HomeMy WebLinkAbout012-1058-80-000
R i
4 N O
0 o
69
a v
lr r
~ O I
Cam. C
~ N w I
O I _ >
N (0
O)
p O
Lf) C
y N
.q O
O
O
O_
X
y - o
Er ~ Y
N C
N _
T N 2) (D
O ~Q O LO
Z t ~o
7 (6 ~O <0 N
LL C O) M
O ~
OOHS
C O U n .O
N
'O
E Q 07 O.
N
U
N ~
CL
~ O
w
Z O
: O
Z s. C
N 4)
rn
n N w a co
N F- U)
U)
N
O 2 : _N
U ~ r 3
mz~' N ~I
N
C
w O
N ~
N
• '
Z Z O
O
N N ~ I
d T
V C ca £ N
7 A
d
) a .6 E
N >
N G G a t
a~ o N N
E CD H H H
3 2 Z
m a. a. IL
'a
co J U rn rn }
M a
ArV m N O p0 C5
O
N N
O O O 7 C N N I
CO CL co
O v N N
d fdi
~1 C o ~
~i op V1 N
C
~ O ~ N C 01
3
y O M -
O Q O O N C (O (O O
.It .
O
C E
M p O L y a rn o 0
N N
L. - O u.) E CL
LO Fo Lo LO r-
~I N
w p O 2= 0 N
L
C (p _ N ~
L" Ci a co
O O O O H N~
~ N^ (6 Lo O E C~7
• ~'V O N W 0 O Z U]
I.. :w £
E
a
• C v y a y
Lei u a 2 0 N 0
1
~~[[~~CATipN: ERI~j pR IE 27.30.17.404A SE,NE 1 0TH
~Nisconsin 6epart mentot Industry, PRIVATE StWAGE SY TEM County:
Labor and Huriian Relations INSPECTION REPORT
Safefy and Buildings Division
GENERAL INFORMATION ATTACH TO PERMIT) Sanitary Permit No.:
175666
Permit Holder's Name: ❑ City ❑ Village E*Town of: State Plan ID No.:
DALTON JOHN J & JEAN M ERIN PRAIRIE
CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.:
/ !/1) • 48,~.~alr 5. e, d 012-1058-80-
V TANK INFORMATION ELEVATION DATA A9200324
TYPE MANUFACTURER CAPACITY STATION BS HI FS EL V.
Septic Cnc' 5-05~ Benchmark l eef
Dosing
Aeration Bldg. Sewer
Holding St/ Inlet Z0r
TANK SETBACK INFORMATION St/ . Outlet
Vent
TANKTO P/L WELL BLDG. Airito ntake ROAD Dt Inlet
NA Dt Bottom ffv~' 0 , r (Tx
Septic
Dosing NA Header/ Man.
$3 u8 rb~ „j
Aer ~on NA Dist. Pipe
Bot. System
Holding
I
PUMP /-INFORMATION Final Grade
Manufacturer Demand
O Q 10.0
# now GPM 3,0Z '
Model Number
I - I
TDH Lift 7,/D' Friction System TDH ~Ft D of 'c' E: ! 91 'n 2
Forcemain Length 13/ 1 Dia. I-f2!~ Dist. To Well
SOIL ABSORPTION SYSTEM
BED /TRENCH width 5 r Length , i No. Of renches PIT o. O Pits side Dia. Liquid Depth
DIMENSIONS N I N
SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufa
SETBACK er. INFORMATION Type O CHAMBER Mo a Nyen
System: /~IGC~ _-5~ OR UNIT
~2$ DISTRIBUTIO SYSTEM
r/ Manifol Distribution Pipe(s) , i x Hole Size x Hole Spacing Vent To Air Intake
Length Length t-e Dia. Spacing N
_ea_ 414
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over } 1~ xx Depth Of / xx Seeded / S dded xx Mulched
OedaTrench Center 1 2 " I O 4e64-Trench Edges j " IS Topsoil es ❑ No es ❑ No
COMMENTS- T ~~include code discrepancies, persons present, etc. /mow . S~6
~ Aye- a G2 ~ G°-~~ - 'o (-1 F5 I
Plan revision required? ❑ Yes
Use other side for additional information.
SBD-6710 (R 05/91) Date Inspector's Signature Cert. No.
