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HomeMy WebLinkAbout008-1099-60-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. ermit Holder's Name: City Village X Township De Gross, Joe Eau Galle Townshi ST BM Elev; Insp. BM Elev: BM Description: _- ~, ,; .. ~ ~ r~ ,~~ -,L, ~ ~. ~ err/.r'. TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~ ~ ~ ' - ~ zr ~~ ~ ~ ~ r Dosing r- Aeration ; ~ ~ _.._. __ ~ _ ,~ ~- ~,~-~;_..» .. Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD 1,,; if 1,"~ Septic L'.;'~; ,. ~ ` ,{ ~, . ~ 1 i ..I f ~ . ~ Dosing ~ ~~' ~~~~ ,- 1 ~ ~ -~j~ ~ 1 ~ v~ Aeration _... ` - "" y Holding ~_~ "... PUMP/SIPHON INFORMATION Manufacturer 'r Demand ' ". GPM ~ j +,~, ~ Model Number t t ~ ~ + ~ ~, i' ~ -_ ' TDH Lift. Friction Loss: Syste ead TD ~F't ~ Forcemairi l_engtfiy~ ~'~ '~ // Dia. _ Dist. to well d~ r Cnll ARC R If1AI CVCTFM ELEVATION DATA County: St. CrOiX Sanitary Permit No: 399698 0 State Plan ID No: Parcel Tax No: 008-1099-60-000 STATION BS HI FS ELEV. .~ ~~ ~ ~ ill Benchmarks- /~ ~,~ '-- 1 j ~ Alt. BM ~ i /} , Bldg. Sevvert ,, ~ t~.~ g7•~ SUHt Inlet ~ F ~ ~ r f $,UHt Outlet ~"[. I r i;4 ~~-l. Dt Inlet~V,l~,~ Dt ottom J YI -V7 . (~ 5 Header/Ma~ ~, 1 _ _ ,-- ~ ~ '- Dist. Pipe ~ 1. ~> G d Bot. System,- '' "' ) ~ I /-~.l ~~ 1~` Final Grade ~ f. Gq p S.~ t Cover ~ r - Ld rl s<~ ~- , D ., - - ~'~ BED/ RENCH Width Length No. Of Trenches 3 'D 15~". PIT DIMENSIONS No. Of Pits Inside Dia. uid Depth ~ DIII6ENSIONS ~, ~ ~ ~~t-t~- - Ll ~,*Q S ~.~ SETBACK SY TEM TO P/L -.;.,; LDG.~ = . WEt:.L LAKE/STREAM I_ AC G Manufacturer CH ER OR INFORMATION Type~SOf System: ~ ~ ~, ~V ~J Ut11T.~ Model Nu er. r11STRIRI IT1ON SYSTEM -lf`f~ ~,`' its,...;.,. ~ ' <t '~" , ; : , i --- HeadedManif d i ~ ' Distribution -~~! ~ x Hole Size / ~ x Hole Spacin~q - Vent to Ai Intake ' ~ i t ~ pipes) r ~j • - ~rl' ~ f ~~ ~ ; r ~ ( Length~_Dia Dia Spacing iJ Length J s -" ~ ~%-' SOIL COVER ., ore~~~~.e c.,~•o..,~ n.,l.. YY Mrilmrt nr'At_(;rade Systems Only ~r}-,..--.~:,: _ --L-r, ~U,. Depth Over ~~ Dg h Over - x Depth of ~ xx Seeded/Sodded -- xx Mulched Bed/Trench Center ~ - Bed rench Edges Topsoil ~ ~ ` " Yes '; No ' Yes ' No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1<~`J / .~ / 1~~' jV~~lt/) Inspection #2.__-'_%_`~~ / i_-' Location:. 2554 Pierce-St. Croix Road Spring Valle , WI 54767 (SW 1/4 SE 1/4 35 T28N R16W) A L~/' Parcel No: 35.28.16.535 ~ /~ ~ a~ , 1. Alt BM Descri tion = , ~ r/ ~ t%L/ I' ~~1~ ~`r%" ~ ~~ t~L' P ~ '1"' o `1 '~Q.-gam ~ :_ _"" '-'`'~'`f,C -~d~ 2.) Bldo-j~rIPnnth = __ / ~ ~`~ ~~` DPW . ____ s ~ ~~ ~~~rer- ~~'~ GQo c~'~ ~ ~' ~-.9~G ~~ -amount ofc(over = , 3.) Contour = ~~ I ~ ~ ~ J ~ ~OC~c- -1'!'~rTrr. ~ ~ ~ ~[f ud.2 R ~b.~-e ~ L~ 1~ ~GYU~ ~r1Qs ''an revision Required? `~, fes tton. _ ,. _ - _ _ _ _ ~ `her side for additional Info ma ~ ~ ~ ~ D.__, ~~ <''?l~" ~ 1!~~Y~ _ ~, Uate Insepctor's ignature Cert. No. ~ J (R.3/97) Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 ST CROIX iseonsin Madison, WI 53707 - 7162 Site Address 2554 PIERCE-ST CROIX R~AD~ . De artment of Commerce S,n;tary permit N . Sanitary Permit Application 399'8 In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ^ Check if Revision tna be used for second ses Privac Law, s15. 1 m State plan I.D. Number I. Application Information -Please Print All Information 6q 33g~.. Parcel umbe~poa- )099-60-e~aa Property Owner's Name JOE DE GROSS 35.28.16.535 Property Location Property Owner's Mailing Address ~,, 5315 CHURCH AVENUE ~~E u. s 35 T28 N R 16W Zip Code Phone Number '~ ~ ~ . Block Number City, state ~ ~ -'~ A. .. N A ~'°~ u tsronNatne:°; CSMNumber SPRING VALLEY WI 54767 715/778-5 ~~'~1 4,y~~ ` ,•~, ~ ~ ry II. Type of Building (check all that apply) ~~/ 9 t+ut.