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HomeMy WebLinkAbout040-1125-40-000 y (D cO CD i o a ao a O O O O C O O 0 O © ~ I ~ 0 I ~ O N ~ I C C V N X N > W 0 C O Z Y c N C 7 (6 ti (6 LL O O N E C 'O U E Q V N U ~ M Q I ~ Il! W i.: £O Z O Z II' y y CO 00 N W a m M H U) c N O C O N m O Z d d z u~ r h z '2 o v m `o v 0 N ( C •►y .O O C N :3 N O V Z Z U z N N c O N C N Y1 N Q LL d - L1 E O O. w c CO (D 06 W d i O~ O 0 0 N D D a -Q 01 N N N (n N fn N 'uV"- O O 0 0 0 a Z O O 0 (L (L (L CL c ~ p fA I' ~ c0 c0 N fn J U U rn m a) (D } 0 r- ao N 0 0 0 N_ N C, 00 d O O O E M N O n 0 0 00 LO V N rr O Q N C I _ C O r.+ ' O M O 0 y N a d 0 0 0 0 C Q C C O O O O Lo 'D N N_ _ N N O O c O N r N O V CO 00 T 00 3 F r m o co o o N U • a, ° N E co O yy O M H N O Z U) CC m CL • c~ a m .2 m r Q U a 0 N U rY o ~ °o, I to 0 6a c a o a ~ w o I N I ti N I I I GL I I I CD o z C U. co 3 ~ a I ~ M CL Y o z E z m d 00 r"iHUwi am o _oza E z v) F z I 'S N ~ I ►i c 0 Z Z O N z d N y N m` - m E CN CL (D co CD v O Q a m ~Op N N N w z j U) U) fn :3 N ! N N N m 0 0 Q z o O O aaa y •Ai LL IL g a~ i O O N (D CD I~j o N ti~ d 00 O 1~ 00 « E o, o O O 3 y :3 N c ~ m o rn ~0 O I 'o ¢ > cn ca a :2 N N °c O y c _ C C\l ~O fl O N E N y c V d p p C v C N O E o o c °~-D o rn o 'D r N r c6 Lo r 0-4 2:1 co E cc ~O 0 M H N O Z N 2 fA v~ y m € a xt a is a 4` 2 4) r`Iv o R 3 'o f A V a 2 0 (n 0 Parcel 040-1125-40-000 10/08/2007 10:29 AM PAGE 1 OF 1 Alt. Parcel 33.28.19.523A 040 - TOWN OF TROY 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 O - WAY, KIM ELLEN ALBRECHT KIM ELLEN ALBRECHT WAY 542 CTY RD M RIVER FALLS WI 54022 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 542 OLD CTY RD M SC 4893 RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 6.445 Plat: N/A-NOT AVAILABLE SEC 33 T28N R19W 6.445A IN SE SW COM Block/Condo Bldg: S1/4 COR TH W 396.94 FT, N 4 DEG W 574.8 FT, N 54 DEG E 552.53 FT TO E LN SW1/4, Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) TH S 0 DEG W 902.09 FT TO POB 33-28N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 862/375 07/23/1997 742/142 2007 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/23/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 6.400 79,000 157,400 236,400 NO Totals for 2007: General Property 6.400 79,000 157,400 236,400 Woodland 0.000 0 0 Totals for 2006: General Property 6.400 79,000 157,400 236,400 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 218 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS C/ y_ SUBDIVISION / CSMt LOT t SECTIONT PSI N-RTown of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM X 7c ~c &)o 0 To 7 Y' ~ewSE ~D o n 1, ovo ~ bSb INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK. irZ) ALTERNATE BM: ANK / PUMP ~CHAMBE-p / HOLDING TANK INFORMATION Manufacturer: ; ~ l ee,4 Liquid Capacity: Setback from: Well House Other Pump: Manufacturer Q~_fj Model!