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HomeMy WebLinkAbout006-1058-20-000St. 1''oiix Co~,cnty ~"lanning and Zoning Thursday, Jantuu~~ 1;, 2QD8 at 12:40:25 P:M11 Detatl Sanitary Information Page 1 of / Computer #: 006-1058-20-000 SublPlat: 40 acres Section: 26 Parcel #: 26.31.16.400 I_ot: TN/RNG: T31N R16W Municipality: Cylon, Town of CSM: 114 114: SW 1/4 SW 1/4 Owner: Sullwold, Richard 2424 County Highway 63/64 Emerald, WI 54013 State Permit: Issued: 05/12/2004 POWTS Dispersal: Mound less than 24" suitable s Permit: Reconnection County Permit: 74 Installed: 05/12/2004 POWTS Detail: NA Bedrooms: 3 WI Fund: POWTS Pretreatment: NA issuedlnspector t~s C3uilt Plumber Other Requirements Additional Notes Morten Gwed Kevin Grabau NA DeYoung, Timothy MP Kevin issued reconnection permit based on our $0.00 None No records for 1983 system. See notes regarding plumber who must pertorm work -both permits in 2004 folder. Owner: Sullwold, Richard 2424 County Highway 63/64 Emerald, WI 54013 State Permit: 38490 Issued: 06/21!1983 POWTS Dispersal: Mound less than 24" suitable s Permit: Replacement County Permit: 100 Installed: 08/02/1983 POWTS Detail: NA Bedrooms: 3 WI Fund: POWTS Pretreatment: NA t3iot~.s Issuer/Inspector As Built Plumber Harold Barber Yes Smith, Gale Tom Nelson Yes t~lainter¥ ~rac~ Scheduled Pump C?~te__!'umped 8/2/1986 10/ 1 /2003 10/1/2006 12/12/2006 12/12/2009 Other Requirements Additional Notes Monev._Owed Duplicated permit #38490 on parcel #006-1058-30- $0.00 000. System was connected to two houses with two septic tanks and one dose tank to mound. Owner was to have an affidavit recorded on deed to document 2 buildings with common POWTS, but no record in the file. Filed with 2004 reconnection permit, now entered in database as of 2007. f" ;~tior, Notification 04101 /2005 S't. Croix County Planning and Zoning fi'ednesday?, ~Ylarch 28, 2007 at 12:36:54 P.~YI Detail Sanitary Information Page 1 oJ1 Computer #: 006-1058-20-000 Sub/Plat: 40 acres Section: 26 Parcel #: 26.31.16.400 Lot: TN/RNG: T31N R16W Municipality: Cylon, Town of CSM: 1/4 1l4: SW 1/4 SW 1/4 Owner: Sullwold, Richard 2424 County Highway 63!64 Emerald, WI 54013 State Permit: Issued: 05/12/2004 POWTS Dispersal: Mound less than 24" suitable s Permit: Reconnection County Permit: 74 Installed: 05/12/2004 POWTS Detail: NA Bedrooms: 3 WI Fund: POWTS Pretreatment: NA Notes Issuer/Inspector As Built Plumber Other Requirements Additional Notes Monev Owed Kevin Grabau NA DeYoung, Timothy MP Kevin issued reconnection permit based on our $0.00 None Signetµ C7ff; No records for 1983 system. See notes regarding plumber who must perform work Owner: Sullwold, Richard 2424 County Highway 63/64 Emerald, WI 54013 State Permit: 38490 Issued: 06/21/1983 POWTS Dispersal: Mound less than 24" suitable s Permit: Replacement County Permit: 0 Installed: 08/02/1983 POWTS Oetail: NA Bedrooms: 3 WI Fund: POWTS Pretreatment: NA Notes Issuer/Inspector As Built Plumber Other Requirements Additional Notes Monev Owed Harold Barber Yes Smith, Gale missing from archives see fake permit #938490 -parcel #006-1058-30- $0.00 Tom Nelson Si,r~ect CfF: Yes 000. System was connected to two houses with two septic tanks and one dose tank to mound. Owner was to have an affidavit recorded on deed to document 2 buildings with common POWTS, but no record in the file. Mairrt~:ance Scheduled Pump Date Pumoed 1st Notification 2nd Notification 3rd Notification 8/2/1986 10/1/2003 04/01/2005 10/1/2006 12!12/2006 12/12/2009 05/p3/d4 IdON 08:01 FAX 715 386 4686 ST CRX CO ZONING X1001 •~ - - --- v -•• • •• •~• ~ . w. n u ~ r.t,q+~ wz<uv~ a ~i V 'ST_ CROIX COUNTY WISCONSIN !n accord wltlti 15.04 St. Croix Caxtty Sanitary Ordinance ZONING OFFICE Personal inforrnatica you provide may be used for secondary purp~~. . CROIX COUNTY GOVERNMENT CENTER (Privacy law. S. 15.04(1 xm)) 1101 Camrichael Road Hrrdson.llVl 54018-7710 (715 Fax 5)3$t31168g Attactr complete for the syeteyn on not less than 8.11x x 11 int~es in sire. Coin ~ Permit # ^ Check if revision to previous application ikatlon Infarrrratlon -Please Print all Information l.ocadom e owner Name '- .. , u1 1/4 5 W i/4, Sec o2-b ~ j L l~ 5~ 1 ~ w 0~~ ~ 3! N, a c~ R t 6 E (ar) owrtet's Haling Address 7 sat ! ~~ r '7 lot Number Block Number ~• State ZP Code Phone Subdivision Name or CSM IVu G.n~ca(d c~~. ~~o f 3 ~s- a~~- sa7~ a ~ ~ I Type of t3uilding: check one ~ ~ 1 ~_ l~;ity p Village awn of 2 Famly Dweling - Na. of Bedrooms: =`5-J ~ C] PublirJ(lommer~d (describe use}: ~ ~ a. r C rO •n f ^ 3tatdoamed ~ Nearost Road I. Type of PermlC (Check any one box on Pme A. Cheat box on G 8 if appl .w+•-. Parcel ax Nu be ~ 3 ' 6 y 1.d Repair 2-~ Reconnedion . ^ Non-pittrribing . ^ Rejuwlon ~s"~ w~ Sanllat~n ~ Permit Number D~ Issued state Sanitary PenNt wag previously issued 3 $ Y d 7- a ,~- 83 .Type of POWT sy,atem: (Check ail that aPPM) ~a >< ~$~ -4-~iCr • r~ ^ ~bn-pressurtzed In-ground ~Z~ 3^~~,,,,~, Mound ^ Sand Filter p Constructed Wetlar~l ^ Pressurized In~grourM t2Sl~a,~c¢S ~ d Holding Tank ^ Single Pass [] grip IJne ^ At~rade ^ Aerobic Treatment Unit ^ Rer:irGUlating ^ Olhar . Dis Information; 1.Oeslgn Flew ) .1]isper~l Area 3. Dispersol Area 4. Soil AppGcatiar Rate 5. Perrda8on Rate B. System Elevation 7- Firal Grade . ~ ~(~ fired Proposed (GalsJday/sq.ft, (Min~nch) ~ Elevation . T:ftk Inforntatbn Capdigy in GallOfit3 Total # MarxtfaelUrer Prefab Site Con- Steel Fiber- Mastic New ~dsting Gagons Tanks Cortrsete strutted glass Tanks Tanks N VIl. Responsibility &tatemeni _ 4 I, Ilte txtderstgned, assume responsibility for repaiNreconnerx,~lloryrejuvertatlonJlnstal4ation of rton-plumbing far the PQW'TS shown on the dltadied plans. A CL a is not aired for terratiA repair ar the installation of non-plumbing saNtatlpl s m. s Name t} Plumber Signature stamps} PR8 No. Business hone Number ,.