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HomeMy WebLinkAbout020-1103-10-000 0. 0 ~ Do h 0 691 o~ N CD g c ~ ~ I o ~ ~ I .a N o U ' E I o o' 2 ti O N ~ a) CD S > p N p D O Y N C E m E L M CCD N N m 6 Z 4EE) 1 U. c ova o O v_1 N Vi c (D CL E Q F-Na'fn I ~ M y rn ~ Z ~ m H z a m I o I O z d c c d Z v o ° ~ c m Zz 0 ch N CL 3 m M (D w N w • m a~ c N a 0 L g I c O Q Z F- Z N z d c Lo i m E N N N ~ O a CL c co No o d a L 00 1 o G o a U N w Z j (A fA !n N WSJ n o •fta X000 N a o v 3 N N N W J U 2 a) } 0 rn N N 0 r o o E .a co c d N N 2 Y Q (A f0 to d N l0 op° Q o aci w e o c E L I.d d [O E L N C ai V 0 M m~ v) co c E a ',0 N 0 0 3 m O"o p N 'Np o LO L 0 .41 7 ~ L W o M 2 1 o Z N g U v~ _ € 4) CL 1 EL L: d rw 3 0 r Q U a OU) V i z RO /pe ; SfEYE C G •gr~i i4 / " ~1 ltD~v li /1- 6~~/ 7 AS BUILT SANITARY SYSTEM REPORT s0C,&r/ A'bof S,gO)w6-S OWNER TOWNSHIP v9S0„~ q SECTION SATE ADDRESS ST. CROIX COUNTY, WISCONSIN SUBDIVISION LOT LOT SIZE PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM ORIGINAL 7- e~ N~~ W&-ft- r--0L vD 7-0 13&- 1407ACT JJ' /,v 56vk 0,eae_-r°- , - c w"¢ S 2"D iN GGS o Scv.r 7/fNk PiP SOT ilJ l7 ~ Ui'f /~/%vG~ INDICATE NORTH ARROW BENCHMARK: Elevation and description: I3M."CA' ,d 1c04& 4SEPTIC TANK:Manufacturer: Liquid Cap. Final grade elev: Rings used: Manhole cover elev:g3~ Tank inlet elev.: ffank outlet elev.: 70,7 No. of feet from nearest load : Front Side , Rear Ft . From nearest prop. line:Front Side , Rear Ft. Z , No. of feet from: Well 7S , Building: y (Include this information in the above plot plan) (2 reference dimensions to septic tank) SEE REVERSE SIDE PUMP CHAMBER Gv ~EKS GUNG/~P~ T~ Manuf acturer : p/2O~LCTS Liquid Capacity: r Pump Model: Pump/Siphon Manufact.: zoo/~' Pump Size Elevation of inlet: LO Bottom of tank elevation y 3 Pump on elev.: Pump off elev.: Gallons/cycle: l~`S Alarm: Man.: LEU~G Aotq to - Switch Type: Location LN Distance from nearest prop. line: Front?y Side, Rear-Ft. Distance from: Well Building SOIL ABSORPTION SYSTEM r- t Bed:h Seepage Pit: Width: ✓j Length Number of Lines:: Area Built _ /o~. Exist. Grade Elev. Proposed Final Grade Elev. Fill depth to top of pipe: 20 ~O y2 DP`w No. feet from nearest prop. line:Front 75 , Side , Rear Ft. No. feet from well: L/ / No. feet from building HOLDING TANK Manufacturer: Capac' No. of rings used: Elevation of tom tank: Elevation of inlet: No. feet from nearest op. line:Front , Side , Rear Ft. No. feet from: 1 , building , nearest road Alarm Manu acturer: I/~t -~.oM. p So„J INSPECTOR: DATE : PLUMBER ON JOB : LICENSE NUMBER: 6/90:cj HOP!ESITE SEPTIC PLUMBING GO. 655 O'NEIL RD., HUDSON, M.S. W16 ROBERT ULBRIGHT WIS. MASTER PLUMBER LIG. NO, 3307 M.P,R.S. MINN. INSTALLER & DESIGNER LIC, NO, 00663 NO4"ESITE SEPTIC PLUMBING CO. 655 O'NEIL RD., HUDSON, WIS. 54016 ~,~(S~► J'A"~X ROBERT ULBRIGHT Qr G WIS. MASTER PLUMBER LIC. NO. 3307 M.P.R.S. +AWNN. NgTALLER 8 DES!GNEER LLIC. NO. 00883 l DGf~7 / Z zN FROST pROoF C/o 3 )-0 AAC4n °F \ i t7~bLvEST EOG~" j 6 & ° 6"92-- ° F~rrsru o~ t4 k'5 h7' Sewe 900A Glr/:~wfy w~,,e mew gvsvatrerv9.5a, . fv eaut e- R1eeAS , 01 eve th+ 972-5 To of pi`r e % / / To o f / E y. 9x.30 p IL7 ^1 snare- Toro- y ~pE /G' ` /NLeT TD Dipop ~oX -T-,PE,v~k. SP~cs Di's Til'~ ~ vTro~ a-7a f poc. 3 p 1)I' S .rye 13 UT 1.0 -j p p G-- ~s~ PL o r ~G~t•v c `Vi7iuonrsil6epartm~ejnlo~InOdustry4.29.19.4PR11/ATE'$E1~/AGE Sl~$TEIVIERT RD. County: Labor and Human Relations INSPECTION REPORT Safety and Buildings Division ST. CROIX GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Permit Holder's Name: 180275 ❑ City ❑ Village [Town of: State Plan ID No.: SOCIETY FOR SAVINGS INC. HUDSON CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: ~GJ C>7 GU .Yr , G 7 020-1103-10-000 TANK INFORMATION ELEVATION DATA A9200354 22_ TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. enchmark a age tJ, J q&' BC Septic it), gr.,- cc-'C' 77 Dosing Aer Bldg. Sewer Holding St/)~( Inlet r~.6 TANK SETBACK INFORMATION St/ VOutlet r //G9' O,IoO TANKTO P/L WELL BLDG. VAenttake ROAD Dt Inlet Septic 7~ 2 / NA Dt Bottom 17 35 / Dosing 13 Z CJ, NA Headers-• Aer NA Dist. Pipe Holding Bot. System PUMP/ INFORMATION Final Grade Manufacturer Q~ Demand ~2 Model Number t'67?g GPM TDH Lift 6,66 71 qZ Systems TDH/(,'C Ft oss Head Forcemain Length Dia. ~;L~ Dist. To Well 7 / SOIL ABSORPTION SYSTEM BED/TRENCH Width Lengt / No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS c5' EN I N SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHI Manufacturer: SETBACK CHAMBER INFORMATION Type O Mo tuber: System: C_,. t-1 7 y> 50 ' OR UNIT DISTRIBUTION SYSTEM Header /*4&m4e*t /r Distribution Pipe(s) , x Hole Size x Hole Spacing Vent To Air Intake Length Ion Dia. Length _Z2_ Dia. Spacing L/ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over / „ Depth Over , i xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center 2 1 - `toy Bed /Trench Edges 2/ _(/2 Topsoil ❑ Yes ❑ No ❑ Yes ❑ No ter COMMENTS: (Include code discrepancies, persons present, etc.) _7-r,, C L LOCATION: HU +Y DSON 34.29.19.411A,NW,SW,LOT I,GILBERT RD. f -e , ~~Lo l Plan re~ ision required? ❑ Yes a-KO Use other side for additional information. 9 SBD-6710 (R 05/91) Date Inspector's Signature Cert. No. a ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: 13 V A!59 57 -&VEA) HR SANITARY PERMIT APPLICATION COUNTY In accord ith ILHR 83.05, Wis. Adm. Code- ~ 9 Y00 ago ~~fi~2 - a Y Z ki! 13100 Af406,727 HIAZAI. S'$ 4e 2_S STATE SANITARYPERMIT# -Attach complete plans (to the county copy only) for the system, on paper not less than 1:1 " 8% x 11 inches in size. c if vii on to previous application -See reverse side for instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. PROPERTY OWNER PROPERTY LOCATION ,l .50GiE'7` 4`05AVI~Q6-S .'~vG NA0%S6V S 3T T N, R I E (or) W PROPERTY OWNER'S MAILING ADDRESS LOT # ~ BLOCK # CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER II. TYPE OF BUILDING: Check one CITY t 77 NEAREST ROAD T 7 ( ) State Owned VILLAGE-~ is~.