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HomeMy WebLinkAbout042-1043-10-000 2 9.18.2 t~,[~ j~~j T ] 1 TH ST L r)+'sTr part us~r -F'KIV/RTE11TJVk8 STSTENfn County: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division s (ATTACH TO PERMIT) sanitary ermit o.: GENERAL INFORMATION Permit Holder's Name: ❑ City ❑ Village © Town of: State Plan o.: BM Elev.: BM Description: / x Parcel Tax No.: S BM Elev.: _P11 / GCJ I i Ca l~ _ n4,3_1.0- TANK INFORMATION ELEVATION DATA A9300031 p 7 TYPE MANUFACTURER CAPACITY STATION BS =S ELEV. Septic Benchmark (P~~ /lam, G Dosing C, C~ ~/l Y~ /G 2, 7 AerqtknT- Bldg. Sewer Holding St/0 inlet 2 TANK SETBACK INFORMATION St/ O TANK TO P / L WELL BLDG. Ventto ROAD Dt Inlet Air Intake NA Dt Bottom 3 a / Septic > /8 ' Dosing > 7s6' NA Heade Aer NA Dist. Pipe g7 C„/ Holding Bot. System PUMP/ SH44ON INFORMATION v~U Manufacturer G% Demand /Z 9z, Model Number 97 6 GPM TDH Lift.1C7 Friction.System TDH,;~, H Ft Loss f,) Forcemain Length.-) i Dia. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length / No. Of Trenches PIT Inside Dia. Liquid Depth DIMENSIONS DIMENSIONS LEACHING Man cturer: SETBACK SYSTEM TO P / L BLDG WELL LAKE /STREAM CHAMBER Mo el Numbe . INFORMATION Type Of SQv ~ i > 2 i OR UNIT System: Tie ~p~ DISTRIBUTION SYSTEM Header / I r, Distribution Pipe(s) Hole Size x Hole Spacing Vent To Air Intake Length Dia 12-C Dia. Spacing ~o SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Depth Over It 9 Depth Over " xx Depth Of xx Seede ded xx Mulched Bed/ T1hnV*)1Center g Bed/T h "dges Tod ~ Yes ❑ No E] Yes El No COMMENTS: (Include code discrepancies, persons present, etc.) pppQ LOCATION: WARREN Uh.29.a8.246D,NW,NW, LOT 1, 10TH ST. C G~KJ~y ~ ~%~,~1'r~ Y' ~~c~;~=-' i~ ,~~G.C✓~ Ga,~ ~ chi c 4'( Q Plan revision required? ❑ Yes 21N0 Use other side for additional information. L__? / kzlm/t~ n SBD-6710 (R 05/91) Date Inspector's Signatur Cert. No. S ~ G C ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: 7DILHR SANITARY PERMIT APPLICATION COUNTY In accord with ILHR 83.05, Wis. Adm. Code STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than El 19,13-7 I 8% X 11 inches in size. Check if re sion to prev ous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION r~ U L.) '/4l✓ &/'/4, S f T N, R r~ E (Or) Gov PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # y , Q T i S7~ ,v I e) CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMB ~t II. TYPE OF BUILDING: (Check one) CITY NEAREST ROAD ❑ State Owned VILLAGE ; at, ST ❑ Public 91-1 or 2 Fam. Dwelling-# of bedrooms A I TAX N MB R( Ill. BUILDING USE: (If building type is public, check all that apply) 1 ❑ Apt/Condo 20 Assembly Hall 60 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. ~"ew 2. ❑ Replacement 3. ❑ 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 El Mound 30 El Specify Type 41 ❑ Holding Tank 12-9-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) ye ,f0 ELEVATION 9X.60 Feet S Y Feet VII. TANK CAPACITY Site in allons Total of Prefab. Fiber- Exper. INFORMATION New lExisting Gallons Tanks Manufacturer's Name Concrete strutted Con- Steel glass Plastic App. Tanks Tanks Se tic Tank or Holdin Tank Lift Pum Tank/Si hon Chamber v C ` VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) PRSW No.: !Business Phone Number: ni C c..J' 0 38 ZG8 Plumber's Address (Street, City, State, Zip Code): ? , ryW IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved sanitary Permit Fee (includes Groundwater ate Issue Issuing Agent Signatu ps) Surcharge Fee) p Approved ❑ Owner Given initial / 5l Adverse Determina ion X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety s Buildings Division, Owner, Plumber Ell INSTRUCTIONS 40 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 renevval 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 (S13D 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. 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 mainsiwater 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) soit 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) APPLICATION FOR SANITARY PERMIT S T C - 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. - - - - - - - - - - - - - - - - - -~1- - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property ~f,447-11 P 6:5-eZ7-4G Location of Property //L ft/'4, Section , T C-2 N - R W Township ~lli2Ci~l i Mailing Address CQI oe off' //d S-77 Subdivision Name Lot Number Previous Owner of Property 67,E24~,d AhdE4" Total Size of Parcel 1, ~3 Date Parcel was Created 1976 Are all corners and lot lines identifiable? Yes No Is this property being developed for resale (spec house) ? Yes X No Volume and Page Number C;)/(o as recorded with the Register of Deeds INCLUDE WITH THIS APPLICATION ONE OF THE FOLLOWING: 1. Warranty Deed 2. Land Contract 3. Other recordings filed with the Register of Deeds Office 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 the Certified Survey Map shall also be required. - - - - - - - - - - - - - PROPERTY OWNER CERTIFICATION 1 (We) eenti6y that aU statements on thin jonm aAe tAue to the best of my (ouA) k.nowtedge; that 1 (we) am (ahe) the owneA(s) o~ the pnopenty deg c ibed in this .in6onmat%on jonm, by viAtue ob a waAAanty deed neconded in the Ojjice o6 the County RegisteA o6 Deeds as Document No, r,ISSLK ; and that I (we) pnesentPy own the pnoposed site Aon the sewage d-isposa2 system (on 1 (we) have obtained an easement, to nun with the above duc ibed pnopen-ty, bon the convstnuc ion'o{ said system, and the same has been duty neconded in the 066.ice o6 the Coun-trq Register ob Deeds,, as Document No. - ) . SIGNATURE OF OWNER V SIGNATURE OF CO-OWNER (IF APPLICABLE) DATE SIGNED DATE SIGNED DOCUMENT NO. STATE BAR OF WISCONSIN FORM 2-1982 THIS SPACE RESERVED FOR RECORDING DATA WARRANTY DEED 484889 VOL REGISTER'S OFFICE A / ST. CROIX CO., W1 r" /y i;• Recd for Record JUN 191992 conveys and warrants to l of 9:45 A. M 5,' v~ . / 1P r~ b Sa a~ 0 een-V-4A Register of Deeds RETURN TO the following described real estate in S t L Y' C 1•X County, State of Wisconsin: Tax Parcel No: Pa.t-I- o-f -fh 'e.. A 01a N hl'/-/ o-' ScOio h 161 Toum5hir qq /VcfA, lilanq, I West, d r~ 1 X Cau,~+ WI sco~ 1 51' n c~e 5C V i` 6e l us I (auus : "s I 0 Cer`~ .y py Map Oied Fe bruk_ar~ 3) 19Ila i'n VOl . ayea/61 DO, 6. V~n M SO_+ISfa1;()n ~at1d -•I 'h 1 5 &E E d 1 S I ~ Con~-rac`E" I, This i5 Noy homestead property, (is) (is not) l ( I Exception to Warranties: F0_ 