HomeMy WebLinkAbout040-1221-20-000
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Pam Quinn
From: Matthew_Gulick@Dell.com
Sent: Tuesday, August 31, 2004 10:18 AM
To: Kevin Grabau
Subject: Septic Inspection Questions (Voice Mail Follow-up)
Importance: High
Kevin,
I left a voicemail but wanted to follow with eMail also.
I am being relocated from Wisconsin out of state. The relocation company has ordered
various inspections, including one of the septic system.
What are the requirements for a septic inspector for a system in Troy?
Must the inspector be licensed in Wisconsin, or St. Croix County? The address of the home
is 224 Country Oaks Rd. It has a River Falls zip code and is just about 1/2 south of the
Troy recycling center on Chinook.
I have requested that they accept an inspection from "Tri-County" there in Hudson. They
claim they can use "A- Northern Cesspool, Inc." in Plymouth MN.
I know you are very busy and that this is short notice, but I need to get the info as soon
as I can as I am scheduled to close escrow on my new home tomorrow am.
Thank you very much for your help.
Matt
Matt Gulick
Dell Computer Corporation
One Dell Way
Round Rock, TX 78682
(512) 724-0188
Matthew-Gulick@dell.com
1
,ti 11ons 144'U~',
Labgr and Human Relati gUIL ANU SITE EVALUATION I Page _Z__ of 3
Division of Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code
t COUNTY
f Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but ST; ~iP¢~ 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. 130,446~5 OAS sl7e- 41e;elf' a rTeo s.o;
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION 41-f3 REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
G - 14064/,/1 GOVT. LOT V W 1/4 .iE 1/4,S L/ T 1e ,N,R 19 E (or) W
PROPERTY OWNERS MAI 4IING ADDRESS LO # BLOCK # SUBD. NAME OR CSM #
w 9 3aL b'Oo -M e¢r.~ 70,e- C414,14-17A V o4x. -19
CITY, STATE , ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE ZrOWN NEAREST ROAD
/Z i'v~ F~/~S GU, • 5 yv z z ( 715) YL 5 - 7o 3 z 7- p ~bv v7Rr D,f fi-5 /p,pf
[ New Construction Use [KI Residential / Number of bedrooms y Addition to existing building
j ] Replacement [ ] Public or commercial describe
Code derived daily flow !14 0 gpd Recommended design loading rate 4_bed, gpd/ft2K 3 trench, 9Pd/ff2
Absorption area required bed, ft2 trench, ft2 Maximum design loading rate bed, gpd$ - 3 trench, gpolft2
Recommended infiltration surface elevation(s) _ S,44 P j - 3 It (as referred to site plan benchmark)
Additional design / site considerations 44 Tv 14// CMpVeS e10 4.) - ?1SE THE,044 *040-0,0 d-.,X
Parent material S G 5 8 L SED~~`rE-DTs Flood plain elevation, if applicable - • ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE U ESYSTEM l S ILL ❑ HOLDING S UK
U= Unsuitable forsstem D S ®U S❑ U ❑ S MU EIS M Fl
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Structure GPD/ft
Boring # Horizon Texture Consistence Bour-dary Roots Bed Trt~tdt
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
-2 Z 4-
31.1 V Ale C- 3
s,•/ 2, f 5,4 it 4-vi 7i~ s if s
Ground 13, /O r//e f
elev.
1, 2,
Depth to C 33- 61. - 7.5 yk ~ 5'1 Im Iffie - 1 S
limiting
facts, o ~ - 3 ~D/ ~ •
Remarks: 14 Siytw1J/I 54-4046:E_ 4r s.0
Boring # -
io %e 3/3 '~M.,,Fie c s 1 Zf ev. S ,
w o -l3 /o YX y 3 S~/ ,ef,~ C5 2f N/' 3
Ground 15, 13 z 5 /D yR y13 Si ~ 2,4-n, Sh,r
elev G 25 /D ,e y o► 1, Sc/ 1, -F Sh~ n n-F / .2-
ft. 17
Depth to
limiting npiniw
factor %.f I
Remarks: -l"Vo m MUST Cif/SEG OW OfEp w E /f!>,.Pi2o.Us
CST Name:-Please Print Phone:
tea.;-- , T-
j Address: ; NE.I_ RD., HUDSON, WIS. 54016
Signature:D? CIS. Mj "!'ER PLUMBER LIC. N0.3307 M.P.R.S. Date: / yr 3 CS~Number.
