HomeMy WebLinkAbout022-1086-50-000 (2)t' .-1
AS BUILT SN{ITARY SYSTEI,I REPORT
1e lt
sEcrroN--3 D-r Jt-r-n-/&-w
TOWN SHIP /C
T. CROrX COUNTY, WTSCONSTN
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/oD, D G rJ S lJ d nrn €r il*oP
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ADDRESS )
E
SUBDIVISfON - LOT
--f-OTPI,AN VIEI{
SHOW EVERYTHTNG WITHIN 1OO F'EET OF SYSTEM
BENCHI,IARK: Elevation and description :
Alternate benchmar
Rings used t Su.nhole cover erev :
-Finar
grade erev :
-
Tank inlet elev. r Tank outlet e1ev.3_
No.offeetfromnearestroad:Front,Side,Rear-Ft.-
From nearest prop. l ine : Front , Side X , Rear_Ft .
No. of feet from: weIL '75' , Building3
(rnclude this information in the above prot pran)(2 reference dimensions to septic tank)
SEE REVERSE SIDE
's1 o
B-In ' too o
t;ooo 1*\ s*rt;t
Y*> 1a\ f u"n p tq "k
x +(sx x K x x ?( >(
+
INDICATE NORTH ARROW
sEprrc rmrK:Manufacture r, fr 'lLr$J frrcqst Liquid cap . I ooo
?A,
I
,!
I
PTJITP CHAITBER
Manufacturer:iguid Capacity:
Pump Model:Fd L ump/siphon Manufact.: eou N pum p sizekfuElevation of inlet:ottom of tank elevatio
PumP on elev.3_ pump off elev.:GaI lons /cycte z /s(,1 AAlarm: llan. :e witch Type:atiDistance from nearest prop.line: Front_, Si e-f,, Rear_rt. t0'Distance from: Wel t Buildin
SOTL ABSORPTTON SYSTEI.I
Bed:x Trench:
width, 8 ' Len v E,r of Lines z J erea BuiltExist. Grade EIev.roposed Final Grade Elev.F.ill depth to top of pipe:/e
3^f a t'
No. feet from nearest prop.
No. feet from welr, SO, u feet from buildio.
Capacity:of rings used:- Erevation of bottom tank:Elevation of inlet:
No. feet from nearest prop.line: Front _ ,
bui lding_
HOLDTNG TA}II(
Manufacturer:
No.
No. feet from: WeI
Alarm Manufactu::er:
DATE:{
Side_, Rear_Ft . _
nearest road
TNSPECTOR:
PLUI.{BER ON JOB:
LTCENSE NUMBER:
4
6/90: c j
rc a o' 2 Fnft,rA1t5fBdttfl&ffih,'65N
Labor an:d Hulhan Relations'Salfty and Esildrngs Diviiion INSPECTION R
GENERAL INFORMATION (ATTACH TO,PERMIT)
me:
nsp
TANK INFORMATION ELEVATION DA
TANK SETBACK INFORMAT]ON
PUMP / STPHON INFORMATION
SOITABSORPTION SYSTEM
3 00
93403
ty
o
).b
2-108 6-50
HI E LEV.
a.Q2
AT
3
FS!s
st lnlet
st/Outlet
STATION
Benchmark
Bldg.Sewer
Final Grade
Bot. System
Dist. Pipe
]#f/Man.
Dt Bottom
Dt lnlet
TYPE MANUFACTURER CAPACITY
Septic
Dosing aOa^y'
Aeratirrn-/
Holding
TANK TO PIL WELL BLDG.Ventto
Air lntake ROAD
Septic
Dosing o2r'NA
AeratioE/NA
Holding
Manufacturer G Demand
Model Number (.^-)
+
GPM
TDH Li Friction 9 rDH/C.PFt
Forcemain Length 76tt Dia.2"Dist Io well >54
BED / TRENCH
DIMENSIONS
width d Len No.PtT ,--..-
DIMFNSIONS
lnside Dia Liquid Depth
INFORMATION
5Y5TEM TO PIL BLOG WELL LAKE / STREAM tEACH TtG
CHAMBER
OR UNIT
Type Or k/r,,io,{. I
Svstem: / .j-.- zf ZLs,)tdz'
DISTRIBUTION SYSTEM
/ " ,o"r,nn y'{"DiaLength Length Dia
x Hole Size -
,//1"
x Hole Spa.ing36'VentTo Air lntake)J.s'
sort covER x Pres3ure Systems Only xx Mound Or At-Grade Systems Only
Depth Over /O//gd++rlitr Center / O
Oepth Over ,t ^,8.d+rrench Edses /Z -/Y
xx Depth Ol
Topioil
xx seeded /
O Yes
sodded,EK xx Mul.hed
E Ye5 DNo
LOCATION:
hr,4/
KINNICKINI{IC 30.28.
o{ ugs.r,Oy( f/l.Q=/*'t sa':- tl
COMMENTS: (lnclude code discrepancies, persons present, etc.)
