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STC - 104
AS BUILT SANITARY SYSTEM REPOR±
^~r~ rte? n,
OWNER
ADDRESS o2 d mJ,41 g Ua ee A2-4
'el~qy -a
SUBDIVISION / CSM# LOT #
_T_N-RW, Town of7-k-~
SECTION
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SH EVERYTHING WITHIN 100 FEET OF SYSTEM
a
.Ilar~~ ? 5 D ~ U v
~L
~ a
v
INDICATE NORTH ARROW
s
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
d'
BENCHMARK:
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer:
v Liquid Capacity:
Setback from: Well . U
1'r~ House s'o
Other
Pump: Manufacturer
Model#- ?,F7-- Size
Float seperation
Gallons/cycle: l3-a
Alarm Location
aa. ,9
':SOIL ABSORPTION SYSTEM
Width: ~Length
Number of trenches
Distance & Direction to nearest
prop. line: Setback from: well: /'40 House /de `
_ other
ELEVATIONS
Building Sewer
ST Inlet; ST outlet
PC inlet PC bottom
Header Pump Off
/Manifold Bottom of system
Existing Grade
Final grade
DATE OF INSTALLATION:
PLUMBER ON JOB:
LICENSE NUMBER:
INSPECTOR: r
3/93:it
s
Wisconsin Departmgnt of Industry, PRIVATE SEWAGE SYSTEM County ST. CROIX
L Labor and-Human Relations INSPECTION REPORT
Safety andBuildings Division (ATTACH TO PERMIT) Sanitary Permit No.:
GENERAL INFORMATION
Pe:~rmit Ffp91y~§9& , BERNARD & AMY ❑ City ❑ Village Town of: State Plan D o.: Irrnv CS~TBIMKEEllev.: Insp_ BM Elev.: BM Description: Parcel Tax No.:
173
d~ G !GlJ, C~ ate r ? ~g ` l
_
TANK INFORMATION ELEVATION DATA 4_
TYPE MANUFACTURER CAPACITY STATION BS HI ELEV.
Benchmark 3.1131 /G
Septic _ILA ; r / a
Dosing
NTA ion Bldg. Sewer /.c
ng St W Inlet q ~ I dom.
K SETBACK IN FORMATION St/~t outlet le% "Ca
TANK TO P/L WELL BLDG. vent to ROAD Dt Inlet
Airlntake
Septic NA Dt Bottom ss D.
Dosing j~v' lU SS ~NA r / Man. 5.~5 9 7, /
S,
Aeration Dist. Pipe } = 9 7
Holding Bot. System Cam, o.s3
PUMP)-Si NFORMATION Final Grade
Manufacturer ~QcS ;Demand
ModelNumber~tG
oss
TDH Liftf,, Friction Systemf.,:_ TD Ft
Forcemain Length Dia.' Dist.Towell
SOIL ABSORPTION SYSTEM
BED / Width . Length i No. Of Trenches PIT No. Of P Inside Dia. Li th
DIMEN I N ~~7 DIMENSIONS Manufa r
SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACHING
SETBACK CHAMBER Mo I Num er:
INFORMATION Type o U 14- OR UNIT
System: r-cif l
DISTRIBUTIONS STEM
/Manifold C „ Distribution Pipe(s)/ x Hole ize x Hole Spacing vent To Air Intake
Length. Dia Length Dia ! Spacing
SOIL COVER X Pressure Systems Only xx Mound Or At-Grade Systems Only
Dept h Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched
Yes ❑ No ❑ Yes ❑ I
Bed /r~C>=nter Bed /midges Topsoil ❑
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: Troy.16 28.19W, SW, SW, ownsyalley Road
.`_lT--' l -C.xi. ' 4 T~./ L<- ~ 7'C_ / _ ~ ~_.//y1/'O✓~'r" ~~"C.l (V:-~ ",i ~ s ! ~Y`"-~L~'
Plan r4vision required? ❑ Yes ~►40
Use other side for additional information. 7 J
SBD-6710(R 05/91) Date Inspector's Signatur Cert. No
'
ADDITIONAL COMMENTS AND SKETCH
j ,
SANITARY PERMIT NUMBER:
~ c~~y z-~~~' Gtr h
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 r
than 8112 x 11 inches in size.
