- �,� : � ; - ,, - - --� �� - / :� - -; �� .. __� _� � � -- -- rr � � v / �- - / _ , - - - -- - - - -- -- � ,� / - J - ��f _. �� �---- --�-� -� '- � 1 - - ;- --r- -- _� �: _ � � ��� -- - � , 1 - �� �J,: � - � � -- - - � -- _ , � :; — � � -- ����� � �� I _ _ -- �! � _ . - - �- �a-� —� ;- - -- .� l i _ . , i � - - -- -- 0 X 0)0 \ r , n ■ & m z § \\ /\ j \ k ~ ° - 0 /� /co c ƒ Q C > ® E E a o 8 E ; g g cc © m / C y � .. \ \ ° CD o N) CD ' W \ \ / ) ) i § E c co > ƒ r! c _ \ 0 0 0 \ rr . § k R I Co.) § C.0) i ( > \ S c o § ` s k i CD ■ � ® -u c / � � & ; C5= . B s § § E . CD ° � �. .ice ƒ C ® e . / U) k k / : / z E P R 0 . .. m § o Z CL G A \ $ 7 E G) { . o =E£C'W =w> 7 7 \f§E@(\ o, {f ■ § \02k - "/ 5 . ID - ; E :3 0, \ dia$I ®fA o n\ -0) :3 ; n . - Eo_� - =a E,� 88 &£� Z R;@�I /�k k � 0 0 ID 0 M- E § j m - -*3 C cr £'IJ \S ; \03 N) :3 w _ @ I m a) qb \) �<�� \ 0 k . § \ � C)� . �\ Parcel #: 042 - 1023 -10 -100 06/06/2005 03:39 PM PAGE 1 OF 1 Alt. Parcel #: 09.29.18.129A -10 042 - TOWN OF WARREN Current X', ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): ' = Current Owner MATHEW A & ERICA J HERINK ' HERINK, MATHEW A & ERICA J 1092 120TH ST ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): " = Primary Type Dist # Description ' 1092 120TH ST SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 3.074 Plat: 0740 -CSM 13/3526 SEC 9 T29N R18W PT NE NE BEING LOT 1 CSM Block/Condo Bldg: LOT 1 13/3526 3.074AC Tract(s): (Sec- Twn -Rng 401/4 1601/4) 09- 29N -18W Notes: Parcel History: Date Doc # Vol /Page Type 12/31/1998 594887 1392/107 WD 07/23/1997 914/301 07/23/1997 434/180 2005 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/11/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.074 42,700 273,000 315,700 NO Totals for 2005: General Property 3.074 42,700 273,000 315,700 Woodland 0.000 0 0 Totals for 2004: General Property 3.074 42,700 273,000 315,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 n to p 3 - 0 n o o d _1 � c o, o � co v � • d CD o S D7 Cn O O j N N N ICI CD CD CD � O D w S O Cb j 1 C= Db O 3 w co �1 c cn CD O N a s 0 n co `�. O O O to 3 a = c rn O m _ CD F ;o CL z CO 0 QI clan m too c 0 000 � °� �• CD CA m a ' cr v v W y 0 C (D r, y 0 = 3 — a N .. _z y N z °_ za)z 0 D o. O v CD U) y CD m C G N CD W CD O. a 3 _ z CD O O fb c A z 0 n a z3 7 z —I co A eD m N 0 z CL 0 %� z m Cb v Cl) y F o m D am m m L CD 3 m m n m o F. ° ? F m s= w �� �z<D : . O c , CL NN O z o CA CD C y 0 0 7..= O C O N CD S•� O&Sra= N 'o 3 x• = = n C) C CD O N 0 9 .; O Cl N Cfl CD N o N U f O= 3 y d n O M y RL �m� i Ol = 0 N CD L1 O'' CD O O..+ O a A I 0 8 _. _ o f o e to CD O N'D C. N A O ca 7 O C CD O w _ ;3. N O CD co O CD EF CD x W CD A o b is CD CD o O C " N CD ° a `'� Parcel #: 042 - 1023 -10 -000 06/03/2005 05:23 PM PAGE 1 OF 1 Alt. Parcel #: 09.29.18.129A 042 - TOWN OF WARREN Current X; ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * KENNETH J & PAMELA F HERINK HERINK, KENNETH J & PAMELA F 1057 110TH ST - ROBEIRTS 54023 Districts: SC = School SP = Special Pro s): * = Primary Type Dist # Description 1092 120TH ST SC 2422 ST CROIX CENTRAL Q�"'�" SP 1700 WITC (�- / -n o �0— Legal Description: Acres: 30..132 Plat: N/A -NOT AVAILABLE SE 8W NE NE B & EXC 3 Block/Condo Bldg: M 13/3526 13/362 a Q� Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 09- 29N -18W L Notes: Parcel History: Date Doc # Vol /Page Type 09/14/1998 587048 1357/084 WD 07/23/1997 914/301 07/23/1997 434/180 2005 SUMMARY Bill #: Fair Market Value: Assessed with Use Value Assessment Valuations Last Changed: 07/11/2003 Description Class Acres Land prove Total State Reason AGRICULTURAL G4 29.132 2,000 0 2,000 NO UNDEVELOPED G5 1.000 100 0 100 NO Totals for 2005: General