HomeMy WebLinkAbout020-1062-30-200
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STC - 104
AS BUILT SANITARY SYSTEM RE O`R '
M ` 1.E1f ~ o~ ,
OWNER
ICt,(G~h~
ADDRESS ,Lo 7` y ,lJcry~/~ xYf `r/ , • ,
SUBDIVISION / CSM# G( `f LOT #
SECTION b23 T --Zy' N-R~W, Town of l/ek,'7d~
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
a
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10
a
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3_
0
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK: ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: Liquid Capacity: /?tea
Setback from: Well .;z- House Other
Pump: Manufacturer Model# - FFC Size
Float seperation Gallons/cycle:
Alarm Location
_ v
SOIL ABSORPTION SYSTEM
Width: Length ~ g-o- Number of trenches
Distance & Direction to nearest prop. line: r
Setback from: well: /GG House Other
ELEVATIONS
Building Sewer ST Inlet. ST outlet
PC inlet PC bottom Pump Off
Header/Manifold Bottom of system
Existing Grade Final grade
DATE OF INSTALLATION::i' %l
PLUMBER ON JOB:
LICENSE NUMBER:
~O
INSPECTOR:
3/93:jt
onion
Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County:
Labor and Human Relations INSPECTION REPORT ST. CROIX
Safety o+zJ Buildings Division
• (ATTACH TO PERMIT) Sanitary Permit No-:
GENERAL INFORMATION
Permit Holder's Name: ❑ City ❑ Village RR Town of: State Plan ID No.:
MULCAHY, INC. IR
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
/00 10 -10,4'k 4A' ' TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic 7 SO(Q) Benchmark 10~N /00
Dosing
Aeration Bldg. Sewer
Holding St/ Ht Inlet /0,30
S
TANK SETBACK INFORMATION St/Ht Outlet -7
TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet G
Air Intake
Septic )1/00 r/bp > 10 S I NA Dt Bottom / y, 9 p~ 7
Dosing > DO > NA Header-/Man. L/a /0/;9
Aeration NA Dist. Pipe 3,43, /ar.v
Holding Bot. System , 03 0/- a 7
PUMP/ SIPHON INFORMATION Final Grade
Manufacturer Demand
Model Number GPM 1,N 9~.
TDH Lift~U Lriction System Q TDH Ft
Forcemain Length f ~ Dia. aK Dist. To well
SOIL ABSORPTION SYSTEM
BED / TRENCH Width Length $ No. Of nches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS DIMENSIONS
SYSTEM TO P/ L BLDG WELL LAKE / STREAM LEACHING manufacturer:
SETBACK
INFORMATION Type0 CHAMBER Mode Number:
System: rMX-V & t >/00 OR UNIT
DISTRIBUTION SYSTEM
b+eader-/ Manifold Distribution Pip (s) x Hole Size x Hole Spacing Vent To Air Intake
Length Dia. Length Dia. Spacing l /I aS
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over ~k xx Depth Oft1 xx Seeded /tudde6 ~t litz Mulched
Bed /Trench Center Bed/ Trench Edges Topsoil l0 wrYes ❑ No Wes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.) {
' u C c_ z c C,Lc
LOCATION:
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v
10
yY 5 , -
o _
4
Plan Seision-required?3, Yes ❑'N0 ` F& I /
Use other side for additional information. 1qd okdl-
SBD-671 0 (R 05191) Date ~spiictor's Signature Cert. No.
OWN ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
I
I
EM:7EI 'ISANITARY PERMIT APPLICATION
~:HR 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 ;2 2 14{/(/"bOp'
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.
PROPERTY OWNER " SOPERTY LOCATION
,'c e5 zq= "AedL Z i t/a,ow t/a, S a,? T , N, R E (or
Se
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
S' 92- -116/ d el L
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION AME OR CSM NUMBER
o S/? z - 5- A0G / 9,
II. TYPE OF BUILDING: Check one CITY NEAREST ROAD
) El State Owned O VILLAGE
OF*: A01
19 Public ❑ 1 or 2 Fam. Dwelling-# of bedrooms - PARCEL AX
NUMBER(S)
Ill. BUILDING USE: (If building type is public, check all that apply) Q 2 Q - ~Q ~Q
1 ❑ Apt/Condo
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 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. ~0 New 2. ❑ Replacement 3. ❑ Replacement of 4.0 Reconnection of 5.E] 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 K Mound 30 El Specify Type 41 ❑ Holding Tank
12 El 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) _2d ELEVATION
15-e 3Qc / 6o ( .var- ~GlFeet (O.?r9D Feet
VII. TANK CAPACITY Site
in allons Total of Prefab. Fiber- Exper.
