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Home My WebLink About004-1029-95-000 (2)T Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). Permit Holder's Name: ^ City ^ Village ^ Tc~vn of: Haselman, Joe Cady Township CST BM Elev.:- Insp. BM Elev.: BM Description: C va Z o'' ~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~rr~ ~ ~w ~ ca.3~ Z Ud Dosing ~~ era t Ho TANK SETBACK INFORMATION TANK TO P/ L WELL BLDG. vent to Airlntake ROAD Septic ~ r'~' ~ (3 r ~ NA Dosing >v~0~ ~ gyp' 2,~1 NA A Hol PUMP /SIPHON INFORMATION ~~~~~ Manufacturer ~j' S Demand Model Number d ~ 3~.`~~PM TDH Lift ,,~ Lrictionz Syste ~ ~ TDH Ft Forcemain Length ~bS / Dia. 2 ' ~ Dist. To Well SOIj,ABSORPTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No.: 363865 State Plan ID No.: Parcel Tax No.: 004-1029-95-000 STATION BS HI FS ELEV. Benchmark - , ~ G Alt. BM ,(~ 76 ~r,~ Bldg. Sewer 'Ar /6' ~/ Ht Inlet ~ b. (R (~ Dt Bottom ,S~ 3, ~ Header /Man. ~ ~ ~/, Dist. Pipe ~.sa;"~ Bot. System y' 3 ~ 3 • ~'S~ Final Grade St cover '~ f o , Z S N1 b 3o Go /. S P./ to U eo„ ~ •- G f ~-~ 9Z . a BED TRENCH Width , ~ Leng ~ No. Of Tre ches PI No. Of Pits Inside Dia. Liquid Depth EN I N S DIME SYSTEM TO P/ L BLDG WELL LAKE /STREAM LEAC anufadurer: SETBACK CH BER M INFORMATION TypeO ~. / t ~ r-~ oe r. System: - y7 6 S UNIT DISTRIBUTION SYSTEM Header /Manifold Z Distribution Pipe(s) ~ ~ x Hole Size / x Hole Spacing Vent To Air Intake Length ~ Dia. Length 3 ~ Dia. ~ Spacing ~ / 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 ^ Ye ^ No ^ Yes ^ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1`: [q /-~9/~y Inspection #2: t; /So / o ~+ Location: 3227 County Road N, Spring Valley, WI 54767 (SE 1/4 NW 1/4 13 T28N R15W) - 13.28.15.202B _ 1.) Alt BM Description ='~fi~ a~ ~~•`K .~~ w~(( I-u f - ~ ,~ 1 'L ~'~ 5 2.) Bldg sewer length = (3 7 r, rw r ~/~ ,Q -amount of cover = / ~ 6 ~ GI~Q^t/-/~ ./~'~~ ~ i~~s~Ta~~~° ~,cwr~r^/ / 1 3.) contour= (,, /~ ~93,~~ ~ lur•ll S~PT ~ loG~~iG~i'~ 7Ccvrcr ~fdv ~~i P~ ooh tc't--.6~ ~~r~ Vim` `~,) ~~M~( '~(/~'M "NC(if~ ~`) 7M4'rr !S y~' OT f'~'--~ (.~m~Gr ~ ~S~ Qy s ~~p~.oK~~ ' d' r~ t,~ o Plan revision required? ^ Yes ~ No ~--•- Use other side for additional inform ton. G 3(! oo (~ SBD-6710 (R.3/97) Da a Inspector's nature Cert. No. x ,- - SANITARY PERT APP - ~VisCons~n ~-..~. Department of Commerce In accord with Comm 83:05, Wi d `-~ ,. ~ 1 Safety and Buildings Division 201 W. Washington Avenue P O Box 7162 Madison, WI 53707-7162 • Attach complete plans (to the county copy only) for the syste ~y~pa]~~s 1` ~ courtty~~, ' -' ~ ' ` ~ - jj than 8 v2 x 11 inches in size. ~ ~ ~y/ o ~ o( IJ • See reverse side for instructions for completing this applicat S~ 3 ,r ~ ~J ~(~ tat n ~ary Permit Number , ~,.' . 1~X ` csi ~, ~~0~ ~- r G Persanal information you provide may be used for secondary purposes, _~, ST ' ~ revision co previous applica[ion ^ C [Privacy Law, s. 15.04 (1) (m)]. ;; ~ ~ s ; ~ 'Review Transaction Number I. APPLI ATI N INFORMATION -PLEASE PRINT ALL IN ~ A N 3l ~8y Property Owner Name ~'o ,~ ~ ~fo i n 1 a 1 1 T-~ , N, R/ E (or) Property Owner's Mailing Address Lot Number Block Number / ~`yy City, State Zip Code Phone Number Subdivision Name or CSM Number r ~ ( ) av~c.l cter.~'4ee~ b roe~0 YP IL IN (check one) ^ State Owned ~ !t Nearest Road Public 1 or 2 Famil Dwellin - No. of bedrooms ~ rowan OF G ~ ParcelTaxNumber(s) ~3. Z$.!