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HomeMy WebLinkAbout040-1185-40-000 ry o (D o a 0 61 M o a h C N 0 N T O O co O C w V .N N.L.. C O O O C N N N L Oyi N O C L N L O d N O Z N Y C C LL c .0 m c E -e E N O N.N. O O aL y Q Z F- in m ~ N Z H rn z 0 O Z M co w a m O 76 O Z v ~ r ti 0 N F r :t z E N M N C • A~ ,D L p O 0 Z Z z N t C: Its U N y N L ~1 Q m U r~ll v a ;a « vi c O~ O O 0. E -0 (D c (pE m N N N U O _ a ~Nv 0 ~i O O O Z •N c0' a (L a ~1 g -o ~,i 0) M U) -j U = 0) rn O Lf) 0 70 a) N N o o O E O n O a) m 10) 0 p d ¢ Z N W 7 E ^i O O O N C O 0 0 O w v 0=. 0 0 C O O Z5 E u-) `=yam') 4O a0 O co O d N N T m 4) • a 7 CO O W O E N U ;0.4 M~ N F' •C L O I` y~ O M F- N O Z -7 (n v1 y € a r'1V +r ~ ~ c c 3 r A U a j O U) 0 4 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 111irYcl?e irrsize. Plan must include, but Attach complete site plan on paper not less than p not limited to vertical and horizontal reference X"N direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and tence to nearest road. APPLICANT INFORMATION-PLEASPRiNT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: ' P EROTY LLOOCATION4~ 1/4,S3o T a8 N ,R 19 E (or) W Y PROPERTY OWNER':S MAILING ADDR SS ~OT# BLOCK # SUBD. NAME OR CSM # I' Y I a Z0N NU,;FF! S CITY, STATE ZIP ODE ` PHONE NUMBER 3 EHL4AK MOWN NEAREST ROAD , -R^o YY~1 v ear Fodks . GOT 1540ZZ' New Construction Use[ ] Residential / Number of bedrooms [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow y SO gpd Recommended design loading rate bed, gpd/ft2 trench, gpd/ft2 Absorption area required . f bed, ft2 trench, ft2 Maximum design loading rate bed, gpd/ft2 trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL MOUND 7IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U=Unsuitable fors stem ❑S ❑U ❑S ❑U ❑S ❑U ❑S ❑U ❑S ❑U ❑S ❑U 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 I. i z, iI a 56K In v -Er 0- a y s a IS-3 p Y `I] 3 S11 01 m sb~ MV-~_r C 1Y~ , S Ground 3 3Z-149 IO Y L4 6 1 f 66K mv'Fr c, Iv-' •S 41 elev. ft. y8- r Oo Is s ML Depth to ~j 657 -1a 1 C r -11q IS Ume, 0-V 5 M L S . (o limiting factor ~p a _ lp9 r 7 Ctme j'Y1 Remarks: Boring # I -19 jD 0, r Z1 t n l i' 5bK v CL ,S . iq 3b 41,4 5i 1 Z m bK rnv C , y 1's Ground -ro0 ' 0 Y 41 t ( K L C V-F . ' . ~ S elev. 400-`1 Y b I (o Is T. S ML 94'q t ft. Depth to J 7a-10% 10 1 I q 5 0-f' i limiting factor Remarks: CST Name:-Please 0nt Phone: A/ Q "5 6 owl C : } n<2r_ Address: g. "'10 CI t _ R \\r t 5 , r4 Signature: u l Date: CST Number: PROPERTY OWNER SOIL DESCRIPTION REPORT Page x- 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 Trench all 3 1q-Q(0 I bur 414 S i m Ground (0-`13 10(4 ie' 9 (o Si 1 C. ~V~ q S elev. qs ft. y qa-o i® r~ 0 i co m L , S , Depth to j 67-I0$ IDUr 7 of L limiting factor Remarks: Boring # 1 o-1a ow z) 1~ o b m v-6 Q a~ - S , a 1x-30 113 , j Zm K L' f Y , Ground 3 104r 4 io t l I -F b MVPr 0, ) v y 4 elev. A4 N3-8 r (0b Is 60b n - 5 m L 5 -I Y 7/3 1,S Co - L _ , 5 Depth to limiting factor Remarks: Boring # 41 d-I6 I r Zf n a 56K MvFr OL 0-If , S Ila-a r 414 i 1 b mU -Fr IV-F 'q S Ground 3 ab-48 r b (o S i l L f sb K , y, s elev. 4e IC9 c>r 7/4 _ ' . 