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HomeMy WebLinkAbout006-1027-10-050 a 0 Cl) O a n v C c Z 0 n 7 fD "V CD d CD (D 3 = ~ A7 0 g Z N ° n w O C . 00 (D CD O N) CD N) 00 CD :3 0 rn fn ''I .t < 11 0- _ 0 (D Ij q C) CD > 3 CL N) Ln to M- CD 0 0 tn L4 t'.) m N a s m F _ CD s w c co ° o! Cb Cl) 3 c m rn w CL !Z :Z 0 CD C Co Co CD 0 -4 m ° C o, -4 r! 17 3 :2 M z O O O CC • A O C Z o 0 c N N p D N 9 a v v °O O CCD cr to N N d p m e Cl) N CD = hD Cn d CD W z I o D D o it O :3 E; ° P+1 • I CD c I w z CD ' Z tNp O N' X - K A z O N C 7 O W -0 m w w (D (D s 3 a 0 z M m 3 !n z wCD 41 CD Q a ~ n C/) T v z a ° o O rn m cf) t a I I m I ~ o- ',I fi A ~ w O O V R o b o w < pp w 0 °CD a az-2-310 6~ i VOL PAGE 5241 REGISTER H. DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD • 07/14/2006 11:35AN c7-v -i z p m ° ♦,,~a►~ •,,I~~~ RECTFEE: 13R 00Y MAP c: p _ wrt 2 COPY FEE.- 3.00 r'4 CD n o ``rb~ 16 5 0 PAGES z 2 ~x n y Op ~f gw~x z, m~ 0 a m co co rut co C:~ °v o ° _o ♦ o C!p Q cc, Afialk co Ln p ° o v 77 N m o o z cu'i~ cn v O o• ti lo~ z:r F !!)n d rn 9 3 D N o to QNel AIIF_D 1.AAU .4F QWN-C:g rn ~n II W m cD C) Z' v o' o' NOO'44'49"W 496.48' n o o v ° n `m' cn w m o~ y m o o o O V v .B \ f a° 3 0 r ® D w° N 5, N I o O c Q o N ® Q• Ili N W cc 3 -`D c~ C) M N' 7 0' I O r- S O (15 to rq j Ic CD ` OD r D D <p T~ o ii I- Ia C p o (7) m \ O O 0 x' ? IC v n Iv N) (0 _ -1 r^ V o N m n IZ orn O N co Q f~ VJ o G9. O I ➢ N D I- I--i E ;:u 7 q r- - ° :L o 0 IN / w O ~7 b - o O- TO N ➢ ~~J n X f V n kD n w 4 1 w O OD C7 Z A O (D Z m ° I~ y p ° OA Q. m rt CY) t,l t7 y x Z n c ~ ---I G7 C rt l _ 499 00' q m w / S0576 00 yi p o_ gnti 112.23.-... - 0oo- o rt a c~ OS v 6 254, 2?' O ti o' C) 5 :3 `i' n -~cfir of W4)- S w VO (n rri o DEED 377 PAGE_72 m C1 - - - - - v CEiy O 'RU,yE - S89'30 '02'W Z)4 S_T.y 3, 87.87' . i G7 S00'44'49"E - _ 2679.62' .o N C-) i _ _mc» Vl z-v-1 v wmz m o j- X o Z O n. m 2 Oj c-n 21 O N ^ n N n v' Cn 1 1 y f A N A n S A co O S ➢ C) G7 II m BEARINGS ARE REFERENCED TO THE NORTH LINE OF ° 1 a a THE NE 1 /4 OF SECTION 13, TOWNSHIP 31 N., RANGE 1D 16 W. WH:CH IS ASSUMED TO BEAR N89'30'02"E. h o 1 oi2 Vol 21 Page 5241 Parcel 006-1027-10-050 02/23/2007 10:31 PAGE 1 OF 1 F 1 Alt. Parcel 13.31.16.182A-20 006 - TOWN OF CYLON Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 07/14/2006 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - SOLBERG, ERIC W & KRISTIE K ERIC W & KRISTIE K SOLBERG 2192 HWY 63 DEER PARK WI 54007 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description * 2192 HWY 63 SC 1127 CLEAR LAKE SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 9.600 Plat: 5241-CSM 21-5241 006-06 SEC 13 T31N R1 6W PT NE NE CSM 21-5241 Block/Condo Bldg: LOT 02 LOT 2 (9.6 AC) Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 13-31N-16W NE NE Notes: Parcel History: Date Doc # Vol/Page Type 07/14/2006 829671 21/5241 CSM 07/23/1997 1186/431 WD 07/23/1997 1141/271 LC 07/23/1997 950/550 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 09/14/2006 Description Class Acres Land Improve Total State Reason Totals for 