~,, G S/~ ~i s y6 - LL ~ d F'kanber's Address (Street, City, Slate, Zlp Code) Z/ i/,s~w,1~4 G~ li ~~ ~ .S~/d ~7 VIII. County Use only Disapproved Sanitary Permit Fee Date Issued 1 W Agent Signs (No stamps) ~' Approved Owner Given Initial Adverse I -_ Determination 1.2 ~ ~Z 1 V(. Conditlvns of ApprovallReasons for disapproval: >--- Q' ~,~ ~,.,~. ~3~ ~-s d~~~ s~ 48'3. C +~~ os ~,le~ ./ w~ ~t~ Pia. c2.s 1 ~;~~~~ ~y ~ ~~~~~~ AS BUILT SANITARY SYSTEM REPORT OWNER R i /~ /?~ S~~1LG !!~. ® f~ TOWNSHIP ~ yC a N SEC .:Z6 T~N-R/f,W ADDRESS R ~--/ ST. CROIX COUNTY, WISCONSIN. SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 100 FEET OF SYSTEM ~ Liquid Capacity : /p d r ~ L ' ~_' SEPTIC TANK: Manufacturer : /;~ „~ s'~~~ Number of •rings on cover _ _ _ Tank manhole cover elevat on: Tank Inlet Elevation: Tank Outlet Elevation: PUMP CHAMBER Manufacturer : G~ i~ ~"~~'S Number 'of gallons / _ Number of gal. pump set or a cycle gallons; tota capacity o distribution lines /`~,~~ gallon: ize o pump head; _ gallon per minute _ - ~ , horsepower___~~ ran name of pump ~~ and model number Type of warning ev ce f i"r~ y t ¢ Al AR M HOLDING TANK: Manufacturer Number of gallons Elevation of manhole cover pe of warning device T y SEEPAGE PIT SIZE: um er o pits eet iameter feet liquid dept seepage pit in et pipe-elevation bottom of seepage pit a evation feet.. SEEPAGE BED SIZE: number of lines wi t length the depth SEEPAGE TRENCH: width length PERCOLATION RATE ~ ~ UI D ~~ BU LT 7,S"v INSPECTOR DATED ~- ~ - b~''~ PLUMBER ON B ~. LICENSE NUMBER ~-~ qo M P ~e~r"i~ tA~~ ~V iN~~t,~ ~Q6>~~' vU~lat-%6~~:3 C~~v~,~/vB.~~No, r~~ti~S- Se-~~~~c TANK ~-IA~~e i- - 98 3S' d~r~et- y:7.Q~ c:oye,~_~9 ~;~ ~vo.R~,v~gS- o;. Pl/^'r aCX.4M6~R-live e ~` - `ld~s`~ oyY'~e t- y6.3r1 t,orei?_l~~,y7 ~yv,Ri-~~s- 3 _, ~- BENCHMARK: (Permanent reference Point) Describe: ~'oP dF G'vRN~R /'~ms'>' eyv f~nr~~ 1.iiv~ Elevation of vertical reference point: /,~,~' Slope at site: ~ DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS P.O. BOX 7969 MADISON; WI 53707 ^ CONVENTIONAL ALTERNATIVE ^ Holding Tank ^ In-Ground Pressure ^ Mound SAFETY & BUILDINGS DIVISION BUREAU OF PLUMBING State Ptan I.D. Number: (l~a~igpa{!/ 7 6 5 NAME OF PERMIT HOLDER: Richard Sullwold ADDRESS OF PERMIT HOLDER: RR 1, Emerald, WI INSPECTION DATE: ~-a~-g3 ~ :[9UPiGr BENCH MARK (Permanent reference point) DESC RIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV_: SW SW, Sec. 26, T31N-R16W, Town of Cylon f Name of Plumber: MP/MPRSW Na.. County: '. Sanitary Permit Number: Gale Smith 5690 St. Croix 38490 ' ~DU SEPTIC TANK/HOLDING TANK: l ( , V UU - ~/~IJ MANUFACTURER: _ LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV.: WARNING LABEL LOCKING COVER ti~C,L~G2"5 Ioa D ~ Y ~ $ 9 7 ~q ~ PROVIDED: ^ PROVI " . j . YES NO EB NO BEDDING: VENT DIA.: ~( ~ VENT MAIL: / HIGH WAT ALARM. NUMBER OF FEET FROM ROAD. ~' ¢ ~ PROPERTY LINg!'~+ f WELL: / - f BUILDING: ~~ VENT RESH AIR ^YES NO ~l ^ O NEAREST o~CJ2) I DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY PUMP O L. PUMP/SIPHON MANUFACTURER: WARNING LABEL LOCKING COV ER /" ~ r L ~L""' ^ 1 ~~~ P O ED: PR ED: (/~/~ G YES NO YES ^NO YES ^NO GALLONS PER CYCLE: PUMP AND CONTRO PE ATIONAL: UMBER OF PROPERT / L WELL. BU ILDI G: VENT TO FRESH (DIFFERENCE BETWEEN ~ FEET FROM LIN~~w (V~(t~y ~~ ~ / // AIR INLET: PUMP ON AND OFF- ' YES ^N O NEAREST l N SOIL ABSORPTION SYSTEM. Check he soil moisture at t e th of lowin LLB+c;TH DIAMETER MATERIAL AND MA we or excavation. (lf soil can be rolled in to a wire, construe on shall cease unt9 FORCE the soil is dry enough to continue.) MAI N CfIN\/FNTIANAI SVSTFM• WIDTH: LENGTH. NO. OF DISTR E SPACI G ER INSIUE DIA.. #PITS LIQUID BED/TRENCH TRENCHES: . MATERIAL: PIT . DEPTH. DIMENSIONS GRAVEL DEPTH FILL DEPTH DISTR. PIPE DISTR. PIPE DIST P MATE L NO. DISTR. NUMBER OF PROPERTY WELL: BUILDING: VENT TO FRESH BELOW PIPE&. ABOVE COVER: ELEV. INLET ELEV. END: PIPES. FEET FROM LINE: AIR INLET NEAREST- -i- MOUND SYSTEMS I~ Mound site plowed perpendicular to slope Check the text a of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upstope: mound systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- meets the criteria for medium sand. TIONS MEASURED. ES ^NO SOIL COVER EX7URE PERMANENT MARKERS: OBSER V ATION WELLS. f ~ YES ^NO ~1'ES ^NO DEPTH OVER TRENCH; ED DEPTH OVER TRENCH/BED DEPTH OF TOPSOIL: SODDED: SEEDED- MULCHED: CENTER. / EDGES. ^YES ^NO ^YES ^NO ^YES ^NO PRESSURIZED DISTRIBUTION SYSTEM: BED/TRENCH WIDTH ~ LENGTH: NO. OF TRENCHES: LATERAL SPACING. GRAVEL DEPTH 8E L0 IPF.: FILL DEPTH ABOVE COV DIMENSIONS ~ ~ +-- ELEVATION AND MANIFOLD EJ~yy FJ~ f ~ " J PUMP ELEV.: MANIFOLD DIA..