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HomeMy WebLinkAbout034-1031-90-000 .ell, A ~ STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER) !n Ol lam„ C7r (~l_~ ADDRESS b l" Z:IAZ SUBDIVISION / CSM# /V A LOT # SECTION__Z I _aT N-R_(W, Town of `r v~ 15. 223 ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ~A/ ~iA x INDI T NORTH ARROW Provide setback and elevation information on reverse f t is form. Provide 2 dimensions to center of septic tank manh le cover. A " r i BENCHMARK: ' /C z C ItOe, nC ou•\j lh /o a O o ALTERNATE BM: O.1U ®L kt5 ACvk Couek- ok ajuvg4a C hCx C~~ ~~.OO SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: I Prr. -Pr-eg S~ Liquid Capacity: ( C__) Setback from: Well House S Other Pump: Manufacturer 7t3c~ ~dC Model #t()r_- jj Size ILI f Float seperation Gallons/cycle: 175 S- Alarm Location T, ( P OINT-2, ,A40c,,,& SOIL ABSORPTION SYSTEM Width: Length ji-_~ 3 Number of trenches Distance & Direction to nearest prop. line: Setback from: well:'; House Other ELEVATIONS Building Sewer d ST Inlet, gS-")_y ST outlet k, C PC inlet X99 PC bottom / Pump Off Header/Manifold Bottom of system Existing Grade / b/_ Dy Final grade DATE OF INSTALLATION: n PLUMBER ON JOB: LICENSE NUMBER: INSPECTOR: 3/93:jt v Cock, O 140 Co v~=VI- " ~,cl I I I ;j t ~ I C.r At j.WA i;WartrnWATnAF;ELD 14.29~RIV Sir T,AS YSrT • E County: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division' T C OIX (ATTACH TO PERMIT) Sanitary Permit No-: GENERAL INFORMATION 193447 Permit Holder's Name: ❑ City [I Village DATown of: State Plan ID No.: J SPRINGFIELD BM Iev.: Insp. BM Elev.: BM Description: Parcel Tax No.: OD 10 c l , % n 4! - •1 034-1031-90-000 TANK INFORMATION ELEVATION DATA A9300106 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark . 4a, ! P / Dosing / 5 Aeration Bldg. Sewer Holding St/ Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. AirI to ntake ROAD Dt Inlet Air I Septic NA Dt Bottom i 'lL Dosing NA Header/ Man. Aeration NA Dist. Pipe Holding Bot. System /a. /p .d 3 PUMP/ SIPHON INFORMATION Final Grade Manufacturer 16Le4l-LL Demand Model Number GPM TDH Lift Friction Syste h TDH -Ve" Ft Forcemain Length y2~ Dia. j`' Dist.ToWell SOIL ABSORPTION SYSTEM BED/TRENCH Width Length .h rent s PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DJ DIMENSIONS SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: SETBACK CHAMBER INFORMATION Type of ao f Model Number: System: OR UNIT DISTRIBUTION SYSTEM Header / Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length k1 DiaLength ' Dia. Ire Spacing I/U~i A SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded /~odb2tl xx Mulched Bed /Trench Center Bed /Trench Edges ° I Topsoil eyes ❑ No 93 ,*Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) ATION: SPRINGFIELD 14.29.15.223,SW,SE,CO. RD.E r r. Plan revision required? ❑ Yes Ejlf4o ",e other side for additional information. -6710(R 05/91) c~. ,mete 1nspedor'sSignature Cert No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: , m DILHR SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05, Wis. Adm. Code .4 ST. CROIX STATE SANITARY PERMIT# -Attach complete plans (to the county copy only) for the system, on paper not less than ❑ 193 /-/-/71 8% x 11 inches in size. Check if revision to previ us application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. S92-40397 PROPERTY OWNER PROPERTY LOCATION DONALD E CORN JR SW '/4 SE 1/4, S 14 T 29, N, R 15 E (or a PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # 8457 REGENT AVE. N # 14 N/A N/A CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER Minneapolis, MN 55443 1(612 721-7511 N/A CITY : NEAREST ROAD Ili. TYPE OF BUILDING: (Check one) ❑ State owned VILLAGE ; SPRINGFIELD CO RD E ❑ Public ®1 or 2 Fam. Dwelling--# of bedrooms -1 PAR T X NUM ER( ) 111. BUILDING USE: (If building type is public, check all that apply) 034-103190 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 4 ❑ Church/School 80 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. ❑ Replacement 3.E1 Replacement of 4. ❑ Reconnection of 5. ❑ 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 12. 