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HomeMy WebLinkAbout018-1045-70-000 H o m c ts m d; 4 o I w ~ ~ I e C4 N ~ I ~ I tt ~ I ti ~ I i c m U 'Q O O ~ I o I w aNi ~ I (0 = z ° I U. c acoi 0 3 m I E ¢ _N co a I d' ~ N E `i O Z O z c~ H z a m o I o z t I to FZ- r aa) Z E C') C . N L O C O O z z N Z N o R _ f0 Cl) ,ts `O a '5 U c y ° y ` O p ~,coa N N m _ to to N a a o E o Z p _R 0 E E co co o N m ) M J V 1 2 rn m CO M ti~ O °O Q> C O r _ > E v Q ° ° O O L 'O m N a= W 9 Q fn f6 ~r ~O 3 w I ~ O ~ N C I T C 04 CO p O O m O C tOA V a p r- 04 c c W E a~ a E .r v 0 CO ayi a~ v FL- c a~ n I W N cc O CNO O m O E U O N S m N 0 Z N Z 5 (n 29 V EE L da gay` i E c°~~ oN00 ~1 A a STC - 104 AS BUILT SANITARY SYSTEM REPORT 4 OWNER ADDRESS gC3 Q ' S ~ 16 L.-,. o-ZG 4SUBDIVISION / CSM# tul4 LOT iU A SECTION- ~T~N-R OW, Town of ST. CROIX COUNTY, WISCONSIN P IEW SHO EVERYTHING WITHIN 100 FEET OF SYSTEM V ZaJ r 3 Si r a~ ,8 - INDICATE NORTH ARROW Provide setback an elev information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. r 1 BENCHMARK: lit C~~~ (Mtte~~ ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: , /drC) Liquid Capacity: Xo~~ -74 r Setback from: Well $•S House Other Pump: Manufacturer e_n ~ Model# (ir-763fl Size Float seperation //e.Z Gallons/cycle: 7 Alarm Location 6n1 -jq, c3s2. -:SOIL ABSORPTION SYSTEM Width: S Length 7-5 Number of trenches Distance & Direction to nearest prop. line: Aj fA cv Setback from: well House C s Other - ELEVATIONS Building Sewer ST Inlet: ST outlets s~ PC inlet 93-3,;),TC bottom v9 a Pump Off 6~ Header/Manifold Bottom of system Id7l Existing Grade Final grade DATE OF INSTALLATION: 7 - / \ PLUMBER ON JOB: LICENSE NUMBER: Te;-a% INSPECTOR: 1.,.. 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 262395 Permit Holder's Name: ❑ City ❑ Village Town o : State Plan ID No.: BOUCHER, ELROY HAMMOND CST BM /E1llev.:~ Insp. BM 1Elev.: BM Description: /J/ Parcel Tax No.: Ul/ x!01 l GU ,CCU ~~,~n P 5 / (G--- TANK INFORMATION ELEVATION DATA V/7hV- TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark . 3v 07 160, Dosing 0,4 rv(, 3.05 D/, Ov-' Aer Ion Bldg. Sewer Holding St/*1 Inlet /d /5 93•g~ S~ TANK SETBACK INFORMATION St/}fir' Outlet 31 ~ TANK TO P/ L WELL BLDG. Ventto Air Intake ROAD Dt Inlet Septic r q g ( Al "-),4 NA Dt Bottom Dosing 7 j SS S NA Header / Man. Aeration- NA Dist. Pipe a' /O?1,~~ Holding Bot. System 3 99,70 PUMP / SFORMATION Final Grade Manufacturer 8e"m0 iM r Model Number Lc~EC~ //L S _pewlrd TDH Lift Friction c8System2~ TDHj3,8SrFt Loss H / Forcemain LengthA~S Dia. Dist. To Well ~/11~ SOIL ABSORPTION SYSTEM I BED/TRENCH Width Length / No. Of Trenches PIT No. Of Pits Inside Dia. i th DIMENSIONS s 75 DIMEN I SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING INFORMATION TypeO CHA Mo el Number: System:/ &,6d,Mnd, ti DISTRIBUTION SYSTEM L . -NeZ "anifold Distribution Pipe(s) / i x Holeize~r x Hole Spacing Vent To Air intake ~ Length D Length Dia. Spacing T 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: HAMMOND. 21. 29.~W, NE, /RF, 901.'H AVE 97 99 M,97 ~l 1e~ U Plan revision required? ❑ Yes ❑ No / Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signa re AC e ~rNo. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: i SANITARY PERMIT APPLICATION ve~~■rfa In accord with ILHR 83.05, Wis. Adm. Code COUNTY S}1 Crv I STATE SANITARY PERMIT -Attach complete plans (to the county copy only) for the system, on paper not less than "q& o2 39,1, 8% x 11 inches in size. ❑ Check if revision to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION N 9 Y4 WE I S T 14N, R W PROPERTY OWNER'S AILING ADDRESS LOT # BLOCK # tk MA A) CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISI N N ME OR CSM NUMBER vil" PrIa % -4- (ja t oa 331 I TT A) ~ P1 II. TYPE OF BUILDING: (Check one) r_1 State Owned O VILLAGE NEAREST ROAD y fi slt El C~ Public ~1 1 or 2 Fam. Dwelling-#of bedrooms - PARCEL TAX NUMBER(S) III. BUILDING USE: (If building type is public, check all that apply) L~ l.J l U ~ 10 Apt/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 in line A. Check line B if applicable) A) 1. ❑ New 2. K Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit # 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 El Seepage Trench 22 ~In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 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 5o REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) > ELEVATION ~L 5 3 7.5,6 _5 / 161 Feet Feet VII. TANK CAPACITY Site in allons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New ii-sting Gallons Tanks Concrete structed glass App. Tanks Tanks Septic Tank or Holding Tank fOZfil~ e r Lift Pump Tank/Si hon Chamber, ( p h, VIII. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. PI ber's Name ' Plumb is Signature: (N Stamp /MPRSW No.: Business Phone Number: Plumber's Address (Street, City State, Zip Code): L09 _ S-t-^ c,f2.. R? •Q w3 K~ ~h W~ p IX. COUNTY/DEPARTMENT USE ONLY Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued uing Agent n re (No Stamps) g.~ Surcharge Fee) j XApproved ❑ Owner Given Initial 12 -1 Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(11.08/93) 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 the 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 (BBD 6399) to be t 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 & 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 in 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 in ##1-7. VII. Tank information. Fill in the capacity of every new and/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% 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 i 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, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) Wiscorrsff"e hmentofIndustry, PRIVATE SEWAGE SYSTEM Safety and Buildings Division Labor and Human Relations Bureau of Building Water Systems REVIEW APPLICATION Hayward Office La Crosse Office Madison Office Shawano Office Waukesha Office 209 W 1st Street 2226 Rose Street 201 E. Washington Ave. 1053kE. Green Bay Street 401 Pilot Court, Suite C Rt 8, Box 8072 LaCrosse, WI 54603 P.O. Box 7969 P.O. Box 434 Waukesha, WI 53188 Hayward, WI 54843 Phone (608) 785-9334 Madison, WI 53707 Shawano, WI 54166 