2007: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ST. CROIX COUNTY ZONING DEPARTMENT AS BUILT SANITARY REPORT Owner Address h("-;O" 6 . City/State C IrA k .tL-,E W,2 , Legal Description: Lot Block Subdivision/CSM # 14 NE 14.E9 Sec. tj-, T-ILN-R-W, Town of G PIN # SEPTIC TANK - DOSE CHAMBER HOLDING TANK INFO TION: Tank manufacturer Size ST/PC Joz~Q/k) Setback from: House aZWell,EZ P/L Pump manufacturer _ Model Fa Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM: Type of system: Width 8 Length Number of Trenches Setback from: House /D) Well 11 P/L Vent to fresh air intake ELEVATIONS: Description of benchmark a ,E ~~-~-~L.. Elevation Description of alternate benchmark Elevation Building Sewer ST/HT Inlet 7, 25- ST Outlet o~..s PC Inlet 2S / PC Bottom Header/Manifold S/ / Top of ST/PC Manhole Cover Distribution Lines ' ( } Bottom of System { ) .S; { ) ( } Final Grade { } ( } ( } Date of insta[tation 8 I WI Permit number s~ State plan number to a d 7,57/ Plumber's signature at~.x t~ License number I . 7yS"~ Date / I Inspector U Complete plot plan or r 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 tank manhole covei~a, v;} f • Show alternate benchmark, if applicable. PLAN VIEW Iv 1 1 INDICATE NORTH ARROW N_ NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the sysitem. D/ o • Two horizontal reference points to center of septic tank manholie .cbveh,, ~ T,k ~G Qc~/cF • Show alternate benchmark, if applicable. q ~i5~ PLAN VIEW Iv a a~ '7 b a d~ i i L INDICATE NORTH ARROW Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: aty nd Human Relations Safety and Buildings Division INSPECTION REPORT ST. CROIX (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 299014 Permit Holder's Name: ❑ City ❑ Village Town of: State Plan ID No.: SOLBERG, ERIC CYLON CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 006-1027-10-000 TANK INFORMATION ELEVATION DATA A9700332 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 1(j, yS IDIj o 4,1 c I Dosing D Aeration ✓ Bldg. Sewer Holding St/Ht Inlet -y5 ja S' TANK SETBACK INFORMATION St/ Ht Outlet Vent TANK TO P/ L WELL BLDG. Air Ito ntake ROAD Dt Inlet Air Septic 7 NA Dt Bottom 11,7 g~ 7 Dosing '5-7, 3 NA Header/Man. Aeration NA Dist. Pipe Holding Bot. System 5_ql Gz./, PUMP/ SIPHON INFORMATION Final Grade Manufacturer ^ Demand Model Number ld'; GPM ra ( System 1. _ TDH Q Ft TDH Lift 5,_o F Loss riction Head FForcemain I I Length / Dia. Dist. To Well r SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION TypeO CHAMBER Moe Number: System: A 6 , /0 7 ~2 v /U OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake r. Length Dia. Length Dia. Spacing 14 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only PB epth Over Depth Over xx Depth Of xx Seed /Sedded- I xx Mulched e d /Trench Center Bed /Trench Edges Topsoil 6 ~ EkYes ❑ No O Yes ❑ No I COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: CYLON 13.31.16.182A,NE,NE 2192 HWY 63 GG /f,; ~7Gt} 6/ / LL of J , _Yh ( f Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's signature Cert No. ADDITIONAL COMMENTS AND