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(D I c 0. 0 ~ I ~ I 0 o I N O I C I 'D I GL I C I ~ I I c Z C U. C O 3 v I a I Cl) v ~ I Z y OO Lo a m O I m Z Z RD Cl) I I ~ C 0 Q z z O N Z ~j N d N V M E a d _ 2 I al ! CD H ` o CO 0 ~Ic, NNI ~ w I ~ fn rN rNr ~ (~cp ~ N N I yr' 300 if co z y CL CL IL ~l a -ca 3 0 U) Co 9 O N y J U ~i N 0) C1 3 ~ ~ O I o ° O C LO 0) rn _ E I S m y c ° Cl) I ii 0 Q } cn m o w c O ,L.. O 'O E Q O M~ Y V C N N US C1 CL I 00 V E c C N j 0 C N2 O O ~ W L w n 0 1 Ob co L N N •d,, 7~ C L 04 - d N 0 Z N Z: fn Q O I 24 M Ys L a a Z` I `IV +r E ` 'c t A 0C r ML !~~v Ira ~ . FILED DEC 1 3 1995 ► JAN - 5 1996 KATHLEEN H. WALSH Register of Oats SLCrolxco„Wl ~I ST_.•fit01X000NTY 53'433 RvEI~ R' RE OR CERTIFIED SURVEY MAP LOCATED IN THE SW 1/4 OF THE SE 1/4 OF SECTION 15, T28N, RIM TOWN OF RUSH RIVER, ST.CROIX COUNTY, WISCONSIN. PREPARED FOR:EDW~QRD AND LYNDA AFFOLTER UNPLATTED LANDS I' s N 90° 00' 00" E 34 7. 15' z O LOT I 5.00 ACRES 0 0 Z N (217,815 S0. FT.) 0 Z 'u b :"U NOTE: BEARINGS ARE REFERENCED TO r v; r THE SOUTH LINE OF THE SE 1/4. -4 :-4 (ASSUMED BEARING). m m : -I m vt ; r co :Z EXISTING N :Z WELL O :v CA yr- ~ ; CA l~ 249, g2. 35. 9' /V 7903 195 67.3 8'03" W 367 / 5 1 -,_,r 0 - SET I" X 24" IRON PIPE WEIGHING 1. 13 LBS. PER LINEAR FOOT. UNPLATTED LANDS .fl I 66' 9 I oI z N EXISTING ROADWAY 7'. rn EASEMENT VOL. 11 5 2 PAGE 4 5 1, i w SE CORNER OF SECTION nl ? f"~° " 15. (COUNTY MONUMENT Ph" S- I /4^CORNER, OF SECT ION S^90° 00' 00" E i I FOUND). V;tk e STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER '}fie` c Lj l l t e e i S 4` r_ r, W'. ADDRESS U r,, e- 1'CiviflC::t7F~1C~ ,~+0' ';7, SUBDIVISION / CSM#LOT # SECTION T^ _N-RW , Town of S <t ✓ C ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM Lb 4 CA #4 0 t a 1 Y / r I L1" j INDICATE NORTH ARROW i Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK' !J • °l' o r~ L ~~U G v ALTERNATE BM: ~~Ct 0,43 G E, SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: )Ne C'wes tc,-h Liquid Capacity: 1(206 7s v Setback from: Well 7 House 5'0 Other Pump': Manufacturer `4 Model# Size Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: Length ? Number of trenches Distance & Direction to nearest prop. line: ,7 5- Setback from: well: House yo Other ELEVATIONS Building Sewer 00, ST Inlet; 6 0, 5- ST outlet jd GUS 4 PC inlet 3, 3 PC bottom P9 Pump Off ~/4 Header/Manifold Bottom of system ,U Existing Grade ~ Final grade ,S DATE OF INSTALLATION: a PLUMBER ON JOB: LICENSE NUMBER: 6~ :Y6 INSPECTOR: 3/93:jt Wiscorisin`Departmentof Industry, PRIVATE SEWAGE SYSTEM County: Lab4and Human Relations INSPECTION REPORT ST. CROIX "Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No-: GENERAL INFORMATION 942 Permit Hol er's Name: ❑ City ❑ Village ©Town of: State Plan No.: PATTPRSON, KEITH X CST BM Elev.: Insp. BM Elev.: BM Description: RUSH RIVER Parcel Tax No.: &J, air Q - TANK INFORMATION ELEVATION DATA ?1%23191,1 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark /GV,Ce Dosi n9 " of r11 & ,27 1' Aerat' Bldg. Sewer A/ tJ Holding St/ Inlet -70 },~3> TANK SETBACK INFORMATION St/ Outlet Vent TANK TO P/ L WELL BLDG. Air Ito ntake ROAD Dt Inlet Air r Septic 3` SO NA Dt Bottom Dosi ng Sal ?~tbr -(75 ~x" ' NA r / Man. <1 ~ Aeration NA Dist. Pipe 72-f- Holding Bot. System PUMP.] ON INFORM~ATI Final Grade Demand b o 5.7, YIAC~kc C111,11 - 3, Manufacturer pe_ e. 11 Model Number 7 3 GPM 6v TDH LiftI LrictionDS~ SystTDH/d j,2 Ft oss Head Forcemain Length3s Dia. 02 Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Q i Length,/ No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS O SYSTEM TO P/ L BLDG WELL LAKE / STREAM NG Man er: SETBACK CHAMBE INFORMATION Type 0 Y1 t4.,L Mo System: kult~.d OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x HoleSze/ x HoleS~ Spacing Vent To Air Intake Length ~ Dia. 02 Length ~ -Dia. Spacing V SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded / Sodded )tx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: RUSH RIVER.15.28.17W, SW, SE, 30TH AVE ~ 97 0' d U C - Plan revision required? es ❑ No q Use other side for additional information. 