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HomeMy WebLinkAbout018-1011-20-130 co n: o I w ~ ~ I o O 0 I ° I E M N O X Y ~ O CL N O y O O O L V n co O co (U U _ C Z N 7 (4 U) N LL C m O 0 0) c C> L .3 'D I M z z o z N - a co Z Co F ' N c C7 ~ I ° z d a v ~ ~ ~ w I w z c N N ° ~ E ° E 5 ° _ N O 00 •p~ p 0 N O Q O O Q Q N z z z o N Cl) N I N R ~v N I LO *a d i', co N tid.. a o a c O !n U) N •i 0 0 0 •~y 3 m a a 7 O ~ N z N M N fn J t7 ~ rn 60)1 O L O O = 1 d W w O ~ 'a N Q z m ~ o O C N C C CO (D U C N 0) O N O = Q CO o O O N 10 N c N E N N c s Q) E o) vii Q E U M a ° .O N W N E Y E E E N O U • L~ O 00 = = O H Cn /1 y m a #6 a CL • ~ a m ~ d y c rr`M►1 E i c c ~ A 0 a 'i' 0 N V PP_ LOCATION: HAMMOND 06.29.17.86A-30,NW,NW, 150TH, LOT 3 Wisconsin Department of Industry, PRIVATE SEWAGE SYSTEM County: 'Labor and, HumanRelations INSPECTION REPORT ST_ CROTX Safety and E3uildings Division (ATTACH TO PERMIT) Sanitary Permit No-: GENERAL INFORMATION 17 14 1 Pgrmit Holder's Name: I~ - ❑ City ❑ Village] Town o : State Plan ID No.: /Q/93^ I MA VEY N & SUZANNA HHAMMOND CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: , TANK INFORMATION ELEVATION DATA A9200204 9 r"'` c,f TYPE MANUFACTURER CAPACITY STATION BS HI FS 'ELEV. Septic C1 uS Ste-~~ Benchmark Dosing y 1~ Aeratio Bldg. Sewer /Z' Holding St/ Vinlet y 2$ TANK SETBACK INFORMATION St/ byf Outlet ILI" TANK TO P/ L WELL BLDG. Aeintake ROAD Dt Inlet Septic - /6e)11,,, o ;2., NA Dt Bottom ~ 106, Z=- S , S6 Dosing ~.l~~~0 5 5 NA Head/Man. Aeratio NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grad Manufacturer Demand r , ,z5 97' G k Model Number /V73 GPM 61,i TDH Lift~,~ Lriction,L~, ' Head SystemZ TDH ~Ft r rr Forcemain Length 0(4 Dia. Z Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width i Length 2 f No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS IME SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manu 7!~~ SETBACK INFORMATION Type O CHAMBER Mo a Number: I <U r o System: Y1AOR UNIT DISTRIBUTION SYSTEM J"eder/ Ma rf9Id , Distribution Pipe(s) „ N x Hole Size,, x Hole Spacing Vent To Air Intake L- Length Dia. a Length _3P Dia. Spacing 16 l~ t SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only l' Depth Over 0 FBed/+refteK-Ec1ges h Over r, /i xx Depth Of xx Seede /sedde& xx Mulched Bed/ ~ Center 1 z - I Topsoil es ❑ No es ❑ No COMMENTS: (Include code discrepancies, persons present, etch 99-55 - / / /Q6,55 Ec/' 1(.'FI"_ , /lam) l f : ' ;g 10 r; Plan revlsllel required? ❑ Yes ~ 0 Use other side for additional information. SBD-6710 (R 05/91) Date Inspector's Signature Cert No. i ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: /2~4~ ~ ~ .moo ~ ~ ' 1i, ov 77on m SANITARY PERMIT APPLICATION UN , C TUJLHR In accord with ILHR 83.05, Wis. Adm. Code couN STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than /7/4/,39 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. S9.2, in 2 P--? PROPERTY OWNER PROPERTY LOCATION q r r/L l z r f(~ rr.