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HomeMy WebLinkAbout032-2092-80-000 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS- SUBDIVISION / CSM# LOT S ECTION__4;;-~T__,2LN-R /j2 W , Town of_ ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM O T l I \ I i 4 w~~~ INDICATE NORTH ARROW 7 _ Prov id c n info mation on reverse of this form. 6,10e, Provide dimensi ns to f septic tank manhole cover. BENCHMARK: j lz~271~7 ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer:/GAS Liquid Capacity: Setback from: Well House Other Pump: Manufacturer ModelgSize Float seperation _ Gallons/cycle: Alarm Location144-kCc SOIL ABSORPTION SYSTE /;~O..,✓D Width: Length 23 ;75- Number of trenches Distance & Direction to nearest prop. line: Setback from: well: LS , House 5 ~ Other ELEVATIONS Building Sewer ST Inlet. ST outlet PC inlet R,3 PC bottom Pump Off Header/Manifold Bottom of system Existing Grade Final grade DATE OF INSTALLATION: PLUMBER ON JOB: LICENSE NUMBER: ~~S 9 INSPECTOR: y 3/93:jt Wisconsin beparttnent of Industry, PRIVATE SEWAGE SYSTEM County: Labo a rl. Human Relations INSPECTION REPORT ST. CROIX ~fety ar;d Buildings Division (ATTACH TO PERMIT) Sanitary Permit No.: I GENERAL INFORMATION Permit Holder's Name: ❑ City ❑ Village ❑ Town o : State P159 M? 9 GERMAIN, MICHELLE X CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: *9500023 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark ~9.7G ov. Dosing Aeration Bldg. Sewer Holding St/ Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet /o,a < - 11 Vent irito ROAD Dt Inlet TANK TO P / L WELL BLDG. A Ar ntake ff Septic > a >d5` NA Dt Bottom Dosing 'd 5 _~,2 NA Header/ Man. Aeration NA Dist. Pipe 3.5 9G,a c' Holding Bot. System 'v qs 74 PUMP/ SIPHON INFORMATION Final Grade r Manufacturer fij , V j Demand Model Number GPM Loss , Head riction 3, 7 Systema,o- TDH/;,9; Ft TDH Lift/ lPS F Forcemain 1 1 Length( Dia.,p ' Dist. To WeII,,d S ' SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS i DIMENSIONS SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING manufacturer: SETBACK INFORMATION Type Oc CHAMBER Mode Number: System: OR UNIT DISTRIBUTION SYSTEM Header / Marf-if8ld Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length 14 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 xx Mulched Bed /Trench Center A Bed / Trench Edges /01) " Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: Somerset.24.31.19W, NE, SE, Lot 5, 80th Street /2 /7/ - _9 Ljq, 74 Plan revision required? ❑ Yes [Er/No Use other side for additional information. l a Ird rt c 6 SBD-6710 (R 05/91) Date I or's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY JVC:~F~l ' STATE S9{VIT✓~ ~j ✓ ~ , Q(p~ a -Attach complete plans (to the county copy only) for the system, on paper not less than d' 8% x 11 inches in size. ❑ Check if revision to previous application -See reverse side for instructions for completing this application. STATE I. 'Q,, NNUUMB~R 1. APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION. `1W PROP OWNER PROPERTY LOCATION AIX' ,4S.. , N, R (or PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # - ?R IV CI STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER CITY NEAREST RO D VILLAGE 11. TYPE OF BUILDING: (Check one) ❑ State Owned 0 TOWN OF ❑ Publlc 5711 or 2 Fam. Dwelling- # of bedrooms PARCEL TAX NUMBER( ) 111. BUILDING USE: (If building type is public, check all that apply) Q-? 