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HomeMy WebLinkAbout002-1052-50-100 2 N 00 <r O v) 7 y M Q. O O ~ 00 ' O ~ U N _ N N O) p C R 0 v N E i 3 ti I E~ O U Y G Z f0 N C Q O (6 y 0 LL O n O _ a) "O Z7 t ~ O r6 a 3 M v ~ Z N Z O O Z m m (L 04 m w N N F- U) C O N O U O Z d c a) Z d N O O v a N C • -1 L O 0 O a a v 2 Z Z p Z N N C co V O O N O W 1a.6 L 0- to 0 co 2 .2 d N v G O Z > H Fy- IN- O p ~i -co •r.~ m 00aaa zp N 3 o N y O O O y ` , V1 J C~ O CF) U) Qi } Cl) c0 2V! 1~i 41 O O 04 CIJ N O O y V N ~ O N N O CL to ~ w r ao V cn N d a } a) 3 O O O N C y O O C © CC Co C U U W O C ON CO O) O O T+ N O w l) C Q z3 N N N L M N C E O LO O C O C N O O N N LO = 'C r.- LO 0) co a) F- (B cli ~ O N O co N O E U rrr'VVV y' O N co (D N O N cG Cn mgt a La G ; ID - m p ~1 A im2 0 N0 !lot STC - 104 AS BUILT SANITARY SYSTEM REPORT` J / 4 OWNER ADDRESS-)Q, 2 4 yIf ~9h1~ St 13a./~1~~ h 144 t S`e(vv',~, SUBDIVISION CSMJ LOT SECTION / ~ ~ T_21N-R_LW, Town of 134 /d w ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM r-In 4 C.\ / s r, 7 2 'q"4 INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to r~,a -1 - 11 T BENCHMARK • /J /1 r ! G h ! d (J ALTERNATE BM: So et G j" GT 134tG j.*, e t; 17.04 SEPTIC TANK / PUMP CHAMBER / BOLDING TANK INFORMATION Manufacturer: • Liquid Capacity: /lJUO - boon Setback from: Well_~~ House Other Pump: Manufacturer Zod /ej Modell Size Float seperation l~~Z Gallons/cycle= 1 4j Alarm Location :SOIL ABSORPTION SYSTEM Width: Length ? S Number of trenches Distance & Direction to nearest prop. line: X5'~ Setback from: well: - House S7510 Other Q G~G ST Inlet. ELEVATIONS Building Sewer / ! 7 3 ~ ST outlet 7 -M, 3 e PC inlet ) 3 d PC bottom ON~, 5' ( d~ Pump Off Header/Manifold Bottom of system D o Existing Grade Final grade DATE OF INSTALLATION PLUMBER ON JOB: t LICENSE NUMBER: ~4 /7 INSPECTOR:- 3/93 : i t i I WisconsinDepartment ofIndustry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST• CROIX Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION village1 Town of: State Pan I o.: PUI~L~rS~Qe. ERIC & KELLY El City El CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: co is y~'?Q tI `y A96001 64 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark x,35 ' Dosing 0,5V d~ Aeratio Bldg. Sewer, Holding t/ bR Inlet TANK SETBACK INFORMATION St/ Outlet TANK TO P/ L WELL BLDG. ventto ROAD Dt Inlet ` Air Intake Septic ` a(p / NA Dt Bottom Dosing NA Hsaer / Man. Aeration NA Dist. Pipe Holding,- Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer ' ~e' - il'- ! V emanY t Model Number M 3 TDH Lift 19.. Lriction~ (_,1' F eadm~~ TDH A, Ft oss Forcemain Length 5g6Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width , I Length - No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ;7 DIM~NSI N SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHIN acturer: SETBACK CHAMB R / . Ji Model Number: INFORMATION Type System: r\ 4_,o, to- ~T OR UNIT >M1~IcU~-~ DISTRIBUTION SYSTEM C .WMa n _ Distribution Pipe(s)A r tr x Hole Size x Hole Spaacing Vent To Air Intake Length c rt Dia- 1S Length JJ Dia. Spacing 76 '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: BALDWIN.22.29.16Ui SE NE 250TH,3T L Plan revision required? ❑ Yes ETIN-o n n~ Use other side for additional information. 