3 . SBD-6710 (R 05/91) Date Inspector's Signature Cert. No s Safety and Buildings Division ~ 4NITARY PERMIT APPLICATION Bureau of Building Water Systems x 201 E. Washington Ave. A In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 • Attach cginplete ' J (to7tho4cQuntyzillpy only) for the system, on paper not less County than 81/k )*4, 1 inches insi`ie. :5+ ' i • See reverses de for insttructionsJforto Ipleting this application State Sanitary Permit Number 2- 6i:,V.S3 The information yon prbvtdp may be uQfo'tttgo government agency programs eck it revision to previous application [Privacy Law, s. 15.04 (1) (m)1 State Plan I.D. Number 1. APPLICATION INPOftMAMON -PLEASE PRINT ALL INFORMATION 59- j 3/2 Property Owner Name Property Location Keith Patterson SW 1/4 SE 1/4, S 1 S% T 28 , N, R 17 E (or) W Prop005 Qyvner's Mai[ingp.ddress Lot Number Block Number Greenbrier Rd 315 A City, State Zip Code Phone Number Subdivision Name or CSM Number I .304 C_W Minnetonka MN 55305 ( ) 537433 II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ ~t( age Ne est Road Public 1 or 2 Family Dwelling - No. of bedrooms ❑ V II Town oFRush River 30 th. Ave. III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 023 1024 80 100 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. ® New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 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 450 376 376 1.19 0 7.0 Feet 98.5 Feet VII. TANK Capacity gallons Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Existin strutted Tanks Tanks Septic Tank or Holding Tank 1 1 000 1 Midwestern EJ ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber 1 750 1 Midwestern ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installaj~oq of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plum is Signature: S s MP/MPRSW No.: T~,ness Phone Number: Joe Stang - MP 6646 1-715 698-2266 Plumber's Address (Street, City, State, Zip Code): 506 Willow Dr. Woodville, WI. 54028 IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issue Issuing A ent S re mps) Surcharge Fee)/~~ Approved F] Owner Given Initial Adverse Determination )1~4_ a 7. X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SHD-6398 (R. 05/94) DISTRIBUTION: Original to county. One copy To: Safety & Buildings Divr ion, Owner, Plumber INSTRUCTIONS s 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 irlownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD-6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII_ Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) fora 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 and Buildings Division ,'s 'otimM .vov axo ~p~'■,'~iR SANITARY PERMIT APPLICATION Bureau of Building Water Systems 201 E. Washington Ave- -j 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 1 than 8 1/2 x 11 inches in size. I Y • See reverse side for instructions for completing this application state sanitary Permit Number The information you provide may be used by other government agency programs heck i( revision to previous application (Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION 414 Property Owner Name Property Location Keith Patterson c Xl~ 1/4 S 1/4, 515% T 28 , N, R 17 E (or) W Prop y Zbn is Mai n Addr s Lot Number Block Number 0- GreenRier d 315 / City, State Zip Code Phone Number Subdivision Name or CSM Number tjlznnetonka. 1417 55305 ( ) 537433 .rv,"r 1/ /1 3~': 11. TYPE OF BUILDING: (check one) ❑ State Owned ❑ it Nearest Road ❑ Village Public' T or 2 Family Dwelling No. of bedrooms Town OFRus1-i .i.ver 30 'th Ave: 111. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 023 1024 80 100 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. [g New 2. ❑ Replacement 3. E] Replacement of 4. ❑ Reconnection of 5, E] 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) Elevation 450 376 376 1.15 0 7.0 Feet 98.5 Feet ' VII. TANK Capacity acltns Total # of Prefab. Site Fiber- Exper. INFORMATION g Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New Existing strutted Tanks Tanks Septic Tank or Holding Tank 1 1000 1 1V1L1.d1,7CS,0_.r 1 ® ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber 1 750 1 "'j,dm-'a-Lern ❑ ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility or installa " of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plum is Signa=NS ps) , MP/MPSW No.: Business Phone Number I? 6646 1-715 698-2266 " NR Plumber's Address (Street, City, State, Zip Code): 506 bqillow Dr. l w-0caaville t°TI. 54028 IX.' COUNTY/ DEPARTMENT USE ONLY Disapproved Sanitary Permit Fee (includes Groundwater ate Issued I Issuing Adent Si ure afnps) - Surcharge Fee) pproved E] Owner Given Initial Adverse Determination ' X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: ,SBD-6398 (R. 05/94) DISTRIBUTION: Original w County. One copy To: Safety& Ruildrogi" ivision, Owner, Plumber _ INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2_ Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD-6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. Il. 