9 ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: S13D-8330(8.05/92) Wiscontin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division County INSPECTION REPORT ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) SanitarMr§7t.. Personal information you provice may be used for secondary purposes [Privacy L , s.15.04 (1)(m)]. Permit Holder's Nam Village Town of: State Plan ID No.: RIVARD, PATRICK CST BM Elev.: Insp. BM Elev.: BM pescription: nT1185-40-000 11, I GU . GU r TANK INFORMATION ELEVATION DATA A9700240 /6 A~'8 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic C~~ S. rY C_y~ <r C - 0~4 Benchmark 60 Dosing //7 53 A e r a ion Bldg. Sewer Holding St/>f Inlet' Jl75,S5~ TANK SETBACK INFORMATION St/ bK Outlet r3 - Vent TANKTO P/L WELL BLDG. Air Ito ntake ROAD Dt Inlet n Air - Septic / dA NA Dt Bottom Dosing NA Header LA~arr (0 Aeratio NA Dist. Pip; I, v Holding Bot. System ii, ' " y7 PUMP / INFORMATION Final Grade Manufacturer o~ y Demand Model Number 9 y GPM TDH Lift Friction Systern7 TDH Ft Forcemain Length Dia" Fi Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No_ Of Trenches PIT No. Of Pits Inside Dia. epth DIMENSIONS DI SETBACK SYSTEM TO P/ L BLDG WELL LAKE / STREAM LEACHING INFORMATION TypeO CHAMBER Moe Number: System: t-NcL._j q 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.) DRIVE LO 7 r/~?•r LOCATION: TROY 36.28.19,SE,NW 61 E WOODNDGE, 4-1111 7. 06. D O Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R.3/97) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH ' SANITARY PERMIT NUMBER: Illl~~is Safety and Buildings Division v~■~r■r,. SANITARY PERMIT APPLICATION Bureau of Building Water Systems 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. X • See reverse side for instructions for completing this application state Sanita Permit Number Rp9 4139 The information you provide may be used by other government agency programs ❑ Check if revision to previous application (Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION- PLEASE PRINT ALL INFORMATION PropeLtyO Name q / R , 1/4 ).Z01/a, S -36 T N, R/ 9 E (or) Property Owner's Mailing Addr s Lot Nu er Block Number J 19 h.- /A S-,~' City, State ip Code Phone Number Subdivision Name or CSM Number rn, ( > rid Jam'. EQ SL` Cit II. TYPE OF BUILDING: (check one) ❑ State Owned ity r, Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms ~,Towan pF I v` 111. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) ` 1 ❑ Apartment / Condo Q Ll o L cD 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. K New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an ------System Syste_m 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 (.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-ln-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) o Elevation_._._- 1-5- 0) 1 3 7 7 G / !f Feet Feet Ca acit VII. TANK in gallons Total # of Prefab. Site Fiber- Plastic Exper. INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel New strutted glass App- Existing Tanks Tanks Septic Tank or Holding Tank (pp ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plum1i Name: (Print) PIu ber' Signature) No Stam MP'/MPRSW No.: q Business Phone Number: C-Q( Plumber's Address (Street, City, State, Zip Code): IX. COUNTY/ DEPARTMENT USE ONLY ❑ Disapproved Sa itary Permit Fee flncludesGroundwater Date Issued Issuing ent Signature (No S ps A roved Surcharge Fee) pp ❑ Owner Given Initial Adverse Determination d CJ_ X. CONDITIONS F AP ROV~ ON FOR D SAAPPPROVAL: SBD-639B 105/94) DISTRIBUTION: Original to County, One copy To: Safety & Built ings Division, Owner, Plumber ,I I 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, 608-266-3815. 