•t (1 ~i'/a~14/'/a, S G T N, R j .E{t>r} W PROPERTY OWN R' Aj' I G/>< ?DRE LOT # A BLOCK # 3 15-/4 ! i~t 1614 CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER 7 ) 1~a~ o d ~'~/'S rq / S' 7/s- ZYG- 5"51 II. TYPE OF BUILDING: Check one) CITY NEAREST ROAD ❑ State Owned VILLAGE ~ Hq pr h?o ~ f G t ~ ~ ~ In 0 ❑ Public 1 or 2 Fam. Dwelling-# of bedrooms 3 PAR LTAX NUMBER (S) III. BUILDING USE: (If building type is public, check Z11 that apply) 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 4 ❑ Church/School 80 Mobile Home Park 12 ❑ Service station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1. lpVOFe w 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ 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. ASSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/da /sq. ft.) (Min./inch) ELEVATION 5 G ; ? 3 ? ~GG Feet /6L.Z Feet VII. TANK CAPACITY Site in allons Total # of Prefab. Fiber- Exper. INFORMATION New istin Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks structed Septic Tank or Holding Tank M .'d W tir t'C r*1 F1 1- Ej F] Lift Pump Tank/Si hon Chamber % t Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for in allation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plum 's Signature: (No ) RSW No.: Business Phone Number: G~/ qG ?ism l~Y~ a~~ Zip Code Plumber's Address (Street, Cl , k/ .t 1,1e, ff IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuin Agent Signature (No Stamps) 9U Approved I ❑ Owner Given Initial arge Fee) ~j ~rgg y Adverse Determination v. S 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 • . h 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new ` criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. 11. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling. 111. 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'f 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; fricton loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations PRIVATE SEWAGE PLAN APPROVAL Western Regional Office 2226 Rose Street LaCrosse, Wisconsin 54603 WEGERER SOIL TESTING & DESIGN Owner: HARVEY HEILKEMA PO BOX 74 1516 110TH AVE RIVER FALLS WI 54022 HAMMOND WI 54015 RE: Plan Number: S92-40287 Date Approved: May 26, 1992 Gallons Per Day: 450 Date Received: May 20, 1992 Project Name: HEILKEMA, HARVEY Location: NW,NW,6,29,17W Town of HAMMOND County: ST CROIX The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped 'conditionally approved'. This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. This approval will expire two years from the date approved or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. The Section of Private Sewage has reviewed these plans for private sewage system code requirements only. These plans have not been reviewed for the code requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 of the Wisconsin Administrative code. This approval is for the following components only: - NEW MOUND Inquiries concerning this approval may be made by calling (608) 785-9348. Sincerely, SV 4 RARD M. SWIM ~f Section of Private Sewage z co Division of Safety and Buildings PPP039/0009n/26 cc: HARVEY HEILKEMA X Private Sewage Consul SBD 8423tR. oI/91j ' St' 6nW t b ' Page )-Of MOUND SYSTEM FOR A 3 BEDROOM RESIDENCE LOCATED IN THE NW 1/4 OF THE ^1W 1/4 OF SECTION 6 T 24 N, R 1-1 W, TOWN OF lA Poir~p1.i ~ , ST GR COUNTY, WISCONSIN. -0 LK ~1-oT j of vo` . 