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HomeMy WebLinkAbout006-1024-40-100St. Croix County Planning and Zoning Tuesday, November 21, 2006 at 1:10:03 PM Detail Sanitary Information Page 1 of I Computer #: 006-1024-40-100 Sub/Plat: NA Section: 11 Parcel #: 11.31.16.162A Lot: 1 TN/RNG: T31 N R16W Municipality: Cylon, Town of CSM: Vol. 09 Pg. 2437 1/41/4: NE 1/4 NW 1/4 Owner: Setter, George 2487 CTY Rd H Deer Park, WI 54007 State Permit: 5449 Issued: 07/1211979 POWTS Dispersal: Non-Pressurized In-ground Permit: New County Permit: 145 Installed: 08/14/1979 POWTS Detail: Bed -Seepage Bedrooms: 3 WI Fund: POWTS Pretreatment: NA Notes Issuer/lnsoector As Built Plumber Other Requirements Additional Notes Monev Owed Harold Barber Yes Steel, Gary L. used TMC steel septic tank to 18' x 53' bed -file $0.00 Tom Nelson Signed Off: Yes with replacement in 2004 Owner: Setter, George 2487 CTY Rd H Deer Park, WI 54007 State Permit: 453398 Issued: 07/20/2004 POWTS Dispersal: Mound less than 24" suitable s Permit: Replacement County Permit: 0 Installed: 08/13/2004 POWTS Detail: NA Bedrooms: 3 WI Fund: POWTS Pretreatment: NA Notes Issuer/Insaector As Built Plumber Other Reouirements Additional Notes Monev Owed Not determined NA Friedell, Ron $0.00 Ryan Yarrington Signed Off: Yes Maintenance Scheduled Pump Date Pumped 1st Notification 2nd Notification 3rd Notification 8/13/2007 Parcel #: 006-1024-40-000 11/21/2006 01;05 PM PAGE 1 OF 1 Alt. Parcel #: 11.31.16.162 006 -TOWN OF CYLON 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 -SETTER, GEORGE & KATHLEEN M GEORGE & KATHLEEN M SETTER 2487 CTY RD H DEER PARK WI 54007 Districts: SC =School SP =Special Property Address(es): "=Primary Type Dist # Description ' 2487 CTY RD H SC 1127 CLEAR LAKE SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 36.780 Plat: N/A-NOT AVAILABLE SEC 11 T31 N R16W NE SE EXC PT TO CSM Block/Condo Bldg: 9/2437 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 11-31 N-16W Notes: Parcel History: Date Doc # Vol/Page Type 06/28/2004 767211 2605/153 QC 12/15/2003 749150 2474/355 AFF 07/23/1997 839/218 07/23/1997 673/290 more... 2006 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 09/08/2004 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 32.780 3,600 0 3,600 NO UNDEVELOPED G5 1.000 100 100 NO OTHER G7 3.000 12,000 116,100 128,100 NO Totals for 2006: General Property 36.780 15,700 116,100 131,800 Woodland 0.000 0 0 Totals for 2005: General Property 36.780 15,700 116,100 131,800 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch #: 512 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 • 4. =~R '~ ~ ~ , TOtr1NSHIP _SEC. , ~ °%' `- 0. ADDRESS1/ _ T~/N R~~W ~' , ST. CROIX UNTY, WISCONSIN. . a ~ u '3DIVISION ~ LOT ~ LOT SIZE/~O,q~,.,~ . ~0~ - ~ba ~ / d'~ / ~ ,~ PLAN VIEW " •Distances & dimensions to meet requirements of H62.20 ~ 3 ~~z~l~ SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM r ~„ ~` -7 ~~ ~l ~ .,\ . `_ . h ~ ~7 . lo. ~~ ~ • ~ : ~ _ . ~- _ ~ .; • ~ ~' _ ~ ~, ''TIC TANK(S)~_ MFGR. ~/~~ ~ , `. CONCRETE CST N0. of rings on cover / Depth " DRY WELL "'NGHES N0. of ;width length .area no. of lines~~ width /8 , length ,5~ ~ area~6 b" dg~t/h/ to top f pipe ~~" ~' ~REGATE _ ~~-~ ~~' ~ ~ ~. ~ - ~u~ R~TE._ /~" AREA REQUIRED 9~-~~ AREA AS BUILT 9.~ ~'~ ~ . ~: lciaimer: The inspection of this system by St. Croix County does not imply complete j -aliance with State Administrative Codes. There are other areas that it is not possible inspect at this point of construction. St. Croix County assumes no liability for ~ ~teim operation. However, if failure is noted the County will make every effort to ermine cause of failure. ~ . ~ASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM """"""~"~~~' . ..----- • ~'IN TOR `l. ~ ~ . l ~..~D~TED PL SEER ON JOB ~`~ LICENSE NUMBER i ~ ', .. __ ~~. r ~ -,~ `~„ '. . Z • i ~- -: 6 REPORT OE TNSPECTION_INDIVIDUAL SEGIAGE SYSTEM '~~ ~, San~,~any Perm S~aze SPp~.cc\\,___1~ NAME ~ ~'~ ~'~t' fownah~,p ~/ ~,a~'''~ S~. Cna~.x County --'- ~ 1.' SEPTT~ TANK ~ -- - I S~.ze~L~Z°Z'' ga.~.Qon~. Numb en as Compan~men~~ ~ D.ca~anee 1=nam: tUe~..~ .~~ ~ ~~. 12~ on gnea~en b:~ape ~~' 8u~..~d.Lng !„~ ~ fix. We~.~ande ~~. DISPOSAL SYSTEM D~,b~ance Fnam: E'TELD DIMENSIONS: H.ighwa~en ~ ~~. Bu~.Qd~,ng ~ (~Sx. H.i,ghwa~en ~~. w~.d~h a ~ ~nench~1~ b~. Length as each .~~.ne~~~. Numb en a~ .~~.ne~ - _-~~-- ~'o~aQ .~eng.th a ~ .L.ine~s~~.t. D~.~s fiance b e~,veen .2.Lne~s ~°' ~~. To~a.E ab~ anb~.ian anew / C~ d ~~.t2 2 Requ.ined anea -~ ~~ 12 0 on gnea~en d.~ope ~ ~~. Ul e~.2and~s F~. Depth as naeFz be.~aw ~~..2e ~''Z_ .in. Depth a~ noeFt oven ~~..2e Z-- .i,n. Depth o~ ~~..2e 6e.2aw gnade ~~ ~.n. S.~ape a~ ~neneh ~- ~.n pen 100 ~~. Depth ~a bednaefz - S~. Depth ~a gnaundwa~e -- ~~. Type a~ Caven: Pape an S~naw PTT DIMENSIONS: Numbers o~ p~,~a nave.2 anaund p.i~~s yea no Ouzd.ide d.iame~en ~ ! Depth be.~aw ~.n.Ce~ ~~. 2 Ta~a.2 ab~sa .cqn anea ~~ A Anea n qu~,ne S~2 ~ rn TNSP~CTE~ By ~ '-~ ~2" TI TL APPR~ VED DATE ~ ( l 9 7~. REJECTED ~ ,DATE ~. ~, 7 ij ~~ ~s ~ ~.