HomeMy WebLinkAbout008-1013-60-100
eV 03 my 0 60~
d
o I o I
a a
e I I
o I I
a I I
N I
o I
~ ~ I I
E I I
w
I I
N N
z z
U
C
W CD
O .y U. O N
3 ~ E I o 3 ~ ~ I
Q w 1 5 Q c
I 0
3 CO U M
I
N N
Z y I
c0 w O I " o
Z
co
N w a m a m
I I
o
O Z v
v ~ r I -
fq H y Z
E ~ I E I
I
7 7
m I o I
~ c I ~ I
z z O o 1 0 z z O
N Z '
V d C N I ~ C
Pitt 4)
O G R m m
CL
C
o
oty d ` C C B- c
2 CD .0 ~ID
Y N Gr G CL N N G 1r a N
U) U) U) E U) w
000 • ~aaa N I~a000
aa
a c C,4 C,4
U) U v rn rn o 1 °o 0 o
Z •O M m N N Z
Co I
N N `J O O N N N _ O
22 Q O O m C M 0 0 CD C
IN a`~' la ~I
~ OI y7 'O UJ O m
d Q fn f0 •O d Q Z fn
LO LO
16 Cl (A 0
O rn H C O y C
li N 0'D C E co CO ( N O
O N N
[ co 0 N C y a a m °o t o pVj C
m C-
c6 0 7 r 7 O~ C L 7 r0+ 'D
I~ N
• O to m o o o f U t o o a~ o
D o w o z y Zi9 0) rn Z T Y Z
0 co
'
[ l t7 , = = E
rn d~•a i ~ € I ~a I
V
IL 4-,
• co o d 0 j m a E' m 0 C
3
`i*1 4.0 E . u c c c3
L) IL 2 0 U) U U) L)
i
1.) 4, 02%U1 MON 12:35 FAX 715 386 4686 ST CRX CO ZONING Q001
County Sanitary Permit Application $7. CROIX COUNTY WISCONSIN
In accord vrith 15.04 St Croix County Sanltary OrdinanCe ZONING OFFICP
Personal Information you provide may be used fof secondary purposes ST. CROIX COUNTY GOVERNMENT CENTER
jPrivacy Law. S. 15.04(1)(m)) 1101 Carmichael Road
~y~+~ Hudson, WI 34016-7710
(715)386-4680 Fax 715 388-4686
Attach wM to plans for the system on paper not-tes8 112 x 11 inches in site.
County Sanitary Permit # 13 Check If rev r s p l t
000
f
2 1 N
1. Application Information - Please Print all information cation:
Property Owner Name ' l\tl1t1 V [U -A
SE 114 NW 114, See 5
JON MOULTON ;.--s T 8 N. 16 r- 'j Ul Property Owner's Mailing Address umber Block Number
~.J ST CROIX N/A
2290 55TH AVENUE couNrr
City, State Zip Code Phon N(~3k bdlvlsion Name or CSM Number
BALDWIN WI 54022 715/6 4 11 N/A
h pe o Buildino. (Oheok one) pity ❑ Village own of
1 or 2 Family Dwelling - No. of Bedrooms: 3 EAU GALLE
G PwWWCommerdal (describe use):
State-owned Nearest Road
II. Type of Permit: (Check on line A. Check box an One 137appr7able) 55TH AVENUE
Parcel Tax Number(a)
A} 1.0 Repair Reconnection 3. Non-plumbing 4. ❑Rejuvenalion
sanitation part of 008-1013-10
l5) Permit Number Date Issued
11 State Sanitary Pemutwas previously issued 175650 08-21-1992
N. Type of POWT System: (Check all that apply) 5. • (
C Non-pressurized In-ground jI Mound ❑ Sand Filter 0 Construoted Wetland
Pressurized In-ground ❑ Holding Tank ❑ Single Pass ❑ Drip Una
At -grade ❑ Aerobic Treatment Unit ❑ Recirculating 113 Other
V. Dis erasaUTreatmentArea Information:
1. Design Flow (gpd) 2. Dispersal Area 3. Disperoal Area 4. Soil Apolication Rate 5. Percolation Rate 6. System Elevation 7. Fin o
Required Proposed (Galsdday/sq.ft) (Min./inch) Elevation
450 375 375 .6 95.3 97.57
VI. an n ormat on pa ,t In a ens -ibbl_ of ManAOUW Prefata Site Cart- Steel Fiber Plastic
New Exisiing Gallons Tanks Concrete structed glass
Tanks Tanks
1000 1000 1 MIDWESTERN PRE AS[D X a to ❑ O
750 750 1 [MIDWESTERN PREC S`IIN ❑ ❑ ❑
VII. Re5ponsiblilty Statement
I, the undersigned, assumo responsibility for repalrfeefbnnencton/rejuvenationlinstallatlen of non-plumbing for the POWTS shown on the attached plans. A
license is not required for terralift repair or the Installation of non-plumbing sanitation system.
