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Home My WebLink About018-1044-90-100 AS BUILT SANITARY SYSTEM REPORT OWNER ll age- -e, TOWNSHIP 6-L SECTION -24 T-,?2 N-R /7W ADDRESS/f G.LcI ST. CROIX COUNTY, WISCONSIN SUBDIVISION Q/iC LOTdjG LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM Z /GGyo S~p~~ aG /S IS i I'I INDICATE NORTH ARROW BENCHMARK:Elevation and description: Alternate benchmark SEPTIC TANK: Manufacturer: 1f? = d W ~~i`' Liquid Cap. ~G U Rings used:,e-Z_Manhole cover elev: Final grade elev: Tank inlet elev.: Tank outlet elev.: No. of feet from nearest road:Front, Side , Rear Ft.f4Y2 - From nearest prop. 1 ine : Front,, Side, Rear_L/-Ft. No. of feet from: Well, ,94' ; r1,Pcj Building: 40k (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE l PUMP CHAMBER 1 c+l G~1 Q- S~ Manufacturer: Liquid Capacity: Pump Model: ,Pump/Siphon Manuf act 2 v e Pump Size J /~r~ Elevation of inlet: Bottom of tank elevation Pump on elev.: Pump off elev.: Gallons/cycle: Alarm: Man.: :Sr lD/ 21VAY Switch Type : Auer c Location Distance from nearest prop. line: Front, Side., Rear&_Ft. Distance from: Well 2- V'41,'Ile q/ Building SOIL ABSORPTION SYSTEM Bed: Trench: Seepage Pit: Width: Length Number of Lines: Area Built Exist. Grade Elev. Proposed Final Grade Elev. Fill depth to top of pipe: No. feet from nearest prop. line:Front , Side , Rear Ft. No. feet from well: No. feet from building HOLDING TANK Manufacturer: Capacity: No. of rings used: Elevation of bottom tank: Elevation of inlet: No. feet from nearest prop. line:Front Side Rear Ft. No. feet from: Well , building , nearest road Alarm Manufacturer: INSPECTOR: DATE : PLUMBER ON JOB LICENSE NUMBER: r 6/90:cj Wisc,nsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page N of 3 L.aU and Human Relations * Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY sue-. 15C 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. Q/ - 0- APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION RE DATE PROPERTY OWNER: PROPERTY LOCATION 3r c- 3U4~12 GOVT. LOT NW 1/4 SW 1/4,S Z.O T 2-9 N,R 11 E (oGW PROPERTY OWNER':S MAILING ADDRESS " LOT # BLOCK # SUBD. NAME OR CSM # CITY STATE ZIP CODE PHONE NUMBER []CITY (]VILLAGE CfOWN NEAREST ROAD S u o t S (-AS) -796. 53~ l otU bbd -M 57' ~Q New Construction Use Residential / Number of bedrooms 3 [ ] AddibQn to existing building j j Replacement [ ] Public or commercial describe Code derived daily flow LLSU gpd Recommended design loading rate bed, gpd$ 0.35 trench, gpd/ft2 Absorption area required 3-I S bed, ft2 3771 S trench, ft2 Maximum design loading rate o - 'S bed, gpd/ft2 0.6 trench, gpd/ft2 Recommended infiltration surface elevation(s) 1 O Z• S ft (as referred to site plan benchmark) Additional design / site considerations +nov+vp w/ S `x S `t R uGH , M/ 1U1Nu/N 1 r 0 V- StVv\Z~ J=1 L L Parent material L LS S nu JCL G `hethL T1 L Flood plain elevation, if applicable 1y - H- III S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for s stem ❑ S (XU EWS ❑ U ❑ S ALI ❑ S ®U ❑ S KU ❑ S Iv u SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 0 -9 `w-ur- 313 S l Z m 3\0M `F►~ o. S- 0-S 0.6 Z 9-Zy 1o~e 3/~ - 5 i 1 2'~S~tir »z~~- cS - o•S o-6 Ground 3 24-29 S ` l z 3) S z•,wl oL b1T yrt C o• 5 0.6 elev. q 9~ ft. y Z9-69 5 `T L 3 /y S d Y+-1 w►`~~--M`~t~ Depth to ' x rV 5 1Z limiting factor lty-e T-t F S ~t'N Z°I Remarks: Boring # S 1 Z+n s bk m`~►~ o~, - o. S 0 6 Z e1-20 lu` z 3/~ g Z sdk m'F►~ CS S a 3 20-Za S IZ_ 3 /y - s) Zm a_6v, Vq ' I,- S Q S ' a. 6 Ground elev. 14 z~,6y S y2 3!y - S1 cow. W& M 1 ) tio3.4ft. ~ Depth to C-o>U TTV ru S G ` nil s - S . limiting qo F/ factor Remarks: CST Name:-Please Print Phone: Arthur L. We