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HomeMy WebLinkAbout008-1025-20-000 -0 C) Q) o ~ o a 4 0 c O y d N i N O a v, N E I w, I L L O h I p~,a c m I ~ o c Q U N a) a) a O. ~ C a) v, C w ~ O N a) C 5 _NC_ N L]. E p z U N yO 7 N -0 f6 7 LL C C O O a) y 3 y Co co a) C Q N L. 3 M v ~ z y ' O z 0 O z V m y 00 (L m 0) ' c L v°, o I (7 a) o z v Z m z d' ~ ~ o (D z E '2 O M o v N C •MV -O O 7 O m O Z Z - E N z N N V 00 pj ~ L I N U LO a 'M V m i a) w O Lr) 0 0 d E C C ~~V Y ~+y ~ c H 1- F' 2 J ~i :2 O O O z •iV m a m m a a~ (V 3 O N O co M a) m rn o f~ J U (n rn Z 'O CO 7 :7 'a CO F41y Cl) 00 a) 00 C) ! M N C N N 11 O 00 'N" I~ m I cn a) 0 w O J N N is 3 1 O O C C lot N (O O © O! N U O w O O O O C) Co F- CV N! O O. C N N N lV, Y CF w C N O a) C O a) N"t co N_ 0 C', w _0 06 (U O' N O C C r co 0 w ca Q L a? . a v ~ y 3 a J L A U L 0 0 0 STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER C~ ►~.J «P L~.7 ADDRESS SUBDIVISION / CSM# LOT # SECTION T N-R Town of ST. CROIX COUNTY, WISCONSIN L PLAN VIEW SHO E YTHING WITHIN 100 FEET OF SYSTEM r 0 1 r, M pwd- - M~ 5 IN CATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. BENCHMARK: b tt ALTERNATE BM: SEPTIC TANK / PUMP CHMBER / HOLDING TANK INFORMATION A 14( we f91- c..4 % f- Manufacturer: Z--Q~-~ Liquid Capacity: Setback from: Well S~ House L O Other Pump: Manufacturer 2a-e~~..•tr Model# tb Size ~t Float seperation Gallons/cycle: o~ Alarm Location- Lk rn ate. ~d SOIL ABSORPTION SYSTEM Width: d < Length 6 _ Number of trenches 1 Distance & Direction to nearest prop. line: 5 t Setback from: well: 900 House 1, r.O 1 Other ELEVATIONS Building Sewer 4 .p- ST Inlet _ ST outlet < < PC inlet F 46'1 PC bottom '90.k>- Pump Off Header/Manifold Bottom of system Existing Grade 11 ( Final grade 6*-X~ vo. DATE OF INSTALLATION: PLUMBER ON JOB: 1 Y ~J~-C LICENSE NUMBER: INSPECTOR: 3/93:jt LWf tpart n~►TiTot~ s 9.28.16 -MKTE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division ST_ rRQ1X GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: 199933 Permit Holder's Name: ❑ City ❑ Village R Town of: State Plan ID No.: KA 7rN EAU GALLE ev.: Insp. BM Elev.: BM Description: Parcel Tax No.: 1 00-R-1025-20-000 TANK INFORMATION ELEVATION DATA A9300339 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Aeration Bldg. Sewer Holding St/ Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet Verit TANK TO P/ L WELL BLDG. A irIto ntake ROAD Dt Inlet Septic NA Dt Bottom Dosing NA Header/Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft oss H Forcemain Length Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK INFORMATION Type O CHAMBER model Number: System: OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia- Length Dia. Spacing 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 ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) a LOCATION: EAU GALLE 9.28.16.128A _v . F 1 ~ t,1 Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD-6710 (R 05/91)--- - ~~i4~ Inspector's Signature Cert _ No. s 7 DILHR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than 1 8% x 11 inches in size. ❑ Check if revision to previous application -See reverse side for instructions for completing this application. STATE PLAN I: l). NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER ~I PROPERTY,,,LQCATION N,A- L o ! y i i C> /I n $ Y. NO Y., S T :Z95, N, R E (or) PROPERTY OWN S (LING ADDRESS LOT # BLOCK # 1 7~a Th ,4- A,, -e CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER II. TYPE OF BUILDING: Check one CITY NEAREST ROAD l ( ) ❑ State Owned 0 VILLAGE ❑ Public 0 1 or 2 Fam. Dwelling-# of bedrooms PARCEL AX Nu III. BUILDING USE: (If building type is public, check all that apply) B 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 40 Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TY~~P771E OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. V9 New 2.E] Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit # - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 Mound 300 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) [1~/' ELEVATION 3 7 ,S 7 Feet 1,,--7o,3 Feet VII. TANK CAPACITY Site INFORMATION in allons Total #of Manufacturer's Prefab. `Fiber- Exper. New istin Gallons Tanks Name Concrete Con- steel glass Plastic App Tanks Tanks structed - Septic Tank or Holdin Tank 16%1 v / Lift Pump Tank/Si hon Chamber I / 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 Sta ps) MP/MPRSW No.: Business Phone Number: c fi x is Z . G ~h s ~ 6 -3 30 Plumber's Address (Street, City, State, Zip Code): IX. C NTY/DEPARTMENT USE ONLY ue Issuing Ag nt Signatu Sta s) ❑ Disapproved Sar~jtary Permit Fee (Includes Groundwater 717 Approved ❑ Owner Given Initial urcharge Fee) Adverse Determination 1-4~2 X. CO NDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety a Buildings Division, Owner, Plumber te, ' s 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 renew -A any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer Renewal Form (SB 8:990 to be submi#red to the county prior to installation. 5. Ons;te sewage systems must be properly maintained, The saptic tank(s) must be putt ~,,efd t• 1^censed pumper whenever necessary, usually every 2 to 3 years. 6, hyou 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. Ji. 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 cn system type. VI Absorpti"-r, system information. Provide all informat on requested in ##1-7. VII. Tank ir,f=~rmation. Fill in the capac<ty of .every new and/or ex~~,I Mn tank, `ist the total Al i~nP~er of tanks ano.i manufacturer's name lndicaie prefab or site constructed orci tank material. tar c. (.c for all sept(-,, p::i p.,siphon and holding tanks for This system. Check expr =.::r l approva; +.:.r , received exper;m,.-W,ai product approval from DII_HR. VIII. Responsibility statement. Installing plumber is to fill in name, license nwnber with appropYssrarprefix (e.g. MP, etc.), address and phone number. Plumber must sign application loin. IX. County/Department Use Only. X. County/Department Use Only. Complete plan?i vine specifications not smaller than 8'h x 11 inches must be submittc,~ t-) thr crrunty. The plans muses d~. the, following: A) plot pian, rirawr, to scale +r with oniplete. dl 'firm of holding 'sir sF tank(s) or other t A,-:~Pment tanks; buiidi 1o rs, wells; ,va~~ . : z,- t r service- streams; -~r 6 !&ik.es pump or Siphon tanks, distribution boXt°S, s(I'i ~t SCJ !ltit)!1 SySzhl+?z; ~ --~vStern areas; an(the !ovation of the bUi'ding served; 8) horizontal an,-` rtica6 ;'levatior iEtt?renr.e C) complete specifications for pumps and controls; dose volume; tale': a on difference::: friction lo!:;s; pump performance curve; pump model and pump manufa(,turer; D) cross section of the so.i 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 rectUlatCN, pr:~cfices which can effect groundwater. The rnonie.. :+sP'ected through hese surcharges ait.;.Feel i'..r tar s C,i; qro-_t-id'watr`+ water tontarrtincbtion inves?ig3tiJns and establishn.F ;i 1'f gar, Ards- SBD-6398 (R.11/88) CD _0 cn C z 00 z CIO M 0), m 0 m DO WINN ~ r O C m x < M rn U) C) 00 r m ` 0 DO co C O m y C) r x = g = G) D C7 a m n :X) N Cn Z O 0O o C Z U D C/) Fn 0 ccf) -n C 2 < C z 00 m o _ C) O Z O p cn ~5- z I-1 C Z G/ m m I$ ~oN= av vd z coon p m --1 O.j m N Q N N d y~ N N $ N m m 7'~ ~F H SJHo~ ap/ me n m S O M y = MC, m O Q o c Q _ -I 0 3 9' °y m `g o H 3 m rn 3mfD c W ~3°' H »a`~°3 'o A < m m cn rn 7` 7 H N `~'G F W S ~q N W ~v ~ ~ s, SN,a 01 s~ O 0 T co - 3 3 3 fD Co y <3 0 °D'• mm° m ~3 0 m. ovN 3 n' Z m D < g d O Z ~ to. 7 S a O •o m3 0 no. "d m ti 0 s 3 3 o ' c D w 3 2L so. C~ N N ` N N m m m - = m w SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations October 4, 1993 2226 Rose Street La Crosse WI 54603 ART WEGERER PO BOX 74 RIVER FALLS WI 54022 RE: PLAN S93-41084 FEE RECEIVED: 