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Parcel 23.29.19.840 020 - TOWN OF HUDSON Current 1K ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * MURPHY, BRIAN J & JACQUELINE A BRIAN J & JACQUELINE A MURPHY 858 BRADLEY DR HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 858 BRADLEY DR SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.120 Plat: 1963-FOX VALLEY SEC 23 T29N R19W PLAT OF FOX VALLEY LOT Block/Condo Bldg: LOT 12 12 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 23-29N-19W Notes: Parcel History: Date Doc # Vol/Page Type 07/23/1997 1091/032 WD 07/23/1997 1074/79 WD 07/23/1997 803/241 07/23/1997 589/555 2004 SUMMARY Bill M Fair Market Value: Assessed with: 2113 211,600 Valuations: Last Changed: 07/21/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.120 45,300 118,400 163,700 NO Totals for 2004: General Property 3.120 45,300 118,400 163,700 Woodland 0.000 0 0 Totals for 2003: General Property 3.120 45,300 115,300 160,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 138 Specials: User Special Code Category Amount 018-RECYCLING SPECIAL ASSESSMENT 27.00 Special Assessments Special Charges Delinquent Charges Total 27.00 0.00 0.00 n STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER~~a~ ADDRESS 52F L ~ e u S /V4 W 5!~ 'ell SUBDIVISION / CSM# LOT # 2 SECTION 2,? -2Q N-RA~7 W, Town of lyl'<ds t-),Al ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM a N M 11 ~14 c°✓ INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: 5' l' ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: ~j,GL~ u2~7~ ~~ca Liquid Capacity: 14'B,--) Setback from: Well House Other Pump: Manufacturer z w4 eg' Model#?F7§_Size _ Float seperation Gallons/cycle: I'17 Alarm Location G SOIL ABSORPTION SYSTEM Width: 4~' Length Number of trenches ca Distance & Direction to nearest prop. line: J7- r S~ Setback from: well: House-,:57 f 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: PLUMBER ON JOB: 1~~C~~_~ LICENSE NUMBER: &j jo INSPECTOR: fJ^ 3/93:jt elationsdustry, PRIVATE SEWAGE SYSTEM County: aboranY~uma Rment of In ST. CROIX Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No-: Permit Holder's Name: ❑ City ❑ Village Town of: State Plan a: ROULEAU, JIM X CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: A940023 55 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark o 01 0 Dosing DD.' $ Aeration Bldg. Sewer '37 Holding St/Ht Inlet 5^ 93 TANK SETBACK INFORMATION St/ Ht Outlet G-7,1- 93.~,O/ TANK TO P/ L WELL BLDG. Airi to ROAD Dt Inlet Ar Intake ~ y~ rla- Septic > 3 So?Sr` NA Dt Bottom 9 9©, 6 >a s~ NA Header / Man. qs Dosing >5 d/ ",5,(j Aeration NA Dist. Pipe y SS ~S l Holding Bot. System IS a, PUMP/ SIPHON INFORMATION Final Grade J, &S ~c Manufacturer , Demand 5 / ~y awl, Model Number GPM 0~.," X09 ~/l_d~l FTD Lift u~s`~ Friction SysteT TDHJ,4~ Ft Forcemai n Length S-~ Dia. ' F ' d Dist. To Well )o? l / SOIL ABSORPTION SYSTEM BED /TRENCH Width t Length r , No. Of Tre hes PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ' DIMENSIONS SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type Of CHAMBER Model Numer: OR UNIT system: tn(&,YvS f >50 C'` t DISTRIBUTION SYSTEM Header /Manifold Distribution Pipe(s) x Hole size x Hole Spacing Vent To Air Intake I Length Dia. Spacing ( rz 5 0 Length Di a. SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over , xx Depth Of X xx Se ed / xx M ched Bed /Trench Center J Bed /Trench Edges Topsoil Yes [j No Yes [~.fVo COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: Hudso .23.29.19W, NE, SE, Lot 12, Bradley Road r (_L l 7S re,a~ Plan revision required? ❑ Yes ❑ No / Z 6 Use other side for additional information. 7 l~ 19Z11 SBD-6710 (R 05/91) Date s e is Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH c, SANITARY PERMIT NUMBER: 7-(-~ X3'1 ,d e . . SANITARY PERMIT APPLICATION "ADIL.HR In accord with ILHR 83.05, Wis. Adm. Code CO . -.e.._,..a....,.. # ch complete plans (to the county copy only) for the system, on paper not less than STATE :~TARYPERMIT SS -3IT -Atta 8% x 11 inches in size. ❑ Check If revision to previous application -See reverse side for instructions for completing this application. STAT LAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. - O a 3 PROPERTY OWNER PROPERTY LOCATION p ei- GC~ Y4 6 X S 2,? T o? 9, N, R E (or PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # ccsT 5' 7 CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER ~a. F e 6 ~ 1z / 11. TYPE OF BUILDING: Check one) CITY NEAREST ROAD : 71 ( ❑ State Owned VILLAGE OF: ❑ Public Sal or 2 Fam. Dwelling-# of bedrooms -3! PARCEL AX NUM ER( ) III. BUILDING USE: (If building type is public, check all that apply) ©7 1 El 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 50 Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE I OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. [9 New 2.E] 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 Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 UF Mound 30 ❑ Specify Type 41 El 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) Q ELEVATION -17 'VA-- Feet Feet VII. TANK CAPACITY Site in allons Total #of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete strutted Con- Steel glass Plastic App Septic Tank or Holding Tank Tanks Tanks y F1 I Lift Pump Tank/Si hon Chamber VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system show on the attached plans. Plumber's Signature: (No Stamps) M MPRSW No.: Business Phone Number: Plumber's Name (Print): ~J 1 ` ~u err ,2 i -,3 0? t 1 4141 Plumber's Address (Street, City, State, Zip Code): Sd,~ IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved SaqM' ry Pg~FQQQ~~~' Fee (Includes Groundwater a e Issued Issuing Agent s ys~ \ QGSurcharge Fee) ~Approved ❑ Owner Given initial p~ f, Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Pib-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber i 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 authori,.y. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Re ewal Form (SRD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) m-.jst 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 rind/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. I 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; well;; 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) SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations June 27, 1994 201 East Washington Avenue P. 0. Box 7969 Madison WI 53707 ULBRICHT & ASSOCIATES ROBERT ULBRICHT 655 O'NEILL ROAD HUDSON WI 54016 RE: PLAN S94-02436 FEE RECEIVED: 360.00 ROULEAU, JIM NE,SE,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 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. Pleases to the plan number shown above. Sinc rely'`' IA Rid `j_ f- f 4^14! f ` d ~ ~...i n th Stiemke Plan Reviewer Section of Private Sewage KA (608) 266-8230 7.00 to 3:45 Mon. thu Fri `t..,rr SBD-6423(R. 01/91) BRADLEY DR. GL t 24.1 40r- h codeNs;iZ o2 TOP of- . ~ A4wE PER I SCAL . 1 30' _ 134c1c,11 of Prrs o - E IEVhT't'o.~S - f35, z3y ~ ~ a A, ~y sa p lly ~ 3-0 S~"PO itolia 9yzo /sax Cott v / im a ` 53 b Sol. tP.60A NO A ` / ~t D VAO. of SO E fc`~POtN I 0 o E C~/~`vEST~',✓ P~ IfST SEE Pit P s D 0 ,w 4v E// NFGO /aao @w Z 5 0 O ~ ~a 5r P ~~chs r St~T/c T PUA P c.G j Ex 1'S 'x'1,.16 ZS '10T,41 .0 f 5r f " f3eD~'~'1• s~ go .0 z Pl~C NAM IE- FOR [E m4iAJ if' .r.. 0-..'57 w GP S Ls N~us M vuED BM 1 tN - By 44 2 . I}vuSE' IuDt)ERS 'ihe 6 fl. 6eloW Ihonsoo ctio of Iho Soil A u plion $yslem MOO Inio undisloli d. ~y , .95, P~• zo S f IfRoss SECT IO~J of mouAjD - w i T ti f3ED (3eo cF ro S 94 - 02 4 3 -G ~.y Aj5Qc5ATE• DIST(2i(3UTt o~ Gr r h k).s F S S pip (P.) oF T°P ,so L SYSTEM t IEVAr o,J U)Ji FORM Toe u yJr, 2-0 u, H ~ Rrt3o . Msg..' ~ e . 9• SAND. piowto ToPSol, • FORM (p °1o StoPE t=oRce Mhil') etmVA- Ioa UNDER BED 1c~/ ZO .T) /.o Fr. - ELL-VArioN) S y Fr. lmvERr of / IATERMS 70 FT. • Top o F R ock Icy G b Fr. r~ 0 H / FT, Top OF ( IArERA IS /cys' PLAN VIEW of MOOED Wirti 13E ;D FvRcE MAiAJ A 6 Fr. &3 Fr K /o Fr 93 7-11- A .L• i I f7 _ W Fr W .s _o II w z8 Fr ti 1 BEE of PVC. cAppEr> To p,RtVA~E SEWAGE SYSTEM d(35ERVAr►oo A 93PE5 eonditionally p.pES APPROVED OF USTRY, tA90R & NU AN RaATIONS PERM^&)ENT MARKERS 0 01 ION OF SAFETY AN UILDINGS f REC?uMeo' BASAL AgCA ` TALL whsrE"Flow Q NZE 00 SOIL 10-f0rRATWE 5- - C APAci ry sa. Fr. PRoposED BAsM AReN = B X A + - X03 x G 12(o0 1 CEPTRAL MAA)i FOLD D►STR~BuT,oAJ pipe ►jerwoR k S94m-92436 . P 1 P CEQTRAL 9t5TR113uTl0a MM LATERAIS AN%t= o L0 tND ~AP.S 2__.. I I x i UG FoR~E Y P MAW LAST ~{o1E S HA" RE NEX.r To END CAP FT. 2 S-40M VOID V0 j uME FoR .J~ ~VR S T atly cF 2 Fo Rce M Ai u gA SS ~oAp1 ' XsweRr E IeVAR0 OndittU ~y ~ ~o D E v ® Aol U AN S b H ptNGS gpR 1L Of f,. \Q~ : PIPE DETAi L Holes IOCATeD oA 'I VARiAISLE y t q V huy SphceD . Y DtSTaNCE P Fr Hole Dil►hET e R ►N' L ATERA L R MANI FOLD " 2. IN X a iNChES Foecr MA4 A,) 2 iN. I 7 " ~NCI,ES 4 4 = 7 OF 1i01E5/ P I P E fl DISTRi t3u'r1oN D►SCHAR&e RATE PER LATERAL 3( Gad TOTS E, 1)15LkAR &e RATE NE-rWOR k 3 7. GAL, 594'00243 PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS pfF E g OF S VENT CAP 4'C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING JUNCTION BOX MANHOLE COVER 25 FROM DOOR, W1 (v,1~ 1,06- 1A/3EI WINDOW OR FRESH 12"MIU. • I AIR INTAKE quir 1-/O v GRADE 4111 / I y" MIIJ. ~,~j 16 97'0 CONDUIT-- y.o PROVIDE I INLET AIRTIGHT SEAL I III / I II v 5 4 flG I I (I APPROVED JOINTS J/APPROVED PEJOIN7 IN ~ ~(,p {'~~M ~ 1V ATE SAGE SYS4~ I III W/C.I. PIPE ' 0 ` ( I I EXTENDING 3' EXTOWTOENDISOLNG ID 3SOIL Undit,On~jl I _11 ALARM ONTO SOLID SOIL B '(o \ 3 3 I I ON IONS lF T. c NlpppB EL E I V. & WA* ~ S r lot. tNOBSTRl 'SAFET'Y A FF D 3 Iv1SM% O ~lE v>j f loA✓ _E C RISER EXIT PERM11TED OIJLtl IF TA MANUFACTURER HAS SUCH APPROVAL SEPTIC E SPECIFICATIOUS DOSE TANKS , MANUFACTURER: MPDWESTERN PREYhST ~~~I UMBER OF DOSES: te PER DAy 112. TANK SIZE: 15 0 GALLONS DOSE VOL ME F 11-7 ALARM MANUFACTURER: 5.-T. ELFcTR0 INCLUDIWG BACKFLOW: G' .LO~'c MODEL NUMBER: lot- O 1 ~f CAPACITIES: A INCHES OR 300 GALLONS.:, SWITCH TYPE: A R cu R Y F IO AT B c z IIJCHES OR 3 ~..5 GALLONS PUMP MANUFACTURER: 6OV L.19S C= X0.3 INCHES OR 117 GALLONS MODEL NUMBER'., 3?g5 Y3 I-f P 051 D= 15.7 INCHES OR 2.15. S GALLONS SWITCH TYPE: PI6&yt3AC.K 1`"teRCURY ITIOAT- NOTE: PUMP AWD ALARM ARE TO BE MINIMUM DISCHARGE RATE y~ _GPM INSTALLED ON SEPARATE CIRCUITS S VERTICAL DIFFERENCE BETWEEAI PUMP OFF AND DISTRIBUTION PIPE.. 7 FEET SP~GS + MINIMUM NETWORK SUPPLY PRES,/SURE . . . . . . . . 