Permit Nu ber
• See reverse side for instructions for completing this application State Sanitary !,~J 3
The information you provide may be used by other government agency programs ❑ Check it revision to previous appli ation
[Privacy Law, s. 15.04 (1) (m)]. State Plan LD. Number
I. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION
Property Owner Name Property Location
4~ a W 1145-W _1/4,S 1(:' T, ,-,F , N, R /Q E (or W
N
Property Owner's Mailing Address Lot Number Block Number
City, State) ip Code Phone Number Subdivision Name or CSM Number
yd ( ` )
II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ ity Nearest Road
❑ Village
❑ Public 1 or 2 Family Dwelling - No- of bedrooms , ? 90 Town OF ti
III. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s)
c2 a <fa- /oG6-lG? s0 F
1 E] Apartment/ Condo 11 2 El Assembly Hall 6 E] Medical Facility/ Nursing Home 10 Outdoor Recreational Facility
3 E] Campground 7 E] Merchandise: Sales/ Repairs 11 E] 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. Io Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an
System System- _______Tank Only______________ Existing System _____ExistingSystem
-
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 M Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 ❑ Seepage Trench 22 ❑ In-Ground Pressure 42 ❑ Pit Privy
13 ❑ Seepage Pit 43 ❑ Vault Privy
14 ❑ System-In-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc- Rate 6. System Elev. 7. Final Grade
Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft-) (Min./inch) Elevation
10410 0; •S /ZsGr. ~l` Feet 11, d meet
VII. TANK Ca clt
in ga Ilons Total # of 's Name Prefab. CoSite n- Steel Fiber-
ass Plastic xppr-
INFORMATION New Existing Gallons Tanks Manufacturer concrete strutted g
Tanks Tanks jLj2E1 Septic Tank or Holding Tank d( 4fl 0 A1❑ ❑ ❑
Lift Pump Tank /Siphon Chamber 1Sd'`,W4)e,s 7~~ ❑ ❑ ❑ ❑
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite se age system shown on the attached plans.
Plumber's Name: (Print) Plumber's Signature: (No Stamps) V/MPRSW No.: Business Phone Number:
,`lli'a I- aA&M 44ec A`
Plumber's Address (Street, City, State, Zip Code): _
d e S~
IX. COUNTY / DEPARTMENT USE ONLY
uing Agent Signature (NO Stamps)
Iss
❑ Disapproved Sant y~ry Permit Fee (Includes Groundwater Ez:~
Surcharge fee) [ 4pproved ❑ Owner Given Initial QM6 j~ Adverse Determination o~u
X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL:
SBD-6398 (R. 05/94) DISTRIBUTION: Original to County. One copy To: Safety & Buildings Di-ion, Owner, Plumber
INSTRUCTIONS
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit may be 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 v,henever
necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of
Wisconsin, Safety and Buildings Division, 608-266-3815.
To be complete and accurate this sanitary permit application must include:
1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the
system is to be installed.
II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling.
III. Building use. If building type is public, check all appropriate boxes that apply.
IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair.
V. Type of system. Check appropriate box depending on system type.
VI. Absorption system information. Provide all information requested for numbers 1 through 7.
VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, numb,.ar 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 experimenta' 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 8 112 x 11 inches must be submitted to the c(-u,,ty. The plars must
include the following: A) plot plan, drawn to scale or with complete dimensions, ocatior, of hc,lcling tank(s), septic
tank(s) or other treatment tanks; building sewers; wells; water mains/water serric~!, streams aril lakes; pump or siphon
tanks; distribution boxes, soil absorption systems; replacement system areas arc 1.1-ie locat;cn of the building served;
B) horizontal and vertical elevation reference points; C) complete specifications ff- r purips anc controls; dose volume;
elevation dif{erences; friction loss; pump performance curve; pump model and Pump mar'ufa( .arer; D) cross section
of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information.
GROUNDWATER SURCHARGE
1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can
effect groundwater.
The monies collected through these surcharges are used for monitoring groundwater contamination investigations
and establishment of standards.
U LB A I C HT & ASSOCIATES CO. Reg. Designers of Engineering Systems
655 O'Neil Road • Hudson, WI 54016 Private Sewage Consultants
715-386-8185
PROJECT INDEX C~b/Qiy~~ pCV,v~►S - T/iK /POSE
E A-K~~vs
DILHR Plan I.D. # S95-01427 Date !995
- May pg&V Owner Bernard & Amy Christensen Phone 715-425-6081
Address 320 Townsvalley Rd. River Falls Wis. 54022 11 Legal Description Tax Parcel # 040-1066-10. Meets & Bounds survey.