18 . 466D,NlV, NE, HWY 65N
G,/2'.40s'
'los,' l.N{,?d'l//x",,1,4: bc 1"^ f / ,-, -x
b pZ-"* ./ dorlo,
z,o5,
t/Lt4ttY Z,r- a
u)/b-,n,c e-/..n<aUt <l@2..-s4Zx.s&fl,a//k64/ 6
Pla n on required?@4 ENo
Ure other side for additional information.
s8D-6710 (R 05Dr)
*I ,/?
Oate
.-a
ta
lnspector's Signature Cert No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
1.70
@ Cl
daa,. d"o g
d;"t / /6."aaza<4 Lry'"rrn
du;u."itC,,--FiluaK, ba4.A"(
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*-artll !/^ ), p-f. /h.,/{/1u, ,1r*.
/a 3, /d
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HFI
r.-SANITARY PERMIT APPLICATION
ln accord with ILHR 83.05, Wis. Adm. CodeI
-Attach complete plans (to the county copy only) for the system, on paper not less than
8%x 11 inches in size.
-See reverse side for instructions for completing this application.
I. APPLICAI{T INFORiIATION - PLEASE PRINT ALL INFORiIATION.
SUBO]VISION NAME OR CSM NUMBER
srATE sanrrnRYrpERMrr # I
"Afl, 3"{,9,.#"s ap p r i cati on
STATE PLAN I.D. NUMBER
PROPERW LOCATION
' iLi'ii' i F/,,; 7 o r 3h N, R ./P, ro&
LOT #PROPERW OWNER'S MAJLING ADDRESS
tY 1 HLo,^ L< N
'fJ;;$ h/k t ZIPCODE1*:]a (
PHONE NUMBER
n
Dtrtrtr II
ROAD
VILLAGE:
1
2
3
4
5
6
7
8
I
tt
trtrtrtr
llin
lr
10 Outdoor Recreational Faci I ity
RestauranUBar/Dining11
12 Service Station/Car Wash
13 Other: Specify
lll. BUILDING USE: (lf building type is public, check atlthat apply)0e%l2tb-
Medical Faci lity/Nursing Home
Merchandise: Sales/Repairs
Mobile Home Park
Otf ice/Factory
ApUCondo
Assembly Hall
Campground
Church/School
Hotel/Motel
!1. TYPE OF BUILDING: (Check one)
f] proti" E r or 2 Fam. Dwe
State Owned
9-# of bedroom "3
!V. TYPE OF PERMF: (Check only one in line A. Check line B if applicable)
B) E A Sanitary Permit was previously issued. Permit #
5.E tr 4.trA) 1.E
Date lssued
Repair of an
Existing System
Replacement 3.
System
Replacement of
Tank Only
Reconnection of
Existing System
New 2.
System
V. TYPE OF SYSTEiI: (Check only one)
Non-Pressurized Distribution Pressurized Distribution
Seepage Bed
Seepage Trench
Seepage Pit
System-ln-Fil!
Other
41
42
43
trI
Experimental
30 E Specify Type Holding Tank
Pit Privy
Vault Privy
2'l
22
Mound
ln-Ground
Pressure
11
12
13
14
2. ABSORP. AREA
REQUIRED (sq.ft.)
3be
3. ABSORP. AREA
FiioelEe'o [ili. tt.l
4. LOADING RATE
(Gals/daylsq. ft.)/,t?
6. SYSTEM ELEV.
/j2,0 reeta{o /e t( reet
VI. ABSORPTION SYSTEM INFORMATION:
7. FINAL GRADE
ELEVATION
5. PERC. RATE
(Min./inch)
CAPACITY
in qallons Prefab.VII. TANK
INFORIIATION New
Tanks
Existing
Tanks
Total
Gallons
#ot
Tanks Manufacturer's Name
Site
Con-
structed
Steel Fiber-
glass Plastic Exper.
App.
Seotic Tank or Holdino Tank x /,0e0 f )CS E
Lift Pump Tank/Siphon Chamber x Vtc I t,r(!