7 7 D-6710 (R 05/91) Date Inspector's Signature Cert No. 311 Safety and Buildings Division SANITARY PERMIT APPLICATION Bureau of Building Water System: 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 Count j Cry/X than 8 112 x 11 inches in size. T 2 • See reverse side for instructions for completing this application state sanitary Permit Number The information you provide may be used by other government agency programs El Check if revision o previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION Property Owner Name t Property Location E)m -4- We116ul / rx.564 $£114NE 114,522 T.2q ,N,RI~-E(or)W Pro erty Owner's Mailing Addre Lot Number Block Number ~2 2 v r~1 A I 5 V City, State Zip Code Phone Number Subdivision Name or CSM Number 0A it 4( 0-0-2 ( ) II. TYPE F BUILDING: (check one) ❑ State Owned [!t~ /d Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms ° Town OF 8,~ ` It h 25 v s III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) ! o v 1❑ Apartment/ Condo U 2 16,5-2- 6-0 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. [A New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an -_____System ________System_____________TankOnly 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 218 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 Requi ~~sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation 2 j, z U 1 V Feet E/v. 4- Feet VII. TANK Capacity site in gallons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION Gallons Tanks Concrete glass App. New Existing structed Tanks Tanks Septic Tank or Holding Tank V UU Me C.= lL/eS ttr h IT ❑ ❑ ❑ ❑ ❑ tt Lift Pump Tank /Siphon Chamber V I (~UU ❑ ❑ ❑ ❑ ❑ VIIL RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility f pr installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumb s Signatur Stamps) PRSW NO.: Business Phone Number: doe- -5 tGh 7tr-6qf--.22G~ I 4-ve, r Plumber's Address (Street, Cit tate, Zip Code): IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sa Itary Permit Fee (Includes Groundwater ate ssue Issuing Agent Signature (No Stamps) Surcharge Fee) Approved ❑ Owner Given Initial / Adverse Determination X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: SOD-6398 (R. 05/94) DISTRIBUTION: Original to county, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD-6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3815. 