Property 30.132 2,100 0 2,100 Woodland 0.000 0 0 Totals for 2004: General Property 30.132 2,100 0 2,100 Woodland 0.000 0 0 Lottery Credit Claim Count: 0 Certification Date: 12/29/1997 Batch #: PRGRM Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 g D s FILED i 9 S EP 3 0 1998 �► 1U A7 KATHLEE H. WALSN ST. CROIX COUNTY Registerof Deeds 11 SURVEYOR'S RECORD St. Croix Co., W! C ER T .I is 1 ED SUP V E Y MA P Located in the Northeast quarter of the Northeast quarter of Section 9, Township 29 North, Range 18 West, Town of Warren, St. Croix County. Wisconsin. Ken Herink - owner 1057 110th Roberts, Wi. Northeast Corner Section 9 _29 _18 W (County monument fnd) East line of the NE 1 A UNPLATTED _LANDS ° y ✓ of Section 9 N 89'03'10 0 E 338.18' W: LOT i 133,896 square feet Q� . 3. 074 acres) `�•' a to 1 W� 1 v inclhding right -of -way.: L 1 co M 132,477 square feet � 1 Z I ,,, ,, u„ Z (3.041 acres) !lc 4 excluding r col l Q g g y'' m �►' ,.. 0 1 1 O� �• :� j 1 as.... �. o m: '` I Curve Information ��N' o °; 1M I Radius - 2225.72' 19 " .75' 1 I Central angel - 3 ° 29'34 314.46' S 89 "W 334.21' I I , Chor - S07 0 50 24' W UNPLATTED LANDS I I 135.66' — - - - -- — — - --- -- I I Tangents - S06 °05'37 "W Legend I I Z t I S09 1 "W • indicates a 1 "X24" Iron pipe weighing ~i 1.68 pounds per lin. foot set. � N� O fz Bearings referenced to the East line of the I I ti i gortheast quarter of Section 9, assumed S00 0 31 1 57 "E. I h I Q J� ° ZI WARREN �Jlj T29N: -R.18W z9 SEE 11 PAGE 43 E • \ C /6�ence P • La n • Ga a Da wy 6 � f�IQE � /`lar•t i� s�se Xen 6 74.69 1 / 7z Mer• 77 7 w l , • ,t s � � LoL�,is p W N b 9 /Ue/son 4 V I. z7 aacyM is fir- eo/f 0 b9s9 zo C O M y /zo f I � PO .- w � J /ao � /"/a Z7an eO •2 0 � Fiede�.e.E z•st-o = W Effe/ f F i�,E w " 4a Q/A .67 W. • .,p E E �� w.0 4o S6 \O J' • W� M /Ce /SO Sr �a/y f ITohn • • S>Q /e l /o O/enn E. Francis • \ 0 T- F 17orothy • ® 9 ""O zz s, ri RTN(� Z{ nde s h'r :nk Feder- i'c,E .Picha d f! Ha/'ve M. 80 my �h0 vo k/a /fe/ Ah7 /ia./r7 Bo Kamm Jc a y 0 l d Ke n�. fer E /tzeme/ T o Wes, s Mai 3 S e� ne � J � V cn /a Ma /one -y /oo N/e /kern 0 Q'� ,c \ y v3 k �` so 3io c / Fiede�ib.F /6a 10 B. 0 s �Pober-t y ' - Dona /d C /cL Ke .,a, b C .Lbr,s Sha./'on rPu�s/7xu Q.r - ms, ,7Ja.T /cnG L.uci //e F�edei'ic.E 6.DO�is • G✓e 'ss Sne. /s7 s KQ /bo • • /6 O vCiren z7 2 D. • h ^ rB. /a • r. Leo TJ • C \' Wa /ter / / / S. ss • v cXenna \' Nechv //e W Gi// Scout nnll k N C /a oo f 6C ^� •� :e 60 l ' 78.4• /zo C5)— oix I/a //e y '"'• y.� C /bo • �.h n • do a J o �oberr . C h L/e n� ��a� zsYZ 4 W 13 ect . F' obe'/ % '� Leo. C t y n %U rFed tu Ha // /97 v /2 rs7 9s cSChu /te ° 12 z. � a M. J. • PL't'AS •y, • • • �� 4i0 � a/ 5�� � AipEH C�C. .Qotf•jiU� N �Ol BO bu (b�o 0 y W o� � � � o /Ye we/ P rbo Rode U�p ^ v. tlb�y �r�aaid /bo ¢ aCryO w��.`0 lC� h N w zssz ^ �r�es, •B bs- off' q• : o� pCOq x a %Q tlU� ( d Itu 4 /6 z.9r /zo W CLr i>er- /BO n \ W fed U V r1/ewr // vU a0 V �` V 234 C� ah o a— BO • ��, 0 Mattson ^ _ �,esD 9fas C Sr ene 03tl tl tl ^ 4 l 0 Far•ins, y n � c rsB 7s €ti Ha,r/ /.n Pech man � n �� �` V tl V Snc. � ROBE —.4 n o Fo Koshe a \� tl b N j�tl .v� A �( /Ta ies • Co\ /es /Ve /s P /en 74 3 •' h W 0 h e tl S fa.r�/e g V o /ct E IQ f/ // 1 4 3 t o Sew // B ��� 0 Co � Q(� �� Vrs rbo rs9 • \ FL - QC cToseoh Tho as F. Sewe // eted b 'e <r s :o "✓`sosae Hu tl7? a 4. o /a.ter r • o ° ' / -^ 1 C � 65 Craig sa Namnr7 O /av <O /au O'Conne // �yvW O h q °� g r/B z �� � �Aiane Er-v,n J /taukcnes rzo .,,C 9 '0', N . cS ith cScs.. /t3 �y 0' V N oOR. F. tote b ` S rA rro h V• 7 rsr 6. .¢. 4 11a s' Q enyi off <Fio�c ee kr�-ij 9e/• .Prido�oh • 4 We /ey cLa 9h /.:� hr• e iebo /d re��,yer 99.43 C /a�a �u � Wesley Co es B 44 r/ < 94 eta / r ,- , ' � P .77oris v V. G'tQPjo .