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HomeMy WebLinkAbout006-1052-70-000 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER /JC it n y S / Lc- Ra S:t--'r ADDRESS 4ac SUBDIVISION CSM# LOT SECTION oC 3 T 3 1 N-R t(o W, Town of C x/o,1 ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM dy lV j•{,a~i C, e~ ~u ,r INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. f r~ BENCHMARK: 3, Ten ALTERNATE BM: e- Spa 6 ~y ALI- [SS v SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: UV ; e- GC--r Liquid Capacity: 12 Setback from: Well House Other Pump: Manufacturer per,/lCt- Model# Size Float seperation 2- Gallons/cycle: /(a 1s Alarm Location 8 'v f r"d ~c e SOIL ABSORPTION SYSTEM Width: Length 5_ Number of trenches t Distance & Direction to nearest prop. line: 331 ! Setback from: well: House Other ELEVATIONS Building Sewer .yC ST Inlet: ST outlet: PC inlet PC bottom J. (~'C) Pump Off / 5"ev Header/Manifold (4 Bottom of system 3;L Existing Grade Final grade 1 DATE OF INSTALLATION: q- PLUMBER ON JOB: 1 i0hcf LICENSE NUMBER: l 35 ~0,~ INSPECTOR: 3/93:jt yvisconsi ;Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor andHuman Res INSPECTION REPORT ST. CROIX Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 284342 Permit Holder's Name: ❑ City ❑ Village Town o : State Plan ID No.: DEROSIER. DENNIS CYLON CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: ✓~C~ 006-1052-70-000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic: Benchmark 3•~6 /D ,GU i Dosing ~drn ~,y~ i 7T:✓l=rz~rn . Aeratteff- ' Bldg. Sewer 9 Holdin St/,Rt Inlet 66' TANK SETBACK INFORMATION St/ lyrf Outlet AA - Vent irIto ntake ROAD Dt Inlet TANK TO - P/ L WELL BLDG, A Air ' Septic~~' NA Dt Bottom 15, (4 Dosing " NA Heagbe+1Man. 11,631 2' Aeration NA Dist. Pipe q9 Holdin Bot. System PUMP / N INFORMATION Final Grade Manufacturer Q.,~ Demand Model Number h GPM TDH Lift Friction System - TDH Ft oss Forcemain Length Dia. I Dist. To Well } SOIL ABSORPTION SYSTEM BED/TRENCH Width i Length(,2 No. Of Trenches D EN 1 N No. Of Pits Inside Dia. Liquid Depth J DIMENSIONS SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHI nufacturer: SETBACK CHAMBER INFORMATION Type O Model Number: System: 1 %c rel3SSO• 2d r 75 ✓rif~ OR UNIT DISTRIBUTION SYSTEM N.@p6er / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia- Length (00 Dia. Spacing (o SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: CYLON 23.31.16.35 6B7SW,SE 2458 200TH AVENUE l t;i J 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 SANITARY PERMIT NUMBER: _ I I I i SANITARY PERMIT APPLICATION BuSafetyreau o oand ff BuiluildinWater System: ng Water 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 81/2 x 11 inches in size. S ( Gra / >c- • See reverse side for instructions for completing this application State Sanitary Permit Number The information you provide may be used b other agency ro rams 9ff q3~ by government pq ❑ Check if revision to previous application (Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION S ci 6 - 309.7Property Onwner Name Property Location ,Dee- ; r e e.