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HomeMy WebLinkAbout032-1037-70-100 N ~ O v> ao m I ! I N cc I o co N c 't '9 ! Co o c 3 I ! z y p o ~ 4= I c z cc~ U. ID N 3 CoY E ¢ C14 M CL I ! H ~ ~ o II I ~ M LLJ a m o I ! o z to IZ- r (D Z E ~ I I ww ~ M I c I ~ .c p I 0 Z Z O z N p d 7 I t6 E N 0 - O 0 ca C) W d 2 0 J 0 O co y G C a N E _ LO U) o F' to N C%j 3 ° z C) WAVA ~aaa • a (D ' ~ o 0)~ 0) CD U) i ti o u~ ce ~ I o o w. E ' 5 d m c U) cc co O O v O ° N H C 1~ O~ m M O C C E O CO 0 O CL CL c C M O 0 C o o m CO O 00 W T. L L r 'Op r o t 0 0 1- I- C CD N O E E R U • O C6 U) Z N O Z O fA O ~ I ! ~ I • IL a d `m a d E r A c0 ao !,0U)0> ~ STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS- SUBDIVISION / CSMJ LOT A)4 SECTION_ T N-R_L_W Town of spy ►~ri.~ ,~-r-- ST. CROIX COUNTY, WISCONSIN D PLAN VIEW J VERYTHING WITHIN 100 FEET OF SYSTEM F SH130 sy' 0 oQ . fr INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: 1,60 ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: /f-4 r/pd iquid Capacity: 16n, C-0 -C 7 Setback from: Well , H use Other /0 S~7z Pump: Manufacture r~-~ Model Size ` L Float seperation 1i Gallons/cycle: 1,29 `t Alarm Location SOIL ABSORPTION SYSTEM Width: _-2_ Length L Number of trenches Distance & Direction to nearest prop. line: xj Setback from: well: 1 r House Other ELEVATIONS Building Sewer ST Inlet• ~©e ST outlet: PC inlet PC bottom_7Z Pump Off 7 Header/Manifold Bottom of system-ZAP, 7 Existing Grade Final grade DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: 3/93:jt Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor andHuman Reis INSPECTION REPORT ST. CROIX Safety and Buildings Div Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 299108 Permit Holder's Name: ❑ City ❑ Village Town o : State Plan ID No.: NASH, SCOTT SOMERSET CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: /G[j✓~' r /l/l,, G ~C~-~-~ 032-1037-70-100 TANK INFORMATION ELEVATION DATA o ---2X TYPE MANUFACTURER CAPACITY STATION BS Ht ELEV. Septic Benchmark GG, Cv Dosing 6 vn.~~`ncz >`G --O u Aeratiun- r Bldg. Sewer 7 X195 Holding St/ 0 Inlet 09 TANK SETBACK INFORMATION St/ Outlet Vent ir Ito ntake ROAD Dt Inlet TANK TO P/ L WELL BLDG. A Air Septic 550, 3 NA Dt Bottom A 90 26, -7.2 Dosing << r< « ~7 NA Fir/Man. 01,3? Aeration A Dist. Pipe / 16 3g ~ Holding--- Bot. System 5 ,1x3 J, 7•,' PUMP / INFORMATION Final Grade Manufacturer r v, r Demand Model Number x 't ( GPM G TDH Lift Friction System TDH Ft oss ~ I Forcemain Length / Dia.,H" Dist. To Well i SOIL ABSORPTION SYSTEM I BED/TRENCH Width Length / No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSION 57q DIMEN I N SYSTEM TO P / L BLDG WELL LAKE/STREAM LEAC Manufacturer: SETBACK INFORMATION Type Of ~ , BIER Model Nu System: OR UNIT it DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) x Hole Size x Hole SSpacing Vent To Air Intake Length Dia. Length s~ Dia. Spacing ~y 3(O SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only C~ r Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed/ Trench Center Bed /Trench Edges 12- - ! Topsoil Co E] Yes 0-rdif C] Yes p-Wo 1 ,C 3 COMMENTS: (Include code discrepancies, persons present, etc.)_ TREE LOCATION: SOMERSET 13.31.19.188-B,NE,SE 2132 80TH (?97S, 2_ 77 i Plan revision required? ❑ Yes EDN'o Use other side for additional information. /o k7 0* 1,_9 SBD-6710 (R 05191) Date Inspector's Sign ture Cert. No ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: Misconsin Safety and Buildings Division SANITARY PERMIT APPLICATION Po1. .Washington Ave. Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County N than 81n x 11 inches in size. a / • See reverse side for instructions for completing this application ' State Sanitary Permit Number The information you provide may be used by other government agency programs ❑ Check if revision toprevious application [Privacy Law, s. 15.04 (1) (m)]. 36u7t)c/ State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION 10 ;~/d' Prope Owner Name $roperty Location 21 IL-114~~ 1/4,S 13 T 31 , N, R E (or~ Property Owner's Mailing Address Lot Number Block Number (996 ~zi Ste- y, State Zip Coe Phone Number Subdivision Narr)e CSM Number vyI c' c ' 1(71) ' '7 /v > 2.517251 II. TYPE F BUILDING: (check one) ❑ State Owned ❑ City Nearest Road C] Village Public 1 or 2 Family Dwelling - No. of bedrooms Town OF _'i" 4 - 111. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo /9, S/ - / 9' /N 5 d 3 Z - O 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_____________TankOnly______________ Existing System _________Exi-----yytem B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day/ % ft.) (Min./inch) Elevation ~~Z 5- 37-1.- Feet O ; 3 Feet VII. TANK Caa inglloacltns Total # of Prefab. Site Fiber- Ex er. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existin strutted Tanks Tanks Septic Tank or Holding Tank 10166 G~1Q ' ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber - i, 57) •r- % L ❑ ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's plame: (Print) Plumber's Signature: (No Stamps) MP PRSW No.: Business Phone Number: I~r G r Plum er's Ac dress (Street, City, ate, Zip C d k): r rS S IX. COUNTY /DEPARTMENT USE ONLY ❑ Disapproved Sa ary Permit Fee (includes Groundwater aIssu ing A ent t re ( Stampproved [I Owner Given Initial ~W6 Surcharge Fee) Adverse Determination X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-W98 (R.11/96) DISTRIBUTION: Original to county. One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years- 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD-6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3151. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. 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 isto fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section - of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. SAFETY AND BUILDINGS DIVISION 15837 USH 63 NYtisconsin Hayward, WI 54843 Department of Commerce Tommy G. Thompson, Govemor 01-Oct-97 William J. McCoshen, Secretary Gustum Septic Tom Gustum N 13450 937 St New Auburn WI 54757 Scott Nash Plan ID 9710418 NE,SE,13,31,19w , Municipality of Somerset Inspector: Leroy G. Jansky County of St Croix (715) 726-2544 Private Sewage plans including the following element(s): MOUND 450 gpd The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(2)(e), Wisconsin Statutes, is responsible for compliance with all code requirements. This plan action is subject to no additional conditions. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department. All permits required by the state or local municipality shall be obtained prior to commencement of construction/installation/operation. This project is under the supervision of a state inspector. As inspection concerns arise feel free to contact the state inspector at the number listed. The inspector for this project is listed above. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Please refer to Plan ID number listed at the top of this page when making an inquiry or submitting additional information. Sincer , Thomas Bra Plan Reviewer (715) 634-3026 RESIDENTIAL MOUND DESIGN INDEX AND TITLE SHEET Project Three Bedroom Mound Owner Scott Nash Address 2132 80th Street Somerset, WI 54025 715-247-5129 Legal Description NE SE SEC 13 T 31 N R 19 W .,Q W.S.S. Township Somerset County St.Croix ConjU ona y Subdivision Name na Lot No. na ED DE M Of W1MMIEM Parcel ID Number SAFETY 00 Plan ID Number SEE CORR DENCE QF VI//s INDEX SHEET PAGE ONE MOUND CALCULATIONS PAGE TWO MOUND DRAWINGS PAGE THREE THOM S D. (P PRES. DIST. CALCS. & LATERALS PAGE FOUR GUSTUM =Z PUMP TANK DRAWINGS PAGE FIVE ' 1201 PUMP CURVE PAGE SIX • PLOT PLAN PAGE SEVEN ~~S1G NEQ` Designer Thomas D. Gustum License Number D1201 ' Phone No. 715-658-1344 . Signature'c~ -,,4. Date 17 Jq7 1 -1 Notice: Tampering with this file by unauthorized persons is prohibited. RECEIVED Deliberate modification will result In disciplinary action under s. 145.10, Wis. Stats. SBD-10462-E (R.W97) Page 1 of 7 SEP 16 1997 SAFETY & BLDGS. DIV. 97 10418 s A y p S ,f • X141;.,_ u RESIDENTIAL MOUND DESIGN Eight Bedroom Maximum Complete information in red framed boxes as necessary. (y or n) n Is the system over creviced bedrock? Slope 4 % Number of bedrooms 3 Lpd Wastewater flow rate 450 gpd 1703.3 Depth to limiting factor 26 in 66 cm .0 In situ soil infiltration rate (code) 0.5 gpd/ft2 20.4 Um2 Contour line below the upslope edge of absorption cell 99.7 ft 30.39 m Use standard fill depths? OR Designer spec 'd depth in cm Place X in box to use standard depths (12, 24, A+4 Inclusive) OR specify design fill depth. Center or end manifold a (core) Estimated hole space 3 ft Not a final calculation. Lateral spacing 3 ft Minimum dose 10 times void volume use all lateral spacing for trenches. Pump tank elevation 88 ft outside bottom of tank Number of laterals Ro~ Force main diameter 2 in Force main length ft Force main actual dia. 2.067 in SYSTEM SOLUTIONS Inch-pounds Metric Cell media "x" one only. Estimated daily flow 450 gpd 1703 Lpd x Aggregate and pipe Chamber and pipe Absorption cell Design load rate & area 1.2 gpdift2 375.0 ft2 34.84 m2 Linear load rate 8.3 gpd/ft 102.9 Lpd/m Design width (A) 7 ft 2.13 m Cell length (B) 54.0 ft 16.46 m Depth of cell (F) 9.9 in 25.1 cm Sand filter Upslope fill depth (D) 12.0 in 30.5 cm Downslope fill depth (E) 15.4 in 39.1 cm Basal area required (gpd/infiltration rate) 900 ft2 83.61 m2 Supporting components Topsoil depth 6.0 in 15.2 cm Subsoil depth at center 12.0 in 30.4 cm Subsoil depth at cell wall 6.0 in 15.2 cm End slope toe length (K) 10.4 ft 3.17 m Upslope toe length (J) 7.6 ft 2.32 m Downslope toe length (1) 10.6 ft 3.23 m Total mound length (L) 74.8 ft 22.80 m Total mound width (W) 25.2 ft 7.68 m Project: Three Bedroom Mound Plan I.D. Page 2 of 7 MOUND PLAN VIEW observation pipes (typical) I~ FE A~ A= 7.0 ft 2.13m W= 25.2ft 10 7.68 m B = 54 ft 16.46 m 11 B K J= 7.6 ft 2.32m I = 0.6 ft 3.23m K = 10.4 ft 3.17 m ft = 74.8 I L 22.8 m typ. obs. pipe A X B refers to absorption cell width and length (anchored securely) J = upslope width I = downslope width K = end slope dimension s" (150 mm) T MOUND CROSS SECTION D = 12.0 in 30.5 cm lateral topsoil G H subsoil cap E = 15.4 in 39.1 cm invert 101.2 ft F = 9.9 in 25.1 cm elev. 30.85 1~ m see note F G = 12.0 in 30.4 cm H = 18.0 in 45.6 cm / D E ASTM C33 Sys. 5-6-6-71 . ft Sand Fill elev. 30.69 m 99.7 ft contour 4% 30.39 m slope Note: Absorption cell media will D = upslope fill depth plowed layer consist of aggregate and pipe E = downslope fill depth or leaching chambers and pipe Aggregate F = absorption cell depth as specified MChamber G = subsoil + topsoil depth at cell wall at right. H = subsoil + topsoil depth at cell center Designer notes: If aggregate is used it is covered with code compliant material. Project: Three Bedroom Mound Plan I.D. Page 3 of 7 PRESSURE DISTRIBUTION CALCULATIONS Absorption cell Inch-pounds Metric Width (A) 7 ft 2.13 m Length (B) 54.0 ft 16.46 m Lateral specifications Number laterals 2 Holestlateral 18 holes Lateral length 51.0 ft 15.5 m Perforation dia. 0.25 in 6.4 mm Lat. dis. rate 20.97 gpm 1.3 Us Sys. dis. rate 41.94 gpm 2.6 Us Hole spacing 36 in 91.4 cm Lateral diameter Pipe diameter Design options Design choice Designer must 1 in/25 mm Place X in red X' one choice 1 1/4in/32 mm box of chosen from the options 1 1/2in/4o mm x x diameter. provided. 2in/50 mm x 3inf75 mm X Manifold diameter Pipe diameter Design options Design choice Designer must 1 in/25 mm X' one choice 1 1/4in/32 mm Place X in red from the options 1 1/2in/4o mm x box of chosen provided. 2in/50 mm x X diameter 3in/75 mm x 4in/100 mm X Distribution system contains 2 lateral(s). LATERAL DIAGRAM - END CONNECTION Place correct lateral diagram by clicking in one of the drawings at right and dragging the diagram into this area. Latera s centered over the A & B dimension Last hole drilled next to end cap en `Icap P All laterals are identical I<- X -.)I Holes drilled on the bottom of the lateral s equally spaced • Force main connection via tee or cross to manifold at any point. Laterals & force main of PVC Sch 40 e =permanent end marker (per COMM Table 84.30-5) Inch-pounds Metric Lateral length (P) 51.0 ft 15.54 m Lateral spacing (S) 3 ft 0.91 m Manifold length 3 ft 0.91 m Hole diameter 0.25 in 6.35 mm Lateral diameter 1.5 in 40 mm Number of holes per pipe 18 Invert elevation of laterals 101.2 ift 30.74 m Project: Three Bedroom Mound Plan I.D. Page 4 of 7 Total dynamic head System head = 3.25 ft 0.99 m Vertical lift = 12.40 ft 3.78 m Are laterals the highest point in the Friction loss = 2.88 ft 0.88 m system? Yes "x' here. C~ Total dynamic head = 18.53 ft 5.65 m if no, what is the highest elevation Dose Volume downstream of pump? I~.J Lateral void volume = 10.8 gal 40.9 L Force main drain Minimum dose = 112.5 gal 425.9 L back to tank? ('Y' one) Drain back = 17.4 gal 65.9 L x Yes Dose volume = 129.9 gal 491.7 L No Typical Pump Chamber Layout In combination with state approved treatment tank. Tank construction as per Comm 83.20(3) WAC. approved manhole cover weather proof w/waming label and padlock grade levels grade levels junction box quic disconect W k r alternated utl et 4" vent pipe _ electric as per NEC 300 and L Comm 16.28 WAC ocation 18" (46 cm) min. wall of pump approved chamber or outlet combination joint tank A 1/4" weep Grade levels alarm on T hole as pump tank manhole = 4" min. above finished grade pump on B necessary pump tank man. =100 mm min above finished grade C vent = 12" min. above finished grade pump 88.8 ft j vent= 300 mm min. above finished grade off elev. 27.1 m D 3 " (75 mm) of bedding under tank and anchor tank as necessary 88.0 ft Pump tank elevation 26.8 m bottom of tank Tank specifications: Midwestern Precast,inc Pump tank = 17 gal/in Pump tank volume = 650 gal Capacities. Inches Gallons A = 22.6 384.1 Pump manufacturer: barnes B = 2 34.0 Pump model number: SE411 C = 7.6 129.9 D = 6 102.0 Project: Three Bedroom Mound Plan I.D. Page 5 of 7 PERFORMANCE CURVES, BARNES ~.T-E.W- ~aF-7 Pa ` PUMP MODELS 52, 102, MODEL 1 APPLICATION: T°"""A° TILT. /T. In normal pressure sewer systems the effluent pump is in- 42 140 stalled in a basin on the discharge side of the septic tank. 120 In new home construction, the septic lank contains a pump H 120 insert section which allows the pump to be installed in the tank Ilsell. 110 Usually a home has its own pumping unit, but it is feasi• w 100 r ble to discharge two homes into a simplex system or 90 several homes into a duplex system. Design layout of the pressure system would depend on location and topography 20 60 of the individual lots. 70 INSTALLATION: 16-00 Barnes Effluent Pumps can be installed by one of three so methods: (1) the stationary system, for areas having 12 40 > shallow frost lines; (2) the rail system, or (3) the flex hose system, where deeper frost lines exist (refer to drawings w below). All can be furnished in a duplex arrangement. • 20 Fiberglass basins can be furnished in almost any size (con- tact Barnes for detailed information). 