HomeMy WebLinkAbout042-1085-90-000 (2)St. Croix Count Fla nning and ZoninYIJ "edit estla.v, S'eptembei- 05, 2001' at 10:5.7:50.AM
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Detail Sanitary I nformatI011 Pa C64 /
Computer #:
042-1085-90-000
Sub/Plat: metes & bounds Section,
31
Parcel #:
31.29.18.480B
Lot: TN/RNG:
T29N R18W
Municipality:
Warren, Town of
CSM: 1/4 1/4:
NE 1/4 NW 1/4
Owner:
Department of Transportation
Highway 94 Weigh Station Roberts, Wl 54023
State Permit:
180258 Issued:
06/15/1992 POWTS Dispersal: Pressurized In -ground
Permit: New
County Permit:
0 Installed:
06/15/1992 POWTS Detail: NA
Bedrooms: 0 WI Fund:
POWTS Pretreatment: NA
. ... .. .. ...
ISSuer,'Ins ar As Built
Not determined NA
Not determined C" No
r0
Scherdu-le�,d Pump. Date Pumped
6/15/1995
PIUMber Other � equirpi`nerlkg
Geissler, Glendon
-1st ... Notification
04/20/2006
3rd Notification
Additional Notes Money Owed
Plumber: Glendon Geissler, Issuer- DILHR-Vicki $0.00
Sm ith
For DOT Weigh station
t
St, Croix, County Play�nin� and Zonin
Detail Sanitary Information
J . e I
T' diiesdtq, ,Mpist 22, 200 7 (it 4:28:12 A11
1"t-ttle I of I
Computer #:
042-1085-90-000
SublPlat: metes & bounds
Section:
31
Parcel #:
31.29.18.480B
Lot:
TN/RNG:
T29N R18W
Municipality:
Warren, Town of
CSIVI:
1/4 1/4:
NE 1/4 NW 1/4
Owner: /0epartm'Zhrit of Transportation Highway 94 Weigh Station Roberts, WI 54023
State Permit: 180158 Issued: 06/15/1992 POWTS Dispersal: Pressurized In -ground
18OUl 58
County Permit: 0 Installed: 06/15/1992 POWTS Detail: NA
POWTS Pretreatment: NA
1SSUqr/lnqpe r� As 8 jilt I It Plurnber Other Rqqqjernents
qtp_ -- - - - - - ---------
Not determined NA Gause, Kenneth
Not determined No
Scheduled Pumi) Date Pumr)ed 1 s t N o i f 1c a It io.t 2nd Notification 3rd Notification
---------- ------------- - ------- ..................
6/15/1995 04/20/2006
Permit: New
Bedrooms: 0 WI Fund:
Ad.d-ltional Notes Money Owed
Plumber: Glendon Geissler, Issuer: DILHR-Vicki $0.00
Smith
For DOT Weigh station
Parcel #: 042-1085-90-000
08/22/2007 04:27 PM
Current X Z Z-) 1. UMUIA UUUIN I T, VV10%,,U1N011N
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): 0 = Current Owner, C = Current Co -Owner
0 - STATE OF WISCONSIN, D 0 T
D 0 T STATE OF WISCONSIN
718 W CLAIREMONT AVE
EAU CLAIRE Wl 54701
Districts: SC = School SIP = Special Property Address(es): Primary
Type Dist # Description
SC 2422 ST CROIX CENTRAL
SIP 1700 WITC
Legal Description: Acres:
SEC 31 T29N R18W 3.76A PRT NE NW S OF
HWY
2007 SUMMARY
Description
STATE
3.760 Plat: N/A -NOT AVAILABLE
Block/Condo Bldg:
Tracts): (Sec-Twn-Rng 40 1/4 160 1/4)
31-29N-18W
Parcel History:
Date Doc #
07/23/1997
Fair Market Value: Assessed with:
0
Last Changed: 05/03/1994
Land Improve Total State Reason
0 0 0 NO
Totals for 2007: General Property 0.000 0 0 0
Woodland 0.000 0 0
Totals for 2006: General Property 0.000 0 0 0
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
0.00 0.00 0.00
nmlx� -WEEMEW'.0w,
OILHR
SANITARY PERMIT APPLICATION
In accord with ILHR 83 05. 'Nis Acrn Code
St. Croix
S I
'rArE
-Atlacn complete plans (to the county copy only) for the system. on paper not !ess than
AlA x 11 inches in size. c 4131orl 10 ;)ro)V'G�s -A
_See reverse side for instructions for completing this applicatid'n.- STATE PLAN 3 NU"8ER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. State Prof #1020-09-7
PROPERTY OWNER PROPERTY LOCATION
WI Department of TLanaDQrtation - Central NE '4 NW '/,&, S 31 T 29 N. R18 IZ)= W
PROPERTY OWNER'S MAILING ADDRESS LOT # I BLOCK 0
4802 Sheboycran f RQM 651 NZA NZA
CITY. STATE ZIP COOE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
1, 1— -3 4 — — — T.T_r I ( r'np P-,-irr-pi dP_.q(-_rintion attached
11. TYPE OF BUILDC:] C I TY NEAREST ROACD
BUILDING: (Check one) T State Owned VILLAGE Warren] j
`7 TOWN OF-. 1-94
. Public 1 or 2 Farn. Dwelling-# of bedrooms OARCEL TAX NUMBER(S)