2.5 FEET EAC(A, 0~- 1J} Pl- Ioo pt FRICTION FACTOR.. FEET E-l.VAI S (d ~ + 2,17 FEET OF FORCE MAIN X 1'ST F~ 3 p TOTAL DtiIJAMIC HEAD = - FEET ~O g ~ f LIQUID d DEPTH INTERNAL. DIMEIJSIONS OF TAIJK: LENGTH „ ;WIDTH , rr S 94 42 3 •Y11N.YM =now ! SEffluent Pumps . T 388a AYAIWIE CEIIIIHCIRNNK •rr fTL LISTED SUBM[p$1BLE pyyp It CIaSSIA1M1„DIV.2AND L~1 CLASS W OW. 1 a1D 2 ` ETl 1FS,NM, tABORAfORKS, WC. CDRIIAND, NEW 90PoI 13DIS GIOB6131480 uNADllwsrAlaARDASSOCUiwN SP - PERFORMANCE RATINGS (gallons per minute) MODELS + WE0511H WE0511HO Series HP Volts MU MU. Amp. RPM 3" till. (lkQ =Or10i WE0512H WE07120 WE1012H WE1512H WE0512HN WE1512HO WE0311L 115 9.4 NO. WE0311L WED311M WE0532H WE07320 WE1932H WE1532H WES532HN WE1532HN WE1312L WE0312M WE0534H WE0734H WE1034H WE15340 WEDS74NN WE1534NM WE030311M % 115 230 14 4.7 1750 56 KID A h % 1 1 % % 1 ~4 12 pm 1750 1750 3500 3500 3500 3500 3500 3500 WE0 230 1 4 4.7 5 100 70 80 90 106 - 60 - WE05111H 115 130 10 80 65 76 87 102 112 56 84 WE0512H 230 6.5 15 60 57 72 84 100 108 53 82 WE0532H 20&= 3 3.4 20 36 45 65 19 95 105 48 77 WE0534H 1h 460 1.7 60 25 25 59 74 91 100 45 75 WE0511HH 115 13.0 Z 30 50 67 85 96 40 72 WE0512HH 230 1 65 M 35 40 61 79 92 35 70 WE0532HH 20M g 3.3 1 40 26 52 72 86 30 67 WE0534HH 460 1.65 45 _ 10 43 64 80 25 64 WE0712H 230 1 10.0 ^50 30 54 73 18 60 WE0732H 1i 208230 3 5.4 3500 55 17 42 65 12 58 WE0734H 460 2.7 WE1012H 230 1 12.5 70 54 --65 6 130 54 6 40 3 51 WE1032H 1 208/230 7.0 - 7o 5 26 47 WE1034H 460 3 3.5 75 14 43 WE1512H 230 1 15.0 90 4 40 WE1532H 20N30 9.2 90 33 WE1534H , 460 3 4.6 I; 100 24 WE1512HH 1 230 1 15.0 80 i. 110 15 WE1532HH 2O8Q30 9.2 120 5 WE1534HH 460 3 4.6 p 1 metal parts, BUNA-N elastomers. • Temperature: 160° F (71° C) METERS FEET " maximum. • Fasteners: 300 series 25 MODEL 3885 80; stainless steel. - I-' SIZE Solids • Capable of running dry WE15H I without damage to ' components. 20 ; WEIGH ! 0 604_. - 5GPM M.tor. uar ! WE07H • Single phase: 1/3 HP, 115 or 15 50' _ SFr 230 V, 60 Hz, 1750 RPM; c I . .4_4 l.. HP, 115 V, 60 Hz, ao .1- 3500 RPM; 14 HP through 10 ` WE03M t .j.... ..__r -1... 1 %2 HP,230 V. 60 Hz, 30 . 3500 RPM. ; - WE03L .w_. J.- - i - Built-in overload with 201 - - automatic reset, class B 5 - insulation. 10 . _ .r.. _ • Three phase: %2 HP through o o 1 % HP 208/230 V. 460 V, 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM 60 Hz, 3500 RPM. 1_ Class 8 insulation, overload 0 10 _2 Protection must be provided CAPACITY 30 m3lh in starter unit. 8 r _ s E'w 6 S EGov D) -'E-5 T" Ake,,, - i4 Do jeA. ~ 0,-1 777) _ ,,1"004E fC J-f0OA.0 SPTE - ~ts rv~213E/~ l3)/ 1 CO.cj S TRU c f,~•o,v J Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page 3 'Labor and Human Relations _ Of Division of Safety fL 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' 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. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Jr' H R b U L I_ A L~_ GOVT. LOT N iE 1/4 51F_ 1/4,S 23 T 29 N,R l 9 E (or(R) PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUED. NAME OR CSM # 52. 8 I_0CVS7- S'1 12 # FOY- UAWSY CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE ~N NEAREST ROAD LADS oA.~ 51/ 616 P15) 3FL • G p5p HuOSoA.~- EAST PAi2T t3RADLEy 'f2D . jkfNew Construction Use [.Residential / Number of bedrooms 3 [ ] Addition to existing building j ] Replacement [ ] Public or commercial describe r Code derived daily flow yso gpd Recommended design loading rate -S bed, gpd/ft2 - trench, gpd/ft2 Absorption area required 375 bed, 9 37-5 trench, ft2 Maximum design loading rate 5 bed, gpd/0' ~ trench, gpd/ft2 Recommended infiltration surface elevation(s) 9'5--2-0 w/ /1" SAN D ft (as referred to site plan benchmark) Additional design / site considerations 5.1'7'-*-- So.,, 7.9-13 /,e a v c y yco,~ -4f o Parent material S 5P - c04 A I&,v S i' L. • S (LT- Flood plain elevation, if applicable A.1 A— It f S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ❑ S C~ 2_T ❑ U ❑ S ETT ❑ S BV ❑ S Ceti' O S Ceti' SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundely Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed ranch A 0 -I S /o VR 312- 51' 1. z f sbk /►~.-F >z is 3 T . S .6 B 13-4 /o y le 31 3 5 i 1. 2 At,, 5~ ,C f R CS Ground C y Y6 /o yR 3/l, st- / . 3A., b k •..-f elev. 9'y 70 ft. Depth to limiting factor w > YG Remarks:p/Qi ZDa `IG /4l>OD~~ w,~ T' it T Boring # A /01//2 3/2- 6d. sk /k, -F R s 3~ S .G ,Q~ 11 /o YR 313 5r' i f sb,~ f R C s 2 1/ S Ground C S ~ bk /k, -f elev. l~'3 O ft. Depth to limiting factor 22, 3 Remarks: CST Name:-Please Print R o M P_T 2A L ,B R l C k T Phone: 7/J"1-3 f6 P IF-5- Address: ASS O' xv ~i L 'RD• 4UDS0,J 49l S . SY016 Tv~E- 20 CSTM 14gL Signature: Date: I 1/F CST Number: /Gio s 7- /~~r EOiilTf' s0/4 /I'/.1/ a 0MGIN ~L PROPERTY OWNER SOIL DESCRIPTION REPORT Page? of PARCEL I.D4 GO J' - L2 Foy, UJE lt-6-y Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Ou. Sz. Cont• Color Gr. Sz. Sh. Bed Trench o-~ 16 le 3/3 S~'/• L f s b& AMA 1e c s z~ .5 . ,e -f e 1 .5 [31 (3 P .1 ~ -7 - 5 V ie Z,,., $40 A+% 5 Ground C - 3 /O R 31/d G 5 SG~ l f S6~ ,w4 -f/ . Z 3 elev. fy. zo ft. 4 T p b0 0,~ r : Tom' E.v U,v fl - ~iP c TT' Depth to ~i %y S 7r~ limiting factor 2 Sss Remarks: Boring # Ground elev. n. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # - - • . Ground elev. ft. Depth to limiting factor Remarks:, COf1 070A/D AG M•l\ I a~AQ sky ~R. NC /3M Tbr of ilE pep 1-155 -!3. E I~ vhr~'o y = /00, p SCA LE.: • ' /34C/C,4of P/'TS c f35 - G ILVANOA.)S - ' 23yJa a 9d i 80' y 53,o p J / 0 / Q 9 y z o / 4'0." qir3 PRo~osED 0 W E// z/,u how r, u/l° FvRA-1 :t!lS TI w16 ~trp~~ gFb E sy 13EDQM. a Nc~H ~ s8' 2' 90 Q o 5? /L G~ J HOUSE MnUED BM IN- By 41 z. !n, H•OVS~ IyoUERS „ ~ 3~ 3~y z SST 3 " i ~yE~~rnov - P~ 3 o+3 - 8 _gv , ~ n l o~ / Z- 07 c7/ ,qc eEs / l l l e~/ / yep/j Z G-OT o < 41 / o f 9 0~ 1 •I-. G' 7-07- 1 1 ~ I } • ~',tX -.77AO o zo - 1153 t-, 0 - a o v STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER T/-'l l` o u L Eit C& 3 k6' 6 JF58 MAILING ADDRESS S2-9 c v s T ST- Mu Ose-) Cv i• . s y0 1(f& PROPERTY ADDRESS SS $ 1~/, A11-4t . (location of septic system) Please ob n from the Planning Dept. CITY/STATE fv r ~tG~'~ PROPERTY LOCATION N 1/4, S 1/4, Section 2-3 T 2( N-R W TOWN OF H-u pSao ST. CROIX COUNTY, WI SUBDIVISION Fa)- UA < < y LOT NUMBER I CERTIFIED SURVEY MAP , VOLUME , PAGE , LOT NUMBER _ Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED: DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 r 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/cohtractor,(spec house), thenia 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 T' 41 ?0U L_6Au Location of* property'y fC- 1/4 S~_7 1/4, Section Zl , T Z~ N-R ~f W Township Wu 4,,j I Mailing address S Z 8 L U` v 5 5/' 171UyS y,-,, Z,~j/ S a, Address of site.- Z 0 Lo 7- Subdivision name K Lot no. Other homes on property? yes v No ? Previous owner of property Total size of parcel 3° Z Date parcel was created Are all corners and lot lines identifiable? =Yes No Is this property being developed for (spec house)? Yes N 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 he County Register o'. Deeds as Document No. S/SY a- 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 No. s' r ture o ap licant C pplic t Dais of Si nature Data S a e L _ • -x .DOCUMENT NO. WARRANTY DEED THIS SPACE RESERVF.O FOR RECORDING OATA STATE BAIT OF WISCONSIN FORM 2-1982 - - Yip 1071 79 Norman C. Mears and Frank LaPlante !*W *d Ito f . . APR 15 1994 , ~ 10: 3 i - conveys and warrants to James V V , ROUleau M - OTDIIeC9 RETURN TO . the following described real estate in .-St- _Cro. ___County, - - - - State of Wisconsin: - Tax Parcel No:......... Lot 12, Plat of Fox Valley in the Town of Hudson, St. Croix County, Wisconsin. ITA-ANSFEb FEE This _...1S nOt homestead property. U (is not) Exception to warranties: Easements restrictions and rights-of-way of record, it any. Dated this (L~4- - day of . - Apri.l..._. 19 94 ` J > _ (SEAL) - ?Ly G (SEAL) Frank-LaPlante--------------------- ` ---Nozman_C._ Mears-- ---------(SEAL) .(SEAL) - ~I AUTHENTICATION ACKNOWLEDGMENT I' Signature (a) ......_Fr3Trk--LAPlante-........................ STATE OF WISCONSIN .Norman C...Mears. sa. t authenticated t~ y Aril - - county. this _ daof-__.p___________• lg_ 94 Personally came before me this day of 19 the above named Kristin Ogland - ` TITLE: MEMBER STATE BAR OF WISCONSIN i (If not, authorized by ?06.06, is. Stats.) i to me known to be the person who executed the rHl= foregoing instrument and acknowledge the same. ra INSTRUMENT WAS DRAFTED BY l Kri atina__Qgland--------------------------------------- - - Attorney at Law ' Notary Public (Signatures may be authenticated or acknowledged. Both - . - -.County, Wie. are not necessary.) My Commiss.on is permanent. (If not, state expiration date: 19...... • - - amen of persons ai[ninQ 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 - IY82 Milwaukee, Wisconsin o o0 (A ~ 3 t/1 1 I O N N O ~ O I O Y31 d y O o 0 1 d H O 0 0 C W N• 00 03 cn c ^ N~ G O 7c c. I ~ O~ N ` 1 t o ((OO H 3 1 (n ° Q c co OD 0 1° V I a F °D v oS° O~y 10 S; W I S,' m p ~N I o W H d'° a a l D a a m (D n y (D W I m c~ c a c ooh a i 3 O < I 0 W I ~ AE=I ~ ((D O 2 1 O O y I O C o o 3"c "Mo 0001 000- °r Z _ I ~ I cn 9 vi W Co I Sys' J3 to cn - N °c 7 3 I o 3 Q v_ < o, (D I c~ ~ ~ I ~ y m I a o I of oZ ' B y o I 0 D o ~c c o o' 0 O > > i ° a 0 a I (D m c E W N 3 I CD 3 I Z = 3 j A a H I m ~ to la I ?n I I (D Z W T Er I m N 7 1 1 a a Z I a ~ 3 i p~ ~o 1 3 1 ~ 3 " co H z I z 1 W 1 W p I I I n > > y a ~ I a a m c 1 y m FL a. R CS I m o a I 3 20 <v = 0 4 I H 1 <-00 0 0 1 0 ay (0 < cc I m o Q. o. o 0 N 0 < C'Q0 1 c 0. rJ d m I CD ~ i 7 m CL I o n c o a2 (D (D N y I mom °o I CD I fD~EF =r a ti I o 0 ~ A N I < I m O 69 to 0 •A o a o f I 0 C N Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County- Labor and Human Relations INSPECTION REPORT 5T. CROIX Safety and:oBoildings Division x (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION PROUL IEdeer Na a1 , E] City [I Village k, Town of: State Plan ID No.: Hunsom CST BM Elev.:U Insp. BM Elev.: BM Description: 1 1 A94001 27 go" Parcel Tax No.: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosi ng Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANKJO P/ L WELL BLDG. v tto ROAD Dt Inlet' Air tp-take Septic NA Dt $ottom Dosing \NA ,deader/Man. Aeration a Dist. Pipe Holding Bot. System PUMP / SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft oss mead Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width ength No. Of Trenches PIT No. Of N\ Inside Dia. Liquid Depth DIMENSION DIMENSIONS SYSTEM /0 P/ L BLDG WELL LAKE/STREAM LEACHIN Manufacturer: SETBACK INFORMATION Type O CHAMBER Model Number: System, OR UNIT DISTRIBUTION SY TEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacin Vent To Air Intake Length Dia Length Dia. Spacing SOIL COVE x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: Hudson.23.29.19W, NE, SE, Lot 12, Bradley Drive C/GG 5 yam a uz 416V W 4yr c~,sa„ Plan revision re re ? ❑ Yes ❑ No Use other side for additional information. S D-6710 ( 05/91) Date ,Ins ector's Signature Cert No. V%A LICATION SANITARY PERMIT APP ~.HR In accord with ILHR 83.05, Wis. Adm. Code ) c~ _ S, X =:i r STATE SANITARY PER Te'vious # -Attach complete plans (to the county copy only) for the system, on paper not less than aoQ[~~ 8'/4 x 11 inches in size. ❑ Check if revision to application wee reverse side for instructions for completing this application. ST 414 I.DNUMB 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. - PROPERTY OWNER PROPERTY LOCATION p, '/4.5'x'/a, S T,?