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) fora 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. ~3,rn, 70~~~' l~•~~ 7.3 '71 /0 a•a .D /S~ 3011 Sv f SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations October 2, 1996 2226 Rose Street La Crosse WI 546 WEGERER SOIL TESTING 421 N MAIN STREET PO BOX 74 RIVER FALLS WI 54022 RE: PLAN S96-41312 REVISION TO PLAN S95-41194 FEE RECEIVED: PATTERSON, KEITH SW,SE,15,28,17W TOWN OF RUSH RIVER 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. - The approved changes will become an addendum to the plans previously approved. All other portions of the installation shall conform to the original approval. 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. SBDA-7987 (H. 1044) f SAFETY & BUILDINGS DIVISION i I State of Wisconsin Department of Industry, Labor and Human Relations WEGERER SOIL TESTING Page 2 October 2, 1996 PLAN S96-41312 Inquiries should be directed to me at the number listed below. Please refer j to the plan number shown above. Sincerely, 4 erard M. Swi Plan Reviewer Section of Private Sewage (608) 785-9348 SBDA-7987(8. 10/84) r Page of 6 MOUND SYSTEM FOR A 3 BEDROOM RESIDENCE S96 °4131.2 LOCATED IN THE SO 1/4 OF THE SE 1/4 OF SECTION ~5 ,T 78 N, R XI W, TOWN OF j~,US@} ~1U~1Z. ST". C~ZUIX COUNTY, WISCONSIN. RECEIVED INDEX SEP 3 0 1996 PAGE 1'of 6 TITLE SHEET SAFETY & BLDGS. DIV. 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 0 s''PG ~qll~ PREPARED FOR ~ L Coll tit ~~0~s l T so t\) _ 1~ "`Tbi ~ T~12 e GCZ N ►JeRI~IZ CL ; ~S~oo ~,~o f 03 LOS 1`~t~_~E''CO~Yr-~-~ wlrv Ss ~~geoUSt~c s*E G® PREPARED BY 4QQ~.e~,ae~cor~. WECERER SQ = L TEST S NG a~~~®@7`'~~e AND DES = GiV SERA I CE °i F.O. BOX 74 421 N. MIN ST. $ ARTHUR L. RIVED FALLS. VI 54822 • = o s,s r ~ O 6LLSW!'iRTH, • i Ms. 715-4225-0101 i t SIGIA$ tQs u `MS p 1 tl'~N \s A R,ej1 S r qAj T-0 F S 95 - 11 l gV_ Z _rvvE o iZI Gt A_l z tows Q! tj "iso '1 X12 ft S 3 2 ~ ti.,iY~ JrvDlV~~ s~prlc ~ 12 pv~P 1 h . vz vksQb q- Z6 -q~ `rte ltuv sF ~o c~i)ti tit s i.>so c ~a~, G~ . JOB NO. Q 6- Z 6 S PLOT PLAN Page Z of Scale l"=LW S so' of y" pvC WL t ►v . L~.Z ` 2 ~I ~ ~ B~~;ti•~y r~ N 1`~UV s E 2 ~ a a 7 J Cp,v 0 ' J ~ 8~o a e~- g~~ Z ~-LC. t vim? ~ B:3 8.6 • P S' oT-- z4? v c 6 WLOl5 31y'`~,lYj. C~uC ptp~ r \ w / Lr~'1't} /y • 'D'o FvoT lP ft-c.T' U1Z / 6 M l~~S~Z.3 ~tS A2.LSA ~.s ~ L-LOL-L It 1 ~31 w~L `to '%E AT L 5 T S F,~or , r , ov a rl.~ • ~ O Page Of 6 Approved Synthetic Covering Fs-r" C- 3; Distribution Pipe - Medium Sand Topsoil ==H_ G F Elev. q1.O , 3 E D b 8 % Slope Bed Of 2~- 2 (Force Main Plowed Aggregate From Pump Layer D 1.O Ft. Cross Section Of A Mound System Using E Ft. F o.$ Ft. A Bed For The Absorption Area G 1.O Ft. A Ft. H \ . S Ft. Linear Loading Rate= Cl- 6 GPD/LN FT B Ft. Design Loading Rate= 0,9 GPD/SQ FT j ~ b Ft. J '1 Ft. K Ft. -A-g-Position F Ft. of Force Main W 3 1 Ft. L J Observation Pipe g K A I - - - I0----- w o Distribution Bed Of 2«- 2 Pipe z Aggregate, I Observation Pipe Permanent Markers (Anchbr securely) Plan View Of Mound Using A Bed For The Absorption Area 6 Page L) Of . Perforated Pipe Detall J""" 0 End View )Perforoted End Cop ~\e~' PVC Pipe as Install permanent-marker at end of each lateral Holes Located On Bottom, Are Equally Spaced 2 S / P PVC Monifotd Pipe PVC Force Main 4 Oistri ution Pipe Lost Hole Should Be I Next To End Cop End Cap P Z L Ft. Distribution Pipe Layout S _Y Ft. X 118 Inches Y q `6 Inches Hole Diameter Inch Lateral Inch(es) Manifold Z Inches Force Main Inches # of holes/pipe Invert Elevation of Laterals CI-1.5 Ft. 6X ~-l1= ~.OZ may= ~3.oY, .t Place lst hole 24 from center of manifold with succeeding holes at LILY' intervals. Last hole to be next to the end cap. PUMP C.HAMB.ER CROSS SECTIOIJ ARID SPECIFICATIOMS ' PAGE OF VENT CAP ti" C.L VENT PIPE WEATHER PROOF APPROVED LOCKING MANHOLE JUMCTIOIJ BOX COVER WITH WARNING LABEL' ~ 10' FROM DOOR, IT"MIU. wiUDOW OR FRESH I AIR IWTAKE I GRADE I '40 AIM. I Ie -AIN. COWDUIT • PROVIDE I 11JLET 7 AIRTIGHT SEAL I III ~ l ill v APPROVED JOUJ*f A Tank construction shall comply I 1'I APPROVED JOINTS with ILHR 83.15 and ILHR 83.20 i 'II ALARM a i ~I I ON C - - 3D LLEV. L FL PUMP-~ OFF 0 90 \'1 COUCKETE DLOCK 3" APPROVED RISER EXIT PERMITTED OIJLtJ IF TANK MAUUFACTURER HAS SUCH APPROVAL gEDpIµG SPECIFICATIONS ...333...