- Sc✓ V4 S /4, S ..2 7 T N, R l6 E (or)C:Y/ Property Owner's Mailing Address Lot Number Block Number ,2 r O T-~z- A4,. W G¢ I/ City, State Zip Code Phone Number Subdivision Name or CSM Number 4e e, A r Q ~ (7,s- 111-116,' 11. TYPE F BUILDING: (check one) ❑ State Owned !t~ Nearest Road ❑ VII age Public or 2 Family Dwelling - No. of bedrooms ffilZown OF III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Num er(s) 1 ❑ Apartment/ Condo 16- 4V~, 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 _ System System Tank Only Existing System ________Exlsting 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 21,1~Wound 30 ❑ Specify Type 410 Holding 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. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation d o _S`vc2 _S-Z> ~7= Feet l7"eet VII. TANK Capacity gallons Total # of r Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existing structed Tanks Tanks Septic Tank or Holding Tank A~2 5%✓ Jt G✓r'Gl .Ir 1 a ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber C-/~- -f- ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (No Stamps) AIQ / PRSW No.`. Business Phone Number: Plumber's Address (Street, ity; State, Zip Code): IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved itary Permit Fee (Includes Groundwater ate Issued Issuing Agent Signature (No Stamps) Surcharge Fee) Approved ❑ Owner Given Initial n Adverse Determination cJ / X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SOD-6398 (R. 05/94) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber 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 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, 608-266-3815. 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 1/2 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), 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. 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. 4 Wisconsin Department of Industry, SOIL AND SITE EVALUATION -Labor and Human Relations Page of Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. ` Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County / include, but not limited to: vertical and horizontal reference point (BM), direction and d percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. Od W'_S~f APPLICANT INFORMATION - Please print all information. Reviewed by 4r Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Prope Owner Property Location S' CF+A Govt. Lot 1/4 1/4,S T kF~ Property Owner's Val ling Address Lot # Block Subd. Nam or CS ZUNI- City State Zip Code Phone Number Nearer ( ) El City Vi age [Z Town Cpl/ ❑ New Construction Use: ® Residential / Number of bedrooms Addition to existing building ® Replacement ❑ Public or commercial - Describe: Code derived daily flow. pQ0 gpd Recommended design loading rate &0 bad, gpd/f?__Z___2trench, gpd/ft2 Absorption area required bed, ft2 Q_trench, ft2 Maximum design loading rate /Vf2 bed, gpd/fl2' Z trench, gpd/ft2 Recommended infiltration surface elevation(s)1~, 5 ft (as referred to site plan benchmark) Additional design/site considerations Parent material / Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system ❑ S LZ U 2 ❑ U ❑ S ®U ❑ S [NU ❑ S 2U ❑ S 01 U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft2 9 Texture Consistence Boundary Roots re in. Munsell Qu. Sz. C nt. Color Gr. Sz. Sh. Bed , Trench 1 1 J Z Al 14-1 Z__ Ground elev. Depth to limiting factor c~2~in. Remarks: Boring # / .C s' Ground elev. Depth to limiting factor ,__~in. Remark. CST Name (Plea P - t) ' Signature Telephone No. Address Date CST Number Me A2~ ? - PROPERTY OWNER ZA~ IJ`S: Z~-- -ZfSOIL DESCRIPTION REPORT Page of ~ y PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Co t. Color Gr. Sz. Sh. Bed , Trench 44 Ground o 5 elev. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # ; Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. , Depth to limiting factor in. Remarks: SBDW-8330 (R. 08/95) • . ~ ~~i, s ~.~as~x~ s~J~ , St s~ ~ T~1/1; a°/~ w 1 ge r a OPTIONAL WORKSHEET • 1. MOUND SYSTEM II. IN-GROUND PRESSURE SYSTEM-Continued- 1. Wastewater Load, Total Daily Flow= 990 gal. 10. Force Main: y.2. m. Use s. ILHR 83.15 (3) (c) Minimum Dosing Rate = Spin. Diameter = i"' Adm. Code and PROVIDE A DETAILED 11. Total Dynamic Head: LIST OF SIZING ON PLANS. 2.S ft. 2. Depth to Limiting Factor = it. System Head = Vertical Lift ft. 3. Landslope r R' ~ 4. Distance from Dose Chamber to Friction Loss = ft. Distribution System = Ito ft. TDH = ft. 5. Elevation Difference Between 12. Pump Selection: Pump and Distribution System = -ae~ ft. Pump will discharge at least glint at Yj6-ft. total dynamic head. 6. Absorption Area Sizing: Pump me" ""'`""S;~ - ?0'_ «Lr- Area Requited = f Ac, ~ 2Trt..c arc ' , /►,w 4 « -'►IV, y Bed or Trench Length (8) _ (yS>n Volume: Icon . 05.1 - r s'2 x Z. Bed or Trench Width (A) 13. Dose Trench Spacing (C) _ ft. 10 Times Void Volume of 7. Mound Height: Distribution Lines= 1104 Pi. l Fill Depth (D) Daily Wastewater Volume + 4 Doses In 24 hrs. _ eal• Fill Depth Downslope (E) ■ gackflow = - P gal. Bed or Trench Depth (F) fL Minimum Dose = gal. Cap and Topsoil Depth (G) = ft. Cap and Topsoil Depth (H) _ ft. 14. Dose Chamber: vU Volume gal. 8. Mound Length: End Slope (K) = moo, /1 ft. Total Mound Length (L) _L 111. CONVENTIONAL PRIVATE SEWAGE SYSTEM 9. Mound Width: i. Wastewater Load. Total Daily Flow = gat. Upslope Correction Factor= Use s. ILHR 83.15 (3) (c) , Wis. Upslope Width ■ ft. Adm. Code and PROVIDE DETAILED Downslope Correction Factor LIST OF SIZING ON PLANS. Downslope Width (1) ft. 2. Required Septic Tank Capacity = gal. Total Mound Width (W) _ .7 iL 3. Percolation Rate = min./in. 10. Basal Area' 4. Absorption Area Sizing: Infiltrative Capacity of Refer to Table 2 in ch. ILHR 83 Natural Soil = ga1./94.ftjday and PROVIDE A DETAILED LIST OF Basal Area Required = Q0042 94• ft. SIZING ON PLANS. Basal Area Available = A600 sq. ft. Required Area = sq. ft. 11. If Standard Tables from Chapter ILHR 83 Length = ft. are used, Indicate Table # Width = ft. 12. For the Distribution Network, Use Numbers 5.141 Section I1. Number of Trenches = Trench Spacing ■ it. 11. IN-GROUND PRESSURE SYSTEM S. Distribution System: Lateral Length = ft. 1. Depth to Limiting Factor ft. ■ Number of Laterals = 2. Landslope = 3. Percolation Rate = min./in. Lateral Spacing = In. 4. Proposed System Elevation ■ ft. Distance from Sidewall to Pipe = In. 5. Wastewater Load, Total Daily Flow: Pl. System Elevation Use s. ILHR 83.15 (3) (c) , Wis Adm. Code and PROVIDE A DETAILED IV. SYSTEM4N•FILL LIST OF SIZING 0" 'PLANS. Fill in All items from Section Ill. Required Septic Tank Capacity ■ gal' V. SEPTIC TANK 6. Absorption Area Sizing: 1. Capacity = PI' Percolation Rate ■ min./in. Area Required = sq. ft. 2. Manufacturer: System Length ft. 3. Show Site Constructed Tank Details on Plan System Width ■ ft. 7. Distribution Pipe Sizing: VI. DOSING TANK Hole Sire ■ in. I. Capacity = gal. Hole Spacing = . y`t 2. Manufacturer: Lateral Length • 3. Pump Manufacturer: L.11r6al Silo • _ I.