erer 715-4 erer Soil Testing & Design Service-P.O. Box 74 River Falls, ge Signature: Date: CST Number: C t 93.61 4/-Zy-g3 M00576 PROPERTY OWNER ~PCC~ SOIL DESCRIPTION REPORT Page ?I 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 S t) Z `F S ~Ac `F~• a. S - o, S o 6 w, 'F,,- CS 6A - s o • Ground 17 - Z.9 5 lZ 3 l51 S ~ Z M OIL C% elev. le ft. y 9 S ~d fZ 3!y - 8 rn`~►- m~ - _ Lem qutmt~ Depth to /v ~Q, vs, limiting factor Remarks: Boring # r _~j Ground PUG F:- ~ZUh1 elev. 1 S S~ L `T~l~ owu L~ G 1 ft. Depth to limiting factor Remarks: Boring # hiv Ground elev. ft. Depth to limiting factor Remarks: Boring # WIN, v Ground elev. ft. Depth to limiting factor Remarks: S13D-8330(8.05/92) PLOT PLAN Page 3 of 3 V SSA ~z-" SCALE 1"= 3O '/z h ii Ie TO 31 w►~ 3/y" DI R. PU c- P) P6- iv/L,-TH 3.Z LIZ, 1113 V I 0 , a a w DoT Su ~T~cdl~ c~rR~q ~o a FUR "oJArp ~p s~ 6 ~o t3.3 L-L 103 N I 0 t,3 if 31y"Pve API 99 g u tier IbO' ~0 I SOT Litt L C 10 3 F R't' L~ItST S' !=-Ci U 1" ~oU+vp, 93-6/ "Z Y- 9 3 (715 ) 4L-0165 _ M00576 CST Signature Date Signed Telephone No. CST # Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of 3 Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY sT- C.~..~115C 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 $1 L__ F~ C,E av4~1t GOVT. LOT NW 1/4 Sit) 114,S Z-o T Zq N,R 11 E (00W PROPERTY OWNER'S MAILING ADDRESS „ LOT # BLOCK # SUBD. NAME OR CSM # S°to kL~tJ p R ,T. - - ~t~c,~~os c s f"I CITY STATE ZIP CODE PHONE NUMBER []CITY []VILLAGE ®fOWN NEAREST ROAD ~~►M t)~D ~ S CEO l 5 (~!S) '796 , 537 ~CR't'11'''I p1.,1 II,O 'f'k S't' J~ New Construction Use [,)Q Residential / Number of bedrooms 3 [ j AdditiQ,n to existing building j ] Replacement [ ] Public or commercial describe Code derived daily flow ySZ gpd Recommended design loading rate _ bed, gpolft2 0-~ trench, gpd/ft2 Absorption area required 3") S bed, ft2 31 S trench, ft2 Maximum design loading rate Cs- 5 bed, gpd/ft2 0.6 trench, gpd/ft2 Recommended infiltration surface elevation(s) 1 O Z • S ft (as referred to site plan benchmark) Additional design/ site considerations w~uvrvp w/ S `x S ' I-Tr_e7vc-if . M[ pi)JIUH if D>= SiwU H t-L. Parent material Lo V~-zl % S ov OL G `-►vO-LW ~ l ►LL Flood plain elevation, if applicable N - A- ft g Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING ~T U = Unsuitable for stem ❑ S [XU WS ❑ U ❑ S NU ❑ S O U ❑ S KU ❑ S +J U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Chu. Sz. Cont. Color Gr. Sz. Sh. Bed ranch t- 1 0 -9 ~O`'1~Z 313 s ~ 1 Z M 3,01k yn Fh 0-S 0-L 9-zy to pie 3/6 s i 1 Z ~s~x 1-n cS - a. S o Ground 3 ?'q --Z9 S Li (L 3) 5 z 0.bk wt 'Fh C S o• S o• 6 elev. C O-16 It. y Z9-6S S Lt P_ 3 /y Depth to 'TMN S fpA 'Zlr limiting Z~q A o kZ" S F S lid i Remarks: Boring # S o -9 ~0~-t R 313 - s i Z►n s bk m`Ft~ o~,q - o. I 0 6 Z ' Z q-z-o to`'1R. 3!6 S 11 Z'Fsdk m~~ C. S _ o S o• •~vv'i n~i: t i\ ~:v4:~ 3 Zo-Zb S Ll IZ 3 /y - S) ZM a_blz YK 0-S a-6 Ground S "a- 3!y - S1 UWX w1f it-M Depth to limiting fact t Z Remarks: TName:-Please Print Phone. Arthur L. We erer 715-425-0165 Address: Soil Testing & Design Service-P.O. Box 74 River Falls,WI 54022 Signature: ~~~~r(f Date: CST Number: iV4_, ;e. 43 - 61 V-ZV_'?3 M00576 PROPERTY OWNER ~PCC~ SOIL DESCRIPTION REPORT Page Z of 3 PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounday Roots GPD/ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 0. -1 tz~ l~`-t 2 313 - S i Z `F S V1c iM. `F , OL. S - o . S a L WniF - cS - o,S o•6 Ground 3 17-Z. 5 bR 3/ S~ 'Z )n 0.01 >n CS - 0 S 0•L elev. 10 , o ft. y 9--)S Lt (t Sly 8 O r~ rn~t. -m`~ i Depth to limiting factor LO) ' FT 1 .1 F Remarks: Boring # f-1 L b w ~j We- I,1 I 6 Ground L L) )JUG 1= lAt IZUhJ elev. 1 S S 0?j e l ft. A\j Depth to ' limiting factor Remarks: Boring # 4 Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft Depth to limiting factor Remarks: SBO-8330(R.05/92) PLOT PLAN Page 3 of 3 u sN ~Z SCALE 1"= 3 0 ' le t~cc~~T Rs 9UcOw ~Frv c ~ 3jyuDrfr. PU0- P! pE wl LrrTN a.?