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HomeMy WebLinkAbout014-1016-90-000 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS 4 SUBDIVISION / CSM# LOT SECTION---7_T -L N-R~W, Town ST. CROIX COUNTY, WISCONSIN --PLAN. VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM o 4D INDICATE NORT A OW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. `BENCHMARK: ALTERNATE BM: SEPTIC TA2~~/ PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: G~~ P Liquid Capacity: Q&wo Setback from: Well,mo0&11 House, Other Pump: Manufacturer (j 0L C& :Model Size Float sePeration l c~~ (GcJ L ~ Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM l Width: Length 7~ Number of trenches /'Y1 D i Distance & Direction to nearest prop. ' ne • i Setback from: well: ,-)O House Other ELEVATIONS = Building Sewer ST Inlet: ST outlet:G' • PC inlet ,5- PC bottom ;7 S Pump Off a Header/Manifold 6 -bottom of system a~ Existing Grade, ~ Final grade DATE OF INSTALLATION: - PLUMBER ON JOB: LICENSE NUMBER! INSPECTOR: 3/93:jt • Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM count Safety and Buildings Division INSPECTION REPORT • CROIX Sanitar~~r~il W GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provice may be used for secondary purposes [Privacy L *W, s.15.04 (1)(m)]. STEINt3 GEK; PATRICK ~Li1y.J~~(illage ❑ Town o : State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM Description: Vtc~S Parcel MINQ-1016-90-000 B TANK INFORMATION ELEVATION DATA A9700265 ,3oP~ TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 'Y : ' - j Benchmark ,0,,25-` _ a ,'7Z' Dosing fA s 64, x I . ?0, 1. Aeration,-_________ Bldg. Sewer ' Holding St/ Inlet TANK SETBACK INFORMATION St/,yt Outlet 1?1 X9 q, 94/ TANK TO P / L WELL BLDG. Aeintake ROAD Dt Inlet clo c~ ' , $ 75' Septic NA Dt Bottom e~lj Dosing „?S ` NA }mac/Man. 3,~Lo (,d 7~ Aeratio NA Dist. Pipe Holding Bot. System P P / INFORMATION Final Grade Manufacturer ~Dernand Model Number ' q!yGP Friction System,,-9, TDH Li",02 Loss 1, Head $p' TDH , ~Ft Forcemain Length S' Dia. ` Dist.ToWell >/p' SOIL ABSORPTION SYSTEM _ BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia iquid Depth DIMENSIONS DIMENS anufactur SETBACK SYSTEM TO P / L BLDG WELL LAKE / STREAM INFORMATION Type Of v , o CH ER Mo a Num er: !4 UNIT System: crti.c DISTRIBUTION SYSTEM Header/manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake 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: FOREST 7.31.15.112,SE,SE 2228 270TH STREET. ff r f "I- ~41 f tom., j L CJ d N r :~,Ct-> ~'..?c✓_.~~ /`_J "J:l`:'..,, i~~ L!.,.'}•.,! j`1t- 't J i s GJ C.d°» Plan(revision required? ❑ Yes ❑ No Use other side for additional information. __1 F__ SBD-6710 (R.3197) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ' r ng sion SANITARY PERMIT APPLICATION Safety andBuildi Di 20 E. Wash. ~isconsin I In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Department of Commerce 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. ~ V_ D • See reverse side for instructions for completing this application State Sanitary Permit Number yq qqg The information you provide may be used by other government agency programs ❑ Check i revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION PLEASE PRINT ALL INF RMATION Prop rtyOwner-Name 1 Property Location 1/4 J 1/4, 5 / T N, R IS E (or) Property Owner's MailingAddress , Lot Number Block Number ` c, J r ) li' City, State Zip Code Phone Number Subdivision Name or CSM Number E] City Nearest Road II. TYPE F B IL ING: (check one) E] State Owned ~ <1 Villae Public 1 or 2 Family Dwelling - No_ of bedrooms o Town OF JY~~ Z,4- yr Ill. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 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. ~g 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 11171 Seepage Bed 214!!jl/lound 30 ❑ Specify Type 411-] Holding Tank 12 ❑ Seepage Trench 22E] 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 Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) /Elevation :6 --Feet Feet VII. TANK Capacity in gallons Total # of Prefab. Site Fiber- Ex er- INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel Plastic p New Exist ln strutted glass App. Tanks Tanks 1 -1 Septic Tank or Holding Tank r%L v ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber 1 ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name`. (p"9 PluMs- Plumber's gnature (No St ) MP/MPRSW No.: Business Phone Number: Ac dress (Street, City State, Zip Code). _ IX. COUNTY/ DEPARTMENT USE O Y ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing Agent Signature (No Stamps) Approved Surcharge Fee) ❑ Owner Given Initial Adverse Determination X, CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: L~'~ SBD-6398// (R.11/96) 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, 608-266-3151. 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. M. 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 Commflrw East Green Day Street „mom Shawano WI 54166 BYRON BIRD JR 896 68TH AVE CRY WI 54001 RE: PLAN 597-30660 FEE RECEIVED: 180.00 STEINBERGER PATRICK SE,SE,7,31,15W COSY OF ST CROIX TOWN OF FOREST 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. Sincerely, Kei h Wilkinson Plan Reviewer Section of Private Sewage (715) 524-3627 SBD-7997 (R.11/96) m w f SAFETY & BUILDINGS DIVISION State of Wisconsin 1W47 Department of Commdri%) t a st. r I s.sE'n ljav r a°c:,e t. tihrrwano w i ~416t, Ea`°Ftp}~ 111 K1? it, t 1,46 6TH Al'F AMEKY Wl 54001 I'l,AN S97-10600 FF3? KF(T IVVD: 180,00 31 , 15W Fi)KFST ,-r)t VIN O S1c'KOIX NVVNI:? SYSTEM The Department has rev i,'-,Ned the abovu---reI.,rtnccd submit UkI . Conditional approval is hercbv granted for the system plan :submittal, All noted items must be correc•t,A. The review and approvtaI of the system is based on chapter 14.~, W'isconsin Sta.tutes, and chapters Comm '11'3 nod 44, Wisconsin Administrative (Ic>t, aa1ul js contingent upon compliance with any stipulations shown on the plans. This svstem has not been reviewed for the code requirements set forth in chapter Corr+m 82 or in chapter ILIA 50-64, Wisconsin Administrative Code. This plan subm i t ui l apps c,v=a 1 u i l l o p i rer two ve<ar,. f f ow the approval date, or it' a sanitary permit, ia~ obtained. plan a:pprc-x`,91 will cNpirc° on the day the initial sanit.arv pernlit expire-;. The Iircn,~-,ed 1?iuiaih;r rya<,ponsible For this installation sha.I I keep ()n(set of 'PIan s wi"h tht° I)Ut+rtRK-0t`s stamp of' approval at the cons true:ticrn site. 1'he ire taI Ic_'1- shral l notify the appropriate inspectoe when inspect .ion!: can be made. All permits required by the city, village, (ownship or county shall be obtained prior to inst,a I ltyt ion, Inquiries should be directed to me at the nurnberl istc~d below. Please refer to the plan number shown above, Sincerely, kei .1 i;i lkinson Plain Reviewer Section of Private "iewapre 17 15) 424-362'x? SBD-7997 (R.11/96) PLOT PLAN PROJECT Patrick Steinberqer ADDRESS 255 . Rd K Clayton Wi 54004 SE 1/4 SE 1/4S 7 /T 31 N/R 15 TOWN Forest COUN'. ST.CROIX MPRS Shaun Bird 3532 6i x/97 eDROOM 3 DATE CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL. LIFT HOLDIi TANK MOUND X)OCX SEPTIC TANK SIZE 1000 Gallons LIFT 'T'ANK SIZE DC TANK SIZE 800 Gail HOLDING TANK SIZE LOAD RA'Z'E 