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 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. I SAFETY & BUILDINGS DIVISION Wisconsin Department o r and Human Relations October 11, 1995 2226 Rose Street La Crosse WI 54603 WEGERER SOIL TESTING 421 N MAIN STREET .'J3 PO BOX 74 i.~ RIVER FALLS WI 54022 RE: PLAN S95-41292 FEE RECEIVED: 180.00 GULLIXSON, ERIC SE,NE,22,29,16W TOWN OF BALDWIN 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. m HReviewer Section of Private Sewage (608) 785-9348 2856R/ 1 SHDA•7997 IR. 1&441 r Page of 6 MOUND SYSTEM S95-41292 FOR A 3 BEDROOM RESIDENCE LOCATED IN THE SE 1/4 OF THE NE 1/4 OF SECTION Z Z, T Zc' N, R 16 W, TOWN OF S Nl.\Jwl )y , S r C.(,Z0 W 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 PREPARED FOR OCT ~~c ~~..~y ~~L~ucson, SgFSTy ~ ~ f99$ Zo ~ ~ sr. af0~s. 0/V, ~ LDWl IV , wl 5 ~L boZ PREPARED BY s'`XEGIS% EEz;t ER SO = L TESTING COw-o~ AND DES = GN S1EE:ZW I[ CE j. . m s ARTHUR 1. F.O. BOX 74 421 K. KAIK ST. i - ® WEF,- = e•a Q~5 P RIVU. FALLS. KI 54022 p = KLSV:ORTH, ® s wrs. 115-425-0165 e'oeo~~S I G lv S ,wet, ~'~tettt~'►~e~ 10-3-9 S JOB NO. 'IS-Z97 Page 3 Of Approved Synthetic Covering S95m41292 r~sTM c 33 Distribution Pipe Medium Sand Topsoil F Elev. I D a O -J o 3 E b % Slope - (Force Main Plowed Trench of From Pump Layer Aggregate D N. p Ft. Undisturbed Soil E 1.35 Ft. Cross Section Of A Mound System Using F 0,8 Ft. I Trench For The Absorption Area G a Ft. A S Ft. H S Ft. B S Ft. I S Ft. Linear Loading Rate= GPD/LN FT p `7 Ft. Design Loading Rate= O.3 GPD/SQ FT K Ft. L ~1 S Ft. iri tei „+e - Pe5itieR e rE e-M a i rW Z-1 Ft. L Force K Main A - W Distribution Trench Of 2 - 2 2 Pipe Aggregate Permanent J Wit;.. Observation Markers PipesI (Anchor securely) - ® Mp0 `CGS ti 0 Mound Using I Trench For Absorption~5 4F O~Y~JG~ sac. 5 ON t'~ Page Of 6 Perforated Pipe Detoll S95'041292 0 End View )Perforated End Cop e~. PVC Pipe Install permanent-marker at end of each lateral Holes Located On Bottom, Are Equally Spaced Q End Cop ,x PVC Force Main ywo 4 ~t f+~~isi~S LAM A9 95 DF Distroution Pipe Lost Hole Should Be ~V Next To End Cap Distribution Pipe Layout P ? S Ft. X Inches Y Inches Hole Diameter Inch Lateral Inch(es) Manifold Inches Force-Main Z Inches # of holes/pipe -1 Invert Elevation of Laterals 109•S Ft. Gy- t_ k1- --)-02-y- Z= N.04 GPM Place lst hole 3 from tee with succeeding holes at 6 intervals. Last hole to be next to the end cap. • PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS PAGE S OF VC WT CAP S 9 5' 412 9 2 4' C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING MANHOLE JUUCTIOLI BOX COVER WITH WARNING LABEL ~t 10' FROM ODOR, 12•MIU. WIIJDOW OR FRESH AIR INTAKE I GRADE I `i"MIAJ. , r' E2.L00t I • I IeMIU. COQDUIT %,w IS"MIAI. PROVIDE I INLET AIRTIGHT SEAL I I i l A Ta le 'rc ri'struQt on shall comply i III APPROVED JOINTS APPROVED JOIUT T ,j bftF aka ILHR 83.20 I II ALARM ~2 ; I I 1 tai ~6'' I I ow m X10 ~i- I LLEV. FT.r \N NQkPUMP--~ r y"~• ~v11 ~ OFF D ~gP C+~ I OIICRETE BLOCK 3" APPROVED RISER EXIT PERMI-fED ONLY IF TAWK MAMUFACTURE:R HAS SUCH APPROVAL BEDDINQ SPECIFICATIOUS DOSEt wR- j'RT NUMBER OF DOSES: PER DAB TA►JK /+IAIJUFACTURER: TANK SIZE: L O O O GALLOWS DOSE VOLUME z Zy-J ALARM MAUUFACTLIRER: S ` 3tLT"/S INCLUDING, 5ACKFLOW: GAttoNs S 5, ~,~~`[TtD - MODEL HUMBER: \0\ ~LAj CAPACITIES: A= ~Z WCHE5OR - 1 Z GALLONS ~L-) a= Z INCHES OR S Z` C# +LLOW5 SW17GH TYPES PUMP MANUFACTURER: 7-A ~Z--' Z C " C z 9 it' -IUCHES OR zq-) GALLOIJ5 MODEL WUMDER: L3-7 D= `S INCHES OR al O GALLOMS ~'CrcL. = ~ 001 5WITCH TSPE: t`2C~2~7 MOTE: PUMP AMD ALARM ARE TO DE I l~. oy INSTALLED OW SEPARATE CIRCUITS MIlJIMUM DISCHARGE RATE ~-GPM VERTICAL DIFFEILEMCE OETWEEII PUMP OFF AUD."DISTRIBUTIOU PIPE.. It,,, • z 5 FEET + MINIMUM NETWORK SUPPLY PRE$5UFLE . . . . • 2-50 FEET 0 -F- S lO FEET OF FORCE MAIM X 0.y S F~o FtFKICTIOU FACTOR.. FEET -21.05 TOTAL DIJUAMIC. HEAD FEET = DIAMETER `r DEPTH 3a lZ' IMTERAIAL DVALWSIOIQ i OF TAWK: LENGTH ;WIDTH - - 'LIQUID DEP BOTTOM AREA - - 231 - GAL/INCH AS PER MANUFACTURER = Z 6-Z) GAL/INCH r X9541292 ? it TOTAL DYNAMIC HEAD/FLOW 4 3/4 7 3/8 w HEAD CAPACITY CURVE PER MINUTE MODEL 137-139 EFFLUENT ANDOEWATERING ` 6 1/8 30 SERIES 137-139 Feet Meters Gal. Ltrs 8 5 1.52 104 394 0 25 10 3.05 79 300 0 0 4 3/4 15 4.57 64 242 ° 20 6.10 36 136 W Z1•o5 0 0 6_ 25 7.62 8 30 = 20- u 26 7.92 0 0 a o 1 112' - 11 112 NPr o t5 4 It(.py a 0 10 ti 2 5 12 3/4 I 0 U.S. GALLONS 10 20 30 40 50 60 70 80 90 100 110 LITERS 1 80 160 240 320 400 1 I 4 p FLOW PER MINUTE _i 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 130°F. (54'C.) special quotation required. Standard all models - Weight 47 lbs. -1/z H.P. SELECTION GUIDE 1371139 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 1 &8 - switch. Refer to FM0447. N137/139 115 1 Non -10.4 2or2&7 3or5&6 3. Mechanical alternator "M-Pak" 10-0072 or 10-0075. D137/139 230 1 Auto 5.2 1 art &8 - 4. Combination Starter. Refer to FM0514. El 37/139 230 1 Non 5.2 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 8.2 1&e 6. Mercury sensor floatswitch 10-0225 used as a control activator, specify duplex 1137/139 200-208 1 Non 8.2 2&7 3or5 & 6 (3) or (4) float system. J137/139 200-206 3 Non 4.2 2&4 3&4 of 5&6 7. Four (4) hole "J-Pak", junction box, for water tight connection or wired-in ' F137/139 230 3 Non 3.0 2&4 3&4 ors&6 G137/139 460 3 Non 1.2 2&4 3&4 or 5&6 simplex or 2 pump operation, 10-0002. ' ' No molded plug 8. Two (2) hole "J-Pak", for Watertight connection or splice, 10-0003. Three phase units require a control switch to operate an external magnetic or combination starter. CAUTION For information on additional Zoeller products retertocatalog onCombination starter, FM0514.Piggyback All installation of controls, protection devices and wiring should be done by a qualified licensed Mercury Boat Switches, FM0477: Electrical Alternator, FMO486; Mechanical Alternator, RW495: Alarm electrician. All electrical and safety codes should be followed including the most recent NationalElectric Package, FL40513: and Sump/Sewage Basins, FMO487. 