SKETCH r SANITARY PERMIT NUMBER: Aa .i N*6consin SANITARY PERMIT APPLICATION 01 E w shnilgtonAve sion P.O. Box 7969 Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 1/2 x 11 inches in size. !A I X • See reverse side for instructions for completing this application State Sanittary_Peer mit plumber The information you provide may be used by other government agency programs ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION 5cl - )D-151 Property Owner Name ujPrroperty Location r 10 1 r E/4 E 114, S 3 T N, R (Or)/ Property Owner's Mailing ddr Lot Number Block Number Qty, State Zip Code Phone Number Subdivision Name or CSM Number W(Lk 5`4W5 II. TYPE F B I DING: (check one) ❑ State Owned !ty Nearest Road 3 Village CL~ /0 Public 1 or 2 Family Dwelling - No. of bedrooms Town OF 111. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Nu/,mber( 1 ❑ Apartment/ Condo ~~Q 10 2"_7 ^ ) D 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 5. ❑ Repair of an System System Tank Only Existing System Existing 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 21Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12E] Seepage Trench 22-[:] In-Ground Pressure 42 ❑ Pit Privy 13E] Seepage Pit 43E] Vault Privy 14E] System-In-Fill VI. 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 /~D Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) _ Elevation Feet Feet VII. TANK Capacity gallons Total # Of r Prefab. Site Fiber- Exper INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Exist in structed Tanks Tanks 0. Eft - Septic Tank or Holding Tank Jle)A - ❑ ❑ ❑ ❑ ❑ - ni .600 - Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ Vill. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plum 's Signatur : (No Stamp P PRSW No.: Business Phone Number: d Plumber's A ess (St t, City, State, Zip Code): P b • x 22 IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sytary Permit Fee (includes Groundwater ate ssue Issuing Agent Signature (No Stamps) (CAD ~ Approved ❑ Owner Given Initial Surcharge Fee) L Adverse Determination -el X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: 880-6398 (R 11/96) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS t 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe 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 installation 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, Safety and Buildings Division, 608-266-3151. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. 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 on line 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 1/2x 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; 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 by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATEIR 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. •Oc-31-00 03:09P P.Ol Private Sewage System Plan Index/Checklist All plan sets should be legible and pcmanent copies, organized into sa4, by an index sheet such as this sample. No other bounds staples and covered paw set is signed Your cooperation expedites your plan review