/~ Size Float seperation / Gallons/cycle: Alarm Location tnl w k ve 0 SOIL ABSORPTION SYSTEM width• Zf I Length Number of trenches Distance & Direction to nearest prop. line: e;)-' Setback from: well: D106~ I House-O/ Other ELEVATIONS Building Sewer ST Inlet. ST outlet PC inlet PC bottom Pump Off Header/Manifold Bottom of system Existing Grade Final grade DATE OF INSTALLAT N PLUMBER ON JOB: J LICENSE NUMBER: S , INSPECTOR: 3/93:jt Wisconsin Department of Industry, • PRIVATE SEWAGE SYSTEM • County: Labor and Hun'ian Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 268541 Permit Holder's Name: ❑ City ❑ Village Town o : State Plan ID No.: WAY, KIM TROY CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: ' i W,0,;( 106f I loo TANK INFORMATION LEVATION DATA 960 n A C_ TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic ~trU Benchmark q6, a9 7 Dosing Aeration Bldg. Sewer Holding St/Ht Inlet 94 TANK SETBACK INFORMATION St/ Ht Outlet TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake X30' 9a. `l9 Septic -25 WE— h(0' 1,7S NA Dt Bottom Dosing ra y >a5' ~o ' 1,2 S NA Header / Man. 35 ci 9y Aeration NA Dist. Pipe ~/.3d 9~-4 Holding Bot. System p r g3 PUMP/ SIPHON INFORMATION Final Grade 95.09 Manufacturer And'o Demand 9, Model Number &jt ® 3l/ L ;S 0%GPM TDH Lift x,55 Friction qbl System05o TDH q,g5'Ft Forcemain Length ?0' Dia.o2 Dist. To Well '5D' SOIL ABSORPTION SYSTEM BED/TRENCH width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth I DIMENSIONS S S yG DIMENSION LEACHING Manufacturer: SETBACK SYSTEM TO P / L BLDG WELL LAKE / STREAM INFORMATION TypeO _ CHAMBER Mode Number: 6, 5- System: ~jj1 a o' >5v' 01-4 OR UNIT DISTRIBUTION SYSTEM Header /Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake f + Length Dia. 02 r Length 2~ Dia. r Spacing 11 ~{8 Y S0 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Seeded" xx Mulched Bed/ Trench Center lg Bed /Trench Edges Topsoil L 2KYes ❑ No a-4es ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: Troy.33.28.19W, SE, SW, Old Cty M Plan revision required? ❑ Yes [!(No Use other side for additional information. 8 Iq( ,?b cx SBD-6710 (R 05/91) Date 11 elt 's Signature Cert. No. ~ITIONAL COMMENTS AND SKETCH , • " SANITARY PERMIT NUMBER: = IDANITARY PERMIT APPLIcOrION In In accord with ILHR 83.05, Wis. Adm. Code Q Y-0 I STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than 5-y/ 8% x 11 inches in size. ❑ Check if revision to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPER OWNER PRO~ RTY LOCATION iFY. sb1S 2~ T N, R E (or PROPER NE'S M~LI RE LOT # BLOCK # 5 0 M I STATE- I_ZIPCODE~~ PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER D~ III. TYPE OF BUILDING: (Check one) CITY NEARESS 0 11 State Owned ❑ VILLAGE : ❑ Public ❑ 1 or2 Fam. Dwelling-# of bedrooms ~ PARCEL TAX NUMBER( ) 111. BUILDING USE: (If building type is public, check all that apply) eyo -//x- 1 ❑ Apt/Condo 2 El Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 El OtatdoorAecreational Facility 30 Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/,Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) -A) 1. ❑ New 2. P Replacement 3. ❑ Replacement of 4.0 Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ®-Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 12. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Ga/ls//dal/sq. ft.) (Min./i ch) L VATION ~,5~6 :?76 374 < ~ Feet Feet VII. TANK CAPACITY Site in allons Total of Prefab. Fiber- Exper. INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank O(Jl? 4 ( !al't's /fCuS El F~ R F] Lift Pump Tank/Si hon Chamber El 0 El VIII. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on th attached plans. Plumb is Name (Print): kk Plt~r' Signature: (No Stamps) MP/ PRSW N ~ Business Phone mbr: 1 A t" ad 5-a S Plumber's Address (Street, r State Zip Code): :tAi n I) V 6 VC /(I A IX. C NTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing A nt Sig t e ( Stamps) (j 62 1., Approved ❑ Owner Given Initial Surcharge Fee) T-C,-D 7 Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(R.08/93) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS r 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. s 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 & 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. It. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling. Ill. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. Vt. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. - - - GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) • SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue P.O. Box 7969 Madison, Wisconsin 63707 State of Wisconsin DepartmeWndustry, Labor and Human Relations November 9, 1995 1340 East Green Bay Street f.g SUITE 300 Shawano WI 54166 WEGERER SOIL TESTING` 421 N MAIN STREET N PO BOX 74 , i z~ RIVER FALLS WI 54022 RE: PLAN S95-31562 FEE RECEIVED: 180.00 WAY KIM SE, SW, 33, 28,19W TOWN OF TROY 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 orientation of the mound system must be such that the mound's longest dimension is perpendicular to the direction of maximum slope. Also, the area within 25 feet of the mound's downslope toe must remain undisturbed by anything, including the force main. 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. SBD•6928 (B. 81/91) • SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue P.O. Box 7969 Madison, Wisconsin 63707 State of Wisconsin Department of Industry, Labor and Human Relations WEGERER SOIL TESTING Page 2 November 9, 1995 PLAN 595-31562 Inquiries should be directed to me at the number listed below. Please refer to the plan number shown above. Sincerely, -Y-Q._ Karl Schultz Plan Reviewer Section of Private Sewage (414) 424-3311 3343R/ 2 sBD4926 (R. oi/ei) Page of 6 MOUND SYSTEM FOR A 3 BEDROOM RESIDENCE LOCATED IN THE SF. 1/4 OF THE SW 1/4 OF SECTION 33 , T 28 N, R l1 W, TOWN OF - -Azz 1-( ST, <ZA-WLX COUNTY, WISCONSIN. INDEX PAGE 1 'of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW-CROSS SECTION PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUMPING CHAMBER ' PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR wx~ 1-1 16-j pt If ,SqZ R1UM FiN-t.LSjkA_ S(/02,z- PREPARED BY eJ 6 WEGEE;t ER E3 C3 11_ TEST I NG AND. p i3ES a• ARTNU:i L s P.O. B01 74 421 K. MIK ST. wr"``R RIM.. FNJ-S. VI 54022 sw~aT"' ® b , 115-425-0IbS ~ ®~c+~ I G 3'a V JOB NO. C( 5 -3 I1 PLOT PLAN Page z-of ~ Scale 1"=M W* 1 -EEL- wOO.Ql' cv.► `tap CAF 14 " S Q.ut-fR - W1z~oo p~Ce V-61T. ~q L 2 8.3 F~1vCE 31, o as m ~ Za'oF rPv~ eL ao . ' N 2S1°f / 1 i PoQ-C!1 e S P Zy~, ~ / Ob ►.IOT ~`-C1W1p1C~-j O12 too / / C 110 i-Nm .0. LU 2 X ~ J , f- L 1FC.E ~X 1S~1A ~a S~ 1~° `j C- tTL ~I 1, AS coDF CO►-J'P LLJAjG 1k.). , f)LL _ \5?L'~-TS, LT wlP~`'1 12E~1"1'CN iN V 100 'f'CL wtk:;z CC)h1Ce ~ ei~n L° `S'l%kt ~)S Sew ti 0 2 o. ZS WX GI.aJDF~t,L b1Z.tue NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. ( Y required) 3. Install 4" observation pipes with approved caps. ( T -required) 4. Septic tank to be VN3Z gallon capacity manufactured by V-011 Z ` J C,p M PMObQCTTS • C1 F OM&;- Ftiw'~P ~`K+~hc ~U B~ t~5Ez2 7S0 6A-~ rttt~c . 