INFORMATION New Existing Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
Septic Tank or Holdin Tank o2 r
Lift Pump Tank/Si hon Chamber OG L f I El F-1 L1 I El - r-1
Vlll. RESPONSIBILITY STATEMENT
1, 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) P PRSW No.: Business Phone Number:
r/ rC G G G✓ 3 -~-~l~! AA" y5
Plumber's Address (Street, City, State, Zip Code):
IX. COUNTY/DEPARTMENT USE ONLY
0 ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signatur s)
0e, Surcharge Fee)
Approved ❑ Owner Given Initial 3 _ c~ -
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 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 (S'?D 6399) to be
submitted to the county prior to installation.
5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed
pumper whenever necessary, usually every 2 to years.
6. If you have questions concerning your onsite sewage system, contact your local code administrator or the
State of Wisconsin, Safety & Buildings Division, 608-266-3815.
To be complete and accurate this sanitary permit application must include:
1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of
where the system is to be installed.
II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling.
III. Building use. If building type is Public, check all appropriate boxes that apply.
IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or
repair.
V. Type of system. Check appropriate box depending on system type.
VI. Absorption system information. Provide all information requested in ##1-7.
VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of
tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all
septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received
experimental product approval from DILHR.
VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g.
MP, etc.), address and phone number. Plumber must sign application form.
IX. County/Department Use Only.
X. County/Department Use Only.
Complete plans and specifications not smaller than 8'% x 11 inches must be submitted to the county. The
plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of
holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service;
streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system
areas; and the location of the building served; B) horizontal and vertical elevation reference points;
C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump
performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if
required by the county; E) soil test data on a 115 form; and F) all sizing information.
GROUNDWATER SURCHARGE
1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of
regulated practices which can effect groundwater.
The monies collected through these surcharges are used for monitoring groundwater, ground-
water contamination investigations and establishment of standards.
SBD-6398 (R.11/88)
f
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SAFETY & BUILDINGS DIVISION
State of Wisconsin
Department of Industry, Labor and Human Relations
August 11, 1994 201 East Washington Avenue
P. 0. Box 7969
Madison WI 53707
ULBRICHT & ASSOCIATES
ROBERT ULBRICHT
655 L ROAD ORIGINAL
HUDSON ON WI WI 54016
RE: PLAN S94-03195 FEE RECEIVED: 180.00
MULCAHY INC
NE,NW,23,29,19W
TOWN OF HUDSON 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 approval does not include plans for the general plumbing systems or
sewer piping leading to the septic/holding tank that may be required for
this project. See section ILHR 82.20, Wis. Adm. Code, to determine if plan
submittal and approval is required.
- The plumbing for this project discharges to a private sewage system. The
approval covers only domestic/sanitary wastes directed into this system.
The Department of Natural Resources must be contacted regarding the
treatment and disposal of all industrial wastes, including those combined
with domestic/sanitary wastes.
- The discharge of hazardous wastes to a private sewage syste;hey' sf prohibited
by state and federal regulations. Accidental discharge of hazardous
substance to a private sewage system must be reported to the Department of
Natural Resources or the Wisconsin Division of Emergency Government.
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.
SM).6423 (N, 01191)
a
JAWMRO
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r
SAFETY & BUILDINGS DIVISION
I
State of Wisconsin
Department of Industry, Labor and Human Relations
ULBRICHT & ASSOCIATES
Page 2
August 11, 1994
Inquiries should be directed to me at the number listed below. Please refer
to the plan number shown above.