-].- in. `+ret 4. Pump Mrslel: p. S. OperatinIt Head ■ ft. i.atrr.d Spacing 6. Flew Ralo= Ui%lancr' Irani Sirirwall •tn Pilic in. X. Diatrlhulian Pipe D60,irge Rate: 7. Show Site Constructed Tank Details on Plans Number of I [tiles Pet Pipe I low Per Pipe * Itpm. VU. IWI.UING TANK 9. Manifold Siting: 1. Capacity = am' Ins" 1 yte (center or anal) C_ h d_ 2. Manufacturer: Length = It. 3. Show Site Constructed Tank Details on Plans • Dlatnctor = in. S .9 3.0 V 4 3 -SHOW ALL INFORMATION ON PLANS- - - r ~7/ E i I ,C 9- 7 u S S°`iV1 ! i ' p Sl EV A~ j , PTO I r y, Jet i R , 'A 1LD GS . A, RE- 0 PC N tE 09 i , j I ` I - ~ ~ I j i i i I I I I I i f I , l l i~ i i + I r i ~r Ir i! ~ j i 5T 7,r ie L. i / - . 14. 4 ' o I i 47 14 - -ffr - ~ - Ff 0'9 7' 4T- - Page Of 596-3.0973 Cross Section Of A Mound Using A Trench For The Absorption Area Rst~,c33 ~ H Medium Sand Fill 6" Topsoil E D tyso 'rI oea Trench Of I? - 211" Aggregate, Plowed Layer 6" Below Pipe, Covered With D _I Ft. Straw, Marsh Hay Or Synthetic Fabric E /,/d Ft. G Ft. F_ Ft. H J-*"Ft. ONSITE SE~VAOE SYSTEM R AND HUMAN RELATIONS , DEPARTNIINQI~~s~~~~ ~V\t1' !Using A Trench For The Absorption Area S- CC)FIRESPONCENCE Force Main Distribution Pipe I-\7 Permanent Markers Observation Pipe ±AV W ~ K 8 G \Tr h 0 h" - 215" Aggregate I H soL~ L A Ft. K /O_ Ft. Ft. (oz.5 • /S'/.o1Ft. B . Ft. J . 7, Ft. L _ G F T. License , Number: Date: / c..JI&T Signed: ~~~cY 96-309' 3 1~GQ p1? G/~ S96-309'3 Distribution Pipe Detail For Two Lateral Network ~Ttip,l Holes Located On Bottom Are Equally Spaced x x PVC Force Main End Cap 7 H. Y 1b PVC Distribution Pipe p•~ P Z5~ g,5 ~ r Igo (le ~=S ~rro H C e oP * Last Hole Should Be Next To End Cap ~rVCe 1"OL ~tj o~ P 6.0 Ft. Hole Diameter Inch X bo Inches Lateral Diameter Inch(es) Y 0. Inches Force Main Diameter , -,2- Inches # Of Holes/Pipe Invert Elevation Of Laterals Signed: 4--;-!~ License Number: Date: 1! 1813;1! ,SEyV CUE SYSTEM dle • ~ . , N RELAZlO • UB~.DVRGS ANU S SC: 0,ARES?t7UflE~~E Ec- i. 09'3 S96 3 SEPTIC TANK E'PUMP CHAMBER CROSS SECTION AND SPECIFICATION' S96-309"3 bOF 4" CI VENT PIPE 12n MIN. ABOVE GRADE ~ WEATHER PRO FRESH AIR INTAKE W/ PADLOCK 6 25' FROM DOOR, WINDOW OR W)GAS- FINISHED GRADE 4" CI RIESER -WARNING LABEL SOLID HTCONDUIT MANHOLEDCOVER 7 6" MIN. ~~_..4" MIN. 18" IN. ABOVE GRADE 6" MAX. ~ INLET GAS- WATER TIGHT SEALS TIGHTi p SEAL APPROVED 411 BAFFLE ~ ALM JOINTS W/ CI 3' CI ONTO PIPE B ON PIPE 3' ONTO U"tai I E SEWAGE SYS`i 13A SOLID SOIL C SOIL ELEV . ly~d FT• OFF RISER EXIT D PERMITTED ONL) IF TANK MANUFACTURER HAS APPROVAL DEPARTVIEIe'r ; L,t- ~ ,QV ED BEDDING UNDER TANK DEvlsioa~ OF SAFETY A CONCRETE PAD '5 +I• FICATIONS SEPTIC ~`-OSERRCSPOfV[~ENCE TANK MANUFACTURER: 41res.Qws NUMBER DOSES PER DAY: DOSE DOSE VOI~ME FINCLUDING TANK_ SIZES: SEPTIC GAL: LOWBACK: GAL. 7171 ALARM MANUFACTURER: _ s.T cc-. CAPACITIES: A = jlr'lNCHES = V51, GAL. MODEL NUMBER: B = 2 INCHES = GAL. SWITCH TYPE: c•-<<-~~ PUMP MANUFACTURER: T de-CGe.