HomeMy WebLinkAbout018-1066-85-100
STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER Pin) 6 Q/ri V FC~ rs 6-V`
ADDRESS IS a~31
-a
SUBDIVISION / CSM# LOT #
SECTION _,_:?D T__L3 W, Town of din-j,yYt,~ ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
l
Y L~ 3~i~v
6?S.
S
3
IND ATE NORT W
S~~
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
i
BENCHMARK:
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: Liquid Capacity:
Setback from: Well ASIA House .33 Other
S 6Lt-Ads .
Pump: Manufacturer Model# WP_c6.5 L Size 6
Float seperation Gallons/cycle:
Alarm Location 9 n h b ti s e.
SOIL ABSORPTION SYSTEM Width: (o Length 6.1, 5 Number of z a4ienes
Distance & Direction to nearest prop. line: ~S,
Setback from: well: _~'lJ/,►~ _ House 5 Other
ELEVATIONS
Building Sewer 4Da, 7 ST Inlet; /d/, S ST outlet
PC inlet 1W, Q cg- PC bottom Pump Off ,
Header/Manifold /Q $.a3-Bottom of system /07,3.3
Existing Grade 1,J&, 33 - Final grade .169,,?
DATE OF INSTALLATION: S l 2
PLUMBER ON JOB:
LICENSE NUMBER:
INSPECTOR:
3/93:jt
Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County:
1 Labor and Human Relations INSPECTION REPORT ST. CROIX
Safety and Buildings Division
(ATTACH TO PERMIT) Sanitary Permit No-:
GENERAL INFORMATION
ttftv
Permit Holder's Name: E] City Village El Town of: State P13 .8
PEDERSON, ROBERT X
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
TANK INFORMATION ELEVATION DATA S`
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Benchmark /(0 30 CJ
Septic O
, ZY 113, 0,
Dosing 113,
Aeration Bldg. Sewer
i
Holding St/ Inlet 1d3
TANK SETBACK INFORMATION St/ Outlet g /d 3.
TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake 27 1143,33
i
Septic U~ 2 NA Dt Bottom
l 2 NA }isad-or / Man., 67,
Dosing
Aerati Dist. Pipe 107 9,7
Holding Bot. System 3 X, /v? 35
PUMP INFORMATION Final Grade
Manufacturer Demands
p~ou Model Number cvC-0311 L ~d GPM
TDH Lift (D~ Friction 61 System -O TDH D • t
oss L, Head
Forcemain Length ,,n Dia. 3Dist. To Well
SOIL ABSORPTION SYSTEM
BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia.
DIMENSIONS DIMENSIONS
SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING
SETBACK CHAMB
2ur i Model Number:
INFORMATION Type O _
System: A141" d 3 OR UIVIT
DISTRIBUTION SYSTEM
Vent Tor~ke
nifold Distribution P2e(s)// x Hole Siz / x Hole spacing
Ac/ M22a'
Length ~O Dia. Length S` Dia. Spacing y
v.,
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over d Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched
Bed/ TrgntsCenter Bed /1j5W*FrEdges /o2 Topsoil ❑ No 9-Yin ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.)
LOCATION: ammond.30.29 1 17W SE E 160th Street
(A
-791
r 12
Plan revision required? ❑ Yes No
Use other side for additional information. /
SBD-6710 (R 05/91) Date Inspector's Signature Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER: '
11111 DILHFi SANITARY PERMIT APPLICATION
CouN
In accord with ILHR 83.05, Wis. Adm. Code
~57.. Cv'*O
STATE SANITARY PERMIT
-Attach complete plans (to the county copy only) for the system, on paper not less than off ) la 9,3K
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. S 9' - 6S
PRO RTY OWN PROPERTY LOCATION
~b..e,r .ever-So+~ Y. /11,5ti., S T~7, N, R /7 ) W
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
;L3/ /l1
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
w
3Y6 1 s- A-5 -.fit 17
II. TYPE OF BUI ING: Check one NEAREST ROAD
( ) ❑ State Owned V CIL GE >60
`
❑ Public 1 or 2 Fam. Dwelling- # of bedroom PAR ELT X NUMBER(S)
III. BUILDING USE: (If building type is public, check all that apply) ofd cl ^ /,o W g) / d"6
1 ❑ Apt/Condo J
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
4 ❑ Church/School 80 . Mobile Home Park 12 ❑ Service Station/Car Wash
50 Hotel/Motel 9 ❑ Office/Factory 130 Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1.X New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ 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 Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 Mound 30 El Specify Type 41 El Holding Tank
12 1:1 Seepage Trench 22~ In-Ground 42 ❑ Pit Privy
13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy
14 ❑ System-ln-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1. GALLONS PER DAY 12. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE
G~L~ REQUIRED q. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION
37.5 c37S 1. 12- -~U A- `07+A3 Feet / Feet
VII. TANK CAPACITY Site
in allons Total #of Prefab. Fiber- Exper.
INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
Septic Tank or Holdin Tank
Nei El 7_0
Lift Pump Tank/Si hon Chamber 7
VIII. RESPONSIBILITY STA EMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name ( : Plumber's Signatu . o Stamps) AWMPRSW No.: Business Phone Number:
~-3 156_3 ?fir •2 -/.3~
Gal ut , F.
Plumber's Address (Street, City, State, Zip Code):
IX. CO NTY/DEPARTMENT USE ONLY
❑ Disapproved Si a ry Permit Fse (Includes Groundwater a e Issued Issuing ent Siggature)N6 Stamp )
Approved El Owner Given initial Surcharge Fee)
Adverse Determination
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber
INSTRUCTIONS
1. A' aanltary -permit is valid for two (2) years.
2. 'Your sanifary 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 rp,vision . 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
subrr)itted..to the county, prior to installation. t
5. Ons t* sewage systems must be properly maintained. The septic tank(s) must be pumped by`a licensed
pumper, whenever necessary, usy#lly every 2 to 3 years. -
6. If you haire questions concerning your onsite sewage system, contact your local code administrator or the
"
State of Wisconsin, Safety & Buildings Diyjsioo, 608-266$$15.:
To bt'cbmplete and accurate this-sa itar 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 t
tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all
`
septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received
experimental product approval from DILHR.
VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g.
MP, etc.), address and phone number. Plumber must sign application form.
1X. 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 cprve; pump mgdel and pump manufacturer; D) crps„s.section of the soil, absorption system
"raquired b Ahe eounty; E}lsoil,test data on a''11I.Slorm; and F) air sizing information..
J GROUNDWAftR; SCIHCHARGE
1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of
regulated practices which can effect groundwater.
x
R3 c , :`The lr to ies collected through these surcharges are used for monitoring oundwater, roundr
ti- 9C_ 9
water contamination investigations and establishment of standards.
y
SBD-6398 (R.11/88)
SAFETY & BUILDINGS DIVISION
State of Wisconsin
Department of Industry, Labor and Human Relations
July 8, 1994 2226 Rose Street
La Crosse WI 54603
POWERS, CALVIN JR
1969 - 185 AVE
NEW RICHMOND WI 54017
RE: PLAN S94-40654 FEE RECEIVED: 180.00
PEDERSON, ROBERT
SE,NE,30,29,17W
TOWN OF HAMMOND COUNTY OF ST CROIX
MOUND SYSTEM
The Department has reviewed the above-referenced submittal.
Conditional approval is hereby granted for the system plan submittal. All
noted items must be corrected. The review and approval of the system is based
on chapter 145, Wisconsin Statutes, and chapters ILHR 83 and 84, Wisconsin
Administrative Code, and is contingent upon compliance with any stipulations
shown on the plans. This system has not been reviewed for the code
requirements set forth in chapter ILHR 82 or in chapters ILHR 50-64, Wisconsin
Administrative Code.
This plan submittal approval will expire two years from the approval date, or
if a sanitary permit is obtained, plan approval will expire on the day the
initial sanitary permit expires. The licensed plumber responsible for this
installation shall keep one set of plans with the Department's stamp of
approval at the construction site. The installer shall notify the appropriate
inspector when inspections can be made.
All permits required by the city, village, township or county shall be
obtained prior to installation.
Inquiries should be directed to me at the number listed below. Please refer
to the plan number shown above.