___ oosE TANK MANUFACTURCK' 1~tDweS N 1~t ST NUMBER OF DOSES:_..3 PER OAy TANK SIZE: GALLONS DOSE VOLUME r 3 S ALARM S.S. ~L.E?~~ZO S`tS*7?~ MAUUFA,CTURCR: INCLUDING 6ACKFLOW: GALLONS `I1 1 ~W CAPACITIES: A= 1 WCHC509 31~ ' O GALLONS I'SODE:L 1JUMBCR: SWITCH TSPE: B= IMCHES OK 3'1' 0 0QLLOIJS PUMP MANUFACTURER: Zo ~ L`~ (2z C = ILICHE5 OR \3 L' S CALLOUS MODEL NUADER. 5-1 D= \3'I IZINCHES OR Z,03 "Z GALLONS `r6l".=ISO, 5WITCH TYPE' ~'1~12Cu12-`~ LIOTE: PUMP AND ALARM ARE TO DE MIMIMUM DISCHARGE RATE Z & O S GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE DETWEEAI PUMP OFF AUD_DISTRIBUTIOM PIPE.. 6.zo FEET t MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . 2.50 FEET -F 3S FEET OF FORCE MAIN X 6j F%o t<xFRICT101J FACTOR. O' S6 FEET go TOTAL DIJIJAMIG HEAD = g --Z FEET DIAMETER 1 ~q IUTERNAL DIMENSIOW~ OF TANK: LEKIGTH _ ;WIDTH _ ;LIQUID DEPTH 38 BOTTOM AREA - - 231= GAL/INCH AS PER MANUFACTURER S GAL/INCH _ 4'/e _ 6y4 HEAD CAPACITY CURVE 45/8 _ W LL "57" - "59" SERIES w 4 /6 25 _ _ 1'k - 11'h NPT 43/16 20 I 6 - a I W V 15 z 4 915/16 O J F O 10 Q / ~ +Zb 33/32 2 5 TOTAL DYNAMIC HEAD/ FLOW PER MINUTE EFFLUENT AND DEWATERING HEAD CAPACITY UNITS/MIN 0 FEET METERS GAL LTRS 10 20 30 40 50 US 5 1.52 43 163 GALLONS 10 3.05 34 129 LITERS 0 80 160 15 4.57 19 72 FLOW PER MINUTE 19.25 5.87 0 0 .11 CONSULT FACTORY FOR SPECIAL APPLICATIONS . Piggyback Mercury Float Switches a Available with special cord lengths of 15', available. 25', 35' and 50'. *Variable level long cycle systems -Alarm systems available. available. a Duplex systems available. Standard cord length - automatic 9 ft. SELECTION GUIDE Standard cord length - non-automatic 15 ft. 1. Integral float operated mechanical switch, no external control required. 2. Single piggyback wide angle mercury float switch or double piggyback mercury 57/59 SERIES f;ontrol Selection float switch. Refer to FMO477. Model Volts-Ph Mode Am SIm lex Duplex 3. Mechanical alternator 10-0072 or 10-0075. M57/59 115 1 Auto 8.0 1 or 1 &7 - 4. See FM0712 for correct model of Electrical Alternator. "E-Pak". N57/59 115 1 Non 8.0 2 or 2 & 6 3 or 4 & 5 5. Sensor mercury float switch 10-0225 used as a control activator, with "E-Pak" D57/59 230 1 Auto 4.0 1 or 1& 7 - duplex (3) or (4) float system. E57/59 230 1 Non 4.0 2or2&6 3or4&5 6. Four (4)hole "J-Pak', junction box, for watertight connection or wired-in simplex or 2 pump operation, 10-0002. 7. Two (2) hole "J-Pak", for watertight connection or splice, 10-0003. 57 Series - Wt. 27 -.3 H.P. 59 Series - Wt. 29 -.3 H.P. CAUTION For information on additional Zoeller products refer to catalog on Combination Starter, All installation of controls, protection devices andwiring should bedone byaqualified FM0514; Piggyback Mercury Float Switches, FM0477; Exectrical Alternator, FM0486; Mechani- licensed electrlclan. All electrical and safety codes should be followed Including the cal Alternator, FM0495; Alarm Package, FM0513; Sump/Sewage Basins, FM0487; and Simplex most recent National Electric Code (NEC) and the Occupational Safety and Health Act Control Box, FM0732. (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16347 Louisville, KY 40256-0347 nufacturers of . Q SHIP TO. 3280 Old Millers Lane Louisv, KY 40216 O 0~~~~/ 1 O~ (502) 778-27311(800) 928-PUMP `147MP8 F1=7 1839 " FAX (502) 774-3624 Safety and Buildings Division SANITARY PERMIT APPLICATION Bureau of Building Water System, 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. -0A • See reverse side for instructions for completing this application State Sanitar Permit Number 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 Property Owner Name Property Location Keith Patterson SW 1 /4 SE 1/4, S 15 T28 , N, R 17 E (or) y1/ Property Owner's Mailing Address Lot Numr, Block Number 10205 Gn~__nhrjer Rd 31S City, State Zip Code Phone Number Subdivision Name or CSM Number Minnetina,MN 55305 ( > 4-3? 