~ , N, R E (or PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # 1' 4. , s-7- .S 7` 12 CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER ccil'> ) ZVI , ~ 11. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD ❑ State Owned ~ VILLAGE : ~ ❑ Public 1 or 2 Fam. Dwelling,# of bedrooms PARCEL AX . UM R( ) Ill. BUILDING USE: (If building type is public, check all that apply) / S 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. ❑ 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 0 Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE _ REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) / ELEVATION 5 ( e Feet Feet Vlll. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name oncret Con- Steel glass Plastic App Tanks Tanks structed Se tic Tank or Holdin Tank F? I F1 F, Lift Pump Tank/Si hon Chamber x / Z Vlll. 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) P/ PRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Code): IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanit ry Permit Fee (Include g roue Water a e ssue Issuing Agent Signatur (No Stamps) Approved ❑ Owner Given Initial 1/ , y Adverse Determination W X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: c/ SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber I i 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 revisionsao this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to ;I 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 tacks; 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; (Jose 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) - - - r a SAFETY & BUILDINGS DIVISION i i State of Wisconsin Department of Industry, Labor and Human Relations i May 5, 1994 201 Fast Washington Avenue P, O. Box 1969 Madison Wl 53707 ILBRICHT & ASSOCIATES ROBERT ULBRICHT 655 O'NEILL ROAD HUDSON WI 54016 RE: PLAN S94-01178 FFE RfCHIJED: 180.00 ROULEAU, JIM NE,SE',23,29,19W TOWN OF HUDSON COUNIY nE ST CROIX MOUND SYSTEM The Department has reviewed the above-referenced submittal. Conditional approval Is hoi-eby granted for the sy steri plan subriiitt:al. All noted items must he corte(l ed. Tho review and, approval of the system is based j on chapter 145, Wisconsio Statutes, and chapters 1LHR 83 and 84, Wisconsin Administrative Code, and is contingent upon c;ompllance with any stipulations shown on the p1dfis. ThiC system has riot been reviewed for the code requirements sof forth in chapter ILHR 82 or in chapters) "[HR 50-64; Wisconsin Administrative Code, This plan submittal approval will expire two years from the approval date, or if a sanitary permit is obtained Ilan approval will expire on the day the s s The initial sanitary Permit expires. Thc, licensed t,1uml}e:~r responsible for this installation shall keep onc_, set of plans with the DPl)artWot'S stamp of approval at the construction site. The Installer Shall notify the appropriate inspector when inspections can be mad(. All permits required by fho pitY> vilia9e, town,hiP or, c:oontY shall be obtained prior to installation. Inquiries should be directed to me at the number 1 i,,tr.,rl below. Please refer to the plan number shown Above. SI ~1- erely, (/James Quinlan Plan Rpviewer Section of Pri+rate SeW'-jgP (608) 266--3937 SRD•6422 i R. 61/911 - - - 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. # 5 T Y- 0 //7 ~ Date -9 5 ~W Owner Tt'M (20UI-F r2L Phone -715-- 3P6 - &S'5W Address 528 L-OCUST ST. Nupso,..) zot'5. 5g0t.(,' Legal Description Lot 12- , Fvx L)A t to y Sv t30t'V i'Sr o,~ _ ,"V SAC • L 3 , T 2. f A-) i R t 5 tti PARCEL C-92-0^ It S3 - L o - voo Town of u os'o >J County 5T• C R 0 t' k C.S.T. Ro(3ele 2tIb12ic~T' Installer Local Authority/ Supervision 5T. GRo C C UU z 1`Y Zp,v i Z 6-- .,J)C-P77 PROJECT DESCRIPTION AJew CSTiatr- 3 13~~RM . E t S R t_ i O c, Lo l- 12- A D Ep A G-~ t~4r Ly 4' tv,4r 54eFlow " H S & sees . So(IS Ae - pERMiA04,L.t C ,5 G- PL)I'Fi -BL)T 361tSOAJI~11y s ~`vlQhr>cv ~4T 2.~ -FjeA, Tv~t=y 19 o10,-A -E tyx~ 5TS (fit-(6) SC'AS&A, A- IIY Sit-TVA rcO aRrzv,~S T6- M. a 5 T- I M n 1,,7-0 50; t2 es-r-t~ r~'~,~ rs 5"96-4jh try S A-ru KA-rt; p ('j t? t' 2,a a s . J~- L p , Cr- iu t2 t? o c-~ I-t v ~.u L? Lo ~'Ulf- Pg.l PLOT PLAN VIEWS Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWS Pg.3 PIPE LATERAL LAYOUT Pg.4 DOSING CHAMBER CROSS SECTION famw. Pg.5 PUMP PERFORMANCE SPECS RECE'VEt) L%BF ff D11ti0 ; HUD= MAy 5199 ow. h SAFETY & BLDM' - ' Co ~ar=R. 2 18 (3RAD~EY ~ _ - - roe OF 0 f3M 5.1c& TRoN OAR l 55 3 Ar 1►~•w. Lor COINIER PEP / L t_tA vh r f o,~ t d C9 . p TkFsT AReA- 3 j W a W. 3 2 < 3 9t 134 I 01 I W LU 2.5 f- I o 30' T CDTA L of a N 51b ; FoRoe- MA's p p / 2 i uew -150 D / 0 The ~~ea 25 IL Wow the WOSiope 8111 01 the Soil Absor lion S stem must remain undisturbed. P Y .