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HomeMy WebLinkAbout040-1131-60-000 -0 0 R o o N ^r III p u°ry I M e c y O a~ o i-_ o 0 o w C N O rn C LO O 'O O M Q O a TO h co 22 a a) O CO C ? O a) En CL N ~ 3 N y C O i ~ dQ3 C)) (L) U 'O 00 OO -O ~ -O O C c n co 00 C n O V1 N LO Z 7 C _ X i fd fC _ 7 -o LL C a. vi c O U) m C O N 0) C p U O' N a Y O (0 ftS C Q r OD O .0. M V N Z y rn z y o ~ Z d d co ~j a m LO (N M Z O N C U' N O Z d n w N Z :!t s c o w E o ~ E o K 0 0 o m f9 N O .2 p N O Z Z Z Z o O C N LO 0 Lo 06 N a Y a+ (n N N d N L o LL O O a E O H H H FL O O O 0 a- CL a. co 0 U O `n `n rn 0) 0) o -j CC w Z v co ~N °o °o O (O OD O N I~ O 3 _ V O O E o o cD a N o Q > in cu uj 7 N N t N C o _ O E CC) r~ C, LO O O Q O W C V a al O O Ci O) o N C E N C (D O C N 0 Y C N 06 H O N O N M a.. ~ C n O M I-- U- N O z N '7 fn j'O\ ~ is ~ I w' E I V v~ `m E a 3 S. m CL a RS y c E L c ~1 A U 0. o co U ' i STC - 104 AS BUILT SANITARY SYSTEM REPOR :q A 'O OWNER App- /W/of /q cc) ADDRESS 13 / Wy- SUBDIVISION / CSM#~r T # SECTION T 2d N-R //o W, Town of TR d ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM Y See /04~ Tr,4 w INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. r ~ BENCHMARK: ~`E~'f"T~D.c~ = /00• LowEST ~O~`4- ©~y- lope j¢/~j~y~,~ uy ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING-TANK INFORMATION 5,T- Manufacturer: t)&Okf `)W C4,{t lp • Liquid Capacity:_Rd/G' moo Ste, T r S. T - 8 Setback from: Well Sy IiouseP-C. 7-5 other Pump: Manufacturer Zo /l Mode l# 9V Size Float seperation Gallons/cycle: 12--,0 C.467, . Alarm Location r SOIL ABSORPTION SYSTEM Width: Length 5 Number of trenches Distance & Direction to nearest prop. line: .25 Setback from: well: ( 31 House Other l"- ELEVATIONS io 7,oz ~ /d~- ya Building Sewer ST Inlet; ST outlet PC inlet 10y70 PC bottom /00'000 Pump Off /O L' 3a Header/Manifold Bottom of system /0 y 30 Existing Grade b al grade /04"p 70 !A461 v t; 8e,=9 1 113 DATE OF INSTALLATION: ?"S7- -(-z> P .2- /jam PLUMBER ON JOB: PIORERT UL_2P_ ['CGLT- LICENSE NUMBER: AINS.930 INSPECTOR: 1141V y JCV4-1-V.57 3/93:jt A ~ T • INN CAI o 11 y O '414 p, °V1 p N 114) b ~ti i I~ a y I I `d 4 W ki) 10 C ~W C~~ N •n r ~ ~ ~qsT LOT G' LfN o L Wisconsin Departtent of Industry, PRIVATE SEWAGE SYSTEM County: Labor and HuXrt9rt Re f s INSPECTION REPORT ST. CROIX Safety and Building, , ion GENERAL INFORMATION (ATTACH TO PERMIT) SanitaryPermitNo.: Permit Holder's Name: ❑ City ❑ Village ❑ Town of: State P I FRANZMEIER, ART X CST BM Elev.: Insp. BM Elev.: BM Description: Troy Parcel Tax No.: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. Airi to ntake ROAD Dt Inlet Ar I Septic NA Dt Bottom Dosing NA Header / Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer J Demand Model Number GPM TDH Lift Friction System TDH Ft Head Forcemain Length / ~ ' Dia. ` Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSION D DIMENSIONS SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type Of IVV4,0 CHAMBER Moe Number: System:1 OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size 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 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.) C C` LOCATION: Troy.35.28. 