need and signed shortens as plan long en n thetun83 tryindex sheet for each e. IMan r Le~at Desonptton • C 10ty Ell u~ 1 1' N Q/ (o E 0- p S! . L ~-Ifox CO CYLON Croy moos Contcnb Cowmen j~eC1>t<1 d1t1'OCttODs Pate s included Two copies amded for all plans I Plot Platt 2 Plan View/Lateral Return by Mail 3 Cross Section 4 Tank & Pump/ Siphon Information 0 Fax to (County) (Subtnitter) Circle One and Provide Fax ( ) System siz;n (Public) 6 [D Gall for Pick-UP: ( ) 7 Q Other i, the undersigned, hereby certify that the Seal (if applicable) plans and specifications submitted herewith were prepared under my dir ction and control. ~~it,'~ Liistrtetos► r tom' LL a.rCJ MP-11456 Address City stun ~.o. ('~x ~a 1 ~1f►~t''~ (A?Z Sittsa0nt Attach PRIVA~Q9lWAGW36YSTEM Soil a site evaluation Ate`""'°n Conditionally Fee Needed for NnWiag Took Submittal: APPROVED one cc" of nolarumd holding sank apeement. (Originals to County) DEPT. of inu=TIIY, LAW i NVMMi MAMW Needed for At-Grade Submittal: DIVISION OF SAFETY AM OrWoal signed and notarized ApOiration lot "Use of as At- Grade" SEE COR S NDENCE County ov-site One additiaa ul set of plans SOD-10264 (N.01M) AUG 1 2196 f,,A FM & BUM 01V. S 9 6- 20751 v Ok , ~~/C So f Qc. ~/o T ~Xq Nay S/3T3/ it?X <F- fi~A ;Z 7 Sr Sys IR#, E/~ , y o ' o a Q H'► ~l ~.,Q w/ Q le 11/0 pp /c0 P~ oeive .uvciv 120 Nc w Na~n~. 2 hXK, L a° Go ~ (~3 ~7 J Z 1' ZLC MA MATL "LA '960 \ MusT Set 0.7 rn i n So F/a.ri S yJT in 'b+ pro 2s , ~ v i-,s 7, //4 *&.u4d ~ S*vs q~ S96-20751 s 0 N LL Li- LL LA- rn L i/} t IL OO ~ `p' 11 II 11 11 , n v Q oa Y J , ~I, LL LL LL LL L.L I II II II II 11 T-- C7W lL~_ -3.y1 Y 4. Q) 11 p a w I o c q Q_ ~ ~ I I nI I W _q I t1 ~2r L I- j (n 7- l LL r- Z i C-I L _ - ~C in ~ N nl ` - U. r-- n cr UI O I I h L - L ~ nl CY Cll o O U' cn CPII L O - p, -C rn N CD M i j .t p O U O C] O C cn b U I L u) I E v Q) Q O CI) r. n o - o •o tD - Ln L i~ L Ql lY y L11 L] ~ P C L N_ _ S 9 6 - 2 0'7 51 C) -3 0 X N N r 2 CD iD fTl ~ N = n C O v N N (D 'L `7 j N Q tD < Y) O r D D O 7 cn ~ n ~ r -2 7 r (D w p l1 O ~ t3 m r fD t> n ro O a O Q a- ~o ❑ 7 ss "Tl-3 r- S -<XUD m c r-r ro o ~ ~Ir', ,ao n Zt oQ 7 • ro O 3 ~ ~ ~"1 TI 'rl ro w ~ fD r r r ❑ Z~ ° . ,D T - - 7- n -u ro t~ U x o o n 0 T D- s J' cn ro n TJ cn C tm Z 0 m r 0 c m a- 7 0 0 1 ~ ~ A o PUMP CHAMBER CROSS SECTION AN10 s~ECIFICATIOI►I, 0,f~ e 2 u iv, VCWT CAP i C.Z. VENT PIPC WEATHER PROOF APPROVED LOCKING - . F JUNCTION BOX lKAMMOLC COVER LSD FROM ODOR, ' ~(C wIWDOW OR FRESH IL MIU. I AIR IWTAKC I ~vl GRADE i y' MIIJ. pow 10 IR'Mlu. CONDUIT-,/ •11'KOVIDE I IIJ .E T AIRTIGHT SEAL 7 I I v APPROVED JOIIJ APPROVED JOINT A I III APC.I. PIPE w/C.z. PIPE r ,r P e O I III ExTEUDIUG 3' EXTENDING 3' J~-LC ( II Al/1RM ONTO SOLID 60 OIJTO 601.10 &O1 L B I i i I ON ~ I I sr T LLEV. _QQ~~: L`SFT. PUMP- __J orf o CONCRETE BLOCK r APPA RISER EXIT PERMITTED ONLY IF TANK MAWLIFACTUitCR HAS SUCH APPROVAL. ggppl~ 5 PECIFICAT10kis SEPTIC E mmxm~ - DOSE NUMBER Of DOSES: --PER OAS TAWK MANUFACTURER: TAWK 51ZE : 600 400 o GALLONS DOSE VOLUME GALLON / ZdAl INCLUDING 6ACKFLOW:1 ALARM MAIJUFACTUR[R: L DL y']/ ~~~~j, t/ MODEL NUMBER: LI/ CAPACITIES: Aa~l¢~.0.1._IWCHES UR GALLCU; SWITCH TUPE: da - -HJCHCS ORa '641 GALLOW C. -IUCHES OR L2317F W►LLOU PUMP /KAWUFACTURER: ~y gy MODEL NUMBER: 0- - IMCHES OR GALLOW SWITCH TYPE: -MOT' PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RAT 3~GPM NSTAlLEO ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWECN PUMP OFF ANO OISTRIBUTIOM PI E.. FEET + MINIMUM NETWORK SUPPLY PRE3 SURE . . . . . . . 