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HomeMy WebLinkAbout030-2088-80-000 Y STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS SUBDIVISION / CSM# LOT # SECTION 3 ~ T .26 N-R W ~ `.l ~~C' Town of 5 C ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM grk% t I f,oec~2l 5~~~~~ U try s e ?s,,h d -o INDICATE NORTH ARROW I Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. r BENCHMARK: ALTERNATE BM: l SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: P Liquid Capacity: C?C~/,~d Setback from: Well House Other Pump: Manufacturer Model#. f1L~- Size /6 Float seperation Gallons/cycle: &4('S Alarm Location ,7 v 0 11 SOIL ABSORPTION SYSTEM / Width: Length 1Z Number of trenches Distance -&-Direction to nearest prop. line: - ---1 Setback from: well: J~ House ~f Other ELEVATIONS Building Sewer ST Inlet. ST outlet PC inlet PC bottom Pump Off Header/Manifold Bottom of system Existing Grade Final grade 1 / P yr DATE OF INSTALLA "T, N. y PLUMBER ON JOB: ✓'1~~J UJ,'L LICENSE NUMBER: INSPECTOR: 3/93:jt Wi9consin Dtpartment of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No-: GENERiiAL INFORMATION PeKELLE~, NAM & SHIELA City E] Village ©Town of: State Plan o.: CST BM Elev.: Insp. BM Elev.: BM Description: 11~~ r rcel Tax No TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. a / Septic Benchmark Dosing I',! ~(l C! / Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANKTO P/L WELL BLDG. ventto ROAD Dt Inlet Air Intake Septic NA Dt Bottom Dosing NA Header/Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number 9 = J I/ 7 \ GPM TDH Lift Friction Systerm TDH Ft Forcemain Length Dia. H Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS LEACHING Manufacturer: SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM INFORMATION Type o CHAMBER Moe Number: System: OR UNIT DISTRIBUTION SYSTEM t To Air Intake Hole Header / Manifold Distribution Pipe(s) x Size x Hole Spacing Ven Length Dia. Length Dia. Spacing I I I SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil Q Yes No ❑ Yes El No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: ST. JOSEPH.34.30.19W,NW,SE, LOT, OACWOOD LANDE -1 Plan revision required? ❑ Yes ❑ No I Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH , z SANITARY PERMIT NUMBER: I • SANITARY. PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code coin X STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than 8% x 11 inches in size. ❑ Check kvision to pprrevious application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER , PROPERTY LO,C~►TION X_ s lei //P 1~ l~'/a _ ,7'/4, S T3v, N, R E (or W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK CITY T TE ZIP CODE PHONE NUMBER SUBDIVISION NAMUR C NUMBER 5G~2 o b r -e II. TYPE OF BUILDING: (Check one) El State Owned VILLAGE • NEAREST R AD ❑ Public 1 or 2 Fam. DwelNn Se l / g-#ofbedrooms PARCEL TANUMBER(S) III. BUILDING USE: (If building type is public, check all that apply) 1 ❑ Apt/Condo CJ ll C1 2 ❑ Assembly Hall 60 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 120 Service Station/Car Wash 5 ❑ 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. ® New 2. ❑ Replacement 3.E1 Replacement of 4.E] Reconnection of 5.E1 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 ILA Mound 300 Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground 420 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 f q. ft.) PROPOS (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION ( Feet b Feet VII. TANK CAPACITY Site in allons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper. INFORMATION New lExisting Gallons Tanks Concrete structed glass App. Tanks Tanks Septic Tank or Holdin Tank Lift Pump Tank/Siphon Chamber CD / VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on th ached plans. Plumber' Name (Print): Plu s ignature: (No S amps) M PRSW Business Phone Number: Plumber's Address (Street, City, State, lip Code 1z;1h ~*(o IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater ate Issued ui g Agen lure (No Stamps) Approved ❑ Owner Given Initial Surcharge Fee) Adverse Determination X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: a SBD-6398(8.08/93) 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 Sarrhary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your_onsite sewage system, contact your local code administrator or the State of Wisconsin, 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 repai r. 