Sincerely,
j
Prardwim
Plan Reviewer
Section of Private Sewage
(608) 785-9348
4711R/ 1
SBD.64231 R. 01 /9t )
Wior dustry,
Labor z Relations SOIL AND SITE EVALUATION REPORT Page 1 of 3
; r n
viJision.o, .:i,ty d Buildings in accord W}tf 1R 83'05., lirT10
►D A_ COUNTY
Attach r:::,.: icte site plan on paper not less than n 1/2 x 11 inches in size. Plan must includo, but St. Croix
not lira to :o vertical and horizontal reference pooh (BM), direction and % of slopu, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road. 018-1066-80
APPLICA;:T INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPER i~Y 0"J1NER: PROPEHTY LOCATION
Ro ' GOVT. LOT SR 1/4 NE 114,S 30 T 29 N,R 17 x:R(or) W
PROPE.i (C' iNER':S MA!t.ING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM #
Box 7.' 1
CITY, S i A- - ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE [MOWN NEAREST ROAD
Hartmto,.d , W1. 54015 (719 796-5217 1 Antb _ ct
fj New ,,_;nsauction Use Residential I Number of bedrooms 3 ( ) Addition to existing building
O Replacement ( ] Public or commercial describe -
Code oerr,-0J daily flow 450 gpd Recommended design loading rate __4 bed, gpd/ft2.5 trench, gpd/ft2
Absorption area required 375 bed, ft2 375 trench, ft2 Maximum design loading rate ,.4 lbed, gpd/ft2 .5 trench, gpd/ft2
Recommend:.,d infiltration surface elevation(s) 1 (17 31 ft (as referred to site plan benchmark)
Additional design / site considerations na
Parent material glacial drift Flood plain elevation, if applicable na It
S = Suiln!e for system CONVENTIONAL MOUND IN GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U= Unsalable for svstem i D S ~1 BS ❑ U ( O S CCU I [IS )NU I ❑ S IM ❑ S M
SOIL DESCRIPTION REPORT
Boring # 1-iorizonl Depth Dominant Color I Mottles Texture I Structure Consistence lBouriclary ( Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Traxh
1.... 1 0-8 10 r3/3 none 1 2msblc mfr if .5 .6
- 2 8-19 10yr3/4 none scl 2msbk mfr gw if .4 .5
Ground 3 19-27 10yr4/4 none sl 2msbk mfr gw na .5 .6
elev. mP
106.73. 4 27-62 10yr5/8 7.5 r5 8 sil if 1 mfr w na n .3
Depth to 5 62-75 10 r6/6 none s 0 s mfr na na n !n
limiting
factor
27"
Remarks: H-5 weakly cemented sandstone residuum
Boring #
1 0-10 10 r3 3 none 1 2msbic mfr crW if .5 '.6
2 2 10-22 10yr3/4 none scl 2msbk mfr gw if .4 .5
3 I22-30 10yr5/6 none sl lfsbk mfr gw na .4 s' .5
Ground 2mp
elev. 4 30-39 10yr5/8 7.5 r5 8 sil 1f P1 mfr na n n
06 J-h ft. 7.5yr5/2
Depth to 5 39-6 10yr5/8 7,5yr5/8 sit M na na.
limiting
factor --T
30"
Remarks:
CST Name:-Piease Print Phone: •
Gary L. Steel 715-246-6200
Address. 1554 200th. e. , New RicrVnond, WI. 54017
Signature: Date: CST Number:
5-10-94 CSTM 2298
ATY OWNER Robert Pederson SOIL DESCRIPTION REPORT Page 2 •of3
EL I.D. # 018-1066-80
i Depth Dominant Color Mottles Structure !
Boring # Horizons I Texture Consistence Bxrcby I Roots GPD/ft
, in. I Munsell Ou. Sz. Cont. Color I Gr. Sz. Sh. Bed ITrendr
1 1 0-8 l r 3 If .5
ITTB-14 10yr3/4 none 1 2 msbk mfr 9w if
_ .4 (.5
Ground 3 14-22 10yr4/4 none sl 2msbk mfr gw na .5 .6
elev.
1Q5.63. 4 22-38 10yr5/6 none.r°sil lfsbk mfr 7w na np.3
Depth to 5 38-60 10yr5/6 2mp 7.5yr5/8__j si 1- M na ra na np ` .3
limiting I -
factor
38" l -
Remarks:
Boring #
Ground -
elev.
1-
it.
Depth to - - I - -
limiting
factor
i
Remarks: - - - -
Boring # _ _ ,
I;
Ground -
elev.
Depth to -
limiting
factor
i
Remarks: - -
Boring # •
i
•
I
Ground
elev.
f
i
Depth to
limiting
factor
I I
Remarks:
SflD-E3a0(R.05/92)
1
STEEL'S SOIL SERVICE
Gary L. Steel
CSTM2298 Robert Pederson 1554 200th Ave.
MPRSW 3254 SE4NE4 S30-T29N-R17w New Richmond, WI 54017
r town of Hammond (715) 246-6200
N
1"= 40'
BM= top of county survey stake at el. 100' .
_ontour line at el. 106.33
~l
O
J10~
)01"
,1
51
!d 6/
2
Gary L. Steel
5-10-94
PQd•e.V-
/ o ~
W1. SyoLS
WORKSHEET - MOUND SYSTEM DESIGN
PROBLEM:
Design a mound system for a 3
The site characteristics are:
Depth to groundwater or-~ in•
Landsl ope % if d~ 2-
Percolation rate._
Distance from dose chamber to distribution system ,low ft.