1.2 ABSORPTION AREA 375 BED S. E 8' X 47' BENCHMARK V.R.P. Base of Metal Rod with Orange ASSUME ELEVATION 100' ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM F1,EVATION $g.,,S• B-1 Area 25' 4% Downslope to B.NI~ Slope Remain Dose Tank to be Undisturbed Provided with Approved Warning Label and Lock Down Cover ❑B-2 DT B-3 Mound to be installed ST along the,5' Tanks to be Contour Line Properly Bedded Scale a 1/4' = 10' Garage r Pro 3 Bedroom House Condition iy P iveway Existing House on EP ~ME1►>ri Of Site to be Converted to MIOf W~j11 a Storage Shed and not used for Living SppND Quarters EE E)Well 270th St. y 1%3 °~•n4~~l:kygy 4~; ~'~ip A 7 M►~ No 25 4rou-'~Joven Filce.r Fabric ObSer~4~~o►1 P iP~ ~a:r~ora~~.~ ~ , bQIoW ~i Itev Fabres Cils -bution Pipr *Srm C-33 SoL100 o i i -1-Y E -I c p / Slope r`.. - ! Force Mofp pi, 'd Dra+n Qac{~ From F u r, r L c: C r Gres Sec lion Ot A Mour)-; System Usin E A Bed For Tne Absorption Arco F 40 P.()•WT•S' G f ConditionallyFt. F tAPpp,QVE ENT OF CWtAERCE I f r~fb DEPp,R7M AND EUIL011~ ~ l o Q.! L . ^ ' DIVISION Of SAFE Ft. CORRESPONDENCE l f' F t . Z y SEE Ft. Observation Pipe I K A', ! - - - Force Moin 1 - .d _ _ - _ _ _ j From Pump ~)i;fributiC~', ~eBt!d Of ' 2 - Z z t'ipe Drain Rock '>t~crrvaiior, f~ipc Permonenl Mork Pi pe or- Rods Mouse Ucinc A Bed For The Absorption At c ,GE Oi ' k ~ AMP i~Sfi,'~~ +n r w ~ e` Page Of ,pistNI6ikt ovi Pipe DetaA For A Lateral Network P~G Q i str: bu! i on Pi ere. PVC Force Main P i 't P.O.W.T.S. Conditionally VC Manifold pipe y APPROVED DEPARTMENT OF COMMERCE DIVISION OF SAFETY AND BUILDINGS 1 , 5 SEE CORRESPONDENCE x' * Last Bole Should Be Next To End Cap P Y-5 F t. S -5 Ft. X3,4~ Inches Y. -t inches ell Mole Diameter ~ Inch Lateral Diameter /Z Inch(es) Manifold Diameter Inches Force. Main Diarneter! Inches R' Holes Per Pipe I invert .Elevation Of Laterals 9. t. G. ~V. r PU/"\P CHAT`\EER CROS5 SEC T IOIJ AI~G EPECIFICATIO~!S VENT CAP 4 C.Z. VC"JT F!FE WEATHERPROOF APPROVE6 LOCKIAJG JUIJCTION BOX M1 A,IJHO LE ":OVE F. wi4A- - C~ = F0'1 ROOF, W (tfi1-V%. e~ WINDOW OR FRESH Iz"MIU. AIR IIJTAKE GRADE yMIIJ. 18" /"111JIJ . _ CONDUIT .o Cott i t _ ~~l - - - IIJLET PROW CE I EDRTIGH T SEAL ENT OF COMMERCE A DEPART (VISION OF SAFETY AND SUtlOlNGS I I I I E I I'~ A[ A-{M Is EE CORRESPONDENC I 11 I *APPROVED I I oli c JOINTS WITH I I ELEVYR-.~!L-T. APPROVED PIPE 3' ONTO PUMP O D SOLID SOIL OFF 5~ttri AS CONCRETE BLOCK RISER EXIT PERM( D OQLy IF TANK MAQLlFACTUR_:R HAS SUCH P..,ROVA,L - t:cPTIC f SPECIFICATIQ ►JS IF D0S TAUKS MAUUFACTURER: (/lJ Jt~MBEK OF DOSES: / PER DA-'J TAIJK SIZE: ©a GALLONS DOSE VOLUME ALARM MA►JUFAC7UiZi<R: - S► 11JCLUD 1C 6ACKFl OW: _ tl3O GALLONS MODEL ►JUMBER: CAPACII A--Z IQ S OR ~5 O GALLOWS 5WITCH TJPE: + ~ r ~ ~ B = Iti .S OR GALLONS PUMP iAANUFACTURER: Q'] C = W 5 OR /3o GALLOUS MODEL ►JUMBER. D. IN -S OR 0' GALLOUS 5WITCH TYPE: AC1 it- `M-zrIJOTE: -1'P A►JD ALARt RE TO DE MINIMUM DISCHARGE RATE ~7~ r;`p/•~ TALLED 0►J PRATE CIRCUITS VERTICAL DIFFERENCE BETWEEU PUMP OFF AAJD DISTRIBUTIOJJ PIPE- FEET ~ C-9 ~CL-` ` ID + MIAIIMUM NETWORK SUPPLY PRESSURE. , 2 FEET t; FEET OF FORCE MAIN X QL~ F/ooFT.FRICTIOU.FACTOR.. A FEET TOTAL DYNAMIC. HEAD FEET ~ t. INTERNAL DIMENSIO L OF TANK: T IC N LIgUIL DEPTH ' SIGIJED: LICE • x._ ►JSE tiJUMBER. - DATE: 6 /y S~~~mersible Effluent Pump r EP04 l EP05 APPLICATIONS • Fasteners: 30G series • Fu ly submerges 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 :tficient strength, and durability. • Effluent systems dry without damage to heat transfer. a Motor Cover: ThermoPlas- • Homes components. tic cover with integral handle • Farms Motor: manual l o for tio,,. Automatic and float switch attachment • Heavy duty sump • EP04 Single phase: 0.4 HP, anmatic models include mechanical points, • Water transfer 115 or 230 V, 60 Hz, 1550 M Power Cable: Severe du RPM, built in overload with Float Switch ass~inbled and duty • Dewatering preset at the faci-,ry. rated oil and water resistant. automatic reset. SPECIFICATIONS • EP05 Single prase: 0.5 HP, ■ Bearings: Upper and lower 115 V, 60 Hz, 1550 RPM, FEATURES heavy duty ball bearing Pump; EP04 built in overload with construction. s EF04 Impeller fhenno- • Solids handling capability: automatic reset. plastic Semi-opus, design '/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 I,~ es f o on. • Total hearts: up to 24 feet, with three prong grounding SP C;,nadianStandards Association • Discharge size: 1'12" NPT. plug. Optional 20 foot w EF05 Impeller- I hcnno CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed (;esign for improved pedow m;e end in or "AC".) rotary/ceramic stationary, three prong grounding plug BUNA-N istofneis. (standard on f P05) a Casing and limiged • Temperature. then ioplastic des (in piovides 104°F (40°C) continuous super for Strength :ind 140°F (60°C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 • Capable of running dry without damage to 9 30'-.____. ~~-5GPM. - componenis. Pump: EP05 e t-2.5Fr • Solids h,-roiing culpability: /4" I laxinluin w v • Capacities: al s: heads: u up to to 60 31 GPM. feet. s 201 i • Discharge size: 1'/" NPT. Z 5 • Mechanical seal: carbon o 15 rotary/ceramic stationary, o a I I BUNA-N elastomers. EPOS • Temperature: 3 10 , - - _ ! - - 104°F (40°C) continuous 140°F (60°C) inter ittent. z ; EPOa '10 SO GP~ jp C 2 1 a I 12 ml/h CAPACITY ,v G. 1995 Goulds Purnps, Inc. Effective may, 1995 83871 _ Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division ~o~f Safety and Buildings Page of Buret of Integrated Services in accordance with s. ILHR 83.09, Nis. 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 O j percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.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) (rn)). Property Owner Property Location Govt. Lot 1/4 ' r 1/4,S T N,R j E (or W Propert y Owner's Mailing Address Lot # Blo a Subd. Name or CSM# r city State Zip Code Phone Number ❑ City 1 Village Town Nearest Road ❑ New Construction Use: Residential / Number of bedrooms Ado ;ion to existing building Replacement ❑ Public or commercial - Describe: Code derived daily flow gpd _ Recommended des: pt loading rate v bed, gpd/ft2 •c- 'trench, 9Pd/ft2 A Absorption area required bed, ft 2_ trench, ft2 Maximum des: ;n loading rat bed, gpd/ft2-fi trench, gpd/ft2 Recommended infiltration surface elevation(s) ._ft (as referred to site plan benchmark) Additional design/site considerations ft Parent material Flood plain elevation, if applicable , S = Suitable for system Conventional Mound In-Ground Press .,re AT Grade System in Fill Holding Ta k U = Unsuitable for system El s U S El U El s ~1, ❑ S U El S ~ E:1 SU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft2 g Texture Consistence Boundary Roots f in. Munsell Qu. Sz. Cont. Color Sz. Sh. Bed , Trencrt I ~q i / r Grouno 1Y_\ -r elev., - I~- -i ft. % i rr ire ~4 fd r; Depth to limiting fa el" cto -t in. _ Remarks: ?-;L Boring # r ty, Ground ! r f ~i✓~ elev.. , ~ , ft. Depth to r limiting factor in. Remarks: CST Name (Please Print) Signature Telephone No. Address _ Date CST Number SOIL DESCRIPTION REF PROPERTY OWNER 'age of _ PARCEL LD.