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. I SBD-6398 (8.11/88) SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations July 14, 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 S94-02411 FEE RECEIVED: 180.00 KELLER, TIM/SHIELA NW,SE,34,30,19W TOWN OF ST JOSEPH COUNTY OF ST CROIX MOUND SYSTEM The Department has reviewed the above-referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval of the system is based on chapter 145, Wisconsin Statutes, and chapters ILHR 83 and 84, Wisconsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter ILHR 82 or in chapters ILHR 50-64, Wisconsin Administrative Code. This plan submittal approval will expire two years from the approval date, or if a sanitary permit is obtained, plan approval will expire on the day the initial sanitary permit expires. The licensed plumber responsible for this Installation shall keep one set of plans with the Department's stamp of approval at the construction site. The installer shall notify the appropriate inspector when inspections can be made. All permits required by the city, village, township or county shall be obtained prior to installation. Inquiries should be directed to me at the number listed below. Please refer to the plan number shown above. Si rely, ames Quinlan Plan Reviewer ORIGINAL Section of Private Sewage (608) 266-3937 SHM64231 R. 01/91) JAWWRO 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. # S yV- 02-1111 Date JULY [q- 191 Owner Phone 7/S- 3 ?(a Address tO.o• 4011- 3Fy llvOso") 4~/S- SVO/6 Legal Description LOT- # - -bEEe Fi E"L17 S U G3Oj 0 I'S 1oJ N w %y 5 /5/ -See.. 3 y, T 3 0 &3 , 12 1 5 w Town of 6 *r- i' oS P tt County S "r- C R 01' K C.S.T. RDeeer 7ALBe- Ci T-+CST'H 2-4~Z Installer GA F-Y Si E EL G s -t- - Local Authority/ Supervision s-r, c~ni x covA3Ty zaAz i ~~Pr• PROJECT DESCRIPTION sniLS 1.,. TeST- /4,Rc A ^RE" f.4(P-Ly P~12rTf'n alE i~ 1t.t- 1'op ~i GA ( z o C2 APE- S 4b w L'/ p '/tf,, C3 iE /3E/o w gj_L 0~ T~ ~S /9- 1 r6vwP T yloE- s Ys 7-2!~ILY - 1/A,e)e0 c) 1"' o v vp S K S rE~ Fo%' A Z7'1 t15 &-~2PM . 1 i 5 o/~aS O ~oo Ys. 1,6e-t, 5TI,y~-rE22 AVA- 5TH "/~iw 5'/57~tiI /_5 ~51- f',,g7p V51-%u6:- Pg.1 PLOT PLAN VIEWS Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWS 7~2f7- 4F -F1 Pg.3 PIPE LATERAL LAYOUT Pg.4 DOSING CHAMBER CROSS SECTION w~~r Pg.5 PUMP PERFORMANCE SPECS, * flowtw. u wvcKr D11 ~ / KlDal'~L I w~. r ORIGINAL - G v/• UA S~ G p Ga C~ I - L b ~ - c `I O b m (n 1 fi L o ty r' rn Q) INS C4 "A •G~1~NdNO-Y y io:i a N fi IF n ~ W c N `p Z n - o -a o LA 94-PU2411~ q .c. o '['j c.005S SECT ►OAJ of NlouAjD to i r ti f3eD I3eo OF ro 1v Allec-5ATE ~1 ST Rif3uT~ o,J G, T{~ickaFSS P,P s ysrEM OF T~Pso~L. t=levArioo 00, Uri FORK ToE 4 /DO .O ar N L-I~ E P Plowco To P So i L- o u u F R!~ /a °70 SIoPE FoRcE" EIMVAT'00 U~~ER Mhi~ REP I9 • /-o Fr. Et_EvAr1o~ s E / Fr. INVERT- OF 1AT£RMS /00 -6-0 F FT To P O F R oc>k /DD. S 7 G / . D FT. H !-ToP of IATERAIS 100-70 • S FT. PLA W VIEW OF MouAjD wi rte 13E D FoRcE MAiN A (o FT, Fr K F r Fr _ 3/ a- W o 0 FT- BED of Tv PV C_ cAppEp A 12E hT,E r ' C9(3SERVhTI0a 99 L MMAN R1r1_A pipes C,' 3,A-E'fv, AM) EUILD1,WUS PEQMA&) ENT MARKERS REcquMeo (3ASAt_ AReAC = 'DArt_Y ~hsT'EF'~ow _ oo - X5-00 SOIL 101ITIRAT)oE C APAci Ty 7 54. FT. Ro oSED BASA4 ARe = a (A + = S94-02411 r J w • 3 a~ 5 D►ST ,orjoA.) PIPE IJETwoRK LAyou'r n R MIN a%F0 -r o Allow fell \ 2 ' Nowr+~/s 2, p ~Q Fr \ \ A41/acv F"R ~ 3.0 i=- ` R Fr y X FoRcE MAi&3 INcRES Fr of z Pvc y ~ ~ucMEs VRRI'AGLE TOTAL. V(9tD Volwi S~ GAIS. ST^,~j cft H otE D,AMETE'R 7 INGN~S LhTEPA L- " Z ►JC!}ES MMI,FOLD z ►Nc~4Es FoRcE ~Aw z I Qct4ES Of HoIE5 /Pi PE 17 MOVERT ELEVATtoo of LATERAB 5 v Po.i✓ i'.r - G V ~94~fl4,~'i1^.i6vf OF /OD. SEE CORR P ~ P E 'D E TAB L-- L' X' 1) e- AP PE R Fc~ R ATE ~ ® RemouE An 1)Rilt BURRS ~ \ Y Ho'ES IocATeD oA3 BOTToM ECQ L) V-A IIY SPACED 77i 5TRi t3uT'►oN D►SchAQ CsE RATE PoR EE Ach ~grERA L_ PGA OTC-5 - GAL~MiN. TOTAL 1'7i5TRi(30Tl0rJ 'DiScH^R&E FATE FOR NETwoR K GAL/Mi•JV. C a•5' Mi*ml•MuM S94-02411 PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS P!