Loading...
HomeMy WebLinkAbout010-1000-30-000 4. c p ° 3 0 h O F» a ~ o m tY OEM N U O - C N - N N L N N N U C co 3 N N I w c0 O co O N j U -0 'CO C m. 7 c O 0 p) 7 ° E O > in U N h C f0 O x E 3 °cacmoE O U m y 3 U C Z N Y "O 2 5 7 f6 n. 26 .2 c U LL U C O>'M N 0 U) co f>9 Y 00 N°o x' c Q ~ a 3 Cl) z H (O N C m J O Z ° o a m H U c N O N is O l d co w ~ r N oUi 2 d N c z fn F- r ~I'. E 'a N co M C (6 O w N N c • O O O c c O U 'v Z Z o N _ z N - N M m R ~ - w O c O N d lC Y H O O O N U 0 d E m ca E h /1 ~p 2i F- F- a ~ w N °000 Zo Q) a a a CL E w 'D (o }~yy N J U (n U) rn rn O ~J Z 7z z 0 ~a O 0 LO LO ~V O N O O N N m ~trn N R O O O N N C © to o p aUi c c a rn° V f+ 04 N c c L N O O '6 N c N N 7 N co r- CO U. O O w U N O N O r ri1 as • cl a• N 2 0 .O. C a. 0 0) 0 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER 9~e7`e~ C - 7` e ADDRESS SUBDIVISION / CSM#_~,e- LOT # SECTION T 3eN-R ZL W, Town of ,t19C~ a,~aQ ST. CROIX COUNTY, WISCONSIN PLAN VIEW ` SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM II f i ~I 1 ~I 1 , r~ ~~Z3 ;r I s 7-- INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: P~ Liquid Capacity: %v~WG Setback from: Well 3G- HouseO Other Pump: Manufacturer ~QY )P/-01-.c/ Model# Size Y~ Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM 5-171d 71~ --CV Width: / Length Number of trenches Distance & Direction to nearest prop. line: Setback from: well: l~0 House Other ELEVATIONS Building Sewer ST Inlet: ST outlet: PC inlet PC bottom Pump Off Header/Manifold Bottom of system Existing Grade Final grade DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: 3/93:jt Safety and Buildings Division ~•p'~;.u'■-'■;i 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 c than 8112 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Permit Number A9&3;- The information you provide may be used by other government agency programs ❑ Check it revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION - 4~ Property Owner Name Property Location 114 114,5 T N,R G E(or~ Property Owner's Mailing Address Lot N mber Block Number City, State Zip Code Phone Number Subdivision Name or CSM Number &9W12(a 10-0 1W "V ss-q ( _ ) 3a c II. TYPE F BUILDING: (check one) ❑ State Owned ❑ ity Nearest Road Public 1 or 2 Family Dwelling - No. of b E] VIl age edrooms Town OF G' d 111. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 f-1 Apartment/ Condo (0/0- /coo- so 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 34IgI.r //Y IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) • A) 1. jaNew 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System ___System_____________TankOnly Exlsting 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 21AdMound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate. 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation 15-a6 3aCS° 15 a a ~ 1,01r 5- Feet Feet _T, 6 TANK Capacity VII. INFORMATION in gallons Total # of Prefab. Site Fiber- Exper. New Existing Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App strutted Tanks Tanks Septic Tank or Holding Tank yL a~CJO ~f fyj, ` LS t- ❑ 1:1 11 Lift Pump Tank /Siphon Chamber ®Q~ ( G ❑ ❑ 1:1 ❑ El VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite se age system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature:( o stamps) MPRSW No.: T usiness Phone Number: / /g ^3 ^ ~!a Plumber's Address (Street, City, State, Zip Code): Q ? d `s e- c t IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved SaI y Permit Fee (Includes Groundwater ate Issue I Agent Signature (No Stamps)` ved Owner Given Initial IJ Surcharge F ee) 