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Wisconsin Department of Industry, SOIL A E EVALUATION REPORT Page \ of 3
Labbr,and Human Relations , t
Division of Safety 8 Buildings i{ a:c rd 83.05, Wis. Adm. Code
r COUNTY
0j, Ix
Attach complete site plan on paper no an t-1 inches i i Plan must include, but ST
not limited to vertical and horizontal r e e $ f , di n a o f slope, scale or PARCEL I.D. #
dimensioned, north arrow, and locati dist a to t'road. - b lZ 6 S S --7 O
APPLICANT INFORMATION-PL PR AIL RMA REVIEWED BY DATE
PROPERTY OWNER:
TA'x c, w PROPERTY LOCATION
'F~N GG4k ,NUJ 1/4 SW1/4,SZST 3Q N,R 1`1 E(ore
PROPERTY OWNER':S MAILING ADDRESS 5 a1 LOT # BLOCK # SUED. NAME OR CSM #
p•~. $ux IS-7 - -
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE DOWN NEAREST ROAD
~ l1~Jlly W I SL(~02 (7tS) &8y_ S $ ZS llZl Zv0 y 1f ST.
1- 11
[5(J New Construction Use GxJ Residential / Number of bedrooms Z [ ] AdditQp to existing building
j ] Replacement [ ] Public or commercial describe
Code derived daily flow 3oe gpd Recommended design loading rate - bed, gpdtft2 trench, gpdtf?
Absorption area required D bed, ft2 7-SO trench, ft2 Maximum design loading rate o -S bed, gpd/ft2 0.6 trench, gpd/ft2
Recommended infiltration surface elevation(s) 1 O 3.0 ft (as referred to site plan benchmark)
Additional design/ site considerations f-Aovh p w / S'X Sp' `T\2 C.C( Y" I IN . 0-_ S PO b ]=I r_L r Lb
Parent material % fLy L%zi P&-A Tt t.\- Flood plain elevation, if applicable N - A. It
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U= Unsuitable for s stem ❑ S 19U OS ❑ U ❑ S NU ❑ S glU ❑ S t1 U ❑ S ® U
SOIL DESCRIPTION REPORT
i
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bouncla~, Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends
, R 31 Z - S I)
0., S 3 v G- S o-
jq~' W1
'F-L ~.S~ttSC$ ~}~mvy
Ground 3 Z7-So -1-3`1 R 3J y ~Z 6L3 L pw, - -
elev.
q8 tt.
Depth to
limiting
factor
Remarks:
Boring #
ZO`tV_ 31Z - std cr S 3u~ o-S o,
1x. ;4:2
i i.
`x Z 9-Z8 toy-t►z yl3 - s ~ Zm s~l~ ~ ~fl~ I\X o. S u- ~
SLf
Ground
elev.
19.9 It
Depth to
limiting
facts ,
Z8'
Remarks:
CST Name:-Please Print Arthur L. We erer Phone. 715-425-01.65
egerer_Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022
76 _1 CSTNumber i - -
5'igRatu[a - Date
PROPERTY OWNER T-AiRly SOIL DESCRIPTION REPORT Page Z of
PARCEL I.D.# O k2.- LOSS--70
Depth Dominant Color Mottles Structure GPD/ft
Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trendy
i
Z °t-29 Arl 4 IZ v SI ZM sbh In U` I.. CS 1vf C.1 o.~
Ground 3 Z4 -S) 7. S `1 R 3 / - - ' j
to ¢S&3`e 'F1elev.
1~3-6 ft. j'
Depth to
limiting
factor
2,9 u
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting i
factor '
Remarks:
Boring #
.I~
Ground i {
elev.
ft.
I
Depth to
limiting I
factor
i
i
y~!