10 A control panel can be installed at the pump basin or in- 1o to fo b fo fo 7e side the dwelling, as can a visual or audio high water alarm. iITLn[ Power costs to operate Barnes Effluent Pumps are much 37 76 113 181 169 227 2" lass than for any major appliance normally found in the home PERFORMANCE BARNES PUMP MODELS EH 3 1, SE 411. SE 421 SERVICE AND MAINTENANCE: TOTAL "SAO reT. FT. It is recommended that, in most cases, a pressure sewer system be owned, operated and serviced by the local sewer _ authority. A sewer district should be formed if none exists Is so in the area. Maintenahce personnel would receive training to repair and rebuild pumps locally. Spare pumps would be kept on hand to replace pumps needing servicing. The home owner 12 40 would receive a monthly sewer charge to cover cost of operating and maintaining the system. ° 20 BASIN INSTALLATION SYSTEMS • 20 Lill Union Connection System 0 10 Rail System Flex Hose _ System ` 10 20 20 so go 7o fo fo 100 110 120 LITLM R",IN, 75 191 227 202 376 Oft PERFORMANCE CURVES, BARNES PUMP MODEL9EH 51, o 52, 53, 54, I I TOTAL "EAO WT FT. 90 24 f0 .r 70 is f0 1 so - - 12 OO 70 f 20 At left, a cutaway view of a 1000-gal. fiberglass intercep- tor tank fitted with a Barnes effluent pump. It illustrates 10 LLL_ use of the flex hose system, utilizing an S. T.E.P. series pump. Recommended for most new residential installa- tions (aee picture on back of this flap). LITERS 10 20w so fo 7o fo fo PER u ML". 7f tft 327 fM 5~, ash P lol Pion a ► 3 a. 36* ,S4Y ' Spm2~Se~• ~ W~ S' ~f 0,15 ; lo~.b' bo NE Sl* sec, 13 , T.3.1 #1, KR. W, 406M= So _"ers2~' 'Townsh; rOx Cpu, o ouse S, 14 D12-0Alt ,O I R.P. r~ So; I ;60rny rx 1~~ , Par o~ QLO acres r 6-3 had cmiour O'Con~oie~ 6 -1 r S ~r i pvc !6c'l! b n .r~ t ~ 1 1 o iao o ~~^z 5 ro S~{s~C 3o s N ~ _ PVC +o m • well ~a rA~t , k4ouse c-, ~,e l N 0 P e 7o ~F .7 Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code > COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but S4. 1~~-U 1 not limited to vertical and horizontal reference =ULCrn n and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and t /037 7a ej o APPLICANT INFORMATION-PLE 1 ON REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION SCE GOVT. LOT Aj t- 1/4 1/4,6 13 T 31 N,R k PROPERTY OWNERS MAILING ADDRE iv LOT # ROCK # SUBD. NAME OR CSM # 54-A _51'r T t RC3fX /A+ Al iJA 2 CITY, STATE ZIP ❑CITY ❑VILLAGE MOWN NEAREST ROAD r 4V T S-q oa : (7rS 1 - Si r Se f eFtA .ski ~'>v ( ] New Construction Use [ X) Residential r of ms S [ ] Addition to existing building M Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate 6,5 bed, gpd/ft2 Cf, ~ trench, gpd/ft2 Absorption area required bed, ft2 trench, ft2 Maximum design loading rate bed, gpd/ft2 Dr & trench, gpd/ft2 Recommended infiltration surface elevation(s) 99, '7 ` G6n -~)rcr ft (as referred to site plan benchmark) Additional design / site considerations Parent material G I a c l a j -k i Flood plain elevation, if applicable N f4 ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ❑ S 19U ;.S ❑ U ❑ S NU ❑ S ~U ❑ S j2U ❑ S JRU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 6-S Q Y 313 a 54 a rn C-r MA- as 3-C o"S 0. 5--l izwg s i I d on s bk r cu) 1 In, b .s 0• to Ground j io 5-14 n , St a+n S 6+ MV fir- O.S 0• to elev. ft. 7 5- tw y (ti S I ~ rr~5 ►Jf Gud Q,S ('X (o toy 1-1 Depth to - : 6 - 4 5_7;2 q14, -3 4.sYsZ s s i 1 ~-,y, s bk raft - 0.5 16, (a limiting factor Remarks: Boring # /0 3 3 no Si ~ r f1~Y ~ ~~+t d•S 0.