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HomeMy WebLinkAbout261-1305-00-000 Q o I 3 o I n. p E» o y c 1 3 o o ai c U 7 O 0 0o E L y 9 ~ 01 O) O I '00 x Q I m N ~ Y C N L N R `iU Z O - O m -0 E w jU U O N C Z N O R y C O 3 R 0 O LL 0 N y C. N Q L N I ~ M I, W Z _ O O w Z a D v F- C (n O c C7 0 ~ O Z d w .R Z d' O c Z to F- r' ~ ~ -p M E ~ ° D C N (D I ~ Q Q - C m n = U O O 2 Z Z p N Z y N N C 'C R E T m -4 _0 d ~ t d .R. .L. co C ~ 0 ~l U y d i O O O I ~r11 0 d. 'a N N FV~~~J N N F H I- O 01 N N E Z CL Z o o Iv O O O nN o N rn (0 (.0 ~i U) 1 J U = rn O) } M M v °o ~2 _M O N O 0 O O O O 7~ i Q.~ r- y Q r of ►N E i o~j y y O U C y C O E N (O O ~ > N C C L> IL O O y O 3 +O- Y Y O 'p N lvl L L6 7 d C C OC) Z O - N O^ e- O O ~2 '7 ❑ O O N t=y~,j ~ M T LF- ~ N R m N O g • *V y',i' U CO N O Y.j 4 r ~ w E d CL xt o _ w .V N C rMM• CC CL d n ~ O R a 3 O A 0CL OmcU E y o R 7 t 1 9~ STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNERS ADDRESS SUBDIVISION / CSM# LOT # SECTIONT 30 N-R /g(oTown of ' ST. CROIX COUNTY, WISCONSIN r)v -0(' q&&) Q _lCY PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM e~ J 0 a p to L 411.39 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: SEPTIC TANK / PUMP CHAMBER / HOLDING TAJKK INFORMATION Manufacturer: Liquid Capacity: 1006 - 66o Setback from: Well. House Other Pump: Manufacturer Model# S. Size Float seperation,, y~ Gallons/cycle: / Alarm Location SOXL ABSORPTION SYSTEM Width: Length G Number of trenches Distance & direction to nearest prop. line: • Setback from:-well: 'House Other .,ELEVATIONS Building Sewer 0 9 ST Inlet:'' 93,S-I- 3,S 7 ST outlet: ~f 3,rs PC inlet PC bottom Pump.Off Header/Manifold Bottom of,syste+m Existing Grade Final grade DATE OF INSTALLATION: - 3 - / PLUMBER ON JOB: ~/~l7`r~y vfi~ % LICENSE NUMBER: INSPECTOR: 3/93:jt s Wisc&sin'Departmentofindustry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations ST . CROIX Safety and Buildings Division INSPECTION REPORT Sanitar~p6e$624.: GENERAL INFORMATION (ATTACH TO PERMIT) Permit Holder's Name: ❑ Ity ❑ OVNaye Town of: State Plan ID No.: BARTIZAL, STEVEN M. R CC::jj~lj UU P CST BM Elev.: Insp. BM Elev.: BM Description: arcel Tax No.: ~..3e 3U 1100.(20, OU d v r AZ4 TANK INFORMATION ELEVATION DATA A9600312 9-3-7a TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic _ {J Benchmark Q Dosing Aeration Bldg. Sewer Holding St / Ht Inlet TANK SETBACK INFORMATION St/ Ht outlet 0fs C~ /S Ventto ROAD Dt Inlet Ela TANK TO P / L WELL BLDG. ir Intake Septic G b 5 NA Dt Bottom Dosing .a $ ~p 5' NA Header/ Man. Aeration NA Dist. Pipe Holding Bot. System ?q, PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand /1. Model Number L' GPM TDH Lift/,d Friction ~o SystemoS TDH I~,Q Ft FFii Forcemain Length W. Dia.a d Dist. To welly SOIL ABSORPTION SYSTEM BED /TRENCH width Lengt~ ~ No. Of Tr riches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS Lf I DIMEN I N Manufacturer: SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING SETBACK CHAMBER Model Number: INFORMATION Type O ~`v, S 7 ~a N OR UNIT System: DISTRIBUTION SYSTEM Header/Manifold 1 Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia- o Length q-,)- Dia. Spacing ~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only LBe h Over xx Depth Of / f xx