Elevation difference between Dump and distribution system ,_•~,i ft.
Step 1. WASTEWATER LOAD 5 X 3 = 5~ yS0 gal
Step 2. SIZE THE ABSORPTION AREA
A) Area required sq. ft.
B) Bed or b"nich lengt4-4B) _ ~a•Sft.
C) Bed or _ (A) _ .,42 ft.
:-D) Trench spacing.(C)
' Wastewater load .24 coal/ft2/day B = ft.
Y.
trek ei s
Step 3. MOUND HEIGHT
A) Fill depth (D) _ ft.
B) Fill depth (E) = D +6 slope (AJf'~) L'49 ft.
C) Bed or trench depth (F) _ X13, t
D) Cap and topsoil depth (G) _ ft.
E) Cap d topsoil depth•(H) _ ft.
,:;i gn
ldccnue i"U:
I,S'G,
_G _
Date
RobE~ ,Qaer>0rs, `
6 5 4
Step 4._ MOUND LENGTH
A) End slope (K) _ CD + E / + F + H x 3
4. , S 9-4 h 90
B) Total mound lengt (L = B + 2(K) _ _83, ft.
/0~,5,+ x /11,61=~3oi
Step 5. MOUND WIDTH J
Al) Upslope correction factor = tG~-S
A2) Upslope width (J) - (D + F + G)(3)(factor) ft.
C/4.934 ~X; X .-115'=. 71768
B1) Downslope correction factor =
B2) Downslope width (I) _ (E + F + G)(3)(factor) = ft.-
~l~
Cl) Total mound width (W) for bed = J J_+ A + I
1 (Q 4 r
/a -a5,8
C2) Total mound width (W) for trenches =
iJ + (no. trenches -1)(c) + A + I'- IVIA, ft.
Step 6, BASAL AREA
A) Infiltrative capacity of natural soil, gal./ft2/4ay
B) Basal area required = wastewater flow
natural soil infiltrative capacity = sq•
ft.
450;,9- 11a5-
C1) Basal area available for bed for sloping sites =
B x (A + I) = IA /42.5sq. ft.
~a,s k C~--A) -/~aS
C2) Bas are~y available for trench for sloping sites =
B W (J + A = /?J/#sq. ft.
C3) Basal area available for trench or bed for level
ites = B x W = sq. ft.
Liconse 'i'u: / L -
o erv e d r-:5 O v- _
Step 7. DISTRIBUTION SYSTEM
-1A) SIZE DISTRIBUTION SYSTEM
_ in.
Hole
size
1)
2) Hole spacing = o? in.
3) Distribution pipe length a 3 in.
4) Distribution pipe diameter = Z in.
5) Spacing between distribution pipes in.
6) Distance from sidewall to distribution pipe in.
7B) DISTRIBUTION PIPE DISCHARGE RATE •3/ ft.
1) Number of holes per pipe = _ ~Jr
2) Flow per pipe _14 GPM
7C) SIZE MANIFOLD
1) Manifold is central/ end
2) Manifold length = ..3_ ft.
3) Number of distribution lines =
4) Manifold diameter = -3 in.
7D) SIZE FORCE MAIN
GPM r
1) Minimum dosing rate =
2) Force main diameter = in.
3) Friction loss ft ,
I
7E) TOTAL, DYNAMIC HEAD
1) Vertical lift = ft.
2) Friction loss = ft.
3) System head 2.5 ft. ft.
4) Total dynamic head 913 ft.
Tl!S9,4--40654 _31.
7F) PUMP SELECTION
1) Pump selected will discharge GPM at ft.
total dynamic head.
2) Pump model and manufacturer
$8-5 ao~ w C-6 3111-
7G) DOSE VOLUME
1) 10 times void volume of distribution lines gal./cycle
/,OX(, 0 9.a 5 it x j/)
2) Daily wastewater volume : 4 doses/24 hrs. gal./cycle
3) Minimum dose volume = f~ 9 gal./cycle
7H) DOSE CHAMBER
1) Minimum capacity required = S'UO -75~ 150 gal.
Sign ~
Licc n; .'u:_156
Date:_
RO~0,4 I .~c~2~5~ Q lfil'L V ~ s ~ 9
• a~ a3i s~~~ s 3 7 9 7
ST` e4 L+IX
a m°
A 5e Ian
j- C a.~.- ~ ~ ! . ~J~j ~ promo S~ f~,• ~ u- ~
~D,a re - i s- 99
I
4563 / 104
/oar o-P .S f-, c.
4lea 31~L Ga"kAS P~ ?
n ~
dS X $ 3
(S c,4
a
"q to;
co-A q
6 r-
to. DoV~seog 83.