~. ~ ~~~ F[, . > C~ '` ~~ (~ 1 or 2 Family Dwelling -Number of Bedrooms 3 S Vflla~~'r ^ Public/Cotntne cial -Describe Use =+ ~ _ '~ hip E ,~ ALLE ^ State Owned~`~9~~0 -'` ~ oath' ;` C ~ t ~ ..D y: ~.ZS t(t5tt ~~ ....,,,PIE _E-~~~' ROIX RD X ~ t III. Type of Permit: (Check only one box on line A (numbering scheme for internal us `C ~p'le' a 4i a tf applicable) A For County use 1 ®New 2 ^ Replacement System 3 ^ Replacement of 6 ^ Addition to S stem Tank Oni Existin S stem Permit Number Date Issued B. ^ Check if Sanitary Permit Previously Issued IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) ~""~ ' 44 ^ Non -Pressurized In-Ground 21® Mound 47 ^ Sand Filter 50 ^ Constructed Wetland 22 ^ Pressurized In-Ground 41 ^ Holding Taiilc 48 ^ Single Pass 51 ^ Drip Line 45 ^ At-Grade 46 ^ Aerobic Treatment Unit 49 ^ Recirculating 30 ^ Other V. Dis ersal/Treatment Area Information: Design Flow (gpd) Dispersal Acea Dispersal Area Soil Application Petcol~ohn)Rate System Elevation Final Grade Required Proposed Rate(Gals./Days/Sq.Ft.) (Min. Elevation /eo, oS 450 450 450 1 N/A 98:25 VI. Tank Info Capacity in .Total Number Manufacturer Prefab Site Steel Fiber plastic Gallons Gallons of Tanks Co~rete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank 1000 - 1000 1 WIESER CONCRETE X Dosing Chamber 650 650 1 WIESER CONCRETE X VII. Responsibility Statement- I, the undersigned, assume respoasibWty for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum 's Signature Mp/MP12S Number Business Phone Number BENNIE HELGESON 220292 715/772-3278 Plumber's Address (Street, City, Spate, Zip Code) W 1229 770TH AVENUE, SPRING VALLEY WI 54767 VIII. Corm /De artment Use Oral Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stttatps) Approved ^ Disapproved Surcharge Fee) ~ ^ Owner Given Initial Adverse . ~" ~ ~'` Determination 3zS I- ~ ~ 1X. Conditions of ApprovaUReasons for rsa ro al. (~ l~ Gee ~ „~~~-, ~ ~:~ v ~ Attach a I (to the Coaa only for We cyst on paper not than 81/2: chat ~:,: ~ SBD~6398 (R. 05(01 ~. - /~ ~, ~~. ~,. --,~ i. - too` of ~l'` Pic g7 F'1.iN. ~LZ4~U~ .-~' ~ 1SS~Oi Z~PV~F M, B 3 coo rvor ~~wt?vZ-e-r o1z o~S1v2~ `~lf1S ~~. o . ~t.s h~ ; 1 e 1~ NOTES : ~ ti'1 ~.C~ _ ST=C.Q,mlX lZUt4'~~ _ 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation ipes with approved caps. ( 2 required). 3. Septic tank to be 1pOU ~6SOgallon capacity manufactured by ~ti~~~Z ~~- C'1~.~~' W/ I~ - l90o z-~-13'x_ ~~rtl2 • PLOT PLAN • •Page 3 of 7 Scale 1"=yd' Bl~'t.~,__~.lA~ p _Or.,. 5 P 1 h-t. 3~ _ 1°(.B UV.L _6 R¢~Wvi~ - - --- - a~•~-Z=~c-- °c~l~-n' on17oF' OF~.~'RH~1v~-AND.,. 4 . $ench marks S~ !°d3nt ~ ~ 5. Divert surface water around system to prevent ponding at the uphill side. ~~ `~ ~o REc~~~E ~scons~n r Department of Commerce ~~~~ ? ~ ~`~~~ December 11, 2001 CUST ID No.267341 ARTHUR L WEGERER WEGERER SOIL TESTING & DESIGN SERVICE PO BOX 74 RIVER FALLS WI 54022 CONDITIONAL APPROVAL PLAN APPiZOVAI';~ EXPIRES: 1'/I/:OU3 SITE: Joe Degross 2554 Pierce - St Croix Rd Town of Eau Galle St Croix County SWl/4, SE1/4, 535, T28N, R16W S FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 823517 _ Identific bers_ Transaction ID No. 69338 Site ID No. 639623 Please refer to both identification numbers, above, in all corres 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 owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. 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" SBD-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. [n addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the Mound manual, and section VI of the pressure distribution component manual are complied with. A copy of this letter including instructions and information relating to proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. • Limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). In addition, the owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. commerce.state.wi. us/sb www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Acting Secretary ;~~1i/ ,. A7TN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 ARTHUR L WEGERER Page 2 12/ll/0l • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. • 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. Stets. • 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. Stet A copy of the approved plans, specifications and this letter. shall be on-site during construction and open to inspection by authorized representatives o'the Department, «hich may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. 