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HomeMy WebLinkAbout012-1049-00-000 Q c Q) O a p °603, N y N ~ O 0 C h O O N N o o m v y N H (0 ~ C U S ' a) C a z - CL C O w li c 3 O N O C Q O 3 I 3 co Z N E O z d m co LU CL m N F- U 0 v o z :!t y o CD 2 d c Z w E ' ~ M I aQ II ' ~ I C c i O q z z o I E N z o v N O. m w Y C LO 'O W N O f0 O U C C C a 11 E N cu E E U) U) U _I - o v Z o •N 3aaa CL a) to U rn rn } u) CD L O O E N ° m EL' rn 'd U> N a) MOi y Q m O 7 U) U) o o Ali co y c a C E N O O CO O N H O N C N d 0 0 r M N ~ N E f: O N N 11 Q~ V 4~ .cam C C I~ O C O n- C N "O F- Q) ^I N M C 7 O y O E U • O N W N O Z N Z (A CC 3 a a L' • Q @ .U N w C 1 A C) Gam. r2 0 co U Wiiiscot sin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of Labor and Human Relations j. Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan m i e, but T c l x not limited to vertical and horizontal reference point (BM), direction and % of sb a or PA # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION r,F, REVI DATE vii n PROPERTY OWNER: P TY LOCH jONE` ONP~I~IJ GUrvf`JE:'S S S~fsrir 1/4,S,~ 30 N,R 1`1 E(or)® PROPERTY OWNER':S MAILING ADDRESS LO (ttNA M # CITY, STATE ZIP CODE PHONE NUMBER Q NEAREST ROAD ST-~1'NL~ `F'tIV SSI~Z (blZ) ZZ..~_$~l3S ~ New Construction Use [4 Residential / Number of bedrooms 3 [ J AddifiT to existing building j) Replacement [ J Public or commercial describe Code derived daily flow gSZi gpd Recommended design loading rate - bed, gpd/ft2 0 - 3 trench, gpdflt2 Absorption area required 3`ZS bed, 112 3-1 S trench, 11:2 Maximum-design loading rate o •\\l bed, gpdAt2 -__S trench, gpolit2 Recommended infiltration surface eievation(s) • © It (as referred to site plan benchmark) Additional design / site considerations 'F')WK),z) w / s 'x- -)s' `T1Z cll . t-~►/v, ` G IF S1PojD R Lt-. Parent material s 1 Lt4 S MjMevT ov(M 'TtLL Flood plain elevation, if applicable N• A It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem El S ®U RIS ❑ U ❑ S o u ❑ S ®U 11 S [OU ❑ S ® U SOIL DESCRIPTION REPORT # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft Boring ..:h;;>: in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. _ Ided ranch 3PRI Z 8-fib ~•o~R- 316 - S' ~ - - - ~ Consistence 3 16 =tlJ 1 • S y R.. Y/ S C'- elev. Nm.b ft. z.o 3u 7- S LiR V)6 S _ - _ _ Depth to ►~w - S BofiuN v G w t ~U c_ ` limiting fac S 3Oh 12_~l/ vS~ !77 C-t ~Ut.iPti~ GU " Z8-9' e ~V ! Remarks: _ Boring # SCR U e "Ov M U S M'i ov L✓ Ut L Z - v 1S'CuSZB L~ Sol f Ground elev. 1 n S R It R C' C-y S 'm f'vA'tS Ta Depth to limiting j factor r Remarks: TName:-Please Print Arthur L. We erer Phone. 715-425-0165 egerer Soil esting & Design Service-P.O. Box 74 River Falls,WI 54022 Signature: S Date: S- Z pf CST Number: M00576 PLOT PLAN Page Z- of y ` SCALE 1"= L4p ' 1=-X vs T. -?oUg @LpG, pry- fit, ~lS-b2. orv CPS ~ Bo`i'1D1ti or ELF= '~vtL~)1uC SLOIIVG.