~ 197 ~? S ,, i ~' L ~ 7 State and County Permit A lication pp ~/ ~ for Private Domestic Sewage Systems *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY State Permit # '~ ~~~ County Permit County B. LOCATION! /f,'C '/~'/4, Section ~, T~N, R_(~ E (or) W Lot# City Subdivision Name, nearest road, lake or landmark Blk#Lry/`7/ Village Township (' V /r+ st C. TYPE OF OCCUPANCY: *Commercial *Industrial *Other (specify) *Variance Single family ~~_ Duplex No. of Bedrooms `~, No. of Persons~_ D• SEPTIC TANK CAPACITY la-~-c~ Total gallons No. of tanks n~-..-~c- HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete Poured-in-Place Steel L---~" Fiberglass Other (specify) New Installation c_-- Replacement Lift Pump Tank or Siphon Chamber Total gallons Prefab concrete Poured-in-Place Other {Specify) E, EFFLUENT DISPOSAL SYSTEM: Percolation Rate ~ ~ Total Absorb Area '% ~~~ sq. ft. New ~ Replacement Alternate (Specify) Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (topes No. of Trenches Seepage Bed: ~ Length. 'S' 3 r Width.~~ ~ Depth~~~ Tile depth (top- ~n~ No. of Lines 3 Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land ~' ~~ Distance from critical slope WATER SUPPLY: Private Joint ^ Community ^ Municipal ^ Owners name as listed on EH 115 if other than present owner: I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I leave sized the effluent disposal system from the EH-115 prepared by the Certified Soi! Tester, 1` NAME ~~i ~ li ~~I-~~ ,~~/'~~jT /~ ~ti C, C.S.T. # `r ~ ~ and other information obtained from (owner/builder-. Plumber's Signature I MP/MPRSW# ~V ~ `~_Phone # ~-~d- 5 `~ ~- Plumber's Address ~ ~~' ~-~ PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca- tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors. property. If well has not been drilled please indicate. ~~_m _. m. t. ~ ... ~ ~. ~ ~: x a ~ ~ ~ ~~R ~~ ~,~ ~, _. { a ~ ~ ~ ,~~~ x m~ ~ m. ~ __ ~ ~.. E ~~ ~ 5 ~ ~ - a f.....e.m,«,~«M m_ ~ ~~ ~ ~'~.~ _.~,o~ Do Not Write in Spa Below - FOR COUNTY AND ST T~RTMENT USE NLY ~f / Date of Application ~" Fees Paid:. State ~ County. , C~ Date ! ""! Permit IssuedLB~r~ed~ (date) ~ -/,~ - ~ ~ Issuing Agent Name Inspection Ye~iNo /' State Valid# Date Recd 1. .county. N rtel~-copy) 3. owner (green copy) DIVISION OF HEALTH., P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 7/1/78 Mailiny Address: EH. •1.15 '~ WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH ~ ~ ~ ~ P.O. BOX 309 MADISON, WISCONSIN 53707 REPO~~R//T ON SOIL BORINGS AND PERCOLATION TESTS LOCATION: ~t'/4,.~~/4, Section ,t'..~., T.~LN, R ~ E (or) W, Township or Municipality ~ b n - Lot No. ,Block No. County ~~ C-~^° ~ X Subdivision Name Owner's Name.: , ~ ..r- °~ S' y'7~e a Mailing Address: 1!~.l ~o~- ~/'f' «~i 5 TYPE OF OCCUPANCY: Residence ~ No. of Bedrooms ~ Other EFFLUENT DISPOSAL SYSTEM: NEW ~ ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS - 7 ~ C, ~~ER//COLATION TESTS 7~--~ ' 79 SOIL MAP SHEET ~ SOIL TYPELQC ~ ~El P ~~ ~r! 4~7~° C-orh~,[~x PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME INTERVAL DROP IN WATER LEVEL, INCHES RATE NUM- BER INCISES THICKNESS IN INCHES SINCE HOLE 1ST WETTED HOLE AFTER SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 MIN/IN P-~ 3~ S~~-/.30.`~ ~~ ~ a ~' / ~ l3 P ~ 3 t ~, ~ ~ y ~~~ ~ r ' ' ,z ~ l r P J 3 ~ , ' ,, ~ ~ ~..~ ~n ~ ~~ 3 y 3 ~ ~d SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES {NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) B ~ ~ 7 ~~ ~ y'-' .~. ~, ~ 7~ G `f'--5~ T 7 7 '' ~ to ~ ~- s ~z ~ ~, ~ t » ~ ~ 6'~ ~ G"_ c, PLAN VIEW (Locate percolation testssoil bore holes and suitable soil areas.) Indicate orrthe plan the location and square feet of suitable areas. Indicate nu ber of are feet of abs ion area needed for building type and occupancy. ~~* scale or distances. Give horizontal and vertical reference points. I dicat lope. ~i n iJ y X ~ M ~ ~ r 1 ~ ~ ~ n ~ ~ 1 ^~ _ I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Admi istrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. Name (print) t/ Address Name of installer if known t. Certification No. , ~~ 3 CST Signature COPY A -LOCAL AUTHORITY Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTQC~ r,TO PERMIT) Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X~Township Setter, Geor e C Ion Townshi CST BM Elev: Insp. BM Elev: BM Description: ~~ ~ ~ TANK IN FORMATION TYPE MANUFACTURER CAPACITY Septic 5'k~ / I` ~,,/ >Q~ Dosing GB ~ ~ C~ Aeration ~~i ~ ~ / 1ci Holding TANK SETBACK INFORMATION TANK TO P/ L WELL BLDG. Vent to Air Intake ROAD Septic nn ~~, ~~t~C}' 7 ~~/ ~~~ ~ ~ f Dosing ~~~~~ ~~~ / ~- ~~ ~ Aeration Holding PUMP/SIPHON INFORMATION Manufacturer r ~ Demand l GPM Modei Number ~ f L I TDH Lif~ ~~ Friction Loss? S stem Head 7 TDH t , s''~' ~~ ~ Forcemain Length ~ / Dia. ~ ~I Dist. to Well 7 ELEVATION DATA county: St. Croix Sanitary Permit No: 453398 0 State Plan ID No: Parcel Tax No: 006-1024-40-100 SectionlTown/Range/Map No: 11.31.16.162A STATION BS HI FS ELEV. Benchmark ,, 5`1} ~r ,,-f `` - ~~ . q~, ' t; Alt. BM Bldg. Sewer pJ ~ ~~ 7 SUHt Inlet ~ ~ C 7 ~G Z~ 0 St/Ht Outlet •~ ~. 