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Home My WebLink About036-1087-20-000 (2)sr'l 0 CROIX COUNTY ZONING DEPARTMENT 11% /;) AS BUIL.T VE 0 ,SANI;rARY REPORT R[Ltl Owner Address k, ST 0 City/State Y F1, 0N'N G 0 Legal Description: Ile, LotBock Q 1,A; `/< 4 Y4 -R,�Ll W, Town of N PIN # (%.3 �'' IK)S' SEPTIC TANK —DOSE CHAMBER -2-9C, —HOLDING TANK INFORMATION: Tank manufacturer Pump manufacturer Size ST/PC/L�,, .2L-, Setback from: House/) Well J3P/L Model Alarm location 71, r -,6 -A &4^A --P^ (HOLDING TANKS ONLY) Setbacks: Service road --------- 7_Vent to fresh ..... e .......... Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM: Type of 'System: P(?.e�_ Width Leygth 6' Number of Trenches Setback from House / -5 Well -P/L Vent to fresh air intake /50 ELEVATIONS: Description of benchmark � �,��j Description of alternate benc"'hrna-rk Elevation Elevation BuildingSewer Wt�4eX;- ST Outlet. ��- � � `�� J PC Inlet PC Bottom G Header/Manifold ZTOP Of ST/PC Manhole Cover Distribution Lines ( )---�"�'_-y� _ O i Bottom of System ( ) % � � � Final Grade ( ) v � � Date of installationb_2/1/1,0� Plumber's si nature Inspector V� �G; State plan number 4,- License number , 3457, Datz ,.If ConlPIC(C plot pl,"- NOTICE: Plcasc provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. Show alternate benchmark, if applicable. A 'Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provice may be used for secondary purposes [Privacy Law s. 15.04 (1)(m)]. IP t H 1A N1 nnnf IF-1 Cit villa own of: error U %Z: 1 3 qu MYERS, MATT & PAM CST BM Elev.:- Insp. BM Elev.: � 0- TE) TANK INFORMATION BM Description: V S "t Ali T 614 TYPE MANUFACTURER CAPACITY Septic L) os, ng rr Aeration Holding TANK SETBACK INFORMATION TANK TO P 1 L WELL BLDG. Air Intake ROAD NA Dosing/ NA Aeration NA Holding ELEVATION DATA County: ST, CROIX Sanitary Permit No.: 315872 State Plan ID No.: Parcel Tax No.: 036-1087-20-000 STATION BS BenchV�af k _7 A9800260 HI FS mmmwwlwwx� l c� j l S7 Fl 12. Z_ d �`% PUMP/ SIPHON INFORMATION-t,�qt,\�. Final Grade Manufacturer [C Dem'and w Cw Model Number GPM Frictio SYstem ,' T D H Lift Loss mead Ff�TD Ft Forcemain Length 10 Dia Dist. To Well SOIL ABSORPTION SYSTEM d Bldg. Sewer St / Ht Inlet St / Ht Outlet Dt Inlet Dt Bottom Header / Man. Dist. Pipe Bot. System ELEV_ �/Oo (CET�l TRENCH Width Length No Of Trenches (�7 _7 PIT No- Of Pits inside Dia. Liquid Depth DIMEN510 .......... DIMENSI LEA6HII - N . G Manufacturer' SYSTEM TO P/L BLDG WELL LAKE / STREAM SETBACK INFORMATION TypeOf System E. CHAMBER Model Numbe, + OR UNIT _5c) DISTRIBUTION SYSTEM Header / Manifold Distribution Pipes) x Hole Size xHole Spacing Dia. Spacing Vent To Air I ake Length Dia Length SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed / Trench Edges Topsoil ❑ Yes ❑ No Yes ❑ No COMMENTS: (include code discrepancies, persons present, etc.) LOCATION: STANTON 33,31.17,528C,SE,SE 1806 170TH STREET k - r Plan revision required? []'Yes No Use other side for additional information_ SBD-6710 (R-3/97) Date Inspector's Sgature < e �rtN o.1 Safety and Buildings Division SANITARY PERMIT APPLICATION 201 E. Washington Ave. Visconsin In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Department of Commerce Madison, WI 53707-7969 Attach complete plans (to the county copy only) for the system, on paper not less County,,.... than 81/2 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Permit Number The information you provide may be used by other government agency programs Checo r 1, 9: r7v application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION PLEASE PRINT ALL INFORMATION Property Owner N e A Property Location :5A�;- 1/4 1/4, S