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_ ,._ Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildinns Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provice may be used for secondary purposes [Privacy Law,~.15.04 (1)(m)l. IR~hghl~, ~ ^ cty ^ v ~I mwnshi~ CST BM Elev.: Insp. BM Elev.: BM Descµription: ~'. O r ` YW~ 2 ~~~ TANK INFI(~RMATIAN FI FVATI~N AT TYPE MANUFACTURER CAPACITY Septic ~,-~,{., l 2 vp~ '~ Dosing t~ c ~ Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. vent to Air Intake ROAD Septic ~~s~ ,2 i NA Dosing > ~-S' ~~ i.t -• ZD r NA Aeration NA Holding PUMP /SIPHON INFORMATION \~ Manufacturer ~~ O Demand v Model Number ~ TV ~~ GPM TDH Lift ~~•°~ Lriction.~„ Syetem~.Z TDH2O• t Forcemain Length typ' Dia. FFiit °i Dist. To Well SOIL ABSORPTION SYSTEM 1 A7 1 h STATION BS HI FS ELEV. B c rk , t~ 2p ~ ~, °(, p ~~r4 Bldg. Sewer /3, zo I~ g'~. 9c7~ St/Ht Inlet /3.3z. ~'. ~-$~ St/Ht Outlet Dt Inlet Dt Bottom l6.83~ r85; Z~'- Header /Man. ~t ~ 13 t° ~' 3~! IG• 9 Dist_ Pipe . 3 ..`~ 5. Z.S ~~ . ~ ` Bot. System S `lI `~ ' [ I ~, jg' ~t~~~ e Sf. cF~ ~.3v . ~ 3Z p ~ Width r Length f N .Of T PIT No_ Of Pits Inside Liquid Depth EN 1 N ~" DIMEN I N SYSTEM TO P/L BLDG WELL LAKE/STREAM LEA ING Manuac SETBACK INFORMATION Type O as, ! g ~ ~ CHAMB OR UN o el Num er: r System: DISTRIBUTION SYSTEM '~''' . f. ~.53~ ~ l 3 ~ a ~ ~ 0~- Header / a ~ifold ~ ~ ~ Distribution Pipe(s) ~ u 36~j x H ~e Sizeu x Hole Sp u ng Vent To Air ntake Dia th Len t 33 Dia ~' O Spacing Len Z . g g . SOIL COVER x Pre sure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Uepth Of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil InS eCtlO # Yes No InS 1@!1 # No {~M~)ENTS' (~ cl dde ode discr nu ers ~G1- - Location: 21Z~ ~th ~-venue, vereFh~~, ~~ ~4~~~~e(~1/4~ S`W`1/4 3 T28N R16W) - 312816467B 1.) Alt BM Description = ~~Q `'~j '~'+~• 2.) Bldg sewer length = ~ 3 . o ' -amount of cover = y 6~,~„ 30 r ~' N'~ : /°~`Z~r ` 3.) contour = R?j •8a ~5~' J ~ ~ (~, ~p{~ 1 Plan revision required? ^ Yes ~'No ~ Use other side for additional information. ~',~ SBD-6710 (R.3/97) Date Inspector's Signature Cert. No. ~, - np : a3s~is~ ~ 212( S Sanitary Permit Application Safety & Buildings Division ~ [n accord with Comm 83.21. Wis. Adm. Code 201 W. Washington Ave. PO Box 7 02 %eonsin ~ See reverse side for instructions for completing this application Madison WI 53707-730^ Department t~f Commerce personal information you provide may be used-fior~sesoedary purposes [Privacy Law, s. 15 DA(I xrty)] ` . (Submit completed form to county if r~ % ~ state owner. Attach com lete tans (to the county co • only) f r..th~~"'stem. a er xe than 8-]/2 x 11 inches in size. County~{~- v State S~~j[lita P it Number p"check if re(T1~iec-.{p R- ious RIt,¢ ion ~ ~ ~ State Plan 1. D. Number l L2~~ /t. e~., ~ U 3 ~ '.,. i d L. I. A lication Information -Please Print all Information ; ,_.. Location: Property Owner Name~~r ~ ~~.~+ ~~~ ~~F3C?tY ~]~~ ~ !'~~~~J "~~i/~~ ~~~' ~~ Property Location / ~ ~~ ~ 3 ~ ~ / _1/ T {/4.5 i .W or Propert wjner's M~ailfin/g A,dd-re-ss /~ ~ ~~~G~F{CE ~~~ •4 y~O ~ ~ LotTlumber Block Number ~ . ~,..~:. ~~`~ ( r/~'i.~/~''~ Its City, State Zip Code P ~~~~ i Subdivision Name or CSM Number II Type of Building: (check one) ,,,y yu, ® 1 or 2 Family Dwelling - No. of Bedrooms: ," ~ ~ pQows . City v ~~,~~ ^ Village _ , , I ^ Public/Commercial (describe use): 1 0' Town of ^ State-owned III Type of Perr.:it: (Cheek only one bex on line A.. Check box on line B if applicable) Neare~(I~oa~ ~-lam ~~ ~ [ p) I. I~New System 2. ^ Replacement 3. ^ Replacement of 4. ^ Addition to Parcel Tax Number(s) S stem Tank Onl Existin S stem © "~ Ci S B) Permit Number Date Issued ^ A Sanit Permit was reviousl issued !o IV. Type of POWT System: (Check all that apply) ~ ^ Non-pressurized In-ground t ~MOUnd ^ Sand Filter ^ Constructed Wetland ^ Pressurized In-groundC~o,,,~cdr' 9`}. 