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 450 3~ $ 3'7 N/A # Oa oFeet 10<1,-3 Feet VII. TANK CAPACITY Site in allons Total #of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holdin Tank 1000 1000 1 MIDWESTERN PRECAS Lift Pump Tank/Si hon Chamber, 750 750 1 MIDWESTERN PRECAS X Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) MP/MPRSW No.: Business Phone Number: BENNIE HELGESON 3215 715 772-3278 Plumber's Address (Street, City, State, Zip Code): W 1229 770TH AVENUE, SPRING VALLEY, WI 54767 IX. COUNTY/DEPARTMENT USE ONLY Stamps), No ❑ Disapproved Sanitary Permit Fee (includesS Groundwater ate Issued Iss g Agent SignatL~5~~al A Approved ❑ Owner Given Initial T urcharge Fee) i/f 1 )r, r6- Adverse Determination U X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any, new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever 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. To be complete and accurate this sanitary permit application must include: 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. 11. 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 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 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) A State of Wisconsin \ Department of Industry, Labor and Human Relations SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue P.O. Box 7969 PRIVATE SEWAGE PLAN APPROVAL Western Regional Office Madison, Wisconsin 59707 2226 Rose Street tk)o 7-3~ LaCrosse, Wisconsin 54603 WEGERER SOIL TESTING & DESIGN Owner: DONALD CORN BOX 74 4a 1Jmj0 WG- Av.,N RIVER FALLS WI 54022 ? t ~ V MENNEAP0618 1141 464W. X41 RE: Plan Number: S92-40397/y-LL Date Approved: June 3, 1992 Gallons Per Day: 450 04,of-S,i l -,i Date Received: June 2, 1992 Project Name: CORN, DONALD -Location: SW,SE,14,29,15W Town of SPRINGFIELD 3 County: ST CROIX . s~ 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: - NEW MOUND Inquiries concerning this approval may be made by calling (608) 785-9348. Sin ely, GERARD M. SWIM Section of Private Sewage Division of Safety and Buildings PPP039/0009n/57 cc: DONALD CORN X Private Sewage Consultant S13D-7483 (R. 05/88) Page 1 of 6 MOUND SYSTEM <1 y;U9 Ny~ FOR A 3 BEDROOM RESIDENCE LOCATED IN THE SW 1/4 OF THE SE- 1/4 OF SECTION 114 T Z9 N, R )S W, TOWN OF SpiZIKJG >=tEt b , ST. ~R~1K COUNTY, WISCONSIN. INDEX PAGE 1 of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW-CROSS SECTION PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUMPING CHAMBER PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR oo~ ~~o cuter., V 12- 1 RV N j G r~vE . ~i0T?-T-; MIrJNC~~o~IS, NrN 554IZ PREPARED BY WEGI=FREF;Z SFlQ 11_ TEST I [NJ G; 46dao~C0 Te~oie4ct~ecs*46A DES I G;m SEIZZ V ICE •.''•;S J 'A r i • ART... iq L P.O. BOT 74 421 N. MAIN ST. WT aE.R q RIVER FALLS. MI 54022 ELL89yiXTH. 7I5-425-0155 wr. JOB NO. °1 z _ 9 9 PLOT PLAN Page Z of em Scale 1"= LiO 4 4 0C "rvc. 3 BDRM R.ts t arm C JQ! 0 F z'l PuC Fou..cE MhiAl ~E W p,GE SYS7E ` 10 e~ _ a-. q 1.6 ~ o►., \ S~ • ToP OF wq,l. Weftb c~ kj(j ~IQNS REt-A 1 OMAN Y` pa AN $ D ull ING~., \ pF INDLIS~ SAFE P►N OEPART~AE 1VISO E SEE COP 1 r Do >JoT 12e"'PhcT OR - - -r '1?4lS ~2t:`q - L BN - g1.ev• trio 10, OQ 2s , e SP112~ it RBOVE G~uWD t1~1 w~+sr sro~ eF ~s 03 ' s u~65T LWt of VD ~1eR~ t~hRCt. - _ -r- if 4F o. b M, ro o. q NOTES : 1;z;n 1 C %Nb 43 CZti "w" 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. ( required) 3. Install 4" observation pipes with approved caps. ( required) 4. Septic tank to be -F gallon capacity manufactured by 5. Bench Mark sue- KgovE 01-11N F+- Divert surface water around mound to nrevent nondina at the uuhill side. Page 3 Of Approved Synthetic Covering Distribution Pipe Medium Sand _ H G Topsoil F Elev . \O Z. b 3 E p „ b ONSITE SEWAG /o lope Bed Of 2 %Z Force Main Plowed Conjitiona I Aggregate From Pump Layer U 0 \.o Ft. MAN RELATIONS pEPARTM Op~OF VI INDUSTRY, LABOR BUILD10ross Section Of A Mound System Using E S Ft. A Bed For The Absorption Area F o.8 Ft. SEE CO ENCE G Ito Ft. A Ft. H 1. S Ft. Linear Loading Rate= GPD/LN FT B 4.3 Ft. Design Loading Rate= 0.3V{ GPD/SQ FT 1 15 Ft. J -7 Ft. K \ \ Ft. Alternate Position. L_ Ft. of- Force Main W ZS Ft. L Observation Pipe g K 0I A I - W j-------- Force Main M M Distribution 7-B ed Of z - 2 Pipe Aggregate I Observation Pipe Permanent Markers (Anchbr securely) Plan View of Mound Using A Bed For The Absorption Area Page Of to Perforated Pipe Detail 0 End View )Perforated End Cap PVC Pi od~° `c pe Install permanent 'marker at end of each lateral Notes Located on Bottom, Are Equally Spaced Q S PVC Force Main Q - PVC Manifold Pipe 4 Distn ution Pi e Lost Hole Should Be Next To End Cap End Cap P 30 Ft . Distribution Pipe Layout S q$ E* llv_ QNSITE SEWAGE SYSTEM p X gl$ Inches (fon1 tiO~fu Y - '18' Inches Hole Diameter 1111 Inch P%rr,KAUVED Lateral J Inch(es) DE-PARTME F IN. DUSTRY, LABOR AND AN RELATIONS Manifold " Z Inches IViS10N SAF B I AS N Force Main " Inches SEE 5 # of holes/pipe- Invert Elevation of Laterals NW-5 Ft. 4 Place lst hole -2-q from center of manifold with succeeding holes at qe "intervals. Last hole to be next to the end cap. r ,PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS ' PAGE 5 OF VEIJT GAP ti C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING MANHOLE JUMCTIOM BOX COVER WITH WARNING LABEL 25' FROM DOOR, I2'MIU. WIMDOW OR FRESH I AIR IMTAKE GRADE s I y. MIN. ~ ~ 1e'MIU. ~CONDUIT 18~P1 I ICI. GFJtS+Xe~EM I INLET ONSITE SE~AAIRTI SEAL I I Iff ) . 9,- i III Q,Jitjonaq 1 11 APPROVED JOINTS I APPROVED JOINT I / A moft AL ED i I III ALARM 1 1 RELAT 0 I e I I OEPARjMEN F IN,,'JSTRYOR AN) ANP gEp i ( ON C SION OF I 'I GLEV. fT. SEE CWRE PUMP---- ~ OFF O Lri_ -76 • SO COMCKETE BLOCK 3APPRWCD RISER EXIT PERMITTED ONLY IF TANK MAIJUFACTURER HAS SUGH'APPROVAL• 12~ p pl SPECIFICATIOAIS DOSE I~►Wt~~sT IJ PR RS'T TAAIK 1AAIJUFACTU0. HUMBER of OOSEs: PER DA.4 CR. TANK :rIZE: ISO GALLONS DOSE VOLUME ALARM MMJUFACTURCR: S'S• L~-IZ-•TM SkS7L11 S INCLUDINC9 6ACKPLOW: GALLONS MODEL NUMBER: 10I Hw CAPACITIES: A= 151IZ-IWCHESOF. 302.3 CALLOUS SWITCH TyPC: >✓1~R 5= Z IMCHES OR 3q .O G, ►LLOUS PUMP MAIJUFACTURCR: ZO~'L~R COrtPA►~`f C. q IMCHES OR GALLOIJS : 0~ ~ MODEL IJUMDER IMC14ES OR Z,3'O GALLOM6 SWITCH TYPE: Y'Ie~tzY MOTE: PUMP AND ALARM ARE TO 6E MIMIMUM DISCHARGE RATE 3~'4 GPM INSTALLED OU SEPARATE CIRCUITS VERTICAL. DIFFERENCE BETWEEU PUMP OFF AUD.DISTRIBUTIOIJ PIPE.. Lill FEET -I- MINIMUM NETWORK SUPPLY PRESSURE 2.50 FEET -I- 3Z 5 FEET OF FORCE MAIM X 1- t FYo fEFRICTIOU FACTOR. FEET TOTAL OtIUAMIC HEAD 3q.40 FEET DIAMETER - v f IIJTERNAL DIMEIJSIONf OF TANK: LENGTH - ;WIDTH ;LIQUID DEPTH 1Z'_ BOTTOM AREA - c 231'= GAL/INCH HEAD/CAPACITY CURVE 161, 163 AND 165 SERIES TOTAL DYNAMIC HEADIFLOW PER MINUTE LL EFFLUENT AND DEWATERING 2e 90 SERIES 161 163 165 FT. M. Gal. Ltrs. Gal. Urs. Gal. Ltrs. 24 80 5 1.52 106 401 61 • 231 61 231 MO EL 10 3.05 100 378 61 231 61 231 70 DE 15 4.57 91 344 60 227 60 227 zo W so 163 20 6.10 82 310 59 223 60 227 = 25 7.62 74 280 57 216 59 223 1e so 30 9.14 65 246 55 206 58 220 Z 40 12.19 46 174 46 172 55 206 p 12 50 15.24 21 80 33 125 51 191 J OD L 60 18.29 15 57 43 161 s 30 p 70 21.34 30 114 1-_ 20 80 24.38 14 53 11.4 y 90 27.43 4 1o 100 30.48 1 -1 Lock Valve: 56' 66' 87' 0 GALLONS t0 00 40 50 tip 70 s0 90 100 110 LITERS 0 so 40 240 020 400 r . FLOW PER MINUTE ° Standard all models - Weight 77 Ibs. - 20 fl. cord - S H.P. +s • +w rrr 161 MODELS Control Selection „a „r, pq Mode! Volts-Ph Mode Am Simplex Duplex 3-ewT - I M161 115 1 Auto 14.0 1 or 1 S 9 - 1 N161 115 1 Non 14.0 2or2S8 3or5&6 D161 230 1 Auto 7.0 1 or 1 & 9 E161 230 1 Non 7.0 2or2& 8 3or5& 6 F161 230 3 on 3.0 2S4 3&4or5&6 T- '1-1161 200-208 1 Auto 82 1&9 - 1161 200-208 1 Non 8.2 2&8 3 or 5 6 6 *J161 200-208 3 Non 2.2 2 S 4 3& 4 or 5& 6 'G161 460 3 Non 1.5 21k 4 311 4 or 5 A 6 Standard all models - Weight 771bs. - 20 ft. cord - % H.P. ' 163 MODELS Control Selection ~T Model Volts-Ph Mode Amps -Simplex Duplex 4 M163 115 1 Auto 14.0 1 or 1 &9 - N163 115 1 Non 14.0 2or2A8 3orS&6 - D163 230 1 Auto 7.0 1 or 1 &9 - E163 230 1 Non 7.0 2or2&8 30r5 &6 F163 230 3 Non 3.0 2&4 3 3 4 or 5 A 6 SELECTION GUIDE - 1. Integral float operated mechanical switch, no external control required. [*G3~ H163 200-208 1 Auto 8.2 1&9 1163 200-208 1 Non 82 2&8 3 or 5 &6 2. Single piggyback mercury float switch or double piggyback mercury- float J163 200-208 3 Non 2.2 2&4 3 8 4 ors & 6 switch. Refer to FMO477. 