1 ❑ Apt/Condo 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 in line A. Check line B if applicable) A) 1.[K 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 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 42 ❑ Pit Privy 130 Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION 37, Feet Z Feet VII. TANK CAPACITY Prefab. Site Fiber- Exper. in gallons Total # of Manufacturer's Name Concrete Con- Steel glass Plastic App INFORMATION New !sting Gallons Tanks structed Tanks Tanks /40"y I - Septic Tank or Holdin Tank Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installs ion of the onsite sewage system shown on the attached plans. Plumber' Nam (Pri Plumb 's na re: s) MP/MPRSW No.: Business Phone Number: ktd/ 177 Plu ber's ddress (Street, City,State, Zip Cod WA)~) IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued Issuing Agent Signature (No Stamps) s l Surcharge Fee) Approved ❑ Owner Given Initial U -ys Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(R.08/93) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS Yti Y 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the 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 & 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. ll. 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 in 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 in ##1-7. VII. Tank information. Fill in the capacity of every new and/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% 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, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations February 23, 1995 2226 Rose Street La Crosse WI 54603 K 0 CONSTRUCTION 308 MIDPINE CT STAR PRAIRIE WI 54026 RE: PLAN S95-40083 FEE RECEIVED: 180.00 GERMAIN, MICHELLE NE,SE,24,31,19W TOWN OF SOMERSET 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. Sincerel erard M. Sw Plan Reviewe Section of Private Sewage (608) 785-9348 7630R/ 1 SHDA•7997 (K. 18M) Safety Wisconsin Department of Industry, PRIVATE SEWAGE~ REVIEW APPLICA ON YSTEM and Buildings Division Labar•and Human Relations Bureau of Building Water Systems - : Hayward Office La Crosse Office Madison Office Shawano Office Waukesha Office 209 W 1st Street 2226 Rose Street 201 E. Washington Ave. 1053A E. Green Bay Street 401 Pilot Court, Suite C Rt 8, Box 8072 LaCrosse, WI 54603 P.O. Box 7969 P.O. Box 434 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 (715) 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 ' fat' tQ where your review was scheduled. Please call any of the listed offices if you need help filling out the form or h (gsypns on I006 submit. PLEASE PRINT VERY CLEARLY. A sample of a completed form is on the reverse side for your referen UU!! 5 M 1. APPOINTMENT INFORMATION -if ou have scheduled an appointment, fill in the information requested below to save time: Appointment Da ReWwer me [Plan Identification Number _ 2. PROJECT INFORMATION If this review is a revision or extension to your existing plan identification number, provide that number here: Proje ame ❑ City ❑ Village ® Town Of: County roject Location GOVT. LOT - 1/4 114 T N ,R L or r 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 $110.00 ~M A ❑ 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 $300.00 P ❑ Pressurized In-Ground Over 15,000 gallon septic tank 0 ❑ Other: Up To 1,000 gallon dose chamber FED$~70.00 ~ 1,001 - 2,000 gallon dose chamber DU $ 8s 499 Building Type (check one): 2,001 - 4,000 gallon dose chamber .......SA FETY J 100 00 . 