HomeMy WebLinkAbout004-1021-95-000St. Croix County Planning and Zoning
Detail Sanitary= information Page t of I
Computer # 004-1021-95-000Sub/Plat.- 40 acres Section: 10
Parcel : 10.28.15A50 tot: TNIRNG: T28N R15W
Municipality_ Cady. Town of CSM: 1f4114: NW 114 NW 114
Owner: Summit Cheese Factory, Ed Creenway 487 State Hwy 128 Wilson, WI 54027
Mate Permit- 5497 Issued. 08 22}1979 POWTS Dispersal: lagoon treatment
County Permit: 192 Installed: 09/0611979 POWTS Detail: NA
POWTS Pretreatment: NA
Notes
Issuer/inspector As Built
Harold Barber Yes
Tarn Nelson Signed Off: No
Maintenance
Scheduled hump Date P umped
9i6120Q5
Plumber Other Requirements
Anderson, Robert J 92
1st Notification 2nd Notification 3rd Nofi cation
Owner; Summit Cheese Factory, Ed Creenway 487 State Hwy 128 Wilson, WI 54027
Mate Penrlit: 5481 Issued: 081 1 1979 POWTS Dispersal: lagoon treatment
County Permit; 177 Installed: 98116.1979 POWTS Detail_: NA
POWTS Pretreatment: NA
Notes
Issuer•inspecicr
As Built
Harold Barber
Yes
Darold Barber
Signed Off. Yes
Plumber Ciher Reouirements
Anderson, Robert ,i #2
Permit: Replacement of Tank
Bedrooms: 4 WI Fund:
AdditionalNotes Money Owed
This is for house just north of Summit Cheese 0;00
factory, existing tank collapsed, so installer) 1350
Wieser tank connected to lift station that
discharges to lagoon treatment area.
Permit: Replacement
Bedrooms: 0 WI Fund:
Additional dotes Lloney Qvved
Commercial sewage disposal system consisting of $ 00
old septic tank connected to new 1750 gal. septic
tank to lift station and then discharged into
lagoon. Wastewater from both factory toilets and
3 BR apartments plus 10 full-time employees
1550 gal.. total capacity required.
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St. Croix County Planning and Zoning
Wednesday, October 04, 2006 at 10:50:51 AM
Detail Sanitary Information Page I of 2
Computer #:
004-1021-95-000
Sub/Plat: 40 acres Section:
10
Parcel #:
10.28.15.150
Lot: TNIRNG:
T28N R15W
Municipality.
Cady. Town of
CSM: 114114:
NW 114 NW 114
_._
Owner:
. _ .._ .......
Summit Cheese Factory, Ed Greenway 487 State Hwy 128 Wilson, WI 54027
State Permit:
2923 Issued:
08/27/1980 POWTS Dispersal: Lagoon treatment
Permit: Replacement of Tank
County Permit:
153 Installed:
09/0611980 POWTS Detail: NA
Bedrooms: 0 WI Fund:
POWTS Pretreatment: NA
Notes
Issuer/inspector As Built Plumber Other Requirements
Harold Barber No Nimmerguth, Elmo MP
Harold Barber Signed Off: Yes
Owner: Summit Cheese Factory, Ed Greenway 487 State Hwy 128 Wilson, WI 54027
State Permit: 5497 Issued: 08/22/1979 POWTS Dispersal: Lagoon treatment
County Permit: 192 Installed: 09/06/1979 POWTS Detail: NA
POWTS Pretreatment: NA
Notes
Issuer/Inspector As Built
Harold Barber Yes
Tom Nelson Signed Off: No
Plumber Other Requirements
Anderson, Robert J #2
Additional Notes Money Owed
attach to original Summit Cheese Factory $0.00
plansipermits from 1979 - Mead & Hunt, Inc. plans
show Evaporator building addition, which would be
north of factory. Discharge to lagoon system after
installation of new 4' sanitary line and 1000 gal.
concrete septic tank
Permit: Replacement of Tank
Bedrooms: 4 WI Fund:
Additional Notes Money Owed
This is for house just north of Summit Cheese $0.00
factory; existing tank collapsed, so installed 1350
Wieser tank connected to lift station that
discharges to lagoon treatment area.