460 3 Non 1 5 2 S 4 3 S 4 or 5& 6 3. Mechanical alternator "M-Pak" 10-0072 or 10-0075. Standard all models - We 4. Combination starter. Refer to FMO514. Ight 82 Ibs. - 20 ft. cord -1 H.P. 5. See FM0712; for correct model of Electrical Alternator, "E-Pak". 165 MODELS Control Selection 6. Mercury sensor float switch 10-0225 used as a control activator, with "E-Pak" Model Volls-Ph Mode Am Simplex Duplex alternator, 3 or 4 float system. 0165 230 1 Auto 9.0 1 or 1 & 9 _ 7. SIMPLEX CONTROL BOX 10-0050, 115/230V, 1 Ph. max. 2HP use one (1) E165 230 1 Non 9.0 2 or 2 8 3 or 5 6 single piggyback wide angle mercury float switch OR two (2)10-0225 mercury F165 230 3 Non 6.6 2&4 3 S 4 or 5 & 6 ~n~ floats for level control. 8. Four (4) hole "J Pak", junction box for watertight connection or wired-in E*H165 200-208 1 Auto 10.7 1 or 1 & 9 - simplex or duplex operation. 200-206 1 Non 10.7 2 &8 3 or 5 & 6 9. Two (2) hole "J-Pak", function box. for watertight connection or splice. 200-208 3 Non 7.0 2 &4 3 & 4 or 5 b 6 'No Molded Plug 460 3 Non 3.3 2&4 3 S 4 or S 6 For.kdorlrradon on addhimW Zoeller products refer to catalog on Combination Starter. CALMON FMOS14: Piggyback Mere" Switchet, FMO477: Electrical Alternator. FM04e6: Mechanical All iahllaaaa af ee++k I P14 leek and wkbq dt dd be done by a aoeraed qualified Alternator. FMOM Alarm Package. FMOS13: SumplSewage Basins. FM0487: and Simplex steekidan. Aa ale~l k and oslov eodat e11a1d be laaoewd brakring ar a1ea1 reead Hasoew Control Sox, FM0732. El A-1, cede pWq and • e OeeupdWW Sakty and HeM Act MSt1A). RESERVE 'POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. 3280 Old Maters Law Manufacturers of... P.O. Box 16347 Loukieft 0 ZM~Zliff ZZ7. K 40216 - (502) 778-2731 Q uwrr P uuPS S,vcE Iffly Al O 4 W ' N ~Q f uu O TIN _ > -TI LA Vt • R 1 ' Z of ° DU , ID NIX W r' i State of Wisconsin \ Department of Industry, Labor and Human Relations SAFETY & BUILDINGS DIVISION 201 E. Washington Avenue P.O. Box 7969 PRIVATE SEWAGE PLAN APPROVAL Western Regional Office Madison, Wisconsin 53707 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2226 Rose Street LaCrosse, Wisconsin 54603 WEGERER SOIL TESTING & DESIGN Owner: DONALD CORN BOX 74 4312 IRVING AVE N RIVER FALLS WI 54022 MINNEAPOLIS MN 55412 RE: Plan Number: S92-40397 Date Approved: June 3, 1992 Gallons Per Day: 450 Date Received: June 2, 1992 Project Name: CORN, DONALD Location: SW,SE,14,29,15W Town of SPRINGFIELD 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: - NEW MOUND Inquiries concerning this approval may be made by calling (608) 785-9348. X41 Sin ely 46/ GERARD M. SWIM Section of Private Sewage Division of Safety and Buildings cQf PPP039/0009n/57 cc: DONALD CORN X..... Private Sewage Consul t tc' . SBD-7483 (R. 05/86) 1 ' Page 1 of 6 MOUND SYSTEM 1`> FOR A 3 BEDROOM RESIDENCE LOCATED IN THE SvJ 1/4 OF THE SE. 1/4 OF SECTION 11 TZq N, R IS W, TOWN OF SptZ1X3 G F1 NL, p , ST. ~R~tK COUNTY, WISCONSIN. INDEX PAGE 1 of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW-CROSS SECTION PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUMPING CHAMBER PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR OOl~I F"LD C0R_w V_,~s 11 1 ?-\J) N G rev 1,302 R4 Y~IIJTJCA~oLiS, Mfl Ss~IZ PREPARED BY ~aQttt4eaoa~t, WECEF;EFZ SQ I L TESTING ~ AND .~Pfo SCONE , -0* ICES I G; t%4 SEFR %,,P ICE • Os ARTu' lR 1. F.O. BOX 74 421 N. MAIN Si. t W[dvERFR G-s1. G RIVER. FALLS. VI 54022 r [r LSVr W'JF.TM, t 715-425-0155 s ~ d 3r`i si `S I G N •tttt~~ JOB NO. °1 Z - q 9 PLOT PLAN Page Z of !o Scale 1"= LIO 4°p~~ 1 t0 oG 4 PVC ~ 3 B DRM R,~S t pry ct? 3LS~OF Z~ PUC FpRC~ }7(4~N f EK~S17N6 WL=1.L S wA~'E SYSTEM e~ _ gi.61 + ptSStTE ~ ,-oP of wq.L WOtb a goo D OV kj(, O ULAN 4tE~lONS F~~\ LPBOR ` RZV,ti OF iNG'~1'1 SAF AND Ull INFS.. OEPF IyiSION CE Stitt OOR+3p A i 1 1 8N - aeU. W13. o' o1J 2S ; 8Z a\ S'P11t~ tr R80vE 6RCUND 85 11J WEST SIDt?' OF ~po u %-e 6" M wP~~ 28 ~ I ccy.r•Rt~tt U~sT LWt of ~ VD ReR~ PMtc~t.. 0.6~ O•gh1I to NOTES: IPWIT C RartD 3 c'TN "w" 