5 t-//)j e l co V P1 CL I~s ahd re5s ric 0,7 5 O V eCor I -r h Dated this ~ Lo day of (SEAL) sGi/ CT (SEAL) ck L Ala 8 E!o,-w (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT o; ....r, r,.t STATE OF WISCONSIN SS. Stea Croix County. authenticated this day of , 19 Personally came before me this 16th day of June '1992 the above named Gerald La Nadeau TITLE: MEMBER STATE BAR OF WISCONSIN (If not to knXiii t ~ha pArsop who executed the authorized by § 706.06, Wis. Stats.) ore oir Mi, ! t a' . • ~%yredge thip same. THI INSTRUMEN S RAFT Notary Publiry • •t-3-County, Wis. (Signatures may be authenticated or acknowledged. Both My Commlgr, 7*I7etjVq'oe(1t' ..;(If not, state expiration ) are not necessary.) date: AArt'17~~i,r•'~~ _1993 'Names of persons signing in any capacity should be typed or printed below their signatures. SB2 NTF 0021 WARRANTY DEED STATE BAR OF WISCONSIN Nelco Tax Forms, P.O. Box 10208, Green Bay, WI 54307-0208 Form No. 2 - 1982 _ 1L ED FE • • o Q o 1976 3 313 8 S GM,°Gti d, V r T v NW CORNER OF N 1/4 CORNER OF SECTION 16 , T29N, R18 W SECTION 16 T29N, R18W POINT OF BEGINNING NORTH LINE OF NW 1/4 33' 2656.60' r-l 86.3@' i0 EXISTING 1420.00' _ S89-31'E TOW ROAD _ 75, _ p\ 50_'___ _2_00'__ 200'_ - 670_ 0 6 E' X2.19' 0 5' CONTOUR LIN PIP AO a a' 2"PIPE - or DRAINAGE 4) LAO 0.0 SE C 2 3 4 99 'Q 36 A C m 1.69 AC~~ o I 1 1~ a a c M .BT 51C.11I1Q It 6.4 2 Ai !k \o, x'• n z o~\v~ 1 .83 AC: 24 M re 1.54AC, M 1.7 2 C. r 5.91 AC.2, \ o c 0 CD o 1/ 109Q/ I i R 2 %:;.\ts z co 1 X06 2 / a cm y 175.33' 200' 43.63' W \ ~ a 9 yk EL.99.720 %G Na9°31'W 454.25 9 156. 7' 1100 INE 670' 2"PIPE bp 0 F - N O° 29'E ,o N89-131 -W 826.37'. ~0° 9 r 9 'L 2a 50.00 FLOOD ELEVATION •97 cg9 NW-NW JUNE, 1975 NE-NW SCALE IN FEET I 0' 200' 400' NOTES: 1) :Acreage of parcel including tol.n road easement. 2) Acreage of parcel exclu.ling to;.n road easement. 3) 2' contour line is 2' above the highest knot-in flooding which occilred in JWIC, 19-5. 4) 5' contour line is 5' above the highest known. flooding which occured in Jwle, 1975. ct I LL•i. VD C-j SECTION CO?:tiLR 2" X 36" IRON PIPE IVI'III "(iGILNSTCV G•U)" 1" IRON PI PH FUND i1hVGR FM:D;nPEL 110 MANN O 1" IRON PIPU SET, UNLESS ::ffm '-Sissni IL\L\N sr. EAU CLAIR1i,IVISCONSiN 54701 - - - RIC IT-OF- \1' LINT: (ll'M R $ SI(RUI\'I111:R UR1I\:\GG CC 11161: 11C Al\RSII i i l'IU\ial \r\I11,14I ROM:RUS, WISCONSIN S•1023 IIGSCRI P'f l l t~ G/ A parcel 5t land located in rile N1/2 of the iv,1;/4 or 7sectic;, l:•, Tail?!, I?lSt` , Tomi of' !'.til'l'er:. St. Croix Count}, Wisconsin described as follms: Conallencing at the NW comer of Said Section 16; thence S59°31'G (true bearing) •186.53' along; the North line of said \?:I/•i of Section 16 to the point of beginning; thence S89°.51'I: 1420.00' along said ;north line of the NWI/4; thence SO°29'11 417.43'; thence N39°31'W 326.37'; thence \orth 0°29'i: 50•1.10'; thence N89°31'W 454.25'; thence N20°17'20"iV 393.97' along the centerline of an ex i.tin, town road to the point of beginning. Subject to an existim; tole road easement across the North 33' and the Westerly 33' thcrcof. Subject to casc•nlc•IItS of rcCOrd. I certify that the above description •uld map are correct and that I have ru;ly complied with the provisions of Sec. 2.56.34 of~ the Wisconsin Statutes and Section 5.4.2 of St. Croix Cocalty Zoning Ordinance. SURX11'rD BY: ~ ••>i-~- PL. I7:LEI2ItiG CO. lialtcl'.1. Glr.ol~ - 22.1-.101 •o. 1_3 E.E.U.1 sT. APPROED `~`GO~'ratr~; RI\?iR Fr\!.I IVI~'.