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' V O 0 ti A coc + 0 co K ✓p W to O '- ti O O CDy 0 a ti til I n AA►hQ r_ - n n (A)15 C — F ci. .I)) Wiscons;n Departrriant of 6� p(I per/ Count • Safety and Buildings Divi (, ` , "�"'� GQ'""- INF( \'�� " , �..- ilt4°z Sanita ' " o GENERAL �, 1 Personal information yo /S � I. y p u°"9 _� ;9-� .Ship State Plan ID No.: ,yL IRrIvtiii.M;fiyl ; VA. - (,ws (03`' �� ` T , . ID . (1 — l;K ,1; II I I I I CST BM Elev.; ` \Ky-►� °` ` TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY I STATION BS HI FS ELEV. Septic W Q e- I (MO((, O B rk 9,gyp 10-0 \! Dosing CGAA) h� Al+• OM '(0`5--- I oc,OS" ' Aeration ,...„„2 Bldg.Sewer ( oQ )A4IBv) Holding --r' __ St/Ht Inlet I5,$L-{ TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. vAirlenttontake ROAD Dt Inlet Septic y (a-ID` > lab` aSt) NA Dt eceititum(FAS.) 1,9.4C 90.zS— Dosing �f (E7.....7„) �-5' NA Header/Man. Aeration NA Dist. Pipe R'S-0 (o 1..0 Holding ---) Bot.System �'I� i cslD .S 0 PUMP/SIPHON INFORMATION j 46t &tat- •4 6ef--A.11. - S) Manufacturer -1cy t c. Demand % C�>cl u - ur'� `+ "� SP / 1-�� - 41D 2'' GPM '�gbModel Number �j SSyy _ 4 TDH Lift (a.2� Fric ion3,%1 Hetem3'2sTDH1�-la Ft Forcemain Length",\opt Dia. zif Dist.To Well — SOIL ABSORPTION SYSTEM Width / Length o. f PIT No.Of Pits Inside Dia. Liquid Depth Iti REN l IZ -gyp �a�1� DIMENSIONS \\ ENSIONS anufacturer. SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING SETBACK — CHAMBER Mode tuber: INFORMATION Type Of ^ I q r ��• OR UNIT System: M°t d�-- (�r > I I� ` 3 DISTRIBUTION SYSTEM (1- 4-D-t-oe-r�w'"^a) I°•4( ' to ..-to (� ; (.I �— Distribution Pi e s r� \ ti r� x Hole Size x Hole S,pacing Vent To Air Intake 3.2 Header/Manifold tt P � ) �r.�"J / �� Ss/ l Length'(et Dia. 2 I Length 55. Dia.t `2 Spacing __ //(p SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over xx Dept xx Seeded/Sodded xx Mulched Depth Over P l Bed/Trench Edges Topsoi Inspeetio1 #1-- Yes/ n/No Ins e�Ition #ll No I I Bed!Trench Center 9 �( IQ I ( )(�t a tAnaLQ' w�/ MN�I`NTS' cldeod disc e a eserso �p esen �t b13 ( E 1/4 SE 1/4 10 T29N T5W) - 10151 oca Ion. f O i usiic�toac� �,` o I �-oQQ 647 S.T u l�� 1.) Alt BM Description � 2.) Bldg sewer length = ^1i �,b( •�,,,r� -amount of cover = �g,o 10i` , 3.) contour= 99.30 (Sir sk- to.Mo c- t t = tog-1-o ) '`fit' ` "`_off 4""t4Y-' 4n� „-+-. z nw�;� so,I tbuo,_ _ °' PQ" ?} • Plan revision required? ❑ Yes No Use other side for additional information. 01 02. 011 - 4 .41510 --____. Date Inspector's Signature Cert No SBD-6710(R.3/97) I .. . • ! Sanitary Permit Application Satiety Buildings Division in a:.cord with Comm.83.21. Wis Adm Code 201 W. Washington Ave. • p See reverse side for instructions for completing this application PO Box 7302 MSCOflSIfl Personal information you provide may be used for secondar7r purp.Jses ' G Madison.WI 537(ii-730 Department of Commerce (Submit completed form to if r [Privacy Law. s. 15.04(1)(m)] I pcounty state owner Attach complete plans(to the county c jay only)for the system.on paper net't« s than 8-1/2 x 11 inches in size. County State Sanitary Permit Number 0 C,nect,iirevisi n to previ us appitt#tion State Plan I.D.Number s 7 0t2 ,.A-- 3FSV3 ,' <� 3 S�5! fs I. Application Information - Please Print all Information /. t' 7,'4, Location: _— t Property Owner Name (.0%\ t�`' Property Location 1 A PE:-7'sz o()-11Ic rt — /<'I A.)6 q s( 2 s x SL v4 Sc=lra.SA) T�z ,N.lei ., Propert Owners Mailing Address \ , s i_areeLot Number Block Number OIG .f �� -� 3arY ✓ Ji4Ci StateZip::ode � -Subdivision Nor C'M Number (`--,14:7C)11)0er)LE Ty Lt)I I .5-,-/0 / c ( - ± • .• .,!-g-Illel 7' lt-VA 40 a"..Aft..rv‹...i2) II Type of Building: heck one) ,,,/ As, ct O F d CI Village 0 I or 2 Family Dwelling-No,of Bedrooms: 3 Iv...,. Q(a.M,. 0 Public/Commercial(describe use): XI'own of„ ` 0 State-owned - J /?