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Home My WebLink About030-2096-00-010 Q o N 00 O U9, a ° ~ I O O N ' ti 'C I I ~ I 'O Z C _ 3 (CS LL ~ Q Cl) Z H I o II E N Z, ~ O ° w a m N H Z c o z ~t co U ~ ~ ' N I e¢ o in N N Z E '2 Cl) O • !~~1 s 0 *w I c ~ m N Z Z o N Z W ~ '0 I N E E A N N ° m Y 2 -6 Y ° N N i N c ~ O c w a a -0 O N A U o cn to (A _ U o .++V -n F U) F. w N 0 0 0 Z a ° _Lo (D ~o~ °0) 0) D 10 I AV o a~i o cn O eo N L r- O .D n O E N N co d a } o C) 0 E 0) 00 co a N E c v c rn ° at ° a~ 'aw O N w 7 ° N O LL'" N O 'p r N CO O a) io ( ~ J t[YX to U O O ~VV U' O N (n N O N Z U) CL Z 'L) m a rra~y . E L O V> "~1 A V a v t Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 Human Relations ~"'~°ii's~nro Safety & Buildings ~ in accord with ILHR 83.05, Wis. Adm. Code COUNTY St. Croix Attach complete site plan on paper not less than 8 1/2 x 1 Plan must include, but not limited to vertical and horizontal reference point (B r t ope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distanc st road. 030-2096-00 REVIEWED BY DATE APPLICANT INFORMATION-PLEASE PRI L fhT10N PROPERTY OWNER: P TY LOCATION Vernell A. & Stephen L. SkoglG T NE 1/4 NW 1/4,S24 T 30 N,R 20 *(or) W PROPERTY OWNERS MAILING ADDRESS S-T Gpjc~ L BLOCK # SU V_A NAME OR CSM # 149 High St. f' na Country Side Estates CITY, STATE ZIP CODE P ME ❑VILLAGE 00WN NEAREST ROAD New Richmond, WI. 54017 ( ~7 Joseph H #35-64 New Construction Use [x] Residential / Number of bedrooms 3 [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow 450 9pd Recommended design loading rate -5 bed, gpd/ft2 .6 trench, gpd/ft2 Absorption area required 375 bed, ft2 375 trench, ft2 Maximtmt design loading rate • 5 bed, gpd.gt2.6 trench, 9pd/ft2 Recommended infiltration surface elevation(s) 104.12 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material pitted glacial drift Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem I ❑ S tRU ®S ❑ U ❑ S ®U ❑ S ® U ❑ S ® U ❑ S 97 U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourcby Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 -15 10yr3/3 none sl 2msbk mfr gw 2f .5 .6 2 15-31 10yr4/4 none sicl 2msbk mfr gw if .4 .5 Ground 3 31-52 7.5ry4/4 c2p 7.5yr5/8 scl M na na na np .2 elev. 103.12ft. Depth to limiting factoi31 Remarks: Boring # 1 0-13 10yr3/3 none 1 2msbk mfr gw 2f .5 ..6 2> 2 13-29 10yr4/4 none sil 2msbk mfr gw if .5 .6 3 29-60 7.5yr4/4 c2p 7.5yr5/8 sicl M na na na .2 .3 Ground elev. 103.12ft. Depth to limiting Remarks: CST Name:-Please Print Gary L. Steel Phone: 715-246-6200 Address: 155 00th. Ave. New Richmond, WI. 54017 Signature: 8-10-95 Date: cstm 02298 CST Number: PROPERTY OWNER V. & S. Skoglund SOIL DESCRIPTION REPORT Page,,.?~Af 3 PARCEL I.D. # 030-2096-00 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary I Roots GPD/ft in. Munsell Cu. Sz. Cont Color Gr. Sz. Sh. Bed ITiench 1 0-10 10yr3/3 none 1 2msbk mfr gw 2f .5 .6 N j 3 aw 2 10-26 10yr4/4 none sil 2msbk mfr gw if .5 I .6 Ground 3 26-48 7.5yr4/4 c2p 7.5yr5/8 scl 2msbk mfr na na .4 i .5 IOM2% i Depth to limiting factor 26" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) a y STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 Vernei 1 A. & Stephen L. Skoglund New Richmond, WI 54017 MPRSW 3254 NE4NW4 S24-T30N-R20W town of St. Joseph (715) 246-6200 t lot #10-Country Side Estates NI 1"=40' BM.