}~E of 5 VENT CAP 4"C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING 25' FROM DOOR, JUNCTIOAI BOX MANHOLE COVER W INOOW OR FRESH 1413E AIR INTAKE I lI1AD~ ~~E v^T/oN GRADE MIN. /00.0 C ON DU IT 15" MIIJ. - yb ~IE~ArI IIJLET PROVIDE I L_ ~ ~ AIRTIGHT SEAL I v APPROVED JOINT A INh I III APPROVED JOINTS W/C.2. PIPE I A SUM i I III W/C.I. PIPE EXTENDIAIG 3' /0~ I I) ALARM EXTENDING 3' OWTO SOLID SOIL, ~D I I I ONTO SOLID ow c ~3.9r~ I ELEV. FT. PUMP OFF D .1- k ,fVJ BLOCK /E VAf~ ya' yS RISER EXIT PERMITTED OIJLJ IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E SPEC 1171CATIOUS DosE Md6otsT ',v IOR -C - 3 TANKS MANUFACTURER: WMBER OF DOSES: PER DA-4 / 0-019 Zoo TANK SIZE: GALLONS DOSE VOLUME (o 2-o6 ALARM MANUFACTURER:. LE &I AlARIt Co INCLUDING BACKFLOW: GALLONS MODEL NUMBER: 7~).L)-L_' CAPACITIES: A= ~(p INCHES OR o0 GALLONS SWITCH TYPE: N ER(V e y F l OAT- B= z INCHES OR 5~0 GALLON PUMP MANUFACTURER: 2oE~~E~ r lt?,2.2-4= INCHES OR GAA MODEL NUMBER: y0 `l~ /P ~~7 y /~.y D= INCHES OR GAlO1JS SWITCH TYPE: PI G&Y BAC-k 'I CIE-CU R1, FIOAI- NOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATE- 2, GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. (1-6 FEET -rAA.) lECS + MINIMUM NETWORK SUPPLY P3RE1-S1SURE . . . . . . . . . 2.5 FEET 6ACL- TI o~ P f~l + 3S FEET OF FORCE MAIN X _ F ,FKICTIOM FACTOR../' 15 FEET ~40rls as TOTAL DYNAMIC HEAD = ZS FEET INTERNAL. DIMEWS►ONS OF TAWK: LENGTH ;WIDTH ;LIQUID DEPTH 70 I* ~ SEA t S94-02411 y to HEAD CAPACITY CURVE 3 7/86 1/4 0 MODEL "913" 30 4 5/B 8 - 1 25 Wj4 6 0 15 3/16 1 10 1 1/2-11 1/2 NPT 2-- 5- 0-- U.S. GALLONS 10 20 30 40 50 60 70 8( LITERS 80 160 240 0 FLOW PER MINUTE TOTAL DYNAMIC HEAD,'FLOW PER 69•IUTE EFFLUENT AND DEWATERING CAPACGY 12 HEAD UNITSINNN FEET METERS GALS LrRS 5 1.52 72 ^73 10 3.05 61 6t :>3t 15 4.57 45 l i o _ 20 6.10 25 95 t 3 5/16 Lock Valve CONSULT FACTORY FOR SPECIAL APPLICATIONS Electrical alternators, for duplex systems, are available and a Mercury float switches are available for controlling single and supplied with an alarm. three phase systems. r*. Mechanical alternators, for duplex systems, are available with or • Double piggyback mercury float switches are available for without alarm switches. variable level long cycle controls. SELECTION GUIDE Standard all models - Weiht 39 IbS. - ;i2 IA. P. 1. Integral float operated 2 pole mechanical switch. no external control required. 2. Single piggyback mercury lloal switch or double piggyback mercury. Iloat 98 Series Control Selection switch. Refer to FM0477. Model Volts-Ph Mode -Amps Simplex Duplex 3. Mechanical alternator 10-0072 or 10-0075. ` M98 115 1 Auto 9.0 , 1 or 1 & 7 - 4. See FM0712, for correct model of Electrical Alternator, "E-Pak". N98 115 1 Non 9.0 2 or 2 & ti 3 or 4 & 5 5. Mercury sensor float switch 10-0225 used as a control activator, specify D98 230 1 Auto 4.5 1 or 1 & 7 - duplex (3) or (4) Iloat system. 6. Four (4) hole "J-Pak", junction box, for watertight connection or wired-in sim E9fl 230 1 Non 4.5 2 or 2 & 6 3 or 4 & 5 Alex or duplex operation, 10-0002. 7. Two (2) hole "J-Pak", for watenight connection or splice. CAUTION For Information on additional Zoeller products refer to catalog on Combination Starter, FM0514; All installation of controls, protection devices and wiring should be done by a quat6 Piggyback Mercury Switches, FMO477; Electrical Alternator, FM0486; Wt' chanical Alternator, tied licensed electrician. All electrical and safety coder should lar followed includ- FM0495; Alarm Package, FM0513; Sump/Sewage Basins, FM0487; and Simplex Control Box, ing the most recent National Electric Code (NEC) and the Occupational Safely and FM0732. Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor Is lffgineered into the design of every Zoeller pump. MAIL TO. P.O. BOX 16347 ZA9Z1Z,JJf SHIP 70.3 40256-0347 Manufacturers of... ® SHIP 70: 32eO 80 0%r,~Aiilers Lane a ; LG vide, KY 45?16 QU.IL/IYAws Ski- ARY f502) 778-2731 0 FAX 1502) 7743624 - . ~ - -ram----•--'-^~r x: 894P-02411 Apl ,vpv.