5 . Bench Mark SEEtE TI8o uQ, 6. Divert surface water around mound to prevent ponding at the uphill side. Page Of Perforated Pipe Detail 0 /End View Perforoted End Cop ot`°~\~ ` PVC Pipe Install permanent -marker at end of each lateral Holes Located On Bottom, Are Equally Spaced Q S i PVC Manifold Pipe ~j * PVC Force Main C / Oistn ution Pipe Lost Hole should Be Next To End Cap I End Cop P Z.Z Ft. Distribution Pipe Layout S_ Ft. X L{8 Inches Y L/ 8 Inches Hole Diameter !~Y Inch Lateral ) Inch(es) Manifold Z Inches Force Main Z Inches # of holes/pipe (o Invert Elevation of Laterals 9LI-00R. bX~•l~ -7.oL ~y . z.z3. o~ Gpw1 562 S Place lst hole Z41'from center of manifold with succeeding holes at 1~$" intervals. Last hole to be next to the end cap. PUMP AMBER CROSS SECTIOIJ AND SPE ATIONS ` PAGE S OF 6 VEWT CAP y'C.I. VENT PIPC WEATHER PROOF APPROVED LOCKING MANHOLE JUMCTIOW BOX COVER WITH WARNING LABEL 10 `FROM DOOR, IYMIU. imDOW OR FRESH J AIR INTAKE J GRADE 1 yrMI1J COIJDUIT - PROVIDE I IAILE T AIRTIGHT SEAL. 1J v APPROVED JOIIJT A Tank construction shall comply I I~) APPROVED JOINTS with ILHR 83.15' and ILHR 83.20 AL IJ ARM; i b I i ON --LLEV.`b$FT. --J PUMP OFF 0 PROPERLY E A ~TANF,'`~, gg,o0 1 COMCKETE BLOCK ILHR 83.15( ANCHOR 3" APPRWIEr> gNNSQW I ~ rMITfED ONLY IF TANK MAUUFAC•TURI~R HAS SUCH APPROVAL I SEDDINQ ILHR $3.15(4)(b) WAC S PECIFICATI0kJS DOSE TANK MANUFACTURER: W~ MCL*j4'* QI?'M NUMBER OF DOSES: 3 PER DAU TANK SIZE: SCE GALLOWS DOSE VOLUME t lib-3 S` S1_e! S INCLUDING 5ACK►LOW: ALARM MANUFACTURER: GAELONS MODEL AIUMbER: L CAPACITIES: A= 1S I#ICHESOR3Qo'8 GALLOIJS SWITCH TSPV.: Y'1q~t-au Ni"`T 5= Z HUGHES OR 2" 1 GQLLOW5 PUMP MANUFACTURER: Z ~~L LIZ Coml>hn~1 C- -7 IUCHE5 OR 14 03 GALLOWS MODEL NUMBER: S-7 D= INCHES OR Z60. b GALLOWS ~z zY MOTE: PUMP AND ALARM, R TO 6 1L $ SWITCH TYPE• . MINIMUM DISCHARGE RATE Z$'D$ GPM INSTALLED OU 5EPARATE CIRCUITS VEKTICAL DIFFERENCE OETWEEN PUMP Off AUD-DISTRIBUTION PIPE.. • 9Z FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . 2.50 FEET + ?S FEET OF FORCE MAIN X Fy0FxFRICTI0M FACTOR. 0,T) FEET TOTAL OtIUAMIG HEAD = I FEET 2 DIAMETER tl . INTERLIAL DIMEIJSIOMf OF TAWK: LEW&TH - ;WIDTH ;LIQUID DEPTH BOTTOM AREA - 231= GAL/INCH AS PER MANUFACTURER = _20.%3S GAL/INCH cr6 of6 4 6'/ - W HEAD CAPACITY CURVE W `r5Tr - '4599' SERIES I.- LL W 4s/6 25 . a _ 11/2 - 111/2 N P T 43/16 el 20 6 I . o ~ a W v 15 f a z 4 915/16 0 J H ° 10- 33/32 ~.8z 2- 5 TOTAL DYNAMIC HEAD/ 8. 0& 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 e Piggyback Mercury Float Switches -Available with special cord lengths of 15', available. 25', 35' and 50'. e 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 FM0477. Model Volta-Ph Mode Am Simplex 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 Auto 4.0 1 or l &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. ' n 57 Series - Wt. 27 -.3 H.P. 59 Series - Wt. 29 -.3 H.P. 1`0 r b4i CAUTION J For information on additional Zoeller products refer to catalog on Combination Starter, Atllnstallationofcontrols,profeotiondevicesandwiringshouldbedonebyaquagtled FM0514: Piggyback Mercury Float Switches, FMO477; Exectrical Alternator, FM0466; Mechani- licensed elecMdan. 