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 everyZ.Ueller pump. MAIL TO: P.O. BOX 16347 Louisville, KY40256-0347 Manufacturers of SHIP T0: 3280 014 Millers Lane Louisville, KY 40216 (502) 778-2731. 1(800) 928-PUMP FAX (502) 774-3624 HEAD/CAPACITY CURVE EFFLUENT and DEWATERING WARNING: Model 18514185 should not be subjected to less than 30 feet TDH. TOTAL DYNAMIC HEADICAPACITY PER MINUTE 1n 0Y 1 ssss SERIES U 46 6759 96 127.129 1 0144140 11414161 7679167 1659,165 18511486 10601196 19614164 11914169 191 LL FT. M. Gal. Lb.. GN. Lt.. Gal. U, GN. U. Gal. LYf Gal. -.Lks Gal. LIn Gal. Lbt Gal. L6s. Gat. Lft Gal. Lhs, Gal. Um. Gol. Um. WI. in 1 4 5 IM U.S 62 28 106 43 tU 12 272. 93 252 94 256 106 401 61 221 61 271 50 220 155 97 : 155 96T- 45 ' 111 42 10 2A6 131 w 27 97 U 117 61 221 79 300 90 341 100 276 61 U/ 61 221 9 220. 148 660 151 $12 45 170. IS :11 t13 15 447 6.9 is 07 19 ' 45 K U 14 11 w w 221 Se 112 1 115 20 9.10 2.5 1 3 11 29 11 36 136 72 276 42 310 59 227 w 227 56 220 176 919 140 S20.: 4S .170 40 25 7b2 6 30 63 236 74 20 57 216 59 223 9 220 128 414 127 603 45 170`- 30 9.14 53 201 65 246 $5 206 56 220 90 346 56 226 121 464 127 461 45 170 40 1219 30 11446 11446 172 55 206 75 262 56 220 10S 397 114 43145 17038 21 w 33 125 51 111 9 219 9 22090 341 100 279 45 11160 1019 IS 67 43 11436 136 9 2" 71 214 65 n 45 110 70 2134 30 114 10 U $2 .197 51 192 70 ' M 45 ::170. 36 191 40 24.74 14 13 45 170 16 104 9 204 4s 171 1 1 90 21A3 32 121 2 1 37 140 < /5 '110 100 30.46 10 68 21 79 w :1f{'`. 34 110 22.00 7 26 4 20; 30 ' 14 1 10 u0 m.54 20 32 105 120 39,62 w Us Loa WM: 21.4• 21' 1925' 2r 26' IF S6' 66' it 73. 115' 91. 11r 12r 100 30 95 28 - -t 90 186, 26 4186 85 165, % 24 80 4165 75 0 22 70 x U 20 Q 65- z 0 18 60 163, 4163 189, 55 4189 0 16 50- 14 45 12 40- 140, 188, 35 4140 4188 10 30 137, 185, 39 n ~~I 8 4185 6 20 'S 4N, L 15 4 10 2-- 5-- 43 48 53,55 161, 57,59 9 4161 0 U.S. GALLONS 10 20 30 40 50 60 70 80 90 100 110 120 lf!0 140 150 160 LITERS 80 160 240 320 400 480 560 640 0 FLOW PER MINUTE 009922 Note: For Head Capacity on Model 112, industrial column-explosion prooof pump, see FM0219. o rn 0 0 o_ 0 0 0 0 C; m N w N A ~LL a~ I q ~Np g co ZO S (J n 1^. N N e~ 00 p N N N N O 1D h b h N A ~y y~ qqq ~p p O a C ~f ooq !'1 qp _.1,N' N S N h 00 r ..J 'A tl o W q N W M N 1 so n J f S r o M ~ (7 F ('.y- Q~ 8i ~i N g Y~ ♦ {V A p o W a J n n . n ILIA-Z So~~~ o 0 qp app N U W h S H N ' O O Q N iD M h Q Q q O 0 O A S o ;p 8 N wm M + 9 U p' m o N N Q N N M A m h h ~ I - ' ~J w d U V N A C4 O A 1ff n N O Q