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030-2045-50-000
rY o ° N N o C) h ti 0 ° e 0 °60-:k y 0 0 a a 0 o w c o U, R! CD a 3 o m 0 0 m 0 N m m ° a rn N E DS a w v N y m (D rn•3`" 21 a CC 21 a'~ O o E a~ ~ Lo CO u > LL Co U) h L O) E w O m In ~i O` N Z N m O C Z O) N C U C Z O 3 m C m Y~ m 7 c6 -0 W O= O m_ LL O C c 'O a) N Co E QI Q CD mum, m ¢ aa) U 12 N 3 ° CL a) (D w f/! Z y E N Z OO r 00 p Z V ° w a m a m N H Z O O Z c p' 7 m Z c c Z H E E 2 d r~ v _ rn N _ 04 U) a0 N O C C C, a ° a Lf) y C C r_ CD _r_ 0 ~i > co O m 0 ~ Z co z o a C Z N o z m 4.; w = c v w m w m cv 7 E C y C H 0 2 m 2 .0 0 = 2! CD .5 - CL M CL > 4- m 0 w 2 d .d. a~ g c in a E ~ E o o a a h„ d o m r vr) vr> o v U) m r rm m CL u „+J E X 3 3 3 d, m o 3 3 a N Z 16 •N Zaaa ~aaa a m C C 0 0 N o o n n m } N J U `N OOi OOi Z w 0) 0) ~l c N 0) 0 co co a) M C O O 0 .2 O W O O O O 0 O O .5 C d1 C m c d N O O ~ N a) m ~ U 'p 07 Q Z Cn ` 'p d Q (n m w C N m d m ~ O O C 0 N C N C Q W O O O j 0 to 0 C) TO ~ L U O U Y O O V L a C/) O (n U) C m QO 00 O d' ° 0 c N C O) O Q1 c 7 Ci N O O t(n _O N Z y n N 4) co co M v o E CD O N m m • O O N r- 0 U) S N Z G H 2 N 0 Z C U) V~ y a y a LL L: IL u CL • a m .2 d m c d d c E c c 0 c 0 r A c.) a. OUU I,Omci Parcel 030-2045-50-000 03/24/2005 04:13 PM PAGE 1 OF 1 Alt. Parcel 27.30.20.509E 030 - TOWN OF SAINT JOSEPH Current X, ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): Current Owner * SCHOOL DIST OF, HUDSON HUDSON SCHOOL DIST OF 416 ST CROIX ST HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 14.000 Plat: N/A-NOT AVAILABLE SEC 27 T30N R20W 1 AC IN NE NE BEG 2 RDS Block/Condo Bldg: N OF SW COR NE NE; TH N 208'9" E 208 FT 9 IN; TH S 208 FT 9 IN; TH W TO POB Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) AS DESC IN VOL 14 PAGE 544 & ALSO PT 27-30N-20W DESC IN VOL 358/195 ALSO PARCEL DESC 1050/567 HOULTON ELEMENTARY Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1050/567 WD 07/23/1997 358/195 07/23/1997 /544 2004 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 05/24/1994 Description Class Acres Land Improve Total State Reason OTHER X4 14.000 0 0 0 NO Totals for 2004: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2003: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 K s ~ REPORT OF INSPECTION - INDIVIDUAL SEWAGE SYSTEM Sanitary Permit State Sept-i.e NAM Town4hip St. Ckoix County Location Section JLot # S bdivi,6ion SEPTIC TANK Size gatlo n4 l Numb en o6 eo mpantmen-tb Di,s tanee bnom:, Wett CJ Buitding l2 0 4,.ope Highwater.- PUMPING CHAMBER Size $atto n.a _ Pump Manu 5aetuner. Mo de.b Number. 110LOINu TANK tm Size galtonb -.Numbe oIt ent4 Pumper. A.Ca m y Di4tanco- 6nom: WeZZ Building 120 4Zope_ Highwate,% ABSORPTION SITE Bed Tkeneh Diatanee .6r.om: Wett Buil-ding ~ _12% .6tope Highwater. ABSORPTION SITE DIMENSIONS _ a Width o5 tr.eneh 6t Requi&ed area 6t r , Length o6 each Zine 92 61t Depth ob kock below tite in Numbe,% o6 tip ie4 Depth o j %ock ovet tit'e in TotaX Length 06 tine4 ~ S 6t Depth o6 tale below grade ~ 3 in D.i.exanee,between tine4 bt Sto.pe v6 t,%endh in. pen 100 6t 1 To-tat ab4o4ption area L2 00 6t Type o6 Cover.: Paper o 4t4aw R' PIT DIMENSIONS Numbe4 o.6 pit4 %avet around pit4 _y e.6 no Out.6ide diameter K Depth below inlet bt Totat ab4or,ption area `6t Area r.equin.ed bt ?1'; 4.81 REPORT ON INSPECTION OF SANITARY PERMIT # (1 Name and Addr,.^- Pe . Holder Person /Persons at Site (2 )Date of Inspection Time of Inspection ame, ress, icense o. o ns a ing Plumber 3 INSTALLATION CONSISTS OF: ❑ Septic Tank ❑ Seepage Trench ❑ Dosing Chamber ❑ Seepage Pit ❑ Seepage Bed ❑ Holding Tank ❑ Fill System ermanen reference Point) escri e: Elevation of vertical reference point: Slope at site: (5)MATERIAL AND DEPTH OF SEWER: (6)SEPTIC TANK: Manufacturer: Liquid Capacity: Tank Inlet Elevation: Tank Outlet Elev: # ft to lot or property line: # ft to well: M DOSING TANK: Manufacturer: # of gallons: # of gallon pump set for a cycle gallons; total capactiy of distribution lines gallon; size of pump head; gallon per minute horsepower ; brand name of pump and model number Is the warning device installed? ❑ YES ❑ NO Wired? ❑ YES ❑ NO ; 8 HOLDING TANK: Manufacturer o gallons construction ; depth to the cover ft; If septic tank is being used are baffles removed? YES ❑ NO; ft from residence; ft from well; ft from property line. Type of warning device Is the warning device installed? [I YES ❑ N0; Wired? ❑ YES ❑ N0; Locking device on cover? ❑ YES ❑ NO; Diameter of vent and material Distance from building to vent (9) SEEPAGE PIT SIZE: # of pits; ft diameter; ft liquid depth; ft to residence; ft to well; ft to property line; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than seepage pit inlet pipe-elevation ft; bottom of seepage pit elevation ft. (10) SEEPAGE BED SIZE: ft width; ft length; tile depth.; lineal feet tile; ft to residence; ft to well; ft to lot or property line; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than 20% falling away toward lakes, water courses or drainage ditches Elevation of tank discharge line entering bed ft. 11 SEEPAGE RE . Total length of seepage trench ft; width ft; tile depth ft; ft to well; ft to ordinary high water mark of lake or stream; ft to edge of slopes greater than 20% falling away toward lakes, water courses or drainage ditches; elevation of tank discharge line entering seepage trench ft. (12) Has system been installed in area indicated on EH 115? ❑ YES ❑ NO (13) Has system been installed in floodway? ❑ YES ❑ NO Floodplain? ❑ YES ❑ NO DILHR-SBD-6095 N. 8 ~buLTGN W jS LOU SQ. • Y Rte/ ~oN p~, . Vt,ri a/3SE Y ~iNES ~~4P~9RT J 10 \ \ \ ~G v /30 77~o M (o ` to \ co \ \ iyoTE" /9frE~ evrTlNy obc To/~ SoiC. - Sep E'/tv9TiAv . i"111 /se \ EAST .tiosT' •Tif of 13EL7 \ !✓i// /iE EX4c7l- y S'0 NoRT/f of /3M . r o , .r E,r,srtiy o,~ywEi~ couER aoc E.r/ST/.V ~X~sI>N~ S~~oTi~ Sc ~oTi'c E~ 2 c..Z: covEiPS I ~~'iSTi~/ y ,f c'leoz t c. V . . _F r 73 71 PLB 6 7 State and County State Permit # Permit Application County Permit # for Private Domestic Sewage Systems County *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF P RTx Mailing Address: f/vOSO.v Sc PROP s (PC #0V/ 7.0,0 eG&'Al. SIC koa L 110,0-fog AVIS Sv B. LOCATION: /V9/ %/VE- Section L? , T30 N, R2 E (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk# Village //Wy. Township5T 705'16PH- C. TYPE OF OCCUPANCY: Commercial *Industrial *Other (specify)Sc ooL *Variance Single family Duplex No. of Bedrooms No. of -Ref&eas 0441- "S, D. SEPTIC TANK CAPACITY 37&0 Total gallons No. of tanks / HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete Poured-in-Place Steel X Fiberglass Other (specify) New Installation Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: Percolation Rat Total Absorb Area O sq. ft. New Replacement X Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed: X Length ?4? i Width X9, Depth a Tile depth (top)_?