- t r4 A 40 o 4 DoT Su ~`f^kdl~ tl'RNQ ~R 19CUNp ~Z. tp s~ 6o~O ~,3 ~to3o. r tots 3!y" puC A t of N w! ~7N R $ Np Z-°!9_ r 3Co' _ _ O~S~Re s^cr oR r r ~~Yv~Z~ DoT Lw C 0 3 F h't- t sT 5' V;~tz.o h "ouk,p~ 1 wc1.L `M R~ ftT Lfti ' So' Mto-, muu&,t~ , 93-6/ oc.''S ,r +~t -,Z q3 (715 ) 425-0169 M00576 CST Signature Date Signed Telephone No. CST # LOCATION: HAMMOND.20.29.17 (160TH) Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX 'Safety and Buildings Division (ATTACH TO PERMIT) SanitaryPermitNo.: GENERAL INFORMATION 193500 Permit Holder's Name: ❑ City ❑ Village Town of: State Plan ID No.: ACE, WILLIAM HAMMOND CST BM Elev.: , Insp. BM Elev.: BM Description: Parcel Tax No.: C~ 018-1044-90-100 37 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic >f?` it ~~4 Benchmark S O~ , Dosing ~'I I - ' I Aeratipn Bldg. Sewer ? Holding St/WInlet p TANK SETBACK INFORMATION St/JOutlet TANK TO P/ L WELL BLDG. Ventto Airlntake ROAD Dt Inlet Septic 11*2,4- NA Dt Bottom 7p, JV6 Dosing 9~/~a (ot~ 0/ NA -r/Man. Aeration NA Dist. Pipe Holding Bot. System PUMP /INFORMATION Final Grade Manufacturer D~e,Xmand 7 Model Number t~-9 J ~GP,M TDH Lift ( Lriction Systems TDH t Forcemain Length Dia. Dist. To well , SOIL ABSORPTION SYSTEM BED/TRENCH Width I Length r No. Of Trenches PIT No. is Inside Dia. Liquid Depth DIMENSIONS 5 DIMENSION SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING anu a, r. SETBACK INFORMATION Type O -Pe, CHAMBER Moe Num e . Air System: !1/1h.~' 7lllc~~ gv = L OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe sj A/ ~i x Hole Size x Hole Spac~g Vent To Air Intake Length Dia. Length 2,C Dia. Spacing 14 1 / (p 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 4OM Trench Center / -Bed=/Trench Edges /r? Topsoil 6 / es E] No E]1es ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: HAMMOND. 20.29.17 (160TH) / l ' i . f, Plan revision required? ❑ Yes Use other side for additional information. l~ SBD-6710(R 05/91)_L,- - / Date Inspector'sSignature Cert. No. ILI ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ` am _A a DILHR SANITARY PERMIT APPLICATION In accord with iLHR 83.05, Wis. Adm. Code COUNTY -5/ T 4 / STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ h~ 8% x 11 inches in size. c ec i son ous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION l lA C S ge T10g, N, R or) W PROPERTY OWNER'S MAILING ADDRESS LOT # BLOC l6 S y e Ti( CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER r - II. TYPE OF BUILDING: (Check one) F1 State owned VILLLLAGE NEAREST ROAD 0 &g 3 ❑ Public or 2 Fam. Dwellin of bedrooms - PAR AX NU BER III. BUILDING USE: (if building type is public, check all that apply) / ?0104 1 ❑ Apt/Condo (J~ 2 ❑ Assembly Hall 60 Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 30 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. K New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ 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 42 ❑ Pit Privy 13 ❑ Seepage Ptt Pressure 430 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 ~~ll REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION y.