19W, NW, NE, Highway MM C" Plan revision required? ❑ Yes ❑ No Use other side for additional information. 9117 ,'zBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH " SANITARY PERMIT NUMBER: , I r Iw~~ µ SANITARY PERMIT APPLICATION •ys In accord with ILHR 83.05, Wis. Adm. Code COT c~o~•~ STATE S~[VITAjY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than Q~ 8% X 11 inches in size. ❑ Check if revision to pr vious application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION A e T` F !?A02 t t R NW t/a Pf '/a, S T 21f, N, q /57 E (or W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # /f_f O 56P. w sS~.v 4AI CIJY, STATE .~ZIP ~G ~7 PV2_5 NUMBER SUBDIVISION NAME OR CSM NUMBER 11. TYPE OF BUILDING: (Check one) State Owned ❑ V CITY 112,1OWN OF: ! v NEAREST ROAD ILLAGE: ~ hia Y. .,A4 ❑ Public L"'11 or 2 Fam. Dwelling-# of bedrooms PARCEL TAX NUMBER(S) Ill. BUILDING USE: (If building type is public, check all that apply) ©l© . 1131- G delo -751 1 El Apt/Condo 20 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 PERMIT: (Check only one in line A. Check line B if applicable) A) 1. New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 51:1 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 t~ 'Mound 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 77 375- 3 ~i df/ / O7"35-Feet Feet VII. TANK CAPACITY Site in allons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New istin Gallons Tanks Concrete structed glass App. Tanks Tanks Septic Tank k 1dVV Lift Pump Tank/Si hon Chamber d 0 Poo Co v 2 VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) IMMPRSW No.: Business Phone Number: 1R013E0,T- 1.11612'C 4 ~.r✓C(~. 3307 7~S 3Z 'P Iles- Plumber's Address (Street, City, State, Zip Code): &55 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing A nt 'nature Sta s) Approved ❑ Owner Given Initial Surcharge Fee) Adverse Determination O~(J X. CONDITIONS OF AP PO L/ ASONS FOR DISAPPRO L: _ 6 SBD-6398(8.08/93) DISTRIBUTION: Original to County, One Copy To: Safety a Buildings Division, 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 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;-Safgty Buildings-Division, 608-266-3815., To be complete anq 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.inst*ed. 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. Vlll. 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 curvy; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115form; 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) I SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations May 9, 1995 201 East Washington Avenue P. 0. Box 7969 Madison WI 53707 ULBRICHT & ASSOCIATES ROBERT ULBRICHT 655 O'NFILL ROAD HUDSON WI 54016 RE: PLAN S95-01153 FEE RECEIVED: 180.00 FRANZMEIER, ART NW,NE,35,28,19W TOWN OF TROY 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. Si rely, James Quinlan Plan Reviewer Section of Private Sewage (608) 