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HomeMy WebLinkAbout008-1084-20-000 Q c w 0 n p n m oq m a n oc -0° N °o N ~ N N ~.y N L w I > O N tom. L ~ U P U (0 -0 Co C C N - Zf '2 CL m E N U 'O' V N • 6- 3 E '9 a5 ~aY a I v N m co o E 3 C z E C U U ?`U) N U. c a c E CL O Y N (u Q- O Q U coaN i 3 M v a) z a O C OL z L ' co 0) a m 04 N F- O O_ z d U 1 w co avi Z d c O fA I- N z E _0 v M O t ~ C Z •O O Q Q w 2 z z z N ~ N W u L ISM ~ ',d - d N ~ W d O? 0 0 u D D d rn N O H F- F- d 0 0 O z o 0 'IT •►v m I ~CL CL CL a w V I' a> a) o I M Z :7 0 z o 0 o 0 E Q O O T3 N_ m O t I ? m ° m o n m Q z E m N 7 w O y N U) O oO n O O W C O N N X 0 0 Oi N I- N O_ CL O O r _ N_ N V 40. CO n O D O O O O_ N ca 7 M - 06 CL (0 I- H c ca cD Q) ao N_ E rn 2 • O rn m ao c 0 E E U Y. O N W U N O - -7 O ~ w 3 EL ! a w • Cn CL d .V 47 rr~~ j E i C C w 7 r Wisconsig 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. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and l,- r y~ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. # ae~-iQ~Y- ~ d APPLICANT INFORMATION - Please print all information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location J eYfi a try b~~/ .SLrI 1/45 1/4,S.2 T,2e N,R E (orLQ Property O ner's Mailing Address Lot # Block# Subd. Name or CSM# /P 0 bx ity State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road ,xldGr, W' 402 ( 7/S 92 Qa 6"w e 11,077 ® New Construction Use: ❑ Residential / Number of bedrooms 3 Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow ~/SD gpd Recommended design loading rate bed, gpd/fit 3 trench, gpd/ft2 Absorption area required bed, ft2 trench, ft2 Maximum design loading rate bed, gpd/fi2 ' 3 trench, gpd/ft2 Recommended infiltration surface elevation(s) Brs too n1 0F Qe~>< o v 7,a- ali Q7t ft (as referred to site plan benchmark) Additional design/site considerations )1,1 G c,JTv a%,y yl , I Parent material SA" ; Ay 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 w u Ms ❑ U ❑ S ®U ❑ S M U ❑ S A U ❑ S Z u SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench / -8' /a R33 U,~1e / ahk P~ ~s 3l0 ,K S g36 7.S R S.'I SbY, M Aur"t- C S 2 F ; '3 Ground 3 0-q2 .2,4bk rn M F Ct S ,t/ 4 elev. 4s . t. Depth to limiting factor Remarks: Boring # -7 d• R 3 3 144k pi y~,Fr, c s 3 irr Y s 3 ;f-yy7,5 b/f QS Ground l elev. CE~~E. Depth to limiting factor ~_in. Remarks: xmmo of" i CST Name (Please Print) Signature Telep7na' r-, t;t l" 4-1 S'CCi[cn1 a6i'ev is - K 2 Address Date CST Number w a d PROPERTYOWNERzV'"y SOIL DESCRIPTION REPORT Page 2 of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3 a-~a 1,4 /V/? ,uo,JG l lctbk~ /ty fv- c S 3m Y S V-30 sh K m~ ~Y c s h ; 3 Ground ,3 D-:3G 7• S ~ y c zd /o ~ ~ a G F ~ G, 5' elev. Depth to limiting factor ; d in. 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 'n. Remarks: Boring # Ground elev. ft. , Depth to limiting factor in. Remarks: SBDW-8330 (R. OB/95) n t L ~ n P n ~ h Q o y 1 ~ ~ ^1 o n IS' 7 ? r ~ U i I l r\ T T \ V 10, % 1 W W Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: 'Labor ant Human Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 289366 Permit Holder's Name: ❑ City ❑ Village Town o : State Plan ID No.: CAMPBELL, JERRY EAU GALLE CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 008-1084-20-000 TANK INFORMATION ELEVATION DATA A970 181 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic C✓ l Ns-~~ I o Benchmark S -p 0 ' ~J ' Dosing )c., hl '"I ,Z,fI w~~w v)" 111, T'V AAeratioTY- Bldg. Sewer A` 93. -3 Holding St / I K Inlet TANK BACK INFORMATION St/ Ht Outlet TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic NA Dt Bottom A; 9(11' Dosing NA Header / Man. Aeration NA Dist. Pipefj Holdin Bot. System, . <ysa I PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift (o JUG Frictions System„ TDH/O.?