seeded /&eddtd xx Mulched Depth Over l c~ Bed /Trench Center r /Tre nch Edges Aa"/ r Topsoil ` Yes ❑ No p Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: RICHMOND.4.30.18W, SE, NW, HIGHWAY 64 Q yJ yes Plan revision required? ❑ Yes No 244ectlors Use other side for additional information. S SBD-6710 (R 05/91) Date Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH ,s SANITARY PERMIT NUMBER: ' 1 1 Safety and Buildings Division SANITARY PERMIT APPLICATION Bureau of Building Water system! 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 i • Attach complete plans (to the county copy only) for the system, on paper not less count than 81/2 x 11 inches in size. , • See reverse side for instructions for completing this application state Sanitary Per/m~it Nu~m/ber { pS ~ ~ lo/~ '7 The information you provide may be used by other government agency programs ❑ Check it revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATI N Prope Owner N8 5 P o 1 /J pperty Location 1/4, S T , N,® (oryF) Property Owner's Mailing Address Lot Number Block Number go V i City, State Code Phone Number Subdivision Name or CSM Number / - 7 (7/6-7 - y J All II. TYPE F BUILDING: (check one) ❑ State Owned o C11 ~~~Nearest Road j Vilage Public 1 or 2 Family Dwelling - No. of bedrooms own OF III. BUILDING USE: (If building type is public, check all that apply) Parcel Ta Number(s) 1 F1 Apartment/ Condo - 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel /Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. ❑ New 2. &Replacement 3_ E] Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an ------System SystemTankOnlyExisting 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 S. Perc. Rate 6. System Elev. 7. Final Grade V5_6 Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (M~~) u Elevatio et /V/~ Feet VII. TANK Capacity Total # of Prefab. Site INFORMATION in g Gallons Tanks Manufacturerrs Name Concrete con- Steel Fiberglass- Plastic App. Exper. New Exist in strutted Tanks Tanks Septic Tank or Holding Tank /,nOA a00 41 El, ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name: (Print) Plumbe s ignature: oStamna14 /7 MP/MPRSW No.: Business Phone Number: S&P Glr/yxd Plum P. is ddress ( eet, ity, State, Zip Co~ L IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanit ry Permit Fee (Includes Groundwater ate ssue Issuing Agent Signature (No Stamps) yApproved Surcharge Fee) ❑ Owner Given Iniiial0/ ~ Adverse Determination X. CONDITIONS OF APPROVAL / REASONS OR DISAPPROVAL: SBD-6398 (R. 05/94) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Diwsion, Owner, Plumber - - 3 INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. x t 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 roust include: L Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. ll. 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 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. i VI. Absorption system information. Provide all information requested for numbers 1 through 7- V11. 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. S 1 ' 1= OR n DAVID G11 L_ E N 31"ATE:. OE- W :l S(::t:Ji,aS I1', PAGE 1 OF' 7 4()4 NORTH k'NOWL..E:S AV. ST . L:RO I X COUNTY NEW F :I C:.H!"IO D W:L' 5 tj.017 M(:)(.jND ('::)Y(:iTEII'lI ('t 1 S ) 246-33t30 COVER SHEET. 