53 oP Cs" S, 1pon6e ZZZO) INDEX PAGE 1 of 6 TITLE SHEET PAGE 2 of 6 PLOT PLAN PAGE 3 of 6 PLAN VIEW-CROSS SECTION PAGE 4 of 6 DISTRIBUTION PIPE LAYOUT PAGE 5 of 6 PUMPING CHAMBER PAGE 6 of 6 PUMP PERFORMANCE CURVE PREPARED FOR 14 N?1\) Y ak a sib lto~+ av~ . L -j1 S4o1S PREPARED BY WEC-3EFRE1=2 SCI I I TEST I NC-s AND L7 E S I C-a S E R ~1 I C E a®Qe~,~~E1Q1iQ1~~09 e ~e G®f Ave P.O. BOX 74 421 N. VAIN ST. • $ RIVER FALLS. VI 54022 0 • x oD . 715-42,-615c , ARTHtIP. L ® E Lb'R',.H. H, sio®~,sz~s I G 14S OaCallao JOB NO. 0I.2 - cj3 PLOT PLAN Page Z of Scale 1"= W c'~PC\~3 T LAY LtN~1 Z S " 00 ►~oT ~.oria~cT oR \~\Slv\C-b 1T11S ARC \ 1~RAPo3 LRS~, ~BD2w1 \2~910E1ucE s (n ` r QV C' ~~O N MIN a ) S P \~ow to `y° pv C Po~e~ 4''vvc 0 I C~h SZ EM ONS~TE ROV S~~A~E SY "'J '.L -M e C- hT LL~ST So f= R»~ r-1 owp r'+~a ~1T ~~~n s r 2 s' ~1ZO r~ g AND QE& 6vAi\IT OF INt}t)STt3Y,~B>a N I 1NG5 Yaws. VISO% Of Il 1\ 61 S, NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install permanent markers at end of each lateral. ( 4 required) 3. Install 4" observation pipes with approved caps. ( 2. required) 4. Septic tank to be 1~0 gallon capacity manufactured by " ~ Dw l:S ~LtV PSZ~ 4 1-1 1 "C . - KIME [ NAO e&-R 'its U 15a CAA Lt e 4 Mt b WES' MN t LIE(ASr 5. Bench mark )tZL V too o~ \ PVC ~1 PE N. ExT To -\,4swt~m ~oLl • C sQ-k:- c ou~~ 6. Divert surface water around mound to prevent ponding at the uphill side. Page 3 Of Approved Synthetic Covering Distribution Pipe Medium Sand H _ G Topsoil = F Elev. \\3t). S 3 E D ~ q r , VI\i.`rl 4 t SEVy ~ ~AGE J b % Slope Gndilio Bed Of 22 %2 Force Main Plowed Aggregate From Pump Layer iris OVED . PARINIEN 0~ It:LJSTRY, LABOR AND HL11 . IELAI LN,S D l.o Ft '1tSSLI3 1011, JTN VUl GS Cross Section Of A Mound System Using E ZS Ft. A Bed For The Absorption Area F Ft. SEE CORRG 1•o Ft. A _ Ft. H i. S Ft. Linear Loading Rate= 7. 1 GPD/LN FT B 63 Ft. Design Loading Rate= o. y GPD/SQ FT I \ Z Ft. J F6 Ft. K __\o Ft. Alternate Position L 83 Ft. of Force Main W 2 (o Ft. L Observation Pipe g - ~ W o K F•----- ( Force Main Distribution Bed Of 2"- 2 z Pipe Aggregate Observation Pipe Permanent Markers (Anchbr securely) Plan View Of Mound Using A Bed For The Absorption Area Page y Of 6 Perforated Pipe Oetoll 0 End View )Perforated End Copj . b`c~b PVC Pipe Install permanent marker at end of each lateral Holes Located On Bottom, Are Equally Spaced Q S PVC Force Main Q PVC Manifold Pipe Distn ution pi e Last Hole Should Be I Next To End Cap End Cap P 30 Ft. ONSI "E SEWAGE SL" an Pipe. Layout S Conditionally ~ X Y$ Inches Y V 8 Inches -5, Ov it, Hole Diameter '/y Inch OEPART&% LIF 1,NVUSTRY, LABOR AND AN RELATION'S Lateral ) Inch(es) IVISION SAF 'D ILDI GS., Manifold Z Inches SEE CO ~pc CE Force Main Z Inches #of holes/pipe 8 Invert Elevation of Laterals lot-c) Ft. Place 1st hole Zq" from center of manifold with succeeding holes at 48! intervals. Last hole to be next to the end cap. PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS ' PAGE S OF VENT GAP 4" C.I. VENT PIPC WEATHER PROOF APPROVED LOCKING MANHOLE -f r-7 JUAJCTION 80X ?