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Home My WebLink About026-1041-70-000 s6p r. 2 ,5 3 , y1'a Z STC - 10 4 AS UILT SANITARY SYSTEM REPORT OWNER .Z q6 - ~l 2,S Si'T Q ADDRESS Tex 02-( jaqj ~0 SUBDIVISIO(N~ / CSM# n LOT ~ SECTION l T 3 N-R d W, Town of K C61 -x4 D.v C_) ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW. SVERYTH,ING` WITHIN 100 FEET OF SYSTEM ti 07-&=-ss -9~x I'S'T7 0/008 S Tic T s7- c~ T.F.l/c, wf -9 S SO r z 6 d2. -Fn re b-3 q- ,v,?.cv- BUG f s 111S-,4~X T-Z~:D %,v 7~ 774,t-k INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide-2, dimensions to center of septic tank manhole cover. ' 04~,- YXW-,0S 4Me, U~ BENCHMARK: l?6 7-70-t4 0/,c7 r ALTERNATE BM: F7. (;,3 6)( I'S 77a CT / - C,9 S T. _F.vk /,0 om , ~9 ~l N U-fA- Gt1tA1Z--. - C-I.v !<N O X-.J Z vj SEPTIC TANK / PUMP CHI,MBER / Manufacturer: ,1ut~ Liquid Capacity: Poo 6PM-'-( `~C Setback from: Well ~~00 House ~Z Other Pump: Manufacturer Model# 14Ey0 /l 10 P Size Float se eration p Gallons/cycle• 45 Alarm Location ~~S'lD~•~tF - /~'I6U.v j.y Put- SOIL ABSORPTION SYSTEM Width: Length Number of trenches Distance & Direction to nearest prop, line: b, (3 b Sa F~4S l'' 161 r Setback from: well: House 7g Other -6 ELEVATIONS F (c Building Sewer ST Inlet- ? ST outlet: / 0 PC inlet 10.31 I PC bottom 93--go " ~ TOP of Pump Off S • 3 0 (old100-~O' Bottom of system -~s Existing Grade Cn f ~'1 ~r• 61~•7S Final grade AUXA, MOu.'uD ° r ~PA`~~LP'QF INSTALLATION: 26 6 < 1 PLUMBER ON JOB: (J~/J v1hA14h7- LICENSE NUMBER: 114 /15 330 2 INSPECTOR:. 3/93:jt /C~~ ~0S 3• 6,o fop 115 41 op~ -b* P) 31 Ir BENCHMARK: ALTERNATE BM: f ~ / j ,rx I's 7-1,0 SEPTIC TANK / PUMP CHKMBER / LA' - Manufacturer: ~~~5 ~-~cS►~7~.e- Liquid Capacity: as p I' e Setback from: Well ~~0d House ' Z Other Pump: Manufacturer Alff / Model# 14EW Size 4( P Float seperation /•0 „ Gallons/cycle: IS 5 . Alarm Location pur SOIL ABSORPTION SYSTEM, Width: 'Length C 7 Number of trenches Distance & Direction to nearest prop. line: Sa • 45 Setback from: well: 161 House 78 Other p6 Cd l~~ ELEVATIONS Scp p i ? 2 ~0-~Co Building Sewer ST Inlet: ~j ST outlet: PC inlet 10,3111 PC bottom 93 ~0 0 Pump"Off S'30 TO P of , Header/Manifold /0a7 Bottom of system S' 75 e C 4-L ftr- Existing Grade 75 Final grade S ex-, Ru, Mpu;uD INSTALLATION: ~ ' G 0~ Pvn ~ PLUMBER ON JOB: A08 V1h/e1 LICENSE NUMBER: myc .2• S ~~~D ~5 r INSPECTOR: TEA) ri1, 3.0 yc;f t'c% /0S S ?-?w 3/93: jt 4- ' ~D12 ~f I(lS 1 9114 0'.60 1~- ~fA 1-0 i~p w I 1 '4 pz) pvc Puc Ys y,~ PING qs y r EIO 17 L)c Pik z.,. pv~ 5-T. Ir '7- 2 2- ~ r9 ~ Iq z ~ ~ ,r P /S0 70m o f Si1~icJ Cr `Z- C U = 1400.0.1, fit AW Tope oF SAP . s-r~p . r✓'~2v.-' S7~Co3 ~ I Z~,vOi'sr~R/3 I ~ y3 I ~~ai/s I f ~ I I I z 90 I i I 7- e Ulbrlcht & Associates Private Sewage Consultants 666 O'Neil Rd. Hudson, Wis. 54016 • ~ ~ ISM d'~- S f° CiNSv c or5 N Co /vi yo pvc Poe q Pic i1 7/0~ 2 7- jlp b ~Witt- l/ V 0 Z S af= Simi c~ G-- s LL r~M Z I lv I T°p Of S 2s - - zwPl'STvk I~1 y3 I 3oi/s I I I 2-90 - I i I I ME40 SERIES 4/10 HP Effluent and Drain Water Pumps DURABLE MOTOR WILL DELIVER MANY YEARS OF RELIABLE SERVICE ■ Oil-filled motor for maximum heat dissipation and continuous bearing lubrication. ■ Overload protected, shaded pole motor eliminates starting