180.00 MALOY, MONIKEN SE,NW,9,28,16W CITY OF EAU GALLE COUNTY OF ST CROIX MOUND SYSTEM The Department has reviewed the above-referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval of the system is based on chapter 145, Wisconsin Statutes, and chapters ILHR 83 and 84, Wisconsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter ILHR 82 or in chapters ILHR 50-64, Wisconsin Administrative Code. This plan submittal approval will expire two years from the approval date, or if a sanitary permit is obtained, plan approval will expire on the day the initial sanitary permit expires. The licensed plumber responsible for this installation shall keep one set of plans with the Department's stamp of approval at the construction site. The installer shall notify the appropriate inspector when inspections can be made. All permits required by the city, village, township or county shall be obtained prior to installation. Inquiries should be directed to me at the number listed below. Please refer to the plan number shown above. Sincerely, erard Swim. Plan Reviewer Section of Private Sewage 608 785-9348 ~4 2314R/ 1 ^cN f~~Li N SHD-6423 (R. 01/81) I Page of 6 MOUND SYSTEM A 3 BEDROOMRRESIDENCE 1 4 LOCATED IN THE SC 1/4 OF THE NW 1/4 OF SECTION q ,T?'8 N, R 1 6 W, TOWN OF k! ~ 6)N l~ ST• C_lu1}~( COUNTY, WISCONSIN. INDEX PAGE l 'of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN .PAGE 3 of 6 PLAN VIEW-CROSS SECTION PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUMPING CHAMBER PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR "a U') 11 L . 1M ~K3 0tE1' z. if f e\ s. H r~'wz 1Ck-~ 2o Z3 30 m AvE . SEP 2 9 W X BLOCS. 01V. PREPARED BY WEGEf:R ER E3 C3 I L TEST I 1,4 Cg AND DES = C- P4 SiERV ICE mom ' AFlTHU 1 S .t U ~ WF_GFFcR ~ F.O. BOX 74 421 K. KAIK ST. ~ SAN" H. RIVET? FALLS. NI 54022 i' 7I5-42`.x-0165 `,04 KK bQ JOB NO. 3 - 1 ~ o PLOT PLAN Page Z of ~ Scale 1"='~ ' 0- ~L Lp0_p' 0o3 IG~ 3/ywDIH. PUc PIPE t-~)cT ITS 8" Otr1. wo~~ FojGt~- PosT. `11 0 S93-41084 tEL a4° t J ~ / J ~ o wk)T CZ H P R (?-T Cm b t S 1v R t3 6) 6 / c~ v S 49 1-4 I~ S_ tiab ~C-E S / ~o' of y` PV C- I S , 96 ,C k a w , . s ~iGj m'i++ ~ : o u`arre~s v m I ; OR & V10 0~ IND11gT8Y LAS Q f SAS 1►1i IiISION i G0 i I w~~ L R~ 1~T LAST Sv PR0} i mny-b l~\, ~T LIiW S T Z S 1- IZU wl `1 Y1_ N k S , NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. ( Z required) 3. Install 4" observation pipes with approved caps. ( Z required) 4. Septic tank to be 1000 gallon capacity manufactured by Y~~pw~s`\~z.1J ~\~s~sT - ~Ur-t~~ eN-~wla~ ~ ~e Aso wttnwrs7~,~ TtiNlt, 5. Bench Mark S A~t3~U~ 6. Divert surface water around mound to prevent ponding at the uphill side. Page Of 6 Y Approved Synthetic Covering Distribution Pipe Medium Sand H_ ~G Topsoil F Elev. CI-),SO E D 3 b 6 % Slope WeoCtj i" Of i~- 2 Force Main Plowed Aggregate From Pump Layer Undisturbed D 1-O Ft. Soil E 3 Ft. Cross Section Of A Mound System Using F IS Ft. I Trench For The Absorption Area G a Ft. A S Ft. H )-S Ft. B -IS Ft. I 1 S Ft. Linear Loading Rate= 6•o GPD/LN FT j `7 Ft. Design Loading Rate= o• 3 GPD/SQ FT K ~O•S Ft. L O~ 6 Ft. A! ternate W Z1 Ft. L Force ain 1 A- >~TSITE B K t W Distribution Trench Of 2~ Pipe Aggregate rmanen Observation PMa rkerrs t YYfEJ i Pipes (Anchor securely) A C 111UUSTRY, LABOR & H L SAFETY 46und Using I Trench For Absorption Area S` J 1 1... P'9 4J ate., Page `J Of Perforated Pipe Detail End View Perforated End Cop) PVC Pipe 1m_ ~o`~a~a°cc lY as Install permanent-marker at end of each lateral Holes Located On Bottom, Are Equally Spaced Q End Cap * PVC Force Main Distribution Pipe Lost Hole Should Be Next To End Cop Distribution Pipe Layout Coil X Inches y ~`l_ Inches F pRO Hole Diameter 5~J6Inch DEPT. OF INDUSTRY, LABOR i H A -7 N Lateral Z Inches ) DIYIS! OF SAFETY AN r- Manifold " Inches Force Main 2 Inches SEE CAF P 6 # of holes/Pipe 13 Invert Elevation of Lateralsgg•o Ft. `i If Place lst hole 1-7 from tee with succeeding holes at 3Y intervals. Last hole to be next to the end cap. PUMP CHAMBER CROSS SECTIOIJ ARID SPECIFICATIDKIS ' PAGE 5 OF ~ • r VEAIT CAP S93-41084 ti" C.I. VENT PIPC r__T WEATHER PROOF APPROVED LOCKING MANHOLE 10 ' FROM DOOR JUNCTION DOX COVER WITH WARNING LABEL ~ . 