1`E Dt Inlet \ ~~ Dt Bottom ,~ ~1. ~~ Header/Man. Z 3~ ~ - / , / ~I 1 Dist. Pipe Bot. System ~ ~b ~ • b~ ~3 ~ ~ Final Grad 1 ~` ice- ~ , ~ ~~ / / J ~, St over `~ ~ M. ~'~ ~ ~~ ~ a ~~ (- ~.,- ~ z - Z~ ,~ SOIL ABSORPTION SYSTEM ~. __ n :~ / . le rl /')tom (~, ...'.~ _.ll BED/TRENCH DIMENSIONS Widt ~ ` ~ Lenglh~~ / o. Of T,r~enc tf~ s v PIT DIMENSIONS No. O\Pits Inside Liqui Depth SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER OR Manufacturer: Type Of System: ~ ~,L ~ ~' I / `~ ~~ ~ UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold ` ~t J ' ~ Distribution ~ r t Pipe(s) 1 /~ I ~~ ~ x Hole Size ~' x Hole Spacing ~ ~J Vent to r Intake Length ~ Dia ~ ~ Length ' Dia ~ Z' Spacing ~ 2, ~ a `T t3S ~ SOIL COVER x Pressure Svstems Onlv xx Mound Or At-Grade Svstems Only Depth Over ~ Depth Over xx Depth of xx Seeded/Sodde xx Mulched Bed/Trench Center r 1 _~ ~ ~ ~/ Bed/Trench Edges \ Topsoil 1 ~ + ~ i. Yes No i I ;, Yes No ( , COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: g / ~~/ ~~ Innspection #2: / / Location: 2487 CTY Rd H Unknown (NE 1/4 NW 1/4 11 T31N R16W) NA Lot 1 ~~ s c.~.I ~~~-'' "Parcel No: 11.31.16.162A tt VVV 1.) Alt BM Description = S ` LaJ'/`- 3 ~~~ ~ /~ 5 ^ - ^' ~ 2.) Bldg sewer length = !~ a , ~- ~ ~- kf' (IYt~, ~J - amount of cover = > I $ ~ 3.) Contour = Plan revision Required? Yes ~ _ No I 4 1_ Use other side for additional information. I ~ ._. Date SBD-6710 (R.3/97) xx~, Z U~ ~~~~?~' Cert. No. Safety and Buildings Divis' 201 W. Washington Ave., P.O. ~ Cowuy s~ ~~ i ~ ~ ,~~O~~ ~ Madisc?n, WI 53707 - 71 Sanitary Permit Number (to be filled in by Co.) , i i Department of Commerce (608) 266-3151 .~ 3 Sanitary Permit Appl~ea~'~~~`°~""-~ - ~~ ~~ ~ State Plan I. .Number Ir accord with Comm 83.21, Wis. Adn,. Code, personal i~,formatiori you~r d ~ ~ ~ - ~~~ • Q may be used for secondary purposes Privacy Layr, s15.04(1)(m) a r Proje t Address (if different then mailing address) 1. Application Information -Please Print All Information -~ ~- ' Property Owner', Name ~ ~ _ ,: Parcel # ~ Lot # 'Btoek-M o ~~ S ~ -t'G~- !n._.....~ ~ti.E ~ "___--_'-~_.~~'= tz.c~,~ ~~- ~ ~ z.4- - 40 - i oc~ ~ , ~~~ Property Owner' ~ Mailing Address W ~ r ~ Property Location 24~~ LTA ~ t~ ~1 ~~~ t ~ S~tion `~ ~ ~~ ~~ _ City, State _ Zip Code Phone Number '~ s"= '' ~DE ER. ~A'fi~.l'< V`~~ 5 ~ t `li 5>2~9 - 848 i ~' (circle one) E or W T ~! N; R~ II. Type of Bu.Iding (check all that apply) _ 1 or 2 Family Dwelling -Number of B Brooms _ 3 t ~ ~ ~ , ~eSM Number ` O ~ ~ 9 ^ Public/Comm ;reial -Describe Use . ~$ )C Z~ / ~'l ~ 2 f 3 P' 2 * ^ State Owned -~ Describe Ust: ~` Q = ~ •0 ~ ~~ ~ ~ ^City_^Village Township of C ~. ej~,L [II. T ype of PF rmit: (Check y one box on line A. Complete line B if applicable) A' ^ New System Replacement System ^ Treatment/Holdin Tank Re lacement Onl g p y ^ Other Modification to Existin S tam B Ys B. ^ Pcrmil Renewal ^ Prnnit Revision ^ Change of ^ Petmit Transfer to New List Previous Permit Number and Date Issued 13efore Ea piration Plumber Owner . IV. T e of P()WTS System: (Check all that a I ^ Non -Pressur, zed In-Ground ~ Mound >_ 24 in. of suitable soil ~' Mound r 24 in. of suitablE soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wet and ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Rceireulating Sand Filter ^ Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain) V. Dis ersaU'I'reat ant Area Information: Design Flow (BP' I) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation q.5o I.6 .q-~o ~-~o q3. t? VI. Tank Info Capacity in Total Number Manufecturyr Prefab Site Steel Fiber Plastic Gallons Gallons of Units w~., A _A ~,,.~/p~ '~ oncrete Constntcted Glass New Existing C~ - ~~ Tanks Tanks Septic or Holding T snk ' ~d® ~- I~ V I /~ ~ K~tA] l.Lf1~ ,~/ rl Aerobic Treatment Jnit Dosing Chamber i~•) ~~~ VII. Responsibility Statement- I, the undersigned, assume responalbitity for ittstallatlon of the POWTS shown on the attached plans. Plumbt,~ 's Name (Print) bar's Si ature P PRS Number Business Phone Number ~ialJ r 2 ~rzc~~t-~- 221v51~ 1 t ~ l~3? -3a ~o Plumber's Addre. s (Strcet, City, State, Zip Code) lM~ ~3~`~ A~J 'F3plz~~s ~~ e,z VIII. Count /I-e artment Use Onl Approved ^ Disapproved Sanitary Hermit Fee includes Groundwater Surcharge Feo) - -. Date Issued [s ing ant Signature o Stamps) ~ r ~~ 20 ^ Owner Given Reason for Denial IX. Conditions of Approval/Reasons for Disapproval 3 ~ ~~ ~ s X7--1 .. Ir4t.~Y ~-. SYSTEM OWNER: 1 Septic tank, effluent filter and tp~~ ~P ~ta~ la~µt¢-~C~ 3 dispersal cell must all be serviced / .maintained t~ ---- ~ as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances. ' Attach complete plans (to the County only) for the system on paper hot IHa than atrz x t t tncnes In slze SBD-6398 I R. 01/03) J ,~ ~r ;'', S I"rE P1~.N L~ N~~ L ~c~ f~~a, <~ ~, ,~ ..,\ ~~ `~ 5 ~i,~ ~tL. ~ I - r~n~c- To Wlus~ r C~c~r^+^~ `~' •~3`' 2~G~ . Foy.. S-3~ ~ P-rc,H ANt? (_t~-Y+vr f'x1.