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, rec;:)nnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information Provide all informatior requested for numbers 1 throuch VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, n, rr L rof tanks and manufacturer's name, indicate prefab or site constructed and tank materiai Complete for ;L! ,)tic, pump/siphon and holding tanks for this systern. Check experimental approval only if tanks received experirn(--,t~i ;,)rodu(t approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropi a = :)refix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. cm;~letc plan a speCi not srria:1,,r than 8 10 x 11 !nche•s rrust be sui,. unty. The plans must 1;-0 [hie fu) hj p,ot r>lan, draw scale or vlltfl Ct)it,s~ : ~ r a., £~=51 1 k,; ding 'ank(s), septic t I s t rrn,-r or siphon c r <;nl b.:;Idm w(li,, ,n served; C) Lie 1 .i r) rnp i cur i.r, 'r, D) ci css s°ction of _ SJ i .-b crpuo. system if required by Gil ~z,L r ~)rrT a -,J ng inforration. GROUNDWATER SURCHARGE 1983'r' "1G' included the crea'on c` surcharges (fee,) ^c,r a numb- z- A pi i i,_ , (Vhich can effect groundu,<ate. The r,rf : •-~s ed through these surcharges are used for monitoring grog. v :-T investigations and establishment of standards. SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Commerce July 10, 1997 2226 Rose Street La Crosse WI 54603 WEGERER SOIL TESTING 421 N MAIN STREET PO BOX 74 RIVER FALLS WI 54022 RE: PLAN S97-40857 FEE RECEIVED: 360.00 RIVARD, PATRIC SE,NW,36,28,19W TOWN OF TROY COUNTY OF ST CROIX MOUND SYSTEM The Department has reviewed the above-referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval of the system is based on chapter 145, Wisconsin Statutes, and chapters Comm 83 and 84, Wisconsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter Comm 82 or in chapters ILHR 50-64, Wisconsin Administrative Code. This 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, 6rard M. wim Plan Reviewer Section of Private Sewage (608) 785-9348 SBD-7997 (R.11/96) 6 S97-40 g 57 Page -1 -Of MOUND SYSTEM RFIlI FOR I A 3 BEDROOM RESIDENCE Jul sAFFTy ~ 0 1997 BOGS. D/V LOCATED IN THE 1/4 OF THE iVW 1/4 OF SECTION 36 T N, R 19 W, TOWN OF T-2olr , ST C~ZFILX COUNTY, WISCONSIN. INDEX PAGE 1'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 PREPARED FOR -t S. 4•~•~~ Wally coriditi° ~Q -1 DY S 7'N 5r. ti0~ PSTPT** 2 O~ ~E s 11v~So ►J i~J l .S ~ ~ t b ~~oE ~o a1 ~~aa~~'EN o~p s~ o~s~ PONp~NGE SEE GD~tR PREPARED BY WEGEFtER SO S L .TESTING ~~~e~~90oNN~., AMID . DES = CN S d IEF~V = CE F.O. B01 74 421 K. MIK ST. A"(JR L. RIVU FALLS. KI 54022 %FGEREA 715-425r0165 ELLSWORTH, LA'S I G 13 JOB NO. r~ i PLOT PLAN_ Page Z of 6 - yD ' r Scale 1"= ZOO' ~ n2w~M/ lAe:.rtT1~ 7t C.OvM0 8~, WCA /_J O~Bm~, ~ NZ. ~p$.o~'L p6o . 8 a~o Q i ~ 8.3 p 3 G3Dt i %A-p) F 3 cr > O > S'pF~`'cv C '~aZ0~~ P .y o ~ ~ by ? ZOO cJ fir" 1 • Wo.p' oN ~P O1= 2 '1i16 M Cm\,kt. TV . \ DO NoT Cowl PST Oft 't_--,i S UttD .T. V~z Y-111vMp ?'t►`tZS'R ' o1Z ~L wtT~t!>\► Z,5'b~iwl:lS~.01~N 0l=7It~ _l~iU~►ui~. ~1iv2LrU ~ t-hjUSF ~.~~r~JSll~-UC"T?