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, FMO732. (OSHA). RESERVE POWERED DESIGN ! For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MA/L T0: P.O. BOX 16347 Louisville, KY 40256-0347 Manufacturers of... O Z 7/ SHIP T0: 3280 Old Millers Lane LL Louisville, KY 40216 (502) 778-1731.1(800) 928-PUMP QUAL/TY 411MV9 ~iYCE IYYf Wwonsin Department of Industry, 4PO I L AND SITE EVALUATION FO O R T Page of 3 Labor and14uman Relations Division of Safety & Builclings in acc91 d 1 i 05, Wis. Adm. Code COUNTY ~ I _1 Attach complete site plan on paper not less tha x 11 inches in size. ust include, but not limited to vertical and horizontal reference BM), diret#io %o , scale or PARCEL I.D. # dimensioned, north arrow, and location and a to ruaarest O Y Q- 11Z.S- t{ Q REVIEWED BY DATE APPLICANT INFORMATION-PLEASE T ALL IIF@RMA ON PROPERTY OWNER: 3` RTYLOCATION SiZ 1/4 SW 1/4,S T Za N,R E(o~W PROPERTY OWNER -S MAILING ADDRESS ,y # JBLOCK# SUED. NAME OR CSM # S 4Z OLD n y,) N CITY, STATE ZIP CODE PHON _ []CITY []VILLAGE ®fOWN NEAREST ROAD Rw~ Frct.~s,:w1 sou (~ts)~tzs 30[ Z-tw , ~ . [ J New Construction Use [xJ Residential / Number of bedrooms 3 [ J AddibQn to existing building Replacement [ ] Public or commercial describe Code derived daily flow 11 SD gpd Recommended design loading rate o - Y bed, gpd1ft2 " trench, gpd/ft2 Absorption area required 31 S bed, ft2 -S1 S _ trench, ft2 Mabmum design loading rate D • 5 bed; gpd/g2 0, 6 trench, gpd/i12 Recommended infiltration surface elevation(s) ai 3 • S It (as referred to site plan benchmark) Additional design /site considerations w 116' K 4-l' B~ Parent material si `M ou`act c\\ Flood plain elevation, if applicable M - R ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable for s stem ❑ S ®U WS O U ❑ S ®U ❑ S U ❑ S ®U ❑ S Q U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Baxxf<ay Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed rends :v o-~q ~o~ R z t z - s t 1 Z s b vvt ck, 0-S 0-L Z )°130 to`~iZ 3!2 st( Z~sbh m~ cS o.S o.b Ground 3 3p_4 v O -t R- wt a.b1R W, J V C_ S o. S o. elev. o .0 n y ul -63 l u'~ 2 Y~G S ti R. S jf5 Depth to limiting factor Remarks: Boring # o - t o 1012 31 z - s 1 s b>Z wt 0-S o. L Z Z lt3 ~oLi Z ZL-Z S1) Zw► 3bh >n ~ e g - U. S 0, fit, - o- 5 v. 6 3 Z3-~13 3/~ S > > Z'i't s MT fn Ground elev. °t y3 -6S 1 ~'z l2 y~3 0-sp tz y / L S iC J o tiv► I` - ~-7 It Depth to limiting factor Remarks: TName:-Please Print Phone. Arthur L. We erer 715-425-0165 ergerer Soil sting & Design Service-P.O. Box 74 River Falls,WI 54022 Signature: Date: CST Number: 9 5 -31-7 LO--QS-9,S M00576 PROPERTY OWNER w Wf 4OIL DESCRIPTION REPORT • Page Z of 3 PARCEL I.D.