Loading...
HomeMy WebLinkAbout022-1086-50-000 g ^ 0 o0 4 ° 3 0 ao I a~ ~ 0. 0 c , N E r~ N ~4 it E e c 'C3 c h ~ N > N o 0 0 z ~ m 5 LL c I - Ys C 0 T L E Q U E ° _m M v a~ 3 w li ~ ~ I z ILL m o z 0 c z v o aUi Z I c z fA F- r it N i E ~ N M i N . 0 L ~ I 01 p ~zz w Z N y ~ 'cc I d E N Z~Vly 7 N T E O o o (0 U) La all G G CL L O N N O N v y N Q N N N N U O O O O 2> O V a' V 0 0 0 z o 0 0 IL IL 0- y 3 O fJ) al co co rn 0) a) N J V L L rn co N ~5 'a 0) CD .J ' 0 0 O O N III LO O O 7 O co co (fl m a ¢z--✓i o C 0 3= w c p Cq °o 0 F°- I- ° c E LO (n "w O (Jo U .i r v C N U a 0 0 0 l .c L E 0_ 'D N N N W 00 Y I', m0 co C aL) C x 0 0 0 3 M M M C) 0 cu -0 c Q) C Cg (n O E y?' o co oY N o Z y Z U) 41 v 3 L: (L Cj CL 4) E ° c A 0 a a 2 I' O in AS BUILT SANITARY SYSTEM REPORT OWNER h D Zen TOWNSHIP epniol(I'lon"o SECTION 30 T N-R 2C- W ~ I ADDRESS M 5 ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT -"-LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM $m , lob D o, 1)000 7~0 5a~ 'Pr~~, P tah k x ~~x x x x x x x ~-f INDICATE NORTH ARROW BENCHMARK: Elevation and description: 10D, v S P ltd Alternate benchmark V, SEPTIC TANK:Manufacturer:%"I lkes Liquid Cap. UG Rings used:-E-Manhole cover elev: Final grade elev: Tank inlet elev.: ' Tank outlet elev.: No. of feet from nearest road:Front , Side , Rear Ft. From nearest prop. line:Front , Side, Rear Ft. lc~~ No. of feet from: Well- , Building: (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE ~I s PUMP CHAMBER 11 Manufacturer: ,ry~i~~[ t dGvfS~ ~rlc~"z ~ Liquid Capacity:__2~~ Pump Model k F-631j1- Pump/Siphon Manufact.: 0 Pump Size Elevation of inlet: Bottom of tank elevation Pump on elev.: Pump off elev.: Gallons/cycle • Alarm: Man.:leoeULm Switch Type: ACa Location Distance from nearest prop. line: FrontL~- , SideRear_Ft . -Q_ Distance from: Well/pl Building SOIL ABSORPTION SYSTEM Bed: k Trench: Seepage Pit: Width: X-~Length . Number of Lines: c2 Area Built Exist. Grade Elev. Proposed Final Grade Elev. Fill depth to top of pipe: lF No, feet from nearest prop. line:Front , Side_X ~ , Rear Ft. 5No. feet from wall: 5 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:_ 6/90:cj r g ~ g ~ , j~j ~t ~~yy~~E LA 'ijQ*artr>Ut''M4cA;PNIC 30.2PIZIVA EWAWG' STM65N y: Labor acid Human Relations Count Safety and Bmildings Division INSPECTION REPORT ST. CROIX (ATTACH TO PERMIT) SanitaryPermitNo.: GENERAL INFORMATION 193403 Permit Holder's Name: ❑ City ❑ Village [Town of: State Plan ID No.: i KINNICKINNIC lev.: Insp. BM Elev.: BM Description: Parcel Tax No.: j 022-1086-5070 0 TANK INFORMATION ELEVATION DAT 3 _Q006 r TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic lil-e Q Benchmark y U Dosing A a' 3. /a AAeratiwf- Bldg. Sewer , 3T $ Holding St/_f Inlet 2.35" TANK SETBACK INFORMATION St/ jVf Outlet TANK TO P/ L WELL BLDG. Airl to ntake ROAD Dt Inlet Air l Septic NA Dt Bottom Dosing NA #eadr /Man. U~ Aerati Qp~ NA Dist. Pipe 1,3. ' Holding Bot. System 2. Z PUMP/ SIPHON INFORMATION Final Grade Manufacturer GCZ14~ Demand Model Number C-i , - L GPM TDH Lift~~ Ia' Lri :tion _ Syetem TDH16, ~ Ft oss Forcemain Length if Di a. t " Dist. To Well >5~ / SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT Inside Dia. Liquid Depth DIMENSIONS 