HomeMy WebLinkAbout032-1011-20-000
S.3t i~ (oSf~
STC - 10 4
AS BUILT SANITARY SYSTEM REPORT
OWNER
ADDRESS ,jS I ►"1 X
SUBDIVISION / CSM# LOT #
SECTION . T N-R , W, Town of
ST. CROIX COUNTY, WISCONSIN
PLAN VIEW
/ SHOW VERY I HG WITHIN 100 FEET OF SYSTEM
~usz
Sir
76
-1
INDICATE NORTH ARROW
Provide setback and elevation information on reverse of this-form.
Provide 2 dimensions to center of septic tank manhole cover.
BENCHMARK: /fez
ALTERNATE BM:
SEPTIC TANK / PUMP CHAMBER / HOLDING.TANK INFORMATION
Manufacturer: Liquid Capacity:
Setback from: Well House Other
Pum : Manufacturer Model# Size i
Float seperation /?Gallons/cycle:
I
Alarm Location J cy f h ka2 o
I
SOIL ABSORPTION SYSTEM
Width: Length ~,xs Number of trenches
Distance & Direction to nearest prop. line:
Setback from: well :,,is- ' House /;r5 Other
ELEVATIONS
I
Building Sewer ST Inlet: ST outlet
PC inlet PC bottom Pump Off
Header/Manifold 3 Bottom of system KGs
Existing Grade Final grade
DATE OF INSTALLATION: /
PLUMBER ON JOB: ✓
LICENSE NUMBER:
INSPECTOR:
3/93:jt
A 'r attm ntYJrtttc7h ti' 5.31.19 • 5Ioj&, AbE~Y tEM UNTY LI INE_ County:
Labor and Human Relations INSPECTION REPORT
Safety and,Buildings Division ST- CROIX
Sanitary Permit No.:
GENERAL INFORMATION (ATTACH TO PERMIT)
193441
Permit Holder's Name: ❑ City ❑ Village ❑Jown of: State Plan ID No.:
SOMERSET
C T BM Elev.: Insp. BM Elev.: BM Description: r Parcel Tax No.:
/G, 032-1011-20-000 ZX
TANK INFORMATION ELEVATION DATA A9300100(d'0-3
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
Dosing 751_',
r
r
Aer Bldg. Sewer
Holding St/ V( Inlet d '
TANK SETBACK INFORMATION St/ W Outlet S. , d~
ent to
TANKTO P/L WELL BLDG. V
take ROAD Dt Inlet
Air In
Septic >/GDS NA Dt Bottom !X ~7,a3
Dosing /a)'t NA Header kAAaa
Aerati NA Dist. Pi r
pe ~ ~ D 5/, OL
Holding Bot. System 3,~O
PUMP /N INFORMATION Final Grade
Manufacturer Demand
Model Number 601CdS/ f GPM
TDH Lift Friction System, TDH Ft
Loss H
Forcemain Lengthy Dia. 5" Dist. To Well >
~ r
SOIL ABSORPTION SYSTEM
BED/TRENCH Width I Length / No. Of Trenches PIT Of Pits Inside Dia. Liquid Depth
DIMENSIONS DIMEN I N
f
acturer:
SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING ~Manu
SETBACK CHAMBER
INFORMATION Type0 ode ber.
System: OR UNIT
DISTRIBUTION SYSTEM
Hevdef-4 Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Ai~lntake
Length Dia r Length_ Dia. Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over „ Depth Over xx Depth Of xx Seeded /Sodded xx Mulched
Bed/ Trench Center f ~ Wed-' Trench Edges/,;) Topsoil G ❑ Yes ❑ No ❑ Yes ❑ No
COMMENTS: (Include code discrepancies, persons present, etc.) I62,) c,4 /I .~Z,o1
LOCATION: SOMERSET 5.31 `49.65B,NE NE,_LO~ , COUNTY LINE RD. 67
h
j6,0 4"
Plan revlslorf required? ❑ Yes P_NT
Use other side for additional information. lO sue-
SBD-6710 (R 05/91) Date Inspector's Signat re Cert. No.
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
zV-
r7
1lf~lJ _ _
i
SANITARY PERMIT APPLICATION
7DILHR In accord with ILHR 83.05, Wis. Adm. Code COUNTY
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than l R
8% x 11 inches in size. ❑ Check if re2on li. application
-See reverse side for instructions for completing this application. STAT PLAN I. P. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. 15 V ?2 (4 0,-3 SQ
PROPE OWNER / PROPERTY LOCATION
t/4 '/4,S T N,R (or
PROPERTY NER'S MAILING A ORE LOT # BLOCK #
r
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
11. TYPE OF BUILDING: (Check one) El State Owned VILLAGE: " NEAREST OA
❑ Public 14 1 or 2 Fam. Dwelling-# of bedrooms -5 PARCEL TAX • NUMBER(b)
Ill. BUILDING USE: (If building type is public, check all that apply) &Q -/6
1 ❑ Apt/Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining
40 Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Off ice/Factory 13 ❑ Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. ❑ New Replacement 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./ rich) ELEVATION
Feet .S Feet
VII. TANK CAPACITY Site
INFORMATION in allons Total # of Manufacturer's Name Prefab. Con- Steel Fiber- Plastic Exper.
