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HomeMy WebLinkAbout024-1029-90-000 ST. CROIX COUNTY ZONING DEPARTMENT " AS BUILT SANITARY REPORT 4 Owner Address City/State l CCOT Legal Description: w Lot Block Subdivision/CSM # so NA~ Sec. A, T ~EN-RAW, Town of Alho, NN # 002 y `a x? TD O X4 log-7 so SEPTIC TANK DOSE CHAMBER DING TAN ORMATION: Tank manufacturer Size ST/PC 8 etback from: House /.2 Well 7/L Pump manufacturer Model 1-3-7 - - Alarm location fl 0"4.q.- (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM: l Type of system: Mo- -JQ Width Length Number of Trenches Setback from: House Well PAL Vent to fresh air intake ELEVATIONS: Description of benchmark //0", 1-20 Elevation °O a Description of alternate benchmark,. a ra . Elevation l oo i/9J79 Yr ra, 6 Building Sewer 3. 7 $ ST/HT Inlet Re 93, -~3 ST Outlet- 9 9 3c6 PC Inlet qz. / PC Bottom S 8, sg" Header/Manifold / o o , 0 3 Top ok:g)PC Manhole Cover 49 6 y Distribution Lines / o a , o Bottom of System O 9 9 . O ( ) Final Grade O ® S~ O ( ) Date of installation /10 /QBPermit number _ a2-5 ' 33 3 State plan number S l ° 18 f 8 Plumber's signature - License number P> 3 Date /10/ Q Inspector e%u complete plot plan er 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. • Show alternate benchmark, if applicable. i n) PLAN VIEW ro? O.u.AI-e f O ~ I ~ 3® 0 ff II I( l~ INDICATE NORTH ARROW o (3 tY1 I 'r4- la~ Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: fely and•Iu ions Labor S Safety and Buklydings ngs Division INSPECTION REPORT ST. CROIX (ATTACH TO PERMIT) v Sanitary Permit No.: GENERAL INFORMATION 284333 Permit Holder's Name: ❑ City ❑ Village Town of: State Plan ID No.: RAIHALA, WILLIAM PLSNT VALLEY CST BM Elev.: Insp. BM Elev.: BM Description: Su"r 4s if S T'5 Parcel Tax No.: ( C7 L7 I >C___1 11 11 l d orb 024-1029-90-000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ! - VC-7p t c, Benchrrw ,,E, j02 105.0 Dosing } e 1Z1 V1. 0 % 7 lam? . C~~, Aeration _ Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet{ o~ TANK TO P / L WELL BLDG. Air Intake ROAD lnw- Septic NA 5b n oc- el Dosing C10` A.> NA Header/ Man. (b7. S 00 03 Aeration NA Dist. Pipe (a?-53 7 • Sr /00~Oy Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand % W41 i g 6~we, $ q ' Model Number ~?5-7 ~SGPM t 14-2,X F 0) TDH Lift S} Friction Systems TDH I q. fft t~ T Forcemain Length 1 pZ' Dia. HH y Dist. To Well A C4 , 16 G. 1 U 0 -Cd S ABSORPTION SYSTEM 9Prx e5)`lei 7•!;^-q k4se lcxc> _VtBED~ TRENCH Width Length / No. Of Trenches PIT No. Of Pits inside D a. Liqu epth btMENSIONS ' Q DIMENSIONS LEAC Ivid rer: SETBACK SYSTEM TO P / L BLDG WELL LAKE /STREAM INFORMATION TypeO CHA BER er: Syste ►~E%~ , OR U MN DISTRIBUTION SYSTEM Header / Ma ifold j~ Distribution Pipe s)~ x Hole ize~ x Hole Spacing Vent To Air Intake Length ~3ry Dia. Z Length Dia. ~ Spacing I4 e SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over rr Depth Over xx Depth Of 7~tt~ xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges 12, Topsoil bD Yes ❑ No Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) ~o 5 G 9g.y/ 16. 2_-7_ 9o.z4 ~8.~fa LOCATION: PLEASANT VALLEY 21.28.17.183,SW,NW 275 170TH STREET ' Uje (I wa-I a.1 yo, Vic ke!