-o ~o2'T~~Cs of M 1\T ~~ nt- l)SU O . ~jc~s w»R. ~--~ ~J E ~2r~. Novs~ To 7n-J K. Ta B~ Z~=~~~-s n~ ~-n ~~- ~,w.rr. ~i2.3o~ ~~ !:> I3 Bench Mark EL IUU.UU 1. . l~a..o' 1JIv~, ~ Fc.M., ~ ~~ A•,~~1o~sus D~u~ ~'o;t fin-L ~o ~.~ To of q-''~~cF~s w (N~-t~ 4 F't.~, ~i~~l~. :)ti~~~.,'I nak~ Puma (~llnrM3i'1`- C,o N~1 G ~~~sr ,?~{,u~~l l..-a~ Skr.w Icc,~~ibc.~ cJn~. C;;m-x> 't~.~Jl:• ~ WALL (,,ac"/~'`t ~r- flcvi~~n ~.15~~ IZU~ Ct~t~. i ~~ ~~,. -, ~c~v Mound and Pressure Distribution Component Design Design Worksheet Site Inform ation (r or c) R Residential or Commercial Design 300.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 450.00 Design Flow (gpd) 8.00 Site Slope (%) 82.00 Contour Line Elevation (ft) 22.00 Depth to Limiting Factor (in) 0.60 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 120.00 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Pressure Disribution Information (c or e) c Center or End Manifold 0.00 Lateral Spacing (ft) 2 Number of Laterals 0.156 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimated. Orifice Spacing (ft) _ 2.00 Forcemain Diameter (in) 130.00 Forcemain Length (ft) 86.00 Pump Tank Elevation'(ft) 4.55 System Head (ft) x 1.3 7.00 Vertical Lift (ft) 1.37 Friction Loss (ft) 12.92 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. o tions choice --.__._~ 0.75 1.00 1.25 x __ 1.50 x _ x ' 2.00 x _ _ 3.00 x Treatment Tank Information 1039.00 Septic Tank Capacity (gal) ~Skaw Pre-Cast ~ Manufacturer Note: Sand fill (D) calculations assume a Table 83-dd-3 in-situ soil treatment for fecal coliform of <= 36 inches. 3.75 Cell Width (ft) Are the laterals the highest point in the distribution Y network? Enter Y or N If N above, enter the elevation (ft) of the highest point. 11.25 ft2/orifice Does the forcemain drain back? ~~ Enter Y or N 21.21 Forcemain Drainback (gal) 54.39 5x Void Volume (gal) 75.60 Minimum Dose Volume (gal) 21.54 System Demand (gpm) in. 1.50 2.00 3.00 Gallons/Inch Calculator (optional) Total Tank Capacity (gal) Total Working Liquid Depth (in) gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information r 642.00 Dose Tank Capacity (gal) Zabel Filter Manufacturer 16.47 Dose Tank Volume (gal/in) A100 Filter Model Number Skaw Pre-Cast ~_~Manufacturer Project: veorge Setter Page 2 of 8 Mound Plan View 1~ '1 i ~ L Mound Component Dimensions A 3.75 ft B 120.00 ft D 14.00 in E 17.60 in F 9.50 in G 0.50 ft r 450.00 (ft2) Dispersal Cell Area C 3.75 (gpd/ft) Linear Loading Rate H 1.00 ft ~ 10.89 ft J 5.95 ft -t -~ -I -i K 9.33 ft L 138.65 ft W 20.59 ft 1756.58 (ft2) Basal Area Available 12.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 94.96 (ft) 93.17 (ft)-~• F Dispersal CF~II Elevation .. . .~ 8.0 % Site Slope Shading Key ~ a ~ ~- 1~ Topsoil Cap ~ = 1.5 ft 0 ~~~~~~~;~ Subsoil Cap ~ ~ ` ° `° _~y__ T ~:~ f~STM C33 Sand - Tilled Layer ~ ~ 0.5 ft Q5 Aggregate v c _~___ -r I A ---~ ;, >> . 00 (ft) Contour Elevation Geotextile Fabric Cover See lateral details on Page 4 for number, size, and spacing of laterals. Laterals are equally spaced from the distribution cell's centerline in the distribution cell (AxB). 93.67 (ft) Lateral Invert Project: George Setter Page 3 of 8 commerce.wi.gov isconsin Department of Commerce Safety and Buildings 10541N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264-8777 www.commerce.state.wi.us/sb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary May OS, 2004 CUST ID No.226S64 RONALD E FRIEDELL FRIEDELL PLUMBING 1419 13TH AVE BARRON WI 54812 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/05/2006 SITE: Identification Numbers Transaction ID No. 994880 Site ID No. 682816 George Setter Please refer to both idenfification numbers, 2487 CTH H above, in all correspondence with the agency. Town of Cylon, 54007 St Croix County NE1/4, SE1/4, S11, T31N, R16W FOR:. Description: Replacement mound, 3 bedroom residence ~' ~ Object Type: POWTS Component Manual Regulated Object ID No.: 9SS867 ~f r I"P Maintenance required; Replacement system; 4S0 GPD Flow rate; 22 in Soil minimum depth to limiting factor from .~ original grade; System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/O1) and SSWMP Publicatio `:, ~^'~' 9.6, "Design Of Pressurized Distribution Networks For Septic Tank- Soil Absorption Systems." ~`~ ~3 M vim F The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes °"'"" and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in ______~`= ~"-= chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. ~`=~ C(~' No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the design manuals noted above. • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. Key Item(s) • This mound is not designed for installation on a concave slope and may not be installed on such a slope. • The tank access openings shall be per Comm 84.25(7). • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. RONALD E FRIEDELL Reminder Page 2 5/5/04 • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • Abandon failing system per COMM 83.33. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence maybe made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, ~`' POWTS Plan Reviev6er , Int.