# 0q l~- LkZ-S- 40 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench o-LO 10`itZ 3I2 Sj Sbh ~,i CS - o•S o.b ?t 2 to-z I k-~ `ti'p- 31 C S t 1 Z wr S ~h 'VI., L d o, s u. Ground 3 Zl -3 1 `i 2 3 s ic~ 1 d~ l°_S o• Z v• 3 elev. Depth to limiting factor Remarks: Boring # Ground elev. ' ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor LLL Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: ssn-esaO(R 0-3/92) PLOT PLAN Page 3 of 3 SCALE I"= 3 D ' C4F 14" S 4 uPt L- w~oo eoaT. ~,gz ? &3 R1vCE 3 I D o. I ~~iuSE iD ~ r 'Q1)" LJkrLL PoRC.l1 ~ / o~ ►.ioT ~w►pltt-T oR T*1 S H'uj~A 0 I ? X 3j , 2S ~ rr J U e ,z. ~cy" ' Q7 s, o ~o 1~i Z 0 o C) 4 o. ZS wt j lb °l S qS -3 l7 (715 ) 4L-0169 M00576 CST Signature Date Signed Telephone No. CST # Wisconsin Department of Industry, Labor and Human Relations *OIL AND SITE EVALUATION R OO R T Page of 3 Division of Safety & Buildnys in accord with ILHR 83.05, Wis. Adm. Code COUNTY ST' (z-~lX Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but 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. O y Q 1 vz' S - 140 APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION t M LJ GOVT-E SZ 1/4 SW 1/4,S :!3 T N,R L E (a~W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUED. NAME OR CSM # CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE MOWN NEAREST ROAD L RwQ,~t_ Fv.,Ls,.WI VIsIx PIS) gZS_Z301 [ ] New Construction Use Residential / Number of bedrooms [ ] Addition to existing building (kj Replacement Public or Commercial describe Code derived daily flow to SO gpd Recommended design loading rate . o - Y bed, gpd/ft2 trench, gpd/ft2 Absorption area required S bed, ft2 31 S trench, ft2 Maidmum design loading rate o • S bed, gpd/f ~6 trench, gpd/ft2 Recommended infiltration surface elevation(s) 0t 3. 5 It (as referred to site plan benchmark) Additional design/ site considerations k j,/ '6' Y_ q1' BL-Z) Parent material s t. ~.-`N ou\NL cA Flood plain elevation, if applicable M . f41 - ft S = Suitable for System CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable for system ❑ S ®U 10S ❑ U ❑ S MU. ❑ S 0 U O S ®U ❑ S U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed iench 1 o_L`l ~o~R ztz - s> 1 Z~sb vv~ ct-v - o.S 0.6 &vim Z 1°I-3 to4 tz3l2 s1I Z~sbk YvL`~- cS o-S 0.6 Ground 3 3u-41 1 O ~t R 3I6 - S t I 2 a bk W, iv t^_ S o. S o_ elev. 0,o.0tL y y1-63 10`22 V/S y R sl$ sic eNwl Yv1 T - Depth to limiting factor y Remarks: Boring # 0_10 lo"IR 3J Z S 1 ~ Z. ~ S b>2 wt.'~ ~w ~ 0• S o• Z Z 1t'~ ZLZ _ s t) Zw► gbh ~n 1- c g - u. s a 6 3 Z3-~13 Lo y tZ 3JL s 1 Z-" s hk fn ~1_ (11J elev. ~{3 -6 S l o li y~3 C. Ground tiv► l` - sp 1)1-1 y / L S 1C_ O %'A fL Depth to limiting factor 4 Remarks: CST Name:-Please Print Arthur L. We erer Phone 715-425-0165 egerer Soil sting & Design Service-P.O. Box 74 River Falls,WI 54022 Signature: Date: CST Number: q5-31-7 LO--Qs -aS M00576 PROPERTY OWNER SOIL DESCRIPTION REPORT Page 2 of 3 PARCEL I.D.# O~{O- LI2.S- L1 O Boring # Horizon Depth Dominant Color Mottles Texture Structure i'onsistence Boc~nclary Roots GPD/ft In. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 0-10 10`itZ 3/i s~ Sbh Cg - o•S o.b 13 Z 1o-z~ 1 `tie- 31 L S!) Z soh o.S n. b Ground 3 ZI -3 1 D `i 2 3lir z i~~ l W, o- Z v. 3 elev. t p `1 -71 s LI 2 SA6 ~,t L Depth to limiting factor remarks: _ Boring # Lioll, i Ground elev. ft. i Depth to limiting factor I Remarks: Boring # 13 Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Sqn-AIINR nS~op~ 3 PLOT PLAN* Page 3 of SCALE 1"= 310 - ta- loo. eoj 'toP ov~ 4 s Qu woo 'F~wee P~aT• ~t,qi z . &3 F~IvCE 3 ~ ~ 31 o Z S, .o ' A I. ~`j1ivSE 'o I I PoQ C.e1 ~C2-`t