\ C~ 1!7u 9 9 B i e ~ '6 o- ~L.IOO 6 o _ Q I 4 4•L998 za J ~ O Z/ 14, I mw b `nt y6 --?s (715 ) 425-0765 1400576 CST Signature Date Signed Telephone No. CST # Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of LalJor and Human Relations Division of Safety & Buildngs 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 - not limned to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. If dimensioned, north arrow, and location and Instance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION 01~1f'~ lJ CGUSV r`l es S GGkq. GPF SE 1/4 1/4,S 7-1 T 30 N,R 11 E (or)® PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUED. NAME OR CSM # t o 8-t ~.~s T RvF, - - CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE [MOWN NEAREST ROAD ST.P1'N~-~ Div SsI~Z (blZ) ZZ7-8~3SLfl 1~R1~12L` c`CZ}'~ ~-rr New Construction Use [~Q Residential / Number of bedrooms 3 [ J Addition to exiting twikling [ ] Replacement [ J Public or commercial describe Code derived daily flow qSo gpd Recommended designs loading rate - bed, gjxl* 0 - 3 trench, W*. Absorption area required 31S bed, ft2 3~ S trench, ft2 Mai imtxn"design loading rate o ~l bed, q - S trends, gpol(t2 Recommended infiltration surface elevation(s) N o\ . Q) It (as referred to site plan benchmark) Additional design / site considerations I-10►.)K;b W / S'k _)5' ` i NCN . A-~ ►n~. ` n 1= S` o_)1b R LL. Parent material s t Ltxi S m1mL%v*r ouL'"R- -TVLL Flood plain elevation, if appkable 1-J• A ft S = Suitable for System CONVENTIONAL MOUND W NMI) PRESSURE AT-GRADE SYSTEM IN FILL HOLDM TANK U= Unsuitable for stem EIS ®U US O U EIS O U ❑ S ®U [IS ®U 0S IOU SOIL DESCRIPTION REPORT i. Depth Dominant Color Mottles Structure GPD/ft t Boring # Horizon Texture Consistence Bounclary Roots- : Bed in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Trench Ground 3 l~ Zb • S `t tt y/ ~ S G elev. _ 1w-6 ft io 3D -7-S `?RV) _ S - - - - Deo to k30 S 1aQWAJ v G t ~U c_ limiting factor vsL S ~u PI~,1~ 6~ ? 8-9 4 -1;z)v b Remarks: Boring # 1F'-T-7-UQ 1" 10 MUST M oV L €1-O UL L IS' _ -N)) 0-1) Sol -9 LnM -13 Ground ~U ~J S L 1~ ' OF- ' I"1 A_,b . S (.it - t►7 t 4 elev. R TO 3 R- $ G. 5 81 NA"C:) 8 Depth to limiting factor Remarks: CST Name: Please Print Phone: Arthur L. We erer 715-425-0165 egerer Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022 S* adxe: Date: S _ Z. - pl I T Number: -mss C~ M00576 PLOT PLAN Page Z- of SCALE 1"= L~C ' sT-. pry - fit. aS-bZ orv CPr ?rr B oJTM t o f= Po 1--E `wvLsz~j1►V C 5101RX.~ 8.3 4L-~7// cl- 10 o a i mvj ~t 1 q 0 r~vE . _ -~1 r _ 96 --)S (715 ) 425-0169 1400576 CST Signature Date Signed Telephone No. CST # vnSCLAPb wupaiulwnt Ul 111UU6Uy, SUIL AIVU bi I t tVALUA 1 IUIV Htt:IJUH 1 rage 1 01 3 Labor abd Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY nclude, but St. Croix e. Plan must i Attach complete site plan on paper not less than 8 1/2 x 1OW not limited to vertical and horizontal reference point (Et (f slope, scale or PARCEL LD. # dimensioned, north arrow, and location and distance to n. 4 RE APPLICANT INFORMATION-PLEASE PR VIEWED BY DATE fYT ALL I ATIO PROPERTY OWNER: RTY LOCATION LOT SE 1/4 SE 1/4,S 21 T 30 N.R 17 xfG (or) W Donald R. Gunness PROPERTY OWNER':S MAILING ADDRESS BLOCK # SUED. NAME OR CSM # 1087 Pleasant Ave. n na na CITY, STATE ZIP CODE PHONE NUMB. ,,r\(sITY VILLAGE JUOWN NEAREST ROAD St. Paul, MN. 55102 (612) X27= 435„- Erin Prarie Rd AT [ New Construction Use [x] Residential I Number of ` ! 