Sinc rely,
QJ euinlan
Plan Reviewer
Section of Private Sewage
(608) 266-3937
cc: ST CROIX
Leroy G. Jansky
Department of Natural Resources
S BD•6423 M. 01/91)
Wscnsin Derart Relations Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3
#DiVislion of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but
St. Croix 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. (22-6- / 0 In -2 - l d
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION R IEWED BY DATE
a 0 ~lA k-lvl
PROPERTY OWNER: PROPERTY LOCATION
Mulcahy, Inc. GOVT. LOT NE 1/4 NW 1/4,S23 T29 N,R lg for) W
PROPERTY OWNERS MAKING ADDRESS LOT # BLOCK # SUBD. NAME M
5232 N. Glenbrook Ave. na na na ,C 5122 0771
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE QfOWN NEAREST ROAD
Oakdale, MN. 55128 P12)770-5250 Hudson Norflex dr.
New Construction Use [ ] Residential / Number of bedrooms Addition to existing building
j ] Replacement (x* Public or commercial describe R. R. repair shop, 6 employees, 6 floor drains
Code derived daily flow 420 gpd Recommended design loading rate • 5 bed, gpd/ft2 •6 trench, gpol11112
Absorption area required 350 bed, ft2 350 trench, ft2 Maximum design loading rate • 5 bed, gpd/ft2 - 6 trench, gpd/ft2
Recommended infi;tratio surface slevation(s) 101.22 ft (as referred to site plan benchmark)
Additional design / site considerations na
Parent material outwash over silty sediments 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 ~9 ® S ❑ U ERS 1:1 U MCS ❑ U 13 S M ❑ S :au
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence I Boundary Roots GPD/ft
in. Munsell Qu: Sz. Cont Color Gr. Sz. Sh. Bed Trend
1 0-13 10yr2/2 none 1 2msbk mfr gw 2f .5 .6
2 13-28 10yr4/4 none sil 2msbk mfr gw if .5 .6
Ground 3 28-4 7.5yr4/6 none is Osg ml clw na .7 .8
elev. p
100.22 ft, 4 46-60 10yr5/3 7,5yr5/8 scl M na na na np np
Depth to
limiting
factor
46"
Remarks: H-4 intermittent layers of 7.5yr4/6 is with the scl
Boring #
1 0-15 10yr2/2 none 1 2msbk mfr gw 2f .5 ::.6
2 15-2 10yr4/4 none sil 2msbk mfr gw if .5 .6
:h
3 29-39 7.5yr4/6 none is Osg ml gw na .7 .8
Ground CZP
elev. 4 39-55 10yr5/3 7,5yr5/8 scl M na na na np jnp
99.97 ft.
Depth to
limiting
factor'
391,
Remarks: H-4 intermittent lens of 7.5 r4/6 is throu haut horizon' I
CST Name:-Please Print Phd11e:
Steel 71:. " tv2OO cr
Gary L.
Address: 1554 20 h. Ave. , Ne Richmond, WI. 54017
Signature: Date: - r' Number.
A !c 7-13-94 cstm2Z98
16-
PROPERTyOWNER Mulcahy, Inc. SOIL DESCRIPTION REPORT PPMe, 2~of3 _
PARCEL I.D. # C ) OO ! I D 6 Z /O
Boring # Horizon Depth I Dominant Color Mottles I Texture I Structure Consistence IB ndely I Roots GPD/ft
) in. Munsell Cu. Sz. Cont. Color Gr. Sz. Sh. Bed iTmendi
1 0-15 10 r2/2 none 1 2msbk mfr 2f .5 .6
2 115-27 10yr4/4 none sil 2msbk mfr if 1.5 i.6
Ground 3 127-35 7.5yr4/6 none S Osg ml gw na .7 ; .8
lev.
99. 97 ft. 4 135-60 10yr5/3 c2p7.5 r5/8 scl M na na na n ' n
Depth to
limiting
factor
35"
Remarks:
Boring # t I
1 0-13 10yr2/2 none 1 2msbk mfr gw if .5 .6
4 2 13-25 10yr4/4 none sil 2msbk mfr gw if .5 !.6
3 25-35 7.5yr4/6 none is Osg mvfr na na .7 .8
Ground
108qv- ft.
