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Home My WebLink About032-2093-10-000 STC - 10 4 AS BUILT SANITARY SYSTEM REPORT OWNER _1, i ael:4 ADDRESS SUBDIVISION / CSM9 LOT SECTION4Z:,~ T_ ?l N_R ~2 _W, Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW f.i SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ago ~ Cs.rra~ //(r " ~e fltaush may' 9 ~Af 8 INDICATE: E4oRTIi ARROk,' Provide setback and elevation information on reverse of this foi-m. Provide 2 dimensions to center of septic Lank manhole cove' 1 r BENCHMARK: i ALTERNATE BM: ~s 'f1 SEPTIC TANK PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: - Liquid Capacity Setback from: Well House Other Pump: Manufacturer 4a, Modelk I," Size Float seperation Gallons/cycle: 1 So? Alarm Location i~J HauS.z /5&-1)0 SOIL ABSORPTION SYSTEM Width: Length y Number o f trenches Distance & Direction to nearest prop. line: Setback from: well: House Other ELEVATIONS Building Sewer ST Inlet. 1&7e7 ST outlet r PC inlet 5' PC bottom Pump Off Header/Manifold Bottom of system ~1,7 Existinq Grade Final grade DATE OF INSTALLATION: - PLUMBER ON JOB: LICENSE NUMBER: 9 INSPECTOR: ' Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION PeyERMA~)!~ j, j~6~ o11d r' Na 'RICHELLE ❑ City El Village Town of: State Plan o.: , CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: Y ~ TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI ' FS ELEV. Septic Benchmark ~7/iDu,o~ Dosing U. Aeration` Bldg. Sewer L Holding St/ Inlet 71 TANK SETBACK INFORMATION St/,~kf Outlet TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake r Septic Q~~ r r' z ' NA Dt Bottom Dosing u•_~>?~ NA Her/ Man. ` Aeration Dist. Pipe Holding Bot. System q PUM /-J INFORMATION i `Final Grade Manufacturer ~Quf~ Demand Model Number 5 1 GPM 1 TDH Lift39' Friction X01 System- TDH 6,3,ft Loss 0. Head , Forcemain Length, j' Dia. Dist. Towe ,j SOIL ABSORPTION SYSTEM BED/TRENCH Width . Lengt , . No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DWE_N I N_ LEACHING cturer: SYSTEM TO P/ L BLDG WELL LAKE /STREAM SETBACK fir- INFORMATION Type O , CHA Model Number. System: r~Ile OR UNIT DISTRIBUTION SYSTEM `v Header :MMaann,:f:o!d j~ Distribution Pipe(sf ^ x Hole Size x Hole'S/paacing Vent To Air Intake Length Dia / ! Length Dia. a Sparing ljl' 5~4 71 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 Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: Somerset.24.31. 19W NE SE 80th S reet~ ' .Z Plan revision required? ❑ Yes Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert No 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. , Z • See reverse side for instructions for completing this application State sanitary Permit Number a 33AI f The information you provide may be used by other government agency programs ❑ Check it revision to previous application [Privacy Law, s. 15.040)(m)]. State Plan I.D. Number 1. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION Property wner Na I Property Location 1 r "1/4~ T , N, R(o Pro eit Owner's Mailing Ad r ss of Number Block Number Cit tate Zip Code Phone Number Subdivisio me or CSM m r II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ City Nearest Road ❑ VII age ❑ Public 1 or 2 Family Dwelling - No. of bedrooms Town OF III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment / 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 box on line A. Check box on line B, if applicable) A) 1. New 2. ❑ Replacement 3. ❑ Replacement of 4_ ❑ Reconnection of 5. ❑ Repair of an System System___ Tank OnlyExisting 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 A Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43E] 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 Feet Feet /TANK Capacity VII. in gallons Total # of Prefab. Site Fiber- Exper. Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic INFORMATION App New Existing strutted Tanks Tanks Septic Tank or Holding Tank - / ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber :~Lj - ® ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for'nstallation of the onsite sewage system shown on the attached plans. Plumbe s Name: (Pri / Plumb r' ignature: jNo Stam ) MP/MPRSW No.: Business Phone Number: Plu tier's Address treet, Cit tate, Zi de): PA / IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sa ary Permit Fee (Includes Groundwater 10aslue ing Agent Sign ure (No Stamps) Surcharge Fee) ,qApproved ❑ Owner Given Initial a 71 ~ Adverse Determination V X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBO-6398 (R. 05/94) DISTRIBUTION: original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe renewed before the expiration date, and at a time of renewal any new criteria in the ' Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD-6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3815- To be complete and accurate this sanitary permit application must include: L 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, r~.,ce~nnection, or repair. V. Type of system. Check appropriate box depending on system type. VI- 7:.hsorption system information Provide all information requested for nurn e-s 1 througl. 7- VII. Tj-i . ;;formation Fill in the ca,?acity of every new/or existing tank., lisp 0ie rota- _;a!lons, of tanks and anufacturer's ~an,e, indicate ,prefab or sire c,..;nstructed and tank materiai- C.r.,;,)! eie fG, ah;c, pump/siphon and holJing tanks for this system C`:eck experimental approval only if tanks rereivec., .~xperin-,?ni at )roduct approval from DiLHR. V111_ Responsibility statement. Installing plumber is to gill in name, license number vv appropriate prefix (e.g_ MP, etc_), address and phone number. Plurnber must sign application form_ iX_ Courr,y/ Department Use Only. X. COLinty r Department Use Only. y- , rtri sma; l, t ' n R 11;2 x ? r~_ he plans must n..vi A. r~u' -anr r,c~_;eorwiti,cry. Ji i g _ankl r, r _ Seal yip :,r ding :,t ved; _ ,-..,r ,.o: F) s;., 'tsp... ;r .^ato-.. GROUNDWATER Sl.`• CHARGE 1 cu t r :fra.a . surcharges (fee,,) e,-! -h can are ~:sed'c:-mv.-11i:' r- P a ~ ~~~sC/rV.~ 5 S/ ~f Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 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 PARCEL # not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION GOVT. LOT 1/4 1/4,S c T AR ~ (orw~ PR P RTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAM OR CSM # y - CITY, STATE ZIP CODE PHONE NUMBER ❑CITY 171VILI ®fOWN NEAREST Ro c New Construction Use Jj(] Residential / Number of bedrooms [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow - - gpd Recommended design loading rate ~'bed, gpd/ft2_2_,2 trench, gpd/ft2 Absorption area