/Ft Loss H Forcemain Length 16d)' Dia. _2 Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMEN I N urer: ING SETBACK SYSTEM TO P / L BLDG WELL LAKE /STREAM LEACH - INFORMATION Typeo CHA R Mode Number: System: //r' NIT DISTRIBUTION SYSTEM J , Ad Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Header/Manif length Dia- Length 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 ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: EAU GALLE 2256 10TH AVENUE 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: „„:ems Safety and Buildings Division Bureau of Building Water Systems ~.■~Inr■ SANITARY PERMIT APPLICATION 201 E. Washington Ave. In accord wjth 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 8 112 x 11 inches in size. - f • See reverse side for instructions for completing this application State Sanitary Permit Number 0~ k9'3& 6 The information you provide may be used by other government agency programs ❑ Check if revis on to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION Prop rty Owner Name Propert Location Y; r C qn be- S(J114 g,,,- 114,5 T 2 Y ,N,R 14,6or) W Property O er's Mailing Address Lot Number Block Number 030 frh41"A S= City, Stat J Zip Code Ph ne Number Subdivision Name or CSM Number 1 3 d tv , `h wl s ~r c~ G L Z' II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ City Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms ❑ Towan OF III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1❑ Apartment/ Condo o O 3- 0 41 - L O 2 ❑ Assembly Hal[ 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. Z] 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 21 §j Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System-In-Fill 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) G Elevation G[ 5 U 3 7 (e 3 ? / _ / 7 ? Feet g Feet VII. TANK i Capacity gallons Total # of r Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existing strutted Tanks Tanks Septic Tank or Holding Tank j o O O r we s6 e-n ❑ 1:1 El El ❑ lift Pump Tank /Siphon Chamber G 5 U ti ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibilit for inst ation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plu er's Sign (No Stamps) rPRSW No.: Business Phone Number: J-oe St.Gn 6 4 915~~ ~k2 46 Plumber's Address (Street ity, State, Zip Code): ~ U 4 Gr/r C~ v u- P l? d v f e Ge% S 3 4'0'~-~ IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issue sSi ature (No S s) Surcharge Fee) Approved ❑ Owner Given initial 9/7 s Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-6396 (R. 05194) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Divr_ion, Owner, Plumber INSTRUCTIONS = 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. 1 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. SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations March 28, 1997 2226 Rose Street La. Crosse WI 54603 WEGERER SOIL TESTING 421 N MAIN STREET PO BOX 74 RIVER FALLS WI 54022 RE: PLAN 997-40153 FEE RECEIVED: 180.00 CAMPBELL, JERRY SW,SE,29,28,16W TOWN OF EAU GALLE COUNTY OF ST CROIX MOUND SYSTEM The Department has reviewed the above-referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval of the system is based on chapter 145, Wisconsin Statutes, and chapters Comm 83 and 84, Wisconsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter Comm 82 or in chapters ILHR 50-64, Wisconsin Administrative Code. This plan submittal approval will expire two years from the approval date, or if a sanitary permit is obtained, plan approval will expire on the day the initial sanitary permit expires. The licensed plumber responsible for this installation shall keep one set of plans with the Department's stamp of approval at the construction site. The installer shall notify the appropriate inspector when inspections can be made. All permits required by the