Depth to
limiting
factor
+35"
Remarks:
Boring #
Jiwtit:tit6: iiii
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
i
Remarks:
SBD-8330(R.05/92)
r
STEEL'S SOIL SERVICE
Gary L. Steel Mulcahy, Inc. 1554 200th Ave.
CSTM2298 NE4NW4 S23-T29N-R19w New Richmond, WI 54017
MPRSW 3254 town of Hudson (715) 246-6200
N
BM.= top of SE lot survey stake at el. 1001- vertical & horizontal reference point
elevation within system and 25' surrounding,less than 1' el. difference
area of system and 25' downslope area to be left undisturbed
/Vo~2~t'EX Or•
Cr~
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COrY.~R
Gary L. Steel
7-13-94
Parcel 020-1062-30-200 01/25/2005 12:29 PM
PAGE 1 OF 1
Alt. Parcel 23.29.19.235F 020 - TOWN OF HUDSON
Current lk ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): * = Current Owner
* AG PARTNERSHIP
AG PARTNERSHIP
3050 ECHO LAKE AVE
MAHTOMEDI MN 55115
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description
SC 2611 SCH D OF HUDSON
SP 1700 WITC
Legal Description: Acres: 2.000 Plat: N/A-NOT AVAILABLE
SEC 23 T29N R19W PT N1/2 NW1/4 BEING LOT Block/Condo Bldg:
4 OF CSM 10/2807 2 ACRES
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
23-29N-19W
Notes: Parcel History:
Date Doc # Vol/Page Type
07/23/1997 1093/162 WD
2004 SUMMARY Bill M Fair Market Value: Assessed with:
48119 507,400
Valuations: Last Changed: 10/29/2001
Description Class Acres Land Improve Total State Reason
COMMERCIAL G2 2.000 56,600 335,900 392,500 NO
Totals for 2004:
General Property 2.000 56,600 335,900 392,500
Woodland 0.000 0 0
Totals for 2003:
General Property 2.000 56,600 335,900 392,500
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
001-WATER SPECIAL ASSESSMENT 0.00
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
i I
r FORM NO. 985-A
L~
Stock No. 26273 of
520618 JNOS sot o peed`
ulv-
CERTIFIED SURVEY MAP NO. 520618 ~S4 f
VOLUME 10 , PAGE 2807
PART OF THE NW 1/4-NW 1 /4 & NE 1/4-NW 1/49
SECTION 23, TOWNSHIP 29 NORTH, RANGE 19 WEST,
TOWN OF HUDSON, ST. CROIX COUNTY, WISCONSIN
BEING LOT 1, C.S.M. NO. 2778 NORTHWEST CORNER
Z SEC.23, T29N, R19W
FND. CO. MON.
A = 69.40'19' BEARINGS REFERENCED TO THE NORTH UNE OF
R = 192.75' THE NW 1/4, SEC. 23, T29N, R19W, ASSUMED
L = 234.38' BEARING N 89'06'48" W.
LC= N 34.57'51.5' E 220.21'
FT= N 69'48'01' E LEGEND
GOVERNMENT CORNER (AS NOTED)
00'07'4
177
9.3 O FOUND 1" IRON PIPE
CD a~ • FOUND 3/4" RE-BAR
Z o"1OVE®
11) 0 O SET, 3/4"X24" REBAR C
.,c 'D M G~ ZS y ` WEIGHING 1.502 LBS.
01 rV a PER LINEAL FOOT.
A. ppW AUG x141
£ -n C'D'W m Ns SCALE:1 "=300'
13 rn
Cil n v ; , A L'ROiX COUNTY
co
m r < ~ 0' 300' 600' ? ; );:,pre.~ensive Piaruiit
310.61 30' SETBACK 9 z m Toning arid
I(' r •96.90' P K F~w- ks Committee
z
I,zb 13'71'
Z
z N
PREPARED FOR £
z > a~ z not recorded
ly £ ~ µ C. 1 ✓ > ROBERT A. ANDERSON j~• ' 119115 bf
y z In a 720 NORFLEX DRIVE
m £ ro ' HUDSON, Nn 54016 GV~ HSt@
LINE, NW-NW In a T '8r'shiih 66
Id I• I~ ro E.
