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024-1015-30-000 (2)
ST. CROIX COUNTY ZONING DEPARTMENT AS BI TJ,"MrjT SANITTARY REPORT • Owner Property Adqess 14 City/State _14awolbVid k.)/ lqo(,� Legal Description: Lot Block Subdivision/CSM # I[/ ,4 Sec. T -R 17 Town of Pt-eRWPtl N N W ---------- 116010 �Wrlvjl �SEPTIC TANK DOSE CHAMBEk— HOLDING TANK INFORMATION: � M� ?Setback from: House Well PIL-iLp SizeST/PC Tank manufacturer w Pump manufacturer C--Ivu tal Model V11 e Z) 2L_,,;1 I Alarm location NA jn�j� I (HOLDING TANKS ONLY) ater Line Vent to - fresh ater Line Setbacks: Service ro Meter locatio Alarm loca n —�v SOIL ABSORPTION SYSTEM: Type of system: M 6 Q-A d - . Width Z4 t Length 1bU Number of Trenches Setback from: House (P (op" Well P/L Vent to fresh air intake ELEVATIONS: Description of benchmark I C> D 3/411 fluL Dioe_ Elevation I�c7 1 Elevation Description of alternate benchmark —10 0 0_� �Ll:c�L , aLc�m C,-X/ �Ol• Building Sewer ST/HT Inlet3ST Outlet PC Inlet Manhole Cover PC Bottom 3 —qHeader/Manifold Top &* �S'� Distribution Lines O � � � '7'"� O � Bottom of System ( ) � • � ( ) � Final Grade O O � � Date of installation D/V /I mit number 3�Sgl`� State plan number 7 Y(o (09 �Yer ���55 Date ��L�License numberPlumber's signature - Inspector Complete plot plan wr 4b NOTICE: Please provide the following: A plan view sketch showing everything within 100 feet of the system. Two horizontal reference points to center of septic Whole cover. Show alternate benchmark if applicable. • WCA I • VV4m;dQnsin Department of Commerce Safety and Buildings Division GENERAL INFORMATION PRIVATE SEWAGE SYSTEM INSPECTION REPORT (ATTACH TO PERMIT) Persona! information you provice may e usea Tor secondary purposes [Privacy Lqw, s-15.04 (1)(m)] Permit Holder's Nam :ity VAIftjj Town of: fANSON, CHRi-S/HANSON, JON "He CST BM Elev.: Insp. BM Elev.: BM Description: - / TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic pt 6/V1 -44 Dosin Aeration Holding TANK SETBACK INFORMATION TANK TO P / L WELL BLDG. vent to Air Intake ROAD Sept! NA Dosing NA Aeration NA Holding PUMP/ SIPHON INFORMATION q 'l inPNA MZ0(_ I Manufacturer id 5 Lit Demand Model Number "3(IL-1-1 35 OGPM TDH1 Lift �riction�,�me �ystemD"S-LTDH)ad . Forcemain Length D i a. Dist. To Well SOIL ABSORPTION SYSTEM ELEVATION DATA CountyST CROIX San'1ta 11 State Plan ID No.: Parcel &24`L:1015-30-000 STATION BS HI FS E LEV. Benchmark Ls LA.0 t a4 Bldg. Sewer 05 &a StIr Inlet 3 St / Ht Outlet Dt Inlet Dt Bottom Header / Man. Z Dist. Pipe ,;�p 75 Bot. System 7 ;`0 3 %7 16I- Final Grade P0, 43 YVA 3-S BED NC / R RI Width Length .o No. Of Trenches PIT No. Of Pits inside Dia. Liquid Depth N DIMEN S % 0 /0 0 . I .2 1 DIMENSION�_ SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER TypeOf del Num C. stem OR UNIT QLS�TRIBUTION SYSTEM kaa�i&/ Manifold Length D Distribution Pipe(s) Length 9yr 1 Dia- Spacing 10 x Hole Size 114 1 x H I S acing 79 Vent To Air Intake -PQ I a - e_,;� 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: PLEASANT VALLEY 9,28,17,82,NW,NE 1753 CTY ROAD Z ._1 kjz 111I 1� 101n V11 11� Vi cxA-cz,,i -eAcAf Va c' e7 f VeM a4At1VL 1�' Plan revision required? E] Yes No , r I Use other side for additional information. � SBD-6710 (R-3/97) Date Inspector' Signature Safety and Buildings 2226 ROSE ST LA CROSSE Wl 54603-1905 Tommy G. Thompson, Governor Isconsin Deartment of Commerce William J. McCoshen, Secretary p September 04, 1998 CUST ID No.6306 BOLDTS PLUMBING AND HEATING INC 820 MAIN ST PO BOX 87 BALDWIN WI 54002 RE: CONDITIONAL APPROV APPROVAL EXPIRES: 09/04/2( SITE: Site ID: 7325 St. Croix County, Town of Pleasa-. NWI/4, NEI/4, S9, T28N, R17W Joyn Hanson FOR: Description: Mound A TTN.- PO WTS INSPECTOR RECEIVED � �� � � ST CROX vl� identification Numbers Transaction ID No. 78669 Site ID No. 7325 Please refer to both identification numbers') above, in all correspondence with the agency. Object Type: POWT System Regulated Object ID No.: 17972 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • The approved changes will become an addendum to the plans previously approved. All other portions of the installation shall conform to the original approval. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(d), Wis. Stats. 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/installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, '" ARD M SWIM POWTS PLAN REVIEWER GER Integrated Services (608)785-9348 5 MON - FRI, 7:15 AM - 4:00 PM. jSWIM@COMMERCE. STATE. WI -US DATE RECEIVED 05/07/1998 FEE REQUIRED 180-00 FEE RECEIVED $ 180-00 BALANCE DUE $ 0.00 Page Uf-^�� ,. ',^ . .. . . Straw, Marsh Hoy, Or Synthetic < AS 1"WI C *� 3 Distribution Pipe Medium Sand - Topsoil zwww% -� 0 _L 'Yo Slope Trench Of 2 zl?" Force Main Plowed Soil F�. Cross Section Of A Mound System Using F Ft� � Trenches For The Absorption Area Q Ft. A /� Ft. H Ft. Signed 8 Ft. / Ft. License Number: 220953 K /0 Ft. Date: L 1Z<� Ft. ----- ' J Ft' Alternate Position of Force Main I Ft. Force h- Main Pipes Markers I P.0 t,O Coll O|aYr|buUon �~Trench Of - 2 - Pipe Aggregate IDV ��`- Mound Using 2 T,aoohos For Absorphon Area Page _..Of,. Distribution Pipe Detail For A Four Lateral Network r Al to Fo rcl PVC Dist, Y P Ft. or S Ft. X y' Inches S i d : Y -34 Inches gne 53 Rio i e Diameter `f Inch License Number: 1 Lateral Diameter / ,, Inch (es) Date Manifold D i ame t o r I nch e s Force Ma i n Diameter ! nche5 I Ho► i e s Per Pipe 3 Invert Elevation of Laterals /0/&0/j Ft. Page .3 Of ~COMBINAT10N SEPTIC TANK/PUMP CHAMBER (No 'Sca I e)' . 'Approved Locking Manhole Cover With Warning Label Attached Weatherproof Warning Label Junction Box Final Grade-, � 18" Minimum Approved Joint w/C,I, Pipe Extending 3' Onto Solid Soil n 8 Minimum � 6" Maximum ----- 4" C,Is- / Insp. Pipe 8affles ------- wv 3" of 8eddfnq Under Tank-/ Note: Pump and Alarm Are On Separate Circu*lts Tank Size-Septic/Pump: /Z,90/7 0 Gal I ons Al arm Manufacturer: Model Number: Switch Type: _Z22 C_ 1.4 Pump Manufacturer: 6o y Minimum Discharge Rates.- 4" C| Vent Pipe with Approved Cap, +25* From Ouiidingy Approved Vent Caphi Y 12" Minimum __ \ 1 4~ Minimum Quick Disconnect l/4" Weep Hole Joint Number of Doses/ Per Day Gallons Per Day/' - osesGallons J� Volume of Back{low: .....~~+ Gal lons«��5 Total Dose `� Volume:~~..~.~~ llns oo^_^_^_-~_ ��«�� w 1=v� ��e~«�5 Capacities: inches lons n+inches �al Ions � � o llons���� ��~^� * [ �c e r ° + nchss o Gallons Total~....= —inches o�,Gallons | Vertical Difference Between pump Off and Distribution p1pe:/y^-,5Feet Minimum Required Supply Pressure: ............... ..~~.~~...+ eet /,'7 0 F eet of Force Ma in x rict1on Fmctor/l0O Feet: Feet�°~~ �� _Inch Diameter Force Main 1`7,06~p ��`-� To�al Dvn�m�c Head:~.~ ^» Internal Tank Dimensions: Length �Wi dth F4 ^ Liquid Dept Si�na�u iC���� NU�b� 81:il a 0 Mm NINON No 10111 0 so me FA 30mommons NMI lonommo .19095000 OMNI loommommoll'Som sommasomm monsoon MENOMONEE a h- hm., mum- loommumms on MEN JIM MEN a on MISM1111MMA aml...5110110iai�■n-n�■ .T y. f at r. r t`., r wr• NONE limmmmmmmmmm Oft"Woomm m Jill" ltm■■m■!■■■ ' ■!■m■om■o■L..._...��. .i�■■t■■■■! ■■■m■ ■��� i■!■ ■■�■ � 25 !m!!■ l4mom M■!■ ■■N» uj mm mlms■mtN 101MOI,t■MIM■■IEWI■■■! 20 �■ ■M■■t■MINUMME N■EME■INI IN . ��!!! ■1i■.■ice \1��! ■■fit■���■ 41,1 1R. i 10 � ►�l�����■\�■ia����■■ice t■ t■ ■■ ■■!