0) ^ Holding Tank ^ Single Pass ^ Drip Line ^ At-grade t , f~ w ^ Aerobic Treatmen`Unit n ^ Recirculating ^ Other: ~- ( ° ~ " a - X Ma~~nit. C . ~ 2. o C t `f / 5 ~.a~ V Dis ersal/T'reatment Area Information: 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade ~0~ Required Proposed Rate (Gals./day/sq. ft.) (Min./inch) Elevation 6po 6a VI Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing Crete structed Tanks Tanks ~ ~ ~s ~ ~ ~ a~~ o l ~ !S -~- ~ ^ ^ ^ ^ ^ ^ ^ ^ ^ VII Responsibility Statement I, the undersi mod, assume res onsibili fcr installation of the POWTS shown on the attached laps. Plumber's Name (print) Plumber's Si azure (no slam s): MP/MPRS No. Business Phone Number ~ r ~i R i L f~ l~h ~ s S- ~ ~ ~-~ 7 7 ~ S-6 ~~,'.3~7 3 0 Plumber's Address (Street, City, State,Z7ip-Code) VIII County/Department Use Only ^ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) ~ Approved ^ Owner Given Initial Adverse Sur~arge~ ~. ~~'' S Zee I M Determination . :J'~ I va~: fApproval/Reasons for Disappro s o ItX. Conditi o n nn pp __ '' / i7v~^(tt.Ot-~e.Nit,Q,~.t..¢'S . ff ~ iQ~,~ SRs M"'~t~'f' ~ w.cu~'~atlnedC t-~ ~- ~ ^ - n n o ` ~ ~ ~6rul{B~''~/ ,rv,~ah'~" .Qw~A.w~it_. `t-~-t~~ S-Q(~~TtG [o•~t~-- ~Z~~ ~-1`~~ iS ~~WIU.t~/q`~11~FJC. ~tp 1 -~~-^ ~ t~ S ~s . ~ , SBD-6398 (R. 07/00) /~ ~ 4 PLOT PLAN Scale 1"= tip ~~ Page 3 of 7 1 ~ ~ ~ V~I R-~.W . LtN 6 b ' 'Co us ~ 63 t3:3 N,_,q\ s i ]gyp ~lT ~'1~-Y i~ , • !~ ~, `rli'1S R1~ ~i -~/ ~ ~ /~ ~: / \~ ~~ ice/ ~~ ~ / ~~ ~ ~ n J dti 3 ~i ~' ~~-- ex.~slin~ G ~ti.~,z~ q~~ con,`ru~zs N s ~r~ o~~~ $ ~ v :~ . a L~b~oF2,ypVC F. wt. ~/ P S C 5' b~ y YPU C o ~ 3 ~t e D c~~ ~~E ~~~z 3wt~fj-- EZ_ IUO.p~ ~ Sp~~, ~0`' ~ov~ G1~~n.D ~.~v ~o~~-~ _~a~ ~3 ~''~ Lfi Z _ ~- . ot-l .c3 ~ r, k Z~" K ti 1 ~ 4 n l19___1~SL '~ ~L_~. _~ F -~T' L~ sT so' ~~ -^~ o~x~y . F7aVD 1°r7" -,LL~rs:1' " Z 5 ' r-~~iwl 1-r~~vrz , NOTES : . _ . _. __ . 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with a 3. Septic tank to be tZoo j8ougallon capacity manufacturedrbyuired). Y''1 C ~ L`! ~SZ~2~ ?\~-~~-.~ Ja,C w~ Z ~~ ;_~ `fir 4 . $ench mark S g ~` Ir'cr3ov ~. Divert surface water around system to prevent ponding at the u hill side P ~~ isconsin Department of Commerce January 03, 2001 '" .. CUST ID No.691727 ! --- ,~.. :c. ~~1.Cr.C.~,~,~^' ARTHUR L WEGERER ~. ~ ply J, ,. -¢ 421 N MAIN ST `•~ . ; ~-;~~` PO BOX 74 ~~~ RIVER FALLS WI 54022 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 01/03/2003 ''~, ~. Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi. us/SB Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary 1~f .. y`-,~J ATTN.• POW7S INSPECTOR ~~'~' ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Site ID: 625361, Gary and Dawn Reinberg St. Croix County, Town of Eau Galle NW1/4, SW1/4, S31, T28N, R16W FOR: Description: Four Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 776465 Identificati rs Transaction ID N .606864 Site ID No. 62536 Please refer to both identification numbers, `..above in all comes ondence with the a enc . The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBI)-10572-P (R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10573-P (8.6/99). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. T,`-. ARTHUR L WEGERER Page 2 1/3/01 A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, Gerard M. Swim POWTS Plan Reviewer -Integrated Services (608)-789-7892, Mon. to Fri. 7:15 AM to 4:00 PM j swim@commerce. state. wi. us DATE RECEIVED 01/02/2001 FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 t TITLE SHEET MOUND SYSTEM FOR A y BEDROOM RESIDENCE Page 1 of Z This plan has been prepared in accordance with the Mound Component Manual SBD-1057 P and the Pressure Distribution Planual SBD-10573-P C cz. b! q,q~ C tz. 6 l 4 g~ LOCATED IN THE 1yW 1 /4 OF THE SW 1 /4 OF SECTION 31 , T Z-~ N, R Igo 6d, TOWid OF ~~ G~ll.