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. ( required) 3. Install 4" observation pipes with approved caps. ( required) 4. Septic tank to be gallon capacity manufactured by 5. Bench Mark Ste, l,<gcug %-ILP%N 6. Divert surface water around mound to prevent ponding at the uphill side. Page 3 Of b Approved Synthetic Covering Distribution Pipe Medium Sand G Topsoil F Elev. VOZ.c3 -J ~ 3 E p " fu is ONSITE SEWAG /o Slope tones Bed Of '2 2 -2 (Force Main Plowed ~D Aggregate From Pump Layer gem CAMI, AP P R V 1:160 D V o Ft. OEPARTME " OF INDUSTRY, LABOR MAN RELATIONS E N- S Ft. DIVISI F BUIL0II0ross Section Of A Mound System Using A Bed For The Absorption Area F 0.8 Ft. SEE CO ENCE G I- o Ft. A 6, Ft. H 1• S Ft. Linear Loading Rate= I GPD/LN FT B 43 Ft. Design Loading Rate= O.3V GPD/SQ FT I 1 S Ft. J -7 Ft. K 1 \ Ft. Alternate Position L S Ft. of- Force Main W Z S Ft. L Observation Pipe FA K ( W - _Force Main 0 Distribution Bed d Of 2 - 2 2 Pipe Aggregate Observation Pipe Permanent Markers (Anchor securely) Plan View Of Mound Using A Bed For The Absorption Area Page H'Of b Perforated Pipe Detail 0 End View )Perforated End Cop. PVC Pipe Install permanent-marker poi`°SO~`e at end of each lateral Holes Located On Bottom, Are Equally Spaced Q S PVC Force Main Q PVC Manifold Pipe Distrn ution Pi e Lost Hole Should Be I Next To End Cap End Cap P 30 Ft. Distribution Pipe- Layout S qS E*. 6N _ ~ ONSITE SEWAGE SYSTEM X q $ Inches j ~OIZditio y V8 Inches APPR rm I Hole Diameter 11Y Inch OVO"D Lateral 1 Inch(es) DEPART(4it F lNO:STRY, LABOR ANED IN S RELATIONS Manifold " Z Inches iViSION SAF Force Main " Inches SEE OORR E of holes/pipe Invert Elevation of Laterals 102--5 Ft. Place lst hole Z-q from center of manifold with succeeding holes at 4 e intervals. Last hole to be next to the end cap. 'PUMP CHAMBER CROSS SECTIOW ARID SPECIFICATIONS ' PAGE S OF (o VEIJT CAP - ti"C.I. VENT PIPE WEATHER PROOF APPROVED LOCKING MANHOLE - r-f 25' FROM DOOR, JUNCTION DOX COVER WITH WARNING LABEL ~ IYMIU. wIN00W OR FRESH I AIR INTAKE I GRADE I 11'5 MIfJ• COIJDUIT-- 18.1r11AJ. ~SnXe~.E~ IAILET ONSITE SSWAGAIRTI SEAL I IiI ,12 .1101. 77 APPROVED JOIM'r A o I I ( APPROVED JOIAITS I III OVEU ' I II ALARM e N RELAf I I An , S~gY LABOR AND ~ . DEPARTM~N F INOJ ~ A BUi I I ON C iStOt4 OF f I LLEV. FT SEE CORD PUMP-~~ __J OFF r D trL.. -76 • SO COAICKETE 9LOCK APPRoVEp RISER EXIT PERMITTED OIJLy IF TANK MANUFACTURER HAS SUCH APPROVAL gEDO1~ 5 P E C I F I C AT I 0kJ S DOSE MW1,y~s~scs►J PRA ST TANK MAIJUFACTU0.ER. ~ NUM9ER OF DOSES: 3. S PER OAy TANK 51ZE: 1 S O GALLONS DOSE VOLUME ZZS- S ALARM MANUFACTURER. • S.S, Lzl.~tT12p St[S7'LH S INCLUDING OACKFLOW: GALLONS MODEL NUMBER: 1p I tjw CAPACITIES: A= ! 5 I I ZINCHE5 OR 3DZ 3 GALLONS SWITCH T?jn: Mq%t C.Q Vol 8 = Z INCHES OR 610 G~ LLOA15 PUMP MANUFACTURER: COF'IP~N`( Cs q INCHES OR ♦-)S.S GALLONS MODEL MUMBER: 110 D-"-INCHES OR Z', 3'o GALLONS SWITCH TYPE: VII CUSZY MOTE: PUMP AND ALARM ARE TO bC INSTALLED OIJ SEPARATE CIRCUITS MtIJIMUM DISCHARGE RATE Z-1'4 GPM VERTICAL DIFFEKEMCE BETWEEN PUMP OFF AAIO_DISTRIBUTION PIPE.. 2'4'$1 FEET t MINIMUM NETWORK SUPPLY PRESSURE . . . 2.50 FCET ♦ 3zs FEET OF FORCE MAIN X L-32 FYopt,FKICTIOU FACTOR. 'S7 FEET TOTAL Oy1JAMIC HEAD = 3~I.40 -FEET DIAMETER - INTERNAL, DIMLIJSION~ OF TANK: LEM&TH ',WIDTH ~ ;LIQUID DEPTH y~0 1Z' BOTTOM AREA = 231= GAL/INCH AS PER MANUFACTURER = ti~1:5 GAL/INCH ~K(S (a (30 W 1= 6 HEAD/CAPACITY CURVE 161, 163 AND 165 SERIES TOTAL DYNAMIC HEAD/FLOW PER MINUTE EFFLUENT AND DEWATERING LL ze SERIES 161 163 165 90 FT. M. Gal. Ltrs. Gal. Ltrs. Gal. Ltrs. 24 5 1.52 106 401 61 231 61 231. MO EL 10 3.05 100 378 61 231 61 231 70- 15 4.57 91 344 60 227 60 227 w 20 163 20 6.10 82 310 59 223 60 227 = 60 25 7.62 74 280 57 216 59 223 30 9.14 65 246 55 206 58 220 16 so a 40 12.19 46 174 46 172 55 206 2 /2 50 15.24 21 80 33 125 51 191 a 3K • OD L 60 18.29 15 57 43 161 ~a 30- 0 70 21.34 30 114 Zo 80 24.38 14 53 Y Y 90 27.43 4 10 100 30.48 Lock Valve: 56' 66' 87' 0 GALLONS 10 30 40 50 60 70 80 90 100 110 LITERS 0 80 160 240 320 400 r FLOW PER MINUTE V6%006 Standard all models - Weight 77 tbs. - 20 fL cord - 1h