`~ ~ Y ❑ Public ®1 or 2 Fam. Dwelling-~# of bedrooms AR ELTAX NUMB RO G~ / III. BUILDING USE: (If building type is public, check all that apply) 07 ll o 3 ! o 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 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1.0 New 2. ~AJ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 Seepage Trench 22 ❑ In-Ground 42 ❑ Pit Privy 13 Seepage Pit Pressure r 43 ❑ Vault Privy 14 ❑ System-In-Fill will -&Se- DjeT/Gyv /Pet7--c7_ Oe Or VI. ABSORPTION SYSTEM INFORMATION: 4jr'je 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE ~f D REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/dqy/sq. ft.) (Min./inch) 5 jt- ELEVATION 7 a ~I 7 ,-a - & • Feet Feet VII. TANK CAPACITY Site in allons Total of Manufacturer's Name Prefab. Con- Steel Fiber Plastic Exper. INFORMATION New lExisting Gallons Tanks oncret structed glass App. Tanks Tanks Septic Tank or Holdin Tank X 600 7- n I El El Lift Pump Tank/Si hon Chamber LC9E~ s I El El 11 1 11 1-1 VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps 1PRSW No.: Business Phone Number: PoIWT lilkiCGtT" 71 Plumber's Address (Street, City, State, Zip~Codg): SS D "AJ~"/L IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved SQtary Permit Fee (Includes Groundwater Date ss Issui Agent Signature (No Stamps) /yyJ~ ~b~f(J~S Surcharge Fee) Approved E] 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 r INSTRUCTIONS A, s~initary;pgrmit is valid for two (2) years. 2. ''Ybusan'itary~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 sanitbry permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8'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; 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 monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) b4 l Yo o o/D egf-V-7W -10L 3Y Z 13 f/ 'yam Ski s- 7~` j'" S T C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor,(spec house), 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 50C.-e-7! Location of, property P/ V 1/4, Section 37 , T -2~ N-R /L W Township o~ Mailing address 31 /~efr?- s 7- eTo I( 7-2-o o Goww , 061ys, 2-2-00 Address of site 3J ~~~C7t~T_ ' //VP 00 4.V1, 5 Subdivision name GS143533 L 11442 Lot no. Other homes on property? yes No Previous owner of property pj/ ,S~u~'~ySo•y Total size of parcel 3 fi ~7 s Date parcel was created Are all corners and lot lines identifiable? • Yes No Is this property being developed for (spec house)? Yes _Z No Volume / and Page Number as recorded with the Re iste of Deeds. 9 r 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 ir~k} tl1,e office of the County Register of Deeds as Document No. ~X t / Z , and that I own the (We) presently 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. ainaturee of app c t Co-applicant L3,yF- 2 Date of Signature Date of Signature 63.5' 17 wls ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK This is to certify that I have inspected the septic tank presently serving the residence located at: Nw 1/4, ✓ k) 1/4, Sec. 3 , T 2.f N, R lc 7 W, Town of 0 y Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be - /`!f~ ti0 SCV.H O~ _vvly~ functioning properly, Ta Last time serviced Did flow back occur from absorption system? Yes No X(if no, skip , next line) Approximate volume or length of time: gallons minutes Cp. - ~ Tb Capacity: 10 YV11S rrftiK Construction: Prefab Concrete- X_Steel Other Manufacurer (if known): ~f1®T ~yOlc~.v-~ ~~~'?XS Td fJ CU/g~ Age of Tank (if known): ? (Signature) (Name) Please Print RN S 3 30 101.,eS 33 o 7 (Title) (License Number) (Date) Form to be completed by licensed plumber (s.145.06, Wisconsin Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code) - - - - - - - - - - - - - - - - - - - - - - - - - - - Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requirements`% of