~ DISTR. PIPE EL .. MANIFOLD MAT RIAL: NO. DISTR. PIPE&. DISTR. PIPE DIA~~ DISTRIBUTION PIPE MATE IAL $ MARKING: V i / ~ ~ , ~ DISTRIBUTION INFORMATION HOLE SIZ HOLE SPACING. DRILLED CORR ECTLV r ^ ~ COVER MATERIAL: VERTICAL LIFT CO PLANS: ESPON DS TO APPROVED ` ~ SCE YES ^NO YES ^NO COMMENTS: PERMANENT MA KER OBSERVATION WELLS: NUMBER OF PROPERTY LIN WE B L ING: ~,(j YES ^NO 2 YES ^NO FEET FROM NEAREST S'Q _ , ~~a ~^ 2 ~ ,~,~ ~q~~3 I'W~ ~ ~q2 zl ~. ~= 33~c~2~ 1 Sketch System on Z ,~L ~etain,in county file for audit. Reverse Side. SIGNATURE ITLE: .. DILHR SBD 6710 (R. 01/82) """"~ ~:.~, ice" ~"" ,. ' ~ State o~ Wisconsin ~~ Department of Industry, Labor & Human Relations Division of Safety & Bldgs. Bureau of Plumbing Platting & Fire Protectiorrl P.O. Box7969 Madison W1.53707 Te1.60&266-3815 QtU.e, Si~y~ i~ flu m bind t~isla-k- 2 J Cgtav~wtx~ Git-~ . tAJ ~ .~13 IN ALL CORRESPONDENCE REFER TO PLAN lgDENj~T/FICAT/ON NO. j~ 0 ~ V 2 ~~~~ ~`i- ¢50 NAME OF ROJECT ..., ,n TY AP,PROVc°L_ r~ Vd t~.- S'.~,t~r~~a.e. ~~~ Gentlemen: Examination of plumbing plans and specifications for the above-mentioned project has been completed. In accord with Chapter 145, Wisconsin Statutes and Wisconsin Administrative Code, the plumbing plans and specifications are approved contingent upon com- piiance with the stipulations indicated on the plans. Please review your code for the requirements of each code section noted. The architect, professional engineer, registered designer, owner or plumbing contractor shall keep at the construction site one set of plans bearing the stamp of approval of the department. In granting this approval, the Division of Safety and Buildings does not hold ittelf liable for any defects in plans or specifications, plan omissions, examination and reserves the right to order changes or additions should conditions arise making this necessary. This approval is based on Wisconsin Administrative Code requirements. It shall be necessary to obtain and fulfill the permit require- ments of the city, village, township or county in which this installation is to be constr~u~ct~edp. Failure to obtain local permits will auto- matically void this acceptance. ~~~Zy ~ ~/ ~l t- r/ ~~Q.~ l/W'l.f `''~'~ '~1~ For Prdv~te Sew-ache Sys#el;,s Gr;'y; Sincerely, (. „~ /~ /f ~~ ,_ r+~V~i ,~, -', f.;~ • ;.,,. e ' ~ y '~ t~%;; E ~4~::>~ t~~lt w,~ ~ ~t~~ E~~i ~~?~!l f2'uiC Oi Ifl@ 1i31~1fi~ ~~ 'f'"~ _ __ sansXu;y permit. James Sargent-Bureau Director PLANS.REVIEWED BY: ~ (DATE: ~l ~ 41 ~~ ce: DPS Owner DILHR L I Plumber H & R (21- un Mfp. Rep. Bur. of H~Ith Fac. & Services D 1 LH R S D-6099 (N. 06/80) ReC. & Env. Services -State Of w1SC0I1Sli1 ` Department of Industry, Labor and Human Relations' +~1Siif' ~~`t ~~ SAFETY & BUILDINGS DIVISION >~a,~~i+~ O~ ~~t~~7g 2fl1 East MA3~11C#gtc~ ~ P.O. 8t?x 7~6'~ E~~r~1s~, idfSCO#S3~ '.~01 r~e ~. a ~ ~ un o.~-viz i ~ ~-*~ mar qtr. St1rll~idt SnB 1~n1d~: R4ci~xr~ - R~54d~ ~3i+~-I~ati~ S~-SL~a _ ~. Sit, ~t,2~,~1, l ~~1 ~'~ ~' ~~r3~~, St. Crux f:s~utt~Ys ttI t s~+~,~~t Pet~t~ta~ for Md~#f ltat#t~ of ~~t~t~ ~ S~.Z~ (1 j ~~tj ~f` tht ~d~ss~~~s~r~ ~+~is~r,~t~re Gc~ )was ~si~' ~ Jae ~#, 1'$. It eras ap~sr "~~~~ ~ul~ ~efr~s that the s~~ii ~e ~t test ~ iris I~~tat~~-at~d ~at~tr~l s~si 1 ab~v~ ~~i~tlLed ~t'gb g~roci~tter f+~ t~ ~ ~~ta l at~~ arf ,t we ':~rss~~e. ~'~-,~~ ~~rf ~ r~t~s~~st~c~ ~~s t~ ~aR3~t~~ l ~ s~s~l~ ~s a ~SR.~ rare ti~~re ~# i ~ i ~ctas t.~ +~xti~aLe~# ~ t~ grc~rat+~. All ~ t~s~ ~t~ d ~t~L+InLs ~rstitt+Eacf ital b~haif t~f ttzt:E pett~4 r~r~ ~t~l~~x#t~~d«` #s ~~i ~s 'Jrf~~ tv ' suD~iact preti#:i ~ t ~ ~~slr ~,y i~lt+~l ii~~Cat~t~-s. S~ ~lX>F 5~~~c~~ rlrr~te r~~e ~~~ ~1at .1~CPP:,~1~ ___ +~~: L~~~ J~I~~' ~ - i~f~trict &, ipp~etrlra ~~~~ls ~' 1t~+~1, 5t. Cra~~t C~ant,~ ~a~~e ~L~ Pl #ng ~#es~t#a~g DILHRSBD-6423 (N. 04/81) __ ___ l ~ _ ~ '~ ION~4L WOKKSHEET MQUND SYSTEM 1. Wastewater Load, Total Oaily Flow = ~.~ gal. Uu section H 63,15 (3) (c), Wis. Adm, Code and PROVIDE A DETA ILED LIST OF SIZING ON PLANS. 2. Depth to Limiting Factor = ___,~~ ft 3. Landslope = ~V ,~ 4. Olstance from Dou Chamber to Dlstrlbution System = _ _'S~ ft. S. Elevation Difference Between Pump and Distribution System = ~~ ft .6. Absorption Area Slzing: Area Required = ~r Trench Length (B) _ ~, sq ft ._.~~ ft. ed r Trench Width (A) _ %(~ ft. Trench Spacing (C) _ ~/A ft. 7. Mound Height: FiN Depth (D) _ ~~ ft. FIII Depth Downslope (E) _ _~,~_ ft. Bed or Trench Depth (F) _ 7S ft. Cap and Topsoil Depth (G) _ % ft. Cap and Topsoil Depth (H) _ ! _ ft 8. Mound Length:. . End Slope (K) _ _ 1~.J,~.t i Total Mound Length (L) _ _-yb',JQ ft 9. Mound Width: . Upslope Correction Factor = _ ,,~/~ :ti Upslope Width O) _ ©.qc~ ft. ' Downslope Correction Factor = ~ j,/Q Downslope Width (I) _ ~/,3g: ft. Total Mound Width (W) _ _3a,3j ft 10. Basal Area: Infiltrative Capacity of Natural Soil = ~~ gal./sq,ft./day Basal Area Required = _,/ I~..1 sq. f[. Basal Area Available = _/(od~~q, ft. 11. If Standard Tables from Chapter H 63 are Uud, Indicate Table No. 12. For the Distribution Network, Use Numb ers 5-14 in Section II. 11. IN-GROUND PRESSURE SYSTEM 1. Depth to Limiting factor = ft 2. Landslope = . ~ 3. Percolation Rate = min./In 4. Propoud System Elevation = . f t S. Wastewater Load, Total Daily Flow: . gal Uu section H 63.15 (3) (c), Wis. Adm. Code and PROVIDE A DETAILED LIS"f OF SIZING ON PLANS. Required Septic Tank Capacity = gal. 6. Absorption Area Sizing: Percolation