3 [ ] Addition to existing building J Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate • 4 bed, gpd/n2 •5 trench, gpd/fl2 Absorption area required 375 bed, n2 375 trench, 112 Maximum design loading rate • 4 bed, gpd/ft2 - 5 trench, gpdm2 Recommended infiltration surface elevation(s) 100.42 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material groun moraine Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable for system I❑ S 56 56 ❑ U ❑ S fR U ❑ S 3BU ❑ S ®U ❑ S O U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed tench :axc:•sxr:: haarsx't:xs:5: l 1 0-8 10 r3 2 none 1 2msbk mfr Cs 2f 5 .6 2 8-14 7.5yr4/4 none scl 2msbk mfr gw if .4 .5 Ground 3 14-31 5yr4/4 none sl lmsbk mfr gw na .4 .5 98,37' ft 4 31-56 2/5yr4/4 c p7.5yr5/8 sicl M na na na np .2 Depth to limiting factor 31" Remarks: Boring # w 1 0-8 10yr3/2 none 1 2msbk mfr cs 2f .5 '.6 OF - xAr A 2 8-16 7.5yr4/4 none scl 2msbk mfr gw if .4 €.5 & MEN 3 16-3 5yr4/4 none sl lmsbk mfr gw na .4 .5 Ground 4 32-68 2/5yr4/4 c2p elev. 7.5yr5/8 sicl M na na na n ' .2 99.82 ft. Depth to limiting factor 32" Remarks: CST Name:-Please Print Phone: Gary L. Steel 715-246-6200 1554 200th. Ave., Ne Richmond, WI. 54017 Signature:' Date: CST Number: 9-28-94 cstm 02298 PROPERTYOWNER Donald Gunness SOIL DESCRIPTION REPORT Page 2 f 3 PARCEL I.D. #r I GPD/ft g # Horizon Depth Dominant Color Mottles I Structure Consistence Boundary Roots eorin in. Munsell Ou. Sz. Cont. Color Texture Gr. Sz. Sh. Bed ITrerch 1 0-11 10yr3/2 none 1 2msbk mfr gw 2f .5 1.6 3 t...0`vj 2 11-20 7.5yr4/4 none scl 2msbk mfr 9w if .4 .5 Ground 3 20-36 7.5yr4/6 none sl lmbk mfr gw na .4 i .5 elev. c 2p 99.8x. 4 36-55 5yr4/4 7.5yr5/8 scl lmsbk mfr na na .2 .3 Depth to limiting factor 36" Remarks: Boring # Er: Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limitino_ factor Remarks: Boring # Ground elev. j ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel Donald Gunness 1554 200th Ave. CSTM2298 SE4SE4 S21-T30N-R17w New Richmond, WI 54017 M4PRSW 3254 town of Erin Prarie (715) 246-6200 I N 1"=40' BM.= top of govt. survey marker at se corner at el. 100' Z Flo 8.3 4 A.- s~ 2?, 40 6 as T4 a- 9 9 gg. Gary L. Steel 9-28-94 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER, ✓ /L r/ c 1~ rl e ADDRESSQ,~ SUBDIVISION / CSM# Z:f -5151 LOT # SECTION 5~1 / T Je N-R17 W, Town of .e ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET F SYSTEM je6e c, INDICATE NORTH ARROW i Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. r BENCHMARK: ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: Liquid Capacity: ZZ11 1 Setback from: We11/J,,r,a-- /EdHouse 1~21 Other Pump: Manufacturer -j'<-_ Model# Size Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM 5-7 Width: ` -Length Number of trenches Distance & Direction to nearest prop. line: Setback from: well: 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: " lC? -~2- INSPECTOR: T~ 3/93:jt Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX • Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 268691 ftiql' ;S Nbb%ALD CERt ❑ PIRAIRIEWn of: State Plan ID No.: CST BM Elev.: , Insp. BM lev.: , BM Description: N Parcel Tax No.: J~. TANK INFORMATION ELEVATION DATA A960C(394 ' TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic r~rc`~ Benchmark Dosing LA EHI ati on . 1411- Bldg. Sewer 3O ding St Inlet d,;/ TANK SETBACK INFORMATION St/ Outlet Q. c_t TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Cp P d Air Intake Septic > SD ' ~3 NA Dt Bottom Dosing 7 so NA H"Ox-l Man. Aeration NA Dist. Pipe 3d l f~'! Holding Bot. System o S (~z), 31 ~ PUMP/ Slf INFORMATION Final Grade Manufacturer e r s Demand °f S'T Gp' S 36' Model Number 3 aP TDH Liftq %pl Friction ~ System,2, TDH~(o,V t Loss Forcemain Length 2 - Dia. HDist. To Well 3 SOIL ABSORPTION SYSTEM BED/TRENCH Width 5 Length S ' No. Of Trenches PIT o. Of Pits Inside Dia. Liquid Depth DIMENSIONS 76- Dim N I N SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHI !an,er: ufactuSETBACK CHA BER INFORMATION Type O Mode Number: System: ~ l~/C• /lD OR UNIT DISTRIBUTION SYSTEM HQ&de'//M~ani of )/n( 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: ERIN PRAIRIE.21.30.17W, SE, SE, 140TH AVENUE CO. T° 0-Y S~ U 0 Plan revision required? ❑ Yes to Use other side for additional information. j 2A SBD-6710 (R 05/91) Date Inspector's Signature Cert No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: Safety and Buildings Division Bureau of Building Water Systems ~.■`r■■~ SANITARY PERMIT APPLICATION 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 e Croix than 8 112 x 11 inches in size. 5- . • See reverse side for instructions for completing this application State Sanitary Permit Number c:;~, 4g 691 The information you provide may be used by other government agency programs ❑ Check i( revision to previous application tPrivacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION Property Owner Name Property Location !F e ss Shni4 S E 1/4, S a~ T N, R 17 E (or)(V Property Owner's Mailing Address Lot Number Block Number Id 7 ea-,yea- w A 4) ~a- City, State Zip Code Number Subdivision Name or CSM Number Phon 11. TYPE OF BUILDING: (check one) ❑ State Owned ❑ City Nearest Road ❑ Village ❑ Public 1 or 2 Family Dwelling - No. of bedrooms _ Town OF , '1rr O o III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 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, gkNew 2. ❑ Replacement 3. ❑ Replacement of q. ❑ 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 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) /d Q Elevation l 5-6Q S"Dd GC. Feet 10-7. SFeet VII. TANK Ca in acit gallons Total # of Prefab. Site Fiber- Plastic