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HomeMy WebLinkAbout020-1330-90-000 ST. CROIX COUNTY ZONING DEPARTMENT 61 AS BUILT SANITARY REPORT RECEIV,ED 6 Owner X c o f/- ja re 1998 Address T=`rr ST cNaxTY C' City/State .gg.y ~.s couN 20NWGOFFI0 Legal Description: Lot Block Subdivision/CSM # S~ '/4 , Sec. 23 , T a 9 N-RAW, Town of C L~lt~ se.J PIN # OZO - 1336.90 -Q5JO SEPTIC TANK DOSE CHAMBER HOLDING TANK INFORMATION: D ,rJ o^t ll~~L Tank manufacturer h7 we s`T Size ST/PC /1244 / la6d Setback from: House a e Well P/L Pump manufacturer Cps r Model Alarm location s -e- (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM: Type of system: P7 v e wd Width )0.~r Length Number of Trenches Setback from: use ,2S0 Well ~d~D`'-Yo ' Vent to fresh air intake ELEVATIONS: Description of benchmark r 7~a /V= Elevation / o D, Description of alternate benchmark i el Elevation Building Sewer ST/HT Inlet T L4 ST Outlet Y/• 9 PC Inlet PC Bottom Header/Manifold Top of ST/PC Manhole Cover Distribution Lines `y/.7 ~ ( ) Bottom of System ( ) 41,16 /D/,& ) ( ) Final Grade O O ( ) IV Lvotj Date of installation 41Y7 Permit number State plan number S97 Plumber's signature License number Date Inspector G7 Complete plot plan I c~ .Yl~ NOTICE: Please provide the following: • A plan view sketch showing everything within 100 feet of the system. • Two horizontal reference points to center of septic tank manhole cover. • Shove alternate benchmark, if applicable. - 7--p o h ow, e~afrV- J PLAN VIEW a a T 4 O !C ~v pp b hV~ ~ a jY d rc 5'_- i INDICATE NORTH ARROW Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor andHuman Reisis INSPECTION REPORT ST. CROIX `Safety and Buildings Div Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 299118 Permit Holder's Name: ❑ City ❑ Village Town o : State Plan ID No.: HAYES, SCOTT HUDSON 39`7 -all a- p CST BM Elev.: Insp. BM Elev.: BM Description: ~P °f- ' r;D'" Parcel Tax No.: U ` loon / o D ~0 ad csT~ s - I 020-1330-90-000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic w,P /20<> Benchma% 10 / 00 Dosing N~wl~ 75a TP• _ t, 12 -6-1 42-ef Aeration Bldg. Sewer q,3,1 Holding St/ Ht Inlet ► /D 62 Z. TANK SETBACK INFORMATION St/ Ht Outlet R3•I //•2d q TANKTO P/L WELL BLDG. Ae Intake ROAD Dt Inlet G; .1 Septic f5 /'Iot, 201 VOf NA Dt Bottom -7 Dosing NA Header / Man. - Aeration NA Dist. Pipe /OS82 3 5?5 D/ 7 Holding Bot. System /OS32' q-/(", /0 /(0, PUMP/ SIPHON INFORMATION Final Grade Manufacturer 0uw Demand S~ M-„y~,,/,. ,I l~•9, 86 Model Number tPp5- 21 GPM TDH Lift 23,6gt LrictionZ.d System25- TDH21, Ft oss Head Forcemain Length3o Dia. _2 " Dist.ToWell Y\01- SOIL ABSORPTION SYSTEM BENCH Width Length No. Of Trenches PIT No. Of Pits Inside D a. Liquid Depth DIMENSIONS tool I DIMENSIONS LEACHING Manufact SETBACK SYSTEM TO P / L BLDG WELL LAKE /STREAM INFORMATION TypeO CHAMBER OR UNIT ModelN ber. ~1Z1 System: lf%w 30D DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length I Dia Length Dia. ]1 Spacing rr (p/ ~r 7L5- SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over i Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center 1'19 Bed/ Trench Edges Topsoil ' ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) ynounc( /A _ _ q~ ,q ~G 5 29 C'o„1b4i- Ve- 0 /aO.0;5 LOCATION: HUDSON 23.29.19,SE,NW 7318l WALDROFF FARM RD -'EVERGREEN OT 9 