(1►~1. - - -2. Lv~tL `Tp 3F ~T L"-&-r ISO, 1= tzOM "OVvv~) '1~it~1J ~T L~T ZS ' F=l-zep4 s_ ~}-UU S eUrv 5~1~ t.Y101y olZ ~ '1 rJ ~~'D~W U'P~~ t'fe-~-`~S S Fo R Lt~'i~lZ : 1 n~ S~~t~LAfi D ~J , _ +-l- `ltM U0SWPZ SL 0 - Y-~Uv F r,~ %LeQZ ! ~ T} Fi " S ktM ~ SCt . S, veRit ~r Lol- U"IZS toVA _ COQ ST~it,c UtJ, - NOTES: •1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. required) 3. Install.4" observation pipes with approved caps. ( Z required) 4. -Septic tank to be 1tsob I6oo gallon capacity manufactured by ~tnz CAIV @WXTE i> R01JUe-'rS 5. Bench Mark s. ~$pUN 6. Divert surface water around system to_prevent .ponding at the uphill side. Page Of Approved Synthetic Covering PrsTm C- 33 Distribution Pipe Medium Sand _ H _ G Topsoil = F Elev \0'8-0 _11 3 E D - b % Slope Bed Of 22 Force Mbin Plowed Aggregate From . Pump Layer D Z, o Ft. E z-5 Ft. Cross Section Of A Mound System Using A Bed For The Absorption Area F c.b Ft. . G 1-O Ft. A 8 Ft. H N.S Ft. Linear Loading Rate=O~- 6 GPD/LN FT B Ft. Design Loading Rate= o-~ .GPD/SQ FT j 16 Ft. J ~Z Ft. K 1 Ft. A! termatp-Posit+oii, L 15 Ft. o~ W_ Ft. L Observation Pipe-, A I - - - I.----- ---------------------~I W o Force Main Distribution \.,,Bed Of 2N- 2 2 Pipe Aggregate I Observation Pipe Permanent Markers (Anchor securely) Plan View Of Mound Using A Bed For The Absorption Area Page -Of Perforated Pipe Detail 0 End View )Perforated End Cap.) PVC Pipe Install permanent marker at end of each lateral Holes Located On Bottom, Are Equally Spaced Q S PVC Force Main II P PVC Manifold Pipe Distri ution Pipe Lost Hole Should Be I Next To End Cap End Cap P Z Z Ft. Distribution Pipe Layout S Ft. X8 Inches YS Inches Hole Diameter 11Y Inch Lateral Inch(es) Manifold Z- Inches Force Main Inches # of holes/pipe Invert Elevation of Laterals 108:5 Ft. bx1.V') ~•01Y ~4 zg.ug GW~ Place 1st hole Z~4from center of manifold with succeeding holes at L18y intervals. Last hole to be next to the end cap. Combination SepL"c, Tank acid PLl-MP CHAMBER CROSS SECTION ARID SPECIFICATICIMS PAGE S OF C~ -VEUT CAP WEATHER PROOF JUUCTIOM BOX , `'C.I. VENT PIPE APPROVED LOCKIIJG lO' f ROM DOOR, MANHOLE COVER k-JIV '.iIUDOW OR FRESH 2 wARN1uG L1~6EL. AtR IUTAKE DJ, s I `(r MIU. 107 I I I ~ I B' MI IJ. 11~ _ PROVIDE I IAILE T AIRTIGHT SEAL I III ~ gFFt~s ~ I i ~ l_ v APPROVED JOIM r A I I I APPROVED JOIWT aR I 11 I W/LI. PIPE~pu w/C.I. PIPE Tank construction I II shall comply with I I ALARM ILH e I II ~ 1;3.15 and 33.20 • I i oN C I I LLI- V. FT. Pump OFF 0 COkICRETE BLOCK 13" APPRo RISER EXIT PERMITrID ONLU IF TAUK MANUFACTURER HAS SUCH APPROVAL. BEDDINi- SEPTIC E SPCGIFICATIOMS DOSE TAWK A►1UFACTURGR: UUMBER OF DOSES: PER DAB M TAWK SIZE: /630 GALLOUS, DOSE VOLUME z INCLUDING BACKFLOW: GALLONS ALARM MAAIUFACTURi`R: O1 N J MODEL iJUMBER: 1 CAPACITIES: A= 'Z -2 IUCHES OR 3D GALLOIJS SWITCH TyPC: 1~ ~'y~~t' B= Z IIJCHES'10R X3'6 G~LLOk15 PUMP MANUFACTURER: zO~L~~R C-O C= ~ 1 WLHES,OR GALLOU5 MODEL NUMBER: D- lZ IMCHES OR GALLONS `lIJOTE: PUMP AMD ALARM ARE TO BED ~ SWITCH TYPE: MINIMUM DtSGKARGE RATE GPM IN5TALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE DETWEEU PUMP OFF AW0.015TRIBUTIOU PIPE.. _t' SO FEET + MINIMUM NETWORK SUPPLY PRESSURE . , . , . 