Maintenance
Scheduled Pump Date Pumped 1 sst Notification 2nd Notification 3rd Notification
9/6/2005
Owner. _ Summit Cheese Factory, Ed Greenway 487 State Hwy 128 Wilson, WI 54027
State Permit: 5481 Issued: 08/01/1979 POWTS Dispersal: Lagoon treatment Permit: Replacement
County Permit: 177 Installed: 08/16/1979 POWTS Detail: NA Bedrooms: 0 WI Fund:
POWTS Pretreatment: NA
Notes
Issuerllnspector As Built
Harold Barber Yes
Harold Barber Signed Off: Yes
Plumber Other Requirements
Anderson. Robert J #2
Additional Notes Money Owed
Commercial sewage disposal system consisting of $0.00
old septic tank connected to new 1750 gal. septic
tank to lift station and then discharged into
lagoon. Wastewater from both factory toilets and
3 BR apartments plus 10 full-time employees =
1560 gal. total capacity required.
St. Croix County Planning and Zoning
Monday, Apr!! IS, 2013 at 4:38:00 PM
Detail Sanitary Information Page•1 oft
Computer #:
004-1021-95-000
Sub/Plat: 40 acres Section:
10
Parcel #:
10.28,15.150
Lot: TNIRNG:
T28N R15W
Municipality:
Cady, Town of
CSM: 114 114;
NW 114 NW 114
Owner:
Summit Cheese Factory, Ed Greenway 487 Slate Hwy 128 Wilson, WI 54027
State Permit
2923 Issued:
08/2711980 POWTS Dispersal: Lagoon treatment
Permit: Replacement of Tank
County Permit:
153 Installed:
09/06/1980 POWTS Detail: NA
Bedrooms: 0 WI Fund:
POWTS Pretreatment: NA
Notes
issuer/Inspector As Built Plumber Other Requirements
Harold Barber No Nimmerguth, Elmo MP
Harold Barber Signed Off: Yes
Owner: Summit Cheese Factory, Ed Greenway 487 State Hwy 128 Wilson, WI 54027
State Permit: 5497 Issued: 08/2211979 POINTS Dispersal: Lagoon treatment
County Permit: 192 installed: 09/0611979 POWTS Detail: NA
POWTS Pretreatment: NA
Additional Notes Money Owed
attach to original Summit Cheese Factory $0.00
plans/permits from 1979 - Mead & Hunt, Inc. plans
show Evaporator building addition, which would be
north of factory. Discharge to lagoon system after
installation of new 4" sanitary line and 1000 gal.
concrete septic tank
Permit: Replacement of Tank
Bedrooms: 4 Wl Fund:
Notes
Issuer/Inspector As Built Plumber Other Requirements Additional Notes Money Owed
Harold Barber Yes Anderson, Robert J #2 This is for house just north of Summit Cheese $0.00
Tom Nelson Signed Off. No factory; existing tank collapsed, so installed 1350
Wieser tank connected to lift station that
discharges to lagoon treatment area.
St. Croix County Planning and Zoning
Monday, April 15, 2013 at 4:38:00 PM
Detail Sanitary Information Page•1 oj1
Computer #:
004-1021-95-000
SublPlat: 40 acres Section:
10
Parcel M.
10.28.15.150
Lot: TNIRNG:
T28N R15W
Municipality:
Cady, Town of
CSM: 114 1/4:
NW 114 NW 1/4
Owner:
Summit Cheese Factory, Ed Greenway 487 State Hwy 128 Wilson, WI 54027
State Permit:
5481 Issued:
08/01/1979 POWTS Dispersal: Lagoon treatment
Permit: Replacement
County Permit.
177 Installed:
08/16/1979 POWTS Detail: NA
Bedrooms: 0 Wl Fund:
POWTS Pretreatment: NA
Notes
Issuer/Inspector As Built Plum r Other Rjguirements
Harold Barber Yes Anderson, Robert J 02
Harold Barber Signed Off: Yes
Maintenance
Scheduled Puma
Date Pumped
2/5/2008
2/5/2011
2/8/2008
2/8/2011
2/13/2008
2/13/2011
5/8/2008
5/8/2011
7/18/2008
7/18/2011
10/14/2008
10/ 1412011
9/5/2008
9/5/2011
1/22/2009
1/22/2012
2/18/2009
2M 812012
6/16/2009
6/16/2012
6/24/2009
6/24/2012
4/15/2010
4115/20 4 3
Additional Notes Money Owed
Commercial sewage disposal system consisting of $0.00
old septic tank connected to new 1750 gal. septic
tank to lift station and then discharged into
lagoon. Wastewater from both factory toilets and
3 BR apartments plus 1Of ull-time employees =
1550 gal. total capacity required.
R, d I (I f5 r c", I I Ns 11 1' C I0 N I N V I V I P d A L S L W A (; E V S I [ M
S' P h mi t /trat—I-
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Tmv yl st. C�xt'x c(mwit q
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N1 Ff IC I ANK tL
e6
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Aqhwatv,
NT P I N G' 0 o A M S E K
lhoq) Mano Q&An Mot W&v�
HOLDING IANK
S 1 a gafponb NumW o6 Compaqtuwn;tA
I'tavriperc A6vi)n SqteM
rl r ar ti m
Highwatol
ABSORP71ON SIV
Bvi T Y v n c
Mtanry Pwm: W0t"Tr. Piro.