/ /OK GZ 9 III Type of Permit: (Check on! ,onebox on line A. Check box on line B if applicable) Nearest Road i7 5;-7c / A) I. a yste 2. Replacement 0 Replacement of 4. ❑Addition to Parcel Tax Numbers) system Tank Only. Existing System Q S'`/ — ID2 3__/C) - o eie) B) Permit Number Date Issued A Sanita Permit was reviousl 'issued • a • /5 . //o() IV.Type of POWT System:(Check all that apply) 4( —lCD ❑Non-pressurized In-ground l, Mound 0 Sand Filter 0 Constructed Wetland ❑Pressurized In-ground ❑ Holding Tank 0 Single Pass 0 Drip Line At-grade l / i / 0 Aerobic Tr atment Unite 0 Recirc ating,, Other: cstt,a+" 99. ) (4.o x 11Z•S M64),)462 clak "D = lq"(1.17 -(t. Dispersaareatment Area Information: I.Design Flow(gpd) 2.DispersalArea 3,Dispersal Area 4.Soil Application 1 5.Percolation Rate- 16.System Elevation 7.Final Grade Required Proposed Rate(Gals.idayisq.ft.) I (Min./inch) Elevation 5/- - (/-50 y5z) V Z) / s' I kid, 7:;-7 (t7 3 VI Tank Capacity in Total 4 of 1 Mau facturer Prefab ' Site 1 Steel I Fiber- Plastic Information Gallons Gallons Tanks Con- Con- i glass New Existing crete structed I Tanks Tanks l I ❑ ❑ 0 0 I F S�ao Ti �4 1�5r� 4lF)1 f` �--n IiF Sr / 0 1 ❑ D ❑ VII Responsibility Statement I,the undersigned,assume responsibility for installation of the POWTS show the attached plans. Plumber's Name(print) 1 Plum a's Signature(no tamps): M IPRS No. Business Phone�N/umber i✓ / tend c. /D c' / .i /1 � �' / 3 2' 3 O Plu ber's Address(Street,Cit State,Zip G e) „C/-s-57 -,7-- / ,k (/ r y6 o t` , 5 /77>- VIII County/Department Use Only 0 Disapproved i Sanitary Permit Fee(Includes Groundwater Date issued Issuing Agent Signature(No stamps) Approved ❑Owner Given Initial Adverse Sure ge Fee)_ UU )2.11,....--_ Determi ' n 3.ZS - L Zq, 20fl 1 � � IX.Conditions Approve easons for Disapproval: - icl ( Sit ;� v4,..a.i-tfre_ �s.. -}'v-ceN New 1\t.9-+M- ,19A�,ovtS -., -s ,L& .t--e-r 2...nA..e,tn1`Ko✓C -- , stfAG-{- -4 ltef- t s SBD-6398(R.07/00) (Flove el-PrN = e6•n1E (- e. Plot_ Map m I , 0 £i Pooh agsna h/ _ to_ _ cr ;..) o _i_ 0 ) i or) i_ ,� s a�c(3 r. �� Q = o o�,ao Ste._ v"- m c0Uo-\ ov,a a-0 m a� �� S o 46 O— LL1 O � �- : a lr_\�7 v e Q o m o o v ,0 N N �? D � C � E • co 0 10 N X 0 W SIiiir r' o d cr. ro • \\ CO CD Q U 1 rn \\` ll-J CO I / IF / / CL .----n 1 1 pp C i C tfl 7 In , -A-CI 1 I U.) CL CC / O O 1 N N Ca- 1 i 1 i p \ Vf „ / O 0.3 1 1 1 �/ 1 Y ti o / CV O CO 1 ' / / -0I+] / / Qr CVO CO O, i ' / / 6Q W 3 I I �\ o o 6Z't a¢ois / co II ' I 0 U C O Q CO 'O 1 N 0 1 = cr. d 1 F- O + I 1 I I w / U) I O CD V ' I U I Z p _ I i = ; Cr O co / Li: ■ /I I\ O ,=, � 11 ; co W / I ? ? J I I / O .__/ ---/ UJ i / CO IAA I-,-, (-0 / // CO OD >` i 11 11 11 0 i o o/ i N U CJ 7 CO cc) c. Page 7 of 8 \ v v °° CD 114 m Safety and Buildings PO BOX 7162 MADISON WI 53707-7162 TDD#:(608)264-8777 • \ye: sconsinwww•commerce.state.wi.us/sb Department of Commerce www.wisconsin.gov Scott McCallum,Governor Brenda J.Blanchard,Secretary April 16,2001 CUST ID No.227618 ATTN:POWTS Inspector ZONING OFFICE THOMAS GUSTUM ST CROIX COUNTY SPIA N13450 937TH ST 1101 CARMICHAEL RD NEW AUBURN WI 54757 HUDSON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/16/2003 Identificati hers Transaction ID . 6 444 Site ID No. 6281 5 SITE: Please refer to both identification numbers, LYLA PETRANOVICH-RESIDENCE above, in all correspondence with the agency. ST CROIX COUNTY,TOWN OF SPRINGFIELD;RR#3 SE1/4, SE1/4, S10,T29N,R15W FOR: DESCRIPTION: NEW MOUND SYSTEM/450 GPD OBJECT TYPE:POWT SYSTEM REGULATED OBJECT ID NO.: 787212 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes,is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: 1. On page 5,observation pipes shall have the bottom six inches slotted and the pipes shall be provided with a suitable means of anchoring. See Figure 8 of the approved mound system component manual for complete details. 2. On page 7,as determined from the soil test report,this parcel size is 40 acres. 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/instal lation/operation. In granting this approval the Division of Safety&Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance.As per state stats 101.12(2),nothing in this review shall relieve the designer of the responsibility for designing a safe building,structure,or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. THOMAS GUSTUM Page 2 4/16/01 Sincerely DATE RECEIVED 04/03/2001 FEE REQUIRED$ 175.00 FEE RECEIVED$ 175.00 TER PAGEL BALANCE DUE $ 0.00 POWTS PLAN IEWER II,INTEGRATED SERVICES (608)266-2889 ,M-F,0700- 1530 HRS PEPAGEL@COMMERCE.STATE.WI.US WiSMART code: 7633 cc: LYLA PETRANOVICH L Mound System Cover Page pg 1 of 8 Owner's Name Lyla Petranovich Owners Address 1016 Rustic Road#3 Glenwood City, WI 54013 (715) 265-4897 Legal Description SE%, SE%, S10, T29N, R15W Township Springfield County St Croix Subdivision C h� fAi • T S Lot# A p iflohall .v O Parcel ID 0/viso 4 N Ov GAF T!co 4 WROE & ®F ® Table of Contents 3 EF CpRR� o/ „. ... ..