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Home My WebLink About042-1070-90-000 O ° C0 Q QD 1 3 o p 6o O o ~ c I ~ a c - 0 e 3 w aci o L) y O III i N= d.jQ=.O C '0 0 Ory 3 O D C E m C mL o w ~'t M Co y E o c so C ° > 3 > ° CL U)Ma) ' c ° •o 0> 0 C~ I C~c~m NCL ° 1 a m E O] O O m m N L N m d C 7 O U - X m U CE > O X c a) O mC7U0 m E U co m U c m a tz a N ~ aac)"a am m U°-0 N c E oSm0Qa E E E N E° co N N N C EL.. > v N N 3 0 'p N O N L N p Z° rn" Z ~O U O TZ c° my m E m Eoa~iaXim'0~°) V C LL N a LL CO p N w L m E 'g -5 3: 0 E 0-0 CL m 0) U) N ..O ° C 00 a m U N L C N 'O U O E Q m- Q U~ ~ 3 :pt co -M V U N m m Q co Q V N N fN S~ Lll E E ao O O V Oy O Z rn d m d m LO C14 N F- U) C c O ° C U U O Z w w ~ N O a~i Z I 'o c ° ~ c Z fn F- E ° O E a) M h s rn 0 a) e'W N Q N N N C N O N'0 r U O O U Q Q a co z Z Z p N Z Z C N y c N 04 C _ N R E C m NE C: O 0 ca a (a co \i 06 ° o N 4) ° ° o N G o d a> C C a .0 > •(p N (D Cl) (D Q 4) N H~ E N F H F. dl Z ~ d Z o ~n O O O z ,n O O O •.~.i a a a _aaa f a j N ) 0) m aNi r 0' 0) 0) y to U a rn rn } s r2 } (O 1 3 0 0 "C5 E 7 0 0 Y:~ p CD CD C IL Q) co U) Q ~y w d to t3 d A 4 ~r O « C) u=i N ~ a c C o m ° p a c o E C co 0) Lo a) 0 4) 0) a 00 CL 0) C) rn 0) E a ° N U. d M N m N a) y E r C4 00 (D c C r C co N 75 U') ° 0) O ao 1, o o Z M a Z ai LO `m H m CO y~ r""i N N Y O co E M .C ` ~i) u=i O E O U Cl) • La O N t N (0 N= H U) L N O N Z:5 o ~ I I +r E E a m a xt a a a y ~ ~ C C w ~ C O rrww 6~ O m 7 3 t6 O 3 w O `~1 A va Oinv 0 mV o CRO~x COU AA TqTy A PLANNING ZONING July 6, 2007 Allen D. Hays 1470 70th Ave. Roberts, WI 54023 RE: Remodeling/bedroom addition, Town of Hudson, St. Croix County Code Administration Lot 1 Of CSM #374388, Vol. 4, Page 1129 715-386-4680 Parcel # 042-1070-90-000 - Computer #25.29.18.398-B Land Information & Dear Mr. Hays: Planning 715-386-4674 You have requested the Zoning Office review your remodeling/addition project for Real Property compliance with the state sanitary code (COMM 83). When remodeling or adding 715-386-4677 onto a dwelling, you are required to examine whether or not the planned modifications involve an increase in design wastewater flows to the Private On-site Wastewater Recycling 715-386-4675 Treatment System (POWTS). I have reviewed your remodeling plans for the above residence, which consists of an addition with three (3) bedrooms, bathroom and utility room. The three existing bedrooms will remain in use. The existing POWTS was designed and installed based on wastewater flow for three (3) bedrooms (450 GPD) with a maximum occupancy of six (6) persons. Technically the POWTS will be undersized for the number of bedrooms within the residence; however, current occupancy does not exceed the design wastewater flow for the POWTS. An Occupancy Affidavit is required to disclose the disparity between number of bedrooms and septic system sizing to any future owner(s) of the residence. The affidavit was submitted to the St. Croix County Register of Deeds office for recording against the deed prior to issuance of a building permit from the Town of Hudson (Document #855086). The original system was installed in June 1995 by Henry Nechville and was inspected by zoning staff. The system was found to be code compliant at the time of installation. Inspection report and sanitary permit documents are on file with the zoning department. Walter Nechville inspected your POWTS on 7/3/07 and made recommendations for maintenance and repair of the components of the system. To prolong the POWTS lifespan, the septic tank should be pumped at least once every three years or when the tank becomes 1/3 full of sludge and scum. In addition, water conservation measures are recommended, such as repair/replacement of leaking plumbing fixtures, reducing shower time, running the dishwasher only when full, avoid using a garbage disposal, using a wash machine with a suds-saver feature, etc. The long-term function of your POWTS is dependent upon proper maintenance of the system. ST. CROIX COUNTY GOVERNMENT CENTER 1 101 CARMICHAEL ROAD, HUDSON, W1 54016 715-386-4686 FAX If this POWTS should fail at any time in the future, the system will be need to be inspected by a licensed plumber or POWTS maintainer to determine if it requires replacement according to state code requirements in effect at that time. The proposed remodeling and room addition project must comply with all applicable building codes. Please contact the Building Inspector for the Town of Warren to obtain a building permit. Should you have any questions, please contact this office. Sincerel Gum-,~- Pamela Quinn Zoning Specialist Cc: Brian Wert, Building Inspector Henry & Walter Nechville, POWTS Installers file ST. CROIX COUNTY GOVERNMENT CENTER 1 10 1 CARMICHAEL ROAD. HUDSON, W1 54076 715-386-4686 FAX . . I IIIIII VIII VIII VIII VIII VIII IIII IIIIII IIII IIII * 8 5 5 0 8 6 2 858088 Document Number Document Title KATHLEEN H. WALSH REGISTER OF DEEDS St. Croix County ST. CROIX CO., WI RECEIVED FOR RECORD Occupancy Affidavit 07/05/2007 03:45PN AFFIDAVIT EXEMPT A a r ~,y REC FEE: 13.00 Name - (Owner) Typed or printed PAGES: 2 being duly sworn , states, under oath, that: 1. He/she is the owner/part owner of the following parcel of land located in St. Croix County, Wisconsin, recorded in Volume A 53,V Page l~3 Document /3 Number l„~St. Croix County Register of Deeds Office: Records Area i Name and Retum /dress A parcel of land located in the5\ J V4 of th6 ~ 'h of Section N\\A"d ~ • A~civ 01 T_ -kct N - R 1 g W, Town of yA1 N Ir c St. Croix t yid 7 County, Wisconsin, being duly described as follows (include lot no. andG subdivision/CSM or detailed legal description): Qty?.' IN'7°-9©~E~Jt7E Parcel Identification Number (PIN) As owner of the above described property, I acknowledge that the septic system serving this residence is sized for a bedroom home, or a design flow of i pd. The design flow is calculated by assuming 150 gpd for 2 Individuals per bedroom. There are currently f occupants Irving in this residence; 6 occupants are permitted based on the design flow. Therefore the septic system serving this residence is code compliant. However, understand that if there are intentions to exceed the number of permitted occupants, the system will need to be modified to aceomodate any increased wastewater flows and/or contaminant loads. I also acknowledge that I will make this information available to any future parties interested in purchasing this property. Dated this _ 9; day of :S~2,'4 * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) )ss- audwAcated this day of St. Croix County. ) Personalty came before me this day of S aa~ the above named . I a TITLE: MEMBER STATE BAR OF WISCONSIN ' (If not, to me known to be the person(s) who T*c Lited:ft f9r*" authorized by § 706.06. Wis. Slats.) instrument and acknowledge the Sam- INSTRUMENT WAS DRAFTED BY " THIS Notary Public. State of YWiscoh n• • • • • t c (Signatures may be authenticated or acknowledged. Both are not My Commission is pernuinent. rfot, bilbfe exp yralion date: necessary.) Date: Z D "THIS PAGE IS PART OF THIS LEGAL DOCUMENT- DO NOT REMOVE" This Infort»eUon must be oorgpleted by submilter cfocurnernt HUe. narrne 6 return address. and e(N (if requked). Other information such as the the VwAV clauses. leagal description, eta may be placed on this brst page of the document or may be placed on additional Pages Of document. Note: Use of this cover page adds one page to your document and 12-00 to ft reconorirna fee. tisoonsin Staudes. 59.517. • ro ynl_ .15J4PAGE 63 STATE BAR OF WISCONSIN FORM 3 - 1999 62 is KATHLEEN H. . W ALSH Document Number QUIT CLAIM DEED REGISTER OF DEEDS ST_ CROIX CO-, WI This Deed, made between Joy E. Hays RECEIVED FOR RECORD 08-14-2000 9:30 AM QUIT CLAIM DEED Grantor, and Allen D. Hays EXEMPT M 8M CERT COPY FEE: COPY FEE: TRANSFER FEE: RECORDING FEE: 10.00 PAGES: 1 Grantee. Grantor quit claims to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Name and Return Address part of the SW'/+ of SE'/. and Part of the SE'/, of SE'/. of Section 25, Township 29 First Federal Savings Bank LaCrosse-Madison North, Range 18 West, St. Croix County, Wisconsin described as follows: Lot 1 of 201 So. Second Street Certified Survey Map filed November 10, 1981 in Vol. 4, Page t 129, Doc. No. Hudson, WI 54016 374388. 042-1070-70 Parcel Identification Number (PIN) This homestead property. (is) (is not) Together with all appurtenant rights, title and interests. Dated this 3rd day of August 2000 ~ • Jo E. H • AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) )Ss. St. Croix County ) authenticated this day of Personally came before me this 3rd day of August , 2000 the above named Joy E. Hays TITLE: MEMBER STATE BAR OF WISCO NOr'a9j, to me known to e t e person s w execute the foregoing (If not, instrument and acknowledged the same. authorized by § 706.06, is. Stats.) -yr r Ma gene R. Schmidt - THIS INSTRUMENT WAS DRAFT Attorney 0;'v id J. Estreen Q+=. Notary Pu ic, State of Wisconsin Hudson, W54016 My Commission is permanent. (If not, state expiration date: - M 10/20 OZ (Signatures may be authenticated or acknowledged. Both ar • Names of persons signing in any capacity must be typed or printed below their signature. In(x Ikon Professionals company. Fond du Lx. wi STATE BAR OF WISCONSIN $00455-2021 QUIT CLAIM DEED FORM No.3 - 1999 r a ~ any " { 1 5 r. I- f I i I i i jcnl s b~ r+1 1 } 4 I t gym.. AIR l I r ~ WI w { i k 4 i f - 0~,~~,,. ~ vLw ~ Z,~i t~ 41r~u*' ~.hvv'c. L : ~ ~ C( ~.vpwv - Wavsk c3.