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HomeMy WebLinkAbout042-1026-10-100 i i nyrO 3-0 n f~ 01 # eo I chi o3i y ` wo o ° co C c ~ ~OV • 3 C m iv r~ y CD CD N OWO N N N .`7. rl Cn = j 0 = C.0 (n' OD N O ^ -0 Cn CD 3 = 7 H O O r. O p CD (n{D 4w .1~1. m y co a 3 c 3 a0 = c°~c rn TVi N mm° yp C v v \r D ~ ~r < t~~11 V °Do OOOo N o < z CD a D o 3 N Co N CD °o o CD o j Ol O t CD CL 7 w j z M N c D D o o :r a I = m I w a 3 A z CD CD M Z ° o' o z m w B g N ~ CD A CL m a o' O' 3 'm c o= o a CD y d y O I A I I °w N 0 °a a CD o CD O ° : Wisconsin Department of Industry, Labor and Human Relations SOIL AND SIT AL R R T Pap-of 3 Division of Safety & Buildings in accord wit R 8 p Wis. m. Co CID a ft,,O N COUNTY s. Attach complete site plan on paper not less than 8 1/2 x 11 in S"s n size.~agt include, t not limited to vertical and horizontal reference point (BM), direc oD- d ° pyscale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest ''V~~ Ut+~ Gruel APPLICANT INFORMATION-PLEASE PRINT ALL INFOR 'I F ?if \ REVIEWED BY DATE {,AA PROPERTY OWNER: P RTY LOCATION LE HA RT 3 f RA k3c.-E5 F R i E D R I C -k GOVT. LOT IV E 1/4 N£ 1/4,S /0 T 2- 9 N,R I Q E() W PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 95z f ,S~i%/w~-tE',p f3 ~vcQ . N , cs.y PE',~pi,v IG- CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE [MOWN NEAREST ROAD GALE- EJko, Aft • 55o1!'t. (Coll) 777- 22.5-5 W,4R,t'E-Av ~ O-L [q"New Construction Use [ Residential / Number of bedrooms 3 - Addition to existing building ) Replacement IT6 _ [ I Public or commercial describe Code derived daily flow GOO gpd Recommended design loading rate bed, gpd/ft2 • BJ^ trench, gpd/ft2 Absorption area required 37 0 bed, ft2 Sa u _ trench, ft2 Maximum design loading rate • y bed, gpd/ft2 • ~ trench, gpd/ft2 Recommended infiltration surface elevation(s) S-2e P y . 3 ft (as referred to site plan benchmark) Additional design / site considerations Parent material 5C-5 S2- 13f i 1 5 . Flood plain elevation, if applicable A14- ft c S =Suitable for system CONVENTIONS MO_U~I IB ❑ U I UND PRESSURE AT-GBADE SYSTEM ❑ U ❑ S I I HOLD ❑ S NG TANK U = Unsuitable forsystem] ❑ S E[J [y'$ ❑ S la *S SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Baxtdary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tterldh l o-/o io VA" 3/7-Ground L p '/G /O yip 313 Sid 2.a, ~6,F nr•-F ti° s /U . $ . 6 elev. 9,~• o ft. 3 4-26 to ye 31 y si/ 2,, he fie cs l u f s Depth to 16-39 7 S Yle 3 MM fie $ , • Z '5 'Vj limiting factor„ 5 7-S" S f yjZ S f M~f i a% N N Ns /o V t C&*--rs C_ .5 O S /►N► 'e- ?0 Remarks: &il /taA.) y ~ESiS T 5 501/ tlt,i,r ' Boring #/aw~0 io yg 3 /L 5'//. / f 5k N►,.fA Cs 1 of . S /o ye 3/ S~/. 2.>~, sd.~ ~i2 s l of . S . '`n°.......... Ground If 3 7. S VR 3151 L,r.+ S,k fnf R 4,C • S ele . 37-7,0 75 YR 3/y ' S s/ /f die f; a,~• - N M l~_sva G~ft. Depth to i0 y/2 VI'V R,4AJ,00,4 SA f, C5 0, d' limiting OATS f37 Remarks: 0E'4e-4-'7_eD 1R4 (ri~i► C/~f S S ~N 1714>.e~•~-~ tll CST Name:-Please Print ~CJ6EIZT- 2t L(3 R1 Gf.~T Phone: 7!S 3R6 SO/605- Address: (BSS O r N ~i L 12D h+ U IBS O,J W f S S Ll 0 1 ' !r✓''- CS rV 1-q PZ PROPERTY OWNER SOIL DESCRIPTION REPORT Page L of 3 PARCEL IA rl LO / CS rL a s= ~Di Cr-- Depth Dominant Color Mottles Texture Structure Consistence Boud3y Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench - vR 3 /Z Pi ° w c~ y S,•! ! f S~~ n~'F~ c S (OF z- /o yR 313 s;/. z f sbl~ fP s tuff . s . Ground -3 7 , y lo Y hk M~ 7cie CS . S elev. ,3/ S~ 2.r►, S~i~ i"' fie -Ot . S ft. y/ 4M rr a Depth to 7.S ~lir2 Xy 10 i2 S / lrie of r 4 - N N limiting i fac°rr, o y AMAIPort O S S! Y o ~ Remarks: Boring # Ground elev. ft. Depth to limiting factor. Remarks: Boring # 4.vv .i. a\:?r FT Ground elev. ft. Depth to limiting factor Remarks: Boring # x.< g s v« Ground elev. ft. Depth to limiting factor 0 ~~yo ~o z o ~ o 1 - N N Q N i t J, Q 0 1 ~ w c °o %A 0 ~m y v G) IT) p C 1s n ~3 > C3 fri - a CA o tA ~ I u b 0 o O d ~ r CERTIFIED SURVEY MAP Located in part of the NE} of the NEI of Section 10, T29N, R18W, Town of Warren, St. Croix County, Wisconsin. OWNER Lehart J. b Frances H. Friedrich 9524 Stillwater Blvd., N. Lake Elmo, Minnesota 55042 I I JfJPI_P~-IiCG LANIG'Q s°' 110TH A-VENILIE 1130' NORTH LINE OF THE NE I/4 N89°46'40"E _ N89046'40"E 418.03_' 2228.73' M NE Corner Section S89°38'19"E 318.01' 10 N} Section 10 -I 3/4" pinch top is N05°40'54"W, N co 5 30' froaLWt pipe I N ~ I C I ~ z M 50/G N h N p 0 00 Off 1. Z L. I I 100' 65' w V.0 4j 0 -LOT 1 04- f- 0 e 6.97 Acres Inc. R/W: 00 c% 303,488 Sq. Ft. ro o" V) 5.08 Acres Exc. R/W. U)I cJI-~ 0 221,227 Sq. Ft. _ - nl Q)I N o - O L I -ii , 00 Ch Q0 C14 W o, r 1 °i CJ I J I ,n 3 LJ I ~I JI M Ln 21 I-I zo <i I co I-- I M I- 00 C)j SI o o U)I ao lI V )I o o N I I z N o -7~ o LEGEND --)I Aluminum County Monument Found tL~y y` • 3/4" Pinch Top Found y O Survey Marker Set I 5' C ty w O 1" Iron Pipe Set, weighing 1.68 z u: lbs per linear foot a ~ t 'l`ift( cif • ' ~ 100 foot Roadway setback line o i407 t e t' 0{(! 