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 stets 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely ,~ ,~,~~~ .~ ~~. _.~ Charles L Bretz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@commerce. state.wi. us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 TITLE SHEET FOUND SYSTEM FOR A 3 BEDROOM RESIDENCE. Page ~ of 1 This plan has been prepared in accordance ~oith the Mound Component Manual SBD-1057 P and the Pressure Distribution Manual SBD-10573-P CCz. blgq~ Ctz. 614g~ LOCATED IN THE SW 1 /4 OF THE Ste. 1 /4 OF SECTION 3 S , T Z~ N, R 1 6 W, TOWi1 OF ~~U GP~I_~ , ST'- ~.~?~ 1x COUNTY, WISCONSIN. INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEM riAi1AGEMENT PLAN PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW-CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUI•iPING CHAZiBER CROSS SECTION • PAGE 7 of 7 PUriP PERFORMANCE CURVE ~~ U ~~w PREPARED FOR ~~n FL 1 ® ~~ I`~c~ j,~ ~0~r _~~ _ ~~ ~ cup s s B~~ -- - - --s -~-~ ~ -c~-~~~-~~-~-- spy PREPARED BY • WEGEt~ER SOIL .TEST = NG AND . DES I G~i S~RV I CE P.O. Box' 74 421 N.Ifain St. ~r~,gs~g~~ ~~~~'i'~}.; - River Falls WI 54022 ,, ~p Phone 715-42.5-0165 ~:~° t °~~~~~ ~~~'~ Fax- 715-425-6864 ~~ ~''• '"~° <a- . ~ .., ~a a~ ~ . ~. - ~ Wr ~~ . u ~~ APPROVED ~:.R, ~'~~ - ~ ~.~ ~~ oeAartrM~ro~ coM~r~ ~~~~~~a~ ~ ,~~ tZ-7-01 SEE CORRESPONDEN E JOB N0. Ol-31Z Mound System Management Plan Page Z. of ~ . Pursuant to Comm 83.54, Wis. Adm. Code - Septic 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 tanks 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. Pum° 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 S tem No trees or shrubs should be planted on the mound. Plantings maybe 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 for 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 GODS, 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 paint 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 occun-ed 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 -POWYS 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 shall be sealed 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. Continaencv 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 should be directed to: The County Zoning-Office at ~1,~^)_3~jEj_ l.(,~jg(~ . ST L°~•21~X -The system installer at '-~ I ~ . ~Q ~ , ZZ~ (~ SSG The tank manufacturer at ~1~~, 3Z,~_$~lS(, l~.Jt~'St?1Z The effluent filter manufacturer at gy0 _2.2(~,S-~t.[.Z, ~~ ._.r__.___.__._.___ .. . e pump manufacturer at __-- - ~ - -(x`30-~2A=~~t,[~-------~CSU~~15 `--- _ -..._ - PLOT PLP.N • ~ •Page 3 of 7 Scale 1 "= yp ' ~ir't i~-1 - _~. tAl~._O O~v_.S P 11•~.~; :3~ °: t°!$ UtJ:~"=6 R~VIv-~ -------- - 8 ~^•1•~F-Z - ~L a- ~ =:D _~/t/ 1'O p OF ~'1-~'~? 1~1'~ f~l~ l~~D.._ 100 of y'~ p~c N't.th~. ~Z4000~ ZSS` 0-- ZK PVL F !~, l- 1 `~ LL ~~ ~~ ~ 3 coo rvor ~~w~r~-r otz ~~s~v~z~ ~s . R. • l.th1 O . ~}..S ir1 i t Q 1-0 ~_ NOTES : ~ ti's ~~~ - ST C.Q~tX lZoi9--o_ 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 1 pOU l6 SO gallon capacity manufactured by ~Ul.`~~1Z ~0h.! C~..~~'- W/ l~ 1000 Z-M'13 ~Z, f=~~.~ 4 . $ench marks S~ 1°~i~n1 ~ ~ 5. Divert surface water around system to prevent ponding at the uphill side. ~' Page ~ Of -( Approved Synthetic Covering AST~i C33 Medium Sand Topsoil-~ ;"- 3 " ' ~~ ~: istribution Fipe ~ a.gd r~ F ~' Flev, ~-ZS / o~ ~- _ Ra•z3 8 . ~ . % Slope ~. Distribution Cell of ~ Force Main Z" to 2Z" Aggregate From Pump CROSS SECTION OF A MOUND SYSTEK ~~.a Flowed Layer D 1-Z S Fi. (, 23 Ft. F O~ Ft. G o• 5 Ft. A ~_ Ft. ~ H 1.0 Ft. Linear Loading Rate=~. O GPD/LN FT f3 ~_ Ft • .. Design Loading Rate=0.39GpD/gQ FT ~ . j ~ Ft. J ~ Ft. • K L O Ft. ~ Position ~ ~ O Ft. of Force Main W 30 Ft. ' .. ~ I . ~ ~ -Observation Pipe ~ ~ I< I -- -- r --- - -~ ~ ~ ------- -------- ----------=-- ---- A