~, LIP. , qq .JO2, -4 P~ Plan revision required? Yes ❑ No Use other side for additional information. I I J F FT I SBD-6710 (R 05/91) Date Inspector's Signature Cert. No ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: Safety and Buildings Division SANITARY PERMIT APPLICATION Bureau of Building Water Systems 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Permit Number a213-3 3 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)J. State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION Property Owner Name Property Location • ra ~W1/4 V 1/4,SX T g ;7 N, f7 E(or W Property Owner's Mailing Ad ress Lot Number Block Number :Z -7 --X SA -.Is 101"AWO-1-4d City, State Zip Code Phone Number Subdivision Name or CSM N mbe A c /-X5 f Vill /p Nearest Roa II. TYPE OF BUIL ING: (check one) ❑ State Owned ❑ ityage ❑ ❑ Public 1 or 2 Family Dwelling - No. of bedrooms s~- own OF 1o III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment / Condo © -Z 16:z? 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 / Mote[ 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF RMIT: (Check only one box on line A. Check box online B, if applicable) A) 1. ew 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5_ ❑ Repair of an _____System-__-____System______----- __TankOnly-_-------------------------------------------------- Existing System -___-Exlstln-----m 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 [Mound 30E] Specify Type 410 Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate S. Perc. Rate 6. System Elev. 7. Final Grade ~-7 Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) $ Elevation < 73s- 7 3 S r Feet / O Y'. 9 Feet VII TANK Capacity . FORMATION in Total # of Prefab. Site Fiber- Exper. gallons Gallons Tanks Manufacturer's Name Concrete Con- steel glass Plastic App New Existing strutted Tanks Tanks Septic Tank or Holding Tank jaaA C~-U-t AO 91 Li Lj_ Lift Pump Tank /Siphon Chamber 68 C7 f Kt VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) ` Plumber's Signature: (No Stamps) M PRSW N Business Phone Number: F .~c~v, ~ju~~e © 7fs~z~~-3.3zz Plumber's Address (Street, City, State, Zip Code 6 7 IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved San ary Permit Fee (Includes Groundwater Date Issue Issuing A nt Sig s) ❑ o~~ C Approved Owner Given Initial Surcharge f ee) ,~y{~ Adverse Determination v;`d'c./ X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SHD-6398 (R. 05/94) DISTRIBUTION: Original to County. One copy To: Safety & Ruildings Divi 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. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD-6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form- IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. nDentofnd~0~ SOIL AND SITE EVALUATION REPORT Page! a 3 Labor and Huron Relations Division of Saity a Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY ST G,pOi'X Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (113", direction and % of slope, scale or PARCEL I.D.4 drrwnsioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER lvM . PROPERTY LOCATION GOVT. LOT 5W 1/4 Vk! 1/4,S 11 T 2.