� 6Y 9/ ` v & Cow /<S ro — Iu cs /B. r2 tl .na Jomes rho O JJ'N tenA� . • .¢. r.' V� /us cSch. a /en ^ Caw /es r.37 2s7a i 77• BB O `\ Ci : /bo 2o6a t.B. 6Cr1` E ' • f/a rr• LLee,t �! e rzo a e ' eTames l 9 . �a ti'do �t 80 8zs etux a . � Hansen , �e uV,-`� K ^1 V Merton 2 , iT watt (Tames .Darwin Geo g �� e h c o N 4 TiinmrT anagcrnen/ Fob t Fogerty 7z. s ' o /Ph • . r o� z27 6 Co Pzi se ?a! rata 2ao Ct2L O BO /59.6 • /s6 - > �a °y may. Bb 9 PINE IrAOLL • �' /9bB ,P °c..E dMaP P.. /s,r q.Pe v r979 s Rr SEE PAGE /7 c5't. Cra:x County ws; Hammond ALINE PUMP Dependable Hybrids Golf Course WELL SERVICE a From Dependable People Daily Green Fees SALES Food & Bar Richard H. Kamm INSTALLATION SERVICE Phone: 796 - 2266 T ye , 796 -2294 ••.o•M ®ti.o,�•wo -LO Roberts, Wisconsin North Edge Of - Hammond HAMMOND WISCONSIN CALL: 749-3332 ST. CROIX COUNTY ZONING DEPARTME l am% AS BUILT SANITARY REPORT r' RECEIVED Owner - ('' �..�, Property Addres '`' T CRax City /State on,I 0FFICE to -2 Legal Description: / "' / -.., .. --- � Lot Block Subdivision/CSM ,&L t /4 ._ t/4, Sec. , T-4!2 N -RAW, Town of - ?-lo # /Y,/ 3 -lo SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION Tank manufacturer / Size ST/PC z�x,- / 3�Po Setback from: House Well P2 Pump manufacturer Model F� Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM Type of system: , ,1z1,j., Width 5— Length — ��2 Number of Trenches Setback from: House Well — PAL Vent to fresh air intake ELEVATIONS Description of benchmark Elevation Description of alternate benchmark L Elevation , 7-e:z Building Sewer 9, ST/HT Inlet 95 ST Outlet Zg PC Inlet PC Bottom Header/Manifold lee,, A.� Top of ST/PC Manhole Cover Distribution Lines Bottom of System O �,��, ,-95-- O ( ) Final Grade ( ) () ( ) Date of installation Pe it number .,��� State plan number /�� Plumber's signature v License number .2 Date Inspector �n Complete plot plan �+ NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Show alternate benchmark, if applicable. PLAN VIEW 07,41 7G y9. Eck l3, 1/surg I /1( 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.: Y P Y seconda P [ ()( )) 320272 Personal information y rovice ma be used for seconda p Privac L w, s.15.04 1 m Permit Holder's Name: I ❑ Gt � Village Town of: State Plan ID No.: HERINK, KENNETH WARREN CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: k9a 1 Ca 3/ f ' 042- 1023 -10 -000 TANK INFORMATION ELEVATION DATA A9800460 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. S �f l COQ Benchmark Dosin w � Ab t 643 a Aeration Bldg. Sewer 8( �a �6,0j Holding St/ Inlet TANK SETBACK INFORMATION St /,YK Outlet TANK TO P/ L WELL BLDG. Air I to ROAD Dt Inlet 1 7:7 Air ntake Q' -7 � c 61 Se' -� N S S NA Dt Bottom l y / /' j Dosin sb 11 '6 9 Z) NA Header / Man. 5 r � Aeration NA Dist. Pipe s.( IGL�i Holding ot. System 4ia ,2, 100,x. PUMP/ SIPHON INFORMATIONS Final Grade Manufacturer Demand n/1 Imo , cj�, (b Model Number 2,1r0° GPM /0& *12 j TDH Liftq•77 Friction 3 Syste TDH'�3- Ft (-{ ,� Q Forcemain Length Dia. Dist. To well SOIL ABSORPTION SYSTEM /• �> I BED/TRENCH width < �/ Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSION !� DIMEN I N SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK CHAMBER INFORMATION Type Mode Number: syst +'SZ� �7A OR UNIT DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) x Hole Size x Hol Spacing Vent To Air Intake Length _1L Dia, Z Length 7-1— Dia. Spacing q 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.) BWeld_� 3 (p 7 LOCATION: WARREN 09.29.18.129A,NE,NE 1092 120TH r i� �wH,l (►Lo,� oL�1��o►'��' � . �- ,`�. � /��r. -F-:�� ry tu,ew�,� �v � c�,l�.� l � t.