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
L
PLOT PLAN - Page 3 of 3
SCALE 1 To FeT
t~X-U$'PT NS St1Ut,~N E~LD 1v0 012,-LOSS-70
II
~ `5' oo ~ o~ ~-qw►p ReT UR
0~~ ~ Q9 9 ivq
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tio1~ ;
`r`~i`vSE ~ 3r, ~ LAST ZS' ~Z.o►y >vi uuivlJ ,
~s-ZZ9
715 _ 42.5-01-65 1✓I4U576
CST Signature Date Signed _ Telephone-No. _CST #
Vftonsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of 3
Labor and Human Relations
Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but ~j 1~ Ix
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road. b l.Z _~ll S S --7 O
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: PROPERTY LOCATION
Tf--~ 'F=Z~RN GGVPteT NW 1/4 SW 1/4,S ZST 30 N,R 11 E(oroW
PROPERTY OWNERS MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM #
P•o.8CS X ZS-7
CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE (MOWN NEAREST ROAD
~Pc~~wlJV WI S~()o1 Pis) &8L!-S$ZS ER~t~ 1RL- Zoo `Ttt sT.
[JQ New Construction Use [ICJ Residential / Number of bedrooms Z [ ] Addikn to existing building
j ] Replacement [ [ Public or commercial describe
Code derived daily flow Sod gpd Recommended design loading rate - bed, gpd/ft2 .28 trench, gpd1ft2
Absorption area required bed, ft2 ZSO trench, ft2 Maximum design loading rate o • S bed, gpd$ .6 trench, gpolft2
Recommended infiltration surface elevation(s) ti O 3.0 ft (as referred to site plan benchmark) r
Additional design / site considerations ' -A Q)Qtvp w / S 'K 5 c I . M IN. o S Py-,b F~l L_. E=- "0
Parent material S i~~ U" 1't L\. Flood plain elevation, if applicable N - A. ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN ALL HOLDING TANK
U =Unsuitable fors stem ❑ S [a U ®S ❑ U ❑ S ®U ❑ S ®U ❑ S C au ❑ S ® U
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure Consistence Bourday Roots GPD/ft
Boring # Horizon in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Tench
A.`' y1 ) d-8 1p`~Itz-31Z - Si[ Z 9~ wiFl~ 0..S 3vj o.S o.~
Z 8-z.~ 1.0~.~. yl~ sl Z+nsbk w,v~~. Cw o•S o-6 ,
FL ~.S~r~st$ ~mvy
Ground 3 Z1-S -1_S `t R 31 y w ~Z 613 L o t - -
elev.
q8 -1 It
Depth to
limiting
factor
Remarks.
Boring # '
l01't1Z31Z S1~ Z''~9L W1'~t- ~S 3uF o-So.~
Z q-z8 10 2 y/3 - s) Zwt sel-t ►~1 U ~N ck, S - ~
3 2$-~19 ~•Sy IZ 3l y t t i Z26 !g~ ~ rv, rn - - -
Ground
elev.
99.9 ft
Depth to
limiting
factor ,
Remarks:
CST Name--Please Print Phone:
Arthur L. We erer 715-425-01.65.
egerer.S.oil Testing & Design Service-P.O. Box 74 River Falls,WI 54022
zgAafure - - __'LZ Daw - T119;-:NDMb
"
PROPERTY OWNER 1V SOIL DESCRIPTION REPORT Page of
PARCEL I.D.# O \2 - l0 SS-
Depth Dominant Color Mottles Structure GPD/ft
Boring # Horizon Texture Consistence Baxnday Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trerxh' .
z
3 0- 9 \ O`-t R 31 Z s l I Z m' as 3~ F o. 5 0 i
`r F Z -29 Ao4~1 vt3 SI Zm sbt~ vi U f1, cs 1vf o,s o.~I,
L,
Ground 3 Z9-S) -).s YR 3! F*( to p- & 3sl8
L Y ova YH `~1~ _ - ;
elev.
von-It. ft.
i
Depth to I
limiting
factor
Zcy 11
Remarks: j
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
La., ! ',I
.i
Ground
elev.
ft.
Depth to .'i
limiting I
factor
Remarks:
Boring #
t v1.
I,
Ground
elev.
ft.