1 J z w r ilo T14 avE. rA ~ 318 0l~ 1-20po-.R) W14 0 C.QauE L Gk NC Wow, I I ~ I f'?v~ascl7 I I ~ t ~'i G I I I A11 eb I I I I i 148.01 70,00' IcaO.000 111= 100.00' seT r~> Arcx I ~ N I 1l i I I -1, 1-6 .02' I i;o,01 LOX&-M b J IA Pa1? t or- ?I+L k4 E\/4 OF "T11 ~ N Eb4 of SC-G-no4 to , T z q W/ R 18 W, TOW4 bF I-In•21zE, ST poik cvu"ry i WISCOWSIN SITE F>L.,&,Kt III= 1001-01, r o~ F _ D CC~9 n~ FILED JUIN 8 1995 0 JLW 2 6 G KATHLEEN H. WALSJJ Register of Deeds SL Croix Co., WI ST. CROIX CO NTY 529930 RVEYOR'S RECORD 11 S CERTIFIED SURVEY MAP Located in part of the NEJ of the NEJ of Section 10, T29N, R18W, Town of Warren, St. Croix County, Wisconsin. OWNER Lehart J. & Frances H. Friedrich 9524 Stillwater Blvd., N. Lake Elmo, Minnesota 55042 70- 110TH nucNuE-i- 1I30' NORTH LINE OF THE NE 114 N89°46'40"E N89046'4011E 418.03' 2228.73' M NE Corner S89°38'19 "E 18.01' I Section 10 N~ Corner I I 4~ Section Corner 10 1~ - PPRO V ED 3/4" pinch top is N °40'54"W, N N 5.30' from set pipe I JUIN ' 4-) A-t M U - . N N N CROIX COUNTY 0 ° N nprehensive Plai*11 z 1 100' ss' Zoning and L- M 4- 0 Parks Commiits9 O.C 4.) 0 LOT 1 if not recorder! L. c V Atfthin 30 day§ 6f a c 6.97 Acres Inc. R/W: a¢provaltSb 303,488 Sq. Ft. L 4j •rorova sFs~~l m ~c 5.08 Acres Exc. R/W q(1(_,ud ao m'' cJ~-I o 221,227 Sq. Ft. ^ _ o LIII°" <I N :nl cl ~I ^ Cn Q71 ^ JI co M Ol =1 3 WI c.ll JI Ln of I 00 <I oo C1 4 M l 1 0 >i U)I o ~°n o L I c zz ° `I LEGEND -j1 Aluminum County Monument Found W • 3/4" Pinch Top Found t "xn.• 0 Berntsen Survey Marker 1 s' \ c (nai 1 set) w L O 1" Iron Pipe Set weighing 1.68 2 lbs per linear foot (24" in Length o HA Clp rya 1407 ~ 100 foot Roadway setback line w ~ spa z r r~ V~~. ~ t y 6 d' C 0W ov0 d r_ I o~ o ~ v1 C ID 3 3 rr 7 fD n 13 rte... d # CD n _ N O ` y O 03 -n 0 0 A A `C ~ • O j' (n N (0 O" N N ICI Q O (D (O Dry S 7 CD 0 C~ O O V O w u c n < j D o 3 o rn 0 0 0 m H 0 O o m 00 p \il CD cn 3 r. CD cn CD i~3 CL 0 00 00 CD O D 00 00 0 O C c o o CD tr N a °A Q a 0 0 0 7 < Z o 3 3 N y N p O D C) a < a C _O W ~ (O 00 a (D Z M I Z=Z o D T 7 o 9 O w I ~ m o y h• N C S N W (D C) CL Q 3 0 7 Z (o d (o ' -I CO) Q p A Z n c O ~ O- A z 3 Cn N A 00 m (D Z 0 3 A o m o0 m z g C) (a (D A -h -w S N N G Q o3 (Q;0 1 1 O. (c ,7 CD cpo T < 7c S V C (D ~ m C o y Z m = s a O I 00 5'o y C W O C y d h O 0 A ,n.. C. (D (D y O G 0 53 .133 CL CD CO CD O. O O 1. s ~Q 7 N Z S ~ N N F N N CL U, N co ` O O p ~ `J'C M (D 4 t) • 69 O 0 (D y O " V .1 O 0 ! y C Parcel 042-1009-70-100 08/02/2007 04:17 PM PAGE I OF 1 Alt. Parcel 04.29.18.64A-10 042 - TOWN OF WARREN 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 - FRIEDRICH, CYRIL L CYRIL L FRIEDRICH 1108 120TH ST ROBERTS WI 54023-8423 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description ' 1108 120TH ST SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 5.000 Plat: 3866-CSM 14/3866 SEC 4 T29N R18W PT SE SE BEING CSM Block/Condo Bldg: LOT 1 14/3866 LOT 1 5.OOAC Tract(s): (Sec-Twn-Rng 401/4 1601/4) 04-29N-18W SE SE Notes: Parcel History: Date Doc # Vol/Page Type 06/12/2000 624606 1518/171 WD 10/15/1997 566932 1270/286 PR 07/23/1997 868/577 07/23/1997 315/218 2007 SUMMARY Bill Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/20/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.000 25,000 94,400 119,400 NO AGRICULTURAL G4 4.000 400 0 400 NO Totals for 2007: General Property 5.000 25,400 94,400 119,800 Woodland 0.000 0 0 Totals for 2006: General Property 5.000 25,400 94,400 119,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 10/27/2005 Batch 05-44 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 . 'Wisconsin Department of Commerce Safety and Buildings Division PRIVATE SEWAGE SYSTEM County: INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: Personal information you provice may be used for secondary purposes Law, s.15.04 1()(m Permit Holder's Name: [Privacy )l• Friedrich, Cyril ❑ City ❑ Village ❑ wn of: State Plan ID No.: Warren Township CST BMElev.:- Insp. BM =vj~BM_D7rcri ption: fl arceax NO.: tic GST gnt2 TANK INFORMATION ELEVATION DATA F TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic gCJO Be 0(o /0`( o~ Dosing 10-V -C) f Aeration WI, em /.to S's` Z(0 e Bldg. Sewr S La . 8(p gY / Holding St/Ht Inlet 6a 7. Z_T TANK SETBACK INFORMATION (d . $Z. ~5 St/ Ht Outlet 7 cf6 TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Cd , Air Intake 13 g2.o~ Septic NA Dt Bottom Dosing 3 3' al' Z NA Header/ Man. Aeration NA 4Grade Holding 2 / PUMP/ SIPHON INFORMATION Manufacturer ~j Dema;nd Model Number Lm-- GLriction ead P.2 TDH , 1 Z' Dia. Z " Dist . To Well ti 33 t SOIL ABSORPTION SYSTEM 2_~ RENC Width 3 , Length r No.O Trenches PIT No. Of Pits Inside Dia. ~LiqquuiddDepth DI MEN 2 DIMEN I N SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufactu4re~,:,~ INFORMATION Type r O CHAMBER S' 441.1 ' System: OD I Ip~ ` o e Num er: OR UNIT _ u DISTRIBUTION SYSTEM Header/Ma if Id Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. 