3 II. TYPE OF BUILDING: (check one) ❑ State Owned City Nearest Road 11 village ❑ Public 1 or 2 Family Dwelling - No. of bedrooms 3 own OF Rush River 30th. Ave. III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) a23 -/oZ~ 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. New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5_ ❑ Repair of an System System Tank OnlyExisting 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 E] 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) Elevation 450 376 376 1.19 0 97.0 Feet. 98.5 Feet VII. TANK Ca in gallons Total # of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App New Existing strutted Tanks Tanks Septic Tank or Holding Tank 1 1000 1 Midwestern 0 ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber 1 650 1 Midwestern 0 ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibilit or installs ion of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plu er's Signatur Stam ) MP/MPRSW No.: Business Phone Number: Joe Stang NP 6646 1-715-698-2266 Plumber's Address (Street, City, State, Zip Code): 506 Willow Drive Wood 'lle WI. 54028 IX. COUNTY / DEPARTMENT USE ONLY , ❑ Disapproved Sanitary Permit Fee (Include' Groundwater Date Issue Issuing Agent Signature (No Stamps) Approved f-1 Owner Given Initial Surcharge Fee) al. /0 1 Adverse Determination _j 11 1 . X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: SBD-6398 (R. 05/94) DISTRIBUTION: original to County. One copy To: Safety & Buildings Divi.ion, Owner, Plumber INSTRUCTIONS 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 througl- 7. VII. Tank information. Fill in the capacity of every new/or existing tank, listthe tota Gallons, num'a_r of tanks and manufacturer's name, indicate ;.+refab or site constructed and tank material. Corr plete fo 3(~ ;tic, pump/siphon and Bolding tanks for this system, C~~eck experimental approval only if tanks received experirr ent,3~ roduct approval from DILHR. VIII. Responsibility statement Installing plumber is to fill in name, license number vvd ,i appropriate ,refix (e g. MP, etc.), address and phone number. Plumber must sign application form. IX. County / Department Use Only. X. County / Department Use Only. et« J.an, and sp-~cIflcatloi not smaller than 8 112 x 1 1 ;Aches rr:wt be su d ..o lr my he plans must Ding t,;nk(s), septic L:,i r,51 v l1_ ~.v= s tr:~ 'akrpump or siphon lil: Ing ';e; VF- v lu ej oy _ -cu td".. nfor!~,ation- GROUNDWATER SURCHARGE 1983 Wtsconslr'_ Act X110 included the creation of surcharges (fees) for a number of ree(,lated prr,ct:Jt_s which can effect groundvvater The monies collected through these su-charges are used fo- monitoring groundoiate :.ntamir-aJc.!- ivestigations and establishment of standards. SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations October 2, 1995 2226 Rose Street Crosse WI 54603 WEGERER SOIL TESTING' P,~a? ~r 421 N MAIN STREET u' Liz:; PO BOX 74, RIVER FALLS WI 54022 RE: PLAN S95-41194 FEE RECEIVED: 180.00 PATTERSON, KEITH SW,SE,15,28,17W TOWN OF RUSH RIVER COUNTY OF ST CR.OIX 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 Depart.ment'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, a.rd i Swim Plan Reviewer Section of Private Sewage (608) 785-9348 2708R/ 1 SHDA-7887 (K. 10184) S 9 5 - 4 1- 9 Page of 6 MOUND SYSTEM RECEIVED FOR SEP 2 5 111" A 3 BEDROOM RESIDENCE SAFETY & BLDGS. DIV. LOCATED IN THE SW 1/4 OF THE Se: 1/4 OF SECTION ~5 TZ.B N, R 11 W, TOWN OF U S~~ R 1 QNEZ. , ST". C~tOI x COUNTY, WISCONSIN. INDEX PAGE l 'of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW-CROSS SECTION PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT .PAGE 5 of 6 PUMPING CHAMBER ' PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR - N~:L'TtA ~#l-'TTkTQ SO N 1(3 05 CtzLx- J8RLeiz 2D 1+ 315 = ti"117~ IvE'~CO~~ ~ )"1N SS3~S PREPARED- BY ML°€ll WEGEF:ZER SQ I L TESTING c~~ DES I GtV SlE[~V I CE e ARTHUR L t6~ we i F.U. BUI 74 421 M. KAIM ST. 0.997515 P P RIVET FALLS. MI 54422 a t r~s~RTH. 715-4ir-4165 ~ t ~s~if S I G N ftnen Gt -ZI-9 S JOB NO PLOT PLAN 4 J 4 Page -z-of Scale 1 Y~o u S E 1 _ O 7 S . J N o C v ~ ~ Tbuv) @~J ' 2 LLQt by 8 0 tTl°t-1, LT • P O a s.3 $ ZSoF Z 9V PC o~ 69 ' F• r►. ~3w~ U1 \ 100.0 ~N 814WIGll a-~ 6 ~~0 31~(``1'11Ij, ~uC PIPS ~2 A3 5 N / -R°T~F ,N M 'Do ►voT c0~'iPh ~-T OR ' 6 9 ' AftV get`(, l4iS5 e° A?