III. BUILDING USE: (It building type is public, check all that apply) N/A
L
I L_j Apt/Condo
0 L_j Medical Facility/Nursing Horne 10 ❑ Outdoor Recreational Facillv�
2 Assemt)ly Hall 70 Merchandise: Sales/Repairs 11 ElRestauranVBar/Dining
3 Campground [1Service4 Church/School 8 E Mobile Home Park 12 Station/Car WashWeigh Sta.
r7 Hotel/Motel 90 Office/Factory 13 FX1 Other-. Specify 5
IV. TYPE OF PERMIT: (Check only one In line A. Check line B if applicable)
A) 1. 2. El Replacement 3. ❑[1 Replacement of 4. El Reconnection of Repair of an
1XI New Existing System Existing System
System System Tank Only
E) El A Sanitary Permit was previously issued. Permit # Date Issued
V_ TYPE OF SYSTEM: (Check only one)
Non -Pressurized Distribution
1 ❑ Seepage Bed
Ile- ❑ Seepage Trench
13 Ell Seepage Pit
14 L-] System -In -Fill
Pressurized Distribution
21 0 Mound
22 ® In -Ground
Pressure
Experimental
30 [] Specify Type
I, I
Other
41 ❑ Holding Tank
42 pit privy
43 L-.j Vault Privy
VI, ABSORPTION SYSTEM INFORMATION:
1-. GALLONS PER DAY
2. ABSORP. AREA
3. ABSORP. AREA
ft.)
4. LOAOING WEE`
(G-&IsJday/s,�.'k.)
t
8EWPATED"16.
(Min,/Inch)
SYSTEM ELEV.
17. FINAL OP
ELEVA
REQUIRED (sq. ft.)
PROPOSED (sq.
1696
2120
2,208
0.77
9
1023 - 74 Feet
11028.0
CAPACITY
VII. TANK in gallo fie
INFORMATION Now isd
Totaf
Gallons
Tanks
1 Site I
Pfefab I b er -
Manufacturer s Name I oncret-ei Con- Stew glass
strutted
'iasuc
Tanks Tanks
C1
I
Septic Tank or Holding Tank -5 nn
2500
1
I I I It
27A
Lift Pump TankiSiphon Chamber 4
127A
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 Sta I MPIMPRSW No.: Business Phone Numcer,
Plumber's Address (Street, City, State. Zi GMO):
f
IX. COUNTY/DEPARTMENT USE ONLY
Lj Disapproved Sanitary Permit Fee tincludes Groundwater
Surchargo Fee)
)(Approved ❑ Owner Given Initial . * C)
L�Veae 0-otgrminatiRn . I
X. CONDITIONS OF APP R OVALJ REASONS FOR DISAPPROVAL:
t��sJ�e—asv
)ace issued Issuing Agent Signature kN0eta rrQ5?
(Cr1S;OR'�-
r'�ISTRIBIJTION Originai to Counrv- Orl-8 �_Oc* -0 Sdf@(-y S
S60-6398f1ormer1yP1b--67e)iR ly
i
FQ ice
PLUMBE krt AFw-AM"
TOWN OF(LL44A%A&EvAN LOCATED JVFw__1&
I IN
AiLo 'U SEC_ -T_ N;Rtrtw
91 a aj 2A
401101ft BLOCK
CHAPTER 145.135 WISCONSIN STATUTES
(a) The purpose of the sanitary permit is to allow installation of the
private sewage system described in the application for permit.
(b) The approval of the sanitary permit is based on regulations in
force on the date of issue.
(c) The sanitary permit is valid for 2 years from original date of
issuance and may be renewed for similar periods thereafter. Application
for renewal shall be made through the county and shall comply with
regulations in effect at the time.
(d) Changed regulations will not impair the validity of a sanitary permit
until the time of renewal.
(e) Renewal of the sanitary permit will be based on regulations in
force at the time renewal is sought. Changed regulations may impede
renewal.