ASSORPT ION :6 U VIMENSIONS
I ra i q;(h h i,
N 6 C 4 410
'F(10e
At 04stanve
T(Ytail a0A('llr),(40n
("I r P I M I N ti, I (?NS
ufrsa_cfc a rm o'
aiva It
A"erya �Wqn t
I NS 11 � C"I 1 0 8 v
APPROMP
RUJCCffl)
u A'XN P OR VTJl C F7 ON
Ra:yiaad
Vvpfh v6 We AM acira
Stope oA Vench pen 100 It
r.
Ty" n6 Qum Papen oi wtAaw
Glalve nAound N fl,
P(!rt'h boYmA) aviUt 6t
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TJAT F 19
tutte of wisc�onsin
Department of Industry, Labor & Hurnan Relations
Division of Safety & Blidgis.
Bureau, of Plonibing Platting & Fire Protection
P.O. Box79619
Madison Wi. 153707
Tel, 608-266-3815
IN ALL CORR E,3PONDENCE
REFER TO PLAN
(DIFNTIFICA 77ON NO.
x
xre
�" ", 11
GentVemen S
Examinadon Of PlUrnbnng plans and specifcations flor die above-men0m,ied pmjiact has been um'ipleted, h-i accomlw'it hi Chapter 145,
Wiscor)snn SlatUIHS and Wisconshi AdirikiistiratJve Code, thm rflurnbhig phins arrid sp&c,ificatloins are aprn raced con tingjerlt Upon corn-
pHance, with the stipuiatioims iindicated on the pIans, IPlease review your code foie the reqjtjjjarernents of cai,,Ji code sectk.)n noted,
The architect, professionai englneei,, regktered desiqrm, owneii or I'fluinbing coritnacvrii Muflll keep at the (�x)nstruction site omase'
plans beau rrig the stainir of approval of the depai tnient.
In the event instaIllation of tjrlje plurnbhrig knprovements ()tr system has not ("'Onurnenced %vitlh6n two
shah becorne void and new application shaIi be rnade, fov apla.mil of fl-�ese plarns, before wcnk may cornmence,
In Wanting this approval, the Mis'uon of Safely and B�..ijkhngs does not hoId itseIl' foie arty defects urn Pjar)S err spy
ornissions, examinatiori and reseT Ps the 6011 to order changes or- ackfitions, should condiiions a6se making this necesreq,,
This approval Is baspsi on Wiscom0i Acfiriunistrative Code ier�ip.Jrem(,�ints, It shaft be necessary to obtain avid W
ments of thie city, viflage, tommshif) or county 'n which this instailafion is to be constructed, Fadure to, obta'
maticaHy void this acceptance.
Sincerely,
el- 'Jew
JafleeS Sargent-RureaLA Dhector
IPLANS REVIEWED BY:
cc; DPS-OWS, 1) 1
Lo"�I M Plumber [A 8a R (2)
County Mfg. Rep. Bur, of Hemltl�iFac, & Servw ces
MI-14IR SgD-6099 (N. 06/80) Rec. & Env. Servi,ces
1078
00i Return Upper
—47ton Of This Form With
Any Return Correspondence
DETACH HERS
PROJECT NAME. PLAN RCS.
stiriiicf of W;Seornsin
UIV ISON OF HEALTl-I
W'-'CTJON OP PLUMBING
AND FIRE PROTECTION SYSTEMS
MAM ADDRESS� K0. BOX 309
This is to acknowledge receipt of youir plans and specifications, for the above -indicated project.
Preliminary review indicates the plan tevlewfee recjWred is $
El cPian acceFeerepivedrvs$
accepted 'tar veviem 11
Fee is being returned inecause of LJ oveir Payment El underpayment.
Providing orre of the two catagorlps above. is diecked, remit correct fee tin one pay I. 7"t
ElNo fee has been re6tted, Plans sulfirnitted vvitir no fees will be hokl dire abeyance,
ElPlans rsearrg returneri.
ElAdditionai infornortion required. SEE BELOW
1, Phn Submission
Additionaf information shiall be sulrrn0ed in r6phcate unless specifically note&
E-1 Plans not r4ear, iegible or perm anent,
I-] Ail information submitted Ocail lye sugned,sealkrd ar stamped urr accoid w0 Sacliorr H 62.250ai Wisconsin Adminfstrrrtive Code,
ED Af fidavdt enclosed.
