HomeMy WebLinkAbout004-1048-95-100
STC - 104
AS BUILT SANITARY SYSTEM REPORT
OWNER
ADDRESS L] ~6~ /-P-~ Off. r'7Qn~( rJ~d/0 ice' • 0279 0291'.
42,~d4~~, Spr~7 wu~
SUBDIVISION / CSM# ~s LOT #
SECTION _T N-R li-W, Town of ~CQ
ST. CROIX COUNTY, WISSCO ~INS~ 32~A
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
r`
u
vov~~P70
co... b~ task
1b0
~ t MO
INDICATE RTH A RO
w
'Yy n \ J "
t P ovid etback and elevation information on reverse of thi form. j
re 2 dimensions to center of septic tank manhole cover.
BENCHMARK: crvl-
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION
Manufacturer: ,0etsey-c Liquid Capacity: u r-.~v
Setback from: Well 13()' _ House SL% Other
Pump: Manufacturer ~v Model#3' Size y~
Float seperation Gallons/cycle: / 9
Alarm Location Weu c,
SOIL ABSORPTION SYSTEM
Width: Length 9</ Number of trenches /
t.
Distance & Direction to nearest prop. line: igo
Setback from: well House Other
ELEVATIONS
Building Sewer ST Inlet; ST outlets
PC inlet f PC bottom Pump Off 9,~
Header/Manifold Bottom of system 1
~~.2•~
Existing Grade Final grade
DATE OF INSTALLATION: (o
PLUMBER ON JOB:
LICENSE NUMBER: INSPECTOR: 3/93:jt
L( T4(ATpr,rtCAMn&1t.y?8.15 (29 ATE SEWAGE SYSTEM County:
Labor aril Human Relations INSPECTION REPORT
'-Safety and Buildings Division
GENERAL INFORMATION (ATTACH TO PERMIT) Sanitar rinit
Permit Holder's Name: ❑ City ❑ Village X Town of: State PIZ%M 1:
~ , yF '
S lev.: r Insp. M Elev.: BM Description. Parcel Tax No.: i
004 J-048-11 -
TANK INFORMATION ELEVATION DATA A9200442
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic 0- Benchmark 6. ,S, Z5' cff
G
Dosing eDm 6111a467" 41-nK 660
Aeration Bldg. Sewer
Holding St/ Ht Inlet `
TANK SETBACK INFORMATION
TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet
Air Intake
Septic NA Dt Bottom Ar~0. r
Dosing NA 6leader / Man.
Aeration N Dist. Pipe 5/S G0.58
Holding Bot. System ZZ~ ~
5•
PUMP / 6N INFORMATION Final Grade
Manufacturer a a/~ D> nd ~O•//
i
Model Number 3 3 ~ GPM
TDH Lift f Lrictio
' System TDH 11,tP Ft
Forcemain LengthDia. Hr ` Dist. To Well7/
SOIL ABSORPTION SYSTEM
/ TRENCH Width i Leng/ / tI~ / No. Of drenches PIT No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS DIM
SYSTEM TO P/L BLDG WELL LAKE/STREAM ACHING Manufacturer:
SETBACK
INFORMATION Type Of /r CH ER Mo a Number:
jnz?f OR UNIT
System: gj
DISTRIBUTION SYSTEM
Header / Ma ifold Distribution Pipe(s) x Hole Size,, x Hole Spacing Vent To Air Lntake
Lengt Length Dia. Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over f Depth Over r xx Depth Of e/ xx Seeded/ Sodded xx Mulched
Beef/Trench Center Ge*/Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.),-51-
LOCATION: CADY.21.28.15 290TH)
01
id
Plan revisi n required? ❑ Yes o p~
Use other side for additional information.
SBD 6710 (R 05/91'/AS Dat Inspector's Signat re Cert. No.