1
ADDITIONAL COMMENTS AND SKETCH
SANITARY PERMIT NUMBER:
DI~.HR SANITARY PERMIT APPLICATION COON
In accord with ILHR 83.05, Wis. Adm. Code NY , C fQ t~ X
STATE SANITARY PERMIT #
-Attach complete plans (to the county copy only) for the system, on paper not less than i7 56 6 (p
8% x 11 inches in size. ❑ Check if revision to previous application
-See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER
1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. S 9 a 7 7
PROPERTYpWNER PROPERTY LOCATION
,m/f i' eTF,4N 1/_0A1 '/a '/a, S TJ0 , N, R E (or W
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK #
'3SS l9o _S
CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER
II. TYPE OF BUILD7110r, ' heck one CITY NEAREST ROAD
State Owned LLAGE Q
F ,u cx
❑ Public 2 Fam. Dwelling of bedrooms _ PA EL TAX NU BER( )
III. BUILDING USE: (If building type is public, check all that apply)
1 ❑ Apt/Condo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
30 Campground 70 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 on one in line A. Check line B if applicable)
A) 1. ❑ New 2. Replacement 3. ❑ Replacement of 4.0 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 Pressuriz 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
p REQUIRED (sq. PROPOSED (sq. tt.) (Gals/day/sq. ft.) (Min./inch) ELEVATION
soo 5-00 ~g" ~ Feet l0abD Feet
VII. TANK CAP ITY -IV Site
in alIons 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 Holding Tank / Cc / TES 6f--
Lift Pump Tank/Si hon Chamber P•
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' Signature: (No Stamps) MP PRSW No.: Business Phone Number:
YX tvk ' -CA v,'.1 - 3 ~-S8 01/5- )2Y9-J&-l-2
Plumber's Address (Street, City, State, Zip Code):
iro co l57 1LS
IX. COUNTY/DEPA MENT USE ONLY
❑ Disapproved Sanitary Permit Fbe (includes Groundwater Date ssue Issuing Agent Signature (Jlo Sta ps)
Approved ❑ Owner Given Initial a 8O• Surcharge Pee)
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 "
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 Cevisions to this permit must be approved by the permit issuing authority.
4. 'Chan ges 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 (;.installed.
II. Type of building being Mved. 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. Cbmplete 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.
GROUNI MATER 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)
Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page _ of
Labor and Human Relations
Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but
not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road.
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE
e O -1
PROPERTY OW n PROPERTY LOCATION
r7 GOVT. LOT 1/4 _SjJ/4,Sa71' 0 N,R ~7 W
PROPERTY OWNER'S MAILING ADDRESS LOT # BLOCK # SUED. NAME OR CSM #
3 / 75 ,
C17/ ,STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAG N NEAREST ROAD
[ j Ne onstruction Use[ ] Residential I Number of bedrooms [ j Addition to existing building
j eplacement ( ] Public or commercial describe
Code derived daily flow gpd Recommended design loading rate bed, gpd/ft2 trench, gpd/112
Absorption area required bed, ft2 trench, ft2 Maximum design loading rate bed, gpd/ft2 trench, gpd/ft2
Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark)
Additional design / site considerations -
Parent material 11," Flood plain elevation, if applicable It
j Fu-= Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
Un suitable fors stem ❑ S ❑ U [I S El U ❑ S ❑ U ❑ S ❑ U ❑ S ❑ U ❑ S ❑ U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trnrtch
GC, r
U
Ground , S = 5; L 15 k
elev.
ft.
Depth to
limiting
factor
Remarks: lt-~l , tic c~ C .Z s`I -V~ car
Boring #
Ground
elev.
ft.
Depth to ,
limiting
factor
Remarks
CST Name:-Please Print Phone:
Address:
Signature: Date: CST Number:
PROPERTY OWNER SOIL DESCRIPTION REPORT Page•_of
PARCEL I.D. #
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Trench
Ground i j
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
: ,
kg-
t
IN
H•r. •:;3}3:5
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
-
Remarks:
MUM Es Department of Industry, SOIL AND SITE EVALUATION REPORT Page of 3
' and Human Relations -
Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
COUNTY
' ST ceo, x
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but
? not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. #
dimensioned, north arrow, and location and distance to nearest road. So~G O,u .S'iTE
APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION 64!!~e6rIT,+rioA. REVIEWED BY DATE
PROPERTY OWNER: n PROPERTY LOCATION
To ff c~ ~E~~ ~~l ~To.✓ GOVT. LOT 1/4 N~ 114,S 2-7T 30 N,R. 17 E (o
PROPERTY OWNERS MAILI G ADDRESS LOT # BLOCK # D. NAME OR CSM #
13.5y /9a s r.