~-c ~a sir/s /f'Q)010`7_ -7-30 - yz csT ~~~r SEE/ ;6V LAQ6-i 0 6-- ARE's} Fo/'2 IW PV-9Q - . S ysTE,tj . Wisconsin Department of industry, Labor and Human Relations SOIL AND S IT E"; EV4r1, U ATI O N REPORT Page l of z Division of Safety & Buildings in acc¢ „Wis. Adm. Code 1 COUNTY S i , G Attach complete site plan on paper not less than 1 incheon size. st include, but not limited to vertical and horizontal reference j, directs of scale or PARCEL I.D. # dimensioned, north arrow, and location and di o ne&(04 road`- APPLICANT INFORMATION-PLEASE P ALL twOffitATION t"'1I REVIEWED BY DATE PROPERTY OWNER: P TY LOCATION T/ M 1/4 SE 1/4,S 3 yT 30 N,R / E ( W PROPERTY OWN R%S MAILING ADDRESS L # BLOCK # SUBD. NAME OR CSM # ~0 b ~~C Pt's c. D CITY, STATE ZIP CODE PHONE NU []CITY []VILLAGE 9I`OWN NEAREST ROAD 5_41eV6 (76) 396- 5;r. uos,--pif- OAeWOov L,V . (q'New Construction Use ( q-Residential / Number of bedrooms ( J Addition to existing building I ) Replacement ( ) Public or commercial describe Code derived daily flow ~o Cx~ gpd Recommended design loading rate bed, gpdffl2 • 5 trench, gpolit2 Absorption area required .4_6V bed, ft2 ✓ 6C trench, 112 Maximum design loading rate • s bed, gpd/ft2 - trench, gpol(t2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerati ons S1'TE- sew- ~t/,~~~ e~ i lco e - 40,E ,c 414~oewvco . Paren material G/ e,, ra/. Flood plain elevation, if applicable N+ ft S = Suitable for system CONVENTIONAL M-OU D IN-GROUND PRESSURE AT.T.G DE S U ❑ S l_ F ❑ S HOLDING TAN U = Unsuitable fors stem ❑ S au C] LA'S ❑ U S [o0 tJ EM K SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed mrK:h 0-/0 io /Q 312-- Sr , 2- 5h f2 CS 3~-. S 4 a /o lR 7 7 - S,~ ~ ~h es 2 S Ground /.32t 75 Ylf y 51C .5 . elev. ~y ft. c 1- 6h, -7. s yle y 51 o, .r►~t, -e i A 1,P Depth to limiting factor 19PIV ~il° E~Ts ffA/ Remarks: /t'i ZD.c/ d _ A,¢ S S%l~~ - ~i(~r`f (r i Pi¢.✓ . ~-?tivt evt Boring # L-73 Ground --r elev. ft. Depth to limiting factor Remarks: _ CSTName: Please Print P013 459 r id AA' ~'GC 7 Phone: 72,5 Address: _j vA3 -1 - It CST.y 2 S/PZ Signature: Sy0l~ Date: CST Number: ftSS ,2/,p v i•v G- 4Pi'l . PROPERTY OWNER SOIL DESCRIPTION REPORT Page Of PARCEL ID.# Depth Dominant Color Mottles Texture Structure Consistence Bourd3y Roots GPD/ft Boring # Horizon in Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed ranch [3 L Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # I Ground elev. ft Depth to limiting - factor Remarks: Boring # Ground elev. ft Depth to limiting factor Remarks: Cori OOO/VD ACIAIM G v/ 11,4 5,1,c O C m W Q G3 p o rn w ~ o L b m c vj LIJ ~ 4 C ~ ~ ur w ~ ~ ~ n rn w ~ o c ~ 1d b X71 c 1 y ~NIA" I w 1 1~~~, Q o o o •o~1~ddHO~ ~ , W ~ fii N b ~ ~ c a ;PD zb i u ~ c m `off i~ °s' ~ o o J ~ N o ~ -n PLAT OF C.Ari.'.aERH U E L D LOCATED IN THE NWI/4 OF THE SEI/4 AND IN PART OF THE SWI/4 OF THE SEI/4, ALL IN SECTION 34, T3ON,.RI9W,,.. TOWN OF ST. JOSEPH, ST. CROIX COUNTY, WISCONSIN; INCLUDING PART OF LOTS 2, 3 AND 4 OF CERTIFIED SURVEY MAP RECORDED IN VOLUME 7, PAGE 1989 AT THE ST. CROIX COUNTY REGISTER OF DEEDS OFFICE', DOCUMENT NUMBER 438728. CURVE DATA cvwc wl emu, aeon • [w,. tw.e eum•1 me.1 k . ee_ w. ItR1r u,~ Kap,, L5! I)•02 Mai L°_I!f. m y is<nron i " ' r - , - w.on w•nn,• w)•)v.r.f•, wr,wr n,.u aw•avo•1 ne•.NU-( 1V y! • ~ No:m• m•u•u• w,•uru.,•t N..u• u,.n• oo•u•u•t ' w•uoe•, F" u R..w• 1o•1ov,• wYU•n•1 n.oo• n.w• No.oe• ` u•on,e• .,.•.,•s.•c ua.w u,.w• aI ae.oo• w•n•u• ,orbvw.f•c N. n• n.u' All I . , _ , _ R..w• ' foarw• w)o.o,e•a 100, ns.n• )w•nvo•. ,aowvr. .:r , 1p~^. . ^ 1 1 w,.w• "41'01• „>4.HLVr ' 211.11. 111.11• ,,.•,Y D•r ,w•N•awr >1 DI 2i mr.00' )e•p,',O', n,•l.'q-r 1e1.,1' m>. a1' f I 0 " "UNP~ATTED LANDS L N j I OI OI r or r.. Itv. 4 f(cr,o. a. I m' I>,' 411 ~ MI 'd ( aBG•27'J7•E 1321.14' w I M v~ yY n,,.r_ ~...oo. , ua.ao I A-* . ,.a.r°• -*t..e...r 1.1 f UI' 1 "NJ k . k y; "1 Sob R•j 5O(~`"~...... xa ~F~--•( OTB IpI SCALE IN FEET_ o 00 " A la•,aa w. IT. LOT 7 PLATLOCATION LOT 9 Y LOT 5 /.a Y'e s 3 4~ { jj!! r " ,w,,ar ,o. IT. /rr m. ^ , YI I I I .yYl LOT 11 ~e c q l •u i ii ` ( I FLi] T11 A ' - ri + ZSECTION ]a, iJON,RI°W 1 ~ 01 LISTrO cN..e' ~tlC al X r (i 100 ~r, r; , I 2 e ti / LOT 4 B 7 7 LOT 14 r O1 ' LOT I I t.......... . s,` uo..w ae. Ir., vi EL GEN A . D . CWwlr fa(Tre. ✓o.r.