`::SIN 54032 9161 1 Z NVC UaT.:: G::L1}21iR 1-, 1175. ST. OR= COUNTY w ' CO-MPREIENc!VE FAR.XS PLAlJN-11,\NnLTE" 1. ~a ' ITS 1NST::'.?'L\'r ..:\S DR~\l'1•?i_, M AND Z0f;:4G COIA.411IME 1t R[GORY 5-12=y 1 RIVER F,._LS. ' 0 1.,. D ':`.l; 1 r".:'(:.!3':~AL ~ l/~\ J_~ lie i ~ env C Z=~`G _ae 1 ,fie H H y S T C - 105 r' . r y H SEPTIC TANK MAINTENANCE AGREEMENT 0 St. Croix County z d 9 OWNER/BUYER J7//✓ Sie/LmG ~r ROUTE/BOX NU^MBEI1001T~X41e V59' Fire Number CITY/STATE ~20~aE~27-6 G✓/5, _ LIP_ _ PROPER'T'Y LOCATION:/M `Z, NW!& Section f~► T Aq N, R __W, Town ottt/4 kl&--A/ St. Croi-x County, , Subdivision Lot number l _ Improper use hnd maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed ~tic tank pum er. What you put into the system can affect the function of the septic tank as a treat- went 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 systems properly IllaillCai►led~~ 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 veri- fying that (1) the on- site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if nec- essary), 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. H 0 I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with x H the standards set forth, herein, as set by the Wisconsin Depart- rn menu 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 ~tGdZ. DATE St. Croix County Zoning Office P.O. Box 98, Hammond, WI 54015 7115-716-2239 or 715-425-8363 Sign, date and return to above address. safety & Buiiuwngs Division Wisconsin Itpartment of industry, SOIL DESLMPTION REPORT P.O. Box 7969 Labor and Human Relatign$ Madison, WI 53707 (Attach Soil Proi' Location Map - To Scale - On A Separate, Signed Sheet) - Page ~ of 1-7 3~'~-So3G scs 9 s~3 ,atomer Name i va uauon Data urrent Lan Use or Vegetative Cow Parent Matena s o vE~P S AlAhor~ D5TEnr.9 G- A14Y 2--) - q z ~ e,4/ 9.~,~SSES 5,'i-7- sEo,~,~ ~TS sumaty • owe~~ rou ater am evasion 361 4~j refs L ~t10 f rJ tJ s. Jr 69 y O County as arce J- 4"/ oic yscem Loa ftate in a ons Prr q. ft. Per by sr c/~o, X got / • ~,~r<~ ' S ~fP Ct ><o~ lot lega psscrsyuon ystem eomytry an Dep an S ti~ls ON L E tJ 5truct~to Remarks: clayskins Loading nt Color Mottles Horizon (ID, sell u. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots EounBounda ry_ ores Hand other GPD/h.2 A -1/3 S/ / 1j, si+~ /w~ fe 2-f sP s/ ~ 51'- ,w .rk /vf s , . S YR 4116, 7'0 L ~ F/~ Yet Ti o,J Ic~' structure Remarks: clays IM Loading Horizon Depth Dominant Color Mottle In. Munsell u. Sz. Cont. Color Texture Gr. Sz. Sn. Consistence Roots Boundary ores H and other GPD/ft.2 f -2+ V'e S/ 7 5 YR dG 10 Brwvs f ~~re7/ 7c• f~'rtvuc~t /¢~So C ~T-f`i:v5 y/e 01 PDVL'--'- 00 Horizon 11n Dominant Cal" Mottle Structure Remarks: clayskins aing Munsell u. Sz. ContColor Texture Gr Sx Sh Comistenre Roots Bounda pores H. and other CiPD!1t.2 /oY,e y s/ 2, sk e t f ~`3 ! o• y 71g 41- - s 0,,11, ;;e ms _ S - f3 - 5 /o yR 1s (X. of /0 VA YA/ 51 f )Uf, br rtn-rle Ctiff~'~✓ tiP 8 p, u`~k z`, lo vie s 12 ,E rr- /dd.'