N, R E (oruw 33 T3/ Property O\kner's Mailing Address Lot Number - Block Number City, State 1p Cod Phone Number ,Subdivision Name or CSM N,qn be it C 11. TYPE OF BUILDING: (check one) El State Owned El VII(N e a a dage 16 V 0 Public N'L 1 or 2 Family Dwelling - No- of bedrooms bdTown OF 111. BUILDINTUSE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 0 Apartment/ Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 E] Outdoor Recreational Facility 3 F1 Campground 7 ❑ Merchandise: Sales/ Repairs 11 E] Restaurant/ Bar/ Dining 4 ❑ Church / School 8 ❑ Mobile Home Park 12 [:] Service Station / Car Wash 5 Hotel/ Motel 9 El Office/Factory 13 El Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line 13, if applicable) A) 1. E] New 2. /ZSRyeplacement I [:] Replacement of 4- [] Reconnection of 5. E] Repair of an System stem Tank Only Existing System Existing System ------ ------------------------------------------- ---------------------------------------- B) F1 A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non -Pressurized Distribution Pressurized Distribution Experimental Other 11 seepage Bed 21 ❑ Mound 30 Specify Type 41 [:] Holding Tank 12 0 Seepage Trench 22 ❑ In -Ground Pressure 42 E] Pit Privy 13 [:] Seepage Pit 43 ❑Vault Privy 14 [] System -In -Fill V1. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2- Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate G. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation & Z C�), 0 0 1 /a # 115_� 1 9 Feet, 4?7,f,o Feet VII. TANK Capacity S ite in gallons Total # of Prefab. Fiber- Plastic Exper. Zo INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass App- New Existin structedil Tanks -Tanks Sept_i(:Ta��_ Lift Pump Tank /Siphon Chamber I Vill. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility forinstallatlonpKtq onsite sewage system shown on the attached plans. Plumber's Name: (Pr- Plumber, ' Ii/ tire: , ta s) MP/MPRSW No.: Business Phone Number: 35 3 1/ 4 1 +rdN Plumber's Address (S icpCity, e, Zi Code}.� Ilk COUNTY/ DEPARTMENT USE ONLY (includes Groundwater Date Issued Issul g nt tore (No Stamps) n Disapproved Sanitary Permit Fee , surcharge ee) F vel PvApproved [:]Owner Given Initial 02) 7Z) roo rI-:7; Adverse Determination V X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: - SB D-6398 (R. 11/96) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, owner, Plumber NLU i PLAN PROJECT Y� , — YY\1_4A:e4.z ADDRESS /�� y�lZ S�. 1/4 :5 1/4/S 3 rr -31 IN/R)7w N COUNTYu M P R S DATE.. � �-� -� S � �� ,,., �� BEDROOM CLASS PERC--.;5 CONVENTIONA0d IN -GROUND PRESSURE CONVENTIONAL LIFT .,>/,'MOUND HOLDING TANK SEPTIC TANK SIZE LIFT TANK SIZE '0 0 DOSE TANK SIZE HOLDING TANK SIZE ABSORPTION AREA,/ PERC RATE BED SIZE/�',;�,�7 Benchmark V.R.P.' Assume Elevation loot Location of Benchmark /4�-jo�'t �A.v ��.?�-vim/� H V R. P. 1:3 Borehole Q well = t 0 Perc Hole System Elevation %�X Wisconsirf Department of Industry, SOIL AND SITE EVALUATION REPORT Page I of 3 Labor and Human Relations Division of Safety & Buildings in accord with I LHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less the !fix '11 in 6i�-in size. Plan must include, but Eit. Croix not limited to vertical and horizontal referenc nj.' Vl)"'dir'e-ctiop ar;&,O�o of slope, scale or PARCEL I.D. # less t ha r rn r dimensioned, north arrow, and location an d 1pt)'ce to neaiWt road. 026-1016-30 P Rr 11 DATE APPLICANT INFORMATION -PLEA OR` IN T A) LV P'*P� M A T 11"0" PROPERTY OWNER- IPROPERTY LOCATION Matt & Pam Myers GOVT. LOT SE 1/4 SE S33 T 31 ,N,R 17 an 1/4 k (or) W PARCEL R PROPERTY OWNER'.