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'Laaborr and Huma Relations Industry, SOIL AND SITE EVALUATION REPORT Page of 3
Division of Safety & Buildings in accord with ILHR 83.05. Wis. Adm. Code
COUNTY
e
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or 1PARCELID
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY D TE
PROPERTY OWNER: PROPERTY LOCATION
GOVT. LOT 1/4 1/4,S
PRO RTY OWNER' :S MAILING ADDRESS LOT # BLOCK # SUED. NAME OR CSM #
ew'o -
CITY, S TE ZIP CODE PHONE NUMBER []CITY []VILLAGE GOWN NEAREST ROAD
er F&16-
New Construction Use [ /J Residential / Number of bedrooms [ ] Addition to existing building
j ] Replacement [ ] Public or commercial describe
Code derived daily flow _ &,0 gpd Recommended design loading rate I_bed, gpd/ft2_~trench, gpd/ft2
Absorption area required .t po bed, ft2 4,06,0_ trench, ft2 Maxi m design loading rate ~~bed, gpd/ft2_,','trench, gpd/ft2
Recommended infiltration surface elevation(s) . r a ft (as referred to site plan benchmark) S
Additional design/ site considerations e gOL
Parent material Flood plain elevation, if applicable It
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U= Unsuitable fors stem ❑ S 4 U QJ S O U ❑ S O U MS U S QJ U ❑ S O U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bwxlary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
Bed Trendt
m- • as
s
Ground 3 _ ° s •
elev.
ft. c 1 _ I
Depth to
limiting
factor
&I OT
Remarks:
Boring #
~3 ~.s y s s
1171/59 Ao A4
Ground S - _ B z ° s
el
atL ev. y Y- m Z - e
ft. N
Depth to
limiting ST
factor
95.7
Remarks: q*J -0-y e
CST Name: Please Print Phone:
Address:
o 1 Gs ~-3
Signature: Date: 7 umber:
PROPERTY OWNER ~b D+ti SOIL DESCRIPTION REPORT Page_,?_ of _
PARCEL I.D. # JJ
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends
G O S
Ground 3 2.7-7-7. 0 8 l s
ele
v. p
9 "If t.
Depth to _ /O At 2L 42
limiting
factor
Remarks: 0-57 Pepe
Boring #
y L- o o r
Ground A o _ 7
elev. 2 9 _ _ E G t: - S'-
L ft.
Depth to S -TZ o - 8 2 ~ - ~ ~
limiting
factor ,
fP 7
Remarks:
Boring #
'(0 - der
Z X~-1v <a- ~s cs ,s
Ground 3 0-'So a -s .1 - o .
elev.
'ft.
Depth to
limiting
factor ,
Fl d
Remarks: Y
Boring #
Ground
elev.
ft.
Depth to j
limiting
factor
Remarks:
AN it
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STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER J"ac ..a
ADDRESS
SUBDIVISION / CSM# LOT # 02
SECTION T N-R W, Town of lv(,MAUA')
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
l ai all
V
K
n
G
y
~DDa, S'.' Tz
,PL p
~INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
i
BENCHMARK:
a / S
ALTERNATE BM:-,,9,ti
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: Liquid Capacity:.
/moo lJ
Setback from: Well S7 House- ' Other
Pump: Manufacturer /p- v ' ~odel# Size
Float seperation
Gallons/cycle:
Alarm Location
ep e s„ S 7x-77 ~ SPQZ~BSORPTION SYSTEM
Width: Length /
Number of trenches
Distance & Direction to nearest prop, line:
Setback from: well:__ House. Other
ELEVATIONS
Building Sewer ST Inlet:
ST outlet
PC inlet PC bottom
Pump Off
Header/Manifold Bottom of system
Existing Grade Final
grade
DATE OF INSTALLATION: /e/ S/ I S
PLUMBER ON JOB:
LICENSE NUMBER:
INSPECTOR:-
3/93 jt
Wisccnsin D,partment of Industry, PRIVATE SEWAGE SYSTEM County:
Labe_- and Human Relations INSPECTION REPORT ST. CROIX
Safety and Buildings Division
(ATTACH TO PERMIT) Sanitary Permit No_:
GENERAL INFORMATION 240783
PeWt §&s Na70EL [I City [I Village [Town of: State Plan ID No.:
Kinnickinnic
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
A9500276
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic o 0J Benchmark
Dosing
Aeration Bldg. Sewer
Holding St/ Ht Inlet
TANK SETBACK INFORMATION St/ Ht Outlet
TANK TO P/ L WELL BLDG. AirI to ntake ROAD Dt Inlet
irl
Septic NA Dt Bottom
Dosing NA Header / Man.