1_0C AT 100 s P(-)(3E 1 . COVER SE: 1/4 teaW 1/4 PAGE 2. PL_.OT PI_.AN si--C. 1+, 1.. 30 PAGE 3. PI_aal•4 V I EW ' C.,F~(319S 9E='C 1- 10N R I BW PAGE 4„ D I STR I BLFr I (ON F` I PE i_AY(Ol_JT RICHMOND I-OWN 1° €-t(w'-E::: ~ P(.Ji'lP I NG C:i- ()t BE_R PAGE- 6. PUMP PERFORMANCE CLJRVE PAGES 7. S0:1:1.... EVAI....(.JA..I..:l("JN FZE1='(::J BRADY UTGARD Materal.s om:5 C e-r- ( i'j()() 7[. 5_ BUry as per 82.30 5-6-7 Tanks as per 83.15(l).-(5) ~ Installed as per 83-23 Fi iction loss as per table 9,8,3.144 PRIVATE SEWAGE SYSTEM Conditionally APPROVED OEPT. INDUSTRY, D'VI N LABOR & HUMAN RELATIDNS DI Of SAFETY AND BUILDING SEE CORR P NDENCE 9 6m,20005 Owe// $c~;/e ,Ci m /coo ' yo r Ncm~ P S, ( The 8rsa 25 L h.:"" d fz7 t9 C?tetn. its Sall Absorption Sywklom jiws2 remain, u'".disturbs Z ~ E FA AIA. WIL I/ 0 dot 1 S y.~o Otlo Slone i ~ sv i 890- 0000 5 NOTES; 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. (a required) 3. Install 4" observation pipes with approved caps. (2 required) 4. Septic tank to be oo o gallon capacity manufactured by 5. Bench Mark Q v,a ~o 6. Divert surface water around mound to prevent ponding at the uphill side. S 7S- a60- Page Of 2 Approved Synthetic Covering Distribution Pipe Medium Sand Topsoil H F _IG Elev. 3 E .S~ % Slope (Force Main Plowed Trench of i"-2%y" From Pump Layer A-ggre~ate Undisturbed D ~ Ft. Soil E Ft. Cross Section Of A Mound System Using F ,`17 Ft. I Trench For The Absorption Area G / Ft. A Ft. H Ft. B f Ft. Ft.19.94' Linear Loading Rate= y79 PD/LN FT Ft. Design Loading Rate= PD/SQ FT K G.DFt. L / F t . Position of Force Main W,~Ft. ;3 J ~ B K Distribution Trench Of 2 - 2 Pipe Aggregate I J Observation Permanent Markers Pig es (Arch r securely) Mound Using I Trench For Absorption Area I-) C) ~ t t ~ Page y Of Perforated Pipe Detall 0 End View )Perforated End Gap) PVC Pipe 1 . ~oito ce Pi Install permanent-marker at end of each lateral Holes Located On Bottom, Are Equally Spaced Q End Cop Q ~ PVC Force Main Distrioution Pipe Lost Hot$ Should Be Next To End Cap Distribution Pipe. Layout / P Ft. X _y9 Inches Y_.. - inches4'5 Hole Diameter -A Inch Lateral Inch(es) Manifold Inches Force Main Inches # of holes/pipe-t2- Invert Elevation of Laterals 99,q Ft. ~1oP~rPje e- 160,6 Place 1st hole ~V from tee with succeeding holes at J/y intervals. Last hole to be ext to the end cap. „ PUMP CHAMBER CROSS SE&IOW AND SPECIFICATIONS 4'C.I. VENT PIPC WEATHER PROOF APPROVED LOCKING JUNCTIOLI BOX MANHOLE COVER v~ ~ J:S' rROM DOOR, IYMIU. ~ f\(C wiwooW OR FRESH I AIR ILITAKE I CR.. GRADE ( y. MIN. i ~ le~Mlu. COWDUIT le'I'IIAI. 'PROVIDE ( - - - LET AIRTIGHT SEAL . ~ I i I V I I APPROVED JOIIJT: APPROVED JOILIT A W C.I. PIPE e, c) W/C.I. PIPE O Y\ p I\ I I I , EXTENDIN[, 31 - I II ALARM EXTENDIIJ4 3 m ( ONTO SOLID SOIL 01JT0 60L10 601E e I I I I ON c i I q I LLEV !4'' p FT. (jCSE ~i~o~E,e. ~~N^ PUMP ~ Ori o cOMCKETE BLOCK J3#- APPRov RISER EXIT PERMITTED OWLtl IF TAWK MALIUFACTURCR HAS SUCH APPROVAL. B8O0i SEPTIC E SPEC,IFICATIOMS DOSE IZ~S/~ TAM MALJUFACTURER: NUMBER OF DOSES: PER DA4 TAIJK 51ZE: 1000 `O0 -GALLOWS DOSE VOLUME / 135.44 1~u~y✓~ INCLUDING BACK/LOW: _ GALLONS ALARM MAUUFACTUIICR: y MODEL NUMBER: CAPACITIES: AINCHCS OR SL/ 4 GALLOIJS SWITCH TYPE: B =INCHES OR IC3"4 GALLOL~~IS PUMP MAMUFACTUKCR: ~C '__Z-SIJCHES OR 44- ~3 GA3 0m MODEL LIUMBER: Do- IMCHES OR 118, Z GALLONS SWITCH TYPE: C MOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATE GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCC 15ETWEELJ PUMP OFF AMD DISTRIBUTION PIPE.. '"7g FEET + MINIMUM NETWORK SUPPLY PKE16SSURE . . . . . 