~V 3'7.S 93'? . _.S' l~Z~ Feet 1091 Feet VII. TANK CAPACITY Site INFORMATION in allons Total # of Manufacturer's Prefab. Fiber- Exper. New lExisting Gallons Tanks Name Concrete structed Con- Steel glass Plastic App Tanks Tanks Septic Tank or Holdin Tank le~y 14 ;6f Aleg 7- -77 Lift Pump Tank/Si hon Chamber e-11.0- 0 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's Signature: (No Stamps) M RSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Code): 7 S .0 V- 1IF4 / L IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved S 7 tary Permit Fee (Includes Groundwater Date issued Issuing Agent Signature (No Stamps) Approved ❑ Owner Given Initial Surcharge Fee) Adverse D rmin ti n 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 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 (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever recessary, usually every 2 to years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's narne and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. ll. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this systE:m. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8'% x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water, mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system arras; and the locatioi of the building served; B) hcrizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences;. friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the so i absorption system if required by the counter; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATEiR SURCHARGE 1333 Vi;sconsirr Act 410 included the crE+ation o' -4urcharges (fees) for a numbz~r of regulated practices which can effect groundwater. Tho monies cox iected through these surcharges are used for monitoring groundwater, ground- water contamination invesl:igations and estabiishment of standards. S8 D-6398 (R.11M) SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations PRIVATE SEWAGE PLAN APPROVAL Northeast Regional Office . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1053A East Green Bay Street P.O. Box 434 Shawano, Wisconsin 54166 WEGERER SOIL TESTING PO BOX 74 RIVER FALLS WI 54022 RE: Plan Number: S93-30279 Date Approved: May 19, 1993 Gallons Per Day: 450 Date Received: May 11, 1993 Project Name: PACE BILL Location: NW,SW,20,29,17E Town of HAMMOND County: ST CROIX The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped 'conditionally approved'. This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall !peep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. This approval will expire two years from the date approved or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. The Section of Private Sewage has reviewed these plans for private sewage system code requirements only. These plans have not been reviewed for the code requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 of the Wisconsin Administrative code. This approval is for the following components only: - NEW MOUND Inquiries concerning this approval may be ;Wade by cal 12,, 627. Sincerely, ms's KEITH A. WILKINSON to ~'p C, 'v~.a f'~Co Section of Private Sewage Division of Safety and Buildings 09 3PP032/0009n/42 ti cc: Private Sewage Consultant S SHD-6423 (R. 01/91) Page 1 of b MOUND SYSTEM FOR A 3 BEDROOM RESIDENCE LOCATED IN THE MW 1/4 OF THE Sk) 1/4 OF SECTION ZA T V~ N, R 17 W, TOWN OF sT, elm))( COUNTY, WISCONSIN. INDEX PAGE 1'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 TE Sr2**D'FOR ANSI CL w► . N1f~~'l~S~~1QN$ t,A N 5 DEPA~~MENO~ iNpUSTRY, DIVISION Of 5AF~ ANQ BUtLOtNU cORRSSPOND PREPARED BY ®®g~,oetste~ WEGEER. ER E 3 C3 I L TEST I tVG 0,Av ®m®~ AND. DES = GtV SEi~V I CE ® ARTHUR L. P F.O. BOX 74 421 N. MIN ST_ ® WEGERPER 0.Sis v RIVE? FALLS. MI 54022 s : GLLS WORTH, 5-LI 13 6 JOB NO. c/2 - PLOT PLAN Page -z-of Scale 1 M) ' U gN Pe)vice • PIZO~~R-1Y ~.ln~E 3/y" bi R PU C P! PE tv/C..It W a.z a1. l p.3 ~ ONSITE SEWAGE SYSTEM a Lp,TiONS HUMAN RE DEPARTMENT OF INDUSTRY, LABOR ANDILDNGS DIVISION OF SAFETY ~j IO OF 4Np17C a 5 SEE CORRESPONDENCE sup Q, ~OF44PVC- 1 ~ FvR 1r-ia~Np _ LO s~ 6 o~O 3 ~ 1.03 $t'! Ajo TL 99 6 p r JSh'R@~p~cT oe ` 0 %p LOT L-11- C To 3 F Per LekST S ` PRO i`t r-iOUNp, `i WELL To t3NE- >1fi L*wrr SOS lr'mom mUVAjt~ awl z s ~t NOTES : .E.