Exper- INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass App. New Existing strutted Tanks Tanks r Septic Tank or Holding Tank ~Dl.S ,(d e T- ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber c o-S ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite se ge system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: o Stamps) P PRSW No.: 7~AJBusiness Phone Number: Plumber's Address (Street, City, State, Zip Lope): JJC 10V d or 1'1~' '60 7!7- IX. OUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issue suingAg nt Signature (No St s) Surcharge Fee) e4 \ 0 .,d Approved El Owner Given Initial~u ~a(!5)s Adverse Determination v /T DITI NS OF APFROVAL ASONS APpR L: Se SBD-6398 (R. 05/94) DISTRIBUTION: Original to Counly, 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 systern, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3815- To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. 11. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. _ VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations June 7, 1996 2226 Rose Street La Crosse WI 54603 WEGERER SOIL TESTING 421 N MAIN STREET PO BOX 74 RIVER FALLS WI 54022 RE: PLAN S96-40486 FEE RECEIVED: 180.00 GUNNESS, DONALD SE,SE,21,30,17W TOWN OF ERIN PRAIRIE 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. SincePM. 0 rSw i rb R~«rt~ Plan Reviewer Section of Private Sewage L 1996 (608) 785-9348 Sr SHDA -79971 K. I (M) f SAFETY & BUILDINGS DIVISION 1 State of Wisconsin Department of Industry, Labor and Human Relations June 7, 1996 2226 Rose Street La Crosse WI 54603 WEGERER SOIL TESTING 421 N MAIN STREET PO BOX 74 RIVER FALLS WI 54022 RE: PLAN S96-40486 FEE RECEIVED: 180.00 GUNNESS, DONALD SE,SE,21,30,17W TOWN OF ERIN PRAIRIE 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. 9 Sincerel rd M . Sw i Plan Reviewer Section of Private Sewage alt; (608) 785-9348` CC, 4 SUDA-7997 (K. 10/94) Page of b MOUND SYSTEM A BEDROOMRRESIDENCE S96-40486 LOCATED IN THE SF 1/4 OF THE ~ 1/4 OF SECTION Z 1 , T Q N, R 11 W, TOWN OF 7E- VtQ %-ZA 1 R I (-zz 3~ • GRc11 X COUNTY, WISCONSIN. INDEX PAGE 1"of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN -PAGE 3 of 6 PLAN VIEW-CROSS SECTION PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUMPING CHAMBER PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR RECEIVED -z0)'j)%fL.b R . JUN - 3 1996 sT'• 1't'rvt-, m NJ ss 113 SAFETY & BIDGS. Cf;~ PREPARED BY WEGEE~ER SQ I L TEST I NC #0 co AND . ~'`~✓'g, DES I G411 SIE=RV = CE g~}•'•. •t •~~GM : ARTHUR C, G ® _ FGERER YJ } F.U. BUI 74 421 K. KAIK ST. EISWORTN, RIVET FALLS. MI 54422 4715-4ir4165 -0 11ally col, ID, ~'~d~ ~sIG13 11©11 ~j gEih ®ii Ng11Rt1 c owCS at p►V1S1 ONti SEE GORE JOB NO. qG - S PLOT PLAN • Page Z of 6 Scale 1"= L-10' S96-40456 EX,Z.S T. -po l.g Bt,pG, , aS-~Z orv cry 8 o`Rpt-t o r ~ t-E ~vt~~y►vc S~oJr-,G ► I ~tS'oF z,t a~ C . ~I'luC o / J Z' 113A L72 (r too 6 r ~ r I r !1 c~99$ 28" a m %Y-1 - kn-tsI C)U I L T -1/i , y& . 