-S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 1806 170the Sto zc*NG na na na _I CITY, STATE ZIP COD /urll"OE NUMBER^\,q E]CITY []VILLAGE SOWN NEAREST ROAD New Richmond, WI. 54017 Z46� n2 Stanton 170th. St, [ ] New Construction Use k I Residential / Number of bedrooms 4 [ ] Addition to existing building [A Replacement [ I Public or commercial describe Code derived daily flow 600 OD�d Recommended design loading rate .5 bed, gpd/ft2 or- - — 6 Absorption area required 1200 bed, ft2 1000 trench, ft2 Maximum design loading rate .5 bed, gpd/ft2 - 6 Recommended infiltration surface elevation(s) 94.80 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material__. glacial drift Flood plain elevation, if applicable na S = Suitable for system CONVENTIONAL IONAL MOUND IN -GROUND PRESSURE AT -GRADE SYSTEM IN FILL U = Unsuitable for system El S El U El S El U ® S El U EN S El U ® S 1:1 U SOIL DESCRIPTION REPORT Ground elev. 97 . Eft. Depth to limiting factor Boring # .......... .......... ........... ............ .......... I ....... ................. ................. 2 ................. .................. ................. Ground elev. 98.2 ft. Depth to limiting factor +9011 trench, gpd/ft2 .trench, gpd/ft2 ft HOLDING TANK El Ou Horizon NOMMMM Depth i n. Dominant Munsell Motes om Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ft2 I Bed �Tmr& 1 0-9 10yr3/3 10yr4/4 7.5yr4/4 none none none 1 sici is 2ms'bk 2csbk Osg mfr mfr mvfr 9W 9W 9 2 f 1f na 5 .6 4 .5 .7 .8 2 3 9-18 18-39 4 39-65 7.5yr4/4 none S1 2csbk mfr 9-W na .5 '06 5 65-84 7.5yr4/6 none is Osg mvfr na na .7 8 Remarks: 1 0-10 1 Oyr3/3 none 1 2msbk mfr cs 2f .5 06 2 10-32 10yr4/4 none sici S1 Icsbk 2mgr mfr mvfr 9W na if na 2 .3 5 06 3 32-90 7.5yr4/4 none Remarks: CST Name: --Please Print Gary L. Steel Address: 1554 2001h)Ave., New Ricffmqnd, WI 54017 Signature: Phone: 715-246-6200 Date: 6-17-98 CST Number: m02298 PROPERTY OWNER Matt Myers � IL DESCRIPTION REPORT SOIL O Page 2 s. of 3 . PARCELI.D.# 426-1016-30 Baring # Depth Horizon Dominant Color Mottles Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence BoLrxiary Roots G P Dlft Bed Tw& in Munsell 1 p-16 1 oyr3/3 none 1 2msbk mf r Cs 2 f .5 .6 Otis 3 :. . ........ :� 2 1-36 1 oyr4/4 none s icl 1 csbk mf r gw if .2 .3 Ground 3 36-96 7.5yr4/4 none sl 2mgr mvfr na na .5 .6 elev. 98 . 00ft. Depth to limiting factor +96 11 Remarks: Boring # Y: Ground elev. ft. Depth to limiting factor Remarks: Boring # ...... Ground elev. ft. Depth to limiting factor Remarks: Boring # ............. Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) STEEL'S SOIL SERVICE Gary L. Steel 1 554 tooth Ave. CSTM2298 Matt Myers New Richmond, WI 54017 M P RSW-3254 SE 4SE 4 S33-T31N-R17W (715) 246-6200 town of Stanton N 1 "=40 ' Bin. = top of SE corner of cement slab @ el. 100, Alt. BM.= bottom of siding of house @ el. 101.151 Gary L. Steel 5-17-98 ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving the fresidence located at: 4, ./`'' 4, Section 5,3 1 T- N1 R_ W, Town of Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced: Did flow back occur from absorption system? Yes No (If no, skip next line) Approximate volume or length of time: gallons minutes Capacity: Construction: Prefab Concrete �<— Steel Other Manufacturer: (If known): Age or Ta known): (Signature) (Name) Please print (Title) Date 7p, (License Number) Form to be completed by licensed plumber (s.145.06, Wisconsin Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code) Plumber (applying for sanitary permit) certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requirements of ILHR 83, Wis. Adm. Code except for inspection opening over o�u let baffle). S Name Signature /MPRSI-'� ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer %%� Mailing Address _��4(G /�� °�iC. 5K �C.levJ� ,c��►-.v.