$.?OZQ III.. BUILDING USE: pfbuildingtypeispublic,checkaltthatapply) TQ/ e a ~ ~ /02 q - gs--o6 a 1 ^ Apartment/Condo 2 ^ Assembly Hall 6 ^ Medical Facility/ Nursing Home 10 ^ Outdoor Recreational Facility 3 ^ Campground 7 ^ Merchandise: Sales/ Repairs 11 ^ Restaurant/ Bar/ Dining 4 ^ Church /School 8 ^ Mobile Home Park 12 ^ Service Station /Car Wash 5 ^ Hotel /Motel 9 ^ 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. ~ New 2. ^ Replacement 3. ^ Replacement of 4. ^ Reconnection of S_ ^ Repair of an -_____S~stem ________System_____________TankOnly______~_______ ExistinQSystem ________ Existin~System B) ^ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution ~ Pressurized Distribution Experimental Other 11 ^ Seepage Bed 21 (~ Mound 30 ^ Specify Type 41 ^ Hoiding Tank 12 ^ Seepage Trench 22 ^ In-Ground Pressure 42 ^ Pit Privy 13 ^ Seepage Pit 43 ^ Vault Privy 14 ^ System-In-Fill ' 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./inch) o Elevation a ~~~ " ~ 'Y ~ ~ Feet Feet , ..5 G SO ~ ,,(1 / ~ O VII. TANK INFORMATION Ca acct in gallo s Total # of Manufacturer s Name Prefab. Site Con- l St Fiber- Plastic Exper. N E i ti Gallons Tanks Concrete ee glass App. ew x n s strutted Tanks T nk epticTan oTMoMirtgiasik ~ ~ d e p~ ^ ^ ^ ^ ^ Pump Tank tuber r'~ ~ ~~` g f lOiv ^ ^ ^ ^ ^ VIII. R SPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite s age system shown on the attached plans. Plumber's Name: (Print) Plumber's Signatur ~ ( o Stamps MP PRSW No.: Business Phone Number: `/ld~ s 7Q ~ ~~ ~ !~. i Plumber's Address (Street, City, St e, Zip Code): ~ ~ a ~, L IX. COUNTY /DEPARTMENT USE ONLY A d ^ Disapproved Sanitary Permit Fee (1nc~udesGrourtdwater ate ssue Surcharge Fee) / Issuin gent Signature (No Stamps} pprove ^ Owner Given Initial ~ Q ) ~ ~ r / Adverse Determination / r Da ` ~C~/ DITIONS OF APPROVAL /REASONS FOR DISAPPROVA . ~0~,~ ~~ ~~~~,. (r,~aJyj SG V'lJi~~•3" •'' ~'~. p / ~ 3~0 ~r~ T r'ahS . / ~,p ]..n, ~ ~ At „.~ ~~, ' 7- ~~ ' ar yNaY ~ -zr ~~~''~ ~-~' ,~ !~~'chk~ ws ~ ` Vlc ~ M r~ ~ivea.e~ vv~,n 19~t1~t,~s~betv:a~3+~tord~.rc.~, allow+eol (oe to /bays SBD-6398 (R.12I99) DISiRtBUT10N: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber tilOp r A ~ ) `INSTRUCTIONS - ' 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer /Renewal Form (SBD-6399) to be submitted to the county prior to instillation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safetyand Buildings.Dyisipn, ~,Q8-~66-3151. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide t~he~legal description and parcel tax number(s) of where the system is to oe installed. ' I1. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one online A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County /Department Use Only. , X. County /Department Use Only. . .Complete plans and specifications not smaller-than 8 1/2 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), sept'fc tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or~siphon tanks; distribution boxes; soil absorption systems;: replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required bythe county; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. • - ., . ,i.,° a . . . ' ~ . a ' ~„ ~ ~ iscons-n Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi. us Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary Apri126, 2000 CUST ID No.691727 ARTHUR L. WEGERER 421 N MAIN ST PO BOX 74 RIVER FALLS WI 54022 RE: CONDITIONAL APPROV PLAN APPROVAL EXPIRES: 0 ATTN: POWTS INSPECTOR ~,,~~--° - ZONING OFFICE ~^°'"o ~ „ ~4f ` ~ T~ `' . ST CROIX COUNTY SPIA y,- 1101 CARMICHAEL RD ~- ~~ HUDSON WI 54016 ~~~Fg..