1 NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. ( Z required) 3. Install 4" observation pipes with approved caps. ( z required) 4. Septic tank to be 1000 gallon capacity manufactured by "Oz, mil ? ~ A s i 'C~vr-11~ G Pc~-►~ 'N A~ r~ ~ 1J w L~~ 7' Sp ~ ~ 5. Bench Marks SQL' "ot, 3 6. Divert surface water around mound to prevent ponding at the uphill side. Page 3 Of Approved Synthetic Covering r~sTM c 33 Distribution Pipe Medium Sand -.rte H IG , Topsoil F Elev. VO\ • 13 1 E D - 3 , b Z % Slope . (Force Main Plowed Trench of h"-2k" From Pump Layer Aggregate Undisturbed D O Ft. Soil E 1 Ft. Cross Section Of A Mound System Using F o.8 Ft. Trench For The Absorption Area G N•n Ft. A S Ft. H I- S Ft. B 1S Ft. I 15 Ft. Linear Loading Rate= ~o GPD/LN FT J Ft. Design Loading Rate= 0.3 GPD/SQ FT K ID Ft. L q5 Ft. W Z$ Ft. L 77- Force B K - Main - A. - - - - - - - - - L~+RS h~ w w o~pusfR`. i ~?VD Distribution Trench Of 2 - 2 Pipe Aggregate l 1 Observation Permanent Markers Pipes (Anchor securely) Mound Using I Trench For Absorption Area Page Of Perforated Pipe Detail 0 End View )Perforated End Cop. ~\ey. PVC Pipe '10 Dote Install permanent-marker at end of each lateral Holes Located On Bottom, Are Equally Spaced Q End Cap * PVC Force Main i Distribution Pipe Lost Hole Should Be Next To End Gap Distribution Pipe Layout P 3M S Ft. X Inches Y 3 Inches Hole Diameter ley Inch Lateral V Inch(es) Manifold - Inches Force Main " Z Inches # of holes/pipe - Z-Invert Elevation of Lateralsl0\•S Ft. ~Zxl.l`1 ~ 1~•0~ K L_ 2.8.0$ Place lst hole l~Yfrom tee with succeeding holes at 2%` intervals., Last hole to be next to the end cap. ' PUMP CHAMBER CROSS SECTIOU AK1D SPECIFICATIOMS ' PAGE S OF VENT CAP '1°C.L VEKIT PIPC WEATHER PROOF APPROVED LOCKING MANHOLE JULICTIOIJ BOX ' COVER WITH WARNING LABEL 10' FROM DOOR. wimoOW OR FRESH 12'M111. AIR INTAKE I GRADE i COIJDUtT PROVIDE I IAILET r AIRTIGHT SEAL I III ~ APPROVED JOINT/ A Tank construction shall comply I ICI APPROVED JORITS with ILHR 83.15 and ILHR 83.20 i 'II ALARM I I OW c I I LLEV.-.~ FT. PUMP-~ --i ~ OFF D CONCRETE OLOCK 3" APPRQvCL RISER EXIT PERMITTED OWLI IF TANK MANUFACTURER HAS SUCH APPROVAL $Epplµ~ SPEGIFICATIOKJS 1~~LL DOSE J' 1 t Qi`Jt V1Q L~ yr NUMBER OF DOSES: 3' 3 PER DAU TAtJK MANUFACTU0.CR: TAWK SIZE: DSO GALLOWS DOSE VOLUME z ALARM MMJIIFAGTUR6R: s'S• ~`C~O S~S1 ~ S IWCLUDINCa OACKIFLOW: 6'O GALLONS MODEL NUMBER: 101 NW CAPACITIES: A= 16 INCHE5OR 31Z.'2 GALLONS SWITCH TSFE: r-Ika-~t_CUjt.Y B= Z INCHES OR 39'0 G(LLOU5 PUMP MANUFACTURER' tl4 ~ S G = a INCHE5 OR CALLOUS MODEL MUMBEIC 1'1(1-r 33 D- 1 1MCHES OR Z'~ 3$ GALLOKIS L'~ CRY MOTE: PUMP AND ALARM ARC TO DE0 ~ SWITCH TYPE: MIMIMUM DISCHARGE RATE _"'02 GPM INSTALLED OW SEPARATE CIRCUITS VERTICAL DIFFERENCE CETWEEN PUMP OFF AUD_DISTRIBUTION PIPE.. ~ FEET . + MINIMUM NETWORK SUPPLY PRESSURE . 2.50 FEET + Z` FEET OF FORCE MAIN X `'b1 fyOFT.FRIGTi011 FACTOR. 3'46 FEET TOTAL OytJAMIC. HEAD - Zs,q FEET DIAMETER INTERUTAL DIMEfJSIOKJ~ OF TANK: LENGTH ;WIDTH .