Loading...
HomeMy WebLinkAbout034-1044-70-000 -0 0 (D o 0 G~, o a Q` o Y ~ N O N N 7 Q O O O O U C ° U LO O X (2 O O \O L N p O O U LL ~1crn~ FO. .0p O°)1N W N O U co C N - 7 z 3 C E 0 co 3 N O N LL 7 N . O C X j N N ~ L7 j Q 0- v U -0 v ~ z E U) o V £ i Z a m rn U) ° o o z :r N ~ ~ N v z o ~ C: N O _0 4~ *i c U m O z z o N z ° N j E L y N N N C45 a r+ w O CO cn N d i N O p y o o a -Q O) N o F- F. wo N Lo 0 'IT 0 0 0 a z O •N ca aaa CL o N rn rn N to J U m rn } 00 3 0 0 GC) o o ~ i s Q' m L V N N O 'C d ,1 19 00 0) C: O N 7 C: U) V CQ O O F. E O y w a C 0 (D CD : r M O _ a Q -0 N N Lo 4) o o ~f. O N C) L L 27 O C O) O N E E N co co 'n U 0 U) 04 In W l6 ( a xt a : L a w s a m N y c r`1rr1 E c c 3 D U a. m 3: 0 in U Parcel 034-1044-70-000 10/04/2007 09:24 AM PAGE 1 OF 1 Alt. Parcel 19.29.15.303 034 - TOWN OF SPRINGFIELD Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner CYNTHIA C BLAKE O - BLAKE, CYNTHIA C 2772 80TH AVE WOODVILLE WI 54028 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ` 90TH AVE SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 19.000 Plat: N/A-NOT AVAILABLE SEC 19 T29N R15W 19AC SW SE EXC PART TO Block/Condo Bldg: CSM 8/2392 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 19-29N-15W Notes: Parcel History: Date Doc # Vol/Page Type 06/26/2006 828299 WD 03/09/2005 789217 2762/154 QC 03/05/2003 712117 2162/87 WD 10/22/1999 612521 1465/118 WD more... 2007 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/15/2007 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.000 12,700 57,350 70,050 NO UNDEVELOPED G5 18.000 27,900 0 27,900 NO Totals for 2007: General Property 19.000 40,600 57,350 97,950 Woodland 0.000 0 0 Totals for 2006: General Property 19.000 21,300 46,650 67,950 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 V STC - 104 r , AS BUILT SANITARY SYSTEM REPORT " -LA ~p t'1A~ E 9 ADDRESS U SUBDIVISION / CSM# LOT # SECTION T N-R i ;F"W, Town of el: ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM i~ 1 t 4 i 3 i1 ~ ~ 11 p Fj Jr +f I . .r-w+n _ a a.f..ti..rt. .am..,....„ .r_ v..-.,...-.. n ...~-v...i.... INDICATE_ NORTH- ROW V61 Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK : ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION r~~ y is ! G Liquid Capacity: Manufacturer: Setback from: Well House/ Other Pump: Manufacturer 2" < Model# Size seperation Gallons/cycle: l Alarm Location- SOIL ABSORPTION SYSTEM Width: Length Number of trenches :Distance & Direction to nearest prop. line: ~ Setback from: well: House Other ELEVATIONS Building Sewer ST Inlet: 0 r ST outlet: PC inlet PC bottom ~5",-10 Pump Off Header/Manifold Bottom of system Ll Existing Grade Final grade DATE OF INSTALLATIO r. PLUMBER ON JOB: C/ LICENSE NUMBER: J f L I~Jt. INSPECTOR: 3/93:jt II Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIK Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No-: GENERAL INFORMATION 268670 Town of: State Plan ID No.: jr] Permit Holder's Name: El City ❑ Village TANGEN, TOM SPRINGFIELD CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: ~:.,~a7y» TANK INFORMATION ELEVATION DATA