CITY, STATE ZIP CODE PHONE NUMBER ❑CITY E]VILLAGE KYOWN NEAREST ROAD
..SVoo Z 19 o rA S*7
[ ] New Construction Use [x ] Residential/ Number of bedrooms Addition to existing buiIdttfg`-"r-
jX] Replacement [ j Public or commercial describe
Code derived daily flow boo gpd Recommended design loading rate _ • 1 bed, gpdM2 • S trench, gpd/ft2
Absorption area required 5290 bed, ft2 5_,0-0 trench, ft2 Maximum design loading rate - S bed, gpd/ft2 6 trench, gpd/ft2
Recommended infiltration surface elevation(s) S-Oe P • 3 ft (as referred to site plan benchmark)
Additional design / site co 'dera ions 'DES i(rte ,fS 40-s6- ~ Nx d'ow 9P A ~/ou uv 4s Po,S Si'AL e-
. Parent material 5C5 ff5 10,46 vD,P - S. `T SEp/%vEc~TS Flood plain elevation, if applicable /1/~9r- ft
ri /.I log- A,
~for system CONVENTIONAL MOUND IN-GROUND PRESSURE T AT-GRADE SYSTEM IN FILL HOLDING TANK
s stem ❑S [X1U ®S ❑U ❑S ®U ❑S ®U ❑S 7U FKlS ❑U
SOIL DESCRIPTION REPORT
Depth Dominant Color Mottles Structure GPD/ft
Boring # Horizon Texture Consistence Boundary Roots Bed Trends
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.
z,.w. SdK v.2 c s 3f s
2 f sh/~ .e s
Y /3f s
Ground 3 Lz /D Vie /,-F 64 f2 Z 3
elev. 'YL
/
1i. C ft. 2-2-54, / 7S Ve 41K,,
s/ f
l s ~
s 9 f -S
Depth to
limiting
factor 2
Remarks: 4
Boring #
p- 10y2 3/3 3 f '5
. G
:.Z o s// 5 4
Ground
elev. 152- OP -F,
f5-,L2_ ft.
C' 0' s 5/ Z,~I, sh,C „M-rR c5' if ,
Depth to
limiting C -,m ' 3 P G'/ SL✓.~ 1;-A 7
factor
r~
-mot - Remarks:
CST Name: Please Print V
&S Q'NEIL OKSITE SEPTIC PLUMBING CO16 Phone: -7V_- 3 P F1e~
RD..'HUDSON, WIS. 540
Address: ROBERT ULBRIGHT
Si ature: IAINN. 14!'ITALLER & DESIGNER LIC. NO. 00663 Date: CST Number:
~ 92 zy~z
PROPERTY OWNER SOIL DESCRIPTION REPORT Page? of 3
PARCEL I.D. I
Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounday Roots GPD/ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench
} : < akn D - /O Ye 313 q2 5 3 F . S - 4
Z"A
k
3
Ground 7 13 /O ye %/f< Sl ' Sit 4-r -~C/e ~S / U f 2-
S ry C C,
'Q t 7,3 - 7 y 5 ,P
Depth to
limitng - -
factor
2-3
s
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
I'
GAm ign
round
elev.
ft.
Depth to
limiting
4
factor
Remarks:
Boring #
yr..r...r
j Ground
elev.
ft.
j Depth to
limiting
factor
Remarks:
SBD-8330(R.05/92)
1VM7% GD 7-
Igg
O,f'iUEwh
~gi6i t~ G'
L 97o2rv-
`l~R~~~ y &pegs
will ~ 0 1 r3M G
I 5'°
1
M
C/~TTLE hGn/ 95 71
i
Iy3
33
ak yy
1$,
J~E•u Lf ~
I
~LEV~rro,~s
T3, 722,
2^ I'O;."ESITE SEPTIC PLUMBING CO.
665 O'NEIL RD., HUDSON, WIS. 64016
/3 ROBERT ULBRIGHT cST#
NIS. MA ~TEi3 PLUMBER LIC. N0.3307 M.P.R.S.
e!tNN. IN;TAIAER & DESIGNER LIC. NO. 00663
s y5TIEM 61-eII-7-/o c)
3 a
1307-TO,-l ~OG~" SIG
SAFETY & BUILDINGS DIVISION
201 E. Washington Avenue
P.O. Box 7969
Madison, Wisconsin 63707
State of Wisconsin
Department of Industry, Labor and Human Relations
PRIVATE SEWAGE PLAN APPROVAL Office of Division Codes and Application
201 East Washington Avenue
P.O. Box 7969
Madison, Wisconsin 53707
ROBERT ULBRICHT Owner: JOHN & JEAN DALTON
655 O'NEIL ROAD 1358 - 190TH STREET
HUDSON WI 54016 BALDWIN WI 54002
RE: Plan Number: S92-02779 Date Approved: August 17, 1992
Gallons Per Day: 600 Date Received: August 17, 1992
Project Name: DALTON, JOHN - RESIDENCE Location: NE,SW,27,30,17W
Town of ERIN PRAIRIE 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.