~,~~. a®~ ~3`A.S~cwvG'✓i" t~~b..,,~ ~n.i~r of ~-:1i ~ 2~, _ Se,+..~1R N~r`~11 1 Owner's name f l n v Address I q 7o -7o /T . 5'~ • 3aQ-out a City and state Zip code S y o 3 Previous owner's name(s) V) _ _ Q 0A, a County T. T V -C Legal E CJ Type of occupancy • Date of installation l Q 4 Building currently occupied? Y N ❑ # ~3 Y Sf Permit information available? Y® N® f 0 Q S Soil report on file with county? Y ® N ❑ Owner Interview Y❑ NU back-ups Y❑ N ® Freeze-ups Y0 N®, Seepage Y ❑ N Sa slow drainage Y❑ N ® Foul -odors . YO N R Other Date of last septic tank servicing S -"-e1J g ' tO Other comments: Owner's signature: Date: b Onsite Inspection Type of private sewage.systems: Below grade At grade Mound Dosed Pressure A Gravity Bed Trench Pit Holding tank Privy Other Treatment tank setback compliance: Well Building 8 Lot line 8 Pool Surface water a Other Dosing tank setback compliance: '11 Well R11 Building Lot line ® Pool Surface water other Well Nc SAS setback compliance: Building' Lot line Pool . Surface water Other Explain other(s) yj pq ?&a, ThemformationvoumovidemavbcmedbyotheragencYprograms [PnvagL,2v,s.15.04 (lxm)]. r Comuonent Condition Treatment tank: Size: J000 Gallons Baffles: IN Functional O Need replacement device OlWarning label Manhole cover:o K 0Replace O4V~ Infiltration: OY itN Holding tank: Size: /j A . Gallons Manhole cover: W O Replace O Locking device O Warning label Alarm functional: O Y O N Infiltration: O Y O N Dosing tank: Size: 800 Gallons Manhole cover: o K O Replace W*focking device 0<arning label Alarm functional: I.Y O N K Pump functional: IN Y O N Infiltration: O Y q N SAS: Total area: _I ?4 Square feet Ponding depth: 0 Inches Sow4 ~rO System depth below grade: 42.3 lashes+ Vent/observation pipe functional: %Y O N Seepage or surface discharge: O Y PLN Potential replacement area available: It Y O N Clogging mat formed: O Y 8 N Comments and Recommendations © 3 . o to *30- to ...Qa,-.rte. J A,,: o La~ OVIV m Certification and Disclaimer I certify that the above information is true and correct to the best of my knowledge as observed on - 7 - 3 - 96 1 . Operational aspects and observations reported are based on the conditions noted at the time of inspection. This inspection does not in any way guarantee or warrantee the continued operation of the system described herein. -7 - o1a0 7 1,2-7110 Inspector's Signature and Date 20 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER_ f UMj t,-" ADDRESS 'S/7o -70 7% SUBDIVISION / CSMJ LOT SECTION T770/ N-R l Town of ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM a L 0 7 /x AV / ~ic 6 m v~ 3 ;0L loo S~QI~ N 7D-7X u INDICATE 140RTH Provide setback and elevation information on reverse of this form- Provide 2 dimensions to center of septic tank manhole Cover BENCHMARK: /07/ O e IQD,p1 ALTERNATE BM: - ;r ao SEPTIC TANK / PUMP CHAMBER / HOLD G TANK INFORMATION Manufacturer: F-y Liquid Capacity: .0000,304 s,]- Setback from: Well House y,--4 "64/Other Pump: Manufacturer X,!D Model#- ;:Z& 7 Size 011 Float seperation ,6 <,Gallons/cycle: i Alarm Location jo~g~ ~ 9, SOIL </ABSORPTION SYSTEM Width: Length I Number of trenches Distance & Direction to nearest prop. line: -V// Setback from: well:-~ House ~Q Other Nont, ELEVATIONS o-Q Building Sewer ST Inlet. ST ST outlet PC inlet PC bottom Q, 3 Pump Off 4 '7 y Header/Manifold 9 7. Bottom of system 9 7 3C~ Existinq Grade ,.3Q Final grade DATE OF INSTALLATION: , 7 - PLUMBER ON JOB: _,/J/FY K/Gn,I/~`/~• LICENSE NUMBER: INSPECTOR: 3/93:)t i i _ i. I~1m ICI o Ira n cc~ ' , ti ~ I +h 3 ` 3 0 0 or n, 'Ile 1 • ' ' Q _ i _ va I q l• Z VV 1 47 'Wiscon§inDepartment ofIndustry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION Pe1tiK er's L ❑ City ❑ Village R Town of: State Plan o.: i 1~ Warren CST BM Elev.: Insp. BM Elev.y BM Description: Parcel Tax No.: /lr], GD ors lac TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Benchmark C~ Gl~ Septic Dosing ,u L'9 r -Cr Aeration- Bldg. Sewer CO A Holdin St/Xt inlet TANK SETBACK INFORMATION St/jdt outlet TANK TO P / L WELL BLDG. Ventto Air Intake ROAD Dt Inlet G~ Septic LSD l NA Dt Bottom i Dosing NA her/ Man. 97 Aeration NA Dist. Pipe ~ ~ 02,75 r 97 9S~ i Holding Bot. System 5102 9702 P LIV"TNFORMATION Final Grade Manufacturer Demand (J Model Number GPM TDH Lift, Lrictior~ Lt~ Systems TDH J Ft oss Head Forcemain Length 3a' D a" Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length 1 No. Of T enches PIT No. Of Pits Inside Dia. iqui pth DIMENSIONS 6o DIMEN M acturer: LEACRM_ SETBACK SYSTEM TO P/ L BLDG WELL LAKE/STREAM INFORMATION Type O CHAMBER' Model Number: S) stem: OR UNIT DISTRIBUTION SYSTEM r / Manifold Distribution Pipe(s) f x Hole Size / x Hole Spacing Vent To Air Intake Length eT Dia. Length 6Q/ Dia. Spacing '~`/dry/}Y -a-6 1 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only ~`CJ Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges,~ Topsoil ~s E] No a-re-s E] No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: Warren.25.29.18W, SW, SE, 70th Ave ue 97,31) Plan revision required. ❑ Yes 0_<0_ / Use other side for additional information. a SBD-6710 (R 05/91) Date Inspector's Signature Cert No ADDITIONAL COMMENTS AND SKETCH ' SANITARY PERMIT NUMBER: SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COU STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than a X3455 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. PRO E TY OWNER PROPERTY LOCATION /,sQ W I/a SZ'/4, S T N, R E (Oril W PROPERTY OWNER'S MAILIN ADDRESS LOT # BLOCK # .i/ O P i_= CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER 6~3 57 --WSJ CIGE NEAREST ROAD TYPE OF BUILD71or : heck one) ❑ State Owned OLLA WczH~slJ 4 ❑ Public 2 Fa m. Dwelling-#~of bedrooms"- PARCEL TAX NUMBER(S) d~ Ill. BUILDING USE: (If building type is public, check all that apply) ©YoZ O 76 O O 1 ❑ Apt/Condo i 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 40 Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Off ice/Factory 130 Other: Specify IV. TYPE OF PERMIT: (Check onl ne in line A. Check line B if applicable) A) 1. ❑ New 2. Replacement 3. ❑ Replacement of 4.0 Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressuri Distribution Experimental Other 11 ❑ Seepage Bed 21 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) ELEVATIO j 5_0 >5- 9 98' 3® Feet 101' Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New xistin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank f~~0 Lift Pump Tank/Siphon Chamber OD 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) MP/MPR No.: Business Phone Number: tDOJ f r ku ` 1 o Q ~ ® a ?!S' 7Y9 3.3 2 Plumber's Address (Street, City, State, Zip Code): IX. COUNTY/DEPARTMENT SE ONLY a .4 ❑ Disapproved SaniUp mit Fee (includes Groundwater Date Issued 1 g Agent Signature (No Stamps) Surcharge Fee) C - Approved Owner Given Initial!/~ (fl Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398(R.08/93) DISTRIBUTION: Original to County, One Copy To: Safety8 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. It- 5. Onsite sewage systems (rust 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, 60£3-266-3815. 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 systern. 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 8i2 x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. - - GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used lfor monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) • r SAFETY & BUILDINGS DIVISION I State of Wisconsin Department of Industry, Labor and Human Relations April 27, 1995 201 East Washington Avenue P. 0. Box 7969 Madison WI 53707 ULBRICHT & ASSOCIATES ROBERT ULBRICHT 655 0 NEILL ROAD HUDSON WI 54016 RE: PLAN S95-00886 FEE RECEIVED: 180.00 IRKE NEIL SW,SE,25,29,18W TOWN OF WARREN 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. y, Sinc el Peter Pagel Plan Reviewer Section of Private Sewage (608) 266-2889 SUDA-7987 (R. 18M) ULSRICHT & ASSOCIATES CO. 655 O'Neil Road ` Hudson, WI 54016 Reg. Designers of Engineering Systems 715-386-8185 Private Sewage Consultants May 30,1995 St-Croix County Zoning Dept. Gov't. Center Bldg. 1101 Carmichael Rd. Hudson, Wis. 54016 Re: State approved plans S95-00886 (Neil IRke Mound System). Because of a faulty defective level, an error was made regarding elevations as indicated on above plans. All elevations are actually 12" lower than originally represented. These corrections will be made by me, in red ink, on the original plans on file with your office. If you have any questions, plese call. True system elevation JWr&9"' MU True "off" position 91.65's True existing bottom of tank P/C 90.251 True invert elevation 97.80' dyov Sincerely yours, 1-~~ wf-le~~ Robert Ulbricht cc: Installers, Henry & Walter Nechville. ~I I I t ULBRICHT & ASSOCIATES CO. 655 O'Neil Road • Hudson, Wl 54016 Reg. Designers of Engineering Systems 715-386-8185 Private Sewage Consultants PROJECT INDEX DILHR Plan I.D. # S95-00886 Date 4-27-95 Owner Niel lhrke Phone 715-796-5538 Address 1470 70th Ave. Roberts, Wis. 54023 Legal Description Parcel # d42-1070-000. Lot.1, CSM Vo14, Pg. 11291 2.3 acres. SW1/4, SE1/4, Sec.25, T29N, R18 W. Town of Warren County St. Croix C.S.T. Fcb.ert Ulbricht CSTM2482 Installer , Local Authority/ Supervision .