Aeration NA Dist. Pipe
Holding Bot. System
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand
Model Number GPM
TDH Lift Friction System TDH Ft
Forcemain Length Dia. Fi Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS DIMENSIONS
SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
SETBACK
INFORMATION Type O CHAMBER Moe Number:
System: 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
Depth Over Depth Over xx Depth Of xx Seeded/ Sodded T[] x MulcheBed /Trench Center Bed /Trench Edges Topsoil El Yes [I No Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
L0164ION KKinni~ckinnic.22.28.18W, NW, SE, Lot 2, River Road
Plan revision required? ❑ Yes ❑ No
Use other side for additional information.
SBD-6710 (R 05/91) Date Inspector's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER: `
~ i
~~U o
-
lei
t.
9.i o
teri .
r^~i~■'■n SANITARY PERMIT APPLICATION BureaSafetyu o oand ff Bui Buiildin ng Waater Systems
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 8112 x 11 inches in size.
• See reverse side for instructions for completing this application State Sanitary Permit Number
of ~d 7O
The information you provide may be used by other government agency programs E] Check if revision to previous application
[Privacy Law, s. 15.04 (1) (m)]. State PI I.D. Nu r
1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION S
Property Owner Name Property Location
41e,4 dlkj v4s'd1i4, S o?.2 ToZ j , N, R /g E (or)&1
Property Owner's Mailing Address Lot Number Block Number
City, State Zip Code Phone Number Subdivision Name or CSM Number
I. TYPE F BUILDING: (check one) ❑ State Owned ^ E] !tr Nearest Road
Public fij 1 or 2 Family Dwelling - No. of bedrooms -7 VII age r pp~~
OF i' r i vr.(~ e L/
Own WAJI
II1. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s)
91% _?0C
1 ❑ Apartment/ Condo I 00? 4`1 -6 ov -4-1
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. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
......System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 [&Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy
13 ❑ Seepage Pit 43 ❑ Vault Privy
14 ❑ System-In-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade
Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) D r Elevation
Gad d" C Feet Idle SeFeet
VII. TANK Capacity
in gallons Total # of Prefab. Site Fiber- Plastic- Exper.
INFORMATION Gallons Tanks Manufacturer's Name Concrete Con- Steel
New Existing strutted glass App.
Tanks Tanks
Septic Tank or Holding Tank ~.ZDd 1 jn /4'./e.97cy~ [a ❑ ❑ ❑ ❑ ❑
Lift Pump Tank /Siphon Chamber 111,04 j r eves7e ❑ ❑ ❑ ❑ ❑
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name: (Print) Plumber's Signature: (No mps) /MPRSW NO.: Business Phone Number:
r ~
jW - /S-
Plumber's Address (Street, City, State, Zip Code):
11j
G Ga
o _4i-.ga..-e-- O
IX. COUNTY / DEPARTMENT USE ONLY
❑ Disapproved Sa itary Permit Fee (Includes Groundwater ate Issued Issuing Agent Signature (No Stamps)
ZApproved E] Owner Given Initial Surcharge fee)
OfA
I Adverse Determination
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SBD-6398 (R. 05/14) DISTRIBUTION:. Original to County, One copy To: Safety 8 Buildings Division, Owner, Plumber
INSTRUCTIONS a
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 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 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.
11. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling.
111. 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, 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.
SAFETY & BUILDINGS DIVISION
State of Wisconsin
Department of Industry, Labor and Human Relations
August 7, 1995 8 9 201 East Washington Avenue
P. 0. Box 7969
Madison WI 53707
ULBRICHT & ASSOCIATES
ROBERT ULBRICHT
655 O'NEILL ROAD
HUDSON WI 54016
RE: PLAN S95-02607 FEE RECEIVED: 180.00
LARSON, JOEL
NW,SE,22,28,18W
TOWN OF KINNICKINNIC 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.
Sin rely,,
e er E. P ge
Plan Reviewe
Section on of of Pr vate Sewage
ORIGINAL
(608) 266-2889
SBDA-7987 (6.10/84)
ULBRICHT & ASSOCIATES CO.
655 O'Neil Road • Hudson, WI 54016 Reg. Designers of Engineering Systems
715-386-8185 Private Sewage Consultants
PROJECT INDEX
DILHR Plan I.D. # s95-02607 Date 8-7-95
Owner Joel Larson Phone 715-425-9960
Address
410 E. Johnson St. River Falls, Wis. 54022
Legal Description
Lot #2, CSM 529259, Vol. lo, Pg. 2923. 2.83 acres.