Depth to
limiting
factor
Remarks' - - - y
PLOT PLAN Page 3 of 3
SCALE 1"= y0' ~~F F~Rti
~X t?1~sPT HS S tiUwN ~L D Mk) OIZ- IOSS-70
oo Uo< e-uw►p~eT UtZ
0 ;'h \
v--L a99
0 4,Ov ~ ' o`er
^ Bty -~TZ .100-D oN
~t co, t3 I' "
3NODM.
f { PU C ~1 P ~
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' ~L''~f2C7ST LINE O<; ZZO Atciz(E 13N-2c-c.. ,
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8-,-S
7I=5 ) 4L= 1 h
-CSTSIgate - - - _ Datelgried - Telephone Na.,. _CST #
STC - 104q
AS BUILT SANITARY SYSTEM REPORT
L °T7' r~ ti~ Nr, }-hIiOWNER
ADDRESS _Rd C'. 13 ox-
)3 e
414 ,
SUBDIVISION / CSM#
LOT #
SECTION %Z J T 30 N-R~W, Town of Z--12
r'h
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
13
2
~y fj ws
~ r
n ✓
J
N ~
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
l
BENCHMARK:
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: In I'd.,~S t C• n Liquid Capacity: 1060
Setback from: Well tJ House •C G Other
Pump: Manufacturer 2 u e. //Gje Model# Size
Float seperation Gallons/cycle: ~U 2
Alarm Location
SOIL ABSORPTION SYSTEM
Width: S Length S y Number of trenches
Distance & Direction to nearest prop. line: !2 5-0
Setback from: well: House Other
ELEVATIONS G r
Building Sewer /u.?. qo ST Inlet. 71 S 2 ST outlet /
PC inlet PC bottom Pump Off
Header/Manifold Bottom of system
Existing Grade Final grade
DATE OF INSTALLATION
PLUMBER ON JOB: }y~ /
LICENSE NUMBER:
INSPECTOR:
3/93:jt
Wisconsin D.Vpartmentof Industry, PRIVATE SEWAGE SYSTEM County:
Lat,6r and Human Relations ST. CROIR
Safety and Buildings Division INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-:
249741
PenAlder~L*: ❑ City ❑ Village [ Town of: State Plan ID No.:
CST BM Elev.: Insp. BM Elev.: , BM Description: Parcel Tax No.:
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI F ELEV.
Septic S JO e-d. Benchmark
7.70
Dosing
Aeration Bldg. Sewer
,30 d~ U3
HoIdin St/, Inlet IR' 9 - 7'
TANK SETBACK INFORMATION St/ Outlet
Verit
TANK TO P/ L WELL BLDG. A
ir Ito ntake ROAD Dt Inlet
Septic NA Dt Bottom
Dosing NA / Man.
Aeration NA Dist. Pipe 62 ~d~ Id Z' ('/11'
Ho ding Bot. System / 63' L d
PUMP / Si INFORMATION Final Grade
Manufacturer Demand
Model Number 3s GPM '
TDH Lift . Friction 9. Syestemy <j TDH/,&I' Ft
oss Forcemain Length Dia. Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth '
DIMENSIONS MEN I
SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEAC Manufacturer:
SETBACK
INFORMATION Type O /lx,cY' r CHAMBER Model Nu
System: rNe4An_d >166' OR UNIT
DISTRIBUTION SYSTEM
Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake
Length Dia. Length Dia. Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
C , Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched
Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
a COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: Erin Prairie.25.30.17W, )!~IW, SW, 200th Street
fi /
y r? I " ~U. n,
Plan revision required? ❑ Yes r, C0
Use other side for additional information.
SBD-6710 (R 05/91) Date Inspectors Signature/ Cert. No.
it
SANITARY PERMIT APPLICATION B reauoa utilding WaterlSystem!
201 E. Washington Ave.
In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969
Madison, WI 53707-7969
• Attach complete plans (to the county copy only) for the system, on paper not less County
than 8 112 x 11 inches in size. t^D(
• See reverse side for instructions for completing this application State Sanitary LPeerrmmiit Number
The information you provide may be used b other government agency ~
Y Y programs ❑ Check if revision to previous application
(Privacy Law, s. 15.04 (1) (m)].