266-3937 n~ R1GIN fl SHDA-7997(K. I W W ) , ULBRICHT & ASSOCIATES CO. 655 O'Neil Road • Hudson, WI 54016 Reg. Designers of Engineering Systems 715-386-8185 Private Sewage Consultants PROJECT INDEX DILHR Plan I.D. # S95-01153 Date May 10•, 1995 Owner Art Franzmeir Phone 715-425-2364 Address 1450 S. Wassen In. #22, River Falls, Wis. 54022 _ r Legal Description Tax parcel # 040-1131-6000. NW 1/4, NF; 1/4, Sec. 35, T28N, R19W. c, Town of Troy County St. Croix C.S.T. Installer R. Ulbricht• CSTH2482 Local Authority/ Supervision St. Croix Cty. Zoning Dept. PROJECT DESCRIPTION New Construction. 3 Bedrooms total. Estimated daily wasteflow: 450 gals. St. Crcix Cty. Zoning (J.Thompson) determined from review of old 1988 soil report, that site WAS NOT code compliant for a mound system since slopes indicated were in excess of 12%. Site verification by Ulbricht & Associates revealed actual slopes across the western edge of 1988 site were 18.5 Anew soil , pit was evaluated, the test site was enlarged, to the east, where slopes are 12% or less. A conventional mound system is proposed in this new area. Soils are permiable (.5 GPD/ft2) but saturated at 29" with fractured limestone beneath at 42". Most immediate soil restriction is saturated soils. A incrund with 12" sand fill is proposed. Pg.l PLOT PLAN VIEWS Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWS Pg.3 PIPE LATERAL LAYOUT ~~~~~~~5 Pg.4 DOSING CHAMBER CROSS SECTION 1 C N ROBERT W. Pg.5 PUMP PERFORMANCE SPECS a ULBAICHT M160 SAS IluasoN, WI s 'yo ~g I G~~' Any use of this POWTS design ty any licensed plumber, or any r related unlicensed parties or persons (excavaters, laborers) j shall not be construed as an assumption of responsibility by J the designer for the workmanship, construction, placement, !R substitution or selection of any components not specified, or j any assumptions by the plumt-er that 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. I S95 - 01153 ♦ N 53 1 c n; w R -4~ o a Q, rn N Z G _ - a Z ` L 0 q w w aim IC" men, C ~ W cn A ►P.S m! 7 'LIN~ N L u► o ~ / ~ Ti \ z c Q D CI) fo / z N co) . ~ o rn z ® 3 R, 3 o Cr1 It) m r - G OW 595-0115Q9 o~ 5 P~. 2. Ct2055 SEGT10&) OF moUoD wi Ttj f3eD BED OF % ro y" A55Qc5ATE- V 57R43uT%oo G, rktCktisES3 Pip 6- 5y5TEM of ToP Soi L e IEVAriora its N a /D y 35~ . U u 1 FO R M To E- RhTi0 ME1). • • • 1 • ' 9 SAap , 1 p I w E 0 T o p so I. L- 1 IZ%° StoPE FoR~E uu FORM MhC S t WATIOO UuMR REP /03.35 ' Fr. - ELEVAr1o,-J 5 ~ °y• ~S I. lmveRr OF ( Li 1ATiFRA(5 Top of Rock If) 5. t5 1-0 F-T. of - N 1.5 ' FT. Top °F y IATERA IS ~ - PL. ,N Vit y x MOO-)JD ~ wi rH 13E D - OF fF10USTRY1 LABOR ` DIVISION OF SAFET AND BUiLO1NgS /l~~ FvRcE MAW F1-, 77 SEE cO ppNDENCE I F r I _ K. /z Fr 13 i•o ° 1~ (O w 1• ---j 1 FT a Y w 3 n Bev of PVC- cgppEp To 1 osseRVhrlox) A 9 jPejATE- a -s PERMA,JENT M Ae KERS Rrz(gv ep (3ASAL_ AREA = ~At~y ~/tsr~F►ow - y~o - 9~ro Solt 10-fi l rRATW E ,C c AfAci Ty sa. Fr. PRopo5EV BASM AReN = B X (A t z 1 S95-01153 t53co C l sat. FT. CS-IUTRAt. MANi Fotrp Dt5TRt*BUTI0N Pipe NErwoR k Kier 