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HomeMy WebLinkAbout042-1043-10-000 (2)_r (QN� rri .ul , ;" AT -51 'df S�STi k TH I'l �artW"AV?�Jus;p . 29 . 1-8 . 24fi-D NW MW Labor and Human Relations VMV E WA Safety and Buildings Division INSPECTION REPORT (ATTACH TO PERMIT) GENERAL INFORMATION Permit Holder's Name.- )0,TVjRTA(-, MA City [] Village Town of: WARREN C51T _BM E I e v.: Insp. BM Elev BM Description'. TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic 6�1­ jev Dosi ng Aerat+oTT— .......... ........... Holding TANK SETBACK INFORMATION TANK TO P L WELL BLDG- Ventto Air Intake ROAD Septic NA Dosing > NA Aer NA Holding PUMP / 1 INFORMATION M" N Manufacturer Demand Model Number (77 .'GPM Friction System TDH 6�, t 11 TDH L4 F L 0,5� Head I Forcemain Length Dia. Dist. To Well > SOIL ABSORPTION SYSTEM ELEVATION DATA County: Sanitary '-Pe—rFnit 110".- 1293 37 31 State Plan 7I5_I`T0."-. Parcel Tax No.- rIA2-3 043-3 0-000 A 9 3 0 0 0 3 1 -7 /,,-, --,) STATION BS HI FS ELEV_ Benchmark 4Vr,vjpr Bldg. Sewer St / J.+ t Inlet St / � Ou.tte_t.,-_­ Dt Inlet ------- Dt Bottom 7r-xl Header Dist. Pipe 1,0, ­37 Bot. System 14mei Grade'' BED/TRENCH Width Length No. Of Trenches PIT inside Dia. Liquid Depth DIMENSIONS DIMENSION SYSTEM TO P L B L DE G WELL LAKE/STREAM LEACHING M a ri�,act u r e r SETBACK INFORMATION CHAMBER Type 0 Model Number­�.. System: OR UNIT DISTRIBUTION SYSTEM Header / N&&=fe+c1 Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia Length �22427 Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems_'Onlp�� Depth Over Depth Over xx Depth Of xx Seedetied �Ye xx Mulched B e d / T1fie>VK enter Bed / T,�gpj&hf dges Topsoil 11 s 0 No I Yes No COMMENTS: (include code discrepancies, persons present, etc.) LOCATION: WARREN 9 ,NW,Nov , LOT 11 110TH ST. C Plan revision required? E] Yes o Use other side for additional information. SBD-6710(R 05/91),,� Date 1.00111- Inspector's Signaturk Cerl No UAMCCwMan RANITARV PFRMIT APPLMATION ���M T i In accord with ILHR 83.05, Wis. Adm. Code COUNTY OEM STATE SANITARY PERMIT # / / • -Attach completeplans (to the county copy only) for the system, on paper not less than 81/2x 11 inches in size. 0 Check previous application ZZ : -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION 1/49S/6 I P re r- ra 1/4 A,) T'2_5 , No R lo E (or) _QoE PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # L CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER 1111. TYPE OF BUILDING: (Check one) E] VILLAGET YNEAREST ROAD State Owned I :C LU QF Q Public '_42=1 -1 or 2 Fam. Dwelling-# of bedrooms PARCEL TAX NUMBER(S) N11-1 111. BUILDING USE: (if building type is public, check all that apply) &IOU 1 F Apt/Condo 2 G Assembly Hall 6 1:1 Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 30 Campground 7 El Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 F Church/School 8 1:1 Mobile Home Park 12 El Service Station/Car Wash 5 El Hotel/Motel 90 Off ice/Factory 13 G Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. �"ew 2. F1 Replacement 3. El Replacement of 4. El Reconnection of 5. F1 Repair of an System System Tank Only Existing System Existing System B) G A Sanitary Permit was previously issued. Permit # Date Issued V. TYPE OF SYSTEM: (Check only one) Non -Pressurized Distribution Pressurized Distribution Experimental Other 11 El Seepage Bed 21 El Mound 30 G Specify Type 41 0 Holding Tank 12-9LSeepage Trench 22 F-1 In -Ground 42 G Pit Privy 13 El Seepage Pit Pressure 43 El Vault Privy 14 El System -In -Fill ORPTION a ABS V1. ABSORPTION SYSTEM INFORMATION: 'GA 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.) (Min./inch) qtlro ELEVATION 620 1 JL_ 19j-. 60 Feet Feet V V" T, 11. TANK INFORMATION CAPACITY in qallons New xisting Total Gallons # of Tanks Manufacturer's Name Prefab. Concrete Site Con- Steel Fiber- glass Plastic Exper. App. Tanks Tanks structed Septic Tank or Holding Tank El 0 -Z 0_,c Lift Purne Tank/Siehon Chamber 7-T 0 k%-%. Ac 07 0 F] Vill. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) PRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Code): / ? .3 4) /?A� .0 , - ­1 IX. COUNTY/DEPARTMENTUSE ONLV J Disapproved Sanitary Permit Fee (includes Groundwater Surcharge Fee) Issued7l g Agent Signatu Issuingr 16 ps) Approved © Owner Given Initial Adverse Determination , X. CONDITIONS OF APPROVAUREASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS � G 1. A sanitary permit is valid for two (2) years. r 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer 'Renewal Form (SBD 63991) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete ## of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic. pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following- A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers,- wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soif test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. • S B D-6398 (R. 11/88 ) APPLICATION FOR SANITARY PERMIT S 11 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/contractur,("spec house"), then a second form should be retained and completed when the propLrty is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property 11f,4P-r1,i1 65ic/z7w G Location of Property � 4 �, Section 2 T N - R W Township Mailing Address C01?1V6)e J)0'f _Za69'W , 1116 577 Subdivision Name Lot Number Previous Owner of Property 'Total Size of Parcel Date Parcel was Created /9 A, Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes x No Volume and Page Number .cpl(o — as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 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 Mal), the