required 7s- bed, ft2 , ;~57 trench, ft2 Maximum design loading rate _,Z bed, gpd/ft2 trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations Parent material :Z~/ /o aa~~~ 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 El S U 2S ❑ U ❑ S O U ❑ S 0 U ❑ S RIU ❑ S O U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft Boring # Horizon in Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tmr& J E,_2cl 1,-2 Z12.4_ 1 /41 Ground - elev. ft. Depth to limiting factor Remarks: Boring # Z ii~ --mac ~ Ground 17 elev. ft. 5 Depth to limiting Tv factor Remarks: CST Name: Please Print Phone: Address: - - Signature: Date: CST Number: 1 PROPERTY OWNER SOIL DESCRIPTION REPORT Pagk~:~'of PARCEL I.D. # Boring # Depth Dominant Color Mottles Texture Structure Consistence Bour GPD/ft Horizon Roots in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Tench . w - Ground elev. io 7-12 ft. Depth to limiting factor Remarks: Boring # 91~~ 4E 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) SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations June 22, 1995 2226 Rose Street La Crosse WI 54603 K 0 CONSTRUCTION 308 MIDPINE CT STAR PRAIRIE WI 54026 RE: PLAN S95-40573 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. Sincerely, G and . Swi Plan Reviewer Section of Private Sewage (608) 785-9348 1250R/ 1 SUDA-78871K. 111841 Wisconsin Department of Industry. PRIVATE SEWAGE SYSTEM Safety and Buildings Division Bureau of Building Water Systems Ldbor and Human Relations REVIEW APPLICATION Hayward Office La Crosse Office Madison Office Shawano Office Waukesha Office 209 W 1 st Street 2226 Rose Street 201 E Washington Ave 1 340 E Green Bay Street 401 Pilot Court, Suite C ilt8, Box 8072 LaCrosse, WI 54603 P.O. Box 7969 Suite 300 Waukesha, WI 03188 Hayward, WI 54843 Phone (608) 785-9334 Madison, WI 53707 Shawano, WI 54166 Phone (414) 54111-8606 Phone (715) 634-4804 Fax (608) 785-9330 Phone (608) 267-51 19 Phone ( 715) 524-3626 Fax (414) 548-8614 Fax (715) 634-5150 Fax (608) 267-0592 Fax (71 S) 524-3633 INSTRUCTIONS: To save time, schedule your review with one of the offices listed above pnur to submittal Fill in all applicable data arid 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 have questions on what information to submit PLEASE PRINT VERY CLEARLY A sample of a completed form is on the reverse side for your referencR 9 esa 80 1. APPOINTMENT INFORMATION - If you have scheduled an appointment, fill in the information requested below to save time: Appointment Date Reviewer 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: Project ame E] city El Village 0 Town Of County 4P,je"ct Location GOV I t OT 1 /4 1/4,S 2-/T _ N ,R chi E or , liC~~ 1 X 3. APPLICATION FOR 4. FEE COMPUTATIONS FEE SUBMITTED System Type (check one). System Type t (include new and existing tanks) Up To 1,500 gallon septic tank $ 110 00 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 - 9,000gallonseptictank $200.00 N Non-Pressurized in-Ground (conventional) 9,001 -15,000 gallon septic tank $ 300.00 . Over 1 5,000gallon septic tank $500.00 P ❑ Pressurized In-Ground O Other: Up To 1,000 gallon dose chamber $ 70.00 1,001 - 2,000gallon dose chamber $ 8000 . Building Type (check one): 2,001 - 4,000gallon dose chamber $10000 4,001 - 8,000 gallon dose chamber $120.00 . D Dwelling, 1 