2.52 FEET FLFRIC710k1 FACTOR. FEET + ~Q FEET OF FORCE MAIN X `'t'1 FY100 \,`3 TOTAL 09UXMIL HEAD = \1I V1 FEET Pump chamber DIAMETER ~I INTERAIAL DIMLWSIOW~ OF TAIJK: LEAIGTH ;WIDTH ;LIQUID DEPTH S 1 BOTTOM AREA 231= GAL/INCH AS PER MANUFACTURER = ~I.B Z GAL/INCH 6 a b 3 /8 6 1/4 a HEAD CAPACITY CURVE 30 MODEL "98" 4 5/8 8 25 0 3 5/8 6 ° ® O - Q O 15- 4- t .t3 4 3/16 F 0 10- 5- 8 08 2 1 112-11 1/2 NPT 0 U.S. GALLONS 10 20 30 40 50 60 70 80 LITERS 80 160 240 0 FLOW PER MINUTE TOTAL DYNAMIC HEAD/FLOW PER MINUTE EFFLUENTANDDEWATERING CAPACITY 12 HEAD UNITSIMIN FEET METERS GALS LTRS 5 1.52 72 273 I 10 3.05 61 231 15 4.57 45 170 4 3/16 20 6.10 2s 9s L_J Lock Valve 23' SK11112 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and • Variable level float switches are available for controlling single supplied with an alarm. and three phase systems. • Mechanical alternators, for duplex systems, are available with • Double piggyback variable level float switches are available or without alarm switches. for variable level long cycle controls. SELECTION GUIDE 1. Integral float operated 2 pole mechanical switch, no external control required. Standard all models - Weight 39 lbs. - 1/2 H.P. 2. Single piggyback variable level float switch or double piggyback variable level, 98 Series Control Selection float switch. Refer to FM0477. Model volts-Ph Mode Amps Simplex Duplex 3. Mechanical alternator 10-0072 or 10-0075. M98 115 1 Auto 9.4 1 or l &7 - 4. See FM0712, for correct model of Electrical Alternator, E-Pak. N98 115 1 Non 9.4 2 or 2 & 6 3 or 4 & 5 5. Control switch 10-0225 used as a control activator, specify duplex (3) or (4) D98 230 1 Auto 4.7 1 or 1 & 7 - float system. 6. Four (4) hole J-Pak, junction box, for watertight connection or wired-in E98 230 1 Non 4.7 2 or 2 & 6 3 or 4 & 5 simplex or duplex operation, 10-0002. 7. Two (2) hole J-Pak, for watertight connection or splice. CAUTION Forinfonnationonadditional Zoellerproductsrefertocatalog onCombination Starter, FM0514;Piggyback All installation of controls, protection devices and wiring should be done by a qualified Variable Level Switches, FM0477;ElectricalAltemator,FM0486;Mechanical Alternator, FM0495;Sump/ licensed electrician. All electrical and safety codes should be followed including the most Sewage Basins, FM0487; and Single Phase Simplex Pump ControVAlarm Systems, FM0732. recent National,Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. .T MAIL TO. P.O. BOX 16347 Louisville, KY 40256-0347 Manufacturers of.. Z Ly SHIP TO: 3649 Cane Run Road _ LoulSvdle, FAX(502J KY 40211-1961 Q~caurrPruias Slh'Mr ARMY PUMP !O_ (502) 778-2731 - 1 74.3628PUMP WmonsinDepartmentof lndusty, SOIL AND SITE EVALUATION REPORT Page \ of 3 Labor and Human Relations Divi, of Safety & Buildings in accord with ILHR 83.05,.Wiis. Adm. Code COUNTY r Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but C lk not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. vy.0 - 1 l Qf 5 - y n APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: ~c\ D FO X PROPERTY LOCATION Qv~-► ~2: V" Per Z Cjr- IR V mtt) Gew.