New P-xisting Gallons Tanks Concrete structed glass App.
Tanks Tanks
Septic Tank or Holdin Tank S
Lift Pump Tank/Si hon Chamber
VIII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installs on of the onsite sewage system shown on the attached plans.
Plumbe s Na a (Pint - Plumb 'a gnatu MP/MPRSW No.: Business Phone Number:
71S
6Z&_Z2 22
Plumbe s Address Street, City, State, Zip Co e):
J,~) Z7
IX. C NTY/DEPARTMENT USE ONLY
❑ Disapproved S itary Permit Fee (includes Groundwater Date Issued issuing A nt 51QRSL a stamps)
~v Surcharge Fee) D/
Approved ❑ Owner, iven Initial e&--
I Adverse Determination .001
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
1A sanitary permit is valid for two (2) years.
2. Yotir 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.(- A1[ reylsiorls to,this permit must be approved by the permit issuing authority.
4. ` `Changes in owneir5hip 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 locar code administrator or the
State of Wisconsin, Safety & Buildings Division, 608-266-3815.
To be complete and accurate this sanitary permit application must include:
- I
1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of
where the system is to be installed.
II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling.
Ill. 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 pumps 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.coynty; 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
State of Wisconsin
Department of Industry, Labor and Human Relations
PRIVATE SEWAGE PLAN APPROVAL Western Regional Office
2226 Rose Street.
LaCrosse, Wisconsin 54603
KO CONSTRUCTION
KIM A O'CONNELL
RR 1 BOX 105
STAR PRAIRIE WI 54026
RE: Plan Number: S93-40342 Date Approved: May 25, 1993
Gallons Per Day: 450 Date Received: May 24, 1993
Project. Name: KRIESEL, GARY Location: NE,NE,5,31,19W
Town of SOMERSET 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 keep 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:
- REPLACEMENT MOUND
Inquiries concerning this approval may be made by calling (608) 785-9336.
Si4DVIv,S erely,
R. SORENSON
Section of Private Sewage
Division of Safety and Buildings
PPP027/0009n/65
cc: Private Sewage Consultant.
SHD-6423 (R. 91/91)
Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM Safety and Buildings Division
'Labof and Human Relations Bureau of Building Water Systems
REVIEW APPLICATION
Hayward Office La Crosse Office Madison Office Shawano Office Waukesha Office
209 W 1 st Street 2226 Rose Street 201 E. Washington Ave. 1053A E. Green Bay Street 401 Pilot Court, Suite C
Rt 8, Box 8072 LaCrosse, WI 54603 P.O. Box 7969 P.O. Box 434 Waukesha, WI 53188
Hayward, WI 54843 Phone (608) 785-9334 Madison, WI 53707 Shawano, WI 54166 Phone (414) 548-8606
Phone (715) 634-4804 Fax (608) 785-9330 Phone (608) 267-5119 Phone (715) 524-3626 Fax (414) 548-8614
Fax (715) 634-5150 Fax (608) 267-0592 Fax (715) 524-3633
INSTRUCTIONS: To save time, schedule your review with one of the offices listed above prior to submittal. Fill in all applicable data and submit this
form together with fees and plans/information. Your submittal must be received at least one working day prior to the appointment at the office
where your review was scheduled. Please call any of the listed offices if you need help filling out the form or have questions on what information to
submit. PLEASE PRINT VERY CLEARLY. A sample of a completed form is on the reverse side for your reference.
1. APPOINTMENT INFORMATION -if ou have scheduled an appointment, fill in the information requested below to save time:
Appointment Date Reviewer Name an Identification Number
2. PROJECT INFORMATION -If this review is a revision or extension to your existing
Protect ame plan identification number, provide that number here:
❑ City ❑ Village ® Town Of: raou
rL ca ion 1 •
GOVT. LOT 1/4 11/4,S T N R E or •
3. APPLICATION FOR 4. FEE COMPUTATIONS FEE SUBMITTED
System Type (check one): System Type + (include new and existing tanks)
A ❑ At-Grade Up To 1,500 gallon septic tank $110.00
1,501-2,500 gallon septic tank $120.00
H ❑ Holding Tank 2,501 - 5,000 gallon septic tank $160.00
M ® Mound 5,001 - 9,000 gallon septic tank $200.00
N ❑ Non-Pressurized In-Ground (Conventional) 9,001-15,000 gallon septic tank $300.00
P ❑ Pressurized In-Ground Over 15,000 gallon septic tank $500.00
O ❑ Other: Up To 1,000 gallon dose chamber $ 70.00
1,001- 2,000 gallon dose chamber $ 80.00
Building Type (check one): 2,001 - 4,000 gallon dose chamber $100.00
.