ILHR-83, Wis. Adm. Code (except for inspection opening over outlet baffle). Name /w 13 ~k 7- I~/L,p ~ 1 ~ S ' / ~ 3 3 ~ignature /~1)/ DAP/MPRS 0 5/88 K`+ ;l Y ~b 4 1 ~ yy }.t guy l~~ o G # 3~YZ /4/ S T C - 105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County p OWNER BUYER 56C/" Tr7'y ADDRESS 31 NArr ST /"d °~dX Zia FIRE NUMBER CITY/STATE ZIP PROPERTY LOCATION: NV 1/4 1'5'40 1/4, SECTION T Z/ N-R /f W TOWN OF - H ash , St. Croix county, GS 4 31/ 3 33 Z SUBDIVISION_ y?~< 44-49 , 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 date. SIGNED: .4., DATE : 2 3 St. Croix co. Zoning Office 911 4th St. Hudson, WI 54016 ti IA w 'k, lxn49 0 C ~ Q 3 ~R Orr t,, A V► "T '~a1 d In to T \ 3 Fr 00 , O R 1 Z \ r o ` (T> ~ I-IT kA N 4 (-A R o y I r m LA G - = #6A (i L,, kA N a tro C o ?t 7f z 7D M V 0 o -i 3 ~ N f Ci ~ 3 O n O W,v+ '*-I Q cot I ~ ~ M w a In ~ ~1 C, - V- ~ W ~ w A I O t` A T II y C b ~ 1 ~ ~ ~ Ns, "C n b '0 `'a MoM 3~d y o o ° D a• m ?K -CO .y c C y W ~ A \ O 1Y \ \ v~ ~ ~ O O v ~ C 00 0. h r Oai 3 = y~ Ww n1w r_` -40 ov to IS N kA 0 ~m :7 93 , «c C C M Iw y o 1\ ILA Z O w o e I' o w p r•' ~ L N C V1 ~o o ~ 0 r C ~ Y Z N ~ ~ A 5 7» to n ~w INI C , 1 ~ C ro N I ~M w a CIO It ro a A^ o n a r. a 3 a Z W t N 1 3 A r' "o tA f~, \ \ 0 Or I CL. a 4, ep O~ tk (1 -1 UP %Oc v, A -'.0 C) 1 _ W ln1 m d p II ! at, d M' to 2 :r cx = ~ -%0 A ~ H" l1Vw ~lw ~ C 41- N v Y O I \ ZZ) 93 Cl~ a c", O ^y n » p n o y 0 s s o~ a to 'J V ~ M M C A w O 12, o m A C e 3 a O A ~ C ~ d ~ ro ~ 'O }o O m 0 7,2 -tA 1~./ ,W ~ ~ O w w w ~ \\o Q , Ic CL r T ` A w O l,/~] VVVV ~ ~ i r O r 0 7r a. n QO C N x V '1 %4 10 O N 'Sk -Z ob N~o I G N 3 Q p C ~w 0-00 G 0- r, .1 3 r r p,r A, 11 A con , `A ~A o ; "~l tom. ~1 Z Ate'/ N ry'~ 3~ Fr 03. Mo f1 h N % D o C n o a ° d S r~ l^ In 1 ro ° ^ O CIS r- !r 0, V1 LA c en ;k %c 0 '0 o T 3~ ; 3 a 3. v+ 0 no O ~ a \ A C Z o ~o o ° M a O W C 70 w ' p h a %A W 111 n► y, N c ~ c H~ fl ~ ~J N N A d w ro d ~ v ~ A 0 a I I j w z 41 0 CL 1 -X4 w *WC C w ~ -G Cl r ~O C A -00 . aU+~~T sx'PT; ~ 1000 s . / G I ~A) ~ ~ S i~EK~ST ,Op 3 1o r--J otAiN fieco 0 ~3p Jv y y, 0 '5Y Srf-E/~ f•~~t'f~ ~ ~ ;Q; /iV/%tJ P6 ,err WOW l I i ~K S /4- S1 g7 v 9~ / 75 ~ k i i ~ ~ I~ r ; To%l L• S¢ • % /P~,vGGrs I ~ f f r r . _ _ C~--- $ 3 10 Torf of I N~u> ~'Do • PEE «ST , (Nv 4 ©pv GiPf rim /W j To K. u /0/,o C~ r P6 r of GiF T - q Q PLUMBING CO- 'Q 1'O?hrglTE SEPTIC SON WIS. 5406 y y81- 65, O'NEIL RD•. H JD ROt3ERT ULBRIGHT 3307 M.P.R.S. /0 2 , yy n r t tjgFR LIC N0. 00663 N . LIC Al •.NIS• 0 r.+•1 ; RP =n 2OESIGNEP P~ y 2 193 /o 160 IlAd C3y oa, S s ~.~ct : / - 3 0 S yS T E-Ai 6 le_u +ri o.Js SOW y~ 3 T/~~'(1C.~ $ ~i~ E- ZISE/~ 4 = Ex i ST~.J G- cl~Al~ S _ BOTTOM /bWes r t S T of Tpeac M i ~Oc~ ~"~2 e C17t ME t 1 10.449 r Te CA.) O j CA ,~,Afw v f y. UAT 10 #3 • Fresh Air Inlets And Observation Pipe Approved Vent Cap Minimum 12".Above Final Grade S f/e l0 Z . So 4" Cast iron 30 "Above Pipe -to Final Grade Vent Pfpe Marsh Hay Or Synthetic Covering min. 2" Aggregate Over Pipe • Distribution Tee Pipe 0 0 0 0 0 Aggregate Beneath Pipe o Perforated Pipe Below Coupling Terminating At o ii Bottom Of System 99.0 s %S