~Qrated Services (715) 634-7810, Fax: (~YS) 634-5150 , M-f 7:45 am - 4:30 pm pshandorf@commerce.state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code:-7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Project Name: Owner's Name: Owner's Address Legal Description: Township: County: Subdivision Name: I_ot Number: 'arcel LD. Number. Plan Transaction No.: Residential Application INDEX AND TITLE PAGE George Setter George Setter 2487 Cty Road H Deer Park ~g.~,~,-1 (715) 269-5481 NW NE SE S11 T31N R16W Cylon St Croix oun yawing Lateral and dose tank System maintenance specifications Management and contingency plan Pump curve and specifications Site Plan Page Page 4 Page 5 Page 6 Page 7 Page 8 Block Number: 006-1024-40-100 ~ ~,~ }~~. (~ ~~y ~,~~ NT OF,~ E Paye 1 Index and title pFETY A Il.olyt Page 2 Data entry ~--~ 3 M d d s ~- -' ~ ~~-- F~ESPOND 99~~ Designer: Ron Friedeii License Number: 226564 t3ate: 04/(25/04 Phone Number: X715) 637-3020 Signature: i~_,w,- ~ Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 3.11 (R. 06/01 } Page 1 of 8 Center Connection Lateral Layout Daigram 1 P ~I IF X--~IExf2 I xf2~l Laterals & foroe main of PVC Sch 40 (per COMM Table 84.30-5] Holes drilled on the bottom of the lateral, • =Turn-up wfballvaly or cleanoutplug equa8y spayed FJumber of Laterals 2 Orifice Diameter Lateral Diameter 1.50 in Orifice Spacing (X) lateral Length (P) 59.28 ft Orifices per Lateral lateral Spacing (S) 0.00 ft Orifice Density lateral Flow Rate 10.77 gpm Manifold Length ;system Flow Rate 21.54 gpm Manifold Diameter Dotal Dynamic Head 12.92 ft Forcemain Velocity Dose Tank Information Electrical as per NEC 300 and -fi Comm 16.28 WAC Disconnect lank component is properly vented ,,kaw Pre-Cast Capaci 642.00 Volume 16.47 Manufacturer Gallons gal/inch I:)imension Inches Gallons A 24.39 401.70 B 2.00 32.94 C 4.59 _ 75.60 D 8.00 131.76 Total 38.98 642.00 _r A B C D tank. Alarm Manuafacturer S J Electro Alarm Model Number 101 W ~^ ~._--- Pump Manufacturer _Goulds Pump Model Number PE51 _ F ump Must Deliver 21.54 gpm at 12.92 ft TDH 0.156 in 3.04 ft 20 11.25 ftZ/orifice 0.00 ft 0.00 in 2.20 ft/sec Locking cover with warning label and locking device and sealed watertight i 4 in. min. ---~_ E-- Alternate outlet location Forcemain diameter ~ 2 in. Weep hole or anti- siphon device P~ ump oPf elevation (ft) 86.67 Dor se tank elevation (ft) 86.00 Project: George Setter Page 4 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name Friedell Plumbing-~~_-~ Phone (715)637-3020 POWTS Regulator's Narne St Croix County Zonrng -'~ Phone (715)386-4680 System Flow and Load Parameters Design Flow -Peak 450 gpd Maximum Influent Particle Size 1!8 in Estimated Flow -Average 30U gpd Maximum GODS 220 mg/L Septic Tank Capacity 1039 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu1100 mL Service Frequency Septic and Pump Tank Effluent Filter F'ump and Controls Alarm Pressure System Mound Other Ins ect and/or service once eve 3 ears Should ins ct and clean at least once eve 3 ears Test once eve 3 ears Should test month) Laterals should be flushed and ressure tested eve 1.5 ears Ins ct for ondin and see a e once eve 3 ears Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished ..•••••......•• ... .... ............... Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: George Setter Page 5 of 8 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shalt be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be_ maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shalt be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least-once every 3 years by inspection. Th utlet fills shall be cleaned as necessary to ensure proper operation. The finer cartridge should not be removed unless provisions are made o retain solids in the tank that may slough off the filter when removed from its enclosure. If the fitter is equipped with an alarm, 1 the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending ~.. `~ continuous alarm. The septic tank shall have its contents removed when the volume of slu a and scum in the tank exceeds 1!3 the li uid volume of the ~~ tank. I e contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Puma Tank The pump (dosing) tank shalt be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an ei~luent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shy ubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and muicf red as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infikrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mu{ched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L GODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L GODS, 30 mglL TSS, 10 mg/L FOG, and 10' cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contin4encv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present bcation by increasing basal area if tce leakage occurs or by removing biologically clogged absorption and dispersal media, and retateEf piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: George Setter Page 6 of 8 ~~GOULDS PUMPS Submersible Effluent