(f) The sanitary permit is transferable. A sanitary permit transfer
shall be obtained from the county authority.
* if you wish to renew the permit, or transfer ownership of the
permit, please contact the county authority.
� AUTHORIZED ISSUING OFFICER - D TE
THIS PERMIT EXPIRES_&_WjS7=,'C?14 -UNLESS RENL1--,-kED BEFORE DATE
SBD-6499 (R, 1 1188)
DURING CONSTRUCTION
DEP �q , ivitNT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY,
- 1
OLHR 83.09(1) & Chapter 145) Df VISIC}�:
LABOR AND
PERCOLATION TESTS (115) MADISP OQ BOX 795=
HUMAN REN, WI 'S3713.
LOCATION tlr,% SECT! N TOWNSHIPIMUNICIPALITY LOT NO. BLK. NO. SUBDIVISION NAME
hIj�/ I� 1/ 13/ /T zi N'R /g on rox v � jol 45
COUNTY
+�i� �o� 1"r MAILlN A R
1,V
USE DATES OBSERVATI NS MADE
NO. BEDRNK.: COMMERCIAL I TION- ��-tt
E II TS
Residence %P'IJG' ,ICJ WNevv Replace %j�l ? C7 Fr
+ CJ
RATING: S- Site suitable for system U-� Site unsuitable for system
CONVENTIONAL: MOUND: IN' OLIN : Y M•IN-FILL OLDING TANK: RECOMMENDED SYSTEM: (optional)
[g S [:iu D S O NS
DU
Ej
S XU El SNU c�wv�,v 7-"
If Percolation Tests are NOT required DESIGN RATE: It any portion of the tested area is in the
under s. ILHR 63.09(5)(b), indicate: 17 Floodplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS
BORING TUT -AL DEPIH TO QROUNOWATER-INCHES CHARACTER OF SOIL WITH THI KN SS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN. ELEVATION OBSERVED H TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
L 5"'/ BA C
009 e I oo e " l r I :F - 3z 3z -- / o c>
B- 3 l oo t1ouZoe--
B- q- /00 1,029,73 C?AIQ97 100 e9 - I-3 13 --30- 3Z -- /oo
B- /oo toZe-T,o7 X/O/,/ o!5' t9a-Ek.- 100 o -13 13-04:�? 2,9 -r1010
1B- 61 100 1/0, Xlea-jtc- 0 '00 0 '6
PERCOLATION TESTS
TEST
NUMBER
DEPTH
INCHES
WATER IN HOLE
AFTER SWELLING
TEST TIME
INTERVAL -MIN.
DROP IN WATER L V EL -INCHES
RATE MINUTES
PER INCH
FE RI 1
PE Ftj0D 2
PERIQD
yj
P.
2
P.
P-
.C.�,
C•�
j l
B//
%' icy
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hc-
zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and perce_
of land slope.
SYSTEM ELEVATION 9- 5cCo uv.A° ` ;E7Z Vj /o Z 3, 7 9-
i�
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 Wsscons.-
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): �3Q1-4AIP-� r—�Ir Z.) TESTS WERE COMPLETED ON:
1941t> s-,x'. � Il -
ADDRESS: �� ci►- l�'14 7 j.- 3;rh4 /— ERTIFI ATICIN NUMBER. PHONE NUMBERtoptlonatl
53 7/ 3
[CST SIGNATURE: Il
DISTRIBUTION: Original and one coon to Lore, Auiho,oy Procner-y Oyvner ana Sods Tester
DEPARTMENT Of REPORT ON SOIL BORINGS AND
INDUSTRY,
LABOR N REDLATIONS PERCOLATION TESTS (115)
(ILHR 83.09(1) di Chapter 145►
SAFETY & BU;LDIN';S
DIVISION
P•Q. 30X 7959
MADISON, WI 53707
_OCA I ION TOWNSHIP/MUNICIPALITY LOT NO.-BLK- NO - SUBDIVISION NAME
OV
Lj ir, 114vv /TZ?N/R)9
O U N T Y MAILING ADDRESS
S iI1 f a ,�"� ► /�/�''� !7 Llr
DATES OBSEAVATfONS MADE
x+ a ►_
NO. BEDRJu6& : COMM_R C IA L D E S C RI O: L zr�
N TESTS
DResidence r)� CJC I-0c 161-N XNew Replace rZ2
�/ % _
s '7
RATING. S- Site suitable for system U- Site unsuitable for system
ONVEN I NAL: MOUND: IN- M-IN-FILL OLDNG TANK: RECOMMENDED SYSTEM (optional)
Rs 0U EJS-NU., NfS MU f-1SSU El S 01 60V11.5 A,/ 7-/0w4 Z-
If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the
under s. ILHR 83.09f51(b), indicate: (7- Flpodpiain, indicate Fioociplatn elevation:
PROFILE DESCRIPTIONS
BORING
NUMBER
TOTAL
DEPTH IN,
ELEVATION
PTH TQ GR UNDWATER-INCHES
CHARACTER OF Oil WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.(
OBSERVED
HE
B- �
/00
1OZg'i
��v�
- coo
Sf :7/ �n C/ fan /y- 9r
e -� e -- - z 4 -- /oa
B- 9/
o 0
f D zg► 7
pe2l-llc
0 v Ia
--
B_
Dom'
��G(0,h�)
AZV0
�'`-',% '�•Vd
B-
B-
B-
PERCOLATION TESTS
PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate wale or distances. Describe what are the hori-
zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percen.
