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AS BUILT SANITARY SYSTEM REPORT
OWNER 'J2 Q ✓7 MO t Z
ADDRESS /Q a3 ~,✓L/C /
I
SUBDIVISION / CSM# LOT #
SECTION I TN-R_L5 W, Town of
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
33 ~ _
N4
J
t3w►
}
INDICATE NORTH RO
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK:
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: 1991 al WEst eA*" Liquid Capacity:
Setback from: Well House Other
Pump: Manufacturer ;;;p Jlefe Model# / Size
Float seperation g Gallons/cycle:_ 13&
Alarm Location XN ~a ✓ IQ~ t4 p l
SOIL~IABSORPTION SYSTEM
Width: Length __q / Number of trenches
Distance & Direction to nearest prop. line: ,epy
Setback from: well House Other
M
ELEVATIONS.
Building Sewer O O G ST Inlet. ST outlet
PC inlet PC bottom V3 Pump Off
Header/Manifold 1 VV• q Bottom of system l Uhl.
Existing Grade Final grade G►
Z e/+ ~'•"rte 10v.4'~
DATE OF INSTALLATIO pt-
PLUMBER ON JOB:
LICENSE NUMBER:
INSPECTOR:
3/93:jt
Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County:
Labor and Human Relations
INSPECTION REPORT ST. CROIX
Safety and Buildings Division
(ATTACH TO PERMIT) Sanitary Permit No.:
dENEI AL INFORMATION 284298
Permit Holder's Name: ❑ City ❑ Village Town o : State Plan ID No.:
MOTZ, DEAN SPRINGFIELD
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
034-1065-50-000
TANK INFORMATION ELEVATION DATA A970 068
MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Se ti Benchmark /()S 72,
,3,~~j 103, 72
Dosing pp
'Aen Bldg. Sewer 72 O b ' G /
Holding St/Ht Inlet 57,
TANK SETBACK INFORMATION St/ Ht Outlet
Vent
ir Ito ntake ROAD Dt Inlet
TANK TO P/ L WELL BLDG. A
Air
Septic NA Dt Bottom $q,
Dosing NA Header/Man.
Aeration NA Dist. Pipe
Holding Bot. System GJ~ 7~
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand /9,A 6Y' 7-
Model Num GPM AQ,nhje- C,4- Zt~ % $ t.7 (o
TDH ft Loss System TDH Ft
Head
Forcem ngth Dia. Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS DIMENSIONS
SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
SETBACK
INFORMATION TypeO CHAMBER Model Number:
System: OR UNIT
DISTRIBUTION SYSTEM
Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
Length Dia. Length Dia. Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched
Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: SPRINGFIELD 29.29.15.44911SE SE HWY[[~~1,,2 LOT 1 r
S ~ 4-c..~ t...., 5 w,.~: C_, Y1 ~ ~ ~h w ~ ~ e 6JCLD •io / ~ f ~ r~ ~ ~ `~d U #~*.rs`)
-Fvr ►-cnL ~cdrt-fir 6 y'In-1 NP (SUS ,
Plan revision required? ❑ Yes ❑ No
Use other side for additional information.
SBD-6710 (R 05/91) Date Inspector's Signature Cert No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
r^r.i`rin SANITARY PERMIT APPLICATION BureaSafetyu o oand ff BuilBuildinWater Systems
ng Water 201 E. Washington Ave.
In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969
Madison, WI 53707-7969
• Attach complete plans (to the county copy only) for the system, on paper not less County
than 8 112 x 11 inches in size. • Clr"6t
• See reverse side for instructions for completing this application State Sanitary Permit Numb
aPV~? W
The information you provide may be used by other government agency programs ❑ Check it revision to previous application
[Privacy Law, s. 15.04 (1) (m)). ~ ¢ S g W. "VVY. I ~ Will Soy) State Plan I.D. Number
1. APPLICATION INFORMATION -UPLEASE PRINT ALL/INFORMATION
Prope Owner Name Property Location
fr' 0 1/4 5E 1/4, S 21 T q , N, R /S E (or) W
Property Owner's Mailin Address Lot Number Block Number
/9c 3'` o
City, State Zip Code Phone Number Subdivision Name r M Number
ll. TYPE O BUILDING: (check one) ❑ State Owned ❑ City Nearest Road
❑ Village
Public 1 or 2 Family Dwelling - No. of bedrooms Town OF !ce J , / v-
III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s)
1 ❑ Apartment/ Condo i52q' oRq • J5. 4491 a 3 `V _ S - s-u
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. D, New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
-----System System Tank OnlyExisting System Existing System
B) ❑ A Sanitary Permit was previously issued- Permit Number Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 K 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/sq. ft.) (Min./inch) G' Elevation
L' S u 7e 3,76 / 9. Feet 160, e Feet
VII. TANK Capacity
in gallons Total # of Prefab. Site Fiber- Exper
INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel lass Plastic App
New Existin strutted g
Tanks Tanks
Septic Tank or Holding Tank d J OQQ 11Zf YC w P/CCas t' R1 ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber , 5-o ✓eu- ❑ ❑ ❑ ❑ ❑
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibilit for inst tion of the onsite sewage system shown on the attached plans.