Rate = min./in Area Required = . sq. ft. System Length = ft System Width = . ft 7. Distribution Pipe Sizing: . Hole Site = ~,~ ,, in Hole Spacing = _ . ~ fl. Lnlcral Lcnglh 1 ~- 11.35 Laler.d sl.e -~=~ ,n Larcr,rl Sp,rling . -3 ~ It L)i~l.urcc hour Sirlawall~lu I'ipc . ~ '~ K, Ulrlrlbullon Plpu Ulscharµu Ra1u: ^ Nwnhur of Ilulus Pur Pipe law I'ur Plpc T-' ) `-. Manllnld Siiinµ: KPm. ' I Yhu (cottlul U! l7fid) ,~~~ Lenglli = ~ I1 Oiamcwr . --~_ In. /Qir,hklrcl~ Si/L-LI.Jv Ld /tea y e II. Ih'-GROUND PRESSURE SYSTEM{on 1~1' need- ~c~ 7 a 10. Force Main: Minimum Dosing Rate = ~ gpm. Diameter ~_ in. 11. Total Dynamic Head: -- System Head = 2.5 ft. Vertical Lift = -,~~t~--. ft. Frictlvn Loss = _ ~ ~G f. Tl~il = /! j ~ ft 12. Pump Selection: p Pump will di charge at least .a gpm ice ~ at , - ft, total dynamic head. Pump model and manufacturer: _ ms/~~ amp 13. Dose Volume: 10 Times Void Volume of Distribution Lines = gal -`-`~_ Dally Wastewater Volume Y - 4 Doses In 24 hrs. = r as gal Backflow =~ . --~`L gal. Minimum Dose = .,~43, 5/ gal 14. Oose Chamber: Volume = -[~l,e.~ gal. 111. CONVENTIONAL PRIVATE SEWAGE SYSTEM 1. Wastewater Load, Total Dally Flow = gal Use action H 63.15 (3) (c), Wis. Adm. Code and PROVIDE DETAILED LIST OF SIZING ON PLANS. 2. Required Septic Tank Capacity = gal. 3. Percolation Rate = min./ir> 4. Absorption Area Sizing: Refer to Table 2 in chapter H 6~ ~ ~ 'G) and PROVIDE A DETAILED L ~y SIZING ON PLANS. Required Area = sq, ft. Length = ft. Width = ft. Number of Trenches = Trench Spacing = ft. 5. Dlstrlbution System: Lateral Length = ft. Number of Laterals = Lateral Spacing = in Olstance from Sldewall to Pipe = i System Elevation = n ft. IV. SYSTEM-IN-FILL Fill in All Items from Section III ,- : i V, SEPTIC TANK ~~ " 1. capacity = ~ ~ Q tr, 2. Manufacturer: ~I. ~!J 3. Show Site Constructed Tank Detailsi)f~Ian, ; , I , ~`~~'' V1. DOSING TANK 1. Capacity = gal. 2. Manulacturcr. 3. Pump Manulnclurer: 4. Pump Mudcl: 5. Operating Hcad= ft. (+. flow Rate= 7. Show Site Constructed Tank Details on Plans gpm V11. HOI.UING TANK I. Capaclly = 2. Manufacturcrc gal. 3. Show Slte Constructed Tank D t il e a s on Plans -SHOW ALL INFORMATION ON PLANS- :NLHR SBD•6761 (R.U3/82) / . Smith Plumbing & Heatingr PHONE (715) 265-4838 ' GLENWOOD CITY, WISCONSIN 54013 R rC~~R~ SQL ~ lvo,C d /9f~ ~~e ~' Aid, G~.i syo/.z i o~ ~ ~ouNd { ,~ S ys~~''tM I ~.F_._.._ ~ ~' .._ i I ` I { ~~ ~6~ ° om~~ ~..~._~.._ G .,~~ 6Ned ,'~ ~ ~~, 3 ~°~se rood a~4 ~~ pr;~. ~~N~ _ k°~~ A~ !°~ P ~ /~A~B~R ~.a `~ ~ •'t'l'~ ~~w~t,. Bo ~lG = A P~R-~=° ~. ;.- _ . . fFL.(i'~~.R~~~, per' P . ,, ~ ~',tr.f; ~ ~?~S : ~ task rre~:, m P ~. ~.>a7 DEPi~RFi~iEiVT QF 11~r~~~ r •~Y'r „~ „"~ r <~ ry'~, ~!` (3iVlS! id Q~ ~ V Y~ ` C..r ~ .~ ;f ,'ice 5~~ CCR€z~~t~CrtdC~~~~~t o' ,y~yr.~y„ '~N t/a ~ ~ ~~~ ~ l"!v ure /ov® GA ~ S~/~',c. ~".daK' ~~~~ r 3 .~ -_ ~!/,!~ ~F ~~,lcr~s~ ~ 19~~ ,~ ~. Page ~ ~f Straw, Marsh Hay, Or Synthetic Covering Distribution Pipe Medium Sand ~. G Topsoil =- =---.~=- F _J ~ E ~~ D 3 u ~ ~~ Slope Bed Of Zy- 2 %2 Force Main Plowed Aggregate From Pump Layer D Ij s__ Cross Section Of A Mound System Using E -~~~ , F ~~ A Bed For The Absorption Area -` ' G % 0 p Signed: ~~~~e- lc% .~ .~~ License Number : .S6Q0 /~9f Date : ~~.~.,_. Alternate Position of Force Main ~ Observation Pipe--~ ~ K ~- B --- - - - - -- --- ~ - - - - r ___------------------ ------ A ~ ~:---------------------- ----------------------•~ I Force Main 4 -- -------------- ---------------------~ From Pump o j W -_ - _--1-,_,__ PIL k... {$~~,."'.xi'ti i.'~ u ~ u Distribution ed~ Of %,,,~ 2 2 ~ _ _; Pipe ~~~~~:~',~~~i~~lgc{te ~ F,,~ ~ ,, , ~ h_ ` ~~ ~ Mark~f~:; ~ Observation Pipe " ~ ~ Pec-mansnt; ~ L A~ Ft. H ~.s B ~ Ft. I ~/,~q Ft. J ~~Ft. K ~'~"Ft.~~.~{t L ~~ Ft .~ , Ft.~33(~2"7~5 W ~~! ~ , ~; a-.,,ry,. Pian View Of Mound Using A Bed For The Absorption Area Page ,~ Of Er a Locotsd On Bottom, re EQually Spaced note Poaltlon 01 Main From Pump Loat Ne "~' "°~ uisiribution Pipe Layout Signed : .~~,~ Z~' `cj' -~`.~,- ~ License Number: t~?F'~6Q0 Date: ~ f z ' ~ ~a 111a P ~ ~O! 141' 3~ R ~ , ~ 302"7~5 S~ X ~f- S Y ~ 7~~ Hole Diameter %y Inch Lateral ~_ Inch(es) Manifold .3 Inches Force Main ~. Inches a - _ ~~~~~~.~. ~~ ~, Perforated Plpa befall _ PUMP CHAMBER CKOSS SECTION AND SPECIFICATIONS 'i"C.I. VENT PIPE ~ 25' FRCM DC:GR, WINDOW Ok F-RE:SH AIF~ INTAKE -- -- VEN~f CAP WLATNEK PKOOF JUAICTION BOX 12°MIU. C>RADE 18"MIAI. ~ INLE: r ~ I I I I I `-- PAGE ~ OF APPROVED LOCKIAlG MANHOLE CUVER CONDUIT V~ \~~\~ ~~: 1 PROVIDE j y" MIiJ. I ~ i IB"MIAI. AIRTIGHT SEAL I I i I ~~ I I I APPkO`JE U ,)DINT A III APPROVED _10{ W~C.'t. PIPE. I I I j W/C.I. PIPE EIrfENDIRJG .5' __ I I) EXTEWDIAIG 3 OI,1TU SOLID ;r,,1L. B I I I ALARM ONTO SOLID S: `i ~:~ I I , v:~~ I orv I I t I PUMP ~., --- OFF D i r _ i ~.. , COg1C,IR ~,E B!_O j ~ ----- 193 ~~ .- _ - ,.: , .. RISER EXIT PEKMITfED U - I,J!_`1~ l-F `fA1JK MAi~It1FACTURER NAS SUGH APPROV'LC~ „ `: _ ,~ OPTIC ANU SPECIFIGATIC)f~1S )SE T'ANK`.; MA-JUFAC:TUREK. ~e-5c-.^ ~ - _ NUMBEk OF DOSES: _PER DAy TAIJK .SIZE : ___...--..lL_'~O_..-----_-_-- GALLC)L1S . / DOSE VOLSJME: .~ ~3%7 _GALIUt~-S ALAKM MAAIUFACTUKEK: _~'~__~/c°G_7~t^O__ CAPACITIES: A-_='3~)_,INGHE$ OR ~O%G C;AILGt MGUEL -.1UMhEK: ._--___L~? ~__~Gc-~ -------- _ ~_ __Q2__INCNES UK -S~~CJ LALLOti SWITCH TYPE: ______~te/eKr^y - T--------- C--_~INCHES D,, ) 3~ - +~`~_~_ GALLUAi I'LIMI' ~j~, ~ MAf`111FA( I Uk6 a: ~-__[LlL'~1QS~ __-_ C= c~ WLHES OF ~8 U Mi.