2-5 FLET 20 FEET OF FORCE MAIN X If* fyortFRICTION FACTOR- FEET TOTAL DYNAMIC. HEAD FEET INTERNAL. DIMENSIONL OF TANK: LENGTH ;WIDTH ;LIQUID DEPTH 91GNE 0: L.ICEWSE WUMDEK: DATE: S96-20751 gobw OW f.Ea P. Or" . ~ P~6E L~ OF 6 HEAD CAPACITY CURVE 3 7/8 6 1/4 - MODEL "98" 30 4 s/e • 8 9 25 3 5/8 6 20 } + O z 4 3/16 is- 4- pip to 1 1/2-11 1/2 NPT 2 5- 0 isa-as as J.S. GALLONS 10 20 30 40 50 60 70 80 fTERS so 160 240 0 FLOW PER MINUTE TOTAL DYNAMIC NEADIFIAW PER NORM EFFLUENT AND DEWATEieNG CAPACITY 12 HEAD UufTSAMlm FEET METERS GALS LTRS 5 1.52 72 273 -T 10 3.05 61 231 T 15 4.57 45 170 3 5/16 20 6.10 25 95 Lock VaWe 23' CONSULT FACTORY FOR SPECIAL APPLICATIONS Electrical alternators, for duplex systems, are available and • Mercury float switches are available for controlling single and supplied with an alarm. three phase systems. Mechanical alternators, for duplex systems, are available with or • Double piggyback mercury float switches are available for without alarm switches. variable level long cycle controls. SELECTION GUIDE 1. Integral float operated 2 pole mechanical switch, no external control required. Standard all models - Weight 39 lbs. - 1/2 H.P. 2 Single piggyback mercury float switch or double piggyback mercury, float 98 Series Control selection switch. Refer to FMO477. Model Volts-Ph Mode Am simplex Duplext 3. Mechanical alternator 10-0072 or 104)075. M98 115 1 Auto 9.0 1 or 1 & 7 - 4. See FM0712. for correct model of Electrical Alternator. "E-Pak". N98 115 1 Non 9.0 2 or A 6 3 or 4 91, 5 5. Mercury sensor float switch 704725 used as a control activator, specify 098 230 1 Auto 4.5 1 or i & 7 - duplex (3) or (4) float system. 8. Four (4) hob ••J-Pak'•, junction box. for watertight connection or wired-in Sim- E98 230 1 Non 4.5 2 or 2 6 6 3 or 4 6 5 piex or duplex operation, 10-0002- 7. Two (2) hob "J-Pak". for watertight connection or splice. CAUTION 4 information on additlorW Zoeller Products rota to catalog on Combination Startar, FM0514; AN installation of controls. Protection devices and wiring should be done by a quali- :apyback Mercury %vitchas. FM0477; Electrical Allertabr, FMO486: Medtartic it AMrmOor, tied licensed electrician. All electrical and safety codes should be followed includ- 40495; Alarm Package, FM0513; Sumprkwage Basins, FM0467; and Simplex Control SM Ing the most recent National Electric Cods (NEC) and the Occupational Safety and A0732. Health Act (OSHA). . RESERVE POWERED DESIGN S96-20751 For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. A/AfL TO. P.O. f= 191347 Z Lm inft XY 402W 4W Manufacturers of . Z jt'M f spar tLoTO: 3260 dW ref KY 