= top of SW lot stake C el. 100' 1 (Y '4j N 0 3 'n aa ss' 37 77- S3 Gary L. Steel 8-10-95 E 9 10 Rfc X STC - 104 t` AS BUILT SANITARY SYSTEM REPORT S 7N". ZO& lAtGor OWNER ADDRESS SUBDIVISION / CSM# ~rn ~,;Oc S~!✓~ LOT # SECTION _T_:~_~N-P,:::~W, Town of ~ ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM s' i ~r ~rrsx INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK•p ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer:-h_,~ Liquid Capacity: Setback from: Well House Other Pump: Manufacturer Z Model # Size Float seperation Gallons/cycle: Alarm Location SOIL ABSORPTION SYSTEM Width: Length Number of trenches Distance & Direction to nearest prop. line: Setback from: well: House Other ELEVATIONS Building Sewer ST Inlet, 22 /7 ST outlet PC inlet 9/, 2<- PC bottom _ Pump Off Header/Manifold Bottom of system ,ysr- Existing Grade 97 Final grade DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: 3/93:jt - -epartmentondustry, PRIVATE SEWAGE SYSTEM County: WiscoSnd Human Relations ST. CROIX 11afety and Buildings Division INSPECTION REPORT (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION Pegnib&E4`8iV , : DAVE ❑ City E] Village Town of: State Plan o.: CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 0 / v ( li t.~ V'd% _A9500377 TANK INFORMATION ELEVATION DATA ~I=3~ " i °i ' 3D TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic , Benchmark Q Dosing ~r:;,.~~~(~ ~,rr .r ~~o ,a•; ~ Q ~-ter Aeration Bldg. Sewer Holding St/ Ht Inlet r 9 !7 TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic NA Dt Bottom Dosing S , >Sv y , 7a NA Header / Man. Jr 3 Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade N 3 1 !vv 1;4 ' Manufacturer Demand Model Number Al) 510GPM TDH Lift Friction S` IS-feadm)}, TDHq,1~ Ft Loss Forcemain Length Dia. Dist.To Well ~a SOIL ABSORPTION SYSTEM BED / TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 6 DIMENSIONS SYSTEM TO P/L' BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type O 1WAJ_1 CHAMBER Model Number: System:-y;" ~•-i> >J~ ~S OR UNIT DISTRIBUTION SYSTEM He er/ Manifold Distribution Pipe(s) I x Hole Size I x Hole Spacing I Vent To Air Intake t/ .7~ 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 / Seeded-' xx Mulched Bed /Trench Center Bed /Trench Edges r Topsoil C3 Yes ❑ No Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: St. Joseph.24.30.20W, NE, NW, Lot 10, Plan revision required? ❑ Yes E~No _ Use other side for additional information. SBD-6710 (R 05/91) Date In edor"s Signature Cert. No- 1 y Safety and Buildings Division SANITARY PERMIT APPLICATION Bureau of Building Water System: 201 E. Washington Ave. In accord with ILHR 83.05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 8 112 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Permit Num er The information you provide may be used by other government agency programs E] Check if re islon to pre ous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION - / Prop y Owner Name Property Location 114 1/4, S T , N. R E (or)g 22 Propert Ov~ger's i1 !ng A es of Numb r / Block Number 1[~ s St Zi o Phone Number Sub-di-vi- n Na a or CSr~t~er II. TYPE F BUILDING: (check one) ❑ State Owned ❑ it Pea rest Road Villa e Public 1 or 2 Family Dwelling - No. of bedrooms -3 Town of 111. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo _AJ 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 a 5 ❑ Hotel / Motel 9 ❑ Office/ Factory 13 ❑ Other: specify i IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. Dq 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 E] gl,Mound 30 E] Specify Type 41 E] 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 I 1? Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./' ch) Elevation 7- - s " Feet Feet TANK Capacity VII. FORMATION in gallonTotal # of Manufacturer's Name Prefab. CoSite n- Steel Fiber- Exper. Gallons Tanks Concrete glass Plastic App New Existing structed Tanks Tanks Septic Tank or Holding Tank " " ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber / ? S ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for' stallation of the onsite sewage system shown on the attached plans. Plumber' Name: (Pri Plumb is Si n ur mps) MP/MPRSW No.: Business Phone Number: Plum er's A dress (S tree . ity, State' Zip . lalnl? 1A a. /1~"4 'e i br IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved San! ry Permit Fee (Includes Groundwater ate Issued Issuing Agent Slgna tamps) ^ y l S _ Approved ❑ Owner Given Initial OQ Surcharge Fee) Adverse Determination ` X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD-6398 (R. 05/94) DISTRIBUTION: Original to Counly, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS r x- 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. r 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. 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, 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 f include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which-can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. s SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations September 29, 1995 2226 Rose Street La Crosse WI 54603 K 0 CONSTRUCTION KIM 0 CONNELL 308 MIDPINE CT STAR PRAIRIE WI 54026 RE: PLAN S95-41189 FEE RECEIVED: 180.00 MIDDLETON, DAVE NE,NW,24,30,20W TOWN OF ST JOSEPH 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. Sincerely, Dennis Sorenson Wastewater Specialist Section of Private Sewage (608) 785-9336 SUDA-7997 1R.19/9U W)sconsin tepartment of Industry, PRIVATE SEWAGE SYSTEM Safety and Buildings Division Labor afid Human Relations REVIEW APPLICATION Bureau of Building Water Systems Hayward Office La Crosse Office Madison Office Shawano Office Waukesha Office 209 W 1 st Street 2226 Rose Street 201 E. Washington Ave. 1340E Green Bay Street 401 Pilot Court, Suite C Rt 8, Box 8072 La Crosse, WI 54603 P.O. Box 7969 Suite 300 Waukesha, WI 53188 Hayward, WI 54843 Phone (608) 785-9334 Madison, WI 53707 Shawano, WI 54166 Phone (414) 548-8606 Phone (715) 634-4804 Fax (608) 785-9330 Phone (608) 267 5119 Phone 1715) 524-3626 Fax (414) 548-8614 Fax (715) 634-5150 Fax (608) 267-0592 Fax (715) 524-3633 INSTRUCTIONS: To save time, schedule your review with one of the offices listed above prior to submittal Fill in all applicable data and submit this form together with fees and plans/information. Your submittal must be received at least one working day prior to the appointment