12•MW. WINDOW OR FRESH - AIR INTAKE I GRADE `I" MIN. 18' MIiJ. COIJDUIT IB"IKIIJ. \ W LE T ~,I'eM PROVIDE AIRTI&HT SEAL I III - - • ~ *''"`A~ ~ I III APPROVED jot A z ' Tankr ion, shall comply I I I APPROVED JOI11T$ with approved 1ait1-"R 8 an ILHR 83.20 I III pipe extending ALARM 3 feet onto a F,°>iu~iS I II solid soil. ~SDR 1 I I ON Both sides of C OF ,NpUStA'I SSW N90 I I tank. . Z S QEPt • aE5I1S~Dh I LLEV. FT }E!,{ PUMP-~ _-J OFF D SSE GOES kEL q.0 CONCRETE BLOCK 3" APPRovep RISER EXIT PERMITTED OWLI IF TANK MANUFACTURER HAS SUCH APPROVAL. BEDDING SPECIFICATIOUS DOSE t~~DI,y~ST~ZIJ 'REC 3. G TAWK MANUFACTURER: NUMBER OF DOSES: PER DAy TANK 51ZE : GALLONS DOSE VOLUME t EZ~C-ZO S~-/STeJ S INCLUDING BACKI LOW: 5 6'o GALLONS ALARM MANUFACTURER: MODEL I.IUMBER: 101 ~~W CAPACITIES: A= 17-WCHE5 OIL 30Z ' 3GALLOAIS SWITCH TyP[: L~ 12.GU(Z 9 = Z INCHES OR 19 ' O G~ LLOLIS PUMP MANUFACTURER: C s g INCHES OR 1 S6.O GALLONS MODEL NUMBER: D w. , S INCHES OR Z9Z, S GALLONS SWITCH TYPE: ~~acU~z-Y MOTE: PUMP AND ALARM ARE TO OE MINIMUM DISCHARGE RATE L4131 GPM INSTALLED OM 5EPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AIJO_DISTRIBUTION PIPE.. 11', 5 FEET + MIIJIMUM NETWORK SUPPLY PRESSURE . . . . . 2.50 FEET + ~ IZ) FEET OF FORCE MAIN X 3' bO FYp FtFRICTIOU FACTOR.. G FEET TOTAL DIJUAMIC HEAD = 21'09 FEET DIAMETER - ,I INTERNAL DIMENSIOW~ OF TAWK: LENGTH ~ ;WIDTH ;LIQUID DEPTH LIO I~Z. BOTTOM AREA - 231= - GAL/INCH AS PER MANUFACTURER = \q_S GAL/INCH Pc- G El_ 6 o F HEAD/CAPACITY CURVE 161, 163 AND 165 SERIES TOTAL DYNAMIC HEAD/FLOW PER MINUTE w EFFLUENT AND DEWATERING ~ w ` zfi LL SERIES 161 163 165 90 FT. M. Gal. Ltrs. Gal. Ltrs. Gal. Ltrs. 241---Lo- 5 1.52 106 401 61 231 61 231 MODEL 10 3.05 100 378 61 231 61 231 70 15 4.57 91 344 60 227 60 227 ~ zo w 163 20 6.10 82 310 59 223 60 227 _ 60 25 7.62 74 280 57 216 59 223 U 16 50 30 9.14 65 246 55 206 58 220 Q 40 12.19 46 174 46 172 55 206 Z } 12 40 50 15.24 21 80 33 125 51 191 OD L 60 18.29 15 57 43 161 Q H 3070 21.34 30 114 OF a -Li 09 80 24.38 14 53 20 90 27.43 4 47.3 2 100 30.48 10 Lock Valve: 56' 66' 87' -1-1 1-1 GALLONS 10 30 40 50 60 70 80 90 100 110 S9 0 R A 0 3-41 .F4'% file 6N-~ LITERS 0 80 160 240 320 400 FLOW PER MINUTE i Standard all models - Weight 77 tbs. - 20 ft. cord -1F, H.P. - - { 0 1'h - tl'.: NPT 161 MODELS Control Selection I`z-nI NPT ,ORI 3-6 NPT 6"n Model Volts-Ph Mode Amps Simplex Duplex M161 115 . 1 Auto 14.0 1 or 1 & 9 - i N161 115 1 Non 14.0 2or2&8 3or5&6 D161 230 1 Auto 7.0 1 or 1 & 9 - E161 230 1 Non 7.0 2or2&8 3or5&6 F161 230 3 Non 3.0 2&4 3&4or5&6._ 'H161 200-208 1 Auto 8.2 1 & 9 - '1161 200-208 1 Non 8.2 2& 8 3 or 5& 6 J161 200-208 3 Non 2.2 2 & 4 3 & 4 or 5 &6 a.,,. G161 460 3 Non 1.5 2&4 3&4or5&6 I- Standard all models - Weight 77 tbs. - 20 ft. cord - 1h H.P. - ! 163 MODELS Control Selection T Model Volts-Ph Mode Amps Simplex Duplex ~n(~ fi M163 115 1 Auto 14.0 1 or 1 &9 N163 115 1 Non 14.0 2or2&8 3or5&6 1-- - -.1 D163 230 1 Auto 7.0 1 or 1 & 9 - E163 230 1 Non 7.0 2or2&8 3or5&6 F163 230 3 Non 3.0 2 & 4 3 & 4 or 5 & 6 SELECTION GUIDE 'H163 200-208 1 Auto 8.2 1 & 9 - 1. Integral float operated mechanical switch, no external control required. 1163 200-208 1 Non 8.2 2 & 8 3 or 5 & 6 2. Single piggyback mercury float switch or double piggyback mercury float J163 200-208 3 Non 2.2 2 & 4 3 & 4 or 5 & 6 switch. Refer to FM0477. G163 460 3 Non 1.5 2 & 4 3 & 4 or 5 & 6 3. Mechanical alternator "M-Pak" 10-0072 or 10-0075. 4 Standard all models -Weight 82 tbs. - 20 ft. cord - 1 H.P. . Combination starter. Refer to FM0514. 5. See FM0712; for correct model of Electrical Alternator, "E-Pak". 