H.P. 1%- 11% wuPT 161 MODELS Control Selection `2-11%rModel Volts-Ph Mode Am Sim x Du lex M161 115 1 Auto 14.0 1 or 1 & 9 - N161 115 1 Non 14.0 2or2&8 3or5&6 D161 230 1 Auto 7.0 1 or 1 & 9 - E161 230 1 Non 7.0 2or2&8 3or5&6 T- F161 230 3 Non 3.0 2&4 3&4or5&6 'H161 200-208 1 Auto 8.2 1&9 - i '1161 200-208 1 Non 8.2 2&8 3 or 5& 6 'J161 200-208 3 Non 2.2 2&4 3 & 4 or 5 & 6 -G161 460 3 Non 1.5 2&4 3&4or5&6 Standard all models -Weight 77 tbs. - 20 ft. cord - yz H.P. ~ 163 MODELS Control Selection Model Volts-Ph Mode Amps Sim lex Duplex 6 M163 115 1 Auto 14.0 1 or 1 & 9 - N163 115 1 Nop 14.0 2or2&8 3or5&6 D163 230 1 Auto 7.0 1 or 1 & 9 - E163 230 1 Non 7.0 2or2&8 3or5&6 F163 230 3 Non 3.0 2&4 3 & 4 or 5 & 6 SELECTION GUIDE 'H163 200-208 1 Auto 8.2 1&9 - 1. Integral float operated mechanical switch, no external control required. '1163 200-208 1 Non 8.2 2&8 3 or 5 & 6 2. Single piggyback mercury float switch or double piggyback mercury. float 'J163 200-208 3 Non 2.2 2&4 3 & 4 or 5 & 6 switch. Refer to FM0477. •G163 460 3 Non 1.5 2&4 3 & 4 or 5 & 6 3. Mechanical alternator "M-Pak" 10-0072 or 10-0075. Si4tndtM aq models -Weight 82tbs. - 20 7L cord -1 H.P. 4. Combination starter. Refer to FMO514. 5. See FM071Z for correct model of Electrical Alternator, "E-Pak". 165 MODELS Control Selection 6. Mercury sensor float switch 10-0225 used as a control activator, with "E-Pak" Model Volts-Ph Mode Am Simplex Duplex alternator, 3 or 4 float system. D165 230 1 Auto 9.0 1 or 1 & 9 - 7. SIMPLEX CONTROL BOX 10-0050, 115/23OV, 1 Ph. max. 2HP use one (1) E165 230 1 Non 9.0 2 or 2 & 8 3 or 5 & 6 single piggyback wide angle mercury float switch OR two (2) 10-0225 mercury F165 230 3 Non 6.6 2&4 3 & 4 or 5 & 6 sensor floats for level control. 8. Four (4) hole "J-Pak", junction box, for watertight connection or wired-in 'H165 200-208 1 Auto 10.7 1 or l &9 - simplex or duplex operation. '1165 200-208 1 Non 10.7 2&8 3 or 5 & 6 9. Two (2) hole "J-Pak", junction box, for watertight connection or splice. 'J165 200-208 3 Non 7.0 2&4 3 & 4 or 5 & 6 'No Molded Plug 'G165 460 3 Non 3.3 2&4 3&4or5&6 For. information on additional Zoeller products refer to catalog on Combination Starter, CAUTION FM0514'. Piggyback Mercury Switches. FM0477; Electrical Alternator, FM0486-. Mechanical M NrfallaYon d an6 A p Ack desloI and wkfrlg should be done by a iarlsed qualified Alternator, FM0495; Alarm Package, FM0513; Sump/Sewage Basins, FM0487; and Simplex electrician. M decrial and defy codes should be 1o8owed Irlc1-1 tale oast raosrN National Control Box. FM0732 l7netrle Cade PIEC) and the Oeagalbnsl Solely and Heellh Ad (OSHA} RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. 2 0 OldiUN Low Manufacturers of... ZAIZZLff O. LoukV01 4 KenhWky 40216 ® (502) 778-2731 QhAL/rY 444-9 SiYCB Iffff DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS INDUST44Y, DIVISION AN REDLATIONS PERCOLATION TESTS (115) MADISOP.O. BOX 76 N WI 3707 HUMAN (ILHR 83.0911) & Chapter 145) LOCATION: SECTION: OWNSH UNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION NAME: Z'110 1/4 sE1/ 14 /TZ1N/R 1SE (o spR1~~~=t~~n - - COUNTY: MAILING ADDRESS: 4312 1RV1/t1G nUt_. KN&kTH sT-CA_ROVC _ZavrtiLp C~12ty V-11~►~ owls wtly. ss41Z USE DATES OBSERVATIONS MADE NO. BEDRMS.: COMMERCIAL DESCRIPTION: I ROFI DESCRIPTIONS: PERCOLATION TESTS: Residence 3 k3.1 , New ❑ Replace l 6-1Z- 9' / 6-13-,?/ RATING: S= Site suitable for system U= Site unsuitable for system OQSITS 13Y S1Ml 7}f'01tlP,30A3 Ohl 6-18-9/ ONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILLHOLDING TANK: RECOMMENDED SYSTEM: (optional) EIS ®u 21s ❑u a s ®u ❑ s ®u ❑ s ®u "L~'JkJ~ - 1A, G14 ~~~>uDW 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: N• Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN, ELEVATION OBSERVED EST. IGHEST TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- 1 qq , 2 t~o>v Z 8 s i~h Z a>` Z B- Z 6Z 9 S ~r 39 Ii B- 3 L) 0 tio1.10 Z7 B- B- B- PERCOLATION TESTS TEST DEPTH WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTERSWELLING INTERVAL-MIN. PERIOD 1 PERIOD 2 PERIOD PER INCH P- 'LU NQ Z C) 1 '/16 ' 1/11. 