-~ No. of Lines 8 Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land O -Z Zh Distance from critical slope WATER SUPPLY: Private Joint ❑ Community ❑ Municipal ❑ Owners name as listed on EH 115 if other than present owner: I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH-115 prepared by the Certified Soil Tester, NAME D 146Rich7- C.S.T. #Sy.OZ y~Z and other information obtained from VE (owner/builder . Plumber's Signature MP/MPRSW# /1~►, T~ gJ Phone #72 L 6 85f -23 71 Plumber's Address [.v PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca- tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors property. If well has not been drilled please indicate. C /Poi's S&G f i'O /v Oi ~~JD/111~ cAv riv m f cou Q ORf*61V A e.. 10 )h a<, a e l~ u f - - - - - - - ~ ~ ;ll ~RT cis 7R loo" ~1,1Pc 10, MAvEL 2 „ e o a C_> v 0 o .o 0 0 0 crt o; o 0 0 ~ DuTLt T 12 -EH, ~o ~i'><c.e~ ~j£ALf <-1£ALS S'c boo~ 1° 11 i5Rev.9/78 ~ J REPORT ON SOIL BORINGS AND PERCOLATION TESTS n~/ Of Z PAGES WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION: `JL'/d,,VzSection 21 ,T ~ N,Fi LSE (or).ML Toow_nship or Municipality Lot No. , Block No. County` Cleo #BuLTON GIE,ti! SGAODL ivisionV~.fO/V ,.SGHdOL SysTE-~► Owner's/Buyers Name: i , hwY ouLTbrc) &WI . Mailing Address: TYPE OF OCCUPANCY: Residence No. of~~f~~~s $ee}reerr+s 40 COMMERCIAL EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM OTHER DATES OBSERVATIONS MADE: SOIL BORINGS,00-A8-fo PERCOLATION TESTS Q'-d-000 SOIL MAP SHEET SCS y~ NAME OF SOIL MAP UNIT 80MI11+0)7T PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE R'UM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTE INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 • ±td Cod- P-2- ao a. s 7 ')IV-AA," I T-0 > >6 y P- Q.V c v IP- ~JiO . w SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, MOTTLING AND DEPTH TO BEDROCK NUMBER INCHES OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES B- /o NPAl x/08 0"~~• F Is 9"J ,fIN.Q ~y"~i~a,~. s~ iZ"~s. sue„ s e- Z /OS Nom > 8 S I3N,46..f w B- AJOV > / k Sc /O" L-1 a'-7, r "04 .C5 W1 B- O.tJ > "jev. JC QN . cs w ~ar_- B- B- PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy yZ, Dd.6Q• Ff• Alt Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. /3Ej~ (!FE J0~6,`c- 2 1 ~ J nn A „dp ..t S i j " 9j y . w o O O - C~ _ N i r ~ , I Q hboez. 44 Par E / • N Ne Q' o Gs I COP 91 /S Tow of CZ 9" C 0146-4 (JVOR? Co tlER 7`0 ` /✓a. SR i C E /4 f P CE~ R T C t of LiL>. _ 1 i E 6 E ; DA6,x- 2- 6?c 2_ rEH 4115Rev. 9/78 REPORT ON SOIL BORINGS AND PERCOLATION TESTS ~i96ES' WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES P.O. BOX 309, MADISON, WISCONSIN 53701 LOCATION:/" '/4,L'/<, Section 27 T N,R?~E (or) W, Township or Municipality ~'fE~ Lot No. , Block No. County S7 ' «Ol X Subdivision Name /S/y~,~O,c! .SG~ ~ C sySTE Owner's%Buyers Name: Ho L) LT-0,Q ~ ~EAj ita TA JeY SC k n a L Mailing Address: Ni.e~ y C~ 11.9" AJ Cf7ls. 0'y) W ~S TYPE OF OCCUPANCY: Residence No. of Bedrooms COMMERCIAL ,jC~r00 L~ E~E~y, EFFLUENT DISPOSAL SYSTEM: NEW REPLACEMENT ALTERNATE SYSTEM x OTHER DATES OBSERVATIONS MADE: SOIL BORINGS 9-d-fo PERCOLATION TESTS SOIL MAP SHEET <65 NAME OF SOIL MAP UNIT ,&U4el7/}ffA9 T PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTE INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P- ,ZiN S : c TAN P- P- D t e R CGS ooM ~i'4 c fo 2 U P - P- SOILBORING TESTS~sT7v~ TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, MOTTLING AND DEPTH TO BEDROCK NUMBER INCHES OBSERVED ESTIMATED HIGHEST IF OBSERVED IN INCHES B- 512/; of DiCXIVrfLP )?EA9• CGAs't B- E / O CG Ss iPM. B- B- /yo 5. X C /ASS- A014. X 6 c Tog s= 1/2 Q O B- B- PLAN VIEW (Locate percolation tests, soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of suitable areas. Indicate number of square feet of absorption area needed for building type and occupancy y2 b0 57~. Ff Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. EV T%o~1 s y /"~',f}Si 7-e- SET FIEU Tl -A) . (?•oP o ~X/~as v C..~• S' ,o %c. ~~y ? ' _ . _ ,M /33 - 30" ' 9k /o'w /3 _ N i , ~.w I /S t j 1 i ~ s 3 ~ ; ~ I ~ ~ I ! Department of Industry, Labor & Human Relations Division of Safety & Bldgs. State of Wisconsin Bureau of Plumbing Platting & Fire Protection P.O. Box7969 Madison WI. 53707 Tel. 608-266-3815 INALL CORRESPONDENCE REFER TO PLAN IDENTIFICATION NO. NAME OF PROJECT TYPE OF APPROVAL STREET AND NO. CFA ~ 'r0 CITY OR TOWN STATE ZIP 10 SEP 8 19 80 OWNER 4& Az Gentlemen: Examination of plumbing plans and specifications for the above-mentioned project has been completed. In accord with Chapter 145, Wisconsin Statutes and Wisconsin Administrative Code, the plumbing plans and specifications are approved contingent upon com- pliance with the stipulations indicated on the plans. Please review your code for the requirements of each code section noted. The architect, professional engineer, registered designer, owner or plumbing contractor shall keep at the construction site one set of plans bearing the stamp of approval of the department. In the event installation of the plumbing improvements or system has not commenced within two years from this date, this approval shall become void and new application shall be made for approval of these plans before work may commence. In granting this approval, the Division of Safety and Buildings does not hold itself liable for any defects in plans or specifications, plan omissions, examination and reserves the right to order changes or additions should conditions arise making this necessary. This approval is based on Wisconsin Administrative Code requirements. It shall be necessary to obtain and fulfill the permit require- ments of the city, village, township or county in which this installation is to be constructed.. Failure to obtain local permits will auto- matically void this acceptance. Sincerely, James Sargent-Bureau Director PBY: DATE: cc: DPS-OWS Owner DI LHR Local PI Plumber H & R (2) County Mfg. Rep. Bur. of Health Fac. & Services DI LH R SBD-6099 (N. 06/80) Rec. & Env. Services rtb , S14' A5 4 ! ,KY •api y, e a.. E . Ai" § 1• "max < ~ r . - Pfl lE( T.W.(rd~' *e r S,~ 'ir. ~''f c , tY 7 dr; `.A ! ~'"/"t 2~ ~F K `r 41 arc 4' 1 ~l~e ~"w7' ~ rte r ~ ji lei _ r~;' ~~;'i#;~Ck~.~~@. < ~ A 77 j" V4 jtm M). y #ot , indkifi~l clu ew. r F ~ k bf Qyretpayrrf9 ♦i +r BUJ der~ejpm nt. F ~e is cheC{r ,err ' gt eCtfee in went. s fi~ f{ nli k' l y $ N rl of~~ a day', t 4v.fv 4 a e y F y~ {p, t a iVp° a Man 1oct.} = f` xz a R b ; Aa~tlit+t~n l i~fbrr Ipr ~aRllt ae rrrtiited h tip w4ess spea"RV oted. n 4 04, Pts 3titit-deat~ ie9tbfe or penent. + , . € r., C] {A~~-g-+~jM*t i<ori.eul itieO s4*11 bo'signed,' s i~cl,,or st4owd in accord z+~ Section<,H 62.26(~O (a) `wS e~ ! 1 tAf Fl it 8t~closetl r 1 _ p lir' ' 'j } Atemataxs~ ~csiaosai Sysw nd Syste+as► x v . 1~ ► i' , uwof ~riatternate'.sYsxern j Des, c~icu# tio* for ressurize d' tributiorr 7cr ,cy) D'gn p a cs rr~uz ~i. i~ipelateral layout: '0 Plan viav~ of ai~t ate. v 4, Ai. r,X11. Ptivatel* svus[ tsAl Systems , [l i"`,r tl -u i '.ctsntotrrs rn.Otire are&,W- 4ait absorption system sex 'nding 25` on all dde4 ' i ~ I r 1 fev itin pent t t refere es point (bemcht "a o 0 ttWcy n cif reA suktt 7 for 4piaCetlent s tn,- proviefe soil Vast data. ' . Pit ptygrt~CZi s and adkiateral distan> fi~&tt>t seevage dissa#>& tem or holding tank to,.b( eq, et r Q. d,~a}( 1tQ#ding or lift p4~k +fz5rte cuss tank nranufacti,trer C r, cr-Vs4cn of soil pt'1oC+SYst®m. . A _'~r I I , , f + 1$1 0,9++rfk4~ 1151~L trtifi*dsoi.i t';(1 'Copy) ~1 1 to : T#beyrre than kipste¢ use of O4 copies of ?t;~ 60 Onciosed. ] iJ + t adn teQuere* (7 ,WPr). 