Phone (414) 548-8606 Phone (715) 634-4804 Fax (608) 785-9330 Phone (608) 267-5119 Phone (715) 524-3626 Fax (414) 548-8614 Fax(715)634-5150 Fax(608)267-0592 Fax(715)524-3633 INSTRUCTIONS: To save time, schedule your review with one of the offices listed above prior to submittal. Fill in all applicable data and submit this form together with fees and plans/information. Your submittal must be received at least one working day prior to the appointment at the office where your review was scheduled. Please call any of the listed offices if you need help filling out the form or have questions on what information to submit. PLEASE PRINT VERY CLEARLY. A sample of a completed form is on the reverse side for your reference. 1. APPOINTMENT INFORMATION -if ou have scheduled an appointment, fill in the information requested below to save time: Appo tment Date Review ame Plan Identification Number QA I qS I gn ss 313 ~ -7 2. PROJECT INFORMATION If this review is a revision or extension to your existing plan identification number, provide that number here: Project Name ❑ City ❑ Village ~ Town Of: County Project Location GOVT. LOT 1/4 Ajr- 1/4,S Q) T N ,R or W 01 ti ST 3. APPLICATION FOR 4. FEE COMPUTATIONS FEE SUBMITTED System Type (check one): System Type 1 (include new and existing tanks) Up To 1,500 gallon septic tank $110.00 A At-Grade 1,501-2,500 gallon septic tank $120.00 H Holding Tank 2,501 - 5,000 gallon septic tank $160.00 M Kn Mound 5,001 - 9,000 gallon septic tank $200.00 N Non-Pressurized In-Ground (Conventional) 9,001-15,000 gallon septictank $300.00 P ❑ Pressurized in-Ground Over 15,000 gallon septic tank $ 500.00 ` O Other: U To 1,000 gallon dose chamber $ 70.00 74 1,001 - 2,000 gallon dose chamber $ 80.00 Building Type (check one): 2,001 - 4,000 gallon dose chamber $100.00 4,001 - 8,000 gallon dose chamber $120.00 D Dwelling, 1 or 2 Family 8,001 -12,000 gallon dose chamber $140.00 P ❑ Public Building Over 12,000 gallon dose chamber $160.00 S ❑ State-Owned Building U To 5,000 gallon holding tank $ 60.00 5,001 -10,000 gallon holding tank $100.00 Code Derived Daily Flow 1 gpd Over 10,000 gallon holding tank $150.00 Check If Replacing Existing System Experimental System (additional one time fee) $ 300.00 Revisions To Approved Plan 2 $ 60.00 Petition For Variance: Setback $100.00 Petition For Variance Site Evaluation $225.00 Plumbing $22 MO 1116.. Revision 5.....3 'Rip ❑ Groundwater Monitoring Groundwater Monitoring - Per Site $ 60.00 (other than a proposed subdivision) ❑ Site Evaluation in Lieu of Groundwater Monitoring Site Evaluation in Lieu of Groundwater Monitoring $ 60.00 Subtotal: Priority Review: Enter same amount as Subtotal: MAKE ALL CHECKS PAYABLE TO: SAFETY AND BUILDINGS DIVISION Total Fee: ~b 5. SUBMITTING PARTY INFORMATION Telephone No. (include area code & extension) Cp any Name Contact Person ( -l /5) a S 1 c9 w e vs C c v ` l f C h c<~ U', No. & Street Address Or P.O. Box Cit, Town or Villa e, State, Zip Code 1 Aerobic or prepackaged treatment system fees are calculated based on equivalent size septic tanks and dose chambers. 