165 MODELS Control Selection 6. Mercury sensor float switch 10-0225 used as a control activator, with "E-Pak" Model Volts-Ph Mode Amps Simplex Duplex alternator, 3 or 4 float system. D165 230 1 Auto 9.0 1 or 1 & 9 - 7. SIMPLEX CONTROL BOX 10-0050, 115/230V, 1 Ph. max. 2HP use one (1) E165 230 1 Non 9.0 2 or 2 & 8 3 or 5 & 6 single piggyback wide angle mercury float switch OR two (2) 10-0225 mercury F165 230 3 Non 6.6 2 & 4 3 & 4 or 5 & 6 sensor floats for level control. 8. Four (4) hole "J-Pak", junction box, for watertight connection or wired-in 'H165 200-208 1 Auto 10.7 1 or 1 & 9 - simplex or duplex operation. '1165 200-208 1 Non 10.7 2&8 3 or 5 & 6 9. Two (2) hole "J-Pak", junction box, for watertight connection or splice. J165 200-208 3 Non 7.0 2 & 4 3 & 4 or 5 & 6 'No Molded Plug G165 460 3 Non 3.3 2&4 3&4or5&6 For information on additional Zoeller products refer to catalog on Combination Starter, CAUTION FM0514; Piggyback Mercury Switches. FM0477, Electrical Alternator, FM0486; Mechanical AN installation of controls, protection devices and wiring should be done by a licensed qualified Alternator, FM0495; Alarm Package. FM0513: Sump/Sewage Basins. FM0487. and Simplex electrician. AN electrical and safely codes should be followed aduding the most recent National Control Box. FM0732. Electric Code (NEC) and the Occupational Safety and Heat81 Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. 3280 Old Millers Lane Manufacturers o1.. . O ZZ~/ L L ZZ' Box 16347 Louisville, Kentucky 40216 o (502) 778-2731 QUAL/TY PUMPS SINCE /939 Wisconsin Department of Indus", SOIL AND SITE EVALUATION REPORT Page of 3 Labor and Human Relations Divii6n of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code • COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but 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 iA Vt"l_0 4 'I'l0►J I C1rt~11V GOVT. LOT SE~- 1/4 tNLJ 1/4,S °1 T ZS N,R l (o E (orj~ PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # ZO Z`3 30 'nt RUN. - - CITY, STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE OWN NEAREST ROIL ~1\L1bwtAJ IWl SVOo Z. PIS) 68(1- z459 k-L a Z3b l~ ST. New Construction Use Residential / Number of bedrooms 3 [ ] Additlgn to existing building j j Replacement [ ] Public or commercial describe Code derived daily flow '-ISO gpd Recommended design loading rate o • bed, gpd/fl2 , 3 trench, gpcW Absorption area required 31 S bed, 11112 11 S trench, ft2 Maximum design loading rate o • S bed, gpd/00- (o trench, gpdjft2 Recommended infiltration surface elevation(s) a-1. S It (as referred to site plan benchmark) Additional design / site considerations SI?F "13TE Oka pry z Z Or- Parent material . S "\-t Lora-~ Tt t_~_ Flood Main elevation, if applicable t-) • A It S = Suitable for system CONVENTIONAL MOUouND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOSING TANK U = Unsuitable for stem 11 S ICU ®S ❑ U 11 S ED [I S 2u ❑ S M SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consisbenoe Bou nd3y Roots GPD/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed mr& l3 - i 1 Z~Sbk wlf~. s u Ground 3 \3 -Z-6 S L/ P 3 S/ - s Z c`b1rC lout v' 1- ~-S 1 O S • L elev. ~Z -7.s-1 ¢V/6 014-0 It. Z6-2 1, S`/2 31y z~, 1u~t~z s ti s -'F0. bVL wf ujI,_ S - - Depth to S Z9-u 7 S 'i tZ 31 y s /n 'IF - - limiting factor DA'L'? S P U -Tt Sz)LPQ-Je3 74 W l 10`1 k S/2 SAS 0-4►FTS Remarks: Boring # o- 8 l0 `t 2 31 S l Z-`FS X12 v`~'F~ G S 1 o. S o Z Z-t1 to`1~ yl5l - Sl `FSb>t yn ~'~.F ,S' 0.6 ~m Sbk ynU 1~`~ €o•S Ground Z ~.syR elev. y ZQ3S ~•5 y12 Vy$~z w~te sit s~ l~n 5blz ~U"~~ '~~S rm X7.5 ft . _ s 3s _ sz s ~t e ~/y s l o r►-, k' I 4- Deem to limiting S S -S) I of factor Remarks: CST Name:-Please Print Phone: Arthur L. We erer 715-425-0165 e~gerer Soil Testing & Design Service-P.O. Box 74 River Falls,WI" 54022 Signature: Date: CST Number: L13-ZOO MOO576 L_ D"I'PL f PROPERTYOWNERSOIL DESCRIPTION REPORT Page?