~ ~„ ~f ,., ~ :~a«~ Identification Numbers ~ ~ °''~~ ~ ~° , ~ Transaction ID No. 310844 `~ Site ID No. 190586 ~f ~F~4 ~~/.y}~- f ~~ ._, +i' w ~ Please refer to both identification numbers, k SIT Site ID: 190586, Joe Haselman ~' , ; , - ~° e' '~ above, in all comes ondence with the a enc . St. Croix County, Town of Cady `~ ' ~ , ~ i ~ l,, SE1/4, NWl/4, S13, T28N, R15W FOR: Description: Four Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 659313 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. 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(2)(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, ~ //G~ erard M. Swim POWTS Plan Reviewer -Integrated Services (608)-785-9348, Mon. -Fri. 7:15 AM to 4:00 PM j swim@commerce. state. wi.us DATE RECEIVED 04/17/2000 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 BALANCE DUE $ 0.00 WiSMART code: 7633 isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LACROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce. state.wi. us Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary Apri126, 2000 CUST ID No.691727 ARTHUR L. WEGERER 421 N MAIN ST PO BOX 74 RIVER FALLS WI 54022 RE: CONDITIONAL APPROVAL ~ PLAN APPROVAL EXPIRES: 04/26/2002 ,/ I ~•.'; r ~ + SITE: j;`-~ Site ID: 190586, Joe Haselman St. Croix County, Town of Cady SE1/4, NW1/4, S13, T28N, R15W ` FOR: ~, " Description: Four Bedroom Mound System ~., Object Type: POWT System Regulated Object ID 1~, ATTN.• POWTS INSPECTOR ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 _' . ' Identification Numbers ,~,~„ Transac 'on ID No. 310844 '"' ^ ~~ '~ 'Site ID N 190586 Please re r to both identification numbers, r, ,, ~,~ ,-. e, in comes ondence with the enc~ ~ `~ -, / ~593~16 f ..~ 1~~~ 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. 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(2)(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, ~ erard M. Swim POWTS Plan Reviewer -Integrated Services (608)-785-9348, Mon. -Fri. 7:15 AM to 4:00 PM j swim@commerce. state.wi.us DATE RECEIVED 04/17/2000 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 BALANCE DUE $ 0.00 WiSMART code: 7633 Page ~ of 6 MOUND SYSTEM FOR A ~ BEDROOM RESIDENCE 1--o1Z.. QW iv ~= 2a USE. _-------- LOCATED IN THE SE 1/4 OF THE N~'`~ 1/4 OF SECTION ~~ , T ~ N, R ~ S W, TOWN OF eP~~-( , ,~ , °LRAI.X COUNTY, WISCONSIN. INDEX PAGE PAGE 1 2 'of of 6 6 TITLE SHEET PLOT PLAN p,O.V'V.T.S. ~(-jltlltlOYlUl~y PAGE 3 of 6 PLAN VIEW-CROSS SECTION ; PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT ~ ~ ~~~ . PAGE 5 of 6 PUMPING CHAMBER DEPARTMENT OF COMMERCE D BUILDINGS PAGE 6 of 6 PUMP PERFORMANCE CURVE , F s E Dive SEE GORRE P NDENCE PREPARED FOR __ _ 30~. ~~~~ ` _---- w 3p-t,y 6q~ `fti Avg.. ----._S4~iZtn,G Vr~.l5.~1, ~1 5~~~61 PREPARED BY WEGEI~ER SQ I L .TESTING AND . DES I G~i EERV I CE P.O. BiII 74 421 K. BAIM ST. RIVEF. F~1LS. YI 54022 7I5-S25-016 ~~~~~~ ~` ~;~; E ~q ~ ~ ~ooo F~~ & BtD GS p~~ JOB NO. Od- ~ 9 y_ ~3 !O o PLOT PLAN Scale 1 "= y, p' ~~.JTOVVZ. Q.~V , Q3. v ~~~ 1`0l I $oJ° ~ $-y ~ ~ I~ I I ji i q ~ ~~. $~ g•\ .< ~1 ~d 1~ 1 `~~ °o / ~,-s- ~ i --ZS'~~ ~ ~~ Nil' CUr'1P'~r OR OISIyR-g 'j'}}2S fj1~1 I -o i H I ~ , ~ I i B'3 ~J 3 ~' Z ,~~ Page Z of .~, I ~ I j 2I ~( p ~ ~I /- .~ ~~ N ~~rn i ~~ , c~ o ~~S w lS'o~~*p~~ ~R°~-g~J~'S ~ R~''0~~~ G ~ ~2" t• ~~F 3"P~ sty; y"vvC w~tF° ~ 4"pve Bv~~O~wG,S~^,+CR c~~~., ovj- e~,s9 SE'~'PoN ~ ~~ ~ ` ~^ ~`~ ~~~ U~ _~~.