city, village, township or county shall be obtained prior to installation. Inquiries should be directed to me at the number listed below. Please refer to the plan number shown above. Sin ere , ® ~A G and M. im 2 an Reviewer „ VVt~- Section of Private Sewage (608) 785-9348 co pp 9? SBDA-7997 (B. 1044) Page 1 of 6 MOUND SYSTEM FOR A 3 BEDROOM RESIDENCE . Sg7-40 153 LOCATED IN THE SW1/4 OF THE &E 1/4 OF SECTION Z~ T N, R 14 W, TOWN OF ~~y G1'c~-`-E , S1^. C(2UUC COUNTY, WISCONSIN. d c INDEX R Z ~99~ v PAGE l 'of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW-CROSS SECTION : SPF~~~ PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUMPING CUMBER PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR ~'~--Cz-Y Cf'~1`-113 ALL 1130 FZ1AtQ\tLW ST. fox 31~ -PREFAIM BY WEGEE;tEFL SQ I - TEST I NG AND . ~~,~®t0®otee~ pGE SY S = Gtv 13E-=F:v m CE c0IV QaV na~1S P.O. BOX 74 421 N. MIN ST. a, ly ~ itt RIM.. FALLS. MI 54022 C®jy~. ; ARTHUR L. " 715-42`5-0165 wD915p 49 ELLSWORTH, 'AS w .jo Vol sswsee of°~'S1oF'sa awo e~ °y~~ S I GN dam' av~s~ ~ ~N~n Y see GO JOB NO. ~~-~y PLOT PLAN Page -of Scale 1"=yp' 7vC~l' W ~L ~o ~E 'H-T' L'~RST SU' Fti'r,;U ri'1 ~ (~V►vD 3 Bo2.r~ I Gq~ ~~ov5 ~ I Yl 30 of y~`PV c. 0J o v►i yp'oF Z,"P'vC F.~ 8•Z l ~p Npj- Cp1'iPRC'r OR ~ ~ y s1ti~Z8 TWI S H''u"A 1'11 iy ~M 1 L 1~~~'A St(33T U"e- OF 0.3s to i 1"0 'V~ O Y~ e.12~3' ~PtSZCLsL . Z2Z ~-A ST. t O T)4 NOTES: •1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. ( z required) 3. Install-4" observation pipes with approved caps. ( Z required) 4. Septic tank to be looo ASO gallon capacity manufactured by Y-I 1 l"~Wz-zT ZL2 j 71 tZet s r, I )v C, 5. Bench Mark %i n* t - LrL ioo•o' ou SPihLe b"fjBrjuE G12 uyy 1r..) zy • bjrj . TVjE . Qr11k 2 - t'I- °n. o oiv 1bP b F S I't. Po ST P f~ rv~Z'~ d V 6. Divert surface water around system to. prevent, .ponding at the uphill side. Page 3 Of Approved Synthetic Covering ~sTM c 33 Distribution Pipe Medium Sand • Topsoil -"H t F Elev. 01-1.0 3 E` D „ b y % Slope (Force Main Plowed - Trench of ,2"-2,1,2 " From Pump Layer Aggregate Undisturbed D \.0 Ft. Soil E 1",- Ft. Cross Section Of A Mound System Using F o.® Ft. I Trench For The Absorption Area G N•,u Ft. A Ft. H I- S Ft. B q~ Ft. I \Z Ft. Linear Loading Rate= y;-)8GPD/LN FT J 8 Ft. Design Loading Rate= o.3GPD/SQ FT K lU Ft. L 1 ~\j Ft. Pern~osition of Force Main W Zy Ft. L B K w M W Distribution Trench Of 2 - 2 2 Pipe Aggregate 1 Permanent-/ Observation Markers Pipes (anchor securely) Mound Using 1 Trench For Absorption Area Page q Of _b Perforated Pipe Detoll 0 End View )Perforated End Copt oPVC Pipe t .4a~" `pt`G6 Install permanent-marker at end of each lateral Holes Located On Bottom. Are Equally Spaced Q End Cop * PVC Force Main i Distnoution Pipe Last Hole Should Be Next To End Cap Distribution Pipe_ Layout P 6 Ft. X V8 Inches Y V8 Inches Hole Diameter <<Y Inch Lateral ll'y Inch(es) Manifold Inches Force-Main Inches # of holes/pipe N -L Invert Elevation of Laterals °17.5 Ft. \z \ . . \\A .~Y k z_ -L G a" Place lst hole Z y4from tee with succeeding holes at Libs intervals. Last hole to be next to the end cap. Combination Septic; Tank and PL]MP CHAMBER CROSS SECTIOU ARID SPECIFICATIOUS' PAGE S OF Io WEATHER PROOF -VEMT CAP JUWCTIOIJ BOX . PPROVED LOCKIMG y' C.L VENT PIPE OA R wlnl iO' FROM DOOR, AIJHOLE COVE .fWDow OR FRESH AjR INTAKE t y" MIA. I ~ I B" MI IJ. L - - I6"MIN. ~ lh PROVIDE I IAILE T AIRTIGHT SEAL I I C I ~ APPROVED JOINT BAPFL~S A I I i I APPROVED JOOIAfJJTTS W/C.T. PIPE DR I I I /C.L IPE Tank construction I II ALARM shall comply with .I 11 ILHR 183.15 and 83.20 d i I I I ow C I I I LLEV.a3 FT PUMP- OFF D COUCRETE I DLOCK L2. Ham. D O . APPRWED RISER EXIT PERMITTED OMLy IF TAWK MANUFACTURER HAS SUCH APPROVAL. gEDpINf~ SPEC.IFICATIOUS SEPTIC f DOSE y,~, was tzn, pt~tyST- WMBER OF DOSES: 3'y PER oAy TANK MANUFACTURER: - TAWK 51ZE: lbO~l 1 SO GALLOWS DOSE VOLUME t 5 S• ~~T~O S~f5~~~"JS INCLUDING OACKFLOW: GAIrtONS ALARM MAUUFACTURGR: MODEL WUMBER: `'2~ 1 Nw CAPACITIES: A= 1$ INCHE5 OR 3 O 6 GALLONS SWITCH TYPE: M~Z~CL-Y B= Z INCHES'OR 2~ 4LLOW5 PUMP MANUFACTURER: GOU L O S G: S ACHES OR 13 6 GALLOWS MODEL MUMDEM 38-11 E~oy D- \O INCHES OR 1-10 GALLOWS SWITCH TYPE: Y'1~1Z.CVR~ NOTE: PUMP AUD ALARM ARE TO 6 MIWIMUM DISCHARGE RATE Z ~S GPM INSTALLED OW SEPARATE CIRCUITS VERTICAL DIFFERENCE OETWEEU PUMP Off AUD.