Pump .. ,~ PE SPECIFICATIONS APPLICATIONS Specially designed for the following uses: • Mound Systems • Effluent/Dosing Systems • 1_ow Pressure Pipe Systems • Basement Draining • Heavy Duty Sump/ Dewatering METERS F~ 0 5 10 {- ` I 30 0 '¢ 25 x V Q Z 20 0 15 0 10 5 o~ 00 0 2002 Goulds Pumps CifnH:..n /.I....n.r.4.... x!1/11 Pump -General: • Discharge: 1'/Z" NPT • Temperature: 104°F (40°C) maximum, continuous when fully submerged. • Solids handling:'/" maximum sphere. • Automatic models include a float switch. • Manual models available. • Pumping range: see performance chart or curve. PE31 Pump: • Maximum capacity: 50 GPM • Maximum head: 25' TDH PE41 Pump: • Maximum capacity: 60 GPM • Maximum head: 29' TDN PE51 Pump: • Maximum capacity: 70 GPM • Maximum head: 37' TDH General: • Single phase • 60 Hertz • 11 S volts • Built-in thermal overload pro- tectionwith automatic reset. • Class B insulation. • t)i{-filled design. • High strength carbon steel shaft. PE31 Motor. • .33 HP, 3000 RPM • 12.0 Maximum amps • Shaded pole design PE41 Motor. • .40 HP, 3400 RPM • 7.5 Maximum amps • PSC design PE51 Motor. • .50 HP, 3400 RPM • 9.5 Maximum amps • PSC design ..Y__.._.. :r_.i E51 - _ ,_ , -- t - - ,. ~ -• -r I i t i r ~ i .i.. t MODEl5:PE31,PE41,PE51 ~ i : ' a_ f F I 1~ t t j+ HP:.33..40, .50 ' .. . 4 ... 1 _ i { , : } -s 2 GPM ~ i _ i , , t + ,. t . a t ~ .. ~ ~ ~'.~ -! i PE41~--- -.-' ~ T '' - -' ; ~ 4 1 F r ... . ... . ~ ~ _ i ~ ~ _. t . . ,.. ...I _ ~ j -~-- t - ~- -~- ..t "~ .. ~...~-- - _ _ - - . -_t... ~ , . s . - -. -- ~- - - - - --4-- ;--- a...t. . ... t 7.. ._.. .. - . is .. --' - ..: --+:: ~ _ ~... ~. 1::;:.. ~...i.._ _ } .. 1 ~ _. - . r - ' ._ ~ ' a_ I - I - ~. i. -t .~, ~ ...... ... ..... 3 --- ~-- .- --- --~ ~--- .. ~ - ~ _ I ~; _ ... . . 1 ~ f I ~ : 1. ~ ~ ~ :: - - -- -: :~::: :: .. :: - ~ .. _ i + ..i-- - -- -- . .. . ... ..1.. t ... 111 ... 1... .. . _ I 1 _ __ _ .. __ _ .. .. .. .. .. ..... _ ._ _ .. _ _ i .. r : I_::: ~ ~ t , ~~~ . . ... {.. .. . . .. ..... .. .. ... .. ....... ...... . . . .. . .. . . _ .... . _. lU LU yv gv 5 10 CAPACITY MOTOR JV 60 70 GPM SO FEATURES ^ Corrosion resistant construction. ^ Cast iron body. ^ Thermoplastic impeller and cover. ^ Upper sleeve and lower heavy duty ball bearing construction. ^ Motor is permanently lubricated for extended service I'rfe. ^ Powered for continuous operation. ^ All ratings are within the working limits of the motor. ^ Quicic disconnect power cord, 20' standard length, heavy duty 1613 S1TW with NEMA 5-15P, three prong, 115 vok grounding plug. ^ Complete unk is heavy duty, portable and compact. ^ Mechanical seal is carbon, ceramic, BUNA and stainless steel. ^ Stainless steel fasteners. AGENCY L15TING5 S~• c us Testied to UL 778 and CSA 22.2108 5larrdartls BY ('arw~rl Sbndards Assodation Hle ~LR3$549 Goulds Pumps is Ko 9at1 Regls~ered. 15 mom Goulds Pumps ~~ (~ Itl(~UStrIeS ,~ C~ ..~ sJ~rE Pi~.N ~,:~ N w~ L ~ i i' J 9 I,' ~t `3 ~ ~` ~i[~ et (~/ I t < ~ {`', ~ -~, .3 __~.._- _ _-- __.,,~ \ ~ !' ` \ `\ f~ ~\~. _ ~ v L ~ c.) ~ ~~ ~ ,.. ,.` ~,_ .__ ____.`-__.. ~ ........----------x -_.__. t~z"'~~ 3 ~~ e~• ~ _._.__. 1~euS~ .----____ _ i ~ ~~ ~TlR, ~~~ 3Cy3h-~>Gic, XI V~ K ~ .rJr3"u.~ efL ,I i ~~~n}Ci ~To ('vlt~tG r ~..t~mrti, ~a~.• 3c:i' ~Gt FO~.51~1s ~ (~1T(..N A13D ('itlrv-~ F'Jh•IU ~o2'Ty~iy ~~ m ~Tc~a-t a. JSeso . 5~u~~n. t_-1,~ ~ ~iu.~~. 1-lovs~ To Tn~ K To 8~ z~.~~~a/~ Ai ~p t~~~. ~',~ 13 Bench ~Vtark EL. 10.00 o, ~ ~3r . ice? .o' ~1tiL ~ F~.~(~, t N ~- I.~ol.~st3 U~c-1~ y o ~T f3n~L ~t_ `l~ ~R Ta ~,F ~1.,.`~c*.-, ~ ~,,~ (N~tl.. 4~ F't.~c,. °i1~,1~- ~ `~ it,, n1JY~' pVMt~) L~~~~11r11~tJ~'- ~aU N1t31 L N~~I'ls~ f ~ - ,.)fil. ,i t/ ~~kt~u.a {cG~~(bW cjn+... C.cthi'xD 'tr,Jl;.. ~ (tv~Ll.. (,c,c-/i'ftvr~ I '' lo(i Ir~c~s ~r~ 3.l`~i". 1'Lt.~' tr,l~t~t.. 2~t~.~,~to~ 13~,-105 C>vl~~R~.l.+_ ,~ cJ v (Y1G1"r1\r~i~l~tU-J ~.•(1=5f~U-It~b~ll ~~I~,~:~i~Ui~ Wisrx+lnsin Department of Commerce SOIL EVALUATION REPORT Page 1 of Division of Safety a id Buildings in accordance with Comm 85, Wis. Adm. Code ` ~ County 'ST C.,2.o1 K, Attach complete cite plan on paper not less than 8 1/2 x 11 inches in size. Plan must _ indude, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, stile or dimensions, Korth arrow, and location and distance to nearest road. UOIo - t t~24 -~ 40 - 100 Please print all information. Revi ed by pate Personal Mfom~attm you provtde may be used fors ndary a ~. t5 (t) (m)). ~ '~ Property Owner(' Pro rty Locaflon Jiq, `~1~Ur~C-.t% ~~~~~ Gov,. Lot ~~ i/45tsT' 1/4 S ~ ( T 3i N R ~ ~s'(Or)W Property Owner's Mailing Address lot Block # Subd. Name ar CSM# 24g"7 C~~ ~ ~Pi©At~ ~ ~~~. ~ROiXCiJU(~T., _.' ___. City State Zip Code P amity ^ Village ®Town Nearest Road ~1~~ 1Z PA 2K ~~ J`-400 (~ l ) ~laq' -54A~ 1 C `tt lt7 -.,) L cn ~.w`i U ^ New Construction Use: ® Residential / Number of bedrooms Code derived design flow rate 4~5 d GPD ®Replacement ^ Public or commerdal -Describe: I~ Parent material ._ 1J ~ K,O -,J -..1 Flood Plain elevation if applicable N .. A , ft. Geheral comments it and recommendation s: ~ D u tJ D ~J `i 5'Tt~'r~ ~tvC,c~rhw'+'~ 1J ~ ~ ~ ~tc~ t~Ot~LUr,J g2~1C.orJTOVt:,. ~~ Boring # C~ t3ortng 1 1 1 ~1 _~ _...L__ _ G'~ 1 A ~ ~3 n ~ ey r~~ .. ......................,..,.. .