�■■ ■!!!� ■■S■ ■■t! ■i■i■■!!■■ ■o■oi■m!■■ ■■!■t■ iT . ri■i■■■■■■■mtii■!iltm■■■S■ J: 40!I;;.K-rIIs,kl; v I: n 14anson NtC. 1545 Ravi S St .- '41amm-ol)ol 4JI if. I N'04' NE% elf 9 /7 W G� s� N� co I b t' �h .q 0000,1 e d nn �� ,�3 G b 164h . Ir e, a B ! = 100, 13 o4 r, r 0 1 frarAr e .42 Ll Q� A p Jcale � qo -I �r;ve IJOLy 4 SO A ,41,I CJ T- ZZ085-3 9-q-fig 05 Safety and Buildings Division SANITARY PERMIT APPLICATION 201 W. Washington Avenue s onsin In accord with ILHR 83.05, Wis. Adm. Code P 0 Box 7302 Department of Commerce Madison, WI 53707-7302 Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. X See reverse side for instructions for completing this application State Sanitary Permit Number Personal information you provide may be used for secondary purposes VCheck it revision to previous application [Privacy Law, s. 15.04 (1) (m)]. /753 Cq State Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PR NT ALL INFORMATION tz, �,? Property Owner Name Property Location I)f — 1/4$S T N $ R J 7 (d(Lw- 1�,)l /4 A),E Property Owner's mailing Address 2) Lot Number Block 1 N b y 72� V_ . City, State 07Z0'Cocle / 0 ,V�, Phone Number -, ) Subdivision Name or CSIVI Number i` ' ,% 11. TYPE OFRUILDING: (check one) State Owned. 1© Cit 0 Village lk Nearest Road Publ'tle* ic 1 or 2 Family Dwelling - No. of bedrooms 1?,�: a;, 'Town OF I? III. BUILDING USE: (if building type Is public, check all that apply) Parcel Tax Number(s) q - a 8. 17 0Z 1 [-] Apartment/ Condo - 2 D Assembly Hall 6 El Medical Facility/ Nursing Home 10 [j Outdoor Recreational Facility 3 El Campground 7 Cl Merchandise: Sales Repairs 11 ❑ Restaurant Bar/ Dining 4 R Church /School 8 R Mobile Home Park 12 Service Station Car Wash 5 El Hotel / Motel 9 El Office/ Factory 13 Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. 0 New 2. R Replacement I E] Replacement of 4. E] Reconnection of 5. E] Repair of an ------ System -------- System Tank Only Existing System Existing System B) [] A Sanitary Permit was previously issued. Permit Number 315 Date Issued V. TYPE OF SYSTEM: (Check only one) Non -Pressurized Distribution Pressurized Distribution Experimental Other 11 El Seepage Bed 23,N Mound 30 Ej Specify Type 410 Holding Tank 12 D Seepage Trench 22 R In -Ground Pressure 42 E] Pit Privy 13 El Seepage Pit 43 © Vault Privy 14 E] System -In -Fill V1. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area I 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) Elevation 1 4� 65�749 .5-0in 1 1, 2- 1Jf e2rJ Feet j ,Feet VII. TANK INFORMATION Capacity in gallons Total Gallons # of Tanks Manufacturer's Name Prefab Concrete site Con- Steel Fiber- glass Plastic Exper. App. New Existin Tanks Tanks structedl Septic Tank or Holding Tank JIIZ:5-e�,v 1:1 El 1:1 El Lift Pump Tank /Siphon Chamber 620�,bat L El El El El 1:1 L 1:1 VIFF 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) MP/MPRSW No.: 13 Business Phone Number: 1715 X.. dr_, 4216 Plumber's Add} ress (Street, C ity, State, Z I p Code)., Inc. COUNTY DEPARTMENT USE ONLY [] Disapproved I Sanitary Permit Fee (Includes Groundwater I=sue7d Issuing Ag nt Si 4KApproved [:]Owner Given Initial Surcharge Fee) jDate 1 Adverse Determination ZA X. CONDITIONS OF APPROIVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11197) DISTRIBUTION: Original to County. One cupy To: Safety & Buildings Division, Owner, Plumber ► Safety and Buildings Division r�s►� . SANITARY PER IVI T APPL�CATI O N 201 W. Washington Aveiaue In with ILHR 83.05, Wis. Adm. Code of P C Box 730z Department Commerce Madison, WI 53707-7302 Attach complete plans (to the county copy only} for the sy�n, on paper not less County than 8 1/2 x 11 Inches in size. • See reverse side for instructions for completing this application State Sanitary Permit Number �4 Personal information you provide may be used for seconds Privacy Law, s. 15.04 (1 )(m)]. secondary purposes heck if revision to previous application /753 C/ l State Plan 1.D. Number I. APPLICATION INF RMATI -� PLEASE PRI T # RiVIATION Property Owner Name Property Location C. ice- /4 �'�--'/JW/4 1 , S T N R o W/ E f 7 EK Property owner's Mailing Address Lot Number Block Num e City, (State ip ode Phone Num ber Subdivision Name or CSM Number *enen 0 PL tg Iq& <9 . � IL IN : (check one) ❑ State Owned ❑ t Nearest Road ❑ Viliage Public al or 2 Family Dwelling- No. of bedrooms own OF �P6..soj� voli Ofy 4 d, 2: III. BUILDING USE: (1f building type is public, check all that apply} Panel Tax Number(s) 70 3F& -�/ - lel!500'- 1 Apartment/ Condo 7. '3 2 ❑ Assembly Hall 6 ❑ Medical Facility / Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church I School. 8 ❑ Mobile Home Park 12 ❑ Service Station 1 Car Wash S ❑ Hotel/ Motel 9 [] Office-,1 Factory 13 ❑ Other: specify IV. TYPE OF: PERMIT: (Check only one box on line A. Check box on line B, if applicable) I�p ) q) 1, ❑New 2_ ❑Replacement 3' ❑ Replacement of 4. Reconnection of 5. Repair of an S stem System Tank Only ❑ ❑ y_.._________ _____ _ _y .� __ Existing System -� ExistingSystem ___ _ __ ___-_-__-- ___--___ _ B.) ❑ A Sanitary Permit was previously issued. Permit Number 315 Date Issued � V. TYPE OF SYSTEM: (Check only one) Non --Pressurized Distribution �=st butivn Pressurized Distribution Experimental ether 11 ❑ Seepage Bed 21,[�Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground'Pressure 42 ❑Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill 4 - VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area- 3. _Absorp. Area, 4. Loading Rate 5. Pert. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./in h) Elevation eet 3- /3eet V1I. !ANK •Capacity in gallons Total # of Site Plastic INFORMATION Manufacturer's Name Prefab. Con- Fiber- Exper_ New Existrn Gallons Tanks Concrete strueted steel glass App. Tanks Tanks Septic Tank or Holding'Tank Z 4 Z43-9peo f' � e- 15� El 1:1 1:1 1:1 0— Lift Pump Tank /Siphon Chamber ►� .-�►. LL ❑ 1:1 1:1 ❑ 1:1 1:1 VIII. RESPONSIBILITY STATEMENT y 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (Nv Sta.mps) MP/MPRSW No.: Business Phone Number: PlumberAddress Street, City State, zip Code).-,. f f I I � IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (incivaes'Grounc6ater Date issue Issuing Age t Si tamps) Surcharge Fee) *Pprl❑owner Given Initial . -.� Adverse Determination ,� rX.CONDITIONS of APPROVAL/ REASONS FOR DISAPPROVAL: $BD- 639E (R.11197) DiST OUTIM: original to County. One copy To: Safety & Buildings Division, owner, Plumber unmeon� DIL H SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code 'Attach complete plans (to the county copy only) for the system, on paper not less than 8% x 11 inches in size. —See reverse side for instructions for completing this application. I. APPLICANT llhlfNIATION —P)LEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION PROPERTY OWNER'S MAILING ADDRESS LOT # CITY, STATE ZIP CODE PHONE NUMBER 111. TYPE OF BUILDING: (Check one) F❑I State Owned El Public A 1 or 2 Fam. Dwelling—# of bedrooms COUNTY STATE SANITARY PERMIT Ch ck if revision /to revious application STATE PLAN I.D. NUMBER T2?1 Nj R j -7 8 (or IBLOCK# 4rAll? SUBDIVISION NAME OR CSM NUMBER CITY NEAREST ROAD VILLAGE �l('C1Sl?/.