40216 ~.fe. VAAW fAInr /.9.7.9 779-2731 • 1 (MM 928-Ptrfi4P Department of lnckrtry, SOIL A N D' S IT E EVALUATION REPORT Page Of :sir HumP►s Relations 4~n otSafev a Buir*9S In accord with ILHR 83.05, Wis. Adm. Code COUNTY ach complote site plan on paper not less than 8 1/2x 1I inches in size, Plan must include, but 4 limited to yordcal,ank1 horizontal reference point j8M); direction and % of slope, scale or PARCEL I.D. # _ LSO( nensloned, north arrow, and location and distance to.nearest road. le 07 IV - ~REVIEWED BY DATEa tPLICANT INFORMATION-PLEASE PRINT,ALL INFORMATION ROPERTY OWNER PROPERTY LOCATION C GOVT. OT No 114 X)I' 1/0 10 T 3 f _~R Ft ~(e~,w RGPERTY.OWNI'sR' MAILING ADDRESS A LO'f # BLOCK # SUED. NAME OR CSM # 6107":D~sK ST. Q 0 Avx 933 V/A N/X _ y TY, STA7E 21P CODE PHONE NUMBER []CITY []VILLAGE EJfOWN NEAREST ROAD , Clete' I~kx. o~S (7a) 943 - 87 J New Comtruction : ,Use [Yl Residential / Number of bedrooms Addition to existing building J Replacement (J Public or commercial describe _ _ ode derived day how_ gpd Recommended design loading rate '.✓lr bed, gpolft ^ e trench. gpolft` .trzorption area required bed, 1112 trench, ft2 Maximum design loading rate N1,,f bed, gpd/It2L/ _trench, gpdIR2 , ec*mrwded infiltration surface elevation(s) _f&"dlos'.~.. tGRIt (as referred to site plan benchmark) f ldition8l design /site tAnslderndats~,e4 t '01 st 2&-Y arent material QcZiA 7-gyje Flood plain elevation, if applicable It Suitable fix system CONVENTIONAL MOUND IN-GROUND PREssURE AT•GRADC SYSTEM IN PILL HOLDING TANK a Unsuitable, to CIS M U RI S❑ U [IS ®U ❑ S Q U Q S 0 U ❑ S ® U SOIL DESCRIPTION REPORT epth Dominant Color Mottles Structure GPD/rt Ig # Hertz in. Munsell Qu. Sz. Copt Color Texture Gr. Sz. Sh. Corsistence Boundary Ronts BedJiTTr'd, -7 rf CZd .nd It J - -T Ig Remarks• , fff .R yf --10 sl zC~ sdK Aft' W14 W id % 491401, S/ AJ AtC3d w/S lyd - -11. ,g I.& ±12-11 •r Remarks: Nacre:---Pia#sePlinf Phone: , ,'reps: - i~zM.~ •~re ,nr, ~.f•~i-~ ,.~v, ~.3"f~~•Q ` Date~ AP "'L4 • f ~ fir`' 'd;~..:. ~ (,~bt..t:. .4.'Vo , u..s.r,..r.ar..+..aM-+►'r...rna.w.. b k;;~. SleR4 SOIL DESCRIPTION REPORT Pao F r,. + J Sn t, nng "Horizon Depth Dominant Color Motues Texture Structure BAY Roots GPD ? Consistence in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed (Txy& LL 3 1 oro o sx ~r w .S y /a=as y~ o S ~i/aft e~ s i.N, CAA77 GroundA gat3 :y y , y l64 a6/C X14 Depth t0 14 firniting factor \~r r• , 'ReM sa GrouW, elev. It Depth to actor. --17 Remarks: Borind # i i Grouts ' elev. fti f Depth to ftiiing facto i Remark;;: k Y Ground elev. Depth b .1~ limiting % Re: # WOO w4d + R~~ Fes-. ~ r , . t i IN, \mx , , I I I , 4w. - T. t V► '4~ i p ~r' r4 1m. I , 07-5 , ` rr~r'.tf'' '~d 3 C. '~~•~r';' ~'o~r~! o~~.