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HomeMy WebLinkAbout038-1096-95-000 -0 0 Z 0 3 o h ~ O o ~ ° I ~ I n o ~ O ' c N y6 a N ° ? O O a a -0 N U o C c Y N OQ An co E c a~ o O 0-0 c Y U 'D N s O N O ~ arnm C:, I 6 O C C z ~ N w 3 (6 O N N LL O 'O O) c '0 Z 3 c CD m 'o E :a Q c U M m ch 6. CO N F- ~ C z N U N Z 7 O !n I- r N ° z N E 'O `O M E 7 o a~ ~ N c • N L O C m O Z Z w z N ° Y C .0 M N co E C O I~ N > m h v° C m U CL ~a c LO O o a N (6 U) U) y Z c D F H f- 7 0 ~i o 0 0 0 d 0 Z •►v E a a a *i 7 ° N 3 `n `n ~~yy~, to U a~ _rn rn ° \i z z LO ti a~ ~ o 0 O 7 N O O 00 cr) O O E > Q m t a N O GO O NO 7 z I IMF O c N yl ° 3 w C? m F° ~ p y a7 co o Q M- ° N c ca - °s o _ N O o 0) W 12 C O N o S: 7 - co c s t' co C 0 ~ c a) CD r.- O CY) (D V) E co Y. O N (n IL N O O ~ r ~ d cc . m ro y a # « - 5 # ° a Mai E v c c 40 ~rww 1 A s O 6; v 9 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNERJ)~ P~o 0 Q ADDRESS / a <o a d Z~ J 'l, SUBDIVISION / CSM# LOT SECTION oZ~ T3/ N-R-W, Town of 'r av~ i ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM io ~y 1 ~ ~laJ+wp -750 j 3 'd ly a 9INDIC TEE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: ALTERNATE BM: P PUMP H CDPG TANK INFORPATTn~ Manufacturer: 7 Liquid Capacity: 7 Setback from: Well / .3 7 -2 House a O Other Pump: Manufacturer G qO-L~ Modell--&_ Sizett), y ~ Float seperation Gallons/cycle: abi, ~ Alarm Location SOIL ABSORPTION SYSTEM Width: 3 ~ Length ;2,5= Number of trenches Distance & Direction to nearest prop. line:. 41, Setback from: well: House U S Other ELEVATIONS Building Sewer /V ST Inlet. - ST outlet 9' ~6 PC inlet PC bottom Pump Off / Header/Manifold /D/, Bottom of system Existing Grade g9; Final grade 41") 3. DATE OF INSTALLATION: _ PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: 3/93:it ST. CROIX COUNTYtj ZONING,.OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that have inspected the septic tank presently serving the LLdr~j residence located at: 4...5 1/4, Sec. Q 3 T IN, R__~ 9 W, Town of _ar rattiw~~ Upon Inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. Last time serviced Did flow back occur from absorption system? Yes,4".No (if no, skip next line) Approximate volume or length of time: FA(-~)---gallons minutes Capacity: Construction: Prefab Concrete I)r_steel Other Manufacurer (if known).: /d o o Pc e Age of Tank (if known) : "r ap y N Y~ ~ O`er e `r C (S nature _c, U i S g (Name) Please Print (Title) (License Number) (Date) Form to be completed by licensed plumber (x.145.06, Wisconsin Statutes.) or Licensed Disposer (NR 113 Wisconsin Administrative Code) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requirements of ILHR-83, Wis. Adm. Code (except for inspection op i g ver outlet baffle). Name-~X Signature /MPRS 5/88 Wisconsin Xpartmentofindustry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No-: GENERAL INFORMATION Permit Holder's Name: [I City El Village ❑ Town of: State PI o.. PEPER, MARK CST BM Elev.: Insp. BM Elev.: BM Description: star PT Parcel Tax No.: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Benchmark