� . I39 y(1 y y s PO aQf 1 Cover page EN F cot THOMAS D. ;o 2 Mound Sizing Calculations GUSTUM 3 Pressure Distribution Layout and Dynamics 1201 • loose Tank Calculations k ® and System Drawings . 6 Management and Contingency Plan NOD lot Map CORRSC;�pN� O�DENCt 8 Pump Curve Specifications StiE CORRESQ total#of pages: 8 Designer Name: Tom Gustum License#: D1201 Date: 1/15/2001 Ph. #: 1.715.658.1344 Signature: Mound System Design Methods Used per"Mound Component Manual For Private Onsite Wastewater Treatment Systems"(Version 2.0)SBD-10691-P(N.01/01) per"Pressure Distribution Component manual for Private Onsite Wastewater Treatment Systems"(Version 2.0)SBD-10706-P(N 01/01) Mound Sizing Calculations page 2 of 8 Site Conditions Private Dwelling or Commercial (P or C) p Slope 7.2 % #of Bedrooms, 1 or 2 family dwelling only 3 Depth to limiting factor 22 inches Absorbtion rate of fill material 1 gal/ft^2/day In Situ Soil absorbtion rate 0.5 gal/ft^2/day Max BOD effluent value 220 mg/I Max TSS effluent value 150 mg/I Design Wastewater Flow Design Flow- Private Dwelling 450 gal/day Design of the Distribution Cell Bottom area of Distribution Cell: 450 Ft^2 Distribution Cell Width (A) 4 ft Distribution Cell Length (B) 112.5 ft Ground Contour Elevation of Mound 99.4 ft Design of Entire Fill Depth at upslope edge of cell (D) 14 Inches Depth at downslope edge of cell (E) 17.5 Inches Distribution Cell Depth for Aggregate (F) 9.5 Inches Cover Thickness at Distribution Cell Center(H) 12 Inches Cover Thickness at Distribution Cell Edges (G) 6 Inches End Slope Width (K) 9.4 Feet Fill Length (L) 131.3 Feet Upslope Width (J) 6.1 Feet Toe (Downslope Width) (I) 10.6 Feet Fill Width (VV) 20.7 Feet Basal Area Basal Area Required 900 ft^2 Basal Area Available for Sloping Site 1642.5 ft^2 Observation Pipes Location from each end of distribution cell (Z) 18.7 Feet Pressure Distribution Calculations page 3 of 8 Lateral Layout Lateral Elevation 101.07 ft #of laterals 2 Center or end manifold (c or e) c Distal Pressure Requirement 2.5 ft Orifice diameter 0.188 in Lateral Length 55.75 ft Orifice Spacing/Distribution Est. Orifice Spacing in Inches 32 in Est. Orifice Spacing in feet 2.6667 ft Available Orifice Choices: Actual Orifice Spacing in Inches 32.63 in Fractional 1/8 3/16 1/4 Actual Orifice Spacing in Feet 2.72 ft Decimal 0.125 0.188 0.250 Orifices per Lateral 21 Square feet per orifice 10.71 ftA2 Lateral/Manifold Design Lateral Diameter$ 1.5Iin Lateral Discharge Rate 13.836 gpm Manifold length 0 ft Manifold Diameter 0 in System Discharge Rate 27.673 gpm Lateral Spacing 0 ft Lateral to Distribution Cell Edge 2 ft Force main Friction Loss Forcemain Length 250 ft Forcemain Diameter 2 in Friction Loss from Forcemain 4.174 ft Center Manifold Lateral Side View a — Lateral Manifold Lateral x 'r x 'r x '1 x 4 x x x f x-i x it x 'r x -T x -r x / 2 0 La Loral L elm I6 '="< Lateral Long II 2 Lateral Center Manifold Plan View l< La Loral Lanatlt >I 0 1 V= Ol boas on boLLcm of la Loral egpally spaced Laterals a.ForesmaH of 5el iO I'VC 0—fort-up wf ballwalke or doornail plug Septic, Pump and Dose Tank Calculations page 4 of 8 Total Dynamic Head Calcs. Are laterals highest point in pressure system? y If not, list the highest elevation 0 Distal head + network losses(distal x 1.3) 3.25 ft Vertical Lift(pump off to lateral) 17.07 ft Friction Loss in the Forcemain 4.174 ft Total Dynamic Head (TDH) 24.5 ft Dosage Volume Calcs. Does forcemain drain back to tank? y Lateral Void Volume 11.79 gal Lateral Void Volume x 5 58.93 Manifold Volume 0.00 gal Forcemain Volume 43.56 gal Total Dosage: 102.49 gal Tank Information Tank Manufacturer Midwestern Precast I Tank Capacity 646 gal Tank Gallons per Inch Water Level 17 gal/in Bottom of Tank Elevation (inside) 83 ft Pump Manufacturer/Model Hydromatic Shef 40 I Minimum Septic Tank Rating: 450 gpd Septic Tank Capacity Chosen: 1000 Septic Tank Manufacturer: Midwestern Precast Effluent Filter: Zabel A100 Pump Tank Diagram Access opening of sufficient size to be lib`atertghb Icxknq cover provided to allow removal of filter. Opening to terminate at or above grade. 