4,001- 8,000gallon dose chamber $120.00 .
D Dwelling, t or 2 Family 8,001 -12,000 gallon dose chamber $140.00
P Public Building Over 12,000 gallon dose chamber $160.00
S ❑ State-Owned Building Up To 5,000 gallon holding tank
S 60.00
5,001-10,000 gallon holding tank $100.00
Code Derived Daily Flow 77 (J gpd Over 10,000 gallon holding tank $150.00
Check If Replacing Existing System Experimental System (additional one time fee) $ 300.00
Revisions To Approved Plan 2 $ 60.00
Petition For Variance: Setback $100.00
❑ Petition For Variance Site Evaluation $225.00 .
Plumbing $225.00
Revision S 75.00
❑ Groundwater Monitoring Groundwater Monitoring - Per Site S 60.00
(other than a proposed subdivision)
❑ Site Evaluation in Lieu of
Groundwater Monitoring Site Evaluation in Lieu of Groundwater Monitoring $ 60.00
Subtotal: g~ t9
Priority Review: Enter same amount as Subtotal: / AA -
MAKE ALL CHECKS PAYABLE TO: SAFETY AND BUILDINGS DIVISION Total Fee:
S. SUBMITTING PARTY INFORMATION
Telephone No. (include area code & extension) Com 'any Name Cont Person
No. & Street Address Or P.O. Box City, Town or Vill ge, State, ip ode
-14
I Aerobic or prepackaged treatment system fees are calculated based on equivalent size septic tanks and dose chambers.
2 Revision fees are not applicable to temporary holding tanks or extensions to existing approvals.
NOTE: Fees are pursuant to Wis. Adm. Code, Chapter ILHR 2, and are subject to change annually.
SBD-6748 (R. 03/93) OVER
! hay
'
WORKSHEET - MOUND SYSTEM DESIGN
PROBLEM:
Design a mound system for a - -
The site characteristics are:
Depth to groundwater or bedrock in.
Landslope x
Percolation rate
Distance from dose chamber to distribution system ft.
Elevation difference between Dump and distribution system / ?3 ft.
Step 1. {WASTEWATER LOAD = gal.'
Step 2. SIZE THE ABSORPTION AREA l
A) Area required sq. ft.
B) Bed or trench length (6) • ft.
'x . C) Bed or trench width (A) ft.
;C.~ D) Trench spicing (C)
Wastewater load .24 coal/ft2/day S ft.
tre ic` eT"'s-'
Step 3. MOUND HEIGHT
A) -Fill depth (D) . ft.,
4%).
6) Fill depth (E) ■ D +6 slope (AJ
ft.
C) Bed or trench depth (F) ■3 ft.
D) Cap and topsoil depth (G) _ ft.
E) CaR a topsoil "depth (H) _ -T, ft.
win:` .
ate _ L:
;04-64 Of
Step 4. MOUND LENGTH
A) End slope (K) _ D + E + F + N x 3 = fp~~ ft.
6) Total mound length (L) = B + 2(K) . ft.
Step 5. MOUND WIDTH
t14 0
~Al) Upslope correction factor =
A2) Upslope width (J) _ (D + F + G)(3)(factor) _ ft.
. $3-ti)Cj)(, 8~;) s 7:30
Bl) Downslope correction factor = zsju
62) Downslope width (I) _ (E + F + G)(3)(factor)ft.
(/,a~~, 8s t i) CY5 C/, ; i~~3ca
C1) Total mound width (W) for bed ■ J + A + I . Wit.
0
~a
C2) Total around width (W) for trenches
■
J + + (no. trenches -1)(c) + A + i` ft.
Step 6 r '
BASAL
AREA
A) Infiltrative capacity of natural soil 9&1./ft2/day
B) Basal area required = wastewater flow f
natural soil infiltr ive• capacity sq. ft.
.514 .
C1) Basal area available for bed for sloping sites ■
B x (A + I) _ ft.
areal avail5le for trench for sloping sites ■
C2) BTW
B CJ
+ A sq. ft.
~
C3) Basal area available for trench or bed for level
\ tes = B x W = sq. ft.
sign: 9'S.75
X(~f-Xa'
Liconso hu.... 51._.
Data: n
+ 1J~ ~ 4 -9
Step 7. DISTRIBUTION SYSTEM
_ 7A) SIZE DISTRIBUTION SYSTEM
f
1) Hole site = in.
i
2) Hole spacing
3) Distribution pipe length = in.4) Distribution pipe diameter • n.
5) Spacing between distribution pipes = in.
6) Distance from sidewall to distribution pipe = l in.
16) DISTRIBUTION PIPE DISCHARGE RATE ft.