I _VN + gM To (?o,( h °"4,e 03.1 J 2 # ~d~ F--~ e4 <yev,Iewe 1 3 av' -FvrceVAC r 3IF iM~Lwe W* 11DWeel o^ 10- Q1, V16 pie ~vcyul fie P^ fr)lpdffwu,, to5~ectr Yom/ . rc=s vttt~;t' Sl~a'`:,~cwtPtfR°71t+r rig * r~<~~. S"29'"rro✓~D?5.o3' flI/0532 41" Plan revision required? E] Yes Cg No Use other side for additional information. Z, eewt_ SBD-6710 (R 05/91) F/44( (I A9 `l•7 Date Inspector's Si ature . No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: Safety and Buildings Division SANITARY PERMIT APPLICATION 201 E. Washington Ave. Vis* consin 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 y than 8112 x 11 inches in size. s'( eyo- Z • See reverse side for instructions for completing this application State Sanitary Permit Number A g9ll 6 The information you provide may be used by other government agency programs ❑ Check if revision to previous application (Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATION S - ~a Property Owner Name Property Location 747"- 64= fz ro Sr 1/4 " 1/4, 5 3 T a , N, R E (oro Property Owner's Mailing Ad,2s s Lot Number Block Number Y's-61 o y City, State Zip Code Phone Number Subdivision Name or CSM Number 4~Ag el A) eel e, A- -..-o 11 II. TYPE F BUILDING: (check one) ❑ State Owned ❑ !ty Nearest Road ❑ VI1 age Public 1 or 2 Family Dwelling - No. of bedrooms Town OF a.LS t III. 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 Recre tional Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church / School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel / Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. ® New 2. ❑ Replacement 3, ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 Z Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 42E] 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 _ 6~® 3"O D d d " - s l1- 161,1 Feet / a, Feet VII. TANK Ca ingaltoacits Total # of 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 410 f' P ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber a 762~ / e5T`eY~t/ A] ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite se age system shown on the attached plans. Plumber's Name: (Print) Plumber's Signatur : (No Stamps) MPRSW No.: Business Phone Number: 7t ~5- - 3 ?a GJ~ 'l Gaa we cc e.N ~o' 2 Plumber's A( dress (Street, City, State Zip Code): G d~ d &J ^ IX. COUNTY / DEPARTMENT USE ONLY ❑Disapproved Sanitary Permit Fee (Includes Groundwater aDate lue Issuing Agent Signa (NoStamps) Surcharge Fee) Approved ❑ Owner Given Initial 6 Adverse Determination .10 Ally X. CO NDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: S8D-8398 (R.1 V96) 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: L, 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. 111. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one or 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. V111_ 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. v SAFETY AND BUILDINGS DIVISION <a 15837 USH 63 consi c^„~ Hayward, WI 54843 '\*Asn Department of Commerce Oyr Tommy G. Thompson, Govemor 23-Sep-97 William J. McCoshen, Secretary Schumaker PI - - William SchumakerTE 1070 Scott Rd ~ H udson WI 54016 RW LaCasse Const _y Plan ID 9710402 /1/ SW<NW,23,29,19W Municipality of Hudson Inspector: Leroy G. Jansky County of St Croix (715) 726-2544 Private Sewage plans including the following element(s): MOUND 600 gpd The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, fs defined in chapter 101.01(2)(e), Wisconsin Statutes, is responsible for compliance with all`icpde reqbirements. This plan action is subject to no additional conditions. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department. All permits required by the state or local municipality shall be obtained prior to commencement of construction/installation/operation. This project is under the supervision of a state inspector. As inspection concerns arise feel free to contact the state inspector et,the.number listed. The inspector for this project is listed above. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Please refer to Plan ID number listed at the top of this page when making an inquiry or submitting additional information. Sincerely, Carl LippertWastewaterSpecialist • (715) 634-3484 t RESIDENTIAL MOUND DESIGN INDEX AND TITLE SHEET Project MOUND INSTALLATION Owner R.W. LACASSE CONSTRUCTION Address 1220 OAKWOOD LANE HUDSON, WI 54016 Legal Description SW 1/4 OF NW 1/4, S 23 T 29, N,R 19 W Township HUDSON County ST. CROIX Subdivision Name EVERGREEN ESTATES Lot No. 9 Parcel ID Number PENDING z Plan ID Number F=H8~ INDEX SHEET PAGE ONE MOUND CALCULATIONS PAGE TWO MOUND DRAWINGS PAGE THREE PRES. DIST. CALCS. & LATERALS PAGE FOUR PUMP TANK DRAWINGS PAGE FIVE PUMP SPECIFICATIONS PAGE SIX SITE PLAN PAGE SEVEN Designer BILL SCHUMAKER License Number 227990 Signature Phone No. 715-386-3121 Date 8/18/97 p.O.W.T.S. Notice: Tampering with this file by unayt~aorizeibited. Deliberate modification will result In dis r under s. 46.10, Wis. Slats. SBDA0462-E (R.04M7) P&PIR~~ E of DEPARTMENT Of AND ON OF SAFE NDO , 7 SEE CO ESpONDENCE 212 RESIDENTIAL MOUND DESIGN Eight Bedroom Maximum Complete information in red framed boxes as necessary. (y or n) n Is the system over creviced bedrock? Slope 4 % Number of bedrooms 4 Wastewater flow rate 600 gpd 2271 Lpd Depth to limiting factor 34 in 86.4 cm In situ soil infiltration rate (code) 0.5 gpd/ft 20.4 Um` Contour line below the upslope edge of absorption cell 100.1 ft 30.51 m Use standard fill depths? L~ OR Designer speed depth in cm Place X In box to use standard depths (12, 24, A+4 Inclusive) OR specify design fill depth. Center or end manifold (c ore) Estimated hole space 5 ft Not a final calculation. Lateral spacing FoRft Minimum dose 10 times void volume Use a 0lateral spacing for trenches. Pump tank elevation 79.25 ft Outside bottom of tank. Number of laterals 2 Force main diameter 2 in Force main length 220 ft Force main actual dia. 2.067 in SYSTEM SOLUTIONS Inch-pounds Metric Cell media "x" one only. Estimated daily flow 600 g p d 2271 Lpd x Aggregate and pipe Chamber and pipe Absorption cell Design load rate & area 1.2 gpd/ft2 500.0 ft' 46.45 m` Linear load rate 6.0 gpd/ft 74.4 Lpd/m Design width (A) 5 ft 1.52 m Cell length (B) 100.0 ft 30.48 m Depth of cell (F) 9.7 in 24.6 cm Sand filter Upslope fill depth (D) Oft' in 30.5 cm Downslope fill depth (E) in 36.6 cm Basal area required (gpd/infiltration rate) 111.48 m2 Supporting components Topsoil depth 6.0 in 15.2 cm Subsoil depth at center 12.0 in 30.4 cm Subsoil depth at cell wall 6.0 in 15.2 cm End slope toe length (I) 10.2 ft 3.11 m Upslope toe length (J) 7.5 ft 2.29 m Downslope toe length (1) 