or 2 Family 8,001 -12,000gallon dose chamber $140.00 . P Public Building Over 12,0009allon dose chamber $ 160 00 S State Owned Building Up To 5,000gallon holding tank $ 60 00 5,001 -10,000 gallon holding tank $100.00 . Code Derived Daily Flow 9pd 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 $106.00 _ Site Evaluation $225.00 _ . Petition For Variance Plumbir"eGC $22500 Revision E~~ $ 75.00 Groundwater Monitoring - PJI $ 60.00 Groundwater Monitoring (other than a proposed subdivision) ~ Site Evaluation in Lieu of - ft't i $ 60 00 - Groundwater Monitoring Site Evaluation in Lieu of rou d `~W~ • Subtotal: - Priority Review: Enter same amount as Subtotal: MAKE ALL CHECKS PAYABLE TO: SAFETY AND BUILDINGS DIVISION Total Fee: 1i 5. SUBMITTING PARTY INFORMATION Telephone No (include area code & extension) Company ame Contacers No. . & Street City, To or Villag State, ip Code ✓ t Address -Or PJ 0. Box ( t Aerobic or prepackaged treatment system fees are calculated based on equivalent size septic ianks 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 may be used by other government agency programs (Privacy Law, s 15.04 (1) (m)I OVER SBDW-6748 (R 09/94) of Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Pap Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code ~ ~ t'~ c~ COUNTY rt I § 9 1 Attach complete site plan on paper not less than 8 1x 11 inches in size. Plan must include, but PARCEL ` . # not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or dimensioned, north arrow, and location and distance to nearest road. 11 APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION GOVT. LOT 1/4 1/4,S rr/T \ - AR q (o0 LL! r„ I Al '5 ) PROTTY OWNER':S MAILING ADDRESS LOT If BLOCK # SUED. NAM OR CSM # CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE [TOWN NEAREST ROA New Construction Use j Residential / Number of bedrooms [ J Addition to existing building j J Replacement [ ] Public or commercial describe Code derived daily flow _ gpd Recommended design loading rate __Z_bed, gpd/ft2_,/_~Vench, gpd/ft2 Absorption area required ?1; bed, ft2 .?7 trench, ft2 Maximum design loading rate gibed, gpd/ft21,~trench, gpd/ft2 Recommended infiltration surface elevation(s) i It (as referred to site plan benchmark) Additional design / site considerations Parent material 1// /J > l Flood plain elevation, if applicable ft S = Suitable for system CONVENTIONAL MOUND T71NDPIRESSURE N-GROUAT-GRADE SYSTEM IN FILL HOLDING TANK U=Unsuitable for system ❑ S D U 10 S ❑ U ❑ S ❑ U El S O U ❑ S ®U ❑ S Oil SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft Boring # Horizon in Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trerch Ground elev. ft. Depth to limiting factor Remarks: Boring # Z 'Y c Ground elev. ft. Depth to limiting factor i Remarks: CST Name:-Please Print > Phone: `1Z r Address: i,~~ r^ / ~ ~ ~ x l Signature: Date: CST Number: of PROPERTY OWNER SOIL DESCRIPTION REPORT Page,-:::~ PARCEL''LD. # w g r -40' ' 73 • Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourxlmy Rodts GPD/ft in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 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: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05192) 1 / / r I : I tt/ r ~ pry r /I \ f v i i I, 1 I. r ~ 11aj I I I I L WORKSHEET - MOUND SYSTEM DESIGN