State Plan I.D. Number
1. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION
Property Owner Name Property Location
Jeff Fern NW 1f4 SW 1/4, S 25 T 30 , N, R 17 XE (or) W
Pro ert Owner's Mailing Address Lot Number Block Number
V.8. Box 257
City, State Zip Code TP hone Number Subdivision Name or CSM Number
Baldwin, WI. 54002 715) 684-5825
II. TYPE F BUILDING: (check one) ❑ State Owned it Nearest Road
Public 1 or 2 Family Dwelling - No_ of bedrooms 2 ° To~an OF 200 th. St.
III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s)
1 ❑ Apartment/ Condo 0 s~5 _ - 70
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. g New 2. ❑ Replacement 3_ ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
______System.________System____ Tank Only Existing System _________Existing System
B) ❑ A Sanitary Permit was previously issued- Permit Number Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 [N Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy
13 ❑ Seepage Pit 43 ❑ Vault Privy
14 ❑ System-In-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade
Required (sq. ft.) Proposed (sq: ft.) (Gals/day/sq. ft.) (Min./inch) Elevation
300 250 250 .83 103 Feet 104.5 Feet
VII. TANK Capacity
in gallons Total # of Prefab. Site Fiber- Ex er.
INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel plastic p
New Exist in strutted glass App.
Tanks Tanks
Septic Tank or Holding Tank x 1000/650 1 M.idwestrn ® ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber ❑ ❑ ❑ ❑ ❑ ❑
Vlll. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility or insta ati o the onsite sewage system shown on the attached plans-
Plumber's Name: (Print) Plum is Signa ps)----- fjPf jfLRSW No.: Business Phone Number:
Joe Stang ~ Mp 6646 1-715-698-2266
Plumber's Address (Street, City, State, Zip Code):
506 Willow DRive Woodville, WI. 54028
IX. COUNTY/ DEPARTMENT USE ONLY
❑ Disapproved San tary Permit Fee (Includes Groundwater Date Issue Issuing Age t Signa a No m
Approved ❑ Owner Given Initial Ao Surcharge Fee)
I Adverse Determination ,~(.~V GD
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
S81)-6398 (R. 015/94) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber
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.
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 systern, contact your local code administrator or the State of
Wisconsin, Safety and Buildings Division, 608-266-3815-
To be complete and accurate this sanitary permit application must include:
1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the
system is to be installed.
II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling.
III. Building use. If building type is public, check all appropriate boxes that apply.
IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair.
V. Type of system. Check appropriate box depending on system type.
VI. Absorption system information Provide all information requested for numbers 1 through 7.
VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, numb,,!r of tanks and
manufacturer's name, indicate prefab or site constructed and tank material. Complete for all sE.ptic, 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.
~i d Spf . Ifik-j!1 tl5 n o I STlal~n'i to f~ X llb S rr aT <c tt-J he C-I inty_ hi3 plans must
Jin"`ankGY septic
p;:mp or siphon
X17" -enli?tEr IL.^~ s-,t tl'.E I.-_1'ldtng ,~erved
' dose volume
_
--toss section
J zin information.
GROUNDWA-iFR SURCHARGE
1 a8 ^ti :~eo, ~n Act 410 included the creation r)f surcharges, f e-,> ft>r c nur r ,I._ t, d ct!,c_s which can
effectgrouodv ater.
1 -tie m _ n es _~=!ecte_1 though thz° e urcharges are used for mon!tc:lring groundv/at :nn~an jtior +nvestigctions
art" est h!ishment of standards-
r~
i
f SAFETY & BUILDINGS DIVISION
I
State of Wisconsin
Department of Industry, Labor and Human Relations
August 24, 1995 2226 Rose Street
La Crosse WI 54603
~ r
WEGERER SOIL TESTIN
421 N MAIN STREET
PO BOX 74 `
RIVER FALLS WI 5402
RE: PLAN S95-41070 FEE RECEIVED: 180.00
FERN, JEFF
NW,SW,25,30,17W
TOWN OF ERIN PRAIRIE COUNTY OF ST CROIX
MOUND SYSTEM
The Department has reviewed the above-referenced submittal.