-. ... ~aNu. ~,....~.u..a.a~.~ ~ ~„y~. SoilAppNcation Rate Horizon Depth DottSinanf Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munseil Qu. Sz. Cont. Cofar Gr. Sz. Sh. •Eff#1 •Eff#2 ~-$ ?•5`t2- 5 ~ Zw,sbk m f 2 • fo I.O 2. ~- ~, to ~, 51 Zmab k, m l . (~ 1.0 z- Z a, e.. 5 2.5ti ~ 4 8 ~ z :j ~ Zrn oJo k ~.~ - , 4 • ~ Z L ~ 5 2 5 ~e.'t- b 3 ~.,. 5 L~ 'Lu~b ~,;. M 1 --- -' .4 . ~o Boring # ~~~t Boring ` I[y Pit Ground surface elev. ~(. ~ it. bepth to limiting f9ctor ~ in. Soli Ap fication Rate Horizon Depth Dominant Color Redox Description texture Structure Consistence Boundary Roots GP D/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. _ , 'Eff#1 "Eff#2 C~-`~ Z.S~t~ Z ~ ~ 'Zw,shk ~'' SS 2-~ b l.c~ 2 9- e.. _ ~S M i 5 1 .~ I.~ ~_ ~ 2.s~f~~a- s Gi SGI 2w~abk. mkt g5 - . :.4 .fa , Effluen #1 = BODR > 30 < 220 mg/L and TSS >30 < 150 mg/L `Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number ROIJ ~ t ED t/ Z~.lo~J Address Date valuation and ted Telephone Number ~41~ i3~"Ad 3~~RvrJ 1~54~i2 t~-'13~b4- C°165~(o3~-3bZC~ CRf)-R7'ih ~Rn7lnm y Property Owner S ~-~ ~- ~ ~..T?~t? Parcel ID # 6C~ °- 1 ~ 24 - 4C)' (c7 O Page ~_ of ~_ Boring # ^ Boring _ Icel on Ground surface elev. ~ ~ • ~ ft. Depth to limiting factor ~, r Sail Application Rate .Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Clot Texture Structure Gr. Sz. Sh. Consistence Boundary Roots +E~GPDfR Eff#2 6~- 7,5~fa. 3~ S 1 2r-~sbk m S 2 .~ ~ .v Z 3 9-24 4- b Q. ~ 5~e, q-~tp - - 2>-rea s ~ cQ 5I. Sc~ 1 Zrr-obfc Or•-. nn~ 1 p~j ( ~ lQ '_'• _" d 1 < O d ^ Boring ,~ Bonng # Ground surface elev. ff. Depth to NmiHng factor In• n Pit Soit Application Rale Horizon Depth Dominant Color In. Munsell Redox Description Qu. Sz. Cont. Cdor Texturr3 Structure Consistence Gr. Sz. Sh. Boundary Roots ~Etf#1 PDT*Eff#2 L ~ _ [~ Boring Boring # t--1 Pit Ground surface elev. ft. .Depth to limidng factor In• U Soil Application Rate _~ Horizon Depth Dominant Color Redox Description in. Munsell Qu. Sz. Cont Color Texture Structure Consistence Boundary Roots ~E~GPD/t~=Efiti2 Gr. Sz. Sh. • Efflr lent #1 = BODs > 30 < 220 mg/L and TSS >30 < 150 m9n- 'Effluent #2 =BODE < 30 mg/t. and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the deportment at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) SITE 'PLAN PROPERTY OWNER: G~O{~,r,,,L, S~TI`~+~ PROPERTY- LOCATION: ~~ `'~ ~~~ 5~ %4 5~c.11 T311s K~bw T o w ~,1 ©F Cy Lo n1 -- ST GizU - -c. Go Cv NwY ~~iq 5t u a.~T ~~ S`vF qo ` 91 q2 ~ 93~,, 1 ~ ~ f ~ ~ ~ ~ ~ ~ ~ B ~_ x ~ I \ ~ ~ ~ K \ / \\ \ \ • \ BI •~ Us ~ /~ ~ ~ ~ _ '~ 8°lo B~ ~ \~~ d ~ ~ ~ sled ~ ~^ ~X 1 ST_ S~TpfeG~ x 7+ h ~I ~ 1I ~ 1 =~~ (Q BM BEVCHMARK: '6~ , tel.- - cx~. o' tai p - ~. ~ FLac„ 1 r~ NouS~ D~~K 4~os-r F3M2 l=lr ~1(. ~.,Tl~o P of 4~~ P~bS~ ~ t~A1~.F F4~aG, ~, BORE SOLES ~~ g, q ~. t4 ~~~z ~ . ~ ~~~3 9Z.~ ~'° w~W. lovAS log 3.22 h ~PA~--- . C.o • N wy N ~ i~P t~sc ~aop~T~t l.l--.~ ~ Ron Friedell #226564 ~'.-~, 41~3~~- ~~~./ s~r caolx covlvTv SC?I'T'[C TANK MAINTENANCE AGREEMENT . ANi~ OWNERS1iIP CERTICICATION FORM OwnerlBuyer ~t~c~rr..C,,t;3 ~t~Tl-i,~ Mailing Address 248 Z ~i y ~Ru 1~ DAR ~A~tt l~~ 5 4 ~ Properly Ad~iress ~j ~' kti ~ (Verification required from Planning Uepattment for new City/State 1~~ ~A tic l~7=, Parcel Identification Number dcxo - I02A- - 40 -- bCx~ (. 1620 Lcc~c, nESC><urTxoN Property Location ,~_ %,, Ste' _ '/,, Sec.. I f . T~_N• R,~_W, Town of ~. Subdivision _ .Lot # Certified Survey Map # `~~-~- Z~t~l~, Volume ~~ Page # .3~ Warranty Deed # ~~~ 3.C'~ .Volume ~3 Page # Z~~ Spec house C7 yes ®no Lot lines identifiable f~1 yes ^ no SYSTEM MA.I:NTENANCE Improper use and maintenance of your septic system could resalt in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner. if needed by s licensed pumper. What you put into the system can aII'ect the fc notion of the septic tank as a treatment stage in the waste disposal eysbem. The im~Y owner agrees to submit to St. Ckoix Zoning Department a certification form, signed by the owner and by a masterplumber, journoyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than I/3 full of sludge. Uwc, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards net forth, herein, as set by the Department of Commerce and the bepartment of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Cmix County Zoning OISce within 30 days o e , year a don date. SIGNATURE OF APPLICANT DATE OWNER CEl2TTFICAT)<ON I (we) ccrt'fy that alI statements on this form arc true to the best of my (our) knowledge I (we) am (are) We owner(s) of the p rty desr above, by virtue of a warranty deed recorded in Register of Deeds Otrce. / ~~ SIG T O:c~ APPLICANT DATE •••'*+ Any inG~tmation that is tnis-represented may result in the sanitary permit bring revoked by the Zoning Department. ••••*« +• include with this application: a atampcd warranty deed from the Register of Deeds o[Yice a copy of the certified survey map if reference is made in the warranty deed _ _ _ ___ .. __...r. __ ____.._.