ADDITIONAL COMMENTS AND SKETCH
f
SANITARY PERMIT NUMBER:
SANITARY PERMIT APPLICATION
=:T:ffff1 F Inaccord with ILHR 83.05, Wis. Adm. Code couNTY
- ST. CROIX
STATE S NIT~~EERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than
8'fi x 11 inches in size. ❑ Chec if revision to previous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. S93-20535
PROPERTY OWNER PROPERTY LOCATION
JR. GLENN HOVDE NW Y4 NW Y4, S 21 T 28 , N, R 15 E (or
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
77 COULEE ROAD N/A N/A
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
HUDSON t-J1 54016 715 489271
11. TYPE OF BUILDING: (Check one) ❑ State Owned ❑ VILLLLAGE : NEAREST ROAD
CADI 290TH ST
❑ Public X❑ 1 or 2 Fam. Dwelling-# of bedrooms--! PAR L UMB
Ill. BUILDING USE: (If building type is public, check all that apply)
1 ❑ Apt/Condo J cr
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. ❑ New 2. ❑ Replacement 3.0 Replacement of 4.0 Reconnection of 5.0 Repair of an
System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 ❑ Seepage Bed 21 ® Mound 30 ❑ 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 (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION
450 750 750 .6 N/A 99.8 Feet - 1 Feet
VII. TANK CAPACITY Site
in allona Total # of Prefab. Fiber- Exper.
App
INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic
Tanks Tanks structed
Septic Tank or Holdin Tank 100 1000 1 WIESER CONCRETE X
Lift Pump Tank/Si hon Chamber 600 600 1 WIESER CONCRETE X
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans.
Plumber's Name (Print): Plumber' Signature: (No Stamps ) MP/MPRSW No.: Business Phone Number:
BEA1idIE HELGEISOP1 3215 715 772-3278
Plumber's Address (Street, City, State, Zip Code):
W1229 770TH AVENUE SP Il.1G VALLEY tell 54767
IX. COUNTY/DEPARTMENT USE ONLY
Disapproved Sanitary Permit Fee (includes Groundwater a e Issued Issuing Agent '
❑ Approved ❑ Owner Given Initial Surcharge Fee) c,
Adverse Determination
X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety& Buildings Division, Owner, Plumber
INSTRUCTIONS
1. A sanitary permit is valid for two (2) years.
2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new
criteria in the Wisconsin Administrative Code will be applicable.
3. All revis;--ns to this permit must be approved by the permit issuing authority.
4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Fc;-rn (SBD 63~ti9) to be
submitted to the uounty prior to installation.
5. - -6nsite sewage systems must be properly maintaiied. The s~-ptie tank(s) must be !:r cis Ucensed
pumper whenever necessary, usually every 2 to 3 years.
6. If you have questions concerning your onsite sewage system, contact your local code adrn+nistrator 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.
11. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family :welling.
III. Building use. It 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
VII. Ta;r«, ,orlon Fi!1 'in 'he capacity of every new and/or existing tank, 'isi th , lot rl nirnber of
tanks and panu, arrre 's name. Indicate prefab or Site constructed anal tank ma. k>i'•. t-!i for all
septic, pUr°cp/siphon and h0ding tanks for this systM. Check cs err ;,t~~ rppr wal c~t _;fi-,., received
exp (,Ie l ;,ro pct approval from Dll_HR
VII! ! espcr~ ~ii~ility statprnYnt. Installing plumber is to fi!i in name i( .r,se rw !r ber `n,itr, app) 3!t~ i?,efix (e.g.
;P, eta:.: r an_: ph,)ne number. Plumber must sign application fr, m
IX. Ceunfy; ;eparfine~:t Use On!y.
X. on:'y-
Complete lan ind specif cations not smaller than 8% v 11 inches must be submit Jh~c(-junty, The
plans inciuii? tfle following: -r) plot plan, draw'1 to scaie or with corer F' .n of
ht<<=~~ „ : ii~;S` pt~~ -ar!k(s) or ether treatment tanks; buildimcl sewer: , usie; ;rrrt?'per service;
sivearrr,v H~,~IctKt~`~:; purnp or siphon tanks; distribution boxes.. BC1~i a.bso~ i:?ti-rl SYS"On"'S c q.,r~..-, oe.,-t systern -
.jr.t!c, of. the building served; l?) horizorta, are i :erticj. ,i£,.s'rr' .,,f t :F ;e,; nt;;
G) complete spec) ications for pumps and controls; iJose volume; elevat yr d;ffereric_;!s; tr;c;t:o i loss; pump
perforrnanc:e curve; pump model and pump manufa,,-turer; D) cross section of the soil absorpflon 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 pracliCes which can effect groundwater.