~l~k l -JUMtSEK: S'R ~ ___ _____ _ --- _ ---- NUTS. PUMP ANG ALARM ARE TCi BF .~WI I(_ ~-, - -: _ _. _ .___.~ _-- - -- - IhISIALLED OW SEPARATE CIRCUITS r 4 f'UMF' UISLHAKC,E RA_f_E ____~7.-1_.-~ _ GPM VERI ICAI. . DIFFcI«NCE F~L I WE-E N F'UMf' ()s F AtJU [)I51'kIfSUTION F'IF'L.. ~'?L _ FLE 1 + MIAIIMUM NETWORK SUPPLY PKE_55ukE" ~ _ _ - F i/. + ~Q i E E f .S _ FEET -~ GF FORCE MAIN ?~ FKtCfI0A1 F ' - ilc,urr ' AC70R~ / FEE t -- . __ ___ . 1 C7l AL D`1NAh11~ HEAD -~. __.T'~ ~~J F E_ET R,R~' ' ~N ~ ~ay~ ot~l~ a~ c; N y a>G '7f'~a M]K : i.~ n8 ~ ~~+: 80 +~ ~d-i p~iH ~o „ ~6 , --- r U Q'N o C1 D E t}r u. ' ~ SECTION 500 Pa~E 5 ,. ~ ~ ~, :, ~~. ~ ~~>-.--~~;v ~Yr~~r~ JUl'J 9 ~9$~ n, ~~, CI,L~L1 ~~iYa /.`(r ^ SR4 SUBMERSIBLE SEWAGE PUMP 500/6 Features Pump Impeller is recessed Powertul 4/10 HP Motor is oil filled Rotar~r Shaft Seal has carbon and Micro Switch (SR4A) has per-, "Tornado" type -operates com- for good insulation and lubrication of ceramic faces for positive seal. manent magnet on switch arm for pletely out of volute passage giving bearings and seal. Overload protec- Body is stationary, prevents string or activating switch. full opening for flow of liquids and tion built-in. No starting switch or trash from winding on seal. ABS Plastic Operating Switch solids up to 2 inch dia. relay mechanism. Switch Housing (SR4A) is com- (SR4A) has steel follower molded Motor Housing is heavy cast iron, Thrust Washers and Sleeve Bear- pletely sealed from sump liquid, into top for activating switch epoxy coated. Stator is pressed in ings are oil lubricated for smooth easily removed for replacement if magnet. for perfect alignment, best heat operation, long pump life. needed. transfer. Dimensions Total Feet 2 4 6 8 10 12 14 16 18 20 22 Head Meters 61 1.22 1.83 2.44 3.05 3.66 4.27 4.88 5.49 6.10 6.11 Gallons Per Hour 6,000 5,500 4,900 4,300 3,600 2,800 2,100 1,200 420 Liters Per Hour 22,110 20,818 18,547 16,276 13,626 10,598 1,949 4,542 1,590 Performance Capabilities Capacities to 95 GPM 360 LPM Heads to 19 feet 5.79 meters Pump Down Range* 6 to 6%z inches 152.4 to 165.1 mm Solid Handling Capability 2 inch dia. solids 50.8 mm dia, solids Liquids Handled Fresh, drainage ef fluent waste water Intermittent Liquid Temp. 150°F 66°C Motor 4/~o HP Electrical 115/230 V., 12.0 A/6.0 A, 1 ~, 60 Hertz Dischar e 2 inch 50.8 mm Automatic Model, (manual pump variable with switch). F.E. Myers Co., Division of McNeil Corporation Ashland, OH 44805 (419) 289-1144 Telex 98-7443 • • • Accessories Performance Curve Performance Table _ -~ .W :State of V~ iseonsin ~., " ~F ~`~ ~Gy~F~~ .~,~ ~.. .~ Department of Industry, Labor & Human Relations Division of Safety & Bldgs. Bureau of Plumbing Platting & Fire Protection P.O. Box7969 Madison W1.53707 Tel. 608-266-3$15 /N ALL CORRESPONDENCE REFER TO PLAN IDENTIF/CATION NO. ~3~2`-;z~~ -- ~~~p NAM~O~ ~ i ~AE~~ ~ f.i ~ IL ~N(~ ~1l ~ ~-k '~ ~~ 'v ~ Gentlemen: Examination of plumbing plans and specifications for the above-mentioned project has been completed. In accord with Chapter 145, Wisconsin Statutes and Wisconsin Administrative Code, the plumbing plans and specifications are approved contingent upon com- pliance with the stipulations indicated on the plans. Please review your code for the requirements of each code section noted. The architect, professional engineer, registered designer, owner or plumbing contractor shall keep at the construction site one set of plans bearing the stamp of approval of the department. ~ tk-e_ g shalt- In granting this approval, the Division of Safety and Buildings does not hold itself liable for any defects in plans or specifications, plan omissions, examination and reserves the right to order changes or additions should conditions arise making this necessary. This approval is based on Wisconsin Administrative Code requirements. It shall be necessary to obtain and fulfill the permit require- ments of the city, village, township or county in which this installation is to be constructed. Failure to obtain local permits will auto- matically void this acceptance. ~ ~-~~j ~ ~~ ~;~1 ~- ~i ~ ,~ ; .~ `' ~~,~~, ~'' ~} ,f.~ ~~F~.~~/a~~y~ ~„~ <. n ~~ '" ~J ...~' ' ~ a ~~~,.~r.'~... ,.' . ~ ~ ~~ :~ ~ For Private S~~~r~g~ Systems Only: Sincerely, , ~ ~ l /~, ~ r ~ ~!~-- This a~nra~Fal ;~ va:l~ P©r ~ .t/c~ !,7 ~ 1 yE'urS vi' ~~ 11;~; i^i" Vyt'~ ~ pit 'ii +--~ Ij~.. ~,,,~ i./r trZL E}~~)I?~~.IJ~ QC~tC-: o€ t~l Pi inltiisl ~' i j~ ~..~ James Sargent-Bureau Director` r'~ ~_~' (PLANS REVIEWED BY:~ ~ ~~ _ ~UH 1 G: / / ~ ~ f I cc: DPS=~ Owner DI LHR Local Plumber H & R (2) unt Mfg. Rep. Bur. of Health Fac. & Services DI LH R S D-6099 (N. 06/80) Rec. & Env. Services _,_ -State of Wisconsin June l~, i383 Mr. Riehard St~llwgl+d Raa#+~ i raid, Misearsin 54012 Department of industry, Labor and Human Relations SAFETY & BUILDINGS DIViSiON Bureau of P1t~ing 2tf1 €sst ~ashirtgtoa Arenas - _ P.O. Brut T969 Madisaa, ~tiscoasia 53Tt37 Pet i L i fln Ncr, 83-C127b5-1' Dear Mr. Sullwoid Re: Sullw~tld, Aiettar# - itesidertce Alternttire Systen Ski, S1i, 26, 31, l6M ?avert of Cylcxr, St. Croix County, ~tI The sub,~ect PeLitietn for !!bdif icattcrrt of sectioFt ~ 63.23 ~ 1 } (d} of the I~iselr-rtsirt Adnti~istrative Cade ryas utrtsiciered art June 14, 1983. it was a~p~roved. The rate r•equ#r~s that that! shall !