-DISTRIBUTION PIPE.. 16.7 FEET + MIIJIMUM mETWORK SUPPLY PRESSURE . ; . . . . . . . 2.50 FLET + ZO FEET OF FORCE MAIM X A.bl FY0►EFKICTIO►J FACTOR__ °,3Z FEET TOTAL OtJUAMIC. HEAD = ~Z 49 FEET DIAMETER Pump chamber IUTERAIAL- DIMLW6IO1Jt OF TANK: LEM&TH - ;WIDTH --LIQUID DEPTH 3_ 8 BOTTOM AREA 231= GAL/INCH AS PER MANUFACTURER = O GAL/INCH Goulds Submersible Effluent Pump - r 11 L~J 3871 EP04 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- • Homes components. Available for automatic and tic cover with integral handle • Farms Motor: manual operation. Automatic and float switch attachment • Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical points. • Water transfer 115 or 230 V, 60 Hz 1550 Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, built in overload with preset at the factory. rated oil and water resistant. automatic reset. ■ Bearings: Upper and lower SPECIFICATIONS • EP05 Single phase: 0.5 HP, FEATURES heavy duty ball bearing 115 V, 60 Hz, 1550 RPM, construction. Pump: EP04 built in overload with ■ EP04 Impeller: Thermo- • Solids handling capability: automatic reset. plastic Semi-open design 3/4" maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. CO. Canadian StandardsAssodatlon • Total heads: up to 24 feet. with three prong grounding ■ EP051mpeller: Thermo- • Discharge size: 11/2"NPT. plug. Optional 20 foot (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for end in "F or "AC".) rotary/ceramic-stationary, three prong grounding plug improved performance. BONA-N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 1040F(400C)continuous superior strength and 140°F (60°C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10- • Capable of running dry without damage to s 30 ►-s GPM components. - Pump: EP05 8 1 Fr. • Solids handling capability: 0 25 maximum. w z - • Capacities: up to 60 GPM. s 20 • Total heads: up to 31 feet. • Discharge size:1 Y2" NPT. i 5 • Mechanical seal: carbon- 0 15 rotary/ceramic-stationary, a a - - -----_-1z 4 - EPOS BUNA-N elastomers. o • Temperature: 3 10 1040F (400C) continuous 140°F (600C) intermittent. 2 jza.a 5 1 0- _0 10 20 30 40 50 GPM 0 2 4 6 6 10 12 m3/h CAPACITY ©1995 Goulds Pumps, Inc. Effective May, 1995 83871 041.5%97 rRI 10:17 FAX 715 386 4686 ST CRX CO ZONING z001 STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNERIBUYER ~s ~-yG 2 ~ MAILING ADDRESS l l 3 I 0 ~Q PROPERTY ADDRESS 5 G U 1 (location of septic system) Please obtain from the Planning Dept. c~ 7 (ter lle 13~ law s CITY/STATE 1/4 S 1/4, Section T N-R l W PROPERTY LOCATION IL/ } ST. CROIx COUNTY, WI TOWN OF LOT NUMBER SUBDIVYSION VOLUME , PAGE , LOT NUMBER. CERTIFIED SURVEY MAP 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. 0/6 of th e cost St. Croix County residents may be eligible to receive a grant for a maximum of 60Croix County of replacement of a failing system, which was in operation prior to July 1, 1978. 