a-~---- ---- --------- -------------- ------ ~ 8 6 ~_ w @---~- ---~ ------ L ~~~~~ ----------------------~--o - -- - - -= -=----- ~ ~~ - ~~;~ ~. Distribution Pipe 1 „ ,~~ Cell of z to 2 z ~ aggregate Observation Pipe iaachor secirely) --` . PLAiS VIED OF A MOUND SYSTE:4 ' Distribution Pipe Layout Page S of 6 Place the holes at the bottom of the distribution pipes . at equal spacing. Remove all burrs from the pipe and holes. Extend the end of each latezal up with the use of Long turn or 4f ° fitting to a point within six . inches of the final grade. Terminate the ends of the laterals with a valve,: threaded cap or .threaded plug. Provide access from final grade for the valve, threaded cap or threaded plug. " ~-_ eCCc•gS ~oti_ pvc Fvc Svc Lateral ~ ~ Manifold ~--. Lateral x x x x!Z xQ x x x - . ' ~ 'Lateral Length - Lateral Length t~ L'FrN V \ ~ --- a- - ~ ~ ~_ o__ C- i'rcc~s -b~X - -~ ---0 _ ~q F ~ Ft. x 2 - ~~ ~ "Hole Diameter 1~~ Inch - - 5 3 Ft. ~ Lateral 1 • InchEes) X ~-3 Inches Manifold Z• Inches • -- ~ Force Main " Z Inches ;t of holes/pipe ~3 ~• ` Invert Elevation of.Laterals 98-?S Ft. .. _. ~ •• Combination Sept,3.c~•Tank and • ' PUMP CHAMBER CRO55 SECTIOIJ ARID SPECIFICATIOAIS ' ~ PAGE ~ . OF 7. • .. ....1: . ~ . • -VEU7 CAP ~~- WEATHER P~t00f• ' Ju1JC710U 90X . ti C.I. VEI~1T PIPC ti APPROVED LOCK1t~IG ~ 1Q' FROM OOOR.. MIl3JHOLE COVER 1N1'M :itU00W OR FRESH 1 wAttt.LltJG L~6EL. uv3PtCC11o~J PtP+` ~ . coatwlr •wlrl-~czSlsgi-c.np ~ ~ A~_IUTIIKE t , " " .. ;~ •- , G~oE ~,v 18'I''11A1. ~; ---------- ~~ ~ .. • ~ -•- - ~ ~~l WLET ~ ;~ PROVIDE I - •'' ~7"'AiRTIGHT SEAL I III 8 tiTrFLC •^, I I I I I Approved zfl8~. u~~ _.A~ i III Approved joint w/ ~_ ~~300 ~ I joint w/ . I II ALARM PVC pipe PVC pipe rs I II I r c I I .°u ~I t ii ~Lcv83•gZFr ~ I • PUKP ~ "-~ OFF _ D COUCRETE 3U. ~f33.OO ~ ~ DLOLK ~: , ~- RISCR EXIT_ PERMiTfED O-JLy IF TAUK MAUUFACTUR!`R HAS SUGH APPROVAL 3"ApPRo~.Fp ~ ~BFDt~ t N4 sEPrlc F SPEC.IFICaTtOf`!S . oos _ E TA-JKS MA-JUFACTURCR:wI~~ ~Ne-R~~ -JUMgEA OF DOSES: ~-~ PER OAS • TA)JK :,fZC : 1llUC~ ~ 6 SU GAt_LOA15 DOSE vOLUME r • ALARM MAU F S.S- Il~tCWD1U » U ACTURCR. ~- S`2S~7~g G 6ACKfI.oW: - Q ~ -- ~-- - GALLOhi„ MODEL 1.1UM8ER: 10 I N'LV _ ~ gj CA . PACITIES: A_ IUCHCS OR 3~0~[6 GALLOys SWITCH T~Pf: _ ~ ~'L~~ g . Z IUCHES'OR _.-L,. GpLL0u5 PUMP MAt`IUFAGTURCR: __ GOV l..tj C = ~ IuCHES OR ~' l WtLL01J5 MODEL ),DUMBER: 3$~ I EPO S •~~ D= 11 INCHES OR ~L~7 CALLOUS SWITCH TyPE: -~~~~~1 IJOTE: PUMP AUD ALARM ARE TO 60L b MlAJIMUM DISCHARGE RATE ~~' ~8 GpM INSTALLED OAI SEPARATE CIRCUITS ` ~ ~ ~~ VERTICAL DIFFEREtJCF DETWCEU PUMP oFF AuO..DISTRIBUTIOU PtPE..I -~3 FEET ~ ~~' `''• ~- I'SILIIMUM 'i~IETWORK SUPPLY PRESSURE . . ~ , , 6. SO 'FEET ~•0>< L. 3~ ~- `SS FEET OF FORCE MAITJ X ~_~F~pFEFRICTIOU FALTOR..3- 3 FEET ~a ~j _ ~~~` ~ TOTAL Oy1JAMIC HEAp~ c Z~"7~'~FEET As per >;lanufacturer x`1.0 gal/in. Liquid depth 3~" . ,--~ ' ~sE ~ or 7 Goulds submersible Effluent Pump ~~ ~ 3871 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ^ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. Effluent systems .dry without damage to heat transfer. ^ Pdotor Cover: Thermoplas- • Homes components. Motor: Available for automatic and tic cover with integral handle n Farms Heavy duty sump - • EP04 Single phase: 0.4 HP, manual operation. Automatic a d float switch attachment points. -, • Water ransfer 115 or 230 V, 60 Hz, 1550 RPM built in overload with models include Mechanical Float Switch assembled and ^ Power Cable: Severe duty Dewatenn -~'~~~~ ,r 9 :.