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 To soil P ❑ Yes ❑ No ❑ Yes E] No COMMENTS: (Include code discrepancies, persons preserl?ytE on #l: I1 /2B/00 Inspection #2: Location: 1108 120th Street, Roberts, WI 5402 (SE 14W SE 1/4 4 39N R1 8W) - - of 1 1.) Alt BM Description = rP Ske~ 51 S~ «.l to 73 2. Bldg sewer length - O / - ~4 - -amount of cover = e_IS z Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R.3/97) Date Inspector's Signature Cert. No. Safety and Buildings Division SANITARY PERMIT APPLIC N 201 W. Washington Avenue P O Box 7162 Visconsin Department of Commerce in accord with Comm 83.05, Wis Madison, WI 53707-7162 • Attach complete plans (to the county copy only) for the syste ap r n4less o n , than 8 vi x 11 inches in size. RECEIVED -1 :q-- Cr" c X • See reverse side for instructions for completing this applica i Sta itary Permit Number JUN r 71 &3 q01 Personal information you provide may be used for secondaryurposes ❑ k f revision to previous application [Privacy Law, s. 15.04 (1) (m)]. /W l ZD~` / ` O ( rf s Sta P Review Transaction Number 1. APPLICATION INFORMATION - PLEASE RIf7NlT AL I c'' Property Owner Name operty Loca T ,2 N R W Prop i y ` 5ner~ {ailing Address S + Lot Block Nurpber ! r /1l r City, State , Zip Code Phone Number Subdivision Name or SM Numb , e IWA , e-~oit6 (ws qal. ,aZ47 cs j" 110 pa 3 Z 'C' 1. B ILD NG: (check one) ❑ State Owned 0 !t( Nea st Road p Vll age ti. Public 1 or 2 Family Dwelling - No. of bedrooms Town OF 00-AAoI, .S f". III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 0 1 ❑ Apartment/ Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ utdoor Recr ational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/Bar/Dining 4 Church/ School 8 E] Mobile Home Park ash 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, i ap A) 1. g.New 2. ❑ Replacement 3, ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an ------System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit 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 r i 42 ❑ Pit Privy 13 ❑ Seepage Pit t Z 43 ❑ Vault Privy 14 ❑ System-In-Fill 'Z C VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. Systems Elev. 7. Final Grade a ✓ Required (sq. ft. Proposed (sq.~ (Gals/day/sq. ft.) (Min./inch) 94,i 6j gs,a Elevation S ,~o ✓ /K Feet 44. S°'6 et VII. TANK Capacity in allons Total # of , r Prefab. Site Fiber- Exper. g Manufacturers Name Con- Steel Plastic INFORMATION New Existin 11 Gallons Tanks concrete strutted glass App. Tanks Tank ep is Tank goo see ~.i c1 ❑ ❑ ❑ ❑ ❑ L' Pum Tank r 9100 $oO 111,A4 t."-P ~ ❑ ❑ ❑ ❑ ❑ VII . PONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) I Plumber's Signature: (No Stamps) MP/MPRSW No.: Business Phone Number: 6s.'I~F4 - 33 o.t+et - I, - Ale d.kj e t 1 e, L3 -1105 Plumber's ~e (Street , City, Stat&Zi~ Code): A IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing AgentSi nature (No Stamps) Approved ❑ Owner Given Initial Surcharge Fee) I~ T Adverse Determination ZS <::57 0 X. v ~t,~ afh = ,~..c G CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: j- ,:A0 Ir s4&.- 6~4, r e /0 01C ee (/l r %P%f y ~ llrkmd(C 64&-e( sle er,ge 4,srced > 1I~ QI\ I+~~lri0r ~llkvhblr'►1 ~►l1(51~ ~t ✓!N\OVGG{ ~tPah GOrlIP(~~:t7Y~ j3~ ~QCI~DHdENLv~i ~~!!~((fK~ IerCe,4~ TO%~ 4f rc perw%f 4,,;l( Ire u`.ve jGl.er-( p(kwt~e~~t rsu<tcd ~cr.a( rv-o,,4 `/,ke~ stcf~F~iy►..•.l Sf , SBD-6398 tR.12/991 DISTRIBUTION: Original to county. One copy To: Safety & Buildings Division, Owner, Plumber r r I've -e N N f-K o w d K ~ ,tom s sB ~ p 7 ~ r gad co zf tii ! ^ • _ i! M o , o B M 0 _lp W ° 624051 CERTIFIED S V RVEY MAP LOCATED IN PART OF THE SE1/4 OF THE SE1/4 OF SECTION 4, T29N, R18W, TOWN OF WARREN, ST. CROIX COUNTY, WISCONSIN. LEGEND CURVE DATA ALUMINUM COUNTY SECTION NUMBER U1 O CORNER MONUMENT FOUND RADIUS 2347.01' 2337.01' CENTRAL ANGLE 0215311 01'3T20' 1' X 24' IRON PIPE SET WEIGHING CHORD BEARING NO6°28'262 W NOt•43'10'W 0 1.13 LBS. PER LINEAR FOOT CHORD LENGTH 118.22' 88.17 SOIL TEST ARC LENGTH 118.24' 88.iT TANGENT N0r55'01'W N02'31'S0"W JUN 0 1 2000 ( PREVIOUSLY RECORDED DATA TANGENT NO6°01'50•W NOO'54wv Fj ~~N.WALSH 4 i Co El/4 SC OR. N - s h w o~ UNPLsA77ED LANDS I 50' ®1OS® 1SeV_Y_~IbOW~R ~ !'