N Q EV p p- O O Z W J 'f M A in N 0 L N N ° O 2° " o ooi d A A N p N er ~ y J ao M. °R p N~ y Q f M h Oe N V~ W N A O O N N O O O 0 _ O 0 0 Y1 NN V } ~ e o h Q V N S O N N o~ U Q o .y H N Jy e'l N O N 0 LLI p p h W J / 1 Q N Q+ !D N N a N Z n ~ V > O ` O D) c W a O N r O r N N q 01 r a. `V1` g O L: mi V ~ppD A o~ -p p ~ Y e W m O U 0 N 1~L 0 O 0 N H N S _h tp A J Ne 3 W t O 'n a O N Q y V M ~o aNn Q N i0o ooaNO W Y oer M o N y W In W o ^ o N Z U W C,4N e Ch n 8 j 00, U ~ Ne N $ ` Q w O v 0-0 N N U Q m 0 c N N c n LLI C, O N N co is o W 0 C 2 ^ 0 O. 0 o N N 0 d C N h N 44 oa - U _ \ L lC N a m d U ao ~ c D. C O Td 7 O yOOin co n C.O cA N U UI N 0 0 v v, n« R 0 O co C m=U N 0 an Orn vO,c w 0 0 _o N C-0 O m o v ar o rn 1333 ° e Ln r °a n ~i N ^ o n oz LL 0 In 0 0) y S8313W N o ao ~n N o a0 .o e N " d ^Q\V o=- N N N U N w 10 V N W a o v OV3H 31"VNAa -mol J M o \ O Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Lalfpr and Human Relations Division of Safety & Buildings in accord with 11, tom; jAli Adm. Code COUNTY ex TAttach complete site plan on paper not less than 81/es in size Plan de, but not limited to vertical and horizontal reference point (on and -4 PARCEL I.D. # dimensioned, north arrow, and location and distance road- APPLICANT INFORMATION-PLEASE PRINT RMATIUIV REVIEWED BY DATE PROPERTY OWNER: St~1Z [Z`f Lt.) Z ev "4 TROPERTY ~ , TION ~3v~ : ~R~ C ~rC~TL L.t-( 6U Ll.l N f~ BT'° 1/4 1V E` 1/4,S?Z T Z q N,R It E (or W PROPERTY OWNER':S MAILING ADDRESS LOT, B K# SUED. NAME OR CSM # CITY, STATE ZIP CODE PHONE NUMBE QVILLAGE [MOWN NEAREST ROAD BPjA,Ow>>u, wl Sy0o2 (--)lS) 6at/1 LI-9 t~v ZSO `r~( IsT- [X New Construction Use [X] Residential / Number of bedrooms 3 [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow qSo gpd Recommended design loading rate bed, gpd/ft2 6-_1 trench, gpd/ft2 Absorption area required 31 S bed, ft2 37.5 trench, ft2 Maximum design loading rate 6 • S bed, gpd/ft2 6, b trench, gpd/ft2 Recommended inflltralion surface elevation(s) 109.: G ft (as referred to site plan benchmark) Additional design/ site considerations 1 1 (!~uXdb kJ/ S 'Xc -I S 'f_L=~v G.•f- - "]A-,. I ' OF Sf xb Fu(. Parent material is -n u, Flood plain elevation, if applicable N • A , ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ❑ S ®U 2 S ❑ U ❑ S ®U ❑ S ®'U ❑ S LZU ❑ S OU 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 Tmnch ' «1 o_~ lp`12 3 L3 - Std ZM Sbh Yn'~1- ~-S - o•S o.~ S1 Z sbk mkt- C~ Ground 3 1S -30 S `12 31 S I 1 e sbk v~~. Ct~ _ a- o• S elev. 108-3 ft. 3o-c/~ S y IZ 3/ ~ S 2 ! S C ~ o w,.`~1:. - Depth to limiting factor Remarks: Boring # <::,,:}-IU lb`l12 313 - St) Zh-t$b1Z m~'l- 4-S o.S o.