# Boring # Horizon Depth Dominant Color Mottles ucture 2 g Texture Consistence Boundary Roots G~pjft in. Munsell Qu. Sz. Cont. Color -3 Z. Sh. Bed Trench 17' 'a I J' 4/ n w Ground /9 eleN - / I, Ltt. Depth to limiting actor in. 1 Remarks: Boring # - - Ground elev. - - I Depth to - - - - I limiting factor __in. Remarks: riorizon Depth Dominant Color Mottles ,ructure GPD/ft2 Texture: i Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color I Sz. Sh. Bed Trench Boring # Ground elev. Depth to I limiting l factor in. Remarks: Boring # ! - ---1-- ail i Ground elev. Depth to limiting factor in. Remarks: 1 SBD-8330 (R. 07/96) Soil Test Plot Plan Project Name Patrick Steinberger h ✓ran Bird Jr, Address 255 Co Rd K Clayton Wi 54004 ' C:~TM #3479 Lot Subdivision Date 0'/1$/97 SE 1 /4 SE 1/4S7 T 31 N/1315 W Township Forest Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft.Base of Metal Rod with Orange Ribbon System Elevation 9765 * H R P Same as Benchmark 4% BO Slope B.M. El 1 B-3 B-2 cr L~ C CD r Garage CD Pro 3 Driveway to 270th St. Bedroom House Existing House on Well is Located 18o' Site is to be Coverted East of B-3 to a Storage Shed 270th St. : rn, ra PLOT PLAN PROJECT Patrick Steinberqer ADDRESS 25510-0. Rd K Clayton Wi 54004 SE 1/4 SE 1/4S 7 /T 31 N/R 15 TOWN Fores: COuN Y ST. CROIX MPRS Shaun Bird 3532 5' 18/97 cEDROOM 3 DATE CONVEN'T'IONAL IN-GROUND PRESSURE CONVENTIONAL :,I1"T HOLDI TANK MOUND XXXX SEPTIC TANK SIZE 1000 Gallons LIFT 'L'ANK SIZE D, >E TANK SIZE 800 Gall HOLDING TANK SIZE LOAD RATE 1.2 ABSORPTION AItEA 375 BED S GE 8'X 47' BENCHMARK V.R.P. Base of Metal Rod with Orange ASSUME ELEVATION 100' ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION B-1 Area 25' B _ n 4% Downslope to M'-' Slope Remain Dose Tank to be Undisturbed Provided with Approved Warning Label and Lock Down Cover B } DT B-3 ST Mound to be installed along ;hem Tanks to be Contc,,ir Line Properly Bedded Scale 1/4' = 10' ° Garage r Pro 3 Bedroom House Drivew.ry Existing House on Site to be Converted to a Storage Shed and not used for Living Quarters Well 270th St. - v on-Woven Filt Fabric ;,it ~Diilr ulion Pipc .r . r Stop-c--- I i= - i Force Mot Fi,..-d c... from Fun Lc;cr f E _Cress Section Of A 1.-!ounc; system Usin A Bed For The Absorption Arco F G c A O _ Ft. Ft. -Ft. kf Ft. ~~W•~ t . Ouservclion Pipe j i - - A I - J. ~ - Force Moin From Pump Distribulio Bed Of F'lpt Drain RocK ?beer va ion Pipe Pt rmonenl Mork Pi ot: or Rods Pv1Uu~iU ' Orin!, : ~ 8r.. For The AbSorplion Ar GE -OF Page Of I>c: De ta~ For A Lateral Network PVC Force Main % ' - X Last F4 le Should Be Next To End Cap P Ft. S Ft. X-3,6 Inches Y Inches • - Hole Diameter i n c h Lateral Diameter Inch(es) Manifold Diameter vC Inches Force. Main Diameter Inches fl holes Per Pipe f qq invert Elevation Of Laterals . J Ft. 'A(0 G F PUMP CHAMf;ER CROSS SEC T IOQ AIJG SPECIFICA'ryjs VENT CAP C. T_. V "JT FIFA WEATHERPROOF APPROV LOC41NIG y _ c Rv OR. JUNCTION BOY AIJHOL, LOVE F. WINDOW OR FRESH 12'MIU. TT AIR INTAKE GRADE I y.. MIN. I 18" MI IJ. CONDUIT 1&"M 11.1. INLET PROVIDE AIRTIGHT SEAL I I i I * I I I I / w A I III I III II At cM 1.7 I I I 8 *APPROVED I I Kli JOINTS WITH I I ELEW FT APPROVED PIPE 3' ONTO PUMP O D SOLID SOIL CONCRETE BLOCK -x- RISER EXIT PERMI7rED ONLY IF TANK MAIJUFACTUF,~-R HAS SUCH n P OVA/ SEPTIC f SPCCIFICATI0QS DOSE TANKS MAQUFACTURER: CAL NUMBER OF DOSES: J PER DAy TANK SIZE: Oa GALLONS DOSE VOLUME ALARM /`1AULIFACTURER: S INCLUD J, DA,KFLOW: 3o GALLONS P10DEL NUMBER: CAPACII A IM( 5 OR ~/0 GALLONS SWITCH TJPE.: g = IIJ: S OR ' GALLONS PUMP /1ANUFACTURE R: I C=SZ~1 IIJ: 5 OR 13 ~ GALLONS MODEL NUMBER: D= IN =S OR 120 0 GALLONS SWITCH TYPE: i'-- Yv'- MOTE: -,P AMD ALARr RE TO DE TALLER ON ARATE CIRCUITS MINIMUM DISCHARGE RATE ~7y G M VERTICAL DIFFERENCE DETWEEU PUMP OFF AND 015TRIBUTIO►J PIPE..