4,001-6,000 gallon dose chamber 10DIGS.. D ® Dwelling, 1 or 2 Family 8,001 -12,000 gallon dose chamber $140.00 DrV 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 S 60.00 Petition For Variance: Setback $100.00 ❑ Petition For Variance Site Evaluation $225.00 Plumbing $225.00 Revision $ 75.00 ❑ Groundwater Monitoring Groundwater Monitoring - Per Site $ 60.00 (other than a proposed subdivision) Site Evaluation in Lieu of Groundwater Monitoring Site Evaluation in Lieu of Groundwater Monitoring $ 60.00 Subtotal: _lQIL_ Priority Review: Enter same amount as Subtotal: 1R& MAKE ALL CHECKS PAYABLE TO: SAFETY AND BUILDINGS DIVISION Total Fee: JA94 5. SUBMITTING PARTY INFORMATION Telephone No. (include area code & extension) Com an Name J Conta Pers n I a ~f. J No. & Street Address Or P.0 Box , City, Town or Villa fi~ Stat , Zip Cod 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. SBD-6748 (R03/93) OVER Wisconsirr Department of Industry, SOIL AND SITE EVALUATION REPORT Page ~of ) abocartd Human Relations Divisioh'of Safety & Buildings in accord wit >05~ Wj.ib Ce vv 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 PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPEJ3, TY OWNER: PROPERTY LOCATION GOVT. LOT 114 1/4 T3 N,Ror~ PROPERTY OWNER'-.S MAC G ADDRESS LOT # BLOCK # SUED. NAME OR CSM # CITY STATE ZIP CODE PHONE NUMBER ❑CITY VILLAGE NO N NEAREST ROAD New Construction Use M Residential/ Number of bedrooms ' [ ] Addition to existing building [ ] 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 /.,2 bed, gpd/02/ trench, gpd/ft2 Recommended infiltration surface elevation(s) P~~~ ft (as referred to site plan benchmark) Additional design / site considerations Parent material ~,ra av i A A0 9 v l 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 ® U 0S ❑ U ❑ S ®U US ❑ U ❑ S E ❑ S oil SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft Boring # Horizon in. Munsell Cu. Sz. Copt. Color Gr. Sz. Sh. Bed Trench Z' 'Z Ground J S elev. ys "5 Q ft. Depth to limiting factor Remarks: Boring # /1_0~ A0 1V14 Ground ys elev. Depth to limiting factto`r~ Remarks: CST Name: Please Print Phone: S Address: ,--5/ - Signature: / Date: CST Nu be : PROPERTYMNER ~F~/ ,~laJ) SOIL DESCRIPTION REPORT Page_--2 of_ PARCEL'I:D. # S~9 5--40 0 8 3 Depth Dominant Color Mottles Texture Structure Consistence BoundEvy Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Co t. Color Gr. Sz. Sh. Bed Trends 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 - T- Remarks: i Boring # Ground elev. ft. Depth to limiting factor Remarks: 56D-8330(8.05/92) S95 1,400 3S ,s/ r, a~ , I I I ~ I I ~ I/ ~~bSih ley t I a-i' /6 ~ WORKSHEET - MOUND SYSTEM DESIGN X95- 4008,1 PROBLEM: ) Design a mound system for a The site characteristics are: Depth to groundwater or bedrock in. Landslope Percolation rate s' Distance from dose chamber to distribution system ft. Elevation difference between sump and distribution systern ft. Step 1. WASTEWATER LOAD aXIk gal. Step 2. SIZE THE ABSORPTION AREA A) Area required = 5` , t J B) Bed or trench length (B) C) Bed or trench width (A) _ ft. ',D) Trench spacing (C) _ rt /`,r Wastewater 1 2 oad .24 gal/ft /day B = ft. tr enc'Ts Step 3. MOUND HEIGHT A) Fill depth (D) _ ft. B) Fill depth (E) = D + slope ft. C) Bed or trench depth (F) _ ;t. D) Cap and topsoil depth (G) _ ft. E Cap and topsoil depth (H) Q f, ft. wipn: I,icenue ~<u: 7 - - Step 4. MOUND LENGTH A) End slope (K) _ ~D_ + E1 + F + H x 3 = f t. /0, 1 B) Total mound le (L) = B + 2(K) ■ ~~/,f~ 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) ft. J I,-2 - , 93 t c) (3) ( io-) - y J_~s C1) Total mound width (W) for bed ■ J + A + I = <22&~ ft. 79 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 r B) Basal area required ■ wastewater flow = natural soil infiltrative capacity = sq. ft. , Cl) Basal area available for bed for sloping sites = 93 P'//~ 9,8' = ~~93 75- C2) Bas are avail le for trench for sloping sites 6 W ~J + q 1 ■ ~ sq. ft. 'F J C3) Basal area available for trench or bed for level jes aBxW= sq. ft. Sign License e n'u Date: 2 s- 95 .40083 Step 7. DISTRIBUTION SYSTEM 7A) SIZE DISTRIBUTION SYSTEM 1) Hole size = in. 2) Hole spacing. in. 3) Distribution pipe length frr•f7- 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 GPM 7C) SIZE MANIFOLD 1) Manifold is„_ central/ end 2) Manifold length ■ _ ft. 3) Number of distribution lines a. 4) Manifold diameter = in. 7D) SIZE FORCE MAIN 1) Minimum dosing rate = GPM 2) Force main diameter 3,7`9 _ in. 3) Friction loss X ft. 7E) TOTAI DYNAMIC HEAD 1) Vertical lift = ft. 2) Friction loss = ,219 ft. 3) System head 2.5 ft. ft. i 4) Total dynamic head = 11912-ft. n: Uce11gC:y Date w Pvt- Of S95-4 i7F) PUMP SELECTION 1) Pump selected will discharge -9,45- GPM at ft. total dynamic head. 2) Pump model and manufacturer 7G) DOSE VOLUME 1) 10 times void volume of distribution lines Zy9al./cycle aX5/C ~X , 09~ X ib = 8S!C~ 2) Daily wa tewater volume 4 doses/24 hrs. gal./cycle 3 Minim ~a ose volume ;/YZ,,Sgal./cycle 7H) DOSE CHAMBER 73 1) Minimum capacity required a Spp.7SV7 = gal. Sign: LicLnsc "u:~ _ Date: 7-.J-1N'I le/9A/ S95-40083 r $O s~ ~/ac,,raSrr:~~.~ •Y/~5~/-5~ 3/ _ _ SYST M 0 V E L"') DEPT. OF INDUSTRY, LABOR i HUMAN RELATIONS DIYIS SAFETY BUILDRN"GS SEE CORK NDENCE ~S 'TAW & ICCCC-.Ai•,~-~i i~ ~b TAN K JaO.lS,G e~wc",to iJk i S95 40 0 83 oesigner. Non-Woven Filter Fabric 4" Observation Pipe ~Dielr;buIion Pipe i ASTM- C 33 Sand H G Alter. Po s. of Topsoil _ r Force Main o E n -3. % Slope Force Main `,_.Plowe d Bed Of %ZM-2 i SYSTEM Drain Rock From Pump Layer PRIVATE SEWAGE Conditionally D Z tesinq F Cross Section 0f A Mound Sys E 1{ 8ELJ1S1 LWR PPMVED ONS A Bed For The Absorption Area P ELJ1S1 G VIM. of RIou at► Btl►~lta''s Div A Ft. . B q~y Ft SE COR PONDENGE Ft. J 7,f Ft. K)0, -2 Ft. Alternate Position L js Ft. of Force Main W Ft. 14"Observotion Pipe--~ 17 J ---8 L--- 1 -K CL A _o Force Moin W cn 'o,~ From Pump c - 3 o Distribution Bed Of 2 2 %Z Drain Rock Pipe ] 4Observation Pipe Permanent Marker Pipe or Rods. Plan View Of Mound Usinq A Bed For The Absorption Area PAGEt~ OF_ZD PERFORATED PIPE DETAIL 895m4008 c~ and 3 DISTRIBUTION PIPE LAYOUT Perforated Schedule 40 PVC Pipe End CaP~ aa \ 4 ' ti' ap~oe Holes Located On Bottom Are Equally \ Spaced End / VATE SEWAGE SYSTEM Cap Schedule 40 nditionally PVC Force Main A nn MPMOVED Last Hole DEPT. OF INDUSTRY. LABOR i HUMAN RELATION= Should Be DIYlSI BAFETY WILgENG= Next To End Cap S ORR NDENCE Owner's Name: p feet Plumber/d i nerI's