~ at least 24 inches of unsaturated atLt;iral sa1l above esttautted high groutx~rater. for the instal'iatioA of a aawM systeat. Tate variance regtts~sted ryas to Install a sx~uerd systtso cm a site rl~tere there is 19 i riches tit est lasted high growater. Ail of the data and statements submitted in behalf of the petition sere eonsid~red, This approval lx specific tit the subject pit#t#on ~Irrd cannot be used fcrr any additional modlf ications. Si~erely, Jerome Knepp, Ch#ef Sect#tt,~ of Private Sewage zmd Platting JK:PP;~t cc: Lerey J~Ir~slcy, £hi5 - district 5, Chippey+a Fai is ran tielsart, St. Croix Coutaty sale Smith Plt~biag ~ heating DI LHRSBD-6423 (N. 04/81) -~ r SBA 6678 (9/81) (Ptb 100x) ,~~ Detach And Return Upper Partibn Of This Form With ~ , Any:. Return Correspond.. , 6C'.'' ~. DATE: Q~/d'~/83 .., J~ STATE OF WISCONSIN DILHR = DIVISION OF SAFETY & BUILDINGS ~~". BUREAU OF PLUMBING g 201 E. WASHINGTON AVE. RM t78 9 P.O. BOX 7969 MADISON, WI 53707 1 'rQ 606-266-3815 Ei~Ep , ~9~ ~ PROJECT: 1 5ullwold, Richard - I~est~~nce ~. 4ata) ~ 4~ Tn EmBraid is Gale Sulith Plumbing & Neat Z St. Ciraix WI Roue 2 G l ~nwt)c~d City, I ~1 54013 - PLAN ID. # 83-Q2765 P - ~,.~ DETACH `^ HERE ...__ 'i e s~llil~~~; ~~cr-~~d - a~~iaen~~ s3-o~,~~ ~ PROJECT NAME PLAN ID. # ~ ~ This is to acknowledge receipt of your plans and specifications for the aoove-indicated projee"t. `~ Preliminary review indicates the required fee is $ ~~ n """"" 190.00 Fee Received is $ ~ ^ .Underpayment -Please submit the additional fee. ~ Overpayment -Refund forthcoming. ^ Plan accepted. for review, Plans. being returned. ^ No fee has been remitted. Plans submitted with no fees will be ~ Additional information required. SEE BELOW. held. in abeyance. 1 i ~; L Plan Submission ^ Complete data. relative tb anticipated use of bldg. p f ^ Additional information shall be submitted in duplicate un~ ^2 copies of PLB 60 enclosed. `-'~ less specifically noted. '' ^ Deed restriction required (1 copy:). "` [] Plans not clear, legible orperrhanent, ^ Condominium declaration. (1 copy) All inform,~~jgn, submitted .shall be signed, dated and sealed =A" or stamped in accord with Section H 63.08(2)(a) Wisconsin j Administrative Code. Affidavit enclosed: IV. Holding Tanks - d ^, Profile of holding tankvshowing vent, manhole alarm an ' man~facturer~ if precast. Complete construction details if ' li. Pressurize Distribution Systems (Mound or In Ground Pressure) site onstruci~ed. ' ^ Application for use of an alternative system signed by owner ^ Hoid g tank yagr~'ementsigned by owner and local unit of and notarized. (1 copy) ^ County onsite required (1 copy), ^ Design calculations gover ent (s~rpple enclosedl. Soil te~t or statement' ^ Reason for irist ]ling holding tank .for pressurize distribution. ^ Soit boring & percolation , _ _ . ,.:. from county py)~ ,: - test data. ^ Cr ti f t ^ l l l ^ Plot plan sho in loeation of holding tank with lateral dist- n oss sec on o em. sys Pipe atera ayout. ding, wells, water service piping, water .A antes to anyt bi ^ Plan view of system. ^ Plot plan, course, lot lir~es,+'svvimming pools, all weather service road, ; ^ Verification of Exception Status Form by County. 11 .copy) Etc. Provide benchmark with elevation reference point. 111. Private Sewage Disposal Systems V. Lift Pump ^ Ground slope with 2' contours in entire area of soil absorp- - ^ Calculations for total lift pump discharge, head and gallons . tion system extending 25' on all sides. pumped per cycle. ^ Elevation of .permanent reference point .(benchmark). - ^ Size, length & depth of forge main. ^ Location of area suitable for replacement system -provide ^ Detail & modeli of. pump or automatic siphons including soil data. size, pump curves, dravii~lovvrrand average flow rate GPM. ^ Plot plan showing lot size and all. lateral distances from ^ Cross section of lift pump tank showing pump(s) or sewage disposal system to buildings, lot lines, well, water siphon(s). course, swimming pools, water service piping,`Etc. ^ Construction detail of septic, holding or lift pump tank if site constructed or tank manufacturer if precast. V I. Systems In Fill (Fill must be placed prior to plan submission) (] Construction detail and cross-section of soil absorption ^ Total area filled (fill to extend 20' beyond edge of trench ~ system, before side slope begin), ' ^ Soil boring and percolation test on 115 completed by ter- ^ Depth and type of fill. lifted soil tester (1 Copy), ^ Copy of onsite report by county or district staff. ~: P L B 6 7 State and County State Permit # Permit Application County Permit ~°~ for Private Domestic Sewage Systems County S¢' ~Y'O > ~' *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if .Required ~~ /,~~ ~~ State Plan I.D. # ~-3 ~ ~ ~ ~~- A. OWNER OF PROPERTY Mailing Address: ~/C f~fl/~c/ ~~~LL 1.rr L~ ~f~ ~l~le"fZ .