2g5y~ FLET + FEET OF FORCE MAIN X0i1LS L_FYortFRICTI0kI FACTOR.. le _ FEET Z.IIo TOTAL Dy1JAMIL HEAD =FEET I3.C14 13 IMTERNAL. DIMLW51OWS OF TAIJK: LENGTH IBS,- ;WIDTH 7 __---.;LIgU10 DEPTH S 7 C~G7%J7oATE: ~tI t' LICEIJSE ►JUMBER. ~~l~lL 91GIJED: az~ ~00 s'~i I P~6E 6FJ HEAD CAPACITY CURVE 3 7/116 1/4 30- MODEL "98" 4 5/8 -1 e- e I as 3 5/6 AD 1s 4 3/16 4 /3 {0 1 1/2-11 1/2 NPT - S 2 s jv 1 GALLONS 10 20 30 40 50 60 70 LI2S so 160 240 r 0 FLOW PER MINUTE Tr7TAL DYNAMIC 11tAgd LOW MR MWUTt t►iUltllT ANO OCWI111JaM0 CAPACITY 12 NEAR UNITWN N FEET METUN aAti LTM 5 1.52 72 273 10 3.05 61 231 15 4.57 45 170 3 5/16 20 910 2t► as Lock Vahre 23' • ' - .r CONSULT FACTORY FOR SPECIAL APPLICATIONS loclrical alternators, for duplex systems, are available and tr Mercury float switches are available for controlling single and L11)phed with an alarm. three phase systems. tu:Awnical alternators, for duplex systems, are available with or o Double piggyback mercury float switches are available for /,tlioul alarm switches. variable level long cycle controls. SELECTION GUIDE Standard all models - Weight 39 IbS. H.P. 1. kd@W IAodoperated2polo fled>~gwach, oexten'al `°`waregwro3. a SuVW pippyback mercury Goal a Ash or doubt pWyback marcury. Ilual 94 Sort** CartUol sdecrloe switch. PaW to FM0477. "lul - volts-Ph Mode Am elm a Dua J. Medtarlkal altern4to110072 or 10-0075. I ml 115 1 Auto 0.0 1 or 1 •7 - 4. See F1,40712, for correct awdel of Electrical Merriam "E Pak". u, 11 & Mercury swam Noss r^tch 100225 used as a oontrol activator, specdy ru 230 1 Auto 4.5 1 or 1 &7 duplex (3) or (4) Goat system. - 6. Four (4) tale "J-Pak". lunctial box for wawtight oorlnecuon or weed-in sim- ~tl 2:1U 1 Nod 4.5 2 or 2 A 6 3 or 4 & 6 1l"pr duel operation, loom. 7. Two (2) hole "J-Pak". ror watarughl conroatiort or spkA. CAUTION ,,,-maven on AdWaW Zoo" product telm b cmA1a0 on Combnmfim SI& w. FId11614; All fnWlle ion d conlrole, pratection d"i"s and wiring abould be sum by a qwp- yi-A tlacwy 8wokAss, FW477; Elech" Aharnaia. FM040a; Medurrcal AllsaWar. had liaeneed electrician, AU alacb" and codas should be IoUowed mclud- 4ut.. Alarm Pacaees. Ft40M3; Yw ortiev ap Ba**, F&W447; aad Glawi" Go" sox inp the awet reeanl NeUaW ElacYie Code (NEC) and the Occupational Salley and / Neaft Ad (0611N. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. i11Ar Tft P.A i900f Idwy ~ rot,~.ts. Kr ro2ssala Narxdachaers N . 7 u/R TML- 7itpl~ Ltid I/irrs l alla p ~T /t_ wiscons:rt Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 and Human Relations L ..jio^ of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x so Plan must include, but St. Croix not limited to vertical and horizontal reference point l~1i lope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distan o arest road. (0 r. REVIEWED BY DATE APPLICANT INFORMATION-PLEASE PRI T- LL IVO T N p PROPERTY OWNER. fJi f P TY LOCATION r G OT S E 1/4 NW 1114,S 4 T 3 0 N.R 18 8 (or) W V:l DAv i d G i 11 e n PROPERTY OWNER':S MA!IING ADDRESS BLOCK # SUBD. NAME OR CSM # 404 N. Knowles Ave. s na na CITY, STATE ZIP CODE P 8 ❑VILLAGE )'OWN NEAREST ROAD New Richmond, WI. 54017 Richmond St. Hy. #64 New Construction Use (!q Residential / Number of bedrooms 3 Addition to existing building Replacement ( ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate n p bed, gpdm2 • ench, gpd/ft2 Absorption area reauired n P bed: ft2 375 trench, ft2 Marimurn desionInadinn .ara n p b?d, nn.