1 Inch with warm! label Mnrrum Imbed Grade ii- OuHe.Alternate T Inches Gallons LecatAP1 Hectreal per A= 18.0 305.5 Cann 16.28 and B= 2.0 34.0 I FOrtama In F C Q req. C= 6.0 102.5 �- D= 12.0 204.0 Weep Hole h 4 .0 Tota=l 38.0 6 6 or AntrSphan ' ',— Vevre I I 11 11 I I ti Selected pump requires a minimum operating rating of: 24.5 feet of head pressure at 28 GPM ,. Mound System Drawings page 5 of 8 Mound Plan View i i s 0p T76ervati-al plp F' , A= 4 Ft. 0(Q�F� B_ 112.5 Ft. A ° F7I'tributacrt Cell ° ��0�� J= 10.66. Ft. w 1 / K= 9.4 Ft. l �' g L= 131.3 Ft. —K '`I K ��� W= 20.7 Ft. Z= 18.7 Ft. I filledArea/Fill Material j I' L -4 Mound Cross Section View (Typical) Final Grade - 14 In. — — Observation Pipe p- Synthetic Fabric ''�-� G Distribution Cell �' ,t E= 17.5 In. System Elevation ' ny• _ &.� .r�F F= 9.5 In. p �� 1 G= 6 In. Cover Material Lateral 1. .._ H= 12In. Invert Fill Material E -_ � -,� .r ° $ Tilled Area e 4 � 'ag-.+, -. x s. Slope Forcemain System Contour Final Grade: 102.36 ft Slope= 7 % Lateral Invert: 101.07 ft Minimum of 6"aggregate below and 2"above lateral(s) System Elevation: 100.57 ft Fill material consisting of ASTM C33 Sand System Contour: 99.40 ft Distribution cell aggregate to comply with Comm 84.30(6)(1) Synthetic Fabric covering cell per Comm 84.30(6)(g) Lateral Cleanout Detail Clean-Gut plug Inal Grade or ball value Lawn -� 5prinkier Pax Lateral Lam] sweep 9� Gr two .45.1 Mound System Management Plan pursuant to corm 83.54 W.A.C. page 6 of 8 Owner's Responsibility: The component owner is responsible for the operation and maintenance of the component. The county, department or POWTS service contractor may make periodic inspections of the components, checking for surface discharge,treated effluent levels, etc. The owner or owner's agent is required to submit necessary maintenance reports to the appropriate jurisdiction and/or the department. Septic Tank: Septic tank(s)are to be inspected routinely and maintained by department approved individuals when necessary in accordance with their approvals. The use of chemical/biological"treatments"is not required or recommended. If such additives are used, make sure they are approved by Department of Commerce, Safety and Buildings Div.. Effluent filterare to be removed&cleaned as necessary) with pr_visions to keep solids from passing the septic during removal. No more than 1/3 of the usable tank volume may be occupied by sludge/scum. 3 year inspection: If tank has greater than 1/3 volume sludge, tank contents must be emptied and disposed of in accordance with NR 113 Wisconsin Administrative Code by an approved individual. If the inspector does not recommend pumping of the septic tank, then the owner must be notified of when pumping should be done as to not exceed 1/3 sludge volume. Septic tank should be routinely inspected to be watertight and of good repair. Pump/Dose Tank If an effluent filter has been installed in the pump/dose tank, it must be removed&cleaned as necessary,with provisions to keep solids from passing to the mound component during removal. The pump,float switches and alarms must be inspected at least every three years for proper operation. Pump/dose tank should be routinely inspected to be watertight and of good repair. Mound and Lateral System The mound system component must remain free of ponded surface water prior to pump operation. If 4 inches or more water level is detected in the observation pipes, the owner must be notified of possible problems/failure. The designed daily flow capabilities of the component should never be exceeded. Trees and any other deep rooted vegetation should never be planted, or allowed to grow anywhere on the component. Activities OTHER than mowing/maintenance(i.e. excessive walking, pets, vehicles, etc...) could compress the component and reduce it's absorbtion capabilities and/or possibly cause it to freeze in winter conditions. Lateral distribution pipes should be flushed out/tested every 18 months using the cleanout points at each end of the component to remove scum that may clog orifices. Performance Monitoring: Performance monitoring must be done at least once every