~-~A -` fl~ ~1' fir ZS,._ _ ~~-~T-1'~~vk . NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. (~ required) 3. Install 4" observation pipes with approved caps. ( Z required) 4 . ~ Septic tank to be \.Z..oo ~eoo gallon capacity manufactured by 5 . Bench Mark ~y, ~~o.o' iti ~` ~-~, o~~ `nom 6. Divert surface water around system to. prevent.ponding at the uphill side. i Page ~ Of b Approved Synthetic Covering ~s~-W) C 3 3 Medium Sand Topsoil - . __ -J i ~- 3 1 ~ _,., S % Slope Bed Of 2~- 2 %Z Aggregate Distribution Pipe _ ~, G p ~ ~ Force Main From Pump Cross Section Of A Mound System Using A Bed For The Absorption Area Linear Loading Rate= ~. 5 GPD/LN FT Design Loading Rate= p,~.GPD/SQ FT n -e-f, L ~ A S Ft. B b3 Ft. I 1b Ft. J ~ Ft. K l) Ft. L ~5 Ft. W 3~ Ft. Plowed Layer D ~•~ Ft. E `•b`I Ft. F o.~ Ft. G ~•O Ft. H ~- S Ft . ~ Observation Pipe r- -- fi --- ------- ~ K A I - - - -~ (------ -------------- ----------------------•I Force Main W ~ - ~---------------- ~;~5 A~ ~ p ~ ,~ op'po S ~ ~'E Distribution Bed O f z- 2 2 f-~ Pipe Aggregate Observation Pipe Permanent Markers (Anchor securely) Plan View Of Mound Using A Bed For The Absorption Area Page ~Df b Perforated Pipe Oetoil End Cal 311 permanent-marker nd of each lateral Holes located On Bottom, Are Equally Spaced Distribution Pipe Layout P 3a Ft . S ~ Ft. X 48 Inches Y Vv Inches Hole Diameter Jay Inch Lateral 1~ Inch(es) Manifold Z- Inches Force Main Z Inches # of holes/pipe S Invert Elevation of Laterals q y-~ Ft. Place lst hole Z~~from center of manifold with succeeding holes at ~{~` intervals. Last hole to be next to the end cap. Combination Sepi^ic~ Tank and • PUMP CHAMBER CRO55 SECTIOtJ AND SPECIFICATIONS ' PAGE S OF •VEAIT CAP WEATHER PKOOF ~uucTlou eox Y~C.I. VENT PIPE , APPROVED LOCKING ~ lO' FROM DOOR, ~MAIJHOLE COVER ~vl'11i 'WINDOW OR FRESH ~ u'ARtJI-JG LP.6EC.. A~-uTAKE -~ `1Z 5~>-~~x .-~- ~ ,~ MITJ Ib~/'IIAJ. IAILET Approved jOlnt TJ/ PVC pipe y°INSVccTlw.~ PI?, w!H-tt~lsttr ~R-P 8 ~FTrt~S Tank construction shall comply with ILH~ 1;3.15 and 33.20 CLEV.80,b~ FT. LSL~J. 90,00 AIRTIGHT SEAL I PUMP ~ COAICRETE BLOCK I I •I I .~ I __J' ~~ Y' xl u. ~ ~ j Ig•Mlu. III ~~ I ~ ~ I Approved ~ ~ I joint w/ ~LARM PVC pipe II 1 I ~ o~, I OFF RISER EXIT PERMITTED OIJLy IF TAIJK MA-.IUFACTURCR HAS SUGH APPROVAL~3,•ApPQ~Ep REDOeN4 SEPTIC ~ ~ SPECIFICATIOf\1S DOSE T/~,IJK MA-1UFACTURCR: ~ lp1'`I~jT~Z-~ 1~4~-C'C~-~' jJ~lyER OF DOSES: 3• S7 ZZ.DO ~ $pp TAAJK SIZC : GALLO-JS pOSC VOLUME PER DAy z ALAR!"1 MAUUFACTURCR: S'S• S`1S ~ IAlCLU01iJG 6ACKFLOW: lFsq'S _, G11ltON: MODEL IJUMBER: COL ~ CAPACITIES: A= lq Oo.O IAICHCS OR ~_ GALLOlJS SWITCH TyPC: ~~ZC(.I~ZY g . Z IAICHES°OR 4~•1 PUMP MAIJUFACTURCR: GOUI.,~ C= ~ G~LLOI~I$ IAIGHES OR ~~~• S 3$11 ~oS MODEL t\IUMBER: ~ 0 8 GALLous ld~ ~ SWITCH T y P E : - ~" 1 ~-CLl1~-~' ' INICHES OR GALLOIJS `Y'D'}~ci $ 00. O .. IJOTE: PUMP AAIp ALARM ARE TO bC MIAJIMUM DISCHARGE RATE 31'~~ t;pM INSTgLLEO OIJ SEPARATE CIRCUITS VERTICAL OIFFEREIJCE DETWCEU PUMP Off AA10..DISTRIBUTIO-J PIPE.. `3'~3 FEET + KIIJIMUM -.IETWORK SUPPLY PRESSURE , ~ 2.SCl FEET + 130 FEET OF FORCE MAIN X ~'•~YF~o FRICTIOtJ FACTOR 3•S~O Fr .. FEET TOTAL Oy1JAMIG HEAD = ~_ '~9 FEET ~ cor.~D~~T i~ ~ ~ I f I ~-- ~ ~~ ~\~; ,, s c D -- - As per manufacturer 21. o S gal/in. Liquid depth 3'~W ~- . ,, ~~ ~~~Z.~~ZI'Z~JCt`. 