TE,/-, Fresh Air Inlets And Observation Pipe Q+- Approved Vent Cap .Minimum 12" Above Final Grade 36 "Above Pipe ~ 4" Cast Iron Vent Pipe' • 'to Final Grade • Marsh May Or Synthetic Covering Min. 2" Aggregate Over Pipe Distribution -Tee Pipe 0 0 0 0 0 , SyST~i~ ~Be eagthePip, e o Perforated Pipe Below q7, Z 0 Coupling Terminating At Bottom Of System L DGrl~s T` TiP~,v c • Fresh Air Inlets And Observation Pipe • Approved Vent Cap Minimum 12" Above ~i V/S e-en flfw&=` 7~ Final Grade 72 36 46 ' 7Z " Above Pipe 4" Cast iron ~ 'to Final Grade Vent Plpo' _Mo•sh Hay Or Synthetic Covering min. 2" Aggregate Over Pipe Distribution F Tee . pipe 70-0 0 0 . 'a Aggregate ° Perforated Pipe Below Beneath Pipe o Coupling Terminating At Bottom Of System -s Y5 7Z Fresh Air Inlets And Observation Pipe f Approved Vent Cap • -Minimum 12" Above Final Grade Above Pipe 4" Cast Iron 'ro Final Grade Vent Pipe• • Marsh Hay Or Synthetic Covering • Min. 2" Aggregate Over Pipe Distribution Tee Pipe 0 0 0 0 0 , " Aggregate Beneath Pipe ° Perforated Pipe Below 0 Coupling Terminating At j Bottom Of S v s t e m I PUMP CHAMBER CROSS SECTIOM AND SPECIFICATIOUS 9,4 OF ,C VENT CAP 4"C.I. VENT PIPE APPROVED LOCKING WEATHER PROOF MANHOLE COVER 25' FROM 0008, JUNCTION BOX I' ~ w 4i~(Nlo(~~f)/gE~ WINDOW OR FRESH 12~MILl. I / AiR INTAKE vue ~~~~~1?SON GRADE I I y"MIN. io- COWDU IT 7 L"d lEy~rl/oN 2 PROVIDE I _ INLET AIRTIGHT SEAL I I i I I I ii APPROVED JOINT A INS A►~~ I III W~C=VPIPEOINTS rj IJ/C.I. PIPE I ~ o I EXTENDING 3' EXTENDING 3' O ( I ALARM ONTO SOLID SOIL ONTO SOLID SOIL r, `f ( 7 I 39 . ( I oN i C ELEV. FT. PUMP-~ OFF j 4AP k 1 ` BLOCK / ~~DDI a I ~(EVn flog 1 ' 0 ' RISER EXIT PERMITTED DULY IF TANK MANUFACTURER HAS SUCH APPROVAL 1 SEPTIC E SPEC,IFICATIOUS DOSE lpvC~P~'TC TANKS MANUFACTURER: IJUMBER OF DOSES: PER DAy TANK SIZE: ~dy GP GALLONS DOSE VOLUME/5O `CVfG /I~~Jjp~1 INCLUDING BACKFLOW~ GALLONS ALARM MANUFACTURER: /S MODEL NUMBER: 21 y CAPACITIES: A= INCHES OR CALLOUS B = Z INCHES OR GALLONS SWITCH TYPE: PUMP MANUFACTURER: C= INCHES OR GALLONS i MODEL NUMBER:9. C` X 2 ff //J~~/ v D= ~Z INCHES OR Z~G GALLONS SWITCH TYPE: 11"rMOTE: PUMP AMD ALARM ARE TO BE MINIMUM DISCHARGE RA-fE~GPM INSTALLED ON SEPARATE k VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE.. /GAO FEET. ~Ao F S~~CS + MINIMUM NETWORK SUPPLY PRES URE , . . . . . . . . . . ~ FEET EAG~ 0'r '-9{ f ILL ~ q / FEET OF FORCE MAIN X /J FTI00 FT.FRICT►OAl FACTOR../ '3/ FEET 2 D. S i40r►s GA/s. TOTAL Dy1JAMiC HEAD FEET f ' INTERNAL DIMEWSIONS OF TANK: LEMGTH --;WIDTH ~ -;LIQUID DEPTH I. I I y r, Vo~~ Uo~v-ter ~ To 1z ~'v ~ % -sue . yo ~ /BUG ~y . tl I' In HEAD CAPACITY CURVE 3 7/86 1/4 MODEL "9€3" 30 4 5/8 8 25 a 9 I 3 5/8 ;4' - = 6 2 m ai V + ' O ill 15 4 3/16 4 - to r 10 1 1/2-11 1/2 NPT 2 0 U.S. GALLONS 10 20 30 40 50 60 70 80 LITERS so 160 240 0 FLOW PER MINUTE a f , TOTAL DYNAMIC HEAD/FLOW PER MIfIUTE EFFLUENT AND DEWATERING 1 } CAPACITY 12 HEAD UNITS/MIN FEET METERS GALS LTRS 5 1.52 72 273 i 10 3.05 61 231 15 4.57 45 170 +y 20 6.10 25 05 3 5/ 16 '4 - 4 1 Lock Valve 23' i `y CONSULT FACTORY FOR SPECIAL APPLICATIONS 't>` • Electrical alternators, for duplex systems, are available and • Mercury float switches are available for controlling single and