1) Number of holes per pipe = ,5_
2) Flow per pipe GPM
7C SIZE MANIFOLD n4 0 '14 9
1) Manifold iscentral/ end
2) Manifold length • ft.-.
3) Number of distribution lines = ..cs~...
4) Manifold diameter in.
7D) SIZE FORCE MAIN
1) Minimum dosing rate = GPM
2) Force main diameter 9 ys in.
3) Friction loss = Ao fjlop ft.
7E) TOTAL DYNAMIC HEAD
1) Vertical lift ■ 4= ft,
2) Friction loss =,l 1,99 ft.
3) System head 2.5 ft. ft.
4) Total dynamic heed = „~,,ga ft.
License;
,c of
7F) PUMP SELECTION
1) Pump selected will discharge GPM at Qom„ ft.
total dynamic head.
2) Pump model and manufacturer ,
. -0 4 0
7G) DOSE VOLUME
1) 10 times void volume of distribution lines ■ „)-T,L gal./cycle
02X'e,/d--/, kso C /s"o,i's
2) Daily wastewater volume : 4 doses/24 hrs. gal./cycle
-~So 4 sos1 //..-v /4? -
3 ) Minimum dose volume ■ 2!3~2 gal./cycle
7H) DOSE CHAMBER
1) Minimum capacity required ■ soo-~5-0 ,$y_ gal.
• 1~k~s. oeO~~~Plaw~to
Licanso 1.u:~,.y
Date: v
A/I
i
r
•
1. 10
001,
3 2
I I- L 11
poll
i
W~
r- W
10
f7f
L
a
1
s „ T" t s; n d
V <
Ilo/
lool,
t ~ .
77
r
h'- r...._._.~-.-.. .
-HT
Designer.
Data.. IC-- ~r" 2
Non-Woven Filter Fabric
4" Observation Pipe
Distribution Pipe
ASTM- C 33 Sond /
-'-"a Alter, Pas. of
Topsoil \
► Force Main
L 'T
1
(G) y: Slope
Bed Of 2 = Force Moin Plowe d
Drain Rock From Pump Layer
D
Oi'5S6Ti" SEVVAGE ,";`tTirP='_
Cross Section Of A Mound System Using
~~A Bed For The Absorption Areo F --c$-3
(folw-Ug ~
N
A Ft.j
,.,rte , ? a i B 9,?, Ft.
A%l RJELA; ~^"JS 40
DEPART J OF 11j' LwA RDR XK)
• IViSDN Jr T E Ai ID Bt Ct DlNaU5 I Ft :
J ..X,4 Ft:
i F n -=o
K 1Q,,l Ft:
Alternate Position •
L 1LL~ Ft:
of
Force Main W ,,u 77-04 Observation Pipe
o A
W Force Main
From Pump
3
° Distribution Bed Of iZ"- 2
.o
Pipe Drain RocK
1
M
4 Observation Pipe Permanent Marker
SiAgiL12F t3car.. Pipe or Rods.
Pion View Of Mound Using A Bed For The Absorption Area
PAG E Or _,a_
PERFORATED PIPE DETAIL
an
DISTRIBUTION PIPE LAYOUT
Perforated Schedule 40
PVC Pipe
End
Cap
area 4
a~$K, Holes Located On
Bottom Are Equally
k Spaced
End \ _ f
Cap ~ 4 .
Schedule 40
PVC Force Main
Last Hole ~ •
Should Be
Next To
End Cap
Owner's Names
P` feet
Plumber/ esigner's ignat re:
x f inches
Y - J,) _ inches
Dates I r R License No.:
-3J.5C
` Hole Diameter inch
ITE GE;AG S`S E Lateral Diameter
aY1 'inch (es)
Force Main Diameter
inches
it F' Ana u9~:7 r'
Holes per Lateral
AND H4~~,~~:PJ feet. Invert Elevation
DEPAIRQ of Laterals
.i
Page 0 f
d
Z .
u
G
c ~ •l
-I
I
_---II-II
M
I
.
•
I--
I--
I
I --JJ
I-- T
I-
- I •
' U
r ~
.0
0 al
a ~
54
w Wo
o so
V
~ tu Q
w ~ 01
rr x
Lu W
i
I
PAGE F.,LlL
PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS
VENT CAP
H'C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING
MANHOLE COVER
2" 25'. FR¢M DOOR, JUNCTION SOX.
_-Tr
WINDOW OR FRESH 12"MIU.
AIR INTAKE
GRADE
I yr MAN' ~r!