10.3 ft 3.14 Lm Total mound length (L) 120.4 ft 36.70 Total mound width (W) 22.8 ft 6.9 9.T. . Project: MOUND INSTALLATION Canona, ly Plan I.D. S97-00000 ® T~ 2 of ~~{tTME0 OF COMMEVt DIVDE N F SAFE? AND BUILDINGS SEE C ESPONDENCE MOUND PLAN VIEW observation pipes (typical) I W= 22.8 ft q A= 5.0 ft 1.52m 6.95 m T O A% B= 100 ft 30.48 m B "K J= 7.5 ft 2.29m I I = 10.3 ft 3.14 m K= 10.2 ft 3.11m L = 120.4 ft 36.7 m typ. obs. pipe A X B refers to absorption cell width and length (anchored securely) J = upslope width I = downslope width K = end slope dimension 6'(150 mm) T MOUND CROSS SECTION T, D = 12.0 in 30.5 cm subsoil cap lateral topsoil r H E = 14.4 in 36.6 cm invert 101.6 y F = 9.7 in 24.6 cm elev. 30.97 m see note ;IMF G = 12.0 in 30.4 cm 11, H = 18.0 in 45.6 cm D E ASTM C33 Sys. 101.1 ft ~i Sand Fill elev. 30.82 m 100.1 ft contour 4% 30.51 m slope Note: Absorption cell media will D = upslope fill depth plowed layer consist of aggregate and pipe E = downslope fill depth or leaching chambers and pipe Aggregate F = absorption cell depth as specified MChamber G subsoil + topsoil depth at cell wall at right. H = subsoil + topsoil depth at cell center Designer notes: If aggregate is used, it is covered with code compliant material. wxS conditionally Project: MOUND INSTALLATION A Plan I.D. S97-00000 DEPARTMENT O4F0 M191M R D to I of SAFETY AND BUILDINGS SEE G ESPONDENCE PRESSURE DISTRIBUTION CALCULATIONS Absorption cell Inch-pounds Metric Width (A) 5 ft 1.52 m Length (B) 100.0 Ift 30.48 m Lateral specifications Number laterals 2 Holes/lateral 10 holes Lateral length 48.3 ft 14.8 m Perforation dia. 0.25 in 6.4 mm Lat. dis. rate 11.65 gpm 0.7 Us Sys. dis. rate 23.30 gpm 1.5 Us Hole spacing 61 in 154.9 cm Lateral diameter Pipe diameter Design options Design choice Designer must 1 in/25 mm Place X in red "X" one choice 1 1/4n/32 mm X x box of chosen from the options 1 1/2in/40 mm X diameter. provided. 2int5O mm X 3in/75 mm X Manifold diameter Pipe diameter Design options Design choice Designer must 1 in/25 mm "X" one choice 1 1/4n/32 mm None required from the options 1 1/2in/4o mm No choice necessary. provided. 21n/50 mm X 3inr75 mm 4n/100 mm Distribution system contains 2 lateral(s) LATERAL DIAGRAM - CENTER CONNECTION Place correct lateral diagram by clicking in one of the drawings at right and dragging the diagram into this area. P I end cap • • IE- x-+-x12 I x1241 Laterals & force main of PVC Sch 40 Last hole drilled next to end cap (per COMM Table 84.30-5) Holes drilled on the bottom of the lateral, equally spaced • =permanent end marker Inch-pounds Metric Lateral length (P) 48.5 ft 14.78 m Lateral spacing (S) 0 ft 0.00 m Manifold length 0 ft 0.00 m Hole diameter 0.25 in 6.35 mm Lateral diameter 1.25 in 32 mm Number of holes per pipe 10 Invert elevation of laterals 101.6 ft P.Q 30.87 m Project: MOUND INSTALLATION Conc tionally Plan I.D. S97-00000 Ya9 OMMERCE Al N p~ SAFETY ND BUILDINGS plVl SEE GOR PONDENCE Total dynamic head System head = 3.25 ft 9Nm m Vertical lift = 21.60 ft m Are laterals the highest point in the Friction loss = 2.14 ft m system? Yes "x" here. Total dynamic head = 26.99 ft If no, what is the highest elevation Dose Volume downstream of pump? L.