~„1 Ra 3 St. Croix County Zoning Dept. PROJECT DESCRIPTION A replacement system. 3 bedrooms, estimated daily wasteflow: 450 gals. The failing existing system (1982 I.G.P. DILHR #82-01519 ) is in code compliant soils (see attached soil evaluation 4-10-95). Existing system will be left intact for future reuse, after 3 years idle rest; old system will be available for reconnection via a sch.40 PVC bull valve. Existing septic tank and pump chamber will be reused. Conditions for reuse of tanks are noted in plans. Soils in replacement area (lower area in landscape) are seasonally saturated at 31". A standard mound, curved on slope, with 12" sand fill is proposed. Pg.l PLOT PLAN VIEWS k' , ````"\`aatunmurnpgiq',' S Pg•2 SYSTEM CROSS SECTIONS & SYSTEM PL4NI ss~1 CONv Pg . 3 PIPE LATERAL LAYOUT. ROBERT W. ctrl ¢I CHT Pg A DOSING CHAMBER CROSS SECTION , / l~1 ts0 "Ai sins.", Two P g.5 PUMP PERFORMANCE SPECS Pg. 6 SUMMERY OF I . G . P . SPECS `S95-00886 f ( w~sr- ~o T om. z z i, 9 ~ W N ~ Tr C • D u U1 n D W ~ fri y o CUP lahm lmbx ~ ~0 3 o w o N W C=11. o~ 'Xl ~5F c d Cub r 6 i w ~ >Q 00 ~"00 / 1 C\ S95--00886 a i ~ N hi ~P P j^ r ~ ~ w ri o y o ° o I H y n rn 0 e n • Oki c 4t- ~o r %-;:'.45 7- I-► r a5 S , CROSS SECT iOQ OF MoL)AjD T ti f3eD pEo ~F % ro z" ID1 ST RiaoT%°N AggQc-SaTF G, TktckaG- s3 PIp10(T- sysr~M OP Tc P soi L ~IEVhI'io/~ k 7f 30 U) .3i Fop K To E- LI•A-) E °<<< ~ RhTrp 1t• M61~• ~ ~ • • • 9 • p i o w m c> T o p s o i uu ~ FaRM % 510pE FORCE' ~ E4WN MW UupER Rep ?130 d FT. - ELEvhr"o►J s 9 E iNVeRr of /y IATERAIs PO - F 2- r- T T'op of R ock 12- /-0 F-r. H 1-6- FT k• PLAN ,V fEW M u D w~ rat 13E D 4k vRcE MAIN Co FT• B ~y Fr fi f T T !3 K >I I F T w Y W z7 o Fr Bev of r2" S95-00886 To ~ y" PVc cAPpEp A Prj ATE" o (35E R V/!Tt o,~ p,pes 1 PERMA,v EuT M AQ KERS REcgviRED 13A5AL AgeA _ 7PAiLy tohsrE'Flow - ys''o - 9az~ SOIL 10-fi ITtRATIOE Z sq• FT, C A IPAc i Ty S- Gpp~f~ PRoposEb BASM AReA = X A z l Co ~ t 3 ~ 1 2 l ~O FT. J 3 o-f - D15TRI f3uTI oA.3 PIPE MET-WORK LAYoL)-" LI'QUiD cApACI'1 I oF E' L i2 l=o (Z A-TED )JETwoR,K , P R OLQ -r o ~o\ E R 3.0 Fr .s FORCE' M A i N I N c N E S Fr Y --r IucHE yD 2- PUG of s ARC A(3LE TOTAL_ VOlD U0jWjr; GAIS ST^,,j c ft , Hole DANE-r6R INCNeS L.hTEPq.L. INc tiE5 MANIFOL,t- " Z I N c t4 ~ s FoRcE A'IAw 2- 895-008,86 OF HOI£5/pi PE ~~O MOVERT ELEVAT100 o F- L ATE RM S 7e. ro -De TAi L- E u p c AP PE R F0 R PrTE PIPE •r--J • RtMovE- Ail DRill BURRS ~ y • H6IES IOCATeD 0,3 BoTi'oM UWAIIY SPACED ?)i STRi C3urtoN DISChAR &E RATE F;oR LE,jch LArER i L PER 0T C-5 -7 2- GAL TOTAL 17i5TRi(30TIo0 'DtScHAR~~ FATE POR NETwoR K 3-7 y~/ 6r AL 111",V. MiNI'MUM I+ EA T) . 9 FZ - EiC Titi G-- 7-4w -5 co R~ • u s~:v G- , PUMP CHAMBER CROSS SECTIOW AND SPECIFICATIONS P,4 If OF 6 -VENT CAP H"C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING JUNCTION BOX MANHOLE COVER > 25' FROM DOOR, w1 4Vn1''JI'v6- IA13EI WINDOW OR FRESH 12"MIU. AIR INTAKE I q/W T/OA/ GRADE I y„ MIM. 1j~ ~ ~ I B" MI IJ. yg•~ COIJDUIT 1 ~IEU~fi acv , 95 z2~ ~NvE~r 9y~s' PRO ) 111 L E T A1~ i~N T 56}$ i ilI APPROVED JOINTS APPROVED JOIN-A 106/aNK W/C.I. PIPE W/ C.I. PIPE ,~(U ff - LA EXTENDING 3' ~ II ONTO SOLID SOIL EXTENDING 3' ~0 r OuTO SOLID SOIL B C ELEV. FT. PU - r OFF ,(AP' BLOCK Cie VA iod RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E 5PCC.IFI'CATIQUS DOSE (~J~~~s CO.UGI.Cf-e ICJ, WMBER OF DOSES: -3 PER DAB TAWKS MANUFACTURER: /SO TAMK SIZE: ~?d o GALLONS DOSE VOLUME (o (o 17 LlLI~~L A(A Lem ~o INCLUDING BACKFI.OW: GALLONS ALARM MANUFACTURER: MODEL HUMBER: U' L- CAPACITIES: A=/6'5- INCHES OR 3 00 GALLONS SWITCH TYPE: /LIE~~ V 12, Fib hT 8= l INCHES OR 3GALLONS INCHES OR 7 GALLOWS PUMP MANUFACTURER: 3 ~ GALLONS = INCHES OR MODEL NUMBER: Z.co P. I s u D I(y SWITCH TYPE: PIyjY f3RGK ME-IQGu12y CATNOTE: PUMP AND ALARM ARE TO BE ~_GPM INSTALLED ON SEPARATE CIRCUITS MINIMUM DISCHARGE RATE S VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. ~.Z FEET -"AA.lk PEGS II,, f " + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . 2.5 FEET EA( (A, Orr- t + yo z.4z F7. /.01/ 2 TOTAL OF FORCE MAIN X oFtFRICT1oN FACTOR..FEET tg0A TOTAL 139MAMIC. HEAD FEET RouAvD Q It 5~y /'0 INTERNAL DIMLWSIONS OF TANK: LENGTH -;WIDTH v / _;LIQUID DEPTH 895-00886 NO 7i~ 1-9-e 5 y-/O - Y5 /~E~~•~/.~ Ems. i 5 ~i :v G-- /f,~~,~ p•CZ ~i is ~7~ i9'/~ Ova i s ,~-T•f-lost ~-e- " D~ T'~ o i?~T~-~ IA'l 5 1 t J i S O HEAD/ W 1 113 CAPACITY 3411° - 32 105 - VE 30 100 - CUR 95 28 90 26 85 I I EFFLUENT 2+ 80 MODEL and Q 75 MODEL 189 DEWATERING = 22 70 165 V 20 85 - - Q > t8 80 - 55 F 18 50 MODEL O 183 MODEL t- 14 45 188 12 40_ - 35 10 MODEL 30 MODEL 137,139' 185 SEWAGE and 25 DEWATERING 6 20 t - MODEL 15 MODEL 161 4 7 10 - - a 1~il 2 MODEL W + 5 53, 55, - 57, 59 0 GALLONS 10 20 30 40 50 6'0 70 60I 90 100 110 21 60 - - LITERS 0 80 160 240 320 400 75 22 FLOW PER MINUTE 70 - 85 18 60- - MODEL R 295 -el S 16 53 O So - 14 IS MODEL Z 294 12 40 p - MODEL 35 I - i 10 293 0 - I f - - 30 MODEL 284 5` O O 813 6 S9 i e 25 I - ~ MODEL e 20. 282 + - - 16 1110 0 MODEL Z'0' a'a w Z'~F. _ 267, 266 e 3280 Old M/llem Lane GALLONS 10 26 30 40 SO 60I 70 80 190 100 1110 120 130 140 i5o 160 1io 180 190 P.O. Box 16347 + 1 1 I Louisville, Kentucky 40216 LI7tM a e0 lee 240 320 400 490 S60" 640 720 (502) 778-2731 FLOW PER MINUTE "267" and "268" Cast Iron Series CAPACITY - ffoc UNITS/MIN • h H.P., 1 Ph., 115V or 230r 230V r • Non-clogging vortex impeller design. eters Gal. Lirs. 1.52 128 484 • Passes 2 inch solids (sphere). 305 e9 337 • 267 series features a 2" NPT discharge. 407 so 37 189 • 268 series features a 2" female - 3" male com- 4 6.10 57 to 38 bination NPT discharge as part of the pump. e z1 s • Float operated, s ubmersible (NEMA 6) mech- anical switch. O /n Canad enplo.al • Automatic reset thermal overload protection. listed A'+ll~ Apr~a, available • Stainless steel screws, bolts, handle, guard, arm and seal assembly 268 - State of e Switch case, motor and pump housing, base and 7 Wisconsin approved impeller are of cast iron. 1 71 SC-2225 N267, non-automatic, available packaged with a piggyback mercury NOTE: No UL listing for 200-208V/1 Ph. M260 Pictured (loaf switch. pumps. Mercury float switches are available for N268. Pg.6 of 6. SUMMERY OF I.G.P. SPECS FROM 1982 PLANS (582-01519). Established: all pump and control settings, all taNK features( as rill be set for the new mound system requirements are very compatible with all the crigi al I.G.P. requirements. The new diversion valve can be used to simply shift existing force main flow to either system. # Hc-les per lateral 6 Total # of holes for netwrk 36 Size of hcles 1/4--inch Hole spacing 36 inches. Total Discharge rate 42.12 GPM at 2.5' head. I.G.P. # of doses set 4 Dose volume 113. Void volume flow back for 77' of 3" force main 33 gal. Total needed IGP dose volume 146 Gal. Total Head IGP system Existing vertical lift 4.5" Min. head 2.5' Friction loss for 77' of 3" force main at, 42, jGPM .30' Total Head / Friction Loss 7.3' I S95-00886 Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY .ST. ~/Po x Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. o v.2 '1070 • 70 000 APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION /I//EL --7_l iPGOVT. LOT SW 114 SE" 1/4,S 2-4-T 2-9 N,R /e E (01 10 PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # M70 -70K- AL)EC • / CS Al Ua/. tl P • l[ z l CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE [MOWN NEAREST ROAD % 1R66E12T'S Wt • 5462-2- (-7/5) 7y6•55-9 &..1,4 Re,---Al -7o -tif- Aute- . ( J New Construction Use [kl' Residential / Number of bedrooms 3 [ J Addition to existing building [kJ-Replacement [ ] Public or commercial describe Code derived daily flow fl ~0 gpd Recommended design loading rate bed, gpd/ft2 trench, gpd/ft2 Absorption area required 3 ?5 bed, ft2 ~3 7-5 trench, 112 Maximum design loading rate -S bed, gpd$ • G trench, gpd/ft2 Recommended infiltration surface elevation(s) ?P-30 f ft (as referred to site plan benchmark) 'C vR ()'E Additional design/ site considerations WSE' 45 40Av(r 3 NAR126 w A- No ua0 ,4 S P 0 s S f 13 I e' - 0A) Parent material $GS t~ fE~' (J i +1- - SEDi~E ~7'S Oaf Flood plain elevation, if applicable 41I • It tiff S = Suitable for system CONVENTIONyI IN-GROUND PRESSURE AT-GRADE -)f- SYSTEM IN FU HOLDING _ IS, [3 tJ 2S ❑ U ❑ S 20 S fra'l7 U = Unsuitable fors stem ❑ S V ❑ U ❑ SOIL DESCRIPTION REPORT '9 21E'Jo"E'S "WA of R 14 0N1-y Depth Dominant Color Mottles Texture Structure Roots GPD/ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Consistence Boundary Bed Trench - z-f sb 5 f • S / o - /0 /o 12. s/ of R > _«K 2 0•/7 /0 VR 3/3 S/ 2-f Sb& m,-f R, C S Ground 3 7- /D YR y/ S/ Z n-,.. h& Hof R tj l f S elev. / nNt QO S 4~ 7 97 W_ f1. y 7.5 yR S y/ ~P W+C r S Td.v E EN 6-0 vN ,2 1n • Depth to /YT" 4-',? too limiting factor Remarks: Boring # 10 - /6 lo yg 3 /2- 2 -F S/ /►N+~ i a tJ I f S G , 6- 1- Ewa /207~D f/' l'N G. Ground y S/ ,a,t ,6~ 7~/'e S `U f • S • 4 elev. 2 G - 3 /p)//+~ .2 r 7.3 2- ft. 3 y- y i0 VX / s/ 1.11 7C/ s G ee' -7. _s leg S 1 Depth to - • ~ LIJ limiting ! D 7•S ~t' 64 0 A fact7_5 M 41'e fFT ~,P~4-c Tv,P ~ ' ES 7'oa ~.u 60 U..