0- Appro Adverse Determination S X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-6398 (R. 05194) DISTRIBUTION: Original to Counly, One copy To: Safety & Buildings Divi ion, Owner, Plumber INSTRUCTIONS t 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe 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 isto fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service- streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a-number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. f SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations 10 August 6, 1996 2226 Rose Street C6 4 La Crosse WI 5 REe0aVE D ra AU G 1 2 1956 ST rpo)( WEGERER SOIL TESTING `fl C JNTy 421 N MAIN STREET , ZONING O~-ic,~ ti RIVER FALLS WI 54022 S RE: PLAN NUMBER G96-40475 FEE RECEIVED: 160.00 COURTNEY PIMS 2609 HWY S TOWN OF EMERALD COUNTY OF ST CROIX The plans and specifications for this project have been reviewed by the Section of General Plumbing for compliance with the applicable plumbing code requirements. The plans have been stamped "CONDITIONALLY APPROVED." This approval is based on Wisconsin Statutes and the Wisconsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. All noted items are required to be corrected. All items required by the city, village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation is required to keep one set of plans with the department's stamp of approval at the construction site. When inspections can be made, the installer shall notify the appropriate inspector. This approval will expire two years from the approval date. If construction has not commenced prior to the expiration date, new plan approval must be obtained. This approval is for the following: The installation of the -44:J,»+A wa+Ar M^ - 4- p1UUgT ih1ZC`Ry~ Y-1 f"o rJ Sew e1Z - This approval does not include the private sewage system. Plans for the private sewage system are required to be submitted and approved before beginning construction on this project. Inquiries should be directed to me at the number listed below. Please refer to the plan number shown above. Sincere y, Donald Oremus Plan Reviewer Section of General Plumbing, Fire Sprinkler and Licensing (608) 526-4944 sd13A-7W7,J,,")KEN PERTZBORN Bowman Plumbing, Inc. Page 37f 3 n Master Plumber No. 5875 2819 Knapp Street Menomonie, WI 54751 (715) 235-4634 FAX (715) 235-3650 Sou, MW SrrE EVAIAATION IWOW Peter Cour ney NW,NE,1,3 16W Emerald t ship St. Croix ounty o a ~ U ri 'D loretta arrabee CSTM 3719 s u O U] 'O I S1 4-1 - / o 6 Q~ . Z4 1 a y v 1 T .3 6~j 0 L e Page Y. t)f -7 Approved Synthetic Covering lprs-rm C- 33 Distribution Pipe Medium Sand G Topsoil F Elev. L p . S -J 1 3 E _ p . b S % Slope Bed Of 2"- 2 %2 Force Moin Plowed Aggregate From Pump Layer D 1, S Ft. Cross Section Of A Mound System Using E k'9 Ft' A Bed For The Absorption Area F O.8 Ft. G 1.l3 Ft. A 8 Ft. H I- S Ft. Linear Loading Rate=q•4 GPD/LN FT B SS Ft. Design Loading Rate= a.y GPD/SQ FT j Ft. J °I Ft. K iZ Ft. L 9 Ft. W 3 3 Ft. L j ~l Observa ion Pipe 01 r-------------------- - A I - - - I~---- ---------------------~I W o j---- Force Main Distribution Bed Of 2~- 2 %N z Pipe Aggregate I Observation Pipe Permanent Markers (Anchor securely) Plan View Of Mound Using A Bed For The Absorption Area Page -s Of 7 Perforated Pipe Detail 0 End View Perforated End Cop. PVC Pipe 1 °e~O Install permanent marker at end of each lateral Holes Located On Bottom, Are Equally Spaced Q S PVC Force Main Q PVC Manifold Pipe Distrr ution PiQe Last Hole Should. Be iI Next To End Cap End Cap P Z S. S Ft . Distribution