00
CONDUIT
' \ 111
INLETPROVIDE
AIRTIGHT SEAL. I III
APPROVED JOINT A X F I III APPROVED JOINTS
W/C.I. PIPE W/C.I. PIPE
EXTENDIWO, 3' EXTENDING 3'
ALARM
ONTO SOLID. SOIL $ v ( I I ONTO SOLID SOIL
DEPA ENT OF INDwlSTRY, LABOR AND flG^i.A,~d f~ =LA;luNS
DIV'ISI N S -ETY AND BUILDINobtAP --j
OFF
D
• SEC CORRESPONDENCE
CONCRETE 51.004t
I
RISER EXIT PERMITTED ONLY IF YANK MANUFACTURER HAS SUCH APPROVAL
SPECIFICATIOU
EPTIC AND
SE TANKS MANUFACTURER: -.h2krla S IJUMBER OF DOSES: PER DAy
I:. ' TANK LIZE
GALLONS DOSE VOLUME: GALLONS .
LARM MANUFACTURER:..
-,?g INCHES OR :V-37 . CALLOUS
' MODEL NUMBER: Bs .-INCHES OR GALLONS
'.SWITCH TYPE: ✓Ca-J3 INCHES OR raj GALLONS
HUMP MANUFACTUREK' __INCHE$ OR _ GALLONS
MODEL NUMBER: NOTE: PUMP AND ALARM ARE TO BE
bWITC.H TJPE: ~16 INSTALLED ON SEPARATE CIRCUITS
PUMP DISCHARGE. RATE ~S GPM
VERTICAL.DItFERENCE bETWEEN PUMP OFF AND DISTRIBUTION PIPE.. .1-5-,.?. FEET
♦ MINIMUM NETWORK SUPPLY PRESSURE FEET
-h am FEET OF FORCE MAIN Y, R/ F/ooFtFRICTION FACTOR..L 99f FEET
TOTAL DYNAMIC HEAD - ~9 FEET
IIJTERNAL. DIME SIOWS OF ANK: LENGTH ;WIDTH ._.....ILIQUID DEPTH
1
51GIJED: LICENSE NUMBER: ~ ~T OATEN, e95'O
44 Subme~~ /dam /G
Performance
Curvestr4- J
METERS FEET
80
MODEL 3885 '
25 SIZE 3/4' Solids
WEUHH
70
20 WE10H
0 60 Tl~
0. -WE07H
15 50
WE
40
1 11
30
10 E03M
TJN
5 f ~ -S ~ . i3 T4 E03L
5
10
0 0
0 10 20 30 40 50 60 70 eo 90 100 110 120 GPM
I 1 , 1
0 10 20 30 rWlh
CAPACITY
GOULDS PUMPS, INC.
SB,ECA FALLS MV YORK 13148
METERS FEET
i
120 MODEL 3885
35 „o WE15HH SIZE 3/a" Solids
30 100
90
25
70
20
60
O-
50 WEOSHH
15
40
10 30
20
5
10
0 0
0 10 20 30 40 50 60 70 80 90 100 110 120 GPM
1 1 1 1
0 10 20 30 m'/h
CAPACITY
01986 Goulds Pumps, Inc. EMSCLiw July, I M
C3885
ST. CROIX COUNTY
k. WISCONSIN
rh ~p ZONING OFFICE
ST. CROIX COUNTY COURTHOUSE
911 FOURTH STREET • HUDSON, WI 54016
(715) 386-4680
I
Apr ii 29, 1993 ~y
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 Gary L. Kriesel property, known
as lot 1 CSM vol. 2 pg. 336 and located in the NE'-,NE;, S.5, T.31N.,
R.19W., Town of North Somerset, St. Croix County, WI., has been
conducted with the assistance of Kim O'connell, CSTM# 2344 .
This onsite revealed suitable soil for onsite sewage disposal to a
depth of 26" while meeting the requirements of the A + 4" rule.
This site should be suitable for a replacement mound septic system
having 12" of sand fill.
Should you have any questions, please feel free to contact me at
this office.
gr rely,
K. Thompso'h
Assistant Zoning Administrator
cc: file
Laabora dHuanRelatio "sTM~' SOIL AND SITE EVALUATION REPORT pap of
Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but J .
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
PROPS OWNER: PROPERTY LOCATION
GOVT. LOT AIZ 1/4 AIZ 1/4,S T N,R P'(orCW)
PROP ER': MAILING ADDRESS LOT # BL # SUED. NAME OR CSM #
1
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY LLAGE OWN NEAREST ROAD
[ j New Construction Use b4 Residential / Number of bedrooms _ [ ] Addition to existing building
bQ Replacement [ j Public or commercial describe
Code derived daily flow gpd Recommended design loading rate _,/..~2 bed, glcW,1--2 trench, gpdv
Absorption area required bed, ft2 7;N-_ trench, ft2 Maximum design loading rate -L.2-bed, gpd/ft2, ~_trench, gpdO
Recommended infiltration surface elevation(s) 114 3 s ft (as referred to site plan benchmark)
Additional design /site consider lions
Parent material Flood plain elevation, if applicable A/d It
S - Suitable for System CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANKJ
U- Unsuitable fors stem ❑ S C U ® S ❑ U ❑ S O U ❑ S ®U ❑ S O U ❑ S ® U 1 7 SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Structure GPD/ft
Boring # Horizon in. Munsell Qu. Sz. Cpnt Color Texture Gr. Sz. ShConsistence Boundary Roots Bed Tiendil
.