41~ i :k ~ a a { ter- z - ~ e x v , E I - - - • 3` _ y p 1 PUMP 8003.c.) 4 MAUUFACTURER_ MODEL FRICTION LOSS WITHIIJ FORGE 0 MEASUREMENT BETWEEN PUMP ON AUD PUMP OFF____- 51-011 GALLONS PUMPED PER CyCLE_ 2700+ LIFT PUMP TANK (8400. 7.7.-n T7rH'ea3j MAMUFACTURER_ Weiser_.-__ 51ZE OF TANK___3000~~1___ VERTICAL WEIGHT FROM PUMP BASE TO OISTR15UTI ON BED OR TREUCH_ g I _an _ _ _ _ _ MANHOLE - MINIMUM 24" I.0. 4" VENT IV ABOVE GRADE 2S' FROM DOOR, WINDOW OR FRE5H AIR IIJTAKE NOTEI INSTALL AUDIO OR III VISUAL ALARM IN ~I I CONSPICUOUS LO- II I I CATION 11 I I II ~ I I I~ ( FORCED MAIN J I I I MIAJIMUM 1.0 . INLET. iOUTLET I I CAST IRON PIPE EXTEND- 1 I 1 WEEP INCA 3 FEET UNTO UW- HOLE DISTURBED (*ROUND HIGH WATER i I I I APPROVED WARNINIm DEVICE I I JOINT PUMP ON I I PUMP OFF 5UBMIT CONSTRUCTION DETAILS OF TANK IF SITE CONSTRUCTED pLu W, a IN1 G ~ r RECEIVED S E P 3 1980 ~ , ; }~~c_•~..y.r PLUMBING SECTION o v~To~J /EM . Sc ~ oo L ,4fip roN -/-0 VIE H a u LTO A.) w i S yL o u sq. r'f . po" Ut^'~ olds ~f> ooo i~ \ t /E~.sr oN of ~~,v: ` ~ R~ /30 7~o M l3M. \ NOTE /iEf CvTTiNy \ "-~Jof/C ;rv so 14. - \ tD SEP E/tv'~Tiav (+~i / lye y l IEEE o, \ EAST MosT 'tiP of 13Ev w;11 Ile y D NoR7# of /3M - \ ~o Ex%s7i~vy dFPl~ at 44 COVER ~A'/S~'/•!~ EJfiS~/N!~ SHPT C SC pTi'c E~ / 2 C..T co vEiPS ~'~E,,,,r;o,v of BM = O i Form- STC- 110044 AS BUILT SANITARY SYSTEM REPORT OWNER ~/GDS4~~~cika~~ TOWNSHIP ST ~oSE~ir SEC. a'/ T 30 N-R a0 W ADDRESS ST. CROIX COUNTY, WISCONSIN ,~YDa1LTnn/ SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of IZHR 83 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ✓aur ~0~ As,pg,4tT ; I-~ 90' s'S " ~sG •~~cY ~c w ~AsT 5x / sr/NG S c tfcyo~ ~1 ~I ,PIW Kit/G /~soH4~~ ,D.Plvtc~s StoUTH Proof-e-r/ INDICAT NORTH RROW TK O Sc,FL£ PITMP CHAMBER Manufacturer: 6&le6z~f Liquid Capacity: Pump Model: Pump/Siphon Manufacturer: Pump Size Elevation of inlet: Bottom of tank elevation: V .SD Pump off switch elevation: Gallons per cycle: /qr(. •'rV 4'i4s.S. Alarm Manufacturer: - l" 'E4 /~Al2m Alarm Switch Type: ~~_r1c~~y Ca.rrn~l Number of feet from nearest property line: Front, O Side, O Rear,(BrFt., Number of feet from well:_1;2~ SG Number of feet from building: SG (Include distances on plot plan). SOIL ABSORPTION SYSTEM Bed: C~~ 17-0.90! Trench: ,(,✓rrM LENT~IIE~- IYlrf~vrFcxp Width: Length: 90 ' Number of Lines: /V A Area Built: s✓Soysg~r Fill depth to top of pipe: r1S~ Number of feet from nearest property line: Front, O Side, (y1ear,0 Ft. 3 Number of feet from well: Number of feet from building: (Include distances on plot plan). SEEPAGE PIT Size: Number of pits: Diameter: Liquid depth: Bottom of seepage pit elevation: Area Built: Has either a drop box O or distribution box O been used on any of the above soil absorbtion sytems? (Check one). HOLDING TANK Manufacturer: Capacity: Number of rings used: Elevation of bottom of tank: Elevation of inlet: Number of feet from nearest property line: Front, O Side, O Rear, 0Ft. Number of feet from well: Number of feet from building: DEPAR i`MENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDING LABOR & HUMAN RELATIONS DIVISION P.O. BOX 7969 ON-SITE SEWAGE SYSTEMS OFFICE OF DIVISION CODES & APPLICATION MADISON, WI 53707 State Plan I.D. Number: NE , i NE 4, Sec. 27, T30-R20 ❑ CONVENTIONAL ❑ ALTERATIVE (If assigned) Town of St. : ;Jos ept Holding Tank ❑ In-Ground Pressure ❑ Mound rrir O PE OL R: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: Hudson School District 416 St. Croix St. Hudson', W1 5401 1 -97 3,~d BENCH MARK (Permanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.: Name of Plumber: MP/MPRSW No.: County: Sanitary Permit Number: Zappa Bros. Inc. 3395 St. Croix 135370 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER PROVIDED. PROVIDED: ❑ YES ❑ NO ❑ YES ❑ NO BEDDING: VENT DIA.: VENT MATL.: HIGH WATER NUMBER OF ROAD: PROPERTY WELL: BUILDING: VENT TO FRESH ALARM: FEET FROM LINE: AIR INLET: ❑ YES ❑ NO ❑ YES ❑ NO NEAREST DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY: PUMP MODEL: PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COVER PROVIDED: PROVIDED: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH (DIFFERENCE BETWEEN FEET FROM LINE: AIR INLET: PUMP ON AND OFF ❑ YES ❑ NO NEAREST 00- SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing FORCE LENGTH DIAMETER: MATERIAL AND MARKING: or excavation. (If soil can be rolled into a wire, construction shall cease until MAIN the soil is dry enough to continue.) CONVENTIONAL SYSTEM: BED/TRENCH WIDTH: LENGTH: NO. OF DISTR. PIPE SPACING: COVER PIT INSIDE DIA.: # PITS: LIQUID DEPTH: TRENCHES: MATERIAL: DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DISTR. PIPE MATERIAL: NO. DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPES: ABOVE COVER: ELEV. INLET: ELEV. END: PIPES: FEET FROM LINE: AIR INLET: NEAREST MOUND SYSTEM: Mound site plowed perpendicular to Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM slope and furrows thrown unslope: mound systems to make certain that it ON REVERSE SIDE. SHOW ❑ YES ❑ NO meets the criteria for medium sand. ELEVATIONS MEASURED. SOIL COVER TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS; ❑ YES ❑ NO ❑ YES ❑ NO DEPTH OVER TRENCH/BED DEPTH OVER TRENCH/BED DEPTHS OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER: EDGES: ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH: LENGTH: NO. OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: TRENCHES: DIMENSIONS MANIFOLD PUMP MANIFOLD DISTR. PIPE MANIFOLD MATERIAL: NO. DISTR. DISTR. PIPE DISTRIBUTION PIPE MATERIAL & MARKING: ELEV.: ELEV.: DIA.: ELEV.: PIPES: DA.: ELEVATION AND DISTRIBUTION HOLE SIZE: HOLE SPACING: DRILLED CORRECTLY: COVER MATERIAL: VERTICAL LIFT CORRESPONDS TO INFORMATION APPROVED PLANS ❑ YES ❑ NO ❑ YES ❑ NO PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF PROPERTY WELL: BUILDING: COMMENTS: FEET FROM LINE: ❑ YES ❑ NO ❑ YES ❑ NO NEAREST- Sketch System on Retain in county file for audit. Reverse Side. SIGNATURE: TITLE: SBD-6710 (R. 06/88) DILHR SANITARY PERMIT APPLICATION C I n accord with ILHR 83.05, Wis. Adm. Code f STATE SANITARY PERM T # -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ /3 5-7 a 8% x 11 inches in size. Check If revision-to o previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. Q'- PROPERTY OWNER PROPERTY LOCATION '/a neL '/4, S N, R E (or) W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # CITY, STATE T P CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER d II. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD ❑ State Owned VILLAGE - ✓ Public ❑ 1 or 2 Fam. Dwelling-# of bedrooms - P R ELTAX NUMBER(S) III. BUILDING USE: (If building type is public, check all that apply) 1 ❑ Apt/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 in line A. Check 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 # - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 N In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 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 " Feet Feet VII. T NK CAPACITY Site in allons Total #of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete strutted Con- Steel glass Plastic App Tanks Tanks nqAlrA~ Septic Tank or Holdin Tank D Lift Pump Tank/Si hon Chamber ~e3 Dt7 VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name Print): Plu Si ature: N Stamps MP/MPRSW No.: Get Business Phone Number: Plumber's Address (Street, City, State, Zip Code): .r . IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater a e ssue Issuing Agent Signature (No Stamps) Approved ❑ Owner Given initial /y5-,o 4 Surcharge Fee) e_0 I C_ Adverse Determination lo -3Q-v X. CONDITIONS OF APPROVAUREASONS FOR DISAPPROVAL: SBD-6398 (formerly Pib-67) (R. 11/88) 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 the 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 & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: .ti 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. 111. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in 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 in ##1-7. VII. Tank information. Fill in the capacity of every new and/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% 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 it 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 the`sal.sWcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) /VORTIf ! ed'AVrrY .4vAVE 13 ~.i1S7-1N4r,, -mod/( .s r- 70 /~l3.o/vooNED - OOS/N (o ~/dgM~s L K 15'~"!NG • AS 1--14,f 1 T l~vOc.P~ Y SEg/c ~,Nc P i,,r,ec Aj p '4-ks ~.foOos.E~ New ONSITE SEWAGE SYSTEM /A -r (fonalitiona Inv e-f y /NE AF%Pw%0 - ivm:om& DEPARTMENT of INDUSTRY. LAK3 HUMAN Rs"pflohs EIV AND I~ ago ..,AWSIM OF J(i sY-//Uzx/S/Ia Asv Al Ul~ivEw.4Y rye. 1-24•PK4ov G A.e--A I STi ou (o SO' 10'U p N h 14 to Q ~Q O V Z p u V CD cl: 2 Q~ w sea cnv a J V " %4 p ~ ~ y' Q o W o cn Cl 4 w o a ' (D .~j 0 LLI n o En V ~ O (J w 2 C Q 2 w V or 1 3 0 it, \5 \A_ v `n $ a H ° V-1 $ C O v. a vi q vv~ %j V- " V ~ M G Q 2 N C~ U n p ~ a R 't 3 a ~ N ~ o ac4e LU x N N a co U Q V c a LU p co ~ vi oi0c _Itu a CL CL G 05 cc Q Q ~ c CO Q v vj 0 v J p _ ti w w ac C • v nw 0 ~ s ~ z SIT SEW E S TEM .,to Q (moo deco d 2 02~'OVEO"h tF 2.1ST#Y, LAi SAN €3T; •o ~ r 5, b x ~ ~ ~ ~ U O e a ~ v lp VI `n 0 Q to ri n Q I. n u 09 F H U Go S ~ D a s J a ~ ti ~ h ~ Q c~ Q r~ x ' 0 w u W uj N Q 0.~ r4 ~ V uj t (D U- ~j , ° kL 28 0 00 = ~ a V z o vi t z v v) %I J a Q, ggf ~k~§ C n\ h J O vp5v l ♦ ~1 V 1 p D t 00 11 lh ~ ~ lYl ~ M ~ ac ~ ~ J; do ~ 0'1 0~ tJo ~ ~ ~ ~ 1rtl rl) 4 v a s a 2 V i F v~iO ``v^ ' ? 1 J a < II 11 11 `t ° °V0o ~ ~ ~ Cj qL iJ o ~ 11 a it 1U N U vl ~J" s _ oc v Q ' V, - a ? 1.4 C \ -o~w4 ~J Z W W 0 n o v vi p CO : ~ V cc v~ c~ r tAj vi vi ~p o N La, s O 0 11 ZZ CC) W, -I.- of- Q V v ~ ~ ~J 0 t ~ s Q U 2 ~ ~ ct W h h 3 t Q ' ' ~V Submersible S89-40445 Wastewater Pumps High Head Peabody BaRnes NOTE: PUMP CAN OPERATE DRY FOR EXTENDED PERIODS WITHOUT DAMAGE TO MOTOR AND/ OR SEALS. 1. 4" discharge models handle 3" spherical solids. 2. Choice of 4.5, 7.5 or 11.3 HP High Head models. 3. Single- and three-phase oil-filled motors running at r1750 RPM. 4. Heavy duty cast iron construction with stainless steel hardware. 5. Choice of 230 or 460 volt models. 6. Exclusive semi vortex pumping principle has two non- clog impeller vanes with added back vanes to keep solids from seal area. 7. Shaft seal is the double mechanical type in patented oil- filled, pressure-equalized chamber. Motor end of seal is ceramic and carbon, pump end of seal is also ceramic and carbon faces. 8. Equipped with 25' of 10/4 SO Cable. 9. Equipped with moisture and temperature sensors as a standard. SPECIFICATION TABLE ` MOTOR DATA Approx. Model Size Solids H.P. RPM Phase Volts wt. 4SEH302 4" 3" 4.5 1750 3 230 280 4SEH304 4" 3" 4.5 1750 3 460 280 4SEH502 4" 3" 7.5 1750 3 230 310 4SEH504 4" 3" 7.5 1750 3 460 310 m 4SEH752 4" 3" 11.3 1750 3 230 340 ' 4SEH754 4" 3" 11.3 1750 3 460 340 4SEH1002 4" 3" 15 1750 3 230 400 4SEH1004 4" 3" 15 1750 3 460 400 16.36 • 4SEH301 3" 4.5 1750 1 230 280 4SEH501 4" 3" 7.5 1750 1 230 310 TOTAL HEAD MTIIS.I FT. hrlorm.ne. Cun. fn ~ fYMMnNM WrIwSM Pump 20.06 saa. • M- aPIH.I.r 8.18 EE I nao nPM so 70 P..O.ay 9- 1- 20-- I ~DDE E Go ~N ~ HO 7~' T ~y 41r 7 1s so Iha 10 OE`t'8fh ~7 Eby 34.12 70 N 4.00 DIA. 10 i DISCHARGE s 10 6.6 U.S. GALLONS 100 700 300 aq we NO Too we S00 PER MINUTE LITENf -1 I F I 1 40 SS-0 77W 7500 7000 Mwo MS00 MMOO MESS PER MINUTE 3.50 DIA. 10 SUCTION ~ C 'IC! J " ~ ~ m 3 d+ -Ne 1 b+ v 00 V) w t/i 3 N h l +C `n v 11-4 r ' ~ r R ~ O ~ ti ~ ~4 w 10 4 *t 0 " ~ -mac w vl ~ N n ~V~Qgv)Q~ 4~y v Z rn v a v N r ~ r DEPARTMENT OF' REPORT ON SOIL BORINGS AND S 8 93`4@ vT* IN LABOR DUSTRY, P.O. BOX 76 HUMAN NDATIONS PERCOLATION TESTS (115 ) MADISON WI 53707 REL (H63.090) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/MH}fFC.. 1.-Y: OT NO.: BLK. NO.: SUBDIVISION NAME: NE 1/r- 1/ 27 /T3a N/Rao~(or► Sr tP - - COUNTY: OWN A `S'T CQv 1 x YT SC.►( L h1SiIR ICr USE DATES OBSERVATIONS MADE NO. DRMS.: COMMERCIAL `DESCRIPTION: M7-RIIITLTDESCRIPTIONS: A N TS❑New Replace 7 /Qo 70 1 dcT 90 - S h - riZ"i R t{ 50 c.~ 01C Kimi 41 s4 )LS RATING: S- Site suitable for system U- Site unsuitable for system B>t AQ4 CO~ STCJU • M®~• OU IN ~ ~ S M L HQ~LDiNG TANK: RECOMMENDED SYSTEM:(optional) If Percolation Tests are NOT required DESIGN RATE: I if any portion of the tested area is in the A under s.H63.09(5)(b), indicate: CL. S3 / Floodplain, indicate Floodplain elevation: tVA U c- Ff PROFILE DESCRIPTIONS BORING TOTAL DEPTH T R UNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH W. ELEVATION OBSERVEQ_ EST. HI H TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- Z 9.9Z 2-7 ' 9.4Z /C,'& - LT o~ ~Y -S 9 ' k4 e 4Y ONE B- M$ Gig Ca b~ST ZZ'80.,.CS B- g 33 9S.~i~ oN > f$.33 8"C. Bi.MA ITS 19'G,v 1 ~3~BaNSt($u~Ky B- y~6Y$It S. ~tGyf►►oT, /o BQ.,S, Fs tls o'~?tiCS C.~ B• 3x.33 5.6o ar ? 4.33 9"QLSL-s "Q<a s.c C~ 1o~i2n@e M i B- "e L e 'Q- 04.16 Ccj,M " 21 ' L eAN <<d C, eZ . 44 PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER I~&iiES AFTER SWELLING INTERVAL-MIN. PER INCH P. 1 .1d P44 me llq-.,Io 0 I 't4 P. 2 4.&o oNC llqs.qQ 10 3 3 33 P- 3 a r4olic 9 0 3 3 3 3 3 P-. P- tt_cJd?► N A-r P Qt. P- PLOT PLAN:' Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope, i SYSTEM ELEVATION w .?U I I ~ ~ ~ I I I • 1._..x.._1_ _ ' - - -T . >RSC ~ ~ i rY: CD C_.) IV i rrt cr) P-3 Ss 1 Ste' s~ ~ i I /0O, 4 g-Z P"Z OCP I ~ 10 ~A~v I ~6~ a 1 o L ' OAI .n fir. Q, f 1 L~ NOTE o ryOL L SYSTEM TD I Ifottu ANb WEST FcR $t,,xumatk _ Tdp pG' I ^ I p~' Scs ~~s . 4 I v No~c,+ u uG~ 0~ I? FT Best ustz Sir loN - Z~ KTIOQ < 190~ 1 /0.35 I t4ol i I I I I S~.