Pipe Layout S 14 Ft. X Z~ Inches Y Inches Hole Diameter lly Inch Lateral 1 icy Inch(es) Manifold Z Inches ` Force Main." Z Inches # of holes/pi pe_ Invert Elevation of Laterals 101..0 Ft. Place lst hole l8 from center of manifold with succeeding holes y at 3~ intervals. Last hole to be next to the end cap. ' _PUMP CHAMBER CROSS SECTIOM AND SPECIFICAT16.MS PAGE (o OF -7 VCWT CAP y"C.L VENT PIPC Tr - T WEATHER PROOF APPROVED LOCKING MANHOLE 2 10' FROM DOOR. JUNCTIOW BOX COVER WITH WARNING LABEL WINDOW OR FRESH I2~AlIt1• AIR UJTAKE i GRADE I Ie•Mlu. CoIJDUtT !8"MlAI. _ 1MLET PROVIDE T AIRTIGHT SEAL, I III ` ' I 11 V APPROVED JOINT A Tank construction shall comply I 11 APPROVED JOI►1TS with ILHR 83.15 and ILHR 83.20 1 11 I I I ALARM a i 11 Ou --CLEU 82.On FT PUMP ~ OFF 0 CONCRETE BLOCK RISER EXIT PERMI-WED 0WLy=:IF.TAWK MAIJUFACTURER HAS SUCH APPROVAL 3"APPROVED ScODINQ SPEC-IF ICATIOAIS DOSE M-I I Dt~1es~2~J P ar TA M Ks MAIJUFACTURCR. • - T IJUMBER OF DOSES: S-0 PER D" TANK SlZL : ~2-t (3 GALLONS DOSE VOLUME t ALARM MA1114FA_CTU.R!~R: S'S S~IS`1LT}1S IWCLUDING OACKFLOW: ~Og GALLONS MODEL I.IUMBER: \O~ ~A iN - ) - CAPACITIES: A. WCNCS OR GALLONS SWITCH TYPE: INCHES OR S Z 4LLOL15 PUMP MANUFACTURER: ZQ ~A • C= INCHES OR. Oa GALLOWS MODEL LIUMSER: 16-2 Doc-\,z 3\ Z INCHES OR GALL01►IS SWITCH TYPE: C..CJ)001. IJOTE: PUMP AND ALAR LE TO DE MIWIMUM DISCHARGE RATE 4Z-<Z GPM INSTALLED ON 5EPARATE CIRCUITS VERTICAL DIFFERENCE OETWEEm PUMP OFF AUO_DISTRIBUTIOM PIPE., Z.O'Op FEET f MIMIMLIM NETWORK SUPPLY PRESSURE . 2.50 FEET f Z FEET OF FORCE MAIN X 3' F in Fr.FKICTIOU FACTOR. FEET TOTAL DyUAMIC HEAD = IOX7-FEET DIAMETER q INTERWAL DIMEIJSIOWe OF TAWK: LELICYTH ;WIDTH LIQUID DEPTH 3a~ 11? BOTTOM AREA - - 231= GAL/INCH AS PER MANUFACTURER = . Z6: © GAL/INCH - - ~ -7 DF - ' Y HEAD CAPACITY CURVE TOTAL DYNAMIC HEADIFLOW PER MINUTE U 161,163 AND 165 SERIES SERIES 151 163 165 Ff. M. Gal Ltr. Gal Ltr Gal Ltr 5 1.52 106 401 61 231 61 231 28 g0 10 3.05 100 378 61 231 61 231 15 4.57 91 344 60 227 60 227 80 20 6.10 82 310 59 223 60 227 24 25 7.62 74 280 57 216 59 223 p 165 30 9.14 65 246 55 206 58 220 70 40 12.19 46 174 46 172 55 206 = 20 163 50 1524 21 80 33 125 51 191 60 7 __0__1lL2L 15 43 161 f 70 21.34 30 114 16 50 80 24.38 14 53 p 90 27.43 100 3°.48 r 12 40 LOCK VALVE 56' 66' 87' O 30 30,17 8 20 %i;~ 'I 4 10 212 161 4 7/32- 8 3/4 0 Is, I . I ` I U.S. GALLONS 10 20 30 40 50 60 70 80 g0 100 110 LITERS 0 80 160 240 320 400 4 7/32 FLOW PER MINUTE 1 6 11/32 Standard all models - Weight 77 His. - 20 cord - ih H.P. 161 MODELS Control Selection Listings 1 Model Volts-Ph Mode Amps Simplex Duplex CSA UL 1 112" -11 1/2 NPT M161 115 1 Auto 155 1 or l &9 y y I 2" - 1 1 1/2 NPT (OR) N161 115 1 Non 15.5 2 Or 2& 8 3 or 5& 6 Y Y 3" - 8 NPT 6161 230 1 Auto 7.0 --1-or 1& 9 y y I E161 230 1 Non 7.0 2or2&8 3or5&6 Y Y F161 230 3 Non 4.0 2&4 3& 4 or 5& 6 Y Y I ' H161 200-208 1 Auto 82 1&9 Y N ` 1161 200-208 1 Non 8.2 2&8 3 or 5& 6 Y N I J161 200-208 3 Non 5.2 2&4 3& 4 or 5& 6 Y Y G161 460 3 Non 2.0 2&4 3&4or5&6 Y Y 18 9/16 1 Standard all models - Weight 77 His. - 201t. card - % H.P. 163 MODELS Control Selection Listings Model Volls-Ph Mode Amps Simplex Duplex CSA UL M163 115 1 Auto 14.0 --Tor 1& 9 y y I 6 N163 115 1 Non 14.0 2or2&8 3or5&6 Y Y D163 230 1 Auto 7.0 1 or 1& 9 Y Y E163 230 1 on 7.0 2or2&8 3or5&6 Y Y F163 230 3 Non 4.0 2&4 3&4or5&6 Y Y H163 200-208 1 Auto 8.2 1& 9 Y N ' 1163 200-208 1 Non 8.2 2&8 3 or 5 & 6 Y N SELECTION GUIDE J163 200-208 3 Non 5.2 2 & 4 3 & 4 or -5& 6 Y Y 1. integral float operated mechanical switch, no external control required. ' G1 33 460 3 Non 2.0 2 & 4 3 & 4 or _5& 6 Y Y 20 Single piggyback mercury float switch or double piggyback mercury, float switch. Refer to FM0477. Standard all models - Weight 77 His. - 20 lt. cord -1 H.P. 3. Mechanical alternator "M-Pak" 10-0072 or 10-0075. 