~-L.l Gy/~ B. LOCATION: ~'/'/a, Section '~~ T~LN, R~$ (or) W Lot# City Subdivision Name, S ~'', nearest road, lake or landmark Blk# Village Township G C. TYPE OF OCCUPANCY: *Commercial *Industrial / *Other (specify) Variance Single family X Duplex No. of Bedrooms fa No. of Persons_y'~ D• SEPTIC TANK CAPACITY f0'z~ Total gallons No. of tanks _Z- HOLDING TANK CAPACITY Total gallons No. of tanks Prefab concrete X Poured-in-Place Steel Fiberglass Other (specify) New Installation Rej/pla~~cement Lift Pump Tank or Siphon Chamber~Total gallons Prefab concrete x Poured-in-Place Other (Specify) E. EFFLUENT DISPOSAL SYSTEM: ercolation Rate_y s Total Absorb Area 7~~i, sq. ft. New Replacement Alternate (Specify) ~ D y ~~~ Seepage Trench: No. of Lineal Ft. Width Depth Tile depth (top) No. of Trenches Seepage Bed:__-~_Length- ~-~ Width.~d Depth Tile depth (top- No. of Lines ~ Seepage Pit: Inside diameter Liquid Depth No. of Seepage Pits Percent slope of land. ~~~' Distance from critical slope WATER SUPPLY: Private ^ Joint I~ Community ^ Municipal ^ Owners name as listed on EH 115 if other than present owner: I, the undersigned, do hereby certify that the information 1 have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I Have sized the effluent disposal system from the EH-115 prepared by the Certified Soil Tester, NAME ~-e4- ~ ~ jY/{/f / 7`/y C.S.T. # /~~~ and other information obtained from ~ $" ~ (owner/builder-. Plumber's Signature MP/MPRSW# -~'~9e Phone #iZ~,~"~~',3,a Plumber's Address ,:~ PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20. Well loca- tion shall be included on the sketch. Indicate or dimension location of all wells on the property or neighbors property. If well has not been drilled please indicate. ~~~~~ E __a.~ ®.- ~_ ~ __ a~~ ~ ~ - ~~ E 3 E , n ~ . t ~--- i Do Not Write in Space Below - FOR COUNTY AND STRTM1 NT USE ONLY Date of Application rp vl!^ ~~ Fees Paid:. State Count nDate Permit Issued/iiejeeee~d (date) ~-" ~/ g„3 Issuing .Agent Name C;, p Inspection Yes„~_No State Valid# Date Recd 1. county (white copy) 3. owner (green copy) DIVISION OF HEALTH; P.O. BOX 309, MADISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) Revised Date 7/1/78 DOCUMENT N0. ~~ 342058 '~o~~ 55~ ~r,~:4~(~ BY THIS DEED, Melvin J. Simonson and Laura B. Simonson, ' husband and wife as point tenants ___ ____ nicnara H. ~ullwola ana Gayle ri. Grantor conve sand warrants to _--,_-____ ___T~____.-_ -_ __ --_____- Sullwol~, husband and wife, as Ooi.rlt tenants Grantee S for a valuable consideration Ei teen-Thousand Five-Hundred and ----- no/100ths ($18,500.00)-------------------- ---------- - the following described real estate in t Counly, State o[Wisconsin: STATE BAR OF WISCONSIN- FORM 2 WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA ~' REGISTERS OFFICE ST. CROIX CO., WIS. ~~ Recd. for Record this 2nd ~ ~ay of > >~t A. D. 1977 t , M. ~ / ~ R~gisfs~ d Deedf -~ -~~ -- - R~TUR~O ~\ ~' i ~ ~ ~ . ~~ L ~.. r , ttj-e_~ ~,, lE',~ (till -. 'Tax Key N__77.25(1)_ '. This is not homestead property. The Southwest Quarter (SW~4) of Section 26, Township 31 North, Range 16 West, except the following described tract in the Southeast corner thereof described as follows: Commencing at the Southeast corner of the Southwest Quarter (SW4) of Section 26; thence West 14 rods; thence North 11 3/7 rods; thence East 14 rods; thence South to the Place of Beginning. This deed is executed for the purpose of fullfilling a land contract dated May 30, 1966, and recorded with the Register of Deeds for St. Croix County in "422", page 585, which land contract was assigned by Quit Claim Deed, dated June 4, 1969, recorded with St. Croix County Register of Deeds in "452", page 241, to Richard A. Sullwold and Gayle M. Sullwold, husband and wife, as joint tenants. This deed, however, is subject to the following mortgages: 1. Mortgage to Farmers Home Administration, United States Department of Agriculture, dated November 23, 1966, and recorded with the Register of Deeds for St. Croix County in "429", page 117. 2. Mortgage to Farmers Home Administration, United States Department of Agriculture, dated June 11, 1969, and recorded with the Register of Deeds for St. Croix County in "452", page 243. (CONTINUED ON REVERSE SIDE OF DEED) ,, ~~ - Glenwood City Wisconsin ~ ~ ~'y ~ ~~ G•'= / ~~ Executed at _ ___- _ - - - . - ~ _ _ -__ -_ - __ ___ this- -- day of_- ____ _~' 7 -- __-- , 19. ~, SIGNED AND SEALED IN PRESENCE OF ~~ ' '' ~ ~ ~'' `-~ ~~y~"'• "- `~ •' J ~ (SEAL) ~ ~ ~ Melvin J. Simonso -- ------- - E~~T --- -- - ---- _ ~ . ~/ ~~ C ~ l Ci_ YlI .' ~ i ~ yt C° , ~~-' ~' °% ' (SEAL) Laura B. Simonson (SEAL) (SEAL) Signatures or ___Melvin J. Simonson and Laura B. Simonson __ -- --- -- -- --- - - --=z~ -,~ r ~ - authenticated this __ _~- ____-- day of ~_,L__jL ~ _~_ t.' -~-1 -- 19~_. 1 / /' 'f- it I ~t~ Richard P. Rivard _ ___ _ Title; Member State Bar of Wisconsin or Other Party Authorized under Sec. 706.06 viz.__.. ' TE OF WISCONSIN S5. _ _ County. - -- --- --- - - -- , 19 -- .. , !'crsunally r~umc bcfurc ;~.1lris - - - -_ - ay o - -- - _ _ --- the above named ~ ~"' to me known to be the person_.__ who executed~herforegoing instrument and acknowledged the same. This instrument was drafted by Richard P. Rivard The use of witnesses is optional. Notary Public My Commission (Expires) (Is) Names of persons signing in any capacity should be typed or printed below their signatures. WARRANTY DEED-ST~ATF, SAR OF WISCONSIN, FORM NO. 2 - 1971 County, Wis. w -'' H. C, MJ/erCanpary~ ICI L i SEND YOUR ORDER TO ~.~. c~arFC&son WHOLESALE DISTRIBUTION CENTER 901 NORTH THIRD STREET, MINNEAPOLIS, MINNESOTA 55440 ~~ e ~ d. Y~- f- ,~ .