the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (We) ceAti6y that aU statetnent6 on this 6o&m aae PLue to the bat o6 my (ouT) knowtedge; that I (we) am (a4e) the owne-Aks) o� the, pAopetty desnibed in this in6ottmation 6o4m, by viAtue o6 a waAAanty deed teco4ded in the 066ice o6 the County Regi,6teA oA Deed,6 as Document No. 1 Y-/ g? 2 ; and that I (we) p4e,,sent,fy own the pAopo,6ed site. bon. the sewage' JZEposat �116tem (o& I (we) have obtained an eazement, to �.un with the above dens mibed ptopeAty, Jots the coyotAuction.o6 6aid sy/stem, and tite same It" been duty Aeo-o4ded in the 066ice o6 the County RegizteA o� Deeds,, ctz Document No. A 4—. �A SIGNATURE OF OWNER /%%air: , - /-/, - - - - /-! ?3 DATE SIGNED SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DOCUMENT NO. STATE BAR OF WISCONSIN FORM 2-1982 WARRANTY DEED VOL 627 conveys and warrants to C C7 the following described real estate In 1 �. Y' (k County, State of Wisconsin: THIS SPACE RESERVED FOR RECORDING DATA REGISTER'S OFFICE sr. cRoix co., VA , 11" Rec'd for Record JUN 191992 at 9:45 A. M 0 &r� Register of Deeds RETURN TO ' Tax Parcel No: �► N � - /'vr' 1Vlly o y 5ecilarl 16 ) J � I ry 'i 1\ C Y\ �, W1, S n n J�of �- je- eb M- 0,V 3) q 7 6) 1. 1) Vo Do 3313S`l r 0.-+ t 5 S7 19 C,v n i rccC�' �- This I /V O Y homestead property. (is) (is not) f Fa 5" G CO U� K 6k LZ re 5Ir I,C -f;t o i j s o-C V e c o r 4 n Warranties: �- i? �' Exception to Wa s l! �i Dated this 1 t h day of (SEAL) (SEAL) AUTHENTICATION authenticated this day of 119 TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) THI INSTRUMEN S RAFT B Q (Signatures may be authenticated or acknowledged. Both are not necessary.) 19 - a-2-(SEAL) (SEAL) ACKNOWLEDGMENT STATE OF N/ISCONSIN N SS. St Croix county. Personally came before me this 1 bth day of June 1992 the aho"e named Gerald i,�;, Nadeau r � 1 S '•�. � to k An Iit3�pH�S� �•;� who executed the ore olrrg ��'SE'r,a vyfedge I iame. • J � 00 e� Notary PGblicy^_.��--3:OX County, Wis. My Comm►*si�oV4s, pe'' o R�' (If not, state expiration date: APf'�.1,,�.,''•, -- , 19 93 ) 'Names of persons signing in any capacity should be typed or printed below their signatures. SB2 NTF 0021 WARRANTY DEED STATE BAR OF WISCONSIN Nelco Tax Forms, P.O. Box 10208, Green Bay, WI 54307-0208 Form No. 2 — 1982 4.t NW CORNER OF SECTION 16 T29N. R18W — POINT OF BEGINNING NORTH r FEB IS if) JAA04 1976 CO Reg'.111p,0. "01 NNE(( 14 cedr C. V N 1/4 CORNER OF SECTION 16 T29N#1 R18W L I N E OF NW 1/4 33 2656.60' �EXISTING G 14 20. 0 0 ' TOW (D S090311E Ik 350, 2 00' 200 3% 02. 19* 0 2 PIPE 1car M w 2 3 0 rn Cl en 3 Z..3 6 A C 1.69 C.0 � C4 0 \r- I. 8 3 A C to M to 1.54A ct 0 < z w a 0 a) t-A r 10 6 2, Lu y 11 7 5 33' 200 I.®7 AC.I)mul.ti in: 1. 