4ooRj< VD(V,4-i E' 7-'11 P 1 CENTRAL 9tSTRI13UT100 R PVG LATERAIS M AN t FO t_ o EN o CAP 5 -7i Y pvG FoRC-E M h 1' N LAST' vAole S HA II BE NEt1.T TO END CAP FT. Vo1D VOluMt FOR z5 d F 2-- ~o RcE gA1s. XMUERr E IEVATION MAW 10 ?.5 tw ` w. n OF INDUSTRY, LABOR $ HUMAN L11VISION OF SAFETY AMU BULL IHNG$, DER€` EA"r6NC FPIPE DErAi L Holes IncAreD 0,0 Q. - G oTrom Sti Ali Be I~ ~I VAR1AML.E Y Ir 4z0hlly 5~I4c.eD. Y >,csraNCe p 30 Fr Hole DiAKr= e R ~N• LATERAL 3.0 R MANC FOLD " 27 lN. X 3~ IN~hES Foech M,A k) Z iN. Y g 11~G~.~s 4#- °F HOIE5/ PIPE DISTP, [3uTlo>u DtSCHAR&E RATE PER L.ArERAL Cr A J TOTAL 'DISGLIAR bE RATE / NET'WO(? S l' 49 G/4 L. S95m0115 • t PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS PX E OF rj -VENT CAP 4"C.I. VENT PIPE T WEATHER PROOF APPROVED LOCKING JUNCTIOAI BOX MANHOLE COVER 25 FROM DOOR, 12"MIU, WINDOW OR FRESH to/ 4v,4X'UIA)61 /A13E/ I AIR INTAKE f1I1AOr- Vi17~ON GRADE I I 4° MIIJ. 105.0 CONDUIT-- ~IEU~n ov ~ 11~ ~O3•~, INLET PROVIDE I I - 1_.---+► AIRTIGHT SEAL I III T n I I APPROVED JOINT A h10E I III APPROVED JOINTS W/ C.-1. PIPE 105196 N ~AP - to ) III WIC.I. PIPE EXTENDING 3' 0 ` G1 ( I I ALARM EXTENDING 3' OIJTO SOLID SOIL, B I II ONTO SOLID SOIL ~j 3~ 3. L5 I I oN c IoI. ~ ELEV. FT. PUMP ~ OFF o d BLOCK 00 cc me v~I f r ~y•~a RIStR EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E SPECIFICATIONS DOSE W Et S ,AA4A tt- 4D y TANKS MAIJUFACTURER: Q IJUMBER OF DOSES: PER DAH TANK SIZE: v od GALLOAIS DOSE /VOLUME y ALARM MANUFACTURER: Lauel- , 1,*?Aj ~ . INCLUDING BACKFLOW: I ( (v GALLONS MODEL NUMBER: -P.U' ' CAPACITIES: A= /T'CO INCHES OR 3~d GALLONS SWITCH TYPE:1'IERGURYEl0AT- 2- INCHES OR GALLOMS PUMP MANUFACTURER: p' INCHES OR GALLOIJS MODEL NUMBER: 1 k yi 0=1&,-F INCHES OR 21/2 ~ GALLONS SWITCH TYPE: piggy tsAcjG MEQcuRy f/0^r NOTE: PUMP AND ALARM ARE TO BE 7~J GPM INSTALLED ON SEPARATE CIRCUITS MINIMUM DISCHARGE RATE VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. 3.7 FEET -'AA* SPECS 4- MIIUIIMUM NETWORK SUPPLY PRESSURE . . . 2.5 FE.t cALLI, Of --'D{ P14 -I 2-5- FEET OF FORCE MAIN X FJoorTFRICTION FACTOR.. FEET ~'Urls Z.a. S A~s= TOTAL DYNAMIC HEAD = 7 3 FEET J + ~dV.vD 37 INTERNAL DIMENSIONS OF TANK: LENGTH ;WIDTH ;LIQUID DEPTH R171IISTRY, L,',9O 3 & HUMAN RELA74 31id t',RII~sDd OF SAFETY AND BUILDINGS ' OORRESPONDENCE ' I HEAD CAPACITY CURVE 3 7/e 6 1/4 MODEL "913" 30 4 s/e e I j i 6 m 2 e I %kkN I 3 5/8 1O 4 3/16 ~ 4 6 11 1/2-11 1/2 NPT 2 5 0 U.S. GALLONS 10 20 30 40 50 60 70 eo LITM e0 160 240 0 FLOW PER MINUTE TOTAL DYNAMIC HEAD/FLOW PER 91v1UTE EFFLUENT AND DEWATEFi1NG CAPACITY 12 HEAD UNITS/M1N FEET METERS GALS CFRS 5 1.52 72 231 r-, I 10 3.05 81 271 15 4.57 45 170 20 6.10 25 95 3 5/16 Look Valve i , CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and • Mercury float switches are available for controlling single and supplied with an alarm. three phase systems. Mechanical alternators, for duplex systems, are available with or a Double piggyback mercury float switches are available for r : without alarm switches. variable level long cycle controls. j SELECTION GUIDE ! Standard all models - Weight39 1bs. I '/a H.P, 1.' Integral float "rated 2 pole mechanical switch, no external control required. 