> 7y/
~G
1
\U
r
Page__L_Of-~
~ 02C '
4 06 5 ~
Straw, Marsh Hay, Or
Synthetic Covering Distribution Pipe
Ai tlc- ILHA CV,16.23 k~)kt,
Medium Sand
H G
Topsoil
F
- 31 J D
3 % Slope Force Main Plowed Layer
Bed of ~"-2Y"
Aggregate
Cross Section of a Mound System Using
A Bed For The Absorption Area D Ft.
E Ft.
F Ft.
A Ft. G / Ft.
B a, Ft. H Ft.
Signed: ( QZ.'~"" K /C.A(#Ft.
L $ 3.1 Ft.
License s YOr& tq I /
Date: to -/.s - / P?° Ft.
0L
@2 ~ '°"~12101~s
1AjjMPA far
ueoa sul~.aa~~s
OFD, of INOi1s 0
L`41t►S►
Alternate Position of
Force Main SSE C R
L _I
J Observation Pipe
B Imo---- K
-
- -
A
W W 10 4-7"----------
Distribution Pipe L Bed of ~"-2~"
Aggregate
Observation
I Pipe Permanent Markers
Plan View of Mound Using a Bed For the Absorption Area
1 r
!3 a1. .23/
1 ~~r►,~,..,,.,~ W ~ ~ Hof
Pd9o. Q: ,
Cl
I
Perforated Pipe Detail
n
End View % Perforolsd
End Cop PVC Pipe
e``o ice
pn+~ Holes Located-oft Bottom,,
s Are. Equally Spaced
PVC Force Moirr
4
Q PVC
Manifold Pipe
Alternate Posillon of
Drttrih +tion
pipe Force Main
Lost Mole Should Be
Nest To End Cop
End Cop Distribution Pipe Layout
P 3 Ft. 30,,5
R ~
S
;T
:
XInches X = Zr
Y Inches ZS `5
Signed• Hole Diameter Inch
. Lateral Inch(~s~
L i c F n 0 AWR*, nAc,E Ss (o -3 Manifold " .3 Inches
Date: ~'rdzfi- Force Main " 3 Inches
# of holes/pipe /.5
Invert Elevation of LateralsaAFt.
DEPT. 00 INDUSTRY, LABOR & NUS
DIVISION F SAFETY AN
SEE COB
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PAGE LQ9 OF
'PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS
VENT CAP
4 C.I, VENT PIPE
WCATHER PROOF APPROVED LOCKING
25' FROM DOOR, JUNCTION BOX MANHOLE COVER
WINDOW OR FRESH 12 MIU.
AIR IMTAKE i
'H
GRADE
-711A61- ( y" MIN.
CONDUIT IB"MIu.
11~
PROVIDE
~T.~ AIRTIGHT SEAL I I
APPROVED JOINT A
W 'p` { I III APPROVED JOIN1
/C.Z. PIPE. t v ~ :~i?~ i~ E~~ a j I I I W/C.I. PIPE
EXTENDmC•
EXTEUDIUG 3'
OMTO SOLID SO:;. - I I ALARM
R® I I ONTO SOLID WIt
NS I
LOOK & IJUMAH ` A I10 I
flf6Pt]G. OF wousTRY BU;Lomp I I OM
D! ION sAfE"
I I
1 PUMP----
n tP
II[[ OFF
Ir r
NI?_y 1
R
SEE COR
I
I
CONCRETE BLOCK
I
RISER EXIT PERMITTED ONLY IF TANK MAUUFACTURCR HAS SUCH APPROVAL
S'PCC.IFICATIC)QS
SEPTIC AND tt
~4SE TANKS MAWLIFACTURER: J4) Q A_g_0 n
NUMBER OF DOSES: ~-PEP, pA~j
TANK GIZE : _-If)
GALLONS DOSE VOLUME Q
ALARM MAAIUFACTURER: It~1CLUC'!'!'- 3,C".FLOW: GALLONS
MODEL 1.1UMBER: ,LI~L CAPACITIES: A= ;?3 ~//D,SS
IIJCNCS OR GALLO>JS
SWITCH TJPL: E
8 = a INCHES OR 35, GALLONS
PUMP MANUFACTURER: tI
C--7 IUCHES OR /16C)lbfGALLONS
MODEL NUMBER: p, O INCHES OR ! 7j'y
GALLONS
SWITCH TYPE; MOTE: PUMP AND ALARM ARE TO BE
PUMP DISCHARGE RATE '91-6 GPM INSTALLED ON 5EPARATE CIRCUITS
VERTICAL DIFFERENCE Dot IZLIU PUMP OFF AND DISTRIBUTIC)m PIPE.. FEET ~7,
+ MINIMUM NETWORK SUPPLY PRESSURE 2.5
/ FEET
+ FEET OF FORCE MAIN X -1-e _FOOFT.FRICTIOU FACTOR. 8/ FEET
I~ TOTAL OyNAMIC. HEAD = 3 FEET
INTERNAL RIMENSIONC OF TA1JK: LENGTH~ -
7-~--WIDTH ;LIQUID DEPTH
SIGNED: LICEWSE NUMBER: /s6J DATE: 0/-/S-
-117-
.