9 y8Z
PROPERTY OWNER G' 14( - :9 1
QPyJ SOIL DESCRIPTION REPORT Page Zof_
PARCEL I.D. # Lp It M,f 3o 40vv 7R/ 04k3S
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ra's'h
':C•: iiiti ~:•ii:"u
313,
/0 YA r
z, f s b
Ground /3 e - (Q a.-f 1 Sbk ,w~ f /Z c 5 ! f . S - G
elev. 7 ft. L )9- 3 7S YX 116 S y,~ S/CF S/ 1. f SbK f/~ s i' , S
Depth to C 3y ~o S y/e S/'~ ; s s S f, y'~ n~ try ~vP 'NP
limiting
fact
4
Remarks: ZO•✓ `~G /f 9,f4,-,,
Boring #
r
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
oa
Ground
elev.
ft.• - -
Depth to
limiting
factor
Remarks:
SBD-8330(8.05/92)
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AS BUILT SANITARY SYSTEM REPORT
OWNER /6Z~,~~ a
ADDRESS ~y
SUBDIVISION / CSMJ LOT
SECTION,=~T _N_R_W, Town of
~y
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
g., t Zo'K' 3d
e
a.?3 `
~uSE
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK'
ALTERNATE BM: 42
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: Liquid Capacity:
Setback from: Well- Houses Other
r
Pump: Manufacturer--/~a_
r Modell Size.
Float seperationGallons/cycle-':__Z y/
Alarm Location ,.J K
SOIL ABSORPTION SYSTEM
Width: Length ~p Number of trenches.
Distance & Direction to nearest prop, line: 11/1'1~?/-'
Setback from: well: - -House Other
ELEVATIONS
Building Sewer ST Inlet. ST outlet
PC inlet 9Z91'e/ PC bottom_ l y Pump Off 97-2
Header/Manifold_2S , 7 Bottom of system_ 9S,r:^7
Existing Grade Final grade
DATE OF INSTALLATION:
PLUMBER ON JOB:
LICENSE NUMBER: ~~S 1
INSPECTOR:
3/93:jt
Wiscoan Dep anRelt if Industry, PRIVATE SEWAGE SYSTEM County:
Safety and Buildings Division INSPECTION REPORT ST. CROIX
(ATTACH TO PERMIT) Sanitary Permit No.:
GENERAL INFORMATION 268527
Permit Holder's Name: ❑ City ❑ Village Town o : State.Plan ID No.:
GULICK, MATT Troy
CST BM Ele Insp. BM Elev.: , BM Description: Parcel Tax No.:
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic l Jpc 2 ~ Benchmark
Dosing
Aer Bldg. Sewer • 6S
Holding St /0 Inlet 70 3.~D
TA 4k SETBACK INFORMATION St/bE Outlet 3' 9f, a 7'
TANKTO P/ L WELL BLDG. Ae Intake ROAD Dt Inlet
114
Septic NA Dt Bottom 76(~
Dosing 70"' > 75 NA .MQ*deP# Man.