The rnonies olr cted thrt uch i' ese S ; c:hafge s 1-,re °~re fnr n)dnrtC'r;: (,rt; `din 34s?r
water ;:onlarou-ration invest-yations and ustah is at k of str$v. J,3rds
SBD-6398 (R.11/88)
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY &BUILD INGS
INDUSTRY, DIVISION
LABOR AND PERCOLATION TESTS (115) MADISP.O. BOX 76
HUMAN RELATIONS
ON WI 53707
LHR 83:09(1) & Chapter 145)
LOCATION: TOWNSH MUNICIPALITY: LOT NO.: BLK. NO.: SUBDIVISION NAME:
NU)'/ uJTp N/R/5-E (f q,Q
COUNTY: (OWNEWSOBUYER-S-VAME: A I D R SS:
0 3ah a5`1 r1~ ~a S~
USE DAT S OBSERVATION MADE
NO. BEDRIA 1, FILE DESCRIPTIONS: PERCOLATION
L~fiesidence R ~ TESTS:
J ONew L_`tReplace /O y r~ ivJ
!v ~ I
RATING: S- Site suitable for system U- Site unsuitable for system
M Y : MOOUN'', N-GROUND: S N-FI HOLDI TANK: RECOMMENDED SYSTEM: (optional)
IS L_J S E9 I OS I
D S C` CCIU
- - I
If Percolation Tests are NOT required DESIGN RATE: i
If any portion of the tested area is in the
under s. (LHR 83.09(5)(b), indicate: N Floodplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS
BORING TOTAL DEPTH T GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTH IN, ELEVATION OBSERVED HE TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.)
- ST
B- -410 47 C) 9/ :5 Ts 3"car S1/ a?"',PdBh SCL `j/„13fMet
!S J" t~ia ~i~ .2~'Q7 5.( e-)
3% t „ to " 61 S;1 TS q",6, S,*( „ (3K 5", 'M.~
5'c L
B-
B-
PERCOLATION TESTS
TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 P I D PER INCH
P-
P-
P-
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 percen
of land slope.
SYSTEM ELEVATION
i
--S - _ ~1 1,
i
. N
s.
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 Wisconsin
Administrative Code, and that.the data recorded and the location of the tests are correct to the best of my knowledge and belief.
NAME rint : TESTS WERE COMPLETED ON:
tsO.•`
ADDR
ESS: ' r CERTIFICATION NUMBER: PHONE NUMBER (optional):
PC) L4 1-7
CST SIGN TORE:
l
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 10/83) - OVER -
tNrttontrnDews ment of lnustry' bUIL Ut~Lt%lt' i lvrs rsL r un r
Labor and Human Relations' = U Sox :It- (Attach Soil Profile Location Map - To Scale • On A Separate, Signed Sheet) Maditon,141 =3%.
Page
C AtLYra w&GV ,o CVMfHt Lme Ue6/VtO COMA ►An@rr ►Mttnvf, KMVAVECT 0. t►y~t4t
,j /to I D Ar Clover 5 LlJ lA it ~/tl
ORY
dta S~ arATe S , 1,1 g 0 ( ens LoAOw 600114 e
ex -1476
LOCA1r71 f0.TL?I ipWM ► rAX PAM IraJAatn
9C>RIAIC C S M r
LOT BLOCK' sunolvislotr _ rrzw _ "V%,Aei
3. , Horizon Depth Dominant Color Mottles Structure Llmlting Factor/ Loaant;WDIK
In Munsell u. St. Cont Color Texture Gr St. Sh. Consistence Roots Boundary Dspth Trench eta
0- 10Y 0 E. s6 MA- ~ IlF aw , b
ilt:v = ~
1-1 10,18 1 c. l r,,4 V4 . 3 P
9/v 3 13- 121 o t S M t y L~ E s+
<•.w is -3 3 P sb t 5
~ S.