- ~ , ;:. automatlc reset. ...preset at the factory. rated oil and water resistant . ,;~ -: ; f . . SPECIFICATIONS . • EP05 Single phase: 0.5 HP, 115 V, 60 Hz, 1550 RPM, FEATURES ^ Bearings. Upper and lower heavy duty ball bearing Pump: EP04 built in overload ith w ^ EP04 Impeller: Thermo- construction. Solids handling capability: ° 3 automatic reset. plastic Semi-open design /a maximum. _ • Power cord: l0 foot with pump out vanes for ~ ~ Capacities: up to 55 GPM. ~_ ptal heads: up to 24 feet. standard length,l6/3 SJTO with three prong grounding mechanical seal protection. --0ischarge size: l'/z" NPT. plug. Optional 20 foot ^EP05 Impeller: Thermo- ~-" ; -.Mechanical seal carbon- length,l6/3 SJTW with plastic enclosed design for rotary/ceramic-stationary, three prong grounding plug improved performance. ' BUNA-N elastomers. (standard on EP05). ^ Casing and Base: Rugged Temperature: thermoplastic design provides :;104°F (40°C) continuous superior strength and 140°F (60°C) intermittent. corrosion resistance. • Fasteriers 300 series M~-rl= RS ~_~ _ stainless steel. io • Capable of running dry without damage to_ s components. - Pump: EP05 e - ~.Solids,haridting capability: o ~.3/a" maximum. _ a ~ • Capacities: up to 60 GPM. _ Total heads: up to 31 feet. ~ s Discharge size:l'/".NPT. Z 5' • Mechanical seal: carbon- o rotary/ceramic=stationary, ~ a :..•BUNA-N elastomers. ,Temperature: ` ~'- ° 3 N_.104°F,(40°C) continuous ~':140°F{60°C) intermittent { _ ~ z- ~ :~ ~ z _, ~-~ •, - 1 ~G ~25 10 5 AGENCY LISTING SP• Canadian Standards Association (CSA listed model.numbers ,,~ :^ end in "F' or "AC":) ^ ~~:"~ ~~ ~+~ 0 10~Y 20 30 40 50 "GPM .Fx ,- - _.,. µ -, r ~ '~~~ - 9 2 , 4 6 8 ~ ~. 10 ~ 12 r m~/h _ .~ ' . ,z~ ,_ CAPACITY ~` ,., -_.. .. < ®1995 Goulds Pumps, Inc. • • Effective Ma , 1995 ~~.FO~~c~ ~v~v~. Wisconsin jepartment of Commerce ~y~ision of Safety and Buildings SOIL fi, ~~Cs~7f~EPORT Page ~ of 3 in accordance with C ,Wis. ~m.~Codh,~ "\~-~''¢" ~'~ C7 ~ l Attach complete site plan on paper not less than 8 1/2 x 11 in si ~ inGude, but not limited to: vertical and horizontal reference.; (BM), erection and cel LD. percent slope, scale or dimensions, north arrow, and local'" 'd distan~ t n~ar6atafPid L~Ut1L ~ ` =~` Od8- 1Q~R - 60 _0 d Please print all informafi ~~ ,~ ~1 ' •~ . Sr cH0-x ' Rgviewed by Date ~'{ r Personal information you provide may be used for. secondary purpo ` 'vacy Law )). $~/~ •'t Property Owner „~ ropetty Lo ~~E D~G~~Sg ~ 1/4 SE 1/4 S 35 T Z.~j N R 16 E(o W Property Owner's Mailing Address lock # Subd. Name or CSM# s . ~ t s e~iv~2e.r1 ~~E _ - - - City State Zip Code Phone Number ^ City ^ Village ~ Town Nearest Road Sp2tlvG V i~U~?~ k~ ~ S ~~-)~7 (~ LS)-178 , SS Z (~ Ll°t'~-) G t~L~ PJL~2.C~ .ST,C.R.2flsL RD [~ New Construction Use: ® Residential / Number of bedrooms 3 Code derived design flow rate L~.Sl7 GPD ^ Replacement ^ Public or commercial -Describe: Parent material L.O~s` U L Z ~TL l_(, Flood Plain elevation if applicable N 1'~ ft. General comments and recommendations: 1'"1~U]~j ~~ g rK S d' b lS`nZL_Q V~7 0 iV L° (JLL_ V'~) I w L H1 V Hi 1 S~~ O >` S i°17~-~~ ~I. ~-L- ~~hUv2 ~7-~SV °l-),p ~ Boring # ^ Boring 1 ®~Pit Ground surface elev. ~ ~' 6 ft. Depth to limiting factor Z~ in. -~ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 a-6 to~2~LZ - sip Zr>2sbk rn~ ass _ . s .~ Z 6 -'Z~ LD`~2.316 - sip Z.'~sbk >n ~ cs - . S .~ 3 zD-~C3 ~a~2 ~l6 cZP ~s~~zsl~ cl o~,., m~-~ - • o • ~ ^ Boring # ^ Boring ~- ^ pit Ground surface elev. ~~°) ft. Depth to limiting factor~in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 c~-6 ~u~~ 3L z - Si I z~Fs~k m`Ft- c~.s _ ,5 - ~, Z. ~-t3 l~`?23L6 1 S11 Z~E'sbk yrL~-- ~S ~ •S _e 3 ~3 Z~ 1D`?2 yL3 - S 1cJ 3`P-Sb~ h~'Pi- ~s ~ • ~ < ~ ({ 2.7 3S 1 D`12 y~6 C'~ry. ~ •S'-12 S ~$ C I Caw, rn ~'s- ~ - v • ~ - tmuent ~~ = tsuus > 3t7 < zZ0 mg/L antl T55 >30 _< 150 mg/L ' Efttuent #2 =GODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Sign lure CST Number Arthur L. Wegerer ~. 0131 Z 220254 Address C~ e g e r e r S o i l T e s t i n g & Design S e r v i C e D j to L valuation Conducted Telephone Number i21 ~1. Bain St. giver calls t]I 54022 ~ 4--°l7 81'~ ~' 3 715-425-0165 ~ ~ ~ ~ ~t-o1 13 ~ Property Owner y~. G ~~ S S - Parcel ID # ~ ©~ -1(~ Q 9 - ~ d --~Gb < ,` Do ~ <.F 1 S Boring # ^Boring _ ®Pit Ground surface elev. ~S' ~ ft. ,Depth to limiting factor z in. Soil Application Rate HHorizon ~ Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 O- b Lot ~Z s ~ z -~ s i 1 z`C--sb -z m`Ft~ a. s _ , s , g Z 6 -~ ~ ! D `Z 2 3l (o ~ s 1 ~ z'Q-sb k -.n~y. es - • S . ~ 3 l~[-2,y lv`12Y~3 - sic. 2'Fsbk In1F~- eS ~ y ,b Z4~ 30 ~ 0 `? R ~~6 cam. ~<S~~-S~6 c 1 Dh~ . ln~~ ^~ • D Boring # ~ Boring ^ Pit Ground surface elev. ~~• 3 ft. Depth to limiting factor Z~in, Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz r in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ~ •Eff#1 `'Eff#2 f ~-1 ti0'~R3~Z Si I Z sb-~ Yvi'F>^ -- .S .