Conditional approval is hereby granted for the system plan submittal. All
noted items must be corrected. The review and approval of the system is based
on chapter 145, Wisconsin Statutes, and chapters ILHR 83 and 84, Wisconsin
Administrative Code, and is contingent upon compliance with any stipulations
shown on the plans. This system has not been reviewed for the code
requirements set forth in chapter ILHR 82 or in chapters ILHR 50-64, Wisconsin
Administrative Code.
This plan submittal approval will expire two years from the approval date, or
if a sanitary permit is obtained, plan approval will expire on the day the
initial sanitary permit expires. The licensed plumber responsible for this
installation shall keep one set of plans with the Department's stamp of
approval at the construction site. The installer shall notify the appropriate
inspector when inspections can be made.
All permits required by the city, village, township or county shall be
obtained prior to installation.
Inquiries should be directed to me at the number listed below. Please refer
to the plan number shown above.
S' cerel
w
rard M. Sw'
Plan Reviewer
Section of Private Sewage
(608) 785-9348
2159R/ 1
SUDA-7987(8.10184)
r
Page 1 of 6
RECEIVED MOUND SYSTEM s --41,070
FOR
AUG 7 A Z BEDROOM RESIDENCE
SAFETY i KWS. W.
LOCATED IN THE NW 1/4 OF THE S W 1/4 OF SECTION -~S,T 3D N, R 1-l W,
TOWN OF ~2l►y ~~1ZR~1ZL(v , SY LCZJJ~X COUNTY, WISCONSIN.
INDEX
PAGE l 'of 6 TITLE SHEET
PAGE 2 of 6 PLOT PLAN
PAGE 3 of 6 PLAN VIEW-CROSS SECTION
PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT
PAGE 5 of 6 PUMPING CHAMBER
PAGE 6 of 6 PUMP PERFORMANCE CURVE
PREPARED FOR
-TI F F FQ10-4
X ZS 1
~~LOwijv, w~ s~tooZ
PREPARED BY
WEC-sEF'tEF~ SO I L- TEST I PI C-3
AND
DES = G~V S~R~1 = CE ARTHVR t.
YJEC-EviER
C-575 A t
F.O. BOX 74 421 N. KAIM ST. r # woarm. a
RIVED FALLS. NI 54022 i ` '
115-425-0165
•o~~, ~sIG1~4E
wx ~
!ii!!!Na
PrvG . -.11, Z-1 LC19 -s
JOB NO. clS-ZZ9
PLOT PLAN
Page -2-of 6
Scale 1"= qQ~ '
S95-4107®
orb tg2
v ~
y
X100 XP
B ~ ^ ABM -L'Z-. lOc~-~~ Orv
ti
the F vt• t3" \~IGN 3/y"DIH.
o o~ ~ Pv ~ PVC 11-1PN w~
R~ n ~~u~~ _ as vc ° Uk
P
0 01P.
Ok
VIE
0 1 h1 Ma J
1' ~Pc
V1 F 1°~ + k~j`t
O f0 D~ pi115
1.JOTC
, vSE )-iz~ 3E P-T- U-Z~ST ZS' PjZ.Ow/ Y4oukjb.
NOTES:
1. Elevations shown are existing ground elevations unless otherwise noted.
2. Install permanent markers at end of each lateral. ( Z required)
3. Install 4" observation pipes with approved caps. ( 2- required)
4. Septic tank to be lMOASO gallon capacity manufactured by
~~~~sr~~v ~R tsr~ wC. _
5. Bench Mark SCE "O Ue
6. Divert surface water around mound to prevent ponding at the uphill side.
Page 3 Of 6
Approved Synthetic Covering S95-41070
~s~M c ~3 Distribution Pipe
Medium Sand
~G
Topsoil _-ti F Elev-. \p3.0
-J 1 E D -
3
b
1Z % Slope
Force Main Plowed
Trench of %2"-212" From Pump Layer
Aggregate
Undisturbed D 1•o Ft.
Soil E 1. Ft.
Cross Section Of A Mound System Using F y-B Ft.
1 Trench For The Absorption Area G N • n Ft.
A S Ft. H I- S Ft.
B SO Ft.
Ft.
Linear Loading Rate= b.o GPD/LN FT J Ft.
Design Loading Rate=().-&,GPD/SQ FT
K Ft.