/dl ° LY.JI go 22.51' I p~ I ~ 428.51' 2 W I u7 1 Er+~- u, I1~-i i lu X I I i2l ~1 1 lI ~ al®I LO LOT 1 U-I ® I cn_ Z. 1 5.000 ACRES INC. RW T- Iffi i N 217,818 SO. FT. ° p Nei 1® ~ Z ,rl 4.884 ACRES EXC. RW 11 i [~1 212.750 SO. FT. I ®1 1® I 1 z I 1 Z 1 A 9w 1 OM A' A x!x W,ae x~x 49+h I SWAB N85°04'39"E 400.231 (E 400.9T)1$TItJG VED W OWNER DONALD GREENFIELD PIOMMO IAnkp and Part COMMKIM 1472 HWY'12' g I I ( 50 ROBERTS. WI 54023 JUN Q 12000 _ 46 ` If not noordW within 30 days of SE CDR. I SCALE IN FEET 1„ = 100' ~r-1 dab aWmat shah be SEC. 4 nul and void 100 100 200 THIS INSTRUMENT DRAFTED BY EDWIN FLANUM JOB NO. OD-15 DATE 2-10.00 Vol.14 Page 3866 /o a&, /,0 -/o STC AS BUILT SANITARY SYSTEM REPORT OWNER t E M ;c_ A ADDRESS ~//d `4,Q1 ILC syoa3 SUBDIVISION CSM# SECTION 1 d T=N_R~ W, Town of A N ST. CC~OIX COUNTY, WISCONSIN S W EVERYTHING WITHIN EW L 100 FEET OF SYSTEM l y. t _ i K ' ry ` 57 NM# s``J sue. ~a i~ INDICATE NORTH ARROW Provide setback and elevation information on revers Provide e of this form. 2 dimensions to center of septic tank manhole cover. n • BENCHMARK: A) CO 4,A' 55• ~ Z/ ALTERNATE BM:- S w G~.+.. a►"lA ~l 9 S S SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: L",;, Liquid Capacity: la.50 1 750 Setback from: Well 13 House 3 Other Pump: Manufacttrer 6~10,, a Model # W 63/ L Size l Float seperation Gallons/cycle:, ,Io? .S' Alarm Location SOIL ABSORPTION SYSTEM Width: Length /QD Number of trenches Distance & Direction to nearest prop. line: Ajeyt , 949 Setback from: well House_ Other ELEVATIONS Building Sewer ST Inlet: 94, 45 ST outlet: 1 PC inlet gs. S3 PC bottom 931,1 Pump Off Sa7 Header/Manifold 9s+oS Bottom of system 9 (p Existing Grade Final grade 9 9'~ DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: LS(v_~ INSPECTOR: 3/93:jt Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Count safety and Buildings Division INSPECTION REPORT §T. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Sanita29gjAjih1y.: Personal information you provice may be used for secondary purposes [Privacy LqW, s.15.04 (1)(m)]. Permit Holder's Nam C1Lit~~lillage ❑ Town of: State Plan ID No.: RIEDRICH, 8:YRIL WWAAKKKK CST BM Elev.: Insp. BM Eiev.: BM Description: ParcelcVQ,1026-10-000 TANK INFORMATION ELEVATION DATA A9700199 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Q 3 ~.~C_.,r"~t Aeration Bldg. Sewer Holding St/ Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet Z TANKTO P/L WELL BLDG. vent to ROAD Dt Inlet Airlntake Septic > NA Dt Bottom Dosing y NA Header/Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft oss mead Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS LEACHING Manufacturer: SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM 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: WARREN 10.29.18.145A,NE,NE LOT 1 9 -1 - q '7 / 9 , = , 1295 ] loth 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: i ,o S✓ 1 w Safety and Buildings Division ■ SANITARY PERMIT APPLICATION Bureau of Building water systems rigL■7~ 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. . 1 Q-r0 • See reverse side for instructions for completing this application State Sanitary Permit Number aaj'"9'Z?' The information you provide may be used by other government agency programs ❑ Check i( revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION Property 0 er Name Property Location r_ 1/4 1/4, S T , N, R 1&-'r) W T et,2A r % ca Prop e3yCOw~n Mailing Address Lot Numbe Block Number t , tate Zip Code Phone Number Subdivision Name or M umber ~o~ 9.5 O V v T lic Ct v ( ) 5 a. II. TYIFE F BUILDING: (check one) ❑ State Owned ❑ l t~ fNea;rest Road ❑ VII age 't 1A ❑ Public 1 or 2 Family Dwelling - No. of bedrooms Town OF CR.(` III. BUILDING USE: (If building type is public, check all that apply) arcel Tax Number(s) 1 ❑ Apartment/ Condo O J1 a _ Icia (O _ 1 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. rgL New 2. ❑ Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an 11 -System System Tank Only Existing 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-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 12. 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) Elev ion (CM ~ 5aQ , S Iq- 9~i Feet , . E` Feet VII. TANK Capacity site in gallons Total # of Prefab. Fiber- Plastic Exper. INFORMATION Gallons Tanks Manufacturer's Name Concrete Con Steel glass App. New Existing strutted Tanks Tanks Septic-Tank or Holding Tank X ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber A '75o I rot Vill. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Prp,,, Plumber's Sig a re: (No Stamps) r P/MPRSW No.: T-T siness Phone Number: U~ (5-d -5th Plumber's Address (Street, City, State, Zip code): l ~q Q IX. COUNTY / DEPARTMENT USE ONLY ~ ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issue Issuing Ag nt ignature No S TTIp App E] surcharge f ee)/~~/~~ A roved Owner Given Initial ~ Adverse Determination V4~~z X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: SBD-6398 (R. 05/94) DISTRIBUTION: Original to County. One copy To: Sufety & Buildings Di-ion, 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, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one 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 8 112 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 ''I 15 form; and F) a€l 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. • PRIVATE SEWAGE SYSTEM Safety and Buildings Division REVIEW APPLICATION Bureau of Building Water Systems Hayward Office LaCrosse Office Madison Office Shawano Office Waukesha Office 209 W. 1st St. 2226 Rose Street 201 E. Washington Ave. 1340 E. Green Bay St. 401 Pilot Court, Ste. C Rt 8, Box 8072 La Crosse, WI 54603 P.O. Box 7969 Suite 300 Waukesha, WI 53188 Hayward, WI 54843 Phone (608) 785-9334 Madison, WI 53707 Shawano, WI 54166 Phone (414) 548-8606 Phone (715) 634-4804 Fax (608) 785-9330 Phone (608) 266-3151 Phone (715) 524-3626 Fax (414) 548-8614 Fax (715) 634-5150 Fax (608) 261-6699 Fax (715) 524-3633 INSTRUCTIONS: To save time, schedule your review with one of the offices listed above prior to submittal. Fill in all applicable data and submit this form together with fees and planstinformation. Your submittal must be received at least two working days prior to the appointment at the office where your review was scheduled. Please call any of the listed offices if you need help filling out the form or have questions on what information to submit. PLEASE PRINT VERY CLEARLY. A sample of a completed form is on the reverse side for your reference. Personal information you provide may be used for secondary purposes [Privacy Law, s. 15.04 (1)(m)]. 1. APPOINTMENT INFORMATION - If you have scheduled an appointment, fill in the information requested tMvlWo Ave tim . Ap ointment Date Rev' er Nam Plan Identification Number l [t S 4 2. PROJECT INFORMATION If this review is a revision or extension to your existing plan identification number, provide that number here: Project Na a County %N~ ICJ ❑ City ❑ Village (Town of. Project Locati GOVT. LOT A)t 1/4 (VS1/4,S T N,R K E!gr) W Q_ro 3. APPLICATION FOR 4. FEE COMPUTATIONS FEE SUBMITTED System Type (check one): System Type 1 (include new and existing tanks) A ❑ At-Grade Up To 1,500 gallon septic tank ....................................$110.00...................... H ❑ Holding Tank 1,501 - 2,500 gallon septic tank .....................................$120.00...................... M *P Mound 2,501- 5,000 gallon septic tank .....................................$160.00...................... N ❑ Non-Pressurized In-Ground (Conventional) 5,001- 9,000 gallon septic tank .....................................$200.00...................... P ❑ Pressurized In-Ground 9,001 -15,000 gallon septic tank .....................................$300.00...................... O ❑ Other: Over 15,000 gallon septic tank .....................................$500.00...................... p To 1,000 gallon dose chamber 70.00...................... o' RE % Building Type (check one): 1,001 - 2,000 gallon dose chamber 80.00...................... EIV D Dwelling, 1 or 2 Family ,IUN 10 001 - 4,000 gallon dose chamber ...............................$100.00...................... P ❑ Public Building 4,001 - 8,000 gallon dose chamber ...............................$120.00...................... S ❑ State-Owned Building 01 - 12,000 gallon dose chamber ...............................$140.00...................... Over 12,000 gallon dose chamber ...............................$160.00...................... Up To 5,000 gallon holding tank 60.00...................... Code Derived Daily Flow toco gpd 5,001 -10,000 gallon holding tank ...................................$100.00...................... Over 10,000 gallon holding tank ..................................$150.00...................... ❑ Check if Replacing Existing System Experimental System (additional one time fee) ................$300.00...................... Revisions to Approved Plan Z 60.00...................... Petitions for Variance: Setback ...................................$100.00...................... ❑ Petition for Variance Site Evaluation .........................$225.00...................... Plumbing $225.00...................... Revision 75.00...................... ❑ Groundwater Monitoring Groundwater Monitoring - Per Site 60.00...................... (other than a proposed subdivision ❑ Site Evaluation in Lieu of Groundwater Monitoring Site Evaluation in Lieu of Groundwater Monitoring 60.00 Subtotal: Priority Review: Enter same amount as Subtotal: MAKE ALL CHECKS PAYABLE TO: SAFETY AND BUILDINGS DIVISION Total Fee: . ~X0 119- 5. SUBMITTING PARTY INFORMATION Telephone No. (include area code & extension) mpany Name Co act(Person No. & Street Addre s or P.O. Box City, Town or V' age, State Zip Code Mocl_ s 5e`r- ~e W-1, 0) Aerobic or prepackaged treatment system fees are calculated based on equivalent size septic tanks and dose chambers. 