~v►~h~ S e7 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 lkSL~o gallon capacity manufactured by 1'1 \ b W 0- S TtSCLty C~ 2r C A~ 3 Y J ti C. . 5. Bench Mark SkFE~ "Due 6.•Divert surface water around mound to prevent ponding at the uphill side. Page 3 Of b Approved Synthetic Covering Distribution Pipe Medium Sand H _ I G Topsoil F Elev-. \t-~,Z-S p - 3 E b 6 % Slope Q*-d Of 22 Force Main Plowed Aggregate From Pump Layer Undisturbed D 1.0 Ft. Soil E 1. j Ft. Cross Section Of A Mound System Using F 0.8 Ft. I Trench For The Absorption Area G N.a Ft. A S Ft. H I- S Ft. B -)S Ft. I NZ Ft. Linear Loading Rate= 6.13GPD/LN FT J 8 Ft. Design Loading Rate= o•3SGPD/SQ FT K 11 Ft. L q-1 Ft. W Z5 Ft. L Force B - K _ Ma- A. - - - W 2" c~t~PeSIIFD. OistP but 2 SEWAW*&f 9 1 P anent J Observation EW kers Pipes (anchor - DEPARTMENT OF INQUSTR , OiVISiON OF SAFETY AND BUILDI14GS SEE COR ER SPCt~V-N~ Mound Using 1 Trench For Absorption Area X0279 Page Of b Perforated Pipe Detoll 0 End View Perforated End Cap y PVC Pipe I _ Ja~,a.\eace asp Install permanent-marker at end of each lateral Holes Located On Bottom, Are EQuouy Spaced Q End Cap * PVC Force Main i Distribution Pipe Last Hole Should Be Next To End Cop ITE SEWAGE SYSTEM ONS '.n Pipe Layout P 3y,.'1 Ft. X Inches E V DEPARTMENT OW INDUSTRY, LABOR AND HUMAN REI.pTIONS Y ~ Inches DIVISION OF SAFETY AND BUIIDI J y Hole Diameter Inch Lateral Inch(es) SEE CdRRESPUNDENLt Manifold - Inches Force Main 2 Inches # of holes/pipe '7 Invert Elevation of Laterals 10'5-0 Ft. i , r~ 80 2 7 09 Place lst hole 31from tee with succeeding holes at 6y intervals. Last hole to be next to the end cap. l PUMP CHAMBER CROSS SECTION AMID SPECIFICATIONS PAGE S OF VEWT CAP 4" C.I. VENT PIPE WEATHER PR00► APPROVED LOCKING MANHOLE 25' FROM DOOR, JUNCTION BOX COVER WITH WARNING LABEL WINDOW OR FRESH It'MI~. AIR INTAKE I f GRADE L2. 100 S Y' MIN, I D' MI N. COWDUIT-- 18"fKIAI. - ll~ PROVIDE - IIJLET AIRTIGHT SEAL I III I I I APPROVED JOIN A I ANA Ccl~ 5 i>tlx[ ~ I ~ S (~r4 LL _ I I ~ I APPROVED JOINTS L C~ PLy tiv t z► t .I LH rZ 3, ~5 /q N i~ I W I rl4 1) ALARM ~ WAGE SYSTEM , ~ i Ow Sc, L 84•gZ 81TESE A ELEV. FT. PUMP -OFF 02 ()VE sipa - R1~[o"CLOCK E lpurc~rOWL I T ¢Y/1 T1dRER HAS SUCH APPROVAL SEDDIRoVED; V EOO TIOKIS DOSE CORR TANK MAUUFACTURCR: t~W 1J P2~M ST WUMBER OF DOSES: PER W14 TANK SIZE: SO GALLONS DOSE VOLUME l36 S ALARM MMJUFACTURGR: %"Z' L-ttTcTRO SY37-131 j S IIJCLUDIW6 SACK►LOW: 6Af.~ONS MODEL NUMBER: 1S~l 1 HW CAPACITIES: A= INCHES OR 331• S GALLONS SWITCH TJPC: - ►`~V-1 GUT^t-L/ g = INCHES OR 34-0 G(LLOIJS PUMP MANUFACTURER: ZC)e-LLLxTt Cs 7 INCHES OR \-1 CALLOUS MODEL NUMBER: Q1 D- 11 INCHES OR 331. S GALLONS SWITCH TYPE: - 'Flkne t-ol MOTE: PUMP AND ALARM ARE TO DE MINIMUM DISCHARGE RATE \L-Sb GPM INSTALLED ON SEPARATE CIRCUITS VEKTICAL DIFFERENCE DETWEEN PUMP OFF AIJD..DISTRIbUTION PIPE., 13.38 FEE I& cc~ + MIAJIMUM NETWORK SUPPLY PRESSURE 2.50 FEET ♦ FEET OF FORCE MAIN X °-SZ F j o.LLz. a loo pr.FRICTIOLI FACTOR.. FEET TOTAL DtIWAMIC HEAD = 1~'0o FEET 1r DIAMETER - INTERNAL. DIME►JSION~ OF TAIJK: LEW6TH 6~I roP ;WIDTH &LIQUID pEPTH Y3 S'9j/24,8er- S' 14".