switches and relays which are prone to fail. THE ME40 IS DESIGNED FOR MANY YEARS OF MAINTENANCE FREE OPERATION ■ Positive sealing, quick connect float and switch cords make replacement simple if service is ever necessary. ■ Field tested, wide angle, mercury-free mechanical float switch provides maximum draw down. (Automatic models only.) PRODUCT CAPABILITIES Capacities To 60 GPM 227 LPM Heads To 32 ft. 9.75 m Max. Spherical Solids iii in. 19 mm Liquids Handling domestic effluent & drain water Intermittent Liquid Temp. up to 140° F up to 60° C Motor Electrical Data 4/10 hp. 1600 rpm shaded pole, oil-filled 115 volts, 11.5 amps, I ph, 60 Hz 230 volts, 5.8 amps, 1 ph, 60 Hz Third Party Approvals Pending Acceptable pH Range 6-9 THE MYERS ME40 SERIES EFFLUENT PUMPS ARE Specific Gravity .9-1.1 ONE OF THE MOST EFFICIENT 4/10 HP EFFLUENT Viscosity 28-35 SSU PUMPS ON THE MARKET TODAY. The enclosed two Discharge, NPT I!i in. 38.1 mm vane impeller provides the flow and head required Min. Sump Dia. Simplex 24 in. 61 cm for today's dosing systems and the many tough Duplex 36 in 91.4 cm drainage applications. The ME40 is constructed of only the highest quality corrosion resistant materials Construction Materials - like cast iron, stainless steel and thermoplastics - Motor Housing cast iron, Class 30, ASTM A48-76 for many years of service in the harsh effluent Impeller enclosed, engineered environment. The ME40 is available in automatic thermoplastic models with built-in mechanical float switch or Impeller Wear Ring 304 SST manual models for use with external controls for volute thermoplastic precise dosing. For more information, call your Volute Sealing Ring Buna-N Myers distributor today or the Myers Ashland, Ohio Power cord 10 or 20 n.16/3 SJOW/SJOW-A Sales office at 419/289-1144. Mechanical Shaft Seals carbon & ceramic ADVANTAGES BY DESIGN Fasteners W series SST TWO VANE IMPELLER DESIGN PROVIDES MAXIMUM DOSING EFFICIENCY ■ Enclosed design for high efficiency pumping. ■ Eliminates possibility of jamming between impeller and volute. ■ Passes a full'/ inch solid. ■ Original performance can be restored if wear occurs by replacing volute seal ring. WHERE INNOVATION MEETS TRADMON M"IV ME40 SERIES 4/10 HP Effluent and Drain Water Pumps POWER & FLOAT CORDS PLUG DIMENSIONS Quick-connect, watertight Replaces switch assembly fittings are interchange- for manual operation. able, replaceable from 1 h r>pr • (3s.1mm) pump exterior. O Discharge MECHANICAL FLOAT, s SWITCH _ Mercury-free, 900 angle P N - - operation. Irn - L - I® 5.66 I - - (144mm) - (21.68 96.5mm) --'1 MOTOR HOUSING Cast iron for efficient heat transfer. OVERLOAD SWITCH Built-in to protect against overload conditions. ..oa.., g 4/10 HP MOTOR JAI, 1600 rpm, 60 Hz, 115 or N v j r 230V, single phase. Oil- cooled and lubricated. ROTARY SHAFT SEAL - - - - i - - ~d c L- J Carbon, ceramic faces. - a . PERFORMANCE CUM CAPACITY LITERS PER MINUTE I 0 50 100 ISO[ 200 250 300 350 40 12 szi VOLUTE/IMPELLER SEAL RING 10 Maintains high efficiency 30 and reduces recirculation, a tai Z zs replaceable. M EAR TWO VANE 20 1,' . s High efficiency, passes HIGH EFFICIENCY ABS ' S 3/4" spherical solids, with VOLUTE ° - ( } t 4 stainless steel wear ring. Corrosion resistant. Passes ' ° ~rX:v 3/4" spherical solids. 