natu e: x inches y inches Date: License No.: Hole Diameter inch Lateral Diameter inch(es) Force Main Diameter inches Holes per Lateral feet. Invert Elevation of Laterals Page 7 of m • w a s 9 N Q. ~ O ro o ~ N N fA 0 fD ' f1' 0 O 0 ~ VrI \ fD fA N ~ N A.t ro a rt J f+. O - L' hfi W (D _ rt H P* m O 0 O r fD I rt SYSTEM ~ SSW p,GE r. cn ionally a Condit Hu~pO RE1J► rt BaR A ~ BWI.DtkSS 0~• OP 1N SA VAN S~~p~.tJGS S a M r• a w H a a co f J~ / l l PAGE OF PUMP CHAMBER CROSS SECTION AW SPECIFICATIONS 895"40083 VENT CAP ti C.I. VENT PIPE APPROVED LOCKIRJG WEATHER PROOF /r1A1JHOlE COVER BOX ~ 25' FROM DOOR, FJUQCTIOU WIUDOW OR FRESH I AIR IAITAKE i GRADE i 4rMI1J. I B° MIIJ. CONDUIT-- 11~ - I ~PROVIDE IAILE T AIRTIGHT SEAL I I i I V I A ~ cJ~S~E~A I III APPROVED JOWTS APPROVED JOINT Ytr,,~~. ( III W/C•I. PIPE W/C.I. PIPE ti p~y I I I ALARM EXTEUDIUG 3' EXTENDIAI(s 3 I o°~~~~ OWTO SOLID SOIL OWTO SOLID SOIL I I GN R~ OS g H~MpN CGS ~ I I s c) PUMP - SOFF Std A S COUCKETE BLOCK S • RISER E PERMITTED OUL9 IF •TAIJK MAUUfACTURER HAS SUCH APPROVAL SPECIFI•CATIOPIS i:P'`IC AND u5{: TANKS MAWUFACTURER: IJUMBER OF DOSES: PER DAy TANK ; IZI<: GALLOWS DOSE VOLUME: GALLONS ALARM MAULIFACTURER: -S ~f, ti /c' CAPACITIES: l~• _I►JCHES OR GALLO►,15 AlrliU MODEL 1JUMBER: kl - UCHES OR CALLOUS SWITCH TYPE: C=_c~Z/-.INCHES OR CALLOUS' PUMP MAMUFACTLIKE R: D= -.L/ JULRES OR 11a. GALLOUS i MODEL MUMBER'. 1A)"E© qua MOTE. PUMP AMD ALARM ARE TO BE I USTALLED ON SEPARATE C.IRCU ITS bWIlCN T`JPE: ~ PUMP DISCHARGE. RATE GPM© /S / VCKTICAL•Dil,FEREIJCE bF-TWEEU PUMP OFF AOD DISTRIBUTIOU PIPE.. FEET + MIUIMUM NETWORK SUPPLY PRESSUR~TE//. 2 5 FEET + /FEET OF FORCE MAIN X ~LF/ooFtFRIC"fIOU FACTOR.. FEET TOTAL DYNAMIC. HEAD FEET • r~,/iMt~ric 8'S'~~ /i IIJTERMAL. DIMEW, IOIJS OF TAIJK: LENGTH ;WIDTH -;LIQUID DEPTH SIGIQED: LICEIJSE UUM8ER: DATE: 225- • t ~=ski'. ~ ~ - ~ b ~ b :t tryr' A i. ►n•. bwr' t Performance k Curves 'umps METERS FEET s959040083 90 MODEL 3885 25 - 80 SIZE 3/4" Solids col/z WE15H 70 t 20 WE10H 60 0 WE07H 15 50 40 W E05H 10 30 WE03M WE031 20 5 10 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM L i i i 0 10 20 30 m'/h CAPACITY MGOULDS PUMPS. INC. SEW-CA FALLS PEW YOM i31d8 METERS FEET 120 MODEL 3885 35 SIZE 3/4" Solids 110 WE15HH 100 30 90 25 80 70 20 60 O ~ WE05HH 50 15 40 10 30 20 5 10 - t I I I 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM i L i i 0 10 20 30 m°/h CAPACITY 01985 Goulds Pumps, Inc. Effective July, 1985 C3885 lwa~buic a filumat Relations ustry, SOIL AND SITE EVALUATION REPORT Page of 'D'q"is,on.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 0 ic in size. Plan must include, but not limited to vertical and horizontal reference point (BM), I d % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location qnd distance"to nearest APPLICANT INFO RMATION-P ASE PRINT.ALL FNFOR N REVIEWED BY DATE PROPE TY OWNER: > PROPERTY LOCATION GOVT. LOT 114 1/4 T& N,Rore r PROPERTY OWNER':S MAC G ADDRE S'". ~ J LOT # BLOCK # SUBD. NAME OR CSM # / 1,2 CITY STATE ZIP C r PHONE NUMBr ❑CITY VILLAGE [ZTOWN NEARS T ROAD s New Construction Use M Residential/ Number of bedrooms [ ] Addition to existing building Replacement [ ] Public or commercial describe Code derived daily flow" gpd Recommended design loading rate Z.;.2 bed, gpd/ft2_)j trench, gpd/ft2 Absorption area required -375- bed, ft2 ,37_5 trench, ft2 Maximum design loading rate gibed, gpd/ft2.