~,~,~ .f i~ F ~ ,. ~~ ~ i l- 7 f S` / ~ ~ ~ ~~ f 1 ~~ i ,f%f~-~s- 1~ ~,..'~"' ,, ~~i~ ~~ mow. ^ wxm~ x outm~ uz~ ~`~ 'i USE ... Toll-Free Phone-In Minnesota ...... Dial: 800/552-1200 Out-of-State ..... Dial 800/328-4425 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, CC DIVISION HUMAN F3EDLATIONS PERCOLATION TESTS (11J, MADISON WI 53707 LOCATION: s' ~~ '/.5 ~ 4 SECTION: ~ ~ /T.3 N/R/d ~-- W TOWNSHIP/ . LOT NO.: BLK. NO.: SUBDIVISION NAME: COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: ~y~.~ ,S'~ ~~. 1 ICF NO. BEDRMS.: COMMER IAL DESCRIPTION: Residence ~ ^New [Replace RATING: S= Site suitable for system U= Site unsuitable for system DATES OBSERVATIONS MADE A TESTS: CONVENTIONAL: as ®u MOUND: ®s au IN-GROUND-PRESSURE: ^s ©u SYSTEM-IN-FILL ^s ~u HOLDING TANK: ~s au RECOMMENDED SYSTEM:loptional) ~ ~ ~ y~ If Percolation Tests are NOT required DESIGN RATE: S ST ~ ~ If any portion of the lot is in the under s.H63.09(511b1, indicate: - ~ Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL PTH TO ROUN DWATER-INCHES CHARACTER OF SOIL WITH THICKNESS TEXTURE COLOR AND DEPTH NUMBER DEPTH iM, ELEVATION. OBSERVED E T. HEST , , , TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- j j ,~ , , ~ `,~~/ , ~' ~ ~,~„ ~-~/ / i ~Si 3. ~ ~~i w/ er p~ B- d`. a' 97 /s'' ~ . / pp ~ j h ~ ~+ri q5~ ~MP . 6::5 ,c31 j I. o i~.~ ,'I . ~s l„~ s; r %p.~, ' s /,3~s1 w i B- B- s- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. P RIOD 1 PERIOD 2 P R PER INCH T P- .. u ~. P / ~ 1 .r a .T fi 3 . P- P- P- PLAN VIEW: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slop. SYSTEM ELEVATION 9y~ d' __.~ ~ ~ ~ ~ _ ~. ~.~. ~_ .~.__ ~_~ ~ ..,~ _l~`~.N '~.~~ L~'~ ` ~y ~,_. ~ ~ _e .. i t ', ,f~ ~ ~R /'(~ ~Od, p .. ~~~~.ri ~ t ~ I ~~ ~ ~~~'rlCf ~ f ' ' ~_ E q D ,~. ~ , Q ~, L ~~8~~~.M _~'ns f- ..~ ~ ri a ~ d = _;~( mss, .~_ ? _ __ ~ -~~_ ~ o P v-~-~ - n ~ ~ .SL s ~ i ~ -- __ - ~--~-.~- _ ~- ~ . ~.9-~~- ;2 -=; .~~ ~_ _ ~_ 7 ~- ~ -_-~-- , ,~ ~ ~ (/7 e t t F O~ ~ ` E C ~ [ f r ~tw.w mow. ~......... ...„... ._... ~ .... .e,.... .... ~ .... j s s ~ ~ ~ ~ ~ 3 ~ i ~~.. ~ ~~ ~_....a~ ~S'oj`-j`~ti1 ~~~'egll'it'oLeS t ~ i~z ~~..3~ ~ ~~__ _~_ ~ ._ ~. ~ .._. ~_ . __ ,. .~- ,~Y,~~.i~ ~~ .~ ~. _.e _.. _.. ~.. _.. . i ~,~ y6 _ ~~ _~~ 3 ~ ~ ~_ ~ .~_ I ~ ~ ~._ ~ ~ X __ ~ s _~ _~.. _ _. t_e_ ....... _. _ __.__. ~_._ __ ~.. _. _~ ~.._ vv I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures methods spe~ ieJdin the Wisconsin Admimistrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print : TESTS WERE COMPLETED ON: ADDRESS: CERTIFICATI ON NUMBER: PHONE NUMBER optional): / ~Pi Gtr 2~ r"i / ~ ~ ~ S G / ~ ~` (~ ~• ~' CST SIGNATURE: ., DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester. DILHR-SBD-6395 (N. 03/81) uI WISCONSIN DEPARTMENT OF INDUSTRY, LABOR AND HUMIiN RELATIONS DIVISION OF SAFETY & BUILDINGS, BUREAU OF PLUMBING P.O. BOX )9G9, MADISON, WISCONSIN 53701 Verification of Exception Status for an Alternative Private Sewage System In the County of st. Croix Location SW l/q, sW 1/4, Sec. 26 T 31 N, R 16 ~(Or) W Town or ti~i~~,~x cylon Street Address Lot No. Block Subdivision Landowner's Name: The application for this site is for: new construction use. ® replacement system use. If this is NEW CONSTRUCTION USE, the alternative private sewage system is: ~to have one of the first five approvals guaranteed for this year. This is number - - of those applications. (Use one of the first five quota nom ersissued to you.) one of the applications needing a quota nurnher. The quota number assigned to this application is - - [~.~for one additional honresite on a farm to be occupied by a parent, child, grandchild, sibling, niece, nephew, or first cousin. ~.~for an individual lot for which a sanitary permit was issued but was later ruled unsuitable due to new or changed soil criteria established by the department. ~_ .for an application nn file prior to February 1, 19130. [_..~for a lot that meets the criteria for a conventional private sewage system. If this is a REPLACEMENT SYSTEM USE, the alternative private sewage system is replacing: (~a failing conventional soil absorption system. ^ a holding tank that was installed and in use prior to February 1, 1980. ^ a privy that was installed and in use prior to February I, 1980. If this is a REPLACEMENT SYSTEM USL and the lot meets the criteria for a conventional private sewage system, check. here.L~ I certjfy that the above information is true and accurate to the best of m knowledge. -- Name Thomas C. Nelson _-~"S~ignature ~ ~~ County Official Title Assistant Zoning Administrator Ddte May 27, 1983 DILNR-SE,0-6158 (R 12/82) St. CROI X COUNTY WI SCO NSI N ZONING OFFICE 796-2239 (HAMMOND) 425-8363 (RIVER FALLS) HAMMOND, W 154015 May 27, 1983 Division of. Safety and Building Bureau of Plumbing P. 0. Box 7969 Madison, WI 53707 Dear sir: An on-site investigation for the Richard Sullowold property located at the SW4 of SW%, Section 26, T31N-R16W, Town of Cylon in St. Croix County, revealed suitable soils at a depth of 1.6 feet, below which seasonable high ground water was noted. This site should be suitable for a mound system. Should you have any questions, please feel free to contact this office. Sincerely, ---- .. -~~: Thomas C. Nelson Assistant Zoning Administrator TCN:mj