-E SE 1/4 K)W 1/4,S 31 T ZS N,R 101 E (00 PROPERTY OWNER'.S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # )oy 8r►t ST. N.IaIL TI T*~ 2 1 - 1346"V-- l~-~O66 hcCc..s CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE ®fOWN NEAREST ROAD Sw-j~ kiI 580[6 (itS)3Rs SgL9 TZU 1WWbV-1DQ DQ.Ehs"T [X! New Construction Use [X] Residential / Number of bedrooms 3 [ ] Addikn to existing building [ ] Replacement [ ] Public or commercial describe Code derived daffy flow SO gpd Recommended design loading rate • \4 bed, gpdlft2 trench, gpdjft2 Absorption area required 31 S bed, ft2 31 S trench, ft2 Maximum design loading rate , q_bed, gpd/ft2 , S trench, gpcW Recommended infiltration surface elevation(s) - S It (as referred to site plan benchmark) Additional design / site considerations ovt~\~ w~ ~~V 1 31~A • V--,Irv . L k S' of S)" F-j LA_. Parent material Sf'C~►nS`TO 111 Flood plain elevation, if applicable 1- f\ . It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESS7RE=ATG1R ADE SY STEM IN FILL HOLDING TANK U = Unsuitable for system ❑ S ® U ®S ❑ U ❑ S [2U ❑ S [8'U ❑ S ®U ❑ S ® U 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 tench TAY .H : ?y' n_ _ J Y 1 fi • 1 0-8 't `i.R 3) - S VA S VC g CS 4 S Z &4 -!&'1 IL V/ - S > 1~nSbk `MV \h CS _ 'S Ground 3 \-L-y g ~0 ti 616 - `Fs o S 9 t Cg . S elev 10-1 a ft 10,- Q_ _ ~S o s 9 Yrl • S , b Depth to S 460/b+- S"M G 1,1 L v S, limiting factory 1 1 SO R Remarks: Boring # 1-~ 1 - s1 1sbk ds cs _ •q s Z Z -7- zL WL - ~s o s9 1 C T SSS Ground elev. °-ft Depth to z limiting factor Remarks: TName:-Please Print Arthur L. We erer Phone: 715-425- egerer Soi Testing & Design Service-P.O. Box 74 River Falls,WI 54022 Signature. t; ~hi _ 1-1 (o Date: -7 CST Number: M00 5 7 6 PROPERTY OMER. ~Z1V PM[ D SOIL DESCRIPTION REPORT Page - of 3 PARCELI.D.# 040-11$S-yO Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounday Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 79 `11Z 3 l S) tins S cS - • 5 Z a 33 lv`~1Z 3lcf - ~s~ ~v4Sbk ynv l ~S _ • 4 •5 Ground 3 11-Sb 1 ~ tz ell - ~ g O S-) - - S . L elev \0°I 9 ft. 3 Cps, N S > °`o SP%J~a 8 vi M1 - S 8 Depth to limiting factor Remarks: Boring # C3 Ground elev. ft. Depth to r limiting , factor Remarks: Boring # 13 Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) PLOT PLAN page 3 of 3 SCALE 1"= L4p ' j Zoo' ~ ~2i,u~wf~y L.oeXno,~ c x w~ LuctmuN 0 t0 0 ~ Lam. l0 q ~ 0 ~ B.3 0 V ° Otitov~ b o O r \ b @ti t~p►q ~P 3 p ~ a- i` ` of a 11103° . \ WL ~L. LOl s ~ J ~3. c1 ~"1 vau-rj' ON SOP O~ 2~lt16t+ Gc6\.l TV Pao. LrL -0i, Om r~1o1iL": 1, Cho NoT ~o~i1'~T _atiL of s~v~~R ~ ir-iuviu~D -'A~n'~R OSt `T Pm ~..,t`~}th► ZS' c slgP 61=_7ttL-~inu~uo, B.- W zL4- _ k 6 (715 ) 423-0169 1400576 CST Signature Date Signed Telephone No. CST # Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page \ of 3 Labor and Human Relations Division of Safety & Buildngs in accord with IL.HR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but C~~ Zk not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dmensioned, north arrow, and location and distance to nearest road. 0qo - W&5_ q u APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: 1QWfV ZD F-0 X PROPERTY LOCATION 8v`1 ~i : PPt'i' (CSZ V ~ V Pt 'RD GeW-EO • S E 1/4 MW 1/4,S 36 T ZS N,R l c1 E (0(@ PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # SUBEr. NAME OR CSM # boy BYIt ST. vaokTH 1'1-pTW 2 -I - ash- Vk-L06E" 1f~UZss CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE EFOWN NEAREST ROAD Soau, Lit sk.ol6 (7tS)3~)- S9'L9 WooUR1DGt? DR.Eyts"1' [>q New Construction Use [X] Residential / Number of bedrooms 3 [ ] Addition to existing building j ] ReplaMent [ ] Public or commercial describe Code derived daily flow A SO gpd Recommended design loading rate • ~ bed, gpd/ft2 ~ trench, gpd/ft2 Absorption area required 31 S bed, 1112 31 S