11, Alternate sewage Dsposal Systems (Mound Systems)
El PLB 108 (Application foi u.ase of ana4errwe syslern).
County onsitie required 41 copy). Design ca1culaosivs for piessiriruzcd (fistribuli(m
Cross section of rrnoun& f..a Pipe lateral layout, Man view of alternate.
lit, Private Sewage DisposA Systems
E-1 Ground siope with 2' conkours in EaJjtirr(" arjrpa ()f Soil ab5orplon system cxlendinq 25' on all sides.
E] Elevation of permanent reienmce point (benr;hmai k),
11 Location of area su'Gtable for replacrunent systern - Provide soil test dala.
1-11 Plot plan showing lot sire and all lateral distances fronr sewarge disl'.)osal qystem or holding tank Ir.) Wigs, lot lines, well, waterocrume, ale,
L-J Construction detail of septic, holding or lift purnp tank if sitrr consnuced or lank manufacturer if precast.
Construction detail and cross-section of soil abjorrption systcirr.
Soil boring and percolation teso on FI-I 115 completed by cwtifiedsoil tirstei It coPY).
F]Cornplete data relative to anflcipated use of Ndq. L-1 3 copies of l 60 enclosed.
1-1 Deed restriction requited J1 copy).
IV. Holdiing Tanks
-7 Profile of holding te)rrk,
ED Hokfing tank agieernent signed by owner and 4)Cal Ulm of govei narent (,"ints1v enwlosorb.
- I RBD&Do for installing holding taNk soil tesf or stateiry"mit from county (1 copy),
V. Lift Pump
F lCakulaficins for total lift purnin dischanlytt, head and gallow, pumped per cycle.
I- 1&ze, length & depth of force main,
F11 Detad & mode of purnip or auwrnanic, siphons inclutfing 6ze, purnp curves, erasoudr)vvn and aveiaager flow rate, GPM,
Gross, section of kft purnp rank ;howng purnp60 or siphoriW,
Vl Stirsu,,,rns Ift FRI JFM must be, placed prior to plan subliflSsurA
i"'Irnta� area fiHed UM to extend 2'0' beyond edge M trench before sidr, skrrru WyWnp.
Deptlh ord type Hof hiL
Copv of cmsite firprOt by counly or &W icr, pirm-flon.9 wpervisor.
Lenqh of 6nn fill has been in place.
, i.,o 4 4 2
REPOR'"I" ON INSPECTION OF SANI-TARY PERM11-
Ss Of �Ter
a ic
'id Xre
w, e s s, I c e n s e -no-' ottlrF
ne V
?
ON C0,4
1"4
INSt-ATtA"T N Septi,
7r iT, mm r q M", FR7 TFi rm TFFf i;�Tyr Tt
Person/Persons gnat, Sitr�
Ta n k
e Bed
T...-T 177
Seepage 'rrem-,h
14olell rig 'prank_.._._
JjIM? ear Inspec limi
Time Of IrISPeCtiO�nl
CjDosing Chamber
Elevation of vertical reference point..-- Slope at Site:
. ............
(5)MATERIAL AND DEPTi OF SEWER:
Liquid Capaci
-T6)SEPTIC TANKH acturer: Q (, . . . . .........
M a ni ti 0 Tank Outlet
T'arjk Irilet, Elevat
# ft to lot or property line.__ ft to wel
_ _ Al A
Fill Systein
o f g a I I o n s
(7)DOSING TANK: M a n u f a c t u r e r i y o f di s t r i b ut i o n
pre gallor� PUMP Sot f(.)j- a cy(.,,'Ie gal Ions 'total cap,jct
s gl o n ; si ze o f PumP head; gal I on pe�r nd nute
neal
; xPr narne of� pumpnd modelnumber? []YES NO
Is the warning device installed? ]YES NO Wired
o -F�15T on
L ffTj--0-TF—AN F7.795 MT7-77r� pth to t e , cover if septic 'tank is
construction ---Cj
Y E S, NO (Torn residence;
being, U&ed a'� Eaffles reiiiove� warrring device...,�____�.'r�-�'--�__._,"--r-l'�-'-
ft from well; ft from proper,ty I i ne ype o " NO;
E] Y E S El NO ; W i re(l ? YES [j
Is the warning device nstal e � '� f vent and,
r? YES NO Diameter r)
Locking device on cove .