Ail permits required by the city, village, township or county shall be obtained
prior to construction. The licensed plumber responsible for this installation
shall keep one set of plans with the department's approval stamp at the
construction site. The installer shall notify the appropriate inspector when
inspections can be made.
This approval will expire two years from the date approved or if a sanitary
permit is obtained, it will expire the day the initial sanitary permit expires.
The Section of Private Sewage has reviewed these plans for private sewage system code
requirements only. These plans have not been reviewed for the code requirements
set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 of the
Wisconsin Administrative code.
This approval is for the following components only:
- REPLACEMENT MOUND
Inquiries concerning this approval may be made by calling (608) 266-3937.
SBD-8817 (R. 01/91)
SAFETY & BUILDINGS DIVISION
201 E. Washington Avenue
P.O. Bog 7969
Madison, Wisconsin 53707
State of Wisconsin
Department of Industry, Labor and Human Relations
ROBERT ULBRICHT
Page 2
s Merely,
g4'e~
AMES QUINLAN
Section of Private Sewage
Division of Safety and Buildings
PPPO12/0009n/ 3
cc: JOHN & JEAN DALTON
Private Sewage Consultant County UW-SSWMP Plumbing Consultant
Owner Plumber Environmental Health
SBD-8817 (R. 01/91)
i
I.L.H.R. 83.08(2)
is
PROJECT INDEX S H E E T
Owner: J6i~v
Address: if
,ter y
Site Location : -1M/' ,5K p 11CIVI- 1A /3/9,V
' 5~/y ,vim- /y , s ~ ? i 3 c? ~ 7 ~v r o~iv o,~ ,E~/;v ~,p,•,~,/~-- 'I '
Project Description: ST CoV110T~
f
~~5 /9 ~if/Gi.v ~~n~~+af-' r~•t>ll~'uT/G!c..~'.9 ,L
SD iG S /,v D~ t//
/3v T" 10
7k
i31
Page 1. PLOT PLAN VIEWS
Page 2, MOUND CROSS SECTION & SYSTEM PLAN VIEWS
Page 3. PIPE LATERAL LAYOUI r
i' Page 4. DOSING CHAMBER CROSS SECTION
Page 5. PUMP PERFROMANCF SPECS
PLUMBER: 4
y ~ -0 9
RECEIVED
OFF' rF
`IDES . i
DATE: - SITE EVALUATER/ DESIGMER
SIGNATURE
A-A4~
_y HOMESITE SEPTIC PLUMBING CO.
655 O'NEIL RD., HUDSON, WIS. 5401 2
ROBERT ULBRIGHT
N{S. MASTER PLUMBER LIC. NO. 3307 M.P.R.S.
4'FNN. INS)IALLER a DESIGNER LIC. NO. 00663
I
No2flti Goi i
0 2
~ n r
BM ?q,
- c
NEu) /zoo ~j~0
I ! O P feC-f57 SEjfiIC
5't) I T
If/t!-!l 9,50 J~BA '
.s Pay G~A,v/3E1'
0
1W S
t'1p
Prior To Plot*ing Installer will carefully
3
Shift or orient Mound position ( toe l~i_ne
and area under bed ageregare) so groiu,ci
elevations across slope are as uniform as
possible. Suggested elevation, (staked on
site with lathe marker;) are shoT,7n herein
and on pg. 2.
PRIVATE
~
re -vz
Conde a s ;•r' } Un)pis rUR>;F D Sca 1 L
APP
INDUSTRY, LABOR I A7{
~GE~~4?'iO,vS ~lSION DF SAFETY C
1-31 9&, 7Z = CORRESPONI -1
-7 2- IS4
WITS
Z/32- PO','~SITE SEPTIC PLUMBING CO.
RD.,11UDSON, WIS. 54016
R08ERT ULBRIGHT c57 RECEW
3 NIS. MO=M PLUMBER LIC. NO. 3307 M.P.R.S. i~se
;N.^,'AI-+ 1:P & DESIGNER LIC. NO. 00663
ysT 774,.)