-5, FROM DOOR COVER WITH WARNING LABEL , WIAIDOW OR FRESH It~M1U. I AIR INTAKE I GRADE EL W0. 4 " MIN. I F!' MIIJ. COWDUIT-" Ib"MIN. IAILET ONSITE SEWAGE S16J M I AIrIGHT SEAL I I i I ~ II v I I APPROVED JOIJJT A APPROVED JOINTS ~ I I . I I I ALARM PpRovorimmm"k I II M, A I 8 PARTME OF wDUSTRY, LABOR AND NU RELATIONS j i I ON C IVISION 0 AF AN BUI NG i IN LLEV. °IO'\SFT SEE CORRf ~ Pump,, OFF r 0 LZ Ct~ COKICRETE BLOCK 3" APPROVE RISER EXIT PERMITTED OWLy IF TAWK MANUFACTURER HAS SUCH APPROVAL. acouINQ 5PCC.IFICAT10KJS DOSE , MtGwaST Z J P SI- IJLIMBER OF DOSES: 3'g' PER DAy TAWK MANUFACTURER. TANK SIZE: 723 GALLONS DOSE VOLUME s-:7, Lj. c k3 S`i$TGmS INCLUDINfa DACKFLOW: b'S GALLONS ALARM MANUFACTURER: MODEL WUMBER: ZO I tNw CAPACITIES: A=16, 11z- INCHES OR 3Z 1', GALLONS SWITCH TSPE: C-U\-r- Lf B= Z INCHES OR 3q.0 4LLON5 Zu ZL ~P~i-7 PUMP MAIJUFAGTURCR: C C = INCHES OR X36. S GALLONS MODEL WUMBER: N X31 D- NS INCHESOR Zq-e- 5 GALLONS SWITCH TYPE' C_ul---f MOTE: PUMP AND ALARM ARE TO DE MIIJIMUM DISCHARGE RATE 3-'E4y GPM INSTALLED OW SEPARATE CIRCUITS VERTICAL DIFFERENCE BETWEEN PUMP OFF AUD._OISTRIBUTION PIPE.. lO• FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . 2.50 FEET ♦ FEET OF FORCE MAIN X Z" 33 F o prFRICTIOU FACTOR.. Z° 66 FEET TOTAL DtJWAMIC HEAD = X6'03 -FEET DIAMETER , IJJTERNAL DIMENSIOLI~ OF TAWK: LEWGTH - ;WIDTH - ;LIQUID DEPTH y0 BOTTOM AREA 231= GAL/INCH AS PER MANUFACTURER \01:5 GAL/INCH G G 6 o Y= 4% 7% 6% w U` HEAD CAPACITY CURVE METERsYNAMICHEADFEET/ o M O D E L137-139 CAPACITY GALLONS/LITERS 4% 30• CAPACITY + HEAD UNITS/MIN '0'0 0 15411 Ye 8 FEET METERS GAL LTRS - NPT O 25' 5 1.52 104 394 517/a w 10 3.05 79 300 = 0 15 4.57 64 242 U 6 20' 20 6.10 36 136 1 a 25 7.62 8 30 2 } 26 7.92 0 0 O 15• 16.03 0 4 10 37`y y 2 5' l 12% l 0 U.S. 10 20 30 40 50 60 70 80 90 100 110 GALLONS LITERSI 80 160 240 320 400 4 0 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS • Three phase pumps are available in 200/208V or 230V. • Mercury float switches are available for controlling single • Electrical alternators, for duplex systems, are available and and three phase systems. supplied with an alarm. . Double piggyback mercury float switches are available for • Mechanical alternators, for duplex systems, are available variable level long cycle controls. with or without alarm switches. a Long cords are available in lengths of 15-25-35-50 feet. • Combination starters are available. • Over 130°F. (54°C.) special quotation required. Standard All Models - Weight 47 tbs. % H.P. SELECTION GUIDE SELECTION GUIDE 1. Integral float operated 2 pole mechanical switch, no external control required. 