Aeratio NA Dist. Pipe 5~75~ 7
Holcli . Bot. System 3 Sd 7
PUMP/ SW)tM INFORMATION Final Grade
Manufacturer ~demarid
Model Number ),C-Oi'/L Est P
iia TDH Lift Friction Systems TDH1,.qq'Ft
oss Head
Forcemain Length O~ Dia. a " Dist. To well
SOIL ABSORPTION SYSTEM
BED /TRENCH Width Length i No. Of Trenches PIT f Pits Inside Dia. Liquid Depth
DIMENSIONS DIMENSIONS
SETBACK SYSTEM TO P / L BLDG WELL LAKE /STREAM LEACHING urer:
INFORMATION Type O Pe- 3 O UNIT Model Number:
System: 073 Xo, /a 7
DISTRIBUTION SYSTEM
-HQ-a~ Manitold. Distribution Pipe(s) / / S 14- x Hole Size x Hole Spacing Vent To Air Intake
Length is Length ' Dia. e2 `r ! Pacing i~ 60
(A. ~pJ
n SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
t;) 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: Troy.21,28.19W,.,NW, SE, Country Oak Road 7
J
Plan revision required? ❑ Yes 0-"10 yl
se other side for additional information. L
a
UZ~~ I I ~ki9l
SBD-6710 (R 05/91) Date Inspector's Signat re Cert. No.
ADDITIONAL COMMENTS AND SKETCH fk
SANITARY PERMIT NUMBER: '
Safety and Buildings Division
v~■■-r■r■ 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 81/2 x 11 inches in size. _5~
• See reverse side for instructions for completing this application State SanitPermit Number
The information you provide may be used by other government agency programs ❑ Check if revision to pl`eGi6us a t i
[Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number
1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION
Propert w r Name Property Location
1/4 1i4, S T , N, R (or~q
Property Owner's aiIin Addr r s of Number Block Number
City, to Zip Code Phone Number Subdivision N v or CSM N ber
( )
II. TYPE F B ILDING: (check one) ❑ State Owned E] !t Nea t R d
Public
14 1 or 2 Family Dwelling - No. of bedrooms o rowan OF
III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s)
1 ❑ Apartment/ Condo
2. ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining
4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash
5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify
IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable)
A) 1. pZ 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.Zi ch) Elevation
Feet Feet
VII. TANK Capacity
INFORMATION in gallons Total # of Manufacturer's Name Prefab. Site Fiber- plastic Exper.
New Existing Gallons Tanks Concrete Con- Steel glass App-
New
Tanks Tanks
Septic Tank or Holding Tank ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber t ^ _S ❑ ❑ ❑ ❑ ❑
VIII. RESPONSIBILITY STATEMENT
I, th undersigned, assume responsibility for i allation o the onsite sewage system shown on the attached plans.
Plu rbs Na e: t) Plumb 's S r N o ps) P/MPRSW No.: Business Phone Number:
✓ S °
Plumber' Addre s et, ty, State ip Code):
),J7 Loe
lC
r
Is-orz IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved Sa itary Permit Fee (Includes Groundwater Date Issued Issuing Agent Si tamps)
/~YA/pproved E] Owner Given Initial Q® Surcharge Fee) l L - rG .z`
Adverse Determination
.'CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SBD-6396 (R. 05/94) DISTRIBUTION: Original to County. One copy To: Safety 8 Ruildings Division, Owner, Plumber
INSTRUCTIONS
1. A sani Lary permit is valid ~`oi- wo (2) years.
2. Your sanitary pF-rni+ m,,y oe renevved before the expiration date, and aL a time of renewal any' ne - ::.,iteria in the
Wisconsin Administr,;JN e rCode vviII be app IIcc:b?e.
1 All revisions to this permit ;rust be approved by the permit issuing authority.
4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD-6399) tc; 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 licemed pumper whenever,
necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code administrato 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 Dwei!ing.
Ill. 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 13 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 11.5 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
June 26, 1996 2226 Rose Street
La Crosse WI 54603
K 0 CONSTRUCTION
KIM 0 CONNELL
504 THIRD AVE
OSCEOLA WI 54020
RE: PLAN S96-40664 FEE RECEIVED: 180.00
GULICK, MATT
NW,SE,21,28,19W
TOWN OF TROY COUNTY OF ST CROIX
MOUND SYSTEM
A 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.