~aL~ ~ = 30 I 1 !I . APPLICATION FOR SANITARY PERMIT 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 in delays of the permit issuance. Should this development be intended for resale by ownst/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 School District of Hudson Location of property 1/4 1/4, Section 27 , T 31 N-R 20 V Township St. Joseph Mailing address 416 St. Croix Street Hudson, WI 54016 Address of site x`70 County Road E Houlton, WI 54082 Subdivision name Lot number Previous owner of property School District of Hudson Total site of parcel 4 acres Date parcel was created Feb. 1952 Seut. 1880 Are all corners and lot lines identifiable? % as No Is this property being developed for resale (spec house)? Yes % No Volume land Page Number 544 as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A VARRANTY 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 (out) 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) have STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER School District of Hudson ROUTE/BOX NUMBER 416 St. Croix Street FIRE NO. CITY/STATE Hudson, WI ZIP 54016 PROPERTY LOCATION: NE 1/4 1/4, Section 27 , T 31 N, R 20 W, Town of St. Joseph , St. Croix County, Subdivision , Lot No. 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 $3000 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 systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master 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. Certification form will be sent approximately 30 days prior to three year expiration. 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 Department of Natural Resources. Certification form must be completed and returned to the St.Croix County Zoning Office within 30 days of the three year expiration date. SIGNED DATE L') St. Croix County Zoning Office P.O. Box 98 Hammond, WI 54015 (715) 796-2239 or (715) 425-8363 Sign, Date, and Return to above address ' RE¢ASTERED PROFESSIONAL ENGINEER LICENSED LAND SURVEYOR CARROLL A. GRUBB River Falls, Wisconsin • Feb. 5, 1959 Description for School District for parcel to be obtained at Houlton--.--- A parcel of three acres located in the northeast quarter of the northeast quarter and the northwest quarter of the northeast quarter of aection 27, T 31 N, R 20 W. further described as follows: commencing at a point two rods north of the southwest corner of said northeast quarter of the northeast quarter, thence north along the west line of the acre tract described in Vol. 14, Page 544, a distance of 208 feet and 9 inches; thence east along the north line of said acre tract a distance of 208 feet and RK 9 inches; thence north on an extension of the east line of said acre tract a distance of 208 feet and 9 inches; thence west on a line parallel with the north line of said acre tract a distance of 417 feet and 6 inches; thence south on a line parallel with the west, line of said acre tract a distance of 417 feet and 6 inches to a point 2 rods north of the centerline of said northeast quarter; thence east a distance of 208 feet and 9 inches to place of beginning. ~I L, - N rq V✓ - N Gr 0 o 4 17 nrPSPrt v A C-~ 00 1 va 14~ payer ' 2 ro cf 4 31 -zo Na &1. Warrants tined-Common Form 1(RTATO OF R18CON8M Publlebed by Eau Claim Book 4 8tetlonery Cr. 9.o. 285.18, Wis. statute,. Form Na 1 i 215 8 0 9 4 i O4is 3dienture made this 11th day of April , A. D., 1959 between 'bUreella A. Joyce - l part y of the first part, and Joint School District No. 1 of the City of Hudson anA the Towns of HuAson, Troy. ;i St. Joseph anA Somerset, Ste Croix County, Wisconsin part y of the second part. { (MitntOOtty: That the said part y of the first part, for and in consideration of the sum of I i ' One Dollar ($1.00) and other valuable consiAerations- - - - - - - - - - - - - i.l to her in hand paid by the said art I!I p y of the second part, the receipt whereof is hereby confessed and acknowledged, has given, granted, bargained, sold, remised,- released, aliened, conveyed ! and confirmed, and by these' presents does give, grant,. bargain, sell, remise, release, alien, convey and confirm unto the said part y of the second part, its heirs and assigns forever, the following described real estate, situated in the County of St. Croix j and State of Wisconsin, to-wit: A parcel of three acres locateA in the northeast quarter (NE4) of the northeast quarter (NE;) anA the northwest quarter (NWO of the northeast quarter (NE4) of i Section Twenty-seven (27), Township irty (30) North, Range Twenty (20) Weate further AescribeA as-follows: comma ing at a point two rocs north of the southwest corner of saiA northeast quarter (1EJ) of the northeast quarter (NEI), the north along the west line of the acre tract AescribeA in Volume 14, page 544, a Aistance of Two HunAreA Eight (208) feet anA Nine (9) inches; thence east along the north line of saiA acre tract a Aistaace of Two HunAreA Eight (208) feet an,; Nine (9) inches; thence north on an extension of the east line of saiA acre tract a Aistance of Two HunAreA Eight (208) feet anA Nine (9) inches; thence west on a line parallel with the north line' of sa1A acre tract a Aistance of Four HunAreA Seventeen (417) feet j anA Six (6) inches; thence south on a line parallel with the west line of sail acre tract a Aistance of Four HunAreA Seventeen (1417) feet anA Six (6) inches to a point two (2) roAs north of the centerline of sail northeast quarter,(NEi); thence east a Aistance of Two HunAreA Fight (208) feet anA Nine (9) inches to place of beginning, subject to existing highways, easements anA rights of way of recorA• i ~II i i! h i i • iIl Cogetgtc with all and singular the hereditame and appurtenances thereunto belonging or in anywise appertaining; and all the estate, right, title, intest, claim, or demand whatsoever, of the said part y of the first part, either in law or equity, either in possession or expectancy of, in and to the abovq kargained premises and their hereditaments and appurtenances. 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C p O £ L' c ~C •rr'- r c yr L/ o c«< ~4! t1 C! cl <~i.~ " apH ' . D c«GCy ~c.c All, r rlrY e au7 lcor~k/y1Fi & o<rdo7td' Ci7 {rl d~ CJ t Q ~ . r x[ rr r C!-<-<L F lvFrI ;I a<.... :TJ y P a o c< c f/ ~ C / s[ . - CJJ ~~C<L/ cv t ytJ GZU STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNERA n/),S if~~ LJ~Si P/~T ffDu~Tonl AJ'~'/~ Py ADDRESS SUBDIVISION / CSM#LOT # /k 4 , SECTION T~o N-Raj-W, Town of fr. ~1vri~ti ST. CROIX COUNTY, WISCONSIN ~9o` -Alva' AoPLpfrr L.iAIE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM -l ~x~ST/NG ~ /~BsaPOridN ~~pc~{ o,~i%" aaRL6trE s' _ 44 oo o%'PTta/J I S Mex 35 'To ScHwo cE In,41'.v C.45 Q?oP~Pfi' `1 n Lhs r ~+Pdv 0. L, P S«vE Ile0 e,rlL ~"Fr LH4"m f-v-rA" s O 35~Pf ~r~~ L,vT ~ 0~ / ~E.Vr f' OES c r~~ LrfPS IAJ E*,CH e-,0i" of G 5 4• e S--PTIC T.wK S' /~~35oPP?7onl /kiP ~y sg 1 ~G Get . SLUric 1;tAJK lJ r4 Owr4, r SAAftS ~gNrov~n Qoo?wAy /%UStd ~,GawP /Jp S1A4.6 E<EJ =ion oo' S~cN~~- G~ASSQoo~`~DD ~T ~"J INDICATE NORTH ARROW 1 Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: /NiSN <vae OL ~xrFoot, Ai- //ooPrA C!ClOP(0 Ay ALTERNATE BM• SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer:_ jj/.6 ,p Liquid Capacity: 3a3o 6!