�,�, w.= Property Address Z felt c k k & 7 4) AJ 6 r1j (Verification required from Planning Department for new construction) cli _- City/State 14J-z— Parcel Identification Number �yo� � LEGAL DESCRIPTION Property Location '/4) S 4 '/4, Scc-.3 3 T N-R W, Town of Sb96J4Zr"CJ Subdivision Lot # z 14 Certified Survey Map # Volum Page Warranty Deed Volume Page Spec 11OLIse 0 yes no C57 .3% Lot lines identifiable yes F no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification etal, that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days o the e ar expiration date. SIGNATURE 9fF APPEfANT DATE 0 WNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF,/'/APPLICFNT DATE * * * * * * Any information that is mis-represented may result in the sanitary pen -nit being revoked by the Zoning Department. Include Nvith this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed /1 I l "U 13Dy 315 165, 4165 65 4163 v i + i � Y 1 2 -V I 7 r, r1 137, •�� 139 2 , 4 —T I 2 s HEADICAPACITY CURVE EFFLUENTand DEWATERING WARNING: Model 18514185 should not be subjected to less than 30 feet TDH. TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE SERPE3 43 44 5r•51 ` 14 1j7•111 14004140 1004 16 1 f 161/4163 155:r16S 1&V4I15 i 1 W4 166 1W4�= -• —'.' `':, , Gal. Lin. Gal, Mtn. U. I UM, � G81, Um Gal. LtnLn FT. M := Gal. Lbs;:' Gal. 1,.tr1t:': Gal. ; Lin Gal. Us : Gil. : n ` GA :;1 tri Gal. tits 43 :.i63:' 72 :273. 13 73I:': $4 :=:]56 : 1D5':IC1 61 ]]1 i1 =: 2]1' S4 22C: 1SS $47 ! 155 54] �: 171 :i4 23 :=I1.:'. 34 .'11g 61 2]1.. 74 34d.': i0 :'3�t:: 1oa 3T4 61 2i4' 41 131 51 225. Its I~EO fir c7; „ 1,1 134 S15 t4� ih 1r1 -. S5 :: 1.1 1S :`r7: 11 r 4S ra 64 4 43 t4 91 Ito 6a 22] 40 27r ; 51 2n 1147 51 Z20 20 ; ;1;ii' 2.S :: f" ] i3 : IS 13=: 36 >134:: 73 :Z]5.:: 12 314 51 223• : to Z2I: 26 63 A31: 74 . 260 : S7 ;.216 S1 223 - 124 t44 111 5C3 + s 1 ]0 3a S3 :rat: 6S 241. SS tat S4 : ttb. : ua S4 Zre': 121 "A fir 461 :ttf- 1 4614: 4iA73 -23. S 101 31704A $Q f0A '14 711' i4 274. +: 7 fQ 3i1 , 1X 3T1 i 0' ri 2S1 45 32 =s 1]1 t S .: 3 43 11V 36 !:136 $4 221: I9 x1.y4: 30 it4: 14 U ' 62 •:i47:: 51 113 rC 1st •s 176 4a ::a�i: 14 , ss 4S 1]1' 21 lot 5� ?4•i �: 1]4 tQ �:2r:t3 32 1i1 2 � 4 100 110 :'IL04 ' 129 71 ! 11 — "' : ` Loct Vat": Ke zv 11.25' 2x _ 26' AC S6' 66' I?• 13 1 , 5 186, ��- 418fi f i • 4140 -\' 8 1 1 4...-�._.r - .t��.. ...-...-F.� Asa, 4188 185. � 4185 43 48 53,55 gB 161, 57,59 4161 I u _. �T7'0 so 160 0 12140 L_ S I 10 201 30 401 50 �- 80 160 240 320 400 480 550, FLOW PER ti4lNUTE - t�ote; For Head Capacity on Model 112, industrial column -explosion pr000f pump, see Fhlj^2 1 q. PL] 4,\P CKAt�iELR CRG�5 SEC.`_10tJ A�jG �GECIFICAT10 ]S 9 C E.LE �VEIJT CAP RISER EXIT PERMITTED O1JLy IF TAIJK MAIJUFACTURZR HAS SUCH APPROVAL ` SEPTIC SPEC IFICATIOUS � DOSE TAIJKS MAQUFACTUR.ER. QUMBER, OF DOSES: PER DAB TAQK SIZE : C� � G LOQ S DOSE VDLt1lHE ALARM MAUUFA�C.TUKrLR: INCLUDING BACKFI.O ZY&O GALLONS � � M E f,� _ OD L I�..1L�M�ER.� .--. ..._.. .. CAPACITIES. � -- IAICNES C71R *� GALLOWS SWITCH TYPE. ar 13 = cam. WCHES OR GALLOJS PUMP IAAfJUFACTURER: C = II EHES OFF GALLOUS MODEL QUMBER. D 1h1GHES OR, GALLOU5 s'''� Y� 5W1TC H TSPE: . •rL _ �JQTE: PUMP A�JD ALARM ARE TO RE r l Murr DISCHARGE SATE M IN5TALLED OQ ,5EPPRATE CIRCUITS VERTICAL ©1FF E CE�JCE bET�EE�PUMP OFF AM❑ D157R16LlTIoIJ p1PE.. FEET + MlkJI!' LIM QCTWORK SUPPLY PRESSURE . F LET + FEET OF FOR 69Y,00FT.FKlCTl0kJ PACT ,,�� .cE MCI� X �I�.. FEE T TOTAL D'3MAM IC. HEAD _ FEE T 1/ �'''� IiJTERMAL. DII'r'1EWS a OF TAIJ r LEK,GTH 2 ,WIDTH --..,;LIQUID DEPTH 5IG>UE -Z D LICE-IU E" QUMBE . S R DATE.