~ Lateral void volume = 7.5 gal 28.4 L Force main drain Minimum dose = 150.0 gal 567.8 L back to tank? (')('one) Drain back = 38.3 gal 145.0 L x Yes ZD Dose volume = 188.3 gal 712.8 L No Typical Pump Chamber Layout In combination with state approved treatment tank. Tank construction as per Comm 83.20(3) WAC. approved manhole cover weather proof wMarninq label and padlock -73 ~ grade levels grade levels junction box /a quick disconect -1-7 I alternate 2 u 4' vent pipe electric as per NEC 300 and F-- outlet Comm 16.28 WAC location 18" (46 cm) min.-- 1~ 2 ?2 wall of pump kr approved chamber or outlet combination joint tank A 114^ vveep Grade levels alarm on hole as pump tank manhole = 4" min. above finished grade pump on B necessary pump tank man. =100 mm min above finished grade vent = 12" min. above finished grade pump 80.0 ft C vent = 300 mm min. above finished grade off elev. 24.4 m D F- -LJ 3 " 75 mm of bedding under tank and anchor tank as necessary 79.3 ft Pump tank elevation 4.2 m bottom of tank Tank specifications: Midwestern Precast Pump tank = 17.44 gal/in Pump tank volume = 750 gal Capacities: Inches Gallons A= 24.2 422.2 Pump manufacturer: Gould B = 2 34.9 Pump model number: EP 05 C = 10.8 188.3 D = 6 104.6 Project: MOUND INSTALLATION of Plan I.D. S97-00000 (Iitioa I I y GIVED "i. iiENAit ' EN1 0 CND BURDINGS ONU SAFETY ESPONDENCE PAC,= b ~F Z Goulds i R 17, 11 - 3871 EP04 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high m Motor Housing: Cast iron stainless steel. grade turbine oil for for efficient heat transfer, Specifically designed for the . Capable of running lubrication and efficient strength, and durability. following uses: dry without damage to heat transfer. m Motor Cover: Thermoplas- • Effluent systems components. tic cover with integral handle • Homes Motor: Available for automatic and and float switch attachment • Farms HP, manual operation. Automatic points. • Heavy duty sump • EP04 Single phase: 0.4 50 models include Mechanical • Water transfer 115 or 230 V, GO 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 AGENCY LISTING 3/4".maximum. • Power cord: 10 foot with pump out vanes for *,Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. Co. Canadian Standards Association • Total heads: up to 24 feet. with three prong grounding m EP05 Impeller: Thermo- Discharge size: 11/2" NPT. plug. Optional 20 foot plastic enclosed design for (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with end in "F" or "AC".) rotary/ceramic-stationary, three prong grounding plug improved performance. BUNA-N elastomers. (standard on EP05). - ■ Casing and Base: Rugged thermoplastic design provides • Temperature: superior strength and 1040F (400C) continuous 140°F (600C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 I + • Capable of running _ - - -►~~-5GPM dry without damage to 30 components. Pum : EP05 25 1 Qtj- JLA J.. • Solids handling capability: 0 7 3/4" maximum. W _ - - • Capacities: up to 60 GPM. 6 20 • Total heads: up to 31 feet. a Discharge size: 11/2" NPT. Z 5 • Mechanical seal. carbon o 15 - rotary/ceramic-stationary, a 4 EPOS! - BUNA-N elastomers. o • Temperature: ~ 3 10 - 1040F (40°C) continuous EP04 140°F (60°C) intermittent. 2- - 5 0 00- 10 20` ` 30 40 50 GPM 0 2 4 6 8 10 12 ml/h CAPACITY ©1995 Goulds Pumps, Inc. Effective May, 1995 B3871 w 7 PLOT PLAN Scale qo t Page Of BM1=--od dA I" AJB ale- = Iad.oo BM2= No~+h 3My 9-0 D o Nod- CO^PACI- , 40 0& 0%SjV46 ~ T~R~S Rdie/1 Sub&i(A C)N~`ht ~ UN l~ loo-1 00. e IA\/ wl~? 