~irt-t,~'sf~r~~~ a ~ u'+~~" ` Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of :3 ` - Labor and Human Relations Division of Safety & Buildings in accprd..w...ith ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 112 x 11 inches i'asizp. Plan must include, but not limited to vertical and horizontal refereAce, point (BM), direction and"%I f slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nsaies4toad. b OG~(e -1eX7-10 APPLICANT INFORMATION-PLEA'$E'PRINT A,LL INFQR1NATi'-#~ REVIEWED BY DATE PROPERTY OWNER: t r` PROPERTY LOCATION i e .So e R # GOVT. LOT ^/E 1/4 1/4,S 13 T 3 ~ N,R r(w) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # a1o? 04K ST , o Box 333.. CITY, STATE ZIP CODE '-PHONE NIJM(3 ❑CITY 0VILLAGE KJiOWN fit REST ROAD Cl e- L4K~ w ` o dS /87 Cyj-oAl 6 3 " PC] New Construction Use [X] Residential / Number of bedrooms [ ] Addition to existing building I ] Replacement [ ] Public or commercial describe Code derived daily flow .lo gpd Recommended design loading rate _ A40 bed, gpd/ft2 t)/ trench, gpd/ft2 Absorption area required *04 bed, ft2 VIA trench, ft2 Maximum design loading rate N/l/ bed, gpd/0&Z trench, gpd/ft2 Recommended infiltration surface elevation(s) 9~! o ft (as referred to site plan benchmark) r Additional design/ site considerations O #AP Mffl,,A13 c I .So. %s 6eAdi- opus ' STAY ";v Parent material &c,: jL T;G.L. Flood plain elevation, if applicable ,✓14 ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ❑ S ®U ®S ❑ U ❑ S ®U ❑ S ®U ❑ S W U ❑ S U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench c w /o- Z6f)S1,r( Mv{'l-, e~ 2Sy' .C Ground la-so syx y~ C 6~ 4 /6 4Ae MA, - N/A WIA elev. 3, o ft. Depth to limiting factor „ Remarks: Boring # 2" Af 7 ,q y/ -o-- sl z.(~,) sdK ',rvF2 e w . G Ground elev. ft. Jr3 $ Y/(. C3d A N/A Depth to limiting factor Remarks: CST Name:-Please Print Phone: C71,111~ 8-53/8 Address: Signature: Date: CST Number: dt®rr.,,c e;a,✓ A9 YS- v-o 7 I- Ay PROPERTYOWNER So11~rKa SOIL DESCRIPTION REPORT Page Z a PARCEL I.D. K BOG - /O~ /O Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench /0 y~ - o - S K MVO' r w . S , G Ground I ✓l ~i SC / 6ti0a4k m c,' v ///4 A1.4 elev. D ft. Depth to limiting factor ~ II Remarks: Boring # }\vtyyty '::'v Ground elev. ft. Depth to limiting factor Remarks: Boring # f 4r'4 F?V ` Ground elev. ft. Depth to limiting factor Remarks: Boring # of Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) 4 ' Mop Wed I i I t ~y -Ae, ikA (fA I I IcYft o I O j + •~CA - -i~+ f , i , 'K f 0 w YD J .14 _ w , ~ '4 ~a so - NZ! h D 0 A j i - - I - y ' " - -a~ F, AL . I CA .t I v1 e I vw~ ~ ~r ~'oatbl of ~vrtx5~/7ia~ ow+~sT` \ f=165 _ I r i s, T.. - - - _ _ _ _ _ - ~ I I - , i ~ i - - _ _t._ ~ I s i y .r ~ i ~ a 1 _li ___r._ _ _ I ~ i _ s i ~ , t + ~ ~ V i . ~ ~i- ~ - ~ i .V - ~ I ~ I ~ , 1 ~ - ------1----t--- - --r---- - - 1 t ~ - - r , i ~ _ i` ~ ' -r--- r - ~ _T-`- - - . ' i~ • - ' ' 'i . , t - 4 I t - ~ ! ~ i.; i ~ i I I i . ~ ~ - --E--~_ : - - ~ ~ -p----- - 1_- - - - ~ _ _ i ---r- - --t _ _ ~ - - ~ --j- a I ~ ~ ~ i ---`-1-~---~._. - ~ - ~---r- - - - ~ - -t ~ -T ~ .I ~ I ~ ~ ~ i j - ~ I I ' ~i i; t R ~ _ ~ -A-----1- a ~ - • I 1 rt 1 ~ ' .~--r--± ~ - ------w - + i ~ I ~ v ~ -7- - - _ - - r--- t- - - ~ ~ - , .3._ _ _..._.1 J s j 4- --T.~. - _ ' ~ ~ - ' - LT-~- ~ j ~ i i it ~ I ~ ~ . , ~J. ~ c__. is 1 - ~ _ _ _ - ' ~ I ' ~ { . ~ _ - - _ ._~_~..