~ S S Remarks: CST Name:-Please Print RO QE 2 T- ?mil L 8 k t G 1,7' Phone: S 499 Address: (o g S 0' /.12-1 L ~ ~ • N" U O S o,J k_) • S q 01(o 41-lo - Y,57 CST-di IL W2__ Signature: Date: CST Number: ~STi9~i3L/S~E1D filPaNl El/~/u~T-iv.J off' y ; s: xrs Ti.~ Cr 7. 6r: /1. SYS 741,y /3 46r /pE• ZrSEP • I/V4 14/¢/vE- syS 7L&-.4-1 Norte / OAS/"~r~V /~'IOU.vO 'lC S/:vCr /,eT' 561'Z- /t ES77c'/'cTio.cJ ~st~4soarr/ry s~F rc~~D s©,~..s~ w , •e~- " .s,~,u~ PROPERTY OWNER /V 2fj~RkF SOIL DESCRIPTION REPORT Page 2 -of -3 PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft A;: Y in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench -f she r ; 2 6 - 31 /o YAP Y y - S•/ 2.r►~ 56,e C, Ground 3 1 SL 75 he yI 7 I R S S 2 -F 5 fit! n ►ti'~ 1 Q Gv S elev. 1FS.5'2 - ft. 9/ ~ ~ ,~G V~2~'~ ~rE Ta~E ,c1GoV TE~ Depth to limiting factor , r Remarks: Boring # >x:. D - /7 /o Y,P 2/2- S~ / 2 s6,~ -FR Cs 2r-, s 17-30 /o /i2 3/Z COM ACrerv Si~ I `F s hk Hof i c Ground::. 3 -,r .-/O y/e y s~ f 56 f-+ P, 4 1 UT 5 . G C / d 7~ev. ft. S- IS Ye 7 /5 Depth to limiting factor 11. cog"_ 1) OF S s . S . = f3. o D pdk a Ex•'s r tyS. 96::-Z S SS Remarks: t-tUAAatC^L Sol L D I'S+VP13hacc- R6-soLT! ofz Boring # tN S+'t Lr' a :~{~:~:{~Y ~ ~ G• P. y s r M, Ground elev. ft. Depth to limiting factor Remarks: Boring # h?r jt:: jjhh\j + . Ground elev. ft. Depth to limiting factor Remarks: 0011 077-M ACMM • . ~ cuFST Lo T L z z 9 C • D u W W r- G tt~Y ~ ~ 11 G O ro S0 1 S-1 oL N of - ~ W c to ~ m 6 cl~ N Q ~ a C 1 ~ H b I~'` to W ~1 ~ RO w JI w o y 1~, ~ y v, N ~ Z a ~ ~ m y 'b i N` o `l h o O I ~ \ ' W 0 i (~1 2 Z o- ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving the -'1- / '~r /Vh.iF- residence located at: 4, s 1/9, Sec., T ~~N, R9~ Town of C-Un titi c Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. /I/E F/ r Last time serviced ~Ij--- Did flow back occur from absorption system. Yes No (if no, skip next line) Approximate volume or length of time: gallons minutes Capacity: (poo goo gaQ c,12o .C. Construction: Prefab Concrete Steel Other Manufacurer (if known) : 1.c1 ~-.l C ~/~p Age of Tank (if known): jam-~.~ l (Signatu e) (Name) Pleaso6 Print Cc - o 3 2 S-?, (Tittle) (License Number) (Date) Form to be completed by licensed plumber (s.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 opening over outlet baffle). f Name i6A/1'y cJtu/)~F-Signature:2" MP/MPRS 5/88 STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNERIBUYER ~~Q~p,~ p ~!ry /7 C MAILING ADDRESS / Y 7o 70 PROPERTY ADDRESS A ~'YI (location of septic system) Please obtain from the Planning Dept. CITY/STATE /?6 f0~/"' / S " az'r~ PROPERTY LOCATION 1/4, S-F-7 1/4, Section 57 T N-R l W TOWN OF ktl)Q I- J✓ ST. CROIX COUNTY, WI SUBDIVISION LOT N EMBER CERTIFIED SURVEY MAP-~ 7 , VOLUME l, PAGE 7 , LOTNUMBER_ Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED: ~ )4~ DATE: 5 Z ' q St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson. W1 54016 11/93 S T C.- 100 ,t 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 N EQ ( "I t"k e Location of property-19 41 1/41/4, Section ,T_a9 N-R~ Township Mailingaddress /'Y74 7d /llvE Address of site Pi '7 C) "70-1-1 ~'j 0- Subdivision name Lot no. Other homes on property? Yes No Previous owner of property -\Aj es Total size of property 2.3 ac, es Total size of parcel Z e 3~ s Date parcel was created Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house) ? Yes v--No Volume &-09 and Page Number -~/L/3 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. , 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. I Signature of Applicant Co-Applicant S, -2 6 -q3 Date of Signature Date of Signature 1 * ~ Pit ED ;I Of 1981 374389 1 of, ~ cam"''' w CERTIFIED SURVEY MAP "s LOCATED IN THE SW 1/4-SE 1/4 AND SEI/4-SE 1/4 SECTION 25,T29N,R18W TOWN OF WARREN, ST.CROIX COUNTY. 1, Arthur L. Wegerer, re;=;istered 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 Ordinance and under the. direction of Wesley Cowles, 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 SWI of the SE1 and the SE4 of the SE14 of Section 25, T29N, R18W, Town of Warren, St.Croix County, Wisconsin, to-wit: Commencing at the SE Corner of Section 25; thence West along the South line of said section 131$.9$? to the point of beginning; thence continuing West along said line 392.50'; thence North 254.96?; thence East 392.50?; thence South 254.96t to the point of beginning. Contains 2.30 Acres subject to Town Road right-of-way over the southerly 33? thereof. APPROVED Dated this Zl day of Ai3GUST .919$1. '%101110 OCT 3 198-1 , 0 /V ~r.....••, ST. CROIX COUNTY ~i~ COMPdEHENSIVE PARKS PLANNING • : AND ZONING COMMITTEE f ARTHUR L. L Arthur L . We ge- e 3 WEGERER = Kozel, Wegerer and Assoc., Inc. :C ELLSWORTH River Falls, WT M WIS. 10 0 :--I ~ SURGE NOTE: BEARINGS M UNPLATTED LANDS REFERENCED TO THE SOUTH LINE OF SEC. 25.(ASSUMED BEAR •C ING WEST.) •Z OLD BARN FOUNDATION D EAST 392.50 •D moo .Z o00° .m 00. , C7 00, 9° z o :r- o C N :D LOT I N= :Q N 2.30 ACRES TO CL ko N E ko (100,072 SQ.FT.) a _ 2.00 ACRES R.O.W SCALE 1'= 100, tp (87,120 SQ. FT) NOTE: EXISTING HOUSE o~ ON PARCEL. 0 50, 100, 200' R.O.W. LINE 00 392.50 ~0 0 - - - $0 w w BOO WEST 1318.98' EAST w g_~' 41U .5.TH- 926.87 w ROAD WEST 392.50 ST w S114 COR. SEC. 25, SOUTH LINE SEC. 25 E CDR. SEC.25 T29N, R18W T29N, R18W (C.S.M. SET) (C. S.M. SET) UNPLATTED LANDS 0=SET I'k24"IRON PIPE WEIGHING 1.13 LBS. PER LINEAL FOOT. Volume 4 Page 1129 - l{1 ~ 'PI c- C> - p,cprr r4i FTF'h o,,- R r rEt~rrlve.~.,,F$R A DOCUMENT NO. STATE BAR OF WISCONSIN-FORM 2 tT [n~S WARRANTY DEED VOL 638 PAU443 THIS SPACE RESERVED FOR RECOROING DATA 1 RECAS A ERS C FfI•_t -Wesley G. Cowles and Doris A. Cowles, husband and wife. ST. CRo'!x Co., W1.5. as_joint tenants, rar i, ov A. D. i 9`31 conveys and warrants to -Neal R.' Thrk- A"n E Thr ke 1 !::30 r' M. husband-;and wJf`P,__!,&_J.QJnt tenants, - + j R.tI9111 of Dsodl - RETURN TO the tollowing 0-scribed real estate in- St. Croix County, State of Wisconsin' Ai tCh.`a_ „T LAV1 BALL 1.'-,!N, ',,wl ~,a002 That part of the Southwest Quarter of Southeast Quarter (SWk of SE`s) and Southeast Quarter of Southeast Quarter Tax Key No. (SE-1f. of SE's) of Section Twenty-five (25), Township Twenty- nine (29) North, of Range Eighteen (18) West, :own of Warren, St. Croix County, Wis^onsin, described as follows: Lot One (1) of Certified Survey Map filed November 10, 1981 in Vol- ume 4, page 1129, Document No. 374388, in the office of the Register of Deeds for St. Croix County, Wisconsin. Grantors agree to pay all real estate taxes for the year 1981. This jg_og~___ homestead property. (Is) (Is not) Exception to warranties: The above described real estate is subject to easements and rights of way of record. Dated this 24th---- day of - IouembeC - - - 19 81- . (SEAL){ SEAL) Wesley C. Cowles (SEAL.) d= e_~ C.~ SEAL) Doris A. Cowles AUTHENTICATION ACKNOWLEDGMENT Signatures authenticated this play of STATE ()F WISCONSIN 1i_ tiff St. Croix ~ Personalk came before me, this 24th_ lac of November, 181 the above named Wesley G. 11hLE. M. %IHER STATE BAR OF ''NISCONSI% Cowles and Doris A. Cowles, husband and authorized by ;06.06, Wis. Stats.) wife, as joint tenants. This instrument was dratted b`, Harold D. Olson, Atty. me known t) be he person Nho executed 'he t e,,olne instrument and acknowledged the same Baldwin WI 54002 l Hi Signatures may be Authenticated or acknowledged. Both- are Harold not necessary.) ,`rotary Public Count. WAS My C")mmission is permanent (LLnn1._.,i&Lp_e.&puaUQr1 - hALa _ tH ' AMRANTY DEED STATE BAR OF WISCONSIN FORM NO 1-1977 ULBRICHT & ASSOCIATES CO. 655 O'Neil Road • Hudson, WI 54016 Reg. Designers of Engineering Systems 715-386-8185 Private Sewage Consultants May 30,1995 St.Croix County Zoning Deot. Gov't. Center Bldg. 1101 Carmichael Rd. Hudson, Wis. 54016 Re: State approved plans S95-00886 (Neil IRke Mound System). Because of a faulty defective level, an error was made regarding elevations as indicated on above plans. All elevations are actually 12" lower than originally represented. These corrections will be made by me, in red ink, on the original plans on file with your office. If you have any questions, plese call. co v• v/~ ! True elevation 96.30' 5,/S ri " ✓ True "off" position 91.65" True existing bottom of tank P/C 90.25' True invert elevation 97.80' Sincerely yours, Robert Ulbricht cc: Installers, Henry & Walter Nechville. 