Sincerel ,
erard M. S
Plan Reviewer
Section of Private Sewage
(608) 785-9348
SBDA-7987(8. 10M)
Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM Safety and Buildings Division
Labor asid Human Relations REVIEW APPLICATION Bureau of Building Water Systems
Hayward Office La Crosse Office Madison Office Shawano Office Waukesha Office
209 W 1 ft Street 2226 Rose Street 201 E. Washington Ave. 1340 E. Green Bay Street 401 Pilot Court, Suite C
Rt 8, Box 8072 LaCrosse, WI 54603 P.O. Box 7969 Suite 300 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 referi4e(
4
1. APPOINTMENT INFORMATION -if you have scheduled an appointment, fill in the information requested below to save time:
Appointment Date Reviewer Name Plan Identification Number
2. PROJECT INFORMATION If this review is a revision or extension to your existing
plan identification number, provide that number here:
Projec Nam ry~
City ~ Village IV Town Of: County
P oleo Location
GOVT. LOT 1/4, 15Z 1/4 N ,R 19 or
3. APPLICATION FOR 4. FEE COMPUTATIONS FEE SUBMITTED
System Type (check one): System Type I (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 ® Mound 5,001 - 9,000 gallon septic tank $200.00
N Non-Pressurized In-Ground (Conventional) 9,001 -15,000 gallon septic tank $ 300.00
P Pressurized In-Ground Over 15,000 gallon septic tank $ 500.00
O Other: Up To 1,000 gallon dose chamber $ 70.00 j~ -
1,001 - 2,000 gallon dose chamber S 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 Up To 5,000 gallon holding tank $ 60.00
5,001 -10,000 gallon holding tank $100.00
Code Derived Daily Flow gpd Over 10,000 gallon holding tank $150.00
Check If Replacing Existing System % Experimental System (additional one time fee) $ 300.00
"Oft, isions To Approved Plan 2 $ 60.00
F n Petit rVariance: Setback $ 100.00
, Site Evaluation $ 225.00
Petition for Variance Q4 A 96 Plumbing $225.00
B Revision S 75.00
E] Groundwater Monitoring ndwater Monitoring - Per Site S 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: 1&
S. SUBMITTING PARTY INFORMATION
Telephone No. (include area code & extension) Coma Nam Conta Pers n
( ) 4
City, Town or Vi age, Statte, ip Code
No. & Street Address Or P.O. Box
~P I
1 'e
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.
The information you provide may be used by other government agency programs [Privacy Law, s. 15.04 (1) (m)).
SBDW-6748 (R. 09/94) OVER --11111-311110-
j .
Private Sewage System Plan Index/Checklist
S96-40664
All plan sets should be legible and permanent copies, organized into sets, bound with staples and covered
by an index sheet such as this sample. No other pages need be signed as long as the index sheet for each
set is signed. Your cooperation expedites your plan review and shortens plan entry time.
Plan 1D a Owner's Name
5*
Legal Description Address
C~tyNill e/%o County
Contents Comments/Special Instructions
Page M Included Two copies needed for all
plans
1 Plot Plan
2 Plan View/Lateral Return by Mail
3 Cross Section
4 Tank & Pump/ Q Fax Letter to (County) (Submitter)
Siphon Information Circle One and Provide Fax M ( )
17 7 System Sizing (Public)
Call for Pick-Up: ( )
Q Other
I, the undersigned, hereby certify that the Seal (if applicable)
plans and specifications submitted
herewith were prepared under my
direction and Control.