at the office where your review was scheduled Please call any of the listed offices if you need help filling out the form or,hpve c)u scions on fiat information to submit. PLEASE PRINT VERY CLEARLY. A sample of a completed form is on the reverse side for your refere U ~1. APPOINTMENT INFORMATION -if you have scheduled an appointment, fill in the information requested below to save time: AppointmenntyDate x? Reviiee~wer Name Plan Identification Number 2. PROJECT INFORMATION If this review is a revision or extension to your existing plan identification number, provide that number here: Projec Name Town Of: County City Village IAJ ,i _ r= Project Location GOVT LOT 1/4 / 1/4,S T N,R E 001 3. APPLICATION FOR 4. FEE COMPUTATIONS FEE SUBMITTED System Type (check one): System Type I (include new and existing tanks) Up To 1,500 gallon septic tank $11000 ..4140 - A E] At-Grade 1,501 - 2,500 gallon septic tank $120.00 H Holding Tank 2,501 - 5,000 gallon septic tank $160.00 . M Mound 5,001 - 9,000 gallon septic tank $ 200.00 . N Non-Pressurized In-Ground (conventional) 9.001 -15,000 gallon septic tank $ 300.OG . P El Pressurized in-Ground Over 15,000 gallon septic tank $500.00 O F] Other: Up To 1,000 gallon dose chamber . $ 70.00 z~ 1,001 - 2,000 gallon dose chamber $ 80.00 Building Type (check one): 2,001 - 4,000 gallon dose chamber $100.00 4,001 - 8,000 gallon dose chamber $120.00 D 40 Dwelling, 1 or 2 Family 8,001 -12,000 gallon dose chamber $140.00 P ❑ Public Building Over 12,000 gallon dose chamber $160.00 . S State-Owned Building Up To 5,000 gallon holding tank $ 60.00 5,001 -10,000 gallon holding tank $100.00 Code Derived Daily Flow gpd Over 10,000 gallon holding tank $150.00 Check If Replacing Existing System Experimental System (additional one time fee) $ 300.00 . Revisions To Approved Plan 2 $ 60.00 Petition For Variance: Setback .........RECE, $100.00 El Site Evaluation E0 . Petition For Variance Plumbing $225.00 _ Revision SEP 6 NA00 Groundwater Monitoring - Per Site FETY & BAD $ 60,00 . Groundwater Monitoring Site Evaluation in Lieu of (other than a proposed subdivision) GS. DI/- Groundwater Monitoring Site Evaluation in Lieu of Groundwater Monitoring $ 60 00 . Subtotal: Priority Review: Enter same amount as Subtotal: MAKE ALL CHECKS PAYABLE TO: SAFETY AND BUILDINGS DIVISION Total Fee: /,fp 5. SUBMITTING PARTY INFORMATION Telephone No (include area code & extension) Comp ny ame Conta Pers No & Street Address Or P O Box City, To n or ViI ge, State, Zip ode 1 Aerobic or prepackaged treatment system fees are calculated based on equivalent size septic tanks and dose chambers 2 Revision fees are not applicable to temporary holding tanks or extensions to existing approvals NOTE: Fees are pursuant to Wis Adm Code, Chapter ILHR 2, and are subject to change annually The information you provide maybe used by other government agency programs [Privacy Law, s 15 04 (1) (m)j. SBDW-6748 (R. 09/94) OVER Wisconsin Cftapartment of Industry, SOIL AND SITE EVALUATION REPORT Page of Labor and Human Relations Division of Safety & Buildings in%%V tht-_H 8~1 0 Vyiq. "m. Code a. v °:i:. G ash COUNTY 7 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 PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROP TY