NW 1/4, SE 1/4, Sec. 22, T28N, R18W.
Town of u , County --St. Croix
C.S.T. David Fogerty CSTM 3233 Installer
Local Authority/ Supervision
St. Croix County Zoning Dept.
PROJECT DESCRIPTION
New construction, for a proposed 4 bedroom sized home-
estimated daily wasteflow: 600 gals.
Soils in the top 30" are fairly permiable (.5 GPD/Ft2)
but seasonally saturated,, t 37". A conventional long & narrow
mound system is propo,"d,;
~ dsna t~u
Ft 81
Pg.1 PLOT PLAN V11 WS a
L3'1ICHT
UUDSON. WI
Pg.2 SYSTEM CROSS SECTI. SYSTEM PLAN VIEWS
Pg. 3 PIPE LATERAL LAYOUT ~~'S..
4
'~~ii~~nrunn u
Pg.4 DOSING CHAMBER CROSS SECTION rG
Pg.5 PUMP PERFORMANCE SPECS
This design for installation is based entirely on measurements, elevations,
landscape conditions (slopes etc.) and soil suitability provided by CSTM 3 ~3
The accuracy of his specs, as reported, shall remain the sole responsibility
of the CSTM.
S95.02607
Any use of this POWTS design ty any licensed plumber, or any
related unlicensed parties or persons (excavaters, laborers)
shall not be construed as an assumption of responsibility by,
the designer for the workmanship, construction, placement,
substitution or selection of any components not specified, or
any assumptions by the plumber that any unspecified components
are state approved or proper, or the effects of poor judgement
if working under adverse damaging weather conditions (wet/frozen
soils) by any such parties or persons.
CST S RA4 N.fi/ ,B.fsE 0,4 f . f Ti0.U moo. C7
13,q P 3y No ~o r
IY /
G f~~ c u R u~ p /Z ~
vNiFr~l?AA cofTOUR l1'NF fP
° 99.08 Pz.. ,
i3s
' N 9a
the o~ea Y~ n, below Iho do~sfo~e o~~o of loo ~
Soil ~b or~lioa Sydam mall moll iadhmds
/Vpk.) lzoo 4"` . PpECkST 5.? a r
AiPwESTER4 pfre-*3r zNc.
y ~
10
woo . g8, _
Afec is T
Po yl Cti•r,,e4pz «0
P,lap
h
56 ALE: yo
3
• _ /8~0~ 10, T.S
su pv~ yo p S 2• 7-
.0
b sP tiw nr- ca~P,v Ex .
S 5
Q 9~ fo "
Bl-
3
CR055 SECTIOXJ of MouAi D wi rtj f3ED
Bev aF ro
z` Ay9~9-5^TE.
'TDi ST R i GO'N o&j
~N G-
Cs , rkeekf= °s s pip
s ysrEM
OP ToP soiL EItvAridW
Umi FoRM To E- k /DO. OR
RATIO MED. • ~M
IOToSot L- /
PWEO P~
um i FoRM
% SIoPE FORCE"
El~W1'hDa U"M-R
Mhi~ dill'
Bep 99.0 8
I. a FT E~EVhT'ioa S
1.25 Fr. • 1mveRr OF )A'reRh(5 10'0- SP
fT Z FT• Top of Rock 1 dC7 . `j0
'G _
N Top o F 14 T E R A I S t b CJ. Z.,
BE a
~f' 'F Mou~~ wi To Vi
F`~A pers. , FoRcsz MAW
(v F r4
gyp
' ® ( d F r
Fr
F
k ~I
c~° w F, r .
2.00
Fr
„595-02607.
Bev of
PVC cgppEp To Ii" A 53 Pei Are'
d(35ERVhrlo0
PIPES
PERMAPj EAuT M AR kERS
Rvqumep 13AsAI_ hREh = v~r~y whsrFF~cw (000
901t~ ia~:Ir~tnTwE
C ^PAciTY sa. Fr,
PRopoSEb MsM Ar?eA, = B ~c (A + 1) IGOOO
s ~2. I=T.
C
DiSTRi 6oTl oAl PIPE N ~ r_w_oR._K .._.LAyo_u-r
Trri'•¢/ AA--Twotl~-
/ ? Z s .