SW 1/4, SW 1/4, Sec.16, T28N,'T,R19 W
Town of County St.Croix
C.S.T. Installer
Robert Ulbricht CSTM2482
Local Authority/ Supervision
St. Croix County Zoning Dept.
PROJECT ASCRIPTION Replacement system. For a 3 bedroom home.
Estimated daily wateflow: 450 gals.
Soils are permiable (.5 GPD/ft2) but seasonally wet at 2811.
The available replacement area is not very long, and it will
need to be carefully cleared of brush & vegetation. A few lg.
trees will need to be carefully logged off without disturbing
i
the soils.
A conventional mound system using 12" sand fill is proposed.
Existing (non code compliant) treatment tanks (2) will be
properly abandoned per ILHR 83.03(2). 1
Pg.l PLOT PLAN VIEWS
Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWS
Pg. 3 PIPE LATERAL LAYOUT 5~;1$`D6~•
Pg A DOSING CHAMBER CROSS SECTION
Pg. 5 PUMP PERFORMANCE SPECS CuprNSl''''
t: ao w.
UWise a 1
~~SIG
~mnoa~
95-0 IL42
Any use of this POWTS design by any licensed plumber, or any
related unlicensed parties or persons (excavaters, laborers)
shall not be construed as an assumption of responsibility by
the designer for the workmanship, construction, placement,
substitution or selection of any components not specified, or
any assumptions by the plumber tha_ any unspecified components
are state approved or proper, or the effects of poor judgement
if working under adverse damaging weather conditions (wet/frozen
soils) by any such parties or persons.
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DEo ~F % ro
A55Q~S,o~'E
T~ISTRi(3uT% 00
G, TN,GkaE"S9 pip IN) 6-
So( rEM of T°P L E 16VA rioA3
u 14.35
V O i FORM TOE- ut "
1 I JU E 9 Z, O ,u L cc RATIO MEV.
' 5AuD
~J-
uu FORM
FORCE"
17 % S l o p E HAW E l Ei,llTlvf~ UO VER M hi BEV R 5.3 5
1.0 Fr. ELEVhTIO►J 5
~FG . ~S
E 2.0 Fr. ItuvER*r of I-y_ lATERA(5
F . TU_ FT Top of Rock
.77
• Top of l y I ATER A I S H 5 FT.
rPL A W VIEW, OF MOU-0D wirtt LED
FvRc.E MAiAJ A $ FT.
L°'tlt%, IIr HUMAN RELATIONS -7 4 OF SAF AA_64_0 . Btffl "is
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CORRESPONDEgCE I I... -I l
FT
w
0 w 3 2 FT-
BEV of !/2-"
To I .
PVC cAppED A 51PFgATE
d 135E R VhT1 o,~t
pipES
-►14'
PERMAAJ EuT MARKERS
ArL w hs r~ y.~U REcquiRED BASAL INReA •v Flow y'O U _ y - -
Soft- 1010TIRATIOE C" at. Fr,
AfAci ry
oPOSEd (3ASA4 ARel~ t PR Z •Z2-
F T, C
-VEUT CAP
APPROVED
VEPJT PIPE WEATHER PROOF LOCKING MANHOLE COVER /A /
JUAICTIOIJ BOX W/ 1A) 13E 25' FROM DOOP„ 12"MI►J.
WjUDOW OR FRESH
AIR mTAKE L-
IE U,T71OA] GRADE I 4" M10. ~/'AD I
JJ I ~ IB" MIAI.