VIII. RESPONSIBILITY STATEiIENT
l, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name (Printl:
f,n*na3 ,{ llq*q
Plu MP/MPRSW No.:(No Business Phone Number:
( ?I|t ?trf,
Plufibbr'5 Address (Street, City, State, pip Code):' A
-
t . I i- -1;/ir';'"""'''i. i''ilV' E t(;rer E //sl l^,t:. ,rrc
IX.ENT USE ONLY
sr,o,"o
Disapproved
Owner Given lnitial
Adverse Determination
Fee)
Permit
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:f
SBD€398 (formerly Plb{7) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Salety & Buildings Division, Owner, Plumber
E
T
PROPERTY
tr
trtrtrtr
trtrtr
n tl L]LJ
V?t t
IFI
2.',-
3.
4.
5.
6.
1.( . 4 sanltr{.p€rmit is valid for two (2) years.
Ybur sanitery'permit may b€ r€newed betore ths expiration date, and al lho time ot renewal arry new
crit€ria in the Wisconsin Administrative Cods will b€ applicable.
All revisions to lhis permit must be approved by the permit issuing authority.
Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be
submitted to th€ county prior to installation. .'
Onsite sewage systems must be prop€rly maintained. The septic tank(s) must be pumped by a licensed
pumper when'8ver nec€ssary, usually every 2 to 3 years.
lI you have qusstions concsrning your onsite s€wage system, contact your local code administrator or the
State o, Wisconsin, Safety & Buildings Division, 60&26&3815.
To be ictmplete and accurate this sanitary permit applicqtion must include:
l. Property owier's name addr€ss. Provide the lsgal dBcription and parcel tax number(s) ol
whsre the system is
ll. Type ol building bei only one and complete # of bedrooms il I or 2 Family Dwelling.
lll. Building use. l, building type is Public, check all appropriate boxes lhat apply.
lV. Type ol permit. Check only one in line A. Complote line B if permit is lor tank replacement, reconnection, or
repair.
V. Type ol system. Check appropriate box depending on system type.
Vl. Absorption system inlormation. Provide all intormation request€d in #1-7.
vll. Tank inlormation. Fill in the capacity ol svery n€w and/or existing tank, llst the total gallons, number ol
tanks and manufacturer's name. lndicate prolab or site constructed and tank material. Complete lor a//
septic, pump/siphon and holding tanks lor this system. Check experimental approval only il tanks received
experimental product approval trom DILHR.
Vlll. Responsibility statement. lnstalling plumber is to fill in name, licgnso number with appropriate prelix (e.9.
MP, 6tc.), address and phone number. Plumb€r must sign application lorm.
lX. County/Dopartment Us€ Only.
x. County/Department Use Only.
Complete plans and Bpecilications not smallsr than 8% x 11 inch€s must be submitted lo ths county. The
plans must includ€ the lollowing: A) plot plan, drawn to scale or with complete dimensions, location of
holding tank(s), septlc tank(s) or other treatmsnt tanks; building sewers; wells: water mains/water service;
streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system
areas; and th€ location ol tho building served: B) horizontal and vsrtical elevation relerenc'e points;
C) complete sp€cilications tor pufhps and controls; dose volume; elevation dillorences; lriction loss; pump
porformance curv€; pump modsl and pump manufacturer; D) cross section ot the soil absorption system l,
requir€d by th€ county; E) soil t€st dala on a l lS lorm; and F) all sizing informatlon.
1gEO Wisconsin Act 410 included the creation ol surcharges (f€es) lor a number ot
regulated practices which can efiect groundwater.
The monies collected through these surcharges are used for monitoring groundwater, ground-
vyater contaminalion investigations and €stablishmenl of standardsl
iti
sBD6398 (R.fi/88)
i!l
I{f
5fI
SAFETY & BUILDINGS DIVISION
20f E. Washington Avenue
P.O. Bor 7969
Madison, Wisconsin 53707
State of lVisconsin
Department of Industry, Labor and Human Relations
Hovember ?, l99e
ROBERT ZE}.IK
177 HIGH}IAY 65 }IORTH
RIVTR FALLS }'I 54022
Petl ti on l{o. S92-t[0
Dear i{r. Zenk I
Re: Zenk, Robert - Resldence
Prlvate Sewage System
lltl,HE,30,28 r8tt
Town of Klnnlcklnnlc, ST. Croix Coun(y, l{I
Your petltlon for a varlrrge to sections ILHR 83.23 (l )(a2., lJlsconsln Admlnlstratlvc Code, has been revlewed. Th
condltlonally approved. The condltlons are as follorrs:
!aep
nd 83.?3 (2)(c)
etltlon has been
l. All surface water runoff shall be dlverted around and away from the
proposed mund area.