E SEZBPC~ s y
I, IN -c IiV
cn o AD
z
ti IA r
0 100
18.77' o I~ 1-0 0m
a DRAFTED BY D.M.C.
296.94' ~ 3 ~~9n z
II-` 9 `a Z 0
315.71 30' SETBACK n E
I~m '~aaaae~ia~re~.
Z 5 o, S C 0 N S
Z' w •a........ / t
v
O~ O
Jot.
0 \D
z CD N o ° ow DONALD M.
CLARK i °
ti y `A 8.1580 r
MENOMONIE,
r
rv 1+ = 20.57108' ' O$
Ln 3>
~4 c) a R = 460.00' ~~b VR $sip`
A i L = 168.21'
can
LC= IN N 80.16'35' E 167.28'
'ark +
BT= N 69'48101' E
FT= S 89.14151' E l7~
NORTH 1/4 CORNER
50' SETBACK N ro SEC.23, T29N, R19W
S 00.30'09' W 1062.83' v FND. 2" I. PIPE
6E m w S00•t)B23'W
s UNPLATTED LANDS
CEDAR CORPORATION
604 WILSON AVENUE
MENOMONIE, WI 54751
(715) 235-9081 PAGE OF Z
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STC-105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County ~i
OWNERMUYER 1'411IG 44AG - IY410-4
MAILING ADDRESS 572- 3 2_ Cry J24A Q /ZOO '4 v-~ OA'*Qi4A9- 1Af v • S FAk
PROPERTY ADDRESS -I-,k Zrt -aJ-Z
(location of septic system) Please obtain from the Planning Dept.
CITY/STATE
PROPERTY LOCATION NE- 1/4, w 1/4, Section 2 , T2f N-R I W
TOWN OF 4V P'rd,) ST. CROIX COUNTY, WI
SUBDIVISION LOT NUMBER
CERTIFIED SURVEY MAPsz ® , VOLUME PAGE a TLOT NUMBER!
4F 2'T7
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 r ed to the St. Croix
County Zoning Officer within 30 days of the three year expiration date.
SIGNED:
DATE: fJ (
St. Croix County Zoning Office
Government Center
1101 Carmichael Road
Hudson, WI 54016 11/93
r STC-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), thenla second form should be retained and completed when
the property' is sold and submitted to this office with the
appropriate deed recording.
-----------------------------1-/- I-----
Owner of property A V 1 C,+( Y 4• 1yv1e_4A TES~j9~
G
Location of 'property 1/4 /0 1/4 , Section L3 , T 2I N-R_./?_W '14 o
Township
Mailing address 52-3>- 6r-l&(- ('S eoaet e4I-Q
Address of site
Subdivision name Lot no. !
Other homes on property? yes No
Previous owner of property
Total size of parcel &e
c
Date parcel was created l `
Are all corners and lot lines identifiable? Yes No
Is this property Oeing developed for (spec house)? Yes No
Volume and Page Number as recorded with the Register
of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE
NUMBER & 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 o.
Deeds as Document No. a 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 County Register of deeds as Document
NoXonatur fapplicant t C applicant
Date of Signature Date of S ature
C1C1;;UMENT NO. it WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA
1
j STATE BAR OF WISCONSIN FORM 2 -1982
REGISTER'S OFFICE II
Anderson.-Holdings,..-Inc.-,..a..Minnesota_ Corporation, ;I ST. CROIX CO., W1
1br Record
Reed .
-
AUG 2 9 1994
- - - p M
conveys an - d warrants to _..._.---AGPartnership, a Minnesota - 3:30
Partnership
~ d'
RegiBLer Of Deeds
L
RETURN TO
_ .
the following described real estate in St. Croix County, - -
.
State of Wisconsin:
Tax Parcel No
Part of the N 1/2 of the NW 1/4 of Section 23-29-19 described as follows:
Lot 4 of Certified Survey Map filed August 25, 1994, in Vol. "10", page 2807.
III I~
I
iI
I
jl
This 1S-_LIOt........ homestead property.