�4!l��j� OFr,�v ,lVJI 111111. BUILDING USE: (If building type is public, check all that apply) 1 ❑ Apt/Condo 2 El Assembly Hall 6 ❑ Medical Facility/Nursing Home 3 El Campground 7 Merchandise: Sales/Repairs 4 0 Church/School 8 Mobile Home Park 5 El Hotel/Motel 90 Office/Factory IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. N New 2. El Replacement 3. ❑Replacement of System System Tank Only B) El A Sanitary Permit was previously issued. Permit # V. TYPE OF SYSTEM: (Check only one) Non -Pressurized Distribution 11 El Seepage Bed 12 F1 Seepage Trench 130 Seepage Pit 14 1:1 System -In -Fill Pressurized Distribution 21 Mound 22 In -Ground Pressure nz 5'--hl 1s'-3v 10 El Outdoor Recreational Facility 11 1:1 Restaurant./Bar/Dining 120 Service Station/Car Wash 13 El Other: Specify 4. El Reconnection of Existing System - — Date Issued Experimental 30 1:1 Specify Type 5. El Repair of an Existing System Other 41 El Holding Tank 420 Pit Privy 43 0 Vault Privy V11. ABSORPTION SYSTEM INFORMATION: 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) 2) ELEVATION :51oo N� I IV79- I A'/ Feet A93* O/Feet V1111. TANK INFORMATION CAPACITY ingallons New xisting Total Gallons # of Tanks Manufacturer's Name N Prefab. Concrete Site Con- Steel Fiber- Plastic Exper. A. Tanks LTa�n Tanks strutted glass pp Se tic Tank fil am 9F"l I Lift Purn Tankj;A- Ohmi 61181. r [le4l.0 M� V"C- 40 Z? 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) MP/MPASW No.. Business Phone Number: 2 ze,-;?63 Plumber's Address (Street, City, State, Zip Code): 00� R :5 F- We COUNTY/DEPARTMENT USE ONLY Approved 0 Disapproved F-1 owner Given initial Sanitary Permit Fee (includes Groundwater Surcharge Fee) Date Issued 1 Issui A n Signature (No Stamps) -Adverse Determination 0 A X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber Safety and Buildings 2226 ROSE ST Aff LACROSSE WI 54603-1905 nsconirn Tommy G. Thompson, Governor Department of Commerce William J. McCoshen, Secretary May 27, 1998 OUST ID No.6306 BOLDTS PLUMBING AND HEATING INC 820 MAIN ST PO BOX 87 BALDWIN W1 54002 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 05/27/2000 A TTN.- POWTS INSPECTOR Transaction ID No. 78669 SITE: Site ID: 7325 St. Croix County, Town of Pleasant Valley NWI/4, NEI/4, S9., T28N, R17W JOHN HANSON FOR: Description: MOUND Object Type: POWT System Regulated Object ID No.: 17972 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Adm. Code. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(d), Wis. Stats. 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 c on struction/in stall lation/loperation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. When making an inquiry or submitting additional information, please refer to Transaction ID No. in the regarding line. Sincerely, 4f A& RARD M SWIM , POWTS PLAN REVIEWER Integrated Services (608)785-9348 1 MON - FRI, 7:15 AM - 4:00 PM JSWIM@COMMERCE. STATE. WI.US DATE RECEIVED 05/07/1998 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 BALANCE DUE $ 0.00 P.O.W.LS.'0Conditional/Y BOLDT s A-16ex-ff A PLUMBING & HEATING INC. "Serving You For 40 Years" 820 Main Street Baldwin, W1 54002 (715) 684-3378 Fax (715) 684-3144 Page of rig 6 Date: Mound System For A 14 -Bedroom Residence ]Located M* the Nld l /4 of the/&' 1/4 of Section TZLN9 R/7 L /W Town of -.P/e a Lq;�� txa //P_ 9 X_ County, Wisconsi. R'E�'FIIndexV��D Kq y .. Pagel of � f�g� Title Sheet SAFETY Page 2 of 8 Plan View Cross Section & � Ijiv Page 3 of 8 Distribution Pipe Layout Page 4 of 8 Pump Chamber Page 5 of 8 Pump Performance Curve Page 6 of 8 Soil Evaluation Report Page 7 of 8 Site Plot Plan Page 8 of 8 Mound System Plot Plan Prepared For: 0 17 1140 0 N-6 V It to — — — DEPARTMENT OF CofAMERCE MSM Of ILDINC 0 Prepared By. Dale Hudson Certified Soil Tester /Master Plumber #220863 4 BOLDTS PLEG. HTG. Fax 715-6841-16144 May 26 '98 06:51 P.02 Page, Of L. Cross Section Of A Mound usin,A- Trewh- For. --,The Absorption Area Medium $and Fill 6" Topsoil —'E D. Trench Of w 2" Aggregate P Plowed Layer 6" Below Pipes Covered With D 0 Ft. Straw, Marsh Hay Or Synthetic Fabric E ZO� Ft. G A Ft F Ft. Re Plan View Of found Using A Trench For The Absorption Area I Force 14a i n 4F Distribution Pipe. (Permdnent Markers Observation Pipe W A 13 K Trergh Of ;*"J NO Aggregate L A fit. Ft,, ,---*I0 Ft. w z3 Ft* 8 Ft.* J Ft, Ft �)� �,. ' /4�� / License Signed: Number: 53Date: � �,�la� 9� BOLDTS PL9G. HTG. Fax 715-68L-,7>144 May 26 '98 06:51 P.03 .5 0 t Z5 ftw--"bp ror Two Lateral Network Distribution Pipe Deta Holes LOCated On 80tt0fn End Ca PVC Force Main aced Are Equal'Y Spa pVC Distribution Pipe X P X Last Hole Should Be Next To Ens;CaR L Inch p Hole Diameter Inches X Lateral Diameter wjnCh(ps) 41� I nches Y :� Force Main Diameter Inches Uf Holes/Pipe Elevdtion Of Laterals Ft. Invers, S i gned License Number: Date IF ,BOLDTS PLEG. HTG. Fax 715-684-3144 May 242 '98 13:50 P.04 .,j P U f-li P C H.A. t^. EL C R C c !J A ►J D "PLCIF ICATIO"r V C QT C AP �-v C A7 W F K F K 00 F- A P P R 0 VC D L DC I C. JUUCTIOU E50X PkA&JH0Lr. COVE f-. Z5' --CTOrn DODR. z m Li WIQL)OW ORF;ZCSk AIR W7AKE & RA IDL 4- "00 owmemmw~ /lK IQ. COUDUIT FKDVIDE MILE T AIRTI(PHT SEAL. APPROVED JOIIJT A APrvDVED J01W ol ALAlk ?A rLYTLkIDiLjG ONTO SOLID Soi, om 71 r- L E V. p U PAP OF T- 00lJCFCTFL ELOCK X- KISZK EXIT PLKM11TED GIUL!J IF TALA MAtJUFACTUK7-K HAS SUCH ^PFKOVAL stp-ric SPECIFICATION JS D06E TA W KS tI MAkJUFACTUkKl: --tAl' -y-r . rr. QUMBER OF 005ULS's p E K DA1.4 TAWK SIZE = `2 r,7ALLOUS D05i: VOLUME z/11 ALAKM MAW FACT IAER: % IMCL001JUG 6ACKFLOW. CvA.LLON5 A0Dt-'L klUKbtK*.— ChPACITIES: A OR GALL Ow 5 v,- Y 5 W I TIC, 14 TJ F E "p' rALL0U5 PUMP MAQUFAlLTUKZK. 60 L4 C,;-- WCHE5 OR1 (PALL0Q5 MODEL MUABEFLO. �?=e- INCHES ORZ95t7Z SWITCH TVPE: c vo, c- U WTE' PUMP AWD ALARM ARE TO 6E MWIMUM 015CMAKOE RATE G YP,6,k INSTALLED OU 5EPARATL CiRCUITS VLK7-lC-l4L- Dlf'IFF-&VJCE DETWELIKJ PUMP OFF ALJO 015-rK115ilTiaki FIVE— z—'o'o FEET +- MI&JIMUM IJETWOKK SUPPI,.' FKCSSURX IL It 0 - . 0 , ' ' Z-5 FuLT 4- --FEET OF rORCE MAJ�j Y, Ir X, FKICTIOM FAr-,ro,.-2.08 F CC T 10TERUAIMWIO�J F TAJ\' T �( LIQUID 01:P"r H 1 G E 0: z zo 5- zz- 5 U LICE-WAF UUMBER', DATE. wo low 7 * For Homes • Farms � Trailer courts • Motels • Schools • Hospitals • Industry e Effluent Systems anywhere effluent or drainage must be disposed of quickly, quietly and efficiently. Heavy -Duty Solids Handling Dependable Capability to 314" p p Y 112 H.P. 60 Hz i Single Phase 115, 230 Volt. 1� 1h1 3149 19 11h H.P. 60 Hz Single Phase 230 Volt. Three Phase 208-230, 460 Volt. I`- W W U. w U_ a Z .J 0 Bulletin CLZ11A. July 8, 1983 GOULDS Model 3885 (Supersedes Model 3870) Submersible Effluent Pumps Pump Specifications Solids Handling Capability to Discharge Size 2" NPT. Semi -open Impeller 3 vane design. threaded on sr,- units use impeller locknut to back -off- Pump o,-jt vanes on for protection of mechanical sG ' Casing Volute type for maximum effEcir7r Stainless Steel Fasteners Series 306 stainless steel for { resistance. Mechanical Seal Ceramic vs. Carbon sealing faces. sta�rEF spring and Buna N elastomers. Maximum Temperature 1600 F - Capable of Running Dry without damage to component: Motor SpecificatiorIST Motor Fully Submerged in high grade turbine oil for tion of bearings and mechanicalc seal al --- efficient heat dissipation- Motor sealed environment by rugged cast Bearings Heavy-duty all bail bearing consti Stainless Steel Shaft Series 300 stainless steel for c c resistance Threaded shaft Single Phase Units All single phase units have overload protection with auton' Y'' Three Phase Units Overload protection in starter 460 volts. Threaded shaft 60 Hz operatior Power Cord Water and oil resistant. Epoxy seal on n;o:: acts as a secondary moisture barrier in ca damage to outer jacketing. Corrosion r,3s. gland nut. Single Phase Units 'Is, '/,- H.P- models equipped wi-Lh 1-5' of 16 13 SJTO with 3-prong grounding plug 1. ' models equipped with 15' of 11 3 STO pc %% ti, cord. SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE. '-0 GOU LDS PUMPS, INC. SENECA FALLS NEW YOPK 13148 C57 ZZO?:503 oil scorsin Oepartment of Commerce SOIL AND SITE EVALUATION Division of S,:ifety and Buildings 13ure"au of Integrated Services in accordance with s. ILHR 83-09, Wis. Adm. Code Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan'Must County include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # Page of APPLICANT INFORMATION - Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Govt. Lot 14,IL�,) 1/4 17 �— 1/4,S T ;7<? , N, R /L//� 14_.. 