7 A2C. 143-6 3X' 1 N89*31 W 454 .25 C3 ROAD 670 4 5' CONTOUR L17N 4) "PIP DRAINAGE L (0 0.0 U SE 99 6.4 2 AC.; re) qt�ell 0 0 5.91 A C. 2) IT V )XL ;J1 ),U E L .99.7 1 0 ONTOUR LINE 0670 0 2 "PIPE - 1-1 0\ '-2w ::� N 00 29 'E I 1 N 8 9 *13 1 - W 826 .37 50,00, FLOOD ELEVATION s97 C) N W N w JUNE, 1975 N E— N W SCALE IN FEET 0' 200' 4 0 0' NOTES: 1) Acreage of parcel including toim road easement. 2) Acreage of parcel excluding to-.%ii road cascinert t. 3) 2' contour line is 2' above the highest known [looding which occured in Jule, 19-3. 4) 51 con our 11ne is S' above the highest Lnown. flooding which oct:Ll red in Jwic, Ill. LECILND C-j SECTION C0!._-,1-_-rR 2" X 36" IRON PIPE 111111 "BEMSTEL-N. CAI" • 111 IRON PIFIE FOUND CA N N. F. R FR_':D,,c,n11FL 1'01-MWN 0 lot IRON PIPL' SE.T, UNLESS 2sissm:itwN s,r. FAU CLAIM-:0VISCONSIN S4701 — RIGIT-OF-*:,"AY LINT RtM:1Z F, S1 HIM X'11)1:R I.RA I NAGE 07'k 11611: 1 R01WRPS1 W1 SCoN`; IN S-1023 F)['-S C R I P, I' I ON A parcel ---\f lmc! located in tile N`1/2 oC tho St. Croix CoLultv, Wisconsin des%,Zribcd as follois: Coitunencing .it the NW coillel- of 5.1;Ad Section 16; thciice S89"31'1- (true bearing) .1,96.58' zilong the North line ol' S;iid of Section 16 to the point of begiLiming; thence S89"31'1: 1420.00' along said North I ikilo OC the %114; tliclice, S0'29'1V 417.43' ; thence N39031 'W 826.37' ; tllcllcc ­01-t1l L- so. qn, thence N 89 ' 3 11 W 4 S 4. 2 S' tliciice N20' 171 2 0"N 39 2. 9 7' a I oil g t I ic cen t c r I i lie of all C t i: if, tc%\Tl road to the point of boInn ill.g. -Stll)jcct to all existill.1'. to"m road casewlit acro;s the North 33' and the Viesterly 33' thurcof. Subjcct to CaScmiuiLS of I-CCOI'd- I certify that the above description .uid map are correct and that I h.-Ne fu; 1\1 coml)] i eJ with the provisions of Sec. 236.34 of the Wisconsin Statutes antl Section COL'"'Ity ZZoning Ordlil.,ulce. A,4 co. F\,Tl-t :To) -7,-0-. S - D 123 F.ELS4 M s,r. APPRO �)r_ D 1-' 7' \1 0261. R I I I FA"I . 'A 111 Al' I*S I -, r P I % % , %_j L) A I 'L I ii 71 11.) 75 . ST. CROiA" COUNTY FA2XS KYALTEn J_r.)R\1T!:­' PY AND ZG1-'%,4G COMWITEEGO Ky 1, 5-12:4 ,t L F,' -LS, vw, I 0 %L 7 Vz: S T C - 105 I SEPTIC TANK MAINTENANCE AG*IZE'EMENT St. Croix Counry OWNER1BUYER1W4,eT11vYz2. Os76IL7AG I -rw ROUTE/BOX NUMB ER100"#*X41e. f 16 —Fire Number-_­­­­­ CITY/STATE R4)&Fg%6 I Z 111 PIiOPERTY LOCATION:/O�Z- Sectiol,16 T- A_q N, R __W) Town o'- St Croi-x COL111L , I Y Subdivisioii Improper use hrid maintenance of your SUI)L iC sysLum could result in its premature failure to ha n d'L e- wastes. Proper 111ZA ill t CLIc-ALIL, L! C-1011 - sists of pumping out the septic tank Lavery three years or S0011er, if needed, by a 11-cunsed Sej)LiC t a n k What yuu put into L h e s y s L 0- ill c a n of f 0- c- L t It 0- function of the septic t a iA k as -A L r I L - 11tellL Stage ill tile- waste disposal