� Plan revision required? Yes ❑ No Use other side for add i onal in r atign. SBD -6710 (R.3/97) e 7►.�� Date Inspect is Signature � �'7f` UN 1 �13Ig9 Safety and Buildings Division Vi scons i n SANITARY PERMIT APPLICATION 2 01 W. Washington Avenue In P O Box 7302 Department of Commerce accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less Coun than 8 112 x 11 inches in size. • See reverse side for instructions for completing this application State sanitary Permit Number 3 '0 Z� Personal information you provide may be used for secondary purposes ❑ Check it revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATI N Prop Owner Name Property Location I , 1 /a va, S , N. R f (or� Pro erty Owner's Mailing Address Lot Num er Block Number City Zip Code ( hone Number Subdivision Name or CS er L N. TYPE F BUILDING: (check one) ❑ State Owned It Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms s � Tow OF / III. BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 E] Merchandise: Sales/ Repairs Ill ❑ Restaurant /Bar /Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash S ❑ 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 ig New 2 ❑ Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System Sanitary Permit was previously issued. Permit Number 25 Date Issued 0& -27 - V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ZMound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Mi /inch) Elevation O. Feet Feet Capacit VII. TANK in gallo Total # Of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturer s Name Concrete Con- Steel glass Plastic App New Existin strutted Tanks Tanks Septic Tank or Holding Tank 9 ❑ ❑ ❑ 1 ❑ ❑ Lift Pump Tank /Siphon Chamber ' ❑ ❑ ❑ ❑ 1 ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the u dersigned, ass9,me responsibility f r in Ilation of a onsite sewage system shown on the attached plans. Plumber' ame: ri Plumb n�tp� MP/MPRSW No.: Business Phone Number: PIu ber's Aa dress CSt re9t, City, te, Zip IX. COUNTY / DEPARTMENT USE ONLY XApproved ❑ Owner Given Initial [�� Disapproved Sanitary Permit Fee (includes Groundwater ate ssue Issuing Agent Signature (No Stamps) ❑ q Surcharge Fee) Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11/97) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber Safety and Buildings 2226 ROSE ST LACROSSE WI 54603-1905 Nvisconsin Tommy G. Thompson, Governor Department of Commerce William J. McCoshen, Secretary September 05, 1998 CUST ID No.267341 ATTN. Rod Eslinger WEGERER SOIL TESTING & DESIGN 421 N MAIN ST PO BOX 74 RIVER FALLS WI 54022 RE: CONDITIONAL APPROVAL Identification Numbers APPROVAL EXPIRES: 09/05/2000 Transaction ID No. 145400 Site ID No. 159570 SITE: Please refer to both identification numbers, Site ID: 159570 above, in all correspondence with the St Croix County, Town of Warren agenc NE1 /4, NE1 /4, S9, T29N, R18W Kenneth Herink FOR: Description: Mound Object Type: POWT System Regulated Object ID No.: 422812 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. Adm. Code. • 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 09/01/1998 FEE REQUIRED $ 180.00 DENNIS R SORENSON , WASTEWATER SPECIALIST FEE RECEIVED $ 180.00 Field Operations BALANCE DUE $ 0.00 (608)785-9336, MONDAYS 7:00AM- 3:45PM DSORENSON @COMMERCE, STATE. W I. US Page of 6 MOUND MSTEM RECEIVr-O FOR A 3 BEDROOM RESIDENCE AUG 3 t 1,998 SAFETY & BL DIV. LOCATED IN THE N� 1 /4 OF THE MQt 1/4 OF SECTION 0 i , T Z-' ' N, R 1 8- W, TOWN OF W p��,�Z S-'. c- UC COUNTY, WISCONSIN. INDEX PA GE 1 'of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW -CROSS SECTION PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT .PAGE 5 of 6 PUMPING CHAMBER PA GE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR kC 0 e i He �v k i� S � 10 TN Sr. ROREIITS, Lv 1 s � oZ3 PREPARED' BY WECGEE:ZEF2 SO I L TEST S P4 AND. I3 ES = GtV sEFZV z cE 4`gC F.O. BOX 74 421 K. KAIK ST. Y A •••• ••• "'�r �• RIVFF FALLS. YI 54011 aATHUR� 715-42`55165 w0.9ER'R EuSWORiM, wrs. r•r ......