Distance from building to --- ---
ft id i a mf-.� -teem ft "liquid depth;
(9) SEEPAGE PIT SIZE: --J� 0 f pi 't S ft to pro�perty I - ri - e;-
-.ft to residen-c-e-� rrr-------- ft to wf,��11 -ft to edge of slopes
....... .. . ft to ordinary high water mark of lake ov- stream;
gre - a I'll t - e - r, - t h a n s e e p a q e pi t i nI e t, p i p e - e I e v a t i o n f t bottom Of
seepage pit elevation
fu
f t,
W1 I dth -ft, length; 'I eadept,
(10) SEEPAGE BED SIZE:
n e al f e t to I e -ft to re si d e n rc e ft to well ft 'to lot or
to e!dge
prop(,,�rty line; ft to ord pnary high water mark of lake Or strearn, f t
of sloples greater than 2(.)% faj'ljnng awa.v, t,mmrd tlakes, wat(.,j, coujrses or drainage flitches
.......... . . . ...... . . ...........
11. Elevation of' tank dL2 r 1 kie enter,i.ng Lred f t
"I'To" 1 1 t h (�) F s e e p a 9 e� t r (,,u n c h Width
I't -f't to wel I t(-F -o'r,di na r, ' Y high water mark of
t d e pt h f t _ to edc�.je of Sl DP�L'S, grea Ler than 20% fi,-11 I i rig away toward I al<es
I ake or st�oeam; C11 t a d i s c h a r 9 e I e e n t r g s e le p a g e
watE�r cr)Ljr,ses or drai-n a-ge d�tches; elevatloT
treinch - --11 ft-1 -
--
(U) Has system been instal �ed in area indicalled on EH 11 'YES E) MD
. . . ...... . . . ......... . _.....a.
��as systlem, been instal led in floOdWY? Y E S M F1 o o id pl a i n ? YES XNO
06r-
-Y7-
/`-P,? Ce-,L4, kl-, IT
Sigture of Inspector%
FA
State and COUnty
PLB'67 Permit Application
for Private Domestic Sewage Systerns
-DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State it Required State Plan I.D. #
A, OWN-E fll -Oi+ROP-6-RZY Mading Address
LOCATION: "I Sernion T22�L NIR -E (o,1 yyh' lov;
n Name. nearest road, lake of I a i i Out a i k Blk#
State Permit #
County Pennit 143
CoU I ItY
City —
Village
Towns 71;r1-1--t111
C. TYPE OF OCCUPANCY: 'Commercial ndustrodl y 'Other (specify) "Variance
Single family _ Duplex No. of Bedrooms No, of Persons
D, SEPTIC TANK CAPACITY_ ,_L—Total gallons No. o,f tanks
HOLDING TANK CAPACITy_Toital gallons No- of ranks
Prefab concrete Poured -in -Place Steel (sPechY)
F i be rg I as s 0 t In el
New Installation _Replacement
Lift PUR)p Tank or Siphon Chamber --- Total gal Ion s PT efab concr ete Poured-ii n-Place — Other (Specify)---.-
E EFFLUENT DISPOSAL SYSTEM Percolation Ra1e-.------TotaI Absorb Area---sq. ft.
New. —Replacement__-- — Alto rn ate (Specify)
Seepage Tench: No. Lineal Ft, ------kVidth . .. . . . . .......... —Depth . .. . ....... —Tile depth hop) —No. of T?Lriches—
Seepage Bed: Demur—.--.--..TiIe depth (top t.-—No. of Lines —---
Seepage Pit: —--_.._Inside diameter . ........—Liquid Depth —--No. of Seepage Pits -------------------
Pei cent slope of land----. Distance from critical slope ------
WATER SUPPLY: Private ;4 Joint 1.7 Community Municipal
Owners name riq listed on PH' 115 if other than present owner:
------------
1, the Undersigned, do hereby certify that the information I have reported is in accord with Section 1462,20,
Wisconsin Adrninisirativp Code, and that I have sized the effluent disposal system fionr the EH-115 prepared
by therzafred S I Tester
NAME and other information
obtained fr.- C
Plurnber13 Phone 40,
Sign
Si'
" r 1'�
Plumber"' a
ddre
PLAN VIEW Provide sketch below of system (include direction Of Slope and all distances in accord with H62.20. Well lo
tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors
property. If well has not been drillrid please indicate.
Do Not Write in Space Below FOR COUNTY AND STATE-- DEPARTMENT USEONLY
c 0 DzgliL 6F-a) Date of Amph ati n Fees Paid State County
Permit Issued/Re4eeted !d e) v;2 2 Issuing Agent Name at
Inspection Yes Llslo State Valid# --..-.--_____ Date Rec'd----
1. county Cwhite copy) 3- owner (green copy) DIVISION OF HEALTH, P.O. BOX 3019, MADIS SON, WI 53701
2. state (pink copy) A. Plumber (canary copy), Revised Date 7/1/78
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[Clof:
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DAY
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MEAD AND HU
'tNt Tit
AS BU!'I'T SANITARY SYSTEM REPORT
M
TOWNSHIP
DRESS
j ST. CROIX Cbff;fY';CON, Wl,
BDIVISION LOT LOT SIZE
e
PLAN VIEW
Distances & dimensions to meet requirements of H62.20
4
Ai m
A 'h
Av
J"
SEPTIC-TANK(S)
IT, GR.