0 / 7 U- (or)o Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# I I A city State Zip Code Phone Number ❑0 city 0 Village Nearest Road X9 2Z.11 1/q1)192 1V 0 New Construction Use: Z Residential / Number of bedrooms 41_Addition to existing building 1:1 Replacement E]Public or commercial - Describe: Code derived daily flow gpd Recommended design loading rate bed, gpdtfe-f -3trench, gpd1W Absorption area required C7 bed, ft2 trench, ft2 Maximum design loading rate bed, gpd/fF I to trench, gWt2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design/site considerations Parent material t.'o .5 e Flood plain elevation, if applicable ft X .S = Suitable for system Conventional Mound In -Ground Pressure AT -Grade System in Fill Holding Tank U= Unsuitable for system 1:1 S N U a] S 0 U - 0 S IM U 1 0 S ON U 0S 'a U 0 S -,.N U Boring # Y` . ME, Ground elev. /0 0.f /S ft. Depth to limiting factor in. Boring # Ground elev. Depth to limiting factor in. SOIL DESCRIPTION REPORT 4 Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPQ/ft2 Bed Trench 310, Alr.4 Z AJO40i C" C' s 2 ^0 • 3 ZI-31 /0 YA /S A),,,?s - .r -.15� , Y� /C- 3 Remarks: YZ_ Z- 3 _3 Z 1.4- /') G +C �" Remarks: CST Name (Please Print) Signature Telephone No. a1 . t d:5-0 ' �� --�- --. ��r -- �- Address Date CST Number Fz o C) CJ SOIL DESCRIPTION REPORT PROPERTY OWNER Page of PARCEL I.D.# r 4M Boring # �#orizon Depth DominantColor Mottles Texture Structure Consistence Boundary Routsft GVD/ft_ e?2 Ground -Cl ILF .14 elev. Orr. 7 ft.YR d AR '5 /C pr 4F Depth to limiting factor �_in. Remarks: Boring # Li , , Ground elev., Depth to 1 limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Boring # e Ground elev. ` ft. ' , Dept to limiting factor in. Remarks: SBD-8333 (R. 07136) in. Munseil �?u. Si. Cont Color Gr. Si. Sh. � Bed ,Trench l r , Horizon Depth in. Daminant Color Munseil Mottles Chu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIf#� Bed ,Trench f 9,6-6-/7 �� a /0 c, 0 C7 vt 4 S -55 V?j v 10 -d too 0 (n �Af11��j U C N cv 0 0 co 17) dam v a10 CL Biz _ /co, /3 CD 3-i*3 y 9 r 17 Sca/e. roc ov�f -CPO 7f IV Cl ;,A, J w, w C) )y i W-3-U&M 4v 11 p 0'& = ff 1 -0111,013 IV J'44y/ F70.2 � J St •c+or = �a 47 � I To jv- x i r J E� L� 3N ' t�Cq GvccI cvo�trs 5',APO ,5o'3 f ` C / A Of. I � � Z fb Wiseon-;n Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of Bureau of Integrated Services in accordance with s. iLHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and ` percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # (77 n_aLf W-11 APPLICANT INFORMATION - Pl pr' rhf a!1 If ll`iE?T'm 'pn. Rev' wed by Date Personal information you provide may be usectfcr'secondarypurpows (Privacy Law, `s. 15.04 (1 ) (m)).V•7 Property Owner Property Location Govt. Lot ' 1/44/� 1/4,S T ,N,R IV (or'�:/ Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# A114 City State Zip gode", E Or Nearest Road l It r ❑ City ❑ Village .� 21 New Construction Use: Residential / Number of bedrooms Addition to existing building /✓ D ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow - CSC gpd Recommended design loading rate bed, gpd/ft2 �� trench, gpd/ft2 Absorption area required bed, ft 2 - trench, ft 2 Maximum design loading rate bed, gpd/ft2 '� trench, gpd/ft2 It Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design/site considerations f Parent material .J e 00 107 el 17 Flood plain elevation, if applicable ft S - Suitable for system Conventional Mound In -Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ S 21 U a] S ❑ U ❑ S .M U ❑ S ,2 U ❑ S'a U ❑ S_'N U Boring # Ground elev. /�'��� ,/_3 ft. Depth to limiting factor .�/_in. Boring # z Ground elev. Depth to limiting factor S ?_in. SOIL DESCRIPTION REPORT Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ft2 Bed , Trench Ale - J� S b Yet v�" Q '2M ' 2 .. Z- -5-21 s� Z 1"'v).-5 1� ry-) V C 2- kv-) / V o i1, -2 / yi S jai : i r Cj YS /C Remarks: --A / �'-f-11 �� r' fi' ,►' /� V ram' Remarks: CST Name (Please Print) Signature Telephone No. �7/_5-•6' �. 7, r Address -�( Date _ CST Number _j Owner/Buyer ST CROIX COUNTY SEPTIC TANK MAINTENA.N('_fE AGREEMENT AND OWNERSHIP CERTIFICATION FORM 4- :!J7 rt S flan s on Mailing Address Govz y Property Address 7 �C)o (Verification required from Planning Department for new construction) City/State Parcel Identification Number e5 ZI lev��3 LEGAL DESCRIPTION Property Location /'� = VS ec. T /4,51 N-R I W Town of'4"'O'/ "' Subdivm`on Lot it Certified Survey Map # Volume Paige # Warranty Deed 9 3 z;7' Volume Page tf Spec house 0 yes U/no Lot lines identifiable 19/yes El no -SYSTEM M� NANCE . Improper use and =int=ncc of your septic system could remltm' its PLr.;MatUMfailure to handle wastes. Ptoper maint=ance consists of pumping out the septic tank cvery three years or sooner, if umled by a licensed pumper. -What you put into the �m can affect the function of the septic tank as a tmatraent stage in the waste disposaj.Vstem the property owner agrees to submit to St. Croix Zoning Dcpartmcnt a certification form., signed by the owner and by a .ma- plumber, journeyman plumber, restricted plumber or a licensed pun r verifying that (1) the on -site wastewater disposal system 9 is in proper operating condition and/or (2) after inspection and pumping (if neccssary), the septic tank is less than 1/3 full of sludge. Itwes the undersigned have read the above reqw=mts and agree to mainfn in the private sewage dis� system with the standards set forth, hemin, as set by the Dcpartment of Commerce and the Department of Natural Resources, State of Wisconsin- Certification statimg that your septic system has been maintained must be completed and returned to the St Croix County Zoning Officc within 30 days of the thin y xpiration date. 6,7 SIGNAWRE OF APPLICANT DATE OWNER. CRKU FWATMN I (we) certify that all statements 011 this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the pro 11, r1D descnibcd above, by virtue of a warranty deed recorded in Register of Deeds Office. S�_GNATURE OF APPLICANT DATE * * * * * * Any infonnation, that is minis -represented may result in the smlitary permit being revoked by the Zoning Department.""" Include with this application.- a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is nmdc in the warranty deed �.