2 Revision fees are not applicable to temporary holding tanks or extensions to existing approvals. NOTE: Fees are pursuant to Wis. Adm. Code, Chapter ILHR 2, and are subject to change annually. SBD-6748 (R. 03/93) OVER Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Pa g Labor and Human Relations g of Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but S t C ra \ X 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 a p LkG % Q y GOVT. LOT AJ C- 1/4 1/4,S,-a/ To? 9 N,R -jpor) W PROPERTY OW R':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # f ' -5 • • N 14 N A., 7J ,a, CITY, STAT ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE OWN NEAREST ROAD r r ! 5i(ot 015) oZ -337 [ ] New Construction Use[ ] Residential / Number of bedrooms Addition to existing building XReplacement [ ] Public or commercial describe Code derived daily flow ~4Z gpd Recommended design loading rate _L_~Y_bed, gpd/ft2 ..5 trench, gpd/ft2 Absorption area required -37S bed, ft2 37S trench, ft2 Maximum design loading rate , Y-bed, gpd/ft2 1-5 trench, gpd/ft2 Recommended infiltration surface elevation(s) Q/ o a ~o ft (as referred to site plan benchmark) Additional design / site considerations MLitt oir 7d A, a~ to :t ) Parent material f ' Flood plain elevation, if applicable n~/A ft S = Suitable for system CONVENT 0 AL UND IN-GROUND RESSURE AT-GRADE SYSTEM IN ILL HOLDINGTT~A4NK U=Unsuitable fors stem I ~ A I _I El S U S❑ U ❑ S U ❑ S )N U ❑ S U ❑ S ® U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. ShConsistence Boundary Roots Bed Trertch . /0 ~eR '4j AL m .56k, trif IN !s 3if /d sJ d rn Shk ,s S oari' Ground elev. 9f- -Yv /o e S C 5 $ S / o'? m .56k m~S J $ , . ft. Depth to limiting act L I Remarks: Boring # D- L or.Q- l S k t-n r O 3 y iS / NDrw S 0M t r C ~7 4,9 - Ground elev. ft. Depth to limiting fac Cb =0 i5 ~ Remarks: CST Name:-Please Print r T Phone: a J d C.v' 2 r-.5 ~1 - ':V309 -yr/3t5 Address: x w .s a Signature- Date- CST Number: ~`-a9-~s s PROPERTYOWNER G/ hD y C&Ltcker SOIL DESCRIPTION REPORT Page a of 3. PARCEL I.D. # Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench bn k + W Ground 3 30-U elev. "ft. Depth to limiting factor~ Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) C _34 d _ . I I I I CS .3 4~j I r t i ' f I I I I i ( I I i I ~ I I( j l l! i I~ I - _ _ - i_-- - - i , At i 7 c I I f I + I I I ~ I 1 I 1,7 i I ' ~ ~ I i I i ~ I I ~ I j t I 1_ I ' I : 9-1r-0y 13 0 u.c,h e Y- WORKSHEET - MOUND SYSTEM DESIGN PROBLEM: Design a mound system for a mac asr~ - The site characteristics are: Depth to groundwater or bedrock. ~.34 in. Landslope P¢ , Percolation rate .~.5_ m Distance from dose chamber to distribution system a30 _ ft. Elevation difference between Dump and distribution system , 9 ft. Step 1. WASTEWATER LOAD 5v '5~57> gal Step 2. SIZE 'THE ABSORPTION AREA A Area required = 4-50 -i "L sq. ft. B) Bed or trench length (B) = 54-~r= 75 7.s ft. C) Bed or trench width (A) ft. D) Trench spacing (C) E d Wastewa `er load .24 (?al/ft2/day B a , ft. tr~•i~e+~i sue" Step 3. MOUND HEIGHT A) Fill depth' (D) a ft. B) Fill depth (E) - D + 6 slope (Aj-fP) ~ l• ~ : ft. 0 / X s~ - a5 C) Bed or trench depth (F) a , 83 , 8.3 fit. D) Cap and topsoil depth (G) _ ft. E) Cap and topsoil depth'(H) r 1,5 ft. T. j -Canuo - ,lj 6 cam. ch.