?0 ~A r/oN Horizon Depth Dominant Color Mottles Structure Remarks: clayskins Loading In. Mumell u. Sz. Cont. Color Texture Gr. Sz. ih. Consistence Roots Boundary ores H and other GPD1f0 2f S .--3 a-u /4 ilR 4/3 S-// 4,-" -L7 /oYk ' .2,f, s t~/c k 4-k I f c s -3 s-fo /o we - c~titttiTcv 00 . 3 v for a conventional- septic s stem. Horizon Depth Dominant Color Mottles i~ Structure Remarks: clayskins Loading In. M n 11 u. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Boundary ores H and other GPD/ft.2 5// z, fie- zf S " 3 /0 ye.4/3 - AP 16YR y j , 29- Y /o ,e 31 - , fs ri0t,iESITE SEPTIC PLUMBING CO. sib:; O'NOL RD., HUDSON, WIS. 5,1016 ROBERT ULBRIGHT r 11.3. MASTER PLUMBER LIC. NO. 3307 M-PAS Additional Re~narki:` tom, ~ _ 100- $ /A4 726- °/f - .S ! Soy/ Tex TLWx 5: -s ~o'7 ~i•4l~ ~~,~V><D So115 o A.&L `7S /Sf/O _~ti c y S'i o S ~f a~ z°E 7- la'" a-4 491~14 other Site Features: 1 WA lirnitiny Factors/Depth: CST Signature Oate Signed Telephone No. CST 0 iLO d3JOIN 0INO) f fi ll~J¢ S do 44(111DU~ /00 Ca •~C s s~.ti~ j k,~ r C.~-1t tiT ~w`-r Sr9.~VS Of 6 0 4' N e,& S 2( S E` i rc~5Li 13 u T(aj I I 40 r r= !U ~ N L 1~ SAT -4i tAJ 1 ) SI 17 ~ to g\ Q f t~ •J ~.,v c~_ S 643 50,P .S~i~/low - SGcu~~:e ~lo~.v _I_~o,~~ C~'•.~ J3~ts~~c,~~u ~/~71U/ ~!f '~a r fir' ~~'vs~ ~c rr rl L/r 7-- p u'`c P 01 At r~ v,y rj S-fn i 4ex -r `j i /00 Li dge ~ItLuA-n'o,v S - T3 3 /OZ, 0 V) By /oo , ~o 96 '?0 o , 2-0 ziuG FoR 3 r 15: &o s y'5 rE,~ hR --4 tiEt~~o - 90o s¢. T,PE',ucGt S I - ; /33 _ _ SAX l0 I v 3 TptNGG`S i~ 3 ~ ~ 2 S X (o ~ This test site APPROVED for a conventional septic system. 1 ~ v 35 copy BI SE r 31y ,S"/& / j, 6 /EY't Tioti = i 0 v• O w 0 . f p~a0, ~,,ooo v- Q T a so~~ i ' NGtX- SITE SEPTIC PLUMBING CO. 3 0rj 3 e,F: O'NEIL RD., HUDSON, WIS. 54016 ROEERT ULBRIGHT CST iY~~ ~S. h! 7-1 P UMBER LIC. NO. 3307 M.P.R.S. n ,Y DESIGNER LIC. NO. OM 1 ' GL• /00 1L=yitWoAjS s 3 /0 22, 0 ~t 4 By Io o , eo J ~S `400, 30 SCALE; / Yo r ol"' TIt't` 95'. &0 S i'Z r v - FoR 3 s Y 5 r6-,,-t 13 Qe : ~7 NSA' 1 7A rte-u c.4 S _..I 133 Pj /4°aSa G~ o COc.~.,t~ Pvc ,„P'~c I'MA ► O S rt r S 1c.P- t t r„n ~'ti ~ ~ p 3 L( _ y Tag ~ ~vLe rr t.,1': , , c0C-c M LC ro 6~ ~a~~ rid /vw'rY wv/iy x0- C- t6 T ZS R !0'!✓ > J-o' ~ 't, !•✓grr•er. - ro...+r^,r4~p ~0~ y 6J0 7 t1 ~ +t r ~ I LhT ^ T 7 e ~1 y r E L syr S y 11 Ttr4.,<< SET 31Y 9c.~ . o P ,y 1 LOw~ r rr't hLC ~ /1~~EY~T~OgJ r /d E7 , l Amt- T-~- _ 1 I D T LO -r L ' Lf I''7, G ? o a SOHO s- fool t 3oy`3 t , PAGE or___. ' PUMP GHAMEfER_ CROSSS_EGTIOM AKIO SPECIFICAr11)IJS' VCWT CAP • ti 40C.I. VENT PIPC WEAT•NEK PROOF APP(IOVCD LOCK11614 JUUCTIOLS OOIL ^A"LC COVER 25' FROM DOOR, Irmo. ' waiDOw OR PRE;H 1 Alit INTAKE mom GRADE 1 I '1' MIAI. Alt. . , Ib' h11N. COWOUIT 1 PROVIDE I IIJLICT -7 AIRT14MT 59AL I I1 0 c..,~ c v I I APPROVED JOINT A ...,I I'.I APPROVED JC W/ca. PIPC 1~1u,.7; r P. OsTcr Tsg I 111 w/C.t. PIPE EXTENDIU6 3' JL //0 f S'r I I) ALwRI~ ONTO ONTO 60L10 601E b I OLLTO som SOLID i . , I I ON C to c 7-,'o,, ELCk..._.. FT yvw ~~y wc.~ ~iH Se PUMP-~„ "_J 7' 5 R I P' w *Fr sr c -c u T LOttCRETC OL06K • Mlul, j L.Ic RISCR EXIT PERMIVED OULU IF TAWK P"UFACTURCR.'' &WAH APPROVAL wPPRovwC -OOw4 SEPTIC SPECIFICAT10kis OOSE TAUK MANUFACTU CR: PER DAN TAUK 61ZE: 1a y zJO GALLOWS ODSE YOLUAE INCL.UOIN(p OACK/Lgwi ~iA1.LO~ ALR j MAUUFACTUKER: S EL /MODEL WADER: - CAPACITIES: !