COIJDUIT
9g S° y.o
l~ U,4 rr o,,, 11~ - -
PROVIDE I IIJLET AIRTIGHT SEAL I III
I I
J~d V I I I i APPROVED JO11JT5
q7' I K I II /C.I. PIPE A PPROVED JOINT 'f A W INy~ar ,~pIA - EXTEIJOIIJG 3'
1J/C.I. PIPE 1 . I III ALARM OUTO SOLID SOIL tXTFMDIIJG 3' O I II (1)
OIJTO SOLID SOIL B I •y `6N
I I OKI
• l'Q C I, I r ~,•t~l
QZ 7 swFt~i Yaki 1 Ikd _Y MP
ELEV. FL i OFF
GT
RIStR EXIT PERMITrED OULy IF TA►JK MANUFACTURER HAS SUCH APPROVAL
SPECIFICATIOIIS
SEPTIC E
DOSE A4, '>1Vf_ 1rbRA) 10A 4OR 157 ~o • ►JUMBER OF DOSES: PER DA4
TANKS MANUFACTURER: //i-
TAMK SIZE. 75'b GALLOlJS DOSE VOLUME lie GALLONS S. T F_LEc,TJ!C.> INCLUDING BACKFLOW:
ALARM MA,JUFACTURER: ' I - d I+ CAPACITIES: A= I~1P INCNES OR GALLOMS
MODEL I.IUMBER: ' - _ Z- INCHES OR f ~•'7 GALLONS; '
SWITCH TYPE: /-tERGJIeY FEAT 8 (I~. 6 O O L D C- GINCHES OR GALLONS
PUMP MANUFACTURER: 3985 WED 311 L D= 15 INCHES OR 1 GALLONS
-15 MODEL NUMBER: C.k F/0147- 5WITCH TYPE: ~15~yQ~ NOTE: INSTALLED AONRSEPARATE CIRCUITS
MINIMUM DISCHARGE RATE--f-GPM ~J3f -1-AA)k S~~CS • FEET VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE..
2.S FEET E~a~~n ° P
+ MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . .
+ 2s FEET OF FORCE MAIN X Z.df-FYoir.FRICTIOU FACTOR.. FEET -ItT'40AIS ~lj• Al~
TOTAL DyIJAMIG HEAD F E. E T ~ N
(c' g" LIQUID DEPTH
INTERNAL DIMEMSIONS OF TANK: LENGTH S --;WIDTH
rUj b=1~ f~ ~i -r a <
- i-). . 30-c 5 _
DISTRI 13oT I oi1/4.3 pipE 1.) E1woRk LAyour
__----\
P K\r)
__---
----
_--
____------ \
0 el-I.
\51' .....
\
R g. 0 Fr
X ti?
wcNE5
FoRcE- A4 Aito
2.5 Fr.
of-
( VARI'A6LE
/ PIST/ JCL
TOTAL VOID UolUME Gals .
HotE Di'AmE-ra---R (4/
i-A-TEE.A-L. " -,./
IcES
Pli API it koii Itif L
DEPT. OF INDUSTRY, L'IBOi, & HUMAN RELATIONS
MAK) IFOLD 2
I).JC ft E'S DIVISION OF SAFETY AND BUILDINGS
FOPCE MARI " 2._ I ?f164,,,,A.0444------ 24,-..11
fJci-(E-
, SEE CORR e SPONDENCE
4-P. of [10Ie5/ pi pE 13
lovERT- ELEVATIO0
OF LATER/NIS
'DE TA‘' I- a',it: cAP
PiP
PER FoR 1'1'1E2 0 4-1
\ \ I
• ReMovE MI Rli i BURRS ---/--
.
* HOES I OC AT E r) 0 A) C9 TT
-- — °PA ) EqUAily SPACE !) .
DiSTRiBuTtom DiSchm2 CvE RATE FOR EAch L ArER#11--
PR °VS /c. 2/
&AL / mi',O •
TOTAL D (sTRiBoTioo Discil"NRE RATE PoR
f
/0E-T WOR K- 3 0 . 1/ 2. I
G-ALImi',0 . e .2.5 mi. mu AA
lie/VD .
Submersible
Effluent Pumps
3885
AVAILABLE CERTIFICATIONS
ETL LISTED SUBMERSIBLE PUMP
CLASS I AND 11 DIV. 2 AND E
CLASS III DIV. 1 AND 2
ETL TESTING LABORATORIES, INC.
CORTLAND, NEW YORK 13045 G1086131480
CANADIAN STANDARD ASSOCIATION sP
PERFORMANCE RATINGS (gallons per minute) MODELS
WE0511H WE0511HH Series HP Volts Phase Max. Amp. RPM Solids Wt. (lbs.)