PROBLEM: Design a mound system fora The site characteristics are: Depth to groundwater or bedrock in. Landslope % Percolation rate ~ •-I min./in. Distance from dose chamber to distribution system ft. Elevation difference between aump and distribution systern _A_ ft. Step 1. WASTEWATER LOAD gala Step 2. SIZE THE ABSORPTION AREA A) Area required sq. ft. B) Bed or trench length (B) ft. a.. C) Bed or trench width (A) M• ~ ft. D) Trench spacing (C) _ ^JL Wastewater load .24 coal/ft2/day B = ft, to n c e" F"s"'- Step 3. MOUND HEIGHT A) Fill depth (D) _ ft. B) Fill depth (E) ■ D + slope ft. C) Bed or trench depth (F) _ "fs rt. D) Cap and topsoil depth (G) ft. E) Cap and topsoil depth (H) ■ Z< ft. ldconuo NU: /~jll~/~.C llfi. 6e.6s~.1J V Step 4. MOUND LENGTH 895-40573 A) End slope (K) ■ ~D+ E1 + F + N x 3 ■ W ft. t/;5~ X.~ _ /0,35 B) Total mound len O B + 2(K) ■ /Q= ft. Step 5. MOUND WIDTH ~i Al) Upslope correction factor = F A2) Upslope width (J) (D + F + G)(3)(factor) ■ ft. 0 V,- 6SO = 7, 30/ BI) Downslope correction factor ■ lAgii B2) Downslope width (I) ■ (E + F + G)(3)(factor) ft. J,d-/r -gs''- 0 41d')) , C1) Total mound width (W) for bed ■ J A + I ft. C2) Total mound width (W) for trenches = 2 (no. trenches -1)(c) + A + I ft.` 2 ~ Step 6. BASAL AREA A) Infiltrative capacity of natural s ~ oil --.ie.. gal./ft2/day B) Basal area required ■ wastewater flow _ natural soil infiltrative-capacity -,sq. ft. C1) Basal area available for bed for sloping sites Bx (A+I) • Ll,,-sq. f t . C2) Bas are avail le for trench for sloping sites ■ B W - ~J + Al 7/ Zsq. ft. C3) Basal area available for trench or bed for level sj xW■ sq. ft. License Fu Data: 895-40573 ~Icrl~I~,e~k~-.~,N - O Step 7. DISTRIBUTION SYSTEM 7A) SIZE DISTRIBUTION SYSTEM 1) Hole size in. 2) Hole spacing in. 3) Distribution pipe length fzr,f; 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 = /VDU-/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 _ in. 3) Friction loss ft. 7E) TOTAL DYNAMIC HEAD 1) Vertical lift = ^S~ ft. 2) Friction loss_ ft. 3) System head 2.5 ft. ft. 9~~/.Total dynamic head = ft. / L J a S95-40573 /)/,C//X4` 7F) PUMP SELECTION 1) Pump selected will discharged GPM at ft. total dynamic head. 2) Pump model and manufacturer 7G) DOSE VOLUME 1) 10 times void volume of distribution lines gal./cycle 2) Daily wastewater volume 4 4 doses/24 hrs. gal./cycle 3) Minimum dose volume /-T/ gal./cycle 7H) DOSE CHAMBER 1) Minimum capacity required gal. Si u,a : Lictsnso '!u:__-~1. Date 4;~ ' l.2s::: r 8 9 5 x 4 0 5 7. ix 5 `iu/'.'r~s.e /~✓l~ J NCB/j ~ r -,r' ice.' ~ i iJi ~ ! j A,C, 1%, / h71. I l ,01. i ~I ~ GIG/ , 1 BR 'TANk SEW p,GS SYSTEM P~tl~ ATE 71, cond itionailY 't-AW K - R ,ONs LABOR & H 9~ DlD1HG 1. DRDUSTRY, FESY N ORpT OF A D1~! IS DON i / A, S95-40573 Designer! Date.' Non-Woven Filter Fabric 4" Observation Pipe .Distribution Pipe ASTM - C 33 Sand G Alter. Pos, of Topsoll r Force Main p-; . ti: Slope Bed Of %P 2 i Force Mo in Plate d Drain Rock From Pump Layer M d ~ T~ OEV+f AO'E SYSSE D D nolly Conditto Cross Section Of A Mound System Usinq F A Bed For The Absorption Area G f, D 9% SID N4 ® Eu~d pN P Nu~► s A Ft. H l,s ~ 0 B~SU.'