Plumber's Name: (Print) Plum is Signa o Stamps) PR W No.: Business Phone Number:
e 4-A eI~~G 715-Lys- 2 616
PI bgt'sAddress ( tree y, State 2-Code):
IX. COUNTY DEPARTMENT USE ONLY
❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issue Issuing gent si ature ( St ps}
Surcharge Fee)
Approved ❑ Owner Given Initial
Adverse Determination CXJ ~~G}~
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SBD-6398 (R. 05/94) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Divi.ion, Owner, Plumber
INSTRUCTIONS
L
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, 608-266-3815.
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.
11. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling-
III. Building use. If building type is public, check all appropriate boxes that apply.
IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair.
V. Type of system. Check appropriate box depending on system type.
VI. Absorption system information. Provide all information requested for numbers 1 through 7.
VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and
manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and
holding tanks for this system. Check experimental approval only if tanks received experimental product approval from
DILHR.
VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.),
address and phone number. Plumber must sign application form.
IX. County/ Department Use Only.
X. County/ Department Use Only.
Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must
include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic
tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon
tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served;
B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume;
elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section
of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information.
GROUNDWATER SURCHARGE
1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can
effect groundwater.
The monies collected through these surcharges are used for monitoring groundwater contamination investigations
and establishment of standards.
nDepartmentofIndustry, SOIL AND SITE EVALUATION REPORT P 1 of 3
and Human Relations _
of safety & Buik5ngs , 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 ST. 1)(
not firrited:to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. 3
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFO RMATI E PRINT ALL INFORMATION RE1rIlEWEDBY DATE
PROPEWOWNER: z`R7..1 f"10 YZ PROPERTY LOCATION
1"1 WE?, EL- 6e f. tee % E: 114 S E 114,SZoI T Z 9 N,R I S E( W
PROPERTY OWNER•:S MAILING ADDRESS LOT BLOCK If SUED. NAME OR CSM tt
Z e M J 1-k kQ jftA / kZ -
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE [@TOWN NEAREST ROAD
WVLSoIV wI 59 oZ1 ('71S) 698-2.566
bQ New Construction Use [)4 Residential / Number of bedrooms y [ ] AdditiQn to existing building
j j Replacement (J Public or commercial describe
Code derived daily now 600 gpd Recommended design loading rate -O-• bed, gpoltt2 0. S try, gpc2
Absorption area required Sua bed, f12 Sob trench, ft2 Maximum design Toad rig rate p- 5 bed, gpdAt2 a- L trench, gpd/ft2
Recommended infiltration surface elevation(s) 9q-1D t ft (as referred to site pk:n benchmark)
Additional design/ site cortsideratiorts N1o~>vo w/ 8'X 61" B®. r-~ tv , 1 O S Pr>vb Ft I- L
Parent material s l u"N - ov t-=t't. T t Rood plain elevation, if applicable N - R ft
S = Suitable for system CONIIBJTIONAt MOUND N GROUND PRESSURE AT GRADE SYSTEM IN FILL T HOLDING TANK
U= Unsuitable for stem ❑ S IOU Os ❑ U ❑ S (RU ❑ S ®U ❑ S O U ❑ S f U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Motdes Texture Structure Consistence Bouxlary Roots GPD/ft
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed fertdt
}zu
- 8 " I R 2 tZ S Z °1ti- m CS - o .S o.
Z 8-t
9 ~b~>z Y/3 - s i l Z `Fs bk m ~4- ~S - o.s a. 6
Ground 3 vi -3 y S `•t Iz Y 16 - Is o S9 M V i~ c-S _ o• -1 C, t
eley.
q ft. 314-Sy -1-S IM Y! Wit, Sti 2 S )a i s O 3g
+►~v `Ft~ _
Depth to CA rV kL ~C Clv T- k S
limiting
factor
34 ,
Remarks:
Boring #
1 +,-8 ~o~trZZCZ _ sil Z►nsU1~ LS - o.So.6
Y_ Z Z $-7?Z low\Z Y[3 st1 Z"Fsb4~ w,~~ cs - o•So,6
3 ZZ3~-S`'12~/1~ G~ Is bs9 wtv~t cs - 1
4
Ground
elev. 3~-S -I S ttRY/6 ;1
4, V4 UiA.-
9S-S ft.