A9600375 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic SP Benchmark 63 Dosing a-M , 16, VYI tzoo, f S ~S, 5 7 Aeration Bldg. Sewer X71 Holding-- St/ef Inlet TANK SETBACK INFORMATION St 1)1K Outlet °s TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet y- Air Intake Septic NA Dt Bottom G3 </o' G Dosing 11 l l 025 / NA Man. 99,5 Aerati NA Dist. Pipe , SS Holding Bot. System ~Ij PUMP % SIPHON INFORMATION Final Grade Manufacturer ~e r errand 7 . Model Number 57 SP TDH Lift 310, Friction`<L)' System2.!5d TDH/, j Ft ss 0" Head Forcemain Length Dia. " I Dist. To well 0 SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches IT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS s DIMEN FL NG Manuf SETBACK SYSTEM TO P / L BLDG WELL LAKE / STREAM INFORMATION TypeO r2,,,,,. t O r CHAMBER r. System: -f,~❑j 3 OR UNt DISTRIBUTION SYSTEM 1:Leaf /Manifold Distribution Pipe(s) 11 x Hole Size x Hole Spacing Vent To Air Intake jr I/ Length Length //J Dia. Spacing ! f~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only M; [De th Over Depth Over xx Depth Of xx Seeded / Sodded Mulched /Trench Center Bed /Trench Edges Topsoil E] Yes El No xYes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) rn: LOCATION: SPRINGFIELD.19.29.15W, SW, SE, 80TH AVENUE Qfs 3. /3 ~~7 y/J l c r / lr ' ? 1 r..~.7 '1W° Plan revision required? ❑ Yes o Use other side for additional information. lU dCY SBD-6710 (R 05/91) Date Inspector's Sign ture Cert No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: Safety and Buildings Division v;a.ri SANITARY PERMIT APPLICATION Bureau of Building Water Systems 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 ~ • Attach complete plans (to the county copy only) for the system, on paper not less County Croix than 8 112 x 11 inches in size. 56. • See reverse side for instructions for completing this application State Sanitary Permit Number ,20~ 74 The information you provide may be used by other government agency programs ❑ Check if 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 Tom Tanen sw 1/4 SE 1/4,S 19 T 29 , N, R 15 E (or) R/ Propert Owner's Mailing Address Lot Number Block Number P.3. Box 23 City, State Zip Code Phone Number Subdivision Name or CSM Number Wilson, WI. 54027 (715) 698-3188 II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ cit~ rest Road [3 VII age ❑ Public 1 or 2 Family Dwelling - No. of bedrooms 1 Town of rin field T 80th. Ave. III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 E] Apartment/ Condo 3 11 - -1 G ?h 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) 1.1 f-4 New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System -----System System Tank Only______________ Existing System ---------Existi - 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 210 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 150 125 125 1.2 98.9 Feet 100.4 Feet TANK Ca aat VII. in gallo s 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 X 1000 1 Midwestern © ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber g 650 1 Midwestern ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plum