165 MODELS Control Selection listings 4. Com4ination starter. Refer to FM0514. Model volts-Ph Made Amps Simplex Duplex CSA UL 5. See FM0712, for correct model of Electrical Alternator, "E-Pak". D165 230 1 Auto 9.8 1 art & 9 y y 6. Mercury sensor float switch 10-0225 used as a control acgvator, with "E-Pak" E165 230 1 Non 9.6 2 or 2& 8 3 or 5& 6 y y alternator, 3 or 4 float system. F165 230 3 Non 6.6 2&4 3 & 4 or 5 & 6 Y y 7. SIMPLEX CONTROL BOX 10-0050,115230V,1 Ph.lnax. 2HP use one(i) single piggyback wide angle mercury fabat switch OR two (2) 10-0225 mercury sensor 'H165 200-208 1 Auto 10.7 1&9 y N floats for level control. '1165 200-208 1 Non 10.7 2& 8 3 or 5 & 6 Y N 8. Four (4) hole "J-Pak", junction box, for watertight connection or wired-in simplex 'J165 200-208 3 Non 7.0 2 & 4 3 & 4 or 5 & 6 y y or duplex operation. ' G165 460 3 Non 3.3 2 & 4 3 & 4 or 5 & 6 y NN g Two (2) hole "J-Pak", Junction box, for watertight connection or sprlce. BA165 575 3 Non 3.0 2&4 3 & 4 or 5 & 6 Y 'No Molded Plug CAUTION ForinfomntiononadditionalZoeikrproductsrefertoatatoponCombination Starter, FMD514; A"Installation alcoalmis, protection dedassadwidngshould redonebyaqualified licensed NWAa&V&cMSwkd=.FW477;EktrialAltemator,FM0486;MechankxlAhemator,FM0495; electrician. All electrical mad safety codes should he followed Including the most react Alarm Padage, FM0513; Sump/Sewage Basins, Fid0487; and Simplex Control Box, FM0732. National Electric Code (NEC) and the Occupational Salellr and "ant Ad (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. k Bowman Plumbing, Inc. Page 3 of 3 j7 Master Plumber No. 5875 2819 Knapp Street Menomonie, WI 54751 (715) 235-4634 FAX (715) 235-3650 SOIL AND SITE EVAURTION REPORT Peter Cour ney NW,NE,1,3 16W Emerald t ship St. Croixk ounty m U / Loretta arrabee CSTM 3719 „91 x ~ U ky S M 4-) U J o 0 R 4-1 0 _4 `4! S4 0 -I r-I ~4 Q) c~ v o 54 cJ~ d59 ~ - ter.-- ~ w ~f ~9 a CZ4 .v tlo~ I u dY ~°1 l1 G 1 SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations August. 5, 1996 2226 Rose Strt~ v I La Crosse WA 3 , WEGERER SOIL TESTING 421 N MAIN STREET PO BOX 74 r RIVER FALLS WI 54022 RE: PLAN S96-40949 FEE RECEIVED: 360.00 COURTNEY, PETER NW,NW,1,30,16W TOWN OF EMERALD 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 beep 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, s- G yard M. im Plan Reviewer Section of Private Sewage (608) 785-9348 SUDA-7897 (R. 18M) 4 MOUND SYSTEM Page I of • FOR ij,~ ki-tt" Wt,~ -F4_0 MD K_) S96-40949 Irv N Ck Tu@ wwQ wll 9-1fpwYe' LOCATED IN THE N W 1/4 OF THE N W 1/4 OF SECTION \ , T 3p N, R 16 W, TOWN OF S r. c-~wty COUNTY, WISCONSIN . INDEX RECEIVED PAGE 1 of 7 TITLE SHEET PAGE 2 of 7 PROJECT DATA AUG - 5 1996 PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 FLAN VIEW-CROSS SECTION SAFETY i ELMS, DIV. PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 DOSE CHAMBER PAGE 7 of 7 PUMP PERFORMANCE CURVE PREPARED FOR boo p D ~RTR e-~~tc, R~~-D j►-~r~~ck ~L.r~N, "N s s3s9 PFtdV ATE ,WAGE SYSTEM conditionally ~D PREPARED BY ArpRom mum pp 1l~a~ • S Q= 1- T E S T I N G; d~~ AND se c c 1 t~v a IA '6y NpENCE SlEFtV I CE ESPO & r = t ARTHUR L. S F.O. BIIT 74 421 N. KAIH ST_ _ WEGERER { RIVE. FALLS. WI 54022 $ o-s,,P tiVJRTH, ~ i wrs. ' 715-425-OId5 ~ ~SIG~ 8 -Z-4 ~o JOB NO. 6-127 PROJECT DATA Page Z- of This