p / 0,Cl) Septic ^ e CO , 00g SQ Dosing Aeration Bldg. Sewer Holding StIA Inlet ~~.TANK SETBACK INFORMATION St/ Fy Outlet S, tea TANKTO P/L WELL BLDG. Veritt Air Intake ROAD Dt Inlet 57~ Septic Xf}- NA Dt Bottom d, Dosing ter) >2- ,5 > NA HaaLef-/-Man. Aeration' Dist. Pipe Holding Bot. System P / } INFORMATION CT Final Grade Manufacturer Demand Model Numbed GPM TDH Lift I Friction System Head ^ Loss TDH Ft Forcemain Length /_~O Di a.Dist.Towel _ i0 " SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No_ Of Trenches PIT No. Of Pits Insi id Depth DIMENSIONS EN 1 N L IN Manufacturer: SETBACK SYSTEM TO P/ L BLDG WELL LAKE /STREAM INFORMATION Type O , HAMBER Moe Number: OR UNIT ~ System: Y i DISTRIBUTION SYSTEM er / Manifold Distribution Pipe(s) x Hole Size Vent To Air Intake [Hea d ength 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 Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: Star Prairie.23.31.18W, SW, SE, 240t4 Avenue ~ ~ C~ ~r~ 9tc i ,~l /111 ~.r ~~~,J v ti y' Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710(R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: 4 ~ SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code CO-UNTY ,C STATE SANIT RY PE IT # -Attach complete plans (to the county copy only) for the system, on paper not less than 8% x 11 inches in size. ❑ Check if revision to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. Z C1 S -L40 "7 5 PROPERTY OWNER PROPERTY LOCATION rn ti 11 Px~ 0 Q_ kZ P_%,S T31,N,R Mr)W PROPERTY OWNER'S MAILING ADD ESS LOT # BLOCK # CITY, STAT ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER N 1(7tS kit-t-079 tj 1p, II. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD ❑ State Owned ❑ VILLAGE : N-ToWN OF: STa r- prc.~ 'Clk ❑ Public W 1 or 2 Fam. Dwelling-¢# of bedrooms PARCEL TAX NUMBER() III. BUILDING USE: (If building type is public, check all that apply) 3 g - a 9 9.5 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 100 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. ❑ New 2. Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.0 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 2i` KMound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ 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 3 , .5 / .Z N14 /00, 7 Feet f©a `sFeet VII. TANK CAPACITY Site in allons Total of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tan structed Septic Tank or Holdin Tank 1 F2-- F] Lift Pump Tank/Si hon Chamber +^r VIII. RESPONSIBILITY STAT MENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plu ber's Signat e: (No tamps) NP/MPRSW No.: Business Phone Number: / 3~ (p s Plumber's Address (Street, City, State, Zip Code): 5 " Q : tnn~ Z-1~ 11.0-1 - M10 f_0 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate ssue Issuing A nt Signature No Stam S rcharge Fee) Approved ❑ Owner Given Initiallr4' 9 , / Adverse D termination 7 X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(R.08/93) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber J INSTRUCTIONS 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. 