$ N.R 17 E (o PROPERTY OWNER':S,MNLING ADDRESS LOT tt BLOCK # SUED. NAME OR CSM i 3527 25 TM qu.e. So. PA¢T- of: Co ACQCS CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE NEAREST ROAD 1i41AW-6-4n011S 1f11*,V- S$S/Oh (60.1) 7al- 7301 PIEASA,-.5T VA11EY ( Construction Use ( <Residential / Number of bedrooms y Addition to eAstirg building j 1 Replacerttent (j Public or commercial describe Code derived daily flow (000 gpd Recommended design loading rye - y bed, gPdM2 ' trench, gpP V Absorption area required 150 e>bed, fl2 trends, g2 rr~ d loading rate bed, %d/fl2 ' G tench, gpnW Reoonmsersded infiltration surface elevation(s) It (as referred to site pram benchrro SITE' Su/'T.rQlE G ` ~/P /NOUNQ yr,P,Q~t.J f 5~ifr v Additional design / site conssiderations Parent material Sc s Ss Re'AoUA s 1. s I.T- Flood Pain elevation, d applicable lklf- ft v ov 7-19- S - Suitable for system CONS8010101, mom "MAD PRESSURE AT-GRADE SYSTBrt N FILL HOLDM TAN( U - Unsuitable for stem ❑ S CCU 131 ❑ U ❑ S air- ❑ S ❑ S 044-- ❑ S SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Corssistersce Bancdry Roots GPD/tt in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed tends 0-1 /0 X Y/2- 2 3f .5 .Co C3 1.7-2-o (o y12 51i/ 51"1 2 A.% 5hC 'IS zf . S • ~ Ground ~z zo • z /o vR Sly s I 2. f, 56,1~ f R CS 2 t . s .4 ele+1. y S~~T ~~TS rJ to v ft. 1-6 e r 2,o,) z I~ A s -7. S yj~ Depth Gh .4',~.v I / l i ~t~ W- /Cy R '12- s' Z' s . 00 S c l bk 'I" v~ P ~ _2. sss . Remarks: Bonng # Ap 04 8 /0 YX y~i 5./ ~.f, sdr ~»f~ ~S i f • S . G Z P, 9-149 16 yR Sl Y F s 6 24 a Yje s/ s~ z, f skc ,I.,-FR C s . s Ground _50 P4 - /o yp 4/2 sal bK elev. e It. 1&op to limiting fectorr ct Remarks: T Name:-Please Print RE-Tg-r. 24 („(3 ~ t CA-r Phone: 715 - 384- 919 5 rasa: L S~ 1 i 1 Pry u~, nCn_N t<~f s Syo~(v ►~ou . -7 - 9 3 cSTM i48Z PROPEII?Y MNER G(~q~ . 2hi 4 A I A- SOIL DESCRIPTION REPORT pap Z of 3 PARCE LI). tD, dh Dominant Color Mollies Texture tar 8orx>Zkry ~o~ D/ Boring Munsell OU. Sz. Cork Color 3 Si 2, , 5 ~K f ft s 5 . ~o 3 io YR. / Iv, 5 Ground ~O y~ 5~ etev. fc 1o y R 4/12- s. 2 , 5 c b k v~ Depth In fimilirq • 2n~ S•S•S• Remarks: Boring # slaw U-111 I AMA Ground elev. it Depth to fimAirg factor Remarks: Boring 9 Ground FF elev. ft. Depth to factor Remarks: Boring #t Gnwnd elev. tc Depth to / 7p H-- S T" f11 r 1 77 o p - C "7 x ~ r ' i m o~ 3 N ^I 'D N ~z N SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations June 30, 1995 201 East Washington Avenue P. 0. Box 7969 Madison WI 53707 ULBRICHT & ASSOCIATES ROBERT ULBRICHT 655 O'NEILL ROAD HUDSON WI 54016 RE: PLAN S95-01898 FEE RECEIVED: 180.00 RAIHALA, WILLIAM SW,NW,21,28,17W TOWN OF RUSH RIVER 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 ILHR 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 ILHR 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. inc rely, Ke n th Stiemke Plan Reviewer Section of Private Sewage ` n AL (608) 266-8230 7:00 to 3:45 Mon. thu Fri 0 R, v SBDA-7987(8. 10/84) ULBRICHT & ASSOCIATES CO. 655 O'Neil Road • Hudson, WI 54016 Reg. Designers of Engineering Systems 715-386-8185 Private Sewage Consultants PROJECT INDEX DIL"R Plan I.D. # S95-01898 Date June 30th, ''1995 Owner Wm. Raihala Phone 612-721-7301 Address 3527 25th Ave. South, Minneapolis, Minn. 55406 Legal Description _ part of 60 acres. SW 1/4, NW 1/4, Sec.21, T28N, R 17 W. c Town of Pleasant Valley/Rush River County St.Croix C.S.T. Robert Ulbricht CSTM2482 Installer Local Authority/ Supervision St.Croix County Zoning Dept. PROJECT DESCRIPTION New construction, for a proposed 5 bedrm. 