~ Z Z lv-l8 l O `i Q Y!y - s l t Z `Fsb1~ m c f v o. S o. 3 ►g 30 ~•SH~ 3t - s 1 ~Sb~ W, U CLk, o~~( as Ground elev. 3v-V~( 7•S kM 3/y C/ P_ / set o rat 'F~. - WL- z ft. Depth to limiting factor Remarks: CST Name:-Please Print Arthur L. We erer Phone: 715-425-0165 ergerer Soil esting & Design Service-P.O. Box 74 River Falls,WI 54022 Signature: S_ Z 4 Date: ` O` 3_ S CST Number: M 0 0 5 7 6 PROPERTYOWM GU%-%-kxSw SOIL DESCRIPTION REPORT Page of PARCEL I.D. # • Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Bot~rclary Roots Bed Trench o `0 `12 31 3 - S rv~ J b ` vc CI- C>,- S S o b 4~:~ Z $-~y to y/y S J Z s~k wr`F~ Ck, u. s a. 6 Ground 3 )L/Z.` ,7•S `i2 3) S) C Sblz VA U ~-S o•Y o•5 elev. 3l tioL5 ft. tR y Depth to limiting factor i Remarks. Boring # 0-9 tio~ Q 3 L3 - s 1 1 Zw, 9 b h eS - o. S o. 6 ti Z g-IS Lu`1.R q/ S 1' Z'~Sb1~ yr~ CS o. S o. 6 3 1S -ZS S y 2 31 S l e Sb~C YYl V t^. C S o. q 0.5 Ground elev y ZS,4 S 13`iR- 31 L y y! SCI ~Y"` ►'n1^ V,Z ~ ft. Depth to limiting factor ZS" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # I` Ground elev, ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER j: c l J ; ti S MAILING ADDRESS / ~?2 O YY1 I~ PROPERTY ADDRESS - 2 S U s~ / 1,A, y . (location of septic system) Please obtain from the Planning Dept. CITY/STATE 94 4 - ' ,-t &-j, .5 PROPERTY LOCATION L^ 1/4, 1/4, Section T N-R ` W TOWN OF 94 k ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAP SrY~ 2 ` , VOLUME A , 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. Me, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED: DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 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 Elf ~ C_ 4. It ill y [ - I1,IV -VI .1-1 Location of property S'E 1/4_1/4, Section IT N-R l W Township 8 a ldl L-~ 1,1 Mailing address 1 2 j'yI Ae le- 84 Str cl Lam', h Lr~ r'S7 5-q O o 2 Address of site U s U t G( v Subdivision name Lot no. Other homes on property? Yes L---~No Previous owner of property rrv n~ Z Total size of property Total size of parcel Date parcel was created Are all corners and lot lines identifiable? L-4es No Is this property being developed for (spec house) ? Yes No Volume (Lll- and Page Number ~L 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. ~-~q q2-S-' , 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 App icant Co-Applicant &X2 A41 Date' of signature Date of Signature r. co FILED n?P 2 4 1996 0, KATHLEEN H. WALSH 1 I Register of Deeds SLCroucCo.,WI T' CERTIFIED SURVEY MAP Located in part of the SEA of the NEJ of Section 22, T29N, R16W, Town of Baldwin, St. Croix County, Wisconsin. OWNERS Jerry Lorentz Carol Lorentz 887 250th Street APPROVE Woodville, WI 54028 NE Corner of N Section 22 ST. CROIX COU-N- V omprehensive PI3#'* Zoning and N m W Parks Committee N d fp t/N I if not tscord+ad y JNFI_A. i T `G LANDS CAN _ withm30days'of CD (D o - approval data ~ m %D ZO Ln N 7pprowal shall be o ~ ' Q 0 `-h 0 Ln null & void 0 (D 00 0 I M CD °z w Zen Z 0 a I I _ 0 -h c`Di° N89005'32"W 611.29' L71 OD Q o mi 