~, S't'- ~~~X COUNTY, WISCONSIN. INDEX ' PAGE 1 of 7 PAGE 2 Of 7 PAGE 3 of 7 PAGE 4 of 7 PAGE 5 of 7 PAGE 6 of 7 PAGE 7 of 7 TITLE SHEET SYSTEP•1 MANAGEMENT PLAN PLOT PLAN PLAN VIEtJ-CROSS SECTION DISTRIBUTION PIPE LAYOUT PUI~7PING CHAZIBER CROSS SECTION PUMP PERFORIiANCE CURVE PREPARED FOR ~Pt~z.:Y_ - lH=l~1t~ _ ZU~W -~1 t~ ~ l ~ s1~Z1Z. C~ ~ 1 Z S L'1 `tom- ST . N , PREPARED BY ~~~~~ of ~~~- ~~ c . 2 Zoo, ~& B ~o~s v~ WEGEt~EF? SOIL .TESTING "' AND . . DESIGN SEF~V I CE P,0. Box' 74 421 N.Piain St. River Falls, idI 54022 Phone 715-425-0165 Fax 715-425-6864 P.o•W ovally Cvndi OVEN RP P R f COMMERC INKS pEPARtMEN E~ ~p BUILD z ow~s-oN pENGE SEA GpR~S ~~ ~ ~j}~j aa,~:,,~ K'i'~FRt~N a U.9•y p JOB N0. ~O- Z L 3 Mound System Management Plan page Z of Pursuant to Comm 83.54, Wis. Adm. Code Seotic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of.the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank; If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Puma Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than far vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General - This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manual [SBD-10572-P (R. 6/99)] arid local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shat{ be sea}ed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump,. pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area 'rf toe leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. questions about the operation or maintenance of this system shoulcj be directed to: The County Zoning Office at ~ 1 S - The system installer at utiJlrzl~)OWt` The tank manufacturer at 1- $00- °lol. The effluent filter manufacturer at 1 tRfi '[l+tS l1ry~ -2S10 - ~3t)O - ZZl - S~ ~ Z ST - C(Zxj 1. M l p W ~TL~R.N The _ PufaP_. ___ __ pump manufacturer at \- ~0p_.g2.Y, e_ • PLOT PLAN Scale 1"= yp' ~ S ~ QUE. Page 3 of ~ 6 6 ' 'ro uS ~ 63 • R_o.~ . UNL lip ~l1' CO~"1F~P~e-Y //~/ ~3~ -/ /~ `rat s ~ 1~ -~ ~ . ~ / ~ , d ~ ~~ ~' ,3 i ~ -i, cy. ~~ ex-LST1v 6 ~- Q ~~~ eor~`tULZg N ~~,z ~-.9.4.0 v fit. °~ l . o °~ X96 s 2 '~' ~ o. C a~+'~l ~`~ Loo'oFZyPvC 'F.~, P 2 S C 5' ep y r~~ c o ~ 3 , 4 B D R-wt ~wttF - LL_ lUa.p~ ~ Sp~k.L, Lp`. ~ov~ G1ZOV~p iti ~u~ ~a ~ v'1 ~ Z _ ~- _ 0'1-.•1.9' K ~ ZEE `~ ,~ K ., ~ C~-4_ l~ l fq- -~'~zts~ ~ ~ To_ _~ ~ -~-r t.~rt-sr so ' Fcw~ w, ovwa fi=r __~ ors r_ NOTES : - - - - --- --- 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved ;caps. ( Z required). 3. Septic tank to be tZuo j8ougallon capacity manufactured by ~M. ~ ~ 111 ~ST~.!`1 lam- ~~~g`r', 1/V C W~ Z -~3~L !=-L l..l-N12 4 . $ench mark S - SLL~ ipct3oy ~ . ~5. Divert surface water around system to prevent ponding at the uphill side. • Approved Synthetic Covering ASTi`i C33 Medium Sand Topsoil _J I E 3 i g °!e Slope Distribution Cell of~ Z" to 2z" Aggregate ~ .' Page ~ Of 7 istribution Pipe F D ~~ b Force Main From Pump CROSS SECTION OF A MOUVD SYSTEM Linear Loading Rate= 8.9 GPD/LN FT Design Loading Rate= 036GPD/SQ FT n i 'DT ~ _r„ u,; L < ~ < I/ $ A ~_ Ft. 8 b 1 Ft. I l b Ft. J 8 Ft. • K r.~ Ft. L °1.3 Ft. W 3 3 Ft. -Observation Pipe G Elev . X16 . ~ Plowed Layer D Z.a Ft. E Z.ZZFt. F o•$ Ft. & 0.5 Ft. ti ~. o Ft . K • a o~~--------- -- --- --- --- ---- =- ----- =----- B - ~~ ~6_ _ _ _ _ ~ Force Main w ~--- ~-- ~___ -----__----! ~-~~ ao~ Distribution ~ ~ ~~ :„ • ~ ~ to 2s Pipe Cell of z ~ aggregate • Observotion Pipe U-achcr securely) ', .. . • ~ PLAN VISid OF A MOUND SYSTE:4 Distribution Pipe Layout !~- L'PrN V1~ _. Place the holes at the bottom of the distribution-pipes . at equal spacing. Remove alI burrs from the pipe and holes. Extend the end of each lateral up with the use of long turn or 4~ ° fitting to a point within six inches of the final grade. Terminate the ends of the laterals with a vaIve,:threaded cap or threaded plug. Provide access from final grade for the valve, threaded cap or threaded plug. ~"`i P.1 CTS L _ t;,ZDS S.. S~-1Z0 -.