-_~__...y_'_ STC - loo 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 property4!:-21e- A) a.-,d Location of property_,tfZ__1/4_" 1/4, Section ~ ,T_,3LN-R w Township_ Mailing address Address of site a / c 7a ff/,c( Subdivision name Lot no. Other homes on property? Yes No A Previous owner of property 4j,/1 as /e Total size of property 76 Total size of parcel Date parcel was created Are all corners and lot lines identifiable? X"' Yes No Is this property being developed for (spec house)? X Yes No Volume t_ and Page Number L7.:iL as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document No. 400-2!267: 0-2!2 S , and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of the County Register of Deeds as Document No. ignature of Applicant Co-Applicant Dat of . ianaturP na+ o .,f c; r. STC- 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County O WNER/I3 UYER L (.l a.z r.~ ►''s `St•'~. ~O l~ e.- 4 MAILING ADDRESS t1--96 &%,r ~ 3 G~~ L.✓~ `~GIOS' PROPERTY ADDRESS a l9~~ (location of septic system) Please Obtain from the Planning Dept. CITY/STATE PROPERTY LOCATION iV,_ NE' 1/4, Section T N-R_ _W TOWN OF C V6dyt ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAP , VOLUME 6, PAGE LOT NUMBER Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment 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 system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. UNkle, 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 DNR Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNCD: 45t~~~ DATE: rz o - - St. Croix County Zoning Office Government Center 1101 Cann ichacl lWad Hudson, \\'I 54016 1 T s DOCUMENT NO. S T 4TE BAR Of- WISCONSIN - FORM 2 WARRANTY DEED 545930 I-,P'kCE AESE~VED F^R RECORDING DATA - - i REC GTcn G- riCE William J. Ar:;dt a/k%.a WI11isr, ' - ST. CROIX CTY•, WI A n ci _2 h e r pc P _Z2.-~r.IlLI Poe" 1~r Feoc•~ JUN 2 6 96 conveys and warrants to F _Q_W So 1 br r !j _ Kr i S i 5b nd and . At 9:30 A. M . - - - - . tJAk - Ruyis:erofDsels RETURN TO the following described real estate in STROI X County, i State of Wisconsin: I _ oc_d_w Lt:- qyC1- Lf Tax Key No. The North One-Half (NIJ of the one-quarter (NE;) of Section 13-31-16, EXCEPT Lot 1 Surrey Map filed ? December 15, 1986 in Volume "6", =756, Doc. No. 420295. N C i This deed is in satisfaction of contract dated May 26, 1995 recorded September 25, 1995, Vol--:-;-.e ..Yl, Page 271, Document No. 420295. I a a This is not homestead property. (is) (is not) Exception to warranties: i Dated this 21St day of -__June-, ,9 (SEAL)~.~ (SEAL) -William J' Arndt a/k/a erese M. rndt William J. Arndt, Jr. (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGEMENT Signatures authenticated this Jay of S-A r CW WISCONSIN 19 ss. _r o i x _ county. 21st }x~ 7-a y came before me, this day of 91 - - e- t9 TITLE: MEMBER STATE BAR OF WISCONSIN the above named _ (If not, authorized by 6706.06,Wis. Stats.) __Arndt-a,lk/-a__William J. - Jr. & Therese M. Arndt This instrument was drafted by 0OM46w4 __D.OAR* DR1LL_AND SKOW _ + O - ' - - - - c-&a^ b~tTi rs4 JA _V_ who executed the foregoi% in- s^_L. n _Q d,he same.