-)trench, gpd/ft2 Recommended infiltration surface elevation(s) 9G ft (as referred to site plan benchmark) Additional design / site considerations Parent material O ls)rT,/~ /.ye Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL MOUND 7IPRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U=Unsuitable fors stem ❑S ®U 0 S ❑U ❑S ®U CIS ❑U ❑S oU 7 ❑S ®U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boun>d;3y Roots GPD/ft in. Munsell Qu. Sz. Copt. Color Gr. Sz. Sh. Bed Trench Al Ground S elev. ys s ft. NZ ~Vz Depth to limiting factor Remarks: Boring # 75~5- 'Z Ground 3 ys`~' / - n elev. _ i A~a 1'w' ft. Depth to limiting factor~ Remarks: CST Name:-Please Print Phone: S - - Address: , Signature: Date: CST Numbe : PROPERTY OWNER ae4d,i) SOIL DESCRIPTION REPORT Page= of PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. 2$2t. Color Gr. Sz. Sh. Bed Trench . 4 Ground / elev. ~s~s d Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) 3s 9V :21-;~ 1 i 31 ~ ; /~ouS,E 08/11/94 14:03 r$ COUNTY CLERK Z001/002 LINE !E114,8EC.24 N£ CORNER OF 1/4 OF SECTJON 24,T Sl N,p J! _ ~7 / 1119. 15 . r saoJ N 97157' 0^ w -•'J JJaa.: S T R E E T o~ v 2e ze0.0 .2 a00 o. . Wk. N eo. a40 9 W ~ W p e N^ NQ S x Mlsq ft. 133,951 sq. ft. x 131,599 s4 ft. !33,951 •q• ft, Ao \0 S ~ oo. 9~i o s 2as-OO 9 260.00 g4 ~0 0`;0• 265-00 Nd7.57'o5"W 670.00 g g g 6X 171,001 sq. ft. Ne7.57'o s "w ~ s7aoo .v. wo ~y . 0 •r N 7 \ Q N 159, 600 sq, ft. N 87'37 G5 "W ea 1 0.00 w Oh ' - g oa 8 N NN UN, R.f9W. Bg, VVV, ti OPUS., a 159,600 sq. ft. N N87.57'05"W ~7M•.!~ ~ s7o.oo C 1 ' C .r :ltlrOA' le.TNN,AIrW ~p~} f1 Nf CONNLN OC SC IN Or.{ - w r,0, x lrN[ aCINiJCC.I~ :n,l.f xn•e roe"w _nrue t: .`d - 7r!'i'C~ YT){IGlik 41 hl wnaroa'm'w-n. Z xaa o,•w.,uz]m PUBLIC r tir .q +]oo"i L,_,h....!!00 STREET - os' w- r .ur e W us.u eaooo p o± 6 sAOO os. ] 8~ y zaao, ea esa .oo sq zasn~- - g;' ~ e4 00 r ~ g•,.++ t 4a.,r .o° ....qsa w-. n° • oo° ye ^,I: r,, d°° q.u : A ! '(~Qa L, V+s, ,d' 141 I z qti >a PP \ 1 y C• lAp~~(~` e y~~}:o. oo •D R t.~F~ Wd rz vl r„ , iG~46•,,• A Ie 'i 17S,3oo sq I, In,ooo.°. rr $ g s~. ae ' O P : _ . g F f r yy ` W '•J~ 2 3 4 z' 5 " w tir 11 l e t y: s w ! ~.~`,++i,ti_++ ° °p o,• ~ eV,.''4"`{ 'I t>. 130,13110 . /L 133,831 rp.fl. 131,389 .4 It. 133,931 .p 1r D: . ..+~or: •r... yo' o,. • Q 137 2 1 t . y~/ 4• ^ L .1eyyA IBY,730 eq 1/ ~r xu•saoew rrer. x.a•eronw eao oo ~A G r ro+ o ~ I `C 'ji 171001 rq. Ir. APPROXIMATE HIGH WATER ELEV.•86QC`-~ 4 it a,ooo w so - ' APPROXIMATE LOW WATER ELEK•835.3 z1 11 APPROXIMATE WATER ELE v lafoo pyA h 1p (APRIL, 19611 ' ?iF` f• ,K q,Y3.~,g30 l !l ALL ELEV ON U. S. G. S.. MEAN SEA rv~ ...e LEVEL DATUM o U' • \ • C fl U. 1 ~ o~aT rqo y cL~ N d 1 r';~'r I. +T x r^ / z•o:'ee'.,,~' • 139,600 so. Ir I X- FF "J, a 9 ".100 1\ _"'off \•0. 171,001 a° ft e ~ x.r•arro„w I NO. I a J QS CERTIFIED SURVEY MAP V; yoL Igo, PACE Np e° D4c..N.4. ' z ~ 159,600 sq.hpl 9 140.031 K N APPROXIMATE HIGH WATER ELEK • 86Q0 11 ~t Ar• APPROXIMATE LOW WATER ELEV. x833.3 l1 rr•tr. U_ APPROXIMATE WATER ELEV.- 6600 ` q \yt (APRIL, 1881) \'.t` zW „^yx I' `R m ` ALL ELEV. ON U.S.O.S.. MEAN •?P\ _ 1SEA LEVEL DATUM. 131,830 rq•Ir "e0 ~~xra•]ros'w TURTLE eyy,a LAKE " ' rx. °r }xC xl/R,xrlN,rlc.H,T.Nx.x.UN. 14 tl! Ike W. PRIVATE POND •.Wr ...MeT•QO,,-w 2 APPROXIMATE WATER ELEV 860.0 4q+. 