2, The entlre sand flls. ILHR 83.23 (3)(a rea of the mound shal I be pl ored i n accord wl th
3. If thls system becfires a falllng system, oF contarninat*s the waters of
the state, thls varlance shall be resclnded.
The rule belng petltloned requlres that the Iongest dlnrenslon of a mound and
dl strl butl on netmrk shal I not be I nstal I ed over a fal I i ng conyentl onal system.
The varlance requested was to lnstall a replacement mound system over afalllng conventlonal system on a slte rlth sllghtly complex slopes that are at
varlous angles to the bottsn of Ure absorptlon bed.
la)g
Att of the data and statements suhltted on behalf of th
consldered. Thls varlance ls speclfic to the subJect pe
used for ary addl tl onal modl f icatl ons.
e peti tl oner Heretition and cannot be
Sl ncerely,
-K*d*t*d{tr*@)
Dlrector, Office of Dlvlslon
Codes and Appllcatlon
(608) 266-3C80
Rt'l:Gl,lSl17431{PP3cc: Leroy Jangky, Pllvate $qwgge Consultant - Dlstr{ct 6, Chlppera Falls
Thomas Hel son-,_ Zonl ng Adml nl strator - St. Crol x County
8BD{BrrR..,"f,homas tlang, Pl umber-
z-c)1o
6'
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4
Arts
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Dlstrtbutlon Plpe Detar I For A Four Lateral iletrrcrk
Page_o f
PVC Force lta I n
]blcs Equal ly Spaced
0n 8ot tom
Altcrnatc Posltion Of
Force tta I n
PVC Distrlbutlon plpe
\\\r\
I
\\
P
PVC ltanlfold Plpc
End Cap
\5r
P\\t\I
I
\t
t
I
I
'1
s
x
t Last ]ble Should Be Ne^
x
T
\Y
oe"
P L3 Fr.
L/ Ft.s
S I gned:
L I cense Nunrbcr:
Date:
3gzt _U
I
t'
x-3 b lnches
Y b lnchesil,,..",
Lateral Dlarmter
t{anl fold Dlanpter
Forcc t{aln Dianpter
I nch
)I nch (es )
I nches
I nchesa(-
I tblcs Per Plpe
Invcrt Elevatlon 0f Laterals
0o
I oL Ft.
laFlrr.rP: .'tir lF l I
-
Page
-
0f
-
Slrow, Morsh Hoy, Or
Synlfretic Covering
Dislribul ion Pipe
Mcdium Sond
--dt: Topsoil
PRIVATE sEws\t€S+SFM
': t/. Slopc
I
ErJ.0f nousrnY
unsl0ll SAFENT A}ID
\
ConditioJfilfr
AP PROVEB
Bcd Of
Aggrcgolc
tlBOR &HUIAH REL^NOIs (6tt Below Pipe)
G
L'-z\
u
t
8EE
Si gned :
Llcense Number:3e3 t
Date:?lrttqs
s Scc lion Of A Mound Sy stcm Using
A Bcd For Thc Absorplion Arco
I
tJrl,5
13./r5
75
/o._
t?
3/
A
B
K
L
J
I
I.l
Forc e Moin Plowed
Loyer
D _1 '. Ft.
E 2.b Ft.
F ,75 FT,
G t.o Ft,
H t.5 Ft.
Forc e Moin
Ft.
Ft.
/- t
Al ternate Positlon
Ft.
Ft.
Ft.
Ft
Ft.of
Force Main
L
B
I Observolion Pi Pe\
K
a-- ---w
Distribution Bed Of h"-"r;
P ipe Aggregole
Permonenl MorkersObservo lion Pipe
Plon Vlcw 0f Mound Uslng A Bcd For Thc Absorption Areo
PAGI Or
-
PUIAP C HAAE,ER CROS5 SECTI OIJ ANO SP crFtcA'ilorJs
d
I
5
ENT PIPE
RO^1 OOOR,
OR FRESH l2'l-11u.
VE NT CAP
egA DE
\^/EATHER.PROoF
JUUCTION BOX
!/t
AIR IUTAKE
IE.AIN.
APFROVED LOCKIIUG
AANHOL E COVE E.
Y'AtN.
E.LEV.
-
FT.
SEPTIC d
OOSE I
TAITKS |^AUUFACTUB.ER:
TANK SIZE:4h
AODEL NUABEi,:AtA
SWITCH TSPE:tlo
PUl{P Go,,t,r
lo' ltltl.