&< Setback from: Well 46&' House Z4' Other Pump: Manufacturer 6_7 &rnAc Model#SFS/,'/oW Size / .-4,4-vz, Float seperation . T?7` Gallons/cycle: 4y5. io G.tis Alarm Location o^j G xT~/1 oR oic ls/dR•rg tj,4,L4 0~ Sc uoo~ Q« SOIL ABSORPTION SYSTEM Width:-3(,' Length 47 9 Number of trenches /mil C,2ou*J4 Af4654f?Z Distance & Direction to nearest prop. line: ",jof r/4 R~ro' Setback from: well: House S~- Other ~}SSn~pr,0NAPiA% ELEVATIONS - 95. 'r7' Building Sewer 9(p.~~' ST Inlet:' 93.'7S ST outlet: PC inlet 87. i5p PC bottom 4F5,0'3 Pump Off Header/Manifold fV.3n' Bottom of system 8~.,Vo' Existing Grade 95-, oo' Final grade 5'~. SS DATE OF INSTALLATION: PLUMBER ON JOB: e~7 _5, LICENSE NUMBER: MAe5' INSPECTOR: 3/93:jt ,Wisconsih Department of Commerce PRIVATE SEWAGE SYSTEM y' Safety and Buildings Division Count ST . CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitarp".: Personal information you provice may be used for secondary purposes (Privacy Lakw, s.15.04 (1)(m)). f UDD bnfe~ftbL DISTRICT EMMY [Jr6NP9 Town of: State Plan ID No.: CST BM Elev.: Insp. BM Elev.: BM Description: Parcel _3'32045-50-000 r t TANK INFORMATION ELE ATION DATA A9700301 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark o~ Dosing Aeration Bldg. Sewer 3,3~, ' 9G,7, Holding St/Ht Inlet ~`°a4 y5, ss9 4b,17 Y' TANK SETBACK INFORMATION St/ Ht Outlet' si S- ''s'' a11 '93.3.0 TANK TO P/ L WELL BLDG. AirI to ntake ROAD Dt Inlet Air I Septic -7 9 NA Dt Bottom 14'.05 5. 3' Dosing NA Teader/Man. >a~ ' Aeration NA Dist. Pipe L24(r Ct77,34/r Holding Bot. System /U.loB~ 8Q, y' PUMP/ SIPHON INFORMATION Final Grade Manufacturer n Demand` Model Number SH_ /0 ix` (a GPM y, TDH Lift 53 Friction 79 Systema 5 TDHg5j Ft Forcemain Length Dia. 3" Dist. To well ~a?bv SOIL ABSORPTION SYSTEM BED/TRENCH Width, Length Ne 6f Trernhes PIT No. Of Pits Inside Dia. Liquid Depth DIMENSION ,36 - DIMENSIONS SYSTEM TO P/ L BLDG WELL LAKE /STREAM LEACHING Manufacturer: SETBACK INFORMATION Type O rr; CHAMBER Moe Number: System: ,tJy0 p S 3q~ 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.) LOCATION: ST. JOSEPH 27.30.20.509E,NE,NE 70 CTY TK E Plan revision required? ❑ Yes [ja/No Use other side for additional information. W '11-114 SBD-6710 (R.3/97) Date ctor's Signature Cert No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: I i i DILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY EzSTATE SANITARY PERMITP -Attach complete plans (to the county copy only) for the system, on paper not less than v 97 /r LJ 9 8% X 11 inches in size. ❑ Check if revision to previous application -See reverse side for instructions for completing this application. -70 C1 Y - TIC.- STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. f - PROPERTY OWNER PROPERTY LOCATION '/a ' '/4, S TM, N, R E (Or )o PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER Id-Y,0,19. S CITY NEAREST ROAD 171 II. TYPE O BUILDING: (Check one) ❑ State Owned ❑ VILLAGE : avGtr6~ E X Public ❑ 1 or 2 Fam. Dwelling4 of bedrooms -'PARCEL AX NUMBER(S) III. BUILDING USE: (If building type is public, check all that apply) v9£ 83 0 2v 46-- 50 1 ❑ Apt/Condo A7-940..20. 509E 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 50 Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. ® New 2. El Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. El Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit # - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ® In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 140 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 9.50 2 1P6 A100 y P,9. y% Feet S/. D Feet VII. TANK CAPACITY Site in alIons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank O U LIMF.PFA Lift Pump Tank/Si hon Chamber -las- S 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 Si ature: (No Stamps) AMP/MPRSW No.: Business Phone Number: 6- 0 Z. Plumber' A dress (Street, City, State, Zip Code): IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing gent Signa Surcharge Fee) Approved ❑ Owner Given initial fJj CO? p'/aC)r Adverse Determination O CC// Q X. CONDITIONS OF APPROVALIREASONS FOR DISAPPROVAL: SBD-6398 (formerly Pib-67) (R. 11/88) 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 the time of renE!wal 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) 'o 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 & 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 in 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. VL Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for al/ 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'h x 11 inches must be submitted to 'he county. The plans must include the following: A) plot plan, drawn to scale or with complete dimension,,, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers- veils; water mans/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absc)rption systems; rep~a,:ement system areas; and the location of `he building served; B) horizontal and vertical elevation referenre points; Cl) 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 absc rption system if required by "lie county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin A- I-t 410 included the creation of surcharges (fees) for a nun its."r of regulated practices which can effect groundwater. The ni.on4is ct)i~~;cted through these surcharges are. used 'Kr rr:.0-Mitoring gro.widwater, groun-'.- water contamination investigations and establishment of standards. SBD-6398 (R 11/88) SAFETY & BUILDINGS DIVISION July 31, 1997 State of Wisconsin 2226 Rose Street Department of CommerceLa Crosse WI 54603 ZAPPA BROTHERS 715 SIXTH ST N HUDSON WI 54016 RE: PLAN S97-40856 FEE RECEIVED: 260.00 HOULTON ELEMENTARY SCHOOL NE,NE,27,30,20W TOWN OF ST JOSEPH COUNTY OF ST CROIX PRESSURIZED IN-GROUND SYSTEM The Department has reviewed the above-referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval of the system is based on chapter 145, Wisconsin Statutes, and chapters Comm 83 and 84, Wisconsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter Comm 82 or in chapters ILHR 50-64, Wisconsin Administrative Code. This plan submittal approval will expire two years from the approval date, or if a sanitary permit is obtained, plan approval will expire on the day the initial sanitary permit expires. The licensed plumber responsible for this installation shall keep one set of plans with the Department's stamp of approval at the construction site. The installer shall notify the appropriate inspector when inspections can be made. All permits required by the city, village, township or county shall be obtained prior to installation. Inquiries should be directed to me at the number listed below. Please refer to the plan number shown above. Sincerely, and M. S Plan Reviewer Section of Private Sewage (608) 785-9348 ~,II SBD-7997 (8.11/96) 6 1 rb b ~ o ~,Tt CD oQ r Z Z r r ,O ° y 2 4 y ca vi) y , INA Lk ` O '1 g CIA m nc~ ~n g O $ • ell C N r Z y r~ rry o AM 0 kA z m g~ N a m ~i NA to m o . a ~ . , . ~ y ,.;t ~t9 ~ r t ~ ~ .9. mr a yy i! _w L f s~ ~ rt ~ $ " ~ E IJo(,,TN )oRo P,-4 A4rJ' 7- -A ~ iSTiNG pk00£4''rY Sysreh, 617-44ji J6((S AeCA f I Sc 140 OIL n~ ate' 4 A-1, 14R9- 4 Ex ~ ST/N G 70~ p~K,~ ~ DoT I Co~n,rY 7~iQL(nl K f-~/~ I-l ~r. //VC J i I i i i _ ~s- _ _ _ _ - ass- - D/QL7 /~C~~l ~Y 1 NLS i 45' iSTiNG rihQK~NG DoT S~A4 J i ti I y n` I tN r -.Owl o_N14 i y ► < y~'-- IN V,A 2 W A o n~ ~ g N a y ~ y b y ~ y Z is R Q a ~ 01 ~ ~ ~ ~ L ~t ~ z c v p ~ 0 0 N n N N W O O r 11 ~ ~ 1 o O 1 t W n O J~' w ~ z N ~ ~ I I n A I a W N r R \ W W ; 1~ t l C` ~ -a ~ \ `ftl4 r' 76 1 r ~pl r \ M r \ N b x~ Jo 6 6N rz t) Z 016 r 71 A~ p 1., N F Z ~p f~ `n u a J~N 14 e ~ U1 y a r IA vl m wh N ^ ~1 S N T 0 C, G'J w U i 3 (A ~ s s At, k 1~ ~ I n ? ~ ~ ~ x Rl ~T p n N n s ~ ~ ~ h o (yip - - L N 11 + ~ n ,!y S .J 3 POP v~ v - -76 I 1 p 1 1 1 ~ m d ~1 If 11 fi 31; A Vc. 