(is not)
Exception to warranties: Easements, restrictions and rights-of-way of record,
I'I if any.
Ij
III Dated this " day of - August - 19 94
derso H d$ngs, Inc.
I
BY: `
(SEAL) - (SEAL)
Robert A. Anderson, President
(SEAL) - - ------(SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Signature (s) obert- A. _ Anderson STATE OF WISCONSIN
ss.
~J~~9~'- County.
authenticated this !~_`___day of______Allgllst . 19 _94 Personally came before me this ________________day of
19-------- the above named
Kristina _ Oland
MEMBER STATE BAR OF WISCONSIN
(If not-
authorized by § 706.06, Wis. Stats.)
to me known to be the person who executed the
foregoing instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY _
Kristina 0gland
Attorney at Law
Notary Public ---------------------------------------.-County, Wis.
(Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration
are not necessary.) date: 19__-__-_-.)
'Names of persons signing in any capacity should be typed or printed below their signatures.
WARRANTY DEED STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc.
FORM No. 2 - 1982 Milwaukee, W;sconsin
ULBRICHT & ASSOCIATES CO.
655 O'Neil Road - Hudson, WI 54016 Reg. Designers of Engineering Systems
Private Sewage Consultants
715-386-8185
HULCHER SERVICES INC. MOUND SYSTEM
R/R Derailment-Emergency Repair Shop
All elevation cited on plans are derived .+rom the CSTM and are
assumed to be rrect and accurate. The suitability of soils to properly
sustain a mourid77type`septic-'rs+y~at:em,,;.Ijall also remain the sole responsibility
of the CSTM.
SIZING OF DOMESTIC WASTE LOADS
Provided for: 2 regular employees (40 gals.), 3 office floor drains (150 gals)
and at times-up to 18 emergency crew/drivers may be in building (360 gals).
Total estimated peak wasteflow: 550 gals per day. Mound system is designed
to sustain 650 gals. per day.
Soils are permiable ( soil infiltrative rate of .5 GPD/ft) but seasonally
saturated at 35 inches.
Minimum required septic tank capacity - 750 gals.+ 650 gals = 1500 gals.
Proposed, for ultimate effluent quality and for surge events, 2 septic tanks
in series shall be installed (1000 gals.+750 gals). Total proposed capacity:
1750 gals.
NON-DOMESTIC WASTES
6 vehicle garage bays (and the open shop) will be served by an 80'
trench drain. Per I.L.H.R. 82.34 (4) the trench drain will be connected
to a state approved catch basin. The outlet of catch basin shall empty
into an exterior sealed retaining tank (1000 gal. precast tank- from
Midwestern Precast Inc.), installed per I.L.H.R. 83.18 (7), complete with
high water alarm system as for domestic wastes. All non-domestic wastes
from retaining tank shall not be connected in any way to the Mound system.
The introduction of garage/vehicle wastes into the mound system can and will
destroy the system.The disposal of garage wastes from the retaining tank
shall be by a licensed waste hauler in accord with Wis.'NR114 codes.
00CEIVED
PROJECT INDEX AU6 1 1994
SAFETY & SLOGS. MV.
59 03/qs Date
DI LH R P l a n I. D. # 7
Owner C-Aley 1001cthy - Hu ( GHER SERWCI;15 Phone ce 12.- 770 • SZ-$'O
Address 52-32. N. &1EX(3Rao k AU E. OAKPis1e~ )Llo• 5512.?
Legal Description LOT q csm ~3 E ►,Aw %y us.23~ T2-yAJ, L~{ t~
Town of t+tj19SO- County ST• CRO C Y,
C.S.T• &ARy ST&ETL cSr.Y zv?e Installer
Local Authority/ Supervision ST•Ctzo1'x Cov.~T`~ ZpNt'~~ Df' pT.