0 DIMENSIONS SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufa rer: SETBACK INFORMATION TypeO / 1 ~4 , CHAMBER Mode Number: System: Jr o - /dl) OR UNIT DISTRIBUTION SYSTEM Her / Manifold Distribution Pipe(s) //(7',~ x Hole Size x Hole Spacing Vent To Air Intake Length _a Dia. Length o?.3 Dia. / Spacing 7 0 A~ 3 > p7s SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over „ xx Depth Of xx Seeded/ Sodded xx Mulched Bed*T-Mr Center . *6d Trench Edges Topsoil ❑ Yes ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) a!as LOCATION: KINNICKINNIC 30.28.18.466D,NW,NE,HWY 65N Plan revision required? es [:1 No Use other side for additional information. Ile 193 s- SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: F 1 . i SANITARY PERMIT APPLICATION OIL-HR COUNTY In accord with ILHR 83.05, Wis. Adm. Code Now STATE SANITAR PERMIT# -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ _ Q V6 8% x 11 inches in size. c ecif ision to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWN R 7 PROPERTY LOCATION Z ~ en r, Y4 /4, S _C) T P9- N, R d:2-)E (o PROPERTY OWNER'S LING ADDRESS LOT # BLOC Cl STATE ZIP ODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER 4e~ V II. TYPE OF BUILDING: (Check one) El State Owned CITTMLAGE f f NEARER ROAD ❑ Public N1 1 or 2 Fam. Dwelling-# of bedrooms - R PACEL NUMBER 5 III. BUILDING USE: (If building type is public, check all that apply) 601-1_ IOU- ~r 1 ❑ Apt/Condo 7 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1.0 New 2. [AReplacement 3. ❑ Replacement of 4.0 Reconnection of 511 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 Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION f! 3 S' 46 d QP.0 Feet Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New xistin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank X / Br'd eS 9 [I I L1 Fj Lift Pump Tank/Si hon Chamber 1 VIII. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumb is Name (Print): Plumb ignature: (No Sta z MP/MPRSW No.: Business Phone Number: P u b i i Address (Street, City, State, gip Code): Aj?02 ~ ~Z, X 1~ 15 f ev F4 /A IX. COUNTY/DEPARTMENT USE ONLY tary Permit Fee (Includes Groundwater rate issue Issuin A ant Si ❑ Disapproved Prt-'O Approved ❑ Owner Given Initial rcha rge Fee) e Determination CXJ 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 A•sanitark.permit is valid for two (2) years. 2. 1Fo6r sapitary=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 necessary, usually every 2 to 3 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. . i To be complete and accurate this sanitary permit applicetion must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is. II. 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 system. 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 areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pufnps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump- manufacturer; D) cross section of the soil absorption system If required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards: SBD-6398 (R.11/88) - - SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue P.O. Boa 7969 Madison, Wisconsin 63707 State of Wisconsin Department of Industry, Labor and Human Relations a CO O U) L r~~ z o C) '17-1 HI CAHiIAY 65 N0RTr; oho o N j!Vi:r ~7ALLS till 54C22 m N Peti t i ors '..u. S9e-4084b 3 £ Z ) gar 11r. Zenk: Re: Zeal; , Robert - Residence nrivaO Seaiage Systei.i W,NL,3U,28,8W Town cf Kianickinnic, ST. 0'roix Cougrty, 141 four petition for a variance to sections ILHR 33.23 +.')