-m ,r* 00, RLSD 9 FEB 0 8 1999 ►► 12 KATHLEEN H. WALSH Register of Deeds St. Croix Co., W1 CERTIFIED SURVEY MAP LOCATED IN THE NW 114 OF THE NE 114, OF SECTION 9, T. 28N. , R. 17W. TOWN OF PLEASANT VALLEY, ST. CROIX COUNTY, WISCONSIN PREPARED FOR: NORTH QUARTER CORNER CHR I S HANSON SECTION 9 -- FOUND UNPLATTED LANDS COUNTY MONUMENT .... , , ... ' ........................ _ NOR TH LINE OF THE NE 114 S89 ° 44' 07" E 2630. 53' , S89° 44` 0 - E S89° 44' 07" E 512. 50' .. •Z.. N89° 44' 07" W _ �'� _ _ - ---'fir - -� 736. 76` Co .To H, rev _ _13$1. 27` C� S890 44' 070 E 517. 1 I ' C ; ' `1 _ ' NORTHEAST CORNER (0 / 0 $ o SECTION 9 - FOUND q COUNTY MONUMENT no................................ ..................... o w BUILDING SETBACK LINE DRIVE HOUSE % tr) DECK 0 : Z7 \ MOUND SYSTEM N LOT ! 10.65 ACRES N: 464, 014 SO. FT. 10. 16 ACRES EXC. RiW p+ 442, 393 $0. FT. d ON S87° 21' 1 1" W 484. 71 ` UNPL A T TED LANDS LEGEND 0 - SET I" X 24" IRON PIPE WEIGHING 1.13 L BS. PER LINEAR FOOT BEARINGS REFERENCED TO THE NORTH L I NE OF THE NE 1 �4 OF SECTION 9. (ST. CROIX COUNTY COORDINATE SYSTEM) 1 " - 150, 1 1 p mmml� 2 0 75 150 300 SHEET OF 98050E THIS INSTRUMENT DRAFTED BY J I M WEBER JUN 2 ST. CROIX COUNTY SURVEYOR'S RECORD h � r a '4D b� •Y ^ /V r ca JAWS M. WtBE'R -S- l804 NEL SEN-�ER L AIDURVE Y I NG DATED IX-�-+� R��� \- %\-101% cl Vol.13 Page 3601 N W E S PLEASANT VALLEY/RUSH RIVER PI -AT r j T-28-N R-17-W $� JJJ. Q Farm & Home Publishers, Ltd. HAMMOND PAGE 36 See Pages 115-116 For Additional Names. H� , �1 RLEASA N,1...VALLEY,1 . . . . . . -RU-19H B . ...... teven & 1jMP.'1jytP1tj1 ortild ... ...... . ... 4 ;u ne Tara 5� a -0 :;re jQry w Charlene 80 Allen Hansen 119 Charles I Baldwin Walquist 13 .11 El enee einbuch 7 tL--J Steven Cox x co 9 jerns Kenton Patrick Beliville K11D & p__ Aden & Brian 39 1 & Xong L 14Linda oock Merritt 38 Z6 26 JSK & Family etas & Hanson I 60 Mary Gre8ory o n& LLc 2 Her W 2 66 N hagen Wilcox C v Trust 137 Richard Jeffrey L 9 Trust I uoho 134 a64 Ruo 163 75 Tho an Merritt 162 55th AVE Cbaries & Rosrund 1�e`arson 102 tr ■ C&L 72 R 99 Trust 79 �U) 35 2 Christen on 57 .00000000 Herbert b Sun Steven & Sun & Verla Ridge -1 —, Solberg "Thompson 4 Rance Ridge Trust 124 1 Farms 110 ii anet a) I F- 94 o Riva d Adelaide Trust E, 7 HeInb uch Farms 72 1 Inc Inc 34 1, Farms James ; 1! Arvid & 71 126 DeYoung Elmer & M 72 Irian lohnson LorenJrM & Lyk on e & Marilyn Nippoidt Farms S&K 21 eabody 0 78 200 Ramona Hendrickson ndr *1 1 4 Flanum 70 -h, 30 56 0'. 55 Smeester sm Inc 75 121 40 Nelson N ZSO F r- 40 I[& I Willi Loren jr & 50t AVE —V 40 FLIC 5 Jeffrey A&M A F mily Trust 16 --2 n )& Boru�-Z Inc & 1 21 + L21 ekH1 &Ma Marilyn atricia 5 Smeestey airis 3;0 0 I & 112 8 E&M 2 Huentak T&j 20 20 Delong & Cynthia S es 55 Vm rust 63 d dul e is K Herman Her Delores Schulte Christian n Bros Hanson' 115 Timothy & W Jeffrey & Cindy Michael & Conr-de KM �Thomas & Margaret andy & ndra John & C R& David Heinbuch Trust 174 Robert 160 149 q� q., Karen Laura Bishop Halvorson 80 Ltd 1 Bonnie Moe 185 Symes40 Van- 15 Keuren I 32 Erdman 1 60 R uette 77 See K 9 & Mary Zwald 78 21 PrtnTShp 12U 4 Win & lane rville & ariene 136 261 Kurt Daryl & Lurene Fairmont Patricia i-- Jeffrey Schwartz D., 1-- 100 U) Eric Trust 80 D&R Alan & Boniaz Afdahl 40 Bo Mal Bahnsen 115 I Farms Kairis Cf) L&B 0 Symes 80 Newton 79 Barg Mary Rand E A&A MlA & Jeanne Owens Inc 40 Inc 80 Inc Glen 159 Mahn 5 75 & P 5; 34 ussnerr 4 Ve s n K 7 .0 IV14LA Carolyn 135 N 30 Tubman 75 34 7 Dj 6 —E 35 Duane BD& tshi Fredrick Kurt Afdahl Ll win & Glen & mat.. f14 qu ;0 Newton Carol 0 Linquist Roger & P r% p 150 Owens 152 Afdahl Family Scott Gerald & 'Owens Sharon ;F 9 g$jl Darleen Stoppel 120 4 Dawn 4 Harnman �9 i2 Trust X 7 e 0 2 2 q9 Woodside June Linquist Trusty 77 Tz 80 79 Afdahl 3 4:2 t; mold cverly j i., Mohn so 220 Duane Newton Z,,r D Family LP 73 & & �AD 140 iKuft Legr-d er Gary 9ax acobso 40 60 le 0 .g 5 G-y N-vwn 76 10 35th 35 Bruns 41) �VE Kurt Scott P airmont Gregory Thomas Zwald & Lloyd & Jon De ary 00 Z.,-, tanaffis r- I Gerald It Sharon Vaugn Bornaz Alan & Slick Robert & Sandra Mary 40 jorgens & Jayne 3S Durdall & Carol Morgan arms c 40 & Mary Aaby 40 inn, Espwcna 36 Eleanor Weber 120 Richard Farms Walton IncKaren Leslie & IC WA Afdahl 40 Inc Jeanne Bradford 46 so 3 KP 0 154 159 5 9Larson rH 0 Mary Afdahl Owens 60' 79 Frederick 60 Victor & Mira W&Barbara r Casey Z an 'o P 4, 139 Afdahl 128 Family Trust Lenertz 64 Staut 46 39 38 El lis 4 0 D& 14 801 7- 0) 5 4 35, &70 I , I r [N S L— r W 1! Z IZ Z `4L 40 Kathryn sn Smith 20. Reis 20 1 &M I Pmes & 7 ichelle KH lyde W 5 30th AVE Kurt V )my D S 15 (0) g2ard 39 49 2 D&S ©airy LLC 39 78 .4 0 John "" 80 Reil Herman s4O Delores & I Schulte &M M 9 oannc acobson Matthew & Moriah Schmidt Fairmont 40 acili U Ebertz 160 W Glenn Alice & Heinbuch Trust William & Jane Bros 155 rust 0 Fischer 74 & Heather Landin Farms Inc "I cfi De Todd & E b th h Anderson DDornlnk Excavating W4 Z Spear INeumann 120 Raihala 152 3 145 Farm pr 4 Inc 1 40 40 Inc 8 5 5th AVE 120 40 33 80 60 4 5 lemey & Tracy 63 '-1'.',..,9arence & 'A 3 Lawrence 0 & Cynthia Joel & Cind Robert & Mccut- Richard r chron Pame a 15 40 Whisperir silos -'acobson 81 I 38 cv co Nelson r- Johnson 80 117 Kim & 22n L Schuitz 120 Dorisi Hansen 160 W ....... Walton so YMsaker Daniel VanBeek 60 r U hAjL & oroth ohn & Raelle Bruce 91 Luella 40 y 72 E& eumann Sharon Gil So 40 Jorae 80 kamberg 40 1.Maule C 10 1 1 Ot z James Z1V;eI 50 - - — — - Schulte Bros - Lee Betty I" & U04WA Betty & Maid Lee& Betty C P er & Sara P: Th6mas Werimont y 118 00 .7 Fosse 78 1 &40 80 Jacobson 40 40 Jacob akkc 4 4o40 ;Jacobson80 0, e.,rim 4 79 i 401 18th AVE — -,�=cken F3P 20 40 U I ly w G KS Perini TEE:- L -3 U 1 A V moth J 20 Colby 0, IN Charles Smith Patrick lk Donna Hayes W V, g Matz Matz 5 Uos Inc PH 11 7 c Charles Langer H Maxln� Eric & wells SitZ 40 Michelle W=L 40 C rai 2 40 =3 = qj 40 17 V1 U= JH JK9 PT 9 40, 163 -fa-Tn J&L �9 14 had & 61 0 Swenson 1 30 9 Jeremy Lawrence Se & Cynthia 9 Paul & Kristin V.0 t CV 4j 20 Barbara Berg - Eugene M�r Erilen 68 & David David Sander Harley Allen 20 Mane r lark 41 & Rita Raverty Johnson Ko5t,--- 1 so A .05 0 0 -W 80 scblon 49 Svycnson Gordon Joseph 1-/rrUr:e & pc 40 ce so H & uth X&D Robert 04 Im 11nothy 0 P 'a &B 20 ietsen 0,9 R ]h Cheri s Trust James & Mary 1 150 Sand Douglas oewra Monicken & Rory Gilbert 60 Mary Koenig 82 80 ill L0 Nol e etal Holdings 120 LTD 80 Sharon Joan i astcri Rostrum 113 915hllings— CL 0 Randy Marion 12 27 U U" Coltrain 40 40 1 Oth AVE 40 A Alan Kraft Beth John. mace Michael n V Michael Robert & & Denise athleen James Blackwell 40 20 0 e Julie L&J Ro a SplekeT a Kathice & Dana Kerry Kathleen 2 wenson Freeman ath AV lalre 0 �G Thompson 0 20 22 40 Farah 40 Timmers W Lich Swenson 77 t 0 159 Joseph ustrum Lh 84 th Timothy &C Andrew & 109 231 60 Koury 55 P Kou AVE Karl & Eileen Lafavor th 20 I & Rose Rudesill KC _0 12 30 1vF9- 1 Eleanor Schiltgen 80 M P Mark & Carol Lebo Trust 48 I Karlson 77 39 40 s eblon 84 � Zo 0 -K2 �A 0 P b Q %J%j yy Charles Tom& Tony Cannon Mark jean & Allan marktrt & Beverly Henry & Nancy Larry vldd, W obert & baron Ohn Monicken 7 Alan & L6 Barry & Karen Daniebn 23 39 Cynthia 4 Symes RP 40 5 Gies & Diane welter 40 Barbara Weyer 80 Dallman 122 ary ritsch River Ranches LLC 160 0 Mo-elter 80 I Barts 40 roost 120 nnis & odd o cen H—s Cooper A A azlID-11— Holz 36 David cc -T I r ra— 12A ustrurn A© 77 Jeanne Owens Ow 153 janfrey y f Thoen 40 --1.