~Q LI' d ~q . PLUS Pe 64%(JOR'5 (L~ New 1 0 0 ~elL , pi° M1[E SEWAGE SYSTRA j sepT-V c TANK r o well ~J pleoposFD 3 (3tu1?~t . t4 C>-tE' s (TE s' t l o Y N.IbirILDINGS _TEs1' ARE^ n , a t Ouse- will ( - -.-•r - t O()aD t A-) - fly SEE CORRESPO ENCE S~q~E : ,at = 3 ~ 23' 14 , H-ousa- h ooevS - - = /~A•c~Li oE- ~0 i TS - E(EVATfO45 - 4y 97/0 / M ouuD SY S rt_ ti E IEVA-r 1'0,j -r ST- AReA 2- I'CPOSS SECTIOQ OF MouAjD Wirtj f3ED GeD OF ro A 551Q WJATE' ~i ST(ti(3uT~o,J G Tl~i Gk.s ES 9 pip sysrEM OF So (L e(EvArioz U)Ji FORM ToE ~~r r~ H ' y~, io ' RrtT~o ` MED. • . • • I SAW> . 1 • ~ . L 111 i/l ~ PIowEL> To P's u1J FORM. . (9 % SlopE FORcE EtMOA'1100 UjuDER Mho ~ C3ED q Q• I C~ .T) I•C) Fr. tLEvArIo,,)S F .8v Fr• • TOP OF Rock rl~ f~o G 1.0 F I q ~F 7S> H 1.5 FT. ' Top OF IATERAIS PLAN VIEW 0F Mou,~j D wir" 13ED FvRcE MAbJ A Fr. - I Q y F r K Id Fr w I' 1 FT f T 'y Fr .2f.9 ;a C.iV€ faty of PVC. CAPPED To 11.'~ a ,IzON OF SAIEfY A~! Rg9teEgh~ o(3SE2vhrioa , PERMAA, EruT N► A e ICERS REC.2umED BASAL ARIA _ TAi~y wRSrFFiow - ysd - foo SOIL I0-f; ITY?nT1bE . S sa. Fr. CApAcitr PROPIOSEb BASA•l ARe~ = B X CA + z~ w ~7 x fi I 1 2 g 0 `f P~ . 3 o-f 5 - D%STRif3uTloA.3 PIPE NETwoRK LAyoo-r It' R ~Fo .r o Mho ~s ANow FoR F z' ENo~vhlr s `z-~ P ~ d r \ ~llaw FoR 3 Fr X 7Z . I FoRcE MAiN - NcWF, Fr. 7 Z P vc IuCMEs VARr*ALE TOTAL Votc> Volus4h GAls, 'DiST,1p,ce H olE7 Dt*AmETEp y iN~Ht_s r MM IFOLD 2 INCf{ES FopcE MAIN Z I t~~~lES of HOIES/pi PE MOVER"r CLI VATIok3 of LATERA S y B Rid i (,iN OF ~SAFE9'"i =0 CUILDING5 . 'DE TAi L._ EO O CAP SEE CORRESF'al~ • RemovE, All DRil 1 \ Y I BURRS , HoIES 1dC^TEto o,J BoTT'oM EgV^IIY SPACED V 5TRi Bu-riwj T)ISchAR CsE RATE FOR EAc.h I-A'rERi L PER OTC S 12,.k7 GAL /Miti1 TOTAL 1`7iSTRH30Tiojl 'DiScHAR&E RATE FOR INETwo R k' 2S.-7q GAL M,.,), a•5 f Mr'M1 MUAA PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS )9,4 E I OF 5 VEIJT CAP ' `"c.I. VENT PIPE WEATHER PROOF APPROVED LOCKING T JUNCTION BOX MANHOLE COVER lU/1~(~~~~/ 25' FROM DOOR, W1 WINDOW OR FRESH I2"MIU. AIR INTAKE I ~~AD~ ~~E^T/oN GRADE I y" MIN. z/" I IB" MIW. -5-o MJOUIT 11~ _ 9~0 INLET PROVIDE I r E - _ m~Tli®BPE$YySTEM I III °w I III APPROVED JOINTS 1JPCIVPIPEJ0INT A INy AP~OM t _ I III W/C.I.PIPE EXTEWOIU 'XTENDING 3' ~0 ` " I I I ALARM G 3' O ONTO SOLID SOIL ONTO SOLID SOIL a DEPT. ~1 SY, LAI30I"t b HUtlAhl r'sF.ap c VISION OF SAFETY 7D BUILDINGS ON (o -~,A ELEV. FT. Ram p --J OFF D 3 t SEE CORRESPONDENC 4AP H I BLOCK PeVAfiop AD-- 1 --4 79.50 RISER EXIT PERMITTED OIJLLJ IF TAUK MANUFACTURER HAS SUCH APPROVAL SEPTIC E S P E C, i F I'CAT 10U S DOSE ti DWESTERlJ NeCAST -T,"c JUMBER OF DOSES: PE.R DAU TANKS MANUFACTURER: TANK SIZE: 15 O GALLOIJS DOSE VOLUME 5 11-7 5.3. ELF C TR d INCLUDIMG, BACKFLOW GALLONS ALARM MANUFACTURER: MODEL WUMBER: I ol- o I if CAPACITIES: A= ISO INCHES OR 3p0 GALLONS MERCORY Flo A7 B= z INCHES OR 315 GALLONS SWITCH TYPE: G Oy L0-5 C= (P'3 INCHES OR 117 GALLOWS PUMP MANUFACTURER: 3~8s Y3 tiP U5V 15.7- 111CHES OR 2175. S MODEL NUMBER: - D= ' GALLONS SWITCH TYPE: P(6c-YpAC.4',' MERCuRy F1oAT- NOTE: PUMP AND ALARM ARE TO BE MI INSTALLED ON SEPARATE CIRCUITS NIMUM DISCHARGE RATE 3 ~ GPM fCS , VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. 7 FEET SP - "L f + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . 2.5 FEET EAC(4- I, O~ P/ s z } 30 FEET OF FORCE MAIN X ~-ST F o FT.FRICTIO►J FACTOR.. FEET -t . r 40A t S I ~ s I2 /S. TOTAL OyWAMIC. HEAD = 72' FEET IMTERNAL. DIMEIJSIONS of TAWK: LENGTH ;WIDTH ;LIQUID DEPTH ' I I I Submersible Effluent Pumps 3885 AVAILABLE CERHRCATroNs ETL LISTED SU CLASS1AN0 BMERSIBLE PUMP G 11 DI .2 AND CLASS 111 DIV. I AND 2 - - ETL TESTING LABORATORIES, INC. - } - CORTLAND, NEW YORK 13045 G1096131480 r CANADIAN STANDARD ASSOCIATION SP r ORMANCE RATINGS (gallons per minute) MODELS - WE0511H WE0511HH Series HP Volts Phase Max. Amp. RPM 801163 W1. 11113.) WE0512H WEV12H WE1012H WE1512H WED512HH WE1512HH WE0311L 115 9.4 No. WEU111L WE0311M WED532H WE0732H WE1032H WE1532H WE0532HH WE1532HH WE03121 230 4.7 1750 56 WE0312L WEN12M WE0534H WE0734H WE1034H WE1534H WE0534HH WE1534HH WE0311M 115 9.4 Np 'h 'h '/z 1 1'/z '/2 1'h WE0312M 230 ' 4.7 1 mm 1750 1750 3500 3500 3500 3500 3500 3500 WE0511H 115 13.0 5 100 70 80 90 106 - 60 - WE0512H 230 6.5 10 0 65 76 87 102 112 56 84 WE0532H 206230 3 3.4 15 6 60 57 72 84 100 108 53 82 1.7 60 0 3 45 65 79 95 105 48 77 WE051 HH '/2 1115 13.0 25 - 25 59 74 91 100 45 75 WE0512HH 230 1 6.5 30 50 67 85 96 40 72 WE0532HH 2081230 3 3.3 35 40 61 79 92 35 70 WE0534HH 460 1.65 $ 40 26 52 72 86 30 67 ' 45 10 43 64 80 25 64 WE0712H 230 1 10.0 50 30 54 73 18 60 WE0732H 1: 208230 5.4 3500 17 42 65 12 58 WE0734H 460 3 2.7 70 ¢ 55 WE1012H 230 1 12.5 60 6 30 54 3 54 WE102H 1 208230 7.0 65 16 40 51 WE1034H 460 3 3.5 70 5 26 47 WE1512H 230 1 15.0 75 14 43 WE1532H 2081230 9.2 80 4 40 WE1534H 460 3 4.6 80 90 33 WE1512HH 11h 230 1 15.0 100 24 WE1532HH 208230 9.2 110 15 WE1534HH 460 3 4.6 120 - meta parts, BUNA-N elastomers. METERS FEET • Temperature: 160° F (710 C) 90 maximum. i • Fasteners: 300 series 25 80 MODEL 3885 SIZE Solids ddd 4 stainless steel WE,1 ' • Capable of running dry 70 - without damage to 20 - WE Components. 60 . 5GPM Motor: _ WEO I I s Fr • Single phase:'/3 HP,115 or < 15 50 - 230 V, 60 Hz, 1750 RPM; o wlo~H % HP, 115 V, 60 Hz, ao 3500 RPM;''/2 HP through I , G..... 1'/2 HP,230 V, 60 Hz, 10 30 we0n 3500 RPM. _wE0 Built-in overload with 5 20 automatic reset, class B - F t insulation. 