'home- estimated daily wasteflow: 750 gals. Soils are permiable (.4 GPD/ft2) but seasonally saturated at 24". A long narrow mound system with 12" sand fill is proposed. For ultimate effluent clarity, and longevity of system, two treatment tanks in series shall be installed ahead of the pump chamber. I Pg.l PLOT PLAN VIEWS I Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWS Pg . 3 PIPE LATERAL LAYOUT 5C0~ Pg.4 DOSING CHAMBER CROSS SECTION -47 ~ l• R0661T 1N. ULBRIdIT Pg.5 PUMP PERFORMANCE SPECS 01160 - HUDSON, WI S I GTA ~igi4nitmmat~~ i ' / 70 f-4- S T- ~3 N a u n 11 1 b IA t C~ p N h cn O o ^O ~ ~ O p ~ S O r R pTE Sp,G~ SYSTS r3s p~iV onditionally NPPTjj-O,v ~Y. INLl4 $A~ p1V1S~~~ of 0 ESP 3 ~r -41 U l i w ec n P.zoo 5 C~'n55 SEGTiOXJ OF MouAjD w rt-t f3E~ 13E'D aF % ro Ay5Qc5ATE ~i5t(ti(3uT~n,J G-, rktckkaFss PiPwG- s ysrEM of Top Soi L IEVAr►O►~ Uu i FORM To E N k~6 2 O RAW ` MED. 1 @ SAND plow 6 t7 -r n P so u k) + FdRM SIopE FoRcE- MAW E:IEUATCW ()AJOER f3ED /o/ ~ 9. yca Fr. - ELEVAT•10,0s z~ Fr. INVERr OF ~2 1ATERM S FT F T•oP of ROCS /'Z~-~(~Z %OV••Z~-. GFT. H FT T P z I ATER A 1 S PLAN VIEW of= MOULD Wi TVA 13E D C E~Tiei¢~- FvRcE MAiN A 6.1 FT• _ .I B Fr K ~o fr F a w pRIVATE SfVVAGS~S EM Conditi®nal1Y f3 E n o F p.UR ~ltr rADn~r~ Z ~ d..z, v,aAYiiP~" cr=uTRaL- Magi FOLp DiSTRiBUT, oAJ pipe uErwoR k CENTR/!L- 9~yTRlpuTioN ~ PVG LAT E RAIS 1 M AN ~ Fo ~ ~ ENP CAPS I I x x x Y , i [BUG FoRcE M M N LAST- ole 5 HA II (3F- Nf-1-T TO END CAP FY. VOID Vol urn E Fo R /OD auERT 61 EVAn p,YE SON dF FoRcE MAIN Q tia l corldit `p l p E D E TA i L Q 140IES IOCATFD oN G oTrom SH A II Be I` 'I VARiApLE y quhll\/ SphceD.. Y DISrgNCE p D Fr HOIE Di AKA Te R 3 LATERAL R MANIFOLD Z 10. X y0 iNChss ~ . roRcr MRIkU 3 ~N. Y 1$ 1xi che s of IWeV pi pE PUMP CHAMBER CROSS SECTION AMD SPECIFICATIONS Pr4 yE ~f of S -VENT CAP 4"C.I. VEI,JT PIPE WEATHER PROOF APPROVED LOCKING JUAICTIOU BOX =MAMR07LE COVER 25' FROM DOOR„ l,(AJ1N C~ IA~EI WINDOW OR FRESH 12"MIN. ( AIR INTAKE I GRADE I 4'MIM. v~ I 19" MIM. /b 3'v CONDUIT /r 144P a1.1 ` 17'0 PROVIDE I - l~ AIRTIGHT SEAL I I APPROVED JOINT A INy I A~ ~ I I ~ WAPPROED PC =VP PEOINTS 1J/C.I. PIPE ~ U~1 ( I ~ ~ EXTENDING 3' EXTENDIIIG 3' /~0 1C G ALARM OMTO SOLID SOIL / yJ, i II ONTO SOLID SOIL 10u q 1 C ;I ELEV. T. --J ' PUMP OFF ~6- I 1 AN V VA f o d I I BLOCK RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC 5PECIFItAT10M5 DOSE ~~iCS ~~ICiC~t TANKS MANUFACTURER: IJUMB~~~OF DOSES: PER DAy TANK SIZE: GALL/OOHS DOSE VOLUME 2- ALARM MANUFACTURER: INCLUDING BACKFLOOW: GALLOMS MODEL NUMBER: -~y L CAPACITIES: A=NICHES OR GALLONS SWITCH TYPE: MEPCOA F/O8T a= y INCHES OR 3p GALLONS PUMP MANUFACTURER: 1-+~--- C= INCHES OR GALLOUS MODEL NUMBER: -7 Al D= /2- INICHES OR L3S GALLONS.` SWITCH TYPE: Fi&6,YeAd' Ifer"p,9Y r1o4T NOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATE co'S GPIA INSTALLED ON SEPAR/~ATE CIRCUITS 15- VERTICAL DIFFERENCE BETWEEN PUMP OFF AUD DISTRIBUTION PIPE..% FEET ~Ao 5~1 ~5 MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . 2 5 FEET EAc(A- 4 /9d FEET OF FORCE MAIN X • y5 F O itFRICTIOU FACTOR.. FEET (~Ur f S ~9, ~O I - TOTAL DYNAMIC HEAD FEET J ADO V11-11p I/ r..u~• i r..~ ru .