[.I ..(Mratw r. F ^I i a.n ae.n R >.oo c.n CAI 1.1i A". = 1 er.'so.>.••` . 1..e, + ra °°te' n «,,.F«,io " : • I .RGR J bb u..... ear. ' 100 w &4.a A- A, At. 51 LOT 3 LOT 12 y LOT 13 1 w ;.,A •.t. no t uo, w. fo, n, uo. uo ,o. rr, var.uo......1 a. oo •c.u . `a'te N..e.'•.u )y I I I X ..,ru•r 4 ( _-WALSH ROAD 3 _ (,.•o NB9•LT a7•W I Oaa. ~9' >1 irl PI . r- rnl st • ;I 1 ' O S I I)a , e' I 01 ~ WI ")1 ' I J1 WI _ w Y ; 41 JI GI - n F i 0 2 a 5°i• R N I Cr' 1 18 ' [ o CERTIFIED SURVEY MAP IN VOLUME 7, PAGE 1909 • .w.w• aR0•.^7'37•E e1G.90_~-- I - ' ! see•U'33 w ,]r.az'" DOC. N0. 430728 i Ro ~ LO I SMALL M1J^ bon >.a NB9.27'37'W ..vruo rw. > . on a aN1a, w+>• bai.. co o 98.90' ucr,e. "i' LOT I I LOT 2 - CkYIJEJQ _SVBYEY LAAE 1N YQLVbif F6`111 141 ,OOC. N0. 393031 STC-105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County ~f OWNER/BUYER Time r>yv L. ~ S`hF/_~ M. ~Ell~f2 -r. MAIt.ING ADDRESS _ E0 g O x A ~/-/cr'0s a'kj 60:'SC 5M)6' PROPERTY ADDRESS I'D, Bg ORE U),96 D (location of septic system) Please obtain from the Planning Dept. CITY/STATE L u r%sm J tA)I'-, S Y6140 PROPERTY LOCATION A JAI 1/4, AJ P' 1/4, Section T_0 N-R_Z_q _W TOWN OF 57-, J/;senh , ST. CROIX COUNTY, W1 SUBDIVISION LOT NUMBER _Z CERTIPIED SURVEY MAP I 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 tit August of 1980, with the requirement that owners of all flews stems 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 Jess 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, W( 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. 1 i Owner of property 71 morAtV L c5'17~P /i~ H. A~QICk Location of property N W 1/4 ,f09_ 1/4 , Section 94 -,T 30 N-R__L?_W Township CST-LJGMailingaddress p, ~OX g 8 A&.6.S.6t/ GCIi~S . SZIU/ ~o Address of site Owu)oab LASE Subdivision name bEFX_F/EL1~ Lot no. d Other homes on property? Yes X No Previous owner of property j7'_oa'1/E 71 Alael ni9 &5,AhAIIA16- Total size of property -5-0) Total size of parcel Date parcel was created 1993 Are all corners and lot lines identifiable? X Yes No Is this property being developed for (spec house) ? Yes X No Volume /0 $s and Page Number #67 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 (off) 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. _S18'6 79 , 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. 5-18 7 9 Signatu of Applicant Co=Applicant -T -7-IV- 5 1` 7-Jj/- 94 Date of Signature Date of Signature i I' THIS SPACE RESERVED FOR RECORDING DATA ICI 'DOCUMENT NO. ;STATE BAR OF WISCONSIN FORM 1-1982 j; WARRANTY.. DEED 518679 8" 67 STEVEN W. HENNING and This Deed, made between i llve%i lair fta;.wd ..NORMA---_- -J•.-_HENNING. husband and:.iaifei_________________________ JUL 5 1994 Grantor, F 1:45-' P and TIMOTHY __Ls,__ KELLER_ and__5.HEILA- M. _ KELLEg, _ husband. I. --.and..wff _.a-s-.. urvivorship marital__progertY............................ ~I I °PD~raa~` , Grantee, iI I Witnesseth, That the said Grantor, for a valuable consideration...... _ _ _ RETURN TO conveys to Grantee the following described real estate in St-.__ Croix.-_.•-_ County, State of Wisconsin: Tax Parcel No: D~ °wq_~ Lot 8, Plat of Deerfield in the Town of St. Joseph, St. Croix County, Wisconsin. I I' .l _ FF Y TOGETHER WITH and SUBJECT TO reservations, restrictions, easements and rights-of-way of record, if any. I, it I i is not homestead property. I This (is) (is not) Together with all and singular the hereditaments and appurtenances thereunto belonging; And.......................................................................................................................................................... warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except I II and will warrant and defend the same. Y . ! Dated this Jul ~ 94:.. 1st day of July 19._ SEAL . (SEAL) * _ SL .I I.W. _UNNI-NG........ (SEAL) ................(SEAL) * * NORMA•J-..