Horizon Depth Dominant Color Mottles Structure
E3 z In. Munsell u. St Cont. Color Texture Gr St. Sh. Consistence Roots Boundary Depth Irte Bed
I -i 10~k VI - i a 5b w S-
Elev
-2 I-I to
~yfz ~ l~ 1 1 r» I t A) P
L P 3 Iir o R 't ✓ L,.3 . (.4
v <M 3 t° C~ F hF t~
rr C~' 4
B, I Horizon Depth Dominant Color Mottles Structure' Ltmltlng Factor/ Loadnq<1PDes4 n.
Ina Munsell u. St. Con Color Texture Gr. St. Sh. Consistence Roots Boundary Depth Trench tied
o- 10YR i Ale, ~ii~~ s
Elev-
o f 0, '
6ps a_I) o yR rl b
44 1-) 26- to `y s b c, C~
c.~ d cs~ H.C!✓
B (Houton Depth Dominant Color Mottles `structure Limiting Factor/ Loading4PD1s4h.
In. Munsell u. St. Cont. Color Texture Gr. St h Consistence Roots Boundary Depth Trench Bed
Elev
B- Horizon Depth Dominant Color Mottles Structure Llmfling Factor/ LoadngaPD,syh.
In Munseil u.S Con Color Texture Gr St h. Consistence Roots Bounda Depth Trench Bed
Elev ra
a
Additional Remarks: RECOMMENDED SYSTEM pTYPE: r n n t-%-v,,
ca.~s.\Y't~ tfo k ) X to v. S. 41- s sE'~n ri e'l~ l'I lornc,-l
o h cJl ~n Q C.ti A w oX e e {~t
Uttter site Ftall~~urec
Y
0 , /C i (7 f ) -7 7..)-32 7x 30`
- 9^a Date Sined
System Elevation 9 Telephone No. CST
,I
h v. -2 1~1 e c s o. 1 UL I E i Sy 7 6
CST Name (Print) city Slate Zip
V \ CI--N_
~ p
(mil ~G
04
Po<<
Pao~~ Al~~ raU,~
LO
Fes! ~O/~` o
;ILH For--c ~a..
I I!
i
L ~roPssa--~
s; 1 \ Jvl o ` n!
,-j, rJ-/
63
OJ
b~
0
v
sv/ /,Lo.
.ti ~Tl SE'N~'•.`.E.
PKi
ft
a~ RE~A1 @NS
pEPARTME~C~I~ , ` I z
r ~H
E
POND C
GORF.
cJ lx ,n " Q ° d
S93-20535
Page Of
Cross Section Of A Mound Using A Trench For The Absorption Area
loo. ,43
Medium Sand Fill F -6 Topsoil
99 8a
3 E D
Trench Of 23-2" Aggregate, ,y~ g17 Bg. Plowed Layer
6 Below Pipe. Covered With D y~ Ft.
Straw, Marsh_Fay`~, ,ygth%tftl'F"ric
{~~RVVA ~ E 2. !(o Ft. G / Ft.
. 6 8o Ft. H Ft.
RE-AIIOIS
DEPARTMEN T D - , UIDiNC,S
D~JIJiJ'N `
P1 n View Of nd Us h The Absorption Area
R SPO EN OE
Force Main
J Distribution Pipe
Permanent Markers Observation Pipe
A o -o
W 6 K
r •Y•
\Trench Of - 212" Aggregate
I
f L -
f A I ~v S Ft. K/ Ft. W age 1 Ft.
B Ft. J 9•(o Ft. L / Q Ft.
License
Signed: 2, 1 ;-Z//
Number: Date: (p-~~ -y3
S93- 2053 5-.
0(s~fneV My Gkev,,w
A rte.. L -1:3
P~2-rp2A-T =b 7->l Pc Z,- _ I L
U~ V ~L' I
J
r' • o-- \iJ~THLI PEIZ.HHIJE~.7T }^~~.'.F"~~~-'~.
O S'' AT EUt) Or 6Ir CH Lf,TL'RAL
CA
Q
ZiUIES LU^.Ii ~J p{J c~JTZIM Cl-
.f+ _.~I.~E R1JD ARC 1='OVPLt.Y SPAC:.ti~ .
pVC
/ pRGE H H ! 1J
' FRAf'1 1~t1 h P
-PVC- ' LAT•c-~LS
1JEx.'r 'c'o ~..iJ CnP
~J\S~RIBUT703J. PIPE
- " T L i~ P FT.
iC_
PV,iv A
C?•
ca
L~ DtAn_.__ t~
All IONS
DFPARTMI N D
OF 1 WLES/J~1 PI- /q
. r~ r.F
`LCD C 4~-~=~-FDP..