•~ v~ ~ O l D h6~J ' Step 4. MOUND LENGTH A) End slope (K) ' CD + E~+ F + H x3 ft ./6- /y 2 B) Total mound 1 e tai L = B + 2 --;a 95• Z-~ 7s aC~ 95,13 Step S. MOUND WIDTH Al) Upslope correction factor A2) Upslope width (J) ^(D + F + G) (3) (factor) _ ft, s-1• C C/-f •d'3t1~h 3x i9~ $13 B1) Downslope correction factor = # 3 c> B2) Downslope width (I) _ (E + F + G)(3)(factor) _t l C/Iasf, k3KA03 Cl) Total mound width (W) for bed = J + A + I f~2-s t- + C2) Total mound width (W) for trenches = + + no. nches 1) (c) + A + I_~ Step 6. BASAL AREA A) Infiltrative capacity of natural soil .rs., gal./ft2/day r B) Basal area required = wastewater flow natural soil infiltrative capacity = 94~ sq. ft. Cl) Basal area available for bed for sloping sites = B x (A + I) sq. ft. C2) Bas are avail le for trench for sloping sites ~f S B + A q. ft. gaa,s 7-5 X ~3, ' C3) Basal area available for trench or bed for level SitSBXW= sq. ft. S i (.1 License c:u~ MLS~3_ S95-31387 Step 7. DISTRIBUTION SYSTEM 1A) SIZE DISTRIBUTION SYSTEM 1) Hole size = in. 2) Hole spacing in. 3) Distribution pipe length 2 10 4) Distribution pipe diameter in. 5) Spacing between distribution pipes in. 6) Distance from sidewall to distribution pipe =0 in. 7B) DISTRIBUTION PIPE DISCHARGE RATE 1) Number of holes per pipe = << s .1~ 2) Flow per pipe 2-7 = GPM 7C) SIZE MANIFOLD A I/L'<~ 2) Manifold length ft. 3) Number of distribution lines = 4) Manifold diameter = in. 7D) SIZE FORCE MAIN 1) Minimum dosing rate GPM 2) Force main diameter in. l 3) Friction loss ft. 7E) TOTAL, DYNAMIC HEAD 1) Vertical lift = 9 ft. 2) Friction loss = / L:67 ft. 3) System head 2.5 ft. 0~.5 ft. 4 Total dynamic head ft. ~icersc: ~,S'(o 3 Sc 31387 7F) PUMP SELECTION 1) Pump selected will discharge r1_ GPM at ft. total dynamic head. 2) Pump model and manufacturer W -,G'0 311J- 7G) f DOSE VOLUME 1) 10 times void volume of distribution lines = S, gal./cycle iDX~ C o IQ X-7q~ 6&,a8 2) Daily wastewater volume 4 doses/24 hrs. _ PAS gal./cycle `1SO a, 5 3) Minimum dose volume = gal./cycle oZ ytd ww. b kX 13 82. s ~ c /112- 7H) DOSE CHAMBER 1) Minimum capacity required = gal. n: Ucunoc Da to ~5 I l a , I i ~ o -a -her X11-9aR 17_-I- I I 0 Jt~'d~o•-►,w~.b I l~ •r%Jr ,i6 ~S' fit ' I ! I Gt1 ~ ! I I I I r a I U P1 _.I , I I i i I I ! 1 - a / I _ I ' I J I I J I 60'j. c' -V-QV Page of lD f Straw, Marsh Hay, Or Synthetic Covering f~_Si7a1 3 Distribution Pipe m Sand ' Tops - " Slope Bed Of 2M- 2 12 Force Main Plowed Aggregate Layer Ft. Cross Section Of A Mound System Using E - Ft' A 'Bed For The Absorption Area F Ft. G / Ft. A A_ Ft. H Ft. B Ft. Signed: License Number: IS 06 ~3 K D,/ Ft. Date: Vol 9 L Ft. Jr~ Ft z Alternate Position I Ft. 1 of / Force Main W Ft. .L Observation Pipe g K PA Force Main w _ A Distribution. Bed Of 2y- 2 i Pipe Aggregate 1 Observation Pipe l Permanent Markers 5-31387 Plan View Of Mound Using A Bed For The Absorption Are Y Perforated Pipe Detall End View )Perforated End Cop( PVC Pipt Holes Located On Bottom, W a``o