1 SAFETY & 13UILDINGS DIVISION I State of Wisconsin j Department of Ind' stry, Labor and Human Relations April 27, 1995 r 10 201 East Washinyton Avenue P. 0. box 7969 Madison WI 53707 0'a ULBRICHT & ASSOCIATES 2 199 ROBERT ULBRICHT- 655 O' NE I LL ROAD HUDSON WI 54016 RE: PLAN S95-00886 FEE RECEIVED:. 180.00 IRKS, NEIL SW,SE,25,29,18W TOWN OF WARREN COUNTY OF ST CROIX MOUND SYSTEM The Department has reviewed the above-referenced submittal. Conditional approval is hereby granted fr.)r, they 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 systems has not been reviewed for the code: requirements set forth in chapter ILHR 82 or" in chapters ILHR 'i0-64, 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 clay the initial sanitary permit expires. The license(i plumber re,.,ponsible for this installation shall keels one set of plans with the Departiflent's stamp of approval at the construction site. The im-taller sh(01 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 nuWse'r list((i 60ow. Please refer to the plan number shown above. Sinc ely Pe er Page Plan Reviewer ~L Section of Private Sewage (608) 266-2889 v SBDA-7897 (R. 10184) - - - 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. # S95-00886 Date 4-27-95 Owner Niel thrke Phone 715-796-5538 Address 1470 70th Ave. Roberts, Wis. 54023 Legal Description Parcel # 0(42-1070-000. Lot.1, CSM Vol4, Pg- 1129 2.3 acres. SW1/4, SE1/4, Sec.25, T29N, R18 W. Town of Warren County St. Croix C.S.T. Bcx.ert Ulbricht CSTM2482 Installer Local Authority/ Supervision St. Croix County Zoning Dept. PROJECT DESCRIPTION A replacement system. 3 bedrooms, estimated daily wasteflow: 450 gals. The failing existing system (1982 I.G.P. DILHR #82-01519 ) is in code compliant soils (see attached soil evaluation 4-10-95). Existing system will be left intact for future reuse, after 3 years idle rest; old system will be available for reconnection via a sch.40 PVC bull valve. Existing septic tank and pump chamber will be reused. Conditions for reuse of tanks are noted in plans. Soils in replacement area (lower area in landscape) are seasonally saturated at 31". A standard mound, curved on slope, with 12" sand fill is proposed. Pg.l PLOT PLAN VIEWS ttiumi,r,»r»,rr' i 0 Ns Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PIA a3„ e, Pg . 3 PIPE LATERAL LAYOUT ROB MMUCHT :'fit a y 09160 PgA DOSING CHAMBER CROSS SECTION HUDSON, WI Pg.5 PUMP PERFORMANCE SPECS 4k' 4 4PS ,''~r r i r p r n u m n u u►~~~ a Pg.6 Summery of I.G.P. SPECS S95-00886 ~ w r ~ ti c • CIO sma 1,3 CIO CID ~ L~ 3x O CES ES com ° ,..e~•y{°•~~ W eub I G M soma- ta= p m raft- % , oll $95-00886 o i • \ v~ ~ ~A 1~ 41 N k-A 41 ~ It IS h ( 2- 2- CROSS SECT ION of M0UAjD w i r t-t f3ED OED aF 0 " ro 1 y" 'DI STRi(3UT~oAJ ASgec-SATE rs TNi cka E5 9 pip vo G- s ysrEM of TOP So(L IE~VA2r'i~.oo It z' 6 VOi FORM TOE lit i~ H to E 3 F 1-7,30 ccc J-RAT-O MEU. e - u t) FORM Cp % SIoPE FoRCE' Etr=VAT%CD,3 UuMR MAW RED t45z-0 16,30 d Fr. ELEVAr1o►J s y T. lmvERT' of / ' )ATERM S F ? FT' ToP of R ock %1. !Z 7,'0 G, Fr, x< , fl•Top OF 2. IATE AIS 1-6 FT. 1 UAJD - wi r" 13E D r FORcE MAbJ FTM. . I (3 y Fr '~K ~e-- F r (o w l 13 T- 'T FT T !3 6~° w r w f T- 2.7 FT ~A 1 Bev of X2'1 To t!. ~ PVc CAPPED y d(35ERVhTio~ A 93PF5ATE pi1PES $95-00886 PERMA-J tA3T MARKERS REC.2UIRED (3ASAL A(2eA - 'PAiLy ujAsrE Fi w 45''0 _ 90z0 901t. 101 *17PATIOE Sly, FT, C A PAc i ry S- 6-PAPA-1. y NopoSEd BASM ARe~ = B (A + 11 ~efl x !3 J sat. FT C . P~. 3 o4 - DISTRI BuTi oA.3 PIPE N e Tw oR K LAypur' FRvtO cApACI-1-y OF I~~=12Fo DATED \ MerwoRK /l• d S lam, To MAO% (,p0 7- 3.0 Fr r X yU `b N ES F o R cE M A i ,v ~ I n c A1 y~ Fr. 2 V G . P y _,~~NES VARt'Af3LE ST^a cim TOTAL. VUtD Valu~lE 6A15 H olE D,-AmeTE R Y4/ ~NCN~s L•hTEPAL 1.5- INc lies MMIFOLn Z INc0es Foi2cE MAIN 2- ~N~NES 595-0088: Of HOI£5/pi m /Co IOVF-RT- ELEVAT100 c,F LATERM S -DE TAi L- A c AP PER Fc~R ATE ~ P~ P~ III • RemouE- Ali 'DRM (3uR RS l Y NoIES Ic)CATEo ox) BOTTOM EgL)A11Y SpACEv , T)i STRi BL.)rIom T)ISC hAR &E RATE FOR E~Rch LArERA L.. PAR C)T(-S 72 - GqL TOTAL- 1T)fSTR030T1o)3 'Di5clI^R6E7 RATE r-oR 1VETWOR K' 3 7 y~l &AL/Mi•,). 2.57 f MI*01*MUM 1 1t6AT) . Zf Si:J Cr -A ST/•v 6- CoDE CdM,O //AAA T 2 PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS pi4GE of -VENT CAP 4"C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING JUNCTION BOX MANHOLE COVER 25' FROM DOOR, lv/1ieUho6 ~~A 12"MIN. WINDOW OR FRESH AIR INTAKE I I/IADE, C~~E~17/O n/ GRADE I 4°MIN. 1/~ I I8"MIN. yg•~ CONDUIT-- v'4rrow C ' 040VIDE I M~~c~ IN LE T AI CJ) '~G ~4 i~•~j~ APPROVED JOINTS APPROVED JOINT A iNyia►~K©~ W/C.=. PIPE 7-XTE . PIPE EXTEUDING 3' EXTENDING 3' ~0~ t Ct~q~S~F E~ I ONTO SOLID SOIL ONTO SOLID SOIL Old ELEV. FT. PUMP--~ OFF D I ~p I k p~~~l~~ I BLOCK 40 cc /EVAfiod 1 RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC SPEGIFIC. AT IOPIS E DOSE TANKS MANUFACTURER: w,6F&L-5 r,cJct~e{-f LO' WMBER OF DOSES: 3 PER DA-4 TANK SIZE: S?d GALLONS DOSE VOLUME (y (o 7 LLl>~5L /tIItIRM Cp INCLUDING BACKFIOW: GALLONS ALARM MANUFACTURER: MODEL NUMBER: -D. U, L- . CAPACITIES: A=16 . INCHES OR 300`/ GALLONS . -AE-R(Ul?V FICA~T-' B= INCHES OR 36*et GALLONS SWITCH TYPE: INCHES OR 1S 7 GALLONS PUMP MANUFACTURER: zo~~C 9 O MODEL NUMBER: Z. (o. / /2' 14 P 1 ' t' S V D= lD / INCHES OR 3 GALLOWS SWITCH TYPE: NilV BACK MiIQGvIQy C t O TMOTE: PUMP AMD ALARM ARE TO BE -GPM INSTALLED ON SEPARATE CIRCUITS MINIMUM DISCHARGE RATE s VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. (0.2- FEET jA~k_ TEC-5 MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . 2.5 FEET EAC (A + 7 FEET OF FORCE MAIN Y, Z•4ZF>I/ooFT.FKICTION FACTOR..~c FEET (BOA S ld 2_ TOTAL DYNAMIC HEAD FEET J PCumv 7 y INTERNAL DIME.WSIONS OF TANK: LENGTH ;WIDTH -LL-;LIQUID DEPTH A S95-00886 No Ti- Spe-er;o f 47- S ~N ov y' to /91 ,v~~ . roU"e-w 1,5 L! HEADI 2 119 CAPACITY 34 32 105 - CURVE 30 190 - 85 28 i 90 28 85 EFFLUENT 24 --so- MOD L and Q 75 MODEL 189 DEWATER/NG = 22 70 155 FJ 20 85- a z 18 BO G 55 H 16 S0 ODEL G 183 MODEL F- 14 45 188 12 40- - - - 35 10 MODEL 30 137,139 MODEL 185 SEWAGE and ° 25 DEWATER/NG a 20 - MODEL 15 MODEL 161 4 7 10 - - - ri 2 MODEL - { 5 53, 55, x 57, 59 0 80 GALLONS 10 20 30 40, s0 80 70 80 90 100 110 24 LITERS 0 80 160 240 320 400 75 22 FLOW PER MINUTE 70 20 s 18 80- - MODEL a 295 W 55 x 1t V so 14 45 MODEL - } . . _ -It- 294 j C 12 40_ - 7 } - MODEL 35 j 10 293 - 1 - - - - - O 30 MODEL 284 8 25 1 MODEL - e 20- 292 - 1s - ~/~F Fp 10 MODEL - ~ ~ 287, Zee ~ it e 3280 Old Mlllem Lane GALLONS /0 20 30 40 so so 70 80 190 100 110 120 '130 140 i5o /50 1i0 1e0 190 P.O. Box 16347 ' { l 1 ' i - I I Louisville, Kentucky 40216 uTtAt a ee 1e0 240 3" 400 480 560 849 720 (502) 778-2731 ' FLOW PER MINUTE S95-00886 "267a and "266" Cast Iron Series CAPACITY HEAD UNITS/MIN • 1/2 H.P., 1 PFi.,'115V or 230V. • Non-clogging vortex impeller design. Feet Meters Gal. Ltrs. • Passes 2 inch solids (sphere). s 1.52 129 464 • 267 series features a 2" NPT discharge. 10 3.05 89 337 t6 4.57 50 169 9 268 series features a 2" female - 3" male com- 20 4 57 to 36 6 10 - bination NPT discharge as part of the pump. IS Float operated, submersible (NEMA 6) mech- Lock Vale 215' anical switch. Canadian Standards • Automatic reset thermal overload protection. listed Sp Assoc Approval • Stainless steel screws, bolts, handle, guard, arm avaitabfc and seal assembly 268 - state of • Switch case, motor and pump housing, base and Wisconsin approved impeller are of cast iron. SC-2225 N267, non-automatic, available packaged with a piggyback mercury NOTE No UL listing for 200-206V/1 Ph. M266 Pictured float switch. pumps Mercury float switches are available for N266. i Pg.6 of 6. SUMMERY OF I.G.P. SPECS FROM 1982 PLANS (S82-01519). Established: all pump and control settings, all taNK features(as will be set for the new mound system requiren-ents are very compatible with all the crigi al I.G.P. requirements. The new diversion valve can be used to simply shift existing force main flow to either system. I i # Holes per lateral 6 Total # of holes for netwrk 36 Size of holes 1/4-inch Hole spacing 36 inches. Total Discharge rate 42.12 GPM at 2.5' head. I.G.P. # of doses set 4 Dose volume 113. Void volume flow back for 77' of 3" force main 33 gal. Total needed IGP dose volume 146 Gal. Total Head IGP system Existing vertical lift 4.5" Min. head 2.5' Friction loss for 77' of 3" force main at 42 GPM .30' Total Head / Friction Loss 7.3' / I 895-00886 ST. CROIX COUNTY WISCONSIN ZONING OFFICE 1, 99xllxllnn■ arrrb ST. CROIX COUNTY GOVERNMENT CENTER , 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 June 28, 1995 Century 21 Hudson, WI 54016 Attn: Al Cowles Dear Mr. Cowles: Inspection of the recently