(a) and 8:4.2:,, (2)(c) 2., Wisconsin Administrative Code, ray b=een r,~view!d. l`w-\ petition has been conditionall,,, approved. The corrditioos are as follows: 1. All s€arf'ace cuter runoff shall b~ divertv,,! around and away from the proposed mound area. Tne t i re sans: fill area of th ~(.;urd shall be, plowed in accord with s I'..?iii 83.2:3 3) 3 If this sys i;er; eco res a fai l i nJ s.,,s test':, or con tar i hates the waters of the state, this variance seal l be rescinded. The rule by i nj petitioned, requires t~rdt "he longest dims-~nsi on of a mound and distribution network shall not be installed over a fa l i ncj conventional system. T ~ ra iurice requested ias to install a replaceiaent r1cutid system over, a i'aili t conventional system on a Sitc wi h sligfttly complex slopes that arz-_~ at vzxio ,s anglos to the toiaunr of the dbsorptic,-i !,,ed. A! I o4f the data and staterr;ents submitted c.n behalf o{:. tla petitioner were co°:sidcred. this variance is specific to th.-, subject ;ao~tition and cannot be +as d for any additional modifica;ium. S.2rely, ticrcr` ~Iey e cf11 tec l E3irector , ice ter 3ivisiuri Code} . and 'applica .ion cc: ,array 3lnsky, Private Sewayc, CoriS i -,;ant - f E s r"! t,t u-, Chippewa Falls 1'ho:aas Mel son, Zoni nr! AdrEat - i strator - St. J roi x County san.ss ,R.o,,,jhooras 14an;, Plu:,,lber s~"r Bob Z any- 'n w ~Iq Ai- 1y ~eC /(t n rti 7~ 121$ tyv [177 Y- Co _ ,?r i V f 2~ J~1 ve- I83 blo 1. ~ ra-~ ~ ►Tcc~~ 1 \ l ~'Gv/.tr_ ~ I 0(01 6t 611 1 co Ord ar6, . ✓ oorra I I looc~ gal 13 5 Q gp~► 0 u 'l J 17C Kjnnictinnic, SIS. aH0 Ri vet ~ Lo of GE o Z ~aa s~ w ~ I elf) r1 ICS /n/1iC, ~IUe~ Page Of Distribution Pipe Detail For A Four Lateral Network Alternate Position Of End Cap Force main p PVC Distribution Pipe PVC Force Main P Holes Equally Spaced PVC Manifold Pipe On Bottom rES~ X con S ~ ~ z X1 Der. 0jr °ms~o S''rr. 1460,8 * Last Hole Should Be Ne.. N op S AN HS qN gE4no NS 1 Y s~ ERR i I r , P 2,3 ~ Ft. p CE S y Ft. X .3(P Inches Y (P Inches Signed: License Number: 3 Hole Diameter Inch Lateral Diameter Inch(es) Date: Manifold Diameter V Z Inches Force Main Diameter ~i Inches w / Holes Per Pipe Invert Elevation Of Laterals 100L Ft. Page - Of _ 1 Straw, Marsh Hay, Or Synthetic' Covering Distribution Pipe Medium Sand H G ,6!!_ Topsoil _ F D A6, WeJap- P"TE SE1A1►ZGE M_ E too b Con~n~ I.. slope Bed Of 2 12 Force Main Plowed Aggregate Layer ATlRO M" an, of MUSTRY. LSSOR 3 HUMAN ROAM" (6" Below Pipe) W=IoN OF SAFM AND BUl D Ft . E x. y Ft. ~ .s Section Of A Mound System Using SEE CORR D CE A Bed For The Absorption Area F .15 Ft. G i.o Ft. A 8 Ft. H I.S Ft. Signed: 4 LAIM 6 U,7. 5 Ft. License Number: 3 a 3 I K 13.