10 • Three phase:'/2 HP through o o 1'/2 HP 208/230 V, 460 V, 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM 60 Hz, 3500 RPM. I Class B insulation, overload ° 10 20 30 m3R1 protection must be provided CAPACITY in starter unit. 8 f VVMnsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page I of 3 Labor and Human Relations Division or Safety & Buildings in accord with I L Wis. Adm. Code COUNTY ST. CP OI'X t Attach complete site plan on paper not less than 81/2 x 1j in size. s ' lude, but PARCEL I.D. # not limited to vertical and horizontal reference point(B ,~t3fy~cti0 nd~'aof slo a or dimensioned, north arrow, and location and distance w rest rof"'~a r.r O 20 • S,3 - 2 - O - o aO ~f REVIEWED BY DATE APPLICANT INFORMATION-,PLEASE PRINT INF .RMATION_ . , , PROPERTY OWNER: q w PR PER ATION 1 M O CA Cp{~ GOVT. 1/4 1/4,S 2-3 T 2 N,R A? E (or) W NAY PROPERTY OWNER':S MAILING ADDRESS OFF _&OT LOCK # SUBQ. NAME OR CSM # 52-9 LO c c7 S T- sT. FOX U~4r/E V CITY, STATE ZIP CODE PHONE NUM s 11 []VILLAGE [9MN NEAREST ROAD 00Sa'j wt. 5yo16 (?is) 3PG H012SO,J E Pher /3ipADL~ DAP%O [ Thew Construction Use [ rj' Residential I Number of bedrooms -3 [ J Addition to existing building j J Replacement [ J Public or commercial describe Code derived daily flow ysb gpd Recommended design loading rate S bed, gpolft2 trench, gpdAl? Absorption area required 3-75 bed, 9 315 trench, ft2 Maximum design loading rate 5 bed, gpd/(t2 • G trench, gpcW Recommended infiltration surface elevation(s) See p5. 3 ft (as referred to site plan benchmark) Additional design/ site considerations 5 d/ t d/E- o v cY {oiQ /yo uaD 7 %Aes 5y57eA-f Parent material 5C5 5 $ w k& t E a 5%~T SFOiA+e vTS Flood plain elevation, if applicable tip- ft S - Suitable for system coNvEgnONAL moutjD IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for system ❑ S IaU as ❑ U ❑ S 21f ❑ S 911:f ❑ S lid;- ❑ S BV- SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Boud3y Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed rends [3 8 f} 0-7 ioye 3/2- - 104,,1 z.f,sd& nMfRe e- .5 3~f .5 - r. 7- 2 z 7.5 y/Z 3/j' s/ /'M, yti° v'F R a S / ~ S Ground C '3 /o yt? Y/CP S y R• s sC/ Z. d,r -F i a ti : q_. 5 elev. .Z"' It ip,¢c TvR F G~;~,E-s 70-~ 31/ " i Depth to limiting - factor „ i 2Z Remarks: ~it°F~ aF /.3 i NoT Sv~'T,t,t3/~' ~yE•y ~Y ov-vD . Boring # to 9 /0 y,Q 3/2- f SAW All •F P, S 3 f • Y S ~ S~/ / f sd,C f ~P a s 2 f • S z (3 - zo /o yR 31 R -3(, F,p,4 cr-v~2 G':~EST ,vim- T- Ground elev. I 'zlfL 'ODI A I Depth to limiting factor „ .0 ~3•Q Remarks: E.4 of z. NoT Syi'T~tl3~~- EUE^'•~ ~10~~D CST Name:-Please Print *Ra (3EeT Z{ Lt3 R C CkT- Phone. Z ( 5 " 3 ~(o _ g S Address: 655 d` Nr=r~ ~D F}uvso,.) w► 54d~C~ 5-1-gy csTh 1Sl~Z Signature: Date: CST Number: N O-T E MOST' / 1-Ina= Dr'hTE Soi'L S~f-rv,~~t-7~7~ Jfa,P.'zo,~s (e 1 /t Lo v (r ,t'll"Ve"o-6w PROPERTY OWNER T~ M lth SOIL DESCRIPTION REPORT Page 2 Of PARCEL LM T 12 F b X UA I I t Y Boring # Horizon DTpth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Nia-ch 3 A O-li /oY12 3/2- i'I. 2f56k- ew,fP_ 5 Zuf- .5 •G 13 ,~-3y `oyle 3 / ~ 6i(. 3... bk i cs 1Uf ..S Ground C y yk -7.5 yR 31q 5 - 2 5 v' 61 1 Am gn U'f R e- ft. ~SATv~~ n AT- %0 Depth to f= ~ A-c t 12 C D L~ 5 T a-U N ;N limiting f3 S'SS i Remarks: Boring # A 10-/3 /o VR 312- 5i I. 2 f 5h t R 5 2 u •F . 5 . G 13 3 -Y6 /o y,P 3/y 5 • I 3 A-~% k ~►N►-F C.S lu f 5 • G C x-50 7.5VR 3/ f' Res L,5 Ground elev. !U ft Depth to limiting faces-~ SS5 Remarks: . C. Boring # A o- y /o yR 3/z 511 .2 -F 56k R S-5 2- v+ .5 5 L3 ~j-26 /o Vk 3/y 2 f 56/C -FR C5 luf S •G C 16- 3 -7 5 %/P, 31V 2 f 5 bK nom. ~ (t 5,1 Ground R S g elev. R p- yL FRl4cTu2Ep Lr'.~tES 1`a~ N N Depth to limiting factor sss Remarks: Boring # Ground elev. ft Depth to limiting factor Remarks: CDn OOOA/D ACK1n\ sp Lor ~o4a~R ~o BRADLEY ~D R'oE 21~' 0 13M.= TdP °F PhOA5E I" s6w& TOO SAW L 155 colPivEIR Pei) -11 AT p•w- LoT ~ r IF Lt: VArfoa 1 oC9.0 TEST' ARaA- O J N W 3 13 4 85 1310 . \ 3P 98 0 120 3 ~ O J N IL ILA( pleoposeo I 3 f3tDR~'1. N C~►-tE' S iTF I -fear ARCH 1 t 00sE will 1 - • RooaD 1A-) - I3y 5CAUE: l = 30' IH N'b~SE H DU~'IQS 23. - ElEV8T1'O#3S - f3 3 9~ i I 431 .~~/o~ Cis 5~ oG . t3z M ovoO Sy s rr: ti e lEv,+r i'oAj 'TC sr AREA 2 Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT . Papa l f>f 3 tabor and Human Relations -0WIsion of Safety & BUIdin s in accord with ILHR 83.05, Wis. Adm. Code COUNTY ST. C~or'X t ltttach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, WA not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or .D. fN dimensioned, north arrow, and location and distance to nearest road. 1153 APP LICANT INFORMATION-.PLEASE PRINT ALL INFORMATION D BY DATE PROPERTY OWNER: PROPERTY LOCATION SI • M 'Rp u L C h k GOVT. LOT N,- 1/4 -e46-1/4,S 3 T 2f N,A 19 E (a) W PROPERTY OWNER':S MAILING ADDRESS LOT 4 BLOCK SUB . NAME OR CSM 8 .2-9 I-O c vs 7- ST . /Z- > oX //.4//ey CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE 91OWN NEAREST ROAD 012S61J Wt. sya (?/.S) 38G -&,?Se tfuVso.a E •PARr /3,MADLG'' [ New Construction Use [ Residential / Number of bedrooms -3 [ J Addition to etdsting building j J Replacement Public or commercial describe Code derived daily flow ySa gpd Recommended design loading rate • S bed, 9 polft2 • french, Absorption area required 3 75 bed, ft2 375 trench, g2 Maximum design loading rate • S bed, gpdM2 treflCll, gpdr't12 Recommended infiltration surface elevation(s) S-eR- . 