installed septic system, which serves the Neal Ihrke property at 1470 70th Ave. located in the SW1/4 of the SE1/4 of Section 25, T29N-R18W, Town of Warren, were conducted June 12 - 28, 1995. This system was designed and installed to accommodate the needs of a three bedroom home. During the initial inspection, a code deficiency was noted relating to the surface discharge of grey water from a clothes washing machine. Since that time this deficiency has been corrected, with the grey water piping being removed and access provided to the interior plumbing network. At the time of final inspection this septic system was found to have been installed in accordance with the requirements set forth by Chapter ILHR 83 of the Wisconsin Administrative Code. Enclosed is a copy of the inspection report should you need one. Should you have any questions, please feel free to contact this office. ince ely, es K. Thompson Assistant Zoning Administrator cc: file y aG , ~4 y'" ~ AS BUILT SANITARY SYSTEM REPORT OWNER TOWNSHIP a, ~ SEC .25 TMN-R /BW ADIiRRSS ST. CROIX COUNTY, WISCONSIN. SUBDIVISION LOT LOT SIZE PLAN VIEW Distances and dimensions to meet requirements of H63 EjiyTHING WITHIN 100 FEET OF SYSTEM lit# t, I di a e o th A ro SC LE: BENCHMARK: (Permanent reference. Point) Describe: --nc~J-Zv. Ja.A" Elevation of vertical reference point: iaoit Slope at site: ! ~ ~o SEPTIC TANK: Manufacturer: Liquid Capacity: /000 Number of rings on cover : / Tan manhole cover elevati.on:g Tank Inlet Elevation 513jg Tank Outlet Elevation: " PUMP CHAMBER Number of gallons TO 0 Manufacturer: Number of gal. pump set or a cyc e gallons; tots capacity o , distribution lines j3,1p gallon: size o pump 4W '7• -►p sad; gallon per minute q$L horsepower Ya NP ,ran name of pump and model number Type of warning ev e HOLDING TANK: Manufacturer- Number of gallons Elevation of manhole cc.,ver Typpe of warning device` SEEPAGE PIT SIZE: 1111512 r o pits feet diameter feet liquid depth seepage pit inlet pipe-elevation bottom of seepage pit E: evat on feet. SEEPAGE BED SIZE; number (if lines 3 wi th g length3! -tile depth 4& SEEPAGE TRENCH: width length PERCOLATION RATE 5" , DUI - RE BU N 3 INSPECTOR DATED PLUMBER ON J B Lo LICENSE NUMBER g~ .t7 Q~ p j 00 o o D • ~c~o s o - o II 1 ( ~ DEPARTMENT OF INDUSTRY, INSPECTION REPORT FOR SAFETY & BUILDINGS LABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION P.O. BP X 7xtJt BUREAU OF PLUMBING MADISON, WI 53707 ❑ CO N V E NT I ONA ❑ ALTERNATIVE State an I.D. Number: ❑ Holding Tank] In-Ground Pressure ❑ Mound (lf assigned) dog lq N E OF PERMIT HOLDER: ADDRESS OF PERMIT HOLDER: INSPECTION DATE: ~fmanent reference point) DESCRIBE IF DIFFERENT FROM PLAN: REF. PT. ELEV.: CST REF. PT. ELEV.. BE CH MARK ,(/Per W 6 , Name of Plumber: MP/MP W No,- County Sanitary Permit Number: ` A(e!l 9:5 -6-31 SEPTIC TANK/HOLDING TANK: MANUFACTURER: LIQUID CAPACITY: TANK INLET ELEV.: TANK OUTLET ELEV. IWARNNG ILABEL LOCKING OVE PROVIDED: PROVID 0 J 9(-`l7 9L,,z9 X1 YES ❑NO O NUM_ ~ BEDDING: VENT DIA.. VENT MATL.: HIGH V BER ROAD: PROPERTY WELLBUILD G: VE TO 1 ALARFEET FROM LINEAIRI L YES ❑NO ( ❑O NEAREST ' UO ~l DOSING CHAMBER: MANUFACTURER: BEDDING: LIQUID CAPACITY PUMP MODEL. PUMP/SIPHON MANUFACTURER. WARNING LABEL LOCKING COVER PR VIDED: PROVIDED: ~'J~ YES ❑NO YES ❑ NO YES ❑ NO BER OF PROPERT WELL B DI VENT TO FRESH GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL: FNEAREST-77711-] (DIFFERENCE BETWEEN T FROM NE AIR INLET: PUMP ON AND OFF) ❑YES ❑NO SOIL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing 1h-_ / JAMETER IM ATERIAL ANDMARKING or excavation. (If soil can be rolled into a wire, construction shall cease until FORCE i the soil is dry enough to continue.) MAIN 7={ CONVENTIONAL SYSTEM: _ W IDTH. LENGTH: NOOF DISTR. PIPE SPACING: COVER INSIDE DIA. PI LIQUID BED/TRENCH TRENCHES MATERIAL: PIT DEPTH: DIMENSIONS bHAV tL Utl' IH FILLDEPTH DISTR. PIPE TR. PIP DISTR PIPE .MATERIAL NO. DISTR. NUMBER OF RO R _L: BUILDING: VENT TO FRESH BELOW PIPES ABOVE COVER: ELEV. INLETf E E'/ EN PIPES. FEET FROM UN AIR INLET : NEAREST r7 ~ I MOUND SYSTEM: j Mound site plowed perpendicular to slope ck the texture of the fill material for PROVIDE A DIAGRAM OFSYSTEM and furrows thrown upslop;NO fno nd systems to make certain that it ON REVERSE SIDE. SHOW ELEVA- m 'e criteria for medium sand. TIONS MEASURED. ❑YES SOIL .'OVER. TEXTURE: PERMANENT MARKERS: OBSERVATION WELLS: 1 ❑YES ❑NO ❑YES ❑NO DEPTH OVER TRENCH;BED jDEPfH OVER RENCH/ D EPTH OF TOPSOIL: SODDED: SEEDED: MULCHED: CENTER E1'6ES: ❑YES ❑NO ❑YES ❑NO ❑YES ❑NO PRESSURIZED DISTRIBUTION SYSTEM: .VIDTH: LENGTH: NO.OF LATERAL SPACING: GRAVEL DEPTH BELOW PIPE: FILL DEPTH ABOVE COVER: BED/TRENCH TRENCHES DIMENSIONS t, MANIFOLD PUMP _ MANI OLD DISTR PIP MANIFOLD MATERIAL: NO. DISTR. ID ISTR. PIPE DISTRIBUTION PIP MATERIAL & MF{RKING. ~.D'LEV.: ELEV. DIA. ELEV.p PIPES / DIA.: J ELEVATION AND 9(. .pq L } 1~.~ ~~(~l, L. l r •~-c_1.✓ ( 0 c DISTRIBUTIONf INFORMATION`S LE SIZE HOLE SPACING DRILLED CORRECTL.Vr COVER MATE IAL: VERTICAL LIF CORRESPONDS TO APPROVED PLANS. YES ❑NO 681, YES ❑NO COMMENTS: PERMANENT MARKERS: OBSERVATION WELLS: NUMBER OF P OP PITY WELL: JBUILDING: FEET FROM LINE: l XYES ❑NO XYES ❑NO NEAREST__- 0'1/ ~ )sgz `3M I0;t,,G I , . / -1r0 1 S!'1 t jI'i3z, 4. 1 0 Sketch System on Retain in co my file for audit. Reverse Side. SIGNA~T/. ,r TITLE: DILHR SBD 6710 (R. 01/82) DEPARTMENT OF APPLICATION SAFETY & BUILDINGS INDVSTRY, FOR SANITARY DIVISION LABOR AND PERMIT P.O. BOX 7969 HUMAN RELATIONS (PLB 67) MADISON, W1 53707 Attach plans for the system on paper not less than 8% x 11 inches in size. Include a plot plan that is dimensioned or drawn to scale. Horizontal and vertical elevation reference points must be shown. All appropriate separating distances and physical characteristics as specified in chapter H-63, Wis. Adm. Code, must be shown. An index page or each page must be signed, sealed and dated by the designer. If designed by a Master Plumber, the date, signature and license number must be shown. The owners copy or a legible reproduction of the soil test report must be included. ailing Owner: MAddress: Property Location: City, Village or Township: County: ' 0 %5 F- %S ~T 7-ct N/R E (O cw~v,ow l"• Lo N b.,r: 1BIkNo.: Subdivision Name: Nearest Road, Lake o Landmark: S ate Plan I.D. Number: `,T;k 0,5.E (If assign TYPE OF BUILDING Number of ❑ P blic* ❑ Variance* ❑ Other (specify)* Bedrooms: E&Or 2 Family *State Approval Required. TOTAL NUMBER PREFAB POURED -IN STEEL FIBERGLASS NEW REPLACE- OTHER GALLONS OF TANKS CONCRETE PLACE INSTALLATION MENT (Specify) SEPTIC TANK CAPACITY /OVO 8$ I ' HOLDING TANK CAPACITY LIFT PUMP TANK/SIPHON CHAMBER QQ I NAl, /W I =-YAWS MANUFACTURER: (,tJ i!/Gi~6 cL /Y EFFLUENT DISPOSAL SYSTEM PERCOLATION RATE ABSORPTION AREA (Minutes per in h): PROPOSED (Square f et): 17 New Replacement ❑ Experimental Seepage Bed El Seepage Pit ~p„CryJ /ot5 y ( Alternative (specify) _Tk 49, c~ Ad /-r Arss Seepage Trench !v WaterUpply: Owner's Name as Listed on Soil Test eport If other than present owner): L'S Private ❑ Joint ❑ Public Al A, 1E_ I, the undersigned, hereby assume responsibility for installation of the private sewage system shown on the attached plans. Name f Plumber: II// Signatu MP R o Phone Number: IV CZA II.- -ZS-S__ Plumber's Add ss: Name of Desi ner: /P 6 rt- W'c COUNTY/DEPARTMENT USE ONLY Si nat r o4of Issuin A ant Fee: Date: APPROVED Sanitary Permit Number: r. v'U > f ~ DISAPPROVED 573 Reason for Disapproval: lP V ~o Alternate course(s) of Action Available: Change of ownership, building use or plumber requires a Sanitary Permit Transfer Form (67-T) to be submitted to the county prior to in- stallation. Failure to comply will void the sanitary permit. DISTRIBUTION: White-County, Canary-Bureau of Plumbing, Pink-Owner, Goldenrod-Plumber DILHR-SBD-6398 (N.03/81) F-~ as 0 M • rb A I~ ~ r •ca ' o~K~ rl w 3 , y/" S ~ oC Goy' elA M 1A La r I h1 J cr n J ci o- m H b ~ -d -s ~ I 'ab aD Cp pp ~ o ~ ~ r r _ d ct g% n i- LIZ 7 -9 O Q ~ a ft r .o h 1 b J a 0• r A I p E - tL _ a d w ep n eat ep cD m I aC -c 2. s ~ VE~ VI 4 Y~ S to M T a y J O 000 10T i a 000 ~ a o h v K I~ • o O C Qoo ~ ~ 3 0 0 v 0 • ~o s ~ o o e o c'l ~ 000 Lob -1 f d o d- r4 .;u d N - - TOTAL DYNAMIC HEAD FEET/METERS HEAD CAPACITY CURVE CAPACITY GALLONS/LITERS MODEL 267 HEAD CAPACITY rn 8 _ UNITS/MIN. Ir FEET METERS GAL. LTRS. W 5 1.52 108 408 U. I W 15, 10 3.04 60 227 4 15 4.57 20 76 i 18 5.48 0 0 U 10, 2 Y Q 2 M' SU.S. 20 40 60 80 100 GALLONS LITER§ I 1 2 320 400 0 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators for duplex systems • High water alarms available. available with mercury float switches. • Mechanical alternators available for • Minimum recommended basin size duplex systems. Simplex -18" x 30" Caution: Maximum temp. sewage or Duplex - 36" x 36" dewatering -150 degrees. SINGLE PHASE UNITS Mode' H.P. waft Amps Wl. nu. Consult NEC and Local Code for proper in- 261 Automatic f4 115 10.4 49 We, slallalion of controls, protection devices 0261 Aulomeic 14 230 5.2 49 lbs. and wiring. N267 Non•Aulomauc 1S 116 10.4 49 ibe. E267 Non•Aulomauc K 230 6.2 40 We. "You Get More for Your Dollar- When You Buy a Zoeller" RESERVE POWERED DESIGN OELLIR TZ Engineered purposely to pump less than design characteristips permit in order to 3280 01d Md0s Lane allow a safety factor for unusual conditions. LOUISVIlle, Kentucky 40216 (502) 772.2584 ZZ7_ 3280 Old Millers Lane Louisville, Kentucky 40216 (502) 778-2731 COMPARE THESE FEATURES Mode/ "267" • Vortex Impeller Design • Float operated, submersible (NEMA 6) mechanical switch. • Durable cast construction. Cast iron "WASTE MATE" switch cap, motor shgo. pump housing, base and impeller. No sheet metal parts SUBMERSIBLE to rust corrode. Stainless steel screws, bolts, float rod. is SEWAGE PU M P handle, guard, and arm and seal assembly. OR DEWATERING PUMP is 10 foot UL-approved. 