series WED512H WE0712H WE1012H WE1512H WED512HH WE1512HH WE0311L 115 9.4
No. WE0311L WE0311M WE0532H WE0732N WE1032N WE1532H WE0532HH WE1532HH WE0312L 230 4.7 1750 56
WE0312L WE0312M WE0534N WE0734H WE1034M WE1534H WE0534HH WE1534HH WE0311M /3 115 9.4
MP y, y3 1/2 3/a 1 1'/z '/2 1'/2 WE0312M 230 1 4.7
RPM 1750 1750 3500 3500 3500 3500 3500 3500 WE0511H 115 13.0
~5 100 70 80 90 106 - 60 - WE0512H 230 6.5
i _t0 80 65 76 87 102 112 56 84 WE0532H 208/230 3.4
1 15 60 51 72 84 100 108 53 82 WE0534H 460 3 1.7 60
20 36 45 65 79 95 105 48 77 WE0511HH 115 13.0
-25 25 59 74 91 100 45 75 WE0512HH 230 1 6.5
w 30 50 67 85 96 40 72 WE0532HH 208/230 3 3.3
35 40 61 79 92 35 70 WE0534HH 460 1.65 3/4.
8 40 26 52 72 86 30 67 WE0712H 230 1 1Q.0
45 10 43 64 80 25 64 WE0732H 3/. 208/230 3 5.4 3500
30 54 73 18 60 WE0734H 460 2.7
10 2 .55- 17 42 65 12 58 70
WE1012H 230 1 12.5
. _-60 6 30 54 3 54 WE1032H 1 2081230 7.0
65 16 40 51 WE1034H 460 3 3.5
70 5 26 47 WE1512H 230 1 15.0
75 14 43 WE1532H 208/230 9.2
-80 4 40 WE1534H 460 3 4.6 80
90 33 WE1512HH 1 Y2 230 1 15.0
10 00 24 WE1532HH 208/230 9.2
_110 15 WE1534HH 460 3 4.6
120
metal parts, BUNA-N
elastomers. METERS FEET
• Temperature: 1600 F (710 C) 90
maximum. _ MODEL 3885
• Fasteners: 300 series 25 80: SIZE 3/4" Solids
stainless steel. wE,SH
• Capable of running dry 70
without damage to 20- WEIGH
components. 0 a 60WE0~ TH~'~~ -
_ 5T
Motor: _
• Single phase:'/3 HP, 115 or a 15 50 `j
230 V, 60 Hz, 1750 RPM; 0 40 wEOSti gym/
'/2 HP, 115 V, 60 Hz, } - -
3500 RPM;'/2 HP through 10 30 wEO
1'/2 HP,230 V, 60 Hz,
3500 RPM. 20 wEQ
Built-in overload with 5
automatic reset, class B 10 }
insulation.
• Three phase:'/2 HP through o o -
1'/2 HP 208/230 V, 460 V, 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM
60 Hz, 3500 RPM. 0 110 20 30 m3/h
Class B insulation, overload CAPACITY
protection must be provided
in starter unit.
8
~rlrwMil~iir,
Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page / of 3
Labor and Human Relations
' Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY !W X,
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but PARCEL I.D. #
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
M a",e GOVT. LOT Sw 1/4 5k/ 1/4,S /(r T 2Q N,R /y E (or) W
PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK If SUBD. NAME OR CSM #
32-0 ?bu/NS (/,+//E' Rr> -
CITY, STATE ZIP CODE PHONE NUMBER QCITY []VILLAGE JaOWN NEAREST ROAD
w/, SAlou ( 715) 4/)_5 - i o0 7,QD - e!F,+sT /-)9RT 1O,dNS
[ ] New Construction Use Residential / Number of bedrooms -3 [ J Addition to existing building
Replacement [ ] Public or commercial describe
Code derived daily flow yS0 gpd Recommended design loading rate bed, gpd/ft2 • A~ trench, gpdfft2
Absorption area required 3 75 bed, ft2 3 2S tr ch, ft2 Maximum design loading rate -S bed, gpd/ft2 ` 5 trench, gpd/ft2
Recommended infiltration surface elevation(s) S ft (as referred to site plan benchmark)
Additional design/ site 'derations S' TF s v lTit 8 /E D.v y {~~e i`! O U~l~ S YS 7e-%ti
Parent material 5G5 92 Ro E 4- Z3,/,f1- t,PD7- .5 , t-v J Flood plain elevation, if applicable 14-1,4- It
6 S 7'41,4.., E
S = Suitable for system CONVENTIONAL MOUND IN•GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U= Unsuitable forsystem-Lo S ID U ,E] S O U ❑ S U [IS .®U [Is ®U ❑ S f~ 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 tench
p_ /0 Y4 .312 S' 1, sh~f' ~nV R ~s e-
/,o . G
yie ZjJ3 s,6,< ~,fR cs 24-^ . s . G
Ground .71- 3 a /0 YX Jr, ~ -2j, s *k' ,w,-f a c S
elev
9q G~ ft. 92 0 yo 7, S yR Y/ /S 1, f A< 07°,P, S /vf , 7 i
Depth to C /oYR 5 R' _5/JV SG~ J, "F, S 6K M"-F 3
limiting
„ s Ova D e wt r
factor MM/ 40V
Ile 7+V
tAV
& A r- SG' 70 " ' c-fv* ti
Remarks:
Boring # 0 _ /PJ %/e 3/~- s1~ •.w,, 5~i~ 4n V /,e S zL • S '
? ~-/f A9 X13 5;f/ S6,C /M-fk es S
, G
13p- /0 Ye y S.1 .2. f , she .-.4 z-f . 5-
Ground _
, 2-.f, / .f, She ~-f
ev Z L~ to re y/r R 51 s
E ~fLI ft
C o. 0 75YI2 4/~ f S Sl a, f T~ W Ass/~. / - • ~3
Depth to
limiting
fact .