&ur. BOTTOM AREA 231 GAL/INCH AS PER MANUFACTURER 1q.S GAL/INCH W UJ LL. HEAD/CAPACITY CURVE 4% s"• MODEL 97 41A --*-I 30' 8 25' 1'12 11'12 NPT *3/, Q 20' 6 W 6 = V 1,6.00 z 15' 0 4 )638 FO 10' 2 5'- 0- us 10 20 30 40 50 60 70 GALLONS, I LITERS 0 80 160 240 1011/,6 FLOW PER MINUTE TOTAL DYNAMIC NEAD/FLOW PER MINUTE EFFLUENT AND DEWATERING CAPACITY HEAD UNITSIMIN 35/,6 FEET METERS GAL LTRS 5 1.52 56 212 _ 10 3.05 46 174 15 4.57 35 133 20 6.10 15 57 Lock Valve 23.75' CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available a Mercury float switches are available for controlling and supplied with an alarm. g- single and three phase systems. e Mechanical alternators, for duplex systems, are avail- a Double piggyback mercury float switches are available able with or without alarm switches. for variable level long cycle controls. SELECTION GUIDE 1. Integral float operated 2 pole mechanical switch, no external control required. Standard All Models - Weight 33 lbs. - 1/2 HP 2. Single piggyback wide angle mercury float switch or double piggyback mercury float switch. Refer to FMO477. 97 Sarin Control Selection 3. Mechanical alternator 10-0072 or 10-0075. Model Volts-Ph Mode Amps Simplex DUF"x 4. See FMO712 for correct model of Electrical Alternator, "E-Pak". M97 115 1 Auto 12.0 1 or 1 & 7 - 5. Mercury sensor float switch 10-0225 used as a control activator, specify duplex (3) N97 115 1 Non 12.0 2 or 2 & 6 3 or 4 & 5 or (4) float system. D97 230 1 Auto 6.0 1 or1 &7 - 6. Four (4) hole "J-Pak", junction box. for watertight connection or wired-in simplex or g97 230 1 Non 6.0 2 or 2 & 6 3 or 4 & 5 2 pump operation, 10-0002. 7. Two (2) hole "J-Pak for watertight connection or splice, 104003. CAUTION For information on additional Zoeller products refer to catalog on Combination All installation of controls, protection devices and wiring should be done by a Starter, FM0514; Piggyback Mercury Float Switches, FM0477; Electrical Alternator, qualified licensed electrician. All electrical and safety codes should be followed FM-0486; Mechanical Alternator. FM0495; Alarm Package, FM0513; and Sump/- including the most recent National Electric Code (NEC) and the Occupational Sewage Basins. FM0487. Safety and Health Act (OSHA). smiMo 893 .0 6 RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. 3280 Old Millers Lane Manufacturers of . OEZ&Lff TZ7. P. O. Box 16347 • Louisville, Kentucky 40216 (502)778 2731 • FAX (502)774 3624 ,QMAUrr 19MMAY F1NCE /,93A9 ij PRI ei tLIkIIN i i I j CEP T I F I ED SUP V E Y 14A P Located in the NW 1 /4 of the SW 1/4 of Section 20, T29N, R 17W, Town of Hammond,. St. Croix County, Wi. 1 Sec. 20 Owned by:, Donald Rode E1/4 corner, T29N,R17W 836 160thY St, Berntsen cap fnd. I Hammond, W i. 54015 S 00004'25"E Surveyed f, r: Bill Pace n 590 Klien Dr. 210.00 ' Hammond, W i . W 54015 Z J Z 0 mo iv Z ,~r HARVEY G. f`1 JOHNSON 1- S-1899 i w CIO HUDSON i 3 W iS r LOT I , Z o~io~aaoo® O 132232 SQ. FT. (3.036 AC.) rn Q M INCL. R.-O.-W. N (D o Ln (D of ~I Uj 0 125302 SO. FT. ( 2.877 AC. ) 01 EXCL. R.-O.-W. to s3 a~ M m - a wl U) U 06) 0) LEGEND al CO 00 - - Section corner monument Z (as noted) ° 1 "x 24" iron pipe set weighing 1.68 lb s'. / lin. ft. Fenceline W 1/4 cor. Sec. 20 _ N 00'15'00"W 210.00' (set) M M j60TH ST. N 00`15'00"W 10 - -210.00'- Bearings referenced to the East-W.est 1/4 Scale in feet 1"=100' Section line, assumed N89 55'35"E. 0' 25150' 100' 200' 300' Drafted by: JulG 493-2160 i i 9i0fiS 't& 'uospnH 16 xog 'O'd ' ouI ' 2utAanxnS uosuuor ,668i-S uosuuor 'O AaAaeH ' jatjaq puE 2utpuE4s aapun a23pajtAOUN TEUOtssapad Aui jo ;saq aq; o; aouLlul O uotstntpgnS puouzuzEH jo uneoy agp puE 'aou-:utpaO uoisintpgnS d;unoo xtoao 'IS aq4 'sa4nj-e4S utsuoostM aq; JO i~£' 9£Z not;oas ijo suotstnoad ag; uItnn patjdutoo Ajjnj anEu 14Egj puE :pay aAxns puEj aq; joj'satxEpunoq aotaa4xa atp jo uot4E4uasaxdaa loaaaoo puE ana4 a st 4Ejd Bons ;Eq3 IA4aadoad pagtaosap anoq-e agp