2 Revision fees are not applicable to temporary holding tanks or extensions to existing approvals. NOTE: Fees are pursuant to Wis. Adm. Code, Chapter ILHR 2, and are subject to change annually. SBD-6748 (R. 03/96) C'YRIL. cf~ r s, 83 9-1 A-5 m I N c A o e WORKSHEET - MOUND SYSTEM DESIGN PROBLEM: Design a mound system for a -46) --r The site characteristics are: Depth to groundwater or bedrock 7 in. Laodslope - % Percolation rate .S_ min./in. Distance from dose chamber to distribution system . ft. Elevation difference between sump and distribution system $ ft. Step 1. WASTEWATER LOAD = ~ gal. Step 2. SIZE THE ABSORPTION AREA A) Area required = 6W A a = -5'Co0 jef6 sq. ft. B) Bed or trench length (B) _ /cr2D /0z) ft. C) Bed or trench width (A) S S ft. ,h . ` :0) Trench spicing (C) Wastewa er load .24 cal/ft2/day B = A A ft. r tr is es Step 3. MOUND HEIGHT A) Fill depth (0) a ft. ,Z B) FiIl depth (E) D + slope (A)+P 5 ft. /4605A5) C) Bed or trench depth (F) _ 183 rt. D) Cap and topsoil depth (G) --ft. E) Cap and topsoil depth (H) _ ft. ✓ r n RECEIVED JUN 10 1997 CyRIL f'RcQR / cfl. vt_ r Step 4. MOUND LENGTH A) End slope (K) _ (D1 + F + H x 3 = /G), des ft. + /,as + C B) Total mound length (L) = B + 2(K) ft. Step 5. MOUND WIDTH Al) Upslope correction factor = A2) Upslope width (J) (D + F + G)(3)(factor = 7. ft. B1) Downslope correction factor = B2) Downslope width (I) _ (E + F + G)(3)(factor) ft. -8f,V l~ ~3 x 1, l /x,90 Cl) Total round width (W) for bed = J + A + I '2.31 ft. -7, i t s t ic.? :,)3,-9 C2) Total mound width (W) for trenches = J + + (no. trenches -1)(c) + A + I ft. Step 6. BASAL AREA A) Infiltrative capacity of natural soil gal./ft2/day B) Basal area required = wastewater flow natural soil infiltrative-capacity = 41Da sq. ft. i C1) Basal area available for bed for sloping sites = B x (A + I) = isq. ft. C2) Bas are avail le for trench for sloping sites = B W-- ~J +A1 = /so.. ft. C3) Basal area available for trench or bed for level sites = B x W = •sq. ft. Si f; n : License Eu Date S Step 7. DISTRIBUTION SYSTEM 7A) SIZE DISTRIBUTION SYSTEM 1) Hole size : in. 2) Hole spacing = Jt in. 3) Distribution pipe length in. 4) Distribution pipe diameter in. 5) Spacing between distribution pipes = 0 in. 6) Distance from sidewall to distribution pipe -3~ in. 7B) DISTRIBUTION PIPE DISCHARGE RATE ft. 1) Number of holes per pipe = _/~7 2) Flow per pipe ca GPM 7C) SIZE MANIFOLD 1) Manifold is A central/ end 2) Manifold length = ® _ ft. 3) Number of distribution lines = 4) Manifold diameter in. 7D) SIZE FORCE MAIN r~ GPM 1) Minimum dosing rate = 2) Force main diameter = -3 in. 3) Friction loss = 170 ft. 7E) TOTAL DYNAMIC HEAD 1) Vertical lift = ft.. 2) Friction loss = .~.L ft. 3) System head 2.5 ft. ft. 4) Total dynamic head = A 91 ft. J3. IO F. Of V31 j t 7F) PUMP SELECTION 1) Pump selected will discharge GPM at ft. total dynamic head. 2) Pump model and manufacturer 7G) DOSE VOLUME ` 1) 10 times void volume of distribution lines gal./cycle 2) Daily wastewater volume . 4 doses/24 hrs. _ gal./cycle 3) Minimum dose volume = gal./cycle f &-Z' ~ 7H) DOSE CHAMBER , V - 1) Minimum capacity required gal. License .:u:_. Date:_ S r~j i I!' I P s ;~o I! I I ~ I I - - -I- t - - _ f . - -r - - I , I I , I ! ~ ! 1 ; I rt ~ T T ~ I I _ I -F- t t 1 t r i-- _ - 1 ~7 t_ d ' I I I I D I ~g ~ I I I ' ' rI t I ~ I I I I Z ~ t ' 1 I I ~ ' i I 1 I I 1 I i i ~ I ~FT I I I I I I f 1_ I I I I. I I ! ! I I pI I IV 'SA~ETV($ E3iat~iS. ~IV. i!! I I I I_ ~ I ' I ~c. - Cy hi Fre d r, cN. Page 63~ Of Straw, Marsh Hay, Or Synthetic Covering Distribution Pipe Medium Sand !J G Tops E % Slope Bed Of 2 Force Main Plowed Aggregate • Layer D . Ft. Cross Section Of A Mound System Using E Ft. . F .,83 Ft. 'A Bed For The Absorption ATea G / Ft. A S Ft. H /cS Ft. 9 k_, aXAAA- Si ned: ~f B /Da Ft. License Number: 1 S C~3 K Ft. Date: J7 - 9' 7 L la018 Ft. J 7~ S Ft Position I 10,9 Ft. of Force Main W .9 , Ft. Observation Pipe J 6 ~ K A I°- w - - Distribution. .,,Bed Of 2M-- g°a Pipe Aggregate Observation Pipe r Permanent MorkA a XNU LJ =>y Plan View Of Mound Using A Bed For The Absorption Area C y r• i 1., f r •e cj h► Ch Page 7 4?/d r Perforated Pipe Detoll n End View Perforated End Cop \e,y PVC Pipe o~~o woe Holes Located On Bottom, f t Are Equally Spaced VIN a. 1-0 e L rc x + P L) At Y 'yn ECV``• ,♦1~ rlb4 fbQ ` Lost Hole SAo ld Be Next To End Cop Dittribulion Pipe Layout P 7 7 Ft. R WP7 S NvA ';.X 36 Inches y -3O Inches Signed: Hole Dianletet• _ Inch ) License Number: 1S 6-3 Lateral A Inch(es Manifold 3 ' Inch:: Date: 5 - 2 `7 Force Main Inc{tij; # pf, holes/pipe 17 Invert Elevation of Latera°ls 9(0•.5 Ft. j ra I page of ld • l t 0 r cn ~ ~ a r• r• N 0 ~t , in ro - h z r v 0 40 x r• o0. T rt V m fi r r t a n rr o A 00 Om L a w rr ' a A x o' rr t '1 a I `4 rt la a 0 reel rIc4 . , C~r r ~ L ; ~ PAGE of L ' PUMP CHAMBER CROSS SEC~TIOt~ Amo SPECIFICATIOUS' VCWT CAP M"C.I. VENT PIPC WCATNCR PROOF APPROVED LOCKING JuucTloW eox MANIaI.c coven LS' FROI'1 OOOR, It•MILI. WINDOW OR FRESH AIR INTAKE I GRADE ~ 'I' 1NIN. COIJDUIT WAIN. IIJLET PROVIDE ( - -7- AIRTIGHT SEAL. I I I f II v APPROVED JOIN A I III APPROVED JOINTS w/C.i. PIPE, I I ( w/C.