3871 EP05 APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS Pump: EP04 • Solids handling capability: 3/a" maximum. -- • Capacities: up to 55 GPM. ,~ • Total heads: up to 24 feet. • Discharge size: 1'/2"NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Pump: EP05 • Solids handling capability: 3/a" maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size:l'/2"NPT. • Mechanical seal: carbon- rotary/ceram ic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz,1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 HP, 115 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: l0 foot standard length,16/3 SJTO with three prong grounding plug. Optional 20 foot length,16/3 SJTW with three prong grounding plug (standard on EP05). METERSIIFEET 10F o ~ a w. s v 6 z 5 0 ~ 4 H 0 • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Automatic models include Mechanical Float Switch assembled and preset at the factory. FEATURES ^ EP04 Impeller: Thermo- plastic Semi-open design with pump out vanes for mechanical seal protection. ^EP05 Impeller: Thermo- plastic enclosed design for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ^ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ^ Motor Cover: Thermoplas- tic cover with integral handle and float switch attachment points. ^ Power Cable: Severe duty rated oil and water resistant. ^ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTING SP• Canadian Standards Association (CSA listed model numbers end in "F" or "AC".) 10 20 30 40 50 GPM ~ ~ ~ ~ ~ ~ 0 2 4 6 8 10 12 m~/h GouIC~ ~1~~3~~~'S1~3~~ ~~~)~~~~ dump CAPACITY isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi. us Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary Apri127, 2000 CUST ID No.691727 ARTHUR L. WEGERER 421 N MAIN ST PO BOX 74 RIVER FALLS WI 54022 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIItES: 04/27/2002 ATTN: Plumbing INSPECTOR MUNICIPAL CLERK TOWN OF CADY 2851 COUNTY RD N WILSON WI 54027-2415 SITE: Site ID: 190586, JOE HASELMAN ST CRODC County, Town of CADY; CTY RD N, WILSON 54027 SE1/4, NW1/4, S13, T28N, R15W FOR: Description: PIMS - 4 B/R home /garage Identification Numbers Transaction ID No. 310960 Site ID No. 190586 Please refer to both identification numbers, above, in all corres ondence with the a enc . Object Type: Sanitary Drain & Vent System Regulated Object ID No.: 659367 Plan Type: Addition The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. A copy of the approved plans, specifications and this letter shall be on-site durins 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, ~~-~~.. HERMAN J DELFOSSE ,PLUMBING PLAN REVIEWER Integrated Services (608)789-5535 , MON - FRI, 7:45 AM - 4:30 PM HDELFOSSE@COMMERCE.STATE. WI.US DATE RECEIVED 04/18/2000 FEE REQUIRED $ 80.00 FEE RECEIVED $ 80.00 BALANCE DUE $ 0.00 WiSMART code: 7657 ~~MEN~ ~kpp ~F SpF~ ~~v\5\4N ~ (J/Y~ pF ~E~ cc: THOMAS L BRAUN ,PLUMBING CONSULTANT, (715) 634-3026, MON. 7:45-4:30 ~- T'ITL.E S l~-. ~~ Page 1 of '2 PRIVATE INTERCEPTOR MAIN SEWER FOR LOCATED IN THE S~ 1/4 OF THE vW 1/4 OF SECTION \3 ,T~ N, R1S W, TOWN OF ~q~~ , ~--,000~X COUNTY, WISCONSIN. INDEX PAGE 1 of 2 TITLE SHEET PAGE 2 of 2 PLOT PLAN PREPARED FOR So E N~S~L I"11~-fV _. --- w3o? 4 540 T?f ~~`,_.__ I'REPARED~ BY WE=GEE~E~ SOIL .TESTING AND . DES = Gt~i S~RV = CE F.O. Bt1I 7S {21 K. tSAIK ST. RIVQ? FF+l.LS. YI 5{071 7y5-S1r4Ib i ;~ . M iZlx~~f7 3f COMMERCE _TY ~yD BUILDINGS ~~ ESP DENCE 8/bQ`(~ ~~'.. ~ _~ .1U~~~+ ,~•• ~•• AR7HUR ~ 'hEOEAEp ji ~ D9t5 P EtLSW;i~7H, ,• / w~ ti.n.~.