z
H Fl ot= S RNp
Depth to eon' A s 1'T o
uniting
3a~ y CA ltotis t'-J\fjtyr
factor
Remarks:
T Name.-Please Print Phone:
Arthur L. We erer 715-425-0165
Add
egress:
Soil Testing & Design Service-P.O. Box 74 River Fa11s,WI 54022
Signature:
6:4a ~ I Date: CST Number:
9S-2qz S M00576
f SAFETY & BUILDINGS DIVISION
State of Wisconsin
Department of Industry, Labor and Human Relations
January 9, 1997 2226 Rose Street
La Crosse WI 54603
WEGERER SOIL TESTING
421 N MAIN STREET
PO BOX 74
RIVER FALLS WI 54022
RE: PLAN S97-40011 FEE RECEIVED: 180.00
MOTZ, DEAN
SE,SE,29,29,15W
TOWN OF SPRINGFIELD COUNTY OF ST CROIX
MOUND SYSTEM
The Department has reviewed the above-referenced submittal.
Conditional approval is hereby granted for the system plan submittal. All
noted items must be corrected. The review and approval of the system is based
on chapter 145, Wisconsin Statutes, and chapters ILHR 83 and 84, Wisconsin
Administrative Code, and is contingent upon compliance with any stipulations
shown on the plans. This system has not been reviewed for the code
requirements set forth in chapter ILHR 82 or in chapters ILHR 50-64, Wisconsin
Administrative Code.
This plan submittal approval will expire two years from the approval date, or
if a sanitary permit is obtained, plan approval will expire on the day the
initial sanitary permit expires. The licensed plumber responsible for this
installation shall keep one set of plans with the Department's stamp of
approval at the construction site. The installer shall notify the appropriate
inspector when inspections can be made.
All permits required by the city, village, township or county shall be
obtained prior to installation.
Inquiries should be directed to me at the number listed below. Please refer
to the plan number shown above.
Si cerely,
rard M. Sw
Plan Reviewer }
Section of Private Sewage
(608) 785-9348 }"'J
r `a
SHDA-7997(8. 10/94)
s
Page of 6
s40, RECEIVED
MOUND SYSTEM
FOR .I~ 8 1997
A 3 BEDROOM RESIDENCrSAFL i r 8LDGS. DIV.
LOCATED IN THE SE 1/4 OF THE Se 1/4 OF SECTION Z ),T-29 N, R IS W,
TOWN OF ' PDZANG FIC.L.D , ST. C~ZUIX COUNTY, WISCONSIN.
INDEX.
PAGE l 'of 6 TITLE SHEET
PAGE 2 of 6 PLOT PLAN
PAGE 3 of 6 PLAN VIEW-CROSS SECTION
PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT
PAGE 5 of 6 PUMPING CHAMBER
PAGE 6 of 6 PUMP PERFORMANCE CURVE RGE Soo
e~~ sue' .011ally
PREPARED FOR,
aern~~ro k~zyaTZ t"r
RESp0N
PREPARED BY
~~A~~s?€t609~Bp~~t
WEGEE~ER SO I L TESTING y V
AND. ; `
~ 'k1tia .•~wewMO'• 6.ys
F.O. BOX 74 421 N. RHIK ST.
RIVET? FALLS. YI 54022 ® ; c~ss:oani. .
M.
715-42`.,-4165 0- 1 Q
ass ~L~ »wNN~ ~ 1
JOB NO. c1
Z
PLOT PLAN
Page Z of 6
Scale 1"= )-4b'
RECEIvr r)
JAN -8
1=-
~o' oF%4fPVC 3 -woXz- 1 SAFETY & BLD66. UIV.
1~
l~sE
~D.S ,C) F
J fit, qs' S I zs' ~
yi zs; a4 8
d ' ' s _z 8.3
69' o rout co PA e T" 01Z
b\STURL3 I)" S , ef
~vRuv 6 l~OvB F o2
Ip°)o a,i L*L qa4 69 3 Q~t~$,p.
ci rj r, 4,
31y''blt~. it, \j C_ PI pi
w/ wc~oU ~hTi♦ ,
2
J
r
o!
UTta J
is U S t '1v 8E hT l ktt-ST ZS ' Y1Z t1 M u-~ ~v~.~ .
\t0.1ELL to y y if SO'
a
~y
V
Q
N
R
• ~I
o- ZS M Tp
Z C) o 71+ ST.
NOTES:
-1. Elevations shown are existing ground elevations unless otherwise noted.