trench, ft2 Mabmum design loading rate__, bed, gpd$ IS trench. gpdtft2 Recommended infiltration surface elevation(s) t0~ - S ft (as referred to site plan benchmark) , Additional design/ site considerations r W jK.;p w/ H 5c V g~ • W> OIJ . L $ 4 OF S't}yvD Fi L.L . Parent material S1( SAO h1L. Rood plain elevation, if applicable 1-3 • f\- it S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for system ❑ S ®U ®S ❑ U ❑ S [2U ❑ S [,8'U ❑ S ®U ❑ S o u SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon in. Munsell Chu. Sz. Cont Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed rench f 1 t7-8 10 ~lR 3 ) - s m S ~1z g CS .,4 .5 Z 8-lZ S`iR y/ - S ~~nS~k `Mv- cS -14 -S Ground 10-OW"WVAJ g LO -1 ~ 6 l 6 - `Fg o s 9 ,,,1 c S ' S L b3 ft to fa- I yyl Depth to S 14 O0 A f :S S'f0 6 h v S, limiting factor y L t ? so ° a' S B R 8 L4 Ll- Remarks: Boring # S) 1 s~k dS 0 - •q .s 4 4 Z -7- ZL loin:. W L - ~s o s9 1 c s - . s .L 3 Z6-4 f~~Q 8/t - SSBR - - - Ground elev. lft T Depth to limiting factor Remarks; TName:-Please Print Phone: Arthur L. We erer 715-425-0165 Ad: egerer Soi Testing & Design Service-P.O. Box 74 River Fa11s,WI 54022 Signature: Date: CST Number: ctiv h C~ M00576 PROPERTY OZwWN1i6RI tV Pt'lZ b SOIL DESCRIPTION REPORT Page -of 3 PARCEL I.D. # 0 4 0- 'W3G - 4 0 Depth Dominant Color Mottles Texture Structure GPD/ft Boring # Horizon In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Consistence Boundary Roots Bed Trench 1 0-9 `0 -,x.31 - S l ~ sb s C-S 9. 33 1tJ`-IIZ - ~s~ lknSbk Y►tv- ~S ,5 Ground 3 ~3-93 1l31-tlz 8l1 - `FS Q S elev \Og9 ft. 3 Cp~v S > 0°~o Sf`C~.JO 8 W IF1 - S & Depth to i limiting factor 3-21 Remarks: Boring # .13 Ground ' elev. ft. D . epth to limiting factor Remarks: Boring # 13 Ground elev. ft. Depth to limiting factor Remarks: 'Boring # i Ground elev. ft. Depth to limiting factor i Remarks: SBD-8330(R.05192) Page of PLOT PLAN 3 3 SCALE 1':= zoo' !}uvsE !gip h7 -a, evo c9 0 \ , k!v- Ira q p ~ a.3 0 by \ ~ O S ~ ~ e` v ~~n,tovcz~ I.Obo 3 p ~ gar ` i, au1~►'~ of d~a L-L 0 „cj, ? ZOO ~ ~ ~ ~"1 -~t.tAO,O~ oN ~P o~ 2~ltt61+ ~c6~ TV Ply. . At -!'t tot.q' oN ri~L ~1u~ posy. NoT~: 1. DO- t~oT cU~.i'~tT - OR of s~v~~t3 ~ 1MU-u~nD_~A Olt 'TM ft-jz" wv-r*IIQ sow (715 ) 42.9-011;9 _ 1400576 CST Signature Date Signed Telephone No. CST # 3 200.00 90 - - 0 -Co. 1-66.00' N' 89053'W 0 0 ( 900 200.00 o Q 77 0~ S 8 Q I 1 0 9e 200-00, ° $ Meadow L~ane•. '~8 o 90~ 900 0 q°° S 89 ° 53' E Soo p b fJ 900 200.00' ° O o ~0 tD 8 1,0 00 CO " S OD 01 N 7 8 N M 84; N 01 0 9 f0'c o 0° N O S O . (n ° N89°53'W - O @W i N 90 200.00' 7,g ti66.00 ° 'P°W , N t J~ N °p M 2\8o\s' 28.44' N89°53'WY~ z ° 8 9O0 ti tlo 190..' 2 0 O' ° 43o AZ' p +O • \ o !y O o °o Z\e°\a 66 0 , Q 8~ ZOO'0 ~g 9.~ 610 0, OP C, 90 0 '249.73' 3042 ' 90 0 ,m. !y A. ~p QO ~9r «I 00;., N 89053'W O ZO g4j 33 r ~iS O0 4 9' S ayo4Z SFe° a 81 °o, '°o. 900 6 \ 1 `des, A sr~, \ o ti 66' \809 a0 \3 05 89053'W 3 042 p 0° N89053'W . 900 2 00.00 0 6 6. 