PER. DA5
6ALLO\J S DosE voLur'l8 b'Etn+ ltu'
5b, 5b 6Aut
CAPACITIES: A = Ll tNCltEs s7 3bb GALLI
B= L tNcHEs on 35 GALL1
C = I lUcHEs oR I 57 oALLr
D - lo INC HES oe 174 GALL
NOTE: PUAP ATID ALARI1 ARE TO AE
INSTALLEO OU SEPARATE CIRCUITS
n.aa f rlt
INLET E,r. 0F HDUgInr, uBoR & HUIAil BRAn0xS PRovloE
UNSMT OF EAFETY AflO Atr.Tt6H7 SEAL
sEE @RR CE
PFNI!1TE SE$IAU€s*SFM
C o ndilio ndll*' c o N D ut r
APPR(}UEB,
-1;-t
*\
c TAPPROVED
JOINTS }IITH
APPROVED PIPE3' 0NT0
SOLID SOIL
PUAP
-
CONCRETE DLOCX
X RtsER Exlr pERntrrED ouLU rF TAuK AANuFA.TuRER HAs sucH AppR,ovAL
)
0
SPtr c lF r'cAT NS
rh Ft , tt-Sf Q(Q-(a,Jf fuu.atcen or DosEs:
AANUFACTURER:
AODEL NUTITDET.:
d
1,,,U LO 3L
SWITC H T9PE:6
f'tlNll{Un DISCHAR(IE RATE b 6PA
vERrlcAL DITFER.ENCE OETWEEN Put^p oFF ANo otsTRtcurtoN ptpE.. to FEET
+ AlulltuA NETWoRK suppLg pREssLJRE . . r . . . . . . . . i€_ FEET+4o - FEET oF FoRcE f,rAlN sq Z,bL 7%o..Il(tcrtou FAcyor,. ,1.o4 FEET
\r o7F
AR i
OU
AL
I
TOTAL OSUAI,IIC HE AD FEE T
INTERNAL DII'I usloNs or TA\IK3 LEUGTH
-;wtDTH -
i Lteulo DEpT H
-
SrGuE o!//"LICEUSE IIUABER:721r DAT E //e
o
ALARII AANuFAcTuRE,R i 4 ilL o.LA+ INcLUDING cAcKrLow:
,hr,h H.P. 6o Hz
Single Phase 115, 230 Volt'
rhr lt, 1, l1h H.P. 60 Hz
Single Phase 230 Volt' Three
Phale 208-230, 460 Volt'
90
u
40 50 60 70 80
GALLONS PEN MINUTE
Bullet in CLL1A
8, 1983
GOULDS \
Model 3885
(Supersedes Model 3870)
Submersible
Effluent PumPs
Pump SPecifications
Solids Handling Capabllily to rir"'
Discharge Size
2" NPT
Semi'OPen lmPeller
f ,nn" alua,qn, tltreacJ"rJ on shalt Throe phase
t.,nrts t,se rrripollcr lockrtttl to prcvenl acctdttrrlal
iacx-oll. Pump out vanes on backside ol rmpeller
lor protection ol mechanical seal
Caslng
Volule lype lor maximum elliciency'
Slalnlesr Sleel Fastener:
Serres 300 starnless steel lor corroston
resistance
Mechanlcal Seal
Ceramic vs. Carbon sealrng laces' stainless steel
spring and Buna N elastomers'
Maxlmum TemPeralure
160" F.
Capable ol Runnlng DrY
wrthout damage lo comPonenls
Motor SPecifications
Motor FullY Submerged
i. niqn gtio" ttrrbine oil lor pcrmanent lubrica-
tron ol bearings ancJ mechanrcal soal and
ellrcient heat drssrpatron Molor sealed lrom
envrronmenl by rtrgged cast lron enclosure
Bearings
Heavy-tuty all ball bearing constructton
Stalnlecs Sleel Shatl
Series 300 slainless steel lor corrosion
resrstance. Threaded shalt.