2. Install permanent markers at end of each lateral. ( q required)
3. Install 4" observation pipes with approved caps. ( Z required)
4.-Septic tank to be ~oubl6Sri gallon capacity manufactured by
W1 t p~~~~ ~ tZ~'~.lt- ST - ~ B~n~~4fi0~ Tthvl2
5. Bench Mark %f_rm
6. Divert' surface water around system to prevent ponding at the uphill side. r
RECEIVED Page 3 Of 6
JAN - 8 1997
SARTY & BLDGS. DIV.
Approved Synthetic Covering
sTw► 33 Distribution Pipe
Medium Sand
H _ G
Topsoil Elev olq. O
p
3 E
~ O % Slope
Bed Of ZM- 2 %2 Force Main Plowed
Aggregate From Pump Layer
D I-0 Ft.
E 1.8 Ft.
Cross Section Of A Mound System Using
F a.8 Ft.
A Bed For The Absorption Area
G t- Q Ft.
A _ Ft. H 1.5 Ft.
Linear Loading Rate= 9.6 GPD/LN FT B X1-7 Ft.
Design Loading Rate= O-y.GPD/SQ FT j Ft.
J `7 Ft.
K i► Ft.
n^,r eriTO'tt n
L
-of-- q Ft.
W Ft.
L
Observation Pipe
A
I - - -
I.----- ----------------------•I
o Force Main
W in
Distribution Bed Of 2M- 2 z
Pipe Aggregate
I
Observation Pipe Permanent Markers
(Anchor securely)
Plan View Of Mound Using A Bed For The Absorption Area
RECEIVED Page I Of
Perforated Pipe Detail JAN - 8 1997
SAFETY & BLDGS. DIV.
/0
End View
Perforated /
PVC Pipe Install permanent marker
End Copt zv,
1 at end of each lateral
Holes Located On Bottom.
Are Equally Spaced
Q S
PVC Force Main
P
PVC
Manifold Pipe
Distri ution
Pipe
Last Hole Should Be I
Next To End Cop
End Cap
P Z - Ft.
Distribution Pipe Layout
S y Ft.
X V Inches
y u Inches
Hole Diameter J! y Inch
Lateral I Inch(es)
Manifold Z- Inches
Force Main " Z Inches
# of holes/pipe 6
Invert Elevation of Laterals q g.5 Ft.
6 K l_ l~ _ -U ZKC(. 2,8.05 Gp"
Place 1st hole Z~rlfrom center of manifold with succeeding holes
at y intervals. Last hole to be next to the end cap.
Combination Septic.Tank and
PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS ' PAGE S OF
WEATHER, PKO0fr
G`v~0 VE1JT CAP JUIJCTiO1J ISOX
4'C.I. VENT PIPC , APPROVED LOCKING
OGS OV•~!_10 ' FROM DOOR. MANHOLE COVER wIV
wARNIUG Lf4gEl.
&O\• .AIR IJJTAKEFRESH c r\r
Sr
~ I
~z. q 1 c~RR i 4" xlw.
MI J1.
PROVIDE (
rrJLE T AIRTIGHT SEAL
~RFF`~S ~ ' I ~ I v
APPROVED JOIAIT - A I I ( APPROVED JOIIJTS
w/C.T. PIPEDR Tank construction I III W/C.I. PIPE~~'
I I I ALARM
shall comply with -I I
ILHR (83.15 and 33.20 Is I II
I I ow
C I i
81.83 I
LLEY. F T. PUMP,, OFF
O CONCRETE
EL 1B L{ .3 0 9LOCK
13" APPRa
RISER E:XIT PERMITTED OAJLy IF TAUK MANUFACTURER HAS SUCH APPROVAL gEDpING
SEPTIC f SPECIFICATIOUS
DOSE 1v11~1yh~` N ST NUMBER OF DOSES: 3 ' 9 PER DAy
TA1JK MANUFACTURER:
TANK sIZC: J6So GALLOMS DOSE VOLUME r
ALARM MANUFACTURER: ' S' ~Z~ SYS 1'1 S INCLUDING 5ACKFLOW: 6 GALLONS
MODEL 1JUM8ER' w CAPACITIES: A= IJJCHE5 OR 30 6ALLOy3
1 b
swITCH TYPE: ~1~~1~C'•~QL B= IMCkEr art GpLLOU5
PUMP MANUFACTURER: C= $ IUCHES OR 11~ GALLOU5
MODEL MUMBEIt: D= INCHES OR 1,13 GALLOUG
SWITCH TYPE: L~ZCU~2 Lf MOTE: PUMP AMD ALA0.~ C To a t46
MINIMUM DISCHARGE RATE Z • 0' GPM INSTALLED OW 5EPARATE CIRCUITS
VERTICAL DIFFERENCE DETWEEU PUMP OFF AUD..13I5TRIBUTIOIJ PIPE.. FEET
+ MIWIMUM NETWORK SUPPLY PRESSURE 2.50 FE.CT
+ ~bS FEET OF FORCE MAIN X 1'61 FjofLFKICTIOIJ FACTOR._ "-9 FEET