---,-..-. I Harvey Hielkema. _ i--19 t 80 Michael 1-hon,,&s &Donna meyrt Trade 36 francinc& 4 Ru . ...... - -- ZAa7!-j-g. PIERCE COUNTY Phone Toil Free: 877-684-5125 Local: 715-698-3800 Toll Free Fax: 877-684-5126 Local Fax: 715-698-3801 Cell: 651-261-2258 Expect the Best! Quality Service, Quality Doors! 104 Trient Drive Craig Willert P.O. Box 245 Owner Woodville, W1 54028 20 4 PLEASANT .� VALLEY .J OOTH RUSH RIV ER `! �fev�n ■ z 17 SEE PAGE 31 R. W. 8N let � � f%2r7s0121 vq`1ti ax • ,rC7he irr/tcantB � �' 9pr/J• ' t✓iI/. o� AYE. 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Wr`//arcz� �r5'� Ts �%r �. • ■ o ` `�i Da /�, s Js L ctr o cJ • 1. !'ems nrU • �■ ■ ■ /IDS 4tp �/�`7r J J193 � e a A/e�or�der r' 00 C .J r ■,tea, ��, r r cT�z� IT �l�r�r, b �a � y c5t,r tisc�ra ZQy e v U T EVAVE _vcz r7ie/sn � Ca iczrre ,►..e„ d v Ire C7r yr n L. CS ►. r, errt�r Q/'cz d fr'Gzr7 .Pleb r g© !N sr+ vrr 0 Ir7,C. PIERCE CDUNlY �9 9� Rude- 5T. C`ROIX /2© ■ .5 �f f Pt E,�,5,� NT VAS L EY T M''P. -�-{- I RUSf� R/YE R TAMP. PREPARE F'OR THE WANG&��N� Toms Electric INSULATION tor Service IN CELLULOSE BLOWN MOTOR CLINIC ATTICS S1 DEWALLS (715) _ 59aa Brian Wang a �' 1 (715) ]I-` 2-3186 TOM VANDEBERG - Owner ` Route One III River Road Wilson, Wisconsin 54027 WoodvilleEast , Wisconsin 54028 19 DEPARTMENT OF INDUSTRY, LABOR & HUMAN RELATIONS P.O. BOX 7969 MADISON WI 53707 NEB, NA4, S91THN-R17W Town Of Pleasant Valley CTY Road Z NAME OF PERMIT HOLDER Jerry Henrickson rBEN,-,, MARK (Pprm.,.- NaFne Of -Plumber L Dale E. Hudson SEPTIC TANK/HOLDING TANK: MANUFACTURER iNSPECTION REPORT FOR SA"E-TY & BUILDINGS PRIVATE SEWAGE SYSTEMS DIVISION ❑ CONVENTrONAL ' BUREAU OF PLIJ�AP_ING 1ALTERNATIVE STT, FT f Holding Tank ❑ In -Ground Pressure �Jound If dSSic 87-02701 AIJI)HESS OF PERMIT HOLDER IN DATE 7542 Emmanuel Ave. S. Cottage Grove, MN 55016 '-Hlbk IF DIFFERENT FRr-jrA Pf.-AN REF. PT. ELEV "P/MPRSVV No P L�V2 �f Number t 6629 S Croix 96062 LlOmn CAPACITY _�� TANK INLET ELEV. TANK (7U_TLET ELEV I _WARN I'JG —L A �(LOCKING COVED Pt 9 V I D E D -1 DIA — Y ES BEDDING, VENT DIA. VENT MAIL 'HIGH WATER NO YES ALARM NUMBER OF ROAD. PROPERTv F DNO FROM ',V E L L• ___7LDING� VENT TOFRESH DYES :EDINO FEET FROM ILINE El YES C, F]NEARESTT AIR INLET —ff DOSING CHAMBER: I�A UFACTURER BEDDING CAP4C1-1 T,( PUMP MODE L PUMP sfp"()rtj MANUF AC-TuRE H_ WARNING LABEL �LOCKING COVER YES PROVIDED PROVIDED M A 'j F A CTU R E R D GALLONS S PER R C YC E N FGALLON PER CYCLE: C PUMP AND CONTROLS r:IPFRA TIONA L YES IN 0 YES El NO (DIFFERENCE BETWEEN NUMBER OF PROPERTY 1,")F! PUMP MP 0 0 LINE BUILDING VENT TO FRESH PUMP ON AND OFF) YES FEET FROM AIR INLET SOIL ABSORPTI N SYSTEM. Check the soil L] NO (NEAREST or excavation. moisture the depth of Plowing 7- MATERIAL AND MARKIN(-, (If soil can be rolled into a wire, construction shall cease until FORCE the soil is dry enough to continue.) MAIN CONVENTIONAL SYSTEM: BED/TRENCH WIDTH _L E N T H NO OF ()[,)'7'P PIPE SPACING COVER DIMENSIONS THENCHES MATERIAL' INSIt)� DIA_ �31 7 LIQUID OU I D BED/TRENCH DIA - IM PUMP L-T DEE IN L I QU 'D GRAVEL DEPTH FILL. DEPTH I PIT (DEPTH T BE LOW PIPES LASTR PfPP PELFDISTR, ABOVE COVER E[ FV r IELFV -Wt MATERIAL NO DISTR PR f) NUMBER OF PROPERTY WELL. PIPES LINE HUILL)INC), V FEET FROM LINE ENT To FRESH NEAREST I AIR INLET MOHKin eve-r 00-i I I V_1V1: Mound site Plowed perpendicular to slope and furrows thrown uPslope: DYES NO �01L�CdVER ITEXTURE DEPTH C}VER TRENCH titIL) DEPTH OVER T T-NITH _RE C) CENTER I ,EDGES PRESSURIZED DISTRIBUTION SYSTEM: I WIDTH Check the texture of the fill material for PROVIDE A DIAGRAM mound mund systems to make certain that it ON REVERSE SIDE, SHOW ELEVA- meets the criteria for medium sand. I -IONS MEASURED. PERMANENT FIRS `.�13SEHV AT I (JN WELLS P E E11M[A N iFR S_ Dt" I H OF TOPSO YES S F7 NO _IL _T_ OYES SODDED D E D FS77E ENO F D F D MULCHED L I T Vrr YES NO O YES NO D YES NO BED/TRENCH LENGTH NO, OF LATERALSPACING � - DIMENSIONS NO. GRAVEL DEPTH BE LOVV PIPF FILL ABOVE �COVER I MANIFOLD ELEVATION AND ELEV. V. DISTRIBUTION INFORMATION HOLE SIZE COMMENTS: Sketch System on Reverse Side. DILHR SBD 6710 (R, 01/82) PUMP MANIFOLD E DIA DISTR_ PIPE MANIFOLD MATERIAL NO DISTR ELEV_ PIPES �qOLE SPACING DRILLED CORRECTLY rCCIVER MATERIAL DYES ':i MARKERS: - ENO PERMANENT ,!KERS 'OBSERVATION WELLS: DYES ONO LYES_ ONO DISTR PIPF DIA f VF R T ICA L LIFT C-_dRR_E_S_P_0N_DS To -AppHOV E 0 PLANS EYES l NO NUMBER OF PROPERTY WELL BUILDING. FEET FROM LINE� NEAREST)----- Retain in county file for audit. SIGNATURE ITITLE-- Zoning Administrator 401000�`�`1�� DILHR SANITARY PERMIT APPLICATION COUNTY �� WIMM7141V LASCM & In accord with ILHR 83.05, Wis. Adm. Code E (f• STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the on paper not less than 8Y2 x 11 inches in size. STATE PLAN I.D. NUMBER -See reverse side for instructions for completing this application. Ly, 7- 6) I. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PETITION PROPERTY E — ❑YES NOPROPERTY 09:W:NER PROPERTY LOCATIONFOR ARIANCE 0 ewo, /1 /4 49 S e2 T j�?Fj No R /7 #(or PROPERTY OWNKS MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME ow_ BLOCK NUMBER �SU SUBDIVISION L N N Z CITY, STATE ZIP CODE PHONE NUMBER LD CITY 0 E NE RE7 R EAREST ROAD, LAKE OR LANDMARK .4 VILLAGE N .7 35' "`U: C)� �', Z, _*7 ITQML Y. 11. TYPE OF BUILDING OR USE SERVED: LNumber of Bedrooms if 1 or 2 Family 44 ORQ Public (Specify): III. PURPOSE OF APPLICATION: (Check only one in #1. Check # 2,3 or 4, if applicable) F%-A 1. a. 10"NI New b. 1:1 Replacement C. Q Replacement of d.S1:1 Reconnection of e. ❑0 Repair of an stem System Septic Tank Only an Existing System Existing System 2. Q A Sanitary Permit was previously issued. Permit # Date Issued 3. Q An Existing System has been inspected and soil conditions meet minimum requirements. 4. Q The System is shared by More than one owner/building. Attach Common Ownership Agreement to County Copy, IV. TYPE OF SYSTEM: (Check only one in #1 and only one in #2) 1. a. Q Conventional b. _X Alternative C. Q Experimental 2. a. Q System- b. Q Holding C. Pit In -Fill Privy d.E1 Vault Privy e. Mound f. ❑ IGP Tank V. ABSORPTION SYSTEM INFORMATION: (Check one 1. a. S e p np ri ge Bed b. Q Seepage Trench c. 11 Seepage Pit 2. PERCOLATION RATE 3. AB RPTION AREA QU So �E REQUIRED 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY: (Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet). 500 Feet Private Q Joint El V1. TANK CAPACITY Public INFORMATION in allons Total of Manufacturer's Name Prefab. Site Fiber- Exper. New isting Gallons Tanks Con- Steel Plastic CAPACITY in a 'o TY n x i s Existing s Tanks Tanks anks Concrete structed glass App. Se tic Tank or Holding Tank 00of-7 46 4') T Lift Pum : /S Lift Pump Tank/Siphon Chamber 1ci&, Q Q [� ❑ VII. RESPONSIBILITY STATEMENT X 1, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans. Plumber's Name (Print)- Plumber's Signature.