er's Signatur tamps) MP/MPRSW No.: Business Phone Number: Joe Stang MP 6646 715-698-2266 Plumber's Address (Street, City, State, Zip Code): 506 Willow Drive Woodville, WI. 54028 IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sa tary Permit Fee (Includes Groundwater Date Issue Issuing ent Signat re (No St ) App ❑ Owner Given Initial roved Surcharge Fee) Adverse Determination C~ X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-6398 (R. 05/94) DISTRIBUTION: Original to County. One copy To: Safety & Ruilrlings 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 wiH be applicable. 3_ All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD-6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served;. B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. f SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations September 17, 1996 2226 Rose Street La Crosse WI 54603 WEGERER SOIL TESTING_ a~--r N 421 N MAIN STREETS PO BOX 74 RIVER FALLS WI 54022 +~~~~+;i C7f=FPC^ n RE: PLAN S96-41176 FEE RECEIVED: TANGEN, TOM SW,SE,19,29,15W TOWN OF SPRINGFIELD 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. Sincerely, Oerard M. Swim Plan Reviewer Section of Private Sewage {608} 785-9348 SBDA-7M (R. 18M) 9 6' 4 1 1` 6 Page of 6 r-CEIVED MOUND SYSTEM FOR SEP 1 0 1996 A BEDROOM RESIDENCE SAFETY & BLDGS. DIY. LOCATED IN THE SW 1/4 OF THE SlZ 1/4 OF SECTION Gl ,TZO- N, Ris W, TOWN OF S C~ tZ 1. ~ G F-~ , S7'• Cf? olX 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 SOS S`~STSM tionally 11 PREPARED FOR o MAN 4 I,uILSOIV, (~11 5{,027 ~ pd C~'~S~OdyO~ty~ 4 SSE 1'RE:PARED BY WEGEE~EF2 SQ I L TEST I NG AND. ®~4o~eev I3ES _ CN SERVICE ~sco}~~ F.D. BOX 74 421 K. 1SMIK ST. _a•.•r tit RIV0. FALLS. MI 54022 ARTHUR L • 715,42.,-0165 ® WEGEPER L ® = D•915 P o • 91SWORTH, 1 WIS.~ 1yN.M•••' $~°ti➢1 91 G 14 JOB NO. CY&-Z3`~ PLOT PLAN Page - of 6 Scale 1"=3c) o° w tAIL c L,o CA-'1ttiuty t y,p' of 1 ~ q q 4 oR l~N Q s B ..Z. L L'1 974 c f~ °18 9 . o • w. L4Ak ~f~@PN.QST t~►ZoPt''~`!"( Ujvg> - 1OU•0 oN `YUF OT M e0 `Tti r _ NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. ( Z required) 3. Install 4" observation pipes with approved caps. ( `E -required) 4. Septic tank to be Vbin0 165'0 gallon capacity manufactured by V-1 ~lW1'~1Z1J SST . 5 . Bench Mark S pU 6. Divert surface water around mound to prevent ponding at the uphill side.. Page 3 Of b Approved Synthetic Covering t~sTM C 33 Distribution Pipe Medium Sand _ H_ G_ Topsoil F Elev. a18- 9 1 D - 3 E b 7 % Slope (Force Main Plowed - Trench of -1k,2"-2,k1,2" From Pump Layer Aggregate Undisturbed D l.0 Ft. Soil E 1.35 Ft. Cross Section Of A Mound System Using F o• 8 Ft. I Trench For The Absorption Area G N.,ch Ft. A S Ft. H I- S Ft. B ZS Ft. I 15 Ft. Linear Loading Rate= b o GPD/LN FT J -7 Ft. Design Loading Rate= o.3GPD/SQ FT K \O Ft. L y S Ft. W Z.