-HENNING..... - AUTHENTICATION ACKNOWLEDGMENT Signature(s) ......Steven W. Henning and STATE OF WISCONSIN ~I ---------•--•--ss. I' Norma J. Henning S-•----•--------County. authe ted this --lstday of_.__ my 19--94 Personally came before me this day of G • 19--94.- the above named Barry- C,_- Lundeen ___-S~n _ W,__ Henning.. and-Norma. J:_. Henning ii TITLE: MEMBER STATE BAR OF WISCONSIN ; (If not, authorized by § 706.06, Wis. Stats.) to me known to be the personS............ who executed the i foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY Attorney Barry C. Lundeen MUDGE, PORTER & LUNDEEN, S .C. County, Wis. WI-•54016 n -s------ Notary Public S Croix .._J.1Q..S.eGOnd._81<xeet ~--Hu--d gig, (Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration are not necessary.) date: 19.........) l .Names of persons signing in any capacity should be typed or printed below their signatures. it Wisconsin Legal Blank Co. Inc. WARRANTY DEED STATE DAR OF WISCONSIN ULBRICHT & ASSOCIATES CO. 655 O'Neil Road • Hudson, W1 54016 Reg. Designers of Engineering Systems ~ Private Sewage Consultants 715-386-8185 PROJECT INDEX DILHR Plan I.D. # S ycl- O z.. Ll Date JULY l q- 191 Owner Phone , 7/37-- 3 Address X00. yj S910 Cv ~s' s5/O/~ Legal Description Lo 7- c~E - -bEEk Fi'Elm S u (3 01' U "'St 0'J Pwjy 5tj1 .5,R-e.3y, T30&3 ~tl w Town of 6-r. S oSt_ Pt'- County S T • C R c) i 1C C.S.T. ROl3Ekr- 7ALBFiC( T- C-ST-,4 Installer &AF-y s- E:E-L csT Local Authority/ Supervision S-r, G~2pi X GoU~Ty Zav~'~G= ~~:rT PROJECT DESCRIPTION snt' t_S t,,.> TeST A'ReA ARE- fAtPzy P E~Rnr'I alE IN 14 PE- /31, /3C/ow DPd~ . S•TF /S S 0 r'TAc ,C3 /E- /t- /L1 G vNP T `per s ys rE.~-r - AVA- 5Ti5 t'/(~ et) ,t--7p Pg.1 PLOT PLAN VIEWS C~ti$',~E,?OAT/G' ~D,tp/uG- Pg.2 SYSTEM CROSS SECTIONS & SYSTEM PLAN VIEWS Pg.3 PIPE LATERAL LAYOUT I Pg.4 DOSING CHAMBER CROSS SECTION •i Pg.5 PUMP PERFORMANCE SPECS ;~t w• p»e~ KUosaK wpt. FlIt3M'~~ 'S94 - 02 4 11 Lit/ . v/ 11,4 5,1 c G O C s - p G~ Q I O L p m n LA ,1= m A` 1 i 7°` `s Q G c~ > I rn z v= - Gl © cz c to N m c _ s ?J • ~ /j~~ ~~I ~ ~ ~ In CO) o O LW W 1 C ~ y L _ $j z ,,1 IF m e N Z c Ilk) 71 594-024 1 0 CROSS SEGTId&) of MoUAjD uv i r tt Ge-o BED of To 'Di STRi(3uT%o0 AggQcSATE Cs Tl~i Gka FS 9 Pi p rN G- OP TOP s o i L. S ~/S 1'EM t (EVA1'io,~] U-)► FORM ToE "r N d BOO •O L-I•~ E ~ 3 ` F ~ o X0_1 _ i,, ~ RrtTiO MEIN. _ i e . i ~ - SAuD , 1 + PlowE►7 To p So i L 1 0 10 FORCE* wai FORM MAW h~ E I WATtoa U" PER REP 99 D ' .1) /-0 f :,T. EL E v A rl o,J S E / Fr. 1mvERr of IATERA(S 100.250 F: FT /00, g 7 • To p o F R ock G / . D FT• H 1.•, FT. • To p ~F Z IAT RATS loo. -7o PLAN VIEW of MOULD wi r4 13E D FoRcE MAW A ( FT- Fr Fr ~K o------------------ o.~ Fr w 1 FT Fr _ 31 o I Fr O -j GE SYSTEM f3En OF 2 To I " PVC- cAppEp I. OBSERVATIOa A 551QE5 ATE PipES r AND RELATI'~ CUILDIN+GS I PF-QMAAJ'eA3T MARKERS }yE CCERESPp ~ NDENP CE REco ReP BASAI- hReA _ 'DAi~y ~hsrFFiow - (000 SOIL I#Xf~JrQATIOE' C APAci Ty SQ. FT. PRopoSED BAsA4 AQeA = X (A t r) 894-024 11 X ~ \ 2 b /~v Lv 1 ~ i S ' T, o~ 5 DiSTRIt3uTioA3 PIPE OETw,- r LAyour P R -r o - T st \\ovE Al/ow F~~P \ Z 6-NDI.rJi41/S 2r p ?Q F r 3.0 X 60 d _ INcREs FoRcE MA«1 Fr. (.7 0 3. S of z PVC Y ~ucNEs VAR►•A(3LE TOTAL VdtjD VoIL),4 S~ GAIS. 'DiST^aCM 1 Hole WAMETER / IwcHeS L.hTEPAL Z-- INctiFs MM tFOLD ~ ►Nct~ ~s I Nch4E5 47 of 01£5/(~i PE 7 MOVERr ELEVATIo►J o F- L ATE RM S /00. 0 SEE CORRESPtJNOENCE P I P E 'D r= TA% ► E~ - ~---J N p CAP PER FOR AT ~ Remmi- All DRill I \ Y (3uR R S . HOIES 10CATED OA3 BoTToM EC~0A11Y SP^CED , V STRi Burlom 1)tSChAR C-E RATE FOR eAch LA-rMi L PER OTCS /9 ~ GAS /Mi~. TOTAL T)(STRiQL)TIOrJ DiSCHRR&E' RATE FOR NErwoR K y~ GAL/MI•~. a•5 MI'Ni MUM 94-024 . 