- C = INCHES = 161, z GAL. MODEL NUMBER : p" 9f' D = INCHES = l. YAAL • SWITCH TYPE: ar~ REQUIRED DISCHARGE RATE GPM PUMP 8 ALARM WIRING AS PER ILHR16.23 WAC VERTICAL DIFFERENCE BETWEEN PUMP.OFF AND DISTRIBUTION PIPE FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . 2.5 FEET + FEET FORCEMAIN X AFT/100 FT. FRICTION FACTOR L FEET TDTAL DYNAMIC HEAD sr FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH WIDTH DIAMETER LIQUID DEPTH iZ •S~~'~ f 4 d ~Y t LICENSE NUMBER: DATE: SIGNED: :5.96-30978 rn 3 7/8 6 1/4 _04 HEAD CAPACITY CURVE MODEL "98" 4 5/8 I 30 25- I x 6 ® + _ 1- V O ; 15 0 4 10 \ Q 1 1/2-11 117 NP-1 5 0 - - U.S. GALLONS 10 20 30 40 50 60 70 80 ` LITERS so 1 0 240 _ 0 FLOW PER MIN TE TOTAL DYNAMIC HEADIFLOW PER MINUTE EFFLUENT AND DEWATERING CAPACITY 12 HEAD UNITSIMIN FEET METERS GALS LTRS I 5 1.52 72 273 10 3.05 61 231 a 3/ 16 15 4.57 45 170 - 20 610 25 95 ~ - Lock Valve r~ ENIIEj CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and Variable level float switches are available for controlling single supplied with an alarm. and three phase systems. el oat switches are available for • Mechanical alternators, for duplex systems, are available with or ~Dobllepevellock cvariable ycle controls. without alarm switches. SELECTION GUIDE 1. Integral float operated 2 pole mechanical switch, no external control required. Standard all models - Weight 39 lbs. - % H.P. 2. Single piggyback variable level float switch or double piggyback variable level, 98 Series Control Selection float switch. Refer to FM0477. 3. Mechanical aflemator 10-0072 or 10-0075. Sim Model Volts-Ph Mode Am Iex Du lex 4. See FM0712, for correct model of Electrical Aflemalor, "E-Pak". M98 115 1 Auto 9.4 1 1 or or 1 & 7 _ 5. Control switch 10-0225 used as a control activator, specify duplex (3) or (4) Ngg 115 1 Non 9.4 2 or 2 8 6 3o r 4& 5 float system. D98 230 1 Auto 4.7 1 or 1 & 7 - 6. Four (4) hole -J-Pak', junction box, for watertight connection or wired-in E98 230 1 Non 4.7 2 or 2 8 6 3 or 4 8 5 7. Tsimplex or wo 2) hole duplex watertight connection or splice. CAUTION For information on additional Zoeller products refer to catalog on Combination Starter, FM0514; All Installation of controls, protection devices and wiring should be done by a qualified PWybeck variable Level Switches, FMO477; Electrical Alternator, FM0486; Mecharocal Axems- licensed electrician. All electrical and safety codes should be followed including the lor, FM0495, Alarm Package. FM0513; Sumpf8awage Beim, FM0487; and Simplex Control Box, most recent National Electric Code (NEC) and the Occupational Safely and Health Act FM0732. (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. ML 70. P.O. BOX f6317 411111, Loulnft KY 1d 0317 tea.. ~I ~ s7o: 3zLV so oaiia~ Lale p LoubvWe, KY 40216 P~.os S~cE /999" PUMP !O" (502) n~502j 4,W4 FAK • .Y..T • ` ~f• ' • V ICI ~ ® ~ ~ ~ SS •it r 9'0 30 973 - r_ • • o mt w H a h ^ h o AAQ 94 h 04 Z r N eq to ' f N p O •~'c Q V 1A ;j 04 X ga u 2 1 $ go .0 0 to 'Woo N c ' VMIS I -IF ~ ~ t1 z~ I • FF- ~ ! I fop STC-105 SEPTIC TANK MAINTENANCE AGREEMENT Y~ St.