}1JV. El£V: pF lAT6P.A LSIAC-O, C/-3 r-T;
N
C sT ( ~Ror'1 T~ w17N Su cc~~lti1 G 1-t~LEs ~-T.y~ ~ ) lJ'~U~-C,S .
HOLE t_AcST t-to~-E 'T~ ~.1Exl' '7D T1"FE END CJ~P.
593-20535
`T ~''e to l~ C n U
SEPTIC TANK 8 PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS
4" CI VENT PIPE 12If MIN. ABOVE GRADE 6 WEATHERPROOF
I
2S' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED
FRESH AIR INTAKE WITH CONDUIT MANHOLE COVE.
W/ PADLOCK c
FINISHED GRADE WARNING LA3E
y µ1'v e: "4 ; . 4r_- 4 " MIN.
18" IN. 6 M X®aa
INLET 1
GAS -
5 4~ S
p P A IR Off c- NI
pwis;ul t TIGHT ~\JAPPROVED
t SEAL JOINTS WITH
APPROVED FOND Cr_ B ALM APPROVED PIPE
S_ CORD i ON 3' ONTO
PIPE 3 ONTO SOLID C ' SOLID SOIL
I
SOIL pevEtSELEV. 19 -SFT. OFF RISER EX=
APE BED f wAC D PERMITTED ON
PR ►I~HR 15(4)\C--_'_ IF TANK
MANUFACTURER
HAS APPROVAL
iqA PPROVED BEDDING UNDER TANK
ANCHOR ILHR $3. 50)(0)
4
CONCRETE PAD
SPECIFICATIONS
SEPTIC / DOSE
TANK MANUFACTURER: (J~}e~sers NUMBER DOSES PER DAY:
TANK SIZES: SEPTIC /c7bU GAL. DOSE VOLUME INCLUDING
DOSE ion GAL. FLOWBACK: 13 y, 7y GAL.
ALARM MANUFACTURER: S ,T. F1,Jv, Sys4,,CAPAC I TIES: A = a5 INCHES = 301.41 GAL
MODEL NUMBER: to i t4
SWITCH TYPE: _Mle+re ^u_v_~t F'__}- B = 2 INCHES = ,13GAT
PUMP MANUFACTURER : C = 11 INCHES = 1 ql. 8 GAi
MODEL NUMBER : l
SWITCH TYPE: D = 13 INCHES = S% 93 GA?'
' 2-
REQUIRED DISCHARGE RATE GPM PUMP & ALARM WIRING AS PER ILHR 16.23 w
VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE R.f3 FE-T
+ MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . . 2.5 FEET
+ /(,D FEET FORCEMAIN X 5 FT/100 FT. FRICTION FACTOR FEET 3.4
T.OTAL DYNAMIC HEAD - _FEET (4.63
INTERNAL DIMENSIONS OF PUMP TANK: LENGTH ; WIDTH ; DIAMETER
~__Q_ _ 7 LIQUID fr=
~ioQc, sh~.e~ S93- 20535
SIGNED: _ LICENSE NUMBER: 3,1 f DATE: -"7
1/818
0 11 A -AP
3?/ ~ MODEL: 3871
uSIZE: 3/4" SOLIDS
Effluent Pump RPM:
U
METERS FEET
8
25 -
7
= 6 20
a 5
15
} 4 _
I I
g 10
E-
5
1
1 A-
0 00 10 20 30 40 50 GPM
0 2 4 6 8 10 12 m3/h
CAPACITY
CQGOULDS PUMPS. INC.