1 PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS pf}y~ g OF S VENT CAP `"C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING JUNCTION BOX MANHOLE COVER - 25' FROM DOOR, 12"M 111. G'j 4,41,0 JA) CA WINDOW OR FRESH AIR INTAKE GRADE I~A9~ ~^T~ON i I 'i" MIN r r p 1B"MIN. COFJDUIT-- yb ~l~ vAn ~ti o INLET PROVIDE I - 1-__-s- 7 AIRTIGHT SEAL I ~II APPROVED I I JOINTS . PIPE JOINT A ~Nh AP ~ M I I ( WAPPROED /CIvPIPE w/C 1 ZXTENDING 3' o r I I I I ALARM EXTENDIWG 3' ONTO SOLID SOIL ^ qO i I I ONTO SOLID SOIL B Irr~ 1 O ~ I ON p c ELEV. 13 FT. I I __J PUMP OFF 'IAJJK D~DDI I BLOCK cc (EVAfiD~J { (A r l a' RISER EXIT PERMITTED GMLy IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E 5PEC.IFICATIOUS DOSE ) -e' 1160tSTalo /A' Iff7 3 TANKS MANUFACTURER: kIUMBER OF Doses: PER DAy TANK SIZE: /0-or-O GALLONS DOSE VOLUME to ALARM MANUFACTURER: GEU~~ '~~fiIP~N ~D INCLUDING BACKFLOW: 204 GALLONS MODEL HUMBER: y~.IJ.CAPACITIES: A= INCRESOR o0 GALLOWS SWITCH TYPE: h F-Pc V p y f=l D/!T- B= Z INCHES OR ZL GALL01>J5, PUMP MANUFACTURER: 2 oE~~E'~Gl p ~ , j C = / ~ INCHES OR G' ~LO'1"I MODEL NUMBER: Zp P5' D= 8 INCHES OR _ GALL S SWITCH TYPE: Pr G(oy BACk rIEIPCufly F[DAT-MOTE: PUMP AND ALARM ARE TO BE MINIMUM DISCHARGE RATE GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. G FEET -rAok SPECS + MIIMIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . 2.5 FEET EACt%- I o~ J E P ~~l 3.S FEET OF FORCE MAIN X LF ooFTFRICTION FACTOR../ is FEET TOTAL DYNAMIC. HEAD = ~~25 FEET `fnJJ• r a ~'/ir ~O ri INTERNAL. DIMLWSIONS OF TANK: LENGTH 8 ;WIDTH ;LIQUID DEPTH a r~ rl ' I7V f1 iJSHY, 14A. I-, I?I A!"iiV Ll ifJlld a~ ,!VISION 0F SAR Tf Ali '!,UlLDlNUi: S94-02411 to "a HEAD CAPACITY CURVE 3 7/86 1/4 Yf MODEL "98" 4 5/8 30] . a 25 ( r 3 5/8 ftftft% = 6-20- O 15 4 3/16 4 e O 10 ` 1 1/2-11 1/2 NPT 2 i 5 - a; . 0 U.S. GALLONS 10 20 30 40 50 60 70 80 LITERS 80 160 240 - FLOW PER MINUTE i 'r TOTAL DYNAMIC NEAD;FLOW PER hPnUTE EFFLUENT AND DEWATERING CAPACITY 12 • HEAD UNITS/MIN tl FEET METERS GALS LPRS - 5 1.52 72 273 - I - - 10 3.05 61 831 3t ly 15 4.57 45 110 3 5/16 20 6.10 25 95 t, Lock Valve 23• r CONSULT FACTORY FOR SPECIAL APPLICATIONS Electrical alternators, for duplex systems, are available and Mercury float switches are available for controlling single and supplied with an alarm. three phase systems. Mechanical alternators, for duplex systems, are available with or • Double piggyback mercury float switches are available for without. alarm switches. variable level long cycle controls. SELECTION GUIDE 1. Integral float operated 2 pole mechanical switch, no external control required. i Standard all models -Weight 39 lbs. - th H.P. 2. Single piggyback mercury float switch or double piggyback mercury, float 98 Series Control Selection switch. Refer to FM0477. Model Volts-Ph Mode Amps Simplex Duplex 3. Mechanical alternator 10-0072 or 10-0075. M98 115 1 Auto i 9.0 , 1 or 1 & 7 - 4. See FM0712, for correct model of Electrical Alternator, "E-Pak 98 115 1 Non 9.0 2 or 2 & 6 3 or 4 & 5 5. Mercury sensor float switch 10-0225 used as a control activator, specify N N98 230 1 Auto 4.5 1 or 1 & 7 r4 duplex (3) or (4) float system. 6. Four (4) hole "^J-Pak", junction box, for watertight connection or wired-in sim- 'E98 230 1 Non 4.5 2 or 2 & 6 3 or 4 & 5 plex or duplex operation, 10-0002. a , 7. Two (2) hole "J-Pak", for watertight connection or splice. CAUTION For information on additional Zoeller products refer to catalog on Combination Starter, FM0514; All installation of controls, protection devices and wiring should be done by a quail- Piggyback Mercury Switches, FMO477; Electrical Alternator, FM0486; Mechanical Alternator, tied licensed alectriciam All electrical and salety codes should be followed includ- FM0495; Alarm Package, FM0513; Sump/Sewage Basins, FM0487; and Simplex Control Box, ing the moot recent National Electric Code (NEC) and the Occupational Safety and FM0732. Heakh Act (OSHA). RESERVE POWERED DESIGN For'unusual conditions a reserve safety factor is d g neered into the design of every Zoeller pump. t MAIL TO. P.O: BOX 16347 Louisvilr KY 40256-0347 Manufacturers of . 