PI /Designer Licertse/ftistration r
Address City state
Signature
TE SE ftI'm Use Only
Attachments: p~~V A ally
Application dItt
Soil & site evaluation
Fee
Needed for Holding Tank Submittal: FEUT~ONS
~A~ ,GS
One copy of notarized holding tank
agreement. (Originals to County) D~STII~l~ Lik6op 6
Elm
Needed for At-Grade Submittal:' ~aV1S~
Original signed and notarized
Application for "Use of an At-
Grade" SEE C'O~ ,
County on-site
One additional set of plans SBD-10268 (N.01/96)
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PERFORATED PIPE DETAIL
and
DISTRIBUTION PIPE LAYOUT
AVv
~ J1
Perforated Schedule 4 ~ry
PVC Pipe
1
End \
Cap
• ~'as~ap~Ga 4
~S~~~s Holes Located On
Bottom Are Equally
k,E Spaced
FK0M
End
Cap 4 (:0RCE MAW, (Ty p,
/ Schedule 40 \
111 PVC Force Main
\ kk
Last Hole
Should Se
Next To
End Cap
1'2
Owner's Names p feet
Plumber/designer's Signature:
x Zio_ inches
y ~0inches
Dates License No.: Hole Diameter inch
Lateral Diameter
inch (es)
Force Main Diameter ' inches
_ Holes per Lateral
M
feet. Invert Elevation
of Laterals
.
Page -~2- of
/~~f:~ • (ou~cK
~ssigner~
Dats' Non-Woven Filter Fabric
4. Observation Pipe
Dislribution Pipe
ASTM- G 33 Sand /
H G Alter. Pas, of
Topsoil r Force Main
E d D
I If,
% Slope
Bed Of
-2 t Force Moin Plowe d
Drain Rock From Pump Layer
D A_
Cross Section Of A Mound System Using E - 14
A Bed For The Absorption Areo F -1-jQ-?
G_4,0
A Ft. H /_,5
BFt.131
1, Ft.
J ,7-2 Ft.
K Ft.
e Position L Ft. 1151, 6"
of
Force Main W,:222, Ft.
14 Observolion Pipe
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0 •L - L
3 8G?Wc
o DistributionBed Ot Ii2„- 2
Pipe Drain Rock
I
M
4 Observation Pipe Permoneni Morker
Pipe or Rods,
Pion View 01 Mound Using A Bed For The Absorption Area
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~ul PAGE or PUMP CHAMBER C9055 SECTION AND SPECIFICATIONS
VE NT CAP
y VENT PIPE
~
WEATHERPROOF _APPROVED LOCKING
JUNCTIOM BOX MANHOLE COVER WITH
~ ZS' FROM DOOR, WAA111N6 LABEL
WINDOW OR FRESH 12~MIU.
AIR INTAKE 1
GRADE 1
MIN
~ IB'rrlu.
COWDUIT
le•nlN. ~ 7_
PROVIDE I
IAILET AIRTIGHT SEAL I III
1 III
APPROVED JOIAI'f A I I (I APPROVED JOINTS
W/ PIPE I III W/'' PIPE
EXTENDING 3' I II ALARM EXTEUDIIIG 3'
OIJTO SOLID SOIL B I ONTO SOLID SOIL
I
I I ON
y C I
LLEV. Z FT. __J
PUMP--., b OFF
0
CONCRETE BLOCK
RISER EXIT PERMITTED ONLY IF TANK MAIJUFACTURCR HAS SUCH APPROVAL
3" APPaoVEa BEDDING tundcr ri%mK
SEPTIC E SPECIFICATIOAIS
DOSE _
TANKS MANUFACTURER: IJUMBER OF DOSES: PER DAy
TA WK SIZE: em L GALLOWS DOSE VOLUME
ALARM MANUFACTURER; -57- 24~ INCLUDING 5ACKFLOW: GALLONS
MODEL NUMBER: CAPACITIES: A=.a~WCHES OR 2521 GALLONS
SWITCH TYPE: B =C-INCHES OR -Le_ GALLOWS
PUMP MANUFACTURER: C-IUCHES OR ,/Z/ GALLOWS
MODEL NUMBER: Da INCHES OR GALLONS
SWITCH TYPE: MOTE: PUMP AWJD ALARM ARE TO BE
MINIMUM DISCHARGE RATE INSTALLED ON SEPARATE CIRCUITS
:30.$•L (7FA,% HIM.-
VERTICAL ~ FEET
VERTICAL DIFFEKEAICE DETWEEU PUMP OFF AWD DISTRIBUTION PIPE..