�r • � I G 1 N +�0e9s� 8 _ z 9 —98 JOB NO. gS - R PLOT PLAN Page Z of scale 1"= �-l) ' r F �. � �^���. oo rvor coM,pt�er oct ss of � Z'tPut l:y- 1O OF y PUC-MIN. � o R wa .Au \` "A7� 1 - 4 -1 ip p erg +k CbhJ1PyJrZ �0 $e�'ror► of bra Z a r J CrL. Usz • S' Ir dc G O WLtL O a o 11• Ioo. 0 ON 8" tHCH, ply "flt� . Pve P�P� wl t l- P�UVATE SEWAGE SYSTEM uonditi®nally APPRO V OF SAFETy, BUILDINGS SEE CORRESPONDENCE NOTES -1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. required) 3. Install 4" observation pipes with approved caps. ( 2. required) 4. - Septic tank to be woo NSr3 gallon capacity manufactured by 5. Bench Mark A�3oUN 6. Divert surface water around system to prevent.ponding at the uphill side. Page .3 Of JAL Approved Synthetic Covering p-s-rm c 33 Distribution Pipe Medium Sand -�� H �= G Topsoil --� I ;; p 3 E b y . % Slope PRivATE SEWAGE SYSTEM Bed Of i « — 2 2 ( Force Main Plowed C onditionally Aggregate From Pump Layer oft Alft VED D Z_ o Ft. BUILD Cross Section Of A Mound System Using E z_3Z Ft. DiV159AN 01: SAF� F 0 Ft. ! A Bed For The Absorption Area =, = � =`—I t��- -� G , o Ft. SEE CORRESPONDENCE q 8 Ft. H V Ft. Linear Loading Rate= 9.S GPD /LN FT B L41 Ft. Design Loading Rate= p.ycj.GPD /SQ FT I l l Ft. J \O Ft. K \A -S Ft. L - 14 Ft. o W 34 Ft. emu i t ; n L Observation Pipe g K r - - - - - - - -- ---- - - - -_ A I - I • - - - -- ----- - - - - -- ------------------ - - --�I Force Main Distribution Bed Of Pipe Aggregate I Observation Pipe Permanent Markers (Anchor securely) Plan View' Of Mound Using A Bed For The Absorption Area Page Of Perforated Pipe Detail 14, Zi x End View . )Perforated —,/. I End Cop.. PVC Pipe Install permanent marker + • � at - end of each lateral Holes Located On Bottom. Are Equally Spaced Q S PVC Force Main PRIVATE SEWAGE SYSTEM PVC Conditionally Manifold Pipe � ED * �� Dis,ri6atian Npp p gUitDi Pipe WON Of Last Hole Should Be Next To End Cop y ' S NDENCE End Cap SEE C . RRESP4 P _z _ L Ft. Distribution Pipe Layout S 4 Ft. X '48 Inches Y ' 8 Inches Hole Diameter 1!y Inch Lateral Inches) Manifold Z Inches Force Main " Z Inches # of holes /pipe Invert Elevation of Laterals % %_Oo Ft. 6Y-1 A _ - ).U - Lx Y= Place 1st hole ZU from center of manifold with succeeding holes at f intervals. Last hole to be next to the end cap. Combination Sept,ic;Tank and PUMP CHAMBER CROSS SECTION AMD SPECIFICATIONS ' PAGE S OF VEWT CAP WEATHER PROOF JuIJCTIOU BOX . H "C.I. VEMT PIPC APPROVED LOCKING �!. 10' FROM DOOR.. MAWHOLE COVER AJIV '.ituoow OR FRESH wAgtvIIJG La6E►L. f coraDutr ALP, � J . al°1 MIN• 4" Hlu• y " U.iSipe°chotJ PIPE PROVIDE -- -- IAILE T AIRTIGHT SEAL V APPROVE =D JOIAIT A I I APPROVED JOIWT: C.T. PI i i i I w /C.I. PIPE�p�c W / Tank construction ALARM shall comply with J ILHR 1)3.15 and 33.20 ° � I p� P►'f Zt�on. � Ow LLEY. FL U P J p0 t T �`o+a�s a� : A RISER EXIT PERMITTED OQLy IF TAW gf 3 4? ETAS SUCH APPROVAL S, INr SEPTIC E 5PEC.IFICAT10KIS DOSE TASK MAUUFACTURCR: -A`�w�ZN l�Z UUMbER OF DOSES: 3• PER DA4 TANK :PIPE LOUV 1 DSO GALLOWS DOSE VOLUME e ALARM MAUUFACTURGR: S'S V- ?d SyS 1 S IUCLUDISC, 5ACKFLOW: ` GALLONS MODEL WUMBER-- COL 1AW CAPACITIES: A= 1$ INCHES OR 3 y O u � GALLOU5 SWITCH TJPC: V1ERCU \ B= ISCHES"OR 3 `— G�LLOUS PUMP MAIJUFACTURCR: GOU 1.D S C = IIJCHES OR S CALLOUS MODEL UUMBER: 3$1l �dV D- O � INCHES OR S GALLONS SWITCH TYPE: KlI-0-(J WLr MOTE: PUMP AMD ALARM ARE TO 6E MIW IMUM DISCHARGE RATE z b •Db GPM, IN5TALLED ON SEPARATE CIRCUITS yERTICAL DIFFERENCE CETWEEIJ PUMP OFF AUD D15TRIBUTIOU PIPE.. "'IS FEET + MIIJIMUM WETWORK SUPPLY PRESSURE .. . . . .. .. . . 