~./If1TL1 ~1 InillD nEP~rH P~ .SOF5P t 2 HEADI • CAPACITY 34 32 -fns 30 1 85 CURVE 9S 28 90 28 85 EFFLUENT 24 80 MODELI and C 75 MODEL 189 DEWATERING = 22 70 185 i V 20 65- - - Q ~ 18 80 0 55 _ J ,8 F 5C MODEL O 163 MODEL ~ 14 4S 188 12 40- 35 j 4- 10 MODEL 30 137, 11~, MODEL 185 SEWAGE and 8 25 Z~t DEWATERING a 29 - -MODEL 15 _ 161 4 7 rn 10 - - - s MODEL LL j 2 5 53, 55, 31 57, 59 O 80 GALLONS 10 20 30 40 SO 80 70 80 90 100 110 21 75 LITERS 0 80 160 240 320 400 22 FLOW PER MINUTE 70 ' 8S 16 80- - MODEL 295 SS Z t6 V SO I4 .4S _ _ MODEL I 294 C q. b - -it----I~ I i J MODEL >s ►6 293 ~ I O 30 MODEL j 284 - MODEL - - • -so 282 _ t8 ~ MODEL YL ~li Oi ! 7{7 768 ~ - { j t • 3280 Old Millem Lane DALIOMf 1{ 30 40 s° 60 70 80 190 100 1110 120 130 140 i50 190 *0 180 160 P.O. Box 16347 1_-_ 1 i i i i Louisville, Kentucky 40216 U1t*$ 0 b 1" 740 3" 400 480 560' 640 720 (502) 778-2731 "137" Cast Iron Series S95-01098 "139" Bronze Series * CAPACITY HEAD UNITS/MIN Feet Meters Gal. Ltrs. • Automatic or Non-Automatic. 5 1.52 104 394 b T C - 1UU -This application form is to be completed in full and signed by the ownner(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 M RQ / L Location of propertyS co 1/41/4 , Section ;9 , T ;:~`g N-R_ Township ay4 /mod Mailing address S 7 S't~i 1~oct-Tk /1'1 r/ilv~~P'lr izyly Address of site S L9 Subdivision name Lot no. Other homes on property? Yes No Previous owner of property T Q fa~ ~co NN~~~ Total size of property Total size of parcel > Date parcel was created - 9 Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house) ? Yes /No Volume -idgIMIML and Page Number as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. 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. -5-16 /9 7 , 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 /-/--~!-7-? 7 Date of Signature Date of Signature STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER GL J$4 ftCl MAILING ADDRESS 3 g -7 ;:z S w PROPERTY ADDRESS ~ a~,~.w~•~^'( (location of septic system) Please obtain from the Planning Dept. CITY/STATE Wl~ - S S5/Oc PROPERTY LOCATION S (,cJ 1/4, 1/4, Section f T 2 .9 N-R_ _7 TOWN OF ST. CROIX COUNTY, WI SUBDIVISION Alk LOT NUMBER lVk CERTIFIED SURVEY MAP , VOLUME , PAGE , LOT NUMBER Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED: A"14- DATE: I 7 7 St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 y v//d 3 DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1 -19At NIE sr-3 REEERVEO rOa SECONDING DATA • 516197 WARRANTY DEED 'VOL 1076PAA 591 This Deed, made betweengrles- R. O'Connell &-Gladys j'"`'"' • l.,'r B... O' Connell-,. his wife; Margaret G 1Cinriey, a -widow Thomas.' ST. Cr (,o yN W. O'Connell-,--a_~,ndower;- 1Nichael• E-•- O'Connell--&--Juliette--F. Ra~'41brRaowd O'C'onnell,--his wife Susan M. Thom son-&- Bonald..J...Thom song MAY 3 g p 1994 her husband-. Patrick M. J'Connell by Rc9 lir J. Newton his attorne fact Francis L 0'Coru~ell *See antors.belo~l* 2:00 ors x. in . and William Raihala .Jane .-L.__Raihala ..as _ urantee, ~Mrdpsaa. W1tne$Seth, That the said Grantor, for a valuable consideration One dollar. and- other.good.