3 R (as referred to site plan benchmark) Additional design /site considerations 5%T~' S v~ •t,(~/F o v cY fox /yo az Jp - S)/S TF~'l ' Parent material 5C5 5 $ w hh t ar a - 5,-4r SEOi~+e ~•S Flood plain elevation, if applicable It S - Suitable for system 0ONVF4rIONAL MOUND IN-GROUND PRESSURE 7 AT-GRADE SYSTEM N HOLDING TARN( U = Unsuitable for system ❑ S CYCJ CC'S ❑ u ❑ s fi3l1 ❑ S C~ d ❑ s [3e ❑ s Sff- SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ in. Munsell Qu. Sz. Cone Color Gr. Sz. Sh. Bed mn:h 0-7 /01/9 3/2- /04.Ar 2..f, sh,& nM-Fie cs 31 .5 . C. 7- 2.2 75 y/Z 3/y 5 j .wt, yid ~►+t v'~ R Q S / 'f! . S Ground c -3 /o yx y~G Sc, R • scl 2 At 'Vw ~ 2 c* - : q s elev. ft. ~ ,4cTvR~ G~:NESTo.~ 311 Depth to limiting - factor .Z - ~S Boring # Remarks: of /31 Nr 501-2.665- 6-&4Fy d/`!ov-v~ . ^ (9-f 100 3/2- Y z - 26 /v )e '31 511 / f sbr 2 nN, 5 s f f3 ~ ~ Q fi Y R ~34 61~crv.4 7-, 50 •0~ Y # / "Af Ground elev. fl Depth to limiting factor „ 20 • E of d T' Syi'Tif.C3/~ EvE~ Remarks: 2 N )215 'oo10vf0 CST Name:-Please Print R. (3E2 T V L (3 P. t G k r Phone: (5 _ 3 ~(o _ 8 5 , Address: Cogs NerL RuOsoa GJ;. SgOIG 5-~'qy CSTM LLI~Z Signahue: Date: CST Number: No-~ E M o s r ~1•ineL)t* 1TE So~'L copy G E ES r~~• 517 Loves 144fX""-64" ~ollvp ACS/%O6 - /a„ S4AA0 fi!/. PROPERTY OWNER Tr'M lr:h~ SOIL DESCRIPTION REPORT Pepe•?'~t 3% PARCEL I.D. # L-or l 2 F o X U,t l 1 y Boring# Horizon D?pth Dominant Color mottles Texture Structure Consistence ew'd3y Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed mnch f} 0-11 /OyR 3/2, f'I. 2 f 56k ,mfA S 2u f . S .G toy 3/y si 1. 3.t w, bK nn~ i CS i~f . S •G Ground -1. 5 yR 31r{ 5 2 5 5 I Am g/Z /M u~f R a Z elev. It. (-5A7-uRArq-L> Ar yo Y Depth to F- i4 It QE -D ~-~%y s 7'V-4J N limiting tac3to ~5s-_ Remarks: Boring # 0-/ 3 /o VR 317- Si 1. 2 f S6k auf .5 B 3-y6 /o y,P 3/y Si 1 3 6k Amf r' CS (uf -S G C -50 7.5YR R 5 sl 1 t Ve vh f R _ : y 5 Ground elev. fc Depth to limiting factor~(~ ~ SS5 Remarks: Boring # A 0-1 /o yR 312- S.'/. 2 -f 56 k ~►N• R S-S 2 L4 .5 = C. . G 5 d 9-26 /O ilk 3/y S,'/ 2 f 56K . -F R CS /of .5 C V6 -3 -7.5yR 31y R s 51 2-+ 5bt SY1F Ground elev. R p y FR/+cTut2a0 L.#'MESTICa N jN ft. Depth to limiting . factor sss Remarks: Boring # .131 Ground elev. It. Depth to limiting factor Remarks: eon e~~nio ncm•a . h f • 1„ sP Lor COCOC ~o (3 AD L E: am . = Tae °F PboaE- 0 1' Sctcd- =Rdw BNR pep p L lSS I4 3 r p.w• Lor CoRNEl2 10 U• L' 6t; VhT'forJ J TEsr AReAA- 3 10 r `o v w 3 dy , • 50 - r 85 iyo \3p 98' c~ 0 120 133 1 0 J H IjJ IL~I PleopoSED I 3 BebPm. H ome- s ITE -rE-s7- AREA ar Douse- wit (3-c. Hoo o iA-) - (&y . 5c AUE: 30 23' IN t+c7oSE' h ooe'ps ° - FIEV/4T1'0~5 - i 3 97 I ~ • MouuL,) Sv sl- m EIEVhT'io~ "TeSr AReA Z.. Lot'il-v W, 5A01) UrPARTME F iz POR"T ' ON FETY & BUILDINGS INDUS~R`r" ! ' G f DIVISION LA(30R ANA Fz'9198 PERG LATtt i v P.O. BOX 7969 14UMAN RE IONS O*/j 3 Q MADISON, WI 53707 LOCATION: E N: TOWNSHIPOA V NAME: lg fv► W H l 1 p.`S• itt COUNTY: ) S NAME: MAIL / r- L_ E,5 USE K'09~~ IE NO.BEDRMS.: COMMERCIAL DESCRIPTION: EI OLA: SS S: ~VResidence RATING: S- Site suitable for system U- Site unsuitable for system ONVENTI NAL: MOUND: IN-GROUNDPRESSUR : S STEM-IN• nal) ~S DU OS DU MS DU OS L /7r If Percolation Tests are NOT required DESIGN R~ATCE: If any portion of the tested area is to the under s.H83,09(5)(b), indicate: Floodplain, indicate Floodplain elevation: rjd I L i~4G)";-Z PROFILE DESCRIPTIONS ~ ! rr e 1~ MEN, BORING TOTAL DF-PTHTOGROU NDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED EST. HE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 5L L} 0,40') 8w 5t1.-1 2.40 ..,a 1,30'~ moo O-5 w B- I 8.OOt x.3,07 0005 ' 0,00 62 0.801 ' 2 D P,,r.l -4 0, 4d; bi,_1 W U I.80'13..rmm~ sw $L L) 0.40'~ 'Bl.t Sil-•} x.10' j k.b FSr.I SrL~ r•eo ~ a^, C 5 B-~ .S r `~3,`~j ~~[7 7 ~r r w U2. o~ a BL L, O SojR~~J S:t Z"50'j -o3" L_S, I.Zg') 'Bw MMD B- 7.70 r s O.4S'• BN ~S O.(oOr' $A1 4, Z/~ CaR Z. 4-0 L L c~,5ta''' O P r.r ScC.,Z,4o'j e FAN LS) 0 7 D ' • Z-a " ` .00' I Lt o, 4d) izo 6~r S', , 2,r 5') R_o Br,i ►-S w~6a 12: D. W, fS.t Me;D C~a B- S -7, 5- °j0.08 ,\I!~►~ L J~ (dr S vt 11 6a 1. &j S L dlor• ~5 D.ZOr' *~S;L~,~ Lrn,, gsMovg Co 13. w N\ PD MoT, 0.35) C3w L w~Grr2J Z .00') &_U6-G &-I B- A N O` GA-( W1 tAPQ 4, AA 10 -(p DOS ':~1, O d.(Or PERCOLATION TESTS, L.~e- To 5-Z. W AAPC) 046-v /v Or. 7 Nofl E 14 O' TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD t eF I PER INCH P. 4.39' o ft 31 2 Y Z. % 1s 2. - PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Deseri what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the di action and percent of land slope.1 r t J TIC \A,/ rte} I SYSTEM. ELEVATION r T. ~ f_ ~j 17 - - - - 1--T ~ L ' l A~ G o L_J ti I r _ , -r_ . i ! I i .1 - apt 1 - "ej ~~0 , r- I 1 li i I~ t l i ` i IA. • 1 i I 1 f I I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wis onsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knovvledge and belief. NAME (print : TES-rS/WERE COMPLETED ON: ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional) . I ° 7' . ~ v t> 5 t~ n ' r. I ~ I ~7a 386 4 o O CST-$IGNATURE: C tar • fC , ' !')!4Tgtt3U?1~!tJ i.tin.,! n•, n..r. • arty t nr:r~ Aut}Wray, Prn;m, ty Owiwr vil f oil Tester