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 the sconsin disposal system in accordance with the standards moust,be herein, ®mples sand ~ urned to he St.Cro~ix Certiftcatiou stating that your septic has been County Zoning Officer within 30 days of the three year iration a . SIGNED: DACE- ~_Xi St. Croix County Zoning Office Government Center 1101 Carmichael Road 11193 Hudson, WI 54016 (w,,25 97 FRI 10:17 FAX 715 388 4686 a1 (--Kn k.V LA001 1.1 8TC• 100 fated in full and signed by the This application form is to be cola p ed. Any inadequacies will owner(s) of the property being develop only result in delays of the permit issuance. should this owner/ contractor, (spec development be intended for resale by house), then a second form gsubmattsdr to this an office 1wi h wths property is sold a the appropriate-deed recording. ~bQ- e 2 C Owrter of property .~1 4 ~ ~ 1/4 , Ssctiott ~:Z' 2~N-R f C W Location of property / _ n / Mailing address [ 33 r, f Township I o 2 2- _S Address of site_ _ rat no • subdivision name ~Ho Other homes on property? Previous owner of property Total size of property Total size of parcel 'Wu Date parcel was created ✓'Yes No Are all. corners and lot lines ident fiabl Is Is this property being developed for (spec house)? -Yes as recorded with the Register Volume 12/q~ and Wage Number ~13 _ of Deeds. INCLUDE WITH THIS APPLICATION TEE rOLOVIGG: AND PAGE A WARKANTY,DEED which includes a DOCUMENT NUMBER, VOLUME addAND P a WR MSER ANU THE SEAL OF THE REGISTER CE DEEDS. In , certified survey, if available, would If. helpful so as description delays of the reviewing process. the dead references to a certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION the I (we) certify that all statements on this form are true to the hest of ray (our) knowledge that 1 (we) am (axe) the owner(s) of property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of and that 7 (we) presently Deeds as Document No. -r'~ 'y 7 ? t- , own the proposed situ for ttae se- wage disposal system ~ for the oht'.ain+ed an easement, to run the above described praperty, construction of said system, and the same heed been ulYoc orted~in the office of the County Register of Ds as S nature' P1 cant Co-Applicant l~aLe of Signature Date cif 9i9nature 554 ij STATE BAR OF WISCONSIN FORM 2 - 1902 • WARRANTY DEED DOCUMENT NO. tin Richard P. Bauer and Martha E. Bauer, AMY husband and wife Gic ;:I I+~ra la coneys and wa mts w Gerald D. Campbell and Marsha JAN. 2 3" 1997 L. H. Campbell, husband and wife, holding as 12:30 P. tt~ survivorship marital property ~Cw.., - WNa.1L H~ypw w t>wl~a THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN AI .HESS the following described real estate in St. Croix C Ams Thurnas A. MICCOrmaek State of Wisconsin: QFFi-' ...'Vest Street Bats" Wis. 54002 008-1084-20 PARCEL MEW-FICATIDN NUMBER Southwest Quarter of Southeast Quarter (Sit of SEk) of Section Twenty-nine (29), Township Twenty-eight (28) North, Range Sixteen (16) Kest. it Subject to the terms and conditions of a Farmland Preservation Agreementli with the State of Wisconsin dated May 2, 1981, and recorded may 14, 1981, in Volume 629 of Records, at Page 241, as Document No. 370836, office of the Register of Deeds for St. Croix County, Wisconsin. ii = NS ER This is not homestead pax 76bx (is not) E=pdontowurantim Easements and restrictions of record. Dated this 17th day of JBnii= A.D.. 19 97 _ (SEAL) (SEAL) I • Richard P. Bauer (SEAL) Ma AX& 66 L / (SEAL) • Martha E. Bauer AUTHENTICATION ACKNOWLEDGMENT Signamte(s) Stage of Wisconsin, sa St.- Croix Coungt authenticated this day of .19- Im Nj tame before me this day of Irv 1911-, the above nattted ii Ricbard P. Bauer and Martha E. j • Balmer TITLE: MEMBER STATE BAR OF WISCONSIN ' (if not. authorized by 1706.06, Wis. Stan) to sae hi r aD be the per" s who executed the fomping ge the same. THIS INSTRUMENT WAS DRAFTED BY STEM F/DiY Thomas A. McCormack Baldwin, WI 54002 1 s . s t, n Ul O 3-a n d C r1 I ~ O cn 3S= z w z ° 00 v X 00 . S m 3 0 m 3 c N °D 0* CD CO - CD ZZ 0) 0) 0 m N 3 m J 0 CD -0 Cn (D ~n O 0 00 cD 7 N Q fD O ° O O. 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