-1 Ft. L Force B, :014 K Main - AIZ-------_- - - 1~ 7 o~?PUS I`tt; W Distribution Trench Of ~Observation Pipe Aggregate Permanent Pipes Markers (Anchor securely) Mound Using I Trench For Absorption Area Page Of Perforated Pipe Detail 0 End View )Perforated End Copt PVC Pipe ~o~~o oocc install permanent-marker at end of each lateral Holes Located On Bottom, Are Egvofly Spored Q End Cap I Q ~-2 * 1 PVC Force Main Distribution Pipe Lost Hole Should Be Next To End Cap Distribution Pipe Layout P X ZS Ft. X 3io Inches Y 30 Inches Hole Diameter 1cc~ Inch Lateral Inch(es) Manifold Inches Force Main Inches # of holes/pipe S Invert Elevation of Laterals q q•y Ft. sX1.\1= S.$s Y- -?-r 11.- )p Cvln Place lst hole Zs~~from tee with succeeding holes at 30' intervals. Last hole to be next to the end cap. - Combination -Septac.Tank acid PUMP CHAMBER CROSS SECTION ARID SPECIFICATIONS' PAGE S OF -VEIJT CAP WEATHER PROOF JUIXTIOM bOX 4'C.I. VENT PIPC N APPROVED LOCKING 2:.10' FROM DOOR, MAWHOLE COYER /•VCltl -.i1WDOW OR FRESH wJ~R IJ1~1G L agEL. ALIIJTAKE 0 r tj ~ i Et.- 91 4- 18'Mir- L-- r PROVIDE I IWLE T AIRT16HT SEAL I . ~ I I v 8>ZFFL~S I I ~ I APPROVED JOINT: APPROVED JOIUT A_ ( I I W/C.I. PIPE~~" W/C.I. PI FEaR Tank construction I I I ( . shall comply with ALARM I II ILH; (83.15 and 83.20 a I I ow C i ga.on gOFF CLEV. PUMP ,CONCRET>~ E3 ~ . 0 4 ~ DLOCK 3" APPRov ~ RISER EXIT PERMITTED OWLy IF TANK MAIJUFACTUR6R H^S SUCH APPROVAL. BEWINQ SEPTIC f SPCC.IFICATIOUS DOSE NUMDER OF DOSES: 1 PER DAy TANK MAIJUFACTURLR: TANK SIZE: 10U0 /650 GALLONS DOSE VOLUME It ALARM MAIUFACTURER: S,-_-S. SINCLUDING 5ACKFLOW: 1~Z GALLONS MODEL AIUMBER: 1 It CAPACITIES: A= 1$ INCHE5 0R 30 6 GALLONS SWITCH TAPE' 8 = Z INCHES"OIR 3 4LLON5 PUMP MANUFACTURER: ZC~ER Z Crj ' C = 6 INCHES OR 12 Z GALLOWS MODEL UUMBER: S7 D= '\Z INCHES OR` 10 GALLONS ~'1~`~12~CJ1ZY MOTE: PUMP AND ALA0.M ARE TO bC b SWITCH TYPE: MIAIIMUM DISCKARGE RATE l\'`~O GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE DETWEEN PUMP Off A1JD.DI5TRI5UTIO►J PIPE.. \\-\40 FEET + AimimUM NETWORK SUPPLY PRESSURE 2-52 FEET loo FLFRIC71o/J FACTOR_. FEET + 1'40 FEET OF FORCE MAIN X 3Z F/ O-q S TOTAL OtIUAMIC HEAD = 3S FEET Pump chamber DIAMETER _ 38y ILITF-KUAL DIMLWSIOW~ OF TAIJK: LENGTH - ;WIDTH ;LIQUID DEPTH BOTTOM AREA 231= GAL/INCH AS PER MANUFACTURER = GAL/INCH 4, 6% U) W HEAD CAPACITY CURVE 45/a F W "57" - "59" SERIES LU *4 5/e 25 _ 11h - 11'h NPT 3/16 6 20 O w I x U ~ 15 z 4 915/16 J Q o t0 11.0 33/32 2 5 TOTAL DYNAMIC HEAD/ FLOW PER MINUTE EFFLUENT AND DEWATERING HEAD CAPACITY 0 UNITS/MIN 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 e Piggyback Mercury Float Switches a Available with special cord lengths of 15', available. 25', 35' and 50'. e Variable level long cycle systems a 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 Control Selection float switch. Refer to FM0477. Model Volts-Ph Mode Am SIM x Duplex 3. Mechanical alternator 10-0072 or 10-0075. M57/59 115 1 Auto 8.0 1 or l &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 t 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, 104=2. 