1371139 Serge' Contra selection 2. Single piggyback mercury float switch or double piggyback mercury float Model volts-Ph Mode Amps Simplex Duplex switch. Refer to FM0447. M137/139 115 1 Auto 10A 1 or l &8 - 3. Mechanical alternator "M-Pak" 10-0072 or 10-0075. N137/139 115 1 Non 10A 2 or 2 6 7 3 or 5 6 6 4. Combination Starter. Refer to FM0514. D137/139 230 1 Auto 52 1 or l &8 - 5. See FM0712 for correct model of Electrical Alternator "E-Pak". E137/139 230 1 Non 52 2or2&7 3or566 6. Mercury sensor float switch 10-0225 used as a control activator, specify 'H137/139 200-208 1 Auto 82 1&8 - duplex (3) or (4) float system. 11137/139 200-208 1 Non 8.2 2&7 3 ors 6 6 ' 7. Four (4) hole "J-Pak", junction box for water tight connection or wired-in J137/139 200 208 3 Non 2.2 2&4 3 6 4 or 5 3 6 'F137/139 230 3 Non 3.0 264 3 6 4 or 5 6 6 simplex or 2 pump operation, 10-0002. 'G137/139 460 3 Non 1-5 2&4 3 &4 or5 6 6 8. Two (2) hole "J-Pak", for Watertight connection or splice, 10-0003. No molded plug Three phase units require a control switch to operate an external magnetic or combination starter. CAUTION All installation of controls, protection devices and wMng should be done by a qualified For information on additional Zoeller products refer to catalog on Combination stater, licensed electrician. All electrical and safety codes should be followed including the FM0514; Piggyback Mercury Float Switches, FMO477; Electrical Alternator, FM0486; most recent National Electric Code (NEC) and the Occupational Safety and Health Act Mechanical Alternator. FM0495; Alarm Package, FM0513; and Sump/Sewage Basins, (OSHA). FM0487. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. 3280 Old Millers Lane Manufacturers of... P.O. Box ° ZZ7Z-ZZZj-ff ZZ7. lLouftlidfle, Kent sky 40216 p (502) 778-2731 QUAL/Tr PUAIP9 SiVCE ~S3y a DEPARTMENT OF REPORT ON S DIVISION INDUSTRY, P.O. BOX 7969 LABOR AND. PERCOLATION TESTS (115) MADISON, WI 53707 HUMAN REldATION$' (ILHR 83.0911) & Chapter 145) WNSHIPI Y: O`TN0. U NO.: SUBOIVISI N N : L-Ot A I N: SECTION: O 3 4'W 114f ~Tzf N/R17 E (.,0 COUNTY: MAILING ADDRESS: SE •B~4/.Ow~.~~ 4~i S . cyf t fI 5 7- DATES OBSERVATIONS MADE U TESTS COMM AL E RI TION: PROFILE DESCRIPTIONS: I 3 op !f- A/- A • ONew ❑Replace EFESCOLATION Il. 14 ~ ~ f r~ 5CS U/~IsAr y ~ Jr we T--)? S r c,r ~ air Ks RATING: S- Site suitable for system U= Site unsuitable for system ro(n EN I NAL: MOUN : 1ESSURE: SYSTEM-iN FILL ODING TANKRECOMMENDED SYSTEM:loptional) $ ElU ©s ❑U El $ 2U ❑ $ [2U ❑ $ RIU Mo ~•~D S IV STEM, If Percolation Tests are NOT required DESIGN RATE: J I If any portion of the tested area is in the Ito' under s. ILHR 83.09(5) (b), indicate: ~6i}SS Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS zU 'LE-C4' A-1 -rI- BORINGTOTAL P H T R UN WATE ES. CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH S PO RV H TO BEDROCK IF OBSERVED SEE ABBRV. ON BACK.) NUMBER EPTH IN. ELEVATION 5 , r :75' tie. 50 T'S. P/owEDt .25' 810 Cicy g- &,o yo ya 5t' / S,o • 13AJ-s Y. 5 PAj0t.AR oR-G-y hors ~4" 2 yL') , cv t 0-. AC Tru.t_. & siDEw~t/! SE J3t~F er `I'o'- ibEiow y0.i M. Ly,.trvT lG (31lt'. SO 1'•S . (Plo w co) . f3 ' er- `I . f3/0C,4c tl . bRflN0t..t2 rova Z 6,0 fp~2, ILO- 3• ZS I.S Rye-ga. SIB w/ ff f 012 - B- it Gy M0TS .2,S ' DE-IC R>=D- ga • 61 w/ f-e.,- B- l ~iST- oI2-Gy rcoTS 3 i3/K. S rS, p/owEv ' Gy-3.,. 