l
Remarks: -sal/S~F yY S~9 T y/~ ~r l~ 1 O
-5-
CST Name:-Please Print Phone: 7/ g/~'r10M~ESITE SEPTIC PLUMBING CO.
Address: 655 O'NEIL RD., HUDSON, WIS. 54016
Signature: 'IS. MASTER PLUMBER LIC. NO. 3307 MR.R.S. Date: s 93 CST Number:
y
INSTALLER DESIGNER LIC. NO. 00803
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PROPERTYOWNER ' th K/'u S SOIL DESCRIPTION REPORT L 3 .
Page - of
PARCEL I.D. #
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Barry Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed rer
a-~ iaY/P 512- s,' z ,,,~t s'hX 2 s 3--A
S
1 23g _1
Ground /3! d - dO 7,5 Y/e 116
yet it. 0- 110 7,5vR 91< S
O ,fie 7
Depth to C , D- SS 2 .S Y,e 5 Y a s Sc~ /,`F Sb,~ C s
limiting
factor cz LTE~'ti-1 T 51 o 'f s
5/00
S "00
Remarks: ZO,✓ C' z i -s yt r 620E 7-
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
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Ground
elev.
ft.
Depth to
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factor
Remarks:
Boring #
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elev.
ft.
Depth to
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factor
Remarks:
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STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER
MAILING ADDRESS eq, &,t' 4-J,'
PROPERTY ADDRESS ~-(location of septic system) Please obtain from the Planning Dept.
CITY/STATE //l' 1~Prn .'A-l~s~ L✓ ~r
PROPERTY LOCATION 1/4, ~w 1/4, Section T N-R W
ST. CROIX COUNTY, WI
TOWN OF
SUBDIVISION , LOT NUMBER
xee
CERTIFIED SURVEY MAP , VOLUME , PAGE , LOT NUMBER
Improper use and maintenance of your septic system could result in its premature failure to handle
wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed
by licensed septic tank pumper. What you put into the system can affect the function of the septic tank
as a treatment stage in the waste disposal system.
St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost
of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County
accepted this program in August of 1980, with the requirement that owners of all new systems agree to
keep their system properly maintained.
The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner
and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1)
the on-site wastewater disposal system is in proper operating condition and (2) after inspection and
pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum.
I/We, the undersigned have read the above requirements and agree to maintain the private sewage
disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR.
Certification stating that your septic has been maintained must be completed and returned to the St. Croix
County Zoning Officer within 30 days of the three y ar expiration date.
SIGNED:
DATE:
St. Croix County Zoning Office
Government Center
1101 Carmichael Road 11/93
Hudson, WI 54016
8 T C - 100
• 'This application form is to be completed in full and signed by the
owner(s) of the property being developed. Any inadequacies will
only result in delays of the permit issuance. Should this
development be intended for resale by owner/contractor, (spec
house), then a second form should be retained and completed when
the property is sold and submitted to this office with the
appropriate deed recording.
Owner of property ev , ~~l p~- of aj,4 Z. ,~S: ie~ sc
Location of property5'1,~~ 1/4 -5'4) 1/4, Section 1,o~ , T a r N-R 41 W
Township ..b_, Mailing addresses d rfow ~a l~.Il~y~
Address of site Si-
Subdivision name Irv v,-~ Lot no.