Slngle Phase Unltr
ntt iinqte phase trnils have btrilt-rn thermal
rlvrtrltlarl Jlrolnclt<ln wrlh attltllnilltr': lt'sr't
Three Plrase ljnils
( )yr'1lr),lrl J)l(rlr'( tt''rl llt :'l;lrllr rll)lt ' lr;l ' ((l (rt
,ll,{) virlt:, Tlrlr',t,lr"l'lr,tll {'ll ll" r'lrt'r"lir 'r
Power Cord
\,r/,tlr,r ,g11rl Itl 11".1".1,1'rl L1rrtr1" ''11 r ';1 '11 '1' rr I'ttrl
;lt l'. .t1; ;l',1'( I rll{l;,tl}' ttttrt''ltllt' I t'lrtlr'1 llt (-'l'r' t rl
tl;tttt;tqo l() trtttr'r ;;tckt-lrrrq CrltItt''tr lrl r't'itril'lrlt
r;llutrl ttrtt
Sinqlo Phase Untls
ll t, rrr.rlt,ls (,. llrJ)pr,(lwrllr l'r rrl lt
',.1I ( ) wrtlt .l I'rl)tlrl tltotltt'lttt'; lrllt'1 I
ttrrtl,'l lr'|(lllll)l)r'rl wrllt lJr ol tl 'lI'ltt;'
cr)t(l
JulY
o For Homes
o Farms
o Trailei courts
o Motels
o Schools
o Hospitals
o lndustry
o Effluent Systems
anywhere effluent
or drainage must be
disposed of quicklY'
quietlY and efficientlY.
HeavY-DutY
Dependable
Solids Handling
CapabilitY to 3A"
-r 4-ea
-\r
80
70
ululteoo
HsoI
?ooz
o30
o20
10
I ilI'
SPECIFICATIONS ARE SUBJECT IO CHANGE
WIIHOUI NOTICE
o 10 20 .30 90 10d 110 120 TraaOULDS PUMPs, INC.
lSZa sEn€cA FALLS h€w Y(x lll48
t
A
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Eiftrrl rure
;ftq '
DEPARTMENT OF
I N DUSTRY,
{ABOR A\D
HUMAN RELATIONS
REPORT ON SOIL BORINGS AND
PERCOLATTON TESTS (115)
SAFETY & BUILDINGS
D !V ISION
P.O. BOX 7969
MADlSON, WI 53707
.09(t) & Chapter 145)
DATES OBSE RVATIONS MADE
RATING: S= Site suitable for system U= Site unsuitable for system
SUBDIVISION NAME
Pl/Rf r ,
NO LK. NO.
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CIPALITY
tnyl Et/l
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r--: New eplaceElResidence
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ER
U t glD65 N/ p;ff
IPTIONS:l?)PERCOLATION TESTS
b/e?/ ?0
Utrs
HOLDING TANK
trS MU "'YUi,i^:J =' s YSr EM : ( oPti o na I )MOUND
trS DU
IN-GBOUN}PRESSURE:
trS EU
CONVENTIONALtrs tru
lf Percolation Tests are NOT required
under s. ILHR 83.09(5)(b), indicate:
DESIGN RATE:lf any portion of the tested area is in the
Floodplain, indicate Floodplain elevation
PROFILE DESCRIPTIONS
BORING
NUMBER
TOTAL
DEFTH+}i.ELEVATION DEPTH TO GROUNDWATER.I NCHES
OBSERVED I CST. HIGHEST
CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
B.I
(/,n lY SO 9,0 tt 30N o- /.00 B /s lnirelu/ollter "rl/.a0Dars
B-tabe F;ll Fron ,ll ExQaD,s (,t, .
J,
lB-/n /o0.0 ?e"3o"D:.(o B lsl ,<o - 1,{o 6u nrl s ( 6r /,so- {,b
Bu mtJ s -/hots a+ so"B-
o-,?s 8l sl' ,r< * /, aS Bh mrl 3+6r /Js-lr"2q,',B.3 1,0 /D/,50
{oo bn meJ S p lnots dt sY "B
PERCOLAT!ON TESTS
TEST
NUTVIBER
DEPTH
I NCHES
WATER IN HOLE
AFTER SWELLING
TEST TIME
INTERVAL-MIN
o I RATE MINUTES
PER INCH
P-l 9T o 30 t7ru z/Y v3 sy
P-P 31 o l,o t7/e t/s t/s ?
P-3 e7 h /o /(v t/n tlo ?
P-
P-
P-
PLOT PLAN: Show locations of p€rcolation tests, soil borings and the dimensions ot suitablo soil areas. lndicate scale or distsnces. Doscribo what aro the hori-
zontal snd vgrticsl alevation reference points and show their location on the plot plan. Show the surlace elevation at all borings and rhe direction and percsnt
of land slope.