mound system will serve a 3 bedroom home and a cattle barn with 1 employee and a floor drain. WASTEWATER 3 bedrooms X 150 gpd=--------- 450 gpd 1 employee X 20 gpd=--------- 20 gpd 1 floor drain X 50 gpd=------- 50 gpd TOTAL = ---------520 gpd A 1200 gallon Midwestern Precast septic tank will be installed with a 1000 gallon Midwestern Precast pump chamber. r - Wisconsin DeparUnent of Industry, SOIL AND SITE EVALUATION REPORT Page \ Labor and Human Relations-~ 3 Divisi&n of safet7 & Buildings. in accord with ILHR 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 ST~ C' 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. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION L3~r~ Cpv Z~ 1`l~i ( LGT--, NW 1/4 N w 1/4,s 1 T 3 p N,R E e ff. PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # CITY, STATE ZIP CODE PHONE NUMBER ~CfTY EIVILLAGE (MOWN NEAREST ROAD l 1 ?t-t0Aj M V ss3 s~ (61Z) 4-j?- 44ZV3 New Construction Use [ J~ Residential / Number of bedrooms 3 [ ] AddifiQrt to existing building P4 Replacement 14 Public or commercial describe "~PMtZ p O l„I 4` wog ~ l~ A irv 1/v ~-l`7L ~~r2?~ Code derived daily flow S ZO gpd Recommended design loading rate y bed, gp(W - trench, gpdV Absorption area required 3 y bed, ft2 _143 y trench, ft2 hWmum design loading rate • S tied, gpd/ t2 • b try, gpd 2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark Additional design/ site considerations MUuup W /8'x Ss 'm . Mlu . L$"OP S)'P.D F U. ~s 1JD` orb s+r Z~ Parent material s I L j ova %I -nLit. Flood plain elevation, if applicable It S =Suitable for system CONVEI'MONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable for stem ❑ S 1011 0S U U ❑ S [R U [IS ®U O S MU [IS 9U SOIL DESCRIPTION REPORT Boring # [Horizon Depth Dominant Color Mottles Texture Structure GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Consistence Bax>~ry Roots Bed Trerxh 0-9 V%13 1-t tZ- 3 t ~ - s 1 ( 2'F~~k v~1~ as - , s . b v_.,.~: Z R-z3 log I"_ 3!(- - S - s~ l z. ~ k h1 e>^ c w • s L Ground 3 F23_V8 S `i R_ V/~ G Ll s 3 elev. 1D1.0 fL 14 SftNjb Depth iD 0)"i hl S Pr L4 r h S`TUty e limiting factor S1 - )v Z SlC Remarks: Boring # t) \D_ ynj ou [111 Z ~2 ZJ t~`11Z~16 - S 1~ z h~ S b1T 4n C w - • S Ground 3 Z -3-7 S) 1 Y+i 3 \'z5k 'M U Q 4- C S - 04 , S elev. 'F L k y SK tz S) B cs -(;O l • S `1 Iz.3l _i_-1 SZS !g Depth ID S So y cU `-t R r, ~3 S I O*-, rh limiting factor y i Remarks: CST lwe:-Please Print Phone: Arthur L. We erer 715-425-0165 j eg rer Soil Testing & Design-Service-P.O. Box 74 River Falls,WI 54022 _ S~nature: - - ; _ Date: CST:Number:_._ PROPERTYOWNER CU~2r1V~Y SOIL DESCRIPTION REPORT + -?age •of ' # PARCEL IA De th Dominant Color Mottles Structure GPD/ft Boring # Horizon F Texture Consistence. Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench x in, n" Llx~u Ground "B L~ • B CS1'l-1 3~ Lq \Z elev. ft. C- Depth to w S SZ v ` E--~M T .PF limiting ` 1 factor \j- ~P~R / S P1ze~ ET?- L (3 011 !lam Remarks: 4.3 Boring # l~ o~ ~c`f~oU 1 ~°r l OF - i )Q 1~v 1 S 1 rU C U W FY-1 L -fit O>"1 N O F - b>= Ground C v. ► h i L~'' T op 2 6 C~ sT. elev. S t y~ \ ft. Depth to j limiting factor Remarks: Boring # w• ~ „ Ground elev. ft. Depth to limiting factor Remarks: i Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05M) Y1Gsconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of 3 Labor aril Humaft RelaSons . Division of Safety & Buildngs in accord with ILHR 83.05, Wis. Adm. Code FREVIEWED - C_"'k Attach complete site pla n on paper not less than.81/2 x 11 inches in size. Plan must include, tut