3-wire neoprene cord 8 plug 2" NPT DISCHARGE • Thermal protected. • Oil filled motor-hermetically sealed. • 60 cycle. 1725 RPM. • Carbon and ceramic shaft seal. is Sleeve bearing running in bath of oil. IY "l M • Passes 2-inch solids (sphere). Aig • 2" NPT Discharge. • On point -11". , • Of point 3". Sump Pump Mly. Assoc. is Major width 121". . 8PMA Specification Number is Height- 14". is Weight - 48 lbs. sc-2226 Att Models SIMPLEX AND DUPLEX SYSTEMS AVAILABLE PACKAGED SYSTEMS AVAILABLE ©ELLE/P !1. 3280 Old Millers Lane Louisville. KeNucky 40216 MODELS AVAILABLE 01crava) (WA 772-2584 • Automatic or Non-Automatic • 2" NPT Discharge • Y2 H. P.. 1 Ph., 115V or 230V ` Manufactures of . Passes 2" Solids S~G~~pN 8201519 - q _ 10 M ~ V 8 8,33 / ~ .~Y,.~•e..~a~►~ !0 8 ~ ~ Ste, (o'►' P l S, SN ~ 6 ~ y -7 9 B3 87"-7,as~ PS s,,s~ ~I? I~ 8 y 610 L,`1' l es- 7 5 & ..v_ , 8(0 -71 J. ST R ~ s s~ H .z E , 8 M ~7 " /37 y 7, 3. S e.,,„,,, o f tk-7ya 6,-714 69 I+ 40 7.3 y. Nt tow*,, o F io 3 yy 64J. D F V 7 S. ~l 70 •~p s~ nv.~x APP . 57-3~ = Z/~ N ROME ' 62 00 SECTION 8201519 3 010-~ ei+ -!l5 6 7 t; &Z3r 7 1# Ef go.,~ ztt~- oi, a t .4, . 4/ 4-111. 1. al 00 PLUS ►;;I* , SECTION 1~' ~ A . N ~ s yy 43, 14 A 8201519 P.40 D ° RCI-t 4- 2- -x = Tan `'r✓1 aM•:w , NG a UA P.& S „2I H 39 ,;17 8 got; 4z- d' 1072 11co it a I~t 3 ~ v 'Ap O~~T I AROR AP'~''^Sr ' DEPT"`~'? OF ~w '30 ~l - Ao I pLu''~ t"~v SEC'i1014 /00 8201519 ai~'►~n ~W-i ~y~C,A✓ , A4 - to 1 '7 a 4, /4" ,w, J'*W 90 o0 TO HAJ T 70 k", RECEIVED r;'. Ay 1 15 • / .ti.ar~►k. t Q~~ f- ~•~ow... ~io...c~ .~-PLtJ'~, ~E?'W~ SECTION 8201519 AA~ Q, Cs,~ • 3Oc' 6-0 90 43 t, 77 WMAb N ~ ~CI~. ~ JAI X. 3 d 3~ , 3 X i %O l /IF ~ ~17. -Nl P P, S 3 3 11- y- 8 RECEIVED Y C no" . t -q va az" b - to o, p v►-~.~. v w~ Vy / 1, ow~ Ol~•~.ti.h.v ~ r A~A .4.~ AaAAyv 12 azol-s- 628 v"N r 7 ~it«1 . a 8201519 Stake of Wisconsin Department of Industry, Labor an ri 1 Rati fir r~, ase Re y [J SAFETY ILDI ~ I*~ON Bureau of ~ "bmg0~~~~ P.O. Box 7 r / Madison, WI Plan Identification Number i f Re: PRIVATE SEWAGE SYSTEM ONLY- =r The Bureau of Plumbing has reviewed plans, site survey information and installation details for the construction of an alternative private sewage system to be installed at the above-mentione$1 location. The plans and specifications were prepared by - and received for approval on The soil and site evaluation was conducted by i 'ter The site meets the soil and site requirements specified in chapter H 63, Wisconsin Administrative Code, for the use of The proposed system is for a r -.1, >a t Wastes from the building will discharge to a gallon capacity septic tank which will discharge to ate' gallon capacity pump chamber from which a pump having a capacity of gallons per minute against a total dynamic head of , "o-f- feet will ~f discharge through a inch diameter pipe to the soil absorption system. It is of utmost importance that the system be installed in complete accord with the plans and installation details and the conditions of approval contained in this letter. The licensed plumber responsible for the installation shall notify the county inspector when the installation of the system will commence so that the county inspector shall be able to inspect this installation. The installer shall not deviate from this approval and shall follow the directions or orders issued by the appropriate local or state authorities. In accord with ch. 145, Statutes, and ch. H 63, Wis. Adm. Code, the plans and specifications are approved contingent upon compliance with the stipulations indicated on the plans. Please review your code for the requirements of each code section noted. The architect, professional engineer, registered designer, owner or plumbing contractor shall keep one set of plans bearing the stamp of approval of this department at the construction site. If the installation of this system has not commenced within two years from the date of this letter, this approval shall become void and new application shall be made for approval of these plans before work may commence. In granting this approval, the Division of Safety and Buildings does not hold itself liable for any defects in plans or specifications, plan omissions, examination oversight, construction or any damage that may result in or after installation and reserves the right to order changes or additions should conditions arise making this necessary. This approval is based on ch. H 63, Wis. Adm. Code, requirements. It shall be necessary to obtain and fulfill the permit requirements of the county in which this installation is to be constructed. Failure to obtain county permits will automatically void this acceptance. cc: OWS County By' Other Enclosures e'~z~'ll..rT~ DILHR-SBD-6159 (R. 7/81) mes Sargent, B erector SBIJ_667$ ?9/81) (Plb 700a) _ STATE Qle WISCONSill LHR betach*And Return Upper DlVtS1d of SAF£TY &t`BUILfdIIte S . Portion Of This Form With BUREAU OF PLUMBING 201 E. WASHIINGTON AVE. FW 17.8 Any Return Correspondence P.O. Box 7968 MADISON, WI 53707 608-2-3816 DATE:, U y 5I12f82 PROJECT; t ihrke, lied) Residence 4 c SW,SE,25,29$18W To Warred T -letter Nechvi l le St. Croix L Route 1, Box 299 Roberts, W1 54023 FLAN ID. # ' 82-01519 i, DETACH HERE PROJECT NAME Thrke, Nell - Retfd&aCe PLAN ID. # $2_Of$19 This is to acknowledge receipt of your plans and specificatigns for the above-indicated project. Preliminary review indicates the required fee is $ Fee Received is $ 51.84 Underpayment - Please submit the additional fee. ❑ Overpayment'- Refund forthcoming. Plan accepted for review. ❑ Plans being returned. No fee has been remitted. Plans submitted with no fees will be Additional information required. SEE sEt:OW held in abeyance. w J. Plan Submission ❑ Complete data relative to anticipaiea4"of- E. ! ❑ Additional information shall be submitted in duplicate un- ❑ Z copies of PGB 60 enclosed. less specifically noted. ~pA-~ ❑ Deed restriction required (1 c©py) Plans not clear, legible or Rgrnia ~j,, a>li'►1 ❑ Condominium declaration. 0 copy) 40 All information submitted shall be signed, dated and sealed or stampedin accord with Section H .63.08(2)(a) Wisconsin r AC*i dministrative Code. ❑ Affidavit enclosed. IV. Hol ng Tanks ❑ Profile of holding tank showing vent* maot)oW atarM "d manufacturer if precast. Complete +struMoh detaiis'tf 11. Pressurize Distribution Systems (Mound or In Ground Pressure) site constructed. ❑ Application for use of an alternative system signed by owner ❑ Holding tank agreement signed by owaff itnd .total u1"it + f and notarized. (1 copy) government {sample enclosed). ❑ County onsite required (1 copy). ❑ Design calculations ❑ Reason for installing- holding tank. Soil *t 0 staterr t for pressurize distribution. ❑ Soil boring & percolation from county 0 copy). test data. ❑ Plot plan showing location of holding tank MtK lateral list ❑ Cross section of system. ❑ Pipe lateral layout. antes to any building, wells, water service piping, water Plan view of system. ❑ Plot plan. course, lot lines, swimming pools, all weather service maid, ❑ Verification of Exception Status Form by County. (1 copy) Etc. Provide benchmark with elevationrefer ento point. 111, Private Sewage Disposal Systems V. Lift Pump ❑ Ground slope with 2' contours in entire area of soil absorp- ❑ Calculations for total lift pump discharge, head and s tion system extending 25' on all sides. pumped per. cycle. ❑ Elevation of permanent reference point (benchmark). ❑ Size, length & depth of force main. ❑ Location of area suitable for replacement system - provide ❑ Detail & model of pump or automatic siphor►s inel4thg soil data., size, pump curves, drawdown and average flow rate Gp, ❑ Plot plan showing lot size and all lateral distances from ❑ Cross section of lift pump tank showing ptlmp(s) or sewage disposal system to buildings, lot lines, well, water siphon(s). course, swimming pools, water service piping, Etc. Construction detail of septic, holding or lift pump tank if site constructed or tank manufacturer if precast. VI. Systems In Fill (Fill must be placed prior fist-p)an i4lamissian). -E] Construction detail and cross-section of soil absorption ❑ Total area filled (fill to extend 20' bdy(Ynd°,` a Qt t{t system., before side slope begin). El Soil boring and percolation test on 115 completed by cer ❑ Depth and type of fill. tified soil tester (1 Copy). ❑ Copy of onsite report by pX=ty _ k" K .e..a ..:.,a. i~..:rh.vi.