-15 Ft. Date: L -75 Ft. j lo Ft. Alternate Position I Ft. of Force Main W 'Ft. Observation Pipe g K Force Main W -•I Distribution Bed Of i•- 2'2r Pipe Aggregate Observation Pipe Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area a , PA&t PUMP CHAMBER CROSS SECTION ARID SPECIFICAT10kJ5 fT T VENT CAP WEATHERPROOF APPROVED LOCKIAIG ox., EUT PIPE ROM DOOR, JUNCTION BOX MANHOLE OVER OR FRESH 1l"MIU. AIR INTAKE GRADE TES 2GE M ( 4" MIN. Cond~ria''-- 1B"Mlu. CONDUIT _ 18"MIN. AI N LE T Opr. OF NIDUSTRY, LABOR 3 HUMAN RELATIONS PROVIDE I = _ - SMION OF SAFETY AND BUI AIRTIGHT SEAL I I I I ` I III w I Mll; SEE CORK D CE I I ( I ALARM B I II. I 1 *APPROVED I I ON JOINTS WITH i ELEV. FT. APPROVED PIPE 3' ONTO PUMP OFF D SOLID SOIL L CONCRETE BLOCK RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL SEPTIC E _SPEC-IFItATIOUS DOSE ' TANKS MANUFACTURER: rA QLAU512e0-a-Ir IJUMBER OF DOSES: PER DAy TANK SIZE:- -IBC) GALLONS DOSE VOLUME (p•5(at /5D• ALARM MANUFACTURER: - INCLUDING SACKFLOW: l t;4, 5!0 GALL MODEL NUMBER: -A/A CAPACITIES: A=~LINCHES OR ,:94041- GALL( SWITCH TSPE: - 96 B =-~-INCHES OR 35 GAIL PUMP MANUFACTURER: - 6OWd C=INCHES OR 15_ GALL, MODEL NUMBER: -WAD 3 L D w -L0 INCHES OR ZZY GALL SWITCH TYPE: k4(9 NOTE: PUMP AMD ALARM ARE TO BE MINIMUM DISCHARGE RATE - 3~D GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. _Lo_ FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . 2.5 FEET 1- .qq/-rN + FEET OF FORCE MAIN X~F/ooftFRICTIOW FACTOR.- 1-19V FEET TOTAL DtIMMIC. HEAD = FEET INTERNAL DIM NSIONi Of TANK: LEWGTH_,!_;WIDTH ~ -ILIQUID DEPTH q 3 51GUE D: LICEKISE NUMBER: ~ ~ ~ DATE:" ~ ° Bulletin CL21A July 8, 1983 • For Homes G O U LD S • Farms Model 3885 • Trailer courts • Motels (Supersedes Model 3870) • Schools • ' Submersible • Hospitals E,,,,MAP,,,V Effluent Pumps • Industry • Effluent Systems Pump Specifications Solids Handling Capability to'/:'. anywhere effluent Discharge Size or drainage must be 2•• NPT, Semi-Open Impeller disposed of quickly, quietly and efficiently. 3 vane design, threadod on shaft Three phase units Use impeller locknut to prevent accidental back-off. Pump out vanes on backside of impeller for protection of mechanical seal. Casing Volute type for maximum efficiency. Stainless Steel Fasteners Heavy-Duty Solids Handling y~ Series 300 stainless steel for corrosion resistance. Dependable Capability to 3/4" Mechanical Seal mic vs. Carbon sealing faces, stainless steel Cera I N elastomers. spring and Buna Maximum Temperature 160° F. 1h, 1h H.P. 60 Hz Capable of Running Dry Single Phase 115, 230 Volt. without damage to components Motor Specifications Motor Fully Submerged ~/Zr 3j/4~ 1Ir 1'h H.P. 60 HZ in high grade turbine oil for permanent lubrica- . Three tion of bearings and mechanical seal and Single Phase 230 Volt 1 'Phase 208-230, 460 efficient heat dissipation. Motor sealed from Volt. environment by rugged cast iron enclosure. Bearings Heavy-duty all ball bearing construction. i Stainless Steel Shaft • Serves 300 stainless stePOW' el for corrosion resistance. Threaded shaft. Single Phase Units All single phase units have built-in thermal overload protection with automatic: la,,nt 90 TIM f r ` ? rl"M Three Phase Units r i u l J;irtot unit V' l .'.111 (,I ♦ •.h~ r . s t 80 ivr•I I,GId lit nl, c ;•r. r, r ti a : r se n rt yi t o 4n 1 yq ` < •11;11 vnlL•• Tlnr•.I,Ir"I '.li;tll (dr 11; .q,. r.iti s Power Cord 7° 7. q4' vswRRM ,50/31. W F•{r y ^ L.t. l^JJtl,r and ul rr 1. t t it Elxrxy . •,H r, r 'n. ,r r1nr1 t. di I 111••1 l I .1 W ;l"'; .e, it tir •r.r rncl,iry rnuc,tun• 111 G.I i' of 1 LL y r ,t1r1 , . r )'.Iris n"ICialll w c r - a ) , 60 ' 'YJ P C . 