not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or dimensioned, north arrow, and location and distance to nearest road. DATE APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION FPROPEMY OWNER: PROPERTY LOCATION C.l~u ~1~ ~ltn~ 1/4 N W 1/4,S \ T O N,R E OWNER':S MAILING ADDRESS LOT 9 BLOCKS SUBD. NAME OR CSM # p D C- ~1'CU ' CITY, STATE ZIP CODE PHONE NUMBER E]CITY E]VILLAGE (MOWN NEAREST ROAD S r~ l.E ~1 f~1/v wJ/v SS3 . (61Z} [ } New Construction Use 1,4 Residential 1 Number of bedrooms 3 [ ) Addikn to e)dsfing building P4 Replacement [X} Public or commercial describe "R?MJ' M 0 m 4` ~a2 ~l IN CA1`~ Code derived dally flow C_ Z13 gpd Recommended design loading rate y bed, gpolftl - trench, gWP Absorption area required LLy bed, ft2 43 V trench, ft2 Maximum design loading rate 5 bed, gpd/ft2 ' b trends, g0djft2 Recommended infiltration surface elevation(s) 1 It (as referred to site plan benchmark) Additional design /site considerations 1 AVJ ~ w `x SS 'M . M J>u . L$ `OF SrM Ftu <Sfr~it-_ om Est Z Parent material s Lt_T~f ov~i, S'l -n u- Flood plain elevation, if applicable N - f~ - ft S =Suitable for System CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM NJ FlLL. HOLD SWG TANK U= Unsuitable for stem O S 10 U ® S 0 U [IS (RU D S ®U ❑ S OU D f 1 U SOIL DESCRIPTION REPORT Boring # Depth Dominant Color Mottles Texture Structure Consistence Ea>ridary RootT rzon in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Ground Z3-V8 S COW) XR, 0-9 vo'-m- 31 !N ,•S `ttz lo`i2 6[3 elev. l Ol • 0 tL `tY lG l~F Depth to 3 cohi nI S A u y Im S` T-0" limiting factor St 1 - N Z Stc Remarks: Boring# 1 - s I L 3 Zm sdk vv_fi o_1Z b0"lR- ,4 s Ground L s't ti S) $ elev. S) C>\" rti F1- sc S y 37-SO , s ? iZ 31 S Su-60 3'-f I1..31 V fie, co `i R t. !3 S ~ o~ m ~ 1 Depth in limiting factor y Remarks: CST Iwe:-Please Print Phone' 715-425-0165 Arthur L. We erer { eg re.r Soil Testing & Design-Service-P.O. Box 74 River Falls,WI.54022 CST Number in= Date. PROPERTYOWNER C-Uy2~'h SOIL DESCRIPTION REPORT PARCEL I,D, Page of Boring # Horizon Depth Dominant Color Mottles Structure In. Munsell Texture Consistence, GP.D/ft. Qu. Sz. Cont. Color [Gr. Sz. Sh. JB,~j Roots Bed 7h elev,nd LO F~• 2 $ cs1'M 37t9 ~Z b ►.J ft. Depth to " limiting S V I factor ` L 1N~ T iDF 1 ~ Lu p jlv Remarks: Boring # ~j E,3 IS )rvCZ Ground 1J v i~., p F~~ 1^ elev. S 14 Depth to limiting factor i i Remarks: Boring # i nmi ~ Ground I elev. Depth to limiting factor L Remarks: Boring # Ground elev, ft. Depth to limiting factor Remarks: SBD-8330(R.OS/02) wlsctyTin Department of Industry, SOIL AND SITE EVALUATION Labor and Human Relations , Page of - Division of Sefpty asrd Buildingc4 in accorda 83.09, Wis. Attach complete site plan on paper not less than 81/2 x 11 i ze. P must ;y County Include, but not limited to: vertical and horizontal reference b a .-S'~ - GnO% ' percent slope, scale or dimensions, north arrow, and location ista road. arcel I.D. # APPLICANT INFORMATION - Please print all atAn.~ D1' eviewed by Date Personal information you provide may be used for aeoondary purposes Law, a Property Owner dy \R ~s ftf o 'L /A/ 1/4 A/E1/4,S 1 T 3C,,N,R /6 4 (ore fop Property Owner's Mailing Address lock# Subd. Name or CSM# cx~ 1~ n n fi A! /9 . O. AI. 0 City State Zip Code Phone Number 1 ❑ Ci Nearest Road 5 s 3 ((ai 3 ) y7Z y f ❑ Village ® /9 oIci wn C/ 411. _r ❑ New Construction Use: ® Residential / Number of bedrooms L3 Addition to existing building A/,4 . ® Replacement SPubilur commercial - Describe: 6ML /Ln cti t Er, G f? J-41 aj,M( 20' 7 Code derived daily flow -5/~d lake- a