44 7-
5- ii
.3 0 B ~Xi'STi0(r
/q, yiP9oS «+.i
j
13 o 7-rO o -l 0/
~it'~pDSED Z1,~J~ oiPtii SiOi;c~ AT se
a
~OU.vj> G~ vim' 7-110 d1c lle5vSE'"
i
ioo, o
Y(51g 90 J*
t~ w G~ v~7iQ.u , 7'p~J O~ /lF %fi'c ;r.: • f- %
T ?j 0
0 X , Page ? Of
5llyy~5 Straw, Marsh Hay, Or
8 0 Synthetic Covering
Distribution Pipe
tedium Sand
R. H I0
Topsoil
aa. F
3_ _1 E
r Nil
y % Slope Trench Of 2% /Force Main Plowed G,3o
Aggregate L~,r 1-ayer
Updisturbedt D 2•0 Ft.
§oil E 21.2 It.
Cross Section Of A Mound System Using F - 90 Ft.
j
Trench For The Absorption Area G ° Ft.
A J Ft. H Ft.
6 Ft.
K /2• Ft.
I. /2/ Ft.
J %O Ft.
Alternate Position of Force Main I /7 Ft.
W 2- Ft.
L
J ~
--[3 K
PRIVATE c,AtVAv:E Sri
,g g
M( \Obsii~l~'b(~~~io~"a,t~ Permanent
P' Markers
P
DEPT. OF INDUSTRY, LAHt7R F3iSlN ItSlATiCirS
DIVISION OF SAFE TY M ~Ud LC3VNIS'y Trench Of Z - z Z
a t"
Crr~,
SEE CORRESPnni• RE EIV;:D
7" 199"'
Mound Using Trench For Absorption Area OFF!
I
l I
Page of
• C7/ j/ a /(u.~-t E~ o~P ~jl FT ,'r= ~l~C C
/4s / le -
Perforated Pipe Defoll
vAc uA i t'a~v 0
t
FEnd View I
erforated
End Cod] VC PipeHoles Located On Bottom,
Are Equally Spaced
Q / / tt
* ! PVC Force Main r
Distribution
ripe Last Hole Should Be
' Next TO End Cap APF G~
.4 r
E " It ~f~tl( _9 L~jtyout
P ~d Ft. '
DEPT. OF INDUSTRY, LMl tta.;, ~.'v 'J
DIVISION OF SAFETY AND B' 1,3."A, ~jQ
X y~ Inches 7~ff
SEE CORRESPONDENCE
Y Inches
Signed: Hole Diameter Inch
Lateral /2. Inch(es)
License Number: Manifold Z Inches
Date: Force Main Z Inches
~d
#of holes/pipe 13
Invert Elevation of Laterals Ft.
1A 7-CR, A 2-
o-r r 5 , -7
o~P/c c30. y%w~
4~~Al 49
RECEIVED
ql
i
PUMP CHAMBER CROSS SECTIOM AIJD SPECIFICATIONS P4jGE- gOF 5
VENT CAP
4"C, I. VENT PIPE APPROVED LOCKING
WEATHER PROOF MANHOLE COVER
JUNCTIOIJ BOX w/
25' FROM DOOR w^~0lp(- IAA-Cl
~ , 12„MIU
WINDOW OR FRESH
AIR INTAKE PI I~~r1T/ON GRADE I 4"MIM.
~RAfl~ ~ I -
0 CONDUIT
~IEv~+n ow
93.50" PROVIDE I
INLET AIRTIGHT SEAL I III
I II APPROVED JOINTS
APPROVED JOIN'( A INy~~~ I III W/C I. PIPE
1J/ C:2. PIPE I C(vM I III ALARM EXTENDIA14 3'
EXTENDING" 3' ~30 / ONTO SOLID SOIL
ONTO SOLID SOIL 7 I II
~ ~~,y I I ti
' I ON
9p.gS , 3-0
I
F-LEV, FT. { PUMP --j
I OFF
D h
o K"~p1"1 !r' z" BLOCK
it VA r
`+v'D RISER EXIT PERMITTED OIJLy IF TANK MANUFACTURER HAS SUCH APPROVAL
I
SEPTIC E SPEC.IFICATIOUS
DOSE /-P. /I 4
IlZZS.6e `t!VrQCTG- (DUMBER OF DOSES: PER DAy
TANKS MANUFACTURER: O
TANK SIZE: GALLO"S DOSE VOLUME. ~y
GALLONS
G~Ry INCLUDING BACKFLOW:
ALARM MANUFACTURER. ~
~•L CAPACITIES: A= ~0 INCHES OR ~00 GALLONS
MODEL 1.1UMBER:
SWITCH TYPE: 7- B = Z INCHES OR 39/ GALLONS
C . INCHES OR /6! / GALLOWS
PUMP MAIJUFAGTURER: ~J
NUMBER:' ~O ~2 rl U D= INCHES OR _1-st-- GALLONS
MODEL
TYPE: Pl'w, 4(k IJOTE: PUMP AND ALARM ARE TO BE
l' INSTALLED ON SEPARATE CIRCUITS
MINIMUM DISCHARGE RATE `35 GPM n
VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. g O FEET, ~A~k Sr1FGS y{
-2.5 FEET EACICn, I o~ P l tel. '
MINIMUM NETWORK SUPPLY PRESSURE . .