585.69' I r zE=j 01 25.60' I J Z1 1 <.1 ~I ~ W 1 - j I - ` M f M LOT I ~ I M d01 r- 10.20 Acres Inc. R/W N N II , ,1 I ~~I 444,386 Sq. Ft. I N ~W I W I t- I 9.80 Acres Exc. R/W l I I W 426,810 Sq. Ft. 1 00 co (Jr) 1 I Lf, C' 0 o I ZI o I I LI '-I O I I CD C) z OI ~I Ln I S89°05'32"E I (V I 4613.10' 22.76' 588.53' 1 E1y Corner of S89°05'32"E 611.29' I Section 22 East - West Line S3 331' f~ nA3.q., h ME a$Ed TT 'TOA •aoTApe aOj papog uAoL ageiadoadde pue ao-rijo BuTuoZ AgunoZ) xtoa, • gs aqg goeguoo Taoaed Aue ButdoTanap ao BIItsegoand eaojag •(•oja 'jaaaed og ssaooe '9ZTB goT mrunTuim 'spuelleA ''a•t) suotgelrBaa pup saTna 'sMeT dTgsuMOI pup Aguno~ 'agegS og goaCgns s (geld) d-em sigg uo uMOgs TaoaEd goeg -am-es .6utdd-em pup BuTAatuns u-r x-roao • gS jo AqunoD aqg go aoueu-rpap UOTS-rATpgnS PueZ aqg Pup sagngpgS uzsuoosiM aqg 3O :PE-9£Z aagdeqo go suo-sTAOad guaaano aqg qqT& paTIdmoo ATTnj eASq I gegg !pagiaosap We p6A6Aans Aaepunoq ao-raagxa aqg go a-Cpos og uoigeguasaadaa goaaaoo v si dpw AatunS pa-rjzgaaD s-rgg legg AjTgaao osTe ' I •paooaa go sguem9sea TTe pue (gaaagS ggOSZ) Peon uMOs aog ApM-jo-ggBTa og goaCgns si Taoaea ('g,!I'bs 98E'jfii,) saaov OZ'OT suTvquoo Teoapd pagiaosaa aqg og 'g993 6Z'TT9 'auTT V/T gsaM - gsea PTvs SuOTe '$uM SOo68S aouagg :ZZ uoigoas Jo autT V/T gsaM - gsea aqg og 'gaaJ EE'LZL '$u8Z,TSo00S aouagg :gaa~ 6Z'TT9 'MuM S0O68H aouagg :gaaj ££'LZL 'uotgoas pips JO V/THM aqg JO auzT gspa aqg BuOTe 'Mu8Z.tSO00N aouagg =ZZ uo-FgoaS pips JO aauaoo V/Tg aqg gp 5 TBgq :sMOTTog se pagtaosap aagganj !u-rsuoosp4 'Aguno;) xioaZ) -:IS 'uiMpZeg go umol 'M9Td 'N6ZZ 'ZZ uo-rgoaS Jo V/T$M aqg -4O V/TSS 941 go gapd ui pageooT pueT go Taoaed v V1. H80PAGs 574 544428 WARRANTY DEED RE(iiSTMOFFICE 8T. CMCTY' wl This Deed, made between Jerry R. Lorentz MAY 3 0 1996 and Carol A. Lorentz, husband and wife, 11: 30 A. M Grantor, and Eric J. Gullixson and ~1, Kelly J. Gullixson, husband Pnd wife, PAGMwdDseft their successors and assigns, as survivorship, marital property, Grantee, Witnesseth, That the said Grantor, for valuable consideration conveys to Grantee the following described (J real estate in St. Croix County, V State of Wisconsin: IX Return to \ `Y y DRAFTED BY I r Part of SE 114 of NE 114 of Section I I ~ 22-29-16 described as follows: Lot I of Certified Survey Map filed April 24, Tax Parcel No: 1996 in Vol. "11 page 3082. a FEE This is/is not homestead property. # L together with all hereditaments and appurtenances belonging thereto and will warrant and defend the same. Dated this ;7 day of , 1996. J rry R. rentz Carol A. Lorentz • - 6 O iy O m LL y 51 LL ocb G 2 6 C y ri Cn - 16 v 0 0 s cu socv sA to ~4 I r 3 :57 a p LO P cn O ~1 ~ ~ ~I Q' ~ in1 ro p Y 'tj y _ I o 2 io _o c HIS F _0 Z~ a' 11 z ~a - - - - .D 0 10 v tc ~ ~-Va s n-l 1oN A ~ Y C70Z \ M J ~ ~ 7 flu cry ~J ~~h O s '0 4 d o~ I ~I •