gpdsj= ~ • ecommended design loading rate bed, gpd/ft2 ~ S trench, gpd/tt2 Absorption area required _,LY__tL,_bed, ft2 trench, ft2,4-- Maximum design loading rate bed, gpdtfF L 6 trench, gpd/ft2 i Recommended infiltration surface elevation(s) „4s. ft (as referr o site plan benchmark) Aztditional desigNsite considerations 9 7 3 ` U' C Parent material l" Flood plain elevation, i applicable n/A - it S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system ❑ S ® U us ❑ U ❑ S Elu ❑ S ®U ❑ s BU ❑ s o u SOIL DESCRIPTION REPORT d3 - 6 Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft2 in. Munsell Ou. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench ....3 6 -16 Ye '16 s ; r r- s 1 . CD- S Ground 1 1.5 6 elev. S - Sill/ 26k r C-15 ; Depth to 5 , '4 Kati C- ti 's rn r t f - A; ; (v , P limiting s' ! factor Remarks: A) Al, F' Boring # /r-j 4L6k !nr (J j (45:6' 6 P-aa 7 5, l%l 375r - % f ".k r Ground 3 a- i7 .S P'/~ 75- %^s/ q / ,,~bk N.P P elev. 9L_~l tt. c, --j/ :2 7_5 YiOA -314 i 7 S P Depth to limiting factor 'U ' ~o in. Remarks: '2'U_45' CST Name (Please Print) Signature Telephone No. BB~~~~ es3 (715)235 =4~3 Ms, loretta A. larrabee Address Business: ` Date CST Number Bowman Plumbing Inc., 2819 Knapp Menomonie, wT 54751 A i /9 CSTM 3719 SOIL DESCRIPTION REPORT "2 1. 3 -,of PROPERTY OWNER / t r t<r r7y PARCEL I.D.ir EDA Boring # Horizon Depth Dominant Cobra Texture Structure Consistence Boundary Roots In. Munaieil.... Ou. Sz. Cont. Color Gr. Sz Sh Bad 'i Trendt /O k m-, cS S C) vg M. CL~ kU Ground Cob w; Depth to N P ; Nmiting 7 j s/ ~Cy .S imC a b k n r: Aj P. factor itn. I I - I /.L~►n Remarks: >u° , ~u`• Boring # Ground elev. Depth to Wdrig F-T factor in. Remarks: Horizon Depot Do'ninant Color Mottles Texture Structure Consistence Boundary Roots GEWO , In. Munsell Du. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # Ground elev. Depth to limiting fac6ns Remarks: Boring # Ground elev. n. Depth tc limiting factor in. Remarks: SBDW-8330 (R. 08/95) 1 Bowman Plumbing, Inc. \P` 3 of 3 ~f Master Plumber No. 5875 2819 Knapp Street Menomonie, WI 54751 (715) 235-4634 FAX (715) 235-3650 SOIL AM SITE EVM-MTION REPORT Peter Cour ney NW,NE,1,3 16W 'S Emerald t ship oSt. Croik unty o U b ~ U Z_ O ~4 loretta arrabee CSTM 3719 Zz A, < zs a O ?UC i~ ° Mr. o o ° 41 131 c~ '9 6 'Y, FROM EFTu o. 8-1996 12:51 F . 1 oe ~~tx A a -'AG. 1006 FROM: OOr~00+~ ].+~']U 1+`• 0 71GOO0700C, I UD4V'T1 I I DAC STC-105 SepTic TAw MAINTENANCE AGREEMMUT St. Crok County OWNERBUYER r c~ ~C y eo,(4,r rV 6 !:J MAIIMG ADDRESS e. OV✓ 6!/~ PROPERTY ADDRESS AlP0, t ?..0 &Z (location of septic system) Please obtain from the Planning Dept. CTI'Y/BTATE PROPERTY LOCATION 1/4,1/4, Sectloe TOWN OF - L21.6 (a / i- ST. CROIX COUNTY, WI SUBDIVISION ~V : LOT NU1BER CERTIMBURVEYMAF VOLUM PAGE LOT NU1VlBER~ Improper use and maintenance of your sepdo system could result in its premature failure to handle wastes. Proper maintenance consim of pumping out the septic tank every throe 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 * maximum of W% of the cost of replacement of a fbiling 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 now systems agree to keep their system properly maintained, The property owner agrees to submit to St. Croix Zoning a certification form, siSnad by the owner end 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 acoordanoe with the atandeAs set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be comp ed and returned to the St. Croix County Zoning Officer within 30 days of the three year i on Slam: PATE:, gt. Croix County Zrotiing Office aovernmont Center 1101 Carmichael Road Hudson, WI 54016 11/93 F R 0 N EFTO QU/05 1j^i; 46 109R FROM, + F. eel99/i99G' 1 ~:3fS 7153967996 HUDWORTH HOM S PAL*- ns a 10- 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 asoond form should be retained and completed when the property is $old and submitted to this office with the appropriate deed recording. .