OWNER: PROPERTY LOCATION GOVT. LOT - 1 A /Li 1/4_S T N,R (oCC PROPERTY OW ER':S MAILING AD RESS LOT # BLOCK # SUBD.,NAM OR CSM # CITY, TA ZIP CODE PHONE NUMBER CITY VILLAGE JjYOWN NEARE T ROAD J 1 J New Construction Use Residential ! Number of bedrooms [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flower gpd Recommended design loading rate bed, gpd/ft2 /„2 trench, gpd/ft2 Absorption area required bed, ft2 - trench, ft2 Maximum design loading rate -zL2-bed, gpd/ft2 , trench, gpd/ft2 Recommended infiltration surface elevation(s)ft (as referred to site plan benchmark) Additional design / site, considerations Parent material 044, 6~&,,: /f Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE IN FILL T HOLDING TANK U= Unsuitable fors stem ❑ S U [Z S❑ U ❑ S is] U ❑ S ,ZZ 7SYSTEM ❑ S ]O U ❑ S U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Bourdary Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench -2 1 ~2 '1 4,9 <:<......... 7 Ground elev. ft. c - - 4Z &-o Depth to limiting factor Remarks: Boring # / _J G Ground su° elev. s - / 9~ ft. Depth to limiting factor Remarks: CST Name:-Please Print Phone: _ Address: Signature:- Date: CST Number: PROP~R70*NER~ SOIL DESCRIPTION tRa!~EPORT Page,-ofd PARCEL I.D. 1J 5 - 4..E 18 9 GPD/ftZ Tre Depth Dominant Color Mottles Texture Structure Consistence Bour~/ Roots Bed Boring # Horizon Gr. Sz. Sh. Bed Trends in. Munsell Qu. Sz. Cont. Color '02 c~ Ground elev. 9~ ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # \y Ground elev. ft. Depth to limiting factor Remarks: Boring # : i }?::xti•:::.:ti: ry'ii: Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) S95-4'139 T~.sof~ ~/~+U.r ~ aac.eTpw ~ I- X ~Coc~r~%~~J o~s• .E ~yG sc.1- .4' I / 22 I /6.4 y y dva oa I - 30 ~ys• Go' 3I~ ' _ - WORKSHEET - MOUND SYSTEM DESIGN PROBLEM: Design a mound system fora i~,,o,n The site characteristics are: Depth to groundwater or bedrock z-L in. Landslope Percolation rate S in. Distance from dose chamber to distribution system ft. Elevation difference between oump and distribution systern ft. Step 1. WASTEWATER LOAD ■ ~ys~~- /sc~. _ gal Step 2. SIZE THE ABSORPTION AREA A) Area required sq. ft. B) Bed or trench length (B) _ ft. C) Bed or tr':nch width (A) ft. -D) Trench spacing (C) _ Wastewater load .24 gal/ft2/day B trenc ~Fies Step 3. MOUND HEIGHT A) Fill depth (0) = 1r1.~~ ft. B) Fill depth (E) - D + slope ft. C) Bed or trench depth (F) _ A!8 , ;t, D) Cap and topsoil depth (G) ft. E) Cap an topso 1 depth (H) ft. ~ipn Liconue NU: ~ - F of .16, Step 4. MOUND LENGTH s A End slope (K) [(j_+ E)+ F + H x3- ft. B) Total mound ength (L ■ B +2(K) u ft. Step 5. MOUND WIDTH Al) Upslope correction factor ■ A2) Upslope width (J) - (D + F + G)(3)(factor) ft. Bl) Downslope correction factor ■ ~ B2) Downslope width (I) ■ (E + F + G)(3)(factor) .2 ft. C1) Total mound width (W) for bed ■ J + A + I ■ ft' C2) Total mound width (W) for trenches ■ i + ~ + (no. trenches -1) (c) + A + I ft. Step 6. BASAL AREA A) Infiltrative capacity of natural soil gal./ft2/4ay B) Basal area required ■ wastewater flow : natural soil infiltr ti capacity ■ .1. sq. ft. Cl) Basal area available for bed for sloping sites ■ Bx (A+I) • sq. ft. C2) Bas are avail le for trench for sloping sites • B W- (J+A1 ,f