supplied with an alarm. three phase systems. Mechanical alternators, for duplex systems, are available with or • Double piggyback mercury float switches are available for 9' without alarm switches. variable level long cycle controls. SELECTION GUIDE ' 1. Integral float operated 2 pole mechanical switch, no external control required. ' Standard all models - Weight 39 lbs. - /s H.P. "i 2. Single piggyback mercury float switch or double piggyback mercury, float 98 Series Control Selection switch. Refer to FM0477. Model Volts-Ph Mode Amps Simplex Du lex 3. Mechanical alternator 10-0072 or 10-0075. 1 M98 115 1 Auto 9.0 , 1 or 1 &7 - 4. See FM0712, for correct model of Electrical Alternator, "E-Pak". N98 115 1 Non 9.0 2 or 2 & 6 3 or 4 & 5 5. Mercury sensor float switch 10-0225 used as a control activator, specify D98 230 1 Auto 4.5 1 or 1 & 7 _ duplex (3) or (4) float system. I 6. Four (4) hole "J-Pak", junction box, for watertight connection or wired-in sim- ' c'v E98 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. r' ~1) CAUTION 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- 1 Piggyback Mercury Switches, FMO477; Electrical Alternator, FM0486; Mechanical Alternator, ur; tied licensed electrician. All electrical and safety, codas should be followed includ- h,1 FM0495; Alarm Package, FM0513; Sump/Sewage Basins, FM0487; and Simplex Control Box, ing the most recent National Electric Cods and the Oocu clonal Safety J FM0732. Health Act (OSHA). (NEC) and yak, RESERVE POWERED DESIGN For 'unusual conditions a reserve safety factor is digineered into the design of every Zoeller pump. MAIL TO. P.U. BOX 16347 Manufacturers o/.. . LouisviY6., KY 40256-0341 0 OE~~ F~ 01 SNIP 70: 3280 0%.^ Millers Lane A, Louisvidt', KY 46216 QUAL/1Y)1/PS YNer A9f (502) 778-2731 • FAX (502) 774-3624 DE~P~~~T.e OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS I N.;~t1STn( DIVISION O. BOX 3707 L, A.'34 J- R H AND PERCOLATION TESTS (115) ADIS P. 7969 HUMAN RELATIONS (ILHR 83.09(1) & Chapter 145) 02-0-1 1 O-000l LOCATION: SECTION: tTDWNS:HI UNICIPALITY: LOT NO.:BLK. NO.: SUBDIVISION AME: Nw 1/4 sw 1/4 /Tz9 N/R19 E for l- ~sorj z - C M UOL. Z P5 SYY COUNTY: MAILING ADDRESS: -7 l0 1L, , 1~!)u T. ST- CiZ, v IK 3`-i N i hRv GC~R g Got=E 2ivQ _ LL5 kJ I 551~~-Z USE 1 '03 5- 7 L DATES OBSERVATIONS MADE NO.BEDRMS.: COMMERCIAL DESRIPTION: PERCOLATION FILE DESCRIPTIONS: TS: IgResidence 3 N -n K New ❑Replace 1- 8-130 &3 f~ RATING: S= Site suitable for system U= Site unsuitable for system 19,7, Tbr1 IU13-SO+v oN 1-8-40 CONVENTIONAL: MOUND: IN-GROUND-PRESSURE: SYSTEM-IN-FILL OLDING TANK: RECOMMENDED SYSTEM: (optional) os®u []Sou osou asOu Msau If Percolation Tests are NOT required DESIGN RATE: If any portion of the tested area is in the under s. ILHR 83.09(5)(b), indicate: 1V - A Floodplain, indicate Floodplain elevation: PROFILE DESCRIPTIONS BORING TOTAL DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH NUMBER DEPTH IN. ELEVATION OBSERVED EST. HES TO BEDROCK IF OBSERVED (SEE ABBRV. ON BACK.) B- $ Ki - h\. 