1!V 5 2 THRUST WASHER, SLEEVE NPT discharge. t ~ BEARINGS ° .a:u; e u o Entimice smooth operoflon 0 10 20 30 40 50' 60 70 e° so 100 and extend pump life. CAPACITY GkILLOM PER MINUTE ME40 SERIES 4/10 HP Effluent and Drain Water Pumps 111 DURABLE MOTOR WILL DELIVER MANY YEARS OF RELIABLE SERVICE ■ Oil-filled motor for maximum heat dissipation and continuous bearing lubrication. ■ Overload protected, shaded pole motor eliminates starting switches and relays which are prone to fail. THE ME40 IS DESIGNED FOR MANY YEARS OF MAINTENANCE FREE OPERATION _ ■ Positive sealing, quick connect float and switch cords make replacement simple if service is ever necessary. ■ Field tested, wide angle, mercury-free mechanical float switch provides maximum draw down. (Automatic models only.) PRODUCT CAPABILITIES Capacities To 60 GPM 227 LPM Heads To 32 ft. 9.75 m Max. Spherical Solids 3A in. 19 mm Liquids Handling domestic effluent & drain water Intermittent Liquid Temp. up to 140° F up to 60° C Motor Electrical Data 4/10 hp, 1600 rpm shaded pole, oil-tilled 115 volts, 11.5 amps, 1 ph, 60 Hz 230 volts. 5.8 amps, l ph, 60 Hz Third Party Approvals Pending Acceptable pH Range 6-9 THE MYERS ME40 SERIES EFFLUENT PUMPS ARE Specific Gravity .9-1.1 ONE OF THE MOST EFFICIENT 4/10 HP EFFLUENT Viscosity 28-35 SSU PUMPS ON THE MARKET TODAY. The enclosed two Discharge, NPT 1 ~6 in. 38.1 mm vane impeller provides the flow and head required Min. Sump Dia. Simplex 24 tn. 61 cm for today's dosing systems and the many tough Duplex 36 in. 91A cm drainage applications. The ME40 is constructed of only the highest quality corrosion resistant materials Construction Materials - like cast iron, stainless steel and thermoplastics - Motor Housing cast iron, Class 30, ASTM A48-76 for many years of service in the harsh effluent Impeller enclosed, engineered environment. The ME40 is available in automatic thermoplastic models with built-in mechanical float switch or Impeller Wear Ring 304 SST manual models for use with external controls for Volute thermoplastic precise dosing. For more information, call your Volute Sealing Ring Buna-N Myers distributor today or the Myers Ashland, Ohio Power cord 10 or 20 ft. 16/3 SJOW/SJOW-A sales office at 419/289-1144. Mechanical Shaft Seals carbon & ceramic ADVANTAGES BY DESIGN Fasteners 300 Series SST TWO VANE IMPELLER DESIGN PROVIDES MAXIMUM DOSING EFFICIENCY ■ Enclosed design for high efficiency pumping. ■ Eliminates possibility of jamming between impeller and volute. ■ Passes a full 3/ inch solid. ■ Original performance can be restored if wear occurs by replacing volute seal ring. WHERE INNOVATION MEETS TRADn7ON W4sconsin Uepartmentof Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit 2 GENERAL INFORMATION 299052 Permit Holder's Name: ❑ City ❑ Village Town of: State Plan ID No.: VANDERVORST, GARTH RICHMOND CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 026-1041-70-000 TANK INFORMATION ELEVATION DATA A9700369 SAP TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing 4 0 Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANKTO P/L WELL BLDG. ventto ROAD Dt Inlet Air Intake e Septic NA Dt Bottom a Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft oss Fi Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMEN I N LEACHING Manufacturer: SETBACK SYSTEM TO P/ L BLDG WELL LAKE / STREAM INFORMATION Type O CHAMBER Mode Number: System: OR UNIT 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.) 