~ PVC F~1C Lateral-~ ~ Manifold ~~ C Lateral Length _ o- - ~ ~ nrsu~w~ a- -- o-- Page S of ~ Lateral P PrC~s ~pK - -o - --c PVC ~=oQC~ r~~ - _ ~q P 3 ~ Ft. 5 3 Ft. X Z~ Inches F - Hole Diameter ~ 1 ~ Inch "- -- -. Lateral 1 ~ Inches) Manifold Z- Inches .Force Main " ~ Inches - ~ of holes pipe ~1 - - Invert Elevation of.LateralsQ6.SO Ft. . ~'1 x o. y.l = 6.9 7 X 6 = X11. 8 Z G 1~ wJ `' . _. ~ ~~ - Combination Septc~.Tank and PL1~MP CHAMBER CRO55 SECTi01J AAJD SPECIFICATIOfJS ~ PAGE .~, OF 7 .._ ~ , -VEUT CAP ~ . WEATHER PROOF JUUCTiOU 80X . ti C.I. VE1JT PIPC ~ APPROVE.D LOCKIIJG ~ lO' FROM DOOR, ~MA~IHOLE COVER Wl~l :iiAJ00W OR FRESH ~ wA(ilJ11JG LA6t:C., LN 3P ~Ci101J (~ IPA _ _ ' Fl N islf© G ~tD E I la'nIN. . IAILET A ro / PP ved joint w/ PVC pipe ' A~IIJT/lKE -i 6~Kw. .' i ., I.:' e ~~~~s --*-~: 'z8~ u~~ ~ _. ~ 6 c D CO~.ICRETC Q S,DO y bLOGK-- I :~ I __J' ~r' xlu. ~ le•Mw. III III OFP V II Approved III joint wl ALARM PVC pipe I(I I ~j ou I •~- RISER EXIT PCRMIT(ED OIJLy IF TAUK MAIJUFACTURER HAS SUCH APPROVAL 3"AAPRo'rFD ~ . Bbpp t NtR SEPTIC F ~ SPECIFICATIOIJS oos>: . TA1J~C MAtJUFACTURCR: ML~W ~~.N P~-g~- ~ AJI1MfSER OF DOSES: ~- 6 l'2~10 I S 00 TAiJK SIZC: GALLOAlS PER Qr~~ DOSE VOLUME r ~ ' ALARt'1 MAUUFACTURCR; S•~•~-~~Il?-0 S~ISTL~IS IAICLUDIA]G 6ACKFLOW: ~~y.1-LF (,AttOhtS MODEL 1JUMSER: ~~~ ~W CAPACITIES: A=-=ZIUCHCS OR X2.1. O CALLOUS SWITCH TyPC: w'1L°12C~uLZ~f " 8 = Z IAICHES'OR y-Z-- ~ GthLtOtJS PUMP MAUUFACTURCR: z-~ ~-~--L [c' _ C = ~ IUCHES OR I ~~' y MODEL 1`JUMHER: ~ 40 . (?ALL0115 O=--L_IAiCHES OR 15~4•S CALLOUS SWITCH TYPE: -- K'1L~ZC~1Z-L'( IJOTE: PUKP AUD ALARM RE TObC~,~ MIUIMUM DISCKARGE ~RATE~Z Gp/~ INSTALLED OA1 SEPARATE CIRCUITS VERTICAL DIFFEREIJCE DETWCEU PUMP OFF AIJO..DISTRIBUTIOU PIPE., tiO.ZS FEET t KI/JIttUM -~ETWORK SUPPLY PRESSURE .. ; ~ ~ ... , ~' ZS FEET ~ S-O x~,'3, + LOO FEET OF FORCE MAItJ X 3's9 F% FRICT101J FACTOR Sg FL ..~ FEET TOTAL.Oy1JAMIC HERO = ~"~=59~FEET CLEY.g 5-~SFY ~ cOwDulT ~ ~ I -I `__ _ ~ ~~ ~\~; 1 ' PROVIDE I `AIRTIGHT SEAL I PUMP ~, As per >atanufacturer Z 1. p S gal/in. Liquid depth 3 ~ ~ k ~ r• N ~ H .. j W . ~ ~ 14 45 12 40 10 O Q = 6 2 _U a i t 0 4 o , 2 s urERs ~U~1P ~? ~D1Z~`~Y~ ~ Cu~Zy~. HEAD CAPACITY CURVE ,'Tor T°'i°r"AMIC"EaDicaPaclTv MODELS "140/4140" PER MINUTE EFFLUENT AND DEWATERING Ft. Meters Gol. Ltrs. 5 1.52 91 344 10 3.05 84 319 15 4.57 76 266 1 4 4 1 40 20 fi.lo 6e 2s7 25 7 62 59 223 . 30 9.14 49 165 35 10.67 36 ua 40 12.19 21 79 45 13.72 5 19 ~~ ~ ~ ~l.8 Lo[k V°IVe: I 46' 70 20~ 30 401 50 60 I 70 80 I 90 100 1170 80 160 240 320 400 FLOW PER MINUTE 010940 CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Mechanical altemators,forduplexsystems,are available withorwithout alarms. <.: • Control alarm systems are available for 1 phase pumps used in simplex system. See FM0732. Variable level control switches are available for controlling single phase systems. ' • Double piggyback variable level float switches are available for variable level long cycle controls. • Sealed Owik-Box available for outdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. • Refer to FM0808 for 200° F. applications. 140 Series - 53 lbs. 4140 Series - 73 lbs. 140/4140"' MODELS Control Selection Model Model Volts-Ph Mode Amps Sim lex Duplex N140 N4140 115 1 Nan 15.0 1 or 1 R 5 2 or 3& 4 16 ~s~~or- 7 SELECTION GUIDE 1/2 NV1 iK1624A ~r 1/2 NPT 6K76246 - 1. Single piggyback variable level float switch or double piggyback variable level float swtch. Refer to FM0447. 2. Mechanical aRemator M-Pak 10.0072 or 10.0075. 3. See FM0712 for correct model of Electrical Alternator E•Pak. 4. Variable level control switch 10-0225 used as a control activator, specify duplex (3) or (4) float system. 