~ID P loovsF ~j we,L -~,m. 8L > so' NE OF 1I0ukjp, . -o V1 o. b tin. i ~ 4L "51 Q0 114 U FE NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral.-(~ required) 3. Install 4" observation pipes with approved caps. ( Z required) 4. Septic tank to be 1bo0 46S0gallon capacity manufactured by 5. Bench Mark SQ'Fz ftz out - 6. Divert surface water around mound to prevent ponding at the uphill side. Page 3 Of 6 S~*6-41x94 Approved Synthetic Covering Fts-7" C- 33 Distribution Pipe Medium Sand Topsoil -=H_ F G Elev. 3 E p ` " 111 S,Je - b ;g % Slope Bed Of 22 i Force Main Plowed r Aggregate From Pump Layer B& D • O Ft .!VISION oss Section Of A Mound System Using E Ft. A Bed For The Absorption Area F Ft. G 1.O Ft. Anv~ A Ft. H Ft. Linear Loading Rate=q, 6 GPD/LN FT B -Z Ft. Design Loading Rate=,O,g GPD/SQ FT j to Ft. . J -7 Ft. K Ft. Position of L Ft. Force Main W 3 1 Ft. L I Observation Pipe r \ I - g K A M 11 Distribution Bed Of z - 2 2 Pipe Aggregate 1 Observation Pipe Permanent Markers (Anchor securely) Plan View Of Mound Using A Bed For The Absorption Area Page LlOf b 595-41194 Perforated Pipe Detail 0 End View )Perforated End Cap./) PVC Pipe 1 ~"a\e nG Install permanent-marker at end of each lateral Holes Located On Bottom, Are Equally Spaced Q S i P PVC Manifold Pipe f~ \\\4. ~ PVC Force Main Disir ution Pipe Last Bole Should Be I Next To End Cop End Cop P Z Z Ft. Distribution Pipe Layout S -Y Ft. A X 'I8 Inches Y Inches 'f Hole Diameter Inch Lateral Inch(es) Manifold Z Inches 41c~s F, 'Alt „ ray, Force Main Inches # of holes/pipe x Invert Elevation of Laterals q1.5 Ft. Place lst hole Z~ from center of manifold with succeeding holes at f{~~intervals. Last hole to be next to the end cap. ` Combination Septic Tank and S 9 jj JsqOj PUMP CHAMBER CROSS SECTION AMD SPECIFICATIONS ~~PA 6 -VEWT CAP WEATHER PROOF JUIJCTIOIJ eox '1'C.I. VENT PIPE APPROVED LOCKIMG x.10' FROM DOOR. MANHOLE COVER P -nv .WINDOW OR FRESH wARN11JG Li4gE1.. ALK IWTAKE co,JDu>r MIAI. LrL C) / I 40 18' M I AI. PROVIDE I UJLE T AIRTIGHT SEAL a gFFLES I I I I I APPROVED J011Jt3 APPROVED JOIAJT A I W/C.I. PIPE~Pw W/C.I. PIPfDR Tank construction I III ALARA shall comply with I t LHR "3-:15 end 83.20 e I 11 ~ _ .f - I I o1J yJ C rSg~• EY.~ FT. PUMPS --j . _ ~ OFF D CONCRETE t t `,t Lsl- q~.OO BLOCK 3•' APPftd•e RISER EXIT PERMITTED OULtJ IF TAIJK MANUFACTURER HAS SUCH APPROVAL gFDpIN~ SEPTIC E 5PEC.IFICAT10US DOSE -~~Owe~TE~eJ 1~tz ST 3 ~9 TAWK MANUFACTURER: WUMBER OF DOSES: PER DAy TAWK SIZE: `r6~O 1 6S0 GALLOWS DOSE VOLUME r ALARM MANUFACTURER: S'am' EL~w 3k5`jEM_S INCLUDINCa BACKFLOW: 11~ GALLONS MODEL ►JUMBER: `Aw CAPACITIES: A= ~1E IMC14ESOR GALLONS SWITCH TYPE: 11-1 k-M CJJNZl'f 8 = Z IWCHES"OR 3T C, .LLOI.IS PUMP MANUFACTURER: LZTL CU• C= 7 INCHES OR 1 9 CALLOUS MODEL IJUA5ER: S-7 D- _ N) INCHES OR l 8-7 GALLOIJS SWITCH TYPE: L1ZCU1Z~f MOTE: PUMP AMDALARM ARE TO bC b MIWIMUM DISCKARGE RATE GPM INSTALLED OM 5EPXRATE CIRCUITS vEKTICAL DIFFERENCE DETWEEIJ PUMP OFF A1JO..0I5TRIBUTIOW PIPE.. 6-se) FEET t MIIJIMUM METWORK SUPPLY PRESSURE . , • • , . . . . 2.50 FE.ET + Z S FEET OF FORCE MAIM X ~ b) F 00 fiFKICTION FACTOR-. O'qc~ FEET TOTAL OtWAMIC HEAD = MEET Pump chamber DIAMETER _y 11JTERLIAL DIMEW510M; OF TAWK: LENGTH ;WIDTH ;LIQUID DEPTH. BOTTOM AREA - 231= - GAL/INCH AS PER MANUFACTURER = ~1 GAL/INCH S 9 ~ 41 19 4PPvGE- 4% 6% HEAD CAPACITY CURVE 45/8 CC W `6579 - "59" SERIES W a /6 25 _ 1 %z - 11'12 NPT 43/,6 20- - I w x 15- V a z Y C 4 9,5/16 J Q F 0 10 °I. 4 8 33/32 2 Ze. 08 5 TOTAL DYNAMIC HEAD/ FLOW PER MINUTE EFFLUENT AND DEWATERING HEAD CAPACITY UNITS/MIN 0 FEET METERS GAL LTRS US 10 20 30 40 50 5 1.52 43 163 GALLONS 10 3.05 34 129 LITERS 0 80 160 15 4.57 19 72 FLOW PER MINUTE 19.25 5.87 0 0 CONSULT FACTORY FOR SPECIAL APPLICATIONS Piggyback Mercury Float Switches -Available with special cord lengths of 15', available. 25', 35' and 50'. -Variable level long cycle systems -Alarm systems available. available. - Duplex systems available. Standard cord length - automatic 9 ft. SELECTION GUIDE Standard cord length - non-automatic 15 ft. 1. Integral float operated mechanical switch, no external control required. 