FEET
0-5- FTloo FLFRICTION FACTOR- /?S
FEET OF FORCE MAIN X -"~-40r I S A~sTOTAL 09MAMIC HEAD FEET
INTERNAL. DIMEMSIONS OF TAQK: LENGTH ;WIDTH LIQUID DEPTH
ArrR'%.'.4
DEPT,kOF INDUSTRY, LABOR & 'G RECEIVED
' DIVISION OF SAFETY A'U E a(
SEE CORRESPnn"n' OFE! rG r ~,'!:j 1I
I~GC
4
r
z
a
HEAD CAPACITY CURVE 3 7/86 1/4
MODEL "9€3" 4 5/6
30
i 13
1*4 25 I5/8
6 P
3/16
z~ 15 a
5 4
0 1 1/2-11 1/2 NPT
1 x .
r- F5-
I
1
I U.S, GALLONS 10 20 30 40 50 6D 70 80
i
UTERS 80 160 240
I 0 FLOW PER MINUTE::
,t
yyTOTAL DYNAMIC HEADIFLOW PER MINUTE
EFFLUENT AND DEWATERING
CAPACi TY 12
HEAD UNITS/MIN
FEET METERS GALS LTRS
} 5 .1.52 72 273
1 j 10 3.05 61 231
15 4.57 45 170 3 5/16 t.i
1
a 20 6.10 25 95
ti
J, Lock Valve 21,
'r } 1
i
' CONSULT FACTORY FOR SPECIAL APPLICATIONS
i Electrical alternators, for duplex systems, are available and • Mercury float switches are available for controlling single and
supplied with an alarm. three phase systems.
} Mechani 6l altemato s, for duplex systems, are available with or • Double piggyback mercury float switches are available for
;gyp ,without 21larm.swltches. variable level long cycle controls. a
• j
SELECTION GUIDE
1. Integral float operated 2 pole mechanical switch, no extemai control required.
Standard all models Weight 39 lbs. - 1/2 H.P. 2. Single piggyback mercury float switch or double piggyback mercury, float
9P Series Control Selection switch. Refer to FM0477.
! odel Volts-Ph Mode Amps Simplex Duplex 3. Mechanical alternator 10-0072 or 10-0075.
4. See FM0712, for correct model of Electrical Alternator, '•E-Pak".
' A98. ` 145. 1 Auto 9.0 1 or 1 & 7 -
115 1 Nom 9.0 2 or 2 & 6 3 or 4 & 5 5. Mercury sensor float switch 10-0225 used as a control activator, specify
duplex (3) or (4) float system.
W D98 ` 230; 1 Auto 4.5 1 or 1 & 7 - 6. Four (4) hole "J-Pak", junction box, for watertight connection or wired-in sim-
y{; E90.;., 230. 1 Non 4.5 2 or 2 & 6 3 or 4 & 5 plex or duplex operation, 10-0002.
7. Two (2) hole "J-Pak", for watertight connection or splice. d
r ION T79
( • . , I.
For Information on additional Zoeller products refer to catalog on Combination Starter, FM0514; All installation of controls, protection devices and wiring should be done by
a quali-
Piggyback Mercury Switches, FM0477; Electrical Alternator, FM0486, fv!schanical Alternator, fied licensed electrician. All electrical and safety codes should be followed includ.
a FM0493; Alarm Package, FM0513; Sump/Sewage Basins, FM0487 and Simplex Control Box, ing the most recent National Electric Code (NEC) and the Occupational Safety and
~IVI0T32: Health Act (OSHA). RECEIVED
w,4l
1 RESERVE POWERED DESIGN C~
(l ' ' p~rri~p
For; unusual conditions a reserve safety factor is ngineered into the design of everyoe er a
MAIL r0: P.O. BOX 16347 Manufacturers of...
Louisviif„ KY 40256-0347
O`/ / 01 SHIP T0: 3280 0 Millers Lane ~r
I'" Louis vide, KY 40216 QUAL/TY UMOS /NCE
(502) 778-2731 a FAY (502) 774-3624 '
-
J
i
S T C - 105
SEPTIC TANK MAINTENANCE AGREEMENT
St. Croix County
OWNER/BUYER -_720 11 A C /y
ADDRESS I /go ST' FIRE NUMBER I ~~O
CITY/STATER ZIP
y~ C) 2.