1 J q LOCATION: RICHMOND 14.30.18.202B,SE,NE 1375 157TH AVE /a 7 41 ll ~G Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ~l. Visconsin Safety and Buildings Division SANITARY PERMIT APPLICATION 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Departmbnt of Commerce Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County /.T C~D( x than 8112 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Per it Number qqo 6~ The information you provide may be used by other government agency programs ❑ Check if revlslon to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number S 1. APPLICATION INFORMATION - PLEASE PRINT ALL INF RMATION SY~ " O L 11 Property Owner Name N I, Property !//fiver (/DRS 7- 51&- 1 i4 J~ 1i4, S /Y T30 , N, R ld E (or W Property Ovn er's ailii Address AC~ Lot Number T ck Number 5 d'l~ City, State Zip Cod rPhore ;umber Subdivision Name or CSM Number S'T t st Road e 11. TYPE F BUILDING: (check one) ❑ State Owned 11 !tyy 7Nea, Z ❑ Village ~ ublic 1 or 2 Famil Dwellin - No. of bedrooms own OF s III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) D,\ 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. replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank OnlyExisting System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurize Distribution Experimental Other 11E] Seepage Bed - 21 ound 30E] Specify Type 41 ❑ Holding Tank 12E] Seepage Trench 22E] In-Ground Pressure 42 ❑ Pit Privy 13E] Seepage Pit 43E] Vault Privy 14E] System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: l~Z.. z S 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.) Pro os d (sq. ft.) (Gals/day/sq. ft.) (Min./inch) 75' r Elevation 12so 353 1.2- Feet Feet TANK Capacity VII. in gallons Total # of Prefab. Site Fiber- Ex er. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- steel glass Plastic App New Existing strutted Tanks Tanks Septic Tank or Holding Tank - - ~a ~Zestx _ ❑ ❑ El E] 11 Lift Pump Tank /Siphon Chamber 15d 7S0 MAD W'pS 'v ❑ ❑ ❑ ❑ ❑ 7M 27 T 7-- VIII. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (No Stam s) 10WtMPRSW No.. Business Phone Numb V08c.r -UL8 a4 ( 133o7 171Y • 38, • P 5 Plumber's Ac dress (Street, City, State, Zip Code): C~ 6 i/v w jWiZ, 4R. /S IX. COUNTY / DEPARTMENT USE ONLY do ❑ Disapproved Sanitary Permit Fee (includes Groundwater ate Issued Issuing Age t Signat a (No St p proved ❑ Owner Given Initial ~Q~~j Surcharge Fee) Adverse Determination lG~ :7 9(7 X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-63138 (R 11196) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Division, Owner, plumber i INSTRUCTIONS ' Q 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit rr ay be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Admirustrati_vEode 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. 