-and valuabg consdera> ion - - - conveys to Grantee the following described real estate in __.SL.,.._ _rQ RETUNh TO 7.2C....... County, State of Wisconsin: ***AS SURVIVORSHIP MARITAL PROPERTY.11 ~ The West Half of the Northwest Quarter of the Northwest Quarter (WZ of NW4 of NW-4) and the Southwest Quarter of Tax parpel No : FEE_ the Northwest Quarter (SW-14 of NW4), Section 21, Township 28 North, Range 17 West, Town of Pleasant Valley. *grantors continued. . . & Nita V. O'Connell, his wife; Richard A. O'Connell, a married man, by Rosalie J. Newton his attorney in fact; Rosalie J. Newton F Richard A. Newton, her husband; Mary C. Anderson & Barry J. Anderson, he-: husband, Grantors. The spouse of Richard A. O'Connell does not join in the execution of this document because Richard A. O'Connell ;.s riot a resident of the State of Wisconsin and therefore the Wisconsin Marital Property Act does not apply to her. The spouses of Charles R. O'Connell, Michael E. O'Connell, Susan M. Thompson, Francis L. O'Connell, Rosalie J. Newton, and Mary C. Anderson join in the execution of this warranty,. deed solely for the purpose of releasing any interest they may have obtained by reason of the Wisconsin Marital Property Act. Rosalie J. Newton is aware that there exists in the records in the St. Croix Co. Clerk of Court's Office a Judgment in Case 92SC1421 of St. Croix Medical Equipment Inc., Creditor,'. vs. Richard O'Connell, Debtor, dated Dec. 8, 1992, and docketed Dec. 9, 1992, at 4:00 p.mij in File Drawer "0" in the amount of $151.50. Rosalie J. Newton knows of her own personal!;' knowledge that Richard A. O'Connell one of the grantors herein by wham Rosalie J. Newton signs as attorney in fact, is not the same Richard O'Connell, Debtor, named in said action. This .....is..not........... homestead property. (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And...$r=tQXS............... warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions, reservations, and covenants if any of record, and highway rights of way and will warrant and defend the same. Dated this 4.g.......... day of -••---•----------AP 1......---......_...... 19.94..... D •--(SEAL) a- ]des R. O'Connell ] Bun -br , (SEAL) as o . •~SYtOime1l r .L~or................ ....(SEAL) '.9....._:.y_.... (SEAL) t ,I Thomas W. Oiriel Ronald J. son gBVAtSB SIDB i~ AUTUNNTICATION ACKNOWLNDaM1iNT ~I Signature(s) STATE OF WISCONSIN II l i - St. Croix County. authenticated this I day of_.......................... 19...... Fersonally came before me this - ..day of i Au 19.94.._ the abme na•ned ' Charles R 0 Connell, Gladys B O'Connel - - Margaret G Kinney,Thomas W 0 Connell r - r - - TITLE: MEMBER STATE BAR OF WISCONSIN Micheal E 0 Connell,Juliette F 0 Conned (If not, Susan M Thompson,IR Thompson n authorized by 1 706.06, Wis. State.) to me known to be th adk, .who executed the foregoing instrua~pnt!~g1~e#he same. THIS INSTRUMENT WAS DRAFTED BY JI/ f) A~•_ 1.i ~i • 1076PVI~ 592 (SEAL (SEAL) Patrick H. O'Connell Richard A. O'Connell Rosalie J. Newton his attorney in fact Rosalie J. Newton his attorney in fact (SEAL) 1`~:f ~~tr r ~Ec (SEAL) Francis IL- 0 Rosalie J. NAfiton Nita V. O'ConnL-U Z ir'~! (SEAL) Richard A. Niewtorf C2z (SEAL) (SEAL) Mary C Barry J. A son ACKNOWLEDGMENT STATE Ov WISCONSIN ST. CROIX COUNTY Personally came before me this 29th day of April 1994 the above named- Pat-ick M O'Conr,ell,Richard A O'Connell, Francis L O'Connell Rosalie J Newton, Nita V O'Connell,Richard A Newton, Mary C. Anderso.i, Barry J. Anderson to me known to be the persons who executed the foregoing instrument ana aZ cnowled a the `a eA''. Notary %bif t-. ro'fx ,Co iln [ Y~.3~I My commision is'prmnetrt,v f.,n-b,t; state erpiratwn =.dati. 4 Date e I SAFETY & BUILDINGS DIVISION b _ State of Wisconsin Department of Industry, Labor and Human Relations 20,1 f:w; f !