+ MIIJIMUM NETWORK SUPPLY PR,E?S-S~URT,E/. . . . . . . . . . . 2 5 FEET /
JS FEET OF FORCE MAIN X _L,.LF/opIT.FRtCTIOU FACYOR..11$ FEET ~v1+
I
TOTAL Oy1JAMIC. HEAD = ZtZ=L4/EET i~.e1
IMTERWAt_ DIMEIJSIOIJS OF TAIJK: LEIJGTH ;WIDTH ;LIQUID DEPTH
51G►JE0: _ LICEWSE NUMBER. DATE:
Performance P~..&,
Curves Pumps
METERS FEET
90
MODEL 3885
25 SIZE 3/4" Solids
WE1SH
70
20 WE10H
60
WE07H
15 50
W EOSH
40
10 30 WE03M
20 WE031
10
S0 0 0
0 10 20 30 40 50 60 70 80 90 100 110 120 GPM
0 10 20 30 ml/h
CAPACI
nGOULDS PUMPS, INC.
Se*CA Fu5 WW YOPK ILok*,
METERS FEET
120 MODEL 3885
35 110 WE15HH SIZE 3/4" Solids
100
30
90
25 80
70
20
60
O
H
50 WE0541
15
40
10 30
20
5
10
0 0
0 10 20 30 40 50 60 70 80 90 100 110 120 GPM
t i i j
0 10 20 30 m3/h
CAPACITY
• 1985 Goulds Pumps, Inc. Effective my, 1985
C38"
/l td cz 4,l, ~ 7 0 7
OPTIONAL.WORKSHEET
1. • MOUND SYSTEM 11. IN GROUND PRESSURE SYSTEM-Continued-
1. Wastewater Load, Total Dally Flow= Zed-) gal. 10. Force Main:
Use section H 63.15 (3) (c), Wis. Minimum Dosing Rate = c2A=.- gpm.
Adm. Code and PROVIDE A DETAILED Diameter = In.
LIST OF SIZING ON PLANS. 11. Total Dynamic Head:
2. Depth to Limiting Factor = KJO System Head = 2.5 ft.
3. Landslope = % Vertical Lift = - _ ft.
4. Distance from Dose Chamber to Friction Loss 1, G ft.
Distribution System = ft. FD" ft.
5. Elevation Difference Between 12. Pump Selection:
Pump and Distribution System = ft. Pump will discharge at least ~r gpm
6. Absorption Area Sizing: at 1-5-_ ft. total dynamic head.
Area Required = s sq. ft. Pump tr ode td manufacturer:
ft. !'°s~~ s
Bed or Trench Length (B) = o?
Bed or Trench Width (A) = ft. 13. Dose Volume:
Trench Spacing (C) = r ft. 10 Times Void Volume of
7. Mound Height: Distribution Lines= W,i/ gal.
Fill Depth ft. Daily Wastewater Volume Fill Depth Do =wnslope (E) ft 4 Doses In 24 hrs. gal.
Bed or Trench Depth (F) _ _..8 ft. Backflow = ).f .14 gal.
Cap and Topsoil Depth (G) = ft. Minimum Dose = gal.
Cap and Topsoil Depth (H) 14. Dose Chamber:
8. Mound Length: Volume = gal.
End Slope (K) ft.
Total Mound Length (L) _ izlyzl ft. 111. CONVENTIONAL PRIVATE SEWAGE SYSTEM
9. Mound Width: 1. Wastewater Load, Total Daily Flow= gal.
Upslope Correction Factor = Q9 _ Use section H 63.15 (3) (c), Wis.
Upslope Width = ft. Adm. Code and PROVIDE DETAILED
Downslope Correction Factor = LIST OF SIZING ON PLANS.
Downslope Width (1) = ft. 2. Required Septic Tank Capacity = gal.