2.50 FCET + SS F E E T OF FORCE MA X F � FKICTI0U FACTOR FEET loo rr. TOTAL OyWAMIL HEAD = L 4 - (.'4 FEET Pump chamber DIAMETER 3$ IIJTEKLIAI- DIIALWSIOW� OF TAUK: LENC,TH ;WIDTH - ;LIQUID OEPTH BOTTOM AREA 231= — GAL /INCH AS PER MJINUFACTURER = -C) GAL /INCH ti /G' yam? /v7G'' �s1 j�t//t>;',�a.✓ �.6ra4 � s =i�Z3 it ms's. ,or, J�ti �ry �3 Ile �� f ?AGE - Of pUMp CHA C�,051 SCr_TICt. AIJC) Si'[C1ftCAT(DK3__ _—VIE�JT CAP 7 4 vENT PIPE V�L AT H E K 'K 0o r APPROVED LOCKING 11N�)JHOLE COVER WMA Wlj�j!) OW OA R L 5 11 Alp, jmTAKE 1K)LE T APPROYED JolwTs _T APPROVED JOIKIT/ I I P E W/ PIPE I G 3' E X T E N D I W Co 3 ol�jro �D SOIL O�JTC) SOLID SOIL c_ L I- V. FT. OFF 0 F,;sc:K E:xiT PERMITTED OJJL'J IF TA\KJA M,kklLF,��,TLj',ZK tiA� SUCH APPROVAL _3" APPA0\'JEN Te"'-1K SEPTIC SPCCIFICATIOKIS� DOSE R, CDT TA U KS t`�AWJFACTU RC-: TAWK Si'_ C : --- GALL D ki S Z __'L U M L _Ows A: , KM MAtJUFACTUFFR: __5z_j' zlkwz�u , WUM15EK: OR .,LLOW5 twITCH T�JPC: I�JCHES 09 G,,LLOUS PUMP t*-�A�JUFACTUR C K*. c- I ki c li F S 0 R ZZ/ GALLOUS /'�ODEL �JUM15LV �7 D- NCHES OR LV -3. G�; LLOUS 5wl7CH T JPE: j'Ljt�P A�JO ALAKM ARE TO 6L lt�STALLEU OU SEPNKATI CIRCUII'S M I Q I M U M 0 1 SC KA K GE R ATr_ V[KTICAL DIFFEILE WCE bETW[[kj P[JMP OFF AlJ0 F C E T KJCTWORK SIJPPL� PKE�SIJKE FccT + FEET OF FOR MAII'J X. Z 1 - '� �'/ 1 , 1 o K F C. T RIC F 0 �,��A: r OTAL F E, I T JUTERUAL nimEwsioQi oF I'AiJK: LF-"(,TtA DEPTH Ic: c j: p,jm o cw. DATE: a PftG� 6 or- 6 Goulds — Submersible Effluent Pump r) 11 Y' Y 3871 EPO4 EP05 /t 211 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover. Thermoplas- • Homes components. tic cover with integral handle • Farms Motor: Available for automatic and and float switch attachment hos P, • EPO4 Single e: 0.4 H manual operation. Automatic points. • Heavy duty sump 115 or 23 V, 60 e: 0.4 H0 models include Mechanical • Water transfer Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, built in overload with preset at the factory. rated oil and water resistant. automatic reset. ■ Bearings: Upper and lower SPECIFICATI IS • EP05 Single phase: 0.5 HP, FEATURES heavy duty ball bearing 115 V, 60 Hz, 1550 RPM, construction. Pump: EPO4 built in overload with ■ EPO4 Impeller: Thermo- Solids hand `1 capability: automatic reset. plastic Semi -open design AGENCY LISTING 3 /4' maximu • Power cord: 10 foot with pump out vanes for • Capacities to 55 GPM. standard length, 16/3 SJTO 1 p p r mechanical seal protection. 65. Canadian Standards Association Total head jp to 24 feet. with three prong grounding • h Discharge e: 1 NPT. plug. Optional 20 foot ■ EP05 Impeller: Thermo- (CSA listed model numbers • Mechanic. � al: carbon- length, 16/3 SJTW with plastic enclosed design for end in "F" or "AC ".) rotary/cer stationary, three prong grounding plug improved performance. BUNA - c mers. (standard on EP05). ■ Casing and Base: Rugged • Temperati_ thermoplastic design provides 104 °F (40 continuous superior strength and 140 °F (60 :) intermittent. corrosion resistance. • Fastener✓: 0 series METERS FEET stainless I. 10 • Capable a: ,nning - - - -- � - - - - dry witho: :image to s 30 ► -5dw compones Pump: EP01, 8 - _ 2-5 FT - - • Solids ha: ng capability: 0 25 7 %' maxin. - -' a • Capacitie p to 60 GPM. s 20 - -- i • Total hea up to 31 feet. • Discharg re:1'/z' NPT. z 5 -- — - • Mechanic. eal: carbon- 0 15 rotary/cep ic- stationary, _j 4 BUNA -N i tomers. o - _ _ EPOS - • Temperat 3 10 104 °F (40 continuous 1 :EPO4 D 40 °F (60 1 intermittent. 2 5 1 i ' I. ' I i 0- 00 10 20 30 40 50 GPM L _L 0 2 4 6 8 10 12 ml /h CAPACITY ®1995GWGl _;nDs Anc. �.._�..._.._.. . 