1.1LWL -~g SSE: PSGL Z- nF Z B- 3 $ -7 B- B- PERCOLATION TESTS EST. DEPTH , WATER IN HOLE TEST TIME DROP I WATER LEVEL-INCHES RATE MINUTES NUMBER INCHES AFTER SWELLING INTERVAL-MIN. P RIOD 1 PERIOD 2 PERIOD PER INCH P- P- P- 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. > VC-G N ] I Ckl Aj S I SYSTEM ELEVATION 7_- F { 3 E //V AU 'ry , 160 i , E , E o. 3 ~R~v to c~Sl Y [L'S►ZTp l~j j1 _ m.. _ SZE Rt~PoRT 8`r w,( `l~19 ~ , r__ _ w. l E _ SC tKLe 1(z 1130f I, 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 that the data recorded and the location of the tests are correct to the best of my knowledge and belief. NAME print WLUERER 901L TESTING TESTS WERE COMPLETED ON: ) - 8- 40 AND ADDRESS: DESIGN SERVICE CERTIFICATION NUMBER: PHONE NUMBER (optional): CST 000 S7G 7 is- Las-P.O. BOX 74 421 N. MAIN ST, CST SIGNA URE: RIVER FALLS; WI 54022 715-425-0165 / DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester. DILHRSBD-6395 (R, 10/83) - OVER - ~l r INSTRUCTIONS FOR COMPLETING FORM 115 - SBD - 6395 To be a complete and accurate soil test, your report must include: 1. Complete legal description; 2. The use section must clearly indicate whether this is a residence or commercial project; 3. MAXIMUM number of bedrooms or commercial use planned; 4. Is this a new or replacement system; 5. Complete the suitability rating boxes. A SITE IS SUITABLE FOR A HOLDING TANK ONLY IF ALL OTHER SYSTEMS ARE RULED OUT BASED ON SOIL CONDITIONS; 6. PLEASE use the abbreviations shown here for writing profile descriptions and completing the plot plan; 7. MAKE A LEGIBLE diagram accurately locating your test locations. Drawing scale is prefered. A separate sheet may be used if desired; 8. Make sure your benchmark and vertical elevation reference point are clearly shown, and are permanent; 9. Complete all apropriate boxes as to dates, names, addresses, flood plain data, percolation test exemption, if appropriate; 10. If the information (such as flood plain, elevation) does not apply, place N.A. in the appropriate box; 11. Sign the form and place your current address and yur certification number; 12. Make legible copies and distribute as required. ALL SOIL TESTS MUST BE FILED WITH THE LOCAL AUTHORITY WITHIN 30 DAYS OF COMPLETION. ABBREVIATIONS FOR CERTIFIED SOIL TESTERS Soll Separates and Textures Other Symbols st - Stone (over 10") BR - Bedrock cob - Cobble (3 - 10") SS - Standstone gr - Gravel (under 3") LS - Limestone 's - Sand HGW - High Groundwater cs - Coarse Sand Perc - Precolation Rate med s - Medium Sand W - Well fs - Fine Sand Bldg - Building Is- Loamy Sand > - Greater Than 'sl - Loamy Sand 'c - Less Than 'I - Loam Bn - Brown 'sil - Silt Loam BI - Black si - Slit Gy - Gray cl - Clay Loam Y - Yellow scl - Sandy Clay Loam R - Red sicl - Silty Clay Loam mot - Mottles sc - Sandy Clay w/ - with sic - Silty Clay fff - few, fine, faint 'c - Clay cc - common, coarse pt - Peat mm - Many, Medium m - Muck d - distinct p - prominent HWL - High water level, surface water ' Six general soil textures . BM - Bench Mark for liquid waste disposal VRP - Vertical Reference Point TO THE OWNER: This soil test report is the first step in securing a sanitary permit. The county or the Department may request verification of this soil test in the field prior to permit issuance. A complete set of plans for the private sewage system and a permit application must be submitted to the appropriate local authority in order to obtain a permit. The sanitary permit must be obtained and posted prior to the start of any construction. c i SOIL DESCRIPTION FORM Attach Soil Prot lo Local ion Na On a Su arato Shoat) C~ T{ G O LINEAR LOADING RAT : PURPOSE:E,)nLViNTP_ ai?