sySLeill. St . Croix C'oullLy L-usidenLs 1o141y be e I I g it) le LU ruC U I VO il 1-ii1i L 1 0 r a Ill Ll X i Ill Ll Ill U f 6 0 % U i L It e C 0 8 L () f r e J) I a C e Ill U 11 t L) t" a a i I i III S y s L e ill which Was in uperaL iUll prior to July 1, 1978. St Cruix COL111L Y accepted this program iti ALIgUSt Of 1980, WiLh tile 1-uquiruillellL that owners of all ii.ly.w. ugree 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 p.1 umber , journeyman plumber, restricLud plumber or a licensed I)LI111per veri- f y i n g t It a t ( I ) t It e- u a -.s i L e wastewater d i s 1) u s a I system i s in 1) r c) p L! r operating condition and (2) after inspection and pmnpin'j (if llec- e- s s a r y ) , t 1i e. s e p t is 'tank is less than I / 3 f u I I o f ,, i Li J 8 u a n d s c u at Certification f o rin will be Sent approximately 30 days pr for to three year expiration. I/WE, the undersigned, have read the above requirements and agree - to maintain the. private sewage disposal systum in accordailLe with the standards set forth, herein, as set by the Wisconsit-i Depart- me-a-t of Natural Resources. Certification form musL be completutd and -returned to LIAL-1 St. Croix County Zoning Office within 30 days of the three yea'r expiration. date. S I G N ED7/7/a t� I �);z V, W D Al - L /y1��e, /� �993 — SL. Croix County Zoning Off ice - P.O. !"lux It a mill 0 11 d 54015 715-796-2239 or 715-425-8363 Sign, date- And return to above address. wiscunsin Ucpartment of Industry, SOIL DESLrilPTION REPORT Safe tyy 6 Builuings Division 969 Labor and Human Relatigns P.O- i ox WI (Attach Soil Prof Location M6,p - To Scale - On A Separate, Signed Sheet) Madison, WI 53707Page of wtomw Neme *114k'% Q STE �"�1"' Oil iva ubtron Date A'J }� 2 "i - �( ,�. urrent lap U$4 or Vegetative z6wef /'� / -- 9�'�iSS� Parent Mxter'& s a- SAD t P1awn t • ustomfr rpf stimatt • owe+t rou water -County 51r CAD/.X arc arce � / 1 a� A--j y�trm lo• �n Rate in Zal onsl—Per r4 Ft. Per ay Lot lt9a DRscr+pUon c . l +!i ,P ystrm tomctry and Dcpt Z. D� w •n �P+O f G _U1 Horizon Depth Dominant Color In. Munsell Mottles Structirr u. Sz. Cont. Color Texture Gr. Sz Sh.FConsistence Roots Boundaryores Remarks: clayskins Hand other Loading GPD/h.2 0 �T7 ? -� 7s re M^ `r am • L IFAF vA 1-1v1J Huriton - Structure Gr. Sr. Sn. _ _ - - Consistence Rots Remarks: clayskins Boundary ores pHand other Loading GPDJ10 1, f rx- UJ- A.% / 0 0 ' e o Huriion DvpUt In. Dominant Color Munsell Mottles U. Sz. font Color Trxturr Structure Gr. 5z. Sh. Cunsi;ti ncr Roots Boundar Remarks; clayskins ores Nand other jerfD cF4jCvrC-v for a conventional s tjc s !