+1N2 e„ch, "aP~'r? Recommended infiltration surface elevation(s) 9 9 . 4 6 ft (as referred to site plan benchmark) Additional design I site considerations system el. based on contour l i n e of el. 98.461 Parent material pitted glacial drift Flood plain elevation, if applicable n a ft S = Suitable for system CONVENTIONAL MOUND IN GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for system ❑ S ®U I ®S ❑ U I ❑ S ©U I ❑ S Q U I ❑ S t3U ❑ S IRU SOIL DESCRIPTION REPORT Boring# Horizon) Depth DominantColor Mottles Texture I Structure Consistence lBourxJaly Roots GPD/ft in. Munsell Gu. Sz. Cont Color Gr. Sz. Sh. Bed Tmnch 1 0-9 10yr4/3 none L 2 k mfr gw 2f .5 .6 1 2 9-24 10yr4/4 none sil 2fp1 mfr gw if np Ground 3 24-3 7.5yr4/4 none scl 2msbk mfr gw na .4 .5 elev. 98.9f>1 4 8-72 5yr4/4 c2p 2.5yr4/8 sicl lmsbk mfr na na .2 .3 . Depth to limiting factor 38" Remarks: Boring # 1 0-11 10yr4/3 none L 2msbk mfr gw 2f .5 .6 2 2 11-1 10yr4/4 none sicl 2msbk mfr gw if .4 .5 3 9-25 10yr4/4 none sicl lfsbk mfr gw na .2i .3 Ground elev. 4 5-35 10yr4/4 none sicl lfsbk mfi gw na .2 .3 i .96 ft. 5 5-70 10yr4/4 c2p 2.5yr4/8 sicl M na na na np .2 Depth to limiting factor 35" Remarks: CST Name:-Please Print Phone: Gar L. Steel 715-246-6200 Address: 1554 00th. Ave., Now Richmond, WI. 54017 Signature: - --f /7 Date: CST Number: ppopEtaTYOWNEIa David Gillen SOIL DESCRIPTION REPORT Page 2_--,'`_' PARCEL I.D. # Boring# Horizon) Depth IDominant Color I Mottles (Texture I Structure IConsistence 1BourbarylRoots PD/it fTrench d in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. I L1311 \.''N 1 0-7 10yr4/3 none L 2msbk mfr w 2f .51 .6 3 2 -25 10yr4/4 none scl 2msbk mfr gw 1f .4~ .5 Ground 3 25-42 7.5yr4/4 none scl lmsbk mfr gw na .2 .3 elev. q 2-70 7.5yr4/4 c2p-2.5yr4/ sic M na na na nP I .2 94.96. Depth to . limiting factor 42" Lj I T-- I- I I I Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor i Remarks: cAn.Wiin(R 051921 STEEL'S SOIL SERVICE Gary L. Steel David Gillen 1554 200th Ave. CSTM2298 SE4NW4 S4-T30N-R18W New Richmond, WI 54017 MPRSW-3254 town of Richmond (715) 246-6200 1 N 1"=40' BM.= top of cement slab of shed at bottom of garage door C el,. 100' Alt. BM.= top of'cement cover of well @ el. 101.52' X 515+, As 4r. I - Y15 tom, O PI (0 V h Y1 q0 473 ~y ~ /3.7 (o % M 00%Jy Gary L. Steel 5-30-95 C7 M 9NI ria v I l ` cn 1 / \ ° x Cn I d ° ~ ~ ~ y 1 1 a ~ , f I~ C D \ I ,I ' O 1~ 1 V ~Q lyl, I ~ ~ I ~ .yI I r` 47 7 N r' ~ z t7 cn U S ~ 2 F* n~zgz~a 12 C ~ +CO~C7...