~s yiUCAOR.906, GALLO► *WIT" Tapt: 4 s,,._~.._u1CMti oA =&~i..4ALLO' PPUMP, ` MAUUFACTURER: 2...: rv m IW91166 QR •~-Z GALL01 MODEL iJUMDER: • 4 NICHES OR 4ALLOi &WITCH Twpc: A-o PUMP! AAID ALAIIM ARE TO pC MIQIINIJPI QISCHARGE RATE GPM I146rhl.1.E0 ON SEFARATE CIRCUITS VERTICAL DIrF691EW DETW96M PUMP Off MO 016TRI15UTIOU PIPE.. FEET + MIUIMUA UCTWOIIK SUPPLU PREfiURE. , f'CCT + _ rCET OF FORCE MMW X 441-1.1-Y XFLFRICTwN FACTOR.. PICT /h -I.-4Cr~~. TOTAL owAMIC. HEAD _ O•r FEET IAITERIJAL DIMCNt10N6 Of TANK: LELICiTN 1L,~iWIDTH -~.~..,.I LIQUID DEPTH 5IGNED:,_ ` ....-s? LICEIJSE IJUMBER:"- -1/.x/4 DATE:3..~3..,,~ HEAD/CAPACITY CUKi id EFFLUENT and DEWATERING WARNING: Model 185 should not be subjected to lass than 30 feet TDH- Q W • - N ~ TOTAL DYNAMIC WD/CAPACITY PER MINUTE LU (W EFFLUENT AND DEMIATERINO W FT. tit 1N /ii 186 in tii 115 {FRIES 6749 97 AGa MI Gal. Ura. Gal. Lull. Gal. Llra. Gal. Gal. *pi Gal. =41q. Gal. 141ri Gal. We. 5 i 697 155 597 34 5 1 6$ 43 183 57 a18 ` 106 s!M 61 61 1 15 146 .590 151 572 1 m" 61 1; 81 110 10 . _ 3AS ' 34 1129 51 .193 79 ' 300 100 8 t5 74.57 19 ''72 43 1{3; 64 242 91 3M' 80 BO 142 145 6W. 32 105 20 710 27 '104 36 ':r39 82 ;310 59 8229 60 w, r 136 ¢t5 140 i530 25 82 8 i'30 74 290 57 191{' 59 126 133 603 30 9:14 95 >249 55 58 90 121 .45{` 127 %461 100 16 174 48 5 72 55 75 ,293 105 .3p7 114 431 30 40 ~2.ta - -7 60 6.24 21 60 33 :"26 61 58 19'` 90 341 100 370 95 6o ; 15 tr1F7p ./3 2141. 36 .43&. 71 .249 95 322 ' 70 ? 21.34 ' 30 10 F31 51 9370 486 28 9o .38 , 14 28 -106 54 204 90 13 2 37 140 . 90 ~Ss t00 Ii 21 , 79 Ito 26 Lock Valve: 19' 24.5' 26' 56' w aT 73' 91' 110' 24 ~ M DEL 75 89 22 70 W = 20 65- U i 11 $5 Z 18 60. 0 55 MO EL r 16 16 ODE o, 50 188 14 45 12 40- M 35-- 2DEI 10 185 30 8 1 7,1 9 25 r 6 20 OD L 161 - 4 15 7 10 2 53, , 5 , 0 GALLONS 10 20 30 40 50 60 70 80 90 100 1110 120 130 140 150 160 ,rs" + --S- 1 11 LITERS 0 09 YiW~:K...s:r.w..+'.r,.iv..+.~'-~'•~'e~V.-.~ FLOW PER MINUTE Nate: For Head Capacity on Model 112, industrial column-explosion proof pump, see FM 219. ti Wisconsin fftpartment of Industry, SOIL DESCKIPTION REPORT Safety b Buiiurngs Divist. labor and Human Relatipns P.O. Box 7969 / (Attach Soil Prof' location Map - To Scale - On A Separate, Signed Sheet) Madison, WI 53707 Page ~ of 17 ustOmtr Name ve wtwn ate urnnt Lan Use or vegetative over Parent Materu s o r/E/Q .S Mfr/PT'/ OSTEIZTr9 G A14Y Z1- 9' Z 9iP4SSE5 6,'1-7 s>=o~~,z<~TS ~a -Flood ustomtr rtss Estimated Shallowest Groundwater am Elevation 361 k>~//o c~ L", w'- `s County ax Parcel ~ GF ystem Loamy to in a ons Ptr t. Per Day Lol` ,p ✓ ✓ 5T Choi)( t Geometry nd Depth an nsptct Ar//Lot Legal Description N-4) l?~ Tsystem T t (LA Horizon Depth Dominant Color Mottles Structure Remarks: clayskins Loading In. Munsell u. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Boundary pores, P H and other GPD/ft.2 A o- 9 /0 vR'1/3 J,-f, She- 2-~ Q S .3 - 7.5, Y'e oc" - 78 Yle 5160 /s ye vf/z 5/ ..S S/ D f sd~ I' . IA; C VS ~o r~s Horizon Depth Dominant Cola Mottles Structure Remarks: clayskins Loading In. MuMell u. S:. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Boundary ores Hand other GPD/h.2 0-~ /o /~e y 3 s/ f Sb~ rw f~ .2f ~s .3 t f S S /o f S sh /c A- -f k /L) 133 s ye 10 o yR "w v'ri2 s o~d~,f' B~w9s ~f _ S /3i /ev.4F.0,j ORIGINAL i mutant Cola Mottles Structure Remarks: clayskins Loading Horizon Depth Do' In. Munsell u. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Boundary ores H and other GPD/h.2 7/5 9 -3v /oyey - s/ 2jsb' 'l,-A-'2 f S '3 • ?,D, Y2- 7 lie 00 Z 1- S YR ~~fl of /o yR Y S f r of h'. 12 1/,4 7-1 00 .1?0 Horizon Depth Dominant Cola Mottles Structure Remarks: clayskins Loading In. Munsell u Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Bounda ores H and other GPD/h.2 a-~ to 4/3 -2j, sd~ S - _ 3 l3 r 7'l~ /0 yiC S~ r, f, she 41- 7C4 C s T"' f° • . lKill cE'~nt.vr~v 2t/ 7-1©w 100-30'-1 for a conventional septic $ stem. Horizon Depth Dominant Color Mottles Structure Remarks: clayskins Loading In. M nsell u. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Boundary ores H and other GPD/h.z ,q 0 ~a /o ye 4/3 1,f, sdk f~ Zf S . 3 ;y /6 yX y yy~o ~o yR O/ C-) vj C o-90 ~oy,P GC ti HOMESITE SEPTIC PLUMBING CO. 655 O'NEIL RD., HUDSON, WIS. 54016 # y y~Z Z ROBERT ULBRIGHT C S 7- i/IS. MASTER PLUMBER LIC. NO.3307MAIft ft IMSTALLER & DESIGNER LIC.140.00183 ~ofJC ittor»I Remarks: ~ - 1',5* Soy/ Ter 7wer-5 r1",~E .vo T `Ts AW M~ ~~t/S ~s~^^~ ~U~f,~-t ~o~~~ S~1`•~l~ ~~'a't`~ l'I,y/~ li,~~~~L~: r Other Site Features: I to ned Telephone No. CST 0 limiting FactorsJDepth: CST Signature a S g 1 500-1330 (N 011w) <S ~sati~//~/ /Llo f fGr.v Soy/s D v .vo T 4AOjer)' 7-6 s ~S S,PV~ ~i9-Tv~t'/h"!' • ~{~~~v 4-7- GUE~~t,,P.t~.tQ 7Ci~ -S~.uv S fa.v F , ~~..u ~i s Gv:/l ~ifi~ ~ . 7~ ~E I•uS~jl/~"L~ ~llii~~dzJ - f0 /LI/~/N~i/Ii✓ Sa~~f~~T%o.~/ O~ 77e,, -c 7 or /wvzE7 E Y ~ _n Co-ti"-1 F.u p >+~z7 C e~- N S u S F Full 'R o c, k- B e low C~t 'bvsTT P r /3 u T foN (S Will C ~~N C.2 - lenfr•tievT- tiAL S/NCB ~"C C'L`~rt.la S w~~! ~ S'l vloto u, ( do T /~C POS 91' iQ I. E-, - r T /4' s~we PUA-1 P •ve~sS AVO ,i I i I~ I ii I (J - /00/4 wAt' AIL'UArl'OAJS 2 _ /02,0 3 V) y '90 134 'V 2-0 L Otci Ti e'.u --95. &0 A-) G - FOR 3 5 Y'5 7-4E 1 A %e& -'f goo 5-'o ffi 13 13,5 Te Cu CA .5' - l ,3 _ - J- X 9O i + 3 7R ctia,,,5 , r~ _ ,ng This test site AIPMOVED for a conventional Septic system. , ~ loo y ~Io ~ w 't _ - J D O 4 p O l7 f "oop, To h'GL4-SITE SEPTIC PLUMBING CO. E3' O'NEIL RD,, HUDSON, WIS. 54016 ` ROEERT ULBRIGHT CST Z y~Z `QS. I -""a Pt.UN1BER LIC. NO.3307 M.P.R.& DESIGNER LIC. NO.00663 - P~ .3 0T 3 ~~s f ESQ - ~RNER 0 F _N 1/4 CORNER OF 16 ,T29N, RIBW SECTION It) T2911,R18W POINT OF BEGINNING NORTH LINE OF Nth' 1/4 2 6 56.60' _ y~ EXISTING 1420.00' _ S[i9031'E T01i ROfD _ 1O 7)C% 3 5 U ' 200, _ -2 0 0~ . . 670, - - - 02.19' _ 5' CONTOUR LIN "PIP crf c z"PIPE I QRAMAr,r L.