- ~ FEET + MINJIMUM NETWORK SUPPLY PRESSUR77E~/. E 5 FEET + FEET OF FORCE MAIN X f ba 100FTFRICTION FACTOR.. " .3/ FEET ~ TOTAL DYNAMIC HEAD OOJJ „C- FEET' J INTERNAL DIMENSlO i OF TANK: LENGTH ---2-;WIDTH ~ ;LIQUII DEPTH C ^ SIGIJED. LICENSE NUMBER: - DATE: k /v ~ac)i 1d submersible` Effluent Put :p Cei 3871 E F E I APPLICATIONS • Fasteners: 300 series • Foy submerged in high ■ N; jr Housing: Cast iron stainless steel grade turbine oil for for ;lent heat transfer, Specifically designed for the . Capable of running lubrication and efficient stre u, and durability. following uses: dry without damage to heat transfer. ■ h r Cover: Thermoplas- • Effluent systems components. tic r with integral handle • Homes Motor: Avai;able for autumatic and art(,, a switch attachment • Farms manual operation. Automatic • Heavy duty sump • EP04 Single phase: 0.4 HP, models include Mechanical por • Water transfer 115 or 230 V, 60 Hz, 1550 Float Switch assembled and ml- ,r Cable: Severe duty • Dewatering RPM, built in overload with preset at the taclory. rate I and water resistant. automatic reset. ■ b ings: Upper and lower SPECIFICATIONS • EP05 Single pase: 0.15 HP' FEATURES he; !uty ball bearing 115 V, 60 Hz, 1550 RI M, _ Punt EP04 built in overlord with col ction. p~ a EF04 Impeller: 1 henno- • Solids handling capability: automatic reset. plastic Semi-open design '/4" maximum. • Power cord. 10 toot AGi Y LISTING with pump out vanes for • Capacities up to 55 GPM. standard length, 16/3 SJTO mechanical seal h)wtectlnn. SF adlanStandards Association • 1 otal hean~. ,Ip to 24 feel with three prosy yruundiny plug. Optional 20 loot ~ EFUS Unpellef 'ncilno- • Discnargc size: 1112" NPT. I plastic enclosed (rt;slgn for (C~ led model numbers • Mechanical seal carbon length. 16/3 SJTW wilts en. F" or "AC".) rotary/cei;)Imc-stationary, three prong grounding plug nlproved perlorn~~rnce BUNA-N eiastomers. (standard on F P05). a Casing and Base: Rutfged • Temperature: there ioplastic dcsifln provides 104°F (40°C) continuous super for strength and 140°F (60°C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET, stainless steel. 10 • Capable of running dry without damage to 9 30 - ~►r 1~-5GPM - , LL J components. Pump: EP05 8 2.5 Fr • Solids handling capability: 0 7 25 1/4" maximum. w f • Capacities: up to 60 GPM. _ U 6 20 Total heads: up to 31 feet. - • • Discharge size: 1'/z" NPT. z s - j EPOS • roMechanical seal: carbon- tary/ceramic-stationary, ° a is BUNA-N elastomers. o • Temperature: 3 10 104°F (40°C) continuous oa 140`'r (GJ°C) inter ittent. 1 / a. 50 GPM 0 2i 13 a ) 12 ml/h CAPACITY 1995 Goutos Pumps. Inc. Q01 995 B3871 • Wisconsin Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of Buresu of Integrated Services 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 r include, but not limited to: vertical and horizontal reference point (BM), direction and k percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # r /0 ;1 6 O APPLICANT INFORMATION - Please print all information. Reviewed by Data Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location S ' Govt. Lot S~ 1/4 Jr 1/4,S 7 T ,N,R E (or kw Property Owner's Mailin Address Lot # Block# Subd. Name or CSM# X 5s prc_J_ N/Lt l✓l City State Zip Code Phone Number ❑ City ❑ Village Town Nearest Roaq IS) 2i1 ❑ New Construction Use: J21Residential / Number of bedrooms Addition to existing building Replacement ❑ Public or commercial - Describe: t Code derived daily flow. gpd Recommended design loading rater . bed, gpd/ft2~trench, gpd/ft2 Absorption area required bed, ft2 3 