padd-ew puE paAanxns anEq 14Eg3 -.c. Ajt4xao Agaaaq 'aokanans pine-I utsuoostM paxa4st4aa 'uosuuor 'O AanaEH 'I ii 'paooaa jo s4uEUZan0o pine suot40ta3saa '94upuzasEa jjE o;.4oafgns Eutaq puE ssaj ao axout (saaoE 9£0'£) ;aaj aaEnbs Z£Z' Z£i 2ututE4uoo '2utuut2aq jo ;utod ag; of ;aaj 00-01,Z 4saM spuooas 00 sa;nutuz SI saaa§sp 00 g4aoN aouag; :;aaj S£"629 4s9M spuooas S£ sa;nutuz SS saaa2ap 68 g;nos aouag4 :4aaj 00.OIZ ;sEg spuooas SZ salnutuz to saax2ap 00 q;nog aouag; :4aaj 00'0£9fpauznssE s4utxeaq) 4sEg spuooas S£ so4nutuz SS saaxEap 68 glaoN aou;DtP ; OZ uot4oaS jo aauxoo I,/ I M ag3 ;E 2utuut2?ag :smojjoj sE pagtaosap 'uisuoostM 'A4unoo xtoao '4S 'puouzu eH jo utAOL ML I U `N6Z,L 'oz uotioaS jo t/ I MS aq3 30 t/ I MN aq4 ut pa;EOOi puEj jo jaoaEd y NOI.LdIdOSaa i r S T C - 100 This application form is to be completed in full and signed by the own'er(js) 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. wner of property OLpcatiop of propertyAlk, 1/4 1/4, Section T_-' `l N-R / -~W j Township , Mailing' address 1~) 44, Address of site Sig V Subdivision name Lot no. Cher homes on property? yes No a Previous owner of property TI tal size of parcel C~'.rl> J, Da ~ to parcel was created - S / Are all corners and lot lines identifiable? Yes 'No 4- this Prop ert bein Is p P Y g developed for (spec house)? Yes No Volume (%`Xand Page Number _c-210 as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A,,WARRANTY DEED which includes a DOCUMENT NUMBER VOLUME AND PAGE NUMBER & THE SEAL OF THE REGISTER OF DEEDS. In addition, E a certified survey, if available, would be helpful so as t to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. i PROPERTY OWNER CERTIFICATION I(we) certify that all statements on this form are true to the best of my !(our) knowledge that I (we) am (are) the owner (s) of the property described in this information form, by virtue of a warranty' deed recorded in t 4e office of the County Register of Deeds as Document No. '/q Kok, , and that I (we) presently own the proposed site for the sewage disposal system or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded.in;t office of County Register of deeds as Document No. U Signature of, applicant ~-applicant Date of Signature Date of Signature i I I I I I I I I f S T C - 105 I' SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County I OWNER/BUYER ADDRESS ~L C) l FIRE NUMBER I I / CITY/STATE~'z,_ ZIP PROPERTY, LOCATIO / 1/4 , t4 1/4, SECTION; T Z _q W TOWN OF St. Croix County, SUBDIVISION LOT NUMBER Improper use and maintenance of your septic system could result in., its premature failure to handle wastes. Proper maintenance consists' of pumping out the septic tank every three years or sooner, if needed by a licensed septic tank pumper. What you put int:.o the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1,'1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journey'man: plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary),, the septic tank is less than 1/3 full of sludge and scum. I/We,,the undersigned have read the above requirements and agree to maintain the private' sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix Co. Zoning Officer within 30 days', of'the three year expiration date. ~c SIGNED: " j DATE:. St. Croix co. Zoning Office 911' 4th! St Hudson, WZ' 54016 i i 'I DOCUMENT NO STATE BAR OF WISCONSIN FORM 2-1982 THIS SPACE RESERVED FOR RECORDING DATA WARRANTY DEED 498846 VOL 1008PAGE 210 REGISTER'S OFFICE ST. CROIX CO., WI Il l Warren A. Rode and 41 Recd for Record Donald H. Rode ii (as tenants in common) MAY 111993 at 9.10 A. conveys and warrants to William T Pace and Dawn M Pace (husband and wife as survivorship