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, AllInstallation Wcontrv*protection devices andwhingshould bedone lyraqualified FM0514; Piggyback Mercury Float Switches, FM0477; Exectrical Alternator, FM0486; Mechani- licensed electrician. AN electrical and safety codas 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 Selelyand Health Act Control Box, FM=. (OSHA). RESERVE POWERED DESIGN (y For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL T0: P.0.80X 16347 Louisville, KY 40156-0347 Manufacturers of... L Z a 01 SHIP T0: 3180 O Millers Lane L" Louisville, KY 40216 qO „ (502) 778-2731.1(800) 928-PUMP QUALITY PUMPS fi=r ~PiJJ FAX (502) 774-3624 Wisconsin Deparw*nt of Industry, SOIL AND SITE EVALUATION REPORT Page of 3 Labor aW Human Relabons Division of Safety & Buildings in accord with ILHR 83.05, Wis. Aden. ode COUNTY STI c 201,SC 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./o of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest rood . O 3y -10~1~ - APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION lEVIEWEDBY DATE PROPERTY OWNER: P05RTYb OCATION 100 TZ)" `T_P01) G ~ -b?1"f SW k-'s 1/4,S 'P\T Zq N,R kS E (4 PROPERTY OWNER':S MAILING ADDRESS LOT # J K' NAME OR CSM # Q o. nox Z3 - CITY STATE ZIP CODE PHONE NUMBER WOWN NEAREST ROAD ~ 1 LAS 0?v t l"V l S 4 bri (7I S71-) 2 - 14 6 39 s p 2l , "Ji (C t-, $ O `f CF r' New Construction Use [DQ Residential / Number of bedrooms I [ ] Additn to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow S O gpd Recommended design loading rate - bed, gpd/ft2 0 - 3 trench, gpd/ft2 Absorption area required 1 L S bed, ft2 2 S trench, It? Makimum design loading rate o S bed, gpd/fl2 ° - ~ trench, gpd Recommended infiltration surface elevation(s) Lis, 9 , ft (as referred to site plan benchmark) Additional design/ site considerations 'f'1 DWJfl W/ S '>c 2 S ' `T Qt CG1j . `(y l ti, 1 ' O R L L Parent material Flood plain elevation, if applicable A , it S = St>We for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANG U = Unsuitable for stem ❑ S ® U ®S ❑ U ❑ S ®U ❑ S [ U ❑ S ®U ❑ S SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Boundary Bed tench L I = s Z $ Z~ 1 b `1 R ~LL3 S 1 Z. Selz h1`~r} G S ; S C S ~k ~t'`4 - Ground Z`f -32 S `'b IZ- V & c -I- S `1 Q S)?, elev. O." 4 ft Depth to limiting factor z Remarks: Boring # - s i t s rn~ a- S - • S 1 0 -S V_ 24-L Z Z 8 - l1 tio~t ~Z Y13 SO Z'~ soh Yv, i - cS - . S 6 ~S o sg1 cS 3 11-2.5 ~•S`~R~1~6 Ground It. 1-• - elev. l~ 23_\45 5 `'t R V C~ S R sJf3 S 1 &'Nj3 Z VA ~.6.7 Depth ID limiting factor S ti Remarks: CSTNerne:-Please Print Arthur L. We erer` Phone. 715-425-0165 egerer Soil Testing.& Design Service-P.O. Box 74.River Fa11s,WI 54022 Si nature: Data: CST Number. s M00r5'76 PROPERTY OWNER -~fCYVG~v SOIL DESCRIPTION REPORT Page Of PARCEL I.D.tf O 1Z)gq-713 Boring # Horizon Depth Dominant Color Mottles Texture structure consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tw& -3 O -S ~0`12 2 L2 t Z 5 ~1-t A~ ck-S S (o $ -2p 1 opt 1i ~!!3 - s t) 2,`Fsbh wl C -S . • s 1, Ground 3 Zvi 3b . S `1 R y l - S 1 cSbl~ w v eS - - S elev. X8.9 ft. 3v-V b S `2R ylL .s y1i SJa S 1 C-S~11z Depth to ' limiting factor , ~ i Remarks: Boring # i Ground elev. ft. ` Depth to ' limiting factor i i i I Remarks: Boring # 3.a ' i Ground ' elev. ft. Depth to limiting factor i Remarks: .Boring # i Ground elev. ft. Depth to limiting factor Remarks: cnn oO~MD nrn~~ PLOT PLAN Page 3 of 3 SCALE 1"= 30 ' ~ gpp~ J a -tw ~ I G 3 / D 3 B•a ~t 9~4 0 EL :,E, L4A-)e A ~ ~ ~►JQ4t~ZE~T i~Rc>>t`ty l1n~E~ - 1~0. p' prJ `t-oP or 3 ~ c Z ' 1m.