~0•• ~ 7"~ ~ J ICJ= Z65 =~nW_ t .C=J r :4 -4 C05, . j c n ~r. c~ y o z e ~ ~ Gr-~r TOro S~~-.r "3~ ~ r1 O 1Q c~ Op _ i s OZ ~ ~ tr NC O ? y G~ C Z a t ~ m n x 'lf! ~ 77f ~IaJ7j1~ Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations -DivisEcr> fi safety a Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x Plan must include, but St. Croix # not limited to vertical and horizontal reference point lope, scale or PARCEL I.D. dimensioned, north arrow, and location and distan o arest road. APPLICANT INFORMATION-PLEASE PRI - y LL INFO TVN p REVIEWED BY DATE PROPERTY OWNER: P TY LOCATION ' G OT SE 1/4 Nye 1/4,S 4 T 3 0 N,R 18 $ (or) W 02, DAvid Gillen PROPERTY OWNER':S MAILING ADDRESS BLOCK # SUBD. NAME OR CSM # 404 N. Knowles Ave. lop na na CITY, STATE ZIP CODE P ❑VILLAGE SOWN NEAREST ROAD New Richmond, WI. 54017 (7Richmond St. Hy. #64 [ ] New Construction Use [ x] Residential /Number of bedrooms 3 [ ] Addition to existing building $ Replacement [ ] Public or commercial describe Code derived daily flow 4 5 0 gpd Recommended design loading rate np bed, gpd/ft2 • 3 trench, gpolft2 Absorption area required np bed. ft2 375 trend: ft2 Aila_rmum dgcinn !._?ding ►ete r1P t<y±, ;n+.•'ft2 . 3 !r°^=h, yrd".,? Recommended infiltration surface elevation(s) 99-46 ft (as referred to site plan benchmark) Additional design/ site considerations system el. based on contour line of el. 98.46' Parent material pitted glacial drift Flood plain elevation, if applicable n a ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable for svstem I ❑ S ®U In S E] U I❑ S ® U C] S U I ❑ S 3aU ❑ S CCU SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure ConsistencelBotnday Roots GPD/ft2 Boring # Horizon in. Munsell Cu. Sz. Cont Color I Gr. Sz. Sh. Mench 1 0-9 10yr4/3 none L 2msbk mfr gw 2f .5 .6 2 19-24 10yr4/4 none sil 2fp1 mfr gw if np .3 Ground 3 24-3 7.5yr4/4 none scl 2msbk mfr gw na .4 .5 elev. 4 8-72 5yr4/4 c2p 2.5yr4/8 sicl lmsbk mfr na na .2 .3 98.9e. Depth to limiting factor 38" Remarks: Boring # 1 0-11 10yr4/3 none L 2msbk mfr gw 2f .5 .6 n 2 2 11-1 10yr4/4 none sicl 2msbk mfr gw if .4 .5 3 9-25 10yr4/4 none sicl lfsbk mfr gw na .2 .3 Ground elev. 4 5-35 10yr4/4 none sicl lfsbk mfi gw na .2 .3 98.96 ft, 5 5-70 10yr4/4 c2p 2.5yr4/8 sicl M na na na np .2 Depth to limiting factor 35" Remarks: CST Name:-Please Print Phone' Gar L. Steel 715-246-6200 Address: 1554 00th. Ave., N w Richmond, WI. 54017 i Date: CST Number: Signature: 5-30-95 cstm 0229 PROPERTYOWNER David Gillen SOIL DESCRIPTION REPORT Page. 2 , of PARCEL I.D. # 1 ~ Boring # Horizon Depth I Dominant Color i Mottles iStructure Consistence iBotxdary I Roots' GPD/ft in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed iTrer 1 0-7 10yr4/3 none L 2msbk mfr gw 2f .5 .6 3.._...... 2 7-25 10yr4/4 none scl 2msbk mfr gw if .4 i .5 1 Ground 3 25-42 7.5yr4/4 none scl lmsbk mfr gw na .2 .3 elev. 4 42-70 7.5yr4/4 c2p 2.5yr4/ sic M na na na n .2 94.9(. p Depth to limiting factor 42" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to - - limiting factor Remarks: Boring # Ground elev. ft. , Depth to limiting factor i Remarks: SBD-8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel David Gillen 1554 200th Ave. CSTM2298 SE 4NW a S4-T30N-R18W New Richmond, WI 54017 MPRSW 3254 town of Richmond (715) 246-6200 1 N 1"=40' BM.= top of cement slab of shed at bottom of garage door C el,. 100, Alt. BM.