CONCRET STEEL—
NUT—o f
rings
on —cover
D e p t h DRY WELL
TRENCHES, No. of
width —en r th
area
BED no. Of lines
wi dtTi leHgt area
dept to F-0—p
I P e
Of P'
*J Aj
AGGRECATE
PERK TE
ARFA
R U` D
ARFA AS BUILT
DISCLAIMER: The inspection of this system by S,t, Croix County clo(.-I no't imply
cm .complete copl-iance with State Administrative Codes. There are c, rier areas
that it is not: Possible to inspect at Lhis point of construction, St. Croix
County assumes i-io liability for system operation. lio,,7ever, if failure is
not .'ed the Cojility �,7ill make every effort to detrermin(,,�! cause of f ailure.
GREASE'S AND O'1LS S110ULD NOT BE DISPOSED THROUIMI TIP:�s SY'13TEM
INSPECTOR
DATED
If`r t tv,
PLUMBE,R ON JOB
LIgory ENSF",
pi -PORT OF SEWAG1 SVSTEM
Sanita"Ly Petvlif.
State So t.,)tic
1- 0 (v il 6 hJ p St. C�Loix countily
Sect�okl
SEPTIC TANK
S naf-Zon6 Numbe�- o4 ComijaAtmejits
V.iztance FAom-- Welt 2 —�t. 1 2 % or[ gkLeatet ,Zope—
Buitding t Wettand,5-6t-
-
DISPOSAL SYSTEM
Distance FAom: W etz, 6t. 1'2% o,,,119,�'Fate, t
8 u iZ di �z 7A w Ft.
Hi g h i v a t et t
FIELV Dlb,(L.-NSTONS
Width o6 Vench_----6t. Depth o 6 rLock bo,tow tiZe--in.
Lenqth c,' eacfa De,[.,>tri o r,,ock ove,PL tiee, ire!..
D e t h o tiee beZow g,,,adc,_in.
Totat Zength o�j S t e 0, t t e r. ch. n Peas 100 �'t.
DiLtance. betWeen Dzp bi to b c, d t
Totat Dep:th to
2
RequiA.ed vLea �t Type 0C 0 oa CA TC�,PCeL O)t SVLaW
PIT DLMENS TONS:
NumbeA 06 pitA Gkavef, a,,Lound pit,5 es --.--n c,
OuV.i.de divnete,'LJt- Depth be.Zouv (n,e,et ---.6t
2
Tota,Z abso+ btton atea 6t
2 -xz
AiLea yqu,.f I
INSPECTED BY
T L
A P'P R 0 V C D VA7 E 7
R E J E C T E VAT( 19 7
F6 7V �." ' Stele and Couard?`3tnmt Pi>rrrr+t #
.y
,�- Perrnit Application C;rauniy PeraY #
r
*.. km Private Domestic Sewage Systems
CYTES STATE: APPROVAL PEQUiiRPEICD
ykgprowaall 9r=(;¢^iveal YircacnState if Neralulresl States F'Iaoa I.D;,I. #
A. OWNER OF PROPERTY Mailing Address:
,Al AA 7 °.. ,✓.��' �" "a' yak"'^ ✓ 4 .:5 a",
s"
B, LOCATiON r J n iN5'.I ` lar) W [ n I # 8'y
SiJbdivitiioii Narne, icjw,,,t road, Ijkv uar landr7 wrk
lowlas9tll:a
(„. -TYPE OF f7C;ClJPA,NC;Y: "C';ermrmwa�;,ia0 ", nr��stlrRal_ "f;EcRi r Cspec y "V+rrrtrUa',e^
Sirigpe furmily _ LDualalex 'Ncs. ,A Efwetnx)fns--._.__—_ Nu rof Pers'ons—._____
D, SEPTIC TANK CAPAC':IIY r✓ �1utal rasllons No of taroks_
HOLDING TANK CAPACITY 1-0tal ydHWIS Na. poi tanks_
Prefab concrew Pourecl-inPhacu "faeel PIN rgla Other L,y.reciifyl
New hvt,llluti('sn--.__Flelalae^eenttnc�__.._____ .,.-_.a._.._ _
Lift Pearrp'1'aval<rrrSiphurr4 arrrleiiLotaPgTGtll ir; F'ue';faba^.nr7c;rct:c__. �PeruarurD-in-F'9aue____Cyt,Irreu4Scuf✓h-.---
F. h f E ILU ENT GDpSPOSAL SYSTEM: Peicol;uflc i Flatel, — 1t>t al Absoiib Are�a/-'e-'i'--.'p-w'
rg ft
fky,w_ 11w171Crd^,ra1a'r nl _. A in "Ir. Q i{aI I fy)_ U
Sa elaage Tu ndia No. cJ Lirneal ( F ___ _.. yuttlttt. (top)-._ -------- -_ No. of l�ieanr.frca—_. .._ . T7e31h T
Seepage Bed: —Length _.__. tft __ .. 7e sth_ ToM depst Gte:au p Naa of Lines --
Seepage Pirf: _ ._..._...�Iroa,Ic9«. diarrle!te1__,,, 1. _Uquidi Depth_ ---No. of See"ad,
Percent slope of Iand..._ __....- - .............. _ �� Ql,trance i'room rxi'tia:raf
VVA.I'ER SUPPLY: Privaate Asp �Joini C omrnlawrlty ] M unlcip ap
_ ......._-_. _..__..