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ods
elledge
S0
ri nt
ER
{oL0ersE
NUMBER
s,
,prtionat)
SYSTEM ELEVATION /Db,sD
Rb
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a
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[=Bar€ #r/rs
o = fev-c
L=/&,0 B. tn q r J 4t S. D- Aase . tornc r
r = R l- q .J Efru ?3,21
trr- o?7.)5
(3- /0d,1
R {- ?1.)< ttt
R<- ?Y,71
R t- /il,0tr)- ?5,50
?3,0 iluu, o{ uqte, in pump,}ronbc
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Dro i,r fr.lJ
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o Uctter &9.6 0
l, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord
Administrative Code, and that the data recorded and the location of the tests are correct to the best of
-RIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester
c z-
:BD-6s9s (R. 10/83)_ OVER _
in the Wisconsin
PFRI.)D'I PF RIOD 2 PFRI()D 3
i APPLICATION FOR SAIIITARI PERI{IT
sTc 105
SEPTIC TANK HAIT{TENANCE AGREEHENT
St. CroIx CountY
OWNER/BUYER lz
/ROUTE/BOX NUHBER
ZIPL?r
y'r
o
CITY/STATE lt Pt^4
PROPERTY LOCATION:
St. Crolx C
53000 of th
pr lor to JuI
1980, ulth
systems ProPe
Tovn of
Subdlvislon
"'r r/4 rV{-v,sectron 70 ,r ?tn,*,'P r,
St. Crolx CountY,
Lot No. :.
t'0'
4
Improper use and maintenance of your septlc system could result ln lts prenature
fallure to handle nastes. proper malntenance conslsts of pumping out the septic
tank every three years or soonir, 1f needed, by a LICENSBD SBPTIC tAllr PUHPER'
uhat you put inlo the system can atfect the function of the septlc tank as a
treatmlnt stage in the uaste disposal system'
ty Resldents llAI be eltglble to recelve a grant for a llAXIlnX of
ort of replacement of a falllng system, which uas ln oPeratlon
, l9?8. St. Crolx County aiceptea thts program ln August of
regulrement tlrat ouners of lLI, npr sysTEt{S agree to keep thelr
malntalned.
ounecy1
the
rly
The property oyner agrees to submit to st. crolx county zonlng a certlflcatlon
form, stgned by the oYner and by a master plumber, journe)mnn plumber,
restr tcted plumLer or a llcensed pumper verl fying that ( 1 ) the on-slte
yasteyater iIrpor"I system is ln proper operattng condltlon and (2) after
lnspectlon and bumping i it necessary)l tne septic tank ls less than L/3 fuII of
sluige and r"ur. cer[itleatlon form vtll be sent approxlrnately 30 days prlor to
three year explration.
l/lfE, the underslgned, have read the above requlrement
the private sevage dlsposal system ln accordance wlth t
hereln, as set by the ttlsconsln Department of Hatural R
form must be eompleted and returned to the St.Crolx Cou
30 days of the three year expiration date.
S I GNED
DATE
St. Crolx County Zonlng 0fflce
St. Crolx County Courthouse
911 lth Street
Hudson, UI 54016(7r5) 386-1580
s and agree to malntaln
he standards set forth,
esources. Certlflcatlon
nty ZonIng Offlce YIthtn
Stgn, Date, and Return to above address
FIRE NO. / 27
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STATE SAF OF WISCONSIN _ FORM 2
WAA'TANTY DEEO
inls Se^cE rasaNtiO tor Facoio'l/i D^r 4?1553 YiL
Gary D. Brecht and Rene M. Breuht,REGISTER'S OFtlCrj
sT. cROrX CO., Wr
Rec'd for Recordlornt ten ants
convoyr and warranls lo Ro rtE -Zenk -and Mary A-
-
JUL I 6 l99l^ol 8:30 A.l,t
\*r-o e*^,-LA
0' Iegirrc' of Dr.dr
zeoh
mari ta I proper tv
i tha lollowlng dosc.lbod roal ostatc ln Sr ar^i Coun'7,
Stet! of wrlconen: Part of the NWI of NEI of Section30, To$/nship 28 North, Range 1g Wdst. described' as follows3 Comnencing at the NE corner thereo'. thence West on North line of said Nwl of NEI 23 eet ithence Sout.h 56.0 feet, thence West 16.5 feet, thenceTarx6yNoSouth 105 feet.i thence S 40o14'W 505.3 feeti thence tf 10,.2 feeti thenceS 7o49f W 135.07 feet to place of beginning, thenc-. S 37o4?t W 210.0 feet;thence S 48"45'E 215.0 feet, more oi less, to cenLerline of KrnnickinnicRiveri.thence NIy ori said centerline to a point S 48.45 E Erom place ofbeginning; thence N 48045r '.it 220.J feet, more or less, to place 6f beginning.Together with a 55.0 foot wide easement for ingress and egress lccaged inthe Nwl of the NEI and also in the NEI of t.ire Nwl of Section 30-28-lB, Townof Kinnickinnic, more fully described as follows: Corunencing at the NEcorner of the NWI of the NEI of said Seceion 3Oi thence West on the Northline of said Nwl of the NEI of said section 30, a distance of 230.50 feet,thence South 56.00 feet, thence west 15.50 feet, thence South 105.00 feettthence S 40o14r00tr W 505.30 feeE; thence West 107.20 feeti thence
W 135.07 feeti thence N 48.45'00" W 33.10 feet to the pojnt of Beginning ofsaid easement., being describcd along centerline as follor.rs: thenie S 37"47'00" y{ 384.54 feet, tL,ence N W 108.35 feet; thence N 37"02'40"lV 512 ieets, more or less, to the centerline of S.T.H. 65 and the point ofBeginning of said ea semen t .