Other homes on property? YesA_No
Previous owner of property Al
Total size of property
Total size of parcel
Date parcel was created
Are all corners and lot lines identifiable? Yes No
Is this property being developed for (spec house)? Yes _P< No
117 and Page Number as recorded with the Register
Volume /
of Deeds.
y
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE
NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a
certified survey, if available, would be helpful so as to avoid
delays of the reviewing process. If the deed description
references to a Certified Survey Map, the Certified Survey Map
shall also be required.
PROPERTY OWNER CERTIFICATION
I (we) certify that all statements on this form are true to the
best of my (our) knowledge that I (we) am (are) the owner(s) of the
property described in this information form, by virtue of a
warranty deed recorded in the office of the County Register of
Deeds as Document No. , and that I (we) presently
own the proposed site for the sewage disposal system or I (we)
obtained an easement, to run the above described property, for the
construction of said system, and the same has been duly recorded in
the office of the County Register of Deeds as Document No.
gnature of Applican Co-Applicant
r- ~
Date of Signature Date of Signature
f
:L
s y • ' 52779 von 1117P~ ~E 592
f
WARRANTY DEED
: f4..ocdl., DDOCUMENT NO. 3'S CEIX Co., va
r P"cc..1
FEPR.t7
THIS DEED made betwm TIMOTHY R. FAWNS and .7 1995
ROSE L. EAKINS, husband and wifeGrantors and BERNARD W. o P.
and f;i
CHRISTENSEN, JR• and AMY M. CHRISTENSEN, husband 0 wife as survivorship marital property, Grantees,
rt D«~r.., F .
WHneswth, That the said Grantors, conveys to Grantees the
following described real estate in St. Croix County, State of
yS
Wisconsin: - ~5 Fe i
- AN
1
Part of the W-1/2 of the SW-1/4, Section 16, Township 28 North, Range 19 West North described as follows: Commencing at the SW comer
fsa said ion 16t the S feet to
211
North
on West line )f said section 16, 870.0 feet; thence
t thence centerlSouthine Town ooaed;
,.T place of beginning; thence North 66032' East ~.00feet
- thence North 28030 West on said centerline of beginning.
300.0 feet; thence South 28030' East 300.0 feet to place T u ,~,15r
i
} This is not homestead property.
TOGETHER WITH and SUBJECT ons, restrictions, easements and rights-of-way
TO reservations,
of record, if any.
Together with all and singular the hereditaments and appurtenances thereunto belonging;
•
And Timothy R. Eakins and Rose L. Eakins warrants that the title is good, indefeasible in fee e
simple and free and clear of encumbrances, and will warrant and defend same.
Dated this 12th day of April, 1995.
(SEAL)
(SEAL)
' tIRIOSE. EAKINS
INS
STATE OF WISCONSIN )
t. )SS.
ST. CROIX COUNTY )
penally came before me this 12th ~ y of ~whoexecuted the foregoing intstrument annd
and Rose L. Eakins, to me known to be persons
' acknowledged the same.
t
.gay ~Y Pv~
N tary public, State of Wisconsin
MAMME R. My Commission Expires:
SCHMIDT
~ 5~
THIS INSTR Y: RETURN TO:
'
Barry C. Lundeen
MUDGE, PORTER, LUNDEEN & SEGUIN, S.C.
110 Second Street
Post Office Box 802
nidson, Wisconsin 54016
T
ST. CROIX COUNTY
..,,.s WISCONSIN
ZONING OFFICE
a n n u r a■ NOUN (1 ST. CROIX COUNTY GOVERNMENT CENTER
1101 Carmichael Road
Hudson, WI 54016-7710
j (715) 386-4680
August 4, 1995
First Federal
201 South Second
Hudson, Wisconsin 54016
ATTN: Jae
RE: Septic Inspection for Bernard Christenson
Address: 320 Townsvalley Road, River Falls, Wisconsin
Dear Jae:
An inspection of the septic system serving the Bernard Christenson
residence located at 320 Townsvalley Road, River Falls, Wisconsin,
was conducted on July 12, 1995. This property is located in the
SW; of the SW', of Section 16, T28N-R19W, Town of Troy, St. Croix
County, Wisconsin. At the time of the inspection, this septic
system was found to be code compliant for a three (3) bedroom home.
If you have any questions with regard to the above, please do not
hesitate in contacting our office.
Since ely,
es . T om o
ssistant Zoning Administrator
St. Croix County, Wisconsin
mz