= top of'cement cover of well C el. 101.52' in ~t ~0 y`e D 1 V j QV~ ` a OON-4OQ a W-1,111 ~%1dE /37 r C~4` 4' fvo oa Gary L. Steel 5-30-95 STC- 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNERIBUYER /~Fy! ! ~ ~ Z MAILING ADDRESS PROPERTY ADDRESS (location of septic ystem) Please obtain from the Planning Dept. CITY/STATE PROPERTY LOCATION 5;~- 1/4, 1/4, Section , T R~W TOWN OF / &~ZX~V 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. LINVe, 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 maintaine must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three y ar expiration date: SIGNED: DATE: St. Croix County Zoning Office Government Center 1101 Camiichacl Road 1 1 1`) 3 Hudson. \VI 54016 S T C - 100 This application fore is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/ contractor, (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of property 1 f~lzT~ Location of propertySje 1/4 NAI 1/4, Section T V N-RI_W Township Mailing address 1139 Address of site / l 3 Cj f~~j~ y Subdivision name Lot no. Other homes can 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 7 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. S "n turd' o-~i Ap icant Co-Applicant Date f Signature Date of Signature ,000LIKIENT NO. STATE BAR ;.F WISCONSIN FORM 2-11M THIS SPACE RESERVED FOR RECORDING DATA WARRANTY DEED ! 530441 VU 1127P,&E 256 Si C - David C. Gillen, a sinjtl3 man GR_ANTC)lt fia:ui.n JUN 96 1995 !j St 8:00 A. "j eonrysana "anantsto Steven K. Bartizal ani_M ryA m Rartiza A{;'~ y~,rl_ ~1 husband and wire, RANTEES R°Y.:fx c r'Z'ca 10°`" r 93 ~1 s9 t RETURN TO Steve Bartizal 1139 highway 64 thefoltowinpdescriedreal estat9In ST. Croix comfy, New Richmond WI. 54017 State of Wisconsin: Tax Parcel No: Part of the SA of NWh of section 4, township 30 North, Range 18 west, St. Croix County, Wisconsin described as follows: of the N8 corner of t'he S CO°°eOC~ 459 feet west and SO feet sough thence West 23 rods; thence Noof the rth 177rrods; t sectIon 4ast ; thence South 17 rods; beginning. East 23 23 rods to the point of &NSW rT4 TW6L i s W. homeeleed property. 00 os not) EneptionloWarrantles:Easements, reservations and restrictions of record Dated this 23rd day of .j1lt1E? -Qn. 1P 95 ~ . a (SEAL) (SEAL) gas!-! G. Gillen XEA) (SEAL) AuTNENTICATM ACKNOWLEDGMENT ftnaturety STATE OF WISCONSIN 410- St. Croix County. authenticated this ear of tp June Personalty came before me is 23rd -day of Connie M 14 9S the above named r2ulljXS(,, Drevid C. Gillen Notary Public TITLE: MEMBER STATE BAR OF Wi N nSir (it not in me }}qQ be the per who exequted the by I708.08. Wis. Stab.) Iorepri.n,T fr~LtrJment and ack 1 THIS INSTRUMENT WAS DRAFTED BY n if SO~L•_ ~ ~ ~ t ST. CROIX COUNTY WISCONSIN _ ZONING OFFICE N I M M N N N N N mile, ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 September 18, 1996 Attn: Brenda Equity Title 400 South 2nd Street Hudson, Wisconsin 54016 Re: Septic Inspection for Property Located at 1139 Hwy 64, New Richmond, Wisconsin Dear Brenda: An inspection of the septic system installed to serve the above described residence was conducted on September 3, 1996. This property is located in the SE, of the NW4 of Section 4, T30N-R18W, Town of Richmond, St. Croix County, Wisconsin. At the time of the installation, this septic system was found to be code compliant for a three (3) bedroom home. If you have any questions with regard to the above, please do not hesitate in contacting our office. Sincerely, Mary J. Jenkins Assistant Zoning Administrator pe