- of 3 PARCEL I.D. # ` Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench lo`tfL Oily S1) ZTsbk m~t^ cS 1v~ ~•S ~.6 Ground 3 )~-Z.b ~•S~1IZ 31tr - S I Z`Fa~1Z MU+ , cS 1v~ 0-S elev. s y 2 ~!b °tb o ft. y -3z 7-S `i2 3!y s ~z~SliotiR srZ S 1 Z'~'~blZ MU Fh c S - - Depth to 5 3Z-~1~ 5 1Zy S1 O'►-t T'L. - limiting factor 5 S e- INS S i B 1 Remarks: Boring # Ground ele q. ft. Depth to limiting factor Remarks: Boring # "v - t )~i ov S >vu i pl, i Ground ~1 UU IV h/ t r S t S elev.b ft. Depth to limiting factor `Remarks: Boring # r Ground elev. ft. Depth to limiting factor T-J- T~ Remarks: SBD-8330(8.05/92) PLOT PLAN Page 3 of 3 !ti SCALE 1"= 30 ' D Q~ - e-. L~U •OOiv 5`GN 31y, OIA. PVC P«t PosT. Lam-cti° e-L 3t, B•1 0.l 5 C3. Z / J -r 1--)No ►uoT Cori P cT oR W~ / / D1 SNRB -Fitts /mi-A i i/ JL: 0 $•3 10 ~j $`y A 1: 'LA 4 6 d~ 'No`m 1~0~ s~ 'to %E R-r L"S T 7-5 F Wo i 1'11 -wZ~ . ~ 3-Zn0 (715 ) 4 .5-01 65 M00576 CST Signature Date Signed Telephone No. CST # Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page I of 3 Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY ST. c-~ Ol X Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but 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: VAJ)1-.01•( PROPERTY LOCATION -qo'llaw 'I bI -s l CW-k-ZIV. GOVT. LOT Sty 1/4 NW 1/4,S 9 T ZB N,R l E (ar W PROPERTY OWNER-.S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # 2O Z'1 3p Tit- P~JF. - CITY, STATE ZIP CODE PHONE NUMBER OCI TY []VILLAGE OWN NEAREST ROgp 1~ Wc~ ~w1A,t W I svm o Z. pis) w/ _ 2-`159 ~^R'~ C~h LL a AR~~ Y~ ST. [SQ New Constnxborn Use Residential / Number of bedrooms 3 [ ] Additkn to wdsting building [ 1 Replacement Public or commercial describe Code derived dally flow qS0 gpd Recommended design loading rate o• bed, gp(W 0 3 trench, gpd/ft2, Absorption area required 31 S bed, ft2 37 s trench, ft2 Ma)iirntrn design loWng rate o • s bed, gpd/ft2 0.6 trench, gpol(t2 Recommended infiltration surface elevation(s) Q-1, S It (as referred to site plan benchmark) Additional design/ site Considerations S 1J0~ E 01"a pkV4tt Z Or- 3 Pawt material } s -~o~t ~.ort*1 ~t ~ti Flood plant elevation, I applicable N . It S = SuiWe for system CONVENT 01Al D N•GROUND PRESSURE AT-GRADE SYSTEM PA.L HOLDM TAW v =vttfiu~,ble r- o S Eau INS o u a S INu a S flav a S On ❑ s ii- -SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure colsistDrice Bwxl3y Roots GPD/ft in. Munsell Qu. Sz. Cont color Gr. Sz. Sh. Bed etch o-a ~C0 313 - sit Z~Sbk w1f~, a-S ~vf. o.s o t~ Z g_l3 1.o`ty-Y/ - sal Zisbk in k- ~S l~F o.S o-b Ground 3 \3-?•6 -SL12 3!y - .s I Zf~b~ w►v'F>r ~-S 1~~ cs o• l elev: ~Z -7 -S•1V.'j/6 'F0.b~ ►rJ~'~~ eS - - ~4 o ft. y 2-6 Z 1. 3va- 31 ~z~„ 1~~IRS l2- SI -2- Depthto S 29-LI7 S Ll t-- 3/y s C3~+-~ ln'F~- - - limiting fact,, y "Q D~1 `l S P u,Del'n eL Rc6 P P W t ! OY k 5/2 SAS ~F Remarks: ; Boring # ~ o - ~ l0 ~.2 31 ~ ~ S t ~ Z`FS X12 v~'~--f h S 1 v'~ o . S ~ tz y/ - s1 I Z~sbh ~s lvf o_s 0.6 3 V)-Zq -)~S-tR Vy - s1 1wL 5b)t ynv~h c S 1~`f C .N:G-S Ground Z ~.syR ~/6 elev. y 2-43 S 7 • S `1 f2 3/y s~z w~ s /2 a I 1n 5 h9 U Cj-)S ft De p1h tD S 3S-Si S`-t~ 3/y ~sl Ov►., tivt~„ - limiting S 'Ss s IQ @ 29 4 Remarks: CST Name:-PleasePrittt Arthur L. We erer B10f8 715-425-0165 Vegerer Soil Testing & Design Service-P.O. Box 74 River Falls,WT 54022 Signature: q 3 -ZOO Date: 9_~ 3_ at 3 CST Number: M00576 PROPERTYOWNERSOIL DESCRIPTION REPORT Page?- of 3 PARCEL I.D. # Depth Dominant Color Mottles Structure GPD/ft Boring # Horizon Texture Consistence Botxhciary Roots, Bed Trench in. Munsell Qu. Sz. Coat Color Gr. Sz. Sh. 1 - 8 lA `-L R 3/3 $ l) `F S 1~ l+ti'Fh 0..S \ v O.5 O: :7i <~`f•:.>kas Z -L lD`L IL Sl/y 51 ZTS bh Yv~'FI~ ~-S l o - S V•6 Ground 3 )6-16 1-1 i>- 31y - 'S Z`Fa~IZ M U+ , cS 1v~ O-S elev. 