0— 6 Goulds _ — Submersible Effluent Pump u 3871 EPO4 - — EP05, APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, p y g • Capable of running lubrication and efficient strength, and durability. following uses: dry without damage to heat transfer. ■ Motor Cover: Thermoplas- • Effluent systems components. tic cover with integral handle • Homes Motor: Available for automatic and and float switch attachment • Farms manual operation. Automatic points. •Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical Water transfer 115 or 230 V, 60 Hz, 1550 Float Switch assembled and ■Power Cable: Severe duty • • Water transfer RPM, built in overload with preset at the factory. rated oil and water resistant. automatic reset. ■ Bearings: Upper and lower SPECIFICATIONS • EP05 Single phase: 0.5 HP, FEATURES heavy duty ball bearing 115 V, 60 Hz, 1550 RPM, construction. Pump: EPO4 built in overload with ■ EPO4 Impeller: Thermo- • Solids handling capability: automatic reset. plastic Semi -open design 3 /4" maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING �- • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. ". Canadian Standards Association • Total heads: up to 24 feet. with three prong grounding ■ EP05 Impeller: Thermo- • Discharge size: 1 NPT. plug. Optional 20 foot (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for end in "F" or "AC ".) rotary/ceramic- stationary, three prong grounding plug improved performance. BONA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 • Capable of running dry without damage to s 30 i.° 5 components. Pump: EP05 8 - n 25 • Solids handling capability: °a 25 /4" maximum. — ' W. I • Capacities: up to 60 GPM. s 20 • Total heads: up to 31 feet. ; • Discharge size: I NPT. z 5 - - -_ — - -`- - -- • Mechanical seal: carbon- } rotary/ceramic- stationary, a 4 15 y BUNA -N elastomers. � - - ---- - --;-- - -- - - - - -T - - --� — - ---; -- -EPOS - -- . p � f •Temperature: 3 10 104 °F (40 °C) continuous Zs- 8 _ I_ EPtia 140 °F (60 °C) intermittent. 2 - - - - -_ - -__ -- - - -- 5 0 00 10 20 30 90�111` 40 50 GPM , 0 2 4 6 8 10 12 m -/h CAPACITY 0 1995 Goulds Pumps, Inc. Effective May, 1995 Wii&onsin Department of Industry SOIL AND SITE EVALUATION REPORT P of 3 Labor and Human Relations — Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but ��• C�0 not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. 7-i E ) APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION FREVI . EWEDBY DATE PROPERTY OWNER: PROPERTY LOCATION EleW. E(YF NZ 1/4 NZ 1 /4,S 9 T 2 q ,N,R 1 J� E PROPERTY OWNER'.S MAILING ADDRESS LOT # . BLOCK # SUBD. NAME OR CSM # 1 W6 ) 3T. - CITY, STATE ZIP CODE PHONE NUMBER ❑CITY []VILLAGE ®TOWN NEAREST ROAD RABAT S 1.J 1 'S4 0 (l L 5) Z y,9 - 3612 W t'nZ ♦ - cA 'cat 9T`. [,Q New Construction Use 6Q Residential / Number of bedrooms 7 [ ] Additign to existing building j ] Replacement (] Public or commercial describe Code derived daily flow `l S 0 gpd Recommended design loading rate _ bed, gpdfit trench, gpo1ft Absorption area required 3Z S bed, 11: 3"1 S trench, ft W)dmum design loading rate • S bed, gpdfi� - lo trench, gVW Recommended infiltration surface elevation(s) V30. S ft (as referred to site plan benchmark) Additional design/ site considerations `i'l Z V � w /$'x \n' ,8Q� , w-wj 1 mu,-i __;'14 of sTT"� F) LL Parent material s % L our L.S B�L 4 S s %R Flood plain elevation, if applicable It S = Suitable for system CONVENTIONAL MOUND W- GROUND PRESSURE I AT -GRADE SYSTEM IN RLL HOLD IWG TANK U = Unsuitable for system ❑ S [RU I ®S ❑ U 1 ❑ S [RU EIS ®U EIS ®U EIS R U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed ffwch lO -31 0..S A . Z e_tz �o`t2 3L(, — sil Z`E'sbk m'Fh es •5 • 6 Ground 3 1Z- l7 10 `1 R sly — �' S csb1� `rn V `�'1� c S - - . L elev. 9 8.0 ft �� -Zf� io `12 li - pis 1�sb1 M v�t� cS -S . L Depth to S Z6 - 3 l 0`12 7 ! 