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 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 i 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) .i . i ~p'~ rtment of Industry, PRIVATE SEWAGE SYSTEM Safety and Buildings Division xan Relations Bureau of Building Water Systems •.-e_~'` REVIEW APPLICATION - f i Office La Crosse Office Madison Office Shawano Office Waukesha Office ' Street 2226 Rose Street - 201 E. Washington Ave. - 1053A E. Green Bay Street 401 Pilot Court, Suite C 3072 LaCrosse, WI 54603 P.O. Box 7969 P.O. Box 434 Waukesha, WI 53188 I 1 54843 Phone (608) 7859334 Madison, WI 53707 Shawano, WI 54166, Phone (414) 548-8606 5) 634-4804 Fax (608) 785-9330 Phone (608) 267-5119 Phone (715) 524-3626 Fax (414) 548-8614 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 kvhere your review was scheduled. Please call any of the listed offices if you need help filling out the form or a wins on what information to submit. PLEASE PRINT VERY CLEARLY. A sample of a completed form is on the reverse side for your referee 5 1. APPOINTMENT INFORMATION -if you have scheduled an appointment, fill in the information requested below to save time: AopQ nt ent mate' _ Reviewer Name Plan Identification Number 2. PROJECT INFORMATION If this review is a revisio or extension to your existing rN <; plan identification number, provide that number here. Project Name ❑ City ❑ Village N Town Of: County r ~icL Project Location V "a Y, I S~A1r ~r0.1Y`l~P GOVT. LOT 1/4 1/4 S T / N ,R or W 3. APPLICATION FOR 4. FEE COMPUTATIONS FEE SUBMITTED System type (check one): System Type t (include new and existing tanks) _ i Up To 1,500 gallon septic tank $110.00 J1,01 i 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 lrJ Non-Pressurized ln-Ground(Conventional) 9,001-15,000 gallon septic tank............. $300.00 _ P ❑ Pressurized In-Ground Over 15,000 gallon septic tank $500.00 O ❑ Other. Up To 1,000 gallon dose chamber $ 70.00 7b 1,001-2,000 gallon dose chamber ` 80.00 Building Type (check one): 2,001 - 4,000 gallon dose chamber $100.00 4,001 - 8,000gallon dose chamber $120.00 D N Dwelling, 1 or 2 Family 8,001 -12,000 gallon dose chamber . $140.00 P Public Building Over 12,000 gallon dose chamber $160.00 S ❑ State-Owned Building Up To 5,000 gallon holding tank $ 60.00 C O 5,001 -10,000 gallon holding tank $100.00 Code Derived Dail Flow ~ Y 9Pd Over 10,000 gallon holding tank $150.00. IYI Check If Replacing Existing System Experimental System (additional on~.. $ 300.00 T"Q Revisions To Approved Plane ..........A../ CIT. 60.00 Petition For Variance: Setback ...........1.. $100.00 Site' $225.00 ❑ Petition For Variance Plumbing $225.00 c i Revision $ 75.00 i Groundwater Monitoring Groundwater Monitoring - Per Site $ 60.00 (other than a proposed subdivision) l ❑ Site Evaluation in Lieu of 111 Groundwater Monitoring Site Evaluation in Lieu of Groundwater Monitoring $ 60.00 Subtotal: Priority Review: Enter same amount as Subtotal: MAKE ALL CHECKS PAYABLE TO: SAFETY AND BUILDINGS DIVISION