'h S `9 R 4/6 °t ft. x-32 7.S `?2 3/y glblk S[Z S Zia-bit YnU'~h aS - - - Depth to 32-y~ 5 1Z tl~~ S 1 O M limiting factor 6,~ S S S L B 1 Remarks: Boring # I Pn L ~3 VV ` 1F'► 11'UkJ Ivu Ground qele ft. Depth to limiting i factor l i Remarks: Boring # -ID, N'tj v \V ~~K 1 ~ ~OV \ S ~u1 V r $ G g I Ground UV yV LtJ 1 Y)i elev. ft. Depth to limiting factor i i Remarks: Boring # `ic ti~~4 f Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(R.05/92) PLOT PLAN Page 3 of 3 J !ti SCALE 1"= 30 ' (0 6>~ - • LoU.O- ph, S``ttlr-H 31v OIA• PVC pipe wooer F~,,c~ po sr. JV6 ctj gl~ 6.1 t3. Z d -r-~bo ►voT cor,~tk~T oR I o a i C-V i !g $-3 3~• i W a tL94s .st 'm PST cats r zs FR o►~ v~,D 3- Z13 ol. R-:13- g3 (715 ) 425-0165 _ M00576 CST Signature Date Signed Telephone No. CST # r S T C 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER M )~a ~ a C_ ADDRESS- 7 7 CITY/STATE Pa I AW%1~ W 1 ~JJ Z Ip `S~y o o_-2- PROPERTY LOCATION : 1/4, SECTIONT AK N_rZW TOWN of AU 6 St. Croix County, SUBDIVISION , LOT NUMBER Improper use and maintenance of your septic systela 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 a 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 60.1 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 (I). 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/tqe, the undersigned have read the above requirements and aarce to maintain the private sewage disposal system in accordance kith the standards set forth, herein, as set by the Wisco.,sin UNR. Certification stating that your septic has been maintained must be completed and returned to the Sr. Croix Co. zoning officer within ]o days of the three year expiration date. d~ Iro- SxGNED: ~ DATE:- ~ 3 St. Croix co. Zoning Oftice 911 4th St. Hudson, Paz 54016 i 1. J i 'I'liis CIPPlication form is to be completed in full and signed b' the ot;ner(s) of the property being developed. Any Inadequacies will only result in delays of the permit issuance. Shoulthis development be intended for resale by owner/contractor,(spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. ; Owner of property A9 U r I yo 'k ; A) o "A ; CA a Location of property~l/4 NU)114, Section' T&N-R_2~ W .Township jQU 6ktt, Mailing address 7 cl o u Address of site Subdivision name Lot no. Other homes on property? _yes,)_No Previous owner of property Total size of parcel _ 3 ~S Date parcel was created Are all corners and lot lines identifiable? Yes No in thin property being developed for (spec house)? Yes No volume_ OY? and Page Number 1= as recorded, with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARIt JITY DLED which includes a DOCUMENT NURDER, VOLUHH AND PAGE tumid-,n & THE SEAL OF THE REGISTkit 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 Hap, the certified survey Hap shall also be required. PROPERTY OWNER CERTIFICATION I(wc) certify that all statements on this form are true to the best of ny (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of 'a warranty deed recorded in the office of the County Register 'of Deeds as Document No. *,5o0 7 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 the construction of. said system, and the same hp been duly recorded`in the office of County Register of deeds' as Document No. Signature of 'ap~l can C -appl cant oat e of S gnature bate of 9 gnature 13140 (D) (For use by: ACA, FLCA, PCA) O ; / 1PAG ...111 1-17 LIMITED WARRANTY DEED 5085x7 THIS INDENTURE, dated October 14, 1993 , between AgriBank, FCB , a federally chartered corporation, Maloy L. Monicken whose post office address is 375 Jackson St., REGISTER" Jr. St. Paul, MN 101, party of the first part, and 1C k.t Malo L. Monicke and Nola J. Monicken husband and ST. MIX co W1 wife, as survivorship marital property, Rec' d fcw ft- cb1rt'( whose post office address is 2023-30th Ave. Baldwin, WI 54002 , party of the second part, N OV'0 8 1993 (hereinafter referred to as party whether singular or 4V 1.00 PA11 plural), WITNESSETH, that the said party of the first part, for and in consideration of the sum of $*A Nineteen Thousand and