~S Z ~ -Z I 10 `Z 12 31f; - s~• I z'P-sb vvrPy 1 - • S • ~ 3 z,l -zs X0'1 tiZ yl6 ~Z~ ~ .s ~ 2 .S~~d c 1 e s b k yYL~I- _ _ • i . ~ ^Boring # ^Boring ^ Pit Ground surtace elev. ~_ ft. Depth to limiting factor in. Soil Application 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 `Effluent #1 =GODS > 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 = BODE < 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. SBD.i.130 (R6/00) . ,. ~ ,, PLOT PLAPd Page 3 of 3 Scale 1' _ ~.p' -1.-__8-, LdU•A _Or., 5 F 1 h-C. 9~L ° I°t~B-UV.L __Gf~vl`.t~ __ _- _. _.. _ __ -- - --- a~~-z-L~ a~L:fl' ors 'rop oF~z.~'~'~~~--~~. PtzoPOS~ 3 6D1z~1 l`tU ~ ~. x -, ~1.sr_ PQ.ot~ a3 c w ~-~- G pctz FC~o, zss4 _. Gv~~z ~u~o-"~ o~c r eo~Prc-e-T' orc fit. ~l`5~ _=._~t4 `-'~~~v~Z~ `~t1S ~`~. ~-- ~- R,p.W . I.IhJ E:~ 6M !#~ Z O - ~E.S ?n ~ J 2 1~ ,~ l~\ 1"ZC~ _ ST G?m1X lZ-C)tq~j _ 1-1~-Q~ ~ ~, 1 Z ~_p~ 715-425-0165 220254 p1_31Z CST Signature Date Telephone Ito. CST T~1o. Job PTO. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ~~ ~e ~t'C~~S Mailing Address Property Address ~~ (Verification required from Planning Department for new 9 City/State ~ a ~,~ Parcel Identification Number C~~~~ ' t~o~s-Ic99 ~ bo - °u'°~ LEGAL DESCRIPTION Property Location 54) '/<, ~C '/<, Sec. 3~ , T~N-R ~ ~ W, Town of ~c ~~~~- Subdivision -----`- ,Lot # -~- Certified Survey Map #'~ /v~ ,Volume Page # Warranty Deed # ~~' `/, ~ 7 '7 ,Volume /f 7 7 ,Page # ~` ~ `~• Spec house ^ yes ~o Lot lines identifiable I~ 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, restrictedplumber or alicensed 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 within 30 days of the three year expiration date. ~-. S NAT OF APPLICANT ~/7 /~~- 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 the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. SI AT ~ OF APPLICANT / 7 / ~~ DATE ****** Any information that is mis-represented may 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 ••......aar.[vT NO. ' STATE BAR OF WISCONSIN 5~.~3~'~''~ WARRANTY DEED This Deed made between Robert Cebulla and Marie Cebulla, a/K/a Marie R Cebulla,husban~ and enants Grantor, and Jose h P. DeGross and Teresa DeGross, husband and wife as "oint tenants and to the survivor thereof as survivorshi marital ro ert Grantee, Witnesseth, That said Grantor, for a valuable consideration conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin: THIS SPACE R88ERVED FOR R&CORpINd DATA VQ1. 11~~PAGf 184 ....: :., ~' ~ r - - . T.... ~ 1 ~•A")~r• i _ F%riCi~,fp; ('e,~;;0ui1 `` MAY 9199 ~'~ 9:30 ~^ ~~ ` ~ t~,.~~: ._ _ ~,~., rrvxN _,.= .1oE E E'~s ~~ 3i ~ Crtuz cif s~. C~~~ SPi2i,J~ l~Atr[.~ra, ~. -~ -~'f 767 The Southwest Quarter of the East Half (E.~) right of way of the Section 35-28-16. This TRAM FER 3S- 2 8~ I h. S"3.~~ (SW'-~) of the Southeast Quarter ( SEA) and 11 that ar / of the Southwest Quarter (SW'-~) 1 in East E p t Chicago, St .. Paul, Minneapolisy and Omaha Ra lway 1Coa,~ ~(y5 G:~'- ~ 'dU~"" CIS NOT> homestead property. r~~~ i Together with~all and singular the hereditaments and appurtenances thereunto belongin~; And Grantor warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and roadways of record, and will warrant and defend the same. Dated this ~~ day of ~) ~, 1996. ` ~~~~~ t Bert Cebulla (SEAL) (SEAL) At7'1'HENTICATION ignature(s) of iy of ~_~ authenticated this 1996. 'TLE: MEMBER OF STATE BAR OF WISCONSIN f not, authorized b ats.) Y X706.06, Wis. *Ma ie Ceb lla ~ (SEAL) (SEAL) ACICNOWLEDQ~IT STATE OF WISCONSIN)ss. Pierce County ) rsonally came before me this -~. day of ~~ 1996, the above named Robert Cebulla an Marie Cebulla me known to be the t foregoing instrume ande acknowledho" executed th • ~_ WisconsinDepartrnentoflndustry, SOIL AND SITE EVALUATION REPORT Labor and Human Relations Division ofSafeN 8 Buildnas ..