5. Four (4) hole J•Pak, junction box, for water tight connection orwired-in simplex or 2 pump operation,10-0002. Et40 E4140 230 1 Non 7.5 1 or 1 & 5 2 or 3 & 4 CAUTION BNt40 BN4t40 115 1 Nan 15.0 t or t ~ 5 2 or 3 & a All installation of controls, protection devices and wiring should be done by BE140 BEat40 230 t Nan 7.5 1 or 1 ~ 5 2 or 3 & 4 a qualified licensed elecVician. All electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the '" Doubleseafplrrpsareava~6b19nrAhoWipn61°giMure 6erlsors.SealFa~indiptorrgAtav6rablenNEMA1orNEMA4X Occupational Safety andHeakhAct(OSHA). eorHtol p9neb. - - _ ~ RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. Ma1.TO: P.o. sox 1s3e7 ~" Loulsnlle, tYY 40256-0347 - _. ~ '~ _ ~ , Madulacfwersol..' . ~~ i ~~ ~ SHIPT0:3649CaneRunRoad ® Louisville, ra 40211-1961 ljvwrrP~Mas S,vcE /9499 PUMP !O. (502J 778.2731.1(600) 928-PUMP FAX(502)774,?624 Q~'s~ nsin Department of Commerce SOIL EV .~ on of Safety and Buildings in accordance with Comm Attach complete site plan on paper not less than 8 1/2 x 11 inch inGude, but not limited to: vertipl and horizontal reference poin percent slope, scale or dimensions, north arrow, and location a to Please print all information. ~; i Personal intom~ation you provide may be used for. secondary purposes ( 'v Property Owner ~Zpg~ ~ pp ~~ ~ tr'1? t. D 6 Prepert~6wHe~-Mailing Address ~.~zs iZ~+ sr. rv , 5,,,'VY/,is. Adg1. Code `'•, ize.R JP O direc!Gl~ nce to neared rot~~~ Law, s. 15.Db.Oc~C~ oY~-~'P~~ ~ >~~ ~ sSlz$ ~ (bS f ~ -~~9 -~~o~ RT Page ~ of 3 •G~,1.D. QOM -~~8 8 _ 3p _ d by ~ .~ _~n~I `~ Date t~ C~~Oluaw -1~JJ~l~lln. I AAas_ I I. SW 1/4 S 31 T ~S N R ~~ E ~d. Name or CSM# I ~I ^ City ^ Village ~J Town ' Nearest Road 5 `n{- ~vt (~ New Construction Use: (~ Residential / Number of bedrooms ^~_ Code derived design flow rate 6 0' 0 GPD ^ Replacement ^ Public or commercial -Describe: Paren4 material _ 1., O ~S OV ~ Gi..!'~~. i1 l.. `f1 L l Flood Plain elevation if applicable ~ ~ ft. General comments and recommendations: y.~pV~~ ~/ct'K~-I f ~`S~I$V~OYJ L` ~1..C_ w~ ty/ti , Zug Ot= S~ ~iLL. Boring # ^ Boring ~i'8 ~ pit Ground surface elev. q. b _ S ft. Depth to limiting factor 1_T_ in. Soil Appliption Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftZ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 o_ q ~oK2 3C3 ~ sly Z'~sblz m`~1- CS ~~ . s -8 Z 9-~~ ln~~. y1~ -~ S• 1 Z~sbk w-`P~• es l~-~ • S -8 3 t~-~ to ~rZ S~t3 elf ~•S`~e Ste e l ~~-sbk wtifF~ - . z .3 Boring # ^ Boring '~'t'~" Z ~ pit Ground surface elev. ~. l • S ft. Depth to limiting factor ~~~ in. Soil Appligtion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 - •Eff#2 o - g l0`t iZ 3 ! 3 - s 1 ~ z`Fsblz tin~H C-S 1~ . S - ~ Z 9-l~ lo~-t2 ~Ly -. stS z.~sbk m`ft- ~s Zvi ~ •S -8 3 1~ z9 ~ v Y a ~~ P-i~ ~ -sk e. sls~ ~ ~ 1 e.sb~ r2`Ft-- - . z ~ 3 Efnuent #1 = BODs > 30 < 220 mg/L and TSS >30 _< 150 mg/L ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Si ature CST Number Arthur L. Wegerer , odlZ13 220254 Address W e g e r e r Soil Testing & Design S e r v i c e Date Evaluation conducted Telephone Number 421 IJ. I~iain St. River Falls, F7I 54022 7-2g .Vp 715-425-0165 b3~~'lz. Property OwAer Z ~~S$~6 Boring # ^ Boring ® Pit Ground surface elev. °l ~ . S ft. Depth to limiting factor ~ 3 in Page Z of Hortzon Depth i Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ft~ n. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 •Eff#2 1 ~ -8 tiD`~!R 3! ~ Si 1 Z-i'sbk `/~`~1~ cs \~ ~ S . 8 2 8-~3 1~`1R fly - si( ~.~sbh m~1^ ~s ~v~ _s .S3 3 13-Z~ IO yaz S!/3 `Fl'F ~.S~ a s!s C ~ 1 ~sbh M `~i- - . Z • 3 ^ Boring # ^ Boring Pit Ground surface elev. f<. na~~-, r„ r..,i~~.,,. a,,.~,,. ~_ Horizon Depth i Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ftz n. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 ^ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in Horizon Depth i Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate Gpp/ftz n. Munsell Du. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 'Effluent #1 =BODE > 30 < ZZO mg/L and TSS >30 < 150 mg/L • Effluent f#2 = BODB < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. Parcel ID # ~ ~B - 1~~8' - 3~ R-'1- S " seo-asso tasroof . . PLOT PLAPd Scale 1'=yp / r~ S `r'1} ~VE• Page 3 of 3 66'1-0 • use 63 R_O•~.! . LINL=, ~p 1WT ~,~7.. / ~ ~ 33 / ,' ~ .5 ~// `/ • ~i ~ ~/ ~`~ / A. ~~ / a~, 4> d cry' 3 < V ~`L exts'T~N G ~ % e ~rv`tU~Z-g a / ~ti->tz t~l.,q ~. o tt °ld.o °°' '_ q s a•-E u.C. - g~'~-1 ~~ ~~ ~ o~ 3 ~ eb~~ ~~E 3h'1 ~i - EL_ LU0.0' ~-) S1~- ~~ ~ 0~' r~ov~ G 1ZO~D ~ti ~w~~ ~at:~ ~3 ~ tt Z - ~- . °tZ •9' ti °~ Z~ ~~ K ti t ~ `' A l i4- ~'T3~t ~~~z 1-28 _00 715-425-0165 220254 00-Z13 CST Signature Date Telephone P1o. CST Ido. Job PTO. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer`!'~~'~ ~ ~ ~~1 Al S g ~ ~ Mailing Address 21, 2 l s"~ ,~-vE- Property Address (Verification required from Planning Department for new ,/ ~/2 S City/State ~ ~~ t~rc' Parcel Identification Number ~~ ~'~0 ~ '~ ~FGAL DESCRIPTION property Location/U~ %~ W '/., Sec. ?v~ , T ~ N-R~W, Town of ~~ ~ 6'~'~'~''€ ------_ Subdivision ~ .Lot # Certified Survey Map # Q~ ' ~ a~cc.IL ,Volume . ,Page # Warranty Deed # 6 ~ / ~ ~ © ,Volume /~'4~1 ,Page # 3 ~ Spec house ^ yes lino Lot lines identifiable [~ yes ^ no SYSTEM MAINTENANCE 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 a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office wlt~ 30 da f the three year iration date. SIGMA O APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of th rty descn~ed abo by virtue of a warranty deed recorded in Register of Deeds Office. / / SIGMA OF APPL CANT DATE s*s*ss Any information that is mis-representodmay result in the sanitary permit being revoked by the Zoning Department. ****** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed • ~fli 1541PAGE342 STATE BAR OF WISCONSIN FORM 2 - 1999 Document Number WARRANTY DEED This Deed, made between Robert Sebion and Dorothy I. Sebion, husband and wife, - Grantor, and Gary E. Reinsberg and Dawn M. Reinsberg, husband and wife, -- - Grantee. ---- Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): W 1/2 ofNl/2 of the SW fractional I/4 of Section 3 ],Township 28 North, Range 16 West, St. Croix County, W isconsin. 629590 KATHLEEN N. WALSH kEGISTEk OF DEEDS ST. CkOIX CO., WI F.ECEIVED FOR RECORD 09-08-000 11:10 AM YARRRMTY DEED EXEMPT Y CERT CORY FEE: COPY FEE: TRAM5FER FEE: 165.00 PEC~05DING FEE: 10.00 Recording Area mm~ ww ncwm nuureSS I I l w. W ~..~ tn.v~- t~+' ~-. 1%tn~lc) w ~ Sit o 2 Z 008-1088-30 Parce! Identification Number (P{N) This __ is not __~ homestead property. OE) (is not) Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. Dated this ~ ~ '~ day of August ~nnp i AUTHENTICATION Signature(s) Robert Sebion and Dorothy I. Sebion, husband and authenticated this day of August 2000 r Kristine OKland .~ + Robert Sebion ' c -- *Dorothy 1. Sebi n ACKNOW4EDGMENT STATE OF WISCONSIN ) ss. ___ ___ County ) Personally carne before me this _ _ day of __. __ ____ , _- the above named I t t ~t: tvtttvtttl:K STATE BAR OF WISCONSIN - ______ _ (If not, to me known [o be [he person(s) who executed the foregoing authorized by § 706.06, Wis. Stets.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED IIY + - - Attorney Kristine Ogland "- - --- - ------ - -- Hudson, WI 54016 ---- Notary Public, State of Wisconsin ---- My Commission is permanent. ([f not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ) act , is ~~ ~~ ~~~ ~i. ze. ~~. `~I + Names of persons signing in any capacity must be typed or printed below their signature. inro~marioa Proresaiowb company, tone o~ tae, wn WARRANTY DEED STATE BAR OF WISCONSIN eao-ass-zozt FORM No. 2 - 1999 WisconsinDepanmentoflndustry, SOIL AND SITE EVALUATION REPORT Page ~ of 3 Latx~,and Human Relations Divisaon of Safety 8 Buil~ngs in accord with ILHR 83.D5. Ws_ Arim Cnrio COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but S~T' ' °L-RU not limited to vertical and horizontal reference int BM , dr n1ar~ o ope, scale or Pc ( ) PARCEL I.D. # dimensioned, north arrow, and location and distance to rye~est,rc~aii:.