- (No Stamps) MP/MPRSW No.: Business Phone Number: r 6 10 Plumber's Name _ �e(P r _&37;7 PlumbeCs Address (Street ) City, State, Zip Code): Name of Designer: 7150' Vill. SOIL TEST INFORMATION Certified SoilTester—(CST) —)Name /J�� f- CST # 0 tf--, , —,. A _. _- —/Z _410 �, Sly0 CST 's ADDRESS (Street, City, State, Zip Code) 2 IV 43 y5ot Phone Number: ;7) P IX. COUNTY/DEPARTMENT USE ONLY / 5 eo-,,1 Approved I I Sanitary Disapproved Sanitary Permit Fee Groundwater Date Issuing Agent Signature (No Stamps) Approved Owner Given initial 11,qrcharge Fee rm ination 7 Adverse Determination X. COMMENTS/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber INFORMATION & INSTRUCTIONS COMPLETING A SANITARY PERMIT TO THE APPLICANT: 1. This sanitary permit is valid for two (2) years; 2. Your sanitary p may be renewed before the expiration date, and at the time of renewal any new Y criteria in the Wisconsin Administrative Code will be applicable; new ermit may be needed 3. All revisions to this permit must be approved by the permit issuing authority. P chap e in our building plans, system location, estimated wastewater flow (number of bed - if there i s a 9 Y rooms, etc.), depth of system, or type of system; hi lumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be 4. Changes in ownership or p submitted to the county prior to installation; should be pumped by a licensed 5. Private sewage systems must be properly maintained. The septic tank(s) P pumper whenever necessary, usually every 2 to 3 Years ntact our local code adrriinistrator or the, 6. if you have questions concerning your private sewage syste = co y State of Wisconsin, Bureau of Plumbing, 608-28S-38 .. To be complete and accurate this sanitary permit application must include: 1. Property owner s name and mailing address. Provide the legal description where the system is to be installed; in or use served: I# public is checked, "Indicate `ype of use.e. 10 unit apartment, 30 seat Il. Type of building restaurant, etc.). Fill in number of bedrooms if building is a one or, two family dwelling; reconnection or Purpose of application: Check only one in #1. Complete #2 if permit is for tank replacement, Ill. pP repair; IV. Type of system. check all appropriate boxes depending on system type. Check experimental only if project is in conjunction with University of Wisconsin; V. Absorption system information: Provide all information requested in #1-5; ns to be installed, VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total galla lets number of tanks an d manufacturer's name. Indicate prefab or site constructed and tank material. Comp for all septic, liftlsip hon chamber and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR; h appropriate refix (e.g. II. Responsibility statement: Installing plumber is to fill in name, license number with if V p P etc. address and phone number. Plumber must sign application form. Fill in designer name M , }, applicable; V I I I. Soil test information: mation: Certified soil tester's name, certification number, address, and phone number. IX. County/Department Use only; X. Comment area for use by county or resaon given when application is disapproved. Complete plans and specifications/2 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; P streams and lakes, dosing or in pumping chambers; distribution boxes; soil absorption systems; replacement o system areas, and the location of the building served; B) horizontal and vertical elevation reference points, C} complete spec ifications for pumps and controls; dose volume; elevation differences, friction loss; pump performance curve; model and pump manufacturer; D) cross section of the soil absorption system i , pump p required by the county; E) soil test data on a 115 form. GROUNDWATER SURCHARGE n May 4 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more On y - Hawn as the groundwater protection law. This change In statutes was the �0rr!r1ioniy k 9 n� r � years of stead nego�6ation and public debate. Thc1 gro jndrvater bi!l � round tie Nesu�t of over � Ye Y �, f .•led p, act;ces which 11��isco �; the creation of surchairges (tees€ for a n�:mbe. o regul � x i, eluded I 1 All e rya -ter t r the surcharg took effect on July ��3� : ov #l^4 ha` buried �t0111 AS O :� � r, C"a n effect groundwater. ;; -� . r building iu returned t(: the gra�indwate: through your soi� a�sa�ption .t used in yo�� 9 ; r system tem or the disposal site used by your holding tank pumper �r s r-ti i't "� h r �! €.,i ..# c r 8 a r o e s are e cif e o P' d v: S. i .; J L �' 'a�!' �� i tl 16 Gi i .: i _,F i a.: C 4 ! r '� •4 he i?ion' �.�o.le.-ted g thE'�e i .� e urce; These tun:-S �,ec t� ,ti T. l ire,-s b [r epartment of Natural Rso �; _ _ ", - �.i e � . i 5 �' ."`. ��' l # i 3 • ' `-' r. `�' c `�1 L:.�. "t d a � d s � s (��F � �r dwater conta►ninatio F ir��esttgat� ins n wc,rtl, protect. na . ... i }6 APPLICATION FOR SANITARY PERMIT STC-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/contractor,("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. -- - - - - - -- - - - -- - - - - - - - -- -- - -__ - - - �- - -- - - - - -- - - - Owner of Property Location of Property �� � `%� �, Section T �(� N - y � R W ! Township - Mailing Address Subdivision Name Lot Number � Previous Owner of Property Total Size of Parcel ,' •,�---'' Date Parcel was Created Are ail corners and lot lines identifiable? Yee No Is this property being developed for resale (spec house) ) ? Yee % No Volume % and Page Number -171,2 � as recorded .. with the Register of Deeds INCLUDE WITH THIS APPLICATION LINE OF THE FOLLOWING: 1. 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 of the reviewing process. If the deed description references to a Certified S delays i Map, thetheCertified Survey Map shall also be required, ed Survey —__—,w--_`--.._..,. — —— .r__rr—_—_.._,...,_.__r—._.— __ .,.__. PROPERTY OWNER CERTIFICATION [I� (We) e eA U 6 y that att d -ta-tements on a 6 onm aAe tAue -to .the b know4edge: r Ca �nro fin h 1 c 1 ! f� e6. a-t 06 my (0c ) (rfa i nrr �, rs 'ti' uL1.L G V a .. V r ti.. % V 1-r r fin... f.J �1 V L l 1w eV :..- Li1... 1.1 A ..i i , r .i /r indo.�lna-t�.on ahm, b,y v 6 a waAAanty deed neeonded .gin the 06 6�e 6 the .� County Regiz.ten o 6 Leech a.a DocumentDocument No. and that I o .the � t '�"�'' I (we) pne.a entt y own .the prcopod ed dite bon .the a ewage p0,6b .6 tem (m I w obtained an ead emen.t, .to nun with..�he above dea cAib ed u ( e) have eona.t��c-uc ion 06 chid dy,d,tem, and .the Game had been duty np�y' bon .the 06 .the Co" Regiz ten 06 Deedd, a,a Document No, y ec pled in .the 0� 6.cce SIGNATURE OF OWNER SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED S T C - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER.- N"Ap- lc-z�Cc) ROUTE/Box NUMBER 1#;;�2 671-1112 G,Ke / J'o Fire CITY/STATE r-o ZIP — PROPERTY LOCATION: LZ,0. -14, Section T o w n o f-� /' 1 Subdivision Al'/ Number -5-5-2)41� T N R W 1) St. Croix County, Lot number -AII/A Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix. County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree 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 plumber , journeyman plumber* restricted plumber or a licensed pumper veri- fying that (1) the on- ' site wastewater disposal system is in proper operating conditiCon and "2) after t c inspeI F ction and pump1;_",LLg I (4-ti: ne,.- essary) the septic 'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein,, as set by the Wisconsin Depart- ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning office within 30 days of the three year expiration date. S I N E D .'