P R
O L9 \ o MhaZF
E
t
5
go Fr
3-o R Fr
X 0.= wc <
FnRcE MAi►V ~E'
2ZS Fr.
o~ puc IutNES
RRRi'A(3LE
TOTAL. Vdlc) UbIuME 3G' 9 6AI5 , 'DiSTA4CL,
N olE 'D~%E!"1ETE'(~ T INCNES
LhZERAI. Imc lies
MAMIFOLD Z. WCOFS
Foggc, MAIN " Z s95-02607
IN~F}E5.
° }oI pE 17
F 10UER"r E LEVAT1oo
of LATER Ms
T+,a+
4
pe R Fa R ATE P P CD -J
• Remove- ml DRill BURRS I ` Y
NOTES IOCATeb CA3 SoTroM EgOAIIY SPACED ,
Ti STRi BuT,10" DVSchAR CAE RATE FOR EAch LAY'ERA L
Pim oti S I GAL. Miti1.
TOTAL 17(5TRjB0TIo0 V5Cti~lRC->E FATE rZnR.
kW-rwOR K 31-79 6rAL MIS. a•5' I MI'MI MVM
ReAD .
PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS P,41E of S
VENT CAP
4" C.I. VENT PIPE WEATHER PROOF APPROVED LOCKIIl1G
JUNCTION BOX MANHOLE COVER
25' FROM DOOR 12"MILL. (v/tlj(Afh)( 1AAF1
WINDOW OR FRESH
AIR INTAKE
E-i^T/ca GRADE I
~~Afl~ ~ I 4" MI►J.
g 3.'~ I • 1 IB" MIN.
yb N coUoulT
fIEV4f7' o~v
INLET PROVIDE. I
AIRTIGHT SEAL I III ~ J~
I II v
APPROVED JOINT A 1051 I0 I III APPROVED JOINTS
w/C.I. PIPE `nM I III W/GI. PIPE
EXTENDING 3' 10 0 I II ALARM EXTENDING 3'
OWTO SOLID SOIL B I q ) I i I ONTO SOLID SOIL
a M (3"3 / I i oN
y ;I
ELEV. ~a FT. J
PUMP---- --j OFF
BLOCK
~tevAf
RIStR EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL
SEPTIC E SPECIFfCATIOUS /
DOSE ~"PloteSTdrRN t*5+y - IJU
TAALKS MANUFACTURER: MBER OF DOSES: ~ PER OAy
200
TANK SIZE: IOOO GALLONS DOSE VOLUME 37
ALARM MANUFACTURER: S. T. LE C-rP0 -t" C . INCLUDIMG BACKFLOW: 2 7 GALLONS
MODEL NUMBER: rItAIL-'1"4W T /o/ ~ CAPACITIES: A= 16 INCHES OR GALLONS
SWITCH TYPE: IeP ` g = Z INCHES OR ~y GALLONS
PUMP MANUFACTURER: GoV LfJs 174 / C= INCHES ORZ3 ~7 GALLONS
MODEL NUMBER: ~f0 «~Sh EfD/ D a X237 INCHES OR ✓s- GALLbWS
SWITCH TYPE: Ypl ~ MLe ~ CU~ tl4 T NOTE: PUMP AND ALARM ARE TO BE
MINIMUM DISCHARGE RATE 0 GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE..1~9o3 FEET -rAAj/,,
F SPECS '
+ MINIMUM NETWORK SUPPLY PRESSUR~,E. . . . . . . FEET EAC(A- Of' y~ P
+ 227 FEET OF FORCE MAIN X '~`"F//ooFtFRICT101J FACTOa..S''9 FEET "UAIS
f!3 ASS
= TOTAL Oy1JAMIC HEAD 2&.
= FEET
INTERNAL DIMENSIONS OF TANK: LENGTH Q ;WIDTH .;LIQUID DEPTH
S95-02607
0
'ondit
1~ZA ~p~Ft
K
Submersible
Effluent Pumps
3885
T AVAILABLE CERTIFICATIONS
it ETL LISTED SUBMERSIBLE PUMP
CLASS I AND 11 DIV. 2 AND
CLASS III DIV. 1 AND 2 `I
ETL TESTING LABORATORIES, INC.