lip.
jtiTr V 1' Ut :tJ {SS'!~1.~ .1*1 li 1
,411FT~ 1 r. 1 M
40
t tiL~11S JhC E, 1 RSIGCE t
G"I.DS.SUU
t.
sf.,~~r SEWAGE AND EFFLUENT PUMPS
a~
ft~ EP0311
}~s.. 1/2" solids 256.80 172.10
t{~ ,b l11y:'1 Yt' p~7['Et?0]11 142 EP0311 1/3 tP 115 V Effluent Pvrp
411 ersible
Sub'
MODEL EP0311
r % r Effluent, Pump
SIZE 3/a" SOLIDS
nG}~ pia` METERS FEE
7
H'1 I 25
20
10
y . 0
2 a
. u
i Et •
4' • O. Op 4 E 12 15 20 24. 21 02 36 10
GPM
0 2.5 5!0 7.5 m'!A
CAPACITY
o • 1 16, t.
Performance 3885
~K:.~ Curve
t v
me Tx" FECT
;95}2` tr `ir n SIZES,"Solids
''✓t tire ~4? ' 70
i'S }l Fi 20
w
y f t
WfOTN-
fv#1 L.. 16 50
.
, NLrYSH ~ r.'
{KLs,J 10 WE
wto>t _
• '0 I
^Y YT"1 1 0 0 ,0 30 30 .0 60 14 70 00 YO 100 110 120 CPU
0
i'h'` t . . ' '
~.3 - - - to >o p ~T
0 CAPACITY
LISC DISC.
y1 _ 3/4' solids 491.55 329.35
+r i r ++~r r GOLTWT0311I. 142 NE0311L 1/3 HP 115 V Low H
jF QJl1R,'E0311M 142 'FfE0311M 1/3 HP 115 V Fbd N 3/4" solids 191.55 329.35 ~t
t C k 3/4" Ablids 704.25 471.85
115 V High H
i 00UPH1.0511H 142 WE0511H 1/2 IT
3/4" solids R43 65 565.25
t 1 iI ( MILI T0712tf 142 UT 112.1 "3/4 Hp 230 V High W.
SPECIFICATIONS. Y
1 •••SEE' F0LU>4IFY PAM FM PES1FCfO 2CE At
PAGE D7u
10/98 DE1yT 30
DATZ
4~ isconr.;n Department of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3
Labor and Human Relations p
• Division of Safety & Buildings in accord with ILH .y 3~IVis l ode COUNTY
Attach complete site plan on paper not less than 8 1/2 x 11 inc i ize. n-&st include,, b~yt St. Croix
PARCEL I.D. #
not limited to vertical and horizontal reference point (BM), dire ib nd % 'scale or
dimensioned, north arrow, and location and distance to nears o d. 018-1066-80
APPLICANT INFORMATION-PLEASE PRINT ALL IN UR AT90N REVIEWED BY DATE
PROPERTY OWNER: P99pERTY LOC QN,
GpIJ ,OT iil4 1/4,S 30 T 29 N,R 17 Xk(or)W
Robert Pederson S$, NE
PROPERTY OWNER':S MAILING ADDRESS TY BLf kY# SUBD. NAME OR CSM #
Box 231 a ;
CITY, STATE ZIP CODE PHONE NUMBER " CITY- '[]VILLAGE [MOWN NEAREST ROAD
Hammond WI. 54015 (7151 796-5217
tk* New Construction Use j) ] Residential /Number of bedrooms 3 ( ] Addition to existing building
j ] Replacement [ ] Public or commercial describe
Code derived daily flow 450 gpd Recommended design loading rate • 4 bed, gpd/ft2 •5 trench, gpd/ft2
Absorption area required 375 bed, ft2 375 trench, ft2 Maximum design loading rate .4 bed, gpd/ft2 .5 trench, gpd/ft2
Recommended infiltration surface elevation(s) 1 m _'1-4 ft (as referred to site plan benchmark)
Additional design I site considerations na