(o0.0 v Is F- 5 ton I w Z a v 4f y tt </AC 1.69AC I. 9 1.87 AC.1 _ q t 6 42AG.1 '•`'i r; ~r l 1~ z l'.83 AC,2 M ~0 1.54ACW 1.72 C. 5.91 AC.2~ v` Y 0.62. r 17 5.33' 200 ' 43 G3' 04 L. 99 .T/0 6 N89°31'W ".454.25' 156.37' L '~grlTo~I~INE 670` 2"PIPE 0 op~`"Z N 0° 29' 10 N090 31,w 826,37' p ii X1.1 50.00' FLOOD ELEVATION *97 -)9 NW-NW JUNE, 1975 NE-NW SCALE 1P4 FEET ' Safery Ilr Buhurngs Division Wisconsin Iiepartmentof Industry, SOIL DESLKIPTION REPORT P.O. Box 7969 Labor and Human Relatigm Madison, WI 53707 (Attach Soil Prof' Location Map - To Scale - On A Separate, Signed Sheet) Page of 7 .S'o 3 G 5c S 9 5/ /3 Wtomer Nam ra wuon Oat* wrens Lan Ule or Vegeut,re ores Parant Mattna t o r/E~Q S QT D STE/l' T~4 G M'1y z') - q Z ii e) / - 'i t wsse-s s, sfo~:yfyTIr Nl ~/l / m tYat1011 uitOmal fp{ lUmalt a O", M~rOY Walt/ 361 /0 1164) 41 h'~Osa w~ s s c,~G; p N panty ae uN o. ystem Loam state m a nlPer q. t. Par sy 5r C~l"oi X Lot` / r Lot Lega stnpuon C / T / t7 Ylt~n eomttry a Dep pe an AlpKt {p~ S Horizon Depth Dominant Color Mottles Structure- Remarks: clayskins Loading In. Mansell u. S:. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Bounda ores Hand other GPDlft.2 o- 9 /0 YR fk 2-F 3 11> 01 7.41-5 AMI~ZAI~' ~ f ~ /N a 6v5 /o.t>S s/ o f s 6,~ ~ I - .~-r- 10AP 71A~ e: -/2' Structure Remarks: clayskins Loading Horizon Depth Domigtirtt Color Mottles In. Mun ell u. Sz. Cont. Color Texture Gr. Sz. Sn Consistence Roots Bounda ores Hand other GPDlh.2 rt y S~/ i sb~ f~ 2f ~s - .-3 o`lo /D /R 3 5 1-f, sb fe lu f S S /o 1 re 51,0 G'. 3 _ f4j'7i G.- 7z ell fj/So G 02- /;V 51& a"i T" 0'j i o Jar s conventional septic syaem. Horizon-r-3 Depth Dominant Color Mottles Structure Remarks: clayskins Loading Munsell u. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Bounda ores H and other GPD/h.2 A-- 74 -5 /oY y - ,5~/ 1,~f, sb,e .~i 2 f c S 13, o- y 7Sye 4/ - s o,~, CP y3z 1- 5 Yle ~ u f SbK rtM-F 12 8~~ of /o yR y ' w~~L ✓ P /0 Ve 9/2- i ao 80 ' 1/-4 rl '7 ~ Horizon Depth Dominant Color Mottles Structure Remarks: clayskins Loading Gr. S,.,h. Consistence Roots Boundary pores, p H and other _GPD/ft.2 In. Mansell u. Sz. Cont. Color FeAure a- lo'ai~ ~ /oyle 1 2,f St;' ~ r-F cs . 3 T/r' T`D ~~2 S Uf, y/~ /yy1 f 7• tv E~t/c~ /l~ we e, e44 7-,k~ 0 00' 30 1 Horizon Depth Dominant Color Mottles Structure - Remarks: clayskins Loading In. M sell u. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Bounda pores, P H and other GPD/ft.2 S' 0- a+~ /o Y4 4/3 .2, F, s''~K z-f- YV lo f, e /0 Yf r fL~ _ P C Q-90 /oi u r' y„~T r' .4 A.47r D N r' tiOldESl-(E SEPTIC PLU"NG CO. db-: O'NEIL RD., HUDSON, WIS. 540114 ~ y yd's ROBERT ULBRIGHT AS. MASTER PLUMBER LIC. NO. 3307 M.PAS- f Additional Remarks. , Soy/ ZeX X-We-5 f'E olio 1,vi d. ~ : j E ~i'Ts `i•90 -5,I1' S ai rc°e- 7- M~t'lt"~~t/S Other Site features: y ~s r e~ ti o7`~ S~ ~ l 3 P PIS ~ yPZ linuting factolvDepth: CST Signature D.3tr Signed Telephone No. CST U SUUtl3J0 tN UINU) - s~ t P . W s V ~ ~ ~ v c fc' fe t_j r ~e rbl'ST ~ 03 U Tfo-Q 4 ~ Will 4~ 10 ~AAJC-z -At T i~ ~,exv, , ! ( d o 7 ~~c~ r~o.S S/ Q 7-- 1~v S-f~►~%o~ .~01' ~ per, P 44N 1 II A jI :I if I~ ~i 3 /02,0 ~ By /oD , ~D l 9 . &'o 13A 4leffoE P,'rs .20 . ~ ~ 5 ►'z ~ ~ - 'FoR 3 t'04~' Tip uG-c,. = 9~ &o " 5 y 5 r•~-r %P v ^ ~vFtDED - 9vo S~, ffi I 'yC~ zrs~ s T/Pt~tic4 s ~I I' 1 ~ ~ goo y~o ~ ,3 ~ pR s ogre x.100 '1 , B lax a~o t ~ I l SET 31y „ 5-7'(4-e ~o p//L? - 50 0 UAR 1\ fovaD~ Lo T.o t Posi ~3t~' Lai 0 s Y VOME-SITE SEPTIC PLUMBING CO. 1` # j 0 - 3 t ' O'NEIL RD., HUDSON, WIS. 54016 ROBERT ULBRIGHT CST z y~Z ~5, b? "'`':I PL UNISER LIC. NO.3307 M.P.R.S. r '.!'71 DESIGNER LIC. NO.00883 P5 3 0 3 s