TOTAL D!JUAMIC HEAD = X8'86 FEET
Pump chamber DIAMETER - 38►I
ILITERLIAL DIMEWSIOW~ OF TANK: LEKI&TH _ 'WIDTH ;LIQUID DEPTH
BOTTOM AREA - 231= GAL/INCH
AS PER MANUFACTURER = ~1•D . GAL/INCH
~A Gam. 6 o F= ~
r' HEAD CAPACITY CURVE TOTAL DYNAMIC HEADJFLOw 4 3/4 I- 7 3/8
PER MINUTE
4 MODEL 137-139 EFFLUENT AND DEWATERING Its 6 1/8 s 'i9w'
30 SERIES 131.139
Poet Meters bat. tin: ~Q
8 5 1.52 104 394 v,(~
25 10 3.05 79 300 vy~
0 15 4.57 64 242
20 20 6.10 36 136 ° - VS
6 l$ 25 7.62 8 30 0 . O
26 7.92 0 0 ~y
r 15 o 11/2' - 11 112 NPT
o
4 O$
to
2
5
I
12 3/4
0
LITERS GALLONS 10 20 30 40 50 60 70 80 g0 100 11
LITE0
RS
1 80 160 240 320 400
I I 4
0 FLOW PER MINUTE
CONSULT FACTORY FOR SPECIAL APPLICATIONS
• Three phase pumps are available in 200/208V or 230V. • Mercury float switches are available for controlling single and three
Electrical alternators, for duplex systems, are available and supplied with phase systems.
an alarm. • Double piggyback mercury float switches are available for variable
• Mechanical alternators, for duplex systems, are available available with level long cycle controls.
or without alarm switches. - Long cords are available in lengths of 15-25-35-50 feet.
• Combination starters are available. • Over 1307. (54'C.) special quotation required.
Standard all models - Weight 47 lbs. - /h N.P. SELECTION GUIDE
137/139 series control selection 1. Integral float operated 2 pole mechanical switch, no external control required.
Model Volts-Ph Mode Amps simplex Duplex 2. Single piggyback mercury float switch or double piggyback mercury float
M137/139 115 1 Auto 10.4 1 or l &8 - switch. Refer to FM0447.
N137/139 115 1 Non 10.4 2 or 2 & 7 3 or 5 & 6 3. Mechanical alternator "M-Pak" 10-0072 or 10-0075.
D137/139 230 1 Auto 52 1 «1 &8 - 4. Combination Starter. Refer to FM0514.
E137/139 230 1 Non 52 2 or 2 & 7 3 or 5 & 6 5. See FM0712 for correct model of Electrical Alternator "E-Pak".
- H137/139 200-208 1 Auto 82 1&8 6. Mercury sensor floatswitch 10-0225usedas a control activator, specify duplex
1137/139 200-208 1 Non 82 2&7 3 or 5& 6
` J137/139 200-208 3 Non 42 2&4 3&4 or 5&6 (3) or (4) float system.
' F137/139 230 3 Non 3.0 2 & 4 3&4 or 5&6 7. Four (4) hole "J-Pak", junction box, for water tight connection or wired in
` G137/139 460 3 Non 12 2&4 3&4 or5&6 simplex or 2 pump operation, 10-0002.
` No molded plug 8. Two (2) hole "J-Pak", for Watertight connection or splice, 104003.
Three phase units require a control switch to operate an cdemal magnetic or combination starter.
CAUTION
For information on additional Zoeller products (der tocatalog oncombination starter, FM0514;Piggyback All installation of controls, proleclion d"ces and wiring should be done by
a qualified licensed
Mercury Rog Switches, FMD477: Electrical Alternator, FM0486; Mechanical Alternator, FM0495; Alarm electrician. Allelectrical andsakrycodes should befollowed including flat moil recent
NsHoaalEleclrk
Package, FM0513; and Sump/Sewage Basins, FM0487. Code (NEC) and the Occupational Safety and Health Ad (OSHA).
RESERVE POWERED DESIGN
For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump.