1 1/46 26 P_ Z Zo ~o s n L 3/s 1 3ia 1 W9 22 P- 3 Za 30 3/r6 I~i6 1 '/S Z-7 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. 1l7 Z U , I. V O`[^R LT SO I SYSTEM ELEVATION of sI~~\ T J ITT LL-n S T' Z yl =T,~",' V € Pt 8 PI ! i~ + i p3 8C',, _ E I ; I E ~ ~ r a 'L.o~ u~' s►tt3~N : F 4 ~OTZ Y10U~+L~ ; ~ ~ E ~ ~ S E r j ~Y' t I ~ E a i i i ~ V i E ct, L 91 S GALE ~lo~ "T CROlx N see I~ I, the undersigned, hereby certify that the soil tests reported on this for mpde WUNTIV accord th a procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and the location of the tes e, QAIK-tQF6QIEof k Medge and belief. NAME (prinlOfEGERER SOIL TESTING ESTS WERE COMPLETED ON: AND , 6-13-9/ ADDRESS: DESIGN SERVICE CERTIFICATION NUMBER: PHONE NUMBER (optional): CST 60oS76 'CIS- L/2S- 0/6S P.O. WX 7-4 491 N. MAIN • CST SIGNAT RIPER FALLS; Wi 54022 715-425-0165 c~ 1 , 67 DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. _ DILHR-SBD-6395 (R. 10/83) - OVER y . INSTRUCTIONS FOR COMPLETING FORM 115 - SOD - 6395 To be a complete and accurate soil test, your report must include: 1. Complete legal description; 2. The use suction must clearly indicate whether this is a residence or commercial project; 3. MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement system; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing scale is prefered. A separate sheet may be used if desired; 8. Make sure your benchmark and vertical elevation reference point are clearly shown, and are permanent; 9. Complete all apropriate boxes as to dates, names, addresses, flood plain data, percolation test exemption, if appropriate; 10. If the information (such as flood plain, elevation) does not apply, place N.A. in the appropriate box; 11. Sign the form and place your current address and yur certification number; 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soil Separates and Textures Other Symbols st - Stone (over 10") BR - Bedrock cob - Cobble (3 - 10") SS - Standstone gr - Gravel (under 3") LS - Limestone 's - Sand HGW - High Groundwater cs - Coarse Sand Perc - Precolation Rate med s - Medium Sand W - Well Is - Fine Sand Bldg - Building Is- Loamy Sand > - Greater Than 'al - Loamy Sand < - Less Than 'I - Loam Bn - Brown 'sil - Silt Loam BI - Black si - Slit Gy - Gray cl - Clay Loam Y - Yellow scl - Sandy Clay Loam R - Red sicl - Silty Clay Loam mot - Mottles sc - Sandy Clay w/ - with sic - Silty Clay fff - few, fine, faint 'c - Clay cc - common, coarse pt - Peat mm - Many, Medium m - Muck d - distinct p - prominent HWL - High water level. surface water Six general soil textures BM - Bench Mark for liquid waste disposal VRP - Vertical Reference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Department may request verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local authority in order to obtain a permit. The sanitary permit must be obtained and posted prior to the start of any construction. SOIL DESCRIPTION FORM Attach Sol] Prof Ic Localjon Ma On s Su orate Shoat) LINEAR LOADING TE: -'Z4 S GK.1 -Al V PURPOSE: u SLOP D,~CRIPTION BY P~2T}-}UR Ll)E-G~12E~2 ASPECT: j V~ `'Z l q q ( CURRENT LANG USE: DATE: 0 Ofl O DATE: COUNTY/STATE: ST. ZALV_ CeUY-.)T! IAJI VEGETATIV COVER: -tk T~-'U3 4 LOT OESCRTPTION: Set`lL4 TZ9" R lSW DRAINAGE CLASS: ~~~~•C_ ~~I~1~lJL~~ 1 f LOCATION: T~&^-jN OF S R(),J r GALLONS-PER 39. FT. PER OAYt ~ sIGK) T • 3Y SOIL SERIES: ~~~~.~~T S 1 I PARENT MATERIAL(s)/DEPTH: lly! - Q HORI10N DEPTH MATRIX COLORS MOTTLES TEXTURE STRUCTURE CONSISTENCE CLAYSKINS/ PORES ROOTS PII -BOUNDARY REMARKS jn. nnjst Gr. Sz. Shp COATINGS ~ G o-~ to~R Z l - L Z. ck- ymu~~ cs 1, 2 3 -yb S R 31 2 s 1 o yr., enVLs' 3 ek oY~ 6/ LBR Z- TJI& c S 3 21-30 -).sY123! s I 3 cad vnu ' _L4 3u-3~ IOH,R 31~ - 1s 3 eae _~IVf►- c s 1 s 3 c sbk m v'$ r »T S Y-7 YM-3/V it S 1O`1iZ 316 l S IJ6 3 - b - ~ 1 Z), 2. Z!Z Z er Yn U'F w c- S z 6-Z`f to~~ ul3 - Selz rn f~ C-S 3 ZV-27 10lf7- '5 - S O g9 `t's 27-31 M'lZ 3/6 Z~ ~S O s m cS it S 3)-vo 7SKR 3 1y 2c S b 1n, rt 'Fi Bic ►zs 'tom 3 s~ p c pQi C oZ f. ~t~ t~~ ~o S! S Sot(-: c- wt ~-ic~ uhJG OTHER SITE FEATURES/NOTES: 6-2-9) o0o s76 1~~16e Z ora Z LIMITING FACTORS/DEPTH: Signature Date CST M ST. CROIX COUNTY