it• CORTLAND, NEW YORK 13045 G1086131480
CANADIAN STANDARD ASSOCIATION SP
PERFORMANCE RATINGS (gallons per minute) MODELS
t
t WE0511H WE05IIHH Series HP Volts Phase Max. Amp. RPM Solids WI. (IbS
Series WE0512H WE0712H WE1012H WE1512H WE0512HH WE1512HH WE0311L 115 9.4
t No. WE0311L WE031/M WE0532H WED732H WE1032H WE1532H WE0532HH WE1532HH WE0312L 230 47
WE03121 WED312M WE0634H WED734H WE1034H WE1534H WE0534HR WE1534HH 1/3 , 1750 56
t - - PIP A 'A '/2 3/4 1 1'/2 1/1 1 y WE0311 M 115 1 . .4
ppm 1750 1750 3500 3500 3500 3500 3500 3500 WE031 230 4 4.7
5 100 70 80 90 106 - 60 _ WE051 I H H 115 13.0
10 80 65 76 87 102 112 56 84 WE0512H 230 6.5
_ WE0532H 2081230 3.4
15 60 57 72 84 100 108 53 82 3
20 36 45 65 79 95 105 48 71 WE05 ' 460 1.7
WE051 1 H HH /2 115 13.0 60
25 25 59 74 91 100 45 75 WE0512HH 230 1 6.5
w X 30 50 67 85 96 40 72 WE0532HH 208/230 3.3
35 40 61 79 92 35 70 WE0534HH 460 3 1.65 a "
$ 40 26 52 72 86 30 67 WE0712H 230 1 10.0
W. 10 43 64 80 25 64 WE0732H Y4 208230 5.4
3500
5p 30 54 73 18 60 WE0734H 460 3 2.7
55 17 42 65 12 58 WE1012H 230 1 12.5 70
• 60 6 30 54 3 54 WE1032H 1 208230 7.0
65 16 40 51 0 5 26 47 WE1034H 460 3 3.5
~ 7
i 75 14 43 WE1512H 230 1 15.0
WE1532H 208230 9.2
-80 4 40 WE1534H 460 3 4.6 BO
90 33 WE1512HH 172 230 1 15.0
100 24 WE1532HH 208230 9.2
110 120 15 WE1534HH 460 3 4.6
metal parts, BUNA-N 1
elastomers. METERS FEET
• Temperature: 1600 F (710 C) 90 - - µ-4
maximum. i MODEL 3885
• Fasteners: 300 series 25 80 - _ . SIZE Solids
stainless steel.
70 `E~ .I.....
• Capable of running dry
without damage to 20 1NE,
components. 0 60 - - - 5GPM
Q 5 FT
Motor: W 50 EO
• Single phase:'/3 HP, 115 or a 15 i
230 V, 60 Hz, 1750 RPM; o EO
40 1/2 HP, 115 V, 60 Hz, I _
3500 RPM;'/2 HP through 10 30
1'/2 HP,230 V, 60 Hz, . i.......
3500 RPM.
► o
Built-in overload with 20
automatic reset, class B
insulation. 10
• Three phase:'/2 HP through ° o
1'/2 HP 208/230 V, 460 V, 0 10 20 30 40 50 60 70 80 90 100 110 120
60 Hz, 3500 RPM.
Class B insulation, overload ° 10 20 30
protection must be provided CAPACITY
in starter unit.
8 -99.5-02607
1
s
Ot MAY 2 3 1995 r n~
KATHLEEN H. WALSN
6 Register of Deeds
a Croix Co., Wl
529259 16
ti m ) a.
CERTIFIED SURVEY MAP
HOWARD MADSEN
Part of the Northwest 114 of the Southeast 114 of Section 22, Township 28 North, Range
18 West, Town of Kinnickinnic, St. Croix County, Wisconsin,
W 114 COR, S£C. 22, r28N, R/8 W, E114 COR. SEC. 22, r28N, R/8W,
O Indicates 1" x 24" I1 "IRON P/PE FOUND/ /COUNrY SURVEYOR'SMON.1
iron pipe weighing s 88.46'46'•£ 5233.71•
1.13 lbs./lin. ft. set.
E/W //4 L /NE ,
3942.96'
. ! C
UNPL A TrED LANDS
Owner's Address: FENCE
1214 River Drive
0
River Falls, WI 54022 279.3`' ' 60 '4 ~
~ I U I MI N
/oo • ~ . 3 W
Z ~ , h W
Q ~ I ty p b.