AWL TO. P.O. BOX 16347
Loulsvare, KY40256-0347 Manufacturers of
SHIP TO. 3280 ON UMVS Lane
o OfLLf/~ O. LOUD, KY40216
(502) 778-27319 1 1 (8 (800) ) 928-PUMP FAX (502) 774-3624
Wisconsin Department of Industry, SOIL AND SITE E V A L UA.1 O N' Fi _F J-N
Lat~ornd HRelations
page of
Division of Safety & Buildings in accord with ILHR
NTY
rf MSAdm. Co^Attach complete site plan on paper not less than 81 /2 x 1 inches in C an mus'~`~rAtlud'~not limited to vertical and horizontal reference point (BM),
direction sbpej~scale+L ID. dimensioned, north arrow, and location and distance to nearest road. 3 1 Q APPLICANT INFORMATION-PLEASE PRINT ALL INFORMA EWED BY v
- D TE
pqq
PROPERTY OWNER: R OCATIO \
ft% E`- INkU I"11~ S t3 NJ / 1/4,S2 Z 9 N,R IS E (or@
PROPERTY OWNER':S MAILING ADDRESS LOT # SUBD. NAME CSM #
CITY, STATE ZIP CODE PHONE NUMBER ITY ❑VILLAGE WOWN NEAREST RO
WtLSoly kjl S40Z-7 PIS)698-ZSCC SPR-Iwc~Ftf_~, USWI VO
New Construction Use [kj Residential / Number of bedrooms
y [ J qdditiQn to existing building
[ J Replacement [ J Public or commercial describe
Code derived daily flow 600 gpd Recommended design loading rate 9 • bed, gpcW S trench, gpd/ft2
Absorption area required S0-0 bed, ft2 S5Q1 trench, ft2 Maximum design loading rate d- _5 bed. bed, gpd/ft2 d- trench, gpdfft2
Recommended infiltration surface elevation(s) c1q •'0 t ft (as referred to site plan benchmark)
Additional design/ site considerations 'N10y t-p W / & X 61 " 8 r-% ~ rv , 1 r O S NA-0 F-t L
Parent material s t `~-t ov t_srt Tt Flood plain elevation, if applicable N . fl It
S = Suitable for system CONVENTIONAL MOUND FIN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U =Unsuitable for s stem S ®U ®S ❑ U ❑ S (RU O S ® U S ®U El S UdU
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft
Texture Consistence Boundary Roots Bed Trends
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh.
d 1o`tc~ lZ s Z m cs - o .s o. 6
i I Z `F s bk m 'it►- ~S o. s a. 6
Ground 3 \o, -3q S 4v- y1b - Is O S9 tin v it,- e-S o.-t 0. `f3
elev. -
q tL 3q-Sy -I- S La V! Wit, S`-! R s Jg l s O S g Woo V, _
Depth to C.o ti W `rL L LC e\j T t k S
limiting
factor
Remarks:
Boring #
O-8 \>J`'►2ZL2 S 1 S ~~lZ Y"
O.S b.
I Z ' Z g-zZ lQ `11-1 113 'l Z `~s ~~Z w► ~t~ as - o. S o., 6
3 Zia G►- I S 0%9 m v'(~t~ CS _ 0.1 0.8
Ground
9S 5 ft. 3$ S t s -t RV I~ ~l S y Q 57>; G~ 1 s s
Depth to Z " S r'r VV C t+ 0/% 01F S % h b
limiting y GUty fu S t-O\:fj~~Lt_j C4.z: s
factor
38''
Remarks:
TName:-Please Print Phone:
Arthur L. We erer 715-425-0165
V egerer Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022
Signature: Date: CST Number:
q5-3qZ VL--I_01,rj M00576
d
PROPERTYOWNER `~'YN1"~PS~N SOIL DESCRIPTION REPORT Page -of
PARCEL I.D. If
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tw&
1 o_ 1048 Z.LZ - Si LM Sb inna,s - o.s o.6
3
Z 6-z~3 tort- y Sit Lw► Sbh w~ cs CA. S o. l
Ground 3 Z8-3y Lu`ty- 31~ - S 1 Zrn Sbh 'MU' * CL4j - o• S o. 6
elev.
qy ft. 3y-~y -)•S Ire 3l -.S Liz S1a Grscl 0V,
Depth to ► 1n ~L 1 hj v--,L
limiting
factor
Remarks:
Boring #
i
Ground
elev.
ft.
Depth to
limiting
factor
• i
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
OIX
i
Ground
elev.
Depth to
limiting
factor
Remarks:
cnn.a1~0rn ns.m~
PLOT PLAN Page 3 of 3
SCALE 1" 1{ p '
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[~f z l 2. 7- S (715 ) 42.5-01651400576
CST Signature Date Signed Telephone No. CST #
r.
r ~
e FILED
JAN23fl r
r.aw~u
L .
