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HomeMy WebLinkAbout002-1059-70-000 m Oo o M n Vl 04 M C o ~ M 'O C.. O N 01 C j © C -U w N > O y C O N N •X C > N O ~ N U co O U C L U N m '0 N L N p 0 L0 0 O w N N L E U O 1 C ' t U) O N O (0 co -do) N U X N > C Q QNo•m rOi> O CL 07 N Q O O O N c pNj N C'0C) NO C Z N W U°"00~ 7 (6 N ~O C :O U. C _ f0 O =O ~ > - a Q CL Co jC) C C E Q UCD c6 New N U (6 to Cl) W E U) = E O ~ Z T d d (N (L M N F- U) c O C 6 U O Z :t w d z ~ ~ M I a~ of a c m 0 o Q Q ~ Z Z o N Z CD rol E c N C lC E c OD w td co !y N m - m N O CL C l0 o ~coa E m -Z6 U) 0 a) o aS 3: n- = Z°f o O O O •u,i o a a a 0. O O O to N M N to U rn rn } ~ N N O O > E N O O I. ~ 7 ~ Q 'tt I H C O N N ca O M cn N a a~ N rn Y E u': cp l!') (6 0 C C LO C O C N W (`y{'~ of .3 Y cu a IL- `n N O E N O U ~V ~ N N :2 O ~ V ~ 7 EL L: d A • ~ CL d V d w C A c~a~IONU AS BUILT' SANITARY SYSTEM REPORT OWNER ,.Le-=% 1~ ~r I 'k TOWNSHIP SECTION_L'--_T N-R__L(a_W 1 ADDRESS 0 ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOTLOT SIZE 0,0 k) S PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM I INDICATE NORTH ARROW 1G1•~^c~• B~ nc cue ~ic~ BENCHMARK: Elevation and description: Alternate benchmark - /Uoq G'/ a- SEPTIC TANK: Manufacturer: Liquid Cap. d~ Rings used?"' '3Manhole cover elev:'-21<, Final grade elev: ~6. a Tank inlet elev.:-i~-.2 g2, i3 Tank outlet elev.: -it .2 7V-' No. of feet from nearest road:Front , Side P'O, Rear Ft. i8S From nearest prop. line:Front , Side~'D' Rear Ft.iKj 1 ~o ~ / .2 9 No. of feet from: Well 7s' Building: i$ ? 10, (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Manufacturer: J'~I~~Jos~crc, ~rec~,1 Liquid Capacity: /OCR Pump Model: .(A)0074 Pump/Siphon Manufact.: Pump Size 1~q , Elevation of inlet: 11.y3 Bottom of tank elevation ;37,9Q> Pump on elev.: Pump off elev.: ~a o gAcycle: X 53. MGrLtJ~r"1 Alarm: Man.: 5:5 (~je Jf o Switch Type: ~-(e Location Distance from nearest prop. line: Front°® Side_, Rear-Ft. Distance from: Well "i Building /g / SOIL ABSORPTION SYSTEM 14eu x d Bed: Trench: Seepage Pit: Width: Length V Number of Lines: ' _Area Built Exist. Grade Elev. Proposed Final Grade Elev. Y- 67 Fill depth to top of pipe: `l No. feet from nearest prop. line:Front , Side , Rear Ft.~~-" No. feet from well: ~ O~ No. feet from building HOLDING TANK Manufacturer: Capacity: No. of rings used: Elevation of bottom tank: Elevation of inlet: No. feet from nearest prop. line:Front Side Rear Ft. No. feet from: Well , building nearest road Alarm Manufacturer: INSPECTOR: '7~ r....►~ ov` DATE : PLUMBER ON JOB: _ LICENSE NUMBER: - 3215 - 6/90:cj LOCATION: BALDWIN 24.29.16.366,SW,SE, CO. RD. D WsccnsinDepi~rtmentofindustry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: 171435 Permit Holder's Name: ❑ City ❑ Village F1 Town of: State Plan ID No.: GEU INK STANLEY & DONNA BALDWIN CST BM Elev.: Insp. BM Elev.: B DescriptParcel Tax No.: 3 002105970000 A TANK INFORMATION ELEV TON DATA A9200200 TYPE MANUFACTURER CAPACITY STATION BS HI ELEV. SeptictLi~ .Z~ Benchmark Dosing ©1 Aeraainn Bldg. Sewer Holding St/bt inlet 6•~3~ e TANK SETBACK INFORMATION St/kf OutletiZ 96g0 ` TANK TO P/ L WELL BLDG. VVenttake ROAD Dt Inlet Air Int Septic 0- ~ >100 ti ~ ( NA Dt Bottom , Dosin > q0 y ~ NA Header / 3 "o 12,30 Aeration NA Dist. Pipe 