'fa A~ C p ON W\ SECT. 100 TAB Effluent Pumps PG. 101 DATE January 1. 1986 P Y M P • MODEL SEVH- [~0.4] W SESH- loW 20W 96 RATED HP i.o 2.0 SOLID SIZE 3/4 BLADE I-2 SPEED 3415 0 RPM * ; 0 Hz PH VOLTAGE X 84 72 I- W W S~sy. ? 60 2p~ a S`~sy. r 0 = 48 J H 0 ~ 36 CIO W QQ 24 S~~y ,AGL 12 0--- 20 40 60 80 100 120 140 USGPM * SEVH-4W: 115V or 230V, 208V SESH-5W: 115/230V, 208V SESH-10W and SESH-20W: 230V only / /D 6E ASS Pumps Inc. 140 Pond View Drive Meriden, Connecticut 06450 PUMP SPECIFICATIONS SECT. loo TAB Effluent Pumps PG, 102 MODEL: Scavenger SEVH, SESH GENERAL Furnish and install ABS Model Scavenger submersible pump(s) to deliver USGPM against a total head of feet. The motor shall be HP RPM connected for operation on a volt 60 HZ phase service. The pump discharge size shall be PUMP DESIGN The pump(s) shall be of the submersible type with an integral motor and pumping unit. The pump(s) shall have a semi-open or vortex impeller capable of handling and other similar solids-laden fluids without clogging. The suction inlet shall have a wave form with the leading edge of the impeller overlapping the wave form (SESH only). Should a textile or plastic sheet plug the inlet, the shearing action of the leading edge of the impeller against the wave form of the inlet will cut away enough of the material to clear the inlet. PUMP CONSTRUCTION Impeller: The impeller shall be made of erosion-resistant chilled gray cast iron (SESH) or polyamide (SEVH) and shall be of the semi-open, double vane (SESH) or vortex (SEVH), non-Clogging, dynamically balanced design capable of passing a minimum of diameter spherical solids. The impeller shall have a slip fit onto the motor shaft and drive key and shall be fastened to the shaft by a stainless steel bolt. Pump Volute: The pump volute shall be made of gray cast iron with smooth internal surfaces free of rough spots or flashing. The volute shall have a centerline (specify: vertical or horizontal) discharge. Self Cleaning Front Plate: The pump shall be equipped with a gray cast iron front plate, mounted to the volute with four stainless steel adjusting screws to permit close tolerance adjustment between the front plate and impeller for maximum pump efficiency. The front plate shall be designed with a wave shaped inlet and an outward spiraling V- shaped groove on the side facing the impeller, to shred and force stringy solids outward from the impeller and through the pump discharge. (SESH only) Mechanical Seals: Each pump shall be equipped with a lower mechanical seal having a carbon stationary seal face and a ceramic rotating face. Models 1.5 HP and larger shall have a. separate oil chamber separating the motor from the pump end. An angle mounted lip seal shall be fitted to the upper section of the oil chamber to seal the motor housing from the oil chamber. Shaft and Bearings: The pump shaft shall be stainless steel supported by two heavy duty single row ball bearings. Motor and Cable: The pump motor shall be enclosed in a watertight housing of gray cast iron, filled with dielectric oil The motor shall be a NEMA design B with moisture resistant Class B insulation rated for 1200C. Single phase motors shall have inherent klixon motor protection and start capacitors located within the motor housing. Power cable shall be 15 feet long with a PVC insulation suitable for submersion in sewage. O-Rings and Fasteners: All mating surfaces of the pump and motor shall be machined and fitted with Buna N 0- Rings where watertight sealing is required. Sealing shall be accomplished by the proper fitting of the parts and not by compression or special torque requirements. All external screws and fasteners shall be made of stainless steel. All surfaces coming into contact with the liquid media, other than, stainless steel, shall be protected by a corrosion- resistant coating. INSTALLATION The pump discharge(s) shall be provided with either a breakable union or a guide rail system so there will be no need for personnel to enter the wet well for pump removal. Where the guide rail system is used, the pump(s) shall automatically connect to discharge connection(s) when lowered into place on a single guide rail system, requiring no bolts, nuts or fasteners to effect proper sealing. Each system shall consist of no more than one guide rail supported at the top by an upper guide bracket and at the bottom by the discharge connection. The guide rail base shall be equipped with a vertical straightening vane which properly aligns the slot in the pump bracket and centers the pump just prior to final seating. Ease and quick removal of pumps from other than the vertical direction over the center of the pump shall be a requirement of the system. ABS Pumps btc. 140 Pond View Drive Meriden, Connecticut 06450 ° M P-47 14786 (203) 238-2700 a features Watertight cable entry materials of construction High torque capacitor start motors for single phase units Built in thermal protection in single phase units I Dual voltage Dynamically balanced rotor Oversized self lubricated ball bearings • Upper lip seal angle Oil filled motor mounted for long life b All external hardware 304SS 2" or 3" discharge flange *Seal oil chamber I All O-Ring construction Open 2 vane non-clog impeller with back vanes Carbon ceramic mechanical seal Adjusting screw Spiral bottom plate, adjustable and self-cleaning 2.0 HP SESH, 1.5 and 2.0 HP SJS, and all SJE models. f %A6E 9 Note: SEVH and SJV Vortex models not shown. Wisconsin pepartment of Industry, SOIL AND SITE EVALUATION REPORT Page ! of 3 Labor and Human Relations Division of Salary & Buildings in .05, Wis. Adm. Code COUNTY . Plan ust include, but Attach complete site plan on paper not less th not limited to vertical and horizontal referen e of sl scale or PARCEL I.D. # dimensioned, north arrow, and location and di APPLICANT INFORMATION-PLEAS P REVIEWED BY DATE [ PROPERTY 0 NER: ST CROIX P RTY LOCATION N,R Z~ E (or) W bit- L) ~ Q z COUNTY ICS ZW. LOT /J 1/4 Al E7 1/4,S'27 T 36 SGNeot, 1~T C7 PROPERTY OWNER':S MAILING ADDRESS # BLOCK # SUBD. NAME OR CSM # CITY, STATE ZIP CODE PHONE Ill; ❑CITY []VIL GE OWN NEAREST ROAD _ 7 N F New Construction Use[ ] Residential / Number of bedrooms [ ] Addition to existing building j j Replacement kf Public or commercial describe Code derived daily flow gpd Recommended design loading rate bed, gpd/ft2 trench, gpd/ft2 Absorption area required bed, ft2 U ch, ft2 Maximum design loading rate bed, gpd/ft2 trench, gpd/ft2 Recommended infiltration surface elevation(s) 4Q,_t ~ 7 It (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable It S =Suitable for system CONVENTIONAL t~O,UND Irk~r-GGROUND PRESSURE AT•GRADE Y TEM IN FILL HOLDING TANK U = Unsuitable fors stem RI S ❑ U ® S ❑ U ®S ❑ U S ❑ U ,uS ❑ U ❑ S lizu SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bax>day Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trer& ~~h....