538809
CERTIFIED SURVEY MAP
MABEL THOMPSON
Part of the Southeast 1/4 of the Southeast 1/4 and the Northeast 1/4 of the Southeast
1/4 of Section 29, Township 29 North, Range 15 West, Town of Springfield, St. Croix
County, Wisconsin.
O Indicates 1" x 24" iron pipe weighing 1.13 lbs./lin. ft.
set.
NA Indicates fence.
h ~ CA'~gGO ~ ~T•)rE
0•aNp 4,q4, E114 COR. SEC. 29, T29N, R15W,
2 \R~ !2" IRON PIPE FOUND)
„FSr~R ~ i
~~9 9B • s'4 \Rq't
Owner's Address: os,~e \R\o
2891 Highway "12" F /s,,
Wilson, WI 54027 VAR. WIDTH o
Dated: December 23, 1995
M
H1 "Revised this 23rd day of Jan. 1996." s4j 11 3'
Q WA TER COURSE
1I(
LOT l OUTLOT l
a1
1y 93'
1. 23.990 ACRES. I9. 825 ACRES
1 044; 999 $O. FT. 863, 578 SO. FT.
.at 23.484 ACRES EXC. ROAD R,O,W. 19.330 ACRES EXC. ROAD R.O.W.
?I 022, 94 / SO. FT. 842, 02.4 SO. FT.
Jl Approval of thisroutlot does not'mea ~-!yf
,
`11111/Ilff/r~~~,' aCl
` approval for a building site. Rg~er 0WC'
~-~\SG0 n/S'ki~ to D.I.L.R. 83.03. ? ~.I
00
%
`Y
Q0 ' V 00
00 M W M ,HY~ C3 M
h '
13 W w, 0.I
N VER FALLS,; x•,44
v c W v pl
tu its;
•LA.N~ SJ•`~` a , :0 0.01
N
2
Laurence W. Murphy h j W a
N
C1
gistered Land Surveyor ° k i 2 O
o q I I kI.
ti N ~ ~ Q
WQ i
This instrument drafted by Laurence W. N I e
m Murphy \R W 3 ( N
WA TERCOURSE g h M 3
\t~ Il
N O 1 O
SCALE 200 m 7 h } y
0 50' 100'150'200' 300' 400' 500' I' W in
ku y % Ii ? o l
? Q v O
J h li W h l
3 SE COR. SEC.29, T29N, R1UW,
S114 CO R. SEC. 29, r 29N, R / 3 W,
538809
CERTIFIED SURVEY MAP
MABEL THOMPSON
Part of the Southeast 1/4 of the Southeast 1/4 and the Northeast 1/4 of the Southeast
1/4 of Section 29, Township 29 North, Range 15 West, Town of Springfield, St. Croix
County, Wisconsin.
Description:
That certain parcel of land located in the Southeast 1/4 of the Southeast 1/4 and the
Northeast 1/4 of the Southeast 1/4 of Section 29, Township 29 North, Range 15 West,
Town of Springfield, St. Croix County, Wisconsin, more fully described as follows;
Commencing at the Southeast corner of said 0Section 29, the POINT OF BEGINNING, of the
parcel to be herein described; thence N 89 50'13"W (assumed bearing on the South line of
the Southeast 1/4 of said Section 29) a distance of 1321.391; thence N 00008'08"E
1620.88' on the West line of the East 1/2 of the Southeast 1/4 of said Section 29;
thence S 74046'18"E 1371.53' on the South R.O.W. of the Chicago and Northwestern
Railroad; thence S 00015'50"W 1264.40' on the East line of the Southeast 1/4 of said
Section 29, to the POINT OF BEGINNING, containing 43.815 acres, being subject to ease-
ment over the Southerly 33.00' thereof for U.S.H. 1112" R.O.W. purposes and also being
subject to easements of record.
Note: The parcel shown on this map is subject to State, County and Township laws,
rules and regulations (i.e. wetlands, minimum lot size, access to parcel, etc.).
Before purchasing or developing any parcel, contact the St. Croix County Zoning Office
and the appropriate Town Board for advice.
Dated: December 23, 1995 "Revised this 23rd day of Jan. 1996."
This instrument drafted by Laurence W. Murphy
State of Wisconsin)
County of Pierce)
I, Laurence W. Mtlrphy, Registered Land Surveyor, do hereby certify that by direction of
the Owner, Mabel Thompson, I have surveyed and divided the lands shown hereon in
accordance with official records, Chapter 236.34 of the Wisconsin Statutes and the
Ordinances of Sti. Croix County and that this map and description are a true and correct
representation thereof.