_ SA IL S01ZP OrJ SYS SLOPE- 3d /0 iJ l 0 LN t cl\ DECRIPT ION By .T?~ V Z L ` W EG~~~I? ASPECT: 1 B-90 CURRENT LAND USE: ~A I ~ Ls i b el DATE: _COUNTY/STATE ST e ~ c4)V )kj TLf W) VEGETATIVE COVER G-tZ LOT DESCRIPTION:" - S TlZ S g Ru S H lot- Z of C.SM V ox- Z C'9 S Y DRAINAGE CLASS w S I N LOCATION: ~1 ~Sl1N GALLONS-PER S Q. FT. PER DAY: - SOIL SERIES: C•~'C.1 A1 S 111 j PARENT MATERIAL s /DEPTII; ly! Q HORIZON DEPIII MATRIX COLORS MOTTLES TEXTURE STRUCTURE OONSISIENCE CLAYSKINS/ PORES ROOTS PII .BOUNDARY REMARKS in. moist G Sz. Sh . COATINGS 0-to 511 s i 1 w/4s cod 1o-36 ~6- ~ - s l 1-~ i r'rFl -Mv-~• 0-9 s w/ L S ca 1a. 9--3-70 S { ~~V - S SS B )a. 8- Borz[ 6 3 0~9 Si y) S 1 t~l m i - my T' ~2_~~ - s w hT a u,w o ss lZ ?U CU U~..V) -12 p 1 ~ ~ t~iu~ O~ v"1v S u v Sol. G0~{1 ~~~ti Svc ! S lJ0 S~ Le U SSA 1S e 'Su LS, Rk. A° OF .S(U)L. G I N S L k s V .•ill UTt $ G o ~Z 3 Su OTHER SITE FEATURES/NOTES: 8.9c) 000S7 (a nn6~ Z °F 2 LIMITING FACTORS/DEPTH: Signature Date CST N 1 N • HORIZON DEPTH MATRIX COLORS MOTTLES TEXTURE STRUCTURE CONSISTENCE CLAYSKINS/ PORES ROOTS PII •BOUNOARY REMARKS in. 410 1st Or, Sx. Sh -COATINGS v y" OTHER SITE FEATURES/NOTES: of Signature Date CST N _ LIMITING FACTORS/DEPTHW. URV~ypR S COUNTY 343332 I i CERTIFIED SURVEY MAP I W 1/4 CORNER OF SECTION t S 6, 1 34P T29N, R 19W r I i a ~3 - I NW 1/4- SW 1/4 °w IN ro I UNPI.ATTE_Q L ANDS - crG(m 3--0+,E OUT SCALE IN FEET W 83. or INN 2 N76 3R/ Vq \ 0. 50'100` " 200' 300` 33IOO'r 9 5~ '0 '~`S62o \ S 3462 6fE°/2 ~/9 a 6 10a ` 4_UNPL.ATTED _ LANDS o~ 1 'W POINT OF Z I M, E INN G ; 10! m . SHEDS ,3g • 4? ° b 01 0 z I.-, *t@k 8 43 tn ~S 3O° 0,3.17"g I ; 0 8 164°24' 42° 98°p3.43 6 UI ; , EASTERLY 2.52 ACRES ~t I 6 6 RIGHT-OF-WAY LINE O zI I w 1`~0 a ~1 `Q sF90~ APPROW 1 4624 42 C-) 2 S EP 211977 ~cJ o 'l~'9 L /N ST. CROIX COUNTY COMER1>7£MENSIVE.PARKS PLANNING ro AM ZONING COMMITTEE \ •rk LEGEND ` \ w a, - - COUNTY SECTION CORNER MONUTYM. • EXISTING 1" IRON PIPE WEIGHING 1.68#/LINEAL FOOT. 3 4 0_ 1"x24" IRON PIPE WEIGHING 1.68#/LINEAL E FOOT, SET. . SEP .211977 BUILDING A. JAAft Of roHHEt( ' 8; of 080da--'A- FENCES TRUE BEARINGS OI g POWER LINE 343332 Drafted by Gerald Anderson. OWNERS AND SUBDIVIDERS t NA 0) R .R."#1 HUDSON, WISCONSIN 54016 APPRQ~ OES N M l PARP F . P QT FOR BUiIDiMG IT OR SEPTIC 6YTP1N. REFER TO H62,20; w Volume 2 ft. ge 459 t r ',A CL a ~1 Z H O p ~1V w w o, M N O N INI f 76 N ILA o a o O \ r 1 N Z o a to 16A 0 r, ~ m k `H"s F ? A 7D 41 V (D -3 d3 N e% et Im -41 11.) vx O m n O p ro H ~ '),72 2 V ro } d ul ~ A a ro G "b~ ?cam * ~ h m z I ro~ Q k l~ Nd 1' 1~ 0.-1 - cm O-ft s ' G CL - ;n L' O o a a _ d V Q) { "Mo W O r1 ~ 1 1 \ W p d ~ Z ~ V ~ h ~ ~ 3 p a ~ e , g Imo. g t 1A n A O w N 0 61 l7 R 3 A o N v a is A; n 93 ~n 4m 3 c ~C rq. LA ' a W o ° V ~ " 1 ~ ~ ~ 0 r fp o LA o t O 'h o r 41 :9 a VIS G\ C-N N~ N N ` X N C n ~w w r ~a N A ti~ v O m N a C °O c O 00 1 N Z M 0 a 1 Co a w a ` w U) o. V I ~Jl A C. 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