23 220' t=oad MA\n) P.T. r-tev. ~~•ts, i N:T. Rwoi 3y 0 s l Zvi ~s K aPPr~ X .5~ All elevations shown c re existing ground elevations unless noted differently. Setbacks to meet or exceed the following; Mom absor6on cell 5' - lot fine; 10'- water service, unihabited slab; 15'- habited slab, swimming pool- ` . w 25' below grade !foundation, habitable building, public water main, cistern; 5Q' S- iVi l4ryh watermark from septic tank fr 11 2' - lot or property line; 5' - All structures, swimming pools; 10'- undergro dstern 25'- well, high watermark 1'~~► NT GF coMN1ERCE UE~'pR1tJ1E ND BUILDINGS D GN iif SAFE7Y SPONDENGE SE.F CO 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 9 1/2 x 11 Inches in size. Plan must County Include, but not limited to: vertical and horizontal reference point (BM), direction and G/i?0/ X percent slope, scale or dimensions, north arrow, and location and distance.to nearest road. Parcel I.D. # p e'A-)D i N 6- 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 110R/36060 GA•ND ee& . Govt. Lot SW 1/4 AV 1/4,S Z3 T 2-7 N,R /q / E (or W( Property Owner's Mailing Address F ST 1-40 157- )UAT-. Lot # Block# Subd. Name or CSM# 33Z N~NNQS0T-A, :57 h~K rr G-- . 9 ~vER~riPEE~v E5T~4TE'S City State Zip Code Phone Number Nearest Road 11401.. /Z ST PAU L- N1N~ 56 10 &12-) Z'L2- SSSS ~~iV El Village Town d4l h~rZZY /,ZZ . Off"New Construction Use: Residential / Number of bedrooms 3 - Addition to existing building ❑ Replacement ySo ❑ Public or commercial - Describe: - Code derived daily flow & 0 O gpd Recommended design loading rate ' ~ bed, gpdN - F trench, gpd/ft2 Absorption area required __M0 bed ft 2 s0 trench, ft 2 Maximum design loading rate -'bed. gpd$ - trench, gpd/H2 Recommended Infiltration surface elevation(s) $EE PY ' 3 ft (as referred to site plan benchmark) Additional design/site con ations/~ A V/IFS A-e D Parent material 5CS 8 P/'/~0 T ' S,}r 'c- ~p~/.yS • ,v Flood plain elevation, if applicable S = Suitable for system conventional Mound In-Ground Pressu AT-Grade System in Fill Holding Tank U= Unsuitable for system ❑ S [0,6, Q s p u C1 S O s~ ❑ s p-0 ❑ s SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure Consistence Boundary Roots GPD/ft2 In. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Bed Trench l / o -lo lo ye 3/3 LS / s CS /f 8 7- 0 IV 7/r Ground 3 elev. d, S a 5 7 5- Y/ F Zdz Depth to limiting s1l Iv G factor Remarks: Boring # -/3 lo Y/e 3/3 LS 14-M d.5 c5 R Z i 3 -a /0 3t LS / C's 7 ' . F n -3 /o yR S/ S. O, 574 3 t' G . S Ground 7 ' /Q s/ 134.N,0,LCV .s $ elev. /oo, ~/O-ft. .Yt~ Ici s ~C ,~G ; Depth to limiting fact r in. Remarks: CST Name (Please Print) 2 r-~ Signature Telephone NO. L Address SOIL DESCRIPTION REPORT PROPERTY OWNER of Page 2 PARCEL I.D.# 1/0 _94~_ / Faw e ms Boring # Horizon Depth Dominant Color Mottles Structure 2 In. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench 3 a /3 /0Y1 3/3 L / fl z 3- ioy 31L S 400 Ground .4 /Q S U -~.v E s pelev. S C s S , ~4 ~ft. /O t .S~ 13A-V P6V S. a 7~ s' 2 L SL N N Depth to ~r 7•5 limiting factor Lin. tic Boring # Ground elev. ft. ' Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots QVDA? In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. _ Bed , Trench Boring # Ground elev. ft. Depth to limiting factor In. Remarks: Boring # Ground elev. n. ' Depth to limiting factor , in. Remarks: SBDW-8330 (R. 08/95) w N UJ r . • ~ o Cil o c 4` o ~ ~ N r C Z' Q c~ w O CIZ ~ . V D I = (o N r'n 0 m ~ I c000 0 O m r. M N00° 13' 54"E -b ~((OOo O DAD m 230.00' I o~" N M Do -c rn N~3°08'36, n 0. 