3 0 , Z Holding Bot. System 3,ros/~, GS PUMP / SONSWINFORMATION Final Grade 5.'f ~ i oZ 55~~ Manufacturer (;o Demand t v~f g,~p Model Number 4ZI GPM ' ~Co7 f~ $yste%,~ TDHc4( at TDH Liftrr- •I,5 friction 31 H L oss Forcemain Length Dia.a Dist. To well *>7,57' SOIL ABSORPTION SYSTEM BED /TRENCH Width / Lengt No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ D MEN I N urer: SYSTEM TO P/ L BLDG WELL LAKE / STREAM LEACHI ~Manu act SETBACK CHAMBER .INFORMATION Type O /t> System: OR UNIT DISTRIBUTION SYSTEM Heomdw! Manifold „ Distribution Pipe(s) x Hole Size,r x Hole Spacing Vent To Air Intake o Dia. Length z•5 Dia. Spacing & Z~ Length Y~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over p << Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /TreneM Center ~D Bed /Wre Mh Edges / Z Topsoil ~p f❑ No QYesr-~ No COMMENTS: (Include code discrepancies, persons present, ,etc.) ~ Ge ///.GSA /n ® aoe- Ole y 0 C Plan revision Treied? ❑ Yes ddb Use other side for additional information. 9~ SBD-6710 (R 05/91) Date Inspector's Signat re Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: I i I 'I HR SANITARY PERMIT APPLICATION In accord with ILHR 83.05, Wis. Adm. Code COUNTY ST CROIX =:EM! • STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than El j > 8% x 11 inches in size. chec rev ion to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. S92-40296 PROPERTY OWNER PROPERTY LOCATION STANLEY GEURKINK SW Y4 SE Y4, S 24 T 29, N, R 16 V440 W BLOCK # PROPERTY OWNER'S MAILING ADDRESS LOT # 2660 CTY RD D NORTH CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER WOODVILLE, WI 154028 715 698-2689 0 CITY VILLAGE: NEAREST ROAD 11. TYPE OF BUILDING: (Check one) 1:1 State Owned R TOWN : Baldwin CTH D ❑ Public ©1 or 2 Fam. Dwelling- # of bedrooms 5 PARCEL TAX NUM ER( ) III. BUILDING USE: (If building type is public, check all that apply) 002-1059-70 1 ❑ Apt/Condo ' 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 70 Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 40 Church/School 80 Mobile Home Park 12 ❑ Service Station/Car Wash 50 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. ❑ New 2. 0 Replacement 3. ❑ Replacement of 4.0 Reconnection of 5.0 Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ® Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION 750 430? 625 625 .5 N/A 111.8Qet 114.07 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 Se tic Tank or Holdin Tank 2000 2000 2 Midwestern Preca t x Lift Pump Tank/Si hon Chamber, 1000 1000 1 Midwestern Preca t 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) rMPO/7MPRSW No.: Business Phone Number: BENNIE HELGESON 715 772-3278 Plumber's Address (Street, City, State, Zip Code): W 1229 770TH AVENUE, SPRING VALLEY, WI 54767 IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved S itary Permit Fee Includes roeej water a e ssue 1 ' g Agent Signat %ostamps) Approved ❑ Owner Given Initial _ _ Adverse Determination 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 ' y 1. A sanitary_pe.rnz t is valid for two (2) years. ' 2. 'Your ~ranftiiry,3ermat may be renewed before the expiration date, and at the time cf enewai any new criteria in the 'Nisconsin 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 l=oan (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. It. 