__S94-0319
Pg.1 f PLOT PLAN VIEWS '04, jSG
01.4 e
Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWS R
Y II,I / /
Pg • 3 PIPE, LATERAL LAYOUT - 14 1 Mioe %
Y VAAN RELATIG WI&
Pg.4 DOSING CHAMBER CROSS SECTION ~ Si+fHY A140 CUILDINGS
g. PUMP PERFORMANCE SPECS
- r SEE CORRESPONDENCE
Paq"nis!pun ulewai lsnw wowAS uolldACOW IJOS
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PERMA,~F.~uT MhRKERS ~';~y
REC2u~C2r=~ f3Asn~ hr2t~ `vAr~Y whsrE•Ftow _ Gad /
svi~ i~-t:tlTKtnT~uE - • c /►phci Ty ' ~ ' S4. FT.
pRoposeb 4~ts>41 A~?e~ = ~ X ~ A fi ~
/ d_, fi ~ fiJ ~ ter.
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VARY AGUE
TOTAL- VC9tD U01WiE 41-1 GAIS viSTON4C&
1
Ho[E 1>~~}METE(~ y Pic. H~S
l 2- INc liES
MAIJIF0L u 2-
_ INct~e s
Foi2ce MAIN
I N~FlES
P' Of HO I£5/ pi PE /3 I.IJVERT E L£IJATtO►J
c )F- L ATE RA l S
/ O/. 7 Q
Pi PE 'DETAS L e)JD cAp ~ E R Fn R ANTE ~ ~
R Rill BURRS \ L tMouE All Y E rt I PFLATI614S
OF SAFE;`3 Ca31;'x'
HOES IC)CATEr) o,v BOTTOM
~ EG2 0A 11 Y S pA cE
DI STRi C3uTtoN T)►5ChAf2 CG-E RATE FOR laAch LA•rERR L-
P'ER OTC -5 13' 2- /
GAL/ MiN.
TOTAL. 1`- (STRi B0TIo►J 'Di5C HER &E RATE FOR
NETWOl2 I< 319-1"2-- /M~•,~_ /J a f Mi*NI*MvM
CJ l~ t~41'7 .
~ S 1
t ,
. ~ .~~}r. kid: ; ..l,~s'.
II
„
•
PUMP CHAMBER CROSS SECTION AND SPECIFICATIOUS )9,4c6-
EMT CAP
4"C.I. VEUT PIPE WEATHER PROOF APPROVED LOCKING
P-5' FROM DOOR, JUWCTIOAI BOX MAIJHOLE COVER
WIUDOW OR FRESH /,913EI
12"MIU.
AIR INTAKE
lp9t ~ &V/1T4On/ GRADE
I 7 4"MIIJ. ~
Q ~ ~ 18" MI1J.
COUDUIT
70
~IEv.~noti
Ir,LET PROVIDE I
J- ~F-T ~ AIRTIGHT SEAL i III
I I
APPROVED JOINT A y/,~' I K I III APPROVED JOINTS
W/C.I. PIPE ' iN I ~r `VM I III W/C.I. PIPE
Lm ENDIAIG 3' 0~ -I10 I (I ALARM EXTEM01MG 3'
OVJTO SOLID SOIL, ONTO SOLID SOIL
r-
yo 3.3 I I OKI
ELEV. FT. I PUMP
OFF
D
)tppfA.) 6-
BLOCK
lE vet f i0,✓
RISER EXIT PERMITTED OUL4 IF TAUK MANUFACTURER HAS SUCH APPROVAL
SEPTIC E SPECIFICATIOUS
DOSE
~117~4.~FS Tf~p,.> /~iPE'~itST 7
TAIJKS MAIJUFACTLRER: IJUMBER OF DOSES: PER DAy
TANK SIZE: GALLOMS DOSE VOLUME y
ALARM MANUFACTURER: 5--l- F-LeCTRb IMCLUDIMG BACKFLOW: GALLOMS
MODEL HUMBER: CAPACITIES: A=IMC14ESOR ~OS~ GALLONS
SWITCH TYPE: ILtERcoR Fl ohT g = `Z' INCHES OR //(~--77 b GALLOAIS
PUMP MAMUFACTURER: GO Q0 ~jLD C = ✓ INCHES OR ~ GALLOIJS
MODEL AIUMBER: 3 y/~Y& Yi ~P 115 U D= /0' INCHES OR ~ GALLOMS
SWITCH TYPE: P"Aly 0AC-K M-GKWr-y "01-7-MOTE: PUMP AND ALARM ARE TO BE
GPM INSTALLED OM SEPARATE CIRCUITS
MIMIMUM DISCHARGE RATE 1/5-
VERTICAL DIFFEREUCE BETWEEU PUMP OFF AUD DISTRIBUTIOIU PIPE.. FEET -rAA)k ! f fCS^ ~f
+ M~IIUUII'MUM METWORK SUPPLY PRESSURE 2.5 FEET 6A6, O~ y~ P 1r/L'
I FEET OF FORCE MAN X 3* 2.1 F~
ioo Fr FRICTI0IJ FACTOR.. ' FEET -/oA I S 30
,J ~f
TOTAL 09MAMIC. HEAD = ' 7 FEET 9110 A0,
IMTERMAL DIMLMSIOMS OF TAWK: LEUGTH ;WIDTH -Y / ;LIQUID DEPTH
s=ray'`sa3N F SA.-ETY Ajo iWILDING ,
3886
VAILABLE CERTIFICATIONS
IL LISTED SUBMERSIBLE PUMP
ASS I AND 11 DIV. 2 AND I ASS III DIV. I AND 2 `yy,4
!L TESTING LABORATORIES. INC.