----r-r dWnez of property , 6re,q~ (vt IT+~C Location of property section T„~_N•-R_Za--- w Townahip ,e` Iev2Ld Mailing address .Z02 60 k-P Address of a it* C r- 9 l Il - f ~ Ali • , subdivision name Lot nV. Other h0lses on property? Previous owner of property Total size of property Total amts of parcel, SO Date parcel was created Are all corners and lot lines identifiable? _~~Yes _ No IS this property being developed for (ssp0c house)? , Yes ~No volume 1& ~ and Page Number a -17' as recorded with the Register of Deeds. ,y-er r.-y--r--------r------rte-r Yl * --.te r --r- ------ti-r --r~r ZYCLGDE WITZ Waza AVILICAT,ZON Tu FOLLOrxma s A WARRMTY DEED which includes a DOCUMENT N MBER, VOLUME AND PAGE NUMBER AND THE SEAL or THE REGISTER OF 08908. In addition, a certified survey, if available, would be helpful so as to avoid delays or the reviewing process. If the dyed description references to a Certified Survey Nap, the certified Survey Map shall also ne required. PIkOPSATY OWNA c81tTIVICATION I (we) Certify that all statsmente on this Corm 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. 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. s gnature o pp ent Co-Apps cant !~f Date of s gnature Date of 5 gnature • ► _ "CCU!.4rniT NO ` WARRANTY DEED 5404-553- tiTATE £AR OF 'V e c .co a ve V- v: F ~ f jC Lorraine Webster, single person ins Webster, a single Person ' T -y I l cuate); and tc,;rranto _',?ter Cr+ :00 Courtney,.husband and ,ice i r the follov'ic ; described real estate in State of Wisconsin: t- -Cr0.1 Y.. Tax Parcel No: Government Lot 2 and all t North me the hat part of ,r-:_r-_'-ent Lois 3, g and 9 lying present railroad right of w a-., -o 'T'ownship Thirty North (T30>:), Ran e S _ = ction One ( ) County, Wisconsin. 9 ixt_e est (R1hPi), ct Croix Government Lot Ten of Section One (10) -.nd all that p3rt -3. e (1), Township - rngt Lots 3, and y (R16W), St. Croix Count hirty Nor_- Range Sixteen `nest of the railroad right of,way~consin lyin.y S yt=^.erly of the Right ,f ivav West Half (W%) of z Government Lot 1 and aL: all in Section One (1), Township T Ra Lots 5 and 8, (R?6W), St. Croix Count hirty ',730N), ?an e g sixteen y, Wisconsin. T 6"UNSF-ER S D _ This homestead pro FEE (is) (is not) perty. Exception to warranties: Easements and rest -4 _ions of record. t L;Atcd this - _ day of 95 - -(SEAL)_ Webster _ (SEAL;) AUTHENTICATION ACKNOWLEDGMENT Signature(s) - - . STATE CF ISCC~NSIN .i ss. authenticated this - -.t - County. day of--- 19-- i'Y->l'-:, c came before we this - - - - - - 99E... 'fie above named • Lorrsi-_ i•Iebster . TITLE: MEMBER STATE BAR OF WISCONSIN - not. authorized b Stats.) to n k r _ -.r-. -e ttic p r on nF.o executed the THIS INSTRUMENT WAS DRAFTED BY •OI'e}._, i-Tv an(Y :1Ck POt jOKV fir Thomas A. McCormack LAPISM --•o - Notary Z H ~~~Ie11yp W r~ t ~ p W Na p r 0 z ~a -9 z o H ' c j4q 0 rc r , U ~ t •r la" ai 2 + VV-- rt a \r 2 0 s 01 LL _ m 3 o ~ z M ~ a ~ ~ d N b N O 0 N • N O J - 4J o o N N a~ o r' N O 'o' 3 d-) ~ b- b ,r o 0 H 4 N • r1 a °1 r ~ N 0 N I ~ ~ ly ~ O y -P 3r ~ ~ _a 9 Q' + ''a o 02 cn~ l H J7G ri N ' V url c° m o ~ i o /t j Y► j 2 M n Qd a a- Q r 0 2 o1 a rl M o~ r d y a D ~ r r ~ ~a o _o 20 v! d o 4 r~ M