Total Fee: 5. SUBMITTING PARTY INFORMATION Telephone No. (include area code & extension) CPany Name Co tart Perso ( 745) J16 - .513 i 1 ~6 Culp- 4,, No. & Street Address Or P.O. Bo City, own or V~lage, State, Zip Code 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 (R. 03/93) OVER dpa e of Industry, Labor and Human n Relations SOIL AND SITE EVALUATION REPORT Page of3 ' Labor Division of Safety Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Att ach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but %X PARCEL I.D. # not limited to vertical and horizontal reference point (BM), direction and /o of sloPa scale or , dimensioned, north arrow, and location and distance to nearest roa n APPLICANT INFO RMATION-PLEASE PRINT ALL INFOR R*5 4 0 7 5 EVIEWEDBY DATE PROP TY OW ER: P PROPERTY LOCATION 2 V GOVT. LOT SCJ 1/4 5 ,~5 1/4,S a3T .3,N,R /Y 1for) W PROPER OWNER':S MAILING DDRESS L T # BLOCK # SUBD. NAME OR CSM # a /4 W A. CITY, ST E ZIP CODE PHONE NUMBER CITY ❑ LAGE OWN NEAREST ROAD W r 10 :o ,?,do it [ J New Construction Use [ Residential / Number of bedrooms 3 [ ] Addition to existing building Replacement [ ] Public or commercial describe Code derived daily flow SD gpd Recommended design loading rate j_bed, gpd/ft2_&S trench, gpd/ft2 Absorption area required 37S bed, ft2 3 7 5 trench, ft2 Maximum design loading rate r bed, gpd/ft2 r -S trench, gpd/ft2 Recommended infiltration surface elevation(s) 0,6 ft (as referred to site plan benchmark) Additional design / site consider ' s 1•`(1 0 LL hck Parent material Flood plain elevation, if applicable lu/~! ft S = Suitable for system CONVENTIONAL RS IN-GROUND PRESSURE AT-GRAD SYSTEM I FILL HOLDING T OK U= Unsuitable fors stem ❑ S U S❑ U ❑ S U ❑ S U ❑ S U ❑ S U SOIL DESCRIPTION REPORT ~S' d 1 AL Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Bour>dary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tmrxh D .5 o S,' 5- Lj Ground 3/- 7 rjie'p, VA, a m 5.6' 3 y elev. Ca'7 ft: Depth to limiting factor Remarks: Boring # v;. ,...r ti a D' -~o AjM S/ C w y ~s aay SI 51 k, rn Ground elev. ft. Depth to limiting >fact_ orRemarks: CST Name:-Please Print n a I u n ~s Phone: 74 _ a y _ S x.35 Address: 9,6 Signature: Date.5-5-59-5 CST Number: PROPERTY OWNER o.1r~ N' SOIL DESCRIPTION REPORT Page of 3 PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench 1 6- ,U Ty k 51 1 5 C, Lo 2- 8:30 /o Drs` o? m s r C 1- , 17 Ground I/S GZa- 1 f S < rM - Y elev. ft. Depth to limiting factor 1z Remarks: Boring # Ground elev. ft. Depth to limiting factor i Remarks: Boring-# n4 4 Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. s®.. Depth to limiting factor Remarks: SBD-8330(8.05/92) F-( YN c k W ~ ~ r n I TT 9 410 7, q\ I eel ~o G ~ i X95 -40754 WORKSHEET - MOUND SYSTEM DESIGN PROBLEM: n Design a mound system for a The site characteristics are: 30 in. Depth to groundwater or bedrock, Landslope % Percolation rate Distance from dose chamber to distribution system ft. Elevation difference between sump and distribution system ft. Step 1. WASTEWATER GOAD aal k 3 Step 2. SIZE THE ABSORPTION AREA, A) Area required - -4/3 a /2 37.5 sq. ft. B) Bed or trench length (B) ft. C) Bed or trench width (A) ft. ;D) Trench spacing (C) ` Wastewater load .24 r..al/fr2/day B - tr ice ,2, S = 15 a Step 3. MOUND HEIGHT A) Fill depth (D) - 1 ft. B) FiIl depth (E) - D + slope ~gft. , 01 X-1~75~ C C) Bed or trench depth.