of land slope.
SYSTEM ELEVATION 4' � ''�-��''` ' �L �'� I ' z 3, 7LI-
7� Qom`
TN
wi_- -W ----- __ -
1, the undersigned, hereby certify that the soil tests reported on this form were made by rrx 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.
iNAME (print) dG ,4149' /AZ7t .157-4,,Ap'tC C,? TESTS WERE COMPLETED ON:
ADDRESS 1 1 p Z S r� w,q► e 7- 5r r f� T CERTIFICATION NUMBER: PHONE NUMBERiootiona^"1
7
CST SIGNATURE:
C)lSrRIFjiJTION 0', 9`3: B-10 e nV r i Authority Pforf-,y Owner ana Soo, Tester
�.
' SAFcrY & BUILDINGS DIVISION
State of Wisconsin
Department ofIndustry, Labor and Human Relations
September 26, 1991 201 East Washington Avenue
P.O. Box 7969
Madison, Wisconsin 53707
MEAD & HUNT, INC-
65Ol WATTS ROAD SUITE 101
MAOISON WI 53719
RE: Plan Number
Project: WI - DOT - I-94 WEIGH STATION
Location. NE,NW,32,29,18W
WARREN
Owner: WI DEPT OF TRANSPORTATION
4802 3HEBOYGAM RM 651 P O BOX 7916
MADISON WI 53707
nty: ST CROIX
Foe Received 125.00
Date Received: 9/17/91
This letter is to acknowledge receipt of the Petition and Plans which you submitted
to the Office of Division Codes and Application, Section of Private Sewage.
Wecannot however, process your submittal until we receive:
- An ons1te report signed by the Private Sewage Consultant verifying the soil.
Private Sewage Consultant, Leroy Jansky, can be reached at (715) 726-2544 to
arrange for an appointment.
- Revise drawing to show how 4" header pipe will be drained to prevent freeze up.
- The dosing tank 1s required to have a one day storage capacity above the alarm
10 accordance wi*th s- TLHR 83'15 (5)(b).
- Complete calculations for total dynamic head.
- Complete calculations for total gallons pumped per cycle'
- It is recommended that a longer and narrower designed system i's used for this site.
The geometry of this system (46 X 48 feet) means tha± a linear loading of 35 gallons
per linear foot is being used. Based on past practices and design of using a
square bed, this may lead to early failure of this system.
- Plans which are properly signed' If a cover sheet is used, it must be signed,
dated and clearly identify all of the sheets comprising the bound volume.
Plans not properly signed will be returned.
Additional information requested shall be properly signed as per
Section ILHR 83-08 (2) (a).
Unless otherwise specifically noted, please submit two copies of all requested
information -
Please retain one coov of this letter for reference and return the other with
the materials reguested.
Smm" .R.".mu
' r SAFETY & BUILDINGS DIVISION
State of Wisconsin
Department of Industry, Labor and Human Relations
MEAD & HUNT, INC.
Page 2
September 26, 1991
Your Petition and Plans will be processed within 30 working days
fallowing receipt of the requested items.
Petitions or plans submitted to this office which require additional information
will be held 90 working days for receipt of the information. If, after 90 days,
response to this letter has not been received, your plans will be returned.
If you find it necessary to contact us regarding your submittal, please call us at
(608) 266-3937 and refer to the plan number as shown above.
Sin rely,
J MES QUINLAN
Section of Private Sewage
Division of Safety and Buildings
PPP012/0001n/ 3 COMP: 1 15
ELEM. 12
cc: WI DEPT OF TRANSPORTATION
Xcounty Plumbing Consultant
Plumber Environmental Health
UW- SSWM P Qept of Agriculture
Local PI
Facilities Need Analysis Section
�C Private Sewage Consultant
S11D.6423 {k. 01/911