ORTLAND, NEW YORK 13045 G1086131480
ANADIAN STANDARD ASSOCIATION S P '
IPPLICATIONS • Bearings: Ball bearings, Casing: Cast iron volute Designed for Continuous DIME'
specifically designed for the upper and lower. type for maximum efficiency. Operation: Pump ratings are (An d:
• Power cord: 15 foot 2" NPT discharge adaptable within the motor manufacturer's
ollowing uses: standard length (optional for ALS10-20 slide rail recommended working limits,
Homes lengths available). systems. can be operated continuously
Farms Single phase: 16/3 STO Mechanical Seal: Ceramic without damage.
Trailer courts with 3-prong plug. vs. carbon sealing faces, Bearings: Upper and
Motels • Three phase: 14/4 STO stainless steel metal parts, lower heavy duty ball bearing
Schools
• Schools with bare leads. On CSA BUNA-N elastomers. construction.
Hosptitals • listed models, 20 foot
Industry Shaft: Corrosion-resistant Power Cable: Severe duty
length SJTW and STW stainless steel. Threaded rated, oil and water resistant.
are standard. design. Locknut on three Epoxy seal on motor end
SPECIFICATIONS phase models to guard provides secondary moisture
Pump: FEATURES against component damage barrier in case of outer jacket
• Solids handling capabilities: Impeller: Cast iron, semi- on accidental reverse rotation. damage and to prevent
11/2" maximum. open, non-clog with pump out Motor: Fully submerged in oil wicking.
• Discharge size: 2" NPT. vanes for mechanical seal high grade turbine oil for 0-Ring: Assures positive
• Capacities: up to 140 GPM. protection. Balanced for lubrication and efficient heat sealing against contaminants
• Total heads: up to 26 smooth operation. Bronze transfer. and oil leakage.
feet TDH. impeller available as an option.
moo
• Mechanical seal: carbon-
rotary/ceramic-stationary
18-8 stainless steel metal
parts, BUNA-N elastomers. METERS Feel
• Temperature: 160°F (710C) MODEL 3886 t,
maximum. 10 SIZE 1'/2 SOLIDS v,
• Fasteners: 300 series 30' - RPM 1750
stainl~ ~s stP-1.
~GPM IMP. DIA. 51/2"
apable of running dry
without damage to 25 ~,_,o
s FT SEW
components.
Motu,: 20' _ Sew
• Single phase:'/2 HP, 115 or = att~
230 V, 60 Hz, 1750 RPM o 5 15 mst
Built-in overload with nut
automatic reset
• Three phase:'/2 HP t0 f
208/230 V, 460 V, 60 Hz,
1750 RPM. am
5
Class B insulation, overload un
protection must be provided
0 20 40 60 80 100 120 140 GPM
in starter unit. 0 - o
• Shaft: Threaded, 400 series -_-.____--__~-----___i-- '
stainless steel. 0 5 10 15 20 25 30 M3/h
CAPACITY
8 4-0195