Parent material glacial drift Flood plain elevation, if applicable na ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem ❑ S M g&S ❑ U ❑ S 04 ❑ S U ❑ S OU ❑ S L
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
Boring # Horizon in. I Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
1 0-8 10 r3/3 none 1 2msbk mfr if .5 .6
2 8-19 10yr3/4 none scl 2msbk mfr 9w if .4 .5
Ground 3 19-27 10yr4/4 none sl 2msbk mfr gw na .5 .6
elev. mP
106.73. 4 27-62 10yr5/8 7.5 r5 8 sil 1f P1 mfr crw na n .3
Depth to 5 62-75 10 r6/6 none s 0 s mfr na na n n
limiting
factor
27"
Remarks: H-5 weakly cemented sandstone residuum
Boring #
1 0-10 10 r3 3 none 1 2msbk mfr cfw if .5 .6
€>2 2 10-22 10yr3/4 none scl 2msbk mfr gw if .4 .5
"V 3 22-30 10yr5/6 none sl lfsbk mfr gw na .4 .5
Ground
elev. 4 30-39 10yr5/8 2mp 7.5 r5/8 sil 1f P1 mfr crw na n n
106,73 ft. 2mP 7.5yr5/2
Depth to 5 39-6 10yr5/8 7.5yr5/8 sil M na na n n
limiting
factor
30"
Remarks:
CST Name:-Please Print Phone:
Gar L. Steel 715-246-6200
Address: 1554 200th. e. , New Ric ond, WI. 54017
Signature: Date: CST Number:
v 5-10-94 CSTM 2298
PROPERTY OWNER Robert Pederson SOIL DESCRIPTION REPORT Page 2. 6f3
PARCEL I.D. # 018-1066-80
I
Borin Depth Dominant Color Mottles Texture Structure GPD/ft
Boring # Horizon I Consistence Boundary Roots
in. Munsell Cu. Sz. Cont. Color I I Gr. Sz. Sh. Bed ITrer
1 0-8 10 r3 3 none 1 2 rnsbk mfr
if .5 .6
2 8-14 10yr3/4 none scl 2 msbk mfr gw if .4 .5
Ground 3 14-22 10yr4/4 none sl 2msbk mfr gw na .5 .6
elev. i
105.6. 4 22-38 10yr5/6 n ne;- sil lfsbk mfr gw na np .3
Depth to 5 38-60 10yr5/6 2mp 7,5yr5/8 sil M na na na np .3
limiting
factor
38"
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to -
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(8.05/92)
STEEL'S SOIL SERVICE
Gary L. Steel 1554 200th Ave.
CSTM2298 1 Robert Pederson New Richmond WI 54017
MPRSW 3254 SE4NE4 S30-T29N-R17W 715 246-6200
town of Hammond
t
N
1"= 40'
BM= top of county survey stake at el. 100'
contour line at el. 106.33
~I I
j~L~ 1'jr~ ~31
\ 7
v
z~
Gary L. Steel
5-10-94
o FILED 2
6 JUN281994®. 3
JAMES O'CONNELL
Register of Deeds S(
St Croix Co., Wf
CERTIFIED-SURVEY MAR
Located in part of the SE 4 of the NE k of Section 30,
T29N, R17W, Town of Hammond, St. Croix County, Wisconsin.
N T NE Corner
o N Section 30
N d
N Cc' IIrk-D c'IJIRVEY MAP z
c tin - - N 8
o ' `✓71_. r , Irv. 1934
-n m N_ -P
°
0°
' (S89050110"E)
M ; S89°53' 36"W 258.00'
PI-+ =
0 0 M 225.00' 33.00'
CD +a
2 N rh
O+ fD O
- ry
r [-F c+•
O N
S ~ .
33' 33'.