`F.w'•u_ 3.ti.:, . i .....,...r.. sG. _.i .ll. ~1J~4iu:. .v..~a.Y_ - v as r r+ -y Vii' ~f', ~*y AST, W -AW 1* XTY goo, ~y11~". T.~ f'•'•r`y~ t 'S ~,iE., a {~3t~"~T~}. ~ - _ •"r `~R''x AK to j r ~ ~„s~,~t°f,^eN° . ~ .l~~~f~ .~r~?~'• t 7 t'*t'? < . i `E, E`y 'stt4-. u.;,t[ ~'r, 41~ R s E< .~4 Y^rr' a - - u' xr?'rs< E Wit. t ~r11 _ it { '10 yo ~f6pti, ~T - j1I'✓ . - ' tip- Its UL" Y ar. ref ~r°; :ii f'+'.'AW$.S•Si`i R.~.+~t%.. _,.R 7.' rt~- I*;TFr• r } M! . t a ta. t r S t ~ " °),W'` •`•yt•!4~ ^.,i ~ 5} ,1 ~~Y t ~ - #~~~r. a 1 'x. { 1 3.`+ ~T .a"R - 4 f jcy~ T ~ `f3C~ F~'t 4~7 Xf1 1r f ,~`r'~~ j ~ j R•A ~ ~ ~M`~ Yr) .'t a q ~ -=j `Fki ~j; M• rs a ' r i r. ,32 n- - f - ,q-F'•~A ' t +~r'.'t. ..:7`S I'3i "-O Uf'.'.aE °t'~~-.,3fA .awi ~.l ' too 1 n>~:.lY,' VA, PC rl 4 c t i ~';k F L '.c CY. ? F 7p. ~i~l 5r42 ry t 3 ,c-.. ~r ~n ~ Y- - }'^F y~ r •C K 1 ""X h• ~ s3. ~5 S ~ET`~'~5( ''..N~1.; JS" F ,,^S~4Ffi f`}Sf I , r LE! 'fR71'~•f'~ 7,r3fSe ' y..: .fR kc., - i {yl,,< knot, rFl~4 ~ . • i EaN'ks'-~ ~rA a f "~1 ~ °'S' ~„,r~ 4r~V~ _ i 'S~.r'~ fY' r`f'.' ~/t, F~".u u~ .-~f a .~~i ~ Atfffrf~,t'4, rt1 ~G y' s. r'. 3y, .r try. Rvs ,v^~y~ A`v//'%ti'r•~ i F'',:t'~,~~Yrl3'~<i - _ 'c`^y.3=t:f i "~w) 1r' FH4 Ii 3''f rii~r ,1 > 3°' will ' • ~ ~ 1i.0 ~I ~ f?y~f`.. Ay r✓~'{j~i`~'C Y'J 1+-Y:i x. w Pr JI'I.t .{~.h..Yl4t' - ft I ~Y^ 1 ..f. 'r p ~}R=R}~ `aj+' t i! f~ 4t Y ' r' ~ L i. 1 t~~~F ~~lr ti~P. s ~ i'' , i.`77~i ;*'"t,#~ ~ S ~ 4~+ •1 ;y°• ~ .i,i"; F ~~t ;1' A' . ~ - +;~`:fY4T"• - _ , ~ '$'t) f.1♦~{`="' C7~ T"r lip- ~o M T i r( J Y 1 4:' 1 z~ ~H ci. y i 1. tit l ~ c 6 nn rl r M .7 6 4q C4 Ck 1 ~ 'r 1 r ~ y O o Aw r r1 -4x 1 ! a - cr V1 ~ i I ~1 7 OF REPORT ON SOIL BORINGS AND 6 SAFETY & BUILDINGS il~Jfi~(,`STRTRY 7 DIVISION AC4D PERCOLATION TESTS (115) P.O. BOX 7969 HUMAN RELATIONS 1 / ~Mi ON, WI 53707 It ATl N EC I N: OWNSHIP/MUNICIPALITY: OT B SUBI IS sw '/5`'/4 2 /T29 N/R /YE ( W E,v y ~ 2 ~'OUNTY OWNER'S BUYER'S NAME: MAILIN DRESS: USE DATES OBS IONS MAD t', j NO.BEDRM&:ICOMMER?'. •IALDESCRIPTION: A TESTS: ~'.AResidence Z New ❑Repl ace tl4t ~rL G'f %f~ s~ s Q - RATING: S= Site suitable for system U= Site unsuitable for system & le rr J w t ONVENTION L: MOUND: IN-GROUND-PRESSURE: S STEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM: (optional) DS ®u T©S ou E ]S au o S ©u o S au ,N-YeovA> It Percolation Tests are NOT required DESIGN RATE: SYSTM ELEV. If an y portion of the lot is in the under s.H63.09(5)(b), indicate: I Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS 60RING TOTAL ELEVATION DEPTH 7 GROUP ATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, OBSERVED EST. TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 9",BV,Sic, j ' G / %>!u L , & O . SL , 20" wtdj 04 5 !B / 7`~ 7 tt .20 -OR.SL . 4/NESrOV4 /J/e B L (o~ ~o~ ~lar+•~ r`oop i.L"~~ SiL, IS"W /3N c /~"cr ~a S~~ o,P.S• i " Adlow CL AT (as7". LiNtSjOvt BQ. f"/Su- Si-, Z f., ~~•i~u• 1O" L/•/3J -vR. - A r B 7 Z 7 } f v L li Lur: - C L u. /Lr~Q- J3 v Nn jS IB_ 7L ~d - i~..~~.Ra. /0"L/• IjAj 0 SL.,22 Q-v X4 t✓ poC,('Q had L'/• 6,v 6 f L W f f - 0k- uF QA B- H o is ;e0-_65 fn TX A T 72 " - /-yt stou.e .!3/P 13 /L J Si[ ,2 / j~ 2- L r G ,U o B j„ 1r~•+ ~Ac;$ /Obse SA,u/-) w QR. AT 6C) ~/P. (tuts ate PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLIN INTERVAL-MIN. PERIOD 1 PER INCH Z Jr / ro P P 2. L u 25- 7 Y~/r (I P- F / 'LAN VIEW: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- ontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction andpercent -1 land slop. 130TfOM Of M,414110a LL) 1-?CV i1 LL //E _X,44C'ILx 5/,?" 13t /Q't.v- SYSTEM EL ION PT• zF/Ev yE,er U! is iazr d /3cpth0,t. ILL: L> SAca ~4ei f' T/ate s - V ~ 1 , r22 / rope /V %EW , A _ ,~r',pc 5 TFS N (/t ~PTi ~.9L= _1641 MOA oIll! V_u 4*-- 7"0P 7K z ot to"i rT 0,4 "Ovr 14"txk4-",) L4Q1,,ef, leR.42 -5?07 C/ Ace, X94.4 -Tiov rv /L= yAfi ~ • V %S ~ the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures methods specified in the Wisconsin ,dmimistrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. DAME (print : TESTS WE E COMPLETED ON: ~ohER r Z!/6.+Pi ~h1~ y/ l ~j~/ ADDRESS: / CERTIFICATION NUMBER: PHONE NUMBER optional): 1,Fr 3 D X64- CS SIG ATUR DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester. 11 LHR-SBD-6395 (N. 03181) tQW 2 o F 2 104Ar .,s REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS h7, OF DIVISION =SAND PERCOLATION TESTS (115) MADISON, P.O. BOX 7969 WI 3707 ,AN RELATIONS - ' IPALITY: SUBDtVIS10N NAME: LO ATION SECTION: FMAILIN,,ADDRS Z r /T 19 N/R/~ E (orfr7; r 6UNTY: OWNER'S BUYER'S NAME: : BSERVATIONS MADE - - DATES O USE STS: 'al L /re/ . A IE~ NO.BEDRMS.: COMM R ALD RIPTION: A New L ANew ❑Replace RATING: S= Site suitable for system U_m Site unsuitable for system 1:1S NVENTIONAL: M . o~IN•G RE: SSTEM-IN-FILL OLDG®Et 0Yt~nal® S RA It Percolation Tests are NOT required DESIGN RATE: SYSTEM ELE] If any portion of the lot is in the under s_1-163A9(5)(b), indicate: Floodplain, indicate Floodplain elevation: 111 PROFILE DESCRIPTIONS IiURWG TOTAL DEPTH T R NDWATER•INCHES H'ARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION BSERV EST. HIQ E TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 1<oS- /p",J~ 5%G~ Iq„G/•QN 1-, 7"47 ACA. SG,1y,.G~l3 B- (p 70 7/ oR, o 'fir 6,0 c~ w;a, /5~v - c-y i-B- I B- B- , B- B' PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD -PER 10-D P PER INCH P- P- P- P- P PLAN VIEW: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- contal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slop. SYSTEM ELEVATION i J'V rr~ ~ a • f 5 ~s t~ 0~ ~,,`l ~ g f I Fps - t3M G5 3 3, +El~ x X AL~t~~"hr P M a x 3 o~ \y Qty 5 oeP B I I g fa t RV,0 P11744 5' S ~,Pt cr7- 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures methods specified in the Wisconsin Admimistrativ@ Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME print : p TESTS WE EZOMPL~~O(~I: ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER optional): ~P 17 3 a CST GNATURE- DISTRIBUTION: Original-Local Authority, 2nd page-Bureau of Plumbing, 3rd page-Property Owner, 4th page-Soil Tester. PILHR-SBD-6395 (N. 03/81) 1 CERTIFIED SURVEY MAP ADOLPH GRIMM ESTATE Part of the Southwest 1/4 of the Northeast 1/4 of Section 36, Township 28 North, Range 18 West, Town of Hinnickinnic, St. Croix County, Wisconsin. o Indicates 1" x 24" iron pipe weighing 1.13 lbs./lin. ft. set N 89. 41' 31 "E 331.20' N 1/4 COR. SEC. 36, T 28N, R 18 W. (COUNTY SURVEYORS MON.) N LINE NE 1/4 W 3 z OD _ N t0 Y. N J 0) ~ O m d • m W N zm a UNPLATTED LANDS oON O to N _ J •O z z N 89. 42'49"E 208.71' a 0 8,90 \ ~z S1/4 COR. SEC. 36,T28N,R18W, se 90 430' ' 0 z NW (COUNTY SURVEYORS MON.) _ W ti LOT I - W' - ~ = Z N z it Q N a QI O a LOT I s 1.158 ACRES J~ N J 3 50,447 SQ. FT. W 0 aL NETm 1.000 ACRES oI° of : W W co w 43,56 0 SQ. FT. 0 ~ N N 1 1/2 STORY DWELLING N N I 0 50 100 200 300a~cD WITH ATTACHED T) ~I ~z a • GARAGE @g. o_ z N 0` z • O\„ 1 ' Se IA-, 0 I a gO 208.7 i (A W is 0 mM M S 89. 42' 49" W 208.J W iIS INSTRUMENT DRAFTED BY LAURENCE MURPHY a to E W I/4 LINE 66' C.T.H. M SCALE I 100' DESCRIPTIONS UNPLATTED LANDS That certain parcel of:land located in the Southwest 1/4 of the Northeast 1/4 of uection 36, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin, more fully described as follows; COMMENCING at the North 1/4 corner of said Section 36, thenceN 89° 41' 31" E, on the North line of the Northeast 1/4 of said Section 36, a distance of 331.201; thence S 000 18' 28" E 2388.76' to the POINT OF BEGINNING of the parcel to be herein described; thence continue S 000 18' 28" E 241.71'; thence on the East/West 1/4 line of said Section 36, go S 89° 42' 49" W 208.71'; thence N 000 18' 28" W 241.71'; thence N 89° 42' 49" E 208.71' to the POINT OF BEGINNING; containing 1.158 acres, more or less, being 'subject to easement over the Southerly 33' thereof, for C.T.H. "M" R.O.W. purposes, and also being subject to easements of record. (For purposes of this description, all bearings are referenced to the North/South 1/4 line of Section 36, T 28 N, R 18 W, assumed N 00° 18' 28" W) State of Wisconsin) County of Pierce) I, James L. Murphy, Registered Land Surveyor, do hereby certify that by direction of the Owner, Adolph Grimm Estate, I have surveyed and divided the lands shown hereon in accordance with official records, Chapter 236 of Wisconsin Statutes, and 1 II IIIIIIIIIII&I& Ordinances of St. Croix County; and that the above map and description are~'§~ 160 /V V//1 and correct representation thereof. Dated: 26 May 1982f.: JAMES L. NIURPHY S- 1 0 4 2 Vol. Page James L. Murphy RIVER FALLS, q Certified Survey Maps Registered Land Surveyor Wisc. J~ St. Croix County, Wisconsin / "i,, r LARD, ~ "