of c Are Equally Spaced t C~F 'Y \ n5 r;bwfro'? Lau Hole SAo`uTd Be Neat To End Cop / Distribution Pipe Layout P et' R~r S N b X c Inches Y Inches Signed: - Hole Diameter r/ Inch Lateral " 1~ IncM s) License Uumber: I$~3 atn -"2 y Date: C`L2 - ~S Force Main 3 Incho.; # of holes/pips ' C 1 Invert Elevation of Laterals Ft. red ss 3 1t 8 . j page0of ~a o r ~ rt in W . fD A z (D N m N TI i rt r ~ - • "0 o a rr ~ o rr r t a ;r w P o .p A rte. - Vl _ ' Z - fh Ci a a A x ~ o ~I I a is co PAGE OFD ' PUMP_CHAMBER CR055 SECTION AND SPECIFICATIOQS VENT GAP I 't"C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING ZS' FROM ODOR, JUNCTION BOX MANHOLE COVER WINDOW OR FRCSH 12"MIU. AIR INTAKE I GRADE I I I 'i" MIIJ. "/IIN, CONDUIT L-- \ 16 Alm. 10 11~ J ..F; '1' PROVIDE I AIRTIGHT SEAL I I ~ I I I I APPROVED JOINT A I III APPROVED JOIAI • W/C.I. PIPE. I III w/C.I. PIPE CXTCNDIAIC. 3' ONTO S01.10 SG':. - I II ALARM EXTENDING 3' B I I ONTO SOLID SO; I I c I i ON •I I I 1 PUMP---- OFF - 0 COIJCRETE DLOCK RISER EXIT PERMITTED ONLY IF TAI,IK MAMUFACTURER HAS SUCH APPROVAL SPECIFICATIOUS SEPTIC AND DOSE TAAIK$ MAIJUFACTURER: WAA0 - ~ NUMBER OF DOSES:- - PER pAy TANK GIZC: _Z-S 1 GALLONS DOSE VOLUME z.j ALARM MANUFACTURER: stem INCLUO!!!-- ;,;,L FLOC ::L-' iI GALLONS MODEL NUM6ER: CAPACITIES: A= INCHES OR ' ~ALLOuS SWITCII TYPE: ~p a,7~ B = ~2 IMCHES OR 50 7 PUMP MANUFACTURER: - O tale,5 GALLONS //-1 S C=INCHES OR ~oh GALLONS MODEL AIUMBCR: SWITCH TYPE: O--9 INCHESOR ~ -3 GALLONS NOTE: PUMP ANp ALARM ARE TO BE In PUMP DISCHARGE RATE; INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE D 4JCCN PUMP OFF AMD DI5TRIBUT101`I PIPE.. / FEET f MINIMUM NETWORK SUPPLY PRESSURE , J 2.5 FEET 1 -ALL= FEET OF FORCE MAIN X F otr.FRICTIOU FACf00.S FEET 4 s 531 TOTAL DYNAMIC. HEAD Z. FE 9 - INTERNAL.. RIMEWSIGNC OF TAIJK: lt)r1,}~'T{ ~ ~ j LIQUID DEPT 1-I SIGNED: LICEIJSE ►JUMt3ER: 1~6-3 pATE: -117- VF'} a s GOtlIDS SUBMERSIBLE SEWAGE. AND EFFLUENT PUMPS Fti,y~Afi i r EP0311 LLST DISC. i .1 =V P0311 142 EP0311 1/3 HP 115 V Effluent PUTV 1/2" solids 256.80 172.10 4},, : , a .T~n s , Submersible MODEL EP0311 r` h- Effluent Pump METERS SIZE 3/e" SOLIDS 5EFT ti : , 20 \ 41,~.r T_ Fi`L a" 4 ; 10 ' 2 p t 1i 5 ' i Z1 o pp 4 8 12 18 20 24 28 32 ss GPM 40 - - ' ' p1 2.5 5.0 7.S m'/h CAPACITY Performance k Y Curve 3885 t+crEtls FEET • ~ •o MODEL 3885 wk . { n 6o SIZE 3/4" Solid ti t ao d~ ~ eo ...r2 < ~ wEOtn.... 16 70 r EOSM . b to 30 wx 70 WEOX ,1 a~+ 410 0o FF:R C 10 - - to 20 z no 60 60 To ro •o too 110 110 01,111 t 10 CAPACITY 20 +1' ' LISP DISC. 0XI'V E03111, 142 WE0311L 1/3 HP 115 V Law H 3/4' solids k91.55 329.35 , 1z =ZWF.0311M 142 WE0311M 1/3 HP 115 V Mod H 3/4" solids 491 .55 329.35 ' >sl`i , w,7 ooup1ao51in 142 WE05i'1H .'I/2 HP 115 V High H 3/4" solids 104.25 47.1.85 d%IK~ a GOMIE07M 142 WE0712H 3/4 HP 230 V High H3. 3/4" solids 843.65. 