Th'! -.-i-rl nohestead p,o9erry.
(ist lt'ffi,|
Exc€pllon lo waranlies:
No exceptions.t:oli ilc?iB
an-tlo
g{rod rh'! l5t} dey ot Julv rg - -9-1
(SEAL)I ,', ----.2 \/,r (SEAL)
. Gary Brec Rene M. Brecbt
(SEAL}(SEAL)
AUTHENTICATION
Sign.lur6s authenticated this _-__- =_ day ol
__ ,19 ___
ACKNOWLEOGEMENT
STAIE OF WISCONSIN
St. Croi f<-- County
ss.
-lth aay ot
rg 9L.
Personarly camo belore m6. this
TITLE: MEMBER SIATE 8AR OF V,/ISCONSIN -, rn' above nam€d(lf not. ___
aulhorized by I 706.06. Wis. Slal! ),- ,Gary D, BrechE
ThiS Instrumen!'/vas dralted by
DonaId J. Fast
Bald!,i.n, h'I 54002 lo m4 rnown rc he ihe lerson s- who eteculed lhe?9reea)r.g :n!.
an0 sed l
iSrqnalures may be aulhent cale4 cr acr.r*r4,lge.t Both nre nol
neces5a.y.,
.!1.r43 r, ,..r..3 3.q.f'
/i,r-, r 1 /i;r,t,, orJ
starl 5rotral|on , rre'; ,."7j t
tl,r3rv Pubri. st. crcix
V, C,rr.--r55,on rs icfoanenl rrl ior-r_y-,L Lc/- I
.
^eaA.'t lEEi 'ira- BAF i F fr s._tii n
I
t ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
ST. CROIX COUNTY COURTHOUSE
9I I FOURTH STREET O HUDSON, WI 54016
(7r s) 386-4680
October 20, L992
Jerry Swimm
Section of Private SewageDivision of Safety & Building
2226 Rose ST.
LaCrosse, WI 54503
RE: Plan Nunber 592-40846
PRO.IECT: ZENK, BOB
I0CATION:I{III L/4, NE L/4, SEC. 30, T28N-R18W, KINNICKIIWfC
Dear Jerry:
Your correspondence dated October 2, L992 requested that there be
comments from the St. Croix County Zoning Administrator regardingthe site suitability of this site.
Due to the complex slopes, old system and fiII in other areas thisIocation and design seemed to be the only possible Iocation anddesign for this system.
I feel that if installed as per the design the system will functionproperly.
Shou1d you have any additional questions regarding this matter,please feel free to contact this office.
Sincerely,
*,,ffi{tff"*
Thomas C. Ne1son
Zoning Administrator
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ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
ST. CROIX COUNTY COURTHOUSE
9I I FOURTH STREET O HUDSON, WI 54016
(7r s) 386-4680
Sept 18, L992
Division of Safety and Building
Bureau of PlumbingP.O. Box 7969
Madison, WI 53707
To whom it may concern 3
An onsite investigation of the Bob Zink property, Iocated in the NwL/4 of the NE L/4, Sec. 30, TZ8N-RLBW, Town of Kinnickinnic, St.Croix County, has been conducted wlth the assistance of Tom Wang,csT #2860.
This onsite revealed suitable soil for onsite sewage disposal to adepth of 24' .
Should you have anyoffice.questions, please feel free to contact this
Thomas C. NelsonAssistant Zoning Administrator
cj
Sincerely,