sq. ft. )/,Bas I aarea available for trench or bed for level s x W ■ sq. ft. Sign: License , Data: 7-= 2,S-- Step 7. DISTRIBUTION SYSTEM 7A) SIZE DISTRIBUTION SYSTEM 1) Hole size = 1~_ in. 2) Hole spacing = s in. 3) Distribution pipe length ■ _ 'Pfr. 4) Distribution pipe diameter in. 5) Spacing between distribution pipes = in. 6) Distance from sidewall to distribution pipe in. 7B) DISTRIBUTION PIPE DISCHARGE RATE ft. 1) Number of holes per pipe ■ 2) Flow per pipe = $X//7pce~ GPM 7C) SIZE MANIFOLD 1) Manifold 1s central/ end 2) Manifold length ■ 3- ft. 3) Number of distribution lines ■ 4) Manifold diameter 2 in. 7D) SIZE FORCE MAIN 1) Minimum dosing rate ■ „tj~GPM 2) Force main diameter ■ _ in. 3) Friction loss ■ ~s- 75` ft. 0 7E) TOTAL DYNAMIC HEAD 1) Vertical lift a _ ft. 2) Friction loss = 3) System head 2.5 ft. ■ /~FC~/ ft. Total dynamic head = SEP V~ ft. Sign:. sAFETy ? 61995 S. DI S95 t of -ILL '41189 7F) PUMP SELECTION 1) Pump selected will discharge ,~7-,5- GPM at 1~,ft. total dynamic head. 2) Pump model and manufacturer 7G) DOSE VOLUME 1) 10 times void volume of distribution lines gal./cycle ('c 9j 2) Daily astewater volume - 4 doses/24 hrs. gal./cycle 3) Minimum dose volume gal./cycle 7H) DOSE CHAMBER 1) Minimum capacity required Ste, _ S gal . Sica: Licvnec: "u:_ Date:_ 4 3- o j WSJ / i 2 9 ' ar,J Cllr mssO,3 3e C~ rr :«.'r1 2de L ~ ~i .•r JU • i,.T .7 ®.7 /G ~~OS.:O s i•' f i~! !ii'a! A ..48 • J~. i ~ J. 1 ~ J.'i~Jr ~ X1:1. - .9``QfoL/.d)/~. Page ,/a b. S95 Straw, Marsh Hay, Or Synthetic Covering Distribution Pipe Medium Sand H G a s gas Topsoil-,\ F 3 E D ~ Force Main Plowed Layer $ Slope Bed of Y'-2111' Aggregate Cross Section of a Mound System Using DFt. A Bed For The Absorption Area Ft. F sj~ Ft . B l>> 5' Ft. H _Ft. Signed: K Z ~ Ft. I,-gz.1-Ft . License J may, R~ Ftt. I /i9,~ F. WCl~d~` mot. C~1~'Tr.i`I: Date : 41 ~f !rR JCf EiE` ( i lJ i X11 , .1, S{~ ~ ~{~'C Alternate Position of Force L I I Observation Pipe K r------------- _ Forc main A I W 4-:7 Distribution Pipe IBed of Lj"-2Y' Aggregate Observation I Pipe Permanent Marker Plan View of Mound Using a Bed For the Absorption Area • S fi$.iJ} Car ,x d-a. uB is `v ~ ~ 3 PAge Z Ot.1~% Perforated Pipe Detail ♦I nd View P•rforoled End Cop ' PVC Pipe ~~,aroe Holes Located On Bottom, d Are Equally Spaced PVC Force Maier l . r S„'~ ~ 4t f~ Q PVC Manifold Pips fir. p {A~f lr(~p;~• t ~o~Yon 0 ~g,,,~•.-~sS~'~' Oidrib dean ce ma Pipe Zrx~e Lost Hole Should B•~ cry;;rt.tir Nest To End Cop End Cap Distribution Pipe Layout P f: Ft. R _.Z: ;.r S -jr X ZZI_ Inches Y 4/,E Inches Signed: Hole Diameter Inch Lateral Lateral Inch(es) License Number: Manifold " inches Date: r~~-, _ Force Main Inches of holes/pipe _ Invert Elevation of Laterals ~.Ft. ° N H W coo 4 :3 y it ~ a OIMO o rt t-C A o w !c A~ rt 0 M tiara:, 1 to - to g, o r• m 0 0 z r "In < CpM' X`ac c.