` DATE7 St. Croix County Zoning Office P.O. Box 98. Hammond, WI 54015 715-796-2239 or 715-425-8363 0 M Sign, date and return to above address. DtPAFTIMENTOF REPORT ON SOIL BORINGS AND SAFETY&BUILDINGS INDUSTRY; DIVISION LABOR AND HUMAN RELATIONS l J PERCOLATION TESTS (1151 P.O. BOX 7969 H63.09(1) &Chapter 145.045) MADISON, WI 53707 DATES OBSERVATIONS MADE . 94*/' / PROFILE DESCRf P ONS: A ON TESTS: RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND !N-GnND-PRESSURE: SYSTEM -IN -FILL HING TANK: RECOMMENDED SYSTEM:(o tional) os u 3s❑u s UIsaMsZU If Pe:s.H!613 on Tests are NOT required DESIGN RATE If any portion of the tested area is in the unde.09(5)(b), indicate/ Floodplain, indicate Floodplain elevation: ZZ A4 PROFILE DESCRIPTIONS PERCOLATION TESTS TEST NUMBI=R DEPTH-, J 9 WATER IN HOLE AFTERSWELLING TEST TIME INTERVAL -MIN. PER�oD P-, P- P- P- rev+ rLHiv: Snow locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale 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 percent of land slope. SYSTEM ELEVATION tN 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 Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHR-SBD-6395 (R. 02/82) -- -- OVER — Ile ne- / "c i6o,,q 7-5 -Y -fmmonuel cot �07e 550 /4(:�Io 3,.P7, v -�� sent ��- Alo IC5 ,, No C3 0 #4 it -Ben- 15 c k C6,p 40 b SOT e pi 0 ��'.�/Vo 01- _74A �! 7 0 04-/ ve If I %::�10 9 3 MOL,4vl rz� le, 31 Pump q7, 7a 6z 23 Z— 946 - Z U5 Z to Its 7T i. , ni, Of I D-2mot- y, ��'►, 75 &# le J, cT ✓�''� �e h ,-� � C �SO i'I 7542 Zmmariuel Ave Sop <fotfOqc Grove,* M";gjg. 55016 Bitry -,Pat. "Ofe-7 Bore Al® ley NQ • leS C6 fpev- PPIW PC by Oalk �ee /V,,�A 0//-/ 9 VC max, )3.-A), Zkl/l 16016 q7. 100" z #4V PI 0 $1 /oll 70'0' ............... LA re 4 13Z ti ell i � Gz� �� G cr v. 40 z. 7 A ly All z 3 Im /000 qal$ If Parnp 7SO sec t le tz� Nl- Al NLA)4 o)rZy,q R 17 W Lori BY° 10 z 9 Straw, Marsh Hay, Or Synthetic Covering� Medium Sand Topsoil Distribution Pipe F D 4 % Slope Bed Of 2 -2-- Force Main j'2.' Aggregate From Pump n A % Cr c t i o n of A Mound System Us' Ing A Bed For The Absorption Area Signed: , //' c License Number: Date: -2i Alternate Posit- ion of Force Main L A 0 Ft. B 50 Ft Ft. L Ft. J 9-6 Ft. 1 12 Ft. W S1 Ft 6 G Page Of Plowed Layer D Ft. E Ft. F Ft. G //0 Ft. H -Z.� Ft. Observation Pipe-... W ......... . Force Ma -in Distribution Bed e d 0 f 2 ipe Aggregate 'Observation P- ipe Permanent Markers Plan View of Mound Using A Bed For The Absorption Area 4 i•" •.��i `1'1��'��''•," ..KA Of .. Page rrt;4,, End Cap l.� Perforated pipe Detail r r" End View )Perforated PVC Pipit "5-, � A y! ! —wry rr A Holes Loccted On Bottom. Are Equally Spaced \Iftbiripurlon-� -- Alternate Po:ltion Of Pipe J Force Main From -Pump Lost Hale 5houtd 8e � Next To End Cap End C°p Distribution Pipe Layout P R, S —3• x 2,0am, Signed: 4 Y , -' License Number: f �� Hole Diameter Inch �r � ZZ 1#eral / Inch (e s 7 Date: �%'� -� Manifold Inches Force Maim Inches TK .*'ram J 5 �. �.f✓ ilililljllllllll f r � . PU M P c HAMS E R C R o ss � PACE __ a F sCCTION AND SPECIFICATIOUS ---VCUT CAP Ll"C.Z, VENT PIPE' --- WEATHER{ PKOOF APPROVED LOCKING Z5' FRCM DOOR, JIJUCTIOKJ Box---MAMHOLE COVER WIMDo'W OR FRESH�¢ AIR IMT,AK.E GRADE I 1 COUDUIT -- — - I8" /'�IIJ. . � �>�::;.:�R�': • Rii` ',I� -v SEAL AN ROVEr] JOINT ,c � '•:'�`' .�, r�.,'" �' 1 APPRoVED JG1�v E K T E N D I KI G 3' y�r� w, �_ ��l�yi� t , + ,• . :. � r - Ot ,S :; is IhE' it '}'1�# "`' j .Y , s 1^ �'"t °�.� c`t •t `a w' c�].l, f I P i[s ouTa I :, �� a ,• r a SUL D ''r� - �'' �� . •�� ����� �. �wt�y.a ALARM� EXT E il.i D I l� [, ON F o SOLI ❑ SC' ou D OFF C QNC RETE BLOCK RIsE» Exlr PERMITTED GQL!3 IF 'T"AUK MAULA:ACTURER HAS SUCH APPROVAL- how SPEC SEPTIC I F I CAT I OhjS ol DOSE TANKS MAMUFACTURER: f, 5 TANK �I�E : .1.C' (R NUMBER OF DOSES'. p pA� GAL.LoK,IS ALARM MAk1U FACr U ,ram OLUME: � .I'"+�• ' � � �� DOSE VAL MOU�L 1JuMIliER. ., CAPACIi"IES: A II�,1OHES OR ` -��`' LL 0,►tic SWITCH TyPI�: = .� =' II�,ICNE5 -, OR--� - GALLOQ5 PLIMr1 1�,ANr1I~�ArT><! RER= tJ,�� ,�.W C IAJCHES D . GALLCKJc r R MODEL NUMBER:� 0 OR GALLG�S �W1TC H TyPE: /�/�:' � NOTE- PUMP AND ALARM ARE To BE - Joe-. PUMP DISC.HA.RG►E RATE 12 I U 5TALL Z o C3N SEPARATE C I RC U ITS GPM, VERTICAL t]IFFtREIUCE 5ET1n1EE IJ Pi.lNIP OFF AiVD DIST"RIP,L1TIpN � f + MlUIMUM kIETwoRK -SU PP�.� PRESSURE PIPE. FEET ��'.�c�C: -#-- 50 FEET OFF � FEET C)RC.E MAIN x � �'` F�=� fivo FT.FI�ICTlaK3 FAcYa r _ rt�' FEET TOTAL ID J N A M I C. HEAD �.,. �. � �e9lel FEET lkJTE`�7 RILIAL "DIMEMSIONS - 'e " r, p F TANK; ' LIQUID DEPT H ..' LICEUSE NUMBER: f���, - 5? -,1 DATE. !"�,, • For Homes • Farms • Trailer courts 0 Motels 10 Schools 0 Hospitals 0 Industry 0 Effluent Systems anywhere effluent or drainage must be disposed of quickly, quietly and efficiently. Heavy -Duty Solids Handling Dependable Capability to3/4 Y3 , Y2H.P. 60 Hz Single Phase 115, 230 Volt. / 27 314, 1, 1 1/2H.P. 60 Hz Single Phase 230 Volt. Three Phase 208-23©, 460 Volt, 90 80 7© L Viz. 60 U.1 50 < 40 Z 30 0 20 10 0 0 10, VIP _77 7 4---t i�.__�.3nL--.:Rpm,1750/34 50 4-L 711' L 20 30 40 50 60 70 GALLONS PER MINUTE -4 so 90 100 110 120 ,Bulletin CL2.1A July 8, 1983 GOULDS Model 3885 (Supersedes Model 3870) Submersible Effluent Pumps Pump Specifications Solids Handling Capability to ".4" Discharge Size 2" NPT Semi -Open Impeller 3 vane design, thread(�d on sllk'0t I hftw units use irTIP0110F lockr1L)t to hnck-off. P[jr,11) 0(jt v,-jf)p_- of, t ()f ', for protection of rnech�jnj(:;jl r,;, I Casing Volute type for maximum efficiency Stainless Steel Fasteners Series 300 stainless steel for corrosic)r) resistance. Mechanical Seal Cerarric vs Carbon sealing !�jc(, spring and Buna N eljsj()rj)ers Maximum Temperature 1 6W) F Capable of Running Dry without darn,,,ige to componerits Motor Specifications Motor Fully Submerged in high grade turbine oil for permanent 1.jt7rw-i_ tion of bearings and mechanical seal an(j efficient heat dissipation Motor sralorj f,,), environment by rugged cast irr),,, Bearings '.A Heavy-duty all ball bearing Stainless Steel Shaft Series 300 stainless stopi for corrosion resistance Threaded shaft Single Phase Units All single phaSC-) Unit,,; 1)il',T2 I)HIII-Irl therrn,v over1r)ad protection wWl awtomJtic, reset Three Phase Units Ovf)rlO,IcJ Protection in st(wer Unit 209-,l 460 vnit,,,. Threaded shif,, 60 Hz operatiori Power Cord Watc,r -ind oil r-eSislant Fr)o)(, on nic)ir)r o!� ')(:t" (is a secondary mo�skjre harrier i - (7,1'3e 0" dan'i;icje to outer liickohnq gland nut Single Phase Units H P models eq,,jipperj with 1�- of SJTO with 3-prong groun(jinp Ql[,jQ models e(4uipped with 115' of 1,1 3 S' TC� cord SPECIFICATIONS ARE SUBJECT TO CHA",j(-E WITHOUT NOTICE- GOLILDS PIMPS, INC. SENECA FALLS NEW YC)QK CT& u e / A e- (fot�Oeje' R,tX# Denoole-5 -Re"r-'6 mar)( B Pe- t, 4 I*Le, S B o r-c, Ala /CS - ins '13 I .d-IncZ5 e nr b 3, 10 'p c6p by 45 � /Vo r-Srp e 04-1 ve foe 93 L,4 P3 1 P BIA), 4-levvi 16016 3 0c) El- 47, Pump r'� 23 Z- 4?46 -- Z 131 33 9?.,r3 7-y-� sec JRVU FT 14 po '7.5r ll V35 t! %. $� Ij k j XF NW Al I -7 10 I xl-a e'Z9 751,2 p7, D B-0 Ala No " a - zc-'no4CS ?e r-e-- V.�, /ems 'Bon -CA 151 75 by 15 /000�: 7 0 L'4 r, oo Pamp El— q7,. LZ7 B z E3 9?.#3 7 Sec -13 F7 I (Alis 'u AF NW4 -71A) �t y. col, aNc 91 z 9