--` ~ ~~' O U 8 - 108 - 3.0 APPLICANT INFORMATION-PLEASE PRINT kN~O MAA~ION ~, ~`< REVIEWED BY DATE ~ • PROPERTYOWNER: ' "` °' ' '~ -' PROPERTY LpCATION ~,n $~1Z.T ~0 1 Q'N „ : , a ~ eT ~vvJ 1!4 Sk11/4,S 3 ~ T Z8 ,N,R )- ~ E (or~ PROPERTY OWNER': MAILINGADDRESS• ~ ~~ 'J , # BL CK# SUBD.NAMEORCSM# CITY, STATE ZIP CODE PH ENUMB ~"~ S (~ ~ G V t~-t~`1 I s~~?6"I f ~(S~) 1~'~`S~' ~ CITY ' ILLAGE ®fOWN ' NEAREST ROAD . . 6~ LLL s `Ct~ ~V~_ (New Construction Use (JC] Residential / Number of be s` ` ` [ J Addition to existing building (J Replacement [ ] Public or commerdal describe Code derived daily flow L~SU gpd Recommended design loading rate - bed, gpolft2 - 3 trench, gpdftt2 Absorption area required 3-1 S bed, ft2 3~ S_ trench, ft2 Maximum design loading rate • 4 t>ed, gpd/ft2 . S trench, gpd/it2 Recommended infiltration surface elevation(s) °I-8.0' ft (as referred to site plan benchmark) y Additional design / site wnsiderations ~ t'r~-~ L`r G21U4 w / C~PI~~t i'~-T" 1~I.UU>\./~~ $ ;c'1S`SR~.lC.tf I.J~Z~J ot=5ia'O~.D Parent material \,0 ~ S n y~ C.~ `t-t,~ Flood plain elevation, if applicable i~~ ft S =Suitable for system U= Unsuitable for s stem CONVENTIONAL D S ®U MOUND ~S ^ U IN-GROUND PRESSURE ^ S l~U AT-GRADE ^ S ~ U SYSTEM IN FlLL D S CCU HOLDWG TANK D S ® U .~ ~, , Boring # >:~. ,:;{ 1 { Ground ~~ Depth to limiting factor t3N Boring # Z Ground elev. °I.$ ,Oft. Depth to limiting factor ~S`~ SOIL DESCRIPTION REPORT Horizon Depth in Dominant Color Munsell I Mottles Q S C l C Texture Structure Consistence Bcurrlary Roots GPD/ft . u. z. ont. or o Gr. Sz. Sh. B~ ter>cfi o _~ fog. R j 13 - ~ sl. l ~-'f-~bk w~.`F!- ~ S l ~ • s • 6 Z g-~3 L~`~1R~ly - S1CS Z`~sbk V-1`~1~ a-s ~U'~ .~( _S 3 ti3 ~.~ ~ S'~rrZ ~~~ e~ ~ ~ e 1 ~~ >1ti~~ ~ - ti~ z RoT~rLc.• ~~'~ ' ~ o-~ t-~`-t 2 3! 3 - s t 1 Z`~~bc~ M`~- ~ s l~ • 5 .(, Z q-ts t0 `t2 S~Iy st.c.J Z`Fsb~ v~ c~,5 lU`F •~( ~S 3 1.S 30 ~ .S ~t 2 S!!~ ~ •S ~ 2 Sl8 e.) ~ `"~ y~'F},. - r,.,p € , Z Remarks: 1`fi'r b ' ST Name.-PleasePnnt Arthur L. We~erer Phone: 715-425-0165 `~egerer Soil esting & Design Service-P.O. Box 74 River.Falls,WI-54022 >ignature: Date: CST Number:. . ~• ~b-130 S_lS-ap 22025~- PROPERTY OWNER S~LOf~I SOIL DESCRIPTION REPORT ~ Page_~-of '~ PARCEL I.D. ~ O o ~ - l O FS $ -30 Boring # +:.x.. t:: 4:,..: Zi44•::: x.:.\:. ~<i Z;. _`~`~ 3 ?> ... n...t u:.~.~.•. Ground elev. °+6.8 Il. Depth to limiting lac~tOrs „ Boring # ~,..~>,. ~'~y.. Ground elev. WS-~ ft. Deplh to limiting lactor l3 ~~ Horizon Depth in Dominant Color Munsell Mottles Qu Sz Cont Color Texture Structure G S Consistence Bour>dary Roots GPD/ft . . . . r. z. Sh. Bed rerxh 0-~ ~0'~1 2 3!3 -- Si ~ Z`FSbk w,, ~ 3 l'F . S .G Z $ -1.S t.~ K R yly - si ~l Z'P sbk -M'P1- a.s \v'f •~ ~5 3 ~,s - ~ s ~R fly ~ ~ .sa rzs/~ e 1 ~~, y,~ ~,. _ w~~ . z } . _ ~, o.,.,,...~•.. n7- ~ ~ -~ t 0`-f R 3 (3 - S 1 ~ Z'F s blZ Yvl.'~ a.S l~' ,S • (, Z $-~3 t U~-f 2 ~Iy ~. - s1 c.J Z'F~C m~>^ ~ s 1 v~ • 4( S m~ Na •i Remarks: Remarks: Remarks:. PLOT PLAN SCALE 1"= ~O s~ RuE, Page 3 of 3 i 660' ~ v s~ b3 -a~'~1.1t! - ~l, L~U.O~ O-v Spl'2C ~041°~OVE GR-UV>v}~ 1-v ~p~.l~ ~oL~. ~~~ a• E• _ . E B.? >3.3 ~' ~ i,~5 .~ \~ \ 8.~ ~~ i ~ tI ~ ~I ~ N I ~~ I ~ .~ _ ~ .~ ~ ~ RIOT cowl>>R-eT oiZ ~`siti`za `mss R-Z~_ ~~ s~ ~ ~E E'i1" LET ZS ' l=~-u~-t ~°=~oUnn~ , _ _ _ _ - - Y r w __ Br~-~1 ~1~ DYy't# Z 0 O _ l30 . - ---- - - ZzoZSy ; . S- lS~p (715 ) 425-n7 HS _ CST Signature Date Signed Telephone No. CST # ~o~~u~ eZ.