� Ysten1. l�AJ 0 o. - - _ r Loading GPD/It.2 Horizon Depth In. Dominant Color Munull Mottles _ Qu. Sz. Cont. Color Texture Structure Gr, Sz. Sh. Consistence Roots Boundary Remarks:{ clayskins ores pH. and other Loading GPD/tt.2 Y4 / !L/ --- - / ► `f''' `1W' Y y 1 /9:0:: _ &1 14 jei V riOmESITE $EP fIC PLUMBING CO. Ub:, O'NEIL ND., HUDSON, WIS. 54016 ROBEHT ULBRIGHT 0 5 -r '�r 41 rt; Ma TER PLUMU-R LIC. NO. 3307 M.P.R'.b. Additional Ri' ii ks:' 4(w// CI Ile- /" "41 1 Otbe( Site features: A) gri j t u I —c— G f i i i 1 1-11 —(j �t o —tV D-v—P L h I —- Dale SiS,ofhcTcluphone No. CST # 7t ell 7 / t 7 Zn 0 14 .00 e. 'u 24 S L�- A AJ U Aj 5t4U -A 4 r � /V /00 t4 WAe �o Z Y 5 64 • 'r 5'C'4 jP FoR 3 T This test site APPROVEED for a conventional septic system. 6)0 SE r AVe 0 A-) FG 1"X- SITE SEPTIC PLLINWiNG W. O'NEIL RD., HUDSON, WIS. 54016. ROBE HT ULBRIGHT C-'-,r iOWNIBER LIG. N0.3307 M.P.R.S. DESIGNER LIC, f40.00663 zeeel /* 2- 51'Zt'u& - FoR 3 7-,e eau at. S ;Y z6- :)- 7-1?,ev .5- S"X 10 ale r q r Tf i • a -re 16 Z�' R 11y t,J � fl ► 7 S`'D �" r 6 �+• t' r , ry ,� acr .. C.� •v �-CrcIlk , a 5 � 0 �tw- EL r f, h ' ?1 l 1 '� �6vc i�� /ice dF/4 Y l/a4) r /4� •Q r3N • ` � � 4 .� C � . c..,.> , ' L.r d �., C �,.J' p S � C3 � �' L o i (,. ' o, ,� ,,r,,, � � , (fit. c..,,•. � s., �. � �• 3c 3 1 f • • PUMP CHAM ER CROSS SCeTIOM AM0 SPECIFICArldUS' ' 3 VCMT CAP Y. r C.vEUT PIPC W CATUCK PROOF APPf L 0VC 0 OCK1644 J"TIOM &Ox MMLC COV91% •• L S F RalM mass muoow oR rusty It rljV• _ Alit mTAK9 - GRADS ! 4 MINI COWDuIT ir 1 PROVIDIL _... _ IN L Ir T AIRTI&MT SEAL i G � I . AP�RovEa �c APPILOVED JOINT 'V � w/colo rift1"14(ip- r n P, 0s 7-c Tq � � w/C•?. PIPE EXTCLfD1uG . EXTENDI1A 3+ /Uv - � / �� S'r , MATO %QW9 $Di L alrTo S4L1 D z �0 ke T-r f � . Lac a T,•ar-, ' � � CLCk F� �� � `R 1 F' r,.� • off . ,. G.JarV-4 T . S'r —C sL CIiCIC RXIi' PCRr�I�•ED ou�y IF TAUK P"LjF#4TI. RS4." SAX . b"N APPROVAL. wPPRavor6c • SPEC I OM S .SEPTIC � 005E TAW K JAMUFACTU&CR• 1JuIr10CR Q p0;�;. PRR p TAuK 51Z C : Don YaL.us4c Ec 1"CL U0114(p RAGKI��Mr� ��' Z Gr►��o� ALAR AM IrACTVPRR: s-2;: A0=1m WUTAARER • CAI CITl��� A s 6 WC.M 09 GALL0� $WIT" T FC; a • � PUMP ' M uFACTURER: C • uJCKEi aR �ALLo� AW09L. W14KR:. Q ■ mu DALLM sty ITC N T V P C: -� , Pura! AID ALARr► ARE TO OC INJULI•ED ON UPARAT9 CIRCuIT6 t u CHA RAYR � 1''11u1r1 �1 QIS RGC 1 VERTICAL DIFFM"g KTW99M PUMP Off � DISTIMIATI� ���.. FgCT I%ILII u IJCTWOR'K iuPt� PREA6URC .. • . . 0 a 0 • . .' FLO •. j + N1 Ir1 � . . + F ET OF FORCE AMM X'sFTrt FRICTIou 04y": FECT l,3 �cr�I S . ToTAL DU A IL HEAD - of PLET IIJTERLIA6 IDALMSIGMS Of TAWK: I.EWPTM - ;wlDYH , LIQUID DEPTH �iG�1EQ E uu a�R.PAT r. HEAD/CAPACITY CUK : c EFFLUENT and DEWATERING mom � �i�'i �7 � w!w7!2 mE^..Y ��isamm�m EMM man��mmv�mr.