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 submittec to the county. The plans must incline the following: A) plot plan, drawn to scale or with complete dimensions, 5cation of holdino 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 monie ~ cx,.11lecied through these surcharges are used for monitoring groundwater, g,'ourd- water contamination investigations and establishment of standards. SBD-6398 (R. 1/88) w,stonUn Depa•imem of IrdusVy, bUIL Ut:)t.l`It- I Ivt. 1%Lf Llrs I ' Laoor acid Human Relations "U got •.a (Attach Soil Profile Location Map • To Scale. On A Separate, Signed Sheet) T.ladrson,Y:1 53f:C' Page ! m~ CtFTP4~ COI EV DATE CVMBA WO UW VEO COVtn ►AF4!FOWATtAVr. Kdy•VASP*CT 0.000 R,AN LL SL.J N. A00/p5t CITY eTATII _ZM Cown, araT LCADM0 00`01W 11 s 1 I fir 1% 73 cf, 1\! tA iOVrMM AJ TAxr'AIICELNIAetn ~'~..~<t 5 ttcrv+ LL l)J l• DIC(U I GSM/ LOT /k; kf BLOCK sueolvlstoN % C e r,-- ~j -rrtw ✓sLaei I Horton Depth Dominant Color Mottles Structure Umhing Factorl LoaangGPD's% h. In Munsell u. St. Cont. Color Texture Gr. St. Sh. Consistence Roots Boundar Depth Trench Bed s "1 a of , -Icv 1 r ash. .c1 G.~% ~i.l <y, si f v ~ Zi'. caA 6S`- `j,S c m Horton Depth Dominant Color Mottles Structure Llmittng Factor/ Loading.GPDreq. h. In. Munsell Cu. St. Cont. Color Texture Gr. St. 5h. Consistence Roots Boundar Depth Trench Bed 1 - U 3" 5i~ .av~ a LA) 3Z.1-y- 10 AZ .2 CJ- cst -~.u.j I t (i. !i ? 3. a y t) . Houton Depth Dominant Color Mottles Structure Urniong Factor/ loadingaPtY94 n. B . j In, Munsell u. St. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Bounds Depth Trench Bed ~O S► :vF QLJ n ~S Elev = -I S a v~ C L I `7 Eat H,&. W 10~.~c~ 15= ! s-V sal <fi-.r -7. s- V R I Horton Depth Dominant Color Mottles 'structure Umlting Factod LosongGPDnq. h. B. L In. Munsell Cu. St. Cont. Color Texture Gr. SY Sh Consistence Roots Bouitda Depth Twits Bed 1 0-10 16 ) ~ A w All - S Elev = 2 O~fS YR ( D r V-3 00 v _ Horzon Depth DomrnantColor Mottles Structure LlmlDep Factor/ Tionch 9PBed h. n `S In. Munsell u. St. Cont. Color Texture Gr. St Sh. Consistence R oots Boundart, Depth reneh Bed 11 t 3 S ~b S rtr s a.V GlLJ l~ Elev O \ gt Ir U C t.,J , ~P 5 X03; j- -9k ' ` r s I t tJ 6s 3 U 16,-001 'IC) j P -7, va i -L 1 S- 'YR 2 ~S-- -SC' vK S 1k Y4 I Additional Remarks: RECOMMENDED SYSTEM TYPE: to (A C 4♦ IGyC ar, a a</ i Other Site Features: Wn 7Z2 CST Stgnatur! D to Signed Telephone No. CST ar System Elevation , C 4 slate, Name (Print) Cil Zip wrsronsm 0toa"mer-t of Industry, :)UIL Ut:~lnlr I IUt• isu vr. t tabor and human Relations (Attach Soil Profile Location Map • To Scale • On A Separate, Signed Sheet) Madison.'-*0 53:C' Page o C 11NwdE / aoa VALVAre cur•,erT LNO in& Via W4A 1Ar WATEr,U& •l0►VAe/•cT x1000 r1Mr as Ap;Ft errv •TATa D► cckhm aVaT EOA0e40 O►O'We t, Rio. .(7 N W eeAW I I-e CA), S C O I lOCAtiOrr lQTtp~ towhsw X TAx /A11cEL 1AllU 8oR1J4C UJ ' ',E 1 - /4 1 F ,1 A cSEt/ NEW ~ ~E.ueE LOT ! v IT- BLOCK N l1 SUBDIVISION N &OAc Fa Houton Depth Dominant Color Mottles Structure Llmlttng Factor/ LoaangGPD'mh. In Munsell u. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Boundar Depth Trench Bad El C' ve '-7 vn -3c) O t a e- S S i I U "J I U\J -3 10 1~8 t J -7. S- A- P, 6C rn Q _ Houton Depth Dominant Color Mottles Structure Llm0ing Factor/ Londing•GPD054. n. In. Munsell u. St. Cont. Color Texture Gr. St. Sh. Consistence Roots Boundary Depth Trench Bed Elev - - F s t t1 2 Is ~ R S 3 5- Iv vR v" ~CSb B C9 I Houton Depth Dominant Color Mottles Structure Umrong Factor/ Lo+din9aPD's4 It. 1) In. Munsell u. St. Cont. Color Texture Gr. Sz. Sh. Consistence Roots Bounda Depth Trench Bed C~- A t7 3 a <,1 Elev 3A B. n. (Horizon Depth Dominant Color Mottles Structure Umning FaaoN renc gGP .d In. Munsell u. St. Cont. Color Texture Gr. Si. Sh. Consistence Roots Bounda Depth Tr.ncn Bad Elev Horizon Depth Dominant Color Mottles Structure LImlling Factor/ LoadingaPD~s4. h B In. Mun ell u. St. Cont. Color Texture Gr. St. Sh. Consistence Roots Boundary Depth Trench Bed Elev a Additional Remarks: RECOMMENDED SYSTEM TYPE: Other Site Features: - J 411 CST Signature 0 Signed telephone No. CST System Elevation. 6-M; Z ii il / e 1~le /i~; els el o--,- Udlet, CST Name (Print) City Slate Zip I Pro~'k l-e L---0(C'%~i o"1 Mc4) a~ .4" Cl 41 e t ~ • L~5 a - I 0 \ CGr K $1-~`8v~n Od E}a~sP JlCti~~lc, n. tvrQ1l lUe l I go x C-Q p f As i 1 1 I 4 e.T• 14 Page_ of Straw, Marsh Hay, Or r~ C Synthetic Covering Distribution Pipe Medium Sand H 0 iw 1 ~.V Topsoil E p 3 ~ . , % . b Slope ONSITE SEWAGE SYSTEM Bed 01f 2'- 2.2 Force Main Plowed Aggregate From Pump Layer Ft. ~ Ft n Using EUs Section Of A Mound System DZPARTr.';r ur i~fi)1J~ls~" ✓P . `~cS F A~? AND HUMAN RQ~ft SFor The Absorption Area SIC "A Y ANj7 ELIIa „ G I Ft. D;NGS A 7 Ft. Ft. SFC~rUrt~tha:d" Signed: 0 Ft. License Number: -,K 1,3,1 Ft. Date: 3yFt. Ft. Alternate Position of Force Main --V ~ Ft. L 1 Observation Pipe J I S' ~ 83.57' 3.SQ' --3;~--•-- s' K - A i W f Distribution Bed Of i - 2 i Pipe Aggregate Observation Pipe Permanent Markers Plan View Of Mound Using A Bed For The Absorption Area Perforated Pipe Daiall End View Perforated End Cop I. PVC Pipe ob`6 a Permanent End Markers lY Jo~\,occ s Holes Located on Bottom are Equally Spaced e y Po I-c fe ~ PVC Force Main * From Pump P PVC END CAP Monlfold Pipe i Pv~ Distribution.. Pipe Lost Hole Should Se Next To End Cap Distribution Pipe Layout P ~°?•5 R S i X 6 Y Signed: Hole Diameter Inch al License Number: - Lateral ~ Inch (es) Manifold " Inches r t! Force Main " Inches APt. S; It's) 11-5) 's ED OEPAF" -NT OF INDJ i.R1~4~r~ ~1IICx NUNIAN RELATICNd G7' r A111,110 -,SEE GFCSi-t~tw' pry` PAr,F ;F PU14P CHA.MB_R CROSS SEC '"!C'J A~1G =PECIFICA'r10,is VEUT CAP S- T _T 9~ -_7o 11"C.I. VEVT PIPE f~~ WEATHERPROOF APPROVED LOCKIKIG 23' FROM DOOR, JUNCTION BOX MANHOLE COVER WIUCOW OR FRESH 12"MIU. AIR INTAKE I GRADE 4" MI►J. COWDUIT 18" 1'l I Kl. -tip;' vrfj AHT VIDE IKJLET ti SEAL I I i 'A A pt p 7 0 (I~ APPROVED JOIKIT p I i I APPROVED JC9 W/C.I. PIPE I OF + I I I W/C.I. PIPE EXTENDING 3' ~O, f lSl I I ALARM EXTEMI)IMC, 3 ONTO SOLID SOIL d ( °S44 "Cill(fj 1-11 OKITO SOLID SC I I sm ON ELEV. +G` FT PUMP OFF D COAICRETE BLOCK RISER EXIT PERM1717ED OWLy IF TANK MAWLIFACTURE;R HAS SUCH APPROVAL C ^~L~s SPEGIFIGATIOAJS Y ~Sj "II~y~`~°V" DOSE ~+~O ' TAUKS MAWUFACTURER: IJUMBEA OF DOSES: PER DAy TANK SIZE: /l'n e) GALLOIJS DOSE VOLUME ALARM MARlUFACTURER: <.l • 1~ ~ T~ryls IMCLUDING BACKFLOW: GALL OK! MODEL LIUMlSCR: /nI MUJ f~^ CAPACITIES: A- UICHESOK GALLOA! SWITCH TYPE: Ic4LT 8 IUCHES OR ,a^?3c~?! GALLC~.: PUMP MAMUFACTURER: C= •I►ICHES OR DS3•1 GALLOL: MODEL KIUMBER:_L FL~~] 30 v~{~S D-7, -L?IKICHESOR lqq-Oq GALLOL SWITCH TYPE: 'oek1oe_ mzy'C_u.y~ MOTE: PUMP AMD ALARM ARE TO DE MINIMUM DISCHARGE RATE 4/ ._(GPM INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFEREKICE DETWEEKI PUMP OFF AUD DISTRIBUTIOU PIPE..4L FEET + MINIMUM NETWORK SUPPLY PRESSURE 2.5 FEET ♦ ~f7Q FEET OF FORCE MAIKI x- FR1CT10U FACTOR:-_I~ EET" TOTAL OtiWXMIC. HEAD FEET IUTERUAL, DIMEWSIOWS, OF TAWK: LEU&TH /q -;WIDTH - ..;LIQUID DEPTH SIGNEO: / LICEKJSE KJUMBER: DATE: Effluent Performance ~m-t - Curves Pumps METERS FEET q0-7 ~ / 90 MODEL 3885 25 80 SIZE 3/4' Solids G WE15H 70 x 20 WE10H Fa- 60 0 WEO7H 15 50 WE05H 40 10 30 1036 WE03L 20 5 10 0 0 A-11 I 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM _ 't 0 1020 30 m3/h `'CAPACITY [qGOULDS PUMPS, INC. SBECA FALLS PEW YORK 13148 METERS FEET 120 MODEL 3885 35 SIZE 3/4" Solids 110 WE15HH 100 30 90 25 80 70 S 20 60 O 50 WEOSHH 15 40 10 30 20 5 10 0 0 0 10 20 10 30 40 50 60 70 80 90 100 110 120 GPM I I I 0 10 20 30 m3/h CAPACITY 01985 Goulds Pumps, Inc. Effectlve July, 1985 ST C- 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER STANLEY GEURKINK ROUTE/BOX NUMBER 2660 CO RD D N Fire Number 2660 . CITY/STATE WOODVILLE, WI ZIP 54028 PROPERTY LOCATION: SW4 Z, SE 14, Section 24 T •29 ''N, R 16W, Town of BALDWIN St Croix County, Subdivision N/A Lot number N/A Improper use and 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 yvar.8.;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 treat- ment 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 maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper 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. I/WE, the undersigned, have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin Depart- ment of Natural Resources. Certification form must be. completed and returned to the St. Croix County Zoning Offk(;e within 30 days of the three year expiration date. SIGNED DATE _ .6 9°2 St. Croix County Zoning Office P.O. Box 98 Hammond, WI 54015 715-796-223S► or 715-425-8363 Sign, date and return to above address. 'MY.YIw..•-w,.... ..i..... ......wr ...r,.. I'i n~......~.r M1YM.....~".•^'+^^......m...,~~w~. . 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. Should this development be intended for resale by owner/contractor, ("spec house"), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Owner of Property STANLEY GEURKINK Location of Property SW ' SE Section 24 , T 29 N-RW Township BALDWIN Mailing Address 2660 CO RD D N WOODVILLE WI 54028 Address of Site SAME Subdivision Name N/A - Lot Number N/A Previous Owner of Property HULDA GEURKINK Total Size of Parcel 80 ACRES Date Parcel was Created 1907 Are all corners and lot lines identifiable? X Yes No Is this property being developed for resale (spec house) ? Yes X No Volume 535 and Page Number 419 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) eeAti6y that att .6t tement~s on this bonm ane tAue to the but ob my (owe) knowZedg e; that 1 (we) am (ane) the owneA (v) o4 the pnope- ty deg ct bed in this inbonmati,on bonm, by viAtue ob a waAAanty deed tceconded in the Obbtice ob the County Regi6teA ob Deed6 a3 Document No. 332268 ; and that 1 (we) ptuentZy own the pnopos ed site bon the z ewag e d iJs po~.a yr6t ( on I (we) have obtained an easement, to nun w.cth the above des cA bed pnopenty, bon the eon6tAurti.on ob said eyatem, and the same has been duty teco&ded in the Obbice ob the County Reg.usteh ob Dee6, apt Document No. 1. SIGNATURE F OWNER SIGNATURE 0 CO-OWNER (IF APPLICABLE) s s: a S q~ DATE IGN D DA. S GNED 2 2 S' VOL J'_)J I'N i'r 11.;J IRIS JYHC,t nWCnvcU rvn nc., .n.u,,.., u..,. ,.