LOT 2
„J op i ~ I ` t
h 2-
b
Q 2.832 ACRES I I . y y r
L b b 123, 347 SO..Fr. I h I ~,I h OI ;
O 2.027 ACRES N
f 3
88, so,
Dated: 4-13-1995 Q H o o J y,G
_M1 I ~ I ~ I
J I 0 2 ~i
H I b ~
+ lJl~ ~ I
J I Q ROAD SETBACK LINE o 33' 3 I K
r
ZI 66' Q
h' J ~ 3
S 8.9 40' 22 "E 280. 82' O F Q 2
Rt
Q ~
M e D : LU
y
N B8. 36 38'•W 339. B/' V -4 N
W
S L / NE NW 114 SE //4
UNPLA TTED LANDS
This instrument drafted by Laurence W. Murphy '0i-
%%~~SG O NS~~
SCALE I /00'
tr.
...0
0 23' 50' /00' 200'
300' - LAUR C
' W M °C
13
IV FALLS 44
R. 0. W. CURVE DA rA Wisc.
CHORD BEARING- NO/•30'33.5:'£ D •'ca``ll
CHORD DIsr. - 33.31' LA NG
RADIUS - 3762.80'
ARC olsr, - 33.31 '11dil!l10"
CENT. ANGLE- 00.33'07" MAY 23.'951
/ST rAN. 8EAR. - N01 • 34'00"£ Laurence W. Murphy
2ND rAN. 8EAR.• N02.07'07"E
Registered Land Surveyor
Vol. 10 Page 2923 ST. CROIX COUNTY
Certified Survey Maps Comprehensive Rlar%&k SHEET 1 OF 2
St. Croix County, Wisconsin. Zoning and
Parks Corrut>ittelv
tf not recorded
witfrin 30 days of
approval date
rr,
+cpreval shall bo
w it R v *`3''
19
4
i
16 Continued
CERTIFIED SURVEY MAP
HOWARD MADSEN
i
Part of the Northwest 1/4 of the Southeast 1/4 of Section 22, Township 28 North, Range
18 West, Town of Kinnickinnic, St. Croix County, Wisconsin.
Description:
That certain parcel of land located in the Northwest 114 of the Southeast 1/4 of
Section 22, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County,
Wisconsin, more fully described as follows;' Commencing at the East 1/4 corner of
said Section 22, thence N 88046'46"W (ass~'led bearin9 on the East/West 114 line of
said Section 22) a distance of 1310.751; thence S 01 5212111W 974.10' on the East line
of the Northwest 114 of the Southeast 114 of said Section 22, to the POINT OF
BEGINNING, of the parcel to be herein described; thence continue S 01052'21"W 363.00'
on said line; thence N 88036'58"W 339.81' an the South line of the Northwest 114 of
the Southeast 1/4 of said Section 22; thence N 01052'21"E 363.001; thence S 88036'58"E
339.811, to the POINT OF BEGINNING, of the above described parcel, containing 2.832
acres, being subject to easement over Easterly portions of said parcel for C.T.H. "JJ"
R.O.W. purposes, Southerly portions of said parcel for town road purposes as shown on
this map and also being subject to easements of record.
Dated: 4-13-1995
This instrument drafted by Laurence W. Murphy
Note: The parcel shown on this map is subject to State, County and Township laws,
rules and regulations (i.e. wetlands, minimum lot size, access to parcel, etc.).
Before ;purchasing or developing any parcel contact the St. Croix County Zoning Office
and the appropriate Town Board for advice.
State.of Wisconsin)
County of Pierce)
I, Laurence W. Murphy, Registered Land Surveyor, do hereby certify that by direction
of the Owner, Howard Madsen, I have surveyed and divided the lands shown hereon in
accordance with official records, Chapter 236.34 of the Wisconsin Statutes and the
Ordinances of St. Croix County and that this map and description are a true and correct
representation thereof.
N%%,``,~~111rr11111O,/V / ,
~ ~w S/it ,,00;0
Y ,
LAUR INC APPROVED M W M P o
S 71 a.
N V ALLS, J~
MAY 2 3.'951 ,~~F9°•• wisc. ,.•SJQ
L A ND Vol. 10 Page 2923 5T. CROIX COUN'TV
Certified Survey Maps Comprehonsive Plamia Laurence W. Murphy
St. Croix County, Wisconsin. Zoning anti Re istered Land Surveyor
Parks Committee SHEET 2 OF 2
If not recordi.,9
within 30 days of
approval date
ipprovaf shall bo
("A & vrtd
I
L
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER -Zoe- -fQ.' LjC`r o
MAILING ADDRESS ylQ dh.rJSa.y ST R `I x' r F~`Z~ SyG,22
PROPERTY ADDRESS X07.7 ll~J Zo~u-
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE
PROPERTY LOCATION 41 OJ 1/4, 5,6F 1/4, Section 2 , TOF- _N-R_ /7 W
TOWN OF ST. CROIX COUNTY, WI
SUBDIVISION S' LOT NUMBER
CERTIFIED SURVEY MAP S~gL?Sq, VOLUME le , PAGE ;2q.2 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 (l)
the on-site wastewater disposal system is in proper operating condition and (2) after inspection and s
pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum.