< L z r~ s6k r Z 5 D., 19-25 lam 4/2 0.~31 Ground y 5 j m S_~ 1 h l G S M5 SG C~ vNt C S i ® Z 91 ft 7 3 S7 M44/4 Depth to $ - IZ !6w s S~ ra ? l~ limiting ~ fact, Remarks: Boring # A D-! goy 3 C5 ZT O.ao. `.l.:.~♦.,,`+f?-3S' 1WlA 3 -5 iL ~ r-h bK lt+~r e5 1~ 1W]GVN}AA'SGP... Ground 3 ft. >c>~Q4 MS 0, p, Depth to limiting factor Remarks: CST Name:-Please Print Phone:! J~Q~a Address: N O '7 S4,> W, Signature- Date: 7 /3 ~7 CST Number- 0 r1_1 PROPERTY OWNER SOIL DESCRIPTION REPORT Page z of 3 PARCEL I.D. # ; Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ranch . M A - Q /ov l - L, 1/ s bI, M r S Z 6-A 16.!~ i - 33 / 'S s L:~ mFr es 1 D .2 0 a Ground 3 /1~Y,e 3 M 5 54 ~~ab n1 I GS - d .7 p_ I J It /6Y,2 M.S SG Depth to limiting factor 71~Q Remarks: Boring # A -l I L 1 m slk ml~r c 5 2 s 16ye -S / m s bK -F~- cs t o ,-z 0 3 :0 c~e O.9 S /4 1 ri► S b n~ ~ lb4 y 4 ^Ground 32 - 6 ~e1~j It g O 16 YR A Z3 s 6,7 Depth to g -/2 >U`/ve4 3S SCE r O.7 a.F~ limiting factor y /D.OS Remarks: Boring # A L. C.5 Z-E F); /6-y94/3 S i~ I n~ sb~ - r-. l b. -z Ground q%_6 S 7.S y►24 3 SL I rr, s~ rnr C s Clu, ft. r i bY~ 4 3 MS SC6 L-Q&b M 1 (S - .7 O Depth to 8 2 /Zj DY,Q M5 SG /14/ 4.& limiting factor Remarks: Boring # Ground ale Depth to limiting factor Remarks: SBD-8330(8.05/92) i M q J m ~ 4 N L~ I 1 J O ` NO ` a 1 F w e 05 A u Vn W 03 M r 1 L~ r O I W ¢ I vl~ J d ~ Ib ~ I ~ d 74 T I r J 4 1 `Yj~I D ~ 4 z a D ~ cJ- a I.j T I d Q W I co I ~ wy BTC - 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 Location of property.Q(dl/4/x' 1/4, Section T Z2 N-R~W Township T ta►r'"J4 Mailing address Address of site Subdivision name, Lot no. / 1 . Other homes on property? Yes_k-'O' No Previous owner of property , ~ Ggzeaz7Z 1!~,' Tuio or/1 Total size of property 130.~~r~ r~~_ r Total size of parcel _ iv. Date parcel was created Zy. Are all corners and lot lines identifiable? _•~/Yes No Is this property being developed for (spec house) ? _Yes ~No Volume and Page Number 1,99 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. 42.<:Fp96 , 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. D-1 Ipir" Signature of Applicant Co-Applicant Date of Signature Date of Signature STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER ~YGinso . ✓ V C iv a o rritz MAEU NG ADDRESS 11!1UJ PROPERTY ADDRESS U CT/ zl< zeta" i . _ Sy0~.2 (location of septic systeem Please obtain from the Planning Dept. CITY/STATE ~~OQiL, ro . PROPERTY LOCATION IV _ 1/4, gov 1/4, Section, TAN-R_MW_W TOWN OF 1 T Vct1~~Aw ST. CROIX COUNTY, WI SUBDIVISION Al,, A• LOT NUMBER CERTIFIEDSURVEY MAP , VOLUMX&y, PAGE /9 9 , LOT NUMBER /L ,A . 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: DATE: _ St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 i ~ S-1. Warmaty Deed-Common Form (STNS OF WISCONSIN) Published by San Clain Book • Stationary Co. Sac. 286.18, Wis. Statutes. Form No. I 2580.96 04is .JY bruture Made this 20th day of April , A. D., 1959 , between Marguerite Qe Tupper • party of thd"first part, and Joint School District Noe 1 of the City of Hudson anA the Towns of Hudson, Troy,. • Ste Joseph anA Somerset, Ste C.loix County. Wisconsin party of the second part. WitntOWD: That the said part y of the first part, for and in consideration of the sum of • One Dollar ($11.00) and, other -valuable consiAerations - - - - - - - - - - - to her. !r in hand paid by the said party of the second part, the receipt whereof is hereby confessed and acknowledged, ha s given, granted, bargained, sold, remised, released, aliened, conveyed and confirmed, and by these presents do es give, grant, bargain, sell, remise, release, alien, convey and confirm unto the said part y of the second part, its heirs and assigns forever, the following described real estate, situated in the County of Ste Croix and State of Wisconsin, to-wit: A parcel of three acres loeateA in the northeast quarter (NE}) of the northeast quarter (NE}) anA the northwest quarter (NW}) of the northeast quarter (Mi) of Section 'Twenty-sbven (27), Township Thirty-mm (30) North, Range Twenty. ( 20) Waste further Aescribeil as follows t commencing at a point two (2) rods north of the southwest corner of saiA northeast quarter (NE}) of`the northeast quarter (NE}) thence north along the west line of the acre tract AescribeA in Volume 149 page 544• a A istance of Two HunlreA Sight (208-) feet aw Nine (9)-inlehes; thence east along the north line of saiA acre tract a Aistance of Two HunAreA Night (208) feet anA Nine (9). inches; thence north on an extension of the east line of saiA acre tract a Aistance of Two HiWreA Bight (208) feet anA Nine (9)-inches; thence wart"on`a line parallel with the Ylorth line of saiA acre tract a Aistance of Four HunAreA Seventeen (417) feet anA Six (6) inches; thence south ion a line parallel with the crest line of saiA acre tract a Aistanee of Four HunAreA Seventeen (417) feet anA six (6) inches to a point two-(2) roAs north of the`centerlins of saiA northeast quarter (NB}); thence east a Aistance of Two HunAreA Sight (208) feet aiP Sine (9) inches to place-of beginning, subject to existing highways, easements anA rights of way of re c orA a i, hi i I; ~I III CogttOtt with all and singular the hereditaments and appurtenances thereunto belonging or in anywise appertaining; and all the estate, right, title, interest, claim, or demand whatsoever, of the said part of the first part, either in law or equity, either in possession or expectancy of, in and to the above bargained premises and their hereditaments and appurtenances. go Pabt anb to ilolb, the said premises as above described with the hereditaments and appurtenances, ....a.. aL.. ....A ___4_ _-C aL- ..an....A ..ere .-A . 4tw heire nna necior.e MPRV)PIP i 1 k, b or ft c c O ~r C .T y IG a , ~ ~ • N ~ ~J t , V + w b ro~a,o L T7 u' 1 V n:.1 l V*q six luKILL4ra RU ♦ V S'•w ti tjt ~ 'i.w 'SigYtt! ~ jo NtO ~ ~ ~ N•~a ~ u*q Rnl~ Np~s N q R~i~i Ih i~li MPI~a40B 61 ••Q • y " alldza uolss !woo IN I au8,4uo ~dupunog 4,e 2uTpTs9g VOIMftk "d;uno-2 `allgndAJR;ON _ s fit: Pooh •r eauesoTg lK/ •aures aq; pa8paln►ou~aR pus Macunnsq 8uroBalol aq; po;naaza oq n uos od aq; aq o;,u xo .our:o; s®ddus •'p o~T~sfpB pauwu anogs aq; 6961 `•Q °Y ` Tjad'f 10 ARP p e~l alq; lour aso;aq acuaa slleuossad TTDWUTFMW "4um , pot, ONS) a®To ty scAo