(F) _ 193 St. D) Cap and topsoil depth (G) ft. E) ap and topsoil depth (H) _ S ft. i Ern : - t5iiL l ry) S95-40754 Step 4. MOUND LENGTH A) End slope (K) = D'+ E + F + H x 3 = ft. C- 2 ) _ 4 93 B) Total mound le (L) = B + 2(K) a 83;,.,,, ft. Step 5. MOUND WIDTH ' Al.) Upslope correction factor = 9 ~ A2) Upslope width (J) (D + F + G (3)(factor) ft. ( ,03 Bl) Downslope correction factor = 82) Downslope width (I) _ (E + F + G)(3)(factor) ft. C,i934 3 X 1, o3 • CI) T -a'f"mc~un width (W or bed = + A + C2) Total mound width (W) for trenches = J + + (no. trenches -1)(c]) + A + I t. 4- - S-Sy Step 6. BASAL AREA A) Infiltrative capacity of natural soil gal./ft2/4ay B) Basal area required = wastewater flow natural soil infiltrative capacity = sq. ft. 15o .1y = tI,?-r C Basal are available bed for ing si = B A+ q. ft. 7 C2) Bas are avail le for trench for sloping sites = B W Zi + A sq. ft. ~ .J for le fJY'BapT"area available f rench or S-t s x W = sq. ft. Si tn: License Ku: _ Datz).-----. '7 'Step 7. DISTRIBUTION SYSTEM 7A) SIZE DISTRIBUTION SYSTEM S95-40754 1) Hole size = in. 2) Hole spacing = in. 3) Distribution pipe length = .3 i"l-f-I 4) Distribution pipe diameter = li_ in. 5) Spacing between distribution pipes /5. 6) Distance from sidewall to distribution pipe Al in. 7B) DISTRIBUTION PIPE DISCIIARGE RATE ft. 1) Number of holes per pipe = S 2) Flow per pipe GPM 7C) SIZE MANIFOLD 1) Manifold is central/ end 2) Manifold length ft. 3) Number of distribution lines = 4) Manifold diameter = in. 7D) SIZE FORCE MAIN 1) Minimum dosing rate = GPM r 2) Force main diameter = 3 in. 3) Friction loss = _8/ - s 05 ft. idb - 7E) TOTAL DYNAMIC HEAD 1) Vertical lift = / D ft. 2) Friction loss = U5 ft. 3) System head 2.5 ft. a'-S ft. 4 Total dynamic head ft. .Lice rsE:_/S(_~~1 S95-40754 1F) PUMP SELECTION 1) Pump selected will discharge GPM at ft. total dynamic head. 2) Pump model and manufacturer / 3825 G,3A Wi 03114 7G) DOSE VOLUME 1) 10 times void volume of distribution li es gal./cycle /o XC / o9axc/ X~a'5- 2) Daily wastewater volume : 4 doses/24 hrs. _ ~-3 gal./cycle .2 3) Minimum dose volume y v~~ gal./cycle 714) DOSE CHAMBER 1) Minimum capacity required gal. Dicunso .:u:_ Date t3'a AAA f CIA Q CIA "A Q ' A r7 CZ n/ L D ~a X~ E ~fS 0 R ~ S PageO 4 S95-40754 _ traw, Marsh Hay, or Synthetic Covering Distribution Pipe Medium- Sand H G srrsir~: -----------I' F Topsoil E D 3 i a ra' Force Main `Plowed Layer Trench of Y'-2V t% of slope Aggregate Undisturbed Soil Cross Section Of A Mound System Using 2 Trenches For The Absorption Area DFt. A .3 Ft. E t. B , _Ft. F~/ Ft. C~ G Ft. G---~--/~ Ft. K Zp* 2!o Ft. Ft. _VA .L g3. ~°'t' Ft. C J ova Ft I Signed: ~U`~'~ I 3 Ft ~y License S1Q V► E Date:' ] 7 -`~,S 3 