Icy
N j L cn j j l -~1
0 d Z I
0 z z 0 p
IT Q> ' 8 0 0 1 IIV 1C7
is I~ 0 o In
0 10
o I m m LOT 2 1 l) I C/)
IG)
CJ 1C=
'm
2.31 Acres Inc. R/W T I
a I 100,771 Sq. Ft. Inc. R/W Z IU) 1 Lj
r-
> W 2.02 Acres Exc. B/W rl- 1-1
M I<
a Imo? cD 87,898 Sq. Ft. Exc. R/W w W Irl,
APPROVED o I>
j1 ji '941
°
ST. CROIX COUNTY
':;omprehensive Plannir
Zoning and
Pa7ks Committee
it not recorded ! 6 6'
within 30 days Of
approval date
approval shall be
m4 A void
225.00 33.00'
x z-
L N89°38'54"E 258.00' E} Corner
South line of the NE}
LEGEND Section 30
111 Iron Pipe Found I P L I I L J L H r 1-1+@6
J I 1~5 fah
a Masonry Nail Found - OWNER ALL p II
1n x 2411 Iron Pipe Set, neighing Francis K. Russell ~p~Y„•~; ~ R
1.68 lbs. per linear foot 791 160th Street
\ l 407'
U91
Hammond, Wi. 54015
1 Existing Fence Line DIX)
100' Roadway Setback Line w Wi
( ) Previously Recorded Bearing SCALE IN FEET SUP'js~
0 50 100 200
VOLUME 10 PAGE 2781
t
STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
L St. Croix County
owNER/BVYER 8A and Ju I 'l e pedO S CN)
MAII,ING ADDRESS _ P, 6 1 u 23 1, 150 0 din St , -I G M rn o n J , u l S9 015'
PROPERTY ADDRESS
y Cp ut 6 S*'
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE H Q mm 0 o c~ , f -
PROPERTY LOCATION- 1/4, J~E' 1/4, Section Q , TAN-R_LL_W
TOWN OF }A 4m m o nCl ST. CROIX COUNTY, WI
SUBDIVISION LOT NUMBER
CERTIFIED SURVEY MAP , VOLUME 1 v ' PAGE 781, LOT NUMBER.
Improper use and maintenance of your septic system could result in its premature failure to handle
wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed
by licensed septic tank pumper. What you put into the system can affect the function of the septic tank
as a treatment stage in the waste disposal system.
St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost
of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County
accepted this program in August of 1980, with the requirement that owners of all new systems agree to
keep their system properly maintained.
The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner
and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1)
the on-site wastewater disposal system is in proper operating condition and (2) after inspection and
pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum.
I/We, the undersigned have read the above requirements and agree to maintain the private sewage
disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR.
Certification stating that your septic has been maintained must be completed and returned to the St. Croix: County Zoning Officer within 30 days of the three year expiration
date.
SIGNED:
DATE:
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
S T C - 100
This application form is to be completed in full and signed by the
owner(s) of the property being developed. Any inadequacies will
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 &L 't k pec e.cson
Location of property`` _1/4 WE 1/4, Section T~N-R,~_W
Township Pamr 1oc A Mailing address
_ `I 5~j
Address of site 6 -1
Subdivision name to 2.7 Lot no.
Other homes on property? Yes No
Previous owner of property ~`Q~'1C,1 S ice. Q 6<,9
Total size of property !D--
Total size of parcel ~y a
Date parcel was created
Are all corners and lot lines identifiable? Yes No
Is this property being developed for ('spec hous ) ? Yes No
Volume and Page Number 1 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. -~j/g , 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.
-X3~~ Q r
Signature of Applicant Co-Applicant
-7 1 jqq lqlq-~
Date of S gnature Date o S gnature
' 116 . ' DOCUMENT NO.
STATE BAR OF WISCONSIN FORM 2-1982 THIS SPACE RESERVED FOR RECORDING DATA
WARRANTY DEED
5JL857 - • p5PA--UE24~
OL
Kt;~'~d rix R .
- Francis K Russell - A married person JUL i 1994
wa's
t r 1:30 *sai
conveys and warrants to 4- a-IN
Robert R. Pederson and Julie L Johnson-Pederson
RETURN TO
Husband and wife survivorship marital property.
the following described real estate in St. Croix County, b
State of Wisconsin:
Tax Parcel No:
Lot 2 C.S.M. Vol. 10 Page 2781
.h
Located in part of the SE 1/4 of the NE 1/4 of Section 30, T29N, R17W
Town of Hammond, St. Croix County, Wisconsin.
7. .
This is not homestead property.
(is) (is not)
Exception to Warranties:
Dated this 3 day of
(SEAL) (SEAL)
(SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Signature(s)- STATE OF WISCONSIN
( ss.
M«...
f County.
authenticated this day of , 19 Person ly came before me this. Q~ dGG~~ of
'y
19 ;441
• . •
'm Ai.
TITLE: MEMBER STATE BAR OF WISCONSIN
~1 f)
(If not, to me known to be the person who/e>ited the '
authorized by § 706.06, Wis. Slats) for g instrument and apAnowledge the sarw.
THIS INSTRUMENT WAS DRAFTED BY
Ile- L k) ~U S
Notary Public County, Wis.
(Si a4res may be authenticated or acknowledged. Both My Commission is permanent. (If not, state ex iration
are not necessary. P
Y)
date:
'Names of persons signing in any capacity should be typed or printed below their signatures. S82 NTF 0021
IL
WARRANTY DEED STATE BAR OF WISCONSIN Nelco Tax Forms, P.O. Box 10208, Green Bay, WI 54307-0208
Form No.2 - 1982