~N ~fe ~'~1GN~ ~'~~wM'M ~(- l3 .b0 JOB N0. Oo -~ 9 ~. PLOT PLAN Scale 1"= y, p' Page Z of cC:UJTOt~Z ~V , R3. b ~ I Ou~Dr-t ~-= s~ GNU `lu.pt I ~ a, g-.z - -~- S - ~1 ~ ~ I I ~~ NAT CUr'IP~T" o~Z r o~ f D~Slv~ze -~.ts ' I ~ l Ll'•1 ~~ II i l I 8°1 I ' v~O°~~ ~I ~ s-y N I ~, I ~ j ,~ I J ~I i I I ~ 2' _ - I ~ 3 q / a.~ 3t~ \ I 25'.~~N I ~' pI ~' ~I r I I ~ ~' I ~ - -.. I y ~ ~1 ~,d FOR C ~~ L~-L ^'~r ~. ~~ ~ a - ~ PIW 1N1 C3 ! A~ iC i f ' , ~~ ~ ~ ~, o~ ~, ~~ ~" ~ t i~.- PuC ~ c~ ~ -F S - ~_ CLI?ip~OV~ w ~f~O~SI~'~ ~ Q~'~~ lS'oFt4"pV F-..~~~K ~ ar...~oF ` ~ ptz s~w~ ...g I G`~ ^~ ` ~^ - - - - - _ O~U ~~~ ~v ~t" o~Z e"et~nw I ~c9T ~`PTd CLLmra ovj- e.~?-[i39 SAC-'Pont WisoonsinDepartmentofCommerce SOIL AND SITE EVALUATION Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code Page 1 of 3 AC.E. Soil & Site Evaluations Attach compl~e site plan on paper not less than 8'/: x 11 inches in size. Plan must County inGude, but not limited to: vertical and horizontal reference point (BNI), direction and St. CrO1X percent slope, scale or dirnemsions, north arrow, and I distance to nearest road. parcel I D # 6 ~ ; ' ) 3 . . prt of 004-1029-70-000 n. APPLICANT INFORMATION - p/ ~~ ill lttl o~n , D R Personal information you provide may be used se~ndary purps (Privacy 4~vv, . 15.D4 (1) (m)). ~~ Property Owner ~` ` ~ -.'. ~'_.. ` operty Location Clarence Hoekstra Bu er: Joe a $lman vt. Lot SE 1/4 NW 1/4 S 13 T 28 N,R 15 W Property Owner's Mailing Address ~' ~ " , ' ~ :,~~~, ~ # Block # Subd. Name or CSM# _~.; , ~, w,> ,: 3244 Coun H . N 1 __ r City State ,Zip Code Phdr1~7~U1>hler City ^ Village ^Town Nearest Road Wilson WI 54027 "~T3~f~$r~1~2 Cady ~ CountyRoadN ^ New Construction ^ Resid~liti~l{/ Number of ooms 4 ^Addition to existing building ^ Replacement Use. ^ Public o~ describe Code Derived daily flow 600 gpd Recommended design loading rate •5 bed, gpolRz •6 ~~~ 9Pd~ Basal area required 1200 bed, ftz 1000 trench, ftz Maximum design loading rate •5 bed, gpolft2 .6 trench, gpd/ft2 Recommended infiltration surface elevation(s) 94.00' at 12" above 93.00' contour. ft (as referred to site plan benchmark) Additional design / site considerations Parent material loess over sandstone bedrock Flood ain elevation, 'If a licabie NA tt S=Suitable for System Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U=Unsuitable for system ^ S ®u ®S ^ u ^ S ®u ^ s ®u ^ S ®u ^ S ® u 1~'Y~11~~1~~111.-IIJ~1~1~`~:~d1~1.i1 Boring# 1 Ground elev 95.30' ft Depth to limiting factor 33" 2 Ground elev 91.62' ft Depth to limiting factor 32" Depth Dominant Color Mottles Structure i C t B d Roots ~~~ Horizon in Munsell Qu. Sz. Cont. Color Texture ~ ~ ~ ons en s oun ary B~ ;Trench 1 0-4 10yr3/2 None sl 2fcr mvfr cs 2fmlc 0.5 0.6 2 4-9 10yr5/3 None fs lmsbk mvfr cs 2fm,c 0.5 0.6 3 9-24 10yr4/4 None lfs 1 msbk mvfr cw 1 f&m 0.5 ~ 0.6 4 26 ,3.~ 10yr7/4 None fs 1 csbk mvfr cw - 0.5 0.6 5 33-40 IOyr7/4 flp7.5yr5/8 fs lcsbk mvfr gw - 0.5 ~~ 0.6 6 40-56 10yr8/4 m1p7.5yr5/8 SS R - - - - - - Remarks: H6 es tiom resistant to lmtte etrauon at 4u° to mooerarre cemenrsu sancuwiic ax 30 1 0-6 10yr3/2 None sl 2fcr mvfr cs 2fmlc 0.5 ! 0.6 ~ 2 6-18 10yr5/4 None sil 2fsbk mvfr cs 2fm,c 0.5 ~ 0.6 3 18-20 10yr4/4 None sil 2msbk mfr cw if&m 0.5 0.6 4 20-32 10yr5/4 None sl lmsbk mfr cw - 0.5 0.6 5 32-36 10yr7/4 flp7.5yr5/8 fs lcsbk mvfr gw - 0.5 ~ 0.6 6 36-50 10yr8/4 m3p7.5yr5/8 SSBR - - - - - - Remarks: CST Name (Please Print) Signat e: Telephone No. James K. Thompson ~._ 715-248-7767 Address A.C.E. Soil & Site Evaluations Date CST Number Ref # 340 Paulson Lake Lane, Osceola, 54020 3114/00 3602 1183 PROPERTYOWNER: ClarenceHoekstra Buyer:Jcexaselman SOIL DESCRIPTION REPORT PARCEL I.D.