LAa~p .HU~G3^ ISO Position of po"~~~ Force Main L~© C OF, r Observation I r.z W Pipes I Permanent Marker- - I _ Distribution \Trench of 11"-211" Pipe Aggregate I ,J Mound Using 3 Trenches For Absorption Area j Poo 2 r. *10" ' 595-40754 Perforated Pipe Detail End View PuforoUd p ti ~J End Ca PVG Piptt ~ } s Ot~~\~`• 7 H01#. e01e4O1180f1'OT~ Art1, Equotiy%Spao.d ai yt'.;' . S f 1. Q Y f. :rN`` PVC Force Moifr 5 . Q PVC Monlrold, Pipe kr, 0 • b fti AlNrnole PoellJon Of ~ tri Oft Pipe force Main . } LGO'Kile SAout4 Be r; Wsst U End Cop Y. End Cop J Dittribulion Pipe Layout F: P 31_Ft. 1 . • •t .h 14- , < , y X InchPS,. U Y Inches Y= Zl Signed:- Hole Diameter Inch Lateral " , /3 Inch(es) License Number:. S`fv 't, s. T- Manifold " ••3 inches Date: force Main " Inch' # of holes/pipe 45 eoa a ksAnvert El of Laterals Ft 1ran,w.~y► t . j ra 1 pag4.f /D 0 " r' M ' to P. P. \ 0 to N _ W CIT x A N rt r rt p . ~t mss. H fi ~ . ~ v O j1 A 1 x IN o S ~ , II ~ a%jo 3 ~I ,K is ~ c~ 1 , PUMP CHAMBER CROgS gPAGE OF/6 EC710fJ At~O SPECIFICAT►O~1S VCWT CAP ✓ 5 ~ 4 OJ p~ V y '1"C.I. VENT PIP[ WCATHER PROOF APPROVED LOCKING ZV FROM DOOR, JUNCTION BOX MANHOLE COVER WINDOW OR FRESH WMIN. AIR INTAKE I GRADE I ~ `1" MIIJ. 10°/IIN, COUDUIT L-- IB"MIIJ. fAl1.,F:T PROVIDE AIRTIGHT SEAL I - - I ICI APPR.O`JED JOINT A ' W/ C.1. PIPE. EXTENDING. ' APPROVED JC ONTO SOLID Sc::, ( I W/C.I. PIPE . k ALARM EXTENDING C y~z •;,S • I I I ONTO SOLID t21~uS~~~+ ON lip PUMP---_ D OFF CONCRETE BLOCK RISER EXIT PERMI-ITED OIJLy IF TANK MANUFACTURER HAS . SUCH APPROVAL SEPTIC AND SPECIFICATIOMS DOS- E--- TAQ KS MANUFACTURER: Z: ii~ TANK SIZE: IJUMBER OF DOSES: GALLONS PER pAy ALCM MANUFACTURER: DOSE VOLUME INCLUD!!!C MODE BER C^t::FLOw:_ L ►JUM : o GALLON SWITCH TyPL: CAPACITIES: A= INCHES OR GALLON. PUMP MAIJUFACTURCR: C E H B -INCHES OR 1 7 GALL Ot ( i fl JE' ~1 MODEL IJUMBER: I "I ,I 50S i~ C G,IAICHES ORLL Q, ' SWITCH TYPE: /7, D'-- INCHESOR~CAL014J~ PUMP DISCHARGE RA'T'E ---~a NOTE: PUMP AND ALARM ARE TO BE r. P M, INSTALLED OIJ SEPARATE CIRCUITS VERTICAL DIFFERENCE D +ICCU Pu P a FLAN TR B TIOW PIPE., " FEE 7 17i g5 + M1M11AUM MET WORK SUppLy PRESSURE , -I' FEET OF FORCE MAIN x ,8AI 2 5 FEET Fj i I~ ioorr.FRtCTlO11 FACroR.,_ FEET art. ~7 FEET TOTAL DYNAMIC. HEAD 11JTERNAL, RIMEIJSIGNC OF TAIJK; LE 'U ~ N G T H ;WIDTH . 70~ ~ ,LIQUID DEPTH SIGkIE D: LICEt\1SE 1JUM8ER: -117- DATE: i. LE 1 ~ Y GOULDS SUBMERSIB WAGE. AND EFFLUENT PUMP'S S95 --40'754- I= DISC. EP0311 p3UPEF0311 142 EP0311 1/3 HP 115 V Effluent P►77Q 1/2" solids F56.60 172.10 Submersible MODEL EP0311 pt Y Effluent. Pump SIZE 'A" SOLIDS METERS FEET 3- , $v 25 ~ ,4 w , 20 f I J xt41 t~ e:. ti:, c 10 fts 2 r ~ 0 00 4 S 12 16 20 24 2e 32 GPM 40 5.0 7.5 MIN 2.5 0 CAPACITY r Performance e i 385 r ^ ^ Curve fi Y NLTillf f[LT it MODEL 3885»►-~ SIZE/+" Solid ' 2s eo y F. K; c ~10 I f. 4 l.