+q mm~A'~ w ►t?-j OFFICE BY I'HIS DEED, Hulda Geurkink, a woman, ST. CROIX CO., W(S, Recd for Record thfs_ k4-- day Of_6p D. 19-26 Grantor conveys and warrants to Stanley Geurkink and Donna Geurkin -„.,j0o P M husband and wife as ioint tenants. F7 - ee a Grantee S for a valuable consideration RETURN TO the following described real estate in St Croix County, State of Wisconsin: West Half of Southeast Quarter (W-2 of SE-14) of Section Twenty-four (24), Township Twenty-nine (29) North of Tax Key a Range Sixteen (.1-6) West, St. Croix County, Wisconsin, This is no homestead property. subject to all easements and conveyances of land for highway purposes. This deed is given in fulfillment of a certain land contract between Maurice Geur- kink and Hulda Geurkink, husband and wife, parties of the first part, and Stanley Geurkink and Donna Geurkink, husband and wife, as joint tenants., parties of the sec- ond part, dated May 25, 1960 and recorded May 27, 1960 in Volume 368•,.page 56 in th office of the Register of Deeds for St. Croix County, Wisconsin. That the said grantor, Hulda Geurkink, is the surviving wife'of Maurice Geurkink, deceased, who died a resident of the Village of Baldwin, St. Croix County, Wiscon- sin on July 5, 1960. FEE Exception to warranties: qMPT Baldwin, Wisconsin this3lst Executed at day ofMai~ch 196. SIGNED AND SEALED IN PRESENCE OF AA` ~ (SEAL) Hulda Geurkink - (SEAL) (SEAL) (SEAL) Signatures of authenticated this day of 19 . Title: Member State Bar of Wisconsin or Other Party - Authorized under Sec. 706.06 viz. STATE OF WISCONSIN St .Croix ss. County. ` 31s't March 19 76 Personally came before me, this day of the'bbdle,named Hulda Gpir^ki'nk- a unman, - to me known to be the person- who executed the foregoing instrument and acknowledged the same. Tliis instilment wad drafted by HaroldD. Olson St. Croix Harold'=h,' Olson Atty . Notary Public County, Wis. F 77- The use of witnesses is optional. My Commission (Expires) (I0 armament Names of persons signing in any capacity should be typed or printed below their signatures. GRAPHIC PRINTING CO., EAU CLAIRE, WIS. WARRANTY DEED-STATE BAR OF WISCONSIN, FORM NO. 2 - 1971 ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 - ` - (715) 386-4680 May 11, 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 Stanley Geurkink property, located in the SW 1/4 of the SE 1/4 of Sec. 24, T29N-R16W, Town of Baldwin, St. Croix County. This onsite revealed suitable soils at a depth of 12" which meets of A+4" rule. This site will require 24" of sand. This site should be suitable for a mound setpic system. Should you have any questions, please feel free to contact this office. n rely, r mimes K. Thompson Zoning Administrator cj ~s one -i os y - 70wf~, d o') to - d 41 9 5~ ZZ G7 ,.J d \j MIZU C) u, CD ,4 m C S' w -rl Lp Z_ 3 'Z 4 fix I L4J 1 O Q~ re d c! y y ~ 1 C(A CA a o w T- d li i ~ i