L -7 Z Ft.
Position of Force main------____ W Z,-1 Ft.
~I
L
J
,B ~ K 1
W Distribution Trench Of 2w - 2'2y
Pipe Aggregate
I
Observation Permanent
~
Markers; 40,
Pipes (Anchor securely)
f;
Mound Using I Trench For Absorptip
Ool
Page L) Of
Perforated Pipe Detall S 95 - 4 7
0
End Vier
)Perforated I~
End Cop/) \ey~ PVC Pipe
i ~a~`pb aOL6 I'Install permanent-marker
at end of each lateral
i
Holes Located On Bottom.
Are Equally Spaced
Q End Cop
yy
<ilk,
Q xn^
1 d
PVC Force main tit $
r' ~ Ata ~
C, I
51
!)istr~outian ~ii= ,~.o1C1
Pipe d6r~
Lost Hole Should Be
Next To End Cop 4jG
Distribution Pipe Layout P
7-q_ Ft.
X 30 Inches
Y 30 Inches
Hole Diameter ply Inch
Lateral t'1Y Inch(es)
Manifold Inches
Force Main " Z Inches
4 of holes/pipe I O
Invert Elevation of Laterals IC6• S Ft.
1~x `7: 1}.7 X 7 a Z3.4 Ci~M
Place 1st hole from tee with succeeding holes at intervals.
Last hole to be next to the end cap.
Combination Septic Tank and
PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS PAGE S OF
1 7 0 -VENT CAP WEATHER, PROOF
JUUCTIOIa Box
'i'C.I. VENT PIPE APPROVED LOCKIMG
.10' FROM DOOR, MANHOLE COVER Pk-,Iv
'dIIJDOW OR FRESH wARrJUJG LagEL
Al-9 INTAKE couputr
rj
i I
>`TZ l p4 CAA I `f" HIN.
IB' MtN.
PROVIDE I
IAJLE T AIRTIGHT SEAL
3 gFFL~ S
A APPROVED
APPROVED J01Ai'T. I I I ( JOINTS
I ( W/C.I. PIPE4-H'C
PIPEOl T9nk,)r_onstruction
I I'
shajl,,c,~omply with I II ALARM
R ,,3.15 and 83.20 a
elazI C
U ' ~ B 4t "s u~`5 I
~eAsY, n ~,L.k q 6.2 s
B I LLCM- FL PUMP
OFF
D :CONCRETE
5LOCK
s~E C ols.oo
3" AVt'~2oVET
RISER EXIT PERMI TT -D ONLY IF TANK MAJJUFACTURf`R HAS SUCH APPROVAL. gEDpING
SEPTIC E SPECIFICATIOUS
DOSE 1"11~1~1~~Ci'IZIV P~ Cl1ST
TA IJ K MANU FACT U RE R WUMbER OF DOSES: 3'b9 PER DAZ
:
TAWK sAZC : lOOQ 16 S O GALLONS DOSE VOLUME 2
S^~~-XLIT`Cm S`i-YTID 1s INCLUDIAIG ISACKFLOW: 1aZ GALLONS
ALARM MA►JUFACTURCR:
MODEL QUMSER: NW CAPACITIES: A=~INCHES OR ZS`S GALLONS
SWITCH TyPC: k~ZCU}2"~f B=- Z- INCHES OR 3 G( LLOU5
PUMP MANUFACTURER: Zz seL QQ L CUMPflN~l G = G IkXHES OR L O Z GALLOIJ5
MODEL NUMBER: S3 D- S INCHES OF, S S GALLONS
SWITCH T*JPE: ~ZCU2Y MOTE: PUMP AND ALARM A E TO 15L b
MIMIt1UM DISCHARGE RATE 2-a-SD GPM INSTALLED OW 5EPARATE CIRCUITS
VERTICAL DIFFERENCE DETWI`EU PUMP OFF AIJO..0I5TRIBUTION PIPE.. -7" ZS FEET
t MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . 2-50 FEET
7.