Ground
elev. 3
~ It rsy.~6~.~
Depth to
limiting
factor I
f
Remarks:
Boring #
,7-rY,< 44~1
da 4/ Z,2 'V/
Ground
elev. _ 3 y rye .t
4:9 Ale A00
I
Depth to
limiting
factor
Remarks:
CST Name:-Please Print Phone:
Address:
Signature: J Date: IT
Num
PROPERIT OWNER SOIL DESCRIPTION REPORT
Pw,=2-of
PARCEL I.D.
Borin # Horizon Depth Dominant Color Mottles Structure GPD/ft
in. Munsell Qu. Sz. Cont Color Texture Gr. Sz. Sh. Consistence Boundety Roots Bed rends
14
Ground
elev.
Depth 10
limiling
factor
Remarks: `
Boring #
}
t
13
j
Ground
elev.
Depth to
limiling
factor I
I
Remarks:
Boring #
13
Ground i
elev.
It.
I
Depth to
limiling
factor
Remarks:
Boring #
13
Ground
elev.
ft.
Depth to
limibrq
factor
Remarks:
SBD-8330(R.05/92)
I li I I / ~
OQ4
A~X
I LA
y NA'
I
v
,44-9--L of r2avl- JL 7z
r
s
w /
W
0' C,
' I
/ e
/
1
I IT
Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of
Labor and Human Relations
Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
J
'Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
PROPER OWNER: PROPERTY LOCATION
GOVT. LOT 1/4 J/a 1/4,S_5 N,R V(ore
PROPERTY 0 NER':S MAILING ADDRESS L# SUB D. NAME OR CSM #
CITY, STATE • ZIP CODE PHONE NUMBER CITY GE TOWN NEAREST ROAD
J
[ ] New Construction Use bQ Residential / Number of bedrooms _ [ ] Addition to existing building
Replacement [ ] Public or commercial describe
Code derived daily flow gpd Recommended design loading rate bed, gpd/0_)~trench, gpd/ft2
Absorption area required 3y~' bed, ft2.375 trench, ft2 Maximum design loading rate bed, gpd/ft2-trench, gpd/ft2
Recommended infiltration surface elevation(s) 16- ~r .S ft (as referred to site plan benchmark)
Additional design / site consider tions
Parent material - ' L' Flood plain elevation, if applicable 4Zd ft
S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U= Unsuitable fors stem ❑ S O U ®S ❑ U ❑ S O U ❑ S ®U ❑ S ICJ U ❑ S ® U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. nt. Color Gr. Sz. Sh. Bed Trench
V14 Lj
Ground S r `G
elev.
ft. _ lyp
Depth to
limiting
factor
~L
I
I
Remarks:
Boring #
Ground J )
elev. 3 ysyr
ft. - r /
Depth to
limiting
factor
Remarks:
CST Name:-Please Print J Phone: y
Address:
Signature: Date: CST Numb r:
J
PROPERTY OWNER 2~~ Z SOIL DESCRIPTION REPORT Pagk-
PARCEL I.D. #
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourxiary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed
Trench
Z4 se
Ground _
3
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
SBD-8330(8.05/92)
I I
I
1 I I I ~ ~ 1 ~ ( I I _ 1 i I ✓ ~ i
~ j I I I .I I j t , j I i
i I '
I
!
I ~ i ~I ( ~ ~ ~ ~ I I I, i
I , t 1 1
' f I - !
I I '
I 1 ! r 1 ~ + I 1 ~ I I ~
1 , I I
t ,
I I ~ I
I i ! , I i ~ I I ! ! I ; I
it-
~ I I
j T r 1
( I I ~ I ~ I 1 ; I 1 t I _ ~ j I 1 I I
i I
I
3
I
i I
/c)
I
I
- i
I '
I I ~
!
~ I II
I ,
i
1
i I I 1 i '
I
I
r I
I I
i
I
- -
! ~
I
j
j i
- - 7 - - - -
i I
L
I i " I
~ ~ 1 ~ ~
~ _ _ _ t..___..