three years following the installation or at the time of a problem, complaint, or failure. Contingency Plan: If the septic tank, pump tank or any of their components therein(including floats, alarms, pumps, etc) become defective, the defective tank or component must be replaced immediately to ensure that the system can operate as designed. If the mound component cannot accept wastewater or ponds wastewater to the surface,the component must be repaired or replaced in it's current location by either: extending basal toe to provide added absorbtion area; or by removing the clogged bacterial mat,aggregate cell, and distribution piping within the mound and replacing said components in order to return system to proper working order as required. — PU-Lt4A S '• LYL6 'M`r le-s Qc4°,,'6 S — b 2s2 0 . S-t- - • c_R..o tx C ` \' o ►vG : tS - 3$fo- �e� ! -• • . , • pAvvk (vavc.„ S p �. s 1 Engineering Details - SHEF40 Performance Data 40 30 SHEF40 Pump Characteristics Pump/Motor Unit Submersible 20_ Manual Models SHEF40M1 SHEF40M2 Automatic Models SHEF40A1 SHEF40A2 Horsepower 4/10 10 Full Load Amps 12 6.5 -----. Motor Type Shaded Pole(4 Pole) 0 R.P.M. 1550 10 20 30 40 50 60 70 Phase 10 • GPM Voltage 115 230 Hertz 60 Total Head (feet) 10 14 17 21 25 28 30 35 Temperature 120°F Max.Fluid Temp. (m) 3.0 4.3 5.2 6.1 7.6 8.5 8.8 10.7 NEMA Design A GPM (US GPM) 70 60 50 40 30 20 10 0 Insulation Class A (liters/sec) 4.4 3.8 3.2 2.5 1.9 1.3 .63 0 Discharge Size 1 1/2"NPT Solids Handling 3/4 Dimensional Data Weight 28 lbs. 3-7/8' 6-5/8"(168.27)—• 1. All dimensions in inches.(Metric for Power Cord 18/3,SJTW,20'std. (98 42) 5"(127) international use). (30'optional) 0., 3-7/8" ' 2. Component dimensions may Materials of Construction (9842) V` %~� vary_ 1/8 inch. Handle Stainless Steel 3a/e° > '\ / 3. Not for construction purpose lubricating Oil Dielectric Oil (98.42) ° y.,, DISCHARGENPT unless certified. Motor Housing Cast Iron 1 FLOAT SWITCH 4. Dimensions and weights are Pump Casing Cast Iron approximate. Shaft Steel pp Mechanical Seal Faces:Carbon/Ceramic i'i 5.We reserve the right to make Shaft Seal Seal Body:Anodized Steel revisions to our product and their Spring:Stainless Steel lin specifications without notice. Bellows:Buna-N Impeller Engineered Thermoplastic Upper Bearing Bronze Sleeve Bearing 11-3/8“ 1a-3/1s" (288.92) (258.76) Lower Bearing Single Row Ball Bearing Bottum Plate Polyester Coated Steel t Fasteners Stainless Steel 50 8) 3-5/8" Legs Engineered Thermoplastic I1 �j11 ©1998 Hydromatic"'Pumps, Ashland,Ohio. All Rights Reserved. i HYDROMATIC°' —Your Authorized Local Distributor- PENTAIR PUMP GROUP P 4- 8 1840 Baney Road Ashland,Ohio 44805 Tel:419-289-3042 Fax:419-281-4087 Web Site:www.pentairpump.com o Tr srs1, AII SALES OFFICES IN ALL MAJOR CITIES AND COUNTRIES S Le ,� / p Refer to"Pumps"in the yellow pages of your phone directory for your local Distributor �!th ° A s Item#:W 02 6680 1 198 5M POMpnce�� P1117 ORIGINAL 1202 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85,Wis.Adm.Code Certified Soil Testing County Attach complete site plan on paper not less than 8%x 11 inches in size. Plan must St. Croix include,but not limited to:vertical and horizontal reference point(BM),direction and percent slope,scale or dimemsions,north arrow,and location and distance to nearest road. Parcel I.D. 031-- 102 - O31 Please print all information. R iewed By Date Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). jrikA 2002 Property Owner Property Location Petranovich, Lyla Govt.Lot SE 1/4 SE 1/4 S 10 T 29 N R 15 W Property Owner's Mailing Address Lot# Block# Subd. Name or CSM# 1016 Rural Road#3 City State Zip Code Phone Number j City Village it Town Nearest Road Glenwood City 1 WI 1 540131 715-265-4897 Springfield Rural Road#3 _„ New Construction Use: y', Residential/Number of bedrooms 3 Code derived design flow rate 450 GPD ✓ Replacement Public or commercial-Describe: Parent material loess over till Flood plain elevation,if applicable NA General comments and recommendations: install 4'x 114'rock unit mound on 99.4 contour as upslope edge of rock w/1.2'sand fill I Boring# Boring V', Pit Ground Surface elev. 99.4 ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. `Eff#1 *Eff#2 I 1 0-3 10YR 3/2 - sil 2 m gr ds cs 