~v. q ~_o ' .t ~, J WisconsinDeRartmentorlndustry, SOIL AND SITE EVALUATION REPORT Page ~ of 3 labor and Human Relations Division of 9afery K BuikGngs In accord with ILHR 83_D5. Wis_ Arim_ Cnria COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but ST • °LR.U not limited to vertical and horizontal reference point (BM), drection and % of slope, scale or PARCEL I.D. ~ dimensioned, north arrow, and location and distance to nearest road. ' O v S - 108 - 3.0 APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION ~~.OB~TL.'~ ~0 1 pN - 1~9T BUJ 1!4 Sw 1/4,S 31 T Z8 ,N,R l ~i E (or~ PROPERTY OWNER': MAILING ADDRESS. ., ~~ IV -l S S ~ e.oUiv~ ~'PrD N LOT;t BLOCK ~ SUBD. NAME OR CSM ~ - - - CITY, STATE ZIP CODE PHONE NUMBER S f~R-1 u G U tn..(~ (s~l~6~ (~[S') ~~S = u s6 5 ^CfiY ^VILLAGE L~1'OWN ' ~-'PN G ~'L-LL NEAREST ROAD s "RF ~UN._ [}.New Construction Use [ICJ Residential / Number of bedrooms 3 [ ] Addition to existing building (J Replacement [ J Public or commeraal desaibe Code deriaed daily flow LtSU gpd Recommended design loading rate - bed, gpd/ft2 • 3 trench, gpd/ft2 Absorption area required 3"1 S bed, ft2 3~ S trench, ft2 Ma~amum design loading rate • 4 bed, gpolft2 . S trench, gpd/lt2 Recommended infiltration surface elevation(s) °~8.0' ft (as referred to site plan benchmark) y Additional design /site considerations V QN L`l- GR.tU4 ItiJ ~ I~Pt~tf~l X11" 1~1 UV1`1Sj S',c1S `CQ~JCIf W~Z ~ oFSPa~ Parent material ~~ L~ S n U~. e.l 11,u, Flood plain elevation, if applicable (VIA ft S =Suitable for system U= Unsuitable for stem . ~ .... CONVBdTIONAL D S ~ U MOUND ~S D U IN-GROUND PRESSURE D S (~U AT-GRADE D S ®U SYSTEM IN FlLL HOLDQVG TANK D S CCU I D S ® U . , , -~ .- ~~..,,..v Boring # Ground ~ ft. Depth to limiting factor ti 3" Boring # Z~ Ground elev. gS.Dft. Depth to limiting f `osr y SOIL t)ESCRIPTION REPORT Horizon Depth in Dominant Color Munsell I Mottles Q S l C C Texture I Structure Consistence Banclary I Roots I GPD/ft . u. z ont o or Gr. Sz. Sh. B~ rert~ o -$ I.0`1, R j 13 - ~ st. l Z- ` ~bk ~n~l.- ~ S L ~ • S • 6 Z 8 - ~3 LO `1 R ~/~f - S 1 CS , p Zl-Sbk yvL'~1- a-s 1 U`~ . ~ .S 3 13 ~~ ~-5`-rfz ~~y ~~ ~. ~ e l v~ ~.~I~ ~ - ti~ Z Rcm~r4a• Ft'1-J " ~ o -q UD`-l (Z 3 L 3 - s 11 Z`F~b l~ M`~ ~ S L'~ • 5 = • 6 Z ~-t.s to ~ lz ~!y - sl, c.~ Z`~sbk ,,,~,. a, s lv'F -`1 •S 3 lS 30 ?.S~2 ~~~ ~.S~CIZ Sl8 e.) p`^, -n'f~• - M~~ - Z Remarks: \`j't b ' STName.-Please Pnnt ~ Phone: Arthur L. We>7erer 715-425-0165 ~egerer Soil esting & Design Service-P.O. Box 74 River.Falls,WI.54022•' .~ ignature: ~ ~ Date: ~~ CST Number.. o~/. ~ Oo-130 S•.~S-~O 220254 PROPERTY OWNER S~LOt~I SOIL DESCRIPTION REPORT PARCEL I.D. p o ~ ~ - ~ tJ ~ $ -3D Boring # ~4}{.ii~~„~:~~'i ~'•.2 „'~ _`: w 3 t~, ~_, .......'tiS:£~a Ground elev. °-6-i3 ft. Deplh to limiting fac~lOs „ Boring # ~~~'•}x~ Ground elev. ~1S-~ it. Depth to limiting factor x,3'1 r Page ~- of 1~ Horizon Depth in Dominant Color Munsell Mottles Du Sz Cont Color Texture Structure G Consistence Borxxi~y Roots GPD/ft . . . . r. Sz. Sh. Bed rends O- v l O `'t 2 313 -- S 1 ~ Z`F-Stilt +~'-- ~, 3 ~~ . S . (~ Z $ _~ l~ ~t R yly - si cl Z'F sbk -~r`ft- a.s \v'f~ •~( .5 3 ~.s - ~ S ~R fly c~, -SN ~ s~8 e 1 ~~ ~`Ft- - w~~ . z 1 • 1 i i _ I~ D.........1.... F'TT" 1 Z o -$ $ - ~~ l 0`--L R 3 f 3 t U Y 2 y l y - ~. - S 1 ~ S 1 c. ~ Z'~ s blz Z'F sbrc. Yvf.'~y~ wt'FJ- a.S oc~ S 1`~' ~ U'~` ,S ' ~( ~ • (, .S 3 ~ 3 z9 ~.s~t2 y~y ~t ,.sKesi~ e~ d~ m`fl, - Na ~ .z Remarks: 1 ~. ~. Remarks: Remarks: _ h n•i •~n~f• •.r ~. ,. --- - PLOT PLAN Page 3 of ~ SCALE 1"= ~O ' s~ ~v ~, I 660' '~ I v s~ b3 i~'"~1t! - tL IOU.O~ O-v Spllz6 ~D4'f~OVE GR~U~ 1-v ~~.1~.Pa~E. 3r1~z - ~_ a-~•9 ' ~ ~~ ~ . z~" •< << -, 16"Dlfl.`51~ , a ~s ~ ~~, a' ~' ~ • ~- g.Z ~ -/i~5~ ` ~ n ~~. oo~1v~ et~v. 9.6.0 ' , $~rruH c~p,.,e~+ ~.~v. g~.~ i".t ~~ ~~~~ Saba <\\~ X3.3 .\ ~~U~~ \~ ~-- ~, ~ 8.4 ~ H`~ t't-~1S ~ ~~ ~~qs ~ .~ ~ ~ ti ~ NS \ ~ ~. ` ~ ~ ~Or co*1~~ ~r o 2 -_. __. ._. _...._--.. ~. _ _.__ _ _ w - ii J Br~~-} 0 O - l30 - _ - ------- - zzoZ S ~! . S% ~s~ (715 ) 425-n1 h5 e ' CST Signature - ~ Date Signed ~ Telephone No. CST #