marital property) Register of Deeds I RETURN TO ii the following described real estate in St. Croix County, I State of Wisconsin / L~ Tax Parcel No: ~ ee I ;Y ifl • EEE DESCRIPTION A parcel of land located in the NW 1/4 of the SW 1/4 of Section 20, T29N, R 17W, Town of Hammond,. St. Croix County, Wisconsin, described as follows' Beginning at the W1/4 corner of Section 20; thence North 89 degrees 55 minutes 35 seconds East (bearings assumed 630.00 feet; thence South 00 degrees 04 minutes 25 seconds East 210.00 feet; thence South 89 degrees 55 minutes 35 seconds West 629.. 35 feet; thence North 00 degrees 15 minutes 00 seconds West 210.00 feet to the point of beginning, containing 132,232 square feet (3.036 acres) more or less and being subject to all easements, restrictions and covenants of record. This is not homestead property. (is) (is not) Exception to Warranties: I 'I Dated this 11th day of May 1 1993 (SEAL)C.C'~GZrLiC -(SEAL) I; ' Warren A QRode (SEAL) -(SEAL) Donald H. Rode j AUTHENTICATION ACKNOWLEDGMENT (i Signature(s) Warren AA Rode and STATE OF WISCONSIN ss. Donald Hr. Rode County 199 Personally came before me this day of utheRlwB't'~b this. 11 d of May f ` p i 19 the above named ~:~Jgll 1014 &nnell TI LE, ME B•ER STATE BAR OF WISCONSIN (,t.no-Ut klofaQv"x.• My Commission expires 4/20/97 to me known to be the person who executed the ji aqtho,rized by §.Tof,06•, Wis. Stats.) foregoing instrument and acknowledge the same. ii ;H1S tN~ tV 4FN Wl+S DRAFTED BY _ Notary Public County, Wis. Signatures may be authenticated or acknowledged. Both My Commission is permanent. (if not, state expiration are not necessary) date: 19 ) I - - n;n es e!so"s 5.g n,ng n any caoacily should be iype0 or printed below their signatures SB2 NTF 0021 ,*nTr f1AP IF WlllnNSIN I ST. CROIX COUNTY jar WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 - (715) 386-4680 April 29, 1993 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: An onsite soil investigation of the William Pace property, located in the NW-',SW,, S.2, T.29N., R.17W., Town of Hammond, St. Croix County, WI., has been conducted with the assistance of Art Wegerer, CSTM# 0576. This onsite revealed suitable soil for onsite sewage disposal to a depth of 32" while meeting the requirements of the A + 4" rule. This site should be suitable for new construction utilizing a mound septic system having 12" of sand fill. Should you have any questions, please feel free to contact me at this office. 4erely, on mT qZ7, Assistant ng Administrator cc: file Parcel 018-1044-90-100 03/21/2005 05:03 PM PAGE 1 OF 1 Alt. Parcel 20.29.17.314A 018 - TOWN OF HAMMOND Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): Current Owner GOSS, RANDAL S RANDAL S GOSS 849 160TH ST HAMMOND WI 54015 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 849 160TH ST SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 3.036 Plat: N/A-NOT AVAILABLE SEC 20 T29N R17W PT NW SW BEING LOT 1 OF Block/Condo Bldg: CSM 9/2621 3.036 ACRES Tract(s): (Sec-Twn-Rng 401/4 1601/4) 20-29N-17W Notes: Parcel History: Date Doc # Vol/Page Type 05/06/1999 602749 1425/001 WD 07/23/1997 1008/210 WD 2004 SUMMARY Bill Fair Market Value: Assessed with: 56291 194,300 Valuations: Last Changed: 05/13/2002 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.036 29,100 133,600 162,700 NO Totals for 2004: General Property 3.036 29,100 133,600 162,700 Woodland 0.000 0 0 Totals for 2003: General Property 3.036 29,100 133,600 162,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 160 Specials: User Special Code Category Amount 010-GARBAGE SPECIAL ASSESSMENT 60.00 Special Assessments Special Charges Delinquent Charges Total 60.00 0.00 0.00