2f1 m I, .5 .8 2 3-13 10YR 3/2 - sil 2 f sbk ds cs 1 m .5 .8 3 13-28 10YR 4/4 - sil 3 m sbk dsh cs 1f .5 .8 4 28-36 10YR 4/4 f2d 7.5YR 4/6 10YR 6/2 sil 2 m sbk mfr cs 1 m .5 .8 0-- 5 36-54 7.5YR 4/4 c2p 10YR 6/2 scl 0 m mfi - - 0 0 common gy si coats on peds in horizon 3 2 Boring# ! Boring le 1 Pit Ground Surface elev. 99.4 ft. Depth to limiting factor 24in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-4 10YR 3/2 - sil 2 m gr ds cs 2flm .5 .8 2 4-10 10YR 3/2 - sil 2 f sbk ds cs 1f .5 .8 3 10-20 10YR 4/4 - sil 3 m sbk dsh cs 1f .5 .8 4 20-24 7.5YR 4/4 - scl 2 m sbk mfr cs - .4 .6 5 24-36 7.5YR 4/4 f2d 7.5YR 4/6,5/3 scl 2 m sbk mfr cs - .4 .6 6 36-55 7.5YR 4/3 c2d 7.5YR 5/3 sl 0 m mfi cs - .3 .5 7 55-75 7.5YR 4/6 - Is 0 sg ml - - .7 1.2 *Effluent#1 =BOD5>30<220 mg/L and TSS>3 < 150 mg/L *Effluent#2=BODS<30 mg/L and TSS<30 mgL' CST Name(Please Print) Signa r : )Z514—)Z-- CST Number Henry F. Grote c222774 Address Certified Soil Testing Date Evaluation Conducted Telephone Number E.4366 353rd Ave.,Menomonie,WI 54751 8/28/2000 715-233-0398 Property Owner Petranovich, Lyla Parcel ID# • Page 2 of-3 3 Boring# Boring Pit Ground Surface elev. 97.8 ft. Depth to limiting factor 22 min. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 1 0-4 10YR 3/2 - sil 2 m gr ds cs 2f1m .5 .8 I 2 4-14 10YR 3/2 - sil 2 f sbk ds cs 1f .5 .8 3 14-22 10YR 4/4 - sil 3 m sbk dsh cs 1f .5 .8 46 10YR 4/4 f2d 7.5YR 4/6 sil 2 m sbk mfr cs 1 m .5 ,8 10YR 6/2 5 36-44 7.5YR 4/6 f2d 10YR 6/2 scl 0 m mfr cs - 0 0 6 44-65 7.5YR 4/4,4/3 f2d 7.5YR 5/3 scl 0 m mfi - - 0 0 common gy si coats on peds in horizon 3 4 Boring# 0 Boring V,I Pit Ground Surface elev. _ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-10 10YR 3/3 - sil 2 10-18 10YR 5/2 - sil 3 18-26 10YR 5/2 f2f 7.5YR 4/6 sil j - . - gmottling grades to f1 p 5YR 4/6 @ 24-26";this boring 6'east of dry well Boring# Boring :.:J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 i _ I * } �I Effluent#1 =BOD5>30<220 mg/L and TSS>30< 150 mg/L *Effluent#2= BOD5 <30 mg/L and TSS<30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330(R.07/00) Certified Soil Testing -if f > ! 4 —, 7. il ,,, :1 �y f a* 1 `A e , � 9 � 3 1 f 9 ,� + - d ei 1 9 '.' Ll i -9 o � nn �;� � a 2 ,. S N tg f• 0 g d N., ...,, It o 0 N 4 1� 4 i i 0 — i i. 0 i' t / s. r ,A,.� C a q) f ; I • li' r « 9 y Y i ' a i . Ao f s i .-4 A — ---, ,, __, , 0 , i c,i , •- , I ,5. r;) I . I. V 9 tr.. O I, fS CO i e 1 Z < — - Q d d v -�3 —1 /- i a /LA g , �� 9 4 0ae -'7- 0 . r r ORIGINAL 1202 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85,Wis.Adm.Code Certified Soil Testing County Attach complete site plan on paper not less than 8'/:x 11 inches in size. Plan must St. Croix include,but not limited to:vertical and horizontal reference point :„ .'rection and Parcel I.D. percent slope,scale or dimemsions,north arrow,and to • rid is r>fef• •arest road. Please print all infor' a "o • c iewed By Date Personal information you provide may be used for se,.nd. rposes(P sy L s.15.0441) 2 Property Owner / 1�F E4lft[ PropC i, cation i s� 9—COI Petranovich, Lyla j ; T 1 i�� .Lo SE 1/4 SE 1/4 S 10 29 N R 15 W Property Owner's Mailing Address 1,...1 (t ` o # .... :lock# Subd. Name or CSM 1016 Rural Road#3 sT GR0tX City State Zip Code Phone Number thin OF,.CEO F Village Town Nearest Road Glenwood City 1 WI i 54013 �'Th5 2er- 7 �.cr, Springfield Rural Road#3 ▪ New Construction Use: Residential/Nurt1tseOf e_rob°: 3 Code derived design flow rate 450 GPD • Replacement M Public or commercial-Describe: Parent material loess over till Flood plain elevation, if applicable NA General comments and recommendations: install 4'x 114' rock unit mound on 99.4 contour as upslope edge of rock w/1.2'sand fill Boring# MBoring rg Pit Ground Surface elev. 99.4 ft. Depth to limiting factor ---4: -8 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. 1 0-3 10YR 3/2 - sil ' 2 m gr ds cs 2f1 m .5 .8 2 ; 3-13 10YR 3/2 - sil 2 f sbk ds cs 1 m .5 .8 3 113-28 10YR 4/4 - sil 3 m sbk dsh cs 1f .5 i .8 4 1 28-36 10YR 4/4 f2d 7.5YR 4/6 10YR 6/2 sil 2 m sbk mfr cs 1 m .5 .8 5 36-54 7.5YR 4/4 c2p 10YR 6/2 scl 0 m mfi - - 0 0 1 common gy si coats on peas in horizon 3 2 Boring# a Boring Pit Ground Surface elev. 99.4 ft. Depth to limiting factor 24 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary I Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. 