9° 2 0 0.00 0 9 9 'O 8 s 82 0 ° d 5 a d o o o - 0 83 ° g 4 S o - 0 P2 p° - N 8 . •h O O p Vt O _-0 In O S 0 W 0'. O C S 84 8 p ~ 3 3 3 0 0 00 N89053 W 200.00' 00 Z I o N 89053' 200.00' °O o oo 9a, 100.00 100.00 ~o 000 100.00' 100.00' o z to U to U 86 85 g 2 I o 0 0 o 0 C? B I 00 N 0 iI 0 STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER ~'kc\+,a~c1Q P,:,~ r ► C 0CLrCj MAILING ADDRESS ~T , /(j Or L A /I PROPERTY ADDRESS d IK- ~0 a~ S-~/ (location of septic system) Please obtain from a Planning Dept. CTTY/STATE Z~_ Ll y 1 & PROPERTY LOCATION J(~ 1/4, L,-) 1/4, Section 3 ( T-;2k-N-R 'j W TOWN OF ) ` Qp e ST. CROIX COUNTY, WI SUBDIVISION ®Cd(f Rj" f' C(X S LOT NUMBER _ CERTIFIED SURVEY MAP , VOLUME , PAGE , LOT NUMBER Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private 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: ;71111~p -7 St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 ' 8 T C - 100 711 3 This application form is to be completed in full and s7lgh6d by the owner(s) of the property being developed. Any inadequacies till only result in delays of the permit issuance. Should 'his development be intended for resale by owner/contractor, (=pec 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 ti Y 1/4 lJ 1/4, Section T -N-_W Location of ProPert _ Township Mailing address ~ U Li - Address of site 1< Subdivision name C' ca R; ~GQ Acre ~ Lot no. other homes on property? -Yes No Previous owner of property K_ 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 No Volume 06 and Page Number as recorded with the Register of Deeds .T - - INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PI3E 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 recprded i t frice of the County Register of Deeds as Document No.6 ~and that I (we) presently own the proposed site for the sewage disposal system or I (wb) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in th~~o~ fi~e/ of the County Register of Deeds as Document No. s Signa ure of Applicant Co-Applicant Date of Signature Date of Signature .r V~L 1246~E6 1 6 STATE BAR OF WISCONSIN FORM I - 198: .lE1IL2~1 1VARRA*iTi GEED DOCUMENT NO. r6 07FI"F- r This Deed, made between Rolling Hills Developtent, i cT cROUTY,W) Inc., a Wisconsin corporation ,..ti..rK• IN r 0 1997 ~ 41- Gram x r ~1 1`I and Patric J. Rivard .~_marriedperson , 10:00 AM an`i In-p h 17Rivard a single pgrson 'k t-0.6 La am iJnint tenants 9+99w. ,;r [.ea Granter i Witnesseth, That the said Grantor, for a valuableaxiskieranort * YR , conveys to Grantee the following described real estate in St- Croix -HAS SPACE RESERVED FCR RECORDING DATA County State of Wisconsin: -rarrE AND RETURN ADDRF~S Lot Seven (7), Oak Ridge Acres to the Town of Troy. 040-1185-40 IDENTIFICATION NUMBER ~d q~~SFER A. It iK This is not _ homestead property r (is) (is not) Together with all and singular the hereditaments and appurtenances thereun-,o `v.*'or-4And Rolling Hills Development, Inc. warrants that the :itle is good, indefeasible in fee simple and free and clear of encur.,bca-._ crept easements, restrictions, and rights-of-way of record, ;y x ,a and will warrant and defend the same. Dated this 19th day of June ig .-ROL.1 W6-1W6D E VSL-6MN 9i 7 C. Nt rid (SEAL) (SEAL) • Richards N. Fox Presi t v _ (SEAL) ri C r w T (SEAL).c Frances J. Fox, Secretary _ f,•a AUTHENTICATION ACKNOWLEDGMENT Signature(s) State e[ Wisconsin, ss • Pierce County . : authenticated this day of 19_ Persurs&"s sate before me this 19th day of June . 19-9 -7, the abo%e named t . -R+ichard M. Fox and Frances J TITLE: MEMBER STATE BAR OF WISCONSIN 9 (If not, tt>r authorized by §706.06, Wis. Stats.) to me knowm w mic :ht person S-who exe"M V krarLdu-ar m-!aL:lza-siedee the same / t•