SeECA FALLS FEW lOPK 13148
S93- 2053 5
Effective October, 1988
01988 Goulds Pumps, Inc. SPECIFICATIONS ARE SUBJECT TO CHANGE WITHOUT NOTICE PRINTED IN U.S.A.
• W
A O 0 c: ' tN N G7
N ~
6
OO HV' o ,QnnQ~ O I ~o
gn C,4
be z
0 1;; Z N • H o N G~ 3 d l i
z -4 LAA 03
H w PA a En o
H W
Q O W H 0 H O O 94
Q ~ U V a O
U ra O 3 z p 1.4 W W+ A Vl H ^ W
w 6 O W: H W
3 ca a w • v ~1 w 10
m A H 9.4 a
3 a-1 r4
w o °o p
H O v~ as PI 0 W o x"
cn
W :o
•o a - w i~ w w a x
+ H x
1-4
-4i I O H •••D N c~1 3 1. T
0 0 0 Q
v, a Z 0 w x a o r A r~
U z u H z FQ U x H .7 H UI H
w z H W W Wa
-.4 0 i oo •I I'~
U7 I - I
-r a
IO i
~ w _ IL
P
m"L
/ ~0 m
4 zN ".I
z e
/ SECTION 100
t4~J,6;R-O-rnATIC DIMENSIONAL DRAWINGS
PUMPS & PERFORMANCE DATA
MODEL: OSP33 SU13MERSIBLE SUMP PUMP -MAX. SOLIDS s/.„ SPHERE -1750 RPM
Lit. No. 113.5 348
TOTAL
HEAD _ '/lo HP MOTOR
IN FT.
24
22 y
20 tc,9OC'9
_ _ A
18 qC~
16
14
12
I
10
6
s I FULL LOAD
AMPS AT 115 V.
4 6.5
2
0 10 20 30 40 50 60
U.S. GALLONS PER MINUTE
319
MODEL:OSP33
4 7
O
43/s O
O 51/4
O
O •
O •
9'/4 4
• O.
11/4 STD.
PIPE THD.
251,e '
• ~ 43/s
NOTE: CASTING DIM. MAY VARY t Vs
ST C- 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER ('TFNN T4n0VT)F TR
ROUTE/BOX NUMBER Icy - r(t(&bjp Lamp 1,046-o' Fire Number
CITY/STATE ZIP 5~'7(Q~. ~
i
PROPERTY LOCATION: NW I, NW 1&, Section 21 T~.8 N, R19W,
Town of CADY , St. Croix County,
Subdivision N/A , Lot number NfA
Improper use and maintenance of your septic system could result in
its premature failure to handle wastes. Proper maintenance con-
sists of pumping out the septic tank every three years or sooner,
if needed, by a licensed septic tank pumper. What you put into
the system can affect the function of the septic tank as a treat-
ment.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 systems properly
maintained.
The property owner agrees to submit to St. Croix County Zoning a
certification form, signed by the owner and by a master plumber,
journeyman plumber, restricted plumber or a licensed pumper veri-
fying that (1) the on-site wastewater disposal system is in proper
operating condition and (2) after inspection and pumping (if nec-
essary), the septic 'tank is less than 1/3 full of.sludge and scum.
Certification form will be sent approximately 30 days prior to
three-year expiration.
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 Depart-
ment of Natural Resources. Certification form must be completed
and returned to the St. Croix County Zoning Offkf-e within 30 days
of the three year expiration date.
SIGNED j/ O
X
D ATE
- -
St. Croix County Zoning Office
P.O. Box 98
Hammond, WI 54015
715-796-2239 or 715-4,25-8363
Sign, date and return to above address.