i ' I i
i
i i I
I
i ~ ~
r
_ t ~ _ _ _ _
I
~ ~
I ~
~ ~
~ ~ 1 ~
f
~ ~ ~ ~ ~ ~
. _..1._ _ - _ _
I ~ ~
t~_.. -l_. -
~
_ _ ,
I
75
SURVEY M .tif `
l CERTIFIED hereby cel
1 registered land survey or~ er 236.34 of the
I, Arthur L.. Wegerer, rovisions of C}'aP County Subdivision
liance with the p of the St.Crdix th A. Emrick,
is
That full comp, i ons zabe
in full
atuteand the p of Dennis F. and el
t
Wisconsin S direction o d and mapped said pare
les arld
under the ivide dar
,
ordinance and und have surveyed' dents all exterior boun
of land, . land is located in
owners of said land, I plat correctly repres of Somerset,
• and that all Ie own
that such p
the land surveyed; 3i N '
the subdivision of o f Section 5 ~
the TdE of the T~EWisconsin, to-wit:
St.Croix County, thence
commencing at the Northeast inen799-45+ t to o the ' L point nt of of the beginning;
CommDE-h-9 -14
L,1 along the Section , to the L'lest line of
S 88040"40" ° ~ vi 1103 801 to the South line of the "IE thence S 6 11l0" 613.03'
1t1 along said Forte line 445.4
thence S 87'37'47" E along said Forty line
said Fort. ; thence
• thence 1.1 205'7'10" II r 4c'6.401 to the North 1 in to
UU) 1; thence Td 7°00tt~0 L 12.22
TJ °(~()t~()II E 159.77 88040140" E along said Section line 3
of Section 5; thence P1
the point of beginning.
el contains 10.000 acres 33f1thereofJect
p the Northe Y
The aboTowneRoadbRight-Of-Way over' '
to existing;
,.a 1976• ere
th• day of November, Arthur L: , eg
Dated this 17 Wis. R.L•S• NO. S-963Company
River loff Falls, Engineering
`,118G0nsin
M
. ' ' S W40 40"IN
312.E CORNER
_ • ' N8
8°40 E 33.28 GSM. AT NE COR
M 33.35 +~~~t<till E0+i5-31-19
31 .70
0 0)
C.S.M. AT NORTH I/4 COR. O cb.
~ iv C~ ~A
0) 4 r+ 0HOUSE (D
qRT' I'JZ L.
SEC_0
N 4 WF''+' DER
r-l-ARN o : ELLm%,oRTH •
I CC)
W
WIS.
•
to , 0.0 0 00
♦ • •
Q SHED _ ) j`',Y,
01 Alo SUIR\X 0-%%
WEST LINE OFJ I- a CRE ~•41f+111~~~
NE 1/4 O in
"E'/4 Z D N8° 40 4Q~E 976 159.77 l
26jo gxaL eed. "IRON PIPE
9406' X60- votyI X 24
3n WEIGHING 1.13 LBS,/
LINEAL FOOT.
-M
O o
-cop O
_OT ~ APPROVED
X0.000 ACRES DEC 15 1976 ORTH
w
SL CPO1X COUNTY SCALE IN FEET ..w
COMPREH:NSIVE PARKS PLANNING 100
AND
0
N ZONING coMMIrrEE 200 100 0
60
Z 23^
aQ
45. - C..gpUTH LINE OF NEI/4-NE I/
S 87° 37 4, 4 , SUBDIVISION
►"1 ~r. •I~.!1S ~a1► {'~P
ApPRO\ . Al, -OVAL Fj,t SEPTIC
` To HG2.20
Record d in Volume "Z" o DOES
SYSTErL1. I...r~~ I
Maps on page 316
Survey)
S T C - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNERy/BUYER_ C t C CL-
ADDRESS ~ P6 L 1C_ ! •-T&V61 x r,-6A FIRE NUMBER ~ I
CITY/STATE C~
1~`.:C~.t=~~ ~t W
r
i ZIP ~C. L C`
PROPERTY LOCATION : C-
1/4 , M`-1/41 SECTION T2-LN-R-2_W
TOWN OF St. Croix county,
SUBDIVISION LOT NUMBER--L_.
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 into the system can affect the function of the septic tank
as a treatment stage in the waste disposal system.
St. Croix County residents may be eligible to receive a grant
for a maximum of 60% of the cost of replacement of a failing
system, which was in operation prior to July 1, 1978. St. Croix
County accepted this program in August of 1980, with the
requirement that owners of all new systems agree to keep their
system properly maintained.
The property owner agrees to submit to St. Croix Zoning a
certification 'form, signed by the owner and by a mater plumber,
journeyman plumber, restricted plumber or a licensed pumper
verifying that (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/Ile, the undersigned have read the above requirements and
agree to maintain the private sewage disposal system i
n 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 Of icer within
30 days of the three year expiration date.
'
SIGNED:..,*
DATE: St. Croix co. Zoning office
911 4th St.
Hudson, WI 54016
STC-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), thenta second form should be retained and completed when
the property` is sold and submitted to this office with the
appropriate deed recording.