Owvnl r.s name as listed on EH I V'i if olhar than prmsent us^ ncn i
the uitdersiilf wd, do hereby creitlfy rchat the In torimit,on 1 have r a I wa r'tecf is 6n taccatrd witha Section 4iF,2,20,
V'Vi,;c,crosm Arfinifmurwrje C rail:,, [!arise': thaitt i Isave sized 11Ie, efftLn-trY dlnpactsaI sy<<Ie") from the L.H- 15 p'slel)aao'e
by the CerTified `Sc,il Te^3'oa ,
N A E_ p '. .. r�. dD� 1C a" e;,, yew _. Cc.S.Ti , # othea mforrn<a"Km
obtrirpt°d fror•rr _ __Cuvwner/k;'rtailrfrrJ. .! „,+
PIi,anrber'S SifTaa4urk*'"�- "��s, „t."�""" r.�w.�o w,�..r. • MP/tWgPLiSrWxk .-,._.__,....�...PRtcarrag # 1y6
Plumber's "L r-' — � s .— ° 'L,
{ Do Not Write hin ,race C3elcavv FC7y1 G0IJN'1"Y AND S-TA'TE DE PARTIMENT USE QN1 Y
f 1 noiState ,tli�C.te of ApplicationFe fer: Nate
aurnit Issuedl)3 - (date) _ _ kss orlcp A1cnt. Nartte. ....
Inspection Yes No State Vand# �Cyatc Reeec'd
1 craunty (v Xwtta ccaPaY9 3. owner Cgieen copy) DIVISION OF HEALIH, P.O BOX 309, MAL1iSON, WI 53701
2. state (pink copy) d. niumber lcandry rxnovl
KeVISKI I:Ja'Le 1/ I!lb
h i
"NEW" SEPTIC TANK CAPACITY DETERMINATION
FOR
SUMMIT CHEESE OF WILSON, WISCONSIN
BASED ON WISCONSIN PLUMBING CODE H 62.20 (4),(c), 3a,b
Commercial Building minimum 750
3 bedroom apartments 600
10 full-time employees 200
TOTAL CAPACITY 1,550 gals
1,350 gal. and 1,750 gal. capacity tanks are available from WIESER
Slated Floors of Maiden Rock, Wisconsin. Because of this limited
selection, the 1,750 gal. septic tank was chosen for our design.
mead & hunt, inc.
7/17/79
,kS BUILT SANITARY SYSTE11 REPORT
TOWNSHIP
ST. CROIX COUNTYP-VI-SCONSIN
ADDRESS —
SUBDIVISION LOT_ LOT SIZE
11
PLAN VIEW'
Distances & dimensions to meet requirements of H62.20
•MIKEEMMEW
J, SAl
SEPTIC T `NK( SNo. oY MrFinGRgs 4n#k, c_, over i CDONeCpth STEDRYA. ,
E L
TRENCHES No. of width --F --Tc� n g t h — area area
BED no. oT lines wilt —1 length-- X �3 0`�
deptFi totopof Pipe- I Lea X"t-,"n z",^"70
AGGREGATE
PERK RATE MEA —REQUIRL',D
DISCLAI=: The inspection of this system by St, Croix County does not imply
complete compliance with State Administrative Codes. There are other areas
that it is not possible to inspect at this point of construction. St. Croix
County assumes no liability for system operation. Elowever, if failure is
noted the County will make (--,very effort to determine- cause of failure.
GREASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS 'SYSTEM.