~_ .._~_ Page ~ of 3 rr ;., ~~~ uvw•..• ..,u. ~...~ ~ . ........... ...x...,,.... ,.,,,,,,, . COUNTY Plan rfiust include but Attach complete site plan on paper not less than 81/2 x 11 inches in size Ste' ~~~ , . not limited to vertical and horizontal reference point (BM), direction and % of slq~, scale or PARCEL J.Q. # dirriensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY OATS PROPERTY OWNER: PROPERTY LOCATION := ~O>r bE 6 2..~ss eev~e~- s w va S l~ 1/a,s 35 T Z8 ;N,R 1 ~ E (or~W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # S 3 \S C~~~.C.bt ~~~ CITY, STATE ZIP CODE PHONE NUMBER CITY ^VILLAGE ®(OWN NEAREST ROAD S~iZ-I,N6 Vft2.l-fir WI SQL-)6l (~1S) ~~S-SS~.6 ~~c, C~t~-t,~.~ ~e'R~c~-ST'.C.Rax R.p. [~ New Cor~truction Use [SQ Residential / Number of bedrooms 3 [ ] Addii~rt ro e~asting building- ] ]Replacement [ ] Public or commerdal describe Code derived daily flow y S 0 9f~d Recommended design loading rate • Y bed, gpd/ft2 trench, gpolft2 Absorptan area required 3~S bed, ft2 3"'1 S trench, ft2 Maximum design loading rate • 5 bed, gpd/ft2 • ~ trench, gpolft2 Recomrt~rtded infiltration surface elevation(s) q`1 • S ft (as referred b site plan benchmark) Additional design /site considerations 'I`~ Dv r.~ w f 8 ~ X 41 ~ @ C'~ • Y~ ~ rv . ~ ' 01= S >~b F e•~-. Parent material L,O @5 S OV ~`R.. C 1 h LL Flood plain elevation, if applicable ~ ~ ~ - ft S = Suitable for System U = Unsudable ror s Stem CONVENTIONAL ^ S ~ U MOUND ~ S ^ U IN~GROUND PRESSURE ^ S I~ U AT-GRADE ^ S ®U SYSTEM IN FILL ^ S ®U HOLDVJG TANK ^ S ® U SOIL DESCRIPTION REPORT Boring # 1 Ground g6~lo ft. Depth ro Nmifing factor 20" Boring # 2 Ground elev. q~-1 ft. Depth ro 6ntiiting tac~ror, ~~ Horizon Depth in. Dominant Color Munsell Mottles C1u. Sz Cont. Cobr Texture Structure Gr. Sz. Sh. Consistence Bartdary Roots GPD/ft g~ ~h 1 0-6 tio'-t2 3 !i - Sit zr-,, s b m~ti o~ • 5 , t,. Z b ZA lo`I.R. 3!(0 - S 1 ~ Z ~'S~k h~~l- cS ~' • 5 ~ 1, 3 2c~ .~J3 l b `2 2 ~l (o ~-~ . 5 R s/ b C l C~ ~ m 'F 4- Remarks: 0- b t o `1 R- 31 ~. - S t d Z S ~k m `~,. ccrs • S•~ 2 b-13. 10`t2 316 ~ S )~ Z`Fsbk - w~`Fr CS ~ • S s • ~ 3 )3-Z7 t0`~2 y(3 - sic 3'gsbl~ -~`rr cs ~ -~l . s Z~ 35 1 O `1 li Y~io ~ ~ . s yR s/~ C ~ O Y-~- h~- `F^M - _ Remarks: ~TName:-Please Print Arthur L. Wegerer - 715-425-0165 ~e`~gerer Soil Testing & Design Service-P.O. Box 74 River Fa11s,WI 54022 5gnattrre: ~ } ~ ` ,,~ v ,~,~, ` ~ _ ~ 3 Date: ~ `) `~ .~ CST Number: ~~I~V~wvL- ~~ ~~ ~ al ~ M00576 PROPERTY OWNER~~ GQ~3 - SOIL DESCRIPTION REPORT PARCEL LD. #t Boring # 3 Ground elev. °15 • o ft. Depth. to IimiUng faz4N Boring # <Ground elev. ~f6~ ft. Depth to ' Iimlting.. , . fa~ 1 ,, Boring # 5 Ground elev. -""' ft Page ~ of 3 Horizon Depth Dominant Color Mottles Texture Structure Consistence Bouxiary Roots GPD/ft ,, , . in,, ;; Munsell, Qu. Sz. Cont Color Gr. Sz. Sh. Bed Tn3r~ch ~~~ lp`-I.~ 31.Z '~ sl l 2`(~Sbh m h c~,g S • 6. 3 )U Z~ 10 `1rL ~f~3 ~ S1C.` Z.~3~~2 Yn`t`t- °L-S•.._ .._^...• .•_~.y... •.S 2y-30 l~~y.tz~l6 1 S`i2.Sf8 G! C~w~ N'1`Fj- Remarks: ~ o~b 1 O"l R 3l Z _ ~~ Z`~'sbi~c ~~H a.S .. - S ~ • ~ ~ 6-~•6 ~o~t~ 31~ ~ s; 1 2.~sbk m~~ cs 1 • s . ~ 3 !~ Z ?O YR ~/L3 - s> ~J 3`~sbl~ ~'~>-- cg ~ •y ' •5 y Z6 37 L ~'-t R ~l6 ~ . Y c~ 1 c. g b k n~ '~- ' ~ - 's ... i Remarks: Depth to ifmitlng factor E i I ' Boring # iit. II~"*. i. . ~./ ~ Ground slay: ft. Depth to limiting factor Remarks: i Remarks: SBD•9330(R.05/92) _.. - PLOT PLAN Page 3 of 3 SCALE 1"= yD ' J~ J~ ~' ~ ~ r ~~ I e~. t ~.q6 6 ~ q~ y ^ B• 4 ~tq'- - •~ g•Z. ~ B. S ~~ ~ \\ ~~ ~- b~ rvoT c~ P~-c-T Uh d~ X3.3 /~ L~~Sti+vLt3 `nfiLS M~+~aR• ~, ~.1. °t S °- \~~s ~ ~,~ ~ --•~ 6~ ~ ~ :~- +r k ~+t ~( it __ ~'~~4c'IZ-~3T Una OF > 40 1~4d~' C?I11~L, _. 0. ~ S 1~-~ ~_ ..~I'O _.. __ ~, Pi~.c~- ST• Cl~.o~X R.