~ „ .F G7 r t~~,► N t 1 rt 4-4 f ~ A h w ~t a a c~ PAGE OF PUMP CH^M6ER CA055 SECTION AND SPECIFICATIONS ^ 41 -1 VE NT CAP F, -7 y~ VENT PIPE WEATHERPROOF APPROVCD LOCKING JUMCTIOW 80% MANHOLE COVER WITH 2S' FROM DOOR, WRAMING LA WINDOW OR FRESH It'MIU. 8Et AIR INTAKE GRADE I ~I" MIW. I I9• M'Iu. co1JDUlr U-7 11U LET PROVIDE :j A{.lET"orf_is l'+ ( III -T 4`4 APPROVED JOINT A ~•x„ °J' Iji. I III APPROVED JOINTS lr..Q; ((-fJi: .te~ I III W/ PIPE W/'' ! PIPE EXTENDING 3' a# ; S^" ,~r ; .tiw r•. I I I EXTEIJDIUG 3' AMo. x I II ALARM OIJTO SOLID SOIL ' OWTO SOLID SOIL B Rv ~ a •r w;_ ~ F T ON ilMl) ELEV. FT. __j tlt~. OFF D COLICKETE BLOCK RISER EXIT PERMITTED OIJLy IF TAUK MAWUFACT URER HAS SUCH APPROVAL j" AfPAoVED BEDDING under •TIk►aK SEPTIC E SPECIFICATIOUS DOSE TAWKS MAWUFACTUREK: IJUMBER OF DOSES: PER DAS TA►JK SIZE: GA LOADS DOSE VOLUME ALARM MAIJUFACTURER:C>- L INCLUDING BACKFLOW: S GALLONS MODEL IJUM6EK: CAPACITIES: A= IAICHES OR `~I-L GAtL01J5 SWITCH TYPES 5=INCHES OR GALLONS PUMP MANUFACTURER: s C INCHES OR GALLOWS MODEL NUMBER: A L 1 / I-) D=INCHES OR _71L~ GALLOWS SWITCH TYPE: 2; r~.L WOTE: PUMP AMD ALARM ARE TO BE MINIMUM DISCHARGE KATE ~GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEELI PUMP OFF AWO DISTRIBUTION PIPE.. 21eL FEET + MINIMUM NETWORK SUPPLY PR~E~SSSURT,E/. . . . . . . . . 2 5 FEET ♦ --2 L FEET OF FORCE MAIN X 1c.L_L_F/oo rr,FRtCTIOW FACTOR..FEET TOTAL OyNAMIC. HEAD = FEET sly/, ~ IIJTERMAL DIME IJOWS OF T WK: LEIJGTM WIDTH ~iLIQU1D DEPTH SIGrJED: / / LICEWSE NUMBER: Z2~ Llz DATE: U, b N Performance Curves P U M P!E~ - 1 9 METERS FEET 90 MODEL 3885 25 SIZE 3/4" Solids WE15H 70 2 20 WE10H 60 0 IP- WE07H 15 50 40 W E05H 10 30 WE03M 20 WE03L 5 ~ 10 0 0 0 10 20 30 40 50 60 70 80 90 100 110 1?0 GPM 0 10 20~ 30 m'/h CAPACITY 6UL65PUMP5, INC. S&EC.o PkIS *-W YO .3,.1•• METERS FEET 120 MODEL 3885 35 SIZE 3/4" Solids 110 WE15HH 100 30 90 25 80 70 I 20 60 O 1- 50 WE05HH 15 40 10 30 20 5 10 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM L i L 0 10 20 30 m'/h CAPACITY 01985 Goulds Pumps, Inc. Etlective July, 1995 C3W Wiscpnsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page _L of 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 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 PAR # dimensioned, north arrow, and location and distance to nearest road. t F 7y APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION R ED B DATE j 19 PROP TY OWNER: PROPERTY LOCATION u r CRUX fpd~ GOVT. LOT jl~7 114 IJ 1/ T ZOC*j PROPERTY OW ER':S MAILING AD RESS LOT # BLOCK # SUBD NAM R I^E Ft 0AQ' T ITY, TA ZIP CODE PHONE NUMBER CITY VILIf4GE 19OWN 1 4Z New Construction Use Residential / Number of bedrooms [ ] Addition to existing building [ ] Replacement [ ] Public or commercial describe Code derived daily flow -Z/ gpd Recommended design loading rate gibed, gpd/ft21~trench, gpd/ft2 Absorption area required bed, ft2 Yy5' trench, ft2 Maximum design loading rate 1, bed, gpd/ft2_LLtrench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations Parent material ° r 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 0 U [ZS ❑ U ❑ S JKJ U ❑ S fgJ U ❑ S U ❑ S U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Clu. Sz. Cont Color Gr. Sz. Sh. Bed Tmr& i 7 Ground 3 elev. .2 ft. - - Depth to limiting factor . Remarks: Boring # el. 7 /-F 7 Ground elev. q&k ft. Depth to limiting factor Ja Remarks: CST Name:-Please Print Phone: Address: i Signature: 1 Date: CST Number: I SOIL DESCRIPTION REPORT Page jof PROPERTY OWNER 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 hu Ground elev. 9 ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # }}4yv Ground elev. ft. Depth to limiting factor Remarks: Boring # :f -AK Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) VAW e7oA) c~l ~~f-5~ . /~1, ~y✓ jk) ~ecam? >'~o~;r°aof-J /oW ~so&~ 5~4 lms`~ 8 mss- 9s 33~ 30~ ,QrN~ Cn" ,0.