1 - ' (APRIL,19B1/ OUTLOT : e \ I,Y34,830 sq. Il. _ yu ~ ~g L a: 3 Ala ! ! 132,oz1 '•d fr. a uzl ~ j A 4arar 'bD ~r• xoxTN Uxf or Txr !^aesrr i r : Qom. i • e^ ' ~ Wfsa refea Aisl- STC-105 SEPTIC TANK MAINTENANCE AGREEMENT 1St. Croix County OWNER/BUYER '1r~c1 JCS V ~~m . MAILING ADDRESS (3 3r1 l~ a PROPERTY ADDRESS 'GL03q Q 7 (location of septic system) Please obtain from the Planning Dept. CITY/STATE PROPERTY LOCATION F 1/4,_ 1/4, Section, T N-R_j q_W TOWN OF 9&6~~ A ST. CROIX COUNTY, WI,A, nn SUBDIVISION LOT NUM 3ER S a CERTIFIED SURVEY MAP , VOLUM Q( 3, PAGE A i< ) LOT NUMBER Improper use and maintenance of your'septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. / SIGNED: Valra6a4 DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 • G OT 5' S T C - 100 02Q-..Da- gd F. iV . g This application form is to be completed in full and signed by bth1 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 ofproperty Location of property 1/4_1/4, Section,TS1_N-R_W 19 Township -IMU4;t Mailing address p Q - 37 (L Address of site O3Ca a b Subdivision named ILot no. Other homes on property? Yes X No Previous owner of property Total size of property S•Og Total size of parcel 133 ~qs Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house)? )(_Yes No Volume KYA2> and Page Number s' 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. 5 a.0 °I D , 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. 50ogQ.9 Signature of Applicant Co Applicant y Till' SPA(. k. fir,CTIVED FOR RE,nnDIN6 DATA 110oocoMENT NO. WARRANTY DEED ` STATE BAR OF WISCONSIN FORM 2-1982 T. n - - 520929 ST. CROIX CO., WI Reed for R-_ofd _._RiC and M...Hansen. and. .Jane . A..Hansen. I Res r. ord h~ttaand..and..wife 9: 0 A oTIP7"1alf............ 4 ~M conveys and warrants to -Michelle--M-`.-~ranap.51P . ~star ofDee4s int,erest_and..Richard..0.... Stout..and..Janet. °-...Stout,.... nsl.•and..wife.s.-a--sine-half interest-..as..Tenantp.......... in. C omma RcrullN To - Croix .....•---Councy, the following described real estate to . State of Wisconsin: Tax Parcel No: 7 and 8, Block 2, Hansen's Turtle Lake Hills First Addition Lots 4, 5, 6► in the Towl of Somerset, St. Croix County, Wisconsin. I I I 1 I I This S- C10t........... homestead property. (is) (is not) Exception to warranties: easements, restrictions anc'_ rights-of-way of record, if any. 19 94 Dated this ~-'I .1 . . . . . day of i I (SEAL) ~el -fly--.........-(SEAL) J A. Hansen i Richard M. Hansen • ACgNOW LED(}MENT AUTHENTICATION STATE OF WISCONSIN Signature(s) Richard M.•, Hansen ss• Jane A. Hansen St. Croix County. day of Personally came before me this , 19.~.__. 19 the above named authenticated this day of. = Hansen Richard . Hansen, Jane A. / M Kristina Ogland_----......... TITLE: MEMBER STATE BAR OF WISCONSIN S who executed the to me known to he the person (If not . authorized by 708.06, Wia. Stata.) foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY ~ Kristina Ogland w;s •------------Attorney at• _,aw Notary Pubic . Signatures may be authenticated or acknowledged. Both My Commission is p ermane nt [ f no`-, st te expiration a 19..... are not necessary.) date- - - eapacitr should be tYDed or Drinted below their ei¢naturee. Wisconsin Legal blank Cn .Inc I •Names oL Deraone eiRnlnG in ant STATE RAR OP WISCONSIN Mdwa~.lkop, Wisconsin W ARflANTY DEED FORM No. 2- IJN2