85~ N { m c 40 ° R ° v m I c' y °zi N CF) N N m n • t0 N I . 00 -q m cn W W 01 0 _o mD 41 W ° %O N O W zm 0 tONCON 01 ~D I 0 Zr. OD p W-WA O N~ m - NAN O m D N (A OnND RI (71 ~ m ~ O) OVOm -'1 Ir ~ ~ ~ ~N D O - 0 _ /4 IV z I ~ \e3, 3j 0256„E o m I~ 0 Q M o cn y ~ p W N m-~~~` O \ cW0 W W p m m 14 W l0 N m O m 69 O s33 ° • 9~ O Iv - •Z •9?' S 06. \ D o $ g \ ti`33o Ob h' W o o Z C. \ 2g . m wi O W O os',d~ 409 --~i O A m \ F °j t' ~ m 33 20 is 3 9 40 v c .d m •92 9 ~ n •89, J~ y~c' C, CD m p D J N o N r \ Q' D COD M"ca =V m 0) b o w N • - y w _ z O O OD (D v 01 W N m (D W (D 0 OD ° c 'n W -1 CD co cn o ct m -n N V/ 'D n -i 1 Ky ° 01 -4 2 C, O \0j Z Gj ° P w~ N ,A (pp ~QN O N r O r c~ W N pq` GD O Ln cc o W GD O 0 01 O p rt OD D C p Q m ~ o• m cA O y p p t+ 'a ~ r K w n -(271.49'- e y 230.00' 70.97' 394.83' S T C - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYE ADDRESS -734 FIRE NUMBER yc CITY/STATE _IkUja-.._- u~ ZIP yO~(n PROPERTY LOCATION: 54114,&_42114, SECTION Z 3 T_?-!!JN-R 1 J W TOWN OF1 laj 56-- - , St. Croix County, SUBDIVISION_ 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 a 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/lle, 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 Co. Zoning officer within 30 days of the three year expiration da e SIGNED: Zca DATE • _ /C> St. Croix co. Zoning office 911 4th St. Hudson, WI 54016 STC-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 ~n delays of the permit issuance. ,should this development be intended for resale by owner/contractor,(spec house), thenta 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~1/4 AlQ 114, Section -L-3, Township Mailing address 35'0 o r,f f- LAJ s Address of site 7 GJ~ / ~ x'r' 41.,"': ~ 04 z Subdivision nameCtJ _-4 _ A Lot no. L . other homes on property? yes ✓ No Previous owner of property 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/,;?7/ 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 & 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. "71j,Z , and that I (we) presently 4 VIOL PACEZ~ ~ooo/a STATE BAR OF WISCONSIN FORM 2 - 1982 567147 WARRANTY DEED DOCUMENT NO. - - - - - - - - - _ _ r I RPISTER'S QF'FICE -Richard w r masse and G-race j. LaEassP I ST, CROIX C©. WI I; htlshanr and R@Wd for Rog4rd OCT 2 0 1997 conveys and warrants to Ccaf t R Hayes-and Tamara 11:45 A M Ham, _btisbanrl and wife, Re tster 4aed~ II THIS SPACE RESERVED FOR RECORDING DATA - - - NAME AND RETURN ADDRESS the following described real estate mi Croix County, State of Wisconsin: ~v - 53 jI PARCEL IDENTIFICATION NUMBER ii ti I' Lot 9, Evergreen Estates in the Town of Hudson, St. Croix County, Wisconsin. i, i~ TRANSFER This ii 3S not homestead property. *~X (is not) I Exception to warranties: Easements, restrictions and rights-of-way of record, if any. I Dated this y A.D., 9 da of j ' (SEAL) (SEAL) \j V Bi_chard W_ T,aC'as-go 'I (SEAL) - (SEAL) li * r AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, i K. eViy ts~ h t o* St. Croix y4 County.