2 7
PROPERTY LOCATION:,__ 114 ,,V_,~__1/4 , SECTION- , T -A) N-R ✓ 7 W
TOWN OF ;~/y St. Croix County,
SUBDIVISION , LOT NUMBER
Improper use and maintenance of your septic system could
result in its premature failure to handle wastes. Proper
maintenance consists of pumping out the septic tank every three
years or sooner, if needed by a licensed septic tank pumper. What
you put into the system can affect the function of the septic tank
as a treatment stage in the waste disposal system.
St. Croix County residents may be eligible to receive a grant
for a maximum of 60% of the cost of replacement of a failing
system, which was in operation prior to July 1, 1978. St. Croix
County accepted this program in August of 1980, with the
requirement that owners of all new systems agree to keep their
system properly maintained.
The property owner agrees to submit to St. Croix Zoning a
certification form, signed by the owner and by a mater plumber,
journeyman plumber, restricted plumber or a licensed pumper
verifying that (1) the on-site wastewater disposal system is in
proper operating condition and (2) after inspection and pumping (if
necessary), the septic tank is less than 1/3 full of sludge and
scum.
I/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 DNR.
Certification stating that your septic has been maintained must be
completed and returned to the St. Croix Co. Zoning officer within
30 days of the three year expiration t .
SIGNED:
I DATE:
St. Croix co. Zoning Office
911 4th St.
Hudson, WI 54016
S T C - loo
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), thenla 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 _~'Gf~/t✓ +~~C/1/
Location of property 1/4 1/4, Section `Z 7, T3_0 N-R_~2 W
Township
Mailing address J-3 -23 1 ~j(} 7
Address of site
Subdivision name Lot no.
other homes on property? yes- -No
Previous owner of property
Total size of parcel ..S !'~2d
Date parcel was created
Are all corners and lot lines identifiable? -4-Yes No
Is this property being developed for (spec house)? Yes _Z_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 & THE SEAL OF THE REGISTER OF DEEDS. In addition, a
certified survey, if available, would be helpful so as to avoid
delays of the reviewing process. If the deed description
references to a Certified Survey Map, the Certified Survey Map
shall also be required.
PROPERTY OWNER CERTIFICATION
I(we) certify that all statements on this form are true to the
best of my (our) knowledge that I (we) am (are) the owner(s) of
the property described in this information form, by virtue of a
warranty deed recorded }};n the office of the County Register of
Deeds as Document No ~1 ;5 E 7 S 2D , and that I (we) presently
K_ own the proposed site for the sewage disposal system or I (we)
obtained an easement, to run the above described property, for
` the construction of said system, and the same has been duly
recorded in the office of County Register of deeds as Document
No. .
Zi~
nature of applicant Co-applicant
3 f
Date Sign ture Date of Signature
481'750
a 13160 (2- (For um by: ACA, FCB, FLCA, PCA) (y, j
Page I•o(2 ' MER 94(/j~ J.PAr VE 393
TER1S OFFICE LIMITED WARRANTY DEED
GIS
,
E
R ,
ST. CROIX CO., W1 THIS INDENTURE, made this 31st day of MaKch ,
Recd for Record 1992 , between Production Credit Association of
Northwest Wisconsin
APR O 91992 a federally chartered corporation, with a post office address of ,
P.O. Box 199
at 8:30 A• River Falls, WI 54022
party of the first part, and John J. Dalton and Jean M.
Dalton
Register of Deeds
whose post office address is Route #2, 1358-190th St.
Ra7..lwin, WI 54002
v party of the second part, (hereinafter referred to as party whether singular or
plural), WITNESSETH, that the said party of the first part, for and in
consideration of the sum of Fifty Six Thousand and 00/ 100--
Recording Information DOLLARS,
56,; 000.00. to it paid by the said party of the second part, the receipt whereof is hereby acknowledged, does grant,
bargain, sell, and convey unto the said party of the second part, his/her/their heirs, successors and assigns forever, the following described real
estate, situated in the County of St. Croix and State of Wisconsin , to-wit:
South 530 feet of East 411 feet 9f the,SEi of NEB, Section 27, T30N, R17W.
i
vt=
subject to all existing easements and rights of way; also subject to all taxes on said premises for the year 199 and following years; also
subject to all unpaid parts and installments of special assessments on said premises which have fallen due, or will fall due hereafter.