2. Single piggyback mercury float switch or double piggyback mercury, float 96 Serise Control Selection switch. Refer to FM0477. Model V904-ph Mode Am s Sim lax Du lex 3. Mechanical alternator 10.0072 or 10-0075, M98 115 1 Auto 9.0 , 1 or 1 & 7 - 4. See FMO712, for correct model of Electrical Alternator, "E-Pak" 11 1 Ron 9.0 2 or 2 d 6 3 or 4 5 5. Mercury sensor float switch 10-0225 eked as a control activator pecify duplex (3) or (4) float system. . ' I ' 096 230 1 Auto 4.5 1 or 1 6 7 - 6. Four,(q hole "J-Pak", ]unction box, for tAelerllgftt tionnectioFl or wired -in sirlt *96 230 1 Non 4.5 :2 g.2 6 6 3 or 4 6 5 plex or duplex operation, 10-0002. 1 7. Two (2) hole "J-Pak". for watertight connection or splice. CAUjION For Information on addidwal Zoeller products refer to catalog on Combiru.bon Starter, FM0514; All Installation of controls, protection 4eirialea and witltg should be dote by a yya6. Piggyback Mercury SwIlehes, FM0477; Electrical Alternator, FM04W; Ir'_:chanlcal Alternator, lied Naeaad ateelrklen AN elMriaal a slay codas should be followed lnslad- FM04e5; Alarm Package. FM0513; SurnplSewage Basins, FM0467; and Simplex Cor*ol Boa, Ing Ow most renal National Electric Code (NEC) and Ua Oooup&Voeal Safety and Health Ad (OSHA). RESERVE POWERED DESIGN { For'unusual conditions a reserve safety factor is d1i'gineered into the design of odery Zoeller pump. Z ' NAM ro:.P.o. Box 16347 L0tufsy;ll, Ky 40256-0347 Manufacturers of... 0 ~E"~~ Q SHIP T0: 3280 Ox, Millers Lane a 4I~~ ,v 7D - La:iSykh-, KY 402.1 s I t. Q!/AL/71' ,',MLf la (502) 778.2731 `e fAV (502) 774.3624 cap-01153 45 NH I ~I n~GK f~Ql ~ . i !i I I it 00 M a <o~vvE,~ : Tom, Toy Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of 2 Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY ST ~~PoryC Attach complete site plan on paper not less than S 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. p '~/e - 1131• ~O 00 O APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION ,4R r T/e,VL• Afja-';f GOVT. LOTA/U) 1/4 A16 1/4,S 3_4'_T 2. N,R E (or~W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE OWN NEAREST ROAD UE"~ :Zj /117-1115 Ail. ,54&2 z. 2- (715) Yj.5- Z3 G ,Po ) Yw MM [ ew Construction Use [ Residential / Number of bedrooms 3 [ ] Addition to existing building I ) Replacement [ ) Public or commercial describe Code derived daily flow y.SD gpd Recommended design loading rate ' 3 bed, gpd/ft2 ' G trench, gpd/ft2 Absorption area required 3'75 bed, ft2 375 trench, ft2 Maximum design loading rate • 5 bed, gpd/ft2 ' L trench, gpd/ft2 Recommended infiltration surface elevation(s) S-ee- • 3 ' /OY- 3 ti", ft (as referred to site plan benchmark) Additional design / site considerations 60, 41,FP a v AO If4P S S 970 id &0 Parent material SCS 0 - T,rl a 0&&* Flood plain elevation, if applicable A1.4 . ft S = Suitable for system CONVENTIONAL,' I MVP IN-GROUND P_ REASSURE OGS DE ❑ SYSTEM CJ ULL ❑ HOXLDI S NG TAN U = Unsuitable for s stem S Btl CC'S ❑ U ❑ S [el SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tmnch YR 131.2- AM &Ifk 3-f 44 { 13 16 V,,e 313 2 -f- Shoe .5 f Ground 3 - L /O W 31Co 2-, did ~YN fj(~ CS 11e . S • G elev. 03 /O y/0 31& f (5-ie /W 14C.