~1<+,~h'+n~~ton A,~c:nua~. June 30, 1995 r ' ~1 mad lsmn Wi 5;31t:)i ULBRICH] & ASSOCIATE" Co ROBERT UtBRCCHT ' 65S O' NE I i L ROAD HUDSON WI 5'4015 ~ Rt PLAN S95--01€398 i-EE Rf.Ct IVLF): 180.00 RAIHALA, WILLIAM SW,NW,21,28,1 )W TOWN OF RUSH RIVER COUNlY OfCROIX MOUND SYSI E.M The Department h;is reviewod the above-roferenr~et, Conditional dpproval is hereby yranted Iran the syste) plan= subtnit-tal. All noted items must be correr:t.e?d The r .v',ew and approval of the system is based on chapter- 145, Wliscon,,!n "Statutes, and c:h<'tpters li.Hlk ri) e+nd 84, Wisconsin Administrative Codo, and is (,:ont)nytrrt opon i~ra~rrpliar,r>> with any stipulation, shown on the plan,,. lhis :,ystem has not bovo iev'iowi.,d lo! the coda requirements set forth In i:hapter I411!< 8i' of Jrl (t3epi o(s LHffC 110--64, Wisconsin Administrative Coda. this plan submittal dpprovaI wi I i e x p 1 t o two yeeir f- rr,,m t 'he app I ovaI date, or' if a sanitary permit is obtained, plin apptoval will expiie on the day the initial sanitary permit ~;xf,ires, fh(-! ljr-Pnseri p411111)0r responsible for this insta11L3tion shall ki: r p :jn set of plan Witt, tht: :}c fIar+:mvnt' stamp of approval at the i.anstrue_tian site. Tffr.- instal it r shall notify the dpprvpriate inspector when inspection, can be made Ali perinit.s required by khe city, vi f lays, town,,hip ur (-ounty shall tie obtained prior to installation. Inquiries should be directed to me at the number listed br11ow. Please refer to the plan number shr:,wn above. 'inc vIy, i KMin th Stiemko n Plan Rovlewor Section of Private sewage 0 (608) 256-82:10 7:00 ~o.:3:45 Mon, thtl fr." S b qq ta. ►orea, r ' ULBRICHT & ASSOCIATES CO. 655 O'Neil Road - Hudson, WI 54016 Reg. Designers Engineering Systems 715-386-8185 Private Sewage Consultants PROJECT INDEX DILHR Plan I.D. # S95-01898 Date June 30th, `1995 Owner Wm. Raihala Phone 612-721-7301 Address 3527 25th Ave. South, Minneapolis, Minn. 55406 Legal Description _ Part of 60 acres. SW 1/4, NW 1/4, Sec.21, T28N, R 17 W. t Town of Pleasant Valley/Rush River County St.Croix C.S.T. Robert Ulbricht CSTM2482 Installer Local Authority/ Supervision St.Croix County Zoning Dept. PROJECT DESCRIPTION New construction, for a proposed 5 bedrm. 'home- estimated daily wasteflow: 750 gals. Soils are permiable (.4 GPD/ft2) but seasonally saturated at 24". A long narrow mound system with 12" sand fill is proposed. For ultimate effluent clarity, and longevity of system, two treatment tanks in series shall be installed ahead of the pump chamber. Pg.l PLOT PLAN VIEWS Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWS nunuq~~~i Pg. 3 PIPE LATERAL LAYOUT sC0NS a r Pg.4 DOSING CHAMBER CROSS SECTION;:. ULBB Pg.5 PUMP PERFORMANCE SPECS s-=HUDSON NI. ~~~°nn~nta , m S95-oI89tq 1 70 f-14, S I b N kA I ~ \ 0 M h o ~ x r Z rti AGE SYS'v N Si~W ,at a low P ST`l. ► RBBU: x~1i1'r Ir f IN[►U SA~rE 1 V$, p►VIS►Q~ qF c 4 ! N L 1 06 G7 N-Y w pd • Z. of 5 RROSS SECTIO&J OF MOUAJ D c~ i T t~ f3ED 13ED -0 F ro 1 y` A554s-6ATE' p15TRi(3uT~n~ THi cko es 9 P1 P 6- s ysrEM OF T°PSoiL IEVArio~3 , UOiFoRM TOE u, 11 N /62 ,104 Mao' - 3) SAND PIow6I-> ToPSo1' 1 u k) i Fp RM SlOpE roRCE EIWATICW UuOEIR M