0 ~~1L f~ SNIP 70: 3280 O%c' Millers 1) -116Lane Louisvuli', KY 46'16 ,QUAL/TY l/MAS /NCF (502) 778-2731 • FAX (502) 774-3624 S94-024-11 DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, c DIVISION P.O. BOX 76 LABOR AND PERCOLATION TESTS (115) MADISON WI 53707 HUMAN RELATIONS (1-163.090) & Chapter 145.045) LOCATION: SECTION: TOWNSHIP/CITY: LOT NO.:BLK-NO.: SUBDIVISION NAME: NW t/4 Sk/ 34 /T 30N/R Ax-O W St. Joseph 8 n/a Dee COUNTY: OWNER'S BLIMO S NAME: MAILING ADDRESS: St. Croix S. Henning & D. Norell 665 Walsh Rd., Hudson, Wi. 54016 USE DATES OBSERVATIO MADE VAL NO. BEDRMS.: COMMER IAL DESCRIPTION: 77_10-92 FILE DES RIPTIONS: ER LTION TESTS: Clesidence 3 n/avow ❑Replace 7-30-92 RATING: S= Site suitable for system U= Site unsuitable for system CONVENTIONAL: MOUND: IN- GROUND-PRESSURE: IS YSTEM-IN-FILL HOLDING TANK: RECOMMENDED SYSTEM-(optional) ❑ S ®U ~ ❑ U ❑ S ®U El S ❑ S mound If Percolation Tests are NOT required DESIGN RATE: I If any portion of the tested area is in the under s.H63.09(5)(b), indicate: n/a Floodplain indicate Floodplain elevation: n/a T PROFILE DESCRIPTIONS page 42 2 BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL T THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST- HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) 0-8, 10yr4/2, L.; 8-28-, 10yr4/4, sil.; 28-55,- 6- 1 55 103.30 none >55 7,5 r4/4 sl. 0-7, 10yr4/2, 1.; 7-24, 10yr4/4, sil.; 24-58,- g_ 2 58 103.30 none >55 7,5yr4/4, sl. massive 0-8, 10yr4 2, L.; 8-24, 10yr4 , sil.;- B- 3 60 100.70 none >60 24-60, 7.5yr4/4, sl., massive B- B- 6- PERCOLATION TESTS TEST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATER INCH ES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD P- 24 none 0 1 7/8 7/8 34 P- 2 24 none 30 1 % 1 1 30 4 30 P- 24 none 30 1% 1 P-_ P- P- _ PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe 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 direction and percent of land slope. SYSTEM ELEVATION 104.00 : a e- W -IA 3 1 F _ t E 3 3 r E E € ~ [ I- A 1, the undersigned, hereby certify of "atss cdport~this ere made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the c- thdRocation of th are correct to the best of my knowledge and belief. to C ti NAME (print): T, TESTS WERE COMPLETED ON: Gary L. Steel 7-30--92 ADDRESS: CERTIFICATION NUMBER: PHONE NUMBER (optional): 1554 200th. Ave., New 54017 CST SIGNA DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. ILHR-SBD-6395 (R. 02/82) - OVER - INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 To be. a complete and accurate soil test, your r ..)rt must include: 1. Complete legal description; 2. The use section roust clearly indicate wheth is a residence or cc in- I project; 3. MAXIMUM number of bedrooms or comme use planned; 4. Is this a new or replacement system; 5. Cori : to the suitability rating boxes. A q T'. SUITABLE FOR A HOLDING TANK ONLY IF ALL (-Ti ^YSTEMS ARE RULED OUT ON SOIL CONDITIONS; 6. PL E use the abbreviations shown here writing profile descriptions and com;, ig ie plot plan; 7. (i"AKE A LEGIBLE diagram accurately locating your test locations. Drawing to sc.;ir is ;referred. A -a' sheet may be used if desired; 8. re, your benchmark and vertical elevation reference point -nanent; ;:e all appropriate boxes as to dates, names, addresses, flo ,errip- tion, if appropriate; 10, If r;ie information (such as flood plain, elevation) doe<, i pla I`° ~ tf ~ box; 11. Sign the form and place your current address and your C.., ,at+on r; 12. Make legible copies and distribute as re(tuired. ALL SOIL TEST F _ 'VITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st - Stone (over 10'") BR - Bedrock coo) Cobble (3 - 10") SS - Sandstone gr - Gravel (under 3") LS - Limestone s - Sand HGVV - High Gioi r cs - Coarse Sslnd Perc; _ Perc~it. to nwd s - Medium `sand Vt - 1A4,II fs- Fir _ Bldg - Is - Lo i Care Than `sl - Sandy Lr-jm < Less Than 'I - Loam Bn Brotrn sil Silt Loarn BI Black si - Sill Gy - Gray cl Clay Loarn - Y(", 11otn~ sc! - Sandy Clary Loarn R Reel sicl - Silty Clay Loam n,o- - Motll-, sc - )cly Clay }"v - v",itI sic - ty Clay fff pt. Y iy CC - Corr' 1)1. at mar - (Many, r- rn truck d - dstinct p - Dr'Omrn( It HV,1 L I-1 i g h v,, S` I '-Ktures SIP ` , fol disposal BM Bench a.VRP Vertic,. TO THE OWNER: T` 'test report is the t6l, r ;;l SeCUrin1 ° sanitary €r.! . The county or'tt Del, : ~t ast rnaiy request n of this soil t~"" field prior 1o p+'m^ A com 'ete of , r t' p = and %i permit ..ralication must be sut m' ii- api _ 'fruit. The sanitary pertnit mush be obtail I for to t