-,de J.►t eo' 17416 3~' STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER b PME N3 1V-,eN K'iM I Jo fQ MAILING ADDRESS 0,11 'St j`~yJAJ PROPERTY ADDRESS (1 co ation of septic system) Please obtain from the Planning Dept. CITY/STATE PROPERTY LOCATION _ 1/4, 1/4, Section, T_N-RAW TOWN OF asl ST. CROIX COUNTY, WI SUBDIVISION Id2 e" LOT NUMBER 16 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 maint ' ed must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three e r e7i ions te. ~ \ SIGNED: DATE: A St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 i 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 DAI41d KJAe Location of property_,4(1/4OL~ 1/4, Section,T_N-R_~~iY'/ W Township ~+-.L -j Mailing address b-4~- Address of site Subdivision name OnNarzi J 5 Lot no. 1_ Other homes on property? Yes ✓ Nop Previous owner of property sijuN~ Total size of property Total size of parcel Date parcel was created Are all corners and lot lines identifiable? _ Yes No Is this property being developed for (spec house)? Yes No Volume and Page Number as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner (s) of the property described in this information form, by virtue of a warranty deed recorded in the office of the County Register of Deeds as Document No. , and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of the County Register of Deeds as Document No. Signat re of App cant Co-Applicant Date of Signature Date of Signature r 532691 State Bar of Wisconsin Form 2 - 1982 WARRANTY DEED DOCUMENT NO. VOL .1136 PAGE 80 Vernell A Skoglund and Stephen L Skoglund AUG 18 I99 s 11:55 A. , 4r conveys and warrants to David B. Middleton and Eileen K. Vr a, y,~, r j Middleton, husband and wife, I THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS j ,l X Role the following described real estate in St. ~I I.. County, State of Wisconsin: (Parcel Identification Number) +F I'. i Lot 10, Country Side Estates in the Town of St. Joseph, St. Croix County, i~ Wisconsin. I ~I I, I I I' i I I I This 1S not homestead property. ~ I~ (is not) Exception to warranties: Easements, restrictions ane rights-of-way of record, if any. I Dated this day of AtIgust , 1995 . (SEAL) eA. (SEAL) (SEAL) (SEAL) Stephen T Sknalttncl AUTHENTICATION ACKNOWLEDGMENT Signature(s) Vernell A. Skoglund, STATE OF WISCONSIN Stephen L. Skoglund ss. ~I County. it III authenticated this) 4 d0 y of AllgllS t 19 95 Personally came before me this day of 19 the above named Kristina Ogland TITLE: MEMBER STATE BAR OF WISCONSIN I (If not, - I authorized by §706.06, Wis. Stats.) to me known to be the person who executed the i foregoing instrument and acknowledge the same. I I' THIS INSTRUMENT WAS DRAFTED BY Kristina Ogland Attorney at Law Notary Public County, Wis. (Signatures may be authenticated or acknowledged. Both are not My commission is permanent. (If not, state expiration date: necessary.) Names of persons signing in any capacity should be typed or printed below their signatures. WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Co. Inc '