wI&L .1 ou ►~oT cOw►pt~T O~ 1p~~ ti Q\J~v~L~3 -TI" S NR~SA 0 I K J ra r*z,g1~ J zkl f3~ ~ •m 0 ~o ?0 GL~Dt~-~,L t7~ZtuE C~~N~ ~ ~ s-3 !7 9S (715 ) 425-0169 1400576 CST Signature Date Signed Telephone No. CST # STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER MAILING ADDRESS d G l~ PROPERTY ADDRESS Y~ d V (location of septic system) lease obtain from the Planning Dept. I~_ A C e ITY/STATE R(d ~ ~ ~)11 PROPERTY LOCATION S 1/4, l/y 1/4, Section TU N-R~W r\ TOWN 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 and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expir io date. SIGNED: DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 STC-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 ~n delays of the permit issuance. ,should this development be intended for resale by owner/contractor,(spec house), thenta 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 77- Location of'property 1/4, Section Yy, TN-R W Township Mailing address Address of site Uv~ Subdivision name Lot no. Other homes on property? yes----*>,- No Previous owner of property Y 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 No Volume. Y14 land. Page' a a Number of Deeds. 9- as recorded with the Register n ; DOCUMENT NO. - n~u r+rs "a FMCORO1Ne DATA ARRANW 0M STATE BAR OF WISCONSIN FORT( 9-3166 OFFICE SE CMIX Co., %M Todd A. B jerstedt _-and._.Denise A. Bierstedti, _ %ed for Record as his wife and in her own right J9N 11990 M i e A~A~ conveys and warrants to ~.~.41... Fi~_...-...A.......lbr.e......ch..t Wa.Y - len-.. I D C~"C I~roi. . (i FEDERAL SAv _..a ( Rerun" IL~GS BAMC u►anssF-MAasoN T- ssi<.-~.aex the following described real estate in S.t -...CX.Q!.X .................County, Him, WI 54016 State of Wisconsin: Tas AEVI 3r= I Part of the SE}SW} of Sec. 33-T28N-R19W, described as I follows: Beginning at the S} corner of Sec_ 33-T28N-R19W, Troy Township, St. Croix County, Wisconsin; thence North 88°34' West along the South line of Sec. 33 a distance of 396.94 feet; thence North 04°33' West a distance of 574.8 feet; thence North 54°43' East a distance of 552_53 feet to the East line of the SW} of Sec. 33; thence with same South 00°32' West a distance of 902.09 feet to tibe point ` of beginning. Except any of the above described property { lying within the land described in Vol. 762, page 52 as ii Doc. No. 419908. nRAN 31ro Met i This ia............ homestead property. - ' (is) 6iatteat) ii Exception to warranties: Existing highways, easements and rights of way of record. /n . i Dated this 42 day of ar.y......... 19_..9. j is I; 'f ..........................•---....._._.......----_..._...-----.-.(SEAL) --------............(SEAL) lI • _T.n __,R- I ..................................•----:......(SEAL) - - .(SEAL) ~I Denise A. Bjerst it Ii . I AUTHUNTICATL7N ACHNOWLROGURNT i e STATE OF WISCONSIN as. - anthenucated this day of---- 19.__.__ Personally came befaee s this . .T..._day of 1990 the above named ; To dd-_A_.___Rje rsr-dir gad _..De-nise_..A-__ s B j.eX %t a dt-q--_ b u sha nd nand--_m if-e----------- TITLE: MENDEZ STATE BAR OF WISCONSIN - authorized by 1 706.06, WhL State.) to me knawn~l~~! - - pessEa who executed the If ne - ° _ - forego g irujlis the same. - T14I5 INSTRUMENT WAS DRAFTED BY 7~-