I/We, the undersigned have read the above requirements and agree to maintain the private sewage
disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR.
Certification stating that your septic has been maintained must be completed and returned to the St. Croix
County Zoning Officer within 30 days of the three ye pira on te.
. J
SIGNED:
DATE:
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
14
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 J ac-k 1, oce/Se,~
Location of property 6_1/4 1/4, Section J, T,.fr N-R_Ze- W
Township Mailing address y(~ 5' TsAysaAl 5'r
Address of site ~2~d
Subdivision name (f ff o4 Lot no.
Other homes on property? Yes No
Previous owner of property
Total size of property
Total size of parcel 2, a;27 QGr/r
Date parcel was created
Are all corners and lot lines identifiable? Yes _)No
Is this property being developed for (spec house) ? Yes 2_No
Volume 1C24( and Page Number 4(-F_.7 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.
3-a 9
Signature of Applicant Co-Applicant
/
Date` of Signature Date of Signature
DOCUMENT NO. STATE BAR OF WISCONSIN FORD[ 1-1882 TMie arACR RESERVED IOR RECORDING DATA
A WARRANTY DEED ^
7F. 3
St c,.,~:; i i
This Deed, made between i
..4knd.. Qada..M~..MBn~...4?tasban.. JUN 2 1995
and."-llrif e
, Grantor, `I 12:05 P.P
and.....lwe ...dr.._.),+wr em..4nd T nya._.4~...i.BiFsen.7 l; ia•ti,~~- !t~sS.
kluska.nd...aTid..w.....W.l;y.}yorshi,P...4n?~.ta1
..pro.pert..y
Grantee, /
Witnesseth, That the said Grantor, for a valuable consideration...... D - (gfi~-j
conveys to Grantee the foilowi••g described real estate in ...Sit.....Uoli........... RaTuRM To
County, State of Wisconsin:
Lot Two (2) of Certified Survey Map filed 0,22-l0er"y_IF&4
May 23, 1995, in Vol. 10, Page 2923 of TazPared No
Certified Survey Maps, Register of Deeds'
office, St. Croix County, Wisconsin. Being part of the NWk of the
SEE of Section 22, Township 28 North, Range 18 West, Town of Kinnickinni.
This ...A .,IlOt•••••..... homestead property.
(is) (is not)
Together with all and singular the hereditament@ and appurtenances thereunto belonging;
And... Howard..E._.Madsen..and..C arda..M.....Mads.en
warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except
easements, restrictions, and rights-of-way of record, if any,
and will warrant and defend the same.
Dated this 1st................. day of June....................................................
18.. 5_..
(SEAL) ~.."f-........ . . (SEAL)
• Howard Madsen a k a
H aid . •_d
................................._...._.._........_........._._...---(SEAL) - (SEAL)
' G.arda...N.,__.Madsen..............................
AUTBIENTICATION ACKNOWLEDGMENT
Signature(s) -..-Garda...M..-..MAdseD..... STATE OF WISCONSIN
es.
a.1' ...............County.
this 319.6a3! o ....--Half 1995- Personally came before me this .-.1at...... day of
June 19.9-1. the above named
Hnward..Madsen._ a .k
H.oward--Es---11adsen..................................
= BED STATE BAR OF WISCONSIN
rr(u> tary...pubf
;,1ttitifrisey 4 708.06. Wis. Stats.) to me known to be the person who executed the
°a • ion expires 6 - 2 9 - 1'►AY Pv oregoing instrument and acknowledge the same.
TNfa INSTRUMENT WAS DRAII'TIO BY 1AARI.ENE R. ~ o
54022
Rivex... d~.~.$a y Publ i lam-/
c _ County, Wis.
(Signatlres may be authenticated or arJt le ed. Both MY mmission is permanent. (If not, state expiration
are not necessary.)
f ..-.l.Q...tors.7.-•----••_-••--°
"Nazar of persons sianine in any capacity should be typal o their signatures.