```t~tt11~t1tlf~y~,,
LAU NC .
mss' •W RP YI oc~
M
o
1713
. Rt ALLS,.F J~
i _ ~A_ WISC. ~Q ~
S T C - 100
,This application form is to be completed in full and signed by the
owner(s) of the property being developed. Any inadequacies will
only result in delays of the permit issuance. Should this
development be intended for resale by owner/contractor, (spec
house), then a second form should be retained and completed when
the property is sold and submitted to this office with the
appropriate deed recording.
Owner of property neGc n RO A7
Location of property 1/4 S E 1/4, Section ,T_,21_N-R /,S W
Township rj C/ Mailing address _ 1, LPe 5, lver&i/ /ld
;ca emu. p . h ~y 5-6-42;?
Address of site t4
Subdivision name Lot no. _
Other homes on property? Yes No
Previous owner of property M4 e- 41a.11
Total size of property
Total size of parcel
Date parcel was created q- 7
Are all corners and lot lines identifiable? Yes No
Is this property being developed for (spec house) ? Yes No
Volume /,?3~ and Page Number as recorded with the Register
of-Deeds------- C. 11 ►I V& 1~ -
3-°-~`
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. 1h S") ~ !ZQ , and that I (we) presently
own the proposed site for the sewage disposal system or I (we)
obtained an easement, to run the above described property, for the
construction of said system, and the same has been duly recorded in
the office of the County Register of Deeds as Document No.
Signature of Applic Co-Applica
- //-,//-9-7 4 - 9-7
Date of Signature Date of Signature
F STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
ff St. Croix County
OWNER/BUYER ~!t n i'yIdTZ
MAMING ADDRESS 003 5 i 6 Z. #t Z-wzi MYy• 551,202
PROPERTY ADDRESS ) a_
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE
PROPERTY LOCATION j 1/4, 52' 114, Section J, T a 6N-R 7-- W
TOWN OF ST. CROIX COUNTY, WI
SUBDIVISION LOT NUMBER N
CERTIFIED SURVEY MAP , VOLUME AM4 PAGE, LOT NUMBER
Improper use and maintenance of your septic system could result in its premature failure to handle
wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed
by licensed septic tank pumper. What you put into the system can affect the function of the septic tank
as a treatment stage in the waste disposal system-
St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost
of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County
accepted this program in August of 1980, with the requirement. that owners of all new systems agree to
keep their system properly maintained.
The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner
and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1)
the on-site wastewater disposal system is in proper operating condition and (2) after inspection and
pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum.
LfWe, 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 ex anon date.
SIGNED:
DATE:
St. Croix County Zoning Office
Government Ccrnter
1 101 Carmichael Road
Hudson. \\'I 54016 it%`~`
STATE BAR OF WISCONSIN FORM 2 - 1982
ti,5Jry (84U DEED~---,
Y~Y~ PACE 4c~ [REGISTER'S OFFICE
DOCUMENT NO.
ST cROIx cnr., w1
1f~YY~~ 4
Mabel A. Thompson, Trustee of the Mabel Thompson APR 11! 1997
Trust Mated November 10, 19959
11:45 A.M i
conveys and warrants to Dean G. Motz and Karry A. Motz, H8916W of Deeds
husband and wife, as survivorship marital property,
THIS SPACE RESERVED FOR RECORDING DATA
y NAME AND RETURIy!/IDD~
the following described real estate in St. Croix County, Alf', e k.-
State State of Wisconsin: 00~~6
i
034-1065-50
PARCEL IDENTIFICATION NUMBER
Part of SE1/4 of the SE1/4 and the NE1/4 of the SE1/4 of Section 29, Township
29 North, Range 15 West, Town of Springfield, St. Croix County, Wisconsin,
described as follows: Lot 1 of Certified Survey Map filed January 23, 1996, in
Volume-,11 of Certified Survey Maps, page 3044, as Doc. No. 528809.
ij This deed is given in fulfillment of that certain Land Contract between the
parties hereto recorded October 7, 1996,. in Volume 1202, page 187, as Doc. No.
550494.
FEE EXEMPT
This is not homestead property.
x)CM (is not)
Exception to warranties: Easements, restrictions and rights-of-way of record, if any.
Dated this f / day of April , A.D., 19_27
Mabe Thompson Trust da d November 10, 1995
(SEAL) B (SEAL)
• Mabel.A. Thompson
(SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
State of Wisconsin,
Signature(s)
St. Croix SS.
County L.4=1
authenticated this day of , 19 Personally. came before me this day of
a ~ ~ l vo 4
i i
f
i
" V