- Croix County OWNER/BUYER' ~~1\~ H \ J\F'~ MAILING ADDRESS ~2)LjiA A vP n us_ PROPERTY ADDRESS ~4 5 6' (location of septic system) Please obtain from the Planning Dept. CITY/STATE CC~^cT -9 co ('s-~~ PROPERTY LOCATION `)W''4 1/4, 1/4, Section 4,1 , T N-R W TOWN OF \ 4\ ns-_ ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAP , VOLUME , 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. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and turned to the St. Croix County Zoning Officer within 30 days of the three y ar ~piration date. / SIGNED: I~ 2 s•~. a, _ /Z. DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 8TC- 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of property Lou P~ Yyt1 :\~C'S((`1~,\ Location of property/S"1/45E 1/4, Section ~ o ,T_,~3LN-R A~ W Township Mailing address rgq`5'g Ile , Address of site g ;fit ~1 V Subdivision name Lot no. Other homes on property? Yes-No Previous owner of property Total size of property Ceaz Total size of parcel Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house) ? Yes _No Volume-545 and Page Number 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. J 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. 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. gnature of Applicant Co-Applicant ~'--5 f j 9 2 ~5131 ~R`/ Date of Signature Date of Signature NO. §TATtt MAR OI NftN D FORM 2 , •oocUMENT NO 1 WA2tRA% ~ r1f CY DIIatO VOL 545 PA 11 THIS %PACK 1190911VaD 1011 ■aCopoi NG DATA 336809 By This Ltd. Mathew J. Egan and Joyce.M. Eqan REGISTERS OFFICE _ husband and wi `e .as...J.o7.'±.L...te.............................................. :T. Ch.nIX CO., W15. . Recd. for Record this. 24th day of Nov A.D. 19'j6 Grantor a,mey, an<i warrants to D . enni.s .....A. . ros•i•er__and.•.Rarhara_.... e......._ 11 at Q A. , M. Dftros.i.~r. h.u.sb.a.nd_ and-wife.-as...3A.i.at...tenants i Rellster of Doeds Grantee..s...., fora 'aluah;r cuu !cratmn...................................................................................................... 11[T U11N Tv the following drs,-nhrd real estate in.. St.....Craix County, State of Wisc^nsm. Tax Key at This is ~nOt homestead property. The South West Quarter (SW;) of the South West Ouarter (SW-,) of the South East Ouarter (SE4) of Section Twenty Three (23), Township Thirty-One (31) North, Range Sixteen (16) West, in the Town of Cylon. St. Croix County Wisconsin. T') AINSFER FEE Exception to warranties: Exceptions: S+ahject to Easements and Restrictions of Record, if any. 19. to Executed at.......:::......1.=r3.x~~..._r.. L!a(11~a this..... %..7,-/....... ...4a of.~..1~ C/~rsr..__..... .-~•"•.SEAL) SIGNED AND SEALED IN PREBENCZ or Mathew J. E R. (SEAL) x - Joyce M_Egan_ (SEAL) (SEAL) N/A Signatures r:f . . NIA suthenticatt:d this _ day of ~ Member State Bar of LS'iz:rns:^ ether Pant' Title: Authorized under Sec. 106.06 viz. . _ STATE OF XV+SC49X"V iv. f..r:[..Z.~ "Z.-.................. county. daof_. 4'.,.: ^c:-Q a. c : . 19.7 Personally came before me, this Y E a.n...._ the above named. ...Mathew-..J-.. _..F-gan-.and...JQy~e..M...... g to me known to hr :he rers-,n.... s- who executed the foregoing instrument and acknoa• .the some.