1 0-4 10YR 3/2 - sil 2 m gr ds cs 2f1m .5 .8 2 4-10 1 10YR 3/2 - sil 2 f sbk ds cs 1f .5 1 .8 3 10-20 10YR 4/4 - sil 3 m sbk dsh cs 12 51 8 4 20-24 7.5YR 4/4 - scl 2 m sbk mfr c #411114..4 ' .. . 5 24-36 7.5YR 4/4 f2d 7.5YR 4/6,5/3 scl 2 m sbk mfr . - i , .. 1,4 6 36-55 7.5YR 4/3 c2d 7.5YR 5/3 sl 0 m mfi - 00 2 .5 .y` 7 ' 55-75 7.5YR 4/6 - Is 0 sg ml 6' - 1. - als' Effluent#1 =BODs>30<220 mg/L and TSS>30< 150 mg/L 'Effluent#2=BOD<30 m• . S'S <30�mg/L ,F}. CST Name(Please Print) Slgnatu .. 2�/. f�9 Henry F. Grote \.- �!" Address Certified Soil Testing • Date Evaluation Conducted Telephone Number E.4366 353rd Ave., Menomonie,WI 547+1 8/28/2000 715-233-0398 • 'Es Property Owner Petranovich, Lyla Parcel ID# Page 2 of 3 3 Boring# Boring Pit Ground Surface elev. 97.8 ft. Depth to limiting factor 22 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GRD/fr in. Munsell Qu.Sz.Cont.Color Gr.Si.Sh. 'Eff# Eff#2 1 0-4 10YR 3/2 - sil 2 m gr ds cs 2f1m .5 .8 2 4-14 10YR 3/2 - sil 2 f sbk ds cs 1f .5 l .8 3 14-22 10YR 4/4 _ sil 3 m sbk dsh cs 1f .5 .8 f2d 7.5YR 4/6 4 2 10YR 4/4 .10YR 6/2 sil 2 m sbk mfr cs 1 m .5 .8 5 36-44 7.5YR 4/6 f2d 10YR 6/2 scl 0 m mfr cs - 0 0 6 44-65 7.5YR 4/4,4/3 f2d 7.5YR 5/3 scl 0 m mfi - - 0 0 common gy si coats on peds in horizon 3 Boring# aBoring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f�' in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. 'Eff#T Eff#2 1 i 1 Boring# AlBoring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fez in. Munsell Qu.Sz.Cont.Color Gr.Si.Sh. 'Eff# Eff#2 *Effluent#1 =BODS>30<220 mg/L and TSS>30< 150 mg/L *Effluent#2=BOD5 <30 mg/L and TSS<30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330(R 07/00) Certified Soil Testing 3 �� > 3 ` 1 si 9 c) till 0 —t' , 4 ,3 .42. n �M 0 v' f — $ d " — I. �'tja J J1 C.+. yN ' cam' � ;,11 3 , � h 0 J 9f , � � Li o .J 9 - --.".� { � 1n \,,. L�l o n o I�l 4 _ o I s •> t .r N 11 6\a 41 - -0 I 0 4 , D 4, * 4. ll 0 fl0 6 J' o S. 0 _� a --e n d �, (1._ y . .s i :-.)) i I .t.2/ II o a fCA4 "Al 4 4. s di --"I ;k1 , y • ci- r, a� a u d o �J o u S — i - 1 J 9 r 4 'dfJ 'J00 � 5i � tt�0 4� �',�.1 ° �q 1�' s r �, a � � � } (ti +J 7 1tea� M { ;: K + Ft. g w x1 � At1 '7, 11 w', , ' .+ F � P Tr-tir'47: *dw4 :,,, t 4 of + g.st 1 ;n , e � fi kk. h' 'Lr ;4y � gy �k'4 , q a � �7r 4 ?%:' ✓Y . -Na 1 I rl f SiFt. YIr , � : .�f , t . 3 pt!�gat , t L i � }. o , -....4k ,.... . . ..r . ,I.,t, 441111140 plfr.,... , . ,i. .......4tiit."..., _.•:‘,...a._ ,,, ,,:: ,,,,,,,,r, ..if , . , 4.. ,III"44 .art. .,.4-7- .¢ ' •_�. �' EiLit ."++G1� ��L.� .lr_ L`»'ice_1 Li' i I=...� i� .. • ! f_ _ , 1. (� t._,.i(�-. I`IrSil�~- 41- • :� 1Y,►wM i •..i„,,6„. i ,,,,. cif i� i xklmiiii t g 0, t,11t+T-i p,.•�(r ` °i�. '�v=X•"' +"y�- i�."n-41rM fl•u i� WI Cit..i �1% l i itli,q,lS Virlr [C0 i 4" , 7A1i I, ,.2 gill( w llluti i(lillf'1 � IrN era1t f+'dl•t71 r�BNft't� tl t lll�c r 1 { 1/1';41 t17!/ r uitiIIB! rilI It ii iti 14, tt�4.l` ,ivitt ,1t ltcc,c I„„1` .i,,,i+�t.„It{t/fity?�Iiidii. 0. .,I i -e--,ac ,q,Itittlliiifll l.�(fflrf I\ilU (If . (_-'.�,T;=-jl rrntll{iilttj(flilllttt 1 fl({!tf UIJjf)tlii i�(( + 'r h.04,' y eltt omit, I1t1/(tj(ilft/7tj'.ULtf(lldfl'!!ilf (II,. _J _ Bedrooms - Baths Depth - -fig' ...;‘1,,i-k-,,,!: Length - 56' Living Area - �t ! r.a�,: 1,595 sq. r"i. ..-_ .. .. .� f-. -_ '+ ` ` � • kg Artist r�nde�in,feature • ,�aEosoOlY!2 i,i: � •,` ' 11)(i1)0S 4j 1 he�()W,BED COI l; t�„+w L'dliN Ix..,..... . a , ,-..1. , 0„•i i• r, • ){c.l'A.ati Front Entry. ,. _ snrr�root w, # caul r '' i+{ ; • L 1t I 11C1 ACC�ll(S 1 ar ar�k5 w IIR4 • t:l c .i I C f(I[J[,, # i ii• a. sc w ##/1 • I11 i>r t iirl .lf iti - 'WY W ,. , rr n. +,—ii- � a K!CEii b%11 OIKG t0 t _p P,& (L z pl. u �, a+ l{.Cali ( U t I !. h1Ai"r: 2\'A.\(fit: A.rjit}EEMP.T' AND OWNERSHIP CERTIFICATION FORM Owner/Buyer i. �s .f 1L.L.. � j ?°� y n�Cf��►� Mailing Address ���� / 11 /jC� I - ?_......... ...� .,._......___ Property' Address 4'/_ A t..i 14i _- i) (Verification required from Planning Department for new cone ontt )_ - -_-•*._. City/State (, - l4a).CPS [=, l , Parcel Identification Number 3 - ! ILECIALITACalrriON (jo. 2 9. 