Total Mound Width (W) ft. 3. Percolation Rate = min./in.
10. Basal Area: 4. Absorption Area Sizing:
Infiltrative Capacity of 2 Refer to Table 2 in chapter H 63
Natural Soil = gal./sq•ft•/day and PROVIDE A DETAILED LIST OF
Basal Area Required = aC201~ sq. ft. SIZING ON PLANS.
Basal Area Available= e~,W0 sq. ft. Required Area = sq. ft.
11. If Standard Tables from Chapter L~ Length = ft.
H 63 are Used, Indicate Table No. ~G Width = ft.
12. For the Distribution Network, Use Numbers 5-14 in Section I1. Number of Trenches =
Trench Spacing = ft.
11. IN-GROUND PRESSURE SYSTEM 5. Distribution System:
1. Depth to Limiting Factor = ft. Lateral Length = ft.
2. Landslope = % Number of Laterals =
3. Percolation Rate = min./in. Lateral Spacing = in.
4. Proposed System Elevation = ft. Distance from Sidewall to Pipe = in.
S. Wastewater Load, Total Daily Flow: gal. System Elevation = ft.
Use section H 63.15 (3) (c), Wis.
Adm. Code and PROVIDE A DETAILED IV. SYSTEM-IN-FILL
LIST OF SIZING ON PLANS. ~.~i~,n Fill In All Items from Section III
Required Septic Tank Capacity s 12?aa gal.
6. Absorption Area Sizing: V. SEPTIC TANK
Percolation Rate 1. Capacity = gal.
Area Required = sq. ft. 2. Manufacturer:
System Length = J_-V_T- ft. 3. Show Site Constructed Tank Details on Plan
System Width = ft.
7. Distribution Pipe Sizing: VI. DOSING TANK
Hole Sire = in. 1. Capacity = gal.
Hole SildOnM = X n_ 41.,w 2. Manufacturer:
L:Ueral Length ft, 3. Pump Manufacturer:
Lateral Size in. 4. Pump Model:
Lateral Spacing 1.1. 5. Operating Head= ft.
DW.111u+ from 5idewall•lu Pipe _ in, G. Flow Rate= gpm•
8. Disirihutiun Pipe Discharge Raw 7. Show Site Constructed Tank Details on Plans
Number ul I lulus Per Pipe
I low Per Pipe Mill". VII. HOI.VING 7 ANK
4. Mauilold Sizing: 1. Capacity = gal.
I ype (cenici ur end) 2. Manufacturer:
Length = ft. 3. Show Site Constructed Tank Details on Plans
Diameter in.
-SHOW ALL INFORMATION ON PLANS-
DILHR SBD-6761 (R.03/82) a
Wisconsin Department of Industry, SOIL AND SITE EVALUATION
Labor aqd Human Relations Page of
Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis.
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County
include, but not limited to: vertical and horizontal refer action and
percent slope, scale or dimensions, north arrow, a c 2 nearest road. Parcel I.D. #
APPLICANT INFORMATION - Plea nt tion. Reviewed by Date
Personal information you provide may be used for s ry purpbss rivacy Law, s. 15. ) m)).
Property Owner E ` twArty Location
y
Lot 1/4 1/4,1T N,R P6009
;h
Property Owners Mailing Address r ')tj F # Block# SubcT. Name or CS M#
C;I"
City S to Zip Code Nea rest Road
7t'~ i - ~ ❑ City Town
1 1 - I I I 1 4-4 ft,
New Construction Use: Residential / Number of bedrooms Addition to existing building
Replacement ❑ Public or commercial - Describe:
Code derived daily flow Z/rr~/ - gpd Recommended design loading rate A/.,*_bed, gpd/f?_ , trench, gpd/ft2
Absorption area required N//T bed, ft2__5 tre/nch, ft2 Maximum design loading rate AIZ bed, gpd/fl2 trench, gpd/ft2
Recommended infiltration ssuurffaa'ce~elevation(s) ft (as referred to site plan benchmark)
Additional design/site considerations
Parent material Flood plain elevation, if applicable ft
S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade system in Fill Holding Tank
U = Unsuitable for system ❑ S ® U 0 S E:] U ❑ s m U ❑ s [21 U ❑ S ®U ❑ S g U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure GPD/ft2
Consistence Boundary Roots
ri in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ;Trench
3
aAj
_ d r
Ground d ~r r ;
elev. ssc' S6
~ft. - Z
Depth to
limiting
factor ;
,Z,[_in.