2. Single piggyback, wide angle mercury float switch or double piggyback mercury 57/59 SERIES Control Selection float switch. Refer to FMO477. Mode( Volts-Ph Mode Amps Simplex Duplex 3. Mechanical alternator 10-0072 or 10-0075. M57/59 115 1 Auto 8.0 1 or 1 & 7 - 4. See FM0712 for correct model of Electrical Alternator. "E-Pak". N57/59 115 1 Non 8.0 2 or 2 &6 3 or 4 & 5 S. Sensor mercury float switch 10-0225 used as a control activator, with "E-Pak" D57/59 230 1 Auto 4.0 1 or 1 & 7 - duplex (3) or (4) float system. E57/59 230 1 Non 4.0 2or2&6 3or4&5 6. Four (4) hole "J-Pak-. junction box, for watertight connection or wired-in simplex or 2 pump operation. 10-0002. 7. Two (2) hole "J-Pak", for watertight connection or splice, 10-0003. 57 Series - Wt. 27 -.3 H.P. 59 Series - Wt. 29 -.3 H.P. CAUTION For information on additional Zoeller products refer to catalog on Combination Starter, All Installation of controls, protection devices and wiring should be done by a qualified FMO514; Piggyback Mercury Float Switches. FMO477; Exectrical Alternator, FMO486; Mechani- licensed electrician. All electrical and safety codes should be followed Including the cal Alternator, FMO495; Alarm Package, FMO513; Sump/Sewage Basins. FMO487; and Simplex most recent National Electric Code (NEC) and the Occupational Safety and Health Act Control Box, FM0732. (OSHA). RESERVE POWERED DESIGN { - For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16347 Louisville, KY 40256-0347 Manufacturers of . OZZZ-11W OI SHIP T0: 3280 Old Millers Lane Louisville, KY 40216 .(502) 7 78-2731. 1(800) 928-PUMP 14LIA0147-9 SINCE 19,7S FAX (502) 774-3624 Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code i OUNTY 7 Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, t not limited to vertical and horizontal reference point (BM), direction and % of sbPe, scale or t PARCEL I.D. # '7 - dimensioned, north arrow, and location and distance to nearest road. 't 2 APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REV4JYX ATE cocvy PROPERTY OWNER: PROPERTY LOCATION VE ti Eb t f+~t> L,~'I I~DA PcFFta L'(k GGVT-66+^ SW 1/4 r tl t 1 .I 1~ E (orN t 614 PROPERTY OWNER':S MAILING ADDRESS LOT\ # BLOCK # JSUBD. A RCS 116 S Z 30 T* - Nue; • 1 - 1~11WposQb a- %),I CITY, STATE ZIP CODE PHONE NUMBER E]CITY (]VILLAGE MOWN NEAREST ROAD w) 54u6z PIS) ~8~lzosb 'VZvSN V,-"IUN--R ZQNT* ttuc New Construction Use [A Residential / Number of bedrooms 3 (J Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow Ld S O gpd Recommended design loading rate 0 y bed, gpd/ft2 - trench, gpd/ft2 Absorption area required 31S bed, ft2 trench, ft2 Maximum design loading rate 0 S bed, gpd/ft2 a- 6 trench, gpd/ft2 RecommandtA infiltration surface elevation(s) q.1.1 U ft (as referred to siterplan benchmark) Additional design / site considerations *,N0J*Jl rv /8' X u1, B \1~) - M llu . ) C )F St" Ff f.L . Parent material G "-p f'ou h U -%Z> Qi FT Flood plain elevation, if applicable 1L1• ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN RLL HOLDING TANK U= Unsuitable fors stem E] S [KU as E] U [IS ®U ❑ S 03 U El S LO U ❑ S Wu SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Bwmbiy Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed rent >h>: O-`1 ti0 ~-(lz. 31Z - '5 t Z `FShcz ".,`f%, C-S - o• S rA A Z 9-35 ,,s ~c~ 3~y - 1 s o s 9 1 cs o•~ Ground 3 3S_yl 1U`-1R I/(, '~-S~t2SIr3 c~$s1 ~wN elev. q q,0 ft. Depth to limiting factor 3S" Remarks: Boring # Y z£ Z to-uZ ~0~2 31e - s Z~sbh w, fir- cs - s €o. L 3 S `itZ ~!/(o TS o yrt U'Fl- ~g o. S o, b Ground elev. S3-6o ~0 `t lZ Y / S `i Q S l 8 S) Ow, YVJ T►- - - 9~ ft. Depth to limiting factor 5 3" Remarks: CST Name:-Please Print Arthur L. We erer Phone: 715-425-0165 egerer Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022 Signature: f 21'z~ g S_ Z 71 O Date: CST Number. M00576 PROPERTY OWNER SOIL DESCRIPTION REPORT Page of 3' PARCEL I.D. # Depth Dominant Color Mottles Texture Structure Consistence Bouncbry Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench a,S - o.S o. 0-9 1p42 31Z ~ s w,~l- : , Z 9-! 10YtZ 3J6 - G1-SiI Zwi sbk w~ il~ cS uS Ground 3 1$- b ~•s ` iL o S,~s C S a.S o• elev. CL~ A- ft. Depth to limiting factor Remarks: .C~ Boring # 1 p, 1 iz~-t R- 3 f - 3 l Z `F3b1z vn \ r- a-S u . S 0. y Z 8 -30 ~O`1 1 G1~ s t Z.b►n S ~k rn 'F~. S - p. S a. L 3 so-VS "1• S `t~Y/~ -s y~ sly S v w. MU~1. - Ground elev. Q3-S ft. Depth to limiting factor Remarks: Boring # `n .611 MINE, p_g ~p..t\2 31Z 51 ZTSdtiC vn~} C-S o S o. S Z 8-Z8 ~0`11~ 316 - S) ZwL sbk ►n cS 0~s o. b G-~i.S y a- slf, ~g s. c~`^y vn v - - 3 JZ8-6Z loH tL yl Ground elev. I Q?