13/oCKy 8- (Q /00-57 Ito 3,o 1, Z 5 ' 12AR • Qa . 5"Iel, L 2 C o rJ/? LF S 1 w f'~ 6t/. Af Of 5 2.1 ~-t PERCOLATION TESTS DEPTH . WATER IN HOLE TEST TIME D I WA ER L V N H RATE MINUTES PEA=2 PERIOD 3 F NUMBER INCHES AFT SWELLIN INTERVAL-MIN. - t PER INCH Z O P_ 2 2 a/ y i 2 //G Z s(e P 3 Z P_ P- P- PLOT PLAN: Show locations of percolation tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori- zontal and vertical elevation reference points and show their location on the plot plan. Show the surface elevation at all borings and the direction and percent of land slope. 60 j 41 F QD /00.0- SYSTEM ELEVATION Set=- PLOT a 1-11 a Pt vE R- 4e- TN /ti s e 7 Pv tv ro p20vl've- T3ItpM S 0 ujm_- QS ~o•~ ~i'T~ S XP S t-0 r-2 OF- M G wv,0 S y S 7-& ,ti S -ro 17. r U L--* r- S U R FA C er- acN0I"C e- TGt s To 2).r- - H•R . Ok) PL-A-.) APPI°0v-41- sugMrss~d~ 1, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and th#t the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME iPrint : HUMEII SEPTIC PLUMBING------ TESTS WERE COMPLETED ON: 665 O'NEIL RD., HUDSON, WIS.54016 L R08ERT-VORIGHT IFICATION NUMBER: PHONE NUMBER (optional): CERT W6. MASTER UMBER UC. NO. 3301 M.P.R.S. ADDRESS: INN. INSTALLER & DESIGNER LIC. NO. 00663 L p 2_ 13.P6 JP140 S CST SIGNATURE: DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. Il nu HRSBOFi3951110/83) - OVER - L L, 33 ~ Pc~wER Pp1~ SET) I" puc- ('i P-C E(eu~Ti o..~ = 100. 0 3 c-a r 3 0 4 r~ h C h 5c.4IE: p1 '3 o Zti3 HOMESITE SEPTIC PLUMBING CO. 655 O'NEIL RD., HUDSON, WIS. 51016 ROBERT ULBRIGHT s r i y8Z NIS. MASTER PLUMBER LIC. NO. 3307 M.P.R.S. p) NN INSTALLER & DESIGNER LIC. NO. 0060 i j QL ~ II y 90 100 4 t 3 - 3 .HdvvO TOe` ~ 3 Q,V SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County J OWNER/BUYER ,L/ 4 P Ve i ke- y" e ADDRESS : 11-/4 /),o t~ 114 144t* nt ~ q FIRE NO: LOCATION : /A/ 1/4,, 1/4, SEC. _TN-R_Z2_W, TOWN OF: J IG u n Q ST. CROIX COUNTY SUBDIVISION: LOT NO. 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 to help with the cost of the 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 the St. Croix County Zoning a certification form, signed by the owner and by a master 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. Certification from 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 DNR. Certification form must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. SIGNED: I. " DATE:X 5 - 5)9- St. Croix County Zoning Office 911 4th St. Hudson, WI 54016 L 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 perm~.t 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 r ~-7 t-~ ' Location of property~l~4 ~l/4, Section ~ , T~N-R~W Township d Mailing address ) 5 //G~~ ~2G ~I ~4 k? wt ~ ~ e~ k/, 's Address of site l 5 U t~ S Y' ~"~k n, ~ u y !1/•S Subdivision name 3 Lot no. -other homes