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 narne, 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 smal ler 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 purhp 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 w~ 201 E. Washington Avenue P.O. Box 7969 isconsin Madison, Wisconsin 53707 Department of Commerce Tommy G. Thompson, Governor William J. McCoshen, Secretary July 11, 1997 201 East Washington Avenue P. 0. Box 7969 Madison WI 53707 ULBRICHT & ASSOCIATES ROBERT ULBRICHT 655 O'NEILL ROAD HUDSON WI 54016 RE: PLAN S97-02115 FEE RECEIVED: 180.00 VANDERVORST, GARTH SE,NE,14,30,18W TOWN OF RICHMOND COUNTY OF ST CROIX MOUND SYSTEM The Department has reviewed the above-referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval of the system is based on chapter 145, Wisconsin Statutes, and chapters Comm 83 and 84, Wisconsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter Comm 82 or in chapters ILHR 50-64, Wisconsin Administrative Code. - This approval does not include plans for the general plumbing systems or sewer piping leading to the septic/holding tank that may be required for this project. See section Comm 82.20, Wis. Adm. Code, to determine if plan submittal and approval is required. 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. lop SBD-6524(R.07/94) SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue P.O. Box 7969 SCO/ I/'~SII I/~ Madison, Wisconsin 53707 Department of Commerce Tommy G. Thompson, Governor William J. McCoshen, Secretary ULBRICHT & ASSOCIATES Page 2 July 11, 1997 PLAN S97-02115 Inquiries should be directed to me at the number listed below. Please refer to the plan number shown above. Sinc rely, i regory C. N gl Private Sewage Plan Reviewer (608) 266-8230 8:00am - 4:00pm 4295R/ 2 SBD-5524 (R.07/96) w. ULBRICHT & ASSOCIATES CO. 655 O'Neil Road - Hudson, WI 54016 Reg. Designers of Engineering Systems 715-386-8185 Private Sewage Consultants PROJECT INDEX DILHR Plan I.D. # S97-02115 Date July 11,1997 Owner Garthg Vandervorst ; Phone 715-246-4797 Address 1375 157th Ave. New Richmond, Wis. 54017 r Legal Description Small 1 acre approx. lot. Tax parcel # 026-1041-70. SE, Ne, SEc.14, T30N, R18W. Town of Richmond County St. Croix C.S.T. Robert Ulbricht CSTM2482 Installer Robert Ulbricht MPRS3307 Local Authority/ Supervision St. Croix County Zoning Dept. PROJECT DESCRIPTION This is a replacement system for an existing 2 bedroom home. Actual estimated daily w asteflow is 300 gals. However, the new system s13all be designed for a 3 bedroom capacity home - estimated daily wasteflow: 450 gals. The existing deep drpwells are in seasonally saturated soils. All existing treatment tanks are non-code compliant and shall be abandoned per code. Soils are fairly permiable (.4/.5 GPD/ft 2) but seasonally saturated at 28". A mound system using 12" sand fill is proposed. ciates - 4_ Uibricht & Ass( consultants private sewage 855 p.NeU Rd- Hudson, Wis. RECEIVED 3.r JUL Pg.l PLOT PLAN VIEWS BUREAU OF U UILDING Pg.2 SYSTEM CRMATFK$hMTErASSYSTEM PLAN VIEWS Pg.3 PIPE LATERAL LAYOUT Pg.4 DOSING CHAMBER CROSS SECTION Pq.S PUMP PERFORMANCE SPECS ' 714- BALL NON-CONFORMING TRtATMENT TANKS SHALL /3Z leg zY BE ABANDONED PROPERLY FOR ILHR 83,03(2). /3~ z ` r 5~4 CE = / ~ = 2 O NEB O • = Motkoe r -(S G- S N~O~ES~~ o ~ ~ ~ 2~r 9•c°~ • ~~-llJ~/Tiorls ~ ZI.vDE o Z 7RF~~~~ 3S' /2° o~ W ,y we 1 i ►~r ~3 / l3o 77&%Al ecXge- OF . (4) 0 5tRIA76 . 