-C, / N N Depth to limiting factor . sss Remarks: ~OlOrti'TE /S E'.vGDV-e~7'E~t'CZ~ A7- ~/j- Boring # Ground elev. ft. KIMNAL.r Depth to limiting factor Remarks: CST Name:-Please Print 12013EP_7- '24LRi2I'L'k7- Phone: 71s-3P6 ,SO Z 8S Address: &C_5 01,,jC1L R0. RU12SOO WI.5yD!ib cs7'ti Lg00 Z_ Signature: Date: CST Number: Zed,. k N 0T kEl 6 T% Cue 1'x rY Z0,3(06- b 1= P r• U. Y4,0.4 p S 'o Z J Ut Q AJ 12 eU if W i/v (x- oP_ 1'~ INhI- C 9-10-S,5>) Re-pol_j--c - 51TE- ill E ; NdO • e-6 )'fORM i,c) Q~ECAUSC S~OpeS I~~SS `/2- OF 012rGi.vc~hC, /kouvj~ V5 (S-101,45 w &-WE- lK7,444 !i.5 90 1 A NEW /f'pi Ef- w~S Fvcfie~ep - w~ 'E S161Aes lll'E' /mss J PROPERTY OWNER 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. Cont Color Gr. Sz. Sh. Bed Tw& 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 # A Ground elev. ft. Depth to limiting factor Remarks: co~.ononio ncinrn • Q ~ Y W N _rn Rl m N ~ ~1 u Z 4N _ G v► 0 w m C N N t~ 0 ~ c' - J C w ~rn N • Q N nor ~ ~/,9 0 0 N n W C ~ ;zt N tj ~ ~ m ~ -t? p , f STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County oWNERJBIJYER 1,4 MAILING ADDRESS Z~c~,✓!!~ ,y1 16 1-L~ ~C~` f ; P 4,A4 PROPERTY ADDRESS (location of septic system) lease obtain from the Planning Dept. s"~ L Z CITY/STATE PROPERTY LOCATION 4~ 1/4, ,1Y,'C 1/4, Section T l)-y 1'167 TOWN OF N a ,y> ST. CROIX COUNTY, WI SUBDIVISION - LOT NUM13ER 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. U'`O, 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: DATE St Croix County Zoning Office Govermnicnt Centm 1101 Carmichael [,,oad 1 1 /`13 Iludson. Wi 54016 Y M • • S T C - 100 This application form is to be completed in full and signed by the i 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. Z 4 Owner of property Location of property/r') _1/4 1/4, Section T, N-R Township Mailing address < Address of site 75 ~n ~fJ Y/y►y,►~ yjy,~~ < ~r,~LS' S~l~ Subdivision name Lot no. Other homes on property? Yes X' No Previous owner of property if Total size of property Total size of parcel -5",a Date parcel was created 114:51 Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house)? Yes X No Volume and Pa e -J- - g Number 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 (y~~certify that all statements on this form are true to the best of my knowledge y ledge that I (3ote) am (.4xis!5) the owner_W 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. S"s _ l c~ , and that I ej presently own the proposed site for the sewage disposal system or I (30c obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the ofFf//ice of the County Register of Deeds as Document No. S T i u~ 3 7 .4 A Q, Signature of App cant Co-Applicant • Date of Signature na+A of c;~+„r-- • DOCL:MENT NO. WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA STATE BAR OF WISCONSIN FORM 2-1982 523848 VOL - - - - - - REGISTER'S OFFICE Thomas A. Joy, a single person $T CROIX CO., I Recd for Record - - - - IN OV 2 9 1994 conveys and warrants to Arthur E. Franzmeier 8 30. A. M - - , at - - - i Register of Deeds - RETURN TO . the following described real estate in ...................St. Croix County, - State of Wisconsin: Tax Parcel No: Part of NW 1/4 of NE 1/4 of Section 35-28-19 described as follows: Commencing on W line of said NW 1/4 of NE 1/4 at centerline of highway (being 561.0 feet S of NW corner of said NW 1/4 of NE 1/4); thence S39°25' E on said centerline 400.7 feet; thence S58°50' W300.3 feet to said West line; thence North on said West line 464.5 feet to Place of Beginning. This -_-_._is-- not_---__-- homestead property. (im7 (is not) Exception to warranties: easements, restrictions and rights of way of record, if any. Dated this 28th November 94 - day of _ - 19 (SEAL) (SEAL) Thomas A. Joy (SEAL) ------.....--------------(SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN SS. ---------------------------County. authenticated this day of___________________________ 19 Personally came before me this _ 28th day of November---••_-__-..••-_-, 19•-94.. the above named - * Thomas A. Joy - TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stata.) to me known to be thq,," ers who executed the foregoing i strume no~vtedge the same. THIS INSTRUMENT WAS DRAFTED BY - t - Joseph D. Boles - Attorney at Law ' River Falls, WI 54022 (715) 425-7281 Notary Publi. .._.__County, Wis. (Signatures may be authenticated or acknowledged. Both My Commisip gr f }lot, state expiration are not necessary.) ,h5 f - s / • date. s-•--7 ~ S ) •Names of persons signing in any capacity should be typed or printed below their signatures. WARRANTY DEED STATE BAR OF WISCONSIN ° Wisconsin Legal Blank Co., Inc. FORM No. 2 - 1982 ra ~ Milwaukee, WEsconsin d Krueger Real Estate 214 No. Main River Falls, WI 54022 1 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTFj,Y, DIVISION LABO9'AND PERCOLATION TESTS (115) MADISOP.O. BOX N W153969 HUMAN RELATIONS (ILHR 83.0911) & Chapter 145) LOCATION: SECTION: TOWNSHIP/MttN+&H1- ~Y: LOT NO.:BLK. NO.: SUBDIVISION NAME: NWI/ NEE .3s /T-n N/Ri9Z(or)W T/eoy - - - COUNTY: OWNER'S BUYER'S NAME: MAILING ADDRESS: s-rCkolx ?'~aMV±S ,goy ~O. 80)( 352 R/VCR FALLS, wi. 540ZZ USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS: ®Residence 3 W. A, ❑New Replace RATING: S= Site suitable for system U= Site unsuitable for system ON❑VENTIONU. M®S.ou IN-GROUNDPRESSURE:SY❑STEM-IN-FULFi0SGNU Rr/~-EMMENDE /VCHDMOUN/~ptsY_57-C=M MOSSON SUITABLE WITRA Sr OPE SPA rANC 2-4 K 4'1 TRENCHES If Percolation Tests are NOT required DESIGNtt RATE: If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: N. A Floodplain, indicate Floodplain elevation: A/, A, PROFILE DESCRIPTIONS COUNTY AND b, t• L-,H~ ~N51 T 5-8-88 BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- / 77~~ /S' /V0,VE 7 77 /r O-G" 8I sI l (,-33"'ok 131. si n it B-2 -20~~ 9~.s /VOA/6 > 34" o -(o L31 silt 10-34" St 1; 34'70 WCAKL V CON SO LI DA-t~D 55 ~le g_3 SG to /OZ,~ NOIV~ MOTTLES O-5"81 vfss~l~ S-/9"Qn Si l; 19-3S"B,, slcl; AT' S4 " 5- S!e " an si 1 w -F'~'.F , 5'4 " 7~O //0.84 N oN E A-r S_ . S ocs vfss; 1; s- s2. " 8n -FS l; sz - 7 G " B~ B- 4 MOTTLES O-4" L31 vfssil 4-6"pkl31%VfsSi I; 8-21 " fah Vf-SSi) B_ '5 $7 104,03 NON'E AT 311" 2I-S 1" Bn f'ss;/ w Bh rnota4- 317" B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH P- / 22 NONE- 3o nn INJ, 23/4 " 2'/lir" 2" /5 P- Z 22 A/0n•/4-30AA ItQ- Vsl 2`7 P- 3 2Z" rtifc?/J '~U 1IV 8 u i3~1~" 3~40 P- P P- PLOT PLAN: Show locations of percolation tests nd the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points o their to on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION ' z ~.i rh E / °1o I g r!1 N p I 1 ti i - Lct~-` +o54K~'TR~E O _ u T- 41 0 a ! F p opc LO ATI N 3KE C./a , ~ ~$Ul"rA8 LC MouNa AaE i V4 1'0~~ 51 I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME (print): TESTS WERE COMPLETED ON: pe re.e y LEE 1~r tf L 8 __/0 - OrS ONE NUMBER (optional): ADDRESS: CERTIFICATION NUMBER: PIS)Z "eT. / 8OX 14Z.q L3ECt~ENVILLF_ WI, 5 +C)0 ~ a430 13 . J CST,SIGNATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHRSBD-6395 (R. 10/83) OVER - R lCTIONS FOR IPLETING FORM 115 - I t Tc ,urate soil test", your resort e= 1. W 2. T} u ~.e whether this is a resi ` a or Corr) oect; 3_ MAX _ r commercial use pl- 4, Is this n~ rr 5_ Ce SITE IS SUITABLE Ft TANK ONLY IF ALL JT BASED ON SOIL CONJ 6. NL =7, ;"Y here for writing l)rofile de,,,;, r;w os a-+ comp;et'ny plot plan; 7, M 'K[ caa tely locatir•:g Your test i€acatim s. Drawing to seal, is I ~rrz d. A se , 8. P1 and ve cal elevation referena.e 9. Cor ,a boxes as to dates, names, addresses, a ta, perco'__ Pit, 10, if th r as flood plain, elevation) does not aptly, p I, the aap~ x; 11 11, Sian I, Corm and ace your Current address and your certification 12. Make legible copies and distribute as required. ALL SOIL TES-IS JS"I BE FILED WITH TI~JE LOCAL AUTH013ITY WITHIN 30 DAYS OF COMPLETION. 3EVI TI NS FOR CERTIFIES} SOIL TESTERS Scull Separates and Textures _ . _ , mbols St Stone, (over 10") BR Bedrock cols Cobble (3 - 10") 5S Sanc t; e gr Gravel (under. 3") LS - Lime n- `s Sand HGW High r c s - Coarse Sand Perc - Pero ~ e rued s Medium Saint W - t'll fs Fine Sand Bldg F' Is - Loamy Sand - ra "sI - Sandy Loam < L Tin "I L am Bn i~r s 'l - Loam BI - Black si fay Gray *ci Loam y - Yellow sc.] _ =dy Clay Loam R Red sicl Silty Clay Loam snot Mottles sc Sandy Clay w/' Wi ih sir; Si=ty Clay fff few, fine, f,~ *c cc common , pt- mm - Many, In ck d distin,.t p prorni HWL - High Si> I texture's surfac `oI. I' .waste disposal I - 3em, N - V ' Verticai r point. TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the department may request verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage system and a permit application must be submitted to the apr., f >cal authority in order to obtain a permit. The sanitary permit must be obtained and posted prior to the ;,:art of any construction.