4 r• u R Ir11J to VI Ilr•r g. d. r7C I•I'Ckr. rt x r , 4ll (11and not W t o kz , + 1.r fi+ ` _ 1 6 i~ f r y ♦ Mi a U ;e w ' t ' Single Phase Units 40 H P 111(id is egmplied wllh 1', 0 If, r {,lu.l 1. t ill, r rInraIutrn1 'ri •.s I1a l ,roar ~ l .:N ,,I I O wit Q t n° rt ~ , • 1 f 1 i-wrr O 30 o ry ' 11-1-k -vii lu•d with V, of 1.1 3, y WE03M: r r nrrl O 20 r y - SPECIFICATIONS ARE SUBJECT TO CHANGE s ~ r r+~~: 'r t-_•_• 10 WITHOUT NOTICE. •0 .r a, , ~W rti f r~'4'~ wdpv ° 0 o X10 20 30 40 so 60 70 so 90 100 110 120 ~ GOU LDS PUMPS. INC. GALLONS PER MINUTE SENECA FALLS NEW voax 13148 L DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUSTRY, DIVISION P.O. BOX 76 LABOR AHD PERCOLATION TESTS (115) MADISO N WI 53707 HUMAN RELATIONS 83.09(1) & Chapter 145) LOCATION: SECTION: CIPALITY: LOTNO.:BLK.NO.:SUBDIVISION NAME: GDS/ 3 TaN/RR E (o W - UNTY: OWNER' YER'S NAME: MAI ING ADDRESS: b ~ N rler l ' sy~ /7 LO Q if, 7 x USE f DATES OBSERVATIONS MADE BEDRMS.: COMMERAL DESCRIPTION: PROFIL E CRI TIONS: PERCOLATION TESTS: NO. CI INResider New ®Replace 7 a3 q~ KJ X19 ~a RATING: S= Site suitable for system U= Site unsuitable for system r ONVENTIONAL: MOUND: IN-GROUND•PRESSURE: SYSTEM-IN-FILLHOLDING TANK: REC MMEN ED SYSTEM: (optional) as au ©s ❑u " ❑s Zu os ®u os ©u dl! If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL D PTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH-Md. ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- %8 b 3D'' 0- y60 ,g S ix2 e~ So' S 4ppW9 B- ~o b e Z Fro o Se fi E dav. B- 106,6 gyp" 30 1( ,-gyp b,<D- .SO "'d SVgr 1.s'o-9:Cb B- 14 me S W Z86 tS a f 3 B- 3 41,D e 34 r B- f60, MjnedS 1'kwts tto PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERT D 1 PERIOD2 P R D PER INCH P_ / V Y 0 7 3 P- ay 0 0 /Vi, 11g P- a y '41 • P- P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. SYSTEM ELEVATION 100.5D f !P R$ 1 Rb ' ".por,o~ e me f E 3 E L~ 43 i~p ©Ra • _ _ ~H 'Top aver E ~ n ramp CA Ic» o From 0fgwt~e E . +3~' ~ tv ~~e _ . 9~• D ~l_e a f _wa~er ~ n p,r,~ m ~t ~i ~ er Kin iC~irult~~ ~0tr r 3 t~ I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord t~ e pr es a /SI}fythods s eci d in the Wisconsin Administrative Code, and that the data recorded and the location of the tests are correct to the best of m wledge a eJlef.-~~`O s NAME rint): / T ET N: ' ioila t CER 1 Y ER: NUMBER( ptiona0: ADDRESS: dE R'v cr r - 1'_' 1 CST SIG E 'RIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. ,BD-6395 (R• 10/83) - OVER - +I l i OMP LETft 11 "r - s .;395 To 2, arre.>,:al project; 3 4. IF 4 L ! LT[" Ptt r'es Bn Gy y En< T THE OWNER: This soil test report is the first step in securing y The county 10rrt may recfcrest verification of this soil test in the. field prior tc 4, Complete plans for the private sewage systern and a permit application must be su, Lu tttc appropriate (oval authority ~n order to obtain a permit, The sari ~tary"Perm it must be obtained and frosted prior to the start of any construction. STC - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER ROUTE/BOX NUMBER l l 7 FIRE NO. CITY/STATEf('1) ZIP PROPERTY LOCATION: Al 1/4 1/4, Section , TN, RW, r Town of o-,I St. Croix County, Subdivision , Lot No. 