EXCLUDING therefrom and excepting and reserving to said party of the first part all mineral and royalty rights, interests, estates and titles
heretofore reserved or excepted of record by The Federal Land Bank of Saint Paul prior to January 22, 1986, if any, with such easements for
ingress, egress and use of surface as may be incidental or necessary to use of such rights. The foregoing exclusion, exception and reservation
shall include, but not be limited to, all oil, gas, hydrocarbons, coal and other minerals of whatsoever nature lying in or under the above-
described lands and all royalty interests as to oil, gas and other minerals produced and saved therefrom. It is expressly understood that the said
party of the first part will make no warranty as to the extent of its ownership of minerals, or as to its title thereto.
TOGETHER with all and singular the hereditaments and appurtenances thereunto belonging or in any wise appertaining; and all estate, right,
title, interest, claim or demand whatsoever, of the said party of the first part, either in law or equity, either in possession or expectancy of, in
and to the above bargained premises, and their hereditaments and appurtenances.
TO HAVE AND TO HOLD the said premises as above described, with the hereditaments and appurtenances unto the said party of the
second part, and to his/her/their heirs, successors and assigns FOREVER.
AND THE SAID party of the first part, for itself and its successors, does covenant, grant; bargain and agree to and with the said party of
the second part, his/her/their heirs, successors and assigns, against all and every person or persons lawfully claiming the whole or any part
thereof„ by, through or under said party of the first )art, and none other, it will forever WARRANT and DEFEND.
I
ZZOS -IM sTTvd zanzg
66T xog •0'd uoszapuy •g
uzsuooszM lsaMgazom Jo VO
:4 pal3e.ip seen luawtulsut stgs•
56 61 ' 6 TT-Iv sa idxa uounwwoi (N uzsuooszM '+Gunoj
xzoz &JIql. PION
~W zu49G
_ t
II
u"omo3• puavgb uo
uzsuooszM IsaMqIzoN Jo uoz4PT3OSSy gzpaz0 U0,T, po ~o
4uapzs9zd aOin TPUOZ ag (ally) ' z:lzaugag. tzar (awvu) Xq
Z 6 6 i 'T E q 9 -ILW (arvp) ito aw aiofaq pa8palmtoupu svn( iuawnasul 8ulo8a of ayZ
i
xzoz0 ':IS- AO AINnOD
•ss
uzsuoaszM d0 aixiS
.
61 va .tdxa uolssltuwoa (N 'Xtunoj atlgnd (rn1oN
• I
lnvd 1S fo pog 1}par, turvq fo flvz(aq uo 'Jmflul-,Catuolly sv
fo
(al1l~) (awvu) iiq
(amp) uo atu aiofaq pa8palmoupv svnt ;uawngsut 8u7o8arof atLL
40 AINMOD
•ss
do 2l.LV.LS
i
(app (aweN) 1
luapzsazd a3TA TEUOZ ag zgzauga7 za
u S.
ls9mglaOM 90 UOTIPToossy 4zpaz0 uoz:lOnpoza :ao
lned '1S 3o xueg llpaiD uue3 io3 a3e3-ul-,Cautolly se 8mlay
I .
30
'Iflvd •,LS 30 xmvii ,LIQHHO PIMV3 :SSaSSAALLIM
i •uall!lm anogs lsig
.tea,C pus ,Cep agl oweu oltaaodioa slt u► pa)noaxa aq of smosaid asagl pasneo sEq 'wed lsig agl 3o 4iud pies atp 909IMM SSUNJIM NI
~VV 30 dP1,1J a)8~~ Z)oz abed
Y 1 (J) ObIEI
ST. CROIX COUNTY
WISCONSIN
ZONING OFFICE
l ~ ) a r i
ST. CROIX COUNTY COURTHOUSE
V 911 FOURTH STREET • HUDSON, WI 54016
(715) 386-4680
Aug. 5, 1992
Division of Safety and Building
Bureau of Plumbing
P.O. Box 7969
Madison, WI 53707
To whom it may concern:
An onsite soil investigation of the John Dalton property, located
in the NE1/4 of the SW1/4, Sec.27, T30N, R17W, Town of Erin Prarie,
St. Croix County, WI., has been conducted with the assistance of
Bob Ulbricht, CST# 2482.
This onsite revealed suitable soil for onsite sewage disposal to a
depth of 14" while meeting the requirments of the A + 4" rule. This
site should be suitable for new construction using a mound septic
system having 22" of sand fill.
Should you have any questions, please feel free to contact this
office.
ince ely,
ames K. hompson
Assistant Zoning Administrator
cc: file