WARRANTT DRZD STATE BAR Or WISCONSIN Wisconsin f eal Blank Co. Inc
DORY Ne. 1-1987 Milwaukee, Wis.
z
Wisct °:;Sin Department of Industry, SOIL AND SITE EVALUATION REPORT Page / of 3
tabdr and Human Relations
,,Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but PARCEL I.D. #
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY LOC TIN t /
PROPERTY OWNER:
a L GOVT. LOT 1/4$ 1/4,S 2T ~2 N,R E (or)ep
PROPE OWNER':S MAILING ADDRESS LOT # BLOCK # SUED. NAME OR CSM #
0 G
CITY STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE V rOWN NEAREST ROAD
[n New Construction Use [A Residential / Number of bedrooms yr [ J Addition to existing building
[ J Replacement [ J Public or commercial describe
Code derived daily flow 6O0 gpd Recommended design loading rate __bed, gpd/ft2 trench, gpd/ft2
Absorption area required S-G_ bed, ft2 = ---trench, ft2 Maximum design loading rate __,,7 bed, gpd/ft2___,.L_Vench, gpd/ft2
Recommended infiltration surface elevation(s) 9P. ~ Cft (as referred to site plan benchmark)
Additional design / site considerations -
Parent material Flood plain elevation, if applicable ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U= Unsuitable fors stem ❑ S ❑ U ❑ S ❑ U ❑ S O U 0S O U ❑ S O U ❑ S U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
.7
Ground -29 /o- 6 s .1 Xf 41 A" .7
elev.
a ft. 3 o- f - s t kr /
Depth to _ s - S -
limiting
factor
Remarks:
Boring #
f> o-~ o -Y / s Y
2- 7
-
3 31-`l9 Cl_~ Z - s 5 7
v'r ft. Ground
elev s' AY 1 v5 o . 6
-ter
Depth to
limiting _
factor ,
QS 7
Remarks: } r
CST Name:-Please Print Phone: - `
Address: ~r'r>~ o -jam
PROPERTY OWNER jae'4 ~r SOIL DESCRIPTION REPORT Page 4 of
PARCEL I.D. #
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
o - k, l
.7 S
Ground le-23 /0 - / Qs
e1-7 f
lev --j
ft. 27 _ 33 66 _ S o ar / 4 .
Depth to _ 6 S AOV / c f
limiting
factor
AV -
.e
Remarks: n t _cz
Boring #
rp;
~i
m dr
Ground
elev. Al_ 7 S f tir/ cr .S
e~ ft.
Depth to 6m < s s
-17 j
limiting f- y _ S2 0 _ P 1
factor d
.93.7
Remarks: vl f' ~c la.
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground DAVE FM
elev. Ucenaed Pair To t 2189 ber
ft. #
Depth to ROBERTS• WS NSIN 23
limiting
factor
r
L I
Remarks:
j
1 V
V
V ~
if
cm
0
cow
4
en z c?
h
04
a
u. ! r
y ui i o
a~ 0
I ~ ~ Y
o
f~
V
v ~9
s
4` V
,a z N
~I
-7 IN
4
,3 .
x h Q `
l
y~ d
Q ~ 1
3
Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page - of
and Human Relations
Labo
Di n of f 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
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.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPERTY OWNER: ~ f PROPERTY LOCATION
GOVT. LOT 1/4 1/4,S T N,R E (a) W
PROPERTY OW ':S MAILING ADDRESS LOT # BLOCK # SUED. NAME OR CSM #
CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE ❑rOWN NEAREST ROAD
[ ] New Construction Use[ J Residential / Number of bedrooms [ ] Addition to existing building
j ] Replacement [ ] Public or commercial describe
Code derived daily flow gpd Recommended design loading rate bed, gpd/ft2 trench, gpd/112
Absorption area required bed, ft2 trench, ft2 Mabmum design loading rate bed, gpd/ft2 trench, gpd1ft2
Recommended infiltration surface elevation(s) It (as referred to site plan benchmark)
Additional design / site considerations
Parent material Rood plain elevation, if applicable It
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U=Unsuitable fors stem ❑S ❑U ❑S ❑U ❑S ❑U ❑S ❑U ❑S ❑U ❑S ❑U
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure GPD/ftBoring # Horizon in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Conslstenoe Boundary Roots Bed
rends
Ground C
elev.
ft.
Depth to
limiting
factor
Initial: Date
PROPERTY OWNER SOIL DESCRIPTION REPORT Page_
PARCEL I.D. #
Boring # Horizon Depth Dominant Color Mottles Texture Structure Roots GPD/ft
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed much
i
13
Ground
elev.
It.
Depth to
limiting
factor
Remarks:
Boring #
13
Ground
elev.
ft
Depth to
limiting
factor
4 Soil pit locations
N