no/100 DOLLARS, ($19,000.00), weep isteipf~ to it paid by the said party of the second part, the receipt whereof is hereby acknowledged, does grant, bargain, sell, and convey unto the said party of the second part, his/her/their heirs, successors and assigns, forever, the following described real estate situated in the County of St. Croix and State of Wisconsin , to-wit; Recording Information SE4NW4, except the following described parcel: Commencing 208.8 feet North of the SW corner of said SE4NW$, thence East parallel with E-W 1/4 line of said Section 9, 208.0 feet, thence North parallel with the West line of said SE4NW4 200.00 feet, thence Nally 223.58 feet to point on said West line 282.0 feet North of point of beginning, thence South on said West line 282.0 feet to point of beginning; W2SW4NEa; All in section 9, Township 28 North, Range 16 West. This conveyance is exempt from state deed transfer tax and return pursuant to Wis. Stats. Sec. 77.25 (2). subject to all existing easements and rights of way; also subject to all taxes on said premises for the year 1993 (pro-rated) and following years; also subject to all unpaid parts and installments Of special assessments on said premises which have fallen due, or will fall due hereafter. EXCLUDING therefrom and excepting and reserving to said party of the first part all mineral and royalty rights, interests, estates and titles heretofore reserved or excepted of record by the party of the first part prior to January 22, 1986, if any, with such easements for ingress, egress and use of surface as may be incidental or necessary to use of such rights. The foregoing exclusion, exception and reservation shall include, but not be limited to, all oil, gas, hydrocarbons, coal and other minerals of whatsoever nature lying in or under the above-described lands and all royalty interests as to oil, gas and other minerals produced and saved therefrom. It is expressly understood that the said party of the first part will make no warranty as to the extent of its ownership of minerals, or as to its title thereto. TOGETHER with all and singular the hereditaments and appurtenances thereunto belonging or in any wise appertaining; and all estate, right, title, interest, claim or demand whatsoever, of the said party of the first part, either in law or equity, either in possession or expectancy of, in and to the above bargained premises, and their hereditaments and appurtenances. TO HAVE AND TO HOLD the said premises as above described, with the hereditaments and appurtenances unto the said party of the second part, and to his/her/their heirs, successors and assigns FOREVER. AND THE SAID party of the first part, for itself and its successors, does covenant, grant, bargain and agree to and with the said party of the second part, his/her/their heirs, successors and assigns, against all and every person or persons lawfully claiming the whole or any part thereof, by, through or under said party of the first part, and none other, it will forever WARRANT and DEFEND. IN WITNESS WHEREOF, the said party of the first part, has caused these presents to be executed in its corporate name the day and year first above written. AgriBank, FCB Lee Strom , Director, Real Estate Services (Name) (Title) STATE OF MINNESOTA ) ss. COUNTY OF RAMSEY ) The foregoing instrument was acknowledged before me on October 14, 1993 MARY LOU LEVI by Lee Strom Director, Real Estate Services of AgriBank, FCB, a NOTARY PUBLIC-MINNESOTA federally chartered cor o ation, on behalf of said corporation. y p WASHINGTON COUNTY My Comm, Exphas May 27, 1997, vvVVVWvvvvvv~'✓v,, vvvwvv VVVWVVVVV a (Pry Lou Levi Notary Public, Washington County, Minnesota My commission expires 05-27 , 1997. This instrument was drafted by: SEND TAX STATEMENTS TO: AgriBank, FCB Maloy L. Monicken Real Estate Services 4E-27 2023-30th Ave. 375 Jackson St. Baldwin, WI 54002 St. Paul, MN 55101