2 -2.S y V_ s /t3 - limiting factor yell � e Z 6" sS% Remarks: Boring # o�� �.�vttz 3t3 � S%1 Z�sbk wti�>" a. - •s € -� Z 2, - 1 zz to�R �tl ro - G� si) 2wt sb> �� tS • S 3 ii - zs� L0 `'i fl- 3L6 e. 1 3`� abbe cQ h cS -� • S Ground elev. Zq 1O `t R 6/3 I-SIM CL I.3 ft. Depth to limiting factor n Remarks: CST Name: PleasePra,t Phone: Arthur L. We erer 715 425 - 0165 egerer Soil Testing & Design Service -P.O. Box 74 River Fal1s,WI 54022' S&ture: Date: 7 CST Number: / 98 - ZO - )-\\ _ � - MOO 76 PROPERTY OWNER SOIL DESCRIPTION REPORT Page of PARCEL I.D.# Depth Dominant Color Mottle.s Structure GP D/ft2 Boring# Horizon Texture Consistence Boundary Roots in. Munsell Qu.Sz.Cont.Color Gr. Sz. Sh. Bed Trench I -10 1,1Y _ a 5A;AZ_ S — • S , Z s1 4 Ground 3-Z-.38 I RSA C,Nv c-er-votnrc) elev. purce en-6 ft. Depth to limiting factor 32" Remarks: Boring# LdJ Ground elev. ft. Depth to limiting factor Remarks: Boring# Ern Ground elev. ft. Depth to limiting factor Remarks: Boring# • • , Vasa Ground . • elev. • ft. Depth to limiting factor Remarks: SBD-8330(R 05/92) PLOT PLAN Page 3 of . 3 SCALE 1 "= Ll0 ' n '4 I A7 �0 M h lL. quo • S' a 1 2r 0 '1. loo. 0' ON 8" kfICH' a N"t> 1 n . Pve wLU�"- I 4 m, Lf� - c -y ( 715 ) 425-0169 I4 oQ 576 CST Signature Date Signed Telephone No. CST # Of. PLOT PLAN Page 3 3 SCALE 1 "= DLO ' rorwr CpM.PfKT OR �p ~ �� �a �LQ•8 °_ tr y rUA ��P $ ca�rr�wvz gL.48.S' d o N Z �c`s � a 2 n W 0 - am -L - q2- 1la0. 0 ON 8" t+1 CH, 3 fV Y Dtf . PvC w/ - -t^ ". r I q6 -Z57— A On > 425 —m6s X4 00576 CST Signature Date Signed Telephone No. CST # ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ]1 e A N F T � Mailing Address /D S'7 Property Address 0 9 Q Q ez, �, (Verification required from Planning Department for new constructs n) City /State Parcel Identification Number LEGAL DESCRIPTION Property Location ' /., '/4, Sec. , T-QI?N -R -W, Town of iJ Subdivision Lot # Certified Survey Map # , Volume , Page # Warranty Deed # Volume 1& , Page # Spec house ❑ yes N no Lot lines identifiable ❑ yes X 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 masterplumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal 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 the three a exp' tion date. S GNATURE O PLICANT 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 v eg virtue of a arranty deed recorded in Register of Deeds Office. § ICWTURE OF APIGIIIICA ATE * * * * ** 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 DOCUMENT NO. STATE BAR OF WISCONSIN FORM 2 -1982 WARRANTY DEED 587048 VOL 1357 PAC[ 08 4 John J. Herink and Dorothy Herink, a /k /a ST. CRO CO„ W Raa'd ftbr hgpord' ' Dorothv A. Herink ��� SEP 14 1998 `�`" 11 L -4k �� � conveys and warrants to Kenneth Herink and Pamela Herink husband and wife as survivorship marital prop rty � pr RETURN TO KENf�E�lT i'FEP���fk �OS //D S7�• the following described real estate in St. Cro County, State of Wisconsin: Tax Parcel No: N2of NE4 and E2 of NE4 of NWQ of Sedtion 9 -29 -18 EXCEPT Beginning on the North line of NEQof NE4 of Section 9, 630 feet Westerly of the Northeast corner thereof; Westerly along said line or an assumed bearing N85 511.17 Feet; S5 11 W 209,07 feet; S35 511 feet; N5 211 Feet more or less to the point of beginning. TRANSFER $ILI This i n homestead property. (is) (is not) Exception to Warranties: Dated this day of �e 4 e e ✓— 19 ��- (SEAL) (SEAL) • John J. H ink (SEAL) (SEAL) _ • Dorothy Herink AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ss. County. }cam_ authenticated this day of 19 Personally came before me this �� day of