__ ___ _. ~ _.`.-__ i DOCUMENT NO. I' wA~~~Y ~~~ ~~e L~~~ ~s[eVLD /ow aLC6apINe ewTs ( STATE BA& OI' WII3CON8IN lORDt =-1lY II 44'7353 _ i ~ -_ vcY~~r~~t~~ _~_ _ _. ~ - . -_- _ . _ _ ~_-__ -_- _ _ __ ___ - . ______: REGISTER'S OFFICE ;` ~ ST. CROIX GO. WI ~, ' Irene Setter, a single person, Reid for Record (~ ~~ 8.30 A.M ~ '~ conreys and warrants to Geor;?. Se£~:er /~ ............................................................................................................... :~ (~~ ~I ., ~, -- -- ....................._.....-................-...._....-.......................-.................................. i~' RETURN TC .. ................... ........... St Croix - _ tlw following described real estate in .-.......e ......................................Count-. j State of Wiaeansin: ?' Tsx Parcel No:.......--•-----°-._.._..---° i! NEB of SE SEA of SE~, SEA of NE~, NWT of NE~~ and~SW~ of NE~except w innin at a o~rlt 44 rods East hat arcel escribed as ollo s. g P of the Southwest corner of the SW~ of NEB, thence North 30 rods, thence East 16 rods, thence South 30 rods, thence West 16 rods to the point of beginning; all in Section 11-31-16, St. Croix County, Wisconsin. This deed is given in satisfaction. 1979 and recorded April 11, 1979 in as Document No. 356171. of a land contract dated April 1, Volume 592 of Records at Page l91 T . ;~F~ i r~,} E This ._-._.._i3.-IlOt..---- homestead property. (is) (is not) Exception to warranties: Municipal and zoning ordinances and recorded easements, restrictions and reservations, and any liens or encumbrances created or suf- ferred to be created by *_he acts or defaults of the grantee. ~ 2bth ......-•------. d:y af .-----...APril ..............................................., 1x.89.!. Dated this ................................. ........ ............. ............................................(SEAL) ............................................• _..................-.. (SEAL) .....w~.t..va..+.....~` •"`.'u'^r.~'rt-'----•-- -•-- ••--•---(SEAL) • ............Irene..Setter ......................... ADTggNTICATION ACHNOWLSD~3MSNT Signature(s) .................................... STATE OF WISCONSIN ........................ ns. .........................•----------•---......--------------------•---......._.. ...Count ._~U~~G .............•-•--•--.. y. t9-.,_.. Personalty came before me this ....26th.-day of - • ~ - 19.$.~.. the above named _~ o-,--„ ~ ~, r / 2 . , o FILED 3 ~EC 3.O NNELI JAMS ~ Deebs R M s IFIE~ SU LOCATED IN PART OF THE NEI/4 OF THE SEI/4 OF SECTION II, T31N, R16W, TOWN OF CYLON, ST. CROIX COUNTY, WISCONSIN. OWNER LEGEND GEORGE SETTER !~ FOUND ALUMINUM MONUMENT 2439 C.T.H. "H" ~ FOUND 2~~ IRON PIPE DEER PARK, WI. 54007 O SET I" X 24~~ IRON PIPE WEIGHING 1.68LBS/LINEAR FT. (715) 269 - 5481 UNPLATTED LANDS - - - - - - - - - EAST 5237.47 ,- ' A CENTERLINE OF HIGHWA f7 O Z m m n w N~ 04 IC Iz I'0 Ir ID I~ Im 1D Ir ID Iz I~ I z 0 N Oo A 0 0 - - - EAST/WEST I/4 LINE, SECTION I I - - - - - - - - - - - - -~ C.T. H . ~~ H ~~ w ~'~. Y - "- WEST EAST 494.00 w °'- ~ 673.43 w R/W C.T.FI-'rH~~ EAST 494.OOT- O'• ~ I C ~~t _ I Z iL ~ I ~•., o cn ~•. ~ o Ir LO T I 9~`• ~ ID «~ m m~ ~~ = A , O W ~ Z .m o~ ~ BUIk41~s~T~AS~ ... - ro = I~ ~ - --- - --• - --• - --• - •-• - '~.~ WELL ~?' I--I 140, 296 SQ. FT. (3.22 ACRES) ~ a N ~ a INCLUDING HWY. R/W HOUSE o_ ap Inl ~7 ~ Q 123, 994 SQ. FT. (2.85 ACRES) ~ IO ~ ~~ ~ EXCLUDING HWY. R/W SEPQTIC SEE NOTE ON BACK OF THIS SHEET WEST 494.00 UNPLATTED LANDS BEARINGS ARE REFERENCED TO THE EAST/ WEST I/4 LINE OF SECTION II ASSUMED TO BEAR EAST. NOTE:. This lot was .created SCALE for the purposes of farm consolidation. 0 50 100 200 This instrument was drafted by D.J.Z. SURVEYOR'S CERTIFICt~TE ~~~ c~ o . <., o Ir'- L n; ~:; s~~ ID '~ IZ ~ ~ <; ID c~L~ ~; «3u~J~ ~~ ~~ ~ ~. ~ ~r ~ QO;~ALD F. ~'. ~O}iNSON ~ y--1 1 B~ j +~ AMCF2Y. wls. ; ~ f-~ ! r~oQ- ewe ` Nw..~ /• NI~~t~N I, Ronald Johnson , a Registered ~7isconsin Land Surveyor, do hereby certify that I have surveyed and mapped a parcel of land in the NE4 of the SE4 of Section 11, T31N, R16W, .Town of Cylon, St. Croix County, Wisconsin; described as follows: Commencing at the E4 corner of said Section 11; thence West 673.43 feet along tha east and west one-quarter line to the point of beginning; thence South .284.00 feet; thence West 494.00 feet; thence North 284.00 feet; thence East 494.00 feet along said east and west one-quarter line to the point of beginning. Containing 140,296 square feet (3.22 acres). Subject to right-of-way for County Trunk Highway "H" and subject to all easements, restrictions, and. covenants of record. I further certify that I have complied with the provisions of Chapter 236.34 oi: the Wisconsin Statutes and the subdivision regulations of the Town of Cylorzwand the County of St. Croix in surveying and mapping same. 'Ctonald F : Johnson P.O. Box 194 Amery, Wisconsin R.L.S. No. 11.86 54(701 Tel. (715) 268-2601 VOLUME 9 PAGE 2437 Date "~ -s„ ,~ ~''