Owner of propertyl( L
Location of, property tifl/4 fjL 1/4, Section , T,,2[_N-R ~Z W
Township _ . "LYLSO
Mailing address -3
Address of site AV4-1 c
Subdivision name_C5_LY( L~ o?~ 3_21,O Lot no..
other homes on property? yes No
Previous owner of property _ ( h F° ELL
l~ t1
Total size of parcel (6 t C" IL G_
Date parcel-was created
'Are all corners and lot lines identifiable? Yes No
is this property ¢eing developed for (spec house)? Yes L No
Volume_,:~91_/and.Page*
Number L.:aa 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, 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 deed recorded in the office of the County Register of
Deeds as Document No.and that I (we) presently
own the prop osed 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 the office of County Register of deeds as
Document
No.
9 /
Signat a of applicant Co-applicant
Date of signature
Date of Signature
~I / STNTE BAR ~FANTY DEED FORM I
/ DOCUMENT NO e ~M E 7
tJ THIS SPACE RESERVED FOR RECORDING DATA
VC'
3532x$
This need, made between __Jeffrey--Feske and-.Christine- REGISTERS OFFICE
M. Teske,- husband. .and-wife__as_3oint..tenants._--......... ST. CROIX CO,, WIS.
Recd. for Record this 20
....Grantor
and Gary. L_-Kriesel_.and--Ann-.E.-Kriesel,__husband and. day of Nov. A.D. 1978
wife.- as. joint.. tenants t 9:30 A . M
Grantee,
ltness th That the s id Grantor fo a valuable,c nsiderption Of . U9 -a Wood I
one dollar and oUher good and vacua le considerations
- -
RETURN TO
conveys to Grantee the foil wing described real estate in St•-- GroiX P J¢ ls;.1 ell
County, State of Wisconsin: k 31r
sce~/a~ CG)is• jy/oYc
Lot 1 of the Certified Survey Map recorded in the Tax Key No
St. Croix County Register of Deeds office on December 17,
1976, in Volume 2 of CSM, page 336, as Document No. 337171,
being a part of the Northeast Quarter of the Northeast
Quarter (NE; of NE14) Of Section S, T31N, R19W;
TAR STATEMENTS FOR REAL PROPERTY DESCRIBED HEREIN SHALL BE SENT TO:
Home Federal Savings and Loan Association
730 Marquette Avenue
Minneapolis, Minnesota 55402
Grantees Address:
Gary L. Kriesel and Ann E. Kriesel TRANS
Route #1, Box 155
Osceola, Wisconsin 54020 _ ` OF
Transfer Fee: $ 41.60
This AS_ homestead property.
(is) (is not)
Together with all and singular the hereditaments and appurtenances thereunto belonging;
eske- and. Christine M.- Feske,--gradtor:
And.. Jeffrey,, y...
warrants chat the title is good, indefeasible in fee simple and free and clear of encumbrances except
easements and restrictions of record
and will warrant and defend the same.
Dated this T. " Q . _ day of - , 19__ -g_.
C_ ',I1- ;1 . ..---.---(SEAL)
- (SEAL)
-
Jeffrey--Feske------------
-
(SEAL) • ----(SEAL)
' -.Christine- -R.._Feske------
AUTHENTICATION ACKNOWLEDGMENT
Signatures authenticated this day of STATE OF WISCONSIN
19..------ sa.
County.
Polk
k.day of
Personally clme before me, this -?a
the above named Jeffrey
_
TITLE: MEMBER STATE BAR OF WISCONSIN Feske_ _and ri tine_M._ .Feske
(If not, ---•---•°•----•---s---
authorized by § 706.06, Wis. Stat.)
to me known to be the person .S..... who executeAhe•-_
'(Fl{$ INSTRUMENT WAS DRAFTED BY
foregoing instrument and acknowledge'the game.
Maki F~ Ludyigsan,_ Attorneys at Law
' 54OZ0_ . - - . . Z-
_WLSCOnsin.--
-Osceola,
Notary Public Ctant-, WSs,,:
(Signatures may he authenticated or acknowledged. Both My Commission is permanent. (If nq~atatt?'CSSx-- cti*9iprt
are not necessary.)
date: _--._---_1
'Names of persons signing In any capacity should be typwi or printed below their signatures.
STATS BAR OF WIHCONSTY Wisconsin i.<gal BI-L Co. Inc.
WARRANTY DSSD FORM No.t-1977 Milwaukee, wrs. (Job33291)
ST. CROIX COUNTY
WISCONSIN
~n?~k
{j 1 ry Y~ ~ ~ ~ `i
rh ;rte M*hva. 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 Gary L. Kriesel property, known
as lot 1 CSM vol. 2 pg. 336 and located in the NE',NE;, S.5, T.31N.,
R.19W., Town of North Somerset, St. Croix County, WI., has been
conducted with the assistance of Kim O'connell, CSTM# 2344 .
This onsite revealed suitable soil for onsite sewage disposal to a
depth of 26" while meeting the requirements of the A + 4" rule.
This site should be suitable for a replacement mound septic system
having 12" of sand fill.
Should you have any questions, please feel free to contact me at
this office.
7 rely,
ames K. Thompso
Assistant Zoning Administrator
cc: file