h~ RED /O/_ & O Fr, - ELEvhrio►J s zy Fr. lmvF-Rr of ~Z 1ATGRA(5 /03, xo F .QO FT ' • Top of Rock • To OF / Z IATERq IS 3, H A fi FT, P S Ca di W OF MOUK)D Wi Ttf BED FvRcl~: MAW (3 / 0 9 -F r a - - I 1 L. /z • I w 1 FT K ~I a ~ T F r 2,9 FT- f3Et~ of To 1 Oise renn~r~ 2 CEuTRgL. MqA31 FO LC) Di STR;f3UT,oAJ Pipe IJErwoR k p 1 CENTRAL ~►yTR►13UTlo►J R PVG LATERAIS M AN► Fo ~ ~ END CAP 5 I I X X X Y i FVC FORCE f-- MAW LAST' Hole s 14A 11 3E NEXT TO END CAP FT. Ges61W VOID Vol uMt FoR /oD p1gWA 6 s ` , 3C~. ~O riall dF FoRCE MAu gAlI XMUERr G IEVAnoN COO dt~~p 10 QF US t1F °SA~ET`t 'I"` D PIPE DErAi L FIOIEs IncATFD o~1 ~ fS c~Tto~1 Sl-}All i3E I` 'I VARiAMLE Y E( uhll~~ S~hGe'D.• Y Dl sTgNce P o Fr Hole DiAhET'e R ►N• L ATERA L- Z a R 3.~ MAO% FOLD Z IN y0 iNe. hES ~ . „ -ORce MR1k) 3 IN. Y 1/0 i►vcl•ES of FWES/ pi pE C A PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS pAle ~ of S -VEIJT CAP 4"C.I. VENT PIPE APPROVED JUNCTIOAI BOX LOCKING WEATHER PROOF MANHOLE COVER _ P-5' FROM DOOP„ 12"MIU. w/ aAXA)W&- IA13EI WINDOW OR FRESH I AIR INTAKE ex- /F_ /p n/ GRADE I y"MIIJ. C~'' , I IB" MIIJ. CONDUIT-- IE U~Tr a 4" 11, - 99. 0, PROVIDE I INLET AIRTIGHT SEAL I I i I I I I IDE I II APPROVED JOINTS APPROVED JOINT A INy~~(~K I III W/C.I. PIPE W/C.I. PIPE I (UM, I III EXTENDING 3' EXTENDING 3 '00~ 5 ALARM ONTO SOLID SOIL ONTO SOLID SOIL I II / ( I I ow I I c I ELEV. FT. ' PUMP --J OFF BLOCK 40 cc tt k VA EDV I RISER EXIT PERMITTED OUL4 IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E SPEC. IF I'CATI DU S DOSE Co,,I,f,0 IJUMBE OF DOSES: PER DAy TANKS MANUFACTURER: ~~7 TANK SIZE: X027`~ GALLOUS, DOSE VOLUME 37 ZZ GEV~L A~/'F~/~'1 INCLUDING BACKFLOW: GALLONS ALARM MANUFACTURER: MODEL HUMBER: -U• wf L CAPACITIES: A=INCHES OR GALLONS SWITCH TYPE: Mr-f (V Ry F COAT B = Z INCHES OR 3 G / GALLOAIS PUMP MANUFACTURER: C= 115, IMC14ES OR 1'2- r GALLOMS, MODEL NUMBER: 13 fr D= /Z INCHES OR 2,3S GALLONS,.' SWITCH TYPE: Pi6-6,Y,6ACk' /`1f--W6'9y r/Ofr NOTE: PUMP AUD ALARM ARE TO BE INSTALLED OM SEPARATE CIRCUITS MINIMUM DISCHARGE RATE (0-157 GPM a VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE..- ' FEET -rA~FL 5' lE(S MINIMUM NETWORK SUPPLY PRESSURE 2 5 FEET 6A t-, { ~9d FEET OF FORCE MAIN X is F optFRICT1otJ FACTOR.. FEET (~UrIS ~9, ~pD. TOTAL DYNAMIC. HEAD FEET ,Pov..1fJ r.~~ ru X -UllnTW IN :LIQUI0 DEPTH 5©~5 P MEAD/ LL 115 ~ 34 CAPACITY 32110 1OS - CURVIEW 30 195 - 95 28 90 28 85 EFFLUENT 24 •0 MODEL and Q 7,5 MODEL 189 22 DEWATERING 70 185 V 2° 85' - - 2 18 80 55 H 18 50 O 183 p MODEL H 14 15 188 12 40_ 35 10 MODEL i 30 137, 139 , MO SEL SEWAGE and ° 25 DEWATERING 6 20 MODEL 15 MODEL _ 181 4 7 10 - - 2 MODEL a L° LL 5 53, 55, - Q 57, 59 41 0 GALLONS 10 20 30 40 SO 80 70 80 90 100 110 21 LITERS 0 80 160 240 320 400 75 - 22 FLOW PER MINUTE 70 20 S 1• 80_ - MODEL 0 295 SS I 1• - i V So 14 1+4s MODEL - 294 C 12 .40 _ _ - MODEL >S M293293 EL O ~ MO 284 MODEL _ 282 - t-- ' ' IP O. } MODEL ZffZLE ~ ~ ~ l !•7.2.9 • 3280 Old Millers Lane GAL 1e ze So 40 so 80 70 80 i 90 100 1110 120 '130 140 15b 180 *0 ISO 110 P.O. Box 16347 - i ----1 =Tj- 1 G 1 Loulsville, Kentucky 40216 lft[1tt 9 00 t•0 240 320 400 480 580 840 720 (502) 778-2731 "137" Cast iron Series S95-01898 "139" Bronze SeriesHEAD TCAPACITY UNITS/MIN Feet Meters Gal. Ltrs. • Automatic or Non-Automatic. 5 152 104 394