~ . (715 ) 4 .5-ni ~S IR00576 CST Signature Date Signed Telephone No. CST # WisconsinDepartrrientoflndustry. SOIL AND SITE EVALUATION REPORT Labor and Human Relatwns r]ivision ofSafeN & Builrfinas __ ~.~ ., , .r, ..., ..~ ..r.SZ wJ~ n_.,.. Page ~ of 3 r 111 QWVIV nI111 IL.1 II l W.VJ, ...,~• ..~.... W,/~ COUNIY Ste, ~~ but Plan fiust include lete site lan on a er not less than 81/2 x i i inches in size Attach com , p p p p . not~imited to vertical and horizontal reference point (BM), direction and 9~0 of slope, scale or PARCEL I.O. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION - REVIEWED BY GATE PROPERTY OWNER: PROPERTY LOCATION s. ~Oi`. bE 6 h-~c)3S Q6V~-t@T- S W 1/4 S F 1/4,S 35 T 2.$ ;N,R 1 ~ E (a1`.J PROPERTY OWNER':S MAILING ADDRESS LOT# BLOCK # SUBO. NAME OR CSM # S 3 tS C!'r~~C.bt C~~• CITY STATE ZIP CODE PHONE NUMBER ~ - Vim' QVILLAGE ®I'OWN NEARESTROAD S ~$- ss z.6 ~,l.-r, vrrc.~~.r W I s~116~ (CIS) ~ ~-~, G~~~ ~t~c~-sr, cawx tz..ta. [~ New Construction Use [J4 Residential I Number of bedrooms 3 ' [ J Addition to existing building j j R~lacement [ J Public or commeraal desaibe Code derived dally flow u s o 9Pd Recommended design baling rate - y bed, 9pd/ft~ trench, gpollt~ Absorptan area required 3'~S bed, ft2 31 S trench, ft2 Maximtan destigrt badirg rate • 5 bed, gpd/ft2 • ~ trench, gpolft2 Recomrrferided aifiltration surface elevation(s) q-1 • S ft (as referred to site plan benchmark) Ad~tiona! design /site considerations 'M ov iJp w / $' X u ~ ' 8 ~ , ~ ~ L ti . } ' n ~ S Mv1D F ~~- . Parentmaterial LO~sS ova C.1 h~L Flood plain elevation, ifappGcable ~ • ~ • ft $ _ SUltable fOr System CONVENTIONAL MOUND ~1-GROUNO PRESSURE AT-GRADE SYSTEM MI FILL HOLDWG TMAC U = UnSUitable for Stem ^ $ ~U ~ S ^ U ^ $ (~ U ^ S ®U ^ S ®U ^ S ~U SOIL DESCRIPTION REPORT Boring # 1 Ground 96.(o ft. Depth to Fmitirig factor Zo~ Boring 2 Ground elev. 9~•l ft 9 fa~ ~~ rizon H Depth Dominant Color Motifes Texture Structure ~ ~~ Roots GPD/ft o in. Munsell Qu. Sz. Corn. Color Gr. Sz. Sh. Bed rends ~ o- 6 LD `ttz- 31Z s i t Zm s b m'f'h o~, • S. h Z b ZA lbKtZ 3~` - S 1 J Z ~S~k 1+1'~t- ~S - 5 - (, 3 Z~ _ 1 b `1 [z- SEA(, ~•~ P R s / v c ~ C7 ~ m '~ t- Remarks: o-~ lotiR-31Z -- std Z~'Sbk m~ ~S - .S ,~ 2 6-t3. lo~tZ 31` s~)I Z`~sbk -wt`s.. cs ~ •5.~ 3 13-Z7 to`•12 Yl3 - SIC 3'Rs6k wl`fh cS - -`~ • S Z~ 35 J O y li Y~6 c~ . s yR s/g C ~ Ow, Yv~'t^H - - Remarks: -Please f~inr Arthur L. Wegerer er Soil Testing & Design _F ~., C!G~/ ~'vy~ ~l - y l- ~ ~'!-~~ 715-425-0165 Service-P.O. Box 74 River Fal1s,WI 54022 q~-v3 ~~ 1- 1 ~-`~`? ~~ p0576 PROPERTY OWNER~~ GAOLS ~ 'SOIL DESCRIPTION REPORT PARCEL LD. # , Boring # 3 Ground elev. q5•o ft. Depth. to .limitlng fac~to~ ti :Boring # LGround , • ~.~ ft• Deppth to ."Iimif~ng.;; . faZ,[ ,, Page ?' of 3 Horizon Depth Dominant Color Mottles Texture Structure Consistence Botx~y Roots GPD/ft in,, ., . . Mu~seli. Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trerxh 0- b ~p ~-1. R_ 3L Z ~ s i l 2 s hh wti 1^ cam., S S • 6 . Z ~-1~ L ~`tiCz.. 3!6 1 S) ~ Z`f s ~k yrl `Fi^ C..S ~ • S • ~ 6 24 3'0 1•~KR 516 > S`~2.S`8 G! ~w~ N'1 Cj- i Remarks: ~••~ 1 b`'t R 31 Z. ~ zt Z`~ S~k I'h `~H ~• S ., • J I • ~ Z 6-l~ 1p`1R 31~ ~ s- I Z•~'Sb1z Y»~H CS • 5 • ~ 3 1 {v Z ? 0 `11Z Y L3 - s i ~ J 3 `(~sbir: yn'~~- cg ~ ~ • y; • s ~ Z6 37 l O ~ tz Y~~ ~ y C ~ 1 cg ~ h w~ `Ff- '- - ' - ... :Boring # 5 Ground elev. ~'^ ft: Depth to ;limiting factor ~ Boring # ~• x ~~y;. f~•~ 'r is . 4,?' ;Ground elev ft. Depth to ' limitlng factor Remarks: 1 t~ ~ Y`~1 Z ~/ f~ V N V 1 L i Remarks: .~ 1 - 11 I I I ,~ Remarks: SBD•8330(R,05/92) . PLOT PLAN Page 3 of 3 SCALE 1"= y.D ' - -- ---moo - -- - _ .~?vS.F ~0"8E -- Pty- "~ -L@PrST 2. s ' YRO -~ w1 u ~0 . - - - -- -- - - J~' A i 34 4H'30tirr GtZO~-p tN ,~~' J,n' / &•1 e-t,g6 6 ~ q6 y ~ 8, ~ / b ~`C 3~' 1 ,/.a`J B,Z / 2 ~ 8. 5 V i I ~`- pp -vpZ- Cr~P~T Uh ~~s ~~~, - -~ 6~ ~ ~ ~~._ X2.0. cv Ual L ~ -w ~ CNepctt.~3T' Una OF > ~0 t~RE' ..C~A'R~Ci-~ ' ~. ~l S Yyf j ~'O Y 9~-03 ~--..1 ~{-~7 c ~ isoo ~6 715 42.5-n1 ~S _~ CST Signature Date Signed Telephone No. CST #