# ort of 004-1029-70-000 3 Ground eiev 91.08' ft Depth to limiting factor 33" 4 Ground eiev 95.67' ft 183 Page 2 of 3 A ('_F._ Snil & Site Evaluations Depth Daninant Cola Mottles Structure i t B d Roois GPDlftz Horizon in. Munsell Qu. Sz. Conk Cola Texture Gr. Sz. Sh. ence s s oun ary Bed ~ Trendl 1 0-6 10yr3/2 None sl 2fcr mvfr cs 2fmlc 0.5 0.6 2 6-16 10yr5/4 None sil 2fsbk mvfr cs 2fm,c 0.5 ~ 0.6 3 16-26 10yr4/4 None sil 2msbk mfr cw if&m 0.5 ~, 0.6 4 26-33 10yr5/4 None sl lmsbk mfr cw - 0.5 ~ 0.6 5 33-39 10yr7/4 flp7.5yr5/8 fs Icsbk mvfr gw - 0.5 ~ 0.6 6 39-54 10yr8/4 m3p7.5yr5/8 SSBR - - - - - - KemarKS: 1 0-4 10yr3/2 None sl 2fcr mvfr cs 2fmlc 0.5 0.6 2 4-17 10yr5l4 None sil 2fsbk mvfr cs 2fm,c 0.5 ~ 0.6 3 17-28 10yr4/4 None sil 2msbk mfr cw if&m 0.5 ~ 0.6 4 28-38 10yr5/4 None sl lmsbk mfr cw - 0.5 0.6 5 38-46 10yr7/4 flp7.5yr5/8 fs Om mvfr gw - 0.4 ~ 0.5 6 46-60 10yr8/4 m3p7.5yr5/8 SSBR - - - - - - Depth to limiting factor 38" Ground eiev Depth to limiting factor KemarKS: Ground eiev bepth to limiting factor zos~'f ~•~$acs. ~, 3 0~3 SC:a~ ~ :, ~0 , e~ ^ day ©~5erura~,b~ P•£ ~ ~/eda~i6~'7 ~~~„~„ d ~f q5.c> r ~` zo" ~ q~.ov ~ 8~ ^ ~ ~~ 4s 30 (proposed ~ eS;dn„ee wc~ ded C'-Oared i4~eu ~ ~~ ALA" Brn : Sao;1~e~n .w chary free. Elegy . 90~." Banta. MarX= i~a; /;~ ZD°Qa75' face. Assurntd elegy` =/CX~.c~. .~ O ~,Yi52r,;,_ ~~~ ro FJaea(~7d~,~ve ~, Q ~e~s 4 w ter: GLa~e~e ~ L . ~ cis ti'q 3 LUy ~..Pd, r1 ems: ~e ~s~•na.,, w. 3oa~ b9o'~,4~. S,or,~ da,~ y, u7 ~. sy767 1 o ca.~ a~ 3Eyynwyy S. i3 T,ZPn; ,P. ~Skl., inn . o{• Cody, S£. C.re ~X ~•. ~~ ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNL'RSHIP CERTIFICATION FORM OwnerBuyer •,l O e- use / m ~ .-~ Mailing Address Pmpecty Address 3 ~ ~ 7 ~ d ~~ ~ (Verification required from Planning Department for new City/State ~ Parcel Identification Ntunbcr ~/ ' 0 ~ ~ ~ ~ ~ LEGAL DESCRIPTION Property Location ~ '/., ~ '/., Sec. ~ 3 . TAN-RAW, Town of a ~ _ Subdivision ,Lot # Certified Sarvey Map # .Volume .Page # Wat~ranty Deed # 1 ~~1.~OS .Volume I4'~'~ .Page # Spot house ^ yes f~. no Lot lines identifiable ~ yes l~l no SYSTEM MANTENANCE Improper use and maintenance of your:eptic system could result is its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage is the warte disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeymanplumber, restrictedplumber or a ticcnsedpumper verifying that (1} the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1!3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as :et by the Department of Commerce and the Depart<neat of Natural Resources, State of Wisconsin. Certi#'ication stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. i ~zl~ J~l~l ~d 9~T1JRE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a wam~nty deed recorded in Register of Deeds Office. GNATIJRE OF APPLICANT DATE s«.as« Any information that is mis-represented ms<y result in the sanitary permit being revoked by the Zoning Department.'•««s« •• Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the wamnty deed ~_ rY vo1.1498r~s;E~.