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 PUMPn. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County Residents MAY be eligible to receive a grant for a MAXIMUM of $3000 of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of ALL NEW SYSTEMS agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper 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. Certification form will be sent approximately 30 days prior to three year expiration. I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Department of Natural Resources. Certification form must be completed and returned to the St.Croix County Zoning Office within 30 days of the three year expiration date. SIGNED DATE St. Croix County Zoning Office St. Croix County Courthouse 911 4th Street Hudson, WI 54016 (715) 386-4680 Sign, Date, and Return to above address i I . I IAPPLICATION FOR SANITARY PERMIT 8TC- 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor,(spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of property Location of property 1/4 ~ 1/4, Section T= -R,=Y L101121C~L~Zltl Township Mailing address L Address of site ~C~ G t Subdivision name IV~I Lot number Previous owner of property Got -t V h Total size of parcel Date parcel was created Are all corners and lot lines identifiable? on 0 Is this property being developed for resale (spec house)? Yes 0 Volume and Page Number . 21 = as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER, and the SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. 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 d ded in the Office of the County Register of Deeds as Document No. 1_~-; and that I (We) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of said system, and the same has bee rded in the Office of the County Re later of Deeds, as Document No. Signature of Owner Signature of Co-Owner (If Applicable) ha ? Dat of 81ature Date of Signature i K: Mr:lerCa.y.v~~ 1 1 STATE BAR OF WISCONSIN - FORM 2 DOCUMENT NO. . WARkANTY DEED 47-i 3 V,'L Pa'E HIS SPACE PESER, co FOR RECORD, DATA j5i 1 _ - REGISTERS OFFICE Gary D. Brecht and Rene M. Bre~,ht, $T. CROIX CO., WI 3 o i n e nans Recd for Record - - JUL 16 1991 at 8:30 A. M conveys and warrants to Robert E. _Ze end Miry g~_-_ C ZenkL `iusband and wife as survi~Qr-shiF- a a rope - Register of Deeds _ t~ mari t 1 p RETURN TO y~ the following described real estate in Coun'y, State of Wisconsin: Part of the NWj of NEJ of Section 30, Township 28 North, Range 18 West described as follows: Commencing at the NE corner thereo thence West on North line of said NWI of NEJ 230. eet; thence South 66.0 feet; thence West 16.5 feet; thence Tax Key No. South 105 feet; thence S 40°14' W 605.3 feet; thence W 10.2 feet; thence S 7°49' W 135.07 feet to place of beginning; thence S 37°47' W 210.0 feet; thence S 48°45' E 215.0 fee*_, more or less, to centerline of Kinnickinnic River; thence Nly on said centerline to a point S 48°45 E from place of beginning; thence N 48°45' W 220.0 feet, more or less, to place of beginning. Together with a 66.0 foot wide easement for ingress and egress lccated in the NWJ of the NEI and also in the NEI of the NWi of Section 30-28-18, Town of Kinnickinnic, more fully described as follows: Commencing at the NE corner of the NWj of the NEI of said Section 30; thence West on the North line of said NW} of the NEI of said Section 30, a distance of 230.50 feet; thence South 66.00 feet; thence West 16.50 feet; thence South 105.00 feet; thence S 40°14'00" W 605.30 feet; thence West 107.20 feet; thence S 7°49'00" W 135.07 feet; thence N 48°45'00" W 33.10 feet to the Point of Beginning of said easement, being described along centerline as follows: thence S 37° 47100" W 384.64 feet; thence N 51°52'40" W 108.35 feet; thence N 37°07'40" W D-12 feet, more or less, to the centerline of S.T.H. 65 and the Point of Beginning of said easement. This lS homestead property. (is) pcSMR Exception to warranties: w No exceptions. Dated this 18th- day of Julx____ 19 _ .91. ' l (SEAL) (SEAL) - 4ar, AB rr ee cc h Rene M. Brecht (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGEMENT Signatures authenticated this day of STATE OF WISCONSIN ss. - _____'19 St. Croix---County. _ Personally came before me, this -9th day of 1991 T _TITLE: MEMBER STATE BAR OF WISCONSIN in, above name (If not. - - authorized by § 706.06. Wis. Slats.) Gary_ Ds. Brecht This instrument was drafted by Donald J. Fast Baldwin, WI 54002 tome Known to t;e the Gerson 3_ Who executed thelpregding ;n•, stru^e K^N ~a9ea'~ same ~a nd 3n~-,. (Signatures may be authent cafe or ac4nowledgen Both are not _ necessary.) Nrar'v Public St. Croix Ceanty', '.Vid. t - _ - - - _ _ `dy C;:~rr„issOn is permanent, of not, Staff, bxprcation ate~ ~_a Ir ~'r ,%'A yr) z - ''v71 WAPPAN'r DEED - ;ro"_ BAP c 0"" ST. CROIX COUNTY 't;>r WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, W154016 (715) 386-4680 s+r October 20, 1992 Jerry Swimm Section of Private Sewage Division of Safety & Building 2226 Rose ST. LaCrosse, WI 54603 RE: Plan Number S92-40846 PROJECT: ZENK, BOB LOCATION:NW 1/4, NE 1/4, SEC. 30, T28N-R18W, KINNICKINNIC Dear Jerry: Your correspondence dated October 2, 1992 requested that there be comments from the St. Croix County Zoning Administrator regarding the site suitability of this site. Due to the complex slopes, old system and fill in other areas this location and design seemed to be the only possible location and design for this system. I feel that if installed as per the design the system will function properly. Should you have any additional questions regarding this matter, please feel free to contact this office. Sincerely, Meat Thomas C. Nelson Zoning Administrator cj 44 4/0 6> Zee / 6 J /Val A/, 30 2 8, ~8 ngvicA`77/ c ti GV 2 / 9 9 Z colt l~ Co s &"~At t.~ ~ • ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 Sept 18, 1992 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: An onsite investigation of the Bob Zink property, located in the NW 1/4 of the NE 1/4, Sec. 30, T28N-R18W, Town of Kinnickinnic, St. Croix County, has been conducted with the assistance of Tom Wang, CST #2860. This onsite revealed suitable soil for onsite sewage disposal to a depth of 24 ,11. Should you have any questions, please feel free to contact this office. Sincerely, Thomas C. Nelson Assistant Zoning Administrator cj