on property? yes No Previous owner of property ~~4 r v ~ ~/S~ ~ ~ Total size of parcel _ 2 s-o ' ~ ~ 25' ~ Date parcel was created Are all corners and lot lines identifiable? ~ Yes No Is this property being developed for (spec house)? Yes No volume f ~ ~ and Page Number _ as recorded, with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WAIZR1,ttTY DEED which includes a DOCUHENT NUMBER, VOLUHE AND PAGE i1UMBER & TIE SI~:AT, 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 referenc©s to a certified survey Map, the Certified Survey Map shall also be required. PROPIIZTY OWNER CERTIFICATION I (we ) certify that all statements on this form are true to the best of my (our) knowledge that I we am the property described i ( ) (are) the owner(s) of ~ n this i warranty deed recorded in the office aofotheorm, by virtue of a D Count eed Re i s as Document No . C~~ ~ ~ Y g stet of own the proposed site for the sewage disp salt ystem) orr I e(we) obtained an easement, to run the above described property, for ttie construction of said system, and the same has been duly record; in the office of County Register of deeds as Document No. ~ ~ Signature of ap~alicant Co-appl cant bate of Signature Date of Signature _ - ST. CROIX COUNTY WISCONSIN r ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 June 7, 1990 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 Dear Sir: An on site investigation for the Harvey Heilkema property, located in the NA of the NW4 of Section 6, lot 3, T29N-R 17W, Town of Hammond, St. Croix County, revealed suitable soils at a depth of 2.42' below which seasonable high ground water was noted. This site should be suitable for a mound. Should you have any questions, please feel free to contact this office. Sincerely, Thomas C. Nelson Zoning Administrator cj ST. CROIX COUNTY WISCONSIN ZONING OFFICE N "a M x r"■ ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 = s (715) 386-4680 July 11, 1994 Ms. Sue Birch 1191 150th Street New Richmond, Wisconsin 54017 RE: Septic System Dear Ms. Birch: Enclosed are copies of materials from within our file regarding your septic system. If there is anything else that we can help you with, please do not hesitate in contacting our office. Very sincerely, '6~ 4~ V Marilyn Zais Administrative Secretary mkz Enclosures (0 PY( } ~ J 6'r::. . 3 'R yt~~^ X~ ri ,t t r y r k ''F! ? ~Xr 4 t'~ i-f h~ ~.a iFf REPT131 HAMMOND ST. CROIX COUNTY ZONING PAGE 1 09/14/92 11:15 REQUESTS FOR INSPECTION WORK SHEETS FOR: 9/16/92 AREA: JT Activity: A9200204 9/16/92 Type: MOUND Status: PENDING Constr: Address: HAMMOND 06.29.17.86A-30,NW,NW, 150TH, LOT 3 Parcel: 018-1011-20-130 Occ: Use: Description: 171439 Applicant: HIELKEMA, HARVEY N & SUZANNA H Phone: Owner: HIELKEMA, HARVEY N & SUZANNA H Phone: Contractor: STANG, JOE Phone: 698-2266 Inspection Request Information..... Requestor: STANG, JOE Phone: Req Time: 09:09 Comments: Q:36 Items requested to be Inspected... Action Comments Time Exp 00012 FINAL INSPECTION Inspection History..... Item: 00012 FINAL INSPECTION