~.r;LIQUID DEPTH 3S Z BOTTOM AREA 231= GAL/INCH AS PER MANUFACTURER = 1q-S GAL/INCH _ P~ 6 0 F ME Series 1/3 through 14/2 HP Effluent Pumps Performance Curve CAPACITY LITERS PER MINUTE 0 50 100 150 200 250 300 350 400 450 i 100 90 28 80 24 Cl) MF~SO w 70 M H W F~00 20 U- 60 z z ~ MF> 16 w W' 50 S = Y a O 40 MFSKI 12 0 30 ZS•4Z e 20 4 10 Lab 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 130 CAPACITY GALLONS PER MINUTE M"IW • 1101 Myers Parkway, Ashland, Ohio 44805-1923 419/289-1144 FAX 419/289-6658 Telex 98-7443 K3327 8/92 Printed in U.S.A. {STC- 105 SEPTIC TANK MAINTENANCE AGREEMENT nn St. Croix County Q(a~ OWNER/BUYER MAILING ADDRESS l qntN k 4 mr-)n 1o ioz- PROPERTY ADDRESS t 6L1017 (location of septic system) Please obtain from t e Planning Dept. CITY/STATE -a t1- e- 469> -4k PROPERTY LOCATION 5 1/4, 1/4, Section, T^ ~b N-R~W TOWN OF Ej1,g pf-,-j,`~ t~ ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAP , VOLUME jLg PAGE 011_, 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: ~crVN~( 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 '7 esf Location of property S 4F 1/4 SL 1/4, Section a2 / T_30 N-R 1,2 W Township ~,Ck/V /OR9 IUA,t Mailing address 1.2 /y~ ~s ~•`c`imv2~ c,JiS SYQ17 Address of site Subdivision name Lot no. 1W ac ra C Other homes on property? Yes OL No Previous owner of property ~h ,t0 InCA C. able (fu r}-' Total size of property 0 1C-e Total size of parcel 4f0 /4o re s Date parcel was created Are all corners and lot lines identifiable? _o4- Yes No Is this property being developed for (spec house)? Yes No Volume //0 1- and Page Number 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. 5,23.2,9 , 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 y - ~O yg~-4 9A,-w~~ 0 ~:;A . Signature of Applicant Co plicant Date of Signature Date of Signature DOCUMENT NO. I STATE BAR OF WISCONSIN FORM 16 - 198: II ns sr.ce .....Veo roR RECORM.42 DAT• e=3235 TRUSTEE'S DEED - i :.i. cn!X Co., W1 Rdc'd br Rawd 0 as Trustee of ` . .Ee..~??~.. writable Remainder 'fiitrurt NOV 7 1994 - 1:15 AP.M for a valuable consideration witt~~ut Donald L. tkulness3T1CicgaYqChelle S, husiUaril3""aiid"' y :~,'erd! er:b and odr1 } ..w................. tYgiants . - r Grantee, the following described re`! estate in St. --Cr--- -------oix County, State of Wisconsin: L Tax Parcel No: The SE 1/4 of the SE 1/4 of Section 21, T wnship 30, Range 17 : RAANS Ujb l 151 t F ~I i I Dated this 35th 94 day of .19 (SEAL) Do E. ter (SEAL) -o Trustee Trustee AUTHENTICATION ACKNOWLEDGMENT MINNES= Signature(s) STATE OF gyp( RAMSEY ss. . . . . County. 0'00'~ "day of authenticated this da . 19....._ Personally came before me this " 25th OCtOiJer . 19 94 the a ve named ~I • b~ I Diorgthy E.._Conter as Trustee of the Dgrot.W E ..Canter Charitable Remainder' TITLE. MEM R'STATE BAR OF WISCONSIN [klltrilst IL (If - aut rued by ?06.OA. Wis. 3tats j to me known to be the person who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY BANNIGAN_& KELLY,P.A. { - ,..---.L...1.../1 ~I