~ ft. Depth to - - - limiting facto Remarks: Boring # c cl vzm- z- 312 S 1 Z 5~1~ w~`~1~ C,,--S _ o. S n_ 6 UUyt4}• I Ley..?? 1?:•.}~ Q- S : b 6 ~ Z °t~3~J LO `[2 3~L - Grzil Z.~3b12 rn'F~- cS - O~►, wt U'f 1. I' 3 34-0 Lu-l 2 V /V S/a ~3 t S , Ground elev. Depth to limiting factor Remarks: SBD-8330(8.05192) PLOT P LAN Page 3 of 3 SCALE 1"= qp 1 J Coki B U 8:3 t3.6 • P $_y N M ~L X00.0 ON `~~t~ lGN a-\~] PAC Piet: ENV, 'ao ►voT WwtPhtT Ott 61y, 8.2 ~ Ni LL°1Zy t!Lctq n TES !u ^V,? `llw C R O V O-b M1 4. '30 `f14 4a U E ay ~r l- C1 S (715 ) 425-0169 M00576 CST Signature Date Signed Telephone No. CST # S g FILED iv DEC 1 3 1995 ► 10 KATHLEEN H. WALSH ~ St.CtoixC0.W1 j1 537433 CERTIFIED SURVEY MAP LOCATED IN THE SW 1/4 OF THE SE 1/4 OF SECTION IS, T28N, R17W, TOWN OF RUSH RIVER, ST.CROIX COUNTY, WISCONSIN. PREPARED FOR:EDWI RD AND LYNDA AFFOLTER UNPLATTED LANDS ' _ H 0 N 90000'00"E 347.15' 0 z O LOT I 5.00 ACRES 0 0 Z N (217, 815 SO. FT.) O :C ;Z D c~ii NO NOTE: BEARINGS ARE REFERENCED TO THE SOUTH LINE OF THE SE 1/4. cn (ASSUMED BEARING). m m : m r rn v' ; :z EX v WELLTING NO ;Z : :v L.ij 24g• 92, 35. 92' i '95 79°38' 03„W z~ 67• g~, I STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER Keith Patterson 10205 Greenbrier RD # 315 Minnatonia MN MAILING ADDRESS PROPERTY ADDRESS / kS 36 t 4 Ila (location of septic system) Please obtain from the Planning Dept. CITY/STATE /~U) ! GL S `/0 0 2-- PROPERTY LOCATION SW 1/4, SE 1/4, Section 15 T 28 N-R 17 W TOWN OF Rush River ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAPS-.? ?733, VOLUME//2 ,PAGE LOTNUMBER- a4 3&z6 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. leted and returned to the St. Croix Certification stating that your septic has been maintained must be 2/nt. County Zoning Officer within 30 days of the thre*year ' eSIGNED: DATE: c 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 Keith Patterson Location of property SW 1/4 SE 1/4, Section 15 T 28 N-R 17 W Township Rush River Mailing address 10205 Greenbreir RD # 315 Minnentonka MLA 55305 Address of site / k S-# 3 U yq j , SZfap ~i 01 Subdivision name Lot no. Other homes on property? Yes X No Previous owner of property Ed Affolter Total size of property Total size of parcel Date parcel was created Are all corners and lot lines identifiable? X Yes No Is this property being developed for (spec house)? Yes X No Volume 17 and Page Number ~ Cif' 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. L( 2 146,3 , 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. 'y gnaturaeof 6pp~ Co- lic /vim Date o. Signature Date of Sign ure v42 63 STATE BAR OF WISCO?CZti FORM 2 - 1982 r I ; WARRAiTI DEED 7EG13iERJ CF-FICS VOL 1173 P%'z 298 ; s~ CRO~x ctv, tiv1 ? DOCUMENT NO. ' Edward J. Affolter, a/k/a Edward John APR 19 1996 it Affolter and Lynda L. Affolter, husband ft 3:00 and wife comePs and warrants to Keith J. Patterson and Jacquelyn I y ng as ' it -3 I E. atterson, husband and wife, holdi survivorship marital property it I T IS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS the following described real estate in St. Croix County 3R t1 Lpnr a'SU tJ i 1 ii State of Wisconsin: PI py N s s uN a TRAM .z FEE r PARCEL IDENTIFICATION NUMBER Part of the Southwest Quarter of the Southeast Quarter (SW'k of SEh) of Section Fifteen (15), Township Twenty-eight (28) North, Range Seventeen (17) West, more particularly described as Lot t, f Certified Survey Maps, filed December 13, 1995, in Volume { 1 C11 of Certified Survey Maps, at Pages.-302 , as Document No. 537433, office of the Register of Deeds for St. Croix County, Wisconsin, together with 66 Loot wide ingress and egress easement y; as shown on said Certified Survey Map and in Volume 1152 of Records, at Page 451. r This is not homestead property- (is not) Exception towarranues: Easements and restrictions of record. Dated this day of ~D t C A.D., 19 96 (SEAM- IQ~ZA (SEAL) n'!-' s dward J. Affolte 1 (SEAL) (SEAL) Af' y Lynda L Affolter AUTHENTICATION ACKNOWLEDGMENT ) State of Wisconsin, Signature(s) ss. +Y?~ i