INSPECTOR
DATED d PLUMBER ON JOB
LICENSE
REPORT OF INSPECTION —INDIVIDUAL SEWAGE S2S7EM
Sanitalu flomit
State Sept�c
NAME n 6 h P- St. C"Loix County
V
Sectiori "Lazat,iog
SEPTTC TANK
Size ( gattopzs . Numbc,t o6 Compa,,Ltment,6_
Vi,5tance. F,,Lcm: 12% ok 9rteatet 6tope___Ft
Hig hwate,k
VYS.P-0-SAL SVSTEM
vi'stfkrtcs' FA.orrt: 12'f oA ,JAC(ItV
f cu t dz Ft.
Highwatek 6't ... .......
FIELD DIMENSIONS
Width o6 t.tench----�t.
D c. p c
o CI
rt,od� [)v4'OX
Length o� each °,iwae
t.
Depth
o
o c, k o v e,a, tZ e, e,
'4n.
NumbeA o�,
Depth
o
beZow gtafi.e
a,n.
T o t a t zengttt 0�
Stop e,
v,�,
'L v h --'in
pe/t 100 6t.
Di.6ta8'ace. bo-twee)i
f,-, .
D o, p fh,
�: o
, ' , c, k
b�(� ��
Total- abo,,,btioki
6,t 2
t.,o
Requi,ted aAea
_jt 2
Type
cad
CovvPapa?A oA
StAaW
PIT VIMENSIONS:
Numbe,t c6 GxaveX. CULOund
OutAide- diaric tot fit. Ve�:.)th b(c..(!w
2
To -tat. abscY,,tbtion a&c-a_6t
A& e a it c, o u i,,L e d 6t2
INSPECTED
A P P-P 0 V E D DATE 19 7
REJEC-fED 9
State and County State Permit
Permit Application County Per� 't
for Private Domestic Sewage Systerns County .ZZ
*DENOTES STATE APPROVAL REQUIRED
Date Approval Received from State if ReqLflred State Plan I.D. #
A. OWNER OF PROPERTY Mailing Address:
—LOCATION: Section L W Lot# —City
_e,, , T N R _z�l E (o 0
Subdivision Name, nearest road, lake or landmark BIk# V i J I age___
C . TYPE OF OCCUPANCY: 7o_mmercial *hridustrial—_*Other (specify)__Variance
Single family "v, DL;Plex__No. of BedroWTIS_ZNo. of Persons
D. SEPTIC TANK CAPACITY _Ljj1'r_Total gallons No of tanks
HOI-DING-TANK CAPACITY _Total gallons No. of tanks -
Prefab concrete Poured -in -Place — Steel —Fiberglass — Other (specify)
New Installation Replacement
Lift Pump Tank or Siphon Chamber ---Total gallons Prefab concrete — Poured -in -Place__ Other (Specify)_
E . EFFLUENT DISPOSAL SYSTEM; Percolation Rate-- Total Absorb Area---------_sq. ft.
New —ReplaceniL,iit----._Alternate (Specify)--
Seepage Trench:__ No. of Lineal Ft. —WicJtli----Deptli--.—..--Tile depth (top) --No. of Tnenclheq_
Seepage Bed: __Length____....__Wic1th_ Dep le depth (top) _ ----No, of Lines—__
Seepage Pit:—Insicle diameter ____Ltq1Jid Depths._..__ No. of Seepage
Percent slope of land.------ Distance from critical slope ----_.--
WATER SUPPLY: Private [Z Joint E Community Municipal ----------
Owners name as listed on EH 115 if other that) present owner:
1, the undersigned, do hereby certify that the Inforrnmt on I have reported is in accord vvith SLction 1162.20,
Wisconsirr Administrative Code, and that I have sized the effluent cliqjobdi systems from the EH-115 prepared
by the Certified Soil Tester,
NAME C.S.T. # and othser information
obtained from (owner/buildetk
Plumber's Signature .1
MP/MPRSW# Phone ' —S;(
Plumber's Acldiess_*' kg. (i -tji,t,t,A ti? rt .„ r..•ILA-
PLAN V I EVii: Provide sketch below of systern (include direction of slope and all distances in accord vvuth H62.20. Well loca-
tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors
property. If vivell has not been drilled please indicate.
`7
L
1� 0 -------
A
Do Not Write in SI)av,@ Below FOR COUNTY AND STATE. NJJSIEONLY c
Date of Appli ation Fees Paid: State �c t ,.Date,,
at e,,
Permit Issued/ 2 ne ", (date) Issuing Agent Name
inspection Yes I No State VaHd# Date Rec`dL,
1. county (white copy) owner rgreen copy) DIVISION OF HEAL-1 H, P'.0, BOX 309, MADISON, WI 53701
L state (pink copy) 4. plumber (canary copy) Revised Date 7/1/78