Remarks:
Boring #
3 f9- JP ief ?I_-2 J :'S
/
/
j
A/ Z
S' 6
Ground &221 _"2f'j
elev.
Depth to
T-F
limiting
factor
~_in. Remarks:
Signature Telephone No.
CST Name lease int
5K-2.0 _
J, _ - j - ZoLg 7 Address Date CST Number
~y
~,d xjaj-
SOIL DESCRIPTION REPORT
PROPERTY OWNER ~ G Page zz;2--af, 3",,
PARCEL LD.#
i
Boring # Horizon Depth Dominant Color Mottles Structure 2
in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots
Bed Trench
A -t 0-5
Ground /
elev. S us
Depth to
limiting ;
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
in.
Remarks:
Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPDfft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
in. Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
in. Remarks:
SBDW-8330 (R. 08/95)
6-71
17"
T ioS
f
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNERIBUYER
MAILING ADDRESS
PROPERTY ADDRESS
(location of septic s ste )Please obtain from the Planning Dept.
CITY/STATE L
PROPERTY LOCATION 1/4, Section T-
_,,2L_N-R Z'G W
'SOWN OF ST. CROIX COUNTY, WI
SUBDIVISION LOT NUMBER
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
rind by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (I)
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
LUV
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.
4~
owner of property 2
Location of prope rtyl/J,~ 4 , Section_, `rte-N-R 1 w
Township ailing address
Address of site
Subdivision name , Lot no. ,
other homes on property? Yes No
Previous owner of property
Total size of property
Total size of parcel
Date parcel was created
Are all corners and lot lines identifiable? ,-,,Yes No
Is this property being developed for (spec house)? Yes l/No
Volume .227-1 and Page Number _ as recorded with the Register
of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE
NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a
certified survey, if available, would be helpful so as to avoid
delays of the reviewing process. If the deed description
references to a Certified Survey Map, the Certified Survey Map
shall also be required.
PROPERTY OWNER CERTIFICATION
I (we) certify that all statements on this form are true to the
best of my (our) knowledge that I (we) am (are) the owner(s) of the
property described in this information form, by virtue of a
warranty deed recorded in the office of the County Register of
Deeds as Document No.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.
.'LC ure of p1p) licant Co-Applicant:
Date of Signature Date of Signature
V
WARRANTY DEED
11 7
L 'n.
Document Number
r a
APR 29 1996
11:15 A.
Return Address
Parcel I.D. Number: 040-1221-20 Ray Galep, Robert L. Mackey, Laurence Murphy and Norwood Ecklund conveys and warrants to
Matthew S. Gulick and Lisa S. Gulick, husband and wife, the following described real estate in St. Croix
County, State of Wisconsin:
Lot 2, Country Oaks in the Town of Troy, St. Croix County, Wisconsin.
T At~~FER
This is not homestead property.
Exception to warranties: Easements, restrictions and rights-of-way of record, if any.
Dated this day of April, 1996.
Kam, (SEAL)
SEAL)
aTeencee Murphy . orwood Ecklund
AUTHENTICATION
Signature(s) of Laurence Murphy sa Norwood
996.
Ecklund authenticated this Y of April,
Kristina Ogland
TITLE: MEMBER STATE BAR OF WISCONSV4
THIS INSTRUMENT WAS DRAFTED BY:
Kristina Ogland
Attorney at Law
Hudson, WI 54016
r
~ ~ ~