1 J • f 0) Property Location '/<, _.;.4, _ 4, Sec. 1 T N.R i s Town of 56 ir'`7//� ) Subdivision ti� r4 , Let # /-r/A Certified Survey Map # , `- , Volume , ., Page * Warranty Deed # Z 5 volume . ._..,� ._., Page # / , Spec house D yes no Lot lines identifiable 0 yes 0 no SYMM.MairCIA= Improper use and maintenance of your septic sysmrn could result ist Us premium.failure to handle wastes.Proper maintenance consists of pumping out the septic tank every three years or sooner,if needed by a Hennaed pumper. What you rut into the system cs s lle�the�-e the o task as a t<exttt nt st r,,J to sC� +.1 • ��- =►ems r ,v c Sa�r�c rC ��°*>r� .�u.s s da ..v c�c. 4 y - % property owner agrees to submit to St, Croix Zoning Doper cnt a certification form, sighed by the owner and by master plumber,joumerneoPIUMber.restrictedplumberoralicensedpumperverifyingtat(I)thectniitewautewaierdisposalsystem is in pram operating condition and/or(2)after impaction end pumping(if oseeeeaa:y) the septic tank is less than I/3 full of sludge. I1we,the undersigned have Lead the above requirements and agree to maintain the private sewage disposal system with the steadards set forth,herein,es set by the Department of Commerce and the Department of Natutsi Resources,State of Wisconsin Cert faeatiue sty that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 3 days of the yea rexpi edon date (// 1 7111677 SIGNATURE OP APRICOT DATE CthT4 ON I (we) certify that all atatemenas or this form art art:to the best dirty (out) knov4dac. ;we) (are) the owner(s) o`' the property described above,by virtue of a warranty deed recorded in Ragiet+er of Leeds Comae. s 1 C.21 11(QIs LSTGNATURE OP AM-It/kW DATE •..*** Any information that is aria-repreacrttad may result in the sanitary permit Wes revoked bY the Zoning Depurtnexn "44*Y .4 include with this application: a stamped warranty dead from the Register of Deeds oiih e a copy of the certified survey map if reference is made in the warranty deed • • c • + • • 5. ..: s.se ',.1..,�css,M.fi;, s's.'.::A- ...ate:.,,:. - .. • .. '.. ... - _ _•� ';"; - aa. w ns—oUMWUMWoom os roes U Or w g009.0 1 Mo f�.l�.wb No�Mo M 116,1 robere.a 4 Ise chin Maur wr.ns a 299828 This Indenture. Madethia 10th day of • February ,A. D.. 1970 . between Theoline Hendrickson, a/k/a Theoline A. Hendrickson, a woman, • party of the first part,and • William Petranovich and Lila Petranovich, husband' and wife as joint tenants, part ie s of the second part dIEittntdtittfl: That the said part y of the first part, for and in consideration of the sum of Four Thousand and no/100 Dollars to her in hand paid by the said part ies of the second part, the receipt whereof is hereby confessed and acknowledged, ha s given, granted, bargained, sold, remised, released, aliened, conveyed and confirmed, and by these presents does give, grant, bargain, sell, remise, release, alien, convey and confirm unto the said part iesof the second part, their heirs and assigns f forever,the following described real estate,situated in the county of St. Croix F and State of Wisconsin, to-wit: An undivided 13/15th interest in the Southeast Quarter of Southeast Quarter (SEt of SEE) of Section 10, Township 29 North, Range 15 West, Grantor herein reserves the right rent free for the use and occupancy of the dwelling house upon said:-premises for her brothers or the survivor of them for a period of one year from date hereof. 7" ?SEER 7 • . a, SI y yy eri ma. Y r i t • second parr, the ihreirs and assu ns,g against all and every person or persons, lawfully claiming the whole or any part thereof, she will forever WARRANT and DEFEND. if in Cilittnen0 laiDevtet, the said part y of the first part has hereunto set her hand and seal this • o day of ,A.D.,19po. Signed and Sealed in Presence of �w ` 1 2\t2 -ivo-t / '-e Sea! �� Theoline Hendrickson ) ate" . Z,,...„---- ._._(Seal) Lawrence L. Olson (Seal) ..,/ ( lei // (Seal) Jenny M. Olson M INNESOTA State et HF;J`!EF IN ss. _______- -- County. a,,,,u►,,,,,, ', Personally came before me, this 10th day of February S• Y.,.19'• �, the above named Theoline Hendricksoniiirl4:.?' �/�•.r s. to me known to be the person who executed the foregoing instrument and ackn time'�sa�q�1.� LAWRENCE L:� l 4'01,190N,•,- Notar Public, Hanna n Minnesota Y P County, Watiomalsx My commission expires April 4, , A. D., 1975 .