~ING Dom, uF eNO~sSv' B Ft. 11,3 Ft. Go SPOND~~C J Ft. K gyp, Ft. Alternate Position L Ft. of Force Main W Ft. 14"Observalion Pipe e Force Moin w - - - - - - - From Pump C - 3 o Distribution 0 '1~0 0f 2 %Z ~v i , Pipe Drain Rock 1 4 Observotion Pipe Permanent Marker Pipe or Rods, IPion View Of Mound Uclnq A Bed For The Absorption Area PAGE G OF--2f PERFORATED PIPE DETAIL DISTRIBUTION dPIPE LAYOUT S95-40573 Perforated Schedule 40 PVC Pipe End Cap ce 4 Holes Located On Bottom Are Equally Spaced End f \ Cap ~••4 / Schedule 40 PVC Force Main Last Hole Should Be Next To End Cap Owner's Name: P feet Plumber/~esigner'-s Signature: x inches r y inches Date: 5's- License No.: Hole Diameter .-=..L_ inch Lateral Diameter1 inch(es) PB V"; 011iti® Force Main Diameter - inches a. Holes er Late IV I ,LP ral Opp AEIASIONS OF ItiD0MY# LAW ~DUt~ LO as feet. Invert Elevation of Laterals 0 ,5. p11~IStON E N FVAGE S E Page of . 'v r+' cn a m co o r+ 0 W rt CO P. = a o a M b ~ IA rtr C b A I La W rr rt o ~ p. ~ F, H. _ - C rH'►i 't n ~l► _ 0 7 Q m r M~ ct d n a :j s., rr T. 0 x o rr M W W N ti a a co r ~~PAC, E OF PUMP CHAMBER CROSS SECTIOIJ AND SPECIFICATIONS VEIJTCAP S95-4U D73 'i•C.2, VENT PIPE WEATHER PROOF APPROVED LOCKING > JUNCTIOIJ BOX MANHOLE COVER 25' FROM DOOR, WIQDOW OR FRESH 12'MIU. AIR INTAKE ! GRADE ~ ti' MIN. C O l'i IDUIT--// 11~ INLET PROVIDE AIRTIGHT SEAL I III 'T I II v APPROVED JOINT A I III APPROVED JOJN' W/C,Z, PIPE AGE SYSTEM I III W/4W, PIPE EXTENDIN¢ 3'pRjV T S~ I II ALARM LXTENDIAJG 3' ONTO SOLID SOIL i~ionally i I I ONTO SOLID S01 1*0 I I GN ® NS I A RELpTIQ _ _ 1 Srlp DU Z8Y LASOF► A N PUMP OFF gUt DltiC~S DEYt...D11! 1U f • - C OUC RETE DLOC4( C ' RISER EXIT PERMITTED 01JL9 IF TAQK MAULWACTURE.R HAS SUCH APPROVAL SPECIFICA, T101JS -PTIC AMC) )SE TANKS MANUFACTURER: IJUMBER OF DOSES: 11 PER DAb TA►JK GIZE : GA~JLONS OOSC VOLUME: Sl CALLOUS ALARM MANUFACTURER: CAPACITIES: A: I►JCHES OR - -2 GALLO~J: MODEL ►JUMBER: ! B= 7 INCHES OR GALL Oki S SWITCH TYPE: C= 4 INCHES OR / GALLOQJ PUMP MANUFACTURER: 0= INCHES OR GALLO►J MGI)EL NUMBER'. •'1/~ IJOTL'. PUMP ANO ALARM ARE TO BE IIJSTALLED ON SEPARATE CIRCUITS bW11CH TJPE: PUMP DIS(.HAR(,E. KATL G PM- VLRTICAL,DII,F'EREMCE DETWEEJJ PUMP OFF AND DISTRIBUTION PIPE.' ` FEET + MINIMUM NETWORK SUPPL. PRESSURE 2 5 FEET 4- r'/G FEET OF FORCE MAIN X F00UFRICTION FAC.TOR..FEET TOTAL Dy1JAMIC HEAD 21-71 FEET IJJTERAJAL. DIMENSIONS OF TAUK: LEA,IGTH ;WIDTH ;LIQUID DEPTH S!GIJED: ' t L CEIJSE IJUMBER: DATE: l ,LZy' -Performance u m Curves u s METERS FEE T 895-40573 90 , s 25 MODEL 3885 80 y SIZE /4,1 Solids WE15H i_~i' % S 70 l~ I 20 WE10H 60 WE07H H i 15 50 WE05H 40 10 WE03M 30 20 WE03L 5 10 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM I L J 0 10 20 30 m,/h CAPACITY GOU LDS PUMPS, INC. METERS FEET 120 MODEL 3885 35 110 WE15HH t-- SIZE 3/4" Solids 100 30 90 i 25 80 70 2 20 J ~ o 60 - - - 50 WE05HH 15~ 40 -4 10 30 20 5 - +H"-r 10 0 p I ' i 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM I 0 10 20 30 ml/h CAPACITY 019M Goulds Pumps, Inc. ENactlve July, 1985 ~~qp~ L-0r ~ c~3a- X093- o F. AI. STC-105 SEPTIC TANK MAINTENANCE AGREEMENT - St. Croix County OWNER/BUYER MAILING ADDRESS t7 , 4'~or 310 8 d ~S~ PROPERTY ADDRESS 901'2 ~Acs (location of septic system) Please obtain from the Planning Dept. CITY/STATE W I PROPERTY LOCATION PJF, 1/4, 5E 1/4, Section ~)4/, T 31 N-R_17__W TOWN OF ~t 4 ST. CROIX COUNTY, WI SUBDIVISION LOT NUMBER CERTIFIED SURVEY MAP , VOLUME /093, PAGES , 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: ~J DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 S T C - loo 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 Location of property 01E 1/4SV: _1/4 , Section, T 3 1 N-R Township ly~ Mailing address JP,0. gm4k ~ `1S1 Address of site &C)IC, 12 Subdivision name -10a Lot no. Other homes on property? nnYes__z~_No Previous owner of property u~2 Total size of property IS17 , (OL) Total size of parcel '2~ (p t? Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house) ? _>_Yes No Volume 1()c(3 and Page Number yam 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 c,0 9a°r , and that I (we) presently Deeds as Document No. 5- 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. ,5 02 U ~9° ii Signature of Applicant Co-Applicant 08/11/94 14:03 $ COUNTY CLERK Q)ool/002 F. LINE 9E114,SEC,P4 N£ COpN£R OF P~ SE 1/4 OF SECTION 24,T3,N,Pl9 L".> NB7°5708°W..-114QJ5.-.. . 2 saol N e7' 37' 06" W 1116 or^. S T R E E T o6. 2es.00 WOO B'P. 2 300 ~.p• dA 9 I w W ng a$ o, ~ h O 2 NQ a r w ao 331 sq. ft, 133, 951 sq. ft- x 13/,599 84 ft 133,951 9q. ft, J7 0~ ~p ■y, 285-00 260.00 90 206-00 - r Md7.57 p6"w 670.00 S` O 8 p 6X 171, 001 sq. ft. Ner•s7'oe"w • s7aoo t~. Ao ~m . aP 0 0 t° N 7 $ 159, 600 sq, ft. u~ T, N87.5705"W ew J 70.00 g o~ 8 a 8 ~ NN UN,R.19W Bg- I '~ps•. ° ~u 159,600 sq. ft ~ a7o.oo z IF, 1s Y 77 77 71777 ,r DOCUMENT NO. WARRANTY DEED nas s►acc RESERVED ►oR R[GORDINO 0174 -yC S/w0929 STATE BAR OF WISCONSIN FORM 2-1982 VOL 1093PasE495 REGli i 1,.fZ'S OiTi~;E r, Ss. CROM co., WI Richar-d.Mt..Hansen.and..Jane. A...Hansen, RxrdltxRe:ord hban4~.. and..)!r. fe SEP 1 1994 9:~pM ' conveys and warrants to ......interest.. and.. Richard.. 0-... Stout.. an2..Janet..p.,. -Stout A.......... f+leQsteraDeeOs husband..and..wife.a..a..one-half interest,I..as..Tenants.......... the following described real estate in Ste...rQiX............. County,,". - .r State of Wisconsin: 3 Tax Parcel No: Lots 4, 5, 6, 7 and 8, Block 2, Hansen's Turtle Lake Hills First Addition ' in the Tours of Somerset, St. Croix County, Wisconsin.' r' i~ 4 i ~ This i! . 11Pt........... homestead property. (is) (is not) sit Exception to warranties: easements, restrictions and rights-of-way of record, if any. Dated this day of ~i q. 1.: 4 . 19 94 i` r.:. (SEAL) _ G{/. Richard M. Hansen J A. Hansen)" •--••-.....------•--------...(SEAL) ....(SEAT.) ,a AUTHENTICATION ACKNOWLEDGMENT S Signature(s) ...._Richard M. Hansen, STATE OF WISCONSIN _ Jane A. Hansen ss. St. Croix y r dr ......County. y authenticated this ~y _._da o1..''t " 19.j._._ Personally came before me this day of 19 the above named r i'•._.._......_°_°--------•••-. Richard M. Hansen, Jane A. Hansen Kristin Ogland TITLE: MEMBER STATE BAR OF WISCONSIN 44 authorized b - (If not,_. person who executed the by $ 708.08, Wis. Stata.) to me known to be the who executed the foregoing instrument and acknowledge the same. _ THIS INSTRUMENT WAS DRAFTED BY Kristin Oglarld - Notary Public • . . --.-..County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.). date- 19......... ) •Names of persons signing in any capacity should be typed or printed below their signatures. WARRANTY DEED STATE PAR OF WISCONSIN Wisconsin Legal Blank Co, InC. ~ FORM No. 2- 1381 Milwaukee, Wisconsin