(0 < o? . - tx j o 2 3 h s i ate, s b M- CW lw~ 0-S :a (o fo x 5-4 s.I a-PK5b m Guy - o. p.co Ground elev. a.l- a iU k sj C/ ►'1ur . S a,~s b rh r ~w t3.5 1 10.(0 92 -Aft. Depth to ~ ?,5 R Y . S i 3 e 5 b k m ~f - - 0 •S 4~(0 limiting factor Remarks: CST Name:-Please Print 5UZCLnn t1V(. Phone: r~ ~S _(o 5.9 -(3L/ Address: ll, 3 q Sd c1 3, t+ SJr eel urn r.UZ 5'f'7, Signature: Date: CST Number: PROPERTYOWNER 15cvW NO.56 SOIL DESCRIPTION REPORT Page i of 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 Trer& - 11 t - S 10`f-C 313 11 S 1 my Cl S a 5-13 1ov 3 none sit ams~ rnv~r cw OS .(v r Ground 3 113-31 10 ie 3 n" ~ a M b v nq +i- GkJ 0,5- elev. SY/l 518 31- q0 (Sik. (-5,2 7fS'fA 711 5d a m sbK ot~r - 0,5' 0,(r Depth to limiting factor ,31 Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) ash P Ion Phan a ► 3 a FsO` See~- Spme~S~~` W~ OAS' ~o~o►~-t NE,aEtsec. 13T, 31 Pd.f, ~ &6m= E(, lot u, SOrners,e+ TOwnSh;P~ S~.CcoixCou~~r d house sid~n~ S(k a wr,x fK , uL~.iA. CST ~3 7~ ~f A-l so 4.9-P, 9-y-~7 'Id = soil 60 c i M55 wl b4J. Oc part of a0 acres 6-3 9 9.'7 -7 I Cmt ur100.0'covikar 1 V 3 'r ~.'eXt s rna /b 3 0 r- ►3edroU~ well ~ o e wc`~ Pa-g~- 3d~ 3 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. ---------------------Y--------------J-j Owner of property Location of roperty-AJ&5 1/4 1/4, Section T ~N-R W Township rtvrc-rs~,=~- Mailingaddress 77 - Address of site L32 c) Subdivision name ~f Lot no.~ other homes on property? Yes i _No Previous owner of property C lzl C T `,7 j,J Total size of property Total size of parcel Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house) ? Yes _.,L(,_No Volume a-4 and Page Number 12-3 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. - 11 71 7 , and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of the County Register of Deeds as Document No. 4i i T'7 27 Signature of Applicant Co-Applicant Date of Signature Date of Signature STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Cr ix County OWNER/BUYER -_S- ' MAILING ADDRESS ~ 13,>_ ~G ~ 'T72[`-7=~ r.~iryl z-rL,:St--7-. C2 S PROPERTY ADDRESS L I Z" Yd L. 5 S (location of septic system) Please obtain from the Planning Dept. CITY/STATE ? 4° Y : C„--7t~5t ti PROPERTY LOCATION l 1/4, Se` 1/4, Section 13 T_31_N-R_Lf _W TOWN OF &,Ina L72c_s ST. CROIX COUNTY, WI SUBDIVISION z Am LOT NUMBER CERTIFIED SURVEY MAP , VOLUME ( ' ,PAGE ~L 3 , LOT NUMBER Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED: -~~t'~ yt~,_ DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 a• d. e .ri61t'y STATE BAR OF WISCONSIN FORM 2 - 1962 i V I WARRANTY DEED s" DOCUMENT NO. ~ 17%~~~ 123 _ - Eri AEGMER'S 0, r F- 4 Eric ) rm a i n o .a u mom} ST arhPlA T Gnr am ay tA CM --husband and wife JUL 1' V, coneys and warrants to Scott W NBCh and i.,rl n 12:30 P e-en M Nash. husband and wife, d3 SUrV1VrShl marital p r ooe r t v -4~,jAd__ +i id&44 Hupstw ut Cea~s THIS SPACE RESE /ED FOR RECORDING DATA •IAiE ` the following described real estate in t Croix coumv AND RETURN ADDRESS State of Wisconsin: t 'i 'iRCFL IDENTIFICATION NUMBER The South 1/2 of the Northeast 1/4 of the 1/4 of Section 13-31-19. s Southeast }t i This is homestead (ic) property. XW)WX Exception to warranties: Easements, restrictions and rights-of-way of record, if any. Dated this day of June 7 A. D, 199 li (SEAL) Eric J. Germain - (SEAL) Michele T. Germain n (SEAL) I~ . w (SEAL) I~ l AUTHENTICATION ACKNOWLEDGMENT Signature(s) Eric J. Germain, Sine of Wisconsin, Michele T. Germain ss, authenticated this day of Tune 19_QZ _ County. i~ ptasumAs ,-te before me this day of 19 , the above named K ' • TITLE: MEMBER STATE BAR