~H . WE07H•• tiof k . C 'E F r- ROSH Yx1~d f~P' 10 70 WE. _ St WE03L A 10 0 EO 70 s0 W 100 ' 110 • 170 OPIN 'a 7 f0 20 70 DISC. LIST } ,3/4 solids 491.55 329.35 Y f , :ter (1dUPYfE0311I. 142 WFA311L 1/3 HP 115 V IoM H 3%4" solids 491.55 329.35 OMWWE031114 142 WE0311M 1/3 HP 115V Mod H r 3/4".ablids 304.25 4.1;85' 1p~►a ' 'S' (30tlpYri0511H 142 WEOSIIH 1/2 IM 115 FU;h H ;/4„ solids A4] 65: 565.25 apglpWE0712H 142 NE071i11 3/4 HP 230 V High Hd Mvw~ 5 t •**~+SEE pdL1i0WING PAGE FM PFRFCTiMANCE ACID SPE7C IFICAITCNS. PAGE 07U ?H "r s' Ok3'P 30 D= 10/88 r-11 1Z J J1 DEC 6 '+e+ o4~ FSe~ 0. 1916 ca V iJ aJ aJ ° fCD NI~F S l j , CA r 1r Cc eed+ M\ w17GO,c unt, CERTIFIED SURVEY MAP s I. Arthur L. Wegerer, registered land surveyor, hereby certify: That in full compliance with the provisions of Chapter 236.34 of the Wisconsin Statutes and the provisions of the St.Croix County Subdivision Ordinanee and under the direction of Paul Larson, owner of said land, I have surveyed, divided, and mapped said parcel of land, that such plat correctly represents all exterior boundaries and the subdivision of the land surveyed; and that this' land is located in the Szl of the SE4 of Section 23, T 31 N, R 18 W, Town of Star Prairie, St.Croix County, Wisconsin, to-wit: Lots #1,2, & 1: Commencing at the SE corner of Section 23; thence S 89°57'00" W along the South line of the S`E4 of Section 23 a distance of 1875.65t to the point of beginning; thence continuing S 89°57' 00', W 450-001; thence N 0°18,00" w 323.40'; thence N 89°57'00" E 450.00'; thence S 001810011 E 323.40' to the point of beginning. Lot #4: Also commencing at the SE corner of Section 23; thence North along the East line of the SE4 of Section 23 a distance of 200.001 to the point of be inning; thence S 89°5710011 W 288.001; thence North 227.26'; thence N 89°5710011 E 288.00t; thence South 227.261 to the point of beginning. Dated this 9th. day of August, 1976. 0,4w Dittloff Engineering Co. Arthur L. Weg rer River Falls, WI. 54022 Wis. R.L.S. No. S-963 N 89°57' E 288.00' _ o - C X 24" IRON PIPE WEIGHING 255.00 33, 33' . V 1.13 LBS./ LINEAL FOOT 00~, 9h~ t0 cj N ~iann~Rnrir~~i • - IRON PIPE FO,Il1Q16 Q IVS N ti o~ ti LOT 4 N N N . , N ti C ARTHUR L. N 1.503 ACRES C WEr' F?ER _ • S•963 ELLSWORTH O NORTH WIS. O cn Z 0, 0°, 255.00, 31 331 SCALE IN FEET Q~SUS 89057 W 288.00' 100 50 0 50 100 N N 89° 57' E 450.00' W e90 150.00' 150.00' 150.00 0,h W O _1 O F O cn o LOT I LOT 2 LOT 3 o N W qt - - - 4r M 1.114 ACRES 1.114 ACRES 1.114 ACRES N p 3 O N M ct 3 co -d M = m OD O O m 0 W O 3 N O 0) N O 0) z N O Z OD N O Z o O O O O S.E. CORNER Z to SEC. 23-31-18 150.00' 150.00' 150.00'~90 41. . 0 TOWN M 9~ 150.00 r' 150.00 150.00 , M S 89°57 ' W ROAD S 89° 57' W 450.00 _M 1875.65 • This corrects C.S.M. in Vol. 1, P.i SOUTH LINE SEC. 23 V,!,lumF - a =e 333 " STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNERBUYER MAILING ADDRESS 24 / a ~ a o7 ~ d cY-Q- . PROPERTY ADDRESS R'.