=. PIPE EXTENDING 3' ( II ALMA EXTENDING 3' ONTO $OLID TOIL d I i I ONTO SOLID i01L . ` I I ON c •i 1 ELEV.StSZ:.Z. FT. PUMP-~ --1 ~ g&~S ~ OFi 0 CONCRETE BLOCK RISER EXIT PERMITTED OWLy IF TAWK MANUFACTURCR HAS SUCH APPROVAL ISEAPDOING t SPEGIFICATIOUS SEPTIC q ~y DOSE - TAWK MANUFACTURER: ~~QSer 1JUMbER.OF CAf PER DAS i TAWK SIZE: 7,50 GALLOWpS D04C VOLUM ALAR M MANUFACTURER: S - INCLU04M6 6: G((Awo LLONS MODEL IJUMGCR: /0/ A/ CAPACITIES: A= INCHES OP. GA LLOyS SWITCH TyPC: AllDh,t- g= c7l IN ESOR - 35.7 GALLOW PUMP MAWUFACTURCR: cu1jS 7777_' a.•, ghgES OR ICA ~OIJS 1©?. o MODEL NUMDCR: 3>r&S ~(,yEO 3//,Lp _ / _ INCHES OR GAL10U5 SWITCH TYPE: URP AMD-ALARM ARE TO bE MINIMUM DISCHARGE RATE 310 GPA QQINSTALLED OM SEPARATE CIRCUITS VERTICAL DIFFERENCE DETWEEII PUMP.OFF ANO.pISTRIbUTION PIPC.. _.S~ FEET + MIUIMUM IJETWORK SUPPLY PRESSURE /p.. , /2.5 FLCT 7, .0.5 ' + 120 -FEET FEET OF FORCE MAIN X p rtFRICTION FACTOR..-L-'2- FEET TOTAL O'J JAMIE HEAD [,t~ 9 FEET p I g,yr12~ r -J IWTERNAL DIMEWSIOWS O TAWK: rrn N r;LIQUID DEPTH y n i / T ~1 ~`~~~+7r c } C y ~"'t 1 1 r bfX Y' ~ C. ~ !Q 1~~.u GOULDS SUBMERSIBLE +,~P~rlraavc .a SEWAGE' AND EFFLUENT PUMPS XI ♦r.~a EP0311 DISC. C?JUPEP0311 142 EP0311 1/3 HP 115 V Effluent Rrlp 1/2" solids 256.80 172.10 t, t►W11 zr, Submersible MODEL EP0311 a 4 Effluent Pump. METERS FEET SILL Va r SOLIDS 25 6 .20 1s ti 0 10 ' 2 - F.. 0 00 4 8 12 18 20 24 28 32 36 GPM 40 i-- 0 2.5 8.0 7.5 m'/h ' CAPACITY ~nr Performance f+t Curve 3885 MCTt11f fEET f ' MODEL 3885 SIZE'/4" Solid h:! I 20 V" 2 so WEOSH - t `s +o 30 r EOX WW - - iR TY 1r5,. o 0 0 10 20 00 ,40 . s0 40 t0 so so 100 110 120 0Pq r CAPACITY a LIST DISC. i+ G + + CaOUNE03111, 142 WE0311L 1/3 HP 115 V law H 3/4' solids A91 .5S 329.35 GOtPAM0311M 142 WE0311M 1/3 HP 115 V Mid H 3/4" solids 491.55 329.35 + 3/4" solids 704.25 411.85 7`• CKUPKrA511H 142 WE0511H 1/2 HP 115 V High H T. " CiOWWT0712H 142 WE07i2H 3/4 HP 230 .V High W. 3/4" solids 843.65 565.25 ,,,y~ { •*•*•sEE EOdowING PACE Frn P ADID 5PFx2FICA7IO49. DEI1T 30 PAGE Dh ^v 10/aa DA3T I 9 lp Wisconsin Department of Industry, SOIL AND SIT AL R RT Page of 3 Labor and Human Relations L Division or Safety a Buildings in accord wit RIP A,~Wi . 1. Co N COUNTY ID 8 I 5 s C a/*)( Attach complete site plan on paper not less than 8,1/2 x 11 in s n size. PbIT f include, t not limited to vertical and horizontal reference point (BM), direc oD. d pyscale or v PARCEL I.D. dimensioned, north arrow, and location and distance to nearest ING pPFICE APPLICANT INFORMATION-PLEASE PRINT ALL INFOR REVIEWED BY DATE PROPERTY OWNER: P RTY LOCATION LE HA RT 3 f RA Oc,E5 F R i e D R i c h GOVT. LOT N e 1/4 Al F_ 1/4,S /0 T 2 Ir N,R IF E() W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUED. NAME OR CSM # ?572-f e •~1~i%!'k~~4TEA? 13 /vd . N cSM PE'.uD/a G- CITY, STATE ZIP CODE PHONE NUMBER (]CITY []VILLAGE MOWN NEAREST ROAD - ,~I:E 0, ~a . 5504V-x- (c, l:) -7-77- 22.5-5 a~~k~ IC/L/ ( ew Construction Use [ -<Residential / Number of bedrooms 3 [ J Addition to existing building j J Replacement ySo _ [ J Public or commercial describe Code derived daily flow GOO gpd 31s- Recommended design loading rate ~ bed, gpddltt2 4 ^ trench, gpd/ft2 Absorption area required 3?0 c bed, ft2 SOD trench, ft2 Maximum design loading rate y bed, gpd$ ' ~ trench, gpd/112 Recommended infiltration surface elevation(s) •S~ p S • 3 it (as referred to site plan benchmark) Additional design / site considerations Parent material S~ S 52- 13 R i I 5 i Flood plain elevation, if applicable N ft i% s S = Suitable for system CONVE10OONAI •MOU IN-GROUND PRESSURE-1 21T I 8t 0 AT-G DEE U SYSTEM IN FI HOLDING TANK U= Unsuitable fors stem ❑ S BID En O U O S SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Bwxl3y Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed rend1 o-/o io VR 3/z A•m-f,4e as / of . Y . S Ground Z /0-/6 /O YR 313 `Sid 2.w. sdk n~•f s' t.0 . $ . 6 9SeoY' ft. 3 - 2G io y e 3! y 2,,►, h~ All fie c5- l of . S Depth to - 3-0 7 s y/? 3 /f < S t. l 41 fie 4s4 M S i y '•S limiting E fo 5 ?.S VR ?/y S 5 fact „ VIZ a8• GS /o y~ S/c/ c s o S 6% ~2 a ~ERnj,~L3i IlIx SM • oGK 'TS Soi / Ktii FE' r CEvE~Tt~~i rYG~'/~~ G/~+S's ,6TRI•cTo Remarks: P y 4,t-:-Y157-_S Boring # YX 3 Pi°c"eso 14 •Sk A".f R cS /"/9 /O )e 313 S ' Q~• -3 T-37 7. S VR 3Ad' S/ sd/e ro R • s i . G around 7- 75 y T/ T- I S S/ /7~ r1ie 'f at.t' N N Jr✓/. A U it. . /o Y2 /Qh,JpoM SAI, C I b' Ate, K.f Depth to o W&_r'r limiting fact Remarks: 0,G,1E.417_~C-p 1 PWidi}-' C/,fS S ~N 171e>,t°iZ°~ CST Name:-Please Print R 0 13 EQT- Z(L(3 121 G1& T_ Phone: 7 IS , 3 R6 Address: (o 5 5 o r N e:-i L C) • N- O 175- a '.D 1 S . $ L4 O l Co (o •y5--- Cs7'-Y I. PZ Date: CST Number: PROPERTY OWNER SOIL 6ESCRIPTION REPORT;' Page 2- of S' LD...,~T ( CSK ¢~CAj~/rJC PARCEL Boring # Horizon Depth Dominant Color Mottles Texture Structure Roots ' GPD/ft In. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench I ~a w ~v f /OVR 3 /.1 -F [OF Z -iy /Lo Y/2 ,313 f sk fo, s_ rvf Ground- elev. Depth to d 7••sVP- 3/ 12 S `j~ /7C y vfrr 44 ,cf rmidj- factor SA46 f~ y Remarks: Boring 40 Y f -~w 7 x^ Ground.: etev: tt Depth to' tlmitln _ . factor Remarks; _ Bo, 6ng # Ground . _ t : elev. tt: ~ Depth to.. rmitlng factor . Remarks: - - Boring i ' F i Ground t elev.+.._ _Depth smiting factor _ _ _ ~,vECi <o T G.. 6-77,31' 0 ~~yo ~o z N O O \ , oID ' w C~ N Ar. .t' 0 y A O l ~ C H CIO C CIA p I y m R, u1 r% N v1 r f r, CA ti I n ~ rn ~ o o d FILES ' JUN 8 MS ► r V' ~t~~t~tttt ..1 t N; {,y 47 rrc~ I' 'ffF i ~j`•^~ eLaoratM, y !Y} V Q+dfyyt N ~ R ♦ , ' .1r,91 ~!~t, `fl.~tt✓~f. •1jJJ~y 1. •~.i~ ,.'ylI" '.4 S tp.,l.' ft• D•~ ~gS►'~,f~r f p'Mi r. CERTIFIED SURVEY: MAP '~s~ N .ef rM u~ oj geatioa 10, T299, ~AlSW, -T 4,0 the Nat 1.orat:od 1~ part: of the HZI of , ~ti ~ t 1j•A t Croix County, wwonain. of marten, 8 . OWNER - Lehart j. i Frances H. Friedrich 9524 Stillwater Blvd., H. Lake Elmo, Hinnesote 55042 I I JNPL.ATTEG L!~'dDS 110TH AVEfJIlE~~----- ~ • ~ : us OF TYS IS 1/4 ; HB9.46'40"E"E _ _r84e46'40"E 418.031 22Ye eIB Corn N} Corner Se9e3e119"E 41e.011 PROVE 4 4,' ; ( . ~w1 w Section 10 3/40 pinch top is NOS 40054% t e~ 5.301 from set pip. ~ c °.y`t1 It r t M~ yyYY t. " f• K ~ . •caolx tAitliT r• + . •j 1001•:10.. N .ZOflIflQ Blld . ~ LOT ` ,1 . E.~,~ j3 a ; t ` a+ j c•r. J t(IIOt f~eord~ ' ' 7'i t l 'yiutr •z~ % within 30 dby~t 0~, ~'"•%t Acres Inc. 1"• . v •Q' MZ`nMa ~1 RaptxoVa~) ~t~ of SW s40e Sq. Ft. ~ i•Y~ ti ~ • s~ r;}!~~ ~ x ~ J v~ ik i 5.06 Acres t. .i t 1 x..Yd r. ~ ~ ~ ~r Q 2218.{( Sq. Ft• r :i~t ^ •w~. .a.w ' ..fir i.. f to 1 ^I R°•~' t~+p• J t i>V 1~~ir R-tt•~ .is'yy'•t ~1 lit s ~•I+ L Sl y~,~i'~l :7 41 "'~•JrY 1'. t r/.~ X1 t ~T•.. •r .Y A~~•~C, :1~~.i.l ~Y '~9~ ~~.Sr t i ( ~e • t"k'c fwt .r ~ w.f *c;r' ~Mh7i ~I 1 ~ i , • r''c ~ .R: ~ ± ~}~i •.a y ~ ~1. r .M t , I f ~ hr,• V)1 . . +.dr ~ ,J;1 ~ i' Q.t=~ ,fit • ' • • ~.tl j . ~ y t~ Y Y: r' ~ ~ ~ ,t' Cy,..~ • r , ,r 1 Al ud nun County Konument Falnd M • 3140 Pimh Top Found' _ $G O leratsea•etu'eey Karker (mil sot) Al o 1w Iron pipe Set, •,et~ IIr 1.68 lea per I h mr toot (!4w 1s Length 1ff 100 toot Roadway setback line 9 STC-105 SEPTIC TANK MAINTENANCE AGREEMENT f St. Croix County OWNER/BUYER CiYTLI L ~R~t'E01Z1 G~ MAILING ADDRESS 92350 SA-5m% ME; Ave S. LeTrpc2e Gluivelf Mu PROPERTY ADDRESS (location of septic system) Please obtain from the Planning Dept. CITY/STATE S'~dtiTS,~ PROPERTY LOCATION Wk, 1/4, J-1C 1/4, Section l4 T Z1 N-R $ W TOWN OF ~N~IZIL~I~I ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAP VOLUME PAGE 293 (0, 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: 77 St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 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 G\/(?-, 1._ L-. jFi?4EOIZ1c-*4 Location of property We 1/4 WC 1/4, Section JO , T Zvi N-R ~ g W Township ~lPrR~l~ ~J Mailing address 4'b--M-10 ! 1&S M1 QC NAw Address of site Qcxb 1lj I / 957- Subdivision name LS~A %o $ qS ~U x936 Lot no. Other homes on property? Yes X No Previous owner of property ~cH-O.iL~ ~tytEOMUi Total size of property cJ,O a C, Total size of parcel 5. d g G Date parcel was created to~'$ ~°►S ~v/ Are all corners and lot lines identifiable? ^ Yes No Is this property being developed for (spec house)? Yes X No Volume 11'5 and Page Number 23ti 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. 5 -jZ4W -C+ , 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. ~ r Sig ture of Applicant Co-Applicant Date of Sianature na+ ~f c; f i y.I DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1-1982 THIS SPACE RESERVED FOR RECORDING DATA WARRANTY DEED OL 1135 9 ~ T. PA,_ This Deed, made between Leh art J. Friedrich and AUG 1 A 1995 Frances H. Friedrich 9:45 A. Grantor. s`'..•1 ~1.i . - and Cyril L. Friedrich Grantee. LAWSON, MARSHALL, MM KU Witnesseth, Tha; the said Grantor. for a valuable consideration t RETURN TO 3110 UVERNE AYF)K~ no conveys to Grantee the following described real estate in- St. Croix LAKE RI110. MN MW County, State of Wisconsin: ~~n J Tax Parcel No: Lot I' of a Certified Survey Map recorded June 8, 1995 in Volume 10 of Certified Survey Map at page 2936, as Document No. 529950 in the St. Croix County Register of Deeds, Town of Warren, St. Croix County, Wisconsin. t, j This is not homestead property. Together with all and singular the hereditaments and appurtenances thereunto belonging; And-grantors warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except and will warrant and defend the same. Dated this 9th day of August 1995 (SEAL) (SEAL) Lehart J. Fr r c r. '~~rez /z (SEAL) h (SEAL) r FF snces ie r cr c ~t - I AUTHENTICATION ACKNOWLEDGMENT