trench, ft2 Maximum design loading rat - bed, gpd/ft2 trench, gpd4t2 -4- 3 25 Recommended infiltration surface elevation(s) Z ~ ✓ ft (as referred to site plan benchmark) Additional design/site considerations Parent material Flood plain elevation, if applicable ft IF: Suitable for system Conventional Mound In-Ground Pres ure AT-Grade System in FII Holding T k Unsuitable for system ❑ S ky ❑ U ❑ S u ❑ S ❑ S ❑ S U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/1`12 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench _g f r Z Ell -51 am 01 Ground _ YY1 I n ' l elev. 25 ~ft. _ 1j d" y vv, m 114 I Depth to limiting factor 17 Remarks: 5 0/ iV z4v_ ~lk kor; Boling # f n ALI 604 /1 al r YVV Ground y Ud Syr,G :V 42A' I 1 elev. ; Depth to limiting facto in. Remarks: -SO-z- C04 19- CST a (Please Print / Signature ' Telephone No. Addre Date CST Number _2/ 79 PROPERTY OWNER a ~`1 r k OIL DESCRIPTION REPORT Page of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots Gep/ft2 1- in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 7' _7 ✓ 6 a ,s ~Gro~und b o~ m- f ✓ e g li ► ft• f~ r l l-Al1A , sr- Depth to limiting actor Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots PD/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: SBD-8330 (R. 07/96) Soil Test Plot Plan Project Name Patrick Steinberger B,, Bird J ~11 Address 255 Co Rd K Clayton Wi 54004 Z~-STM #3479 Lot Subdivision Date 6/18/97 SE 1 /4 SE 1/4S7 T 31 N/1315 W Township Forest ❑ Boring ()Well PL Property Line County ST. CROIX , BM or VRP Assume Elevation 100 ft.Base of Metal Rod with Orange Ribbon System Elevation 97.65 * H R P Same as Benchmark 4% Slope B.M. B-3 B-2 0 c~ r Garage Pro 3 Driveway to 270th St. Bedroom House Existing House on Well is Located 180' Site is to be Coverted East of B-3 to a Storage Shed 270th St. STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER MAIL NG ADDRESS 0 > J~ PROPERTY ADDRESS o~ (location of septic system) Please obtain from the Planning Dept. CITY/STATE PROPERTY LOCATION .S~ 1/4, SI- 1/4, Section , T_:32 N-R_Z, W TOWN OF ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERIMUDSURVEY 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. VWe, 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. SIGNED:. DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, Wi 54016 11/93 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 Location of property ~,Z--' 1/41/4, Se ion T N-R W Township b;-e,,, Mailing address'" I' Address of site c2ac2 02 704, r~ Subdivision name Lot no. - Other homes on property? Yes No Previous owner of property Total size of property T0 Total size of parcel Date parcel was created Are all corners and lot lines identifiable? Yes No Is this pro`p~erty being developed for (spec house) ? Yes _No Volume,V~7 and Page Number as recorded with the Register of Deeds. 4 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. ~j 3-5-:::;~_, 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. Signature of Applicant Co-Applicant b i 7-q2 Date of Signature Date of Signature 553522 STATE BAR OF WISCONSIN FORM 2 - 1982 WARRANTY DEED - DOCUMENT NO. VOL 21.4. PAC[, t HEGISTE;'i'3 OF ICE Hamelot Partnership, a Minnesota partner hip ST.CROIXCO.,W1 -94 Reed for Record DEG 19 1996 conveys and warrants to Pa t r i r k T S t p i nhergp~~nri 11:30 A. M Tracie L. Steinberger, husband and wife, 0,4f, as survivorship marital property, e Heglsler of O8UG3 THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS the following described real estate in _St. Croix County, CQUA-4 -Ft.HQ, State of Wisconsin: 4t71D S. drX& #t((S t~vL~ ~f-G71 L.JJT- '5.1 'o l (o f~S t; I S,j q b ' 014-1016-90; 014-1016-80 PARCEL IDENTIFICATION NUMBER The South One-half of the Southeast Quarter (S1/2 of ,SE1/4) of Section Seven (7), Township Thirty-one (31) North, Range Fifteen (15) West, St. Croix County, Wisconsin. TRAM S= Ek j so This is not homestead property. X(YgXX (is not) Exception to warranties: Easements, restrictions and rights-of-way of record, if any. Dated this ck day of Novembpr A.D., 10 96_. H e1ot n ship (SEAL) B V !