555.25 C' *****sEE FazcwING PAGE FCR PmFC *wM AND &,B=r1c&TIONS. PAGE 07u p4T'E 10/88 DEPT 30 STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County At\ OWNER/BUYER. V MAILING ADDRESS ~ Lo' S n -`5-~r- PROPERTY ADDRESS I -7c (location of septic system) Please obtain from the Planning Dept. CITY/STATE ~cs 1~ t~o~ n : SAC C) PROPERTY LOCATION I~ 1/4, NIC_ 1/4, Section T- -N-R_W , TOWN OF H cam Mn r, , ° ST. CROIX COUNTY, WI LOT NUMBER N SUBDIVISION CERTIFIED SURVEY MAP , VOLUME PAGE , LOT NUMBER Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of-?replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal 'system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in.accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED: DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 A 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. A Owner of property: Location of property N 1/ NI 1/4, Section ~,T~9•N-R 1 '7 W H Township jAa v,,, 4.0 AA_ Mailing address Qp ~4, v (_ol~ Address of site JIN ,,,n o must C) Subdivision name 1-N R Lot no. (A Other homes on property? Yes__X_No Previous owner of property Total size of property Total size of parcel Date parcel was created Are all borners and lot lines identifiable? yes No. Is this pry perty being. develop Mpr ('spec house)? Yes No Volume-- 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 o the County Register of Deeds as, Document No. 5 ,:~_qV nd 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 Ap icant Co-Applicant Date of Signature Date of Signature A t TtF00RDING Q~ORMATION OCUh ENr NO. WARRANTY DEED L Von Z1n~PA,F~~~ REGISTER'S OFFICE 2 88 ST. CROIX CO., WI Reed for Record THIS DEED, made between Belveidera Boucher, a single person. Grams,. and Bettj Lou DEC 2 +Y 1994 Manning, LaDonna M. Johnson, Elroy J. Boucher, Grantee, t 8:30 i► A. M WrrNESSETH, That the said Grantor, for a valuable concideratiom coneys to the Grantees bLr undivided 1/4 interest in the following described real estate in SL Croix Canty. State of Wisconsin' North 200 feet of the East 373 feet of the Northeast Quarter (NE 1/4) of the Northeast Quarter GYE - ..,..1 1/4) of Section Twentyone (21). Township Twenty: nine (29) North. Range Seventeem (17) West, except that part heretofore conveyed for highway purposes. RETUR V TO Battles Norman, New Richmond, WI L Tat Parcel Na: This is homestead property. T Together with alt and singular the hereditament& and appurtenances the eusso belonging; and Grantor warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except: Easements, highways, utility rights and reservatioms of record, and will warrant and defend the same. Dated this r, j ye o ` - Y FEE 7't (SEAL) ACKNOtVTF~GEMFNT • Belveidera Hotrc~Y STATE OF WISCONSIN ) (SEAL) ) aL ST. CROIX COUNTY ) • Personally came before me this Beelveidera Boucher day of 19~ the above named AIlTHENT[CA'IION Signature(s) of ' ra Boucher to me known to be the peraon_ who Behy-t executed the foregoing instrument and acknowledged the same. /2day 19 authentkaja& • Thomas R. Schumacher I.D. *101498!_ Notary ~blle' minty, y. T1 TLE MEMBER STATE BAR OF WISCONSIN (if nk authorized by } 706.06, Wis. Stats) My Commission is permanent. (If not, state expiration date:. THIS INSTRUMENT WAS DRAFTED BY: BAKKE NORMAN, S.C. NEW RICHMOND, WISCONSIN 'Names of persons signing in any capacity should be typed or printed below their signatures i