���mv cam 80 160. MEN Lim omm so 146k I 45 ML A� Wisconsin Department of Industry, Labor and Human Relations SOIL DESLrilPTION REPORT S.O. B x 7969 ngs oiYis� p.C). Box 79b9 (Attach Soil ProfWLocation Map - To Scale - On A Separate, Signed Sheet) Madison, WI 53707 <,,- C" ( x-q� 4-,/ /-� page / of astomer Name r / d STD T�-G--� wa uation Date urrant Lan use or Vegetative over ��9 y �, Parent materials © 016 ustomer ras 3 Z' stimate Shallowest Groundwater G/ Plain Elevation /a/ aunty ���X Tax Parcel No. � ©` ystem Loading Rate in Gal ns Per Sq. Ft. Per Day Lot Legal ptscnptaon T ystem - eometry an Dept ope an Aspect Horizon Depth Dominant Color In. Munsell Mottles u. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Roots Bounds Remarks: clayskins ores Hand other Loading GPD/h.2 1,45 (9f So� AA f� /GvS�o.�.�5 IF 271�;�u4e 71D **t-* u I 5611, y, Horizon De th P In. Dominant Calar Munsell Mottles u. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Roots eoundar Remarks: clayskins ores Hand other Loading GPD/h- 6 /© //e 3 --- , Vj 3 2 7 5 Y,e 06 /'s 5-(e A j �)/'kl V4�e /0 Ye-5141- 5/ A P 7/ - 6— f,&a t, ..P u C !f l f% /S U C , u T - /.t-� s 131 r 5 10r4F YR ORIGINAL i Remarks: clayskins Loading .5 i� I/'o Imp (?12- .(?0 Horizon _Depth DominantCoJor Mottles^ Structure f� Remarks: clayskins Loading In. Munsell u. Sz. Cont. Color `Texture Gr. Sz, Sh. Consistence Roots Bounds ores H and other _GPDlit.2 r _ i� to 11 A 3 .5// .2, �f, s40 � hk W 21 /� _ -- 2 f711 A, s h� �4-,� �J f stv i3 /D ------ � -f !, r y� -S` s_�o / �i% /�- -----. S ©, vf, y2 , , �� -- ---- w Est �� A W-nuvr I 4V rw LJ o°..' 3 ' '7 for a convention septic s �. Horizon Depth Dominant Color Mottles Structure Remarks: clayskins Loading In. Munsell u. Sz. Cont. Color Texture Gr. Sz. Sh, Consistence Roots Bounds ores H and other GPD/ft.2 .2, f Yhe %, -f e- ------- 30*11 .2, T 10Y)e /OY C�_ i V /� n/%t �- /� �je;✓Zr -AJ HOMESITE SEPTIC PLUMBING CO. �n dbt; O'NEIL RD., HUDSON, WIS. 54016 Z ROBEIRT ULBRIGHT '0 s r r 16. MASTER PLUMBER LIC. NO. 3307 M.P.R . r ►N. IWTALLE'l & DESIGNER LIC, 1-40. 0M / r)✓ o°..' 3 ' '7 for a convention septic s �. Horizon Depth Dominant Color Mottles Structure Remarks: clayskins Loading In. Munsell u. Sz. Cont. Color Texture Gr. Sz. Sh, Consistence Roots Bounds ores H and other GPD/ft.2 .2, f Yhe %, -f e- ------- 30*11 .2, T 10Y)e /OY C�_ i V /� n/%t �- /� �je;✓Zr -AJ HOMESITE SEPTIC PLUMBING CO. �n dbt; O'NEIL RD., HUDSON, WIS. 54016 Z ROBEIRT ULBRIGHT '0 s r r 16. MASTER PLUMBER LIC. NO. 3307 M.P.R . r ►N. IWTALLE'l & DESIGNER LIC, 1-40. 0M / r)✓ HOMESITE SEPTIC PLUMBING CO. �n dbt; O'NEIL RD., HUDSON, WIS. 54016 Z ROBEIRT ULBRIGHT '0 s r r 16. MASTER PLUMBER LIC. NO. 3307 M.P.R . r ►N. IWTALLE'l & DESIGNER LIC, 1-40. 0M / r)✓ iti�n&l Remarks: e 4C 4��Ool 7ZF -57d 115 Lo Atok- 19,,,7s e e 41 5'�� o,W �Al 70 Other Site Features: hu� Llrnj7,;7q -f,,(tO(VDeplw-. CST Signature Dale Signed Telephone No. CST 0 SUD-030(N 01/90) -;fx" 0 t���ti� . so,�s o� do �--�,�,�E�m rd � s��s�ti.���y 257 �b�j�s lav�'r��,��0 C��� ��� Ct��tiT� z� �'�^-r .Svrv�5.