WISCONSIN y" ZONING OFFICE v ✓7 ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715)386-4680 May 21, 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 Don Corn property, located in the SW 1/4 of the SE 1/4 of Sec. 14, T29N-R15W, Town of Springfield, St. Croix County. This onsite revealed suitable soils at a depth of 28" of suitable soil requiring 12" of sand fill beneath the mound. This site should be suitable for a mound setpic system. Should you have any questions, please feel free to contact this office. in`cerely, 7~ James K. Thompson Zoning Administrator cj APPLICATION FOR SANITARY PERMIT 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. Shduld 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 ' DONALD CORN ;Location: of Property 14, Section 14 T N-R--~„ _ W Township SPRINGFIELD Mailing Address 8457 REGENT AVE N, #114, MINNEAPOLIS, MN 55443 Address of Site, 3 r Subdivision Name. Lot.Number Previous' Owner of Property Total: Size- of`-Parcel ~ ,Date Parcel was'Created ire all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes No Volume' and Page Number 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 refer- ences.to a Certified Survey Map, the Certified Survey Map shall also be required. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION I (We) eexti6y that att dtatements on this bonm ane t)Lue to the but o.6 my (ouh) knowtedge; that I (we) am (axe) the• ownen(.a) o6 the pnopenty dac ibed in this .i,nso,,unation Sown, by viAtue o6 a waAAanty deed neconded in the Oss.ice o6 the County Regizten o6 Deedsa6 Document No. ~,ga , and that I (We) pnedentZy own the ptoposed z to Son the sewcge dispos syst (on I (we) have obtained an easement, to nun•with the above de uti,bed pnopuay, Son the eonstnuc ion o6 said system,. the same has bge duty neconded in the 046ice` o6 the County Reg~ten o6 :Deeds, e e o. 9~ ) C, ~k Al I NATURE OF OWNER SIGNATURE OF CO-OWN (IF APPLICABLE) •,.DATE' SIGNED DATE SIGNET? BOOK 819-PAIlf 11 DOCUMENT NO. WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA • S~T~1TE BAR OF WISCONSIN FORM 2 -1982 REGISTER'S OFFICE -The__ First.__Nat ona_1_ Bank._ of__Ba.ldwin,______.__--__._____-_ $T. CROIX CO., WI Wiscons_in_,_. a__national__ banki_ng_.corporation........ Rec'd for Record MAY 121988 conveys and warrants to -D.onald._E-.-..C.orn..... ir......axxd--------------------- Marc_el.la__J_.._Cox_n_,.__hushand._Ja.nd__wife of 10:35 A. M Register of Dee& RETURN TO the following described real estate in ...St....-Croix. .......................County, _ State of Wisconsin: Tax Parcel No The Southwest Quarter of the Southeast Quarter (SW4 of SE4) of Section Fourteen (14), Township Twenty-nine North (T29N), Range Fifteen West (R15W). TRANS, FM $-_3-b-sop FM This i_S__ not homestead property. X]B$ (is not) Exception to warranties: Easements and restrictions of record. Dated this 6th------------------------ day of -------------------May----------- - ----------------------19.88. THE FIRS TIONALLBANK OF BALDWIN ---------(SEAL) by ---------(SEAL) * Doug- W res t (SEAL) by = EAL) * * Jon- Mentink, Vice- -resident------ AUTHENTICATION ACKNOWLEDGMENT Signature (s) STATE OF WISCONSIN ss. St. Croix County. authenticated this ....----day of 19.----. Personally came before me this At -.__._day of ~Y_--------------_. 19.88. the above named Douglas--S-•---Wynveen-Vice_ President_ & Jon M. Mentink, Vice-President TITLE: MEMBER STATE BAR OF WISCONSIN authorized by § 706.06, Wis. StatsJ to me k n to be the person S---------- who executed the y ` j4 foregoi g i trument aid ac owled a the same. THIS INSTRUMENT WAS DRAFTED BY " omas A. McCormack Je I Pederstuen C S , Baldwin, WI 54002 sz J t_' Croix !"4>... •8}- Notary Public - - - - ---County, Wis. (Signatures may be authenticated or acknot -11491 ';nth My Commission is permanent. (If not, state expiration are not necessary.) 4f~~ .':~4. date: wry ti - f- . ~r . • . ^ MY_ Commission Expires Mar 11. 1990 'Names of persons signing in any capacity should be typed or printed below their signatures. WARRANTY DEED STATE BAR OF WISCONSIN R•isenasin Legal Iila,,4 C,.. I,,,FORM No. 2 - 1982 dl I nnkc•r wi®.