~9 WARRANTY DEED Document Titlo This Deed, made between Clarence L. Hcelrstra and Lori IC. Hcekstra, husband and wife with right of survivorship, Grantors, and Joseph Haselman and Shannan Randall, as joint tenants with right of survivorship, Grantees, 620205 REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD era-e7-zooo t2:oo Pn ~IIRRAn1Y DEED EXEnPT ! CERT COY FEE: COPY FEE: TRAtI~'ER FEE: EEl.ha RECORDIFIG FEE: tE.00 PAGES: ~ Witnessetly That the said Grantors, for a valuable ltETIJRN TO: consideration of one dollar and other good and valuable consideration Joseph Haseltnan conveys to Grantees the following described real estate in St. Croi: 690' Ave. County; State of Wisconsin: Spring Valley, WI. 54767 P.IN.: 00 ~ - 102°1 - °~5 - DoG7 LEGAL DESCRIPTION: of the Northwest Starting at the Southwest corner of the East Half (E'h) Quarter (NW'/.) of Section 13-T28N-R15W for the place of beginning: Thence North to where County Road "N' intersects the West line of the East Half of the Northwest Quarter; then following County Road "N" at a southeasterly direction to the Southeast corner of the East Half of the Northwest Quarter of Section 13-T28N-R15W; thence west along the southern line of the East Half of the Northwest Quarter of Section 13-T28N-R15W to the place of beginning• (Approavmately 3.4 acres ) Attached to this Warranty Deed and made a part hereof by reference is Exlu'bit "A". This is homestead property. Together with all and singular the hereditaments and appurtertam belonging; dnd grantors warrants that the title is good indefeasible in fee simple and free m encumbrances except easements of record, if any and will warrant and defend the same. Dated this a 3 nay of Mash, 2000 sEAL> + rto..,,~p r u.,Plrcrra -SEAL) C~~~~ (SEAL) + Lori K Hoelastra EAL) AUTHENTICATION Signatures o~ authe~icated this day of * Diane L. Gavic Title: MEMBER STATE BAR OF WISCONSIN THIS INSTRL3NIlrNf D12AFPED BY: ~--'~ • Diane L. Gavic . =~1AR>r s Attorney 'K V . P.O. Box 344 : * •,• P1JS~~•: Spring Valley, WI. 54767 ~, • • • . • ~~; ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. County of .Sl• - Cro ~ ~. ) ra• personally pane before me t}tia Z~ day of {'(~rCk`r 7A00 the above named Queax L ISoekstra Lori K. Ilodrstta to mo ]mown w be the person(s) who wcectaed the fine8am8 inatruznmt sad aclmowledge the'saJme. Yew • ! ~ \~ tiT~i~++ --•• [fie i , + ~ r~?a t. t~~nr•$~•4Pr~SL'n Notary Public of ~ • ~t~ County. VYts. >vty commission ~o,_ 1498~`~ x.70 EXf]IBIT "A" The Grantors, Clarence Hcelcstra aad Lori Hcekstra, and the Grantees, Joseph 13aaelman and Sharman Raadsll, agree that the following provisions shall be made part of the Warranty Deed dated the _~~ day of March, 2000: l . That the Grantors shall have the right of first refusal should the Grantees at any time um the firture decide to sell this ptopcrty . 2. That the Grantors must be notified in writing of the Grantees intention to sell the property. 3. That the Grantors shall notify the Grantees in writing of their decision to exercise their right to purchase the property under the right of first refusal 4. The Grantors and the Grantees agree that the tight to purchase the land under the right of first refusal shall be under the following terms: a. Onc (1) acre of land is to be listed as the homestead and shall be purchased at Market Vahu. b. The homestead shall include a~+ septic system, well and buildings placed on the 1 acre property. c. Market value will be determined by having an appraisal done of the property by an appraiser agreed upon by the two parties. d The parties agree that the balance ofthe land, 2.4 acres, shall be vafied at two thousand ($2000) per acre.