APPLICATION FOR SANITARY PERMIT
STC - 100
This application form is to be completed in full and signed by the owner(s) of the
property being developed. Any inadequacies will only result in delays of the permit
,
issuance. Should this development be intended for resale by owner/contractor, ( spec
house"), then a second form should be'retained and completed when the property is
sold and submitted to this office with the appropriate deed recording.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Owner of:.Pioperty GLENN HOVDE JR''
:.Location. of Property NW NW '-L, Section 21 , T 2$ N-RW
Township CADY
=Mailing Address 77-COULEE AD
HUDSON WI.54016_
Address of Site l'~lA~l~e -~a~ye / c~~l~fh ~f- Prt~S ~c~l~2st, We, 76 7
...Subdivision Name
Lot.Number k1A
Previous °Owner of property jai r
Total. Size of-Parcel &4-es
Date Parcel was`Created / -
!ire all corners and lot lines identifiable? Yes No
Is this property being developed for resale (spec house) ? Yes ~C No
Volume 9 gb and Page Number w 'a 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 refer-
ences.to a Certified Survey Map, the Certified Survey Map,shall also be required.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
PROPERTY OWNER CERTIFICATION
1 (We) cvLti 6y that att 6tatement6 on th .6 6oAm aAe true to the best o.6 my (ouA)
k.nowZedge; that 1 (we) am (aAe) the- owneA(.6) o6 the pAopenty deb ehibed in this
.in6oAmati,on SoAm, by viA tue ob a waAAanty deed Aeconded in the 06~ice ob the
County Reg.i6teA o6 Deeds" Document No. ; and that 1 (We) pAeaent2y
own the phopoded z to joA the aewcige dibpoa byatem (oA I (we)- have obtained an
easement, to kun-with the above desoLibed ptopeAty, Sox the eon6tAuctcon o6 6ac
aystem, and the Game has been duty Aeconded in the 066ice o4 the County Regi,6teA of
Deeds, as Document No. j
SIGNATURE OF OWNER SIGNA.URE OF C0-0 ER (IF APPLICABLE)
.DATE SIGNED DATE SIGNED
DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1-1982 THIS SPACE RESERVED FOR RECORDING DATA
WARRANTY DEED
491475 VOL ^,.980PME 60;xo RECIISTIRf$
This Deed, made between ..Lyle..Chris-topher son-,.-a.......... R
ST. eed for for Rec
single..man---------- Record
NOV12100
- • ------------------------------------------------Grantor, lit. 12 :30 P. M
and-Gl.enn..F.--Hpv_do__and__Rita_.M,.-_Hoyde_,__husband_and__-__-__
- a ~
viT1f_e as.. surv vQrsh p magi------ roperty -
RIpl~etoiDee
, Grantee,
Witnesseth, That the said Grantor, for a valuable consideration......
conveys to Grantee the following described real estate in St.-_-Cro1x........... RETURN TO
County, State of Wisconsin:
Lot One (1) of Certified Survey Map dated August,
13 1992, recorded September 30, 1992 in Vol. 9 of Tax Parcel No____________________________________
CSM at page 2544, as Document Number 489271,
described as follows:
A parcel of land located in the Northwest Quarter of the Northwest Quarter (NW4 of
NW4) and the Southwest Quarter of the Northwest Quarter (SW-41 of NW4) of Section
Twenty-one (21), Township, Twenty-eight (28) North, Range Fifteen (15) West,
Town of Cady, St. Croix County, Wisconsin, more fully described as follows:
Commencing at the Northwest corner of said Section 21; Thence S 0000100"W along
the west line of the Northwest Quarter (NW4) a distance of 1035.14' to the point of
beginning: Thence N9000010011E, 380.001; Thence S 003811311W, 581.001; Thence
S 8505010811W, 374.52' to a point on the west line of the NW4; Thence N 0000'00" E,
608.16' to the point of beginning. Contains 5.14 acres subject to Maple Lane
right of way.
SFE
+1 ID
This s..Ilot........... homestead property.
(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
all easements, restrictions and rights of way of record.
and will warrant and defend the same.
Dated this 9•-•••----•---------•° day of Nove bar--
(SEAL) (SEAL)
* .I,.y]e.-Christo --arson
*
...................(SEAL) (SEAL)
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) _~_yle..CYlristaphersQlt'. a STATE OF WISCONSIN
ss.
----single.. man-------------------------------------------------------
County.
r--Richardson ay f_-N -ember.-.-.., 19.92. Personally came before me this day of
1 19-------- the above named
•
ichardson-------------------------------
STATE BAR OF WISCONSIN
§ 706.06, Wis. Stats.)
to me known to be the erson who executed the
foregoing instrument and acknowledge the same.
NT WAS DRAFTED BY
ROBERT J.__RICHARDO----------------------------------------------------
Attorney--at I a..........................................
.----..Spx1ngy .-V-alley-_ WZ_- 547fl7__-__-_-___-_-__-__ County, Wis.
Notary Public
(Signatures may be authenticated or acknowledged. Both My Commission is permanent. (If not, state expiration
are not necessary.) date:
•Names of persons signing in any capacity should be typed or printed below their signatures.
WARRANTV T%I..rn STATR BAR OF WTSCONSTN T.,,•.,n o,...t. n.. T...,