/7 (SEAL) • Fr _HaWp~A (SEAL) By: ~az (SEAL) * Paul I. Hamel AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, ss. St. Croix County. authenticated this day of , 19 Personally came before me this day of AJ A,-t--, h ~l in n e -L - - Wisconsin ,Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of Labor and Human Relations ~Q Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code q 0UNTY (b A. St. 'x Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must includ u not limited to vertical and horizontal reference point (BM), direction and % of slope, scale o # dimensioned, north arrow, and location and distance to nearest road. h 0 - /J APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION E E E DATE 7 c~ T C X 7ffilj"~ PROPERTY OWNER: PROPERTY LOC ' Patrick & Tracy Steinberger GOVT. LOTSE 11A1/4,~ R 15 f(or) W PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # D~ NAW P # F~~&~~ S'1/Z ~ _ j 255 Co. Rd. "K" na nn 8 r~CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE :DOWN NEA ST ROAD Clayton, WI. 54004 1115)948-2698 Forest 270th. St. =Replacement Use Residential Number of bedrooms 3 Addition to existing building Public or commercial describe 450 gpd Recommended design loading rate • 4 bed, gpd/ft2 •5 trench, gpd/ft2 Absorption area required 375 bed, ft2 375 trench, ft2 Maximum design loading rate .4 bed, gpd/ft2 .5 trench, gpd/ft2 Recommended infiltration surface elevation(s) 95.20 ft (as referred to site plan benchmark) Additional design / site considerations system el. based on contour line of el. 94.20' Parent material glacial drift Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ❑ S ® U RIS ❑ U ❑ S ®U ❑ S 12 U ❑ S ® U ❑ S [RU 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 1 -9 10 r4/3 none sil 2msbk mfr cs 2f .5 6, 2 9-16 10yr4/4 none sicl 2msbk mfr gw if .4 .5 Ground 3 16-41 7.5yr4/4 none scl 2csbk mvfr gw na .4 .5 elev. 95,8 ft 4 41-62 5yr4/4 c2p 7.5yr5/8 scl M na na na np .2 Depth to limiting factor 41" Remarks: Boring # 1 0-9 10yr3/3 none 1 2msbk mfr cs 2f .5 ,6. 2 2 9-19 10yr4/4 none scil 2msbk mfr gw if .4 .5 3 19-38 7.5yr4/4 none scl lcsbk mfr gw na .2 ::.3 Ground elev. 4 38-55 5yr4/4 c2p 7.5yr5/6 sicl M na na na np .2 90.7 ft. Depth to limiting factor 381, Remarks: CST Name:--Please Print Gary L. Steel Phone: 715-246-6200 Address: 1554 204e. New Richm nd WI 54017 Signature: Date: 11-1-96 CST Number: m02298 PROPERTYOWNER P. & T. Steinberger SOIL DESCRIPTION REPORT Page wof 10 PARCEL I.D. # 014-1016-90 Depth Dominant Color Mottles Texture Structure Consistence Bourxk/ Roots GPD/ft Boring # Horizon in Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0-9 10yr3/3 none 1 2msbk mfr cs 2f .5 .6 3 2 19-27 10yr4/4 none sicl 2msbk mvfr gw if .4 .5 Ground 3 27-50 7.5yr4/6 c2d 7.5yr5/6 s1 2csbk mfr na na .5 .6 elev. 90.8 ft. Depth to limiting factor 27" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) i STEEL'S SOIL SERVICE Gary L. Steel Patrick & Tracy Steinberger 1554 200th Ave. CSTM2298 SE4SE4 S7-T31N-R15w New Richmond, WI 54017 MPRSW 3254 town of Forest (715) 246-6200 t N 111=401 BM.= nail in Oak tree C el. 100, Alt. BM.= nail in Oak tree C el. 103.85' .3 e5 '10 Apt xv N i a Gary L. Steel 11-1-96