11 / C.57,!; a r 8~ -#z I I I u TOP °f P.O.W.T.S. I i I ~E Conditional 2-~- PPROV a DEPARTMENT Of COMM CE ( i 1 / SIGN OF SAFETY AND (DINGS Pl Z of 5 CROSS SECT►C» of 1~IOUOD wj T-tj 'f3ED t3tav of IV ro I " A51et-IATE' •DiSTRi(3uTioo G, rN,ckaFS3 PIPING- sysrEM of ToP so( L elcvAri0,3 e t)o i FoR M To E, it H T ~ RRT~O ,t• M61~. 18 • • ' • ' , • 1 ~ . SANP o ll~ lll~ Plow C LD ToP S uu. FdR►~ 51oPE FORCE ~ tneVATToa 0000-R .)t cI RED !O 75- /.d Et_EVAria~ 5 F T. F- Fr. INVERT' o f z IATGRA (.5 F • 93 FT • •ToP of Rock 60. 5"? G T.o / Fr • OF /z ft, IArE A(s ~~O• Yd . PLAN VI Ew OF MoUK)D wit" 13E D FvRcE MAW A (o FT• - . I d Fr K /a F r --a-- FT- pq o a 9 K rl a T /S F T- w r W 30 o FT-- r4 Bev of %P.O.W.T.S. -r„ , L „ ld tonally 3 o4 5 D%5TR1 f3ur1 oA.3 PIPE K MT'w oR k LAyou T~1'h I V of q,.4 op OttwotIc ffoq \ P R -cam M~~ ae~T O F .3.0 R Fr FoRce MAfk x `fg 1NCHE5 /2(9 Fr. 2- y g o f P V c - u c H E5 VARi•AGLE TOTAL. V(9jD VoIuNE 6a15. v'sT^,.3 cL t H oIE WAMETEp, /7 iNCN~s LhTERhL 2. ~►,c F}ES ItJCN~s OF HOIE5/pi pu Ay ZuvERT ELEUATtoo °F LATERM 5 P.O.W.T.s. C~'ondit c nanny GE APPROVED PARTMENT OF COMi CE E 0 p GA F "ON OF SAFETY AND U DIN SATE P' P6 ~ SEE CU p \ • Re"ovE- All DRi►l BURRS ~ y PUMP CHAMBER CROSS SECTION AkJD SPECIFICATIONS P,44E I of S -VEIJT CAP 4"C.I. V0JT PIPE APPROVED LOCKIMG WEATHER PROOF JUNCYION BOX MANHOLE COVER 25' FROM DOOR, w/ 4v,1,4AJlo&- IA13EI WINDOW OR FRESH 12"MILT. AIR INTAKE ~ , JJrle ti,17/On/ GRADE I 4°MIIJ. n t rf 25 ! COQDUIT ~.a5 - ~I~U~tI r~N ` 9o'd PROVIDE I y INLET AIRTIGHT SEAL I III I III JOINTS APPROVED JOINT A yl D K I III WAPP/C.I. PIROVEDPE IJ IN ~t I III /C.I. PIPE ~(U 1 EXTEMDIHG 3' .60~ I II ALARM EXTENDING 3' ONTO SOLID SOIL. 10 n I 1 I ONTO SOLID SOIL Lih (y I B 7v ~3'3 I ON g1. go ' ELEV. FT. PUMP--~ --i OFF ~ SAN k t D01~ ~ BLOCK /E VA i 0 3,.OP~o~ RISER EXIT PERMITTED OIJLy IF TANK MANUFACTURER HAS SUCH APPROVAL S~~ ~ SEPTIC E SPECIFI'CATIOUS DOSE TANKS MANUFACTURER: ~ES~ °ti &6f S7- WMBER OF DOSES: PER DAS 110 ,r~ TANK 51ZI- : C GALLONS DOSE VOLUME 20 !7D ALARM MANUFACTURER: Gt yd +(/~INCLUDING BACK//FL//OW: GALLONS MODEL MUMBER: DuL- CAPACITIES: A= INCHES OR .30V GALLONS SWITCH TYPE: " 1 ~1eeo~`"~ 7 B = INCHES OR GAlLOA1S PUMP MANUFACTURER: C INCHES OR ~ (7~ `Q cGALLOLIS MODEL NUMBER: INCHES OR 2 GALLONS SWITCH TYPE: Pi yQAj~~ MOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATE _GPM INSTALLED ON SEPARATE CIRCUITS ' 4s A,k SPIEC S VERTICAL DIFFERENCE BETWEEN PUMP OFF ANO DISTRIBUTION PIPE.. IFEET 1'A 4- MINIMUM NETWORK SUPPLY PRESSURE , . , . . . . . 2.5 FEET EAG(A. I O~ P /.Un' S 7S + 12-0 FEET OF FORCE MAIN X2,&2- F jo FT.FRICTIOU FACTOR.. i4 FEET TOTAL D`JNAMIC. HEAD = ' d FEET Y rJ / N INTERNAL DIMEIJSIoIJS OF TANK: LF-KI&TH,0-_ ;WIDTH C9 / •;LIQUID DEPTH ZO P 5 HEAD/ ! W 115 _ 34 110- CAPACITY 32105 - CURVE 30 100 - 95 28 90 26 85 I I EFFLUENT 24 6o MODEL and Q 75 MODEL 189 DEWi4TERING = 22 165 - V 20 8S- - - Q 80 z 18 55 F 18 50 ODEL O 163 MODEL H 14 45 188 12 40- 35 10 MODEL MODEL 137, 139 185 SEWAGE and 6 25 DEWATERING 6 20 MOD MODEL 164 - 15 4 7 MODEL µ°Ci W 2 5 53, 55, - - x S- 57,59 0 GALLONS 10 20 30 40 50 60 70 80 90 100 110 24 80 LITERS 0 80 180 240 320 400 75 22 FLOW PER MINUTE 70 20 Tr i 18 80_ - MODEL 295 W 55 = 18 ~ U 50 Q 14 4S MODEL Z 294 > C 12 40_ - - J 35 MODEL la-~ 10 293 O MODEL 1- 30 284 - 8 25 I - - MODEL 6 20. 