OF WISCONSIN (if not, - jl authorized by §706.06, Wis. Stats.) to me kmowa au Ne the person who executed the fixealwno ii Wisconsin Department of Industry, SOIL AND SITE EVALUATION 3 L•abo and'Hwman 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 inche must County include, but not limited to: vertical and horizontal reference (Ri tior~ C r percent slope, scale or dimensions, north arrow, and loc stance to`r9 26 ad. Parcel I.D. # -16 ~lf_r APPLICANT INFORMATION -Please pr' t~ / oration. - Re W wed Data/ Personal information you provide may be used for secondary sesr 9LEPs. 1 (m)). v Property Owner perty Lo. ation ! G Q. r r ovt.'Lot E 1/4 1/4;S I T ) N,R E (or W Property Owner's Mailing Address koq Lo lock# Subd. Name or CSM# S4 . / State Zip Code Phone Num L Ro City F-1 Village Town Nearest zr' Ll city r ❑ New Construction Use: Residential / Number of bedrooms Addition to ex'sting build' D~ ~-O ,Replacement ❑ Public or commercial - Describe: Code derived daily flow gpd Recommended design loading rate bed, gpd/ft2_tr ch, gpd/ft2 Absorption area required ~?_75bed, ft2 3 7 S trench, ft2 Maximum design loading rate bed, gpd/fF 1-trench, gpd/ft2 O Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) 703 Additional design/site considerations Parent material Flood plain elevation, if applicable S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Ta I '21 U = Unsuitable for system El S U S❑ U El s )kU ❑ S U ❑ S XU [I S U SOIL D Xrb-CRI REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft2 g Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 0-10 nn e.-5, e~z 0_6 r AL- Ground - 5 ~elev~ d i / Depth to limiting facto : in. Remarks: a2e~ 4 4' V Boring # V' r ~VIW 1-1114. "/1 Ground „ielev. i vl ft Depth to limiting fa or in. Remarks: CST Name (Please Print) Signature Telephone No. f / 4 . Address Date ST Numbe I PROPERTY OWNER SOIL DESCRIPTION REPORT ' Page of PARCEL I.D.# I Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench 3 o-la Ground n "e Depth to limiting fa r~ n. Remarks: Boring # 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 in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBDW-8330 (R. 08/95) Parcel 032-1037-70-100 05/30/2007 11:17 AM PAGE 1 OF 1 Alt. Parcel 13.31.19.188-B 032 - TOWN OF SOMERSET Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - NASH, SCOTT W & JODEEN R SCOTT W & JODEEN R NASH 2132 80TH ST SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 2132 80TH ST SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 20.000 Plat: N/A-NOT AVAILABLE SEC 13 T31N R1 9W NE SE S 1/2 OF NE 1/4 Block/Condo Bldg: OF SE 1/4 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 13-31 N-1 9W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1193/339 WD 07/23/1997 1009/617 WD 07/23/1997 837/90 07/23/1997 714/76 more... 2007 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 08/09/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 48,000 94,100 142,100 NO AGRICULTURAL G4 13.000 1,200 0 1,200 NO UNDEVELOPED G5 4.000 8,000 0 8,000 NO Totals for 2007: General Property 20.000 57,200 94,100 151,300 Woodland 0.000 0 0 Totals for 2006: General Property 20.000 57,200 94,100 151,300 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 Soil Test Plot Plan Project Name Eric Germain Byron, Bird Jr. Address 2132 80th St. Somerset Wi 54025 CSTM #3479 Lot Subdivision Date 5/30/97 NE 1 /4 SE 1/4S13 T 31 N/R 19 W Township Somerset n Boring ()Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft.Base of Siding System Elevation 99.2 * H R P Same as Benchmark Driveway Existing 3 22' Bedroom Garage 2' House 7' 24' 6' Well 30' 50' 20' *B.M. 30' 110th St. 15' T Overflow 35' -1 33' 60' B-2 7' 28' B-3 15' Property Line