~ y'"x S"wooD po ST• ~ M `rt f r~v~ ac) Z3q. 9- S-OHO (71 ) 4 2,5-O-165 m00576 CSTSignature -Date Signed Telephone: No. CST # WiscorsinDepartmentoflndusby, Labor and Human Relations SOIL AND SITE EVALUATION REPORT Page 3 Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. PI r" not limited to vertical and horizontal reference point (BM), direction and % o-kale or AtaCEL I.D. dimensioned, north arrow, and location and distance to nearest road. ? ~ 'Y x': ' l O 3y -104 ~I - ?0 { APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATit~lil' a` REYIEINEDBY DATE PROPERTY OWNER: ROPERTY LOCH `r C` .1 To`Nl `~R 6 q, W1/4''x, Y4 S T Z.q N,R k S E (ar W~ PROPERTY OWNER'S MAILING ADDRESS 3~`~~ ~4 SUBD_ N CSM CITY STATE ZIP CODE PHONE NUMBER CKITY~ INEALRESTROAD ~\,t~SO),jtwI S\1 0 7_-1 (-)tS1-1-)2- 1639 91.~~ Bo New Construction Use [A Residential / Number of befooms ) [ ] A" to existing building l J Replacement [ J Public or ODrrtfnercial desrnbe Code derived d* flow l SO gpd Recommended design loading rate - bed, gpd/ft2 o - ~ trench, gPW Absorption area required 1 Z, S bed, f12 ~_2 S trench, ft2 Maximum design loading rate o S bed, gpolft2 ° - trench, gpdM2 Recommended infiltration surface elevation(s) C1&9 It (as referred to site plan benchmark) Adctitional design / site oonsideraborr.," DUINfl W1 S'X Z S' `T)L~ c .t} • 'f" I kv,. )'OF SA~.JD }-c LL _ Parent material L o s o v Flood plain elevation, I applicable IQ • N• It i S = Suitable for system coNVENTIoNA!_ MOUND W-GR D PRESSURE AT-GRADE SYSTEM W FU HOI.DWG TANG U = Unsuitable for system ❑ S ®U ®S ❑ U ❑ S ® U ❑ S [9U O S ®U ❑ S RJ U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ Boring # Horizon Texture Consistence: Botrxiary Roots in. Munsell Qu. Sz. Cont Color Or. Sz. Sh. Bed rt'nch ' o-8 Vo%--j jz-7- LZ sLti Z~sbk y, a.-S - S b Z $ Z`f 1 b `1 R ~E.13 S 1 Z- S~k Yn C S _ S Ground 3 Z`f 3 S "t R- V& cam. s~Q S I S 1 C S~12 1v1~~ - - elev. a0•q ft Depth b limiting factor Remarks: Boring # J -a lb`1 tZ zL2 Sl~ Z.~S~~ Yvti`~~. 0.;$ • S € fir` cS , S ` • b Z ` Z 8-11. tio~ ~zY13 sl't YA 3 ~~.-ZS S `i R t1~6 - - ~ S 0 s9 ~ ~ c_ g .1 • ~ Ground °l6 '1 fur I L y C s 117- 51g s 1 ~~1 c wt ' n-• Depth b _ limiting factor Sy Remarks: 1 CSTNme:-Please Print Arthur L. We erer Phone: 715-425=0165 I eg r.er:.Soil Test:ing.& Design Service-P.O. Box 74.River Falls,WI 54022 F Signature: - Date: - CST Number F - --MOO 76 t i PROPERTY OWNER 'r'PC1uG~ty SOIL DESCRIPTION REPORT page of `3 PARCEL I.D. # O Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence 136unda Roots GPD/ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3 $ ~u` l R 2(.Z Z S b~7 Wl CLS.'. 