Plumber's Name (print) Plumb Signature (no s` s): MPIMPRS No- Business Phone Number
ENNIE HELGESON 1220292 715/772-3278
Plumber's Andress (Street, City, State, Zip Code)
W1229 770TH AVENUE, SPRING VALLEY WI 4767
VIII. County Use Only
Disapproved Sanitary permit Fse Data Issued l6suing Agent Signature (No stamps)
Approvetl Owner Given !ni5al Adverse dD
Datermination BLS - 2 U0
IX_ Conditlona of ApprovaUReesons for Dis~apppr*vval'
w~~' ' ~ WTI
5 E~.r..acr
O
•t ~r s E. ~ TcR ~ ~5
' rc P Ic~cz
i
Him
i j
13
T- _
i
3y5
'Pole d j~ s~~,yc
f
1
3 "mot- o/
i
ss~~ A
AS BUILT SANITARY SYSTEM REPORT
OWNER )0., ?l., I ka TOWNSHIP Arl `e
SECTION! T_N-R~CWJ
ADDRESS ~O Z C`3~~ C+{.,c c.~ ST. CROIX COUNTY, WISCONSIN
SUBDIVISION LOT LOT SIZE
PLAN VIEW
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
P~ec 5
C G Ale
4
INDICATE NORTH ARROW
BENCHMARK: Elevation and description: /t)d oo - x.0 Drs St~ce~
~~,x ~ ~o Corn e~
Alternate benchmark
SEPTIC TANK: Manufacturer: Jwec-tv,-, Liquid Cap. l~~ y
1teCkc~'
Rings used: Manhole cover elev: MA) Final grade elev:
g. Tank outlet elev.: 0
ev.. .
Tank inlet el 7
No. of feet from nearest road:Front , Side c/ Rear Ft. uo~
From nearest prop. line:Front , Side Rear Ft. Y 00
No. of feet from: Well U)e , Building:
(Include this information in the above plot plan)
(2 reference dimensions to septic tank)
SEE REVERSE SIDE
L
PUMP CHAMBER
7 ~O G~
Manufacturer: 11 d( ~ ,e, of Liquid Capacity:
.
Pump Mode 1:W 60 3,"61 Pump/Siphon Manufact.: Pump Size `0
Elevation of inlet: 97.6(0 Bottom of tank elevation y _ 2
Pump on elev.:,90`~Pump off 'elev.:_Z'~-VGallons/cycle: 2aS
Alarm: Man. •~r--'~k. -V° Switch Type:I4e Location Sv A0
Distance from nearest prop. line: Front, Side --*',~Rear_Ft.
Distance from: Well- Q Building a V
SOIL ABSORPTION SYSTEM
Bed: Trench: Seepage Pit:
re~
Width: _Length e6Q 1 Number of Lines: E Area Built fv
Exist. Grade Elev. 3,o Proposed Final Grade Elev.
Fill depth to top of pipe: 6
i
No. feet from nearest prop. line:Front Side , Rear Ft.~
No. feet from well:A)O No. feet from building
U)Ql
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: a-Elk
Tti-~~-~
DATE:.. PLUMBER ON JOB : _e e ~i c s
LICENSE NUMBER:
6/90:cj
,
i
W
4 r
' ~ III
T
I 1 ~
n ~
i
i '
I. 1 \
I 0 ~
_fT O .
.__..i_____.._.....~.. r, _ ..rte. /J4~P/~c
I
1
t
i
1
1
n
i V
I off' ?o ~ ~ ,
..o
n
77
^ p ~ I
e ~ J' vJ
ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
ST. CROIX COUNTY COURTHOUSE
911 FOURTH STREET • HUDSON, WI 54016
_ (715) 386-4680
July 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 Jon Moulton property,, located in the
SE 1/4 of the NE 1/4, Sec.5, T28N-R16W, Town of Eau Galle, St.
Croix County, has been conducted with the assistance of Ben
Helgeson, CST #3094.
This onsite revealed suitable soils at a depth of 24" with 12" of
sand fill.
Should you have any questions, please feel free to contact this
office.
in rely,
James K. Thompson f
Assistant Zoning Administrator
cj