� J_57tt-Lt� 4�i/l %Jfiv � 7 O e_Z 'S�1illlOG> - 70 /LI/i/Nf�I/.N /4 S��1f��FT%C�,U h6 4ptAi 6 S E A Full tj ltt- Z ?'S T jei13uTia,40 f� � el" I *D& �,.e -S �L?rT At t�Aj 'r Ij w� � l R 5 at p f , a .5 w /// 4-c.- Ski �/lo ry — SGiu -A 1,n z-fj �f ftecj �t Q �t S 4-f EwRr� y/�,ru, v�, � ; � ( 7- 0090 7- Be po.s IT 7— d- �w+ ,, � �e P _OV *0 -AIV rj'0 AJ57 �'�. 2" 2- - T3.3 102,0 V) i ,�o D Zf� 100,30 4',5 -FoR Y A -- — i3 L "i Tie Ic Ad 4A z-- --2-- 7-�c 7 Te /09 This t6st site APPId 0"VED 1i for a conventional septic system. 1\4 h. Se r 31� S-7"& e -f LO F-J,MCSITE SEPTIC PLUMBING CO. C;r O'NEIL RD., HUDSON, WIS. 54016 ROEERT ULBRIGHT C -5- 7' .2, :YP S. N" Pt -UMBER LIC. NO. 3307 M.P.R.S. r-.,) 4, DESIGNER LiC. 140. 00663 ze& Z- c A ` Wiiconsin ticpar ment of Industry, Labor and Human Relatipns 2 P/ - l:,-) .2 SOIL DE!)LrtIPTION REPORT SafetBuhuings Division P.O. VolSx 7969 (Attach Soil P109kLocation Miip - To Scale - On A Separate, Signed Sheen Madison, WI 53707 7 Page l of - ustomsr Name walv• uatJon Date cuffent l+n Use or Veyet+tivr Zovel Parrrnt materials uttvmer rp1 Burnwtr i �w owrst rou water P a�n E evatwn aunty ✓ter e/►,cs �. as Farc4lo. O� L10 ystern Low in9 fLate in na ons Per g. it. Prr ay Lot lrgw tstrrpu4n �tv , T--- ystern cometry an Dep I optn _ �D UJL41ii Horizon- Depth Dominant Color In. Munsell Mottles u. Sx. Cont. Color Texture Struct.re Gr. Sz Sh. Consistence Roots Bounds Remarks: clayskins ores H and other Loading GPD/h.� 14 2- - /o ,e s �-- s/ l,-� st �►� -�,e /v , s -1� � s y>e -------- , �, -�' SL9 up -516 /l e 7/N /j6 t�orrzun �3 z Remarks: clayskins Loading Boundaryores H and other GPDJftJ cs .�� c? 451e �/ d� / o f conventional8@pt�C sys#t�rn. Dominant Color Mottlrs Structure Munsell u. Sr. Cant C"Aw TLxturr Gr. Sz.'ih Cunsist�rce Roots Hour Yk o yA ' CAD . V 1 /'J AV Loading GPD/ft.2 _LP Al J.P Huritan�Dtipth In. Dominant Munsell Mottles u. Sz. Cont. Color Texture Structure Gr. Sx. 'ih. A Conslarnce Roots Boundaryores Remarks: clayskins Hand other Loading GPDlit.2A0 _ y,,e Horizon- Depth In. Dominant Color Munsell Motuits Structure u. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Boundaryores Remarks: tlayskins H and other Loading GPD/h 2 y, 3 —�---- ��� .2, .r S��k --,— 2-� . -� �� . �� ,�� �� p y �`� rijiAESffE SEPTIC PLU1AbiNG CO. u�' O'NEIL RD., HUDSON, WIS. W10 ROBERT ULBRIGHT 0 - 4- �I;. MASTER PLUMBER LIiC. NO.3307 M-P-8.5. w( Site f caturet: LimiUJIV f4clolvDvpLh. CS(s1palule Teltphone No. S116 0 ) jo IN u viol rj 7Y0.,4j B2- 21 T1 /02,0 30 �10 0 '5 y 5 7-Z L,4 �r 54C 4 /- j5 Opp goo � f a�D SOP CON SE r SY& e :67 13 C' I I'L s A-) F0,M.0 SITE SEPTIC PLUMBING W. CYNEIL RD., HUDSON, WIS. 54016 ROEERTULBRIGHT C-'7- �''�- s. m. -'",I PLUMBER LIC. NO. 3307 M.P.R.S. DESIGNER LiC. N0.006W A.) e()- v