+ 3! FEET OF FORCE MAIN X ,'\s' FYoFLFRICTIOIJ FACTOR.. d- FEET
TOTAL DyNAMIG HEAD = l~'~O FEET
Pump chamber. DIAMETER = 3 8
IAITERAIAL_ DIMLWSIOW~ OF TANK: LEM&TH ;WIDTH iLIQUID DEPTH
BOTTOM AREA 231= - GAL/INCH
AS PER MANUFACTURER = V-)JO GAL/INCH
1n I- nP1 G 1~- 6 0 V= '6
'W UJ W HEAD CAPACITY CURVE 4'~a 61/4
W
W -UZ
"53-55" SERIES 456
25 m
TOTAL DYNAMIC HEAD/ I 4%
FLOW PER MINUTE
EFFLUENT AND DEWATERING
CAPACITY +
20 HEAD UNITS/MIN -11/2 -
- 1 Q 6 FEET METERS GAL LTRS6 111/2 N PT
!J I 5 1.52 43 163 °
= 10 3.05 34 129
V 15 4.57 19 72
15 19.25 5.87 0 0
4 ~4 070
Q 10 X0.10
H
O
H 2
Z3.~IQ
5
915/16
0
US 10 20 30 40 50 33/v
GALLONS
LITERS 0 80 160
FLOW PER MINUTE
CONSULT FACTORY FOR SPECIAL APPLICATIONS
• Piggyback Mercury Float Switches • Available with special cord lengths of 15',
available. 25', 35' and 50'.
• Variable level long cycle systems • Alarm systems available.
available. • Duplex systems available.
Standard cord length - automatic 9 ft.
Standard cord length - non-automatic 15 ft.
SELECTION GUIDE
M53/55 SERIES Control Selection 1. Integral float operated mechanical switch, no external control required.
Model Volts-Ph Mode Amps Simplex Duplex 2 Single piggyback wide angle mercury float switch or double piggyback mercury float
M53/55 115 1 Auto 8.0 1 or 1 & 7 - switch. Refer to FM0477.
N53/55 115 1 Non 8.0 2 or 2 & 6 3 or 4 8 5 3. Mechanical alternator 10-0072 or 10-075.
D53/55 230 1 Auto 4.0 1 or 1 & 7 4. See FM-712 for correct model of Electrical Alternator, "E-Pak".
E53/55 230 1 Non 4.0 2 or 2 g 6 3 or 4 & 5 5. Sensor mercury float switch 10-0225 used as a control activator, with E-Pak (3) or (4)
float system.
53 Series - Wt. 231bs. -.3 H.P. 55 Series - Wt. 25 tbs. -.3 H.P. 6. Four (4) hole "J-Pak", junction box, forwatertight connection or wired-in simplex or
duplex operation. P/N 10-0002. _
7. Two (2) hole "J-Pak", junction box, for watertight connection orsplice, P/N 10-0003.
For information on additional Zoeller products refertocatalog on Combination Starter, FM0514; CAUTION
Piggyback Mercury Floet Switches, FMO477; Electrical Alternator, FM0486: Mechanical Altema- All installation of controls. orotection devlkes and wiring should be done by a qualified
nator. FMO495; Alarm Package, FM0513; Sump/Sewage Basins, FM0487; and Simplex Control licensed electrician. All electrical and safety codes should be followed in addition to the
Box, FM0732. most recent Naflonal Electric Code (NEC) and the Occupational Safety and Health Act
(OSHA).
RESERVE POWERED DESIGN
For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump.
MAIL TO. P.O. BOX 16347
Loufstn7le, KY40256-0347 Manufacturers of. . .
0YZ1 ZZJffj O. SHIP T0: 3280 Old Millers Lane
O p (502) 778-2731 11. 1(800) 928-PUMP `QUAL/TY PUMPS F1hVr 1PJP rr
FAX (502) 774-3624
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER Jeff Fern
MAILING ADDRESS P.O. Box 257
PROPERTY ADDRESS
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE Baldwin, WI. 54002
PROPERTY LOCATION NW 114, SW 1/4, Section 25 T 30 N-R 17 w
TOWN OF Erin Prairie ST. CROIX COUNTY, WI
SUBDIVISION LOT NUMEBER
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 leted and tumed to the St Cro1~
County Zoning Officer within 30 days of the three yea cpirat d
SIGNED.