5 • .lo Z• g -2p 10`"(12 ~!!3 _ S t~ -`Fs~k M CS , S Ground 3 2~ 3b . S `1: R y l - S) 1. C-S b~z w► v `FH eS ; _ . • S elev, C78.9 ft. 3u_~/b S '~R y/` -S I \L S/B S~ 1 S ~1t yn - j Depth to limiting fact3 r " O Remarks: Boring # i # i Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. C Depth to i. limiting I factor I Remarks: Boring # i Ground elev. ft. Depth to limiting factor Remarks: ~[On nnn/~ll~ nrM~ ' PLOT PLAN Page 3 of 3 SCALE 1"= 3Q ' J \ cr^ 1~~ ~ Q i y 3 , 4, o B.3 q 9 o. w- mauve --l ~ - 0-3evzst t -i~-oar-f uwE~ 3~(Z'Th1,~ yyxS4NW0 ppS7'. ~ r~ BO `M ( 715 ) : 4 2.5 - n.l ns X400 5 7 6 CSTSignature Date Signed' Telephone No: - - CST # STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER Tom Tangen MAILING ADDRESS P.O. Bocxy~2 3 PROPERTY ADDRESS c~ 774 d y 44-,/ (location of septic system) Please obtain from the Planning Dept. CITY/STATE Wilson, WI. 54027 PROPERTY LOCATION SW 1/49 SE 1/4, Section 19 , T 29 N-R 15 W TOWN OF Springfield , ST. CROIX COUNTY, WI SUBDIVISION , LOT NUMBER CERTIFIED SURVEY MAP , VOLUME 9 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 a d retuped to the St. Croix County Zoning Officer within 30 days of the three ye expiration dated - SIGNED:, f c- DATE: 9-30-96 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. -------------------------------------------------7----------------- owner of property Tom Tangen Location of property SW 1/4 SE 1/4, Section 19 T 29 N-R 15 W Township Springfield Mailing address P.O. Box 23 Wilson, WI. 54027 Address of site Subdivision name Lot no. 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 corners and lot lines identifiable? x Yes No Is this property being developed for (spec house)? Yes X No Volume 016 and Page Number (J 3_3 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. 4 'Nf3 °!'1 , 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 off' e of the county Register of Deeds as Document No. ~s~~Y3 g S gnature of pp icant Co-Applicant 9-30-96 Date of Signature Date of Signature 9Z. pp7 II STATE BAR OF WISCONSIN FORM 2 - 1992 +j ~4J WARRANTY DEED i! DOCUMENT NO. - - = - a 1-1~~_~A [FOWWOFRM Stamm," Sue Tangen, a/k/a Sue S. Tangent, FAN41 4we1 AUG 2 0 1996 11.00 AN conveys and warrants to ThoiAs'1s BL TanPen Ljjj~ THIS SPACE FlESEH'+Fl) FOR tECOADING DATA + NAME AND RETURN ADORESS~ the following described real estate in Sz ('rpi x c /a i State of Wisconsin: 6W3 o~ k;hA ~j 034-1044-70 i PARCEL IDENWICAT)ON P&W-3EA i II ~ ~I SW1/4 of SE1/4 of Section 19, Township 29 North, Range 15 West St. Croix County, Wisconsin, EXCEPT Certified Survey Map in Vol. "8", Page 2392, Doc. ',o. 472783. i ~ FiER I This is not homestead property. WAXXi5 not) Exception toWarmntks: Easements, restrictions and rights-of-way of record, if any. I~ i Dated this day of _ August _ A.D., 19 96 ~I I a" _ (SEAL) (SEAL) ap2en a/kiA_.'itte q- 'tangent TT- 1 •Sue I (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin ss. authenticated this day of , 19 Personally came before tzar this J&~ay of AUgti cl 1S 9_, the above named - Sue Tang en,kja-Suei~angeLi, I TITLE: MEMBER STATE BAR OF WISCONSIN ER V. SEW -AV (If not, r_ NOTARY authorized by §706.06, Wis Stats.) am., known to be the person wbn r~ecuted the foregoing i - and ack US the same. THIS INSTRUMENT WAS DRAFTED BY