~'-Yvm S' D / 7 (location of septic system) Please o tain from the Planning Dept. CITY/STATE S /YI~C PROPERTY LOCATION S w 1/41 S 1/4, Section -3 , T 3l N-R /91 W TOWN OF v~ ► r P ST. CROIX COUNTY, WI SUBDIVISION /V AL) LOT NUMBER CERTIFIED SURVEY MAP , VOLUME , PAGE LOT NUMBER I 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 j 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 an d _(2) after inspection and j `pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I 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 med to the St. Croix ! County Zoning Officer within 30 days of the three year expiration date. SIGNED: DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 i I i S T C - 100 .This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will I only result in delays of the permit issuance. Should this i 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. 1 Owner of property V` P Q- Y^ Location of prop Prrck-tn-,o ty~1/4 1/4, Section ,T~LN-R 1 W Township S-+g v Mailing address J _a IQ- d~ Address of site Subdivision name Lot no. Other homes on property? Yes No Previous owner of property (J" K ca -Q- Total size of property Total size of parcel Date parcel was created ~.~.y-, - 0 y - v - Are all corners and lot lines identifiable? -4-Yes No Is this property being developed for ('spec house) ? Yes No Volume /683 and Page Number 3~(O 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. 86 7(-~ 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. 2 u F ig ature of Ap icant Co-Applicant Date of Signature Date of Signature DOCUMENT NO. STATE BAR OF WISCONSIN '(1RM 3- 1982. THIS SPACE RESERVED FOR RECORDING DATA 518076 QUIT CLAIM'DEED Tipl SIT. CROW VA : r >tEx Re»sxd Mark D. Peper` and BethAnn Peper, husband and JUN 2 0 1994, i-~ quit-claims to M►_><__ D.__ Piper and BethAnn Peper, ~i' ..husband--and__w fe_,___tak ng---ti-tle_ as. survivor....... • ship-.marital_..prope>~ty......... 1 rs~T a l! the following described real estate in St- CrAiX County, State of Wisconsin: RETURN TEETERS. NELTQN LAWYER X$69 BALSAM LAKE, W1. 54819 two.. -r.Tax-Parcel No- Lot l Of Certified Survey Map filed December 6, 1976 in Volume 2, Certified Survey Maps, page 333, as Doc. No. 336991, being part of the Si of SEa in Section 23-31-18. r~ The sole purpose of this deed is to create a survivorship.mari.tal ~T interest in the parties. - .This is homestead property. (is) Olietxatk Dated this ••-...15th.... day of` ....................June 1994.:_. --=-•----(SEAL) ...lC.I.L~ ............................(SEAL) *Mark D. Peper *BethAnn .Peper •--.....:..........(SEAL) (SEAL) . , • - * AUTHENTICATION ACKNOWLEDGMENT Signature(i) X ...D.... Peper..and STATE OF WISCONSIN`. BethAnn Peper ss. County. authenticated this-1-5 ..day of........ JUne......... 19-9A, Personally came before me this ................day of- , 19..-- - - the above named j= - - 40- , 'j! i - - - a` TITLE: MEM . BER STATE BAR OF WISCONSIN. (If not, authorized by § 706.06, Wis. Stats.) to me known to be the person who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY ~.~tal~.. S Nelton ...Lawyer aa(ft,10 W...................................... sconsin 54810__ Notary Public. County, Wis. (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) date: 19......... ) QUIT CLAIM DEED STATE BAR OF WISCONSIN Wisconsin Leal Blank Co. Inc. I L ORM No. 3 - 191411 AM--k.. Wi.