DATE
St. Croix County Zoning Office
Goveniment Center
1 101 Carmichael Road
Hudson. W1 54016 11 )
S T C - 100
This application form is to be completed in full and signed by the
owner(s) of the property being developed. Any inadequacies will
only result in delays of the permit issuance. Should this
development be intended for resale by owner/ contractor, (spec
house), then a second form should be retained and completed when
the property is sold and submitted to this office with the
appropriate deed recording.
Owner of property Jeff Fern
Location of property NW 1/4 SW 1/4, Section 25 T 30 N-R 17 W
Township Erin Prairie Mailing address P.O. Box 257
Baldwin, WI. 54002
Address of site I 3"Z 5 '4 ®U -6 Subdivision name -1 J ,
Lot no.
Other homes on property? Yes x No
Previous owner of property
Total size of property 120 acre
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 q 9-3 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 n the office of the County Register of
Deeds as Document No. G~5Zv11- , 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
;na office of the County Register of Deeds as Document No.
VZFan Co-Applicant
Date of Signature Date of Signature
DOCUMENT NO. WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA
STATE MR OF WISCONSIN FORM 2 -1982
95012 VOL 913 REGISTER'S OFFICE
ST. CROD(CO.. wr
Recd !cr Record
.
. . . . . •
Rail.Uj_fert&..and..Kathel Inc_U1ferta.._husband--and._wife....... FEB 1 2 1993
..anal.TbLeodor_Ulferta..and-.Irene.-Ulferts,__husband-and at 2.50 PM
.VlP-e........................................................... 61
conveys and warrants to ...J.df_r-ey--.Vern ReaistadOeeds
RETURN TO
A
the following described real estate in ----------------St_e-_CxQAX County,
State of Wisconsin:
Tax Parcel No------------------
NFBi of SVI; and NFh of SW% of Section 25-30-17; SVx of
Std in Section 25-30-17.
This deed is signed by the grantors in satisfaction of
the terms of a contract recorded with the Office of the
Register of Deeds, St. Croix County, Wisconsin, on
4-7-89, in 837-285, #446690.
v
FED
This ia__nat......... homestead property.
(is) (is not)
Exception to warranties:
day of February-..----•------• 19..3...
Dated this
(SEAL)
.i'...... - (SEAL)
• Rarl..Ulferts-•--.....-•-•- a Th ar..Ulferts..
..(SEAL)
---....-...(SEAL) -
• Rathe>;ine__lIlferts-------------------------------- Irene_Ulferts....... -
AUTSBNTICA?ION ACHNOWLBDODIBNT
Signature(s) .4 .g91'~.__vlft r_ta..and__Katheit:[A~ STATE OF XXZRUMXK ILLINO
Ulferts - a&
County.
- - - - fit,
authentica day of----- FebmLarry..... 1993_ Personally came before me this 4j"04 of
19__91. the above named
•...Iahn..0_ Mealln.gem-------- 11ievdoT-U1ferts__and__Irene__U1ferts.___...___.._
TITLE: MEMBER STATE BAR OF WISCONSIN _
e~lt w
(If not............ R~~a~7Prtsr---
authorized by 1706.06. Wis. Stats.) to me known to be the pers s...... fAWVJW BFGNW the
foregoing instrument and a n~j~ept1r~A~p
THIS IN9YRUMENT WAS DRAFTED BY 1/..4u~
• • •~-~-~.1-r
..--......Iobua_ G..i[esi<i~ngeat._ Attorney----------------- 1( .<.mw
1M.UX A9-_Vigc-4j181t 54COZ_-------__---- Notary Public
permanent. (If not, state expiration ~L NOIS
(Signatures may be authenticated or acknowledged. Bo
19f 6.._.)
are not necessary.) a date:
- --^'-=`-~c-
-Namur of persons sitaing in any capacity should be typed or printed bdo~ thei etIIatu,es, v
WA$$AN T DEED STATE BAR OF WISCONSIN Wisconsin ! egal Blank Co.. Inc.
FORM No. 2 - ion Miheaukee. Wisconsin