282 4 15 10 MODEL 2 S 267, 268 t 0 3280 Olaf MNlem Lane GALLONS 10 20 30 40 SO 60 70 80 90 100 110 120 130 140 150 160 110 180 190 P .O. Box 16347 1 I --TI, -a I- Louisville, Kentucky 40216 LITERS 0 80 160 240 320 400 480 560_ 640 720 (502) 778-2731 FLOW PER MINUTE ct• tt rtff Lt ft!! « ~ k ~ ~ ~ 111G1-# HEAD 1G•1,.- 1~3 - 1~a 18.~i ~ 1$8 - 89 Se ~s ►.IP) (1/, IIP) (1 HP) (1 HP) (1/2 H) (2 ) I\ 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. 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 C o percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # 6 - /o Yl - ~0 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 Ua.vd e_Y' UO S y Govt. Lot Lj' ' 1/4N,'1/4,S T3 N,R E (or)11t~ Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 3 "7 /S7Tf► ~a e City State Zip Code Phone Number ❑ City ❑ Village Town Nearest Road ,(J,IW rp o ril t ma,vel GJ i p/ (71 > ) a q6 -1/7 97 c ti vH ! S- 7 7"Ai v ❑ New Construction Use: Residential / Number of bedrooms Addition to existing building ® Replacement ❑ Public or commercial - Describe: Code derived daily flow S'0 gpd Recommended design loading rate 'Y bed, gpd/ft2 • S trench, gpd/ft2 Absorption area required 37 S bed, ft 2 3 7 S trench, ft 2 Maximum design loading rate < bed, gpd/ft2 . trench, gpd/ft2 Recommended infiltration surface elevation(s) It (as referred to site plan benchmark) Additional design/site considerations Covo u Parent material t; a'r'c L DLt?fkrs 1. Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system ❑ S Dff-U RS ❑ U ❑ S O U ❑ S R U ❑ S o u ❑ S ® U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft2 in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed , Trench; l o-!f a s/ m s' a f s 2 1/d-:_11 7, 5- Y _ 5r< 1- ;2 fn "/I V? if t s / F . Al ~ S Ground y rF y~ 1s'!F x7,57VA 141 4Wft. Depth to - limiting factor - - - - - 3.2 " in. Remarks: Boring # 1 0-yeo my s; 1 make f l' ~s ~ . s G Sc~ ~,~b~y cS VF r7 Ground _ lev. - O ft. - - - - Depth to - A - limiting factor Qt in. Remarks: CST Name (Please Print) Signature Tel rS d L0. ,ry 4 Address Date CST Number PROPERTY OWNER _1/a )d e-j, UoYYsT SOIL DESCRIPTION REPORT Page v_ of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 =Ift in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Ground 3 g elev. Depth to limiting factor Remarks: Boring # f ' I Ground elev. ft. ' Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # Ground , elev. ft. Depth to - limiting , factor 'n. Remarks: Boring # Ground elev. n. Depth to - - limiting factor in. Remarks: SBDW-8330 (R. 08/95) c/~Q.r'Lid, r^s~ a F 3 l5? Tfi j~p-~. i /y! a ToI°a Go ra-ei e 5 te/~•r -3 m V i , r ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to cerr/t~"ify that I have inspected the septic tank rese serving the cT U~-,(/~E(~ V ~~s 1-- p ntly residence located at: 9, /UE_1/9, Sec. ~ I Ti 11 Q N, R f " W, Town of Upon Inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced L-2. Z,) Q:1 Did flow back occur from absorption system? YeskNo (if no ski Approximate volume or length of time: next line) gallons minutes Capacity:jOcC~ Construction: Prefab Concrete- Manufacurer (if known): ? Steel -Other Age of Tank (if known): 2 (S gnature) "~oF -y-- /'j (Name ) ~Pylease int (Title) (License Number) (Date) Form to be completed by licensed or-Licensed Disposer (NR 113 Wisconsplumber (s.145.6, wis in Admini tra ive Code)nsin Statutes) Plumber (applying for sanitary permit) Certification In accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requirements of ILHR-83, Wis. Adm. Code (except for Inspection opening over outlet baffle) Name I~ol3~97 ~L~RACO1 Signature yIIP/MPRS 5/88 S T C - 100 This application form is to be completed in full and signed by the ,owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of property 1e U~,v~ (lD~'s Ldcation of property S~ 1/4 1/4, Section ( T30 N-R W Township ' ~ C-RkOA)o Mailingapddress Address of site S~- Subdivision name Lot no. Other homes on property? Yes No Previous owner of property 'T'otal size of property if G4,9 ~ it 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 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. and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run ti above described property, for the construction of said system, a d the same has been duly recor d in the office of the Coun egister of eeds as Docume No. Signature of Applicant -Applicant .F 9 ~o Q7 Date of Signature Date of Signature J , { STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER CT~f~ U ~L ti1~•(~~~y6i~„S 7- MAILING ADDRESS 315 s dt-- PROPERTY ADDRESS (location of septic system) Please obtain from the Planning Dept. CITY/STATE GG 6 PROPERTY LOCATION •SG- 1/4, /V~- 1/4, Section T 30 N-R ~d W TOWN OF P1 je/; K /q y- ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAP , VOLUME , PAGE , LOT NUMBER Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than .1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewa disposal system in accordance with the standards set forth, herein, as set by the Wisconsin D Certification stating that your septic has been maintained must be completed and returned to t St. ix 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 J h DOCUMENT NO. ~ WARRANTY DEED 'W" ••ACR RLS[RVM "A Per-CM1Ro OA7a STATE "A OF WISCONSIN BOiM 2- 494913 REG,S TER' GFFICE ST CPW CO. M D d~..Bou hex..$r~d .K mDe~rtx.. r P 'd ',-r P:,rord . , _ - FEB 1 01993 ~ at 9:00 ,M ooareya and warrants to s1Pl3Q~Per.. Kit , ---and.. C~art ....._.....Yander._.Ynrst Ilr,r„e1p - . tho following deaerbed real "tat* in ~='01.~..._......_-- _ ittata of Wioaoaain: T= Paroel No...._.-..._.__..-.__ The West 158.7 feet of the North 258.7 feet of that part of the SE 1/4' of NE 1/4 o- Section 14, Township 30 North, Range 18 West, St. Croix County, YiRconsin lying South of the Town Road. • his ....w '.wO-tead property. ti) (4 not) XMMPt Ion towsrranues: easements, restrictions and rights-of-way of record, if any. Dated this _ January 1:11n day of - - - X99--- (SEAL) <ns •Denas 3. toucher Kimberl S. • _-Boucher (SEAL) • UTRUXTICATION ACKWOWLBDGMBNT m er , Denis J., Boucher., STATt OF Vx9co alwJanu8Z'y-_.------.93 ' POO Mbr sa.e before me this ----------------day of the above named • Kristine Q and - „ - ItD1i$EB STATE DAR OP WISCONSIN a~ b 1 90e.86„ ilia. Btat~j - - - - - - to me ka°vn' to it Se Perwo wbo executed the TMs "WnUJUaW was onAnto BY foreglAW hmob-.ea wnt and acknowledge the mane. - ~S stf~la 0aland